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Oliver C, Puiras E, Sharma V, Mazmanian D. Careful considerations for the treatment of posttraumatic stress disorder during and following pregnancy. Expert Rev Neurother 2024; 24:159-170. [PMID: 38196397 DOI: 10.1080/14737175.2024.2303430] [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: 05/28/2023] [Accepted: 01/05/2024] [Indexed: 01/11/2024]
Abstract
INTRODUCTION The focus on perinatal mental health has expanded recently, though there is less research on post-traumatic stress disorder (PTSD). Therefore, a review of the literature was undertaken and coupled with expert clinical insights to discuss current clinical practice recommendations for PTSD in the perinatal period. AREAS COVERED This review covers considerations for the assessment, prevention, and treatment of PTSD during the perinatal period. Within these sections, evidence-based and promising practices are outlined. Extra attention is afforded to treatment, which includes considerations from both psychotherapeutic and psychopharmacological perspectives. This review closes with coverage of three important and related areas of consideration, including bereavement, intimate partner violence, and childhood sexual abuse. EXPERT OPINION Psychotherapeutic interventions for PTSD during pregnancy are limited, and no strong recommendations can be supported at this time while evidence points toward the effectiveness of cognitive behavioral therapies and eye movement desensitization therapy as first-line treatments postpartum though research evidence is also limited. Research on psychopharmacological interventions is similarly scarce, though selective serotonin reuptake inhibitors may be beneficial. Clinicians should also be mindful of additional considerations that may be needed for the treatment of PTSD in the context of bereavement, intimate partner violence, and history of sexual violence.
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Affiliation(s)
- Casey Oliver
- Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada
| | - Erika Puiras
- Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada
| | - Verinder Sharma
- Department of Psychiatry, Western University, London, Ontario, Canada
- Department of Obstetrics & Gynecology, Western University, London, Ontario, Canada
- Parkwood Institute Mental Health, St. Joseph's Health Care, London, Ontario, Canada
| | - Dwight Mazmanian
- Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada
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Meili X, Sasa H, Ying H, Lijuan Z, Guanxiu T, Jun L. Prevalence of postpartum post-traumatic stress disorder and its determinants in Mainland China: A systematic review and meta-analysis. Arch Psychiatr Nurs 2023; 44:76-85. [PMID: 37197866 DOI: 10.1016/j.apnu.2023.04.007] [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: 09/07/2022] [Revised: 02/18/2023] [Accepted: 04/18/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND The prevalence and risk factors of postpartum posttraumatic stress disorder reported by population-based studies have significantly varied and the data are all collected from regional populations in Mainland China. AIMS To utilize published data to estimate the overall prevalence of postpartum posttraumatic stress disorder and its determinants in Mainland China. METHODS Comprehensively electronic searches were performed across six English databases and three Chinese databases. Random effects of the meta-analysis were performed to evaluate the pooled prevalence of postpartum posttraumatic stress disorder. Meta-regression was performed with the variable of study design, sample size, setting, measures, region, time points, and publication year. RESULTS Totaling of nineteen studies was included, with a sample size of 13,231 postpartum women. The pooled prevalence of postpartum posttraumatic stress disorder was 11.2 % in Mainland China, with a higher prevalence at the timepoint within 1 month postpartum (18.1 %). Significant publication bias and heterogeneity were found (I2 = 97.1 %). Sample size and measurements were conditional on the prevalence of postpartum posttraumatic stress disorder. Postpartum depressive symptoms, sleep problems, cesarean section, and low levels of social support were the major risk factors for postpartum posttraumatic stress disorder. While being the one child in the family was the protective factor. CONCLUSION An increasing prevalence of posttraumatic stress disorder within one month postpartum significantly arises awareness to provide screening and more mental health services during this period. Screening programs for postpartum posttraumatic stress disorder are still needed in Mainland China.
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Affiliation(s)
- Xiao Meili
- Department of Nursing, the Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan Province, 410013, China; Xiang Ya School of Nursing, Central South University, 172 Tongzipo Road, Yuelu District, Changsha, Hunan Province, 410013, China
| | - Huang Sasa
- Department of Nursing, the Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan Province, 410013, China; Xiang Ya School of Nursing, Central South University, 172 Tongzipo Road, Yuelu District, Changsha, Hunan Province, 410013, China
| | - Hu Ying
- Department of Nursing, the Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan Province, 410013, China; Xiang Ya School of Nursing, Central South University, 172 Tongzipo Road, Yuelu District, Changsha, Hunan Province, 410013, China
| | - Zhang Lijuan
- Department of Nursing, the Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan Province, 410013, China; Department of Pediatrics, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan Proviince, 410013, China
| | - Tang Guanxiu
- Department of Nursing, the Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan Province, 410013, China; Department of Geriatrics, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan Province, 410013, China.
| | - Lei Jun
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan Province, 410013, China.
