Stress, anxiety, intolerance of uncertainty, and psychological well-being characteristics of pregnant women with and without threatened miscarriage: a case-control study.

The aim of this study was to examine the stress, anxiety, intolerance of uncertainty, and psychological well-being of pregnant women with and without threatened miscarriage. This is a case-control study. The research was carried out between January 2022 and March 2022 in the early pregnancy service and obstetrics clinic of the only training and research hospital in a province in the Central Anatolian Region of Turkey. Two hundred and one pregnant women with threatened miscarriage constituted the study group and 201 pregnant women without threatened miscarriage constituted the control group. A total of 402 pregnant women were included in the study. Stress, anxiety, and intolerance of uncertainty were found to be important risk factors affecting the psychological well-being of pregnant women with threatened miscarriage at a rate of 52% (F = 63,196, p < 0.001). In addition, the pregnant women with threatened miscarriage had higher levels of stress, anxiety, and intolerance of uncertainty, and their psychological well-being was considerably lower compared to pregnant women without threatened miscarriage (p < 0.05). There was a moderate and negative relationship between psychological well-being and intolerance of uncertainty (p < 0.05). It was determined that stress, anxiety, and uncertainty of pregnant women with threatened miscarriage were considerably higher compared to controls, and their psychological well-being was adversely affected. Health professionals should evaluate the levels of anxiety, stress, intolerance of uncertainty, and psychological well-being of pregnant women, especially in the routine follow-up of pregnant women with threatened miscarriage, and they should provide holistic care, not only physiologically but also bio-psychosocially.IMPACT STATEMENTWhat is already known on this subject? Although there are many studies on the emotional and psychological effects of miscarriage, there are limited studies on the effect of threatened miscarriage on the mental health of pregnant women.What do the results of this study add? Stress, anxiety, and intolerance to uncertainty were found to be important associated risk factors that negatively affect the psychological well-being of pregnant women with threatened miscarriage. It was determined that the pregnant women with threatened miscarriage had higher levels of stress, anxiety, intolerance to uncertainty, and their psychological well-being was much lower than the pregnant women without threatened miscarriage. It was determined that there was a moderate and negative relationship between the mean psychological well-being of pregnant women and the mean scores of intolerance to uncertainty.What are the implications of these findings for clinical practice and/or further research? This is the first case-control study to examine the determination of stress, anxiety, intolerance to uncertainty and psychological well-being of pregnant women with and without threatened miscarriage. Health professionals should evaluate the anxiety, stress, intolerance of uncertainty levels and psychological well-being of pregnant women, especially in the routine follow-up of risky pregnant women, and should provide holistic care not only physiologically but also bio-psychosocially to these pregnant women with a holistic approach.

Determination of Dyadic Adjustment, Marriage and Sexual Satisfaction as Risk Factors for Women with Lifelong Vaginismus: A Case Control Study.

This study was conducted to assess dyadic adjustment, marriage, and sexual satisfaction as risk factors for women with lifelong vaginismus. This is a case-control study. A total of 142 women were included in the study: 71 women with a diagnosis of lifetime vaginismus constituted the study group and 71 women without a history of vaginismus/painful sexual activity constituted the control group. Data were collected using a questionnaire and the Revised Dyadic Adjustment Scale (RDAS), the Marriage Satisfaction Scale (MSS), and the Golombok-Rust Inventory of Sexual Satisfaction (GRISS). Duration of marriage (OR = 1.344), frequency of sexual intercourse (OR = 0.059), marital satisfaction (OR = 1.450), sexual satisfaction (OR = 0.901), and consensus (OR = 1.749), which is a sub-dimension of RDAS, were found to be risk factors increasing likelihood of vaginismus by 83% (χ2 = 140.191, p < .001). In addition, those with low level of education, diagnosed with a psychological disorder (anxiety, depression, etc.), who found their spouse's body disgusting, who scored lower in MAS sub-dimensions, and who received lower total score in the RDAS and its satisfaction subdimension were more likely to have vaginismus (p < .05). Duration of marriage, sexual intercourse frequency, sexual satisfaction, marital satisfaction, and consensus are important risk factors for vaginismus. It may be incomplete to consider vaginismus only as a vaginal penetration problem. Women's demographic characteristics, dyadic adjustment, and marital and sexual satisfaction should be handled in a holistic manner.

Midwives' experiences of witnessing traumatic hospital birth events: A qualitative study.

