题名

新手父母產後憂鬱預防夫妻團體之發展及成效研究

并列篇名

Couple-Focused Postpartum Depression Prevention Group Program for New Parents

DOI

10.3966/156092512020060072005

作者

劉彥君(Yen-Chun Liu)

关键词

夫妻關係 ; 產後憂鬱 ; 新手父母 ; 預防介入 ; couple relationship ; new parents ; postpartum depression ; prevention

期刊名称

應用心理研究

卷期/出版年月

72期(2020 / 06 / 01)

页次

177 - 227

内容语文

繁體中文

中文摘要

本研究旨在設計以「夫妻關係」為基礎之產後憂鬱預防介入方案,並以問卷追蹤新手父母的產後憂鬱症狀及婚姻滿意度、衝突溝通模式、社會支持程度的變化。本研究共計招募42對夫妻為介入組,47對夫妻為控制組。研究結果顯示:(1)介入組之新手父母皆認為課程內容有助於增進其對產後憂鬱的認識、溝通技巧、婚姻品質與當新手父母的準備,且有助降低父親產前的憂鬱分數及減少母親產後憂鬱的程度,具有短期效果;(2)介入組父親產前的溝通模式較差,經課程介入後,溝通模式仍顯著差於控制組父親,且介入組與控制組母親產後的各變數皆未有明顯的差異,說明產前短期介入方案並未具有顯著的長期效益;(3)比較夫妻對偶資料的一致性,介入組夫妻在配偶適應與相互建設溝通的一致性顯著高於控制組夫妻,表示介入方案可增進夫妻對關係知覺之一致性。綜上,產前夫妻團體在臨床實務上仍具有一定程度的效益,可協助新手父母瞭解產後憂鬱,提升夫妻溝通技巧及預防母親產後憂鬱程度的增加。

英文摘要

The goal of this study is to develop a couple-focused postpartum depression prevention group program for new parents and to examine its effectiveness by comparing the differences between invention group (42 couples) and control group (47 couples) on postpartum depressive symptoms, marital satisfaction, conflict communication patterns, and social support, using longitudinal data. The results show that: (1) couples improved on their understandings of postpartum depression, communication skills, marital quality and preparedness for parenthood, while there were short-term effects on reducing fathers' prenatal depression and maternal postpartum depression. (2) The prevention program did not show long-term benefits on reducing new parents' postpartum depression. (3) The dyadic concordance of constructive communication and relational adjustment was significantly higher in the prevention group. The findings support the psychosocial benefits of prevention groups program on improving couples' communication skills and reducing the risk of postpartum depression, at least for the short-term.

