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Wang Y, Gao Q, Liu J, Zhang F, Xu X. Translation and validation of the Chinese version of the maternal postpartum stress scale. BMC Pregnancy Childbirth 2023; 23:685. [PMID: 37740223 PMCID: PMC10517469 DOI: 10.1186/s12884-023-05990-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 09/11/2023] [Indexed: 09/24/2023] Open
Abstract
OBJECTIVE To translate the Maternal Postpartum Stress Scale (MPSS) into Chinese and validate its psychometric properties in postpartum women. METHODS A total of 406 postpartum women were recruited from six hospitals in Nantong, Jiangsu Province, China. Cronbach's α co-efficient, split-half reliability, and test-retest reliability were used to evaluate the reliability of the translated scale. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to evaluate the structural validity of the scale. The Edinburgh Postnatal Depression Scale, Depression Anxiety Stress Scale-21 anxiety dimension, and Perceived Stress Scale were used as calibration scales to measure the correlation of MPSS. All data were analyzed using SPSS 25.0 and Amos 24.0. RESULTS The Cronbach's α co-efficient of the Chinese version of MPSS and its three dimensions were 0.940 and 0.882-0.911, respectively. The split-half reliability was 0.825, and the test-retest reliability was 0.912. The scale's content validity index was 0.926. Three common factors were extracted from the EFA. The CFA validated the explored 3-factor structure, and the indicators were fitted well (χ2/Df = 2.167, comparative fit index = 0.918, Tucker-Lewis index = 0.907, incremental fit index = 0.919, and root mean square error of approximation = 0.075). CONCLUSION The translated Chinese version of MPSS had suitable reliability and validity in assessing postpartum stress in Chinese women. The translated scale can also help with the early identification of postpartum stress and provide a scientific basis for the formulation of early personalized intervention measures. Overall, the scale has certain clinical value and practical significance for enhancing the physical and mental health of postpartum women. However, future studies including large, diverse populations are warranted.
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Affiliation(s)
- Yanchi Wang
- Affiliated Nantong Hospital of Shanghai University (The Sixth People's Hospital of Nantong), Nantong, Jiangsu, China
- Medical School of Nantong University, Nantong, Jiangsu, China
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China
| | - Qian Gao
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China
| | - Jin Liu
- Medical School of Nantong University, Nantong, Jiangsu, China
| | - Feng Zhang
- Medical School of Nantong University, Nantong, Jiangsu, China.
| | - Xujuan Xu
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China.
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Walker LO, Murry N, Longoria KD. Modification and Psychometric Analyses of Stress and Coping Scales for the Extended Postpartum Period. J Obstet Gynecol Neonatal Nurs 2023; 52:405-419. [PMID: 37356808 DOI: 10.1016/j.jogn.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/26/2023] [Accepted: 06/01/2023] [Indexed: 06/27/2023] Open
Abstract
OBJECTIVE To modify and psychometrically assess two scales that are used to measure stress and coping during the extended postpartum period. DESIGN Instrument modification and psychometric assessment. SETTING Online, community, and health care settings. PARTICIPANTS Mothers with infants who were 2 to 22 months old: 20 in Phase 1 and 373 in Phase 2. METHODS In Phase 1, participants from diverse backgrounds served as content experts to recommend modifications of items on two scales: Sources of Stress-Revised (SoS-R) and Postpartum Coping Scale (PCS). The results were 32-item modified versions of each scale. In Phase 2, we conducted a psychometric analysis of both revised scales using principal components analysis to identify dimensionality, Cronbach's alphas to estimate internal consistency reliability, and Pearson correlations to estimate validity of the SoS-R and PCS with the Perceived Stress Scale and the Brief COPE, respectively. RESULTS We identified six components for the SoS-R: Overload, Changes After Pregnancy, Baby-Related Concerns, Working Mother Concerns, Low Support Resources, and Isolated Motherhood. The Cronbach's alpha for the SoS-R was .94. The SoS-R subscales demonstrated correlations with the Perceived Stress Scale that ranged from 0.55 to 0.30. We identified six components for the PCS: Self-Regulation, Spiritual Care, Self-Care, Use and Seek Support, Internal and External Resources, and Health Promotion. The Cronbach's alpha coefficients for the PCS ranged from .84 to .66. The highest correlations observed between the PCS subscales and the Brief COPE subscales ranged from 0.67 to 0.26. CONCLUSION The SoS-R and PCS each include six components. Internal consistency reliability for all SoS-R subscales and four of six PCS subscales exceeded .70. The dimensions of each scale highlight areas of clinical and research concern.
