The Effect Of Solution Focused Approach On Advanced-aged Primiparas With Anxiety And Depression

Objectives The purpose of this study is to understand the advanced-aged primiparas’ condition of anxiety and depression before and after delivery,and investigate the effect of solution focused approach on advanced-aged primiparas with anxiety and depression,and provide scientific basis for the nursing care for advanced-aged primiparas during pregnancy and perinatal period.Methods From June 1,2015 to October 31,2015,a total of 84 subjects meeting the inclusion criteria were selected using the convenience sampling method from the department of obstetrics of a 3A hospital in Changchun.In the study,4 patients were lost to follow-up,and there were 40 cases in the intervention group and control group respectively.From June 2015,patients were selected and were intervened.Patients in control group only received routine health education.In addition to routine health education,patients in intervention group were also intervened by solution-focused approach.Research time was from 28 th week of gestation to 6th week after delivery.There were 6 to 8 times of intervention carried out mainly in fetal heart monitoring room before delivery and 20 to 40 minutes for each time and a telephone follow-up carried out mainly in ward or patients’ home every two weeks after delivery and 5 to 20 minutes for each time.The measurement tools were general information questionnaire,self rating Anxiety Scale(SAS) and self rating depression scale(SDS).Dates were established using Epidata 3.1 and Excel 2007 and were analyzed using SPSS17.0.Descriptive analysis method was used to analyze the general information of the research objects,the general information of the two groups were compared using Chi-square test.SDS and SDS consistent with the normal distribution were compared using analysis of Variance within group or test between group,and those not consistent with the normal distribution were compared using nonparametric tests 28 th week before delivery,the discharge day and 6th week after delivery.Results 1. The antenatal anxiety score of advanced-aged primiparas was 54.06±2.46 in control group and 54.13±2.10 in intervention group.There was no significant difference in antenatal anxiety score between the groups(P>0.05),indicating that the two groups are comparable.The antenatal depression score of advanced-aged primiparas was 55.69±2.52 in control group and 55.66±2.42 in intervention group.There was no significant difference in antenatal depression score between the groups(P>0.05),indicating that the two groups are comparable. 2. On the day of discharge,anxiety score was 51.19±5.45 and the incidence of anxiety was 50% in control group compared with 46.72±5.29 and 32.5% in intervention group. Anxiety score was higher in control group than in intervention group(P<0.05).There was no significant difference in the incidence of anxiety between the groups(P>0.05).In control group,depression score was 52.44±4.74 and the incidence of depression was 57.5% compared with 46.44±5.49 and 27.5% in intervention group on the day of discharge.There were statistical differences in both depression score and the incidence of depression between the groups(P<0.05). 3. Anxiety score was 49.78±4.72 and the incidence of anxiety was 42.5% in control group compared with 40.28±4.64 and 7.5% in intervention group 6th week after delivery. There were significantly differences in both anxiety score and the incidence of anxiety between the groups(P<0.01).Depression score was 50.78±3.93 and the incidence of depression was 52.5% in control group compared with 39.88±5.92 and 10% in intervention group 6 weeks after delivery.There were significantly differences in both depression score and the incidence of depression between the groups(P<0.01) 6th week after delivery.Conclusions 1. Solution focused approach could significantly reduce the score and incidence of anxiety of advanced-aged primiparas on the discharge day and 6th week after delivery. 2. Solution focused approach could significantly reduce the score and incidence of depression of advanced-aged primiparas on the discharge day and 6th week after delivery. 3. Solution focused approach is better than traditional health education in psychological nursing for advanced-aged primiparas with anxiety and depression.