Feasibility and Usability of the Job Adjustment Mobile App for Pregnant Women: Longitudinal Observational Study.

BACKGROUND: Working pregnant women often need to adjust their physically demanding jobs for a healthy pregnancy. However, uncertainty about the extent of these adjustments can hinder their effectiveness. To address this, we developed the Job Adjustment mobile app, which allows users to input job and health details to generate a variety of personalized action plans. As this is the first version of the app, assessing its feasibility and usability is crucial. OBJECTIVE: This study aims to verify the feasibility and usability of the Job Adjustment mobile app. METHODS: A longitudinal observational study was conducted on pregnant Japanese women who were allowed to use the app anytime from 12 to 34 weeks of gestation; they received reminder emails every 2 weeks encouraging app use. A questionnaire was administered before app use and at 20 and 32 weeks of gestation. Feasibility was evaluated across 4 domains: implementation, demand, acceptability, and adverse events. Implementation was evaluated based on 3 parameters: dropout rate, initial reminder email receipt rate, and adherence rate (measured as pregnant women who used the app at intervals of 2.5 weeks or less). Demand was measured by intervals between use and intervals between log-in, and participants answered 15 questions to assess acceptability. Adverse events were assessed by analyzing the degree of anxiety related to work. Demographic data were analyzed to determine any statistically significant differences in intervals between uses. Usability was evaluated using the System Usability Scale. RESULTS: The analysis included 66 pregnant women, and 61% (n=40) of them were multipara. The dropout rate, adherence rate, and initial reminder email receipt rate were 18% (13/71), 44% (29/66), and 79% (52/66) respectively. The median intervals between use and intervals between log-in were 2.94 (IQR 2.00-5.13) weeks and 2.28 (IQR 1.81-4.00) weeks, respectively. Overall, 60% (35/58) to 90% (52/58) of the participants responded positively to all 15 questions assessing acceptability, and no anxiety regarding work was recorded. The mean System Usability Scale score was 66.1 points. Multipara women had significantly longer intervals between app use compared to primipara women (P=.01). CONCLUSIONS: The results demonstrated acceptable levels of feasibility and usability of the app. However, the low adherence rates, especially among multipara women, suggest the need for modifications to reduce the time burden of the app. Further research should explore more effective and acceptable intervals between use and timing, involving a larger sample and accounting for diverse characteristics of pregnant women. TRIAL REGISTRATION: UMIN Clinical Trials Registry UMIN000042943; https://tinyurl.com/ydrchfas.

Occupational stress is associated with job performance among pregnant women in Japan: comparison with similar age group of women.

BACKGROUND: Pregnancy results in physical and psychological changes in women; however, pregnant women hesitate to take a break from work even when they feel the need. Since working while physically ill leads to decreased job performance, it is important to determine the factors that lead to this phenomenon. AIM: To study the occupational stress associated with job performance and absenteeism of pregnant women compared with non-pregnant women. METHODS: In 2019, non-pregnant and pregnant employed women in their 20-40 s in Japan completed an online survey examining job performance (Work Limitation Questionnaire - Short Form), absenteeism, occupational stress (Brief Job Stress Questionnaire), and working situations. RESULTS: Of 918 respondents who met the inclusion criteria, 904 were included in the final analysis (454 non-pregnant and 450 pregnant women). Logistic regression analyses showed that absenteeism was significantly higher for pregnant women. However, for women who were absent, there was no significant difference between non-pregnant and pregnant women. After adjusting for attributes and working conditions, pregnant women had significantly higher (p < .001) work productivity losses than non-pregnant women, but only in the physical tasks domain; their physical stress response was also higher compared to non-pregnant women (p = .048). However, pregnant women reported significantly less interpersonal conflict stress (p < .001) and psychological stress (p = .026), as well as better workplace support as a buffering factor for stress (p = .021), than non-pregnant women. CONCLUSION: Clarifying the physical burden associated with pregnancy and assisting women in coordinating their work duties while considering the physical demands of pregnancy may minimize work productivity losses among pregnant women.

