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Nissen M, Barrios Campo N, Flaucher M, Jaeger KM, Titzmann A, Blunck D, Fasching PA, Engelhardt V, Eskofier BM, Leutheuser H. Prevalence and course of pregnancy symptoms using self-reported pregnancy app symptom tracker data. NPJ Digit Med 2023; 6:189. [PMID: 37821584 PMCID: PMC10567694 DOI: 10.1038/s41746-023-00935-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023] Open
Abstract
During pregnancy, almost all women experience pregnancy-related symptoms. The relationship between symptoms and their association with pregnancy outcomes is not well understood. Many pregnancy apps allow pregnant women to track their symptoms. To date, the resulting data are primarily used from a commercial rather than a scientific perspective. In this work, we aim to examine symptom occurrence, course, and their correlation throughout pregnancy. Self-reported app data of a pregnancy symptom tracker is used. In this context, we present methods to handle noisy real-world app data from commercial applications to understand the trajectory of user and patient-reported data. We report real-world evidence from patient-reported outcomes that exceeds previous works: 1,549,186 tracked symptoms from 183,732 users of a smartphone pregnancy app symptom tracker are analyzed. The majority of users track symptoms on a single day. These data are generalizable to those users who use the tracker for at least 5 months. Week-by-week symptom report data are presented for each symptom. There are few or conflicting reports in the literature on the course of diarrhea, fatigue, headache, heartburn, and sleep problems. A peak in fatigue in the first trimester, a peak in headache reports around gestation week 15, and a steady increase in the reports of sleeping difficulty throughout pregnancy are found. Our work highlights the potential of secondary use of industry data. It reveals and clarifies several previously unknown or disputed symptom trajectories and relationships. Collaboration between academia and industry can help generate new scientific knowledge.
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Affiliation(s)
- Michael Nissen
- Machine Learning and Data Analytics (MaD) Lab, Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, Carl-Thiersch-Straße 2b, 91052, Erlangen, Bavaria, Germany.
| | - Nuria Barrios Campo
- Machine Learning and Data Analytics (MaD) Lab, Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, Carl-Thiersch-Straße 2b, 91052, Erlangen, Bavaria, Germany
| | - Madeleine Flaucher
- Machine Learning and Data Analytics (MaD) Lab, Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, Carl-Thiersch-Straße 2b, 91052, Erlangen, Bavaria, Germany
| | - Katharina M Jaeger
- Machine Learning and Data Analytics (MaD) Lab, Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, Carl-Thiersch-Straße 2b, 91052, Erlangen, Bavaria, Germany
| | - Adriana Titzmann
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstraße 21/23, 91054, Erlangen, Bavaria, Germany
| | - Dominik Blunck
- Department of Health Management, Institute of Management, Friedrich-Alexander-Universität Erlangen-Nürnberg, Lange Gasse 20, 90403, Nürnberg, Bavaria, Germany
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstraße 21/23, 91054, Erlangen, Bavaria, Germany
| | - Victoria Engelhardt
- Keleya Digital-Health Solutions GmbH, Max-Beer-Straße 25, 10119, Berlin, Germany
| | - Bjoern M Eskofier
- Machine Learning and Data Analytics (MaD) Lab, Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, Carl-Thiersch-Straße 2b, 91052, Erlangen, Bavaria, Germany
- Translational Digital Health Group, Institute of AI for Health, Helmholtz Zentrum München - German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Bavaria, Germany
| | - Heike Leutheuser
- Machine Learning and Data Analytics (MaD) Lab, Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, Carl-Thiersch-Straße 2b, 91052, Erlangen, Bavaria, Germany
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A Cross-Sectional Study Examining the Association between Physical Activity and Perinatal Depression. Medicina (B Aires) 2022; 58:medicina58091174. [PMID: 36143851 PMCID: PMC9504270 DOI: 10.3390/medicina58091174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: International organisations recommend that women without illness should have regular moderate-intensity physical exercise throughout their pregnancy and postpartum period as a measure to prevent possible pathologies in both the mother and the newborn. Physical activity during pregnancy reduces the likelihood of depression during pregnancy and after childbirth, benefiting both the pregnant woman and the foetus. However, most pregnant women are known to be inactive. The Pregnancy Physical Activity Questionnaire (PPAQ) analyses the level of physical activity of pregnant women. These data are correlated with the variable depression, for which the Edinburgh Postnatal Depression Scale (EPDS) during pregnancy was used. Materials and Methods: The research employed a cross sectional study design on ninety-nine pregnant women. Results: The data on physical activity in relation to depression in those pregnant women who had not previously suffered from depression were 719.29 METS min/wk compared with 624.62 METS min/wk in those who had. And for pregnant women who suffered from depression at the time of the study, their physical activity was 698.25 METS min/wk, while those who did not suffer from depression reached 826.57 METS. Conclusions: Pregnant women without depression are much more active. A favourable employment situation or a high level of education is directly related to higher physical activity. Physical activity and higher energy expenditure occur at home, as opposed to activity carried out as transport, exercise or at work.
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Urkia-Susin I, Rada-Fernandez de Jauregui D, Orruño E, Maiz E, Martinez O. A quasi-experimental intervention protocol to characterize the factors that influence the acceptance of new foods by infants: mothers' diet and weaning method. Dastatuz project. BMC Public Health 2021; 21:918. [PMID: 33985471 PMCID: PMC8120711 DOI: 10.1186/s12889-021-10967-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Children usually refuse to eat and taste fruits and vegetables; and turning unhealthy eating habits around is an important social challenge in industrialized countries. The Dastatuz project aims to study children food neophobia and to enhance fruit and vegetable acceptance. METHODS A quasi-experimental, multicentre, controlled and prospective intervention study is proposed, in which early factors influencing new food acceptance will be studied. Mothers in the third trimester of pregnancy (n = 144) and their infants will be the study population. Experimental groups will be established based on mothers´ fruit and vegetable intake (standard or high intake) and weaning method (baby lead weaning vs spoon feeding). The project will assess the possible impact of maternal diet and complementary feeding on infants eating behaviour until 18 months of age. Outcome measures will comprise maternal diet and psychological features during pregnancy and breast-feeding (validated questionnaires). Compositional and physicochemical analysis of milk during breastfeeding will also be carried out. During weaning, until 18 months of age, children's diet will be assessed with 24 h recalls and acceptance of new fruits and vegetables will be studied using video recording. DISCUSSION If the intervention is effective, this research work would have a high potential to be transferred to future public health programs or nutrition guidelines, as a feasible solution to achieve a higher intake of fruits and vegetables among children. TRIAL REGISTRATION This study is registered at ClinicalTrials.gov. Identifier: NCT04262102 . Registration date: February 10, 2020 - Retrospectively registered.
