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1.
J Clin Psychiatry ; 82(4)2021 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-34232578

RESUMO

Objective: The conditions created by the COVID-19 pandemic could negatively affect maternal mental health and the mother-infant relationship. The aim of this study is to determine the impact of the COVID-19 pandemic on depression, anxiety, and mother-infant bonding among women seeking treatment for postpartum depression (PPD).Methods: Baseline data collected in two separate randomized controlled trials of a psychoeducational intervention for PPD in the same geographic region, one prior to COVID-19 (March 2019-March 2020) and one during the COVID-19 pandemic (April-October 2020), were compared. Eligible participants had an Edinburgh Postnatal Depression Scale (EPDS) score of ≥ 10, were ≥ 18 years of age, had an infant < 12 months old, and were fluent in English. Outcomes included PPD (EPDS), anxiety (Generalized Anxiety Disorder-7 [GAD-7]), and mother-infant relationship (Postpartum Bonding Questionnaire [PBQ]). All were measured continuously and dichotomized at accepted clinical cutoffs.Results: Of the 603 participants (305 pre-COVID-19; 298 during COVID-19), mothers enrolled during the COVID-19 pandemic reported higher levels of symptoms of PPD (B = 1.35; 95% CI, 0.64 to 2.06; Cohen d = 0.31) and anxiety (B = 1.52; 95% CI, 0.72 to 2.32; Cohen d = 0.30). During COVID-19, women had 65% higher odds of clinically significant levels of depression symptoms (OR = 1.65; 95% CI, 1.13 to 2.31) and 46% higher odds of clinically relevant anxiety symptoms (OR = 1.46; 95% CI, 1.05 to 2.05). However, there were no statistically significant differences in mother-infant bonding.Conclusions: The findings of this study suggest that rates and severity of PPD and anxiety symptoms among women seeking treatment for PPD have worsened in Canada during the COVID-19 pandemic. However, treatment-seeking mothers have consistently maintained good relationships with their infants. Considering the difficulties women with PPD face when accessing treatment, it is important that strategies are developed and disseminated to safely identify and manage PPD to mitigate potential long-term adverse consequences for mothers and their families.Trial Registration: ClinicalTrials.gov identifiers: NCT03654261 and NCT04485000.


Assuntos
Ansiedade/etiologia , COVID-19/psicologia , Depressão Pós-Parto/etiologia , Relações Mãe-Filho/psicologia , Mães/psicologia , Apego ao Objeto , Pandemias , Adolescente , Adulto , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Ansiedade/psicologia , COVID-19/epidemiologia , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/psicologia , Feminino , Humanos , Lactente , Recém-Nascido , Ontário/epidemiologia , Fatores de Risco , Autorrelato , Índice de Gravidade de Doença , Adulto Jovem
2.
BMC Pregnancy Childbirth ; 21(1): 473, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34210276

RESUMO

BACKGROUND: In response to the COVID-19 pandemic, drastic measures for social distancing have been introduced also in Italy, likely with a substantial impact in delicate conditions like pregnancy and puerperium. The study aimed to investigate the changes in lifestyle, access to health services, and mental wellbeing during the first Italian lockdown in a sample of Italian pregnant women and new mothers. METHODS: We carried out a web-based survey to evaluate how pregnant women and new mothers were coping with the lockdown. We collected data about healthy habits (physical exercise and dietary habits), access to health services (care access, delivery and obstetric care, neonatal care, and breastfeeding), and mental wellbeing (psychological well-being and emotive support). Descriptive analysis was performed for both groups of participants, whereas a Poisson analysis was used to measure the association between some structural variables (age, education, socio-economic data, partner support, contact, free time, previous children, and pregnancy trimester) and anxiety or depression, difficulties in healthy eating and reduction in physical activity after lockdown started. Chi2 and Adjusted Prevalence Ratios were estimated only for pregnant women. RESULTS: We included 739 respondents (response rate 85.8 %), 600 were pregnant (81.2 %), and 139 (18.8 %) had delivered during lockdown (new mothers). We found a high score for anxiety and depression in 62.8 % of pregnant women and 61.9 % of new mothers. During the lockdown, 61.8 % of pregnant women reduced their physical exercise, and 44.3 % reported eating in a healthier way. 94.0 % of new mothers reported to have breastfed their babies during the hospital stay. Regarding the perceived impact of restrictive measures on breastfeeding, no impact was reported by 56.1 % of new mothers, whereas a negative one by 36.7 %. CONCLUSIONS: The high prevalence of anxiety and depressive symptoms in pregnant women and new mothers should be a public health issue. Clinicians might also recommend and encourage "home" physical exercise. On the other hand, about half of the sample improved their approach towards healthy eating and a very high breastfeeding rate was reported soon after birth: these data are an interesting starting point to develop new strategies for public health.


