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一项预防产后父母心理困扰并促进婴儿福祉的心理教育干预措施的有效性:一项随机对照试验的研究方案

Effectiveness of a psycho-educational intervention to prevent postpartum parental distress and enhance infant well-being: study protocol of a randomized controlled trial.

作者信息

Missler Marjolein, Beijers Roseriet, Denissen Jaap, van Straten Annemieke

机构信息

Department of Clinical, Neuro and Developmental Psychology and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.

Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands.

出版信息

Trials. 2018 Jan 4;19(1):4. doi: 10.1186/s13063-017-2348-y.

Abstract

BACKGROUND

The first months after birth can be challenging for parents, leading to parental distress and decreased well-being. Parents with high levels of distress are found to respond less adequately and sensitively to their infant, which in turn affects infant well-being and health. The goal of this study is to examine the effectiveness of a psycho-educational intervention to prevent postpartum parental distress and enhance the quality of caregiving and infant well-being. In contrast to other interventions, this intervention will be (1) offered already before birth, (2) offered to all parents-to-be, regardless of their risk of postpartum distress, and (3) include fathers. The proposed study examines the effectiveness of this intervention on (1) parenting distress, (2) quality of caregiving, and (3) the infant's well-being.

METHODS/DESIGN: In this randomized controlled trial, 128 pregnant women and their partners will be recruited through midwifery practices and general media. Women with a complicated pregnancy, current psychopathology, insufficient Dutch language proficiency and without Internet access will be excluded. Parents will be randomized to either the intervention or a waitlist control group. The intervention consists of a booklet and video (offered prenatally), a home visit at 34-36 weeks of pregnancy and a telephone call 4 weeks after birth. Information and practical tools are provided on (1) sensitive responding and making contact with the baby, (2) crying, (3) feeding, and (4) sleeping. Assessments will take place at baseline (26-34 weeks of pregnancy), during the home visit (34-36 weeks of pregnancy), and 2, 6, and 10 weeks after birth. The control group will be offered the intervention after the end of the study. The primary outcome is maternal parenting stress. Secondary outcomes are: paternal parenting stress, parental well-being, quality of caregiving, and infant well-being and health.

DISCUSSION

The goal of this study is to test the effects of a psycho-educational prenatal parenting intervention to prevent postpartum parental distress and to enhance well-being in both parents and infants. When the intervention appears effective it can be implemented broadly because of its low costs. It will make support available for a large number of parents and their children.

TRIAL REGISTRATION

Netherlands National Trial Register, ID: NTR6065 . Registered on 15 September 2016.

摘要

背景

婴儿出生后的头几个月对父母来说可能具有挑战性,会导致父母苦恼和幸福感下降。研究发现,苦恼程度高的父母对婴儿的反应不够充分和敏感,这反过来又会影响婴儿的幸福感和健康。本研究的目的是检验一项心理教育干预措施在预防产后父母苦恼、提高照料质量和婴儿幸福感方面的有效性。与其他干预措施不同的是,这项干预措施将:(1)在婴儿出生前就提供;(2)提供给所有准父母,无论其产后苦恼风险如何;(3)将父亲纳入其中。拟开展的研究将检验该干预措施对以下方面的有效性:(1)育儿苦恼;(2)照料质量;(3)婴儿的幸福感。

方法/设计:在这项随机对照试验中,将通过助产机构和大众媒体招募128名孕妇及其伴侣。患有复杂妊娠、目前存在精神病理学问题、荷兰语水平不足以及无法上网的女性将被排除。父母将被随机分为干预组或等待名单对照组。干预措施包括一本手册和一段视频(产前提供)、在怀孕34至36周时进行一次家访以及在婴儿出生后4周进行一次电话随访。内容包括:(1)敏感回应和与婴儿接触;(2)哭闹;(3)喂养;(4)睡眠方面的信息和实用工具。评估将在基线期(怀孕26至34周)、家访期间(怀孕34至36周)以及出生后2周、6周和10周进行。对照组将在研究结束后接受干预措施。主要结局是母亲的育儿压力。次要结局包括:父亲的育儿压力、父母的幸福感、照料质量以及婴儿的幸福感和健康状况。

讨论

本研究的目的是测试一项心理教育产前育儿干预措施在预防产后父母苦恼以及提高父母和婴儿幸福感方面的效果。如果该干预措施被证明有效,因其成本低廉,可广泛实施。这将为大量父母及其子女提供支持。

试验注册

荷兰国家试验注册库,编号:NTR6065。于2016年9月15日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f74/5753513/28a34953fb1a/13063_2017_2348_Fig1_HTML.jpg

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