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1.
Womens Health (Lond) ; 17: 17455065211042190, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34465268

RESUMO

OBJECTIVES: The COVID-19 pandemic has caused considerable stress throughout the world. Little is known about how postpartum women who gave birth during the early months of the pandemic were impacted. The purpose of this study was to explore and describe the associations between potential risk, protective factors, and psychological distress among postpartum women who gave birth during the early months of the COVID-19 pandemic. METHODS: Postpartum women over the age of 18 years who gave birth in the US hospitals between March and July of 2020 and spoke English completed a survey about their experiences. Demographic and health variables were measured via self-report. Stress was measured using the Perceived Stress Scale-10. Mastery was measured with the Pearlin Mastery Scale. Resilience was measured with the Connor-Davidson Resilience Scale-2. RESULTS: This study included 885 women. Participants had higher stress and lower resilience relative to pre-pandemic norms. Participants had high levels of depression, anxiety, and stress. Women who had an infant admitted to the neonatal intensive care unit had more stress. Income, full-time employment, and partnered relationships were associated with lower stress. Resilience and mastery were related to lower stress, depression, and anxiety. Black, Indigenous, or People of Color women showed higher stress and lower resiliency. Single women were likely to report lower levels of mastery than partnered women. CONCLUSION: Stress, depression, and anxiety were high in postpartum women in this study. Income, partnered relationships, and employment security, along with protective traits such as mastery and resilience, may reduce the impact of stress on postpartum women in a pandemic. Care models should be modified to support women during a pandemic. Health disparities exist in postpartum stress. Future interventions should focus on building resiliency and mastery and ensuring appropriate resources are available to postpartum women in a pandemic.


Assuntos
COVID-19/epidemiologia , Pandemias , Período Pós-Parto/psicologia , Estresse Psicológico/epidemiologia , Adulto , Ansiedade/epidemiologia , COVID-19/psicologia , Estudos Transversais , Depressão Pós-Parto/epidemiologia , Feminino , Humanos , Gravidez , Fatores de Proteção , Angústia Psicológica , Resiliência Psicológica , Fatores de Risco , SARS-CoV-2 , Fatores Socioeconômicos , Inquéritos e Questionários , Estados Unidos/epidemiologia
2.
Artigo em Inglês | MEDLINE | ID: mdl-34559088

RESUMO

ABSTRACT: Purpose: The purpose of this study was to describe birth satisfaction in women who gave birth in U.S. hospitals during the earliest months of the COVID-19 pandemic (March-July 2020).Study Design and Methods: A cross-sectional survey of 747 postpartum women who gave birth in the United States during the early COVID-19 pandemic was conducted. Participants in the United were recruited via social media. They completed a questionnaire that included demographic, health, and obstetric experience questions, and the Birth Satisfaction Scale-Revised. Descriptive statistics, t-tests, analysis of variance (ANOVA) models, and nonparametric correlations were performed.Results: Higher birth satisfaction scores were associated with higher income, marriage, white race, vaginal birth, having a birth partner present, and sufficient support during birth. Factors negatively associated with birth satisfaction were separation from infant, unplanned cesarean birth, neonatal intensive care unit admission, hypertension, preeclampsia, hemorrhage, depression, and anxiety.Clinical Implications: Presence of birth partners, sufficient birth support, and minimizing separation of mother and infant improve birth satisfaction. Obstetric complications, including unplanned cesarean birth, negatively affect birth satisfaction. There are racial disparities in birth satisfaction. It is critical to develop further interventions to end racism in maternal health care.

3.
Qual Health Res ; 31(8): 1486-1503, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33884945

RESUMO

This study explored how ethnic Yazidi refugee women overcome adversity to promote psychosocial health and well-being within the context of U.S. resettlement. Nine Yazidi women participated in two small photovoice groups, each group lasting eight sessions (16 sessions total). Women discussed premigration and resettlement challenges, cultural strengths and resources, and strategies to overcome adversity. Yazidi women identified trauma and perceived loss of culture as primary stressors. Participants' resilience processes included using naan (as sustenance and symbol) to survive and thrive as well as by preserving an ethnoreligious identity. Findings suggest that women's health priorities and resilience-promoting strategies center on fostering a collective cultural, religious, and ethnic identity postmigration. Importantly, women used naan (bread) as a metaphor to index cultural values, experiences of distress, and coping strategies. We discuss implications for this in promoting refugees' mental and psychosocial health in U.S. resettlement.


