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1.
Ethiop J Health Sci ; 34(1): 15-26, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38370567

RESUMEN

Background: Knowledge, attitudes and practices (KAP) of human papilloma virus (HPV) is a necessary measure in curtailing delayed diagnosis and poor control practices. The objective of this study was to assess the knowledge, attitudes and practices vis-à-vis HPV infection, cervical cancer and vaccination among women. Methods: This cross-sectional study was conducted at 15 selected health-care facilities in Otukpo metropolis and it involved 168 pregnant women. The data were collected using structured questionnaire, and analysed for descriptive and analytical statistics using Epi Data Version 3.1 and SPSS statistical package Version 21. Results: Most of the respondents (75.0%) have heard of human papilloma virus and their information source were mostly the health-care providers. In total, 132(78.6%) agreed to take the vaccine if offered for free but 152(90.5%) stated that it is imperative to seek the opinion of health providers before vaccine uptake. However, only 27(16.1%) have undergone recommended checkup for human papilloma virus/cervical cancer and 23(13.7%) have taken at least a vaccine dose. Some respondents 66(39.3%) had good knowledge while 95(56.6%) demonstrated positive attitude. However, most respondents 161(95.8%) demonstrated poor practices. Conclusions: There is enormous need to improve HPV sensitization especially in women due to cervical cancer associated risks. Healthcare personnel are therefore encouraged to create more awareness on HPV infection and screening of cervical cancer (CC) via counseling sessions and communications tool like the new media. KAP approach is a critical tool towards successful CC screening and HPV control.


Asunto(s)
Infecciones por Papillomavirus , Vacunas contra Papillomavirus , Neoplasias del Cuello Uterino , Humanos , Femenino , Embarazo , Infecciones por Papillomavirus/prevención & control , Infecciones por Papillomavirus/psicología , Neoplasias del Cuello Uterino/prevención & control , Neoplasias del Cuello Uterino/diagnóstico , Nigeria , Estudios Transversales , Conocimientos, Actitudes y Práctica en Salud , Vacunación/psicología , Encuestas y Cuestionarios , Aceptación de la Atención de Salud
2.
Arch. argent. pediatr ; 122(1): e202310199, feb. 2024.
Artículo en Español | LILACS, BINACIS | ID: biblio-1526429

RESUMEN

La adolescencia constituye una etapa atravesada por cambios físicos, emocionales y sociales significativos, que incluyen la adquisición de múltiples habilidades. Aumentan los riesgos de sufrir alteraciones mentales, consumo de sustancias, embarazo no deseado, trastornos alimentarios, y se evidencian los efectos negativos del uso inapropiado de las redes sociales. El bienestar digital implica el uso saludable de la tecnología, la protección de la privacidad y la seguridad en línea. Los adolescentes utilizan las redes con la finalidad de identificarse, relacionarse, entretenerse y buscar información. La exposición no regulada conlleva riesgos: acceso a contenido inapropiado, ciberacoso, consumo problemático y fraudes. Desde el ámbito pediátrico, se debe acompañar a los adolescentes para que optimicen el uso de la tecnología y, para ello, es fundamental implementar estrategias multisectoriales para minimizar los riesgos y promover el bienestar de los adolescentes en línea, así como garantizar la alfabetización digital y el acceso equitativo a recursos tecnológicos de calidad y telesalud.


Adolescence is a period characterized by significant physical, emotional, and social changes, including the acquisition of multiple skills. It is also a time when the risks of mental disorders, substance use, unwanted pregnancy, eating disorders, and negative effects of inappropriate social media use manifest greatly. Digital well-being implies the healthy use of technology, the protection of privacy and security online. Adolescents use social media to identify themselves, interact with others, entertain themselves, and seek information. However, risks are present, including access to inappropriate content, cyberbullying, problematic consumption, and fraud. The pediatric field must support adolescents in optimizing their online use. Implementing multisectoral strategies can minimize risks, promote digital literacy, and ensure equitable access to quality technological resources and telehealth, thereby promoting adolescent online well-being.


Asunto(s)
Humanos , Embarazo , Adolescente , Telemedicina , Trastornos Mentales , Estado de Salud , Personal de Salud , Emociones
3.
Enferm. clín. (Ed. impr.) ; 34(1): 23-33, Ene-Feb, 2024. ilus, tab, graf
Artículo en Español | IBECS | ID: ibc-229654

