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Lin KY, Tsai YJ, Yang JF, Wu MH. Physical therapists' experiences and perceptions of antepartum and postpartum care. BMC Pregnancy Childbirth 2022; 22:176. [PMID: 35241016 PMCID: PMC8896273 DOI: 10.1186/s12884-022-04484-7] [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] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/16/2022] [Indexed: 11/26/2022] Open
Abstract
Background Little is known about the physical therapists’ practice and perceptions toward management of pregnancy/postpartum-related disorders in Taiwan. The aim of this study was to document current practice of physical therapy in antepartum and postpartum care in Taiwan. Methods An exploratory, cross-sectional study was conducted in registered physical therapists living in Taiwan. An anonymized online survey was designed, piloted, and advertised widely from March 2020 to March 2021. Data were analyzed using descriptive statistics, Chi square analysis and multivariate logistic regression. Results Of the 364 respondents, 37.6% had experience of treating pregnant or postpartum women in clinical practice. The most commonly treated pregnancy/postpartum-related disorder in practice was low back pain (61.3%). All respondents reported little to moderate level of confidence in their ability to manage pregnancy/postpartum-related disorder. Being female (p < 0.01); working at a regional hospital (p = 0.01), district hospital or district teaching hospital (p < 0.01), clinic (p = 0.01) or physiotherapy clinic (p = 0.01); and having prior experience of treating antepartum or postpartum women (p < 0.01) were significantly associated with willingness to provide customer-oriented service or health education to patients/clients with pregnancy/postpartum-related disorder after controlling for other confounding variables. The most commonly reported barrier was “lack of available training” (81.3%). Conclusion The majority of participating physical therapists indicated a positive attitude to antepartum and postpartum care but were not confident in management of various pregnancy/postpartum-related disorder in practices. The findings of this study highlight the educational needs related to antepartum and postpartum care in clinical practice for physical therapists in Taiwan.
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Affiliation(s)
- Kuan-Yin Lin
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan, 701, Taiwan. .,Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Yi-Ju Tsai
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan, 701, Taiwan.,Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jeng-Feng Yang
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan, 701, Taiwan.,Physical Therapy Center, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Meng-Hsing Wu
- Department of Obstetrics and Gynecology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Wang M, László KD, Svedberg P, Nylén L, Alexanderson K. Childbirth, morbidity, sickness absence and disability pension: a population-based longitudinal cohort study in Sweden. BMJ Open 2020; 10:e037726. [PMID: 33234618 PMCID: PMC7689079 DOI: 10.1136/bmjopen-2020-037726] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To investigate associations of morbidity with subsequent sickness absence (SA) and disability pension (DP) among initially nulliparous women with no, one or several childbirths during follow-up. DESIGN Longitudinal register-based cohort study. SETTING Sweden. PARTICIPANTS Nulliparous women, aged 18 to 39 years and living in Sweden on 31 December 2004 and the three preceding years (n=492 504). OUTCOME MEASURES Annual mean DP and SA days (in SA spells >14 days) in the 3 years before and after inclusion date in 2005. METHODS Women were categorised into three groups: no childbirth in 2005 nor during the follow-up, first childbirth in 2005 but not during follow-up, and having first childbirth in 2005 and at least one more during follow-up. Microdata were obtained for 3 years before and 3 years after inclusion regarding SA, DP, mortality and morbidity (ie, hospitalisation and specialised outpatient healthcare, also excluding healthcare for pregnancy, childbirth and puerperium). HRs and 95% CIs for SA and DP in year 2 and 3 after childbirth were estimated by Cox regression; excluding those on DP at inclusion. RESULTS After controlling for study participants' prior morbidity and sociodemographic characteristics, women with one childbirth had a lower risk of SA and DP than those who remained nulliparous, while women with more than one childbirth had the lowest DP risk. Morbidity after inclusion that was not related to pregnancy, childbirth or the puerperium was associated with a higher risk of future SA and DP, regardless of childbirth group. Furthermore, morbidity both before and after childbirth showed a strong association with SA and DP (HR range: 2.54 to 13.12). CONCLUSION We found a strong positive association between morbidity and both SA and DP among women, regardless of childbirth status. Those who gave birth had lower future SA and DP risk than those who did not.
