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Sun S, An S. Associations between patterns of social support and perinatal mental health among Chinese mother: the mediating role of social trust. J Psychosom Obstet Gynaecol 2024; 45:2325451. [PMID: 38465671 DOI: 10.1080/0167482x.2024.2325451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 02/23/2024] [Indexed: 03/12/2024] Open
Abstract
This study aims to explore the correlation between different social support patterns and perinatal mental health, and the mediating role of social trust in this. A cross-sectional survey was conducted in Jiangsu, China, with a sample size of 1705 pregnant respondents. Latent class analysis (LCA) was utilized to identify various social support patterns, while a multiple regression model was employed to analyze the mediating effect of social trust on the relationship between social support patterns and perinatal mental health. The study found four distinct social support patterns among the respondents: primary relationship-centric support, overall weak support, primary-secondary relationship-balanced support, and overall strong support. In the relationship between social support patterns and perinatal mental health, social trust played both a partial and full mediating role. The findings indicate that a social support system that enhances maternal trust and promotes honest disclosure of symptoms can effectively promote perinatal mental health.
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Affiliation(s)
- Sheng Sun
- Department of Sociology, School of Law, Jiangnan University, Wuxi, China
| | - Shanshan An
- Department of Sociology, School of Law, Jiangnan University, Wuxi, China
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Su X, Wang H, McQueen K, Dennis CL, Zhang Y, Chen M, Liu G. The reliability and validity of the Postpartum Partner Support Scale among Chinese women. Midwifery 2024; 136:104067. [PMID: 38901127 DOI: 10.1016/j.midw.2024.104067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 05/04/2024] [Accepted: 06/12/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND The benefits of partner support have been well documented for maternal and child health and wellbeing. Chinese women who practice traditional postpartum rituals may lack support during the confinement and often rely heavily on their partners. Currently, there is no validated measure to assess postpartum partner support in China. AIM To translate the Postpartum Partner Support Scale (PPSS) into Chinese, evaluate its psychometric properties and assess postpartum support among Chinese women. METHODS The PPSS was translated into Chinese using a validated process and administered to 428 postpartum women residing in the city of Quanzhou in the Fujian Province in China between September 2021 and July 2022. RESULTS Reliability analysis demonstrated a Cronbach's α coefficient of 0.97, a split-half coefficient of 0.93, and a retest correlation coefficient of 0.91 (p < 0.01). The item analysis and content validity results fell within the recommended range, with no items requiring deletion. Exploratory factor analysis revealed the extraction of a single common factor, which accounted for 74.05% of the cumulative variance. Confirmatory factor analysis yielded a χ2/df ratio of 1.48 and an RMSEA value of 0.05. Several demographic variables were associated with significantly lower levels of postnatal partner support including older maternal and paternal age, lower maternal education, higher household income, fair relationship with in-law family, female infant sex, and premature birth. CONCLUSION The Chinese version of the PPSS exhibited good reliability and validity providing evidence that it may be suitable for evaluating partner support among postpartum women in China.
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Affiliation(s)
- Xiaojuan Su
- Department of Nursing, Quanzhou Medical College, Quanzhou, Fujian 362011, China
| | - Huifang Wang
- Department of Obstetrics and Gynecology, Quanzhou Medical College, Quanzhou, Fujian 362011, China
| | - Karen McQueen
- Lakehead University School of Nursing, Thunder Bay, Ontario P7B 5E1, Canada
| | - Cindy-Lee Dennis
- Bloomberg Faculty of Nursing, University of Toronto, Ontario M5T 1P8, Canada
| | - Yuezhen Zhang
- Department of Nursing, Quanzhou Medical College, Quanzhou, Fujian 362011, China.
| | - Meide Chen
- Nursing Department, Quanzhou Women and Children(')s Hospital, Quanzhou, Fujian 362000, China
| | - Guihua Liu
- Department of Child Health Care, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian 350001, China
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Xu CW. The big heroine genre: motherhood and the maternal body in postsocialist Chinese television. MEDICAL HUMANITIES 2024; 50:332-342. [PMID: 38604655 DOI: 10.1136/medhum-2023-012839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/20/2024] [Indexed: 04/13/2024]
Abstract
This article explores the feminist social critique in the 'big heroine' drama, a newly emerged genre of television that focuses on empowering yet dramatic stories of urban women in contemporary China. The article theorises the genre as a site of ongoing contestations to inform and critique women's maternal reality in neoliberal, pronatalist China. The big heroine genre is situated in the postsocialist structure of feeling defined by alienation and precarity, responding to China's need to stabilise the emerging population crisis and labour shortage. Using a popular instance within the genre, Left Right (2022), as a case study, the article argues that the show validates the legitimacy of women's anxieties and challenges in maternity and then invites viewers to engage in a multifaceted analysis of the intricate web of structural injustices women experience in pregnancy, childbirth, the postpartum and having a second child. By doing so, it not only resonates with viewers' yearning for recognition and empathy but also stimulates a broader discourse on new and persisting maternal challenges in pronatalist China. I conclude that the genre's contradictory and contingent nature mirrors the complexities of the Chinese party-state's attempt to navigate the ideological instability surrounding maternity and motherhood. The genre is progressive in its alternative imagination of kinship and care networks for women navigating the moral, medical, and cultural dilemmas of the maternal body and motherhood in the moment of the state's transitioning into a more aggressive form of pronatalism.
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Shan H, Saharso S, van Kroonenburg N, Henrichs J. Understanding the relationship between maternity care providers and middle-class Chinese migrant women in the Netherlands: A qualitative study. Midwifery 2023; 125:103775. [PMID: 37480628 DOI: 10.1016/j.midw.2023.103775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/16/2023] [Accepted: 07/18/2023] [Indexed: 07/24/2023]
Abstract
OBJECTIVE This study aims to provide insights into the formation and the quality of the maternity care provider-woman relationship between midwives, maternity care assistants and middle-class Chinese migrant women in the Netherlands. DESIGN online in-depth interviews addressing interpersonal trust, women's autonomy in shared decision making and culturally sensitive care PARTICIPANTS: 46 middle-class Chinese migrant women, 13 midwives and 12 maternity care assistants in the Netherlands FINDINGS: Midwives and maternity care assistants reported challenges interpreting the needs of middle-class Chinese migrant women in care practices while Chinese migrant women experienced receiving insufficient emotional support. Midwives and maternity care assistant tended to attribute women's different preferences for care to culture which reinforced difficulties of addressing women's needs. Middle-class Chinese migrant women experienced a lack of responsive care, feelings of being overlooked, being uncomfortable to express different opinions and challenges in developing autonomy in the shared decision-making process. CONCLUSIONS A trusting relationship, effective communication with maternity care providers, and a culturally sensitive and safe environment could be beneficial for middle-class migrant mothers. Chinese migrant women held ambivalent attitudes towards both traditional Chinese health beliefs and Dutch maternity care values. Each individual woman adopted the practice of the "doing the month" tradition to a different extent. This indicated the need for maternity care providers to recognize women's various needs for more responsive and individualized care, especially for first-time migrant mothers to negotiate their ways through the new healthcare system. IMPLICATIONS FOR PRACTICE We suggest a more proactive role for maternity care providers addressing the individual's subjectivity and preferences. Our findings are relevant and applicable for maternity care professionals conducting shared decision making with middle-class and highly educated migrant women living in Western contexts.
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Affiliation(s)
- Haiyue Shan
- Department of Sociology, Vrije University Amsterdam, De Boelelaan 1105 HV, Amsterdam 1081, the Netherlands.
| | - Sawitri Saharso
- Department of Sociology, Vrije University Amsterdam, De Boelelaan 1105 HV, Amsterdam 1081, the Netherlands
| | - Nandy van Kroonenburg
- Department of Sociology, Vrije University Amsterdam, De Boelelaan 1105 HV, Amsterdam 1081, the Netherlands
| | - Jens Henrichs
- Department of Midwifery Science, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, De Boelelaan 1118 HZ, Amsterdam 1081, the Netherlands
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Shan H, Saharso S, Henrichs J. Experiences of peripartum depressive symptoms among Chinese middle-class migrant women in the Netherlands: a qualitative study of migrant motherhood. BMC Pregnancy Childbirth 2023; 23:638. [PMID: 37670269 PMCID: PMC10481590 DOI: 10.1186/s12884-023-05957-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 08/26/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND A low educational level and poor economic status have repeatedly been identified as the main risk factors of peripartum depression among migrant women in existing studies. However, there is limited knowledge about a group of highly educated and middle-class migrant women, and how this group of migrant women deals with those risks and which protective factors facilitate a successful transition into motherhood in the host country. This study aims to shed light on the multifaceted psychosocial challenges during the peripartum period for Chinese migrant women in their relationships with intimate partners, mothers, and mothers-in-law. METHODS In this qualitative study, semi-structured in-depth interviews were conducted digitally with 46 pregnant and postpartum middle-class Chinese migrant women with peripartum depressive symptoms in the Netherlands. The interview data were analyzed using content analysis. RESULTS The multifaceted psychosocial challenges for women with peripartum depressive symptoms were classified into three key categories: the ambivalence towards different mothering values, perceived inadequate and mismatching social support and adverse childhood experiences. CONCLUSION Well-educated middle-class Chinese migrant women with peripartum depressive symptoms faced challenges in the transition into motherhood due to the unmet self-expectations regarding the pursuit of a good quality of life and a happy motherhood. The nurturing intimate relationships and adequate social support in the host country have mitigated recollections of their adverse childhood experiences. Future prevention programs and postpartum care should consider the contextual specificity based on the childhood history. International mental health research should pay more attention to the growing and potentially vulnerable group of well-educated middle-class migrant women.
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Affiliation(s)
- Haiyue Shan
- Department of Sociology, Vrije University Amsterdam, De Boelelaan 1105, 1081HV, Amsterdam, Netherlands.
| | - Sawitri Saharso
- Department of Sociology, Vrije University Amsterdam, De Boelelaan 1105, 1081HV, Amsterdam, Netherlands
| | - Jens Henrichs
- Amsterdam University Medical Center, Vrije University Amsterdam, Amsterdam, Netherlands
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Huang W, Li G, Wang D, Qu H, Tian M, Wang Y. Postpartum depression literacy in Chinese perinatal women: a cross-sectional study. Front Psychiatry 2023; 14:1117332. [PMID: 37389174 PMCID: PMC10306307 DOI: 10.3389/fpsyt.2023.1117332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 05/17/2023] [Indexed: 07/01/2023] Open
Abstract
Background Postpartum depression literacy is a specific mental health literacy that can help perinatal women identify, manage, and prevent postpartum depression. However, the current status and associated factors of postpartum depression literacy among Chinese perinatal women are still unclear. This study investigated postpartum depression literacy and its associated factors among this group. Methods A cross-sectional survey was conducted involving 386 cases of perinatal women using the convenience sampling method. Participants completed four questionnaires to evaluate their general characteristics, postpartum depression literacy, perceived social support, and general self-efficacy. The SPSS 24.0 software was used for descriptive statistical analysis, univariate analysis, and multivariate analysis. Results The total PoDLiS score was (3.56 ± 0.32). The factors that composed the final multiple regression equation included planned pregnancy condition (β = -0.137, p = 0.003), education (β = 0.127, p < 0.001), history of depression (β = -0.271, p < 0.001), social support (β = 0.0012, p < 0.001), self-efficacy (β = 0.030, p < 0.001), and complications (β = -0.0191, p = 0.0019). They accounted for 32.8% of the total postpartum depression literacy variation (R2 = 0.328, F = 24.518, p < 0.001). Conclusion The findings of this study improved our understanding of perinatal women's postpartum depression literacy and its associated factors. Women with low postpartum depression literacy urgently need to be identified. Comprehensive nursing intervention measures should be taken from six dimensions of mental health literacy, social support, and self-efficacy to improve the postpartum depression literacy of perinatal women.
