Effects of postpartum fatigue, parenting stress, and family support on postpartum depression in Chinese first-time mothers: a cross-sectional study.

PURPOSE: This study aimed to explore the levels of postpartum fatigue, parenting stress, family support, and postpartum depression (PPD) experienced by first-time Chinese mothers and to investigate their impact on PPD. METHODS: This cross-sectional survey involved 150 primigravida women attending postnatal checkups in Hebi City, Henan Province, China. Demographic data and information on environmental variables (living conditions, family relationships), postpartum fatigue, parenting stress, family support (expected vs. actual level), and PPD were collected. RESULTS: The average age of the women was 26.25 years (SD, ±3.90), with 78.7% at risk for PPD (score ≥10). Significant correlations were found between PPD and postpartum fatigue (r=.63, p<.001), parenting stress (r=.59, p<.001), and family support (r=.40, p<.001). In model 1, which examined the influence of women's demographic variables on PPD, significant factors included a poor relationship with parents (ß=.24, p=.001), a poor relationship with parents-in-law (ß=.18, p=.029), and a poor relationship with the husband (ß=.20, p=.013). When the three research variables were incorporated into model 2, the factors contributing to a higher level of PPD included a poor relationship with parents-in-law (ß=.14, p=.033), increased postpartum fatigue (ß=.37, p<.001), increased parenting stress (ß=.33, p<.001), and less family support than expected (ß=.12, p=.048). CONCLUSION: The most critical factors influencing PPD include postpartum fatigue, parenting stress, poor relationships with parents-in-law, and low family support among Chinese primiparas. To mitigate PPD levels, healthcare professionals should screen mothers for depression in outpatient clinics and offer education and counseling to both mothers and their families or companions regarding PPD.

Serial Multiple Mediation of the Marital Satisfaction and Parenting Competence in the Relationship Between Postpartum Depression and Parent-Infant Attachment in First-Time Parents With Low- and High-Risk Pregnancy Experiences: A Cross-Sectional Study.

Little is known regarding the effects of postpartum depression on parent-infant attachment in high-risk parents. Based on Mercer's theory of becoming a mother, this study aimed to (1) examine the mediating effects of marital satisfaction and parenting competence in the relationship between postpartum depression and parent-infant attachment using a serial mediation model in first-time parent couples during the first 6 months postpartum, and (2) compare the serial mediation models between parents who had experienced low-risk and high-risk pregnancies. In this cross-sectional study, a total of 194 first-time parent couples at 1 to 6 months postpartum were included. Participants completed an online survey on postpartum depression, marital satisfaction, parenting competence, and parent-infant attachment. In both low- and high-risk groups, parenting competence was a common mediator of the impact of postpartum depression on parent-infant attachment. A sequential mediation effect involving both marital satisfaction and parenting competence was observed in high-risk mothers. Our findings suggest that the adverse impacts of postpartum depression on parent-infant attachment can be mitigated by boosting parenting competence or improving the marital satisfaction in couples experiencing first high-risk pregnancy.

Effectiveness of the CANCER-AIMS intervention on nutritional status and symptom management in patients with gastric cancer following gastrectomy: A randomized controlled trial.

BACKGROUND: Dietary education and modification interventions are valuable and feasible strategies for enhancing nutritional status and managing symptoms in patients with gastric cancer following gastrectomy. In alignment with administrative policies prioritizing shorter hospital stays and enhanced postoperative self-management, the provision of a simplified nutritional management approach following gastrectomy holds promise for preventing weight loss and expanding resources for monitoring both the nutritional and symptomatic aspects of these patients. OBJECTIVE: This study evaluated the effectiveness of an integrative approach involving the five sequential steps of Conversation, Assessment, Nutrition plan, Complications, Evaluation, and Reassurance or Removal (CANCER) into Altering Intake and Managing Symptoms (AIMS), with specific focus on enhancing nutritional status and symptom management. DESIGN: A single-blind, two-arm, randomized controlled trial. SETTING: This study was conducted at a tertiary hospital in Shandong province, China. PARTICIPANTS: Patients with total or subtotal gastrectomy for gastric cancer. METHODS: The participants were randomly assigned to either the intervention or control group in a 1:1 ratio. The intervention group received a 16-week CANCER-AIMS intervention program. The control group received usual routine care dietary guidance. Questionnaires and electronic medical records of each patient were used to assess dietary intake, dietary symptoms, and subjective and objective nutritional status. Outcomes were assessed at four specific time points: the day before discharge and at 4-, 8-, and 16-weeks following hospital discharge. RESULTS: Thirty-eight participants completed the study. The findings revealed significant interaction effects between group and time for dietary intake, dietary symptoms, and nutritional status between intervention and control groups (P < 0.001). The intervention group had significantly higher dietary intake, fewer dietary symptoms, and better nutritional status post-intervention than the control group (P < 0.001). Moreover, there were significant differences in dietary intake, dietary symptoms, and nutritional status according to time in both the intervention and control groups. CONCLUSION: The CANCER-AIMS intervention for patients with gastric cancer following gastrectomy may be efficient at enhancing nutritional intake, reducing negative dietary symptoms, and thus improving both their subjective and objective nutritional status.

