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Sun S, An S. Associations between patterns of social support and perinatal mental health among Chinese mother: the mediating role of social trust. J Psychosom Obstet Gynaecol 2024; 45:2325451. [PMID: 38465671 DOI: 10.1080/0167482x.2024.2325451] [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: 12/28/2023] [Accepted: 02/23/2024] [Indexed: 03/12/2024] Open
Abstract
This study aims to explore the correlation between different social support patterns and perinatal mental health, and the mediating role of social trust in this. A cross-sectional survey was conducted in Jiangsu, China, with a sample size of 1705 pregnant respondents. Latent class analysis (LCA) was utilized to identify various social support patterns, while a multiple regression model was employed to analyze the mediating effect of social trust on the relationship between social support patterns and perinatal mental health. The study found four distinct social support patterns among the respondents: primary relationship-centric support, overall weak support, primary-secondary relationship-balanced support, and overall strong support. In the relationship between social support patterns and perinatal mental health, social trust played both a partial and full mediating role. The findings indicate that a social support system that enhances maternal trust and promotes honest disclosure of symptoms can effectively promote perinatal mental health.
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Affiliation(s)
- Sheng Sun
- Department of Sociology, School of Law, Jiangnan University, Wuxi, China
| | - Shanshan An
- Department of Sociology, School of Law, Jiangnan University, Wuxi, China
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Yi F, Ahn S, Park M. Psychometric testing of the Chinese version of the Perinatal Infant Care Social Support tool: a methodological study. WOMEN'S HEALTH NURSING (SEOUL, KOREA) 2024; 30:128-139. [PMID: 38987917 PMCID: PMC11237360 DOI: 10.4069/whn.2024.05.21] [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: 01/22/2024] [Revised: 05/20/2024] [Accepted: 05/21/2024] [Indexed: 07/12/2024]
Abstract
PURPOSE This study aimed to translate the Perinatal Infant Care Social Support (PICSS) instrument into Chinese and to verify the reliability and validity of the translated version. METHODS This study used a cross-sectional design to examine the reliability and validity of the Chinese version of the PICSS (C-PICSS). A cohort of 150 first-time mothers in China participated, attending hospital follow-up care at 6 weeks postpartum. Data were collected after obtaining informed consent from the mothers. RESULTS The majority of mothers were aged between 20 and 29 years, with a mean age of 26.25 (±3.90) years. An item analysis of the 19 items in the C-PICSS showed that all items had an item-total score correlation above 0.2. This resulted in a Kaiser-Meyer-Olkin value of 0.92 and a significant Bartlett's test of sphericity (χ2=1,778.65, p<.001), confirming the suitability of the data for factor analysis. Correlation analyses revealed a strong positive relationship between infant care social support and general social support (r=.62, p<.001), and a negative relationship between infant care social support and postpartum depression (r=-.38, p<.001). Higher scores for infant care social support were associated with reporting positive relationships with their husbands (t=3.72, p<.001) and high levels of spousal involvement (t=4.09, p<.001). In terms of structural support, spouses were identified as the primary source. CONCLUSION The research results indicate that C-PICSS is reliable and valid as an indicator of social support for infant care among Chinese mothers.