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Pan C, Gong Y. Association among postpartum posttraumatic stress disorder, family coping, neurodevelopment, and language development in high-risk infants: a retrospective study. Transl Pediatr 2022; 11:728-737. [PMID: 35685076 PMCID: PMC9173877 DOI: 10.21037/tp-22-128] [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: 05/16/2022] [Accepted: 04/28/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND A high-risk infant (HRI) is a child whose fetal, neonatal, and infant development is impacted by adverse factors that may cause cognitive, sensory, behavioral, or language defects. The complex situation in the treatment process is a continuous challenge and stressor for parents. If parents fail to take appropriate coping styles, it will have an adverse impact on the health of parents and the growth and development of children. The purpose of this study was to explore the impact of clinical characteristics, postpartum posttraumatic stress disorder (PTSD), and family coping on the neurodevelopment and language development of HRIs as a reference for targeted intervention. METHODS This study retrospectively recruited 211 children who were hospitalized in the neonatal intensive care unit (NICU) of Suzhou Kowloon Hospital from January 2018 to December 2021. HRI and their mother were interviewed by telephone with general information questionnaire, Perinatal Post-traumatic Stress Disorder Questionnaire, medical coping modes questionnaire, Bayley Scales of Infant Development the Early Language Milestone Scale to investigate HRI and their mothers; Logistic regression was used to analyze the relationship between HRI mothers' emotions and family coping with neurodevelopment and language development. RESULTS The neurodevelopmental scores of HRIs differed according to gestational week of delivery, birth weight, and disease diagnosis. The language development scores of HRIs differed according to gestational week of delivery, birth weight, disease diagnosis, and maternal education. Multiple stepwise regression analysis showed that the neurodevelopmental scores were affected by gestational week of delivery, postpartum PTSD score, and family coping. Logistic regression analysis showed that the language development scores were affected by maternal education and neurodevelopmental level. The correlation analysis showed that the postpartum PTSD scores were negatively correlated with family coping, neurodevelopment, and language development, and that family coping was positively correlated with the neurodevelopment and language development scores (P<0.05). CONCLUSIONS The neurodevelopment and language development of HRIs were affected by the gestational week of delivery, maternal education, the child's birth weight, and disease diagnosis. NICU wards can promote the healthy development of HRIs by providing mothers with targeted health education concerning the child's condition, postpartum PTSD, and family coping strategies.
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Affiliation(s)
- Chunhua Pan
- Pediatric Department, Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine, Suzhou, China
| | - Yong Gong
- Pediatric Department, Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine, Suzhou, China
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Health care practitioners' views of the support women, partners, and the couple relationship require for birth trauma: current practice and potential improvements. Prim Health Care Res Dev 2020; 21:e40. [PMID: 33004100 PMCID: PMC7576522 DOI: 10.1017/s1463423620000407] [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: 11/06/2022] Open
Abstract
AIM To examine health care practitioners' views of the support women, partners, and the couple relationship require when affected by birth trauma, barriers to gaining such support, and potential improvements. BACKGROUND Ongoing distress following psychologically traumatic childbirth, also known as birth trauma, can affect women, partners, and the couple relationship. Birth trauma can lead to post traumatic stress symptoms (PTSS) or disorder (PTSD). Whilst there is a clear system of care for a PTSD diagnosis, support for the more prevalent experience of birth trauma is not well-defined. METHOD An online survey of health care practitioners' views of the support parents require for birth trauma, barriers to accessing support, and potential improvements. Practitioners were recruited in 2018 and the sample for the results presented in the article ranged from 95 to 110. RESULTS Practitioners reported differing needs of support for women, partners, and the couple as a unit. There was correlation between practitioners reporting having the skills and knowledge to support couples and feeling confident in giving support. The support most commonly offered by practitioners to reduce the impact on the couple relationship was listening to the couple. However practitioners perceived the most effective support was referral to a debriefing service. Practitioners observed several barriers to both providing support and parents accessing support, and improvements to birth trauma support were suggested. CONCLUSIONS Practitioners indicate that some women, partners, and the couple as a unit require support with birth trauma and that barriers exist to accessing effective support. The support that is currently provided often conflicts with practitioners' perception of what is most effective. Practitioners indicate a need to improve the identification of parents who need support with birth trauma, and more suitable services to support them.
