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Ramiro-Cortijo D, de la Calle M, Benitez V, Gila-Diaz A, Moreno-Jiménez B, Arribas SM, Garrosa E. Maternal Psychological and Biological Factors Associated to Gestational Complications. J Pers Med 2021; 11:183. [PMID: 33807903 PMCID: PMC8000308 DOI: 10.3390/jpm11030183] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/18/2021] [Accepted: 03/02/2021] [Indexed: 01/07/2023] Open
Abstract
Early detection of gestational complications is a priority in obstetrics. In our social context, this is linked to maternity age. Most studies are focused on biological factors. However, pregnancy is also influenced by social and psychological factors, which have not been deeply explored. We aimed to identify biopsychosocial risk and protective factors associated with the development of maternal and fetal complications. We enrolled 182 healthy pregnant women, and plasma melatonin and cortisol levels were measured in the first trimester by chemiluminescent immunoassays. At different time points along gestation, women answered several questionnaires (positive and negative affect schedule, hospital anxiety and depression scale, pregnancy concerns scale, life orientation test, resilience scale, life satisfaction scale and life-work conflicts scale). They were followed up until delivery and categorized as normal pregnancy, maternal or fetal complications. Maternal complications were associated with low melatonin (OR = 0.99 [0.98; 1.00]; p-value = 0.08) and life satisfaction (OR = 0.64 [0.41; 0.93]; p-value = 0.03) and fetal complications were associated with high cortisol (OR = 1.06 [1.02; 1.13]; p-value = 0.04), anxiety (OR = 2.21 [1.10; 4.55]; p-value = 0.03) and life-work conflicts (OR = 1.92 [1.04; 3.75]; p-value = 0.05). We conclude that psychological factors influence pregnancy outcomes in association with melatonin and cortisol alterations. High maternal melatonin and life satisfaction levels could be potential protective factors against the development of maternal complications during pregnancy. Low anxiety and cortisol levels and reduced work-life conflicts could prevent fetal complications.
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Affiliation(s)
- David Ramiro-Cortijo
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA;
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain;
| | - Maria de la Calle
- Obstetric and Gynecology Service, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Paseo de la Castellana 261, 28046 Madrid, Spain;
| | - Vanesa Benitez
- Department of Agricultural and Food Chemistry, Faculty of Science, Universidad Autónoma de Madrid, C/Francisco Tomas y Valiente 7, 28049 Madrid, Spain;
| | - Andrea Gila-Diaz
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain;
- Pharmacology and Physiology PhD Program, Doctoral School, Universidad Autónoma de Madrid, C/Francisco Tomas y Valiente 2, 28049 Madrid, Spain
| | - Bernardo Moreno-Jiménez
- Department of Biological and Health Psychology, Faculty of Psychology, Universidad Autonoma de Madrid, C/Ivan Pavlov 6, 28049 Madrid, Spain;
| | - Silvia M. Arribas
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain;
| | - Eva Garrosa
- Department of Biological and Health Psychology, Faculty of Psychology, Universidad Autonoma de Madrid, C/Ivan Pavlov 6, 28049 Madrid, Spain;
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Ventres WB, Frankel RM. Personalizing the BioPsychoSocial Approach: "Add-Ons" and "Add-Ins" in Generalist Practice. Front Psychiatry 2021; 12:716486. [PMID: 34899410 PMCID: PMC8652412 DOI: 10.3389/fpsyt.2021.716486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 10/26/2021] [Indexed: 11/13/2022] Open
Abstract
Generalist practitioners often find interacting with patients deeply satisfying and joyful; they also experience encounters that are challenging and complex. In both cases, they must be aware of the many issues that affect the processes and outcomes of patient care. Although using the BioPsychoSocial approach is an important, time-tested framework for cultivating one's awareness of patients' presenting concerns, recent developments suggest that additional frames of reference may enhance communication and relationships with patients. In this article, we describe several additions to the BioPsychoSocial approach, considerations we call "add-ons" and "add-ins". We invite generalist practitioners and, indeed, all health care practitioners, to consider how they can improve their ongoing care of patients by personalizing these and other additions in their day-to-day work with patients.
