The effect of birth ball exercise on labor pain, delivery duration, birth comfort, and birth satisfaction: a randomized controlled study.

PURPOSE: This study aimed to examine the effect of birth ball exercise on labor pain, delivery duration, birth comfort, and birth satisfaction. METHODS: The study used a randomized controlled trial design. All 120 primiparous pregnant women were randomly assigned to the intervention (IG) and control groups (CG). After the cervical dilatation reached 4 cm, the pregnant women in the IG performed birth ball exercises, adhering to the birth ball guide created by the researcher. No intervention was made in the control group other than standard midwifery care practices. RESULTS: The labor pain level between the groups (VAS 1-when cervical dilatation was 4 cm) was similar to each other. The labor pain level (VAS 2- when cervical dilatation was 9 cm) scores of the women in the IG were significantly lower than those in the CG (p < 0.05). The time between the active phase of labor until dilatation is complete and the time until the baby's head comes out after full dilatation was found to be statistically significantly shorter in the IG compared to the CG (p < 0.05). Childbirth comfort and satisfaction mean scores between the groups were found to be statistically insignificant (p > 0.05). CONCLUSION: As a result of the study, it was determined that the birth ball exercise significantly reduced labor pain and labor time. We recommend that the birth ball exercise be applied to all low-risk pregnant women because it helps fetal descent and cervical dilatation, and shortens labor pain and delivery time.

The effects of exposure to physical and emotional violence from partners on psychological resilience, forgiveness, happiness, life satisfaction, and depression level in Turkish women.

The data of this descriptive and correlational study were collected from 583 women between October 2021 and December 2021 with information form, Brief Resilience Scale, Oxford Happiness Scale-Short Form, Epidemiological Research Center Depression Scale, Heartland Forgiveness Scale, and Life Satisfaction Scale. There is a statistically significant difference between the resilience, happiness, and life satisfaction levels of women exposed to physical violence from their partners and the presence of depression (p < .001). A statistically significant difference was found between the presence of depression and resilience, happiness, and life satisfaction (p < .001) and forgiveness (p = .004) in women who were exposed to emotional violence from their partners. While resilience, happiness, and life satisfaction levels decreased in women who were exposed to physical violence from their partners, the incidence of depression increased. While the presence of depression increased in women who were exposed to emotional violence from their partners, the level of resilience, happiness, life satisfaction, and forgiveness decreased.

The effects of dyadic coping strategies and dyadic conflict resolution styles on postpartum depression of mothers in heterosexual marriages in Turkey.

The authors of this study aimed to determine the effects of coping strategies and conflict resolution styles on postpartum depression in heterosexual mothers in the postpartum period in Turkey. A descriptive, cross-sectional study was conducted with 369 mothers with babies aged 1-12 months. The study was carried out between October 1, 2021, and December 1, 2021, in the pediatric outpatient clinic of the Medical Faculty Hospital of a province in the Central Anatolian Region of Turkey. Seventy-four (20.1%) mothers had scores above the depression scale cu-off point (>13). Having problems in marriage, getting a low score on the spouse's self-perception scale of dyadic coping with stress, and having negative, nonsubmissive, and retreating conflict resolution styles were found to be important factors associated with postpartum depression (p < .05). The incidence of postpartum depression was found to be associated with having problems in the marriage, not having good dyadic coping strategies, and having negative conflict resolution styles.

The relationship of psychological well-being and cognitive emotions with breastfeeding self-efficacy in mothers in the postpartum period.

