体外受精-胚胎移植女性孕期焦虑抑郁情绪与妊娠结局的关系

目的:探讨体外受精-胚胎移植(IVF-ET)女性妊娠不同阶段焦虑、抑郁情绪变化及其与妊娠结局的关系。方法:对IVF-ET女性在孕前(进入周期时)、早孕期、中孕期、晚孕期进行焦虑自评量表(SAS)、抑郁自评量表(SDS)问卷调查,分析随访资料完整的88例(IVF-ET组)和同期行孕前检查并于妊娠后定期产检的妇女88例(对照组)的相关资料,比较两组妊娠4个不同时段SAS及SDS评分的情况,以及IVF-ET组不同妊娠结局(胎膜早破、早产、低出生体质量儿、分娩方式)与4个时段中SAS及SDS评分的关系。结果:IVF-ET组的SAS评分在4个不同时段均高于对照组(P0.05),并且IVF-ET组内孕前、早孕期及晚孕期的SAS评分高于中孕期(P0.05);两组在4个不同时段的SDS评分比较,差异均无统计学意义(P0.05)。IVF-ET组中分娩方式为剖宫产的孕妇其在4个不同时段的SAS评分均显著高于阴道分娩孕妇(P0.05),而早产、胎膜早破组、低出生体质量儿中其SAS、SDS评分比较,差异均无统计学意义(P0.05)。结论:行IVF-ET治疗的女性孕前及孕期焦虑的情绪高于正常女性,且焦虑症状在早孕期和晚孕期仍然明显,孕期焦虑可能会导致剖宫产率升高。IVF-ET女性的抑郁情绪变化不显著。     

心理干预联合营养指导对妊娠期糖尿病孕妇及新生儿的影响

目的 研究心理干预联合营养指导对妊娠期糖尿病（GDM）孕妇及新生儿的影响。方法 选取80例GDM孕妇,采用随机数字表法将其分为参照组与观察组,每组40例。参照组开展常规护理,观察组在参照组基础上开展心理干预联合营养指导。比较两组护理效果。结果 护理前,两组空腹血糖（FPG）、餐后2 h血糖（2h PG）及糖化血红蛋白（HbA1c）水平比较,差异无统计学意义（P>0.05）;护理后,两组血糖均得到有效控制,且观察组FPG、2h PG及HbA1c均较参照组低（P<0.05）。护理前,两组心理状态评分比较,差异无统计学意义（P>0.05）;护理后,两组心理状态均有明显改善,且观察组焦虑自评量表（SAS）、抑郁自评量表（SDS）评分均较参照组低（P<0.05）。研究组不良母婴结局发生率5.00%低于参照组的22.50%(P<0.05)。结论 心理干预联合营养指导方案可有效降低GDM孕妇的血糖水平,改善其心理状态,降低母婴不良结局发生风险,值得临床推广。     

责任制护理对孕产妇妊娠结局及产后抑郁情况的影响观察

目的 观察责任制护理对孕产妇妊娠结局及产后抑郁情况的影响。方法 选取90名孕产妇,根据随机数字表法分为对照组（采用常规护理）与观察组（采用责任制护理）,各45名。比较两组孕产妇妊娠结局及产后抑郁情况。结果 观察组自然分娩率为84.44%,明显高于对照组的64.44%(P<0.05)。护理前,两组焦虑自评量表（SAS）、抑郁自评量表（SDS）评分比较,差异无统计学意义（P>0.05）;相比护理前,护理后两组孕产妇SAS、SDS评分均有所降低（P<0.05）;相比对照组,观察组SAS、SDS评分均更低（P<0.05）。相比对照组,观察组孕产妇医疗服务满意度评分更高（P<0.05）。结论 孕产妇接受责任制护理,可提高自然分娩率,改善孕产妇不良心理状态,孕产妇对医疗服务满意度明显提升。     

人文关怀护理在妊娠剧吐孕妇中的应用价值

目的 探析人文关怀护理应用于妊娠剧吐孕妇中的应用效果。方法 选取80名妊娠剧吐孕妇,按照单盲法分为对照组(38名)与观察组(42名)。两组均行常规护理,观察组另行人文关怀护理。比较两组呕吐症状缓解时间、住院时间、焦虑评分、抑郁评分及睡眠质量评分。结果 观察组呕吐症状缓解时间和住院时间均短于对照组,差异有统计学意义(P<0.05)。干预前,两组焦虑自评量表(SAS)、抑郁自评量表(SDS)评分比较,差异无统计学意义(P>0.05);干预后两组SAS评分、SDS评分均低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。干预前,两组睡眠质量评分比较,差异无统计学意义(P>0.05);干预后,两组睡眠质量评分低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论 人文关怀护理应用于妊娠剧吐孕妇中能够缩短呕吐症状缓解时间和住院时间,减轻不良情绪,且有效提升孕妇睡眠质量,应用价值较高。     

