非专业团体心理辅导对中国孕产妇抑郁症状影响的系统评价

doi:10.3761/j.issn.1672-9234.2023.06.013

摘要/Abstract

摘要：

目的系统评价非专业团体心理辅导在缓解我国孕产妇围产期抑郁症状的效果。方法检索国内外数据库中关于非专业团体心理辅导缓解我国孕产妇围产期抑郁症的随机对照试验（试验组为非专业团体心理辅导，对照组干预措施不限制），检索时限为从建库至2022年11月1日。2名研究者独立筛选文献、提取数据和评价质量，并进行数据分析。结果共纳入20项研究，3 085例研究对象。Meta分析结果显示，干预结束时，试验组围产期抑郁症缓解效果优于对照组[SMD=-1.38，95%CI（-1.76，-0.99），P<0.001]。与对照组相比，试验组焦虑症状评分更低[SMD=-1.52，95%CI（-2.72，-0.32），P=0.013]、总产程时间更短[SMD=-1.93，95%CI（-2.45，-1.40），P<0.001]、自然分娩率更高[RR=1.70，95%CI（1.42，2.05），P<0.001]和生存质量评分更高[SMD=0.82，95%CI（0.39，1.25），P<0.001]。结论非专业团体心理辅导能有效缓解中国人群围产期抑郁症。但现有的研究样本量仍较少，多为短期干预效果的测量，未来可开展更多高质量、大样本、长期随访的随机对照试验，进一步验证干预效果。

关键词: 围产期, 抑郁症，产后, 循证护理学, 非专业团体心理辅导, 系统评价

Abstract:

Objective To systematically assess the effect of lay-delivered group psychotherapy （LGP） in China on perinatal depression（PND）. Methods Databases at home and abroad were searched from their establishment to November 1，2022 for randomized clinical trials（RCTs） of lay-delivered group psychotherapy for PND of China（The experimental group adopted lay-delivered group psychotherapy，and the control group has no restrictions on intervention measures）. Two researchers screened the literature，extracted data and evaluated the quality，and conducted data analysis independently. Results A total of 20 RCTs with 3，085 participants were included. The results of Meta-analyses indicated that experimental group had lower PND score than control group[SMD=-1.38，95%CI（-1.76， -0.99），P<0.001] at the end of the intervention. Compared with the control group，the experimental group had lower anxiety symptom score[SMD=-1.52，95%CI（-2.72，-0.32），P=0.013]，less total labor time[SMD=-1.93，95%CI（-2.45，-1.40）， P<0.001]，higher rates of vaginal birth[RR=1.70，95%CI（1.42，2.05），P<0.001]，and higher quality of life score[SMD=0.82，95%CI（0.39，1.25），P<0.001]. Conclusion LGP can effectively relieve PND，and may become one of effective measures to prevent and treat PND in areas with limited mental health resources in China. The sample size of the existing LGP studies is small，and most of them are short-term effect. More RCTs with high quality，large samples，and long-term follow-up should be carried out in the future to further verify the intervention effect of LGP on PND.

Key words: Peripartum Period, Depression，Postpartum, Evidence-Based Nursing, Lay-delivered group psychotherapy, Systematic review

邓春燕,杜兴梅,冉凌云,杨中婷,闻萱,邓睿,黄源. 非专业团体心理辅导对中国孕产妇抑郁症状影响的系统评价[J]. 中华护理教育, 2023, 20(6): 707-715.

DENG Chunyan,DU Xingmei,RAN Lingyun,YANG Zhongting,WEN Xuan,DENG Rui,HUANG Yuan. Lay-delivered group psychotherapy to relieve perinatal depressive symptoms in Chinese：a systematic review[J]. Chinese Journal of Nursing Education, 2023, 20(6): 707-715.

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