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Xu CW. The big heroine genre: motherhood and the maternal body in postsocialist Chinese television. MEDICAL HUMANITIES 2024; 50:332-342. [PMID: 38604655 DOI: 10.1136/medhum-2023-012839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/20/2024] [Indexed: 04/13/2024]
Abstract
This article explores the feminist social critique in the 'big heroine' drama, a newly emerged genre of television that focuses on empowering yet dramatic stories of urban women in contemporary China. The article theorises the genre as a site of ongoing contestations to inform and critique women's maternal reality in neoliberal, pronatalist China. The big heroine genre is situated in the postsocialist structure of feeling defined by alienation and precarity, responding to China's need to stabilise the emerging population crisis and labour shortage. Using a popular instance within the genre, Left Right (2022), as a case study, the article argues that the show validates the legitimacy of women's anxieties and challenges in maternity and then invites viewers to engage in a multifaceted analysis of the intricate web of structural injustices women experience in pregnancy, childbirth, the postpartum and having a second child. By doing so, it not only resonates with viewers' yearning for recognition and empathy but also stimulates a broader discourse on new and persisting maternal challenges in pronatalist China. I conclude that the genre's contradictory and contingent nature mirrors the complexities of the Chinese party-state's attempt to navigate the ideological instability surrounding maternity and motherhood. The genre is progressive in its alternative imagination of kinship and care networks for women navigating the moral, medical, and cultural dilemmas of the maternal body and motherhood in the moment of the state's transitioning into a more aggressive form of pronatalism.
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Yaqoob H, Ju XD, Bibi M, Anwar S, Naz S. "A systematic review of risk factors of postpartum depression. Evidence from Asian culture ". Acta Psychol (Amst) 2024; 249:104436. [PMID: 39142256 DOI: 10.1016/j.actpsy.2024.104436] [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: 04/21/2024] [Revised: 07/08/2024] [Accepted: 07/25/2024] [Indexed: 08/16/2024] Open
Abstract
OBJECTIVES One of the largest health concerns, postpartum depression (PPD), has detrimental effects on new mothers, their child, and their family. Investigating under-researched risk factors for postpartum depression in Asian women is the goal of this review of the literature. METHODS The literature was searched using a number of electronic research databases. This review included studies that meet the following requirements: (a) they evaluated risk variables; (b) they were conducted in Asian countries using quantitative or qualitative methods; and (c) they were published in English in peer-reviewed journals between 2007 and 2023. A total of 90 studies from 14 different countries were reviewed, compiled, and synthesized. RESULTS In Asian countries, where rates ranged from 0.82 % to 93 %, South Korea and Japan had the lowest and highest rates of postpartum depression, respectively. The risk factors for postpartum depression were divided into five main categories: biological/physical (e.g., ABO blood group, oxytocin level), psychological (e.g., antenatal depression, body dissatisfaction, child care stress), obstetric/pediatric (e.g., loss of baby, abortions, pain), socio-demographic (e.g., low social support, poverty, loss of autonomy), and cultural (e.g., gender preference). CONCLUSION This phenomenon is prevalent in Asian cultures as it is in European Countries. The repercussions of untreated postpartum depression can lead to long-term psychological and developmental issues in children and strain the familial bonds essential for a nurturing environment. Moreover, understanding the specific risk factors faced by Asian women can pave the way for culturally sensitive interventions and support systems designed to address and mitigate these challenges effectively.
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Affiliation(s)
- Hina Yaqoob
- School of Psychology, Northeast Normal University, Changchun, Jilin, China.
| | - Xing-Da Ju
- School of Psychology, Northeast Normal University, Changchun, Jilin, China; Jilin Provincial Key Laboratory of Cognitive Neuroscience and Brain Development, China.
| | - Maryum Bibi
- School of Psychology, Northeast Normal University, Changchun, Jilin, China.
| | - Saeed Anwar
- School of Psychology, Northeast Normal University, Changchun, Jilin, China.
| | - Sumaira Naz
- School of Psychology, Northeast Normal University, Changchun, Jilin, China.
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Zhi X, McKenzie-McHarg K, Mai DL. Investigating cultural conflicts in everyday self-care among Chinese first-time pregnant migrants in Australia. Midwifery 2024; 135:104038. [PMID: 38823211 DOI: 10.1016/j.midw.2024.104038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/13/2024] [Accepted: 05/28/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND Given the fast-growing migration and globalisation trends in the last decades, women increasingly experienced pregnancy as migrants and often faced complex and unique challenges related to both migration and pregnancy in a foreign land, affecting their psychological wellbeing during pregnancy. Cultural conflicts between pregnant migrants' home and host cultures could play a critical role affecting their pregnancy experiences and psychological wellbeing. AIMS This study aimed to explore cultural conflicts that challenge Chinese first-time expectant mothers living in Australia regarding their pregnancy self-care and their psychological wellbeing. METHOD A qualitative methodology was adopted utilising interpretative phenomenological analysis. Participants were 18 Chinese-born first-time pregnant migrants in Australia. A semi-structured interview schedule focused on their pregnancy self-care and psychological wellbeing and any effects of Chinese-Western/Australian cultural conflicts. FINDINGS Two psychosocial approaches were identified to explain how all the participants were psychologically challenged by self-care cultural conflicts to some extent: 1) challenging decision-making processes about self-care cultural conflicts and 2) interpersonal tension if the decisions conflicted with someone's advice/beliefs/opinions. CONCLUSION Emotional, cognitive, and social factors were relevant in shaping the participants' engagement with and their experiences of various pregnancy self-care activities.
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Affiliation(s)
- Xiaojuan Zhi
- Department of Psychology, Counselling and Therapy, La Trobe University, Australia
| | | | - Dac L Mai
- Department of Psychology, Counselling and Therapy, La Trobe University, Australia.
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Li W, Cheng H, Wu L, Wu H, Deng Y. Characteristics and effects on daily lives of pelvic girdle pain during early postpartum in Beijing women, China. Women Health 2024; 64:330-340. [PMID: 38556776 DOI: 10.1080/03630242.2024.2334691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/19/2024] [Indexed: 04/02/2024]
Abstract
Pelvic girdle pain (PGP) is a common problem during pregnancy and postpartum and negatively affects women's well-being. Yet it is not well known in China. This study assessed PGP's intensity, location, and quality and the status of daily activities on postpartum women with pain, and explored the relationship between pain and the prevalence of depressive symptoms. A cross-sectional study recruiting 1,038 eligible women at 6 weeks postpartum from the obstetric clinic of a hospital was conducted in Beijing, China. Data were collected using self-reported questionnaires, including Introductory information form, Body chart, Number Rating Scale, McGill Pain Questionnaire-2, Pelvic Girdle Questionnaire, and Edinburgh Postnatal Depression Scale. In this study, 32.2 percent women experienced pain. The mean (SD) pain intensity score was 3.07 ± 1.60. About 50.6 percent women experienced sacroiliac joint pain, and 25.5 percent women experienced pain in a combination of locations. About 73.1 percent women experienced aching pain, and 57.5 percent experienced more than one kind of pain quality. The mean total score, which assesses activity and symptom limitations, was 21.93 ± 17.35 (percent), of which a normal sex life (1.29 ± 0.94) was made more challenging due to pain. In mental health, the prevalence of depressive symptoms coincided with the prevalence of pain (p = 0.008). Postpartum PGP still needs to be taken seriously, and women with pain require further support. The above knowledge offers information to manage pain, daily lives and depressive symptoms, contributes to think about strategies to better promote postpartum women physical and mental health in the future.
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Affiliation(s)
- Weitao Li
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Huan Cheng
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Liping Wu
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Huiling Wu
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yafang Deng
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Christopher SM, Donnelly G, Brockwell E, Bo K, Davenport MH, De Vivo M, Dufour S, Forner L, Mills H, Moore IS, Olson A, Deering RE. Clinical and exercise professional opinion of return-to-running readiness after childbirth: an international Delphi study and consensus statement. Br J Sports Med 2024; 58:299-312. [PMID: 38148108 DOI: 10.1136/bjsports-2023-107489] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 12/28/2023]
Abstract
Female athletes have identified a lack of guidance as a barrier to successfully returning to running postpartum, and existing guidelines are vague. Our aim was to define the current practice of determining postpartum run-readiness through a consensus survey of international clinicians and exercise professionals in postpartum exercise to assist clinicians and inform sport policy changes.A three-round Delphi approach was used to gain international consensus from clinicians and exercise professionals on run-readiness postpartum. Professionals who work with postpartum runners participated in an online survey to answer open-ended questions about the following postpartum return-to-running topics: definitions (runner and postpartum), key biopsychosocial milestones that runners need to meet, recommended screening, timeline to initiate running, support items, education topics and factors that contribute to advising against running. Consensus was defined as ≥75% participant agreement.One hundred and eighteen professionals participated in round I, 107 participated in round II (response rate 90.6%) and 95 participated in round III (response rate 80.5%). Responses indicated that, following a minimum 3-week period of rest and recovery, an individualised timeline and gradual return to running progression can be considered. Screening for medical and psychological concerns, current physical capacity, and prior training history is recommended prior to a return to running.This study proposes recommendations for the initial guidance on return-to-running postpartum, framed in the context of current research and consensus from professionals. Future research is needed to strengthen and validate specific recommendations and develop guidelines for best practice when returning-to-running after childbirth.
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Affiliation(s)
- Shefali Mathur Christopher
- Department of Rehabilitation Sciences, Doctor of Physical Therapy, Tufts University, Seattle, Washington, USA
- Elon University, Elon, North Carolina, USA
| | - Gráinne Donnelly
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | | | - Kari Bo
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- Department of Obstetrics and Gynecology, Akershus University Hospital, Lorenskog, Norway
| | - Margie H Davenport
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Marlize De Vivo
- Perinatal Physical Activity Research Group, School of Psychology and Life Sciences, Section of Sport, Exercise and Rehabilitation Science, Canterbury Christ Church University, Canterbury, UK
- Active Pregnancy Foundation, None, UK
| | - Sinead Dufour
- The World of my Baby (WOMB), Faculty of Health Science, McMaster University, Hamilton, Ontario, Canada
| | - Lori Forner
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Hayley Mills
- Perinatal Physical Activity Research Group, School of Psychology and Life Sciences, Section of Sport, Exercise and Rehabilitation Science, Canterbury Christ Church University, Canterbury, UK
| | - Isabel S Moore
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | | | - Rita E Deering
- Department of Physical Therapy, Carroll University, Waukesha, Wisconsin, USA
- Department of Orthopedics & Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Sun L, Wang X, Gao H, Li Z, Chen M, Qian X, Gu C. Development and psychometric testing of a Chinese version of the postnatal care experience scale for postpartum women. BMC Pregnancy Childbirth 2023; 23:868. [PMID: 38104121 PMCID: PMC10724998 DOI: 10.1186/s12884-023-06187-z] [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: 09/23/2022] [Accepted: 12/10/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Postnatal period is a critical transitional phase in the lives of mothers and newborn babies. In recent years the importance on promoting a positive experience of care following childbirth is increasingly emphasized. Yet published evidence of the methodological and psychometric quality of instruments to evaluate women's experience of comprehensive postnatal care is still lacking. OBJECTIVE This study aimed to develop and validate a unique scale (the Chinese version of the Postnatal Care Experience Scale, PCES) to measure women's overall experience of care during postnatal periods. METHODS The PCES instrument was developed and validated over three phases, including item development, scale development, and scale evaluation. The item pool of the PCES was generated through existing literature and in-depth semi-structured interviews, followed by assessment of content validity and rating of importance and feasibility of items through two-round Delphi surveys. Psychometric properties were examined in a convenience sample of 736 postpartum women. Both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to assess the construct validity of the developed PCES. The relationship between the total PCES score and the global item construct was estimated using Pearson product-moment coefficient. Reliability was assessed using Cronbach's alpha and Spearman Brown coefficients. RESULTS The content validity index of the Chinese version PCES was 0.867. Following item reduction analysis, this instrument consisted of 30 five-point Likert items. The Kaiser-Meyer-Olkin statistic was 0.964 and the chi-square value of the Bartlett spherical test was 11665.399 (P < .001). The scale explained 75.797% of the total variance and consisted of three subscales, including self-management, social support, and facility- and community-based care. The Pearson correlation coefficient between the total PCES score and the global item construct was 0.909. The CFA showed that the 3-factor model had suitable fitness for the data. Cronbach's alpha value and Spearman-Brown Split-half reliability for the total scale were 0.979 and 0.941, respectively. CONCLUSIONS The newly developed 30-item PCES is a psychometrically reliable and valid instrument that assesses women's overall experience of postnatal care. Future research should aim to use the PCES in various populations to obtain further evidence for its validity and reliability.
