Psychological experiences during pregnancy in women of childbearing age with epilepsy: A qualitative study
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摘要:
目的 了解育龄期女性癫痫患者妊娠期真实的心理体验,明确育龄期女性癫痫患者妊娠期心理状态,以期为育龄期女性癫痫患者妊娠期身心健康管理提供依据,并采取针对性干预措施,减轻妊娠期心理负担。 方法 选取2021年5—12月已育、子代月龄≤ 24月且在陆军军医大学第二附属医院神经外科长期随访治疗的女性癫痫患者为研究对象,通过目的抽样法选取8例患者,采用现象学研究方法进行半结构式深度访谈,应用Colaizzi 7步分析法进行资料分析。 结果 8例育龄期女性癫痫患者妊娠期心理体验可归纳为4个主题:(1)来自家庭、社会的压力,表现为传宗接代、延续香火的观念根深蒂固,认为婚后没有宝宝的家庭是不完整的家庭,介于家庭和社会的压力选择生育宝宝;(2)来自癫痫相关知识缺乏的压力,表现为缺乏抗癫痫发作药物及癫痫疾病本身对自身及胎儿影响的相关知识,导致非计划性怀孕;(3)来自对子代健康影响的压力,表现为担心疾病会遗传给子代,担心抗癫痫发作药物会影响子代健康;(4)来自对自身健康影响的压力,表现为担心怀孕后会加重癫痫的发作。 结论 育龄期女性癫痫患者较正常女性面临着更大的压力,医务工作者应针对患者的主要心理压力源,给予患者及家属妊娠相关知识宣教,提高家庭社会支持,并指导患者孕期保健,使患者安全度过妊娠期。 Abstract:Objective To understand the actual psychological experiences during pregnancy in women of childbearing age with epilepsy, and to clarify the psychological states during pregnancy in this group of women, to provide a basis for the implementation of physical and mental health management, and to undertake targeted interventions to reduce psychological burdens of pregnancy in this population. Methods Female patients with epilepsy who were fertile, had offspring ≤24 months of age and were undergoing long-term follow-up treatment in Department of Neurosurgery, Second Affiliated Hospital of Army Medical University from May to December 2021 were selected for the study. Eight patients were selected by purposive sampling method, semi-structured in-depth interviews were conducted using a phenomenological approach, and Colaizzi ' s seven-step method was applied for data analysis. Results Four themes were obtained from the analysis: (1) Having a child due to reproductive stress caused by social and family related factors, such as deep-rooted beliefs about procreation and carrying on the family name, and the beliefs that a family without a child after marriage is an incomplete family, and choosing to have a child due to family and social pressure; (2) Stress caused by lack of knowledge about epilepsy, including antiepileptic drugs, and the impact of epilepsy on their own health and their offspring, which may be associated with an unplanned pregnancy; (3) Stress caused by the impact of pregnancy on the health of their offspring, namely the fear of passing epilepsy to their offspring, and the impact of antiepileptic drugs use on the health of their offspring; (4) Stress caused by the impact of pregnancy on their own health, namely the fear of pregnancy-related exacerbation of epileptic seizures. Conclusion Compared with their healthy counterparts, this group of women faces greater psychological stress during pregnancy. To ensure their safety during pregnancy, medical staffs should take steps to provide pregnancy-related health education for epilepsy patients and their families, improve social and family support for the patients, and provide antenatal care to patients according to the causes of their psychological stress during pregnancy. -
Key words:
- Women with epilepsy /
- Pregnancy /
- Psychological experience /
- Qualitative research
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