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Almasaudi AS, Alashmali S, Zedan HS, Kutbi HA, Alharbi MD, Baattaiah BA. The associations between dairy product intake, fatigue status, and physical activity among postpartum women in Saudi Arabia: a cross-sectional study. BMC Public Health 2024; 24:2759. [PMID: 39385137 PMCID: PMC11465780 DOI: 10.1186/s12889-024-20294-2] [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: 10/17/2023] [Accepted: 10/04/2024] [Indexed: 10/11/2024] Open
Abstract
BACKGROUND Fatigue is a major issue that affects women during the postpartum period. A healthy dietary pattern and increased physical activity (PA) are commonly recommended lifestyle modifications to promote health during this time. However, little is known about the interrelationship between dairy product intake, PA level, and postpartum fatigue (PPF) among women. The aim of this study was to evaluate whether PPF is associated with dairy product intake in relation to PA level. METHODS A total of 242 women were included in this cross-sectional study. Data related to dairy product intake and PA were collected using a food frequency questionnaire and the International Physical Activity Questionnaire-Short Form, respectively. PPF was assessed using the Fatigue Severity Scale. Logistic regression models were used to examine associations between the intake of dairy products and PPF among women engaged in low, moderate, and high levels of PA while controlling for potential confounders. RESULTS Higher consumption rates of yogurt and total dairy predicted lower odds of PPF in women engaged in moderate levels of PA (aOR = 0.24 [95% CI = 0.07, 0.86] and 0.70 [95% CI = 0.53, 0.93], respectively). In women engaged in high levels of PA, lower odds of experiencing PPF were predicted by higher consumption rates of milk (aOR = 0.24 [95% CI = 0.07, 0.89]), yogurt (aOR = 0.21 [95% CI = 0.05, 0.83]), laban (aOR = 0.16 [95% CI = 0.03, 0.86]), and total dairy (aOR = 0.66 [95% CI = 0.47, 0.92]). However, no association was observed between dairy product intake and PPF in women with low levels of PA. CONCLUSIONS Higher consumption rates of dairy products were associated with lower odds for experiencing PPF, particularly for women engaged in moderate to high levels of PA. These findings support nutritional and PA promotion programs to moderate issues with PPF. However, the cross-sectional design of this study could limit the ability to infer causality between dairy intake, PA, and PPF. Further longitudinal studies are needed to establish causality and explore the mechanisms underlying these associations.
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Affiliation(s)
- Arwa S Almasaudi
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Shoug Alashmali
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Haya S Zedan
- Department of Public Health, College of Health Sciences, Saudi Electronic University, Riyadh, 13316, Saudi Arabia
| | - Hebah A Kutbi
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Mutasim D Alharbi
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, P.O. Box 80324, Jeddah, 21589, Saudi Arabia
| | - Baian A Baattaiah
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, P.O. Box 80324, Jeddah, 21589, Saudi Arabia.
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Chee CYI, Ng JQX, Liu VC, Shorey S. Strength Amidst Struggles: A Descriptive Qualitative Study of Maternal Experiences of Low Socioeconomic Status Mothers in the Third Month Postpartum. J Adv Nurs 2024. [PMID: 39253794 DOI: 10.1111/jan.16426] [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: 03/19/2024] [Revised: 07/30/2024] [Accepted: 08/09/2024] [Indexed: 09/11/2024]
Abstract
AIM To explore the experiences, expectations and needs of mothers from low socioeconomic status at 3 months postpartum. DESIGN Descriptive qualitative. METHODS Mothers aged 21 years old and above, from low socioeconomic status (monthly household income is less than Singapore Dollar [SGD] $4300), and irrespective of their parity were invited to participate in one-to-one in-depth interviews at 3 months postpartum from September 2022 to June 2023. A semistructured guide was used in the interviews, which were conducted until data saturation. A trained researcher conducted the interviews that were audio recorded, transcribed verbatim and analysed thematically. Written informed consent was obtained and voluntary participation was reinforced. RESULTS Twenty mothers participated in this study and four themes were identified: (1) difficult trade-offs; (2) help-seeking behaviours and (3) 'But if?' Concerns about Emergencies. CONCLUSION This study explored the difficult circumstances that mothers from low socioeconomic status face in their third month postpartum, and how wider societal inequalities exacerbated these circumstances. Current policies and practices need to be relooked, reframed, and reformed to address the unique needs of this community. IMPLICATIONS FOR PATIENT CARE Nurses should keep mothers' struggles in balancing employment and childcare in consideration and explore other ways of supporting the low socioeconomic status mothers such as online modes in providing patient education and peer support. IMPACT Mothers from low socioeconomic status are less likely to seek formal help from healthcare professionals, external organizations and the government. These mothers need flexible, affordable and accessible childcare options to return to work. More targeted family-oriented policies that create empowering and understanding workplaces in Singapore could help ease the stress on mothers returning to employment postpartum. Online peer support groups consisting of mothers of similar socioeconomic backgrounds could help engage and retain this hard-to-reach yet vulnerable population. REPORTING METHOD COREQ checklist. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Cornelia Yin Ing Chee
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
| | - Jamie Qiao Xin Ng
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Verity Chandelle Liu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Pouranayatihosseinabad M, Taylor M, Hawrelak J, Peterson GM, Veal F, Ling T, Williams M, Whatley M, Ahdieh K, Mirkazemi C. Maternal Antibiotic Exposure and the Risk of Developing Antenatal or Postpartum Depressive Symptoms: The Maternal Experience Study Protocol. Methods Protoc 2023; 6:98. [PMID: 37888030 PMCID: PMC10609134 DOI: 10.3390/mps6050098] [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: 08/18/2023] [Revised: 10/02/2023] [Accepted: 10/02/2023] [Indexed: 10/28/2023] Open
Abstract
Limited epidemiological evidence suggests a link between antibiotic use and developing depression. This study seeks to investigate this association in depth, using a cohort of pregnant individuals. The primary aim is to explore any association between the use of antibiotics during pregnancy and the development of antenatal depressive symptoms up to the third trimester, as well as the use of antibiotics during pregnancy and within 12 months postpartum and the development of postpartum depressive symptoms. A national prospective, observational, longitudinal cohort study has been designed to examine these relationships. A sample size of 1500 pregnant individuals has been sought for this study, assuming 10 potential predictor variables (including antibiotic use) in the final multiple logistic regression model and allowing for a 30% drop-out rate. The development of depressive symptoms is considered either a diagnosis by a medical doctor and/or a scoring 13 or higher on the Edinburgh Postnatal Depression Scale. Data will be collected during the third trimester and at 6 weeks, 6 months, and 12 months postpartum. These surveys include variables previously identified as associated with antenatal and postpartum depression (e.g., level of social support, experience of intimate partner abuse, and obstetric complications), as well as antibiotic and probiotic use. This study will provide an update on the prevalence of the symptoms of depression during pregnancy and postpartum and its associated risk factors. It will also, for the first time, comprehensively explore the potential association between antibiotic use during pregnancy and up to 12 months postpartum and the development of depressive symptoms.