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Affiliation(s)
- Iratxe Urkia-Susin
- Department of Pharmacy and Food Science, Faculty of Pharmacy, University of the Basque Country EHU/UPV, Vitoria-Gasteiz, Basque Country, Spain
- Bioaraba Health Research Institute, Nutrition and Food Safety group, Vitoria-Gasteiz, Araba, Basque Country, Spain
- Department of Clinical and Health Psychology and Research Methodology, Faculty of Psychology, University of the Basque Country EHU/UPV, Donostia-San Sebastián, Gipuzkoa, Basque Country, Spain
- Biodonostia Health Research Institute, Mental Health group, Donostia-San Sebastián, Basque Country, Spain
| | - Diego Rada-Fernandez de Jauregui
- Bioaraba Health Research Institute, Nutrition and Food Safety group, Vitoria-Gasteiz, Araba, Basque Country, Spain
- Department of Preventive Medicine and Public Health, Faculty of Pharmacy, University of the Basque Country EHU/UPV, Vitoria-Gasteiz, Basque Country, Spain
| | - Estibaliz Orruño
- Bioaraba Health Research Institute, Araba University Hospital, Vitoria-Gasteiz, Araba, Basque Country, Spain
| | - Edurne Maiz
- Department of Clinical and Health Psychology and Research Methodology, Faculty of Psychology, University of the Basque Country EHU/UPV, Donostia-San Sebastián, Gipuzkoa, Basque Country, Spain.
- Biodonostia Health Research Institute, Mental Health group, Donostia-San Sebastián, Basque Country, Spain.
| | - Olaia Martinez
- Department of Pharmacy and Food Science, Faculty of Pharmacy, University of the Basque Country EHU/UPV, Vitoria-Gasteiz, Basque Country, Spain
- Bioaraba Health Research Institute, Nutrition and Food Safety group, Vitoria-Gasteiz, Araba, Basque Country, Spain
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Laitinen L, Nurmi M, Rautava P, Koivisto M, Polo-Kantola P. Sleep quality in women with nausea and vomiting of pregnancy: a cross-sectional study. BMC Pregnancy Childbirth 2021; 21:152. [PMID: 33607953 PMCID: PMC7893929 DOI: 10.1186/s12884-021-03639-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/09/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Nausea and vomiting of pregnancy (NVP) deteriorates many aspects of daily lives of women. However, little is known about associations between NVP and sleep quality. METHODS Women attending to routine mid-pregnancy visits in maternity health care clinics in Turku city area and surrounding municipalities, Finland, during 2011-2014, were invited to participate. A cohort of 1203 volunteers (mean age 30 years, mean gestational week 16.6, mean BMI 24.4 kg/m2, nulliparous 46%) was recruited. The severity of NVP in the worst 12-h period of current pregnancy was assessed with Pregnancy Unique Quantification of Emesis Questionnaire (PUQE) and categorized accordingly into no/mild/moderate and severe NVP. Sleep disturbances during the past 3 months were assessed with selected questions (difficulty falling asleep, night awakenings, too early morning awakenings and sleepiness during the day) from Basic Nordic Sleep Questionnaire (BNSQ). In addition, general sleep quality, as well as physical and mental quality of life (QoL) were rated with three visual analog scales (VAS). Associations between PUQE categories (severity of NVP) and sleep disturbances, general sleep quality, physical QoL and mental QoL were evaluated with multinomial regression analysis. RESULTS According to PUQE, NVP was most frequently moderate (n = 629, 52.3%), followed by mild (n = 361, 30.0%) and severe (n = 77, 6.4%). Only 11.3% had no NVP (n = 136). The most frequent sleep disturbance was night awakenings (69.9%, n = 837), followed by sleepiness during the day (35.7%, n = 427), too early morning awakenings (12.0%, n = 143) and difficulty falling asleep (7.1%, n = 81). In adjusted analysis (age, parity, body mass index, smoking, employment), more severe NVP was associated with night awakenings (AOR 3.9, 95% CI 1.79-8.47, P < 0.0001) and sleepiness during the day (AOR 4.7, 95% CI 2.20-9.94, P < 0.0001). In VAS, women with more severe NVP rated worse general sleep quality and worse physical and mental QoL. However, in multivariable analysis, the association between the severity of NVP and physical and mental QoL was stronger than that of sleep . CONCLUSIONS More severe NVP is associated with sleep disturbances and in close relation to lower physical and mental QoL. Thus, in comprehensive care of women with NVP, also sleep quality should be evaluated.
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Affiliation(s)
- Linda Laitinen
- Department of Obstetrics and Gynecology, Central Finland Central Hospital, Keskussairaalantie 19, 40620, Jyväskylä, Finland.
- University of Turku, Turku, Finland.
| | - Miina Nurmi
- Department of Public Health, University of Turku, Turku, Finland
| | - Päivi Rautava
- Department of Public Health, University of Turku, Turku, Finland
- Turku Clinical Research Centre, Turku University Hospital, Turku, Finland
| | - Mari Koivisto
- Turku Clinical Research Centre, Turku University Hospital, Turku, Finland
- Department of Biostatistics, University of Turku, Turku, Finland
| | - Päivi Polo-Kantola
- University of Turku, Turku, Finland
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland
- Sleep Research Center, University of Turku, Turku, Finland
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Safajou F, Soltani N, Taghizadeh M, Amouzeshi Z, Sandrous M. The Effect of Combined Inhalation Aromatherapy with Lemon and Peppermint on Nausea and Vomiting of Pregnancy: A Double-Blind, Randomized Clinical Trial. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2020; 25:401-406. [PMID: 33344211 PMCID: PMC7737842 DOI: 10.4103/ijnmr.ijnmr_11_19] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 02/19/2020] [Accepted: 07/04/2020] [Indexed: 12/17/2022]
Abstract
Background: Nausea and vomiting are almost inevitable features of pregnancy which have a serious impact on the quality of life of pregnant women. This study aimed to determine the effects of combined inhalation aromatherapy with lemon and peppermint on nausea and vomiting of pregnancy. Materials and Methods: The parallel randomized clinical trial was conducted on 90 pregnant women suffering from nausea and vomiting of pregnancy referred to health centers in Birjand-Iran- from February 2015 to August 2016. Participants were randomly divided into two groups. The combined lemon and peppermint essential oils were used as an inhaler for the intervention and the placebo for the control group. Both groups were trained to place three drops of the solution onto a cotton ball and keep it in a 3-cm distance of their nose. The intensity of nausea, vomiting and fatigue was assessed through 24-hour Pregnancy Unique Quantization of Emesis (PUQE-24) questionnaire and Fatigue Severity Scale (FSS), respectively. Results: Mean (SD) scores of nausea and vomiting intensity before the intervention and on the first day of intervention were not significantly different between the two groups, but became significant on the second, third, and fourth days of intervention. The results showed that the effect of time on the mean intensity of nausea and vomiting was significant in the aromatherapy group (F2,84 = 22.92, p < 0.001) but was not significant in the placebo group (F2,78 = 0.26, p = 0.836). Conclusions: The combined lemon and peppermint aromatherapy could reduce mild to moderate intensity of nausea and vomiting during pregnancy.
