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2.
Codas ; 32(2): e20190093, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31939494

RESUMEN

PURPOSE: The attitude of mothers of children who stutter is believed to be crucial in the management of therapy process. Therefore, this study aimed at the description of resilience, perceived social support and trait anxiety levels of mothers of children with stuttering, as well as at the exploration of the relationship between them. METHODS: The study sample consisted of 33 mothers of children with stuttering aged 6-12 years. The data were gathered using the following instruments: Mother Resilience Scale, Revised Parental Social Support Scale, State-trait Anxiety Inventory, Stuttering Severity Instrument-4, and a personal information form. RESULTS: Resilience of mothers of children who stutter was high, whereas perceived social support and trait anxiety levels of the participants were lower. Mother's increased level of perceived social support resulted in increased resilience level and decreased trait anxiety level. The trait anxiety levels of mothers with a college degree were significantly lower than those of mothers with other education levels. No statistically significant correlation was observed between stuttering severity and the levels of resilience, perceived social support and trait anxiety. CONCLUSION: Although mothers of stuttering children present the required skills to cope with the situation, it is believed that they need more social support. Consequently, offering professional support to mothers in the course of stuttering management and referring them to appropriate intervention programs are emphasized.


Asunto(s)
Ansiedad/psicología , Madres/psicología , Resiliencia Psicológica , Apoyo Social , Tartamudeo/psicología , Adulto , Niño , Escolaridad , Femenino , Humanos , Masculino , Relaciones Madre-Hijo/psicología , Percepción , Escalas de Valoración Psiquiátrica , Valores de Referencia , Índice de Severidad de la Enfermedad , Estadísticas no Paramétricas , Encuestas y Cuestionarios , Turquia
3.
Prax Kinderpsychol Kinderpsychiatr ; 69(1): 22-39, 2020 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-31918644

RESUMEN

The Emotional Competence of Mothers and the Clinical Quality of Mother-Child Relationship in a Preschool Psychiatric Population The quality of mother-child interaction and relationship is an essential risk factor for the development of mental disorders at preschool age. We examine maternal emotional competence and maternal level of psychopathology as predictors for the quality of mother-child relationship. At the beginning of their treatment a clinical sample of mother-child-dyads at the Child Psychiatric Family Day Hospital in Münster was assessed concerning the emotional competence of mothers (EKF), the maternal psychopathology (SCL) and the mother-child relationship quality, the latter with three different instruments reflecting the mother's, the child's and the therapist's perspective (PIR-GAS, SKEI, M-PCR). The mothers showed decreased results in the EKF scales emotional regulation, recognition of emotions and in the EKF-overall-score and presented a higher level of maternal psychopathology compared to the normal population. There is a direct relation between emotional regulation and the M-PCR scales affective bond and functional-conflict. Besides the direct influence of the maternal psychopathology, the expected moderator effect of emotional expressiveness and the M-PCR scale functional-conflict, reported by mothers, was apparent. Certain aspects of the emotional competence of mothers and their psychopathology show an influence on mother-child relationship quality. The method and the perspective of assessment are crucial to the results.


Asunto(s)
Emociones , Trastornos Mentales , Relaciones Madre-Hijo , Madres , Preescolar , Femenino , Humanos , Madres/psicología , Psicopatología
4.
Lancet ; 394(10216): 2283-2284, 2020 12 21.
Artículo en Inglés | MEDLINE | ID: mdl-31868634
5.
Int J Gynaecol Obstet ; 148(1): 27-34, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31544243

RESUMEN

OBJECTIVE: Despite the recognized importance of person-centered care, very little information exists on how person-centered maternity care (PCMC) impacts newborn health. METHODS: Baseline and follow-up data were collected from women who delivered in government health facilities in Nairobi and Kiambu counties in Kenya between August 2016 and February 2017. The final analytic sample included 413 respondents who completed the baseline survey and at least one follow-up survey at 2, 6, 8, and/or 10 weeks. Data were analyzed using descriptive, bivariate, and multivariate statistics. Logistic regression was used to assess the relationship between PCMC scores and outcomes of interest. RESULTS: In multivariate analyses, women with high PCMC scores were significantly less likely to report newborn complications than women with low PCMC scores (adjusted odds ratio [aOR] 0.39, 95% confidence interval [CI] 0.16-0.98). Women reporting high PCMC scores also had significantly higher odds of reporting a willingness to return to the facility for their next delivery than women with low PCMC score (aOR 12.72, 95% CI 2.26-71.63). The domains of Respect/Dignity and Supportive Care were associated with fewer newborn complications and willingness to return to a facility. CONCLUSION: PCMC could improve not just the experience of the mother during childbirth, but also the health of her newborn and future health-seeking behavior.


