应用Walker-Avant经典概念分析法界定产后抑郁污名化

Using Walker⁃Avant classical conceptual analysis to define the stigmatization of postpartum depression

目的分析产后抑郁(postpartum depression,PPD)污名化的概念发展及应用、属性、前因、结果及典型案例,以期为PPD心理求助相关研究提供理论参考,为母婴健康照护实践提供依据。方法系统检索数据库知网、万方、维普、Sinomed、Embase、PubMed、Scopus、CINAHL和Web of Science收录的所有有关PPD污名化的文献,以Walker-Avant经典概念分析法为理论框架进行分析。结果共纳入文献40篇,归纳总结出PPD污名化定义属性包括3个方面:消极情绪体验、负面认知评价以及歧视倾向;其前因包括4个方面:个人障碍、社会障碍、卫生保健障碍及公众障碍;其后果是对患者生理心理均产生不利影响。结论界定PPD污名化有助于医护人员开展相关理论研究,编制相关适用测评量表及制定相应的干预措施,提高对PPD污名化的识别及干预能力,为提升围生产期精神卫生保健利用率提供参考依据。

Objective To analyze the conceptual development and application,attributes,antecedents,outcomes,and typical cases of PPD stigmatization,to provide theoretical references for research related to psychological help for PPD,and to provide a basis for maternal and child healthcare practice.Methods A systematic search was conducted for all literature on PPD stigmatization included in the databases cnki,Wanfang,Vip,Sinomed,Embase,PubMed,Scopus,CINAHL,and Web of Science,and analyzed using the Walker⁃Avant classical conceptual analysis method as the theoretical framework.Results A total of 40 papers were included in the literature,and it was summarized that the defining attributes of PPD stigmatization included 3 aspects:negative emotional experience,negative cognitive appraisal and discriminatory tendency;its antecedents included 4 aspects:personal barriers,social barriers,health care barriers,and public barriers;and its consequences were adverse impacts on both the physiology and psychology of the patients.Conclusion Defining PPD stigma will help healthcare professionals to carry out relevant theoretical research,develop relevant and applicable assessment scales and corresponding interventions,and improve their ability to identify and intervene in PPD stigma,so as to provide a reference basis for improving the utilisation of perinatal mental health care.