Association of spiritual/religious coping with depressive symptoms in high‐ and low‐risk pregnant women

Coping with subjective and objective stress during a pandemic pregnancy: implications for maternal mental health

The COVID-19 pandemic heightened prenatal maternal stress, a risk factor for poorer maternal and infant health. There was substantial variability, however, in the extent to which the stress of pandemic pregnancy influenced maternal mental health. Some of this variability may have been due to the different coping strategies used to manage pandemic stress. In this cross-sectional study of 7,383 pregnant women in the U.S. (M = 25.69 ± 8.71 weeks gestational age) recruited during the first and second U.S. waves of the COVID-19 pandemic, we examined associations of objective stressors, the subjective experience of stress, and the use of four coping strategies with anxiety and depressive symptoms. Spiritual coping, planning/preparation, and avoidant coping were associated with increased subjective and objective stress and with greater mood and anxiety symptoms, whereas coping by positive appraisal was associated with modestly lower subjective stress and with lower mood and anxiety symptoms. We also found small interactions of stress and coping in predicting mood and anxiety symptoms, suggesting that fit between coping strategy and type of stress influences coping outcomes. Specific coping strategy used as well as the fit between coping strategy and stress type may determine whether coping buffers or exacerbates mood and anxiety symptoms. The small magnitude of these associations suggests that individual-level coping may be insufficient in the face of the overwhelming nature of the stress accompanying a global pandemic. This work adds to our understanding of coping with pregnancy stress in the context of population-level stressors (i.e., a pandemic or large-scale disaster).

Adolescent pregnant women's perception of health practices: A qualitative study

AIM

To explore adolescent pregnant women's perception of health practices.

DESIGN

A qualitative study.

METHOD

Fifteen pregnant women in Tehran (capital of Iran) were selected based on purposive sampling to participate in semi-structured, in-depth interviews. The content of interviews was recorded and transcribed and then analysed using conventional content analysis.

RESULTS

The first theme extracted was health practice with main categories of balanced rest/activity pattern, observance of an appropriate diet, sensitivity to personal health, observance of an appropriate pattern of social interactions, religious and spiritual orientations, recreational and leisure time activities, and stress management; second theme was perceived benefits with main categories of a sense of physical health improvement, a sense of mental health improvement, positive attitudes towards the effect of nutrition on pregnancy and childbirth health; and third theme was effective factors with main categories of facilitators of health practices and inhibitors of health practices.

CONCLUSIONS

Most pregnant adolescents' perception of health practices is at a satisfactory level; however, some inhibitors of health practice were explored in this study. These should be improved by adopting appropriate approaches in health policies. No Patient or Public Contribution.

Contextualizing the experiences of Black pregnant women during the COVID-19 pandemic: 'It's been a lonely ride'

The emergence of the COVID-19 pandemic significantly changed the prenatal care experience, specifically regarding medical appointments and social opportunities. It is critical to capture this change through the narratives of pregnant people, particularly those of marginalized populations, whose voices may often be underrepresented in the literature. This mixed-methods paper summarizes the experiences of 40 pregnant Black/African American (AA) women during the COVID-19 pandemic. A cross-sectional, online survey was administered between 2020 and 2021 to assess prenatal health and the impacts of the COVID-19 pandemic on patients' pregnancy experience. Coping behaviors during the pandemic were self-reported using the COPE-IS. Univariate analyses were conducted. An additional analysis of participants (n = 4) was explored through a week-long qualitative exercise using a photo documentation procedure. Photo-Elicitation Interviews (PEI) were conducted to capture and center their pandemic pregnancy experiences. Sources of stress during the pandemic varied, with the most common being financial concerns (n = 19, 47.5%). Over half of the sample (n = 18, 54.5%) self-reported increases in their positive coping behaviors during the pandemic, such as communicating with friends and family, talking to healthcare providers, listening to music, and engaging in spiritual practices-such as prayer. The four PEI study participants reflected on the impacts of social distancing on their prenatal experience and mentioned hospital and provider-related weariness due to their race. The findings of this study suggest that during the COVID-19 pandemic, Black/AA pregnant women in Charlotte, NC used social support, mindfulness practices, self-advocacy, and health literacy to navigate challenges present during their prenatal health experience. This paper highlights the personal, social, and structural experiences of pregnant women during a public health crisis so that responsive and effective programs or policies can be planned in the future.

