The changes of parental functioning of the patients with bipolar disorder and major depression since discharging from hospital: A longitudinal study.

AIMS AND OBJECTIVES: This study examined the changes in patients' parental functioning and the associated factors, including manic, depressive symptoms and social support from before discharge to 6 months post-discharge. BACKGROUND: For parents with bipolar disorder and major depression, parenting is a recovery factor for patients, but little research examines the dynamic parental functioning from acute hospitalisation to a remission stage. DESIGN: A longitudinal design was used. The STROBE Checklist were used in presenting this research. METHODS: Participants were inpatients with bipolar disorder or major depression (n = 33) recruited within one week before discharge from the acute psychiatric ward in Taiwan. Data on parental functioning was collected four times: before discharge (T1), the 1st (T2), the 3rd (T3) and the 6th (T4) months of post-discharge. Baseline parental functioning before admitting to the acute word was retrospectively assessed at T0. The questionnaires included positive and negative domains of parenting practice, hypomanic/manic symptoms, depressive symptoms and social support. Generalised estimating equations were applied for data analysis. RESULTS: The negative parenting domains (poor monitoring, inconsistent discipline) decreased during hospitalisation but increased at one month post-discharge, except corporal punishment at 3-months discharge. The positive parenting domains (parental involvement and nurturance/responsiveness) did not recovery to baseline. While clinical symptoms remained stable during 6 months post-discharge, social support decreased at 3 and 6 months post-discharge. Higher depressive symptoms and low social support were associated with positive parenting domains but not related to negative parenting domains. Manic symptoms were not associated with positive or negative parenting domains. CONCLUSIONS: Positive parenting domains did not fully return to the usual situation during 6 months post-discharge. RELEVANCE TO CLINICAL PRACTICE: Parenting functioning recovery program targeting at the impacts of depressive symptoms on the parenting functioning and insufficient social support is needed from hospitalisation to post-discharge.

The effectiveness of compassion-based interventions among cancer patients: A systematic review and meta-analysis.

OBJECTIVES: This study examined the effects of compassion-based intervention on mental health in cancer patients by using systematic review and meta-analysis of randomized controlled trials (RCTs). METHODS: Eleven bibliographic databases were searched from their earliest data available date up to March 1, 2022. The databases were PubMed, CINAHL, MEDLINE, PsycINFO, WOS, Cochrane, Embase, Scopus, ProQuest Dissertations, Airiti Library, and the National Digital Library of Theses and Dissertations in Taiwan. RESULTS: Ten studies from 2015 to 2021 were included with a total of 771 cancer patients. Most were targeted at women with breast cancer. Brief compassion-based interventions of approximately 30 minutes were conducted by audio file, paper, and web-based self-guided writing prompts. Most were conducted after the completion of active treatment. Anxiety was the most measured outcome. Constructive compassion-based interventions with 4- to 12-week sessions were conducted by a trained facilitator. Most were conducted for patients who had undergone treatment, and depression was the most measured outcome. The meta-analysis indicated that compassion-based interventions had a significant effect of reducing depression and increasing self-compassion. Moderation analysis indicated that constructive intervention showed more benefits of increased self-compassion than brief intervention. Both face-to-face and non-face-to-face web-delivered formats had benefits for increasing self-compassion compared with the control condition. SIGNIFICANCE OF RESULTS: Compassion-based interventions might provide an effective strategy for improving self-compassion and depression among patients with breast cancer. Suggestions for further research and health-care providers follow.

The experiences of family resilience from the view of the adult children of parents with bipolar disorder in Chinese society.

AIMS: This study explored how adult children perceived family resilience, barriers to develop family resilience and how cultural values influence their experience of parents with bipolar disorder in Chinese society. DESIGN: A qualitative design with an interpretive phenomenological analysis of data was employed. METHODS: Twenty adults who had lived with parents with bipolar disorder during childhood were recruited from the acute psychiatric ward when their parents were admitted to the hospital. They described their experiences of perceived family resilience and barriers to resilience (October 2013-September 2015). Semi-structured interviews were conducted in the hospital meeting room or at a convenient location. FINDINGS: Six themes were identified in family resilience: ill parents try to be good parents, parents' personal strengths, parents' positive attitudes towards mental illness, flexibility of family role, cohesive relationships between family members, and families' social connections. Three themes were identified in the barriers to develop family resilience: poor parenting/family function, conflict between parents and poor mental health literacy. CONCLUSION: Children's views of family resilience could transform their suffering from lived experiences with a mentally ill parent to a positive growth experience. Family resilience includes well and ill parents' efforts and social network's help to maintain family function. However, the conflicts between well and ill parents and poor family function result in a traumatic growth experience. IMPACT: To enhance a positive growth experience, family resilience programs for a parent with bipolar disorder aiming to cultivate both the ill and well parents' inner strength and their competence of parenting skills with connecting their social network to maintain family function is needed. Moreover, early stress-reduction intervention needs to be developed for children who did not experience family resilience.