Assuntos
COVID-19/psicologia , Estilo de Vida , Saúde Mental , Mães/psicologia , Parto/psicologia , Gestantes/psicologia , Quarentena , Adulto , Ansiedade/epidemiologia , Aleitamento Materno , Depressão/epidemiologia , Dieta Saudável , Exercício Físico , Feminino , Acesso aos Serviços de Saúde , Humanos , Itália/epidemiologia , Pessoa de Meia-Idade , Gravidez , SARS-CoV-2 , Adulto Jovem
3.
Reprod Health ; 18(1): 127, 2021 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-34120650

RESUMO

BACKGROUND: Quality of essential newborn care is defined as the extent of health care services to improve the health of newborns. However, studies are scarce regarding the quality of newborn care implementation. Therefore, this study aimed to measure the magnitude and factors associated with essential newborn care implementation perceived quality among health facility deliveries in Northwest Ethiopia. METHODS: A facility-based cross-sectional study design was employed to collect data from 370 randomly selected deliveries in 11 health facilities from November 2018 to March 2019. Essential newborn care implementation perceived quality was assessed in two domains (delivery and process) from clients' perspectives. A pre-tested interviewer-administered structured questionnaire was adopted from different kinds of literature and guidelines. The research data were collected by trained midwives and nurses. A binary logistic regression model was used to identify associated factors with newborn care implementation perceived quality. Odds ratio with 95% CI was computed to assess the strength and significant level of the association at p-value < 0.05. RESULTS: About 338 mothers completed the interview with a response rate of 97.1%. The mean age of the study participants was 26.4 (SD = 5.7) with a range of 12 and 45 years. Most mothers, 84.3%, have attended antenatal care. The overall implementation perceived quality of essential newborn care was found to be 66.3%. The implementation perceived quality of cord care, breast-feeding and thermal care was 75.4, 72.2 and 66.3% respectively. Newborn immunization and vitamin K administration had the lowest implementation perceived quality i.e. 22.4 and 24.3% respectively. Friendly care during delivery (AOR = 5.1, 95% CI: 2.4, 11.0), partograph use (AOR = 3.0, 95% CI: 1.1, 8.6), child immunization service readiness (AOR = 2.9, 95% CI: 1.5, 5.7), BEmEONC service readiness (AOR = 2.1, 95% CI: 1.2, 3.9) and facing no neonatal illness at all (AOR = 4.2, 95% CI: 1.6, 10.9) were significantly associated with good essential newborn care implementation qualities. CONCLUSIONS: The perceived quality of essential newborn care implementation was low in the study area. This is associated with poor readiness on BEmEONC and child immunization services, unfriendly care and not using partograph during delivery. Hence, availing the BEmEONC and the child immunization service inputs, continuous training and motivation of healthcare workers for friendly care are vital for improving essential newborn care implementation perceived quality.


Assuntos
Aleitamento Materno , Atenção à Saúde , Cuidado do Lactente/normas , Recém-Nascido , Mães/psicologia , Cuidado Pré-Natal , Adolescente , Adulto , Aleitamento Materno/estatística & dados numéricos , Criança , Estudos Transversais , Etiópia , Feminino , Instalações de Saúde , Humanos , Pessoa de Meia-Idade , Gravidez , Qualidade da Assistência à Saúde , Adulto Jovem
4.
Neonatal Netw ; 40(3): 140-145, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-34088859

RESUMO

The impact of the COVID-19 pandemic upon the health care landscape has prompted many organizations to revise policies in response to ever-changing guidelines and recommendations regarding safe breastfeeding practices. The application of these professional guidelines into clinical practice is fraught with barriers, inconsistencies, and often-minimal evidential support. Key concerns for health care providers and patients include antenatal versus postnatal transmission, milk transmission, and separation care versus rooming-in, including the subsequent impacts upon breastfeeding and bonding. While SARS-CoV-2 is a novel virus, the volume of literature to support best practice for couplet care continues to be developed at a rapid pace. The benefits of breastfeeding are steeped in evidence and outweigh the potential risk of transmission of COVID-19 from mother to newborn. Health care organizations must continue to seek guidance for policy revision within the ever-growing body of evidence for best practice and evaluate current practices for feasibility during and after hospitalization.


