心理支持疗法对孕妇分娩过程的影响

目的探讨心理支持疗法对孕妇分娩过程的影响。方法将应用焦虑自评量表(SAS)、抑郁自评量表(SDS)在分娩前2周内测评出有焦虑、抑郁情绪的90例孕妇,随机分为治疗组(45例)与对照组(45例),对治疗组给予心理支持治疗,比较两组分娩情况。结果治疗组:剖宫产率低、产程短、新生儿窒息和产后出血少,两组差异有显著性(P<0.05或P<0.01)。结论心理支持疗法对孕妇分娩过程起积极的促进作用,应在产科领域积极推广、应用.     

音乐疗法配合心理激励对初产妇心理和分娩结局的影响

目的:观察音乐疗法与心理激励措施在初产妇中应用效果,进一步分析初产妇心理现状、分娩结局的情况。方法:选取2013年1月-2015年12月笔者单位的100例初产妇为研究受试者,根据护理措施的差异分成了观察组及对照组,各50例产妇。对照组产妇采取常规的产科护理措施,观察组则在对照组的基础上加音乐疗法、心理激励措施。对患者心理情绪指标、分娩结局等进行评价。结果:观察组患者汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分、抑郁自评量表(SDS)评分、焦虑自评量表(SAS)评分均显著低于对照组(t=-14.1567,-106329,-9.4004,-10.3742;P0.01)。观察组产妇的第一产程、第二产程、第三产程以及总产程均低于对照组(t=-6.6420,-12.3747,-27.2876,-6.8092;P0.01)。观察组顺产例数高于对照组(χ~2=6.8501,P0.05);观察组产褥期感染例数低于对照组(χ~2=4.3956,P0.05);观察组新生儿Apgar评分高于对照组(t=5.4727,P0.01),观察组产妇的产后出血量低于对照组(t=-35.0457,P0.01)。结论:音乐疗法联合心理激励措施能够显著改善初产妇的心理负性情绪,产程时间缩短,剖宫产风险降低,出血量减少。     

导乐分娩球配合自由体位助产对初产妇心理状态、分娩结局及服务满意度的影响

目的:探究导乐分娩球配合自由体位助产对初产妇心理状态、分娩结局及服务满意度的影响。方法:回顾性分析2016年10月-2017年12月我院经导乐分娩球配合自由体位助产(观察组)及经传统体位待产及分娩(对照组)的初产妇各98例临床资料。比较两组分娩前及分娩后焦虑、抑郁情绪[焦虑自评量表(SAS)、抑郁自评量表(SDS)]差异,并记录两组分娩结局(自然分娩、阴道助产、剖宫产)、自然分娩产妇产程时间及服务满意度差异。结果:分娩后,观察组SAS、SDS评分与分娩前比较,差异无统计学意义(P0.05);而对照组SAS、SDS评分均较分娩前升高(P0.05),且高于观察组(t=-13.214,-10.986;P0.05)。两组阴道助产率比较,差异无统计学意义(P0.05);观察组自然分娩率明显高于对照组(P0.05),而剖宫产率明显低于对照组(P0.05)。观察组自然分娩产妇第一产程、第二产程、第三产程时间及总产程时间均低于对照组(t=-15.540,-9.460,-17.099,-18.964;P0.05)。观察组服务满意度明显优于对照组(Z=3.399.P0.05)。结论:导乐分娩球配合自由体位助产对初产妇心理状态改善效果显著,也能促进产程顺利进行,提高医疗服务质量,临床使用价值较高。     

心理护理对急性脑血管患者焦虑、抑郁情绪的干预

目的　探讨心理护理对急性脑血管病 ( ACVD)患者焦虑、抑郁情绪的干预作用。方法　将 64例 ACVD病人随机分为对照组和研究组 ,采用焦虑自评量表 ( SAS)和抑郁自评量表 ( SDS) ,评价两组病人入院时和研究结束时的焦虑、抑郁症状。结果　 64例 ACVD病人出现焦虑和抑郁者分别为 43 .75 %和 40 .63 % ;心理护理后 ,研究组 SAS及 SDS评分较入院时明显减少 ,t检验 ,P<0 .0 5。结论　心理护理能有效地改善 ACVD病人的焦虑、抑郁情绪。     