Asunto(s)
Servicios de Salud Materna/organización & administración , Atención Dirigida al Paciente/métodos , Resultado del Embarazo/epidemiología , Adulto , Femenino , Humanos , Recién Nacido , Kenia , Servicios de Salud Materna/estadística & datos numéricos , Madres/psicología , Oportunidad Relativa , Atención Dirigida al Paciente/estadística & datos numéricos , Embarazo , Encuestas y Cuestionarios
6.
Niger J Clin Pract ; 22(12): 1662-1668, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31793471

RESUMEN

Background: Postpartum fatigue means tiredness, sense of suffocation, and decreased physical and mental capacity. Fatigue reduces postpartum women's ability of concentrate, which may increase the frequency of postpartum depression, and their babies and cause babies' weaning off breastmilk earlier. Aim: Postpartum fatigue reduces the ability of mothers to concentrate and has a negative effect on communication between mothers and their babies. This study was performed to determine the effect of fatigue on breastfeeding and breastfeeding behaviors in postpartum women. Subjects and Methods: The study had a descriptive desing and was carreid out in a postpartum clinic of a maternal, obstetric, and pediatric diseases hospital. It included 374 women giving normal vaginal birth. Data were gathered with a socio-demographic features form and Visual Analogue Scale for Fatigue. Results: The mean score was 6,91 ± 2,25 for the subscale fatigue and 2,38 ± 0,91 for the subscale energy. The women reporting that it was not difficult to give birth and that they had little or some fatigue had significantly higher scores for energy (P = 0.001). The women starting to breastfeed in the hour of giving birth (P = 0.003) and the women breastfeeding at 1-hour intervals (P = 0.100) had a lower score for fatigue. The women not needing help while breastfeeding had a significantly lower score for fatigue (P = 0.001), while those reporting to give additional food had a significantly higher score for fatigue (P = 0.014). Conclusion: Women feel tired in the early postpartum period due to giving birth and their tiredness is increased by breastfeeding and infant care.


Asunto(s)
Lactancia Materna/psicología , Fatiga/complicaciones , Madres/psicología , Periodo Posparto/psicología , Adulto , Parto Obstétrico , Depresión Posparto , Fatiga/psicología , Femenino , Humanos , Lactante , Recién Nacido , Embarazo , Encuestas y Cuestionarios , Turquia
7.
Medicine (Baltimore) ; 98(44): e17737, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31689820

RESUMEN

The World Health Organization and United Nations Children's Fund's Baby-Friendly Hospital Initiative is aimed at the global promotion, protection and support of breastfeeding. In this study, we compared breastfeeding-related information received, knowledge and behaviours among postpartum women in Baby-Friendly Hospital Initiative accredited and non-accredited hospitals. We selected 10 hospitals: 9 non-accredited hospitals in the Campania region in southern Italy and one accredited hospital in the Piedmont region in northern Italy. In total, 786 women (580 (73.8%) in Campania and 206 (26.2%) in Piedmont) in the hospitals' maternity wards completed a questionnaire comprising 5 sections within 24 to 72hours after giving birth. The questionnaire investigated breastfeeding activities in the days immediately following childbirth, as well as the information provided by health personnel, knowledge about breastfeeding before and during hospitalisation, and participation in antenatal classes. To evaluate the comparison between the 2 regions, we performed at first a bivariate analysis and then a multinomial and a multivariate logistic regression. Compared with Piedmont, in Campania hospitals there was a rate of breastfeeding of 44.3% vs 89.3%, a skin-to-skin contact between mother and child of 74.5% vs 90.7% and first milk feed within 2hours of 15.0% vs 87.2%. The Campania group had fewer problems with child latching. The Campania group reported receiving less information about breastfeeding in general compared with the Piedmont group. In general, both groups showed good basic knowledge about different aspects of breastfeeding. In both regions, about 90% reported that the information received during the antenatal classes simplified the breastfeeding experience. Our study confirms the importance of systematic promotion of breastfeeding and subsequent delivery of adequate support to maternity departments, in accordance with international guidelines.