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Affiliation(s)
- Mahsa Pouranayatihosseinabad
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Maggie Taylor
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Jason Hawrelak
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Gregory M. Peterson
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Felicity Veal
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Tristan Ling
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Mackenzie Williams
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Megan Whatley
- Department of Obstetrics and Gynaecology, Royal Hobart Hospital, Hobart, TAS 7000, Australia
| | - Kyan Ahdieh
- Launceston Medical Centre, Health Hub, Launceston, TAS 7250, Australia
| | - Corinne Mirkazemi
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
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Bulguroglu HI, Bulguroglu M, Gevrek PTC. Investigation of the effects of physical activity level on functionality level and quality of life in the postpartum period. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:25. [PMID: 36998096 PMCID: PMC10061954 DOI: 10.1186/s41043-023-00368-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 03/23/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND Physical activity, known to have positive effects in every period of life, may decrease due to anatomical and physiological changes and increased responsibilities in the postpartum period. This study aimed to understand how women's physical activity levels, functional levels, and quality of life are affected in the postpartum period and to emphasize the importance of physical activity levels in the postpartum period. METHODS The population of our study was planned as a cross-sectional study of postpartum women who applied to a private center. The sample consists of 101 volunteer postpartum women participating in the study. Physical activity levels; with the International Physical Activity Questionnaire (IPAQ), postpartum functional levels; with the Inventory of Functional Status After Childbirth (IFSAC), postpartum quality of life level; with Maternal Postpartum Quality of Life (MAPP-QOL) were evaluated. RESULTS It was determined that the amount of physical activity of postpartum women was 928.347 ± 281.27 MET-min/week, which means low physical activity level, and 35.64% were not physically active. The mean total score of IFSAC was 2.13 ± 0.79, and the mean total score of MAPP-QOL was 16.93 ± 6.87. It was determined that there was a positive and significant correlation (p < 0.05) between IPAQ and IFSAC (r = 0.034) and MAPP-QOL (r = 0.214). A significant difference was found when the IFSAC and MAPP-QOL scores were compared between the three groups with different physical activity levels (p < 0.05). CONCLUSIONS As a result, it was observed that the physical activity levels of women in the postpartum period were low, negatively affecting their functionality and quality of life.
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Affiliation(s)
- Halil I Bulguroglu
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara Medipol University, Ankara, Turkey.
| | - Merve Bulguroglu
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara Medipol University, Ankara, Turkey
| | - P T Cansu Gevrek
- Department of Therapy and Rehabilitation, Programme of Physiotherapy, Ankara Medipol University, Vocational School of Health Services, Ankara, Turkey
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Sultan P, Ando K, Elkhateb R, George RB, Lim G, Carvalho B, Chitneni A, Kawai R, Tulipan T, Blake L, Coker J, O’Carroll J. Assessment of Patient-Reported Outcome Measures for Maternal Postpartum Depression Using the Consensus-Based Standards for the Selection of Health Measurement Instruments Guideline: A Systematic Review. JAMA Netw Open 2022; 5:e2214885. [PMID: 35749118 PMCID: PMC9233232 DOI: 10.1001/jamanetworkopen.2022.14885] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
IMPORTANCE Maternal depression is frequently reported in the postpartum period, with an estimated prevalence of approximately 15% during the first postpartum year. Despite the high prevalence of postpartum depression, there is no consensus regarding which patient-reported outcome measure (PROM) should be used to screen for this complex, multidimensional construct. OBJECTIVE To evaluate psychometric measurement properties of existing PROMs of maternal postpartum depression using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) guideline and identify the best available patient-reported screening measure. EVIDENCE REVIEW This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. PubMed, CINAHL, Embase, and Web of Science were searched on July 1, 2019, for validated PROMs of postpartum depression, and an additional search including a hand search of references from eligible studies was conducted in June 2021. Included studies evaluated 1 or more psychometric measurement properties of the identified PROMs. A risk-of-bias assessment was performed to evaluate methods of each included study. Psychometric measurement properties of each PROM were rated according to COSMIN criteria. A modified Grading of Recommendations Assessment, Development, and Evaluation approach was used to assess the level of evidence supporting each rating, and a recommendation class (A, recommended for use; B, further research required; or C, not recommended) was given based on the overall quality of each included PROM. FINDINGS Among 10 264 postpartum recovery studies, 27 PROMs were identified. Ten PROMs (37.0%) met the inclusion criteria and were used in 43 studies (0.4%) involving 22 095 postpartum women. At least 1 psychometric measurement property was assessed for each of the 10 validated PROMs identified. Content validity was sufficient in all PROMs. The Edinburgh Postnatal Depression Scale (EPDS) demonstrated adequate content validity and a moderate level of evidence for sufficient internal consistency (with sufficient structural validity), resulting in a recommendation of class A. The other 9 PROMs evaluated received a recommendation of class B. CONCLUSIONS AND RELEVANCE The findings of this systematic review suggest that the EPDS is the best available patient-reported screening measure of maternal postpartum depression. Future studies should focus on evaluating the cross-cultural validity, reliability, and measurement error of the EPDS to improve understanding of its psychometric properties and utility.