心理干预对癌症患者家属负性情绪的影响

目的 探讨综合心理干预对癌症晚期患者家属焦虑抑郁情绪的影响.方法 将86例癌症晚期患者家属随机分为两组.对照组不进行干预,干预组进行团体心理治疗,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评定其情绪状况,观察比较家属在综合心理干预8周前后SAS和SDS评分结果.结果 干预组患者家属焦虑情绪得到明显改善,前后比较有显著性差异(t=4.225,P＜0.001);干预组患者家属抑郁情绪得到明显改善,前后比较有显著性差异(t=4.345,P＜0.001).结论 综合心理干预可以改善癌症晚期患者家属的焦虑抑郁情绪.     

孕妇心理因素对分娩方式及妊娠结局的影响

目的:观察孕妇心理因素(焦虑)对分娩方式及妊娠结局的影响,为产前心理疏导提供理论支持。方法:回顾性分析2013年11月-2015年11月期间于我院妇产科生产的130例孕妇的基本住院资料,通过焦虑自评量表(SAS)将130名孕妇分为观察组(有焦虑情绪孕妇)与对照组(无焦虑情绪孕妇),分别为47例和83例,观察两组孕妇阴道自然分娩与剖宫产人数,同时对分娩结局进行比较。结果:观察组孕妇阴道自然分娩率27.66%,刨宫产率72.34%,对照组孕妇阴道自然分娩率60.24%,刨宫产率39.76%,两组数据差异显著(χ~2=12.75,P0.001);观察组孕妇阴道自然分娩时间、剖宫产出血量均显著高于对照组,新生儿Apgar评分低于对照组(t=3.80,3.41,-19.00;P0.01);产后抑郁、产后出血以及新生儿窒息的总发生率显著高于对照组,(P0.001),差异存在统计学意义。结论:孕妇在孕期出现的焦虑症状会显著增加剖宫产率,降低阴道自然分娩率,同时焦虑情绪会增加分娩时间、加大出血量,给产后婴儿及孕妇带来一系列不良影响。     

心理干预对冠脉综合征患者不良情绪的影响

目的探讨心理干预对冠脉综合征患者焦虑抑郁不良情绪的影响。方法将56例冠脉综合征患者随机分为2组,观察组27例,对照组29例,2组均给予心血管内科常规治疗。观察组在此基础上联合心理干预,观察6周,于心理干预前及干预2周、6周末采用焦虑自评量表、抑郁自评量表评定两组患者的焦虑抑郁状况。结果心理干预前2组患者焦虑自评量表、抑郁自评量表评分均无显著性差异(t=0.704和0.523,P>0.05),干预2周后观察组评分均显著低于对照组(t=2.077和2.081,P<0.05),干预6周末后观察组评分也均显著低于对照组(t=2.244和2.209,P<0.05)。结论心理干预能显著改善冠脉综合症患者治疗过程中的焦虑抑郁不良情绪,有利于提高患者的生活质量。     

团体心理治疗对乳腺癌患者焦虑抑郁情绪的影响

目的探讨团体心理治疗对乳腺癌患者焦虑抑郁情绪的影响。方法将96例乳腺癌病人随机分为两组。对照组接受常规化疗,干预组在临床治疗的同时,进行团体心理治疗,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评定其情绪状况,观察比较病人在团体心理治疗8周前后SAS和SDS评分结果。结果干预组患者焦虑、抑郁情绪得到明显改善,前后比较有显著性差异(t=3.34,3.65;P<0.01)。结论乳腺癌患者在进行躯体治疗的同时,实施有效的心理治疗可以纠正患者不恰当的认知,改善其焦虑抑郁情绪,故可作为乳腺癌治疗的辅助方法应用于临床。     

