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Zou H, Sun M, Liu Y, Xi Y, Xiang C, Yong C, Liang J, Huo J, Lin Q, Deng J. Relationship between Dietary Inflammatory Index and Postpartum Depression in Exclusively Breastfeeding Women. Nutrients 2022; 14:nu14235006. [PMID: 36501036 PMCID: PMC9738724 DOI: 10.3390/nu14235006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/19/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022] Open
Abstract
(1) Background: Research has shown that chronic inflammation can increase the risk of depression. The dietary inflammatory index (DII) is a novel measure of dietary inflammation, which has been used to investigate the relationship between diet and mental disorders in adults. However, little research has been conducted to establish an association between dietary inflammation (as measured by DII) and postpartum depression (PPD) in exclusively breastfeeding women. (2) Methods: In this cross-sectional study, 293 women who were exclusively breastfeeding for 6 months or less were enrolled. The DII scores were evaluated using semi-quantitative Food Frequency Questionnaires (FFQ), and the Edinburgh Postpartum Depression Scale (EPDS) was used to measure depression levels of breastfeeding mothers during the six months following delivery. The participants were classified by tertiles, and the possibility of DII being associated with PPD was assessed by binary regression analysis. (3) Results: The average DII score was 2.32 ± 1.08, which ranged from -1.66 to 4.19. The rate of depression was 60.1%. Adjusted for potential risk factors such as age, educational level, occupational level, number of babies, number of caregivers, social support level, and sleep quality, the results showed that the lowest DII score was associated with a lower risk of PPD than the highest score (OR tertile Q1 vs. 3 = 0.47, 95% CI: 0.24, 0.93, p = 0.030). (4) Conclusions: In exclusive breastfeeding women, the inflammatory potential of dietary intake seems to be related to depression. Interventions to improve diet quality might consider including a dietary component that aims to lower chronic systemic inflammation to prevent PPD. However, the relationship between DII and PPD among Chinese women remains to be demonstrated in a larger population.
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Affiliation(s)
- Hanshuang Zou
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China
| | - Minghui Sun
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China
- Jining First People’s Hospital, Jining 272000, China
| | - Yan Liu
- Department of Child Care, Changsha Maternal and Child Health Care Hospital, 416 Chengnan East RD of Yuhua District, Changsha 410007, China
| | - Yue Xi
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510275, China
| | - Caihong Xiang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China
| | - Cuiting Yong
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China
| | - Jiajing Liang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China
| | - Jiaqi Huo
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China
| | - Qian Lin
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China
- Correspondence: (Q.L.); (J.D.); Tel.: +86-138-7482-0173 (Q.L.); +86-135-4864-3020 (J.D.)
| | - Jing Deng
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China
- Correspondence: (Q.L.); (J.D.); Tel.: +86-138-7482-0173 (Q.L.); +86-135-4864-3020 (J.D.)
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2
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Tan ML, Ng KL, Loh LWL, Haugan G, Wang W, He HG. A descriptive qualitative study exploring the postpartum confinement experiences among first-time mothers from the three major ethnic groups in Singapore. Midwifery 2022; 114:103463. [PMID: 36054950 DOI: 10.1016/j.midw.2022.103463] [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: 03/22/2021] [Revised: 05/18/2022] [Accepted: 08/17/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Modern Singaporean mothers still embrace traditional confinement practices after childbirth, which often marks a significant milestone in maternal experiences. However, limited studies have explored in-depth the collective confinement experiences of mothers in Singapore. This study hence aimed to explore the postpartum confinement experiences of first-time mothers from the three major ethnic groups in Singapore, namely Chinese, Malay, and Indian. DESIGN A descriptive qualitative study was conducted. Purposive sampling was adopted to recruit participants. Individual semi-structured face-to-face/telephone interviews were used to collect data, which were analysed using thematic analysis. SETTING AND PARTICIPANTS Sixteen first-time mothers were recruited from two obstetric clinics in a tertiary hospital in Singapore. FINDINGS Five themes emerged: "Specific diets adopted and avoided for different purposes", "Complexity of various traditional confinement practices (TCPs) adopted", "Reasons for adopting TCPs", "Reasons for modifying TCPs", and "Postpartum challenges". KEY CONCLUSIONS Our study provided unique insights about Singapore's Chinese, Malay and Indian first-time mothers' postpartum confinement experiences. While confinement practices were still observed, many mothers no longer subscribed to guidelines followed by previous generations and were modifying or forgoing practices they deemed impractical. Mothers faced challenges adapting to new motherhood and often felt restrained or stressed by confinement practices. IMPLICATIONS FOR PRACTICE Healthcare professionals should take the lead to educate mothers and their families on harmful traditional confinement practices and their misconceptions. Future studies could explore alternative methods of postpartum check-up to improve first-time mothers' confinement experiences, and focus specifically on lower-income families to explore their unique confinement experiences.
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Affiliation(s)
- Meng Lynn Tan
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore; National University Health System, Singapore; Department of Nursing, National University Hospital, Singapore
| | - Kai Lin Ng
- National University Health System, Singapore; Department of Nursing, National University Hospital, Singapore
| | - Leta Wei Ling Loh
- National University Health System, Singapore; Department of Nursing, National University Hospital, Singapore
| | - Gørill Haugan
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Faculty of Nursing and Health Science, Nord University, Levanger, Norway
| | - Wenru Wang
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore; National University Health System, Singapore
| | - Hong-Gu He
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore; National University Health System, Singapore.
