The Application Of Narrative Nursing In Reducing The Primiparas’ Fear Of Childbirth In Third Trimester And Labor

ObjectiveTo study the effective intervention methods of narrative nursing to reduce the fear of childbirth in the third trimester(gestation ≥ 37 weeks)and the parturient,and form the basic intervention framework of narrative nursing to reduce the fear of childbirth and improve the discomfort during childbirth.To provide effective nursing intervention methods for primipara with childbirth fear in late pregnancy(gestation ≥ 37 weeks)and after childbirth,so as to reduce the degree of childbirth fear of pregnant women,help them regain childbirth confidence,make pregnant women actively participate in the childbirth process,improve the natural childbirth rate,reduce the cesarean section rate,and bring a positive childbirth experience and childbirth outcome for pregnant women.MethodsAccording to the inclusion exclusion criteria,122 first pregnant women who were selected in a tertiary hospital in Inner Mongolia from January 2019 to October 2019 for prenatal examination,37 weeks of gestation and delivery attitude questionnaire(CAQ)score≥ 28 points.They were randomly divided into intervention group and control group according to the order of admission.The subjects of the two groups were 61 each.The control group was given routine nursing,including urging pregnant women to carry out routine prenatal examination on time,health education during pregnancy and routine process management.The intervention group carried out narrative nursing on the basis of routine nursing in the control group.By listening to the main events that bothered the pregnant woman,we analyzed the problems they faced and the causes,explored the positive significance of the narrative events to the problems they faced,enhanced their sense of personal control,and changed their fear of childbirth.And intervened in the steps of externalization,deconstruction,rewriting,external witnesses,treatment documents,etc.Every intervention lasted for 30-45 minutes,once a week.The subjects in the intervention group received narrative nursing on the basis of routine nursing,and intervened in the steps of externalization,deconstruction,rewriting,external witnesses,treatment documents,etc.once a week during pregnancy,each intervention lastedfor 30-45 minutes.Personalized narrative nursing interventions based on the situation of the pregnant woman during labor,incubation,active period,uterine incision,and second stage of labor after labor are performed,and the duration is about 5-20 minutes.Before intervention,after intervention and in labor,CAQ was used to evaluate the fear of childbirth of the two groups,and the rate of cesarean section,the rate of drug-induced labor analgesia,the time of labor,the amount of bleeding within 2 hours after delivery and Apgar score were compared between the two groups.Spss25.0 was used to analyze the data.The description of measurement data is determined by the distribution characteristics.For normal distribution data,mean ± standard deviation((?)±s)is used.For non normal distribution,median and quartile spacing are used.For normal distribution,t-test and variance analysis are used.For non normal distribution,rank sum test is used.The difference of CAQ scores before intervention,after intervention and at the time of labor was compared by repeated measurement analysis of variance.The counting data were expressed by frequency,percentage and chi square test.All the tests were bilateral,P <0.05 with statistical significance.ResultsThe data of 122 subjects were collected.The results showed that:(1)In this study,the average CAQ score of 122 subjects before intervention was(36.20 ± 3.31),and the incidence rate of fear of delivery was 67.78% in primipara.(2)Comparing the intervention group with the control group,the CAQ scores of the study subjects in the intervention group after the intervention and at the time of labor were lower than those in the control group at the same period(P <0.001)and lower than before the intervention(P <0.001).(3)The cesarean section rate in the intervention group was lower than that in the control group(P<0.05).(4)The analgesic rate of drug delivery in the intervention group was lower than that in the control group(P<0.05).(5)The time of the first stage of labor intervention group was shorter than the control group(P < 0.05),while the time of the second stage of labor intervention group was similar to the control group without statistical significance(P> 0.05).(6)In this study,there was no difference between the two groups in the amount of postpartum hemorrhage and Apgar score(P > 0.05).Conclusion(1)Narrative nursing can effectively reduce the degree of fear of childbirth in the first trimester of pregnancy(pregnancy ≥ 37 weeks)and postpartum labor,greatly improve their negative and negative emotions,promote them to face pregnancy and childbirth actively,improve the natural childbirth rate,reduce the use of drug-induced childbirth analgesia,shorten the birth process,and reduce the cesarean section rate.(2)When using narrative nursing to intervene the fear of childbirth of primipara,it is necessary to use externalization,deconstruction and rewriting alternately and repeatedly.The time of intervention in pregnancy should be once a week,about 45 minutes each time,and the time and frequency of intervention should be adjusted according to the specific situation of primipara.Personalized narrative nursing interventions based on the situation of the pregnant woman during labor,incubation,active period,uterine incision,and second stage of labor after labor are performed,and the duration is about 5-20 minutes.At the same time,the nursing staff should have good empathy ability,medical narrative ability,professional knowledge and skills.(3)The fear of childbirth has negative effects on pregnant women and their families.The incidence rate is high.Medical staff should strengthen the importance of pregnant women’s psychological status during pregnancy,find out pregnant women with fear of childbirth as early as possible,and implement pertinent,scientific and effective intervention measures in a timely manner,so as to better promote the physical and mental health of pregnant women and ensure the safety of mothers and infants.