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Baradwan S, Hafedh B, Alyafi M, Algreisi F, Baradwan A, Alghamdi DS, Atalla EMI, El-Mazzally YM, Ismail HS, Shrief KE, Abdelhakim AM, Khodry MM. The Effect of Virtual Reality Application on Pain and Anxiety During Episiotomy Repair: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Int Urogynecol J 2024:10.1007/s00192-024-05867-4. [PMID: 39042152 DOI: 10.1007/s00192-024-05867-4] [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: 03/04/2024] [Accepted: 06/20/2024] [Indexed: 07/24/2024]
Abstract
INTRODUCTION AND HYPOTHESIS There is a rising trend among women towards nonpharmacological approaches owing to their minimally invasive nature and limited adverse effects. Virtual reality (VR) has recently gained popularity as a new technology for reducing pain and anxiety in medical settings. Our research sought to investigate the impact of VR on pain and anxiety levels while undergoing episiotomy repair. METHODS A comprehensive search was carried out across PubMed, Scopus, Cochrane Library, and ISI Web of Science to find relevant randomized clinical trials (RCTs) up to January 2024. These trials investigated the use of VR as a treatment during episiotomy repair compared with a control group that did not receive VR intervention. Meta-analysis was performed using Review Manager software to analyze the data collected. Our primary outcomes were pain scores reported during and after episiotomy repair measured by a visual analog scale. Secondary outcomes analyzed included anxiety scores during and after the procedure, as well as the duration of episiotomy repair. RESULTS Seven RCTs, involving 578 patients, met the inclusion criteria. VR resulted in a significant reduction in pain scores both during and after episiotomy repair (p < 0.001). Additionally, anxiety levels during and after the procedure were significantly reduced in the VR group compared with the control group. Moreover, the duration of episiotomy repair was significantly shorter in the VR group. CONCLUSION Using VR has proven to be an effective technique in reducing pain and anxiety during and after episiotomy repair, as well as potentially speeding up the procedure.
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Affiliation(s)
- Saeed Baradwan
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Bandr Hafedh
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Mohammad Alyafi
- Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Fahad Algreisi
- Department of Obstetrics and Gynecology, Jeddah University, Jeddah, Saudi Arabia
| | - Afnan Baradwan
- Department of Obstetrics and Gynecology, Al Salama Hospital, Jeddah, Saudi Arabia
| | - Deama Saeed Alghamdi
- Department of Obstetrics and Gynecology, Faculty of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | - Yousef Mohamed El-Mazzally
- Department of Community Medicine and Industrial Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Hany Said Ismail
- Department of Anesthesia and Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Khaled Elsheshtawy Shrief
- Department of Anesthesia and Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed Mohamed Abdelhakim
- Kasr Al-Ainy, Faculty of Medicine, Cairo University, 395 Portsaid Street, Bab El-Kalq, Cairo, 11638, Egypt.
| | - Mostafa Mohamed Khodry
- Department of Obstetrics and Gynecology, Faculty of Medicine, South Valley University, Qena, Egypt
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Tjernström K, Lindberg I, Wiklund M, Persson M. Overlooked by the obstetric gaze - how women with persistent health problems due to severe perineal trauma experience encounters with healthcare services: a qualitative study. BMC Health Serv Res 2024; 24:610. [PMID: 38724992 PMCID: PMC11084138 DOI: 10.1186/s12913-024-11037-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 04/23/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND During the first year postpartum, about 25 per cent of Swedish women with severe perineal trauma (SPT), i.e., a third- or fourth-degree perineal laceration at childbirth, are unsatisfied with their healthcare contacts. Further, there is a lack of research on the more long-term experiences of healthcare encounters among women with persistent SPT-related health problems. This study explores how women with self-reported persistent SPT-related health problems experience their contact with healthcare services 18 months to five years after childbirth when the SPT occurred. METHODS In this descriptive qualitative study, a purposive sample of twelve women with self-reported persistent health problems after SPT were individually interviewed from November 2020 - February 2022. The data was analysed using inductive qualitative content analysis. RESULTS Our results showed a paradoxical situation for women with persistent health problems due to SPT. They struggled with their traumatised body, but healthcare professionals rejected their health problems as postpartum normalities. This paradox highlighted the women's difficulties in accessing postpartum healthcare, rehabilitation, and sick leave, which left them with neglected healthcare needs, diminished emotional well-being, and loss of financial and social status. Our results indicated that these health problems did not diminish over time. Consequently, the women had to search relentlessly for a 'key person' in healthcare who acknowledged their persistent problems as legitimate to access needed care, rehabilitation, and sick leave, thus feeling empowered. CONCLUSIONS Our study revealed that women with persistent SPT-related health problems experienced complex health challenges. Additionally, their needs for medical care, rehabilitation, and sick leave were largely neglected. Thus, the study highlights an inequitable provision of SPT-related healthcare services in Sweden, including regional disparities in access to care. Hence, the authors suggest that Swedish national guidelines for SPT-related care need to be developed and implemented, applying a woman-centered approach, to ensure equitable, effective, and accessible healthcare.