产后抑郁心理干预

目的：了解心理支持治疗和认知行为疗法对产后抑郁症状的影响。方法：将30名伴有抑郁症状的产妇给予常规治疗的同时采用支持性心理治疗和认知行为疗法。心理干预前、干预2月、干预4周自评量表（SCL-90）、焦虑自评量表（SAS）、抑郁自评量表（SDS）,分别评估病人心理状态。结果：心理干预四周SCL-90躯体化,焦虑精神症状得分及SAS,SDS标准分与干预前比较,差异有统计学意义（P〈0.05）;干预四周SCL-90各因子得分及SAS,SDS标准分与干预前比较差异均有统计学意义（P〈0.05）。结论：心理支持治疗和行为疗法能有效改善心身症状。     

精细化干预对妊娠期高血压疾病患者的护理价值及对焦虑、抑郁情绪的影响

目的 探究妊娠期高血压疾病患者护理中采用精细化干预的应用价值,及分析其对焦虑、抑郁情绪的改善作用。方法 选取65例妊娠期高血压疾病患者,根据随机数字表法将其分为对照组（32例）与观察组（33例）。对照组采用常规护理,观察组采用精细化干预。比较两组干预前后血压水平、焦虑、抑郁情绪及护理满意度。结果 干预前,两组舒张压、收缩压水平比较,差异无统计学意义（P>0.05）;干预后,两组舒张压、收缩压水平均低于干预前,且观察组明显低于对照组,差异具有统计学意义（P<0.05）。干预前,两组焦虑自评量表（SAS）、抑郁自评量表（SDS）评分比较,差异无统计学意义（P>0.05）;干预后,两组SAS评分、SDS评分均低于干预前,且观察组明显低于对照组,差异具有统计学意义（P<0.05）。观察组患者护理满意度96.97%高于对照组的78.13%,差异有统计学意义（P<0.05）。结论 妊娠期高血压疾病患者护理中采用精细化干预,可控制患者血压水平,显著缓解焦虑、抑郁情绪,提高护理满意度,值得临床推广与应用。     

运动疗法联合心理护理应用于妊娠期糖尿病中的效果分析

目的 评估运动疗法+心理护理对妊娠期糖尿病(GDM)孕妇的护理效果。方法 选取86例GDM孕妇,按照入院时间的先后顺序分为对照组与观察组,每组43例。对照组采用基础护理服务,观察组在对照组护理基础上增加运动疗法联合心理护理。对比两组护理前后的血糖水平、心理状态及妊娠结局情况。结果 护理后,两组空腹血糖、餐后2 h血糖水平均低于护理前,且观察组空腹血糖、餐后2 h血糖水平低于对照组,差异有统计学意义(P<0.05)。护理后,两组焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均低于护理前,且观察组SAS、SDS评分低于对照组,差异有统计学意义(P<0.05)。观察组不良妊娠结局发生率4.65%低于对照组27.91%,差异有统计学意义(P<0.05)。结论 为妊娠期糖尿病患者提供运动疗法联合心理护理的干预模式,可以有效控制血糖水平,改善心理状态,减少产妇和新生儿的并发症发生情况,效果较显著。     

基于赋能理论的护理干预在妊娠期糖尿病孕妇中的应用效果

目的 探讨基于赋能理论的护理干预在妊娠期糖尿病（GDM）孕妇中的应用效果。方法 选取110名GDM孕妇为研究对象,随机分为两组,各55名。对照组采用常规护理干预,观察组采用基于赋能理论的护理干预,比较两组的自我护理能力、糖尿病自我效能、血糖控制、妊娠结局及纯母乳喂养情况。结果 干预后,观察组自我管理行为量表评分、糖尿病自我效能量表评分、血糖控制有效率、自然分娩率和纯母乳喂养率均高于对照组,剖宫产率、巨大儿发生率、产后出血率、宫内窘迫率及新生儿窒息率均低于对照组,差异有统计学意义（P<0.05）。结论 基于赋能理论的护理干预在GDM孕妇中的应用效果较好,能提高孕妇的自我护理能力及自我效能,有效控制血糖,降低不良妊娠结局发生率,值得推广应用。     

