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Walker LO, Murry N, Becker H, Li Y. Leading Stressors and Coping Strategies Associated With Maternal Physical and Mental Health During the Extended Postpartum Period. J Midwifery Womens Health 2024. [PMID: 38780101 DOI: 10.1111/jmwh.13641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/06/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION A critical gap exists in understanding stressors and coping that affect women's health beyond 6 weeks postpartum. Using new stressor and coping scales tailored to postpartum women, we examined the relationship of postpartum-specific stressors and coping to women's physical and mental health between 2 to 22 months after childbirth. METHODS A total of 361 women of diverse race, ethnicity, and functional abilities recruited through clinical and online methods completed online surveys that included Sources of Stress-Revised subscales, such as overload, changes after pregnancy, and low support resources; Postpartum Coping Scale subscales, such as self-regulation, self-care, and health promotion; Patient-Reported Outcomes Measurement Information System Global Health, covering physical and mental health dimensions; and social demographic items. Analyses included hierarchical linear regression models adjusted for social factors. RESULTS Education and employment were the only social factors associated with physical and mental health, respectively. After adjusting for social factors, overload (P < .001) and coping through health promotion (P = .020) were the only additional variables associated with physical health. After adjusting for social factors, overload (P < .001) and low support resources (P = .002) and coping through self-care (P = .036) were the only additional variables associated with mental health. Thus, being overloaded was the key stressor associated with decreases in physical and mental health. Health promotion was associated with increases in physical health, and self-care was associated with increases in mental health. DISCUSSION These findings point to directions for health care and community interventions to promote health for postpartum women under stress. Strengths of our study include application of stress and coping scales tailored to postpartum women, whereas a limitation is use of a cross-sectional design.
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Affiliation(s)
| | - Nicole Murry
- The University of Texas at Austin, School of Nursing, Austin, Texas
| | - Heather Becker
- The University of Texas at Austin, School of Nursing, Austin, Texas
| | - Yang Li
- The University of Texas at Austin, School of Nursing, Austin, Texas
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Schalla MA, Stengel A. The role of stress in perinatal depression and anxiety - A systematic review. Front Neuroendocrinol 2024; 72:101117. [PMID: 38176543 DOI: 10.1016/j.yfrne.2023.101117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/29/2023] [Accepted: 12/31/2023] [Indexed: 01/06/2024]
Abstract
Perinatal depression (PND) and anxiety affect around 20% of women, but available pharmacotherapy is not sufficiently effective in 20-60% of them, indicating a need for better understanding of these diseases. Since stress is a significant risk factor for PND, the aim was to examine the role of biological, environmental and psychological stress in PND and anxiety through a systematic literature search. Overall 210 studies were included, among which numerous rodent studies showed that perinatal stress induced depressive-like and anxious behavior, which was associated with HPA-axis alterations and morphological brain changes. Human studies indicated that the relationship between cortisol and perinatal depression/anxiety was not as clear and with many contradictions, although social and psychological stress were clearly positively associated with PND. Finally, oxytocin, synthetic neuroactive steroid and n-3 PUFA diet have been identified as potentially beneficial in the therapy of PND and anxiety, worth to be investigated in the future.
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Affiliation(s)
- M A Schalla
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 12203 Berlin, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Germany; Department of Gynecology and Obstetrics, Helios Clinic, Rottweil, Germany
| | - A Stengel
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 12203 Berlin, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Germany; German Center für Mental Health (DZPG), Site Tübingen, Germany.
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Sun Y, Chia SC, Shi Y. How Exposure to Online Parenting Content Relates to Mothers' Self-Discrepancy and Postpartum Mental Health. HEALTH COMMUNICATION 2023; 38:2782-2794. [PMID: 36127777 DOI: 10.1080/10410236.2022.2114769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Postpartum mental health problems are common and have deleterious effects on new mothers and their babies. This study developed a theoretically informed model of the relationship between exposure to images of motherhood in online parenting content and mothers' postpartum mental health. The model was tested using survey data collected from 509 Chinese mothers during their 12-month postpartum period. The results revealed that greater exposure to online public parenting content was indirectly related to lower levels of shame among new mothers via two mediators: the presumed influence of parenting media content on their partners, and the mothers' perceptions of the discrepancy between their actual selves as mothers and their partners' expectations of an ideal mother (i.e. actual/own - ideal/partner self-discrepancy). In contrast, increased exposure to online private parenting content shared by peers was indirectly related to increased levels of shame among new mothers via the mediation of social comparison with parenting media images, and of the mothers' perceptions of the discrepancy between their actual selves as mothers and their own expectations of an ideal mother (i.e. actual/own - ideal/own self-discrepancy). Additionally, new mothers were more likely to experience depressive symptoms and shame if they felt that they fell short of their partners' expectations of an ideal mother. However, increased social support reduced the anxiety and shame that stemmed from this belief.
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Affiliation(s)
- Yanqing Sun
- School of Journalism and Communication, Hunan University
| | - Stella C Chia
- Department of Media and Communication, City University of Hong Kong
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Walker LO, Murry N, Longoria KD. Modification and Psychometric Analyses of Stress and Coping Scales for the Extended Postpartum Period. J Obstet Gynecol Neonatal Nurs 2023; 52:405-419. [PMID: 37356808 DOI: 10.1016/j.jogn.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/26/2023] [Accepted: 06/01/2023] [Indexed: 06/27/2023] Open
Abstract
OBJECTIVE To modify and psychometrically assess two scales that are used to measure stress and coping during the extended postpartum period. DESIGN Instrument modification and psychometric assessment. SETTING Online, community, and health care settings. PARTICIPANTS Mothers with infants who were 2 to 22 months old: 20 in Phase 1 and 373 in Phase 2. METHODS In Phase 1, participants from diverse backgrounds served as content experts to recommend modifications of items on two scales: Sources of Stress-Revised (SoS-R) and Postpartum Coping Scale (PCS). The results were 32-item modified versions of each scale. In Phase 2, we conducted a psychometric analysis of both revised scales using principal components analysis to identify dimensionality, Cronbach's alphas to estimate internal consistency reliability, and Pearson correlations to estimate validity of the SoS-R and PCS with the Perceived Stress Scale and the Brief COPE, respectively. RESULTS We identified six components for the SoS-R: Overload, Changes After Pregnancy, Baby-Related Concerns, Working Mother Concerns, Low Support Resources, and Isolated Motherhood. The Cronbach's alpha for the SoS-R was .94. The SoS-R subscales demonstrated correlations with the Perceived Stress Scale that ranged from 0.55 to 0.30. We identified six components for the PCS: Self-Regulation, Spiritual Care, Self-Care, Use and Seek Support, Internal and External Resources, and Health Promotion. The Cronbach's alpha coefficients for the PCS ranged from .84 to .66. The highest correlations observed between the PCS subscales and the Brief COPE subscales ranged from 0.67 to 0.26. CONCLUSION The SoS-R and PCS each include six components. Internal consistency reliability for all SoS-R subscales and four of six PCS subscales exceeded .70. The dimensions of each scale highlight areas of clinical and research concern.
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Mlili NE, Ahabrach H, Cauli O. Hair Cortisol Concentration as a Biomarker of Symptoms of Depression in the Perinatal Period. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2023; 22:71-83. [PMID: 35297354 DOI: 10.2174/1871527321666220316122605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/20/2021] [Accepted: 12/29/2021] [Indexed: 12/16/2022]
Abstract
Pregnancy is a sensitive period when women experience major hormonal and psychological changes. A high prevalence of the symptoms of depression and manifested major depression rates have been reported during this period, leading to negative outcomes both for mothers and the offspring. Despite its prevalence, the aetiology of depression is not yet fully understood. Nonetheless, alterations in cortisol levels have been proposed as a reliable biomarker to identify pregnant women at risk of perinatal depression. Hair cortisol has recently been extensively used in bio-psychological studies as a suitable non-invasive biomarker for several neuropsychiatric disorders. Various studies have published evidence regarding the relationship between cortisol fluctuations during the perinatal period, measured both in hair and in other substrates, and the onset of perinatal symptoms of depression. This current review provides an overview of cortisol level changes measured in women's hair during pregnancy or the postpartum period and its association with perinatal symptoms of depression. Further studies, including repetitive measurement of both hair cortisol and depression throughout the prenatal period, must be performed to clarify the relationship between cortisol levels and perinatal symptoms of depression.