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Affiliation(s)
- William B Ventres
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Richard M Frankel
- Regenstrief Institute, Indiana University School of Medicine, Indianapolis, IN, United States
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Zhang XD, Zhang J, Xie RS, Zhang WH. Sexual and reproductive health correlates of polysubstance use among female adolescents who sell sex in the southwest of China. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2020; 15:59. [PMID: 32807180 PMCID: PMC7433201 DOI: 10.1186/s13011-020-00302-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 08/12/2020] [Indexed: 11/14/2022]
Abstract
Background Substance use and adverse sexual and reproductive health (SRH) outcomes continue to be significant threats to female adolescents’ health and wellbeing, particularly to these marginalized subpopulations. Our research aimed to tackle knowledge gaps regarding the prevalence of concurrent substance use including alcohol, tobacco, illicit drug among Chinese adolescent female sex workers (AFSWs), while to assess the correlates between substance use and SRH risks; the needs for comprehensive SRH services were also examined in this study. Methods A cross-sectional study enrolled 310 AFSWs aged 15–19 years by using cluster sampling method in Kunming, China. Descriptive analysis was employed to characterize the participants who were regular-alcohol users, regular-tobacco users, illicit drug users and polysubstance users. Multivariable logistic regression analysis was performed to detect the SRH correlates of regular-alcohol use, regular-tobacco use, illicit drugs and polysubstance use respectively. Results There is a high prevalence of regular-alcohol drinking (83%, 257/310) among AFSWs, with 44% (136/310) smoking cigarettes regularly and 9% using illicit drug (27/310) in the past year. In multivariate analysis, AFSWs who had middle and high school education, had higher monthly income, experienced of sexual and gender based violence (SGBV) and prior abortion, and regular-tobacco smoking were associated with increased odds of regular-alcohol drinking; engaging in unprotected sex while drunk, having STIs symptoms and using illicit drugs were significantly associated with regular-tobacco smoking; while AFSWs who had an illicit drug using- intimate partner, experienced forced sexual initiation, accessed unsafe medical providers for STIs treatment were associate with increased odds of illicit drug use. Moreover, 35% (105/298) AFSWs sought unsafe medical care for STIs treatment, or no treatment at all, among them, majority were using polysubstance (87%; 91/105). Conclusions Our findings reveal combined threats of substance use to AFSWs’ SRH and wellbeing in China, this study emphasises that the coordinated efforts are needed to integrate SRH promotion and harm reduction service across sectors, and not only fragmented measures. An effective response should include an agreed framework, indicators and targets supported by political will, solid leadership and policy reform to deal with AFSWs’ overlapping vulnerabilities in a systematic way.
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Affiliation(s)
- Xu-Dong Zhang
- Yunnan Research Centre for Healthcare Management, School of Management and Economics, Kunming University of Science and Technology, Kunming, China.,China-UK Research Centre for Reproductive Health (Yunnan Province), The Affiliate Hospital, Kunming University of Science and Technology, Kunming, China
| | - Jun Zhang
- Public Health Research Centre, Tsinghua University, Beijing, China
| | - Ren-Sheng Xie
- School of Medical Humanities, Zunyi Medical University, No.6 Xue Fu Xi Lu Rd., Xinpu District, Zunyi, 563006, Guizhou Province, China.
| | - Wei-Hong Zhang
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,School of public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium.,Research Laboratory for Human Reproduction, Faculty of Medicine, ULB, Brussels, Belgium
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Dasikan Z, Ozturk R, Ozturk A. Pelvic floor dysfunction symptoms and risk factors at the first year of postpartum women: a cross-sectional study. Contemp Nurse 2020; 56:132-145. [PMID: 32216721 DOI: 10.1080/10376178.2020.1749099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: The aim of this study was to determine the frequency of pelvic floor dysfunction (PFD) symptoms experienced the first year of postpartum and obstetric risk factors. Methods: This research was a cross-sectional descriptive study. The study was conducted with 408 women between 3 and 12 months postpartum, in İzmir. Results: It was found that urinary incontinence had been experienced by 33.3% of the women during pregnancy and 25.2% postpartum and 2.9% had experienced fecal incontinence. Other frequently experienced symptoms of PFD were in the order of frequency, perineal pain (53.4%), constipation (40.7%), flatulence (34.1%), dyspareunia (27.7%) and fecal incontinence (2.9%). Conclusion: PFD symptoms are common in postpartum women. Early diagnosis, treatment and preventive approaches should be made by healthcare professionals for perinatal pelvic floor health. Impact statement: Healthcare professionals should acknowledge the importance of PFD after birth and identify the problems early period. Our study emphasizes the size of the problem and improvement for PFD.
