Development and validation of the attitude towards Surrogacy Scale in a polish sample.

BACKGROUND: Surrogacy is one of the options in reproductive medicine that raises a lot of ethical, legal and psychological controversy. Surveying attitudes toward surrogacy plays an important role in building awareness of this phenomenon in the society, which may help eliminate its stigma. In this study authors aimed to develop and validate a scale to assess the attitudes towards surrogacy. METHODS: In this study cross-sectional design was implemented. Development process of the Attitude towards Surrogacy Scale (ATSS) included items development based on literature reviews, other existing questionnaires, confirmatory factor analysis (CFA), and reliability analysis using internal consistence coefficients. A pilot study using adult members of the public was conducted after consultation with the Expert Advisory Panel Board. The final survey, which was used in this study, consisted of 24 items, which were organized into the four subscales: general opinion on surrogacy and its social context (7 items), financing and legalizing surrogacy (8 items), the acceptance of surrogacy (4 items), and attitudes towards the intended parents and children born through surrogacy (5 items). 442 individuals participated in this study. RESULTS: The final version of Attitude towards Surrogacy Scale (ATSS) consists of 15 items, grouped in three subscales. Final version of the ATSS showed that the three-factor model indicated an acceptable model fit: Chi-square = 320.46, p < 0.01, df = 87, CFI = 0.94, TLI = 0.92, RMSEA = 0.078 (90% C.I.: 0.070-0.086), SRMR = 0.040 Reliability was assessed by calculating the McDonald's omega that ranged from 0.74 for the Surrogacy ethical context subscale to 0.94 for the overall ATSS score. CONCLUSION: ATSS was developed to measure general attitude toward surrogacy with satisfying psychometric properties. The analysis of socio-demographic variables with ATSS showed that the most significant predictor of the general attitude towards surrogacy, and three aspects of surrogacy was being a religious person (profess a Catholic religion or profess another religion).

Surrogacy­is one of the most controversial methods of infertility treatment. This concept is associated with difficult ethical, psychological and social issues, in which each aspect may lead to different trends in attitudes. The study of attitudes in society plays an important role in the analysis of various aspects of a given phenomenon, helps to fill legal gaps and ambiguities, and to transform controversial dimensions into normative concepts. Thus, this study aimed to develop and validate a scale to assess the attitudes towards surrogacy.The survey used in this study, consisted of 24 questions, which were organized into the four subscales: general opinion on surrogacy and its social context (7 items), financing and legalizing surrogacy (8 items), the acceptance of surrogacy (4 items), and attitudes towards the intended parents and children born through surrogacy (5 items). 442 individuals participated in this study. The final version of Attitude towards Surrogacy Scale consists of 15 questions, grouped in three subscales: opinion on surrogacy ethical context, financing and legalizing surrogacy, and an acceptance of surrogacy.This is the first scale in Poland for the assessment of general attitudes towards surrogacy. This measure allows to capture the opinions towards three aspects of surrogacy: surrogacy's ethical context, the financing and legalizing surrogacy, and acceptance of surrogacy. The scale can be addressed to various groups in the society, not only for studies related to reproductive medicine.

Maternal adult attachment and maternal-fetal attachment in the context of romantic relationship quality after premature birth-A cross sectional study.

Objective: The primary outcome of the study was to evaluate the maternal adult attachment and maternal-fetal attachment (MFA) in the context of romantic relationship quality among mothers of preterm born children. Associations between MFA, maternal adult attachment, maternal perceived stress, depressive symptoms, social support in the neonatal period were also examined as secondary outcomes. Materials and methods: The study had a cross-sectional design and involved 260 of women after premature birth, who participated in the study in the early neonatal period. The following self-reported methods were used: Socio-demographic questionnaire, Attachment Styles Questionnaire (ASQ), Maternal-Fetal Attachment Scale (MFAS), The Perceived Stress Questionnaire (PSQ), The Dyadic Adjustment Scale (DAS), The Edinburgh Postnatal Depression Scale (EPDS), The Social Support Questionnaire (SSQ). Results: The results showed that a secure attachment style is associated with a higher intensity of the MFA and consequently, a higher quality of the romantic relationship. Regression analysis presented that the higher the secure attachment score, the lower the perceived level of stress and depressive symptoms, which in turn lead to a higher quality of the partner relationship. Conclusion: Maternal secure attachment positively impacts the romantic relationship quality and the maternal-fetal attachment. The findings also draw attention to the role of the secure attachment style as a protective factor while coping with stress and depressive symptoms.