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Affiliation(s)
- Mo Wang
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Krisztina D László
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Pia Svedberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Lotta Nylén
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Academic Primary Healthcare Centre, Region Stockholm, Stockholm, Sweden
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Zulkifly HH, Clavarino A, Kassab YW, Dingle K. The association between perception of health during pregnancy and the risk of cardiovascular disease: a prospective study. SPRINGERPLUS 2016; 5:6. [PMID: 26759745 PMCID: PMC4700040 DOI: 10.1186/s40064-015-1639-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 12/20/2015] [Indexed: 11/10/2022]
Abstract
There is some evidence that self-rated perceptions of health are predictive of objective health outcomes, including cardiovascular disease, and mortality. The objective of this study was to examine the prospective association between perceptions of health during pregnancy and cardiovascular risk factors of mothers 21 years after the pregnancy. Data used were from the Mater University Study of Pregnancy (MUSP), a community-based prospective birth cohort study begun in Brisbane, Australia, in 1981. Logistic regression analyses were conducted. Data were available for 3692 women. Women who perceived themselves as not having a straight forward pregnancy had twice the odds (adjusted OR 2.0, 95 % CI 1.1–3.8) of being diagnosed with heart disease 21 years after the pregnancy when compared with women with a straight forward pregnancy (event rate of 5.2 versus 2.6 %). Women who experienced complications (other than serious pregnancy complications) during their pregnancy were also at 30 % increased odds (adjusted OR 1.3, 95 % CI 1.0–1.6) of having hypertension 21 years later (event rate of 25.7 versus 20 %). As a whole, our study suggests that pregnant women who perceived that they had complications and did not have a straight forward pregnancy were likely to experience poorer cardiovascular outcomes 21 years after that pregnancy.
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Affiliation(s)
- Hanis Hanum Zulkifly
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Kampus Puncak Alam, Puancak Alam Campus, 42300 Bandar Puncak Alam, Selangor Malaysia
| | - Alexandra Clavarino
- Pharmacy Australia Centre of Excellence, University of Queensland, Woolloongabba, Brisbane, QLD 4102 Australia
| | - Yaman Walid Kassab
- Department of Hospital and Clinical Pharmacy, No. 3410, Jalan Teknokrat 3, Cyber 4, 63000 Cyberjaya, Selangor Darul Ehsan Malaysia
| | - Kaeleen Dingle
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove Campus, Brisbane, QLD 4059 Australia
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Kingsbury AM, Hayatbakhsh R, Mamun AM, Clavarino AM, Williams G, Najman JM. Trajectories and predictors of women's depression following the birth of an infant to 21 years: a longitudinal study. Matern Child Health J 2015; 19:877-88. [PMID: 25081239 DOI: 10.1007/s10995-014-1589-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Little is known about the long-term mental health of women following the birth of an infant. This study describes the 21 year trajectory of women's depression following the birth of an infant and identifies early predictors of post-birth maternal depression trajectories. The sample comprises 2,991 women from the Mater and University of Queensland Study of Pregnancy. Using the Delusions-Symptoms-States-Inventory, depression was measured at 6 months, 5, 14 and 21 years after the birth. These measures were clustered and in addition bivariate and multivariate analyses were used to test for significant association between the groups and a range of maternal socio-demographic, psychological and pregnancy-related factors. Two depression trajectories were produced, a no-low depression group (79.0 %) and a high-escalating depression group (21.0 %). The strongest predictors for a high-escalating depression group were conflict in the partner-relationship (p < 0.001), anxiety (p < 0.001) and stress (p < 0.001) in the antenatal period, having many pregnancy symptoms (p < 0.001), being younger (p < 0.001) and having poorer social networks (p < 0.001). To a lesser extent not completing high school (p < 0.05), being unsure about wanting the pregnancy (p < 0.05) and not wanting contact with the infant following the birth (p < 0.05) were also predictors for high-escalating depression trajectory. Our findings suggest a sub-sample of mothers experience persistent depressive symptoms over a 21 year period following the birth of their infant. Partner conflict, inadequate social supports and poor mental health during the pregnancy, rather than factors relating to the birth event, contribute to women's depressive symptoms in the long-term. Given the identification of early markers for persistent depression, there may be opportunities for intervention for at-risk pregnant women.