主题分类 社會科學 > 心理學
参考文献
  1. Heh, S. S.,Fu, Y. Y.,Chin, Y. L.(2001).Postpartum social support experience while "doing-the-month" in Taiwanese women.The Journal of Nursing Research,9(3),13-24.
    連結:
  2. 戈依莉, Y. L.,楊綺儷, C. L.,蔣立琦, L. C.(2008)。坐月子期間執行產後運動對改善產婦疲憊和憂鬱感之成效。護理研究,16(3),177-186。
    連結:
  3. 周玉慧, Y. H.(2009)。夫妻間衝突因應策略類型及其影響。中華心理學刊,51(1),81-99。
    連結:
  4. 高旭繁, S. F.,陸洛, L.(2006)。夫妻傳統性/現代性的契合與婚姻適應之關聯。本土心理學研究,25,47-100。
    連結:
  5. 陳家鳳, J. F.,林惠雅, H. Y.,蕭英玲, Y. L.(2016)。當第一個孩子來報到:新手父母的親職參與和婚姻滿意度。中華輔導與諮商學報,47,91-111。
    連結:
  6. 謝佩玲, P. L.(2017)。產後憂鬱與母嬰連結之變化、相關因子、預測因子探討。中華心理衛生期刊,30(3),233-266。
    連結:
  7. American Psychiatric Association(2013).Diagnostic and statistical manual of mental disorders (5th ed.).Washington, DC:Author.
  8. Baucom, B.,Eldridge, K.,Jones, J.,Sevier, M.,Clements, M.,Markman, H.,Christensen, A.(2007).Relative contribution of relationship distress and depression to communication patterns in couples.Journal of Social and Clinical Psychology,26(6),689-707.
  9. Baum, A.(Ed.),Revenson, T. A.(Ed.),Singer, J. E.(Ed.)(2001).Handbook of health psychology.Mahwah, NJ:Lawrence Erlbaum Associates.
  10. Beach, S. R. H.,Smith, D. A.,Fincham, F. D.(1994).Marital interventions for depression: Empirical foundation and future prospects.Applied and Preventive Psychology,3(4),233-250.
  11. Beck, C. T.,Gable, R. K.(2001).Further validation of the postpartum depression screening scale.Nursing Research,50(3),155-164.
  12. Bielawska-Batorowicz, E.,Kossakowska-Petrycka, K.(2006).Depressive mood in men after the birth of their offspring in relation to a partner’s depression, social support, fathers’ personality and prenatal expectations.Journal of Reproductive and Infant Psychology,24(1),21-29.
  13. Bird, C. E.(1999).Gender, household labor, and psychological distress: The impact of the amount and division of housework.Journal of Health and Social Behavior,40(1),32-45.
  14. Cameron, E. E.,Sedov, I. D.,Tomfohr-Madsen, L. M.(2016).Prevalence of paternal depression in pregnancy and the postpartum: an updated meta-analysis.Journal of Affective Disorders,206,189-203.
  15. Chen, C. H.(1996).Postpartum depression among adolescent mothers and adult mothers.Kaohsiung Journal of Medical Sciences,12(2),104-113.
  16. Choi, E.(2016).Marital satisfaction and maternal depressive symptoms among Korean mothers transitioning to parenthood.Journal of Family Psychology,30(4),516-521.
  17. Christensen, A.,Sullaway, M.(1984).Christensen, A., & Sullaway, M. (1984). Communication patterns questionnaire. Unpublished Manuscript. University of California, Los Angeles..
  18. Clements, M. L.,Martin, S. E.,Cassil, A. K.,Soliman, N. N.(2011).Declines in marital satisfaction among new mothers: Broad strokes versus fine details.Journal of Marriage and Family,73(1),13-17.
  19. Cowan, C. P.,Cowan, P. A.(1995).Interventions to ease the transition to parenthood: Why they are needed and what they can do.Family Relations,44(4),412-423.
  20. Cox, J. L.,Holden, J. M.(1994).Perinatal psychiatry: Use and misuse of the Edinburgh postnatal depression scale.London:Gaskell.
  21. Curran, M.,Hazen, N.,Jacobvitz, D.,Feldman, A.(2005).Representations of early family relationships predict marital maintenance during the transition to parenthood.Journal of Family Psychology,19(2),189-197.
  22. Daley-McCoy, C.,Rogers, M.,Slade, P.(2015).Enhancing relationship functioning during the transition to parenthood: a cluster-randomised controlled trial.Arch Womens Ment Health,18(5),681-692.
  23. Dew, J.,Wilcox, W. B.(2011).If momma ain’t happy: Explaining declines in marital satisfaction among new mothers.Journal of Marriage and Family,73(1),1-12.
  24. Doss, B. D.,Cicila, L. N.,Hsueh, A. C.,Morrison, K. R.,Carhart, K.(2014).A randomized controlled trial of brief coparenting and relationship interventions during the transition to parenthood.Journal of Family Psychology,28(4),483-494.
  25. Edhborg, M.,Matthiesen, A. S.,Lundh, W.,Widstrom, A. M.(2005).Some early indicators for depressive symptoms and bonding 2 months postpartum – a study of new mothers and fathers.Archives of Women’s Mental Health,8(4),221-231.
