Beattie Jill, Hall Helen, Biro Mary Anne, East Christine, Lau Rosalind
School of Nursing and Midwifery, Monash University, Building E, McMahons Road, Frankston, Victoria 3199, Australia.
School of Nursing and Midwifery, Monash University, Building E, McMahons Road, Frankston, Victoria 3199, Australia; Monash Women's Maternity Services, Birth Suite, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia.
Midwifery. 2017 Jul;50:174-183. doi: 10.1016/j.midw.2017.04.006. Epub 2017 Apr 22.
To determine the feasibility and acceptability and measure the effects of a mindfulness intervention compared to a pregnancy support program on stress, depressive symptoms and awareness of present moment experience.
A pilot randomised trial using mixed methods.
Forty-eight women attending a maternity service were randomly allocated to a mindfulness-based or pregnancy support program.
Perceived Stress Scale, Edinburgh Postnatal Depression Scale, Mindfulness Attention Awareness Scale, and Birth Outcomes. Women's perceptions of the impact of the programs were examined via summative evaluation, interviews, diaries and facilitator field notes.
Nine women in the mindfulness program and 11 in the pregnancy support program completed post-program measures. There were no statistically significant differences between groups. Of practical significance, was an improvement in measures for both groups with a greater improvement in awareness of present moment experience for the intervention group. The intervention group reported learning how to manage stressors, fear, anxiety, and to regulate their attention to be more present. The control group reported learning how to calm down when stressed which increased their confidence. Intervention group themes were: releasing stress, becoming aware, accepting, having options and choices, connecting and being compassionate. Control group themes were:managing stress, increasing confidence, connecting, focussing, being accepted, preparing.
The feasibility and acceptability of the intervention was confirmed. Programs decreased women's self-reported stress in different ways. Women in the mindfulness program accepted themselves and their experiences as they arose and passed in the present moment, while those in the control group gained acceptance primarily from external sources such as peers.
Mindfulness programs can foster an internalised locus of self-acceptance which may result in woman becoming less dependent on others for their wellbeing. Adequately powered RCTs, with an active control, long-term follow up and economic evaluation are recommended.
确定正念干预与孕期支持计划相比，在减轻压力、抑郁症状以及测量当下体验意识方面的可行性、可接受性及效果。
采用混合方法的试点随机试验。
48名前往产科服务机构就诊的女性被随机分配至正念干预组或孕期支持计划组。
感知压力量表、爱丁堡产后抑郁量表、正念注意力觉知量表及分娩结局。通过总结性评估、访谈、日记及主持人现场记录来考察女性对各计划影响的看法。
正念干预组9名女性及孕期支持计划组11名女性完成了计划后的测量。两组之间无统计学显著差异。具有实际意义的是，两组的测量指标均有改善，干预组在当下体验意识方面的改善更为明显。干预组报告称学会了如何应对压力源、恐惧、焦虑，并调节注意力以更专注于当下。对照组报告称学会了在压力下如何冷静下来，这增强了她们的信心。干预组的主题有：释放压力、增强意识、接纳、拥有选择、建立联系和富有同情心。对照组的主题有：管理压力、增强信心、建立联系、集中注意力、被接纳、做好准备。
证实了该干预的可行性和可接受性。各计划以不同方式减轻了女性自我报告的压力。正念干预组的女性在当下体验出现和消逝时接受自己及自身经历，而对照组女性主要从同伴等外部来源获得接纳。
正念计划可培养内在的自我接纳轨迹，这可能使女性在幸福感方面减少对他人的依赖。建议开展有充分效力的随机对照试验，设置积极对照组、进行长期随访及经济评估。