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Affiliation(s)
- Weijian Huang
- Eastern Operating Room, Yantai Yuhuangding Hospital, Yantai, China
| | - Guiqin Li
- Obstetrics Department, Yantai Yuhuangding Hospital, Yantai, China
| | - Dongmei Wang
- Obstetrics Department, Yantai Hospital of Traditional Chinese Medicine, Yantai, China
| | - Hua Qu
- Obstetrics Department, Yantai Yuhuangding Hospital, Yantai, China
| | - Maozhou Tian
- Department of Cardiac Surgery, Yantai Yuhuangding Hospital, Yantai, China
| | - Yanmei Wang
- Hemodialysis Department, Yantai Yuhuangding Hospital, Yantai, China
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Yang JP, Qu J, Sun K, Gao LL. Anxiety symptoms and health-related quality of life in mainland Chinese pregnant women: a cross-sectional study. J Reprod Infant Psychol 2023; 41:3-14. [PMID: 36682377 DOI: 10.1080/02646838.2021.1952553] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 06/28/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Health-related quality of life allows the health care professionals to envisage new axes of improvement in antenatal care and is a core aspect of contemporary maternity care provision. This study aims to estimate the prevalence of anxiety symptoms and explore the relationship between anxiety symptoms and health-related quality of life among Chinese pregnant women. METHODS A cross-sectional study was conducted in a local teaching hospital in Guangzhou, China between April and June, 2018. Seven hundred and seventy Chinese pregnant women completed the 36-Item Short-Form Health Survey (SF-36), the Self-rating Anxiety Scale (SAS) and socio-demographic questionnaires. RESULTS 18.2% women were classified as having elevated anxiety symptoms as evidenced by a SAS score ≥50. Compared with women without anxiety symptoms, the pregnant women with anxiety symptoms had worse physical (SF36-PCS) and mental (SF36-MCS) health-related quality of life and a lower level of seven domains of SF-36 (GH, RP, BP, VT, SF, RE and MH). Elevated anxiety symptoms predicted worse physical (SF36-PCS) and mental (SF36-MCS) health-related quality of life. The third trimester predicted a lower level of physical (SF36-PCS) health-related quality of life, while an unsatisfied relationship with mother-in-law predicted a lower level of mental (SF36-MCS) health-related quality of life. CONCLUSIONS The pregnant women with anxiety symptoms had impaired health-related quality of life. Health care professionals should identify pregnant women with anxiety symptoms and facilitate their treatment, which could improve their health-related quality of life.
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Affiliation(s)
- Jing-Ping Yang
- Registered Nurse, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Jia Qu
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ke Sun
- Professor of Nursing, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ling-Ling Gao
- Gynecological and Obstetrical Nursing Section, School of Nursing, Sun Yat-sen University, Guangzhou, China
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Wang Y, Xiao B, Li Y. Maternal mindfulness and preschool children’s social skills in China: the role of parenting stress and authoritative parenting behaviors. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-04084-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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9
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Cai Q, Chen DQ, Wang H, Zhang Y, Yang R, Xu WL, Xu XF. What influences the implementation of kangaroo mother care? An umbrella review. BMC Pregnancy Childbirth 2022; 22:851. [PMID: 36401193 PMCID: PMC9675107 DOI: 10.1186/s12884-022-05163-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/27/2022] [Indexed: 11/19/2022] Open
Abstract
Background Kangaroo mother care (KMC) is an evidence-based intervention that reduces morbidity and mortality in preterm infants. However, it has not yet been fully integrated into health systems around the world. The aim of this study is to provide a cogent summary of the evidence base of the key barriers and facilitators to implementing KMC. Methods An umbrella review of existing reviews on KMC was adopted to identify systematic and scoping reviews that analysed data from primary studies. Electronic English databases, including PubMed, Embase, CINAHL and Cochrane Library, and three Chinese databases were searched from inception to 1 July 2022. Studies were included if they performed a review of barriers and facilitators to KMC. Quality assessment of the retrieved reviews was performed by at least two reviewers independently using the Joanna Briggs Institute (JBI) critical appraisal checklist and risk of bias was assessed with the Risk of Bias Assessment Tool for Systematic Reviews (ROBIS) tool. This umbrella review protocol was documented in the PROSPERO registry (CRD42022327994). Results We generated 531 studies, and after the removal of duplicates and ineligible studies, six eligible reviews were included in the analysis. The five themes identified were environmental factors, professional factors, parent/family factors, access factors, and cultural factors, and the factors under each theme were divided into barriers or facilitators depending on the specific features of a given scenario. Conclusions Support from facility management and leadership and well-trained medical staff are of great significance to the successful integration of KMC into daily medical practice, while the parents of preterm infants and other family members should be educated and encouraged in KMC practice. Further research is needed to propose strategies and develop models for implementing KMC. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-05163-3.
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Applying mindfulness techniques to the management of perinatal women with a depressive tendency in Taiwan: A qualitative study. Asian Nurs Res (Korean Soc Nurs Sci) 2022; 16:149-154. [DOI: 10.1016/j.anr.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 11/21/2022] Open
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Chen H, Chen Y, Yang H, Hsu K, Zhou M, Chen C, Chuang P. Implementation of food safety management systems that comply with
ISO
22000:2018 and
HACCP
: A case study of a postpartum diet enterprise in Taiwan. J Food Saf 2022. [DOI: 10.1111/jfs.12965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Hsinjung Chen
- Department of Food Science and Biotechnology National Chung Hsing University Taichung City Taiwan
- Department of Nutrition China Medical University Taichung City Taiwan
- Department of Food Science and Technology Central Taiwan University of Science and Technology Taichung City Taiwan
| | - Yi‐Jyuan Chen
- Department of Food Science and Biotechnology National Chung Hsing University Taichung City Taiwan
| | - Hui‐Ting Yang
- Department of Food Safety Taipei Medical University Taipei City Taiwan
| | - Kuo‐Chiang Hsu
- Department of Nutrition China Medical University Taichung City Taiwan
| | - Minyi Zhou
- Department of Obstetrics and Gynecology The First People’s Hospital of Loudi Loudi China
| | - Chin‐Shuh Chen
- Department of Food Science and Biotechnology National Chung Hsing University Taichung City Taiwan
| | - Pei‐Ting Chuang
- Institute of Food Safety and Risk Management, National Taiwan Ocean University Keelung City Taiwan
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The Association between Postpartum Practice and Chinese Postpartum Depression: Identification of a Postpartum Depression-Related Dietary Pattern. Nutrients 2022; 14:nu14040903. [PMID: 35215552 PMCID: PMC8880681 DOI: 10.3390/nu14040903] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 01/27/2023] Open
Abstract
Conflicting results of Chinese traditional postpartum practices have aroused concerns over their health effects. The role of postpartum practices in postpartum depression (PPD) is still a matter of discussion, especially from a dietary practice point of view. The current study was designed to (1) explore the association between postpartum practices and PPD, (2) to identify the dietary pattern related to PPD, and (3) to identify the possible pathways among postpartum practices and PPD. This study is part of the YI Study, which was a cross-sectional study conducted in 10 cities in China. Data for 955 postpartum women were used in the current analysis. The Edinburgh Postnatal Depression Scale (EPDS-10) was used to evaluate PPD with a cutoff value of 9. Postpartum practice was based on the participants’ self-reported practices. Individual practices were recorded and categorized as dietary and non-dietary practices. The dietary pattern was identified based on the food intake frequencies of 25 food groups using the method of reduced rank regression. Structural equation modeling was used to explore the potential pathways between postpartum practices and PPD. The current study observed significant associations between postpartum practices and PPD (Adjusted OR = 1.41, 95% CI: 1.04–1.90). A similar trend was also found between dietary postpartum practices and PPD (Adjusted OR = 1.39, 95%CI: 1.03–1.88) but not for non-dietary practices and PPD (Adjusted OR = 1.26, 95%CI: 0.92–1.75). A PPD-related dietary pattern was identified with the characteristics of a high intake of meat and eggs and a lower intake of vegetables, mushrooms, and nuts. This dietary pattern was significantly associated with a higher chance of adhering to postpartum practice (Adjusted OR = 1.26, 95% CI: 1.10–1.44). Based on the pathway analysis, this study also observed the association between postpartum practices and PPD, and the association between dietary practices and PPD were both mediated by sleep quality. In conclusion, this study demonstrated that a substantial proportion of women in modern China experience traditional postpartum Chinese practices and that either overall or dietary-related postpartum practices are associated with a higher risk of PPD. The current dietary practices in postpartum rituals may play an important role in developing PPD. A culturally embedded, science-based dietary guideline is required to help women to achieve both physical and psychological health in the postpartum period.
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Effects of family relationship and social support on the mental health of Chinese postpartum women. BMC Pregnancy Childbirth 2022; 22:65. [PMID: 35078423 PMCID: PMC8787939 DOI: 10.1186/s12884-022-04392-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 01/11/2022] [Indexed: 12/19/2022] Open
Abstract
Abstract
Background
Numerous studies suggest that interpersonal relationships and social support influence the development of postpartum depression and sleep quality for women. However, the effect of support from the husband or the mother-in-law has not been thoroughly validated. The current study examined the relative contribution of marital satisfaction, perceived caring of the mother-in-law, and social support on postpartum depression and sleep quality simultaneously in a path model.
Methods
A cross-sectional study was conducted from March to June 2017 in Hebei, China, using a self-report questionnaire. A total of 817 women participated at 6 weeks postpartum. Sociodemographics and information about marital satisfaction, perceived caring of the mother-in-law, social support, postpartum depression, and sleep were collected. Path analysis was used to analyze the cross-sectional data.
Results
The final model had a highly satisfactory fit. Marital satisfaction and perceived caring of mother-in-law had both direct and indirect effects on postpartum depression through social support, but these two variables had only an indirect effect on sleep quality through social support and postpartum depression. Sleep quality is a consequence of postpartum depression at 6 weeks after delivery. The prevalence of minor and major postpartum depressive symptoms at 6 weeks postpartum was 41.49 and 23.13%, respectively. A total of 371 (45.41%) women experienced sleep disturbance at 6 weeks postpartum.
Conclusions
These findings suggest that interpersonal relationships with family members play important roles in postpartum depression and sleep quality through social support in Chinese women. Improving the relationship between new mothers and their husbands or mothers-in-law and then enhancing social support might reduce postpartum depression and sleep disturbance.
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14
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Nguyen VVT, Zheng MY, Liu SM, Kallen MA, Kay K, Ivey SL. Prevalence of Traditional Asian Postpartum Practices at a Federally Qualified Health Center. J Immigr Minor Health 2021; 24:1251-1260. [PMID: 34905140 PMCID: PMC8669035 DOI: 10.1007/s10903-021-01299-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 11/29/2022]
Abstract
To evaluate the knowledge of, participation in, attitudes towards, and experiences with "doing the month" (DTM), a traditional Chinese and Vietnamese postpartum practice, at a federally qualified health center that serves predominantly Asian immigrants. DTM practices revolve around the balance between yin and yang and include practices such as the mother remaining on bed rest for as long as possible, restricting diet to certain foods, and avoiding visitors and social activities. A cross-sectional survey in Chinese, Vietnamese, and English was developed to determine the prevalence of women who have heard of and participated in DTM. 154 respondents participated. The mean age of respondents was 40.1 years. Without prompting of what DTM was, 58 (37.7%) responded that they had heard of DTM. After an explanatory paragraph, this increased to 117 (76.6%) participants. Out of 107 patients who have children, 65 (60.7%) "did the month" after giving birth. Participation rates were highest for women who identified as Chinese or Vietnamese. Likert-type scale questions showed that respondents believed DTM was stressful but enjoyable and helpful for recovery from childbirth. In conclusion, DTM is a common practice that health providers should be aware of.