Assuntos
Aleitamento Materno/métodos , Aleitamento Materno/psicologia , COVID-19/psicologia , Promoção da Saúde/métodos , Mães/psicologia , Enfermagem Neonatal/normas , Guias de Prática Clínica como Assunto , Adulto , Feminino , Humanos , Recém-Nascido , Pandemias , Gravidez , SARS-CoV-2
5.
Neonatal Netw ; 40(3): 161-174, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-34088862

RESUMO

Early recommendations to separate mothers from their newborns during the coronavirus disease 2019 (COVID-19) pandemic have created a detrimental separation practice. This article presents a review of the latest information regarding the (1) 3 modes of transmission of the virus to the neonate; (2) incidence, clinical signs, and severity of COVID-19 in the neonate; (3) factors to be considered to balance risk and benefits of separation and skin-to-skin contact (SSC) when conducting shared decision making; and (4) compendium of published SSC guidelines; and concludes with recommendations for safe practice of SSC to prevent and/or restrict COVID-19 infection in neonates.


Assuntos
COVID-19/psicologia , Método Canguru/psicologia , Método Canguru/normas , Relações Mãe-Filho/psicologia , Mães/psicologia , Enfermagem Neonatal/normas , Guias de Prática Clínica como Assunto , Adulto , Feminino , Humanos , Recém-Nascido , Masculino , Pandemias , Gravidez , SARS-CoV-2
6.
Nutrients ; 13(6)2021 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-34072039

RESUMO

During the COVID-19 pandemic, breastfeeding women have experienced restricted access to support, placing them at increased risk of mental health concerns and limited breastfeeding assistance. This study investigated the effect of the pandemic on feeding choices and maternal wellbeing amongst breastfeeding mothers living in Australian and New Zealand. We conducted a cross-sectional online survey that examined feeding methods, maternal mental wellbeing, worries, challenges, and positive experiences during the pandemic. Most women were exclusively breastfeeding (82%). Partial breastfeeding was associated with perceived low milk supply and longer pregnancy duration during the pandemic. Reduced mental health and wellbeing was associated with lower levels of family functioning, increased perceived stress, and perinatal anxiety. Longer pregnancy duration during the pandemic was associated with lower mental health wellbeing scores, while higher perceived stress scores were reported for regions with higher COVID-19 infection rates and women with perceived low milk supply. Women reported that the pandemic resulted in less pressure and more time for family bonding, while worries about the pandemic, family health, and parenting challenges were also cited. Mental health concerns of breastfeeding women appear to be exacerbated by COVID-19, highlighting a critical need for access to mental health and broader family support during the pandemic.


Assuntos
Aleitamento Materno/psicologia , COVID-19 , Saúde Mental/estatística & dados numéricos , Mães/psicologia , Quarentena/psicologia , Adulto , Ansiedade/epidemiologia , Ansiedade/psicologia , Austrália/epidemiologia , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Nova Zelândia/epidemiologia , SARS-CoV-2 , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia
8.
MMWR Morb Mortal Wkly Rep ; 70(21): 769-774, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34043611

RESUMO

Breastfeeding is the optimal source of nutrition for most infants (1). Although breastfeeding rates in the United States have increased during the past decade, racial/ethnic disparities persist (2). Breastfeeding surveillance typically focuses on disparities at the national level, because small sample sizes limit examination of disparities at the state or territorial level. However, birth certificate data allow for assessment of breastfeeding initiation among nearly all newborn infants in the United States both nationally and at the state and territorial levels. To describe breastfeeding initiation by maternal race/ethnicity,* CDC analyzed 2019 National Vital Statistics System (NVSS) birth certificate data for 3,129,646 births from 48 of the 50 states (all except California and Michigan†), the District of Columbia (DC), and three U.S. territories (Guam, Northern Mariana Islands, and Puerto Rico). The prevalence of breastfeeding initiation was 84.1% overall and varied by maternal race/ethnicity, ranging from 90.3% among infants of Asian mothers to 73.6% among infants of Black mothers, a difference of 16.7 percentage points. Across states, the magnitude of disparity between the highest and lowest breastfeeding rates by racial/ethnic groups varied, ranging from 6.6 percentage points in Vermont to 37.6 percentage points in North Dakota, as did the specific racial/ethnic groups with the highest and lowest rates. These state/territory-specific data highlight the variation that exists in breastfeeding disparities across the United States and can help public health practitioners and health departments identify groups on which to focus efforts. Targeting breastfeeding promotion programs on populations with lower breastfeeding rates might help reduce racial/ethnic disparities in breastfeeding initiation and improve infant nutrition and health.


