基于小组的围产期抑郁干预对降低抑郁症状、改善母婴依恋和产妇敏感性的初步研究。
A pilot study of a group-based perinatal depression intervention on reducing depressive symptoms and improving maternal-fetal attachment and maternal sensitivity.
机构信息
University of Virginia School of Nursing, 225 Jeanette Lancaster Avenue, Charlottesville, VA, 22903, USA.
Georgia State University, Urban Life, 140 Decatur Street, Atlanta, GA, 30303, USA.
出版信息
Arch Womens Ment Health. 2021 Feb;24(1):145-154. doi: 10.1007/s00737-020-01032-0. Epub 2020 May 15.
To conduct a pilot study of a group-based perinatal depression intervention, the Mothers and Babies Course, on depressive symptomatology, maternal-fetal attachment, and maternal sensitivity, 60 pregnant women with moderate to severe depressive symptomatology were randomized to a 6-week intervention or usual care group at their initial prenatal care visit. Measures of depressive symptomatology and maternal-fetal attachment were collected at baseline and 36 weeks gestation. At 12 weeks postpartum, participants completed a measure of depressive symptomatology, and an objective measure of maternal sensitivity was collected. Participants randomized to the intervention group completed an average of 5.2 sessions, and 70% of women completed all six sessions. Exploratory analyses showed that at 12 weeks postpartum, participants randomized to the intervention group had an 8.32-point decrease from baseline on the Edinburgh Postnatal Depression Scale (EPDS) as compared to a 4.59-point decrease among participants randomized to usual care. Participants randomized to the intervention group had a mean change score of 12.60 in maternal-fetal attachment via the Maternal Fetal Attachment Scale (MFAS) as compared to 4.60 among participants in usual care. Maternal sensitivity scores, assessed via the Nursing Child Assessment Satellite Training-Feeding Scale (NCAST-Feeding), were higher at 12 weeks postpartum for women in the intervention group as compared to women in usual care (59.2 and 51.8, respectively). Our pilot study findings provide preliminary support for the benefits of a perinatal depression intervention, delivered in a group setting, on reducing depressive symptomatology, and improving maternal-fetal attachment and maternal sensitivity. Further research, conducted with larger samples, is necessary to determine the effect of this intervention on indicators of maternal attachment.
为了对基于小组的围产期抑郁干预措施——“母亲与婴儿课程”进行试点研究，以评估其对抑郁症状、母婴依恋和母亲敏感性的影响，研究人员将 60 名有中重度抑郁症状的孕妇随机分为干预组和常规护理组，在她们初次产前检查时进行分组。在基线和 36 孕周时收集抑郁症状和母婴依恋的测量值。在产后 12 周时，参与者完成了抑郁症状的测量，同时还收集了一项母亲敏感性的客观测量值。随机分配到干预组的参与者平均完成了 5.2 次课程，有 70%的女性完成了全部 6 次课程。探索性分析显示，在产后 12 周时，与常规护理组相比，随机分配到干预组的参与者在爱丁堡产后抑郁量表（EPDS）上的得分从基线下降了 8.32 分，而常规护理组的参与者则下降了 4.59 分。随机分配到干预组的参与者在母婴依恋量表（MFAS）上的母婴依恋平均变化分数为 12.60，而常规护理组的参与者则为 4.60。通过护理婴儿评估卫星培训-喂养量表（NCAST-Feeding）评估的母亲敏感性得分，干预组的得分在产后 12 周时更高，分别为 59.2 和 51.8。我们的试点研究结果初步支持了在小组环境中提供围产期抑郁干预措施的益处，该措施可以降低抑郁症状，改善母婴依恋和母亲敏感性。需要进一步开展更大规模样本的研究，以确定该干预措施对母亲依恋指标的影响。
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