Psychometric testing of the Chinese version of the Perinatal Infant Care Social Support tool: a methodological study.

PURPOSE: This study aimed to translate the Perinatal Infant Care Social Support (PICSS) instrument into Chinese and to verify the reliability and validity of the translated version. METHODS: This study used a cross-sectional design to examine the reliability and validity of the Chinese version of the PICSS (C-PICSS). A cohort of 150 first-time mothers in China participated, attending hospital follow-up care at 6 weeks postpartum. Data were collected after obtaining informed consent from the mothers. RESULTS: The majority of mothers were aged between 20 and 29 years, with a mean age of 26.25 (±3.90) years. An item analysis of the 19 items in the C-PICSS showed that all items had an item-total score correlation above 0.2. This resulted in a Kaiser-Meyer-Olkin value of 0.92 and a significant Bartlett's test of sphericity (χ2=1,778.65, p<.001), confirming the suitability of the data for factor analysis. Correlation analyses revealed a strong positive relationship between infant care social support and general social support (r=.62, p<.001), and a negative relationship between infant care social support and postpartum depression (r=-.38, p<.001). Higher scores for infant care social support were associated with reporting positive relationships with their husbands (t=3.72, p<.001) and high levels of spousal involvement (t=4.09, p<.001). In terms of structural support, spouses were identified as the primary source. CONCLUSION: The research results indicate that C-PICSS is reliable and valid as an indicator of social support for infant care among Chinese mothers.

Do age, gender, and subjective health-related factors influence health-related life satisfaction in people with disabilities who are physically active?: a secondary analysis.

PURPOSE: This study explored the factors influencing the health-related life satisfaction of people with disabilities who engaged in physical activity, by age and gender. METHODS: A secondary analysis was conducted of the 2020 Third Disability and Life Dynamics Panel (2021). The participants were 2,796 people who performed regular physical activity at least once a week. The variables selected were disability-related factors (degree of disability, multiple disabilities, and type of disability), sociodemographic factors (age, gender, living alone, and mean monthly family income), and health-related factors (amount of physical activity, self-esteem, depression, chronic disease, subjective health, and health-related life satisfaction). Descriptive statistics, the chi-square test, the t-test, two-way analysis of variance, and multiple regression analysis were conducted. RESULTS: In total, 58.0% of participants were male, and 42.0% were female. For age groups, 14.4% were children/adolescents (0-19 years), 42.6% were adults (20-59 years), and 43.0% were seniors (≥60 years). The mean score for health-related life satisfaction was 5.0±2.15 out of 10. Adults and seniors whose level of physical activity met or exceeded recommendations had higher subjective health. Moreover, men had better subjective health than women in seniors. Health-related life satisfaction was higher among those who had higher self-esteem, were not depressed, did not have chronic diseases, and had better subjective health. CONCLUSION: Gender significantly influenced health-related life satisfaction in children/ adolescents and seniors. Disability-related factors were significant in adults, and health-related factors were significant in all age groups. Therefore, these factors should be considered when designing interventions to promote subjective health and health-related life satisfaction of people with disabilities.

Quality evaluation of pregnancy-related mobile applications in South Korea: a descriptive study.

PURPOSE: This study aimed to describe the characteristics of mobile applications (apps) related to pregnancy in South Korea and evaluate their quality. METHODS: We conducted a systematic search for pregnancy-related apps available in Korea in two app stores as of April 29, 2022. The quality of apps was assessed using the Korean translation of the Mobile Application Rating Scale for objective quality with four subdomains (engagement, function, aesthetics, and information) and four items for subjective quality. RESULTS: In total, 163 apps were selected and reviewed. Both the objective and subjective quality of the apps were found to be desirable, with scores exceeding 3 out of 5 (range, 34-82). All subdomain scores in the objective quality assessment were also desirable. Among the four objective quality subdomains, aesthetics received the highest scores, followed by information, function, and engagement. In terms of subjective quality, the scores for a comprehensive overall evaluation, continuous use, and recommendation exceeded 3 out of 5, with the exception of payment. Only a small number of apps (n=4, 2.9%) were backed by a reliable authority, such as an expert review. Significant differences were observed in the objective quality of apps across different content categories (F=3.86, p=.003). CONCLUSION: Most pregnancy-related apps had desirable levels of objective and subjective quality. However, app content experts seldom provide reviews. It is crucial for nurses to recommend apps to expectant mothers that offer dependable content, regularly updated with the latest information.

