Hospital information system based psychological nursing improves maternal and neonatal outcomes in cesarean section patients

基于医院信息系统的心理护理可改善剖宫产患者的母婴结局

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Abstract

To evaluate the association between Hospital Information System (HIS)-based psychological nursing intervention models and maternal and neonatal outcomes among cesarean section patients during the perioperative period. A quasi-experimental before-and-after study with propensity score matching was conducted at Foshan Women and Children Hospital from January 2022 to December 2023. The control group (n = 284) received standard nursing care between January and June 2022, while the intervention group (n = 284) received HIS-based psychological nursing interventions from July 2022 to December 2023. Interventions included systematic psychological assessment, individualized counseling sessions (4-6 sessions, 30-45 min each), structured education, and continuous perioperative support. Propensity score matching was performed using maternal age, education level, parity, gestational age, and baseline anxiety levels. Primary outcomes included maternal psychological indicators (anxiety and depression scores) and clinical parameters (operative duration, blood loss, complications). Secondary outcomes encompassed neonatal health indicators. The intervention group was associated with improvements in psychological outcomes, with State-Trait Anxiety Inventory scores decreasing by 27.1% (mean difference: -13.1, 95% CI: -14.8 to -11.4, p < 0.001) and Edinburgh Postnatal Depression Scale scores reducing by 41.4% (mean difference: -3.6, 95% CI: -4.2 to -3.0, p < 0.001). Clinical outcomes showed reduced operative duration (mean difference: -6.6 min, 95% CI: -8.3 to -4.9, p < 0.001), decreased blood loss (mean difference: -57.3 mL, 95% CI: -72.4 to -42.2, p < 0.001), and shorter hospital stays (mean difference: -0.9 days, 95% CI: -1.1 to -0.7, p < 0.001). Neonatal outcomes showed higher 5-minute Apgar scores (mean difference: 0.4, 95% CI: 0.2 to 0.6, p < 0.001) and reduced asphyxia rates (3.5% vs. 8.8%, risk ratio: 0.40, 95% CI: 0.19 to 0.84, p = 0.013). HIS-based psychological nursing intervention models were significantly associated with improvements in maternal psychological well-being, clinical outcomes, and neonatal health indicators. However, the temporal separation between groups limits causal inference due to potential secular trends. These findings suggest that systematic psychological support protocols may be beneficial as standard care for cesarean section patients, pending confirmation by randomized controlled trials.

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