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Affiliation(s)
- Nisrin El Mlili
- Institut Supérieur des Professions Infirmières et Techniques de Santé (ISPITS), Tetouan, Morocco
- Department of Physiology and Physiopathology, Faculty of Sciences, University Abdelmalek Essâadi, Tetouan, Morocco
| | - Hanan Ahabrach
- Institut Supérieur des Professions Infirmières et Techniques de Santé (ISPITS), Tetouan, Morocco
- Department of Physiology and Physiopathology, Faculty of Sciences, University Abdelmalek Essâadi, Tetouan, Morocco
| | - Omar Cauli
- Department of Nursing, University of Valencia, Valencia 46010, Spain
- Frailty and Cognitive Impairment Group (FROG), University of Valencia, Valencia 46010, Spain
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Goyal D, Han M, Feldman-Schwartz T, Le HN. Perinatal Experiences of Asian American Women During COVID-19. MCN Am J Matern Child Nurs 2022; 47:71-76. [PMID: 34845174 PMCID: PMC8865031 DOI: 10.1097/nmc.0000000000000796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To explore the wellbeing, pregnancy, childbirth, and postpartum experiences of Asian American women who gave birth during the COVID-19 pandemic. STUDY DESIGN Qualitative exploratory design. METHODS Using convenience and snowball sampling, we recruited Asian American women who gave birth during the COVID-19 pandemic via social media. Participants completed sociodemographic and depressive symptom questionnaires and took part in a virtual semistructured interview where they were asked to describe their pregnancy, birth, and postpartum experiences in the midst of the COVID-19 pandemic. Qualitative content analysis methods were used to identify themes from participant narratives. RESULTS Thirty-eight Asian American women representing several racial ethnic subgroups (Asian Indian, Chinese, Filipino, Hmong, Laotian, Vietnamese) participated in our study. Participants were on average 34 (SD = 3.5) years of age; the majority were married and lived in California. At the time of data collection, participants were 3.7 (SD = 2.07) months postpartum and 5.3 to 10.5 months into the COVID-19 pandemic. Qualitative content analysis revealed two main themes: 1) unexpected perinatal journey, and 2) the emotional and psychological consequences of COVID-19. CLINICAL IMPLICATIONS Our findings are not unique to Asian American women, but they offer insight for nurses taking care of all childbearing women. Nurses can provide individually tailored anticipatory guidance to help women navigate perinatal changes and manage expectations during future public health crises. Nurses can also encourage and help perinatal women identify ways to increase their own social support networks during the pregnancy and postpartum period.
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Xin W. Lack of alternative: Chinese first-time mothers’ construction of social support network of online secondary groups. Digit Health 2022; 8:20552076221129062. [PMID: 36199543 PMCID: PMC9527985 DOI: 10.1177/20552076221129062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 09/09/2022] [Indexed: 11/26/2022] Open
Abstract
Background As a result of rapid modernization and the long-term implementation of One Child Policy, Chinese first-time mothers’ primary child-raising social support network is gradually shrinking. At the same time, the social support system for child raising is still very incomplete. Therefore, Chinese first-time mothers generally face great pressure. Objective This paper aims to understand Chinese first-time mothers’ construction of social support network of online secondary groups. Methods This paper employs a qualitative research method, with semi-structured interviews with 23 participants, two focus groups and observations conducted in nine online child-raising communities. Results Based on the principle of instrumental rationality first-time mothers use various strategies to join different types of online communities and their online social support network is always the dynamic changing. The online social support network is a supplementary channel in which first-time mothers can obtain both instrumental and emotional support. But communication risks and ethical issues remain, such as information exchange interfered by commercial capital, widespread anxiety and superficial social relationships. Conclusions Online social support network is an alternative for Chinese first-time mothers and they urgently need a more well-rounded social support network system with government leading and multiple subjects participating in it.
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Affiliation(s)
- Wenjuan Xin
- A School of Journalism and Communication, Sichuan International Studies University, Chongqing, China
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8
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Trends of Perinatal Stress, Anxiety, and Depression and Their Prediction on Postpartum Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179307. [PMID: 34501906 PMCID: PMC8431252 DOI: 10.3390/ijerph18179307] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/25/2021] [Accepted: 08/30/2021] [Indexed: 01/22/2023]
Abstract
Perinatal stress, anxiety, and depression impacts not only women but also their child(ren). The purpose of this longitudinal study is to explore trends of stress, anxiety, and depressive symptoms from pregnancy to postpartum and understand predictions of stress and anxiety on postpartum depression. One-hundred-fifty-six women at 23-28 weeks gestation (T1), 147 at 32-36 weeks gestation (T2), 129 at over 36 weeks gestation (T3), and 83 at postpartum (T4) completed study surveys. The Perceived Stress Scale, Center for Epidemiologic Studies Depression scale, and State-Trait Anxiety Inventory were used to measure stress, depressive symptoms, and anxiety. Descriptive statistics, Pearson and Spearman's correlation, and Generalized Estimating Equation were applied to analyze the data. Results showed that levels of anxiety and depressive symptoms increased from 24 weeks gestation to postpartum, whereas stress levels decreased during pregnancy but increased in postpartum. Over half of women experienced anxiety symptoms, especially during late pregnancy and postpartum. Stress, anxiety, and depressive symptoms were inter-correlated. Notably, women at late pregnancy and postpartum were prone to stress, anxiety, and depression. Prenatal anxiety could predict postpartum depressive symptoms. Active assessment and management of stress, anxiety, and depression is needed and should begin from early pregnancy and continue until postpartum.
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Slomian J, Reginster JY, Emonts P, Bruyère O. Identifying maternal needs following childbirth: comparison between pregnant women and recent mothers. BMC Pregnancy Childbirth 2021; 21:405. [PMID: 34049520 PMCID: PMC8161655 DOI: 10.1186/s12884-021-03858-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 05/05/2021] [Indexed: 11/10/2022] Open
Abstract
Background The postnatal period is associated with new needs for mothers. Four categories of needs were highlighted in a previous study: for information, for psychological support, for the sharing of experiences and for practical and material support. To ensure that these four needs are inherent to the postpartum period, the aims of this study is to examine these needs by comparing recent mothers’ needs with the needs of pregnant women. Methods The 4 needs previously identified were cross-sectionally investigated by online self-reported questionnaires completed by women in their last trimester of pregnancy and by mothers who had a child between 0 and 6 months of age. Results The 4 needs were largely present during the postpartum period. The need for information seemed to be more present during pregnancy (92.4 %) than during the postpartum period (84.6 %, p = 0.03), but women used the Internet significantly more often to search for information after childbirth (54.8 %) than during pregnancy (41.2 %, p < 0.0001). The needs for psychological support and to share experiences seemed to be closely linked. Even if the global satisfaction with psychological support was fairly high, it weakened after childbirth (p < 0.05). Feelings of loneliness (p < 0.0001) and depression scores (p = 0.01) were also higher during the postpartum period than during pregnancy. Finally, the need for practical support was also more pronounced during the postpartum period than during pregnancy (p = 0.01). Conclusions All mothers seem to meet the 4 identified needs during the postpartum period but at different levels of intensity. Trying to meet these needs could offer an opportunity to improve mothers’ quality of life.
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Affiliation(s)
- Justine Slomian
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Quartier Hôpital, Avenue Hippocrate 13, Bât. B23, 4000, Liège, Belgium.
| | - Jean-Yves Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Quartier Hôpital, Avenue Hippocrate 13, Bât. B23, 4000, Liège, Belgium
| | - Patrick Emonts
- Division and Head of the Public Health Department, Bone and Cartilage metabolism Department, CHU Liège, Quai Godefroid Kurth 45, 4000, Liège, Belgium.
| | - Olivier Bruyère
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Quartier Hôpital, Avenue Hippocrate 13, Bât. B23, 4000, Liège, Belgium.,Division and Head of the Public Health Department, Bone and Cartilage metabolism Department, CHU Liège, Quai Godefroid Kurth 45, 4000, Liège, Belgium.,Division of Public Health, Epidemiology and Health Economics, University of Liège, Avenue Hippocrate 13, Bât. B23, 4000, Liège, Belgium
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Eslahi Z, Alimoradi Z, Bahrami N, Lin CY, Griffiths MD, Pakpour AH. Psychometric properties of Postpartum Partner Support Scale-Persian version. Nurs Open 2021; 8:1688-1695. [PMID: 33608977 PMCID: PMC8186706 DOI: 10.1002/nop2.806] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/30/2020] [Accepted: 01/29/2021] [Indexed: 11/18/2022] Open
Abstract
Aim The aim of the present study was to translate the Postpartum Partner Support Scale (PPSS) into Persian and evaluate its psychometric properties among postpartum women. Design A total of 248 women aged 18–39 years participated in this psychometric study. The PPSS was translated into Persian using a forward‐backward method. Confirmatory factor analysis (CFA) and Rasch model analysis were used to assess the psychometric properties of the PPSS. In addition, the Edinburgh Postpartum Depression Scale (EPDS) was completed simultaneously to assess the construct validity. Internal consistency of the questionnaire was assessed by calculating the Cronbach's alpha coefficient and corrected item‐total correlation. Results The unidimensionality of the PPSS was supported in both CFA and Rasch analysis. The PPSS had a significant negative association with EPDS (r = −0.39 p < .001). The scale had excellent internal consistency (Cronbach's alpha = 0.94) and the correlation between items and total score was satisfactory. Conclusion The Persian version of PPSS with 20 items is a valid and reliable scale to assess postpartum support.