Perceptions and experiences of prenatal mental health: A qualitative study among pregnant women in Ghana

Prenatal mental health problems can have adverse effects on the health and wellbeing of the mother as well as her baby. However, the factors associated with its etiology, expression, and coping mechanisms in Ghana remain understudied. This qualitative study explored the perceptions and experiences of prenatal mental health problems among 21 pregnant women in Accra through semi-structured interviews. Interpretative Phenomenological Analysis led to three dominant themes; "conceptions of prenatal mental disorders" (sub-themes: awareness and constructions of prenatal mental health problems), "experiences of mental health problems" (sub-themes: symptoms of prenatal mental health problems and causal attributions of prenatal mental health problems) and "coping mechanisms of the pregnancy experience" (subthemes: faith, social support and work). The lack of knowledge of mental health disorders in this study and the expression of contextually relevant and culturally defined constructions and experiences of prenatal mental health problems, highlight the need for the development of culturally suitable interventions within the Ghanaian context.

The Effect of Religious Attitudes on Anxiety and Psychological Well-being in Risky Pregnancies: A Cross-Sectional Study from Turkey

The aim of this study was to determine how religious attitudes of risky pregnant women affect their anxiety and psychological well-being. This is a cross-sectional study. It was carried out on 137 women diagnosed with risky pregnancy between December 2021 and February 2022 in a state hospital in Osmaniye, located in the southern Turkey. The findings of the study revealed that the participants' religious attitudes affected their trait anxiety and psychological well-being. Being religious in fact, boosted psychological well-being of the participants and lowered their trait anxiety level. They had a moderate religious attitude and a moderate psychological well-being but they also suffered from high trait anxiety levels.

Does pain after delivery unequivocally lead to postpartum depression? The moderating role of religious coping

OBJECTIVE

The objective of this work is to explore whether the relationship between pain after delivery and postpartum depression is increased or decreased by the use of religion as a coping strategy (moderation).

METHODS

A longitudinal cohort study was conducted. The sample was evaluated on three occasions: third trimester of pregnancy (religious coping), after birth (pain severity) and four months after delivery (postpartum depression). Participants were 122 women (mean age = 31.29; SD = 4.9: range = [22, 42 years]) with low obstetric risk.

RESULTS

Both pain severity and religious coping contributed to postpartum depression (r = .20, p = .029 and r = .28, p = .04, respectively). Religious coping exacerbated the relationship between pain after delivery and postpartum depression (B = -0.11, t = -2.48, p = .014, [-0.20, -0.02]). Depression was highest in participants using religious coping irrespective of pain severity levels.

CONCLUSION

These findings support the importance of person-environment interaction studies and provide new evidence on the deleterious role of religious coping in the well-being of women after childbirth.

Health promotion behaviours of pregnant women and spiritual well-being: Mediatory role of pregnancy stress, anxiety and coping ways

AIM

Little is known about the link between spiritual well-being and health promotion behaviours in pregnant women. The study aimed to explore the direct and indirect effects of spirituality on health promotion behaviours with the mediatory roles of pregnancy stress, anxiety and coping ways.

DESIGN

Cross-sectional.

METHODS

Two hundred women aged above 18 years completed Spiritual Well-Being scale (SWBS), State-Anxiety Inventory (SAI), Promoting Lifestyle Profile (HPLP), Prenatal Coping Inventory (Nu-PCI) and Revised Prenatal Distress Questionnaire (NuPDQ).

RESULTS

Spirituality directly and negatively affected the state anxiety (β = -.41; p < .001) and NuPDQ (β = -.36; p < .001). Health promotion behaviours were negatively related to state anxiety (β = -.36; p < .001) and positively to planning-preparation coping (β = .23; p = .001). Spirituality had a significant indirect effect on health promotion behaviours (β = .33; p < .001), mediated through its association with state anxiety and planning-preparation coping. Thus, health professionals are proposed to consult pregnant women on the benefits of spirituality for improving healthy behaviours.

Relationship of Depression, Anxiety and Stress Levels with Religious Coping Strategies Among Turkish Pregnant Women During the COVID-19 Pandemic

The aim of this study was to investigate the depression, anxiety, stress levels, and religious coping strategies of Turkish pregnant women during the COVID-19 pandemic. Of the pregnant women involved in this study (N = 327), 74.6% were concerned about their health, whereas 85.9% had concerns about the health of the fetus during the COVID-19 pandemic. It was found that 19.9% had extremely severe depression, 97.9% had extremely severe anxiety, and 52.3% had severe stress symptoms. Religious coping scores of the pregnant women included in the study were found to be high. There was a weak positive correlation between positive religious coping and depression and a very weak negative correlation between negative religious coping and depression.

Spirituality and Health in Brazil: A Survey Snapshot of Research Groups

Articles on “Spirituality and Health” have multiplied considerably in Brazil in the last decade. More recently, however, research groups created specifically to investigate this topic have emerged. This study aims to provide an overview of the field by means of a survey in the Directory of Research Groups in Brazil. Thirty-three groups were initially identified, of which 16 were selected for analysis and placed into two categories: “established” groups and lines of research, and “in-process” groups and lines of research. The survey made it possible to identify postgraduate programs that develop studies on this theme, the main researchers, and the potentials and challenges of this research field in Brazil. The results also indicate that “Spirituality and Health” is a fundamentally interdisciplinary field of research that is expanding and has gained greater legitimacy in the scientific community in the last four years. The main challenges to and potentials for advancement of knowledge are the need for theoretical and methodological development to support research, educational improvement in spiritual care, development of a critical and conscious reflection on the political implications of the field (especially due to the religious diversity in the Brazilian cultural context), and the role of spirituality/religiosity in public health promotion policies.

