Implementation And Effect Evaluation Of Early Lactation Program For Critically Ill Pregnant Women In ICU Based On ECASH Concept

Objective:ECASH(Early Comfort using Analgesia,mininmal Sedatives and Maximal Humane care)theory as the foundation,to develop ICU critical maternal Early lactation measures,in order to reduce the incidence of severe maternal lactation startup latency and increase the amount of lactation,24 hours to prepare for ICU critical maternal postpartum breast feeding;To investigate the effect of eCASH based early lactation measures on the incidence of postpartum anxiety and depression in ICU critical pregnant women,and to provide evidence for the feasibility of early lactation in critical pregnant women.Methods:1.Based on the theoretical framework of eCASH,an early lactation group for critically ill women was established to develop early lactation measures for critically ill ICU women.2.Using convenient sampling,critically ill pregnant women who met the inclusion and exclusion criteria when admitted to ICU from November 2018 to May 2019 were selected as the control group,and the control group was the routine nursing group From June to December 2019,critically ill women who were admitted to ICU and met the inclusion and exclusion criteria were included in the observation group,and the observation group implemented the early lactation measures based on the concept of eCASH.3.SPSS26.0 software was used for statistical analysis of data.Mean ± standard deviation was used for statistical description of measurement data.Count data were statistically described by frequency and percentage,and the comparison between groups was conducted by chi-square test.The data is not normally distributed,and the rank sum test is adopted.The minimum value of the data was less than 1,Fisher exact probability test was used,and the difference between the two groups was not statistically significant(P>,0.05),and the difference was statistically significant if P<0.05Results1.The 24-hour effective lactation volume of the experimental group T2 was higher than that of the observation group T1,with statistically significant difference(P<0.05).2.The incidence of lactation start-up delay in the observation group T1 was higher than that in the experimental group T2,with statistically significant difference(P<0.05).3.The incidence of postpartum depression in critically ill women in the two groups was determined,and T2 group was significantly lower than T1 group,with statistically significant difference(P<0.05).4.The incidence of postpartum anxiety in critically ill women in the two groups was determined,and the difference between the two groups was statistically significant(P<0.05).Conclusion1.The implementation of the early lactation program based on the concept of E CASH can ensure the stability of vital signs of critically ill women,reduce the incidence of lactation start-up delay in ICU critically ill women,and increase the lactation volume within 24 hours.2.A multidisciplinary early lactation program based on the eCASH concept can effectively relieve postpartum pain and psychological stress in critically ill ICU women and reduce the incidence of postpartum anxiety and depression.3.After the two-child policy,the morbidity group of critically ill women changed,and these critically ill women could still breastfeed after their illness was relieved,so it was feasible to implement early lactation measures for them.4.Due to life-threatening diseases,the implementation of lactation measures for critically ill pregnant women in ICU requires the cooperation of obstetrics department,ICU department,massage therapy department and other disciplines to ensure the stability of patients’ vital signs.