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Shiffman N, Gluska H, Margalit S, Mayer Y, Daher R, Elyasyan L, Elia N, Sharon Weiner M, Miremberg H, Kovo M, Biron-Shental T, Gabbay-Benziv R, Helpman L. Unfolding of maternal-infant bonding amidst the COVID-19 pandemic: Social support as a risk and protective factor. Dev Psychopathol 2024:1-9. [PMID: 38654408 DOI: 10.1017/s0954579424000853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
BACKGROUND Social, familial, and physiological stressors may put maternal-infant bonding at risk. Therefore, it is plausible that the stressful conditions brought on by COVID-19 could influence maternal-infant bonding. This study aimed to elucidate the contribution of COVID-19-related experience to variance in maternal-infant bonding, beyond that of established risk factors and as moderated by social support. METHODS This longitudinal, multicenter study examined the relationship of demographic and obstetric variables, social support, postpartum depression, as well as COVID-19-related fear, exposure, and subjective difficulty with mother-infant bonding six months following birth. Participants (N = 246) were women who delivered during the pandemics' strict lockdown period and were recruited 10 weeks after a liveborn delivery and followed up six months later. RESULTS Relationship between fear of COVID-19 and maternal-infant bonding was moderated by social support: Amongst mothers with high levels of social support, fear of COVID-19 negatively predicted bonding. DISCUSSION Results indicate that social support, while overall a protective factor for mother-infant bonding, may lose its buffering effect when fear of COVID-19 is high. This relationship was maintained even when early bonding experiences such as forced separation and the risk incurred by postpartum depression were accounted for. Implications for providers are discussed.
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Affiliation(s)
- N Shiffman
- Psychiatry and Mental Health Division, Rambam Medical Center, Haifa, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel
| | - H Gluska
- Obstetrics and Gynecology, Meir Medical center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Shiri Margalit
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Y Mayer
- Department of Counseling and Human Development, Faculty of Education, University of Haifa, Haifa, Israel
| | - R Daher
- The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel
- Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
| | - L Elyasyan
- The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel
- Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
| | - N Elia
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel
| | - M Sharon Weiner
- Obstetrics and Gynecology, Meir Medical center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - H Miremberg
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel
| | - M Kovo
- Obstetrics and Gynecology, Meir Medical center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - T Biron-Shental
- Obstetrics and Gynecology, Meir Medical center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - R Gabbay-Benziv
- The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel
- Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
| | - L Helpman
- Department of Counseling and Human Development, Faculty of Education, University of Haifa, Haifa, Israel
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2
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Chandra N, Smitha MV. Functional status, social support, and anxiety among postnatal women of Eastern India. Eur J Obstet Gynecol Reprod Biol X 2023; 20:100238. [PMID: 37720888 PMCID: PMC10502358 DOI: 10.1016/j.eurox.2023.100238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/31/2023] [Accepted: 09/02/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction Though becoming a mother is a joyous experience, the postpartum time can be difficult and stressful for women as they deal with significant physical alterations and adjustments to their daily routines. However, very few studies have focused on the functional well-being of the woman after childbirth. This study aims to find the level of functional status, social support, and anxiety among women attending immunization clinics. Methods A descriptive cross-sectional research design was adopted to recruit 220 women in this study from two immunization clinic centers in Bhubaneswar, Odisha. Data were collected using a self-reported sociodemographic profile, functional level scale after childbirth, modified multidimensional scale of perceived social support, and postnatal anxiety scale. Descriptive and inferential statistical tests were used for data analysis, including mean, percentage, and Fisher exact. Results 59.5 % of women returned to a moderate level of functional status after six weeks postpartum. The majority of women, 98.6 % and 83.6 %, reported high levels of return to personal care and baby care, respectively, whereas 34.7 % had moderate levels of return to home activities and 90 % had low levels of return to community and social tasks. Also, 70 % of women had high perceived social support, and 87.7 % had no anxiety. In this study, normal delivery women had better functional status than their cesarean delivery counterparts. Moreover, functional status was significantly associated with anxiety at six postpartum weeks. Conclusion After six weeks of childbirth, most women only partially resumed their pre-pregnancy functional state. So, much more time, rest, and support from family members were needed to recover to a fully functional level. Nurses, midwives, and the family members of women should be aware of the critical role that social support plays in enhancing a woman's functional and psychological status during the postpartum period.
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Affiliation(s)
- Nabanita Chandra
- Obstetrical and Gynecological Nursing, College of Nursing, AIIMS Bhubaneswar, Odisha, India
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3
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Wang Y, Gao Q, Liu J, Zhang F, Xu X. Translation and validation of the Chinese version of the maternal postpartum stress scale. BMC Pregnancy Childbirth 2023; 23:685. [PMID: 37740223 PMCID: PMC10517469 DOI: 10.1186/s12884-023-05990-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 09/11/2023] [Indexed: 09/24/2023] Open
Abstract
OBJECTIVE To translate the Maternal Postpartum Stress Scale (MPSS) into Chinese and validate its psychometric properties in postpartum women. METHODS A total of 406 postpartum women were recruited from six hospitals in Nantong, Jiangsu Province, China. Cronbach's α co-efficient, split-half reliability, and test-retest reliability were used to evaluate the reliability of the translated scale. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to evaluate the structural validity of the scale. The Edinburgh Postnatal Depression Scale, Depression Anxiety Stress Scale-21 anxiety dimension, and Perceived Stress Scale were used as calibration scales to measure the correlation of MPSS. All data were analyzed using SPSS 25.0 and Amos 24.0. RESULTS The Cronbach's α co-efficient of the Chinese version of MPSS and its three dimensions were 0.940 and 0.882-0.911, respectively. The split-half reliability was 0.825, and the test-retest reliability was 0.912. The scale's content validity index was 0.926. Three common factors were extracted from the EFA. The CFA validated the explored 3-factor structure, and the indicators were fitted well (χ2/Df = 2.167, comparative fit index = 0.918, Tucker-Lewis index = 0.907, incremental fit index = 0.919, and root mean square error of approximation = 0.075). CONCLUSION The translated Chinese version of MPSS had suitable reliability and validity in assessing postpartum stress in Chinese women. The translated scale can also help with the early identification of postpartum stress and provide a scientific basis for the formulation of early personalized intervention measures. Overall, the scale has certain clinical value and practical significance for enhancing the physical and mental health of postpartum women. However, future studies including large, diverse populations are warranted.
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Affiliation(s)
- Yanchi Wang
- Affiliated Nantong Hospital of Shanghai University (The Sixth People's Hospital of Nantong), Nantong, Jiangsu, China
- Medical School of Nantong University, Nantong, Jiangsu, China
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China
| | - Qian Gao
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China
| | - Jin Liu
- Medical School of Nantong University, Nantong, Jiangsu, China
| | - Feng Zhang
- Medical School of Nantong University, Nantong, Jiangsu, China.
| | - Xujuan Xu
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China.
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4
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Adlington K, Vasquez C, Pearce E, Wilson CA, Nowland R, Taylor BL, Spring S, Johnson S. 'Just snap out of it' - the experience of loneliness in women with perinatal depression: a Meta-synthesis of qualitative studies. BMC Psychiatry 2023; 23:110. [PMID: 36849948 PMCID: PMC9970854 DOI: 10.1186/s12888-023-04532-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 01/06/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Pregnancy and the arrival of a new baby is a time of great transition and upheaval. Women often experience social isolation and loneliness at this time and may develop depression, particularly in the postnatal period. Qualitative studies have reported that loneliness is also a feature of perinatal depression. However, until now there has been no attempt to synthesise research exploring the links between loneliness and perinatal depression. This study's aim was to explore existing qualitative evidence to answer two research questions: What are the experiences of loneliness for women with perinatal depression? What helps and what makes loneliness worse for women with perinatal depression? METHODS A qualitative meta-synthesis retrieved primary qualitative studies relevant to the research questions. Four electronic databases were systematically searched (Ovid MEDLINE®; PsycINFO; Embase; Web of Science). Papers were screened according to pre-defined inclusion criteria and assigned a quality score. Thematic analysis was used to identify major overarching themes in the literature. RESULTS Twenty-seven relevant qualitative studies were included. Themes relating to the interaction between perinatal depression and loneliness included self-isolation and hiding symptoms due to stigma of perinatal depression and fear of judgement as a 'bad mother'; a sudden sense of emotional disconnection after birth; and a mismatch between expected and actual support provided by partner, family and community. There was also a double burden of loneliness for women from disadvantaged communities, due to increased stigma and decreased social support. Validation and understanding from healthcare professionals, peer support from other mothers with experience of perinatal depression, and practical and emotional family support were all important factors that could ameliorate loneliness. CONCLUSIONS Loneliness appears to play a central role in the experience of perinatal depression based on the frequency with which it emerged in women's accounts. The findings provide a foundation for the development of further theories about the role of loneliness in perinatal depression and evidence in which future psychological and social intervention design processes can be rooted. Addressing stigma and offering culturally appropriate professional and peer support are potential targets for interventions that could help women with perinatal depression, particularly in disadvantaged communities, feel less lonely. TRIAL REGISTRATION Prospero registration: https://www.crd.york.ac.uk/prospero/display_record.php? RecordID = 251,936.