孕妇临产前焦虑、抑郁及其影响因素分析

目的:探讨孕妇产前心理状况及影响因素,为产前心理健康教育和心理咨询提供依据。方法:采用焦虑自评量表(SAS)和抑郁自评量表(SDS)作为测评工具,对368名临产前孕妇进行焦虑、抑郁情绪测定,并分析年龄、文化程度、职业和经济收入等因素对孕妇焦虑、抑郁状况的影响。结果:孕妇临产前焦虑发生率为25.54%,抑郁发生率19.84%;与孕妇年龄、文化程度及职业有关(P<0.05);经济水平对孕妇焦虑、抑郁发生率影响无明显关系(P>0.05)。结论:年龄、文化程度和职业对孕妇产前焦虑、抑郁状况有影响;应有针对性地对孕妇开展产前心理卫生健康教育和心理咨询工作。     

心理护理干预对女性血液透析患者焦虑、抑郁的影响

目的探究存在焦虑、抑郁的女性血液透析患者实施心理干预的临床效果。方法本次实验课题研究时间选取2018年10月~2019年6月,研究对象选取为我院进行维持性血液透析的女性患者,按照随机抽取方式将本次实验中的60例患者随机分为两组,一组标为对照组(常规护理),另一组标为实验组(常规干预+心理护理),对所有观察对象干预前与干预后分别进行焦虑自量表(SAS)与抑郁自量表(SDS)进行测试,并进行记录观察。结果干预前实验组SDS和SAS评分与对照组与显著差异(P>0.05);干预后实验组患者优于对照组患者,实验结果评分具有显著差异性(P<0.05)。结论临床心理干预可有效的改善女性血液透析患者的焦虑、抑郁情况,具有较高的应用价值。     

围绝经期潮热妇女焦虑与抑郁状况的分析

目的:探讨围绝经期前后妇女潮热与焦虑、抑郁之间的关系。方法:将符合条件的1 206名40~60岁妇女分为潮热组、无潮热组,分别完成调查问卷。问卷具体内容包括一般情况、潮热状况、焦虑自评量表(SAS)、抑郁自评量表(SDS)。结果:潮热组妇女SAS和SDS的平均值高于无潮热组妇女(SAS:39.8±7.3 vs 36.0±6.1;SDS:44.1±8.3 vs 40.9±8.9,P均<0.05),潮热组轻度焦虑和抑郁的发生率明显高于无潮热组(焦虑:8.3%vs 3.4%;抑郁:23.3%vs 14.2%,P均<0.05)。潮热妇女焦虑、抑郁的发生风险分别是无潮热妇女的4.1倍(95%CI,1.20~13.74)、2.4倍(95%CI,1.15~4.92)。重度潮热妇女较轻度潮热妇女SAS和SDS得分均高(SAS:46.4±7.9 vs 38.8±6.6;SDS:43.9±6.9 vs 52.7±12.5,P均<0.05)。潮热妇女的月经状况与SAS和SDS得分无关。结论:围绝经期潮热妇女易发生焦虑、抑郁症状,且重度潮热妇女更易发生。对妇女进行潮热治疗时,还应对妇女进行心理疏导。     

帕罗西汀联合心理治疗对产后抑郁的疗效分析

目的:观察帕罗西汀加心理治疗治疗产后抑郁的效果。方法:采用Zung-抑郁自评量表(SDS)、Zung-焦虑自评量表(SAS),症状自评量表(SCL-90)、自尊量表(SEI)、特质应对量表(TCSQ)调查62例产后抑郁患者治疗前后的心理状态。实验组患者服用帕罗西汀加40分钟的心理治疗;对照组只予以帕罗西汀,为期8周。结果:两组患者的焦虑、抑郁、消极应对水平减少,自尊、积极应对水平提高,实验组与对照组差异有统计学意义(P<0.01)。结论:帕罗西汀加心理治疗治疗产后抑郁的效果显著。     