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Affiliation(s)
- Pervez Sultan
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California
| | - Kazuo Ando
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California
| | - Rania Elkhateb
- Library, University of Arkansas for Medical Sciences, Little Rock
| | - Ronald B. George
- Department of Anesthesiology, University of California, San Francisco
| | - Grace Lim
- Department of Anesthesiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Brendan Carvalho
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California
| | - Ahish Chitneni
- Physical Medicine and Rehabilitation, NewYork–Presbyterian–Columbia and Cornell, New York, New York
| | | | - Tanya Tulipan
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lindsay Blake
- Library, University of Arkansas for Medical Sciences, Little Rock
| | - Jessica Coker
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock
| | - James O’Carroll
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California
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Ataş AN, Özerdoğan N. Perceived Sleep Quality and Fatigue in a Population of New Mothers: A Cross-Sectional Study Comparing Relationships with Breastfeeding and Bottle Feeding. Breastfeed Med 2022; 17:155-162. [PMID: 34516778 DOI: 10.1089/bfm.2021.0040] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Introduction: This study, which used a cross-sectional design, was carried out to examine the factors associated with the way mothers fed their infants such as breastfeeding or bottle feeding, and to compare perceived sleep quality and fatigue levels. Method: The study sample consisted of a total of 100 women in the 4th to 16th week postpartum, including 50 women breastfeeding and 50 women bottle feeding their infants. The data of the study were collected in Family Health Centers (FHC) through the face-to-face interview technique using "a Personal Information Form," "the Pittsburgh Sleep Quality Index-PSQI," and "the Checklist Individual Strength-CIS." Results: The mothers' total sleep quality (PSQI) score was found to not differ significantly according to the type of infant feeding. Similarly, total scores for fatigue assessment obtained from the CIS did not differ according to the infant feeding type variable. A significant positive correlation was found between total sleep quality and total fatigue level, and subjective fatigue level. Discussion: The sleep quality and fatigue levels of mothers are independent of the method of feeding their infants. Midwives should plan initiatives with parents to improve maternal sleep quality and reduce fatigue levels and inform parents that breastfeeding is not a factor that reduces sleep quality or increases fatigue. Clinical Trials.gov ID: 1129/5463.
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Affiliation(s)
- Ayşe Nur Ataş
- Faculty of Health Sciences Midwifery Department, Selcuk University, Konya, Turkey
| | - Nebahat Özerdoğan
- Faculty of Health Sciences Midwifery Department, Osmangazi University, Eskişehir, Turkey
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Badr HA, Zauszniewski JA, Quinn Griffin M, Burant CJ, Przeworski A, Almutairi WM, Alsharif FH. Effects of Postpartum Fatigue and Depressive Cognitions on Life Satisfaction and Quality of Life in Arab Postpartum Women: The Intervening Role of Resourcefulness. NURSING REPORTS 2021; 11:84-94. [PMID: 34968315 PMCID: PMC8608046 DOI: 10.3390/nursrep11010009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/13/2021] [Accepted: 01/29/2021] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study is to explore the relationships among postpartum fatigue (PPF), depressive cognitions, resourcefulness, quality of life, and life satisfaction in Arab postpartum mothers. A conceptual framework is used in this study based on the middle range theory of resourcefulness, which Zauszniewski developed in 2006. The study is a cross-sectional descriptive design with 123 postpartum women who had given birth within the past six months. used WhatsApp and Facebook for recruitment. developed the self-administered online survey in Qualtrics and collected data from 6 January 2017, to 6 February 2017. Correlation analysis is used to address the research aim and used the P value of 0.05 to determine the significance of the results. There were significant correlations among depressive cognitions and resourcefulness, life satisfaction, and quality of life; there were also significant correlations between PPF and life satisfaction, as well as among resourcefulness, quality of life, and life satisfaction. The results of this study emphasized the importance of assessing depressive symptoms and PPF in mothers early in the postpartum period. The results may contribute to designing future intervention studies aimed toward decreasing the risk of mothers with PPF developing more serious depressive symptoms.
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Affiliation(s)
- Hanan A. Badr
- Department of Maternity and Child Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Jaclene A. Zauszniewski
- Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA; (J.A.Z.); (M.Q.G.); (C.J.B.)
| | - Mary Quinn Griffin
- Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA; (J.A.Z.); (M.Q.G.); (C.J.B.)
| | - Christopher J. Burant
- Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA; (J.A.Z.); (M.Q.G.); (C.J.B.)
| | - Amy Przeworski
- Department of Psychological Sciences, College of Arts and Sciences, Case Western Reserve University, Cleveland, OH 44106, USA;
| | - Wedad M. Almutairi
- Department of Medical Surgical Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (W.M.A.); (F.H.A.)
| | - Fatmah H. Alsharif
- Department of Medical Surgical Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (W.M.A.); (F.H.A.)
