Zaidan Maya, Lawson Andrea S, Andrejek Nicole, Walsh Kate, Dennis Cindy-Lee, Meltzer-Brody Samantha, Silver Richard K, Stuebe Alison M, Vigod Simone N, Singla Daisy R
Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada.
Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.
BMC Med. 2025 Aug 20;23(1):489. doi: 10.1186/s12916-025-04272-y.
High treatment satisfaction is related to improved treatment adherence and outcomes in psychotherapy research. Satisfaction with psychotherapy treatment among racially and ethnically diverse perinatal populations with post-traumatic stress (PTS) remains understudied. The aims of this study are to examine the relations between PTS symptoms, perceived social support, and race and ethnicity, and treatment satisfaction among perinatal women receiving behavioural activation (BA) psychotherapy.
This is a mixed-methods study of the Scaling Up Maternal Mental healthcare by Increasing access to Treatment (SUMMIT) trial-a large, multi-site, non-inferiority trial for perinatal women with depressive and anxiety symptoms (NCT04153864). A two-sample t-test compared baseline PTS symptoms, social support, and treatment satisfaction between participants from white and racial and ethnic minority groups. Hierarchical multiple linear regression examined whether PTS symptoms, perceived social support, race and ethnicity predicted treatment satisfaction. Content analysis of open-ended responses explored facilitators and modifications for improving treatment satisfaction across PTS symptom severity and race and ethnicity.
Of 1230 women, 1119 (90.98%) had ≥ 1 BA session. Compared to their white counterparts, baseline PTS symptom severity was higher (t(1087) = - 4.98; p < 0.001; 95% CI = - 2.23, - 0.97), and social support lower (t(1087) = 8.05; p < 0.001; 95% CI = 0.43, 0.71) among racial and ethnic minority women. Lower baseline PTS symptom severity (β = - 0.009; 95% CI = - 0.016, - 0.002) and higher perceived social support (β = 0.042; 95% CI = 0.013, 0.072) were associated with higher post-treatment satisfaction across the sample. Descriptive analysis revealed no differences in treatment satisfaction across race and ethnicity; treatment satisfaction was higher for racial and ethnic minority women when social support was added to the regression model (β = 0.077; 95% CI = 0.005, 0.149). Content analysis (n = 807) revealed no differences by PTS symptoms severity or race and ethnicity across reported facilitators and modifications. BA as a treatment modality (n = 446, 55.27%) was a key facilitator; modifications included more sessions (n = 202, 25.03%).
PTS symptom severity and social support predict treatment satisfaction among racially and ethnically diverse perinatal populations and should be considered when delivering psychotherapy.
ClinicalTrials.gov NCT04153864. Registered on November 6, 2019.
在心理治疗研究中，高治疗满意度与改善治疗依从性及治疗效果相关。对于有创伤后应激（PTS）的种族和民族多样化围产期人群，其对心理治疗的满意度仍未得到充分研究。本研究的目的是探讨PTS症状、感知到的社会支持、种族和民族与接受行为激活（BA）心理治疗的围产期妇女的治疗满意度之间的关系。
这是一项关于扩大孕产妇心理保健治疗可及性（SUMMIT）试验的混合方法研究，该试验是一项针对有抑郁和焦虑症状的围产期妇女的大型、多中心、非劣效性试验（NCT04153864）。双样本t检验比较了白人群体与种族和少数民族群体参与者的基线PTS症状、社会支持和治疗满意度。分层多元线性回归分析了PTS症状、感知到的社会支持、种族和民族是否能预测治疗满意度。对开放式回答的内容分析探讨了在不同PTS症状严重程度以及种族和民族中提高治疗满意度的促进因素和改进措施。
在1230名女性中，1119名（90.98%）接受了≥1次BA治疗。与白人女性相比，种族和少数民族女性的基线PTS症状严重程度更高（t(1087)= - 4.98；p < 0.001；95%置信区间= - 2.23， - 0.97），社会支持更低（t(1087)= 8.05；p < 0.001；95%置信区间= 0.43，0.71）。较低的基线PTS症状严重程度（β = - 0.009；95%置信区间= - 0.016， - 0.002）和较高的感知社会支持（β = 0.042；95%置信区间= 0.013，0.072）与整个样本中较高的治疗后满意度相关。描述性分析显示不同种族和民族之间的治疗满意度没有差异；当将社会支持纳入回归模型时，种族和少数民族女性的治疗满意度更高（β = 0.077；95%置信区间= 0.005，0.149）。内容分析（n = 807）显示，在报告的促进因素和改进措施方面，不同PTS症状严重程度或种族和民族之间没有差异。BA作为一种治疗方式（n = 446，55.27%）是一个关键的促进因素；改进措施包括增加治疗次数（n = 202，25.03%）。
PTS症状严重程度和社会支持可预测种族和民族多样化围产期人群的治疗满意度，在提供心理治疗时应予以考虑。
ClinicalTrials.gov NCT04153864。于2019年11月6日注册。