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Affiliation(s)
- Zahra Eslahi
- Students Research Committee, School of Nursing & Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Zainab Alimoradi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Nasim Bahrami
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, Hong Kong.,Institute of Allied Health Sciences and Departments of Occupational Therapy and Public Health, National Cheng Kung University Hospital, College of Medicine Taiwan, National Cheng Kung University, Tainan, Taiwan
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.,Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Slomian J, Honvo G, Emonts P, Reginster JY, Bruyère O. Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes. ACTA ACUST UNITED AC 2020; 15:1745506519844044. [PMID: 31035856 PMCID: PMC6492376 DOI: 10.1177/1745506519844044] [Citation(s) in RCA: 410] [Impact Index Per Article: 102.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction: The postpartum period represents the time of risk for the emergence of
maternal postpartum depression. There are no systematic reviews of the
overall maternal outcomes of maternal postpartum depression. The aim of this
study was to evaluate both the infant and the maternal consequences of
untreated maternal postpartum depression. Methods: We searched for studies published between 1 January 2005 and 17 August 2016,
using the following databases: MEDLINE via Ovid, PsycINFO, and the Cochrane
Pregnancy and Childbirth Group trials registry. Results: A total of 122 studies (out of 3712 references retrieved from bibliographic
databases) were included in this systematic review. The results of the
studies were synthetized into three categories: (a) the maternal
consequences of postpartum depression, including physical health,
psychological health, relationship, and risky behaviors; (b) the infant
consequences of postpartum depression, including anthropometry, physical
health, sleep, and motor, cognitive, language, emotional, social, and
behavioral development; and (c) mother–child interactions, including
bonding, breastfeeding, and the maternal role. Discussion: The results suggest that postpartum depression creates an environment that is
not conducive to the personal development of mothers or the optimal
development of a child. It therefore seems important to detect and treat
depression during the postnatal period as early as possible to avoid harmful
consequences.
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Affiliation(s)
- Justine Slomian
- 1 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Germain Honvo
- 1 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Patrick Emonts
- 2 Department of Obstetrics and Gynaecology, CHU Liège, Liège, Belgium
| | - Jean-Yves Reginster
- 1 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Olivier Bruyère
- 1 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.,3 Department of Sport Science, University of Liège, Liège, Belgium
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Chinese American Women's Experiences with Postpartum Depressive Symptoms and Mental Health Help-Seeking Behaviors. MCN Am J Matern Child Nurs 2019; 44:144-149. [PMID: 31033585 DOI: 10.1097/nmc.0000000000000518] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE The objective of this study was to explore the perspectives of postpartum depression (PPD) and mental health help-seeking behaviors among Chinese American women. STUDY DESIGN AND METHODS Using a qualitative design, Chinese American women, who had given birth in the past year, participated in a semistructured interview (English or Mandarin). Depressive symptoms and mental health services questionnaires were also conducted. RESULTS All 15 participants were married and between 29 and 39 years of age. Content analysis revealed two main themes including culture-specific postpartum traditions and mental health help-seeking. Nine reported sadness or PPD symptoms, including three who scored above the cutoff of the Edinburgh Postnatal Depression Scale (EPDS score ≥9) for risk of PPD and others who disclosed such information during the interview. Many women shared that they experienced postpartum depressive symptoms, but some did not believe depression was applicable to Chinese women. CLINICAL IMPLICATIONS Healthcare professionals working with Chinese American women must be aware of culture-specific childbearing traditions to promote maternal-infant well-being outcomes.
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Huang MZ, Kao CH, Lin KC, Hwang JL, Puthussery S, Gau ML. Psychological health of women who have conceived using assisted reproductive technology in Taiwan: findings from a longitudinal study. BMC WOMENS HEALTH 2019; 19:97. [PMID: 31299964 PMCID: PMC6626344 DOI: 10.1186/s12905-019-0801-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 07/08/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Despite the increasing use of Assisted Reproductive Technology (ART) and the significant physical and emotional commitments that these treatments and procedures involve, only limited evidence exists regarding the psychological health of women who undergo ART. This study investigated the changes over time in the psychological health of women who have conceived using ART during the first, second, and third trimesters of pregnancy and during the postpartum period in Taiwan. METHODS A quantitative longitudinal study was conducted at a fertility centre in Taiwan. 158 pregnant women who had conceived using ART completed a web-based questionnaire that included the following instruments: State Anxiety Inventory, Edinburgh Postnatal Depression Scale, Modified Maternal Foetal Attachment Scale, Pregnancy Stress Rating Scale, Maternity Social Support Scale, Intimate Bond Measure, and Parenting Stress Index. The data were collected the first (9-12 weeks), second (19-22 weeks), third (28-31 weeks) trimesters of pregnancy and at 7-10 weeks postpartum. RESULTS Levels of anxiety and depression, which are both key indicators of psychological health, were highest during the first trimester, with scores of 42.30 ± 11.11 and 8.43 ± 4.44, respectively. After the first trimester, anxiety scores decreased and remained stable through the remainder of pregnancy, with scores of 38.03 ± 10.58 in the second and 38.39 ± 10.36 in the third trimester, but increased at two-months postpartum, attaining a score of 41.18 ± 11.68. Further, depression scores showed a similar pattern, declining to a mean of 7.21 ± 4.23 in the second and 6.99 ± 4.11 in the third trimester and then increasing to 8.39 ± 5.25 at two-months postpartum. Pregnancy stress and social support were found to be the most important predictors of change in psychological health during pregnancy and the postpartum period. CONCLUSION Psychological health was found to be poorest during the first trimester and at two-months postpartum. Moreover, pregnancy stress and social support were identified as key predictors of change in psychological health. The findings indicate a need for increased sensitivity among healthcare professionals to the psychological vulnerability of women who have conceived using ART as well as a need to introduce tailored interventions to provide appropriate psychological support to these women.
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Affiliation(s)
- Mei-Zen Huang
- Department of Nursing, National Tainan Junior College of Nursing, 78, Sec.2 Minzu Rd, Tainan City, Taiwan
| | - Chien-Huei Kao
- Department of Midwifery and Women Health Care, National Taipei University of Nursing and Health Sciences, 365, Ming-Te Road, Peitou, Taipei, Taiwan
| | - Kuan-Chia Lin
- Institute of Hospital and Health Care Administration, National Yang-Ming University, 155, Sec. 2, Linong Street, Taipei, Taiwan
| | - Jiann-Loung Hwang
- Department of Obstetrics and Gynecology, Taipei Medical University, 250, Wuxing Street, Taipei, Taiwan
| | - Shuby Puthussery
- School of Health Care Practice & Institute for Health Research, University of Bedfordshire, Putteridge Bury, Hitchin Road, Luton, Bedfordshire, LU2 8LE, UK
| | - Meei-Ling Gau
- Department of Midwifery and Women Health Care, National Taipei University of Nursing and Health Sciences, 365, Ming-Te Road, Peitou, Taipei, Taiwan.
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14
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Kofman YB, Eng ZE, Busse D, Godkin S, Campos B, Sandman CA, Wing D, Yim IS. Cortisol reactivity and depressive symptoms in pregnancy: The moderating role of perceived social support and neuroticism. Biol Psychol 2019; 147:107656. [PMID: 30703466 DOI: 10.1016/j.biopsycho.2019.01.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 01/09/2019] [Accepted: 01/26/2019] [Indexed: 01/17/2023]
Abstract
Perinatal depression negatively impacts mother-infant health and well-being. Previous work has linked cortisol reactivity to perinatal depressive symptoms, but moderating effects including social support and neuroticism, have not been studied. Forty-nine pregnant women (9-30 weeks' gestational age; GA) provided saliva samples in response to the Trier Social Stress Test (TSST) and to awakening (cortisol awakening response, CAR), and completed questionnaires on perceived social support, personality, and depressive symptoms. Two hierarchical logistic regressions, one including the TSST response and one including the CAR as predictor variables, suggest that cortisol reactivity, social support from the baby's father, and neuroticism contribute to depressive symptoms, controlling for GA (both p < .01). Significant statistical interactions among predictors of pregnancy depressive symptoms were, however, only found in the model using the CAR. Findings highlight the importance of considering biopsychosocial interactions in studies predicting perinatal depressive symptoms.
