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Lau, Ying. "Intimate partner abuse in Chinese pregnant women." Click to view the E-thesis via HKUTO, 2003. http://sunzi.lib.hku.hk/hkuto/record/B31972846.
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Sricamsuk, Amornrat, and n/a. "Domestic Violence Against Pregnant Women: A Thai Perspective." Griffith University. School of Nursing and Midwifery, 2006. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20070116.154749.
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Little is known about domestic violence experienced by Thai pregnant women. This exploratory descriptive study aimed to investigate the prevalence of domestic violence during pregnancy and immediate postpartum period among Thai women aged between 18 and 45 years. The study also aimed to investigate maternal and neonatal outcomes for childbearing women, the ways in which they dealt with domestic violence, barriers that inhibited them from seeking help or resisting violence, as well as the needs and support that would be helpful in dealing with domestic violence. A cohort of 421 women in their third trimester of pregnancy was recruited from two tertiary public hospital antenatal clinics located in Khon Kaen Province, Northeastern Thailand. Structured questionnaires were used. Participants were again contacted at six weeks postpartum either in person at the family planning clinics or by telephone. Two hundred and seventy-four women were able to be contacted. The results showed that 53.7% of women reported psychological abuse, 26.6% experienced threats of and/or acts of physical abuse, and 19.2% experienced sexual violence during the current pregnancy. In the postpartum period, 35.4% of women reported psychological abuse, 9.5% reported threats of and/or acts of physical abuse, and 11.3% experienced sexual abuse. Women who were abused during pregnancy showed significantly poorer health status compared to non-abused women in role emotional functioning, vitality, bodily pain, mental health and social functioning. Women who experienced postpartum abuse reported significantly lower mean scores in mental health and social functioning than women who did not. Antepartum haemorrhage was also found to be statistically associated with physical abuse. No statistical differences were found between abuse status and neonatal outcomes. There were several strategies used by abused women in dealing with domestic violence to maximize their safety including crying, keeping quiet, leaving violent situations and temporarily staying with relatives, seeking help from others, and notifying local authorities. Support services that would be helpful for abused women in dealing with the problem included emotional support, social legal assistance, and community health promotion. Domestic violence during pregnancy and after birth is an increasing but under-recognized problem in Thailand. It has pervasive consequences on maternal health. The findings from this study suggest more interventions and urgent domestic violence support services need to be established in this remote area of Thailand. This study also suggests routine screening for domestic violence should be established to provide effective early intervention and prevention of adverse consequences of violence, as pregnancy is a time when most pregnant women seek health care.
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Sricamsuk, Amornrat. "Domestic Violence Against Pregnant Women: A Thai Perspective." Thesis, Griffith University, 2006. http://hdl.handle.net/10072/365872.
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Little is known about domestic violence experienced by Thai pregnant women. This exploratory descriptive study aimed to investigate the prevalence of domestic violence during pregnancy and immediate postpartum period among Thai women aged between 18 and 45 years. The study also aimed to investigate maternal and neonatal outcomes for childbearing women, the ways in which they dealt with domestic violence, barriers that inhibited them from seeking help or resisting violence, as well as the needs and support that would be helpful in dealing with domestic violence. A cohort of 421 women in their third trimester of pregnancy was recruited from two tertiary public hospital antenatal clinics located in Khon Kaen Province, Northeastern Thailand. Structured questionnaires were used. Participants were again contacted at six weeks postpartum either in person at the family planning clinics or by telephone. Two hundred and seventy-four women were able to be contacted. The results showed that 53.7% of women reported psychological abuse, 26.6% experienced threats of and/or acts of physical abuse, and 19.2% experienced sexual violence during the current pregnancy. In the postpartum period, 35.4% of women reported psychological abuse, 9.5% reported threats of and/or acts of physical abuse, and 11.3% experienced sexual abuse. Women who were abused during pregnancy showed significantly poorer health status compared to non-abused women in role emotional functioning, vitality, bodily pain, mental health and social functioning. Women who experienced postpartum abuse reported significantly lower mean scores in mental health and social functioning than women who did not. Antepartum haemorrhage was also found to be statistically associated with physical abuse. No statistical differences were found between abuse status and neonatal outcomes. There were several strategies used by abused women in dealing with domestic violence to maximize their safety including crying, keeping quiet, leaving violent situations and temporarily staying with relatives, seeking help from others, and notifying local authorities. Support services that would be helpful for abused women in dealing with the problem included emotional support, social legal assistance, and community health promotion. Domestic violence during pregnancy and after birth is an increasing but under-recognized problem in Thailand. It has pervasive consequences on maternal health. The findings from this study suggest more interventions and urgent domestic violence support services need to be established in this remote area of Thailand. This study also suggests routine screening for domestic violence should be established to provide effective early intervention and prevention of adverse consequences of violence, as pregnancy is a time when most pregnant women seek health care.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing and Midwifery
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Lau, Ying, and 劉櫻. "Intimate partner abuse in Chinese pregnant women." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2003. http://hub.hku.hk/bib/B31972846.
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Martin, Debbie F., and University of Lethbridge Faculty of Health Sciences. "An apple a day won't keep the violence away : listening to what pregnant women living in intimate partner violence say about their health." Thesis, Lethbridge, Alta. : University of Lethbridge, School of Health Sciences, c2009, 2009. http://hdl.handle.net/10133/2514.
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Researchers have provided evidence that living in intimate partner violence while pregnant negatively impacts the health of both the women and their unborn children. The purpose of this narrative study was twofold, first to gain understanding of the meaning of health as described by pregnant women who lived in intimate partner violence, and second to gain strategies for health care professionals. Six purposefully selected women participated in two interviews. The data were arranged under five themes: loss of body health, loss of mind health, loss of spirit health, coping with loss of body, mind and spirit health, and advice for health care professionals. The results revealed that these women’s health was negatively affected by living in intimate partner violence while pregnant. Universal screening, coalition building, further research, changes in health care policies, and changes in nursing education and practice are needed to properly address this serious health issue.xi, 153 leaves ; 29 cm
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Fleischack, Anne. "Counsellors’ talk about their understanding of, and practices in response to, intimate partner violence during pregnancy: a narrative-discursive analytic study." Thesis, Rhodes University, 2015. http://hdl.handle.net/10962/d1016391.
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South Africa is a very violent society, where violence is often used as a social resource to maintain control and establish authority. Global and local research suggests that there is a high prevalence of intimate partner violence (IPV), a facet of this violence, although little research has been conducted into the effects of IPV during pregnancy in the South African non-governmental organisation (NGO) context. NGOs globally and in South Africa have attempted to address IPV and IPV during pregnancy by providing services that aim to assist (largely female) clients emotionally and logistically. In light of this phenomenon, this qualitative study presents data generated through the use of a lightly-structured narrative interview schedule. The interviews were conducted over three sessions with eight counsellors, all based at two NGOs in South Africa and experienced in counselling women who have suffered IPV and IPV during pregnancy. This study used Taylor and Littleton’s (2006) narrative-discursive analytical lens, infused with theoretical insights from Foucault about power, discourse and narrative in order to identify the discursive resources that shape the narratives that the counsellors shared in the interviews and how these translate into subject positions and (gendered) power relations of the men and women about whom they speak. Six discursive resources emerged from the narratives, namely a discourse of ‘traditional “African” culture’, ‘patriarchal masculinity’, ‘nurturing femininity’, ‘female victimhood’, ‘female survivorhood’ and ‘human rights’. These informed the three main narratives that emerged: narratives about IPV in general, IPV during pregnancy, and the counsellors’ narratives about their intervention strategies. Within these narratives (and the micro-narratives which comprised them), men were largely positioned as subscribing to violent patriarchal behaviour whilst women were mostly positioned as nurturing and victims of this violence. The counsellors also constructed women as largely ignorant of their options about IPV and IPV during pregnancy; they constructed these phenomena as problems that require intervention and identified a number of factors that indicate what successful IPV interventions should entail. In reflecting upon this analysis, this study also aimed to address the questions of what is achieved or gained by using these narratives and discursive resources, what the significance or consequences are of constructing and using these particular narratives and discourses and whether different narratives or discourses would have been possible. Recommendations for further research includes incorporating more sites as well as interviewing perpetrators and IPV survivors themselves, perhaps in their home language where relevant rather than English, to gain a broader and more faceted understanding of the dynamics surrounding IPV during pregnancy. A recommendation for practice in intervention against IPV during pregnancy is to introduce more holistic/systemic intervention strategies and working with communities to address this issue.
