孕期至产后干预对产后意外妊娠影响

目的 分析从孕期至产后开展综合干预对产后避孕知识及意外妊娠的影响。方法 于2011年7月-2012年7月对上海市浦东新区妇幼保健院和普陀区妇婴保健院3542名孕产妇进行干预,按医院分为干预组和对照组,采取结构式问卷进行调查。结果 产后开始避孕时间、产后恢复性生活时间和排卵期计算方法相关知识,对照组回答正确人数分别为364人(45.50%)、622人(77.75%)和374人(46.75%),干预组分别为1905人(69.47%)、2504人(91.32%)和1152人(42.01%);不同避孕方法中,产后意外妊娠103人(3.09%),对照组为35人(4.57%),干预组为68人(2.65%);2组导致产后意外妊娠发生比例最高的分别为口服避孕药和紧急避孕药,其次分别为安全期和体外排精避孕;多因素分析结果显示,干预组产后意外妊娠发生比例较对照组降低45%,文化程度、产后恢复性生活时间与避孕时间的交互作用对产后意外妊娠有影响。结论 以医院为基础的综合干预可有效降低产后意外妊娠发生的可能性。     

正念减压疗法对乳腺癌化疗患者癌因性疲乏及睡眠质量的影响

目的 探讨正念减压疗法对乳腺癌化疗患者癌因性疲乏及睡眠质量的影响.方法 选取2017年1月-2018年12月在本院接受治疗的乳腺癌患者180例,将其按照随机对照原则分为两组,每组90例.对照组接受常规护理干预,观察组在对照组的基础上接受6周的正念减压疗法干预,观察干预前、干预3个月后疲乏水平及睡眠质量.结果 干预前两组...     

Comparison of the effect of lavender and bitter orange on sleep quality in postmenopausal women: A triple-blind,randomized, controlled clinical trial

This trial compared the effects of lavender and bitter orange on sleep quality in postmenopausal women. This trial was conducted in 2015. Eligible postmenopausal women were allocated into one of two intervention groups or a control group (n = 52 per group) in a 1:1:1 ratio using a randomized block design. Intervention groups received 500 mg capsules containing only bitter orange or lavender flower powder, and the control group received 500 mg capsules containing starch. The Pittsburgh Sleep Quality Inventory was used before and eight weeks after starting the intervention. Data analyses were based on intention to treat. A one-way ANOVA showed a slightly significant difference in mean sleep score among the three groups before the intervention (p = .045). The general linear model, adjusted for baseline sleep score and confounding factors, showed significant differences among the groups in the mean sleep score after eight weeks of treatment (p < .001). Bitter orange and lavender significantly improved the mean sleep score compared with the control group (p < .001 and p = .003, respectively). The positive effect of bitter orange and lavender on sleep quality in postmenopausal women suggests that they can be used to improve sleep quality in such women.     

Effects of zinc and magnesium supplements on postpartum depression and anxiety: A randomized controlled clinical trial

Postpartum anxiety and depression are prevalent disorders. The authors of this study aimed to determine the effects of zinc and magnesium supplements on depressive symptoms and anxiety in postpartum women referred to three governmental, educational hospitals in Tabriz, Iran during 2014–2015. In this triple-blind, randomized, controlled clinical trial, the participants were randomly assigned to the zinc sulfate, magnesium sulfate, and placebo groups (n = 33 per group). The intervention groups received a 27-mg zinc sulfate tablet or 320-mg magnesium sulfate tablet per day for 8 weeks, whereas the control group received a placebo tablet each day during the same period. The Edinburgh Postnatal Depression Scale and the Spielberger State-Trait Anxiety Inventory were completed before and 8 weeks after the intervention. Blood samples were drawn from each participant to determine serum levels of zinc and magnesium before intervention at 48 hours after delivery. Also, a 24-hour dietary questionnaire was used during the first and last 3 days of the intervention. Adjusting for baseline scores as well as zinc and magnesium serum levels, no significant difference was observed between groups 8 weeks after delivery in mean scores of depressive symptoms (p = .553), state anxiety (p = .995), and trait anxiety (p = .234). This study concluded magnesium and zinc did not reduce postpartum anxiety and depressive symptoms.     

The effect of immediate postpartum levonorgestrel contraceptive implant use on breastfeeding and infant growth: a randomized controlled trial

Objective

This study assessed whether immediate postpartum insertion of levonorgestrel contraceptive implants is associated with a difference in infant growth from birth to 6 months, onset of lactogenesis, or breastfeeding continuation at 3 and 6 months postpartum compared to delayed insertion at 6 to 8 weeks postpartum.

