RESUMEN
Background: The significant changes experienced by university students in their training are inherent to educational processes. Social isolation caused by the COVID-19 pandemic, online education and the reopening of higher-education institutions produced substantial variations in the lifestyle of university students in health sciences and generated academic stress and perceived stress. This study was conducted at the National University of Chimborazo (UNACH), a public institution located in Riobamba, central Ecuador, the diverse student's population provided an ideal setting for examining the interplay between academic and perceived stress, lifestyle factors, and learning modalities. The research focused on health sciences students across six academic programs. The university's geographical position and demographic characteristics offered a representative sample for investigating these factors within the context changing. Aim: To compare academic and perceived stress and university students' lifestyles at two different periods: (1) during the mandatory social confinement caused by the COVID-19 pandemic with an online learning modality (T1); (2) in the post-pandemic period with a return to face-to-face activities (T2). Design: An observational, analytical, quantitative, and longitudinal study. Participants: Students from six programs (Nursing, Physiotherapy, Clinical Laboratory, Medicine, Dentistry, and Clinical Psychology) from the Faculty of Health of the National University of Chimborazo-Ecuador (n = 2,237) participated voluntarily, the students had one mean age of M = 21.31 (SD = 2.36) at T1 and M = 22.94 (SD = 2.40) at T2. Non-probability convenience sampling was employed due to the accessibility of the student population and the importance of including the maximum number of relevant individuals within the study population. Methods: The following instruments were used: Nola Pender's Lifestyle Profile Questionnaire, Cognitive Systemic Inventory for the study of academic stress, and Cohen's Perceived Stress Scale. Results: In T1 and T2, students reported high levels of stress, and increased unhealthy lifestyle increased with the return to classrooms. Additionally, upon returning to face-to-face activities (T2), the mean score applied to the responses of Nola Pender's Lifestyle Profile Questionnaire decreased from M = 113.34 (SD = 23.02) to M = 107.2 (SD = 29.70; p < 0.001). There was significant difference (p < 0.001) in academic stress in T1 [M = 66.25 (SD = 15.66)] and T2 [M = 64.00 (SD = 17.91)]. Conclusions: Upon returning to university classrooms (T2), the number of students who reported an "unhealthy" lifestyle increased. Academic stress was high in T1 and T2 and was reported higher in online activities during social isolation.
Asunto(s)
COVID-19 , Estilo de Vida , Estrés Psicológico , Humanos , Ecuador/epidemiología , Masculino , COVID-19/epidemiología , COVID-19/psicología , Femenino , Estudios Longitudinales , Universidades , Adulto Joven , Adulto , Educación a Distancia/estadística & datos numéricos , Estudiantes del Área de la Salud/estadística & datos numéricos , Estudiantes del Área de la Salud/psicología , Encuestas y Cuestionarios , SARS-CoV-2RESUMEN
The global health emergency generated by the COVID-19 pandemic (caused by the SARS-CoV-2 virus) led to the implementation of extraordinary measures such as confinement and isolation in many countries to mitigate the spread of the virus. (1) This study analyzes the lifestyles and academic and perceived stresses of university students of health sciences during the period of online learning due to the COVID-19 pandemic. The relationship between lifestyles and academic stress was examined. (2) A parallel mixed-method convergent study was conducted, with a correlational non-experimental design. Quantitative and qualitative data were collected and analyzed in parallel, with parametric and nonparametric testing for quantitative data and Miles and Huberman's approach to qualitative analysis. The qualitative findings complemented the quantitative results. The number of students who participated in this study was 2734, from six programs in health, nursing, medicine, clinical laboratory, physiotherapy, dentistry, and clinical psychology at the University of Chimborazo, Ecuador. (3) Overall, the health science students had "Unhealthy or health-compromising lifestyles", medical students being the ones who have healthier lifestyles. However, more than 80% experienced and perceived stress during the period of online learning and social isolation due to the pandemic, women being the ones who experienced it at a higher level. (4) The online learning modality during the COVID-19 pandemic modified lifestyles and generated stress in health science students, due to changes in daily routines, sedentary lifestyle, and stress, as a result of social isolation. Therefore, the students prefer face-to-face teaching, perceived as enabling more enriching interactions with their teachers and peers and the opportunity to develop essential practical skills in their health practice.
