Dissertationen zum Thema „First-time expectant“

Dissertation (Ph.D.) -- The Institute for Clinical Social Work, 1992.
A dissertation submitted to the faculty of the Institute of Clinical Social Work in partial fulfillment for the degree of Doctor of Philosophy.

This research thesis was based upon an exploratory study that investigated the relationships between stress, psychological distress and social support in a sample of pregnant women and their partners. The study was particularly interested in the exploration of gender differences in reported stress and distress, and the provision of new information about fathers' experiences during pregnancy. Specific hypotheses were proposed which predicted gender differences in reported levels of stress, psychological distress and linear relationships between stress, psychological distress, and social support. Thirty-eight female and twenty-nine male participants expecting their first baby took part in the study during the third trimester of pregnancy The sample was recruited from Parentcraft Groups held at the Leicester General Hospital. Participants completed a booklet of self-report measures on one occasion. Independent T Tests were undertaken to identify any gender differences. Relationships between variables were examined using bivariate correlations. The relative power of variables as predictors of psychological distress was examined using regression analysis. Significant gender differences were found with females reporting higher levels of stress, psychological distress and depression than males. Significant positive relationships were found between stress and psychological distress. No significant relationships were found between social support and stress or social support and psychological distress. Significant negative relationships were found between satisfaction with partner relationships and psychological distress. No significant gender differences in social support were identified. Stress and satisfaction with the partner relationship were the strongest predictors of psychological distress, whilst stress and the quality of social support were the strongest predictors of depression. Clinical implications were proposed in light of the findings. Sample, measurement and design limitations of the study were identified. Directions for future research were presented. For the majority of expectant parents, pregnancy was a time of good psychological adjustment. However, for a minority of expectant mothers and fathers, clinically significant levels of stress, psychological distress and depression were present during pregnancy. It is important that future service provision considers the needs of expectant mothers and fathers during pregnancy in addition to the postpartum period.

Increasing number of pregnancy applications (apps) are complementing healthcare systems to educate expectants and improve their maternal well-being. Using similar kind of applications for people from multicultural background might have varied impact on their pregnancy experiences. Especially for immigrants, cultural beliefs first set in their home country, might conflict with practices followed in country of residence and information provided in digital resources. This study aimed to compare the perceptions on pregnancy app usage by first-time expectants living in Sweden from native and migrant perspectives. Data was collected using semi-structured interviews through an online platform, Zoom, and explored the users’ opinions on app’ usage. Twelve first-time expectants were recruited through snowball sampling technique using social media group. Data was then analyzed using thematic qualitative analysis. The findings indicate the importance of understanding healthcare practices and social support in country of residence. Participants expressed that they developed a connection with unborn through pregnancy apps. However, app usage raised conflicts between user expectations from knowledge gained by apps and information provided by healthcare system, also exposed potential problems faced by immigrants due to different approaches followed by Swedish healthcare system. Participants using English apps expressed that they are receiving updates according to American healthcare system, while participants using Swedish apps asserted that they are getting relevant information adapted to Swedish society. The study advocates that the apps are not well-suited for migratory background users and provided possible solutions to improve existing pregnancy apps for maximum number of users to benefit.

The purpose of this study was to develop a preventive intervention useful in helping first-time expectant fathers deal with the exigencies of pregnancy and prepare for parenthood, thereby diminishing the anxieties, stresses, and marital-family problems commonly associated with the birth of a first child. A pretest-posttest design with control was used to assess the effectiveness of the intervention. Tests were administered at the start and end of the intervention (four weeks apart for controls) and at six weeks post-partum. Subjects were a self-selected sample of 21 first-time expectant fathers, nine of whom participated in the intervention and 12 of whom functioned as no-treatment controls. It was hypothesized that, after participation in the intervention, first-time expectant fathers would: (1) exhibit less state anxiety; (2) have higher paternal self-esteem; (3) feel more positively about their infants; (4) exhibit greater expected role flexibility; and (5) predict a higher level of involvement with their newborns. It was also hypothesized that psychologically androgynous subjects, as indicated by the Bem Sex-Role Inventory, would show less change as a result of the intervention than less androgynous first-time expectant fathers. State anxiety was measured by Spielberger's State-Trait Anxiety Inventory (Form Y). Paternal self-esteem was measured by the Paternal Self-Report Inventory, a modification of Shea's Maternal Self-Report Inventory. Attitude toward forthcoming infants was measured by the Expectations of Newborns Inventory, a modification of Broussard's Neonatal Perception Inventory. Two new instruments were developed for this study: the Survey of Expected Role Flexibility and the Father's Behavior Inventory, which measures direct paternal involvement with the newborn. The data did not support any of the hypotheses. The small sample size,exploratory nature of some of the instruments, and selectivity of the sample are factors which contributed to the paucity of significant results. The results and problems inherent in this kind of research are discussed in a frank manner and implications for future research are noted.