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Nakić Radoš S, Brekalo M, Matijaš M. Measuring stress after childbirth: development and validation of the Maternal Postpartum Stress Scale. J Reprod Infant Psychol 2023; 41:65-77. [PMID: 34151659 DOI: 10.1080/02646838.2021.1940897] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Due to a wide range of stressors during the first postpartum year, this study aimed to develop and validate a self-report measure of stress intensity specific for postpartum. METHOD Postpartum women (N= 603) completed the Maternal Postpartum Stress Scale in a cross-sectional online study. They also filled out questionnaires on general stress, depression, and anxiety . Factor analysis, reliability, and validity were examined. RESULTS Exploratory factor analyses revealed a three-factor structure: Personal needs and fatigue , Infant nurturing , and Body changes and sexuality. The reliability of the total scale and all subscales was good. Significant positive correlation with general stress indicated good convergent validity, and with depression and anxiety good divergent validity. Primiparous mothers had a higher score on the Infant nurturing subscale, and the mothers of infants with health problems had a higher score on the total scale, Personal needs and fatigue, and Infant nurturing. CONCLUSION Maternal Postpartum Stress Scale is a new, valid, and reliable 22-items scale that measures stress during the first postpartum year. The total scale and tree subscales can be calculated separately to provide detailed information about stressors that mothers struggle with. The scale can be used for research and practical purposes.
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Affiliation(s)
- Sandra Nakić Radoš
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | - Maja Brekalo
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | - Marijana Matijaš
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
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Øygarden AMU, Berg RC, Abudayya A, Glavin K, Strøm BS. Measurement instruments for parental stress in the postpartum period: A scoping review. PLoS One 2022; 17:e0265616. [PMID: 35303028 PMCID: PMC8932572 DOI: 10.1371/journal.pone.0265616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 03/04/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Parenting stress is a particular type of stress that is conceptualized as a negative psychological response to the numerous obligations associated with raising children. Despite a considerable increase in research on parenting stress, little attention has been given to the ways parenting stress are measured.
Objectives
This scoping review aimed to provide an overview of available instruments measuring parental stress and to describe their psychometric properties.
Methods
We conducted a scoping review in accordance with international guidelines for scoping reviews. The main search strategy was searches in seven electronic databases. Pairs of reviewers selected relevant studies based on predetermined inclusion and exclusion criteria. Studies had to report one or more psychometric properties of an instrument measuring stress in parents with children 0–12 months. For each included study, we collected information relevant to the review question, guided by the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN). Finally, we collated, summarized, and reported the findings descriptively.
Results
From 2164 unique record, 64 studies from 24 countries were included. They described 15 instruments, of which four were generic and eleven parental-specific self-administered instruments. Only two studies examined parental stress among fathers. Eleven of the studies were validation studies, but they only described seven of the 15 instruments. Internal consistency was the only information provided by 73.4% of the included studies. None of the instruments had information on all measurement properties as per the COSMIN criteria, and there was no information about measurement error, responsiveness, or interpretability for any of the 15 instruments.
Discussion
There are presently 15 instruments with some associated psychometric information being used to measure parental stress among parents with young children, but the amount of information on the instruments’ psychometric properties is slight. There is a need for further research.
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Affiliation(s)
- Anne-Martha Utne Øygarden
- Centre of Diakonia and Professional Practice, VID Specialized University, Oslo, Norway
- Faculty of Health, VID Specialized University, Oslo, Norway
- * E-mail:
| | - Rigmor C. Berg
- Reviews and Health Technology Assessments, Norwegian Institute of Public Health, Oslo, Norway
- University of Tromsø The Arctic University of Norway, Tromsø og Finnmark, Norway
| | | | - Kari Glavin
- Faculty of Health, VID Specialized University, Oslo, Norway
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Moirasgenti M, Doulougeri K, Panagopoulou E, Theodoridis T. Psychological stress reduces the immunological benefits of breast milk. Stress Health 2019; 35:681-685. [PMID: 31691465 DOI: 10.1002/smi.2903] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 09/10/2019] [Accepted: 09/20/2019] [Indexed: 11/08/2022]
Abstract
Our study aimed to assess the impact of maternal psychological stress on the immunological components of breast milk. Eighty-nine women participated in the study. We assessed general stress, postpartum-specific stress, negative affectivity, salivary cortisol of mother, and secretory immunoglobulin A (sIgA) levels of breast milk 4-6 weeks after delivery. Controlling for the effects of women's age, weight, number, and duration of feedings, postpartum-specific stress was related to reduced sIgA concentration (R2 = .206, beta = -.275, p = .020). This study suggests that the established link between psychological stress and immunity may also extend to the immunity of the newborn by reducing the immunological benefits of breast milk. It also suggests that breastfeeding might be a potential mechanism of the relationship between maternal stress and the health of the offspring. Findings highlight the need for interventions addressing women during the postpartum period, in order to ensure the mother's well-being and the infant's optimal development.