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Abstract
OBJECTIVES To assess the prevalence of postpartum fatigue at 10 days, 1 month and 3 months, and to describe the sociodemographic and clinical characteristics of women with fatigue and the associations with infant characteristics, maternal-infant attachment, and partner and midwifery support. SETTING Maternity care in England. Secondary analysis of 2014 National Maternity Survey. PARTICIPANTS Participants were a random sample of 10 000 women selected by the Office for National Statistics using birth registration records. Women aged less than 16 years or if their baby had died were excluded. Questionnaires were sent to women at 3 months post partum and asked about well-being and care during pregnancy, labour, birth and post partum. Specifically, women were asked whether they experienced fatigue/severe tiredness at 10 days, 1 month or 3 months post partum. Responses were received from 4578 women (47% response rate). RESULTS Decreasing but substantial proportions of women, 38.8%, 27.1% and 11.4%, experienced fatigue/severe tiredness at 10 days, 1 month and 3 months, respectively. These figures varied significantly by maternal age, level of deprivation, education and parity. Women reporting depression, anxiety, sleep problems and those breast feeding were at significantly increased risk (eg, OR for depression in women with fatigue at 3 months: 2.99 (95% CI 2.13 to 4.21)). Significantly more negative language was used by these women to describe their babies, and they perceived their baby as more difficult than average (eg, two or more negative adjectives used by women with fatigue at 3 months: OR 1.86 (95% CI 1.36 to 2.54)). Women with postpartum fatigue had greater partner support but were significantly less likely to report seeing the midwife as much as they wanted. CONCLUSIONS Postpartum fatigue is not inevitable or universal, although early in the postnatal period it affects a substantial proportion of women. Predictors include age and parity, but practical help and support from partners and midwives may be protective factors.
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Affiliation(s)
- Jane Henderson
- NPEU, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Fiona Alderdice
- NPEU, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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9
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Wilson N, Lee JJ, Bei B. Postpartum fatigue and depression: A systematic review and meta-analysis. J Affect Disord 2019; 246:224-233. [PMID: 30584956 DOI: 10.1016/j.jad.2018.12.032] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 11/04/2018] [Accepted: 12/16/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND New parents are vulnerable to fatigue and depressive symptoms. Many studies have reported significant positive correlations between the two in postpartum parents, but the size of correlations varies considerably between studies. The relationship between postpartum fatigue and depression is yet to be systematically synthesized and meta-analyzed. METHODS A PROSPERO registered systematic review and meta-analysis (CRD42017065240) was conducted on the correlation between fatigue and depression within the first two years postpartum in parents. Moderation analysis was used to examine the influence of demographic and measurement factors on the effect sizes. RESULTS Thirty-five eligible papers were identified (34 on mothers, 1 on fathers). The meta-analytic summary effect size for simultaneously measured fatigue and depressive symptoms among women in the postpartum period was r = 0.52, 95% CI [0.45, 0.59], p < .001. There was a high degree of heterogeneity in the strength of the correlation between studies. This heterogeneity was not accounted for by demographic (e.g., infant age, maternal age, population type) or methodology (e.g., measurement) related moderators. LIMITATIONS Studies not reporting or providing correlation between fatigue and depression were not included. Unable to assess some moderators due to limited sample size. CONCLUSIONS There is a strong correlation between fatigue and depressive symptoms among women in the first two years after child-birth, but a high degree of heterogeneity in correlation strength exists between studies. Careful assessment of both fatigue and depression when either symptom is reported could facilitate accurate differential diagnosis and prioritizing treatment in postpartum women. Further implications for assessment, treatment, and future research are discussed.
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Affiliation(s)
- Nathan Wilson
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Victoria 3800, Australia
| | - Jin Joo Lee
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Victoria 3800, Australia
| | - Bei Bei
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Victoria 3800, Australia.
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10
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Blakeman JR. An integrative review of the theory of unpleasant symptoms. J Adv Nurs 2018; 75:946-961. [PMID: 30397941 DOI: 10.1111/jan.13906] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 09/07/2018] [Accepted: 10/08/2018] [Indexed: 01/04/2023]
Abstract
AIMS The aim of this study was to explore how the theory of unpleasant symptoms (TOUS) has been used in the methodological design and analysis of symptom research. DESIGN An integrative review, using Whittemore and Knafl's approach. DATA SOURCES Searches were conducted between 26 January-10 February 2018. Databases included CINAHL Complete, PubMed, Proquest Nursing and Allied Health Source, Health Source: Nursing/Academic Edition, Academic Search Complete and Google Scholar. REVIEW METHODS A systematic approach to searching, screening and analysing the literature was applied. The matrix method, content analysis, constant comparison, counting and clustering were used. RESULTS Sixty-four records were included. Most studies were quantitative, cross-sectional, instrument-based and conducted in the USA. Various symptoms and patient populations were represented and each of the TOUS concepts were explored. CONCLUSION Although the theory has a role to play in furthering symptom science, attention should be paid to the areas of the model and of symptom research that have received less attention. More complex statistical approaches and big data will help to illuminate symptom experiences. Additional focus on intervention studies and all symptom dimensions will help to advance symptom science research. IMPACT This review is the first to provide a comprehensive, systematic summary of the uses of the TOUS across the research literature to date. This theory is a diverse, holistic middle-range theory capable of being applied to multiple symptoms and populations. Researchers should consider using the theory as a conceptual framework for studies to advance symptom science and explore symptoms holistically.
