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Ji C, Zhao J, Nie Q, Wang S. The role and outcomes of music therapy during pregnancy: a systematic review of randomized controlled trials. J Psychosom Obstet Gynaecol 2024; 45:2291635. [PMID: 38146963 DOI: 10.1080/0167482x.2023.2291635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/01/2023] [Indexed: 12/27/2023] Open
Abstract
INTRODUCTION The abundant functions of music and its effects on human's mental and physical health have been verified since ancient times, but rarely received attention as an alternative obstetric intervention. OBJECTIVE This study aims to investigate the benefits of music therapy on prenatal and delivery experiences of pregnant women. METHOD A systematic search for articles was conducted in electronic databases including CINAHL, Web of Science, PubMed/Medline, and CNKI. A total of 240 articles were identified, and 17 studies were selected for this review. The extracted data included author, year, location, sample size, intervention phase, type of music, music therapy strategy, measuring instruments, and results. The data were organized chronologically based on the publication year of each study. RESULT The articles indicated that music therapy has advantages in reducing pain during childbirth, lowering anxiety and stress levels in mothers, improving sleep quality, and increasing fetal movements, basal fetal heart rate, and accelerations. CONCLUSION Based on the findings, it can be concluded that music therapy is an effective approach to enhance the experience of pregnant women during pregnancy and delivery. Therefore, its implementation in obstetrical clinical practice is highly recommended.
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Affiliation(s)
- Chao Ji
- Department of Obstetrics, Qingdao Municipal Hospital, Qingdao, China
| | - Jing Zhao
- Department of Obstetrics, Qingdao Municipal Hospital, Qingdao, China
| | - Qiaole Nie
- Musical anesthesia, Beijing Yuedi Music Analgesia Labor Institute, China
| | - Shuo Wang
- Labor Union, Qingdao Women and Children's Hospital, Qingdao, China
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Tandoğan Ö, Oskay Ü. The effect of Rebozo technique on perceived labour pain and childbirth experience: A randomized controlled trial. Medicine (Baltimore) 2024; 103:e39346. [PMID: 39213245 PMCID: PMC11365682 DOI: 10.1097/md.0000000000039346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/10/2024] [Accepted: 07/26/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Pain, stress, and anxiety experienced during childbirth can have detrimental effects on labor and delivery. The rebozo technique is an ancestral method used to minimize pain and enhance relief during gestation. This study aimed to investigate the effects of the rebozo technique on the birth process and its probable benefits on the birth experience. METHODS This survey was conducted from January to May 2021 in a randomized and controlled manner. A total of 113 pregnant women with their first children were surveyed. Women between 37 and 41 weeks of gestation without complications who were admitted to the delivery room with a cervical dilation of 4 cm or more were chosen as participants. In the Rebozo group, subjects were randomly selected by trained personnel to apply the standardized method, while the control group received a relaxing massage. Cervical dilation, fetal position, contraction patterns, and measures related to the birth experience were key indicators. RESULTS Women in the rebozo group had lower pain levels during birth and greater birth satisfaction. Mean cervical dilation in the latent phase was 5.61 cm in the rebozo group and 5.71 cm in the control group. In the active phase, cervical dilatation was 6.03 cm in the rebozo group and 6.68 cm in the control group, and this difference was statistically significant (P < .001). In the transition phase, the birth time was 46.29 minutes in the rebozo group and 68.71 minutes in the control group (P = <.007**). In the total birth experience score, the rebozo group received an average of 68.52 points, while the control group received 51.58 points (P < .001). CONCLUSION This research has established that the use of the rebozo technique throughout labor helps enhance her feelings about being pregnant, as well as heightening fulfillment with delivery.
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Affiliation(s)
- Özden Tandoğan
- Faculty of Health Sciences, Department of Nursing, Istanbul Arel University, Istanbul, Turkey
| | - Ümran Oskay
- Faculty of Nursing Department of Gynecology and Diseases Nursing, Istanbul University-Cerrahpaşa Florence Nightingale, Istanbul, Turkey
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Shchaslyvyi AY, Antonenko SV, Telegeev GD. Comprehensive Review of Chronic Stress Pathways and the Efficacy of Behavioral Stress Reduction Programs (BSRPs) in Managing Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1077. [PMID: 39200687 PMCID: PMC11353953 DOI: 10.3390/ijerph21081077] [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: 06/27/2024] [Revised: 08/08/2024] [Accepted: 08/10/2024] [Indexed: 09/02/2024]
Abstract
The connection between chronic psychological stress and the onset of various diseases, including diabetes, HIV, cancer, and cardiovascular conditions, is well documented. This review synthesizes current research on the neurological, immune, hormonal, and genetic pathways through which stress influences disease progression, affecting multiple body systems: nervous, immune, cardiovascular, respiratory, reproductive, musculoskeletal, and integumentary. Central to this review is an evaluation of 16 Behavioral Stress Reduction Programs (BSRPs) across over 200 studies, assessing their effectiveness in mitigating stress-related health outcomes. While our findings suggest that BSRPs have the potential to enhance the effectiveness of medical therapies and reverse disease progression, the variability in study designs, sample sizes, and methodologies raises questions about the generalizability and robustness of these results. Future research should focus on long-term, large-scale studies with rigorous methodologies to validate the effectiveness of BSRPs.