Asunto(s)
Lactancia Materna/estadística & datos numéricos , Adhesión a Directriz/estadística & datos numéricos , Promoción de la Salud/normas , Madres/estadística & datos numéricos , Servicio de Ginecología y Obstetricia en Hospital/estadística & datos numéricos , Adulto , Lactancia Materna/psicología , Estudios Transversales , Femenino , Conocimientos, Actitudes y Práctica en Salud , Promoción de la Salud/métodos , Humanos , Recién Nacido , Italia , Modelos Logísticos , Madres/psicología , Análisis Multivariante , Servicio de Ginecología y Obstetricia en Hospital/normas , Embarazo , Evaluación de Programas y Proyectos de Salud , Naciones Unidas , Organización Mundial de la Salud
8.
BMC Psychol ; 7(1): 69, 2019 Nov 06.
Artículo en Inglés | MEDLINE | ID: mdl-31694699

RESUMEN

BACKGROUND: The demands of daily life often cause mothers high levels of distress and other negative emotions. Anger, including harsh verbal discipline, has been linked to child maltreatment, with long-term adverse effects on a child's well-being. It is critically important to teach mothers stress management and emotion regulation in addition to parenting skills, but this is yet to be conducted in a formalized manner. Strengthening the multiple protective factors that constitute resilience helps reduce distress. The aim of this study is to evaluate the efficacy of a resilience-enhancement program for mothers. METHODS: We designed a two-arm, parallel, randomized trial with an active control. Mothers and their partners with children between three and six years old will be recruited. Following an online baseline survey, 140 mothers will be randomly allocated to either an intervention or control group. Self-report assessment will be conducted online post-intervention and at a two-month follow-up. The control group will participate in a serious of group discussions. The intervention group will participate in four bi-weekly 120-min sessions of a Cognitive Behavior Therapy-based program designed to enhance resilience, focusing on emotion regulation through cognitive reappraisal. Participants will be encouraged to apply and share the skills they acquire with their partner and children at home. Partners will also be assessed to explore their indirect influence from the mothers. Intention-to-treat analysis will be conducted and the two groups will be compared, applying covariate analysis. The primary outcome of the intervention is improved resilience. Secondary outcomes include improved anger control, self-esteem, cognition of children's misbehavior, and reduced parental stress. DISCUSSION: To the best of our knowledge, this study will evaluate the first resilience-enhancement program focused on emotion regulation for mothers in Japan. It will contribute to the existing body of knowledge on building emotional resilience. If the program is found to be effective, it will provide an alternative means to enhance mothers' resilience against stress and improve their ability to regulate emotion. In so doing, it will offer a way to prevent child maltreatment and protect the mental health of children and families. TRIAL REGISTRATION: UMIN000027232 , May 3, 2017.


Asunto(s)
Terapia Cognitivo-Conductual , Madres/psicología , Adulto , Niño , Preescolar , Protocolos Clínicos , Femenino , Humanos , Japón , Masculino , Encuestas y Cuestionarios
9.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(11): 1170-1173, 2019 Nov 06.
Artículo en Chino | MEDLINE | ID: mdl-31683408

RESUMEN

From August 1(st) to 7(th), 2017, the breastfeeding knowledge of medical staff were collected from 52 medical health institutions in 29 provinces through a network system. A total of 35 243 questionnaires were included in the study to analyze the current status of breastfeeding knowledge and related factors. The qualified rate of breastfeeding knowledge questionnaires for medical staff in this study was 75.3% (26 546/35 243). Compared with those in the eastern region and those who were mothers, the qualified rate of breastfeeding knowledge of medical staff in the central region or the western region and medical staff who were fathers or expectant parents was lower, with OR (95%CI) values about 0.71 (0.67-0.75), 0.66 (0.61-0.72), 0.63 (0.55-0.72) and 0.87 (0.80-0.95), respectively. Compared with those attaining high school education or below and those with children aged<1 month, the qualified rate of breastfeeding knowledge was higher in medical staff with bachelor's degree, graduate degree or above, and with children aged 1-5, 6-23 and ≥24 months, with OR (95%CI) values about 1.92 (1.80-2.05), 2.16 (1.94-2.42), 2.28 (1.93-2.70), 2.41 (2.06-2.83) and 1.99 (1.72-2.32), respectively.