心理康复对创伤性截肢患者不良情绪和生活质量的影响

目的:观察探讨心理康复对创伤性截肢患者不良情绪和生活质量的影响。方法:选取2016年01月至2017年12月我院接收治疗的创伤性截肢患者90例,根据干预方式不同分为观察组和对照组,每组45例,给予对照组常规治疗干预,观察组在对照组基础上实施心理康复干预,比较干预前后两组患者焦虑抑郁和生活质量评分情况。结果:干预后,观察组患者焦虑自评量表(SAS)和抑郁自评量表(SDS)评分明显优于对照组,差异具有统计学意义(t=7.031,8.726;P0.05);干预后,观察组患者生理功能、精神状态、社会功能、一般健康评分明显高于对照组,差异具有统计学意义(t=6.03,8.375,8.105,9.372;P0.05)。结论:心理康复干预可缓解创伤性截肢患者焦虑、抑郁等负面情绪,有利于提高他们的生活质量。     

癌症患者病故对家属情绪状态的影响

目的　探讨癌症患者病故对家属情绪状态的影响。方法　对癌症患者病故的家属共 79人进行问卷随机调查 ,采用焦虑自评量表 ((SAS)、抑郁自评量表 (SDS)和 UCLA孤独量表测量其家属的情绪状态。结果　 1当癌症患者病故其配偶的焦虑、抑郁和孤独情绪明显高于其子女 (P<0 .0 5 ) ;2配偶与子女相比在不同程度的抑郁构成百分比有显著差异 (P<0 .0 5 ) ,在配偶中重度抑郁 2 7人 (62 .8% ) ;3不同性别配偶其情绪状态相比无显著性差异 (P>0 .0 5 ) ;4高龄组配偶的抑郁和孤独情绪明显高于低龄组配偶 (P<0 .0 5 ) ;5在不同性别子女中 ,女性的焦虑和抑郁情绪明显高于男性 (P<0 .0 5 ) ;6子女中高龄组的焦虑情绪明显高于低龄组 (P<0 .0 5 )。结论　癌症患者去世后 ,其家属存在的负性情绪明显 ,应引起社会的关注 ,对于配偶、特别是老年配偶和女性子女等应给予有效地心理、社会支持 ,有利于提高他们的生存质量。     

心理干预对产后妇女心理状况的影响

目的探究心理干预对产后妇女心理状况的影响。方法选取妇产科产妇212例,随机分为观察组和对照组各106例。观察组在刚住院时进行1次心理干预,生完孩子第三天干预1次,包括心理宣教引导和行为训练;产妇出院后,心理咨询师通过电话和上门2种方式进行干预,2周1次,共进行2次。对照组不做干预。两组产后1个月后均采用症状自评量表(SCL-90)对所有产妇进行心理测评。结果①产妇普遍存在躯体化,强迫,人际关系敏感,抑郁,焦虑,偏执等心理问题,其心理健康水平显著低于中国青年常模(t=2.73,4.13,2.73,2.22;P<0.01)结论采用心理干预方法能显著减少产妇不良情绪的发生,提高产妇对新角色的适应能力。     

孕产妇焦虑、抑郁情绪及其护理措施的初步研究

目的了解孕产妇焦虑、抑郁情绪,以便提供护理措施,使产妇顺利康复.方法对200例孕产妇产前及产后用抑郁自评量表(SDS)焦虑自评量表(SAS)测试和46例孕产妇神经介质(5-HT)的检测,然后作统计学处理.结果本文孕产妇产前焦虑发生率为38.34%、抑郁发生率为12.44%,明显高于产后的14.36%和5.85%;产前5-HT的水平明显低于产后.结论部分孕产妇产生有不同程度焦虑、抑郁情绪存在,直接关系到孕产妇心身健康.为此,我们提出了护理措施,并应引起临床工作者重视.     

Effects of pregnancy and delivery on serum prolyl endopeptidase (PEP) activity: alterations in serum PEP are related to increased anxiety in the early puerperium and to postpartum depression