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Affiliation(s)
| | - Inger Lindberg
- Department of Nursing, Umeå University, 901 87, Umeå, Sweden
| | - Maria Wiklund
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, 901 87, Umeå, Sweden
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Opondo C, Harrison S, Sanders J, Quigley MA, Alderdice F. The relationship between perineal trauma and postpartum psychological outcomes: a secondary analysis of a population-based survey. BMC Pregnancy Childbirth 2023; 23:639. [PMID: 37674105 PMCID: PMC10481495 DOI: 10.1186/s12884-023-05950-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 08/24/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Perineal trauma, involving either naturally occurring tears or episiotomy, is common during childbirth but little is known about its psychological impact. This study aimed to determine the associations between childbirth related perineal trauma and psychological outcomes reported by women three months after giving birth and to explore factors that could mediate relationships between perineal trauma and maternal psychological outcomes. METHODS This study was a secondary analysis of data from a cross-sectional population-based survey of maternal and infant health. A total of 4,578 women responded to the survey, of which 3,307 had a vaginal birth and were eligible for inclusion into the analysis. Symptoms of depression, anxiety, and post-traumatic stress (PTS) symptoms were assessed using validated self- report measures. Physical symptoms were derived from a checklist and combined to produce a composite physical symptoms score. Regression models were fitted to explore the associations. RESULTS Nearly three quarters of women experienced some degree of perineal trauma. Women who experienced perineal trauma reported having more postnatal physical symptoms (adjusted proportional odds ratio 1.47, 95%CI 1.38 to 1.57, p-value < 0.001), were more likely to report PTS symptoms (adjusted OR 1.19, 95%CI 1.04 to 1.36, p-value 0.010), and there was strong evidence that each unit increase in the physical symptoms score was associated with between 38 and 90% increased adjusted odds of adverse psychological symptoms. There was no evidence of association between perineal trauma and satisfaction with postnatal care, although there was strong evidence that satisfaction with labour and birth was associated with 16% reduced adjusted odds of depression and 30% reduced adjusted odds of PTS symptoms. CONCLUSIONS Women who experienced perineal trauma were more likely to experience physical symptoms, and the more physical symptoms a woman experienced the more likely she was to report having postnatal depression, anxiety and PTS symptoms. There was some evidence of a direct association between perineal trauma and PTS symptoms but no evidence of a direct association between perineal trauma and depression or anxiety. Assessment and management of physical symptoms in the postnatal period may play an important role in reducing both physical and psychological postnatal morbidity.
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Affiliation(s)
- Charles Opondo
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, OX3 7LF, Oxford, UK
| | - Siân Harrison
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, OX3 7LF, Oxford, UK
| | - Julia Sanders
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Ty Dewi Sant Health Park, Cardiff, CF14 4XN, UK
| | - Maria A Quigley
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, OX3 7LF, Oxford, UK
| | - Fiona Alderdice
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, OX3 7LF, Oxford, UK.
