Centre for Women's Mental Health, Royal Women's Hospital, Flemington Road, Melbourne, VIC, 3052, Australia,
Arch Womens Ment Health. 2013 Dec;16(6):511-20. doi: 10.1007/s00737-013-0364-9. Epub 2013 Jul 3.
The purpose of this study is to test a brief, attachment intervention added to routine maternity care that aims to improve the adolescent mother-infant relationship during transition to motherhood. A pre-test, post-test, peer-control-group trial was set in a large tertiary maternity hospital in Melbourne, Australia. Participants were multi-cultural, pregnant adolescents (n = 97). The two-session 'AMPLE' intervention was provided in late pregnancy and neonatally. The main outcome measure was mother-infant interaction quality at age 4 months, blind-coded using the Emotional Availability Scales (EAS) (fourth edition). Study acceptability was high: participation rate 82.9 % and completion rate 75.3 %. Thirty-five participants received the intervention plus usual care (intervention group) and 38 received usual care (control group). There were no pre-test between-group differences across demographic, psychosocial or obstetric domains. At post-test, mother-infant interaction was significantly better in the intervention group. MANOVA analyses showed an overall intervention effect on emotional availability in 20 min of free play (n = 73), F (6,65) = 5.05, p < .01, partial η (2) = .32, and in 25 min of play plus brief separation-reunion (n = 55), F (6,48) = 2.72, p = .02, partial η (2) = .25. T tests showed significant between-group differences in specific EAS subscales. All effect sizes were medium-large. This promising intervention appears to exert a clinically meaningful effect on the adolescent mother-infant relationship. Further research is warranted to replicate the findings and confirm causality. The study suggests a brief attachment focus, incorporated into routine maternity care, could influence the developmental trajectory of infants of young mothers from birth.
这项研究的目的是测试一种简短的、附加的干预措施,该措施附加于常规产妇护理中,旨在改善青少年母亲在过渡到母亲身份期间与婴儿的关系。该研究采用了前测-后测-同伴对照组的试验设计,在澳大利亚墨尔本的一家大型三级妇产医院进行。参与者为多文化背景的、怀孕的青少年(n=97)。“AMPLE”干预措施共两部分,在妊娠晚期和新生儿期提供。主要结局测量指标是婴儿 4 个月时的母婴互动质量,使用情感可用性量表(EAS)(第四版)进行盲法编码。研究的可接受性很高:参与率为 82.9%,完成率为 75.3%。35 名参与者接受了干预措施加常规护理(干预组),38 名参与者接受了常规护理(对照组)。在人口统计学、心理社会或产科领域,两组在测试前没有差异。在测试后,干预组的母婴互动明显更好。MANOVA 分析显示,在 20 分钟的自由游戏中(n=73),干预组的情感可用性有总体的干预效果,F(6,65)=5.05,p<.01,部分η(2)=0.32;在 25 分钟的游戏加短暂的分离-团聚中(n=55),F(6,48)=2.72,p=0.02,部分η(2)=0.25。T 检验显示 EAS 特定子量表的组间存在显著差异。所有的效应大小均为中到大。这项有前途的干预措施似乎对青少年母婴关系产生了有临床意义的影响。需要进一步的研究来复制这些发现并确认因果关系。该研究表明,一种简短的依恋焦点,纳入常规产妇护理,可以影响年轻母亲的婴儿从出生开始的发展轨迹。