With the development of perinatal medicine, mental health care of pregnant women has become an indispensable part of perinatal health care. Although pregnancy is a normal and natural physiological phenomenon for developing women, it is a huge physiological change and psychological stress process for pregnant women after all. They will have various psychological and physiological changes in a series of physiological processes such as pregnancy, childbirth, postpartum recovery and breastfeeding. Positive psychological reaction of pregnant women is beneficial to fetal development and delivery process, while negative psychological reaction will make psychological activities unbalanced, leading to neurological activities and endocrine disorders, thus affecting the pregnancy outcome and the safety of mother and baby to varying degrees. Therefore, it is an important work to correctly grasp the psychology of expectant mothers and do a good job of psychological care in a targeted manner to ensure the smooth delivery and postpartum recovery of expectant mothers.

2. Research status of this topic (literature review)

In recent years, with the in-depth study of mental health during childbirth, people have realized psychological problems such as anxiety throughout the perinatal period from simple postpartum depression, and put forward early detection and early intervention. Current research shows that the main psychological problems in perinatal period are anxiety and fear; Strange and lonely; Heavy depression; Interpersonal sensitivity, somatization symptoms and sleep disorders. The causes of these psychological problems generally include the following: (1) labor pain; Contradiction and pain; The character of pregnant women; Most pregnant women lack knowledge of pregnancy physiology; Family and social support system and other factors.

At present, the adopted nursing intervention model includes the health education model of IKAP-information.

(Information)-Knowledge-Attitude)-Practice model and self-efficacy theory (CBSEI) model. Different intervention methods are adopted according to different intervention modes, including prenatal intervention (health education) and intrapartum intervention.

3. Research content (content, structural framework and difficulties to be overcome):

Research content:

(1) Analyze the causes of psychological problems of pregnant women.

(2) Carry out corresponding nursing intervention for pregnant women's psychological problems.

Key technical problems: through observation, communication and communication with family members, understand the psychological state of pregnant women, analyze the main causes of problems, and formulate corresponding nursing intervention measures.

4. Research methods and means:

Research methods: Using the means of nursing psychology, in the process of nursing, through cordial conversation. To understand their mental state and their understanding of pregnancy and delivery physiology, so as to carry out targeted nursing during delivery.

Subjects: * * Pregnant women in obstetrics department of a hospital.

5. Research plan:

(1) Understand the psychological status of pregnant women through observation, communication and communication with family members, and analyze the main causes of problems;

(2) Applying nursing knowledge to implement corresponding nursing intervention, and investigating the intervention effect;

(3) Analyze the effectiveness of the intervention effect;

(4) Processing data and writing papers.

Model essay 2: Hypertension is a common and frequently-occurring disease in middle-aged and elderly people. According to the report of the World Health Organization, the prevalence rate of hypertension in the elderly over 60 years old in China is as high as 39.7%. If not treated in time, it will often lead to stroke, coronary heart disease, myocardial infarction and heart failure, and it will also complicate and promote the damage of target organs such as brain and kidney, and even cause disability or sudden death. With the continuous development of society, people put forward higher requirements for the rehabilitation, diagnosis and nursing of hypertension in the elderly with high incidence. The author analyzes the reasonable nursing methods of clinical nursing for elderly patients with hypertension, and now reports as follows.

Psychological nursing and establishing good medical ethics

Create a good environment, enhance patients' love for life and their belief in fighting diseases, and let patients recover as soon as possible. Pathogenic factors: overeating, constipation, mental stress, emotional excitement, great joy and great sorrow, anxiety, depression, paranoia, loneliness, depression, etc. , will increase the release of catecholamine in the body, make blood pressure rise, heart rate accelerate, thus aggravating the condition. Patients should maintain emotional balance, give psychological counseling to patients' various ideological concerns, establish a good nurse-patient relationship, enhance trust, and eliminate their worries and paranoia, which will play a positive role in the treatment of hypertension and the occurrence and progress of complications. Explain the relationship between mental factors and disease formation to patients and their families, teach patients to master certain psychological emergency methods, learn self-psychological consultation and adjustment, improve their psychological endurance and maintain a good psychological state. If blood pressure control is not ideal, even complications or other diseases occur, patients often feel pessimistic, disappointed and afraid. Nurses should be honest with each other, have patience and in-depth understanding of patients' inner world, understand patients' pain, give them emotional help such as care and encouragement, so as to eliminate their fragile emotional state, keep their healthy, peaceful and optimistic psychology, eliminate their self-confidence, enable them to actively cooperate with treatment, improve their self-control ability and help them finally overcome the disease.

