The development and psychometric testing of the Perinatal Infant Care Social Support (PICSS) instrument

Psychometric testing of the Chinese version of the Perinatal Infant Care Social Support tool: a methodological study

PURPOSE

This study aimed to translate the Perinatal Infant Care Social Support (PICSS) instrument into Chinese and to verify the reliability and validity of the translated version.

METHODS

This study used a cross-sectional design to examine the reliability and validity of the Chinese version of the PICSS (C-PICSS). A cohort of 150 first-time mothers in China participated, attending hospital follow-up care at 6 weeks postpartum. Data were collected after obtaining informed consent from the mothers.

RESULTS

The majority of mothers were aged between 20 and 29 years, with a mean age of 26.25 (±3.90) years. An item analysis of the 19 items in the C-PICSS showed that all items had an item-total score correlation above 0.2. This resulted in a Kaiser-Meyer-Olkin value of 0.92 and a significant Bartlett's test of sphericity (χ2=1,778.65, p<.001), confirming the suitability of the data for factor analysis. Correlation analyses revealed a strong positive relationship between infant care social support and general social support (r=.62, p<.001), and a negative relationship between infant care social support and postpartum depression (r=-.38, p<.001). Higher scores for infant care social support were associated with reporting positive relationships with their husbands (t=3.72, p<.001) and high levels of spousal involvement (t=4.09, p<.001). In terms of structural support, spouses were identified as the primary source.

CONCLUSION

The research results indicate that C-PICSS is reliable and valid as an indicator of social support for infant care among Chinese mothers.

Psychometric evaluation of the early postnatal questionnaire for Swedish population

BACKGROUND

Previously developed instruments measuring the quality of postnatal care, based on women's experiences and views, are mainly country-specific which makes it important to have studies for specific populations. The aim of this study was to explore validity and reliability evidence of a previously developed postnatal questionnaire for women living in Sweden.

METHOD

A cross-sectional study based on self-report questionnaire. The questionnaire included the Early Postnatal Questionnaire (EPQ), and was administered to 1061 women who gave birth in two regional hospitals in Swedish during 2017. Validity evidence of the EPQ was undertaken using principal component analysis. Regarding reliability, Cronbach's alpha was used.

RESULTS

The questionnaire was returned by 483 postnatal women. The analysis resulted in three components: Information, Postnatal Environment and Caring Relationship. The Cronbach alpha values of the components ranged from 0.762 to 0.879. Foreign-born women scored higher (more positively) in all three components, compared to women born in Sweden.

CONCLUSIONS

The results of this study suggest that the instrument EPQ is a psychometrically useful tool, suitable for both research and clinical settings. The three-component structure provides researchers with the opportunity to conduct a more detailed exploration of various aspects of postnatal care to develop postnatal care. Further studies focusing on foreign-born women's experiences of postnatal care are warranted.

Preferences for childbirth delivery and pain relief methods among pregnant women in Vietnam

Background

Understanding childbirth delivery and pain relief method preferences is important as a part of the shared decision-making process between pregnant women and health professionals. This study aimed to examine the preferences for childbirth delivery modes and pain relief methods and factors related to these preferences among pregnant women in Vietnam.

Methods

A cross-sectional survey on pregnant women was conducted in two obstetrics hospitals in Vietnam. Face-to-face interviews using a structured questionnaire were performed to collect information about sociodemographic characteristics, pregnancy characteristics, preferences for different childbirth delivery modes, and pain relief methods. Multivariate logistic regression was employed for determining associated factors with the preferences.

Results

Of 576 pregnant women, 34% of participants preferred cesarean section. Most of the sample did not have any preferences for specific pharmacological pain relief methods (70.1%), while support from partner/relatives was the most preferable non-pharmacological method (61.3%), following by water birth (11.1%) and acupuncture (9.9%). Desire to have another baby, relatives' experience, selection date of birth, and instrumental social support were major drivers of the cesarean section selection. This preference was an important factor in the preference for pharmacological pain relief. Meanwhile, high levels of informational and emotional support were associated with non-pharmacological method preference.

Conclusion

This study highlighted a high preference rate for cesarean section in urban pregnant women in Vietnam. Holistic approaches from family, health facility, and policy should be performed to diminish the cesarean rate preference and promote the use of non-pharmacological pain relief methods during birth.

