行動應用程式之社會支持對產後知覺壓力與憂鬱成效探討

The Effects of a Mobile Application Social Support Program on Postpartum Perceived Stress and Depression

10.6224/JN.63.6.52

鄭雪玉(Hsuesh-Yu Cheng)；黃翠媛(Tsuey-Yuan Huang)；簡麗瑜(Li-Yu Chien)；鄭瑜芬(Yu-Fen Cheng)；陳芬如(Fen-Ju Chen)

行動應用程式 ； 社會支持方案 ； 產後知覺壓力 ； 產後憂鬱 ； mobile application ； social support program ； postnatal perceived stress ； postpartum depression

護理雜誌

63卷6期（2016 / 12 / 01）

52 - 60

繁體中文

背景　產後憂鬱為產後婦女常見健康問題，運用有效的社會支持降低產後憂鬱為重要議題，現今智慧型手機的普及，使介入處置的方式有更多可能性。目的　本研究旨在探討以Line為媒介的行動應用程式之社會支持方案，對產後婦女改善知覺壓力與憂鬱之效果。方法　本研究採實驗性研究設計，126位懷孕36週後且有使用智慧型手機習慣者，隨機分配為實驗組（n =61）與對照組（n = 65），實驗組於產後4週以Line提供每週2次的社會支持方案，對照組則無介入方案，並以中文版知覺壓力量表和愛丁堡憂鬱量表評值成效。結果　實驗組產後婦女的知覺壓力（F = 27.25, p ＜ .001）與憂鬱程度（F = 35.73, p ＜ .001）都顯著低於對照組。結論　以Line為媒介的行動應用程式之社會支持方案可有效降低產後婦女知覺壓力與憂鬱程度，依研究結果，行動應用程式之社會支持方案建議可被應用於產後照護。

Background: Postpartum depression is a common health problem for women following childbirth. Using effective social support to reduce postpartum depression has become an important issue. The current popularity of smartphones offers new possibilities for interventional methods. Purpose: To investigate the effects of mobile-application-based social support programs on perceived stress and postpartum depression in postpartum women . Methods: The present study employs an experimental research design. 126 smartphone users at 36 weeks’ gestation were assigned randomly to the intervention (n = 61) or the control (n = 65) group. The intervention group received a social-support intervention via the mobile application Line twice per week for a period of 4 weeks after childbirth. The control group did not receive the intervention. The Perceived Stress Scale—Chinese version and Edinburg Postnatal Depression Scale were used to evaluate the outcome. Results: Participants in the intervention group had significantly lower perceived stress (F = 27.25, p ＜ .001) and postpartum depression (F = 35.73, p ＜ .001) than their control group peers. Conclusion: Social-support programs that are delivered via mobile applications such as Line may significantly reduce the perceived stress and postpartum depression of women during the early postpartum period. The results support the implementation of mobile-application-based social support programs in postpartum care.

