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母亲的力量:一项旨在改善高危母亲心理健康和育儿方式的团体干预的初步结果

Mom Power: preliminary outcomes of a group intervention to improve mental health and parenting among high-risk mothers.

作者信息

Muzik Maria, Rosenblum Katherine L, Alfafara Emily A, Schuster Melisa M, Miller Nicole M, Waddell Rachel M, Stanton Kohler Emily

机构信息

Department of Psychiatry, University of Michigan Depression Center, 4250 Plymouth Road, Ann Arbor, MI, 48109-2701, USA,

出版信息

Arch Womens Ment Health. 2015 Jun;18(3):507-21. doi: 10.1007/s00737-014-0490-z. Epub 2015 Jan 11.

Abstract

Maternal psychopathology and traumatic life experiences may adversely impact family functioning, the quality of the parent-child relationship and the attachment bond, placing the child's early social-emotional development at risk. Attachment-based parenting interventions may be particularly useful in decreasing negative outcomes for children exposed to risk contexts, yet high risk families frequently do not engage in programs to address mental health and/or parenting needs. This study evaluated the effects of Mom Power (MP), a 13-session parenting and self-care skills group program for high-risk mothers and their young children (age <6 years old), focused on enhancing mothers' mental health, parenting competence, and engagement in treatment. Mothers were referred from community health providers for a phase 1 trial to assess feasibility, acceptability, and pilot outcomes. At baseline, many reported several identified risk factors, including trauma exposure, psychopathology, poverty, and single parenthood. Ninety-nine mother-child pairs were initially recruited into the MP program with 68 women completing and providing pre- and post-self-report measures assessing demographics and trauma history (pre-assessment only), maternal mental health (depression and post-traumatic stress disorder (PTSD)), parenting, and intervention satisfaction. Results indicate that MP participation was associated with reduction in depression, PTSD, and caregiving helplessness. A dose response relationship was evident in that, despite baseline equivalence, women who attended ≥70 % of the 10 groups (completers; N = 68) improved on parenting and mental health outcomes, in contrast to non-completers (N = 12). Effects were most pronounced for women with a mental health diagnosis at baseline. The intervention was perceived as helpful and user-friendly. Results indicate that MP is feasible, acceptable, and holds promise for improving maternal mental health and parenting competence among high-risk dyads. Further research is warranted to evaluate the efficacy of MP using randomized controlled designs.

摘要

母亲的精神病理学问题和创伤性生活经历可能会对家庭功能、亲子关系质量和依恋关系产生不利影响,使儿童早期社会情感发展面临风险。基于依恋的育儿干预措施可能对降低处于风险环境中的儿童的负面结果特别有用,但高风险家庭往往不参与旨在满足心理健康和/或育儿需求的项目。本研究评估了“妈妈力量”(Mom Power,MP)项目的效果,该项目是一个为期13节的育儿和自我护理技能小组项目,针对高风险母亲及其幼儿(年龄<6岁),重点是增强母亲的心理健康、育儿能力和参与治疗的程度。母亲们由社区卫生服务提供者转介参加第一阶段试验,以评估可行性、可接受性和初步结果。在基线时,许多人报告了几个已确定的风险因素,包括创伤暴露、精神病理学问题、贫困和单亲家庭。最初有99对母婴被纳入MP项目,其中68名女性完成并提供了自我报告前测和后测措施,评估人口统计学和创伤史(仅前测)、母亲心理健康(抑郁和创伤后应激障碍(PTSD))、育儿情况和干预满意度。结果表明,参与MP项目与抑郁、PTSD和照顾无助感的降低有关。剂量反应关系很明显,即尽管基线相当,但参加了10组中≥70%课程的女性(完成者;N = 68)在育儿和心理健康结果方面有所改善,而非完成者(N = 12)则不然。对于基线时有心理健康诊断的女性,效果最为显著。该干预措施被认为是有帮助且用户友好的。结果表明,MP项目是可行的、可接受的,有望改善高风险母婴对中的母亲心理健康和育儿能力。有必要进行进一步研究,以使用随机对照设计评估MP项目的疗效。

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