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Hall K, Patel R, Evans J, Greenwood R, Hicks J. The relationship between perinatal circadian rhythm and postnatal depression: an overview, hypothesis, and recommendations for practice. SLEEP SCIENCE AND PRACTICE 2022. [DOI: 10.1186/s41606-022-00081-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
AbstractPostnatal depression (PND) is an important public health problem with far-reaching consequences for mothers, families, and society. Current treatment approaches tend to focus on the depressive symptoms of the mother. We propose the need for a shift in the conceptualisation of PND and its management, by focusing on circadian rhythm as an early manifestation of mother-infant synchrony. We have reviewed the relevant interdisciplinary literature to formulate a hypothesis and suggest recommendations for practice. We hypothesise that, after a mother’s circadian rhythm becomes ‘desynchronised’ immediately following birth, persistence of this disruption is implicated in the development of PND. This has important implications for novel treatment strategies in the critical and vulnerable postnatal period, for example the use of outdoor-based interventions and light.
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Dür M, Röschel A, Oberleitner-Leeb C, Herrmanns V, Pichler-Stachl E, Mattner B, Pernter SD, Wald M, Urlesberger B, Kurz H, Frischer T, Zwiauer K, Matter IS, Berger A. Associations Between Parental Occupational Balance, Subjective Health, and Clinical Characteristics of VLBW Infants. Front Pediatr 2022; 10:816221. [PMID: 35299673 PMCID: PMC8922994 DOI: 10.3389/fped.2022.816221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/03/2022] [Indexed: 11/23/2022] Open
Abstract
Objective Very low birthweight (VLBW) infants have an increased risk of mortality and frequently suffer from complications, which affects parental occupational balance. Occupational balance is the satisfaction with one's meaningful activities, which include everyday activities that people need to, want to, and are expected to do. In contrast to work-life balance, the construct of occupational balance addresses different activities equally and it applies to all persons, regardless of whether they are working or not. Parental occupational balance might be related to parents' and VLBW infants' health. Therefore, the objective of this study was to investigate associations between parental occupational balance, subjective health, and clinical characteristics of VLBW infants. Methods A cross-sectional multicenter study was conducted in six Austrian neonatal intensive care units. Occupational balance and subjective health of parents of VLBW infants were assessed with six self-reported questionnaires. The following clinical characteristics of VLBW infants were extracted from medical records: gestational age, birthweight, Apgar scores, Clinical Risk for Babies II Score, and complications of prematurity. Spearman's rank coefficients were calculated. Results In total, 270 parents, 168 (62%) female and their VLBW infants, 120 (44%) female, were included in this study. Parents' mean age was 33.7 (±6.0) years, mean gestational age of VLBW infants was 27 + 3 (±2) weeks. Associations between parental occupational balance, subjective health, and clinical characteristics of VLBW infants were identified (r s = 0.13 - 0.56; p ≤ 0.05), such as the correlation between occupational areas (r s = 0.22, p ≤ 0.01), occupational characteristics (r s = 0.17, p = 0.01), and occupational resilience (r s = 0.18, p ≤ 0.01) with bronchopulmonary dysplasia of VLBW infants. Conclusion Occupational balance is associated with parents' and VLBW infants' health. Interventions to strengthen parental occupational balance might increase parental health and thereby also improve health and developmental outcomes of their VLBW infants.
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Affiliation(s)
- Mona Dür
- Department of Health Sciences, IMC University of Applied Sciences Krems, Krems, Austria
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
- Duervation, Krems, Austria
| | - Anna Röschel
- Department of Health Sciences, IMC University of Applied Sciences Krems, Krems, Austria
| | - Christiane Oberleitner-Leeb
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Verena Herrmanns
- Department of Pediatrics, Clinic Donaustadt, Gesundheitsverbund Vienna, Vienna, Austria
- Department of Pediatrics With Neonatology, St. Josef Hospital Vienna, Vienna, Austria
| | - Elisabeth Pichler-Stachl
- Division of Neonatology, Department for Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Barbara Mattner
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Pediatric Intensive Care, Wilhelminen Hospital, Vienna, Austria
| | - Silvia-Desiree Pernter
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, University Hospital Salzburg, Salzburg, Austria
| | - Martin Wald
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, University Hospital Salzburg, Salzburg, Austria
| | - Berndt Urlesberger
- Division of Neonatology, Department for Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Herbert Kurz
- Department of Pediatrics, Clinic Donaustadt, Gesundheitsverbund Vienna, Vienna, Austria
| | - Thomas Frischer
- Faculty for Medicine, Sigmund Freud University, Vienna, Austria
| | - Karl Zwiauer
- University Hospital for Pediatrics and Adolescent Medicine, University Hospital St. Pölten, Sankt Pölten, Austria
- Karl Landsteiner University for Health Sciences, Krems, Austria
| | - Inu Sarah Matter
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Angelika Berger
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
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Chen WY, Wu YY, Xu MY, Tung TH. Effect of Kangaroo Mother Care on the Psychological Stress Response and Sleep Quality of Mothers With Premature Infants in the Neonatal Intensive Care Unit. Front Pediatr 2022; 10:879956. [PMID: 35935377 PMCID: PMC9354657 DOI: 10.3389/fped.2022.879956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To investigate the effect of kangaroo mother care on the psychological stress response and sleep quality of mothers with premature infants admitted to the neonatal intensive care unit (NICU). METHODS A randomized controlled design was used to recruit participants. The study recruited 126 mothers of premature infants in the NICU from January 2019 to January 2020. The participants were divided into the experimental and control groups according to the random number table method (63 mothers per group). The control group was managed with conventional premature infant treatment, nursing programme, and discharge education, whereas the experimental group was managed with a 4-week kangaroo mother care intervention. The psychological stress state and sleep status of mothers with preterm infants in both the groups were evaluated using the Symptom Check List 90 (SCL-90) and Assens Insomnia Scale (AIS). RESULTS After the intervention, the total SCL-90 score and factor scores such as coercion, interpersonal relationships, depression, anxiety, hostility and additional factors, were lower in the experimental group than those in the control group (P < 0.05). The total AIS score and the items such as night waking, total sleep time, total sleep quality, daytime mood and daytime body function were lower in the experimental group than those in the control group (P < 0.05). CONCLUSIONS The Kangaroo mother care approach can relieve adverse psychological stress and improve the sleep status of mothers of NICU premature infants after mother-infant separation. It can be promoted and used in mothers of premature infants in the NICU to enhance physical and mental health.