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Brophy C, Corbett GA, O Brien L. Shining a light on postnatal perineal granulation tissue. Int J Gynaecol Obstet 2022; 159:315-316. [PMID: 35656745 PMCID: PMC9542055 DOI: 10.1002/ijgo.14297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/22/2022] [Accepted: 05/31/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Caroline Brophy
- Postnatal Morbidity Service (POPPY Clinic), National Maternity Hospital, Dublin, Ireland.,Department of Midwifery, National Maternity Hospital, Dublin, Ireland
| | - Gillian A Corbett
- Department of Obstetrics and Gynaecology, National Maternity Hospital, Dublin, Ireland.,UCD School of Medicine, University College Dublin, Dublin, Ireland
| | - Laoise O Brien
- Postnatal Morbidity Service (POPPY Clinic), National Maternity Hospital, Dublin, Ireland.,Department of Obstetrics and Gynaecology, National Maternity Hospital, Dublin, Ireland.,UCD School of Medicine, University College Dublin, Dublin, Ireland
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Huang B, Lu Y, Zhang Y, Zhang W, Wang X. Application of natural shoulder delivery combined with free position delivery in maternal delivery. Am J Transl Res 2021; 13:14168-14175. [PMID: 35035762 PMCID: PMC8748160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 10/12/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This research was designed to probe into the influences of natural shoulder delivery combined with free position delivery on pregnant outcome and genital tract of puerperants. METHODS Totally 128 puerperants who gave birth in our hospital from May 2018 to November 2019 were selected as the research objects. Among them, 66 in traditional position combined with traditional shoulder delivery were assigned to a conventional group (CG), and 62 in free position combined with natural shoulder delivery were assigned to a research group (RG). Their psychological mood, pain degree, pregnancy outcome, labor time, postpartum recovery and genital tract injury were compared. RESULTS Compared with the CG, the scores of visual analogue scale (VAS) pain, postpartum self-rating depression scale (SDS) and self-rating anxiety scale (SAS) in the RG during delivery were lower (P<0.05); the first, second, third and total labor stages in the RG were shorter (P<0.05). What's more, in the RG, the incidences of lateral episiotomy, urinary retention, stress urinary incontinence, transit cesarean section, shoulder dystocia and neonatal asphyxia were lower, while the perineum integrity and natural delivery rates were higher (P<0.05); the postpartum height of uterus, lochia discharge and blood loss were lower, while milk yield was higher (P<0.05). CONCLUSION Natural shoulder delivery combined with free position delivery can effectively improve the pregnancy outcome, benefit the postpartum recovery, shorten the labor process and reduce the degree of genital tract injury. Hence, it is worthy of clinical application.
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Affiliation(s)
- Baomei Huang
- Department of Gynaecology and Obstetrics, The First People's Hospital of Taizhou City Taizhou 318020, Zhejiang Province, China
| | - Yanmei Lu
- Department of Gynaecology and Obstetrics, The First People's Hospital of Taizhou City Taizhou 318020, Zhejiang Province, China
| | - Yao Zhang
- Department of Gynaecology and Obstetrics, The First People's Hospital of Taizhou City Taizhou 318020, Zhejiang Province, China
| | - Wenjin Zhang
- Department of Gynaecology and Obstetrics, The First People's Hospital of Taizhou City Taizhou 318020, Zhejiang Province, China
| | - Xiaoyan Wang
- Department of Gynaecology and Obstetrics, The First People's Hospital of Taizhou City Taizhou 318020, Zhejiang Province, China
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East CE, Dorward ED, Whale RE, Liu J. Local cooling for relieving pain from perineal trauma sustained during childbirth. Cochrane Database Syst Rev 2020; 10:CD006304. [PMID: 33034900 PMCID: PMC8094618 DOI: 10.1002/14651858.cd006304.pub4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Perineal trauma is common during childbirth and may be painful. Contemporary maternity practice includes offering women numerous forms of pain relief, including the local application of cooling treatments. This Cochrane Review is an update of a review last updated in 2012. OBJECTIVES To evaluate the effectiveness of localised cooling treatments compared with no treatment, placebo, or other cooling treatments applied to the perineum for pain relief following perineal trauma sustained during childbirth. SEARCH METHODS We searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (7 October 2019) and reference lists of retrieved studies. SELECTION CRITERIA Published and unpublished randomised and quasi-randomised trials (RCTs) that compared a localised cooling treatment applied to the perineum with no treatment, placebo, or another cooling treatment applied to relieve pain related to perineal trauma sustained during childbirth. DATA COLLECTION AND ANALYSIS Two review authors independently