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Lee FJ, Lu YY. Associated factors of sexual dysfunction among postpartum women in Taiwan- a cross-sectional study. Afr J Reprod Health 2023; 27:55-62. [PMID: 38051281 DOI: 10.29063/ajrh2023/v27i11.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Sexual function among postpartum women is often overlooked by health-care professionals. This study aimed to investigate associated factors of sexual dysfunction among postpartum women. This study used a cross-sectional study design. A total of 135 postpartum women from a teaching hospital in northern Taiwan who met the inclusion criteria were recruited. SPSS version 22.0 was used to analyze data including descriptive and bivariate analysis. A multiple linear regression was using to identify the predictors of sexual dysfunction among Taiwanese postpartum women. Results indicated that the categories of sexual dysfunction that most commonly experienced in postpartum women were lack of sexual desire, delay or absence of orgasm, pain during intercourse, and inability to become physically aroused. Parity, types of delivery, perineal laceration, breastfeeding, postpartum fatigue, and postpartum depression were significantly associated with sexual dysfunction (p< .05). Sexual counseling and mental support should be necessary for women at risk of postpartum sexual problems such as nulliparous with perineal laceration, breastfeeding mothers, experiencing postpartum fatigue and depressive symptoms to improve their sexual health and quality of life.
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Affiliation(s)
| | - Yu-Ying Lu
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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2
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Ozdemir J, Ozcan S. Do postpartum insomnia, fatigue and depression affect the maternal role of primiparous women? Women Health 2023; 63:837-846. [PMID: 37919971 DOI: 10.1080/03630242.2023.2276150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 10/22/2023] [Indexed: 11/04/2023]
Abstract
Many factors negatively affect the motherhood role. Fatigue, insomnia and depression, which are among these factors, have not been investigated together in any study. Therefore, we carried out this study to determine the effect of insomnia, fatigue and depressive symptoms on the motherhood role in primiparous mothers. In this descriptive and cross-sectional study, we included 153 women who met the inclusion criteria using the simple, random sampling method. To determine the independent variables affecting the motherhood role, we used the backward regression model. In this study, we determined that the women's spending more energy while they performed the activities of daily living in the postpartum period, their suffering from insomnia due to baby care and their depressive symptoms affected their motherhood role by 32.6 percent. We also determined that there was a moderately significant relationship between insomnia, fatigue and depressive symptoms in the postpartum period. In particular, because depressive symptoms are the variable most related with the motherhood role (r = -0.520; p < .001), women should be followed-up regularly in the postpartum period from this aspect. It is also important to deal with insomnia in the early postpartum period, because it is a common problem in most women after childbirth.
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Affiliation(s)
- Jale Ozdemir
- Health Sciences University, Bursa Yüksek Ihtisas Training and Research Hospital Neonatal Intensive Care Unit, Bursa, Turkey
| | - Sadiye Ozcan
- Department of Obstetrics & Gynecological Nursing, Yalova University Faculty of Health Sciences, Yalova, Turkey
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Yan S, Chen J, Zhang F. Infant sleep patterns and maternal postpartum fatigue: A cross-sectional study. J Obstet Gynaecol Res 2022; 48:1193-1201. [PMID: 35179264 DOI: 10.1111/jog.15191] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 01/31/2022] [Accepted: 02/04/2022] [Indexed: 01/15/2023]
Abstract
AIM Unpredictable nature of infant sleep-wake cycles go against that of the adult sleep. Maternal sleep quality is acknowledged as a main factor to postpartum fatigue. This study explored the effects of infant sleep patterns on maternal postpartum fatigue. METHODS A total of 319 mothers of infants from two teaching hospitals in the Nantong City were enrolled. Maternal fatigue status and infant sleep patterns were assessed by the Fatigue Scale (FS-14) and the Brief Infant Sleep Questionnaire (BISQ). Generalized estimating equation analyses were perform to explored the effect of infant sleep patterns on maternal fatigue. RESULTS Sleep-onset time later than 10 p.m., and nocturnal wakefulness more than 60 min were risk factors of postpartum fatigue. After controlling the confounding variables, infant sleep patterns were still the determinant factors of postpartum fatigue. CONCLUSION Infant sleep pattern is a factor of maternal postpartum fatigue. It is recommended to promote infant sleep so as to improve maternal sleep quality and finally alleviate postpartum fatigue.