Prevalence of urinary retention after vaginal delivery: a systematic review and meta- analysis.

INTRODUCTION AND HYPOTHESIS: Postpartum urinary retention requires timely detection and intervention as late detection can lead to long-term voiding dysfunction; however, trends in the prevalence of urinary retention during the postpartum period remain unclear. This systematic review and meta-analysis aimed to estimate the pooled overall prevalence of overt and covert urinary retention in women after vaginal delivery and the difference in prevalence within 4 days after delivery. METHODS: MEDLINE, CINAHL, Ichu-shi web, and J-stage databases were searched up until October 2020. Two researchers screened and included observational studies reporting the prevalence of urinary retention up to 4 days postpartum based on inclusion criteria. The overall prevalence of overt and covert urinary retention was calculated. RESULTS: From 24 studies, the overall overt and covert urinary retention prevalence rates were estimated to be 1% and 13%, respectively. The prevalence of overt urinary retention over time was 2% at 6 h postpartum, 1% at 6-12 h, and 3% from postpartum to 24 h postpartum. The prevalence of covert urinary retention over time was 19% (6 h postpartum), 15% (24 h postpartum), 11% (1 day postpartum), 7% (2 days postpartum), 8% (3 days postpartum), and 0.1% (4 days postpartum). CONCLUSIONS: By postpartum day 4 after vaginal delivery, 14% of women were found to have experienced urinary retention. The highest prevalence was observed at 6 h postpartum, suggesting that urinary retention could be identified at 6 h postpartum.

Prevalence of symptoms of pelvic floor dysfunction and related factors among Japanese female healthcare workers.

OBJECTIVES: Women working in the medical field may be at risk for pelvic floor dysfunction due to high physical activity levels leading to increased abdominal pressure; however, the actual situation remains unknown. This study aimed to clarify the prevalence of symptoms of pelvic floor dysfunction and its associated factors among Japanese women working in the medical field. METHODS: A cross-sectional study was conducted among female employees at a public hospital in Japan from July to August 2020. Participants answered a web-based questionnaire. Three types of symptoms related to pelvic floor dysfunction were assessed based on one or more subscale scores in the Pelvic Floor Distress Inventory-Short Form 20 (PFDI-20). RESULTS: Out of 466 female employees in the hospital, 294 responded (response rate 63.1%). The mean age was 42.8 ± 10.3 years old and 221 (73.5%) were nurses. The prevalence of at least one type of symptom was 63.9%. The prevalence of recto-anal symptoms (45.9%) was highest, followed by lower urinary tract (37.1%) and pelvic organ prolapse symptoms (22.8%). The total PFDI-20 score was associated with constipation (ß = .254), body mass index (ß = .136), and part-time work (ß = .167) after adjusting for other variables. CONCLUSION: This study showed a high prevalence of symptoms related to pelvic floor dysfunction among women working in the medical field. Lifestyle management to prevent constipation and obesity is a promising strategy to improve symptoms of pelvic floor dysfunction.

Relationship between low back pain and stress urinary incontinence at 3 months postpartum.

Previous studies have proposed that pelvic misalignment may be associated with stress urinary incontinence through a decrease in the contractile function of the pelvic floor muscles; however, this relationship remains unclear. This study aimed to clarify the relationship between low back pain, an indication of pelvic misalignment, and stress urinary incontinence at 3 months postpartum. We conducted a cross-sectional study of women who gave birth to full-term babies between July 2008 and July 2009. Stress urinary incontinence was defined as urinary leakage when coughing, sneezing, or exercising. Low back pain was defined as pain between the ribs and gluteal sulcus in the preceding 2 months. Of the 228 subjects included in the study, the prevalence of stress urinary incontinence was 22.8% (n = 52). The prevalence of low back pain in the stress urinary incontinence group was significantly higher than that in the non-stress urinary incontinence group (78.8% [n = 41] vs. 57.4% [n = 101]; p = 0.005). Stress urinary incontinence was associated with older age, primiparity, vaginal delivery, and low back pain at 3 months. In conclusion, low back pain was associated with stress urinary incontinence after adjusting for pregnancy and delivery factors, suggesting pelvic misalignment contributes to the development of stress urinary incontinence. We propose that including care for pelvic misalignment in pelvic floor muscle training, the treatment of choice for stress urinary incontinence, could be beneficial.

