Department of Psychology, Western Washington University, Bellingham, WA, USA.
Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
Arch Womens Ment Health. 2021 Aug;24(4):595-603. doi: 10.1007/s00737-020-01101-4. Epub 2021 Jan 15.
Listening Visits are a non-directive counseling intervention delivered by nurses to depressed postpartum women. In 2007, Listening Visits were listed as a recommended treatment in British national guidelines. They were removed from the guideline update, due to the small effect size drawn from a meta-analysis of five clinical trials with depressed and non-depressed postpartum women. The purpose of this meta-analysis is to provide an estimate of the true population effect of Listening Visits as a treatment for maternal depression compared to control conditions. A meta-analytic review was conducted of studies published before October 2020. Inclusion criteria required that the study was a pragmatic or randomized trial of Listening Visits delivered by non-mental health specialists to mothers with elevated symptoms of maternal depression. Post-treatment depression rates for the treatment and control groups were extracted from eligible studies. Six studies met eligibility criteria which included 703 participants. Analyses of observed effect sizes corrected for study artifacts revealed an estimate of 0.66 (95% CI: 0.32, 0.99) with high heterogeneity (Q = 17.95, p = 0.003, I = 72.14). After removing outliers and addressing heterogeneity across observed effect sizes, the meta-analytic estimate across four methodologically similar studies and 651 participants was 0.43 (95% CI: 0.24, 0.62). The moderate effect size for Listening Visits, considered together with the advantages afforded by how, where, and who provides this treatment, supports Listening Visits as a first-line intervention in a stepped care approach for mothers with mild to moderately severe depression symptoms.
倾听探访是一种非指导性的咨询干预措施，由护士提供给产后抑郁的女性。2007 年，倾听探访被列入英国国家指南的推荐治疗方法。由于五项针对抑郁和非抑郁产后女性的临床试验的荟萃分析得出的效果大小较小，因此在指南更新中删除了它们。本荟萃分析的目的是提供一个真实的人群效应估计，即与对照条件相比，倾听探访作为一种治疗产妇抑郁症的方法。对 2020 年 10 月之前发表的研究进行了荟萃分析审查。纳入标准要求该研究是一项由非心理健康专家对有较高产后抑郁症状的母亲进行的倾听探访的实用或随机试验。从合格研究中提取治疗组和对照组的治疗后抑郁率。六项研究符合纳入标准，包括 703 名参与者。对校正了研究人工制品的观察到的效应大小进行分析，结果表明，治疗组和对照组的估计值为 0.66（95%置信区间：0.32，0.99），异质性很高（Q=17.95，p=0.003，I=72.14）。在去除异常值并解决观察到的效应大小之间的异质性后，四项方法学相似的研究和 651 名参与者的荟萃分析估计值为 0.43（95%置信区间：0.24，0.62）。考虑到倾听探访的中等效应大小，以及这种治疗的提供方式、地点和提供者带来的优势，支持将倾听探访作为轻度至中度严重抑郁症状的母亲的阶梯式护理方法中的一线干预措施。
