- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT07579273
Postnatal Debriefing After Adverse Obstetric Events (DBIRTH)
Effect of a Structured Postnatal Debriefing on Psychological Outcomes and Birth Experience in Women After Adverse or Unexpected Obstetric Events: A Randomized Controlled Trial
Adverse or unexpected obstetric events can negatively affect women's psychological well-being and childbirth experience, increasing the risk of postpartum traumatic stress. However, structured postnatal debriefing is not routinely implemented in clinical practice, and evidence regarding its effectiveness remains limited.
This randomized controlled trial aims to evaluate the effect of a structured postnatal debriefing conducted within the first 24 hours after childbirth in women who have experienced an adverse or unexpected obstetric event.
Participants will be randomly assigned to either an intervention group receiving structured debriefing or a control group receiving usual postpartum care.
The primary outcome is childbirth-related trauma at 6 weeks postpartum. Secondary outcomes include birth satisfaction, early post-traumatic stress symptoms, and clinical maternal and neonatal outcomes.
This study will provide evidence on whether structured postnatal debriefing improves psychological outcomes and contributes to more patient-centered obstetric care
Přehled studie
Postavení
Podmínky
Intervence / Léčba
Detailní popis
This study is part of a mixed-methods research project evaluating the implementation of postnatal debriefing in obstetric care. The present phase consists of a prospective, randomized controlled trial with two parallel groups (1:1 allocation).
The study will be conducted at the Department of Obstetrics and Gynecology of Parc de Salut Mar, Barcelona, Spain. Eligible participants are women who experience an adverse or unexpected obstetric event during labor or the immediate postpartum period and are clinically stable within the first 24 hours after childbirth.
Participants will be randomly assigned to either an intervention group receiving a structured postnatal debriefing or a control group receiving usual postpartum care. Randomization will be performed using a computer-generated sequence with allocation concealment through sealed opaque envelopes.
The intervention consists of a structured, individualized postnatal debriefing session conducted within the first 24 hours postpartum by a senior obstetrician together with the midwife responsible for the woman's care. The session lasts approximately 15-30 minutes and follows a semi-structured guide including emotional assessment, active listening, clinical explanation of the event, validation of emotions, and opportunity for questions. The intervention is adapted to each woman's needs.
Data will be collected at hospital discharge (approximately 48 hours postpartum) and at 6 weeks postpartum using validated instruments, through a secure electronic data capture system (REDCap).
The primary outcome is childbirth-related trauma assessed at 6 weeks postpartum. Secondary outcomes include birth satisfaction, early post-traumatic stress symptoms, and clinical maternal and neonatal variables.
The sample size has been calculated to detect clinically meaningful differences between groups, with a total of 142 participants (71 per group), accounting for potential losses to follow-up.
This study aims to generate evidence on the effectiveness of structured postnatal debriefing as a feasible, scalable, and patient-centered intervention to improve psychological recovery after adverse childbirth experiences.
Typ studie
Zápis (Odhadovaný)
Fáze
- Nelze použít
Kontakty a umístění
Studijní kontakt
- Jméno: Elena Ferriols Pérez, MD, PhD
- Telefonní číslo: +34605588984
- E-mail: eferriols@hmar.cat
Studijní záloha kontaktů
- Jméno: Laura Martínez Verdú, RN, MSc
- Telefonní číslo: +34696591393
- E-mail: lmartinezverdu@hmar.cat
Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
- Dospělý
- Starší dospělý
Přijímá zdravé dobrovolníky
Popis
Inclusion Criteria:
- Women aged 18 years or older.
- Women who have experienced an adverse or unexpected obstetric event during labor or the immediate postpartum period.
- Admitted to the maternity unit of Hospital del Mar and clinically stable within the first 24 hours postpartum.
- Able to understand and communicate in Spanish, Catalan, or English.
- Willing to participate and able to provide written informed consent.
- Access to an email account for follow-up assessments.
Exclusion Criteria:
- Inability to communicate verbally.
- Maternal-neonatal separation due to social reasons.
- Unstable or severe psychiatric condition.
- Immediate perinatal loss (intrapartum fetal death or early neonatal death).
- Admission to intensive care within the first 24 hours postpartum.
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Žádné (otevřený štítek)
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
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Experimentální: Postnatal Debriefing
Participants receive a structured postnatal debriefing session conducted within the first 24 hours postpartum by a senior obstetrician and the midwife responsible for the woman's care.
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A structured postnatal debriefing session conducted within the first 24 hours postpartum by a senior obstetrician and the midwife responsible for the woman's care.
The session takes place in the maternity ward room, in a private and supportive environment, and may include a companion chosen by the woman if she wishes.
The intervention includes a structured clinical explanation of events, emotional validation, and an opportunity for the woman to ask questions and express her experience.
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Žádný zásah: Usual Postpartum Care
Participants receive standard postpartum care, which may include a non-structured clinical explanation of events according to routine practice.
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Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Childbirth-related post-traumatic stress symptoms measured by City Birth Trauma Scale (City BiTS)
Časové okno: 6 weeks postpartum
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Post-traumatic stress symptoms related to childbirth will be assessed using the City Birth Trauma Scale (City BiTS), a validated questionnaire based on DSM-5 criteria for postpartum post-traumatic stress disorder.
