评估家庭支持性咨询和电话支持性咨询对产后抑郁和焦虑的影响：一项随机对照试验。
Evaluating the impact of home supportive counseling and telephone supportive counseling on postpartum depression and anxiety: a randomized controlled trial.
作者信息
Eskandari Bita, Nourizadeh Roghaiyeh, Mehrabi Esmat, Heshmati Rasoul, Ivanbagha Reyhaneh, Akbarivand Zahra
机构信息
Student Research Committee, Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
出版信息
BMC Psychiatry. 2025 May 20;25(1):510. doi: 10.1186/s12888-025-06953-7.
BACKGROUND
Childbirth and postpartum experience often lead to the significant physiological and emotional changes in mothers. Hormonal fluctuations, coupled with the adaptation to maternal roles, play a pivotal role in postpartum depression and anxiety. The present study aimed to evaluate the effect of home and telephone supportive counseling on postpartum depression and anxiety.
METHODS
This randomized controlled trial was conducted on 93 primiparous women aged 18-45 years attended the Taleghani and Al-Zahra educational and medical centers in Tabriz, Iran. Subjects were randomly assigned to the home supportive counseling, telephone supportive counseling, and control (receiving routine postpartum care) groups. Home and telephone supportive counseling were conducted for three 30-45 min sessions scheduled on postpartum days 3-5, 7-9, and 20-25. Data were collected using the Edinburgh Postnatal Depression Scale and the Postpartum Specific Anxiety Scale 10-15 days and 42-60 days postpartum, and analyzed using ANCOVA and Kruskal-Wallis tests.
RESULTS
The mean (SD) depression score was 6.23 (3.09) in the telephone supportive counseling group, 4.78 (3.85) in the home supportive counseling group, and 5.79 (3.39) in the control group during 10-15 days postpartum (P = 0.016). The mean (SD) anxiety score was 28.11 (9.37) in the telephone supportive counseling group, 27.32 (7.38) in the home supportive counseling group, and 39.88 (7.73) in the control group during 10-15 days postpartum (P < 0.001). However, no statistically significant difference in depression and anxiety scores was observed among the three groups during 42-60 days postpartum (P > 0.05).
CONCLUSION
Home supportive counseling effectively alleviates symptoms of postpartum depression within 10-15 days postpartum. Moreover, both home and telephone supportive counseling were found to reduce postpartum anxiety symptoms within 10-15 days postpartum. Considering the cost-effectiveness of phone counseling, it is recommended that healthcare providers use telephone supportive counseling to reduce early postpartum anxiety.
REGISTRATION CLINICAL TRIALS
Iranian Registery of Clinical Trials-Beta vertion, https://irct.behdasht.gov.ir/trial/71775 (IRCT20170506033834N11), registered 2023.8.20.
背景
分娩及产后经历常常会使母亲出现显著的生理和情绪变化。激素波动，再加上对母亲角色的适应，在产后抑郁和焦虑中起着关键作用。本研究旨在评估家庭及电话支持性咨询对产后抑郁和焦虑的影响。
方法
本随机对照试验对93名年龄在18至45岁之间、在伊朗大不里士的塔莱哈尼和阿尔扎赫拉教育与医疗中心就诊的初产妇进行。研究对象被随机分为家庭支持性咨询组、电话支持性咨询组和对照组（接受常规产后护理）。家庭和电话支持性咨询在产后第3至5天、第7至9天以及第20至25天安排进行，每次时长30 - 45分钟，共三次。在产后10 - 15天以及42 - 60天使用爱丁堡产后抑郁量表和产后特定焦虑量表收集数据，并采用协方差分析和克鲁斯卡尔 - 沃利斯检验进行分析。
结果
产后10 - 15天期间，电话支持性咨询组的平均（标准差）抑郁评分为6.23（3.09），家庭支持性咨询组为4.78（3.85），对照组为5.79（3.39）（P = 0.016）。产后10 - 15天期间，电话支持性咨询组的平均（标准差）焦虑评分为28.11（9.37），家庭支持性咨询组为27.32（7.38），对照组为39.88（7.73）（P < 0.001）。然而，产后42 - 60天期间，三组之间的抑郁和焦虑评分未观察到统计学上的显著差异（P > 0.05）。
结论
家庭支持性咨询在产后10 - 15天内可有效缓解产后抑郁症状。此外，家庭和电话支持性咨询均被发现可在产后10 - 15天内减轻产后焦虑症状。考虑到电话咨询的成本效益，建议医疗服务提供者采用电话支持性咨询来减轻产后早期焦虑。
注册临床试验
伊朗临床试验注册中心 - 测试版，https://irct.behdasht.gov.ir/trial/71775（IRCT20170506033834N11），于2023年8月20日注册。
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