Reducing intrusive traumatic memories after emergency caesarean section: A proof-of-principle randomized controlled study.
Reducing intrusive traumatic memories after emergency caesarean section: A proof-of-principle randomized controlled study.
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DOI：
10.1016/j.brat.2017.03.018
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发表时间：
2017-07
影响因子：
4.1
通讯作者：
Holmes EA
中科院分区：
文献类型：
--
作者：
Horsch A;Vial Y;Favrod C;Harari MM;Blackwell SE;Watson P;Iyadurai L;Bonsall MB;Holmes EA
需要对创伤性分娩后的妇女进行预防性心理干预。这项原理验证随机对照研究评估了紧急剖腹产（ECS）后母亲经历的侵入性创伤记忆的数量是否可以通过简短的认知干预来减少。将56名ECS后的妇女以1：1的比例随机分为两个平行组：干预组（常规护理加认知任务程序）或对照组（常规护理）。干预组在ECS后6小时内进行了15分钟的视觉空间任务（通过手持游戏设备玩电脑游戏“俄罗斯方块”）。主要结局是ECS后一周日记中记录的与ECS相关的侵入性创伤记忆的数量。正如预测的那样，与对照组相比，干预组在1周内报告的侵入性创伤记忆较少（M = 4.77，SD = 10.71 vs. M = 9.22，SD = 10.69，d = 0.647 [95%CI：0.106，1.182]）（意向治疗分析，主要结局）。1周后，急性应激再体验症状有减少的趋势（d = 0.503 [95% CI：-0.032，1.033]）（意向治疗分析）。对每日入侵数据的时间序列分析证实了组间的预测差异。72%的女性认为干预措施“相当”到“非常”可以接受。这是制定早期（可能是普遍的）干预措施的第一步，以预防产后创伤后应激症状，这可能对母亲和儿童都有益。ClinicalTrials.gov，www.clinicaltrials.gov，NCT 02502513。一项旨在减少ECS后母亲创伤记忆的干预措施被测试。我们比较了常规护理加视觉空间认知任务与常规护理。一周后，干预组报告的侵入性创伤记忆减少。他们还表现出减少急性应激1周后再次经历症状的趋势。这种早期基于游戏的计算机干预可能对母亲和孩子都有益。
Preventative psychological interventions to aid women after traumatic childbirth are needed. This proof-of-principle randomized controlled study evaluated whether the number of intrusive traumatic memories mothers experience after emergency caesarean section (ECS) could be reduced by a brief cognitive intervention. 56 women after ECS were randomized to one of two parallel groups in a 1:1 ratio: intervention (usual care plus cognitive task procedure) or control (usual care). The intervention group engaged in a visuospatial task (computer-game ‘Tetris’ via a handheld gaming device) for 15 min within six hours following their ECS. The primary outcome was the number of intrusive traumatic memories related to the ECS recorded in a diary for the week post-ECS. As predicted, compared with controls, the intervention group reported fewer intrusive traumatic memories (M = 4.77, SD = 10.71 vs. M = 9.22, SD = 10.69, d = 0.647 [95% CI: 0.106, 1.182]) over 1 week (intention-to-treat analyses, primary outcome). There was a trend towards reduced acute stress re-experiencing symptoms (d = 0.503 [95% CI: −0.032, 1.033]) after 1 week (intention-to-treat analyses). Times series analysis on daily intrusions data confirmed the predicted difference between groups. 72% of women rated the intervention “rather” to “extremely” acceptable. This represents a first step in the development of an early (and potentially universal) intervention to prevent postnatal posttraumatic stress symptoms that may benefit both mother and child. ClinicalTrials.gov, www.clinicaltrials.gov, NCT02502513. An intervention to reduce traumatic memories in mothers after ECS was tested. We compared usual care plus visuospatial cognitive task with usual care. After 1 week, the intervention group reported fewer intrusive traumatic memories. They also showed a trend towards reduced acute stress re-experiencing symptoms after 1 week. This early game-based computerized intervention may benefit both mother and child.