本文選題：妊娠 + 抑郁��； 參考：《山東大學(xué)》2017年碩士論文

【摘要】：目的:妊娠期女性容易出現(xiàn)抑郁、焦慮癥狀,對母親和孩子的身心健康產(chǎn)生嚴(yán)重危害,引發(fā)不良分娩結(jié)局。目前尚不得知簡易應(yīng)對訓(xùn)練和感恩日記是否可以改善孕婦的抑郁、焦慮癥狀。本研究將初步探討這兩種自助式心理干預(yù)方案對妊娠期女性抑郁、焦慮癥狀的影響,解析兩種干預(yù)方式和干預(yù)效果關(guān)系的潛在調(diào)節(jié)因素。方法:本研究采用隨機對照試驗設(shè)計。于2016年4月至2016年9月,通過病例查詢和問卷調(diào)查的方式,在山東省濟(jì)南市某三級甲等醫(yī)院產(chǎn)科門診招募74名妊娠期女性,將其隨機化分為簡易應(yīng)對訓(xùn)練組(37人)和感恩日記組(37人),分別進(jìn)行為期4周的簡易應(yīng)對訓(xùn)練和感恩日記干預(yù)。采用一般資料問卷、愛丁堡產(chǎn)后抑郁量表、狀態(tài)焦慮問卷、壓力知覺量表、疲乏程度量表,分別評估孕婦在干預(yù)前、后的抑郁、焦慮、壓力和疲乏癥狀并采用配對樣本t檢驗進(jìn)行組內(nèi)比較。采用廣義估計方程比較兩組孕婦的抑郁、焦慮癥狀隨著時間的變化情況。通過匹茲堡睡眠質(zhì)量指數(shù)量表、領(lǐng)悟社會支持量表、反芻思維量表評估孕婦的睡眠質(zhì)量、社會支持和反芻思維傾向,并探討孕婦的一般資料和睡眠質(zhì)量、社會支持和反芻思維傾向是否為兩種干預(yù)方式和干預(yù)效果關(guān)系的潛在調(diào)節(jié)因素。結(jié)果:(1)簡易應(yīng)對訓(xùn)練組的孕婦抑郁、焦慮和疲乏癥狀均得到顯著改善(P0.01);而感恩日記組孕婦抑郁和焦慮癥狀得到顯著改善(P0.01),但疲乏癥狀沒有顯著性改變(P0.05)。兩組干預(yù)對孕婦的壓力水平均沒有顯著影響(P0.05)。(2)兩組孕婦的抑郁和焦慮癥狀得分在組別上無顯著的主效應(yīng)(P0.05),而在時間上均存在顯著的主效應(yīng)(P0.01);在疲乏得分上,組別存在顯著的主效應(yīng)(P=0.006),同時組別×?xí)r間的交互效應(yīng)也顯著(P=0.011)。孕婦的壓力水平在組別×?xí)r間的主效應(yīng)和交互效應(yīng)均不顯著(P0.05)。(3)對于抑郁癥狀的改善情況,有2次及以下懷孕經(jīng)歷、社會支持水平較低或反芻思維傾向更多的孕婦更適合采用簡易應(yīng)對訓(xùn)練,而有過3次及以上懷孕經(jīng)歷、社會支持水平較高或反芻思維傾向較少的孕婦采用感恩日記的方式更能改善其抑郁癥狀。(4)對于焦慮癥狀的改善情況,睡眠質(zhì)量相對較好或社會支持水平較低的孕婦更適合采用簡易應(yīng)對訓(xùn)練,而睡眠質(zhì)量很差或社會支持水平較高的孕婦采用感恩日記的方式更能改善其焦慮癥狀。結(jié)論:(1)簡易應(yīng)對訓(xùn)練和感恩日記干預(yù)均能夠有效改善妊娠期女性的抑郁、焦慮癥狀,且簡易應(yīng)對訓(xùn)練還能夠改善孕婦的疲乏癥狀。(2)孕婦的懷孕次數(shù)、社會支持水平和反芻思維傾向會顯著影響兩組干預(yù)方式與抑郁癥狀干預(yù)效果的關(guān)系,而孕婦的睡眠質(zhì)量和社會支持水平會顯著影響兩組干預(yù)方式與焦慮癥狀干預(yù)效果的關(guān)系。
[Abstract]:Objective: women in pregnancy are prone to depression and anxiety, which are harmful to the physical and mental health of mother and child. It is not known whether simple coping training and gratitude diaries can improve depression and anxiety in pregnant women. This study will explore the effects of these two self-help psychological intervention programs on depression and anxiety symptoms in pregnant women, and analyze the potential regulatory factors of the relationship between the two intervention methods and the intervention effect. Methods: a randomized controlled trial was used in this study. From April 2016 to September 2016, 74 pregnant women were recruited from a maternity clinic of Grade 3A Hospital in Jinan, Shandong Province, through case inquiries and questionnaires. They were randomly divided into simple coping training group (37 persons) and gratitude diary group (37 persons). General data questionnaire, Edinburgh postpartum depression scale, state anxiety questionnaire, stress perception scale, fatigue scale were used to evaluate the depression and anxiety of pregnant women before and after intervention, respectively. Stress and fatigue symptoms were compared with paired t-test. Generalized estimation equation was used to compare the changes of depression and anxiety symptoms over time. Pittsburgh Sleep quality Index scale, perceived Social support scale and Ruminant thinking scale were used to evaluate the sleep quality, social support and rumination tendency of pregnant women, and to explore the general information and sleep quality of pregnant women. Whether social support and ruminant thinking tendency are the potential regulatory factors of the relationship between the two intervention modes and the intervention effect. Results in the simple coping training group, the depression, anxiety and fatigue symptoms of pregnant women were significantly improved, while in the gratitude diary group, the symptoms of depression and anxiety were significantly improved (P 0.01), but the fatigue symptoms did not change significantly (P 0.05). The scores of depression and anxiety in both groups had no significant effect on the scores of depression and anxiety, but there were significant major effects on the time of the two groups, and the scores of fatigue, fatigue, and fatigue were not significant in the two groups, but there was no significant effect on the scores of depression and anxiety in the two groups, but there was a significant major effect in the time, and the scores of fatigue were higher than those in the control group, and there was no significant difference between the two groups. There was a significant main effect in the group P0. 006, and the interaction effect of the group 脳 time was also significant (P 0. 011). The main effect and interaction effect of stress level in group 脳 time were not significant (P 0.05). Pregnant women with lower level of social support or more tendency to regurgitate thought were more suitable for simple coping training and had three or more pregnancies. Pregnant women with higher level of social support or less tendency to regurgitate their ruminant thought were more likely to improve their anxiety symptoms by using gratitude diary. The pregnant women with better sleep quality or lower level of social support were more suitable for simple coping training, while those with poor sleep quality or high level of social support could improve their anxiety symptoms by the way of gratitude diary. Conclusion both simple coping training and gratitude diary intervention can effectively improve the depression and anxiety symptoms of pregnant women, and simple coping training can also improve the number of pregnancies of pregnant women with fatigue symptoms. The level of social support and the tendency of ruminant thinking could significantly affect the relationship between the intervention style and the intervention effect of depression symptoms, while the sleep quality and social support level of pregnant women could significantly affect the relationship between the intervention style and the intervention effect of anxiety symptom.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R473.71

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