Ingadóttir Eygló, Thome Marga
Division of Health, Professional Education and Research, Landspitali University Hospital, Reykjavik, Iceland.
Scand J Caring Sci. 2006 Mar;20(1):86-92. doi: 10.1111/j.1471-6712.2006.00385.x.
The purpose of this multicentre and quasi-experimental study is to evaluate the effect of a web-based course for community nurses in Iceland with regard to outcome of postpartum emotional distress. A sample of six community health centres was selected and equally divided into an experimental and a control group. All nurses at the experimental centres attended a web-based course focusing on evidence-based interventions for postpartum emotional distress. All new mothers were screened 9 weeks postpartum using the Edinburgh Postpartum Depression Scale (EPDS). If they scored 12 points or more they were eligible for the study. Mothers answered the EPDS at three different points in time, (9, 15 and 24 weeks postpartum) and the Parent Stress Index: Short Form (PSI/SF) at two times (9 and 15 weeks). Results showed no significant difference in the rate of depressive symptoms between study centres at 9 weeks. At 15 and 24 weeks there was, however, a significant difference between mothers at the experimental and control centres. Nurses at the experimental centres documented significantly more evidence-based interventions than did nurses at the control centres, and they had more frequent contact with new mothers suffering from postpartum emotional distress. There was no significant variation in PSI scores between the groups at any time. More women at the experimental centres were on antidepressants compared to the control centres. Of the total of 32 women eligible for the study, 10 declined participation. The findings are limited by small sample size and a probable confounding effect of antidepressants with the nursing interventions. Findings indicate that the web-based transfer of knowledge to nurses on evidence-based interventions for postpartum emotional distress has a positive effect on distressed women in the postpartum period and warrants further study.
这项多中心准实验研究的目的是评估冰岛针对社区护士开展的网络课程对产后情绪困扰结局的影响。选取了六个社区卫生中心作为样本，并将其平均分为实验组和对照组。实验组中心的所有护士都参加了一门聚焦于产后情绪困扰循证干预措施的网络课程。所有新妈妈在产后9周使用爱丁堡产后抑郁量表（EPDS）进行筛查。如果她们的得分达到12分或更高，则符合研究条件。妈妈们在三个不同时间点（产后9周、15周和24周）回答EPDS问卷，并在两个时间点（产后9周和15周）回答简易版父母压力指数（PSI/SF）问卷。结果显示，9周时研究中心之间的抑郁症状发生率没有显著差异。然而，在15周和24周时，实验组和对照组中心的妈妈们之间存在显著差异。实验组中心的护士记录的循证干预措施明显多于对照组中心的护士，并且她们与患有产后情绪困扰的新妈妈的接触更频繁。两组在任何时候的PSI得分都没有显著差异。与对照组中心相比，实验组中心有更多女性服用抗抑郁药。在总共32名符合研究条件的女性中，有10人拒绝参与。研究结果受到样本量小以及抗抑郁药可能与护理干预产生混杂效应的限制。研究结果表明，通过网络向护士传授产后情绪困扰循证干预措施的知识，对产后情绪困扰的女性有积极影响，值得进一步研究。