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Affiliation(s)
- Katherine Adlington
- Division of Psychiatry, University College London, London, UK. .,Section of Women's Mental Health, King's College London, London, UK. .,East London NHS Foundation Trust, London, UK.
| | | | - Eiluned Pearce
- Division of Psychiatry, University College London, London, UK
| | - Claire A Wilson
- Section of Women's Mental Health, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Rebecca Nowland
- School of Health and Midwifery, University of Central Lancashire, Preston, UK
| | | | | | - Sonia Johnson
- Division of Psychiatry, University College London, London, UK.,Camden and Islington NHS Foundation Trust, London, UK
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5
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Manus MB, Watson E, Kuthyar S, Carba D, Belarmino NM, McDade TW, Kuzawa CW, Amato KR. Prenatal household size and composition are associated with infant fecal bacterial diversity in Cebu, Philippines. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2023; 181:45-58. [PMID: 36847111 DOI: 10.1002/ajpa.24720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/02/2023] [Accepted: 02/08/2023] [Indexed: 03/01/2023]
Abstract
OBJECTIVES The gut microbiome (GM) connects physical and social environments to infant health. Since the infant GM affects immune system development, there is interest in understanding how infants acquire microbes from mothers and other household members. MATERIALS AND METHODS As a part of the Cebu Longitudinal Health and Nutrition Survey (CLHNS), we paired fecal samples (proxy for the GM) collected from infants living in Metro Cebu, Philippines at 2 weeks (N = 39) and 6 months (N = 36) with maternal interviews about prenatal household composition. We hypothesized that relationships between prenatal household size and composition and infant GM bacterial diversity (as measured in fecal samples) would vary by infant age, as well as by household member age and sex. We also hypothesized that infant GM bacterial abundances would differ by prenatal household size and composition. RESULTS Data from 16 S rRNA bacterial gene sequencing show that prenatal household size was the most precise estimator of infant GM bacterial diversity, and that the direction of the association between this variable and infant GM bacterial diversity changed between the two time points. The abundances of bacterial families in the infant GM varied by prenatal household variables. CONCLUSIONS Results highlight the contributions of various household sources to the bacterial diversity of the infant GM, and suggest that prenatal household size is a useful measure for estimating infant GM bacterial diversity in this cohort. Future research should measure the effect of specific sources of household bacterial exposures, including social interactions with caregivers, on the infant GM.
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Affiliation(s)
- Melissa B Manus
- Department of Anthropology, Northwestern University, Evanston, Illinois, USA
| | - Elijah Watson
- Department of Anthropology, Northwestern University, Evanston, Illinois, USA
| | - Sahana Kuthyar
- Department of Anthropology, Northwestern University, Evanston, Illinois, USA.,Department of Biological Sciences, University of California San Diego, La Jolla, California, USA
| | - Delia Carba
- Office of Population Studies, University of San Carlos, Cebu City, Philippines
| | - Nikola M Belarmino
- Office of Population Studies, University of San Carlos, Cebu City, Philippines
| | - Thomas W McDade
- Department of Anthropology, Northwestern University, Evanston, Illinois, USA.,Institute for Policy Research, Northwestern University, Evanston, Illinois, USA
| | - Christopher W Kuzawa
- Department of Anthropology, Northwestern University, Evanston, Illinois, USA.,Institute for Policy Research, Northwestern University, Evanston, Illinois, USA
| | - Katherine R Amato
- Department of Anthropology, Northwestern University, Evanston, Illinois, USA
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Øygarden AMU, Berg RC, Abudayya A, Glavin K, Strøm BS. Measurement instruments for parental stress in the postpartum period: A scoping review. PLoS One 2022; 17:e0265616. [PMID: 35303028 PMCID: PMC8932572 DOI: 10.1371/journal.pone.0265616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 03/04/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Parenting stress is a particular type of stress that is conceptualized as a negative psychological response to the numerous obligations associated with raising children. Despite a considerable increase in research on parenting stress, little attention has been given to the ways parenting stress are measured.
Objectives
This scoping review aimed to provide an overview of available instruments measuring parental stress and to describe their psychometric properties.
Methods
We conducted a scoping review in accordance with international guidelines for scoping reviews. The main search strategy was searches in seven electronic databases. Pairs of reviewers selected relevant studies based on predetermined inclusion and exclusion criteria. Studies had to report one or more psychometric properties of an instrument measuring stress in parents with children 0–12 months. For each included study, we collected information relevant to the review question, guided by the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN). Finally, we collated, summarized, and reported the findings descriptively.
Results
From 2164 unique record, 64 studies from 24 countries were included. They described 15 instruments, of which four were generic and eleven parental-specific self-administered instruments. Only two studies examined parental stress among fathers. Eleven of the studies were validation studies, but they only described seven of the 15 instruments. Internal consistency was the only information provided by 73.4% of the included studies. None of the instruments had information on all measurement properties as per the COSMIN criteria, and there was no information about measurement error, responsiveness, or interpretability for any of the 15 instruments.
Discussion
There are presently 15 instruments with some associated psychometric information being used to measure parental stress among parents with young children, but the amount of information on the instruments’ psychometric properties is slight. There is a need for further research.
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Affiliation(s)
- Anne-Martha Utne Øygarden
- Centre of Diakonia and Professional Practice, VID Specialized University, Oslo, Norway
- Faculty of Health, VID Specialized University, Oslo, Norway
- * E-mail:
| | - Rigmor C. Berg
- Reviews and Health Technology Assessments, Norwegian Institute of Public Health, Oslo, Norway
- University of Tromsø The Arctic University of Norway, Tromsø og Finnmark, Norway
| | | | - Kari Glavin
- Faculty of Health, VID Specialized University, Oslo, Norway
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Saleh OA, Halperin O, Baron-Epel O. Predictors of maternal self-efficacy and the mediating role of postpartum fatigue for Jewish and Arab women in Northern Israel. Midwifery 2022; 107:103281. [DOI: 10.1016/j.midw.2022.103281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 01/11/2022] [Accepted: 02/06/2022] [Indexed: 11/30/2022]
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Lee LC, Hung CH. Women's trajectories of postpartum depression and social support: A repeated-measures study with implications for evidence-based practice. Worldviews Evid Based Nurs 2022; 19:121-129. [PMID: 35019236 DOI: 10.1111/wvn.12559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 07/26/2021] [Accepted: 08/02/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Postpartum depression is one of the most common psychological disorders of women after childbirth. Despite the importance of social support as an influencing factor, there have been few studies on the trends and characteristics of social support as it relates to postpartum depression. AIMS To explore the trends in postpartum depression and social support, to cross-analyze the correlation between the postpartum depression trajectory and the social support trajectory, and to investigate predictors of changes in postpartum depression trajectories. METHODS A prospective repeated-measure study and convenience sampling were used to recruit 230 women at 1, 3, and 6 months after childbirth. Structured questionnaires were used for data collection. Trajectory analysis was used to explore the trajectories of postpartum depression and social support during the 6 months after childbirth, and polynomial logistic regression was used to explore predictors of the trajectory of postpartum depression. RESULTS Postpartum depression was at its most serious in the third month after childbirth, showing patterns of low-risk, moderate-risk, and high-risk trajectories. Social support also showed low, moderate, and high patterns, and the trajectory of postpartum depression was significantly related to the trajectory of social support. The predictors of moderate-risk and high-risk postpartum depression were also found in this study. LINKING EVIDENCE TO ACTION Postpartum mental health education and online learning systems should be used to increase social support for women after childbirth and reduce the incidence of postpartum depression.
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Affiliation(s)
- Li-Chun Lee
- Department of Nursing, Asia University, Taichung, Taiwan
| | - Chich-Hsiu Hung
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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9
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Assal-Zrike S, Marks K, Atzaba-Poria N. Prematurity, maternal emotional distress, and infant social responsiveness among Arab-Bedouin families: The role of social support as a resilience factor. Child Dev 2021; 93:582-593. [PMID: 34779507 DOI: 10.1111/cdev.13705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study investigated predictors of early infant social development and the role of social support as a resilience factor among Arab-Bedouin families. We propose a mediation model in which social support will be related to maternal postpartum emotional distress (PPED), which in turn will be related to infant social responsiveness. One hundred five Arab-Bedouin mothers (age range = 17-44 years) and their preterm (n = 48) and full-term (n = 57) infants were recruited shortly after birth and were followed up at age 12 months. Findings demonstrate that, among the preterm group, higher levels of social support predicted lower levels of maternal PPED, and this, in turn, predicted higher levels of infant social responsiveness.
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Affiliation(s)
- Shuaa Assal-Zrike
- Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Kyla Marks
- Soroka University Medical Center and the Faculty of Health Sciences, Beer Sheva, Israel
| | - Naama Atzaba-Poria
- Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva, Israel
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10
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Stirling Cameron E, Aston M, Ramos H, Kuri M, Jackson L. The postnatal experiences of resettled Syrian refugee women: Access to healthcare and social support in Nova Scotia, Canada. Midwifery 2021; 104:103171. [PMID: 34736018 DOI: 10.1016/j.midw.2021.103171] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 09/18/2021] [Accepted: 10/15/2021] [Indexed: 10/20/2022]
Abstract
AIM The purpose of this qualitative study was to understand Syrian refugee women's perceptions and experiences of access to formal health services and informal supports during the postpartum period in Nova Scotia, Canada and to identify valued and missing services and supports in the community. BACKGROUND The postnatal period is a critical time when mothers may need access to health services (e.g., family physicians, psychologists) and informal supports (e.g., friends, family) to support their positive mental and physical health after birth. Resettled refugee women commonly encounter barriers when accessing care during the postnatal period and often have limited social supports. METHODS Semi-structured, telephone or virtual interviews were conducted with 11 resettled Syrian refugee women who gave birth in Nova Scotia, Canada within the past five years. Data were collected in the summer of 2020. This study was conducted using elements of constructivist grounded theory. FINDINGS Four key themes were identified from women's experiences: (i) postpartum social support was critical, but often lacking, (ii) structural barriers (e.g., irregular interpreter services, limited childcare options) impeded women's access to healthcare, (iii) paternalistic healthcare providers limited women's decision-making autonomy, and (iv) the value and need for culturally competent, integrated care (e.g., newcomer specific healthcare centres), in-home services, and family support. CONCLUSION Resettled Syrian refugee women in Nova Scotia, Canada experience a range of barriers that limits their access to postnatal healthcare. Policy change, program development, and/or interventions are needed to improve access to postnatal services and supports for resettled Syrian women in Canada.
