2018-08-012024-05-18https://scholars.lib.ntu.edu.tw/handle/123456789/705313摘要：妊娠合併症對婦女及子代的健康造成傷害甚至威脅生命。目前國內外週產期婦女的健康指標與妊娠合併症之間的關係性探討，以及長期世代追蹤產前產後健康指標的研究報告仍缺乏。尤其臺灣社會懷孕年齡逐漸增加，醫學中心妊娠合併症求診的婦女比率愈增，妊娠合併症婦女無論是居家或住院的介入照護模式極待發展。研究計畫主要目的：(1)檢視妊娠高血壓或內分泌合併症婦女懷孕期至產後一年的健康指標變化；(2)建構及驗證妊娠合併症婦女健康指標的關係性理論架構；(3)發展介入照護措施，並評估對合併症婦女孕產期健康指標及子代健康指標的成效。研究方法：(1)第一階段採取世代研究設計，長期追蹤妊娠合併症婦女懷孕期至產後期的健康指標。研究對象為某醫學中心妊娠高血壓、妊娠內分泌合併症婦女，預計納入約380位符合條件懷孕婦女。每位參與研究婦女預計完成人口學、懷孕、生產等個人資料表、憂鬱、焦慮、復原力及生活品質等量表。長期追蹤時間點包括懷孕初期、中期、後期，產後3-5 天、1個月、3個月、6個月及1年，預計3年完成此階段計畫。(2)第二階段採隨機單盲臨床試驗，於某醫學中心篩選符合條件之妊娠合併症婦女，採隨機取樣分派至實驗組及對照組。實驗組接受介入措施：電話諮詢及認知行為處置組合，預計進行3次的介入措施，兩組將於介入前、介入後六到八週及產後一個月、三個月測量婦女之憂鬱、焦慮、復原力及生活品質，同時評估子代出生的健康指標。預計共納入300人，至少需2年完成此階段計畫。統計分析包括Chi-Square, ANOVA, ANCOVA, mixed model, t-test及generalized estimating equation等。<br> Abstract: Few reports have addressed mental health for women with pregnancy-related complication over a prolonged time period. Meanwhile, the caring model with intervention for women who have pregnancy-related complication needs to be developed. The aims of this study are to (1) describe and compare the differences in health indicators during pre-pregnancy, pregnancy and 1 year postpartum among women with gestational hypertension or endocrine disorders in pregnancy; (2) develop the theoretical framework of relationship among health indicators during perinatal period; (3) develop a telephone follow-up and consultation program and examine its effect on women’s resilience, depression, anxiety and quality of life. In the first stage, a prospective longitudinal investigation will be performed in women at pregnancy and postpartum. Women with gestational hypertension or endocrine disorders in pregnancy will be recruited. All participants will complete questionnaires that assess demographic characteristics, obstetric and birth history, depression, anxiety, resilience and quality of life. Participants who are in early, middle, late pregnancy, 3-5 days, 1st, 3rd, and 6th month and 1 year postpartum will be contacted to complete the questionnaires by mail or at study site clinics. The sample size was estimated by drop rates and power calculation. Approximately 380 women in early pregnancy will be recruited at a medical center in northern Taiwan. The first stage of this study will be conducted over a 3-year period. In the second stage, randomized control trial with single blind will be used to recruit eligible subjects from women in the waiting room for prenatal examination at a medical center in Taipei. The eligible subjects will be randomized into a control or experimental group. The women in the control group will receive usual care and those in the experimental group will receive four instances of telephone follow-up or face-to–face consultation. Two groups will receive 3 times measurements of depressive symptom, anxiety, resilience and quality of life. Meanwhile, we will assess the health indicators of women’s newborn. Totally, 300 subjects will be approached in terms of including dropout rate. The second stage of this study will be conducted over a 2-year period. Data will be analyzed by Chi-Square, ANOVA, ANCOVA, mixed model, independent t-test and generalized estimating equations.妊娠高血壓內分泌合併症心理健康介入措施gestational hypertensionendocrine disordersmental healthintervention