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Affiliation(s)
- John R Blakeman
- Mennonite College of Nursing, Illinois State University, Normal, Illinois.,School of Nursing, Millikin University, Decatur, Illinois
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Khatun F, Lee TW, Rani E, Biswash G, Raha P, Kim S. The Relationships among Postpartum Fatigue, Depressive Mood, Self-care Agency, and Self-care Action of First-time Mothers in Bangladesh. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2018; 24:49-57. [PMID: 37684912 DOI: 10.4069/kjwhn.2018.24.1.49] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 12/20/2017] [Accepted: 12/21/2017] [Indexed: 09/10/2023] Open
Abstract
PURPOSE Postpartum fatigue can impact maternal well-being and has been associated with levels of perceived self-care. This study aimed to examine the relationship among fatigue, depressive mood, self-care agency, and self-care action among postpartum women in Bangladesh. METHODS A descriptive cross sectional survey was done with 124 first-time mothers from two tertiary hospitals in Dhaka, Bangladesh. The Modified Fatigue Symptoms checklist, Denyes' Self Care Instrument, the Edinburgh Postnatal Depression Scale, and items on sociodemographic and delivery-related characteristics, were used in Bengali via translation and back-translation process. RESULTS High fatigue levels were found in 18.5%(n=23) and 73.4% had possible depression (n=91). There was a significant negative relationship between fatigue and self-care agency (r=-.31, p < .001), and self-care action (r=-.21, p < .05). Fatigue differed by level of self-care agency (t=4.06, p < .001), self-care action (t=2.36, p=.023), newborn's APGAR score (t=-2.93, p=.004), parental preparation class participation (F=15.53, p < .001), and postpartum depressive mood (t=-4.64, p < .001). CONCLUSION Findings suggest that high level of self-care efficacy and behaviors can contribute to fatigue management, and highlight the need for practical interventions to better prepare mothers for postpartum self-care, which may, in turn, alleviate postpartum fatigue.
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Affiliation(s)
| | - Tae Wha Lee
- College of Nursing, Yonsei University, Seoul, Korea
| | - Ela Rani
- College of Nursing, Yonsei University, Seoul, Korea
| | | | - Pronita Raha
- College of Nursing, Yonsei University, Seoul, Korea
| | - Sue Kim
- College of Nursing, Yonsei University, Seoul, Korea
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Hahn-Holbrook J, Cornwell-Hinrichs T, Anaya I. Economic and Health Predictors of National Postpartum Depression Prevalence: A Systematic Review, Meta-analysis, and Meta-Regression of 291 Studies from 56 Countries. Front Psychiatry 2018; 8:248. [PMID: 29449816 PMCID: PMC5799244 DOI: 10.3389/fpsyt.2017.00248] [Citation(s) in RCA: 300] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 11/07/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Postpartum depression (PPD) poses a major global public health challenge. PPD is the most common complication associated with childbirth and exerts harmful effects on children. Although hundreds of PPD studies have been published, we lack accurate global or national PPD prevalence estimates and have no clear account of why PPD appears to vary so dramatically between nations. Accordingly, we conducted a meta-analysis to estimate the global and national prevalence of PPD and a meta-regression to identify economic, health, social, or policy factors associated with national PPD prevalence. METHODS We conducted a systematic review of all papers reporting PPD prevalence using the Edinburgh Postnatal Depression Scale. PPD prevalence and methods were extracted from each study. Random effects meta-analysis was used to estimate global and national PPD prevalence. To test for country level predictors, we drew on data from UNICEF, WHO, and the World Bank. Random effects meta-regression was used to test national predictors of PPD prevalence. FINDINGS 291 studies of 296284 women from 56 countries were identified. The global pooled prevalence of PPD was 17.7% (95% confidence interval: 16.6-18.8%), with significant heterogeneity across nations (Q = 16,823, p = 0.000, I2 = 98%), ranging from 3% (2-5%) in Singapore to 38% (35-41%) in Chile. Nations with significantly higher rates of income inequality (R2 = 41%), maternal mortality (R2 = 19%), infant mortality (R2 = 16%), or women of childbearing age working ≥40 h a week (R2 = 31%) have higher rates of PPD. Together, these factors explain 73% of the national variation in PPD prevalence. INTERPRETATION The global prevalence of PPD is greater than previously thought and varies dramatically by nation. Disparities in wealth inequality and maternal-child-health factors explain much of the national variation in PPD prevalence.
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Affiliation(s)
- Jennifer Hahn-Holbrook
- Department of Psychology, University of California, Merced, Merced, CA, United States
- Center for Excellence in Biopsychosocial Approaches to Health, Chapman University, Orange, CA, United States
| | | | - Itzel Anaya
- Department of Psychology, Palo Alto University, Palo Alto, CA, United States
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Abstract
The purpose of this pilot study was to evaluate the feasibility, acceptability, and cost of a self-management intervention for postpartum fatigue and sleep in socioeconomically disadvantaged urban women. Helping U Get Sleep (HUGS) is a theory-guided intervention developed from the Individual and Family Self-Management Theory. Medicaid-enrolled participants in the United States were recruited from an inpatient postpartum unit. Treatment and attention control interventions were delivered (15 HUGS, 12 comparison) at a week 3 postpartum home visit and 4 follow-up phone calls. Over the 9-week protocol, the HUGS group demonstrated significant improvements in subjective fatigue and subjective sleep disturbance relative to the comparison group. The HUGS intervention was feasible and acceptable, delivered on average, in 100 min and costing US$79 per participant.
