健康諮詢介入措施對非住院高危險妊娠孕婦不確定感、壓力與生產結果之成效

Uncertainty, Stress, and Birth Outcomes in Non-Hospitalized, High-Risk Pregnancy Women: The Effectiveness of Health Consultation

方惠珍(Hui-Chen Fang) ； 劉介宇(Chieh-Yu Liu) ； 戴蕙蓮(Hwey-Lian Day) ； 陳治平(Chie-Pein Chen) ； 高美玲(Meei-Ling Gau)

《護理暨健康照護研究》 7卷1期 (2011/03) Pp. 3-13

https://doi.org/10.6225/JNHR.7.1.3

摘要

Background: Women with high-risk pregnancies, unable to predict with adequate certainty either maternal or fetal outcomes, may face greater stress and uncertainty as well as adverse birth outcome risks than their low-risk pregnancy peers. Limited research has previously been done on non-hospitalized high-risk pregnancy women with regard to strategies on effective continuity care and preterm labor prevention.
Purpose: This study evaluated the effectiveness of an educational pamphlet and 4-week daily telephone health consultation follow-up regimen (administered by nursing staff) in reducing uncertainty and stress and improving birth outcomes. The intervention targeted women in high-risk pregnancies during their second trimester.
Methods: This study was a randomly-controlled trial that recruited 82 non-hospitalized high-risk pregnancy women in their second trimester from one medical center in Taipei. Researchers used block randomization to assign subjects into either the experimental (n=41) or control (n=41) group. Both groups received the same care except for the health consultant intervention program, which included the distribution of an education pamphlet and daily telephone follow-ups over a period of four weeks. Researchers collected data using a structured questionnaire that included a demographic datasheet, the Uncertainty Stress Scale-High Risk Pregnancy (Chinese Version), the Social Support Questionnaire, and birth outcome datasheet.
Results: The designed health consultant nursing intervention program reduced uncertainty (β=-53.11, p＜.001) and stress (β=-33.11, p＜.001) in the experimental group. The experimental group also achieved a higher average birth weight (β=494.89, p＜.001) than the control group. This study found that subjects with higher prenatal uncertainty (β=-3.98, p=.017), higher stress scores (β=-8.13, p=.021) or twins pregnancies (β=-670.99, p＜.001) had higher preterm birth incidences.
Conclusions/Implications for practice: Study results suggest the efficacy of creating high-risk pregnancy case manager positions charged to provide proactive telephone health consultation services to women in high-risk pregnancy situations. Such may facilitate reductions in prenatal uncertainty and stress levels amongst high-risk pregnancy clients, which can facilitate positive birth outcomes and reduce medical costs.

關鍵字

高危險妊娠 ； 電話健康諮詢 ； 不確定感與壓力 ； 早產 ； 低體重兒

並列摘要

Background: Women with high-risk pregnancies, unable to predict with adequate certainty either maternal or fetal outcomes, may face greater stress and uncertainty as well as adverse birth outcome risks than their low-risk pregnancy peers. Limited research has previously been done on non-hospitalized high-risk pregnancy women with regard to strategies on effective continuity care and preterm labor prevention.
Purpose: This study evaluated the effectiveness of an educational pamphlet and 4-week daily telephone health consultation follow-up regimen (administered by nursing staff) in reducing uncertainty and stress and improving birth outcomes. The intervention targeted women in high-risk pregnancies during their second trimester.
Methods: This study was a randomly-controlled trial that recruited 82 non-hospitalized high-risk pregnancy women in their second trimester from one medical center in Taipei. Researchers used block randomization to assign subjects into either the experimental (n=41) or control (n=41) group. Both groups received the same care except for the health consultant intervention program, which included the distribution of an education pamphlet and daily telephone follow-ups over a period of four weeks. Researchers collected data using a structured questionnaire that included a demographic datasheet, the Uncertainty Stress Scale-High Risk Pregnancy (Chinese Version), the Social Support Questionnaire, and birth outcome datasheet.
Results: The designed health consultant nursing intervention program reduced uncertainty (β=-53.11, p＜.001) and stress (β=-33.11, p＜.001) in the experimental group. The experimental group also achieved a higher average birth weight (β=494.89, p＜.001) than the control group. This study found that subjects with higher prenatal uncertainty (β=-3.98, p=.017), higher stress scores (β=-8.13, p=.021) or twins pregnancies (β=-670.99, p＜.001) had higher preterm birth incidences.
Conclusions/Implications for practice: Study results suggest the efficacy of creating high-risk pregnancy case manager positions charged to provide proactive telephone health consultation services to women in high-risk pregnancy situations. Such may facilitate reductions in prenatal uncertainty and stress levels amongst high-risk pregnancy clients, which can facilitate positive birth outcomes and reduce medical costs.

並列關鍵字

high-risk pregnancy ； telephone health consultant ； uncertainty and stress ； preterm labor ； low birth weight