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Affiliation(s)
| | | | - Stephanie M Liu
- The Permanente Medical Group, Inc., 1800 Harrison Street, Oakland, CA, 94609, USA
| | - Michael A Kallen
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA.,, Missouri City, USA
| | - Kerry Kay
- Asian Health Services, Oakland, CA, 94607, USA.,, Oakland, USA
| | - Susan L Ivey
- UC Berkeley-UCSF Joint Medical Program, School of Public Health, University of California, 570 University Hall #1190, Berkeley, CA, 94720, USA
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15
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Chen YY, Canetto SS, Chien-Chang Wu K, Chen YL. Women's Suicide in the First-Year Postpartum: A Population-based Study. Soc Sci Med 2021; 292:114594. [PMID: 34844078 DOI: 10.1016/j.socscimed.2021.114594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/30/2021] [Accepted: 11/20/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND In dominant suicidology there is a long traditionof theorizing that women are protected from suicide, particularly when mothers and during the postpartum. Studies have mostly confirmed the postpartum suicide-protection theory, with low suicide mortality generally observed among postpartum women. A limitation of these studies is that most were conducted in majority European-descent-population countries. A challenge to the more general maternal suicide-protection theory is that in East-Asia women of childbearing age exhibit substantial suicidality, nonfatal and fatal. This study evaluated whether suicide is less likely in first-year postpartum women as compared to women past the first-year postpartum. METHODS This population-based, nested case-control study focused on women whose live birth was between 2001 and 2016 in East-Asian Taiwan. To ascertain suicide outcomes, the women were followed until 2017. For each suicide case, four control cases were randomly selected from the Birth Certificate Application dataset, with a 1:4 matching ratio based on age of last live-delivery and parity (one delivery record vs. two or more records) (cases N = 1571; controls N = 6284). Conditional logistic regression analyses were conducted to assess whether suicide was less likely in women in the first-year postpartum relative to women past the first-year postpartum. RESULTS The odds ratios of suicide were elevated at 42 days postpartum [Odds Ratio (OR) = 2.06; 95% Confidence Interval (CI) = (1.04, 4.16)], six-months postpartum [OR = 2.28; 95% CI = (1.60, 3.29)] and one-year postpartum [OR = 2.26; 95% CI = (1.76, 2.96)], when controlling for sociodemographic and mental-disorder variables. Suicide was more likely in women who were single at index birth, had lower socioeconomic status, or had a mental disorder history. CONCLUSION Our findings suggest that the postpartum stage is not suicide-protective per se. Whether the postpartum stage is associated with suicide protection or suiciderisk appears to depend on context and culture.
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Affiliation(s)
- Ying-Yeh Chen
- Taipei City Psychiatric Centre, Taipei City Hospital, Taipei City, Taiwan; Institute of Public Health and Department of Public Health, National Yang-Ming University, Taipei City, Taiwan
| | | | - Kevin Chien-Chang Wu
- Graduate Institute of Medical Education and Bioethics, National Taiwan University College of Medicine, Taipei City, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei City, Taiwan
| | - Yi-Lung Chen
- Department of Healthcare Administration, Asia University, Taichung, Taiwan; Department of Psychology, Asia University, Taichung, Taiwan.
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16
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Tang L, Zhang X, Zhu R. What Causes Postpartum Depression and How to Cope with It: A Phenomenological Study of Mothers in China. HEALTH COMMUNICATION 2021; 36:1495-1504. [PMID: 32452227 DOI: 10.1080/10410236.2020.1771063] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Culturally specific beliefs about mental illnesses influence people's experience of mental illnesses and their likelihood of seeking help. This study explores how mothers in China understand the causes of postpartum depression (PPD) and their preferred coping strategies through semi-structured interviews. It finds that these mothers often take a situational approach to PPD, attributing it to external factors that could be changed (e.g., lack of support from in-laws) or to internal factors that will disappear over time (e.g., hormonal fluctuation). As a result, these mothers often choose to cope with their PPD symptoms through self-help strategies such as talking to someone, enlisting help, and positive thinking. Seeking professional help is not a preferred coping strategy. Furthermore, participants often make different attributions about the PPD experiences of themselves and the experiences of others. In explaining other women's PPD symptoms, they are more likely to evoke the myths about gender and motherhood in the Chinese culture and blame PPD on these mothers' personality flaws, husbands' affairs, and financial hardships. Practically, our findings provide baseline data for the promotion of professional mental health care among mothers experiencing PPD in China.
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Affiliation(s)
- Lu Tang
- Department of Communication, Texas A&M University
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17
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Jia S(S, Wu B. Topic modelling and opinion mining of user generated content on the internet using machine learning: An analysis of postpartum care centres in Shanghai. JOURNAL OF INTELLIGENT & FUZZY SYSTEMS 2021. [DOI: 10.3233/jifs-189726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In order to reach a compromise between adhering to the traditional culture and embracing the modern lifestyle, more and more Asian moms are heading towards postpartum care centres for postpartum recovery. However, research regarding the quality of care of these postpartum care centres is nearly missing from the literature. This paper investigated the status quo of the postpartum care centres in Shanghai, China from mothers’ perspectives by means of analysing the 34280 pairs of ratings and reviews posted by postpartum care centre customers on the internet with machine learning and text mining. Results show that the mothers are generally satisfied with the studied care centres. Meanwhile, the 13 major topics in the customer online reviews were identified, which provide an overview of the interaction between a mother and a care centre. In addition, weight of topic analysis suggests that the studied care centres can further improve in the areas of support team, environment, and facility.
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Affiliation(s)
- Susan (Sixue) Jia
- School of Finance and Business, Shanghai Normal University, Shanghai, China
| | - Banggang Wu
- Business School, Sichuan University, Chengdu, Sichuan, China
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18
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Guo P, Xu D, Liew Z, He H, Brocklehurst P, Taylor B, Zhang C, Jin X, Gong W. Adherence to Traditional Chinese Postpartum Practices and Postpartum Depression: A Cross-Sectional Study in Hunan, China. Front Psychiatry 2021; 12:649972. [PMID: 34385937 PMCID: PMC8353075 DOI: 10.3389/fpsyt.2021.649972] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 06/25/2021] [Indexed: 12/02/2022] Open
Abstract
Background: The relationship between adherence to traditional Chinese postpartum practices (known as "doing-the-month") and postpartum depression (PPD) remains unknown. Practices including restrictions on diet, housework and social activity, personal hygiene, and cold contact, could introduce biological, psychological, and socio-environmental changes during postpartum. Methods: The cross-sectional study included 955 postpartum women in obstetric clinics in Hunan Province of China between September 2018 to June 2019. Thirty postpartum practices were collected by a self-report online structured questionnaire. Postpartum depression symptoms were assessed by the Chinese version of the Edinburgh Postnatal Depression Scale (EPDS). Multivariable linear regression was used to estimate the differences in EPDS scores according to adherence to postpartum practices. Firth's bias-reduced logistic regression was employed to analyze the binary classification of having PPD symptoms (EPDS ≥ 10). Results: Overall, both moderate and low adherence to postpartum practices appeared to be associated with higher EPDS scores (adjusted difference 1.07, 95% CI 0.20, 1.94 for overall moderate adherence; and adjusted difference 1.72, 95% CI 0.84, 2.60 for overall low adherence). In analyses by practice domain, low adherence to housework-related and social activity restrictions was associated with having PPD symptoms compared with high adherence (OR 1.61, 95% CI 1.07, 2.43). Conclusions: Low adherence to traditional Chinese postpartum practices was associated with higher EPDS scores indicating PPD symptoms, especially in the domain of housework-related and social activity restrictions. Psychosocial stress and unsatisfactory practical support related to low adherence to postpartum practices might contribute to PPD. Longitudinal study and clinical assessment would be needed to confirm these findings.
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Affiliation(s)
- Pengfei Guo
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States
- Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, CT, United States
| | - Dong Xu
- School of Health Management, Southern Medical University, Guangzhou, China
- Center for WHO Studies, Southern Medical University, Guangzhou, China
- Institute for Health Management, Southern Medical University, Guangzhou, China
- ACACIA Labs, Institute for Global Health and Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Zeyan Liew
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States
- Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, CT, United States
| | - Hua He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Peter Brocklehurst
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
| | - Beck Taylor
- Institute for Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Chao Zhang
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Xin Jin
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Wenjie Gong
- Xiangya School of Public Health, Central South University, Changsha, China
- Department of Psychiatry, University of Rochester, Rochester, NY, United States
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19
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Li Q, Xue W, Gong W, Quan X, Li Q, Xiao L, Xu DR, Caine ED, Poleshuck EL. Experiences and perceptions of perinatal depression among new immigrant Chinese parents: a qualitative study. BMC Health Serv Res 2021; 21:739. [PMID: 34311719 PMCID: PMC8311906 DOI: 10.1186/s12913-021-06752-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 06/24/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Immigrant status, acculturation level, race and ethnicity have been found to contribute to the utilization of mental health services in the perinatal period. This study explored perinatal experiences and perceptions among Chinese immigrant mothers and their spouses, as well as the possible barriers and facilitators that affect their health care utilization. METHODS We recruited 13 women ages 18-35 years born in mainland China, living in Rochester, New York, and residing less than 5 years in the United States. Participants primary language was Mandarin Chinese and all had given birth to at least one live infant within the past 7 years. Participants' age was at least 18 years old at the time of delivery. Five spouses also participated. We divided women in two focus groups and held one focus group for men, with data collection including demographic questionnaires and semi-structured focus group questions conducted in December 2014. Data were analyzed following thematic analysis. RESULTS Four themes emerged: experiences of perinatal depression; perceptions of perinatal depression; general preventive and coping strategies; and attitudes toward the supportive use social media applications (apps) and text messaging during the perinatal period. Participants had limited knowledge of perinatal depression and had difficulty distinguishing between normal perinatal mood fluctuations and more severe symptoms of depression. They discussed immigrant-related stress, conflicts with parents/in-laws while "doing the month", the perceived gap between the ideal of "perfect moms" and reality, and challenges with parenting as the causes of perinatal depression. Women approved of screening for the condition but were conservative about follow-up interventions. As for the management of perinatal depression, participants preferred to deal with the problem within the family before seeking external help, due to potential stigma as well as Chinese traditional culture. They were receptive to obtaining pertinent health information from anonymous social media apps, preferring these to personal text messages. CONCLUSION The recent immigrant Chinese parents to the United States in the study had limited knowledge of perinatal depression and did not make full use of mental health services for support due to language and cultural barriers. Screening for perinatal depression is only the first step. Future research should explore what interventions may serve as an acceptable approach to overcoming these gaps.
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Affiliation(s)
- Qiao Li
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Wenqing Xue
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Wenjie Gong
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China.
- Department of Psychiatry, University of Rochester, Rochester, NY, 14642, USA.
- Institute and of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK.
| | - Xin Quan
- Department of Family Therapy, Nova Southeastern University, Fort Lauderdale, USA
| | - Quanlei Li
- School of Nursing, Johns Hopkins University, Baltimore, USA
| | - Lina Xiao
- East China Institute of Social Development, East China University of Science and Technology, Shanghai, China
| | - Dong Roman Xu
- ACACIA Lab for Health Systems Strengthening, Institute for Global Health and School of Health Management, Southern Medical University, Guangzhou, China
| | - Eric D Caine
- Department of Psychiatry, University of Rochester, Rochester, NY, 14642, USA
| | - Ellen L Poleshuck
- Departments of Psychiatry and Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, 14642, USA
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20
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Peng K, Zhou L, Liu X, Ouyang M, Gong J, Wang Y, Shi Y, Chen J, Li Y, Sun M, Wang Y, Lin W, Yuan S, Wu B, Si L. Who is the main caregiver of the mother during the doing-the-month: is there an association with postpartum depression? BMC Psychiatry 2021; 21:270. [PMID: 34034695 PMCID: PMC8147344 DOI: 10.1186/s12888-021-03203-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/31/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To examine the relationship between the main caregiver during the "doing-the-month" (a traditional Chinese practice which a mother is confined at home for 1 month after giving birth) and the risk of postpartum depression (PPD) in postnatal women. METHODS Participants were postnatal women stayed in hospital and women who attended the hospital for postpartum examination, at 14-60 days after delivery from November 1, 2013 to December 30, 2013. Postpartum depression status was assessed using the Edinburgh Postnatal Depression Scale. Univariate and multivariable logistic regressions were used to identify the associations between the main caregiver during "doing-the-month" and the risk of PPD in postnatal women. RESULTS One thousand three hundred twenty-five postnatal women with a mean (SD) age of 28 (4.58) years were included in the analyses. The median score (IQR) of PPD was 6.0 (2, 10) and the prevalence of PPD was 27%. Of these postnatal women, 44.5% were cared by their mother-in-law in the first month after delivery, 36.3% cared by own mother, 11.1% by "yuesao" or "maternity matron" and 8.1% by other relatives. No association was found between the main caregivers and the risk of PPD after multiple adjustments. CONCLUSIONS Although no association between the main caregivers and the risk of PPD during doing-the-month was identified, considering the increasing prevalence of PPD in Chinese women, and the contradictions between traditional culture and latest scientific evidence for some of the doing-the-month practices, public health interventions aim to increase the awareness of PPD among caregivers and family members are warranted.
