Religious Coping and Locus of Control in Normal Pregnancy: Moderating Effects Between Pregnancy Worries and Mental Health

Evaluation of Midwives' Perceptions of Spirituality and Spiritual Care in Aydın, Turkey

Spirituality is an integral part of holistic care, but studies have revealed that the spiritual dimension of care is largely neglected in healthcare settings. This study evaluated midwives' perceptions of spirituality and spiritual care. The study is a cross-sectional design and was conducted from April 1 to June 30, 2018 in Aydın, Turkey. The research sample of the study contacted 101 midwives. The Spirituality and Spiritual Care Rating Scale were used to collect data. It was found that the midwives' perceptions of spirituality and spiritual care were affected by age, having children, family type, and working unit (p < 0.05).

Acceptance of Pregnancy-Induced Disease and Intrapersonal Resistance Resources of Pregnant Women-Preliminary Report

The health problems complicating pregnancy are a source of anxiety and concern about the developing fetus' health and life. The aim of the study was to assess the acceptance of illness and selected intrapersonal resistance resources for women whose pregnancies are complicated by gestational diabetes or pregnancy-induced hypertension and their determinants. The study was conducted from April 2019 to January 2021 in 688 pregnant women who were patients of the pregnancy pathology department and gynecology-obstetrics outpatient clinics in Lublin (Poland), using a diagnostic survey method with the use of the following research tools: Acceptance Illness Scale, Generalized Self-Efficacy Scale, Multidimensional Health Locus of Control Scale, and the standardized interview questionnaire. The study group included 337 women with gestational diabetes and pregnancy-induced hypertension. The control group included 351 women with an uncomplicated course of pregnancy. The level of acceptance of illness in pregnant women with pregnancy-induced diseases is on the border between medium and high acceptance (29.36 ± 7.82). The respondents in the control group had lower levels of self-efficacy (28.47 vs. 29.62) and health locus of control in the internal dimension (24.61 vs. 26.25) (p < 0.05). Respondents with pregnancy-induced diseases are characterized by the internal dimension of locus of health control.

Repetitive negative thinking in the perinatal period and its relationship with anxiety and depression

BACKGROUND

Rumination and worry represent two types of repetitive negative thinking (RNT), and their predictive and maintaining roles are well-established in depression and anxiety, respectively. Furthermore, there is an emerging literature on the link between RNT and psychological wellbeing in the perinatal period.

METHODS

We conducted a scoping review of studies that have investigated the relationship between RNT and perinatal depression and anxiety. We identified 87 papers eligible for inclusion in the review; they included cross-sectional and longitudinal studies, as well as treatment evaluations (pilot trials and randomised controlled trials).

RESULTS

Cross-sectional studies provided evidence of an association between RNT (i.e., rumination and worry) and depression and anxiety, in both pregnancy and postpartum. Longitudinal findings were mixed. Whilst antenatal worry consistently predicted subsequent depression and anxiety (both later in pregnancy and postpartum), rumination did not consistently predict depression. However, there was some evidence that rumination interacted with other processes to predict later psychopathology. Three randomised controlled trials evaluated whether psychological treatments reduce RNT in the perinatal period, only one of which included a clinical sample.

LIMITATIONS

No experimental investigations were eligible for inclusion in the review.

CONCLUSIONS

Further studies are needed to further our understanding of the nature and role of RNT in pregnancy and postpartum, and its consequences for maternal mental health. These include (but are not limited to) experimental investigations, studies with large clinical samples, and RCTs evaluating the effectiveness of psychological interventions targeting RNT to prevent and treat perinatal depression and anxiety.

The Effect of Religious Attitudes on Anxiety and Psychological Well-being in Risky Pregnancies: A Cross-Sectional Study from Turkey

The aim of this study was to determine how religious attitudes of risky pregnant women affect their anxiety and psychological well-being. This is a cross-sectional study. It was carried out on 137 women diagnosed with risky pregnancy between December 2021 and February 2022 in a state hospital in Osmaniye, located in the southern Turkey. The findings of the study revealed that the participants' religious attitudes affected their trait anxiety and psychological well-being. Being religious in fact, boosted psychological well-being of the participants and lowered their trait anxiety level. They had a moderate religious attitude and a moderate psychological well-being but they also suffered from high trait anxiety levels.