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Affiliation(s)
- Liping Sun
- Department of Nursing, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xiaojiao Wang
- Department of Nursing, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Hua Gao
- Department of Nursing, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Zhaorun Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China
| | - Meiyi Chen
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China
| | - Xu Qian
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China.
- Global Health Institute, Fudan University, Shanghai, China.
| | - Chunyi Gu
- Department of Nursing, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
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Yang X, Qiu M, Yang Y, Yan J, Tang K. Maternal postnatal confinement practices and postpartum depression in Chinese populations: A systematic review. PLoS One 2023; 18:e0293667. [PMID: 37903136 PMCID: PMC10615300 DOI: 10.1371/journal.pone.0293667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/14/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND The postpartum period is critical for maternal health status after childbirth. The traditional Chinese postpartum confinement practice, "doing-the-month", is considered especially effective in helping mothers recover during the postpartum period. However, research has not provided evidence to confirm its benefits. Postpartum depression is a common postpartum disease that seriously threatens maternal health. The systematic review aims to explore the association between "doing-the-month" and postpartum depression in the Chinese female population and to provide a scientific foundation for evidence-based postpartum maternal care. METHODS Five databases (PubMed, Embase, Web of Science, Scopus, Cochrane, PsycINFO, and Web of Science) were searched according to the protocol (INPALSY202320102). The JBI assessment tool was used to assess the quality of the included studies. RESULTS Sixteen quantitative studies from China and Chinese female immigrants in other countries, including 15 cross-sectional studies and 1 randomized controlled study, were identified. Four studies indicated that "doing-the-month" rituals reduced postpartum depression risk while 2 studies showed opposite results; 10 studies did not show a significant association between "doing-the-month" practices and postpartum depression. CONCLUSION There is conflicting evidence regarding the association between "doing-the-month" and the likelihood of developing postpartum depression. Some studies have explored the impact of family ties, particular rituals, and specific stressors during the postpartum period on the occurrence of postpartum depression in Chinese women. According to current research, "doing-the-month" practice failed to show a significant protective effect on postpartum depression in the Chinese maternal population. Evidence-based medical health education for the Chinese postpartum female community is urgently needed.
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Affiliation(s)
- Xiao Yang
- Health Policy and Management Department, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Mujie Qiu
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Yichun Yang
- Department of Obstetrics, Longgang District Central Hospital of Shenzhen, Shenzhen, China
| | - Junlin Yan
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing, China
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Jiang J, Huang J, Su Y, Wang Y. Applying the Adjusted Chinese Dietary Balance Index-16 to Assess the Dietary Quality of Chinese Postpartum Lactating Mothers. Nutrients 2023; 15:4499. [PMID: 37960152 PMCID: PMC10650007 DOI: 10.3390/nu15214499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/16/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
A balanced diet is considered necessary in maternal recovery and neonatal development; however, the dietary quality of lactating mothers in China has not been systematically evaluated in different regions and stages of lactation. In addition, the release of the Chinese Dietary Guidelines in 2022 implies that the dietary index method needs to be adjusted accordingly. In this study, the adjusted Chinese Dietary Balance Index-16 (DBI-16) was used to assess the dietary quality of lactating women, referred to as the Dietary Balance Index for lactating women (DBI-L). This study is part of the MUAI study, in which dietary intake and demographic characteristics of lactating mothers from six cities in China and at different stages of lactation were obtained through a self-administered questionnaire and a food frequency questionnaire; 2532 puerperal women were included. According to the DBI-L, 66.2% of participants had inadequate dietary intake (79.1% vegetables, 79.1% fruits, 86.7% dairy products, 39.7% soybeans, and 69.4% fish products, respectively), 57.8% had excessive intake (76.0% cereals, 64.4% meat, and 29.1% eggs, respectively) and 92.2% had unbalanced dietary consumption. Dietary quality was optimal for mothers in the first month after delivery, and the dietary quality of mothers in economically developed places such as Shanghai and Guangzhou was significantly better than that in less developed places such as Lanzhou and Changchun. The dietary quality of lactating women in China is imbalanced, with excessive and inadequate dietary intake. The country should strengthen nutritional interventions for lactating mothers, especially in economically underdeveloped regions.
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Affiliation(s)
| | | | | | - Yu Wang
- School of Public Health, Lanzhou University, Lanzhou 730033, China; (J.J.); (J.H.); (Y.S.)
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Lin-Lewry M, Tzeng YL, Li CC, Lee GT, Lee PH, Chen SR, Kuo SY. Trajectories of sleep quality and depressive symptoms in women from pregnancy to 3 months postpartum: a prospective cohort study. J Sleep Res 2023; 32:e13918. [PMID: 37128654 DOI: 10.1111/jsr.13918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 03/16/2023] [Accepted: 04/14/2023] [Indexed: 05/03/2023]
Abstract
Sleep quality and depression during pregnancy often affect women's adaptation to motherhood and are linked with adverse maternal and neonatal outcomes. Using a prospective cohort study comprising 190 pregnant women in central Taiwan, we investigated the trajectories of sleep quality and depressive symptoms and their associated predictors in perinatal women from pregnancy to postpartum. Sleep and depressive symptoms were assessed using the Pittsburgh Sleep Quality Index and the Edinburgh Postnatal Depression Scale, respectively, from mid-pregnancy to 3 months postpartum. We used group-based trajectory modelling and logistic regression modelling to analyse the data collected from the structured questionnaires. Pregnant women (50.5% primipara) with a mean (standard deviation) age of 32.3 (4.1) years were included. We identified three distinctive classes of sleep quality trajectories during the perinatal period: 'stable good' (18.4%), 'increasing poor' (48.9%), and 'stable poor' (32.6%). We further detected three stable trajectories of depressive symptoms: 'stable low' (36.3%), 'stable mild' (42.1%), and 'stable high' (21.6%). A significant association between sleep quality and depression trajectories was evident (p < 0.001). High fatigue symptoms and low social support predicted the high trajectories of poor sleep and depressive symptoms. Distinctive dynamic sleep quality and stable depression trajectories were characterised. Our findings revealed that both the sleep and depression trajectories were closely associated with one another, with common predictors of fatigue symptoms and social support. The early assessment of maternal sleep and depression status is important for identifying at-risk women and initiating interventions tailored to perinatal women to improve their sleep and mental health.
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Affiliation(s)
- Marianne Lin-Lewry
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Ya-Ling Tzeng
- School of Nursing, College of Health Care, China Medical University, Taichung, Taiwan
| | - Chieh-Chen Li
- School of Nursing, College of Health Care, China Medical University, Taichung, Taiwan
| | - Gabrielle T Lee
- Applied Psychology, Faculty of Education, Western University, London, Ontario, Canada
| | - Pi-Hsia Lee
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Su-Ru Chen
- School of Nursing, School of Post-Baccalaureate Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Shu-Yu Kuo
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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Shan H, Saharso S, van Kroonenburg N, Henrichs J. Understanding the relationship between maternity care providers and middle-class Chinese migrant women in the Netherlands: A qualitative study. Midwifery 2023; 125:103775. [PMID: 37480628 DOI: 10.1016/j.midw.2023.103775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/16/2023] [Accepted: 07/18/2023] [Indexed: 07/24/2023]
Abstract
OBJECTIVE This study aims to provide insights into the formation and the quality of the maternity care provider-woman relationship between midwives, maternity care assistants and middle-class Chinese migrant women in the Netherlands. DESIGN online in-depth interviews addressing interpersonal trust, women's autonomy in shared decision making and culturally sensitive care PARTICIPANTS: 46 middle-class Chinese migrant women, 13 midwives and 12 maternity care assistants in the Netherlands FINDINGS: Midwives and maternity care assistants reported challenges interpreting the needs of middle-class Chinese migrant women in care practices while Chinese migrant women experienced receiving insufficient emotional support. Midwives and maternity care assistant tended to attribute women's different preferences for care to culture which reinforced difficulties of addressing women's needs. Middle-class Chinese migrant women experienced a lack of responsive care, feelings of being overlooked, being uncomfortable to express different opinions and challenges in developing autonomy in the shared decision-making process. CONCLUSIONS A trusting relationship, effective communication with maternity care providers, and a culturally sensitive and safe environment could be beneficial for middle-class migrant mothers. Chinese migrant women held ambivalent attitudes towards both traditional Chinese health beliefs and Dutch maternity care values. Each individual woman adopted the practice of the "doing the month" tradition to a different extent. This indicated the need for maternity care providers to recognize women's various needs for more responsive and individualized care, especially for first-time migrant mothers to negotiate their ways through the new healthcare system. IMPLICATIONS FOR PRACTICE We suggest a more proactive role for maternity care providers addressing the individual's subjectivity and preferences. Our findings are relevant and applicable for maternity care professionals conducting shared decision making with middle-class and highly educated migrant women living in Western contexts.
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Affiliation(s)
- Haiyue Shan
- Department of Sociology, Vrije University Amsterdam, De Boelelaan 1105 HV, Amsterdam 1081, the Netherlands.
| | - Sawitri Saharso
- Department of Sociology, Vrije University Amsterdam, De Boelelaan 1105 HV, Amsterdam 1081, the Netherlands
| | - Nandy van Kroonenburg
- Department of Sociology, Vrije University Amsterdam, De Boelelaan 1105 HV, Amsterdam 1081, the Netherlands
| | - Jens Henrichs
- Department of Midwifery Science, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, De Boelelaan 1118 HZ, Amsterdam 1081, the Netherlands
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Shan H, Saharso S, Henrichs J. Experiences of peripartum depressive symptoms among Chinese middle-class migrant women in the Netherlands: a qualitative study of migrant motherhood. BMC Pregnancy Childbirth 2023; 23:638. [PMID: 37670269 PMCID: PMC10481590 DOI: 10.1186/s12884-023-05957-z] [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: 11/21/2022] [Accepted: 08/26/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND A low educational level and poor economic status have repeatedly been identified as the main risk factors of peripartum depression among migrant women in existing studies. However, there is limited knowledge about a group of highly educated and middle-class migrant women, and how this group of migrant women deals with those risks and which protective factors facilitate a successful transition into motherhood in the host country. This study aims to shed light on the multifaceted psychosocial challenges during the peripartum period for Chinese migrant women in their relationships with intimate partners, mothers, and mothers-in-law. METHODS In this qualitative study, semi-structured in-depth interviews were conducted digitally with 46 pregnant and postpartum middle-class Chinese migrant women with peripartum depressive symptoms in the Netherlands. The interview data were analyzed using content analysis. RESULTS The multifaceted psychosocial challenges for women with peripartum depressive symptoms were classified into three key categories: the ambivalence towards different mothering values, perceived inadequate and mismatching social support and adverse childhood experiences. CONCLUSION Well-educated middle-class Chinese migrant women with peripartum depressive symptoms faced challenges in the transition into motherhood due to the unmet self-expectations regarding the pursuit of a good quality of life and a happy motherhood. The nurturing intimate relationships and adequate social support in the host country have mitigated recollections of their adverse childhood experiences. Future prevention programs and postpartum care should consider the contextual specificity based on the childhood history. International mental health research should pay more attention to the growing and potentially vulnerable group of well-educated middle-class migrant women.
