School of Nursing, Sun Yat-sen University, Guangzhou, China.
Int J Nurs Stud. 2012 Mar;49(3):274-81. doi: 10.1016/j.ijnurstu.2011.09.010. Epub 2011 Oct 1.
Developing a sense of well-being and achieving maternal role competence are considered critical components of maternal adaptation. Given the growing evidence of postpartum depression and its devastating effects, effective childbirth psychoeducation programme to promote maternal role competence, psychological well-being and prevent postpartum depression is essential and of an urgent priority.
To examine the effects of an interpersonal psychotherapy oriented childbirth education programme on social support, maternal role competence, postpartum depression and psychological well-being in Chinese first-time childbearing women at three-month postpartum.
DESIGN, SETTING AND PARTICIPANTS: Randomised controlled trial in a regional teaching hospital, Guangzhou, China with 194 first-time pregnant women, of whom 96 received interpersonal-psychotherapy-oriented childbirth education programme and 98 standard care. The intervention was developed from principles of interpersonal psychotherapy which consisted of two 90-min antenatal classes and a telephone follow-up within two weeks after delivery. Outcomes measurements included Perceived Social Support Scale, Parenting Sense of Competence Scale-Efficacy subscale, Edinburgh Postnatal Depression Scale and General Health Questionnaire, were compared over three-month follow up.
The study group had significantly better improvement on perceived social support (p<0.01), maternal role competence (p<0.01), postpartum depressive symptoms (p<0.01) and psychological well-being (p<0.01) when compared with the control group. The study group also had significantly higher level of social support (t=2.33, p=0.021), maternal role competence (t=2.43, p=0.016) and less depressive symptoms (t=-2.39, p=0.018) at three-month postpartum when compared with the control group.
The childbirth psychoeducation programme can substantially benefit first time Chinese mothers. It could be implemented as a routine care with ongoing evaluation. Future studies could focus on women in lower social classes, with multiple pregnancy and complicated pregnancy.
幸福感的培养和母亲角色胜任感的获得被认为是产妇适应的关键组成部分。鉴于产后抑郁症的证据不断增加及其破坏性影响，开展有效的生育心理教育计划以促进母亲角色胜任感、心理健康和预防产后抑郁症是必要的，且具有迫切的优先性。
在产后三个月时，评估以人际心理治疗为导向的生育教育方案对中国初产妇的社会支持、母亲角色胜任感、产后抑郁和心理健康的影响。
设计、地点和参与者：这是一项在中国广州的一家地区教学医院进行的随机对照试验，共纳入 194 名初产妇，其中 96 名接受人际心理治疗为导向的生育教育方案，98 名接受标准护理。该干预措施是基于人际心理治疗原则制定的，包括两次 90 分钟的产前课程和产后两周内的一次电话随访。在三个月的随访期间，比较了包括感知社会支持量表、父母效能感量表-效能分量表、爱丁堡产后抑郁量表和一般健康问卷在内的结局测量指标的变化。
与对照组相比，研究组在感知社会支持（p<0.01）、母亲角色胜任感（p<0.01）、产后抑郁症状（p<0.01）和心理健康（p<0.01）方面的改善更为显著。与对照组相比，研究组在产后三个月时的社会支持水平（t=2.33，p=0.021）、母亲角色胜任感（t=2.43，p=0.016）和抑郁症状更少（t=-2.39，p=0.018）。
生育心理教育方案可以使中国初产妇显著受益。该方案可以作为常规护理措施，并进行持续评估。未来的研究可以集中于社会经济地位较低、多胎妊娠和复杂妊娠的女性。
