Effects of group prenatal care on psychosocial risk in pregnancy: results from a randomised controlled trial.
Effects of group prenatal care on psychosocial risk in pregnancy: results from a randomised controlled trial.
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DOI：
10.1080/08870446.2011.531577
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发表时间：
2011-02
影响因子：
3.3
通讯作者：
Kershaw TS
中科院分区：
文献类型：
--
作者：
Ickovics JR;Reed E;Magriples U;Westdahl C;Schindler Rising S;Kershaw TS
很少有干预措施成功地减少了孕妇的心理社会风险。本研究的目的是确定是否一个综合组产前护理干预已经显示，以改善围产期和性风险的结果，也可以改善心理社会的结果相比，标准的个人护理。这项随机对照试验包括来自两家公立医院的14-25岁孕妇（N = 1047），她们被随机分配到标准个体护理、团体产前护理或综合团体产前护理干预（CenteringPregnancy Plus，CP+）。访视的时间和内容遵循产科指南，从妊娠18周到出生。每个2小时组产前护理会议包括身体评估，教育/技能建设和支持，通过促进讨论。使用意向治疗模型，在心理社会功能方面没有显着差异;然而，在研究开始时心理社会压力最高的三分之一女性确实受益于综合团体护理。随机分配到CP+组的高压力女性在妊娠晚期报告自尊显著增加，压力和社会冲突减少;产后1年社会冲突和抑郁显著降低（所有p值<0.02）。CP+改善了高压力女性的心理社会结果。这种“捆绑式”干预有望改善心理社会结果，特别是对传统上更脆弱和服务不足的年轻孕妇。
Few interventions have succeeded in reducing psychosocial risk among pregnant women. The objective of this study was to determine whether an integrated group prenatal care intervention already shown to improve perinatal and sexual risk outcomes can also improve psychosocial outcomes compared to standard individual care. This randomised controlled trial included pregnant women ages 14–25 from two public hospitals (N = 1047) who were randomly assigned to standard individual care, group prenatal care or integrated group prenatal care intervention (CenteringPregnancy Plus, CP+). Timing and content of visits followed obstetrical guidelines, from 18-week gestation through birth. Each 2-h group prenatal care session included physical assessment, education/skills building and support via facilitated discussion. Using intention-to-treat models, there were no significant differences in psychosocial function; yet, women in the top tertile of psychosocial stress at study entry did benefit from integrated group care. High-stress women randomly assigned to CP+ reported significantly increased self-esteem, decreased stress and social conflict in the third trimester of pregnancy; social conflict and depression were significantly lower 1-year postpartum (all p-values <0.02). CP+ improved psychosocial outcomes for high-stress women. This ‘bundled’ intervention has promise for improving psychosocial outcomes, especially for young pregnant women who are traditionally more vulnerable and underserved.
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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：
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Ickovics, Jeannette R.
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作者：
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通讯作者：
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