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Affiliation(s)
- Jennifer J. Doering
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Sirin Dogan
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
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Abstract
PURPOSE To describe and explore patterns of postpartum sleep, fatigue, and depressive symptoms in low-income urban women. STUDY DESIGN AND METHODS In this descriptive, exploratory, nonexperimental study, participants were recruited from an inpatient postpartum unit. Subjective measures were completed by 132 participants across five time points. Objective sleep/wake patterns were measured by 72-hour wrist actigraphy at 4 and 8 weeks. Mean sample age was 25 years, high school educated with 3.1 children. Over half the sample reported an annual income less than 50% of the federal poverty level. RESULTS Objectively, total nighttime sleep was 5.5 hours (week 4) and 5.4 hours (week 8). Subjectively, 85% met criteria for "poor sleep quality" at week 4, and nearly half were persistently and severely fatigued through 8 weeks postpartum. CLINICAL IMPLICATIONS The majority (65%) of women in this study met the definition of "short sleep duration," defined as sleeping ≤ 6 hours per night. Adverse effects of this short sleep on physical and mental health as well as safety and functioning, especially within the context of poverty, may be profound. There is an urgent need for further research on sleep in low-income underrepresented women to identify interventions that can improve sleep and fatigue as well as discern the implications of sleep deprivation on the safety and physical and mental health of this population.
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Badr HA, Zauszniewski JA. Meta-analysis of the predictive factors of postpartum fatigue. Appl Nurs Res 2017; 36:122-127. [PMID: 28720232 DOI: 10.1016/j.apnr.2017.06.010] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 04/29/2017] [Accepted: 06/19/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Nearly 64% of new mothers are affected by fatigue during the postpartum period, making it the most common problem that a woman faces as she adapts to motherhood. Postpartum fatigue can lead to serious negative effects on the mother's health and the newborn's development and interfere with mother-infant interaction. The aim of this meta-analysis was to identify predictive factors of postpartum fatigue and to document the magnitude of their effects using effect sizes. METHOD We used two search engines, PubMed and Google Scholar, to identify studies that met three inclusion criteria: (a) the article was written in English, (b) the article studied the predictive factors of postpartum fatigue, and (c) the article included information about the validity and reliability of the instruments used in the research. Nine articles met these inclusion criteria. The direction and strength of correlation coefficients between predictive factors and postpartum fatigue were examined across the studies to determine their effect sizes. RESULTS Measurement of predictor variables occurred from 3days to 6months postpartum. Correlations reported between predictive factors and postpartum fatigue were as follows: small effect size (rrange=0.10 to 0.29) for education level, age, postpartum hemorrhage, infection, and child care difficulties; medium effect size (rrange=0.30 to 0.49) for physiological illness, low ferritin level, low hemoglobin level, sleeping problems, stress and anxiety, and breastfeeding problems; and large effect size (rrange=0.50+) for depression. CONCLUSION Postpartum fatigue is a common condition that can lead to serious health problems for a new mother and her newborn. Therefore, increased knowledge concerning factors that influence the onset of postpartum fatigue is needed for early identification of new mothers who may be at risk. Appropriate treatments, interventions, information, and support can then be initiated to prevent or minimize the postpartum fatigue.
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Affiliation(s)
- Hanan A Badr
- Case Western Reserve University, Frances Payne Bolton School of Nursing, 10900 Euclid Avenue, Cleveland, OH 44106-4904, USA; King Abdul Aziz University, School of Nursing, P.O. Box 80200, Jeddah 21589, Saudi Arabia.
| | - Jaclene A Zauszniewski
- Case Western Reserve University, Frances Payne Bolton School of Nursing, 2120 Cornell Road, Cleveland, OH 44106, USA.
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Doering JJ, Sims DA, Miller DD. How Postpartum Women With Depressive Symptoms Manage Sleep Disruption and Fatigue. Res Nurs Health 2017; 40:132-142. [PMID: 28084629 DOI: 10.1002/nur.21782] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2016] [Indexed: 11/11/2022]
Abstract
Postpartum sleep and fatigue have bidirectional relationships with depressive symptoms and challenge women's everyday functioning. The everyday process of managing postpartum sleep and fatigue in the context of depressive symptoms remains unexplored. We conducted a grounded theory study with a sample of 19 women who screened positive on the Postpartum Depression Screening Scale (PDSS™) Short Form at 3 weeks postpartum. Women completed semi-structured in-home interviews and the full PDSS and Modified Fatigue Symptoms Checklist at 1, 3, and 6 months postpartum. The sample was on average 27 years old, with 2.8 children, and 63% were African-American. They described a basic social process of Finding a Routine Together, during which women's experiences with their infants progressed from Retreating at month 1 toward Finding a New Normal at month 6. In their work to Find a Routine Together, mothers' patterns of change over time were continuous, gradual, or prolonged. Their progress was influenced by depressive symptoms, social support, work and daycare, stability in social circumstances, and underlying stressors. This study's findings suggest the need to allocate resources and tailor interventions to meet the needs of women who are most vulnerable to the health effects of ongoing persistent severe fatigue, disordered sleep, and sub-clinical and clinical levels of depressive symptoms. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Jennifer J Doering
- Associate Professor, College of Nursing, University of Wisconsin-Milwaukee, 1921 E. Hartford Ave., Milwaukee, WI 53211
| | - Dauphne A Sims
- Assistant Professor, St. Anthony College of Nursing, Rockford, IL
| | - Donald D Miller
- Doctoral Candidate, College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI
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Lee SE, Vincent C, Finnegan L. An Analysis and Evaluation of the Theory of Unpleasant Symptoms. ANS Adv Nurs Sci 2017; 40:E16-E39. [PMID: 27525959 DOI: 10.1097/ans.0000000000000141] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The Theory of Unpleasant Symptoms was developed to enhance understanding of relationships among multiple symptoms and symptom experiences. Although the theory has been used to guide research, no formal critique of the theory has been published since 2000. This article comprehensively analyzes and evaluates the theory using Fawcett and DeSanto-Madeya's framework. Although its semantic clarity, semantic and structural consistency, and parsimony could be improved, the theory demonstrates good social and theoretical significance, testability, and empirical and pragmatic adequacy. Understanding multiple patient symptoms is essential, and the theory demonstrates that nurses should focus on multiple rather than individual symptoms.
