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Article(id=1324077681645597179, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077560820282023, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202507275, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1752681600000, receivedDateStr=2025-07-17, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614319477, onlineDateStr=2026-11-02, pubDate=1774368000000, pubDateStr=2026-03-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614319477, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614319477, creator=13701087609, updateTime=1793614319477, updator=13701087609, issue=Issue{id=1324077560820282023, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='6', pageStart='961', pageEnd='1152', issueExtLink='null', onlineDate='null', pubDate='1774368000000', pubDateStr='2026-03-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614290671, creator='13701087609', updateTime=1793614391469, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324077983656444429, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077560820282023, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324077983660638734, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077560820282023, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1024, endPage=1029, ext={EN=ArticleExt(id=1324077681947587068, articleId=1324077681645597179, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Study on integrated mental health care for perinatal depression: A hybrid type 1 randomized effectiveness-implementation trial, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the intervention effectiveness of the Integrated Maternal and Mental Care Model (I2Mcare) for perinatal depression (PND) in primary maternal and child health institutions and explore its implementation process’s facilitators and barriers.

Methods

A hybrid type 1 randomized effectiveness-implementation trial was conducted. PND high-risk pregnant women were randomly assigned to an intervention group (receiving I2Mcare) or a control group (receiving routine maternal care). Four times of depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. We use generalized linear mixed models to analyze the effect of intervention. Semi-structured interviews based on the Consolidated Framework for Implementation Research (CFIR) were administered to pregnant women and healthcare providers (n=27) to collect data on implementation factors. Qualitative data were analyzed by the thematic framework method.

Results

A total of 153 pregnant women completed all 4 depression assessments, including 41 in the intervention group and 33 in the control group. No statistically significant differences in depression scores were found between the two groups during the first three assessments. However, in the fourth assessment, the depression score of the intervention group was significantly lower than that of the control group (P<0.05). Results from the Generalized Linear Mixed Models analysis indicated statistically significant effects for both the group difference (P=0.033) and the time effect (P<0.001). Key facilitators included the model’s relative advantages, China’s well-established maternal and child health system, strong foundational work from mental health departments and so on. Barriers encompassed insufficient public awareness, inadequate policy support and high clinical workload in obstetric departments.

Conclusion

The I2Mcare effectively alleviates depressive symptoms in high-risk pregnant women. Future scale-up should prioritize policy refinement, staff training, interdisciplinary collaboration, and public education.

, authors=Hui-lan ZHOU1, Yu-shan KE1, Shuang-er WU2, Xin WANG1, authorsList=Hui-lan ZHOU, Yu-shan KE, Shuang-er WU, Xin WANG, authorCompany=null, correspAuthors=Xin WANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324077684778742273, articleId=1324077681645597179, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=整合型围产期抑郁症心理健康服务模式研究：一项混合1型效果-实施随机对照试验, columnId=1228016570031604578, journalTitle=现代预防医学, columnName=儿少卫生与妇幼保健, runingTitle=null, highlight=null, articleAbstract=
目的

分析在基层妇幼保健院实施整合型围产期抑郁症心理健康服务模式（Integrated Maternal and Mental Care Model，I2Mcare）的干预效果，探讨模式实施过程中的促进和障碍因素。

方法

采用混合1型效果-实施随机对照试验。将围产期抑郁症高风险孕妇随机分为干预组和对照组，干预组接受I2Mcare模式，对照组接受常规孕产妇保健服务，采用爱丁堡产后抑郁量表评估4次抑郁症状，采用广义线性混合模型分析干预效果。同时，基于实施性研究综合框架对孕妇和医护人员（n=27）进行半结构化访谈，采用主题框架法分析实施过程中的促进和障碍因素。

结果

完成4次抑郁评估的孕妇共74人，其中干预组41人，对照组33人。两组的基线（第1次）和第2、3次抑郁评分无统计学差异，第4次评估干预组抑郁评分显著低于对照组（P<0.05）。广义线性混合模型分析结果显示两组抑郁评分在组间效应（P=0.033）和时间效应（P<0.001）上有统计学意义。I2Mcare模式实施的促进因素包括模式具有相对优势、我国妇幼保健体系完善、心理保健科变革决心强等；障碍因素包括公众认知不足、政策配套不完善、产科负担重变革动力不足等。

结论

I2Mcare模式可有效改善围产期抑郁症高风险孕妇的抑郁症状，未来应完善政策保障、加强人员培训与协作、加大宣传教育以促进其推广应用。

, authors=周慧兰1, 柯雨珊1, 吴霜儿2, 王欣1, authorsList=周慧兰, 柯雨珊, 吴霜儿, 王欣, authorCompany=null, correspAuthors=王欣, authorNote=

周慧兰（2001—），女，硕士在读，研究方向：整合型卫生服务

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王欣，E-mail:
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周慧兰（2001—），女，硕士在读，研究方向：整合型卫生服务