Factors Associated With the Work Productivity of Japanese Working Pregnant Women: A Cross-Sectional Study.

OBJECTIVES: Working pregnant women experience physical and psychosocial changes, which are associated with two aspects of work productivity: presenteeism and absenteeism. We examined the factors that affect these two aspects. METHODS: This cross-sectional study was conducted in April to May 2019 through an online survey. Participants were 450 working women who were pregnant for the first time. RESULTS: Occupational stress (job overload sß: 0.14, suitable jobs sß: 0.16); physical conditions, such as pregnancy complications (sß: 0.32) and gestational period (sß: 0.18); and adjustment status in the workplace due to pregnancy, such as pregnancy disclosure (sß: 0.11) and pregnancy discrimination (sß: 0.18), were related to presenteeism. Meanwhile, pregnancy complications were the only factor associated with absenteeism (sß: 0.32; all P < 0.05). CONCLUSIONS: In addition to physical condition support, support for psychosocial conditions in the workplace is required.

Associations between Coparenting Relationships and Maternal Depressive Symptoms and Negative Bonding to Infant.

Maternal mental illnesses during early postpartum may be caused by lack of the coparenting relationship parents share and cooperate regarding child-rearing. This study clarifies the association of the coparenting relationship and negative mental health of mothers at one and three months after childbirth. This study conducted a secondary analysis of data from an intervention study wherein 24 mothers rearing their first child with a cohabitant (husband/partner) participated. Maternal mental health was evaluated using the Edinburgh Postnatal Depression Scale to determine postpartum depressive symptoms and the Mother-to-Infant Bonding Scale to assess negative bonding. Mothers' average age was 31.5 ± 4.2 years old. All mothers were not working during the research period. The prevalence of postpartum depression and bonding disorder were approximately 13% and 21%, respectively. A better coparenting relationship was associated with lower postpartum depressive symptoms at both one month (ß = -0.617, p = 0.002) and three months (ß = -0.709, p < 0.01) postpartum. In contrast, no association was found between a coparenting relationship and negative bonding. The results indicate that the coparenting relationship may possibly prevent maternal depression during the early postpartum period.

Relationship between number of menopausal symptoms and work performance in Japanese working women.

OBJECTIVE: The presence of various menopausal symptoms could decrease work performance because symptom management strategies differ, and it is difficult to control all symptoms at work. The aim of this study was to examine the relationship between the number of menopausal symptoms experienced and work performance in working women. METHODS: An online cross-sectional study was conducted with 599 working Japanese women aged 45 to 65 years. To represent work performance, absolute presenteeism was measured using the Japanese version of the World Health Organization and Work Performance Questionnaire short form, and menopausal symptoms were measured using the Greene Climacteric Scale. The total number of subscales on which a participant scored more than one point represented the number of menopausal symptoms. RESULTS: Participants' mean age was 54.2 years, and 60.6% were postmenopausal. Their mean Greene Climacteric Scale score and mean absolute presenteeism score were 10.5 ± 10.6 and 61.7 ±â€Š17.9, respectively. The proportions of participants who provided care for a family member, who had chronic disease, and who undertook regular exercise were significantly different among the four groups. After adjusting for other factors, absolute presenteeism was negatively correlated with the number of menopausal symptoms experienced (ß = -0.13, P < 0.001). CONCLUSIONS: Higher numbers of menopausal symptoms were correlated with lower work performance. The maintenance of health and the provision of appropriate working environments would help working women and improve work performance by reducing menopausal symptoms.

