A Mobile Health Mindfulness Intervention for Women With Moderate to Moderately Severe Postpartum Depressive Symptoms: Feasibility Study.
A Mobile Health Mindfulness Intervention for Women With Moderate to Moderately Severe Postpartum Depressive Symptoms: Feasibility Study.
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DOI：
10.2196/17405
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发表时间：
2020-11-12
影响因子：
5.2
通讯作者：
Kubo A
中科院分区：
文献类型：
--
作者：
Avalos LA;Aghaee S;Kurtovich E;Quesenberry C Jr;Nkemere L;McGinnis MK;Kubo A
大约20%的女性患有产后抑郁症（PPD）。由于获得护理的机会有限等障碍，一半患有产后抑郁症的妇女得不到治疗。因此，确定有效和可扩展的干预措施至关重要。传统的正念项目在减少抑郁症状方面是有效的，但获取仍然是一个障碍。自定进度的移动的健康（mHealth）正念计划可能适合那些无法亲自上课的忙碌母亲的生活方式。然而，关于mHealth正念干预在产后抑郁症妇女中的可行性或有效性知之甚少。本研究旨在评估mHealth正念干预对中度至中度重度抑郁症状的产后妇女的可行性，可接受性和初步疗效。我们在大型综合医疗保健系统Kaiser Permanente北方加州（KPNC）内进行了一项移动健康正念干预的单臂可行性试验。参与者是通过KPNC的普遍围产期抑郁症筛查计划的临床医生转诊和电子健康记录确定的，并由研究小组招募。入选标准包括以下内容：讲英语，产后6个月，患者健康问卷（PHQ-8）评分为10至19，没有定期的正念/冥想练习。参与者被要求使用正念应用程序Headspace，每天10到20分钟，持续6周。基线和干预后调查收集了患者报告结果的数据（抑郁和压力症状，睡眠质量和正念）。半结构化访谈捕捉可接受性。保留和坚持被用来评估可行性。在115名符合资格标准或在资格评估前拒绝参与的女性中，有27名（23%）入选。此外，70%（19/27）完成了研究。参与者的平均年龄为31岁（SD 5.2），30%（8/27）为非西班牙裔白色，平均而言，参与者产后12.3周（SD 5.7）。在完成研究的女性中，100%（19/19）至少使用过一次Headspace应用程序，近一半（9/19，47%）在6周干预期间≥50%的天数使用该应用程序。在完成干预后访谈的16名参与者中，69%（11/16）的人报告说，他们对该应用程序非常或非常满意。访谈表明，女性欣赏冥想的多样性，并认为该计划有助于减少焦虑和改善睡眠。观察到干预前后抑郁症状评分（PHQ-8：-3.8，P=.004）、感知压力（10项感知压力量表：-6.0，P=.005）和睡眠质量（匹兹堡睡眠质量指数：-2.1，P=.02，表明睡眠障碍较少）的显著改善。正念的改善也很显著（五方面正念量表简表：10.9，P= 0.01）。对有中度至中度重度抑郁症状的产后妇女进行mHealth正念干预是可行的，也是可以接受的。需要进行疗效试验。
Approximately 20% of women suffer from postpartum depression (PPD). Due to barriers such as limited access to care, half of the women with PPD do not receive treatment. Therefore, it is critical to identify effective and scalable interventions. Traditional mindfulness programs have been effective in reducing depressive symptoms, however access remains a barrier. A self-paced mobile health (mHealth) mindfulness program may fit the lifestyle of busy mothers who are unable to attend in-person classes. However, little is known regarding the feasibility or efficacy of mHealth mindfulness interventions in postpartum women with depressive symptoms. This study aims to assess the feasibility, acceptability, and preliminary efficacy of an mHealth mindfulness intervention for postpartum women with moderate to moderately severe depressive symptoms. We conducted a single-arm feasibility trial of an mHealth mindfulness intervention within Kaiser Permanente Northern California (KPNC), a large integrated health care system. Participants were identified through clinician referral and electronic health records via KPNC's universal perinatal depression screening program and recruited by the study team. Inclusion criteria included the following: English-speaking, up to 6 months postpartum with a Patient Health Questionnaire (PHQ-8) score of 10 to 19, and no regular mindfulness/meditation practice. Participants were asked to use a mindfulness app, Headspace, 10 to 20 min/day for 6 weeks. Baseline and postintervention surveys captured data on patient-reported outcomes (depression and stress symptoms, sleep quality, and mindfulness). Semistructured interviews captured acceptability. Retention and adherence were used to assess feasibility. Of the 115 women who were contacted and met the eligibility criteria or declined participation before eligibility assessment, 27 (23%) were enrolled. In addition, 70% (19/27) completed the study. The mean age of participants was 31 years (SD 5.2), 30% (8/27) were non-Hispanic White, and, on average, participants were 12.3 weeks postpartum (SD 5.7). Of the women who completed the study, 100% (19/19) used the Headspace app at least once, and nearly half (9/19, 47%) used the app on ≥50% of the days during the 6-week intervention period. Of the 16 participants who completed the postintervention interview, 69% (11/16) reported that they were very or extremely satisfied with the app. Interviews indicated that women appreciated the variety of meditations and felt that the program led to reduced anxiety and improved sleep. Significant improvements in pre- and postintervention scores were observed for depressive symptoms (PHQ-8: −3.8, P=.004), perceived stress (10-item Perceived Stress Scale: −6.0, P=.005), and sleep quality (Pittsburgh Sleep Quality Index: −2.1, P=.02, indicating less sleep disturbance). Improvements in mindfulness were also significant (Five Facet Mindfulness Questionnaire-Short Form: 10.9, P=.01). An mHealth mindfulness intervention for postpartum women with moderate to moderately severe depressive symptoms is feasible and acceptable. An efficacy trial is warranted.
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影响因子：
5
作者：
COHEN, S;KAMARCK, T;MERMELSTEIN, R
通讯作者：
MERMELSTEIN, R
影响因子：
7.2
作者：
Flanagan, Tracy;Avalos, Lyndsay A.
通讯作者：
Avalos, Lyndsay A.
DOI：
10.3389/fgwh.2020.00001
发表时间：
2020
期刊：
Frontiers in global women's health
影响因子：
--
作者：
Davenport MH;Meyer S;Meah VL;Strynadka MC;Khurana R
通讯作者：
Khurana R
影响因子：
5.9
作者：
Dimidjian, Sona;Goodman, Sherryl H.;Beck, Arne
通讯作者：
Beck, Arne
影响因子：
7.4
作者：
Bruggeman-Everts, Fieke Z.;Wolvers, Marije D. J.;Van der Lee, Marije L.
通讯作者：
Van der Lee, Marije L.