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Affiliation(s)
- Shuhan Yan
- Medical College, Nantong University, Nantong City, China
| | - Jing Chen
- School of Nursing, Soochow University, Soochow City, China
| | - Feng Zhang
- Medical College, Nantong University, Nantong City, China
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Kawashima A, Detsuka N, Yano R. Sleep deprivation and fatigue in early postpartum and their association with postpartum depression in primiparas intending to establish breastfeeding. J Rural Med 2022; 17:40-49. [PMID: 35047101 PMCID: PMC8753258 DOI: 10.2185/jrm.2021-027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/23/2021] [Indexed: 11/27/2022] Open
Abstract
Objective: To examine the association of objective sleep and fatigue in the
early postpartum period with postpartum depression in Japanese primiparas intending to
establish breastfeeding. Materials and Methods: The participants were 34 primiparas who were in the
postnatal ward after vaginal delivery and responsively breastfeeding their rooming-in
baby. Actigraphy data for objective sleep were collected for three consecutive days
starting from the first day postpartum. Fatigue and postpartum depression were assessed
using the Postpartum Fatigue Scale and Edinburgh Postnatal Depression Scale, respectively,
on numerous days between the first day postpartum and the one-month checkup. Breastfeeding
and rooming-in data were also collected. Results: The mean total sleep time was 252.0 ± 73.1 min/day. Mean
breastfeeding frequency was 12.4 ± 3.2 times/day and mean total breastfeeding time was
247.4 ± 101.8 min/day. Among the participants, 67.6% were exclusively breastfeeding on the
discharge day. Fatigue scores were significantly higher during the hospital stay, compared
with one month postpartum. Multiple regression analysis showed that sleep frequency on the
third day postpartum and mean total breastfeeding time and fatigue on the fifth day
postpartum were factors affecting the Edinburgh Postnatal Depression Scale score. Conclusion: The association between postpartum depression among
breastfeeding primiparas in the early postpartum period and objective sleep, fatigue, and
total breastfeeding time per day was suggested. An environment wherein breastfeeding
mothers can rest and sleep without hesitation will be beneficial. Moreover, the importance
of sleep during pregnancy and the early postpartum period must be highlighted. Midwifery
and/or nursing care starting while the mother is in a postnatal hospital stay can play a
key role in preventing postpartum depression.
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Affiliation(s)
- Ai Kawashima
- Graduate School of Health Sciences, Hokkaido University, Japan
| | | | - Rika Yano
- Faculty of Health Sciences, Hokkaido University, Japan
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Zhang F, Xue Q, Bai T, Wu F, Yan S. Postpartum Fatigue and Inhibited Lactation. Biol Res Nurs 2021; 24:128-139. [PMID: 34719282 DOI: 10.1177/10998004211050047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Postpartum fatigue is a common disorder worldwide and affects both physical and mental functioning. In breastfeeding women, Prolactin (PRL) is not only involved in immunoregulation, but also responsible for lactation. Prolactin levels in women with chronic fatigue are higher than normal, but a chronic fatigue state inhibits postpartum lactation in humans. Objectives: This paper explored the inhibition mechanism of lactation by postpartum fatigue in rats. Methods: Postpartum fatigue models were built by forcing mother rats to stand in water and divided into 3-hour, 9-hour and 15-hour per day fatigue groups according to the underwater time. Mother rats and their offspring were reunited in a dry cage for 90 minutes every 3 hours for feeding. The expression of PRL, PRL receptor (PRLR), Janus Kinase 2 (JAK 2), and Signal transducers and activators of transcription 5 (STAT5) mRNA were analyzed and the microstructure of mammary gland were observed under light and electron microscopy. Results: The expression of pituitary PRL mRNA and its downstream signaling pathway JAK2 and STAT5 mRNA were down-regulated in the severe postpartum fatigue rats. PRL mRNA responses were dose-related to duration of fatigue. The expression of PRLR mRNA increased. Postpartum fatigue led to functional degeneration of mammary gland. The breast lobules were shrunk and the number of alveoli were decreased. Few milk protein granules and fat droplets were observed in the cytoplasm under transmission electron microscope. Conclusion: Postpartum fatigue inhibits the lactation by down-regulating the expression of PRL and PRL-dependent signaling pathway in rats.
