Davis Jacqueline A, Ohan Jeneva L, Bear Natasha, Gibson Lisa, Silva Desiree, Prescott Susan, Finlay-Jones Amy
The Kids Research Institute Australia (Formerly Telethon Kids Institute), Perth, Australia.
The University of Western Australia, Perth, Australia.
BMC Pregnancy Childbirth. 2024 Dec 5;24(1):811. doi: 10.1186/s12884-024-07002-z.
Maternal psychological distress is related to poorer physical and mental health as well as child developmental problems. Interventions that optimise maternal mental health and wellbeing during the "first 1,000 days" of life should have wide-reaching benefits for the mother and her child. Digital mental health interventions (DMHIs) during this critical period have the potential to equip women with enhanced coping strategies that can be applied and maintained in daily life. This study aimed to understand uptake of DMHIs in pregnancy, and the extent participants apply intervention strategies 10-12 months post-participation in a pilot randomised controlled trial (RCT) comparing different digital programs.
A mixed methods triangulation approach was undertaken. We explored demographic data and psychological distress measures in the intervention groups and a comparison group that were offered the intervention but did not participate or did not meet the inclusion criteria based on gestational age (n = 525). Intervention participants (n = 54) were invited to undertake an interview up to 12 months post-intervention to understand ongoing skills application. Fifteen interviews were undertaken using a phenomenological approach to analyse the data.
Baseline psychological distress results showed a significant difference between those who enrolled in the intervention, compared to those who did not, with higher psychological distress (combined), and stress and depression (sub-scale) scores for the intervention groups. Qualitative content analysis identified four main themes relating to long-term engagement: (1) Motivations to use skills; (2) Taking time for oneself; (3) Emotional support; and (4) Improving wellbeing (such as aids sleep and emotional impacts). Within each theme there were several sub-themes, including enablers or barriers to engagement.
This study indicated that women who chose to enrol in DMHIs in pregnancy have greater psychological distress than those who chose not to participate. Many participants in this study continued to apply learnt skills in everyday life, such as breathing exercises. This implies that digital strategies may be effective and applicable longer-term to enable women to apply positive coping skills during critical child developmental periods. Ultimately, this will contribute to designing apps that sustain wellbeing and could be protective in preventing postnatal psychological distress.
Australian New Zealand Clinical Trials Registry Number ( ACTRN12620000672954p ); (12/06/2020).
孕产妇心理困扰与较差的身心健康以及儿童发育问题有关。在生命的“最初1000天”优化孕产妇心理健康和幸福感的干预措施，应对母亲及其孩子产生广泛的益处。在此关键时期的数字心理健康干预措施（DMHI）有潜力让女性掌握能在日常生活中应用和维持的增强应对策略。本研究旨在了解孕期对DMHI的接受情况，以及在一项比较不同数字项目的试点随机对照试验（RCT）中，参与者在参与后10 - 12个月应用干预策略的程度。
采用混合方法三角测量法。我们探究了干预组以及一个对照组（该组虽被提供干预，但未参与或因孕周未符合纳入标准，n = 525）的人口统计学数据和心理困扰测量指标。干预参与者（n = 54）被邀请在干预后长达12个月时接受访谈，以了解所学到的技能的持续应用情况。采用现象学方法进行了15次访谈以分析数据。
基线心理困扰结果显示，参与干预者与未参与者之间存在显著差异，干预组的心理困扰（综合）、压力和抑郁（子量表）得分更高。定性内容分析确定了与长期参与相关的四个主要主题：（1）使用技能的动机；（2）为自己留出时间；（3）情感支持；（4）改善幸福感（如有助于睡眠和情感影响）。每个主题下都有几个子主题，包括参与的促进因素或障碍。
本研究表明，选择在孕期参与DMHI的女性比未参与者有更大的心理困扰。本研究中的许多参与者继续在日常生活中应用所学技能，如呼吸练习。这意味着数字策略可能长期有效且适用，使女性能够在关键的儿童发育时期应用积极的应对技能。最终，这将有助于设计能维持幸福感且可能预防产后心理困扰的应用程序。
澳大利亚新西兰临床试验注册编号（ACTRN12620000672954p）；（2020年6月12日）