RESUMEN

Objetivo: Evaluar la asociación entre edad, paridad, nacionalidad, estudios, empleo y apoyo de la pareja con la depresión y ansiedad durante el embarazo. Determinar el impacto de la evolución de la pandemia COVID-19 en los niveles de ansiedad y depresión de las participantes. Método: Estudio descriptivo correlacional transversal realizado en el Osakidetza/Servicio Vasco de Salud, Atención primaria, Bizkaia (España). Participaron 295 gestantes entre ocho y 41 semanas. Se midió la asociación entre edad, paridad, nacionalidad, nivel de estudios, empleo, apoyo de la pareja y tasas de incidencia de COVID-19 durante el periodo del estudio y las puntuaciones de depresión (medido con la Escala de Depresión Posnatal de Edimburgo) y de ansiedad (medido con la subescala de ansiedad estado-rasgo del State-Anxiety Inventory [STAI-S]) durante el embarazo. Se construyó un modelo de regresión logística y se estimaron las odds ratios (OR) y sus intervalos de confianza de 95% (IC 95%). Resultados: La puntuación media en ansiedad fue de 18,75 puntos (DE = 8,69) y en depresión 6,45 puntos (DE = 4,32). Las mujeres que esperaban su segundo hijo o más obtuvieron puntuaciones más altas en depresión (OR 2,51 [IC 95%: 1,26-5,01]) y ansiedad (OR 1,98 [IC 95%: 1,01-3,89]). Haber cursado estudios universitarios se asocia con puntuaciones más bajas en depresión (OR 0,28 [IC 95%: 0,11-0,77]) y ansiedad (OR 0,2 [IC 95%:0,08-0,54]). Una buena calidad en la relación de pareja se asocia con menores niveles de ansiedad (OR 0,45 [IC 95%: 0,24-0,81). La puntuación media en ansiedad y depresión se relacionan con la incidencia de casos COVID-19; la puntuación en ansiedad fue significativamente más alta en los periodos de mayor incidencia. Conclusiones: Mayor atención emocional a las gestantes con bajo nivel de estudios, multíparas y con un débil apoyo de su pareja, permitiría reducir la ansiedad y depresión en el embarazo. Situaciones de emergencia sanitaria afectan a la salud mental durante la ges...(AU)


Objective: To assess the association between age, parity, nationality, educational level, employment and partner support with depression and anxiety during pregnancy. To determine the impact of the evolution of the COVID-19 pandemic on the anxiety and depression levels of the participants. Method: Cross-sectional descriptive correlational study carried out in the Osakidetza/Basque Health Service, Primary Care, Bizkaia (Spain). A total of 295 pregnant women between 8 and 41 weeks participated. The association between age, parity, nationality, educational level, employment, partner support and COVID-19 incidence rates during the study period and depression (measured with the Edinburgh Postnatal Depression Scale) and anxiety (measured with the State-Anxiety Inventory/STAI-S subscale) scores during pregnancy was measured. A logistic regression model was constructed and odds ratios and their 95% confidence intervals were estimated. Results: The mean score was 18.75 points for anxiety (SD 8.69) and 6.45 points for depression (SD 4.32). Women expecting their second or later child had higher scores for depression (OR 2.51 [95%IC: 1.26-5.01]) and anxiety (OR 1.98 [95%IC: 1.01-3.89]). Having completed university studies was associated with lower scores in depression (OR 0.28 [95%IC: 0.11-0.77]) and in anxiety (OR 0,2 [95%IC: 0.08-0.54]). A good relationship with the partner was associated with lower levels of anxiety (OR 0.45 [95%IC: 0.24-0.81]). The mean anxiety and depression scores are related to the incidence of COVID-19 cases; the anxiety score was significantly higher in periods of higher incidence. Conclusions: Greater emotional care for pregnant women with low educational level, multiparous and with weak support from their partner, would reduce anxiety and depression in pregnancy. Health emergency situations affect mental health during gestation.(AU)


Asunto(s)
Humanos , Femenino , Embarazo , Complicaciones del Embarazo , /complicaciones , Ansiedad , Depresión , /epidemiología , Enfermería , /enfermería , Epidemiología Descriptiva , Estudios Transversales , España
4.
J Obstet Gynaecol ; 44(1): 2319791, 2024 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38419407

RESUMEN

BACKGROUND: Coronavirus (COVID-19) pandemic has affected the training and wellbeing of obstetrics and gynaecology (O&G) trainees. The aim of this review is to offer a worldwide overview on its' impact on the mental health of O&G trainees, so that measures can be put into place to better support trainees during the transition back to the 'new normal'. METHODS: Key search terms used on PubMed and Google Scholar databases include: mental health, COVID-19, O&G, trainees, residents. RESULTS: Fifteen articles (cumulative number of respondents = 3230) were identified, of which eight employed validated questionnaires (n = 1807 respondents), while non-validated questionnaires were used in seven (n = 1423 respondents). Studies showed that COVID-19 appeared to exert more of a negative impact on females and on senior trainees' mental health, while protective factors included marriage/partner and having had children. Validated and non-validated questionnaires suggested that trainees were exposed to high levels of anxiety and depression. Their mental health was also affected by insomnia, stress, burnout and fear of passing on the virus. DISCUSSION: This review analyses the global impact of COVID-19 on O&G trainees' mental health, showing a pervasive negative effect linked to fear of the virus. Limited psychological support has led to prolonged issues, hindering patient safety and increasing sick leave. The study underscores the urgency of comprehensive support, particularly in female-dominated fields. Addressing these challenges is crucial for future pandemics, highlighting the need to learn from past mistakes and prioritise mental health resources for trainee well-being during and beyond pandemics.