孕期综合干预对孕晚期及产后抑郁症的影响

目的：探讨孕期采取综合干预对孕晚期及产后抑郁症患病率的影响。方法选取2012年12月至2013年1月在陕西省妇幼保健院产科进行产检并住院分娩的孕妇202例,随机分为实验组与对照组两组,每组各101例。对照组进行常规产检。实验组在常规产检基础上给予以下干预措施：①孕12～20周,接诊医生对孕妇制定产检计划,并在整个孕期负责对孕妇进行详细答疑解惑;②孕20周后,孕妇接受以人际关系为主题的产前心理教育课程;③孕32周后,由助产士帮助孕妇制定分娩计划、了解分娩过程、熟悉产房环境、掌握分娩技巧。比较两组孕晚期及产后抑郁症发生情况。结果孕中期抑郁症与性格、家庭居住条件、职业压力、与父母/公婆的关系具有线性相关（OR值分别为0．429,2．141,1．445,3．476;均P＜0．05）。两组孕中期抑郁症患病率无差异（χ2＝0．625,P＞0．05）;实验组孕晚期抑郁症患病率为9．18％,低于对照组的19．59％,两组具有统计学差异（χ2＝4．291,P＜0．05）;产后42天实验组抑郁症患病率12．5％,低于对照组的25．77％,两组具有统计学差异（χ2＝5．486,P＜0．05）。实验组在孕晚期及产后42天抑郁症患病率均较孕中期降低（χ2值分别为13．290和11．235,均P＜0．05）。结论家庭居住条件、职业压力及与父母/公婆关系是影响孕中期抑郁症发生的主要危险因素;孕期进行系统的综合的干预可明显降低孕晚期抑郁症发生,同时有助于控制产后42天抑郁症患病率增高。     

婴儿睡眠卫生教育对产妇睡眠质量和睡眠知信行的影响

目的 了解婴儿睡眠卫生教育对产妇睡眠质量、产后抑郁、睡眠认知和睡眠养育行为的影响。 方法 选择在重庆市妇幼保健院接受系统儿童保健1月龄婴儿的600名产妇作为调查对象,随机分成两组。干预组从婴儿第1月龄开始接受每个月1次的婴儿睡眠卫生健康教育(共5次),包括婴儿睡眠教育宣传页、20 min小讲课、一对一睡眠咨询指导以及电话网络咨询服务。对照组每月定期接受的儿童保健指导。在婴儿1月龄和6月龄时,采用匹兹堡睡眠质量指数量表(PSQI)、抑郁自评量表(SDS)、婴儿睡眠健康知识和养育行为问卷对两组产妇进行睡眠质量、抑郁状况、睡眠认知和睡眠养育行为评价。 结果 两组产妇干预前的一般情况、PSQI分值、抑郁状况、睡眠认知和养育行为状况无明显差异(均P<0.05)。干预后:(1)干预组产妇睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍等评分及PSQI总分均低于对照组(均P<0.05);(2)两组产妇的抑郁评分无明显差异(t=0.851,P=0.397);(3)睡眠认知方面:干预组认为孕期情绪对儿童睡眠有影响的产妇比例(60.90% vs. 51.69%)、孕期睡眠状况对儿童的睡眠影响的比例(60.53% vs. 49.58%)、睡眠光线对儿童睡眠有影响的比例(59.77% vs. 47.03%)、认为应采取仰卧或侧卧睡眠姿势的比例(75.94% vs. 61.02%)均高于对照组,差异有统计学意义(均P<0.05);(4)睡眠养育行为方面:干预组产妇在睡眠养育行为如孩子独睡比例(30.08% vs. 22.03%)、不喂夜奶比例(40.23% vs. 27.97%)、夜间睡眠期间安抚不抱比例(42.48% vs. 29.66%)均高于对照组,差异有统计学意义(均P<0.05)。 结论 婴儿睡眠卫生健康教育有效促进了产妇的睡眠质量,改善了睡眠认知和部分睡眠养育行为。     