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Affiliation(s)
- Feiyan Yi
- College of Nursing, Chungnam National University, Seoul, Korea
| | - Sukhee Ahn
- College of Nursing, Chungnam National University, Seoul, Korea
| | - Miyeon Park
- Department of Nursing, Baekseok Culture University, Cheonan, Korea
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3
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Nowland R, Charles J, Thomson G. Loneliness in Pregnancy and Parenthood: Impacts, Outcomes, and Costs. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2024; 97:93-98. [PMID: 38559456 PMCID: PMC10964817 DOI: 10.59249/nktk3337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Background: Becoming a parent has been highlighted as a period associated with increased risks for loneliness, with around one-third of parents reporting feeling lonely often or always. However, as most understanding of loneliness is based on elderly or student cohorts, further insights into the costs of parental loneliness is needed. Method: We conducted a literature review of impacts of loneliness in pregnancy and parenthood and present a synthesis of the health, social, societal, and economic costs. We draw on evidence about impacts and costs of loneliness in other cohorts to help provide a wider context to understand the impacts and costs and how parental loneliness differs from other populations. Results: Similar to literature with elderly cohorts, parental loneliness has impacts on health and wellbeing, such as depression in new parents and increased general practitioner (GP) visits in pregnancy. But also has intergenerational impacts via its association with poor mental health and social competence and increased respiratory tract infections in the child. Physical health impacts widely associated with loneliness in other cohorts have yet to be examined in parents. Loneliness in parents is likely to result in social withdrawal further isolating parents and wider societal and economic costs relating to absence from employment and informal caring roles. Conclusion: Parental loneliness has the potential for negative and pervasive impacts. As parental loneliness has wide ranging and intergenerational impacts it is important that a multi-sectoral perspective is used when examining its costs.
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Affiliation(s)
- Rebecca Nowland
- School of Nursing and Midwifery, University of Central
Lancashire, Preston, UK
| | - Joanna Charles
- Health and Social Services Group, Welsh Government,
Cardiff, Wales, UK
| | - Gill Thomson
- School of Nursing and Midwifery, University of Central
Lancashire, Preston, UK
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Sufredini F, Catling C, Zugai J, Chang S. The effects of social support on depression and anxiety in the perinatal period: A mixed-methods systematic review. J Affect Disord 2022; 319:119-141. [PMID: 36108877 DOI: 10.1016/j.jad.2022.09.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/24/2022] [Accepted: 09/06/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND The social support offered to women in the perinatal period can buffer against depression and anxiety. The sources and types of support that reduce maternal levels of depression and anxiety are not well understood. AIMS To investigate the effects of structural and functional support on depression and anxiety in women in the perinatal period, and to explore the experiences of women around support during the perinatal period. METHOD A comprehensive search of six electronic databases was undertaken. Relevant studies published from January 2010 to April 2020 were included (PROSPERO reference number: CRD42020194228). Quantitative and qualitative studies were eligible if they reported the effects of, or had themes related to receiving functional or structural support in the perinatal period on women's levels of depression or anxiety. Qualitative data was synthesised using a thematic synthesis method. Quantitative data could not be pooled due to the lack of comparable RCTs or cohort studies and was thus presented in a narrative form. RESULTS Fifty-one articles (41 quantitative and 10 qualitative studies) were included. Analysis of quantitative studies demonstrated that insufficient support from partner, friends and family was associated with greater risk of symptoms of depression and anxiety. Distance-delivered interventions (via internet or telephone) diminished levels of depression and anxiety. Qualitative data revealed three overarching themes: appreciating all forms of support in the perinatal period, recognising appropriate and inappropriate support from health professionals and services, and having barriers to mobilising functional and structural support. LIMITATIONS Grey literature was not explored and search strategies only included English, Spanish and Portuguese language articles. The reviewed studies were heterogeneous and for this reason, quantitative assessments were not feasible. CONCLUSION Support from specific sources such as family members, friends who are also mothers, health professionals, neighbours, supervisors, co-workers and online communities still need to be further investigated. Implications for health professionals involved in the care of women in the perinatal period are discussed.
