初产妇产后抑郁症的发病原因及护理措施

产后抑郁症是孕妇分娩后的常见病症之一,属于情感性精神障碍,多发生在生产后的12个月内。它不仅影响产妇及婴儿健康,而且影响到婚姻、家庭和社会。目前我国产后抑郁症发病率约为15％-30％之间,通常在产后2周出现症状。现将初产妇产后抑郁症临床表现、发病原因以及干预措施分析如下。     

产后抑郁症的危险因素及预防措施

产后抑郁症不仅影响产妇的健康，危害婴儿的身心健康，而且影响家庭和社会。为了降低其发病率，提高产妇的生活质量，护理人员应充分评估产后抑郁症的危险因素，加强孕产期的健康保健，适时实施心理护理，充分发挥支持系统的作用，及早处理抑郁症的先兆症状等预防措施，以降低产后抑郁症的发生。     

产后抑郁的临床调查分析及护理研究

目的探讨产后抑郁的发病率及影响因素,研究围产期护理干预的方法。方法随机抽取在哈尔滨市妇幼保健院分娩的720例产妇,产后3～6d采用Zung抑郁评定量表（SDS）、焦虑评定量表（SAS）,社会支持评定量表（SSRS）,问卷式调查抑郁及焦虑发生情况,对产后抑郁的主要影响因素进行分析;阳性者随机分组,对实验组进行护理干预,产后6～8周用SDS追踪评定,比较护理效果。结果产后抑郁的临床发生率为15．14％,年龄、文化程度、分娩方式、家庭支持度、孕期心理准备、社会支持度对产后抑郁有不同程度的影响,其中孕期心理准备、家庭支持度、主观支持度及分娩方式具有显著影响。加强孕期和分娩后健康教育等措施降低了产后抑郁症的发病率,心理护理干预促进了产后抑郁症的恢复。结论产后抑郁临床发病率较高,影响因素成多元性;采取得当的保健和护理措施对产后抑郁的预防和恢复有明显的帮助。     

产后抑郁症的病因分析和护理措施

产后抑郁症是孕妇分娩后常见的病症之一,她属于情感性精神障碍,多发生在产后一个月与一年之间。产后抑郁症不仅影响着产妇与婴儿的健康,而且还影响着家庭与社会的和谐。产后抑郁症产生的原因是多方面的,与孕妇的心理素质、性格特征、家庭环境等有着密切的联系。因而,应从孕前防治、产前宣教、改善环境等多方面入手,提高医疗护理质量,以减少产妇抑郁症的发生率。     

产后抑郁症患者的护理干预

目的探讨产后抑郁症患者的心理因素及相应的护理对策。方法分析发病原因,通过治疗及护理干预,使产后抑郁症的症状得到改善和缓解。结果护理干预对产后抑郁症十分重要,降低了产后抑郁症的发病率巩固了治疗效果。结论护士通过对患者的心理疏导和护理干预使产妇身心健康,这样既有利于婴儿健康,又有利于家庭、社会的稳定,是预防和治疗产后抑郁症的一种有效措施。     

健康教育对产后抑郁症的有效干预

产后抑郁症严重影响产妇身心健康和婴儿生长发育，其发病因素可分为生理和心理社会两大类，通常在产后2周出现症状。表现为易激怒、恐怖、焦虑、沮丧和对自身及婴儿健康过度担忧。常失去生活自理能力及照料婴儿的能力，有时还会陷入错乱或嗜睡状态。不仅影响产妇的健康，危害产妇及婴儿，而且影响到婚姻、家庭和社会。健康教育是减低产后抑郁发病率的重要手段，具体内容包括：宣传和培养自理意识，加强产前保健，完善产褥期家庭访视，将产后保健与婴儿计划免疫相结合，建立完善的产后支持系统。本文探讨如何有效降低产褥期抑郁症发病率。[第一段]     

潍坊市产妇产后抑郁症现状及影响因素分析

目的了解潍坊市产妇产后抑郁症现状并分析影响因素,为降低产后抑郁症的发病率提供科学依据。方法采用随机抽样方法随机抽取潍坊市3所三甲医院产后42 d复查的395名产妇为调查对象,采用自制一般情况调查表及爱丁堡产后抑郁症自测量表对产妇产后抑郁现状及其影响因素进行调查,对产妇产后抑郁现况采用描述性统计分析,影响因素分析采用二分类逐步Logistic回归。结果潍坊市产妇产后抑郁症发生率为12. 40%。经单因素和多因素综合分析发现,婴儿性别与期望中性别一致、从家庭获得的支持和爱护多、不经历负性生活事件以及产后选择看书作为放松方式能够有效降低产后抑郁的发生。结论相关部门应将关注产后抑郁的关口提前,为孕妇提供个性化服务,保障整个孕期的母婴健康。     

产后抑郁症最隐匿

产后抑郁症影响了10％-15％的产妇.产后和产后一个月的抑郁症发病率3倍于非生产的妇女.尽管在分娩风俗和仪式上有很大的文化方面的不同,然而.不同文化环境中的发病率是类似的.因此．产后抑郁症是最常见的并发症.这对孕妇、她的家庭及抚养孩子有潜在的长期严重的不利影响.然而,高于50％的产后抑郁症的病例没被发现.     

