University of Konstanz, Konstanz, Germany.
University of Konstanz, Konstanz, Germany ; Vivo International (www.vivo.org), Konstanz, Germany.
Child Adolesc Psychiatry Ment Health. 2014 Dec 23;8(1):30. doi: 10.1186/s13034-014-0030-7. eCollection 2014.
High levels of stress due to diverse psychosocial factors have a direct impact on the mothers' wellbeing during pregnancy and both direct and indirect effects on the fetus. In most cases, psychosocial risk factors present during pregnancy will not disappear after delivery and might influence the parent-child relationship, affecting the healthy development of the offspring in the long term. We introduce a short innovative prenatal assessment to detect psychosocial risk factors through an easy to use instrument for obstetrical medical staff in the daily clinical practice, the KINDEX Spanish Version.
In the present study midwives and gynecologists interviewed one hundred nineteen pregnant women in a public health center using the KINDEX Spanish Version. Sixty-seven women were then randomly selected to participate in an extended standardized validation interview conducted by a clinical psychologist using established questionnaires to assesses current stress (ESI, PSS-14), symptoms of psychopathology (HSCL-25, PDS) and traumatic experiences (PDS, CFV). Ethical approval was granted and informed consent was required for participation in this study.
The KINDEX sum score, as assessed by medical staff, correlated significantly with stress, psychopathology and trauma as measured during the clinical expert interview. The KINDEX shows strong concurrent validity. Its use by medical staff in daily clinical practice is feasible for public health contexts. Certain items in the KINDEX are related to the respective scales assessing the same risks (e.g.PSS-4 as the shorter version of the PSS-14 and items from the ESI) used in the validation interview.
The KINDEX Spanish Version is a valid tool in the hands of medical staff to identify women with multiple psychosocial risk factors in public health settings. The KINDEX Spanish Version could serve as a base-instrument for the referral of at-risk women to appropriate psychosocial intervention. Such early interventions could prove pivotal in preventing undesirable mother-child relationships and adverse child development.
由于多样化的社会心理因素导致的高水平压力会直接影响孕妇的健康，对胎儿也会产生直接和间接的影响。在大多数情况下，妊娠期间存在的社会心理危险因素在分娩后不会消失，并且可能会影响母婴关系，从而长期影响后代的健康发展。我们引入了一种简短的创新产前评估方法，通过一种易于在日常临床实践中使用的工具，即 KINDEX 西班牙语版，来检测社会心理危险因素。
在本研究中，助产士和妇科医生使用 KINDEX 西班牙语版对一家公共卫生中心的 119 名孕妇进行了访谈。然后，随机选择 67 名妇女参加由临床心理学家使用既定问卷进行的扩展标准化验证访谈，以评估当前的压力（ESI、PSS-14）、精神病理学症状（HSCL-25、PDS）和创伤经历（PDS、CFV）。本研究获得了伦理批准，并要求参与者同意参加。
医务人员评估的 KINDEX 总分与临床专家访谈中测量的压力、精神病理学和创伤显著相关。KINDEX 具有很强的同时效度。在日常临床实践中，医务人员使用它对于公共卫生环境是可行的。KINDEX 中的某些项目与用于验证访谈的评估相同风险的相应量表（例如 PSS-4 作为 PSS-14 的较短版本和 ESI 的项目）相关。
KINDEX 西班牙语版是医务人员在公共卫生环境中识别具有多种社会心理危险因素的妇女的有效工具。KINDEX 西班牙语版可以作为将高危妇女转介给适当的社会心理干预的基础工具。这种早期干预可能对预防不良的母婴关系和儿童发育不良至关重要。
