Vignato Julie, Georges Jane M, Bush Ruth A, Connelly Cynthia D
College of Nursing, University of Iowa, Iowa City, IA, USA.
Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, San Diego, CA, USA.
J Clin Nurs. 2017 Dec;26(23-24):3859-3868. doi: 10.1111/jocn.13800. Epub 2017 May 23.
To report an analysis of the concept of perinatal post-traumatic stress disorder.
Prevalence of perinatal post-traumatic stress disorder is rising in the USA, with 9% of the U.S. perinatal population diagnosed with the disorder and an additional 18% being at risk for the condition. Left untreated, adverse maternal-child outcomes result in increased morbidity, mortality and healthcare costs.
Concept analysis via Walker and Avant's approach.
The databases Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Academic Search Premier and PsychINFO were searched for articles, written in English, published between 2006-2015, containing the terms perinatal and post-traumatic stress disorder.
Perinatal post-traumatic stress disorder owns unique attributes, antecedents and outcomes when compared to post-traumatic stress disorder in other contexts, and may be defined as a disorder arising after a traumatic experience, diagnosed any time from conception to 6 months postpartum, lasting longer than 1 month, leading to specific negative maternal symptoms and poor maternal-infant outcomes. Attributes include a diagnostic time frame (conception to 6 months postpartum), harmful prior or current trauma and specific diagnostic symptomatology defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Antecedents were identified as trauma (perinatal complications and abuse), postpartum depression and previous psychiatric history. Consequences comprised adverse maternal-infant outcomes.
Further research on perinatal post-traumatic stress disorder antecedents, attributes and outcomes in ethnically diverse populations may provide clinicians a more comprehensive framework for identifying and treating perinatal post-traumatic stress disorder.
Nurses are encouraged to increase their awareness of perinatal post-traumatic stress disorder for early assessment and intervention, and prevention of adverse maternal-infant outcomes.
报告对围产期创伤后应激障碍概念的分析。
在美国，围产期创伤后应激障碍的患病率正在上升，9%的美国围产期人群被诊断患有该疾病，另有18%有患病风险。若不治疗，母婴不良结局会导致发病率、死亡率上升以及医疗成本增加。
采用沃克和阿万特的方法进行概念分析。
检索护理及相关健康文献累积索引数据库（CINAHL）、医学索引数据库（Medline）、学术搜索高级版数据库和心理学文摘数据库（PsychINFO），查找2006年至2015年间发表的英文文章，这些文章需包含“围产期”和“创伤后应激障碍”这两个术语。
与其他情况下的创伤后应激障碍相比，围产期创伤后应激障碍具有独特的属性、前因和后果，可被定义为创伤经历后出现的一种疾病，在从受孕到产后6个月的任何时间被诊断，持续时间超过1个月，导致特定的母亲负面症状和母婴不良结局。属性包括诊断时间范围（受孕到产后6个月）、有害的既往或当前创伤以及《精神疾病诊断与统计手册（第5版）》中定义的特定诊断症状。前因被确定为创伤（围产期并发症和虐待）、产后抑郁和既往精神病史。后果包括母婴不良结局。
对不同种族人群围产期创伤后应激障碍的前因、属性和后果进行进一步研究，可能会为临床医生提供一个更全面的框架，用于识别和治疗围产期创伤后应激障碍。
鼓励护士提高对围产期创伤后应激障碍的认识，以便进行早期评估和干预，预防母婴不良结局。