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Roussy, Joanne Marie. "How poverty shapes women's experiences of health during pregnancy, a grounded theory study." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0028/NQ38967.pdf.
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Cyphers, Natalie, Andrea D. Clements, and Jody L. Ralph. "The Relationship between Religiosity and Health-Promoting Behaviors in Pregnant Women at Pregnancy Resource Centers." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/7245.
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Pickett, Elizabeth Anne. "Program effectiveness among recovering susbance abuse mothers in a treatment program." CSUSB ScholarWorks, 2008. https://scholarworks.lib.csusb.edu/etd-project/3344.
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The purpose of this study is to see if all the special circumstances, extra classes, and parenting aspects of a treatment program are effective for pregnant substance abusing women. This study also explored the factors that contributed to the perceived satisfaction and effectiveness of the clients enrolled in a drug and alcohol treatment program.
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Christie, Sarah Louise. "Investigating the psychosocial implications of pregnancy and the early postnatal period for women who are in treatment for heroin addiction : building a theory of aspirations and psychological evolution." Thesis, Staffordshire University, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.693853.
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Taylor, Shauna Rae. "Pregnancy-associated intimate partner violence an examination of multiple dimensions of intimate partner abuse victimization using three unique data sources /." Orlando, Fla. : University of Central Florida, 2009. http://purl.fcla.edu/fcla/etd/CFE0002560.
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Vythilingum, B., A. Roos, S. C. Faure, L. Geerts, and D. J. Stein. "Risk factors for substance use in pregnant women in South Africa." HPMG, 2012. http://hdl.handle.net/10019.1/82324.
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Vythilingum, B. et.al. 2012. Risk factors for substance use in pregnant women in South Africa. South African medical journal, 102(11):851-854ENGLISH ABSTRACT: Objectives. To study the prevalence of alcohol and substance use in a South African antenatal population and its correlates with sociodemographic factors, depression and perceived stress. Methods. A prospective self-report study on all women presenting for their first antenatal visit who consented to the study at a midwife obstetric unit (MOU) in the East Metropole district, Cape Town, using the Alcohol Use Disorders Identification Test (AUDIT), Drug Use Disorders Identification Test (DUDIT), Edinburgh Depression Scale (EDS) and Perceived Stress Scale (PSS). Statistical analyses using the chi-square test, separate one-way analyses of variance (ANOVA) and logistic regression analyses were performed as appropriate. Outcome measures were depression, alcohol use and substance use. Results. The questionnaire was completed by 323 women. During pregnancy 36.8% of women smoked, 20.2% used alcohol and 4% used substances. Using EDS cut-off scores of 12 and 15, respectively, 48.9% and 33.6% of the sample had scores consistent with major depression. An EDS cut-off score of 12 was significantly associated with both alcohol use (25.9% v. 15.2%, p=0.019) and risky drinking (76.9% v. 36.8%, p=0.04), while an EDS cut-off score of 15 was significantly associated with substance use (8.2% v. 1.4%, p=0.004) as well as alcohol dependence (23.1% v. 3.1%). Conclusions. We found high rates of both alcohol abuse and antenatal depression, and a significant association between depression, substance use and alcohol abuse; EDS scores greater than 12 could be used to identify women at risk of alcohol dependence and/or substance abuse.
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Montgomery, Robert A., Tifani R. Fletcher, Andrea D. Clements, and Beth A. Bailey. "Religious Commitment Predicts Substance Use in Pregnant Women." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/7261.
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Introduction: Substance use, including cigarette smoking, while pregnant can lead to a plethora of health concerns for both the mother and unborn child including premature birth, low birth weight, and stillbirth. Compared with women nationally, pregnant women in Tennessee are more than three times as likely to smoke during pregnancy. Preliminary findings suggest high levels of religious commitment may be reliable predictors of negative health behaviors. However, the association between religious commitment and substance use has not been thoroughly investigated in pregnant populations. Using a brief measure of religious commitment, it was hypothesized that pregnant women with higher levels of religious commitment would be significantly less likely to engage in cigarette smoking and other substance use. Methods: Participants included 654 pregnant women involved in the Tennessee Intervention for Pregnant Smokers program who completed multiple interviews during pregnancy. Of interest in the current investigation, participants’ religious commitment was measured using two items from the 12-item Surrender Scale, and a 1-item church attendance measure from the Brief Multidimensional Measure of Religiousness/Spirituality. Participants also completed a background information form assessing demographic characteristics, smoking habits, and drug use, with final substance use variables composites of both self-report and urine drug screen results. Results: Direct logistic regression was performed to assess associations between religious commitment and both smoking status (at conception and delivery) and other substance use. All models included level of education, age, marital status, and insurance status. The full direct model predicting smoking status at conception was statistically significant, χ2 (5, n = 654) = 178.76, p < .001, indicating the model could distinguish between participants who did and did not report smoking early in pregnancy. The model as a whole explained between 24% and 32% of the variance in smoking status, and correctly classified 71% of cases. All variables made statistically significant and unique contributions to the model, including religious commitment (OR=.857). A similar pattern was found in the model predicting smoking status at delivery χ2 = 157.01, p < .001. A third regression, using the same predictors, examining the impact of religious commitment on any illicit drug use prior to or during pregnancy, was also statistically significant, χ2 = 58.46, p < .001. Conclusions and Implications: In this sample, religious commitment predicted smoking status and other drug use during and prior to pregnancy. Inquiry into religious commitment as an additional gauge of health behaviors may be beneficial to healthcare professionals. Future research should investigate the possible mechanism of how religious commitment influences health behaviors in pregnancy.
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Potter, Susan M. "Effects of fetal cocaine and tobacco exposure on newborn information processing." Thesis, McGill University, 1996. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=42119.
