| Objectives:To explore the influence of "4C" transitional care mode on patients with hypertension disorders in pregnancy.This research can provide reference and nursing guidance for the development and application of "4C" transitional care for patients with hypertension disorders in pregnancy in Yunnan Province.Methods:The subjects of this study were selected from the patients with hypertension disorders in pregnancy who had prenatal examination in the obstetric outpatient department of a third class a hospital in Kunming City,Yunnan Province from October 2018 to September 2019.After they met the inclusion criteria and signed the informed consent,the patients were divided into the control group and the intervention group by the method of drawing lots.Intervention duration:from the patients were included in the study to the date of the last obstetric examination.In the control group,routine in-hospital and out of hospital nursing were used,including general supportive care,health education,school for pregnant women and telephone follow-up.On the basis of the control group,the intervention group was intervened by "4C"continuous nursing mode,and the intervention group was intervened by "4C"continuous nursing on the basis of the control group.Including intervention:the establishment of intervention team,establishment of WeChat official account,pregnancy related hypertension patients,unified training of interventionist(conformance guidance,standard language,pregnancy related hypertension,clinical and nursing knowledge).Interventions:establish patient’s personal files,self-management plan based on patient’s characteristics,and WeChat’s official account of pregnancy related hypertension.After intervention:telephone follow-up.When the research objects were included in the study and the last labor examination before delivery,subjective index questionnaires(general information,Pregnancy Pressure Scale,General Self-Efficacy Scale-Schwarzer,Self-Rating Anxiety Scale)were filled in.After delivery,objective indexes(blood pressure,weight growth,delivery mode,concurrent eclampsia,perinatal complications,perinatal complications)were collected.The IBM SPSS statistics 23 statistical software package was used to describe and analyze the data.Cases and percentage(%),((?))were used for statistical description,and chi-square test、Fisher’s accurate test or t test were used for data comparison.Spearman correlation analysis was used for correlation between different dimensions and scales.P<0.05,the difference was statistically significant;P<0.01,the difference was statistically significant.Results:1.There was no significant difference in general social demographic data and disease-related data between the two groups before the intervention(P>0.05);there was significant difference in complications between the two groups after the intervention(P<0.05).2.Before the intervention,the score of PPS of the overall study subjects was 29.269±8.342;among the factors,the score of stressor Ⅱ(the stress caused by worrying about the health and safety of mother and child)was the highest 13.496±3.857,among which the three items with the highest PPS score were worrying about the safe delivery of the fetus 1.916±1.022,worrying about the weight 1.908±0.638,worrying about the baby’s wrong There was no significant difference between the two groups(P>0.05).3.Before the intervention,the total PPS score of the intervention group and the control group were 29.559±7.532,28.983±9.100,the total score of pressure sourceⅠ was 8.915±3.441,8.750±4.542,the total score of pressure source Ⅱ was 13.712±3.200,13.283± 4.427,the total score of pressure source Ⅲ was 3.339±2.279,3.383±2.148,and the total score of pressure source Ⅳ was3.593±1.176,3.567±1.500(P>0.05).After intervention,the total PPS scores of research object were 20.661 ± 7.712,24.716±7.707,the total score of pressure source Ⅰ was 6.712±3.658,7.200 ±4.513,the total score of pressure source Ⅱ was 8.576±2.908,11.783±4.166,the total score of pressure source Ⅲ was 2.458±2.028,2.767±2.424,and the total score of pressure source Ⅳ was 2.915±1.343,2.967±1.353.There was a significant difference in the total score of pregnancy pressure between the intervention group and the control group(P<0.05).In the intervention group,there were significant differences in PPS total score,stressor one,stressor two,stressor three and stressor score between pre-intervention and post-intervention.(P<0.01);in the control group,there were significant differences in total score and stressor three between pre-intervention and post-intervention(P<0.05),but there were no statistical differences in stressor one,stressor two and stressor four(P>0.05).The pregnancy pressure score of the control group was higher than that of the intervention group.4.Through Spearman correlation analysis,all the significant values of the four pressure sources in the pregnancy pressure scale were P=0.000,indicating that there was a significant positive correlation between the four pressure sources(P<0.01).5.Before the intervention,the score of GSES 23.26±4.05 was significantly lower than that of the domestic norm 29.46±5.33(P<0.01).6.Before the intervention,the GSES scores of the intervention group and the control group were 22.847±3.969,23.667±4.111,and there was no significant difference between the two groups(P>0.05);after the intervention,the GSES scores of the intervention group and the control group were 25.881 ±3.227,24.200 ±3.344,and there was significant difference between the two groups(P<0.05).In intervention group,there was significant difference in GSES between pre-intervention and post-intervention(P<0.01);In control group,there was no significant difference between pre-intervention and post-intervention(P>0.05);there was no significant difference between the two groups before intervention(P>0.05),and there was significant difference between the two groups after intervention(P<0.05),and the general self-efficacy score of the intervention group was higher than that of the control group.7.Before intervention,the score of SAS of the overall study subjects was 46.54±8.54,which was higher than that of the domestic norm 29.78±10.07.The difference was statistically significant(P<0.01).8.Before the intervention,the SAS scores of the intervention group and the control group were 45.953±6.273,47.125 ±10.327,and there was no significant difference between the two groups(P>0.05);after the intervention,the SAS scores of the intervention group and the control group were 40.191±3.910,43.646±10.900,and there was significant difference between the two groups(P<0.05).There was significant difference between the two groups pre-intervention and post-intervention(P<0.05),and the scores after intervention were lower than those before intervention.The difference between the two groups before intervention was statistically unsignificant(P>0.05),and the difference between the two groups after intervention was statistically significant(P<0.05),and the difference between the control group was higher than the intervention group.The score of control group was higher than that of intervention group.9.Through Spearman correlation analysis,there was significant correlation between the three questionnaires(P<0.05),there was significant negative correlation between PPS and GSES(r<0,P<0.05),there was significant positive correlation between PPS and SAS(r>0,P<0.01),and there was significant negative correlation between GSES and SAS(r<0,P<0.05).Conclusions:1.In this study,the pregnancy stress level of the patients with hypertension disorders in pregnancy is high,the score of self-efficacy is lower than the domestic norm,and the score of anxiety is higher than the domestic norm.2."4C" transitional care mode can effectively urge the patients to control the weight and blood pressure during pregnancy,help the patients to reduce the pressure and anxiety,improve the level of patients’ self-efficacy,so as to reduce the incidence of mother and child complications and improve the quality of life.3.This study proves that "4C" transitional care mode is feasible for health education of patients,and provides reference for clinical medical staff to improve the nursing quality of patients with pregnancy induced hypertension in the future. |
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