assessed study eligibility, extracted data and assessed the risk of bias of included studies. Data were double checked for accuracy. The certainty of the evidence was assessed using the GRADE approach. MAIN RESULTS We included 10 RCTs that enrolled 1233 women randomised to the use of one cooling treatment (ice, cold gel pad, cooling plus compression, cooling plus compression plus (being) horizontal) compared with another cooling treatment, no treatment, or placebo (water pack, compression). The included trials were at low or uncertain risk of bias overall, with the exception that the inability to blind participants and personnel to group allocation meant that we rated all trials at unclear or high risk for this domain. We undertook a number of comparisons to evaluate the different treatments. Cooling treatment (ice pack or cold gel pad) versus no treatment There was limited very low-certainty evidence that cooling treatment may reduce women's self-reported perineal pain within four to six hours (mean difference (MD) -4.46, 95% confidence interval (CI) -5.07 to -3.85 on a 10-point scale; 1 study, 100 participants) or between 24 and 48 hours of giving birth (risk ratio (RR) 0.73, 95% CI 0.57 to 0.94; 1 study, 316 participants). The evidence is very uncertain about the various measures of wound healing, for example, wound edges gaping when inspected five days after giving birth (RR 2.56, 95% CI 0.58 to 11.33; 1 study, 315 participants). Women generally rated their satisfaction with perineal care similarly following cooling or no treatment. The potential exception was that there may be a trivially lower mean difference of -0.1 on a five-point scale of psychospiritual comfort with cooling treatment, that is unlikely to be of clinical importance. Cooling treatment (cold gel pad) + compression versus placebo (gel pad + compression) There was limited low-certainty evidence that there may be a trivial MD of -0.43 in pain on a 10-point scale at 24 to 48 hours after giving birth (95% CI -0.73 to -0.13; 1 study, 250 participants) when a cooling treatment plus compression from a well-secured perineal pad was compared with the placebo. Levels of perineal oedema may be similar for the two groups (low-certainty evidence) and perineal bruising was not observed. There was low-certainty evidence that women may rate their satisfaction as being slightly higher with perineal care in the cold gel pad and compression group (MD 0.88, 95% CI 0.38 to 1.38; 1 trial, 250 participants). Cooling treatment (ice pack) versus placebo (water pack) One study reported that no women reported pain after using an ice pack or a water pack when asked within 24 hours of giving birth. There was low-certainty evidence that oedema may be similar for the two groups when assessed at four to six hours (RR 0.96, 95% CI 0.50 to 1.86; 1 study, 63 participants) or within 24 hours of giving birth (RR 0.36, 95% CI 0.08 to 1.59). No women were observed to have perineal bruising at these times. The trialists reported that no women in either group experienced any adverse effects on wound healing. There was very low-certainty evidence that women may rate their views and experiences with the treatments similarly (for example, satisfied with treatment: RR 0.91, 95% CI 0.77 to 1.08; 63 participants). Cooling treatment (ice pack) versus cooling treatment (cold gel pad) The evidence is very uncertain about the effects of using ice packs or cold gel pads on women's self-rated perineal pain, on perineal bruising, or on perineal oedema at four to six hours or within 24 hours of giving birth. Perineal oedema may persist 24 to 48 hours after giving birth in women using the ice packs (RR 1.69, 95% CI 1.03 to 2.7; 2 trials, 264 participants; very low-certainty). The risk of gaping wound edges five days after giving birth may be decreased in women who had used ice packs (RR 0.22, 95% CI 0.05 to 1.01; 215 participants; very low-certainty). However, this did not appear to persist to day 10 (RR 3.06, 95% CI 0.63 to 14.81; 214 participants). Women may rate their opinion of treatment less favourably following the use of ice packs five days after giving birth (RR 0.33, 95% CI 0.17 to 0.68; 1 study, 49 participants) and when assessed on day 10 (RR 0.82, 95% CI 0.73 to 0.92; 1 study, 208 participants), both very low-certainty. AUTHORS' CONCLUSIONS There is limited very low-certainty evidence that may support the use of cooling treatments, in the form or ice packs or cold gel pads, for the relief of perineal pain in the first two days following childbirth. It is likely that concurrent use of several treatments is required to adequately address this issue, including prescription and non-prescription analgesia. Studies included in this review involved the use of cooling treatments for 10 to 20 minutes, and although no adverse effects were noted, these findings came from studies of relatively small numbers of women, or were not reported at all. The continued lack of high-certainty evidence of the benefits of cooling treatments should be viewed with caution, and further well-designed trials should be conducted.