The effects of an emergency nurse-led stress-reduction project during the first 120 days of the COVID-19 pandemic in Taiwan.

BACKGROUND: The COVID-19 frontline nurses' stress-reduction programme by the cooperation of manager with the nurses is not-well developed. AIM: This study aimed to examine the effect of an emergency nurse-led stress-reduction project on reducing stress levels during the COVID-19 pandemic. METHODS: The action research was conducted using online and person-to-person group brainstorming strategies. The online survey was used to evaluate emergency nurses' stress levels, causes of stress and needs at the 50th, 80th and 110th days of the pandemic from March to May 2020. RESULTS: The numbers of nurses participating in three-time survey were 160, 166 and 160, respectively. There was a decrease in the nurses' work-related stress after implementing the improvement strategies. Stress from personal protective equipment (PPE), information about infection control and family's worry about being infected reduced across 2 months. Needs regarding PPE, COVID-19 information and a forum for sharing experiences of COVID-19 care decreased whereas needs of allowing more days off increased. CONCLUSIONS: The stress-reduction project targeting at nurses' views of their needs can reduce their stress during the COVID-19 pandemic. IMPLICATIONS FOR NURSING MANAGEMENT: The online and person-to-person group brainstorming building a good partnership between nurses and managers can be an effective nursing management.

The multiple mediating effects of cancer threat appraisal and quality of life on the association between mindfulness and depression for colorectal cancer survivors.

OBJECTIVE: This study explored the multiple mediating effects of cancer threat appraisal, functional status, and symptom distress on the association between mindfulness and depression in colorectal cancer (CRC) patients at the transition stage after completing cancer treatments. METHODS: A total of 90 CRC survivors who received cancer treatments within 3 months participated in this cross-sectional study. The functional status and symptom distress (EORTC-C30 and EORTC CR29), dispositional mindfulness (Five Facet Mindfulness Questionnaire), cancer threat appraisal ( Constructed Meaning Scale), and depressive symptoms (Beck Depression Inventory-II scale) were collected. The mediation and moderation analyses were conducted using the PROCESS macros for SPSS. RESULTS: Survivors' dispositional mindfulness (γ = -0.49, p < 0.001) and cancer threat appraisal (γ = -0.59, p < 0.001) were significantly associated with depressive symptoms. Simple mediation analysis indicated that cancer threat appraisal mediated the relationship between dispositional mindfulness and depression (ß = -0.02, 95% CI = -0.04 to -0.001). The multiple mediated analysis identified the path between dispositional mindfulness and depression via cancer threat appraisal and colorectal symptom distress (ß = -0.01, 95% CI = -0.03 to -0.01). In the mediated moderation model, the path between dispositional mindfulness and depression via colorectal function was moderated by cancer threat appraisal (ß = -0.02, 95% CI = -0.05 to -0.004). CONCLUSIONS: The two cognitive mechanisms of reducing CRC survivors' depression are as follows: (1) dispositional mindfulness reducing the appraisal of cancer as a threat and increasing positive perceptions of CRC symptoms and (2) the cancer threat appraisal buffered the impacts of CRC's mindfulness and colorectal function on depressive symptoms. Developing mindfulness with cognitive training is recommended for improving depressive symptoms among CRC patients in the transition period.

Effectiveness of mindfulness-based intervention on psychotic symptoms for patients with schizophrenia: A meta-analysis of randomized controlled trials.

