【摘要】：目的 通過依托高校附屬醫(yī)院實(shí)施良好的健康教育路徑模式，在其管理的社區(qū)對(duì)育齡初產(chǎn)婦實(shí)施路徑式健康教育，以降低孕產(chǎn)婦的剖宮產(chǎn)率，提高母乳喂養(yǎng)率，提升社區(qū)護(hù)理服務(wù)質(zhì)量，增加孕產(chǎn)婦對(duì)社區(qū)健康教育工作的滿意度。 方法 本研究分為兩個(gè)步驟，第一步，查閱近幾年相關(guān)文獻(xiàn)、相關(guān)書籍、實(shí)地走訪、咨詢婦科、產(chǎn)科專家等方法編制并生成階段性孕產(chǎn)婦健康教育路徑文本，確定具體實(shí)施流程。第二步，將在錦州市古塔區(qū)敬業(yè)社區(qū)衛(wèi)生服務(wù)中心建立健康檔案且符合納入標(biāo)準(zhǔn)的140例孕婦定為研究對(duì)象，對(duì)照組為在2011年9月前在遼寧省錦州市古塔區(qū)敬業(yè)社區(qū)衛(wèi)生服務(wù)中心建立健康檔案且符合納入標(biāo)準(zhǔn)的70例孕婦，干預(yù)組為在2011年10月至2012年10月期間建立健康檔案且符合納入標(biāo)準(zhǔn)的70例孕婦。對(duì)照組應(yīng)用傳統(tǒng)的健康教育方式，根據(jù)健康教育小組成員（未經(jīng)過高校附屬醫(yī)院培訓(xùn)的不同資歷、文化程度，工作經(jīng)歷的護(hù)士）的個(gè)人經(jīng)驗(yàn)隨機(jī)進(jìn)行，干預(yù)組依據(jù)健康教育路徑文本的內(nèi)容和時(shí)間嚴(yán)格執(zhí)行。兩組研究對(duì)象的評(píng)價(jià)指標(biāo)包括：保健知識(shí)得分、剖宮產(chǎn)率、母乳喂養(yǎng)率、孕產(chǎn)婦對(duì)健康教育滿意度。評(píng)價(jià)實(shí)施高校附屬醫(yī)院社區(qū)婦女圍產(chǎn)期保健服務(wù)模式對(duì)孕產(chǎn)婦的效果及對(duì)社區(qū)護(hù)理服務(wù)質(zhì)量的影響。采用SPSS17.0統(tǒng)計(jì)軟件對(duì)所獲得的的資料進(jìn)行統(tǒng)計(jì)分析，計(jì)數(shù)資料采用2檢驗(yàn)，計(jì)量資料采用t檢驗(yàn)。 結(jié)果 1、比較兩組研究對(duì)象的剖宮產(chǎn)率、母乳喂養(yǎng)率：干預(yù)前，兩組研究對(duì)象的剖宮產(chǎn)意愿、母乳喂養(yǎng)意愿無差異(P＞0.05)；干預(yù)后，干預(yù)組產(chǎn)婦的剖宮產(chǎn)率明顯低于對(duì)照組，母乳喂養(yǎng)率明顯高于對(duì)照組(P＜0.05)。 2、比較兩組研究對(duì)象健康教育知識(shí)評(píng)分：孕早、中、晚期及產(chǎn)后各個(gè)階段干預(yù)前兩組組間比較，兩組孕婦保健知識(shí)掌握情況無差異(P＞0.05)；各個(gè)階段干預(yù)前后保健知識(shí)評(píng)分差值d比較有差異(P＜0.05)。干預(yù)組干預(yù)前后有差異（P＜0.05），對(duì)照組無差異（P＜0.05）。 3、比較兩組研究對(duì)象對(duì)社區(qū)健康教育滿意度評(píng)分：干預(yù)前兩組研究對(duì)象對(duì)社區(qū)健康教育滿意度評(píng)分情況無差異(P＞0.05)；干預(yù)前后滿意度評(píng)分差值d比較，有差異(P＜0.05)。干預(yù)組干預(yù)前后有差異（P＜0.05），對(duì)照組無差異（P＜0.05）。 結(jié)論 1、高校附屬醫(yī)院社區(qū)婦女圍產(chǎn)期保健服務(wù)模式可以有效改善孕產(chǎn)婦的剖宮產(chǎn)率和母乳喂喂養(yǎng)率。 2、高校附屬醫(yī)院社區(qū)婦女圍產(chǎn)期保健服務(wù)模式提升了社區(qū)護(hù)理服務(wù)質(zhì)量。 3、高校附屬醫(yī)院社區(qū)婦女圍產(chǎn)期保健服務(wù)模式提高了孕產(chǎn)婦對(duì)社區(qū)護(hù)理健康教育工作的滿意度。
[Abstract]:Objective to reduce the rate of cesarean section and increase the rate of breast-feeding by implementing a good health education path model in the affiliated hospitals of colleges and universities, and implementing the path-type health education in the community managed by the health education route for primiparous women of childbearing age, so as to reduce the cesarean section rate of pregnant women. Improve the quality of community nursing service, increase maternal satisfaction with community health education. Methods the study was divided into two steps. The first step was to review the relevant literature, relevant books, field visits, consulting gynecology, obstetrics experts and other methods to compile and generate the text of the stage maternal health education path. Determine the specific implementation process. In the second step, 140 pregnant women who met the inclusion criteria and set up health records at the dedicated Community Health Service Center in Guta District, Jinzhou City, were selected as the study objects. The control group consisted of 70 pregnant women who had established health records in Guta District, Jinzhou City, Liaoning Province before September 2011 and met the inclusion criteria. The intervention group consisted of 70 pregnant