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Affiliation(s)
| | - Christine Catling
- Centre for Midwifery, Child and Family Health, School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Australia
| | - Joel Zugai
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Midwifery and Health Sciences, University of Notre Dame, Australia
| | - Sungwon Chang
- Improving Care for Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Australia
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Caetano B, Branquinho M, Canavarro MC, Fonseca A. Mattering and Depressive Symptoms in Portuguese Postpartum Women: The Indirect Effect of Loneliness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11671. [PMID: 36141944 PMCID: PMC9516968 DOI: 10.3390/ijerph191811671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/31/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Postpartum depression is described as the most prevalent clinical condition in the postpartum period, with several negative consequences. The current study aimed to understand the relationship between mattering, loneliness and depressive symptoms in Portuguese postpartum women and to examine the potential mediating role of loneliness in the relationship between mattering and depressive symptomatology among postpartum women. METHODS This cross-sectional study included a sample collected online composed of 530 Portuguese women in the postpartum period, who answered self-report questionnaires to assess depressive symptoms, mattering, and loneliness. RESULTS It was found that the relationships between mattering, loneliness, and depressive symptoms were significant, p < 0.001: (a) higher levels of mattering were associated with lower levels of loneliness and depressive symptomatology and (b) higher levels of loneliness were associated with higher levels of depressive symptomatology. The relationship between mattering and postpartum depressive symptoms occurred directly and indirectly through loneliness, 95% CI = [-0.75, -0.46]. CONCLUSIONS These results highlight the importance of studying loneliness as a possible risk factor for postpartum depression and alert to the pertinence of considering mattering and loneliness in the assessment and intervention with women in the perinatal period.
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Affiliation(s)
- Bárbara Caetano
- Faculty of Psychology and Educational Sciences Coimbra, University of Coimbra, 3000-115 Coimbra, Portugal
| | - Mariana Branquinho
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal
| | - Maria Cristina Canavarro
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal
| | - Ana Fonseca
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal
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Kent-Marvick J, Simonsen S, Pentecost R, Taylor E, McFarland MM. Loneliness in pregnant and postpartum people and parents of children aged 5 years or younger: a scoping review. Syst Rev 2022; 11:196. [PMID: 36071448 PMCID: PMC9451126 DOI: 10.1186/s13643-022-02065-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 08/29/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Despite evidence that loneliness increases during times of transition, and that the incidence of loneliness is highest in young adults, loneliness during pregnancy and new parenthood has not been developed as a program of research. Because loneliness research has primarily focused on older adults and other high-risk populations, the concept of loneliness and its effects on this population are not well understood, leaving a gap in our understanding of the psychosocial needs and health risks of loneliness on pregnant people and new parents. A scoping review has been completed in order to map and synthesize the literature on loneliness experienced during pregnancy and the first 5 years of parenthood prior to the COVID-19 pandemic. METHODS To address the aim of this review, a wide net was cast in order to detect experiences of perinatal or parental loneliness and/or instances where loneliness was measured in this population. Among the inclusion criteria were loneliness in people who were pregnant, who were parents in the postpartum period, or who had children aged 5 years or younger. A search for literature was conducted in December 2020 using nine databases: MEDLINE (Ovid), EMBASE (Elsevier), SCOPUS (Elsevier), Cochrane Library including CENTRAL (Wiley), CINAHL (Ebscohost), PsycINFO (Ebscohost), Dissertations & Theses Global (ProQuest) and Sociological Abstracts (ProQuest), and the Web of Science Core Collection (Clarivate). RESULTS Perinatal and parental loneliness studies are limited and have rarely been targeted and developed through a program of research. Loneliness inquiry in this population was frequently studied in relation to other concepts of interest (e.g., postpartum depression). Alternatively, the importance of loneliness emerged from study participants as relevant to the research topic during qualitative inquiry. Across studies, the prevalence of loneliness ranged from 32 to 100%. Loneliness was commonly experienced alongside parenting difficulties, with parents feeling as though they were alone in their struggles. CONCLUSIONS As loneliness has been called a sensitive indicator of mental wellbeing, we believe screening will help healthcare professionals identify common difficulties and early signs of depression experienced during pregnancy and parenthood. SYSTEMATIC REVIEW REGISTRATION The protocol is available on Open Science Framework at DOI 10.17605/OSF.IO/BFVPZ.