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Affiliation(s)
- Aladdin Y. Shchaslyvyi
- Institute of Molecular Biology and Genetics, National Academy of Sciences of Ukraine, 150, Zabolotnogo Str., 03143 Kyiv, Ukraine; (S.V.A.); (G.D.T.)
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Cohen S, Wainstock T, Sheiner E, Reuveni I, Pariente G. The association between emotion regulation and pain during the immediate postpartum period. Arch Gynecol Obstet 2024; 310:1081-1088. [PMID: 37804324 DOI: 10.1007/s00404-023-07232-0] [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: 08/26/2023] [Accepted: 09/13/2023] [Indexed: 10/09/2023]
Abstract
PURPOSE The present study aims to investigate the association between emotion regulation difficulties and pain perception during the immediate postpartum period. METHODS A cross-sectional study was performed in women during the immediate postpartum period. Women completed the Difficulties in Emotion Regulation Scale (DERS) questionnaire to measure difficulties in emotion regulation. A second analysis was conducted for the six subdomains of the DERS questionnaire. The visual analog scale (VAS) was used to measure pain intensity. The association between DERS scores and VAS score was assessed. Multivariable logistic regression models were constructed to control for potential confounders. RESULTS A total of 150 women were included in the final analysis, of whom 112 (74.6%) delivered vaginally and 38 (25.4%) had a cesarean delivery. Higher DERS scores, indicating more difficulties in emotion regulation, were significantly associated with higher VAS scores regardless of mode of delivery. Likewise, higher emotion regulation scores in 5 of 6 subdomains were associated with higher VAS scores (p < 0.001). Using multivariate logistic regression models higher DERS scores were independently associated with higher VAS scores. CONCLUSION Difficulties in emotion regulation are associated with higher pain perception during the immediate postpartum period. Interventions designed to improve emotion regulation may improve maternal well-being in the immediate postpartum period and possibly reduce use of pain medication.
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Affiliation(s)
- Shilo Cohen
- Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B 151, Beer-Sheva, Israel.
| | - Tamar Wainstock
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eyal Sheiner
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Inbal Reuveni
- Department of Psychiatry, Hebrew University Hadassah Medical Center, Jerusalem, Israel
| | - Gali Pariente
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Aslantaş BN, Çankaya S. The effect of birth ball exercise on labor pain, delivery duration, birth comfort, and birth satisfaction: a randomized controlled study. Arch Gynecol Obstet 2024; 309:2459-2474. [PMID: 37405439 DOI: 10.1007/s00404-023-07115-4] [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: 05/04/2023] [Accepted: 06/16/2023] [Indexed: 07/06/2023]
Abstract
PURPOSE This study aimed to examine the effect of birth ball exercise on labor pain, delivery duration, birth comfort, and birth satisfaction. METHODS The study used a randomized controlled trial design. All 120 primiparous pregnant women were randomly assigned to the intervention (IG) and control groups (CG). After the cervical dilatation reached 4 cm, the pregnant women in the IG performed birth ball exercises, adhering to the birth ball guide created by the researcher. No intervention was made in the control group other than standard midwifery care practices. RESULTS The labor pain level between the groups (VAS 1-when cervical dilatation was 4 cm) was similar to each other. The labor pain level (VAS 2- when cervical dilatation was 9 cm) scores of the women in the IG were significantly lower than those in the CG (p < 0.05). The time between the active phase of labor until dilatation is complete and the time until the baby's head comes out after full dilatation was found to be statistically significantly shorter in the IG compared to the CG (p < 0.05). Childbirth comfort and satisfaction mean scores between the groups were found to be statistically insignificant (p > 0.05). CONCLUSION As a result of the study, it was determined that the birth ball exercise significantly reduced labor pain and labor time. We recommend that the birth ball exercise be applied to all low-risk pregnant women because it helps fetal descent and cervical dilatation, and shortens labor pain and delivery time.