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Approximately 10% of women use cocaine and 20% smoke cigarettes during pregnancy. Animal studies indicate that both cocaine and nicotine are neuroteratogenic agents, although findings with humans are inconsistent. Studies with human infants have been plagued by unreliable subject identification procedures, poor control over confounding factors, and invalid measures of CNS integrity. The literature on prenatal cocaine and nicotine use is reviewed and two studies are presented along with an intriguing case report. The effects of maternal prenatal cocaine use (Study 1) and two levels of cigarette smoking (Study 2) on newborn information processing ability were examined using an auditory habituation-recovery paradigm. Case-control designs were employed in which subjects were individually matched on a number of maternal and infant factors. Cocaine exposure was determined by newborn meconium analysis, urine analysis, and maternal self-report. Maternal smoking was determined by self-report and a variation of the bogus pipeline method. Fetal cocaine- and nicotine-exposure were associated with differential impairments in neonatal information processing. Cocaine-exposed newborns exhibited deficits on measures of habituation and recovery to novelty. Dose-response effects of nicotine-exposure were evident on measures of orientation and habituation, but recovery to novelty was not consistently affected. The results imply that fetal cocaine-exposure severely impairs neonatal auditory information processing ability, whereas fetal tobacco-exposure is associated with deficits in information-processing which may be secondary to impairments in arousal regulation. These auditory processing deficits may be related to the later language impairments reported in follow-up studies with cocaine-and tobacco-exposed infants. Following the two studies, a case is presented of an infant born to a woman who reported using large amounts of cocaine throughout pregnancy, although the infant's meco
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Pritham, Ursula A. "Pharmacologic Treatment of Opiod Dependency in Pregnancy: Methadone Versus Buprenorphine and Subsequent Neonatal Abstinence Syndrome." Fogler Library, University of Maine, 2009. http://www.library.umaine.edu/theses/pdf/PrithamUA2009.pdf.
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Jones-Castillo, Jennifer Lynn. "Characteristics and service needs of the pregnant substance abusing population." CSUSB ScholarWorks, 1994. https://scholarworks.lib.csusb.edu/etd-project/930.
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Levey, Elizabeth J., Marta B. Rondón, Sixto Sanchez, Qiu-Yue Zhong, Michelle A. Williams, and Bizu Gelaye. "Suicide risk assessment: examining transitions in suicidal behaviors among pregnant women in Perú." Springer-Verlag Wien, 2018. http://hdl.handle.net/10757/624721.
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El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.The goals of this research were to characterize suicidal behavior among a cohort of pregnant Peruvian women and identify risk factors for transitions between behaviors. The World Health Organization Composite International Diagnostic Interview suicide questionnaire was employed to assess suicidal behavior. Discrete-time survival analysis was used to study the cumulative age-of-onset distribution. The hazard function was calculated to assess the risk of onset of each suicidal behavior. Among 2062 participants, suicidal behaviors were endorsed by 22.6% of participants; 22.4% reported a lifetime history of suicidal ideation, 7.2% reported a history of planning, and 6.0% reported attempting suicide. Childhood abuse was most strongly associated with suicidal behavior, accounting for a 2.57-fold increased odds of suicidal ideation, nearly 3-fold increased odds of suicide planning, and 2.43-fold increased odds of suicide attempt. This study identified the highest prevalence of suicidal behavior in a population of pregnant women outside the USA. Diverse populations of pregnant women and their patterns of suicidal behavior transition must be further studied. The association between trauma and suicidal behavior indicates the importance of trauma-informed care for pregnant women.
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Fletcher, Tifani A., Andrea D. Clements, Lana McGrady, and Beth A. Bailey. "Intimate Partner Violence Screening Tools: Validation for Rural Pregnant Women." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/7259.
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This attempt to validate the brief AAS and WAST against the gold-standard CTS2 resulted in sensitivities of 34.8% (AAS) and 45.5% (WAST) for physical IPV; however both identified a much smaller number of cases of sexual violence than the CTS2 in a rural pregnant population.
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Sanchez, Sixto E., Omar Pineda, Diana Z. Chaves, Qiu-Yue Zhong, Bizu Gelaye, Gregory E. Simon, Marta B. Rondón, and Michelle A. Williams. "Childhood physical and sexual abuse experiences associated with post-traumatic stress disorder among pregnant women." Elsevier B.V, 2017. http://hdl.handle.net/10757/622334.
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El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.Purpose We sought to evaluate the extent to which childhood physical and/or sexual abuse history is associated with post-traumatic stress disorder (PTSD) during early pregnancy and to explore the extent to which the childhood abuse-PTSD association is mediated through, or modified by, adult experiences of intimate partner violence (IPV). Methods In-person interviews collected information regarding history of childhood abuse and IPV from 2,928 women aged 18-49 years old prior to 16 weeks of gestation. PTSD was assessed using the PTSD Checklist-Civilian Version. Multivariate logistic regressions were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results Compared to women with no childhood abuse, the odds of PTSD were increased 4.31-fold for those who reported physical abuse only (95% CI, 2.18–8.49), 5.33-fold for sexual abuse only (95% CI, 2.38–11.98), and 8.03-fold for those who reported physical and sexual abuse (95% CI, 4.10–15.74). Mediation analysis showed 13% of the childhood abuse-PTSD association was mediated by IPV. Furthermore, high odds of PTSD were noted among women with histories of childhood abuse and IPV compared with women who were not exposed to either (OR = 20.20; 95% CI, 8.18–49.85). Conclusions Childhood abuse is associated with increased odds of PTSD during early pregnancy. The odds of PTSD were particularly elevated among women with a history of childhood abuse and IPV. Efforts should be made to prevent childhood abuse and mitigate its effects on women's mental health.
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Cyphers, Natalie A., Andrea D. Clements, and Glenda Lindseth. "The Relationship Between Religiosity and Health-Promoting Behaviors in Pregnant Women." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/7202.
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Pender’s health promotion model guided this descriptive/correlational study exploring the relationship between religiosity and health-promoting behaviors of pregnant women at Pregnancy Resource Centers (PRCs). A consecutive sample included women who knew they were pregnant at least 2 months, could read/write English, and visited PRCs in eastern Pennsylvania. Participants completed self-report surveys that examined religiosity, demographics, pregnancy-related variables, services received at PRCs, and health-promoting behaviors. Women reported they “sometimes” or “often” engaged in health-promoting behaviors, Hispanic women reported fewer health-promoting behaviors than non-Hispanic women, and women who attended classes at the centers reported more frequent health-promoting behaviors than those who did not attend classes. In separate multiple linear regressions, organized, non-organized, and intrinsic religiosity and satisfaction with surrender to God explained additional variance in health-promoting behaviors above and beyond what Hispanic ethnicity and attending classes at the PRCs explained in pregnant women at PRCs.
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Katirai, Whitney Jeanne. "FACTORS ASSOCIATED WITH TOBACCO USE AMONG RURAL AND URBAN PREGNANT WOMEN." UKnowledge, 2011. http://uknowledge.uky.edu/gradschool_diss/811.
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The purpose of this study was to investigate the influences of smoking on rural and urban pregnant women. More specifically, the variables of the knowledge of health effects, health provider recommendations, subscores from the Health Belief Model (HBM), and social support were explored in relation to the smoking behavior of pregnant women. A secondary purpose was to investigate the accuracy of self-reported smoking during pregnancy using biochemical validation. Pregnant women (N=71) completed an anonymous questionnaire, designed by the researcher, to identify variables that predicted smoking for urban and rural women. Participants also gave a saliva sample for cotinine testing.
Approximately 47% of rural participants and 49% of urban participants were classified as smokers. The overall smoking deception rate for the current study was 5.6%. The deception rate for rural and urban participants in this study was 2.8% and 8.6%, respectively. Variables were entered into a standard multiple regression analysis to predict smoking status of the pregnant women. Participants reporting barriers (a component of the HBM) to stopping smoking during pregnancy were significantly less likely to be smokers.