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Affiliation(s)
- Jacqueline Kent-Marvick
- University of Utah College of Nursing, University of Utah, 10 2000 E, Salt Lake City, UT, 84112, USA.
| | - Sara Simonsen
- University of Utah College of Nursing, University of Utah, 10 2000 E, Salt Lake City, UT, 84112, USA
| | - Ryoko Pentecost
- University of Utah College of Nursing, University of Utah, 10 2000 E, Salt Lake City, UT, 84112, USA
| | - Eliza Taylor
- University of Utah College of Nursing, University of Utah, 10 2000 E, Salt Lake City, UT, 84112, USA
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Enlander A, Simonds L, Hanna P. “I want you to help me, you’re family”: A relational approach to women's experience of distress and recovery in the perinatal period. FEMINISM & PSYCHOLOGY 2022. [DOI: 10.1177/09593535211047792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Theoretical approaches have tended to understand perinatal distress through either individual or socio-cultural factors. In contrast, Natasha Mauthner proposed a relational model that understands perinatal distress in the context of interpersonal relationships. This study aims to build on Mauthner's work to explore how women speak about their relationships in connection to their stories of perinatal distress and recovery. Eight women were interviewed for the study. All women had at least one child under the age of three and self-identified as having experienced distress in the perinatal period. Interviews were recorded, transcribed and analyzed using Voice Centred Relational Analysis. Four broad themes were identified: (i) the role of practical support, (ii) the role of emotional support, (iii) relational dynamics, and (iv) the role of socio-cultural norms. Whilst some women experienced practical and emotional support in their relationships, those who did not linked a lack of support to their feelings of distress. Relationships were also found to reinforce unhelpful social norms around motherhood and mental health, as well as offering a space to resist norms and create wider discourses about what it means to be a mother. This study suggests that organizations supporting women in the perinatal period should focus on women's relational needs and consider the cultural discourses of motherhood that they perpetuate.
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8
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Sonnenburg C, Miller YD. Postnatal Depression: The Role of “Good Mother” Ideals and Maternal Shame in a Community Sample of Mothers in Australia. SEX ROLES 2021. [DOI: 10.1007/s11199-021-01239-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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9
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Jamison LE, Howell KH, Decker KM, Schwartz LE, Thurston IB. Associations between Substance Use and Depressive Symptoms among Women Experiencing Intimate Partner Violence. J Trauma Dissociation 2021; 22:540-554. [PMID: 33433303 DOI: 10.1080/15299732.2020.1869646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Associations between substance use and depression among women experiencing intimate partner violence (IPV) have received limited empirical attention. This study examined how demographics, frequency of IPV and problematic substance use were related to depressive symptoms among women exposed to recent IPV. Participants included 112 women (Mage = 32.26; 67% Black) recruited from community organizations in the U.S. Midsouth, many of whom had used substances (80.2%) and were living below the poverty threshold (71.3%). Results from a hierarchical multiple regression analysis revealed that, after accounting for age and income, more frequent IPV and more problematic tobacco use were associated with higher depressive symptoms. Neither alcohol nor illicit substance use were significantly associated with depressive symptoms. These findings highlight a meaningful connection between problematic tobacco use and depressive symptoms, indicating the potential benefits of incorporating tobacco use psychoeducation and cessation strategies into treatment programs for women experiencing depression in the context of IPV.