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Affiliation(s)
- Christine E East
- School of Nursing and Midwifery, La Trobe University/Mercy Hospital for Women, Bundoora, Australia
| | | | | | - Jiajia Liu
- Antenatal/Postnatal Ward, Mercy Hospital for Women, Heidelberg, Australia
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Jahani Shoorab N, Taghipour A, Esmaily H, Latifnejad Roudsari R. Development and Psychometric Properties of the Women's Recovery of Postnatal Perineal Injuries Questionnaire (WRPPIQ). INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2020; 8:311-323. [PMID: 33178854 PMCID: PMC7648862 DOI: 10.30476/ijcbnm.2020.85610.1279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 07/24/2020] [Accepted: 08/23/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Recovery of postnatal women with perineal injuries, especially when perineal tear is severe, occurs much later than the healthy women. There is no specific questionnaire to assess the postnatal recovery in these women. The aim of this study was development and psychometric evaluation of a new tool to measure women's recovery of postnatal perineal injuries questionnaire (WRPPIQ). METHODS In this validation study, which was conducted based on the method developed by DeVellis (2003), 270 women with postnatal perineal injuries who referred to healthcare centers in Mashhad, Iran, were studied between 2018 and 2020. This method consisted of steps: (1) definition of postnatal recovery based on in-depth qualitative interview with 22 women, (2) generation of an item pool, (3) selection of the Likert scale, (4) review of the initial item pool, (5) inclusion of items from relevant instruments, (6) conducting exploratory factor analysis, (7) evaluation of the items, and (8) optimization of the scale length. RESULTS The initially generated item pool consisted of 144 items on a 5-point Likert scale, which reduced to 85 items following face and content validity measurement. The value of the SCVI/Ave was measured 0.901. The conduction of exploratory factor analysis resulted in 33 items and three factors including evidence of wellness, emotional changes as well as independence and support. The Cronbach's alpha for the three factors was calculated 0.92, 0.80, and 0.83, respectively. CONCLUSION WRPPIQ has validity and reliability to measure the women's recovery of postnatal perineal injuries in Iran. It is, therefore, recommended that health care providers to assess women's recovery of postnatal perineal injuries using this newly developed questionnaire.
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Affiliation(s)
- Nahid Jahani Shoorab
- Nursing and Midwifery Care Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Taghipour
- Social Determinants of Health Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Social Determinants of Health Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Robab Latifnejad Roudsari
- Nursing and Midwifery Care Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
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Mirzakhani K, Khadivzadeh T, Faridhosseini F, Ebadi A. Pregnant Women's Experiences of the Conditions Affecting Marital Well-Being in High-Risk Pregnancy: A Qualitative Study. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2020; 8:345-357. [PMID: 33178857 PMCID: PMC7648861 DOI: 10.30476/ijcbnm.2020.85666.1285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 06/25/2020] [Accepted: 07/04/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND High-risk pregnancy is associated with many problems which can affect marital well-being as well as maternal and fetal health. Yet, there is limited information about the conditions which affect marital well-being in high-risk pregnancy. This study aimed to explore the pregnant women's experiences of the conditions affecting marital well-being in high-risk pregnancy. METHODS This qualitative study was conducted from October 2018 to December 2019. Participants were 24 women with high-risk pregnancy who were purposively selected from three public and two private hospitals as well as a primary healthcare center in Mashhad, Iran. Face-to-face semi-structured interviews were conducted for data collection. Data were analyzed concurrently with data collection through Graneheim and Lundman's content analysis (2004). The MAXQDA program (v. 10) was used for data management. RESULTS Conditions affecting marital well-being in high-risk pregnancy were categorized into eleven subcategories and three main categories, namely emotional spousal intimacy in the midst of danger, husband's commitment to manage the difficult conditions of pregnancy and sexual relationship during high-risk pregnancy. CONCLUSION Several conditions can affect marital well-being in high-risk pregnancy. Healthcare providers can develop and use strategies for the effective management of these conditions, thereby improving marital well-being among women with high-risk pregnancy.
