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目的针对体外受精-胚胎移植术(IVF-ET)术后先兆流产孕妇焦虑情绪进行团体心理干预和音乐放松疗法干预,评价该干预方法对IVF-ET术后先兆流产孕妇焦虑情绪改善的效果。方法选择2013年9月至2014年12月南京市妇幼保健院十病区收治的IVF-ET术后先兆流产孕妇220例,运用信封法随机分为对照组和干预组两组,每组110例。对照组给予常规治疗护理方案进行干预,包括遵医嘱用药、做好临床健康教育和常规心理护理;干预组在对照组基础上采用团体心理干预和音乐放松疗法。运用自行设计的《一般情况调查问卷》对患者进行基本资料的采集;两组于入院时、出院时均进行焦虑量表(SAS)评分、社会支持量表(SSRS)评分,结果采用SPSS19.0统计软件录入及处理,对比两组干预前后及组间测量指标的变化及其差异。结果入院时IVF-ET术后先兆流产患者SAS评分及SSRS评分两组比较差异均无统计学意义(P均>0.05)。干预后两组SAS评分均较入院时下降(P均<0.01);且出院时干预组患者SAS评分明显低于对照组(t=7.31,P<0.01)。入院时,两组患者焦虑程度的构成差异无统计学意义(P>0.05);干预后两组患者焦虑严重度均较入院时降低,且出院时干预组患者焦虑严重度明显低于对照组(Z=5.130,P<0.01)。SSRS评分中客观支持、主观支持、支持利用度、社会支持总分:在对照组患者,出院时与入院时无明显变化(P均>0.05);在干预组患者,出院时较入院时有明显提高(P均<0.05);且出院时干预组明显高于对照组,差异有统计学意义(P<0.05,P<0.01)。结论采用团体心理干预和音乐放松疗法的干预措施,在降低IVF-ET术后先兆流产患者的焦虑程度、提高患者的社会支持度评分方面均可获益。
Objective To investigate the effect of intervention on psychological anxiety in pregnant women with threatened abortion after in vitro fertilization-embryo transfer (IVF-ET) by using psychological intervention and music relaxation therapy. Methods Seventy two pregnant women with threatened abortion after IVF-ET were enrolled in the ten wards of Nanjing MCH from September 2013 to December 2014 were randomly divided into control group and intervention group with envelope method, 110 cases in each group . The control group received routine treatment and nursing interventions, including medication prescribed by the doctor, clinical health education and routine psychological nursing; intervention group based on the control group using group psychological intervention and music relaxation therapy. The self-designed “General Condition Questionnaire” was used to collect the basic data of the patients. SAS and SSRS were both scored on admission and discharge, and the results were analyzed by SPSS19.0 Statistics software input and processing, comparing two groups before and after intervention and between the measurement changes and differences between groups. Results There was no significant difference in SAS score and SSRS score between the two groups after IVF-ET surgery (P> 0.05). After intervention, the scores of SAS in both groups were lower than those on admission (P <0.01). SAS scores in the intervention group were significantly lower than those in the control group (t = 7.31, P <0.01) after intervention. At admission, there was no significant difference in anxiety level between the two groups (P> 0.05). After the intervention, the severity of anxiety in both groups was lower than that at admission, and the severity of anxiety in the intervention group was significantly lower than that in the control group Z = 5.130, P <0.01). SSRS score objective support, subjective support, support utilization, social support score: no significant change in the control group of patients, discharge and admission (P> 0.05); in the intervention group, compared with hospital admission was significantly (P <0.05). The discharge group was significantly higher than the control group (P <0.05, P <0.01). Conclusion Interventions using group psychological intervention and music relaxation therapy may benefit the patients with threatened abortion and reduce the anxiety level of patients with threatened abortion and improve their social support scores.