  26. Everingham, C. R.,Heading, G.,Connor, L.(2006).Couples’ experiences of postnatal depression: A framing analysis of cultural identity, gender and communication.Social Science & Medicine,62(7),1745-1756.
  27. Feinberg, M. E.,Jones, D. E.,Hostetler, M. L.,Roettger, M. E.,Paul, I. M.,Ehrenthal, D. B.(2016).Couple-focused prevention at the transition to parenthood,a randomized trial: Effects on coparenting, parenting, family violence, and parent and child adjustment.Prevention Science,17(6),751-764.
  28. Gavin, N. I.,Gaynes, B. N.,Lohr, K. N.,Meltzer-Brody, S.,Gartlehner, G.,Swinson, T.(2005).Perinatal depression: A systematic review of prevalence and incidence.Obstetrics and Gynecology,106(5),1071-1083.
  29. Goldenberg, H.,Goldenberg, I.(2012).Family therapy: An overview.Cengage learning.
  30. Goodman, J. H.(2004).Paternal postpartum depression, its relationship to maternal postpartum depression and implications for family health.Journal of Advanced Nursing,45(1),26-35.
  31. Hahlweg, K.,Kaiser, A.,Christensen, A.,Fehm-Wolfsdorf, G,Groth, T.(2000).Self-report and observational assessment of couples’ conflict: The concordance between the communication patterns questionnaire and the KPI observation system.Journal of Marriage and Family,62(1),61-67.
  32. Harper, J. M.,Sandberg, J. G.(2009).Depression and communication processes in later life marriages.Aging & Mental Health,13(4),546-556.
  33. Heh, S. S.(2003).Relationship between social support and postnatal depression.The Kaohsiung Journal of Medical Sciences,19(10),491-496.
  34. Hopkins, J.(1984).University of Pittsburgh.
  35. Hoseini, S. S.,Panaghi, L.,Habibi, M.,Davoodi, J.,Monajemi, M. B.(2015).The relation between social support and marital satisfaction & couples’ depression after the birth of the first child.The International Journal of Indian Psychology,3(1),5-13.
  36. Huang, Z. J.,Wong, F. Y.,Ronzio, C. R.,Yu, S. M.(2007).Depressive symptomatology and mental health help-seeking patterns of U.S. and foreign-born mothers.Maternal and Child Health Journal,11(3),257-267.
  37. Knapp, M. L.(Ed.),Daly, J. A.(Ed.)(2002).Handbook of interpersonal communication.Thousand Oaks:Sage Publications.
  38. Kuo, W. H.,Wilson, T. E.,Holman, S.,Fuentes-Afflick, E.,O’Sullivan, M. J.,Minkoff, H.(2004).Depressive symptoms in the immediate postpartum period among Hispanic women in three U.S. cities.Journal of Immigrant Health,6(4),145-153.
  39. Lai, B. P. Y.,Tang, A. K. L.,Lee, D. T. S.,Yip, A. S. K.,Chung, T. K. H.(2010).Detecting postnatal depression in Chinese men: A comparison of three instruments.Psychiatry Research,180(2-3),80-85.
  40. Lau, Y.,Wong, D. F. K.(2008).The role of social support in helping Chinese women with perinatal depressive symptoms cope with family conflict.The Journal of Obstetric, Gynecologic, & Neonatal Nursing,37(5),556-571.
  41. McVey, C.,Tuohy, A.(2007).Differential effects of marital relationship and social support on three subscales identified within the Edinburgh Postnatal Depression Scale.Journal of Reproductive and Infant Psychology,25(3),203-220.
  42. Mitnick, D. M.,Heyman, R. E.,Slep, S. A. M.(2009).Changes in relationship satisfaction across the transition to parenthood: a meta-analysis.Journal of Family Psychology,23(6),848-852.
  43. Moshki, M.,Baloochi, B. T.,Cheravi, K.(2014).The effect of educational intervention on prevention of postpartum depression: an application of health locus of control.Journal of Clinical Nursing,23(15-16),2256-2263.
  44. Nishimura, A.,Fujita, Y.,Katsuta, M.,Ishihara, A.,Ohashi, K.(2015).Paternal postnatal depression in Japan: an investigation of correlated factors including relationship with a partner.BMC Pregnancy and Childbirth,15,1-8.
  45. Nomaguchi, K. M.,Milkie, M. A.(2003).Costs and rewards of children: the effects of becoming a parent on adults’ lives.Journal of Marriage and the Family,65(2),356-374.
  46. Norhayati, M. N.,Nik Hazlina, N. H.,Asrenee, A. R.,Wan Emilin, M. A.(2015).Magnitude and risk factors for postpartum symptoms: A literature review.Journal of Affective Disorders,175,34-52.