Middle-aged women's experiences of physical activity for managing menopausal symptoms: a phenomenological study.

PURPOSE: The purpose of this study was to comprehensively understand and describe the meaning of physical activity for managing menopausal symptoms in middle-aged women. METHODS: This study targeted middle-aged women with menopausal symptoms who participated in regular exercise at least three times a week for more than 12 weeks. Nine participants were individually interviewed via in-depth face-to-face interviews, and participatory observation was also employed. Colaizzi's phenomenological qualitative research method was applied for analysis. RESULTS: Participants were asked, "What does it means to participate in physical activity at this time of your life?" Fourteen codes, six themes, and three theme clusters were derived for the meaning of physical activity for managing menopausal symptoms these middle-aged women. The six themes were "reviving the exhausted body and mind," "being free from the yoke of pain," "being settled in life," "finding oneself and becoming altruistic," "striving while anticipating change," and "equipping the body and mind." The three theme clusters were "overcoming my past pain," "taking the initiative for today's life," and "moving towards new change." CONCLUSION: The narratives revealed that physical activity allowed women to overcome menopausal symptoms, the burden of relationships, and stress, thereby enabling them to make positive changes in their lives and have expectations for the future. Thus, physical activity was a positive force in a healthy menopausal transition for women with menopausal symptoms. The findings of this study can be used to encourage physical activity in peri-menopausal women and to develop physical activity programs for managing menopausal symptoms.

An explanatory model of quality of life in high-risk pregnant women in Korea: a structural equation model.

PURPOSE: This study aimed to develop and validate a structural model for the quality of life (QoL) among high-risk pregnant women, based on Roy's adaptation model. METHODS: This cross-sectional study collected data from 333 first-time mothers diagnosed with a high-risk pregnancy in two obstetrics and gynecology clinics in Cheonan, Korea, or participating in an online community, between October 20, 2021 and February 20, 2022. Structured questionnaires measured QoL, contextual stimuli (uncertainty), coping (adaptive or maladaptive), and adaptation mode (fatigue, state anxiety, antenatal depression, maternal identity, and marital adjustment). RESULTS: The mean age of the respondents was 35.29±3.72 years, ranging from 26 to 45 years. The most common high-risk pregnancy diagnosis was gestational diabetes (26.1%). followed by preterm labor (21.6%). QoL was higher than average (18.63±3.80). Above-moderate mean scores were obtained for all domains (psychological/baby, 19.03; socioeconomic, 19.00; relational/spouse-partner, 20.99; relational/family-friends, 19.18; and health and functioning, 16.18). The final model explained 51% of variance in QoL in high-risk pregnant women, with acceptable overall model fit. Adaptation mode (ß=-.81, p=.034) and maladaptive coping (ß=.46 p=.043) directly affected QoL, and uncertainty (ß=-. 21, p=.004), adaptive coping (ß=.36 p=.026), and maladaptive coping (ß=-.56 p=.023) indirectly affected QoL. CONCLUSION: It is essential to develop nursing interventions aimed at enhancing appropriate coping strategies to improve QoL in high-risk pregnant women. By reinforcing adaptive coping strategies and mitigating maladaptive coping, these interventions can contribute to better maternal and fetal outcomes and improve the overall well-being of high-risk pregnant women.

Do spouse burden of care, family resilience, and coping affect family function in gynecologic cancer in Korea?: a cross-sectional study.