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Affiliation(s)
- Wei-Yan Chen
- Nursing Department, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Ying-Ying Wu
- Nursing Department, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, China
| | - Meng-Yan Xu
- Nursing Department, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, China
| | - Tao-Hsin Tung
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
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Röschel A, Wagner C, Dür M. Examination of validity, reliability, and interpretability of a self-reported questionnaire on Occupational Balance in Informal Caregivers (OBI-Care) - A Rasch analysis. PLoS One 2021; 16:e0261815. [PMID: 34941966 PMCID: PMC8700023 DOI: 10.1371/journal.pone.0261815] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 12/13/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives Informal caregivers often experience a restriction in occupational balance. The self-reported questionnaire on Occupational Balance in Informal Caregivers (OBI-Care) is a measurement instrument to assess occupational balance in informal caregivers. Measurement properties of the German version of the OBI-Care had previously been assessed in parents of preterm infants exclusively. Thus, the aim of this study was to examine the measurement properties of the questionnaire in a mixed population of informal caregivers. Methods A psychometric study was conducted, applying a multicenter cross-sectional design. Measurement properties (construct validity, internal consistency, and interpretability) of each subscale of the German version of the OBI-Care were examined. Construct validity was explored by assessing dimensionality, item fit and overall fit to the Rasch model, and threshold ordering. Internal consistency was examined with inter-item correlations, item-total correlations, Cronbach’s alpha, and person separation index. Interpretability was assessed by inspecting floor and ceiling effects. Results A total of 196 informal caregivers, 171 (87.2%) female and 25 (12.8%) male participated in this study. Mean age of participants was 52.27 (±12.6) years. Subscale 1 was multidimensional, subscale 2 and subscale 3 were unidimensional. All items demonstrated item fit and overall fit to the Rasch model and displayed ordered thresholds. Cronbach’s Alpha and person separation index values were excellent for each subscale. There was no evidence of ceiling or floor effects. Conclusions We identified satisfying construct validity, internal consistency, and interpretability. Thus, the findings of this study support the application of the German version of the OBI-Care to assess occupational balance in informal caregivers.
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Affiliation(s)
- Anna Röschel
- Department of Health Sciences, IMC University of Applied Sciences Krems, Krems, Austria
| | - Christina Wagner
- Department of Health Sciences, IMC University of Applied Sciences Krems, Krems, Austria
| | - Mona Dür
- Department of Health Sciences, IMC University of Applied Sciences Krems, Krems, Austria
- Duervation, Krems, Austria
- * E-mail: ,
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Development and validation of a self-reported questionnaire to assess occupational balance in parents of preterm infants. PLoS One 2021; 16:e0259648. [PMID: 34780508 PMCID: PMC8592439 DOI: 10.1371/journal.pone.0259648] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 10/23/2021] [Indexed: 12/30/2022] Open
Abstract
Background Parents’ meaningful activities (occupations) and occupational balance are relevant to neonatal care. Valid and reliable self-reported measurement instruments are needed to assess parents’ occupational balance and to evaluate occupational balance interventions in neonatal care. The aims of this study were to develop a self-reported questionnaire on occupational balance in informal caregivers (OBI-Care) and to examine its measurement properties including construct validity and internal consistency. Methods and findings A mixed method multicenter study design was employed. Items of the OBI-Care were created with parents of preterm infants based on qualitative research methods. Measurement properties were analyzed with quantitative data of parents of preterm infants. Construct validity was assessed by determining dimensionality, overall and item fit to a Rasch model, differential item functioning and threshold ordering. Internal consistency was examined by determining inter-item and item-total correlations, Cronbach’s alpha and Rasch’s person separation index. Fourteen parents participated in item creation. Measurement properties were explored in data of 304 parents. Twenty-two items, summarized in three subscales were compiled to the OBI-Care. Items showed an overall fit and except one item, an item fit to the Rasch model. There was no evidence of differential item functioning and all items displayed ordered thresholds. Each subscale had good values of person separation indices and Cronbach’s alpha. Conclusions The OBI-Care demonstrates construct validity and internal consistency and is thus a suitable measurement instrument to assess occupational balance of parents of preterm infants in neonatal care. OBI-Care is generic and can be applied in various health care settings.
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Nyondo-Mipando AL, Kinshella MLW, Hiwa T, Salimu S, Banda M, Vidler M, Molyneux E, Dube Q, Goldfarb DM, Kawaza K. Mothers' quality of life delivering kangaroo mother care at Malawian hospitals: a qualitative study. Health Qual Life Outcomes 2021; 19:186. [PMID: 34321038 PMCID: PMC8317316 DOI: 10.1186/s12955-021-01823-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 07/16/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Kangaroo mother care is known to help save the lives of preterm and low birthweight infants, particularly in resource-limited health settings, yet barriers to implementation have been documented. Mothers and their families are very involved in the process of providing kangaroo mother care and the impact on their well-being has not been well explored. The objective of this research was to investigate the perspectives and experiences of a mother’s quality of life while delivering facility-based kangaroo mother care.