RESUMEN
BACKGROUND: Approximately 10 to 20% of pregnant women worldwide experience perinatal depression (PND), a depressive episode with onset during pregnancy or after childbirth. We performed a systematic review to identify, summarize and discuss studies on inflammatory biomarkers described in relation to PND. METHOD: Inclusion criteria defined the selection of observational studies written in English, French, Spanish or Portuguese, that evaluate analytical levels of inflammatory molecules (protein levels) in biological fluids in women, with a diagnosis of depression using ICD/DSM diagnostic criteria or depressive symptoms assessed by standardized psychometric instruments, during pregnancy and/or postpartum. Case reports, experimental studies, reviews, qualitative analysis, meta-analysis, gray literature or replicated data were excluded. Three electronic databases were used for search (Pubmed, Web of Science and PsychInfo) and quality assessment of selected studies were performed using the Newcastle-Ottawa Scale. Data extraction included study design; number of subjects; obstetric information; tools and timepoints of depression and inflammatory markers assessment. RESULTS: 56 studies (sample size for cross-sectional and case-control studies ranging from 10 to 469; sample size for longitudinal studies ranging from 26 to 467), where the major aim was to analyze the association between depression and inflammatory biomarkers during pregnancy and postpartum period were included in this systematic review. Overall, the findings of our systematic review lend support to the hypothesis that several inflammatory markers may be associated with peripartum depressive symptoms. The associations were somewhat different looking at pregnancy compared to the delivery time-point and postpartum, and mainly referred to increased levels of IL-6, IL-8, CRP and TNF-α among depressed. DISCUSSION: In summary, our systematic review findings provide evidence supporting the hypothesis that several inflammatory markers may correlate with peripartum depressive symptoms. However, our work also highlighted notable differences in the timing of biological sampling for inflammatory markers and in the methodologies used to assess depression during the perinatal period. Additionally, variations were observed in how inflammatory biomarkers and depression were approached, including their classification as exposure or outcome variables, and the timing of assessments. It is essential for future research to investigate the influence of biological fluids and the timing of assessments for both inflammatory biomarkers and depression to gain a deeper understanding of their association. This comprehensive exploration is pivotal for elucidating the intricate relationship between inflammation and perinatal depression.
Asunto(s)
Biomarcadores , Humanos , Femenino , Embarazo , Biomarcadores/sangre , Complicaciones del Embarazo/psicología , Complicaciones del Embarazo/diagnóstico , Depresión/diagnóstico , Depresión/sangre , Inflamación , Depresión Posparto/sangre , Depresión Posparto/diagnósticoRESUMEN
Although scales that evaluate postpartum stress exist, they lack specificity in maternal postpartum stress. The MPSS was created because there was a need to assess maternal stress during the postpartum stage. The introduction of the MPSS has enriched the evaluation tools for postpartum stress and has helped understand maternal stress at various postpartum time points and identify women at high risk for postpartum stress during this period. The aim was to translate the MPSS into Spanish and study its psychometric properties. Postpartum women (N = 167) with a mean age of 34.26 (SD = 4.71) were involved in this study. In addition to the MPSS, a battery of instruments was administered: a demographic sheet, the Birth Satisfaction Scale-Revised (BSS-R) and the Edinburgh Postnatal Depression Scale (EPDS). The MPSS data were analyzed, checking item communality first. As a result, three items showed unsatisfactory communality values (h2 < 0.40). Confirmatory Factor Analysis was conducted, comparing factor models using the full pool of MPSS items or the version without items with unacceptable communality. As a result, the original three-factor structure was endorsed on the Spanish MPSS, with better fit indices when removing items with low communality (RMSEA = 0.067, CFI = 0.99, TLI = 0.99). The reliability of this version was satisfactory (ω = 0.93). Finally, group comparisons for some perinatal variables were performed, showing no significant differences between groups of interest (p = 0.05 and above). To conclude, the MPSS will contribute to the existing literature, having a wider capacity to assess perinatal mental health difficulties in Spanish-speaking populations.
