产前心理教育对初产妇社会支持和抑郁症状的影响

Effects of Psychoeducation Program on Social Support and Symptomatology of Depression among Chinese First-time Mothers

【目的】探讨以人际关系心理治疗为原则的产前心理教育能否提高初产妇的社会支持水平,减轻抑郁症状。【方法】采用随机对照研究设计,于2008年6月至2009年6月对孕妇学校的194名初产孕妇进行随机分组,干预组96人,对照组98人。对照组只接受医院常规的产前教育,干预组除了接受医院常规的产前教育外,还接受以人际关系心理治疗为原则的心理干预措施(妊娠晚期两节90 min的1次课程和产后2周内的一次电话随访)。结果变量社会支持、抑郁症状分别采用领悟社会支持量表(PSSS)和爱丁堡产后抑郁量表(EPDS)来测量,对所有研究对象分别在干预前、产后6周和产后3个月进行结果变量的测量。【结果】意向性分析显示以人际关系心理治疗为指导的产前心理教育能够促进初产妇的社会支持水平,减轻抑郁症状。干预组PSSS的得分从妊娠晚期的66.28±7.04增加到产后6周的68.76±7.56;而对照组从妊娠晚期的66.19±8.32降低到产后6周的62.59±9.00。干预组EPDS得分从妊娠晚期的8.17±4.33持续降低到产后3个月的5.61±3.33,而对照组EPDS得分产后6周先增加到8.87±4.37然后才降低到产后3个月的6.87±3.97。【结论】以人际关系心理治疗为原则的产前心理教育能够促进初产妇社会支持水平,减轻抑郁症状。

【Objective】 To explore the effects of an interpersonal psychotherapy oriented psychoeducation program on social support,symptomatology of depression in Chinese first-time mothers.【Methods】 A randomized,controlled trial was conducted.The intervention was based on the principles of interpersonal-psychotherapy,and consisted of two 90-minute antenatal classes and a telephone follow-up within two weeks after delivery.One hundred and ninety-four first time pregnant women were randomly assigned to the study group（n = 96） or a control group（n = 98）.Outcomes of the study included social support and symptoms of depression which were measured by Perceived Social Support Scale（PSSS）,and Edinburgh Postnatal Depression Scale（EPDS） at baseline,6 weeks（post-1） and three months postpartum（post-2）.Analysis was by intention to treat.【Results】There were significant treatment effects across time for both outcomes： social support and symptoms of depression.The PSSS score in the study group had increased from 66.28 ± 7.04 baseline to 68.76 ± 7.56 six weeks postpartum while the PSSS score in the control group had decreased from 66.19 ± 8.32 baseline to 62.59 ± 9.00 six weeks postpartum.The EPDS score in the study group decreased from 8.17 ± 4.33 baseline to 5.61 ± 3.33 three months postpartum while the EPDS score in the control group increased to 8.87 ± 4.37 six weeks postpartum then decreased to 6.87 ± 3.97 three months postpartum.【Conclusion】The interpersonal psychotherapy oriented psychoeducation program had positive effects on social support and symptoms of depression for first-time Chinese Childbearing women.It could be implemented as a routine childbirth education with ongoing evaluation.