Methods This study is a secondary analysis of the qualitative data collected within the “Integrating a neonatal healthcare package for Malawi” project. Twenty-seven health workers and 24 caregivers engaged with kangaroo mother care at four hospitals in southern Malawi were interviewed between May–August 2019. All interviews were face-to-face and followed a topic guide. Content analysis was conducted on NVivo 12 (QSR International, Melbourne, Australia) based on the six World Health Organization Quality of Life domains (physical, psychological, level of independence, social relationships, environment, spirituality). Results Fifty-one interviews were conducted with 24 caregivers and 14 health workers. Mothers experienced multidimensional challenges to their quality of life while delivering facility-based KMC. Though kangaroo mother care was considered a simple intervention, participants highlighted that continuous kangaroo mother care was difficult to practice. Kangaroo mother care was an exhausting experience for mothers due to being in one position for prolonged periods, compromised sleep, restricted movement, boredom, and isolation during their stay at the hospital as well as poor support for daily living needs such as food. Discussion A heavy burden is placed on mothers who become the key person responsible for care during kangaroo mother care, especially in resource-limited health settings. More focus is needed on supporting caregivers during the delivery of kangaroo mother care through staff support, family inclusion, and conducive infrastructure. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-021-01823-8.
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Affiliation(s)
- Alinane Linda Nyondo-Mipando
- Department of Health Systems and Policy, School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.
| | - Mai-Lei Woo Kinshella
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital,, University of British Columbia, Vancouver, Canada
| | - Tamanda Hiwa
- Department of Pediatrics and Child Health, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Sangwani Salimu
- Department of Pediatrics and Child Health, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Mwai Banda
- Department of Pediatrics and Child Health, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Marianne Vidler
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital,, University of British Columbia, Vancouver, Canada
| | - Elizabeth Molyneux
- Department of Pediatrics and Child Health, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Queen Dube
- Department of Pediatrics and Child Health, College of Medicine, University of Malawi, Blantyre, Malawi.,Queen Elizabeth Central Hospital, Pediatrics, Blantyre, Malawi
| | - David M Goldfarb
- Department of Pathology and Laboratory Medicine, BC Children's and Women's Hospital, University of British Columbia, Vancouver, Canada
| | - Kondwani Kawaza
- Department of Pediatrics and Child Health, College of Medicine, University of Malawi, Blantyre, Malawi.,Queen Elizabeth Central Hospital, Pediatrics, Blantyre, Malawi
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Younesian S, Eivers A, Shahaeian A, Sullivan K, Gilmore L. Maternal interactive beliefs and style as predictors of language development in preterm and full term children. JOURNAL OF CHILD LANGUAGE 2021; 48:215-243. [PMID: 32618520 DOI: 10.1017/s0305000920000148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Previous research has shown that the quality of mother-child interactions between pre-term children and their mothers tends to be poorer than that of full-term children and their mothers (Forcada-Guex, Pierrehumbert, Borghini, Moessinger & Muller-Nix, 2006). Mothers of pre-term children are less responsive and more intrusive in interactions with their children than mothers of full-term children (Forcada-Guex et al., 2006; Ionio, Lista, Mascheroni, Olivari, Confalonieri, Mastrangelo, Brazzoduro, Balestriero, Banfi, Bonanomi, Bova, Castoldi, Colombo, Introvini & Scelsa, 2017; Laing, McMahon, Ungerer, Taylor, Badawi & Spence, 2010). The current research explored differences between mothers of pre-term and full-term children in terms of interactive beliefs and style, and the potential for language development to be differentially predicted by maternal interactive beliefs and styles in pre-term versus full-term children. Independent t-tests were conducted to compare pre-term and full-term groups in relation to the measures of maternal interactive beliefs and styles. A series of multiple regression analyses were then performed separately for each group to examine the shared and unique contributions of maternal interactive beliefs and styles on full-term versus pre-term children's language development. The results showed that mothers of pre-term children were more intrusive-directive than mothers of full-term children; in contrast, mothers of full-term children were more responsive and supportive-directive in interactions with their children. Moreover, predictors of language development were different in full-term versus pre-term children; in full-term children, maternal supportive beliefs and responsiveness were significant predictors of language development evaluated by both the Bayley Scales of Infant and Toddler Development and the MacArthur Communicative Development Inventory; in the pre-term group, maternal supportive and directive beliefs, as well as supportive and intrusive directiveness, were significant predictors, with the latter being negatively associated with language development indicators. This research can shed light on how to prevent language delay in children and improve mother-child interactions that contribute to language development, which may in turn improve language development in vulnerable children, children born pre-term in particular.
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Affiliation(s)
- Sharifeh Younesian
- Faculty of Health, School of Psychology and Counselling, Queensland University of Technology, Australia
- Speech Therapy Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Areana Eivers
- Faculty of Health, School of Psychology and Counselling, Queensland University of Technology, Australia
| | - Ameneh Shahaeian
- Institute for Learning Sciences and Teacher Education, Australian Catholic University
| | - Karen Sullivan
- Faculty of Health, School of Psychology and Counselling, Queensland University of Technology, Australia
| | - Linda Gilmore
- School of Education, Queensland University of Technology, Australia
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Haddad S, Dennis CL, Shah PS, Stremler R. Sleep in parents of preterm infants: A systematic review. Midwifery 2019; 73:35-48. [PMID: 30877909 DOI: 10.1016/j.midw.2019.01.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 01/09/2019] [Accepted: 01/13/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND Sleep disruption during the first postpartum year is associated with several negative health outcomes including postpartum depression. Such disruption may be a greater issue for parents of preterm neonates, yet literature on this subject has not been critically reviewed. OBJECTIVE To synthesize literature on sleep quantity, sleep quality, and factors influencing sleep among parents of preterm infants during infant hospitalization and following discharge. DESIGN A systematic review. DATA SOURCES Medline, EMBASE, CINAHL, PsycINFO, Scopus, and Cochrane Database of Systematic Reviews were searched from their inception to February 2017. METHODS Potentially eligible citations were reviewed by two independent reviewers. Both quantitative and qualitative studies were eligible for inclusion. Data on eligible studies and review outcomes were extracted using a customized form. FINDINGS Eighteen reports from 16 studies met inclusion criteria. Four studies included a control group of parents of full-term infants. Three studies reported sleep quantity means, of which only one provided values for an exclusive sample of mothers of preterm infants and found on average, mothers obtained 6.3 h of sleep/day in the first 5-10 days. Twelve studies reported on sleep quality; most (n = 10) relied on self-reported measures and identified poor subjective sleep quality whereas two studies objectively measured sleep of poor quality. Parental stress was the most consistent factor associated with sleep quality. CONCLUSION AND IMPLICATIONS Quality and quantity of sleep among parents of preterm infants is inadequate and may negatively influence family health outcomes. Further research on correlates and changes in sleep is required to identify at-risk parents and inform targeted clinical recommendations and interventions aimed at maximizing sleep for parents of preterm infants.