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refs=[Reference(id=1324077689879015980, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2024, volume=41, issue=6, pageStart=701, pageEnd=706, url=null, language=null, rfNumber=[1], rfOrder=0, authorNames=刘娜, 王敏怡, 梁群英, journalName=中国社会医学杂志, refType=null, unstructuredReference=刘娜，王敏怡，梁群英，等．2016—2022年中国围产期抑郁症患病率的Meta分析[J]．中国社会医学杂志，2024，41（6）：701-706．, articleTitle=2016—2022年中国围产期抑郁症患病率的Meta分析, refAbstract=null), Reference(id=1324077689979679277, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2024, volume=41, issue=6, pageStart=701, pageEnd=706, url=null, language=null, rfNumber=[1], rfOrder=1, authorNames=Liu N, Wang MY, Liang QY, journalName=Chinese Journal of Social Medicine, refType=null, unstructuredReference=Liu N, Wang MY, Liang QY, et al. Meta-analysis of the Prevalence of Perinatal Depression in China from 2016 to 2022[J]. Chinese Journal of Social Medicine, 2024, 41(6): 701-706. (In Chinese), articleTitle=Meta-analysis of the Prevalence of Perinatal Depression in China from 2016 to 2022, refAbstract=null), Reference(id=1324077690063565358, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2021, volume=11, issue=2, pageStart=533, pageEnd=536, url=null, language=null, rfNumber=[2], rfOrder=2, authorNames=闫真, 高枫, journalName=临床医学进展, refType=null, unstructuredReference=闫真，高枫．围产期抑郁病因及不良影响研究进展[J]．临床医学进展，2021，11（2）：533-536．, articleTitle=围产期抑郁病因及不良影响研究进展, refAbstract=null), Reference(id=1324077690201977391, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2021, volume=11, issue=2, pageStart=533, pageEnd=536, url=null, language=null, rfNumber=[2], rfOrder=3, authorNames=Yan Z, Gao F, journalName=Advances in Clinical Medicine, refType=null, unstructuredReference=Yan Z, Gao F. Causes and adverse effects of perinatal depression: a review[J]. Advances in Clinical Medicine, 2021, 11(2): 533-536. (In Chinese), articleTitle=Causes and adverse effects of perinatal depression: a review, refAbstract=null), Reference(id=1324077690290057776, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2020, volume=15, issue=1, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[3], rfOrder=4, authorNames=Fekadu dadi A, Miller ER, Mwanri L, journalName=PLOS One, refType=null, unstructuredReference=Fekadu dadi A, Miller ER, Mwanri L. Antenatal depression and its association with adverse birth outcomes in low and middle-income countries: A systematic review and meta-analysis[J]. PLOS One, 2020, 15(1): e0227323., articleTitle=Antenatal depression and its association with adverse birth outcomes in low and middle-income countries: A systematic review and meta-analysis, refAbstract=null), Reference(id=1324077690420081201, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[4], rfOrder=5, authorNames=国家卫生健康委员会, journalName=null, refType=null, unstructuredReference=国家卫生健康委员会．国家卫生健康委办公厅关于探索开展抑郁症,老年痴呆防治特色服务工作的通知[EB/OL]．[2026-02-15]. https://www.gov.cn/zhengce/zhengceku/2020-09/11/content_5542555.htm．, articleTitle=国家卫生健康委办公厅关于探索开展抑郁症,老年痴呆防治特色服务工作的通知, refAbstract=null), Reference(id=1324077690495578674, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[4], rfOrder=6, authorNames=National Health Commission, journalName=null, refType=null, unstructuredReference=National Health Commission. Notice of the general office of the national health commission on exploring the development of characteristic services for the prevention and treatment of depression and alzheimer’s disease[EB/OL]. [2026-02-15]. https://www.gov.cn/zhengce/zhengceku/2020-09/11/content_5542555.htm. (In Chinese), articleTitle=Notice of the general office of the national health commission on exploring the development of characteristic services for the prevention and treatment of depression and alzheimer’s disease, refAbstract=null), Reference(id=1324077690696905267, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[5], rfOrder=7, authorNames=中华人民共和国中央人民政府, journalName=null, refType=null, unstructuredReference=中华人民共和国中央人民政府．关于推进生育友好医院建设的意见[EB/OL]．[2026-02-15]. https://www.gov.cn/zhengce/zhengceku/202501/content_6999132.htm．, articleTitle=关于推进生育友好医院建设的意见, refAbstract=null), Reference(id=1324077690764014132, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[5], rfOrder=8, authorNames=The Central People’s Government of the People’s Republic of China, journalName=null, refType=null, unstructuredReference=The Central People’s Government of the People’s Republic of China. Opinions on promoting the construction of fertility-friendly hospitals[EB/OL]. [2026-02-15]. https://www.gov.cn/zhengce/zhengceku/202501/content_6999132.htm. (In Chinese), articleTitle=Opinions on promoting the construction of fertility-friendly hospitals, refAbstract=null), Reference(id=1324077690860483125, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2019, volume=30, issue=7, pageStart=781, pageEnd=786, url=null, language=null, rfNumber=[6], rfOrder=9, authorNames=中华预防医学会心身健康学组, 中国妇幼保健协会妇女心理保健技术学组, journalName=中国妇幼健康研究, refType=null, unstructuredReference=中华预防医学会心身健康学组，中国妇幼保健协会妇女心理保健技术学组．孕产妇心理健康管理专家共识(2019年)[J]．中国妇幼健康研究，2019，30（7）：781-786．, articleTitle=孕产妇心理健康管理专家共识(2019年), refAbstract=null), Reference(id=1324077690952757814, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2019, volume=30, issue=7, pageStart=781, pageEnd=786, url=null, language=null, rfNumber=[6], rfOrder=10, authorNames=Psychosomatic Health Society, China Preventive Medicine Association, Committee of Women Mental Health Care, China Maternal and Child Health Association, journalName=Chinese Journal of Woman and Child Health Research, refType=null, unstructuredReference=Psychosomatic Health Society, China Preventive Medicine Association, Committee of Women Mental Health Care, China Maternal and Child Health Association. Expert consensus on maternal mental health management(2019)[J]. Chinese Journal of Woman and Child Health Research, 2019, 30(7): 781-786. (In Chinese), articleTitle=Expert consensus on maternal mental health management(2019), refAbstract=null), Reference(id=1324077691057615415, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2021, volume=56, issue=8, pageStart=521, pageEnd=527, url=null, language=null, rfNumber=[7], rfOrder=11, authorNames=中华医学会妇产科学分会产科学组, journalName=中华妇产科杂志, refType=null, unstructuredReference=中华医学会妇产科学分会产科学组．围产期抑郁症筛查与诊治专家共识[J]．中华妇产科杂志，2021，56（8）：521-527．, articleTitle=围产期抑郁症筛查与诊治专家共识, refAbstract=null), Reference(id=1324077691145695800, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2021, volume=56, issue=8, pageStart=521, pageEnd=527, url=null, language=null, rfNumber=[7], rfOrder=12, authorNames=Obstetrics Group, Society of Obstetrics and Gynecology, Chinese Medical Association, journalName=Chinese Journal of Obstetrics and Gynecology, refType=null, unstructuredReference=Obstetrics Group, Society of Obstetrics and Gynecology, Chinese Medical Association. Expertconsensus on screening, diagnosis and treatment of perinatal depression[J]. Chinese Journal of Obstetrics and Gynecology, 2021, 56(8): 521-527., articleTitle=Expertconsensus on screening, diagnosis and treatment of perinatal depression, refAbstract=null), Reference(id=1324077691221193273, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[8], rfOrder=13, authorNames=World Health Organization, journalName=null, refType=null, unstructuredReference=World Health Organization. Guide for integration of perinatal mental health in maternal and child health service[EB/OL]. [2026-02-22]. https://www.who.int/publications/i/item/9789240057142., articleTitle=Guide for integration of perinatal mental health in maternal and child health service, refAbstract=null), Reference(id=1324077691296690746, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2014, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[9], rfOrder=14, authorNames=National Collaborating Centre for Mental Health(UK), journalName=National institute for health and clinical excellence: guidance, refType=null, unstructuredReference=National Collaborating Centre for Mental Health(UK). National institute for health and clinical excellence: guidance[M]. Leicester(UK): British Psychological Society, 2014., articleTitle=null, refAbstract=null), Reference(id=1324077691376382523, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2023, volume=141, issue=6, pageStart=1232, pageEnd=1261, url=null, language=null, rfNumber=[10], rfOrder=15, authorNames=American College of Obstetricians, Gynecologists, journalName=Obstetrics and Gynecology, refType=null, unstructuredReference=American College of Obstetricians, Gynecologists. Screening and diagnosis of mental health conditions during pregnancy and postpartum: ACOG clinical practice guideline no. 4[J]. Obstetrics and Gynecology, 2023, 141(6): 1232-1261., articleTitle=Screening and diagnosis of mental health conditions during pregnancy and postpartum: ACOG clinical practice guideline no. 4, refAbstract=null), Reference(id=1324077691464462908, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2024, volume=15, issue=3, pageStart=686, pageEnd=693, url=null, language=null, rfNumber=[11], rfOrder=16, authorNames=徐东, 蔡毅媛, 陈江芸, journalName=协和医学杂志, refType=null, unstructuredReference=徐东，蔡毅媛，陈江芸．实施科学的前世今生(下篇)——理论、范式和特点[J]．协和医学杂志，2024，15（3）：686-693．