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Abstract
Post-traumatic stress disorder (PTSD) accompanies miscarriage, intrauterine fetal demise, and preterm birth. Levels of PTSD may be higher for women who experience acute, life-threatening events during labor and delivery. Severe maternal morbidities or near misses for maternal death disproportionately impact African American, Hispanic, American Indian, and women in rural communities. Expanding research demonstrates association between severe maternal morbidity or near-miss events and PTSD. Multiple preceding conditions and intrapartum and postpartum events place women at higher risk for PTSD. Postpartum evaluation provides an opportunity for PTSD screening. Untreated perinatal PTSD impacts long-term maternal and child health and contributes to health disparities.
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Chabbert M, Panagiotou D, Wendland J. Predictive factors of women's subjective perception of childbirth experience: a systematic review of the literature. J Reprod Infant Psychol 2020; 39:43-66. [PMID: 32475156 DOI: 10.1080/02646838.2020.1748582] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Up to 33% of women report a negative or traumatic childbirth experience. Given this high prevalence and its consistent association with adverse postpartum and child outcomes, it is essential to identify predictive factors and to improve the management of the childbirth experience. Objective: This systematic review explores and identifies risk and protective factors for women's subjective childbirth experience and birth satisfaction by reviewing original research. Methods: A systematic search was performed for childbirth experience literature on three online databases. Reviewed papers focused on women's subjective childbirth experience and its predictive factors. The articles were assessed with the Mixed Methods Appraisal Tool (MMAT). Results: Risk and protective factors are notably different depending on the study design, the country, or the method employed. The main risk factors are obstetric, such as emergency caesarean and highly perceived labour pain, and women's dissatisfaction with social support. The main protective factors are: obstetric, including highly perceived control during labour or satisfaction regarding partner's support. However, overall results are inconclusive for methodological or conceptual reasons. Conclusions: Several risk factors can be identified through pregnancy or childbirth. This underlines the importance of the quality of maternal interpersonal and professional relationships, especially with first-line perinatal health-care professionals, such as midwives.
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Affiliation(s)
- Margaux Chabbert
- Laboratory of Psychopathology and Health Processes, Université De Paris , Paris, France
| | - Danaé Panagiotou
- Laboratory of Psychopathology and Health Processes, Université De Paris , Paris, France.,Laboratory of Psychology, University of Bourgogne Franche Comté , Besançon, France
| | - Jaqueline Wendland
- Laboratory of Psychopathology and Health Processes, Université De Paris , Paris, France
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Huang D, Dai L, Zeng T, Huang H, Wu M, Yuan M, Zhang K. Exploring Contributing Factors to Psychological Traumatic Childbirth from the Perspective of Midwives: A Qualitative Study. Asian Nurs Res (Korean Soc Nurs Sci) 2019; 13:270-276. [PMID: 31605769 DOI: 10.1016/j.anr.2019.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 10/01/2019] [Accepted: 10/01/2019] [Indexed: 11/26/2022] Open
Abstract
PURPOSE As midwives witness and attend the whole process of childbirth, they have a better understanding of which factors may cause traumatic childbirth. However, because most of the studies paid their attention on mothers, little is known about psychological birth trauma from the perspective of midwives. This study aims to gain a full understanding of which factors may contribute to psychological traumatic childbirth from the perspective of midwives. METHODS A qualitative research was conducted using in-depth interviews, which involved fourteen midwives from the maternal ward of a tertiary hospital. The interviews were recorded and transcribed, and then, Colaizzi's method was used to analyze the contents of the interviews. RESULTS We proposed four themes and eight subthemes on the influencing factors of psychological traumatic childbirth from the perspective of midwives: low perceived social support (lack of support from family and lack of support from medical staff), hard times (protracted labor in the first stage and futile efforts during the second stage), poor birth outcomes (poor birth outcomes of the mother and poor birth outcomes of the baby), and excruciating pain (unbearable pain of uterine contraction and labor pain was incongruent with the mother's expectations). CONCLUSION Medical staff should pay attention to psychological traumatic childbirth and its effects, and emphasis on the screening and assessment of birthing women with negative feelings so that their psychological traumatic childbirth can be prevented and decreased.
