产妇产褥期健康管理期望与感知的现状分析

doi:10.3761/j.issn.0254-1769.2020.12.007

摘要/Abstract

摘要：

目的调查产妇产褥期健康管理（puerperal health management,PHM）期望与感知现状并进行分析,为优化PHM服务提供参考。方法 2019年4月—6月,采用自行编制的“PHM期望与感知现状调查问卷”对北京市某医院产科门诊产后复查的产妇进行调查。该调查问卷包括产妇身心恢复、婴儿照顾、社会支持及产妇期待的健康管理方式4个维度,共21个条目;量表的Cronbach’s α系数为0.937,KMO值为0.730,共提取6个公因子,累计解释76.9%的变异。结果共调查699名产褥期产妇,19项PHM服务中,除妊娠期糖尿病产妇的血糖、妊娠期高血压产妇的血压监测指导及糖尿病、乙肝等产妇的母乳喂养指导2项外,其余各项服务的产妇期望与感知现状间均有差异（P<0.001）。婴儿常见疾病预防、观察与护理知识,婴儿抚触指导,母乳喂养指导,产后体重管理,日常婴儿养育技能评估与指导,产后用药指导6项PHM服务的产妇期望与感知现状差距较大。结论产妇PHM期望与感知现状间存在差距,建议相关部门加大对PHM服务的经费投入,强化质量监管,社区医护人员也应不断提升自身业务能力,以满足产妇不断提高的需求。

关键词: 产褥期, 健康管理, 期望, 感知现状, 产科护理

Abstract:

Objective To explore and analyze expectations and perceptions of puerperal health management（PHM）,so as to provide references for optimizing PHM services. Methods A questionnaire survey was conducted in an obstetrics clinic of a hospital in Beijing from April to June 2019,using a self-designed questionnaire on the puerperae’s expectations and perceived status of PHM services. The questionnaire included 4 dimensions,namely maternal physical and mental recovery,infant care,social support and approaches of PHM. The Cronbach’s α value of the questionnaire is 0.937,and the KMO is 0.730. 6 common factors were extracted,and the cumulative interpretation of variation was 76.9%. Results A total of 699 valid questionnaires were collected. Among the 19 PHM services,except blood glucose and blood pressure monitoring for mothers and breastfeeding guidance for mothers with diseases,the differences between expectations and perceived status of other services had statistical significance（all P<0.001）. There was a significant gap between expectations and perceived status of PHM in 6 services,namely knowledge of common diseases in infants,infant touch guidance,breastfeeding guidance,postpartum weight management,guidance of infant rearing skills,postpartum medication guidance. Conclusion There was a significant gap between PHM expectations and perceived status. It is suggested that relevant departments should increase investment in PHM and strengthen supervision of its quality. Community health workers should also continuously improve their ability,understand the high expectations of PHM,and help to improve the quality of PHM services.

Key words: Puerperium, Health Management, Expectation, Perceived Status, Obstetrical Nursing

田策,姜岳,杨芳,徐英,Lee Soowon,赵红,祝琴. 产妇产褥期健康管理期望与感知的现状分析[J]. 中华护理杂志, 2020, 55(12): 1796-1801.

TIAN Ce,JIANG Yue,YANG Fang,XU Ying,LEE Soowon,ZHAO Hong,ZHU Qin. Analysis of the puerperae's expectations and perceived status of puerperal health management services[J]. Chinese Journal of Nursing, 2020, 55(12): 1796-1801.

图/表 3

表1 调查对象一般资料(n=699)

Table 1 Characteristics of the Participants( n=699)

表2 产妇产褥期健康管理服务期望、感知现状分析[分,M(P25,P75)]

Table 2 Analysis of the puerperae’s expectations and perceived status of puerperal health management services[ sores,M(P25,P75)]

图 1 产妇产褥期健康管理期望与现状对比图

Figure 1 Comparison of the puerperae’s expectations and perceived status of puerperal health management services

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