This review provides a worldwide overview of the impact Coronavirus (COVID-19) pandemic on the mental health of obstetrics and gynaecology (O&G) trainees. Fifteen articles were identified, of which eight employed validated questionnaires (n = 1807 respondents), while non-validated questionnaires were used in seven (n = 1423 respondents). The pandemic appeared to exert more of a negative impact on females and on senior trainees' mental health, while protective factors included marriage/partner and having had children. Studies suggested that trainees were exposed to high levels of anxiety and depression. Their mental health was also affected by insomnia, stress, burnout and fear of passing on the virus.Limited psychological support has led to prolonged recovery issues and increasing sick leave. The study underscores the urgency of comprehensive support, particularly in female-dominated fields. Addressing these challenges is crucial for future pandemics, highlighting the need to learn from past mistakes and prioritise mental health resources for trainee well-being.


Asunto(s)
COVID-19 , Ginecología , Obstetricia , Embarazo , Niño , Femenino , Humanos , COVID-19/epidemiología , Pandemias , Salud Mental , SARS-CoV-2 , Encuestas y Cuestionarios
5.
Sci Rep ; 14(1): 3492, 2024 02 12.
Artículo en Inglés | MEDLINE | ID: mdl-38347064

RESUMEN

Although the causes of neurodevelopmental disorders remain unknown, several environmental risk factors have attracted considerable attention. We conducted a retrospective, longitudinal, population-based cohort study using data from infant health examinations of children born to mothers with pregnancies between April 1, 2014 and March 31, 2016 in Kobe City to identify the perinatal factors associated with neurodevelopmental referrals in 3-year-old children. There were 15,223 and 1283 children in the normal and referral groups, respectively. Neurodevelopmental referrals at the health checkup for 3-year-old children were significantly associated with the lack of social support during pregnancy (adjusted odds ratio [aOR] 1.99, 99% CI 1.14-3.45, p = 0.001), history of psychiatric consultation (aOR 1.56, 99% CI 1.10-2.22, p = 0.001), no social assistance post-delivery (aOR 1.49, 99% CI 1.03-2.16, p = 0.006), Edinburgh Post-natal Depression Scale (EPDS) score ≥ 9 (aOR 1.36, 99% CI 1.01-1.84, p = 0.008), infant gender (male) (aOR 2.51, 99% CI 2.05-3.06, p < 0.001), and cesarean delivery (aOR 1.39, 99% CI 1.11-1.75, p < 0.001). In conclusion, this exploratory study in the general Japanese population identified six perinatal factors associated with neurodevelopmental referrals in 3-year-old children: infant gender (male), cesarean section, maternal history of psychiatric consultation, EPDS score ≥ 9, lack of social support during pregnancy, and no social assistance post-delivery.


Asunto(s)
Cesárea , Depresión Posparto , Lactante , Humanos , Embarazo , Masculino , Femenino , Preescolar , Japón/epidemiología , Estudios Retrospectivos , Estudios de Cohortes , Factores de Riesgo , Depresión Posparto/psicología , Derivación y Consulta
6.
BMJ Open ; 14(2): e068941, 2024 Feb 27.
Artículo en Inglés | MEDLINE | ID: mdl-38417959

RESUMEN

OBJECTIVES: Perinatal mental health problems affect one in five women and cost the UK £8.1 billion for every year of births, with 72% of this cost due to the long-term impact on the child. We conducted a rapid review of health economic evaluations of preventative care for perinatal anxiety and associated disorders. DESIGN: This study adopted a rapid review approach, using principles of the standard systematic review process to generate quality evidence. This methodology features a systematic database search, Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram, screening of evidence, data extraction, critical appraisal and narrative synthesis. DATA SOURCES: PubMed, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Applied Social Sciences Index and Abstracts, PsycINFO and MEDLINE. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Studies that evaluated the costs and cost-effectiveness of preventative care for perinatal anxiety and associated disorders carried out within the National Health Service and similar healthcare systems. DATA EXTRACTION AND SYNTHESIS: A minimum of two independent reviewers used standardised methods to search, screen, critically appraise and synthesise included studies. RESULTS: The results indicate a lack of economic evaluation specifically for perinatal anxiety, with most studies focusing on postnatal depression (PND). Interventions to prevent postnatal mental health problems are cost-effective. Modelling studies have also been conducted, which suggest that treating PND with counselling would be cost-effective. CONCLUSION: The costs of not intervening in maternal mental health outweigh the costs of preventative interventions. Preventative measures such as screening and counselling for maternal mental health are shown to be cost-effective interventions to improve outcomes for women and children. PROSPERO REGISTRATION NUMBER: CRD42022347859.