RESUMEN
Fundamentos: las infecciones de transmisión sexual (its) son infecciones causadas por más de treinta bacterias, virus y pa-rásitos diferentes, que se transmiten por contacto sexual, incluido el coito vaginal, anal o bucal, aunque algunas infecciones también pueden transmitirse de la madre al hijo durante el embarazo, el parto y la lactancia. Según la organización mundial de la salud, una de las principales poblaciones de riesgo para la adquisición de estas infecciones son los/las trabajadores/as del sexo y sus clientes. El objetivo de este trabajo fue analizar los factores de riesgo en la adquisición de infecciones de transmisión sexual en la población de trabajadores/as del sexo.métodos: se realizó una revisión sistemática mediante búsqueda en scopus, pubmed, cinahl, medline, lilacs e ibecs, de estudios observacionales, longitudinales y mixtos realizados en trabajadores/as del sexo que fueron publicados entre enero de 2011 y marzo de 2021, obteniendo una muestra final de cuarenta y tres artículos. La herramienta de evaluación de métodos mixtos (mixed methods assessment tool) fue utilizada para evaluar la calidad metodológica de los trabajos. Resultados: después de analizar la bibliografía se obtuvieron once grupos de factores de riesgo relacionados con la adquisición de its, siendo estos factores económicos, relacionados con las prácticas sexuales, consumo de drogas, trabajo sexual, educación, problemas de salud, país de origen y movilidad, pareja, edad, violencia y otros factores no pertenecientes a las anteriores categorías.conclusiones: las/os profesionales del sexo tienen numerosas características y comportamientos que les convierten en una población vulnerable a las its. Destacan los años ejerciendo la prostitución, el consumo de drogas, el número de parejas y el uso del preservativo, siendo estos factores clave para futuras estrategias de prevención e intervención, así como de investigación.(AU)
Background: sexually transmitted infections (sti), as their name suggests, are infections caused by more than thirty different bacteria, viruses, and parasites and are transmitted through sexual contact, including vaginal, anal, or oral intercourse, although some sexually transmitted infections can also transmitted from mother to child during pregnancy, childbirth and lactation. According to world health organization, one of the main populations at risk for acquiring these diseases are sex workers and their clients. Due to the high prevalence, the characteristics and behaviors that favor the development of these diseases are analyzed. The main objective of this paper was to analyze the risk factors in the acquisition of sexually transmitted diseases in the population of sex workers. Methods: a literature search was conducted in scopus, pubmed, cinahl, medline, lilacs and ibecs, of observational, longitudinal and mixed methods studies conducted in sex workers and published between january 2011 and march 2021, with a final sample of four-ty-three articles. The mixed methods assessment tool (mmat) was used to assess the methodological quality of the papers.results: after analyzing the literature, eleven groups of risk factors related to the acquisition of sexually transmitted diseases were obtained, these being economic factors, factors related to sexual practices, drug use, sex work, education, health problems, country of origin and mobility, partner, age, violence and other factors not belonging to the previous categories.conclusions: sex workers have numerous characteristics and behaviors that make them vulnerable to sexually transmitted in-fections. Of note are years of prostitution, drug use, number of partners and condom use, which are key factors for future prevention and intervention strategies, as well as research.(AU)
Asunto(s)
Humanos , Masculino , Femenino , Enfermedades de Transmisión Sexual , Trabajadores Sexuales , Conductas de Riesgo para la Salud , Riesgo a la Salud , Enfermedades Virales de Transmisión Sexual , Enfermedades Bacterianas de Transmisión Sexual , Grupos de Riesgo , Trabajo Sexual , Factores de Riesgo , Salud PúblicaRESUMEN
BACKGROUND: Maternal stress and psychopathology have a negative effect on mothers and neonates. Maternal stress may affect neonatal growth and development both physically and psychologically. PURPOSE: To study the impact of pandemic-related pregnancy stress and maternal psychopathological symptoms during the COVID-19 lockdown in 2020 on neonatal development. METHODS: A two-phase prospective study was carried out on a sample of 181 pregnant women ranged from 18 to 40 years old in Spain (Europe). Phase 1: Pandemic-related pregnancy stress (PREPS), Prenatal Distress Questionnaire (PDQ), Perceived Stress Scale (PSS) and the revised version of the Symptom Checklist-90 (SCL-90-R) were used to assess psychological symptoms during the lockdown. In the follow-up (Phase 2), obstetric, birth-related and anthropometric variables were collected from 81 pregnant women-neonates dyads. RESULTS: Primiparous women showed higher psychopathological symptoms and higher levels of pandemic-related pregnancy stress than multiparous women. A multiple linear regression model showed that pandemic-related pregnancy stress could predict the length of neonate by adjusting for maternal age and gestational age, especially for primiparous women. IMPLICATIONS FOR RESEARCH: Studies assessing neonates development should evaluate the long-term effect of the COVID-19 pandemic on neonates´ length. IMPLICATIONS FOR PRACTICE: States the relation between pandemic-related pregnancy stress and neonatal development by being able to track the effects on neonates whose mothers had high levels of stress during the COVID-19 pandemic.
