基于认知行为疗法的线上课堂对预防产后抑郁的效果评价

王永欣; 陈秀凤; 姜建兰; 邬敏; 甘泉; 李茗薇

doi:10.16766/j.cnki.issn.1674-4152.001893

基于认知行为疗法的线上课堂对预防产后抑郁的效果评价

doi: 10.16766/j.cnki.issn.1674-4152.001893

1.
蚌埠医学院研究生院，安徽蚌埠 233000
2.
蚌埠医学院附属淮南市第一人民医院护理部，安徽淮南 232000
3.
安徽理工大学第一附属医院淮南市第一人民医院妇产科

基金项目:

安徽省科技攻关项目 1804h08020289

安徽高校人文社会科学研究重点项目 SK2019A0087

蚌埠医学院研究生创新课题 Byycx1947

详细信息

通讯作者:
陈秀凤，E-mail：1363618418@qq.com

中图分类号: R714.69 R473.71
计量
- 文章访问数: 183
- HTML全文浏览量: 52
- PDF下载量: 3
- 被引次数: 0
出版历程
- 收稿日期: 2020-07-26
- 网络出版日期: 2022-02-16

Evaluation of the effect of online classroom based on cognitive behavioral therapy on preventing postpartum depression

1.
Graduate School, Bengbu Medical College, Bengbu, Anhui 233000, China

摘要

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。
- 认知行为疗法 /
- 产后抑郁 /
- 压力 /
- 产后焦虑 /
- 育儿
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.
- Cognitive behavioral therapy /
- Postpartum depression /
- Pressure /
- Postpartum anxiety /
- Parenting

HTML全文

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	-0.721^a	0.471	产次	初产	23	21	0.202^b	0.653
	26~30	15	16				经产	17	19
	31~35	12	10			流产次数	有	14	15	0.054^b	0.816
	> 35	6	5				无	26	25
文化程度	初中及其以上	15	14	-0.523^a	0.601	分娩方式	剖宫产	19	21	0.200^b	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	0.050^b	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	-0.230^a	0.839	是否计划内怀孕	是	31	27	1.003^b	0.317
	2 000~4 000	14	15				否	9	13
	4 001~6 000	15	14			胎儿性别	男	19	21	0.200^b	0.655
	> 6 000	8	9				女	21	19
职业	无业	17	15	2.695^b	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	0.092^b	0.762
	个体经营	2	6				异常	33	34
	农民	3	2			喂养方式	人工	11	9	0.267^b	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	-1.020^a	0.308
医保类型	自费	3	2	0.740^b	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	-1.180^a	0.238
	居民医保	6	4				一般	2	5
是否为独生子女	独生	7	10	0.672^b	0.412		差	0	0
	非独生	33	30
注：^a为Z值，^b为χ²值。

下载: 导出CSV

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±3.83^a
t值		0.043	2.311
P值		0.966	0.023
注：与同组干预前比较，^aP < 0.05。

下载: 导出CSV

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±9.63^a
t值		0.345	3.445
P值		0.731	0.001
注：与同组干预前比较，^aP < 0.05。

下载: 导出CSV

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±7.43^a
t值		-0.048	2.415
P值		0.962	0.018
注：与同组干预前比较，^aP < 0.05。

下载: 导出CSV

参考文献(19)