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3
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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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4
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Stress, Marital Relationship and Quality of Life of Couples Across the Perinatal Period. Matern Child Health J 2021; 25:1884-1892. [PMID: 34626288 DOI: 10.1007/s10995-021-03249-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Transition to parenthood is characterized by a high level of stress, which can affect couples' relationship and quality of life. Limited research compares the relationships and trends in stress, marital relationship and quality of life between both couples across the perinatal period. This study examined the associations, changes over time and gender differences in the stress, marital relationship and quality of life of Chinese couples during the perinatal period. METHODS A convenience sample of 130 couples participated in this longitudinal study. Data on the assessment of stress, marital relationship and quality of life were collected by validated measures during the second or third trimester of pregnancy and at 6 weeks, 6 months and 12 months postpartum. RESULTS Both couples experienced an increased level of stress at 6 weeks postpartum and a gradual decline in marital relationship from pregnancy to 1 year postpartum. The mental component of women's quality of life declined sharply at 6 weeks postpartum and recovered at 6 months postpartum. The physical component of quality of life showed gradual improvements from pregnancy to 1 year postpartum for the women, but a decline for the men. The women showed more stress and poorer marital relationship and quality of life than their partners, and the women's levels of stress, marital relationship and mental component of quality of life were closely related to those of their partners' across the perinatal period. Stress was related negatively to marital relationship and quality of life, and a positive marital relationship was associated with better quality of life during the perinatal period. CONCLUSION The study highlights the need to adopt couple-based approaches in clinical practice directed at helping partners develop realistic expectations and manage stress, which are essential to promoting marital relationships and quality of life during the transition to parenthood.
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5
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Su Z, McDonnell D, Abbas J, Shi L, Cai Y, Yang L. Secondhand Smoke Exposure of Expectant Mothers in China: Factoring in the Role of Culture in Data Collection. JMIR Cancer 2021; 7:e24984. [PMID: 34617907 PMCID: PMC8532012 DOI: 10.2196/24984] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/26/2020] [Accepted: 12/24/2020] [Indexed: 01/22/2023] Open
Abstract
Cancer is the leading cause of death worldwide. Tobacco smoking, including secondhand smoking, causes cancer and is responsible for over 22% of global cancer deaths. The adverse impacts of secondhand smoke are more pronounced for expectant mothers, and can deteriorate both mothers’ and infants’ health and well-being. Research suggests that secondhand smoke significantly increases expectant mothers’ risk of miscarriage, cancer, and other chronic disease conditions, and exposes their unborn babies to an increased likelihood of having life-long poor health. In China, a pregnant woman’s family members, such as her husband, parents, or in-laws, are the most likely people to be smoking around her. Due to traditional Chinese cultural practices, even though some expectant mothers understand the harm of secondhand smoke, they may be reluctant to report their family members’ smoking behaviors. Resulting in severe underreporting, this compromises health experts’ ability to understand the severity of the issue. This paper proposes a novel approach to measure secondhand smoke exposure of pregnant women in the Chinese context. The proposed system could act as a stepping stone that inspires creative methods to help researchers more accurately measure secondhand smoking rates of expectant mothers in China. This, in turn, could help health experts better establish cancer control measures for expectant mothers and decrease their cancer risk.
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Affiliation(s)
- Zhaohui Su
- Center on Smart and Connected Health Technologies, Mays Cancer Center, School of Nursing, University of Texas Health San Antonio, San Antonio, TX, United States
| | - Dean McDonnell
- Department of Humanities, Institute of Technology Carlow, Carlow, Ireland
| | - Jaffar Abbas
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lili Shi
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuyang Cai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Yang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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6
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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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7
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Li N, Su X, Liu T, Sun J, Zhu Y, Dai Z, Zhang Y, Pan L, Jiang W, Zhu W. Dietary patterns of Chinese puerperal women and their association with postpartum weight retention: Results from the mother-infant cohort study. MATERNAL AND CHILD NUTRITION 2020; 17:e13061. [PMID: 33135839 PMCID: PMC7729653 DOI: 10.1111/mcn.13061] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 06/05/2020] [Accepted: 06/17/2020] [Indexed: 12/12/2022]
Abstract
Dietary intake may affect maternal health, but it remains unclear about puerperal dietary intake and its association with maternal health. This study investigated the dietary patterns and their related factors and association with postpartum weight retention (PPWR) in Chinese puerperal women. Participants were from the mother-infant cohort study, in which both mothers and infants were followed up from childbirth to the next 2 years, in seven cities around China. Maternal puerperal dietary patterns were derived by a food frequency questionnaire and principal component analysis (PCA) within 1 month postpartum. PPWR was assessed by the difference of weight at 42 days and 6 months postpartum minus the pre-pregnancy weight. Of 503 postpartum women, four dietary patterns were identified, including 'plant food' pattern (rice and vegetables as dominant foods), 'diverse' pattern (starchy roots, fruit, livestock meat and aquatic products), 'traditional northern' pattern (poultry, eggs and soup) and 'marine-flour' pattern (flour, coarse food grains and marine fish). The diverse pattern was associated with professional puerperal family care and counselling service (p < .05). PPWRs at 42 days and 6 months postpartum were 6.37 and 4.70 kg averagely. The plant food dietary pattern tended to be associated with higher 42-day PPWR (β = .105, p < .05), and diverse pattern was associated with lower 6-months PPWR (β = -.137, p < .05). Conclusively, this study presented four dominant dietary patterns in Chinese postpartum women and showed a lower PPWR in adherence to diverse dietary pattern. The results would provide evidence to furtherly guide dietary practice and improve maternal health.