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Affiliation(s)
- Farzaneh Safajou
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Ghaen Faculty of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran
| | - Narges Soltani
- Instructor of Midwifery, Birjand University of Medical Sciences, Birjand, Iran
| | - Mohsen Taghizadeh
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Zahra Amouzeshi
- Faculty of Nursing and Midwifery, Surgery and Trauma Research Center, Birjand University of Medical Sciences, Birjand, Iran.,PhD Student in Medical Education, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Sandrous
- Midwife, Birjand University of Medical Sciences, Birjand, Iran
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Liu N, Wang J, Chen DD, Sun WJ, Li P, Zhang W. Effects of exercise on pregnancy and postpartum fatigue: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2020; 253:285-295. [PMID: 32916639 DOI: 10.1016/j.ejogrb.2020.08.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/28/2020] [Accepted: 08/21/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Fatigue is a common adverse experience in pregnant and postpartum women and is associated with poor outcomes and can seriously affect maternal and infant health and quality of life. However, data from existing studies are inconsistent, and no studies have examined the effects of exercise on pregnancy and postpartum fatigue. The aim of this review is to evaluate the effects of exercise on pregnancy and postpartum fatigue. STUDY DESIGN PubMed, EMBASE, Web of Science and the Cochrane Library database were used to retrieve literature. Eligible studies were clinical trials that reported the effects of exercise on pregnancy and postpartum fatigue in women. The methodological quality of the included studies was assessed using the Cochrane Collaboration Risk of Bias Assessment Tool. A fixed-effect model was used to analyse the pooled results. Subgroup analyses were used to explore sources of heterogeneity. Sensitivity analysis was used to validate the robustness of the pooled results. RESULTS Seven studies were included. The results of meta-analysis of five studies showed that exercise during pregnancy and the postpartum period may have beneficial effects on women's fatigue ([SMD = 0.29, 95 % CI (0.10, 0.47), P = 0.003]). Subgroup analyses reported that compared with the control, long exercise programmes, postpartum exercise and supervised exercise significantly improved fatigue levels. CONCLUSIONS Postpartum exercise in a supervised programme lasting more than eight weeks may be beneficial for reducing postpartum fatigue. More available data from large-scale and high-quality trials are needed to demonstrate the effects of exercise on pregnant and postpartum fatigue.
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Affiliation(s)
- Na Liu
- Nursing School of Jilin University, Changchun, Jilin Province, China.
| | - Jie Wang
- Nursing School of Jilin University, Changchun, Jilin Province, China.
| | - Dan-Dan Chen
- Nursing School of Jilin University, Changchun, Jilin Province, China.
| | - Wei-Jia Sun
- Nursing School of Jilin University, Changchun, Jilin Province, China.
| | - Ping Li
- Department of Developmental Pediatrics, the Second Hospital of Jilin University, Changchun, Jilin Province, China
| | - Wei Zhang
- Nursing School of Jilin University, Changchun, Jilin Province, China.
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Relationship Between Physical Activity and Fatigue Among Nigerian Pregnant Women. WOMEN’S HEALTH BULLETIN 2018. [DOI: 10.5812/whb.61339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Shobeiri F, Manoucheri B, Parsa P, Roshanaei G. Effects of Counselling and Sole Reflexology on Fatigue in Pregnant Women: A Randomized Clinical Trial. J Clin Diagn Res 2017; 11:QC01-QC04. [PMID: 28764252 DOI: 10.7860/jcdr/2017/22681.9972] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Accepted: 01/13/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Increase of fatigue may lead to problems during pregnancy, delivery and post delivery. Sole reflexology is the application of pressure to areas on the feet. Reflexology is generally relaxing and may be an effective way to alleviate fatigue and stress. AIM To investigate the effect of counselling and sole reflexology on fatigue in pregnant women, referred to the medical centers of Hamadan city, Iran. MATERIALS AND METHODS This study was a randomized clinical trial with three groups - Group A (counselling and reflexology), Group B (reflexology) and Group C (control) with pre and post intervention. A total of forty two pregnant women were selected for each group. Measurement tool was a 30 question standard checklist for fatigue assessment. For all three groups, an explanatory session was held to get their written consents and conduct a pretest. The intervention included five education sessions, twice a week about reflexology in the form of counselling and sole reflexology. The groups were assessed immediately after intervention. Data were analysed using IBM SPSS Statistics 20.0. To analyse the data, descriptive statistics, t test and ANOVA with repeated measures were used. RESULTS In group A and group B, the mean score of fatigue severity after the intervention demonstrated a significant decrease (p<0.05); furthermore, after intervention, a significant difference was observed between the control and experimental groups in terms of fatigue severity (p<0.01). CONCLUSION Based on the results of this study, counselling and sole reflexology significantly decreased fatigue in pregnant women. It is hoped that the results of this study can be used by all treatment groups and midwives for controlling and providing midwifery cares for pregnant women.
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Affiliation(s)
- Fatemeh Shobeiri
- Professor, Mother and Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Behnaz Manoucheri
- Instructor, Faculty of Nursing and Midwifery, Islamic Azad University, Sanandaj Branch, Sanandaj, Iran
| | - Parisa Parsa
- Associate Professor, Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ghodratolah Roshanaei
- Associate Professor, Department of Biostatistics, Modeling Non-Communicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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Hill PD, Aldag JC, Chatterton RT, Zinaman M. Psychological Distress and Milk Volume in Lactating Mothers. West J Nurs Res 2016; 27:676-93; discussion 694-700. [PMID: 16157942 DOI: 10.1177/0193945905277154] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this article is twofold: (a) to compare psychological distress as measured via self-reported perceived stress, sleep, and fatigue levels in lactating mothers of a term infant and mothers of a preterm infant and(b) to determine whether the addition of psychological distress to a previous model predicts milk volume at Postpartum Week 6 by gestation group. The convenience sample of 95 mothers of a preterm infant (31 weeks) and 98 mothers of a term infant completed the Perceived Stress Visual Analogue Scale, Richards-Campbell Sleep Questionnaire, and the Fatigue Visual Analog Scale. Stress, sleep difficulty, and fatigue levels decreased during the 6-week study period for mothers of a term but not for mothers of a preterm infant. Perceived stress, sleep difficulty, and fatigue during the first 6 weeks postpartum were not related to milk volume; thus, the mother’s perceived psychological distress had no apparent effect on lactation.