The Mediating Role of Dispositional Optimism in the Relationship between Health Locus of Control and Self-Efficacy in Pregnant Women at Risk of Preterm Delivery

Difficult situations during pregnancy, such as threatened preterm labor, trigger negative experiences in women. The levels of stress experienced and the way individuals cope with it depend on their personal resources, such as optimism, internal health locus of control, and self-efficacy, among other factors. The purpose of this paper was to determine the role of dispositional optimism in the relationship between health locus of control and self-efficacy in pregnant women with threatened preterm labor. Dispositional optimism plays the role of mediator in relationships between: (1) internal health control and self-efficacy; and (2) impact of random events on one's health and self-efficacy. Dispositional optimism does not mediate the relationship between the perceived impact of others on one's health and self-efficacy. For women with a high-risk pregnancy, dispositional optimism is a significant resource for coping with the problems they encounter. It changes the direction (from negative to positive) of the association between experiencing the impact of external factors (random events) on one's health and perceived self-efficacy. It prevents the cycle of loss caused by the interpretation of random events as having an impact on one's health, and acts as a mediator to initiate a cycle of gains that leads to greater perceived self-efficacy. Optimistic pregnant women maintain a positive outlook, even when confronted with difficult, negative experiences such as threatened preterm labor.

Correlation between religious coping, demographic and fertility factors, and pregnancy anxiety of Iranian primiparous women: a cross-sectional study

BACKGROUND

Anxiety during pregnancy can have side effects for both the mother and the baby. Therefore, it is necessary to study the factors that affect anxiety during pregnancy. This study aimed to investigate the role of religious coping and demographic and fertility factors in predicting pregnancy anxiety in Iranian primiparous women.

METHODS

We conducted a cross-sectional study on 300 primiparous women (n = 100 in each trimester of pregnancy) referred to seven health centers affiliated to the Iran University of Medical Sciences, Tehran, Iran. The sampling method was multistage. It lasted from July 2018 till August 2019. Data collection tools included the demographic and fertility questionnaire, valid and reliable Iranian Religious Coping Scale (IRCS), and standard State-Trait Anxiety Inventory (STAI).

RESULTS

Religious practices, benevolent reappraisal, and active religious coping had a significant inverse relationship with state and trait anxiety. Whereas negative and passive religious coping had a significant direct relationship with state and trait anxiety. The mean scores of state anxiety had a significant relationship with the women's education, spouse's education and occupation, economic status and housing status. There was no relationship between state anxiety and fertility variables. Based on multiple linear regression, negative and active religious coping predicted 27% of state anxiety and 15% of trait anxiety. Among these two variables, the negative religious coping was the more effective in predicting state and trait anxiety.

CONCLUSION

With increasing positive religious coping, the anxiety of pregnant women decreased. Whereas with increasing negative religious coping, their anxiety increased. Our results emphasize the role of negative religious coping in predicting pregnancy anxiety.

Does pain after delivery unequivocally lead to postpartum depression? The moderating role of religious coping

OBJECTIVE

The objective of this work is to explore whether the relationship between pain after delivery and postpartum depression is increased or decreased by the use of religion as a coping strategy (moderation).

METHODS

A longitudinal cohort study was conducted. The sample was evaluated on three occasions: third trimester of pregnancy (religious coping), after birth (pain severity) and four months after delivery (postpartum depression). Participants were 122 women (mean age = 31.29; SD = 4.9: range = [22, 42 years]) with low obstetric risk.

RESULTS

Both pain severity and religious coping contributed to postpartum depression (r = .20, p = .029 and r = .28, p = .04, respectively). Religious coping exacerbated the relationship between pain after delivery and postpartum depression (B = -0.11, t = -2.48, p = .014, [-0.20, -0.02]). Depression was highest in participants using religious coping irrespective of pain severity levels.

CONCLUSION

These findings support the importance of person-environment interaction studies and provide new evidence on the deleterious role of religious coping in the well-being of women after childbirth.

