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Neriya-Ben Shahar R, Yuval F, Tur-Sinai A. "I Would Consult a Doctor, But What the Rabbi Says Goes": Ultra-Orthodox Jews' Relationships with Rabbis and Doctors in Israel. JOURNAL OF RELIGION AND HEALTH 2024; 63:1905-1933. [PMID: 38424387 PMCID: PMC11061032 DOI: 10.1007/s10943-024-02014-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/08/2024] [Indexed: 03/02/2024]
Abstract
We examine relationships among ultra-Orthodox Israeli Jews, their doctors, and rabbis when medical decisions are made. Analyzing excerpts from sixteen focus groups with 128 ultra-Orthodox Jews, we determine how their belief system affects their decisions about whom to trust and follow when the doctor's instructions contradict the rabbi's advice. We argue that the strict behaviors described here with regard to relations among doctors, rabbis, and patients, function as social capital that raises the status of ultra-Orthodox Jews as members of an exclusive club that balances health decisions with the social demand to obey their religious leaders.
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Affiliation(s)
| | - Fany Yuval
- Department of Public Policy and Management, Chairwoman, Guilford Glazer Faculty of Business and Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Aviad Tur-Sinai
- School of Public Health, University of Haifa, Haifa, Israel.
- Department of Health Systems Management, The Max Stern Yezreel Valley College, Yezreel Valley, Israel.
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Alfayumi-Zeadna S, Ghalion HA, O'Rourke N, Azbarga Z, Daoud N. Direct and indirect predictors of postpartum depression symptoms among indigenous Bedouin mothers in Israel. Res Nurs Health 2024; 47:114-124. [PMID: 38073270 DOI: 10.1002/nur.22361] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 10/27/2023] [Accepted: 11/24/2023] [Indexed: 03/25/2024]
Abstract
Postpartum depression (PPD) is a common and complex phenomenon with negative outcomes for children, women and their families. This study set out to identify both direct and indirect predictors of PPD symptoms among indigenous Bedouin mothers in Israel. The study included 305 women, 18 to 45 years of age, who were interviewed while pregnant and again, 2 to 4 months postpartum. Interviews were conducted in Arabic and included the Edinburgh Postnatal Depression Scale, administered at both points of measurement. Using path analyses, we identified four significant, direct predictors of PPD symptoms. The strongest was depressive symptoms when pregnant, followed by low relative income, low hemoglobin, and number of prior miscarriages. The latter was significantly associated with consanguinity, meaning that women married to a first cousin experienced more miscarriages which, in turn, increased PPD risk. Low relative income was the only variable that had both a direct and indirect effect upon PPD symptoms (via symptoms of depression when pregnant and hemoglobin). Education and polygamy also emerged as indirect predictors of PPD via depressive symptoms reported during pregnancy. Results suggest a high rate of PPD in this perinatal sample of indigenous women. Our findings underscore the need for tailored interventions to reduce PPD, especially for low-income Bedouin women, faced with many barriers and insufficient access to healthcare services.
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Affiliation(s)
- Samira Alfayumi-Zeadna
- Nursing Department, School of Health Sciences, Ashkelon Academic College, Ashkelon, Israel
| | - Huda Abu Ghalion
- Department of Epidemiology, Biostatistics, and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion, University of the Negev, Be'er Sheva, Israel
- Clalit Health Services, Be'er Sheva, Israel
| | - Norm O'Rourke
- Department of Epidemiology, Biostatistics, and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion, University of the Negev, Be'er Sheva, Israel
- Department of Psychology, Faculty of Humanities and Social Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | | | - Nihaya Daoud
- Department of Epidemiology, Biostatistics, and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion, University of the Negev, Be'er Sheva, Israel
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Prins-Engelsman S, Cwikel J. Postpartum Depression Symptoms in Various Sects of Ultra-Orthodox Society in Israel. JOURNAL OF RELIGION AND HEALTH 2023; 62:3327-3346. [PMID: 36715878 DOI: 10.1007/s10943-023-01745-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
Ultra-Orthodox society in Israel is characterized by a higher birth rate than Israeli Jewish society. This study investigated the association of reproductive experiences among different sects of 254 ultra-Orthodox women with symptoms of postpartum depression (PPD) and general depression, controlling for demographic features. PPD symptoms were found among 22% of the participants, with Sephardic women with higher rates of symptoms (34%) than women from the Lithuanian sect (16%) and Hasidic women (14%), and those who were formerly secular also had higher rates of PPD (33%) compared to 19% among those born ultra-Orthodox. Implications for health care practitioners are discussed.