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Affiliation(s)
- Pamela D Hill
- College of Nursing, University of Illinois at Chicago, USA
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10
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Kim ME, Hur MH. Sleep Quality, Fatigue, and Postpartum Depression of Mother at Six Months after Delivery. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2014; 20:266-276. [PMID: 37684802 DOI: 10.4069/kjwhn.2014.20.4.266] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023] Open
Abstract
PURPOSE This study was correlation study to identify the factors influencing sleep quality, fatigue, and postnatal depression in mothers who have given birth during the past 6 months. METHODS The study was conducted using a survey with questionnaires to 329 mothers who visited E University Medical Center, or three local clinics located in D city, between August and October 2013. Collected data were analyzed using the SPSS/WIN 20.0 program. RESULTS Out of 329 subjects, 18.2% showed that they had mild postnatal depression whereas 24.3% had severe postnatal depression. Accordingly, 42.5% reported having postnatal depression. Postnatal depression had a significant correlation with sleep hours after childbirth (r=-.16, p=.003), spousal support (r=-.28, p<.001), sleep quality (r=-.35, p<.001), physical fatigue (r=.66, p<.001), psychological fatigue (r=.69, p<.001), and neurosensory fatigue (r=.56, p<.001). Factors influencing postnatal depression include psychological fatigue, sleep quality, number of child births, and neurosensory fatigue, and these accounted for 53% of postnatal depression. CONCLUSION Results indicate that factors influencing postnatal depression involve psychological fatigue, sleep quality, number of child births, and neurosensory fatigue. Therefore for nursing intervention for postpartum mothers, it is necessary to assess the level of depression, fatigue, and sleep quality, and to provide interventions to relieve depression.
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Affiliation(s)
- Mi Eun Kim
- Eulji University Hospital, Daejeon, Korea
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Lukose A, Ramthal A, Thomas T, Bosch R, Kurpad AV, Duggan C, Srinivasan K. Nutritional factors associated with antenatal depressive symptoms in the early stage of pregnancy among urban South Indian women. Matern Child Health J 2014; 18:161-170. [PMID: 23440491 DOI: 10.1007/s10995-013-1249-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Many women of reproductive age from developing countries have poor nutritional status, and the prevalence of depression during pregnancy is high. The objective of the present study was to assess the prevalence of antenatal depressive symptoms in early pregnancy, and to identify the demographic and nutritional factors associated with these symptoms in a sample of urban South Indian pregnant women. This cross-sectional study was the baseline assessment of a prospective randomized controlled trial of vitamin B12 supplementation in urban pregnant south Indian women between the ages of 18 and 40 years ( www.clinicaltrials.gov : NCT00641862). 365 women in their first trimester of pregnancy were screened for depressive symptoms at an urban clinic in Karnataka, South India, using the Kessler Psychological Distress Scale (K-10). Nutritional, clinical and biochemical factors were also assessed. Mean (SD) age of the cohort was 22.6 (3.7) years and mean (SD) BMI was 20.4 (3.3) kg/m(2). 121 (33 %) of the women in the 1st trimester had symptoms consistent with depression (K-10 score >6). In multivariate log binomial regression analysis, presence of antenatal depressive symptoms in the first trimester were positively associated with vomiting, prevalence ratio (PR) = 1.54 (95 % CI 1.10, 2.16) and negatively with anemia, PR = 0.67 (95 % CI 0.47, 0.96). Nutrient intakes, serum vitamin B12, methylmalonic acid, homocysteine and red cell folate levels were not associated with measures of depression. Antenatal depressive symptoms in early pregnancy are highly prevalent in urban Indian women and are more common in women with vomiting and without anemia. In this cross-sectional data, blood concentrations of vitamin B12 and folate were not associated with depressive symptoms. The relationship between nutritional status and depressive symptoms may require larger and longitudinal studies.
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Affiliation(s)
- Ammu Lukose
- Division of Nutrition, Mother and Child Unit, St. John's Research Institute, Sarjapur Road, Bangalore, 560034, India
| | - Asha Ramthal
- Division of Nutrition, Mother and Child Unit, St. John's Research Institute, Sarjapur Road, Bangalore, 560034, India
| | - Tinku Thomas
- Division of Nutrition, Mother and Child Unit, St. John's Research Institute, Sarjapur Road, Bangalore, 560034, India
| | - Ronald Bosch
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
| | - Anura V Kurpad
- Division of Nutrition, Mother and Child Unit, St. John's Research Institute, Sarjapur Road, Bangalore, 560034, India
| | - Christopher Duggan
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
| | - Krishnamachari Srinivasan
- Division of Nutrition, Mother and Child Unit, St. John's Research Institute, Sarjapur Road, Bangalore, 560034, India.
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12
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Psychometric evaluation of a Chinese version of the Lee Fatigue Scale-Short Form in women during pregnancy and postpartum. Int J Nurs Stud 2014; 51:1027-35. [DOI: 10.1016/j.ijnurstu.2013.10.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Revised: 10/14/2013] [Accepted: 10/24/2013] [Indexed: 11/17/2022]
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14
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Tsai SY, Lin JW, Kuo LT, Thomas KA. Daily sleep and fatigue characteristics in nulliparous women during the third trimester of pregnancy. Sleep 2012; 35:257-62. [PMID: 22294816 DOI: 10.5665/sleep.1634] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To examine the association among nighttime sleep and daytime napping behaviors, depressive symptoms, and perception of fatigue in pregnant women. DESIGN A prospective descriptive study with within-subject design. SETTING A university-affiliated hospital and participants' home environments. PARTICIPANTS Thirty-eight third trimester nulliparous women completed sleep and depressive symptom questionnaires, wore a wrist actigraphy monitor for 7 consecutive days, and kept a concurrent diary reporting naps and rating their level of fatigue using a 0-10 visual analogue scale each morning, midday, afternoon, and evening. A generalized estimating equation regression model was applied to evaluate the time-dependent association. INTERVENTIONS N/A. MEASUREMENTS AND RESULTS Mean duration of total nighttime sleep by actigraphy was 386.3 ± 60.7 min, with 11 (28.9%) women having an average total nighttime sleep < 6 h. Nineteen women (50%) napped > 3 days, and only 2 women did not nap over the entire week. Antecedent night sleep duration had a significant inverse association with morning (P = 0.022) and afternoon fatigue (P = 0.009) of the subsequent day. Self-reported naps were significantly associated with midday fatigue (P = 0.003). More depressive symptoms predicted more severe fatigue throughout the day. CONCLUSIONS Results suggest that interventions designed to increase sleep duration and decrease depressive symptoms have the potential to prevent, ameliorate, or reduce fatigue in pregnant women. Depressive symptoms during pregnancy likely share some psychological and behavioral tendencies with fatigue and/or sleep disturbance which may complicate the evaluation of intervention effect.
