目的：針對接受生殖技術治療夫妻產後憂鬱傾向者，發展以家庭為中心的產後照護介 入模式並分析實驗組經介入後，於產後三個月及六個月時的介入成效 方法：本研究為二年期計畫，研究設計為隨機試驗研究法（Randomized Controlled Trial； RCT）。針對接受人工生殖技術治療產後家庭（含夫與妻），於產後第四週篩選夫或妻 （任一方）其愛丁堡產後憂鬱量表 (EPDS)≧10 分者之家庭，依隨機分派方式分為實 驗組（experimental group）及控制組（control group）。實驗組家庭於產後第五週寄發產 後憂鬱照護介入之衛教光碟與手冊，於第六-九週，每週由訪員以電話訪問實驗組夫妻 及針對光碟及手冊照護內容諮詢 20 分鐘，並於產後第三個月及第六個月追蹤照護成 效。控制組家庭則未施以產後憂鬱照護介入，並同時於產後第三個月及第六個月追蹤 照護成效。 對象：本研究預計於中部某生殖技術治療中心進行收案。研究對象選取條件為：（1） 接受人工協助生殖技術治療初產家庭、（2）能閱讀中文者、（3）產後第四週夫妻同時 測量 EPDS 後，夫或妻任一方之 EPDS≧10 者。排除條件為已有生育小孩者。依估樣 本數，預計篩選階段(產後第四週)應收案 268對夫妻。實驗組及控制組夫妻各 63對。 工具：研究者參考國內外有關文獻、本團隊歷年研究經驗、專家意見及下列標準量表 加以編制成的結構式問卷，包括：不孕症夫妻的基本資料、愛丁堡產後憂鬱量表、自 尊量表、簡式親職壓力量表、社會支持量表等。主持人並針對產後憂鬱照護介入研發 衛教光碟及手冊。 統計：以 SPSS/PC Window 19.0 plus Amos19.0進行統計分析，含描述性統計、以廣 義估計方程式（Generalized Estimating Equation；GEE）：進行含時間因素之多變項 分析，瞭解產後照護介入成效及其長期變化。 預期成果： 發展以家庭為中心概念之照護介入模式來探討其對生殖技術治療家庭產後憂鬱的 成效，俾以實證的結果提供此一特殊族群照護參考，建立更完整的照護知識基礎及模 式，俾為未來的家庭及社會照護政策提供參考。 Purpose: The purpose of this study is to develop and evaluate a family-centered postpartum care for postpartum depression in previously infertile couple. Methods: This is a 2-year randomized controlled trial for previously infertile couple who will be divided into experimental group and control group based on Edinburgh Postpartum Depression Scale (EPDS≧10 points, either husband or wife )checked 4 weeks after delivery. Experimental group will receive health education CD/booklet at the 5th week, and telephone consultation for 20 minutes during 6th-9th weeks after delivery. We will analyze the differences 3 months and 6 months later, then. Subjects: Subjects will be recruited from an infertility treatment center in middle Taiwan, who shall meet the inclusion criteria: (1) the primipara for previously infertile couple, (2) the couple can read Chinese. It’s expected that there will be 268 couples complete the EPDS. For either husband or wife whose EPDS greater than 10 points, the couples will be recruited and be randomly assign into two groups and 63 couples available for experimental and control group, respectively. Instrument: With the expert validity, the self-administer questionnaire is composed of subjects’ profiles, Edinburgh postpartum depression scale, self-esteem questionnaire, Brief parenting stress questionnaire and social support questionnaire. Principal investigator will develop appropriate education CD/booklet for this trial. Statistics: Generalized estimating equation will be used for multi-variant time-series data analysis by SPSS/PC window 19.0 plus Amos 19.0 to evaluate the effects and difference of long-term change with the intervention. Expected achievements: Through this study, a family-centered postpartum care for postpartum depression in previously infertile couple model can be developed as a reference for care and policy.
