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Ghosh, Manonita. "Postnatal depression vs. suffering : an anthropological approach to South Asian migrant women's postnatal feelings." University of Western Australia, 2005. http://theses.library.uwa.edu.au/adt-WU2005.0130.
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This thesis is an ethnography of the postnatal experiences of South Asian migrant women in Perth, Western Australia. I examine cultural differences relating to mothering and argue that the South Asian culture in which these migrant women were socialized can impact greatly on how they experience the feelings of what is called “postnatal depression” in the Western medical arena. I carried out ethnographic research among the members of the Bangladeshi and Indian communities in Perth. The main focus group of this study is first time mothers who gave birth in Australia, but I also worked with other women who had grown up children. Due to migration the South Asian women and their families experienced social isolation, cultural differences, language difficulties, economic hardship and low job satisfaction. Moreover, when these women gave birth in Perth they were faced with a lack of physical and emotional support, and also distress at not being able to perform their traditional birth rituals. Their difficult situations led the women to cry, feel despondent, to suffer and to experience a sense of hopelessness. Their painful postnatal feelings can be defined as an illness - depression - by the Western medicine. However, I found these women did not perceive their negative postnatal feelings as an illness, but accepted them as a part of life. I analysed these women’s postnatal psychological understandings about “postnatal depression” by examining the South Asian convention of female virtue which is practiced through restrictions on female behaviour. The migrant women in my study, having internalizing the South Asian cultural schema of womanhood, articulate their negative postnatal feelings as a prerequisite of motherhood. In this thesis I argue that feelings are not the totality of experience, rather, experience is also formulated by the particular sociocultural perspective of the individual who is having the experience. The culture a person belongs to, defines how that person will experience his or her feelings. I also suggest that it is possible to modify dysphoric affect by altering the meaning of feelings
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Hipwell, Alison E. "Psychological vulnerability to postnatal depressive symptomatology." Thesis, University of East Anglia, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.327139.
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Depressive disorders arising in the postnatal period can affect 10-16% of women and there is growing evidence for a range of adverse consequences for the mother and her child long after the symptoms may have remitted. Nevertheless, reliably detecting women who may be at risk of depression following childbirth continues to be problematic to health care workers. Drawing on a diathesis-stress model, the current study used a prospective design to investigate cognitive factors that might indicate a vulnerability to postnatal depressive symptomatology. A cohort of nulliparous pregnant women were recruited from antenatal clinics and parentcraft classes. They were interviewed during the third trimester of pregnancy when assessments of social support, mood, early experience of maternal behaviour, and neurotic personality traits were carried out. In addition, three sets of cognitive measures were included in this interview: the specificity of autobiographical recall, the nature of self-discrepancies, and self-devaluation. Ninety-four women without mental health problems at the time of the baseline assessment were followed up at two weeks and at two months post-delivery, when they were asked to complete measures relating to their mood. It was hypothesised that the cognitive characteristics would predict mood score at 2 months postpartum (Time 3), but not at the earlier follow-up stage of 2 weeks (Time 2) when biologicaVhormonal factors were believed to playa predominant role in aetiology. It was also hypothesised that these factors would mediate the relationship between both early experience and personality style, and postnatal mood. The results showed that the degree of self-devaluation, and low specificity of autobiographical recall, predicted depressive symptoms at Time 3, and that selfdevaluation also mediated the effects of early experience and neuroticism on postnatal mood. Self-discrepancy scores were not found to be useful in predicting subsequent levels of depression in the current sample. The clinical implications of these findings for the detection and prevention of postnatal depressed mood are discussed.
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Taylor, Janice D., University of Western Sydney, College of Social and Health Sciences, and of Nursing Family and Community Health School. "Exploring postnatal fatigue : influential factors and management strategies for women." THESIS_CSHS_NFC_Taylor_J.xml, 2003. http://handle.uws.edu.au:8081/1959.7/740.