The impact of New Families home visiting program on first-time mothers' quality of life and its association with social support: a non-randomized controlled study

BACKGROUND

The transition to motherhood is characterized by physical, psychological, social, and relational changes. Quality of life (QoL) changes substantially during this transition. Higher QoL is associated with social support, essential for coping with the challenges and changes of becoming a mother. An early universal home visiting program (New Families) is developed to strengthen and support families. The study aims to evaluate the impact of New Families on first-time mothers' QoL and to investigate the association between their QoL, social support, and selected possible predictive factors.

METHODS

A prospective non-randomized controlled study with parallel group design. Child Health Services in five city districts of Oslo were matched in intervention and control groups. First-time mothers were allocated based on the residential area and assessed at pregnancy week 28 (N = 228), six weeks postpartum (N = 184), and three months postpartum (N = 167). Measures of the World Health Organization Quality of Life brief, Perinatal Infant Care Social Support Scale, and background variables were collected from October 2018 to June 2020. Multivariate linear regression models were applied to examine intervention impact and assess associations.

RESULTS

Our data did not reveal a significant association between New Families intervention and the QoL levels of first-time mothers at three months postpartum. Thus, we analyzed the whole sample together. Emotional support was significantly associated with higher QoL levels in the physical health (B = 0.19, 95%CI [0.04 to 0.34]) and social relationships (B = 0.40, 95%CI [0.20 to 0.60]) domains. Appraisal support was significantly associated with higher QoL levels in the psychological (B = 0.34, 95%CI [0.18 to 0.50]) and environment (B = 0.33, 95%CI [0.19 to 0.48]) domains. QoL levels in pregnancy were significantly associated with QoL levels postpartum, showing small to medium effect size (ES = 0.30 to 0.55), depending on the domain.

CONCLUSIONS

Further research, including qualitative interviews, could provide more insights into the impact of New Families on QoL. A positive association between QoL levels in pregnancy and postpartum suggests that postnatal interventions targeting improved QoL could potentially improve postpartum QoL. Emotional and appraisal support seems beneficial for first-time mothers' QoL and could be provided and facilitated by public health nurses.

TRIAL REGISTRATION

clinicaltrial.gov NCT04162626.

Relationship between social support and postpartum depression in migrant and non-migrant first-time mothers

AIMS AND OBJECTIVES

This study examines the relationship between social status and postpartum depression by migrant generation and determines whether social support moderates the relationship between migrant generations and postpartum depression.

BACKGROUND

Postpartum depression (PPD) afflicts more than 1 in 10 childbearing women worldwide; and this mental health problem may be higher among vulnerable populations of women such as migrants, an increasingly prevalent group in many countries. Social support and migrant generation (1^st generation-mother and her parents born outside the host country; 2^nd generation-mother born in the host country but not her parents; 2.5 generation-mother and one parent born in the host country) may contribute to the conflicting findings on migrant mothers and postpartum depression.

DESIGN

This study used a cross-sectional design.

METHODS

Sample recruitment of migrant and non-migrant first-time mothers (n=515) was implemented through an online platform. A STROBE checklist guided the reporting of this study.

RESULTS

PPD was lower among mothers with social support. While social support was negatively associated with PPD for all mothers, PPD was not associated with migrant generation nor was a moderation effect found.

CONCLUSIONS

Social support is negatively associated with PPD for all mothers, but levels of PPD for migrant mothers may be linked to country-specific healthcare resources and immigration policies. Immigrant policies influence migrant mothers' healthcare access; thus, immigration policies may influence PPD among first-time migrant mothers and the manner in which nurses can provide formal support. This study finds that social support, including the formal social support provided by nurses, decreases the likelihood of PPD. Demands on nurses' technical and assessment skills are high, but nurses also need to remember that their skills of providing social support are equally important, and for first-time mothers, may contribute to decreasing PPD.

COVID-19 and delayed antenatal care impaired pregnant women's quality of life and psychological well-being: What supports should be provided? Evidence from Vietnam

BACKGROUND

This study explored the associations between different structural and functional supports with the quality of life (QOL) and mental well-being of pregnant women whose antenatal care was delayed due to the COVID-19 pandemic in Vietnam.

METHODS

A multi-center cross-sectional study was performed on 868 pregnant women. The pregnant women's quality of life questionnaire (QOL-GRAV), the Edinburgh Postnatal Depression Scale (EPDS), and the Perinatal Infant Care Social Support (PICSS) instruments were employed. The satisfaction with care from different sources was measured. Multivariate Tobit Regression models were used.

