产后抑郁女性心理体验的质性研究
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摘要
背景产后抑郁(PPD)是产妇常见的心理健康问题,给产妇及其家人带来了痛苦和严重的负面影响,受到了国内外的广泛关注。目的深入了解和探索PPD女性的心理体验,分析其出现PPD的原因。方法采用便利抽样的方法,于2017年5—7月在石家庄市某三级甲等医院产后门诊连续收集14例PPD女性,运用Edmund&Heidegger观点构成的质性研究进行非结构访谈,进行现场录音和笔录,运用Colaizzi的分析程序对访谈内容进行分析。结果本研究PPD女性访谈焦点问题主要为婆媳关系、夫妻关系、家庭经济问题、育儿问题等,提炼出夫妻关系、婆媳关系、缺乏育儿经验3个主题。结论 PPD女性抑郁阶段关注的问题聚焦在人际关系上,尤其是家庭关系是困扰女性产后生活的主要问题;此外,育儿经验缺乏也对女性产后生活造成了一定困扰。
Background Postpartum depression(PPD) is a common mental health problem in parturients,which causes pain and produces serious negative effects on parturients and their families.It has attracted wide attention at home and abroad.Objective To get a deep understanding of the inner experience of PPD in women by a survey,and analyze the causes of PPD.Methods This qualitative study was based on Edmund & Heidegger's interpretive phenomenology.Participants were 14 consecutive PPD female outpatients recruited from a tertiary grade A hospital in Shijiazhuang City during May to July,2017 by use of convenience sampling.Unstructured interviews were conducted to collect data associated with PPD.Interviews were recorded on site,transcribed,and analyzed with Colaizzi's method.Results The focus problems extracted from the interviews mainly were relationship between mother-in-law and daughter-in-law,relationship between husband and wife,family economic issues,parenting issues.And the 3 themes identified were relationship between mother-in-law and daughter-in-law,relationship between husband and wife,and lack of parenting experience.Conclusion Interpersonal relationships,especially family relationships,are the issues concerned most by women with PPD,which also are the major problems that plague their life.In addition,lack of parenting experience also trouble these women to a certain extent.
Background Postpartum depression(PPD) is a common mental health problem in parturients,which causes pain and produces serious negative effects on parturients and their families.It has attracted wide attention at home and abroad.Objective To get a deep understanding of the inner experience of PPD in women by a survey,and analyze the causes of PPD.Methods This qualitative study was based on Edmund & Heidegger's interpretive phenomenology.Participants were 14 consecutive PPD female outpatients recruited from a tertiary grade A hospital in Shijiazhuang City during May to July,2017 by use of convenience sampling.Unstructured interviews were conducted to collect data associated with PPD.Interviews were recorded on site,transcribed,and analyzed with Colaizzi's method.Results The focus problems extracted from the interviews mainly were relationship between mother-in-law and daughter-in-law,relationship between husband and wife,family economic issues,parenting issues.And the 3 themes identified were relationship between mother-in-law and daughter-in-law,relationship between husband and wife,and lack of parenting experience.Conclusion Interpersonal relationships,especially family relationships,are the issues concerned most by women with PPD,which also are the major problems that plague their life.In addition,lack of parenting experience also trouble these women to a certain extent.
引文
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[12]OKUN M L.Disturbed sleep and postpartum depression[J].Curr Psychiatry Rep,2016,18(7):66.
[13]沐婷玉,李玉红.产后抑郁网络干预研究进展[J].中国全科医学,2018,21(14):1761-1764.DOI:10.3969/j.issn.1007-9572.2018.00.018.MU T Y,LI Y H.Recent advances in internet-based intervention for postpartum depression[J].Chinese General Practice,2018,21(14):1761-1764.DOI:10.3969/j.issn.1007-9572.2018.00.018.
[14]狄娜,石明月,魏海燕,等.孕产期抑郁相关因素及其社区管理[J].中国全科医学,2019,22(12):1497-1500.