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Affiliation(s)
- Summer Haddad
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada; The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada.
| | - Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Prakesh S Shah
- Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Robyn Stremler
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada; The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
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Wilson N, Lee JJ, Bei B. Postpartum fatigue and depression: A systematic review and meta-analysis. J Affect Disord 2019; 246:224-233. [PMID: 30584956 DOI: 10.1016/j.jad.2018.12.032] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 11/04/2018] [Accepted: 12/16/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND New parents are vulnerable to fatigue and depressive symptoms. Many studies have reported significant positive correlations between the two in postpartum parents, but the size of correlations varies considerably between studies. The relationship between postpartum fatigue and depression is yet to be systematically synthesized and meta-analyzed. METHODS A PROSPERO registered systematic review and meta-analysis (CRD42017065240) was conducted on the correlation between fatigue and depression within the first two years postpartum in parents. Moderation analysis was used to examine the influence of demographic and measurement factors on the effect sizes. RESULTS Thirty-five eligible papers were identified (34 on mothers, 1 on fathers). The meta-analytic summary effect size for simultaneously measured fatigue and depressive symptoms among women in the postpartum period was r = 0.52, 95% CI [0.45, 0.59], p < .001. There was a high degree of heterogeneity in the strength of the correlation between studies. This heterogeneity was not accounted for by demographic (e.g., infant age, maternal age, population type) or methodology (e.g., measurement) related moderators. LIMITATIONS Studies not reporting or providing correlation between fatigue and depression were not included. Unable to assess some moderators due to limited sample size. CONCLUSIONS There is a strong correlation between fatigue and depressive symptoms among women in the first two years after child-birth, but a high degree of heterogeneity in correlation strength exists between studies. Careful assessment of both fatigue and depression when either symptom is reported could facilitate accurate differential diagnosis and prioritizing treatment in postpartum women. Further implications for assessment, treatment, and future research are discussed.
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Affiliation(s)
- Nathan Wilson
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Victoria 3800, Australia
| | - Jin Joo Lee
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Victoria 3800, Australia
| | - Bei Bei
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Victoria 3800, Australia.
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Marthinsen GN, Helseth S, Fegran L. Sleep and its relationship to health in parents of preterm infants: a scoping review. BMC Pediatr 2018; 18:352. [PMID: 30419873 PMCID: PMC6231258 DOI: 10.1186/s12887-018-1320-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 10/24/2018] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Sleep is essential for human health and functioning. Parents of preterm infants are susceptible to sleep disturbances because of stress related to the preterm birth. Poor sleep has the potential to affect parental health and well-being. The aim of this study was to identify and map evidence on sleep and its relationship to health in parents of preterm infants. No review has summarized the evidence on this topic. METHODS A scoping review was conducted. Seven health and medical electronic research databases were searched for relevant quantitative and qualitative primary studies, including grey literature. The search was performed March 2-7, 2017. RESULTS Ten American studies and one Australian study were included in the review. Most research was quantitative and focused on maternal sleep and mental health within the first two weeks after the childbirth. Both objective and subjective sleep measures were used to study sleep at the hospital; actigraphs were not used after discharge. Maternal sleep was poor early postpartum, and this was associated with negative health outcomes. Two cohort studies compared sleep in mothers of preterm and term infants, but the results were conflicting. In one qualitative study, fathers described their inability to catch up on sleep after homecoming with a preterm baby. CONCLUSIONS Quantitative studies reporting on maternal sleep early postpartum was most frequently occurring in the results. Qualitative research on the topic was identified as a knowledge gap. More cultural and geographical breadth, including research on fathers' sleep, is recommended in future research.
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Affiliation(s)
- Gunhild Nordbø Marthinsen
- Department of Health and Nursing Sciences, Faculty of Health and Sports Science, University of Agder, 4604 Kristiansand, Norway
| | - Sølvi Helseth
- Department of Health and Nursing Sciences, Faculty of Health and Sports Science, University of Agder, 4604 Kristiansand, Norway
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet- Oslo Metropolitan University, NO-0130 Oslo, Norway
| | - Liv Fegran
- Department of Health and Nursing Sciences, Faculty of Health and Sports Science, University of Agder, 4604 Kristiansand, Norway
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Gallaher KGH, Slyepchenko A, Frey BN, Urstad K, Dørheim SK. The Role of Circadian Rhythms in Postpartum Sleep and Mood. Sleep Med Clin 2018; 13:359-374. [PMID: 30098753 DOI: 10.1016/j.jsmc.2018.04.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Women often experience sleep disturbances and worsening sleep quality throughout pregnancy and postpartum. Circadian rhythms are closely linked to sleep problems and mood disorders. This systematic review provides a summary of studies of circadian rhythms and associated sleep problems and maternal distress, among postpartum women. Articles were idenitfied through a systematic literature search. Circadian rhythm disturbances were strongly correlated with depression, social factors and mothers`s exposure to light postpartum. Future research should include larger, prospective studies as well as randomized controlled trials for measuring effect of circadian rhythm interventions on postpartum mental health outcomes.