RESULTS

Seventy pregnant women (8.1%) reported that their antenatal care was influenced by the COVID-19. In this group, a higher level of satisfaction with the care of parents-in-law and a higher score of emotional support were associated with a better "Physical and Emotional changes" domain, while a higher level of appraisal support was related to poorer "Physical and Emotional changes" domain. A higher level of satisfaction with relatives' care and a higher score of emotional support were correlated with a better "Life Satisfaction" domain. EPDS score was negatively correlated with satisfaction with parents-in-law care and appraisal support.

CONCLUSIONS

Our study highlighted that intervention programs to improve the QOL and psychological well-being of pregnant women in epidemics such as COVID-19 or other diseases in the future should involve other family members such as parents-in-law and relatives as sources of support.

LIMITATIONS

The cross-sectional design was unable to draw causal relationships. Recall bias might occur. The convenient sampling method might limit the generalizability of findings.

Social support needs of first-time parents in the early-postpartum period: A qualitative study

Background

The early postpartum period is a critical time for first-time parents as they adapt to their new role. Perceived lack of social support is a risk factor for developing mental health problems. Insufficient or inappropriate professional support for both parents has been reported by many studies. Social support that appropriately meets parents' needs is an important protective factor for parents' wellbeing; however, little is known about the social support needs of both first-time parents.

Aims and objectives

To describe both first-time parents' formal social support needs in the early postpartum period.

Method

Individual semi-structured interviews were conducted with first-time parents recruited on the postpartum ward of a Swiss university hospital. Thematic analysis was used to identify themes and sub-themes.

Results

Fifteen mothers and eleven fathers were interviewed. Twelve themes were identified. Mothers' themes were "experiencing postpartum changes," "creation of a family unit," "self-esteem," "emotional needs," "difficulty in communicating their needs," and "the postpartum stay." Fathers' themes were "to be included in care procedures on the postpartum ward," "to be reassured," "to anticipate their postpartum stay" and "to consider their need as non-priority." Parental shared needs were: "to care for their newborn," and "returning home."

Conclusion

Mothers' and fathers' needs differed. Mothers needed more emotional support than fathers and fathers considered themselves as the main support for their partner. Fathers wanted to be integrated in the care of their newborn.

Validation of the Korean version of the Perinatal Infant Care Social Support scale: a methodological study

Purpose

The purpose of this study was to develop and test the validity and reliability of the Korean version of the Perinatal Infant Care Social Support (K-PICSS) for postpartum mothers.

Methods

This study used a cross-sectional design. The K-PICSS was developed through forward-backward translation. Online survey data were collected from 284 Korean mothers with infants 1-2 months of age. The 19-item K-PICSS consists of functional and structural domains. The functional domain of social support measures infant care practices of postpartum mothers. Exploratory factor analysis (EFA) and known-group comparison were used to verify the construct validity of the K-PICSS. Social support and postpartum depression were also measured to test criterion validity. Psychometric testing was not applicable to the structural social support domain.

Results

The average age of mothers was 32.76±3.34 years, and they had been married for 38.45±29.48 months. Construct validity was supported by the results of EFA, which confirmed a three-factor structure of the scale (informational support, supporting presence, and practical support). Significant correlations of the K-PICSS with social support (r=.71, p<.001) and depression (r=-.40, p<.001) were found. The K-PICSS showed reliable internal consistency, with Cronbach's α values of .90 overall and .82-.83 in the three subscales. The vast majority of respondents reported that their husband or their parents were their main sources of support for infant care.

Conclusion

This study demonstrates that the K-PICSS has satisfactory construct validity and reliability to measure infant care social support in Korea.