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Affiliation(s)
- Ke Peng
- National Clinical Research Center for Cardiovascular Diseases, Shenzhen, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, China ,grid.284723.80000 0000 8877 7471Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Lin Zhou
- Shenzhen Centre for Disease Control and Prevention, Shenzhen, China
| | - Xiaoying Liu
- grid.1013.30000 0004 1936 834XSchool of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Menglu Ouyang
- grid.1005.40000 0004 4902 0432The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Jessica Gong
- grid.1005.40000 0004 4902 0432The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Yuanyuan Wang
- grid.48815.300000 0001 2153 2936Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Yu Shi
- National Clinical Research Center for Cardiovascular Diseases, Shenzhen, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, China
| | - Jiani Chen
- grid.259384.10000 0000 8945 4455University International College, Macau University of Science and Technology, Macau, China
| | - Yichong Li
- National Clinical Research Center for Cardiovascular Diseases, Shenzhen, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, China
| | - Mingfan Sun
- National Clinical Research Center for Cardiovascular Diseases, Shenzhen, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, China
| | - Yueyun Wang
- Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.
| | - Wei Lin
- grid.284723.80000 0000 8877 7471Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Shixin Yuan
- grid.284723.80000 0000 8877 7471Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Bo Wu
- grid.284723.80000 0000 8877 7471Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Lei Si
- grid.1005.40000 0004 4902 0432The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia ,grid.89957.3a0000 0000 9255 8984School of Health Policy & Management, Nanjing Medical University, Nanjing, China
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21
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Chen L, Reupert A, Vivekananda K. Chinese mothers' experiences of family life when they have a mental illness: A qualitative systematic review. Int J Ment Health Nurs 2021; 30:368-381. [PMID: 33427405 DOI: 10.1111/inm.12834] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/19/2020] [Accepted: 12/15/2020] [Indexed: 12/01/2022]
Abstract
The challenges experienced by families in western countries, where a parent has a mental illness, are well established. However, research documenting the experiences of Chinese families with parental mental illness appears limited. This study aimed to systematically review qualitative research about the experiences of families, living in mainland China, Hong Kong, Macao, and Taiwan, where parents have a mental illness. Eight databases were comprehensively searched, along with manual search of reference lists. The identified studies were critically appraised and analysed using a thematic synthesis approach. Ten papers were identified, with nine investigating mothers' experiences, one focusing on children's experiences, and none reporting on fathers' experiences. Subsequently, only papers presenting mothers' experiences were included for thematic synthesis. Five primary themes were identified including managing parenting in the context of mental illness; failure to meet one's expectations of motherhood; being burdened by others' expectations; stigma from self, others and service providers; and support obtained and needed. Similar to western mothers, Chinese mothers struggled to balance the demands of parenting and their illness, and experienced stigma associated with being a parent with a mental illness. Western and Chinese mothers' experiences differ in regard to the influence of parents-in-law and the division of domestic labour. Future research might investigate Chinese mothers with various mental health diagnoses, the perspectives of Chinese fathers with a mental illness, and the children in these families.
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Affiliation(s)
- Lingling Chen
- Faculty of Education, Monash University, Clayton, VIC, Australia
| | - Andrea Reupert
- Faculty of Education, Monash University, Clayton, VIC, Australia
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Aruta JJBR, Antazo BG, Paceño JL. Self-Stigma Is Associated with Depression and Anxiety in a Collectivistic Context: The Adaptive Cultural Function of Self-Criticism. THE JOURNAL OF PSYCHOLOGY 2021; 155:238-256. [PMID: 33539271 DOI: 10.1080/00223980.2021.1876620] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Literature on the cultural psychological aspect of mental health suggests that antecedents of mental health in individualistic cultures, or societies that prioritize independence, autonomy, and personal uniqueness do not always apply in collectivistic cultures, or societies that prioritize interdependence, social connection, interpersonal harmony, and norms. The aim of the present study was to determine the mechanisms underlying the impact of self-stigma on depression and anxiety in a collectivistic culture such as the Philippines. Specifically, this study sought to examine: (1) the mediating role of self-criticism on the impact of self-stigma on depression and anxiety, and (2) the moderating role of interdependent self-construal on the impact of self-criticism on depression and anxiety in Filipinos. Surveys measuring self-stigma, self-criticism, interdependent self-construal, depression, and anxiety symptoms were administered to 312 adolescents in rural communities in the Philippines. Using structural equation modeling, findings revealed indirect effects of self-stigma on both depression and anxiety via self-criticism. Findings confirmed that interdependent self-construal attenuate the detrimental impact of self-criticism on depression and anxiety in collectivistic contexts. This study offers novel insights about the underlying mechanisms that operate in the impact of self-stigma on depression and anxiety symptoms among individuals in collectivist contexts. We highlight that self-criticism may have both adaptive and maladaptive functions in collectivist cultures. The study provides implications on the importance of culturally sensitive clinical interventions in preventing depression and anxiety by combating self-stigma and the negative aspect of self-criticism in collectivist cultures. Limitations and future directions are discussed.
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Heesen P, Orbach-Zinger S, Grigoriadis S, Halpern S, Eidelman LA. The Effect of Analgesia and Anesthesia on Postpartum Depression. Adv Anesth 2020; 38:157-165. [PMID: 34106832 DOI: 10.1016/j.aan.2020.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Philip Heesen
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Sharon Orbach-Zinger
- Department of Anesthesia, Beilinson Hospital, Petach Tikvah, Israel; Affiliated with Saklar Medical School, Tel Aviv University
| | - Sophie Grigoriadis
- Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, FG 44, Psychiatry, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Stephen Halpern
- Department of Anesthesia, Sunnybrook Health Sciences Centre, University of Toronto, 63 Elm Ridge Drive, Toronto, Ontario M6B 1A2, Canada
| | - Leonid A Eidelman
- Department of Anesthesia, Beilinson Hospital, Petach Tikvah, Israel; Affiliated with Saklar Medical School, Tel Aviv University.
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24
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Schwank SE, Chung HF, Hsu M, Fu SC, Du L, Zhu L, Huang HY, Andersson E, Acharya G. Mental health of Urban Mothers (MUM) study: a multicentre randomised controlled trial, study protocol. BMJ Open 2020; 10:e041133. [PMID: 33247023 PMCID: PMC7703424 DOI: 10.1136/bmjopen-2020-041133] [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] [Received: 06/01/2020] [Revised: 10/27/2020] [Accepted: 11/07/2020] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Mental health disorders are common during pregnancy and the postnatal period and can have serious adverse effects on women and their children. The consequences for global mental health due to COVID-19 are likely to be significant and may have a long-term impact on the global burden of disease. Besides physical vulnerability, pregnant women are at increased risk of mental health problems such as anxiety, depression and post-traumatic stress disorder due to the consequences of social distancing. It can result in altered healthcare routines, less support from the family and friends, and in some cases, partners not being allowed to be present during prenatal visits, labour and delivery. Higher than expected, rates of perinatal anxiety and depression have been already reported during the pandemic. Pregnant women may also feel insecure and worried about the effects of COVID-19 on their unborn child if they get infected during pregnancy. Today, young urban women are used to using internet services frequently and efficiently. Therefore, providing mental health support to pregnant women via internet may be effective in ameliorating their anxiety/depression, reducing the risk of serious mental health disorders, and lead to improved maternal and perinatal outcomes. OVERARCHING AIM Our aim is to explore the effectiveness of a web-based psychosocial peer-to-peer support intervention in reducing the risk and severity of perinatal mental health disorders and preventing adverse pregnancy outcomes among pregnant women living in metropolitan urban settings. METHODS AND ANALYSIS We plan to conduct a multicentre prospective randomised controlled trial, Mental health of Urban Mothers trial. Pregnant women living in large metropolitan cities will be recruited using internet-based application through non-profit organisations' websites. The women who consent will be randomised to receive a web-based peer-to-peer support intervention or usual care. Data will be analysed to identify the effects of intervention on Edinburgh Postnatal Depression Score and Generalised Anxiety Disorder 7 scores as well as pregnancy outcomes. The impact of COVID-19 pandemic on maternal stress will be assesed using Impact Event Scale-R. Any differences in outcomes between cities will be addressed in subgroup analyses. ETHICS AND DISSEMINATION The study will be conducted according to the principles of Good Clinical Practice and will follow the ethical principles of the Declaration of Helsinki. The study protocol has been approved by the ethical review board of Chinese University of Hong Kong (IRB number 2019-8170) and Shanghai Center for Women's and Children's Health (international review board (IRB) number 2020-F001-12). The results will be disseminated at national and international scientific conferences, published in peer-reviewed medical journals and spread to the public through social media, news outlets and podcasts. TRIAL REGISTRATION NUMBER NCT04363177; Trial sponsor Karolinska Institute, CLINTEC, Stockholm, Sweden.
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Affiliation(s)
- Simone Eliane Schwank
- CLINTEC, Karolinska Institute, Stockholm, Sweden
- Women's Health and Perinatology Research Group, Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Ho-Fung Chung
- Psychiatry, The University of Hong Kong, Hong Kong, Hong Kong
| | - Mandy Hsu
- Psychological and Brain Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Shih-Chien Fu
- Counseling Psychology, National Taipei University of Education, Taipei, Taiwan
| | - Li Du
- Department of Research and Education, Tongji University, Shanghai, Shanghai, China
| | - Liping Zhu
- Department of Research and Education, Tongji University, Shanghai, Shanghai, China
| | - Hsuan-Ying Huang
- Anthropology, The Chinese University Hong Kong, Hong Kong, Hong Kong
| | - Ewa Andersson
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Ganesh Acharya
- Women's Health and Perinatology Research Group, Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
- CLINTEC Department of Clinical Technology, Karolinska Institutet, Stockholm, Sweden
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25
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Gong W, Jin X, Cheng KK, Caine ED, Lehman R, Xu D(R. Chinese Women's Acceptance and Uptake of Referral after Screening for Perinatal Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8686. [PMID: 33238480 PMCID: PMC7700456 DOI: 10.3390/ijerph17228686] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/15/2020] [Accepted: 11/18/2020] [Indexed: 12/21/2022]
Abstract
China recently issued a national plan on perinatal depression (PND) screening. Previous studies elsewhere suggested that uptake of referral after screening for PND is suboptimal, but little is known in China. In this cohort study including 1126 women in Hunan, we identified women at a high risk of PND using the Edinburgh Postpartum Depression Scale (EPDS) over multiple time points. We texted them and offered free consultations with a psychiatrist/psychologist. Among 248 screen-positive women, only three expressed interest and one attended the appointment. We surveyed the women about their reasons for declining referrals and preferred means of care. Of the 161 respondents, 128 (79.5%) indicated that they could cope with the condition without professional assistance and 142 (88.2%) chose their families as the preferred source of help. Only 15 (9.3%) chose professionals as their first option. Implementing a referral policy for screen-positive women would mean approximately one-third of women who gave birth in China would be eligible. Our result argues against referring all screen-positive women for professional services at this time. Interventions should instead build upon the tradition of family support in a more engaged response. These considerations are relevant for the implementation of national screening for PND in China.
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Affiliation(s)
- Wenjie Gong
- Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (W.G.); (X.J.)
- Institute and of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK; (K.K.C.); (R.L.)
