Izinto zomngcipheko woxinzelelo ngexesha lokukhulelwa

Umxholo

• Iimpawu zomngcipheko we-8 woxinzelelo lwasemva kokubeleka
• Isiqendu esimnyama-ish kuXinzelelo lwasemva kokubeleka

• Ezona zinto zintathu ziphambili zomngcipheko woxinzelelo kwangaphambi kokubeleka yimbali yoxinzelelo, ukunqongophala kwenkxaso kwezentlalo, kunye namava obundlobongela, uphando lubonisa.
• Ukuxhaphaka koxinzelelo ngexesha lokukhulelwa okwangoku yi-15 ukuya kwiipesenti ezingama-21, nangona isenokunyuka.
• Kukho iindleko zomzimba nezengqondo zokushiya ukudakumba kungakhange kulungiswe, kodwa unyango luyafumaneka kwabo balifunayo.

Uphando olutsha olwenziwe nguYin kunye noogxa bakhe, olupapashwe kwiphephancwadi likaFebruwari 2021 Uvavanyo lweklinikhi yezeMpilo , kuvavanya ukuxhaphaka kunye nemingcipheko yokudakumba ngexesha lokukhulelwa (ekubhekiswa kuko njengokudakumba kokubeleka).

Amanqaku ngesigama: Ngaphandle kwexesha lokudakumba ngaphambi kokubeleka, igama ukudakumba kokubeleka lisetyenziselwa ukubhekisa kwimeko yoxinzelelo ngexesha lokukhulelwa kunye ngaphambili ukuzala. Amagama asetyenziselwa ukubhekisa kuxinzelelo koomama olwenzeka ngexesha lokukhulelwa okanye kungekudala emva Ukubeleka kubandakanya ukudakumba kwe-peripartum (uxinzelelo oluqala ngexesha lokukhulelwa okanye ukuya kuthi ga kwiiveki ezimbalwa emva kokubeleka) kunye noxinzelelo lwasemva kokubeleka (uxinzelelo olwenzeka kuphela emva kokubeleka).

Ukudakumba ngexesha lokukhulelwa kunokuba nemiphumo emibi, njengokunyusa ukubakho koxinzelelo emva kokubeleka. Ewe kunjalo, uxinzelelo lweparipartum lwaziswa kwi I-DSM-5 ngenxa yophando olubonisa ukuba isiqingatha seziqendu zoxinzelelo lwasemva kokubeleka siqala ngaphambi kokuhanjiswa.

Ukufumana ukuqonda okungcono kwezinto ezinobungozi boxinzelelo ngexesha lokukhulelwa, makhe siphonononge isifundo esenziwe nguYin kunye nabasebenzisana nabo.

Ababhali benze uphando olucokisekileyo loncwadi kwaye bakhetha amanqaku e-173 (iingxelo ezizimeleyo eziyi-182) kulungelelwaniso lomgangatho kunye nohlalutyo lweemeta.

Ezi zifundo zivela kumazwe e-50 (i-39 ye-173 evela e-US). Ubungakanani besampulu buqala ukusuka kuma-21 ukuya kuma-35,000. Ubungakanani besampulu iyonke yayiyi-197,047.

Elona nyathelo lisetyenziswa rhoqo (iingxelo ezingama-93) zoxinzelelo lwaphambi kokubeleka yayingu-Edinburgh Postnatal Depression Scale okanye i-EPDS. I-EPDS inezinto ezili-10, ezilinganisa oku kulandelayo: ukuhleka, ukuzibek 'ityala, ukonwaba, unxunguphalo, ukoyikeka, iingxaki zokulwa, iingxaki zokulala, usizi, ukukhala nokuzenzakalisa.

Amanye amanyathelo asetyenziswa rhoqo abandakanya iZiko le-Epidemiologic Study Depression Scale (CES-D), Beck Depression Inventory (BDI), Questionnaire Health Health Questionnaire (PHQ), kunye nodliwanondlebe noKwakhiwa kweKlinikhi yoLwazi lweNgcaciso kunye neNcwadi yeNgxelo yeNgxaki yokuPhazamiseka kwengqondo.

Iimpawu zomngcipheko we-8 woxinzelelo lwasemva kokubeleka

Kuzo zonke izilingo ze-173, ukwanda okuhlanganisiweyo kweempawu zokudakumba kokubeleka yayiyi-21% -kodwa i-15% yoxinzelelo olukhulu (izilingo ezingama-72).

Ngokubanzi, ukwanda okuphezulu koxinzelelo lwangaphambi kokubeleka kunxulunyaniswa nezifundo ezenziwa kutshanje (emva ko-2010), kumazwe anengeniso ephantsi, kunye nabo basebenzisa amaphepha emibuzo anika ingxelo (ngokuchasene nodliwanondlebe olwakhiweyo).

Ukuvavanya umngcipheko oqhelekileyo woxinzelelo lwangaphambi kokubeleka, abaphandi baqhube uhlalutyo lweemeta besebenzisa izinto ezininzi ezivela kwizifundo ezingama-35 ezichaza idatha efanelekileyo. Ezi zinto zibandakanya ukulingana (okt inani lokuzalwa), amava obundlobongela, ukungabikho kwemisebenzi, ukukhulelwa okungacwangciswanga, imbali yokutshaya (kubandakanya ngexesha lokukhulelwa), imeko yomtshato, inkxaso kwezentlalo kunye nembali yoxinzelelo. Iziphumo zibonise ukuba zonke ezi zinto zinobungozi, ngaphandle kweparity, bezinonxibelelwano olubalulekileyo noxinzelelo lwangaphambi kokubeleka.

Izilinganiselo zokuhlangana (OKANYE) zidweliswe apha ngezantsi (i-CI ibhekisa kwixesha lokuzithemba):

1. Imbali yoxinzelelo: OKANYE 3.17, 95% CI: 2.25, 4.47.
2. Ukungabikho kwenkxaso yentlalo: OKANYE 3.13, 95% CI: 1.76, 5.56.
3. Amava obundlobongela: OKANYE 2.72, 95% CI: 2.26, 3.27.
4. Isimo sokungasebenzi: OKANYE 2.41, 95% CI: 1.76, 3.29.
5. Inqanaba lomtshato (ongatshatanga / oqhawule umtshato): OKANYE = 2.37, 95% CI: 1.80, 3.13.
6. Ukutshaya ngexesha lokukhulelwa: OKANYE = 2.04, 95% CI: 1.41, 2.95.
7. Ukutshaya ngaphambi kokukhulelwa: OKANYE = 1.97, 95% CI: 1.63, 2.38.
8. Ukukhulelwa okungacwangciswanga: OKANYE 1.86, 95% CI: 1.40, 2.47.