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Affiliation(s)
- Lacy E Jamison
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Kathryn H Howell
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Kristina M Decker
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Laura E Schwartz
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Idia B Thurston
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas, USA.,Department of Health Promotion and Community Health Sciences, Texas A&M University, College Station, Texas, USA
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10
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Nowland R, Thomson G, McNally L, Smith T, Whittaker K. Experiencing loneliness in parenthood: a scoping review. Perspect Public Health 2021; 141:214-225. [PMID: 34286652 PMCID: PMC8580382 DOI: 10.1177/17579139211018243] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS Chronic loneliness is experienced by around a third of parents, but there is no comprehensive review into how, why and which parents experience loneliness. This scoping review aimed to provide insight into what is already known about parental loneliness and give directions for further applied and methodological research. METHODS Searches for peer-reviewed articles were undertaken in six databases: PsycINFO, Medline, CINAHL, Embase, Web of Science and Scopus, during May 2019 to February 2020. We searched for English studies which examined loneliness experienced during parenthood, including studies that involved parents with children under 16 years and living at home and excluding studies on pregnancy, childbirth or postbirth hospital care. RESULTS From 2566 studies retrieved, 133 were included for analysis. Most studies (n = 80) examined the experience of loneliness in specific groups of parents, for example, teenage parents, parents of a disabled child. Other studies examined theoretical issues (n = 6) or health and wellbeing impacts on parents (n = 16) and their offspring (n = 17). There were 14 intervention studies with parents that measured loneliness as an outcome. Insights indicate that parental loneliness may be different to loneliness experienced in other cohorts. There is evidence that parental loneliness has direct and intergenerational impacts on parent and child mental health. Some parents (e.g. with children with chronic illness or disability, immigrant or ethnic minority parents) also appear to be at increased risk of loneliness although evidence is not conclusive. CONCLUSION This work has identified key gaps with further international, comparative and conceptual research needed.
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Affiliation(s)
- R Nowland
- School of Community Health and Midwifery, University of Central Lancashire Brooke Building, Preston PR2 1HE, UK
| | - G Thomson
- University of Central Lancashire, Preston, UK
| | - L McNally
- University of Central Lancashire, Preston, UK
| | - T Smith
- University of Central Lancashire, Preston, UK
| | - K Whittaker
- University of Central Lancashire, Preston, UK
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Fu W, Hettinghouse A, Liu CJ. In Vitro Physical and Functional Interaction Assays to Examine the Binding of Progranulin Derivative Atsttrin to TNFR2 and Its Anti-TNFα Activity. Methods Mol Biol 2021; 2248:109-119. [PMID: 33185871 DOI: 10.1007/978-1-0716-1130-2_8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
TNFα/TNFR signaling plays a critical role in the pathogenesis of various inflammatory and autoimmune diseases, and anti-TNFα therapies have been accepted as the effective approaches for treating several autoimmune diseases. Progranulin (PGRN), a multi-faced growth factor-like molecule, directly binds to TNFR1 and TNFR2, particularly to the latter with higher affinity than TNFα. PGRN derivative Atsttrin is composed of three TNFR-binding domain of PGRN and exhibits even better therapeutic effects than PGRN in several inflammatory disease models, including collagen-induced arthritis. Herein we describe the detailed methodology of using (1) ELISA-based solid phase protein-protein interaction assay to demonstrate the direct binding of Atsttrin to TNFR2 and its inhibition of TNFα/TNFR2 interaction; and (2) tartrate-resistant acid phosphatase (TRAP) staining of in vitro osteoclastogenesis to reveal the cell-based anti-TNFα activity of Atsttrin. Using the protocol described here, the investigators should be able to reproducibly detect the physical inhibition of TNFα binding to TNFR and the functional inhibition of TNFα activity by Atsttrin and various kinds of TNF inhibitors.
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Affiliation(s)
- Wenyu Fu
- Department of Orthopaedic Surgery, New York University Medical Center, New York, NY, USA
| | - Aubryanna Hettinghouse
- Department of Orthopaedic Surgery, New York University Medical Center, New York, NY, USA
| | - Chuan-Ju Liu
- Department of Orthopaedic Surgery, New York University Medical Center, New York, NY, USA.
- Department of Cell Biology, New York University School of Medicine, New York, NY, USA.
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12
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Sahin E, Seven M. Depressive symptoms during pregnancy and postpartum: a prospective cohort study. Perspect Psychiatr Care 2019; 55:430-437. [PMID: 30430584 DOI: 10.1111/ppc.12334] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 10/07/2018] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aim was to determine the prevalence and risk factors of postpartum depression, and changes over time from pregnancy to postpartum period. DESIGN AND METHODS A prospective cohort study was conducted in 23 cities in Turkey, with 497 pregnant women. FINDINGS Of women, 13.5% had a high level of depressive symptoms during pregnancy and 4.8% during the postpartum period. Significant relationships emerged between total Edinburgh Postnatal Depression Scale score and mean age of participants and their husbands, duration of marriage, parity, and history of receiving professional psychological support. PRACTICE IMPLICATIONS Family planning education could be an important intervention to prevent depression in young couples.