Assuntos
Aleitamento Materno/etnologia , Grupos de Populações Continentais/psicologia , Grupos Étnicos/psicologia , Disparidades nos Níveis de Saúde , Mães/psicologia , Aleitamento Materno/psicologia , Aleitamento Materno/estatística & dados numéricos , Grupos de Populações Continentais/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Recém-Nascido , Mães/estatística & dados numéricos , Estados Unidos
10.
Med Sci Monit ; 27: e930214, 2021 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-33986238

RESUMO

BACKGROUND Regulation disorders are already apparent in infancy. The For Healthy Offspring Project was the first Hungarian study aimed at building an effective model for screening and examining the prevalence and complex (medical and psychosocial) background of classic behavior regulation disorders (excessive crying, feeding, and sleep problems) in infancy. MATERIAL AND METHODS Data were collected from families of 0- to 3-year-old children in a pediatric hospital and its neighboring areas through questionnaires, medical examinations, and individual and small-group consultations. RESULTS In the questionnaire study about their children's behavior (n=1133), 15% of mothers reported excessive crying, 16% reported feeding problems, and 10% reported sleep problems. In a subsample (n=619) in which medical examinations were also conducted, the prevalence of medical diagnoses was 15.0% for excessive crying, 15.2% for sleep disorders, 10.3% for breastfeeding difficulties, and 14.8% for feeding disorders. Children who were referred to the screening program (n=183) had significantly more behavior regulation disorders than the other children in our study. Regulation disorders were found to be comorbid with other health conditions in some cases. CONCLUSIONS We developed a complex model to screen for regulatory problems in early childhood. This study adds more information about the relationship between regulation problems and other health conditions. The general incidence (5-15%) of early childhood regulation disorders in other countries is likely similar to that found in Hungary. In order to effectively recognize early regulation disorders, diagnostic instruments widely used in the international field should be adapted in general Hungarian pediatric care.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/fisiopatologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Transtornos do Sono-Vigília/fisiopatologia , Transtornos do Sono-Vigília/psicologia , Adulto , Aleitamento Materno/psicologia , Pré-Escolar , Choro/fisiologia , Choro/psicologia , Ingestão de Alimentos/fisiologia , Ingestão de Alimentos/psicologia , Feminino , Humanos , Hungria , Lactente , Recém-Nascido , Masculino , Mães/psicologia , Poder Familiar/psicologia , Pediatria , Prevalência , Inquéritos e Questionários
11.
CMAJ Open ; 9(2): E548-E555, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34021012

RESUMO

BACKGROUND: Acceptance of a vaccine against SARS-CoV-2 is critical to achieving high levels of immunization. The objectives of this study were to understand mothers' SARS-CoV-2 vaccine intentions to explore reasons for and against SARS-CoV-2 vaccination. METHODS: Participants from the All Our Families pregnancy longitudinal cohort whose children had reached ages 9-12 years were invited in May-June 2020 to complete a survey on the impact of COVID-19. The survey covered topics about the impact of the pandemic and included 2 specific questions on mothers' intentions to vaccinate their child against SARS-CoV-2. Current responses were linked to previously collected data, including infant vaccine uptake. Multinomial regression models were run to estimate associations between demographic factors, past vaccination status and vaccination intention. Qualitative responses regarding factors affecting decision-making were analyzed thematically. RESULTS: The response rate was 53.8% (1321/2455). A minority of children of participants had partial or no vaccinations at age 2 (n = 200, 15.1%). A total of 60.4% of mothers (n = 798) intended to vaccinate their children with the SARS-CoV-2 vaccine, 8.6% (n = 113) did not intend to vaccinate and 31.0% (n = 410) were unsure. Lower education, lower income and incomplete vaccination history were inversely associated with intention to vaccinate. Thematic analysis of qualitative responses showed 10 themes, including safety and efficacy, long-term effects and a rushed process. INTERPRETATION: Within a cohort with historically high infant vaccination, a third of mothers remained unsure about vaccinating their children against SARS-CoV-2. Given the many uncertainties about future SARS-CoV-2 vaccines, clear communication regarding safety will be critical to ensuring vaccine uptake.