, articleTitle=实施科学的前世今生(下篇)——理论、范式和特点, refAbstract=null), Reference(id=1324077691594486333, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2024, volume=15, issue=3, pageStart=686, pageEnd=693, url=null, language=null, rfNumber=[11], rfOrder=17, authorNames=Xu D, Cai YY, Chen JY, journalName=Medical Journal of Peking Union Medical College Hospital, refType=null, unstructuredReference=Xu D, Cai YY, Chen JY. Past and present of implementation science(part Ⅱ)——theories, paradigm, and characteristics[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(3): 686-693. (In Chinese), articleTitle=Past and present of implementation science(part Ⅱ)——theories, paradigm, and characteristics, refAbstract=null), Reference(id=1324077691678372414, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2006, volume=41, issue=9, pageStart=781, pageEnd=784, url=null, language=null, rfNumber=[12], rfOrder=18, authorNames=金三丽, 李明子, journalName=中华护理杂志, refType=null, unstructuredReference=金三丽，李明子．易感性人格类型量表预测产后抑郁症的效果研究[J]．中华护理杂志，2006，41（9）：781-784．, articleTitle=易感性人格类型量表预测产后抑郁症的效果研究, refAbstract=null), Reference(id=1324077691758064191, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2006, volume=41, issue=9, pageStart=781, pageEnd=784, url=null, language=null, rfNumber=[12], rfOrder=19, authorNames=Jin SL, Li MZ, journalName=Chinese Journal of Nursing, refType=null, unstructuredReference=Jin SL, Li MZ. A study of the effectiveness of Vulnerable Personality Style Questionnaire to predict postpartum depression[J]. Chinese Journal of Nursing, 2006, 41(9): 781-784. (In Chinese), articleTitle=A study of the effectiveness of Vulnerable Personality Style Questionnaire to predict postpartum depression, refAbstract=null), Reference(id=1324077693490311744, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2025, volume=83, issue=1, pageStart=168, pageEnd=null, url=null, language=null, rfNumber=[13], rfOrder=20, authorNames=Wu SE, Shi YL, Xu JF, journalName=Archives of Public Health, refType=null, unstructuredReference=Wu SE, Shi YL, Xu JF, et al. Preferences for group psychological interventions on perinatal depression in China: a discrete choice experiment[J]. Archives of Public Health, 2025, 83(1): 168., articleTitle=Preferences for group psychological interventions on perinatal depression in China: a discrete choice experiment, refAbstract=null), Reference(id=1324077693590975041, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2024, volume=19, issue=11, pageStart=177, pageEnd=179, 214, url=null, language=null, rfNumber=[14], rfOrder=21, authorNames=伍金娟, 吴颖芳, 伍少莹, journalName=心理月刊, refType=null, unstructuredReference=伍金娟，吴颖芳，伍少莹，等．孕期团体心理辅导在预防产后焦虑抑郁中的效果评价[J]．心理月刊，2024，19（11）：177-179, 214．, articleTitle=孕期团体心理辅导在预防产后焦虑抑郁中的效果评价, refAbstract=null), Reference(id=1324077693687444034, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2024, volume=19, issue=11, pageStart=177, pageEnd=179, 214, url=null, language=null, rfNumber=[14], rfOrder=22, authorNames=Wu JJ, Wu YF, Wu SY, journalName=Psychological Monthly, refType=null, unstructuredReference=Wu JJ, Wu YF, Wu SY, et al. Evaluation of the effect of group psychological counseling during pregnancy on preventing postpartum anxiety and depression[J]. Psychological Monthly, 2024, 19(11): 177-179, 214. (In Chinese), articleTitle=Evaluation of the effect of group psychological counseling during pregnancy on preventing postpartum anxiety and depression, refAbstract=null), Reference(id=1324077693771330115, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2022, volume=43, issue=1, pageStart=58, pageEnd=64, url=null, language=null, rfNumber=[15], rfOrder=23, authorNames=杨业环, 黄星, 孙梦云, journalName=中华流行病学杂志, refType=null, unstructuredReference=杨业环，黄星，孙梦云，等．中国孕产妇不同时点抑郁状态转归及持续抑郁状态影响因素分析[J]．中华流行病学杂志，2022，43（1）：58-64．, articleTitle=中国孕产妇不同时点抑郁状态转归及持续抑郁状态影响因素分析, refAbstract=null), Reference(id=1324077693884576324, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2022, volume=43, issue=1, pageStart=58, pageEnd=64, url=null, language=null, rfNumber=[15], rfOrder=24, authorNames=Yang YH, Huang X, Sun MY, journalName=Chinese Journal of Epidemiology, refType=null, unstructuredReference=Yang YH, Huang X, Sun MY, et al. Analysis on depression state outcomes and influencing factors of persistent depression in pregnant and perinatal women in China[J]. Chinese Journal of Epidemiology, 2022, 43(1): 58-64. (In Chinese), articleTitle=Analysis on depression state outcomes and influencing factors of persistent depression in pregnant and perinatal women in China, refAbstract=null), Reference(id=1324077693951685189, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2025, volume=25, issue=1, pageStart=192, pageEnd=null, url=null, language=null, rfNumber=[16], rfOrder=25, authorNames=Jing Q, Jie J, Ke X, journalName=BMC Pregnancy and Childbirth, refType=null, unstructuredReference=Jing Q, Jie J, Ke X, et al. The relationship between fear of childbirth and prenatal depression in pregnant women during pregnancy: a cross-lagged analysis[J]. BMC Pregnancy and Childbirth, 2025, 25(1): 192., articleTitle=The relationship between fear of childbirth and prenatal depression in pregnant women during pregnancy: a cross-lagged analysis, refAbstract=null), Reference(id=1324077694018794054, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2022, volume=14, issue=null, pageStart=1667, pageEnd=1679, url=null, language=null, rfNumber=[17], rfOrder=26, authorNames=Navarrete L, Lara MA, Berenzon S, journalName=International Journal of Women’s Health, refType=null, unstructuredReference=Navarrete L, Lara MA, Berenzon S, et al. Challenges of perinatal depression care in Mexico city health centers[J]. International Journal of Women’s Health, 2022, 14: 1667-1679., articleTitle=Challenges of perinatal depression care in Mexico city health centers, refAbstract=null), Reference(id=1324077694119457351, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2016, volume=11, issue=1, pageStart=150, pageEnd=null, url=null, language=null, rfNumber=[18], rfOrder=27, authorNames=Nithianandan N, Gibson-Helm M, McBride J, journalName=Implementation Science, refType=null, unstructuredReference=Nithianandan N, Gibson-Helm M, McBride J, et al. Factors affecting implementation of perinatal mental health screening in women of refugee background[J]. Implementation Science, 2016, 11(1): 150., articleTitle=Factors affecting implementation of perinatal mental health screening in women of refugee background, refAbstract=null), Reference(id=1324077694224314952, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2023, volume=22, issue=1, pageStart=313, pageEnd=null, url=null, language=null, rfNumber=[19], rfOrder=28, authorNames=Xiao X, Ma HX, Zhu SN, journalName=BMC Nursing, refType=null, unstructuredReference=Xiao X, Ma HX, Zhu SN, et al. The perceptions and attitudes of obstetric staff and midwives towards perinatal mental health disorders screening: a qualitative exploratory study in Shenzhen, China[J]. BMC Nursing, 2023, 22(1): 313., articleTitle=The perceptions and attitudes of obstetric staff and midwives towards perinatal mental health disorders screening: a qualitative exploratory study in Shenzhen, China, refAbstract=null), Reference(id=1324077694291423817, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2022, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[20], rfOrder=29, authorNames=黄维健, journalName=null, refType=null, unstructuredReference=黄维健．孕产妇产后抑郁相关的心理健康素养干预方案的构建研究[D]．沈阳：中国医科大学，2022．, articleTitle=孕产妇产后抑郁相关的心理健康素养干预方案的构建研究, refAbstract=null), Reference(id=1324077694354338378, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, doi=null, pmid=null, pmcid=null, year=2022, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[20], rfOrder=30, authorNames=Huang WJ, journalName=null, refType=null, unstructuredReference=Huang WJ. Study on the construction of an intervention program for mental health literacy related to postpartum depression in pregnant and postpartum women[D]. Shenyang: China Medical University, 2022. (In Chinese), articleTitle=Study on the construction of an intervention program for mental health literacy related to postpartum depression in pregnant and postpartum women, refAbstract=null)], funds=[Fund(id=1324077689778352683, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, awardId=21-437, language=CN, fundingSource=美国中华医学会基金公开竞标项目(21-437), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1324077685089120770, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, xref=1., ext=[AuthorCompanyExt(id=1324077685101703683, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, companyId=1324077685089120770, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China), AuthorCompanyExt(id=1324077685114286596, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, companyId=1324077685089120770, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.中山大学公共卫生学院卫生管理学系，广东 广州 510080)]), AuthorCompany(id=1324077685193978373, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, xref=2., ext=[AuthorCompanyExt(id=1324077685202366982, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, companyId=1324077685193978373, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.深圳市宝安区卫生健康局)])], figs=[ArticleFig(id=1324077687014306337, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, language=EN, label=Fig.1, caption=Integrated maternal and mental care model, figureFileSmall=PnqRV7OHBSQqgJVn1URxuQ==, figureFileBig=GdZWiIJ0DvH9OVcRJmnFDQ==, tableContent=null), ArticleFig(id=1324077687106581026, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, language=CN, label=图1, caption=I2Mcare模式, figureFileSmall=PnqRV7OHBSQqgJVn1URxuQ==, figureFileBig=GdZWiIJ0DvH9OVcRJmnFDQ==, tableContent=null), ArticleFig(id=1324077687295324707, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, language=EN, label=Table 1, caption=