Assuntos
Luto , Refugiados , Adaptação Psicológica , Feminino , Pesar , Humanos , Estados Unidos , Saúde da Mulher
4.
Curr Rheumatol Rep ; 23(1): 2, 2020 11 26.
Artigo em Inglês | MEDLINE | ID: mdl-33244621

RESUMO

PURPOSE OF REVIEW: To review the self-management of rheumatoid arthritis (RA) using mobile applications. RECENT FINDINGS: Recent research supports that self-management not only can be an empowering behavior for an individual but also has been shown to improve health outcomes in RA. Mobile health applications are growing in popularity and adoption. Emerging evidence supports that using a mobile application for RA self-management may reduce disease activity and improve health outcomes. This review discusses mobile applications designed to improve self-management of RA as well as applications not specific to RA that also may be useful for self-management in this population. Future research should focus on the efficacy of mobile apps for health outcomes and ways to improve the adoption of and adherence to mobile apps in individuals with RA.

5.
J Midwifery Womens Health ; 65(6): 802-807, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32881276

RESUMO

Researchers who desire to make positive changes for vulnerable populations often conduct problem-focused studies. Although problem-focused research is important, when such studies are not carefully designed, their results can contribute to a deficit discourse. A deficit discourse is a narrative that describes the person through a myopic lens of negativity characterized only by illness, death, depression, failure, or the like. Deficit discourse negatively affects how health care providers and society interact with vulnerable people. This article discusses deficit discourse in health care and strengths-based research: an ethical approach to working with vulnerable individuals in research settings and a strategy to overcome deficit discourse. Strengths-based research approaches balance risks with countermeasures that include areas that are positive and amenable to growth or intervention. Strengths-based research can be conducted using qualitative, quantitative, or mixed-methods methodology. Strengths-based research should be culturally relevant and population-specific, often including the individuals of study throughout the process. By modifying the research approach, critical problems can be identified and addressed while also emphasizing positive ways to empower individuals and improve their lives. Additionally, these changes better the way researchers and health care providers view and care for people while also challenging deficit discourses in society at large.

6.
Rheum Dis Clin North Am ; 45(2): 197-209, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30952393

RESUMO

Mobile applications have the potential to improve health outcomes in patients with rheumatoid arthritis (RA). Whereas other chronic diseases such as diabetes and heart failure have a well-established presence in the mobile application realm, apps focused on RA are still in their infancy. This article presents an overview of the types of mobile apps that can be used for RA and discusses the opportunities and challenges associated with them.


Assuntos
Artrite Reumatoide , Disseminação de Informação , Aplicativos Móveis , Autogestão/métodos , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/psicologia , Artrite Reumatoide/terapia , Barreiras de Comunicação , Humanos
7.
JMIR Mhealth Uhealth ; 6(10): e12221, 2018 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-30373732