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Affiliation(s)
- Beyza Nur Aslantaş
- Department of Midwifery, Health Sciences Faculty of Selcuk University, Konya, Turkey
| | - Seyhan Çankaya
- Department of Midwifery, Health Sciences Faculty of Selcuk University, Konya, Turkey.
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Feng Y, Zhu F, Zhang J, Zeng Z, Li Q. Efficacy of different strategies for reducing labor pain: A Bayesian analysis. Medicine (Baltimore) 2024; 103:e37594. [PMID: 38758902 PMCID: PMC11098187 DOI: 10.1097/md.0000000000037594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 02/22/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND The effectiveness of different medical interventions in managing labor pain has yielded mixed results. Therefore, this systematic review and network meta-analysis aimed to provide a comprehensive summary of the available evidence on the impact of different strategies for reducing labor pain. METHODS We systematically searched 3 English databases (Pubmed, Embase and the Cochrane Library) from inception to January 2023. Randomized controlled trials (RCTs) or controlled clinical trials that investigating the effects of different strategies for reducing labor pain were included in this network meta-analysis. Risk of bias (ROB) was assessed using the Cochrane ROB tools. Network meta-analysis was performed using the R software (version 4.2.1) with gemtc package. RESULTS A total of 9 studies involving 823 patients, including 9 treatments (acupressure, birth ball exercise, Bonapace method, distraction techniques, ice pressure, LI4 acupressure, lidocaine spray, smartphone-based music intervention and placebo). The surface under the cumulative ranking (SUCRA) shows that Bonapace method ranked first (SUCRA, 79.5%), LI4 acupressure ranked second (SUCRA, 65.6%), distraction technique ranked third (SUCRA, 57.6%), birth ball exercise ranked fourth (SUCRA, 51.8%). CONCLUSIONS According to the results of the network meta-analysis, among the different strategies examined, the Bonapace Method stands out as the most effective nonpharmacological intervention for reducing labor pain. The results of this meta-analysis can aid both patients and healthcare professionals in choosing the most effective techniques to reduce labor pain.
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Affiliation(s)
- Yuanyan Feng
- Obstetrical Department, SSL Central Hospital of Dongguan City, Dongguan, Guangdong Province, China
| | - Fengjuan Zhu
- Obstetrical Department, SSL Central Hospital of Dongguan City, Dongguan, Guangdong Province, China
| | - Junfeng Zhang
- Obstetrical Department, SSL Central Hospital of Dongguan City, Dongguan, Guangdong Province, China
| | - Zishan Zeng
- Obstetrical Department, SSL Central Hospital of Dongguan City, Dongguan, Guangdong Province, China
| | - Qiumei Li
- Obstetrical Department, SSL Central Hospital of Dongguan City, Dongguan, Guangdong Province, China
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Watters A, Ekpe E, Okafor A, Donelan E. Patient Perspectives on Outpatient versus Inpatient Cervical Ripening for Induction of Labor. Am J Perinatol 2024. [PMID: 38569508 DOI: 10.1055/a-2298-5166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
OBJECTIVE Our objective was to compare patient perceived control and experience with outpatient versus inpatient cervical ripening. STUDY DESIGN This is a retrospective mixed-methods analysis of a quality improvement initiative focused on the impact to patients of incorporating outpatient cervical ripening into routine practice. Postpartum inpatients who had elected for outpatient cervical ripening (outpatients) and those who met criteria for outpatient cervical ripening but opted for an inpatient setting (inpatients) were invited to participate in the study. Patients completed the Perceived Control in Childbirth Scale, and scores were compared between outpatient and inpatient groups using Mann-Whitney U test. In addition, semistructured questions elicited feedback prior to hospital discharge, and these qualitative data were analyzed using iterative thematic analysis. RESULTS The study population consisted of 36 outpatients and 38 inpatients. The median score on the Perceived Control in Childbirth Scale was 69 for outpatients and 67 for inpatients (p-value = 0.49), out of a maximum score of 72 (representing the highest level of perceived control). Both groups reported similarly high levels of perceived control, regardless of cervical ripening setting. In the qualitative analysis, pain was the most common theme in both groups. Inpatients reported more distress despite access to stronger pain medications. Outpatients utilized a variety of distraction techniques and expressed gratitude for their setting more than inpatients. CONCLUSION Outpatient cervical ripening can be a patient-centered solution to obstetric throughput challenges arising from increased numbers of inductions. Those who underwent outpatient cervical ripening had similar perceived control to those who underwent inpatient cervical ripening, suggesting that individual patient preferences are most important in determining the optimal setting for care. The patients' reported experiences identified focus areas for process improvement efforts and future research, including improving patient education regarding expectations and innovating new pain management strategies for cervical ripening. KEY POINTS · Patient experiences must inform patient-centered care.. · Perceived control with cervical ripening was high.. · Pain with cervical ripening was the most cited theme..