Baseline characteristics and comparison between the two groups

, figureFileSmall=null, figureFileBig=null, tableContent=
基本信息总体(n=74)干预组(n=41)对照组(n=33)t/χ2/ZP
孕周（周）（M（P25,P75））12（12,13）12（12,13）12（12,14）-1.3990.162
年龄(岁) （）30.49±3.5230.75±3.1530.15±3.961.6170.732
婚姻状况[n（%）]0.0160.901
已婚61（82.40）34（82.90）27（81.80）
未婚及其他13（17.60）7（17.10）6（18.20）
文化程度[n（%）]0.3240.569
高中及以下20（27.00）10（24.40）10（30.30）
大专及以上54（73.00）31（75.60）23（69.70）
不良孕产史[n（%）]0.4980.480
有9（12.20）4（9.80）5（15.20）
无65（87.80）37（90.20）28（84.80）
胎次2.1600.142
一胎45（60.80）28（68.30）17（51.50）
二胎及以上29（39.20）13（31.70）16（48.50）
), ArticleFig(id=1324077689006600740, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, language=CN, label=表1, caption=

两组基线特征及组间比较

, figureFileSmall=null, figureFileBig=null, tableContent=
基本信息总体(n=74)干预组(n=41)对照组(n=33)t/χ2/ZP
孕周（周）（M（P25,P75））12（12,13）12（12,13）12（12,14）-1.3990.162
年龄(岁) （）30.49±3.5230.75±3.1530.15±3.961.6170.732
婚姻状况[n（%）]0.0160.901
已婚61（82.40）34（82.90）27（81.80）
未婚及其他13（17.60）7（17.10）6（18.20）
文化程度[n（%）]0.3240.569
高中及以下20（27.00）10（24.40）10（30.30）
大专及以上54（73.00）31（75.60）23（69.70）
不良孕产史[n（%）]0.4980.480
有9（12.20）4（9.80）5（15.20）
无65（87.80）37（90.20）28（84.80）
胎次2.1600.142
一胎45（60.80）28（68.30）17（51.50）
二胎及以上29（39.20）13（31.70）16（48.50）
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Comparison of depression scores at different time points M（P25,P75）

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项目T0T1T2T3
干预组（n=41）11（10,16）10（8,13）10（7,12）7（4.5,11）
对照组（n=33）12（10,15）11（9,14）10（8,14）10（7,12）
检验统计量Z值-0.252-929-0.534-2.208
P值0.8010.3530.5930.027
), ArticleFig(id=1324077689296007718, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, language=CN, label=表2, caption=

两组在不同时间点的抑郁评分比较M（P25,P75）

, figureFileSmall=null, figureFileBig=null, tableContent=
项目T0T1T2T3
干预组（n=41）11（10,16）10（8,13）10（7,12）7（4.5,11）
对照组（n=33）12（10,15）11（9,14）10（8,14）10（7,12）
检验统计量Z值-0.252-929-0.534-2.208
P值0.8010.3530.5930.027
), ArticleFig(id=1324077689371505191, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, language=EN, label=Table 3, caption=

Analysis of group and time effect on depression scores

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效应校正前校正后
Fdf1df2PFdf1df2P
组别4.58412880.0335.20512830.023
时间12.9513288<0.00113.5693283<0.001
组别×时间交互1.39632880.2441.45732830.226
), ArticleFig(id=1324077689459585576, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, language=CN, label=表3, caption=

抑郁评分的组别与时间效应分析

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效应校正前校正后
Fdf1df2PFdf1df2P
组别4.58412880.0335.20512830.023
时间12.9513288<0.00113.5693283<0.001
组别×时间交互1.39632880.2441.45732830.226
), ArticleFig(id=1324077689547665961, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, language=EN, label=Table 4, caption=

