Shorey Shefaly, Ng Esperanza Debby
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
J Med Internet Res. 2019 Aug 29;21(8):e12915. doi: 10.2196/12915.
Social support is known to reduce risks of postnatal depression (PND) and improve maternal emotional well-being. However, the Asian cultural context is often neglected when appraising maternal needs and mothers' preferences for social support. While many preventive efforts have experimented with technology, professionals, and paraprofessionals in providing social support to mothers in need, most studies determined the effectiveness of their interventions through quantitative measurements of maternal outcomes. Experiences and feedback from both participants and administrators are rarely discussed, especially in an Asian setting.
The goal of the research was to evaluate the postnatal experiences of Asian mothers at risk of PND and the perceptions of peer volunteers regarding a technology-based peer-support intervention program (PIP).
A qualitative semistructured interview was conducted with 20 Asian mothers at risk of depression (10 from the control group and 10 from the intervention group) and 19 peer volunteers from a randomized controlled trial. The PIP included weekly correspondence between peer volunteers and mothers through any telecommunication means over 4 weeks. All interviews were approximately 30 to 60 minutes long, audiotaped, transcribed verbatim, and analyzed using thematic analysis. Study findings were reported according to the Consolidated Standards of Reporting Trials checklist.
Two overarching themes comprising five subthemes were generated: postnatal experience (a bouncy ride, a way forward) and evaluation of the PIP (valuable, flexible, and supportive program; building blocks of a good relationship; and lessons learned and the road ahead). Mothers from both the control and interventions groups were generally satisfied with hospital care and the support received from family. They also shared similar breastfeeding challenges and needs for more informed decisions and follow-up support from the hospital. However, mothers who received the PIP tended to have more positive outlooks of their birth experiences. Overall, peer volunteers and mothers involved in the PIP found the PIP useful and expressed satisfaction with the program's flexibility. They also shared their personal takeaways, the qualities of their friendships, and the need for extended correspondence time and recommended outreach to non-at-risk mothers.
The positive endorsement of the PIP by peer volunteers and mothers suggests the success of the PIP in maintaining positive maternal emotional well-being during the postpartum period. With the help of technology, hospitals can easily provide additional peer support to at-risk mothers in addition to existing standard care offered to these mothers.
ISRCTN Registry ISRCTN14864807; http://www.isrctn.com/ISRCTN14864807.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/resprot.9416.
社会支持有助于降低产后抑郁症（PND）风险并改善产妇的情绪健康。然而，在评估产妇需求和母亲对社会支持的偏好时，亚洲文化背景常常被忽视。尽管许多预防措施都尝试利用技术、专业人员和辅助专业人员为有需要的母亲提供社会支持，但大多数研究通过对产妇结局的定量测量来确定干预措施的有效性。参与者和管理人员的经验及反馈很少被讨论，尤其是在亚洲背景下。
本研究旨在评估有产后抑郁症风险的亚洲母亲的产后经历，以及同伴志愿者对基于技术的同伴支持干预项目（PIP）的看法。
对20名有抑郁症风险的亚洲母亲（10名来自对照组，10名来自干预组）和19名来自随机对照试验的同伴志愿者进行了定性半结构化访谈。PIP包括同伴志愿者和母亲在4周内通过任何电信手段进行的每周通信。所有访谈时长约30至60分钟，进行了录音、逐字转录，并采用主题分析法进行分析。研究结果根据《报告试验的统一标准》清单进行报告。
产生了两个总体主题，包含五个子主题：产后经历（一段颠簸的旅程，前进的道路）和对PIP的评价（有价值、灵活且支持性强的项目；良好关系的基石；吸取的教训和未来的道路）。对照组和干预组的母亲对医院护理和家庭给予的支持总体上都很满意。她们还分享了类似的母乳喂养挑战，以及需要医院提供更明智的决策和后续支持。然而，接受PIP的母亲对其分娩经历往往有更积极的看法。总体而言，参与PIP的同伴志愿者和母亲认为PIP有用，并对该项目的灵活性表示满意。他们还分享了个人收获、友谊的特质，以及延长通信时间的需求，并建议向无风险母亲进行推广。
同伴志愿者和母亲对PIP的积极认可表明PIP在产后期间维持产妇积极情绪健康方面取得了成功。借助技术，医院除了为这些母亲提供现有的标准护理外，还可以轻松地为有风险的母亲提供额外的同伴支持。
国际标准随机对照试验编号ISRCTN14864807；http://www.isrctn.com/ISRCTN14864807。
国际注册报告识别码（IRRID）：RR2-10.2196/resprot.9416。
