Analysis of the current status and influencing factors of the caregiver preparedness in mothers of fetus with treatable congenital malformation

doi:10.3761/j.issn.0254-1769.2024.20.009

Abstract

Abstract:

Objective To describe the current status of the caregiver preparedness in mothers of fetus with treatable congenital malformation，and to explore its influencing factor. Methods 210 pregnant women with fetuses diagnosed with treatable congenital malformations in the obstetrics department of a tertiary specialized hospital in Dalian were selected as the study subjects by convenient sampling method from November 2022 to August 2023. The survey was conducted using the General Situation Questionnaire，Caregiver Preparedness Scale，Simplified Coping Style Questionnaire，shortened Chinese version of the Family Resilience Assessment Scale and Social Support Rating Scale. The factors influencing the caregiver preparedness in mothers of fetus with treatable congenital malformation were analyzed using univariate analysis and multiple linear regression. Results Finally，201 mothers of fetuses with treatable congenital malformations were included in the study. The total score of caregiver preparedness was （20.47±6.29），among which the emergency response，management dimension and care stress dimension scored lower. It is concluded that education level，age，subjective support，use of social and economic resources and negative coping are the factors that affect the caregiver preparedness in mothers of fetus with treatable congenital malformation. Conclusion The caregiver preparedness in mothers of fetus with treatable congenital malformation needs to be improved. Medical staff should design a personalized and comprehensive nursing plan to intervene according to the factors，so as to improve the recovery and quality of life of children.

Key words: Treatable Congenital Malformation, Parturient, Caregiver Preparedness, Root Cause Analysis, Obstetrical Nursing, Pediatric Nursing

摘要：

目的了解可治性先天畸形胎儿的母亲照顾准备度现状并分析相关影响因素。方法 2022年11月—2023年8月，采用便利抽样法，选取大连市某三级专科医院产科就诊的210例胎儿被诊断为可治性先天畸形的孕妇（胎儿的母亲）作为调查对象。采用一般情况调查表、照顾者准备度量表、简易应对方式问卷、家庭弹性量表、社会支持评定量表进行调查。采用单因素分析及多元线性回归分析探讨可治性先天畸形胎儿的母亲照顾准备度的影响因素。结果最终201例可治性先天畸形胎儿的母亲纳入本研究，照顾者准备度量表得分为（20.47±6.29）分，其中，紧急情况的应对与管理维度及照顾压力维度得分较低。文化程度、年龄、主观支持、社会经济资源利用度、消极应对为可治性先天畸形胎儿的母亲照顾准备度的影响因素。结论可治性先天畸形胎儿的母亲照顾准备度有待提高，医护人员应针对影响因素，设计个性化、全方位的护理干预方案，进而改善胎儿的愈后及出生后的生活质量。

关键词: 可治性先天畸形胎儿, 孕妇, 照顾准备度, 影响因素分析, 产科护理, 儿科护理学

JU Meihan, LI Tingting, JIANG Tongtong, SHI Tieying. Analysis of the current status and influencing factors of the caregiver preparedness in mothers of fetus with treatable congenital malformation[J]. Chinese Journal of Nursing, 2024, 59(20): 2495-2501.

鞠美涵, 李婷婷, 姜桐桐, 史铁英. 可治性先天畸形胎儿的母亲照顾准备度现状及影响因素分析[J]. 中华护理杂志, 2024, 59(20): 2495-2501.

