高危妊娠产妇产后母婴分离时的心理状态及影响因素分析

目的分析高危妊娠产妇产后母婴分离时的心理状态及影响因素。方法以2013年4月至2017年6月于该院住院分娩的312例高危妊娠产妇为研究对象。其中134例产妇因新生儿转新生儿重症监护病房(NICU)监护治疗而进行母婴分离作为母婴分离组,178例新生儿未转NICU监护、未进行母婴分离作为母婴同室组。对母婴分离高危妊娠产妇及其新生儿基本情况和高危妊娠产妇抑郁、焦虑情况进行调查分析。结果母婴分离组产后焦虑、抑郁的产妇占比均高于母婴同室组(P<0.05);母婴分离组产后焦虑、抑郁的产妇占比均高于产前(P<0.05);母婴同室组产后焦虑的产妇占比低于产前(P<0.05);母婴分离组高危妊娠产妇产后焦虑、抑郁心理的产生与家庭经济收入状况、户籍状况、配偶文化程度、产次、流产史、孕前计划妊娠情况、产前是否定期检查、有无妊娠合并症或并发症,以及新生儿的出生孕周、出生体质量和出生即刻Apgar评分均有一定相关性(P<0.05)。结论经历母婴分离的高危妊娠产妇更易出现焦虑、抑郁等不良心理,护理人员应鼓励家属密切关注这类人群的身心健康,可以结合生理、心理和社会诸多影响因素,制订有针对性的护理方案给予有效的护理干预,以帮助母婴尽早恢复健康。     

高危妊娠产妇产后母婴分离时心理状态及影响因素研究

目的:探讨高危妊娠产妇产后母婴分离时心理状态及其影响因素.方法:选择2018年1月—2018年12月128例高危妊娠产妇为研究对象,回顾性分析其一般资料,分为观察组60例(进行母婴分离)与对照组68例(未进行母婴分离),调查分析母婴分离高危妊娠产妇与新生儿情况及产妇负性情绪情况,分析影响因素.结果:观察组60例产妇中焦虑45例、抑郁15例.对照组焦虑11例、抑郁2例.母婴分离产妇产后焦虑与抑郁的影响因素包括家庭经济收入、产次、流产史、孕前计划妊娠情况、产前是否定期检查、有无妊娠合并症及新生儿出生孕周、出生体重、出生即刻Apgar评分等.结论:高危妊娠产妇产后母婴分离后更易产生焦虑、抑郁情绪,存在多种影响因素,护理人员需依据产妇情绪变化及时给予心理护理,以促进母婴身心健康.     

高危产妇产后抑郁发生现状及影响因素分析

目的 调查分析与高危产妇产后抑郁相关的影响因素.方法 应用爱丁堡产后抑郁量表、知觉压力量表、中文版育儿胜任感量表、社会支持量表,对广州市某三级甲等医院产后1周内高危产妇进行调查,对相关影响因素进行分析.结果 233例高危产妇中,产后抑郁阳性检出率为39.1%(91/233),知觉压力水平高、分娩方式为剖宫产、合并胎膜早破是高危产妇产后抑郁发生的危险因素.结论 高危产妇中产后抑郁阳性检出率为39.1%,产后抑郁的发生受多种因素的影响,医护人员应该重视高危产妇产后心理状态的评估,采取有效的干预措施.     

孕妇产后心理问题发生率调查及风险因素研究

目的了解孕妇产后住院期间抑郁、焦虑、创伤后应激发生率并分析相关风险因素,为促进产后母婴心理健康提供参考。方法 2020年5～9月于北京市某三级甲等综合医院产科选取产妇为调查对象,调查工具选用状态-特质焦虑量表、爱丁堡产后抑郁量表、修订版事件影响量表,问卷填写采用问卷星。结果共160例产妇接受调查,问卷有效率97.5%,产后抑郁发病率60.3%,状态焦虑发病率16.7%,特质焦虑发病率12.8%,PTSD发病率42.3%,抑郁共病状态焦虑发病率15.4%,抑郁共病特质焦虑发病率11.5%,抑郁共病PTSD为6.4%。孕产次数、居住状况、月收入及分娩预期疼痛与产后心理问题发生率相关。结论产妇住院期间心理问题较为普遍,医务人员应对此给予足够的关注并及时提供必要的帮助与支持,以利于维持和改善产妇心理健康状态。     