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Affiliation(s)
- Ann M Kingsbury
- School of Population Health, University of Queensland, Brisbane, QLD, Australia,
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Narusyte J, Björkenstam E, Alexanderson K, Ropponen A, Kjeldgård L, Svedberg P. Occurrence of sickness absence and disability pension in relation to childbirth: A 16-year follow-up study of 6323 Swedish twins. Scand J Public Health 2015; 44:98-105. [PMID: 26459495 DOI: 10.1177/1403494815610051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Pregnancy, delivery, and the postpartum period may imply morbidity leading to work incapacity; however, this is seldom studied. This study aimed to compare twin sisters giving or not giving birth regarding occurrence of sickness absence (SA) and disability pension (DP). METHODS This population-based cohort study included all 6323 female twins born in Sweden 1959-1990, using register data for 1994-2010 about SA and DP. Average number of SA/DP days/year was calculated in relation to the year of the first delivery, or, if not giving birth, the year when the twin sister gave birth. Twin pairs discordant for delivery were used to investigate the importance of genetic and environmental factors for occurrence of SA and DP. RESULTS In all, 52% had a first delivery during 1994-2010. Except for the year of delivery, the average number of SA days/year was similar when comparing women who gave birth to those who did not, while number of DP days was significantly higher in women who did not give birth. Differences between the groups seem attributable to genetic factors. Women who delivered once had higher levels of SA and DP than those who had several deliveries. DP with mental diagnoses was more common among women who had not delivered whereas DP with musculoskeletal diagnoses occurred more often among women who delivered. CONCLUSIONS Levels of SA were similar among women who gave birth and who did not. Women not giving birth had significantly higher levels of DP, indicating health selections into childbirth.
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Affiliation(s)
- Jurgita Narusyte
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden
| | - Emma Björkenstam
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden Department of Community Health Sciences, Fielding School of Public Health and California Center for Population Research, University of California Los Angeles, USA
| | - Kristina Alexanderson
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden
| | | | - Linnea Kjeldgård
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden
| | - Pia Svedberg
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden
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Sabuncuoglu O, Basgul A. Pregnancy health problems and low birth weight associated with maternal insecure attachment style. J Health Psychol 2014; 21:934-43. [DOI: 10.1177/1359105314542819] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We aimed to determine the association between attachment style and health problems during pregnancy, as well as perinatal health variables. In 122 mothers who were 2–18 months postpartum, hot flushes, vaginal discharge, back pain, breast tenderness, hair changes, and psychological problems were shown to be associated with insecure attachment as measured by the Adult Attachment Style Questionnaires. Babies born to mothers with insecure attachment were more likely to have a low birth weight. It is vital to increase awareness of insecure attachment style as a risk factor among perinatal health care providers to optimize services.
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Sumner LA, Valentine J, Eisenman D, Ahmed S, Myers H, Wyatt G, Liu H, Zhang M, Rodriguez MA. The influence of prenatal trauma, stress, social support, and years of residency in the US on postpartum maternal health status among low-income Latinas. Matern Child Health J 2012; 15:1046-54. [PMID: 20652383 PMCID: PMC3043120 DOI: 10.1007/s10995-010-0649-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
This study examined the associations of prenatal psychosocial factors, including depressive symptoms, post-traumatic stress disorder symptoms, trauma exposure including intimate partner violence, perceived stress, and social support, with perceived postpartum health status. Low-income Latinas (N = 203) were recruited from two health plans within the first 12 weeks of their pregnancies and followed through 3 months after birth. Participants completed semi-structured interviews conducted in English or Spanish within the first 12 weeks of pregnancy, and again at 12 weeks postpartum. Perceived health status was measured by the SF-12. Participants with complete follow-up data (n= 193) were used in data analysis. Women were mostly foreign-born (75%) with low-incomes (59%) and reported postpartum health status in the average range (M = 102.5; SD = 12.2). Overall health status was positively associated with decreased levels of perceived stress (P < .0001), being foreign-born and having resided in the US <10 years (P = .003). Emotional well-being was positively linked with being foreign-born and having resided in the US <10 years (P = .002), increased levels of social support (P = .01), and decreased levels of perceived stress (P < .001). Exposure to non-specific IPV trauma (P = .01) and health problems experienced during pregnancy or delivery (P = .05) were negatively associated with physical health status. Prenatal psychosocial factors and length of residency in the US are differentially predictive of overall postpartum health status and emotional well-being, and have less impact on physical well-being after birth. Health professionals are encouraged to assess these factors in early pregnancy.
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Affiliation(s)
- Lekeisha A Sumner
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
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