Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
BMJ Open. 2022 Feb 15;12(2):e056807. doi: 10.1136/bmjopen-2021-056807.
To investigate the roles of mobile health, or mHealth, in the psychosocial health of pregnant women and mothers.
A systematic search was conducted in databases and grey literature including MEDLINE, Web of Science, CINAHL, PsycINFO, PsycARTICLES, Academic Search Complete, SocINDEX, Central Register of Controlled Trials, The Database of Abstracts of Reviews of Effects, NHS Economic Evaluation Database, Health Technology Assessment, UNICEF and WHO databases. Two searches were conducted to include original research articles published in English until 15 November 2021. Several tools were used to assess the risk of bias: revised Cochrane risk of bias tool for randomised trials, Risk of Bias in Non-randomized Studies of Interventions, National Heart, Lung, and Blood Institute quality assessment tool for cohort and cross-sectional studies, Critical Appraisal Skills Program checklist for qualitative studies and Mixed Methods Appraisal Tool for mixed-methods studies. Certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation approach. Due to the high heterogeneity and variability of the included studies, data synthesis was conducted narratively.
44 studies were included among 11 999 identified articles. Most studies reported mixed findings on the roles of mHealth interventions in the psychosocial health of pregnant women and mothers; mHealth improved self-management, acceptance of pregnancy/motherhood and social support, while mixed results were observed for anxiety and depressive symptoms, perceived stress, mental well-being, coping and self-efficacy. Furthermore, pregnant women and mothers from vulnerable populations benefited from the use of mHealth to improve their psychosocial health.
The findings suggest that mHealth has the potential to improve self-management, acceptance of pregnancy/motherhood and social support. mHealth can also be a useful tool to reach vulnerable pregnant women and mothers with barriers to health information and facilitate access to healthcare services. However, the high heterogeneity limited the certainty of evidence of these findings. Therefore, future studies should identify the context under which mHealth could be more effective.
探讨移动健康（mHealth）在孕妇和产妇的心理健康中的作用。
系统检索了包括 MEDLINE、Web of Science、CINAHL、PsycINFO、PsycARTICLES、Academic Search Complete、SocINDEX、CENTRAL、The Database of Abstracts of Reviews of Effects、NHS Economic Evaluation Database、Health Technology Assessment、儿基会和世卫组织数据库在内的数据库和灰色文献，纳入截至 2021 年 11 月 15 日发表的英语原创研究文章。使用了几种工具来评估偏倚风险：修订后的随机试验 Cochrane 偏倚风险工具、干预措施非随机研究的偏倚风险、国家心肺血液研究所队列研究和横断面研究质量评估工具、定性研究的批判性评估技能计划清单和混合方法研究的混合方法评估工具。使用推荐评估、制定与评价方法评估证据的确定性。由于纳入研究的高度异质性和可变性，采用叙述性方法进行了数据综合。
在 11999 篇确定的文章中，纳入了 44 项研究。大多数研究报告了 mHealth 干预措施在孕妇和产妇心理健康中的作用的混合结果；mHealth 改善了自我管理、对怀孕/母亲身份的接受度和社会支持，而焦虑和抑郁症状、感知压力、心理健康、应对和自我效能的结果则存在差异。此外，来自弱势群体的孕妇和产妇受益于使用 mHealth 来改善其心理健康。
研究结果表明，mHealth 有可能改善自我管理、对怀孕/母亲身份的接受度和社会支持。mHealth 也可以成为一种有用的工具，帮助那些获取健康信息存在障碍的弱势孕妇和产妇，并促进他们获得医疗保健服务。然而，高度的异质性限制了这些发现证据的确定性。因此，未来的研究应确定 mHealth 更有效的环境。