AIMS: To evaluate the effects of mindfulness-based intervention on psychotic symptoms, positive symptoms, negative symptoms, depressive symptoms, anxiety, and rehospitalization. DESIGN: A meta-analysis of randomized controlled trials. DATA SOURCES: Medline, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, CINAHL, National Digital Library of Theses and Dissertations in Taiwan, and Airiti Library were searched from their earliest available date up to April 2019. REVIEW METHODS: The guidelines of the Cochrane Collaboration were followed to report this systematic review. Two authors conducted this meta-analysis independently. RESULTS: Nine randomized controlled trials were included. Meta-analysis showed that mindfulness-based intervention significantly decreased psychotic symptoms, positive symptoms, negative symptoms, depressive symptoms, and duration of rehospitalization among patients with schizophrenia, and that the reduction in negative symptoms lasted through short-term follow-up. The moderation analysis showed that significantly decreased positive symptoms occurred in the nurse-led intervention group, while no significant impact was found in the psychologist-led intervention group. CONCLUSION: The psychotic symptoms of the patients with schizophrenia are improved after mindfulness-based intervention and the effects on the negative symptoms can be maintained for at least 3 to 6 months. Mindfulness-based intervention provided by nurses produces more improvements in positive symptoms than intervention provided by psychologists. IMPACT: A growing number of mindfulness-based interventions have been implemented for patients with schizophrenia, although the effectiveness had not previously been established by meta-analysis. Mindfulness-based interventions appear to reduce the symptom severity of schizophrenia patients. Further suggestions for healthcare providers and researchers are provided and discussed.

Factors influencing patient-perceived quality of care in psychiatric hospitals in Taiwan.

Patient-perceived quality of inpatient/outpatient psychiatric care remains under-researched. A cross-sectional survey with purposive sampling comprising 567 inpatients and 549 outpatients was conducted among eight psychiatric care facilities in Taiwan to examine the factors influencing patient-perceived care quality. Inpatients and outpatients perceived moderate quality of care, where "Encounter" was reported as the highest dimension. Inpatients perceived "Secure environment" as the lowest; outpatients rated "Discharge/Referring" as the lowest. Hospital region and customer loyalty were significantly associated with patient-perceived care quality. Other significant factors were also identified: inpatient employment, perceived mental health and treatment effects, understanding diagnosis, previous treatment, and visited by appointment.

Dispositional mindfulness, self-compassion, and compassion from others as moderators between stress and depression in caregivers of patients with lung cancer.

OBJECTIVE: The present study aimed to identify the most important protective factors predicting caregivers' depressive symptoms among factors of caregivers' dispositional mindfulness, self-compassion, compassion from others, and patients' dispositional mindfulness and their moderator effects on the relationship between caregiving stress and depressive symptoms. METHODS: A total of 72 lung cancer outpatients and their family caregivers participated in this study. Family caregivers completed the Kingston Caregiver Stress Scale, Beck Depression Inventory-II (BDI-II), Five Facet Mindfulness Questionnaire (FFMQ), Self-Compassion Scale, and Compassion from Others Scale. Patients completed the EORTC Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), BDI-II, and FFMQ. RESULTS: After controlling for patients' factors (treatment status, symptom distress, and depressive symptoms) and caregivers' health status, caregivers' stress and dispositional mindfulness, the domain of mindful awareness, and self-compassionate action were significantly associated with their depressive symptoms. Further analysis indicated that mindful awareness or self-compassionate action could buffer the effect of caregiving stress on depressive symptoms. When the two moderators, mindful awareness and self-compassionate action, were tested simultaneously, only self-compassionate action remained as a significant moderating effect. CONCLUSIONS: Caregivers' mindful awareness and self-compassionate action were protective factors, which mitigate the impact of caregiving stress on their depressive symptoms. Therefore, the future supportive program aims at training the competencies of self-compassionate action with mindful awareness, which may enhance caregivers' coping resources.

The changes and the predictors of suicide ideation and suicide attempt among HIV-positive patients at 6-12 months post diagnosis: A longitudinal study.