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Affiliation(s)
- Niuniu Li
- Department of Nutrition and Food Hygiene, Peking University School of Public Health, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Xiao Su
- Department of Nutrition and Food Hygiene, Peking University School of Public Health, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Tan Liu
- Department of Nutrition and Food Hygiene, Peking University School of Public Health, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Jing Sun
- Department of Nutrition and Food Hygiene, Peking University School of Public Health, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Yimin Zhu
- Department of Nutrition and Food Hygiene, Peking University School of Public Health, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Zhiyong Dai
- Peking-Ausnutria Maternal and Infant Nutrition Research Center, Peking University, Beijing, China
| | - Yanchun Zhang
- Peking-Ausnutria Maternal and Infant Nutrition Research Center, Peking University, Beijing, China
| | - Lina Pan
- Peking-Ausnutria Maternal and Infant Nutrition Research Center, Peking University, Beijing, China
| | - Wei Jiang
- Peking-Ausnutria Maternal and Infant Nutrition Research Center, Peking University, Beijing, China
| | - Wenli Zhu
- Department of Nutrition and Food Hygiene, Peking University School of Public Health, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
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8
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Effects of a health education program targeted to Chinese women adhering to their cultural practice of doing the month: A randomized controlled trial. Midwifery 2020; 90:102796. [PMID: 32726727 DOI: 10.1016/j.midw.2020.102796] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 07/05/2020] [Accepted: 07/17/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND "Doing the month" is a prevalent Chinese postpartum custom which is believed to restore health after delivery. However, some traditional practices are potentially harmful for women's health. OBJECTIVES To examine the effect of an evidence-based health education program on Chinese postpartum women's adherence to traditional practices of doing the month and the effect of adherence to doing the month on maternal physiological and psychological health. METHODS A randomized controlled trial was conducted. During December 2016-July 2017, we recruited postpartum women at a tertiary hospital. Women randomized to the intervention group received evidence-based health education within 1 week after returning home and received a second visit 1 month later. The control group received routine postpartum home visits. Adherence to doing the month was measured by the Adherence to Doing-the-Month Practices questionnaire (ADP). Maternal physical health was measured by the Chair Stand Test and Postpartum Symptom Checklist. Maternal psychological health was measured by the Edinburgh Postnatal Depression Scale (EPDS). Descriptive statistics, t-test, and chi-squared test were used to analyze the differences in scores and symptoms of the two groups. RESULTS We recruited 124 eligible postpartum women and 108 of them (54 intervention group, 54 control group) completed this study. The ADP score of the intervention group was significantly lower than that of the control group (p < 0.001). The number of participants in the experimental group with poor appetite and indigestion was significantly lower than that of control group. No significant differences were found in numbers of symptoms and average EPDS scores between the 2 study groups (p > 0.05). CONCLUSIONS Evidence-based health education can reduce postpartum women's adherence to some traditional practices of doing the month and improve women's physical health.
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9
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Shorey S, Ying L, Yobas P. Parenting Outcomes and Predictors of Parenting Satisfaction in the Early Postpartum Period. West J Nurs Res 2020; 43:13-24. [PMID: 32389069 DOI: 10.1177/0193945920914593] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examined the relationships among parenting self-efficacy (PSE), social support, postnatal depression (PND), and predictors of parenting satisfaction in the early postpartum period using a cross-sectional exploratory quantitative design. The hypothetical model was tested among interrelated concepts of outcome variables among 250 parents (125 couples). The structural equation model revealed an adequate fit between the hypothesized model and the data. PSE and spousal support were found to be predictors of parenting satisfaction. PSE was also found to be a predictor of social support. PND was not found to be a predictor of parenting satisfaction. None of the obstetric and demographic factors predicted parenting satisfaction. This is the first study that tested interrelations among crucial parenting outcome variables among fathers and mothers in the early postpartum period. It is important to assess interrelated parenting outcomes among both parents so that support can be provided to ultimately influence parenting satisfaction.
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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.,National University Health System, Singapore
| | - Lau Ying
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,National University Health System, Singapore
| | - Piyanee Yobas
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,National University Health System, Singapore
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10
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Ngai F, Lam W. The experience of first‐time Hong Kong Chinese fatherhood: A qualitative exploratory study. Nurs Health Sci 2020; 22:723-731. [DOI: 10.1111/nhs.12719] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 03/31/2020] [Accepted: 03/31/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Fei‐Wan Ngai
- School of Nursing The Hong Kong Polytechnic University Kowloon Hong Kong
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11
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Ngai FW, Wong PWC, Chung KF, Leung KY, Tarrant M. Randomized controlled trial of telephone-based cognitive-behavioral therapy on parenting self-efficacy and satisfaction. Transl Behav Med 2019; 9:1163-1168. [PMID: 30799485 DOI: 10.1093/tbm/ibz017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Developing a sense of parenting self-efficacy and satisfaction is essential for positive parenting and healthy development of the child. The present study evaluated the efficacy of a telephone-based cognitive-behavioral therapy (T-CBT) on parenting self-efficacy and satisfaction at 6 weeks and 6 months postpartum. A multi-site randomized controlled trial was conducted between July 2012 and March 2014. A total of 397 Chinese mothers at risk of postnatal depression were recruited through the postnatal units at three regional public hospitals in Hong Kong and were randomized to receive T- CBT (n = 197) or standard care (n = 200). The T-CBT consisted of five weekly 30-min sessions focusing on changing dysfunctional cognitions and developing problem-solving skills. Parenting self-efficacy and satisfaction were measured by the efficacy and satisfaction subscales of the Parenting Sense of Competence Scale (PSOC-E/S), respectively, at baseline, 6 weeks, and 6 months postpartum. When compared with standard care, T-CBT was associated with a significant improvement in parenting self-efficacy and satisfaction at 6 weeks postpartum (mean difference in PSOC-E: 2.85 [95% CI: 1.72-3.98], p < .001; mean difference in PSOC-S score: 1.61 [95% CI: 0.52-2.71], p = .004), and 6 months (mean difference in PSOC-E score: 3.37 [95% CI: 1.89-4.85], p < .001; mean difference in PSOC-S score: 2.39 [95% CI: 0.96-3.82], p = .001). T-CBT produced significantly greater improvement in parenting self-efficacy and satisfaction than standard care. The results highlight the potential of T-CBT as a promising treatment modality to facilitate maternal adaptation and promote a sense of parenting self-efficacy and satisfaction during the transition to new motherhood.