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Caring for a new child is a significant, demanding, and time consuming role, often associated with increased stress. Postnatal depression is one possible outcome of increased stress and research has highlighted the importance of detecting depression in new mothers. However fatigue a correlate of depression, has only recently become a focus of research among health professionals. Understanding the nature of fatigue and its management within the postnatal period, the focus of this study, may reduce its impact on women’s lives. This longitudinal study explores changes in intensity, physical, mental and emotional dimensions of fatigue, factors associated with higher levels of fatigue, the impact of fatigue on women’s usual activities, and strategies for managing fatigue. Self-administered structured questionnaires gathered data form 504 women at 1, 6, 12 and 24 weeks after birth. Reliable and valid instruments were used to measure the relationship between the defined factors and the outcome of fatigue at the various time points. State anxiety was a consistently strong predictor of fatigue intensity across time and group. Women sought to manage their fatigue by using self-care practices and asking for help from family and friends. This research highlights two issues for health professionals – care of new mothers must include recognition that higher levels of state anxiety are associated with higher levels of postnatal fatigue: ongoing assessment of fatigue and the strategies used to manage it is essential beyond the early postnatal periodDoctor of Philosophy (PhD)
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Lewis, Linda. "Causes of postnatal depression : perceptions of recovered women." Master's thesis, University of Cape Town, 2002. http://hdl.handle.net/11427/6959.
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Bibliography : leaves 122-145.Investigations into the causes of postnatal depression are, with few exceptions, quantitative in nature. Although there are psychological, interpersonal and sociocultural perspectives on postnatal depression, the medical one dominates in terms of academic, professional and lay understandings of aetiology. The medical model has produced a plethora of investigations into the causes of postnatal depression but has paid little attention to the insights of women who have experienced the condition. This study sought to redress this by exploring the causes of post-natal depression from a women-centred perspective. A feminist approach to postnatal depression was adopted. This approach has evolved largely as a critique of the medical model and is grounded in a more qualitative tradition. Semi-structured, in-depth interviews were conducted with twenty women who had recovered from postnatal depression. Transcribed data from the interviews were thematically analysed to uncover the participants' attributed causes for their post-natal depression. A number of common themes emerged and could be broadly grouped under ""interpersonal factors"" (such as the impact of the woman's relationship with her own mother); ""psychological factors"" (such as the impact of unresolved issues and feelings of loss on the new mother) and ""biological factors"" (such as hormonal factors). The dominant theme that emerged from this study was that of ""motherhood"". Included under this heading were all those factors specifically associated with being a mother that were regarded by the women as being the cause of their postnatal depression (such as the experience of childbirth, breastfeeding and lack of sleep). At the core of this theme lay the realisation that motherhood was not what they had expected it to be. Their disappointment in not meeting their own expectations of motherhood contributed significantly to their postnatal depression. An interesting finding was that while many of the respondents located feelings of failure to live up to the ""ideal image"" of motherhood as a cause of their depression, few questioned the validity of the social construction of this ideal. This paper also examined the extent to which women's aetiological explanations resonate with existing models of post-natal depression. Their explanations were found to reflect some of the existing aetiological models of postnatal depression but no single model of explanation could be identified as the cause of their postnatal depression. Rather, women's attributions of cause were multi-layered and complex. They all attributed their depression following childbirth to a number of factors and they differed markedly from one another in their attributions. According to this research, postnatal depression results from a myriad of inter-related factors which interact with one another in different ways to produce a largely different picture for each and every woman. The limitations and contributions of this study are discussed.
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Homewood, Ellen. "Breast-feeding experiences in women with postnatal depression." Thesis, University of Leicester, 2006. http://hdl.handle.net/2381/31225.
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The aim of this review is to consider the current state of evidence for the relationship between postnatal depression and breast-feeding. Postnatal depression has been conceptualised in cognitive, psychodynamic and biological terms. However, research most strongly supports the stress-vulnerability model of depression, which predicts the development of postnatal depression in those who are vulnerable, for example, because of adverse life circumstances and psychopathology. Research has also demonstrated the negative effects of postnatal depression on mother-infant interaction and infant development, and highlighted the possibility that experiences of interaction may contribute to, as well as reflect, maternal depression. Literature on breast-feeding has mainly focussed on predicting feeding duration in relation to cognitive styles and social determinants. Observational studies have shown that breast-feeding, when compared with bottle-feeding, is associated with more positive dyadic (mother-infant) interaction. Differing associations between postnatal depression and breast-feeding have been identified. Research has revealed a positive relationship between maternal depression and breast-feeding, but has also shown that depression has a negative effect on breast-feeding. This latter finding suggests that for infants of depressed mothers, the adverse effects of depression on their dyadic (mother-infant) experiences may be further compounded by their mothers' decisions not to breast-feed. In spite of these findings, some research has indicated that the beneficial effects of breast-feeding on the mother-infant relationship may hold irrespective of maternal mood. On the basis of these findings, it has been hypothesised that breast-feeding may represent a useful intervention for depressed mothers in order to buffer against the negative effects of depression on her interaction with the infant.