AIMS: This study examined the changes and the predictors of suicide ideation/suicide attempt and the moderating effects of psychosocial factors on the suicide ideation/suicide attempts among human immunodeficiency virus (HIV)-positive patients at 6-12 months post-diagnosis. BACKGROUND: Suicide behaviours are prevalent among newly diagnosed HIV-positive patients, but the changes in suicide behaviours after diagnosis and the role of psychosocial factors in these behaviours are not well studied. DESIGN: This study used a prospective longitudinal design. METHODS: A total of 113 participants diagnosed as HIV-positive for 6-12 months were recruited from the outpatient department. Data were collected from June 2015 - October 2016. They were asked to complete Beck's Scale for Suicide Ideation, the Beck Depression Inventory-II, the Body Image Scale, the Meaning in Life Questionnaire and the Multidimensional Scale of Perceived Social Support at baseline, the third month and the sixth month. RESULTS: The results showed the high occurrence rates for suicide ideation ranging from 27.2%, 21.6%, and 25.8% and suicide attempt ranging from 14.7%, 8.6%, and 13.3% at the baseline, the third month and the sixth month, respectively. The education level, social support from family and depressive symptoms were the predictors of suicide ideation. The history of depression disorders, depressive symptoms and social support from friends significantly predicted suicide attempt. Meaning in life-presence moderated the relationship between depressive symptoms and suicide ideation. CONCLUSIONS: After diagnosed for 6-12 months, HIV-positive patients remain the high-risk group for suicide ideation and attempt. Suicide intervention targeting the risk and protective factors are required for HIV-positive patients.

The effects of the interventions on the DNR designation among cancer patients: A systematic review.

OBJECTIVE: The aims of this systematic review were to examine the effects of the overall and the different types of the interventions on the do-not-resuscitate (DNR) designation and the time between DNR and death among cancer patients. METHOD: Data were searched from the databases of PubMed, CINAHL, EMbase, Medline, and Cochrane Library through 2 November 2017. Studies were eligible for inclusion if they were (1) randomized control trails, quasi-experimental study, and retrospective observational studies and (2) used outcome indicators of DNR designation rates. The Effective Public Health Practice Project tool was used to assess the overall quality of the included studies. RESULT: The 14 studies with a total of 7,180 participants were included in this review. There were 78.6% (11 of 14) studies that indicated that the interventions could improve the DNR designation rates. Three types of DNR interventions were identified in this review: palliative care unit service, palliative consultation services, and patient-physician communication program. The significant increases of the time between DNR designation and death only occurred in a patient-physician communication program. SIGNIFICANCE OF RESULTS: The palliative care unit service provided a continuing care model to reduce unnecessary utilization of healthcare service. The palliative consultation service is a new care model to meet the needs of cancer patients in non-palliative care unit. The share decision-making communication program and physician's compassion attitudes facilitate to make DNR decision early. The individualized DNR program needs to be developed according to the needs of cancer patients.

[Body Image in Schizophrenia].

Schizophrenia is a basic self-disturbance that in its early stages causes the sufferer discomfort toward feelings of self. Therefore, fragility or abnormality with regard to sense of self was a core observation of early schizophrenia theory. Rather than body-image-related depression or anorexia, disturbed body experience is the main factor affecting body image in patients with schizophrenia. This is a concept that has been discussed in the literature in recent years. This article will introduce the body self model, discuss the schizophrenic symptoms that influence experienced body disturbances and reduce body self-functions, and explore the relationship between body identity and body image. In order to improve the body image of patients with schizophrenia, it is necessary to conduct assessments and interventions that enhance the sense of body identity.

Prevalence and Predictors of Depression Among People Living With HIV/AIDS: A National Study.

BACKGROUND: Depression is prevalent among people living with HIV/AIDS (PLWHA), but there are few longitudinal studies investigating the prevalence of depression among HIV respondents in Taiwan. OBJECTIVES: This study examined the trend in the prevalence of depression and its main predictors among PLWHA in Taiwan. METHODS: This study analyzed the 2-million random-sample data set of the Taiwanese longitudinal health research database using data from 2000 to 2011and applied the Internal Classification of Diseases, 9th Revision, Clinical Modification diagnostic codes for the detection of HIV infection and depression. Chi-square tests and logistic regression analyses were conducted to determine predictive factors for depression. RESULTS: A total of 769 PLWHA who met the criterion of HIV infection were extracted from the database. Of these respondents, 20.03% had a diagnosis of depression after their HIV-positive diagnosis. The annual prevalence of depression among the study respondents increased significantly from 1.95% in 2000 to 6.93% in 2011 according to time trend analysis (χ = 6.428, df =11, p = .03). Multivariate, logistic regression analysis indicated a history of drug abuse was the main predictor of a diagnosis of depression. DISCUSSION: The increasing trend in the prevalence of depression revealed an urgent need for the development of care programs for PLWHA with depression. Such programs should take into consideration a history of drug abuse as a strong risk factor for the development of depression.

[Exploring Suicide Ideation and Suicide Attempts Among HIV-Positive Patients During the First Six Months to One Year After Their Diagnosis].