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Affiliation(s)
- Deqin Huang
- Department of Nursing, Tongji Hosptial, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Ling Dai
- Department of Nursing, Tongji Hosptial, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Tieying Zeng
- Department of Nursing, Tongji Hosptial, Huazhong University of Science & Technology, Wuhan, Hubei, China.
| | - Haishan Huang
- Department of Neurology, Tongji Hosptial, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Meiliyang Wu
- Department of Nursing, Tongji Hosptial, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Mengmei Yuan
- Department of Nursing, Tongji Hosptial, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Ke Zhang
- Department of Nursing, Tongji Hosptial, Huazhong University of Science & Technology, Wuhan, Hubei, China
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9
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Women's Perceptions of Living a Traumatic Childbirth Experience and Factors Related to a Birth Experience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091654. [PMID: 31085980 PMCID: PMC6539242 DOI: 10.3390/ijerph16091654] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/07/2019] [Accepted: 05/09/2019] [Indexed: 12/02/2022]
Abstract
Although identified by the World Health Organization (WHO) as a global health priority, maternal mental health does not receive much attention even in the health systems of developed countries. With pregnancy monitoring protocols placing priority on the physical health of the mother, there is a paucity of literature documenting the traumatising effects of the birth process. To address this knowledge gap, this qualitative descriptive study aimed to investigate women perceptions of living a traumatic childbirth experience and the factors related to it. Qualitative data, collected via semi-structured interviews with 32 participants recruited from parent support groups and social media in Spain, were analyzed through a six-phase inductive thematic analysis. Data analysis revealed five major themes―“Birth Plan Compliance”, “Obstetric Problems”, “Mother-Infant Bond”, “Emotional Wounds” and “Perinatal Experiences”—and 13 subthemes. The majority of responses mentioned feelings of being un/misinformed by healthcare personnel, being disrespected and objectified, lack of support, and various problems during childbirth and postpartum. Fear, loneliness, traumatic stress, and depression were recurrent themes in participants’ responses. As the actions of healthcare personnel can substantially impact a birth experience, the study findings strongly suggest the need for proper policies, procedures, training, and support to minimise negative consequences of childbirth.
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MacKinnon AL, Houazene S, Robins S, Feeley N, Zelkowitz P. Maternal Attachment Style, Interpersonal Trauma History, and Childbirth-Related Post-traumatic Stress. Front Psychol 2018; 9:2379. [PMID: 30618902 PMCID: PMC6279867 DOI: 10.3389/fpsyg.2018.02379] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 11/12/2018] [Indexed: 12/18/2022] Open
Abstract
Childbirth-related post-traumatic stress has potentially negative and enduring consequences for the well-being of women and their families. Although research to date has identified attachment style and trauma history as individual risk factors, they have yet to be examined as integrative processes in the development and maintenance of childbirth-related post-traumatic stress. The current investigation aimed to examine whether attachment style may moderate the impact of a history of interpersonal trauma on initial levels and the rate of change in post-traumatic stress symptomatology across the first 6 months of the postpartum period. A large community sample of women were recruited from two Canadian urban hospitals. Childbirth-related post-traumatic stress symptoms were assessed longitudinally at 5 weeks, 2 months, and 6 months postpartum. Latent growth curve modeling (n = 251) revealed that attachment style moderated the impact of a history of interpersonal trauma on initial levels and the rate of change in post-traumatic stress symptomatology, while controlling for other well-established psychosocial (e.g., trait anxiety, previous psychopathology, lack of perceived support) and childbirth-related (e.g., mode of birth, labor pain, subjective experience) risk factors. More secure attachment conferred resiliency and more fearful attachment conferred vulnerability among women without a history of interpersonal trauma, while more preoccupied and more dismissing attachment conferred resiliency among women with a history of interpersonal trauma. These findings highlight the importance of understanding the integrative processes among risk and protective factors underlying the development of and ability to cope with childbirth-related post-traumatic stress. Attachment style and trauma history, which can be quickly measured, should be considered as targets in antenatal screening.
