Izici Zengozi Yokucindezeleka Ngesikhathi Sokukhulelwa

-Delile

• Izici Zobungozi Zokucindezeleka Kwangaphambi Kokubeletha
• Isiqephu Esimnyama Sokucindezeleka Kwangemva Kokubeletha

• Izici ezintathu eziphezulu zokubeka ingcindezi ngaphambi kokubeletha zingumlando wokudangala, ukuntuleka kokwesekelwa emphakathini, kanye nokuhlangenwe nakho kodlame, kusho ucwaningo.
• Ukudlanga kokudangala ngesikhathi sokukhulelwa njengamanje kungamaphesenti ayi-15 kuye kwangama-21, yize kungahle kukhule.
• Kunezindleko zomzimba nezengqondo zokushiya ukudangala kungakhulunywanga, kepha ukwelashwa kuyatholakala kulabo abakudingayo.

Ucwaningo olusha olwenziwe nguYin nozakwabo, olushicilelwe kumagazini kaFebhuwari 2021 we Ukubuyekezwa KweClinical Psychology , Ihlola ukwanda nezici zobungozi bokucindezeleka ngesikhathi sokukhulelwa (okubizwa ngokuthi ukucindezeleka kwangaphambi kokubeletha).

Amanothi mayelana netemu: Ngaphandle kwegama elithi ukucindezeleka ngaphambi kokubeletha, igama elithi ukucindezeleka ngaphambi kokubeletha lisetshenziselwa ukubhekisa ekwenzekeni kokudangala ngesikhathi sokukhulelwa kanye ngaphambi ukubeletha. Amagama asetshenziselwa ukubhekisa ekucindezelekeni komama okwenzeka ngesikhathi sokukhulelwa noma kungekudala ngemuva ukubeletha kubandakanya ukucindezeleka kwepheripartum (ukucindezeleka okuqala ngesikhathi sokukhulelwa noma kuze kube amasonto ambalwa ngemuva kokubeletha) nokucindezeleka kwangemva kokubeletha (ukucindezeleka okwenzeka kuphela emva kokubeletha).

Ukudana komoya ngesikhathi sokukhulelwa kungaba nemiphumela emibi, njengokukhulisa amathuba okucindezeleka ngemuva kokubeletha. Ngempela, igama elithi peripartum depression lafakwa kufayela le- I-DSM-5 ngenxa yocwaningo olubonisa ukuthi uhhafu weziqephu zokudangala kwangemva kokubeletha ziqala ngaphambi kokubeletha.

Ukuthola ukuqonda okungcono kwezici zobungozi bokucindezeleka ngesikhathi sokukhulelwa, ake sibuyekeze ucwaningo olwenziwe nguYin nabahlanganyeli.

Ababhali benze ucwaningo olunzulu lwezincwadi futhi bakhetha ama-athikili ayi-173 (imibiko ezimele eyi-182) yokuhlanganiswa kwe-qualitative kanye ne-meta-analysis.

Lezi zifundo zivela emazweni angama-50 (ama-39 kwangu-173 avela e-US). Amasampula wesampula aqala kubantu abayi-21 kuya kwabangaphezu kwama-35,000. Usayizi wesampula ophelele ubuyi-197,047.

Isilinganiso esisetshenziswa kakhulu (imibiko engama-93) sokudangala kokubeletha kwakuyi-Edinburgh Postnatal Depression Scale noma i-EPDS. I-EPDS inezinto eziyi-10, ezilinganisa okulandelayo: ukuhleka, ukuzibophezela, ukuzijabulisa, ukukhathazeka, ukwethuka, ubunzima bokubhekana nezinkinga, izinkinga zokulala, ukudabuka, ukukhala nokuzilimaza.

Ezinye izinyathelo ezisetshenziswa njalo zifaka phakathi i-Center for Epidemiologic Study Depression Scale (CES-D), Beck Depression Inventory (BDI), Patient Health Questionnaire (PHQ), kanye ne-Structured Clinical Interview ye-Diagnostic and Statistical Manual of Mental Disorders.

Izici Zobungozi Zokucindezeleka Kwangaphambi Kokubeletha

Kuzo zonke izivivinyo ze-173, ukwanda okuhlanganisiwe kwezimpawu zokucindezeleka ngaphambi kokubeletha kwakungu-21% -kodwa i-15% yokudangala okukhulu (izilingo ezingama-72).

Ngokuvamile, ukwanda okuphezulu kokucindezeleka ngaphambi kokubeletha kuhlotshaniswa nezifundo ezenziwa muva nje (ngemuva kuka-2010), emazweni ahola kancane, nalabo abasebenzisa imibuzo yemibuzo yokuzibika (ngokungafani nezingxoxo ezihleliwe zomtholampilo).

Ukuhlola izici ezivamile zobungozi bokucindezeleka kokubeletha, abacwaningi benze ukuhlaziywa kwe-meta besebenzisa izinto eziningi ezivela ezifundweni ezingama-35 ezibika imininingwane efanele. Lezi zinto zibandakanya ubumbano (isib. Inombolo yokuzalwa), ulwazi lodlame, ukungasebenzi, ukukhulelwa okungahlelelwe, umlando wokubhema (kufaka phakathi nokukhulelwa), isimo somshado, ukusekelwa komphakathi, nomlando wokudangala. Okutholakele kukhombisile ukuthi zonke lezi zinto ezinobungozi, ngaphandle kobuhlanga, bezinobudlelwano obubalulekile nokudangala kwangaphambi kokubeletha.

Ama-ratios odds ratios (OR) ahlelwe ngezansi (i-CI ibhekisa ezikhathini zokuzethemba):

1. Umlando wokudangala: NOMA = 3.17, 95% CI: 2.25, 4.47.
2. Ukuntuleka kokuxhaswa komphakathi: NOMA = 3.13, 95% CI: 1.76, 5.56.
3. Isipiliyoni sodlame: OR = 2.72, 95% CI: 2.26, 3.27.
4. Isimo sokungasebenzi: OR = 2.41, 95% CI: 1.76, 3.29.
5. Isimo somshado (ongashadile / ohlukanisile): NOMA = 2.37, 95% CI: 1.80, 3.13.
6. Ukubhema ngesikhathi sokukhulelwa: NOMA = 2.04, 95% CI: 1.41, 2.95.
7. Ukubhema ngaphambi kokukhulelwa: NOMA = 1.97, 95% CI: 1.63, 2.38.
8. Ukukhulelwa okungahleliwe: NOMA = 1.86, 95% CI: 1.40, 2.47.