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Affiliation(s)
- Yasmin B Kofman
- Department of Psychological Science, University of California, Irvine, 4562 Social and Behavioral Sciences Gateway, Irvine, CA 92697-7085, USA
| | - Zoe E Eng
- Department of Psychological Science, University of California, Irvine, 4562 Social and Behavioral Sciences Gateway, Irvine, CA 92697-7085, USA
| | - David Busse
- Department of Psychological Science, University of California, Irvine, 4562 Social and Behavioral Sciences Gateway, Irvine, CA 92697-7085, USA
| | - Sophia Godkin
- Department of Psychological Science, University of California, Irvine, 4562 Social and Behavioral Sciences Gateway, Irvine, CA 92697-7085, USA
| | - Belinda Campos
- Department of Chicano and Latino Studies, University of California, Irvine, 3151 Social Science Plaza, Irvine, CA 92697-5100, USA
| | - Curt A Sandman
- Department of Psychiatry and Human Behavior, University of California, Early Human and Lifespan Development Program, 1 University Drive, Orange, CA 92866, USA
| | - Deborah Wing
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of California, Irvine, 333 City Blvd. West, Suite 1400, Orange CA 92868, USA
| | - Ilona S Yim
- Department of Psychological Science, University of California, Irvine, 4562 Social and Behavioral Sciences Gateway, Irvine, CA 92697-7085, USA.
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Ziabakhsh S, Fernandez R, Black B, Brito G. Voices of Postpartum Women: Exploring Canadian Women's Experiences of Inpatient Postpartum Care. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2018; 40:1424-1436. [PMID: 30473119 DOI: 10.1016/j.jogc.2018.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 03/12/2018] [Accepted: 03/13/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To explore and understand postpartum inpatient experiences in a Canadian context. METHODS Inpatients at BC Women's Hospital & Health Centre were invited to complete a questionnaire during their postpartum stay. Completed responses were obtained from 178 women, representing 44% of all postpartum inpatients during the survey period. RESULTS Overall, women had positive experiences during their postpartum stay: 93% rated their experience as "excellent" or "very good"; 78% felt that nurses never seemed rushed or too busy to care for them; and 85% of women found the nurses to be very helpful with breastfeeding. Two-thirds of the women had concerns about going home that were related to infant feeding, feeling overwhelmed, and not knowing how to settle their baby. Other areas of improvement pertained to the hospital environment being less restful than desired. Certain groups needed additional support, such as primiparous women, women who had Caesarean deliveries, and women from certain ethnic groups. CONCLUSION This exploration of women's inpatient postpartum experiences in a Canadian hospital provides valuable information for improving service delivery, including assessing hospital routines, providing information/education, and improving discharge planning. Given that postpartum experiences are not uniform across demographic groups, an alternative or augmented approach to postpartum care may be warranted for some women.
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Affiliation(s)
| | | | | | - Gail Brito
- BC Women's Hospital & Health Centre, Vancouver, BC
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Ding G, Tian Y, Yu J, Vinturache A. Cultural postpartum practices of ‘doing the month’ in China. Perspect Public Health 2018; 138:147-149. [DOI: 10.1177/1757913918763285] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Ying Tian
- Shanghai Jiao Tong University School of Medicine
| | - Jing Yu
- Shanghai Jiao Tong University Affiliated Sixth People’s Hospital
| | - Angela Vinturache
- Department of Obstetrics & Gynaecology, John Radcliffe Hospital, Oxford
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Hajimiri K, Shakibazadeh E, Mehrizi AAH, Shabbidar S, Sadeghi R. The impact of general health and social support on health promoting lifestyle in the first year postpartum: the structural equation modelling. Electron Physician 2018; 10:6231-6239. [PMID: 29588825 PMCID: PMC5853999 DOI: 10.19082/6231] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Accepted: 07/28/2017] [Indexed: 01/19/2023] Open
Abstract
Background and aim Postpartum is a critical period for mothers which often leads to neglect of their own health. Mothers’ new responsibilities may affect their health promoting lifestyle (HPL). The aim of this study was to determine the impact of both general health and social support on health-promoting lifestyle. Methods A cross-sectional survey was conducted on 310 women who gave birth over a one-year period in Zanjan (Iran), 2016. A proportionate stratified random sampling technique was used to select respondents from each stratum. Health-promoting lifestyle was assessed using the health-promoting lifestyle profile II (HPLP II) scale. A structure equation model (SEM) was used to determine the relationship between observed and latent variables. Data were analysed using SPSS version 22 and LISREL 8.5 software. Results The age of 42.6% of the participants was more than 30 years and 40.3% of them had an academic education. The mean score of the health-promoting lifestyle was 131.28 (15.37). The structural equation model fitted well with RMSEA =0.07, CFI=0.92, and GFI=0.94. Among the latent factors, general health, with a factor load of −0.68, had greater impact on health-promoting lifestyle than social support. Moreover, there was a significant correlation (−0.63) between general health and perceived social support in the postpartum period. Conclusion health-promoting lifestyle was not at appropriate levels among women in the first year after delivery. These findings suggest that strengthening general health and social support would improve a health-promoting lifestyle in Iranian postpartum women.
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Affiliation(s)
- Khadijeh Hajimiri
- Ph.D. Candidate of Health Education and Promotion, Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Ph.D. of Health Education, Associate Professor, Department of Health Education and Health Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Asghar Haeri Mehrizi
- M.Sc. of Statistics, Faculty Member, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Sakineh Shabbidar
- Ph.D. of Nutritional Sciences, Assistant Professor, Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sadeghi
- Ph.D. of Health Education, Associate Professor, Department of Health Education and Health Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Yeh YC, St John W, Chuang YH, Huang YP. The care needs of postpartum women taking their first time of doing the month: a qualitative study. Contemp Nurse 2017; 53:576-588. [PMID: 28992751 DOI: 10.1080/10376178.2017.1389615] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND In contemporary Taiwan, after giving birth, many women undertake a traditional postpartum practice called 'doing the month', which occurs in the medical context of postpartum nursing centres instead of at home. Thus, healthcare workers must identify and address the care needs of new mothers in this setting to improve the care of new mothers and their baby and family. AIM To explore new mothers' care needs from their own perspectives during the period of doing the month. METHODS A qualitative study was performed. Eligible participants recruited through purposive sampling were interviewed comprehensively. RESULTS Twenty-seven primiparous women participated (mean age: 32 years; mean marriage length: 3.4 years). Four themes were identified: the need to increase energy to gain more yang force, the need to internalise mothering, the need to be supported by the family and friends, and the need to be understood. CONCLUSIONS For effective care, sufficient support and guidance must be provided to first-time mothers and their families, especially when mother-baby rooming-in is the standard of care.
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Affiliation(s)
- Yueh-Chen Yeh
- a Department of Nursing , College of Health, National Taichung University of Science and Technology , 193 San-Min Road, Sec. 1, Taichung City 40343 , Taiwan (ROC)
| | - Winsome St John
- b School of Nursing and Midwifery , Griffith University , Queensland 4222 , Australia
| | - Yeu-Hui Chuang
- c School of Nursing, College of Nursing , Taipei Medial University , 250, Wu-Xing St., Taipei , 110 , Taiwan (ROC)
| | - Yu-Ping Huang
- d School of Nursing , National Quemoy University , No.1, Dasyue Rd., Jinning Township , Kinmen County 89250 , Taiwan (ROC)
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Use of Traditional Birth Practices by Chinese Women in the United States. MCN Am J Matern Child Nurs 2017; 42:153-159. [DOI: 10.1097/nmc.0000000000000326] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fellmeth G, Fazel M, Plugge E. Migration and perinatal mental health in women from low- and middle-income countries: a systematic review and meta-analysis. BJOG 2017; 124:742-752. [PMID: 27320110 DOI: 10.1111/1471-0528.14184] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND Migrant women are at risk of perinatal mental disorders due to stressors experienced before, during and after migration. OBJECTIVES This systematic review and meta-analysis summarises the prevalence, associated factors and interventions for perinatal mental disorders in migrant women from low- and middle-income countries (LMIC). SEARCH STRATEGY We systematically searched nine electronic databases and the grey literature using a predefined search strategy. SELECTION CRITERIA Studies were included if they assessed pregnant or postpartum migrants from LMIC, used a structured tool and a case-control, cross-sectional, cohort or intervention study design. DATA COLLECTION AND ANALYSIS Data was double-extracted. We calculated pooled prevalence of depression and weighted mean anxiety and depression scores. We calculated crude odds ratios from risk factor studies and summarised intervention studies descriptively. MAIN RESULTS Forty studies were identified from 10 123 references. Pooled prevalence was 31% [95% condidence interval (CI) 23%-40%] for any depressive disorder and 17% (95% CI 12-23%) for major depressive disorder. Previous depression and lower social support were associated with perinatal depression. There were insufficient data to assess the burden of anxiety, post-traumatic stress disorder or psychosis in this population. CONCLUSIONS One in three migrant women from LMIC experiences symptoms of perinatal depression. Social support is an important protective factor. Evidence on LMIC women relocating to other LMIC is lacking. Given the adverse consequences of perinatal mental illness on women and their children, further research in low-resource settings is a priority. TWEETABLE ABSTRACT One in three migrant women from low- and middle-income countries has symptoms of perinatal depression.