RESUMO

BACKGROUND: Patient outcomes are improved and the burden to the health care system is reduced when individuals are active self-managers of their own health. There is a need for technology that facilitates self-management of rheumatoid arthritis (RA) and can reduce the number of patient visits, promptly identify treatment needs, and reduce the costs associated with poor RA management. A mobile app named LiveWith Arthritis (eTreatMD, Vancouver, BC) has been developed that allows patients with RA to use their mobile device to regularly collect self-management data and to take objective measurements of the impact of RA on their finger joints using optical imaging technology. OBJECTIVE: The objectives of this pilot study were to (1) gather preliminary data as to whether a mobile app with hand optical imaging capabilities improves self-management behaviors (self-efficacy in managing symptoms and patient activation), (2) determine if app use shows promise in improving health outcomes (Pain, Health Assessment Questionnaire-II [HAQ-II]), and (3) determine barriers to using the mobile app in adults with RA. METHODS: This pilot study used a mixed-methods design. The quantitative portion was a traditional 2-group experimental design, and the qualitative portion was a follow-up telephone interview for intervention participants who did not complete the study. Measures of self-management included the Patient-Reported Outcomes Measurement Information System (PROMIS) self-efficacy in managing symptoms (P-SEMS) and Patient Activation Measure (PAM). Health outcomes included pain by Visual Analog Scale and disability by HAQ-II. RESULTS: The final sample consisted of 21 intervention participants and 15 controls. There was a statistically significant improvement in P-SEMS and promising trends for improvement in PAM, HAQ-II, and pain scores for participants who used the app. Of the intervention participants who did not complete the study, 12 completed the qualitative interview on barriers to use. Qualitative content analysis revealed 3 themes for barriers to using the app, including (1) frustration with technology, (2) RA made the app difficult to use, and (3) satisfaction with current self-management system. CONCLUSIONS: The LiveWith Arthritis app shows promise for improving self-management behaviors and health outcomes in adults with RA. Future study with a larger sample size is required to confirm findings. Initial app experience is important for adoption and continual use of the app. Individuals with significant disability to the hand would benefit from voice-activated app features. Participants who already have a system of managing their RA may not feel compelled to switch methods, even when a novel optical imaging feature is available.

8.
Public Health Nurs ; 35(6): 508-516, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30216526

RESUMO

OBJECTIVES: (1) Assess feasibility of a smartphone platform intervention combined with Community Health Worker (CHW) reinforcement in rural pregnant women; (2) Obtain data on the promise of the intervention on birth outcomes, patient activation, and medical care adherence; and (3) Explore financial implications of the intervention using return on investment (ROI). SAMPLE: A total of 98 rural pregnant women were enrolled and assigned to intervention or control groups in this two-group experimental design. INTERVENTION: The intervention group received usual prenatal care plus a smartphone preloaded with a tailored prenatal platform with automated texting, chat function, and hyperlinks and weekly contact from the CHW. The control group received usual prenatal care and printed educational materials. MEASUREMENTS: Demographics, health risk data, interaction with platform, medical records, hospital billing charges, Client Satisfaction Questionnaire-8, satisfaction comments, and the Patient Activation Measure. RESULTS: A total of 77 women completed the study. The intervention was well-received, showed promise for improving birth outcomes, patient activation, and medical care adherence. Financial analysis showed a positive ROI under two scenarios. CONCLUSIONS: Despite several practical issues, the study appears feasible. The intervention shows promise for extending prenatal care and improving birth outcomes in rural communities. Further research is needed with a larger and more at-risk population to appreciate the impact of the intervention.


Assuntos
Agentes Comunitários de Saúde , Cooperação do Paciente/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Nascimento Prematuro/prevenção & controle , Cuidado Pré-Natal/métodos , Smartphone , Envio de Mensagens de Texto , Adulto , Feminino , Humanos , Recém-Nascido , Gravidez , Resultado da Gravidez , Gestantes , Serviços de Saúde Rural/estatística & dados numéricos , População Rural , Inquéritos e Questionários , Estados Unidos
9.
Rheumatology (Oxford) ; 57(5): 798-802, 2018 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-29385538

RESUMO

Objective: The aim of this study was to investigate the association of menopause with functional status outcomes in women with RA. Methods: Participants were women in a US-wide observational cohort who developed RA before menopause. The HAQ measured functional status. We controlled for confounding variables and used univariate and multivariable generalized estimating equation methods with the sandwich estimator of variance. Best models were selected using the quasi-likelihood under the independence model criterion. A sensitivity analysis was performed using linear mixed effects regression models. Results: A total of 8189 women were eligible. Of these, 2005 (24.5%) were pre-menopausal, 611 (7.5%) transitioned through menopause during the study, and 5573 (68.1%) were post-menopausal. Within each respective group, the mean (s.d.) ages were 39.7 (7.8), 50.7 (3.4) and 62.3 (9.3) years. Our results showed that women who were pre-menopausal had less functional decline as measured by the HAQ compared with women who were post-menopausal; these results were robust and strong even after adjustment for other significant factors. The ever-use of hormonal replacement therapy, ever having a pregnancy, and longer length of reproductive life were associated with less functional decline. After menopause, the trajectory of functional decline worsened and accelerated in women with RA. Conclusion: The results suggest that menopausal status is associated with functional decline in women with RA. Furthermore, menopause is associated with a worsening progression of functional decline. These data indicate that menopause has a significant impact on the level and rate of functional decline in women with RA.


