终止畸形胎儿妊娠孕产妇哀伤辅导方案的构建及应用

doi:10.3761/j.issn.0254-1769.2022.24.003

摘要/Abstract

摘要：

目的构建终止畸形胎儿妊娠孕产妇哀伤辅导方案（以下简称“哀伤辅导方案”）并进行初步应用，为临床上开展终止畸形胎儿妊娠孕产妇哀伤辅导工作提供参考。方法通过文献回顾、半结构式访谈初步构建哀伤辅导方案初稿。于2021年3月—4月，运用德尔菲法对19名专家进行2轮函询，形成哀伤辅导方案。采用便利抽样法，选取2021年6月—11月在杭州市某三级甲等妇产科医院住院的终止畸形胎儿妊娠孕产妇作为研究对象。试验组在常规护理的基础上应用哀伤辅导方案，对照组进行常规护理，使用围产期悲伤量表评价方案的初步应用效果。结果 2轮专家函询的有效问卷回收率为90.48%、100%，专家权威系数分别为0.845、0.861，肯德尔和谐系数分别为0.323、0.262。最终构建的哀伤辅导方案包含6个一级条目和34个二级条目。干预后，试验组围产期悲伤量表得分较干预前提高[1.50（-7.75，16.50）]分，低于对照组的[16.00（11.00，29.50）]分，两组比较，差异具有统计学意义（Z=-2.123，P=0.034）。结论该研究构建的哀伤辅导方案具有科学性、实用性，可以降低终止畸形胎儿妊娠孕产妇产后1个月的哀伤水平，方案进一步验证后可推广应用。

关键词: 胎儿畸形, 哀伤辅导, 终止妊娠, 德尔菲法, 产科护理

Abstract:

Objective This study aims to construct a grief counseling programme for women undergoing termination of pregnancy due to fetal anomaly（TOPFA） and apply the programme to clinical practice，so as to provide references for future work. Methods Through qualitative research and literature research，a grief counseling programme was drafted and constructed. From March to April 2021，19 experts were consulted using Delphi method，and a grief counseling programme for pregnant women with fetal anomaly was formed. From June 2021 to November 2021，the convenience sampling was used to select pregnant women with fetal malformation in an obstetrics and gynecology hospital in Hangzhou as the research subjects. The experimental group was given the grief counseling programme on the basis of routine care，while the control group was given routine care. Perinatal Grief Scale（PGS） was used to evaluate the application effect of the programme. Results The effective recovery rates of the questionnaire were 90.48% and 100%，the expert authority coefficients were 0.845 and 0.861，and Kendall harmony coefficients were 0.323 and 0.262（P<0.001）. Finally，the established grief counseling programme for women with fetal anomaly included 6 first-level items and 34 second-level items. The increase of PGS score in the experimental group was 1.50（-7.75，16.50） which is lower than that in the control group of 16.00（11.00，29.50），Z=-2.123（P<0.05）. Conclusion The grief counseling programme constructed in this study is scientific and practical，and the programme could reduce their grief level a month after the delivery. The programme can be popularized and applied after further verification.

Key words: Fetal Anomaly, Grief Counseling, Termination of Pregnancy, Delphi Method, Obstetrical Nursing

刘璐, 王为红, 孙世文, 钱嘉璐, 余晓燕. 终止畸形胎儿妊娠孕产妇哀伤辅导方案的构建及应用[J]. 中华护理杂志, 2022, 57(24): 2964-2970.

LIU Lu, WANG Weihong, SUN Shiwen, QIAN Jialu, YU Xiaoyan. Construction and application of a grief counseling programme for women undergoing pregnancy termination due to fetal anomaly[J]. Chinese Journal of Nursing, 2022, 57(24): 2964-2970.

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