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Affiliation(s)
- Shao-Yu Tsai
- Department of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
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Chou FH, Kuo SH, Wang RH. A longitudinal study of nausea and vomiting, fatigue and perceived stress in, and social support for, pregnant women through the three trimesters. Kaohsiung J Med Sci 2008; 24:306-14. [PMID: 18635416 DOI: 10.1016/s1607-551x(08)70157-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Nausea and vomiting (NV), fatigue, stress and social support during pregnancy have been well documented using cross-sectional research designs. However, few studies have addressed the patterns and relationships for these variables using a longitudinal research design. The purpose of this study was to examine the patterns of and relationships among NV, fatigue, perceived stress, and social support in pregnant women throughout the three trimesters. A prospective and longitudinal study was conducted from 2003 to 2005. Data were collected on four different measures: the Index of Nausea, Vomiting, and Retching (INVR), the Visual Analog Fatigue Scale (VAFS), the Perceived Stress Scale (PSS), and the Brief Social Support Questionnaire (BSSQ). A total of 91 pregnant women were recruited from prenatal clinics in southern Taiwan. One-way ANOVA indicated that INVR scores and fatigue were significantly different among the three trimesters, but that perceived stress and social support were not. Post hoc analyses, using least significant difference testing, indicated that the first trimester was associated with significantly higher levels of NV than were the second and third trimesters. The first and third trimesters had significantly higher fatigue levels than did the second trimester. Mixed models indicated that the differences among INVR scores among the three trimesters were independent of gravidity, planned pregnancy and age. The difference in fatigue between the first and second trimesters was independent of gravidity, planned pregnancy and age, but fatigue was positively associated with NV. Perceived stress was positively correlated with NV. However, when further examining the relationships among the key variables by adding fatigue, perceived stress was found to positively correlate with fatigue and not NV, and negatively correlated with social support. The findings of this study provide a more comprehensive understanding and evidence-based data of the patterns of and relationships among the above four key variables for pregnant women throughout the three trimesters. This will help health care professionals to provide more effective and appropriate care strategies based on the different stages of pregnancy.
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Affiliation(s)
- Fan-Hao Chou
- Faculty of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.
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16
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Poudevigne MS, O'Connor PJ. A Review of Physical Activity Patterns in Pregnant Women and Their Relationship to Psychological Health. Sports Med 2006; 36:19-38. [PMID: 16445309 DOI: 10.2165/00007256-200636010-00003] [Citation(s) in RCA: 154] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Regular physical activity contributes positively to physical and psychological health. Adverse consequences of inactivity may be an especially important problem among pregnant women. Up to 60% are inactive during pregnancy. This review found consistent evidence that physical activity is reduced during pregnancy; however, few investigators have sought to quantify physical activity patterns among pregnant women using well validated measures. Some of the barriers to physical activity during pregnancy, such as depression, anxiety and fatigue, have been shown to be attenuated by regular exercise performed by non-pregnant samples. There is a need to better understand the relationships between these factors and physical activity during pregnancy. Available retrospective and prospective results suggest that both leisure time and work-related physical activities are decreased across pregnancy. Intensity and duration decrease both during pregnancy compared with pre-pregnancy and in the third trimester compared with the first. There is a need for well designed longitudinal investigations that document pregnancy-related changes in physical activity at frequent intervals during pregnancy using validated and more precise measures of physical activity. Reductions in physical activity and a worsening mood are common during pregnancy. If the relationship between physical inactivity and mood disturbances is indeed observed and maintained during pregnancy, then decreases in physical activity in the third trimester would be expected to result in a worsening mood. In recent years, increased attention has been paid to antenatal mood disturbances, and this research has yielded a host of important findings. Prior correlational and experimental research with non-pregnant samples has demonstrated a consistent relationship between physical inactivity and mood disturbances. Whether this relationship occurs among pregnant women and/or is maintained as women progress during pregnancy is uncertain. Prior investigations have revealed that there is higher rate of mood disturbance during pregnancy than following pregnancy but little is known about the mechanisms that cause these mood disturbances. It is important to better understand changes in mood with pregnancy because mood disturbances can have major negative consequences for a pregnant woman. The major adverse consequences of depression among pregnant women are largely the same as those of non-pregnant individuals. Only six investigations have quantified the relationship between changes in physical activity and changes in mood during pregnancy. The available evidence suggests that inactivity is associated with worse mood. Additional research into this topic is warranted due to the limited number of published papers and the design and methodology limitations of these investigations.
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Affiliation(s)
- Mélanie S Poudevigne
- Health Care Management Department, Clayton State University, 2000 Clayton State Boulevard, Morrow, GA 30260, USA.
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17
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Jomeen J. The importance of assessing psychological status during pregnancy, childbirth and the postnatal period as a multidimensional construct: A literature review. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/j.cein.2005.02.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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18
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Abstract
BACKGROUND Previous studies on fatigue and pregnancy outcomes were confined to women with occupational fatigue and did not include women who did not work outside the home. Fatigue during mid- and late pregnancy has rarely been studied. AIMS This paper reports a study examining the associations between work factors, household factors, and fatigue among low-risk pregnant women in Taiwan and links the effects of fatigue to preterm births and caesarean deliveries. METHODS The participants were 633 women who were 20-36 weeks pregnant without evidence of obstetrical complications at the time of interview. Pregnancy outcomes were abstracted from the hospital records after delivery. Fatigue was measured using the Fatigue Symptom Checklist. Women were categorized into three groups according to their work status: non-working, sedentary work, and active work. Other work factors included hours worked and exposure to adverse work environments. Household factors included household work and childcare responsibilities. Multiple linear regression and logistic regression were used for the analysis. RESULTS The factors significantly associated with fatigue in the regression model were age, infection during pregnancy, bleeding after 12 weeks of pregnancy, and work status. Women who did not work outside of the home had significantly higher fatigue scores than those who did sedentary work outside the home. Younger women had higher fatigue scores than older women. Fatigue scores during pregnancy predicted caesarean deliveries, given that age and obstetrical risks were controlled in the model. CONCLUSIONS Fatigue is a significant problem for pregnant women. Fatigue assessments should include morbidities during pregnancy as well as household and work-related factors. Special attention should be paid to women who do not work outside the home. Staff should elicit information about fatigue and intervene early, as this may help decrease the number of caesarean deliveries.