[1]	GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016[J]. Lancet, 2017, 390(10100): 1211-1259. doi: 10.1016/S0140-6736(17)32154-2
[2]	曹娟, 王兰云, 刘林, 等. 综合护理干预对高危妊娠孕妇产后抑郁的效果研究[J]. 中华全科医学, 2019, 17(11): 1948-1950, 1972. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201911043.htm
[3]	王永欣, 陈秀凤, 蔡福临. 音乐疗法作用于产后抑郁症患者的系统评价与Meta分析[J]. 右江民族医学院学报, 2020, 42(4): 488-493, 499. doi: 10.3969/j.issn.1001-5817.2020.04.020
[4]	王兰兰, 韩布新, 钟雪梅, 等. 产后抑郁的心理护理研究进展[J]. 护士进修杂志, 2020, 35(13): 1189-1192. https://www.cnki.com.cn/Article/CJFDTOTAL-FSJX202013008.htm
[5]	BORZA L. Cognitive-behavioral therapy for generalized anxiety[J]. Dialogues Clin Neurosci, 2017, 19(2): 203-208. doi: 10.31887/DCNS.2017.19.2/lborza
[6]	SZTEIN D M, KORANSKY C E, FEGAN L, et al. Efficacy of cognitive behavioural therapy delivered over the internet for depressive symptoms: a systematic review and meta-analysis[J]. J Telemed Telecare, 2018, 24(8): 527-539. doi: 10.1177/1357633X17717402
[7]	杨小羽, 何荣霞. 产后抑郁的危害及相关影响因素的研究进展[J]. 西北国防医学杂志, 2019, 40(2): 128-132. https://www.cnki.com.cn/Article/CJFDTOTAL-XBGY201902016.htm
[8]	COX J L, HOLDEN J M, SAGOVSKY R. Detection of postnatal depression. development of the 10-item Edinburgh Postnatal Depression Scale[J]. Br J Psychiatry, 1987, 150(6): 782-786. doi: 10.1192/bjp.150.6.782
[9]	LEE D T, YIP S K, CHIU H F, et al. Detecting postnatal depression in Chinese women. validation of the Chinese version of the Edinburgh Postnatal Depression Scale[J]. Br J Psychiatry, 1998, 172(5): 433-437. doi: 10.1192/bjp.172.5.433
[10]	杨廷忠, 黄汉腾. 社会转型中城市居民心理压力的流行病学检查[J]. 中华流行病学杂志, 2003, 24(9): 760-764. doi: 10.3760/j.issn:0254-6450.2003.09.004
[11]	ZUNG W W. A rating instrument for anxiety disorders[J]. Psychosomatics, 1971, 12(6): 371-379. doi: 10.1016/S0033-3182(71)71479-0
[12]	杨晓, 高玲玲, 张振香, 等. 中文版育儿胜任感量表在产妇中应用的信效度检验[J]. 中华护理杂志, 2014, 49(7): 881-885. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHHL201407033.htm
[13]	GREER J A, JACOBS J, PENSAK N, et al. Randomized trial of a tailored cognitive-behavioral therapy mobile application for anxiety in patients with incurable cancer[J]. Oncologist, 2019, 24(8): 1111-1120. doi: 10.1634/theoncologist.2018-0536
[14]	MILGROM J, SKOUTERIS H, WOROTNIUK T, et al. The association between ante- and postnatal depressive symptoms and obesity in both mother and child: a systematic review of the literature[J]. Womens Health Issues, 2012, 22(3): e319-28. doi: 10.1016/j.whi.2011.12.001
[15]	NURBAETI I, DEOISRES W, HENGUDOMSUB P. Association between psychosocial factors and postpartum depression in South Jakarta, Indonesia[J]. Sex Reprod Healthc, 2019, 20: 72-76. doi: 10.1016/j.srhc.2019.02.004
[16]	章翀. 产妇产后早期情绪状态、社会支持与母婴连结的关系研究[D]. 武汉: 武汉轻工大学, 2019.
[17]	赖婉君. 产妇育儿胜任感现状及与产后抑郁的相关性研究[J]. 护理实践与研究, 2018, 15(10): 18-19. https://www.cnki.com.cn/Article/CJFDTOTAL-HLSJ201810008.htm
[18]	王蓉. 基于ITHBC的微信干预对产褥期妇女健康商数和育儿胜任感的影响研究[D]. 衡阳: 南华大学, 2018.
[19]	JANNATI N, MAZHARI S, AHMADIAN L, et al. Effectiveness of an app-based cognitive behavioral therapy program for postpartum depression in primary care: a randomized controlled trial[J]. Int J Med Inform, 2020, 141. DOI: 10.1016/j.ijmedinf.2020.104145.