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首页> 外文期刊>BJOG: an international journal of obstetrics and gynaecology >STRAWB2 (Stress and Wellbeing After Childbirth): a randomised controlled trial of targeted self‐help materials to prevent post‐traumatic stress disorder following childbirth
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STRAWB2 (Stress and Wellbeing After Childbirth): a randomised controlled trial of targeted self‐help materials to prevent post‐traumatic stress disorder following childbirth

机译：Swearb2（分娩后的应力和福祉）：针对性自助材料的随机对照试验，以防止分娩后创伤后的应激障碍

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Objectives To test whether providing psychological self‐help materials would significantly lower the incidence of post‐traumatic stress disorder (PTSD) at 6–12?weeks postnatally. Design Open‐label randomised controlled trial, with blinded outcome assessment. Setting Community midwifery services in two National Health Service (NHS) trusts in the North West. Sample A cohort of 2419 women receiving normal NHS postnatal care. Methods Midwives screened women for traumatic birth experience; 678 women who screened positively (28.1%) were randomly allocated to self‐help with usual care ( n ?=?336) or to usual care alone ( n ?=?342). The self‐help materials were a leaflet and online film designed to prevent the development of PTSD after trauma exposure through explaining how to manage early psychological responses. Main outcome measure The primary outcome was a composite of diagnostic and subdiagnostic PTSD at 6–12?weeks postnatally using the gold‐standard Clinician‐Administered PTSD Scale (CAPS‐5) interview. Results Of the 678 women correctly randomised plus the nine women randomised in error, 478 (70.5%) were followed up. Diagnostic or subdiagnostic PTSD rates at follow‐up did not differ between groups who received self‐help (26.7%, 65/243) or usual care alone (26.2%, 64/244) (intention‐to‐treat analysis: RR?1.02, 95%?CI 0.68–1.53). Findings remained consistent in the per‐protocol analysis (RR?1.04, 95%?CI 0.85–1.27). Women viewed the materials very positively. There were no adverse effects. Health economic micro‐costing indicated implementation would be very low cost. Conclusions Many women experience a traumatic birth and risk developing PTSD, but self‐help strategies without professional support are insufficient and should not be routinely introduced. Tweetable abstract Self‐help information alone does not reduce the number of women developing PTSD after a traumatic childbirth.
机译：目的是测试提供心理自助材料是否会在出现6-12周内显着降低创伤后应激障碍（PTSD）的发生率。设计开放标签随机对照试验，具有蒙蔽结果评估。在西北两国国家卫生服务（NHS）信托中设定社区助产服务。样本2419名妇女接受正常NHS后护理的群组。方法助产士筛选女性的创伤性出生体验; 678名筛选的女性（28.1％）被随机分配给自助照顾（n？= 336）或单独常用（n？= 342）。自助材料是一条传单和在线电影，旨在防止创伤暴露后开发PTSD，通过解释如何管理早期的心理反应。主要结果衡量主要结果是诊断和次诊断病毒治退的综合性PTSD在后期使用黄金标准临床医生的第四级（CAPS-5）访谈后期出现后6-12个月。 678名女性正确随机加上误，九个妇女出错，478（70.5％）随访。随访的诊断或下限应接受自助（26.7％，65/243）或单独常规护理（26.2％，64/244）（意图治疗分析：RR？1.02）之间没有差异，95％？CI 0.68-1.53​​）。结果在每协定分析中保持一致（RR？1.04,95％？CI 0.85-1.27）。女性非常积极地看待这些材料。没有不利影响。健康经济微价指出的实施成本非常低。结论许多女性经历创伤的诞生和风险发展应接触活动，但没有专业支持的自助策略不足，不应常规介绍。仅特色的抽象抽象自助信息并未减少创伤分娩后开发应税专具的妇女人数。

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