Determinants of Psychosocial Resilience Resources in Obese Pregnant Women with Threatened Preterm Labor-A Cross-Sectional Study

Background: The purpose of the study was to assess the level of such psychosocial resilience resources as self-efficacy, dispositional optimism, and health locus of control in pregnant women with obesity with threatened premature labor. Methods: The study was performed in the years 2017-2020 in a group of 328 pregnant women hospitalized due to threatened preterm labor and diagnosed with obesity before the pregnancy. The following instruments were applied: the Life Orientation Test, the Generalized Self-Efficacy Scale, and the Multidimensional Health Locus of Control Scale. Results: Obese pregnant women with threatened premature labor have a moderate level of generalized self-efficacy (28.02) and a moderate level of dispositional optimism (16.20). Out of the three health locus of control dimensions, the highest scores were recorded in the "internal control" subscale (26.08). Statistically significant predictors for the self-efficacy variable model included: satisfactory socio-economic standing (ß = 0.156; p = 0.004), being nulliparous (ß = -0.191; p = 0.002), and the absence of comorbidities (ß = -0.145; p = 0.008). Higher levels of dispositional optimism were found in women who were married (ß = 0.381; p = 0.000), reported a satisfactory socio-economic standing (ß = 0.137; p = 0.005), were between 23 and 27 weeks pregnant (ß = -0.231; p = 0.000), and had no comorbidities (ß = -0.129; p = 0.009). Conclusions: Generalized self-efficacy in obese women with threatened preterm labor is associated with satisfactory socio-economic standing, being nulliparous, and the absence of chronic disease. Dispositional optimism in obese pregnant women with threatened preterm labor is determined by their marital status, socio-economic standing, gestational age, and the absence of comorbidities.

Maternal Resources, Pregnancy Concerns, and Biological Factors Associated to Birth Weight and Psychological Health

Cognitive maternal adaptation during pregnancy may influence biological variables, maternal psychological, and neonatal health. We hypothesized that pregnant women with numerous general resources and less negative emotions would have a better coping with a positive influence on neonatal birth weight and maternal psychological health. The study included 131 healthy pregnant women. A blood sample was obtained in the first trimester to assess biological variables (polyphenols, hematological and biochemical parameters). Psychological variables (negative affect, anxiety, optimism, resilience, family–work conflicts, pregnancy concerns, general resources, and life satisfaction) were evaluated at several time points along gestation, and birth weight was recorded. Hierarchical linear regression models were used to associate the above parameters with maternal psychological outcome at the end of gestation (depression, resilience, and optimism) and neonatal outcome (birth weight). Maternal depression was associated with leukocytes (β = 0.08 ± 0.03, p-value = 0.003), cholesterol (β = 0.01 ± 0.002, p-value = 0.026), and pregnancy concerns (β = 0.31 ± 0.09, p-value = 0.001). Maternal resilience was associated with leukocytes (β = −0.14 ± 0.09, p-value = 0.010) and life satisfaction (β = 0.82 ± 0.08, p-value = 0.001), and maternal optimism was associated with polyphenol levels (β = 0.002 ± 0.001, p-value = 0.018) and life satisfaction (β = 0.49 ± 0.04, p-value = 0.001). Birth weight was associated with maternal resilience (β = 370.2 ± 97.0, p-value = 0.001), red blood cells (β = 480.3 ± 144.4, p-value = 0.001), and life satisfaction (β = 423.3 ± 32.6, p-value = 0.001). We found associations between maternal psychological, blood variables, and birth weight and maternal depression. This study reveals the relevance of psychological health during pregnancy for maternal and neonatal outcome, and it emphasizes the need to consider it in preventive policies in the obstetric field.

Bear bile use at the intersection of maternal health in Cambodia

BACKGROUND

The consumption of bear gallbladders and bear bile in Southeast Asia is a persistent threat to bear populations. As part of a larger effort to understand the characteristics of bear part consumption in Cambodia, we uncovered a consumer base of women seeking treatment for post-partum and uterine ailments.

METHODS

To better understand this aspect of consumption, we interviewed 122 women in seven different provinces in Cambodia, probing into the motivations and influences for using bear bile, as well as what types of ailments Cambodian women use it for.

RESULTS

We found that it is generally used by young or expecting mothers, and for such issues as post-partum "fatigue" (toas in Khmer), which could encompass post-partum depression. A desire to be supported by kin networks seems to facilitate the continued use of bear gallbladder and bile for these purposes.

CONCLUSIONS

We suggest that efforts to reduce consumption should focus on encouraging older kin to change their means of support to Western/biomedical and by extension non-wildlife alternatives.