The scale evaluates symptoms such as re-experiencing, avoidance, hyperarousal, and negative cognitions related to childbirth.
Scores range from 0 to 60, with higher scores indicating more severe childbirth-related post-traumatic stress symptoms.
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6 weeks postpartum
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Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Postpartum depressive symptoms measured by Edinburgh Postnatal Depression Scale (EPDS)
Časové okno: 6 weeks postpartum
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Postpartum depressive symptoms will be assessed using the Edinburgh Postnatal Depression Scale (EPDS), a validated screening tool widely used to identify women at risk of postpartum depression.
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6 weeks postpartum
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Birth satisfaction measured by Birth Satisfaction Scale-Revised (BSS-R)
Časové okno: 48-72 hours postpartum
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Birth satisfaction will be assessed using the Birth Satisfaction Scale-Revised (BSS-R), a validated 10-item questionnaire evaluating women's perceptions of their childbirth experience, including quality of care, stress experienced during labor, and personal attributes such as control and empowerment.
Each item is scored on a 5-point Likert scale.
Total scores range from 0 to 40, with higher scores indicating greater birth satisfaction
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48-72 hours postpartum
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Early post-traumatic stress symptoms measured by Impact of Event Scale-Revised (IES-R)
Časové okno: 48-72 hours postpartum
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Early postpartum traumatic stress symptoms related to childbirth will be assessed using the Impact of Event Scale-Revised (IES-R), a validated 22-item questionnaire that evaluates intrusion, avoidance, and hyperarousal symptoms associated with traumatic events.
Items are scored on a 5-point Likert scale from 0 to 4. Total scores range from 0 to 88, with higher scores indicating greater post-traumatic stress symptom severity.
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48-72 hours postpartum
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Satisfaction with information and emotional support received after childbirth
Časové okno: 48-72 hours postpartum
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Satisfaction with information and emotional support received after childbirth will be assessed using a structured 5-item Likert-type questionnaire specifically developed for this study.
The questionnaire evaluates clarity of information, opportunity to express concerns, emotional support, consideration of emotional wellbeing, and communication with healthcare professionals.
Scores range from 0 to 20, with higher scores indicating greater satisfaction with communication, information, and emotional support received after the obstetric event.
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48-72 hours postpartum
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Spolupracovníci a vyšetřovatelé
Sponzor
Vyšetřovatelé
- Ředitel studie: Azucena Justicia Diaz, PhD, RN, Parc de Salut Mar
- Ředitel studie: Ramon Escuriet Peiro, Health Department in Catalonia, Spain
Publikace a užitečné odkazy
Obecné publikace
- Mousavi S, Nourizadeh R, Babapour J, Hakimi S, Mokhtari F. Investigating the Effect of Debriefing Intervention on Postpartum Posttraumatic Stress Disorder. Int J Womens Health Reprod Sci. 2024;12(1):42-47.
- Bastos MH, Furuta M, Small R, McKenzie-McHarg K, Bick D. Debriefing interventions for the prevention of psychological trauma in women following childbirth. Cochrane Database Syst Rev. 2015 Apr 10;2015(4):CD007194. doi: 10.1002/14651858.CD007194.pub2.
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Odhadovaný)
Primární dokončení (Odhadovaný)
Dokončení studie (Odhadovaný)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
- Trauma a poruchy související se stresem
- Urogenitální onemocnění
- Duševní poruchy
- Rány a zranění
- Ženské urogenitální onemocnění a těhotenské komplikace
- Těhotenské komplikace
- Kojenec, novorozenec, nemoci
- Stresové poruchy, traumatické
- Vrozené, dědičné a neonatální nemoci a abnormality
- Psychické trauma
- Stresové poruchy, posttraumatické
- Porodnické porodní komplikace
- Poranění při narození
Další identifikační čísla studie
- DEBRIEF-BIRTH-01
Plán pro data jednotlivých účastníků (IPD)
Plánujete sdílet data jednotlivých účastníků (IPD)?
Popis plánu IPD
Informace o lécích a zařízeních, studijní dokumenty
Studuje lékový produkt regulovaný americkým FDA
Studuje produkt zařízení regulovaný americkým úřadem FDA
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Klinické studie na Structured Postnatal Debriefing
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McGill University Health Centre/Research Institute...Nábor
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Universitat Internacional de CatalunyaNáborVzdělávání ošetřovatelství | Učení založené na simulaci | Metoda debriefinguŠpanělsko
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Universidad de MurciaDokončenoKompetence k odvykání tabákuŠpanělsko
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Sakarya UniversityDokončenoSpokojenost | Ošetřovatelský kaz | Simulace fyzické nemociKrocan
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NYU Langone HealthVA Office of Research and DevelopmentUkončenoKlinický výkon | Lékařské znalostiSpojené státy
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University of Vic - Central University of CataloniaDokončenoVzdělávací aktivityŠpanělsko
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Mersin UniversityNáborPohoda, psychologieKrocan
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University of CincinnatiDokončenoKompetence BLS | DebriefingSpojené státy
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Express CollaborativeAmerican Heart AssociationDokončenoPediatrická srdeční zástava (simulovaná)Kanada
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Ohio State UniversityDokončenoPsychologie, Sociální | Dospívající chováníSpojené státy