Psychosomatic approaches to obstetrics, gynaecology and andrology--a review

The Treatment of Complementary and Alternative Medicine on Premature Ovarian Failure

It has been confirmed by growing evidence that common hormone replacement therapy is associated with an increasing risk of causing cardiovascular disease and cancer, while complementary and alternative medicine (CAM) is gaining popularity and application in more and more patients with premature ovarian failure (POF). Although there is little data concerning the clinical safety and efficacy of CAM, the literature includes application studies on the phytoestrogen-rich herbal, acupuncture treatment and intervention therapy. This article reviews recent literature on CAM therapy for POF, aiming to provide theoretical support for clinical application.

Support for pregnant women identified with fear of childbirth (FOC)/tokophobia - A systematic review of approaches and interventions

BACKGROUND

providing appropriate care for pregnant women with high or severe fear of childbirth (FOC) is a challenge in midwifery care today. FOC is associated with predisposing anamnestic factors, various sociodemographic and psychosocial characteristics, and may result in serious healthrelated consequences. It is therefore important to establish which interventions may increase a woman's faith in her own ability to cope with labour and birth.

AIM

to systematically identify and review studies examining interventions for relief of severe fear of childbirth in pregnancy and their underlying conceptual foundation.

METHODS

a systematic literature search was performed following Cochrane Collaboration and PRISMA Statement recommendations. Inclusion criteria were: studies including pregnant women diagnosed with high or severe FOC or who requested a caesarean section due to severe FOC, studies (regardless of design) observing the effect of an intervention addressing FOC, and studies published in English. Publications addressing anxiety or stress were excluded. 377 references were screened by title and abstract. The risk of bias was assessed.

FINDINGS

19 articles referring to 15 research projects were included in the analysis. The studies show heterogeneity regarding assessment methods, type, conceptualisation and application of interventions. There is evidence that both cognitive therapy sessions and a theory-based group psychoeducation with relaxation are effective interventions.

KEY CONCLUSIONS

despite methodological limitations, single or group psychoeducation sessions for nulliparous women or therapeutic conversation during pregnancy (in group or individual sessions) have the potential to strengthen women's self-efficacy and decrease the number of caesarean sections due to FOC. The theoretical validation of an intervention deepens the understanding of psychological processes in women coping with severe FOC.

IMPLICATIONS FOR PRACTICE

theory-based concepts of care for both antenatal and intrapartum support of pregnant women with high or severe FOC should be developed, piloted, tested, evaluated and implemented within the given healthcare system. Midwives need to be competent to address pregnant women's fears regarding labour and birth in antenatal care. The use of a valid assessment tool to identify the level of FOC in women, even if they do not raise the issue, is recommended in routine antenatal care so that appropriate expert support can be offered. A one-on-one conversation may be feasible for those women unwilling to fill in a questionnaire. Cooperative local networks between midwives, psychologists and obstetricians qualified in psychotherapy should be established to ensure timely and effective care for women with high or severe FOC.

Introducing SHIP® as a Psychotherapeutic Model to Access the Body Memory of Traumatised Clients: Depathologising Expressions of Trauma

The purpose of this article is to destigmatise the normal expressions and reactions of people's psycho-biodynamic systems to trauma. A theoretical exposition will be provided on the effect of trauma on the bodily and psychological systems and on how SHIP® (Spontaneous Healing Intrasystemic Process) psychotherapy describes accessing the body memories of traumatised clients. The SHIP® perspective on trauma will be briefly contextualised in an attempt to contribute to the elaboration of the body of knowledge of positive psychology. The article will focus on reframing the chronic dis-ease or “pathology” of traumatised clients as activated healing messages.