Posttraumatic stress symptoms and postpartum anxiety among palestinian women: the mediating roles of self-esteem and social support

War-related trauma in narratives of Gazans: challenges, difficulties and survival coping

The Israeli escalation of violence and oppression in Gaza, particularly following the events of October 7, 2023, has deepened the trauma and exacerbated the already grievous conditions of dispossession and exploitation faced by Palestinians. The present exploratory work sought to analyze war-related traumatic experiences among Gazans following the recent Israeli genocide against Gazans. Thirty participants (mean age for males = 32.45 years, SD = 10.13; mean age for females = 30.28 years, SD = 9.15; range 19-57) were recruited via snowball sampling. Interviews were analyzed through thematic content analysis. Thematic content analysis of the interview transcripts led to the identification of five main themes: (1) challenges and difficulties faced Gazans, (2) traumatic experiences related to war, (3) feelings and emotions among Gazans living in refugee camps, (4) how do Gazans perceive the future and (5) survival coping employed by Gazans following the on-going genocide against the Gaza Strip. The findings of this study highlight the profound humanitarian crisis in Gaza, calling for urgent attention to the ongoing crisis in Gaza and advocating for comprehensive humanitarian support and psychological interventions to address the deep-seated trauma and help rebuild lives shattered by conflict.

The effect of the level of perceived social support in the postpartum period on maternal functioning and maternal attachment

AIM

This study aims to examine the effect of the level of perceived social support in the postpartum period on maternal functioning and maternal attachment.

METHODS

This study was conducted between January and May 2023 in two family health centers selected by simple randomization among 11 family health centers affiliated with the Health Directorate located in eastern Türkiye. The population of the study consisted of 410 mothers in the postpartum period who had babies aged 6-11 weeks old. Data were collected face-to-face using the "Personal Information Form", the "Multidimensional Scale of Perceived Social Support", the "Barkin Index of Maternal Functioning Scale" and the "Maternal Attachment Scale". Data analysis was performed using numbers, percentages, arithmetic means, independent groups t-tests, ANOVA, Pearson correlation analysis, and simple linear regression analysis.

FINDINGS

A positive, moderately significant relationship was found between maternal attachment and maternal functioning (r = 0.554; p < .05). A positive, moderately significant relationship was found between maternal attachment and perceived social support (r = 0.585; p < .05). A positive, highly significant relationship was detected between social support and maternal functioning (r = 0.861; p < .05).

CONCLUSION

This study found that postpartum women's attachment levels increased with the increase in their maternal functioning. It was also found that mothers' attachment levels increased with the increase in their perceived social support levels. Social support levels were proven to be effective on maternal functioning as well as maternal attachment. Women's maternal functioning levels were found to increase with the increase in their social support levels.

PRACTICE IMPLICATIONS

In light of these findings, pediatric nurses and obstetric nurses have great responsibilities. Starting from the prenatal period and including the postnatal period, both the mother and everyone around her should be explained the importance of social support.

A nomogram for predicting postpartum post-traumatic stress disorder: a prospective cohort study

BACKGROUND

Postpartumpost-traumatic stress disorder (PTSD), as a psychological stress disorder, has long-term and widespread harm. Still, compared with other postpartum psychiatric disorders, postpartum PTSD has received relatively littleattention in China. This study aims to investigate the risk factors of postpartum PTSD and to develop a convenient and rapid nomogram screening tool to help clinical staff identify high-risk pregnant womenin time and take preventative and management measures.

METHODS

Recruited pregnant women hospitalized for delivery in Qingdao Municipal Hospital and Jinzhou Maternal and Child Health Hospital from November 2022 to October 2023 as convenient samples for the questionnaire survey. Telephone follow-up was conducted 42 days after delivery. After univariate analysis, multicollinearity analysis, and logistic regression analysis, the risk factors of postnatal PTSD were obtained, a prediction model was established, and a nomogram was drawn by R software. G*power3.1.9.7 calculated the effectiveness of the test. The model was validated internally using the Bootstrap approach, and external validation was carried out using a verification group. The accuracy of the model's predictions and its clinical application value were evaluated by the area under the curve, calibration plot, and decision curve analysis.