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Affiliation(s)
- Emma Stirling Cameron
- Dalhousie University, School of Health and Human Performance, Halifax, Nova Scotia, Canada.
| | - Megan Aston
- Dalhousie University, School of Nursing, Halifax, Nova Scotia, Canada
| | - Howard Ramos
- University of Western Ontario, Department of Sociology, London, Ontario, Canada
| | - Marwa Kuri
- Dalhousie University, School of Social Work, Halifax, Nova Scotia, Canada
| | - Lois Jackson
- Dalhousie University, School of Health and Human Performance, Halifax, Nova Scotia, Canada
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11
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Ngene NC, Moodley J. Pre-delivery angiogenic factors and their association with peripartum perceived stress and pain in pre-eclampsia with severe features and normotensive pregnancies. Int J Gynaecol Obstet 2021; 158:398-405. [PMID: 34622454 PMCID: PMC8989713 DOI: 10.1002/ijgo.13972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 08/18/2021] [Accepted: 10/06/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To determine if any of maternal pre-delivery soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PIGF), or sFlt-1/PIGF ratio correlate with either perceived stress scale (PSS) or verbal numeric rating scale (VNRS) pain scores. METHODS Among 50 pregnant women with severe pre-eclampsia and 90 normotensive pregnant women observed from 48 h or less before delivery until day 3 postpartum, correlations between the following were performed: (1) serum concentrations of each angiogenic factor (sFlt-1, PIGF, and sFlt-1/PIGF ratio) sampled within 48 h before childbirth and a four-item PSS (pre-delivery and one-off 48-72 h postpartum score); (2) the same angiogenic factors above and VNRS ranging from 0 to 10; and (3) PSS and VNRS (both pre-delivery and postpartum). RESULTS In the normotensive group, there was a positive correlation between sFlt-1 and postpartum PSS (ρ +0.214 and P = 0.043), and between sFlt-1/PIGF ratio and postpartum PSS (ρ +0.213 and P = 0.044). In the normotensive and severe pre-eclampsia groups there were non-significant negative correlations between PIGF and postpartum PSS (P > 0.096) and non-significant positive correlations between pre-delivery PSS and pre-delivery VNRS (P > 0.053). Other correlations were uninformative. CONCLUSION Maternal pre-delivery sFlt-1/PIGF ratio in normotensive pregnancy is a promising biomarker for identifying risk of increased postpartum PSS to enable early counselling.
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Affiliation(s)
- Nnabuike Chibuoke Ngene
- Department of Obstetrics and Gynecology, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Department of Obstetrics and Gynecology, School of Clinical Medicine, Faculty of Health Sciences, University of Kwa Zulu-Natal, Durban, South Africa.,Department of Obstetrics and Gynecology, Leratong Hospital, Gauteng, South Africa
| | - Jagidesa Moodley
- Department of Obstetrics and Gynecology, School of Clinical Medicine, Faculty of Health Sciences, University of Kwa Zulu-Natal, Durban, South Africa
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12
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Guo P, Xu D, Liew Z, He H, Brocklehurst P, Taylor B, Zhang C, Jin X, Gong W. Adherence to Traditional Chinese Postpartum Practices and Postpartum Depression: A Cross-Sectional Study in Hunan, China. Front Psychiatry 2021; 12:649972. [PMID: 34385937 PMCID: PMC8353075 DOI: 10.3389/fpsyt.2021.649972] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 06/25/2021] [Indexed: 12/02/2022] Open
Abstract
Background: The relationship between adherence to traditional Chinese postpartum practices (known as "doing-the-month") and postpartum depression (PPD) remains unknown. Practices including restrictions on diet, housework and social activity, personal hygiene, and cold contact, could introduce biological, psychological, and socio-environmental changes during postpartum. Methods: The cross-sectional study included 955 postpartum women in obstetric clinics in Hunan Province of China between September 2018 to June 2019. Thirty postpartum practices were collected by a self-report online structured questionnaire. Postpartum depression symptoms were assessed by the Chinese version of the Edinburgh Postnatal Depression Scale (EPDS). Multivariable linear regression was used to estimate the differences in EPDS scores according to adherence to postpartum practices. Firth's bias-reduced logistic regression was employed to analyze the binary classification of having PPD symptoms (EPDS ≥ 10). Results: Overall, both moderate and low adherence to postpartum practices appeared to be associated with higher EPDS scores (adjusted difference 1.07, 95% CI 0.20, 1.94 for overall moderate adherence; and adjusted difference 1.72, 95% CI 0.84, 2.60 for overall low adherence). In analyses by practice domain, low adherence to housework-related and social activity restrictions was associated with having PPD symptoms compared with high adherence (OR 1.61, 95% CI 1.07, 2.43). Conclusions: Low adherence to traditional Chinese postpartum practices was associated with higher EPDS scores indicating PPD symptoms, especially in the domain of housework-related and social activity restrictions. Psychosocial stress and unsatisfactory practical support related to low adherence to postpartum practices might contribute to PPD. Longitudinal study and clinical assessment would be needed to confirm these findings.
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Affiliation(s)
- Pengfei Guo
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States
- Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, CT, United States
| | - Dong Xu
- School of Health Management, Southern Medical University, Guangzhou, China
- Center for WHO Studies, Southern Medical University, Guangzhou, China
- Institute for Health Management, Southern Medical University, Guangzhou, China
- ACACIA Labs, Institute for Global Health and Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Zeyan Liew
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States
- Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, CT, United States
| | - Hua He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Peter Brocklehurst
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
| | - Beck Taylor
- Institute for Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Chao Zhang
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Xin Jin
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Wenjie Gong
- Xiangya School of Public Health, Central South University, Changsha, China
- Department of Psychiatry, University of Rochester, Rochester, NY, United States
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13
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Albanese AM, Geller PA, Steinkamp JM, Barkin JL. In Their Own Words: A Qualitative Investigation of the Factors Influencing Maternal Postpartum Functioning in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176021. [PMID: 32824941 PMCID: PMC7504078 DOI: 10.3390/ijerph17176021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 01/13/2023]
Abstract
During the first twelve months postpartum, infants require intensive care and mothers are susceptible to physical and mental health concerns as they undergo a period of tremendous psychological and physiological adjustment. The mother’s level of postpartum functioning not only impacts her experience as a mother but also the infant and family unit. However, efforts to bolster functioning are lacking, and previous literature has identified a gap between what experts recommend and what mothers desire during the postpartum period. To address this, we conducted structured interviews with a diverse sample of 30 postpartum mothers to identify factors that mothers report are most influential to their postpartum functioning. In total, we identified 23 clinically actionable factors, all of which are backed by existing literature. In addition to an in-depth presentation of the qualitative findings, we also present a heat map to visualize the relevance of these factors to each of seven established domains of maternal functioning. Lastly, based on our findings, we offer a taxonomy of interventional strategies that could bolster maternal functioning during this critical period.
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Affiliation(s)
- Ariana M. Albanese
- Department of Psychology, Drexel University, Philadelphia, PA 19104, USA;
- Correspondence:
| | - Pamela A. Geller
- Department of Psychology, Drexel University, Philadelphia, PA 19104, USA;
| | | | - Jennifer L. Barkin
- Mercer University School of Medicine Department of Community Medicine, Macon, GA 31207, USA;
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Mohammad Redzuan SA, Suntharalingam P, Palaniyappan T, Ganasan V, Megat Abu Bakar PN, Kaur P, Marmuji LZ, Ambigapathy S, Paranthaman V, Chew BH. Prevalence and risk factors of postpartum depression, general depressive symptoms, anxiety and stress (PODSAS) among mothers during their 4-week postnatal follow-up in five public health clinics in Perak: A study protocol for a cross-sectional study. BMJ Open 2020; 10:e034458. [PMID: 32565453 PMCID: PMC7311026 DOI: 10.1136/bmjopen-2019-034458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Postpartum depression, general depressive symptoms, anxiety and stress (PODSAS) are often overlooked, and may cause morbidity to new mothers, their babies and families. This study aims to determine the point prevalence of depression (post partum and general), anxiety and stress among mothers in five public health clinics in Perak at 4 weeks postdelivery and identify their associated risk factors. Findings from this study will be used to identify the needs for early screening and detection, encourage development of interventions to reduce its occurrence and support mothers with PODSAS. METHODS AND ANALYSIS This cross-sectional study will recruit 459 postpartum mothers during their 4-week postnatal follow-up in five selected public health clinics in Perak from September 2019 to May 2020. Participants will be mothers aged 18 years and above at 4 weeks postdelivery who are able to understand the English and Malay languages. Non-Malaysians and mothers with known diagnosis of psychotic disorders will be excluded from the study. Sociodemographic information and possible risk factors of the participants will be captured via a set of validated questionnaires, postpartum depression (PPD) will be measured using the Edinburgh Postpartum Depression Scale questionnaire and general depressive symptoms, anxiety and stress will be measured using the 21-item Depression, Anxiety and Stress Scale. Data analysis will be conducted using SPSS V.25.0 (IBM). Besides descriptive statistics, multivariable regression analyses will be done to identify possible risk factors and their independent associations with depression (PPD and general depressive symptoms, combined and separately), anxiety and stress. ETHICS AND DISSEMINATION The study protocol was reviewed and approved by the Medical Research Ethics Committee, Ministry of Health Malaysia on 7 August 2019. Results of this study will be reported and shared with the local health stakeholders and disseminated through conference proceedings and journal publications. REGISTRATION NUMBER This study is registered in the Malaysian National Medical Research Register with the ID: NMRR-19-868-47647.