Acceptability and Feasibility of a Sedentary Behavior Reduction Program during Pregnancy: A Semi-Experimental Study.

Physical activity (PA) during pregnancy is associated with maternal benefits. Therefore, innovative strategies that promote PA are needed. This study investigated the acceptability and feasibility of a sedentary behavior (SB) reduction program during pregnancy. The study employed a semi-experimental research design using historical control subjects. The intervention group program consisted of individual face-to-face guidance, automatic alerts during SB from wearable devices, and self-monitoring of SB patterns, from 20 gestation weeks to delivery. PA and SB, assessed using a wearable device, were compared with those of the control group at 24-27 (T1) and 32-35 (T2) weeks of gestation. In 56 women, the mean wearing time was 90.2 days in the intervention phase. The response rate to automatic SB alerts was 55.5% at T1 and 63.0% at T2. Self-monitoring more than twice or thrice a week was 77.8% at T1 and 59.3% at T2. There was no significant difference in the cumulative SB time at T2 between the two groups (F = 2.31, p = 0.132). This program appears to be acceptable and feasible for pregnant women; however, SB reduction effect of the intervention remains unclear. Improvements to increase the response rate to automatic SB alerts and the frequency of self-monitoring are needed.

Longitudinal study of physical activity using an accelerometer in Japanese pregnant women.

AIM: To describe the characteristics of objectively measured physical activity (PA) during the 2nd and 3rd trimesters of pregnancy using a accelerometer. METHODS: This was a longitudinal observational study wherein PA in pregnant women in the 2nd and 3rd trimesters was measured for seven consecutive days using a accelerometer (Silmee W10, TDK, Japan). RESULTS: A total of 34 primiparous women were examined. There was no statistically significant difference in the amount of PA during the 2nd and 3rd trimesters of pregnancy. Sub-group analysis demonstrated that PA in the full-time housewife group increased significantly from the 2nd to the 3rd trimester, while total PA and moderate and vigorous PA of the stopped-working group, decreased significantly over that time. There was no difference in the PA of the currently working group between trimesters. In the full-time housewife group, the amount of PA for each hour significantly increased at 12:00, 18:00, and 22:00 hr. In the currently working group, the amount of PA for each hour significantly increased at 9:00, 10:00, and 16:00 hr. In the stopped-working group, the amount of PA for each hour significantly decreased at 7:00, 8:00, and 18:00 hr. CONCLUSION: Objective measurements using an accelerometer did not identify any significant changes in PA during the different trimesters of pregnancy. Sub-group analysis revealed clear patterns in PA change correlating with different lifestyles during pregnancy. Future research may enable the development of personalized health guidance by identifying the relationship between PA and pregnancy outcomes.

Developing a Prenatal Couple Education Program Focusing on Coparenting for Japanese Couples: A Quasi-Experimental Study.

Having and raising children can be a source of joy for parents. However, the transition to parenthood is associated with a certain degree of strain and stress, and couple relationship quality often declines during the transition. Coparenting, the shared responsibility of childrearing, benefits both parents and children and is an important aspect of the transition to parenthood. In this quasi-experimental study, we aimed to develop a couple education program in Japan that focuses on coparenting among couples expecting their first child. Twenty-one healthy couples voluntarily participated in the intervention group (n = 16) or the control group (n = 5). Couples in each group could voluntarily participate in standard childbirth education classes. The intervention was a couple education program designed to enhance coparenting and consisted of two interactive classes, including discussions within each couple and watching a short video showing an example of childrearing. We collected outcome measures on childrearing, couple relationship, parental mental health, and child adjustment at 1 month and 3 months after childbirth. Multiple regression analysis was performed and showed positive effects of the intervention on childrearing and child adjustment. Being in the intervention group had a significant positive effect on Coparenting Support scores at 1 month after childbirth (ß = 0.457, p < 0.003, R2 = 0.187) and Soothability scores for child adjustment at 3 months after childbirth (ß =0.429, p < 0.006, R2 = 0.157). In conclusion, we have developed the prenatal education program focusing on coparenting for Japanese couples.