women who had established health files and met the inclusion criteria between October 2011 and October 2012. In the control group, the traditional health education method was used, and the individual experience of the members of the health education group (nurses with different qualifications, education level and work experience without training in the affiliated hospital) was randomly selected. The intervention group was strictly executed according to the content and time of the health education path text. The evaluation indexes of the two groups included: health knowledge score, cesarean section rate, breast-feeding rate and maternal satisfaction with health education. To evaluate the effect of implementing community women's perinatal health service mode on pregnant women and the quality of community nursing service in affiliated hospitals of colleges and universities. The data obtained are analyzed by SPSS17.0 software. The counting data are analyzed by 2 tests and the measurement data by t test. Results 1. The rates of cesarean section and breast-feeding were compared between the two groups: before the intervention, there was no difference in the willingness of cesarean section between the two groups (P > 0.05), and after the intervention, there was no significant difference between the two groups in the willingness of cesarean section and breast-feeding (P > 0.05). The cesarean section rate of the intervention group was significantly lower than that of the control group, and the breast-feeding rate was significantly higher than that of the control group (P < 0.05). There was no difference in the knowledge of health care between the two groups (P > 0.05), and there was significant difference in the scores of health care knowledge between the two groups before and after the intervention (P < 0.05). There was significant difference before and after intervention in the intervention group (P < 0.05), but there was no difference in the control group (P < 0.05). 3. The scores of satisfaction with community health education were compared between the two groups. There was no difference (P > 0.05). The difference of satisfaction score before and after intervention was significant (P < 0.05). There were differences before and after intervention in the intervention group (P < 0.05), but no difference in the control group (P < 0.05). Conclusion 1. The mode of community women's perinatal health service in affiliated hospitals of colleges and universities can effectively improve the cesarean section rate and breast-feeding rate of pregnant and parturient women. 2. Community women's perinatal health clothing in the affiliated hospitals of colleges and universities. The mode of community nursing service improved the quality of community nursing service. 3. The mode of community women's perinatal health service in affiliated hospitals of colleges and universities improved the satisfaction of pregnant and lying-in women to the work of community nursing health education.
【學(xué)位授予單位】：遼寧醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R473.1

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