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Affiliation(s)
| | | | | | - Venotha Ganasan
- Gunung Rapat Health Clinic, Kinta District Health Office, Gunung Rapat, Malaysia
| | | | - Paream Kaur
- Greentown Health Clinic, Kinta District Health Office, Ipoh, Perak
| | - Lili Zuryani Marmuji
- Gunung Rapat Health Clinic, Kinta District Health Office, Gunung Rapat, Malaysia
| | | | - V Paranthaman
- Greentown Health Clinic, Kinta District Health Office, Ipoh, Perak
| | - Boon How Chew
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor
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Moirasgenti M, Doulougeri K, Panagopoulou E, Theodoridis T. Psychological stress reduces the immunological benefits of breast milk. Stress Health 2019; 35:681-685. [PMID: 31691465 DOI: 10.1002/smi.2903] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 09/10/2019] [Accepted: 09/20/2019] [Indexed: 11/08/2022]
Abstract
Our study aimed to assess the impact of maternal psychological stress on the immunological components of breast milk. Eighty-nine women participated in the study. We assessed general stress, postpartum-specific stress, negative affectivity, salivary cortisol of mother, and secretory immunoglobulin A (sIgA) levels of breast milk 4-6 weeks after delivery. Controlling for the effects of women's age, weight, number, and duration of feedings, postpartum-specific stress was related to reduced sIgA concentration (R2 = .206, beta = -.275, p = .020). This study suggests that the established link between psychological stress and immunity may also extend to the immunity of the newborn by reducing the immunological benefits of breast milk. It also suggests that breastfeeding might be a potential mechanism of the relationship between maternal stress and the health of the offspring. Findings highlight the need for interventions addressing women during the postpartum period, in order to ensure the mother's well-being and the infant's optimal development.
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Affiliation(s)
- Maria Moirasgenti
- Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Karolina Doulougeri
- Department of Education and Social Policy, University of Macedonia, Thessaloniki, Greece
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Lubker Cornish D, Roberts Dobie S. Social Support in the "Fourth Trimester": A Qualitative Analysis of Women at 1 Month and 3 Months Postpartum. J Perinat Educ 2019; 27:233-242. [PMID: 31073269 DOI: 10.1891/1058-1243.27.4.233] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Social support is essential in the postpartum period when support is positively associated with infant care and maternal adaptation and its absence is associated with postpartum depression. The aim of this qualitative study was to explore how postpartum women experience social support and variations in the type and quantity received. Researchers conducted two semistructured interviews with a convenience sample of 22 participants at approximately one month and three months postpartum. Social support varied in quality and quantity. Respondents indicated that the presence of support made the postpartum period easier, less stressful, and more enjoyable. Efforts to help women plan for postpartum social support during pregnancy should focus on relationships and social networks as well as individual behaviors and community services.
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17
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Development, Psychometric Assessment, and Predictive Validity of the Postpartum Childcare Stress Checklist. Nurs Res 2018; 67:439-446. [PMID: 30067584 DOI: 10.1097/nnr.0000000000000308] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Childcare stress has been shown to predict postpartum depression; however, there is little research exploring and validating the dimensions of childcare stress instruments such that preventive interventions can be created. OBJECTIVES The aim of this study was to develop and psychometrically test an instrument to measure parental perceptions of postpartum childcare stress. METHODS Using research based on postpartum stress and childcare stress, the Postpartum Childcare Stress Checklist (PCSC) was developed, and content validity was judged by experts. The PCSC was psychometrically assessed in a cohort of 541 women in a health region near Vancouver, Canada, who were followed to 8 weeks postpartum in 2002. The psychometric assessment analyses comprised internal consistency, exploratory factory analysis, concurrent validity, and predictive validity. RESULTS The 19-item PCSC had good internal consistency (Kuder-Richardson Formula 20 coefficient: 0.81). Exploratory factor analysis revealed the following dimensions: (a) relationship with the partner, (b) caring for the infant, (c) maternal social interactions, and (d) establishing a new routine. Predictive validity analyses showed that PCSC total and subscale scores at 4 weeks were positively correlated with depressive symptomatology, anxiety, and perceived stress and negatively correlated with global and partner support at 8 weeks postpartum. DISCUSSION The PCSC is a measure of childcare stress with excellent reliability and validity. Upon further testing, it may be used to identify women and couples in need of greater support, individualize postpartum care, and evaluate the effectiveness of preventive interventions.
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18
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Fang L, Hsiao LP, Fang SH, Chen BC. The associations with work stress, social support and overweight/obesity among hospital nurses: A cross-sectional study. Contemp Nurse 2018; 54:182-194. [DOI: 10.1080/10376178.2018.1476166] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Li Fang
- Department of Nursing, Fooyin University, Kaohsiung, Taiwan, R.O.C
| | - Li-Ping Hsiao
- Department of Nursing, Pingtung Christian Hospital, Pingtung, Taiwan
| | - Shu-Hui Fang
- Department of Foreign Languages, Fooyin University, Kaohsiung, Taiwan
| | - Bao-Chen Chen
- Department of Nursing, Pingtung Christian Hospital, Pingtung, Taiwan
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Hitimana R, Lindholm L, Krantz G, Nzayirambaho M, Condo J, Sengoma JPS, Pulkki-Brännström AM. Health-related quality of life determinants among Rwandan women after delivery: does antenatal care utilization matter? A cross-sectional study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2018; 37:12. [PMID: 29703248 PMCID: PMC5921437 DOI: 10.1186/s41043-018-0142-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 04/17/2018] [Indexed: 06/02/2023]
Abstract
BACKGROUND Despite the widespread use of antenatal care (ANC), its effectiveness in low-resource settings remains unclear. In this study, self-reported health-related quality of life (HRQoL) was used as an alternative to other maternal health measures previously used to measure the effectiveness of antenatal care. The main objective of this study was to determine whether adequate antenatal care utilization is positively associated with women's HRQoL. Furthermore, the associations between the HRQoL during the first year (1-13 months) after delivery and socio-economic and demographic factors were explored in Rwanda. METHODS In 2014, we performed a cross-sectional population-based survey involving 922 women who gave birth 1-13 months prior to the data collection. The study population was randomly selected from two provinces in Rwanda, and a structured questionnaire was used. HRQoL was measured using the EQ-5D-3L and a visual analogue scale (VAS). The average HRQoL scores were computed by demographic and socio-economic characteristics. The effect of adequate antenatal care utilization on HRQoL was tested by performing two multivariable linear regression models with the EQ-5D and EQ-VAS scores as the outcomes and ANC utilization and socio-economic and demographic variables as the predictors. RESULTS Adequate ANC utilization affected women's HRQoL when the outcome was measured using the EQ-VAS. Social support and living in a wealthy household were associated with a better HRQoL using both the EQ-VAS and EQ-5D. Cohabitating, and single/unmarried women exhibited significantly lower HRQoL scores than did married women in the EQ-VAS model, and women living in urban areas exhibited lower HRQoL scores than women living in rural areas in the ED-5D model. The effect of education on HRQoL was statistically significant using the EQ-VAS but was inconsistent across the educational categories. The women's age and the age of their last child were not associated with their HRQoL. CONCLUSIONS ANC attendance of at least four visits should be further promoted and used in low-income settings. Strategies to improve families' socio-economic conditions and promote social networks among women, particularly women at the reproductive age, are needed.
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Affiliation(s)
- Regis Hitimana
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Lars Lindholm
- Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Gunilla Krantz
- Section of Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Manasse Nzayirambaho
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | - Jean Paul Semasaka Sengoma
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - Anni-Maria Pulkki-Brännström
- Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Huang YW, Hung CH, Huang MC, Yu CY. First-time fathers' health status during the perinatal period. Appl Nurs Res 2018; 40:137-142. [PMID: 29579489 DOI: 10.1016/j.apnr.2018.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 01/19/2018] [Accepted: 01/19/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND For first-time fathers, the perinatal period is a critical period of stress and imbalance. Marital intimacy and social support may affect their stress and health status while they change their roles. AIM This study was to explore the changes of and correlations among marital intimacy, social support, and health status and predictors of first-time fathers' health status during the perinatal period. METHODS With a repeated measures study design, a total of 217 first-time fathers whose spouses were in the third trimester of pregnancy were recruited for the study. The Chinese Health Questionnaire, Marital Intimacy Scale, and Social Support Scale were employed to collect data at a medical center in the 36th week of pregnancy and the 1st and 4th weeks after childbirth. RESULTS The levels of marital intimacy and social support of first-time fathers during the perinatal period increased significantly with time. Meanwhile, the period of the first week after childbirth was a predictor of first-time father's health status. CONCLUSIONS This study only tracked the first-time fathers' health status in the 36th week of pregnancy and the 1st and 4th weeks after childbirth. Future studies could track them until one year after childbirth in order to explore the impact of the perinatal period on the couples and their babies. During the perinatal period, health care providers shall assess and provide needed interventions to first-time fathers as soon as possible to facilitate the first-time fathers to get ready for the role transition and to promote their health status.
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Affiliation(s)
- Ya-Wen Huang
- School of Nursing, Chung Jen Junior College of Nursing, Health Science and Management, Chia-Yi County, Taiwan; School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Chich-Hsiu Hung
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
| | - Mei-Chuan Huang
- School of Nursing, National Tainan Junior College of Nursing, Tainan, Taiwan.
| | - Ching-Yun Yu
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.