高危孕产妇母婴分离的心理调查与分析

目的对高危孕产妇产前、产后母婴分离焦虑、抑郁情绪进行分析,为实施护理措施提供理论依据。方法采用SAS、SDS自评量表,调查分析120例高危孕产妇产前、产后母婴分离的心理状况。结果高危孕产妇产后母婴分离焦虑阳性率为68.3%、抑郁阳性率为45.0%,高于产前焦虑阳性率(51.7%)和抑郁阳性率(22.5%),差异具有统计学意义(P<0.05或P<0.01)。结论高危孕产妇产后母婴分离焦虑和抑郁发生率较产前有明显升高。应采取多种护理干预,增强高危孕产妇战胜疾病和照顾新生儿的信心,以降低高危孕产妇焦虑、抑郁情绪,安全地度过产褥期。     

住院期间早产产妇产后焦虑与抑郁调查及影响因素分析

目的调查早产产妇的心理状况,为心理干预提供理论依据。方法采用病例采集、SAS焦虑自评量表、爱丁堡产后抑郁量表对100名早产产妇的焦虑与抑郁情绪进行问卷调查,并分析其影响因素。结果不少早产产妇都存在不同程度的焦虑、抑郁情绪,早产儿入住新生儿科导致母婴分离、心疼新生儿治疗性操作、担心新生儿安危及预后等是导致早产产妇焦虑、抑郁的主要因素。结论早产产妇的心理存在不同程度的焦虑、抑郁,有必要进行有效的心理干预,提高自我效能,增加积极健康行为,恢复身心健康,从而减少产后焦虑和抑郁的发生。     

229例产科监护室高危妊娠产妇泌乳启动延迟现状及影响因素分析

目的 调查产科监护室高危妊娠产妇泌乳Ⅱ期启动延迟现状,并分析其影响因素。方法 采用便利抽样方法,选取2019年5—10月浙江省某三级甲等母婴专科医院分娩后入住产科监护室的229例高危妊娠产妇作为研究对象。采用一般资料调查表、泌乳日志、爱丁堡产后抑郁量表及中文版疲乏评定量表对其进行调查。采用二分类Logistic回归分析产科监护室高危妊娠产妇泌乳启动延迟的影响因素。结果 229例产科监护室高危妊娠产妇发生泌乳启动延迟97例,发生率为42.4%;二分类Logistic回归分析结果显示,年龄≥35岁（OR=2.523,P=0.003）、有妊娠期高血压病（OR=2.523,P=0.003）、开奶时间晚（OR=0.924,P=0.025）是产科监护室高危妊娠产妇泌乳启动延迟的危险因素。结论 产科监护室高危妊娠产妇泌乳启动延迟率较高,尤其应关注年龄≥35岁、有妊娠期高血压疾病、开奶时间晚的高危妊娠产妇,建议做好孕期保健及健康教育,加强泌乳干预,促进营养吸收,增加产妇泌乳知识,以降低泌乳启动延迟率。     

产妇产后心绪不良发生情况及其影响因素分析

目的探讨产妇产后心绪不良的发病情况及其影响因素。方法对480例初产妇分别于分娩后1周逐一进行一般状况问卷调查,并采用抑郁自评量表(SDS)调查产妇产后心绪不良的发生率,然后采用Logistic回归分析产妇产后心绪不良发生的影响因素。结果480例产妇产后1周发生产后心绪不良167例,发生率为34.8%;产妇文化程度、经济状况、分娩方式、新生儿性别、产后出血、合并妊娠高血压综合征、新生儿呼吸衰竭、家庭支持系统等是其发生的主要影响因素。结论对有上述高危因素作用的产妇,应加强围产期的精神卫生保健和心理援助。     

母婴分离产妇发生产后抑郁现状调查

目的 了解母婴分离产妇住院期间产后抑郁发生的基本情况,探讨导致母婴分离产妇发生产后抑郁的影响因素.方法 对144例健康儿母婴同室(母婴同室组)和117例疾患儿母婴分离(分离组)初产妇应用爱丁堡产后抑郁量表(EPDS)、简易应对方式问卷(SCSQ)、社会支持评定量表(SSRS)以及自行设计一般情况调查表进行问卷调查.结果 母婴分离产妇住院期间产后抑郁的检出率较母婴同室产妇高(P<0.05);母婴分离产妇发生产后抑郁社会支持较差,其中以缺乏社会客观支持为主(P<0.01);照顾喂养新生儿信心缺乏(P<0.05)、产妇认为自身与新生儿患病有关(P<0.01) 及生女婴(P<0.05)是产后抑郁的诱发因素.结论 对母婴分离产妇要给予更多关注,引导其客观认识新生儿的病因,帮助其树立新生儿喂养信心,同时教育产妇和家人要转变重男轻女的思想.     