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Affiliation(s)
- Maria Moirasgenti
- Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Karolina Doulougeri
- Department of Education and Social Policy, University of Macedonia, Thessaloniki, Greece
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Hung CH, Yu CY, Huang MC. The Perinatal Biopsychosocial Consequences of Various Levels of Gestational Hyperglycemia. Clin Nurs Res 2018; 29:268-275. [PMID: 29631415 DOI: 10.1177/1054773818769210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
This study was to compare biopsychosocial consequences among three groups of women with gestational hyperglycemia. We conducted a repeated-measures study at five time points among 132 women with gestational hyperglycemia. Women's physiological indicators and their psychosocial indicators were measured. There were 22.7% of participants had gestational diabetes mellitus (GDM), 11.4% had gestational impaired glucose tolerance (G-IGT), and 65.9% had mild gestational hyperglycemia (MGH). Women with GDM had higher fasting blood glucose and systolic/diastolic blood pressure than women with MGH. Women with GDM had higher diastolic blood pressure compared to women with G-IGT. Significant differences were found between the five time points regarding women's fasting blood glucose, diastolic blood pressure, depression, and health status. Health care providers should conduct early screening for predictors of metabolic syndrome in women with any degree of gestational hyperglycemia. Nursing interventions could be offered as early as the perinatal period to promote women's health.
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Affiliation(s)
- Chich-Hsiu Hung
- Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Wu CY, Hung CH, Chang YJ. Predictors of Health Status in Mothers of Premature Infants with Implications for Clinical Practice and Future Research. Worldviews Evid Based Nurs 2015. [PMID: 26220369 DOI: 10.1111/wvn.12101] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Postpartum health research has focused primarily on full-term mothers. AIMS To explore postpartum stress, depression, social support, health status, and predictors of health status in mothers of premature infants. METHODS This study employed a cross-sectional design. With convenience sampling, a total of 203 mothers of premature infants were recruited from two medical centers and four community teaching hospitals in southern Taiwan. The Hung Postpartum Stress Scale, Social Support Scale, Beck Depression Inventory, and Chinese Health Questionnaire were used to assess the mothers' psychosocial features during the first 6 weeks postpartum. RESULTS Mothers' health status differed significantly according to levels of postpartum stress and depression. The important health status predictors were age, education, postpartum stress, and depression level. DISCUSSION The concerns and needs of mothers of premature infants differed from those of full-term mothers during the first 6 weeks postpartum; premature infants' health status was found to be a major perceived stressor for their mothers. LINKING EVIDENCE TO ACTION In the process of caring for premature infants' mothers, healthcare providers should provide individualized care to meet their needs, thus facilitating the reduction of postpartum stress and depression levels. During premature infants' hospitalizations, healthcare providers should hold regular faculty meetings to provide postpartum women with relevant information about their infants' health and how to best care for them. Future studies should explore postpartum stress, social support, depression, and health status each postpartum week, which could serve as a guide for nursing interventions.
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Affiliation(s)
- Chia-Yao Wu
- Jian Ping Internal/Pediatric Clinic, Tainan, Taiwan
| | - Chich-Hsiu Hung
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ying-Ju Chang
- School of Nursing, National Cheng Kung University, Tainan, Taiwan
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Hung CH, Stocker J, Hsu HT. Comparing Taiwanese women's biopsychosocial features by location of postpartum recovery. Appl Nurs Res 2013; 27:121-6. [PMID: 24360779 DOI: 10.1016/j.apnr.2013.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Revised: 11/04/2013] [Accepted: 11/04/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND In Taiwan, a culturally sanctioned ritual of maternal rest and recuperation has been traditionally practiced patrilocally during the first postpartum month. However, in recent years, the places where women may observe the ritual have become more diverse. AIM Our goal was to compare women's psychosocial features based on where they stayed during their postpartum recovery. METHODS Using proportional stratified quota sampling of 18 hospitals and clinics in Taiwan by birth rate, we recruited 784 postpartum women. RESULTS Women stayed in their own home (17.1%), with their parents-in-law (33.3%), with their parents (36.0%), or in a postpartum nursing center (13.6%). Women who stayed in their own residence or who stayed in their parents' residence perceived greater social support than women who stayed with their parents-in-law. CONCLUSIONS Further research should compare women's adjustment to motherhood and their competence in childcare based on where they stay during postpartum recovery.
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Affiliation(s)
| | - Joel Stocker
- School of Nursing, Kaohsiung Medical University.
