分娩决策与产后心理健康关系的多层次meta分析。

IF 2.4 Q2 PSYCHOLOGY, CLINICAL
Health Psychology and Behavioral Medicine Pub Date : 2025-02-04 eCollection Date: 2025-01-01 DOI:10.1080/21642850.2025.2456032
Louisa Arnold, Marie Völkel, Jenny Rosendahl, Michael Rost
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引用次数: 0

摘要

越来越多的证据表明,在分娩过程中,分娩个体和医疗保健提供者之间的决策无效。虽然综合研究表明,消极的分娩经历与产后心理健康有关,但尚未综合具体决策措施与心理健康结果之间的初步定量研究。本研究旨在填补这一空白,以便为如何进一步改善围产期护理提供实践证据。方法:运用布尔逻辑进行系统的文献检索。来自14个不同国家的34份出版物最终可以纳入我们的荟萃分析。分娩期决策的衡量标准被整合到四个关键领域:信息、尊重、控制和参与。我们进行了多层次的meta分析,以评估分娩决策与心理健康结果的总体关系,以及与每个决策领域相关的具体相关性。结果:我们的分析显示,分娩时决策效率较低与更多的产后整体心理健康问题(r = - 0.25)、抑郁症(r = - 0.19)和创伤后应激障碍(r = - 0.29)相关。更准确地说,当产中决策的所有领域(信息:r = -。22、介入:r = -。23、尊重:r = -。28,对照组:r = - 0.25)与产后整体精神病理相关,只有信息(r = - 0.18)、尊重(r = - 0.25)和控制(r = - 0.12)与抑郁相关,只有参与(r = - 0.31)、尊重(r = - 0.32)和控制(r = - 0.25)与创伤后应激障碍相关。一个样本中较高的计划剖宫产百分比和出生与产后效果测量之间较长的时间滞后被确定为调节变量。结论:决策无效是导致产后心理健康问题不良结局发生的重要因素。对实践的影响涉及建立许多产前保健接触作为标准,以加强分娩个人和提供者的分娩准备。此外,将分娩决策经验作为衡量护理质量的指标作为一种默认做法,以监测、分析和改进决策,并促进问责制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A multi-level meta-analysis of the relationship between decision-making during birth and postpartum mental health.

Introduction: There is accumulating evidence of ineffective decision-making between birthing individuals and healthcare providers during childbirth. While research syntheses have demonstrated that negative birth experiences are associated with postpartum mental health, primary quantitative studies linking specific decision-making measures and mental health outcomes have not been synthesised. The present study aims to fill this gap in order to provide hands-on evidence on how to further improve perinatal care.

Methods: A systematic literature search using Bolean logic was conducted. A final set of 34 publications from 14 different countries could be included in our meta-analysis. Measures of intrapartum decision-making were consolidated into four key domains: information, respect, control, and involvement. We conducted multi-level meta-analyses to assess the overall relationship of intra-partum decision-making and mental-health outcomes, as well as the specific correlations associated with each decision-making domain.

Results: Our analysisrevealed that less effective intrapartum decision-making is associated with more postpartum overall mental health problems (r = -.25), depression (r = -.19), and posttraumatic stress disorder (r = -.29). More precisely, while all domains of intrapartum decision-making (information: r = -.22, involvement: r = -.23, respect: r = -.28, control: r = -.25) were associated with postpartum overall psychopathology, only information (r = -.18), respect (r = -.25), and control (r = -.12) were associated with depression, and only involvement (r = -.31), respect (r = -.32), and control (r = -.25) were associated with posttraumatic stress disorder. A higher percentange of planned cesarean sections in a sample and longer time lags between birth and post-effect measurement were identified as moderating variables.

Conclusions: Ineffective decision-making is a significant contributing factor to the development of adverse postpartum mental health problems outcomes. Implications for practice concern establishing numerous antenatal care contacts as a standard to enhance birth preparedness for both birthing individuals and providers. Additionally, measuring the experience of intrapartum decision-making as an indicator of quality of care as a default to monitor, analyse, and improve decision-making and to facilitate accountability systems.

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来源期刊
CiteScore
3.50
自引率
3.70%
发文量
57
审稿时长
24 weeks
期刊介绍: Health Psychology and Behavioral Medicine: an Open Access Journal (HPBM) publishes theoretical and empirical contributions on all aspects of research and practice into psychosocial, behavioral and biomedical aspects of health. HPBM publishes international, interdisciplinary research with diverse methodological approaches on: Assessment and diagnosis Narratives, experiences and discourses of health and illness Treatment processes and recovery Health cognitions and behaviors at population and individual levels Psychosocial an behavioral prevention interventions Psychosocial determinants and consequences of behavior Social and cultural contexts of health and illness, health disparities Health, illness and medicine Application of advanced information and communication technology.
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