整体护理干预对高危妊娠产妇负性情绪的影响

目的:探讨整体护理干预对高危妊娠产妇负性情绪的影响.方法:将有焦虑、抑郁等负性情绪的高危妊娠产妇120例随机分为治疗组与对照组各60例,对照组给予常规护理,治疗组在此基础上给予整体护理干预,采用状态-特质焦虑量表(SA-I)和爱丁堡产后抑郁量表(EPDS)测评比较两组术前、术后焦虑、抑郁情况.结果:治疗组术后焦虑、抑郁缓解情况明显优于对照组(P<0.01,P<0.05).结论:对高危妊娠产妇实行整体护理干预,有利于减轻其负性情绪,值得推广应用.     

产后抑郁症相关因素调查研究

为了探索孕妇产后发生抑郁症相关因素,随机抽取１９９７年１～１１月产前门诊中决定在本院分娩的孕妇１０５２例进行情绪测定（ＨＡＤ）,以产后抑郁量表（ＥＰＤＳ）跟踪调查至产后７天８６６例。调查结果表明：ＥＰＤＳ阳性率为１５．０１％,ＨＡＤ问卷中Ａ值总分、Ｄ值总分≥１１分的分别为５．１３％及４．３７％。分析了影响ＥＰＤＳ和Ａ、Ｄ值的相关因素,提出相应的社区护理措施,把孕妇心理护理工作延伸到社区,进入家庭,以适应新的医学模式的转变,以利母婴身心健康。     

农民工家庭产妇产后焦虑、抑郁状况及影响因素研究

目的 了解农民工家庭产妇产后焦虑、抑郁的状况及影响因素,为针对性的护理措施提供依据.方法 在2所综合性医院及1所妇幼保健院以方便抽样的方法选取73例自然分娩的农民工家庭产妇为研究对象,在产后的24 h～1周,用SAS及SDS量表调查她们的焦虑及抑郁状况,同时在相同医院选取45例当地产妇作为对照,对两类产妇的调查结果进行比较.结果 农民工家庭产妇的焦虑及抑郁得分显著高于当地产妇;不同文化程度、家庭类型、家庭收入的农民工家庭产妇的焦虑、抑郁程度不同.结论 农民工家庭产妇存在较高的焦虑及抑郁情绪,应加强对她们的健康教育,指导其有效利用社会保障及支持系统,建立宣泄情绪、情感的正常渠道.     

Anxiety,depression, and quality of life in mothers of newborns admitted to the neonatal intensive care unit: A follow-up study from birth to the first two years of life

AimThere is evidence that the Neonatal Intensive Care Unit (NICU) environment can have a negative impact on maternal psychological well-being, especially in low- and middle-income settings. However, most studies on distress and quality of life in mothers of newborns who needed intensive medical care have measured patient-centered outcomes at only one time-point. Here, we evaluated the levels of anxiety, depression, and quality of life in mothers of newborns admitted to the NICU with follow-up throughout the first 2 years of the child's life.MethodsWe performed a longitudinal study in a region with the worst socioeconomic indicators in Brazil. We included mothers who had newborns admitted to the NICU. Our primary outcome of interest was quality of life, as measured by the WHOQOL-BREF instrument. Secondary endpoints included anxiety levels (Spielberger's State-Trace Anxiety Inventory) and depressive symptoms (Beck Depression Inventory).ResultsFifty-four mothers were included. During the first 48 h after NICU admission, the median quality of life score was 62.5 (IQR 56.3–68.8), and severe levels of state anxiety were observed in 61.1% of mothers. A positive relationship was observed between levels of state anxiety (p = 0.003), depressive symptoms (p < 0.001), and length of stay in the NICU. A significant improvement in the mothers' global quality of life score was observed only 12 months after the child's birth, which remained unchanged at the 24-month assessment.ConclusionsOur findings suggested that the admission of newborns to the NICU may have a long-term impact on maternal mental health.     

The Buffering Effect of Resilience upon Stress, Anxiety and Depression in Parents of a Child with an Autism Spectrum Disorder

The possible buffering effects of psychological resilience on stress, anxiety and depression associated with parenting a child with an Autism Spectrum Disorder (ASD) were investigated in 73 mothers and 35 fathers who had at least one child with an ASD and who completed a questionnaire about their experiences as parents. Mothers were significantly more anxious and depressed than fathers, and reported being “stretched beyond their resources” more frequently than fathers. Both mothers and fathers reported clinically significant anxiety and depression between three and five times the rate reported in the normal adult population. Moderation analysis showed that psychological resilience acted as a buffer against the development of elevated anxiety and depression associated with high levels of daily stress from parenting. Further, although the daily stress of parenting a child with an ASD was associated with quite severe anxiety and depression, even relatively low levels of resilience buffered against this anxiety and depression. Suggestions are made for assisting parents to develop psychological resilience in dealing with the stress associated with parenting their child with an ASD.     

