Leinweber Julia, Creedy Debra K, Rowe Heather, Gamble Jenny
Protestant University of Applied Sciences Berlin, Teltower Damm 118, 14167 Berlin, Germany.
Menzies Health Institute Queensland, Griffith University, Logan campus, University Drive, Meadowbrook, QLD 4131 Brisbane, Queensland, Australia.
Midwifery. 2017 Feb;45:7-13. doi: 10.1016/j.midw.2016.12.001. Epub 2016 Dec 6.
to develop a comprehensive model of personal, trauma event-related and workplace-related risk factors for posttraumatic stress subsequent to witnessing birth trauma among Australian midwives.
a descriptive, cross-sectional design was used.
members of the Australian College of Midwives were invited to complete an online survey.
the survey included items about witnessing a traumatic birth event and previous experiences of life trauma. Trauma symptoms were assessed with the Posttraumatic Stress Disorder Symptom Scale Self-Report measure. Empathy was assessed with the Interpersonal Reactivity Index. Decision authority and psychological demand in the workplace were measured with the Job Content Questionnaire. Variables that showed a significant univariate association with probable posttraumatic stress disorder were entered into a multivariate logistic regression model.
601 completed survey responses were analysed. The multivariable model was statistically significant and explained 27.7% (Nagelkerke R square) of the variance in posttraumatic stress symptoms and correctly classified 84.1% of cases. Odds ratios indicated that intention to leave the profession, a peritraumatic reaction of horror, peritraumatic feelings of guilt, and a personal traumatic birth experience were strongly associated with probable Posttraumatic Stress Disorder.
risk factors for posttraumatic stress following professional exposure to traumatic birth events among midwives are complex and multi-factorial. Posttraumatic stress may contribute to attrition in midwifery. Trauma-informed care and practice may reduce the incidence of traumatic births and subsequent posttraumatic stress reactions in women and midwives providing care.
建立一个综合模型，以探讨澳大利亚助产士目睹分娩创伤后创伤后应激障碍的个人、创伤事件相关和工作场所相关风险因素。
采用描述性横断面设计。
邀请澳大利亚助产士学院的成员完成一项在线调查。
该调查包括有关目睹创伤性分娩事件和既往生活创伤经历的项目。创伤症状采用创伤后应激障碍症状量表自评测量。共情能力采用人际反应指数进行评估。工作场所的决策权力和心理需求采用工作内容问卷进行测量。将与可能的创伤后应激障碍有显著单变量关联的变量纳入多变量逻辑回归模型。
对601份完整的调查回复进行了分析。多变量模型具有统计学意义，解释了创伤后应激症状方差的27.7%（Nagelkerke R方），并正确分类了84.1%的病例。优势比表明，离开该职业的意愿、创伤时的恐惧反应、创伤时的内疚感以及个人创伤性分娩经历与可能的创伤后应激障碍密切相关。
助产士在职业中接触创伤性分娩事件后创伤后应激障碍的风险因素复杂且多因素。创伤后应激可能导致助产士职业流失。创伤知情护理和实践可能会降低妇女和提供护理的助产士中创伤性分娩及随后创伤后应激反应的发生率。