Asunto(s)
Depresión Posparto , Medicina Estatal , Embarazo , Niño , Humanos , Femenino , Análisis Costo-Beneficio , Ansiedad/prevención & control , Salud Mental , Trastornos de Ansiedad/prevención & control , Depresión Posparto/prevención & control
7.
Disaster Med Public Health Prep ; 18: e16, 2024 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-38304943

RESUMEN

OBJECTIVE: It is well known that natural disasters such as earthquakes negatively affect physical and mental health by exposing people to excessive stress. The aim of this study was to investigate determinants of psychosocial health status among the pregnant and postpartum women who experienced earthquake in Türkiye. METHODS: Pregnant and postpartum women (n = 125) living in tent cities in the Kahramanmaras region formed the study sample. Data were collected between February 20 and 26, 2023, through face-to-face interviews. The instruments used for data collection were the Introductory Form, the Depression Anxiety Stress Scale, the Traumatic Childbirth Perception Scale, and the Post-Traumatic Stress Disorder-Short Scale. RESULTS: A moderate positive relationship was found between stress and posttraumatic stress and traumatic childbirth perception in pregnant and postpartum women, and a high positive relationship was found between anxiety and depression. A high level of relationship was found between anxiety and stress and depression. CONCLUSIONS: It is seen that the psychosocial health of pregnant and postpartum women, who belong to the risk group in the earthquake zone, is at high risk. Psychological support is urgently needed to preserve and improve their psychosocial health.


Asunto(s)
Terremotos , Trastornos por Estrés Postraumático , Embarazo , Femenino , Humanos , Turquia/epidemiología , Encuestas y Cuestionarios , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/etiología , Trastornos por Estrés Postraumático/psicología , Estado de Salud , Periodo Posparto , Depresión/epidemiología , Depresión/etiología , Depresión/psicología , Mujeres Embarazadas/psicología
8.
Dev Psychobiol ; 66(2): e22455, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38388206

RESUMEN

Discrimination reported during pregnancy is associated with poorer offspring emotional outcomes. Links with effortful control have yet to be examined. This study investigated whether pregnant individuals' reports of lifetime racial/ethnic discrimination and everyday discrimination (including but not specific to race/ethnicity) reported during pregnancy were associated with offspring emerging effortful control at 6 months of age. Pregnant individuals (N = 174) and their offspring (93 female infants) participated. During pregnancy, participants completed two discrimination measures: (1) lifetime experience of racial/ethnic discrimination, and (2) everyday discrimination (not specific to race/ethnicity). Parents completed the Infant Behavior Questionnaire-Revised when infants were 6 months old to assess orienting/regulation, a measure of emerging effortful control. Analyses were conducted in a subsample with racially/ethnically marginalized participants and then everyday discrimination analyses were repeated in the full sample. For racially/ethnically marginalized participants, greater everyday discrimination (ß = -.27, p = .01) but not greater lifetime experience of racial/ethnic discrimination (ß = -.21, p = .06) was associated with poorer infant emerging effortful control. In the full sample, greater everyday discrimination was associated with poorer infant emerging effortful control (ß = -.24, p = .002). Greater perceived stress, but not depressive symptoms, at 2 months postnatal mediated the association between everyday discrimination and emerging effortful control. Further research should examine additional biological and behavioral mechanisms by which discrimination reported during pregnancy may affect offspring emerging effortful control.


Asunto(s)
Racismo , Embarazo , Lactante , Humanos , Femenino , Racismo/psicología , Etnicidad/psicología , Encuestas y Cuestionarios , Emociones , Depresión
9.
BMC Pregnancy Childbirth ; 24(1): 168, 2024 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-38409006

RESUMEN

BACKGROUND: Intimate partner violence (IPV) impacts physical health, mental health, and healthcare use. IPV during pregnancy, in particular, is associated with lower rates of antenatal care, but no studies have assessed the association between IPV and postpartum healthcare. This study aims to examine the link between IPV (emotional, physical, and sexual) and two outcomes: postpartum healthcare use and access to family planning. METHODS: This study uses data from a cross-sectional survey of 859 women in Nairobi and Kiambu counties in Kenya who gave birth during the COVID-19 pandemic in 2020. RESULTS: In this sample, 36% of women reported ever experiencing IPV. Of those, 33% indicated the frequency of IPV stayed the same or increased during COVID-19. Nearly 17% of women avoided postpartum healthcare and 10% experienced issues accessing family planning. Those who experienced any form of IPV during pregnancy had approximately twice the odds of avoiding postpartum healthcare compared to those who did not experience any form of IPV. Compared to those who did not experience IPV during pregnancy, experiencing sexual IPV was associated with 2.25 times higher odds of reporting issues accessing family planning. Additionally, reporting fair or poor self-rated health was associated with both avoiding postpartum healthcare and reporting issues accessing family planning. Experiencing food insecurity was also associated with avoiding postpartum healthcare. CONCLUSIONS: To our knowledge, this is the first study to establish the link between IPV during pregnancy and postpartum healthcare access. During COVID-19 in Kenya, postpartum women who had experienced IPV were at increased risk of disengagement with healthcare services. Women should be screened for IPV during pregnancy and postpartum in order to better support their healthcare needs. In times of crisis, such as pandemics, policymakers and healthcare providers must address barriers to healthcare for postpartum women.