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Affiliation(s)
| | - Julie Cwikel
- The Spitzer Department of Social Work and the Center for Women's Health Studies and Promotion, Ben Gurion University of the Negev, POB 679, 84105, Beer Sheva, Israel
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Alves SP, Costa T, Ribeiro I, Néné M, Sequeira C. Perinatal mental health counselling programme: A scoping review. PATIENT EDUCATION AND COUNSELING 2023; 106:170-179. [PMID: 36376136 DOI: 10.1016/j.pec.2022.10.347] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/09/2022] [Accepted: 10/22/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To map the evidence on a Perinatal Mental Health Counselling Programme, identifying its characteristics, participants, and outcomes. METHODS This review followed the guidelines of the Joanna Briggs Institute and PRISMA-ScR. Published and unpublished studies, from 2011 to 2021, written in English, Portuguese or Spanish were included. RESULTS Despite the high number of articles identified, only nine articles were included in the final analysis, mainly from Iran, Italy and one Portuguese study. All articles referred to community health care centres and hospitals. The sessions varied between 6 and 16 and lasted 30-90 min. The method used was either individual and/or group, with weekly or monthly sessions or whenever deemed necessary throughout the evaluation. Different techniques were found, but emotional management, problem-solving, relaxation and mindfulness techniques were highlighted. Participants are pregnant women, partners, or family members. All articles suggest a decrease in the levels of stress, anxiety, and depression after the counselling intervention. CONCLUSION Perinatal counselling programme have varied characteristics and mental health nurses are potential facilitators.
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Affiliation(s)
- Sónia Patricia Alves
- Oporto University - Instituto Ciências Biomédicas Abel Salazar, Portugal; Mental Health Nurse at ACES Porto Ocidental - Northern Regional Health Administration, Portugal; Nursing School of Porto, Portugal; Research Group "NursID:Innovation & Development in Nursing" - Center for Health Technology andServices Research (CINTESIS), 4250-224 Porto, Portugal.
| | - Tiago Costa
- Nursing School of Porto, Portugal; Research Group "NursID:Innovation & Development in Nursing" - Center for Health Technology andServices Research (CINTESIS), 4250-224 Porto, Portugal; Hospital Center of Vila Nova de Gaia/Espinho, Portugal; University of Barcelona, Spain.
| | - Isilda Ribeiro
- Nursing School of Porto, Portugal; Research Group "NursID:Innovation & Development in Nursing" - Center for Health Technology andServices Research (CINTESIS), 4250-224 Porto, Portugal.
| | - Manuela Néné
- Research Group "NursID:Innovation & Development in Nursing" - Center for Health Technology andServices Research (CINTESIS), 4250-224 Porto, Portugal; Higher School of Health of The Portuguese Red Cross in Lisbon, Portugal.
| | - Carlos Sequeira
- Nursing School of Porto, Portugal; Research Group "NursID:Innovation & Development in Nursing" - Center for Health Technology andServices Research (CINTESIS), 4250-224 Porto, Portugal.