Facilitators andbarriers in the implementation process of the I2Mcare Model

, figureFileSmall=null, figureFileBig=null, tableContent=
CFIR维度促进因素障碍因素
变革I2Mcare模式具有相对优势I2Mcare模式整合基础良好I2Mcare模式较复杂
外部环境-社会公众对PND的认知不足PND相关服务政策配套不完善
内部环境心理健康工作基础较好科室内部和科室间的协作与沟通不足
个体特征心理保健科变革决心强产科常规工作负担重，变革动力不足孕妇的心理健康素养较低
〖BHDWG1*2〗实施过程动态需求评估确保服务质量与效果动员孕妇参与团体心理辅导较困难
), ArticleFig(id=1324077689648329258, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077681645597179, language=CN, label=表4, caption=

I2Mcare模式实施过程的促进因素和障碍因素

, figureFileSmall=null, figureFileBig=null, tableContent=
CFIR维度促进因素障碍因素
变革I2Mcare模式具有相对优势I2Mcare模式整合基础良好I2Mcare模式较复杂
外部环境-社会公众对PND的认知不足PND相关服务政策配套不完善
内部环境心理健康工作基础较好科室内部和科室间的协作与沟通不足
个体特征心理保健科变革决心强产科常规工作负担重，变革动力不足孕妇的心理健康素养较低
〖BHDWG1*2〗实施过程动态需求评估确保服务质量与效果动员孕妇参与团体心理辅导较困难
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整合型围产期抑郁症心理健康服务模式研究：一项混合1型效果-实施随机对照试验
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周慧兰 1 , 柯雨珊 1 , 吴霜儿 2 , 王欣 1
现代预防医学 | 儿少卫生与妇幼保健 2026,53(6): 1024-1029
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现代预防医学 |儿少卫生与妇幼保健 2026 , 53 (6) : 1024 -1029
整合型围产期抑郁症心理健康服务模式研究：一项混合1型效果-实施随机对照试验
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周慧兰1, 柯雨珊1, 吴霜儿2, 王欣1
作者信息
  • 1.中山大学公共卫生学院卫生管理学系，广东 广州 510080
  • 2.深圳市宝安区卫生健康局
通讯作者:
王欣，E-mail:
作者简介:

周慧兰（2001—），女，硕士在读，研究方向：整合型卫生服务

Study on integrated mental health care for perinatal depression: A hybrid type 1 randomized effectiveness-implementation trial
Hui-lan ZHOU1, Yu-shan KE1, Shuang-er WU2, Xin WANG1
Affiliations
  • School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
出版时间: 2026-03-25 doi: 10.20043/j.cnki.MPM.202507275
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摘要
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目的

分析在基层妇幼保健院实施整合型围产期抑郁症心理健康服务模式（Integrated Maternal and Mental Care Model，I2Mcare）的干预效果，探讨模式实施过程中的促进和障碍因素。

方法

采用混合1型效果-实施随机对照试验。将围产期抑郁症高风险孕妇随机分为干预组和对照组，干预组接受I2Mcare模式，对照组接受常规孕产妇保健服务，采用爱丁堡产后抑郁量表评估4次抑郁症状，采用广义线性混合模型分析干预效果。同时，基于实施性研究综合框架对孕妇和医护人员（n=27）进行半结构化访谈，采用主题框架法分析实施过程中的促进和障碍因素。

结果

完成4次抑郁评估的孕妇共74人，其中干预组41人，对照组33人。两组的基线（第1次）和第2、3次抑郁评分无统计学差异，第4次评估干预组抑郁评分显著低于对照组（P<0.05）。广义线性混合模型分析结果显示两组抑郁评分在组间效应（P=0.033）和时间效应（P<0.001）上有统计学意义。I2Mcare模式实施的促进因素包括模式具有相对优势、我国妇幼保健体系完善、心理保健科变革决心强等；障碍因素包括公众认知不足、政策配套不完善、产科负担重变革动力不足等。

结论

I2Mcare模式可有效改善围产期抑郁症高风险孕妇的抑郁症状，未来应完善政策保障、加强人员培训与协作、加大宣传教育以促进其推广应用。

围产期抑郁症  /  整合服务  /  实施性研究
Objective

To analyze the intervention effectiveness of the Integrated Maternal and Mental Care Model (I2Mcare) for perinatal depression (PND) in primary maternal and child health institutions and explore its implementation process’s facilitators and barriers.

Methods

A hybrid type 1 randomized effectiveness-implementation trial was conducted. PND high-risk pregnant women were randomly assigned to an intervention group (receiving I2Mcare) or a control group (receiving routine maternal care). Four times of depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. We use generalized linear mixed models to analyze the effect of intervention. Semi-structured interviews based on the Consolidated Framework for Implementation Research (CFIR) were administered to pregnant women and healthcare providers (n=27) to collect data on implementation factors. Qualitative data were analyzed by the thematic framework method.

Results

A total of 153 pregnant women completed all 4 depression assessments, including 41 in the intervention group and 33 in the control group. No statistically significant differences in depression scores were found between the two groups during the first three assessments. However, in the fourth assessment, the depression score of the intervention group was significantly lower than that of the control group (P<0.05). Results from the Generalized Linear Mixed Models analysis indicated statistically significant effects for both the group difference (P=0.033) and the time effect (P<0.001). Key facilitators included the model’s relative advantages, China’s well-established maternal and child health system, strong foundational work from mental health departments and so on. Barriers encompassed insufficient public awareness, inadequate policy support and high clinical workload in obstetric departments.

Conclusion

The I2Mcare effectively alleviates depressive symptoms in high-risk pregnant women. Future scale-up should prioritize policy refinement, staff training, interdisciplinary collaboration, and public education.