BACKGROUND: HIV-positive patients are at high risk of suicide behaviors. Because most previous studies have investigated suicide behaviors among HIV-positive patients during their first six months of diagnosis only, there is a current lack of understanding of suicide behaviors among this group. PURPOSE: This study aimed at HIV-positive patients who had been diagnosed between six months and one year ago and examined their suicide ideation and suicide attempt profiles and the associated factors of suicide. METHODS: This study adopted a cross-sectional design. A total of 114 HIV-positive patients were interviewed in the HIV clinics of a medical center in Taipei City. Information collections included demographic and HIV-related data and measurements of suicide ideation, suicide attempt, depression, body image, meaning in life, and social support. Independent samples t tests, chi square tests, and logistic regressions were conducted to examine the associated factors and predictors of suicide ideation and suicide attempt. RESULTS: Slightly over one-quarter (27.2 %) of the participants reported suicide ideation and 14.0% reported attempting suicide in recent one week prior the study interview. Duration since being diagnosed HIV-positive, level of education, and history of depression were each associated with suicide ideation, while only history of depression was associated with suicide attempt. Having a higher level of education and having a higher level of social (family) support were both predictors of lower risk of suicide ideation, while having a higher level of depression predicted a greater risk of suicide attempt. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: This study found high prevalences of suicide ideation and attempting suicide among HIV-positive patients during the six month to one year period after diagnosis. Moreover, the prevalence was similar to that among HIV-positive patients during the first six months of diagnosis. Suicide prevention should be a focus of care plans provided to HIV-positive patients during their first year after diagnosis. These results may be provided as a reference for developing suicide-prevention strategies for HIV-positive patients. Routine screening for depression, guiding families to increase their provision of social support, and giving assistance to individuals with higher levels of depression contribute to the effective prevention of suicide among HIV-positive patients.

The effects of supportive care interventions on depressive symptoms among patients with lung cancer: A metaanalysis of randomized controlled studies.

OBJECTIVE: Our aim was to examine the effect of supportive care interventions on depressive symptoms in patients with lung cancer. METHOD: We searched the databases of the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid EMBASE, PubMed, and the Chinese Electronic Periodical Services (CEPS) from their inception until September of 2015. We included randomized controlled trial studies that compared standard care with supportive care interventions. The standardized mean difference (SMD) (Cohen's d) was calculated to estimate the effect of interventions. Subgroup analysis was conducted to identify possible sources of heterogeneity. RESULTS: A total of 1,472 patients with lung cancer were identified. Compared with standard care, the overall effects of all supportive care interventions significantly reduced depressive symptoms (SMD = -0.74, CI 95% = -1.07 to -0.41), and the effects could be maintained at weeks 4, 8, and 12 of follow-up. Three types of supportive care interventions were identified: psychotherapy combined with psychoeducation, psychoeducation alone, and an exercise program. Both psychotherapy combined with psychoeducation and exercise significantly improved depressive symptoms, while psychoeducation alone did not yield significant effects. The moderating effects indicated that greater improvements in depressive symptoms were found in lung cancer patients with a severe level of depressive symptoms at baseline. SIGNIFICANCE OF RESULTS: Personalized supportive care interventions can be developed based on the main causes of depressive symptoms. Psychotherapy combined with psychoeducation can target the causes of depressive symptoms, including both physical distress and psychological trauma due to lung cancer, while exercise programs can effectively improve depressive symptoms for lung cancer patients with impaired respiratory function.

[The Application of Body-Mind-Spirit Integrated Psychotherapy in Nursing Practice].

Body-mind-spirit integrated psychotherapy reflects the core value of nursing by emphasizing the inseparable concept of body, mind, and spirit and caring for the holistic needs of the patient. Body-mind-spirit integrated psychotherapy was developed based on Western psychotherapy (positive psychology and forgiveness therapy), traditional Chinese medicine, and the Eastern philosophies of Buddhism, Taoism, and Confucianism. The present paper describes the holistic concepts that underpin this therapeutic approach. Physical health is sustained through proper nutrition, physical relaxation, and harmonized breathing; psychological well-being helps maintain inner peace and harmony in interpersonal relationships; and spiritual well-being helps develop an optimistic and meaningful life. We report on several cases in which body-mind-spirit integrated psychotherapy was applied to the care of clients with depressive disorders and of breast cancer survivors and their partners as well as the related efficacy of this intervention in these cases. Finally, we discuss the potential for culturally-enriched psychotherapy to help clients transform illness suffering into life-growth experiences.

