| Objective:1.Guided by the theoretical framework of behavioral diagnosis of PRECEDE-PROCEED model,the present situation of spouse parenting participation of primipara in puerperal period was investigated,and the main influencing factors were explored.2.Constructing a health education intervention programme for parenting involvement of primiparous spouses to address influencing factors.3.Using the method of quasi-experimental study and guided by the intervention theory framework of PRECEDE-PROCEED model,the health education intervention program involving the spouse parenting of primipara was implemented,and its clinical application effect was verified.Methods:1.Based on PRECEDE-PROCEED model,a mixed research method with explanatory sequence design was used to investigate the current situation of spousal parenting participation of primiparas in puerperium and analyze its influencing factors.In the quantitative study,the spouses of primipara who were 3～5 days after delivery in the maternity ward of a third-class A general hospital in Jinan were selected as the study objects by the convenient sampling method.The spouses of primipara were investigated with self-designed general information questionnaire,Father Caretaking Inventory(FCI)and Social Support Rating Scale(SSRS).Using SPSS 23.0 statistical software,use descriptive statistical analysis,independent sample t-test,and analysis of variance were used to investigate the current status of spouses’ participation in parenting.Multiple linear regression was used to analyze the factors affecting their participation.In the qualitative research part,on the basis of the quantitative research,12 spouses of primiparas with low parental involvement(the score of the Father Caretaking Inventory was less than the average)were selected as the research objects according to the principle of maximum differentiation.The results of the semi-structured interviews were used as an effective supplement to the results of the quantitative research.2.Based on the PRECEDE-PROCEED model,construct a health education intervention program for the of spouses of primipara in parenting.By integrating the previous survey results,systematically searching the relevant literature,and combining the theory of Knowledge-Attitude-Practice,the research team constructed the first draft of the health education intervention program for spouse parenting participation of primiparas based on the Precede-Proceed model.Medical and nursing experts in obstetrics,pediatrics and other fields were invited to carry out expert group meetings.The first draft of the scheme was revised and improved again according to the suggestions of experts,and the final draft of the scheme was finally formed.3.Application of health education intervention program for spouse parenting participation of primiparas.Using the method of quasi experimental research,a concurrent control was used,with the spouses of a group of primiparous women who underwent routine pregnancy examinations from June to October 2022 as the control group and the second group as the intervention group.The control group received routine nursing,education and follow-up.On the basis of the control group,the intervention group carried out the health education intervention program based on Precede-Proceed model.The general information and infant care knowledge questionnaire scores of the spouses of the two groups were collected before the intervention.The infant care knowledge questionnaire,Chinese version of parenting sense of competence,Father Role Adaptation Scale and Father Caretaking Inventory were collected on the day of discharge,3 weeks and 6 weeks after discharge.Descriptive statistical analysis,χ2test,Fisher’s exact probability method,independent sample t-test and repeated measurement analysis of variance were used to evaluate the application effect of health education based on Precede-Proceed model in parenting participation of spouses of primiparas during puerperium by SPSS 23.0 statistical software.Results:1.Current status and influencing factors of spouse participation in parenting of primiparas during puerperium.The score of spousal parenting participation of primiparas in puerperium was(28.86±6.56),which was lower than the middle level.The results of univariate analysis showed that age,education level,whether to participate in prenatal health education courses,maternal and infant information understanding and whether to have paternity leave were the main factors affecting spouse’s participation in parenting(all P<0.05);Pearson correlation analysis showed that the total score of parenting participation and the total score of social support were positively correlated.Multiple linear regression analysis showed that age(β=-0.104,P=0.046),education level(β=0.170,P=0.001),whether to participate in prenatal health education courses(β=0.114,P=0.028),maternal and infant information understanding level(β=0.135,P=0.010)and social support(β=0.483,P=0.000)entered the regression equation,which could explain 39.0%of the total variance.Through qualitative interview,three themes and seven sub-themes were extracted,respectively:ability barriers affecting participation(lack of parenting knowledge,poor parenting practice skills),motivation barriers affecting participation(father’s role maladjustment,low parenting competence)and opportunity barriers affecting participation(limited participation time,single access to parenting information,lack of support system).2.To construct a health education intervention program for spouse parenting participation of primiparas.On the basis of previous research,literature review and expert group meeting,based on the Precede-Proceed model,a health education intervention program for spouse parenting participation of primiparas was constructed from three aspects:predisposing factors,contributing factors and reinforcing factors.3.To evaluate the application effect of the health education intervention program for the spouses of primipara.(1)After intervention,the total score and scores of each dimension of infant care knowledge of the spouses of the intervention group were higher than those of the control group at discharge,3 weeks and 6 weeks after discharge,and the differences between the two groups were statistically significant(P<0.05).The time effect,inter-group effect and interaction effect of the total score and scores of each dimension of infant care knowledge of the spouses of the two groups were statistically significant(P<0.05).(2)After intervention,the total score and each dimension score of role adaptation and the total score and each dimension score of parenting sense of competence in the intervention group were higher than those in the control group at discharge,3 weeks and 6 weeks after discharge,and the differences between the two groups were statistically significant(P<0.05).The total score and dimension scores of role adaptation of the spouses of the two groups and the total score and dimension scores of parenting sense of competence had statistically significant time effects and inter-group effects(P<0.05).(3)After intervention,except for the two dimensions of accompanying to sleep and singing children’s songs,the total score of parenting participation and the scores of other dimensions in the intervention group were higher than those in the control group at discharge,3 weeks and 6 weeks after discharge,and the differences were statistically significant(P<0.05).The time effect and inter-group effect of the total score of parenting participation and the scores of other dimensions of the two groups were statistically significant(P<0.05).Conclusion:1.The parenting participation of spouses of puerperal primipara is still at the lower middle level,suggesting that medical staff should pay attention to it and improve their parenting participation by implementing scientific and effective health intervention measures.2.The constructed health education intervention program for spouse’s participation in parenting of primiparas is scientific and feasible,which can be used as an important strategy to promote spouse’s parenting participation.3.The health education intervention program based on Precede-Proceed model can effectively improve the Knowledge-Attitude-Practice level of spouses’ parenting participation and promote the realization of their parenting participation,which has important clinical significance and application value. |
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