de Wolff Mie, Ersbøll Anne Schjødt, Hegaard Hanne, Johansen Marianne, Gustafsson Finn, Damm Peter, Midtgaard Julie
Research Unit Women's and Children's Health, The Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Section 7821, Blegdamsvej 9, 2100 Copenhagen, Denmark; Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Blegdamevej 9, 2100 Copenhagen, Denmark; Department of Obstetrics, Hvidovre Hospital, Kettegaards Allé 30, 2650 Hvidovre, Denmark.
Research Unit Women's and Children's Health, The Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Section 7821, Blegdamsvej 9, 2100 Copenhagen, Denmark; Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Blegdamevej 9, 2100 Copenhagen, Denmark; Center for Pregnancy and Heart Disease, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, Denmark.
Midwifery. 2018 Jul;62:52-60. doi: 10.1016/j.midw.2018.03.012. Epub 2018 Mar 27.
Peripartum cardiomyopathy (PPCM) is a rare and potentially life-threatening condition of heart failure affecting women with no previous heart disease in the last months of pregnancy and up to six months after childbirth.
To explore women's experiences of the process of regaining psychological balance and wellbeing (i.e. psychological adaptation) after having experienced severe peripartum morbidity.
A qualitative exploratory research design was applied to guide the study. Data was collected through in-depth, semi-structured, face-toface telephone and e-mail interviews. Thematic analysis was applied in the data analysis.
The study was a sub-study of a larger nationwide research study investigating the incidence and clinical outcome of peripartum cardiomyopathy in Denmark during a ten-year period of 2005-2014.
Through a criterion-based sampling strategy, 14 Danish women with peripartum cardiomyopathy were recruited for participation in the study. In relation to severity of disease, demographics and pregnancy related characteristic, the sample showed a wide range of diversity.
The overarching theme of the thematic analysis was identified to be Recovering to a new normal after peripartum cardiomyopathy. The overarching theme was comprised by five main themes: Losing trust, Silence after chaos, Disrupted early mothering, Choices made for me and not by me, and Ability to mobilize inner resources.
Findings from this study suggest that women are vulnerable in the time after PPCM diagnosis and struggle to find psychological balance in their life. The need for professional psychological support was often unmet and the physical symptoms were foregrounded in the recovery period. After PPCM, follow-up on psychological wellbeing and morbidity should be offered to women routinely.
围产期心肌病（PPCM）是一种罕见且可能危及生命的心力衰竭病症，影响着孕期最后几个月及产后六个月内既往无心脏病史的女性。
探讨经历严重围产期发病情况后女性恢复心理平衡和幸福感（即心理适应）过程中的体验。
采用定性探索性研究设计指导本研究。通过深入、半结构化的面对面电话和电子邮件访谈收集数据。数据分析采用主题分析法。
本研究是一项更大规模的全国性研究的子研究，该研究调查了2005 - 2014年十年间丹麦围产期心肌病的发病率和临床结局。
通过基于标准的抽样策略，招募了14名患有围产期心肌病的丹麦女性参与本研究。在疾病严重程度、人口统计学和妊娠相关特征方面，样本呈现出广泛的多样性。
主题分析的总体主题被确定为围产期心肌病后恢复到新的正常状态。总体主题由五个主要主题组成：失去信任、混乱后的沉默、早期育儿中断、为我而非由我做出的选择以及调动内在资源的能力。
本研究结果表明，女性在围产期心肌病诊断后的一段时间内较为脆弱，努力在生活中寻找心理平衡。专业心理支持的需求往往未得到满足，且身体症状在恢复期较为突出。围产期心肌病后，应常规为女性提供心理健康和发病情况的随访。