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Affiliation(s)
- G Fellmeth
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - M Fazel
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - E Plugge
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
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Phang KN, Koh SSL, Chen HC. Postpartum social support of women in Singapore: A pilot study. Int J Nurs Pract 2016; 21 Suppl 2:99-107. [PMID: 26125577 DOI: 10.1111/ijn.12340] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This pilot study aimed to identify the levels of support expected and received by postpartum women in Singapore. Another objective was to compare the different subdomains of social support. A descriptive design was adopted using a self-administered questionnaire comprising demographics and the Postpartum Support Questionnaire. The study took place at a subsidized obstetrics and gynaecology clinic at a restructured hospital in Singapore from the end of December 2009 to the end of February 2010. The 25 participants were 6 to 8 weeks postpartum and had delivered healthy term infants. They were recruited via convenience sampling. Data were analysed using descriptive statistics and inferential statistics. The overall support needs of the participants were met. Only their informational support needs were unmet. Assessing the needs of postpartum women and teaching them how to convey and manage expectations are recommended initiatives for health-care practitioners to consider.
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Affiliation(s)
- Koh Ni Phang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Serena Siew Lin Koh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Hui-Chen Chen
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Wan SX, Li HL, Wang W, Shen Q, Li CH, Lyon ME, Kelly BC, Wang J. Psychometric properties of the Postpartum Women Health Quotient Scale among Chinese post partum women. Midwifery 2016; 39:63-70. [PMID: 27321722 DOI: 10.1016/j.midw.2016.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 03/19/2016] [Accepted: 04/09/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE to examine the psychometric properties of a newly developed Postpartum Women's Health Quotient Scale (PWHQS) for Chinese post partum women. DESIGN a cross-sectional survey of post partum women was conducted.Categorical confirmatory factor analysis (CCFA) models were applied to examine the factorial structure of the PWHQS; test information function (TIF) was used to examine reliability of PWHQS subscales; and measurement invariance was examined by testing differential item functioning (DIF) using a multiple indicators multiple causes (MIMIC) model. SETTING two large hospitals with a level 3A designation in Suzhou, Jiangsu Province, China. PARTICIPANTS a convenience sample of 395 post partum women was recruited from April to September 2014. MEASUREMENT the PWHQS consists of 31 items with 5 subscales: health consciousness (HC, 6 items), maternal health knowledge (MHK, 8 items), infant health knowledge (IHK, 6 items), maternal health care ability (MHCA, 5 items), and infant health care ability (IHCA, 6 items). FINDINGS PWHQS has a valid factorial structure with five dimensions as theoretically designed. Each of its subscales has adequate reliability that is particularly high over the lower-moderate range of the factor score scale. Measurement non-invariance in PWHQS is very limited as only two of the 31 items displayed DIF related to one grouping variable (Age). KEY CONCLUSION PWHQS is a valid and reliable instrument that can be readily used as a screening tool to assess health quotient (HQ) among Chinese post partum women. PWHQS will also be useful for the development of interventions to help post partum women maintain and improve maternal and infant health. Further research to confirm the findings of the present study is desirable.
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Affiliation(s)
- Shen-Xian Wan
- The First Affiliated Hospital of Soochow University, No.188 Shizi Street, Suzhou 215006, China; School of Nursing, Soochow University, No.1 Shizi Street, Suzhou 215006, China
| | - Hui-Ling Li
- The First Affiliated Hospital of Soochow University, No.188 Shizi Street, Suzhou 215006, China; School of Nursing, Soochow University, No.1 Shizi Street, Suzhou 215006, China.
| | - Wei Wang
- The First Affiliated Hospital of Soochow University, No.188 Shizi Street, Suzhou 215006, China
| | - Qian Shen
- The First Affiliated Hospital of Soochow University, No.188 Shizi Street, Suzhou 215006, China
| | - Chun-Hui Li
- School of Nursing, Soochow University, No.1 Shizi Street, Suzhou 215006, China
| | - Maureen E Lyon
- Center for Transitional Sciences, Children's National Health System, 111 Michigan Ave., N.W., Washington, DC 20010, USA; School of Medicine and Health Sciences, George Washington University, 2121 I Street, N.W., Washington, DC 20052, USA
| | - Brian C Kelly
- Department of Sociology and Anthropology, Purdue University, 101 N. Grant St., West Lafayette, IN 47907, USA
| | - Jichuan Wang
- Center for Transitional Sciences, Children's National Health System, 111 Michigan Ave., N.W., Washington, DC 20010, USA; Epidemiology and Biostatistics Department, George Washington University, 2121 I Street, N.W., Washington, DC 20052, USA
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Liou SR, Wang P, Cheng CY. Effects of prenatal maternal mental distress on birth outcomes. Women Birth 2016; 29:376-80. [PMID: 27079210 DOI: 10.1016/j.wombi.2016.03.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 02/18/2016] [Accepted: 03/29/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Adverse effects of maternal mental distress during pregnancy have been extensively investigated, but the impact of prenatal maternal mental distress at various time periods during pregnancy on birth outcomes is rarely discussed. By understanding the relationship between maternal mental distress and unfavourable birth outcomes throughout pregnancy, appropriate evidence-based preventative care or intervention may be adopted in a timely manner. AIM This study intended to investigate the effects of maternal stress, anxiety, and depressive symptoms across pregnancy on preterm birth and low birth weight. METHODS With a prospective longitudinal design, this study used the 10-item Perceived Stress Scale, Center for Epidemiologic Studies Depression Scale, and Zung Self-reported Anxiety Scale to investigate 197 participants who, at greater than 24 gestational weeks, completed the self-administered questionnaires during regular checkups in a hospital in southern Taiwan. Descriptive statistics, Mann-Whitney U test/Kruskal-Wallis test, and hierarchical logistic regression were applied for data analysis. FINDINGS The study found that anxiety and depressive symptoms at 25-29 gestational weeks could predict preterm birth, and that anxiety at greater than 30 gestational weeks was able to predict low birthweight. However, stress was not able to predict any kind of negative birth outcomes. CONCLUSION Adverse birth outcomes were somewhat predictable by maternal mental distress; therefore, we suggested that prenatal visits incorporate psychological assessment for early detection and management to prevent possible adverse birth outcomes.
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Affiliation(s)
- Shwu-Ru Liou
- College of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Taiwan
| | - Panchalli Wang
- Department of Obstetrics and Gynecology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Taiwan
| | - Ching-Yu Cheng
- College of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Taiwan.
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Lee A, Brann L. Influence of Cultural Beliefs on Infant Feeding, Postpartum and Childcare Practices among Chinese-American Mothers in New York City. J Community Health 2016; 40:476-83. [PMID: 25331609 DOI: 10.1007/s10900-014-9959-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
As one of the fastest growing communities in the United States, Chinese-Americans receive relatively little research attention on their rates of breastfeeding versus formula feeding, and what factors influence that choice. This research aims to examine the influence of elders and cultural beliefs on postpartum, infant feeding, and childcare practices. Semi-structured interviews with 22 recently postpartum mothers who met the recruiting criteria were conducted between July 2012 and February 2013. The traditional postpartum practice, zuo yuezi, presented negative physical and emotional outcomes and maternal reporting of delay in lactation. Early introduction of solids for traditional reasons was reported. The support from husbands and elders were necessary for breastfeeding success, while some mothers had to first negotiate with elders for breastfeeding. The practice of sending infants back to China to be taken care of by extended families presented cultural implications related to grandparents' involvement in raising grandchildren. With the respect and appreciation for elders and traditions, it is likely that Chinese mothers negotiate between cultural traditions and societal expectation in the western home.
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Affiliation(s)
- Adele Lee
- Nutrition Program, Department of Public Health, Food Studies and Nutrition, Syracuse University, 426 Ostrom Avenue, Syracuse, NY, 13244, USA,
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Factors Associated with Post-Traumatic Symptoms in Mothers of Preterm Infants. Arch Psychiatr Nurs 2016; 30:96-101. [PMID: 26804509 DOI: 10.1016/j.apnu.2015.08.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 08/24/2015] [Accepted: 08/25/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Symptoms of post-traumatic distress in mothers of preterm infants have been a subject of mental health research. The aim of this study was to assess the prevalence of and risk factors associated with such symptoms in mothers of preterm infants in Taiwan. METHODS This was a cross-sectional study performed between January 1, 2010 and June 30, 2011. One hundred and two mothers of preterm infants born at less than 37 weeks gestation and with a subsequent neonatal intensive care unit (NICU) stay between 2005 and 2009 were recruited. Participants completed a demographic questionnaire, the Impact of Event Scale-Revised (IES-R), the Center for Epidemiologic Studies Depression Scale (CES-D) and the neuroticism subscale of the Maudsley Personality Inventory (MPI). The preterm infants' data were taken from medical records. RESULTS The prevalence of symptoms of distress was 25.5% (26/102) in the participants. These symptoms were associated with previous miscarriages, preterm premature rupture of membranes, neurotic personality and depression. CONCLUSIONS The experience of preterm birth and NICU hospitalization can be traumatic to mothers. Early support for mothers during the preterm infants' NICU stay and transition to home care are recommended.