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Affiliation(s)
- Kobra Mirzakhani
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Talaat Khadivzadeh
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farhad Faridhosseini
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life style institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Department of Nursing Management, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Mirzakhani K, Ebadi A, Faridhosseini F, Khadivzadeh T. Well-being in high-risk pregnancy: an integrative review. BMC Pregnancy Childbirth 2020; 20:526. [PMID: 32912254 PMCID: PMC7488451 DOI: 10.1186/s12884-020-03190-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 08/19/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND A prerequisite to the interventions for well-being improvement in high-risk pregnancy (HRP) is to make the concept clear, objective, and measurable. Despite the wealth of studies into the concept of well-being in HRP, there is no clear definition for it. This study aimed to explore the concept of well-being in HRP. METHODS This integrative review was conducted using the Whittemore and Knafl's approach. A literature search was done without any data limitation in dictionaries, thesauruses, encyclopedias, well-being-related textbooks, midwifery, psychology, and mental health journals, and Iranian and international databases. The most primary inclusion criterion was relevance to well-being in HRP. The full-texts of all these articles were assessed using the checklists of the Joanna Briggs Institute. Data were analyzed through the constant comparison method and were managed using the MAXQDA 10 software. Meaning units were identified and coded. The codes were grouped into subcategories and categories according to the attributes, antecedents, and consequences of well-being in HRP. RESULTS Thirty articles were included in the review, from which 540 codes were extracted. The codes were grouped into seven main attributes, eight main antecedents, and five main consequences of well-being in HRP. The four unique dimensions of well-being in HRP are physical, mental-emotional, social, and spiritual well-being. These dimensions differentiate well-being in HRP from well-being in low-risk pregnancy and in non-pregnancy conditions. CONCLUSION As a complex and multidimensional concept, well-being in HRP refers to the pregnant woman's evaluation of her life during HRP. It includes physical, hedonic, and eudaimonic components. The assessment of well-being in HRP should include all these components.
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Affiliation(s)
- Kobra Mirzakhani
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life style institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Farhad Faridhosseini
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Talaat Khadivzadeh
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
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Shoorab NJ, Taghipour A, Mirteimouri M, Roudsari RL. Social Recovery: A Neglected Dimension of Caring for Women with Perineal Trauma in Iran. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2020; 25:333-340. [PMID: 33014746 PMCID: PMC7494167 DOI: 10.4103/ijnmr.ijnmr_245_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 03/08/2020] [Accepted: 04/17/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Social recovery during the postnatal period in women with perineal trauma is a little-known concept. Therefore, this study was designed to explore the experiences of social recovery in women with childbirth-related perineal trauma. MATERIALS AND METHODS A qualitative approach using content analysis was adopted to study a purposive sample of 22 postnatal women with perineal trauma during birth at Omol-banin Hospital, Mashhad, Iran from April 20th to December 25th, 2017. The participants were selected between 10 days to one year after childbirth. Data were collected through semi-structured interviews. Conventional content analysis approach was performed, concurrently, with data collection. To organize data, the MAXQDA 10 was used. RESULTS Social recovery after perineal trauma was conceptualized as 'shifting from personal ill-health to interactional empowerment'. Two generic categories emerged from data analysis including 1) impaired individual and social function, which was recognized by social isolation and lack of ability to manage daily life and 2) empowering social interactions, which was characterized by rebuilding social partnerships and returning to an interactive lifestyle. CONCLUSIONS Social isolation as the result of neglecting social recovery of women with severe perineal trauma endangers the mental health of mothers. Understanding the concept of social recovery for women with perineal trauma, especially in severe cases, will help health professionals to provide quality postpartum care for women with perineal trauma in a longer period after childbirth.
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Affiliation(s)
- Nahid Jahani Shoorab
- Nursing and Midwifery Care Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Taghipour
- Social Determinants of Health Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoumeh Mirteimouri
- Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Robab Latifnejad Roudsari
- Nursing and Midwifery Care Research Center, Mashhad, Iran
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
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