妊娠期睡眠质量与焦虑症状的关联研究

目的：了解孕妇焦虑情绪现状,分析妊娠期睡眠质量与焦虑症状的关系。方法采用自编的调查问卷,对六安市金安区妇幼保健院1010名孕妇进行问卷调查,收集孕妇一般情况信息,采用匹茨堡睡眠质量指数量表（ PSQI）和状态－特质焦虑量表（STAI）评定睡眠质量和状态－特质焦虑症状。结果1010名孕妇中睡眠质量问题检出率为44．65％,状态焦虑症状检出率为16．53％,特质焦虑症状检出率为13．37％。有睡眠质量问题的孕妇状态焦虑症状（19．73％）和特质焦虑症状（17．07％）的检出率均高于无睡眠质量问题的孕妇（χ2值分别为9．67、6．04,均P＜0．05）。多因素Logistic分析结果显示,睡眠质量与状态和特质焦虑症状关联的OR估计值分别为1．44（95％CI：1．03～2．03）和1．71（95％CI：1．18～2．47）。结论孕妇睡眠质量与孕期焦虑症状存在关联,应积极采取综合性干预措施改善孕妇妊娠期睡眠质量和焦虑情绪。     

孕前午睡与目前夜眠时长对孕晚期疲劳的相关性研究

目的 讨论孕前午睡与目前夜眠时长对孕晚期正常孕妇疲劳程度的影响。方法 收集2020年1～12月于厦门大学医学院第二附属医院就诊的正常孕晚期(孕28周～分娩)孕妇490例,收集其一般人口学信息与临床资料,记录孕前午睡与目前夜眠有效睡眠时长,排除3例缺失夜眠时长样本,有效样本487例。按孕前是否午睡分为午睡(n=332)和无午睡(n=141),依据美国国家睡眠基金会建议,以7 h为界点,结合目前夜眠有效睡眠时长≤7 h(n=165)和>7 h(n=308)进行分组。对各组样本进行一般资料调查,采用FS-14量表量化孕晚期妇女疲劳程度,将得分整理为总分、躯体疲劳得分、脑力疲劳得分三个项目,分析午睡、夜眠时长效应的交互作用、不同主效应的差异及夜眠时长与FS-14得分相关性。结果 FS-14总分、FS-14躯体疲劳得分组间差异有统计学意义,FS-14脑力疲劳得分组间差异无统计学意义。无午睡且夜眠≤7 h组孕妇FS-14总分、躯体疲劳得分、脑力疲劳得分均最高,无午睡且夜眠>7 h的孕妇三项得分均值为最低分。不论孕前是否午睡,夜眠时长>7 h,其疲劳总分、躯体疲劳得分均较低。结论 ...     

老年喉癌患者术后癌因性疲乏与睡眠质量的相关性研究

目的调查老年喉癌患者术后癌因性疲乏与睡眠质量现状,并探讨其相关性。方法选取冀中能源峰峰集团有限公司总医院2013年5月—2014年5月收治的132例喉癌患者为研究对象,采用Piper癌因性疲乏量表、匹茨堡睡眠质量指数量表(PSQI)对其进行调查。结果男性Piper癌因性疲乏量表均分为(5.14±0.67)分,女性(5.02±0.61)分,差异无统计学意义(P0.05)。老人60~69岁得分为(4.82±0.59)分,70~79岁得分为(4.99±0.53)分,80岁的得分为(5.51±0.62)分,差异有统计学意义(P0.05)。手术后患者PSQI总分男性为(14.34±3.75)分,女性为(14.58±2.09)分,差异无统计学意义(P0.05)。术后癌因性疲乏与睡眠质量具有正相关性,差异具有统计学意义(P0.05)。结论老年喉癌患者手术后癌因性疲乏发生率高,且易发生高、中度疲乏以及不同程度的睡眠障碍,患者癌因性疲乏程度越严重,睡眠质量越差。     

The healthcare experiences of women with cardiac disease in pregnancy and postpartum: A qualitative study

IntroductionCardiac disease affects an estimated 1%–4% of all pregnancies and is a leading cause of maternal morbidity and mortality. There is a lack of data on the healthcare experiences of affected women to inform health service delivery and person‐centred care. This study sought to explore and understand the healthcare experiences of women with cardiac disease in pregnancy and postpartum.MethodsThis qualitative study used semi‐structured interviews with women who had cardiac disease in pregnancy or the first 12 months postpartum. Data were analysed using thematic analysis.ResultsParticipants were 25 women with pre‐existing or newly diagnosed acquired, genetic and congenital cardiac disease. Analysis of the interviews highlighted the discrepancy between care aspirations and experiences. The participants had a wide range of cardiac diseases and timing of diagnoses, but had similar healthcare experiences of being dismissed, not receiving the information they required, lack of continuity of care and clinical guidelines and of feeling out of place within a healthcare system that did not accommodate their combined needs as a mother and a cardiac patient.ConclusionThis study identified a lack of person‐centred care and responsiveness of the healthcare system in providing fit‐for‐purpose healthcare for women with complex disease who are pregnant or new mothers. In particular, cardiac and maternity care providers have an opportunity to listen to women who are the experts on their emergent healthcare needs, contributing to development of the knowledge base on the healthcare experiences of having cardiac disease in pregnancy and postpartum.Patient or Public ContributionPublic and patient input into the value and design of the study was gained through NSW Heart Foundation forums, including the Heart Foundation''s women''s patient group.     

