住院早产儿母亲的创伤后应激障碍症状阳性率及影响因素分析
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摘要
目的:评估创伤后应激障碍(PTSD)症状在新生儿重症监护病房(NICU)住院早产儿母亲中的阳性率,并确定高危人群。方法:采用围产期创伤后应激障碍问卷、广泛焦虑问卷以及爱丁堡产后抑郁量表对湖北省武汉市三家NICU住院早产儿母亲进行问卷调查,共有124名产妇参与调查。结果:NICU住院早产儿母亲的创伤后应激障碍阳性率为33.1%。Logistic回归分析显示产后抑郁、对患儿照护知识的需求以及患儿医疗费用的支付方式为产后创伤后应激症状发生的预测因素(P<0.05)。多元线性回归分析显示,影响围产期创伤后应激障碍问卷(PPQ)分数的因素有产后的心理(产后抑郁)以及分娩方式。结论:NICU住院早产儿母亲的PTSD症状阳性率相对较高,其影响因素包括自身心理健康水平如抑郁、分娩的方式、患儿医疗费用的支付方式以及相关知识需求。
Objective:To investigate the positive rate of the post-traumatic stress disorder(PTSD)symptoms among mothers with neonatal intensive care unit(NICU)hospitalized preterm infant,and to identify high-risk populations.Methods:A total of 124 mothers with NICU hospitalized preterm infant in Wuhan completed three self-report measures,the Perinatal PTSD questionnaire(PPQ),the Generalized Anxiety Disorder Scale(GAD-7)and the Edinburgh Postpartum Depression Scale(EPDS).Results:The positive rate of the PTSD symptom in mothers of NICU hospitalized preterm infants was 33.1%.Logistic regression analysis showed that postpartum depression,the need for knowledge on children's care and the payment of medical expenses were the predictors of PTSD symptoms(P<0.05).Multiple linear regression analysis indicated that factors influencing PPQ scores were postpartum psychological(postpartum depression)and mode of delivery.Conclusion:The positive rate of PTSDin mothers with NICU hospitalized preterm infants is relatively high.Influencing factors include mothers' mental health level such as depression,the way of childbirth,the payment of infant's medical expenses and the knowledge needs.
Objective:To investigate the positive rate of the post-traumatic stress disorder(PTSD)symptoms among mothers with neonatal intensive care unit(NICU)hospitalized preterm infant,and to identify high-risk populations.Methods:A total of 124 mothers with NICU hospitalized preterm infant in Wuhan completed three self-report measures,the Perinatal PTSD questionnaire(PPQ),the Generalized Anxiety Disorder Scale(GAD-7)and the Edinburgh Postpartum Depression Scale(EPDS).Results:The positive rate of the PTSD symptom in mothers of NICU hospitalized preterm infants was 33.1%.Logistic regression analysis showed that postpartum depression,the need for knowledge on children's care and the payment of medical expenses were the predictors of PTSD symptoms(P<0.05).Multiple linear regression analysis indicated that factors influencing PPQ scores were postpartum psychological(postpartum depression)and mode of delivery.Conclusion:The positive rate of PTSDin mothers with NICU hospitalized preterm infants is relatively high.Influencing factors include mothers' mental health level such as depression,the way of childbirth,the payment of infant's medical expenses and the knowledge needs.
引文
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[2]Helle N,Barkmann C,Ehrhardt S,et al.Postpartum posttraumatic and acute stress in mothers and fathers of infants with very low birth weight:Cross-sectional results from a controlled multicenter cohort study[J].JAffect Disord,2018,235:467-473.
[3]Yildiz PD,Ayers S,Phillips L.The prevalence of posttraumatic stress disorder in pregnancy and after birth:A systematic review and meta-analysis[J].J Affect Disorders,2017,208:634-645.
[4]Gondwe KW,Holditch-Davis D.Posttraumatic stress symptoms in mothers of preterm infants[J].International Journal of Africa Nursing Sciences,2015,3(C):8-17.
[5]Park YK,Ju HO,Na H.[Reliability and validity of the Korean version of the perinatal post-traumatic stress Disorder questionnaire][J].J Korean Acad Nurs,2016,46(1):29-38.
[6]Borghini A,Habersaat S,Forcada-Guex M,et al.Effects of an early intervention on maternal post-traumatic stress symptoms and the quality of mother-infant interaction:The case of preterm birth[J].Infant Behavior&Development,2014,37(4):624-631.
[7]Zhang D,Zhang J,Gan Q,et al.Validating the psychometric characteristics of the perinatal posttraumatic stress disorder questionnaire(PPQ)in a Chinese context[J].Arch Psychiatr Nurs,2018,32(1):57-61.
[8]王进,董燕,王好博,等.广泛性焦虑量表在军人群体应用中的信度和效度[J].中国健康心理学杂志,2017,25(5):733-736.Wang J,Dong Y,Wang HB.Reliability and validity of the generalized anxiety disorder scale in servicemen[J].China Journal of Health Psychology,2017,25(5):733-736.
[9]Kertz S,Bigda-Peyton J,Bjorgvinsson T.Validity of the generalized anxiety disorder-7scale in an acute psychiatric sample[J].Clin Psychol Psychother,2013,20(5):456-464.
[10]栾丹丹,于秀荣,王云芳,等.NICU住院早产儿母亲在母婴分离期的泌乳量及相关因素研究[J].中华护理杂志,2018,1:65-70.Luan DD,Yu XR,Wang YF.The research on milk volume and its influencing factors in mothers with preterm infants hospitalized in NICU during periods of mother-infant separation[J].Chinese Journal of Nursing,2018,1:65-70.
[11]Grekin R,O'Hara MW.Prevalence and risk factors of postpartum posttraumatic stress disorder:A meta-analysis[J].Clinical Psychology Review,2014,34(5):389-401.
[12]Zerach G,Elsayag A,Shefer S,et al.Long-term maternal stress and post-traumatic stress symptoms related to developmental outcome of extremely premature infants[J].Stress Health,2015,31(3):204-213.
[13]孙显丽,刘婉婉,许凤华,等.心理护理在自然分娩产妇中的效果及对妊娠结局的影响[J].国际精神病学杂志,2017,44(6):1 125-1 127.Sun XL,Liu WW,Xu FH.The effect of psychological nursing care on normal delivery puerperia[J].Journal of International Psychiatry,2017,44(6):1 125-1 127.
[14]Shaw RJ,St JN,Lilo E,et al.Prevention of traumatic stress in mothers of preterms:6-month outcomes[J].Pediatrics,2014,134(2):481-488.
[15]Bener A,Gerber LM,Sheikh J.Prevalence of psychiatric disorders and associated risk factors in women during their postpartum period:a major public health problem and global comparison[J].Int J Womens Health,2012,4(1):191-200.
[16]Abedian Z,Soltani N,Mokhber N,et al.Comparing post-traumatic stress disorder in primiparous and multiparous women with pre-eclampsia[J].J Midwifery Reprod Health,2013,1(1):13-18.