Through t-test and chi-square analyses, other variables related to smoking status during pregnancy included: Marital status, financial source for the pregnancy, living with husband or boyfriend, mean scores of the participants‘ knowledge of the health effects of smoking during pregnancy, susceptibility and benefits (constructs of the HBM). Many healthcare providers performed 1A, 2A, and 3A; however, few completed the last step of 4A and none completed 5A.
Implications for health promotion specialists include an increase in the education of pregnant women about the health risks of maternal smoking. Additional training for pre-natal healthcare providers is necessary in order to increase the number of healthcare providers that implement all of the 5A‘s. It is important to include the husband/boyfriend in any smoking cessation interventions since they have daily influence on the smoking status of the pregnant woman. Money used to conduct biochemical verification of maternal smoking status could be better spent on patient education of the health risks of smoking during pregnancy and physician education in implementing all 5A‘s in daily practice.
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Smith, Courtney E. "Influence of Parental Substance Abuse on Substance Use and Psychiatric Severity in Drug-Dependent Pregnant Women." VCU Scholars Compass, 2009. http://hdl.handle.net/10156/2393.
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Fletcher, Tifani R., Andrea D. Clements, and Beth A. Bailey. "Intimate Partner Violence Screening Tools: Are They Valid for Rural Pregnant Women?" Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/7262.
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Introduction: More than 324,000 women per year are identified as having experienced intimate partner violence (IPV) during pregnancy. Correctly identifying women experiencing all forms of IPV is necessary to inform the development and implementation of interventions to prevent and address IPV. The Abuse Assessment Screen (AAS) and Women Abuse Screening Tool (WAST) were designed to quickly identify violence against women, but clinical practice and research are hindered by the lack of validity date for these and other similar screening tools. The purpose of the current study was to compare and validate the brief AAS and WAST against the longer well-validated Revised Conflict Tactics Scale (CTS2) in a rural pregnant population. Methods: Participants in the Tennessee Intervention for Pregnant Smokers (TIPS) program (N=540) completed several questionnaires during a prenatal visit,including the AAS, WAST, and CTS2. The AAS questions: “within the last year have you been hit slapped or physically hurt by someone?” was used for physical violence comparison with the corresponding CTS2 subscale, and “within the last year has anyone forced you to have sexual activities” was used for sexual violence comparison with the corresponding CTS2 subscale. The WAST was compared to the CTS2 subscales using the two questions “has your partner ever abused you physically” and “has your partner ever abused you sexually?” In addition, a third comparison was made between the CTS2 psychological abuse subscale and the WAST question, “Has your partner ever abused you emotionally?” There are no questions on the AAS that specifically addresses psychological abuse to use for comparison to the WAST and CTS2. Results: Prevalence of any form of IPV, as indicated by answering “yes” to any of the IPV assessment questions, was 45% for the AAS, 74% for the WAST, and 80% for the CTS2. According to the CTS2 subscales, the prevalence of physical, sexual, and psychological violence within the last year was 21%, 19%, and 76% respectively. Taking the CTS2 results as standard, sensitivity on the AAS for physical violence was 35%, and for sexual violence was 2%. Sensitivity on the WAST for physical violence was 46%, for sexual violence was 1%, and for psychological violence was 29%. Conclusions and Implications: The WAST performed better at identifying cases of physical violence than the AAS, while the two screening tools performed similarly in identifying cases of sexual violence. However, neither IPV screen identified a large number of sexual violence victims. Because the WAST includes questions regarding psychological abuse in addition to physical and sexual abuse, the WAST captured more cases of any form of IPV compared to the AAS. These results suggest that the WAST should be used with caution as a stand-alone assessment of IPV, and that the AAS should not be used as a stand-alone assessment for physical or sexual violence in this pregnant population.
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Clements, Andrea D., Tifani R. Fletcher, Lawrence D. Childress, Robert A. Montgomery, and Beth A. Bailey. "Social Support, Religious Commitment, and Depression Among Pregnant and Postpartum Women." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/7203.
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Objective: Social support and religious commitment were examined in relation to antenatal and postpartum depressive symptoms in a prospective, longitudinal study to determine whether religious commitment explained variance in depression scores beyond that accounted for by social support. Background: Social support and religiosity are positively related to good mental/physical health, and depression is related to poor health outcomes in pregnancy and postpartum. It was hypothesised that social support and religious commitment would be inversely related to depressive symptoms, and that religious commitment would predict variance in depression scores over and above social support. Methods: In 106 mostly low SES Appalachian pregnant women, social support and religious commitment were measured during the first trimester. First and third trimester (Center for Epidemiological Studies Depression Scale – 10 item version), and 6 weeks and 6 months postpartum (Edinburgh Postnatal Depression Scale) depression symptoms were measured. Hierarchical regression examined relative contributions of social support (Prenatal Psychosocial Profile) and religious commitment (Religious Surrender and Attendance Scale – 3 Item Version) to depressive symptoms at each time point while controlling for education and marital status. Results: Regression results indicated that social support and religious commitment explained 10–18% and 0–3% of the variability in depression scores, respectively. Conclusion: Both social support (all time points) and religious commitment (only at 6 months postpartum) were inversely related to depression. Pregnant women low in social support and postpartum women low in social support or religious commitment may be at increased risk for depression.
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Fletcher, Tifani, Andrea D. Clements, and Beth A. Bailey. "Intimate Partner Violence During Pregnancy in Appalachian Women." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/7246.
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Caudillo, Rachel Clare. "An evaluation of the impact of maternal substance abuse on infant and child attachment." CSUSB ScholarWorks, 2006. https://scholarworks.lib.csusb.edu/etd-project/2961.
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This study examined the impact and extent to which drugs and alcohol, consumed by mothers prenatally and perinatally, has affected their capacity to attach to their children. It examined the role the dependent variables measured (i.e. drug(s)/substance(s) abused, demographic information) played in the attachment process. Data was collected from mothers currently participating in the perinatal substance abuse treatment at the San Bernardino County Rialto program.
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Fletcher, Tifani A., Andrea D. Clements, and Matthew McBee. "Prevalence, Types, Risk Factors, and Course of Intimate Partner Violence in Appalachian Pregnant Women." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/7254.
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Intimate partner violence (IPV) during pregnancy can lead to myriad poor physical and psychological outcomes for both mother and child. There is a paucity of research examining IPV risk factors for rural pregnant women and the course of specific types of IPV throughout pregnancy. The current project investigated the prevalence of IPV and the risk factors for different types of IPV in an Appalachian sample that contained pregnant women from rural and non-rural locations (Study 1). Additionally, for women reporting IPV, the different types of IPV were examined throughout the course of their pregnancies (Study 2). Study 1 included 1063 pregnant womenparticipating in the Tennessee Intervention for Pregnant Smokers (TIPS) program. IPV prevalence was measured using a modified Hurt Insult Threaten Scream (HITS) screen administered at entry into prenatal care, and rural status was defined using Rural Urban Commuting Area Codes based on the participants’ ZIP codes. Self-report prevalence rates during pregnancy were 26% for psychological, 2% for physical, and 1% for sexual IPV. With the exception of one woman, all women that reported physical or sexual violence also reported experiencing psychological violence occurring at the same time (3.5%). Chi-squared analyses indicated that rural pregnant women were not significantly more likely to experience any of the types of IPV compared to non-rural pregnant women.Furthermore, logistic regression analysis supported previous literature findings that pregnant women who are younger, have an unplanned pregnancy, have high levels of stress, and have low levels of social support, are at a greater risk of experiencing anytype of IPV during pregnancy compared to those without these risk factors. To investigate IPV over the course of pregnancy, Study 2 participants included a TIPS participant subsample of 337 pregnant women who indicated they had experienced IPV at any timeduring their current pregnancy. The modified HITS screen was administered up to four times throughout the course of pregnancy, with responses coded based on gestational age at the time of assessment (first trimester, first half of second trimester, secondhalf of second trimester, and third trimester). Generalized estimating equation logistic models indicated that women who experienced IPV at some point during pregnancy were most likely to experience IPV during the third trimester. These results speak to the importance of screening for all types of IPV multiple times throughout the course of pregnancy. If multiple screens do not occur as the pregnancy progresses, some women may not be identified as having experienced IPV, and therefore miss opportunities toassuage the possible negative health outcomes due to IPV. Information obtained from the current research is valuable to prenatal health care providers who need to be aware of IPV risk factors, and that different types of IPV, especially psychological IPV,can occur at any time during pregnancy.