- Department of Psychiatry, University of Rochester, 300 Crittenden Blvd, Rochester, NY 14642, USA;
| | - Xin Jin
- Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (W.G.); (X.J.)
| | - Kar Keung Cheng
- Institute and of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK; (K.K.C.); (R.L.)
| | - Eric D. Caine
- Department of Psychiatry, University of Rochester, 300 Crittenden Blvd, Rochester, NY 14642, USA;
| | - Richard Lehman
- Institute and of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK; (K.K.C.); (R.L.)
| | - Dong (Roman) Xu
- Global Health and Health System, ACACIA Labs and Department of Health Management, School of Health Management, Southern Medical University, 1023 South Shatai Road, Guangzhou 510515, China
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Orbach-Zinger S, Heesen M, Grigoriadis S, Heesen P, Halpern S. A systematic review of the association between postpartum depression and neuraxial labor analgesia. Int J Obstet Anesth 2020; 45:142-149. [PMID: 33221120 DOI: 10.1016/j.ijoa.2020.10.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/21/2020] [Accepted: 10/10/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Postpartum depression (PPD) is the most common complication after childbirth, affecting 10-15% of women. It is associated with serious long-term consequences for the mother and family. Whether or not neuraxial labor analgesia mitigates the risk is uncertain and controversial. The purpose of this review was to summarize studies investigating the association between neuraxial labor analgesia and the incidence of PPD. METHODS A systematic literature search for randomized controlled trials and cohort studies reporting the incidence of PPD among parturients who received neuraxial analgesia compared with non-neuraxial or no analgesia. The primary outcome was the incidence of PPD between 5 and 12 weeks' postpartum. Depression was diagnosed using a cutoff score of ≥10 on the Edinburgh Postnatal Depression scale, a validated screening tool. The risk of bias of each study was evaluated, and odds ratios and 95% confidence intervals calculated from raw data or reported as adjusted odds ratios. RESULTS Eleven observational studies involving 5717 patients were included. Three studies had a critical risk, three a serious risk, and five a moderate risk of bias. Two studies reported significantly lower odds for PPD associated with neuraxial analgesia compared with non-neuraxial or no analgesia, whereas the odds ratios in the remaining nine studies were not significantly different. CONCLUSIONS Our systematic review did not find compelling evidence for an association between PPD and labor analgesia. Studies were heterogenous in nature and had a high risk of bias. Further research controlling for confounding factors is recommended to determine if a relationship exists.
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Affiliation(s)
- S Orbach-Zinger
- Department of Anesthesia, Beilinson Hospital, Petach Tikvah, Israel; Affiliated with Saklar Medical School, Tel Aviv University, Tel Aviv, Israel.
| | - M Heesen
- Department of Anesthesia, Kantonsspital Baden, Switzerland
| | - S Grigoriadis
- Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - P Heesen
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - S Halpern
- Department of Anesthesia, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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Zhao XH, Zhang ZH. Risk factors for postpartum depression: An evidence-based systematic review of systematic reviews and meta-analyses. Asian J Psychiatr 2020; 53:102353. [PMID: 32927309 DOI: 10.1016/j.ajp.2020.102353] [Citation(s) in RCA: 114] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 07/30/2020] [Accepted: 08/03/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE Postpartum depression (PPD) is the most common psychiatric condition after childbirth which not only effects the mother's health, but also might have impact on child's development and parenting behaviors. Because the etiology of PPD has not been fully cleared, the efforts towards identification of risk factors are crucial for both the children and mother's health. METHOD PubMed, EMBASE and PsycINFO databases were searched since inception until July 2019 to collect data about the risk factors of PPD and only systematic review and meta-analysis can be included. RESULT To identify the real risk factors, protective factors and controversial factors, nineteen parts of the interpretation were adopted. The risk factors are mainly concentrated in the following aspects: violence and abuse, immigration status, gestational diabetes, cesarean section, depressive history, vitamin D deficiency, obese and overweight, postpartum sleep disruption and poor postpartum sleep, lack of social support, traditional dietary pattern (Japanese, Indian, United Kingdom, and Brazilian dietary pattern), multiple births, preterm and low-birth-weight infants, postpartum anemia, negative birth experience. The controversial factors are serum level of cortisol, thyroid peroxidase autoantibodies status, acculturation, traditional confinement practices. Skin-to-skin care, higher concentrations of DHA in mothers' milk, greater seafood consumption, healthy dietary patterns, multivitamin supplementation, fish and PUFA intake, calcium, Vitamin D, zinc and possibly selenium are protective factors. CONCLUSION Thirteen risk factors were identified, but five factors still controversial due to the insufficient of the evidence. What's more, skin-to-skin care and some nutrition related factors are protective factors against PPD.
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Affiliation(s)
- Xiao-Hu Zhao
- Second Clinical Medical College, Anhui Medical University, Hefei, China
| | - Zhi-Hua Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China.
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Barriers and facilitators of kangaroo mother care adoption in five Chinese hospitals: a qualitative study. BMC Public Health 2020; 20:1234. [PMID: 32791972 PMCID: PMC7427278 DOI: 10.1186/s12889-020-09337-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 08/03/2020] [Indexed: 11/15/2022] Open
Abstract
Background Kangaroo mother care (KMC) has been proved to be a safe and cost-effective standard of care for preterm babies. China hasn’t adopted the KMC practice widely until recently. We aim to assess barriers and facilitators of KMC adoption in neonatal intensive care units (NICUs) and postnatal wards in China. Methods We conducted clinical observations and semi-structured interviews with nurses, physicians, and parents who performed KMC in seven NICUs and postnatal wards housed in five hospitals in different provinces of China between August and September 2018. The interviews provided first-hand stakeholder perspectives on barriers and facilitators of KMC implementation and sustainability. We further explored health system’s readiness and families’ willingness to sustain KMC practice following its pilot introduction. We coded data for emerging themes related to financial barriers, parent- and hospital-level perceived barriers, and facilitators of KMC adoption, specifically those unique in the Chinese context. Results Five hospitals with KMC pilot programs were selected for clinical observations and 38 semi-structured interviews were conducted. Common cultural barriers included concerns with the conflict with traditional postpartum confinement (Zuo-yue-zi) practice and grandparents’ resistance, while a strong family support is a facilitator for KMC adoption. Some parents reported anxiety and guilt associated with having a preterm baby, which can be a parental-level barrier to KMC. Hospital-level factors such as fear of nosocomial infection and shortage of staff and spaces impeded the KMC implementation, and supportive community and peer group organized by the hospital contributed to KMC uptake. Financial barriers included lodging costs for caregivers and supply costs for hospitals. Conclusions We provided a comprehensive in-depth report on the multi-level KMC barriers and facilitators in China. We recommend policy interventions specifically addressing these barriers and facilitators and increase family and peer support to improve KMC adoption in China. We also recommend that well-designed local cultural and economic feasibility and acceptability studies should be conducted before the KMC uptake.
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Li Y, Coppieters MW, Setchell J, Hodges PW, Scholten-Peeters GGM. How do people in China think about causes of their back pain? A predominantly qualitative cross-sectional survey. BMC Musculoskelet Disord 2020; 21:476. [PMID: 32693774 PMCID: PMC7372862 DOI: 10.1186/s12891-020-03500-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/13/2020] [Indexed: 02/07/2023] Open
Abstract
Background Low back pain (LBP) is the second highest cause of health burden in China. Delayed recovery, poor clinical outcomes and persistence of LBP are associated with negative pain beliefs about LBP. Chinese philosophies are nested into the daily life of people in China, which is likely to influence pain beliefs. However, there is lack of knowledge about people’s discourses regarding their LBP in China. The primary aim of this study was to explore the discourses underlying the beliefs of people in China about what causes their persistent or recurrent LBP. The secondary aim was to investigate the sources of these pain beliefs. Methods People (n = 152) from South Central, East and North Mainland China with LBP completed an online survey about what they believed caused their persistent or recurrent LBP and where these understandings came from. Potential causes of persistent or recurrent LBP were explored qualitatively using discourse analysis. The sources of these discourses were assessed by descriptive statistics with conventional content analysis. Results Five discourses were identified to underpin participants’ beliefs about what caused their persistent or recurrent LBP, namely: (1) biomedical problems (66.4%), (2) unbalanced lifestyle (48.7%), (3) menstruation and ‘kidney’ status (9.2%), (4) the ‘Five Elements’ imbalance (7.9%), and (5) energy status (5.9%). Most participants responded that their pain beliefs were based on information derived from healthcare professionals (59.2%), followed by the internet (24.3%) and family (23.0%). Conclusions People from moderately and well-developed parts of Mainland China think predominantly in line with a Western biomedical viewpoint about their LBP. Traditional Chinese medicine related pain beliefs mainly to the concept of ‘balance’ were evident on contemporary Chinese society’s understandings of LBP. These cultural beliefs could be relevant to consider in LBP management and involve healthcare professionals, family and patient in this process.
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Affiliation(s)
- YiJun Li
- Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 9, Amsterdam, 1081 BT, The Netherlands
| | - Michel W Coppieters
- Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 9, Amsterdam, 1081 BT, The Netherlands.,Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, Australia
| | - Jenny Setchell
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Paul W Hodges
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Gwendolyne G M Scholten-Peeters
- Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 9, Amsterdam, 1081 BT, The Netherlands.
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Seidler Y, Seiler-Ramadas R, Kundi M. 'No Austrian Mother Does This to Sleep Without a Baby!' Postnatal Acculturative Stress and 'Doing the Month' Among East Asian Women in Austria: Revisiting Acculturation Theories From a Qualitative Perspective. Front Psychol 2020; 11:977. [PMID: 32477230 PMCID: PMC7240129 DOI: 10.3389/fpsyg.2020.00977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 04/20/2020] [Indexed: 11/15/2022] Open
Abstract
Acculturative stress is a phenomenon describing negative emotions experienced by immigrants in their socio-cultural and psychological adaptation process to the host society’s dominant culture and its population. Acculturative stress is assumed to be one the reasons for higher prevalence of postnatal depression among immigrant women compared to non-immigrant women. Theories and models of acculturation and coping strategies suggest that certain cultural orientations or behaviors could mitigate acculturative stress and postnatal depression. Nevertheless, quantitative studies applying these theories have so far revealed inconsistent results. Given this background, we ask: what can a qualitative study of immigrant women’s postnatal experiences tell us about the interrelationships between immigrant mothers’ acculturation behaviors or cultural orientations, and maternal psychological health? Particularly, we explore the postnatal experiences of Chinese and Japanese women who gave birth in Austria, focusing on their experiences and behaviors influenced by their heritage culture’s postnatal practices (zuò yuè zi and satogaeri). Theoretically, we apply Berry’s acculturation model through a focus on what we call ‘Postnatal Acculturative Stress’ (PAS). By doing so, we identify factors that prevent or mitigate PAS. Another aim of this article is to critically reassess Berry’s model in the context of postnatal care and maternal psychological health. Data were analyzed using a combination of deductive and inductive method through the application of directed content analysis and phenomenological approach. Women’s postnatal experiences were summarized as an ‘unexpected solitary struggle in the midst of dual identity change’ in four specific domains: postnatal rest and diet, social support, feelings toward significant others and identity. Preventive and mitigating factors against PAS included trust (in self and one’s health beliefs) and mutual respectful relationships with and between the significant others. The application of Berry’s acculturation model provided a useful framework of analysis. Nevertheless, the multifarious complexity involved in the process of acculturation as well as different power dynamics in the family and healthcare settings makes it difficult to draw causal relationships between certain acculturation behaviors or cultural orientations with specific health outcomes. Health professionals should be aware of the complex psychosocial processes, contexts as well as social environment that shape immigrants’ acculturative behaviors.
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Affiliation(s)
- Yuki Seidler
- Center for Public Health, Medical University of Vienna, Vienna, Austria.,Department of Development Studies, University of Vienna, Vienna, Austria.,Center for Health and Migration, Vienna, Austria
| | | | - Michael Kundi
- Center for Public Health, Medical University of Vienna, Vienna, Austria
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Mason KA. When the Ghosts Live in the Nursery: Postpartum Depression and the Grandmother-Mother-Baby Triad in Luzhou, China. ETHOS (BERKELEY, CALIF.) 2020; 48:149-170. [PMID: 35250110 PMCID: PMC8896502 DOI: 10.1111/etho.12277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 02/03/2020] [Indexed: 06/14/2023]
Abstract
In Luzhou, China, where grandmothers often serve as primary caregivers for infants, the past and the future haunt new mothers suffering from postpartum depression. In this article, I draw upon longitudinal interviews conducted with ten families in Luzhou as part of a larger multi-sited ethnography of postpartum depression and anxiety. I argue that the grandmother-mother-baby triad model of infant care in interior urban China accentuates the pain of depressed postpartum mothers by making it difficult for them to rid their homes of the ghosts of past trauma and lost futures. Mothers resent and fear grandmothers even as they rely on them to care for their babies. Memories of trauma, perceived displacement by the grandmother as the mother figure for their babies, and lack of control over their households and children characterize postpartum mothers' experiences. Mothers primarily blame their mothers-in-law for their unhappiness even as they depend on themselves to "self-adjust."