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Affiliation(s)
- Eda Sahin
- Health Science Faculty, Giresun University, Giresun, Turkey
| | - Memnun Seven
- School of Nursing, Koç University, İstanbul, Turkey
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Khan S, Ion A, Alyass A, Greene S, Kwaramba G, Smith S, Carvalhal A, Kennedy VL, Walmsley S, Loutfy M. Loneliness and perceived social support in pregnancy and early postpartum of mothers living with HIV in Ontario, Canada. AIDS Care 2018; 31:318-325. [PMID: 30157684 DOI: 10.1080/09540121.2018.1515469] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The HIV Mothering Study (n = 72) was a prospective, observational, cohort study exploring psychosocial experiences and needs of WLWHIV in pregnancy and postpartum. We performed quantitative analysis of determinants of loneliness (UCLA Loneliness Scale) and lower perceived social support (SS) (Medical Outcomes Study-Social Support Survey). The hypothesized determinants included: age, years with HIV, racism (Everyday Discrimination Scale), depression (Edinburgh Postnatal Depression Scale [EPDS]), nadir CD4 (<200 cells/μL), tertiary vs. community HIV care, and marital status. The median age was 33 (IQR = 30-37); 65.3% were African/Caribbean/Black. Multivariable analyses revealed associations between marital status and perceived social support (β = -16.48, p < 0.0001), and this association was also seen with change over time (p = 0.02). Variables associated with SS that did not change over time were: income, EDS racism, EPDS score. Significant associations with loneliness were seen with the same variables associated with SS. Variables associated with loneliness that also changed over time were: EDS Racism (β = 0.22, p = 0.0005, and over time p = 0.003), and EPDS score (β = 0.74, p < 0.0001), and over time (p = 0.0211). Variables associated with loneliness but that did not change over time were: marital status and income. This analysis provides clinicians with prenatal risk factors which may be associated with increase loneliness and lower SS during pregnancy and postpartum: marital status, income, racism and depression.
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Affiliation(s)
- S Khan
- a Pediatric Infectious Diseases , McMaster University , Hamilton , Canada
| | - A Ion
- b Department of Social Work , McMaster University , Hamilton , Canada
| | - A Alyass
- c Department of Clinical Epidemiology , McMaser University , Hamilton , Canada
| | - S Greene
- b Department of Social Work , McMaster University , Hamilton , Canada
| | - G Kwaramba
- d Department of Medicine , University of Toronto, St. Michael's Hospital , Toronto , Canada
| | - S Smith
- d Department of Medicine , University of Toronto, St. Michael's Hospital , Toronto , Canada
| | - A Carvalhal
- e Department of Psychiatry , University of Toronto , Toronto , Canada
| | - V L Kennedy
- f Women's College Research Institute , Women's College Hospital, University of Toronto & Maple Leaf Medical Clinic , Toronto , Canada
| | - S Walmsley
- g Department of Medicine , University of Toronto, University Health Network , Toronto , Canada
| | - M Loutfy
- f Women's College Research Institute , Women's College Hospital, University of Toronto & Maple Leaf Medical Clinic , Toronto , Canada
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14
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Olin SCS, McCord M, Stein REK, Kerker BD, Weiss D, Hoagwood KE, Horwitz SM. Beyond Screening: A Stepped Care Pathway for Managing Postpartum Depression in Pediatric Settings. J Womens Health (Larchmt) 2017; 26:966-975. [PMID: 28409703 DOI: 10.1089/jwh.2016.6089] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The negative consequences of untreated postpartum depression (PD) for both the woman and her infant are well established. The impact of maternal depression has led to recommendations on systematic perinatal depression screening. Unfortunately, large-scale initiatives on PD screening have found no benefit unless systems are in place to facilitate appropriate interventions for women who screen positive. Pediatric primary care has been a focus of efforts to support screening and management of PD because pediatric providers, unlike adult healthcare providers, have the most frequent contact with postpartum women through well-child visits. Well-child visits thus present an unparalleled opportunity to detect and intervene with PD. Literature reviews suggest that specific strategies are feasible within pediatric settings and could benefit both the woman and her child. In this article, we present a stepped care approach for screening and managing PD, integrating common elements found in existing pediatric-based models. A stepped care approach is ideal because PD is a heterogeneous condition, with a range of presentations and hence responsiveness to various interventions. This care pathway begins with systematic screening for depression symptoms, followed by a systematic risk assessment for women who screen positive and care management based on risk profiles and responsiveness. This approach allows pediatric providers to be optimally flexible and responsive in addressing the majority of women with PD within the context of the family-centered medical home to improve child well-being. Challenges to managing PD within pediatrics are discussed, including strategies for addressing them. Implications for research, policy, and practice are discussed.