碩士
國立臺南大學
諮商與輔導學系碩士班
102
The focus of this study was applying the concepts of Sandtray therapy, using the production of sandtrays and participation in group therapy to help women experiencing the second and third trimesters of their first pregnancy to sort through their experiences, and investigating the effects and experiences related to their participation in the therapy group. A total of eight first-time expectant mothers participated in the study, attending a total of 12 hours of group Sandtray therapy over two days. Each participant produced two sandtrays and was interviewed individually for 1-2 hours after the group. Qualitative research methods were adopted to collect data by semi-structured interviews during and after the group process, and to analyze the data with thematic analysis. Three main themes were identified to represent the pregnancy experiences of women pregnant for the first time: 1. Constructing the images of ideal family function: participants presented images of family spaces with several themes, such as “safe,” “connecting,” “productive,” “casual,” and “learning” spaces. Themes found in their family value images included “giving birth,” “protection,” “stability,” “nurturing,” “company,” “heritage,” and “belonging.” Family future images included themes such as “energy transfer,” “independence,” and “freedom to explore.” 2. Constructing the images of ideal family roles: participants expected that the “ideal husband” should be a “supporter,” “companion,” and “eternal lover;” the “ideal father” should be a “leader” and “companion;” the “ideal mother” should be a “creator,” “protector,” “supplier,” “influencer,” “wise learner,” “bearer of responsibility,” “figure of trust” and “boundary setter;” “ideal children” should be “willing to learn” with “perfect character;” and “ideal relatives” should be “easygoing” and “helpers.” 3. Reconstructing new self images: themes include “awareness of body images” such as “mother-child connection” and “mother-child as whole;” “awareness of polarized emotions” including “surprise and happiness,” “peace and sweetness,” “confidence and power,” “tolerance and acceptance,” “anxiety,” “depression,” “worry and avoidance,” “fear and pressure,” “loneliness and helplessness,” “sensitivity and vulnerability,” “sacrifice and devotion,” and “expectation and preservation.” Themes of “self responsibility”, “self adjustment” and “self realization” expressed the “self achievement and transcendence” of participants who had experienced the pregnancy process . Three main themes which present the experience and effects of participation in the sandtray group of first-time expectant mothers were identified: 1. Sandtray creating experiences: participants experienced choosing miniatures based on “preference,” “status of pregnancy” and “intuition;” and constructing the sandtray pictures based on “personal pregnancy stories,” “pregnancy mood images” and “instinctual images in the moment.” They experienced a variety of emotions, such as “new, special, excited, interested, fun, fantastic, ideal and unreal.” They felt that making sandtrays helped to “record and combine the pregnancy process” and “connect the experiences of the past and the future.” 2. Experiences of sharing sandtray pictures: the sharing of self sandtray pictures helped participants to “recall memories of pregnancy, face the pregnancy, and promote self understanding and self awareness.” To share others’ sandtray pictures helped to “recall aspects of life important to oneself, inspire different ways of thinking, and reflect on personal experiences.” 3. Experiences of group interactive feedback: the group helped participants to “connect with each other via group support and encouragement” and “aided in acceptance of pregnancy via group universality.” The group promoted “being together” and helped to “provide pregnancy information, enrich the vision of pregnancy, express the concerns of pregnancy, and relieve pressure.” Finally, the study engages in discussion based on the results and provides concrete suggestions and advice for women experiencing their first pregnancy, professional helpers and government organizations to practice family planning and perform future research.

碩士
國立台北護理學院
護理研究所
92
ABSTRACT The purpose of this study was to explore the life experience of first-time expectant father when his spouse took bed-rest in the hospital. This study was conducted by the descriptive phenomenological method. Data were collected through one-on-one interviews with six expectant fathers. All data were documented in the form of recording and were dictated. The data were classified and categorized, based on adjusted Colaizzi’s content analysis. The result showed that the life experience of first-time expectant father when his wife took bed-rest in the hospital could be summarized as the following five themes: Being confused and lost, facing the difficulty and attempting to find out the solutions, doing his best to take care of the spouse, expecting to be a father, and casting a look behind with complicated feelings The findings of this study could provide the nursing staff in charge of family-centered maternity care with information about how tocolysis influenced the family of a first-born baby. It could contribute to the improvement of the nursing quality as well.