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Schwank SE, Zhou Q, He Y, Acharya G. Perinatal mental health around the world: priorities for research and service development in China. BJPsych Int 2020; 17:50-53. [PMID: 34287410 PMCID: PMC8281121 DOI: 10.1192/bji.2020.5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 12/19/2019] [Accepted: 01/20/2020] [Indexed: 11/23/2022] Open
Abstract
China's healthcare is improving together with rapid economic growth. Yet, mental healthcare is lagging behind. Prevalence of perinatal depression is high among women of the one-child generation, but access to qualified care is limited. Chinese healthcare professionals, policy makers and patients alike express concerns about insufficient knowledge among the public as well as healthcare providers regarding mental disorders. There appears to be a general lack of help-seeking behaviour for mental disorders owing to perceived risk of social stigmatisation. Social support through family and friends, use of online resources and community healthcare services are preferred, rather than seeking help from mental health specialists.
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Affiliation(s)
- Simone Eliane Schwank
- PhD, MS, MA, Msc, Clinical psychologist, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
| | - Qiongjie Zhou
- MD, Specialist Obstetrician, Obstetrics and Gynaecology Hospital, Fudan University, Shanghai, China
| | - Yanling He
- MD, MintMH, Director, Department of Psychiatric Epidemiology, Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, China
| | - Ganesh Acharya
- MD, PhD, FRCOG, Professor and Head, Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
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Schwank SE, Andersson E, Wickberg B, Fu SC, Ding Y, Lindgren H. Care-seeking behavior and disclosure on self-reported mental health among young women in urban Shanghai, China. Health Psychol Open 2020; 7:2055102919897382. [PMID: 32082605 PMCID: PMC7005976 DOI: 10.1177/2055102919897382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Mental health is a major public health concern in China. Help-seeking behavior
typically does not involve professionals. Aim of the study was to assess
Shanghai women’s care-seeking behavior for common mental health disorders. Using
an online survey, fielding questions regarding perinatal mental health status
and help-seeking behavior. A total of 487 women participated. One fifth of
participants reporting badwell-being did not seek help for mental distress. A
total of 82.2 percent seek online support. A majority entrusted in family and
avoided professional contact. Mother-in-laws were the least trusted source of
support. Shanghai women avoid seeking professional help for mental health
issues. Friends, spouses, and online resources are preferred venues.
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LeMasters K, Andrabi N, Zalla L, Hagaman A, Chung EO, Gallis JA, Turner EL, Bhalotra S, Sikander S, Maselko J. Maternal depression in rural Pakistan: the protective associations with cultural postpartum practices. BMC Public Health 2020; 20:68. [PMID: 31941468 PMCID: PMC6964000 DOI: 10.1186/s12889-020-8176-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 01/08/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Traditional postpartum practices are intended to provide care to mothers, but there is mixed evidence concerning their impact on postpartum depression (PPD). It remains unknown if there is a unique impact of postpartum practices on PPD separately from other types of social support, or if practices differentially affect those with existing prenatal depression. In Pakistan, chilla (چله) is a traditional postpartum practice in which women receive relief from household work, additional familial support, and supplemental food for up to 40 days postpartum. This study aims to understand if chilla protects against PPD independent of other support and whether this relationship varies by prenatal depression status. METHODS Data come from the Bachpan cohort study in rural Pakistan. Chilla participation and social support (Multidimensional Scale of Perceived Social Support) were assessed at 3 months postpartum. Women were assessed for major depressive episodes (MDE) with the Structured Clinical Interview, DSM-IV and for depression symptom severity with the Patient Health Questionnaire (PHQ-9) in their third trimester and at 6 months postpartum. Adjusted linear mixed models were used to assess the relationship between chilla participation and PPD. RESULTS Eighty-nine percent of women (N = 786) participated in chilla and almost 70% of those that participated took part in all of chilla's aspects. In adjusted models, chilla participation was inversely related to MDE (OR = 0.56;95%CI = 0.31,1.03) and symptom severity (Mean Difference (MD) = - 1.54;95%CI: - 2.94,-0.14). Chilla participation was associated with lower odds of MDE (OR = 0.44;95%CI = 0.20,0.97) among those not prenatally depressed and with lower symptom severity among those prenatally depressed (MD = -2.05;95%CI:-3.81,-0.49). CONCLUSIONS Chilla is inversely associated with both MDE and symptom severity at 6 months postpartum above and beyond social support. Specifically, chilla is inversely associated with MDE among those not prenatally depressed and with lower symptom severity among those prenatally depressed. This relationship signals an opportunity for interventions aimed at preventing and treating PPD in this region to draw upon chilla and similar traditional postpartum practices in creating community-based, low-cost, sustainable interventions for maternal mental health. TRIAL REGISTRATION NCT02111915. Registered 18 September 2015. NCT02658994. Registered 22 January 2016. Both trials were prospectively registered.
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Affiliation(s)
- Katherine LeMasters
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, McGavran-Greenberg Hall, CB# 7435, Chapel Hill, North Carolina NC 27599 USA
- Carolina Population Center, University of North Carolina at Chapel Hill, 123 W. Franklin St, Chapel Hill, North Carolina NC 27516 USA
| | - Nafeesa Andrabi
- Carolina Population Center, University of North Carolina at Chapel Hill, 123 W. Franklin St, Chapel Hill, North Carolina NC 27516 USA
- Department of Sociology, University of North Carolina at Chapel Hill, 102 Emerson Dr, Chapel Hill, North Carolina NC 27514 USA
| | - Lauren Zalla
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, McGavran-Greenberg Hall, CB# 7435, Chapel Hill, North Carolina NC 27599 USA
| | - Ashley Hagaman
- School of Public Health, Yale University, 60 College St, New Haven, CT 06510 USA
| | - Esther O. Chung
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, McGavran-Greenberg Hall, CB# 7435, Chapel Hill, North Carolina NC 27599 USA
- Carolina Population Center, University of North Carolina at Chapel Hill, 123 W. Franklin St, Chapel Hill, North Carolina NC 27516 USA
| | - John A. Gallis
- Department of Biostatistics and Bioinformatics, Duke University, 2424 Erwin Road, Durham, North Carolina NC 27705 USA
- Duke Global Health Institute, Duke University, Durham, North Carolina USA
| | - Elizabeth L. Turner
- Department of Biostatistics and Bioinformatics, Duke University, 2424 Erwin Road, Durham, North Carolina NC 27705 USA
- Duke Global Health Institute, Duke University, Durham, North Carolina USA
| | - Sonia Bhalotra
- Department of Economics and Institute for Social and Economic Research, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ UK
| | - Siham Sikander
- Human Development Research Foundation, H 06, Street 55, Sector F-7/4, Islamabad, 44000 Pakistan
- Health Services Academy, Islamabad, Pakistan
| | - Joanna Maselko
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, McGavran-Greenberg Hall, CB# 7435, Chapel Hill, North Carolina NC 27599 USA
- Carolina Population Center, University of North Carolina at Chapel Hill, 123 W. Franklin St, Chapel Hill, North Carolina NC 27516 USA
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Perinatal mental health in China: views of health system professionals in Shanghai. GLOBAL HEALTH JOURNAL 2019. [DOI: 10.1016/j.glohj.2019.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Shorey S, Chee CYI, Ng ED, Lau Y, Dennis CL, Chan YH. Evaluation of a Technology-Based Peer-Support Intervention Program for Preventing Postnatal Depression (Part 1): Randomized Controlled Trial. J Med Internet Res 2019; 21:e12410. [PMID: 31469084 PMCID: PMC6744221 DOI: 10.2196/12410] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 03/19/2019] [Accepted: 07/28/2019] [Indexed: 01/19/2023] Open
Abstract
Background The frenzy of postbirth events often takes a toll on mothers’ mental well-being, leaving them susceptible to postpartum psychological disorders such as postnatal depression (PND). Social support has been found to be effective in restoring the emotional well-being of new mothers. Therefore, mothers need to be supported during the crucial postpartum period to buffer the negative after effects of childbirth and to promote healthier maternal well-being. Objective This study aimed to evaluate the effectiveness of a technology-based peer-support intervention program (PIP) on maternal outcomes during the early postpartum period. Methods A randomized, parallel-armed controlled trial was conducted. The study recruited 138 mothers (69 in intervention group, 69 in control group) at risk of PND from a tertiary hospital in Singapore. To support these mothers, 20 peer volunteers were recruited by word of mouth and trained by a psychiatrist in social support skills before the intervention commenced. The 4-week–long intervention included a weekly follow-up with a peer volunteer through phone calls or text messages. The intervention group received peer support in addition to the standard care offered by the hospital. The control group only received postnatal standard care. Maternal outcomes (PND, postnatal anxiety [PNA], loneliness, and perceived social support) were measured with reliable and valid instruments. Data were collected immediately postpartum, at 1 month postpartum and at 3 months postpartum. The general linear model was used to compare the groups for postpartum percentage changes in the outcome variables at first and third months, and the linear mixed model was used to compare the trend over the study period. Results There was a statistically significant difference in Edinburgh Postnatal Depression Scale scores (d=–2.11; 95% CI −4.0 to −0.3; P=.03) between the intervention and control groups at 3 months postpartum after adjusting for covariates. The intervention group had a significant change over time compared with the control group. Conclusions The technology-based PIP was found to be effective in reducing the risk of PND among new mothers and showed a generally positive trend in reducing PNA and loneliness and increasing perceived social support. This study highlights the importance of training paraprofessionals to provide needed support for new mothers postpartum. A further long-term evaluation of the PIP on maternal and family outcomes and its cost-effectiveness is needed to inform clinical practices. Trial Registration ISRCTN Registry ISRCTN14864807; https://www.isrctn.com/ISRCTN14864807 International Registered Report Identifier (IRRID) RR2-10.2196/resprot.9416
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School Of Medicine, National University of Singapore, Singapore, Singapore
| | - Cornelia Yin Ing Chee
- Department of Psychological Medicine, University Medicine Cluster, National University Hospital, Singapore, Singapore
| | - Esperanza Debby Ng
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School Of Medicine, National University of Singapore, Singapore, Singapore
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School Of Medicine, National University of Singapore, Singapore, Singapore
| | - Cindy-Lee Dennis
- Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Yiong Huak Chan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School Of Medicine, National University of Singapore, Singapore, Singapore
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Ding G, Niu L, Vinturache A, Zhang J, Lu M, Gao Y, Pan S, Tian Y. "Doing the month" and postpartum depression among Chinese women: A Shanghai prospective cohort study. Women Birth 2019; 33:e151-e158. [PMID: 31060983 DOI: 10.1016/j.wombi.2019.04.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 04/14/2019] [Accepted: 04/15/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND The Chinese postpartum custom of "doing the month" characterized by generous social support available through the traditional cultural practices was considered to protect women from postpartum depression in early puerperium. METHODS This study used data from the Shanghai Birth Cohort, a study of 2615 postpartum women from Shanghai, China, that was conducted between 2013 and 2016. Detailed information on the traditional "doing the month" practices and the on the Edinburgh Postnatal Depression Scale scores was collected from questionnaires administered on the 42nd day after childbirth. Logistic regression models were used to examine the association between the adopting traditional puerperium practices and postpartum depression. RESULTS The estimated prevalence of postpartum depression in women from the Shanghai area in China was 11.8% (n = 308) at six weeks postpartum. Women who went outside their homes during the first month postpartum showed higher risks of postpartum depression compared with those who never left the house (1-2 times: OR = 1.9, 95% CI = 1.4-2.4; 3-5 times: OR = 2.3, 95% CI = 1.5-3.5; ≥6 times: OR = 2.5, 95% CI = 1.2-5.1). Women with average sleep of 6 h or less per night were more likely to suffer from postpartum depression compared with those who slept 8 h (6 h: OR = 1.7, 95% CI = 1.2-2.4; less than 6 h : OR = 3.3, 95% CI = 2.2-5.0). Women who opened the house windows most of the time exhibited decreased risks of postpartum depression compared to those who never or rarely opened the windows (often: OR = 0.6, 95% CI = 0.4-0.9; always: OR = 0.4, 95% CI = 0.3-0.7). CONCLUSIONS Our results suggested that not all the activities of "doing the month" provided protection against developing PPD. This study emphasized the need for flexibility to fit and adjust the ritual into the modern life to enhance the positive effects of traditional practices on maternal health.
