NICM, Western Sydney University, Sydney, NSW, Australia.
School of Nursing and Midwifery, Western Sydney University, Sydney, NSW, Australia.
Women Birth. 2018 Jun;31(3):166-176. doi: 10.1016/j.wombi.2017.09.018. Epub 2017 Sep 29.
Treatment strategies for the management of antenatal depression are limited by varied and often modest response rates, unpleasant medication side effects and uncertainty regarding foetal safety. Consequently, many pregnant women experiencing depression seek alternative non-pharmaceutical options. Acupuncture may provide a safe and potentially effective additional treatment, however further investigation is required. In this qualitative study, we explored the views of health professionals regarding the possible incorporation of acupuncture into mainstream care.
Two separate focus groups were run with 16 midwives. In-depth interviews were conducted with two maternity service managers and nine doctors (3 obstetricians, 2 psychiatrists and 4 general practitioners). Data was analysed using thematic analysis.
Participants were generally positive about acupuncture and open to its possible inclusion in conventional care, on the proviso that it was safe and could be shown to be effective. The overarching theme to emerge was 'acupuncture for antenatal depression: it's worth giving it a go', which participants concluded after considering 'the dilemma of mental health' treatment during the antenatal period and the additional limitations this presented, along with the belief that 'if it doesn't do any harm, I'm not against it'. Practical considerations regarding potential 'barriers' and facilitators' to implementation were additionally explored in 'making it mainstream', whereby the different 'philosophical beliefs' held by participants were seen to influence perspectives.
Participants expressed an overall positive attitude towards the possible inclusion of acupuncture into mainstream care for antenatal depression, suggesting various hospital barriers could be overcome with further safety and effectiveness evidence.
产前抑郁症管理的治疗策略受到反应率不同且通常较低、药物副作用令人不快以及对胎儿安全性不确定等因素的限制。因此，许多患有抑郁症的孕妇会寻求替代的非药物选择。针灸可能提供一种安全且潜在有效的附加治疗方法，但需要进一步研究。在这项定性研究中，我们探讨了卫生专业人员对将针灸纳入主流治疗的看法。
我们与 16 名助产士进行了两次单独的焦点小组讨论。对两名产妇服务经理和 9 名医生（3 名产科医生、2 名精神科医生和 4 名全科医生）进行了深入访谈。使用主题分析对数据进行分析。
参与者对针灸普遍持积极态度，并对将其纳入常规护理持开放态度，前提是针灸安全且可以证明有效。出现的首要主题是“针灸治疗产前抑郁症：值得一试”，参与者在考虑产前期间心理健康治疗的“困境”及其带来的额外限制后得出了这一结论，并认为“如果它没有造成任何伤害，我不反对它”。参与者还探讨了在“将其纳入主流”中实施的潜在“障碍”和“促进因素”的实际考虑因素，参与者所持有的不同“哲学信仰”被认为会影响观点。
参与者对将针灸纳入主流治疗产前抑郁症的态度总体上是积极的，这表明可以通过进一步的安全性和有效性证据克服医院的各种障碍。
