Influence Of Maternal Role Facilitation Intervention Based On Transition Theory On Discharge Readiness Of Primipara

Objective:This study focuses on the practical problems of improving the discharge readiness of primipara,integrates the results of ’ quantity + quality ’ research,and deeply analyzes the related influencing factors and nursing needs of primipara discharge readiness.Based on this,the mother role facilitation intervention program is formed,and the influence of mother role facilitation intervention based on transition theory on the discharge readiness of primipara is evaluated,in order to provide reference for the future management of maternal and infant health discharge in obstetrics.Methods:This research mainly consists of three parts.Part I: A total of 198 primiparas who first gave birth in a tertiary general hospital in Shanxi Province from July 2020 to July 2021 and met the inclusion criteria were selected by convenience sampling method.The discharge readiness scale and the discharge guidance quality scale were used for questionnaire survey to analyze the current situation and influencing factors of discharge readiness of primiparas.Part II: The purpose sampling method was used to select 15 primiparas who were about to be discharged from a tertiary general hospital in Shanxi Province from May to July 2021 as the interview objects.On the basis of reading a large number of relevant literature on maternal discharge readiness,the interview outline was formulated,and the real feelings of primiparas,postpartum discharge readiness were deeply excavated through semi-structured interviews in phenomenological research.The interview results were analyzed by Colaizzi 7-step analysis.Part III: Using the method of quasi-experimental study,the primiparas who were filed and delivered in a tertiary general hospital in Shanxi Province from August to December2021 were selected as the research objects.Among them,40 primiparas selected from August to September were the control group,and 40 primiparas selected from October to December were the experimental group.The control group was treated with routine nursing,and the experimental group was treated with the intervention program of mother role facilitation based on the transition theory.The Readiness for Hospital Discharge Scale and Quality of Discharge Teaching Scale-New Mother Form were used to investigate primiparas at discharge.Chinese version of Parenting Sense of Competence Scale and Self-rating Scale of Puerperium Women ’s Self-care Ability were used to investigate primiparas before intervention,at discharge and 42 days after delivery.A self-made questionnaire was used to investigate the breastfeeding status of primiparas 42 days after delivery and the incidence of adverse symptoms within 42 days of maternal and infant delivery.Results:Part I: Among the 198 respondents,the readiness to discharge scores for primigravida ranged from 37 to 120,with a total readiness to discharge score of(90.75 ±17.3)and a mean entry score of(7.56 ± 1.44),placing the readiness to discharge for primigravida in the upper middle range.The results of the univariate analysis showed a statistically significant difference(p < 0.05)in the readiness to discharge scores for the number of days in hospital,place of residence,reason for discharge,birth of newborn,breastfeeding practices and whether or not they had attended maternity school.Multiple linear regression analysis showed that quality of maternal discharge instructions,family residence,and breastfeeding practices were the main influencing factors on discharge readiness of primiparous mothers(p < 0.05),together explaining 45.4% of the total variance.Part II: After sorting out and analyzing the results of the 15 interviews,five themes and ten sub-topics are extracted and analyzed,namely,rich emotional experience of discharge (overflowing happiness and full of worries),more negative emotions of parenting(role confusion and difficulties),difficult realization of scientific“sitting”month(deeply influenced by traditional ideas and insufficient cognition),lack of self-care ability(lack of self-care concept and self-care skills)and insufficient social support(limited access to professional knowledge and difficult identification of information effectiveness).Part III : In the end,a total of 75 primiparas completed the intervention study,37 primiparas in the experimental group and 38 primiparas in the control group.The results showed that: at the time of discharge,the total score of discharge readiness for primiparas in the experimental group was(105.41±4.79)points,and the total score for discharge readiness for primiparas in the control group was(88.29±4.87)points,and the total score for discharge readiness for primiparas in the experimental group was higher Compared with the scores of the control group,the difference was statistically significant(P<0.05);at the time of discharge,the total score of the quality of discharge guidance for primiparas in the experimental group was(160.19±8.10)points,and the total score for the quality of discharge guidance for primiparas in the control group was(144.05±7.88))points,the total score of the quality of discharge guidance for primiparas after intervention was higher than that of the control group,and the difference was statistically significant(P<0.05).group,the difference was statistically significant(P<0.05);the total score of the self-assessment scale of primipara during the puerperium in the experimental group was higher than that in the control group at the time of discharge and 42 days after delivery,and the difference was statistically significant(P<0.05);42 days postpartum,the exclusive breastfeeding rate of primiparas in the experimental group was much higher than that in the control group,and there was a statistically significant difference in the breastfeeding conditions of primiparas between the two groups(P<0.05);42 days after delivery,the incidence of nipple rupture and chapped,postpartum constipation and neonatal readmission in the experimental group was lower than that in the control group(P <0.05);There was no difference in the incidence of poor perineal and abdominal wound healing and acute mastitis between the experimental group and the control group(P > 0.05).Conclusion:(1)The discharge readiness of primipara is at a medium level and needs further improvement.(2)Mother ’s role maladjustment is common among primiparas at discharge.It is urgent to put forward systematic,scientific and targeted interventions to promote the successful transformation of mother ’s role,so as to optimize the discharge experience of primiparas.(3)Mother role enabling intervention based on the transition theory can improve the quality of discharge guidance of traditional health education,help primipara better prepare for discharge,improve primipara ’s parenting competence and postpartum self-care ability,and ultimately promote maternal and child health well-being at home.