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基于咨询的心理社会干预改善受虐孕妇的心理健康:尼泊尔东部一所三级医院的随机对照可行性试验方案。

Counselling-based psychosocial intervention to improve the mental health of abused pregnant women: a protocol for randomised controlled feasibility trial in a tertiary hospital in eastern Nepal.

机构信息

School of Nursing and Midwifery, Griffith University, Loganlea, Queensland, Australia.

Women's Wellness Research Program, Menzies Health Institute Queensland, Nathan, Queensland, Australia.

出版信息

BMJ Open. 2019 Apr 23;9(4):e027436. doi: 10.1136/bmjopen-2018-027436.

Abstract

INTRODUCTION

The strong correlation between domestic and family violence (DFV) and mental health has been well documented in studies. Pregnancy is a period when both DFV and mental distress tend to occur and/or accentuate. Although limited, available evidence from developed countries has shown continual support and education as psychological first aid that can reduce DFV and improve mental health. However, there is significantly less number of studies from resource-constrained countries; thus, there continues to be a substantial gap in knowledge and awareness regarding effective interventions for DFV.

METHODS AND ANALYSIS

A two-arm randomised trial with a nested qualitative study has been planned to assess feasibility and treatment effect estimates of a counselling-based psychosocial intervention among pregnant women with a history of abuse. A total of 140 pregnant women who meet the inclusion criteria will be recruited into the study. Block randomisation will be used to allocate women equally into two groups. The intervention group will receive a counselling session, an information booklet and continuous support by a researcher, while women in the control group will receive contact information of local support services. Feasibility measures, such as rates of recruitment, consent and retention, will be calculated. Qualitative interviews with participants and healthcare providers will explore the acceptability and usability of the intervention. Outcome measures, such as psychological distress, quality of life, social support and self-efficacy, will be measured at baseline, 4 weeks postintervention and 6 weeks postpartum.

ETHICS AND DISSEMINATION

This study has obtained ethical approval from the Griffith University Human Research Ethics Committee, the Nepal Health Research Council and the Institutional Review Board of a tertiary hospital in Dharan, Nepal. The findings will be disseminated via peer-reviewed publications and conference presentations and will be used to inform a future multicentre trial.

TRIAL REGISTRATION NUMBER

12618000307202; Pre-results.

摘要

简介

家庭和家庭暴力(DFV)与心理健康之间的强烈相关性在研究中得到了很好的证明。怀孕是家庭暴力和精神困扰倾向于发生和/或加剧的时期。尽管有限,但来自发达国家的现有证据表明,持续的支持和教育作为心理急救,可以减少家庭暴力和改善心理健康。然而,资源有限的国家的研究数量明显较少;因此,关于有效的家庭暴力干预措施,知识和意识仍然存在很大差距。

方法和分析

一项针对有虐待史的孕妇的基于咨询的心理社会干预的可行性和治疗效果评估的两臂随机试验,计划进行嵌套定性研究。符合纳入标准的 140 名孕妇将被纳入研究。采用区组随机化将女性平均分配到两组。干预组将接受咨询、信息手册和研究人员的持续支持,而对照组的女性将获得当地支持服务的联系信息。将计算可行性措施,如招募率、同意率和保留率。对参与者和医疗保健提供者的定性访谈将探讨干预措施的可接受性和可用性。在基线、干预后 4 周和产后 6 周时,将测量心理困扰、生活质量、社会支持和自我效能等结局指标。

伦理和传播

这项研究已获得格里菲斯大学人类研究伦理委员会、尼泊尔卫生研究委员会和尼泊尔 Dharan 一家三级医院的机构审查委员会的伦理批准。研究结果将通过同行评审的出版物和会议报告进行传播,并将用于为未来的多中心试验提供信息。

试验注册号

12618000307202;预结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef3d/6500424/4b809fb775f3/bmjopen-2018-027436f01.jpg

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