护理学报 ›› 2022, Vol. 29 ›› Issue (12): 33-38.doi: 10.16460/j.issn1008-9969.2022.12.033
孕期丧失患者创伤后应激障碍研究进展
余丹萍1, 顾水琴2
- 1.浙江中医药大学 护理学院,浙江 杭州 310000;
2.嘉兴市妇幼保健院 护理部,浙江 嘉兴 314000
摘要： 目的 了解孕期丧失患者创伤后应激障碍相关研究进展,为开展孕期丧失患者创伤后应激障碍的研究提供参考。方法 对国内外文献进行相关主题的检索、分析与提取,分别对孕期丧失的概念与创伤后应激障碍的概念、发生情况、测评工具与影响因素进行综述。结果 国外孕期丧失患者创伤后应激障碍发生率7%~60%,国内孕期丧失患者创伤后应激障碍发生率1.8%~18.2%;在国外孕期丧失患者创伤后应激障碍在1个月或3个月时发生水平最高;现DSM-5修订版的创伤后应激障碍自评量表包括：创伤后应激障碍症状筛查量表、创伤后应激障碍初级保健量表、创伤后诊断量表等;孕期丧失患者创伤后应激障碍的影响因素包含人口学因素、生育因素、亲密关系因素社会支持因素与认知因素等。结论 随着近年来对孕期女性心理健康的重视,关于孕期各类心理健康的研究逐步增加,孕期丧失患者创伤后应激障碍研究的开展为孕期丧失患者心理障碍的预防和干预提供依据。
中图分类号:
- R471
| [1] Hanish KK, Margulies I, Cogan AM. Evaluation of an Occupation-Based Retreat for Women after Pregnancy or Infant Loss[J]. Am J Occup Ther, 2019,73(5):7305345030p1. DOI: 10.5014/ajot.2019.034025. [2] Fernandez-Ordonez E, Gonzalez-Cano-Caballero M, Guerra-Marmolejo C, et al. Perinatal Grief and Post-traumatic Stress Disorder in Pregnancy after Perinatal Loss: A Longitudinal Study Protocol[J].Int J Envir Res Pub Health, 2021, 18(6):2874. DOI:10.3390/ijerph18062874. [3] Hanish KK, Margulies I, Cogan AM.Evaluation of an Occupation-based Retreat for Women after Pregnancy or Infant Loss[J]. Am J Occup Therapy,2019,73(5):1-6.DOI:10.5014/ajot.2019.034025. [4] Tektaş P, Çam O. The Effects of Nursing Care Based on Watson's Theory of Human Caring on the Mental Health of Pregnant Women after a Pregnancy Loss[J]. Arch Psychiatr Nurs,2017,31(5):440-446. DOI:10.1016/j.apnu.2017.07.002. [5] 周小莉. 胎儿异常引产妇女产褥期心理体验及干预研究[D].杭州:浙江大学,2020.DOI:10.27461/d.cnki.gzjdx.2020.003159. [6] 武文贤,白秀兰,周丹,等.产妇经历胎儿畸形终止妊娠真实体验的Meta整合[J].护理学报,2021,28(22):52-57.DOI:10.16460/j.issn1008-9969.2021.22.052. [7] Grauerholz KR, Berry SN, Capuano RM, et al.Uncovering Prolonged Grief Reactions Subsequent to a Reproductive Loss: Implications for the Primary Care Provider[J]. Front Psychol, 2021, 12:673050.DOI:10.3389/fpsyg.2021.673050. [8] 陈卫. 中国的低生育率与三孩政策——基于第七次全国人口普查数据的分析[J]. 人口与经济, 2021(5):25-35. [9] 中国妇女发展纲要(2021—2030年),中国儿童发展纲要(2021—2030年)[N]. 人民日报,2021-09-28(2版).DOI:10.28655/n.cnki.nrmrb.2021.010335. [10] 曹淑殷,李君琴,王虹,等.胎儿异常引产孕妇创伤后应激反应及与大五人格的相关性分析[J]. 中国实用护理杂志,2016,32(2):81-85. [11] Martin CR, Preedy VR, Patel VB.Comprehensive Guide to Post-Traumatic Stress Disorders[M/OL]. Springer International Publishing, 2016:600-612. https://link.springer.com/referencework/10.1007/978-3-319-08359-9. [12] Horesh D, Nukrian M, Bialik Y.To Lose an Unborn Child: Post-Traumatic Stress Disorder and Major Depressive Disorder Following Pregnancy Loss among Israeli Women[J]. Gen Hosp Psychiatry, 2018, 53: 95-100. DOI: 10.1016/j.genhosppsych.2018.02.003. [13] Turton P, Hughes P, Evans CD, et al.Incidence, Correlates and Predictors of Post-traumatic Stress Disorder in the Pregnancy after Stillbirth[J]. Br J Psychiatry, 2001, 178: 556-560. DOI: 10.1192/bjp.178.6.556. [14] Chung MC, Reed J.Posttraumatic Stress Disorder Following Stillbirth: Trauma Characteristics, Locus of Control, Posttraumatic