Asunto(s)
COVID-19 , Violencia de Pareja , Embarazo , Femenino , Humanos , Estudios Transversales , Kenia/epidemiología , Pandemias , Violencia de Pareja/psicología , Periodo Posparto , Accesibilidad a los Servicios de Salud , COVID-19/epidemiología , Factores de Riesgo , Prevalencia
10.
Artículo en Inglés | MEDLINE | ID: mdl-38397698

RESUMEN

A 28-week supported online intervention for pregnant women, informed by the Behavior Change Wheel Framework, was developed. The intervention included exercises, group sessions and a peer support platform. The aim of this study was to examine the potential effectiveness of the intervention in enhancing resilience and promoting maternal mental health. Using a quasi-experimental design, assessments were conducted at baseline, postintervention and follow-ups at six and 12 months after childbirth. Resilience, resilience attributes, and maternal mental health were measured using standardised scales. The intervention group received the intervention (N = 70), while the control group (N = 32) received care-as-usual. A repeated-measures ANOVA was used to determine within- and between-group changes. Results showed no significant differences between groups regarding resilience and maternal mental health. However, the intervention group demonstrated stable resilience (p = 0.320) compared to a significant decrease in the control group (p = 0.004). Within the intervention group, perceived social support remained stable during the intervention, but decreased significantly at the first follow-up (p = 0.012). All participants faced additional stress from the COVID-19 pandemic alongside the challenges of parenthood. This study contributes to maternal mental health literature with an innovative, supported online intervention. The intervention consists of different deployable components, designed to be offered online, and the current pilot data are promising. Further research is warranted to explore its full potential in clinical practice.


Asunto(s)
Intervención basada en la Internet , Resiliencia Psicológica , Femenino , Embarazo , Humanos , Mujeres Embarazadas/psicología , Proyectos Piloto , Pandemias , Parto
11.
J Affect Disord ; 349: 370-376, 2024 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-38199402

RESUMEN

BACKGROUND: The quality of mother-to-infant bonding (MIB) is a crucial determinant of nurturing behaviors and infant development, with bonding difficulties (MIBD) posing a substantial threat. While it is essential to identify MIBD risk factors, previous studies have generally examined MIBD at one time point, leaving the contributors to persistent MIBD uncertain. This study aims to discern longitudinal risk factors for persistent versus episodic MIBD. METHODS: We evaluated 1833 postpartum Japanese women who delivered in the past twelve months, utilizing the Mother-to-Infant Bonding Scale (MIBS) and other sociodemographic, health, pregnancy, childbirth, and child-rearing related data (T1). Follow-up data were obtained six months later (T2). MIBD was defined as a MIBS score of five or more, with "persistent" and "episodic" MIBD classified based on its occurrence at both or either one of the time points, respectively. Logistic generalized estimating equations and inverse probability weighting were used to identify risk factors and address selective attribution bias. RESULTS: Of the subjects, 15.8 % reported episodic and 11.3 % reported persistent MIBD. Shared risk factors for both conditions included postpartum depression and low levels of family support (OR = 1.501-6.343). However, pre-pregnancy underweight status (OR = 1.698) was a unique risk factor for episodic MIBD, while first-time motherhood, no or discontinuation of breastfeeding, and later postpartum months (OR = 1.540-3.179) were distinctive risk factors for persistent MIBD. CONCLUSION: We identified both shared and unique risk factors for episodic and persistent MIBD. Particular attention should be afforded to persistent MIBD and early and proactive interventions to mitigate identified risk factors are recommended.


Asunto(s)
Depresión Posparto , Madres , Humanos , Lactante , Femenino , Embarazo , Estudios Longitudinales , Relaciones Madre-Hijo , Japón/epidemiología , Encuestas y Cuestionarios , Periodo Posparto , Depresión Posparto/epidemiología , Factores de Riesgo , Apego a Objetos
12.
BMC Health Serv Res ; 24(1): 149, 2024 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-38291449

RESUMEN

BACKGROUND: Perinatal Mood and Anxiety Disorders (PMADs) affect one in five birthing individuals and represent a leading cause of maternal mortality. While these disorders are associated with a variety of poor outcomes and generate significant societal burden, underdiagnosis and undertreatment remain significant barriers to improved outcomes. We aimed to quantify whether the Patient Protection Affordable Care Act (ACA) improved PMAD diagnosis and treatment rates among Michigan Medicaid enrollees. METHODS: We applied an interrupted time series framework to administrative Michigan Medicaid claims data to determine if PMAD monthly diagnosis or treatment rates changed after ACA implementation for births 2012 through 2018. We evaluated three treatment types, including psychotherapy, prescription medication, and either psychotherapy or prescription medication. Participants included the 170,690 Medicaid enrollees who had at least one live birth between 2012 and 2018, with continuous enrollment from 9 months before birth through 3 months postpartum. RESULTS: ACA implementation was associated with a statistically significant 0.76% point increase in PMAD diagnosis rates (95% CI: 0.01 to 1.52). However, there were no statistically significant changes in treatment rates among enrollees with a PMAD diagnosis. CONCLUSION: The ACA may have improved PMAD detection and documentation in clinical settings. While a higher rate of PMAD cases were identified after ACA Implementation, Post-ACA cases were treated at similar rates as Pre-ACA cases.