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Affiliation(s)
- Haiyue Shan
- Department of Sociology, Vrije University Amsterdam, De Boelelaan 1105, 1081HV, Amsterdam, Netherlands.
| | - Sawitri Saharso
- Department of Sociology, Vrije University Amsterdam, De Boelelaan 1105, 1081HV, Amsterdam, Netherlands
| | - Jens Henrichs
- Amsterdam University Medical Center, Vrije University Amsterdam, Amsterdam, Netherlands
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Shen Q, Huang CR, Du WW, Li JY, Redding SR, Ouyang YQ. Galactagogue Food Consumption, Perception of Insufficient Milk Supply, and Exclusive Breastfeeding in Chinese Postpartum Women: An Analysis of Repeated Measures. J Transcult Nurs 2023; 34:365-374. [PMID: 37395493 DOI: 10.1177/10436596231184650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023] Open
Abstract
INTRODUCTION Little research has explored galactagogue food consumption in China. This study aims to investigate consumption patterns and how they relate to perceived insufficient milk supply and exclusive breastfeeding. METHODS Data were collected from postpartum women in China at six time points: baseline demographic questionnaire before hospital discharge (T0), galactagogue food questionnaire at 1 month postpartum (T1), Hill and Humenick Lactation Scale at 6 weeks postpartum (T2), and breastfeeding practices at 1, 2, 3 and 4 months postpartum (T1, T3, T4, T5). RESULTS Of 218 participants who completed the galactagogue food questionnaire, 64.68% were consumers. No association was found between galactagogue food consumption and perceived insufficient milk supply. Consumers were less likely to breastfeed exclusively. DISCUSSION Future research should emphasize a deeper understanding of consumer behaviors and family support in providing professional guidance on postpartum nutrition that considers not only social and cultural experiences but also broader medical aspects.
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Zhang X, Zuo X, Matheï C, Aertgeerts B, Afnan M, Li T, Buntinx F, Vermandere M. Impact of a postpartum care rehabilitation program to prevent postpartum depression at a secondary municipal hospital in Qingdao China: a cross-sectional study. BMC Pregnancy Childbirth 2023; 23:239. [PMID: 37041524 PMCID: PMC10088113 DOI: 10.1186/s12884-023-05547-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/25/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND The emerging postpartum rehabilitation (PPR) program in Chinese hospitals characterized by applying ongoing medical care through traditional cultural practices shows a protective effect in early puerperium in China. This study explores the benefit of PPR program practices to postpartum depression (PPD) and the influencing factors for PPD among Chinese women during the first postnatal six weeks. METHODS The cross-sectional study included 403 participants and was conducted in a Secondary Municipal Hospital in Qingdao, China, from 01 to 2018 to 31 December 2021. Information on this PPR program was collected during the six-weeks postpartum consultation, including the Edinburgh postnatal depression scale (EPDS) scores, the measurement results for diastasis recti abdominis, and the international physical activity questionnaire (long form) (IPAQ-L) scores. Logistic regression models were used to examine the effect of the PPR program on PPD among the local population. The secondary aim of this study was to investigate possible influencing factors for PPD, such as coronavirus disease 2019 (COVID-19), physical exercises, etc. RESULTS: PPR program has shown a positive effect in preventing PPD (p < 0.001) and diastasis recti prevalence (p < 0.001) during the six-weeks postnatal control in Qingdao, China. Better post-pregnancy weight reduction (p = 0.04) and higher metabolic equivalent of task (MET) value (p < 0.001) were noticed in the non-PPR group. Furthermore, lower PPD risk was associated with factors such as longer relationship duration years (2-5 years) (p = 0.04) and exercising one to three times a week (p = 0.01). A higher PPD risk was related to factors such as urinary incontinence during the postpartum period (p = 0.04) and subjective insomnia (p < 0.001). No significant effect was shown between COVID-19 and the EPDS score in this study (p = 0.50). CONCLUSION Our results suggested that the PPR program provided protection against PPD and diastasis recti during the first six weeks after delivery. Urinary incontinence and subjective insomnia were the main risk factors for PPD, while longer relationship duration years and exercising one to three times a week gave protective effects to PPD. This study emphasized that a comprehensive ongoing medical care program, such as the PPR program, effectively improves women's mental and physical health in the early postpartum in China.
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Affiliation(s)
- Xiaoqian Zhang
- Academic Center for General Practice, Department of Public Health and Primary Care, Leuven, KU, Belgium.
- Qingdao United Family Hospital, Qingdao, China.
| | - Xiaoli Zuo
- Qingdao United Family Hospital, Qingdao, China
| | - Catharina Matheï
- Academic Center for General Practice, Department of Public Health and Primary Care, Leuven, KU, Belgium
| | - Bert Aertgeerts
- Academic Center for General Practice, Department of Public Health and Primary Care, Leuven, KU, Belgium
| | | | - Tang Li
- Qingdao University Medical College, Qingdao, China
| | - Frank Buntinx
- Academic Center for General Practice, Department of Public Health and Primary Care, Leuven, KU, Belgium
| | - Mieke Vermandere
- Academic Center for General Practice, Department of Public Health and Primary Care, Leuven, KU, Belgium
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14
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Xue W, Cheng KK, Liu L, Li Q, Jin X, Yi J, Gong W. Barriers and facilitators for referring women with positive perinatal depression screening results in China: a qualitative study. BMC Pregnancy Childbirth 2023; 23:230. [PMID: 37020285 PMCID: PMC10074342 DOI: 10.1186/s12884-023-05532-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 03/20/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Timely screening and referral can improve the outcomes of perinatal depression (PND). However, uptake rates of referral after PND screening are low in China and the reasons are unclear. The aim of this article is to explore the barriers and facilitators for referring women with positive results of PND screening in the Chinese primary maternal health care system. METHODS Qualitative data were collected from four primary health centers located in four different provinces of China. Each of the four investigators conducted 30 days of participant observations in the primary health centers from May to August 2020. Data were collected via participant observations and semi-structured in-depth interviews with new mothers who had positive results of PND screening, their family members, and primary health providers. Two investigators analyzed qualitative data independently. A thematic analysis was conducted, and data were framed using the social ecological model. RESULTS A total of 870 hours of observation and 46 interviews were carried out. Five themes were identified: individual (new mothers' knowledge of PND, perceived need to seek help), interpersonal (new mothers' attitudes towards providers, family support), institutional (providers' perception of PND, lack of training, time constraints), community (accessibility to mental health services, practical factors), and public policy (policy requirements, stigma). CONCLUSIONS The likelihood of new mothers accepting PND referral is related to factors in five areas. Intervention strategies can be developed around these themes and may include educating new mothers and their families about PND, training primary health providers to improve their awareness of condition and indication for referral, building mental health support in routine postpartum home visits, and providing support through mobile technology.
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Affiliation(s)
- Wenqing Xue
- Xiangya School of Public Health, Central South University, 110 Xiangya Road, 410078, Changsha, Hunan, China
| | - K K Cheng
- Institute of Applied Health Research, University of Birmingham, B15 2TT, Birmingham, UK
| | - Lu Liu
- Xiangya School of Public Health, Central South University, 110 Xiangya Road, 410078, Changsha, Hunan, China
| | - Qiao Li
- Xiangya School of Public Health, Central South University, 110 Xiangya Road, 410078, Changsha, Hunan, China
| | - Xin Jin
- Xiangya School of Public Health, Central South University, 110 Xiangya Road, 410078, Changsha, Hunan, China
| | - Jingmin Yi
- Xiangya School of Public Health, Central South University, 110 Xiangya Road, 410078, Changsha, Hunan, China
| | - Wenjie Gong
- Xiangya School of Public Health, Central South University, 110 Xiangya Road, 410078, Changsha, Hunan, China.
- Institute of Applied Health Research, University of Birmingham, B15 2TT, Birmingham, UK.
- Department of Psychiatry, University of Rochester, 14642, Rochester, USA.
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15
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Wu JL, Pang SQ, Jiang XM, Lin Y, Zheng QX. The mothers' breastfeeding behaviour within six weeks postpartum: new scale development and psychometric validation study. BMC Pregnancy Childbirth 2023; 23:138. [PMID: 36864400 PMCID: PMC9979542 DOI: 10.1186/s12884-023-05439-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 02/09/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND The evaluation of mothers' breastfeeding behaviour within 6 weeks postpartum could help health workers comprehensively identify maternal breastfeeding shortcomings, clarify nursing problems, and provide targeted interventions. However, no prior study was found, therefore this study aimed to develop and validate the reliability and validity of the mothers' breastfeeding behaviour scale within 6 weeks postpartum. METHODS A main two-step approach was used: (1) a qualitative pilot study using the purposive sampling method was adopted to test the fitness, simplicity, and clarity of items with 30 mothers; (2) a cross-sectional survey using the convenient sampling method was conducted for item analysis and psychometric validation with 600 mothers. RESULTS The final version of the scale consisted of 36 items with seven dimensions, explaining 68.852% of the total variance. The Cronbach's α, split-half, and retest coefficients were 0.958, 0.843, and 0.753, respectively. The validity of the scale: (1) Content validity: content validity index (CVI) range of items was between 0.882 and 1.000. The scale-level-CVI was 0.990. (2) Structure validity: The fitting indices were as follows: χ2/ⅆf =2.239, RMR = 0.049, RMSEA = 0.069, TLI = 0.893, CFI = 0.903, IFI = 0.904, PGFI = 0.674, and PNFI = 0.763. (3) Convergent validity: The composite reliability and average variance extracted (AVE) of the seven dimensions were between 0.876 and 0.920 and between 0.594 and 0.696. (4) Distinguish validity: The correlation coefficients were less than the square root of the AVE, except for self-decision behaviour, self-coping behaviour, and self-control behaviour. However, the fit index of the original three-factor model was better than that of the other new models, with significant differences (P < 0.001). (5) Calibration validity: The area under the curve was 0.860 or 0.898 when the scale was used to predict exclusive or any breastfeeding at 42 days. The correlation coefficients of the maternal breasting feeding evaluation scale, breastfeeding self-efficacy short-form scale, and the scale were 0.569 and 0.674, respectively. CONCLUSION The newly developed mothers' breastfeeding behaviour scale within 6 weeks postpartum consists of 36 items belonging to seven dimensions with good reliability and validity and is a reliable and valid instrument to be used in future maternal breastfeeding behaviour assessments and interventions.
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Affiliation(s)
- Jing-Ling Wu
- grid.411504.50000 0004 1790 1622School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian China ,grid.256112.30000 0004 1797 9307Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian China
| | - Shu-Qin Pang
- grid.411504.50000 0004 1790 1622School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian China
| | - Xiu-Min Jiang
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China.
| | - Yan Lin
- grid.256112.30000 0004 1797 9307Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian China
| | - Qing-Xiang Zheng
- grid.256112.30000 0004 1797 9307Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian China
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Wu JL, Jiang XM, Zheng QX, Chen XQ, Liu GH. Mothers' breastfeeding six weeks postpartum and factors influencing exclusive breastfeeding during the first six months. Health Care Women Int 2023; 44:262-275. [PMID: 34346293 DOI: 10.1080/07399332.2021.1947287] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We aimed to assess the feeding pattern and influencing factors within six weeks postpartum on exclusive breastfeeding duration among Chinese mothers. This study was conducted using 2:1 matched case-control study. Cases and controls were matched for maternal age, parity and mode of birth. A total of 210 women were included. Approximately 67.9% of women stopped exclusive breastfeeding within the first six weeks postpartum. Maternal non-exclusive breastfeeding intention, lower maternal educational level, mother-infant skin to skin contact over one hour, unsatisfied breastfeeding self-evaluation and maternal unhealthy condition within the first six weeks were risk factors for ceasing exclusive breastfeeding early.
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Affiliation(s)
- Jing-Ling Wu
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xiu-Min Jiang
- Department of Nursing, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Qing-Xiang Zheng
- Department of Nursing, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Xiao-Qian Chen
- Department of Nursing, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Gui-Hua Liu
- Department of Child Health, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
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17
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Tsai SY. Perinatal Depressive Symptoms among Pregnant Employees in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3354. [PMID: 36834062 PMCID: PMC9959548 DOI: 10.3390/ijerph20043354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 02/06/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
This was a longitudinal study of perinatal depressive symptoms among females employed in a large electronics manufacturer in Taiwan, conducted from August 2015 through October 2016. We used questionnaires to collect data on perceived job strain, social support, and the Edinburgh Postnatal Depression Scale (EPDS) scores at three perinatal time-points (pregnancy, delivery, and return to the workplace). Of the 153 employees who agreed to participate, 82 completed the three stages. The prevalence of perinatal depressive symptoms for the three stages was 13.7%, 16.8%, and 15.9%, respectively. The incidence at 3 weeks after childbirth and 1 month after returning to the workplace was 11.0% and 6.8%, respectively. During the third trimester of pregnancy, sleep problems (odds ratio [OR] = 6.2, 95% confidence Interval [95% CI] = 2.1-19.3), perceived job strain (OR = 4.4, 95% CI = 1.5-14.3), and lack of support from family or friends (OR = 7.0, 95% CI = 1.3-40.8) were significant risk factors. Sleep problems (OR = 6.0, 95% CI = 1.7-23.5) and lack of support from family or friends (OR = 27.6, 95% CI = 4.1-322.3) were associated with an increased risk of perinatal depressive symptoms at 3 weeks after childbirth. After returning to the workplace, perceived job strain (OR = 18.2, 95% CI = 2.2-435.7) was a significant risk factor. These findings could provide insight about early symptom detection, and more studies to clarify the association would be worthwhile.
