认知行为疗法对有创伤分娩史孕妇创伤后应激严重程度的影响

Narges Hoseinzadeh, Farnoosh Khojasteh, Zahra Pahlavani Sheikhi
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摘要

背景:创伤性分娩经历可能导致严重的心理损害。最近的研究表明,相当多的女性会患上创伤后应激障碍(PTSD)。目的:本研究的目的是探讨认知行为疗法(CBT)对有创伤性分娩史的孕妇PTSD的影响。方法:对2020年在扎黑丹卫生院就诊的80例有创伤性分娩史的孕妇进行准实验研究。采用方便抽样的方法选取母亲,按照随机分配的方法分为两组(每组40名母亲)。数据是通过干预前和最后一次训练后五周的PTSD问卷收集的。干预组在四周内接受四次CBT治疗,对照组只接受常规妊娠护理。数据分析采用SPSS 22软件,采用独立t检验、卡方检验和配对样本t检验,显著水平< 0.05。结果:研究结果显示,干预组和对照组孕妇CBT前的创伤后应激平均分分别为27.90±10.91和24.97±14.85,干预后分别为15.25±4.08和26.25±11.56。独立t检验显示,两组孕妇的创伤后应激平均得分在教育前无显著差异(P = 0.31),教育后有显著差异(P = 0.0001)。结论:CBT可显著降低有创伤性分娩史孕妇PTSD的严重程度。因此,建议将这种教育干预纳入有创伤性分娩史的孕妇的护理计划中。
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The Effect of Cognitive-Behavioral Therapy on the Severity of Post-Traumatic Stress in Pregnant Women with a History of Traumatic Delivery
Background: Traumatic birth experiences may lead to serious psychological impairment. Recent studies show that a considerable number of women can develop post-traumatic stress disorder (PTSD). Objectives: The aim of this study was to investigate the effect of cognitive-behavioral therapy (CBT) on PTSD in pregnant women with a history of traumatic childbirth. Methods: This quasi-experimental study was conducted on 80 pregnant women with a history of traumatic childbirth, referring to health centers in Zahedan in 2020. The mothers were selected by a convenience sampling method and divided into two groups (40 mothers in each group) according to the random allocation method. The data were collected using the PTSD questionnaire administered before the intervention and five weeks after the final training session. The intervention group received four sessions of CBT during four weeks, and the control group received only routine pregnancy care. Data analysis was performed by SPSS 22 software using the independent t-test, chi-square test, and paired sample t-test at a significant level of < 0.05. Results: The results of the study showed that the mean post-traumatic stress score of pregnant women before CBT in the intervention and control groups was 27.90 ± 10.91 and 24.97 ± 14.85, respectively, and it changed to 15.25 ± 4.08 and 26.25 ± 11.56, respectively, after the intervention. Independent t-test showed that the mean scores of post-traumatic stress of pregnant women in the two groups were not significant before education (P = 0.31), but it was significant after it (P = 0.0001). Conclusions: CBT can have significant effects on reducing the severity of PTSD in pregnant women with a history of traumatic childbirth. Thus, it is recommended to include this type of educational intervention in the care program of pregnant women with a history of traumatic childbirth.
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