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Affiliation(s)
- Li-Yin Chien
- Institute of Community Health Nursing, School of Nursing, National Yang Ming University, Taipei, Taiwan
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19
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Abstract
The HIV-Related Fatigue Scale (HRFS) was developed to address the specific aspects of fatigue experienced by people who are HIV-positive and are not measured in any commonly used fatigue scale. The necessity for a new scale was determined after analysis of a qualitative study to explore HIV-related fatigue in which it was found that HIV-related fatigue has components related to intensity, circumstances, and consequences that must be included in the measurement of fatigue for this population. The HRFS has 56 items, most of which are on a 1-to-10 scale, drawn from five existing fatigue scales and the data from this qualitative study. The items were deemed content valid, easy to understand, and not fatiguing to complete by people with HIV-related fatigue. Cronbach's alpha for the entire tool was .94; internal consistency for each of the three preliminary subscales is reported as well. Test-retest reliability was moderate at r = .43. Further testing needs to be done, but the HRFS has the potential to be a valuable addition to the measurement of fatigue in seropositive persons.
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Affiliation(s)
- Julie Barroso
- School of Nursing, University of North Carolina at Chapel Hill, USA
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20
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Woo K. A pilot study to examine the relationships of dyspnoea, physical activity and fatigue in patients with chronic obstructive pulmonary disease. J Clin Nurs 2000; 9:526-33. [PMID: 11261132 DOI: 10.1046/j.1365-2702.2000.00361.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A descriptive-correlational design was used to examine the relationships between dyspnoea, physical activity, and fatigue in patients with chronic obstructive pulmonary disease (COPD). Lazarus and Folkman's theory of stress, appraisal, and coping provided a framework to guide the study. Dyspnoea was measured by a vertical visual analogue scale, fatigue by the Fatigue subscale of the Profile of Mood States, and physical activity by the six-minute walk (6 MW) test and an open-ended question. A convenience sample of seven male and 15 female patients with COPD provided data for analysis. The sample was characterized by relatively high forced expiratory volume in one second (FEV1) indicating mild lung impairment and high mean levels of fatigue and dyspnoea. No significant gender difference was found in the ratings of dyspnoea and fatigue and the 6 MW distance. Dyspnoea, physical activities, and fatigue were all significantly inter-related (P < 0.001). Results indicated that the higher the dyspnoea scores, the shorter the 6 MW distance walked, and the higher the fatigue scores. Limitations and suggestions for nursing practice and future research are presented.
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Affiliation(s)
- K Woo
- Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario, Canada M5G 1X5
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21
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Tiesinga LJ, Dassen TW, Halfens RJ, van den Heuvel WJ. Factors related to fatigue; priority of interventions to reduce or eliminate fatigue and the exploration of a multidisciplinary research model for further study of fatigue. Int J Nurs Stud 1999; 36:265-80. [PMID: 10404296 DOI: 10.1016/s0020-7489(99)00022-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
A growing interest in the health problem presented by fatigue, both in clinical practice and research, coupled with a decreasing number of reported studies on fatigue in the last decade, make an updated and systematic review of factors related to fatigue necessary. A search of the literature, comprising 53 studies, was therefore undertaken to explore the following research questions: Which significantly social-demographic, cure-related, and care-related factors are significantly correlated with fatigue? And which nursing interventions need priority in experimental research to reduce or eliminate fatigue? Reported factors related to fatigue in analysed studies show that the correlations between the specific cure- and care-related factors and fatigue are similar among the various investigated (patient) populations. This result supports the concept of the non-specific character of fatigue. The intervention of primary effectiveness most suggested in this study is 'energy management'. Interventions of secondary importance which emerge are those of 'emotional support', 'activity therapy' and 'coping enhancement'. This study makes clear that the exploration of a research model for fatigue, with social-demographic, cure- and care-related factors is useful and that care-related factors have their own effects on fatigue not necessarily dependent upon the presence of medical diseases or cure-related factors. In general, multi-related factors could be assessed. Implications and relevant questions for further research on fatigue are also given.
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Affiliation(s)
- L J Tiesinga
- Northern Centre for Healthcare Research, Department of Nursing Science, University of Groningen, The Netherlands.
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22
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Lee KA, Zaffke ME. Longitudinal changes in fatigue and energy during pregnancy and the postpartum period. J Obstet Gynecol Neonatal Nurs 1999; 28:183-91. [PMID: 10102546 DOI: 10.1111/j.1552-6909.1999.tb01983.x] [Citation(s) in RCA: 111] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To describe perceived levels of fatigue and energy before, during, and after pregnancy in a group of healthy women experiencing uncomplicated pregnancies; and to examine relationships between their perception of fatigue and energy, parity, and physiologic indicators of sleep disturbances, thyroid function, and iron deficiency. DESIGN Prospective, longitudinal. SETTING Participants' homes. PARTICIPANTS Convenience sample of 24 primiparous and 1 8 multiparous women. MAIN OUTCOME MEASURES Change in fatigue and energy over time. Measures were obtained at follicular and luteal phases of the menstrual cycle before pregnancy, at each trimester, and at 1 and 3 months after delivery. RESULTS Younger age and lower prepregnancy levels of iron, ferritin, and hemoglobin explained 1st trimester fatigue. Less total sleep was related to fatigue in the 3rd trimester. Postpartum fatigue was related to reduced amounts of sleep and low levels of ferritin and hemoglobin. CONCLUSIONS With the exception of premenstrual (luteal) fatigue, progesterone levels were unrelated to fatigue. Neither paid employment nor family variables influenced perception of fatigue. Nurses working with childbearing populations should counsel women about significant 1st trimester fatigue so they can prepare their work and home environments in an attempt to achieve adequate rest.