To determine the relationship of psychological well-being and cognitive emotion regulation and breastfeeding self-efficacy in mothers in the postpartum period. The research was designed as cross-sectional and correlational and carried out between 1 November 2021 and 1 January 2022 in the pediatric outpatient clinic of a Medical Faculty Hospital of a province in the Central Anatolian Region of Turkey. Responses from a total of 325 mothers who were in postpartum 1-6 months were analyzed. Data were collected using a Personal Information Form, the Scales of Psychological Well-Being (SPWB), the Cognitive Emotion Regulation Questionnaire (CERQ), and the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). The following factors were found to be important associated risk factors that negatively affected breastfeeding self-efficacy in 29% of the mothers (F = 14.536, p < .001): mothers' poor mental health, using self-blaming maladaptive cognitive coping strategy, inability to use positive reappraisal coping strategy, and feeding the baby only formula or both breast milk and formula. Weak and positive correlations were found between psychological well-being of mothers and adaptive cognitive coping subdimensions, and negative and weak correlations were found between psychological well-being of the mothers and maladaptive cognitive coping subdimensions (p < .001). Breastfeeding self-efficacy of mothers in a well psychological state, who can use adaptive cognitive coping strategies, and who exclusively breastfeed their babies is positively affected.

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.

Factors affecting postpartum depression in Turkish women.

AIM: To assess the effects of cognitive emotion regulation, emotional intelligence status and related factors on postpartum depression (PPD) in postpartum women. DESIGN AND METHODS: This descriptive and cross-sectional study was conducted in 268 mothers with babies aged 1-12 months. The study was carried out between 01 November 2021 and 01 February 2022 in the pediatric outpatient clinic of the Medical Faculty Hospital of a province in the Central Anatolian Region of Turkey. Data were collected using the sociodemographic and obstetric data collection form, Edinburgh Postnatal Depression Scale (EPDS), Cognitive Emotion Regulation Questionnaire-Short Form (CERQ), and Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF). RESULTS: Seventy-one (26.5 %) mothers received scores above the cut-off point (>13) in the depression scale. Experiencing emotional violence, having cognitive emotion regulation difficulties, and low emotional intelligence characteristics affected the risk of developing postpartum depression by 16 % (F = 13.757, p < 0.001). CONCLUSION: Exposure to emotional violence, cognitive emotion regulation, and emotional intelligence status reveal that they are important in identifying women at risk of PPD. These findings highlight the need for nurses to develop comprehensive cognitive emotion regulation and emotional intelligence traits assessment programs, including depression screening.

Determination of Sexual Attitude, Sexual Self-Consciousness, and Sociocultural Status in Women With and Without Lifelong Vaginismus: A Case-Control Study.

Vaginismus is a sexual dysfunction occurring in females presented as a contraction of the muscles around the vagina as a reflex, causing the failure of vaginal penetration. Although many psychological, social, and cultural factors that may cause vaginismus have been suggested, its underlying mechanisms are not clear. The aim of this study was to determine the sexual attitude, sexual self-awareness, and sociocultural status of women with and without lifelong vaginismus. This is a case-control study. A total of 148 women were included in the study: 74 women with a lifelong vaginismus diagnosis and 74 women without a history of vaginismus/painful sexual activity controls. Data were collected using a structured questionnaire, the Sexual Self-Consciousness Scale, and the Hendrick Brief Sexual Attitudes Scale. Sexual shyness (OR = 0.854), sexual self-focus (OR = 0.888) and birth control (OR = 1.279), communion (OR = 1.198), and instrumentality (OR = 1.330; the sub-dimensions of the Sexual Attitude Scale) were associated with (χ2 = 96.130, p < .001) vaginismus at the rate of 63%. Those who did not receive sexual information; those who obtained information about sexuality from the social media; those who had negative thoughts about sexuality due to religious reasons; those who found the genitals and sexuality as disgusting; and those having more feelings of fear and pain are more likely to have vaginismus. Some socio-cultural factors may negatively affect women and cause vaginismus. Women with vaginismus had low sexual self-consciousness and negative attitudes toward sexuality. It may be incomplete to consider vaginismus only as a vaginal entry problem. Therefore, in the treatment of vaginismus, women's sexual attitude, sexual self-awareness, and sociocultural factors should be evaluated in a holistic manner.

The effects of family function, relationship satisfaction, and dyadic adjustment on postpartum depression.