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Affiliation(s)
- Amber Watters
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Etoroabasi Ekpe
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, Illinois
| | - Annette Okafor
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- University of Illinois College of Medicine, Chicago, Illinois
| | - Emily Donelan
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Department of Obstetrics and Gynecology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
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Shi L, Zhang D, Ye P, Peng W, Yin Y, Zhang Y. Clinical effect of different concentrations of ropivacaine in the labor analgesia of dural puncture epidural technique for obese puerperae. Perioper Med (Lond) 2024; 13:7. [PMID: 38355657 PMCID: PMC10868062 DOI: 10.1186/s13741-024-00363-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/31/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND This study was performed to analyze the clinical effect of different concentrations of ropivacaine in the labor analgesia of the dural puncture epidural (DPE) technique for obese puerperae. METHODS One hundred and fifty first-term obese women who received vaginal delivery and required labor analgesia in our hospital were selected prospectively for this study, and divided into groups A, B, and C. The three groups of puerpera were given epidurals with different concentrations of ropivacaine (0.075%, 0.10%, and 0.125%) with sufentanil (0.5 μg/ml) for the labor analgesia regimen. The visual analog scale (VAS), Ramsay scale, and Bromage scale of puerperae before analgesia and at different time points after anesthesia, and analgesic onset time, analgesia time, first PCEA time, PCEA pressing time, ropivacaine consumption, labor time, maternal blood pressure and heart rate, maternal adverse reactions, blood gas analysis in the neonatal umbilical artery, and Apgar score were observed. RESULTS The analgesia onset time, PCEA pressing time, and ropivacaine consumption in group C were lower and the analgesia time and the first PCEA time were longer than those in groups A and B. At T1-T3 and T5, VAS scores of group A were higher than those in groups B and C, Ramsay score of group A was lower than that of groups B and C at T2-T3, and Bromage score of group C at any time point was higher than other two groups. The time of the second stage of labor in groups B and C was longer than that in group A, which in group C was longer than that in group B. Compared with groups A and C, the blood pressure and heart rate of puerperae in group B were closer to normal values. Three different concentrations of ropivacaine had no significant effect on the umbilical artery blood gas analysis indices and Apgar scores at 1st minute and 5th minute in neonates. The incidence of maternal adverse reactions in group C was lower than those in groups A and B. CONCLUSION 0.1% ropivacaine combined with 0.5 μg/ml sufentanil through DPE technique has good analgesic efficacy and few adverse effects in obese puerperae.
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Affiliation(s)
- Liping Shi
- Department of Anesthesiology, Taihe County People's Hospital, Fuyang, 236600, Anhui, China
| | - Difei Zhang
- Department of Anesthesiology, Taihe County People's Hospital, Fuyang, 236600, Anhui, China.
| | - Pengfei Ye
- Department of Anesthesiology, Taihe County People's Hospital, Fuyang, 236600, Anhui, China
| | - Weihua Peng
- Department of Anesthesiology, Taihe County People's Hospital, Fuyang, 236600, Anhui, China
| | - Yan Yin
- Department of Anesthesiology, Taihe County People's Hospital, Fuyang, 236600, Anhui, China
| | - Ye Zhang
- Department of Anesthesiology, Taihe County People's Hospital, Fuyang, 236600, Anhui, China
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Jiang A, Perry T, Walker K, Burfoot A, Patterson L. Surgical sensation during caesarean section: a qualitative analysis. Int J Obstet Anesth 2024; 57:103935. [PMID: 37925355 DOI: 10.1016/j.ijoa.2023.103935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 08/13/2023] [Accepted: 10/02/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND Caesarean section (CS) is a major abdominal surgery performed usually on a young and healthy population under neuraxial anesthesia with little to no sedation. This creates a distinct surgical experience whereby patients are aware of the surgical process, physical sensations, and their environment. This study aimed to provide an in-depth descriptive assessment of subjective surgical experience during CS under regional anaesthesia. We expected the information gained would enhance our current understanding and better alleviate patient anxiety through informed counselling. METHODS This qualitative descriptive study was conducted at a Canadian academic centre. Twenty patients participated in semi-structured interviews within a week of CS, using an interview guide developed for this study. Patient medical records were reviewed to collect demographic and surgical information. Thematic analysis was conducted using an inductive approach to determine common themes. RESULTS Nine themes were identified. Five themes were identified in the category of surgical sensation and four themes were identified in the category of peri-operative education. CONCLUSIONS Patients commonly experienced pressure and movement sensations at varying intensity, and most did not experience pain. Environmental factors, including sounds and distraction by the newborn, affected perception of surgical sensation. Patients wish to receive pre-operative counselling regarding potential surgical sensations, as well as ongoing communication from their anaesthesiologist. These results can be used to guide informed discussions with patients and direct further investigation in this area.
