降低紧急剖宫产术后侵入性创伤记忆：一项原理验证性随机对照研究。

Reducing intrusive traumatic memories after emergency caesarean section: A proof-of-principle randomized controlled study.

作者信息

Horsch Antje, Vial Yvan, Favrod Céline, Harari Mathilde Morisod, Blackwell Simon E, Watson Peter, Iyadurai Lalitha, Bonsall Michael B, Holmes Emily A

机构信息

Department Woman-Mother-Child, University Hospital Lausanne, Lausanne, Switzerland; Department of Endocrinology, Diabetes, and Metabolism, University Hospital Lausanne, Lausanne, Switzerland.

Department Woman-Mother-Child, University Hospital Lausanne, Lausanne, Switzerland.

出版信息

Behav Res Ther. 2017 Jul;94:36-47. doi: 10.1016/j.brat.2017.03.018. Epub 2017 Apr 6.

UNLABELLED

Preventative psychological interventions to aid women after traumatic childbirth are needed. This proof-of-principle randomized controlled study evaluated whether the number of intrusive traumatic memories mothers experience after emergency caesarean section (ECS) could be reduced by a brief cognitive intervention. 56 women after ECS were randomized to one of two parallel groups in a 1:1 ratio: intervention (usual care plus cognitive task procedure) or control (usual care). The intervention group engaged in a visuospatial task (computer-game 'Tetris' via a handheld gaming device) for 15 min within six hours following their ECS. The primary outcome was the number of intrusive traumatic memories related to the ECS recorded in a diary for the week post-ECS. As predicted, compared with controls, the intervention group reported fewer intrusive traumatic memories (M = 4.77, SD = 10.71 vs. M = 9.22, SD = 10.69, d = 0.647 [95% CI: 0.106, 1.182]) over 1 week (intention-to-treat analyses, primary outcome). There was a trend towards reduced acute stress re-experiencing symptoms (d = 0.503 [95% CI: -0.032, 1.033]) after 1 week (intention-to-treat analyses). Times series analysis on daily intrusions data confirmed the predicted difference between groups. 72% of women rated the intervention "rather" to "extremely" acceptable. This represents a first step in the development of an early (and potentially universal) intervention to prevent postnatal posttraumatic stress symptoms that may benefit both mother and child.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov, www.clinicaltrials.gov, NCT02502513.

未标注

需要采取预防性心理干预措施来帮助经历过创伤性分娩的女性。这项原理验证性随机对照研究评估了通过简短的认知干预，能否减少母亲在紧急剖宫产（ECS）后经历的侵入性创伤记忆的数量。56名ECS术后的女性按1:1比例随机分为两个平行组：干预组（常规护理加认知任务程序）或对照组（常规护理）。干预组在ECS术后6小时内通过手持游戏设备进行15分钟的视觉空间任务（电脑游戏“俄罗斯方块”）。主要结局是ECS术后一周内日记中记录的与ECS相关的侵入性创伤记忆的数量。正如预期的那样，与对照组相比，干预组在1周内报告的侵入性创伤记忆较少（意向性分析，主要结局：M = 4.77，SD = 10.71 vs. M = 9.22，SD = 10.69，d = 0.647 [95% CI：0.106，1.182]）。1周后有急性应激再体验症状减轻的趋势（意向性分析，d = 0.503 [95% CI：-0.032，1.033]）。对每日侵入数据的时间序列分析证实了组间的预期差异。72%的女性对干预的评价为“相当”到“极其”可接受。这代表了开发一种早期（可能具有普遍性）干预措施以预防产后创伤后应激症状的第一步，这可能对母亲和孩子都有益。