Asunto(s)
Medicaid , Patient Protection and Affordable Care Act , Embarazo , Femenino , Estados Unidos/epidemiología , Humanos , Michigan/epidemiología , Análisis de Series de Tiempo Interrumpido , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/epidemiología , Trastornos de Ansiedad/terapia , Cobertura del Seguro
13.
Med. U.P.B ; 43(1): 65-74, ene.-jun. 2024.
Artículo en Español | LILACS, COLNAL | ID: biblio-1531505

RESUMEN

Durante el embarazo la mujer experimenta muchos cambios, no solo físicos, también mentales, por eso la salud mental perinatal es de gran importancia en esta etapa. La mayoría de las mujeres en embarazo que desarrollan alguna enfermedad mental durante la gestación, como depresión o ansiedad, no son diagnosticadas, lo que puede generar efectos adversos para la madre y el bebé. En ese sentido, es de gran importancia el tamizaje, diagnóstico, manejo y seguimiento de este grupo. Gracias a los avances tecnológicos podemos contar con las tecnologías de la Información y la comunicación (TIC) para buscar maneras cómo aproximarse a las mujeres en etapa perinatal para el tamizaje y hacer el seguimiento de su salud mental. Así que este artículo de revisión se enfoca en ver su aceptabilidad, la percepción, las barreras al acceso y nuevos desarrollos enfocados en mejorar la salud mental en las mujeres en etapa perinatal.


During pregnancy, a woman experiences many changes, not only physical, but also mental, which is why perinatal mental health is of great importance at this stage. The majority of pregnant women who develop a mental illness during pregnancy, such as depression or anxiety, are not diagnosed, which can cause adverse effects for the mother and baby. In this sense, the screening, diagnosis, management and follow-up of this group is of great importance. Thanks to technological advances, we can count on the Information and Communication Technologies (ICT) to find ways to approach women in the perinatal stage for screening and monitoring their mental health. So this review article focuses on seeing its acceptability, perception, barriers to access and new developments focused on improving mental health in perinatal women.


Durante el embarazo la mujer experimenta muchos cambios, no solo físicos, también mentales, por eso la salud mental perinatal es de gran importancia en esta etapa. La mayoría de las mujeres en embarazo que desarrollan alguna enfermedad mental durante la gestación, como depresión o ansiedad, no son diagnosticadas, lo que puede generar efectos adversos para la madre y el bebé. En ese sentido, es de gran importancia el tamizaje, diagnóstico, manejo y seguimiento de este grupo. Gracias a los avances tecnológicos podemos contar con las tecnologías de la Información y la comunicación (TIC) para buscar maneras cómo aproximarse a las mujeres en etapa perinatal para el tamizaje y hacer el seguimiento de su salud mental. Así que este artículo de revisión se enfoca en ver su aceptabilidad, la percepción, las barreras al acceso y nuevos desarrollos enfocados en mejorar la salud mental en las mujeres en etapa perinatal.


Asunto(s)
Humanos , Femenino , Embarazo
14.
J Affect Disord ; 351: 774-781, 2024 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-38290581

RESUMEN

BACKGROUND: Perinatal depression has attracted increasing attention. However, a detailed investigation of the network structure of depression is still lacking. We aim to examine the similarities and differences between the Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire (PHQ-9) from a network perspective. METHODS: A cross-sectional study was conducted from August 2020 to March 2022. We followed the STROBE checklist to report our research. Pregnant women (n = 2484) were recruited. All participants completed the EPDS and PHQ-9. We mainly used network analyses for statistical analysis and constructed two network models: the EPDS and PHQ-9 models. RESULTS: The detection rates of prenatal depression measured by the EPDS and PHQ-9 were 30.2 % and 28.2 %, respectively. In the EPDS network, the EPDS8 'sad or miserable' node (strength = 1.2161) was the most central node, and the EPDS10 'self-harming' node (strength = 0.4360) was the least central node. In the PHQ-9 network, the PHQ4 'fatigue' node (strength = 0.9815) was the most central node, and PHQ9 'suicide' was the least central symptom (strength = 0.5667). For both models, 'sad' acted as an important central symptom. CONCLUSIONS: Psychological symptoms may be more important in assessing depression using the EPDS, while physical symptoms may be more influential in assessing depression using the PHQ-9. For both the EPDS and PHQ-9, "sad" was an important central symptom, suggesting that it may be the most important target for further maternal depression interventions in the future.