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Stubbs, Brittney, and Andrea D. Clements. "Psychosocial Well-Being and Efforts to Quit Smoking in Pregnant Women of Rural Appalachia." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/7234.
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Negative health effects on an unborn fetus have been related to cigarette smoking during pregnancy. Very little research examines stress, self-esteem, depression, and disordered eating in pregnant women who smoke. A study, Tennessee Intervention for Pregnant Smokers (TIPS), recruited pregnant women from five prenatal practices to help them quit smoking before giving birth. Using an expanded 5A’s (Ask, Advise, Assess, Assist, Arrange) model and motivational interviewing, the intervention was implemented by trained health educators over the course of 4 prenatal visits. Women in the study who successfully stopped smoking before delivery had significantly healthier infants than the women who did not. A subset of the sampled 1063 pregnant women with complete data on measures of interest will be analyzed for the current study. We hypothesize that the following factors will differ significantly among pregnant women who never smoked, women who smoked but quit prior to birth, and women who smoked and did not quit prior to birth: stress, as indicated by the stress subscale of the Prenatal Psychosocial Profile (PPP); self-esteem, as indicated by the self-esteem subscale of the PPP; depressive symptoms, as indicated by the Center for Epidemiologic Studies Depression Scale (CESD-10); and disordered eating, as indicated by the Eating Attitudes Test (EAT-26). Additionally, we hypothesize that the odds of pregnant women quitting smoking prior to birth will be predicted by stress, self-esteem, depressive symptoms, and disordered eating. One-way Analysis of Variance (ANOVA) tests will be conducted to compare scores on respective measures for the three groups based on smoking status. A logistic regression will be conducted to assess the degree to which aforementioned variables predict odds of smoking cessation in pregnant smokers. The implications of this research can be used to improve future intervention programs to reduce the adverse health effects of children born to mothers who smoke.
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Stubbs, Brittney, Valerie M. Hoots, and Andrea D. Clements. "Psychosocial Well-Being and Efforts to Quit Smoking in Pregnant Women of Rural Appalachia." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/7235.
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Stress, self-esteem, depression, and disordered eating were analyzed among three groups of pregnant women in Tennessee Intervention for Pregnant Smokers (TIPS): never smoked, smoked but quit prior to birth, and smoked but did not quit prior to birth.
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Stubbs, Brittney, Valerie M. Hoots, Andrea D. Clements, and Beth A. Bailey. "Psychosocial Well-Being and Efforts to Quit Smoking in Pregnant Women of Rural Appalachia." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/7228.
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Stubbs, Brittney, Valerie Hoots, Andrea D. Clements, and Beth Bailey. "Psychosocial Well-Being and Efforts to Quit Smoking in Pregnant Women of South-Central Appalachia." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7199.
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Introduction: Psychosocial well-being variables from the Tennessee Intervention for Pregnant Smokers (TIPS) study, a longitudinal smoking cessation study in South-Central Appalachia, were investigated as potential predictors of smoking status.
Methods: A sample of 1031 pregnant women participated in an expanded 5A's (Ask, Advise, Assess, Assist, Arrange) program, from 2008 to 2011. Measures of stress, self-esteem, depressive symptoms, and disordered eating collected by interview during the first trimester, or during the third trimester in a combined interview if participants began prenatal care late, were hypothesized to differ among three groups of participants: pregnant women who never smoked, pregnant women who smoked but quit prior to birth, and pregnant women who smoked and did not quit prior to birth. Smoking status was measured throughout the study. Whether or not a participant quit smoking was assessed at delivery.
Results: Non-smokers were lowest in stress F(2,1027) = 46.38, p < .001) and depression (F(2,1028) = 39.81, p < .001), and highest in self-esteem (F(2,1018) = 29.81, p < .001). Only self-reported stress and self-reported self-esteem predicted quitting. Higher reported stress levels were related to a slightly lower likelihood of quitting (OR = 0.95, 95% CI 0.92, 0.98, p = .003) and higher reported self-esteem predicted a slightly higher likelihood of quitting (OR = 1.05, 95% CI 1.02, 1.08, p = .001).
Conclusions: Findings may lead to improved intervention programs and reduction of adverse health effects in children attributable to prenatal smoking. More research should be conducted on smoking cessation in rural pregnant women.
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Stubbs, Brittney, Valerie M. Hoots, Andrea D. Clements, and Beth A. Bailey. "Psychosocial Well-Being and Efforts to Quit Smoking in Pregnant Women of Rural Appalachia." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7227.
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Barrios, Yasmin V., Bizu Gelaye, Qiu-Yue Zhong, Christina Nicolaidis, Marta B. Rondon, Pedro J. Garcia, and Pedro A. Mascaro Sanchez. "Association of Childhood Physical and Sexual Abuse with Intimate Partner Violence, Poor General Health and Depressive Symptoms among Pregnant Women." PLoS ONE, 2015. http://hdl.handle.net/10757/344059.
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This research was supported by an award from the National Institutes of Health (NIH), the
Eunice Kennedy Shriver Institute of Child Health and Human Development (R01-HD-
059835). The NIH had no further role in study design; in the collection, analysis and interpretation
of data; in the writing of the report; and in the decision to submit the paper for publication.
The authors wish to thank the dedicated staff members of Asociacion Civil Proyectos en
Salud (PROESA), Peru and Instituto Materno Perinatal, Peru for their expert technical assistance
with this research.Objective We examined associations of childhood physical and sexual abuse with risk of intimate partner violence (IPV). We also evaluated the extent to which childhood abuse was associated with self-reported general health status and symptoms of antepartum depression in a cohort of pregnant Peruvian women. Methods In-person interviews were conducted to collect information regarding history of childhood abuse and IPV from 1,521 women during early pregnancy. Antepartum depressive symptomatology was evaluated using the Patient Health Questionnaire-9. Multivariable logistic regression procedures were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95%CI). Results Any childhood abuse was associated with 2.2-fold increased odds of lifetime IPV (95%CI: 1.72–2.83). Compared with women who reported no childhood abuse, those who reported both, childhood physical and sexual abuse had a 7.14-fold lifetime risk of physical and sexual IPV (95%CI: 4.15–12.26). The odds of experiencing physical and sexual abuse by an intimate partner in the past year was 3.33-fold higher among women with a history of childhood physical and sexual abuse as compared to women who were not abused as children (95%CI 1.60–6.89). Childhood abuse was associated with higher odds of self-reported poor health status during early pregnancy (aOR = 1.32, 95%CI: 1.04–1.68) and with symptoms of antepartum depression (aOR = 2.07, 95%CI: 1.58–2.71). Conclusion These data indicate that childhood sexual and physical abuse is associated with IPV, poor general health and depressive symptoms in early pregnancy. The high prevalence of childhood trauma and its enduring effects of on women’s health warrant concerted global health efforts in preventing violence.
