Development of Nursing Service System for Mothers with Preeclampsia with Severe Features
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Abstract
Abstract
This research and development aimed to study the current situation, develop a nursing service system, and evaluate the effectiveness of the nursing service system for mothers with severe preeclampsia. The 3 phases of the study were conducted: (1) study the current situation; (2) develop the nursing service system; and (3) evaluate the effectiveness of the nursing service system. The sample consisted of (1) 125 high risk mothers receiving antenatal care and delivery at Ratchaburi Hospital, selected through simple random sampling, and (2) 113 professional nurses selected through quota sampling. Research instruments included medical record review forms, in-depth interview guides, focus group discussion guides, health outcome recording forms, perception and behavior questionnaires, self-efficacy perception questionnaires, and the nursing service system. Content validity was verified using IOC, yielding values of .82 - .93, and reliability coefficients ranged from .80 - .93. Data were analyzed using descriptive statistics, t-tests, and content analysis.
The research findings revealed various significant gaps of the existing nursing service system, including lack of specificity in risk screening, incomplete screening results recording, incorrect triage prioritization, diversity in the nurses’ skills and experiences, unsystematic discharge planning, and ineffective communication. The developed nursing service system comprised of 3 components: (1) screening and surveillance guidelines of the risk groups; (2) nursing care guidelines from admission to discharge; and (3) communication and coordination guidelines. After using the nursing service system, it was found that the rate of severe complications decreased from 100% to 57.1%. No seizures and HELLP syndrome were found. The mothers in the group that did not develop severe preeclampsia had significantly higher scores of perceptions and preventive behaviors than the group that developed severe preeclampsia (p < .01 and < .001 respectively). Professional nurses had a high level of overall self-efficacy perception (Mean 3.82, SD .54).
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References
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