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Affiliation(s)
- Guodong Ding
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.
| | - Lei Niu
- Department of Emergency, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Angela Vinturache
- Department Obstetrics & Gynecology, St. George's Hospital, St. George's University Hospitals NHS Foundation Trust, London, UK.
| | - Jun Zhang
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Min Lu
- Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.
| | - Yu Gao
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Shuming Pan
- Department of Emergency, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Ying Tian
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Shorey S, Ng ED. Evaluation of Mothers' Perceptions of a Technology-Based Supportive Educational Parenting Program (Part 2): Qualitative Study. J Med Internet Res 2019; 21:e11065. [PMID: 30758295 PMCID: PMC6391649 DOI: 10.2196/11065] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 10/26/2018] [Accepted: 11/12/2018] [Indexed: 01/21/2023] Open
Abstract
Background Transitioning into parenthood can be stressful as parents struggle to cope with new parenting responsibilities. Although perinatal care in hospitals aims to improve parental outcomes, there is a general consensus that it is suboptimal and insufficient. Therefore, many studies have designed intervention methods to supplement support for parents during this stressful period. However, studies often focus on parental outcomes as indicators of their interventions’ success and effectiveness. Studies evaluating participants’ experiences and feedback are limited. Objective This study aimed to examine the experiences and perceptions of participants who participated in a supportive education parenting program intervention study. Methods A qualitative semistructured interview was conducted with 16 mothers (6 control and 10 intervention) from a randomized controlled trial. The supportive education parenting program received by the intervention group included 2 phone-based perinatal educational sessions, a phone-based educational session after childbirth, and a 1-month postpartum access to a mobile health app. The interviews were approximately 30- to 60-min long, audiotaped and transcribed verbatim, and analyzed using thematic analysis. Study findings were reported according to the Consolidated Criteria for Reporting Qualitative Research checklist. Results The 3 main themes evaluating mothers’ experiences and perceptions were generated: (1) changed perspective toward parenthood, (2) journey from pregnancy to after birth, and (3) a way forward. Mothers from the intervention group mostly had good perinatal experiences with sufficient support received, which elevated their emotional well-being and increased parenting involvement. Mothers in the control group, although satisfied with the hospital care received, were more stressed and shared a need for professional advice and extra support. Apart from technical enhancements, mothers also requested extended social support during early pregnancy up to 1 year postpartum, taking into consideration Asian cultural practices. Conclusions Mothers who received the intervention were overall satisfied with the support provided by the technology-based supportive educational parenting program. The success of the educational program in this study highlights the need to supplement standard care in hospitals with technology-based educational programs. Future research should include fathers’ perceptions to attain an in-depth understanding of overall participants’ experiences and needs in the future development of supportive and educational programs.
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Chen J, Cross WM, Plummer V, Lam L, Tang S. A systematic review of prevalence and risk factors of postpartum depression in Chinese immigrant women. Women Birth 2018; 32:487-492. [PMID: 30559006 DOI: 10.1016/j.wombi.2018.11.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 11/11/2018] [Accepted: 11/30/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND As the number of immigrants grows, the health of Chinese immigrant women, especially their perinatal health, has gradually attracted public attention. Our review has two main purposes. First, estimate the prevalence of postpartum depressive symptoms in Chinese immigrant women, and then determine risk factors for postpartum depressive symptoms among these women. METHODS The following databases: MEDLINE, Embase, Scopus, Web of Science, PsycINFO and PubMed were used in literature search from their commencements until November 21st 2017. The Joanna Briggs Institute (JBI) Critical Appraisal instruments were used to evaluate the quality of the article. Four studies met the inclusion criteria, contributed to our review and meta-analysis. RESULT The prevalence of postpartum depression is high in Chinese immigrant women. Risk factors for postpartum depression in Chinese immigrant women were defined as lack of social support, unstable economic status, and acculturation. CONCLUSION There have been few studies on postpartum depression among Chinese immigrant women. Existing studies have shown a high prevalence of postpartum depression in Chinese immigrant women. Moreover, there is an urgent need for studies on postpartum depression among Chinese immigrant women informing better understanding, programs of care and improving the perinatal health status of Chinese immigrant women.
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Affiliation(s)
- Jiarui Chen
- XiangYa Nursing School, Central South University, Changsha, 410013, China
| | - Wendy M Cross
- School of Nursing, Midwifery and Healthcare, Federation University Australia, Melbourne, VIC 3806, Australia
| | - Virginia Plummer
- School of Nursing and Midwifery, Monash University, Melbourne, VIC 3800, Australia; Peninsula Health, Frankston, VIC 3199, Australia
| | - Louisa Lam
- School of Nursing, Midwifery and Healthcare, Federation University Australia, Melbourne, VIC 3806, Australia; School of Nursing and Midwifery, Monash University, Melbourne, VIC 3800, Australia
| | - Siyuan Tang
- XiangYa Nursing School, Central South University, Changsha, 410013, China.
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Karaçam Z, Çoban A, Akbaş B, Karabulut E. Status of postpartum depression in Turkey: A meta-analysis. Health Care Women Int 2018; 39:821-841. [DOI: 10.1080/07399332.2018.1466144] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Zekiye Karaçam
- Department of Midwifery, Faculty of Health Sciences, Adnan Menderes University, Aydın, Turkey
| | - Ayden Çoban
- Department of Midwifery, Faculty of Health Sciences, Adnan Menderes University, Aydın, Turkey
| | - Burcu Akbaş
- Department of Midwifery, Institute of Health Sciences, Adnan Menderes University, Aydın, Turkey
| | - Erdem Karabulut
- Medical Faculty Department of Biostatistics, Hacettepe University, Ankara, Turkey
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Zhou C, Zheng W, Yuan Q, Zhang B, Chen H, Wang W, Huang L, Xu L, Yang L. Associations between social capital and maternal depression: results from a follow-up study in China. BMC Pregnancy Childbirth 2018; 18:45. [PMID: 29394914 PMCID: PMC5797398 DOI: 10.1186/s12884-018-1673-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 01/25/2018] [Indexed: 01/15/2023] Open
Abstract
Background This study aims to investigate the association between social capital (SC) and depressive symptoms among Chinese primiparas at different time-points from their late pregnancy to postpartum. Methods A total of 450 primiparas were recruited for the current study. The assessments were conducted at three different time-points: T1 – while the participants were recruited at their 30–36 weeks of pregnancy in the antenatal clinic in the maternity hospital in Zhejiang, China; T2 – at their 2nd or 3rd days in the wards after delivery; T3 – at week 6 to 8 after the delivery in the postpartum examination clinic. SC was measured by the 29-item SC scale; while depressive symptoms were measured by the Edinburgh Postnatal Depression Scale. The relationships between SC and depressive symptoms were explored separately at each of the three time-points. Results The prevalence of depression among the primiparas was 25% at T1, 13.5% at T2 and 20.8% at T3, respectively. However, the score of SC and its components at three time-points followed an opposite ‘V’ direction, with the highest score at T2, following by T3 and T1. At T1, the analysis suggested that depressive symptoms among the primiparas were negatively correlated with their social trust and social network levels. At T2, only social trust was negatively associated with depression. While at T3, it is social trust and social participations that were significantly negatively associated with depression. Conclusions SC was associated with depression at all three time-points during and after pregnancy. More attention should be given to SC in the maternal health promotion programs of community pregnancy health care management. Electronic supplementary material The online version of this article (10.1186/s12884-018-1673-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chi Zhou
- Medical School, Hangzhou Normal University, 16 Xuelin Rd., Xiasha District, Hangzhou, 310036, China
| | - Weijun Zheng
- School of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Qi Yuan
- Research Division, Institute of Mental Health, Singapore, 539747, Singapore
| | - Baodan Zhang
- Medical School, Hangzhou Normal University, 16 Xuelin Rd., Xiasha District, Hangzhou, 310036, China
| | - Hao Chen
- Medical School, Hangzhou Normal University, 16 Xuelin Rd., Xiasha District, Hangzhou, 310036, China
| | - Weijue Wang
- Medical School, Hangzhou Normal University, 16 Xuelin Rd., Xiasha District, Hangzhou, 310036, China
| | - Liu Huang
- Medical School, Hangzhou Normal University, 16 Xuelin Rd., Xiasha District, Hangzhou, 310036, China
| | - Liangwen Xu
- Medical School, Hangzhou Normal University, 16 Xuelin Rd., Xiasha District, Hangzhou, 310036, China.
| | - Lei Yang
- Medical School, Hangzhou Normal University, 16 Xuelin Rd., Xiasha District, Hangzhou, 310036, China.
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Demirel G, Egri G, Yesildag B, Doganer A. Effects of traditional practices in the postpartum period on postpartum depression. Health Care Women Int 2017; 39:65-78. [DOI: 10.1080/07399332.2017.1370469] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Gulbahtiyar Demirel
- Department of Midwifery, Faculty of Health Sciences, Cumhuriyet University, Sivas, Turkey
| | - Gamze Egri
- Operating Room Services Program, Vocational College of Healthcare Services, Cumhuriyet University, Sivas, Turkey
| | - Birnur Yesildag
- Department of Nursing, Susehri Health College, Cumhuriyet University, Sivas, Turkey
| | - Adem Doganer
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Kahramanmaras Sutcu İmam University, Kahramanmaras, Turkey
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Cao R, Stone TE, Petrini MA, Turale S. Nurses' perceptions of health beliefs and impact on teaching and practice: a Q-sort study. Int Nurs Rev 2017; 65:131-144. [PMID: 28833101 DOI: 10.1111/inr.12399] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIM To understand Chinese nurses' perceptions of health beliefs, their content, origin and the influence of sociocultural factors, as a basis of their evidence-based practice. This study contributes to a larger study to establish the health beliefs of Japanese, Australian, Chinese, South Korean and Thai nurses. BACKGROUND Registered nurses teach patients and students about maintaining or attaining health are subject to the same range of influences and their health beliefs may be antithetical to current health evidence. METHODS Q-method design using q-sort and interview was used to explore the perspectives on a range of health beliefs of 60 nurses in four cities in China. FINDINGS Three factors arose from the perceptions of the participants about health and accounted for 50.2% of the total variance: (1) social impact, (2) 'the importance of evidence', and (3) beliefs rooted in culture. DISCUSSION Influence on nurses' health beliefs was explored in terms of the internalized and frequently unconscious beliefs, values and norms tying them to their communities, reflecting the need for nurses to be aware of their health beliefs and behaviours. CONCLUSIONS Education for nurses in practice needs to acknowledge that individual practitioners' beliefs strongly influence health teaching for patients and families. In order to implement evidenced-based practice and teach in line with current evidence nurses need to critically examine and reflect on the impact of culture, society and the media on their own health beliefs. IMPLICATIONS FOR NURSING POLICY AND HEALTH POLICY Education policy needs to consider that culture and societal pressures affect nurses' health beliefs and practice. Critical thinking, reflective and evidence-based practice need to be emphasized in clinical training and nurse education. China also needs to develop policies to allow nurses to be able to assess the reliability of health information on the Internet and to make quality health research more available.