Assuntos
Vacinas contra COVID-19/uso terapêutico , COVID-19/prevenção & controle , Intenção , Mães/psicologia , Vacinação/psicologia , Adulto , Fatores Etários , Vacinas contra COVID-19/efeitos adversos , Canadá , Criança , Escolaridade , Grupos Étnicos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos Epidemiológicos , Humanos , Renda , Estado Civil , Pessoa de Meia-Idade , Análise de Regressão , SARS-CoV-2
12.
Can J Public Health ; 112(4): 599-619, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34019282

RESUMO

SETTING: This knowledge mobilization project was conceptualized to increase awareness among breastfeeding mothers and the general public on safe infant feeding practices during the COVID-19 pandemic by addressing myths and misconceptions associated with breastfeeding practices, guiding breastfeeding mothers to make informed decisions around child feeding practices, and offering meaningful guidance in simple language through a short online animated video. INTERVENTION: This project was undertaken in four phases. During phase 1, an informal discussion was held with the breastfeeding mothers, service providers, and community partner in identifying issues surrounding lactation counselling facilities during the COVID-19 pandemic. During phase 2, recommendations from 23 organizations with regard to breastfeeding during COVID-19 were reviewed and analyzed. During phase 3, using evidence from reliable sources, a 5-minute animated e-resource on breastfeeding during COVID-19 was conceptualized and developed. During phase 4, the e-resource was disseminated to the breastfeeding mothers, general public, post-secondary institutions, and organizations providing services to breastfeeding mothers in Canada. OUTCOMES: This evidence-based e-resource facilitated addressing misconceptions around breastfeeding during COVID-19 and raising public awareness on safe infant feeding practices during this pandemic. Overall, the video was described as an informative, user-friendly, useful, and easily accessible resource by breastfeeding mothers who were in self-isolation with little access to healthcare services during the pandemic. IMPLICATIONS: This project highlighted the importance of patient engagement and collaboration with the community partner in protecting breastfeeding during the COVID-19 pandemic. It further illustrated how informational e-resources can protect breastfeeding in situations where breastfeeding mothers' access to healthcare services is compromised.


Assuntos
Aleitamento Materno/estatística & dados numéricos , COVID-19/epidemiologia , Educação em Saúde/métodos , Mães/educação , Mães/psicologia , Adulto , Canadá/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Mães/estatística & dados numéricos
13.
BMC Pregnancy Childbirth ; 21(1): 349, 2021 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-33934698

RESUMO

BACKGROUND: Although there is growing recognition of the importance of person-centered maternity care, the needs and perspectives of pregnant adolescents are rarely considered. The purpose of this study was to compare the maternity care experiences of Mexican-origin adolescents in Guanajuato, Mexico and Fresno, California from both youth and healthcare provider perspectives. METHODS: Qualitative interviews and focus groups were conducted with a total of 89 respondents, including 74 pregnant and parenting adolescents as well as 15 providers between December 2016 and July 2017. Adolescents also completed a short demographic survey prior to participation. Transcripts in English and Spanish were coded and thematically analyzed using Dedoose software. Results were compared by location and between youth and providers. RESULTS: Four themes emerged regarding patient-provider interactions: the need for communication and clear explanations, respectful versus judgmental providers, engaging youth in decision-making, and a focus on the age of the youth and their partners. While youth had similar perspectives and priorities in both locations, youth in Mexico reported more negative healthcare experiences than youth in California. Perspectives varied between the youth and providers, with providers in both California and Mexico identifying several structural challenges in providing quality care to adolescents. In California, challenges to supporting immigrant Latina adolescents and their families included language and translation issues as well as barriers to care due to immigration status and documentation. In both locations, providers also mentioned high patient caseloads and their own concerns about the youth's life choices. CONCLUSION: Youth-centered care requires more effective and respectful patient-provider communication, where adolescents are engaged in their healthcare decision-making and delivery options. Changes in patient-provider interactions can help improve the maternity care experiences and outcomes of Latina adolescents. Healthcare systems and providers need to reconfigure their approaches to focus on the needs and priorities of adolescents.


