妊娠晚期孕妇焦虑抑郁现况及心理干预需求分析

Analysis of anxiety and depression of pregnant women in the third trimester of pregnancy and psychological intervention needs

目的了解妊娠晚期孕妇焦虑、抑郁的影响因素及其心理干预需求,为医务人员和卫生行政部门制定针对性的心理干预策略提供参考依据。方法2020年1—3月采用自制调查表、焦虑自评量表及抑郁自评量表对浙江省瑞安市285例妊娠晚期孕妇进行问卷调查,采用χ^(2)检验和二元logistic回归分析进行数据分析。结果285例孕妇平均焦虑评分(49.74±13.07)分,焦虑症状检出117例,检出率为41.1%,其中轻度焦虑52例(18.2%),中度焦虑34例(11.9%),重度焦虑31例(10.9%);平均抑郁评分(48.68±9.56)分,其中评分≥53分者96例,抑郁症状检出率为33.7%,其中轻度抑郁68例(23.9%),中度抑郁26例(9.1%),重度抑郁2例(0.7%)。二元logistic回归分析结果显示,担忧胎儿性别与期望相反、有无妊娠并发症、担忧家庭经济状况及有无固定工作是妊娠晚期孕妇出现焦虑症状的主要危险因素(均P<0.05);担心胎儿健康状况、担忧胎儿性别及有无固定工作是妊娠晚期孕妇出现抑郁症状的主要危险因素(均P<0.05)。干预需求方面,妊娠晚期女性最期望获得的心理保健知识为产后康复与母乳喂养指导(75.4%),并以团体教育的形式(61.1%)在产检所在的医院(66.3%)由产科医生(75.8%)授予,最希望的信息获得渠道为医院的官方公众号(76.8%),最喜欢的孕妇间交流方式是通过医院建立的群聊进行互动(81.1%)。结论构建良好的社会支持环境,建立以医务人员为主导、官方及权威的孕妇心理健康管理服务平台针对妊娠相关因素进行健康宣教,对于促进妊娠晚期孕妇心理健康尤为重要。

Objective To investigate the influencing factors of anxiety and depression and psychological intervention needs of pregnant women in the third trimester of pregnancy.It provides a reference for medical staff and health administration departments to formulate targeted psychological intervention strategies.Methods From January to March 2020,285 pregnant women in the third trimester of pregnancy in Ruian city,Zhejiang Province were investigated by using a self-made questionnaire,self-rating anxiety scale and self-rating depression scale.The data were analyzed by word 2 test and binary logistic regression.Results The average anxiety score of 285 pregnant women was(49.74±13.07).117(41.1%)pregnant women suffered from anxiety symptoms,including 52(18.2%)women with mild anxiety,34 women(11.9%)with moderate anxiety and 31(10.9%)women with severe anxiety.The average depression score of the pregnant women was(48.68±9.56),96 patients with scores≥53,and the detection rate of depressive symptoms was 33.7%,including 68(23.9%)with mild depression,26(9.1%)with moderate depression,and 2(0.7%)with severe depression.The results of binary logistic regression analysis showed that the main risk factors for anxiety symptoms of pregnant women in the third trimester of pregnancy were worrying about the opposite sex of the fetus,whether there were pregnancy complications,worrying about family economic situation and whether there was a fixed job(all P<0.05);Concern about the health status of the fetus,concern about the sex of the fetus and whether there is a fixed job were the main risk factors for depression symptoms in the third trimester of pregnancy(all P<0.05).In terms of intervention needs,the most desired mental health knowledge for women in the third trimester of pregnancy was postpartum rehabilitation and breast-feeding instruction(75.4%),which was given in the form of group education(61.1%)by obstetricians(75.8%)in the hospital where the delivery examination took place(66.3%).The most desired way to obtain information was the official account of the hospital(76.8%),and the most preferred way of communication between pregnant women was group chat established by the hospital(81.1%).Conclusion The key measures to promote the mental health of pregnant women in the third trimester of pregnancy are to build a good social support environment for pregnant women and establish a health education team composed of doctors and nurses,which provides psychological counseling services for pregnant women.