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[生物和心理社会因素对体重小于1500克婴儿早产后头几个月母亲痛苦及应对方式的影响]

[The effect of biological and psychosocial factors on maternal distress and coping in the first months after preterm delivery of an infant weighing less than 1500 g].

作者信息

Ganseforth C, Kribs A, Gontard A v, Kleffner G, Pillekamp F, Roth B, Sticker E J, Schmidt-Denter U

机构信息

Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie.

出版信息

Z Geburtshilfe Neonatol. 2002 Nov-Dec;206(6):228-35. doi: 10.1055/s-2002-36057.

Abstract

PROBLEM

Several studies have shown that maternal coping after a premature birth has an influence on the psychosocial development of preterm infants. As maternal coping is so important for development of premature infants, in this prospective study the medical state of the child, previous negative experiences, personal and partnership resources and social support outside the family were examined regarding their effects on maternal distress and coping after preterm birth. SAMPLE, MATERIAL, METHODS: 63 of 68 consecutive mothers with a preterm infant weighing less than 1500 g were examined with a semistructured interview and questionnaires (F-Sozu, ADS-L, FPI-R) at the time of discharge.

RESULTS

30.2 % (n = 19) of the mothers had multiples. The mean gestational age of the infants was 28 + 4 weeks (23 + 3 to 34 + 1 weeks), the mean birthweight was 1035 g (380 -1480 g). Although many mothers had fears concerning a handicap of their child, not medical complications per se influenced the mothers perception, but the duration of the medical treatment. Previous distressing experiences through complications of previous pregnancies and deliveries, as well as handicaps, chronic disorders and behavior problems of siblings influenced the perception of the child's health negatively, if they have had an effect on the current pregnancy. The mother's mood was not associated with the perception of the child's health, but with the atmosphere of the intensive care unit, partnership resources and social support outside the family.

CONCLUSIONS

As both biological and psychosocial factors had an effect on the mother's experiences, it is necessary to evaluate previous maternal experiences and coping resources and offer practical counselling for the mothers to optimize the clinical care in the future.

摘要

问题

多项研究表明,早产之后母亲的应对方式会对早产儿的心理社会发展产生影响。由于母亲的应对方式对早产儿的发育极为重要,在这项前瞻性研究中,我们考察了孩子的健康状况、既往负面经历、个人及伴侣资源以及家庭之外的社会支持对早产之后母亲的痛苦及应对方式的影响。样本、材料、方法:对连续收治的68名体重不足1500克的早产儿的母亲中的63位,在出院时采用半结构式访谈及问卷(F-Sozu、ADS-L、FPI-R)进行了调查。

结果

30.2%(n = 19)的母亲生育的是多胞胎。婴儿的平均胎龄为28 + 4周(23 + 3至34 + 1周),平均出生体重为1035克(380 - 1480克)。尽管许多母亲担心自己的孩子有残疾,但并非医疗并发症本身影响母亲的认知,而是医疗治疗的持续时间。既往因先前妊娠和分娩并发症以及残疾、慢性疾病和兄弟姐妹的行为问题而产生的痛苦经历,如果对当前妊娠产生了影响,则会对孩子健康的认知产生负面影响。母亲的情绪与对孩子健康的认知无关,而是与重症监护病房的氛围、伴侣资源以及家庭之外的社会支持有关。

结论

由于生物学因素和心理社会因素都会影响母亲的经历,因此有必要评估母亲既往的经历和应对资源,并为母亲提供实际的咨询服务,以便在未来优化临床护理。

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