Assuntos
Tomada de Decisões , Pessoal de Saúde/psicologia , Serviços de Saúde Materna , Mães/psicologia , Adolescente , Atitude do Pessoal de Saúde , California , Comunicação , Feminino , Grupos Focais , Hispano-Americanos/psicologia , Humanos , Entrevistas como Assunto , México , Gravidez , Relações Profissional-Paciente , Pesquisa Qualitativa , Respeito
14.
Health Qual Life Outcomes ; 19(1): 141, 2021 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-33964935

RESUMO

BACKGROUND AND OBJECTIVE: Many studies have been conducted in Iran on the postpartum quality of life, and the majority have used the general quality of life questionnaire. With a specific tool in this context, the dimensions of maternal postpartum quality of life can be more accurately determined. The present study was conducted to determine psychometric properties and validate the Persian version of the Maternal Postpartum Quality of Life Questionnaire (MAPP-QOL). MATERIALS AND METHODS: The present methodological study was conducted in 2018. The original version of MAPP-QOL was translated into Persian by both forward and backward translation. In a cross-sectional study, the Persian version was completed by 407 eligible postpartum women aged 18 to 47 and living in Tehran. Reliability of the questionnaire was assessed using Cronbach's alpha coefficient and test-retest. For construct validity, exploratory and confirmatory factor analyses were used. RESULTS: The MAPP-QOL showed good content validity; content validity ratio (CVR) ranged from 0.6 to 1.00, and content validity index (CVI) ranged from 0.7 to 1.00. Using exploratory factor analysis, five factors, including Socioeconomic; Relational/Family-Friends; Psychological/Baby; Health & functioning; and Relational/Spouse-Partner, were extracted, which together explained 78.84% of the total variance. After modifications of CFA, the confirmatory factor analysis showed an acceptable goodness-of-fit. AVE value Above 0.5 exhibited appropriate convergent validity, and AVE greater than MSV confirmed divergent validity. The Cronbach's alpha, McDonald's Omega, Composite reliability and maximum reliability H of the five extracted factors were excellent (> 0.9). Also, the AIC values of the factors were good (between 0.721 to 0.859). CONCLUSION: The 38-item Persian version of the postpartum quality of life questionnaire is adequately reliable for postpartum women in Iran. Given its appropriate psychometric properties, this scale is fit to be used in future studies on postpartum women.


Assuntos
Mães/psicologia , Mães/estatística & dados numéricos , Período Pós-Parto/psicologia , Psicometria/normas , Qualidade de Vida/psicologia , Inquéritos e Questionários/normas , Adolescente , Adulto , Estudos Transversais , Análise Fatorial , Feminino , Humanos , Irã (Geográfico) , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Traduções , Adulto Jovem
15.
Sci Rep ; 11(1): 9152, 2021 04 28.
Artigo em Inglês | MEDLINE | ID: mdl-33911108

RESUMO

Italy was the first European country to fight the Covid-19 outbreak. To limit the transmission of the virus, the Italian Government imposed strict domestic quarantine policies and temporary closure of non-essential businesses and schools from March 10th,2020. Although more and more literature is exploring the impact of the pandemic on non-referred children and families, only a few studies are focused on the psychosocial impact of Covid-19 in chronically ill children and their caregivers. The present study investigates asthma control and children and mothers' psychological functioning (i.e.: psychological well-being, fear of contagion, and mothers' Covid-19 related fears) in 45 asthmatic children aged 7-to-14, compared to a control sample. The subjects were administered an online survey after the lockdown (from 28th May to 23rd August 2020). The analysis shows that asthmatic children presented higher concern in relation to contagion, however, no difference in psychological functioning was displayed between the two cohorts. Mothers reported more Covid-19 related fears, and greater worries according to the resumption of their children's activities. Moreover, they indicated a global worsening of their psychological well-being during the lockdown. Furthermore, regarding the clinical sample, the multivariate regression model showed that a worsening of mothers' psychological and children's physical well-being was associated with a worsening of children's psychological well-being during the lockdown. The results of this study indicate that mothers of asthmatic children can be more prone to experience psychological fatigue in a pandemic scenario. Special programs should be developed to support caregivers of chronically ill children.


