Tam Wing Hung, Lee Dominic Tak Sing, Chiu Helen Fung Kum, Ma Kwok Chiu, Lee Albert, Chung Tony Kwok Hung
Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR, China.
BJOG. 2003 Sep;110(9):853-9.
To study whether proactive educational counselling, in addition to routine clinical care, reduces psychological morbidity and improves quality of life and client satisfaction among women who suffer suboptimal outcomes during childbirth.
A randomised controlled trial.
Obstetric unit of a tertiary teaching hospital.
Women who had unexpected antenatal, intrapartum or postpartum events leading to suboptimal outcomes during pregnancy and childbirth.
Educational counselling provided by a trained research nurse in the postnatal ward after delivery. Women in the control group received routine clinical care.
The Hospital Anxiety and Depression Scale, the General Health Questionnaire and the Clinical Global Impression (before and after counselling, at six weeks and six months post-delivery) and the World Health Organisation Quality of Life scale (WHO-QOL) (at six weeks and six months post-delivery).
There was no significant difference in psychological morbidity, quality of life or client satisfaction between the counselling group and the control group. Participants who underwent elective caesarean section and who had the educational counselling had significantly lower depression scores [mean 2.6 (SD 2.6)] compared with those receiving routine care [mean 3.9 (SD 3.2)]. On the other hand, educational counselling may have deleterious effect to women's quality of life in those who had instrumental delivery. Participants allocated to the counselling group had a lower mean score 68 (SD 13) in the physical domain of WHO-QOL than those in the intervention group 74 (SD 13).
Educational counselling, given on top of routine clinical care, does not give additional beneficial effects on the psychological wellbeing and quality of life of women who encountered suboptimal outcomes during pregnancy.
研究在常规临床护理之外，积极的教育咨询是否能降低分娩结局不理想的女性的心理发病率，提高生活质量和患者满意度。
一项随机对照试验。
一家三级教学医院的产科病房。
孕期和分娩期间发生意外产前、产时或产后事件导致结局不理想的女性。
产后由经过培训的研究护士在产后病房提供教育咨询。对照组女性接受常规临床护理。
医院焦虑抑郁量表、一般健康问卷和临床总体印象（咨询前后、产后六周和六个月）以及世界卫生组织生活质量量表（WHO-QOL）（产后六周和六个月）。
咨询组和对照组在心理发病率、生活质量或患者满意度方面无显著差异。接受择期剖宫产并接受教育咨询的参与者的抑郁得分[平均2.6（标准差2.6）]显著低于接受常规护理的参与者[平均3.9（标准差3.2）]。另一方面，教育咨询可能对器械助产的女性的生活质量有有害影响。分配到咨询组的参与者在WHO-QOL身体领域的平均得分68（标准差13）低于干预组的74（标准差13）。
在常规临床护理基础上提供的教育咨询，对孕期结局不理想的女性的心理健康和生活质量没有额外的有益影响。
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