Assuntos
Atividades Cotidianas , Artrite Reumatoide/fisiopatologia , Menopausa/fisiologia , Qualidade de Vida , Adulto , Artrite Reumatoide/diagnóstico , Progressão da Doença , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Índice de Gravidade de Doença , Fatores de Tempo
10.
Int J Womens Health ; 10: 1-9, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29343990

RESUMO

Osteoporosis and depression are major health problems of crisis proportions in postmenopausal women. Researchers have established a relationship between bone loss and depression, although few studies have focused on postmenopausal women. The purposes of this integrative review were to synthesize and summarize the available literature on: 1) the associations between bone loss and depression in postmenopausal women; and 2) potential variables that impact the associations between bone loss and depression in postmenopausal women. After searching the databases PubMed, CINAHL, Embase, and the Cochrane library between 2007 and 2017, 12 articles met the inclusion criteria. The majority of the included studies supported the relationship between depression and bone loss in postmenopausal women, although little information is offered as to why this relationship exists. This review summarizes the research that has been completed on depression and bone loss in postmenopausal women and identifies gaps in the literature. These findings will aid in the planning of future research and the development of health care recommendations.

11.
Arch Psychiatr Nurs ; 30(3): 418-24, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-27256951

RESUMO

AIM: This study's aim is to synthesize and summarize the literature on postpartum depression (PPD) in U.S. rural populations. BACKGROUND: Internationally, PPD has a high prevalence in rural communities. Although women in rural U.S. communities have higher rates of depression outside of the postpartum time period, little study has been conducted on PPD in U.S. rural populations. It is unknown whether rural women in the United States have high rates of PPD as is common in rural populations internationally. DESIGN: We used integrative literature review using Whittemore and Knafl's (2005) methodology. DATA SOURCES AND METHODS: We searched the databases MEDLINE, CINAHL, PsycINFO, and Academic Search Premier with the words "postpartum depression" or "postnatal depression" and the word "rural." RESULTS: We found 11 articles with empirical data that met the criteria and thus were included in the review. Seven articles were quantitative, two were qualitative, one was mixed methods, and one was a nonexperimental design. Five foci emerged in the literature including (a) screening and prevalence, (b) demographic factors, (c) program creation and implementation, (d) mental health care seeking, and (e) social support. The results suggest that prevalence of PPD may be higher in rural U.S. areas, that implementing PPD prevention and screening programs for rural women is feasible, and that women in rural areas rely on informal networks and may face a stigma for seeking mental health care. CONCLUSIONS: Further research is needed on PPD in rural U.S. POPULATIONS: Specifically, this research should focus on the mix of variables found throughout this review such as race and income level. Nurses should lead for changes in clinical practice and policy that increase screening and interventions for PPD in rural communities.


Assuntos
Depressão Pós-Parto/epidemiologia , Programas de Rastreamento , População Rural , Depressão Pós-Parto/psicologia , Feminino , Humanos , Prevalência , Fatores Socioeconômicos , Estados Unidos
12.
Perspect Psychiatr Care ; 52(3): 224-30, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25980434

RESUMO

PURPOSE: Incarcerated women are a vulnerable and unique population of special concern to nurses as they have high rates of mental illness. In this article, the authors discuss how trauma exposure contributes to mental illness in incarcerated women through abuse, socioeconomic factors, and the prison environment, how this trauma exposure manifests in the inmate survivor, and the related implications for practice. CONCLUSIONS: A history of trauma and victimization is related to complex mental health issues which affect the majority of justice-involved women. The correctional environment can exacerbate these issues. PRACTICE IMPLICATIONS: Nursing implications include discussion of the trauma-informed care model. The authors recommend a model of trauma-informed care named "the 4 Es" that can guide nurses in preparing a trauma-informed correctional environment and discuss the importance of nurse-led policy change in finding alternatives to incarceration for women with mental illness.


Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Transtornos Mentais/enfermagem , Modelos de Enfermagem , Prisioneiros/psicologia , Enfermagem Psiquiátrica/métodos , Adulto , Criança , Feminino , Humanos , Transtornos Mentais/epidemiologia , Transtornos Mentais/etiologia , Prisões , Fatores Socioeconômicos
14.
Health Care Women Int ; 36(4): 378-91, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-24654845

RESUMO

Postpartum depression (PPD) is an important area of women's health research internationally and across disciplines. There is no guiding paradigm, however, to ensure that PPD research results translate to women on a global level. This commentary builds on the work of Doucet, Letourneau, and Stoppard ( 2010 ) to determine a "best fit" paradigm with which to guide PPD research. Postpositivism, critical theory, constructivism, and pragmatism are combined with a feminist ideology and critiqued as potential guiding paradigms for PPD research. After thorough examination, I conclude the need for further use of a feminist pragmatist paradigm in PPD research.


Assuntos
Depressão Pós-Parto/diagnóstico , Feminismo , Saúde da Mulher , Adulto , Depressão Pós-Parto/psicologia , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Pesquisa
15.
Issues Ment Health Nurs ; 35(9): 656-63, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25162187

RESUMO

To synthesize existing qualitative literature on the first-hand experiences of women suffering from postpartum depression (PPD), to uncover potential common themes, a meta-synthesis of 12 qualitative studies using Noblit and Hare's 7-phase model of meta-ethnography was used. Four themes were discovered: crushed maternal role expectation, going into hiding, loss of sense of self, intense feelings of vulnerability, plus practical life concerns. A preliminary theory of PPD as a 4-step process is proposed, based on the relationships between the themes in this meta-synthesis. This 4-step process is compared and contrasted with Cheryl Tatano Beck's 4-stage theory of PPD "Teetering on the Edge". This meta-synthesis and theory offers a significant contribution to the literature in helping identify PPD distinctly from depression outside of the postpartum period, and deserves further study.


Assuntos
Depressão Pós-Parto/enfermagem , Depressão Pós-Parto/psicologia , Teoria de Enfermagem , Teoria Psicológica , Adaptação Psicológica , Feminino , Identidade de Gênero , Humanos , Acontecimentos que Mudam a Vida , Pesquisa Qualitativa , Autoimagem
16.
Public Health Nurs ; 31(3): 281-8, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24386885

RESUMO

BACKGROUND: Influenza exposure during pregnancy can cause severe health problems for both the mother and her offspring, including an increased risk of mortality. Influenza vaccination during all trimesters of pregnancy is safe and effective, and recommended by professional organizations such as the American College of Obstetrics and Gynecology. Despite these recommendations, the U.S. vaccination rates remain low in this high-risk population. METHOD: A policy analysis based on the five-part method identified by Teitelbaum and Wilensky () addresses factors to consider in identifying the best voluntary policy options to improve the vaccination rates. The authors provide discussion of the background, landscape, and stakeholder interests and the pros and cons of two voluntary policy options to increase vaccination. The policy options include: (a) financial incentives for providers and (b) an education emphasis for providers and staff. CONCLUSIONS: The authors conclude that based on considerations of cost, provider preference, and practicality of implementation, a continuing educational intervention is the preferred policy venue to increase vaccination rates.


Assuntos
Política de Saúde , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Vacinação/estatística & dados numéricos , Educação Médica Continuada , Feminino , Humanos , Vacinas contra Influenza/economia , Motivação , Formulação de Políticas , Gravidez , Estados Unidos
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