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识别预防产后抑郁症的心理和心理社会干预的共同要素:应用蒸馏和匹配模型对 36 项干预研究中 37 个获奖方案的分析。

Identifying the common elements of psychological and psychosocial interventions for preventing postpartum depression: Application of the distillation and matching model to 37 winning protocols from 36 intervention studies.

机构信息

School of Nursing, Fudan University, Shanghai, China.

Nursing Department, Obstetrics and Gynaecology Hospital of Fudan University, Shanghai, China.

出版信息

Early Interv Psychiatry. 2023 Oct;17(10):947-962. doi: 10.1111/eip.13462. Epub 2023 Sep 8.

Abstract

AIM

Postpartum depression is prevalent worldwide and seriously endangers maternal and child health. Previous studies have demonstrated the effectiveness of psychological and psychosocial intervention programmes in preventing postpartum depression. However, the literature offers limited practice guidance. Therefore, this study aimed to deeply analyse prior findings to gather rich evidence-based information on this topic.

METHODS

Using the distillation and matching model, we conducted a systematic review of psychological and psychosocial interventions used to effectively prevent postpartum depression. Four researchers trained in coding system independently read eligible studies and identified reliable (Cohen's kappa >0.40) and frequently occurring (frequency ≥3 winning study groups) practice elements.

RESULTS

Our review included 36 studies containing 37 winning study groups. Fourteen practice elements were identified and subsequently divided into six categories: postpartum practical problems-related, social support-related, interpersonal psychotherapy-related, cognitive behavioural therapy-related, labour trauma-related and non-specific techniques. The most common practice elements were baby care skills and mother-infant bonding/interaction enhancement. Inter-rater reliability averaged 0.86, ranging from 0.48 to 1.

CONCLUSION

The practice elements identified in this study provide rich evidence-based information that can guide clinical practitioners in selecting or developing effective, realistically available intervention programmes.

摘要

目的

产后抑郁症在全球范围内普遍存在,严重危害母婴健康。先前的研究表明,心理和心理社会干预方案在预防产后抑郁症方面是有效的。然而,文献提供的实践指导有限。因此,本研究旨在深入分析先前的研究结果,以收集有关这一主题的丰富循证信息。

方法

使用提炼和匹配模型,我们对用于有效预防产后抑郁症的心理和心理社会干预措施进行了系统评价。四位受过编码系统培训的研究人员独立阅读合格的研究,并确定了可靠的(科恩氏 kappa>0.40)和频繁出现的(频率≥3 个获胜研究组)实践要素。

结果

我们的综述包括 36 项研究,包含 37 个获胜研究组。确定了 14 个实践要素,并将其分为六个类别:产后实际问题相关、社会支持相关、人际心理治疗相关、认知行为治疗相关、分娩创伤相关和非特异性技术。最常见的实践要素是婴儿护理技能和母婴结合/互动增强。组内一致性平均为 0.86,范围为 0.48 至 1.0。

结论

本研究确定的实践要素提供了丰富的循证信息,可以指导临床医生选择或制定有效、切实可行的干预方案。

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