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Abstract
This study examines the direct and moderating effects of emotional intelligence on postpartum depression (PPD), while taking into account social support and stressful life events. Using a prospective cohort design, 165 women were surveyed in their third trimester and again at 9 weeks postpartum. Results support the direct effects of emotional intelligence (β = -.20, p = .01), social support (β = -.17, p = .04), and stressful life events (β = .17, p = .04) on PPD. Moderating effects are also supported with significant effects on PPD: stressful life events × emotional intelligence (β = -.17, p = .04) and stressful life events × social support (β = -.21, p = .01).
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Song J, Kim T, Ahn J. A Systematic Review of Psychosocial Interventions for Women with Postpartum Stress. J Obstet Gynecol Neonatal Nurs 2015; 44:183-92. [DOI: 10.1111/1552-6909.12541] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Yim IS, Tanner Stapleton LR, Guardino CM, Hahn-Holbrook J, Dunkel Schetter C. Biological and psychosocial predictors of postpartum depression: systematic review and call for integration. Annu Rev Clin Psychol 2015; 11:99-137. [PMID: 25822344 PMCID: PMC5659274 DOI: 10.1146/annurev-clinpsy-101414-020426] [Citation(s) in RCA: 369] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Postpartum depression (PPD) adversely affects the health and well being of many new mothers, their infants, and their families. A comprehensive understanding of biopsychosocial precursors to PPD is needed to solidify the current evidence base for best practices in translation. We conducted a systematic review of research published from 2000 through 2013 on biological and psychosocial factors associated with PPD and postpartum depressive symptoms. Two hundred fourteen publications based on 199 investigations of 151,651 women in the first postpartum year met inclusion criteria. The biological and psychosocial literatures are largely distinct, and few studies provide integrative analyses. The strongest PPD risk predictors among biological processes are hypothalamic-pituitary-adrenal dysregulation, inflammatory processes, and genetic vulnerabilities. Among psychosocial factors, the strongest predictors are severe life events, some forms of chronic strain, relationship quality, and support from partner and mother. Fully integrated biopsychosocial investigations with large samples are needed to advance our knowledge of PPD etiology.
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Affiliation(s)
- Ilona S Yim
- Department of Psychology and Social Behavior, University of California, Irvine, California 92697;
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Chang HP, Chen JY, Huang YH, Tyan JY, Yeh CJ, Su PH, Chin-Hung Chen V. Prevalence and factors associated with depressive symptoms in mothers with infants or toddlers. Pediatr Neonatol 2014; 55:470-9. [PMID: 24768289 DOI: 10.1016/j.pedneo.2013.12.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 12/05/2013] [Accepted: 12/30/2013] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND The objective of this study is to explore the prevalence of and factors associated with depressive symptoms in mothers with young children. METHODS This is a cross-sectional face-to-face study performed between January 1, 2010 and June 30, 2011. Mothers of premature infants with a gestational age of less than 37 weeks were recruited. Premature infants with any congenital anomaly or severe congenital heart disease were excluded. Controls were mothers of full-term infants with birth weight over 2500 g and without admission to a neonatal intensive care unit. Outcome measures included the Center for Epidemiologic Studies Depression Scale for maternal depressive symptoms, the Family Apgar Index for family support, and the Chinese Maudsley Personality Inventory for personality traits. RESULTS A total of 102 mothers of preterm infants and 111 mothers of full-term infants were recruited. The prevalence of depressive symptoms was 27.7% (59/213) in all mothers of this study, 29.4% (30/102) in mothers of preterm infants, and 26.1% (29/111) in mothers of full-term infants. Predictors of maternal depressive symptoms included the following: extended family structure, lack of postpartum confinement, low family support, and a personality characterized by neuroticism. CONCLUSION Depressive symptoms were common among mothers of young children. Family function and neurotic personality were highly correlated with depressive symptoms in mothers caring for young children. Pediatric health care providers are suggested to screen for maternal depressive symptoms and provide family-oriented support in Taiwan.
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Affiliation(s)
- Hua-Pin Chang
- Institute of Medicine, Chung Shan Medical University, Taiwan; Department of Nursing, Chung Shan Medical University Hospital, Taiwan
| | - Jia-Yuh Chen
- Institute of Medicine, Chung Shan Medical University, Taiwan; Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yen-Hsun Huang
- Department of Psychiatry, Taipei City Hospital, Zhong-Xing Branch, Taipei, Taiwan
| | - Jeng-Yi Tyan
- Institute of Medicine, Chung Shan Medical University, Taiwan
| | - Chih-Jung Yeh
- School of Public Health, Chung Shan Medical University, Taichung, Taiwan; Center for Education and Research on Geriatrics and Gerontology, Chung Shan Medical University, Taichung, Taiwan
| | - Pan-Hua Su
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Vincent Chin-Hung Chen
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Psychiatry, Chung San Medical University Hospital, Taichung, Taiwan.
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Liou SR, Wang P, Cheng CY. Longitudinal study of perinatal maternal stress, depressive symptoms and anxiety. Midwifery 2014; 30:795-801. [DOI: 10.1016/j.midw.2013.11.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 09/17/2013] [Accepted: 11/18/2013] [Indexed: 12/31/2022]
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Liu YQ, Petrini M, Maloni JA. “Doing the month”: Postpartum practices in Chinese women. Nurs Health Sci 2014; 17:5-14. [DOI: 10.1111/nhs.12146] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 03/21/2014] [Accepted: 03/26/2014] [Indexed: 12/16/2022]
Affiliation(s)
- Yan Qun Liu
- HOPE School of Nursing; Wuhan University; Wuchang China
| | | | - Judith A. Maloni
- School of Nursing; Case Western Reserve University; Chagrin Falls OH USA
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Psaila K, Kruske S, Fowler C, Homer C, Schmied V. Smoothing out the transition of care between maternity and child and family health services: perspectives of child and family health nurses and midwives'. BMC Pregnancy Childbirth 2014; 14:151. [PMID: 24766674 PMCID: PMC4016663 DOI: 10.1186/1471-2393-14-151] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Accepted: 04/14/2014] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND In Australia, women who give birth are transitioned from maternity services to child and health services once their baby is born. This horizontal integration of services is known as Transition of Care (ToC). Little is known of the scope and processes of ToC for new mothers and the most effective way to provide continuity of services. The aim of this paper is to explore and describe the ToC between maternity services to CFH services from the perspective of Australian midwives and child and family health (CFH) nurses. METHOD This paper reports findings from phase two of a three phase mixed methods study investigating the feasibility of implementing a national approach to CFH services in Australia (the CHoRUS study). Data were collected through a national survey of midwives (n = 655) and CFH nurses (n = 1098). Issues specifically related to ToC between maternity services and CFH services were examined using descriptive statistics and content analysis of qualitative responses. RESULTS Respondents described the ToC between maternity services and CFH services as problematic. Key problems identified included communication between professionals and services and transfer of client information. Issues related to staff shortages, early maternity discharge, limited interface between private and public health systems and tension around role boundaries were also reported. Midwives and CFH nurses emphasised that these issues were more difficult for families with identified social and emotional health concerns. Strategies identified by respondents to improve ToC included improving electronic transfer of information, regular meetings between maternity and CFH services, and establishment of liaison roles. CONCLUSION Significant problems exist around the ToC for all families but particularly for families with identified risks. Improved ToC will require substantial changes in information transfer processes and in the professional relationships which currently exist between maternity and CFH services.
