背景:需要广泛的弹性和适应性的生活事件是育儿。然而,抚养子女的弹性和感知支持各不相同,使现实世界的情况变得不清楚,即使是产后检查.
目的:本研究旨在探讨母亲从新生儿到幼儿在育儿期间的心理社会状况。使用基于新生儿母亲的弹性和适应特征数据的分类器。
方法:进行了基于网络的横断面调查。分析了具有大约1个月大的新生儿的母亲(新生儿队列),以构建可解释的机器学习分类器,以分层与父母相关的弹性和适应特征并识别脆弱人群。由于其高解释力和适用性,使用了可解释的k-means聚类。将分类器应用于具有2个月至1岁婴儿的母亲(婴儿队列)和具有>1岁至2岁幼儿的母亲(幼儿队列)。社会心理地位,包括爱丁堡产后抑郁量表(EPDS)评估的抑郁情绪,通过产后粘合问卷(PBQ)评估粘合,通过匹兹堡睡眠质量指数(PSQI)评估分类组之间的睡眠质量,比较。
结果:共有1559名参与者完成了调查。他们被分成3组,包括各种特征的种群,包括育儿困难和社会心理措施。分类器,将参与者分为5组,是根据新生儿队列中自我报告的弹性和适应性得分得出的(n=310)。分类器确定,在弹性和适应儿童气质和感知支持方面最困难的群体有更高的抑郁情绪问题发生率(相对患病率[RP]5.87,95%CI2.77-12.45),粘合(RP5.38,95%CI2.53-11.45),和睡眠质量(RP1.70,95%CI1.20-2.40),与感知支持无困难的组相比。在婴儿队列(n=619)和幼儿队列(n=461)中,困难最大的分层组有较高的抑郁情绪问题发生率(RP9.05,95%CI4.36-18.80和RP4.63,95%CI2.38-9.02),粘合(RP1.63,95%CI1.29-2.06和RP3.19,95%CI2.03-5.01),与无困难组相比,睡眠质量(RP8.09,95%CI4.62-16.37和RP1.72,95%CI1.23-2.42)。
结论:分类器,基于对孩子气质和感知支持的韧性和适应性的结合,能够在新生儿队列中识别心理社会弱势群体,儿童保育的启动阶段。在质量不同的婴儿和幼儿队列中也确定了社会心理弱势群体,取决于他们的分类器。在婴儿队列中确定的脆弱群体表现出特别高的RP,因为情绪低落和睡眠质量差。
BACKGROUND: One life event that requires extensive resilience and adaptation is parenting. However, resilience and perceived support in child-rearing vary, making the real-world situation unclear, even with postpartum checkups.
OBJECTIVE: This
study aimed to explore the psychosocial status of mothers during the child-rearing period from newborn to toddler, with a classifier based on data on the resilience and adaptation characteristics of mothers with newborns.
METHODS: A web-based cross-sectional survey was conducted. Mothers with newborns aged approximately 1 month (newborn cohort) were analyzed to construct an explainable machine learning classifier to stratify parenting-related resilience and adaptation characteristics and identify vulnerable populations. Explainable k-means clustering was used because of its high explanatory power and applicability. The classifier was applied to mothers with infants aged 2 months to 1 year (infant cohort) and mothers with toddlers aged >1 year to 2 years (toddler cohort). Psychosocial status, including depressed mood assessed by the Edinburgh Postnatal Depression Scale (EPDS), bonding assessed by the Postpartum Bonding Questionnaire (PBQ), and sleep quality assessed by the Pittsburgh Sleep Quality Index (PSQI) between the classified groups, was compared.
RESULTS: A total of 1559 participants completed the survey. They were split into 3 cohorts, comprising populations of various characteristics, including parenting difficulties and psychosocial measures. The classifier, which stratified participants into 5 groups, was generated from the self-reported scores of resilience and adaptation in the newborn cohort (n=310). The classifier identified that the group with the greatest difficulties in resilience and adaptation to a child\'s temperament and perceived support had higher incidences of problems with depressed mood (relative prevalence [RP] 5.87, 95% CI 2.77-12.45), bonding (RP 5.38, 95% CI 2.53-11.45), and sleep quality (RP 1.70, 95% CI 1.20-2.40) compared to the group with no difficulties in perceived support. In the infant cohort (n=619) and toddler cohort (n=461), the stratified group with the greatest difficulties had higher incidences of problems with depressed mood (RP 9.05, 95% CI 4.36-18.80 and RP 4.63, 95% CI 2.38-9.02, respectively), bonding (RP 1.63, 95% CI 1.29-2.06 and RP 3.19, 95% CI 2.03-5.01, respectively), and sleep quality (RP 8.09, 95% CI 4.62-16.37 and RP 1.72, 95% CI 1.23-2.42, respectively) compared to the group with no difficulties.
CONCLUSIONS: The classifier, based on a combination of resilience and adaptation to the child\'s temperament and perceived support, was able identify psychosocial vulnerable groups in the newborn cohort, the start-up stage of childcare. Psychosocially vulnerable groups were also identified in qualitatively different infant and toddler cohorts, depending on their classifier. The vulnerable group identified in the infant cohort showed particularly high RP for depressed mood and poor sleep quality.