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Ashrafinia F, Mirmohammadali M, Rajabi H, Kazemnejad A, Sadeghniiat Haghighi K, Amelvalizadeh M. Effect of Pilates exercises on postpartum maternal fatigue. Singapore Med J 2016; 56:169-73. [PMID: 25820848 DOI: 10.11622/smedj.2015042] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Postpartum fatigue is a pervasive phenomenon and often affects mothers immediately after delivery. The present study aimed to assess the effect Pilates home exercises had on postpartum maternal fatigue. METHODS A total of 80 women participated in our clinical trial study. The women were randomly divided into two groups - the intervention group (n = 40) and the control group (n = 40). In the intervention group, the women performed Pilates exercises five times a week (30 min per session) for eight consecutive weeks. The first session was conducted 72 hours after delivery. The control group did not receive any intervention. Each woman's level of fatigue was evaluated at hospital discharge (as a baseline), and at four and eight weeks after delivery, using the standard Multidimensional Fatigue Inventory (MFI-20) questionnaire and repeated measures analysis. RESULTS During the eight weeks of follow-up, we found that the intervention group had lower mean MFI-20 scores than the control group with regard to general fatigue (7.80 ± 2.07 vs. 12.72 ± 1.79; p < 0.001), physical fatigue (7.12 ± 1.41 vs. 10.42 ± 2.02; p < 0.001), reduced activity (6.95 ± 1.35 vs. 11.27 ± 1.70; p < 0.001), reduced motivation (6.20 ± 1.01 vs. 9.80 ± 2.04; p < 0.001) and mental fatigue (6.85 ± 1.45 vs. 10.72 ± 1.98; p < 0.001). CONCLUSION The present study's findings show that physical exercise can significantly reduce postpartum maternal fatigue in all subscales.
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Affiliation(s)
- F Ashrafinia
- Department of Midwifery, School of Nursing and Midwifery, Kerman University of Medical Sciences, Haft Bagh Blvd, Keman 7616913555, Iran.
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Saidi L, Godbout P. Étude de deux indicateurs de difficulté de mise en place de l’allaitement maternel : la fatigue maternelle et le comportement non optimal du bébé au sein. Rech Soins Infirm 2016. [DOI: 10.3917/rsi.125.0032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Safadi RR, Abushaikha LA, Ahmad MM. Demographic, maternal, and infant health correlates of post-partum depression in Jordan. Nurs Health Sci 2015; 18:306-13. [DOI: 10.1111/nhs.12268] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 11/14/2015] [Accepted: 11/16/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Reema R. Safadi
- Maternal and Child Health Nursing Department; The University of Jordan; Amman Jordan
| | - Lubna A. Abushaikha
- Maternal and Child Health Nursing Department; The University of Jordan; Amman Jordan
| | - Muayyad M. Ahmad
- The University of Jordan; Clinical Nursing Department; Amman Jordan
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Norhayati MN, Hazlina NHN, Asrenee AR, Emilin WMAW. Magnitude and risk factors for postpartum symptoms: a literature review. J Affect Disord 2015; 175:34-52. [PMID: 25590764 DOI: 10.1016/j.jad.2014.12.041] [Citation(s) in RCA: 457] [Impact Index Per Article: 50.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 12/15/2014] [Accepted: 12/15/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND The prevalence of postpartum depression worldwide varies from 0.5% to 60.8% in the first 12 months postpartum using self-reported questionnaire. This review aims to update the current magnitude of postpartum depression based on self-reported questionnaire and clinical interview and explore its associated factors in developed and developing countries. METHODS A literature search conducted between 2005 and 2014 identified 203 studies, of which 191 used self-reported questionnaire in 42 countries and 21 used structured clinical interview in 15 countries. Nine studies used a combination of self-reported questionnaire and clinical interview. RESULT The prevalence of postpartum depression varies from 1.9% to 82.1% in developing countries and from 5.2% to 74.0% in developed countries using self-reported questionnaire. Structured clinical interview shows a much lower prevalence range from 0.1% in Finland to 26.3% in India. Antenatal depression and anxiety, previous psychiatric illness, poor marital relationship, stressful life events, negative attitude towards pregnancy, and lack of social support are significant contributors to postpartum depression. LIMITATION All studies are included irrespective of the methodological quality, such as small sample size and their inclusion could affect the generalizability of the results. CONCLUSION The current prevalence of postpartum depression is much higher than that previously reported, and similar risk factors are documented. A culturally sensitive cut-off score with adequate psychometric properties of the screening instruments should be available. In future studies, examining the physical, biological, and cultural factors in qualitative studies and in those with adequate methodological qualities is recommended.