Positive Emotion and its Changes during Pregnancy: Adjunct Study of Japan Environment and Children's Study in Miyagi Prefecture.

During pregnancy, women experience various emotional changes. Previous research has investigated positive emotion influenced childbirth outcomes positively. This study explored the extent of positive emotion which pregnant women aware of their own pregnancy life subjectively and variables related to the changes thereof. This was an adjunct study of the Japan Environment and Children's Study which is a nationwide epidemiological study to identify the impact of environmental factors on health and development of children in Miyagi Prefecture. Data were collected at 12 weeks (T1) and 24-28 weeks (T2) of gestation. Participants were 3,513 pregnant women. Women's degree of positive emotion was assessed through a numeric rating scale. We also measured related variables, including obstetric factors, physical health status, mental health status, and social situation, using the 8-Item Short Form Health Survey, Kessler-6, and family APGAR score, along with demographic data. Analyses included correlations among variables related to the change in positive emotion. The extent of positive emotion was significantly related with health-related quality of life and satisfaction with family relationships during pregnancy. The women whose positive emotion decreased from T1 to T2 tended to have lower morning sickness symptoms, be unemployed, lower physical and mental health status, and a higher risk of psychological distress in middle pregnancy. Importantly, even discomfort like morning sickness, physical symptoms that indicate being pregnant, might make women to confirm pregnancy. Moreover, employment and satisfaction with family relationships are especially crucial for pregnant women to spend comfortable maternity life.

Maternal Gaze Behaviors During Latching-On for Breastfeeding.

BACKGROUND: Studies in various fields have demonstrated that experts use specific gaze strategies to achieve better performance. Therefore, we hypothesized that mothers familiar with breastfeeding would use a specific gaze strategy to achieve better latching-on. METHODS: A head-mounted eye tracker was used to record pupil positions from 14 breastfeeding mothers with 1-month-old infants. Eye gazes were analyzed during the latching-on and assessment phases. RESULTS: During the latching-on phase, participants tended to fixate on their breast, the infant's lower face, an intermediate region between the infant's face and the breast, and the region of contact between the infant's mouth and the breast. Once the infant latched onto the breast, mothers typically assessed the latch by fixating on their breast or the region of contact between the infant's mouth and the breast. The gaze patterns were generally maintained without being influenced by the subtask properties of each phase. CONCLUSION: Similar to previous studies, we found that mothers fixated on specific locations that were relevant to the current breastfeeding subtask, suggesting that the gaze behavior contributes to the execution of latching-on. Therefore, it is important to consider that successful latching-on is influenced by maternal physical movements and efficient gazing behaviors.

Immediate Needs and Concerns among Pregnant Women During and after Typhoon Haiyan (Yolanda).

INTRODUCTION: Pregnant and postpartum women are especially vulnerable to natural disasters. These women suffer from increased risk of physical and mental issues including pregnant related problems. Typhoon Haiyan (Yolanda), which hit the Philippines affected a large number of people and caused devastating damages. During and after the typhoon, pregnant women were forced to live in particularly difficult circumstances. The purpose of this study was to determine concerns and problems regarding public health needs and coping mechanisms among pregnant women during and shortly after the typhoon. METHODS: This study employed a cross-sectional design utilizing focus group discussions (FGDs). Participants were 53 women (mean age: 26.6 years old; 42 had children) from four affected communities who were pregnant at the time of the typhoon. FGDs were conducted 4 months after the typhoon, from March 19 to 28, 2014, using semi-structured interviews. Data were analyzed using the qualitative content analysis. RESULT: Three themes were identified regarding problems and concerns during and after the typhoon: 1) having no ideas what is going to happen during the evacuation, 2) lacking essentials to survive, and 3) being unsure of how to deal with health concerns. Two themes were identified as means of solving issues: 1) finding food for survival and 2) avoiding diseases to save my family. As the pregnant women already had several typhoon experiences without any major problems, they underestimated the catastrophic nature of this typhoon. During the typhoon, the women could not ensure their safety and did not have a strong sense of crisis management. They suffered from hunger, food shortage, and poor sanitation. Moreover, though the women had fear and anxiety regarding their pregnancy, they had no way to resolve these concerns. Pregnant women and their families also suffered from common health problems for which they would usually seek medical services. Under such conditions, the pregnant woman cooperated with others for survival and used their knowledge of disease prevention. DISCUSSION: Pregnant women experienced difficulties with evacuation, a lack of minimum survival needs, and attending to their own health issues. Pregnant women were also concerned about needs and health issues of their families, particular, when they had small children. Collecting accurate information regarding the disaster and conducting self-sustainable preparation prior to the disaster among pregnant women will help them to protect their pregnancy status, thereby improving their families' chance of survival during and after disasters.

