Hanschmidt Franz, Hoffmann Rahel, Klingner Johanna, Kersting Anette, Stepan Holger
Department of Psychosomatic Medicine, University of Leipzig, Leipzig, Germany.
Department of Obstetrics, University of Leipzig, Leipzig, Germany.
Geburtshilfe Frauenheilkd. 2018 Feb;78(2):160-166. doi: 10.1055/s-0044-100380. Epub 2018 Feb 19.
Diagnosis of fetal anomaly and the difficult circumstances involved in the decision to terminate an affected pregnancy can go along with severe psychological distress. However, little is known about women's help-seeking for emotional problems following an abortion after diagnosis of fetal anomaly.
148 women who had been treated for abortion after diagnosis of fetal anomaly at the University Hospital Leipzig responded to self-report questionnaires 1 to 7 years after the event. Main outcomes were help-seeking intentions and actual help-seeking behavior. Logistic regression was used to explore the associations between participants' sociodemographic characteristics and help-seeking intentions.
Most women reported that they would seek help from their partner (91.7%), friends/family (82.8%) or the internet (62.2%). With regard to health services, 50.0% of women would seek help from gynecologists and between 43.8 and 47.9% from counseling services and mental health professionals. Intentions to seek help from support groups were lowest (21.7%). Age, income, region, and religion were associated with help-seeking intentions. Among participants with elevated levels of current psychological distress, 23.8% indicated that they had not discussed their emotional problems with a health service ever.
Gynecologists are among the most preferred health professionals for women to discuss psychological problems in the aftermath of an abortion after diagnosis of fetal anomaly. They should be actively involved in screening, diagnostic assessment, and referral of affected women.
胎儿异常的诊断以及终止受影响妊娠这一艰难决定所涉及的各种情况，可能会伴随严重的心理困扰。然而，对于在诊断胎儿异常后堕胎的女性在情感问题上寻求帮助的情况，我们知之甚少。
148名在莱比锡大学医院诊断胎儿异常后接受堕胎治疗的女性，在事件发生1至7年后对自我报告问卷做出了回应。主要结果是寻求帮助的意向和实际寻求帮助的行为。采用逻辑回归分析来探讨参与者的社会人口学特征与寻求帮助意向之间的关联。
大多数女性表示她们会向伴侣（91.7%）、朋友/家人（82.8%）或互联网（62.2%）寻求帮助。在健康服务方面，50.0%的女性会向妇科医生寻求帮助，43.8%至47.9%的女性会向咨询服务机构和心理健康专业人员寻求帮助。向支持小组寻求帮助的意向最低（21.7%）。年龄、收入、地区和宗教与寻求帮助的意向有关。在当前心理困扰程度较高的参与者中，23.8%表示她们从未与健康服务机构讨论过自己的情感问题。
对于在诊断胎儿异常后堕胎的女性来说，妇科医生是她们最愿意与之讨论心理问题的健康专业人员之一。妇科医生应积极参与对受影响女性的筛查、诊断评估和转诊工作。