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Affiliation(s)
- Feng Zhang
- Medical College, 66479Nantong University, Nantong City, Jiangsu Province, China
| | - Qin Xue
- Medical College, 66479Nantong University, Nantong City, Jiangsu Province, China
| | - Ting Bai
- Medical College, 66479Nantong University, Nantong City, Jiangsu Province, China
| | - Fan Wu
- Medical College, 66479Nantong University, Nantong City, Jiangsu Province, China
| | - Shuhan Yan
- Medical College, 66479Nantong University, Nantong City, Jiangsu Province, China
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Jeong YJ, Nho JH, Kim HY, Kim JY. Factors Influencing Quality of Life in Early Postpartum Women. Int J Environ Res Public Health 2021; 18:2988. [PMID: 33799474 PMCID: PMC8000893 DOI: 10.3390/ijerph18062988] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/05/2021] [Accepted: 03/11/2021] [Indexed: 12/30/2022]
Abstract
Postpartum women experience various changes in their physical and psychological health and in their relationships with their spouse and newborn. This study aimed to identify and evaluate the factors that affect the quality of life (QoL) of women within six weeks after childbirth. A prospective, cross-sectional correlational study was used. A convenience sample of 179 postpartum women was recruited from four postpartum care centers in South Korea. Participants completed structured questionnaires on postpartum fatigue, postpartum depression, marital intimacy, breastfeeding adaptation, and quality of life. Marital intimacy (β = 0.466, p < 0.001) was the most influencing factor on the QoL of women during the postpartum period. In descending order, postpartum fatigue (β = -0.192, p = 0.001), postpartum depression (β = -0.190, p = 0.001), breastfeeding adaptation (β = 0.163, p = 0.002), and occupation (β = 0.163, p = 0.004) all had a significant influence on QoL (F = 32.09, p < 0.001), and the overall explanatory power was 63.6%. It is necessary to assess and consider the physical, psychological, relational, and demographic factors of women during the early postpartum period. Comprehensive interventions need to be developed to improve the QoL of women during the postpartum period.
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Affiliation(s)
- Yu-Jeong Jeong
- Department of Nursing, Presbyterian Medical Center, 365 Seowon-ro, Wansan-gu, Jeonju, Jeollabuk do 54987, Korea;
| | - Ju-Hee Nho
- College of Nursing, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju, Jeollabuk do 54896, Korea; (H.Y.K.); (J.Y.K.)
| | - Hye Young Kim
- College of Nursing, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju, Jeollabuk do 54896, Korea; (H.Y.K.); (J.Y.K.)
| | - Ji Young Kim
- College of Nursing, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju, Jeollabuk do 54896, Korea; (H.Y.K.); (J.Y.K.)
