在 COVID-19 大流行期间，采用压力管理方法进行咨询对产后焦虑、困扰和母乳喂养自我效能的影响：一项随机对照试验。
The effect of counseling with stress management approach on postpartum anxiety and distress and breastfeeding self-efficacy during COVID-19 pandemic: a ramdomized controlled trial.
机构信息
Student Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
出版信息
BMC Pregnancy Childbirth. 2023 Jan 13;23(1):26. doi: 10.1186/s12884-023-05356-4.
BACKGROUND
Successful breastfeeding is related to the psychosocial conditions of the mother. Covid19 pandemic resulted in psychological consequences in women during postpartum period. Maternal anxiety and distress reduce the chances of exclusive breastfeeding. The present study aimed to investigate the effect of counseling with stress management approach on postpartum anxiety and distress and breastfeeding self-efficacy (BSE) during COVID-19 pandemic.
METHOD
This randomized controlled clinical trial was conducted on 64 breastfeeding mothers referred to health care centers in Tabriz, Iran in 2021. Participants were assigned into the intervention and control groups in a ratio of 1: 1 using block randomization in a block size of 4 and 6. The intervention group participated in six individual 60-90 min sessions. Spielberger State-Trait Anxiety Inventory (STAI), postpartum distress (PMD), and BSE questionnaires were completed before and 4-week after the intervention by the control and intervention groups. Independent t-test and ANCOVA were used to compare the outcomes between two groups.
RESULTS
According to the ANCOVA results by controlling the baseline values and after the intervention, the mean score of anxiety in the intervention group was lower than that in the control group [Adjusted Mean Difference (AMD): -13.82, 95%, confidence interval (CI): -12.35 to -15.29, (p < 0.001)]. Further, the mean score of postpartum distress after intervention was lower in the intervention group compared with that in the control group [AMD:5.31 95% CI: -3.00 to -7.37 (p < 0.001)]. After the intervention, the mean score of BSE in the intervention group was significantly higher than that in the control group [AMD: 25.57, 95% CI: 22.85 to 28.29 (p < 0.001)].
CONCLUSION
Stress management counseling can improve postpartum anxiety and distress and BSE and increase breastfeeding. However, more studies are needed for a definitive conclusion.
TRIAL REGISTRATION
Iranian Registry of Clinical Trials (IRCT): IRCT20171007036615N6. Date of registration: 15/09/2021.
背景
成功的母乳喂养与母亲的社会心理状况有关。Covid19 大流行导致产后妇女出现心理后果。产妇焦虑和痛苦会降低纯母乳喂养的可能性。本研究旨在探讨在 COVID-19 大流行期间，采用压力管理方法进行咨询对产后焦虑和痛苦以及母乳喂养自我效能（BSE）的影响。
方法
本随机对照临床试验于 2021 年在伊朗大不里士的医疗保健中心对 64 名母乳喂养的母亲进行。采用区组随机化（区组大小为 4 和 6），将参与者按 1:1 的比例分配到干预组和对照组。干预组参加了六次 60-90 分钟的个体会议。在干预前和干预后 4 周，对照组和干预组分别完成了斯皮尔伯格状态-特质焦虑量表（STAI）、产后痛苦（PMD）和 BSE 问卷。采用独立 t 检验和协方差分析比较两组的结果。
结果
根据协方差分析的结果，在控制基线值和干预后，干预组的焦虑平均得分低于对照组[调整平均差异（AMD）：-13.82，95%置信区间（CI）：-12.35 至-15.29，（p<0.001）]。此外，干预后干预组产后痛苦的平均得分低于对照组[AMD：5.31，95%CI：-3.00 至-7.37（p<0.001）]。干预后，干预组的 BSE 平均得分明显高于对照组[AMD：25.57，95%CI：22.85 至 28.29（p<0.001）]。
结论
压力管理咨询可以改善产后焦虑和痛苦以及 BSE，并增加母乳喂养。然而，需要更多的研究来得出明确的结论。
试验注册
伊朗临床试验注册中心（IRCT）：IRCT20171007036615N6。注册日期：2021 年 9 月 15 日。
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