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比较触觉疗法和基于认知行为疗法的咨询对高度害怕分娩的女性的分娩体验和产后抑郁的影响:一项随机临床试验。

Comparing the effect of haptonomy and CBT-based counseling on childbirth experience and postpartum depression of women with high fear of childbirth: A randomized clinical trial.

作者信息

Alivand Zahra, Nourizadeh Roghaiyeh, Hakimi Sevil, Esmaeilpour Khalil, Mehrabi Esmat

机构信息

Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.

Faculty of Education and Psychology, University of Tabriz, Tabriz, Iran.

出版信息

J Educ Health Promot. 2024 Sep 28;13:354. doi: 10.4103/jehp.jehp_1075_23. eCollection 2024.

Abstract

BACKGROUND

Fear of childbirth (FOC) leads to the perception of more pain and a negative childbirth experience. Negative childbirth experience is related to postpartum depression. This study aimed to compare the effect of haptonomy and cognitive-behavioral therapy (CBT) on the childbirth experience and postpartum depression of women with high FOC.

MATERIALS AND METHODS

This randomized controlled trial was performed on 99 primigravida women referred to health centers in Tabriz, Iran, from January to August 2022. Participants with Wijma score above 65 were assigned into three groups using block randomization. One of the intervention groups ( = 33) received eight sessions of CBT from gestational age of 24-28 weeks and the other group ( = 33) received haptonomy during five sessions once a week. The control group ( = 33) received routine care. The data were collected using the Edinburgh Postpartum Depression Scale, and childbirth experiences questionnaire version 2.0 and were analyzed using ANOVA and ANCOVA.

RESULTS

The mean score of childbirth experience in the CBT and haptonomy groups was 70.67 (13.70) and 70.63 (14.48), respectively, which was more than that in the control group 61.63 (14.11) ( = 0.01). However, no statistically significant difference was observed between the intervention groups ( = 1.000). There wasn't significant difference in the mean score of postpartum depression among CBT 7.59 (3.03), haptonomy 7.47 (4.49), and control 9.71 (3.05) groups ( = 0.09).

CONCLUSIONS

Both CBT and haptonomy improved the childbirth experience, but did not affect postpartum depression. Considering the lack of significant difference between the CBT and haptonomy intervention groups in terms of childbirth experience and given that haptonomy intervention is employed by midwives with no need for CBT counseling skills and can be presented in fewer sessions than CBT, it can be used as a preferred intervention approach by midwives in the care of pregnant women with FOC to improve the childbirth experience.

摘要

背景

分娩恐惧(FOC)会导致产妇感觉到更多疼痛以及产生负面的分娩体验。负面的分娩体验与产后抑郁有关。本研究旨在比较触觉疗法和认知行为疗法(CBT)对分娩恐惧程度较高的女性的分娩体验和产后抑郁的影响。

材料与方法

本随机对照试验于2022年1月至8月在伊朗大不里士的健康中心对99名初产妇进行。Wijma评分高于65分的参与者采用区组随机化法分为三组。其中一个干预组(n = 33)从孕24 - 28周开始接受八次认知行为疗法治疗,另一组(n = 33)在五周内每周接受一次触觉疗法治疗。对照组(n = 33)接受常规护理。使用爱丁堡产后抑郁量表和分娩体验问卷2.0收集数据,并采用方差分析和协方差分析进行分析。

结果

认知行为疗法组和触觉疗法组的分娩体验平均得分分别为70.67(13.70)和70.63(14.48),高于对照组的61.63(14.11)(P = 0.01)。然而,干预组之间未观察到统计学上的显著差异(P = 1.000)。认知行为疗法组(7.59(3.03))、触觉疗法组(7.47(4.49))和对照组(9.71(3.05))的产后抑郁平均得分无显著差异(P = 0.09)。

结论

认知行为疗法和触觉疗法均改善了分娩体验,但未影响产后抑郁。鉴于认知行为疗法组和触觉疗法组在分娩体验方面无显著差异,且触觉疗法由助产士实施,无需认知行为疗法的咨询技能,且治疗次数比认知行为疗法少,因此在护理有分娩恐惧的孕妇时,触觉疗法可作为助产士改善分娩体验的首选干预方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d114/11639481/dbeeebb017fd/JEHP-13-354-g001.jpg

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