[15]李功迎,宋思佳,曹龙飞.精神障碍诊断与统计手册第5版解读[J].中华诊断学电子杂志,2014,2(4):310-312.DOI:10.3877/cma.j.issn.2095-655X.2014.04.017.
[16]PATTON M Q.Variety in qualitative inquiry:theoretical orientations[M].//Qualitative research and evaluation methods.3ed.California:Thousand Oaks,2002:75-142.
[17]TONG A,SAINSBURY P,CRAIG J.Consolidated criteria for reporting qualitative research(COREQ):a 32-item checklist for interviews and focus groups[J].Int J Qual Health Care,2007,19(6):349-357.DOI:10.1093/intqhc/mzm042.
[18]COLAIZZI P.Psychological research as the phenomenologists view it[M]//.VAILE R,KING M.Existential-pheomenological alternatives for psychology.New York:Oxford University Press,1978:48-71.
[19]池丽萍.中国人婚姻与幸福感的关系:事实描述与理论检验[J].首都师范大学学报(社会科学版),2016,20(1):145-156.DOI:10.3969/j.issn.1004-9142.2016.01.019.
[20]李强,金铃,陈晨,等.夫妻沟通方式与抑郁的关系及样本类型的调节作用研究[J].中国全科医学,2018,21(13):1618-1623.
[21]HOWARTH A M,SCOTT K M,SWAIN N R.First-time fathers'perception of their childbirth experiences[J].J Health Psychol,2017,1:1359105316687628.DOI:10.1177/1359105316687628.
[22]RAUER A,VOLLING B.More than one way to be happy:a typology of marital happiness[J].Fam Process,2013,52(3):519-534.DOI:10.1111/famp.12028.
[23]DOMINIC T S Lee,ALEXANDER S K Yip,SANDRA S M Chan,等.香港华人妇女产后抑郁危险因素的前瞻性研究[J].中国心理卫生杂志,2005,19(9):626-631.DOI:10.3321/j.issn:1000-6729.2005.09.021.
[24]易伍林.复制与嬗变:当代婆媳关系的社会学分析[J].淮北师范大学学报(哲学社会科学版),2010,31(5):94-96.DOI:10.3969/j.issn.2095-0683.2010.05.022.
[2]KLAININ P,ARTHUR D G.Postpartum depression in Asian cultures:a literature review[J].Int J Nurs Stud,2009,46(10):1355-1373.DOI:10.1016/j.ijnurstu.2009.02.012.
[3]胡海萍,吴志国,吴荣琴,等.上海市闸北区孕产妇焦虑、抑郁症状发生率及相关因素[J].中国临床心理学杂志,2014,22(1):110-114.HU H P,WU Z G,WU R Q,et al.The prevalence of anxiety and depression in late pregnant women before and after childbirth[J].Chinese Journal of Clinical Psychology,2014,22(1):110-114.
[4]DENG A W,XIONG R B,JIANG T T,et al.Prevalence and risk factors of postpartum depression in a population-based sample of women in Tangxia Community,Guangzhou[J].Asian Pac J Trop Med,2014,7(3):244-249.DOI:10.1016/S1995-7645(14)60030-4.
[5]STUART S.Interpersonal psychotherapy for postpartum depression[J].Clin Psychol Psychother,2012,19(2):134-140.DOI:10.1002/cpp.1778.
[6]赵静波,季建林.人际心理治疗[J].中国临床心理学杂志,2000,8(1):60-63.DOI:10.3969/j.issn.1005-3611.2000.01.022.ZHAO J B,JI J L.A brief introduction to interpersonal psychotherapy[J].Chinese Journal of Clinical Psychology,2000,8(1):60-63.DOI:10.3969/j.issn.1005-3611.2000.01.022.
[7]HENSHAW C.Mood disturbance in the early puerperium:a review[J].Arch Womens Ment Health,2003,6 Suppl 2:S33-42.DOI:10.1007/s00737-003-0004-x.