: This research was supported by an award from the National Institutes of Health (NIH), the Eunice Kennedy Shriver Institute of Child Health and Human Development (R01-HD-059835). The NIH had no further role in study design; in the collection,
Revisión por pares
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Henninger, Matthew W., Mikayla McAdams, Andrea D. Clements, Emily F. Rothman, and Beth A. Bailey. "Intimate Partner Violence Victimization and Opioid Use by Pregnant Women in Rural Appalachia: A Cross-Sectional Analysis." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/7229.
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Barry, Sarah A. "Interventions for supporting women before and after elective termination of pregnancy." Honors in the Major Thesis, University of Central Florida, 2010. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/1354.
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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.Bachelors
Nursing
Nursing
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Valladares, Cardoza Eliette. "Partner violence during pregnancy, psychosocial factors and child outcomes in Nicaragua." Doctoral thesis, Umeå : Public Health and Clinical Medicine, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-578.
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Irvin, Miriam, and Wilma Shepard. "A qualitative research study on fetal alcohol syndrome." CSUSB ScholarWorks, 1995. https://scholarworks.lib.csusb.edu/etd-project/978.
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Clements, Andrea D., Anna V. Ermakova, and Beth A. Bailey. "Religious Commitment Predicts Lower Incidence of Preterm Birth in Rural Appalachian Women." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/7267.
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Leecost, Thomas B. M. "Factors Associated with High Sexual Risk Behavior in Single Women." VCU Scholars Compass, 2006. http://hdl.handle.net/10156/1926.
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Francisco, Teresa Wise. "Adolescents' Experiences With Terminating Relationships With Perpetrators of Perinatal Abuse." The Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=osu1243879369.
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Clements, Andrea D., Tifani A. Fletcher, and Beth A. Bailey. "Depression Is More Prevalent Throughout Pregnancy and the First Six Months Postpartum in Women Low in Religious Commitment and Social Support." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/7253.
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Stenson, Kristina. "Men's Violence against Women – a Challenge in Antenatal Care." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4140.
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Griffith, Gillian J. "Contraceptive Utilization and Downstream Feto-Maternal Outcomes for Women with Substance Use Disorders: A Dissertation." eScholarship@UMMS, 2016. https://escholarship.umassmed.edu/gsbs_diss/824.
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Background: One in ten people in the U.S. are affected by a substance use disorder (SUD), roughly one third of whom are women. Rates of unintended pregnancy are higher in this population than in the general public. Little is understood about how women with SUD use prescription contraception and think about pregnancy.
Methods: By analyzing Medicaid claims data and conducting qualitative interviews with women with SUD, this doctoral thesis seeks to: 1) compare any use of and consistent, continued coverage by prescription contraceptives between women with and without SUD; 2) determine the extent to which SUD is associated with pregnancy, abortion, and adverse feto-maternal outcomes in women who use prescription contraception; and 3) explore facilitators of and barriers to contraceptive utilization by women with SUD, using qualitative interviews.
Results: Compared to women without SUD, women with SUD are less likely to use any prescription contraceptive, particularly long-acting reversible methods. Among women who do use long-acting methods, SUD is associated with less continued, consistent coverage by a prescription contraceptive. Among women who use contraception, SUD is also associated with increased odds of abortion. When interviewed, women with SUD report fatalistic attitudes towards pregnancy planning, and have difficulty conceptualizing how susceptibility to pregnancy may change over time. Women with SUD also report that pregnancy has substantial impact on their drug treatment prospects.
Conclusions: This study is the first to examine contraceptive utilization by women with SUD who are enrolled in Medicaid or state-subsidized insurance. Our study may help to inform clinical practice and policy development to improve the reproductive health and wellbeing of women with SUD.
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Griffith, Gillian J. "Contraceptive Utilization and Downstream Feto-Maternal Outcomes for Women with Substance Use Disorders: A Dissertation." eScholarship@UMMS, 2003. http://escholarship.umassmed.edu/gsbs_diss/824.
Full textAbstract:
Background: One in ten people in the U.S. are affected by a substance use disorder (SUD), roughly one third of whom are women. Rates of unintended pregnancy are higher in this population than in the general public. Little is understood about how women with SUD use prescription contraception and think about pregnancy.
Methods: By analyzing Medicaid claims data and conducting qualitative interviews with women with SUD, this doctoral thesis seeks to: 1) compare any use of and consistent, continued coverage by prescription contraceptives between women with and without SUD; 2) determine the extent to which SUD is associated with pregnancy, abortion, and adverse feto-maternal outcomes in women who use prescription contraception; and 3) explore facilitators of and barriers to contraceptive utilization by women with SUD, using qualitative interviews.
Results: Compared to women without SUD, women with SUD are less likely to use any prescription contraceptive, particularly long-acting reversible methods. Among women who do use long-acting methods, SUD is associated with less continued, consistent coverage by a prescription contraceptive. Among women who use contraception, SUD is also associated with increased odds of abortion. When interviewed, women with SUD report fatalistic attitudes towards pregnancy planning, and have difficulty conceptualizing how susceptibility to pregnancy may change over time. Women with SUD also report that pregnancy has substantial impact on their drug treatment prospects.
Conclusions: This study is the first to examine contraceptive utilization by women with SUD who are enrolled in Medicaid or state-subsidized insurance. Our study may help to inform clinical practice and policy development to improve the reproductive health and wellbeing of women with SUD.
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Koenig, Juliana Caryl. "Intervention strategies which enable families to be reunified and foster a successful case closure within the County of San Bernardino Department of Public Social Services." CSUSB ScholarWorks, 1994. https://scholarworks.lib.csusb.edu/etd-project/913.
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Perinatal complications resulting from either alcohol or drug abuse include a high incidence of stillbirths, fetal distress, asphyxia, prematurity, low birth weight, pneumonia, congenital malformations, cerebral infarction, and an increased risk to acquired immunodeficiency syndrome.
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Edin, Kerstin E. "Perspectives on intimate partner violence, focusing on the period of pregnancy." Doctoral thesis, Umeå : Public Health and Clinical Medicine Folkhälsa och klinisk medicin, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-838.
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Mercier, Amanda. "Trauma-Informed Research and Planning: Understanding Government and Urban Native Community Partnerships to Addressing Substance-Exposed Pregnancies in Portland, OR." PDXScholar, 2014. https://pdxscholar.library.pdx.edu/open_access_etds/1803.
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In 2011, representatives from the Multnomah County Health Departments and several Native-serving organizations came together to address substance-exposed pregnancies among urban Native Americans in Portland, Oregon. From these partnerships, the Future Generations Collaborative was formed representing a significant shift toward community-led maternal child health research and planning. Additionally, the Future Generations Collaborative adopted a historical trauma-informed community based participatory research and planning process. This is particularly significant considering government agencies' role in colonization within Native communities. The purpose of this case study is to explore partnerships between government agencies and the Portland Native community within the Future Generations Collaborative. Given the profound influence of historical trauma in Native communities, this paper addresses how the partnerships between government agencies and the Portland Native community pose distinct opportunities, challenges, and implications.
