自助式正念减压疗法改善高龄孕妇负性情绪的随机对照研究  

A Randomized Control Trial of Self-Help Mindfulness Based Stress Reduction to Improve Negative Emotion of Advanced Maternal Age

作　　者：张淼苗 王健 杨亮 陈珏 范霞 周健红[2] ZHANG Miao-miao;WANG Jian;YANG Liang;CHEN Jue;FAN Xia;ZHOU Jian-hong(Jing′an District Maternal and Child Health Care Center,Shanghai 200072,China;Department of Obstetrics and Gynecology,Tongji University Affiliated Tenth People′s Hospital,Shanghai Tenth People′s Hospital,Shanghai 200072,China)

机构地区：[1]上海市静安区妇幼保健所,200072 [2]同济大学附属第十人民医院,上海市第十人民医院妇产科

出　　处：《国际妇产科学杂志》2025年第2期137-142,共6页Journal of International Obstetrics and Gynecology

基　　金：上海市静安区医学科研课题(2023GW04)。

摘　　要：目的:探究自助式正念减压疗法(self-help mindfulness based stress reduction,Self-MBSR)改善高龄孕妇负性情绪的作用。方法:将2023年9月—2024年6月上海市静安区15家社区卫生服务中心早孕门诊建册的136例孕妇(年龄≥35岁)纳入研究,随机分为训练组和对照组,每组68例。训练组采取为期21 d和为期16周的两阶段SelfMBSR课程,对照组不采取任何干预。分别采用9项患者健康问卷(Patient Health Questionnaire-9 items,PHQ-9)、广泛性焦虑量表(Generalized Anxiety Disorder-7,GAD-7)、妊娠压力量表(Pregnancy Pressure Scale,PPS)、五因素正念量表(Five Facet Mindfulness Questionnaire,FFMQ)评估干预前(T0)、第一阶段干预后(T1)和第二阶段巩固后(T2)的得分情况。结果:训练组完成率为76.47%,对照组完成率为79.41%。训练组T1、T2时点的PHQ-9评分、GAD-7评分和PPS评分均低于对照组(均P<0.05),训练组T1、T2时点的评分均低于干预前(均P<0.01),训练组T2时点的PHQ-9评分低于T1时点,差异有统计学意义(P<0.05),训练组T1和T2时点的GAD-7评分和PPS评分差异无统计学意义(均P>0.05)。训练组T1、T2时点的观察、描述、觉知、不行动的得分及总分均高于对照组(均P<0.05)。训练组T1、T2时点的观察、描述、觉知、非评判的得分及总分均高于干预前,差异有统计学意义(均P<0.05)。结论:Self-MBSR有助于改善高龄孕妇妊娠期负性情绪,降低妊娠压力,提高正念度。Objective:To explore the effect of self-help mindfulness based stress reduction(Self-MBSR)on improving negative emotion of advanced maternal age.Methods:A total of 136 pregnant women(age≥35 years)registered in the early pregnancy clinics of 15 community health service centers in Jing′an District,Shanghai from September 2023 to June 2024 were included in the study and randomly divided into a training group and a control group with 68 cases in each group.The training group was trained with Self-MBSR,and the control group was not trained.After 21 days of training(first stage)and 16 weeks of training(second stage),Patient Health Questionnaire-9 items(PHQ-9),Generalized Anxiety Disorder-7(GAD-7),Pregnancy Pressure Scale(PPS),and Five Facet Mindfulness Questionnaire(FFMQ)were used to count the scores before intervention(T0),after the first stage of intervention(T1),and after the second stage of consolidation(T2).Results:The completion rate in training group was 76.47%,and the completion rate in control group was 79.41%.Scores of PHQ-9,GAD-7 and PPS in the training group were significantly lower than those in the control group at T1 and T2(both P<0.05).Scores at T1 and T2 in the training group were significantly lower than baseline(both P<0.01).Scores of PHQ-9 at T2 were significantly lower than those at T1 in the training group(P<0.05).There were no significant differences in GAD-7 and PPS scores at T1 and T2 in the training group(both P>0.05).Scores of FFMQ in observing,describing,acting with awareness,nonreactivity and total scores in the training group were significantly higher than those in the control group at T1 and T2(all P<0.05).Scores of FFMQ in observing,describing,acting with awareness,nonjudging and total scores at T1 and T2 in the training group were significantly higher than baseline(all P<0.05).Conclusions:Self-MBSR therapy is conducive to improve negative emotion of advanced maternal age,reduce pregnancy stress and enhance their mindfulness.

关 键 词：正念 孕妇 情绪调节 表现焦虑量表 随机对照试验 自助式正念减压疗法 

分 类 号：R749.92[医药卫生—神经病学与精神病学]