[8]GAVIN N I,GAYNES B N,LOHR K N.Perinatal depression:a systematic review of prevalence and incidence[J].Obstet Gynecol,2005,106(5 Pt 1):1071-1083.DOI:10.1097/01.AOG.0000183597.31630.db.
[9]胡娟,王玉琼.成都市孕产妇产前抑郁与产后抑郁关系的研究[J].中华护理杂志,2009,44(11):984-987.DOI:10.3761/j.issn.0254-1769.2009.11.008.
[10]FISHER S D,WISNER K L,CLARK C T.Factors associated with onset timing,symptoms,and severity of depression identified in the postpartum period[J].J Affect Disord,2016,203:111-120.DOI:10.1016/j.jad.2016.05.063.
[11]IRANPOUR S,KHEIRABADI G R,ESMAILLZADEH A.Association between sleep quality and postpartum depression[J].J Res Med Sci,2016,7(21):110.DOI:10.4103/1735-1995.193500.
[12]OKUN M L.Disturbed sleep and postpartum depression[J].Curr Psychiatry Rep,2016,18(7):66.
[13]沐婷玉,李玉红.产后抑郁网络干预研究进展[J].中国全科医学,2018,21(14):1761-1764.DOI:10.3969/j.issn.1007-9572.2018.00.018.MU T Y,LI Y H.Recent advances in internet-based intervention for postpartum depression[J].Chinese General Practice,2018,21(14):1761-1764.DOI:10.3969/j.issn.1007-9572.2018.00.018.
[14]狄娜,石明月,魏海燕,等.孕产期抑郁相关因素及其社区管理[J].中国全科医学,2019,22(12):1497-1500.
[15]李功迎,宋思佳,曹龙飞.精神障碍诊断与统计手册第5版解读[J].中华诊断学电子杂志,2014,2(4):310-312.DOI:10.3877/cma.j.issn.2095-655X.2014.04.017.
[16]PATTON M Q.Variety in qualitative inquiry:theoretical orientations[M].//Qualitative research and evaluation methods.3ed.California:Thousand Oaks,2002:75-142.
[17]TONG A,SAINSBURY P,CRAIG J.Consolidated criteria for reporting qualitative research(COREQ):a 32-item checklist for interviews and focus groups[J].Int J Qual Health Care,2007,19(6):349-357.DOI:10.1093/intqhc/mzm042.
[18]COLAIZZI P.Psychological research as the phenomenologists view it[M]//.VAILE R,KING M.Existential-pheomenological alternatives for psychology.New York:Oxford University Press,1978:48-71.
[19]池丽萍.中国人婚姻与幸福感的关系:事实描述与理论检验[J].首都师范大学学报(社会科学版),2016,20(1):145-156.DOI:10.3969/j.issn.1004-9142.2016.01.019.
[20]李强,金铃,陈晨,等.夫妻沟通方式与抑郁的关系及样本类型的调节作用研究[J].中国全科医学,2018,21(13):1618-1623.
[21]HOWARTH A M,SCOTT K M,SWAIN N R.First-time fathers'perception of their childbirth experiences[J].J Health Psychol,2017,1:1359105316687628.DOI:10.1177/1359105316687628.
[22]RAUER A,VOLLING B.More than one way to be happy:a typology of marital happiness[J].Fam Process,2013,52(3):519-534.DOI:10.1111/famp.12028.
[23]DOMINIC T S Lee,ALEXANDER S K Yip,SANDRA S M Chan,等.香港华人妇女产后抑郁危险因素的前瞻性研究[J].中国心理卫生杂志,2005,19(9):626-631.DOI:10.3321/j.issn:1000-6729.2005.09.021.
[24]易伍林.复制与嬗变:当代婆媳关系的社会学分析[J].淮北师范大学学报(哲学社会科学版),2010,31(5):94-96.DOI:10.3969/j.issn.2095-0683.2010.05.022.