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评估澳大利亚患有中重度围产期精神疾病的母亲及其婴儿的合作小组干预措施。

Evaluation of a collaborative group intervention for mothers with moderate to severe perinatal mental illness and their infants in Australia.

机构信息

Queensland Centre for Perinatal and Infant Mental Health, Child and Youth Mental Health, Children's Health Queensland Hospital and Health Service, Brisbane, Australia.

Children's Health Queensland Child and Youth Mental Health Service Academic Research Unit, Children's Health Research Centre, South Brisbane, Australia.

出版信息

Infant Ment Health J. 2021 Jul;42(4):560-572. doi: 10.1002/imhj.21922. Epub 2021 Jun 25.

Abstract

Perinatal mental illness is a known risk to maternal-infant attachment and healthy infant development. Mothers experiencing complex mental health issues in the first year following birth are less likely to become involved in parenting programs or day stay interventions because of their mental health difficulties and perceived stigma. Currently, most perinatal day or group treatment programs only include the mother and not their infant. This paper describes "Together in Mind," a perinatal and infant mental health day program developed by the Queensland Centre for Perinatal and Infant Mental Health, targeting mothers with moderate to severe mental illness and their infants under 12 months. The service model was a 6-week, 1 day per week psychoeducation intervention. Psychoeducational material and support were provided across each day session by an adult perinatal mental health clinician, an infant mental health clinician, and a child health nurse working in collaboration. The program was trialed across seven Hospital and Health Service sites in Queensland, Australia, during 2016-18. In total, 24 group day programs were delivered with 84 mothers and their infants. Pre and post intervention quantitative measures and a post-program qualitative survey about participant satisfaction were collected. Statistically significant improvements in all quantitative measures showed a large to medium effect size on the: Health of the Nation Outcome Scale (HoNOS) (d = 0.82; p < .000); Depression, Anxiety and Stress Scale (DASS-21) (d = 0.5; p < .000); Karitane Parenting Confidence Scale (KPCS) (d = 0.63; p < .000); Maternal Postnatal Attachment Scale (MPAS) (d = 0.49; p < .000), Ages and Stages Questionnaire: Social-Emotional (6 months) (d = 0.83; p < .000). The results indicate collaboration and early intervention contributes to strengthening the emerging development of the maternal-infant relationship within the context of complex maternal mental health issues.

摘要

围产期精神疾病是母婴依恋和婴儿健康发育的已知风险。在产后第一年经历复杂心理健康问题的母亲,由于其心理健康问题和感知到的耻辱感,不太可能参与育儿计划或日间干预。目前,大多数围产期日间或小组治疗计划只包括母亲,而不包括其婴儿。本文介绍了昆士兰围产期和婴儿心理健康中心开发的围产期和婴儿心理健康日间计划“Mind Together”,针对中度至重度精神疾病的母亲及其 12 个月以下的婴儿。该服务模式是为期 6 周、每周 1 天的心理教育干预。一位成人围产期心理健康临床医生、一位婴儿心理健康临床医生和一位合作的儿童保健护士在每天的会议上提供心理教育材料和支持。该计划于 2016 年至 2018 年在澳大利亚昆士兰州的七个医院和卫生服务机构进行了试验。共有 84 名母亲及其婴儿参加了 24 个小组日间课程。在干预前后收集了定量测量数据,并对参与者满意度进行了干预后的定性调查。所有定量测量都有显著改善,表明在以下方面具有较大到中等的效果量:国民健康结果量表(HoNOS)(d=0.82;p<.000);抑郁、焦虑和压力量表(DASS-21)(d=0.5;p<.000);卡瑞坦父母信心量表(KPCS)(d=0.63;p<.000);母亲产后依恋量表(MPAS)(d=0.49;p<.000);年龄和阶段问卷:社会情绪(6 个月)(d=0.83;p<.000)。结果表明,协作和早期干预有助于在复杂的母亲心理健康问题背景下,加强母婴关系的新兴发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c46/8453701/f75b5f337bf4/IMHJ-42-560-g001.jpg

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