Effects of a Parent-Child Interactive Program for Families on Reducing the Exposure of School-Aged Children to Household Smoking.

INTRODUCTION: Parental smoking has been identified as the major source of children's exposure to environmental tobacco smoke (ETS). Therefore, parental involvement is critical in ETS exposure prevention programs. This study examined the effects of a parent-child interactive program on reducing children's exposure to ETS at home and enhancing parents' and children's prevention strategies. METHODS: A clustered randomized controlled trial was administered to 75 families of school-aged children from six primary schools in New Taipei City, Taiwan. Families in the intervention group received a parent-child interactive intervention, and parents in the control group received written materials on tobacco hazards. Data on children's exposure and the prevention of children's exposure to ETS at home were obtained at baseline, 8-week, and 20-week or 6-month assessments. RESULTS: The percentage of children with urine cotinine levels greater than or equal to 6 ng/ml was significantly lower in the intervention group than it was in the control group at both the 8-week and 6-month assessments. The intervention significantly reduced parental smoking in the presence of children and increased parents' prevention of children's ETS exposure and children's ETS avoidance behavior from the baseline to the 20-week assessment. CONCLUSIONS: This is a preliminary study design aimed at creating a program for reducing children's ETS exposure at home. Further research to produce evidence supporting the application of the parent-child interactive program in primary schools is suggested. The theoretical basis of the intervention design can serve as a reference for nursing education and the design of health education programs.

The partner's insecure attachment, depression and psychological well-being as predictors of diurnal cortisol patterns for breast cancer survivors and their spouses.

The purpose of this study was to explore whether stress from individual's and partner's depression, anxiety, sleep disturbances, insecure attachment and meaning in life were predictors of diurnal cortisol patterns in breast cancer survivors and their spouses. Thirty-four couple dyads participated in this eight-month follow-up study. The breast cancer survivors and their spouses completed the Medical Outcomes Study Sleep scale, the Beck Depression Inventory-II, the State Trait Anxiety Inventory, the Experiences in Close Relationships-Revised scale and the Meaning in Life Questionnaire, and they collected salivary cortisol at home at the time of awakening, 30 and 45 min after waking and at 1200 h, 1700 h and 2100 h. Diurnal cortisol slopes of survivors and spouses are positively correlated. But the factors associated with diurnal cortisol patterns are different between survivors and spouses. For survivors, neither survivor individuals' nor spouses' psychosocial factors were the predictors of survivors' diurnal cortisol patterns. For spouses, the survivors' higher anxious attachment style was the main predictor of spouses' flatter diurnal cortisol patterns. In conclusion, for spouses, psychophysiological stress responses are mainly influenced by breast cancer survivors' insecure attachment. Future couple supportive care interventions can address survivors' attachment styles in close relationships in order to improve neuroendocrine functions for both breast cancer survivors and their spouses.

Factors associated with low back pain changes during the third trimester of pregnancy.

AIMS: (1) To investigate the course of pregnancy-related low back pain intensity and interference during the third trimester, and (2) to identify risk factors associated with changes in pain intensity and interference over time. BACKGROUND: Pregnancy-related low back pain is common and reaches its peak both in the prevalence and severity in the third trimester. DESIGN: A longitudinal design with consecutive sampling. METHODS: Three waves of data were collected from pregnant women in an antenatal care centre of a medical centre and a regional hospital in the northern Taiwan from February-June, 2010. Questionnaires were administered at gestational ages 28, 32 and 36 weeks. 214 women were enrolled and 179 participants completed all measures. Generalized estimating equations were used to identify the risk factors associated with changes in pain intensity and pain interference over time. RESULTS: Pain interference increased over time during the third trimester. Pain catastrophizing and pain intensity at gestational age 24 weeks and time (from 28-36 weeks) were associated with increases in pregnancy-related low back pain intensity. These same factors plus depression were associated with an increase in pregnancy-related low back pain interference. CONCLUSIONS: This study identified a number of prospective factors related to increases in pain intensity and pain interference during the third trimester. Given that both catastrophizing and depression are modifiable, the findings indicate that research examining the benefits of treatments that address these (e.g. cognitive-behavioural therapy) on pain and pain interference is warranted.