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Spiteri, Mary Carmen. "Postnatal perineal trauma and general health in Maltese women." Thesis, University of Hull, 2009. http://hydra.hull.ac.uk/resources/hull:2384.
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Over the last twenty years there has been an increasing international research interest in women's experience of postnatal perineal trauma and its impact on their physical, psychological and sexual health. To date, however, no research on perineal morbidity and general health has been undertaken in Malta. Using a longitudinal descriptive correlational design, a homogenous systematic sample of 144 Maltese postnatal mothers was recruited with the aim of exploring the relationship between perineal trauma and general health following normal delivery. Self-administered questionnaires within 48 hour s of delivery and again at 10 days, 6 weeks and 13 weeks sought to assess perineal pain, urinary and faecal continence, resumption of sexual intercourse and dyspareunia. The General Health Questionnaire-12 (Goldberg and Williams, 1998) assessed mothers' psychosocial health. Open-ended questions explored further their experience of perineal trauma and general health. The retention rate at the end of time 4 was 86.1%. Following descriptive and inferential statistical analysis, the key findings revealed a constant decline in perineal trauma and an inconsistent but significant rise in general health over time. Mothers sutured by senior hospital officers reported higher scores of well-being, and resumed sexual intercourse earlier than those sutured by registrars and senior registrars. Significant negative correlations persisted between postnatal total perineal trauma and resumption of sexual intercourse at 13 weeks but not at 6 weeks.Qualitative data generated three main themes: experiencing total perineal trauma, resuming sexual intercourse and maintaining general health. Mothers identified tiredness, exhaustion and emotional pain as other burdens alongside a painful perineum. 'Being not ready yet', 'fear of falling pregnant again' and 'caring for the baby and family' were reasons preventing postpartum sexual intercourse. Tedeschi, Park and Calhoun's (1998) post-traumatic growth theory provided an overarching theoretical framework.
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Coldron, Yvonne. "Characteristics of abdominal and paraspinal muscles in postnatal women." Thesis, St George's, University of London, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.429385.
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Gilinsky, Alyssa. "Promoting physical activity among postnatal women : the More Active Mums in Stirling (MAMMiS) study." Thesis, University of Stirling, 2014. http://hdl.handle.net/1893/21226.
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Background: Adults benefit from participating in physical activity (PA) for chronic disease prevention and treatment. Postnatal women are encouraged to commence a gradual return to PA 4-6 weeks after giving birth, with participation in line with PA guidelines. The potential benefits of postnatal PA include weight management, improvements in cardiovascular fitness and psychological wellbeing. There has been limited high-quality information about the efficacy, feasibility and acceptability of PA interventions in postnatal women and few studies in the UK. Behavioural counselling interventions informed by behaviour change theory have been shown to successfully increase PA in low-active adults. Physical activity consultations (PACs) use structured and individualised behavioural counselling to enhance individuals’ motivation for change, and improve self-management skills. This approach may support adoption of PA in low-active postnatal women with research demonstrating that modifiable socio-cognitive factors influence PA behaviour. This thesis reports on the efficacy of a postnatal PA intervention, the More Active MuMs in Stirling (MAMMiS) study on change in PA behaviour. Efficacy of the intervention was tested in a randomised controlled trial. The effect on secondary health and wellbeing outcomes and PA cognitions targeted by the intervention and feasibility results are also reported. Methods: The intervention comprised a face-to-face PAC of around 35-45 minutes and 10-week group pramwalking programme. Non-attenders to the pramwalking group received a support telephone call. A follow-up PAC (15-20 minutes) was delivered after three month assessments. The first PAC involved raising awareness about benefits of PA, developing self-efficacy for change, setting goals and action planning PA, developing strategies for overcoming barriers, encouraging self-monitoring, prompting social support and selecting/changing the environment to support PA. The second PAC involved feedback about changes and preventing a return to sedentary habits. The pramwalking group met weekly for 6 walks of 30-55 minutes at a brisk pace, providing opportunities to demonstrate moderate-intensity walking and to encourage and support PA behaviour change. The control group received an NHS leaflet, which encouraged PA after childbirth. Postnatal women (six weeks to 12 months after childbirth) were identified through a variety of NHS-based and community-based strategies plus local advertisements and word-of-mouth. The primary outcome measure was evaluation of PA behaviour change using the Actigraph GT3X/GT3X+ accelerometer, an objective measure of PA behaviour; self-reported moderate-vigorous physical activity (MVPA) was measured using a recall questionnaire (Seven-Day Physical Activity Recall) and cardiovascular fitness using a submaximal step-test (Chester step-test). Secondary health and wellbeing measures were; anthropometric (i.e. weight and body mass index (BMI)) and body composition (measured using a bioelectrical impedance), psychological wellbeing (measured using the Adapted General Wellbeing Index) and fatigue (measured on a 100-point visual analogue scale). PA cognitions were measured via a questionnaire with constructs adapted from previous studies. All were taken at baseline (prior to randomisation), three and six months follow-up from baseline. Process measures were used to investigate intervention fidelity and feasibility. Acceptability was investigated in a post-trial interviews, conducted by a researcher not involved in the trial. RESULTS: Sixty-five postnatal women (average 33 years old with an infant 24 weeks old) were recruited (77% of those eligible). There was a 91% rate of retention at six months; participants who missed a follow-up assessment were younger (30 versus 34 years old) and had younger infants (21 versus 34 weeks old). Participants were less deprived and older compared with postnatal women in Scotland. Objectively measured PA behaviour did not change in response to the intervention. There was no between-groups difference in change in mean counts/minute from baseline to three months (p=0.35, 95% CI -73.50, 26.17, d=0.22) or three to six months (p=0.57, 95% CI -39.46, 71.18, d=0.13). There was no change in MVPA 7 minutes/day in either group from baseline to three (intervention =-0.70, IQR -9.86, 8.36; control =1.65, IQR -4.79, 8.21) or three to six months (intervention =0, IQR -1.13, 1.10; control =0, IQR -9.86, 8.23), with no between-groups difference baseline to three (p=0.43; r=0.10) or three to six months (p=0.75, r=0.09). Results for relative MVPA were similar. Median steps/day from baseline to three months did not change in the intervention group (0, IQR –1619.44, 1047.94) and increased by 195.95 (IQR -1519.55, 1691.03) among controls. The between-groups difference was non-significant (p=0.37, r=0.18). From three to six month follow-up steps/day increased in the intervention group and not in controls (0, IQR -1147.50, 1303.52), this between-groups difference was also non-significant (p=0.35, r=0.16). From baseline to three months self-reported MVPA declined in the intervention group (15 minutes/week; IQR -111, 15) and increased in the control group (30 minutes/week; IQR –68, 75): a non-significant between-groups difference, with a small effect size (p=0.71, r=0.22). From three to six months a decline in self-reported MVPA was found in controls (53 minutes/week; IQR -41,-101) and no change among the intervention group (0, IQ range -26, 71); a significant between-groups difference with a small effect size (p=0.04, r=0.26). There were no differences between the groups for the change in aerobic capacity from baseline to three months or three to six months with no evidence for change over time in aerobic capacity or fitness category in either group. Change in secondary outcomes did not differ between the groups from baseline to three or three to six months (although fatigue did improve in the intervention group relative to controls from baseline to three months). Considering PA cognitions, outcome expectancies declined in both groups from baseline to three months and continued to decline only in the intervention group from three to six months, a between-groups difference with a small effect size (p=0.03, r=0.26). Self-efficacy increased in the intervention group from baseline to three months and declined in the control group with a small effect size for the between-groups difference (p=0.03, r=-0.27). An increase in action 8 planning was seen among the intervention group but not controls from baseline to three months (p<0.01, r=-0.34). Both groups showed an increase in coping planning and action control; the change was larger among the intervention group relative to controls (i.e. p<0.01, r=0.44, r=0.43, respectively). Increased self-efficacy and action control were maintained from three to six months in the intervention group. Coping planning increased relative to controls (p<0.01, r=0.41) and action planning increased among controls from three to six months (p<0.01, r=0.39). Intervention fidelity and feasibility was good. All intervention participants received the initial PAC and adoption of self-management strategies was high for ‘thinking about the benefits of PA’, ‘action planning’ and ‘self-monitoring’, between baseline and three months. Most participants attended at least one walk (61% attended five or more), 89% of planned walks were conducted with no evidence of poor attendance due to season. Walks were conducted at a brisk pace and met moderate-intensity thresholds. DISCUSSION: MAMMiS aimed to recruit low-active healthy postnatal women to test the efficacy of a PAC and group pramwalking intervention. There was no evidence for an intervention effect on PA or on secondary health and wellbeing outcomes.
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Almalik, Mona M. A. "A comparative evaluation of postnatal care for migrant and UK-born women." Thesis, University of Aberdeen, 2011. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=165719.