Assessing anxiety and depression in parents of preterm infants

PurposeTo measure state and trait anxiety, as well as depression, among parents of preterm infants hospitalized in neonatal intensive care units (NICUs).DesignA convenience sample of 200 parents of preterm infants (124 mothers and 76 fathers) hospitalized in two Greek pediatric hospital NICUs participated in the study.ResultsAmong the 200 participating parents, mothers (which constituted 62% of the total sample) experienced higher levels of state anxiety, trait anxiety and depression than the fathers (p = 0.04, p < 0.001 and p = 0.001, respectively). State anxiety scores were also higher in individuals aged ≥40 years (p = 0.038). Other factors that contributed to higher levels of state anxiety, trait anxiety and depression included being unemployed, living in rural areas and having complications during pregnancy.ConclusionThe severity of state anxiety, trait anxiety and depression among parents of preterm infants hospitalized in NICUs is influenced by various socio-demographic factors and by clinical characteristics of the infants.     

The importance of assessing psychological status during pregnancy, childbirth and the postnatal period as a multidimensional construct: A literature review

This paper presents a comprehensive review of the literature surrounding women’s psychological health in pregnancy, childbirth and the postnatal periods. The content will provide clinically useful information to midwives and health care professionals involved in caring for women during the antenatal, intranatal and postnatal periods. The impact of psychological health status in pregnancy on clinical outcomes such as preterm labour, pre-eclampsia, epidural use, caesarean section, instrumental deliveries and increased rates of admission to neonatal intensive care, alongside the cognitive and social development of the infant and child are well documented. Less research to date has considered the impact of psychological well-being on the mother throughout pregnancy, the peripartum, postpartum and beyond. Psychological status for these women has traditionally been characterised by anxiety and depression, largely ignoring the complex psychological interrelations that characterise pregnancy. Psychological status in pregnancy cannot be defined within a unidimensional framework but must include a comprehensive assessment of all the dimensions that attribute to mood and emotional status for women during pregnancy, childbirth and the postnatal period. This paper intends to address the constructs of anxiety and depression, worry, control, quality of life, sleep and self-esteem. Screening for, and identification of, maternal psychological distress from a multidimensional perspective enables healthcare professionals to recognise and acknowledge normal and abnormal adjustment and offer interventions, strategies and support to facilitate a woman’s transition to motherhood.     

A holistic programme for mothers with postnatal depression: pilot study

Title.  A holistic programme for mothers with postnatal depression: pilot study.
Aim. This paper is a report of a pilot study to identify women's perceptions of participation in a holistic intervention for postnatal depression.
Background. Approximately 10–15% of women suffer from postnatal depression following childbirth. Most programmes for women with postnatal depression include pharmaceutical interventions; however, evaluation of women's perceptions of participation in holistic programmes for those suffering from postnatal depression show that non-pharmaceutical programmes can also be effective.
Method. In-depth interviews were conducted in 2004 with a self-selected sample of 10 women prior to and after an intervention to treat postnatal depression.
Findings. The intervention seemed capable of encouraging and facilitating a positive mother–infant relationship while also effectively reducing the mother's anxiety levels. Participants commented on the supportive environment of other mothers and said that they found playing with their babies difficult and needed guidance and facilitation to do this.
Conclusion. The pilot programme was well accepted and could easily be used by midwives, maternal and child health nurses and other appropriately trained allied health professionals.     

产前/后社区综合护理对预防产后抑郁症的效果分析

目的探讨妇保人员在社区妇保工作中,运用心理干预等综合护理方法,对预防产妇产后抑郁发生的作用。方法选取2009年5月至2010年5月在本院保健科管辖的两个社区分娩的200例产妇作为研究对象:实验组(100例),实施综合、全面的护理干预,同时进行心理护理;对照组(100例),进行常规护理。应用汉密顿抑郁量表(HAMD)和产后抑郁量表(EPDS)法,分别于产前、产后对两组产妇的焦虑、抑郁情绪进行评分。结果产妇产前HAMD评分、产后EPDS评分以及随访结果表明,综合护理的产妇抑郁症发生率和对照组相比明显降低(P0.05)。结论临床综合护理对预防以及提高产后抑郁症疗效有较好的效果。