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Affiliation(s)
- A Jiang
- Department of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre, Kingston, Ontario, Canada.
| | - T Perry
- Department of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre, Kingston, Ontario, Canada
| | - K Walker
- Department of Sociology, Queen's University, Kingston, Ontario, Canada
| | - A Burfoot
- Department of Sociology, Queen's University, Kingston, Ontario, Canada
| | - L Patterson
- Department of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre, Kingston, Ontario, Canada
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Heim MA, Makuch MY. Evaluation of a short in-person and online antenatal educational intervention for high-risk pregnant women linked to antenatal consultation. Eur J Midwifery 2024; 8:EJM-8-03. [PMID: 38239277 PMCID: PMC10795506 DOI: 10.18332/ejm/175927] [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: 11/07/2022] [Revised: 03/20/2023] [Accepted: 12/27/2023] [Indexed: 01/22/2024] Open
Abstract
INTRODUCTION The aim of this study was to evaluate a short educational intervention that focused on labor pain (through visual analogue scale, VAS), postpartum anxiety, and birthing experience before and during the SARS-CoV-2 (COVID-19) pandemic. METHODS This was a quasi-experimental study conducted between November 2019 and May 2021 in Brazil in 100 women with a high-risk pregnancy in the third trimester of pregnancy with an intervention group with in-person or virtual sessions (during the COVID-19 pandemic) and a non-intervention group. The antenatal intervention included breathing and relaxation techniques, upright positions, and information about labor. For evaluation, an antenatal questionnaire, State-Trait Anxiety Inventory (STAI) and a postpartum questionnaire were used. For data analysis, Student's t-test, chi-squared and Fisher's exact tests, ANOVA, bivariate, and multivariate regression analysis, were used. RESULTS When comparing the women in the intervention group to the non-intervention group, it was observed that the latter group reported higher fear of pain at labor during antenatal consultations (p<0.013); more women needed analgesia at 0-4 cm dilation (17/40) (p<0.018); the duration of labor was ≥12 hours (37/50) (p<0.037); while the intervention reported having a regular, good or excellent labor period (36/50) (p=0.014). The multiple regression analysis for labor pain showed a significant relationship between mode of delivery (cesarean delivery: RR; SE -21.43; 5.32, p<0.001) and labor pain, and good satisfaction with labor (RR; SE -13.86; 6.40, p=0.033). CONCLUSIONS Women from the intervention group had more satisfaction and less pain during labor than women from the non-intervention group.
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Affiliation(s)
- Maria A. Heim
- Department of Obstetrics and Gynecology, University of Campinas Faculty of Medical Sciences, Sao Paulo, Brazil
| | - Maria Y. Makuch
- Department of Obstetrics and Gynecology, University of Campinas Faculty of Medical Sciences, Sao Paulo, Brazil
- Campinas Reproductive Health Research Center, Sao Paulo, Brazil
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Bakhteh A, Jaberghaderi N, Rezaei M, Naghibzadeh ZAS, Kolivand M, Motaghi Z. The effect of interventions in alleviating fear of childbirth in pregnant women: a systematic review. J Reprod Infant Psychol 2024; 42:5-21. [PMID: 35435061 DOI: 10.1080/02646838.2022.2059458] [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] [Received: 10/27/2021] [Accepted: 03/22/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The Fear of Childbirth (FOC) is regarded as a general problem, which affects women's health and well-being, justifying demanding caesarean section. Several primary studies have been performed in relation to the interventions performed to reduce the fear of childbirth, which show contradictions between the results of these studies. OBJECTIVE This review aims to provide a comprehensive review of the different types of interventions used to reduce the fear of childbirth in pregnant mothers. METHODS In this study, systematic review of study information related to the effect of different therapies on reducing the fear of childbirth using subject-related keywords and validated with MeSH in SID, MagIran, IranMedex, IranDoc, Embase, ProQuest, Scopus, PubMed, Web of Science (ISI) databases and Google Scholar Search Engine were extracted without any time limit until February 2021. RESULTS After removing duplicates and irrelevant works from among the 5396 articles found, 63 articles remained in the study. The participants in these 63 articles were 5415 cases and 5770 controls. In addition, three studies were on epidural anesthesia, 33 on the effects of psychotherapy, 19 on the effects of education, and eight on the influence of other interventions on alleviating FOC. As shown by the results, psychotherapy intervention and education decreased FOC significantly. CONCLUSION According to the results of this study, to prevent the fear of childbirth, pregnancy training and prenatal preparation courses are recommended to empower pregnant women. It also seems beneficial to use psychotherapy approaches for women who are afraid of childbirth.
