马拉维产后青少年母亲中与广泛性焦虑障碍相关的文化和社会因素：一项横断面调查
Cultural and social factors associated with generalized anxiety disorder among adolescent mothers during the postpartum period in Malawi: a cross-sectional survey.
作者信息
Tembo Chimwemwe, Portsmouth Linda, Burns Sharyn
机构信息
School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia.
Saint John of God Hospitaller Services, Mzuzu, Malawi.
出版信息
BMC Glob Public Health. 2024 Aug 5;2(1):50. doi: 10.1186/s44263-024-00080-3.
BACKGROUND
The postnatal period is an important time for adolescent mothers to regain their health as they adjust to life with their infants. However, it is also a time when mothers are vulnerable to mental health problems. Generalized anxiety disorders (GADs) are among the common mental disorders that can impact mothers. Anxiety disorders can have adverse effects on a child's cognitive development. However, there is a scarcity of studies pertaining to anxiety disorders among adolescent mothers in Malawi.
METHODS
A cross-sectional survey was conducted among adolescent postnatal mothers aged ≤ 19 years to establish the prevalence of probable GAD and identify cultural and social factors that influence anxiety in this population. Adolescent mothers were recruited from the Mitundu Rural Hospital catchment area in Lilongwe district, Malawi. A two-stage random sampling method was employed: clinics were randomly selected, and participants were recruited via systematic random sampling. The Generalized Anxiety Disorder (GAD-7) scale was used to assess anxiety. Data were analyzed using SPSS version 27.
RESULTS
Of the 395 adolescent mothers who participated, 34% were aged 14-17. The prevalence of probable GAD (GAD-7 ≥ 10) was 31.9%. Increased social support decreased the odds of probable GAD (aOR 0.95, 95% CI: 0.91-0.98, p < 0.001). Experiencing intimate partner violence (IPV) increased the likelihood of probable GAD (aOR 4.80, 95% CI: 1.23-18.82, p = 0.02), while those who had contact with a health worker postnatally (aOR 0.38, 95% CI: 0.17-0.83, p = 0.02) and those who were "not prayerful" (aOR, 0.43, 95% CI: 0.21-0.87, p = 0.02) were less likely to report probable GAD.
CONCLUSIONS
Given that the prevalence of probable GAD among adolescent mothers in Malawi is higher compared to the global estimates of their peers, policies and guidelines that prioritize the maternal mental health of adolescent mothers in Malawi are required. The findings also highlight the importance of enhancing social support among family and community. Co-designed mental health promotion, prevention, and early interventions to involve health workers and religious leaders are recommended.
背景
产后时期对于青春期母亲恢复健康而言是一个重要阶段，因为她们要适应与婴儿一起的生活。然而，这也是母亲们易患心理健康问题的时期。广泛性焦虑障碍（GAD）是可能影响母亲的常见精神障碍之一。焦虑障碍会对儿童的认知发展产生不利影响。然而，关于马拉维青春期母亲焦虑障碍的研究却很匮乏。
方法
对年龄≤19岁的青春期产后母亲进行了一项横断面调查，以确定可能的广泛性焦虑障碍的患病率，并识别影响该人群焦虑情绪的文化和社会因素。青春期母亲是从马拉维利隆圭区米通杜农村医院的服务范围内招募的。采用两阶段随机抽样方法：随机选择诊所，并通过系统随机抽样招募参与者。使用广泛性焦虑障碍（GAD-7）量表评估焦虑情绪。数据使用SPSS 27版进行分析。
结果
在参与调查的395名青春期母亲中，34%的年龄在14 - 17岁之间。可能的广泛性焦虑障碍（GAD-7≥10）的患病率为31.9%。社会支持的增加降低了可能患广泛性焦虑障碍的几率（调整后比值比为0.95，95%置信区间：0.91 - 0.98，p<0.001）。经历亲密伴侣暴力（IPV）会增加患可能的广泛性焦虑障碍的可能性（调整后比值比为4.80，95%置信区间：1.23 - 18.82，p = 0.02），而产后与医护人员有接触的母亲（调整后比值比为0.38，95%置信区间：0.17 - 0.83，p = 0.02）以及那些“不祈祷”的母亲（调整后比值比为0.43，95%置信区间：0.21 - 0.87，p = 0.02）报告可能患广泛性焦虑障碍的可能性较小。
结论
鉴于马拉维青春期母亲中可能的广泛性焦虑障碍患病率高于全球同龄人估计水平，需要制定优先考虑马拉维青春期母亲心理健康的政策和指南。研究结果还凸显了加强家庭和社区社会支持的重要性。建议共同设计涉及医护人员和宗教领袖的心理健康促进、预防及早期干预措施。
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