Department of Nursing, Sijhih Cathay General Hospital, New Taipei, Taiwan; School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; TMU Research Center for Cell Therapy and Regeneration Medicine, Taipei Medical University, Taipei, Taiwan.
Midwifery. 2022 Oct;113:103438. doi: 10.1016/j.midw.2022.103438. Epub 2022 Jul 27.
To evaluate the effects of an integrated childbirth education intervention on reducing childbirth fear, anxiety, and depression, and improving dispositional mindfulness.
A two-arm parallel, single-blind randomised controlled trial.
A teaching hospital in Northern Taiwan.
Pregnant women ≥ 20 years of age with a singleton pregnancy (12-24 weeks gestation) and their support partners were recruited. All women included in the study had a score of ≥ 7 points on a fear of childbirth visual analogue scale.
The intervention group (n = 53) received an 8-week course in a childbirth education programme, which included (1) childbirth education using simulation-based learning that highlighted coping with labour pain and (2) instruction in mindfulness breathing, body scans, stretching, sitting meditation, and mindfulness walking. Support partners were invited to participate. The control group (n = 53) received the usual standard prenatal care.
The primary outcome of fear of childbirth was assessed using the Wijma Delivery Expectancy/Experience Questionnaire. The secondary outcomes of anxiety, depression, and dispositional mindfulness were assessed with the Edinburgh Postpartum Depression Scale, State-Trait Anxiety Inventory Scale, and the Mindful Attention Awareness Scale, respectively. Repeated data were collected at baseline, 36 weeks gestation, and 1 week postpartum.
Ninety-one mothers completed the study, with a mean age of 33.9 years (SD = 4.4), and most were primipara (n = 83). The baseline measurements did not differ between the groups. Compared with the control group, there were significant differences in all measures from baseline for the intervention group: the scores were significantly lower for fear of childbirth (mean difference (MD) =-14.8 ∼ -23.7, p < .01), symptoms of anxiety (MD =-7.4 ∼ -6.4, p < .01), and depression (MD =-3.7 ∼ -3.5, p < .01); the levels of dispositional mindfulness were significantly higher (MD =4.9 ∼ 5.7, p < .01) at 36 weeks gestation, and 1 week postpartum.
The 8-week integrated childbirth education intervention was effective in reducing the fear of childbirth in pregnant women. The mindfulness techniques were easily learnt and applied by the participants. Using these techniques during pregnancy and labour enhanced participants' mental health and coping. The integrated childbirth education which includes pregnant women and their support partners could be easily taught by midwives in other contexts.
评估综合分娩教育干预对降低分娩恐惧、焦虑和抑郁的效果，以及改善特质正念。
双臂平行、单盲随机对照试验。
台湾北部一所教学医院。
招募了年龄≥ 20 岁、单胎妊娠（12-24 周妊娠）且有伴侣支持的孕妇。所有纳入研究的妇女在分娩恐惧视觉模拟量表上的得分均≥ 7 分。
干预组（n = 53）接受了为期 8 周的分娩教育课程，其中包括（1）使用基于模拟的学习进行分娩教育，重点是应对分娩疼痛，以及（2）正念呼吸、身体扫描、伸展、坐姿冥想和正念行走的指导。邀请伴侣参加。对照组（n = 53）接受常规的产前护理。
分娩恐惧的主要结果采用 Wijma 分娩期望/体验问卷进行评估。焦虑、抑郁和特质正念的次要结果分别采用爱丁堡产后抑郁量表、状态-特质焦虑量表和正念注意知觉量表进行评估。在基线、36 周妊娠和产后 1 周时收集重复数据。
91 名母亲完成了研究，平均年龄为 33.9 岁（SD = 4.4），大多数是初产妇（n = 83）。两组的基线测量值无差异。与对照组相比，干预组在所有测量指标上从基线开始都有显著差异：分娩恐惧评分显著降低（平均差异（MD）=-14.8～-23.7，p<.01），焦虑症状（MD=-7.4～-6.4，p<.01）和抑郁（MD=-3.7～-3.5，p<.01）；在 36 周妊娠和产后 1 周时，特质正念水平显著升高（MD=4.9～5.7，p<.01）。
为期 8 周的综合分娩教育干预可有效降低孕妇的分娩恐惧。正念技术易于被参与者学习和应用。在妊娠和分娩期间使用这些技术可增强参与者的心理健康和应对能力。包括孕妇及其伴侣在内的综合分娩教育可由助产士在其他环境中轻松教授。