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Affiliation(s)
- Fei-Wan Ngai
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong
| | - Paul Wai-Ching Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Ka-Fai Chung
- Department of Psychiatry, The University of Hong Kong, Hong Kong
| | - Kwok-Yin Leung
- Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hospital Authority, Hong Kong
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12
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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: 17] [Impact Index Per Article: 2.8] [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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Shorey S, Chee CYI, Ng ED, Chan YH, Tam WWS, Chong YS. Prevalence and incidence of postpartum depression among healthy mothers: A systematic review and meta-analysis. J Psychiatr Res 2018; 104:235-248. [PMID: 30114665 DOI: 10.1016/j.jpsychires.2018.08.001] [Citation(s) in RCA: 439] [Impact Index Per Article: 73.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 07/23/2018] [Accepted: 08/01/2018] [Indexed: 01/17/2023]
Abstract
This review aims to examine the prevalence and incidence of postpartum depression among healthy mothers without prior history of depression including postpartum depression and who gave birth to healthy full-term infants. A systematic search of ClinicalTrials.gov, CINAHL, EMBASE, PsycINFO, and PubMed was performed for English articles from the inception of the database to November 2017, as well as a manual search of the reference lists of the included articles, and an expert panel was consulted. Across 15,895 articles, 58 articles (N = 37,294 women) were included in the review. The incidence of postpartum depression was 12% [95% CI 0.04-0.20] while the overall prevalence of depression was 17% [95% CI 0.15-0.20] among healthy mothers without a prior history of depression. Prevalence was similar regardless of the type of diagnostic tool used; however, there were statistical differences in the prevalence between different geographical regions, with the Middle-East having the highest prevalence (26%, 95% CI 0.13-0.39) and Europe having the lowest (8%, 95% CI 0.05-0.11). There was no statistical difference in prevalence between different screening time points, but an increasing prevalence was observed beyond six months postpartum. Intervention studies often neglect healthy mothers. This review reports a similar prevalence rate of postpartum depression among mothers without history of depression when compared to mothers with history of depression. Thus, future studies should place equal emphasis on this neglected group of mothers so that targeted interventions and follow-ups can be introduced at appropriate time points.
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, 117597, Singapore.
| | - Cornelia Yin Ing Chee
- Department of Psychological Medicine, 5 Lower Kent Ridge Road, National University Hospital, 119074, Singapore
| | - Esperanza Debby Ng
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, 117597, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, Block MD 1, 12 Science Drive 2, National University of Singapore, 117549, Singapore
| | - Wilson Wai San Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, 117597, Singapore
| | - Yap Seng Chong
- Women's Centre, 5 Lower Kent Ridge Road, National University Hospital, 119074, Singapore
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14
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Ngai FW, Chan PS. A Qualitative Evaluation of Telephone-Based Cognitive-Behavioral Therapy for Postpartum Mothers. Clin Nurs Res 2018; 28:852-868. [PMID: 29629828 DOI: 10.1177/1054773818768011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to explore postpartum women's perceptions of a telephone-based cognitive-behavioral therapy (T-CBT). Using an exploratory qualitative design, a purposeful sample of 39 first-time Chinese mothers who had participated in the T-CBT was interviewed at 6 weeks postpartum. Data were collected using semi-structured interviews and analyzed by content analysis. The findings revealed that Chinese women perceived T-CBT to be helpful in increasing their confidence in the maternal role, enhancing their emotional control, and increasing their sense of support. The effectiveness of T-CBT was enhanced by the delivery of the intervention by health care professional and the flexibility of intervention to provide individualized and timely information. The evidence suggests T-CBT is a feasible modality with the potential to support mothers in managing the demands of parental transition. T-CBT could be incorporated into perinatal services on an ongoing and regular basis, and therefore readily accessible to all postpartum women.
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Affiliation(s)
- Fei Wan Ngai
- 1 The Hong Kong Polytechnic University, Hong Kong
| | - Pui Sze Chan
- 1 The Hong Kong Polytechnic University, Hong Kong
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15
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Munodawafa M, Mall S, Lund C, Schneider M. Process evaluations of task sharing interventions for perinatal depression in low and middle income countries (LMIC): a systematic review and qualitative meta-synthesis. BMC Health Serv Res 2018; 18:205. [PMID: 29566680 PMCID: PMC5865346 DOI: 10.1186/s12913-018-3030-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 03/16/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Perinatal depression is common in low and middle income countries (LAMICs). Task sharing interventions have been implemented to treat perinatal depression in these settings, as a way of dealing with staff shortages. Task sharing allows lay health workers to provide services for less complex cases while being trained and supervised by specialists. Randomized controlled trials suggest that these interventions can be effective but there is limited qualitative information exploring barriers and facilitators to their implementation. This systematic review aims to systematically review current qualitative evidence of process evaluations of task sharing interventions for perinatal depression in LAMICs in relation to the United Kingdom (UK) Medical Research Council (MRC) framework for conducting process evaluations. METHODS We searched Medline/ PubMed, PsycINFO, Scopus, Cochrane Library and Web of science for studies from LAMICS using search terms under the broad categories of: (a) "maternal depression'" (b) "intervention" (c) "lay counsellor" OR "community health worker" OR "non-specialist" and (d) "LAMICs". Abstracts were independently reviewed for inclusion by two authors. Full text articles were screened and data for included articles were extracted using a standard data extraction sheet. Qualitative synthesis of qualitative evidence was conducted. RESULTS 8420 articles were identified from initial searches. Of these, 26 full text articles were screened for eligibility with only three studies meeting the inclusion criteria. Main findings revealed that participants identified the following crucial factors: contextual factors included physical location, accessibility and cultural norms. Implementation factors included acceptability of the intervention and characteristics of the personnel. Mechanisms included counsellor factors such as motivating and facilitating trust; intervention factors such as use of stories and visual aids, and understandability of the content; and participant factors such as shared experience, meeting learning needs, and meeting expectations. CONCLUSIONS While task sharing has been suggested as an effective way of filling the treatment gap for perinatal depression, there is a paucity of qualitative research exploring barriers and facilitators to implementing these interventions. Qualitative process evaluations are crucial for the development of culturally relevant interventions.