Assuntos
Asma/psicologia , COVID-19 , Mães/psicologia , Adolescente , Adulto , Ansiedade/psicologia , Asma/etiologia , Estudos de Casos e Controles , Criança , Feminino , Inquéritos Epidemiológicos , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Psicologia da Criança , Quarentena/psicologia , Fatores Socioeconômicos
16.
BMC Pregnancy Childbirth ; 21(1): 300, 2021 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-33853542

RESUMO

BACKGROUND: Given the significance of the birth experience on women's and babies' well-being, assessing and understanding maternal satisfaction is important for providing optimal care. While previous research has thoroughly reviewed women's levels of satisfaction with the childbirth experience from a multitude of different angles, there is a dearth of papers that use a gender lens in this area. The aim of this study is to explore through a gender perspective the circumstances attributed to both women's assessment of a positive birth experience and those which contribute to a lack of satisfaction with their birth experience. METHODS: Through the use of a local birth evaluation form at a Swedish labour ward, 190 women gave written evaluations of their birth experiences. The evaluations were divided into groups of positive, ambiguous, and negative evaluations. By means of a latent and constructionist thematic analysis based on word count, women's evaluations are discussed as reflections of the underlying sociocultural ideas, assumptions, and ideologies that shape women's realities. RESULTS: Three themes were identified: Grateful women and nurturing midwives doing gender together demonstrates how a gender-normative behaviour may influence a positive birth experience when based on a reciprocal relationship. Managing ambiguous feelings by sympathising with the midwife shows how women's internalised sense of gender can make women belittle their negative experiences and refrain from delivering criticism. The midwifery model of relational care impeded by the labour care organisation describes how the care women receive during labour and birth is regulated by an organisation not always adapted to the benefit of birthing women. CONCLUSIONS: Most women were very satisfied, predominantly with emotional support they received from the midwives. The latent constructionist thematic analysis also elicited women's mixed feelings towards the birth experience, with the majority of negative experiences directed towards the labour care organisation. Recognising the impact of institutional and medical discourses on childbirth, women's birth evaluations demonstrate the benefits and challenges of gender-normative behaviour, where women's internalised sense of gender was found to affect their experiences. A gender perspective may provide a useful tool in unveiling gender-normative complexities surrounding the childbirth experience.


Assuntos
Feminilidade , Tocologia/organização & administração , Parto/psicologia , Assistência Perinatal/organização & administração , Relações Profissional-Paciente , Adolescente , Adulto , Feminino , Humanos , Linguística , Saúde Materna , Mães/psicologia , Satisfação do Paciente , Gravidez , Pesquisa Qualitativa , Suécia , Adulto Jovem
17.
Womens Health (Lond) ; 17: 17455065211010655, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33886392

RESUMO

OBJECTIVES: Household chaos, including disorder, noise, and crowding within the home, is a risk factor for poor mental and physical health. Household chaos may act upon maternal behaviors of physical activity and sleep, potentially via higher stress. The purpose of this study is to evaluate the relationships among household chaos, maternal stress, and maternal physical activity and sleep, and identify barriers to home organization during the COVID-19 outbreak. METHODS: A cross-sectional study using an online survey of 1721 mothers of preschoolers (ages = 3.0-5.9 years) in the United States was conducted in May 2020 during COVID-19 stay-at-home orders and early reopening. Mothers reported demographic characteristics, household chaos, stress, physical activity and sleep, and barriers to home organization during the outbreak. Mediation models were conducted among household chaos, stress, and physical activity and sleep with adjustment for covariates. RESULTS: About half of mothers were middle income (48.2%), employed full-time prior to the outbreak (59.1%), and met the physical activity (47.7%), and sleep guideline (49.7%, 7-9 h/day). Household chaos and stress were both negatively related to physical activity and sleep. For every 1 unit increase in mother's current stress, mothers were 11% (95% confidence interval = 6% to 16%) less likely to meet the physical activity guideline and 19% (95% confidence interval = 14% to 23%) less likely to meet the sleep guideline. Household chaos was positively related to stress. Stress partially mediated the relationship between household chaos and physical activity and sleep. Virus concerns, occupational changes (i.e. teleworking), and lack of childcare were barriers to home organization. CONCLUSION: During the COVID-19 outbreak, many mothers had poor sleep and physical activity, which was associated with household chaos and stress. Opportunities to promote order at the individual, household, and community level may result in beneficial mental and physical health in mothers of young children during the COVID-19 outbreak and beyond.


