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Worrall S, Christiansen P, Khalil A, Silverio SA, Fallon V. Associations between prematurity, postpartum anxiety, neonatal intensive care unit admission, and stress. Front Psychiatry 2024; 15:1323773. [PMID: 38463430 PMCID: PMC10921229 DOI: 10.3389/fpsyt.2024.1323773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/02/2024] [Indexed: 03/12/2024] Open
Abstract
Introduction It is well established that a premature birth increases the likelihood of developing anxiety during the postpartum period, and that the environment of the neonatal intensive care unit (NICU) might be a contributing factor. Mothers of earlier premature infants may experience these anxieties to a higher degree compared to mothers of later premature infants. The aim of this study was to explore the association between prematurity and postpartum-specific anxiety, and the relationship between postpartum-specific anxiety and stress in the NICU. Materials and methods Mothers (N = 237) of infants aged between birth and 12 months completed an online survey containing the Postpartum Specific Anxiety Scale - Research Short Form (PSAS-RSF) and the Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU). Structural equation modeling was used to analyze the relationship between gestational age and postpartum-specific anxiety, with one-way ANOVAs used to analyze this relationship with respect to categories of gestational age. Hierarchical regression models analyzed the relationship between postpartum-specific anxiety and stress in the NICU. Results For the PSAS-RSF, Practical Infant Care Anxieties (p = 0.001), Maternal Competence and Attachment Anxieties (p = 0.033), and Infant Safety and Welfare Anxieties (p = 0.020) were significantly associated with week of gestation. Practical Infant Care and Infant Safety and Welfare Anxieties were significantly higher for mothers of late premature infants, compared to mothers of term infants (p < 0.001; p = 0.019). There were no significant between-group differences with respect to Maternal Competence and Attachment Anxieties. After controlling for potential confounders, Infant Safety and Welfare Anxieties were significantly associated with increased stress in the NICU (p < 0.001) as measured by the PSS:NICU. Conclusions Our findings highlight the need for interventions for mothers with premature infants, which specifically target anxieties reflected in the PSAS-RSF, such as routine care and increasing maternal self-efficacy.
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Affiliation(s)
- Semra Worrall
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Paul Christiansen
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Asma Khalil
- Fetal Medicine Unit, Liverpool Women’s NHS Foundation Trust, Liverpool, United Kingdom
- Fetal Medicine Unit, St George’s University Hospitals NHS Foundation Trust, London, United Kingdom
| | - Sergio A. Silverio
- Department of Women & Children’s Health, School of Life Course & Population Sciences, King’s College London, London, United Kingdom
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
| | - Victoria Fallon
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
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Conceição TED, Souza MHDN, Esteves RB, Peres PLP, Valente D, Nespoli A. Maternal Concerns in Home Care for the Premature Newborn: An Integrative Review. Rev Bras Enferm 2023; 76:e20220769. [PMID: 38055478 DOI: 10.1590/0034-7167-2022-0769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/23/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE To identify and analyze the scientific literature, both national and international, concerning the primary maternal concerns about caring for premature newborns at home. METHODS This integrative review is based on the guiding question: "What scientific publications from 2012 to 2021 address maternal concerns about the care of premature newborns at home?". Searches were conducted in the electronic databases: Embase, Medline, Web of Science, Lilacs, Scielo, and Cochrane Library. RESULTS A total of 21 articles were identified. The qualitative analysis showed that maternal concerns pertained to breastfeeding, hygiene, sunbathing practices, managing infant colic, identifying signs, symptoms, and clinical changes, temperature control, and the third phase of the kangaroo method. CONCLUSIONS Maternal uncertainties underscore the importance of enhancing strategies focused on supporting families and ensuring continued care for neonates at home.
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Yan Q, Li D, Yin X, Jiang N, Sun N, Luo Q, Pang X, Fan L, Gong Y. Development and validation of a maternal anxiety for neonatal jaundice scale in China. BMC Psychiatry 2022; 22:526. [PMID: 35927624 PMCID: PMC9351162 DOI: 10.1186/s12888-022-04161-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 07/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Maternal anxiety induced by neonatal jaundice has adverse effects on maternal and infant health, but there was no specific tool to identify the anxiety level of mothers. This study aims to develop a Maternal Anxiety for Neonatal Jaundice Scale (MANJS) and to validate it in the target population. METHODS An initial 11-items MANJS was developed through literature review, expert panel consultation, and a pilot-test. Subsequently, mothers of neonates with jaundice were recruited from the Maternal and Child Health Hospital of Hainan Province, China, from June to December 2018, for a formal questionnaire survey. Based on the data collected, the scale was validated for construct validity, convergent validity, discriminant validity, content validity, and internal consistency reliability after the items screening. RESULTS The reliability and validity of MANJS were validated in 1127 mothers of jaundiced neonates. After the item with cross-loadings was removed using exploratory factor analysis, MANJS consisted of two dimensions and 10 items, with a cumulative variance contribution of 74.36% and factor loadings above 0.6 for all items. The confirmatory factor analysis identified three items with cross-factor loading or error correlation and then they were removed orderly. The further confirmatory factor analysis showed a good construct validity for the 7-item MANJS, with standardized root mean square residual (SRMR) = 0.029, root mean square error of approximation (RMSEA) = 0.068, comparative fit index (CFI) = 0.961, Tucker-Lewis index (TLI) = 0.937, incremental fit index (IFI) = 0.961, normed fit index (NFI) = 0.954, goodness of fit index (GFI) = 0.998, adjusted goodness of fit index (AGFI) = 0.996, respectively. The average variance extracted values (AVE) of the two factors were 0.80 and 0.72, and the combined reliability (CR) were 0.94 and 0.88, respectively. Cronbach's alpha was 0.90 for the MANJS, and split-half reliability was 0.72. CONCLUSIONS MANJS was demonstrated to have satisfactory reliability and validity in evaluating maternal anxiety caused by neonatal jaundice among Chinese postpartum women.
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Affiliation(s)
- Qin Yan
- grid.33199.310000 0004 0368 7223Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, 430030 Wuhan, P. R. China
| | - Dandan Li
- grid.33199.310000 0004 0368 7223Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, 430030 Wuhan, P. R. China
| | - Xiaoxv Yin
- grid.33199.310000 0004 0368 7223Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, 430030 Wuhan, P. R. China
| | - Nan Jiang
- grid.33199.310000 0004 0368 7223Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, 430030 Wuhan, P. R. China
| | - Na Sun
- grid.33199.310000 0004 0368 7223Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, 430030 Wuhan, P. R. China
| | - Qing Luo
- grid.502812.cDepartment of Child Heath Care, Hainan Women and Children’s Medical Center, NO.15 South of Longkun Road, Haikou, P.R. China
| | - Xin Pang
- grid.502812.cDepartment of Pediatrics, Hainan Women and Children’s Medical Center, NO.15 South of Longkun Road, Haikou, China
| | - Lichun Fan
- Department of Child Heath Care, Hainan Women and Children's Medical Center, NO.15 South of Longkun Road, Haikou, P.R. China.
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, 430030, Wuhan, P. R. China.
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