  47. Ogrodniczuk, J. S.,Piper, W. E.(2003).Preventing postnatal depression: A review of research findings.Harvard Review of Psychiatry,11(6),291-307.
  48. Olds, D. L.(2006).The nurse–family partnership: An evidence based preventive intervention.Infant Mental Health Journal,27(1),5-25.
  49. Paulson, J. F.,Bazemore, S. D.(2010).Prenatal and postpartum depression in fathers and its association with maternal depression: a meta-analysis.The Journal of the American Medical Association,303(19),1961-1969.
  50. Paulson, J. F.,Bazemore, S. D.,Goodman, J. H.,Leiferman, J. A.(2016).The course and interrelationship of maternal and paternal perinatal depression.Arch Womens Ment Health,19(4),655-663.
  51. Philpott, L. F.,Corcoran, P.(2018).Paternal postnatal depression in Ireland: Prevalence and associated factors.Midwifery,56,121-127.
  52. Pinquart, M.,Teubert, D.(2010).A meta-analytic study of couple interventions during the transition to parenthood.Family Relations,59(3),221-231.
  53. Qian, Y.,Sayer, L. C.(2016).Division of labor, gender ideology, and marital satisfaction in East Asia.Journal of Marriage and Family,78(2),383-400.
  54. Reid, K. M.,Taylor, M. G.(2015).Social support, stress, and maternal postpartum depression: A comparison of supportive relationships.Social Science Research,54,246-262.
  55. Sanford, K.(2010).Assessing conflict communication in couples: Comparing the validity of self-report, partner-report, and observer ratings.Journal of Family Psychology,24(2),165-174.
  56. Shaw, E.,Levitt, C.,Wong, S.,Kaczorowski, J.(2006).Systematic review of the literature on postpartum care: effectiveness of postpartum support to improve maternal parenting, mental health, quality of life, and physical health.Birth,33(3),210-220.
  57. Slep, A. M. S.,O’Leary, S. G.(2005).Parent and partner violence in families with young children: Rates, patterns, and connections.Journal of Consulting and Clinical Psychology,73(3),435-444.
  58. Spanier, G. B.(1976).Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads.Journal of Marriage and the Family,38(1),15-28.
  59. Stewart, D. E.,Gagnon, A.,Saucier, J. F.,Wahoush, O.,Dougherty, G.(2008).Postpartum depression symptoms in newcomers.Canadian Journal of Psychiatry: Revue Canadienne De Psychiatrie,53(2),121-124.
  60. Teng, H. W.,Hsu, C. S.,Shih, S. M.,Shen, W. W.(2005).Screening postpartum depression with the Taiwanese version of the Edinburgh Postnatal Depression Scale.Comprehensive Psychiatry,46(4),261-265.
  61. Thorp, S. R.,Krause, E. D.,Cukrowicz, K. C.,Lynch, T. R.(2004).Postpartum partner support, demand-withdraw communication, and marital stress.Psychology of Women Quarterly,28(4),362-369.
  62. Twenge, J. M.,Campbell, W. K.,Foster, C. A.(2003).Parenthood and marital satisfaction: A meta-analytic review.Journal of Marriage and Family,65(3),574-583.
  63. Uebelacker, L. A.,Battle, C. L.,Sutton, K. A.,Magee, S. R.,Miller, I. W.(2016).A pilot randomized controlled trial comparing prenatal yoga to perinatal health education for antenatal depression.Arch Womens Ment Health,19(3),543-547.
  64. Wang, S. Y.,Chen, C. H.,Chin, C. C.,Lee, S. L.(2005).Impact of postpartum depression on mother-infant couple.Birth: Issues in Perinatal Care,32(1),39-44.
  65. Wisner, K. L.,Parry, B. L.,Pointek, C. M.(2002).Postpartum depression.New England Journal of Medicine,347(3),194-199.
  66. Yim, I. S.,Stapleton, L. R. T.,Guardino, C. M.,Hahn-Holbrook, J.,Schetter, C. D.(2015).Biological and psychosocial predictors of postpartum depression: systematic review and call for integration.Annual Review of Clinical Psychology,11,99-137.
  67. 伊慶春, C. C.(1991)。台北地區婚姻調適的一些初步研究發現。國家科學委員會研究彙刊:人文及社會,1(2),151-173。
  68. 李麗君, L. C.,陳季員, J. Y.,陳彰惠, C. H.(2010)。新移民女性與產後憂鬱。護理雜誌,57(1),106-111。
  69. 施鳳眉, F. M.,朱基銘, C. M.(2017)。北部某醫學中心慢性期中風病患關懷衛教措施對憂鬱指數變化。醫療資訊雜誌,26(3),25-34。
  70. 紀櫻珍, Y. C.,吳振龍, C. L.,李君碩, C. S.,張偉斌, W. P.,許朝, C. C.(2013)。衛生教育介入對輕度中風患者心理社會預後之成效。北市醫學雜誌,10(1),26-37。
  71. 劉彥君, Y. C.(2016)。科技部專題研究計畫成果報告科技部專題研究計畫成果報告,台北=Taipei City, Taiwan:行政院科技部=National Science Council。
  72. 蕭英玲, Y. L.,曾秀雲, H. Y.(2015)。新婚夫妻的衝突反應與婚姻品質。輔仁民生學誌,21(2),37-55。