Assuntos
Exercício Físico , Características da Família , Comportamentos Relacionados com a Saúde , Comportamento Materno/psicologia , Mães/psicologia , Sono , Estresse Psicológico/epidemiologia , Adulto , COVID-19/prevenção & controle , Pré-Escolar , Estudos Transversais , Feminino , Humanos , SARS-CoV-2 , Estados Unidos
18.
Nutrients ; 13(4)2021 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-33920602

RESUMO

Although there is a large body of research connecting emotion to eating behaviors, little is known about the role of caregivers' responses to children's emotions in the context of child feeding. The purpose of this study was to analyze the relation between caregivers' emotional responsiveness and feeding responsiveness. The mothers of 137 children between 2 and 6 years of age reported on their responses to children's negative emotions using the Coping with Children's Negative Emotions Scale and on their feeding practices using the Comprehensive Feeding Practices Questionnaire. The results showed that mothers' supportive emotion responses (e.g., problem-focused, emotion-focused, and expressive encouragement reactions) tend to be positively associated with responsive feeding practices (e.g., encouraging, modelling, and teaching healthy food-related behaviors). Instead, mothers' unsupportive responses (e.g., distress, punitive and minimization reactions) tend to be positively associated with nonresponsive feeding practices (e.g., food as reward or to regulate emotions, and pressure to eat) and negatively associated with responsive feeding practices. Our results suggest that emotional and feeding responsiveness may be intertwined and that differences in parent's emotional responsiveness may translate into differences in their feeding styles, setting the stage for parents' use of positive vs. negative feeding practices.


Assuntos
Dieta Saudável/psicologia , Comportamento Alimentar/psicologia , Mães/psicologia , Relações Pais-Filho , Poder Familiar/psicologia , Adaptação Psicológica , Adulto , Criança , Comportamento Infantil/psicologia , Pré-Escolar , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Portugal , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários , Adulto Jovem
19.
BMC Pregnancy Childbirth ; 21(1): 314, 2021 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-33879065

RESUMO

BACKGROUND: Child abuse and postnatal depression are two public health problems that often co-occur, with rates of childhood maltreatment highest during the first year of life. Internet-based behavioural activation (iBA) therapy has demonstrated its efficacy for improving postnatal depression. No study has examined whether the iBA program is also effective at preventing child abuse. This study aims to investigate whether iBA improves depressive symptoms among mothers and prevents abusive behaviours towards children in postpartum mothers in a randomized controlled trial, stratifying on depressive mood status. The study also evaluates the implementation aspects of the program, including how users, medical providers, and managers perceive the program in terms of acceptability, appropriateness, feasibility, and harm done. METHODS: The study is a non-blinded, stratified randomized controlled trial. Based on cut-off scores validated on Japanese mothers, participants will be stratified to either a low Edinburgh Postnatal Depression Scale (EPDS) group, (EPDS 0-8 points) or a high EPDS group (EPDS ≥9 points). A total of 390 postnatal women, 20 years or older, who have given birth within 10 weeks and have regular internet-access will be recruited at two hospitals. Participants will be randomly assigned to either treatment, with treatment as usual (TAU) or through intervention groups. The TAU group receives 12 weekly iBA sessions with online assignments and feedback from trained therapists. Co-primary outcomes are maternal depressive symptoms (EPDS) and psychological aggression toward children (Conflict Tactic Scale 1) at the 24-week follow-up survey. Secondary outcomes include maternal depressive symptoms, parental stress, bonding relationship, quality of life, maternal health care use, and paediatric outcomes such as physical development, preventive care attendance, and health care use. The study will also investigate the implementation outcomes of the program. DISCUSSION: The study investigates the effectiveness of the iBA program for maternal depressive symptoms and psychological aggression toward children, as well as implementation outcomes, in a randomized-controlled trial. The iBA may be a potential strategy for improving maternal postnatal depression and preventing child abuse. TRIAL REGISTRATION: The study protocol (issue date: 2019-Mar-01, original version 2019005NI-00) was registered at the UMIN Clinical Trial Registry (UMIN-CTR: ID UMIN 000036864 ).


Assuntos
Maus-Tratos Infantis/prevenção & controle , Terapia Cognitivo-Comportamental/métodos , Depressão Pós-Parto/terapia , Intervenção Baseada em Internet , Criança , Feminino , Humanos , Japão , Serviços de Saúde Materna , Mães/psicologia , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Smartphone , Inquéritos e Questionários , Resultado do Tratamento
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