Asunto(s)
Lactancia Materna , Conocimientos, Actitudes y Práctica en Salud , Cuerpo Médico/psicología , Madres/psicología , Adulto , China , Femenino , Humanos , Lactante , Recién Nacido , Persona de Mediana Edad , Factores Socioeconómicos , Encuestas y Cuestionarios , Adulto Joven
10.
Sante Publique ; Vol. 31(3): 451-458, 2019.
Artículo en Francés | MEDLINE | ID: mdl-31640333

RESUMEN

INTRODUCTION: The study had for object to identify factors associated to the cessation of the exclusive breast-feeding at the mothers of children from 0 to 6 months in the urban and rural circles in Mali. METHOD: The study was longitudinal forward-looking, realized in Bamako (urban area) and in Dialakoroba (rural area) from April till November, 2016. in total, 218 mothers were enlisted (114 by area) in a voluntary way in health centers. A monthly follow-up of six months was realized in the place of residence. The SPSS 20 software was used for the seizure and the data analysis. The expected event was to give to the child another food than maternal milk. Test statistics such as Chi2 of Log Rank and Hazard Ratio (HR) were used with threshold of meaning p ≤ 0,05. RESULTS: In urban zones and rural respectively 68,5 % and 71,5% of the mothers had stopped the Exclusive Breast-feeding (EBF) before six months. Factors associated to this cessation of the EBF were: the use of the feeding-bottle (HR=2,61; IC 95%: [1,46-4,48]), the care of the child during less than three months as main occupation (HR=3,18; IC 95%: [1,95-5,20]), the support for the mother during less than three months (HR=3,79; IC 95%: [2,31-6,22]), the advice(council) on the EBF (HR=0,64; IC 95%: [0,46-0,98]) and the experience (experiment) of breastfeeding (HR=0,34; IC 95%: [0,15-0,84]). CONCLUSION: The consideration of the identified factors(mailmen) will allow to improve the practice of the EBF in six months in the sites of the study.


Asunto(s)
Lactancia Materna/estadística & datos numéricos , Madres/psicología , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Femenino , Estudios de Seguimiento , Humanos , Lactante , Recién Nacido , Malí , Madres/estadística & datos numéricos
11.
Rev Lat Am Enfermagem ; 27: e3176, 2019.
Artículo en Inglés, Portugués, Español | MEDLINE | ID: mdl-31596411

RESUMEN

OBJECTIVE: to measure the effect of an infant stimulation therapy (auditory, tactile, visual and vestibular) on the adaptation to postnatal life of the mother-child dyad. METHOD: an experimental and blind study composed of 120 dyads of first-time mothers and full-term newborns, who practiced breastfeeding. The follow-up was conducted during the first five weeks of life and the evaluation was carried at two different times. RESULTS: the adaptive capacity was measured in two modes. The physiological adaptive mode (activity and exercise and neonatal nutrition) and the interdependence adaptive mode (appropriate affection and proper development); and statistically significant differences were found in favor of the experimental group. Regression models that show the collaborative relationship between mother and child, and their reciprocity in the process of adaptation were proposed. CONCLUSION: the early stimulation is a therapy with bidirectional effect, because it has favorable effects on the person who administers it; promotes health and prevents illness in the process of adaptation to birth; especially in contexts of vulnerability. It is recommended its teaching to mothers and its application in the home environment. This study was registered in the Australian New Zealand Clinical Trial Registry (ANZCTR) under protocol number: ACTRN12617000449336.


Asunto(s)
Relaciones Madre-Hijo/psicología , Madres/psicología , Estimulación Física/métodos , Atención Posnatal/normas , Lactancia Materna , Femenino , Humanos , Lactante , Recién Nacido , Estrés Psicológico
12.
Matern Child Health J ; 23(12): 1658-1669, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31584144

