Abstract:

Objective　To study the efficacy of application of Ausubel's problem solving mode in nursing care for women with pre-eclampsia. Methods　Ninety women with preeclampsia treated at Baoji Maternal and Child Health Care Hospital from December 2022 to December 2023 were selected for the randomized controlled trial, and were divided into a control group and a study group by the random number table method, with 45 cases in each group. The control group were (31.19±1.21) years old and (32.19±1.85) weeks pregnant, with a body mass index (BMI) of (27.49±3.29) kg/m². The study group were (31.21±1.19) years old and (32.23±1.92) weeks pregnant, with a BMI of (27.52±3.32) kg/m². The control group took conventional nursing care, and the study group Ausubel's problem solving mode nursing care. The blood pressure control, degrees of gestational stress, and delivery outcomes were compared between the two groups at enrollment and 2 weeks after delivery. t and χ² tests were used. Results　At enrollment, there were no statistical differences in the systolic and diastolic blood pressures between the two groups (both P>0.05); 2 weeks after delivery, the systolic and diastolic blood pressures were lower than those at enrollment in both groups (all P<0.05), and the pressures in the study group were lower than those in the control group [(135.12±6.24) mmHg (1 mmHg=0.133 kPa) vs. (138.52±6.23) mmHg and (98.12±3.52) mmHg vs. (99.97±3.69) mmHg; t=2.587 and 2.434; both P<0.05]. At enrollment, there were no statistical differences in the scores of Pregnancy Pressure Scale (PPS) between the two groups (all P>0.05); 2 weeks after delivery, the scores of PPS were lower than those at enrollment in both groups (all P<0.05), and the scores of the two dimensions and the total score of PPS in the study group were lower than those in the control group [(28.56±3.21) vs. (30.12±3.28), (27.62±3.16) vs. (29.48±3.24), and (56.18±5.26) vs. (59.60±5.19); t=2.280, 2.757, and 3.105; all P<0.05]. The rate of spontaneous delivery in the study group was higher than that in the control group [77.78% (35/45) vs. 57.78% (26/45); χ²=4.121; P<0.05]; the rate of assisted vaginal delivery in the study group was lower than that in the control group [26.67%(12/45) vs. 46.67% (21/45); χ²=3.876; P<0.05]; the rate of cesarean section in the study group was lower than that in the control group [22.22% (10/45) vs. 42.22% (19/45); χ²=4.121; P<0.05]; the incidence of neonatal asphyxia in the study group was 2.22% (1/45), and that in the control group 8.89% (4/45), with no statistical difference (χ²=0.847; P>0.05). Conclusion　Ausubel's problem solving mode nursing care for women with preeclampsia can improve their blood pressures and labour outcomes, and reduce their stress.

Key words:

Preeclampsia, Ausubel's problem solving mode, Puerperae, Blood pressures, Delivery

摘要：

目的　研究奥苏泊尔问题解决模式在子痫前期产妇护理中的应用效果。方法　选取2022年12月至2023年12月在宝鸡市妇幼保健医院接受治疗的90例子痫前期产妇进行随机对照试验。采用随机数字表法将其分为对照组和研究组，各45例。对照组年龄（31.19±1.21）岁，孕周（32.19±1.85）周，体质量指数（BMI）（27.49±3.29）kg/m²。研究组年龄（31.21±1.19）岁，孕周（32.23±1.92）周，BMI（27.52±3.32）kg/m²。对照组给予常规护理，研究组给予奥苏泊尔问题解决模式护理。比较两组产妇入组时、分娩后2周血压控制情况、妊娠压力及分娩结局。采用t检验和χ²检验。结果　入组时，两组产妇收缩压、舒张压对比，差异均无统计学意义（均P>0.05）；分娩后2周，两组产妇收缩压、舒张压均低于入组时（P<0.05），且研究组均低于对照组［（135.12±6.24）mmHg（1 mmHg=0.133 kPa）比（138.52±6.23）mmHg、（98.12±3.52）mmHg比（99.97±3.69）mmHg；t=2.587、2.434，均P<0.05］。入组时，两组产妇妊娠压力量表（Pregnancy Pressure Scale，PPS）评分对比，差异均无统计学意义（均P>0.05）；分娩后2周，两组产妇PPS评分均低于入组时（均P<0.05），且研究组各维度评分及总分均低于对照组［（28.56±3.21）分比（30.12±3.28）分、（27.62±3.16）分比（29.48±3.24）分、（56.18±5.26）分比（59.60±5.19）分；t=2.280、2.757、3.105，均P<0.05］。研究组自然分娩率为77.78%（35/45），高于对照组的57.78%（26/45）（χ²=4.121，P<0.05）；研究组阴道助产率为26.67%（12/45），低于对照组的46.67%（21/45）（χ²=3.876，P<0.05）；研究组剖宫产率为22.22%（10/45），低于对照组的42.22%（19/45）（χ²=4.121，P<0.05）；研究组新生儿窒息发生率为2.22%（1/45），对照组为8.89%（4/45），差异无统计学意义（χ²=0.847，P>0.05）。结论　奥苏泊尔问题解决模式护理可有效改善子痫前期产妇血压水平，减轻产妇压力，改善分娩结局。

关键词:

子痫前期, 奥苏泊尔问题解决模式, 产妇, 血压, 分娩