The Association of Religion and Spirituality with Postpartum Mental Health in Women with Childhood Maltreatment Histories

OBJECTIVES

Although the associations between religion and spirituality and mental health and trauma have been studied extensively across various populations, relatively few studies have focused on the postpartum period. This study aimed to shed light on specific domains of religiosity and spirituality that may be resiliency factors for positive postpartum adjustment defined as low depression and high quality of life in mothers oversampled for childhood trauma histories.

METHODS

We examined several religion and spirituality variables among 108 women at 6 months postpartum as well as prospective relations from religion and spirituality to postpartum depression and quality of life at 12 and 15 months postpartum.

RESULTS

We found that the personal aspects of self-forgiveness and forgiveness for others were most relevant as resiliency factors predicting lower postpartum depression and better quality of life even when controlling for other risks (trauma and demographics). Surprisingly, no other religion and spirituality domain had associations with postpartum depression or quality of life, with the exception of a significant negative association for organizational religiousness with quality of life at 12 months postpartum.

CONCLUSIONS

Our findings suggest that forgiveness, especially to self and to others, in women who have been physically and mentally hurt as children may be associated with mental wellness and quality of life in the late postpartum period. Further, our results point to the need to study specific religion and spirituality aspects in the context of specific populations and conditions instead of generally studying religion and spirituality as a common marker for coping.

The relationship between general health and coping style with perceived stress in primigravida healthy pregnant women: Using the PATH model

The aim of this study was to analyze relationships among general health, coping style, and perceived stress in healthy primigravida pregnant women. A cross-sectional study was conducted at public health clinics in Hamadan city, Iran between July and December 2015. In total, 380 pregnant women were selected through stratified random sampling. Data were collected using the Revised Prenatal Coping Inventory and General Health Questionnaire. Perceived stress was assessed through an interview comprised of open-ended questions. The final PATH model fit well; general health (β = 0.02) as well as anxiety and sleep disorders (β = 0.03) were slightly directly associated with perceived stress, and only planning-preparation was related to perceived stress through general health (β = 0.09). The findings enhance the knowledge gained from previous perinatal stress research. General health status was directly related to stress, and coping style was indirectly related to stress. Coping styles may mediate the relationship between general health status and perceived stress, suggesting that midwives should attempt to improve the general health of women to reduce stress and its consequences during pregnancy by teaching patients appropriate coping styles. Further studies on the effect of coping style interventions on stress are warranted.

The Factor Structure and Psychometric Properties of the Persian Version of the Revised Prenatal Coping Inventory (Nu-PCI)

INTRODUCTION

Familiarity with coping strategies is essential for stress management during pregnancy. The Revised Prenatal Coping Inventory (Nu-PCI) was developed to assess coping strategies during pregnancy.

AIM

This study aimed to assess the factor structure and psychometric properties of the Persian version of the Nu-PCI.

MATERIALS AND METHODS

After forward-backward translation, the Nu-PCI was administered to 210 pregnant women who were enrolled in two teaching referral clinics in the North of the Islamic Republic of Iran (Babol). The participants completed the Persian Nu-PCI and Ways of Coping Questionnaire (WCQ), which was used to determine the validity of the Persian Nu-PCI. To test construct validity of the Persian Nu-PCI, a principal components factor analysis was performed.

RESULTS

Principal components analysis with varimax rotation showed a best fitting 3-factor structure similar to the original with three coping subscales: planning-preparation, avoidance, and spiritual-positive coping. The Persian Nu-PCI was internally consistent and within the acceptable range (α=0.89-0.97). The alpha coefficients for the Nu-PCI and the subscales of planning-preparation, avoidance, and spiritual-positive coping were high. Test-retest coefficients for the Nu-PCI and subscales were 0.98-0.99. The Nu-PCI and its subscales correlated with the WCQ in the entire sample and within each trimester.

CONCLUSION

The Persian version of the Nu-PCI and the subscales of planning-preparation, avoidance, and spiritual-positive coping represent the first reliable standardized tool for measuring coping strategies during pregnancy in the Islamic Republic of Iran. Therefore, it can be applied as a quick and accurate preliminary screening tool for evaluating coping strategies throughout pregnancy in clinics and other medical and research settings.