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Affiliation(s)
- Anna L. MacKinnon
- Department of Psychiatry, Jewish General Hospital, Montreal, QC, Canada
- Lady Davis Institute for Medical Research, Montreal, QC, Canada
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Sarah Houazene
- Department of Psychology, University of Montreal, Montreal, QC, Canada
| | - Stephanie Robins
- Department of Psychiatry, Jewish General Hospital, Montreal, QC, Canada
- Lady Davis Institute for Medical Research, Montreal, QC, Canada
| | - Nancy Feeley
- Lady Davis Institute for Medical Research, Montreal, QC, Canada
- Centre for Nursing Research, Jewish General Hospital, Montreal, QC, Canada
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Phyllis Zelkowitz
- Department of Psychiatry, Jewish General Hospital, Montreal, QC, Canada
- Lady Davis Institute for Medical Research, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
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Goutaudier N, Bertoli C, Séjourné N, Chabrol H. Childbirth as a forthcoming traumatic event: pretraumatic stress disorder during pregnancy and its psychological correlates. J Reprod Infant Psychol 2018; 37:44-55. [DOI: 10.1080/02646838.2018.1504284] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Nelly Goutaudier
- Centre de Recherches sur la Cognition et l’Apprentissage – CeRCA-UMR CNRS 7295, University of Poitiers, Poitiers, France
| | - Charlene Bertoli
- Centre d’Etudes et de, Recherches en Psychopathologie et Psychologie de la Santé – CERPPS EA 7411, University of Toulouse Jean-Jaurès, Toulouse, France
| | - Natalène Séjourné
- Centre d’Etudes et de, Recherches en Psychopathologie et Psychologie de la Santé – CERPPS EA 7411, University of Toulouse Jean-Jaurès, Toulouse, France
| | - Henri Chabrol
- Centre d’Etudes et de, Recherches en Psychopathologie et Psychologie de la Santé – CERPPS EA 7411, University of Toulouse Jean-Jaurès, Toulouse, France
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Abstract
Childbirth is a pivotal event for many women, and evidence suggests that women possess strong expectations regarding this experience. In a longitudinal study of 330 Israeli first-time mothers, we distinguished between physical, emotional, and cognitive factors and used them to assess the underlying mechanism of satisfaction, based on theoretical frameworks of stress and control. Women completed questionnaires during pregnancy and two months postpartum. The negative association between a more medicalized birth and birth satisfaction was partially mediated by perceived control. In turn, specific emotions mediated the association between perceived control and satisfaction: Greater perceived control over the birth environment predicted more positive emotions, less fear, and better perceived care; while greater perceived control over the birth process predicted more positive emotions, less fear, and less guilt. Greater incongruence between the planned and actual birth experience predicted lower satisfaction, mediated by perceived care and feelings of guilt. This investigation unraveled the association between women’s lived birth experience and their birth satisfaction. The findings underscore the value of helping women achieve satisfying births by discussing their expectations with them, providing them with experiences that meet their needs, and supporting those with a gap between their expectations and experience. Respecting individual preferences while lowering blame may improve women’s health and well-being. Additional online materials for this article are available on PWQ’s website at http://journals.sagepub.com/doi/suppl/10.1177/0361684318779537 .
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Zhang D, Zhang J, Gan Q, Wang Q, Fan N, Zhang R, Song Y. Validating the Psychometric Characteristics of the Perinatal Posttraumatic Stress Disorder Questionnaire (PPQ) in a Chinese Context. Arch Psychiatr Nurs 2018; 32:57-61. [PMID: 29413073 DOI: 10.1016/j.apnu.2017.09.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 07/19/2017] [Accepted: 09/24/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Perinatal posttraumatic stress disorder (PPTSD) is a common stress-induced mental disorder worldwide. The Perinatal Posttraumatic Stress Disorder Questionnaire (PPQ) is an excellent questionnaire that measures the symptoms of PPTSD, but has not been translated into Chinese yet. OBJECTIVES The aims of this study were to develop a translated Chinese version of the (PPQ) and validate the psychometric characteristics of the PPQ in a Chinese context. METHODS After translation, back-translation, and expert discussion, 280 mothers at 1 to 18months postpartum filled out the questionnaires through the Internet. Then the reliability and validity of the translated questionnaire were tested. RESULTS The Chinese version of PPQ (PPQ-C) was composed of 14 items. Cronbach's α coefficient was 0.84, test-retest reliability was 0.88, and the content validity was 0.99. Exploratory factor analysis extracted three factors (representing "arousal", "avoidance" and "intrusion") accounted for 53.30% of the variance. The established 3 factors model was well fitted with the collected data (χ2=76.40, p<0.05). IMPLICATIONS FOR PRACTICE The PPQ-C is a short, reliable, and valid instrument that measures the symptoms of PPTSD, and it is recommend for clinical screening. IMPLICATIONS FOR RESEARCH Further research could involve diverse participants, as well as better adapt the PPQ-C to Chinese culture.