Cognitions[J]. Psychiatr Q, 2017, 88(2):307-321. DOI: 10.1007/s11126-016-9446-y. [15] Murphy S,Shevlin M, Elklit A.Psychological Consequences of Pregnancy Loss and Infant Death in a Sample of Bereaved Parents[J]. J Loss Trauma, 2014, 19(1):56-69. DOI: 10.1080/15325024.2012.735531. [16] Biggs MA, Rowland B, McCulloch CE, et al. Does Abortion Increase Women's Risk for Post-traumatic Stress? Findings from a Prospective Longitudinal Cohort Study[J]. BMJ Open, 2016, 6(2): e009698. DOI: 10.1136/bmjopen-2015-009698. [17] Sham A, Yiu M, Ho W.Psychiatric Morbidity Following Miscarriage in Hong Kong[J]. Gen Hosp Psychiatry, 2010, 32(3):284-293. DOI:10.1016/j.genhosppsych.2009.12.002. [18] 余晓燕. 胎儿异常孕妇的心理特征及其影响因素研究[D].杭州:浙江大学, 2016. [19] Turton P, Badenhorst W, Hughes P, et al.Psychological Impact of Stillbirth on Fathers in the Subsequent Pregnancy and Puerperium[J]. Br J Psychiatry, 2006, 188:165-172. DOI: 10.1192/bjp.188.2.165. [20] Farren J, Jalmbrant M, Falconieri N, et al.Differences in Post-Traumatic Stress, Anxiety and Depression Following Miscarriage or Ectopic Pregnancy between Women and Their Partners: Multicenter Prospective Cohort Study[J]. Ultrasound Obstet Gynecol, 2021, 57(1):141-148. DOI: 10.1002/uog.23147. [21] Baransel ES, Uçar T.Posttraumatic Stress and Affecting Factors in Couples after Perinatal Loss: A Turkish Sample[J]. Perspect Psychiatr Care, 2020, 56(1):112-120. DOI: 10.1111/ppc.12390. [22] Westby CL, Erlandsen AR, Nilsen SA, et al.Depression, Anxiety, PTSD, and OCD after Stillbirth: A Systematic Review[J]. BMC Pregnancy Childbirth, 2021, 21(1):782. DOI: 10.1186/s12884-021-04254-x. [23] Lewkowitz AK, Rosenbloom JI, Keller M, et al.Association between Stillbirth ≥23 Weeks Gestation and Acute Psychiatric Illness within 1 Year of Delivery[J]. Am J Obstet Gynecol, 2019, 221(5): e491. DOI: 10.1016/j.ajog.2019.06.027. [24] Krosch DJ, Shakespeare-Finch J. Grief, Traumatic Stress,Posttraumatic Growth in Women Who Have Experienced Pregnancy Loss[J]. Psychol Trauma, 2017, 9(4): 425-433. DOI: 10.1037/tra0000183. [25] Farren J, Jalmbrant M, Falconieri N, et al.Posttraumatic Stress, Anxiety And Depression Following Miscarriage and Ectopic Pregnancy: A Multicenter, Prospective,Cohort Study[J]. Am J Obstet Gynecol, 2020, 222(4):e361-367. DOI: 10.1016/j.ajog.2019.10.102. [26] Blevins CA, Weathers FW, Davis MT, et al.The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and Initial Psychometric Evaluation[J]. J Trauma Stress, 2015, 28(6): 489-498. DOI: 10.1002/jts.22059. [27] Prins A, Bovin MJ, Smolenski DJ, et al.The Primary Care Ptsd Screen for DSM-5 (PC-PTSD-5): Development and Evaluation within a Veteran Primary Care Sample[J]. J Gen Intern Med, 2016, 31(10): 1206-1211. DOI: 10.1007/s11606-016-3703-5. [28] Huang RW, Shen T, Ge LM, et al.Psychometric Properties of the Chinese Version of the Primary Care Post-traumatic Stress Disorder Screen-5 for Medical Staff Exposed to the Covid-19 Pandemic[J]. Psychol Res