产后抑郁症的社区护理

目的:探讨产后抑郁症的社区护理。方法:宣传和培养自理意识,加强产前保健,完善产褥期家庭访视,为产妇提供高水平的社会支持和必要的就诊指导。结果:社区护士要把护理理念从医院延伸到社区,提高社区护理服务技能,而管理到位是社区护理服务质量的重要保障。结论:产后抑郁严重影响产妇身心健康和婴儿生长发育,社区护理干预是减低产后抑郁发病率的重要手段。     

产后抑郁症预防和心理干预研究进展

目前心理干预不仅可以用于预防产后抑郁症的发生,有的干预方法也可作为独立的治疗措施而不是药物的辅助治疗.本文介绍关于产后抑郁症的预防和心理干预研究,包括对孕妇和配偶的心理教育、产前教育课程、人际心理治疗、导乐分娩、产后助产士与产妇讨论分娩过程,助产士在妊娠分娩和产褥期全程护理,产后早期家庭随访等.     

孕妇的保健需求及其家庭亲密度和适应性

目的:了解城市孕妇对保健知识的了解和需求以及其家庭亲密度和适应性特征。方法:采用自制问卷及家庭亲密度和适应性量表对15所省、市妇幼保健机构中接受产前检查的4998名健康孕妇进行调查。结果:孕妇对保健知识有一定了解;对新生儿护理等操作实习及孕期心理健康问题的教育有普遍的需求,希望开展丈夫体验怀孕感受的活动;希望宣教方式多样化;孕妇亲密度和适应性的实际值均低于理想值,孕妇亲密度高于一般人群而适应性远低于一般人群;孕妇的文化程度和家庭收入对孕妇家庭类型可能有影响。结论:有必要开展孕期心理保健知识的宣教,调整宣教的方式,并开展科学合理的协调孕妇家庭亲密和对环境适应的活动。     

Violence against women, symptom reporting, and treatment for reproductive tract infections in Kerala state, Southern India

In this article we examine factors associated with women's self-reports of reproductive ill health symptoms and factors associated with seeking and receiving treatment for the symptoms. We focus on indicators of women's societal position, especially empowerment (indicated by experience of and attitudes toward violence against women), autonomy, and education. We used data from the National Family Health Survey-2 from Kerala state in Southern India. Based on our results we suggest that violence against women, whether actually experienced or internalized as acceptance of its justification, is associated with increased ill health symptoms, and the acceptance of violence is associated with decreased chance of treatment. Women's higher formal education appeared to reduce treatment seeking for reproductive ill health, perhaps due to the stigma associated with sexually transmitted disease (STD) in this cultural setting. Women's work participation had no significant impact, nor did indicators of women's economic and personal autonomy.     

产妇月子行为和传统习惯及其影响因素

目的:探讨产妇月子传统习惯及其影响因素。方法:问卷调查与定性研究结合,对本市区产后42天左右的产妇776例问卷调查;定性研究采用半结构性访谈、关键人物访谈及专题小组讨论共调查63人次,其中半结构性访谈有产妇及其家人(丈夫、婆婆或母亲)36人,关键人物访谈有社区产后访视人员4人、中医4人,专题小组讨论有从事或负责社区产后访视工作的护理保健人员及中医19人。结果:776例产妇中,月子期间不洗头洗澡的有54.9%、不刷牙的有36.3%、不吃蔬菜的有19.3%、不吃水果的有36.1%,活动范围只能局限在居室内走动的为100%。主要是长辈的意愿及其传统观念起主导作用;产后访视次数对吃蔬菜的影响有显著性;产妇的文化程度和保健知识掌握程度与月子健康行为呈正相关。结论:从孕期、住院分娩、直至产后1个月内的家庭访视,要不断地向产妇及其婆婆、妈妈、丈夫等负责照顾产妇的家庭成员进行健康宣教,使保健知识不断得到强化,确立并形成产妇坐月子的健康行为,以利母婴身心健康。     