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Affiliation(s)
| | - Anastasiya Slyepchenko
- Neuroscience Graduate Program, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada; Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON L8N 3K7, Canada
| | - Benicio N Frey
- Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON L8N 3K7, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th Street, Hamilton, ON L8N 3K7, Canada
| | - Kristin Urstad
- Faculty of Health Sciences, University of Stavanger, Kitty Kjellandshus, 4021 Stavanger, Norway
| | - Signe K Dørheim
- Department of Psychiatry, Stavanger University Hospital, Gerd Ragna Bloch Thorsens Gate 8, 4011 Stavanger, Norway
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Wilson N, Wynter K, Fisher J, Bei B. Related but different: distinguishing postpartum depression and fatigue among women seeking help for unsettled infant behaviours. BMC Psychiatry 2018; 18:309. [PMID: 30253778 PMCID: PMC6156854 DOI: 10.1186/s12888-018-1892-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 09/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A growing body of evidence in relatively healthy populations suggests that postpartum depression and fatigue are likely distinct but related experiences. However, differentiating depression and fatigue in clinical settings remains a challenge. This study aimed to assess if depression and fatigue are distinct constructs in women with relatively high fatigue and psychological distress symptoms attending a residential program that assists with unsettled infant behaviour. METHODS 167 women (age: M = 34.26, SD = 4.23) attending a private residential early parenting program completed the Depression Anxiety Stress Scale (DASS21-D), Fatigue Severity Scale (FSS) and self-report sleep variables before program commencement. Confirmatory Factor Analysis examined the associations between depression and fatigue latent factors. RESULTS A two-factor model of separate but related depression and fatigue constructs provided a significantly better fit to the data than a one-factor model of combined depression and fatigue (p < .001). In the two-factor model, the depression and fatigue latent factors were moderately correlated (.41). Further predictive utility of this two-factor model was demonstrated as both depression and fatigue factors were independently predicted by worse self-reported sleep efficiency. CONCLUSIONS This study provides empirical evidence that for women attending a clinical service with relatively high fatigue and psychological distress, postpartum depression and fatigue remain separate but related experiences. These findings suggest that in women seeking clinical support in the postpartum period, both depression and fatigue need to be carefully assessed to ensure accurate diagnoses, and (b) whilst depression intervention may improve fatigue, targeted fatigue intervention may also be warranted.
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Affiliation(s)
- Nathan Wilson
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, 18 Innovation Walk, Clayton Campus, VIC, 3800, Australia
| | - Karen Wynter
- Global Public Health Unit, School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia
- Centre for Quality and Patient Safety Research - Western Health Partnership, School of Nursing and Midwifery, Faculty of Health, Deakin University, Burwood, VIC, Australia
| | - Jane Fisher
- Global Public Health Unit, School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia
- Masada Early Parenting Centre, Masada Private Hospital, East St Kilda, VIC, Australia
| | - Bei Bei
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, 18 Innovation Walk, Clayton Campus, VIC, 3800, Australia.
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Amorim M, Alves E, Kelly-Irving M, Ribeiro AI, Silva S. Quality of life of parents of very preterm infants 4 months after birth: a mixed methods study. Health Qual Life Outcomes 2018; 16:178. [PMID: 30200971 PMCID: PMC6131838 DOI: 10.1186/s12955-018-1011-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 09/04/2018] [Indexed: 11/14/2022] Open
Abstract
Background Knowledge about parental quality of life (QoL) is paramount to family-centred and integrated healthcare on prematurity, but evidence is limited. We aimed to explore mothers’ and fathers’ perspectives about their QoL 4 months after a very preterm childbirth. Methods This is a cross-sectional mixed methods study using a convergent design. Parents of very preterm infants were systematically recruited at all level III neonatal intensive care units in the Northern health region of Portugal for one year. Four months after childbirth, 61 mothers and 56 fathers filled-in the World Health Organization Quality of Life – BREF Inventory, and 26 couples were interviewed. Linear regression models were computed to assess the association between participants’ characteristics and the QoL. Qualitative data were thematically analysed. Results A quantitative analysis revealed that the perception of QoL was not significantly different by gender. QoL scores increased slightly from the environment (Mean (SD): 72.1 (14.2)) to the psychological domains (Mean (SD): 78.7 (14.4)). All scores were influenced by psychological characteristics. Socioeconomic position influenced both parents’ perceptions concerning the environment domain, and maternal physical and psychological QoL. Infant-related factors were associated with overall QoL among women and with the physical, psychological, social and environment domains among men. Qualitative findings indicated accommodation mechanisms that intertwine the focus on constraining factors (surveillance, sleep disturbances, non-supportive healthcare policies, hygienization) with facilitating factors (social support, accessibility/quality of healthcare, opportunities for developing parental skills). These processes were anchored in child-centredness and a framework that construct hierarchies of hope and expectations about infant’s health and development. Conclusions To capture parental QoL using mixed methods raises awareness for developing intersectoral family-centred policies, integrated health services and focused-interventions to decrease the disempowering effects of surveillance and hygienization.
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Affiliation(s)
- Mariana Amorim
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal. .,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200 - 319, Porto, Portugal. .,Global Public Health Doctoral Programme, Porto, Portugal.
| | - Elisabete Alves
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200 - 319, Porto, Portugal
| | - Michelle Kelly-Irving
- INSERM UMR1027, F-31000, Toulouse, France.,Université Toulouse III Paul Sabatier, UMR1027, F-31000, Toulouse, France
| | - Ana Isabel Ribeiro
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200 - 319, Porto, Portugal
| | - Susana Silva
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200 - 319, Porto, Portugal
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14
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Dür M, Brückner V, Oberleitner-Leeb C, Fuiko R, Matter B, Berger A. Clinical relevance of activities meaningful to parents of preterm infants with very low birth weight: A focus group study. PLoS One 2018; 13:e0202189. [PMID: 30153266 PMCID: PMC6112625 DOI: 10.1371/journal.pone.0202189] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 07/30/2018] [Indexed: 11/25/2022] Open
Abstract
Introduction Parents have a major impact on the outcome of health care of preterm infants. Parents’ engagement in meaningful activities could have an impact on their own health and wellbeing and therefore be relevant in neonatal intensive care. The aim of this study was to explore meaningful activities of parents of very low birth weight (VLBW) preterm infants with the purpose to further the understanding of their clinical relevance and to foster their consideration in clinical practice and research of neonatal intensive care. Methods A total of 36 parents of preterm infants born prior to complete 37 weeks of gestation with VLBW (≤1.500 grams) were asked to participate in a focus group interview. Interview transcripts were used to analyse the content of the focus group interviews using meaning condensation method by Steinar Kvale. Results Thirty-six parents participated in a total of twelve focus groups. Parents reported that the meaning of certain activities changed due to preterm birth. Meaningful activities, like bathing the baby and gardening, could foster a transition from a feeling of parental immaturity to a feeling of maturity, following health care instructions to possessing health care skills, and a functioning-only state to a balance of activities. Conclusions In neonatal intensive care, nurses contribute to delivering parental education and thereby facilitate experiences of being a mature parent and of possessing health care skills. Occupational therapy could be used to help re-engage in meaningful activities and maintain a balance of activities in parents of VLBW preterm infants.
