Abstract:

Objective To provide the evidence for the development of personalized health education courses for twin pregnant women. We explored the health education and psychosocial demand of twin pregnant women from the perspective of social ecosystem theory. Methods By purposive sampling，18 twin pregnant women hospitalized in the twin medical center of a tertiary A hospital in Shenyang from January to March 2023 to conduct for semi-structured interviews，and Colaizzi’s 7-step analysis method was used to sort out and analyze the data. Results 3 themes were extracted from the health education and psychosocial needs of twin pregnant women. Microsystem：the content needs of twin pregnant women’s health education（the guidance needs of nutrition intake and weight growth；the needs for fetus health monitoring guidance；the cognitive needs of twin pregnancy complications；the needs for health education knowledge related to puerperium and the diversification of the choice of teaching methods）. Mesosystem：the emotional support needs of twin pregnant women during prenatal and puerperal（the needs of family support and peer education support）. Macrosystem：seeking social support and network information support（the demand of community support；the needs of information related to twin pregnant women’s hierarchical management system and maternal fetal medical referral process and the needs for network health education information）. Conclusion The women with twin pregnancy have different needs for health education content in each stage of pregnancy and puerperium，and there are urgent needs for emotional support and social support. Clinical nurses should construct health education courses according to the needs of twin women，and innovate in content and form，so as to improve the self-care ability of twin pregnant women and the knowledge level of family caregivers，and improve the pregnancy outcome.

Key words: Social Ecological Theory, Twin Pregnancy, Health Education, Need, Qualitative Study, Obstetrical Nursing

摘要：

目的 探索在社会生态系统理论视角下，双胎孕产妇的健康教育与心理社会需求，为制订个性化的双胎孕产妇健康教育课程提供依据。 方法 采用目的抽样法，选取2023年1月—3月在沈阳市某三级甲等医院双胎诊疗中心产科住院的18名双胎孕产妇进行半结构式访谈，采用Colaizzi 7步分析法对资料进行整理和分析。 结果 关于双胎孕产妇的健康教育与心理社会需求共提炼出3个主题。微观系统：双胎孕产妇健康教育内容需求（妊娠期营养摄入与体重增长指导需求；双胎健康监测指导需求；双胎妊娠并发症认知需求；产褥期相关健康教育知识需求；授课途径多样化需求）。中观系统：双胎孕产妇孕产期情感支持需求（家庭支持需求，以应对负性情绪；同伴教育支持需求，以应对孤独感）。宏观系统：寻求社会支持以及网络信息支持（社区支持的需求；双胎孕产妇分级管理制度及母胎医学转诊流程相关信息需求；科学、系统的网络健康教育信息需求）。 结论 双胎孕产妇在妊娠各期与产褥期有不同的健康教育内容需求，且存在迫切的情感支持需求与社会支持需求，临床护理人员应该根据双胎孕产妇需求特点，构建以双胎妊娠为主体的健康教育课程，在内容与形式上进行创新，以期提高其自我护理能力以及家庭照护者的知识水平，改善妊娠结局。

关键词: 社会生态系统理论, 双胎孕产妇, 健康教育, 需求, 质性研究, 产科护理