Williamson Emma, Pipeva Anne, Brodrick Ali, Saradjian Adam, Slade Pauline
Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom.
Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom and Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom.
Midwifery. 2021 Nov;102:103099. doi: 10.1016/j.midw.2021.103099. Epub 2021 Jul 13.
To evaluate routinely collected service data from a 'Birth Trauma' psychology clinic integrated into maternity services, in order to review effectiveness for women with symptoms of Post-Traumatic Stress Disorder (PTSD) following childbirth.
Prevalence of PTSD after child-birth has been estimated to be around 3% for women meeting full diagnostic criteria and up to 9% for sub-threshold symptoms. This can occur even in response to deliveries considered to be medically straightforward. NICE guidelines (2018) recommend psychological therapy as a first line treatment for symptoms of PTSD.
The sample included 114 women referred post-natally for psychological assessment and intervention following a traumatic birth experience. Measures were routinely administered as part of initial assessment (T1) and at completion of intervention (T2). Data from these measures were collated and analyzed using a series of paired sample t tests. Following assessment 101 women were taken on for psychological intervention and of these, 74 completed both T1 and T2 measures.
There were highly significant reductions across all measures of PTSD, anxiety and negative mood symptoms. The treatment effect sizes were very large. Mean total score on a measure of PTSD symptomatology was no longer clinically significant following interventions.
This evaluation suggests an integrated Birth Trauma psychology clinic using a small number of contact sessions is a highly efficient and effective model of care for women experiencing symptoms of PTSD following childbirth.
评估从一家纳入产科服务的“分娩创伤”心理诊所常规收集的服务数据，以审查其对分娩后患有创伤后应激障碍（PTSD）症状女性的有效性。
符合完整诊断标准的女性产后PTSD患病率估计约为3%，亚阈值症状的患病率高达9%。即使是在被认为医疗过程简单的分娩后也可能发生这种情况。英国国家卫生与临床优化研究所（NICE）指南（2018年）推荐心理治疗作为PTSD症状的一线治疗方法。
样本包括114名产后因创伤性分娩经历而被转介进行心理评估和干预的女性。这些测量作为初始评估（T1）的一部分以及干预结束时（T2）的常规操作进行。使用一系列配对样本t检验对这些测量的数据进行整理和分析。评估后，101名女性接受了心理干预，其中74名完成了T1和T2测量。
PTSD、焦虑和负面情绪症状的所有测量指标均有极显著降低。治疗效果量非常大。干预后，PTSD症状测量的平均总分在临床上不再显著。
该评估表明，一家采用少量接触疗程的综合性分娩创伤心理诊所是为分娩后出现PTSD症状的女性提供高效且有效的护理模式。