Asunto(s)
Depresión Posparto , Mujeres Embarazadas , Femenino , Embarazo , Humanos , Cuestionario de Salud del Paciente , Depresión/diagnóstico , Depresión/psicología , Depresión Posparto/diagnóstico , Depresión Posparto/psicología , Estudios Transversales , Tamizaje Masivo , Encuestas y Cuestionarios , Escalas de Valoración Psiquiátrica
15.
BMC Pregnancy Childbirth ; 24(1): 72, 2024 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-38254076

RESUMEN

BACKGROUND: Pregnant people who use unregulated drugs (PPWUD) are at high risk of health complications yet experience a range of barriers to sexual and reproductive health care. Given that improving maternal health and access to reproductive health care are key targets underpinning the Sustainable Development Goals (SDG), there is an urgent need to improve access to appropriate supports and services for this population. Little is known about what programs and practices exist to support PPWUD's access to sexual and reproductive health care. This scoping review aimed to identify the available literature on these programs and practices in Canada. METHODS: A scoping review was conducted using JBI methodology and reported using PRISMA guidelines. Scholarly databases and grey literature sources were searched to identify literature published between 2016-2023 in English or French that discussed, defined, conceptualised, or evaluated programs and practices that support PPWUD's access to sexual and reproductive health care in Canada. Identified literature was screened using Covidence. Data were extracted from included texts, then analysed descriptively. Frequencies and key concepts were reported. RESULTS: A total of 71 articles were included, most of which were grey literature. Of the total, 46 unique programs were identified, as well as several useful practices. Most programs were in urban centres in Western Canada, and most programs offered holistic 'wrap-around services.' Several programs delivered these services on-site or as 'drop-in' programs with the support of staff with lived/living experience of substance use. Most frequent program outcomes included keeping parents and children together, improving connection to other services, and reducing substance use harms. Noted helpful practices included non-judgmental care and the use of harm-reduction strategies. CONCLUSIONS: Several programs and practices that support PPWUD exist in Canada, though few focus exclusively on sexual and reproductive health. There remain opportunities to improve access to programs, including expanding geographic availability and range of services. The review has clinical application by providing an overview of available programs that may support clinicians in identifying services for PPWUD. Future research should consider client perspectives and experiences of these programs. REVIEW REGISTRATION NUMBER: Open Science Framework https://osf.io/5y64j .


Asunto(s)
Salud Reproductiva , Trastornos Relacionados con Sustancias , Niño , Femenino , Embarazo , Humanos , Conducta Sexual , Reproducción , Canadá
16.
BMC Public Health ; 24(1): 116, 2024 01 08.
Artículo en Inglés | MEDLINE | ID: mdl-38191335

RESUMEN

BACKGROUND: Approximately 241,000 people are living with hepatitis B in New York City. Among those living with hepatitis B, pregnant people are particularly at risk for elevated viral load due to changes in immune response and require prompt linkage to health care. The New York City Department of Health and Mental Hygiene's Viral Hepatitis Program implemented a telephone-based patient navigation intervention for people living with hepatitis B in the postpartum period to connect them with hepatitis B care. METHODS: During the intervention, patient navigators called participants to inquire about their past experience with receiving care, available supports, and barriers to care, and worked with them to develop a plan with participants for linkage to hepatitis B care. The information collected during initial assessments and follow-up interactions were recorded as case notes. In this qualitative study, researchers conducted a thematic analysis of 102 sets of case notes to examine facilitators and barriers to accessing hepatitis B care among the intervention participants, all of whom were foreign-born and interested in receiving hepatitis B patient navigation services. RESULTS: The qualitative analysis illustrated the various ways in which patient navigators supported access to hepatitis B care. Findings suggest that receiving care through a preferred provider was a central factor in accessing care, even in the presence of significant barriers such as loss of health insurance and lack of childcare during appointments. Expectations among family members about hepatitis B screening, vaccination and routine clinical follow up were also identified as a facilitator that contributed to participants' own care. CONCLUSIONS: This study suggests that while there are numerous barriers at the personal and systemic levels, this patient navigation intervention along with the identified facilitators supported people in accessing hepatitis B care. Other patient navigation initiatives can incorporate the lessons from this analysis to support people in connecting to a preferred provider.


Asunto(s)
Hepatitis B , Parto , Femenino , Embarazo , Humanos , Periodo Posparto , Hepatitis B/diagnóstico , Hepatitis B/prevención & control , Familia , Instituciones de Salud
17.
Arch Argent Pediatr ; : e202310217, 2024 Jan 25.
Artículo en Inglés, Español | MEDLINE | ID: mdl-38231589

RESUMEN

Maternal mental health problems during pregnancy, childbirth, and the postpartum period are a challenge for public health. Not recognizing them hinders a timely diagnosis and treatment and has an impact on the mother and the establishment of the fundamental bond of the mother-child dyad. We must recognize the risk factors (age, socioeconomic status, mental health history, family dysfunction, unfavorable environment), clinical manifestations, and screening tools. There is evidence that the effect of stress, anxiety, and depression during pregnancy negatively affect fetal neurodevelopment and condition child developmental outcomes. Here we describe the negative impact of postpartum depression during the first months of life, which affects mother-child bonding, postnatal development (emotional, behavioral, cognitive, language), and the maintenance of breastfeeding. We also recognize protective factors that mitigate its effects. It is essential to establish preventive strategies and interdisciplinary diagnostic and therapeutic approaches to minimize the risks to the mother and her children.