Behav Manag, 2021, 14:1371-1378. DOI:10.2147/prbm.S329380. [29] Li J, Zhang W, Chen W, et al.Applications of the Chinese Version of the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) for Children[J]. J Affect Disord, 2019, 254: 109-114. DOI: 10.1016/j.jad.2019.05.021. [30] Foa EB, McLean CP, Zang Y, et al. Psychometric Properties of the Posttraumatic Diagnostic Scale for DSM-5 (PDS-5)[J]. Psychol Assess,2016, 28(10):1166-1171. DOI: 10.1037/pas0000258. [31] Su YJ, Kung YW, Hung FC, et al.Dimensionality of DSM-5 PTSD Symptoms: Validation of the Chinese Version of the Posttraumatic Diagnostic Scale for DSM-5 Across Multiple Trauma Samples[J].J Anxiety Disord,2020,74: 102261. DOI: 10.1016/j.janxdis.2020.102261. [32] Daugirdaite V, van den Akker O, Purewal S. Posttraumatic Stress and Posttraumatic Stress Disorder after Termination of Pregnancy and Reproductive Loss: A Systematic Review[J]. J Pregnancy, 2015, 2015: 646345. DOI:10.1155/2015/646345. [33] Bhat A, Byatt N.Infertility and Perinatal Loss: When the Bough Breaks[J]. Curr Psychiatry Rep, 2016, 18(3): 31. DOI: 10.1007/s11920-016-0663-8. [34] Hamama L, Rauch SA, Sperlich M, et al.Previous Experience of Spontaneous or Elective Abortion and Risk for Posttraumatic Stress and Depression during Subsequent Pregnancy[J]. Depress Anxiety, 2010, 27(8):699-707. DOI: 10.1002/da.20714. [35] 周海. 人工流产患者创伤后应激障碍现况及相关影响因素研究[D].昆明:昆明医科大学, 2017. [36] Horsch A, Jacobs I, McKenzie-McHarg K. Cognitive Predictors and Risk Factors of PTSD Following Stillbirth: A Short-term Longitudinal Study[J]. J Trauma Stress, 2015, 28(2):110-117. DOI:10.1002/jts.21997. [37] Giannandrea SA, Cerulli C, Anson E, et al.Increased Risk for Postpartum Psychiatric Disorders among Women with Past Pregnancy Loss[J].J Womens Health (Larchmt), 2013, 22(9):760-768. DOI:10.1089/jwh.2012.4011. [38] Farren J, Jalmbrant M, Falconieri N, et al.Prognostic factors for Post-traumatic Stress, Anxiety and Depression in Women after Early Pregnancy Loss: A Multi-centre Prospective Cohort Study[J]. BMJ Open,2022,12(3):e054490. DOI:10.1136/bmjopen-2021-054490. [39] Farren J, Jalmbrant M, Ameye L, et al.Post-traumatic Stress, Anxiety and Depression following Miscarriage or Ectopic Pregnancy: A Prospective Cohort Study[J]. BMJ Open, 2016, 6(11):e011864. DOI:10.1136/bmjopen-2016-011864. [40] 傅利芹,李超,黄影平,等.体外受精-胚胎移植不良妊娠结局患者创伤后应激障碍及相关因素的研究[J].中西医结合心血管病电子杂志,2020,8(7):197-198.DOI:10.16282/j.cnki.cn11-9336/r.2020.07.152. [41] 谭湘敏,宁妮,赵倩,等.医护人员对亲密关系暴力的知识、态度及干预现状[J].解放军护理杂志,2021,38(12):82-84. [42] Reich CM, Jones JM, Woodward MJ, et al.Does Self-Blame Moderate Psychological Adjustment Following Intimate Partner Violence?