STRESS RESPONSES TO PRENATAL CARE--CLINIC VS HOME

怀孕、高危怀孕和产前护理都有记录 对大多数孕妇及其家庭来说都是压力源。这些压力源 有可能引起生理和心理反应 这可能对怀孕结果产生负面影响，例如早产 出生对于许多孕妇来说，参加产前护理包括 交通困难、儿童保育问题等问题， 文化差异，在某些地理区域缺乏供应商， 拥挤的候诊室，长时间的等待， 不方便的约会时间，以及重大的个人外- 口袋成本。一个替代的高风险孕妇有 频繁地前往提供者所在地并中断卧床休息， 通过先进的实践提供家庭产前护理服务 护士这项拟议研究的具体目的是比较 生理应激反应的差异（收缩和舒张 血压、心率和子宫活动）和心理 压力反应（状态焦虑、抑郁和敌意） 一组高危妊娠妇女通过检查这些 在诊所进行常规产前检查时的反应， 在先进做法提供的家庭产前护理访问期间， 护士

Pregnancy, high risk pregnancy, and prenatal care are documented stressors for most pregnant women and their families. These stressors have the potential to evoke physiological and psychological responses that may have a negative effect on pregnancy outcome, such as preterm birth. For many pregnant women, attending prenatal care includes problems such as transportation difficulties, child care problems, cultural differences, lack of providers in some geographical areas, overcrowded waiting rooms, long waits to see the provider, inconvenient appointment hours, and significant personal out-of- pocket costs. One alternative to the high risk pregnant woman having to travel freguently to the provider site and interrupt bedrest is to deliver prenatal care services in the home by advanced practice nurses. The specific aim of this proposed study is to compare the differences in physiological stress responses (systolic and diastolic blood pressure, heart rate, and uterine activity) and psychological stress responses (state anxiety, depression, and hostility) in a group of women with high risk pregnancies by examining these responses during routine prenatal care visits in the clinic and during prenatal care visits in the home provided by advanced practice nurses.