RESUMEN
Background: Perinatal depression is a major public health problem, with an estimated prevalence of approximately 15% during the first postpartum year. Despite the high prevalence of postpartum depression, there is no consensus regarding assessment and treatment in the Spanish context. The General Council of Psychology of Spain convened a working group of experts in the field, including both academics and healthcare professionals, to review and propose recommendations based on evidence and best practices that could be applied in the Spanish context. Method: A literature search was completed in various databases (e.g., Medline, PsychInfo) including a combination of terms related to peripartum depression (PPD) assessment and diagnosis, prevention, treatment, and cost-effectiveness. A narrative synthesis of the literature has been conducted together with a critical overview of PPD with a special focus on the Spanish context. Results: In this consensus report, developing questions including prevalence and assessment tools, comparative effectiveness of preventive and treatment interventions, and cost-effectiveness of PPD management have been analyzed. Conclusions: The General Council of Psychology of Spain network advocates the establishment of compulsory screening protocols in all the autonomous regions. Also, it is necessary to promote the inclusion in maternal education of programs for the promotion of mental well-being and selective/indicated prevention carried out by a psychology professional with specialized training in the area. This consensus document also promotes the presence of a psychology professional with specialized training in the area. (AU)
Antecedentes: La depresión perinatal es un importante problema de salud pública, con una prevalencia estimada de aproximadamente el 15% durante el primer año posparto. A pesar de la gran prevalencia de depresión posparto (DPP), no existe consenso sobre la evaluación y el tratamiento en el contexto español. El Consejo General de Psicología de España convocó a un grupo de trabajo de expertos en la materia, tanto académicos como profesionales sanitarios, para revisar y proponer recomendaciones basadas en evidencias y mejores prácticas que puedan aplicarse en el contexto español. Método: Se realizó una búsqueda bibliográfica en varias bases de datos (p. ej., Medline, PsychInfo) que incluía una combinación de términos relacionados con la evaluación y el diagnóstico de la DPP, prevención, tratamiento y coste-eficacia. Se ha realizado una síntesis narrativa de la literatura junto con una visión crítica de la DPP con un enfoque especial en el contexto español. Resultados: Las preguntas de desarrollo que incluyen prevalencia y herramientas de evaluación, la eficacia comparativa de las intervenciones preventivas y de tratamiento y la relación coste-efectividad de la gestión de la PPD se han analizado en este informe de consenso. Conclusiones: La red del Consejo General de Psicología de España aboga por el establecimiento de protocolos obligatorios de cribado en todas las Comunidades Autónomas. Asimismo, es necesario promover la inclusión en la educación materna de programas de promoción del bienestar mental y la prevención selectiva indicada llevadas a cabo por un profesional de la psicología con formación especializada en el área. (AU)
Asunto(s)
Humanos , Depresión Posparto/tratamiento farmacológico , Depresión Posparto/economía , Depresión Posparto/epidemiología , Depresión Posparto/prevención & control , España , PrevalenciaRESUMEN
Background: Infertility generates high levels of stress to women. The aim was to explore optimism and resilience among women undergoing assisted reproductive technology (ART). Method: Participants were recruited in a private fertility clinic. The sample consisted of 229 women under medical treatment for fertility who completed the following self-report instruments: a sociodemographic and clinical questionnaire, Resilience Scale (RS), Life Orientation Test (LOT-R), Perceived Stress Scale (PSS), and STAI State and STAI Trait. Results: Our data revealed that high resilience levels were associated with a reduced psychological stress (β = .02, p < .001, 95% CI [.34, .13]). A significant negative correlation between perceived stress and resilience (r = -.320, p = .001) was found. Conclusion: The findings highlight the protective mediating role of resilience when women are confronted with the negative effects of infertility diagnosis and assisted reproductive technology (ART), and therefore the potential utility of resilience to reduce infertility-specific stress. (AU)
Antecedentes: La infertilidad genera un nivel de estrés elevado en la mujer. El objetivo era explorar el optimismo y la resiliencia en las mujeres que se someten a técnicas de reproducción asistida (TRA). Método: Los participantes fueron reclutados en una clínica de fertilidad privada. La muestra estuvo conformada por 229 mujeres en tratamiento médico para de fertilidad que cumplimentaron los siguientes instrumentos de autoinforme: cuestionario sociodemográfico y clínico, Escala de Resiliencia (RS), Test de Orientación a la Vida (LOT-R), Escala de Estrés Percibido (PSS) y STAI Estado y Rasgo. Resultados: Los datos revelaron que un nivel elevado de resiliencia se asociaba con menos estrés psicológico (β = .02, p < .001, IC del 95 % [.34, .13]). Se obtuvo una correlación negativa significativa entre estrés percibido y resiliencia (r = -.320, p = .001). Conclusión: Los hallazgos resaltan el papel mediador protector de la resiliencia cuando las mujeres se enfrentan a los efectos negativos del diagnóstico de infertilidad y las técnicas de reproducción asistida (TRA) y, por lo tanto, la utilidad potencial de la resiliencia para reducir el estrés específico de la infertilidad. (AU)