RESUMEN

Objectives mHealth interventions for MNCH have been shown to improve uptake of antenatal and neonatal services in low- and middle-income countries (LMICs). However, little systematic analysis is available about their impact on infant health outcomes, such as reducing low birth weight or malnutrition among children under the age of five. The objective of this study is to determine if an age- and stage-based mobile phone voice messaging initiative for women, during pregnancy and up to 1 year after delivery, can reduce low birth weight and child malnutrition and improve women's infant care knowledge and practices. Methods We conducted a pseudo-randomized controlled trial among pregnant women from urban slums and low-income areas in Mumbai, India. Pregnant women, 18 years and older, speaking Hindi or Marathi were enrolled and assigned to receive mMitra messages (intervention group N = 1516) or not (Control group N = 500). Women in the intervention group received mMitra voice messages two times per week throughout their pregnancy and until their infant turned 1 year of age. Infant's birth weight, anthropometric data at 1 year of age, and status of immunization were obtained from Maternal Child Health (MCH) cards to assess impact on primary infant health outcomes. Women's infant health care practices and knowledge were assessed through interviews administered immediately after women enrolled in the study (Time 1), after they delivered their babies (Time 2), and after their babies turned 1 year old (Time 3). 15 infant care practices self-reported by women (Time 3) and knowledge on ten infant care topics (Time 2) were also compared between intervention and control arms. Results We observed a trend for increased odds of a baby being born at or above the ideal birth weight of 2.5 kg in the intervention group compared to controls (odds ratio (OR) 1.334, 95% confidence interval (CI) 0.983-1.839, p = 0.064). The intervention group performed significantly better on two infant care practice indicators: giving the infant supplementary feeding at 6 months of age (OR 1.4, 95% CI 1.08-1.82, p = 0.009) and fully immunizing the infant as prescribed under the Government of India's child immunization program (OR 1.531, 95% CI 1.141-2.055, p = 0.005). Women in the intervention group had increased odds of knowing that the baby should be given solid food by 6 months (OR 1.89, 95% CI 1.371-2.605, p < 0.01), that the baby needs to be given vaccines (OR 1.567, 95% CI 1.047-2.345, p = 0.028), and that the ideal birth weight is > 2.5 kg (OR 2.279, 95% CI 1.617-3.213, p < 0.01). Conclusions for Practice This study provides robust evidence that tailored mobile voice messages can significantly improve infant care practices and maternal knowledge that can positively impact infant child health. Furthermore, this is the first prospective study of a voice-based mHealth intervention to demonstrate a positive impact on infant birth weight, a health outcome of public health importance in many LMICs.


Asunto(s)
Teléfono Celular , Trastornos de la Nutrición del Niño/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Cuidado del Lactante/métodos , Desnutrición/prevención & control , Madres/psicología , Voz , Adulto , Niño , Femenino , Humanos , India , Lactante , Salud del Lactante , Recién Nacido de Bajo Peso , Recién Nacido , Masculino , Madres/estadística & datos numéricos , Áreas de Pobreza , Embarazo , Estudios Prospectivos , Telemedicina , Adulto Joven
15.
PLoS Negl Trop Dis ; 13(9): e0007768, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31568478

RESUMEN

BACKGROUND: Zika virus (ZIKV) infection in pregnancy can cause microcephaly and a wide spectrum of severe adverse outcomes, collectively called "Congenital Zika Syndrome" (CZS). Parenting a child with disabilities can have adverse mental health impacts, but these associations have not been fully explored in the context of CZS in Brazil. METHODOLOGY/PRINCIPAL FINDINGS: A cross-sectional study was undertaken in Recife and Rio de Janeiro, including 163 caregivers of a child with CZS (cases) and 324 caregivers with an unaffected child (comparison subjects), identified from existing studies. The primary caregiver, almost always the mother, was interviewed using a structured questionnaire to collect information on: depression, anxiety, and stress (Depression, Anxiety, and Stress Scale-DASS-21), social support (Medical Outcomes Study Social Support Scale-MOS-SSS), and socio-demographic data. Data was collected May 2017-January 2018. Ethical standards were adhered to throughout the research. A high proportion of mothers reported experiencing severe or extremely severe levels of depression (18%), anxiety (27%) and stress (36%). Mothers of children with CZS were more likely to experience symptoms of depression, anxiety andstress, compared to mothers of comparison children. These associations were more apparent among mothers living in Rio de Janeiro. These differences were reduced after adjustment for socio-economic status and social support. Among mothers of children with CZS, low social support was linked to higher levels of depression, anxiety and stress, but there was no association with socio-economic status. CONCLUSIONS/SIGNIFICANCE: Depression, anxiety and stress were very common among mothers of young children in Brazil, regardless of whether they were parenting a child with disabilities. Mothers of children with CZS may be particularly vulnerable to poor mental health, and this association may be buffered through better social support.