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Affiliation(s)
- Azam Bakhteh
- Student Research Center, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Nasrin Jaberghaderi
- Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mansour Rezaei
- Department of Biostatistics, School of Health & Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Mitra Kolivand
- Department of Reproductive Health, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zahra Motaghi
- Reproductive Health Department, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
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Nori W, Kassim MAK, Helmi ZR, Pantazi AC, Brezeanu D, Brezeanu AM, Penciu RC, Serbanescu L. Non-Pharmacological Pain Management in Labor: A Systematic Review. J Clin Med 2023; 12:7203. [PMID: 38068274 PMCID: PMC10707619 DOI: 10.3390/jcm12237203] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/15/2023] [Accepted: 11/18/2023] [Indexed: 04/22/2024] Open
Abstract
Childbirth is a remarkable, life-changing process and is frequently regarded as an excruciating, physically and emotionally demanding experience that women endure. Labor pain management poses a significant challenge for obstetricians and expectant mothers. Although pharmacological pain management is the gold standard, it still imposes risks on the mother and baby. Recently, non-pharmacological pain management (NPPM) has emerged as a safe, effective option. Six databases were searched for articles published up to 2023 using specific related keywords and defined inclusion and exclusion criteria. The extraction and gathering of data was made so as to be categorized into physical, psychological, and complementary NPPM techniques. In light of the enormous development and diversity of NPPM techniques, the present review aims to examine contemporary NPPM knowledge and application, discussing efficacy, advantages, limitations, and potential adverse effects, with a specific focus on women's individual requirements, to strengthen obstetricians' knowledge in guiding decision-making for women in childbirth.
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Affiliation(s)
- Wassan Nori
- College of Medicine, Mustansiriyah University, Baghdad 10052, Iraq;
| | - Mustafa Ali Kassim Kassim
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
| | - Zeena Raad Helmi
- College of Medicine, Mustansiriyah University, Baghdad 10052, Iraq;
| | - Alexandru Cosmin Pantazi
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
| | - Dragos Brezeanu
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
- Obstetrics and Gynecology Department, Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Ana Maria Brezeanu
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
- Obstetrics and Gynecology Department, Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Roxana Cleopatra Penciu
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
- Obstetrics and Gynecology Department, Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Lucian Serbanescu
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
- Obstetrics and Gynecology Department, Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
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Navarro-Prado S, Sánchez-Ojeda MA, Plaza Del Pino FJ, Vázquez-Sánchez MÁ, Tovar-Gálvez MI, Azirar-Mohamed N. Coping Strategies during Childbirth Related to Cultural Identity: Companionship, Choice of Analgesia and Maternal Satisfaction. Healthcare (Basel) 2023; 11:1714. [PMID: 37372832 DOI: 10.3390/healthcare11121714] [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: 05/10/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
Childbirth is a biological process and how it is experienced and managed is influenced by numerous factors, among them, socio-cultural or health care received. OBJECTIVE The objective of this study is to ascertain whether cultural factors influence the way in which women deal with childbirth through the treatment of pain, companionship and maternal satisfaction. METHODS This study is a non-experimental, quantitative, ex post facto, cross-sectional study of women who gave birth in a border town in southern Spain. The sample consisted of 249 women. RESULTS No relationship was found between cultural factors and the choice of epidural analgesia, alternative methods to alleviate pain, being accompanied nor maternal satisfaction. There was a significant relationship between the type of companionship and with maternal satisfaction. CONCLUSIONS Cultural factors did not influence how women dealt with dilation and childbirth. Results found that the person accompanying the mother was important for increasing maternal satisfaction. The intercultural training of healthcare professionals is necessary.