Associations of Maternal-Infant Bonding with Maternal Mental Health, Infant's Characteristics and Socio-Demographical Variables in the Early Postpartum Period: A Cross-Sectional Study.

(1) Background: There is a continuing discussion concerning the impact of preterm birth on Maternal-Infant bonding with inconsistent results. The large burden of preterm births calls for research to evaluate the impact of it on material psychological outcome in the early postpartum period. Thus, the aim of this study was to evaluate the relationship between maternal postpartum bonding with maternal mental health, socio-demographical factors, and child's characteristics. (2) Methods: A cross-sectional study design was used. In total, 72 women (a mean age of 31.44 years old) of preterm infants (mean gestational age = 33.54; range 24-36) filled out socio-demographic questionnaires, Postpartum Bonding Questionnaire (PBQ), Edinburgh Postpartum Depression Scale (EPDS), Postpartum Depression Screening Scale (PDSS), Generalized Anxiety Disorder Assessment (GAD-7), and Parental Stress Scale (PSS) 1-3 days post-delivery; (3) Results: The results analyses have shown positive correlations between the overall result of maternal postpartum bonding with stress (p < 0.01), maternal educational level (p < 0.01), maternal age (p < 0.05) and the number of children (p < 0.01). However, there were no significant relationships between other investigated variables. The results of linear regression have revelated the important role of the overall scores in experience of stress among mothers (explaining 49% of the variability). The mediating role of maternal stress on maternal postpartum bonding was not found. That relationship of maternal postpartum bonding and maternal stress was not moderated through socio-demographic variables. (4) Conclusions: In this study mothers of prematurely born children had a good level of Maternal-Infant bonding. Maternal stress was found to be a predictor of maternal postpartum bonding among the tested variables. Surprisingly, the study results did not show significant relationships between maternal postpartum bonding and maternal mental health (depression and anxiety).

Paternal Postpartum Bonding and Its Predictors in the Early Postpartum Period: Cross-Sectional Study in a Polish Cohort.

Introduction: Parental postpartum bonding has been studied by many researchers focusing on maternal bonding. The objective of this study was to examine the psychological and socio-demographic predictors of paternal postpartum bonding in the early postpartum period. Methods: In this cross-sectional study, 131 couples (fathers median age of 32.37 years, SD = 4.59; mothers median age of 30.23 years, SD = 3.90) of newborns from full-term pregnancies were recruited from November 2019 until March 2020. The primary outcome was paternal postpartum bonding as measured by the Postpartum Bonding Questionnaire (PBQ). Secondary outcomes included: maternal and paternal anxiety [with the Generalized Anxiety Disorder (GAD) Assessment]; maternal and paternal stress [with the Parental Stress Scale (PSS)]; maternal depressive symptoms [with the Edinburgh Postpartum Depression Scale (EPDS)]; and maternal and paternal socio-demographic variables as fathers' presence at childbirth, education level, age, and parental experience. Results: Paternal postpartum bonding was significantly correlated with paternal anxiety (moderate strength), maternal stress (strong correlation), and maternal postpartum bonding. No significant correlations between paternal postpartum bonding, maternal depression symptoms, and maternal anxiety were found. The mediating role of paternal stress in paternal postpartum bonding was proven. Paternal anxiety strengthens paternal stress (b = 0.98). Further, a high level of paternal stress disrupts paternal postpartum bonding (b = 0.41). Results of regression analyses have revelated that maternal infant bonding (p < 0.01) and paternal stress (p < 0.01) are the only predictors of parental postpartum bonding across all included variables. None of investigated socio-demographic variables were associated with paternal postpartum bonding. Conclusion: Notwithstanding limitations, the current findings add to a growing body of literature on paternal postpartum bonding. The results have shown that paternal mental health is related to parental postpartum bonding directly after delivery. Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT04118751.