Asunto(s)
Humanos , Femenino , Adulto Joven , Adulto , Técnicas Reproductivas Asistidas/psicología , Resiliencia Psicológica , Optimismo , Estrés Psicológico , Ansiedad , España , Infertilidad/tratamiento farmacológico , Autoinforme , Encuestas y CuestionariosRESUMEN
Rationale: Pregnant women are especially vulnerable to mental health problems, including stress, anxiety, and depression. This risk has been increased during the COVID-19 pandemic and differences in psychological symptoms in pregnancy and postpartum before and during COVID-19 exists. Mental health problems can have adverse effects on both the woman, and the neonate, including miscarriages, premature births, low birth weight, and higher rates of cesarean sections and instrument-assisted deliveries. Aim: To evaluate the prevalence of psychological symptoms of pregnant women before and during the COVID-19 pandemic. Method: A cross-sectional study was carried out to assess the psychological profile in a sample of pregnant women selected before the pandemic and a sample of women studied during the first wave of the pandemic. A total of 122 women were selected prior to the pandemic and 181 women during the COVID-19 outbreak. The Symptom Checklist-90 Revised (SCL-90-R) was used to assess depression and anxiety during pregnancy and in the postpartum period. Results: The prevalence of symptoms of depression and anxiety during pregnancy were higher in the sample of women studied during the pandemic (SCL-90-R: M = 54.6 vs. 42.6 and M = 62.6 vs. 51.7 respectively). In the postpartum the difference between both samples of women was even higher for depression and anxiety (SCL-90-R: M = 50.4 vs. 35.0 and M = 51.3 vs. 36.0 respectively). Being a pregnant woman at the COVID-19 outbreak was directly associated with a higher score of depression symptoms (aOR = 8.67, 95% CI [3.26, 23.02], p < .001). Anxiety during childbirth was more frequently reported by women before the pandemic (aOR = 5.13, 95% CI [2.53, 10.44], p < .001). The variable stage (before /during pandemic) was also associated with having a clinical SCL-90-R score above 70 (aOR = 7.61, 95% CI [2.7, 21.47], p < .001). (AU)
Justificación: Las mujeres embarazadas son especialmente vulnerables a los problemas de salud mental, como el estrés, la ansiedad y la depresión. Este riesgo se ha incrementado durante la pandemia de COVID-19, habiendo diferencias en los síntomas psicológicos en el embarazo y el puerperio antes y después de la pandemia. Los problemas de salud mental pueden tener efectos perjudiciales tanto en la mujer como en el recién nacido, como abortos espontáneos, partos prematuros, bajo peso al nacer y tasas más altas de cesáreas y partos asistidos. Objetivo: Evaluar la prevalencia de síntomas psicológicos de gestantes antes y durante la pandemia de COVID-19. Método: Se realizó un estudio transversal para evaluar el perfil psicológico en una muestra de mujeres embarazadas seleccionadas antes de la pandemia y una muestra de mujeres estudiadas durante la primera ola de la pandemia. Se seleccionó un total de 122 mujeres antes de la pandemia y 181 mujeres durante el brote de COVID-19. Se utilizó la Inventario de Verificación de Síntomas-90 Revisada (SCL-90-R) para evaluar la depresión y la ansiedad durante el embarazo y el puerperio. Resultados: La prevalencia de síntomas de depresión y ansiedad durante el embarazo fue mayor en la muestra de mujeres estudiadas durante la pandemia (SCL-90-R: M = 54.6 vs. 42.6 y M = 62.6 vs. 51.7 respectivamente). En el postparto la diferencia entre ambas muestras de mujeres fue aún mayor para depresión y ansiedad (SCL-90-R: M = 50.4 vs. 35.0 y M = 51.3 vs. 36.0 respectivamente). Ser mujer embarazada en el brote de COVID-19 se asoció directamente con una mayor puntuación de síntomas de depresión (aOR = 8.67, IC 95% [3.26, 23.02, p < .001). Las mujeres manifestaron ansiedad durante el parto con mayor frecuencia antes de la pandemia (aOR = 5.13, IC 95% 2.53, 10.44], p < .001). La variable estadio (antes/durante la pandemia) también se asoció con tener una puntuación clínica SCL-90-R superior a 70 (aOR = 7.61, IC 95% [2.7, 21.47], p < .001). (AU)
Asunto(s)
Humanos , Femenino , Embarazo , Embarazo/psicología , Pandemias , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/psicología , Periodo Posparto/psicología , Síntomas Conductuales/epidemiología , Estudios Transversales , Ansiedad , Depresión , Salud Mental , Prevalencia , EspañaRESUMEN
OBJECTIVES: Asthma is a common chronic and burdensome disease which typically begins in childhood. The aim of this study was to assess perinatal and obstetric factors which may increase the risk of developing asthma in the offspring. METHODS: Data from five consecutive waves (n=7,073 children, from birth to 15â¯years old) from a nationally-representative birth cohort of people born in the United Kingdom between 2000 and 2002, the Millennium Cohort Study (MCS), were used. The Kaplan-Meier survival curve was used to graphically display the risk of developing asthma from early childhood to adolescence. The Z-based Wald test was used to prove significant covariate loading. RESULTS: Cox regression analyzing the influence of covariates on asthma development risk showed a significant likelihood ratio test, χ2(18)=899.30, p<0.01. A parent with asthma (OR=2.02, p<0.01), a younger maternal age at delivery (OR=0.98, p<0.05), and the use of assisted reproductive technology (OR=1.43, p<0.05) were associated with an increased risk of developing asthma in the offspring. CONCLUSIONS: Perinatal factors (a younger maternal age, assisted reproductive technology) and a parental factor (a parent with asthma) increased the risk for developing asthma in the offspring.
