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通过婴儿睡眠干预减少产后抑郁、焦虑和压力。

Reducing postnatal depression, anxiety and stress using an infant sleep intervention.

作者信息

Symon Brian, Bammann Michael, Crichton Georgina, Lowings Chris, Tucsok James

机构信息

Kensington Park Medical Practice, Adelaide, Australia.

出版信息

BMJ Open. 2012 Sep 13;2(5). doi: 10.1136/bmjopen-2012-001662. Print 2012.

Abstract

OBJECTIVE

To examine the psychological well-being of mothers following participation in a behavioural modification programme previously shown to improve infant sleep.

DESIGN, SETTING AND PARTICIPANTS: A 45 min consultation with either a general practitioner (GP) or trained nurse providing verbal and written information describing sleep physiology in infants and strategies to improve infant sleep. Eighty mothers of infants 6-12 months of age with established infant sleep problems at a single general practice, Adelaide, South Australia.

MAIN OUTCOME MEASURES

The Depression Anxiety Stress Scale 21 (DASS21) immediately prior to the first consultation and again at follow-up approximately 3 weeks later. The number of infant nocturnal awakenings requiring parental support was also reported by mothers on both occasions.

RESULTS

All measures of maternal well-being and infant nocturnal awakenings improved significantly. The mean number of maximum nocturnal awakenings decreased from 5.0 to 0.5 (mean difference 4.4, 95% CI 3.4 to 5.5). All measures of DASS21 improved significantly. The mean total DASS21 decreased from 29.1 to 14.9 (mean decrease 14.2, 95% CI 10.2 to 18.2); mean depression decreased from 7.9 to 2.8 (mean difference 5.2, 95% CI 3.7 to 6.7); mean anxiety decreased from 4.6 to 2.6 (mean difference 2.0, 95% CI 0.7 to 3.2); mean stress decreased from 16.6 to 9.5 (mean difference 7.0, 95% CI 5.1 to 9.0). The proportion of mothers assessed as having any degree of depression decreased by 85% from 26/80 (32.5%) to 4/80 (5%).

CONCLUSIONS

The number of nocturnal awakenings requiring parental support among infants aged 6-12 months significantly decreased following a single consultation on infant sleep physiology and teaching behavioural strategies to improve sleep. Significant improvements in maternal stress, anxiety and depression were also observed.

摘要

目的

研究母亲在参与一项先前已证明可改善婴儿睡眠的行为矫正项目后的心理健康状况。

设计、研究地点与参与者:与全科医生(GP)或经过培训的护士进行45分钟的咨询,提供关于婴儿睡眠生理学的口头和书面信息以及改善婴儿睡眠的策略。南澳大利亚阿德莱德一家普通诊所中80名6至12个月大且存在婴儿睡眠问题的母亲。

主要观察指标

在首次咨询前以及约3周后的随访时分别使用抑郁焦虑压力量表21(DASS21)进行评估。母亲们还需报告这两个时间点上需要父母安抚的婴儿夜间醒来次数。

结果

母亲心理健康状况和婴儿夜间醒来次数的各项指标均有显著改善。夜间最大醒来次数的平均值从5.0降至0.5(平均差值4.4,95%置信区间3.4至5.5)。DASS21的所有指标均显著改善。DASS21总分平均值从29.1降至14.9(平均降幅14.2,95%置信区间10.2至18.2);平均抑郁得分从7.9降至2.8(平均差值5.2,95%置信区间3.7至6.7);平均焦虑得分从4.6降至2.6(平均差值2.0,95%置信区间0.7至3.2);平均压力得分从16.6降至9.5(平均差值7.0,95%置信区间5.1至9.0)。被评估为有任何程度抑郁的母亲比例从26/80(32.5%)降至4/80(5%),降幅为85%。

结论

在对6至12个月大婴儿的睡眠生理学进行一次咨询并教授改善睡眠的行为策略后,需要父母安抚的婴儿夜间醒来次数显著减少。母亲的压力、焦虑和抑郁状况也有显著改善。

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