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Affiliation(s)
- Mona Dür
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Austria
- Department of Health Sciences, Master Degree Programme of Applied Health Sciences and Bachelor Degree Programme of Occupational Therapy, IMC University of Applied Sciences Krems, Austria
- * E-mail: ,
| | - Victoria Brückner
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Austria
| | - Christiane Oberleitner-Leeb
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Austria
| | - Renate Fuiko
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Austria
| | - Barbara Matter
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Wilhelminenspital, Vienna, Austria
| | - Angelika Berger
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Austria
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15
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Baumgartel K, Facco F. An Integrative Review of the Sleep Experiences of Mothers of Hospitalized Preterm Infants. Nurs Womens Health 2018; 22:310-326. [PMID: 30077237 PMCID: PMC6157631 DOI: 10.1016/j.nwh.2018.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 03/07/2018] [Accepted: 03/01/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To determine what is known about the sleep experiences of mothers of hospitalized preterm infants. DATA SOURCES A literature search of PubMed and CINAHL was performed in February 2018. Additional articles were identified from reference lists. STUDY SELECTION Whittemore's integrative review methodology was used to synthesize existing literature; 17 articles met eligibility criteria. DATA EXTRACTION Data were reported in tabular format, including subjects, purpose, setting, interventions, sleep measurements, psychometric instruments, analyses, and results. DATA SYNTHESIS Overall, sleep is disrupted and of poor quality, and many mothers report insomnia with less total sleep time. Potential beneficial interventions include bright light therapy, relaxation guided imagery, and progressive muscle relaxation. CONCLUSION Although some interventions show promise, there are significant limitations. Future research should consider maternal/infant separation and milk expression.
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16
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Abstract
INTRODUCTION Depressive symptoms burden not only postpartum women, but can also compromise partner relationships and mother-infant interactions. With approximately 15% of women affected by perinatal mood and anxiety disorders (PMADs) each year, maternity care providers must be sensitive to personal characteristics and complaints that influence women's potential to develop postpartum depression (PPD). The purpose of the study was to identify personal characteristics and modifiable factors associated with depressive symptoms in low-risk postpartum women. METHODS A descriptive, correlational design was used to identify predictors of depressive symptoms among mothers who were considered to be at low risk for PPD. Self-report data related to mood, stress, sleep disturbance, and fatigue were collected near the sixth week post-delivery from women (N = 62) in a southern US state. RESULTS The levels of stress and reports of sleep disturbance approached clinical concern in the low-risk sample (n = 62), in addition to being positively correlated depressive symptoms. Cesarean delivery was also associated with increased depressive symptoms and predictive of depression symptoms when combined with perceived chronic stress, sleep disturbance, and fatigue. DISCUSSION The findings underscore the importance of assessing maternal mental health and adjustment during the postpartum period. While some mothers may not report depressive symptoms at post-delivery visits, they may be experiencing symptoms that predispose them to a mood disorder. Using a more holistic approach to postpartum care, with concern for both physical and mental well-being, may be a necessary shift to promote health in new mothers and families.
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Affiliation(s)
| | - Eileen Cormier
- a Florida State University, College of Nursing , Tallahassee , Florida , USA
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17
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Faherty LJ, Hantsoo L, Appleby D, Sammel MD, Bennett IM, Wiebe DJ. Movement patterns in women at risk for perinatal depression: use of a mood-monitoring mobile application in pregnancy. J Am Med Inform Assoc 2018; 24:746-753. [PMID: 28339686 DOI: 10.1093/jamia/ocx005] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 01/06/2017] [Indexed: 11/12/2022] Open
Abstract
Objectives To examine, using a smartphone application, whether mood is related to daily movement patterns in pregnant women at risk for perinatal depression. Materials and Methods Thirty-six women with elevated depression symptoms (PHQ-9 ≥ 5) in pregnancy used the application for 8 weeks. Mood was reported using application-administered surveys daily (2 questions) and weekly (PHQ-9 and GAD-7). The application measured daily mobility (distance travelled on foot) and travel radius. Generalized linear mixed-effects regression models estimated the association between mood and movement. Results Women with milder depression symptoms had a larger daily radius of travel (2.7 miles) than women with more severe symptoms (1.9 miles), P = .04. There was no difference in mobility. A worsening of mood from the prior day was associated with a contracted radius of travel, as was being in the group with more severe symptoms. No significant relationships were found between anxiety and either mobility or radius. Discussion We found that the association of mood with radius of travel was more pronounced than its association with mobility. Our study also demonstrated that a change in mood from the prior day was significantly associated with radius but not mood on the same day that mobility and radius were measured. Conclusion This study lays the groundwork for future research on how smartphone mood-monitoring applications can combine actively and passively collected data to better understand the relationship between the symptoms of perinatal depression and physical activity that could lead to improved monitoring and novel interventions.