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Affiliation(s)
- K A Lee
- School of Nursing at the University of California, San Francisco, 94143-0606, USA
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23
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Pugh LC, Milligan R, Parks PL, Lenz ER, Kitzman H. Clinical approaches in the assessment of childbearing fatigue. J Obstet Gynecol Neonatal Nurs 1999; 28:74-80. [PMID: 9924867 DOI: 10.1111/j.1552-6909.1999.tb01967.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Modifications of the Fatigue Symptoms Checklist can be used clinically to assess fatigue during the childbearing year. Data from a series of studies provide beginning norms that can be used to interpret clinical scores and point to the potential importance of assessments to pregnancy complications and maternal performance. Consistent with North American Nursing Diagnosis Association (NANDA) definition of fatigue and the theory of unpleasant symptoms, fatigue and performance are important phenomena critical to the experience of pregnancy and assumption of the maternal role.
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Affiliation(s)
- L C Pugh
- The Johns Hopkins University School of Nursing in Baltimore, MD, USA
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24
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Tulman L, Morin KH, Fawcett J. Prepregnant weight and weight gain during pregnancy: relationship to functional status, symptoms, and energy. J Obstet Gynecol Neonatal Nurs 1998; 27:629-34. [PMID: 9836157 DOI: 10.1111/j.1552-6909.1998.tb02632.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To examine the relationship of prepregnancy weight and pregnancy weight gain to functional status, physical symptoms, and physical energy. DESIGN Longitudinal panel, with data collected at the end of each trimester. Functional status was measured by the Inventory of Functional Status-Antepartum Period; physical symptoms, by the Symptoms Checklist; and physical energy, by a one-item question. Self-reported weight and height were used to calculate body mass index (BMI), using the formula weight[kg]/height[m2]. SETTING Women's homes. PARTICIPANTS Two hundred twenty-two women, whose pregnancies were low-risk, drawn from a larger study. RESULTS Women were classified by prepregnancy BMI as underweight (BMI < 19.8), normal weight (BMI = 19.8-26.0), or overweight (BMI > 26.0). The groups did not differ in weight gain by trimester, for an average total weight gain of 30.56 lb (SD = 10.18, range = 1-64) (p > .05), with overweight women therefore gaining less weight on a percentage basis (M = 16.87%) than women who were of normal weight (M = 23.58%) or were underweight (M = 26.02%) (p < .00005). The groups did not differ in functional status, physical energy, or number or type of physical symptoms. Women who gained more than the recommended amount of weight for their prepregnant weight group had a lower level of 3rd trimester functional status than those who did not. CONCLUSIONS Individual counseling of women regarding food intake and excessive weight gain during pregnancy needs to be reconsidered in light of these findings.
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Affiliation(s)
- L Tulman
- University of Pennsylvania, School of Nursing, Philadelphia 19104-6096, USA
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25
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Abstract
OBJECTIVE To identify key predictive variables of functional status after childbirth. DESIGN An investigative survey design. SETTING Primary health care maternal child health centres in one large city in Victoria, Australia. PARTICIPANTS 200 mothers selected from a culturally diverse population. All were aged 20 to 35 years, had experienced normal pregnancies, labours, deliveries and delivered a healthy baby between 37 and 42 weeks' gestation. MEASURES AND FINDINGS: The Inventory of Functional Status After Childbirth (IFSAC) (Fawcett Tulman & Myers 1988) was used as the main outcome measure. Three variables predictive of functional status after childbirth were identified, namely, satisfaction with level of stamina and well-being, sleep pattern at night and perceived lack of support following childbirth. KEY CONCLUSIONS Return to full functional status as measured by IFSAC takes longer than physiological recovery after childbirth. Women who experience diminished well-being, interrupted sleep patterns and lacked support, appeared to be at greater risk of role congestion, overload and dysfunction. IMPLICATIONS FOR PRACTICE To help women avoid the additive nature of assuming the motherhood role while also resuming past role responsibilities, practitioners could encourage pregnant women to develop a postnatal support plan. Women need to be proactive in negotiating specific and ongoing support from others with household responsibilities and some aspects of baby care.
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Affiliation(s)
- C A McVeigh
- Faculty of Health, Division of Nursing, University of Western Sydney, Campbelltown, NSW, Australia.
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26
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Abstract
This study explored the early motherhood experiences of 79 first-time mothers. All women reported normal pregnancies and deliveries, delivered healthy infants at term, and were surveyed at 6 weeks postpartum using the Inventory of Functional Status After Childbirth. Mothers' written comments were subjected to a content analysis, and much of their commentary revolved around the "conspiracy of silence" that appeared to exist about the realities of motherhood. Most commented that no one had prepared them for the unrelenting demands of infant care, the level of fatigue they would experience, the loss of personal time and space, and the realities of 24-hour-a-day infant care. The women also cited their partners as their main support person during the early weeks of motherhood. Although maternal child health nurses and midwives are well placed to offer prenatal education and long-term professional support postpartum, perhaps what is needed is active, anticipatory preparation for motherhood that begins long before the first pregnancy becomes a reality.
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Affiliation(s)
- C McVeigh
- Faculty of Health, Division of Nursing, University of Western Sydney, Macarthur, Australia
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27
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Salmon P, Hall GM. A theory of postoperative fatigue: an interaction of biological, psychological, and social processes. Pharmacol Biochem Behav 1997; 56:623-8. [PMID: 9130286 DOI: 10.1016/s0091-3057(96)00429-7] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The concept of postoperative fatigue has been developed to explain the feelings of malaise and the reduction in activity during the convalescent period that follows surgery in humans. Fatigue has been assumed to reflect the degree of surgical trauma and to be a consequence of muscle weakness caused by physiological sequelae of the trauma. The evidence is inconsistent with this reductionist view. Instead we propose a theory that postoperative fatigue is based on an emotional and motivational change that has the function of ensuring inactivity so as to preserve homeostasis in vital systems in response to injury while preserving the physical capacity to respond to new challenge. This response, triggered by the patient's perception of the surgical stimulus, is prolonged by the influence of staff and patient expectations, which, in turn, reflect cultural beliefs in the necessity of convalescence. This theory can be tested by manipulation of clinical practice at pharmacological and psychological levels.
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Affiliation(s)
- P Salmon
- Department of Clinical Psychology, University of Liverpool, UK.