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Affiliation(s)
- Su-Ying Tsai
- Department of Health Management, I-Shou University, Kaohsiung 82445, Taiwan
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18
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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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19
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Luo Y, Sato Y, Zhai T, Kagamiyama H, Ebina Y. Promotion of Parenting and Mental Health Needs among Chinese Women Living in Japan: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13538. [PMID: 36294118 PMCID: PMC9602991 DOI: 10.3390/ijerph192013538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/17/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
Chinese women raising children in Japan tend to experience high parenting stress and poor mental well-being. However, their specific parenting and mental health promotion needs remain unknown. This study aimed to explore the parenting and mental health promotion needs of Chinese women living in Japan and provide recommendations to guide interventions. Semi-structured in-depth interviews were conducted. Participants included 15 women aged 28-39 years who were pregnant or rearing a child younger than six years old. Thematic analysis was performed for data analysis. More than half of the participants experienced mental health problems, such as depressive symptoms and child-rearing stress. Four themes relating to their needs were identified: concrete support, information provision, caring and understanding, and social network building. Information provision and social network building should be emphasized as practical social support mechanisms to improve these women's mental health. Furthermore, a mental health promotion intervention should be developed to address this vulnerable population's needs. Healthcare providers and public health workers should help improve the social support systems of Chinese women in Japan to prevent mental health problems. Potential transcultural education can, arguably, help healthcare providers better understand transcultural care.
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Affiliation(s)
- Yunjie Luo
- Graduate School of Health Sciences, Hokkaido University, Sapporo 0600812, Japan
| | - Yoko Sato
- Faculty of Human Sciences, Hokkaido Bunkyo University, Eniwa 0611449, Japan
| | - Tianyue Zhai
- Department of Obstetrics and Gynecology, School of Medicine, Hokkaido University, Sapporo 0608638, Japan
| | - Hiromi Kagamiyama
- Department of Nursing Faculty of Health Sciences, Japan Healthcare University, Sapporo 0620053, Japan
| | - Yasuhiko Ebina
- Faculty of Health Sciences, Hokkaido University, Sapporo 0600812, Japan
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20
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Huang S, Ash GI, Nam S, Jeon S, McMahon E, Whittemore R. Objectively-Measured Physical Activity and Sedentary Behaviors and Related Factors in Chinese Immigrants in the US with Prior Gestational Diabetes Mellitus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811409. [PMID: 36141683 PMCID: PMC9517195 DOI: 10.3390/ijerph191811409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/30/2022] [Accepted: 09/08/2022] [Indexed: 05/24/2023]
Abstract
Chinese immigrants in the US are disproportionately affected by gestational diabetes mellitus (GDM) and type 2 diabetes (T2D). The aims of this study were to describe their physical activity (PA) and sedentary behaviors (SB) patterns and to identify determinates of objectively-measured PA and SB among Chinese immigrants in the US with prior GDM. We conducted a cross-sectional study among 106 Chinese immigrants with prior GDM across the US. PA and SB were measured by GT9X+ hip accelerometers for 7 consecutive days. Validated questionnaires in English and Chinese were used to assess knowledge and risk perceptions as well as cultural and psychosocial characteristics. Descriptive, bivariate, and multiple regression analyses were performed. Only 27% of participants met the PA guidelines. The median duration of moderate-vigorous-intensity PA (MVPA) per week was 79 (IQR 38-151) minutes. Participants had an average of 9.2 ± 1.4 h of sedentary time per day. Living with parents (who may provide family support) was associated with more MVPA minutes per week, more steps per day, and a greater likelihood of meeting PA guidelines. Higher levels of acculturative stress were associated with fewer MVPA minutes per week. Being employed and having a lower BMI were associated with more SB. Strategies are needed to increase MVPA among this high-risk group, including decreasing acculturative stress and increasing family support. Different strategies are needed to decrease SB among this population.
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Affiliation(s)
- Shuyuan Huang
- Rutgers-NYU Center for Asian Health Promotion and Equity, NYU Rory Meyers College of Nursing, New York, NY 10010, USA
| | - Garrett I. Ash
- Pain Research, Informatics, Multi-Morbidities, and Education (PRIME), VA Connecticut Healthcare System, West Haven, CT 06516, USA
- Yale School of Medicine, Yale University, New Haven, CT 06510, USA
| | - Soohyun Nam
- Yale School of Nursing, Yale University, West Haven, CT 06477, USA
| | - Sangchoon Jeon
- Yale School of Nursing, Yale University, West Haven, CT 06477, USA
| | - Erin McMahon
- College of Nursing, The University of Arizona, Tucson, AZ 85721, USA
| | - Robin Whittemore
- Yale School of Nursing, Yale University, West Haven, CT 06477, USA
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21
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Yip KH, Yip YC, Tsui WK. The Lived Experiences of Women without COVID-19 in Breastfeeding Their Infants during the Pandemic: A Descriptive Phenomenological Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159511. [PMID: 35954868 PMCID: PMC9368050 DOI: 10.3390/ijerph19159511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/28/2022] [Accepted: 08/01/2022] [Indexed: 11/17/2022]
Abstract
The coronavirus disease 2019 (COVID-19) outbreak in 2020 has led to several changes and disturbances in the daily lives of the general public. Particularly for new (first-time) mothers, there has been a significant impact on the practices of raising and feeding their babies. Social distancing measures everywhere have made mothers hesitant to breastfeed their babies anywhere else but at home. Combined with the fear of being infected with COVID-19, the present situation has created unprecedented barriers for breastfeeding mothers to accessing various types of support: emotional, instrumental, informational, and appraisal. There has been no research on the influence of the pandemic on social support regarding breastfeeding in Hong Kong. This study aimed to explore the social support and impact of COVID-19 on mothers breastfeeding their babies. Semi-structured interviews were conducted with 20 currently breastfeeding women in Hong Kong. Colaizzi’s seven-step method was used for data analysis. Two key themes emerged from the interview data: (1) positive influences on breastfeeding support during COVID-19 and (2) negative influences on breastfeeding support during COVID-19. Our findings may help mothers prepare to breastfeed their babies in places other than their homes.
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22
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Bancalari P, Alegre JC, Mendez Alvarez M, Sacks E. " Why would I go if the infant was healthy?": Factors Influencing Postnatal Care Utilization in Chiapas, Mexico. QUALITATIVE HEALTH RESEARCH 2022; 32:1285-1296. [PMID: 35616473 DOI: 10.1177/10497323221091880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Despite global efforts, postnatal care utilization remains low. There is almost no research on factors influencing postnatal care utilization in Latin America. Chiapas has one of the highest rates of maternal and neonatal mortality in Mexico. In 2014, we conducted 101 interviews with recently delivered women, male partners, traditional birth attendants (TBAs), and health staff, to assess factors influencing postnatal care utilization. Data underwent content analysis and thematic coding. Travel costs, postnatal seclusion practices, and a low perceived need for postnatal care were found to be disincentives to seek care. Providers ascribed low care adherence to cultural beliefs and low health literacy, while families indicated that their decision to seek facility care was mediated by the TBA's recognition of danger signs and perceived ability to manage complications. TBAs should be leveraged as gatekeepers, health literacy programs should emphasize the importance of primary care, and structural barriers to care should be reduced.
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Affiliation(s)
- Pilar Bancalari
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | | | - Emma Sacks
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
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23
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Bottemanne H, Charron M, Joly L. [Perinatal beliefs: Neurocognitive mechanisms and cultural specificities]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2022; 50:542-552. [PMID: 35288367 DOI: 10.1016/j.gofs.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 03/05/2022] [Accepted: 03/06/2022] [Indexed: 06/14/2023]
Abstract
Perinatal beliefs contribute to the experience of pregnancy and the process of parenthood. Many of these perinatal beliefs have been perpetuated and evolved over time and throughout the world, exerting their influence on the behavior of pregnant women in interaction with medical recommendations. These beliefs generally offer explanations for gravidic and puerperal phenomena, helping to reduce the uncertainty of parents faced with the biological, psychological and social transitions of pregnancy. But certain beliefs can also be harmful, and alter the maternal experience of pregnancy and postpartum. In this paper, we provide an overview of the beliefs associated with the perinatal period. We successively detail the beliefs concerning fertility, pregnancy, childbirth, and postpartum, specifying the cultural beliefs from other cultures interacting with medical recommendations. Finally, we propose a neurocognitive model of perinatal beliefs generation, and we show the need to know these beliefs to improve care in midwifery, obstetrics, and fetal medicine.
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Affiliation(s)
- Hugo Bottemanne
- Department of Psychiatry, Pitié-Salpêtrière Hospital, DMU Neurosciences, Sorbonne University/Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; Paris Brain Institute - Institut du Cerveau (ICM), UMR 7225/UMRS 1127, Sorbonne University/CNRS/INSERM, Paris, France; Sorbonne University, Department of Philosophy, SND Research Unit, UMR 8011, CNRS, Paris, France.
| | - Morgane Charron
- Department of Psychiatry, Pitié-Salpêtrière Hospital, DMU Neurosciences, Sorbonne University/Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Lucie Joly
- Department of Psychiatry, Pitié-Salpêtrière Hospital, DMU Neurosciences, Sorbonne University/Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
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Liu L, Cai F, Lu Y, Xie Y, Li H, Long C. Comparative Lipidomic and Metabolomic Analyses Reveal the Mystery of Lacquer Oil from Toxicodendron vernicifluum for the Treatment of “Yuezi” Disease in Nujiang, China: From Anti-Inflammation and Anti-Postpartum Depression Perspective. Front Pharmacol 2022; 13:914951. [PMID: 35770099 PMCID: PMC9234167 DOI: 10.3389/fphar.2022.914951] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background: In southwest China, especially in Nujiang, lacquer oil from the drupes of Toxicodendron vernicifluum (Stokes) F. A. Barkley, including black lacquer oil (BLO) and white lacquer oil (WLO), is one of the most important edible oils for the local people. Through the field investigation, the locals believe that lacquer oil has benefits for parturient women and for the treatment of “Yuezi” disease. However, studies on bioactivities and the chemical compositions of lacquer oil are limited.Purpose: This study was designed to reveal the mystery of lacquer oil for the treatment of “Yuezi” disease by testing its anti-inflammatory and anti-postpartum depressant activities and related bioactive compounds.Methods: The anti-inflammatory effects of lacquer oil were examined by establishing a lipopolysaccharide (LPS)-induced RAW264.7 cell inflammation model and detecting the level of pro-inflammatory factors such as NO, IL-6 and TNF-α. The antidepressant effects of lacquer oil were studied by building a mouse model of postpartum depression (PPD), and the animal behavior changes of PPD model mice were assessed by open field test (OFT), forced swimming test (FST) and tail suspension test (TST). The chemical profiles of BLO and WLO were detected by lipidomic and the untargeted metabolomic research methods based on UPLC-MS/MS.Results: The results showed that BLO and WLO exerted anti-inflammatory effects by reducing the release of pro-inflammatory factors and BLO had better anti-inflammatory effects than WLO. While only BLO had anti-postpartum depressant activities, as evidenced by the significantly reduced the immobility time of the BLO-treated PPD mice in TST and FST compared to the PPD model mice. The comparative lipidomic analysis revealed that BLO contained high levels of Diacylglycerols (DAG) and Diacylglyceryl trimethylhomoserines (DGTS) but low level of ceramides (Cer), sphingomyelines (SM), phosphatidylcholines (PC) and phosphatidylethanolamines (PE) compared with WLO. Metabolomics analysis showed that there were 57 chemical markers between BLO and WLO, of which 17 potential biomarkers have been declared to possess anti-inflammatory and/or antidepressant activities.Conclusion: The findings of this study furnish a scientific support for the traditional uses of lacquer oil for the treatment of “Yuezi” disease from anti-inflammation and anti-postpartum depression perspective.