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Affiliation(s)
- Laura J Faherty
- Robert Wood Johnson Foundation Clinical Scholars Program, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Liisa Hantsoo
- Department of Psychiatry, Penn Center for Women's Behavioral Wellness, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Dina Appleby
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mary D Sammel
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ian M Bennett
- Department of Family Medicine, University of Washington, Seattle, WA, USA.,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Douglas J Wiebe
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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18
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Amorim M, Silva S, Kelly-Irving M, Alves E. Quality of life among parents of preterm infants: a scoping review. Qual Life Res 2017; 27:1119-1131. [PMID: 29248997 DOI: 10.1007/s11136-017-1771-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE To synthesize the body of knowledge on the factors influencing the QoL of mothers and fathers of preterm infants. METHODS A scoping review was performed. Publications indexed in PubMed®, Web of Science™, CINAHL® and PsycINFO® were searched, targeting studies presenting original empirical data that examined parental perception on QoL after a preterm delivery. Eligibility and data extraction were conducted by two independent researchers. The main quantitative findings were synthesized and qualitative data were explored by content analysis. RESULTS The studies, 11 quantitative and 1 mixed methods, were derived mainly from the USA (n = 6). Heterogeneity across the studies was observed regarding the operationalization of QoL and the use of units of analysis (mothers, parents, families and caregivers). In a context where 40 out of 45 covariates were analysed by only one or two studies, results suggested that parental QoL after a preterm delivery is influenced by factors related with mother's characteristics, family issues and health care environment rather than infants' variables. Factors regarding fathers' characteristics and structural levels were not addressed. CONCLUSIONS Standardizing the operationalization of the QoL when analysing mothers and fathers of preterm infants calls for a structured questionnaire adapted to their specific needs. Further research should include both mothers and fathers, invest in mixed methods approaches and be performed in different countries and settings for allowing integration and comparison of findings.
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Affiliation(s)
- Mariana Amorim
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas nº135, 4050-600, Porto, Portugal. .,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. .,Global Public Health Doctoral Programme, Porto, Portugal.
| | - Susana Silva
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas nº135, 4050-600, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Michelle Kelly-Irving
- INSERM UMR1027, 31000, Toulouse, France.,Université Toulouse III Paul Sabatier, UMR1027, 31000, Toulouse, France
| | - Elisabete Alves
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas nº135, 4050-600, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
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19
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Ionio C, Lista G, Mascheroni E, Olivari MG, Confalonieri E, Mastrangelo M, Brazzoduro V, Balestriero MA, Banfi A, Bonanomi A, Bova S, Castoldi F, Colombo C, Introvini P, Scelsa B. Premature birth: complexities and difficulties in building the mother–child relationship. J Reprod Infant Psychol 2017. [DOI: 10.1080/02646838.2017.1383977] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Chiara Ionio
- CRIdee, Dipartimento di Psicologia, Università Cattolica, Milano, Italy
| | - Gianluca Lista
- NICU, Ospedale dei Bambini Vittore Buzzi, ICP, Milano, Italy
| | | | | | | | - Massimo Mastrangelo
- Neurologia Pediatrica, Ospedale dei Bambini Vittore Buzzi, ICP, Milano, Italy
| | | | | | - Annamaria Banfi
- NICU, Ospedale dei Bambini Vittore Buzzi, ICP, Milano, Italy
| | - Andrea Bonanomi
- Dipartimento di Scienze Statistiche, Università Cattolica, Milano, Italy
| | - Stefania Bova
- Neurologia Pediatrica, Ospedale dei Bambini Vittore Buzzi, ICP, Milano, Italy
| | | | | | - Paola Introvini
- NICU, Ospedale dei Bambini Vittore Buzzi, ICP, Milano, Italy
| | - Barbara Scelsa
- Neurologia Pediatrica, Ospedale dei Bambini Vittore Buzzi, ICP, Milano, Italy
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20
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Krawczak EM, Minuzzi L, Simpson W, Hidalgo MP, Frey BN. Sleep, daily activity rhythms and postpartum mood: A longitudinal study across the perinatal period. Chronobiol Int 2016; 33:791-801. [PMID: 27097327 DOI: 10.3109/07420528.2016.1167077] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Women with a diagnosis of bipolar and major depressive disorders are at higher risk to develop postpartum depression. The primary objective of this longitudinal study was to determine whether daily activity rhythms and sleep parameters differ between women with and without a history of a mood disorder across the perinatal period. A secondary objective was to determine whether changes in these parameters were associated with postpartum mood. In total, 33 women were included in this study, 15 of which had a history of a mood disorder (high-risk group) and 18 who did not (low-risk group). Sleep and daily rhythms were assessed subjectively and objectively during the third trimester (≥26 weeks gestation) and again at 6-12 weeks postpartum. Mood was also assessed at both time points. Women in the high-risk group showed greater subjective daily rhythms and sleep disturbances across the perinatal period. Objective sleep efficiency was worse in the high-risk group in the postpartum period. Changes in both subjective daily rhythms and objective sleep efficiency were predictive of changes in depressive symptoms across the perinatal period. These findings encourage the development of preventative therapeutics to ensure circadian rhythm and sleep stability throughout the perinatal period.