Effects of sleep hygiene education and behavioral therapy on sleep quality of white-collar workers: a randomized controlled trial

Because poor sleep quality can reduce quality of life and increase prevalence of illness in workers, interventions are becoming increasingly important for businesses. To evaluate how sleep quality is affected by one-on-one behavioral modification when combined with group education, we conducted a randomized, controlled trial among day-shift white-collar employees working for an information-technology service company in Japan. Participants were randomly allocated to groups receiving either sleep hygiene group education (control group), or education combined with individual sleep modification training (one-on-one group). Occupational health professionals carried out both procedures, and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). PSQI scores were obtained before and after the intervention period, and changes in scores were compared across groups after adjustments for age, gender, job title, smoking and drinking habits, body-mass index, and mental health as assessed using K6 scores. The average PSQI score for the control group decreased by 0.8, whereas that of the one-on-one group decreased by 1.8 (difference of 1), resulting in a significantly greater decrease in score for the one-on-one group (95% confidence interval: 0.02 to 2.0). These results show that, compared to sleep hygiene group education alone, the addition of individual behavioral training significantly improved the sleep quality of workers after only three months.     

医学专科学生身体锻炼对睡眠质量影响

目的了解医学专科学生身体锻炼与睡眠质量的关系。方法采用匹兹堡睡眠质量指数量表(PSQI)和身体锻炼等级量表对福建省4所医学专科高校的1602名学生进行调查。结果在被调查的1602人中,睡眠差者占27.9%;PSQI总分为(6.24±2.44)分;身体锻炼得分为(15.19±16.62)分;37.1%学生在睡觉前2h内剧烈运动或活动对睡眠质量造成不利影响;低锻炼量组PSQI总分高于中等锻炼量组和高锻炼量组;中等锻炼量组和高锻炼量组之间差异无统计学意义;对应分析表明,中等锻炼量组和高锻炼量组的学生睡眠好,低锻炼量组学生睡眠差。结论适量体育锻炼有助于睡眠质量,睡前剧烈运动不利于睡眠,应加强午后或傍晚参加适量体育锻炼,改善睡眠。     

A randomized controlled trial of the effect of advanced supply of emergency contraception in postpartum teens: a feasibility study

Background

The study was conducted to test the feasibility of conducting a randomized controlled contraceptive trial in postpartum teens and to assess whether postpartum advanced supply of emergency contraception (EC) to teenaged mothers helps to prevent repeat pregnancies of close proximity.

Study Design

We performed a randomized controlled trial of 50 postpartum teens at an urban academic medical center. Participants in the intervention arm received routine postpartum contraceptive care and advanced supply of one pack of EC pills with unlimited supply thereafter upon request. The routine care arm (RCA) received routine postpartum contraceptive care. We asked open-ended questions about how we might maximize study retention and implemented the participants' requests in both arms.

Results

Our retention rate was 78%. There were three (13%) pregnancies out of 23 participants in the intervention arm and eight (30%) pregnancies out of 27 participants in the RCA. The risk of pregnancy occurring in the intervention arm was 0.57 times that of the RCA (95% CI 0.20-1.60; p=.23).

Conclusions

A randomized controlled trial of postpartum teens to receive and not to receive advanced supply of EC is both feasible and necessary. Our study provides preliminary data to suggest that advanced supply of EC may help decrease repeat teen pregnancies.     