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Affiliation(s)
- Liya Liu
- Key Laboratory of Ecology and Environment in Minority Areas (Minzu University of China), National Ethnic Affairs Commission, Beijing, China
- College of Life and Environmental Sciences, Minzu University of China, Beijing, China
- Key Laboratory of Ethnomedicine (Minzu University of China), Ministry of Education, Beijing, China
| | - Fei Cai
- Key Laboratory of Ecology and Environment in Minority Areas (Minzu University of China), National Ethnic Affairs Commission, Beijing, China
- College of Life and Environmental Sciences, Minzu University of China, Beijing, China
- Key Laboratory of Ethnomedicine (Minzu University of China), Ministry of Education, Beijing, China
| | - Yitong Lu
- College of Life and Environmental Sciences, Minzu University of China, Beijing, China
| | - Yuting Xie
- College of Life and Environmental Sciences, Minzu University of China, Beijing, China
| | - Hao Li
- College of Life and Environmental Sciences, Minzu University of China, Beijing, China
| | - Chunlin Long
- Key Laboratory of Ecology and Environment in Minority Areas (Minzu University of China), National Ethnic Affairs Commission, Beijing, China
- College of Life and Environmental Sciences, Minzu University of China, Beijing, China
- Key Laboratory of Ethnomedicine (Minzu University of China), Ministry of Education, Beijing, China
- *Correspondence: Chunlin Long, ,
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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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The Association between Postpartum Practice and Chinese Postpartum Depression: Identification of a Postpartum Depression-Related Dietary Pattern. Nutrients 2022; 14:nu14040903. [PMID: 35215552 PMCID: PMC8880681 DOI: 10.3390/nu14040903] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 01/27/2023] Open
Abstract
Conflicting results of Chinese traditional postpartum practices have aroused concerns over their health effects. The role of postpartum practices in postpartum depression (PPD) is still a matter of discussion, especially from a dietary practice point of view. The current study was designed to (1) explore the association between postpartum practices and PPD, (2) to identify the dietary pattern related to PPD, and (3) to identify the possible pathways among postpartum practices and PPD. This study is part of the YI Study, which was a cross-sectional study conducted in 10 cities in China. Data for 955 postpartum women were used in the current analysis. The Edinburgh Postnatal Depression Scale (EPDS-10) was used to evaluate PPD with a cutoff value of 9. Postpartum practice was based on the participants’ self-reported practices. Individual practices were recorded and categorized as dietary and non-dietary practices. The dietary pattern was identified based on the food intake frequencies of 25 food groups using the method of reduced rank regression. Structural equation modeling was used to explore the potential pathways between postpartum practices and PPD. The current study observed significant associations between postpartum practices and PPD (Adjusted OR = 1.41, 95% CI: 1.04–1.90). A similar trend was also found between dietary postpartum practices and PPD (Adjusted OR = 1.39, 95%CI: 1.03–1.88) but not for non-dietary practices and PPD (Adjusted OR = 1.26, 95%CI: 0.92–1.75). A PPD-related dietary pattern was identified with the characteristics of a high intake of meat and eggs and a lower intake of vegetables, mushrooms, and nuts. This dietary pattern was significantly associated with a higher chance of adhering to postpartum practice (Adjusted OR = 1.26, 95% CI: 1.10–1.44). Based on the pathway analysis, this study also observed the association between postpartum practices and PPD, and the association between dietary practices and PPD were both mediated by sleep quality. In conclusion, this study demonstrated that a substantial proportion of women in modern China experience traditional postpartum Chinese practices and that either overall or dietary-related postpartum practices are associated with a higher risk of PPD. The current dietary practices in postpartum rituals may play an important role in developing PPD. A culturally embedded, science-based dietary guideline is required to help women to achieve both physical and psychological health in the postpartum period.
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Nguyen VVT, Zheng MY, Liu SM, Kallen MA, Kay K, Ivey SL. Prevalence of Traditional Asian Postpartum Practices at a Federally Qualified Health Center. J Immigr Minor Health 2021; 24:1251-1260. [PMID: 34905140 PMCID: PMC8669035 DOI: 10.1007/s10903-021-01299-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 11/29/2022]
Abstract
To evaluate the knowledge of, participation in, attitudes towards, and experiences with "doing the month" (DTM), a traditional Chinese and Vietnamese postpartum practice, at a federally qualified health center that serves predominantly Asian immigrants. DTM practices revolve around the balance between yin and yang and include practices such as the mother remaining on bed rest for as long as possible, restricting diet to certain foods, and avoiding visitors and social activities. A cross-sectional survey in Chinese, Vietnamese, and English was developed to determine the prevalence of women who have heard of and participated in DTM. 154 respondents participated. The mean age of respondents was 40.1 years. Without prompting of what DTM was, 58 (37.7%) responded that they had heard of DTM. After an explanatory paragraph, this increased to 117 (76.6%) participants. Out of 107 patients who have children, 65 (60.7%) "did the month" after giving birth. Participation rates were highest for women who identified as Chinese or Vietnamese. Likert-type scale questions showed that respondents believed DTM was stressful but enjoyable and helpful for recovery from childbirth. In conclusion, DTM is a common practice that health providers should be aware of.
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Affiliation(s)
| | | | - Stephanie M Liu
- The Permanente Medical Group, Inc., 1800 Harrison Street, Oakland, CA, 94609, USA
| | - Michael A Kallen
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA.,, Missouri City, USA
| | - Kerry Kay
- Asian Health Services, Oakland, CA, 94607, USA.,, Oakland, USA
| | - Susan L Ivey
- UC Berkeley-UCSF Joint Medical Program, School of Public Health, University of California, 570 University Hall #1190, Berkeley, CA, 94720, USA
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Qin Y, Chen Y, Zhang Z, Huang S, Jiao C, Zhang Z, Mao L. Associations of dietary inflammatory potential with postpartum weight change and retention: Results from a cohort study. Obesity (Silver Spring) 2021; 29:1689-1699. [PMID: 34490743 DOI: 10.1002/oby.23238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 05/11/2021] [Accepted: 05/19/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVE This study examined the associations of Dietary Inflammatory Index (DII) with weight outcomes within 1 year post partum. METHODS This analysis included women who participated in a cohort study in South China (n = 468). The assessments included maternal height, weight, and dietary intake. The latter variable was based on three consecutive 24-hour food records collected at 2 weeks and 1 year after childbirth and was used to calculate the energy-adjusted DII (EDII) scores during and after puerperium, respectively. A general linear regression was performed to examine the relationships between the EDII scores and postpartum weight outcomes after adjusting for confounders. RESULTS In an analysis adjusted for confounders, the EDII during puerperium was positively associated with the weight change from 3 to 42 days (β: 0.42, 95% CI: 0.11-0.70). The EDII after puerperium was positively correlated with the weight changes from 42 days to 1 year (β: 0.52, 95% CI: 0.02-1.02) and from 3 days to 1 year (β: 0.63, 95% CI: 0.13-1.14), as well as with the postpartum weight retention at 1 year after childbirth (β: 0.75, 95% CI: 0.29-1.22). CONCLUSIONS The results indicate that a diet with a high EDII score might minimize postpartum weight loss and promote higher postpartum weight retention.
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Affiliation(s)
- Yuting Qin
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China
| | - Ying Chen
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China
| | - Zhiwei Zhang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China
| | - Shaoming Huang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China
| | - Changya Jiao
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China
| | - Zheqing Zhang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China
| | - Limei Mao
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China
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Vo T. Southeast and East Asian immigrant women's transnational postpartum experiences: A meta-ethnography. J Clin Nurs 2021; 32:1556-1568. [PMID: 34514659 DOI: 10.1111/jocn.16037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2021] [Indexed: 01/01/2023]
Abstract
The increase in births to Southeast and East Asian (SEEA) immigrants in their adopted countries is of international importance. SEEA women experience the postpartum period differently than that of the general population. Despite the documented difference, there is limited representation of SEEA women in the literature. The purpose of this meta-ethnography is to synthesise the qualitative findings from different research studies examining the experiences of SEEA immigrant women during the first 4-6 weeks of the postpartum period and has been written in adherence with enhancing transparency in reporting the synthesis of qualitative research (PRISMA). Noblit and Hare's meta-ethnographic approach was used. Seven articles (four qualitative and three mixed-methods studies) were reviewed, analysed and synthesised. Four themes emerged: two were facilitators of birth culture (availability and quality of social support and maternity care provider cultural knowledge and response) and two were barriers to birth culture (lack of structural and social support and cultural alienation after childbirth). Due to lack of structural and social support in SEEA immigrant women's adopted countries, they also experienced social and economic hardships after childbirth and made conscious decisions to modify their postpartum cultural practices out of convenience and practicality. SEEA immigrant women also experienced discrimination from maternity care providers, which prevented them from fully engaging in postpartum cultural practices. Maternity care providers can advocate and intervene for SEEA immigrant women by eliciting any postpartum cultural beliefs, assess their social and economic needs early on in prenatal care and make culturally congruent referrals based on those assessments.
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Affiliation(s)
- Timothea Vo
- School of Nursing, University of Connecticut, Storrs, Connecticut, USA
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30
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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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31
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Li Q, Xue W, Gong W, Quan X, Li Q, Xiao L, Xu DR, Caine ED, Poleshuck EL. Experiences and perceptions of perinatal depression among new immigrant Chinese parents: a qualitative study. BMC Health Serv Res 2021; 21:739. [PMID: 34311719 PMCID: PMC8311906 DOI: 10.1186/s12913-021-06752-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 06/24/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Immigrant status, acculturation level, race and ethnicity have been found to contribute to the utilization of mental health services in the perinatal period. This study explored perinatal experiences and perceptions among Chinese immigrant mothers and their spouses, as well as the possible barriers and facilitators that affect their health care utilization. METHODS We recruited 13 women ages 18-35 years born in mainland China, living in Rochester, New York, and residing less than 5 years in the United States. Participants primary language was Mandarin Chinese and all had given birth to at least one live infant within the past 7 years. Participants' age was at least 18 years old at the time of delivery. Five spouses also participated. We divided women in two focus groups and held one focus group for men, with data collection including demographic questionnaires and semi-structured focus group questions conducted in December 2014. Data were analyzed following thematic analysis. RESULTS Four themes emerged: experiences of perinatal depression; perceptions of perinatal depression; general preventive and coping strategies; and attitudes toward the supportive use social media applications (apps) and text messaging during the perinatal period. Participants had limited knowledge of perinatal depression and had difficulty distinguishing between normal perinatal mood fluctuations and more severe symptoms of depression. They discussed immigrant-related stress, conflicts with parents/in-laws while "doing the month", the perceived gap between the ideal of "perfect moms" and reality, and challenges with parenting as the causes of perinatal depression. Women approved of screening for the condition but were conservative about follow-up interventions. As for the management of perinatal depression, participants preferred to deal with the problem within the family before seeking external help, due to potential stigma as well as Chinese traditional culture. They were receptive to obtaining pertinent health information from anonymous social media apps, preferring these to personal text messages. CONCLUSION The recent immigrant Chinese parents to the United States in the study had limited knowledge of perinatal depression and did not make full use of mental health services for support due to language and cultural barriers. Screening for perinatal depression is only the first step. Future research should explore what interventions may serve as an acceptable approach to overcoming these gaps.
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Affiliation(s)
- Qiao Li
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Wenqing Xue
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Wenjie Gong
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China.
- Department of Psychiatry, University of Rochester, Rochester, NY, 14642, USA.