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21
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Hajimiri K, Shakibazadeh E, Mehrizi AAH, Shabbidar S, Sadeghi R. The impact of general health and social support on health promoting lifestyle in the first year postpartum: the structural equation modelling. Electron Physician 2018; 10:6231-6239. [PMID: 29588825 PMCID: PMC5853999 DOI: 10.19082/6231] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Accepted: 07/28/2017] [Indexed: 01/19/2023] Open
Abstract
Background and aim Postpartum is a critical period for mothers which often leads to neglect of their own health. Mothers’ new responsibilities may affect their health promoting lifestyle (HPL). The aim of this study was to determine the impact of both general health and social support on health-promoting lifestyle. Methods A cross-sectional survey was conducted on 310 women who gave birth over a one-year period in Zanjan (Iran), 2016. A proportionate stratified random sampling technique was used to select respondents from each stratum. Health-promoting lifestyle was assessed using the health-promoting lifestyle profile II (HPLP II) scale. A structure equation model (SEM) was used to determine the relationship between observed and latent variables. Data were analysed using SPSS version 22 and LISREL 8.5 software. Results The age of 42.6% of the participants was more than 30 years and 40.3% of them had an academic education. The mean score of the health-promoting lifestyle was 131.28 (15.37). The structural equation model fitted well with RMSEA =0.07, CFI=0.92, and GFI=0.94. Among the latent factors, general health, with a factor load of −0.68, had greater impact on health-promoting lifestyle than social support. Moreover, there was a significant correlation (−0.63) between general health and perceived social support in the postpartum period. Conclusion health-promoting lifestyle was not at appropriate levels among women in the first year after delivery. These findings suggest that strengthening general health and social support would improve a health-promoting lifestyle in Iranian postpartum women.
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Affiliation(s)
- Khadijeh Hajimiri
- Ph.D. Candidate of Health Education and Promotion, Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Ph.D. of Health Education, Associate Professor, Department of Health Education and Health Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Asghar Haeri Mehrizi
- M.Sc. of Statistics, Faculty Member, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Sakineh Shabbidar
- Ph.D. of Nutritional Sciences, Assistant Professor, Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sadeghi
- Ph.D. of Health Education, Associate Professor, Department of Health Education and Health Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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22
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Demirel G, Egri G, Yesildag B, Doganer A. Effects of traditional practices in the postpartum period on postpartum depression. Health Care Women Int 2017; 39:65-78. [DOI: 10.1080/07399332.2017.1370469] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Gulbahtiyar Demirel
- Department of Midwifery, Faculty of Health Sciences, Cumhuriyet University, Sivas, Turkey
| | - Gamze Egri
- Operating Room Services Program, Vocational College of Healthcare Services, Cumhuriyet University, Sivas, Turkey
| | - Birnur Yesildag
- Department of Nursing, Susehri Health College, Cumhuriyet University, Sivas, Turkey
| | - Adem Doganer
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Kahramanmaras Sutcu İmam University, Kahramanmaras, Turkey
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Choi H, Shin Y. Predictors of Quality of Life in Mothers of Premature Infant. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2017; 23:191-200. [PMID: 37684898 DOI: 10.4069/kjwhn.2017.23.3.191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 06/29/2017] [Accepted: 06/10/2017] [Indexed: 09/10/2023] Open
Abstract
PURPOSE The purpose of this study was to determine the factors that may affect quality of life of mothers who delivered premature infants. METHODS With survey design, data were collected from 145 mothers of premature infants with corrected age of 2 months to 12 months from January 9 to February 2, 2017. Quality of life was assessed with two measures of direct survey in the selected hospital and online survey. A self-report questionnaire was administered regarding personality of the mothers and the infants, postpartum depression, parenting stress, social support, and the quality of life. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients, and multiple regression. RESULTS The quality of life of the mothers of the premature infants was influenced by postpartum depression, parenting stress, parents-infant dysfunctional interactions, and social support accounted for 65% of the variance. CONCLUSION These results indicate that early screening and continuous management of postpartum depression during postpartum period are important to improve the quality of life of the mothers of the premature infants. Education program and information and social support systems need to be developed to monitor mother-infant interaction and their role development.
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Affiliation(s)
- Hyosin Choi
- Department of Nursing, Daegu Health College, Daegu, Korea
| | - Yeonghee Shin
- Department of Nursing, Daegu Health College, Daegu, Korea
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Milani HS, Amiri P, Mohseny M, Abadi A, Vaziri SM, Vejdani M. Postpartum home care and its effects on mothers' health: A clinical trial. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2017; 22:96. [PMID: 28900452 PMCID: PMC5583624 DOI: 10.4103/jrms.jrms_319_17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 05/27/2017] [Accepted: 05/30/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND Postpartum home care plays an important role in prevention of postpartum complications. Regular visits of mothers during this period are imperative. This study aimed to provide postpartum home care for mothers to assess its effects on mothers' health in Iran. MATERIALS AND METHODS This study was carried out in two phases. First, a comprehensive postpartum home care program was compiled by performing a comparative study, using the available guidelines in this regard in different countries and based on the opinions of the experts. Next, a clinical trial was carried out on 276 women who gave birth in the university hospitals affiliated to Shahid Beheshti University of Medical Sciences. There were 92 mothers in the intervention and 184 in the control group. The intervention group mothers were provided with postpartum home care service while the control group did not receive such a service. RESULTS Outcome assessment at 60 days' postpartum revealed a significant difference between the two groups in terms of the use of supplements, birth control methods, postpartum depression, breastfeeding problems, constipation, and fatigue (P < 0.05). No significant differences were noted between the two groups with regard to hospitalization, hemorrhoids, backache and lumbar pain (P > 0.05). CONCLUSION The postpartum home care program had a positive effect on some aspects of the mothers' health status and their satisfaction in our society.
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Affiliation(s)
- Hourieh Shamshiri Milani
- Department of Community Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parastoo Amiri
- Department of Community Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Mohseny
- Department of Community Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Abadi
- Department of Community Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyyed Mohammadreza Vaziri
- Department of Internal Medicine, School of Medicine, Rasoul-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Marjan Vejdani
- Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, Iran
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Morais AODDS, Simões VMF, Rodrigues LDS, Batista RFL, Lamy ZC, Carvalho CAD, Silva AAMD, Ribeiro MRC. [Maternal depressive symptoms and anxiety and interference in the mother/child relationship based on a prenatal cohort: an approach with structural equations modeling]. CAD SAUDE PUBLICA 2017; 33:e00032016. [PMID: 28724023 DOI: 10.1590/0102-311x00032016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 08/24/2016] [Indexed: 11/22/2022] Open
Abstract
This study aimed to investigate the association between maternal depressive symptoms and anxiety and interference in the mother/child relationship, using structural equations modeling. Data were used from a prospective cohort study initiated during the prenatal period with 1,140 mothers in São Luís, Maranhão State, Brazil. Data were collected during prenatal care and when the children reached two years of age. Interference in the mother/child relationship was measured with the Postpartum Bonding Questionnaire - PBQ (N = 1,140). In the initial theoretical model, socioeconomic status determined the maternal demographic, psychosocial, and social support factors, which determined the outcome, i.e., the mother/child relationship. Adjustments were performed by structural equations modeling, using Mplus 7.0. The final model showed good fit (RMSEA = 0.047; CFI = 0.984; TLI = 0.981). Depressive symptoms in pregnancy and the postpartum were associated with higher PBQ scores, indicating interference in the mother/child relationship. The greatest effect was from depressive symptoms in pregnancy. Other factors associated with higher PBQ scores were lower social support, unfavorable socioeconomic status, and living without a partner, by indirect association. Anxiety symptoms and maternal age were not associated with the mother/child relationship. The results suggest that identifying and treating depression in pregnancy and postpartum can improve mother/child bonding in childhood.
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Milani HS, Amiri P, Mohsey M, Monfared ED, Vaziri SM, Malekkhahi A, Salmani F. Effect of Health Care as the "Home Visiting" on Postpartum Depression: A Controlled Clinical Trial. Int J Prev Med 2017; 8:20. [PMID: 28479962 PMCID: PMC5404350 DOI: 10.4103/2008-7802.204003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 11/15/2016] [Indexed: 12/03/2022] Open
Abstract
Background: Postpartum depression is considered as a major health complication of women after delivery. It is necessary to find an essential approach for the prevention of its serious consequences on mothers’ and infants’ health. The aim of this study was to investigate the effect of home visiting on postpartum depression. Methods: The first stage of study was the design of postpartum package. According to the package, a clinical trial was performed for 276 mothers who had delivered in affiliated hospitals of Shahid Beheshti University in 2013 and were divided into two groups, i.e., control group and intervention group. Intervention group received health care by home visiting, and control group had no intervention. Mothers were supposed to fill up Edinburgh Postnatal Depression Scale before and 60 days after delivery, and the results were compared. The data were analyzed by SPSS version 18 software and t-test, Chi-square, and logistic regression test. Results: The mean ages of participants were 27.03 ± 5.2 standard deviation (SD) in intervention group and 27.37 ± 5.4 SD in control group. Occurrence of depression was 7.6% in intervention group and 19% in control group, and there was a significant difference between two groups (P < 0.05). The logistic regression results indicate that groups (intervention and control) (P = 0.087, odds ratio [OR] =2.1); planned and unplanned pregnancy (P = 0.028, OR = 2.5) and the infant nutrition (P = 0.025, OR = 2.2) are significantly associated with the postpartum depression. Conclusions: Providing postpartum home visiting can influence postpartum depression in a positive way and could improve mothers’ and infants’ health.