Figures/Tables 2

References 31

[1]	谢幸, 苟文丽. 妇产科学[M]. 8版. 北京: 人民卫生出版社, 2013.
	Xie X, Gou WL. Obstetrics and gynecology[M]. 8th ed. Beijing: People’s Medical Publishing House, 2013.
[2]	厉传琳. 我国产前诊断和筛査技术服务的规制研究[D]. 上海: 复旦大学, 2014.
	Li CL. Research on the regulation of prenatal diagnosis and screening technical service in China[D]. Shanghai: Fudan University, 2014.
[3]	姜文婧, 陈雨晴, 杨佳汇, 等. 新生儿出生缺陷现状及干预措施实施进展[J]. 中国儿童保健杂志, 2021, 29(12):1317-1320. DOI
	Jiang WJ, Chen YQ, Yang JH, et al. Progress in current situation and intervention measures of neonatal birth defect[J]. Chin J Child Health Care, 2021, 29(12):1317-1320.
[4]	李笑天, 乐小妮, 何晓明, 等. 出生缺陷产前诊断的临床模式研究[J]. 中华小儿外科杂志, 2005, 26(9):449-452.
	Li XT, Le XN, He XM, et al. A new clinical model of prenatal diagnosis for birth defects[J]. Chin J Pediatr Surg, 2005, 26(9):449-452.
[5]	中华医学会小儿外科学分会新生儿外科学组. 常见胎儿结构畸形产前咨询儿外科专家共识[J]. 中华小儿外科杂志, 2020, 41(12):1057-1068.
	Neonatal Surgery Group, Pediatric Surgery Society, Chinese Medical Association. Pediatric surgical expert consensus on prenatal consultation for common fetal structural abnormalities[J]. Chin J Pediatr Surg, 2020, 41(12):1057-1068.
[6]	Archbold PG, Stewart BJ, Greenlick MR, et al. Mutuality and preparedness as predictors of caregiver role strain[J]. Res Nurs Health, 1990, 13(6):375-384. DOI PMID
[7]	李玉荣. 医院住院患儿主要照顾者关怀护理服务需求现状及其影响因素分析[J]. 中华现代护理杂志, 2021, 27(35):4864-4868.
	Li YR. Status quo and influencing factors of the demand for caring and nursing services of the main caregivers of hospitalized children[J]. Chin J Mod Nurs, 2021, 27(35):4864-4868.
[8]	孙娟. 脑卒中病人照顾者准备度、积极感受与疲劳的关系研究[D]. 延吉: 延边大学, 2019.
	Sun J. Study on the relationship between caregiver preparation,positive feeling and fatigue in stroke patients[D]. Yanji: Yanbian University, 2019.
[9]	Henriksson A, Årestedt K. Exploring factors and caregiver outcomes associated with feelings of preparedness for caregiving in family caregivers in palliative care:a correlational,cross-sectional study[J]. Palliat Med, 2013, 27(7):639-646. DOI PMID
[10]	Kramer BJ. Gain in the caregiving experience:where are we what next[J]. Gerontologist, 1997, 37(2):218-232. DOI PMID
[11]	倪平, 陈京立, 刘娜. 护理研究中量性研究的样本量估计[J]. 中华护理杂志, 2010, 45(4):378-380.
	Ni P, Chen JL, Liu N. The sample size estimation in quantitative nursing research[J]. Chin J Nurs, 2010, 45(4):378-380.
[12]	刘延锦, 王敏, 董小方. 中文版照顾者准备度量表的信效度研究[J]. 中国实用护理杂志, 2016, 32(14):1045-1048.
	Liu YJ, Wang M, Dong XF. Reliability and validity of Chinese version of the Caregiver Preparedness Scale in caregivers of stroke survivors[J]. Chin J Pract Nurs, 2016, 32(14):1045-1048.
[13]	肖水源. 《社会支持评定量表》的理论基础与研究应用[J]. 临床精神医学杂志, 1994, 4(2):98-100.
	Xiao SY. The theoretical basis and research application of Social Support Rating Scale[J]. J Clin Psychol Med, 1994, 4(2):98-100.
[14]	解亚宁. 简易应对方式量表信度和效度的初步研究[J]. 中国临床心理学杂志, 1998, 6(2):53-54.
	Xie YN. A preliminary study on reliability and validity of Simplified Coping Style Scale[J]. Chin J Clin Psychol, 1998, 6(2):53-54.
[15]	Sixbey MT. Development of the Family Resilience Assessment Scale to identify family resilience construct[D]. Gainesville: University of Florida, 2005.
[16]	Li YL, Zhao Y, Zhang J, et al. Psychometric properties of the shortened Chinese version of the Family Resilience Assessment Scale[J]. J Child Fam Stud, 2016, 25(9):2710-2717.
