正念課程介入對高危險妊娠安胎孕婦憂鬱、焦慮、睡眠品質之成效探討

Abstract

研究目的：高危險妊娠安胎孕婦之憂鬱、焦慮及睡眠品質具有關聯性，且透過正念課程介入可以降低其憂鬱、焦慮及提升睡眠品質。因此，本研究欲檢驗正念課程介入是否有效降低高危險妊娠安胎孕婦憂鬱、焦慮及提升睡眠品質。研究方法：本研究對象為臺灣北部某醫學中心婦產科病房與產房的高危險妊娠安胎住院孕婦(n = 30)，隨機分配為實驗組 (n = 14) 及對照組 (n = 16)。實驗組參與除接受常規護理指導並接受為期4週、每週1次、每次30分鐘的一對一之正念課程介入；對照組則接受常規護理指導。本研究使用中文版愛丁堡產後憂鬱量表、中文版情境-特質焦慮量表以及中文版匹茲堡睡眠品質量表進行施測，問卷施測共計3次，分別在介入前（基線）、介入後(立即後測)及介入後兩週(追蹤)實施。以點二系列相關、皮爾森積差相關來檢驗社會人口學因素(年齡、全家年收入)、產科妊娠史(懷孕週數、是否人工受孕)之憂鬱、焦慮及睡眠品質的相關性；以廣義估計方程式來分析正念課程介入後之立即效果及延宕效果。研究結果：在社會人口學變項、產科妊娠史之憂鬱、焦慮及睡眠品質之相關性中，僅有後測的憂鬱程度與全家年收入上呈顯著負相關 (p< .05)。經過四週的正念課程後，關於憂鬱方面，實驗組相較於對照組在後測及追蹤分數具有統計上的顯著(p < .05)；關於情境-特質焦慮方面，實驗組相較於對照組在後測及追蹤分數未達到統計上的顯著差異 (p > .05)，至於睡眠品質的部分，兩組間後測及追蹤分數均未達到統計顯著差異 (p > .05)。 研究結論：正念課程介入對於高危險妊娠安胎孕婦的憂鬱具有立即與延宕介入效果，可提供高危險妊娠安胎孕婦降低其憂鬱。

Objective: Depression, anxiety, and poor sleep quality in pregnant women undergoing tocolysis are interrelated and can be reduced through mindfulness-based interventions. This study seeks to validate whether using a mindfulness course intervention can effectively alleviate depression and anxiety and improve the quality of sleep in pregnant women.Methods: This study included 30 pregnant women undergoing tocolysis who were hospitalized at a obstetrics and gynecology ward and delivery room in a medical center in northern Taiwan. The subjects were randomly divided into an experimental group (n = 14) and a control group (n = 16). During the four-week intervention, the experimental group received routine nursing care and a 30-minute mindfulness course once a week; the control group received only routine nursing care. Throughout this study, the Chinese versions of the Edinburgh Postnatal Depression Scale, and the Chinese versions of the State-Trait Anxiety Inventory, and the Chinese versions of the Pittsburgh Sleep Quality Index wereadministered three times, once before (baseline), once after (immediate posttest), and two weeks later (follow-up) the intervention. The correlations between the subjects’ sociodemographic variables (age, annual household income), obstetric history (gestational weeks, whether conception was through in vitro fertilization), depression, anxiety, and sleep quality were analyzed using Point-biserial correlation analysis and Pearson correlation analysis. The immediate and delayed effects of the mindfulness course intervention were analyzed using generalized estimating equations.Results: Among the correlations between the sociodemographic variables, obstetric history, depression, anxiety, and sleep quality of the subjects, only a significant negative correlation (p< .05) exists between posttest depression level and annual household income. As a result of the mindfulness course, the experimental group's posttest scores and follow-up depression scores were statistically significant (p < .05), whereas the control group's were not. As for state-trait anxiety, the experimental group's posttest and follow-up scores were not statistically significant (p > .05), whereas the control group's were not. Both groups did not achieve statistical significance (p > .05) in terms of posttest and follow-up sleep quality.Conclusions: The mindfulness course intervention had immediate and delayed effects on reducing the depression levels among pregnant women at high risk of preterm labor.