一项针对患有与虐待相关创伤后应激障碍的孕妇的心理教育干预的准实验结果分析。
A Quasi-experimental outcomes analysis of a psychoeducation intervention for pregnant women with abuse-related posttraumatic stress.
作者信息
Rowe Heather, Sperlich Mickey, Cameron Heather, Seng Julia
出版信息
J Obstet Gynecol Neonatal Nurs. 2014 May-Jun;43(3):282-93. doi: 10.1111/1552-6909.12312. Epub 2014 Apr 22.
OBJECTIVE
To test the effectiveness of a trauma-specific, psychoeducational intervention for pregnant women with a history of childhood maltreatment on six intrapartum and postpartum psychological outcomes.
DESIGN
Quasi-experimental study comparing women from a single-group, pretest-posttest pilot intervention study with women matched from a prospective observational study.
SETTING
Rural and university-based prenatal clinics.
PARTICIPANTS
Pregnant women entered the study by responding to an advertisement or by referral from a maternity care provider. Women could take part whether or not they met posttraumatic stress disorder diagnostic criteria. Outcomes data exist for 17 pilot intervention study participants and 43 matched observational study participants.
INTERVENTIONS
Participants in the observational study received usual care. Participants in the pilot intervention study received usual care plus the intervention, a fully manualized, self-study program supported by weekly phone tutoring sessions with a health professional.
MAIN OUTCOME MEASURES
The National Women's Study PTSD Module, the Peritraumatic Dissociation Experience Questionnaire, the Perception of Care Questionnaire, the Postpartum Depression Screening Scale, the Postpartum Bonding Questionnaire, and a semantic differential appraisal of the labor experience.
RESULTS
Participants in the intervention study had better scores on all measures. Differences in means between participants in the intervention study and participants in the observational study equated to medium effect sized for dissociation during labor, rating of labor experience, and perception of care in labor and small effect sizes for postpartum posttraumatic stress disorder (PTSD) symptoms, postpartum depression symptoms, and motherinfant bonding.
CONCLUSION
This trauma-specific intervention reaches and benefits pregnant women with a history of childhood maltreatment.
目的
测试一种针对有童年虐待史的孕妇的创伤特异性心理教育干预措施对六种产时和产后心理结局的有效性。
设计
准实验研究，将单组前测-后测试点干预研究中的女性与前瞻性观察研究中匹配的女性进行比较。
地点
农村和大学附属的产前诊所。
参与者
孕妇通过回应广告或由产科护理提供者转诊进入研究。无论是否符合创伤后应激障碍诊断标准，女性均可参与。现有17名试点干预研究参与者和43名匹配的观察研究参与者的结局数据。
干预措施
观察研究中的参与者接受常规护理。试点干预研究中的参与者接受常规护理加干预措施，即一个完全手册化的自学项目，并由健康专业人员通过每周电话辅导提供支持。
主要结局指标
《全国女性研究创伤后应激障碍模块》《围产期分离体验问卷》《护理感知问卷》《产后抑郁筛查量表》《产后亲密关系问卷》以及对分娩经历的语义差异评估。
结果
干预研究中的参与者在所有指标上得分更高。干预研究参与者与观察研究参与者的均值差异相当于分娩期间分离、分娩经历评分和分娩护理感知方面的中等效应量，以及产后创伤后应激障碍（PTSD）症状、产后抑郁症状和母婴亲密关系方面的小效应量。
结论
这种创伤特异性干预措施对有童年虐待史的孕妇有效且有益。
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