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Affiliation(s)
- M N Norhayati
- Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, 16150 Kota Bharu, Kelantan, Malaysia.
| | - N H Nik Hazlina
- Women Health Development Unit, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia
| | - A R Asrenee
- Department of Psychiatry, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia
| | - W M A Wan Emilin
- Perpustakaan Hamdan Tahir, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia
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Razurel C, Kaiser B, Dupuis M, Antonietti JP, Sellenet C, Epiney M. Validation of the postnatal perceived stress inventory in a French speaking population of primiparous women. J Obstet Gynecol Neonatal Nurs 2013; 42:685-96. [PMID: 24128144 DOI: 10.1111/1552-6909.12251] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To develop a Postnatal Perceived Stress Inventory (PNPSI) and assess its psychometric properties. DESIGN Cross-sectional quantitative study. SETTING One nurse-managed labor and delivery unit in a university hospital in a major metropolitan area. PARTICIPANTS One hundred seventy-nine (179) primiparous French speaking women who gave birth at term. METHODS The PNPSI was validated at 6 weeks postpartum. Its predictive validity for depression and anxiety was assessed at the same time. RESULTS The exploratory analysis revealed a 19-item structure divided into six factors. This inventory has good internal consistency (Cronbach's alpha = .815). The predictive validity shows that the PNPSI significantly predicts depression and anxiety at 6 weeks postpartum, and that certain factors are particularly prominent. CONCLUSION The PNPSI's psychometric properties make it a useful tool for future research to evaluate interventions for perceived stress during the postnatal period. Its predictive power for depression indicates that it is also a promising tool for clinical settings.
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Ronzio CR, Huntley E, Monaghan M. Postpartum mothers' napping and improved cognitive growth fostering of infants: results from a pilot study. Behav Sleep Med 2013; 11:120-32. [PMID: 23137338 DOI: 10.1080/15402002.2011.642487] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Little is known about how maternal sleep disturbances in the postpartum period affect mother-infant interaction. The study was designed to assess if less maternal sleep disturbance and less fatigue were associated with more positive mother-child interaction, independent of maternal depression symptoms. Twenty-three mothers completed 1 week of actigraphy and self-report measures of fatigue and depression symptoms. To determine the quality of mother-infant interaction, mothers and infants were then observed in a structured, video-recorded teaching episode. Greater maternal napping frequency was associated with better cognitive growth fostering of the infant (r s = .44, p < .05), a subscale of the interaction assessment. Maternal napping, not the quality or quantity of nocturnal sleep, appears to be associated with improvements in mother-infant interactions.
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Affiliation(s)
- Cynthia R Ronzio
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Medical Center, Washington, DC 20010, USA.
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Doering J. Theoretical contributions to a program of research promoting postpartum health. Appl Nurs Res 2013; 26:96-8. [PMID: 23290532 DOI: 10.1016/j.apnr.2012.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Accepted: 11/07/2012] [Indexed: 11/29/2022]
Abstract
There is a need for interventions that address postpartum fatigue and sleep problems. Of the women who experience this, few receive the needed nursing care during the weeks after childbirth when severe postpartum fatigue and poor sleep are most prevalent. These health problems are significant not only for the well-being of the new mother, but for her infant and other family members. This article outlines four steps in applying theory in research, using a "top-down and bottom-up" approach to develop a nursing intervention for self-management of postpartum fatigue and sleep.
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Affiliation(s)
- Jennifer Doering
- University of Wisconsin - Milwaukee, College of Nursing, Milwaukee, WI 53211, USA.
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Kuo SY, Yang YL, Kuo PC, Tseng CM, Tzeng YL. Trajectories of depressive symptoms and fatigue among postpartum women. J Obstet Gynecol Neonatal Nurs 2012; 41:216-226. [PMID: 22375929 DOI: 10.1111/j.1552-6909.2011.01331.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To identify and characterize the trajectories of depressive and fatigue symptoms and determine the relationship between these two trajectories and associated predictors. DESIGN A prospective, follow-up study. SETTING A teaching medical center in central Taiwan. PARTICIPANTS A convenience sample of 121 low-risk, childbearing women. METHODS Depressive and fatigue symptoms were assessed using the Edinburgh Postnatal Depression Scale and Fatigue Continuum Form respectively during the third trimester (time 1), one day postpartum (time 2), three days postpartum (time 3), and one week postpartum (time 4). Participants also completed structured questionnaires on demographic features, health status, and sleep quality. RESULTS The mean age of participants was 31.2 years. We observed four distinctive trajectories of depressive symptoms and three trajectories of fatigue using group-based trajectory modeling. A frequent conoccurrence of similar levels of these symptoms was found; that is, mothers in the high-risk depressive symptoms group were most likely to fall into the high-risk group for fatigue. Joint trajectories were predicted by poor sleep score (odds ratio = 2.96, 95% confidence interval = 1.2, 7.3) using multinomial logistic regression analysis. CONCLUSION Overlapping but distinct trajectories of depressive symptoms and fatigue were found. These results suggest that differentiation between depressive symptoms and fatigue is possible and important for improving care during the early postpartum period.
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Affiliation(s)
- Shu-Yu Kuo
- Department of Nursing, Ching Kuo Institute of Management and Health, Keelung, Taiwan, R.O.C
| | - Ya-Ling Yang
- School of Nursing, College of Medicine, National Taiwan University and an adjunct supervisor in the Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan, R.O.C
| | - Pi-Chao Kuo
- College of Nursing, Chung Shan Medical University and a research advisor in the Nursing Department, Chung Shan Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Chi-Meng Tseng
- Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
| | - Ya-Ling Tzeng
- School of Nursing, China Medical University and an adjunct supervisor in the Department of Nursing, China Medical University Hospital, Taichung, Taiwan, R.O.C..
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