早产儿校正6月龄内母亲创伤后应激障碍变化轨迹及影响因素分析

Post-traumatic stress disorder in mothers of preterm infants within corrected 6 months and the influencingfactors

目的调查早产儿校正6月龄内母亲创伤后应激障碍的变化趋势, 并进行相关因素分析。方法采用便利抽样法, 选取2018年7月至2019年11月于同济大学附属第一妇婴保健院进行早产儿门诊随访的母亲171名作为研究对象。在早产儿校正1~6月龄时采用创伤后应激障碍问卷对母亲进行评估, 调查一般资料、母亲焦虑及家庭管理情况, 采用线性回归分析明确早产儿校正6月龄内母亲创伤后应激障碍的影响因素。结果早产儿母亲创伤后应激障碍发生率明显高于国内常模, 校正1月龄时发生率35.09%(60/171), 最高得分(4.80 ± 2.09)分, 后逐渐下降, 至校正6月龄时, 母亲创伤后应激障碍发生率降为12.06%(17/141), 得分(3.41 ± 1.82)分。多元线性回归分析结果显示, 早产儿出生体质量、住院时间、母亲焦虑、母亲年龄、家庭管理、出院后再入院是早产儿校正6月龄内母亲PTSD的影响因素(t值为-2.47~3.08, 均P<0.05)。结论早产儿校正6月龄内母亲创伤后应激障碍发生率较高, 虽然随着时间推移发生率逐渐降低, 但仍明显高于平均水平, 值得临床关注。早产儿出生体质量小、住院时间长、母亲年龄小的早产儿母亲需警惕创伤后应激障碍的发生, 早产儿住院期间尽可能提供家庭参与式护理, 提高母亲照护信心。减轻母亲的焦虑情绪, 保持良好的家庭关系, 提高家庭管理能力, 出院后给予延续性护理服务, 有利于防止母亲出现创伤后应激障碍。

Objective To investigate the trend of posttraumatic stress disorder(PTSD)in the mothers of preterm infants within 6 months and analyze the related factors.Methods There were 171 mothers of premature infants selected by convenience sampling method who received outpatient follow-up from Shanghai First Maternity and Infant Hospital,School of Medicine,Tongji University from July 2018 to November 2019.The mothers were evaluated by post-traumatic stress disorder questionnaire from corrected age 1 month to 6 months of preterm infants,and the general data,maternal anxiety and family management were investigated as well.Linear regression analysis was used to determine the influencing factors of post-traumatic stress disorder for preterm infants within corrected 6 months.Results The incidence of posttraumatic stress disorder in mothers of premature infants was significantly higher than the domestic norm.The incidence was 35.09%(60/171)in 1 month and the highest score was 4.80±2.09,and then gradually decreased to 12.06%(17/141)in 6 months,with an average score of 3.41±1.82.The results of linear regression analysis showed that the birth weight of preterm infants,hospital stay and the age of the mother,the maternal anxiety score,the Family Management Measure score,re-hospitalization after discharge were the influencing factors of the maternal PTSD score(t values were-247-3.08,all P<0.05).Conclusions The incidence of post-traumatic stress disorder in mothers of preterm infants within 6 months is higher.Although the incidence gradually decreases over time,it is still significantly higher than the average level,which deserves clinical attention.The mothers of premature infants with low birth weight,long hospital stay and young mothers should be alert to the occurrence of PTSD.During the hospitalization of premature infants,family participatory nursing should be provided as much as possible to improve mothers'confidence in caring.Alleviating mother's anxiety,maintaining good family relationship,improving family management ability and providing continuous nursing service after discharge are beneficial to prevent mother from having post-traumatic stress disorder.