Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, Brixton, London, SE5 9RT, UK.
BMC Psychol. 2024 Nov 30;12(1):714. doi: 10.1186/s40359-024-02213-7.
Social distancing restrictions and the suspension of in-person treatment and support contributed to an increase in postnatal depression during the coronavirus disease 2019 (COVID-19) pandemic. Creative health interventions can help to alleviate anxiety and depression, with studies showing that singing is particularly effective for supporting the mental health of new mothers. We adapted an in-person group singing programme (Breathe Melodies for Mums (M4M)) to online delivery during the COVID-19 pandemic to support the mental health of new mothers, and, in a feasibility study, found improvements in postnatal depression (PND) symptoms at 6-month follow up. The current qualitative study aimed to explore how and why M4M-online impacted the mental health of those taking part.
We took a theory-based approach using the INgredients iN ArTs in hEealth (INNATE) Framework of 'active ingredients' and the Multi-level Leisure Mechanisms Framework of 'mechanisms of action' to identify and categorise intervention components and change mechanisms. Iterative consensus building between three researchers was complemented by qualitative semi-structured online interviews with 24 women experiencing PND symptoms who took part in M4M-online. Data were analysed inductively using reflexive thematic analysis.
Consistency was found between the online and in-person interventions in active ingredients relating to project design, content, programme management and the composition of the group. Key differences were in the social and contextual ingredients. Psychological, social and behavioural mechanisms for improved mental health and wellbeing included: (1) Increased self-confidence as a mother, (2) Increased positive emotional responses, (3) A supported exploration of self-dentity, (4) Reduced loneliness and isolation, (5) Increased social bonding and connections with family and (6) Enhanced sense of time through new routines.
Participating in online group singing can support new mothers experiencing PND by triggering psychological, social and behavioural responses that lead to improved mental health. Key programme features are identified which can be used to design future online creative health interventions or tailor in-person activities for remote delivery to support populations who may face practical and social barriers to attending in-person.
社交距离限制以及暂停面对面的治疗和支持，导致新冠疫情期间产后抑郁症的发病率上升。创意健康干预措施可以帮助缓解焦虑和抑郁，研究表明唱歌对新妈妈的心理健康特别有效。我们将一项面对面的团体唱歌计划（为妈妈们呼吸旋律（M4M））改编为新冠疫情期间的在线交付，以支持新妈妈的心理健康，并且在一项可行性研究中发现，6 个月随访时产后抑郁症（PND）症状有所改善。本定性研究旨在探讨 M4M-online 如何以及为何影响参与者的心理健康。
我们采用基于理论的方法，使用“主动成分”的 INgredients iN ArTs in hEealth（INNATE）框架和“行动机制”的多层面休闲机制框架来识别和分类干预成分和变化机制。三名研究人员之间的迭代共识构建，辅以对 24 名经历 PND 症状并参加 M4M-online 的女性进行的半结构化在线访谈，对数据进行了归纳分析，采用反思性主题分析。
在线和面对面干预在与项目设计、内容、项目管理和小组组成相关的主动成分方面具有一致性。关键区别在于社会和背景成分。改善心理健康和幸福感的心理、社会和行为机制包括：（1）增强作为母亲的自信心，（2）增强积极的情绪反应，（3）支持自我认同的探索，（4）减少孤独和孤立，（5）增加与家人的社会联系和联系，（6）通过新的日常生活增强时间感。
参与在线团体唱歌可以通过触发心理、社会和行为反应来支持经历 PND 的新妈妈，从而改善心理健康。确定了关键的项目特征，这些特征可用于设计未来的在线创意健康干预措施，或调整面对面活动以进行远程交付，以支持可能面临参加面对面活动的实际和社会障碍的人群。
