基于正念的心身保健课程对分娩恐惧孕妇的影响:多中心随机对照研究OACSTPCD

Objective To evaluate the intervention effects of a mindfulness-based psychosomatic health course on pregnant women with fear of childbirth.Methods From April to November 2023,subjects were recruited from Shandong Provincial Maternal and Child Health Care Hospital,Shandong Provincial Hospital and Women Health Center of Shanxi were randomly divided into intervention group and control group.The intervention group received mindfulness-based psychosomatic health course,while the control group received routine maternal health care course.The Wijma delivery expectancy/experience questionnaire(W-DEQ)and five facet mindfulness questionnaire(FFMQ)were used to evaluate pregnant women before intervention,after intervention and three days after delivery.Mixed linear models were used to analyze and compare changes in childbirth fear and mindfulness levels between the two groups.Results There were no significant differences in baseline demographic characteristics and scale scores between the two groups(P＞0.05).After intervention and three days after delivery,the scores of fear of childbirth in the intervention group decreased by 11.24 and 13.53 points,respectively,while the scores of mindfulness increased by 7.93 and 4.53 points,respectively,with the statistically significant difference(P＜0.05).However,there was no statistically significant change in the score of fear of childbirth in the control group after intervention(P＞0.05)and the score of mindfulness decreased by 2.46 and 2.89 points with the statistically significant difference(P＜0.05).At the same time,after intervention and three days after delivery,the scores of fear of childbirth in the intervention group were lower than that in the control group and the mindfulness scores was higher than that those of the control group,with the statistically significant difference(Fgroup-9.823 and 6.180,respectively,P＜0.05).There were no significant differences in delivery mode or labor duration between the two groups(P＞0.05),but the intervention group had a lower proportion of analgesic use during labor.Subgroup analysis further showed that among women undergoing natural childbirth,the intervention group had a lower proportion of oxytocin use during the second stage of labor compared to the control group,with statistical significance(x2=9.191,P＜0.05).Conclusion Mindfulness-based psychosomatic health courses can improve the level of fear of childbirth,increase mindfulness level in pregnant women with fear of childbirth,and reduce the proportion of analgesic and oxytocin use during the second stage of labor.