Effects Of M-Learning On Hospitalized Primiparas' Childbirth Fear And Birth Outcomes

ObjectiveTo compare the effects of Mobile Learning(M-Learning)and traditional health education on the fear of childbirth(FOC)and birth outcomes of primiparas,in order to find out the application value of M-Learning in FOC and intervention of birth outcomes.MethodsA randomized controlled trial was conducted with primiparas whom were selected from the 3 A hospital(64 cases)and the 2A hospital(42 cases)of Wuhan during September to December of 2018.Random grouping(1:1)by SPSS 22.0.The control group received the traditional health education.While based on the dictation approach,the experimental group adopted M-Learning method which including several approaches:inviting primiparas of experimental group to join in the WeChat group or QQ group on the day of admission,developing online education,giving continuous psychological support and answering questions by experts in a specific time.Levels of FOC were measured by the Wijma Delivery Expectancy Questionnaire(W-DEQ-A)and the Wijma Delivery Experience Questionnaire(W-DEQ-A)before and after intervention.The degree of childbirth pain was assessed by Visual Analog Scale(VAS).The data of birth outcomes were collected and the final statistical analysis were carried out.Results1.Among the 106 cases,6 of them dropped off,100 completed.2.There were no significant difference in general information,W-DEQ-A score and FOC level between the two groups before intervention(P>0.05);while after intervention,the number of primiparas with FOC(W-DEQ score?85)in the experimental group was significantly less than that in the control group(3A hospital:13.3%VS 56.7%,P=0.000;2A hospital:10%VS 45%,P=0.002).The scores of W-DEQ-B and VAS in the experimental group were lower than the control group(P<0.05),but there was no significant difference in the "worried newborn" dimension(P>0.05).3.W-DEQ scores in the control group were higher than those before intervention(P<0.05),and the scores in the experimental group were significantly lower after intervention(P<0.01).4.Compared to controls the experimental group had a clinically meaningful but not statistically significant reduction in cesarean section(3A hospital:10.0%VS 23.3%;P=0.166;2A hospital:15.0%VS 20.0%;P=1.000).Comparison of the CS rates between FOC group and Non-FOC group before intervention(the control group:75.0%vs 5.3%,P=0.000;the experimental group:20.0%vs 8.6%,P=0.506).The CS rate increased with the severity of FOC(P=0.001).5.The duration time of labor and 2 hours postpartum hemorrhage in experimental group were shorter than those in control group(P<0.05),but the third stage of labor and the second stage of 2A hospital between two groups were no different(P>0.05).6.Compared to controls the experimental group had a clinically meaningful but not statistically significant reduction in the episiotomy rate(3A hospital:14.8%VS 26.1%,P=0.150;2A hospital:11.8%VS 31.3%,P=0.514).7.Compared to controls the experimental group had a clinically meaningful but not statistically significant rise in neonatal 1 min Apgar score.ConclusionM-Learning might relieve the level of childbirth pain and childbirth fear,improve the birth outcomes.It could be worthy of clinical promotion and application to enhance the experience of childbirth to promote doctor-patient integration,ensure maternal and infant health.