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Affiliation(s)
- Memory Munodawafa
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town, South Africa.
| | - Sumaya Mall
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Crick Lund
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town, South Africa.,King's College London, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Marguerite Schneider
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town, South Africa.,Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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16
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Mathias VA, Holroyd E, Edwards G. Tanzanian Mothers' Cultural Beliefs and Misinformation Regarding the Reasons for Their Cesarean Sections. INTERNATIONAL JOURNAL OF CHILDBIRTH 2018. [DOI: 10.1891/2156-5287.8.3.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUNDIn Tanzania, cesarean section (CS) rates have been steadily increasing, yet little is known about mothers' understanding of the medical rationale for their CSs.AIMTo identify mothers' cultural understandings of the rationale for their CSs.METHODSDesign: A qualitative descriptive design was employed.Setting: A government hospital in the western region in Tanzania.Participants: A total of 117 mothers were interviewed using convenience sampling post CS.FINDINGSForty percent of the mothers were younger than 18 years, with more than 50% having had five or more live babies. Among multigravida women, 40.2% had had one or more previous CSs.The emergent themes were lack of dietary knowledge, use of local herbs, delays in coming to hospital, avoiding stressful labor pains and no ability to exercise, and no personal preferences of “push or go for an operation.”CONCLUSIONPregnant women in Tanzania need improved health education to make informed choices about childbirth and be involved all processes of antepartum care decision making to achieve optimal birth outcomes.
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Shorey S, Dennis CL, Bridge S, Chong YS, Holroyd E, He HG. First-time fathers' postnatal experiences and support needs: A descriptive qualitative study. J Adv Nurs 2017; 73:2987-2996. [PMID: 28557020 DOI: 10.1111/jan.13349] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2017] [Indexed: 11/28/2022]
Abstract
AIM To explore first-time fathers' postnatal experiences and support needs in the early postpartum period. BACKGROUND The postnatal period is a stressful transition period for new fathers. It is imperative to understand their needs and experiences to provide appropriate support for them. The majority of previous studies were based in Western countries and explored fathers' needs during pregnancy and childbirth, with few studies conducted in the postnatal period. In Singapore, a multiracial society with differing paternal cultural values from its Western counterparts, there is considerable need to examine the experiences and needs of first-time fathers. DESIGN A descriptive qualitative design was used. METHODS Data were collected from November 2015-January 2016. Fifteen first-time fathers were recruited from two postnatal wards of a public hospital, using a purposive sampling method. A semi-structured interview guide was used to conduct face-to-face interviews. A thematic analysis was conducted and ethics approval was sought for this study. RESULTS Four overarching themes and seventeen subthemes were generated. The four overarching themes were: (1) No sense of reality to sense of responsibility; (2) Unprepared and challenged; (3) Support: needs, sources, experience and attitude; and (4) Future help for fathers. CONCLUSION Fathers undergo a transition phase where they have unmet support needs during the early postnatal period. Understanding and addressing these needs may facilitate smooth transition to fatherhood. This study's findings can be used to involve fathers and design future supportive educational programs to promote positive parenting experiences and family dynamics.
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
| | - Cindy-Lee Dennis
- Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Shiho Bridge
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
| | - Yap Seng Chong
- Department of Obstetrics and Gynecology, National University Hospital, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Eleanor Holroyd
- School of Clinical Sciences, Faculty of Health and Environmental Sciences, AUT University, Auckland, New Zealand
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
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18
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Ngai FW, Wong PWC, Chung KF, Leung KY. The effect of telephone-based cognitive-behavioural therapy on parenting stress: A randomised controlled trial. J Psychosom Res 2016; 86:34-8. [PMID: 27302544 DOI: 10.1016/j.jpsychores.2016.03.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 03/18/2016] [Accepted: 03/20/2016] [Indexed: 11/18/2022]
Abstract
UNLABELLED Objective Stress related to parenting has detrimental effects on the well-being of children, parents and the family system as a whole. There are limited studies about the efficacy of cognitive-behavioural therapy delivered by telephone in reducing parenting stress. The present study investigates the effect of telephone-based cognitive-behavioural therapy on parenting stress at six weeks and six months postpartum. METHODS This is a multi-site randomised controlled trial. A total of 397 Chinese mothers at risk of postnatal depression were randomly assigned to receive either telephone-based cognitive-behavioural therapy or routine postpartum care. Parental stress was assessed by the Parenting Stress Index Short Form at six weeks and six months postpartum. RESULTS The findings revealed that mothers who had received telephone-based cognitive-behavioural therapy showed significantly lower levels of parenting stress than women only receiving routine postpartum care at six weeks (mean difference=9.42, 95% confidence interval 5.85-12.99, p<0.001, Cohen's d=0.52) and six months postpartum (mean difference=3.58, 95% confidence interval 0.07-7.09, p=0.046, Cohen's d=0.20). CONCLUSION Telephone-based cognitive-behavioural therapy is a promising treatment modality for supporting parenting and reducing stress during the transition period. Integration of telephone-based cognitive-behavioural therapy into routine postpartum care might facilitate positive adaptation in particular for mothers at risk of postnatal depression.