Asunto(s)
Asma , Efectos Tardíos de la Exposición Prenatal , Niño , Embarazo , Femenino , Adolescente , Humanos , Preescolar , Estudios de Cohortes , Estudios Longitudinales , Efectos Tardíos de la Exposición Prenatal/epidemiología , Factores de Riesgo , Padres , Asma/epidemiología , Asma/etiologíaRESUMEN
BACKGROUND: Individuals with cancer often experience stress throughout the cancer trajectory and have a high risk of experiencing depression. OBJECTIVE: The aim of this study was to examine the relationship between allostatic load (AL), a measure of cumulative stress-related physiologic dysregulation of different body systems, and symptoms of depression in cancer survivors. METHODS: Participants were 294 adult cancer survivors from the US National Health and Nutrition Examination Survey (NHANES 2007-2018). Allostatic load was measured using 14 indicators representing cardiometabolic risk, glucose metabolism, cardiopulmonary functioning, parasympathetic functioning, and inflammation. Depressive symptoms were measured with the Patient Health Questionnaire-9. The relationship between AL and depressive symptoms was investigated using multiple regression adjusted for diverse sociodemographic and diagnosis variables. RESULTS: Higher AL was associated with higher depressive symptom scores. The higher risk of depression was concentrated among those survivors in the highest AL quartile, with 21% (95% confidence interval, 11%-32%) of survivors presenting a high risk of depression compared with 8% to 11% of survivors in the lower quartiles. In exploratory analyses, the relationship between AL and depressive symptoms was only significant among survivors with a lower income. In contrast, in survivors in the highest income group, depressive symptoms were lower and unrelated to AL. CONCLUSION: High AL is associated with more depressive symptoms among cancer survivors. IMPLICATIONS FOR PRACTICE: Nurses have an important role in identifying psychological distress in cancer patients and survivors. Further research is needed to investigate the usefulness of AL as a marker in the context of cancer follow-up care and screening for psychological distress.
RESUMEN
The coronavirus SARS-CoV-2 generated an alert that became a state of emergency in health issues worldwide, a situation that affected the entire population, including pregnant women. The present study aims to understand the effect of the psychopathological profile of a sample of pregnant women at the time of the COVID-19 pandemic on themselves during childbirth (Phase 1) and after childbirth and the anthropometric measures of the neonate at birth (Phase 2). The total sample comprises 81 pregnant women aged 32.07 years (SD = 5.45) and their neonates. Sociodemographic and obstetric data of the sample were collected. During pregnancy, psychopathology was measured by means of the SCL-90, as well as other psychological measures on stress and social support. Cluster k-means techniques were used to uncover the heterogeneous profiles of psychopathology in Phase 1. Two main psychopathological profiles were found (Cluster 1: High psychopathological symptoms; Cluster 2: Low psychopathological symptoms). The clusters generated show significant differences in all the SCL-90-R subscales used and in the general index at Phase 1. After childbirth, high psychopathology profile membership was associated with a greater probability of having a non-eutocic delivery. On the other hand, the low psychopathological symptoms cluster shows higher levels of depressive symptoms, hostility, paranoid ideation, and psychotic symptoms in Phase 2. In conclusion, there seemed to exist two heterogeneous profiles of psychopathology in pregnant women during the pandemic; the stress related to the pandemic seemed uninfluential on the development of a profile of high psychopathological symptoms and the psychopathology profile may influence delivery and postpartum outcomes.