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Hung CH, Wang HH, Chang SH, Jian SY, Yang YM. The health status of postpartum immigrant women in Taiwan. J Clin Nurs 2012; 21:1544-53. [DOI: 10.1111/j.1365-2702.2011.03999.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Uğurlu N, Bayar B, Bayar K, Göktaş A, Karakaya IÇ, Polat H. Development, validity and reliability of the Turkish version of the Hung Postpartum Stress Scale. J Obstet Gynaecol Res 2012; 38:705-13. [PMID: 22381128 DOI: 10.1111/j.1447-0756.2011.01754.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The aim of the current study was to translate the Hung Postpartum Stress Scale into Turkish and test the reliability and validity of the Turkish version of the scale. METHODS The translation process of the Hung Postpartum Stress Scale into Turkish and the testing of reliability and validity of the newly developed scale on postpartum stress in women are described. The questionnaire was translated using a back-translation technique. Expert review of internal consistency reliability, content validity, factor analysis of construct validity and criterion-related validity were examined. RESULTS Cronbach's alpha for the Turkish version of the Hung Postpartum Stress Scale was 0.931, indicating very good reliability. Factor analyses resulted in a two factor scale structure: maternal concerns and acceptability of the newborn by the family. Analyses also indicated good test-re-test reliability for the Turkish version of the Hung Postpartum Stress Scale (P < 0.01). CONCLUSIONS The present study describes the design of a Turkish version of the Hung Postpartum Stress Scale. The newly developed scale proved to be reliable and valid and will be a valuable instrument for women's healthcare professionals.
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Affiliation(s)
- Nezihe Uğurlu
- Department of Nursing, Muğla School of Health Sciences, Muğla University, Muğla, Turkey.
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Hung CH. Commentary on Mao Q, Zhu L-X & Su X-Y (2011) A comparison of postnatal depression and related factors between Chinese new mothers and fathers. Journal of Clinical Nursing 20, 645-652. J Clin Nurs 2011; 20:3267-8. [DOI: 10.1111/j.1365-2702.2011.03888.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
AIM To predict important factors in women's postpartum stress. BACKGROUND The transition to motherhood is often accompanied by stress, but research on predictors of postpartum stress is scant. DESIGN A cross-sectional survey was used in the study. METHODS Proportional stratified quota sampling based on births at 11 registered general hospitals and seven specialty clinics in the Kaohsiung area of southern Taiwan was used to obtain a high degree of representation. Eight hundred and fifty-nine women participated in the study within six weeks postpartum. The Hung postpartum stress scale, the social support scale and the 12-item Chinese Health Questionnaire were used in this study. RESULTS Women with minor psychiatric morbidity, one or two children, junior college educational level, formula feeding for their infants, preference for an infant boy and a low level of social support were important predictors for women's postpartum stress. CONCLUSION Our findings provide information and data for service planning and community care for the prevention and amelioration of postpartum stress. RELEVANCE TO CLINICAL PRACTICE Postpartum women face a constellation of factors that could put them at risk for high levels of postpartum stress. Postpartum stress could significantly negatively impact women's health status. Nursing interventions should be tailored to decrease women's postpartum stress as a means of promoting postpartum women's pursuit of well-being.
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Affiliation(s)
- Chich-Hsiu Hung
- School of Nursing, Kaohsiung Medical University, Kaohsiung City, Taiwan.
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Hung CH, Yu CY, Chang SJ, Stocker J. Postpartum psychosocial changes among experienced and inexperienced mothers in Taiwan. J Transcult Nurs 2011; 22:217-24. [PMID: 21519063 DOI: 10.1177/1043659611404432] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To compare differences in psychosocial changes among experienced and first-time mothers over 6 postpartum weeks. DESIGN A trend research study design. METHOD A cohort of 439 first-time mothers and 420 experienced mothers during the 6 postpartum weeks was recruited in southern Taiwan. Each participant was interviewed over the phone to complete the Hung Postpartum Stress Scale, the Social Support Scale, and the Chinese Health Questionnaire. FINDINGS Concern about lack of social support was significantly higher in first-time mothers in the third week than in the first week. CONCLUSIONS Postpartum stressors are different for inexperienced and experienced mothers, and these stressors vary in their importance over the 6 postpartum weeks, suggesting that the postpartum nursing needs of the two groups in 6 postpartum weeks may be different. IMPLICATION FOR PRACTICE Knowledge and skills in mothering capability should be emphasized for first-time mothers, and physical exercises are needed for both groups of mothers.
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Affiliation(s)
- Chich-Hsiu Hung
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Hung CH, Yu CY, Liu CF, Stocker J. Maternal satisfaction with postpartum nursing centers. Res Nurs Health 2010; 33:345-54. [DOI: 10.1002/nur.20387] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Hung CH, Yu CY, Ou CC, Liang WW. Taiwanese maternal health in the postpartum nursing centre. J Clin Nurs 2010; 19:1094-101. [DOI: 10.1111/j.1365-2702.2009.03065.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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