A scoping review of effective health practices for the treatment of birth trauma

IF 2.6 3区 医学 Q1 NURSING
Julie Jomeen , Frances Guy , Julia Marsden , Marilyn Clarke , Jennifer Darby , Angeline Landry , Elaine Jefford
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Abstract

Background

There is currently no consensus on the most effective health practices to manage or reduce the effects of birth trauma (BT) and childbirth-related posttraumatic stress disorder (CB-PTSD).

Aim

The aim was to map the current literature on effective health practices for BT/CB-PTSD, identify key elements (the what, when and how) important for effective health practices, and highlight gaps in maternity care.

Methods

A systematic search was conducted across key nursing, allied, and medical databases (MEDLINE, Scopus, PubMed) for key terms related to (1) birth trauma and (2) intervention. Only peer-reviewed, English-language papers published since 2000 were included to ensure the relevance and timeliness of the findings. Following PRISMA-ScR guidelines, 6,347 articles were identified through databases/registers and citation searching. After removing 1,342 duplicates, 5,005 were screened by title and abstract. A further 4,544 were excluded, leaving 461 for full-text screening. Afterf excluding another 433, 28 papers met inclusion for this review.

Findings

The first session delivered early (within the first 72 h of birth) by a clinician (midwife/psychologist/counsellor) significantly reduced BT/CB-PTSD in the short-term. Both trauma-focused and non-trauma-focused were supported at this stage, provided they were structured. If intervention is delayed (weeks to months post-birth), a trauma-focused, multi-session approach is recommended.

Discussion

Early, structured interventions should be considered routine care for women with BT/CB-PTSD, with more intensive, structured, trauma-focused approach for persistent symptoms. The potential role of digital mental health tools is promising, particularly for women in low-resource settings, but requires further research to evaluate feasibility, acceptability, and sustainability.
背景目前,关于管理或减少分娩创伤(BT)和分娩相关创伤后应激障碍(CB-PTSD)影响的最有效保健方法尚未达成共识。方法在主要的护理、联合和医学数据库(MEDLINE、Scopus、PubMed)中对与(1)分娩创伤和(2)干预相关的关键术语进行了系统检索。为确保研究结果的相关性和时效性,只纳入了 2000 年以来发表的经同行评审的英文论文。根据 PRISMA-ScR 指南,通过数据库/登记册和引文检索,共确定了 6347 篇文章。在删除了 1,342 篇重复文章后,根据标题和摘要筛选出 5,005 篇文章。又排除了 4,544 篇,剩下 461 篇进行全文筛选。研究结果由临床医生(助产士/心理学家/辅导员)进行的首次早期治疗(出生后 72 小时内)在短期内显著减少了 BT/CB-PTSD 的发生。在这一阶段,以创伤为重点和不以创伤为重点的干预都得到了支持,前提是这些干预是有组织的。讨论对于患有 BT/CB-PTSD 的妇女,早期、结构化的干预应被视为常规护理,对于持续性症状,应采取更密集、结构化、以创伤为重点的方法。数字心理健康工具的潜在作用前景广阔,尤其是对资源匮乏环境中的妇女而言,但还需要进一步的研究来评估其可行性、可接受性和可持续性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Midwifery
Midwifery 医学-护理
CiteScore
4.50
自引率
7.40%
发文量
221
审稿时长
13.4 weeks
期刊介绍: Midwifery publishes the latest peer reviewed international research to inform the safety, quality, outcomes and experiences of pregnancy, birth and maternity care for childbearing women, their babies and families. The journal’s publications support midwives and maternity care providers to explore and develop their knowledge, skills and attitudes informed by best available evidence. Midwifery provides an international, interdisciplinary forum for the publication, dissemination and discussion of advances in evidence, controversies and current research, and promotes continuing education through publication of systematic and other scholarly reviews and updates. Midwifery articles cover the cultural, clinical, psycho-social, sociological, epidemiological, education, managerial, workforce, organizational and technological areas of practice in preconception, maternal and infant care. The journal welcomes the highest quality scholarly research that employs rigorous methodology. Midwifery is a leading international journal in midwifery and maternal health with a current impact factor of 1.861 (© Thomson Reuters Journal Citation Reports 2016) and employs a double-blind peer review process.
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