Asunto(s)
Ansiedad/epidemiología , Madres/psicología , Estrés Psicológico/epidemiología , Infección por el Virus Zika/congénito , Adulto , Ansiedad/etiología , Brasil , Cuidadores/psicología , Estudios de Casos y Controles , Estudios Transversales , Depresión/epidemiología , Depresión/etiología , Femenino , Humanos , Lactante , Masculino , Microcefalia , Clase Social , Apoyo Social , Estrés Psicológico/etiología , Encuestas y Cuestionarios
16.
J Consult Clin Psychol ; 87(11): 1056-1067, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31556651

RESUMEN

OBJECTIVE: We evaluated whether initiating the Family Check-Up (FCU) during early childhood prevented a severe form of psychopathology in adolescence-co-occurring internalizing and externalizing problems-and whether effects operated indirectly through early childhood maternal depression and parents' positive behavior support. METHOD: Participants were drawn from a randomized controlled trial of the FCU (50.2% FCU; 49.5% girls; 46.6% Caucasian, and 27.6% Black; 13.4% Hispanic/Latino). At Ages 2 and 3, mothers self-reported depression, and primary caregivers' (PCs') positive behavior support was coded by trained observers. PCs, alternate caregivers (ACs), and teachers reported on 14-year-olds' problem behaviors. Latent profile analyses (LPAs) identified problem behavior groups for each reporter, which were outcomes in multinomial logistic regressions (PC, n = 672; AC, n = 652; teacher, n = 667). RESULTS: LPAs identified a low-problem, internalizing-only, externalizing-only, and co-occurring-problem group for each reporter. For PC- and AC-reported outcomes, the FCU predicted a lower likelihood that adolescents belonged to the co-occurring group relative to the low-problem, externalizing-only (p < .05), and internalizing-only (p < .05 for PC, p < 0.10 for AC) groups; these effects operated through maternal depression (p < .05). For teacher-reported outcomes, the FCU predicted a lower likelihood that adolescents belonged to the co-occurring group relative to the low-problem, internalizing-only, and externalizing-only (p < 0.05) groups; effects operated through positive behavior support (p < 0.05). CONCLUSIONS: Early delivery of the FCU indirectly prevented adolescents' co-occurring internalizing/externalizing problems in both home and school contexts by improving the quality of the early home environment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Asunto(s)
Conducta del Adolescente/psicología , Trastornos de la Conducta Infantil/prevención & control , Trastornos de la Conducta Infantil/psicología , Trastorno Depresivo/psicología , Terapia Familiar/métodos , Padres/psicología , Adolescente , Preescolar , Femenino , Humanos , Masculino , Madres/psicología , Autoinforme
17.
Tijdschr Psychiatr ; 61(9): 626-634, 2019.
Artículo en Holandés | MEDLINE | ID: mdl-31560782

RESUMEN

BACKGROUND: Only 0.8% of the admissions to our mother-baby unit are mothers with schizophrenia, while about half of the patients with schizophrenia become mothers. Mothers with schizophrenia are more likely to live in complex problematic settings and, thereby, more frequently lose custody of their children. Also, they experience stigma against their parenting skills. Literature research shows that they therefore avoid care. However, the inclusion of their role as a mother can contribute to recovery, giving meaning and social integration.
AIM: To initiate debate on responsible motherhood in women with schizophrenia with the aim of optimizing the Flemish care provision and give an incentive towards more scientific research.
METHOD: Consultation of the minimal psychiatric data (mpd) on our mother-baby unit. Narrative literature search using PubMed with a focus on schizophrenia in the peripartum.
RESULTS: Mothers who suffer from schizophrenia are more likely to experience difficulties in social cognition and sensitivity to their children. These problems can make the relationship between mother and baby more difficult. However, this does not exclude the possibility of developing a positive attachment relationship.
CONCLUSION: A persistent case manager-driven care model, which monitors the care for this vulnerable population and focuses on reinforcing the parenting qualities, looks promising. As a result, (shared) responsible motherhood could have a positive impact on their recovery.


Asunto(s)
Relaciones Madre-Hijo , Madres/psicología , Atención Perinatal , Psicología del Esquizofrénico , Adulto , Bélgica , Femenino , Humanos , Lactante , Recién Nacido , Salud Mental , Relaciones Madre-Hijo/psicología , Responsabilidad Parental , Embarazo , Esquizofrenia
18.
Matern Child Health J ; 23(12): 1686-1698, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31529248

RESUMEN

INTRODUCTION: The quality of the mother-child relationship in the first year of life has far reaching implications across the life course (Bornstein in Annu Rev Psychol 65:121-158, 2014). Yet little is known about predictors of maternal bonding and emotional availability in early infancy. In this study we examined the extent to which postnatal bonding, maternal mental health, and substance use at 8-weeks postpartum predicted mother-infant bonding (self-report) and mother emotional availability (observational) at 12-months of age. METHODS: Data were obtained from an Australian longitudinal cohort study of pregnancy (n = 308). Data were collected during pregnancy, at birth, and postnatally at 8-weeks and 12-months. RESULTS: The results show strong continuity between postnatal bonding at 8-weeks and 12-months. Early postpartum stress and depression were associated with bonding at 12-months; however, the effect did not persist after adjustment for bonding at 8-weeks. Tobacco use at 8-weeks, but no other indicators of mental health, predicted lower emotional availability scores at 12-months. DISCUSSION: Results suggest that the mother's felt bond to her child is stable across the first year of life and that early bonding is a more robust indicator of bonding at 12-months than a mother's mental health or substance use. These findings point to the importance of clinical and public health investments in establishing a strong bond between mother and child in the early postpartum period.