Perinatal depression  /  Integrated care  /  Implementation research
周慧兰, 柯雨珊, 吴霜儿, 王欣. 整合型围产期抑郁症心理健康服务模式研究：一项混合1型效果-实施随机对照试验. 现代预防医学, 2026 , 53 (6) : 1024 -1029 . DOI: 10.20043/j.cnki.MPM.202507275
Hui-lan ZHOU, Yu-shan KE, Shuang-er WU, Xin WANG. Study on integrated mental health care for perinatal depression: A hybrid type 1 randomized effectiveness-implementation trial[J]. Modern Preventive Medicine, 2026 , 53 (6) : 1024 -1029 . DOI: 10.20043/j.cnki.MPM.202507275
正文
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围产期抑郁症（Perinatal Depression, PND）是指妊娠期间或产后1年内出现的抑郁发作。据估计，我国PND的患病率约为25%[1]且呈不断上升趋势。PND不仅影响孕产妇身心健康、妊娠结局和子代生长发育，还可能增加心理健康不良事件的发生，其防治已成为重要公共卫生问题[2-3]。
近年来，我国出台多个工作方案和专家共识推动PND防治[4-7]。《探索抑郁症防治特色服务工作方案》[4]建议将PND筛查纳入常规孕检和产后访视，《关于推进生育友好医院建设的意见》[5]强调将心理健康纳入孕妇学校健康教育重点内容，使孕产妇及家属掌握常用心理保健方法。WHO和多国的指南[6-10]推荐将PND相关服务整合进常规基层妇幼保健服务中，并针对PND的预防、筛查和诊治提出了基于循证证据的干预建议。目前多国已建立了围产期抑郁症整合服务模式并实证其有效性。然而，我国尚未在孕产妇保健中常规开展围产期抑郁症心理健康服务，正处于服务模式探索阶段。因此，亟待通过实施性研究助力构建契合我国基层妇幼服务体系的整合型围产期抑郁症心理健康服务模式。I2Mcare（Integrated Maternal and Mental Care Model）模式是本研究团队创新性构建并试点实施的一种整合型围产期抑郁症心理健康服务模式。本研究旨在分析I2Mcare模式对围产期抑郁症的干预效果，并深入探究其实施过程的促进和障碍因素，为我国围产期抑郁症心理健康服务实践提供参考。
1　材料与方法
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1.1　I2Mcare简介
I2Mcare模式（见图1）包括：（1）组建多学科团队：包括产科医生、儿科医生、护士、心理咨询师等不同学科人员；（2）PND高风险筛查：在孕11~15周建立健康档案时进行PND风险筛查；（3）团体心理辅导：筛查结果为高风险的孕妇在孕16~20周、21~24周、25~28周、29~32周常规产检时接受4次团体心理辅导，主题分别为母亲角色适应、自我关怀、正念练习、家庭关系调节，鼓励孕妇的伴侣及家人共同参与；（4）个体心理健康服务：在产后7天和42天通过电话提供一对一线上个体心理健康服务。本研究采用项目协调员与产科护士协同招募的方式，并由具备心理咨询资质的医师提供团体心理辅导，每次辅导1~1.5小时，3~6人参与。
1.2　研究设计与研究对象
本研究在广州市B区区级妇幼保健院和24所社区卫生服务中心招募研究对象。采用随机数字表法，将研究对象按照1:1比例随机分为干预组与对照组，干预组接受I2Mcare模式的心理健康服务，对照组仅接受常规孕产妇保健。研究对象纳入标准：①年龄≥18周岁；②怀孕11~15周；③易感性人格类型量表（Vulnerability Personality Scale Questionnaire，VPSQ）易感性分量表得分>15分；④同意签订知情同意书；⑤可理解和填写调查问卷。排除标准为：①有经诊断的既往心理疾病史；②意识障碍、无法正常交流。
本研究采用混合1型效果-实施随机对照试验设计，既关注干预措施的有效性，又关注干预实施过程的促进和障碍因素[11]。实施过程研究采用目的抽样，选取医院管理者、心理咨询师、产科门诊护士、项目协调员以及2024年11月—2024年12月接受干预的孕妇为研究对象。样本量确定以新增样本的资料不再出现新的主题和观点为标准。
1.3　研究工具
（1）基本信息收集表：为自制调查表，内容包括孕妇的年龄、婚姻状况、受教育程度等人口学特征；孕周、孕产史、胎次等产科相关特征，于孕妇入组时收集其基本信息。（2）VPSQ易感性分量表：用于筛查PND高风险孕妇。该量表共6个条目，采用Likert-5级评分，总得分6~30分，以15分为界区分易感性人格和非易感性人格。研究表明，VPSQ量表易感性分量表评分15分以上的孕产妇发生围产期抑郁症的风险为57%，远高于一般孕产妇 [12]，本研究将>15分的孕妇确定为PND高风险孕妇，招募入组。（3）爱丁堡产后抑郁量表（Edinburgh Postnatal Depression Scale，EPDS）：用于测量孕产妇的抑郁症状。该量表为国际通用的孕产妇抑郁症状评估工具，共10个条目，采用0~3分的Likert-４级评分，总得分0~30分；得分越高表明抑郁症状越严重。本研究聚焦产前4次团体心理辅导的干预效果，于第一次干预前（T0）、第二次干预后（T1）、第三次干预后（T2）和第四次干预后（T3）分别测量两组的EPDS评分。（4）访谈提纲：在I2Mcare模式实施中期通过半结构化访谈收集资料，以实施性研究综合框架（Consolidated framework for implementation research，CFIR）为理论框架，制定访谈提纲。2022年版CFIR包括变革、外部环境、内部环境、个体和实施过程5个维度，共48个构成要素。访谈围绕以下内容：①个人对模式实施的看法；②模式实施的有利条件和挑战；③影响提供/接受服务的因素。2名研究人员现场开展一对一半结构化访谈，每次访谈时长为20~30分钟，在征得访谈对象同意后进行录音。
1.4　数据分析
（1）定量数据：采用SPSS 27.0 进行数据分析。计量资料若符合正态分布，则采用均数±标准差表示；若不满足正态分布，则采用中位数和四分位间距M（P25，P75）表示。计数资料采用频数和百分比表示。采用t检验、Mann-Whitney U秩和检验以及χ2检验比较两组基线资料和各时间点EPDS评分，采用广义线性混合模型分析I2Mcare模式的干预效果。检验水准α=0.05（双尾）。（2）定性数据：将数据导入Nvivo15软件，采用主题框架法进行分析：（1）反复阅读访谈资料；（2）识别有意义的陈述；（3）2名研究人员独立编码，定期讨论编码情况，不断完善编码体系；（4）将编码条目归纳到CFIR的5个维度。在分析过程中，2名研究人员无法达成一致意见时，与第3位研究人员讨论直到达成共识。
2　结果
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2.1　干预效果分析
（1）研究对象的基本情况：本研究于2024年6月—2024年12月采用VPSQ易感性分量表筛查了2 602名孕妇，其中573人为高风险，占比22.02%。141人知情同意进入随机对照试验，其中干预组71人，对照组70人。由于4次随访的周期较长，孕妇的依从性较低。干预组中第一次团体辅导参与71人，后续参与人数依次为57人、48人和41人；对照组中第一次评估完成70人，后续评估完成人数依次为56人、42人和33人。最终干预组41人、对照组33人完成产前全部4次干预/评估。两组基线特征差异无统计学意义（P>0.05），见表1。同时，对完成干预/评估的样本（n=74）与流失样本（n=67）的基线特征进行比较，二者仅在文化程度上存在差异（P<0.001），完成研究的样本文化程度更高，其他基线特征均无统计学差异（P>0.05）。
（2）两组抑郁评分的比较和变化趋势：经Shapiro-Wilk检验，两组的抑郁评分不符合正态分布，故采用Mann-Whitney U秩和检验。两组在T0、T1、T2时的抑郁评分比较无统计学意义（P>0.05），而 T3时干预组的抑郁评分显著低于对照组（P<0.05），见表2。
广义线性混合模型结果显示，两组抑郁评分在组间效应（F=4.584，P=0.033）和时间（F=12.951，P<0.001）效应有统计学意义，二者交互效应无统计学意义（F=1.396，P=0.244）。为进一步验证结果的稳健性，我们纳入了年龄、婚姻状况、文化程度、胎次及不良孕产史作为协变量进行校正。校正后，组间效应、时间效应及交互效应的统计学结论保持不变，见表3。
2.2　实施过程分析
共访谈了16名孕妇、3名心理咨询师、4名产科护士、1名医院管理者和3名项目协调员。从CFIR的变革、外部环境、内部环境、个体特征和实施过程5个主题共总结了11个亚主题。
（1）主题1：变革
I2Mcare模式具有相对优势。I2Mcare模式的实施地点为妇幼保健机构，心理咨询师对孕妇身心需求更了解；针对高风险人群的系列团体辅导系统性强，可发挥同辈作用，孕妇的接受度比健康教育高。
I2Mcare模式较复杂但整合基础良好。I2Mcare模式需要产科、妇女保健部心理科、孕产妇及家人等多角色参与，提供筛查、团体心理辅导、定期评估、转诊和产后随访的连续性服务，多角色协作和连续性服务增加落实难度。但我国孕产妇保健体系已较完善，为服务整合提供基础。
（2）主题2：外部环境