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Affiliation(s)
- Di Zhang
- WuHan University School of Health Sciences, 155 Donghu Rd., Wuchang District, WuHan 430071, PR China
| | - Jun Zhang
- WuHan University School of Health Sciences, 155 Donghu Rd., Wuchang District, WuHan 430071, PR China.
| | - Quan Gan
- Hubei Maternal and Child Health Hospital, 745 Wuluo Rd., Hongshan District, WuHan 430070, PR China
| | - Qiaoling Wang
- Wuhan Medical Care Center for Women and Children, 100 Hongkong Rd., Jiang'an District, WuHan 430015, PR China
| | - Nian Fan
- Wuhan Medical Care Center for Women and Children, 100 Hongkong Rd., Jiang'an District, WuHan 430015, PR China
| | - Rong Zhang
- Wuhan Medical Care Center for Women and Children, 100 Hongkong Rd., Jiang'an District, WuHan 430015, PR China
| | - Yayun Song
- WuHan University School of Health Sciences, 155 Donghu Rd., Wuchang District, WuHan 430071, PR China
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Vignato J, Georges JM, Bush RA, Connelly CD. Post-traumatic stress disorder in the perinatal period: A concept analysis. J Clin Nurs 2017; 26:3859-3868. [PMID: 28295746 PMCID: PMC5599312 DOI: 10.1111/jocn.13800] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2017] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To report an analysis of the concept of perinatal post-traumatic stress disorder. BACKGROUND Prevalence of perinatal post-traumatic stress disorder is rising in the USA, with 9% of the U.S. perinatal population diagnosed with the disorder and an additional 18% being at risk for the condition. Left untreated, adverse maternal-child outcomes result in increased morbidity, mortality and healthcare costs. DESIGN Concept analysis via Walker and Avant's approach. METHODS The databases Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Academic Search Premier and PsychINFO were searched for articles, written in English, published between 2006-2015, containing the terms perinatal and post-traumatic stress disorder. RESULTS Perinatal post-traumatic stress disorder owns unique attributes, antecedents and outcomes when compared to post-traumatic stress disorder in other contexts, and may be defined as a disorder arising after a traumatic experience, diagnosed any time from conception to 6 months postpartum, lasting longer than 1 month, leading to specific negative maternal symptoms and poor maternal-infant outcomes. Attributes include a diagnostic time frame (conception to 6 months postpartum), harmful prior or current trauma and specific diagnostic symptomatology defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Antecedents were identified as trauma (perinatal complications and abuse), postpartum depression and previous psychiatric history. Consequences comprised adverse maternal-infant outcomes. CONCLUSIONS Further research on perinatal post-traumatic stress disorder antecedents, attributes and outcomes in ethnically diverse populations may provide clinicians a more comprehensive framework for identifying and treating perinatal post-traumatic stress disorder. RELEVANCE TO CLINICAL PRACTICE Nurses are encouraged to increase their awareness of perinatal post-traumatic stress disorder for early assessment and intervention, and prevention of adverse maternal-infant outcomes.
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Affiliation(s)
- Julie Vignato
- College of Nursing, University of Iowa, Iowa City, IA, USA
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, San Diego, CA, USA
| | - Jane M Georges
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, San Diego, CA, USA
| | - Ruth A Bush
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, San Diego, CA, USA
| | - Cynthia D Connelly
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, San Diego, CA, USA
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Choperena Aguilar DG. Commentary on a Cochrane Review of Debriefing Interventions for the Prevention of Psychological Trauma in Women After Childbirth. Nurs Womens Health 2017; 21:85-87. [PMID: 28389003 DOI: 10.1016/j.nwh.2017.02.005] [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: 10/24/2016] [Revised: 11/04/2016] [Indexed: 06/07/2023]
Abstract
Childbirth can be a traumatic event for some women, with psychological effects that can be significant and long-lasting. Authors of a Cochrane Review of seven randomized controlled trials concluded that debriefing interventions for women after childbirth are not well-defined in the literature and that not enough evidence exists to conclude that there is a positive or adverse effect from using these interventions.
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Lowe SA. Obstetric medicine and the critically ill pregnant woman. Obstet Med 2016; 9:147. [DOI: 10.1177/1753495x16674129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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