Objective To construct and evaluate the effects of 4C characteristic home health care services model on the health of puerperas and fetuses.Methods A total of 162 puerperas and neonates were recruited,assigned by random nember table to routine community care condition and 4C characteristic home health care condition matched on the type and degree of health condition as well as the puerperas' culture background.The health condition of puerperas and neonates were investigated and compared between the two groups 42 days after delivery.Results The incidence of breast bilges,cracked nipple,re-visit the doctor,re-admission,anxiety and depression were significantly lower in the home health care group than routine community care group [3.7％ (3/81) vs.23.5％ (19/81),2.4％ (2/81) vs.17.3％ (14/81),2.5％ (2/81) vs.16.0％ (13/81),1.2％ (1/81) vs.16.0％ (13/81),(37.35±10.72) scores vs.(41.73±10.55) scores,(39.53±13.19) scores vs.(43.94±13.44) scores,x2=21.753,18.378,8.890,11.259,t=2.621,2.108,P ＜ 0.05 or 0.01].The success breastfeeding rates,correct rate of related knowledge and master degree of newborn,self-nursing newborn skills and puerperas and relatives' satisfaction scores were significantly higher in the home health care group than routine community care group [71.6％ (58/81) vs.37.0％ (30/81),95.1％ (77/81) vs.59.3％ (48/81),91.4％ (74/81) vs.53.1％ (43/81),（92.31±3.61) scores vs.(89.83±5.43) scores,x2=21.202,29.506,29.569,t=3.423,P＜ 0.01].In additon,the rate of re-visit the doctor,re-admission and omphalitis were significantly lower in home health care group than the routine community care group [2.5％ (2/81) vs.13.6％ (11/81),6.2％ (5/81) vs.23.5％ (19/81),4.9％ (4/81) vs.22.2％ (18/81),x2=6.774,9.172,9.288,P＜0.01 or 0.05].Conclusions 4C characteristic home health care reduced the probability of breast problems and unhealthy emotions for the puerperas,reducing the severity of jaundice as well as omphalitis for fetuses,reducing the probability of re-visit the doctor and re-admission for the puerperas and neonates,which can increase patients' satisfactory and promoting the mothers and their families to master self-nursing and newborn nursing skills and the other related knowledge.

Objective To describe the status of the post-discharge coping difficulties in women with hypertensive disorders of pregnancy(HDP),and to explore its influencing factors.Methods A total of 280 women with HDP from a tertiary A maternity hospital in Nanjing City were investigated with the general information questionnaire,the post-discharge coping difficulty scale-new mother form,the readiness for hospital discharge study-new mother form,the family APGAR index.The factors influencing post-discharge coping difficulties in women with HDP were analyzed using univariate analysis and multiple linear regression.Results 238 valid questionnaires were collected,with a response rate of 85.0%.The score of the post-discharge coping difficulties in women with HDP was 5.07±1.69,which is at a middle level.The results of multiple linear regression analysis showed that parity,primary caregiver during the postpartum period,HDP type,readiness for hospital discharge,family APGAR index were influencing factors of post-discharge coping difficulties in women with HDP(P＜0.05).Conclusion Post-discharge coping difficulties in women with HDP remains to be further improved,and it is affected by many factors.Medical staff should pay more attention to post-discharge coping difficulties of such parturients,formulate targeted continuation care programs according to relevant influencing factors,comprehensively improve their coping ability,and reduce their coping difficulties after discharge.

Objective:To investigate the current situation and influencing factors of humanistic care needs of family members of pregnant women in maternal intensive care unit, and to explore the relationship between humanistic care needs of family members of pregnant women in maternal intensive care unit, relocation stress level and perceived social support ability, so as to provide a basis for clinical nursing staff to implement targeted humanistic care for family members of pregnant women in maternal intensive care unit.Methods:From July to December 2022, 267 family members of pregnant women who were observed in the Maternal Intensive Care Unit of Maternity Hospital Affiliated to Nanjing Medical University/Nanjing Maternal and Child Health Hospital were selected as the research objects by the convenient sampling method. The general information questionnaire, Humanistic Care Needs Scale for Family Members of Pregnant Women in the Obstetric Intensive Care Unit, Family Relocation Stress Scale for Intensive Care Unit Patients and Perceived Social Support Scale were used to carry out a cross sectional investigation.Results:The scores of humanistic care needs, relocation stress scale and perceived social support scale were (175.32 ± 16.04), (35.12 ± 8.11), (57.30 ± 15.43) points, respectively. The length of maternal intensive care unit stay ( B=1.301, P<0.05), the family′s role changed for the first time ( B=2.328, P<0.05), the delivery mode doesn′t match the family′s expectations ( B=-2.407, P<0.05), maternal admission to maternal intensive care unit due to childbirth complications ( B=3.228, P<0.05), relocation stress level of intensive care unit patients′ family members ( B=0.891, P<0.05), and family members′ perceived social support ability ( B=0.461, P<0.05) were the influencing factors of humanistic care needs of maternal family members in maternal intensive care unit factors, which explained 83.2% of the total variation. Conclusions:The humanistic care needs of family members of pregnant women in maternal intensive care unit are at a high level. Medical staff should pay more attention to the family members of pregnant women who stay in maternal intensive care unit for a long time, undergo role change for the first time, have unexpected delivery mode and stay in maternal intensive care unit due to childbirth complications, so as to provide them with more comprehensive humanistic care and establish multiple support system, in order to improve the level of humanistic care for the family members of maternal intensive care unit.