父母干预对早产儿父母自我效能感、焦虑、压力和抑郁的影响：随机对照试验的系统回顾和荟萃分析

IF 7.1 1区医学 Q1 NURSING

International Journal of Nursing Studies Pub Date : 2025-05-29 DOI:10.1016/j.ijnurstu.2025.105128

Dyah Tri Kusuma Dewi , Cai Thi Thuy Nguyen , Su-Ru Chen , Gabrielle T. Lee , Shao-Yu Tsai , Mega Hasanul Huda , Shu-Yu Kuo

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引用次数: 0

摘要

背景：在过渡到为人父母的过程中，早产儿的父母需要获得基本的照顾技能，并有效地管理情绪困扰，以满足他们对婴儿的照顾需求。尽管已经开发了各种各样的育儿计划，但它们的有效性仍然没有定论。目的探讨父母干预措施对早产儿父母自我效能感和焦虑、压力、抑郁等心理结果的影响，并探讨影响父母干预措施效果的关键因素。设计随机对照试验的系统评价和荟萃分析。方法检索spubmed、MEDLINE Ovid、Web of Science、the Cumulative Index to Nursing and Allied Health Literature Plus、Embase、PsycINFO自成立至2024年12月20日。独立审稿人进行了研究选择、数据提取和质量评估。采用Cochrane风险偏倚工具第2版评价方法学质量。使用随机效应模型对合并效应进行分析，并进行亚组分析和元回归以确定潜在的调节因子。结果共纳入32项随机对照试验，共纳入4058名受试者，其中29项纳入meta分析。接受育儿干预的母亲在育儿自我效能方面表现出显著改善（标准化平均差异，SMD: 0.64, 95%可信区间，CI: 0.45至0.83），焦虑（SMD: - 0.83, 95% CI: - 1.39至- 0.26），压力（SMD: - 0.20, 95% CI: - 0.33至- 0.07）和抑郁（SMD: - 0.19, 95% CI: - 0.32至- 0.06）的减少。干预也有效地降低了父亲的压力（SMD: - 0.23, 95% CI: - 0.45至- 0.02）。在报告母亲和父亲的综合结果的研究中，观察到抑郁症的显著减少（SMD: - 0.31, 95% CI: - 0.60至- 0.02）。在干预后3个月，对所有产妇结局的影响仍然显著，并且在干预后4至12个月期间，产妇抑郁症持续下降。在医院环境中进行并在非经济合作与发展组织国家实施的干预措施，在提高母亲养育子女的自我效能和减少焦虑方面是有效的。结论父母教养方案显著提高了早产儿父母的父母自我效能感和心理健康水平。这些项目的有效策略应纳入日常护理，以优化结果。未来的研究评估早产儿父母的结果，特别是从父亲的角度来看，是迫切需要的。注册本研究的协议已在数据库PROSPERO中注册（注册ID:CRD42023447039）。

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Effectiveness of parenting interventions on self-efficacy, anxiety, stress, and depression among parents of preterm infants: A systematic review and meta-analysis of randomized control trials

Background

Parents of preterm infants need to acquire essential caregiving skills and effectively manage emotional distress during the transition into parenthood to meet their infants' care needs. Although various parenting programs have been developed, their effectiveness remains inconclusive.

Objective

To determine the effectiveness of parenting interventions on parenting self-efficacy and psychological outcomes, including anxiety, stress, and depression, among parents of preterm infants and to identify the key factors that contribute to effective parenting programs.

Design

A systematic review and meta-analysis of randomized control trials.

Methods

PubMed, MEDLINE Ovid, Web of Science, Cumulative Index to Nursing and Allied Health Literature Plus, Embase, and PsycINFO were searched from inception to December 20, 2024. Independent reviewers conducted the study selection, data extraction, and quality assessment. The Cochrane risk-of-bias tool version 2 was used to evaluate methodological quality. The pooled effects were analyzed using a random-effects model, and subgroup analysis and meta-regression were performed to identify potential moderators.

Results

Thirty-two randomized controlled trials with a total of 4058 participants were identified, 29 of which were included in the meta-analysis. Mothers who received parenting interventions demonstrated a significant improvement in parenting self-efficacy (standardized mean difference, SMD: 0.64, 95 % confidence interval, CI: 0.45 to 0.83) and a reduction in anxiety (SMD: − 0.83, 95 % CI: − 1.39 to − 0.26), stress (SMD: − 0.20, 95 % CI: − 0.33 to − 0.07), and depression (SMD: − 0.19, 95 % CI: − 0.32 to − 0.06). The interventions also effectively reduced fathers' stress (SMD: − 0.23, 95 % CI: − 0.45 to − 0.02). In studies reporting combined outcomes for both mothers and fathers, a significant reduction in depression (SMD: − 0.31, 95 % CI: − 0.60 to − 0.02) was observed. The effects remained significant for all maternal outcomes at three months post-intervention, and maternal depression showed a sustained decrease from four to 12 months post-intervention. Interventions conducted in hospital settings and delivered in non-Organization for Economic Co-operation and Development countries were effective in enhancing mothers' parenting self-efficacy and reducing anxiety.

Conclusions

Parenting programs significantly enhance parenting self-efficacy and psychological health among mothers and fathers of preterm infants. Effective strategies in these programs should be integrated into routine care to optimize outcomes. Future studies assessing outcomes for parents of preterm infants, particularly from the perspective of fathers, are urgently needed.

Registration

The protocol of this study has been registered in the database PROSPERO (registration ID:

CRD42023447039).

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来源期刊

International Journal of Nursing Studies 医学-护理

CiteScore

15.00

自引率

2.50%

发文量

181

审稿时长

21 days

期刊介绍： The International Journal of Nursing Studies (IJNS) is a highly respected journal that has been publishing original peer-reviewed articles since 1963. It provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy, and research methods relevant to nursing, midwifery, and other health related professions. The journal aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. The IJNS is indexed in major databases including PubMed, Medline, Thomson Reuters - Science Citation Index, Scopus, Thomson Reuters - Social Science Citation Index, CINAHL, and the BNI (British Nursing Index).