RESULTS

A total of 602 women were recruited in this study, and the incidence of postpartum PTSD was 11.1% (67/602). Multifactorial logistic regression analysis showed that poor self-assessment of sleep status in late pregnancy (OR = 5.336), cesarean section (OR = 2.825), instrumental delivery (OR = 5.994), having fear of labor (OR = 4.857), and a high score of Five Factors Inventory Neuroticism subscale (OR = 1.244) were independent risk factors for developing postpartum PTSD. A high Quality of Relationship Index score (OR = 0.891) was a protective factor for postpartum PTSD. In the training and validation sets, the nomogram model's area under the ROC curve was 0.928 and 0.907, respectively. The calibration curves showed that the nomogram model was well-fitted, and the Decision Curve Analysis indicated that the nomogram model had good value for clinical application.

CONCLUSIONS

With its strong predictive capacity, the prediction model built using postpartum PTSD risk factors can help clinical caregivers identify high-risk pregnant women early on and implement timely preventive intervention strategies.

The multiple mediation model of social support and postpartum anxiety symptomatology: the role of resilience, postpartum stress, and sleep problems

OBJECTIVE

This study aimed to assess the prevalence of postpartum anxiety and the factors influencing it, while also exploring the multiple mediating roles of related factors between social support and postpartum anxiety symptomatology among postpartum women in China.

METHODS

Between April and August 2023, we recruited a total of 824 postpartum women through a convenience sampling method. These participants completed a series of general survey questionnaires and were evaluated using the depression anxiety stress scale, perceived social support scale, 10-item Connor-Davidson resilience scale, maternal postpartum stress scale, and Pittsburgh sleep quality index. Additionally, we employed a hierarchical multiple regression model to investigate the relevant factors and mediators of postpartum anxiety symptomatology. A structural equation model was used to examine the mediating role of resilience, postpartum stress, and sleep problems in the relationship between social support and postpartum anxiety symptomatology.

RESULTS

Our study found a postpartum anxiety symptomatology prevalence rate of 18.40%. The factors influencing postpartum anxiety symptomatology included age, education of their husband, mastitis, social support, resilience, postpartum stress, and sleep problems. Through a multiple mediation analysis, we found that resilience, postpartum stress, and sleep problems completely mediated the effects of social support on postpartum anxiety symptomatology, with the mediating effect accounting for 83.57% of the total effect.

CONCLUSION

The multiple mediation analysis revealed that among postpartum women, the impact of social support on postpartum anxiety symptomatology is channeled through resilience, postpartum stress, and sleep problems. Therefore, enhancing social support, resilience, postpartum stress, and sleep problems might alleviate postpartum anxiety symptomatology.

Development of a context-specific trauma scale among a Palestinian adult population living amidst military violence

The current study aimed to develop a context-specific trauma scale in the Palestinian context. The sample of our study consisted of 490 Palestinian adults - 230 males and 260 females. Our scale ended up with 32 items to measure traumatic symptoms in the Palestinian context. Results of exploratory factor analysis and confirmatory factor analysis revealed a stable construct of a five-factor structure of the Palestinian specific-context trauma: (1) re-experiencing trauma, (2) avoidance and numbing, (3) hyperarousal, (4) somatic symptoms and (5) psychological symptoms. Reliability of the scale was further established by assessing the test-retest and internal consistency of all subscales. Convergent validity for the context-specific trauma scale was conducted by testing the association between the scale and two existing measures - the WHOQOL-BREF and the Impact of the Event Scale (IES-R). We recommend using our scale in empirical studies incorporating spoken or written disclosure about traumatic experiences. The scale should also be considered when working with clinical and non-clinical groups who have experienced politics-related trauma.