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Affiliation(s)
- Fei Wan Ngai
- The Hong Kong Polytechnic University, Hong Kong.
| | - Paul Wai-Ching Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Ka Fai Chung
- Department of Psychiatry, The University of Hong Kong, Hong Kong
| | - Kwok Yin Leung
- Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hospital Authority, Hong Kong
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19
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Lee A, Brann L. Influence of Cultural Beliefs on Infant Feeding, Postpartum and Childcare Practices among Chinese-American Mothers in New York City. J Community Health 2016; 40:476-83. [PMID: 25331609 DOI: 10.1007/s10900-014-9959-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
As one of the fastest growing communities in the United States, Chinese-Americans receive relatively little research attention on their rates of breastfeeding versus formula feeding, and what factors influence that choice. This research aims to examine the influence of elders and cultural beliefs on postpartum, infant feeding, and childcare practices. Semi-structured interviews with 22 recently postpartum mothers who met the recruiting criteria were conducted between July 2012 and February 2013. The traditional postpartum practice, zuo yuezi, presented negative physical and emotional outcomes and maternal reporting of delay in lactation. Early introduction of solids for traditional reasons was reported. The support from husbands and elders were necessary for breastfeeding success, while some mothers had to first negotiate with elders for breastfeeding. The practice of sending infants back to China to be taken care of by extended families presented cultural implications related to grandparents' involvement in raising grandchildren. With the respect and appreciation for elders and traditions, it is likely that Chinese mothers negotiate between cultural traditions and societal expectation in the western home.
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Affiliation(s)
- Adele Lee
- Nutrition Program, Department of Public Health, Food Studies and Nutrition, Syracuse University, 426 Ostrom Avenue, Syracuse, NY, 13244, USA,
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Sansiriphun N, Kantaruksa K, Klunklin A, Baosuang C, Liamtrirat S. The journey into fatherhood: A grounded theory study. Nurs Health Sci 2015; 17:460-6. [DOI: 10.1111/nhs.12216] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Revised: 02/11/2015] [Accepted: 02/13/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Nantaporn Sansiriphun
- Obstetrics and Gynecology Nursing; Faculty of Nursing; Chiang Mai University; Chiang Mai Thailand
| | - Kannika Kantaruksa
- Obstetrics and Gynecology Nursing; Faculty of Nursing; Chiang Mai University; Chiang Mai Thailand
| | - Areewan Klunklin
- Obstetrics and Gynecology Nursing; Faculty of Nursing; Chiang Mai University; Chiang Mai Thailand
| | - Chavee Baosuang
- Obstetrics and Gynecology Nursing; Faculty of Nursing; Chiang Mai University; Chiang Mai Thailand
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21
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Antenatal education to increase exclusive breastfeeding: a randomized controlled trial. Obstet Gynecol 2015; 124:961-968. [PMID: 25437725 DOI: 10.1097/aog.0000000000000481] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of a professional one-to-one antenatal breastfeeding support and education intervention on the exclusivity and duration of breastfeeding. METHODS A total of 469 primiparous women who attended the antenatal clinics of two geographically distributed public hospitals in Hong Kong were randomized to receive either standard antenatal care or a one-to-one antenatal breastfeeding support and education session. The primary outcome was the prevalence of exclusive breastfeeding at 6 weeks postpartum. Secondary outcomes were the prevalence of exclusive breastfeeding at 3 and 6 months postpartum as well as the overall duration of any and exclusive breastfeeding across the first 6 months postpartum. RESULTS The exclusive breastfeeding rate in the intervention group was 37.8% at 6 weeks postpartum compared with 36.4% in the standard care group (P=.77; 95% confidence interval [CI] -0.08 to 0.11). There were no significant differences between the two treatment groups in exclusive breastfeeding rates at 3 and 6 months or in the overall duration of any (hazard ratio [HR] 1.11, 95% CI 0.88-1.40] or exclusive breastfeeding (HR 0.96, 95% CI 0.79-1.17). The study had a least 80% power to detect a 50% increase in the rate of exclusive breastfeeding at 6 weeks postpartum. CONCLUSION In a setting with a high breastfeeding initiation rate, one-to-one antenatal breastfeeding support and education did not increase the exclusivity or duration of breastfeeding. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, www.clinicaltrials.gov, NCT01648114.
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22
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Predictors of maternal and paternal depressive symptoms at postpartum. J Psychosom Res 2015; 78:156-61. [PMID: 25524435 DOI: 10.1016/j.jpsychores.2014.12.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 12/01/2014] [Accepted: 12/02/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Postnatal depression has emerged as a major public health concern, which has deleterious effects on the well-being of the entire family. The aim of this study was to examine the predictive role of prenatal family sense of coherence, stress, social support and family, and marital functioning; the effect that any changes in these factors from pregnancy to postpartum; and partner's depressive symptoms on depressive symptoms at 6 months postpartum. METHODS This study used a longitudinal design. A convenience sample of 200 childbearing couples in Hong Kong completed assessments of family sense of coherence, stress, social support, family, and marital functioning and depressive symptoms during pregnancy and at 6 months postpartum. Multiple regression analyses were employed. RESULTS The results showed that a low level of family sense of coherence and a high level of depressive symptoms during pregnancy and partner's depressive symptoms were significantly associated with an increase in depressive symptoms for both mothers and fathers at 6 months postpartum. A lack of social support was significantly associated with increased risk of depressive symptoms for mothers, but not for fathers. CONCLUSION The results suggest that couple-based interventions that foster a sense of family coherence may be helpful in promoting parental well-being. Well-designed trials to test the effects of such interventions are recommended for future research.