Number of papers published in English from the nursing departments of 42 national universities in Japan in the past ten years.

BACKGROUND: In Japan, the departments of nursing were established by 2004, and graduate school programs for master's degree were established by 2008, in 42 national universities. With these changes, a more academic mission has been pursued, and the need for writing papers in English has increased. AIM: To investigate the numbers of papers published in English from the nursing departments of national universities in Japan over the past ten years. METHODS: The lists of teachers who have nursing licenses in the departments of nursing in the 42 national universities (n=2292) were obtained from the Japan Association of Nursing Programs in Universities. The number of papers published in English by these teachers from 2004 to 2013 was counted using the SCOPUS database. RESULTS: The average number of total papers, in which at least one of the authors was a nursing teacher, and first-authored papers, in which the first author was a nursing teacher, were 211.4 and 69.9 per year, respectively; both increased approximately two-fold during the past ten years. The means and standard deviations of the number of total papers and first-authored papers were 50.3±63.8 (range: 1-382) and 18.3±23.4 (range: 0-147) according to universities, and 1.39±5.84 (range: 0-140) and 0.33±1.28 (range: 0-21) according to teachers, respectively. When journals with the highest number of papers were analyzed, 12 of the top 20 (total papers) and 12 of the top 16 (first-authored papers) were in journals whose editorial offices are in Japan. CONCLUSION: The number of papers published in English has increased over the past ten years, varied markedly depending on the universities and teachers, and many papers were published in Japanese journals. To our knowledge, this is the first report anywhere to determine the average number of nursing papers "per teacher" in a specific population.

Comfort with motherhood in late pregnancy facilitates maternal role attainment in early postpartum.

Quality of life, comfort, and wellbeing during pregnancy are essential for every country in the world. Pregnancy is considered a preparation period for becoming a mother. Maternal role development, including confidence and satisfaction as a mother, is important in the transition to motherhood. Negative psychosocial affect, such as increased anxiety and distress, during pregnancy adversely influences the childbirth experience and childcare, which contributes to postpartum depression. However, the impact of positive feelings on the maternal role development remains unclear. Therefore, the study purpose was to clarify the relationship between comfort in late pregnancy and maternal role attainment and childcare during early postpartum. We designed a descriptive, longitudinal, correlational study by using the Prenatal Comfort Scale, the Postpartum Maternal Role Confidence Scale, and the Postpartum Maternal Satisfaction Scale. Among 339 participants who had received care at a university hospital located in Sendai city in Japan, 215 subjects completed the longitudinal study by answering a questionnaire for the respective Scale late in their pregnancy or during early postpartum. The subjects consisted of 114 primipara (32.0 ± 5.4 years) and 101 multipara (33.4 ± 4.9 years). In primipara, comfort with motherhood was significantly correlated with maternal confidence regarding knowledge and childcare skills and maternal satisfaction. In multipara, comfort in late pregnancy was related to maternal confidence and satisfaction. Positive affect was related to maternal confidence and maternal satisfaction in early postpartum. Therefore, a prenatal nursing intervention helps women become more comfortable with impending motherhood, thereby promoting maternal role attainment after delivery.