PURPOSE: This study aimed to investigate family functioning among spouses of gynecologic cancer patients in Korea. McCubbin and McCubbin's Family Resilience Model (1993) guided the study focus on burden of care, family resilience, coping, and family functioning. METHODS: An online survey collected data from 123 spouses of gynecologic cancer patients through convenience sampling from online communities for gynecologic cancer patients in Korea. Burden of care, family resilience (social support, family hardiness, and family problem-solving communication), coping, and family functioning were measured by self-report. RESULTS: The patients (44.7%) and their spouses (47.2%) were mostly in the 41 to 50-year age group. Stage 1 cancer was 44.7%, and cervical cancer was the most common (37.4%) followed by ovarian cancer (30.9%) and uterine cancer (27.6%) regarding the cancer characteristics of the wife. Family function, burden of care, family resilience, and coping were all at greater than midpoint levels. Family functioning was positively related with social support (r=.44, p<.001), family hardiness (r=.49, p<.001), problem-solving communication (r=.73, p<.001), and coping (r=.56, p<.001). Multiple regression identified significant factors for family functioning (F=25.58, p<.001), with an overall explanatory power of 61.7%. Problem-solving communication (ß=.56, p<.001) had the greatest influence on family function of gynecologic cancer families, followed by coping (ß=.24, p<. 001) and total treatment period of the wife (ß=.17, p=.006). CONCLUSION: Nurses need to assess levels of family communication and spousal coping to help improve gynecologic cancer patients' family function, especially for patients in longer treatment.

A menopausal transition model based on transition theory.

PURPOSE: The purpose of this study was to construct a hypothetical model based on Meleis and colleagues' Transition Theory and a literature review to explain women's menopausal transition, constructing a modified model considering previous studies and model fit and testing the effects between variables. METHODS: With a correlational survey design, middle-aged Korean women aged 40 to 64 years who had experienced menopausal symptoms were recruited and filled out a self-administered study questionnaire. Measures included menopausal symptoms, resilience, social support, menopause management, menopause adaptation, and quality of life. The data were analyzed using SPSS 24.0 and AMOS 24.0. RESULTS: The model fit indices were considered acceptable: χ2 /degree of freedom=2.93, standardized root mean residual=.07, comparative fit index=.90, and parsimonious normed fit index=.73. All eight direct-effect paths-from menopausal symptoms to support and adaptation, from support to adaptation and resilience, from resilience to adaptation and management, from management to quality of life, and from adaptation to quality of life-were significant. The explanatory power of the menopause transition model was 63.6%. CONCLUSION: Women who experience menopausal symptoms may be able to maintain and improve their quality of life if menopause management and menopause adaptation are successful through resilience and social support. Future research is needed to confirm whether strengthening facilitation as a nursing intervention strategy may promote healthy response patterns.

[Association of postpartum depression with postpartum posttraumatic stress disorder in Korean mothers: a longitudinal survey]. / 한국 산모의 산후 우울과 산후 외상 후 ìŠ¤íŠ¸ë ˆìŠ¤ìž¥ì• ê´€ë ¨ì„±: ì¢ ë‹¨ì  연구.

Purpose: This study aimed to determine the level of postpartum posttraumatic stress disorder (PTSD) and postpartum depression (PPD) in Korean mothers with healthy babies and to explore the factors related to postpartum PTSD. Methods: This study used a longitudinal survey design to explore the levels and association of PPD and PTSD. Two hundred women were recruited during pregnancy and the data were collected via online survey from 166 mothers (84% retained) who gave birth to healthy babies, at two postpartum periods: Fear of childbirth was assessed at the 1st week; and spousal support, PPD, and postpartum PTSD were surveyed at the 4th week postpartum. Descriptive statistics, t-test, one-way analysis of variance, Chi square test, and multiple regression were done. Results: The mean age of mothers was 33.12 (±3.97) years old. Postpartum PTSD was low (8.95±6.49) with 1.8% (n=3) at risk (≥19). PPD was also low (6.68±5.28) and 30.1% (n=50) were identified at risk (≥10). The comorbid rate of PPD with PTSD was 6%. Mothers who did not have a planned pregnancy had higher scores of PPD (t=-2.78, p=.008), whereas spousal support and PPD had negative relationship (r=-.21, p=.006). The overall explanatory power for postpartum PTSD was 55.2%, of which PPD was the only significant variable (ß=.76, t=13.76, p<.001). Conclusion: While only 1.8% was at risk of postpartum PTSD at 4 weeks postpartum, PPD prevalence was 30.1% and PPD was the only influential factor of postpartum PTSD. Assessment and counseling of PPD are required as well as screening for postpartum PTSD. More research is also needed on postpartum PTSD in Korean women.

Corrigendum: Factors influencing prenatal and postpartum depression in Korea: a prospective cohort study.

[This corrects the article on p. 326 in vol. 27.].

Predictors of Antenatal Depression in Pregnant Couples.