BACKGROUND: There is now some evidence that anxiety or anxiety disorders are related to increased activity of serum prolyl endopeptidase (PEP) and that major depression is related to lower serum PEP. The aims of the present study were to examine (i) the effects of pregnancy and delivery on serum PEP and (ii) the relationships between serum PEP and postpartum depression, anxiety in the early puerperium and a past history of depression. METHODS: Serum PEP activity was measured in 11 healthy nonpregnant and in 98 pregnant women 3 days before delivery and 1 and 3 days after delivery. On the same occasions, pregnant females completed the Spielberger State Anxiety Inventory (STAI) and were divided into high and low anxiety responders, as defined by changes in the STAI. The presence of a previous depression and postpartum depression within 3 months of delivery was assessed by means of DSM-IV criteria. RESULTS: Serum PEP activity was significantly higher 1 and 3 days after delivery than before. Women with a past history of depression as well as anxiety responders had significantly increased serum PEP activity over nonpregnant women and puerperae with a negative history and anxiety nonresponders, respectively. Parturients who developed a postpartum major, but not minor, depression had significantly lower serum PEP than parturients without postpartum depression. The results were controlled for maternal and labor variables, such as type of analgesia and delivery, induction of labor, breast feeding, parity, and duration of pregnancy and labor. CONCLUSIONS: Our results show that, in puerperae, increased serum PEP is related to increased state anxiety in the early puerperium and that lowered serum PEP is related to a subsequent postpartum major depression. INTERPRETATION: The results suggest that increased serum PEP may be related to postpartum anxious blues and that lowered serum PEP may predispose toward postpartum major depression.     

维吾尔族女性妊娠心理精神因素对分娩方式及妊娠结局的影响

目的探讨维吾尔族女性妊娠心理因素对分娩方式及妊娠结局的影响。方法对2006年1月至2011年1月乌鲁木齐市妇幼保健院分娩的132例健康维吾尔族女性妊娠心理研究,以汉密顿焦虑量表（HAS）和抑郁量表（HDS）评定精神心理状态,（其中12例终止妊娠,仅对120例进行分析）,对所有妊娠维吾尔族女性予以产科常规指导分娩方式的选择,观察其分娩方式及妊娠结局;并按妊娠心理精神因素及分娩方式不同分出剖宫产组、顺产组、产钳助娩组;并根据妊娠结局的不同分出良好妊娠结局及不良妊娠结局。结果 120例维吾尔族妊娠女性焦虑发生率35%,抑郁发生率28.3%,焦虑并抑郁发生率16.7%。剖宫产组、产钳助娩组的焦虑及抑郁评分明显高于顺产组,而妊娠结局不良的的焦虑及抑郁评分亦明显高于妊娠结局良好的评分。结论维吾尔族妊娠妇女心理精神因素对分娩方式及妊娠结局有一定影响。     

Dream-associated behaviors affecting pregnant and postpartum women

STUDY OBJECTIVES: Evaluate the prevalence and phenomenology of dream-associated behaviors affecting pregnant and postpartum mothers. Episodes consist of anxious dreams and nightmares about the new infant that are accompanied by complex behaviors (motor activity, speaking, expressing emotion). DESIGN: Three-group design (postpartum, pregnant, null gravida), self-report, and repeated measures. SETTING: Pregnancy and postpartum groups: completion of questionnaires in hospital room within 48 hours of giving birth and home telephone interviews; null gravida group: completion of questionnaires and interview in person or by telephone. PARTICIPANTS: Two hundred seventy-three women in 3 groups: postpartum: n = 202 (mean age = 29.7 +/- 4.94 years; 95 primiparas, 107 multiparas); pregnant: n = 50 (mean age = 31.1 +/- 5.44 years); null gravida: n = 21 (mean age = 28.5 +/- 6.34 years). INTERVENTIONS: Subjects completed questionnaires about pregnancy and birth factors, personality, and sleep and participated in interviews concerning the prevalence of recent infant dreams and nightmares, associated behaviors, anxiety, depression, and other psychopathologic factors. MEASUREMENTS AND RESULTS: Most women in all groups recalled dreams (88%-91%). Postpartum and pregnant women recalled infant dreams and nightmares with equal prevalence, but more postpartum women reported they contained anxiety (75%) and the infant in peril (73%) than did pregnant women (59%, P < 0.05 and 42%, P < 0.0001). More postpartum (63%) than pregnant (40%) women reported dream-associated behaviors (P < 0.01), but neither group differed from null gravida women (56%). This was due to different distributions over groups of the behavior subtypes. Motor activity was present in twice as many postpartum (57%) as pregnant (24%) or null gravida (25%) women (all P < 0.0001). Expressing emotion was more prevalent among null gravida (56%) than postpartum women (27%) (P < 0.05) but was not different from pregnant women (37%). Speaking was equally prevalent among the 3 groups (12%-19%). Behaviors were associated with nightmares, dream anxiety and, among postpartum women, post-awakening anxiety (41%), confusion (51%), and a need to check on the infant (60%). Primiparas and multiparas differed in dream and nightmare recall but not in prevalence of dream-associated behaviors. CONCLUSION: The prevalent occurrence of pregnancy and postpartum infant dreams and associated behaviors may reflect the pervasive emotional influence of maternal concerns or changes instigated by severe sleep disruption, rapid eye movement sleep deprivation, and altered hormone levels.     