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Sewnet Amare N, Nibret Gessesse D, Solomon Kinfu Y, Melesew Mekuriyaw A, Amera Tizazu M, Mossie Menalu M, Tsegaw Taye B, Gonie Mekonnen A. Prevalence of antenatal depression and associated factors among pregnant women during COVID-19 pandemic in North Shewa zone, Amhara region, Ethiopia. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022; 17:100459. [PMID: 35859765 PMCID: PMC9281406 DOI: 10.1016/j.ijans.2022.100459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 06/29/2022] [Accepted: 07/09/2022] [Indexed: 12/25/2022] Open
Abstract
Background Antenatal depression is a form of depression that occurs during pregnancy. This problem may worsen during the COVID-19 epidemic and may result in serious consequences for pregnant women, including depression and other multiple psychosocial problems. However, the prevalence of depression during the COVID-19 pandemic in pregnant women and its associated factors has not been studied in the study area, even in Ethiopia. Methods An institution-based cross-sectional study was conducted among 422 pregnant women who were attending antenatal care in public health institutions in the North Shewa Zone, Ethiopia. The data were collected from May 1- June 30, 2021. A logistic regression model with adjusted odds ratio (AOR) and P-value < 0.05 at the 95% confidence interval was used to determine significantly associated factors. Results The prevalence of antenatal depression among pregnant women during the COVID-19 pandemic was 34.1% (95% CI: 29.6-38.9). Divorced marital status (AOR = 7.52, CI: 2.707-20.911), husband's educational status "cannot read and write" (AOR = 4.05, CI: 1.834-8.962) and "can read and write without formal education" (AOR = 2.39, CI: 1.107-5.154) are statistically significant variables associated with depression among pregnant women during the COVID-19 pandemic. Conclusions In this study, the prevalence of antenatal depression in pregnant women during the novel coronavirus pandemic was high. To reduce the level of depression in pregnant women, strategies have to be designed for the early detection of divorced pregnant women with inadequate social support and address enough information for pregnant women and their husbands about depression and COVID-19 during the pandemic.
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Affiliation(s)
- Nakachew Sewnet Amare
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia,Corresponding author
| | - Dereje Nibret Gessesse
- School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yerukneh Solomon Kinfu
- School of Medicine, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Abebayehu Melesew Mekuriyaw
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Michael Amera Tizazu
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Mulat Mossie Menalu
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Birhan Tsegaw Taye
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Alemayehu Gonie Mekonnen
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
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Chen P, Wan G, Zhu B. Incidence and risk factors of symptomatic thrombosis related to peripherally inserted central catheter in patients with lung cancer. J Adv Nurs 2020; 77:1284-1292. [PMID: 33249623 DOI: 10.1111/jan.14666] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 09/14/2020] [Accepted: 11/03/2020] [Indexed: 02/06/2023]
Abstract
AIMS To determine the incidence and risk factors associated with peripherally inserted central catheter-related thrombosis (PICC-RT) in patients with lung cancer. DESIGN A retrospective cross-sectional design. METHODS Patients with lung cancer receiving PICC insertion during 1 March 2014-31 May 2019 at a tertiary hospital in Shanghai, China were enrolled (N = 748). Symptomatic PICC-RT was confirmed by Doppler ultrasonography in the presence of clinical symptoms and signs. Univariate and multivariate logistic regression analyses were performed to identify risk factors of symptomatic PICC-RT. RESULTS Among the patients (mean age, 60.7 years; males, 67.1%), 55 (7.35%) had symptomatic PICC-RT. Based on the multivariate analysis, history of smoking [OR 2.49 (1.13-5.46), p < .05], use of Carboplatin [OR 2.23 (1.19-4.17), p < .05] or Docetaxel [OR 7.23 (1.65-31.56), p < .05], PICC size [OR 3.52 (1.78-6.99), p < .001], and level of D-dimer [OR 5.32 (2.39-11.83), p < .001] were significant risk factors of PICC-RT. CONCLUSION Several modifiable factors (e.g., PICC size and level of D-dimer) were related to PICC-RT. In the future, prospective studies are warranted to examine whether those factors could increase the risk of PICC-RT. Meanwhile, healthcare professionals are recommended to perform a comprehensive assessment of the patients receiving PICC insertion. Close attention should be paid to those at risk for PICC-RT. IMPACT Identification of risk factors associated with PICC-RT is an important step towards individualizing the care plan for patients receiving PICC. Our findings provided evidence for the management of PICC-RT in patients with lung cancer. In clinical practice, nurses could deliver appropriate interventions against modifiable risk factors to reduce the risk of PICC-RT.
