Clinical Impact of Nurses-Physicians Collaboration Intervention on the Treatment of Immune Recurrent Spontaneous Abortion with Low-Molecular-Weight Heparin.

Miaocheng Chen,Xi Wang,Peiru Deng

doi:10.1155/2021/9290720

Abstract

Anticoagulation is currently the preferred and effective treatment for patients with recurrent spontaneous abortion (RSA), but, due to the prevalence of mood disorders in RSA patients and the high number of adverse effects associated with long-term medication, effective care measures are often required. In this study, 94 patients with immune-type RSA who were admitted to our hospital from January 2018 to June 2019 were selected and randomly divided into a control group and a study group of 47 patients each; both groups received low-molecular-weight heparin treatment after admission, and the control group received conventional nursing interventions during treatment, while the patients in the study group received integrated medical and nursing care interventions. Pregnancy outcomes, pre- and postintervention scores on the Self-Assessment Scale (SAS), Self-Depression Scale (SDS), and Pittsburgh Sleep Quality Index (PSQI), levels of serum gamma-interferon (IFN-γ) and interleukin-4 (IL-4) and their ratios, complications, and patient satisfaction with the intervention were observed in both groups. The results showed that the success rate of fetal preservation in the study group (89.36%) was significantly higher than that in the control group (68.09%) (P < 0.05). After treatment, SAS, SDS, and PSQI scores decreased in both groups, with the study group being lower (P < 0.05). IFN-γ and IFN-γ/IL-4 levels decreased and IL-4 levels increased in both groups after treatment, with IFN-γ and IFN-γ/IL-4 being significantly lower and IL-4 levels being significantly higher in the study group than in the control group (P < 0.05). The incidence of adverse drug reactions in the study group was significantly lower than that in the control group (P < 0.05). Patients in the study group were more satisfied with all aspects of the intervention than the control group (P < 0.05). These results suggest that nurses-physicians collaboration intervention may improve the effectiveness of low-molecular-weight heparin therapy in patients with immune-type RSA. It helps to improve patient pregnancy outcomes, mood, sleep quality, and immune function and increases patient satisfaction.

Highlights

Recurrent spontaneous abortion (RSA) is a condition in which a woman of childbearing age suffers two or more consecutive spontaneous abortions with the same sexual partner, with prevalence of approximately 1% to 5% of women of childbearing age [1]. e etiology of RSA is complex and relatively clear causes include chromosomal abnormalities, endocrine system factors, reproductive tract infections, immune factors, and prethrombotic states, among which RSA due to immune imbalance, that is, immune-type RAS, is one of the main types of the disease [2]. e mechanism of action of clinically used low-molecular-weight heparin on RAS is unclear and may be related to its immunosuppressive and immunomodulatory properties
By recording and comparing the pregnancy outcomes of the two groups, we found that the proportions of full-term delivery, miscarriage, survival of preterm delivery, and death of preterm delivery in the control group were 38.30% (18 cases), 27.66% (13 cases), 19.15% (7 cases), and
Comparison of Negative Mood Scores and Sleep Quality Scores before and after Intervention between the Two Groups. Negative emotion scores such as Self-Assessment Scale (SAS) and Self-Depression Scale (SDS) as well as Pittsburgh Sleep Quality Index (PSQI) scores were assessed before and after the intervention in both groups and the data were compared. e results showed that there was no statistical difference between the SAS scores, SDS scores, and PSQI scores of the two groups before the intervention (P > 0.05). e SAS scores, SDS scores, and PSQI scores of both groups decreased after the intervention compared to the preintervention period, with the study group being lower than the control group and the difference being statistically significant (P < 0.05) (Figure 2)

Summary

Introduction

Recurrent spontaneous abortion (RSA) is a condition in which a woman of childbearing age suffers two or more consecutive spontaneous abortions with the same sexual partner, with prevalence of approximately 1% to 5% of women of childbearing age [1]. e etiology of RSA is complex and relatively clear causes include chromosomal abnormalities, endocrine system factors, reproductive tract infections, immune factors, and prethrombotic states, among which RSA due to immune imbalance, that is, immune-type RAS, is one of the main types of the disease [2]. e mechanism of action of clinically used low-molecular-weight heparin on RAS is unclear and may be related to its immunosuppressive and immunomodulatory properties. E mechanism of action of clinically used low-molecular-weight heparin on RAS is unclear and may be related to its immunosuppressive and immunomodulatory properties. It may promote embryonic growth and development by improving maternal blood hypercoagulability, reducing blood viscosity and vascular resistance, increasing placental blood supply, and fundamentally altering intrauterine microcirculation [3, 4]. We give full play to the advantages of integrated nurses-physicians collaboration during the treatment of immune RSA patients via low-molecularweight heparin, standardize the nursing process, and strengthen the communication and medical and nursing cooperation. E nurses-physicians collaboration intervention model refers to a relatively fixed treatment team of doctors and nurses to provide patients with integrated treatment, nursing care, and rehabilitation services, which can achieve the effect of “1 + 1>2” [10]. e studies in [11, 12] have shown that the nurses-physicians collaboration intervention model can improve the quality of medical safety, enhance the awareness of medical and nursing cooperation, and improve the level of medical and nursing cooperation, but there is a lack of research on the integrated medical and nursing cooperation model in the care of immune-type RSA during treatment.

Methods

Results

Conclusion