Los problemas de salud mental materna durante el embarazo, parto y puerperio son un desafío para la salud pública. Su falta de reconocimiento atenta contra el diagnóstico y tratamientos oportunos, e impacta en la madre y el establecimiento del vínculo fundamental del binomio. Debemos reconocer los factores de riesgo (edad, situación socioeconómica, antecedentes psicopatológicos, disfunción familiar, entorno desfavorable), las manifestaciones clínicas y las herramientas de detección. Existen evidencias de que el efecto del estrés, la ansiedad y la depresión durante el embarazo afectan negativamente el neurodesarrollo fetal y condicionan los resultados del desarrollo infantil. Describimos el impacto negativo de la depresión puerperal durante los primeros meses de vida, que afecta el vínculo madre-hija/o, el desarrollo posnatal (emocional, conductual, cognitivo, lenguaje) y el mantenimiento de la lactancia materna. También reconocemos factores protectores que atemperan sus efectos. Es fundamental establecer estrategias preventivas y abordajes diagnósticos y terapéuticos interdisciplinarios para minimizar los riesgos sobre la madre y sus hijas/os.

18.
Nurs Open ; 11(1): e2086, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38268291

RESUMEN

AIM: We explored midwives' experiences and challenges in providing maternity care during the period of the first surge of the COVID-19 pandemic in Dodoma. DESIGN: Phenomenological study design was used to explore midwives' experiences and challenges in providing maternity care during the COVID-19 pandemic in Tanzania. METHODS: We conducted interviews with a total of 23 midwives, using semi-structured interviews and an audio recorder. Five focus group discussions (FGDs) were conducted. To analyse the data, we used interpretive phenomenological thematic data analysis with NVivo software. To analyse templates, we followed a step-by-step process, starting with familiarizing ourselves with the data, followed by preliminary coding, organizing themes, developing an initial coding template, using the initial template, refining the template and finally applying it to the entire dataset. RESULTS: It was found that three themes and eight subthemes merged in the current study. The main themes were ① mental health distress, ② work environment challenges and ③ isolation of midwives by different groups. PUBLIC CONTRIBUTION: Reducing risk and protecting midwives from infectious diseases will improve the workforce, reduce the number of hospital stays, reduce the cost of hospital services, improve birth outcomes and indirectly improve family, community and national economies. CONCLUSION: Due to the system's failure to provide psychological support, protective environment and isolation rooms for confirmed or suspected cases put midwives at a higher risk of contracting the virus and had to work in a stressful environment. In addition to having the right tools, midwives must also receive emotional and psychological support in order to be at their best. The system must ensure that midwives are ready for uncertain times, such as pandemic infectious disease outbreaks, by providing protective work place environment such as personal protective equipment, psychological support and isolation room for confirmed COVID-19 cases.


Asunto(s)
COVID-19 , Servicios de Salud Materna , Partería , Femenino , Embarazo , Humanos , Pandemias , Tanzanía
19.
BMJ Open ; 14(1): e077585, 2024 01 22.
Artículo en Inglés | MEDLINE | ID: mdl-38253458

RESUMEN

OBJECTIVES: While issues in healthcare facilities during the COVID-19 pandemic have been widely discussed, little is known about health service issues from community (demand) sides. This study aimed to identify community needs in the utilisation of health services and highlight the key roles and barriers that community health workers (CHWs) face in delivering community-based services during the pandemic. DESIGN: Cross-sectional study. SETTING: 38 randomly selected villages covered by 21 preidentified community health centres in 3 districts in West Java, Indonesia. The survey was conducted from 22 January 2022 to 7 February 2022 (2 years after the pandemic began). PARTICIPANTS: 118 respondents, consisting of community leaders, vulnerable group representatives and CHWs. RESULTS: Laboratory examination (55.1%), emergency care (52.5%), non-communicable disease screening (50%) and routine treatment (49.2%) were perceived as the highest unmet needs of essential healthcare services. Fear of infection (90.3%) became one main barrier to access healthcare services. Vulnerable populations including lower socioeconomic groups (61.2%), households with elderly (25.4%), persons with disabilities (25.4%), pregnant women, people with mental illness and people with lower education (26.9%) were reported facing difficulties in accessing healthcare services. Further, the pandemic was deemed to have significantly impacted the community economic situation (91.5%). CHWs were actively engaged in community-based services and were mentioned as the first contact when the community needed help (57.6%). CHWs reported essential needs on financial support (45.2%), logistics (54.8%) and protective equipment (22.6%). CONCLUSIONS: Essential health services for the community, including those belonging to vulnerable groups, were highly impacted during the pandemic. CHWs appear to have significant roles in delivering health services during this health crisis, hence, adequate support is needed to equip them in strengthening pandemic response.


Asunto(s)
COVID-19 , Embarazo , Anciano , Humanos , Femenino , COVID-19/epidemiología , Indonesia/epidemiología , Estudios Transversales , Pandemias , Atención a la Salud
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