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Shorey S, Chan SWC, Chong YS, He HG. Predictors of Maternal Parental Self-Efficacy Among Primiparas in the Early Postnatal Period. West J Nurs Res 2014; 37:1604-22. [DOI: 10.1177/0193945914537724] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Maternal parental self-efficacy is a crucial factor for facilitating the smooth transition into motherhood, particularly for primiparas. The aims of this study were to examine the predictors of maternal parental self-efficacy and its relationship with social support, postnatal depression (PND), and socio-demographic variables of primiparas during the early postnatal period. A descriptive correlational study design was adopted. The instruments, Perceived Maternal Parental Self-Efficacy, Perinatal Infant Care Social Support, and Edinburgh Postnatal Depression Scale, were used to collect data from a purposive sample of 122 primiparas on the day of discharge (1-3 days post delivery) in a tertiary public hospital in Singapore. There were significant correlations among maternal parental self-efficacy, social support, and postnatal depression. The main predictors of maternal parental self-efficacy were social support, ethnicity, maternal age, and family income. The maternal parental self-efficacy, social support, and PND should be routinely assessed to provide necessary support to needy mothers.
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Affiliation(s)
| | | | | | - Hong-Gu He
- National University of Singapore, Singapore
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24
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Ong SF, Chan WCS, Shorey S, Chong YS, Klainin-Yobas P, He HG. Postnatal experiences and support needs of first-time mothers in Singapore: A descriptive qualitative study. Midwifery 2014; 30:772-8. [DOI: 10.1016/j.midw.2013.09.004] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 07/21/2013] [Accepted: 09/17/2013] [Indexed: 11/29/2022]
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25
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Liu YQ, Petrini M, Maloni JA. “Doing the month”: Postpartum practices in Chinese women. Nurs Health Sci 2014; 17:5-14. [DOI: 10.1111/nhs.12146] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 03/21/2014] [Accepted: 03/26/2014] [Indexed: 12/16/2022]
Affiliation(s)
- Yan Qun Liu
- HOPE School of Nursing; Wuhan University; Wuchang China
| | | | - Judith A. Maloni
- School of Nursing; Case Western Reserve University; Chagrin Falls OH USA
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26
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Ngai FW, Ngu SF. Predictors of family and marital functioning at early postpartum. J Adv Nurs 2014; 70:2588-97. [PMID: 24673600 DOI: 10.1111/jan.12394] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2014] [Indexed: 11/28/2022]
Abstract
AIM To examine the predictive role of family sense of coherence, social support and stress during pregnancy and their changes from pregnancy to postpartum on family and marital functioning at 6 weeks postpartum. BACKGROUND Family sense of coherence plays a significant role in promoting positive family and marital functioning, which is crucial to the child's well-being. However, studies that evaluate the predictive role of family sense of coherence on family and marital functioning during parental transition are limited. DESIGN The study used a longitudinal design. METHODS Chinese childbearing couples (n = 202) completed assessments of family sense of coherence, stress, social support, and family and marital functioning during pregnancy and at 6 weeks postpartum between January 2011-May 2012. RESULTS/FINDINGS Mothers with a stronger family sense of coherence, greater social support and less stress during pregnancy experienced less decline in family and marital functioning at 6 weeks postpartum, while fathers with a higher prenatal family sense of coherence and family and marital functioning also experienced less such decline. CONCLUSION Couple-based interventions should be initiated early during pregnancy by strengthening family sense of coherence and social support to promote positive family functioning.
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Affiliation(s)
- Fei Wan Ngai
- School of Nursing, The Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
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27
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Yeh YC, St John W, Venturato L. Doing the month in a Taiwanese postpartum nursing center: an ethnographic study. Nurs Health Sci 2013; 16:343-51. [PMID: 25279454 DOI: 10.1111/nhs.12110] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 10/18/2013] [Accepted: 10/22/2013] [Indexed: 11/29/2022]
Abstract
Traditionally Chinese and Taiwanese postpartum women conducted postpartum ritual practices, called "doing the month," at home. Today, many Taiwanese women undertake this ritual in postpartum nursing centers. However, little is known about how the traditional practices are being transformed in relation to contemporary health care in Taiwan. In this ethnographic study observations were carried out in a large post-partum center attached to a major hospital in Taipei for nine months, and 27 postpartum women were interviewed. Data were analyzed using ethnographic approaches to extract codes and categories. Doing the month was reshaped by being relocated from the home to a healthcare setting. Midwives took on roles traditionally taken by family members, which had an impact on family roles and relationships. Some postpartum practices were maintained, based on traditional explanations. However, many were modified or challenged, based on explanations from contemporary scientific knowledge. Midwives need to be aware that there could be differences between their culture of care and the cultural values of the women they care for. This study informs culturally appropriate postpartum care and support for women with traditional and contemporary cultural beliefs and attitudes to doing the month in a range of healthcare contexts.
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Affiliation(s)
- Yueh-Chen Yeh
- School of Nursing, Taipei Medical University, Taipei, Taiwan
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28
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Ngai FW, Ngu SF. Quality of life during the transition to parenthood in Hong Kong: a longitudinal study. J Psychosom Obstet Gynaecol 2013; 34:157-62. [PMID: 24188787 DOI: 10.3109/0167482x.2013.852534] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE Quality of life has emerged as an important health outcome in the care of perinatal families. This study was designed to examine the changes in quality of life among Chinese couples during the transition to parenthood. METHODS A longitudinal design was used. Participants comprised a convenience sample of 203 Chinese-childbearing couples attending the antenatal clinics, who completed data collection during pregnancy and at six weeks and six months postpartum. At each point, couples completed the Medical Outcomes Study Short Form 12-Item Health Survey. RESULTS The results showed that women experienced substantial changes in their quality of life during pregnancy and postpartum, whereas the changes in their partners' quality of life were less noteworthy. Women had a poorer quality of life than their partners during the early postpartum period. The mental health component of women's quality of life was closely related to their partners' across the perinatal period. CONCLUSIONS The findings of the present study highlight the need for more attention to a couple's quality of life during the transition to parenthood. Couple-based and culturally relevant interventions should be developed to assist both parents to cope with the new challenges and demands of parenthood, and thus achieve a better quality of life.