A spiritual intervention to reduce stress, anxiety and depression in pregnant women: Randomized controlled trial

We assessed the efficacy of a spiritually-integrated cognitive-behavioral educational group intervention for reducing stress, anxiety, depression, and blood pressure during pregnancy and improving delivery outcomes. A randomized controlled trial was conducted in 84 pregnant women randomly assigned to either the intervention or a control group. Demographic information was collected at baseline, along with measures of religiosity, stress, anxiety, depression, and blood pressure. Our intervention consisted of four 90-minute group sessions over 8 weeks that utilized a spiritually-integrated cognitive-behavioral approach to help participants cope with the stress of pregnancy. Stress, anxiety and depression scores in the intervention group decreased significantly by 41%, 28%, and 41%, respectively, from baseline to 3-month follow-up. There were also significant differences in systolic and diastolic blood pressure between groups at the 3-month follow-up, favoring the intervention group. Between-group differences were also significant for these outcomes. Applying such spiritually-integrated intervention may help to improve the mental and physical health of young, healthy nulliparous pregnant women.

Predicting postpartum post-traumatic stress and depressive symptoms in low-risk women from distal and proximal factors: a biopsychosocial prospective study using structural equation modeling

PURPOSE

Posttraumatic stress (PTSD) and depression (PPD) are common mental disorders in the postpartum that constitute a threat both to the mother and the baby. It is unclear whether both disorders share similar antecedents, which is important to plan efficient interventions. The goal of this study was to examine the contribution of set of biopsychosocial predictors on both PTSD and PPD.

METHODS

The study design was prospective. The study was conducted at Hospital Universitario de Fuenlabrada, a public university hospital located in the south of Madrid (Spain). The sample was composed of 116 pregnant women with low pregnancy risk. STROBE reporting guidelines were followed.

RESULTS

The multivariate results show that psychopathology severity assessed during the first trimester (ß = 0.50, p < .001) and the Apgar score 5 min after delivery (ß = - 0.19, p = .030) were the two variables to significantly contribute to postpartum depressive symptoms. Conversely, only satisfaction with home care after delivery was independently associated with postpartum posttraumatic stress (ß = - 0.26, p = .016). The proposed model explained 21.8% of the variance of postpartum depressive symptoms (p = .041) and 27.1% of the variance of posttraumatic stress symptoms (p = .014).

CONCLUSION

Special attention should be given to shared and unique predictive factors of PDD and PTSD to develop effective prevention programs in perinatal care.

Understanding the Orthodox Jewish family during childbirth

PURPOSE

This educational intervention uses the generalized empirical method (GEM) of Bernard Lonergan for nursing students to gain an understanding of the Orthodox Jewish family during childbirth.

SETTING AND POPULATION

this activity occurred at a baccalaureate, nursing program in the Northeast United States. It consisted of two semesters of 32 undergraduate junior nursing students enrolled in a maternal-newborn nursing course.

FINDINGS

Five themes emerged from students' reflective journaling related to the Orthodox Jewish Laws and traditions included: Laws of Modesty, Laws of Niddah, Laws of Sabbath and Holidays, Laws of Kosher, and Laws of Naming the child and circumcision.

CONCLUSIONS

The GEM facilitated students' understanding and knowledge of cultural traditions of the Orthodox Jewish childbirth experience. Lonergan's GEM provided insights and reflection so students could become culturally competent in providing nursing care.

Intolerance of uncertainty moderates the relations among religiosity and motives for religion, depression, and social evaluation fears

OBJECTIVES

Intolerance of uncertainty (IU) underlies several psychological disorders, and religion may help some individuals cope with IU and/or protect against psychological symptoms. It was hypothesized that IU would moderate the relations between coping motives for being religious, as well as religiosity, and common psychological disorder symptoms: Depression and social evaluation fears.

METHODS

Study 1 included 473 self-reporting community members (M _age  = 48, 48% female, 80% Protestant/Catholic). Study 2 included 412 self-reporting undergraduates ( M _age  = 19, 71% female, 76% Protestant/Catholic).

RESULTS

For Study 1, coping-based motives related to greater depression for young adults with above-average IU and to lower depression for young adults with below-average IU. For Study 2, religiosity related to lower depression and fear of negative evaluation for individuals with above-average IU and to greater fear of positive evaluation for individuals with below-average IU.

CONCLUSION

IU may be an important mechanism between aspects of religion and psychological disorder symptoms.