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为抑郁母亲及其婴儿设立的治疗性游戏小组:社区拥抱的可行性研究与初步随机试验

A THERAPEUTIC PLAYGROUP FOR DEPRESSED MOTHERS AND THEIR INFANTS: FEASIBILITY STUDY AND PILOT RANDOMIZED TRIAL OF COMMUNITY HUGS.

作者信息

Ericksen Jennifer, Loughlin Elizabeth, Holt Charlene, Rose Natalie, Hartley Eliza, Buultjens Melissa, Gemmill Alan W, Milgrom Jeannette

机构信息

Parent-Infant Research Institute, Austin Health, Melbourne, Australia.

Melbourne Children's Trial Centre, Murdoch Children's Research Institute, Melbourne, Australia.

出版信息

Infant Ment Health J. 2018 Jul;39(4):396-409. doi: 10.1002/imhj.21723. Epub 2018 Jun 28.

Abstract

Symptoms of depression negatively impact on mother-infant relationships and child outcomes. We evaluated a novel, 10-session mother-infant therapeutic playgroup-Community HUGS (CHUGS)-which combines cognitive and experiential components through psychoeducation, play, music, and movement. Participants were mothers experiencing a range of postnatal mental health difficulties, including depression, with infants ≤12 months of age. However, the aim was not to treat maternal depression but to ameliorate associated problems in the mother-infant interaction. In the feasibility study, all participants received CHUGS. In the pilot randomized controlled trial (RCT), participants were randomized between intervention and a wait-list. Outcomes were the Parenting Stress Index (PSI; R.R. Abidin, 1995), Parenting Sense of Competency Scale (Self-Efficacy subscale; J. Gibaud-Wallston & L.P. Wandersman, 1978), and the Depression, Anxiety, Stress Scales (P.F. Lovibond & S.H. Lovibond, 1995). In the feasibility study (n = 74), PSI scores dropped on all subscales, all ps < .01. Depression, p < .001, anxiety, p = .01, stress, p = .01, and self-efficacy, p < .001, all showed improvements, as did observer-rated mother-infant interactions, p < .001. In the RCT, depression, p < .001, anxiety, p = .005, and stress, p < .001, symptoms were significantly reduced for intervention participants (n = 16), as compared to wait-list participants (n = 15). The CHUGS program had high participant satisfaction and produced improvements in self-efficacy, depression, anxiety, stress, and mother-infant interactions that supported the program's acceptability and the utility of further rollout.

摘要

抑郁症症状会对母婴关系和儿童成长结果产生负面影响。我们评估了一种新颖的、为期10节的母婴治疗性游戏小组——社区拥抱(CHUGS),它通过心理教育、游戏、音乐和运动将认知和体验成分结合在一起。参与者是有一系列产后心理健康问题(包括抑郁症)的母亲及其12个月及以下的婴儿。然而,其目的不是治疗母亲的抑郁症,而是改善母婴互动中的相关问题。在可行性研究中,所有参与者都接受了CHUGS。在初步随机对照试验(RCT)中,参与者被随机分配到干预组和等待名单组。结果指标包括育儿压力指数(PSI;R.R.阿比丁,1995年)、育儿能力感量表(自我效能感子量表;J.吉博德 - 沃尔斯顿和L.P.万德斯曼,1978年)以及抑郁、焦虑、压力量表(P.F.洛维邦德和S.H.洛维邦德,1995年)。在可行性研究(n = 74)中,PSI所有子量表得分均下降,所有p值均 <.01。抑郁,p <.001,焦虑,p =.01,压力,p =.01,以及自我效能感,p <.001,均显示出改善,观察者评定的母婴互动也有改善,p <.001。在RCT中,与等待名单组参与者(n = 15)相比,干预组参与者(n = 16)的抑郁症状,p <.001,焦虑症状,p =.005,和压力症状,p <.001,均显著减轻。CHUGS项目获得了参与者的高度满意度,并在自我效能感、抑郁、焦虑、压力以及母婴互动方面取得了改善,这支持了该项目的可接受性以及进一步推广的实用性。

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