[J]. J Interpers Violence, 2015, 30(9):1493-1510. DOI:10.1177/0886260514540800. [43] Steinberg JR, Finer LB.Examining the Association of Abortion History and Current Mental Health: A?Reanalysis of the National Comorbidity Survey Using a Common-Risk-Factors Model[J]. Soc Sci Med, 2011, 72(1):72-82. DOI: 10.1016/j.socscimed.2010.10.006. [44] Trevillion K, Oram S, Feder G, et al.Experiences of Domestic Violence and Mental Disorders: A Systematic Review and Meta-analysis[J].PLoS One, 2012,7(12): e51740. DOI: 10.1371/journal.pone.0051740. [45] Wallin Lundell I, Sundström Poromaa I, Frans O, et al.The Prevalence of Posttraumatic Stress among Women Requesting Induced Abortion[J]. Eur J Contracept Reprod Health Care, 2013, 18(6): 480-488. DOI: 10.3109/13625187.2013.828030. [46] Tinglof S, Hogberg U, Lundell IW, et al.Exposure to Violence among Women with Unwanted Pregnancies and the Association with Post-traumatic Stress Disorder, Symptoms of Anxiety and Depression[J]. Sexual Reproductive Healthcare : Official Journal of the Swedish Association of Midwives, 2015, 6(2): 50-53. DOI: 10.1016/j.srhc.2014.08.003. [47] Gold KJ, Leon I, Boggs ME, et al.Depression and Posttraumatic Stress Symptoms after Perinatal Loss in a Population-based Sample[J].J Womens Health (Larchmt), 2016, 25(3): 263-269. DOI: 10.1089/jwh.2015.5284. [48] 袁玮蔓. 针对女性的亲密伴侣暴力及其与抑郁关系的现状调查[D]. 杭州:浙江大学, 2020.DOI:10.27461/d.cnki.gzjdx.2020.003285. [49] Wang J, Mann F, Lloyd-Evans B, et al.Associations between Loneliness and Perceived Social Support and Outcomes of Mental Health Problems: A Systematic Review[J]. Bmc Psychiatry, 2018,18(1):156.DOI:10.1186/s12888-018-1736-5. [50] 刘文强. 骨折患者社会支持、自我感受负担及创伤后应激障碍的相关性研究[D].延吉:延边大学,2020.DOI:10.27439/d.cnki.gybdu.2020.000054. [51] Galeotti M, Mitchell G, Tomlinson M, et al.Factors Affecting the Emotional Wellbeing of Women and Men Who Experience Miscarriage in Hospital Settings: A Scoping Review[J]. Bmc Pregnancy and Childbirth, 2022, 22(1). DOI: 10.1186/s12884-022-04585-3. [52] Crawley R, Lomax S, Ayers S.Recovering from Stillbirth: The Effects of Making and Sharing Memories on Maternal Mental Health[J]. Journal of Reproductive and Infant Psychology,2013,31(2):195-207. DOI:10.1080/02646838.2013.795216. [53] 陈亚岚,吴羽楠,王珊珊,等.胎儿异常引产孕产妇应对策略的质性研究[J].护理学报,2016, 23(20):72-75.DOI:10.16460/j.issn1008-9969.2016.20.072. [54] 张洁琼. 胎儿异常孕妇同伴支持计划实施及效果评价[D].石河子:石河子大学, 2018. [55] Tomsis Y, Gelkopf M, Yerushalmi H, et al.Different Coping Strategies Influence the Development of PTSD among First-time Mothers[J]. J Matern Fetal Neonatal Med, 2018, 31(10): 1304-1310. DOI:10.1080/14767058.2017.1315658. [56] 张琴,甘祥芝,李倩,等.孕期丧失胎儿妇女情感体验的现象学研究[J].中国护理管理,2020,20(8):1149-1153. [57] Szabo YZ, Warnecke AJ, Newton TL, et al.Rumination and Posttraumatic Stress Symptoms in Trauma-exposed Adults: A Systematic Review and Meta-analysis[J]. Anxiety Stress Coping, 2017, 30(4):396-414.DOI:10.1080/10615806.2017.1313835. [58] 孙小然,赵悦,李文浩,等.术后乳腺癌患者体象对创伤后应激障碍和创伤后成长的影响:反刍的中介作用[J].心理与行为研究,2020,18(5):693-699. [59] Susan A, Harris R, Sawyer A, et al.Posttraumatic Stress Disorder after Childbirth: Analysis of Symptom Presentation and Sampling[J]. J Affect Disord, 2009, 119(1/2/3):200-204. DOI:10.1016/j.jad.2009.02.029. |
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