Information technology and the National Centers of Excellence in Women's Health

Women are increasingly turning to the Internet for health information. The National Centers of Excellence in Women's Health (U.S. Dept. of Health and Human Services) have as one goal the use of information technology to improve care of women. Telemedicine, the Internet, and Resource Centers were used for patient consultation, patient support, support of women in academics, and clinician education regarding women's health. Access of the lay public to high-quality health information was achieved using the Internet as well as Resource Centers employing Internet educational modalities. Telemedicine, distance learning for clinicians and patient consultations for those far from medical care, has been used successfully. For clinicians, continuing medical education regarding women's health and calendars of opportunities for education in women's health were made available on-line. Creative new uses of information technology have been developed by the Centers of Excellence in Women's Health. These modalities may be adopted, tested, and adapted by others seeking to improve the care and health of women.     

Urban women's socioeconomic status,health service needs and utilization in the four weeks after postpartum hospital discharge: findings of a Canadian cross-sectional survey

Background  

Postpartum women who experience socioeconomic disadvantage are at higher risk for poor health outcomes than more advantaged postpartum women, and may benefit from access to community based postpartum health services. This study examined socioeconomically disadvantaged (SED) postpartum women's health, and health service needs and utilization patterns in the first four weeks post hospital discharge, and compared them to more socioeconomically advantaged (SEA) postpartum women's health, health service needs and utilization patterns.     

产褥期抑郁症发生率及危险因素

目的:探讨产褥期抑郁症的发生率及危险因素。方法:用自编调查表和Edinburgh产后抑郁量表(EPDS)对408例产妇进行调查和评定。结果:产褥期抑郁症的发生率为13.24%(54/408),与产妇文化水平、家庭收入、夫妻感情、产前思想准备、分娩方式、分娩并发症、产后睡眠、新生儿健康等因素明显相关。结论:产褥期抑郁症是多种因素综合作用的结果,针对各种危险因素积极干预十分必要。     

Incidence and duration of breast-feeding in a health maintenance organization population

A breast-feeding incidence and duration study in a heterogeneous population confirmed the increased incidence of breast-feeding reported among American women. Of 632 women delivering between May and August of 1980, 66% chose to breast-feed, a decision determined to be significantly related to race, age, marital status, and parity. Cesarean deliveries discouraged breast-feeding, whereas nursing immediately after delivery and keeping the infant in the room during the hospital stay encouraged breast-feeding. Of 417 women who were breast-feeding, 58% had stopped by four months postpartum, a decision found to be related significantly to race, age, and receiving formula in the hospital. Formula supplementation in the hospital was associated with a shorter breast-feeding period. The most rapid decline in breast-feeding occurred in the first two weeks postpartum. Because this is the period in which women are most likely to discontinue breast-feeding, it could be a productive target period for support and assistance by health professionals.     

A qualitative analysis of women's satisfaction with primary care from a panel of focus groups in the National Centers of Excellence in Women's Health

Health issues unique to women and differences in healthcare experiences have recently gained attention as health plans and systems seek to extend and improve health promotion and disease prevention in the population. Successful efforts focused on enhancing quality of care will require information from the patient's perspective on how to improve such services to best support women's attempts to lead healthy and productive lives. The National Centers of Excellence in Women's Health program (CoE), sponsored by the Office on Women's Health within the Department of Health and Human Services, is based on an integrated model uniting research, training, healthcare, and community education and outreach. To examine women's concept and definitions of healthcare quality, 18 focus groups comprising 137 women were conducted nationwide on experiences and attributes of healthcare that women value in primary care. Following the focus groups, a woman-focused healthcare satisfaction instrument was developed for the purpose of assessing and improving healthcare delivery. We describe the qualitative results of the focus group study.     

Effectiveness of a theory-based postpartum sexual health education program on women's contraceptive use: a randomized controlled trial

Background

The aim of this study was to evaluate the effectiveness of a refined theory-based Interactive Postpartum Sexual Health Education Program to enhance postpartum women's effective contraceptive behavior.

Study Design

Participants (N=250) were randomized to three groups. Experimental Group A received our intervention program via strategies that matched participants' learning preparedness, as determined by the transtheoretical model. Experimental Group B received only a pamphlet. The control group received routine education. Only Group A received health education. Data were collected at baseline, 3 days, 2 months and 3 months postpartum.

Results

Women who received theory-based postpartum sexual health education program had significantly greater contraceptive self-efficacy and were more likely to choose more effective contraceptive methods at 2 months postpartum than women in the routine teaching and interactive pamphlet-only groups.

Conclusion

Our theory-based Interactive Postpartum Sexual Health Education Program enhanced postpartum women's contraceptive self-efficacy and effective contraceptive behavior.