Drawing from FGC members' lived experiences and an interdisciplinary body of research, I develop a theoretical model for explaining the government's role in creating and sustaining historical trauma within Native communities. This analysis provides critical context for examining the impact of historical trauma on the relationships between government agencies and the Portland Native community within the FGC. By entering methodological discussions of Native-specific community-based participatory research, this study also addresses how the use of a trauma-informed research and planning model affects the relationships between government agencies and the Portland Native community within the FGC.
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Nunes, Eliane Lima Guerra. "Adolescência e corpo: a prostituição e o abuso de droga como sintoma." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/5/5160/tde-28012009-134219/.
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O estudo propõe, com base na escuta das histórias de vida de dez jovens, entre 19 e 25 anos, que vivem na prostituição em boates da cidade de Santo André-SP, realizar uma discussão a respeito da prevenção das DST/AIDS e da toxicomania. A partir da fala de cada entrevistada sob o enfoque da psicanálise, evidenciou-se o fato de que as jovens, embora disponham de informações sobre medidas preventivas das DST/aids, vivenciam um conflito de identidade expresso em vários níveis de seu discurso que contribui para a vulnerabilidade dessas doenças, sobretudo nas relações que envolvem afetividade. Apoiando-se nesses discursos, foi possível pontuar a implicação dessa ambiguidade no cuidado de si e na necessidade de políticas públicas que abordem a prostituição, levando em conta esse aspecto.The purpose of this study is to discuss the prevention of STDs/AIDS and drug adiction, starting from listening to ten life stories from youngsters, between 19 and 25 years old, who are involved in prostitution at nightclubs from the city of Santo André-SP. Through the speech of each and every one of them, under the psychoanalysis approach, it was possible to notice that, although having information on the prevention methods against STDs/AIDS, the youngsters live an identity conflict shown in many levels of their discourse, which contributes to their vulnerability towards these diseases, mainly in their affective relationships. Based on these discourses, it was possible to identify the implications of this ambiguity while caring for themselves and the need of public policies that take prostitution into account, regarding this aspect, from a woman\'s point of view.
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Kassada, Danielle Satie. "Gestantes na atenção primária à saúde: transtornos mentais comuns, qualidade de vida e uso de drogas." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/22/22131/tde-25012018-112411/.
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Essa pesquisa teve por objetivo geral identificar a prevalência de Transtornos Mentais Comuns (TMC), uso de drogas e a qualidade de vida (QV) em gestantes atendidas na atenção primária à saúde (APS) no município de Campinas, São Paulo. Trata-se de estudo quantitativo, de caráter correlacional, realizado de agosto de 2015 a agosto de 2016 com plano amostral estratificado e proporcional (n=287). Cada estrato foi formado pela Unidade Básica de Saúde sorteada, na área de abrangência de cada um dos cinco distritos de saúde da cidade. Foram instrumentos de pesquisa: questionário sociodemográfico, econômico, farmacoterapêutico e de histórico de saúde; o Alcohol Use Disorders Identification Test (AUDIT) para o rastreamento do uso do álcool; o Self Reporting Questionnaire (SRQ-20), para estimar a prevalência de TMC e o World Health Organization Quality of Life Assessment-Brief (WHOQOL-brief), para mensurar escores de QV na amostra. TMC, QV e uso de drogas lícitas não prescritas e/ou ilícitas foram considerados variáveis dependentes. Para análise das variáveis TMC e uso de drogas lícitas não prescritas e/ou ilícitas foi utilizado o teste de regressão logística simples e múltipla e QV a regressão linear múltipla. Das 287 gestantes entrevistadas 30% foram positivas para TMC. As variáveis associadas à TMC foram: idade (OR 6,63), situação conjugal (OR 2,15), histórico de transtorno mental (OR 4,34), gravidez desejada (OR 3,33), idade gestacional (OR 5,86), relato de ter sofrido violência (OR 18,47) e uso de chá (OR 2,47). Identificou-se que 95,8% declararam ter utilizado pelo menos um medicamento durante a gravidez e desses 2,09% utilizaram sem prescrição. Em relação à classificação de risco, 58,47% dos medicamentos utilizados são da classe A; 30,87% da classe B; 8,84% da classe C, 1,09% da classe D e 0,73% sem classificação. Quanto ao uso de drogas lícitas não prescritas e/ou ilícitas 19,5% relataram o uso sendo a droga mais utilizada o álcool (8,71%), seguido do tabaco (6,61%); sete (2,43%) usaram essas duas substâncias concomitantemente e quatro (1,4%) utilizaram drogas ilícitas associadas ao álcool e/ou tabaco. Por meio do AUDIT, identificou-se que durante a gestação, 2,8% das mulheres foram classificadas como em uso de risco e 0,7% em provável dependência. As variáveis associadas ao uso de drogas lícitas não prescritas e/ou ilícitas foram idade (OR 6,91) e idade gestacional, sendo no segundo trimestre (OR 2,68) e no terceiro trimestre (OR 2,81). Quanto a QV, a média dos escores foi maior no domínio relações sociais enquanto o mais baixo foi no domínio meio ambiente.O preditor mais significativo para menor QV foi TMC. Assim, os achados desta pesquisa poderão ser utilizados na sensibilização dos profissionais da atenção primária, com vistas a maior adequação das ações desenvolvidas no pré-natal e redução de complicações tanto para a gestante quanto para o feto. Além disso, esses indicadores poderão subsidiar a elaboração e implementação de políticas públicas que proporcione uma assistência pré-natal mais integral e qualificadaThe objective of this research was to identify the prevalence of Common Mental Disorders (CMD), drug use and quality of life (QoL) in pregnant women treated at primary health care in the city of Campinas, São Paulo. It is a quantitative, correlational study, carried out from August 2015 to August 2016 with a stratified and proportional sampling plan (n = 287). Each stratum was formed by the Basic Health Unit drawn in the area of coverage of each of the five health districts of the city. They were research instruments: socio-demographic, economic, pharmacotherapeutic and health history questionnaire; The Alcohol Use Disorders Identification Test (AUDIT) for tracking alcohol use; Self-Reporting Questionnaire (SRQ-20), to estimate the prevalence of TMC and World Health Organization Quality of Life Assessment-Brief (WHOQOL-brief), to measure QoL scores in the sample. TMC, QV, and use of nonprescription and / or illicit drugs were considered dependent variables. The simple and multiple logistic regression test and multiple linear regression were used to analyze the MCT variables and use of nonprescription and / or illegal drugs. Of the 287 pregnant women interviewed, 30% were positive for CMD. The variables associated with CMD were: age (OR 6.63), marital status (OR 2.15), history of mental disorder (OR 4.34), desired pregnancy (OR 3.33), gestational age 86), suffered violence (OR 18.47) and tea (OR 2.47). It was identified that 95.8% reported having used at least one drug during pregnancy and 2.09% used no prescription. Regarding the classification of risk, 58.47% of the drugs used are class A; 30.87% of class B; 8.84% of class C, 1.09% of class D and 0.73% without classification. Regarding the use of nonprescription and / or illicit drugs, 19.5% reported the use of alcohol (8.71%), followed by tobacco (6.61%), seven (2.43%) Used these two substances concomitantly and four (1.4%) used illicit drugs associated with alcohol and / or tobacco. Through the AUDIT, it was identified that during pregnancy, 2.8% of the women were classified as using risk and 0.7% in probable dependence. The variables associated with nonprescription and / or illicit drug use were age (OR 6.91) and gestational age being in the second trimester (OR 2.68) and in the third trimester (OR 2.81). Regarding QOL, the mean of the scores was higher in the social relations domain while the lowest was in the environmental domain. The most significant predictor for lower QOL was CMT. Thus, the findings of this research may be used to raise awareness among primary care professionals, with a view to improving the adequacy of the actions developed during prenatal care and reducing complications for both the pregnant and the fetus. In addition, these indicators may support the development and implementation of public policies that provide more comprehensive and qualified prenatal care
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De, Vries Maria Magdalena. "The prevention of fetal alcohol spectrum disorders : an ecological approach." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/20077.