1. 黃寶園(2010)。社會支持在壓力反應歷程中的中介效果。中華心理衛生學刊，23(3)，401-436。
   連結：
2. 楊政穎、鍾才元、陳明終、李曜安(2014)。社群網路使用者之線上社會支持與線上人際關係。國教新知，61(4)，22-27。
   連結：
3. 劉秀珍、陳春賢、李絳桃(2011)。網路化孕期健康照護系統對懷孕婦女服務滿意度之成效。助產雜誌，53，29-39。
   連結：
4. 資策會FIND（2014）．2014 臺灣消費者行動裝置暨APP 使用行為研究調查報告．台北市：資策會創新應用服務研究所。[Institute for Information Industry FIND. (2014). The investigation report of consumers' behavior on mobile device and APP in Taiwan, 2014. Taipei City, Taiwan, ROC: Innovative DigiTech-Enabled Applications & Services Institute.]
5. Beck, C. T.(2001).Predictors of postpartum depression: An update.Nursing Research,50(5),275-285.
6. Cappuccini, G.,Cochrane, R.(2000).Life with the first baby: Women's satisfaction with the division of roles.Journal of Reproductive and Infant Psychology,18(3),189-202.
7. Chabrol, H.,Teissedre, F.,Saint-Jean, M.,Teisseyre, N.,Roge, B.,Mullet, E.(2002).Prevention and treatment of post-partum depression: A controlled randomized study on women at risk.Psychological Medicine,32(6),1039-1047.
8. Chen, C. M.,Kuo, S. F.,Chou, Y. H.,Chen, H. C.(2007).Postpartum Taiwanese women: Their postpartum depression, social support and health-promoting lifestyle profiles.Journal of Clinical Nursing,16(8),1550-1560.
9. Cohen, S.,Kamarck, T.,Mermelstein, R.(1983).A global measure of perceived stress.Journal of Health and Social Behavior,24(4),385-396.
10. Cohen, S.,Wills, T. A.(1985).Stress, social support, and the buffering hypothesis.Psychological Bulletin,98(2),310-357.
11. Cox, J. L.,Holden, J. M.,Sagovsky, R.(1987).Detection of postnatal depression. Development of the 10-item Edin burgh postnatal depression scale.The British Journal of Psychiatry,150(6),782-786.
12. Dennis, C. L.,Chung-Lee, L.(2006).Postpartum depression help-seeking barriers and maternal treatment preferences: A qualitative systematic review.Birth,33(4),323-331.
13. Ford, E.,Ayers, S.(2011).Support during birth interacts with prior trauma and birth intervention to predict postnatal post-traumatic stress symptoms.Psychology & Health,26(12),1553-1570.
14. Gao, L. L.,Chan, S. W. C.,Mao, Q.(2009).Depression, perceived stress, and social support among first-time Chinese mothers and fathers in the postpartum period.Research in Nursing & Health,32(1),50-58.
15. Gao, L. L.,Xie, W.,Yang, X.,Chan, S. W. C.(2015).Effects of an interpersonal-psychotherapy-oriented postnatal programme for Chinese first-time mothers: A randomized controlled trial.International Journal Nursing of Studies,52(1),22-29.
16. Gjerdingen, D.,Katon, W.,Rich, D. E.(2008).Stepped care treatment of postpartum depression: A primary care-based management model.Women's Health Issues,18(1),44-52.
17. Heh, S. S.,Fu, Y. Y.(2003).Effectiveness of informational support in reducing the severity of postnatal depression in Taiwan.Journal of Advanced Nursing,42(1),30-36.
18. Hung, C. H.,Chung, H. H.(2001).The effects of postpartum stress and social support on postpartum women's health status.Journal of Advanced Nursing,36(5),676-684.
19. Lavender, T.,Richens, Y.,Milan, S. J.,Smyth, R. M. D.,Dowswell, T.(2013).Telephone support for women during pregnancy and the first six weeks postpartum.Cochrane Database of Systematic Reviews,7,CD009338.
20. Lee, D. T.,Yip, S. K.,Chiu, H. F.,Leung, T. Y.,Chan, K. P.,Chau, I. O.,Chung, T. K.(1998).Detecting postnatal depression in Chinese women. Validation of the Chinese version of the Edinburgh postnatal depression scale.The British Journal of Psychiatry,172(5),433-437.
21. Lu, L.(2006).Postnatal adjustment of Chinese parents: A two-wave panel study in Taiwan.International Journal of Psychology,41(5),371-384.
22. Mann, J. R.,Mannan, J.,Quiñones, L. A.,Palmer, A. A.,Torres, M.(2010).Religion, spirituality, social support, and perceived stress in pregnant and postpartum Hispanic women.JOGNN: Journal of Obstetric, Gynecologic, & Neonatal Nursing,39(6),645-657.
23. Mohammad-Alizadeh-Charandabi, S.,Malakoti, J.,Sohrabi, F.,Shokranian, N.(2013).The effect of telephone support on postpartum depression: A randomized controlled trial.Journal of Caring Sciences,2(2),147-155.
24. Osman, H.,Saliba, M.,Chaaya, M.,Naasan G.(2014).Interventions to reduce postpartum stress in first-time mothers: A randomized-controlled trial.BMC Women's Health,14(1),125.
25. Shrivastava, S. R.,Shrivastava, P. S.,Ramasamy, J.(2015).Antenatal and postnatal depression: A public health perspective.Journal of Neurosciences in Rural Practice,6(1),116-119.
26. Sockol, L. E.,Epperson, C. N.,Barber, J. P.(2013).Preventing postpartum depression: A meta-analytic review.Clinical Psychology Review,33(8),1205-1217.
27. 洪志秀(2001)。「產後壓力」概念之分析。護理雜誌，48(6)，69-76。

1. 張歆祐(Shin-Yow Chang);陳怡婷(Yi-Ting Chen);陳怡樺(Yi-Hua Chen)(2022)。台灣低憂鬱孕產婦正向心理因素初探。中華心理衛生學刊。35(4)。319-346。