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Affiliation(s)
- Hourieh Shamshiri Milani
- Department of Health and Community Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parastoo Amiri
- Department of Health and Community Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Mohsey
- Department of Health and Community Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Esmat Davoudi Monfared
- Departmetnt of Health and Community Medicine, Faculty of Medicine, Baqiyatallah Medical Sciences University, Tehran, Iran
| | - Seyyed Mohammadreza Vaziri
- Department of Internal Medicine, Rasoul-e Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Akram Malekkhahi
- Sabzerar University of Medical Sciences, Heshmatieh Hospital, Sabzevar, Iran
| | - Fatemeh Salmani
- Assistant Professor of Biostatistics, Faculty of Health, Birjand University of Medical Sciences, Birjand, Iran
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Comparing the Effect of Electronic Software and Training Booklet on Maternal Self-Confidence and Awareness About Newborn Care: A Randomized Controlled Clinical Trial. IRANIAN RED CRESCENT MEDICAL JOURNAL 2017. [DOI: 10.5812/ircmj.44152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Positive predictors of quality of life for postpartum mothers with a history of childhood maltreatment. Arch Womens Ment Health 2016; 19:1041-1050. [PMID: 27518635 DOI: 10.1007/s00737-016-0653-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 07/30/2016] [Indexed: 12/26/2022]
Abstract
The postpartum period brings a host of biopsychosocial, familial, and economic changes, which may be challenging for new mothers, especially those with trauma histories. Trauma-exposed women are at heightened risk for psychiatric symptomatology and reduced quality of life. The current study sought to evaluate whether a set of hypothesized promotive factors assessed during the first 18 months postpartum (positive parenting, family cohesion, and maternal resilience) are associated with life satisfaction in this population, after controlling for income and postpartum psychiatric symptoms. Analyses were based on data collected for 266 mother-infant dyads from a longitudinal cohort study, Maternal Anxiety during the Childbearing Years (MACY), of women oversampled for childhood maltreatment history. Hierarchical linear regression was used to evaluate the study hypotheses. Consistent with prior work, greater postpartum psychiatric symptoms and less income predicted poor perceptions of life quality. In hierarchical regressions controlling for income and psychiatric symptoms, positive parenting and family cohesion predicted unique variance in mothers' positive perceptions of life quality, and resilience was predictive beyond all other factors. Factors from multiple levels of analysis (maternal, dyadic, and familial) may serve as promotive factors predicting positive perceptions of life quality among women with childhood trauma histories, even those struggling with high levels of psychiatric or economic distress.
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Wu WR, Hung CH. First-Time Mothers Psychiatric Health Status During the Transition to Motherhood. Community Ment Health J 2016; 52:937-943. [PMID: 25986393 DOI: 10.1007/s10597-015-9892-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 05/07/2015] [Indexed: 12/01/2022]
Abstract
The study was conducted to examine the changes of first-time mothers' psychiatric health status, social support, marital intimacy, postpartum stress, and maternal attachment during the transition to motherhood. A repeated measures study was conducted at the 36th week pregnancy, the first week postpartum, and the fourth week postpartum with 217 primiparous women. The results showed that the proportion of women with minor psychiatric morbidity declined over time from late pregnancy to early postpartum. The levels of marital intimacy and social support was the highest at the fourth week and the first week postpartum, respectively. Maternal attachment increased and postpartum stress decreased from the first week to fourth week postpartum. Women with minor psychiatric morbidity reported significantly higher postpartum stress than women without minor psychiatric morbidity. Identifying women with psychiatric morbidity in advance, and providing social support during late pregnancy would be effective strategies to enhance first-time mothers' adjustment to the transition of motherhood.
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Affiliation(s)
- Wan-Ru Wu
- Department of Medical Affairs, Landseed Hospital, Taoyuan City, Taiwan.,School of Nursing, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Rd., Kaohsiung City, 80708, Taiwan
| | - Chich-Hsiu Hung
- School of Nursing, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Rd., Kaohsiung City, 80708, Taiwan.
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Abdollahi F, Zarghami M, Sazlina SG, Zain AM, Mohammad AJ, Lye MS. Prediction of incidence and bio-psycho-socio-cultural risk factors of post-partum depression immediately after birth in an Iranian population. Arch Med Sci 2016; 12:1043-1051. [PMID: 27695496 PMCID: PMC5016576 DOI: 10.5114/aoms.2016.58642] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 02/25/2013] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Post-partum depression (PPD) is the most prevalent mental problem associated with childbirth. The purpose of the present study was to determine the incidence of early PPD and possible relevant risk factors among women attending primary health centers in Mazandaran province, Iran for the first time. MATERIAL AND METHODS A longitudinal cohort study was conducted among 2279 eligible women during weeks 32-42 of pregnancy to determine bio-psycho-socio-cultural risk factors of depression at 2 weeks post-partum using the Iranian version of the Edinburgh Postnatal Depression Scale (EPDS). Univariate and hierarchical multiple logistic regression models were used for data analysis. RESULTS Among 1,739 mothers whose EPDS scores were ≤ 12 during weeks 32-42 of gestation and at the follow-up study, the cumulative incidence rate of depression was 6.9% (120/1,739) at 2 weeks post-partum. In the multivariate model the factor that predicted depression symptomatology at 2 weeks post-partum was having psychiatric distress in pregnancy based on the General Health Questionnaire (GHQ) (OR = 1.06, (95% CI: 1.04-1.09), p = 0.001). The risk of PPD also lower in those with sufficient parenting skills (OR = 0.78 (95% CI: 0.69-0.88), p = 0.001), increased marital satisfaction (OR = 0.94 (95% CI: 0.9-0.99), p = 0.03), increased frequency of practicing rituals (OR = 0.94 (95% CI: 0.89-0.99), p = 0.004) and in those whose husbands had better education (OR = 0.03 (95% CI: 0.88-0.99), p = 0.04). CONCLUSIONS The findings indicated that a combination of demographic, sociological, psychological and cultural risk factors can make mothers vulnerable to PPD.
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Affiliation(s)
- Fatemeh Abdollahi
- Department of Public Health, Psychiatry and Behavioral Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehran Zarghami
- Department of Psychiatry, Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shariff-Ghazali Sazlina
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Azhar Md Zain
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Asghari Jafarabadi Mohammad
- Injury Epidemiology and Prevention Research Center, Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Munn-Sann Lye
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
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Tang L, Zhu R, Zhang X. Postpartum Depression and Social Support in China: A Cultural Perspective. JOURNAL OF HEALTH COMMUNICATION 2016; 21:1055-1061. [PMID: 27491938 DOI: 10.1080/10810730.2016.1204384] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study explored how Chinese culture affects the relationship between social support and postpartum depression. In-depth interviews with 38 mothers in mainland China showed that discrepancies between expected and perceived available social support and conflicts among social support providers are two major contributors to the stress associated with postpartum depression. These dynamics are deeply rooted in the context of Chinese culture with its distinctive gender roles and family dynamics. These cultural norms further prevent women from seeking social support.
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Affiliation(s)
- Lu Tang
- a Department of Communication Studies, College of Communication and Information Sciences , University of Alabama , Tuscaloosa , Alabama , USA
| | - Ruijuan Zhu
- b School of Journalism and Communication , Remin University of China , Beijing , China
| | - Xueying Zhang
- c College of Communication and Information Sciences , University of Alabama , Tuscaloosa , Alabama , USA
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Abstract
The purpose of this study was to examine women’s postpartum stress, social support, and health status at different places of residence during their postpartum periods. Using proportional stratified quota sampling of hospitals by birth rate from clinics and hospitals in Kaohsiung City in southern Taiwan, postpartum married women were recruited for the study. The results show that the home of the women’s parents (25.7%), her own home (with parents-in-law; 23.8%), and her own home (without parents or parents-in-law; 23.1%) were the main places of residence for women during the postpartum period. In addition, postpartum women’s mean scores for postpartum stress were low. In contrast, the mean scores for social support were high, although they did not differ significantly for the respective places of postpartum residence. Furthermore, significant differences were not found in these women’s postpartum health status at each of the places of postpartum residence.
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Abstract
Increased family demands during the postpartum period together with having to cope with symptoms and curtailed everyday functioning associated with multiple sclerosis (MS) suggest the need for additional support for mothers with MS throughout the first postpartum year. This study investigated factors (MS duration, MS relapse, symptoms, social support) that affect functional performance of 172 mothers with MS during the second 6-month postpartum period. Data were analyzed with descriptive statistics and path analysis. Findings indicated a good fit of the path models to the data at 9 and 12 months. Significant effects at both 9 and 12 months included positive relationships between duration of MS and symptoms and between social support and functional performance. Significant negative relationships were observed between symptoms and both social support and functional performance. Social support mediated the relationship between symptoms and functional performance. Findings suggest the importance of continued social support throughout the first postpartum year.
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Thorp SR, Krause ED, Cukrowicz KC, Lynch TR. Postpartum Partner Support, Demand-Withdraw Communication, and Maternal Stress. PSYCHOLOGY OF WOMEN QUARTERLY 2016. [DOI: 10.1111/j.1471-6402.2004.00153.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The weeks following the birth of a child can be stressful for new mothers. Maternal stress may be increased when mothers are dissatisfied with instrumental partner support (e.g., division of childcare duties and family decision-making power). The purpose of the current study was to determine if there is an association between dissatisfaction with partner support and maternal stress in the postpartum period, and to examine whether that association is mediated by demand-withdraw communication between partners. Participants were 49 women who completed questionnaires about satisfaction with partner support, female demand/male withdraw communication in their relationship, and their own perceived stress approximately 8 weeks after giving birth. Findings support the hypothesis that demand-withdraw communication mediates the association between dissatisfaction with partner support and maternal stress. This finding suggests that fathers' withdrawal in the context of mothers' requests for discussion or change appears to be associated with increased levels of maternal stress.