Asunto(s)
Salud Mental , Relaciones Madre-Hijo/psicología , Madres/psicología , Apego a Objetos , Mujeres Embarazadas/psicología , Trastornos Relacionados con Sustancias , Adulto , Australia , Depresión Posparto/psicología , Emociones , Femenino , Humanos , Lactante , Estudios Longitudinales , Masculino , Periodo Posparto/psicología , Embarazo , Estudios Prospectivos , Encuestas y Cuestionarios , Adulto Joven
19.
Cochrane Database Syst Rev ; 9: CD012099, 2019 Sep 17.
Artículo en Inglés | MEDLINE | ID: mdl-31529625

RESUMEN

BACKGROUND: Exclusive breastfeeding is recommended for all infants until six months of age due to the many health benefits for both the mother and infant.Evidence suggests that mothers who are overweight (body mass index (BMI) 25.0 to 29.9 kg/m²) or obese (BMI ≥ 30.0 kg/m²) are less likely to initiate breastfeeding and to breastfeed for a shorter duration. Considering the rising prevalence of overweight and obesity globally and the known benefits of breastfeeding particularly in reducing the long-term risks of obesity and diabetes for infants, establishing effective ways to support and promote breastfeeding in women who are overweight or obese is paramount in achieving the goal of healthier communities. OBJECTIVES: To assess the effectiveness of interventions to support the initiation or continuation of breastfeeding in women who are overweight or obese. SEARCH METHODS: On 23 January 2019 we searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the World Health Organization International Clinical Trials Registry Platform (ICTRP) and reference lists of retrieved trials. SELECTION CRITERIA: Randomised controlled trials (RCTs) and quasi-RCTs that compared interventions to support the initiation and continuation of breastfeeding in women who are overweight or obese. Interventions included social support, education, physical support, or any combination of these. Interventions were compared either with each other or against a control group. DATA COLLECTION AND ANALYSIS: We assessed all potential trials identified from the search strategy. Two review authors extracted data from each included trial and assessed risk of bias. We resolved discrepancies through discussion with the third review author. We assessed the quality of the evidence using the GRADE approach. MAIN RESULTS: We found no trials comparing one type of support versus another. We included seven RCTs (including one cluster-RCT) involving 831 women. The number of women in each trial ranged from 36 to 226. The trials were conducted in high-income countries: USA (5 trials); Denmark (1 trial) and Australia (1 trial), between 2006 and 2015. Three trials only included women who were obese prior to pregnancy and four trials included both women who were overweight and women who were obese. We judged risk of bias in the included trials to be mixed; only one trial was judged to be low risk of bias for random sequence generation, allocation concealment and attrition bias.Physical breastfeeding support (manual or electric breast pump) versus usual care (no breast pump)Very low-certainty evidence from one small trial (39 women) looking at a physical support intervention (manual or electric breast pump) versus usual care (no pump) means it is unclear whether physical support improves exclusive breastfeeding at four to six weeks (risk ratio (RR) 0.55, 95% confidence interval (CI) 0.20 to 1.51) or any breastfeeding at four to six weeks (RR 0.65, 95% CI 0.41 to 1.03). The trial did not report other important outcomes of interest in this review: non-initiation of breastfeeding, exclusive or any breastfeeding at six months postpartum.Multiple methods of breastfeeding support versus usual care Six trials (involving 792 women) used multiple methods of support including education and social support through telephone or face-to-face contact. One of these trials also provided physical support through providing a breast pump and a baby sling and one trial provided a small gift to the women at each trial visit. Support in the trials was provided by a professional (four trials) or a peer (two trials). One trial provided group support, with the other five trials supporting women individually. One trial (174 women) did not report on any of our main outcomes of interest.We are unclear about the effects of the intervention because we identified very low-certainty evidence for all of the important outcomes in this review: rate of non-initiation of breastfeeding (average RR 1.03, 95% CI 0.07 to 16.11; 3 trials, 380 women); exclusive breastfeeding at four to six weeks (average RR 1.21, 95% CI 0.83 to 1.77; 4 trials, 445 women); any breastfeeding at four to six weeks (average RR 1.04, 95% CI 0.57 to 1.89; 2 trials, 103 women); rate of exclusive breastfeeding at six months postpartum (RR 7.23, 95% CI 0.38 to 137.08; 1 trial, 120 women); and any breastfeeding at six months postpartum (average RR 1.42, 95% CI 1.08 to 1.87; 2 trials, 223 women).The included trials under the above comparisons also reported on some of this review's secondary outcomes but very low-certainty evidence means that we are unclear about the effects of the intervention on those outcomes. AUTHORS' CONCLUSIONS: There is insufficient evidence to assess the effectiveness of physical interventions, or multiple methods of support (social, educational or physical) for supporting the initiation or continuation of breastfeeding in women who are overweight or obese. We found no RCTs comparing one type of support to another type of support. All of our GRADE assessments resulted in very low-certainty evidence, with downgrading decisions based on limitations in trial design (e.g. risk of attrition bias), imprecision, inconsistency. The available trials were mostly of variable quality with small numbers of participants, confounded by poor adherence within both the intervention and control groups.Well designed, adequately powered research is needed to answer questions about the social, educational, physical support, or any combination of these interventions that could potentially help mothers who are overweight or obese to achieve optimal breastfeeding outcomes. We need trials that examine interventions designed specifically for women who are overweight or obese, delivered by people with training about how to overcome some of the challenges these women face when establishing and maintaining breastfeeding. Particular attention could be given to the assessment of antenatal interventions aimed at improving breastfeeding initiation in women with a raised BMI, and not just focusing on recruiting women who have an intention to breastfeed. Given that the majority of current trials were undertaken in the USA, further trials in a diverse range of countries and settings are required. Future trials need to give consideration to the theoretical basis of the intervention using established frameworks to enable replicability by others and to better determine the components of effective interventions.