Maternal-Infant Bonding and Its Relationships with Maternal Depressive Symptoms, Stress and Anxiety in the Early Postpartum Period in a Polish Sample.

A large body of literature indicates that there is a relationship between maternal psychological well-being and the early maternal-infant bond. However, this relationship is not fully understood, due to the different theoretical frameworks of maternal-infant bonding and different data collections points. Thus, the aim of this study was to examine the relationship between the maternal bond and the maternal psychological state including anxiety, stress, and maternal depressive symptoms. In this cohort study, 150 women who gave birth after 37 weeks of pregnancy completed the following self-reports 1-3 days post-delivery: Socio-demographic questionnaire, Postpartum Bonding Questionnaire (PBQ), Edinburgh Postpartum Depression Scale (EPDS), Postpartum Depression Screening Scale (PDSS), Generalized Anxiety Disorder Assessment (GAD-7), and Parental Stress Scale (PSS). The obtained results showed that the maternal level of stress, anxiety and postnatal depressive symptoms are significantly correlated with the maternal-infant bond in Polish mothers. In addition, regression analysis shows that postpartum depressive symptoms and maternal stress are significantly associated with the maternal-infant bonding process in the early postpartum period. This finding emphasizes the importance of identifying maternal mental state difficulties in the early postpartum period in order to provide interventions to help build healthy maternal-infant bonding.

Social Support, Perceived Stress, Socio-Demographic Factors and Relationship Quality among Polish Mothers of Prematurely Born Children.

Families with a prematurely born child may be exposed to various difficulties associated with prematurity. The study aimed to explain the relationship between social support and the quality of the partnership among mothers of children born prematurely. In addition, the coexistence of social support, perceived stress and social-demographical factors in the neonatal period was examined. The study group consisted of 260 mothers of preterm born children. Subjects completed The Socio-Demographic Questionnaire, The Social Support Sources Questionnaire (SSQ), The Dyadic Adjustment Scale (DAS) and The Perceived Stress Questionnaire (PSQ). In the second phase of the study, mothers completed The Dyadic Adjustment Scale (DAS). Person's correlation coefficients were used to examine the variables and hierarchical linear regression analyses were performed to examine the relative contributions of social support on partnership relation quality. The study results showed that social support is positively related to partnership relationship quality among mothers of preterm born children. Social support measured in the neonatal period is not connected with relationship quality measured in the early childhood period. Social support is related with the father's level of education and perceived stress corresponds with the level of parents' education. The findings highlight the importance of expanding supportive resources for couples dealing with premature birth, especially among those with a lower level of education and lower financial status.

Perceived Stress as a Predictor of Partnership Relation Quality in Polish Mothers of Preterm-Born Children.

The aim of the study was to identify whether perceived stress and significant life changes are related with partnership relation quality in mothers of preterm-born children. The study group consisted of 260 women, who gave a preterm birth. In most cases the delivery took place in the 34⁻36th week of pregnancy. The research consisted of two phases. Phase 1 was carried out in the Department of Obstetrics at the Medical University of Gdansk in the neonatal period (2⁻3 days after birth). Phase 2 was carried out in the place of residence of the mother and child during early childhood (24⁻30th month of the child's life). The following research tools were used in the first phase of the research project: Analysis of nursing and medical reports, an interview questionnaire and psychological interview, The Perceived Stress Questionnaire (PSQ) (Lavenstein, the Polish version, after Plopa, 2008), The Recent Life Changes Questionnaire (RLCQ) (Rahe and Holmes, 1975), the Polish version, after Terelak 1995), and the Dyadic Adjustment Scale (DAS) (Spanier, 1976, the Polish version, after Cieslak, 1989). In the second phase of the study the respondents were once again examined using the DAS. It was shown that stress is related to partnership relationship quality and of all its components, except cohesion. The findings demonstrated that important life events are associated with a couple's emotional expression in the neonatal period. Stressful life events do not correlate with relationship quality.