背景：胎儿丢失在全世界范围内发生率较高，且作为创伤事件对妇女的心理健康造成不良影响。研究表明，胎儿丢失可能导致妇女出现焦虑、抑郁等负性情绪，影响其主观幸福感水平。幸福疗法作为一种短期的、良好的心理干预策略，可以帮助个体识别幸福片段并采取干预措施促进幸福感的产生。目前幸福疗法多用于抑郁、焦虑和慢性病患者，国内暂无将幸福疗法运用于胎儿丢失妇女群体中。因此，将幸福疗法应用于经历胎儿丢失的女性，能否缓解其负性情绪、促进主观幸福感提升，仍有待进一步探索。

目的：探究幸福疗法对胎儿丢失女性抑郁、主观幸福感、应对方式及创伤后成长的干预成效。

方法：采用类实验研究方法，便利选取2023年9月～2025年3月在北京妇产医院68名妊娠12周以上胎儿丢失妇女，于产科一病房选取对照组（n=34），在产科二病房选取干预组（n=34）。对照组产妇在住院期间按照医院常规护理模式进行护理，而干预组在常规护理的基础上，额外接受为期三周的幸福疗法干预。通过文献分析、半结构式访谈结果为基础构建幸福疗法干预方案，在干预前、干预结束时、干预结束后1个月通过爱丁堡产后抑郁量表（EPDS）、主观幸福感指数（IWB）、简易应对方式量表（SCSQ）以及创伤后成长评定量表（C-PTGI）测量胎儿丢失妇女抑郁水平、主观幸福感水平、应对方式以及创伤后成长水平。使用SPSS27.0软件进行数据分析，设定P＜0.05存在统计学差异。使用广义估计方程（GEE）检验干预方案对不同结局指标的干预效果，所有分析均为意向性分析（ITT）。

结果：基线时共纳入68名研究对象，干预组和对照组各34名，干预后进行评估的干预组研究对象为31人，对照组34人，干预完成后1个月进行评估的干预组研究对象为30人，对照组为30人。基线资料间的差异均无统计学意义（P＞0.05）。对两组研究对象干预前后不同时间点的抑郁水平、主观幸福感水平、应对方式以及创伤后成长水平进行对比分析：

（1）抑郁水平：GEE 模型的分析结果显示，时间的主效应以及时间与组别的交互作用在统计学上均具显著性（Wald x²=294.019,P＜0.001；Wald x²=10.264，P＜0.05），组别主效应没有统计学意义（Wald x²=0.671，P＞0.05）。干预后1个月两组抑郁得分差异有统计学意义（P＜0.05）。

（2）主观幸福感：GEE 模型的分析结果显示，时间的主效应、组别的主效应，以及时间与组别的交互作用在统计学上均显著（Wald x²=16.773，P＜0.001；Wald x²=115.778，P＜0.001；Wald x²=8.852，P＜0.05）；两组研究对象在干预结束时以及干预后1个月的主观幸福感得分差异均具有统计学意义（P＜0.05）。

（3）应对方式：积极应对方式GEE 模型的分析结果显示，时间的主效应、组别的主效应，以及时间与组别的交互作用在统计学上均显著（Wald x²=5.820，P＜0.05；Wald x²=44.598，P＜0.001；Wald x²=7.837，P＜0.05）；干预后1个月两组积极应对方式得分差异有统计学意义（P＜0.05）。消极应对方式GEE 模型的分析结果显示，时间的主效应、组别的主效应，以及时间与组别的交互作用在统计学上均显著Wald x²=4.228，P＜0.05；Wald x²=37.076，P＜0.001；Wald x²=14.005，P＜0.001）；干预后1个月两组消极应对方式差异有统计学意义（P＜0.05）。

（4）创伤后成长：GEE 模型的分析结果显示，时间的主效应、组别的主效应，以及时间与组别的交互作用在统计学上均显著（Wald x²=15.033，P＜0.001；Wald x²=113.645，P＜0.001，Wald x²=6.820，P＜0.05）。两组研究对象在干预结束时以及干预1个月后的创伤后成长得分差异均具有统计学意义（P＜0.05）。

结论：本研究中幸福疗法在改善胎儿丢失妇女主观幸福感和创伤后成长方面均具有显著效果。幸福疗法可以有效改善胎儿丢失妇女干预后1个月的抑郁情绪、积极应对以及消极应对水平。建议进一步研究幸福疗法对胎儿丢失妇抑郁情绪的效果研究。

Background: Fetal loss, a traumatic event with a high global incidence, can adversely affect women's mental health, potentially leading to anxiety, depression, and reduced subjective well-being. Well-being therapy (WBT), a brief, effective psychotherapeutic approach, helps individuals identify and enhance happiness fragments to boost well-being. While WBT has been applied in depression, anxiety, and chronic illness, no domestic studies have explored its use in women experiencing fetal loss. Thus, its potential to alleviate negative emotions and enhance well-being in this group remains unexplored.

Objective: To evaluate the impact of well-being therapy on depression, subjective well-being, coping strategies, and posttraumatic growth in women who have experienced fetal loss.

Methods: This quasi-experimental study recruited 68 women with fetal loss after 12 weeks of gestation from Beijing Maternity Hospital between September 2023 and March 2025. The women were divided into an intervention group and a control group, each initially consisting of 34 participants. The control group received routine hospital care, while the intervention group got three weeks of WBT in addition to routine care. The intervention, based on literature analysis, semi-structured interviews, and the six-dimensional mental health model, was evaluated using the EPDS, IWB, SCSQ, and C-PTGI at pre-intervention, post-intervention, and one-month post-intervention stages. Data were analyzed using SPSS 27.0, with statistical significance set at P<0.05. GEE models were used to assess the intervention's effects, with all analyses conducted on an intention-to-treat basis.

Results: At baseline, 68 participants were included. Post-intervention, 31 intervention and 34 control group members were assessed; at one-month follow-up, 30 from each group were evaluated. Baseline data showed no significant differences (P>0.05). Comparisons of depression, subjective well-being, coping strategies, and posttraumatic growth across time points revealed:

Depression: Significant main effects of time and time-group interaction (Wald x²=294.019, P<0.001; Wald x²=10.264, P<0.05), but no group main effect (Wald x²=0.671, P>0.05). One-month post-intervention, depression scores differed significantly between groups (P<0.05).

Subjective Well-being: Significant main and interaction effects (Wald x²=16.773, P<0.001; Wald x²=115.778, P<0.001; Wald x²=8.852, P<0.05). Post-intervention and at one-month follow-up, subjective well-being scores differed significantly between groups (P<0.05).

Coping Strategies: For positive coping, significant main and interaction effects (Wald x²=5.820, P<0.05; Wald x²=44.598, P<0.001; Wald x²=7.837, P<0.05); for negative coping, similar significance (Wald x²=4.228, P<0.05; Wald x²=37.076, P<0.001; Wald x²=14.005, P<0.001). One-month post-intervention, positive and negative coping scores differed significantly between groups (P<0.05).

Posttraumatic Growth: Significant main and interaction effects (Wald x²=15.033, P<0.001; Wald x²=113.645, P<0.001; Wald x²=6.820, P<0.05). Post-intervention and at one-month follow-up, posttraumatic growth scores differed significantly between groups (P<0.05).

Conclusion: Well-being therapy significantly improved subjective well-being and posttraumatic growth in women with fetal loss and effectively reduced depression and adjusted coping strategies one-month post-intervention. Further research on WBT for depression in this population is recommended.