Evaluation of the effect of online classroom based on cognitive behavioral therapy on preventing postpartum depression
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摘要:
目的 探讨基于认知行为疗法的线上课堂对预防产后抑郁的作用。 方法 收集2019年6月—2020年1月产科门诊产检的孕妇80例,按照随机数字表法分为观察组和对照组, 各40例,对照组采用常规产前检查、产科常规护理、产后随访,观察组基于认知行为疗法的线上课堂对孕妇的认知行为进行干预。分别于干预前、产后42 d采用一般状况调查表、爱丁堡产后抑郁量表、焦虑自评量表、压力知觉量表,产后42 d应用育儿胜任感量表进行问卷调查。 结果 在干预前,2组在抑郁状态、焦虑情绪、压力评分上差异均无统计学意义(均P>0.05);在产后42 d,观察组抑郁评分(6.85±3.83)显著优于对照组的抑郁评分(9.13±4.91),差异具有统计学意义(P < 0.05);在焦虑状态上,观察组(28.88±9.63)显著优于对照组(36.12±9.18),差异具有统计学意义(P < 0.05);在压力评分上,观察组的压力评分(20.20±7.43)显著优于对照组(25.12±10.54),2组差异具有统计学意义(P < 0.05);对照组的养育胜任感得分是75.33±10.65,观察组的养育胜任感得分是81.20±9.35,2组比较,差异具有统计学意义(t=-2.622,P=0.011)。 结论 基于认知行为疗法的线上课堂可有效提高产妇的育儿胜任感、降低育儿压力,缓解焦虑情绪,预防产后抑郁症的发生。 Abstract:Objective To explore the effect of online classroom based on cognitive behavioral therapy on preventing postpartum depression. Methods Eighty pregnant women undergoing obstetric outpatient check-ups from June 2019 to January 2020 were collected. According to the random number table, they were divided into observation group and control group with 40 cases each. The control group adopted routine prenatal check-ups, routine obstetric care and post-natal follow-up. An online classroom based on cognitive behavioral therapy were performed on the cognitive behavior of pregnant women. Before the intervention and 42 days postpartum, the general status questionnaire, Edinburgh postpartum depression scale, anxiety self-rating scale, and stress perception scale were used for questionnaire surveys, and the Parenting Competency Scale was used for questionnaire surveys on 42 days postpartum. Results Before the intervention, there was no significant difference in depression, anxiety, and stress scores between the two groups (all P>0.05); at 42 days postpartum, the depression score of the observation group (6.85±3.83) was significantly lower than that of the control group (9.13±4.91), the difference was statistically significant (P < 0.05); in the anxiety state, the score of the observation group (28.88±9.63) was significantly lower than that of the control group (36.12±9.18), and the difference was statistically significant (P < 0.05). On the stress score, the stress score of the observation group (20.20±7.43) was significantly lower than that of the control group (25.12±10.54), the difference was statistically significant (P < 0.05); the parenting competency score of the observation group was 81.20±9.35, and it was significantly higher than the control group (75.33±10.65), and the difference was statistically significant (t=-2.622, P=0.011). Conclusion Online classes based on cognitive behavioral therapy can effectively improve maternal parenting competence, reduce parenting pressure, relieve anxiety, and prevent the postpartum depression. -
Key words:
- Cognitive behavioral therapy /
- Postpartum depression /
- Pressure /
- Postpartum anxiety /
- Parenting
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表 1 2组孕妇一般情况比较(例)
项目 类别 对照组 观察组 统计量 P值 项目 类别 对照组 观察组 统计量 P值 年龄(岁) 20~25 7 9 -0.721a 0.471 产次 初产 23 21 0.202b 0.653 26~30 15 16 经产 17 19 31~35 12 10 流产次数 有 14 15 0.054b 0.816 > 35 6 5 无 26 25 文化程度 初中及其以上 15 14 -0.523a 0.601 分娩方式 剖宫产 19 21 0.200b 0.655 高中或中专 10 9 顺产 21 19 大专或本科 14 14 居住地 农村 21 22 0.050b 0.823 硕士以其以上 1 3 城市 19 18 家庭人均月收入(元) < 2 000 3 2 -0.230a 0.839 是否计划内怀孕 是 31 27 1.003b 0.317 2 000~4 000 14 15 否 9 13 4 001~6 000 15 14 胎儿性别 男 19 21 0.200b 0.655 > 6 000 8 9 女 21 19 职业 无业 17 15 2.695b 0.846 对胎儿性别有无期待 有 15 10 1.455b 0.228 职员 9 8 无 25 30 公务员 2 2 胎儿健康状况 正常 7 6 0.092b 0.762 个体经营 2 6 异常 33 34 农民 3 2 喂养方式 人工 11 9 0.267b 0.606 专业技术人员 5 4 母乳 29 31 自由职业 2 3 夫妻关系 好 39 37 -1.020a 0.308 医保类型 自费 3 2 0.740b 0.864 一般 1 3 新农合 19 21 差 0 0 生育保险 12 13 婆媳关系 好 38 35 -1.180a 0.238 居民医保 6 4 一般 2 5 是否为独生子女 独生 7 10 0.672b 0.412 差 0 0 非独生 33 30 注:a为Z值,b为χ2值。 表 2 2组孕妇干预不同时间抑郁评分比较(x±s)
组别 例数 干预前 产后42 d 对照组 40 9.05±5.25 9.13±4.91 观察组 40 9.00±5.23 6.85±3.83a t值 0.043 2.311 P值 0.966 0.023 注:与同组干预前比较,aP < 0.05。 表 3 2组孕妇干预不同时间焦虑评分比较(x±s,分)
组别 例数 干预前 产后42 d 对照组 40 33.70±8.49 36.12±9.18 观察组 40 33.05±8.35 28.88±9.63a t值 0.345 3.445 P值 0.731 0.001 注:与同组干预前比较,aP < 0.05。 表 4 2组孕妇干预不同时间压力评分比较(x±s,分)
组别 例数 干预前 产后42 d 对照组 40 24.05±9.39 25.12±10.54 观察组 40 24.15±9.31 20.20±7.43a t值 -0.048 2.415 P值 0.962 0.018 注:与同组干预前比较,aP < 0.05。 -
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