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736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26.90%,抑郁发生率18.75%,与年龄、文化程度及职业有关(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。     

Brief antenatal cognitive behaviour therapy group intervention for the prevention of postnatal depression and anxiety: a randomised controlled trial

BACKGROUND: The majority of randomised controlled trials examining the effectiveness of antenatal group interventions at preventing postnatal depression in "at risk" women have used a "psychoeducational" intervention. The aim of the present study is to evaluate the effectiveness of an antenatal cognitive behavioural group intervention in a primary care setting for pregnant women identified with mild to moderate symptoms in pregnancy and/or at risk of developing depression or anxiety in the perinatal period. METHOD: Subjects were randomised to a CBT group intervention or control condition (information booklet) and administered the EPDS and STAI at pre (Time 1) and post intervention (Time 2), and at 2 months (Time 3) and 4 months postpartum (Time 4). MINIs were administered at Times 1, 3 and 4. RESULTS: Of the 774 women approached, 277 accepted and were suitable; thus 191 were randomised to the CBT intervention and 86 to the control condition. The subsequent 52% drop-out left 89 women "completing" the CBT groups and 43 in the control group; these two groups were well matched on demographic variables. Intention to treat analyses revealed relatively low mean baseline EPDS scores (means 6.88 -8.16) with no reduction in EPDS scores in either group from Time 1 to Time 4. MINI depression criteria were fulfilled by 19% of all participants at Time 1 but there was no reduction in depression in either group; in contrast those with MINI anxiety diagnoses reduced from 28% in late pregnancy to 16% at four months postpartum in the CBT group with similar reductions in the control group. Analyses on the 132 "completers" showed significant symptomatic improvement over time for both the CBT group and control condition. Depression scores in the most symptomatic women (EPDS>12; N=19) decreased steadily by over 50% over the total time course but there were no differences in improvement between the CBT and control groups. LIMITATIONS: A number of methodological factors may have obscured our results including a tendency to natural remission in mildly symptomatic subjects and the possibility that our control condition was therapeutic in itself. CONCLUSION: While a modest reduction in depression scores was noted in study "completers", both the CBT group intervention control condition were equally beneficial. The reasons for this finding include the low symptom level at baseline; the potential effectiveness of the control condition; and the brevity of the intervention.     

瘢痕子宫再次妊娠阴道分娩的可行性及安全性评价

目的 评价瘢痕子宫再次妊娠阴道分娩的可行性及安全性。方法 回顾分析2016年1月~2017年12月在南华大学附属常德医院产科分娩的180例瘢痕子宫再次妊娠产妇临床资料为观察组,并选取同期在我院分娩的180例非瘢痕妊娠产妇为对照组,两组产妇均进行阴道分娩试产,对比两组产妇分娩方式、新生儿评分以及产后并发症等情况。结果 观察组阴道分娩率于对照组相比,差异无统计学意义（P＞0.05）;观察组阴道分娩产程时间、出血量、新生儿Apgar 评分、住院时间与对照组对比,差异无统计学意义（P>0.05）;观察组感染、尿潴留、宫裂出血发生率等并发症发生率与对照组对比,差异无统计学意义（P>0.05）。结论 瘢痕子宫再次妊娠孕妇只要进行严密的产前检查,采用正确的助产手段,行阴道分娩完全可行,且不会增加不良反应,避免了再次剖宫产对产妇子宫造成的损伤。