- Institute and of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK.
| | - Xin Quan
- Department of Family Therapy, Nova Southeastern University, Fort Lauderdale, USA
| | - Quanlei Li
- School of Nursing, Johns Hopkins University, Baltimore, USA
| | - Lina Xiao
- East China Institute of Social Development, East China University of Science and Technology, Shanghai, China
| | - Dong Roman Xu
- ACACIA Lab for Health Systems Strengthening, Institute for Global Health and School of Health Management, Southern Medical University, Guangzhou, China
| | - Eric D Caine
- Department of Psychiatry, University of Rochester, Rochester, NY, 14642, USA
| | - Ellen L Poleshuck
- Departments of Psychiatry and Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, 14642, USA
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Huang Y, Liu Y, Wang Y, Liu D. Family function fully mediates the relationship between social support and perinatal depression in rural Southwest China. BMC Psychiatry 2021; 21:151. [PMID: 33711987 PMCID: PMC7953569 DOI: 10.1186/s12888-021-03155-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 03/08/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Perinatal depression is the most common complication of gestation and childbearing affecting women and their families, and good social support and family function are considered protective and modifiable factors. This study aimed to investigate depression status and explore inter-relationships between social support and perinatal depression considering the influence of family function in rural areas of Southwest China. METHODS This is a cross-sectional study. The following instruments were used: the Edinburgh Postpartum Depression Scale, the APGAR Family Care Index Scale, and the Social Support Rate Scale. A structural equation modelling was used to test the hypothesis relationships among the variables. RESULTS A total of 490 rural antenatal (N = 249) and postpartum (N = 241) women (mean age (standard deviation), 28.17 ± 5.12) participated. We found that the prevalence of depression symptoms was 10.4%. Path analysis showed that family function had a direct negative correlation with depression (β = - 0.251, 95%CI: - 0.382 to - 0.118). Social support had a direct positive correlation with family function (β =0.293, 95%CI: 0.147 to 0.434) and had an indirect negative correlation with depression (β = - 0.074, 95%CI: - 0.139 to - 0.032), family function fully mediated the relationship between social support and depression. CONCLUSIONS Findings of this study highlight that family function should be considered as the key target for interventions aiming to lower the prevalence of perinatal depression. Family members interventions are critical to reduce depression among antenatal and postpartum women.
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Affiliation(s)
- Yilin Huang
- grid.13291.380000 0001 0807 1581West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041 China
| | - Yan Liu
- grid.13291.380000 0001 0807 1581West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041 China
| | - Yu Wang
- grid.506261.60000 0001 0706 7839Department of Radiation Oncology, National Cancer Center and Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Danping Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China.
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Peng S, Lai X, Du Y, Meng L, Gan Y, Zhang X. Prevalence and risk factors of postpartum depression in China: A hospital-based cross-sectional study. J Affect Disord 2021; 282:1096-1100. [PMID: 33601683 DOI: 10.1016/j.jad.2021.01.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/03/2021] [Accepted: 01/07/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Postpartum depression (PPD) is a major public health problem worldwide, which adversely affects maternal and infant health. The purpose of this study was to determine the prevalence and related factors of postpartum depression in Chinese puerperium women. METHODS A cross-sectional study was conducted in Baoan Maternal and Child Health Hospital located in the west of Shenzhen, China. The Chinese version of the Edinburgh Postpartum Depression Scale (EPDS) was used to screen PPD. A score of ≥10 was used as the threshold of postpartum depression. RESULTS A total of 4813 puerperal women were included in this study, 11.5% of whom were considered to have PPD. Multivariate logistic regression analysis found that family history of mental illness (OR = 1.94; 95% CI, 1.05-3.57; P = 0.033), living with parents-in-law (OR = 1.41; 95% CI, 1.16-1.72; P < 0.001), anxiety during pregnancy (OR = 3.66; 95% CI, 2.97-4. 52; P < 0.001), depression during pregnancy (OR = 4.25; 95% CI, 3.28-5.50; P < 0.001), and stressful life events (OR = 1.50; 95% CI, 1.03-2.20; P = 0.036) were associated with the high prevalence of PPD. LIMITATIONS The cross-sectional survey cannot assess direct causality. EPDS is just a screening tool and not a diagnostic one. CONCLUSION Postpartum depression is a common disease in Chinese puerperal population. High-risk pregnant women with postpartum depression need routine screening and targeted intervention for PPD.
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Affiliation(s)
- Songxu Peng
- Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha 410078, China
| | - Xin Lai
- Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha 410078, China
| | - Yukai Du
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Liping Meng
- Department of Public Health, Baoan Maternal and Child Health Hospital, Jinan University, 21 Yu'an second Road, Baoan District, Shenzhen, 518101, China.
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan 430030, China.
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing 100101, China.
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Chao J, Ko CY, Lin CY, Tomoji M, Huang CH, Chiang HC, Yang JJ, Huang SS, Su SY. Ethnobotanical Survey of Natural Galactagogues Prescribed in Traditional Chinese Medicine Pharmacies in Taiwan. Front Pharmacol 2021; 11:625869. [PMID: 33679390 PMCID: PMC7928277 DOI: 10.3389/fphar.2020.625869] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 12/23/2020] [Indexed: 01/14/2023] Open
Abstract
Natural medicinal materials have been used to promote breast milk secretion. Here, we investigated the natural medicinal materials prescribed in traditional Chinese medicine (TCM) pharmacies across Taiwan to induce lactation. We collected medicinal materials from 87 TCM pharmacies, identified them in the prescriptions, and analyzed their drug contents. We examined their botanical origins, biological classifications, traditional usage, and modern pharmacological properties. We used the TCM Inheritance Support System to identify core medicinal materials in galactogenous prescriptions. We collected 81 medicinal materials from 90 galactogenous prescriptions. Leguminosae accounted for 12%, whereas Apiaceae accounted for 7% of all materials examined. The primary medicinal plant parts used were roots and seeds. Nineteen frequently used medicinal materials had a relative frequency of citation of greater than or equal to 0.2. According to their efficacy, 58% were warm, 54% were sweet, and 63% were tonifying; 74% of the frequently used medicinal materials have been showed efficacy against breast cancer. The primary core medicinal material was Angelica sinensis (Oliv.) Diels, whereas the secondary core medicinal materials were Tetrapanax papyrifer (Hook.) K. Koch and Hedysarum polybotrys Hand.-Mazz. Most galactogenous prescriptions consisted of multiple materials from Leguminosae and Apiaceae. The mechanisms underlying galactogenous efficacy warrant further investigations.
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Affiliation(s)
- Jung Chao
- Department of Chinese Pharmaceutical Sciences and Chinese Medicine Resources, Chinese Medicine Research Center, China Medical University, Taichung, Taiwan
| | - Chien-Yu Ko
- School of Pharmacy, China Medical University, Taichung, Taiwan
| | - Chin-Yu Lin
- Institute of New Drug Development, China Medical University, Taichung, Taiwan.,Tsuzuki Institute for Traditional Medicine, China Medical University, Taichung, Taiwan
| | - Maeda Tomoji
- Department of Pharmaceutical Sciences, Nihon Pharmaceutical University, Saitama, Japan.,Tsuzuki Institute for Traditional Medicine, China Medical University, Taichung, Taiwan
| | | | - Hung-Che Chiang
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Jeng-Jer Yang
- Department of Pharmacy, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Shyh-Shyun Huang
- School of Pharmacy, China Medical University, Taichung, Taiwan.,Department of Food Nutrition and Health Biotechnology, Asia University, Taichung, Taiwan
| | - Shan-Yu Su
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.,School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
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Vo T, Desai M. Immigrant Southeast and East Asian mothers’ transnational postpartum cultural practices: A meta-ethnography. WOMEN'S HEALTH 2021; 17:17455065211060640. [PMID: 34798791 PMCID: PMC8606925 DOI: 10.1177/17455065211060640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: Southeast and East Asian mothers experience the postpartum period differently than that of the general population. Despite the documented difference, there is limited representation of postpartum cultural practices in nursing and midwifery research. The purpose of this meta-ethnography is to synthesize qualitative findings from studies that examined postpartum cultural practices of Southeast and East Asian mothers globally to ensure better maternal health outcomes. Methods: Noblit and Hare’s seven-step meta-ethnographic approach was used. We analyzed constructs, concepts, themes, and metaphors using Krippendorff’s content analysis. The guidelines for preferred reporting the synthesis of qualitative research were adhered to enhancing transparency (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Results: The collaborative search process in the following databases, PsycINFO, CINAHL, and Scopus, resulted in eight high quality research studies published between January 2017 and February 2020. Five studies discussed postpartum traditions of immigrant mothers (n = 67) living in North America (n = 67), while three studies explored that of mothers living in Southeast and East Asian. Mothers (n = 132) from China, Hong Kong, Taiwan, Korea, Vietnam, and Hmong participated. Findings: Three themes emerged: (1) importance of maintaining postpartum cultural practices; (2) barriers of “doing-the-month”; and (3) modification: practicality over tradition. Although participants recognized value in postpartum traditions, the lack of social support deterred more immigrant than non-immigrant Southeast and East Asian mothers from “doing-the-month.” Due to the influence of western medicine, clinicians’ postpartum care suggestions, and use of modern technology (e.g., Internet), Southeast and East Asian mothers had informed choices to adapt, modify, or “break with tradition.” Conclusion: Similarities and differences existed in how each Southeast and East Asian mother accepted and engaged with postpartum cultural practices, a process which aligned with one’s definition of health. Maternity care providers should further elicit Southeast and East Asian mothers’ needs based on individualized assessments beginning in prenatal care with emphasis on social support for mothers who have recently immigrated and given birth in their adopted countries.
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Affiliation(s)
- Timothea Vo
- School of Nursing, University of Connecticut, Storrs, CT, USA
| | - Manisha Desai
- Department of Sociology, University of Connecticut, Storrs, CT, USA
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Asefa F, Cummins A, Dessie Y, Foureu M, Hayen A. Midwives' and obstetricians' perspectives about pregnancy related weight management in Ethiopia: A qualitative study. PLoS One 2020; 15:e0244221. [PMID: 33332406 PMCID: PMC7746277 DOI: 10.1371/journal.pone.0244221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 12/04/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Midwives and obstetricians are key maternity care providers; they are the most trusted source of information regarding nutrition and gestational weight gain. However, their views, practices and perceived barriers to managing pregnancy related weight gain have not been studied in Ethiopia. The aim of this study was to explore midwives' and obstetricians' observations and perspectives about gestational weight gain and postpartum weight management in Ethiopia. METHODS We conducted face-to-face interviews with 11 midwives and 10 obstetricians, from January 2019 to March 2019. All interview data were transcribed verbatim. We analysed the data using thematic analysis with an inductive approach. RESULTS We identified three themes and associated subthemes. Midwives and obstetricians had limited knowledge of the optimal gestational weight gain. Almost all participants were unaware of the presence of the Institute of Medicine recommendations for optimal weight gain in pregnancy. According to the study participants, women in Ethiopia do not want to gain weight during pregnancy, but do want to gain weight after the birth. Counselling about gestational weight gain and postpartum weight management was not routinely provided for pregnant women. This is mostly because gestational weight gain counselling was not considered to be a priority by maternity care providers in Ethiopia. CONCLUSIONS The limited knowledge of and low attention to pregnancy related weight management by midwives and obstetricians in this setting needs appropriate intervention. Adapting a guideline for pregnancy weight management and integrating it into antenatal care is essential.
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Affiliation(s)
- Fekede Asefa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Allison Cummins
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Maralyn Foureu
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
- Hunter New England Health, Nursing and Midwifery Research Centre, University of Newcastle, Newcastle, NSW, Australia
| | - Andrew Hayen
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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Heesen P, Orbach-Zinger S, Grigoriadis S, Halpern S, Eidelman LA. The Effect of Analgesia and Anesthesia on Postpartum Depression. Adv Anesth 2020; 38:157-165. [PMID: 34106832 DOI: 10.1016/j.aan.2020.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Philip Heesen
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Sharon Orbach-Zinger
- Department of Anesthesia, Beilinson Hospital, Petach Tikvah, Israel; Affiliated with Saklar Medical School, Tel Aviv University
| | - Sophie Grigoriadis
- Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, FG 44, Psychiatry, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Stephen Halpern
- Department of Anesthesia, Sunnybrook Health Sciences Centre, University of Toronto, 63 Elm Ridge Drive, Toronto, Ontario M6B 1A2, Canada
| | - Leonid A Eidelman
- Department of Anesthesia, Beilinson Hospital, Petach Tikvah, Israel; Affiliated with Saklar Medical School, Tel Aviv University.