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Badr HA, Zauszniewski JA, Quinn Griffin M, Burant CJ, Przeworski A, Almutairi WM, Alsharif FH. Effects of Postpartum Fatigue and Depressive Cognitions on Life Satisfaction and Quality of Life in Arab Postpartum Women: The Intervening Role of Resourcefulness. Nurs Rep 2021; 11:84-94. [PMID: 34968315 PMCID: PMC8608046 DOI: 10.3390/nursrep11010009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/13/2021] [Accepted: 01/29/2021] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study is to explore the relationships among postpartum fatigue (PPF), depressive cognitions, resourcefulness, quality of life, and life satisfaction in Arab postpartum mothers. A conceptual framework is used in this study based on the middle range theory of resourcefulness, which Zauszniewski developed in 2006. The study is a cross-sectional descriptive design with 123 postpartum women who had given birth within the past six months. used WhatsApp and Facebook for recruitment. developed the self-administered online survey in Qualtrics and collected data from 6 January 2017, to 6 February 2017. Correlation analysis is used to address the research aim and used the P value of 0.05 to determine the significance of the results. There were significant correlations among depressive cognitions and resourcefulness, life satisfaction, and quality of life; there were also significant correlations between PPF and life satisfaction, as well as among resourcefulness, quality of life, and life satisfaction. The results of this study emphasized the importance of assessing depressive symptoms and PPF in mothers early in the postpartum period. The results may contribute to designing future intervention studies aimed toward decreasing the risk of mothers with PPF developing more serious depressive symptoms.
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Affiliation(s)
- Hanan A. Badr
- Department of Maternity and Child Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Jaclene A. Zauszniewski
- Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA; (J.A.Z.); (M.Q.G.); (C.J.B.)
| | - Mary Quinn Griffin
- Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA; (J.A.Z.); (M.Q.G.); (C.J.B.)
| | - Christopher J. Burant
- Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA; (J.A.Z.); (M.Q.G.); (C.J.B.)
| | - Amy Przeworski
- Department of Psychological Sciences, College of Arts and Sciences, Case Western Reserve University, Cleveland, OH 44106, USA;
| | - Wedad M. Almutairi
- Department of Medical Surgical Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (W.M.A.); (F.H.A.)
| | - Fatmah H. Alsharif
- Department of Medical Surgical Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (W.M.A.); (F.H.A.)
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Shishido E, Shuo T, Shinohara K, Horiuchi S. Effects of epidural anesthesia on postpartum maternity blues and fatigue and its relation to changes in oxytocin. Jpn J Nurs Sci 2021; 18:e12406. [PMID: 33470059 DOI: 10.1111/jjns.12406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 11/30/2020] [Accepted: 12/16/2020] [Indexed: 01/19/2023]
Abstract
AIMS This study aimed to clarify (a) the association of the delivery mode (i.e., epidural anesthesia or no epidural) with women's changes in longitudinal salivary oxytocin (OT) levels from late pregnancy to early postpartum, and (b) the association of these changes with postpartum maternity blues (MB) and fatigue. METHODS We used a longitudinal observational design. We performed measurements of the saliva samples at four measurement points: (a) 36-37 gestational weeks, (b) 38-39 gestational weeks, (c) 1-2 days after birth, and (d) 4-5 days after birth. The inclusion criterion was low-risk primiparous women who were planning to have vaginal delivery. We used Stein's MB scale to evaluate postpartum data and a visual analog scale to examine "postpartum fatigue". We determined the association between the MB/fatigue scores and the changes in the OT levels by Spearman's rank correlation coefficient. RESULTS There were 29 women who delivered with epidural anesthesia and 29 women who did not. A significantly higher mean salivary OT level was observed in the women with epidural anesthesia at 1-2 days after birth than at 36-37 gestational weeks. The mean OT level at 4-5 days postpartum was significantly lower than that at 1-2 days postpartum. The correlation of the MB score with the salivary OT level at 4-5 days postpartum was ρ = -0.33, p = .01. CONCLUSIONS Early postpartum OT level decreased with epidural anesthesia and showed a negative correlation with postpartum MB and fatigue. Healthcare providers should recognize that women who had epidural anesthesia need specific supportive care.