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The aim of this research was to explore perinatal clinical indicators and experiences of postnatal care among European and Middle Eastern migrant women, and to compare them with those of British women, at one tertiary hospital in the North East of Scotland. The numbers of non-British maternity service users increased over the period 2004 to 2008. This increase was not only in numbers but also in diversity of the countries of origins, religions, languages and specific cultural needs, which form new demands on the health services. European women were more likely to be younger, and primigravida and Middle Eastern women were more likely to be married, than British women. Both these migrant groups were more likely to breastfeed at birth and at discharge than British women. However, there was no significant difference in maternal postnatal length of stay in hospital between the study groups. The data do not suggest poorer processes of care or birth outcomes for the new migrant groups. Both migrant and British women reported positive experiences of postnatal care when their needs, those considered basic and essential for each woman after giving birth, were met. Negative postnatal experiences were explored among women from both groups when there were shortcomings in meeting those essential needs. The acceptance of and the expectations about the postnatal care provided differed between migrant and British women, due to their previous experiences in different countries. Although both migrant groups were first generation in Aberdeen and shared some needs and preferences, each migrant group had its own specific needs and beliefs that reflected the women’s culture, religion and country of origin.
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Taylor, Janice D. "Exploring postnatal fatigue : influential factors and management strategies for women /." View thesis, 2003. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20051125.152732/index.html.
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Armstrong, Kylie Jan. "Effectiveness of a Pram Walking Intervention for Women Experiencing Postnatal Depression." Queensland University of Technology, 2004. http://eprints.qut.edu.au/15837/.
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The purpose of the research project was to examine the effects of exercise and social support for postnatal women who reported experiencing Postnatal Depression (PND). PND is a serious condition that affects up to 10%-15% of women (O'Hara & Swain, 1996). Many previous studies have reported an improvement of depressive symptomatology following a pram walking intervention. However, no published research exists which assesses postnatal women who report experiencing PND. A randomised controlled trial was used, where pre-test data were compared to post-test effects. Two studies were conducted. In study 1 (n= 20) a multi-intervention group (exercise and social support) was compared to a control group who received no intervention. Study 2 (n= 19) was conducted 20 months later on a different group of women and involved a pram walking intervention group and a comparison social support group. Structured questionnaires assessing depressive symptomatology, general health and levels of social support were administered at pre-test phase, week 6 and 12. A sub-maximal fitness test was conducted the week before the program started and at week 12. The chief investigator was present at all sessions to guide the participants. Study 1 (S1): The multi-intervention group attended 3 pram walking sessions per week. After the exercise session the group met for refreshments in a local hall. The control group was only required to perform the fitness tests and answer the questionnaires. A 6-week alternative program of exercise and social support was offered to all the women at the completion of the intervention period. Study 2 (S2): The pram walking group met for 2 exercise sessions and were required to make up the third session independently. The comparison social support group met once per week for morning tea with the children. The samples for both studies were drawn from the Gold Coast region in Australia. Women of childbearing age who were experiencing depressive symptoms were recruited. For S1 their child had to be less than or equal to 12 months and for S2 the age cut off was increased to less than or equal to 18 months. The participants were screened to ensure that they did not have a medical condition that would prevent regular aerobic exercise and they were also excluded if they had a previous history of mental illness or could not speak English. Demographic data were obtained from each participant and details such as height, weight and age were collected for use in analysing fitness levels. The data for each study were collected across three time points (pre, week 6 and week 12) using widely tested instruments. Some additional questions relating to the participants experiences were collected at the completion of the study from the women allocated to the intervention groups. Data were also collected on fitness levels (pre and week 12) and the instrument was tested for its reliability. Both pram walking intervention groups were required to complete a weekly exercise diary. For each study, to test for the effect of the intervention over time, a two-way analysis of variance was conducted on the major outcome variables. Group (intervention versus control) was the between subject factor and time (pre-test, week 6, week 12) was the within subject factor or repeated measures factor. Due to the small sample size, further tests were conducted to check the assumptions of the statistical test to be used. The results showed that using Mauchly's Test, the Sphericity assumptions of repeated measures for ANOVA were met. Further, tests of homogeneity of variance assumptions also confirmed that this assumption was met. Data analysis was conducted using the software package SPSS for Windows Release 10.0. (Norusis, 2000). Overall, the findings from both S1 and S2 showed that the groups who received the pram walking intervention improved their depressive symptomatology and fitness levels when compared to those of the control (S1) and social support group (S2). Social support levels did not alter for either group from both studies. These results are encouraging and suggest that a pram walking program is an effective form of intervention for postnatal women experiencing depressive symptomatology.