社会公众对PND的认知不足。随着生育友好理念的推进，社会大众对PND的认识有所增加，但部分孕妇伴侣和家人仍有偏见，导致孕妇接受心理健康服务时存在病耻感。
PND相关服务政策配套不完善。我国卫生行政部门尚未将心理健康服务纳入医疗机构绩效考核，各级医疗机构对该工作缺乏重视，且缺乏工作规范。此外，财政对心理健康服务的专项投入不足、服务定价尚未健全。
（3）主题3：内部环境
心理健康工作基础较好。妇女保健部认为PND是科室的工作重点，已具备开展团体心理辅导课程的经验，心理咨询师人员储备充足且经过专业培训。
科室内部和科室间协作与沟通不足。妇女保健部心理科与产科之间的跨学科协作机制尚未有效建立，产科未能较好承担筛查招募和随访管理工作，一定程度影响服务模式的实施。此外，心理科内部也存在沟通不畅问题。
（4）主题4：个体特征
心理保健科变革决心强。妇女保健部管理者和心理咨询师认为I2Mcare模式的实施不仅是本职工作，还有利于提升科室专业能力。其中妇女保健部主任作为支持模式实施的主要管理者，协调场地、人力等资源并督导项目进度。心理咨询师积极性高，从孕妇的反馈中获得成就感，进一步强化其变革决心。
产科常规工作负担较重，变革动力不足。产科医护人员在模式实施过程中参与不足，阻碍常规筛查。尽管多数人认同PND干预的必要性，但受限于以下因素：工作负荷饱和，常规产检任务繁重，导致心理筛查优先级降低；缺乏围产期抑郁症筛查和管理的知识技能，且围产期心理保健尚未成为其日常工作要求。
孕妇心理健康素养较低。虽然I2Mcare模式提供的筛查和团体心理辅导均免费，但仍较多孕妇对PND及相关服务认识不足、服务需求感知较低。该部分人群对服务的接受度较低，常拒绝参与。
（5）主题5：实施过程
动态需求评估确保服务质量与效果。本研究在项目实施前通过文献研究和问卷调查评估孕妇的心理健康服务需求[13]，针对其孕期不同阶段常见情绪问题和服务偏好设计了系列主题。此外，在每次干预结束后选择1~2名孕妇以及心理咨询师进行一对一访谈，了解其服务体验和改进建议。
动员孕妇参与团体心理辅导较困难。尽管通过宣教和物质激励（如待产包或交通补贴）提升参与度，但动员PND高风险孕妇接受服务仍是主要困难。一方面，受孕妇的健康素养低、需求感知不足、时间或交通限制等因素影响；另一方面也可能是孕妇对招募的项目协调员信任不足，更倾向于信任医护人员。
I2Mcare模式实施过程的促进和障碍因素如表4所示。
3　讨论
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3.1　I2Mcare模式对围产期抑郁症的干预效果
研究结果表明I2Mcare模式可有效改善PND。本研究的干预在产前包括4次团辅心理辅导，伍金娟等[14]也发现增加心理团辅次数可显著降低PND。这主要是由于心理干预效果具有累积性，干预时间越长、效果可能越显著且持续时间越长，同时也表明I2Mcare模式具有时间连续性和内容系统性的相对优势。此外，本研究发现两组抑郁评分变化趋势均为孕早期最高，随孕周增大有所下降，其中对照组在产前呈现“先下降后稳定”的趋势，与杨业环等[15]和Qian等[16]的发现一致。这提示应将围产期心理健康服务关口前移，将孕早期作为健康促进和筛查的起点，并提供连续性、全周期服务。最后，本研究未发现在研究时间内干预随时间变化的交互效应，提示干预效果在不同时间点保持相对稳定，未来可进一步探索长期效果的作用轨迹。
3.2　I2Mcare模式实施的障碍因素
I2Mcare模式实施的制度障碍主要为缺乏资金保障、工作规范和考核要求。2022年世界卫生组织发布的《将围产期心理健康整合到孕产妇和儿童健康服务指南》[8]指出应通过监测和考核强化围产期心理保健整合服务的执行力度。目前我国孕产妇心理保健相关政策多依附于普适性抑郁症防治或妇幼保健工作指南，缺乏针对PND的独立政策框架[4-5]。
I2Mcare模式实施的组织障碍主要为产科医护人员心理筛查的知识技能缺乏、常规工作负荷较重以及专业间的沟通协作不足。多项研究也发现[17-19]，产科医护人员对孕产妇心理健康筛查与管理工作没有做好充分准备，科室之间职责不明、沟通不畅，导致心理服务提供不足。
此外，孕产妇及社会大众对PND缺乏了解也阻碍I2Mcare模式实施。研究表明，增加心理健康教育以及社会支持可以提高孕产妇心理健康素养，从而提高其对心理健康服务的接受度[20]。
3.3　推进I2Mcare模式实施的政策建议
首先，需完善PND相关政策，制定服务规范。组织专家制定适合我国的服务规范以指引医务人员开展服务、明确职责分工和操作标准；健全绩效考核与激励机制，提升服务执行力。其次需加强人员能力培训，建立多学科协作机制。通过培训提高医务人员开展心理健康促进和筛查的能力，明确各科室职责分工和转会诊机制，探索如何将该工作与常规工作兼容，实现筛查结果、转诊需求等信息实时互通。最后需加大PND宣传教育，营造围产期心理健康支持性环境。一方面，通过媒体、社区等加大宣传PND。另一方面，鼓励孕产妇关注自身心理状况，减少病耻感，并提倡孕产妇伴侣及家人共同参与服务过程。
4　小结
收起
本研究表明在基层妇幼保健机构实施I2Mcare模式可有效降低PND高风险孕妇的抑郁症状水平，政策支持不足、专业人员能力和协作水平有限以及孕妇认知不足是模式实施的关键障碍，为PND整合型服务模式构建和实施提供了依据。本研究为单中心研究，样本量相对较小，且因干预复杂，失访率较高。此外，完成干预的孕妇文化程度略高于一般孕妇群体，样本代表性受限。未来可开展多中心研究，扩大样本量，同时关注文化程度较低的孕妇，进一步验证干预效果并进行经济学评价，促进整合型PND心理健康服务在我国基层妇幼保健体系推广应用。
基金
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  • 美国中华医学会基金公开竞标项目(21-437)
文献
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参考文献 引证文献
排序方式：
[1]
刘娜，王敏怡，梁群英，等．2016—2022年中国围产期抑郁症患病率的Meta分析[J]．中国社会医学杂志，2024，41（6）：701-706．
Liu N, Wang MY, Liang QY, et al. Meta-analysis of the Prevalence of Perinatal Depression in China from 2016 to 2022[J]. Chinese Journal of Social Medicine, 2024, 41(6): 701-706. (In Chinese)
[2]
闫真，高枫．围产期抑郁病因及不良影响研究进展[J]．临床医学进展，2021，11（2）：533-536．
Yan Z, Gao F. Causes and adverse effects of perinatal depression: a review[J]. Advances in Clinical Medicine, 2021, 11(2): 533-536. (In Chinese)
[3]
Fekadu dadi A, Miller ER, Mwanri L. Antenatal depression and its association with adverse birth outcomes in low and middle-income countries: A systematic review and meta-analysis[J]. PLOS One, 2020, 15(1): e0227323.
[4]
国家卫生健康委员会．国家卫生健康委办公厅关于探索开展抑郁症,老年痴呆防治特色服务工作的通知[EB/OL]．[2026-02-15]. https://www.gov.cn/zhengce/zhengceku/2020-09/11/content_5542555.htm．
National Health Commission. Notice of the general office of the national health commission on exploring the development of characteristic services for the prevention and treatment of depression and alzheimer’s disease[EB/OL]. [2026-02-15]. https://www.gov.cn/zhengce/zhengceku/2020-09/11/content_5542555.htm. (In Chinese)
[5]
中华人民共和国中央人民政府．关于推进生育友好医院建设的意见[EB/OL]．[2026-02-15]. https://www.gov.cn/zhengce/zhengceku/202501/content_6999132.htm．
The Central People’s Government of the People’s Republic of China. Opinions on promoting the construction of fertility-friendly hospitals[EB/OL]. [2026-02-15]. https://www.gov.cn/zhengce/zhengceku/202501/content_6999132.htm. (In Chinese)
[6]
中华预防医学会心身健康学组，中国妇幼保健协会妇女心理保健技术学组．孕产妇心理健康管理专家共识(2019年)[J]．中国妇幼健康研究，2019，30（7）：781-786．
