【摘要】 目的:了解围手术期剖宫产妇女抑郁、焦虑、恐惧状况,探讨心理干预对其术后生理功能产生的影响,为剖宫产妇女健康教育提供帮助。方法:应用焦虑状态/特质问卷、Zung氏抑郁自评量表及视觉模拟量尺对118例剖宫产妇女手术前后进行心理评估;对其中58例在围手术期进行有计划的心理干预即采取心理支持疗法、个别心理治疗、病人互助治疗、家庭和社会支持治疗以及听音乐等肌肉放松疗法;对照组不采用心理干预措施。观察两组治疗前后抑郁、焦虑、恐惧等情绪变化的异同;并进行术后下床活动时间、肛门排气时间、拔尿管时间和自行排尿时间及泌乳量和刀口愈合等情况的比较。结果:围手术期剖宫产妇女存在不同程度的抑郁、焦虑、恐惧情绪(48.2±9.4,47.9±10.3,44.3±13.2),心理干预能够明显改善其不良情绪(40.8±10.0,36.9±10.0,30.3±12.8),差异有统计学显著性(t=4.2、5.9、5.9,P<0.01);干预组与对照组比较除拔尿管时间和刀口愈合时间两组差不多,未见统计学意义(P>0.05),术后下床活动时间、肛门排气及自行排尿时间和泌乳量比例均高于对照组(分别为88%比39.7%,2.71.7%比44.8%,3.85%对46.6%,88.3%对56.9%),差异有显著统计学意义(χ2=20.0、9.1、19.5、14.8,P<0.01)。结论:妇幼保健医生应重视围手术期剖宫产妇女的心理,并进行必要的心理干预,改善其不良情绪,以有助于患者术前具备耐受手术的良好身心条件及术后尽早地恢复其生理功能。更多还原

【Abstract】 Objective:To study the effect of psychological intervention on mood such as depression, anxiety and fear, and its effect on the rear physiological function. Methods:STAI (state and trait anxiety inventory) and SDS (self-rate depression scale) and VAS-fear (visual analogue scale for fear) were applied to 118 women before and after Caesarean birth. Fifty-eight of them were assigned to psychological intervention group, who received support therapy, individual psychotherapy and patient co help treatment, family and society support treatment as well as relax therapies by hearing music. The other 60 were in control group. The comparison had also items of the time of getting out of bed after operation, the time of anus exhaust, the time of pulls out the catheterization pipe and the time of urinate independently. We also observed the volume of secrete milk and the condition of scalpel mouth heal up etc. Results: In preoperative period, Caesarean birth women had bad mood, such as depression, anxiety and fear (48.2±9.4,47.9±10.3,44.3±13.2), after psychological intervention, these bad mood decreased to 40.8±10.0, 36.9±10.0, 30.3±12.8 respectively ( with t=4.2, t=5.9 ,t=5.9, P<0.01). There was no significant difference between the two groups in the time of pulls out the catheterization pipe and the scalpel mouth heal up (P>0.05). The intervention group had higher proportion in earlier getting out of bed (88% vs. 39.7%,χ2=20.0,P<0.01), anus exhaust (71.7% vs. 44.8%,χ2=9.1,P<0.01) and urinate independently (85% vs. 46.6%,χ2=19.5,P<0.01) and satisfactory secrete milk during the first two days (88.3% vs. 56.9%, χ2=14.8,P<0.01). Conclusion: The psychological intervention can improve the mood of women receiving Caesarean birth and also improve their recovery and enhance their physiological function as new mother.更多还原