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Affiliation(s)
- Steven R. Thorp
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center and Duke University Center for the Study of Aging and Human Development
| | | | - Kelly C. Cukrowicz
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center
| | - Thomas R. Lynch
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center
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Abdollahi F, Etemadinezhad S, Lye MS. Postpartum mental health in relation to sociocultural practices. Taiwan J Obstet Gynecol 2016; 55:76-80. [DOI: 10.1016/j.tjog.2015.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2014] [Indexed: 11/16/2022] Open
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Norhayati MN, Aniza AA, Nik Hazlina NH, Azman MY. Psychometric properties of the revised Malay version Medical Outcome Study Social Support Survey using confirmatory factor analysis among postpartum mothers. Asia Pac Psychiatry 2015; 7:398-405. [PMID: 25808643 DOI: 10.1111/appy.12184] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 02/23/2015] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Social support is an essential component for the physical and emotional well-being of postpartum mothers. The objective of this study is to determine the psychometric properties of the revised Malay version Medical Outcome Study (MOS) Social Support Survey using a confirmatory validity approach. METHODS A cross-sectional study was conducted involving 144 postpartum mothers attending Obstetric and Gynecology Clinic, Universiti Sains Malaysia Hospital. Construct validity and internal consistency assessment was performed after the translation, content validity and face validity process. The data were analyzed using SPSS 20.0 (SPSS Inc., Chicago, IL, USA) and AMOS 20.0 (SPSS Inc., Chicago, IL, USA). RESULTS The original questionnaire consists of four domains (emotional/informational support, tangible support, affectionate support and positive social interaction) and 19 items. Affectionate support domain with three items only was treated as a separate construct and was not included in the factor analysis. The final confirmatory model with three constructs and 13 items demonstrated acceptable factor loadings, domain to domain correlation and best fit; (χ2[df]=1.665 [61]; P-value=0.001; Tucker-Lewis Index=0.944; comparative fit index=0.956; root mean square error of approximation=0.068). Composite reliability, average variance extracted and Cronbach's α of the domains ranged from 0.649 to 0.903; 0.390 to 0.699; 0.616 to 0.902, respectively. CONCLUSION The study suggested that the four-factor model with 16 items (including one separate factor of affectionate) of the revised Malay version MOS Social Support Survey was acceptable to be used to measure social support after childbirth because it is valid, reliable and simple.
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Affiliation(s)
- Mohd Noor Norhayati
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Abd Aziz Aniza
- Fakulti Perubatan dan Sains Kesihatan, Universiti Sultan Zainal Abidin, Kampus Kota, Kuala Terengganu, Terengganu, Malaysia
| | - Nik Hussain Nik Hazlina
- Women's Health Development Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Mohd Yacob Azman
- Medical Division, Kelantan State Health Department, Kota Bharu, Kelantan, Malaysia
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Wu CY, Hung CH, Chang YJ. Predictors of Health Status in Mothers of Premature Infants with Implications for Clinical Practice and Future Research. Worldviews Evid Based Nurs 2015. [PMID: 26220369 DOI: 10.1111/wvn.12101] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Postpartum health research has focused primarily on full-term mothers. AIMS To explore postpartum stress, depression, social support, health status, and predictors of health status in mothers of premature infants. METHODS This study employed a cross-sectional design. With convenience sampling, a total of 203 mothers of premature infants were recruited from two medical centers and four community teaching hospitals in southern Taiwan. The Hung Postpartum Stress Scale, Social Support Scale, Beck Depression Inventory, and Chinese Health Questionnaire were used to assess the mothers' psychosocial features during the first 6 weeks postpartum. RESULTS Mothers' health status differed significantly according to levels of postpartum stress and depression. The important health status predictors were age, education, postpartum stress, and depression level. DISCUSSION The concerns and needs of mothers of premature infants differed from those of full-term mothers during the first 6 weeks postpartum; premature infants' health status was found to be a major perceived stressor for their mothers. LINKING EVIDENCE TO ACTION In the process of caring for premature infants' mothers, healthcare providers should provide individualized care to meet their needs, thus facilitating the reduction of postpartum stress and depression levels. During premature infants' hospitalizations, healthcare providers should hold regular faculty meetings to provide postpartum women with relevant information about their infants' health and how to best care for them. Future studies should explore postpartum stress, social support, depression, and health status each postpartum week, which could serve as a guide for nursing interventions.
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Affiliation(s)
- Chia-Yao Wu
- Jian Ping Internal/Pediatric Clinic, Tainan, Taiwan
| | - Chich-Hsiu Hung
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ying-Ju Chang
- School of Nursing, National Cheng Kung University, Tainan, Taiwan
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Gutiérrez-Zotes A, Labad J, Martín-Santos R, García-Esteve L, Gelabert E, Jover M, Guillamat R, Mayoral F, Gornemann I, Canellas F, Gratacós M, Guitart M, Roca M, Costas J, Luis Ivorra J, Navinés R, de Diego-Otero Y, Vilella E, Sanjuan J. Coping strategies and postpartum depressive symptoms: A structural equation modelling approach. Eur Psychiatry 2015; 30:701-8. [PMID: 26141375 DOI: 10.1016/j.eurpsy.2015.06.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 05/26/2015] [Accepted: 06/01/2015] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Variables such as the mother's personality, social support, coping strategies and stressful events have been described as risk factors for postpartum depression. Structural Equation Modelling (SEM) analysis was used to examine whether neuroticism, perceived social support, perceived life events, and coping strategies are associated with postpartum depressive symptoms at the 8th and 32nd weeks. METHODS A total of 1626 pregnant women participated in a longitudinal study. Different evaluations were performed 8 and 32weeks after delivery. Several measures were used: the Edinburgh Postnatal Depression Scale (EPDS), the Diagnostic Interview for Genetic Studies (DIGS), the Eysenck Personality Questionnaire (EPQ-RS), the St. Paul Ramsey life events scale and the Duke-UNC Functional Social Support Questionnaire. The brief COPE scale was used to measure coping strategies. SEM analysis was conducted for all women and in those women with a clinical diagnosis of postpartum depression. RESULTS Passive coping strategies were associated with postpartum depressive symptoms at both visits (8th and 32nd weeks). Neuroticism was associated with more passive coping strategies and less active coping strategies. Neuroticism and life stress were positively correlated, and social support was negatively correlated with life stress and neuroticism. CONCLUSIONS Early identification of potential risk for symptomatology of depression postpartum should include assessment of neuroticism, life events, social support and coping strategies.
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Affiliation(s)
- A Gutiérrez-Zotes
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain.
| | - J Labad
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - R Martín-Santos
- Psychiatry Department, Neuroscience Institute, Hospital Clinic, IDIBAPS, CIBERSAM and Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain; Neuroscience Program, IMIM-Parc de Salut Mar, Autonomous University of Barcelona, RTA, Barcelona, Spain
| | - L García-Esteve
- Psychiatry Department, Neuroscience Institute, Hospital Clinic, IDIBAPS, CIBERSAM and Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
| | - E Gelabert
- Neuroscience Program, IMIM-Parc de Salut Mar, Autonomous University of Barcelona, RTA, Barcelona, Spain; Department of Clinical and Health Psychology, Autonomous University of Barcelona, Bellaterra, Barcelona, Spain
| | - M Jover
- Hospital Clínico, University of Valencia, CIBERSAM, Valencia, Spain
| | - R Guillamat
- Corporación Sanitaria Parc Taulí, Sabadell, Autonomous University of Barcelona, Barcelona, Spain
| | - F Mayoral
- Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Complejo Hospitalario de Málaga, Universidad de Málaga, Spain
| | - I Gornemann
- Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Complejo Hospitalario de Málaga, Universidad de Málaga, Spain
| | - F Canellas
- Hospital de Son Dureta, Palma de Mallorca, Spain
| | - M Gratacós
- Centre for Genomic Regulation (CRG) and UPF, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - M Guitart
- Corporación Sanitaria Parc Taulí, Sabadell, Autonomous University of Barcelona, Barcelona, Spain
| | - M Roca
- Institut Universitari d'Investigació en Ciències de la Salut, RediAPP, Palma de Mallorca, Spain
| | - J Costas
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS) Servizo Galego de Saúde (SERGAS), Complexo Hospitalario Universitario de Santiago (CHUS), Santiago de Compostela, Spain
| | - J Luis Ivorra
- Hospital Clínico, University of Valencia, CIBERSAM, Valencia, Spain
| | - R Navinés
- Psychiatry Department, Neuroscience Institute, Hospital Clinic, IDIBAPS, CIBERSAM and Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain; Neuroscience Program, IMIM-Parc de Salut Mar, Autonomous University of Barcelona, RTA, Barcelona, Spain
| | - Y de Diego-Otero
- Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Complejo Hospitalario de Málaga, Universidad de Málaga, Spain
| | - E Vilella
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - J Sanjuan
- Hospital Clínico, University of Valencia, CIBERSAM, Valencia, Spain
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Lee LC, Hung CH. Predictors of post-partum stress in Vietnamese immigrant women in Taiwan. Jpn J Nurs Sci 2015; 13:38-45. [DOI: 10.1111/jjns.12084] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 03/31/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Li-Chun Lee
- School of Nursing; Kaohsiung Medical University; Kaohsiung Taiwan
- Department of Nursing; I-Shou University; Kaohsiung Taiwan
| | - Chich-Hsiu Hung
- School of Nursing; Kaohsiung Medical University; Kaohsiung Taiwan
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Lin PC, Hung CH. Mental health trajectories and related factors among perinatal women. J Clin Nurs 2015; 24:1585-93. [PMID: 25623627 DOI: 10.1111/jocn.12759] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2014] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To investigate Taiwanese women's mental health trajectories from the third trimester of pregnancy to four weeks postpartum and the correlations of these trajectories with perceived social support and demographic characteristics. BACKGROUND Previous studies have reported differences between prenatal and postpartum mental health status. DESIGN A repeated design study was conducted in a medical hospital in Southern Taiwan. METHODS One-hundred and ninety-four Taiwanese women completed the Chinese Health Questionnaire and Social Support Scale at the 36th prenatal week and first and fourth week postpartum. RESULTS Three linear mental health trajectories for perinatal women were identified. Consistently poor perinatal mental health was reported by 16·0% of the participants. Less social support was associated with lower prenatal mental health scores. Younger age was a risk factor for consistently poor perinatal health. Vaginal delivery was associated with improved mental health after childbirth. CONCLUSIONS Mental health was worse in the third trimester of pregnancy than postpartum. Less social support was associated with lower prenatal mental health scores, and this association was similarly distributed between women with consistently poor and improved mental health after birth. RELEVANCE TO CLINICAL PRACTICE Health care providers should assess women's mental health status and provide timely interventions during the perinatal period. Social support should be provided for pregnant women, especially younger women or those with lower perceived social support.