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Affiliation(s)
- Zeynep Dasikan
- Department of Women's Health and Disease, Faculty of Nursing, Ege University, Izmir, Turkey
| | - Rusen Ozturk
- Department of Women's Health and Disease, Faculty of Nursing, Ege University, Izmir, Turkey
| | - Aslihan Ozturk
- Department of Oncology Nursing, Faculty of Health Sciences, Bakırçay University, Izmir, Turkey
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Fontein-Kuipers Y, van Beeck E, Kammeraat L, Rutten F. The Woman-Centeredness of Various Dutch Maternity Service Providers During Antenatal and Postnatal Care. INTERNATIONAL JOURNAL OF CHILDBIRTH 2019. [DOI: 10.1891/2156-5287.9.2.92] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIMSTo examine the woman-centeredness of maternity care providers from the woman's perspective. To investigate the validity and reliability of the Client Centered Care Questionnaire among a childbearing population.DESIGNA cross-sectional study.METHODSThe self-report Client Centered Care Questionnaire was administered to evaluate women's one-on-one antenatal and postnatal care appointments with various Dutch care providers: community and hospital-based midwives, General Practitioners, (registrar) obstetricians, sonographers, and maternity care nurses.RESULTSEight-hundred and fifteen completed questionnaires were received. Exploratory and confirmatory factor analyses provided support for a two-factor model, with an acceptable model fit. Woman-centeredness of all maternity care providers showed scores above baseline for the neutral value. Welch ANOVA showed a statistical significant effect of the type of maternity care practitioner in providing woman-centered care during antenatal and postnatal visits (F(5.8) = 7.79). The Bonferroni post hoc test showed that women assigned significantly higher woman-centered care scores to community-based midwives compared with hospital-based midwives (p .011) and compared with registrars/obstetricians (p < .001).CONCLUSIONAlthough overall scores of perceived woman-centeredness indicated a good to excellent performance of woman-centered care, with significantly higher scores for community-based midwives, it cannot be assumed that current woman-centered care completely meets the needs of Dutch childbearing women. The Client Centered Care Questionnaire (CCCQ) is an adequate instrument to measure woman-centered care in antenatal and postnatal maternity services. Further research regarding measuring woman-centered care is needed.
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Schoenwald A, Windsor C, Gosden E, Douglas C. Nurse practitioner led pain management the day after caesarean section: A randomised controlled trial and follow-up study. Int J Nurs Stud 2018; 78:1-9. [DOI: 10.1016/j.ijnurstu.2017.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 08/16/2017] [Accepted: 08/17/2017] [Indexed: 01/07/2023]
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The New Old (and Old New) Medical Model: Four Decades Navigating the Biomedical and Psychosocial Understandings of Health and Illness. Healthcare (Basel) 2017; 5:healthcare5040088. [PMID: 29156540 PMCID: PMC5746722 DOI: 10.3390/healthcare5040088] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 11/10/2017] [Accepted: 11/14/2017] [Indexed: 12/02/2022] Open
Abstract
The importance of how disease and illness are conceptualised lies in the fact that such definition is paramount to understand the boundaries and scope of responsibility associated with medical work. In this paper, we aim to provide an overview of the interplay of these understandings in shaping the nature of medical work, philosophically, and in practice. We first discuss the emergence of the biopsychosocial model as an attempt to both challenge and broaden the traditional biomedical model. Then, we outline the main criticisms associated with the biopsychosocial model and note a range of contributions addressing the shortcomings of the model as initially formulated. Despite recurrent criticisms and uneven uptake, the biopsychosocial model has gone on to influence core aspects of medical practice, education, and research across many areas of medicine. One of these areas is adolescent medicine, which provides a particularly good exemplar to examine the contemporary challenges associated with the practical application of the biopsychosocial model. We conclude that a more optimal use of existing bodies of evidence, bringing together evidence-based methodological advances of the biopsychosocial model and existing evidence on the psychosocial needs associated with specific conditions/populations, can help to bridge the gap between philosophy and practice.
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Young K, Fisher J, Kirkman M. Clinicians' perceptions of women's experiences of endometriosis and of psychosocial care for endometriosis. Aust N Z J Obstet Gynaecol 2017; 57:87-92. [PMID: 28251627 DOI: 10.1111/ajo.12571] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 10/16/2016] [Indexed: 01/05/2023]
Abstract
BACKGROUND Endometriosis is a complex, chronic condition with known psychological and social implications for women. Little is known about clinicians' perceptions of the psychosocial aspects of endometriosis and associated care. AIM To describe clinicians' perceptions of women's experiences of living with endometriosis and of the provision of psychosocial care for endometriosis. MATERIALS AND METHODS A qualitative approach was taken using semi-structured interviews with eight gynaecologists and four general practitioners who provide care to women with endometriosis in Victoria, conducted by telephone and in person from June to December 2014. RESULTS Clinicians' perceptions of women's experiences of endometriosis were consistent with those reported by women, particularly when discussing potential infertility. However, less comprehensive descriptions of the effects of endometriosis on women's work and social life and intimate relationships were observed. Some clinicians asserted that endometriosis is caused by poor mental health. General practitioners positioned themselves as best placed to provide psychosocial care to women with endometriosis; gynaecologists suggested various potential providers but rarely themselves. Most clinicians assessed themselves as not being adequately trained to understand and provide care for the psychosocial aspects of endometriosis; half of the gynaecologists did not believe it was necessary for them to do so. CONCLUSIONS The findings of this research demonstrate clinicians' need for further support in the provision of psychosocial care for women with endometriosis, potentially through expanded clinical guidelines and professional development opportunities.
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Affiliation(s)
- Kate Young
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jane Fisher
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Maggie Kirkman
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Searight HR. The Biopsychosocial Model: "Reports of My Death Have Been Greatly Exaggerated". Cult Med Psychiatry 2016; 40:289-98. [PMID: 26374750 DOI: 10.1007/s11013-015-9471-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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