PURPOSE: To determine the effect of family function, relationship satisfaction, and dyadic adjustment on postpartum depression DESIGN AND METHODS: This descriptive, cross-sectional study was conducted in 337 postpartum mothers. FINDINGS: Fifty-five mothers scored above the depression scale cutoff point (>13). Emotional violence from husband, poor problem solving and communication, low relationship satisfaction, dyadic adjustment, and consensus were important risk factors for postpartum depression (p < .0.05). PRACTICE IMPLICATIONS: Family function and partner relationships should be a key focus for midwives and nurses in the postpartum period. Providing psychological interventions aimed at improving relationship functioning can help protect mothers against postpartum depression.

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.

Associations Between Sexual Violence and Women's Sexual Attitudes, Sexual Self-Consciousness, and Sexual Self-Efficacy.

Sexual violence, a public health problem, can be seen in all societies and among individuals from all levels of educational background. It is important to be aware of the social and individual factors associated with sexual violence to prevent and fight sexual violence. In this study, it was aimed to determine the associations between sexual violence and women's sexual attitudes, sexual self-consciousness, and sexual self-efficacy. This is a descriptive study. The data were collected from 469 women admitted to three family health centers in Turkey between May and September 2018. Data were collected using a data collection form and three scales (the Sexual Self-Consciousness Scale, the Sexual Self-efficacy Scale, and the Hendrick Brief Sexual Attitudes Scale). The data were analyzed using descriptive statistics as well as the independent-sample t test and logistic regression analysis. It was found that 37.7% of the women were exposed to sexual violence. The most frequent response of the women against sexual violence was "crying" with 61%. The first reason why the women maintained the marriage despite sexual violence was to avoid their children growing up without a father (43.3%). There was a statistically significant difference between sexual violence and sexual embarrassment, sexual self-focus, sexual self-consciousness, and sexual self-efficacy scores of the women (p < .001). No significant difference between the means of the women's sexual attitude scores and their sexual violence experiences was observed (p = .526). There was an association between sexual violence and sexual self-efficacy (p = .036; odds ratio [OR] = 1.030, 95% confidence interval [CI] = [1.002, 1.059]). Health professionals may provide sexuality education programs at family health centers, especially for couples preparing for marriage to increase sexual efficacy. Moreover, education may be provided identifying sexual violence acts in marriage and informative awareness programs may be offered regarding sexual violence.

Effects of Antenatal Education on Fear of Birth, Depression, Anxiety, Childbirth Self-Efficacy, and Mode of Delivery in Primiparous Pregnant Women: A Prospective Randomized Controlled Study.

The purpose of this study was to investigate the effects of antenatal education on birth fear, depression, anxiety, stress, childbirth self-efficacy, and mode of delivery in primiparous pregnant women. This is a single-blind, prospective, randomized controlled trial, in which we applied the Consolidated Standards of Reporting Trials (CONSORT) statement. The study was conducted in a city in Turkey's Central Anatolia region, and the data collection process was made between April and September 2019. One hundred and twenty primiparous pregnant women were assigned to either the antenatal education group (n = 60) or the control group (n = 60) via randomized block assignment. A total of 112 women were evaluated at the end of the study. Pregnant women in the antenatal education group were given two 2-hr sessions (240 min) twice a week for 4 weeks. It was found that those in the antenatal education group had less birth fear, depression, anxiety, and stress symptoms and increased childbirth self-efficacy compared to controls (p < 0.05). Those in the antenatal education group had significantly lower postnatal birth fear, depression, anxiety, and stress symptoms compared to controls (p < 0.001). More vaginal births occurred in the antenatal education group compared to controls (p = 0.043). According to the outcome of this evidence-based study: antenatal education has important clinical benefits for women both during pregnancy and in the postpartum period and all pregnant women should receive this education.

The Effect of Exposure to Sexual Violence on Sexual Dysfunction and Sexual Distress in Pregnant Women.

