远程医疗团体干预减少围产期抑郁症状的随机对照试验:混合方法分析。

IF 2.3 4区 医学 Q2 NURSING
Eli Iacob PhD, MSCI, MSTAT, Ryoko Kausler PhD, MSN, FNP-C, Marcia Williams PhD, MSN, FNP-C, Uma Dorn PhD, Sara Simonsen CNM, PhD, MS, MSPH, Marcela Smid MD, MS, MA, Gwen Latendresse CNM, PhD, MS
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引用次数: 0

摘要

导读:围产期抑郁症影响约20%的育龄个体,并与不良围产期结局相关。非药物治疗对轻度至中度抑郁症有效,但存在多重障碍,包括财政限制和亲自预约的不便。远程获取(即远程保健)服务是一个很有前途的选择,但很少有研究对这种方法的有效性进行评估。本研究的目的是在一项随机对照试验中使用混合方法来评估小组视频会议干预减轻围产期抑郁症症状的有效性。方法:参与者被分配到视频会议干预组(VCI;基于正念的认知行为疗法)或一个注意力控制组(AC;分娩准备或早期育儿教育)通过视频会议系统。每组4至6名有轻度至中度抑郁症状的孕妇和产后个体在家中使用电子设备进行为期9周的1小时训练。爱丁堡产后抑郁量表(EPDS)测量干预前后的抑郁症状,随访8个月。焦点小组评估了参与者的远程保健经验,并对共同主题进行了分析。结果:从2020年5月到2022年5月,81名参与者被随机分组,69名(85.2%)最终开始参与研究(VCI组36名,AC组33名)。干预后8个月,两组受试者的EPDS评分均显著下降3.36 (95% CI, 4.55-2.17)。时间与干预组间无显著交互作用(P均为0.249)。在焦点小组分析中,两个干预组的连接、分享经验、赋权和社区建设主题是一致的。讨论:两个干预组在干预后8个月EPDS评分均有临床意义的改善。根据定性分析的共同主题,我们的研究结果表明,参与远程医疗小组会议,无论会议内容如何,都可能有助于减轻抑郁症状负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

A Randomized Controlled Trial of a Telehealth Group Intervention to Reduce Perinatal Depressive Symptoms: A Mixed Methods Analysis

A Randomized Controlled Trial of a Telehealth Group Intervention to Reduce Perinatal Depressive Symptoms: A Mixed Methods Analysis

Introduction

Perinatal depression affects approximately 20% of childbearing individuals and is associated with adverse perinatal outcomes. Nonpharmacological therapies are effective for mild to moderate depression, but multiple access barriers exist, including financial constraints and the inconvenience of in-person appointments. Remote access (ie, telehealth) to services is a promising option, but few studies have evaluated the effectiveness of this approach. The objective of this study was to use a mixed methods approach in a randomized controlled trial to evaluate the effectiveness of a group videoconference intervention to reduce symptoms of perinatal depression.

Methods

Participants were assigned to a videoconference intervention group (VCI; mindfulness-based cognitive behavioral therapy) or an attention control group (AC; childbirth preparation or early parenting education) via a videoconference system. Groups of 4 to 6 pregnant and postpartum individuals with mild to moderate symptoms of depression attended a one-hour session for 9 weeks using an electronic device from their own home. The Edinburgh Postnatal Depression Scale (EPDS) measured depression symptoms before and after intervention with follow-up to 8 months. Focus groups assessed participants’ telehealth experiences and were analyzed for common themes.

Results

From May 2020 through May 2022, 81 participants were randomized, and 69 (85.2%) ultimately initiated study participation (36 in VCI, 33 in AC group). Participants in both groups had a significant decrease in EPDS score of 3.36 (95% CI, 4.55-2.17) that was maintained 8 months postintervention. There were no significant interactions between time and intervention group (all P >.249). In the focus group analysis, themes of connection, shared experience, empowerment, and community building were consistent between the 2 intervention groups.

Discussion

Both intervention groups had clinically meaningful improvement in EPDS scores up to 8 months postintervention. Anchored in the common themes in the qualitative analysis, our results suggest that participation in telehealth group sessions, regardless of session content, may be beneficial in reducing depression symptom burden.

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来源期刊
CiteScore
3.60
自引率
7.40%
发文量
103
审稿时长
6-12 weeks
期刊介绍: The Journal of Midwifery & Women''s Health (JMWH) is a bimonthly, peer-reviewed journal dedicated to the publication of original research and review articles that focus on midwifery and women''s health. JMWH provides a forum for interdisciplinary exchange across a broad range of women''s health issues. Manuscripts that address midwifery, women''s health, education, evidence-based practice, public health, policy, and research are welcomed
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