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Affiliation(s)
- Elizabeth M Krawczak
- a MiNDS Neuroscience Graduate Program , McMaster University , Hamilton , ON , Canada.,b Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton , ON , Canada
| | - Luciano Minuzzi
- a MiNDS Neuroscience Graduate Program , McMaster University , Hamilton , ON , Canada.,b Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton , ON , Canada.,c Mood Disorders Program , St. Joseph's Healthcare Hamilton , ON , Canada.,d Department of Psychiatry and Behavioural Neurosciences , McMaster University , Hamilton , ON , Canada
| | - William Simpson
- a MiNDS Neuroscience Graduate Program , McMaster University , Hamilton , ON , Canada.,b Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton , ON , Canada
| | - Maria Paz Hidalgo
- e Department of Psychiatry , Federal University of Rio Grande do Sul (UFRGS) , Porto Alegre , RS , Brazil.,f Laboratorio de Cronobiologia, HCPA/UFRGS , Porto Alegre , RS , Brazil
| | - Benicio N Frey
- a MiNDS Neuroscience Graduate Program , McMaster University , Hamilton , ON , Canada.,b Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton , ON , Canada.,c Mood Disorders Program , St. Joseph's Healthcare Hamilton , ON , Canada.,d Department of Psychiatry and Behavioural Neurosciences , McMaster University , Hamilton , ON , Canada
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21
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Toral-López I, Fernández-Alcántara M, González-Carrión P, Cruz-Quintana F, Rivas-Campos A, Pérez-Marfil N. Needs Perceived by Parents of Preterm Infants: Integrating Care Into the Early Discharge Process. J Pediatr Nurs 2016; 31:e99-e108. [PMID: 26497754 DOI: 10.1016/j.pedn.2015.09.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 09/16/2015] [Accepted: 09/16/2015] [Indexed: 11/27/2022]
Abstract
UNLABELLED The birth of a preterm infant can have a great emotional impact on the parents when the length of stay is long. Early discharge programs facilitate the transition to the home and have beneficial effects on both the parents and children. However, only a few studies have been conducted to identify the real needs of parents of preterm infants and to determine whether early discharge programs meet such needs. The main objective of this study was to identify the experiences and obstacles, during hospitalization and after discharge, of fathers and mothers of preterm infants who did or did not participate in an early discharge program. METHOD A qualitative study using semi-structured interviews was performed and included 23 parents of preterm infants. Thematic analysis was performed with the assistance of Atlas.ti 6.2 software. RESULTS Two main themes were identified: the emotional experience and obstacles to care during hospitalization and the emotional experiences and obstacles at home related to the early discharge program. The results indicated that preterm birth initially has a deep emotional impact on parents. DISCUSSION There is a remarkable lack of coordination regarding the information provided to parents on their infant's health status. Being first-time parents seems to be an important factor, although further evidence supporting this notion should be provided. CONCLUSION Parents considered early discharge programs to be very useful in addressing the emotional aspects of hospitalization and the acquisition of neonatal care skills. Parents claim that the coordination and the information provided should be improved.
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Affiliation(s)
| | | | | | | | | | - Nieves Pérez-Marfil
- Mind, Brain and Behaviour Research Center (Cimcyc), University of Granada, Spain
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22
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Lee SY, Hsu HC. Genetic Susceptibility and Sleep Disturbance in Black Mothers of Preterm Infants: An Exploratory Study. SAGE Open Nurs 2016. [DOI: 10.1177/2377960816643326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Serotonin (5HT) is involved in emotion and sleep regulation and the 5HT transporter (5HTT) regulates 5HT function. A common 44-base pair deletion (short allele) or insertion (long allele) polymorphism in the promoter region of 5HTT (5-HTTLPR) is differentially associated with 5HTT transcription efficiency. Under stressful conditions, the short allele of 5-HTTLPR has been associated with depression and sleep disturbance. Black women are at higher risk for preterm labor and depressive symptoms. Thus, this exploratory study aimed to examine whether depressive symptoms and sleep disturbance in Black mothers would vary as a function of the 5-HTTLPR genotype when they faced the stress of infant hospitalization after preterm birth at early postpartum. A total of 30 Black mothers filled out a battery of questionnaires, including the Perceived Stress Scale, Edinburgh Postnatal Depression Scale, and General Sleep Disturbance Scale. A wrist actigraph was used to assess total sleep time and circadian activity rhythms. Buccal cells from saliva were collected to test the 5-HTTLPR genotype. Results showed that about 38% of the mothers were heterozygous for the short (S/L) allele, and 62% were homozygous for the long (L/L) allele. Mothers’ perceived global stress, depressive symptoms, and circadian activity rhythms did not vary with their 5-HTTLPR genotypes. Unexpectedly, mothers with the L/L allele reported greater sleep disturbances than those with the S/L allele. Ethnic specificity in genetic susceptibility to stress was discussed.
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Affiliation(s)
- Shih-Yu Lee
- Department of Nursing, Hungkuang University, Taichung, Taiwan
- Georgia State University, Atlanta, GA, USA
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23
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Edéll-Gustafsson U, Angelhoff C, Johnsson E, Karlsson J, Mörelius E. Hindering and buffering factors for parental sleep in neonatal care. A phenomenographic study. J Clin Nurs 2014; 24:717-27. [PMID: 25041598 DOI: 10.1111/jocn.12654] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2014] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To explore and describe how parents of preterm and/or sick infants in neonatal care perceive their sleep. BACKGROUND Parents experience many stressful situations when their newborn infant is preterm and/or sick. This affects bonding. By developing more family-centred care units with single-family rooms, parents are given the opportunity to stay and care for their newborn infant(s) 24 hours a day. Lack of sleep may affect new parents' ability to cope with the many challenges they face on a daily basis. DESIGN A phenomenographic study with an inductive and exploratory design. METHODS Semi-structured interviews were conducted with twelve parents of infants in neonatal care between January-March 2012. To describe variations in perception of the phenomenon, data were analysed using phenomenography. FINDINGS Four descriptive categories were identified within the phenomenon sleep in parents of preterm and/or sick infants in neonatal care: impact of stress on sleep; how the environment affects sleep; keeping the family together improves sleep; and, how parents manage and prevent tiredness. CONCLUSION Anxiety, uncertainty and powerlessness have a negative influence on sleep. This can be decreased by continuous information, guidance and practical support. Skin-to-skin care was perceived as a stress-reducing factor that improved relaxation and sleep and should be encouraged by the nurse. The parents also mentioned the importance of being together. Having a private place where they could relax and take care of themselves and their newborn infant improved sleep. It was also desirable to involve older siblings in order to decrease feelings of loneliness, sadness and isolation. RELEVANCE FOR CLINICAL PRACTICE Improved parental sleep in neonatal care may help the families cope with the situation and facilitate problem-solving, emotional regulation and the transition to parenthood.
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Affiliation(s)
- Ulla Edéll-Gustafsson
- Department of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden
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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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