肾癌患者术后癌因性疲乏与睡眠质量的相关性研究

目的 研究肾癌患者癌因性疲乏(CRF)程度,探讨其与睡眠质量的关系,为肾癌患者CRF综合管理提供依据.方法 选择湖北科技学院临床医学院2013年1月-2014年8月收治的肾癌患者288例作为研究对象.采用Piper(PFS)疲乏量表对患者疲乏症状进行评价,使用匹兹堡睡眠质量指数(PSQI)量表评估患者睡眠情况.结果 288名肾癌患者PFS平均得分为(2.77±1.36)分,不同年龄段肾癌患者感知维度、PFS均值得分差异具有统计学意义(P＜0.05);PSQI平均得分为(7.47±3.41)分,不同程度CRF肾癌患者睡眠质量差异具有统计学意义(P＜0.05);肾癌患者PFS与PSQI呈明显正相关(r=0.24,P＜0.05).结论 PFS适用于临床上评价肾癌患者疲乏症状,CRF与睡眠质量密切相关,应采用综合管理措施减轻肾癌患者疲乏症状,改善预后.     

周末补偿睡眠对学龄儿童睡眠质量和学业表现的影响

【目的】 了解学龄儿童睡眠周末补偿睡眠现状,探索补偿睡眠与睡眠质量及学业表现的相关性。 【方法】 采用分层整群抽样法,于2009年11-12月抽取上海市10所小学的2 249名五年级学生。采用学业成绩表现教师评估问卷了解儿童学业表现(各维度得分越低,学业表现越好),采用中文版儿童睡眠习惯问卷(Children Sleep Habits Questionnaire,CSHQ)评估儿童的睡眠时间和质量(总分≥41分为睡眠质量不良),采用儿童个人及家庭社会环境问卷用于收集基本情况。使用t检验、协方差分析等对数据进行分析。 【结果】 调查对象年龄为(10.81±0.38)岁,男生占49.3%。儿童周末较平时晚睡(37±40)min,晚起(86±54)min。补偿睡眠时间平均(48±58)min,波动范围为3~5.5 h。睡眠质量不良儿童的补偿睡眠多于睡眠质量良好的儿童(t=3.82,P＜0.001)。校正学龄儿童年龄、性别及父母的受教育程度后,协方差分析显示:睡眠不足(平时与周末睡眠时间均≤9 h)儿童和补偿睡眠(补偿睡眠时间≥1 h)的儿童的学业成绩总分分别高于睡眠充足(平时与周末睡眠时间均≥10 h)组的儿童(F=10.99,P<0.001),即学业表现较差。 【结论】 周末补偿睡眠与睡眠不足一样,对儿童的睡眠质量和学业表现都有不良影响,并不能改善儿童睡眠质量或提高学业表现。     

妊娠早期孕妇睡眠质量和人格特征、社会支持的相关性

目的 了解人格特征和社会支持与妊娠早期孕妇睡眠质量的相关性.方法 采用随机抽样方法抽取146名妊娠早期孕妇.对所有样本进行匹茨堡睡眠质量指数(pS QI)、艾森克人格问卷(EPQ)、社会支持量表(SSRS)测评妊娠早期孕妇人格特征及社会支持系统及其与睡眠质量的关系.结果 妊娠早期孕妇的PSQI与EPQ-L、EPQ-E呈显著负相关(r值分别为-0.165、-0.143,均P＜0.05);与EPQ-N、EPQ-P呈显著正相关(r值分别为0.427、0.126,均P＜0.05).SSRS总分和PSQI总分呈负相关(r=0.513,P＜0.05).结论 人格特征和社会支持对妊娠早期孕妇睡眠质量影响较大,可通过提高情绪的稳定性、增强社会支持来改善妊娠早期孕妇的睡眠质量.     

急性白血病患儿睡眠紊乱与疲乏的相关性研究

目的探讨急性白血病患儿的睡眠紊乱与疲乏的相关性。方法采用便利抽样选取65名急性白血病儿童病例,对其主要照顾者进行问卷调查,内容包括儿童睡眠紊乱量表(Sleep Disturbance Scale for Children,SDSC)和PedsQL TMMFS儿童多维疲乏量表。结果急性白血病患儿的睡眠量表总分为(47.83±10.74)分,睡眠紊乱总发生率为6.15%,各维度中睡眠-觉醒转换障碍和睡眠呼吸障碍和觉醒障碍发生率最高。疲乏总分为(60.41±17.26)分,三个维度得分由低到高依次为一般疲乏、休息疲乏和认知疲乏。患儿的睡眠紊乱与疲乏呈负相关(r=-0.51,P0.01),即患儿睡眠紊乱越严重,疲乏程度越高。结论急性白血病患儿治疗期间最常见的睡眠紊乱为睡眠-觉醒转换障碍和睡眠呼吸障碍和觉醒障碍,疲乏主要表现为一般疲乏和休息疲乏。急性白血病患儿的睡眠障碍与疲乏状况呈负相关。