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Affiliation(s)
- Silvia Navarro-Prado
- Department of Nursing, Faculty of Health Sciences of Melilla, University of Granada, 52017 Melilla, Spain
| | | | | | | | - María Isabel Tovar-Gálvez
- Department of Nursing, Faculty of Health Sciences of Ceuta, University of Granada, 51001 Ceuta, Spain
| | - Nurimán Azirar-Mohamed
- Centre for the Temporary Stay of Immigrants of the Autonomous City of Melilla, 52004 Melilla, Spain
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Khojasteh F, Afrashte M, Khayat S, Navidian A. Effect of cognitive-behavioral training on fear of childbirth and sleep quality of pregnant adolescent slum dwellers. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:311. [PMID: 36439000 PMCID: PMC9683451 DOI: 10.4103/jehp.jehp_133_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/24/2022] [Accepted: 03/03/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Fear of childbirth is a common problem during pregnancy, which can give rise to sleep disorders and diminish sleep quality. This study aimed to determine the effect of cognitive-behavioral training on fear of childbirth and sleep quality of pregnant adolescent slum dwellers who visited the slum health centers of Zahedan city, Iran, in 2020. MATERIALS AND METHODS This quasi-experimental study was conducted in 2020 on 100 pregnant adolescent slum dwellers between 11 and 19 years old at 24-28 weeks pregnant. Multi-stage sampling was used and the participants were randomly divided into an intervention and a control group. The intervention group received four sessions of cognitive-behavioral training at weekly intervals. The control group only received routine care. The Wijma Delivery Expectancy/Experience Questionnaire and the Pittsburgh Sleep Quality Index were filled before and 4 weeks after the training course. The data were analyzed in SPSS 21 using independent t-test, paired t-test, Fisher's exact test, and Chi-squared test. and covariance. A P value of < 0.05 was considered significant. RESULTS After the intervention, the fear of childbirth significantly decreased (P = 0.004), and sleep quality significantly improved (P = 0.001) in the intervention group compared with the control group. The results of analysis of covariance to control the significant effect of pre-test scores showed that the mean score of fear of childbirth (P = 0.03) and mean score of sleep quality (P = 0.001) in the two groups after the intervention was statistically significant. CONCLUSION The results showed that in addition to reducing fear of childbirth, cognitive-behavioral training improved the sleep quality of women in the intervention group. Therefore, this training could be used as an easy and accessible method without complications to improve women's health.
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Affiliation(s)
- Farnoosh Khojasteh
- Department of Nursing, School of Nursing and Midwifery, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mahdie Afrashte
- Department of Nursing, School of Nursing and Midwifery, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Samira Khayat
- Department of Nursing, School of Nursing and Midwifery, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Ali Navidian
- Department of Nursing, School of Nursing and Midwifery, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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Akbaş P, Özkan Şat S, Yaman Sözbir Ş. The Effect of Holistic Birth Support Strategies on Coping With Labor Pain, Birth Satisfaction, and Fear of Childbirth: A Randomized, Triple-Blind, Controlled Trial. Clin Nurs Res 2022; 31:1352-1361. [PMID: 35698748 DOI: 10.1177/10547738221103329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The current study was aimed to evaluate the effects of interventions conducted in line with the coping with labor pain algorithm (holistic birth support strategies) on women's coping with labor pain, birth satisfaction, and fear of childbirth. The study is a single-center, parallel-group randomized, three-blind, controlled trial. The study was completed with 33 women in the experimental group and 31 in the control group. The mean score of the women in the experimental group from the Birth Satisfaction Scale (128.57 ± 5.83) was statistically significantly higher than that of the women in the control group (81.80 ± 7.73). The mean score of the women in the experimental group (61.96 ± 9.78) from the Wijma Birth Expectation/Experience Scale, Version B scale was statistically significantly lower than that of the women in the control group (148.64 ± 14.62). It was found that the women in the experimental group were able to better cope with labor pain, had higher birth satisfaction, and had less fear of childbirth.
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Affiliation(s)
- Pınar Akbaş
- Karabük Yenice State Hospital, Karabük, Turkey
| | - Sultan Özkan Şat
- Bitlis Eren University, Faculty of Health Sciences, Nursing Department, Bitlis, Turkey
| | - Şengül Yaman Sözbir
- Gazi University, Faculty of Health Sciences, Nursing Department, Ankara, Turkey
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16
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Chang CY, Gau ML, Huang CJ, Cheng HM. Effects of non-pharmacological coping strategies for reducing labor pain: A systematic review and network meta-analysis. PLoS One 2022; 17:e0261493. [PMID: 35061717 PMCID: PMC8782482 DOI: 10.1371/journal.pone.0261493] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/02/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Facilitating the childbirth process is a global issue. Many strategies have been developed to cope with labor pain and improve the delivery experience and satisfaction of pregnant women. The results of different types of medical intervention on women's expectant pain have been varied. Therefore, this systematic review was aimed at summarizing the body of evidence regarding the effects of various non-pharmacological coping strategies for reducing labor pain. METHODS The review was conducted according to guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We systematically searched the articles published between 1989 and 2020 in six electronic databases: PubMed, MEDLINE, CINAHL, WOS, PsycARTICLES, and Airiti Library, and the reference lists of the Clinical Trial Registry. Twenty studies were identified, with eight eligible studies included in the Bayesian network meta-analysis. RESULTS Eight studies with 713 participants were included in the meta-analysis with nine different non-pharmacological strategies for reducing labor pain. The traditional meta-analysis demonstrated that the non-pharmacological coping strategies were effective in reducing labor pain. Of these interventional strategies, the ranking probabilities analysis of the network meta-analysis suggested that the Bonapace Method may be the most effective strategy in reducing labor pain, followed by acupressure. CONCLUSIONS Non-pharmacological coping strategies can reduce labor pain while maintaining an effective and satisfactory delivery experience. This systematic review, by synthesizing the body of evidence, demonstrated that non-pharmacological coping strategies are effective in reducing labor pain. Furthermore, as demonstrated in the network meta-analysis, the Bonapace Method, modulating birth pain by involving the father, is the most effective non-pharmacological intervention for reducing labor pain.