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Affiliation(s)
- Pei Chen
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Guangming Wan
- Department of Emergency, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Bingqian Zhu
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
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Simhi M, Yoselis A, Sarid O, Cwikel J. Hidden Figures: Are Ultra-Orthodox Jewish Women Really so Different When it Comes to Health Care? JOURNAL OF RELIGION AND HEALTH 2020; 59:1398-1420. [PMID: 31218549 DOI: 10.1007/s10943-019-00862-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Incorporating the needs of at-risk populations into national health care initiatives is essential. Israel has identified ultra-Orthodox Jewish, or Haredi, women, as at risk of increased morbidity and mortality, yet actual data on this insular community are lacking. We reviewed published research on Israeli Haredi women's health status, behaviors and health care access and examined methodologies. Of 273 articles identified, 14 publications and four government reports were included. More research is needed on this community, essential not only to Israeli health care policy, but to that of the USA and the UK, who share the largest percentages of Haredi Jews.
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Affiliation(s)
- Meital Simhi
- Spitzer Department of Social Work and the Center for Women's Health Studies and Promotion, Ben Gurion University of the Negev, POB 653, 84105, Beer Sheva, Israel.
| | - Aviva Yoselis
- Health Advize, POB 383, 90651, Mitzpe Yericho, Israel
| | - Orly Sarid
- Spitzer Department of Social Work and the Center for Women's Health Studies and Promotion, Ben Gurion University of the Negev, POB 653, 84105, Beer Sheva, Israel
| | - Julie Cwikel
- Spitzer Department of Social Work and the Center for Women's Health Studies and Promotion, Ben Gurion University of the Negev, POB 653, 84105, Beer Sheva, Israel
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Grussu P, Andreetto I, Pastore M, Calcagnì A, Quatraro RM. Perinatal psychological well-being in women with zero postnatal anxiety-depressive symptoms scores: a retrospective descriptive study. J Reprod Infant Psychol 2020; 38:199-213. [PMID: 32064910 DOI: 10.1080/02646838.2020.1724915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background: A total absence of psychological symptoms during pregnancy or postpartum period is not common. Although there are some considerations on zero scores detected by EPDS, no thorough analysis is currently present in the literature of the eventuality and meaning of a total absence of postpartum symptoms following the compilation of two or more self-report symptom questionnaires.Methods: In a sample of 960 Italian women, three groups of 31 subjects are defined retrospectively by scores on the EPDS-GHQ12: women with 'zero', 'lower', and 'higher' postnatal symptomatology. The psychological well-being of these groups was compared as detected in pregnancy and after childbirth by PWB questionnaire.Results: Higher and excessive scores in Environmental mastery dimension connote the profile of women with a total absence of postpartum anxiety-depression symptoms. Positive relations with other dimension were less characterising, but it should be noted as a distinctive trait in the 'zero' symptoms postnatal symptomatology group. In the same 'zero' group, the scores of the six PWB questionnaire dimensions - except Personal growth - are all higher than the scores obtained by women in the general population.Conclusion: The atypical self-reported perinatal mood condition present in the 'zero' symptoms group have currently unknown clinical significance.
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Affiliation(s)
- Pietro Grussu
- Consultorio Familiare Service, Azienda ULSS 6 Euganea, National Health Service, Este, Italy
| | - Irene Andreetto
- Consultorio Familiare Service, Azienda ULSS 6 Euganea, National Health Service, Este, Italy
| | - Massimiliano Pastore
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy
| | - Antonio Calcagnì
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy
| | - Rosa Maria Quatraro
- Hospital Psychology Unit, Obstetrics and Gynaecology Section, Azienda ULSS 8 Berica, National Health Service, Este, Italy
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Abstract
PURPOSE This educational intervention uses the generalized empirical method (GEM) of Bernard Lonergan for nursing students to gain an understanding of the Orthodox Jewish family during childbirth. SETTING AND POPULATION this activity occurred at a baccalaureate, nursing program in the Northeast United States. It consisted of two semesters of 32 undergraduate junior nursing students enrolled in a maternal-newborn nursing course. FINDINGS Five themes emerged from students' reflective journaling related to the Orthodox Jewish Laws and traditions included: Laws of Modesty, Laws of Niddah, Laws of Sabbath and Holidays, Laws of Kosher, and Laws of Naming the child and circumcision. CONCLUSIONS The GEM facilitated students' understanding and knowledge of cultural traditions of the Orthodox Jewish childbirth experience. Lonergan's GEM provided insights and reflection so students could become culturally competent in providing nursing care.
