对产后抑郁患者进行个体化心理干预的效果评价

Evaluation on the Effects of Individualized Psychological Interference on Puerperium Depressive Patients

目的 针对有产后抑郁倾向的患者建立由护士实施为期4．6周的心理干预项目。进而评价其效果。方法 将63例患者随机分成两组，对照组31例，接受一般性出院指导及常规心理护理，采用常规访视方式，干预组32例，在产后接受常规出院指导，同时接受4—6周的心理干预，干预措施包括讲授产后康复运动知识、观看并分发与产后情绪及运动相关的资料和光盘、传授音乐配合呼吸训练、音乐背景的引导想象放松训练、帮助建立良好的社会支持系统、电话随访产妇心理状态，允许产妇在产褥期内随时进行门诊心理咨询或电话心理咨询；干预期间的第1周末、第2周末、第4周末、第6周末对两组产妇进行抑郁量表（SDS）及自评量表（SCL-90）测定并比较两组产妇SDS及SCL-90的分值。结果通过心理干预，干预组患者抑郁情绪明显改善，SDS分值的降低幅度均较对照组明显，差异有统计学意义（P〈0．001）。在SCL-90的各分量表中干预组分值显著低于对照组，两组差异有显著性（P〈0．01）。结论 由专业护士建立院外心理干预模式能有效改善产妇在产褥期的抑郁情绪，帮助其渡过产后的情绪脆弱阶段，阻断产后抑郁症的发生。

Objective To establish a 4 - 6 week psychological interference project which is carried out by nurses on puerperium depressive patients, and to evaluate its effects. Methods 63 patients are randomly divided into two groups, the 31patients in the contrast group are given general out - hospital instructions and routine psychological nursing, while the other 32 patients in the interference group are given a 4 - 6 week psychological interference as well as routine out - hospital instructions. Measures of psychological interference include lectures on puerperium convalescent exercises, videos on puerperium emotion and exercises, respiration training with incidental music, imaginative relaxation training induced with background music, establishment of good social supportive system, telephone interview on the psychology of the puerperium patients, and allowing puerperium patients to get psychological consultancy at clinic or by telephone. At the ends of the 1st, 4th and 6th weeks, the depression self- evaluation table （SDS） and the symptom self- evaluation table are used on the two groups, and the scores are compared Results After the psychological interference, the depressive emotion of the patients in the interference group is notably improved, of which all the SDS score decreases are more obvious than those in the contrast group, the differ-ence is statistically significant （ P 〈 0.001 ）. The SCL - 90 scores in the interference group are lower than those in the contrast group, the difference is significant（P 〈 0. 01 ）. Conclusion Out - hospital psychological interference carried out by specialized nurses can effectively improve the depressive emotion of the puerperium patients, help them get through the emotional fragility period, and interdict the occurrence of puerperium depression.