AIMS AND OBJECTIVES: The aim of this study was to investigate in detail the traumatic birth experiences of midwives in the delivery rooms, and their attitudes, reactions, and coping strategies. METHODS: The design of the study is descriptive and the purposive sampling method was used. This approach is ideal for a preliminary exploration of the nature of a phenomenon. Between October 2018 and January 2019, semi-structured interviews were conducted with a purposeful sample of midwives. The research was carried out with the participation of 29 midwives, who work in labour and birth room. They were asked to describe a particular stressful situation they had experienced during the birth process, their emotions about the event, and their coping strategies and support systems. All interviews were digitally recorded, stored in a database, and transferred to MAX Qualitative Data Analysis 18.1.0 for analysis. FINDINGS: As a result of the content analysis, three main themes emerged: psychological impact, defensive practice, and expectations in terms of support from the hospital. It was revealed that, after the traumatic birth, midwives experienced highly emotional exhaustion in the form of sadness, flashbacks, guilt, fear, and empathy, and they performed an increasingly defensive practice. During the interviews, we observed that 19 midwives needed psychological support. Besides, midwives explicitly stated that they were not prepared enough for traumatic events and that most traumatic births were simply ignored in their workplace. Eventually, it was determined that midwives received support mostly from their colleagues in case of a traumatic birth. CONCLUSION(S): Midwives need to feel valued and be supported by their institutions in coping with emotional stress. Therefore, performing clinical inspections by experienced or specialist midwives may serve as a supporting framework for reducing defensive interventions.

The relationship between posttraumatic stress symptoms of maternity professionals and quality of work life, cognitive status, and traumatic perinatal experiences.

PURPOSE: The purpose of this study was to determine the relationship between posttraumatic stress symptoms of maternity nursing/midwife and their quality of work life, cognitive distortions, and traumatic perinatal experiences. METHODS: A descriptive, cross-sectional survey design was used. Two hundred and sixty-six maternity nurses/midwives employed in maternity units of hospitals in a province located in the Central Anatolia Region of Turkey were included in the study. RESULTS: 37.2% of the maternity nurses/midwives met the criteria for posttraumatic stress disorder (% 95 CI [31.6, 43.2]). Previous birth-related traumatic experiences, transferring to another unit, and negative cognitions about the self-increase the risk of development of posttraumatic stress disorder by 63% (F = 7.638, P < 0.001). A positive correlation was found between the outcome variable PTS total score and the following predictors: the number of years in the profession, the number of traumatizing events, quality of work life, burnout symptoms, compassion fatigue, posttraumatic cognition, negative cognition about the world, and negative cognition about the self. It was found that those maternity nurses/midwives who were not happy with their profession, who witnessed a traumatic incident, who transferred to another unit, who considered to quit the profession, who had a history of a psychological disorder, and those lacked social life were more sensitive to posttraumatic stress symptoms. CONCLUSION: These outcomes have significant consequences for both personal and professional well-being of the maternity nurses/midwives and the welfare of the workforce. To prepare maternity nurses/midwives for such exposures, to support maternity nurses/midwives following traumatic perinatal events, and to provide effective intervention for those with significant symptoms, organizational strategies are necessary.

The Effect of Reflexology on Lactation and Postpartum Comfort in Caesarean-Delivery Primiparous Mothers: A Randomized Controlled Study.

AIM: This study aimed to investigate the effect of reflexology on lactation and postpartum comfort in primiparas giving births through caesarean section. METHODS: This randomized controlled trial was conducted in 100 women with first birth through caesarean section between May 2016 and May 2017. Expectant mothers were randomly included into an intervention and a control group. The intervention group consisted of mothers in whom reflexology was performed three times per day at every eight hours for 30 min for 3 days. RESULTS: The mean scores of the breastfeeding chart system and breastfeeding satisfaction scores of the mothers in the intervention group were significantly higher than those of the controls, and the first lactation period of the mothers in the intervention group was shorter than that of the controls. Mean breast-tension, breast-heat, and breast-pain scores were similar in both groups on day 1; however, a significant increase was seen the intervention group on days 2 and 3, compared to those in the controls. The mean scores of the Postpartum Comfort Questionnaire in the intervention group were significantly better than those of the controls. CONCLUSIONS: Reflexology starts lactation earlier in mothers giving birth via caesarean section, supports the breastfeeding period, and increases mothers' postpartum comfort.