Health knowledge guidance

Strengthen health education, including the risk factors of hypertension, the treatment of complications, medication precautions and adverse reactions. Personalized health knowledge education, demonstration and guidance should be given to patients' families, and the basic knowledge of hypertension prevention and treatment should be introduced to them according to their cultural background, customs and habits, so as to help them establish a knowledge system related to hypertension, so that patients and their families can fully realize the harm of bad living habits and actively establish scientific living habits. Encourage and guide patients and their families to actively participate in learning, master the skills of self-care, self-care and self-management, achieve self-control of blood pressure, and regularly check the functions of heart, brain, kidney and other organs and fundus conditions. Adhere to long-term rational drug use according to the condition, so as to reduce and delay the occurrence and development of complications, improve patients' ability to maintain their own health and promote the improvement of their quality of life.

Eat properly, keep the stool unobstructed and prevent constipation.

Reasonable diet is the basis of hypertension treatment, which is of great significance to control the disease and prevent the occurrence and development of its complications. In principle, the diet is light, easy to digest, low in calories, fat and cholesterol, and it is advisable to eat less and eat more meals, mainly with high vitamins. Foods should be diversified, mainly cereals, and coarse grains, freshwater fish, bean products, poultry, lean meat and low-fat milk, such as celery, Chinese cabbage, tomatoes, black fungus, mushrooms, celery, hawthorn, apples, rice and other fresh vegetables and fruits with health care functions, and seafood and foods with high calcium content should be appropriately increased. Avoid overeating, drink plenty of water, quit smoking and limit alcohol, and keep your stool unobstructed.

Exercise and rest care

Actively and appropriately participate in aerobic exercise, combine the changes of blood pressure and consciousness symptoms, choose the appropriate exercise mode and intensity, and do what you can. Walking, jogging, playing Tai Ji Chuan, relaxation therapy and other exercise methods can promote blood circulation and enhance the body's disease resistance. According to the patient's own situation and feelings during and after exercise, exercise moderately. For example, obese people can appropriately increase the intensity of exercise. Avoid the abnormal excitement of sympathetic nerve after strenuous exercise, which will lead to a sharp increase in blood pressure and cause cardiovascular and cerebrovascular accidents. In the process of exercise, in addition to strengthening safety awareness, it is best to stay with others to prevent accidents such as bumps and falls. Sympathetic nerve is excited in the morning, and blood pressure fluctuates easily. Therefore, patients should wake up slowly, wake up for a while, and then get up gradually to prevent the sudden drop of blood supply to the brain from causing fainting and falling. First of all, patients can be allowed to do moderate housework and encouraged to participate in social activities, such as cultivating personal hobbies according to their own tastes, such as calligraphy, planting flowers and raising birds. Guide them to make a personalized schedule, have enough sleep time, and keep the balance between exercise and rest.

Drug nursing

The principle of medication is: control the dose, slowly lower the blood pressure, and insist on long-term medication, that is, start with a small dose and gradually increase. Because the elderly often suffer from arteriosclerosis of heart, brain, kidney and other organs, the overall circulation regulation function of the body is poor, the overall fluid volume of the body is reduced, and excessive hypotension is prone to occur during treatment, so it is necessary to balance the internal environment of the machine. Therefore, for the elderly patients with hypertension, the drug dosage should start from 1/3 ~ 1/2 of the young and middle-aged patients, and gradually increase the dosage by observing its response, and satisfactory results can be obtained after 2 ~ 3 months. According to the circadian rhythm of blood pressure in elderly patients with hypertension, there are two peaks and two valleys, and the best medication time is 6: 00,14: 0022: 00; At the same time, the mechanism of different antihypertensive drugs was considered. In addition, patients and their families should be informed of the precautions and adverse reactions of drugs taken so as to take corresponding preventive measures. In addition, patients are encouraged to develop their potential, minimize physical pain and psychological pressure, and promote physical and mental health. Even if the blood pressure drops to the normal range, you can't stop taking drugs without authorization. You should get in touch with the doctor in time and ask him to adjust the medication and dosage to prevent the sudden increase of blood pressure after stopping the drug, which will lead to repeated illness. If the blood pressure suddenly changes greatly, it will easily lead to the damage of target organs such as heart, brain and kidney. Patients should be instructed to take medicine according to the doctor's advice.