本文選題：城市婦女 + 農(nóng)村流入婦女　； 參考：《華中科技大學(xué)》2014年博士論文

【摘要】：目的：了解武漢城市婦女孕產(chǎn)期抑郁癥狀的發(fā)生情況,掌握城市婦女在整個(gè)孕產(chǎn)期抑郁檢出情況的動(dòng)態(tài)變化特征,探討婦女抑郁癥狀消長(zhǎng)的重要影響因素。了解農(nóng)村流入人口產(chǎn)后抑郁的發(fā)生情況,掌握影響產(chǎn)后抑郁的危險(xiǎn)因素和保護(hù)性因素。比較城市婦女和農(nóng)村流動(dòng)?jì)D女產(chǎn)后抑郁檢出情況及影響因素的差異。 方法：(1)縱向研究。研究人員對(duì)孕早期婦女進(jìn)行基線(xiàn)調(diào)查和抑郁評(píng)估,隨后由社區(qū)醫(yī)生在孕中、晚期以及產(chǎn)后1個(gè)月、3個(gè)月定期開(kāi)展入戶(hù)調(diào)查。所有研究對(duì)象在每次隨訪時(shí)填寫(xiě)調(diào)查問(wèn)卷,并用愛(ài)丁堡產(chǎn)后抑郁量表(EPDS)進(jìn)行抑郁評(píng)分。(2)橫斷面研究。對(duì)滿(mǎn)足條件的農(nóng)村流動(dòng)產(chǎn)婦進(jìn)行問(wèn)卷調(diào)查,并用EPDS進(jìn)行抑郁評(píng)估。 結(jié)果：(1)武漢市婦女在整個(gè)孕產(chǎn)期的抑郁檢出率在孕期表現(xiàn)出一定特征,即在孕期隨著妊娠周期增加抑郁檢出率逐漸上升,在產(chǎn)后1個(gè)月和產(chǎn)后3個(gè)月的抑郁檢出率保持著較高的水平。武漢市孕產(chǎn)婦在孕期抑郁測(cè)評(píng)均分呈現(xiàn)“U”型分布,產(chǎn)后EPDS均分從產(chǎn)后1個(gè)月至產(chǎn)后3個(gè)月呈明顯下降趨勢(shì)。(2)Logistic回歸分析顯示,孕早期抑郁的影響因素為：對(duì)孕期飲食不滿(mǎn)意、發(fā)生對(duì)精神有影響的負(fù)性生活事件；孕中期抑郁的影響因素有：發(fā)生對(duì)精神有影響的負(fù)性生活事件；孕晚期抑郁的影響因素有對(duì)家人照顧不滿(mǎn)意、發(fā)生對(duì)精神有影響的負(fù)性生活事件；產(chǎn)后1個(gè)月抑郁的影響因素有：丈夫?qū)ψ约宏P(guān)心滿(mǎn)意度低、對(duì)產(chǎn)后居住條件滿(mǎn)意度低、對(duì)產(chǎn)后身材恢復(fù)不滿(mǎn)意、發(fā)生對(duì)精神有影響的負(fù)性生活事件；產(chǎn)后3個(gè)月抑郁的影響因素有：丈夫?qū)ψ约宏P(guān)心滿(mǎn)意度低、有向?qū)殞毎l(fā)泄情緒的沖動(dòng)、為產(chǎn)后經(jīng)濟(jì)狀況擔(dān)憂(yōu)。(3)武漢地區(qū)農(nóng)村流入人口抑郁癥檢出率高,產(chǎn)后抑郁檢出率和EPDS均分高于城市居民。多因素logistic回歸分析的結(jié)果顯示無(wú)醫(yī)療保險(xiǎn)、照看孩子感覺(jué)累、丈夫?qū)ζ拮雨P(guān)心程度一般和根本不關(guān)心、對(duì)居住條件不滿(mǎn)意和生活中存在壓力事件是農(nóng)村女性流入人口發(fā)生產(chǎn)后抑郁的危險(xiǎn)因素。 結(jié)論：(1)武漢市婦女孕期抑郁檢出率隨著孕周增加而增加,產(chǎn)后隨著休養(yǎng)時(shí)間延長(zhǎng),產(chǎn)后抑郁檢出率仍保持較高水平。(2)武漢市婦女的EPDS均分在孕期呈“U”型分布,產(chǎn)后隨著休養(yǎng)時(shí)間延長(zhǎng),EPDS均分顯著下降。(3)患抑郁的孕婦在產(chǎn)后的抑郁癥狀降低,產(chǎn)后抑郁水平下降明顯,提示武漢武漢市婦女的抑郁癥狀在產(chǎn)后具有一定的自我康復(fù)能力。(4)農(nóng)村流入人口的產(chǎn)后抑郁檢出率和患病水平較高,遠(yuǎn)高于武漢市本地戶(hù)籍?huà)D女。無(wú)醫(yī)療保險(xiǎn)、照看孩子累、丈夫?qū)ζ拮诱疹櫼话�、�?duì)居住條件不滿(mǎn)、產(chǎn)后不良生活事件是農(nóng)村流入婦女產(chǎn)后抑郁的高危因素。
[Abstract]:Objective: to understand the occurrence of depressive symptoms in urban women during pregnancy and childbirth in Wuhan, and to understand the dynamic changes of depressive symptoms in urban women during pregnancy and childbirth, and to explore the important influencing factors of depressive symptoms in urban women.To understand the incidence of postpartum depression and the risk factors and protective factors of postpartum depression.To compare the detection and influence factors of postpartum depression between urban women and rural migrant women.Methods Vertical study.The researchers conducted baseline surveys and depression assessments of women in early pregnancy, followed by regular household surveys by community doctors during, late and one month after pregnancy, and three months after delivery.All the subjects completed the questionnaire at each follow-up, and used the Edinburgh postpartum Depression scale (EPDS) to carry out the depression score. 