Nieminen Katri, Andersson Gerhard, Wijma Barbro, Ryding Elsa-Lena, Wijma Klaas
a Unit of Medical Psychology, Department of Clinical and Experimental Medicine, Faculty of Medicine and Health Sciences , Linköping University , Linköping , Sweden .
b Department of Obstetrics and Gynaecology , Vrinnevi Hospital , Norrköping , Sweden .
J Psychosom Obstet Gynaecol. 2016;37(2):37-43. doi: 10.3109/0167482X.2016.1140143. Epub 2016 Feb 26.
The aim of the present study was to test the feasibility of Internet interventions among nulliparous women suffering from severe fear of childbirth (FOC) by means of an Internet-delivered therapist-supported self-help program based on cognitive behavioral therapy (ICBT).
Prospective, longitudinal cohort study.
A feasibility study of an ICBT program for the treatment of severe FOC in pregnant women.
Twenty-eight Swedish-speaking nulliparous women with severe FOC recruited via a project home page from January 2012 to December 2013.
The main components of the ICBT program for the treatment of severe FOC comprised psycho-education, breathing retraining, cognitive restructuring, imaginary exposure, in vivo exposure and relapse prevention. The study participants were anonymously self-recruited over the Internet, interviewed by telephone and then enrolled. All participants were offered 8 weeks of treatment via the Internet. Participants reported their homework weekly, submitted measurements of their fear and received feedback from a therapist via a secure online contact management system.
Level of FOC measured with the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ A) during screening at enrollment and weekly during the treatment (W-DEQ version A), and after the delivery (W-DEQ version B).
A statistically significant (p < 0.0005) decrease of FOC [W-DEQ sum score decreased pre to post-therapy, with a large effect size (Cohen's d = 0.95)].
The results of this feasibility study suggest that ICBT has potential in the treatment of severe FOC during pregnancy in motivated nulliparous women. The results need to be confirmed by randomized controlled studies.
本研究旨在通过基于认知行为疗法的互联网提供的治疗师支持自助项目（ICBT），测试互联网干预对患有严重分娩恐惧（FOC）的未生育女性的可行性。
前瞻性纵向队列研究。
一项针对孕妇严重FOC治疗的ICBT项目的可行性研究。
2012年1月至2013年12月通过项目主页招募的28名讲瑞典语的患有严重FOC的未生育女性。
治疗严重FOC的ICBT项目的主要组成部分包括心理教育、呼吸再训练、认知重构、想象暴露、现场暴露和复发预防。研究参与者通过互联网匿名自荐，接受电话访谈，然后登记入组。所有参与者通过互联网接受为期8周的治疗。参与者每周报告家庭作业，提交恐惧测量结果，并通过安全的在线联系管理系统接收治疗师的反馈。
在入组筛查时、治疗期间每周（W-DEQ A版）以及分娩后（W-DEQ B版），使用Wijma分娩预期/体验问卷（W-DEQ A）测量FOC水平。
FOC有统计学显著下降（p < 0.0005）[W-DEQ总分在治疗前后下降，效应量较大（Cohen's d = 0.95）]。
这项可行性研究的结果表明，ICBT在治疗有积极性的未生育女性孕期严重FOC方面具有潜力。结果需要通过随机对照研究来证实。