BACKGROUND: Sexual dysfunction and sexual distress are common during pregnancy, but the effects of exposure to sexual violence on sexual dysfunction and sexual distress in pregnant women is unknown. AIM: The aim of this study was to determine the effects of sexual violence on female sexual dysfunction and sexual distress. METHODS: This is a descriptive study. Data were collected between December 2019 and April 2020 from 605 pregnant women. OUTCOMES: The data were collected with a Data Collection Form (The socio-demographic and obstetric characteristics and exposure to sexual violence were evaluated with questions.), Female Sexual Function Index, and Female Sexual Distress Scale-Revised. RESULTS: In our study, sexual dysfunction was found in 72.9% of the pregnant women, and sexual distress was found in 38.2%. It was found that 11.6% of the women were exposed to sexual violence in their then-current pregnancy. While the rate of sexual distress was found to be significantly higher in women who were exposed to sexual violence during pregnancy (P < .001), no significant difference was found between sexual violence and female sexual dysfunction (P = .572). Sexual violence during pregnancy was found to be a risk factor for sexual distress (P = .006). CLINICAL IMPLICATIONS: This study may be an opportunity for nurses and physicians to determine the effects of sexual violence experienced by pregnant women on female sexual dysfunction and sexual distress during pregnancy. STRENGTH & LIMITATIONS: This is the first and only study that determines the effects of sexual violence on female sexual dysfunction and sexual distress. Our findings cannot be generalized to the entire population of Turkey. CONCLUSION: The presence of female sexual dysfunction in women during pregnancy is quite high, and the rate of sexual distress is moderate. Sexual violence from partner/spouse during pregnancy is a risk factor for sexual distress. Alan Dikmen H, Çankaya S. The Effect of Exposure to Sexual Violence on Sexual Dysfunction and Sexual Distress in Pregnant Women. J Sex Med 2020;17:2394-2407.

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 psychosocial risk factors on postpartum depression in antenatal period: A prospective study.

PURPOSE: The aim of this study was to determine the psychosocial risk factors that may increase the risk of developing postpartum depression (PPD) symptoms in the antenatal period at postpartum 6-8 weeks. METHODS: This study was a prospective longitudinal design, in which women completed questionnaire measures both at the third trimester of pregnancy and 6-8 weeks after birth. The present study was conducted in the women's clinic of a Medical Faculty Hospital in the Central Anatolia region of Turkey between March 15 and August 15, 2019. A total of 245 pregnant women in the third trimester were included in the study. Data were collected using a sociodemographic and obstetric data collection form, Pregnancy Psychosocial Health Assessment Scale, Perceived Stress Scale, Hospital Anxiety and Depression Scale, and Edinburgh Postnatal Depression Scale. RESULTS: Forty-four (18%) of the 245 women had scores above the cut-off point (>13) in EPDS. Being subjected to violence from husband or another male member of the family during pregnancy, having problems in marriage, depression, anxiety, and high levels of perceived stress affect the risk of developing PPD by 55% (χ2 = 101.034, P < 0.001). It was observed that those who scored low on the psychosocial health scale, those who experienced unplanned pregnancy, those with pregnancy that was not wanted by the husband, those who were emotionally abused, and those who experienced a sad event in their families were more sensitive to PPD symptoms. CONCLUSIONS: Psychosocial health, perceived stress, and psychosocial risk factors, such as depression and anxiety, during pregnancy are important determinants of postpartum depressive symptoms.

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.

The attitudes of refugee women in Turkey towards family planning.

OBJECTIVES: This study was conducted to determine refugee women's attitudes towards family planning and related factors. DESIGN AND SAMPLE: Designed in descriptive and cross-sectional type, the study involved 555 voluntary Syrian refugee women in Turkey. MEASURES: A questionnaire and the Family Planning Attitude Scale (FPAS) were used. Independent Sample T test, ANOVA test, and Pearson's correlation analysis were used for data analysis. RESULTS: A significant association was found between the average FPAS scores with educational status, income level, social security, use of FP methods, spousal support for FP, and training for FP in Syria. CONCLUSIONS: It was determined that the attitudes of women towards family planning were at the medium level, nearly half of them used a kind of family planning and received its training, and that their attitudes towards family planning were affected by their and their husband's educational level, their income level, the availability of social security, the type of family planning, the utilization of family planning, and spousal support. Based on our study findings, refugee women and their partners/husbands should be informed on FP and their attitudes towards and the barriers against FP should be investigated by further studies.