产妇心理与分娩方式及分娩过程的关系

目的　观察产妇精神状态 (焦虑及抑郁 )与分娩方式、分娩过程及产后出血的关系。　方法　 92例健康无剖宫产指征的单胎初产妇 ,以焦虑自评量表 (SAS)及抑郁自评量表 (SDS)评定精神状态 ,按均分划分 SAS、SDS高分组及低分组。所有产妇以产科常规进行分娩而不进行干预 ,观察其分娩方式、产程及产后出血情况。　结果　 (1) 92例产妇中顺产 80例 ,其中有 8例发生产后出血。(2 )中学文化程度组较大学文化程度组、顺产组较难产组、无产后出血组较产后出血组的 SAS、SDS评分均要低 ,各组间 SAS评分比较的 t值分别为 3.72、3.75、3.0 8,差异有非常显著性 (P<0 .0 1) ,SDS评分比较的 t值分别为 4.0 6 (P<0 .0 1)、2 .5 (P<0 .0 5 )、2 .6 2 (P<0 .0 5 ) ,差异亦有显著性。而SAS高分组产妇的第一、第二产程均较 SAS低分组要长 ,t值分别为 6 .5 3、5 .41,差异有非常显著性(P<0 .0 1)。同样 ,SDS高分组较 SDS低分组产妇的第一、第二产程也要延长 ,t值分别为 3.6 9、2 .6 8,差异亦有非常显著性 (P<0 .0 1)。　结论　焦虑及抑郁状态可增加难产及产后出血的发生率。故可提供有针对性的心理干预以提高产科质量。     

A psychosomatic intervention in pregnant in-patient women with prenatal somatic risks

Purpose.?This study examined whether a short-term psychosomatic intervention during pregnancy had effects on characteristics of labour and delivery as well as on the long-term course of anxiety, depression and physical complaints in pregnant in-patient women.

Methods.?All gynaecological and obstetric inpatients of a university hospital, who had either exhibited complications during their pregnancy or were considered high-risk pregnancies, were examined. Symptoms of anxiety and depression (HADS) and physical symptoms (GBB) were assessed by standardised questionnaires. Women with elevated scores on either the HADS or the GBB were randomly assigned to either a treatment group, which had received a psychosomatic intervention or an untreated control group. Of the n?=?238 women who were assessed during their stay in our hospital, n?=?135 were included in the follow-up 1-year later.

Results.?More than one-third of the participants (38.7%) had elevated scores of anxiety, depression and/or physical symptoms. The psychosomatic intervention had a significant effect on anxiety scores (p?=?0.006), but not on depression scores, physical complaints and characteristics of labour and delivery.

Conclusions.?Findings suggest that a short-term psychosomatic intervention can have a positive long-term effect on anxiety symptoms. Future studies are needed to show whether the reduction of anxiety symptoms in turn can lead to a reduction of postnatal complications and lower rates of disturbed mother–child interactions.     

The effect of lifestyle-based education to women and their husbands on the anxiety and depression during pregnancy: a randomized controlled trial

Objective: The aim of this study was to determine the effect of lifestyle-based education to women and their husbands on anxiety and depression during pregnancy.

Method: This controlled trial was conducted on 189 pregnant women. Participants were allocated into three groups through block randomization. In the first intervention group, both women and their husbands, and in the second one, only women received the lifestyle-based education. In the control group, women received only the routine care. Edinburgh depression and Spielberger anxiety questionnaires were completed at baseline and 8 weeks after it.

Results: Compared to the control group, significant reductions were observed in the scores of depression (adjusted difference: ?4.7; 95% CI: ?5.9 to ?3.4), state anxiety (?8.1; ?11.3 to ?4.9) and trait anxiety (?8.3; ?11.9 to ?5.0) in the first intervention group, and in the scores of depression (?2.9; ?4.1 to ?1.6), state anxiety (?4.3; ?7.5 to ?1.1) and trait anxiety (?5.5; 95% CI: ?8.7 to ?2.3) in the second intervention group. Comparing the two intervention groups, mean scores of depression and state anxiety were significantly lower in the first group.

Conclusion: Results suggested the positive effect of lifestyle education to women and their husbands on depression and anxiety during pregnancy.     

孕产妇性格类型对围产期及产褥期后心理的影响

目的了解孕产妇的性格类型与围产期心理状态的关系，探讨有效的心理干预措施，为孕产妇心理保健工作提供科学依据。方法随机抽取2002年10月至2003年3月在产科门诊就诊的孕妇570例，采用艾森克个性问卷（EPQ）、焦虑自评量表（SAS）、抑郁自评量表（SDS）进行性格、心理状态及其影响因素的调查，对其中216例进行产时心理调查、300例于产后1～5d和产后42～60d跟踪调查。结果将孕产妇性格分为外向稳定、外向不稳定、内向稳定和内向不稳定四种类型，孕期焦虑、抑郁的发生率分别为10．5％、10．2％，产褥早期焦虑、抑郁的发生率分别为4．0％、5．3％，产褥后期与产褥期后抑郁的发生率分别为40．7％、10．0％，外向稳定的性格类型发生心理障碍者较少，内向不稳定性格类型发生心理障碍者较多。结论孕妇性格的稳定性对孕产妇心理状态的影响主要表现在不同性格人群发生心理障碍的几率不同，对高危人群实行重点干预可能减少围产期心理障碍的发生。     