2) Cross-sectional study.A questionnaire survey was conducted on rural migrant women who met the conditions, and depression was evaluated with EPDS.Results (1) the prevalence rate of depression in Wuhan women showed certain characteristics during pregnancy, that is, the rate of depression increased gradually with the increase of pregnancy cycle.The detectable rate of depression maintained a high level at 1 month postpartum and 3 months postpartum.The average score of depression in pregnant women in Wuhan showed a "U" type distribution. The average score of postpartum EPDS decreased significantly from 1 month to 3 months after delivery. Logistic regression analysis showed that the influencing factors of depression in early pregnancy were: dissatisfied with diet during pregnancy.The influencing factors of depression in the second trimester of pregnancy are: the negative life events which have an effect on the mind, and the influencing factors of depression in the third trimester of pregnancy are not satisfied with the care of the family.The influencing factors of depression after one month of postpartum were: husband's low satisfaction with his care, low satisfaction with postpartum living conditions, and dissatisfied with postpartum figure recovery.The influencing factors of depression after 3 months of postpartum were: the husband's low satisfaction with his care and the impulse to vent his emotions on the baby.The incidence of depression in rural inflow population in Wuhan area was higher than that in urban residents, and the average score of postpartum depression and EPDS was higher than that of urban residents.The results of multivariate logistic regression analysis showed that there was no medical insurance, that the child was tired, that the husband cared for his wife generally and that he did not care at all.Dissatisfaction with living conditions and stress events in life are the risk factors of postpartum depression in rural women.Conclusion (1) the prevalence rate of depression during pregnancy increases with the increase of gestational weeks in Wuhan, and the detection rate of postpartum depression remains at a high level with the prolongation of rest and recuperation.) the mean score of EPDS of women in Wuhan is "U" type distribution during pregnancy.As the rest and recuperation time prolonged, the mean score of EPDS decreased significantly. (3) the depression symptoms of pregnant women with depression decreased significantly, and the level of postpartum depression decreased significantly.It is suggested that the postpartum depression of Wuhan women has a certain ability of self-rehabilitation. 4) the incidence of postpartum depression and the prevalence of postpartum depression in the rural areas are higher than those of the local Hukou women in Wuhan.Without medical insurance, child care is tired, husband takes care of his wife generally, and he is dissatisfied with living conditions. The adverse life events after childbirth are the high risk factors of postpartum depression for rural women.
【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R749.4

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