Innovative psycho-educational program to prevent common postpartum mental disorders in primiparous women: a before and after controlled study.
Innovative psycho-educational program to prevent common postpartum mental disorders in primiparous women: a before and after controlled study.
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DOI：
10.1186/1471-2458-10-432
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发表时间：
2010-07-23
影响因子：
4.5
通讯作者：
Rowe HJ
中科院分区：
文献类型：
--
作者：
Fisher JR;Wynter KH;Rowe HJ
预防妇女产后精神障碍的普遍干预措施取得的成功有限，这可能是因为这些干预措施的理论化程度不够，对性别问题不了解，忽视了相关的风险因素。本研究的目的是确定是否一个创新的简短的心理教育计划的母亲，父亲和第一个新生儿，解决了显着的学习需求，婴儿的行为管理和调整任务的亲密伴侣关系，预防产后心理健康问题的产妇。在澳大利亚维多利亚的七个地方政府区域的初级保健中进行了一项前后对照研究。母婴保健护士连续邀请有一周大婴儿的讲英语的夫妇参加普遍首次家访。招募了两组人，并按顺序进行了跟踪：两组人都在产后四周和六个月完成了电话采访，并接受了标准的医疗保健。干预组的参与者还被邀请参加一个半天的计划，最多有五对夫妇和一个月大的婴儿，由训练有素的护士监督。主要结局是产后前6个月内抑郁或焦虑或适应障碍伴抑郁情绪、焦虑或混合焦虑和抑郁情绪的任何综合国际诊断访谈（CIDI）诊断。通过logistic回归控制潜在混杂因素建立与结局相关的因素，并通过意向治疗进行分析。共招募了399/646（62%）名妇女; 210名仅接受标准治疗，189名还接受了干预; 364名（91%）在产后6个月随访时保留。在没有精神病史的女性中（232/364; 64%），对照组中有36/125（29%）被诊断为抑郁或焦虑或适应障碍伴抑郁情绪、焦虑或混合焦虑和抑郁情绪，而干预组为16/107（15%）。在那些没有精神病史的人中，与对照组相比，干预组诊断常见产后精神障碍的校正比值比为0.43（95%CI 0.21，0.89）。一个普遍的，简短的心理教育小组计划，为讲英语的第一次父母和婴儿在初级保健减少新发产后精神障碍的妇女。一个普遍的方法，辅以额外的程序可能会提高有效性的妇女与精神病史。ACTRN 12605000567628。
Universal interventions to prevent postnatal mental disorders in women have had limited success, perhaps because they were insufficiently theorised, not gender-informed and overlooked relevant risk factors. This study aimed to determine whether an innovative brief psycho-educational program for mothers, fathers and first newborns, which addressed salient learning needs about infant behaviour management and adjustment tasks in the intimate partner relationship, prevented postpartum mental health problems in primiparous women. A before and after controlled study was conducted in primary care in seven local government areas in Victoria, Australia. English-speaking couples with one-week old infants were invited consecutively to participate by the maternal and child health nurse at the universal first home visit. Two groups were recruited and followed sequentially: both completed telephone interviews at four weeks and six months postpartum and received standard health care. Intervention group participants were also invited to attend a half-day program with up to five couples and one month old infants, facilitated by trained, supervised nurses. The main outcome was any Composite International Diagnostic Interview (CIDI) diagnosis of Depression or Anxiety or Adjustment Disorder with Depressed Mood, Anxiety, or Mixed Anxiety and Depressed Mood in the first six months postpartum. Factors associated with the outcome were established by logistic regression controlling for potential confounders and analysis was by intention to treat. In total 399/646 (62%) women were recruited; 210 received only standard care and 189 were also offered the intervention; 364 (91%) were retained at follow up six months postpartum. In women without a psychiatric history (232/364; 64%), 36/125 (29%) were diagnosed with Depression or Anxiety or Adjustment Disorder with Depressed Mood, Anxiety, or Mixed Anxiety and Depressed Mood in the control group, compared with 16/107 (15%) in the intervention group. In those without a psychiatric history, the adjusted odds ratio for diagnosis of a common postpartum mental disorder was 0.43 (95% CI 0.21, 0.89) in the intervention group compared to the control group. A universal, brief psycho-educational group program for English-speaking first time parents and babies in primary care reduces de novo postpartum mental disorders in women. A universal approach supplemented by an additional program may improve effectiveness for women with a psychiatric history. ACTRN 12605000567628.
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DOI：
10.1080/01674820400017962
发表时间：
2004-09-01
影响因子：
3.1
作者：
Dennis, CL;Boyce, P
通讯作者：
Boyce, P
影响因子：
6.9
作者：
Brugha, TS;Sharp, HM;Kirwan, PH
通讯作者：
Kirwan, PH
影响因子：
10.5
作者：
COX, JL;CONNOR, Y;KENDELL, RE
通讯作者：
KENDELL, RE
影响因子：
1.6
作者：
BEEBE, SA;CASEY, R;PINTOMARTIN, J
通讯作者：
PINTOMARTIN, J
影响因子：
3.3
作者：
Bandura, A
通讯作者：
Bandura, A