基于社会学习理论的孕产妇心理保健模式构建与干预研究

The maternal psychological issues growing increasingly prominent, has become a public health problem affecting maternal and fetal health, there is an urgent need for maternal mental care, improving maternal psychological state and reducing the occurrence of mental illness through targeted prevention and intervention. Appropriate maternal mental health care model is not yet formed in China. Our research group found that the main causes of influencing effective development are current service which are still confined to the bio-medical model and lacked of social science perspective. It indicates that we need to construct the model of maternal mental health based on the sociological theory. Therefore, basing on the social learning theory and synthesizing the research and the results of our research group, rounding the "observational learning and reinforcement and self-efficacy, combining with maternal health service status and various institutional characteristics, setting up" production mechanism of maternal and children health care institutions and community "as a whole, reflecting the "continuous intervention of supply-side, peer education of demand-side, family participation and interaction of supply and demand sides", and further developing of intervention management guideline which could effectively carry out the collective intervention model, regulating and coordinating the behavior of all parties participating in maternal mental care including the supply-side and demand-side and management and social support systems. Finally, the collective intervention model for maternal mental health will be concluded as to provide technical support for our country to carry out effective maternal mental care.

孕产妇心理问题日益凸显，已成为影响母婴健康的公共卫生问题。迫切需要开展有效的孕产妇心理保健服务，改善孕产妇心理状况，减少和避免精神疾病的发生。但目前国内尚未形成适宜的孕产妇心理保健服务模式，课题组分析发现影响有效开展的主要原因是现行服务模式仍局限于生物医学模式，缺乏社会学视角，提示需要从社会学理论的视角去构建完善孕产妇心理保健模式并进行验证。因此，在课题组前期研究基础上，综合国内外研究现状，基于社会学习理论，围绕“观察学习-强化-自我效能”，结合孕产期保健服务现状及各类机构的特点，构建集“接产机构-妇幼保健机构-社区”为一体的，体现“供方连续干预、需方同伴教育、家庭支持参与、供需双方联动”的心理保健服务模式，研制保障心理保健有效开展的服务指南，规范和协调参与心理保健的供方、需方、管理方和社会支持系统的各方行为，并通过干预研究验证与完善，为我国开展有效的孕产妇心理保健提供理论和技术支撑。

孕产妇心理问题日益凸显，已成为影响母婴健康的公共卫生问题。迫切需要开展有效的孕产妇心理保健服务，改善孕产妇心理状况，减少和避免精神疾病的发生。本研究在课题组前期研究基础上，综合国内外研究现状，基于社会学习理论，围绕“观察学习-强化-自我效能”，结合孕产期保健服务现状及各类机构的特点，构建集“接产机构-妇幼保健机构-社区”为一体的，体现“供方连续干预、需方同伴教育、家庭支持参与、供需双方联动”的心理保健服务模式，研制保障心理保健有效开展的服务指南，规范和协调参与心理保健的供方、需方、管理方和社会支持系统的各方行为，并通过干预研究验证与完善，为我国开展有效的孕产妇心理保健提供理论和技术支撑。.本研究首先明确了孕产妇心理保健的内涵，界定了孕产妇心理保健服务所需要的五个要素，明确了我国孕产妇心理保健服务提供的现状及存在的问题，构建了基于社会学习理论的孕产妇心理保健模式理论框架；其次，在课题组前期研制的两张孕产期危险因素评估工具上的进一步优化完善，优化后的评估表条目数量较原量表更为精简，信度和效度都有所提高，从而为孕产妇心理保健集体干预的实施提供了技术支持；然后，在孕产妇心理保健集体干预模式理论框架指导下，根据干预地区的实际情况，将优化完善的干预评估技术嵌入到其孕产期保健管理流程中，围绕着干预的8个要素，将模式具化形成了孕产期心理保健集体干预方案；最后研制了促进孕产妇心理保健集体干预模式实施的三个策略方案，并基于“互联网+”的孕产妇心理保健方案研制及可行性研究和信息化孕产妇心理保健方案的效果评价指标体系构建及有效性评价，优化形成服务指南。