Fear of Childbirth and Preferences for Prevention Services among Urban Pregnant Women in a Developing Country: A Multicenter, Cross-Sectional Study

This study aimed to examine fear of childbirth and willingness to pay for fear-prevention services in pregnant women. A multicenter, cross-sectional study was conducted on pregnant women in two obstetric hospitals in Vietnam. The Fear of Birth Scale was utilized to evaluate fear of childbirth. Multivariable, generalized linear regression and logistic regression models were performed to identify associated factors with fear of childbirth, demand, and willingness to pay for prevention services. Of 900 pregnant women, fear of childbirth was moderately high with a mean score of 18.1 (SD = 2.3). Age of partner; ever having complications of pregnancy; attitudes toward different aspects of childbirth delivery; satisfactions with friends, parents, and siblings' care; and information support were associated with fear of childbirth. Only 33.8% participants had a demand for the prevention service, and 43.7% were willing to pay for this service with an average amount of $US 10.0 per month (SD = 72.0). Our study suggested that individualized psychological counseling and information-seeking guidance should be provided appropriately and differently for multiparous and nulliparous women for reducing fear and improving the acceptability of the prevention services.

The experiences of mothers with preterm infants within the first-year post discharge from NICU: social support, attachment and level of depressive symptoms

BACKGROUND

The estimated global premature birth rate for 2014 was 10.6%, equating to an estimate of 14.84 million live premature births. The experience of premature birth does not impact solely on the infant and mother as individuals but occurs in the context of a critical point in time when they are developing a relationship with one another. The aim of this study was to investigate the relationships between social support, mother to infant attachment, and depressive symptoms of mothers with preterm infants within the first 12 months' post discharge from the Neonatal Intensive Care Unit (NICU).

METHODS

A correlational cross-sectional study design was used. Data were collected using a four-part online survey which included the Perinatal Social Support Questionnaire (PICSS), Maternal Postnatal Attachment Scale (MPAS) and the Edinburgh Postnatal Depression Scale (EPDS) with mothers of preterm infants (n = 140).

RESULTS

The prevalence of postnatal depression was 37.9% (95% CI: 29.8 to 46.4%). In univariable analyses, history of depression (p = 0.005), aged 35-39 years (p = 0.006), no formal social support (p = 0.040), less informal social supports (p = 0.018), lower overall maternal attachment (p < 0.001) and lower overall functional social support (p < 0.001) were significantly associated with a higher level of depressive symptoms. Lower scores on two of the maternal attachment subscales (quality of attachment and absence of hostility) and all four of the functional social support subscales were significantly associated with a higher level of depressive symptoms (p < 0.001 for all). In the multivariable analysis, prior history of depression (p = 0.028), lower score of maternal attachment (p < 0.001) and lower emotional functional social support (p = 0.030) were significantly associated with a higher level of depressive symptoms.

CONCLUSION

Women who experience a premature birth, have a prior history of depression, poor infant attachment and poor emotional social support have a higher level of depressive symptoms. Results emphasise the need for professionals to encourage mobilisation of maternal formal and informal social supports. It is important to intervene early to address maternal emotional well-being and enhance the developing mother-preterm infant relationship.

Improvement in Psychological Condition of Patients With Persistent Moderate-Severe Allergic Rhinitis by Drug Therapy Combined With Psychological Intervention

OBJECTIVE

To investigate the effect of drug treatment combined with psychological intervention on mental disorders in patients with persistent moderate-severe allergic rhinitis.

METHODS

Sixty patients with persistent moderate-severe allergic rhinitis who met the criteria were randomly divided into 2 groups: control group and experimental group. The control group was only given medication, whereas the experimental group was given psychological intervention on the basis of the same medication. Cognitive behavioral therapy was used for psychological intervention. After 12 weeks of treatment, Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and rhinoconjunctivitis quality of life questionnaire (RQLQ) were used to evaluate the changes in anxiety, depression, and quality of life before and after treatment.

RESULTS

The SAS and SDS scores of the control group after treatment were lower than those before treatment, and the difference was statistically significant. Similarly, the SAS and SDS scores of the experimental group after treatment were lower than those before treatment with statistically significant difference. In addition, after treatment, the SAS and SDS scores of the experimental group were statistically lower than those of the control group. The results of RQLQ showed that the scores of each dimension in the control group after treatment were lower than those before treatment, and the difference was statistically significant. Similar results were found in the experimental group. After treatment with these 2 different schemes, the RQLQ scores of sleep, nonnasal/eye symptoms, and emotion in the experimental group were statistically lower than those in the control group.

CONCLUSION

Drug therapy or drug therapy combined with psychological intervention can alleviate anxiety and depression of patients with persistent moderate-severe allergic rhinitis and improve their quality of life. Moreover, based on the effect of improving mental disorder and quality of life of patients, drug therapy combined with psychological intervention is better than drug treatment alone.