EnviHeB Lab., Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal.
Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal.
Int J Environ Res Public Health. 2021 Mar 4;18(5):2558. doi: 10.3390/ijerph18052558.
Women are exposed to increased burden of mental disorders during the perinatal period: 13-19% experience postpartum depression. Perinatal psychological suffering affects early mother-child relationship, impacting child's emotional and cognitive development. Return-to-work brings additional vulnerability given the required balance between parenting and job demands. The MAternal Mental Health in the WORKplace (MAMH@WORK) project aims to develop and evaluate the effectiveness of a brief and sustainable intervention, promoting (a) maternal mental health throughout pregnancy and first 12 months after delivery, and (b) quality of mother-child interactions, child emotional self-regulation, and cognitive self-control, while (c) reducing perinatal absenteeism and presenteeism. MAMH@WORK is a three-arm randomized controlled trial. A short-term cognitive-behavioral therapy-based (CBT-based) psychoeducation plus biofeedback intervention will be implemented by psychiatrists and psychologists, following a standardized procedure manual developed after consensus (Delphi method). Participants ( = 225, primiparous, singleton pregnant women at 28-30 weeks gestational age, aged 18-40 years, employed) will be randomly allocated to arms: CBT-based psychoeducation intervention (including mindfulness); psychoeducation plus biofeedback intervention; and control. Assessments will take place before and after delivery. Main outcomes (and main tools): mental health literacy (MHLS), psychological wellbeing (HADS, EPDS, KBS, CD-RISC, BRIEF COPE), quality of mother-child interaction, child-mother attachment, child emotional self-regulation and cognitive self-control (including PBQ, Strange Situation Procedure, QDIBRB, SGS-II, CARE-Index), job engagement (UWES), and presenteeism. Intention-to-treat and per-protocol analyses will be conducted; Cohen's d coefficient, Cramer's V and odds ratio will be used to assess the effect size of the intervention. MAMH@WORK is expected to contribute to mental health promotion during the perinatal period and beyond. Its results have the potential to inform health policies regarding work-life balance and maternal mental health and wellbeing promotion in the workplace.
13-19%的女性会经历产后抑郁症。围产期心理痛苦会影响早期母婴关系，影响孩子的情感和认知发展。重返工作岗位会带来额外的脆弱性，因为需要在育儿和工作需求之间取得平衡。MAternal Mental Health in the WORKplace (MAMH@WORK) 项目旨在开发和评估一种简短且可持续的干预措施的有效性，该干预措施旨在促进：(a) 整个孕期和分娩后 12 个月内的产妇心理健康；(b) 母婴互动质量、儿童情绪自我调节和认知自我控制；同时，(c) 减少围产期缺勤和在职病假。MAMH@WORK 是一项三臂随机对照试验。短期认知行为疗法为基础的（CBT 为基础的）心理教育加生物反馈干预将由精神科医生和心理学家按照经过共识（德尔菲法）制定的标准化程序手册实施。参与者（= 225 名初产妇、单胎妊娠 28-30 周、年龄 18-40 岁、就业）将随机分配到以下三组：CBT 为基础的心理教育干预（包括正念）；心理教育加生物反馈干预；和对照组。评估将在分娩前后进行。主要结局（和主要工具）：心理健康素养（MHLS）、心理幸福感（HADS、EPDS、KBS、CD-RISC、BRIEF COPE）、母婴互动质量、母婴依恋、儿童情绪自我调节和认知自我控制（包括 PBQ、陌生情境程序、QDIBRB、SGS-II、CARE-Index）、工作投入（UWES）和在职病假。将进行意向治疗和方案分析；将使用 Cohen's d 系数、Cramer's V 和优势比来评估干预效果的大小。MAMH@WORK 有望促进围产期及以后的心理健康。其结果有可能为工作生活平衡和促进工作场所产妇心理健康和福祉的卫生政策提供信息。
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