Committed to working for the community: experiences of a public health nurse in a remote area during the Great East Japan Earthquake.

We examined the experiences of a public health nurse (PHN) in a rural area affected by the Great East Japan Earthquake. We used an ethnographic method to obtain in-depth information about her experiences, from which six themes were developed. The PHN risked her life to protect members of the community, but she remained anxious to see her own young children as soon as possible. Nevertheless, she was strongly committed to helping community members and continued to work for them. We suggest creating a practical system to allow PHNs to obtain information about the safety of their own families during a disaster.

Remote community-based public health nursing during a disaster: an ethnographic case study in Japan.

BACKGROUND: The Great East Japan Earthquake that occurred on March 11, 2011 generated a tsunami that directly struck Japan. Public health nurses (PHNs) played important roles in this disaster response and community recovery. This research identified a PHN's experience in an affected area. METHODS: An ethnographic case study approach was used to obtain in-depth information regarding the experiences of one PHN, using semi-structured interviews, participant observation, and statistical documents. RESULTS: Six themes were identified and explored, including that the PHN undertook overwhelming responsibilities to protect the local residents, made several autonomous decisions, and had a strong sense of mission. These were based on the relationship-building that occurred with the local residents due to the geographical characteristics and her own preparations. CONCLUSIONS: The findings encourage PHNs to participate in simulations of disasters in preparation for major catastrophes and establish good collaborative efforts with residents by being a part of the community.

Assessment of quality of life in pregnant Japanese women: comparison of hospitalized, outpatient, and non-pregnant women.

This cross-sectional study explored the comfort and quality of life in hospitalized, preterm, pregnant women compared with pregnant outpatients, and identified the relationship between comfort, quality of life, and hospitalization. Two-hundred-and-twenty-one hospitalized pregnant women who met the inclusion criteria were recruited from obstetric units, and 1015 outpatient pregnant women were recruited from obstetric outpatient units in Japan. The women were questioned on six domains of the Japanese Short-Form-36 version 2 (bodily pain, general health, vitality, role emotional, social functioning, and mental health) and on their subjective comfort. A total of 189 hospitalized pregnant women and 503 low-risk pregnant women were analyzed. Subjective comfort and all six domains of health-related quality of life showed significantly lower scores for hospitalized women than outpatient women (P < 0.05-0.001). The mean differences in social functioning and role-emotional domains between the two groups were particularly marked. The result of this study suggests that these patients require positive psychological support to improve their comfort and quality of life.

Nursing intervention to enhance acceptance of pregnancy in first-time mothers: focusing on the comfortable experiences of pregnant women.

AIM: The purpose of the present study was to describe effective nursing care through evaluation of a nursing intervention that enhanced acceptance of pregnancy and focused on a comfortable experience for pregnant women. METHODS: Thirty-two subjects who were expected to have a normal pregnancy were assigned into either the intervention or the control group. The nursing intervention consisted of the use of a pregnancy diary and four interviews, two of which were held in the first trimester, one in the second and one in the third trimester. The nursing care given was recorded in tapes and field notes. The data were analyzed using a qualitative content analysis method. RESULTS: As a result of analyzing the nursing care of 13 women pregnant for the first time who were provided with nursing intervention, the following seven categories of nursing care were extracted for the intervention: encouragement of women to record their experiences using a pregnancy diary; recognizing and acknowledging negative feelings; reducing the negative aspects of pregnancy and reframing; expression and reinforcement of positive feelings; clarification and reinforcement of positive meanings; awareness of own comfortable experiences; promotion of diverse comfortable aspects and continuation of comfortable experiences. The seven nursing care interventions were effective in increasing the comfortable experiences of pregnant women and enhancing a positive attitude towards pregnancy. CONCLUSIONS: Nursing intervention can aid in enhancing positivity and comfort in pregnant women. Furthermore, this nursing intervention can be applied to adolescents, socially disadvantaged pregnant women, and hospitalized women.