Pregnant women and their partners are at an increased risk of antenatal depression. Therefore, this cross-sectional study of data from 116 couples investigated predictors of maternal and paternal antenatal depression using sociodemographic data, women's risk factors for depression during the antenatal period, women's perceived stress, and antenatal depression in the other partner. Pregnant women had higher depression scores (7.4 ± 4.7) and a higher frequency of being at high risk for depression (25.9%) than their spouses (4.6 ± 3.5, 9.5%). Multiple linear regression analysis revealed that the statistically significant predictors of antenatal depression in pregnant women were perceived stress (ß = .45, p < .001) and antenatal depression risk factors (ß = .30, p = .002) and in spouses, women's antenatal depression risk factors (ß = .29, p = .013). The present findings suggest that nurses should intervene to mitigate the risk of maternal antenatal depression and perceived stress to prevent depression in pregnant couples.

The Impact of Antepartum Depression and Postpartum Depression on Exclusive Breastfeeding: A Systematic Review and Meta-Analysis.

The aim of this study was to systematically review the impact of antepartum depression on exclusive breastfeeding. A total of 15 studies were included in the review and 12 studies were used for the meta-analysis. The mean values of antepartum depression indicated that women who breastfed exclusively between 3 and 6 months had less antepartum depression symptoms (Mean Difference = -0.55, 95% CI = -0.76 to -0.35). The analysis also showed that the existence of antepartum depression was negatively related to continuing exclusive breastfeeding for longer than 3 months postpartum as well as for 8 weeks postpartum (OR = 0.48, 95% CI = 0.26-0.88 and OR = 0.83, 95% CI = 0.75-0.91, respectively). The cumulative evidence is conclusive that antepartum depressive symptoms are negatively associated with exclusive breastfeeding, particularly between 3 and 6 months postpartum. This review supports the necessity of screening and follow-up for depression throughout the perinatal period to promote exclusive breastfeeding for 6 months.

Depression and stress in Korean parents: A cohort study.

AIM: This study identified the level of depression and stress in couples experiencing pregnancy and childbirth. BACKGROUND: Married couples who experience pregnancy and delivery, deal with psychological changes during the parenthood transition. If they do not adapt well, they experience negative emotions that negatively affect them and their child. Therefore, the incidence and changing patterns of depression among couples need to be explored. METHODS: Using a prospective cohort study design, the researchers collected the couples' depression and stress levels 6 times. This study included 219 prenatal pregnant women, 181 spouses during pregnancy in the prenatal period, 178 postpartum mothers, and 125 spouses after childbirth. The levels of depression and stress were investigated using the Edinburgh Postnatal Depression Scale and Perceived Stress Scale. RESULTS: The incidence rate of prenatal depression was 10.5- 21.5% in pregnant women and 10.5-12.7% in their spouses. After childbirth, the incidence rate of depression was 21.3- 32.0% in postpartum women and 6.4-10.4% in their spouses. The levels of depression and stress varied from the prenatal to the postpartum period, showing different patterns between women and their spouses. Significantly, the emotional patterns in the couples were different as far as parity was concerned. CONCLUSIONS: The levels of depression and stress in couples continuously changed during the prenatal and postpartum periods and the patterns differed as well. Even couples who experience a healthy pregnancy and childbirth experience negative emotional changes. Therefore, timely nursing management will alleviate stress and depression not first-time by first-time parents.

Effects of Nurse Navigators During the Transition from Cancer Screening to the First Treatment Phase: A Systematic Review and Meta-analysis.

PURPOSE: Implementation of nurse navigators during cancer screening to the first treatment visit may facilitate early diagnosis and treatment. This study aims to demonstrate the evidence of the effects of nurse navigators during cancer screening in the first treatment phase. METHODS: Eleven electronic databases were searched, including PubMed, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, Web of Science, ScienceDirect, PsycINFO, KoreaMed, KISS, RISS, and DBPIA. The final search was completed in August 2021. Two reviewers independently screened and selected studies, extracted data, and conducted a quality assessment. Data to evaluate the effects of nurse navigators was analyzed through meta-analysis and narrative summary. Subgroup analyses were performed. RESULTS: A total of 16 studies was included. With low to moderate quality of evidence, nurse navigators had favorable effects on improving the timeliness of care during screening during the first treatment visits (MD = 20.42, 95% CI = 8.74 to 32.10, p = .001). Additionally, 13.0% to 45.0% of nurse navigated patients were more likely to complete cancer care services, although insignificant effects were observed. Study participants from individual studies reported a high satisfaction to the nurse navigators. Subgroup analyses indicated that nurse navigators working as key members in multidisciplinary programs had the greatest effect on reducing waiting times. CONCLUSION: Nurse navigators improve cancer patient outcomes by providing more timely care. Additionally, nurse navigators have the substantial potential to increase completion rates to cancer care services and patient satisfaction. For facilitating multidisciplinary care, the use of nurse navigators is highly recommended in the future.