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Affiliation(s)
- Fei-Wan Ngai
- Li Ka Shing Faculty of Medicine, School of Nursing, University of Hong Kong , Pokfulam , Hong Kong and
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29
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Chang SM, Rowe J, Goopy S. Non-family support for breastfeeding maintenance among career women in Taiwan: A qualitative study. Int J Nurs Pract 2013; 20:293-301. [DOI: 10.1111/ijn.12148] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Shu-min Chang
- Department of Nursing; Tzu Chi College of Technology; Hualien Taiwan
| | - Jennifer Rowe
- Teaching & Learning; Faculty of Science Health Education & Engineering; University of the Sunshine Coast; Sunshine Coast Queensland Australia
- School of Nursing and Midwifery; University of the Sunshine Coast; Sunshine Coast Queensland Australia
| | - Suzanne Goopy
- School of Nursing and Midwifery; Griffith University; Brisbane Queensland Australia
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30
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Iseki A, Ohashi K. Relationship in Japan between maternal grandmothers' perinatal support and their self-esteem. Nurs Health Sci 2013; 16:157-63. [PMID: 23809679 PMCID: PMC4237180 DOI: 10.1111/nhs.12079] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 05/15/2013] [Accepted: 05/18/2013] [Indexed: 11/30/2022]
Abstract
This study investigated the influence on their mental well-being of the perinatal support given by Japanese grandmothers. The Rosenberg self-esteem and the Center for Epidemiologic Studies Depression (CES-D) scales were used to assess grandmothers’ mental well-being before and after their daughters’ childbirth. Of 198 grandmothers, 176 (88.9%) supported their daughters and three patterns of perinatal support were observed: grandmothers’ support at the grandparents’ house before childbirth (n = 95) (Satogaeri bunben; Japanese traditional perinatal support), grandmothers’ support at the grandparents’ house after childbirth (n = 53); and grandmothers’ support at the daughters’ house (n = 28). Those who supported their daughters at the grandparents’ house before childbirth – especially the middle-aged (less than 60 years old) – showed significantly lower scores of self-esteem. Scores of CES-D did not significantly change before and after childbirth in either subgroup of grandmothers. It was concluded that grandmothers play an important role in supporting their daughters, and Satogaeri bunben is a typical event in modern Japan. However, Satogaeri bunben is a burden for middle-aged grandmothers, and we need to support them.
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Affiliation(s)
- Atsuko Iseki
- School of Nursing, Faculty of Medicine, Mie University, Mie; Department of Children's and Women's Health, Area of Nursing Science, Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
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Hsu HC, Jeng SF. Differential Effects of Still-Face Interaction on Mothers of Term and Preterm Infants. Infant Ment Health J 2013. [DOI: 10.1002/imhj.21386] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Gao LL, Luo SY, Chan SWC. Interpersonal psychotherapy-oriented program for Chinese pregnant women: delivery, content, and personal impact. Nurs Health Sci 2013; 14:318-24. [PMID: 22950613 DOI: 10.1111/j.1442-2018.2012.00722.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The interpersonal psychotherapy-oriented childbirth education program has the potential to promote social support and maternal role competence and prevent postpartum depression in Chinese women. The present study explored the perceptions of Chinese women about the delivery, content, and personal impact of the interpersonal psychotherapy-oriented childbirth education program. The study was conducted in a regional teaching hospital in China. The intervention was based on the principles of interpersonal psychotherapy, and consisted of two 90 min antenatal classes and a telephone follow up within 2 weeks after delivery. Ninety two women, pregnant for the first time, completed the program. The Program Satisfaction Questionnaires, with five open-ended questions, was used for the process evaluation (n = 83), and a one-on-one, in-depth interview was used for the outcome evaluation (n = 20). The findings suggested that the program could facilitate the participants' adjustment to motherhood, help to establish or improve their relationships, and enhance their perceived social support and maternal role competence. Future programs could be strengthened by lengthening the program and adding more interactive learning.
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Affiliation(s)
- Ling-ling Gao
- School of Nursing, Sun Yat-Sen University, Guangzhou, China.
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Liu YQ, Maloni JA, Petrini MA. Effect of Postpartum Practices of Doing the Month on Chinese Women’s Physical and Psychological Health. Biol Res Nurs 2012; 16:55-63. [DOI: 10.1177/1099800412465107] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of the study was to describe Chinese women’s postpartum physiological and psychological health and adherence to “doing-the-month” practices. A descriptive repeated measures design was used, with data collected at 3 days and 6 weeks postpartum. The convenience sample consisted of 198 healthy childbearing women with a term birth. Maternal physical health was measured by the Six-Minute Walk (endurance), Chair Stand test (muscle strength), severity of physical symptoms, and physical health subscales of SF36v2. Maternal psychological health was measured by the Edinburgh Postnatal Depression scale. Adherence was measured by the Adherence to Doing-the-Month Practices questionnaire. Aerobic endurance and lower-body muscle strength improved significantly across time ( p < .001) but remained suboptimal for maternal age. Women who delivered by Cesarean section had significantly poorer physical health than those who had a vaginal delivery. Physical functioning significantly increased, but general health and role limitations due to physical health significantly decreased over time. Postpartum physical symptoms decreased in number and severity. Depression increased over time ( p < .001). Adherence to doing the month was negatively correlated with aerobic endurance and positively correlated with depression at 6 weeks ( p < .05). These findings challenge the assumption that practices of doing the month are healthy for Chinese women’s recovery after childbirth. Research-based evidence needs to be integrated into doing-the-month practices. Education of Chinese women and families, whether living at home or abroad, is needed about the adverse health effects of doing the month. Routine screening for postpartum depression is also advised.
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Affiliation(s)
- Yan Qun Liu
- Wuhan University HOPE School of Nursing, Wuhan, Hubei, People’s Republic of China
| | - Judith A. Maloni
- Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Marcia A. Petrini
- Wuhan University HOPE School of Nursing, Wuhan, Hubei, People’s Republic of China
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