RESUMEN
BACKGROUND: Breastfeeding promotes children's health and is associated with positive effects to maternal physical and mental health. Uncertainties regarding SARS-CoV-2 transmission led to worries experienced by women and health professionals which impacted breastfeeding plans. We aimed to investigate the impact of self-reported and country-specific factors on breastfeeding rates during the COVID-19 pandemic. METHODS: This study is part of a broader international prospective cohort study about the impact of the COVID-19 pandemic on perinatal mental health (Riseup-PPD-COVID-19). We analysed data from 5612 women, across 12 countries. Potential covariates of breastfeeding (sociodemographic, perinatal, physical/mental health, professional perinatal care, changes in healthcare due to the pandemic, COVID-19 related, breastfeeding support, governmental containment measures and countries' inequality levels) were studied by Generalized Linear Mixed-Effects Models. RESULTS: A model encompassing all covariates of interest explained 24% of the variance of breastfeeding rates across countries (first six months postpartum). Overall, first child (ß = -0.27), age of the child (ß = -0.29), preterm birth (ß = -0.52), admission to the neonatal/pediatric care (ß = -0.44), lack of breastfeeding support (ß = -0.18), current psychiatric treatment (ß = -0.69) and inequality (ß = -0.71) were negatively associated with breastfeeding (p < .001). Access to postnatal support groups was positively associated with breastfeeding (ß = 0.59; p < .001). In countries with low-inequality, governmental measures to contain virus transmission had a deleterious effect on breastfeeding (ß = -0.16; p < .05) while access to maternity leave protected breastfeeding (ß = 0.50; p < .001). DISCUSSION: This study shows that mother's COVID-19 diagnosis and changes in healthcare and birth/postnatal plans did not influence breastfeeding rates. Virtual support groups help women manage breastfeeding, particularly when their experiencing a first child and for those under psychiatric treatment. The complex associations between covariates and breastfeeding vary across countries, suggesting the need to define context-specific measures to support breastfeeding.
Asunto(s)
COVID-19 , Nacimiento Prematuro , Recién Nacido , Embarazo , Humanos , Niño , Femenino , SARS-CoV-2 , Lactancia Materna , Prueba de COVID-19 , Estudios Transversales , Pandemias , Estudios ProspectivosRESUMEN
BACKGROUND: During the COVID-19 pandemic, pregnant women are exposed to potentially harmful stressors that might affect their health. The direct consequences that SARS-CoV-2 may have on perinatal mental health are still unknown. OBJECTIVE: The present study aimed to explore the impact of the COVID-19 pandemic on psychopathological symptoms in a sample of Spanish pregnant women. METHODS: A sample of 186 pregnant women was assessed using the revised Symptoms Check List-90 during the first lockdown in Spain. RESULTS: The results showed clinical scores on the obsession and compulsion, anxiety and phobic anxiety subscales, as well as on the severity indexes. Phobic anxiety was the only variable that was inversely correlated with age and the number of previous miscarriages. A linear regression model showed that age was inversely associated with phobic anxiety scores. A younger age was associated with higher levels of phobic anxiety symptoms. CONCLUSIONS: Our results indicated that younger pregnant women and women in the first trimester of pregnancy were more vulnerable to the effects of stress and concerns about COVID-19.
Asunto(s)
COVID-19 , Embarazo , Femenino , Humanos , COVID-19/epidemiología , SARS-CoV-2 , Pandemias , Mujeres Embarazadas , España/epidemiología , Control de Enfermedades Transmisibles , Trastornos de AnsiedadRESUMEN
BACKGROUND: Post-traumatic stress disorder (PTSD) after birth has generated a growing interest in recent years. Although some risk factors associated with PTSD have been studied, information is still scarce to date on risk factors associated with PTSD. This systematic review aims to identify risk factors associated with the diagnosis of PTSD after childbirth. METHODS: We searched on PubMed, Web of Science and SCOPUS databases, from inception to May 2022. Quality assessment of the articles was performed using the Newcastle-Ottawa Quality Assessment ("NOQAS") scale. This systematic review was performed according to the PRISMA guidelines. Inclusion criteria were women with age ≥18 years; articles in English or Spanish; articles focused on physical, social, psychological, medical-obstetric, and environmental risk factors. RESULTS: A total of n = 17,675 women were included among the studies in this systematic review. The main risk factors associated with PTSD after birth were obstetric interventions and obstetric violence such as emergency caesarean section or a non-compliant birth plan, a previous mental illness, having suffered from of a traumatic event or depression and/or anxiety, and having poor social support throughout pregnancy and/or during birth. CONCLUSIONS: Obstetric interventions, obstetric violence, experiencing a traumatic event or depression and/or anxiety, and a previous mental illness are factors associated with the diagnosis of PTSD after birth. Protective factors are multiparity, adherence to the mother's birth plan and skin-to-skin contact.