GDM孕妇妊娠压力、应对方式与心理健康的相关分析

目的探讨妊娠期糖尿病（gestational diabetes mellitus,GDM）孕妇妊娠压力与个人应对方式及心理健康之间的关系。方法将280例GDM孕妇作为病例组,220例正常孕妇作为对照组,采用妊娠压力量表、症状自评量表（SCL-90）及医学应对方式问卷调查,分析三者之间的关系。结果除“人际关系敏感因子”外,病例组孕妇（SCL-90）表各因子平均分、总分高于对照组,差异均具有统计学意义（P〈0．01）;病例组妊娠压力因子“为确保母子健康和安全而引发的压力感”高于对照组（t=5．53,P〈0．01）;与常模比较,GDM孕妇应对方式因子“回避”和“屈服”维度得分病例组低于对照组（t=12．211与9．537,P〈0．01）。GDM孕妇心理健康与妊娠压力之间存在负相关（w=0．581,P〈0．01）,与应对方式之间存在正相关（w=0．218,P〈0．01）。结论GDM孕妇比正常孕妇更易出现躯体和心理方面的症状,应给予GDM患者主动、持续、个体化的集关爱与综合干预一体的临床诊治,以提高GDM孕妇的心理健康水平。     

Effectiveness of a Counseling Intervention after a Traumatic Childbirth: A Randomized Controlled Trial

Abstract: Adverse childbirth experiences can evoke fear and overwhelming anxiety for some women and precipitate posttraumatic stress disorder. The objective of this study was to assess a midwife‐led brief counseling intervention for postpartum women at risk of developing psychological trauma symptoms. Method : Of 348 women screened for trauma symptoms, 103 met inclusion criteria and were randomized into an intervention (n = 50) or a control (n = 53) group. The intervention group received face‐to‐face counseling within 72 hours of birth and again via telephone at 4 to 6 weeks postpartum. Main outcome measures were posttraumatic stress symptoms, depression, self‐blame, and confidence about a future pregnancy. Results : At 3‐month follow‐up, intervention group women reported decreased trauma symptoms, low relative risk of depression, low relative risk of stress, and low feelings of self‐blame. Confidence about a future pregnancy was higher for these women than for control group women. Three intervention group women compared with 9 control group women met the diagnostic criteria for posttraumatic stress disorder at 3 months postpartum, but this result was not statistically significant. Discussion : A high prevalence of postpartum depression and trauma symptoms occurred after childbirth. Although most women improved over time, the intervention markedly affected participants’ trajectory toward recovery compared with women who did not receive counseling. Conclusions : A brief, midwife‐led counseling intervention for women who report a distressing birth experience was effective in reducing symptoms of trauma, depression, stress, and feelings of self‐blame. The intervention is within the scope of midwifery practice, caused no harm to participants, was perceived as helpful, and enhanced women's confidence about a future pregnancy.     

Mental health of patients visiting an outpatient menopause clinic

OBJECTIVE: It is understood that psychological factors affect climacteric disturbances. However, details behind these issues remain unknown. The aim of this study was to investigate the mental health of climacteric patients. SUBJECTS AND METHODS: The subjects were 127 Japanese women who visited our outpatient menopause clinic, complaining chiefly of climacteric disturbances. There were 38 premenopausal patients included. The responses to the HADS (Hospital Anxiety and Depression Scale) and the SDS (Self-rating Depression Scale), obtained at the first examination, were compared with HADS data from 2,943 healthy women and 94 patients hospitalized to receive gynecological surgery. RESULTS: The HADS score and the SDS score of the outpatients of the menopause clinic showed a relatively high (statistically significant) correlation. The average HADS total, anxiety and depression scores for these patients were significantly higher than those for healthy controls. The total and depression scores were also significantly higher than those for patients hospitalized to undergo surgery for benign conditions, and were comparable to those for patients with malignant conditions. The comparison between pre- and postmenopausal patients showed that the premenopausal group was more likely to be depressed. The anxiety score was also high in this group (not significantly). CONCLUSIONS: These results indicate that patients with climacteric disturbances, especially premenopausal patients, often experience psychological discomfort, and that attention should be given not only to their depression but also to their anxiety.