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Gong W, Jin X, Cheng KK, Caine ED, Lehman R, Xu D(R. Chinese Women's Acceptance and Uptake of Referral after Screening for Perinatal Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8686. [PMID: 33238480 PMCID: PMC7700456 DOI: 10.3390/ijerph17228686] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/15/2020] [Accepted: 11/18/2020] [Indexed: 12/21/2022]
Abstract
China recently issued a national plan on perinatal depression (PND) screening. Previous studies elsewhere suggested that uptake of referral after screening for PND is suboptimal, but little is known in China. In this cohort study including 1126 women in Hunan, we identified women at a high risk of PND using the Edinburgh Postpartum Depression Scale (EPDS) over multiple time points. We texted them and offered free consultations with a psychiatrist/psychologist. Among 248 screen-positive women, only three expressed interest and one attended the appointment. We surveyed the women about their reasons for declining referrals and preferred means of care. Of the 161 respondents, 128 (79.5%) indicated that they could cope with the condition without professional assistance and 142 (88.2%) chose their families as the preferred source of help. Only 15 (9.3%) chose professionals as their first option. Implementing a referral policy for screen-positive women would mean approximately one-third of women who gave birth in China would be eligible. Our result argues against referring all screen-positive women for professional services at this time. Interventions should instead build upon the tradition of family support in a more engaged response. These considerations are relevant for the implementation of national screening for PND in China.
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Affiliation(s)
- Wenjie Gong
- Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (W.G.); (X.J.)
- Institute and of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK; (K.K.C.); (R.L.)
- Department of Psychiatry, University of Rochester, 300 Crittenden Blvd, Rochester, NY 14642, USA;
| | - Xin Jin
- Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (W.G.); (X.J.)
| | - Kar Keung Cheng
- Institute and of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK; (K.K.C.); (R.L.)
| | - Eric D. Caine
- Department of Psychiatry, University of Rochester, 300 Crittenden Blvd, Rochester, NY 14642, USA;
| | - Richard Lehman
- Institute and of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK; (K.K.C.); (R.L.)
| | - Dong (Roman) Xu
- Global Health and Health System, ACACIA Labs and Department of Health Management, School of Health Management, Southern Medical University, 1023 South Shatai Road, Guangzhou 510515, China
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Prevalence and Associated Factors of Postpartum Anxiety and Depression Symptoms Among Women in Shanghai, China. J Affect Disord 2020; 274:848-856. [PMID: 32664024 DOI: 10.1016/j.jad.2020.05.028] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 04/02/2020] [Accepted: 05/10/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND Postpartum anxiety (PPA) and postpartum depression (PPD) are associated with immediate and long-term health risks for both mothers and babies. The purpose of this paper was to evaluate relationships between sociodemographic, perinatal variables, and PPA and PPD symptoms of parturients 6 weeks postpartum. METHODS A cross-sectional survey with 1204 women who had a healthy and term birth in a baby-friendly hospital, Shanghai, China. PPA and PPD symptoms were measured by using the Self-Rating Anxiety Scale (SAS) and the Edinburgh Postnatal Depression Scale (EPDS). RESULTS The mean score of SAS and EPDS was 40.79 ± 8.48 and 8.18 ± 5.80, respectively. The estimated prevalence of PPA and PPD symptoms was 15.2% and 23.2%, respectively. Multivariable logistic regression analysis showed that the presence of fatigue and PPD symptoms were risk factors for PPA symptoms, whereas having support from family and being satisfied with labor experience were protective factors. In terms of PPD symptoms, its risk factors included smoking before pregnancy, maternal separation from baby, fatigue, encountering difficulties in breastfeeding, and the presence of PPA symptoms. In contrast, the protective factors for PPD symptoms were having support from family and having support from colleagues or friends. LIMITATIONS Convenience sampling and voluntary participation may have led to a selection bias. CONCLUSION PPA and PPD symptoms occur commonly among parturients in Shanghai, China. The findings from this research provide a better understanding of factors associated with PPA and PPD symptoms and will help guide personalized approaches to the management of postpartum anxiety and depression.
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Su X, Zhu W, Li N, Sun J, Zhu Y, Liu T, Xia H, Dai Z, Zhang Y, Pan L, Jiang W. Adjusting DBI-2016 to dietary balance index for Chinese maternal women and assessing the association between maternal dietary quality and postpartum weight retention: A longitudinal study. PLoS One 2020; 15:e0237225. [PMID: 32817619 PMCID: PMC7444517 DOI: 10.1371/journal.pone.0237225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 07/22/2020] [Indexed: 12/12/2022] Open
Abstract
Diet is believed to play a major role in maternal recovery, postpartum weight retention (PPWR) is one of the challenges for Chinese women. However, the association between puerperal women’s diet and PPWR remained unclear and complicated in China. The study assessed the dietary quality of puerperal women using adjusted Chinese Dietary Balance Index-16 (DBI-16) and explored its associations with PPWR. Participants were enrolled in the Mother-Infant Cohort Study of China. Dietary intake and demographic characteristics were obtained by a semi-quantitative food frequency questionnaire and a self-designed questionnaire at 0–3 months postpartum. PPWR was calculated by the weight difference at 0-3months and 6-8months postpartum minus pre-pregnancy weight. Dietary quality was assessed using adjusted DBI-16. 316 puerperal women were enrolled. According to adjusted DBI-16, 84.8% of participants had an insufficient dietary intake (vegetables 84.8%, fruits 91.8%, dairy 87.3%, soybean 61.4% and aquatic foods 79.4%, respectively), 67.1% had an excessive intake (cereals 60%, meat 57.3% and eggs 64.9%, respectively), 98.4% had an imbalanced diet consumption. PPWR at 0–3, and 6–8 months were 6.0 (±5.1) kg and 5.2 (±7.7) kg, and the percentage of PPWR (≥5kg) were 63.0% and 52.8% respectively. Multivariable linear regression showed the intake of fish and shrimp at 0–3 months postpartum was negatively associated with PPWR at 6–8 months (β = -0.114, SE = 0.279, p < 0.05). The diet quality of Chinese puerperal women was unreasonable and imbalanced. Fish intake tended to be a favorable factor for postpartum weight loss.
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Affiliation(s)
- Xiao Su
- Department of Nutrition and Food Hygiene, National Health Commission Key Laboratory of Reproductive Health, Peking University School of Public Health, Beijing, China
| | - Wenli Zhu
- Department of Nutrition and Food Hygiene, National Health Commission Key Laboratory of Reproductive Health, Peking University School of Public Health, Beijing, China
| | - Niuniu Li
- Department of Nutrition and Food Hygiene, National Health Commission Key Laboratory of Reproductive Health, Peking University School of Public Health, Beijing, China
| | - Jing Sun
- Department of Nutrition and Food Hygiene, National Health Commission Key Laboratory of Reproductive Health, Peking University School of Public Health, Beijing, China
| | - Yimin Zhu
- Department of Nutrition and Food Hygiene, National Health Commission Key Laboratory of Reproductive Health, Peking University School of Public Health, Beijing, China
| | - Tan Liu
- Department of Nutrition and Food Hygiene, National Health Commission Key Laboratory of Reproductive Health, Peking University School of Public Health, Beijing, China
| | - Haoye Xia
- Department of Nutrition and Food Hygiene, National Health Commission Key Laboratory of Reproductive Health, Peking University School of Public Health, Beijing, China
| | - Zhiyong Dai
- Peking-Ausnutria Maternal and Infant Nutrition Research Center, Beijing, China
| | - Yanchun Zhang
- Peking-Ausnutria Maternal and Infant Nutrition Research Center, Beijing, China
| | - Lina Pan
- Peking-Ausnutria Maternal and Infant Nutrition Research Center, Beijing, China
| | - Wei Jiang
- Peking-Ausnutria Maternal and Infant Nutrition Research Center, Beijing, China
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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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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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Mason KA. When the Ghosts Live in the Nursery: Postpartum Depression and the Grandmother-Mother-Baby Triad in Luzhou, China. ETHOS (BERKELEY, CALIF.) 2020; 48:149-170. [PMID: 35250110 PMCID: PMC8896502 DOI: 10.1111/etho.12277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 02/03/2020] [Indexed: 06/14/2023]
Abstract
In Luzhou, China, where grandmothers often serve as primary caregivers for infants, the past and the future haunt new mothers suffering from postpartum depression. In this article, I draw upon longitudinal interviews conducted with ten families in Luzhou as part of a larger multi-sited ethnography of postpartum depression and anxiety. I argue that the grandmother-mother-baby triad model of infant care in interior urban China accentuates the pain of depressed postpartum mothers by making it difficult for them to rid their homes of the ghosts of past trauma and lost futures. Mothers resent and fear grandmothers even as they rely on them to care for their babies. Memories of trauma, perceived displacement by the grandmother as the mother figure for their babies, and lack of control over their households and children characterize postpartum mothers' experiences. Mothers primarily blame their mothers-in-law for their unhappiness even as they depend on themselves to "self-adjust."
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Sun S, Yang M, Zhang J, Zhou X, Jia G, Yu X. Family support for pregnant women with foetal abnormality requiring pregnancy termination in China. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:1020-1029. [PMID: 31919920 DOI: 10.1111/hsc.12935] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 11/28/2019] [Accepted: 12/05/2019] [Indexed: 06/10/2023]
Abstract
Family support is an important protective factor for pregnant women with a foetal abnormality and can prevent adverse psychological outcomes in this population. This study aimed to explore the importance and influencing factors of family support for pregnant women with foetal abnormalities requiring pregnancy termination and then determine the correlation between family support and women's post-traumatic stress symptoms. A mixed methods study was conducted from March 2016 to September 2017. In all, 214 participants were surveyed using self-reported questionnaires including the demographic, family and obstetric information questionnaire, the Family Adaptation Partnership Growth Affection and Resolve Index and the Impact of Event Scale-Revised to collect quantitative data. Semi-structured in-depth interviews with 28 participants were conducted to collect qualitative data. Of the pregnant women with foetal abnormalities, 35% had obstacles in family function such that family support was low. The Impact of Event Scale-Revised score was negatively associated with total score on the Family Adaptation Partnership Growth Affection and Resolve Index as well as the score for each item on this index. In terms of family support, the demographic, family and obstetric variables hierarchically entered into the regression models significantly explained 20.0%, 26.5% and 2.6% of variation, respectively. In addition, three key themes were identified based on qualitative analyses: intensified instrumental support, inadequate emotional support and insufficient informational support. The findings showed that family support plays a protective role in preventing post-traumatic stress symptoms following termination of pregnancy. At present, family support still needs to be improved, especially in emotional support and informational support. The factors influencing family support may be important to consider for improving family support.
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Affiliation(s)
- Shiwen Sun
- Department of nursing, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - Mengye Yang
- Department of Nursing, Suzhou Municipal Hospital, Suzhou, China
| | - Jieqiong Zhang
- Department of nursing, The Second Hospital of Lanzhou University, Lanzhou, China
| | - Xiaoli Zhou
- Department of Nursing, Suzhou Municipal Hospital, Suzhou, China
| | - Ge Jia
- Department of Nursing, Medical college of Shihezi University. No, Shihezi, China
| | - Xiaoyan Yu
- Department of nursing, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
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Ngai FW, Chan PS. Perception of family sense of coherence during parental transition: A qualitative study. J Health Psychol 2020; 26:2435-2449. [PMID: 32306765 DOI: 10.1177/1359105320914062] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study described the perspectives and interplay of factors affecting the family sense of coherence of Chinese couples during the perinatal period. We adopted a grounded theory approach and conducted semi-structured interviews with 36 Chinese couples during pregnancy and at 2-3 months postpartum. Four major themes emerged involving meaningfulness, comprehensibility, and manageability of new parenthood and factors affecting the family sense of coherence. The strong sense of family unity and harmony embedded in the Confucian philosophy and the collective coping, in particular the strong social support network, seemed to contribute to couple's experience of new parenthood as meaningful, comprehensible, and manageable.