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Affiliation(s)
- Eri Shishido
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
| | - Takuya Shuo
- Faculty of Pharmacy, Hokuriku University, Kanazawa, Japan
| | - Kazuyuki Shinohara
- Neurobiology and Behavior Department of Translational Medical Sciences, Course of Medical and Dental Sciences, Nagasaki University, Nagasaki, Japan
| | - Shigeko Horiuchi
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
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Abstract
Background Postpartum fatigue means tiredness, sense of suffocation, and decreased physical and mental capacity. Fatigue reduces postpartum women's ability of concentrate, which may increase the frequency of postpartum depression, and their babies and cause babies' weaning off breastmilk earlier. Aim Postpartum fatigue reduces the ability of mothers to concentrate and has a negative effect on communication between mothers and their babies. This study was performed to determine the effect of fatigue on breastfeeding and breastfeeding behaviors in postpartum women. Subjects and Methods The study had a descriptive desing and was carreid out in a postpartum clinic of a maternal, obstetric, and pediatric diseases hospital. It included 374 women giving normal vaginal birth. Data were gathered with a socio-demographic features form and Visual Analogue Scale for Fatigue. Results The mean score was 6,91 ± 2,25 for the subscale fatigue and 2,38 ± 0,91 for the subscale energy. The women reporting that it was not difficult to give birth and that they had little or some fatigue had significantly higher scores for energy (P = 0.001). The women starting to breastfeed in the hour of giving birth (P = 0.003) and the women breastfeeding at 1-hour intervals (P = 0.100) had a lower score for fatigue. The women not needing help while breastfeeding had a significantly lower score for fatigue (P = 0.001), while those reporting to give additional food had a significantly higher score for fatigue (P = 0.014). Conclusion Women feel tired in the early postpartum period due to giving birth and their tiredness is increased by breastfeeding and infant care.
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Affiliation(s)
- D K Senol
- Department of Nursing, Faculty of Health Sciences, Çankırı Karatekin University, Cankiri, Turkey
| | - M Yurdakul
- Departmant of School of Health Midwifery, Mersin University, Mersin, Turkey
| | - S A Ozkan
- Departmant of School of Health Midwifery, Adıyaman University, Adıyaman, Turkey
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10
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Abstract
OBJECTIVES To assess the prevalence of postpartum fatigue at 10 days, 1 month and 3 months, and to describe the sociodemographic and clinical characteristics of women with fatigue and the associations with infant characteristics, maternal-infant attachment, and partner and midwifery support. SETTING Maternity care in England. Secondary analysis of 2014 National Maternity Survey. PARTICIPANTS Participants were a random sample of 10 000 women selected by the Office for National Statistics using birth registration records. Women aged less than 16 years or if their baby had died were excluded. Questionnaires were sent to women at 3 months post partum and asked about well-being and care during pregnancy, labour, birth and post partum. Specifically, women were asked whether they experienced fatigue/severe tiredness at 10 days, 1 month or 3 months post partum. Responses were received from 4578 women (47% response rate). RESULTS Decreasing but substantial proportions of women, 38.8%, 27.1% and 11.4%, experienced fatigue/severe tiredness at 10 days, 1 month and 3 months, respectively. These figures varied significantly by maternal age, level of deprivation, education and parity. Women reporting depression, anxiety, sleep problems and those breast feeding were at significantly increased risk (eg, OR for depression in women with fatigue at 3 months: 2.99 (95% CI 2.13 to 4.21)). Significantly more negative language was used by these women to describe their babies, and they perceived their baby as more difficult than average (eg, two or more negative adjectives used by women with fatigue at 3 months: OR 1.86 (95% CI 1.36 to 2.54)). Women with postpartum fatigue had greater partner support but were significantly less likely to report seeing the midwife as much as they wanted. CONCLUSIONS Postpartum fatigue is not inevitable or universal, although early in the postnatal period it affects a substantial proportion of women. Predictors include age and parity, but practical help and support from partners and midwives may be protective factors.