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Affiliation(s)
- Ching-Yi Chang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Meei-Ling Gau
- Department of Midwifery and Women Health Care, National Taipei University of Nursing and Health Sciences
| | - Chi-Jung Huang
- Center for Evidence-based Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hao-min Cheng
- Center for Evidence-based Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Program of Interdisciplinary Medicine (PIM), National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
- Institute of Public Health and Community Medicine Research Center, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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Pishahang S, Hakimi S, Vatankhah S, Ghaffarifar S, Ranjbar F. Psychometric properties of the Tilburg Pregnancy Distress Scale-Persian version (TPDS-P). BMC Pregnancy Childbirth 2021; 21:608. [PMID: 34488663 PMCID: PMC8422693 DOI: 10.1186/s12884-021-04078-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 08/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Given the importance of screening pregnant women's distress, it was intended to investigate the psychometric properties of the Persian version of the Tilburg Pregnancy Distress Scale (TPDS-P) for screening pregnancy distress. METHODS This methodological psychometric study was conducted with participation of 360 pregnant women. The TPDS was translated into Persian. Factor analysis was used to investigate the construct validity. The results of the correlation test between the results of the two questionnaires, Depression Anxiety Stress Scales-21 (DASS-21) and TPDS-P, were used to determine the criterion validity of TPDS-P. Internal consistency of the items was calculated by the Cronbach's alpha coefficient. Stability of the results was examined by test-retest method and Intra-class Correlation Coefficient (ICC) was calculated. Examining the structure of the factors derived from exploratory factor analysis, fitness of the model was done through confirmatory factor analysis. Statistical analysis was done using SPSS software. RESULTS Kaiser-Meyer-Olkin (KMO) was 0.846 (p = 0.001). Sixteen items of TPDS-P accounted for 51.42 percent variances. The TPDS-P exhibited appropriate fitness. There was poor to moderate but significant direct correlation between the subscales of DASS-21 and TPDS-P. Cronbach's alpha coefficient of the TPDS-P was 0.81 and ICC was 0.70. CONCLUSIONS TPDS-P, with appropriate validity and reliability, can be used as a practical scale to evaluate women's distress during pregnancy in Farsi-speaking societies.
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Affiliation(s)
- Solmaz Pishahang
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sevil Hakimi
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Solmaz Vatankhah
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeideh Ghaffarifar
- Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Ranjbar
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
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Srisopa P, Cong X, Russell B, Lucas R. The Role of Emotion Regulation in Pain Management Among Women From Labor to Three Months Postpartum: An Integrative Review. Pain Manag Nurs 2021; 22:783-790. [PMID: 34215526 DOI: 10.1016/j.pmn.2021.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 05/11/2021] [Accepted: 05/28/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Emotion regulation is a regulatory process to modify emotional activation in a wide range of situations and shows potential effects to reduce pain and emotional distress. The purpose of this review was to enhance an understanding of the role of emotion regulation strategies and their outcomes in reducing women's pain from labor to 3 months postpartum. DESIGN Integrative review. METHODS The literature was reviewed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The search was conducted using electronic databases CINAHL, PsycINFO, PubMed, Scopus, and ProQuest dissertation from 1990-2019. RESULTS Nine publications were included. Two emotion regulation strategies, mindfulness and distraction, were used. The findings revealed that prolonged training in mindfulness-based interventions produced significant improvements in decreasing pain intensity during labor and increasing maternal comfort 2 hours postpartum. The distraction strategy showed a significant decrease in pain intensity during labor for women who were trained and self-practiced during the prenatal period. CONCLUSIONS Both mindfulness and distraction would be offered to pregnant women as part of alternative self-pain management strategies to prepare them for dealing with pain and other discomforts. Future research needs to test the effects of the intervention beyond childbirth.
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Affiliation(s)
| | | | - Beth Russell
- Department of Human Development and Family Sciences, University of Connecticut, Mansfield, Connecticut
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