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Affiliation(s)
- Kim Psaila
- School of Nursing and Midwifery, University of Western Sydney, Sydney, Australia
| | - Sue Kruske
- Director Queensland Centre for Mothers & Babies, The University of Queensland, Brisbane, Queensland, Australia
| | - Cathrine Fowler
- Tresillian Chair for Child & Family Health, Centre for Midwifery, Child & Family Health, Faculty of Nursing, Midwifery & Health, University of Technology Sydney, Australia
| | - Caroline Homer
- Faculty of Nursing, Midwifery & Health, University of Technology Sydney, Sydney, Australia
| | - Virginia Schmied
- School of Nursing and Midwifery & the Family and Community Health Research Group, University of Western Sydney, Sydney, Australia
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Lee TY, Landy CK, Wahoush O, Khanlou N, Liu YC, Li CC. A descriptive phenomenology study of newcomers' experience of maternity care services: Chinese women's perspectives. BMC Health Serv Res 2014; 14:114. [PMID: 24602231 PMCID: PMC3975855 DOI: 10.1186/1472-6963-14-114] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 02/27/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Maternity health care available in Canada is based on the needs of women born in Canada and often lacks the flexibility to meet the needs of immigrant women. The purpose of this study was to explore immigrant Chinese women's experiences in accessing maternity care, the utilization of maternity health services, and the obstacles they perceived in Canada. METHODS This descriptive phenomenology study used in-depth semi-structured interviews to examine immigrant Chinese women's experiences. Fifteen participants were recruited from the Chinese community in Toronto, Canada by using purposive sampling. The interviews were digitally recorded and transcribed verbatim into written Chinese. The transcripts were analyzed using Colaizzi's (1978) phenomenological method. RESULTS Six themes were extracted from the interviews: (1) preference for linguistically and culturally competent healthcare providers, with obstetricians over midwives, (2) strategies to deal with the inconvenience of the Canadian healthcare system (3) multiple resources to obtain pregnancy information, (4) the merits of the Canadian healthcare system, (5) the need for culturally sensitive care, and (6) the emergence of alternative supports and the use of private services. CONCLUSIONS The findings provide new knowledge and understanding of immigrant Chinese women's experiences in accessing maternity health services within a large metropolitan Canadian city. Participants described two unique experiences within the themes: preference for linguistically and culturally competent healthcare providers, with obstetricians over midwives, and the emergence of alternative supports and the use of private services. Few studies of immigrant maternity service access have identified these experiences which may be linked to cultural difference. Further investigation with women from different cultural backgrounds is needed to develop a comprehensive understanding of immigrant women's experiences with maternity care.
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Affiliation(s)
- Tsorng-Yeh Lee
- School of Nursing, York University, #312 HNES Building, 4700 Keele St, Toronto, ON M3J 1P3, Canada.
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Negron R, Martin A, Almog M, Balbierz A, Howell EA. Social support during the postpartum period: mothers' views on needs, expectations, and mobilization of support. Matern Child Health J 2013; 17:616-23. [PMID: 22581378 DOI: 10.1007/s10995-012-1037-4] [Citation(s) in RCA: 188] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Research has indicated that social support is a major buffer of postpartum depression. Yet little is known concerning women's perceptions on social support during the postpartum period. The objective of this study was to explore postpartum women's views and experiences with social support following childbirth. Four focus groups were conducted with an ethnically diverse sample of women (n = 33) in a large urban teaching hospital in New York City. Participants had completed participation in a postpartum depression randomized trial and were 6-12 months postpartum. Data transcripts were reviewed and analyzed for themes. The main themes identified in the focus group discussions were mother's major needs and challenges postpartum, social support expectations and providers of support, how mothers mobilize support, and barriers to mobilizing support. Women across all groups identified receipt of instrumental support as essential to their physical and emotional recovery. Support from partners and families was expected and many women believed this support should be provided without asking. Racial/ethnic differences existed in the way women from different groups mobilized support from their support networks. Instrumental support plays a significant role in meeting women's basic needs during the postpartum period. In addition, women's expectations surrounding support can have an impact on their ability to mobilize support among their social networks. The results of this study suggest that identifying support needs and expectations of new mothers is important for mothers' recovery after childbirth. Future postpartum depression prevention efforts should integrate a strong focus on social support.
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Affiliation(s)
- Rennie Negron
- Department of Health Evidence and Policy, Mount Sinai School of Medicine, New York, NY, USA.
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Ko SH, Chen CH, Wang HH, Su YT. Postpartum Women's Sleep Quality and Its Predictors in Taiwan. J Nurs Scholarsh 2013; 46:74-81. [DOI: 10.1111/jnu.12053] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Shu-Hua Ko
- Associate Professor, Department of Nursing; HungKuang University; Taichung City Taiwan
| | - Chung-Hey Chen
- Professor, Institute of Allied Health Sciences & Department of Nursing; National Cheng Kung University; Tainan Taiwan
| | - Hsiu-Hung Wang
- Professor, College of Nursing, Kaohsiung Medical University; Kaohsiung Taiwan
| | - Yu-ting Su
- Lecturer, Department of Nursing; HungKuang University; Taichung City Taiwan
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Abstract
Mothers of preterm infants are at risk for poor sleep quality, which may adversely affect their health, maternal-infant attachment, and infant caretaking activities. This study examined the relationship of an 8-week relaxation guided imagery intervention on sleep quality and the association between sleep quality and maternal distress (perceived stress, depressive symptoms, and state anxiety) in 20 mothers of hospitalized preterm infants. Mothers received a CD (compact disc) with three 20-minutes recordings and were asked to listen to at least 1 recording daily for 8 weeks. This analysis used self-report data gathered at baseline and 8 weeks. Pearson correlations were used to examine the relationships between mean cumulative relaxation guided imagery use and measures of maternal distress and sleep quality scores at 8 weeks. Complete data on 19 mothers were available for analysis. At 8 weeks, higher mean relaxation guided imagery use was inversely correlated with sleep quality scores (r = -0.30); sleep quality scores were positively correlated with stress (r = 0.42), depressive symptoms (r = 0.34), and anxiety (r = 0.39) scores. In mothers of preterm infants, sleep quality was negatively affected by mental distress and may be improved by a guided imagery intervention.
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Goyal D, Wang EJ, Shen J, Wong EC, Palaniappan LP. Clinically identified postpartum depression in Asian American mothers. J Obstet Gynecol Neonatal Nurs 2012; 41:408-16. [PMID: 22536783 DOI: 10.1111/j.1552-6909.2012.01352.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To identify the clinical diagnosis rate of postpartum depression (PPD) in Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese) compared to non-Hispanic Whites. DESIGN Cross-sectional study using electronic health records (EHR). SETTING A large, outpatient, multiservice clinic in Northern California. PARTICIPANTS A diverse clinical population of non-Hispanic White (N = 4582), Asian Indian (N = 1264), Chinese (N = 1160), Filipino (N = 347), Japanese (N = 124), Korean (N = 183), and Vietnamese (N = 147) mothers. METHODS Cases of PPD were identified from EHRs using physician diagnosis codes, medication usage, and age standardized for comparison. The relationship between PPD and other demographic variables (race/ethnicity, maternal age, delivery type, marital status, and infant gender) were examined in a multivariate logistic regression model. RESULTS The PPD diagnosis rate for all Asian American mothers in aggregate was significantly lower than the diagnosis rate in non-Hispanic White mothers. Moreover, of the six Asian American subgroups, PPD diagnosis rates for Asian Indian, Chinese, and Filipino mothers were significantly lower than non-Hispanic White mothers. In multivariate analyses, race/ethnicity, age, and cesarean were significant predictors of PPD. CONCLUSION In this insured population, PPD diagnosis rates were lower among Asian Americans, with variability in rates across the individual Asian American subgroups. It is unclear whether these lower rates are due to underreporting, underdiagnosis, or underutilization of mental health care in this setting.
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Affiliation(s)
- Deepika Goyal
- Valley Foundation School of Nursing, San Jose State University, San Jose, CA 95192-0057, USA.
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Hung CH, Wang HH, Chang SH, Jian SY, Yang YM. The health status of postpartum immigrant women in Taiwan. J Clin Nurs 2012; 21:1544-53. [DOI: 10.1111/j.1365-2702.2011.03999.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Uğurlu N, Bayar B, Bayar K, Göktaş A, Karakaya IÇ, Polat H. Development, validity and reliability of the Turkish version of the Hung Postpartum Stress Scale. J Obstet Gynaecol Res 2012; 38:705-13. [PMID: 22381128 DOI: 10.1111/j.1447-0756.2011.01754.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The aim of the current study was to translate the Hung Postpartum Stress Scale into Turkish and test the reliability and validity of the Turkish version of the scale. METHODS The translation process of the Hung Postpartum Stress Scale into Turkish and the testing of reliability and validity of the newly developed scale on postpartum stress in women are described. The questionnaire was translated using a back-translation technique. Expert review of internal consistency reliability, content validity, factor analysis of construct validity and criterion-related validity were examined. RESULTS Cronbach's alpha for the Turkish version of the Hung Postpartum Stress Scale was 0.931, indicating very good reliability. Factor analyses resulted in a two factor scale structure: maternal concerns and acceptability of the newborn by the family. Analyses also indicated good test-re-test reliability for the Turkish version of the Hung Postpartum Stress Scale (P < 0.01). CONCLUSIONS The present study describes the design of a Turkish version of the Hung Postpartum Stress Scale. The newly developed scale proved to be reliable and valid and will be a valuable instrument for women's healthcare professionals.
