Swift Emma M, Guðmundsdóttir Fjóla, Einarsdóttir Kristjana, Sigurðardóttir Valgerður Lísa
Faculty of Nursing and Midwifery, University of Iceland, Iceland; Reykjavik Birth Center, Hlidarfotur 17, 102 Reykjavik, Iceland.
Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Iceland.
Sex Reprod Healthc. 2024 Dec;42:101037. doi: 10.1016/j.srhc.2024.101037. Epub 2024 Oct 18.
Given its complexity, childbirth can elicit both positive and negative psychological reactions and, in some cases, women may experience symptoms of childbirth-related post-traumatic stress disorder (CB-PTSD). Several risk factors for CB-PTSD have been identified previously, including history of mental health issues and childbirth related complications. The aim of our study was to explore the role of satisfaction with care in CB-PTSD symptoms.
CB-PTSD was measured with the City Birth Trauma Scale (CityBiTS), a questionnaire with 29 items distributed according to DSM-5 diagnostic criteria. A CityBiTS score >28 points was defined as CB-PTSD symptoms. Birth satisfaction was measured with the Birth Satisfaction Scale-Revised (BSS-R), a self-report questionnaire. Logistic-regression was used to calculate odds ratios and 95 % confidence intervals for the association between birth satisfaction and CB-PTSD, adjusted for age, relationship status, education, income, parity, mode of birth, postpartum depression and maternal and infant health-related problems during pregnancy and birth.
Of 600 participants, 34 (5.7 %) indicated symptoms of CB-PTSD. When adjusted for socio-demographic and pregnancy and birth-related factors, birth satisfaction was independently associated with symptoms of CB-PTSD. For each additional point on the BSS-R, the odds of having CB-PTSD symptoms decreased by 16%. Support during labor and birth, effective communication and shared decision making were factors significantly associated with CB-PTSD symptoms.
Increased satisfaction with care was strongly associated with less symptoms of CB-PTSD. Emphasizing sense of control with support, effective communication and shared decision making may significantly improve the overall experience for women and possibly reduce CB-PTSD symptoms.
鉴于分娩的复杂性，它可能引发积极和消极的心理反应，在某些情况下，女性可能会出现与分娩相关的创伤后应激障碍（CB-PTSD）症状。先前已确定了CB-PTSD的几个风险因素，包括心理健康问题史和与分娩相关的并发症。我们研究的目的是探讨护理满意度在CB-PTSD症状中的作用。
采用城市分娩创伤量表（CityBiTS）测量CB-PTSD，这是一份根据《精神疾病诊断与统计手册》第5版（DSM-5）诊断标准编制的包含29个条目的问卷。CityBiTS得分>28分被定义为有CB-PTSD症状。采用修订后的分娩满意度量表（BSS-R）测量分娩满意度，这是一份自我报告问卷。使用逻辑回归计算分娩满意度与CB-PTSD之间关联的优势比和95%置信区间，并对年龄、关系状况、教育程度、收入、产次、分娩方式、产后抑郁以及孕期和分娩期间母婴健康相关问题进行了调整。
在600名参与者中，34名（5.7%）有CB-PTSD症状。在对社会人口统计学以及与怀孕和分娩相关的因素进行调整后，分娩满意度与CB-PTSD症状独立相关。BSS-R每增加一分，出现CB-PTSD症状的几率降低16%。分娩期间的支持、有效的沟通和共同决策是与CB-PTSD症状显著相关的因素。
护理满意度的提高与较少的CB-PTSD症状密切相关。通过支持、有效的沟通和共同决策来增强控制感，可能会显著改善女性的整体体验，并有可能减少CB-PTSD症状。