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Affiliation(s)
- Josephine DeVito
- Seton Hall University College of Nursing, South Orange, New Jersey
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Carroll M, Downes C, Gill A, Monahan M, Nagle U, Madden D, Higgins A. Knowledge, confidence, skills and practices among midwives in the republic of Ireland in relation to perinatal mental health care: The mind mothers study. Midwifery 2018; 64:29-37. [DOI: 10.1016/j.midw.2018.05.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 01/15/2018] [Accepted: 05/12/2018] [Indexed: 01/07/2023]
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Higgins A, Downes C, Carroll M, Gill A, Monahan M. There is more to perinatal mental health care than depression: Public health nurses reported engagement and competence in perinatal mental health care. J Clin Nurs 2017; 27:e476-e487. [DOI: 10.1111/jocn.13986] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2017] [Indexed: 02/06/2023]
Affiliation(s)
- Agnes Higgins
- School of Nursing and Midwifery Trinity College Dublin Ireland
| | - Carmel Downes
- School of Nursing and Midwifery Trinity College Dublin Ireland
| | | | - Ailish Gill
- School of Nursing and Midwifery Trinity College Dublin Ireland
| | - Mark Monahan
- School of Nursing and Midwifery Trinity College Dublin Ireland
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Gabbay E, McCarthy MW, Fins JJ. The Care of the Ultra-Orthodox Jewish Patient. JOURNAL OF RELIGION AND HEALTH 2017; 56:545-560. [PMID: 28102466 DOI: 10.1007/s10943-017-0356-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The Ultra-Orthodox Jewish community embraces a system of values and a rigorous behavioral code that are deeply rooted in religious tradition and history. Here we describe some of the unique challenges that stem from the encounter between modern medical practice and the Ultra-Orthodox world. Through examples of clinical and ethical scenarios ranging from prenatal care to end-of-life decisions, we illustrate problems related to observance of age-old practices in a modern hospital setting, balancing acceptance of Divine will with standard risk assessment, reconciliation of patient autonomy with deference to rabbinic authority and fear of stigma associated with mental illness in a traditional society. We also offer a generalizable model where inquiry precedes pre-formulated judgment to help clinicians provide enhanced care for this population.
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Affiliation(s)
- Ezra Gabbay
- Hospital Medicine Section, Division of General Internal Medicine, Department of Medicine, Weill-Cornell Medicine, 525 East 68th Street, Box 331, New York, NY, 10065, USA.
| | - Matthew W McCarthy
- Hospital Medicine Section, Division of General Internal Medicine, Department of Medicine, Weill-Cornell Medicine, 525 East 68th Street, Box 331, New York, NY, 10065, USA
| | - Joseph J Fins
- Division of Medical Ethics, Department of Medicine, Weill-Cornell Medicine, New York, NY, USA
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Lima MDOP, Tsunechiro MA, Bonadio IC, Murata M. Sintomas depressivos na gestação e fatores associados: estudo longitudinal. ACTA PAUL ENFERM 2017. [DOI: 10.1590/1982-0194201700007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo Identificar a frequência de sintomas depressivos no decorrer da gestação e verificar sua associação com variáveis sociodemográficas, obstétricas e de saúde. Métodos Estudo longitudinal realizado com 272 gestantes de 12 unidades de saúde do Município de São Paulo. Os dados foram obtidos por meio de um formulário para as variáveis independentes e da Escala de depressão pós-parto de Edimburgo aplicada nas 20ª, 28ª e 36ª semanas gestacionais. Utilizou-se modelo de equações de estimação generalizadas para avaliar os fatores associados e chances de risco. Resultados A frequência de sintomas depressivos foi de 27,2%, 21,7% e 25,4%. Maior escolaridade, gestação planejada e continuidade da gestação foram fatores de proteção. Sofrer ou ter sofrido violência psicológica foi fator de risco independente do período gestacional. Conclusão A frequência de sintomas depressivos na gestação foi elevada. Os fatores associados foram maior escolaridade, gestação planejada, continuidade da gestação e sofrer ou ter sofrido violência psicológica.
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