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Affiliation(s)
- Pei-Chao Lin
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chich-Hsiu Hung
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
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Xiao RS, Kroll-Desrosiers AR, Goldberg RJ, Pagoto SL, Person SD, Waring ME. The impact of sleep, stress, and depression on postpartum weight retention: a systematic review. J Psychosom Res 2014; 77:351-8. [PMID: 25306538 PMCID: PMC4252881 DOI: 10.1016/j.jpsychores.2014.09.016] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 09/22/2014] [Accepted: 09/24/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To review the impact of sleep, stress, and/or depression on postpartum weight retention. METHODS We searched three electronic databases, PubMed, ISI Web of Science, and PsycInfo. Studies were included if they were published between January 1990 and September 2013 in English, measured sleep, stress, and/or depression in the postpartum period, and assessed the association of these factors with postpartum weight retention. Two reviewers reviewed included articles and rated study quality using a modified version of the Downs and Black scale. RESULTS Thirteen studies met our pre-defined eligibility criteria, reporting on 9 study samples. Two were cross-sectional studies and eleven were longitudinal studies. The study sample size ranged from 74 to 37,127. All four studies examining short sleep duration and postpartum weight retention reported a positive association. The four studies examining postpartum stress and weight retention reported non-significant associations only. Of 7 studies examining postpartum depression and weight retention, 3 reported non-significant associations, and 4 reported positive associations. CONCLUSION Research investigating the impact of postpartum sleep, stress, depression on weight retention is limited. Future longitudinal studies are needed.
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Affiliation(s)
- Rui S. Xiao
- Clinical and Population Health Research Program, University of Massachusetts Medical School, Worcester, MA,Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Aimee R. Kroll-Desrosiers
- Clinical and Population Health Research Program, University of Massachusetts Medical School, Worcester, MA,Division of Biostatistics and Health Services Research, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Robert J Goldberg
- Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Sherry L. Pagoto
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Sharina D. Person
- Division of Biostatistics and Health Services Research, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Molly E. Waring
- Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
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Postpartum fatigue, baby-care activities, and maternal-infant attachment of vaginal and cesarean births following rooming-in. Appl Nurs Res 2014; 28:116-20. [PMID: 25468429 DOI: 10.1016/j.apnr.2014.08.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2013] [Revised: 07/29/2014] [Accepted: 08/04/2014] [Indexed: 11/23/2022]
Abstract
AIM This study compares women's postpartum fatigue, baby-care activities, and maternal-infant attachment following vaginal and cesarean births in rooming-in settings. BACKGROUND Postpartum women admitted to baby-friendly hospitals are asked to stay with their babies 24 hours a day and to breastfeed on demand regardless of the type of childbirth. METHODS The study used a descriptive cross-sectional study design. A total of 120 postpartum women were recruited from two accredited baby-friendly hospitals in southern Taiwan. Three structured questionnaires were used to collect data, on which an analysis of covariance was conducted. RESULTS Women who experienced a cesarean birth had higher postpartum fatigue scores than women who had given birth vaginally. Higher postpartum fatigue scores were correlated with greater difficulty in baby-care activities, which in turn resulted in weaker maternal-infant attachment as measured in the first 2 to 3 days postpartum. CONCLUSIONS Hospitals should implement rooming-in in a more flexible way by taking women's postpartum fatigue and physical functioning into consideration.
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Deniz C, Ayaz S. Factors causing stress in women with babies 0-3 months old and their coping styles. J Psychiatr Ment Health Nurs 2014; 21:587-93. [PMID: 24251897 DOI: 10.1111/jpm.12119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/23/2013] [Indexed: 10/26/2022]
Abstract
This study was conducted in order to identify the factors that cause stress in women who have babies aged 0-3 months and the ways to deal with stress. This descriptive study was conducted in outpatient clinics for newborns. The sample consisted of 322 women. Data were collected through a questionnaire and Ways of Coping with Stress Inventory. It was found that most of the women became stressed because of problems regarding self-care, baby care and social life. Women mostly used ineffective coping styles to cope with stress.
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Affiliation(s)
- C Deniz
- Nursing Program, Gazi University, Institute of Health Sciences, Ankara, Turkey
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Fang L, Hung CH. Predictors of Married Female Nurses' Health. Workplace Health Saf 2014; 62:447-55. [DOI: 10.3928/21650799-20140804-06] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 07/14/2014] [Indexed: 11/20/2022]
Abstract
Excessive workload from employment and household duties may negatively affect married female nurses' health. This study explored job stress, family stress, social support, and health status among married female nurses to identify predictors of nurses' health status. Using a cross-sectional design, 233 married female nurses were recruited from two regional teaching hospitals. The results showed that working hours per week, job stress, and overcommitment to their jobs were significant determinants of health status. Based on study findings, nursing supervisors should avoid scheduling nurses to work more than 48 hours per week. Job stress adjustment courses could enable nurses to relax after work, avoiding overcommitment.
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Jarosinski JM, Pollard DL. Postpartum depression: perceptions of a diverse sample of low-income women. Issues Ment Health Nurs 2014; 35:189-97. [PMID: 24597584 DOI: 10.3109/01612840.2013.848960] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Postpartum depression (PPD) continues to significantly impact women and their families during the perinatal period. Consequences of untreated PPD in the mother may lead to impaired mother-infant bonding, recurring psychiatric illness, and fewer positive parenting behaviors. North Carolina participates in the Pregnancy Risk Assessment Monitoring System (PRAMS) survey and has the second highest self-reported rate of postpartum depressive symptoms at 19.0%. The full study used both quantitative and qualitative methods. The qualitative approach, an interpretive Heideggerian perspective, elicited the postpartum clients' perceptions of risk factors, how those perceptions affected the pregnancy experience, and how self-efficacy played a role in their perceived ability to make healthy choices. The sample was comprised of 60 pregnant women between the ages of 18 and 40. Four themes were found: (1) Feeling joy and apprehension at once, (2) Depression is something you think about (3) Rearranging your thinking, and (4) Garnering support. The women in this study believed that support was an indispensable tool in dealing with feelings of sadness and depression. Critical aspects of becoming involved in their pregnancy included changing their expectations and knowing how to detect and seek help when depressive symptoms occurred.
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Hung CH, Stocker J, Hsu HT. Comparing Taiwanese women's biopsychosocial features by location of postpartum recovery. Appl Nurs Res 2013; 27:121-6. [PMID: 24360779 DOI: 10.1016/j.apnr.2013.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Revised: 11/04/2013] [Accepted: 11/04/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND In Taiwan, a culturally sanctioned ritual of maternal rest and recuperation has been traditionally practiced patrilocally during the first postpartum month. However, in recent years, the places where women may observe the ritual have become more diverse. AIM Our goal was to compare women's psychosocial features based on where they stayed during their postpartum recovery. METHODS Using proportional stratified quota sampling of 18 hospitals and clinics in Taiwan by birth rate, we recruited 784 postpartum women. RESULTS Women stayed in their own home (17.1%), with their parents-in-law (33.3%), with their parents (36.0%), or in a postpartum nursing center (13.6%). Women who stayed in their own residence or who stayed in their parents' residence perceived greater social support than women who stayed with their parents-in-law. CONCLUSIONS Further research should compare women's adjustment to motherhood and their competence in childcare based on where they stay during postpartum recovery.
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Affiliation(s)
| | - Joel Stocker
- School of Nursing, Kaohsiung Medical University.
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Abstract
The purpose of this descriptive, longitudinal study was to identify topics and sources of information sought by new mothers. Eighty-nine mothers were recruited from prenatal classes conducted at two health-care systems located in the Midwest region of the United States. Telephone contact was made with the mothers between 2 and 3 weeks postpartum. Each mother completed prenatal and postpartum questionnaires addressing mothers' perceived support systems. Findings indicated that, despite attending prenatal classes and receiving child and postpartum care instruction, mothers often want additional information after they bring their baby home. The study's results contribute to nursing knowledge by confirming that new mothers seek and receive information regarding childcare from multiple sources. Nurse-initiated contacts with postpartum mothers provide support and information that can assist mothers in caring for their newborns.
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Affiliation(s)
- Katherine K Sink
- KATHERINE K. SINK is an associate professor in the College of Nursing at the University of Toledo in Ohio
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