Full textAbstract:
Thesis (M Social Work)--Stellenbosch University, 2012.ENGLISH ABSTRACT: Fetal alcohol spectrum disorders (FASD) is caused by maternal drinking during pregnancy. Pre-natal drinking has a range of deleterious effects including physical, mental and behavioural consequences for the affected child. Although FASD is completely preventable, it is irreversible with consequences that last into adulthood. The range of effects of FASD forms a spectrum with fully developed FAS on the one end and no effects on the other end of the spectrum. The Western Cape has one of the highest recorded rates of FAS in the world. This seriously affects almost all systems in society and strains the already overburdened educational-, health-, social- and judicial systems. For this reason preventing FASD is of the utmost importance and requires a comprehensive approach on multiple levels. This study explores and describes FASD prevention services in the Bonnievale, Robertson, Ashton and Montagu-areas – a wine-producing area in the Western Cape. Available FASD prevention services on all levels of prevention, the focus-areas of the different prevention activities, collaboration and co-ordination between the role-players and obstacles in delivering prevention services, was examined. By adopting an ecological approach, FASD prevention services could be investigated on multiple levels. This study used a combination of quantitative and qualitative research. An exploratory design and a purposive sampling method were used. Participants were interviewed individually and with the help of a semi-structured questionnaire. The findings of the empirical investigation show that, although prevention efforts are applied on the universal, selective and indicated levels of prevention, a lack of formal prevention efforts that are actively pursued - especially on the level of indicated prevention - exists. This is aggravated by the absence of formal co-ordination of services and structured systems of referrals. NGO‟s and government departments are, as a result, not clear about their respective roles and responsibilities and women with the highest risk for having a child with FAS, therefore, fall through the cracks of the system. This happens partly because social workers are often perceived as the only agents for social change in the community. According to the ecological approach all levels (micro, meso and macro) of organizations in the social environment should work together for change by repeating prevention messages on the different levels and thereby reinforcing it. In the study area, however, most FAS prevention services were on the micro-level with few on the meso-level and virtually none on macro-level. Participants identified a lack of co-ordination, unplanned families, a lack of resources, a lack of training and training material and low levels of education as obstacles in service delivery. Recommendations resulting from the study indicate that FAS prevention will benefit from structured, formal programs on all levels of prevention. This will require non-government organizations and government departments to co-ordinate services and to develop a formal system of referral amongst the role-players. Training of personnel in clinics, NGO‟s, government departments and volunteers, as well as the development of training material targeted at people on different levels of education, should receive attention. It is, in conclusion, recommended that community organizations and structures such as churches, places of business, farmer‟s associations and liquor outlets are actively involved in the prevention of FASD.
AFRIKAANSE OPSOMMING: Fetale Alkohol Spektrum Afwykings (FASA) word veroorsaak deur alkoholgebruik tydens swangerskap. Alkoholgebruik tydens swangerskap het „n reeks skadelike effekte, insluitend fisiese, psigiese en gedragsafwykings in die geaffekteerde kind. Alhoewel FASA heeltemal voorkombaar is, is dit onomkeerbaar en duur die gevolge daarvan voort in volwassenheid. Die reeks effekte van FASA vorm „n spektrum met volledig ontwikkelde FAS aan die een kant en geen effekte nie aan die ander kant van die spektrum. Die Wes-Kaap het een van die hoogste aangetekende voorkomssyfers van FAS in die wêreld. Dit affekteer feitlik alle sisteme in die samelewing en plaas nog meer druk op die reeds oorlaaide opvoedkundige-, gesondheids-, maatskaplike- en regssisteme. Om hierdie rede is die voorkoming van FASA van uiterste belang en word „n omvattende benadering op veelvuldige vlakke vereis. Hierdie studie ondersoek en beskryf FASA voorkomingsdienste in die Bonnievale-, Robertson-, Ashton- en Montagu-area – „n wynproduserende streek in die Wes-Kaap. Die beskikbaarheid van FASA voorkomingsdienste op alle vlakke van voorkoming, die fokus-areas van die verskillende voorkomingsaktiwiteite, samewerking en koördinering van dienste tussen die rolspelers, sowel as struikelblokke in voorkomingsdienste, is ondersoek. Deur die ekologiese benadering aan te neem, kon FASA voorkomingsdienste op veelvuldige vlakke ondersoek word. Die studie kombineer kwantitatiewe en kwalitatiewe navorsing. Die ontwerp van die studie is verkennend en daar is „n doelbewuste steekproef gedoen. Indivuduele onderhoude met deelnemers is met behulp van semi-gestruktureeerde vraelyste gevoer. Die bevindinge van die empiriese ondersoek toon dat, alhoewel voorkomingspogings aangewend word op die universele, selektiewe en indikatiewe voorkomingsvlakke, daar 'n gebrek bestaan aan formele voorkomingspogings wat aktief nagestreef word, veral op die indikatiewe vlak. Dit word vererger deur die afwesigheid van formele koördinering van dienste en gestruktureerde verwysingsisteme. Nie-regeringsorganisasies en staatsdepartemente het gevolglik nie duidelikheid oor hul onderskeie rolle en verantwoordelikhede nie. Die gevolg hiervan is dat vroue met die hoogste risiko om geboorte te skenk aan kinders met FAS, deur die krake in die sisteem val. Dit geskied deels omdat maatskaplike werkers dikwels gesien word as die enigste agente vir maatskaplike verandering in die gemeenskap. Volgens die ekologiese benadering behoort alle vlakke (mikro, meso en makro) van organisasie in die sosiale omgewing saam te werk om verandering teweeg te bring deurdat voorkomingsboodskappe op die verskillende vlakke te herhaal en sodoende te versterk word. In die studie-area is die meeste voorkomingsdienste egter op mikro-vlak gelewer met min op meso-vlak en feilik geen op makro-vlak nie. Deelnemers aan die studie het „n gebrek aan koördinasie van dienste, onbeplande gesinne, „n gebrek aan hulpbronne, „n gebrek aan opleiding en opleidingsmateriaal en lae vlakke van geletterdheid geïdentifiseer as struikelblokke in dienslewering. Aanbevelings wat uit die studie voortvloei, dui aan dat FASA voorkomingsdienste sal baat vind by gestruktureerde, formele programme op alle vlakke van voorkoming. Dit sal vereis dat nie-regeringsorganisasies en staatdepartemente hul dienste koördineer en „n formele verwysingstelsel tussen die verskillende rolspelers ontwikkel. Opleiding van personeel in klinieke, NRO‟s, staatsdepartemente en vrywilligers, sowel as die ontwikkeling van opleidingsmateriaal wat persone op verskillende vlakke van opvoeding teiken, behoort aandag te geniet. Dit word laastens ook aanbeveel dat gemeenskapsorganisasies en strukture byvoorbeeld kerke, besighede, boere-verenigings en verkoopspunte vir alkohol, aktief betrek word by die voorkoming van FASA.