碩士
國立臺北護理健康大學
護理助產及婦女健康系護理助產研究所
107
Design: A qualitative study based on in-depth individual interviews and analysed with the Colaizzi method (1978). Setting: the study was conducted at a medical center in Central Taiwan with 1292 deliveries in 2016. Participants: Twelve term-pregnant primigravidas aged between 20-43 years old who sought help at the labor room during the latent phase of labor and were refused admission. Findings: Primigravidas in the latent phase of labor who were rejected admission to the labor room had the following experience: (1) the sense of uncertainty; (2) the sense of mis-matchedness; (3) Insecurities of leaving the safe area (labor room); (4) Strategies to avoid admission refusal; (5) Facing the helplessness due to families’ pressure; (6) The feeling of powerlessness. Conclusion: primigravias admitted to the labor room in the latent phase of labor experienced major changes in physical, mental, social and interpersonal aspects. As pregnant women in Taiwan, they not only experience physical discomfort during the latent phase of labor, but also have pressure from their families’ expectations. Thus, they need midwives and nursing staff to provide correct information, professional support, and confirmation of the normality of the labor progress. Key words: Admission, Primiparity, Latent phase.

碩士
國立臺北護理健康大學
護理助產研究所
105
The purpose of this study was to evaluate the effects of expectant fathers’ accompanying birth education program in childbirth on stress, accompanying efficacy, couples intimate bond, parents-infant attachment and women’s childbirth self-efficacy. The experimental study design was used. A total of 88 expectant parents who were at 34 weeks gestation, and who met the study criteria, were allocated by randomization to experimental (n = 46) and control (n = 42) groups. The subjects were recruited from a northern regional hospital. For the experimental group, the birth education program was implemented. Members of the control group were given a slip of paper entitled “Small tips for the expectant fathers who accompany their partners in labor and delivery.” The expectant couples completed their basic personal information, Perceived Stress Scale, Intimate Bond Measure, expectant fathers’ completed Expectant Father Accompany Efficacy Scale; women completed Childbirth Self-efficacy Questionnaire when they were recruited. In two days after delivery, all the couples completed Perceived Stress Scale, Intimate Bond Measure, expectant fathers completed Expectant Father Accompany Efficacy Scale and Paternal Attachment Inventory, and women completed Childbirth Self-efficacy Questionnaire. Four-six week postpartum, all the couples completed Intimate Bond Measure; expectant fathers completed Paternal Attachment Inventory. The duration of data collection was from January 2016 to June 2016. The results of this study showed expectant fathers’ accompanying birth education program in childbirth on stress, fathers of the two groups in the prenatal period (14.26 vs. 14.40, p > .05) and on second day postpartum (14.28 vs. 14.88, p > .05) had not significantly; mothers in the prenatal period (17.63 vs. 15.90, p > .05) had not significantly, and on second day postpartum (15.02 vs. 15.95, p < .05) had significantly. Expectant fathers in accompany efficacy, in the prenatal period (74.04 vs. 71.74, p > .05) had not significantly, and on second day postpartum (58.85 vs. 63.07, p < .05) had significantly. Couples Intimate Bond: care-intimate bond that fathers had no significantly in the prenatal period (25.87 vs. 26.43, p > .05) and four-six week postpartum (26.26 vs. 26.24, p > .05), had significantly on second day postpartum (27.83 vs. 26.50, p < .05); control-Intimate bond that fathers had no significantly in the prenatal period (13.96 vs. 14.86, p > .05) and on second day postpartum (13.35 vs. 15.00, p > .05) and four-six week postpartum (13.78 vs. 14.48, p > .05). Care-Intimate Bond that mothers had no significantly in the prenatal period (26.54 vs. 26.64, p > .05) and four-six week postpartum (26.20 vs. 26.10, p > .05), had significantly on second day postpartum (29.33 vs. 27.36, p < .05); Control-Intimate Bond that fathers had no significantly in the prenatal period (9.80 vs. 9.33, p > .05) and on second day postpartum (8.70 vs. 8.95, p > .05) and four-six week postpartum (9.70 vs. 9.48, p > .05). In the women’s childbirth self-efficacy, outcome expectations of self-efficacy, had no significantly in the prenatal period (118.37 vs. 112.95, p > .05), had significantly on second day postpartum (124.07 vs. 106.81, p < .05); efficacy expectations of self-efficacy, had no significantly in the prenatal period (98.43 vs. 97.93, p > .05), had significantly on second day postpartum (117.59 vs. 105.07, p < .05). In the father-infant attachment, there was no significantly on second day postpartum (65.11 vs. 64.14, p >.05) and four-six week postpartum (67.28 vs. 64.45, p >.05). In conclusion, expectant fathers’ accompanying birth education program was able to effectively relieve mother’s childbirth stress, to enhance fathers’ accompany efficacy and mother’s childbirth self-efficacy, to enhance couples care-intimate bond. In general, the result of this study could offer healthcare providers some references to future expectant fathers’ accompanying birth education program, as well as both physical and psychological support for expectant fathers and mothers. It could help them adopt a positive attitude toward the challenge of labor, and gain a more enjoyable childbirth experience.