Asunto(s)
Lactancia Materna/psicología , Promoción de la Salud/métodos , Madres/psicología , Obesidad , Sobrepeso , Femenino , Humanos , Lactante , Madres/educación , Obesidad/prevención & control , Sobrepeso/prevención & control , Periodo Posparto , Ensayos Clínicos Controlados Aleatorios como Asunto , Factores de Tiempo
20.
Psychiatr Danub ; 31(Suppl 3): 338-344, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31488750

RESUMEN

INTRODUCTION: Mental difficulties are common in the postpartum period. They can manifest in a mild form, but also as serious disorders which need to be treated in a timely manner. The most common psychological problem is "Baby blues" characterized by relatively short duration without consequences and treatment is largely unnecessary. Postpartum depression is characterized by a sense of sadness, loss of interest, insomnia, discomfort, loss of energy, reduced concentration. Postpartum psychosis is the most serious disorder but is also rare and may have serious consequences for the mother and child. Important factors in the postpartum mental problems/difficulties are genetic factors, situation of unwanted pregnancy, a feeling of discomfort with the role of motherhood and sudden hormonal changes. AIM: to investigate the frequency and type of mental problems in postpartum period, as well as possible type of help needed by the women in postpartum period. SUBJECTS AND METHODS: One hundred (112) respondents participated in the survey. The survey was conducted from November to December 2017 through a "google docs" application. The survey was placed on different social networks, and the participation in the survey was voluntary and anonymous. A series of 14 questions with the offered answers was used in the survey. RESULTS: The results of the survey have shown that psychological difficulties and disturbances in the postpartum period to be common problems encountered by almost 50% of women (44.46%). The most common difficulty is Baby blues, followed by postpartum depression and anxiety disorders. Age and the mode of birth did not affect the emergence of changes, while social factors such as family support had a great impact. CONCLUSION: The provision of information to the mothers can help, but inaccurate information can do the opposite. Thus, the role of health care professionals is important for helping mothers in that period to prevent certain difficulties as well as in identifying and referring mothers to seek help in a timely fashion.


Asunto(s)
Ansiedad/epidemiología , Depresión Posparto/epidemiología , Depresión Posparto/psicología , Madres/psicología , Periodo Posparto/psicología , Trastornos Psicóticos/epidemiología , Ansiedad/psicología , Niño , Femenino , Humanos , Recién Nacido , Madres/educación , Embarazo , Embarazo no Deseado/psicología , Trastornos Psicóticos/psicología , Encuestas y Cuestionarios
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