Psychosomatic Health Society, China Preventive Medicine Association, Committee of Women Mental Health Care, China Maternal and Child Health Association. Expert consensus on maternal mental health management(2019)[J]. Chinese Journal of Woman and Child Health Research, 2019, 30(7): 781-786. (In Chinese)
[7]
中华医学会妇产科学分会产科学组．围产期抑郁症筛查与诊治专家共识[J]．中华妇产科杂志，2021，56（8）：521-527．
Obstetrics Group, Society of Obstetrics and Gynecology, Chinese Medical Association. Expertconsensus on screening, diagnosis and treatment of perinatal depression[J]. Chinese Journal of Obstetrics and Gynecology, 2021, 56(8): 521-527.
[8]
World Health Organization. Guide for integration of perinatal mental health in maternal and child health service[EB/OL]. [2026-02-22]. https://www.who.int/publications/i/item/9789240057142.
[9]
National Collaborating Centre for Mental Health(UK). National institute for health and clinical excellence: guidance[M]. Leicester(UK): British Psychological Society, 2014.
[10]
American College of Obstetricians, Gynecologists. Screening and diagnosis of mental health conditions during pregnancy and postpartum: ACOG clinical practice guideline no. 4[J]. Obstetrics and Gynecology, 2023, 141(6): 1232-1261.
[11]
徐东，蔡毅媛，陈江芸．实施科学的前世今生(下篇)——理论、范式和特点[J]．协和医学杂志，2024，15（3）：686-693．
Xu D, Cai YY, Chen JY. Past and present of implementation science(part Ⅱ)——theories, paradigm, and characteristics[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(3): 686-693. (In Chinese)
[12]
金三丽，李明子．易感性人格类型量表预测产后抑郁症的效果研究[J]．中华护理杂志，2006，41（9）：781-784．
Jin SL, Li MZ. A study of the effectiveness of Vulnerable Personality Style Questionnaire to predict postpartum depression[J]. Chinese Journal of Nursing, 2006, 41(9): 781-784. (In Chinese)
[13]
Wu SE, Shi YL, Xu JF, et al. Preferences for group psychological interventions on perinatal depression in China: a discrete choice experiment[J]. Archives of Public Health, 2025, 83(1): 168.
[14]
伍金娟，吴颖芳，伍少莹，等．孕期团体心理辅导在预防产后焦虑抑郁中的效果评价[J]．心理月刊，2024，19（11）：177-179, 214．
Wu JJ, Wu YF, Wu SY, et al. Evaluation of the effect of group psychological counseling during pregnancy on preventing postpartum anxiety and depression[J]. Psychological Monthly, 2024, 19(11): 177-179, 214. (In Chinese)
[15]
杨业环，黄星，孙梦云，等．中国孕产妇不同时点抑郁状态转归及持续抑郁状态影响因素分析[J]．中华流行病学杂志，2022，43（1）：58-64．
Yang YH, Huang X, Sun MY, et al. Analysis on depression state outcomes and influencing factors of persistent depression in pregnant and perinatal women in China[J]. Chinese Journal of Epidemiology, 2022, 43(1): 58-64. (In Chinese)
[16]
Jing Q, Jie J, Ke X, et al. The relationship between fear of childbirth and prenatal depression in pregnant women during pregnancy: a cross-lagged analysis[J]. BMC Pregnancy and Childbirth, 2025, 25(1): 192.
[17]
Navarrete L, Lara MA, Berenzon S, et al. Challenges of perinatal depression care in Mexico city health centers[J]. International Journal of Women’s Health, 2022, 14: 1667-1679.
[18]
Nithianandan N, Gibson-Helm M, McBride J, et al. Factors affecting implementation of perinatal mental health screening in women of refugee background[J]. Implementation Science, 2016, 11(1): 150.
[19]
Xiao X, Ma HX, Zhu SN, et al. The perceptions and attitudes of obstetric staff and midwives towards perinatal mental health disorders screening: a qualitative exploratory study in Shenzhen, China[J]. BMC Nursing, 2023, 22(1): 313.
[20]
黄维健．孕产妇产后抑郁相关的心理健康素养干预方案的构建研究[D]．沈阳：中国医科大学，2022．
Huang WJ. Study on the construction of an intervention program for mental health literacy related to postpartum depression in pregnant and postpartum women[D]. Shenyang: China Medical University, 2022. (In Chinese)
2026年第53卷第6期
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doi: 10.20043/j.cnki.MPM.202507275
  • 接收时间：2025-07-17
  • 首发时间：2026-11-02
  • 出版时间：2026-03-25
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  • 收稿日期：2025-07-17
基金
美国中华医学会基金公开竞标项目(21-437)
作者信息
    1.中山大学公共卫生学院卫生管理学系，广东 广州 510080
    2.深圳市宝安区卫生健康局

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2种不同金属材料的力学参数
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小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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