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Affiliation(s)
- R Cao
- School of Health Sciences, Wuhan University, Wuhan, China.,Zhongnan Hospital of Wuhan University, China
| | - T E Stone
- Chiang Mai University, Chiang Mai, Thailand
| | - M A Petrini
- Chiang Mai University, Chiang Mai, Thailand.,HOPE School of Nursing, Wuhan University, Wuhan, China
| | - S Turale
- Chiang Mai University, Chiang Mai, Thailand.,International Nursing Review, International Council of Nurses, Geneva, Switzerland
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Tang L, Zhu R, Zhang X. Postpartum Depression and Social Support in China: A Cultural Perspective. JOURNAL OF HEALTH COMMUNICATION 2016; 21:1055-1061. [PMID: 27491938 DOI: 10.1080/10810730.2016.1204384] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study explored how Chinese culture affects the relationship between social support and postpartum depression. In-depth interviews with 38 mothers in mainland China showed that discrepancies between expected and perceived available social support and conflicts among social support providers are two major contributors to the stress associated with postpartum depression. These dynamics are deeply rooted in the context of Chinese culture with its distinctive gender roles and family dynamics. These cultural norms further prevent women from seeking social support.
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Affiliation(s)
- Lu Tang
- a Department of Communication Studies, College of Communication and Information Sciences , University of Alabama , Tuscaloosa , Alabama , USA
| | - Ruijuan Zhu
- b School of Journalism and Communication , Remin University of China , Beijing , China
| | - Xueying Zhang
- c College of Communication and Information Sciences , University of Alabama , Tuscaloosa , Alabama , USA
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45
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Sharma S, van Teijlingen E, Hundley V, Angell C, Simkhada P. Dirty and 40 days in the wilderness: Eliciting childbirth and postnatal cultural practices and beliefs in Nepal. BMC Pregnancy Childbirth 2016; 16:147. [PMID: 27381177 PMCID: PMC4933986 DOI: 10.1186/s12884-016-0938-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 06/24/2016] [Indexed: 12/04/2022] Open
Abstract
Background Pregnancy and childbirth are socio-cultural events that carry varying meanings across different societies and cultures. These are often translated into social expectations of what a particular society expects women to do (or not to do) during pregnancy, birth and/or the postnatal period. This paper reports a study exploring beliefs around childbirth in Nepal, a low-income country with a largely Hindu population. The paper then sets these findings in the context of the wider global literature around issues such as periods where women are viewed as polluted (or dirty even) after childbirth. Methods A qualitative study comprising five in-depth face-to-face interviews and 14 focus group discussions with mainly women, but also men and health service providers. The qualitative findings in Nepal were compared and contrasted with the literature on practices and cultural beliefs related to the pregnancy and childbirth period across the globe and at different times in history. Results The themes that emerged from the analysis included: (a) cord cutting & placenta rituals; (b) rest & seclusion; (c) purification, naming & weaning ceremonies and (d) nutrition and breastfeeding. Physiological changes in mother and baby may underpin the various beliefs, ritual and practices in the postnatal period. These practices often mean women do not access postnatal health services. Conclusions The cultural practices, taboos and beliefs during pregnancy and around childbirth found in Nepal largely resonate with those reported across the globe. This paper stresses that local people’s beliefs and practices offer both opportunities and barriers to health service providers. Maternity care providers need to be aware of local values, beliefs and traditions to anticipate and meet the needs of women, gain their trust and work with them.
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Affiliation(s)
- Sheetal Sharma
- KenBerry Solutions Ltd., Nairobi, Kenya. .,Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK.
| | | | - Vanora Hundley
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Catherine Angell
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Padam Simkhada
- Centre for Public Health, Liverpool John Moores University, Liverpool, UK
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46
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Abdollahi F, Etemadinezhad S, Lye MS. Postpartum mental health in relation to sociocultural practices. Taiwan J Obstet Gynecol 2016; 55:76-80. [DOI: 10.1016/j.tjog.2015.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2014] [Indexed: 11/16/2022] Open
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Cai D, Stone TE, Petrini MA, McMillan M. 'An exploration of the health beliefs of Chinese nurses' and nurse academics' health beliefs: A Q-methodology study'. Nurs Health Sci 2016; 18:97-104. [PMID: 26727168 DOI: 10.1111/nhs.12251] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 08/12/2015] [Accepted: 08/23/2015] [Indexed: 12/01/2022]
Abstract
Q-methodology was used to investigate the health beliefs of Chinese clinical nurses and nurse academics. Twenty-eight participants from one hospital and nursing school in China were involved. The four stages of this study included: (i) concourse development from literature review, Internet searches, and key informant interviews; (ii) A pilot study to develop the Q-sample from the concourse; (iii) participants sorted the Q-sample statements along a continuum of preference (Q-sorting); and (iv) PQ data analysis using principal component analysis and varimax rotation. Five viewpoints were revealed: (i) factor 1--health management and the importance of evidence; (ii) factor 2--challenging local cultural belief, and Eastern and Western influences; (iii) factor 3--commonsense; (iv) factor 4--health and clinical practice; and (v) factor 5--health and nursing education. This study presents a need for nurses and nurse academics to think critically, examine their long-held health beliefs, and promote the use of evidence-based practice.
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Affiliation(s)
- Dan Cai
- HOPE School of Nursing, Wuhan University, Wuhan, China
| | - Teresa E Stone
- Graduate School of Medicine, Yamaguchi University, Ube, Japan
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Abstract
To assess parenting stress and major difficulties experienced in early motherhood among immigrant and Taiwanese women in Pingtung, southern Taiwan. A comparative, descriptive, cohort study of parenting stress and maternal psychological health, using the Child Care Stress Checklist and Edinburgh Postpartum Depression Scale. A purposive sample of 26 foreign-born Vietnamese and 162 Taiwanese mothers were surveyed at 6 weeks' postpartum. Both groups of mothers experienced similar parenting difficulties including the establishment of a regular sleeping schedule for the infant, consoling a crying infant, awareness of infant's needs, conflict with family members, and difficulties managing household chores. Curtailment of social activities was reported more often by Taiwanese mothers, whereas inaccessibility to other experienced mothers and poor maternal-infant bonding were experienced more by immigrant mothers. There were significant differences between groups, with high levels of child care stress and postpartum depression symptoms reported more often by immigrant mothers. Nurses-midwives and community child health nurses need to be sensitive to the particular difficulties and stresses of parenting in mothers from different backgrounds and provide effective interventions and support activities.
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Murray L, Dunne MP, Van Vo T, Anh PNT, Khawaja NG, Cao TN. Postnatal depressive symptoms amongst women in Central Vietnam: a cross-sectional study investigating prevalence and associations with social, cultural and infant factors. BMC Pregnancy Childbirth 2015; 15:234. [PMID: 26423807 PMCID: PMC4590693 DOI: 10.1186/s12884-015-0662-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 09/16/2015] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND This study investigated the prevalence and socio-cultural correlates of postnatal mood disturbance amongst women 18-45 years old in Central Vietnam. Son preference and traditional confinement practices were explored as well as factors such as poverty, parity, family and intimate partner relationships and infant health. METHODS A cross-sectional study was conducted in twelve randomly selected Commune Health Centres from urban and rural districts of Thua Thien Hue Province, Vietnam. Mother-infant dyads one to six months postpartum were invited to participate. Questionnaires from 431 mothers (urban n = 216; rural n = 215) assessed demographic and family characteristics, traditional confinement practices, son preference, infant health and social capital. The Edinburgh Postnatal Depression Scale (EPDS) and WHO5 Wellbeing Index indicated depressive symptoms and emotional wellbeing. Data were analysed using general linear models. RESULTS Using an EPDS cut-off of 12/13, 18.1% (n = 78, 95% CI 14.6-22.1) of women had depressive symptoms (20.4% urban; 15.8% rural). Contrary to predictions, infant gender and traditional confinement were unrelated to depressive symptoms. Poverty, food insecurity, being frightened of family members, and intimate partner violence increased both depressive symptoms and lowered wellbeing. The first model accounted for 30.2% of the variance in EPDS score and found being frightened of one's husband, husband's unemployment, breastfeeding difficulties, infant diarrhoea, and cognitive social capital were associated with higher EPDS scores. The second model had accounted for 22% of the variance in WHO5 score. Living in Hue city, low education, poor maternal competence and a negative family response to the baby lowered maternal wellbeing. CONCLUSIONS Traditional confinement practices and son preference were not linked to depressive symptoms among mothers, but were correlates of family relationships and wellbeing. Poverty, food insecurity, violence, infant ill health, and discordant intimate and family relationships were linked with depressive symptoms in Central Vietnam.
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Affiliation(s)
- Linda Murray
- School of Public Health and Social Work, Queensland University of Technology (QUT), Victoria Park Rd, Kelvin Grove, Queensland, 4059, Australia.
- School of Medicine, University of Tasmania, 1/17 Liverpool St, Hobart, Tasmania, 7000, Australia.
| | - Michael P Dunne
- School of Public Health and Social Work, Queensland University of Technology (QUT), Victoria Park Rd, Kelvin Grove, Queensland, 4059, Australia.
- Institute of Community Health Research, Hue University of Medicine and Pharmacy, 06 Ngo Quyen St, Hue City, Vietnam.
| | - Thang Van Vo
- Institute of Community Health Research, Hue University of Medicine and Pharmacy, 06 Ngo Quyen St, Hue City, Vietnam.
- Faculty of Public Health Hue University of Medicine and Pharmacy, 06 Ngo Quyen St, Hue City, Vietnam.
| | - Phuong Nguyen Thi Anh
- Institute of Community Health Research, Hue University of Medicine and Pharmacy, 06 Ngo Quyen St, Hue City, Vietnam.
- Hue University of Medicine and Pharmacy, 06 Ngo Quyen St, Hue City, Vietnam.
| | - Nigar G Khawaja
- School of Psychology and Counseling, Queensland University of Technology (QUT), Victoria Park Rd, Kelvin Grove, Queensland, 4059, Australia.
| | - Thanh Ngoc Cao
- Institute of Community Health Research, Hue University of Medicine and Pharmacy, 06 Ngo Quyen St, Hue City, Vietnam.
- Hue University of Medicine and Pharmacy, 06 Ngo Quyen St, Hue City, Vietnam.
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Ho M, Li TC, Liao CH, Su SY, Su SY. The Association Between Behavior Restrictions in Doing-the-Month Practice and Mental Health Status Among Postpartum Women. J Altern Complement Med 2015; 21:725-31. [PMID: 26366719 DOI: 10.1089/acm.2013.0474] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES Doing-the-month practice has been commonly observed by women during the first month after delivery for hundreds of years in several countries of Asia. This retrospective study examined the correlation between these restricted behaviors and mental status in postpartum women. MATERIALS AND METHODS The frequencies of seven restricted behaviors during the first month after delivery and levels of depression, anxiety, and sleep quality were measured in 341 women 4-6 weeks after delivery through self-reported questionnaires. The multivariate linear regression model was used to determine independent behavioral predictors for depression, anxiety, and sleep quality. RESULTS Bathing or showering was an independent predictor of low depression status, low anxiety status (p<0.05), and good sleep quality (p<0.001). Behaviors related to high depression status were touching cold water and squatting (both p<0.05). Squatting was also related to high anxiety status (p<0.01), while exposing oneself to drafts was related to poor sleep quality (p<0.05). CONCLUSION The results indicate that the restrictions on squatting, touching cold water, and exposure to drafts are positively associated with good mental health in postpartum women and are worth preserving; however, the restriction on bathing or showering might negatively impact the mental health of postpartum women and needs further evaluation.
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Affiliation(s)
- Ming Ho
- 1 Department of Obstetrics and Gynecology, China Medical University Hospital , Taichung, Taiwan
| | - Tsai-Chung Li
- 2 Graduate Institute of Biostatistics, College of Public Health, China Medical University , Taichung, Taiwan .,3 Department of Healthcare Administration, College of Medical and Health Sciences, Asia University , Taichung, Taiwan
| | - Chun-Hui Liao
- 4 Department of Psychiatry, China Medical University Hospital , Taichung, Taiwan .,5 College of Medicine, China Medical University , Taichung, Taiwan
| | - Shan-Yun Su
- 6 Taiwan Transactional Analysis Association , Taipei, Taiwan
| | - Shan-Yu Su
- 7 Department of Chinese Medicine, China Medical University Hospital , Taichung, Taiwan .,8 School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, China Medical University , Taichung, Taiwan
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