Relationship of psychosocial tasks of pregnancy and attentional functioning in the third trimester

Different neurocognitive controls modulate obstacle avoidance through pregnancy

Understanding why falls during pregnancy occur at over 25% rate over gestation has clinical impacts on the health of pregnant individuals. Attention, proprioception, and perception of the environment are required to prevent trips and falls. This research aimed to understand how the changes to these neurocognitive processes control obstacle avoidance through gestation. Seventeen pregnant participants were tested five times in 6-week intervals. Participants walked an obstacle course (OC), and we analyzed the crossings over obstacles that were set to 10% of participants' body height. Participants also performed an attentional network test (ANT: performance of specific components of attention), an obstacle perception task (OP: ability to visually define an obstacle and translate that to a body posture), and a joint position sense task (JPS: ability to recognize and recreate a joint position from somatosensation). In the OC task, average leading and trailing foot crossing heights significantly reduced by 13% and 23% respectively, with no change in variation, between weeks 13 and 31 of pregnancy, indicating an increased risk of obstacle contact during this time. The variability in minimum leading foot distances from the obstacle was correlated with all three neurocognition tasks (ANT, OP, and JPS). Increased fall rates in the second and third trimesters of pregnancy may be driven by changes in attention, with additional contributions of joint position sense and environmental perception at various stages of gestation. The results imply that a holistic examination on an individual basis may be required to determine individual trip risk and appropriate safety modifications.

Is marital adjustment a way to increase women's identification with the motherhood role during pregnancy?: A correlational assessment

The researchers sought to determine the correlation level and factors that affect the correlation between pregnant women's marital adjustment and their identification with the motherhood role. A total of 146 healthy, married, and pregnant women were included. There was a negative and significantly low-level correlation between marital adjustment and identification with the motherhood role. The correlation was significant among women who were multiparous, married for six to 10 years, with low level of education, and decided to marry in agreement. The authors of this study suggest promoting marital adjustment may be way to facilitate women's identification with the motherhood role.

Development of a Chinese short form of the Prenatal Self-Evaluation Questionnaire

AIMS

To develop a short-form version of the Chinese Prenatal Self-Evaluation Questionnaire and to examine its reliability and validity. Background. Health professionals are short of screening instruments, especially in Chinese, to assess adaptation of pregnant women.

DESIGN

A cross-sectional research design was used. Pregnant women who visited prenatal clinics in southern Taiwan were recruited for this study. This study was conducted in two phases. The first phase was to develop a Chinese short form of the Prenatal Self-Evaluation Questionnaire, using a convenience sample that consisted of 600 pregnant women. The second phase was to examine the reliability and validity of the short-form Chinese Prenatal Self-Evaluation Questionnaire, and used a convenience sample consisting of 225 pregnant women. Internal consistency and split-half reliability were used to assess reliability. Construct, convergent and discriminate validities were conducted to assess the validity.

RESULTS

Item, correlation, factor and cluster analyses were used to eliminate 35 items from the questionnaire and to retain 44 items in phase one. The correlation coefficient between the short-form Chinese Prenatal Self-Evaluation Questionnaire and the original Chinese Prenatal Self-Evaluation Questionnaire was 0.95, indicating that the short-form Chinese Prenatal Self-Evaluation Questionnaire was acceptable. In phase two, 35 items were eventually retained and divided into six factors: concern for well-being of self and baby (seven items), acceptance of pregnancy (six items), identification of a motherhood role (three items), preparation for labour (six items), relationship with own mother (eight items) and relationship with husband (five items), accounting for 50.42% of the total variance. The convergent and discriminant validities were good, because the correlation coefficients between subscales and the total scale as well as between subscales and subscales were 0.57-0.71 and 0.18-0.41 (p < 0.01), respectively. The Cronbach's alpha and split-half reliabilities of the short form were 0.90 and 0.88, respectively.

CONCLUSIONS

A 35-item Chinese short form of the Prenatal Self-Evaluation Questionnaire was developed. The results of this study can be used as a measurement tool for widespread, cost-effective clinical assessment and further research.

RELEVANCE TO CLINICAL PRACTICE

Use of the new tool may help nurses to understand the adaptation status of pregnant women and thereby provide suitable nursing care for good adaptation to pregnancy as well as enhanced quality of life.

Directed Attention in Normal and High‐Risk Pregnancy

OBJECTIVE

To compare the ability to direct attention in women having a high-risk pregnancy with those having an uncomplicated pregnancy.

DESIGN

Descriptive comparative.

SETTING

A tertiary-care hospital.

PARTICIPANTS

Women in the 3rd trimester of pregnancy receiving care from perinatologists were recruited for this study and comprised the high-risk group (n = 67). Women in their 3rd trimester of pregnancy with uncomplicated pregnancies and enrolled in prenatal classes were the comparison group (n = 57).

MAIN OUTCOME MEASURES

Objective measures of directed attention included digit span forward, digit span backward, Trailmaking A, and Trailmaking B. Subjective measures included the Attentional Function Index and Mental Effort in Tasks.

RESULTS

Women having a complicated pregnancy had significantly more difficulty directing attention on all measures than women having normal pregnancies. When all covariates were considered, women having a high-risk pregnancy had significantly more difficulty directing attention as measured by Trailmaking A, Trailmaking B, and Mental Effort in Tasks.

CONCLUSIONS

Women having high-risk pregnancies may have more difficulty with activities that require directed attention than women having normal pregnancies. Learning new information and skills, problem solving, and planning may require additional effort for women having complicated pregnancies.

Attention and Restoration in Post-RN Students

BACKGROUND

The impact of a restorative intervention using the natural environment on capacity to direct attention and issues that contribute to attention fatigue for diploma-prepared nursing students (Post-RN students) enrolled in a baccalaureate nursing program was examined.

METHODS

This study used a quasi-experimental comparison group design. Subjective (Attentional Functional Index) and objective (Finding A's Test and Symbol Digits Modalities Test) measures were employed.

RESULTS

Thirty-two students at two universities participated. Results of the split-plot analysis revealed a within-subject effect on the Attentional Functional Index (p < .05), a significant within-subject effect on the Finding A's Test (p < .05), and a significant within- and between-subject effect on the Symbol Digits Modalities Test (p < .05).

CONCLUSION

Recognizing and managing attention fatigue throughout the school year may enhance Post-RN students' abilities to direct attention and contribute to an enhanced academic experience.

Restoring attention in pregnancy: the natural environment

The purpose of this quasi-experimental pretest-posttest study was to test whether regularly spending time in the natural environment would improve concentration for women in the third trimester of pregnancy, a time when women rely on their ability to concentrate in order to prepare for birth and parenting. Several measures requiring concentration were administered before an intervention that included spending 120 minutes each week in restorative activities involving nature. When posttest measures were collected women in the intervention group had signficantly fewer errors compared to the control group. Other measures did not reveal significant differences. These results suggest that encouraging women to spend time in activities that involve nature and designing health care environments to incorporate nature may help pregnant women improve their ability to concentrate and reduce errors at a time when they have many demands on their time and attention.

Exploring Women's Preferences for Labor Epidural Analgesia

The purpose of this study was to explore demographic factors related to women's prenatal preferences for using an epidural during labor. Women recruited from prenatal classes provided data for this descriptive correlational study. Women with the most education, income, and parity indicated greatest preference for epidural analgesia. Thus, these women may be comfortable with the technology and most likely to be willing to pay for epidurals and to select care providers who provide epidural anesthesia. In this sample, prenatal preference for an epidural was not predictive of actual use, although it has been shown to be predictive in previous research.