Tessema Marta, Abera Muluemebet, Birhanu Zewdie
School of Midwifery, Institute of Health, Jimma University, Jimma, Ethiopia.
Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia.
Front Psychiatry. 2025 Apr 17;16:1548356. doi: 10.3389/fpsyt.2025.1548356. eCollection 2025.
Postpartum depression literacy assists mothers in recognizing and preventing postpartum depression (PPD). So, this study assessed the effectiveness of antenatal group psychoeducation in improving PPD literacy among pregnant women in Jimma, Ethiopia.
A cluster randomized controlled trial was conducted from 28 March to 1 December 2022 involving 32 non-adjusted health centers that were randomized into two groups (16 health centers for each arm). The study enrolled 550 participants who scored (0-9) on the Patient Health Questionnaire-9. The intervention group received standard antenatal care and group psychoeducation, while the control group received only standard care. Postpartum depression literacy was assessed in face-to-face interviews at 12-20 weeks gestation and 6 weeks postpartum using the PPD literacy scale. Higher scores indicated higher literacy. An intention-to-treat analysis was used. Demographic factors were compared between groups using χ² and independent sample t-tests, indicating no significant differences except for educational status and parity. General linear models and mixed-effect models assessed intervention effects and outcome variable predictors, respectively.
The overall response rate was 92.9%. The study demonstrated a significant difference between groups regarding the overall mean PPD literacy score (intervention, 3.75 ± 0.46; control, 3.48 ± 0.46; ηp² = 0.07), ability to recognize PPD (intervention, 4.30 ± 0.64; control, 3.94 ± 0.75; ηp² = 0.06), knowledge of risk factors and causes (intervention, 4.03 ± 0.69; control, 3.67 ± 0.70; ηp² = 0.05), and access to PPD information (intervention, 3.28 ± 1.25; control, 2.01 ± 1.13; ηp ²= 0.21) at p = 0.001, with marginal significance regarding self-care activities (intervention 4.37 ± 0.54, control 4.26 ± 0.50, ηp² = 0.01, p = 0.051). Conversely, there were no significant differences in knowledge of professional help (intervention 2.97 ± 1.13, control 2.83 ± 0.80, p² = 0.00, p = 0.303), beliefs regarding professional help (intervention 2.67 ± 0.89, control 2.50 ± 0.72, p² = 0.01, p = 0.063), and attitudes toward PPD recognition and help seeking (intervention 3.91 ± 1.02, control 3.91 ± 1.02, p² = 0.00, p = 0.586). Moreover, partner emotional support (AOR = 0.1, 95% CI = 0.02-0.17), maladaptive coping [AOR = -0.14, 95% CI = -0.22-(-0.07)], and multiparty [AOR = -0.15, 95% CI = -0.22-(-0.08)] showed significant associations with overall PPD literacy score.
The study showed that antenatal group psychoeducation had a moderate effect on overall PPD literacy score. However, further research is required to effectively change negative attitudes toward seeking formal help.
https://pactr.samrc.ac.za/, identifier PACTR 202203616584913.
产后抑郁知识素养有助于母亲识别和预防产后抑郁症（PPD）。因此，本研究评估了产前小组心理教育对埃塞俄比亚吉马地区孕妇产后抑郁知识素养提升的有效性。
于2022年3月28日至12月1日进行了一项整群随机对照试验，涉及32个未经调整的健康中心，随机分为两组（每组16个健康中心）。该研究纳入了550名在患者健康问卷-9上得分为（0-9）的参与者。干预组接受标准产前护理和小组心理教育，而对照组仅接受标准护理。在妊娠12-20周和产后6周通过面对面访谈，使用产后抑郁知识素养量表评估产后抑郁知识素养。得分越高表明知识素养越高。采用意向性分析。使用χ²检验和独立样本t检验比较组间人口统计学因素，结果显示除教育程度和产次外无显著差异。分别用一般线性模型和混合效应模型评估干预效果和结果变量预测因素。
总体反应率为92.9%。研究表明，两组在产后抑郁知识素养总体平均得分（干预组，3.75±0.46；对照组，3.48±0.46；ηp² = 0.07）、识别产后抑郁的能力（干预组，4.30±0.64；对照组，3.94±0.75；ηp² = 0.06）、危险因素和病因知识（干预组，4.03±0.69；对照组，3.67±0.70；ηp² = 0.05）以及获取产后抑郁信息的途径（干预组，3.28±1.25；对照组，2.01±1.13；ηp² = 0.21）方面存在显著差异，p = 0.001，自我护理活动方面差异边缘显著（干预组4.37±0.54，对照组4.26±0.50，ηp² = 0.01，p = 0.051）。相反，在专业帮助知识（干预组2.97±1.13，对照组2.83±0.80，p² = 0.00，p = 0.303）、对专业帮助的信念（干预组2.67±0.89，对照组2.50±0.72，p² = 0.01，p = 0.063）以及对产后抑郁识别和寻求帮助的态度（干预组3.91±1.02，对照组3.91±1.02，p² = 0.00，p = 0.586）方面无显著差异。此外，伴侣情感支持（优势比 = 0.1，95%置信区间 = 0.02 - 0.17）、适应不良应对方式[优势比 = -0.14，95%置信区间 = -0.22 - (-0.07)]和多胎妊娠[优势比 = -0.15，95%置信区间 = -0.22 - (-0.08)]与产后抑郁知识素养总体得分显著相关。
该研究表明产前小组心理教育对产后抑郁知识素养总体得分有中等程度的影响。然而，需要进一步研究以有效改变对寻求正式帮助的消极态度。
https://pactr.samrc.ac.za/，标识符PACTR 202203616584913。