RESUMEN
OBJECTIVE: Increases in stress, anxiety, and depression among women pregnant during the COVID-19 pandemic have been reported internationally. Yet rigorous comparison of the prevalence of maternal mental health problems across countries is lacking. Moreover, whether stress is a common predictor of maternal mental health during the pandemic across countries is unknown. METHODS: 8148 pregnant women from Germany, Israel, Italy, Poland, Spain, Switzerland, and the United States were enrolled in the International COVID-19 Pregnancy Experiences (I-COPE) Study between April 17 and May 31, 2020. Sociodemographic characteristics, pandemic-related stress, pregnancy-specific stress, anxiety, and depression were assessed with well-validated instruments. The magnitude of stress and mood disturbances was compared across countries. A path model predicting clinically significant levels of anxiety and depression from maternal characteristics and stress was tested for all study participants and then examined separately in each country with >200 participants. RESULTS: Countries differed significantly in magnitude of pandemic-related pregnancy stress and pandemic-unrelated pregnancy-specific stress, and in prevalence of clinically significant anxiety and depression levels. A well-fitting common path model for the entire sample indicated that mood and anxiety disturbances were strongly predicted by pandemic-related and pregnancy-specific stress after accounting for maternal characteristics. The model was replicated in individual countries. CONCLUSIONS: Although pregnant women in high-income Western countries experienced different levels of stress resulting from the COVID-19 pandemic, stress is a strong, common predictor of anxiety and depressive symptoms in these individuals. The common model can be used to inform research and clinical interventions to protect against adverse consequences of prenatal maternal stress, anxiety, and depression for mothers and infants.
Asunto(s)
COVID-19 , Mujeres Embarazadas , Embarazo , Lactante , Femenino , Humanos , COVID-19/epidemiología , Pandemias , Depresión/epidemiología , Ansiedad/epidemiología , MadresRESUMEN
The study aims to assess pregnancy-specific stress among pregnant women in Spain during the first lockdown of the COVID-19 pandemic. Two samples of pregnant women from the south of Spain (Andalusia) were assessed using the Prenatal Distress Questionnaire (PDQ) and a sociodemographic and obstetric questionnaire. Group 1 (N = 155) was recruited face-to-face, whereas Group 2 (N = 78) was recruited online. Pregnancy-specific stress levels were significantly different in both groups. The face-to-face group (Group 1) had higher pregnancy-specific stress levels than the online group (Group 2). The online sample over-represents young adult pregnant women with high education levels and a high number of previous miscarriages. The face-to-face study seems more accessible to racially and ethnically diverse groups. The main concern among both groups was the risk of having a sick neonate. Research during the COVID-19 pandemic can benefit from using online resources to collect data to screen and identify perinatal mental health problems in a crisis environment. Nevertheless, researchers should be aware of the potential limitations this strategy can have, for example, certain groups of people may have limited access to the internet.
Asunto(s)
COVID-19 , Recién Nacido , Adulto Joven , Femenino , Embarazo , Humanos , COVID-19/epidemiología , Pandemias , Control de Enfermedades Transmisibles , Mujeres Embarazadas/psicología , Parto/psicología , Estrés Psicológico/epidemiología , Estrés Psicológico/psicología , AnsiedadRESUMEN
Introduction: Pregnancy has been associated with diminished maternal mental health and a deterioration in partner relationship quality. The recent COVID-19 quarantine measures have created additional stressors for pregnant women due to isolation and a surge in partner conflict.Objective: The purpose of this study was to assess how partner relationship conflict and social support may mediate mental health outcomes during the COVID-19 lockdown.Methods: A cross-sectional study with a sample of 152 pregnant women using psychological measures, (i.e. Prenatal Distress Questionnaire, Symptom Checklist-90-R, Duke-UNC-11 Functional Social Support Questionnaire, Perceived Stress Scale). Demographic characteristics, obstetrics history, and partner relationship conflict were assessed using questionnaires.Results: While there were few reports of physical violence in this sample, between 18% and 59% of women reported partner relationship conflict on the psychological subscale (e.g. afraid of one's partner or screamed at by one's partner). Further, the psychological subscale was significantly associated with symptoms of psychopathology. There was a significant negative association between social support and pregnancy-specific stress (p = .005), and perceived stress (p= .038).Conclusions: These findings suggest that partner relationship conflict and social support may act as important buffers for prenatal mental health in childbearing women during vulnerable situations, such as the COVID-19 pandemic.