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28
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Tiesinga LJ, Dassen TW, Halfens RJ. Fatigue: a summary of the definitions, dimensions, and indicators. NURSING DIAGNOSIS : ND : THE OFFICIAL JOURNAL OF THE NORTH AMERICAN NURSING DIAGNOSIS ASSOCIATION 1996; 7:51-62. [PMID: 8716946 DOI: 10.1111/j.1744-618x.1996.tb00293.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Fatigue is a universal complaint that may or may not be related to medical diagnoses or therapeutic treatment. Fatigue is a complex, multicausal, multidimensional, nonspecific, and subjective phenomenon for which no one definition is widely accepted. The absence of theories concerning the nursing diagnosis of fatigue limits insight into the phenomenon and hinders the development of valid and reliable instruments for the measurement of fatigue. Therefores, the authors have undertaken a concept of analysis of fatigue, to a) document how it is defined in the literature; b) which dimensions of the concept of fatigue are distinguished; and c) which indicators of both the content and forms of fatigue represent the concept in practice. This concept analysis has resulted in a theoretical frame of reference that can indicate directions not only for further research into the nursing diagnosis of fatigue, but also for the development of measuring instruments.
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29
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Affiliation(s)
- L C Pugh
- School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA
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30
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Schaefer KM. Sleep disturbances and fatigue in women with fibromyalgia and chronic fatigue syndrome. J Obstet Gynecol Neonatal Nurs 1995; 24:229-33. [PMID: 7782955 DOI: 10.1111/j.1552-6909.1995.tb02467.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE To determine the relationship between sleep disturbances and fatigue in women with fibromyalgia (FM) and those with chronic fatigue syndrome (CFS) and to assess whether any differences existed between the two groups. DESIGN Descriptive comparative. SETTING Community program on chronic fatigue syndrome and related disorders. PARTICIPANTS Sixty-three women who attended the program; 13 had CFS, and 50 had FM. MAIN OUTCOME MEASURES A moderately strong relationship between fatigue and sleepiness was found (r = .63, p < .01). Trouble staying asleep was the highest rated sleep disturbance, and fatigue was the most common subjective feeling reported. Women with CFS reported significantly more trouble staying asleep than women with FM, t(61) = 1.81, p < .03. CONCLUSIONS Data from this study support that women with FM and CFS encounter problems sleeping. Clinicians are encouraged to assess women with FM and CFS for their quality of sleep rather than amount of sleep. Researchers are encouraged to continue study of sleep disturbances in women with FM and CFS to improve understanding of the disturbances and to test the effectiveness of sleep interventions.
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Affiliation(s)
- K M Schaefer
- Allentown College of St. Francis de Sales, Center Valley, PA 18034, USA
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31
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Toth P, Lukacs H, Hiatt ES, Reid KH, Iyer V, Rao CV. Administration of human chorionic gonadotropin affects sleep-wake phases and other associated behaviors in cycling female rats. Brain Res 1994; 654:181-90. [PMID: 7987667 DOI: 10.1016/0006-8993(94)90478-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We investigated the possible effects of human chorionic gonadotropin (hCG) on sleep-wake phases and other associated behaviors controlled by the medial preoptic area, cerebral cortex and hippocampus. Chronic epidural electroencephalographic (EEG) and temporal muscle electromyographic (EMG) electrodes were placed in cycling female rats. After a week of recovery, rats were injected intraperitoneally at 3.00 pm on the day of proestrus with either saline or highly purified hCG or indomethacin or hCG plus indomethacin. Three hours after injection, EEG, EMG and behavioral activities were recorded for 3.5 h. The administration of hCG increased high and low amplitude sleep, resting phase and decreased active awake phase, walking, sniffing and chewing as compared to the controls. While the administration of indomethacin alone had no effect, coadministration inhibited hCG effects. Medial preoptic area, cerebral cortex and hippocampus contain immunostaining for LH/hCG receptors. The administration of hCG resulted in an increase of immunoreactive PGD2 and a decrease of PGE2 in median preoptic area, cerebral cortex and hippocampus as compared to the controls. In summary, hCG administration affects sleep-wake phases and other associated behaviors in rats which can collectively be described as decreased activity. These effects are probably mediated by increasing PGD2 and decreasing PGE2 in areas of brain which control these activities. The above findings may be relevant to pregnant women who experience decreased activity when hCG is present in the circulation and cerebrospinal fluid.
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Affiliation(s)
- P Toth
- Department of Obstetrics and Gynecology, University of Louisville School of Medicine, KY 40292
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32
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Pick B, Molloy A, Hinds C, Pearce S, Salmon P. Post-operative fatigue following coronary artery bypass surgery: relationship to emotional state and to the catecholamine response to surgery. J Psychosom Res 1994; 38:599-607. [PMID: 7990068 DOI: 10.1016/0022-3999(94)90057-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Post-operative fatigue is an important subjective problem for surgical patients, but its basis is unknown, and the possibility of a psychological component has been neglected. To investigate its putative physiological and psychological bases, 74 patients undergoing coronary artery bypass graft surgery were studied. Circulating catecholamine levels were measured at intervals perioperatively and questionnaires were used to measure fatigue, depression and anxiety up to 30 days post-operatively. We tested whether fatigue was related either to the catecholamine or to the emotional responses to surgery. The second element to the design was a controlled randomized study: patients underwent different forms of psychological preparation or a no-treatment control procedure in an attempt to test whether post-operative fatigue was amenable to psychological manipulation. Psychological preparation had no effect. Fatigue at 30 days was greatest in patients whose noradrenaline levels were greatest perioperatively. Independently of this relationship, fatigue at 30 days correlated with concurrent levels of depression and anxiety. Post-operative fatigue has both physiological and psychological correlates.
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Affiliation(s)
- B Pick
- Department of Psychology, University College, London, U.K
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33
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Gift AG, Pugh LC. DYSPNEA AND FATIGUE. Nurs Clin North Am 1993. [DOI: 10.1016/s0029-6465(22)02868-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Abstract
Self-reported sleep disturbances and levels of vitality and fatigue were studied in a secondary analysis of 25 pregnant and 29 postpartum employed women. Results indicate that pregnant women have problems initiating and maintaining sleep, and postpartum women have problems maintaining sleep, but not falling asleep. The primary reason for midsleep awakenings was urinary frequency among the pregnant women, and child care responsibilities among the postpartum women. Chronic sleep disturbance was indicated by a greater percentage of postpartum women who fell asleep easily, very few who felt highly energetic at work, and most who perceived a high level of fatigue during the past week. Even with these sleep disruptions, no differences occurred in the mean scores for perception of fatigue and vitality between the two groups. Clinicians can use these findings to educate women about some changes they may anticipate and how they might manage them during pregnancy and postpartum.
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