多媒體護理指導對初產婦生產自我效能及生產經驗之成效

生產準備是協助產婦因應生產疼痛的一種有效策略。本研究之目的在檢視產前多媒體生產護理指導對婦女生產自我效能與其生產經驗之成效。研究採類實驗研究法，以立意取樣於南部某區域教學醫院產科門診及產後病房收案，收案對象為懷孕32-36週第一次生產之婦女，無孕期合併症且無計劃剖腹產之孕婦，為避免兩組交叉污染，先收對照組再收實驗組，對照組個案接受一般常規照護，實驗組個案則除了接受一般產前常規照護外，同時接受多媒體生產護理指導。研究工具有：人口學資料、焦慮視覺類比量表、生產期望量表、生產自我效能量表及生產經驗態度量表。本研究採用統計方法包括：描述性統計以次數、百分比、平均值、標準差來表示，推論性統計有Independent sample t test, paired t test, ANOVA, Chi-square, Pearson’s r correlation coefficient,以及ANCOVA。研究結果為：1.是否接受生產多媒體護理指導對婦女的結果期望、效能期望或生產自我效能總分都無顯著差異；2.多媒體護理指導對待產經驗無顯著成效，而針對生產時經驗是否接受多媒體護理指導有顯著差異。本研究結果提供孕期護理指導光碟對婦女生產自我效能以及生產經驗之影響初步實證資料，未來可推展經濟有效的護理指導光碟於臨床實務運用。

關鍵字

多媒體護理指導；生產自我效能；生產經驗

並列摘要

Background: Childbirth preparation is one of the effective methods to help women for coping with labor pain. Aims: The purpose of this study is to examine the effectiveness of multi-media instruction on women’s childbirth self-efficacy and childbirth experience. Methods: A quasi-experimental study was conducted and purposive sampling from prenatal clinical department and postpartum ward in a teaching hospital in South Taiwan. Participants were primigravida women in their 32-36 weeks of pregnancy with no prenatal complication and no anticipated cesarean section. To avoid the contamination of two groups, the control group women were selected and received general prenatal care first and the experimental group women received multi-media instruction after. Instruments are demographic data, Visual Analogue Scale for Anxiety (VAS-A), Childbirth expectation Questionnaire (CEQ), Childbirth Self-Efficacy Inventory (CSEI), and The Attitudes about Labour and Delivery Experience questionnaire (ADLE). Statistics: Descriptive statistics were presented by percentage distribution, mean, and standard deviations. Inferential statistics were presented by Independent sample t test、paired t test、Chi-square、Pearson’s correlation coefficient, and ANCOVA. Results: 1. No statistically significant difference in childbirth self-efficacy by women who had received multi-media instruction and who had not; 2. No statistically significant difference in labor experience by women who had received multi-media instruction and who had not; 3. There was significant difference in delivery experience by women who had received multi-media instruction and who had not. The results of this study provide the evidence based data to understand the effects of multi-media instruction on psychological heath of childbirth women and implement a cost-effective prenatal education program on clinical practice.