[17]	Li YL, Qiao YJ, Luan XR, et al. Family resilience and psychological well-being among Chinese breast cancer survivors and their caregivers[J]. Eur J Cancer Care, 2019, 28(2):e12984.
[18]	官小莉, 李静, 卢俊, 等. 93例人工耳蜗植入患儿主要照顾者准备度现状及影响因素分析[J]. 护理学报, 2020, 27(7):51-54.
	Guan XL, Li J, Lu J, et al. Analysis on the status quo and influencing factors of primary caregivers’ readiness in 93 children with cochlear implant[J]. J Nurs(China), 2020, 27(7):51-54.
[19]	张照明, 林茜. 慢性肾脏病患儿主要照顾者的照顾准备度现状及影响因素分析[J]. 护理与康复, 2019, 18(12):17-20.
	Zhang ZM, Lin Q. Present situation on care preparedness of main caregivers of children with chronic kidney disease and analysis on its influencing factors[J]. J Nurs Rehabil, 2019, 18(12):17-20.
[20]	吴金花, 倪志红, 赵雪萍, 等. 肠造口新生儿家长照护体验的质性研究[J]. 中华护理杂志, 2021, 56(11):1627-1633. DOI URL
	Wu JH, Ni ZH, Zhao XP, et al. Caring experiences of parents of neonates with enterostomy:a qualitative study[J]. Chin J Nurs, 2021, 56(11):1627-1633.
[21]	King RB, Hartke RJ, Houle T, et al. A problem-solving early intervention for stroke caregivers:one year follow-up[J]. Reha-bil Nurs, 2012, 37(5):231-243.
[22]	Paulson D, Bassett R. Prepared to care:adult attachment and filial obligation[J]. Aging Ment Health, 2016, 20(11):1221-1228. PMID
[23]	张习习, 李漓, 廖小妹. 急性白血病化疗患儿主要照顾者参与用药安全体验的质性研究[J]. 中华护理杂志, 2023, 58(16):1977-1983. DOI URL
	Zhang XX, Li L, Liao XM. Primary caregivers’ experience of engagement for medication safety in acute leukemia children with chemotherapy:a qualitative study[J]. Chin J Nurs, 2023, 58(16):1977-1983.
[24]	滕伟钰, 辛明兰, 邹桂元. 精神分裂症照顾者准备度及相关因素[J]. 中国心理卫生杂志, 2018, 32(12):988-990.
	Teng WY, Xin ML, Zou GY. Related factors of caregiver preparedness in patients with schizophrenia[J]. Chin Ment Health J, 2018, 32(12):988-990.
[25]	张欣桐. 初产妇分娩恐惧与内在力量对分娩意愿的影响[D]. 延吉: 延边大学, 2020.
	Zhang XT. The effects of primiparous delivery fear and internal strength on childbirth desire[D]. Yanji: Yanbian University, 2020.
[26]	王瑶菡, 王颖, 曾利红, 等. 胎儿畸形孕妇围引产期心理健康远程管理APP的构建与应用[J]. 中国护理管理, 2024, 24(1):68-73.
	Wang YH, Wang Y, Zeng LH, et al. Construction and application of a remote management APP for mental health of pregnant women with fetal abnormalities during pregnancy termination[J]. Chin Nurs Manag, 2024, 24(1):68-73.
[27]	马翠. 乳腺癌患者家庭复原力现状及其影响因素分析[D]. 遵义: 遵义医科大学, 2021.
	Ma C. The status and influencing factors of family resilience in breast cancer patients[D]. Zunyi: Zunyi Medical University, 2021.
[28]	杨苗, 张倩欣, 梁智灵, 等. 哮喘患儿父母家庭复原力现状及影响因素的研究[J]. 护理管理杂志, 2022, 22(11):813-817.
	Yang M, Zhang QX, Liang ZL, et al. Study on family resilience of parents of asthmatic children and its influencing factors[J]. J Nurs Adm, 2022, 22(11):813-817.
[29]	刘君. 晚期乳腺癌患者照顾者准备度现况和影响因素分析[D]. 湖州: 湖州师范学院, 2022.
	Liu J. Analysis of status and influencing factors of caregiver preparedness of caregivers for patients with advanced breast cancer[D]. Huzhou: Huzhou Normal University, 2022.
[30]	黄梦阳. 流动儿童家庭抗逆力及其对儿童情绪的影响[D]. 上海: 上海师范大学, 2020.
	Huang MY. Migrant children’s family resilience and its impact on emotion[D]. Shanghai: Shanghai Normal University, 2020.
[31]	胡颖, 周明芳, 陈世华, 等. “互联网+”集中群组干预模式在孕晚期初产妇中的应用研究[J]. 中华护理教育, 2023, 20(8):957-962.
	Hu Y, Zhou MF, Chen SH, et al. Study on the application of “Internet+” centering pregnancy health care model in late pregnancy of primiparas[J]. Chin J Nurs Educ, 2023, 20(8):957-962.