TY - JOUR
T1 - Group antenatal intervention to reduce perinatal stress and depressive symptoms related to intergenerational conflicts
T2 - A randomized controlled trial
AU - Leung, Sharron S.K.
AU - Lam, T. H.
N1 - Funding Information:
This project is one of the intervention projects of FAMILY: A Jockey Club Initiative for a Harmonious Society, funded by The Hong Kong Jockey Club Charities Trust (Principal Investigator, Prof. T.H. Lam). We thank Prof. Sunita Stewart for her advice on developing the project; and Dr. Shirley Leung, Dr. Rachel Cheng, Dr. Karen Tso, and Ms. Frances Au, Family Health Service, Department of Health, Hong Kong, for their advice on the intervention. We are grateful to the kind assistance provided by MCHC nurse-in-charge and her team.
Publisher copyright:
© 2012 Elsevier Ltd. All rights reserved.
PY - 2012/11
Y1 - 2012/11
N2 - Background: Intergenerational conflicts are a major source of stress, which might lead to depression in new mothers. The conflict is heightened when grandparents are involved in childcare.Objectives: To examine the effectiveness of an interpersonal psychotherapy oriented group intervention to reduce stress and depressive symptoms in new mothers and enhance happiness and self-efficacy in managing intergenerational conflict in childcare. This study is one of the intervention projects of FAMILY: A Jockey Club Initiative for a Harmonious Society, funded by The Hong Kong Jockey Club Charities Trust.Design: Multisite randomized controlled trial with two arms: an intervention group attended an additional 4-week program and a control group who received usual care only.Setting: Six Maternal and Child Health Centres in Hong Kong.Participants: From September 2009 to January 2010, 156 pregnant women who would have grandparents involved in childcare were recruited at their 14-32 weeks' gestation.Methods: Participants were randomized to groups using computer generated random sequences by blinded recruitment staff. Primary outcomes were stress and depressive symptoms immediately after the intervention and 6-8 weeks after delivery. Secondary outcomes were happiness and self-efficacy in managing conflict.Results: After screening 2870 pregnant women, 156 eligible participants were randomized. Intention-to-treat analysis showed that the intervention group (n=78) had significantly lower perceived stress (p=0.017; Cohen d=0.38) and greater happiness (p=0.004; Cohen d=0.41) than the control group (n=78) immediately after the intervention. However, the effects were not sustained at postnatal follow-up. Subgroup analysis showed that participants with depressive symptoms (EPDS > 12) at baseline reported significantly lower stress, greater happiness (p=0.035 and 0.037, respectively; both Cohen d=0.61), greater self-efficacy in managing conflict (p=0.012; Cohen d=0.76) than the control group after the intervention. Also, after delivery, they had significantly greater self-efficacy in managing conflict (p=0.025; Cohen d=0.61) and more able to cooperate with grandparents in childcare (p=0.046; Cohen d=0.59) than the control group.Conclusion: The intervention was effective in reducing stress and enhancing happiness among new mothers, particularly those with higher EPDS scores. Postnatal follow-up contacts as booster interventions may be needed to achieve lasting effects of the intervention.
AB - Background: Intergenerational conflicts are a major source of stress, which might lead to depression in new mothers. The conflict is heightened when grandparents are involved in childcare.Objectives: To examine the effectiveness of an interpersonal psychotherapy oriented group intervention to reduce stress and depressive symptoms in new mothers and enhance happiness and self-efficacy in managing intergenerational conflict in childcare. This study is one of the intervention projects of FAMILY: A Jockey Club Initiative for a Harmonious Society, funded by The Hong Kong Jockey Club Charities Trust.Design: Multisite randomized controlled trial with two arms: an intervention group attended an additional 4-week program and a control group who received usual care only.Setting: Six Maternal and Child Health Centres in Hong Kong.Participants: From September 2009 to January 2010, 156 pregnant women who would have grandparents involved in childcare were recruited at their 14-32 weeks' gestation.Methods: Participants were randomized to groups using computer generated random sequences by blinded recruitment staff. Primary outcomes were stress and depressive symptoms immediately after the intervention and 6-8 weeks after delivery. Secondary outcomes were happiness and self-efficacy in managing conflict.Results: After screening 2870 pregnant women, 156 eligible participants were randomized. Intention-to-treat analysis showed that the intervention group (n=78) had significantly lower perceived stress (p=0.017; Cohen d=0.38) and greater happiness (p=0.004; Cohen d=0.41) than the control group (n=78) immediately after the intervention. However, the effects were not sustained at postnatal follow-up. Subgroup analysis showed that participants with depressive symptoms (EPDS > 12) at baseline reported significantly lower stress, greater happiness (p=0.035 and 0.037, respectively; both Cohen d=0.61), greater self-efficacy in managing conflict (p=0.012; Cohen d=0.76) than the control group after the intervention. Also, after delivery, they had significantly greater self-efficacy in managing conflict (p=0.025; Cohen d=0.61) and more able to cooperate with grandparents in childcare (p=0.046; Cohen d=0.59) than the control group.Conclusion: The intervention was effective in reducing stress and enhancing happiness among new mothers, particularly those with higher EPDS scores. Postnatal follow-up contacts as booster interventions may be needed to achieve lasting effects of the intervention.
KW - Antenatal depression
KW - Intergenerational relations
KW - Interpersonal psychotherapy
KW - Postnatal depression
KW - Preventive health services
UR - http://www.scopus.com/inward/record.url?scp=84868361928&partnerID=8YFLogxK
U2 - 10.1016/j.ijnurstu.2012.06.014
DO - 10.1016/j.ijnurstu.2012.06.014
M3 - Journal article
C2 - 22818396
AN - SCOPUS:84868361928
SN - 0020-7489
VL - 49
SP - 1391
EP - 1402
JO - International Journal of Nursing Studies
JF - International Journal of Nursing Studies
IS - 11
ER -