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Li Q, Yang S, Xie M, Wu X, Huang L, Ruan W, Liu Y. Impact of some social and clinical factors on the development of postpartum depression in Chinese women. BMC Pregnancy Childbirth 2020; 20:226. [PMID: 32299376 PMCID: PMC7164157 DOI: 10.1186/s12884-020-02906-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 03/27/2020] [Indexed: 11/13/2022] Open
Abstract
Background Postpartum depression (PPD) is prevalent and may present major adverse impacts on mother and child health. According to previous studies, mostly from the western society, PPD may have complicated etiologies, such as genetic, social and psychological factors. The aim of this study was to explore the associations of some social and clinical factors, particularly those unique in Chinese, with significant PPD symptoms. Methods A sample of 556 pregnant women in their 36th to 40th gestational week were randomly recruited in a cross-sectional study using a self-reported questionnaire, which collected maternal sociodemographic and clinical information. During their 2nd to 4th postpartum months, 522 participants responded to our screening of significant PPD symptoms, based on a score of Edinburgh Postnatal Depression Scale ≥9. Results A total of 90 (17.3%) participants were identified with significant PPD symptoms, and the following factors were observed more frequently in women with significant PPD symptoms (PPD+) than with fewer symptoms (PPD−): intensive involvement of parents-in-law in a participant’s life (living together with her, taking care of her, or discriminating against a female baby), lack of support from husband, cesarean delivery, and breast milk insufficiency (supplemented with formula). After multiple logistic regression analysis, parents-in-law’s preference to baby boy while devaluing baby girl, dissatisfaction with husband’s support, cesarean delivery, and mixed feeding were strongly associated with significant PPD symptoms. Conclusion The potential risk factors for significant PPD symptoms, i.e., “son preference” custom, cesarean delivery and mixed feeding, deserve confirmation in continued, especially clinical diagnosis-based longitudinal studies.
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Affiliation(s)
- Qing Li
- Department of Dietetics, Nanfang Hospital, Southern Medical University, 1838 N. Guangzhou Avenue, Guangzhou, 510515, China
| | - Shunyu Yang
- Department of Dietetics, Nanfang Hospital, Southern Medical University, 1838 N. Guangzhou Avenue, Guangzhou, 510515, China
| | - Ming Xie
- Department of Dietetics, Nanfang Hospital, Southern Medical University, 1838 N. Guangzhou Avenue, Guangzhou, 510515, China
| | - Xiaoming Wu
- Department of Dietetics, Nanfang Hospital, Southern Medical University, 1838 N. Guangzhou Avenue, Guangzhou, 510515, China
| | - Liping Huang
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, 1838 N. Guangzhou Avenue, Guangzhou, 510515, China.
| | - Weiqing Ruan
- Department of Health Management, Nanfang Hospital, Southern Medical University, 1838 N. Guangzhou Avenue, Guangzhou, 510515, China.
| | - Yungang Liu
- School of Public Health, Southern Medical University, 1023 S. Shatai Road, Guangzhou, 510515, China.
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Zhou Q, Zhang L, Lee SK, Chen C, Hu XJ, Liu C, Cao Y. A Quality Improvement Initiative to Increase Mother's Own Milk Use in a Chinese Neonatal Intensive Care Unit. Breastfeed Med 2020; 15:261-267. [PMID: 32129666 DOI: 10.1089/bfm.2019.0290] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background: To evaluate the efficacy of a multidisciplinary quality improvement intervention to promote mother's own milk feeding and reduce necrotizing enterocolitis (NEC) in very low-birth-weight infants. Materials and Methods: We conducted a pre (January 2014 to March 2015)-post (April 2015 to June 2016), nonrandomized, interventional cohort study of infants born at <1,500 g birth weight and admitted to the Fudan University Children's Hospital level III neonatal intensive care unit in Shanghai. The intervention included establishing a breast milk promotion team and breast milk pumping room, educating staff and parents, and distributing teaching materials. The primary outcome was breast milk feeding rate. Secondary outcomes included incidences of NEC, NEC needing surgery, mortality, and time to full enteral feeds. Results: A total of 488 infants (210 baseline, 278 intervention) <1,500 g were enrolled. The intervention group had significantly increased feeding rates for any mother's milk (34.76% vs. 80.58%; p < 0.01) and high-volume mother's milk (≥50% of feeds; 22.86% vs. 61.15%; p < 0.01), and decreased incidence of NEC needing surgery (7.62% vs. 3.24%; adjusted odds ratio [OR] 0.32, 95% confidence interval [CI] 0.14-0.76). There were no significant differences in rates of mortality (0.5% vs. 1.49%; adjusted OR 2.10, 95% CI 0.22-19.6), NEC (10.00% vs. 7.55%; adjusted OR 0.59, 95% CI 0.31-1.14), and time to full enteral feeds (20.18 ± 1.67 days vs. 24.15 ± 1.65 days; adjusted OR = 1.09, 95% CI 0.99-1.21). Conclusions: Our quality improvement initiative increased the consumption of mother's own milk and reduced the severity of NEC in very low-birth-weight infants.
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Affiliation(s)
- Qi Zhou
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Lan Zhang
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Shoo K Lee
- Department of Paediatrics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Obstetrics and Gynecology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Paediatrics, Maternal-Infant Care Research Centre, Sinai Health System, Toronto, Ontario, Canada
| | - Chao Chen
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Xiao-Jing Hu
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Chan Liu
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Yun Cao
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
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48
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Zhou Q, Younger KM, Cassidy TM, Wang W, Kearney JM. Breastfeeding practices 2008-2009 among Chinese mothers living in Ireland: a mixed methods study. BMC Pregnancy Childbirth 2020; 20:51. [PMID: 31973693 PMCID: PMC6979383 DOI: 10.1186/s12884-019-2713-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Accepted: 12/30/2019] [Indexed: 11/10/2022] Open
Abstract
Background Migration to another country has a potential influence on breastfeeding practices. A significant difference in breastfeeding rates between Irish nationals and non-nationals has been reported. This study was conducted to explore breastfeeding practices of the Chinese in Ireland, one of the largest Irish ethnic groups, and to explore the influence of living in Ireland on breastfeeding practices. This is the first and the only migration study so far on breastfeeding practices among the Chinese in Ireland. Methods A sequential explanatory mixed methods approach was adopted. The first phase was a cross-sectional self-administered retrospective mailed survey, to explore breastfeeding practices and determinants of breastfeeding among a convenience sample of Chinese mothers living in Ireland (n = 322). Recruitment was conducted in the Dublin metropolitan area, with the application of the snowball technique to increase sample size. The second phase consisted of seven semi-structured focus groups (n = 33) conducted in Dublin, to explore the influence of living in Ireland on breastfeeding among Chinese mothers who had given birth in Ireland. Quantitative data were analyzed by univariate and multivariate logistic regression analyses, and informed the qualitative data collection. Qualitative data were analyzed by thematic content analyses, to explain and enrich the qualitative results. Results The breastfeeding initiation rate among Chinese immigrants to Ireland who gave birth in Ireland (CMI) (75.6%) was high and close to that of Chinese immigrant mothers who gave birth in China (CMC) (87.2%). However, giving birth in Ireland was independently associated with a shorter duration of breastfeeding (< 4 months) among Chinese immigrants. Qualitative results explained that a shorter breastfeeding duration among CMI than that of CMC was mainly due to cultural conflicts, a lack of family support, language barriers, immigrants’ low socioeconomic status, and mothers’ preference for infant formula on the Irish market. Both quantitative and qualitative data revealed a strong cultural belief in the efficacy of the traditional Chinese postpartum diet for breast milk production for both CMC and CMI. Antenatal feeding intention was a strong determinant for breastfeeding initiation and duration among CMI. Conclusion Migration to Ireland was found to be associated with a shorter duration of breastfeeding of the Chinese. Culturally sensitive and language-specific education and support of breastfeeding is needed for the Chinese mothers living in Ireland. The mixed methods design presented here might serve as a template for future migration research on breastfeeding.
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Affiliation(s)
- Qianling Zhou
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China.
| | - Katherine M Younger
- School of Biological Sciences, Dublin Institute of Technology, Kevin Street, Dublin 8, Republic of Ireland
| | - Tanya M Cassidy
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Republic of Ireland
| | - Wenyi Wang
- Johns Hopkins University, Baltimore, USA
| | - John M Kearney
- School of Biological Sciences, Dublin Institute of Technology, Kevin Street, Dublin 8, Republic of Ireland
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Yu X, Zhang J, Yuan L. Chinese Parents' Lived Experiences of having Preterm Infants in NICU: A Qualitative Study. J Pediatr Nurs 2020; 50:e48-e54. [PMID: 31787470 DOI: 10.1016/j.pedn.2019.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 10/11/2019] [Accepted: 11/09/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE To explore Chinese parents' experiences and expectations of having preterm infants in a Chinese neonatal intensive care unit. DESIGN AND METHODS A qualitative descriptive design with semi-structured interviews was used to describe the experiences and expectations of parents of preterm infants in a neonatal intensive care unit in the central region of China. Purposive sampling was adopted to recruit parents (n = 15) of preterm infants and data were collected by face-to-face interviews from January to May 2018. Themes were identified by thematic analysis. This study followed the consolidated criteria for reporting qualitative research (COREQ). RESULTS Five themes emerged from the analysis: (1) mixed emotional experiences; (2) separation from the infants; (3) perceived incompetence in taking care of preterm infants; (4) obtained support through various sources; (5) desired more from healthcare professionals. CONCLUSIONS Parents experienced additional emotional burdens due to separation from their infants as well as a lack of an effective approach to their associated needs. While NICU staff adopted several strategies to help parents cope with their infant hospitalization, these parents still expected to receive more support from healthcare providers to meet their needs. PRACTICE IMPLICATIONS Healthcare providers should be more aware of parents' various needs in neonatal intensive care units and of their important role as constant caregivers. Hospital-based neonatal care should be specifically designed to supply positive support and necessary strategies for parents to strengthen their confidence in parenting infants.
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Affiliation(s)
- Xiaoyan Yu
- School of Health Sciences, Wuhan University, Wuhan, China; Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Zhang
- School of Health Sciences, Wuhan University, Wuhan, China.
| | - Lu Yuan
- Wuhan Medical Care Center for Women and Children, Wuhan, China
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50
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Wang Y, Liu Y, Bai J, Chen X. The Effect of Maternal Postpartum Practices on Infant Gut Microbiota: A Chinese Cohort Study. Microorganisms 2019; 7:E511. [PMID: 31671639 PMCID: PMC6920906 DOI: 10.3390/microorganisms7110511] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 10/25/2019] [Accepted: 10/28/2019] [Indexed: 12/12/2022] Open
Abstract
(1) Background: The human gut microbiota at early life is shaped by numerous factors, especially factors from mothers, which have huge influence on infants' gut microbiotas. The aim of this study was to investigate the effect of maternal adherence to Chinese traditional postpartum practices of "doing the month" on the development of infant gut microbiota at 6-month postpartum. (2) Methods: A cohort of 62 Chinese women at late pregnancy was recruited from a tertiary general hospital in a central region of China. The participants and their babies were followed up to 6 months postpartum. Finally, 50 mother-infant dyads were enrolled in the study. Women's adherence to the traditional postpartum practices was measured by adherence to doing the month practices (ADP). Infant fecal samples were collected at six months of age and were analyzed using 16S rRNA V3 and V4 gene region sequences. (3) Results: Ruminococcus gnavus was significantly less abundant in infants whose mothers had a better adherence to the traditional postpartum practices of "doing the month." Infants receiving Clostridium-butyricum during the first month after delivery had a significant dominance of Escherichia/Shigella. (4) Conclusions: Adherence to the traditional postpartum practices of "doing the month" can impact an infant's gut microbiota at 6 months of age. Infants receiving probiotics during the first month after delivery had a significant dominance of opportunistic pathogens.
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Affiliation(s)
- Ying Wang
- Affiliation Wuhan University School of Health Sciences, Wuhan University, 169 Donghu Road, Wuhan 430071, China.
| | - Yanqun Liu
- Affiliation Wuhan University School of Health Sciences, Wuhan University, 169 Donghu Road, Wuhan 430071, China.
| | - Jinbing Bai
- Affiliation Emory University Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road, Atlanta, GA 30322, USA.
| | - Xiaoli Chen
- Affiliation Wuhan University School of Health Sciences, Wuhan University, 169 Donghu Road, Wuhan 430071, China.
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