Yoga online: Inter-conception care to prevent PTSD symptoms after stillbirth

在线瑜伽：孕间护理可预防死产后的创伤后应激障碍症状

• 批准号: 9319625
• 负责人: Jennifer Lynne Huberty
• 金额: $ 31.5万
• 依托单位: ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9319625
• 关键词: Address; Adherence; Affective; Age; Anxiety; Caring; Cessation of life; Child; Chronic Disease; Clinical; Cognitive; Comorbidity; Compassion; Conceptions; Control Groups; Diabetes Mellitus; Dose; Effectiveness; Emotional; Environment; Fetal Death; Future; General Population; Goals; Grief reaction; Health; Health Services Accessibility; Heart Diseases; High Prevalence; Home environment; Incidence; Intervention; Intervention Studies; Live Birth; Low Birth Weight Infant; Measures; Meditation; Mental Depression; Mental Health; Methods; Mind-Body Intervention; Mission; Mothers; Outcome; Parents; Persons; Pharmaceutical Preparations; Physical activity; Physiological; Pilot Projects; Play; Population; Post-Traumatic Stress Disorders; Postpartum Period; Pregnancy; Premature Birth; Premature Mortality; Psyche structure; Public Health; Quality of life; Randomized; Randomized Controlled Trials; Recruitment Activity; Reporting; Risk; Role; Sample Size; Sleep; Sleep disturbances; Stream; Stretching; Support Groups; Symptoms; Testing; Therapeutic; Time; United States National Institutes of Health; Vulnerable Populations; Weight; Woman; Work; Yoga; arm; base; clinically relevant; common treatment; cost; cost effective; design; emotion regulation; evidence base; experience; fetal; follow-up; group counseling; high risk; improved; interest; intervention effect; mindfulness; novel; physical conditioning; post intervention; pregnant; prevent; psychologic; residence; satisfaction; social media; stillbirth; stressor; traumatic event

PROJECT SUMMARY/ABSTRACT Bereaved mothers with stillbirth (death at >20 weeks of gestation) have more than a 6-fold higher risk for Post Traumatic Stress Disorder (PTSD) compared to mothers after live birth. PTSD declines at a slower rate among bereaved mothers compared to other bereaved populations and often escalates in subsequent pregnancies. Because more than 85% of women will get pregnant within 18-months, the inter-conception period is a critical time to improve the mental and physical health of bereaved mothers with stillbirth. Non-pharmacological approaches, such as yoga, may be an alternative option for bereaved women with stillbirth. Yoga has been established as an effective, safe, acceptable, and a cost effective approach to improving mental health in a variety of populations, including, pregnant and post-partum women and as a means to cope with PTSD associated with surviving a traumatic event. We are unaware of any studies that have explored yoga to reduce PTSD in bereaved mothers with stillbirth. Furthermore, online-streamed yoga (on-demand videos played in the home) has recently grown in popularity and may address the unique barriers that women with stillbirth may have. The primary goal of this project is to determine the feasibility and acceptability of a 12-week, home-based, online-streamed yoga (www.Udaya.com) intervention for bereaved mothers with stillbirth. We will also make adaptations and determine acceptability of a control group that can be used for a future, larger trial. Finally, we will explore the preliminary effects (not powered for efficacy) of a home-based, online-streamed, yoga intervention with differing doses (low and moderate) on symptoms of PTSD and its comorbid conditions (i.e., anxiety, depression) and the potential mechanisms (i.e., self-compassion, emotional regulation, and sleep disturbance) by which yoga may improve PTSD symptoms. This is a three-group randomized feasibility pilot study with baseline, post-intervention (12 weeks from baseline), and follow-up (20 weeks from baseline) assessments. Women will be randomized into one of three arms (intervention low dose (LD) = 60 mins/wk yoga; intervention moderate dose (MD) = 150 mins/wk yoga); or a stretch and tone control group (STC). This study plays an important role in our understanding about yoga and PTSD related outcomes in bereaved mothers with stillbirth. This study will inform the design of a larger study to test the effectiveness of online yoga as a low-cost, non-pharmacological strategy for inter-conception care to improve maternal and fetal outcomes for bereaved mothers with stillbirth.

项目概要/摘要 死产（妊娠超过 20 周时死亡）的丧亲母亲发生产后妊娠的风险高出 6 倍以上 与活产后母亲相比，创伤性应激障碍 (PTSD)。创伤后应激障碍 (PTSD) 下降速度较慢 与其他失去亲人的人群相比，失去亲人的母亲的痛苦通常会在随后的怀孕中升级。 由于超过85%的女性会在18个月内怀孕，因此受孕间期是一个关键时期 是时候改善死产丧亲母亲的身心健康了。非药理作用 对于死产的失去亲人的妇女来说，瑜伽等方法可能是一种替代选择。瑜伽已经 被确立为一种有效、安全、可接受且具有成本效益的改善心理健康的方法 各种人群，包括孕妇和产后妇女，并作为应对创伤后应激障碍的一种手段 与创伤事件的幸存有关。我们不知道有任何研究探索瑜伽可以减少 死产丧亲母亲的创伤后应激障碍（PTSD）。此外，在线流媒体瑜伽（在 家）最近越来越受欢迎，可能会解决死产妇女可能遇到的独特障碍 有。 该项目的主要目标是确定为期 12 周的家庭培训的可行性和可接受性。 在线瑜伽 (www.Udaya.com) 对死产丧亲母亲的干预。我们还将制作 适应并确定可用于未来更大规模试验的对照组的可接受性。最后，我们 将探索家庭在线瑜伽的初步效果（不提供功效） 对 PTSD 症状及其合并症（即， 焦虑、抑郁）和潜在机制（即自我慈悲、情绪调节和睡眠） 扰），瑜伽可以改善创伤后应激障碍（PTSD）症状。这是一个三组随机可行性试验 研究基线、干预后（距基线 12 周）和随访（距基线 20 周） 评估。女性将被随机分入三组之一（干预低剂量 (LD) = 60 分钟/周 瑜伽;干预中等剂量 (MD) = 150 分钟/周瑜伽)；或拉伸和音调控制组 (STC)。 这项研究对于我们理解瑜伽和创伤后应激障碍（PTSD）相关的丧亲者结局发挥着重要作用 死产的母亲。这项研究将为更大规模的研究设计提供信息，以测试在线瑜伽的有效性 作为一种低成本、非药物的孕间护理策略，可改善孕产妇和胎儿的结局 对于死产的失去亲人的母亲。