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Affiliation(s)
- Jane Henderson
- NPEU, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Fiona Alderdice
- NPEU, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Gholami Z, Mohammadirizi S, Bahadoran P. Study of the Impact of Educational Behavioral Interventions on Fatigue in Mothers in the Postpartum Period in the Groups of Face-to-Face and Electronic Training. Iran J Nurs Midwifery Res 2017; 22:465-470. [PMID: 29184586 PMCID: PMC5684795 DOI: 10.4103/ijnmr.ijnmr_223_15] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Maternal fatigue in the postpartum period include factors that affect the quality of life and health of both the mother and newborn. This study aimed to investigate two educational approaches regarding mother's fatigue in the postpartum period. MATERIALS AND METHODS This experimental study was performed among 110 pregnant mothers during their postpartum care using random sampling. The participants were divided in three groups, namely, face-to-face, e-learning, and control groups. Interventions included individual meetings between the researcher and mothers in the face-to-face group and giving educational compact disc to the e-learning department to improve maternal fatigue. Personal information and fertility data was obtained (before training); the maternal fatigue questionnaire Fatigue Severity Scale (FSS) was completed before and after any type of (face-to-face, e-learning, and control) education. Obtained data were analyzed using one-way analysis of variance (ANOVA) and repeated-measures ANOVA. RESULTS Results showed that both face-to-face and e-learning methods had similar maternal fatigue scores. The average change on the maternal fatigue score in the second treatment was (p = 0.02) and the third treatment was (p < 0.001)among three groups that was indicative of significant statistical differences. Similarly, there was no statistically significant difference in the average maternal fatigue score between the two groups before the intervention and in the second and third groups after the intervention. Therefore, over time, the training was unaffected. CONCLUSIONS The findings of this study indicate that both face-to-face and e-learning methods are effective to reduce maternal postpartum fatigue.
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Affiliation(s)
- Zahra Gholami
- Student Research Center, School of Nursing and Midwifery, Isfahan University of Medical Science, Ma Midwifery Hajar Hospital Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Soheila Mohammadirizi
- Department of Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvin Bahadoran
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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Holm C, Thomsen LL, Norgaard A, Langhoff-Roos J. Single-dose intravenous iron infusion or oral iron for treatment of fatigue after postpartum haemorrhage: a randomized controlled trial. Vox Sang 2017; 112:219-228. [PMID: 28198084 DOI: 10.1111/vox.12477] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 10/19/2016] [Accepted: 11/01/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND OBJECTIVES To evaluate the clinical efficacy of a single-dose intravenous infusion of iron isomaltoside compared with current treatment practice with oral iron measured by physical fatigue in women after postpartum haemorrhage. MATERIALS AND METHODS Single-centre, open-label, randomized controlled trial. Participants received intravenous iron (n = 97) or oral iron (n = 99), and completed the Multidimensional Fatigue Inventory and Edinburgh Postnatal Depression Scale, and haematological and iron parameters were measured. Primary outcome was the aggregated change in physical fatigue score from baseline to 12 weeks postpartum. RESULTS The difference in physical fatigue score was -0·97 (95% CI: -1·65; -0·28, P = 0·006) in favour of intravenous iron, but did not meet the predefined difference of 1·8. Across visits, we found statistically significant differences in fatigue and depression scores, as well as in haematological and iron parameters, all in favour of intravenous iron. There were no serious adverse reactions. CONCLUSION A single dose of intravenous iron was associated with a statistically significant reduction in aggregated physical fatigue within 12 weeks after postpartum haemorrhage compared to standard medical care with oral iron below the prespecified criteria of clinical superiority. As patient-reported outcomes improved significantly and intravenous iron resulted in a fast hematopoietic response without serious adverse reactions, intravenous iron may be a useful alternative after postpartum haemorrhage if oral iron is not absorbed or tolerated.