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Affiliation(s)
- Nezihe Uğurlu
- Department of Nursing, Muğla School of Health Sciences, Muğla University, Muğla, Turkey.
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Kinser PA, Goehler LE, Taylor AG. How might yoga help depression? A neurobiological perspective. Explore (NY) 2012; 8:118-26. [PMID: 22385566 PMCID: PMC3293477 DOI: 10.1016/j.explore.2011.12.005] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Indexed: 11/28/2022]
Abstract
Depression is a prevalent mental health condition worldwide and is the leading cause of disability in adults under the age of 45. Most individuals with major depressive disorder (MDD) report only a 50% decrease in symptoms with the use of the standard allopathic treatments for depression. The mechanisms underlying depression remain poorly understood even though stress and its correlates contribute to multiple aspects of the phenomenology of depression. Thus, stress and depression are clearly linked, as stress may precipitate or exacerbate depressive symptoms and depression may be a cause and/or outcome of acute or chronic stress. Therefore, use of additional therapeutic approaches to address stress and depression, such as complementary therapies including yoga, may contribute importantly to symptom reduction. Based on an emerging picture of how stress and mood are regulated within the nervous system, and considering the Executive Homeostatic Network concept that we have recently advanced, we provide an integrative overview of biological mechanisms and substrates that may mediate depression, which should be targets for research to evaluate how the practice of yoga can mitigate depressive symptomatology.
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Affiliation(s)
- Patricia Anne Kinser
- Center for the Study of Complementary and Alternative Therapies, School of Nursing, University of Virginia, Charlottesville, VA 22908, USA.
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Pio de Almeida LS, Jansen K, Köhler CA, Pinheiro RT, da Silva RA, Bonini JS. Working and short-term memories are impaired in postpartum depression. J Affect Disord 2012; 136:1238-42. [PMID: 22100126 DOI: 10.1016/j.jad.2011.09.031] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Accepted: 09/28/2011] [Indexed: 11/24/2022]
Abstract
BACKGROUND Postpartum depression affects parents of newborns. Major depression causes cognitive prejudice. Nothing is known about memory impairment in those affected of postpartum depression. This study has a purpose to assess working and short-term memories during the postpartum period in mothers and fathers in the city of Pelotas, RS, Brazil and also to correlate the changes in memory with postpartum depression, sociodemographic factors and possible confounding factors. METHODS This cross-sectional study includes families assisted by the public health system. The sample consisted of fathers and mothers of live births, born from March to December 2008. The participants were evaluated during home visits using the Edinburg Postnatal Depression Scale (EPDS) and the word span test. The cutoff point for depression in the EPDS scores was ≥13, and the word span scores were evaluated as discrete variables. RESULTS The sample consisted of 395 individuals (222 women and 173 men). The prevalence of depression was 16.2% among mothers and 5.2% among fathers. Depressed individuals performed worse on the memory test. LIMITATIONS The number of men evaluated was smaller than that of women. That's a transversal study, so we have the prevalence bias. CONCLUSIONS This study shows that postpartum depression affects both men and women, and the symptoms of depression affect the working and short-term memories of affected individuals. Given that this was a larger study than those in the literature, the results emphasize the importance of detecting and treating postpartum depression and helping affected families.
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Affiliation(s)
- Laura Sigaran Pio de Almeida
- Programa de Pós-Graduação em Saúde e Comportamento, Centro de Ciencias da Vida e da Saúde, Universidade Católica de Pelotas, Brazil
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Abstract
Major depression is a frequent complication of the postpartum period. Untreated postpartum depression increases the risk of maternal suicide and can impair parenting capability with resultant adverse effects on offspring development. A number of factors influence a woman's vulnerability to postpartum depressive episodes. This article summarizes processes for assessing these risk factors and implementing primary preventive interventions, and summarizes methods of early detection to promote secondary and tertiary prevention.
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Affiliation(s)
- Laura J Miller
- Department of Psychiatry, Brigham and Women's/Faulkner Hospitals, Harvard Medical School, 75 Francis Street, Boston, MA 02115,
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Ni PK, Siew Lin SK. The role of family and friends in providing social support towards enhancing the wellbeing of postpartum women: a comprehensive systematic review. ACTA ACUST UNITED AC 2011; 9:313-370. [PMID: 27819889 DOI: 10.11124/01938924-201109100-00001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Maternal postpartum health is a neglected area both in research and practice. This aspect warrants more attention as the health of postpartum mothers has a considerable influence on her infant and also other family members. Social support provided by family and friends has been identified as a buffer against the many stressors faced by the women. Outcomes such as self-esteem, stress, postnatal depression, breastfeeding levels, infant care, and maternal adaptation have been studied and found to be significantly related to social support. The need to understand the role of social support provided by family and friends provide the impetus for conducting this review. OBJECTIVES The objective of this systematic review was to appraise and synthesise the best available evidence which discusses the impact of social support from family and friends on enhancing the wellbeing of postpartum women. INCLUSION CRITERIA This review includes women who were within their first year postpartum period, with any number of children, and had given birth to healthy infants. Mothers who had co-existing morbidities such as depression were excluded. Mothers from low socio-economic groups were excluded.This review considered any study that involved the provision of social support by family and/or friends. Interventions provided by peer counsellors were also considered.The six outcomes were stress, self esteem, breastfeeding levels, mental health in relation to postnatal depression, infant care and maternal adaptation.Quantitative This review considered any randomised controlled trials that examined the effectiveness of social support from family and friends on the well being of the postpartum women. As it was not likely to find RCTs on this topic, this review also considered observational studies (cohort, case control, quantitative descriptive studies such as surveys).Qualitative This review considered any interpretive studies that drew on the experiences of social support from family and friends in postpartum women including, but not limited to, designs such as phenomenology, grounded theory and ethnography.The search was conducted only in published literature in English. A search was conducted in the following databases: PsycINFO, MEDLINE, CINAHL, SCOPUS, THE COCHRANE LIBRARY, BMJ Clinical Evidence, Wiley Interscience, ScienceDirect and MEDNAR.Each paper was assessed independently by two reviewers prior to critical appraisal using Joanna Briggs Institute-System for the Unified Management, Assessment and Review of Information (JBI-SUMARI) developed by Joanna Briggs Institute (JBI). DATA COLLECTION/EXTRACTION Qualitative and quantitative data were extracted using the tools from the JBI-SUMARI DATA SYNTHESIS: Qualitative data was synthesised using QARI (Qualitative Assessment and Review Instrument). Quantitative data could not be pooled due to the lack of comparable RCTs or cohort studies and was thus presented in a narrative form. RESULTS This review included 24 quantitative articles, comprising of two RCTs and 22 descriptive studies. From these studies, social support was shown to have a significant positive correlation with outcomes such as breastfeeding, infant care, maternal adaptation, and self esteem. In addition, social support was shown to have a negative correlation with the levels of stress and postnatal depression. This indicated that increasing the social support of postpartum women will promote breastfeeding, infant care, maternal adaptation and self esteem. Rendering social support also aids in buffering their levels of stress and postnatal depression.Three qualitative articles were included in this review. Meta-synthesis of the qualitative findings yielded 17 findings which were grouped into seven categories and then further categorised into one synthesised finding which was, "Motherhood as a period of learning, adjustment, seeking positive social support whilst buffering against stressors'. This synthesised finding suggested that social support offered by family and friends has both positive and negative effects with which the postpartum mothers have to learn to cope. CONCLUSIONS Family members such as the partners and grandmothers should be involved in the provision of care towards the postpartum women. The support from peer volunteers may also contribute to the desired health outcomes. Healthcare professionals ought to be equipped with the knowledge on social support so that they can better assess the needs of the postpartum women and develop a support plan.Further research is necessary to better understand the negative effects of social support and to test interventions to buffer them. The effectiveness of the various types of social support interventions should be subject to further testing in future research. Further research may help to identify which support provider is more effective in enhancing a particular health outcome.
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Affiliation(s)
- Phang Koh Ni
- 1. The Singapore National University Hospital (NUH) Centre for Evidence Based Nursing: A Collaborating Centre of the Joanna Briggs Institute
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Ni PK, Siew Lin SK. The role of family and friends in providing social support towards enhancing the wellbeing of postpartum women: a comprehensive systematic review. ACTA ACUST UNITED AC 2011. [DOI: 10.11124/jbisrir-2011-94] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Hung CH, Yu CY, Liu CF, Stocker J. Maternal satisfaction with postpartum nursing centers. Res Nurs Health 2010; 33:345-54. [DOI: 10.1002/nur.20387] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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