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Affiliation(s)
- Su-Chin Serene Olin
- 1 Department of Child and Adolescent Psychiatry, New York University School of Medicine , New York, New York
| | - Mary McCord
- 2 Department of Pediatrics, New York University School of Medicine , New York, New York.,3 Department of Pediatrics, Gouverneur Health Services , New York, New York
| | - Ruth E K Stein
- 4 Albert Einstein College of Medicine/Children's Hospital at Montefiore , New York, New York
| | - Bonnie D Kerker
- 1 Department of Child and Adolescent Psychiatry, New York University School of Medicine , New York, New York
| | - Dara Weiss
- 1 Department of Child and Adolescent Psychiatry, New York University School of Medicine , New York, New York
| | - Kimberly E Hoagwood
- 1 Department of Child and Adolescent Psychiatry, New York University School of Medicine , New York, New York
| | - Sarah M Horwitz
- 1 Department of Child and Adolescent Psychiatry, New York University School of Medicine , New York, New York
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Relationship-Building Skills of Child-Rearing Mothers in Japanese Communities. Nurs Res Pract 2016; 2016:9091039. [PMID: 27429804 PMCID: PMC4939190 DOI: 10.1155/2016/9091039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 04/15/2016] [Accepted: 06/08/2016] [Indexed: 11/18/2022] Open
Abstract
This study elucidated the skills of mothers who used to build positive interpersonal relationships with people they met through child-rearing. The research method was qualitative descriptive study. The participants were 24 mothers who had children between ages of one and four years. These participants were recruited at child-rearing salons and childcare centers located in various municipalities in Japan. The survey period was from September 2013 to July 2014. The mothers' interpersonal relationship-building skills were described by six categories: “ability to strive for new encounters,” “ability to try to interact socially with others,” “ability to choose compatible people,” “ability to continuously maintain good relationships,” “ability to take action suitable to a situation,” and “ability to build positive relationships with parents-in-law.” Cognitive aspects of assessing and understanding the interactions that occur during exchanges and behavioral aspects guided by these cognitions were identified within these skills. This study contributed to providing a framework to understand mothers' interpersonal relationship-building skills for public health nurses involved in child-rearing support.
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Brockington I. Emotional Rejection of the Infant: Status of the Concept. Psychopathology 2016; 49:247-260. [PMID: 27583348 DOI: 10.1159/000448334] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 07/11/2016] [Indexed: 11/19/2022]
Abstract
Emotional rejection of the infant is a morbid, clinical phenomenon, central to mother-infant psychiatry. It occurs in about 1% of births in the general population, but much more often in mothers referred to specialist services. It has severe consequences for children, but responds well to treatment. It is now better recognized, but research is required, especially cohort studies and neuroscientific investigations.
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Affiliation(s)
- Ian Brockington
- Professor Emeritus, University of Birmingham, Birmingham, UK
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