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Affiliation(s)
- C Holm
- Department of Obstetrics, Juliane Marie Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Pharmacosmos A/S, Holbaek, Denmark
| | | | - A Norgaard
- Section for Transfusion Medicine, Capital Region Blood Bank, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - J Langhoff-Roos
- Department of Obstetrics, Juliane Marie Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Doering JJ, Sims DA, Miller DD. How Postpartum Women With Depressive Symptoms Manage Sleep Disruption and Fatigue. Res Nurs Health 2017; 40:132-142. [PMID: 28084629 DOI: 10.1002/nur.21782] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2016] [Indexed: 11/11/2022]
Abstract
Postpartum sleep and fatigue have bidirectional relationships with depressive symptoms and challenge women's everyday functioning. The everyday process of managing postpartum sleep and fatigue in the context of depressive symptoms remains unexplored. We conducted a grounded theory study with a sample of 19 women who screened positive on the Postpartum Depression Screening Scale (PDSS™) Short Form at 3 weeks postpartum. Women completed semi-structured in-home interviews and the full PDSS and Modified Fatigue Symptoms Checklist at 1, 3, and 6 months postpartum. The sample was on average 27 years old, with 2.8 children, and 63% were African-American. They described a basic social process of Finding a Routine Together, during which women's experiences with their infants progressed from Retreating at month 1 toward Finding a New Normal at month 6. In their work to Find a Routine Together, mothers' patterns of change over time were continuous, gradual, or prolonged. Their progress was influenced by depressive symptoms, social support, work and daycare, stability in social circumstances, and underlying stressors. This study's findings suggest the need to allocate resources and tailor interventions to meet the needs of women who are most vulnerable to the health effects of ongoing persistent severe fatigue, disordered sleep, and sub-clinical and clinical levels of depressive symptoms. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Jennifer J Doering
- Associate Professor, College of Nursing, University of Wisconsin-Milwaukee, 1921 E. Hartford Ave., Milwaukee, WI 53211
| | - Dauphne A Sims
- Assistant Professor, St. Anthony College of Nursing, Rockford, IL
| | - Donald D Miller
- Doctoral Candidate, College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI
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14
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Chen SL, Chen CH. Effects of Lavender Tea on Fatigue, Depression, and Maternal-Infant Attachment in Sleep-Disturbed Postnatal Women. Worldviews Evid Based Nurs 2015; 12:370-9. [PMID: 26523950 DOI: 10.1111/wvn.12122] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Lavender inhalation aromatherapy is widely believed to impart a hypnotic effect, act as a mood stabilizer, and enhance the positive feelings of mothers toward their infants. However, research into these and other potential therapeutic effects of lavender tea has been limited. AIMS This study was conducted in Taiwan to evaluate the effectiveness of lavender tea in relieving sleep quality, fatigue, and depression; and in improving maternal-infant attachment during the early postpartum period. METHODS A total of 80 Taiwanese postnatal women with poor sleep quality (Postpartum Sleep Quality Scale; PSQS score ≥16) and with no history of allergy to herbal teas, foods, or medicines were assigned systematically to either the experimental group (n = 40) or the control group (n = 40). The participants in the experimental group were instructed to drink one cup of lavender tea after spending time to appreciate and smell the aroma each day for a period of 2 weeks, whereas their control group peers received regular postpartum care only. The PSQS, Edinburgh Postnatal Depression Scale, Postpartum Fatigue Scale, and Postpartum Bonding Questionnaire were used to assess outcomes. RESULTS ANCOVA analyses using education level and pretest scores as covariates showed that experimental group participants perceived less fatigue (F = 6.281, p = .014) and depression (F = 4.731, p = .033) and showed greater bonding with their infant (F = 4.022, p = .049) compared with the control group. However, the scores for all four instruments were similar for both groups at the 4-week posttest, suggesting that the positive effects of lavender tea were limited to the immediate term. LINKING EVIDENCE TO ACTION Healthcare researchers assume accountability for integrating research results into clinical practice. The findings in this study can gain greater attention among healthcare practitioners and encourage the correct and positive use of herbal therapy in postpartum health care.
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Affiliation(s)
- Shu-Lan Chen
- Lecturer, Department of Nursing, Fooyin University, Kaohsiung, Taiwan
| | - Chung-Hey Chen
- Professor, Institute of Allied Health Sciences & Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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