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Lea, Eloise. "Exploring the experiences of women with postnatal depression who access community services." Thesis, Staffordshire University, 2018. http://eprints.staffs.ac.uk/4899/.
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The aim of this thesis is to explore the experiences of women who access community services for postnatal depression. Paper one is a qualitative literature review that synthesises the findings of seven empirical papers. Following a thematic analysis, a hierarchical model of five themes (External hopelessness, secrets and permission, desire for choice, loss of control and inadequate services) was developed to illustrate the experiences of women and the cultural and societal influences that impact upon these experiences. Paper two is an empirical research paper that explores the experiences of six women who self-identify with the term postnatal depression and accessed NHS community services for support with this. Face to face interviews were completed and data analysed using a narrative approach. A single story was constructed to illustrate the shared meanings from the women’s experiences. This identified trauma, feeling unheard, the use of language and the impact of social constructs of motherhood as key narratives. The clinical application of the research is discussed as well as future research implications. The final paper is an executive summary produced in order to provide a succinct summary of the empirical research paper. Main findings of the research are presented along with clinical implications and recommendations in the context of service development of perinatal mental health services.
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Zumla, Ameera. "A qualitiative investigation into the experience of postnatal depression in Asian women." Thesis, University of Manchester, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.493456.
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Postnatal Depression (PND) can inflict profound psychological suffering on new mothers, and if not treated, this disorder can also cause significant disabling complications for the entire family (National Institute for Clinical Excellence for Antenatal & Postnatal Mental Health- NICE for APMH, 2007). NICE for APMH guidelines, (2007), suggested that in order to assess and treat PND accurately, it is unperative to know the factors associated with the development and maintenance of the illness. However, almost all of the theoretical perspectives, screening, assessment tools and interventions for PND to date had been derived from western populations, and little research had been undertaken with Asian mothers.
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Binti, Mohd Arifin Siti Roshaidai. "Perspectives of postnatal depression in Malaysia : exploring experiences of women and healthcare practitioners." Thesis, University of Stirling, 2016. http://hdl.handle.net/1893/24176.
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Background: Postnatal depression (PND) is one of the most common maternal mental health problems for women worldwide. Yet the wide range of reported rates of PND in different countries raises questions about how PND is experienced by women in different cultures and whether interventions developed in western cultures are appropriate in very different settings. It is important to establish how PND is defined, experienced and managed in different cultures in order to create culturally relevant interventions. No previous studies of experience of PND and its management have been conducted in Malaysia. The aim of this study was to explore women’s experiences and healthcare practitioners’ (HCPs) perspectives of PND in a multicultural country, Malaysia. Methods: This was a qualitative study informed by a critical realist approach. Semi-structured interviews were carried out with 33 women (from three different cultural backgrounds) attending for child or postnatal care and 18 HCPs in six purposively selected maternal and child health (MCH) clinics and a female psychiatric ward in Kuala Lumpur, Malaysia. Data were analysed using framework analysis. Findings: There were some differences in the women’s perceptions of PND experience across three different cultural backgrounds in Malaysia. Malay women were more likely to describe the symptoms of PND based on a combination of emotional and behavioural changes, whereas Chinese and Indian women talked more about emotional changes. Traditional postnatal practices were described as contributing to PND by some Malay women but were accepted as promoting maternal and infant well-being by the majority of Indian women. Religious activities were reported as an effective strategy for the Malay women but were not seen as helpful by the majority of Chinese women. Considering HCPs, it appeared that the absence of a clear and specific policy and guideline in the management of PND within the Malaysian healthcare system has resulted in a lack of professional ownership in the management of PND, especially among HCPs in MCH clinics. Conclusion: The women and the HCPs had distinct ways of conceptualising PND experiences, although they agreed on several symptoms and causal explanations. This study calls for a system-based enhanced PND care with an initiation of culturally appropriate care for PND within the healthcare system.
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Baxter, J. "Listening to women after birth : their perceptions of postnatal support and the potential value of having a postnatal debriefing session with a midwife." Thesis, City, University of London, 2017. http://openaccess.city.ac.uk/17911/.
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This thesis examines women’s experiences of postnatal care in hospital and on postnatal debriefing. The objectives were to determine what postnatal debriefing is; to understand reasons why some women attend such services; identify the views of women and staff towards this and finally explore women’s feelings about their birth experience to identify possible links between this and the need for women to talk to a professional. A case study utilised secondary data sources to identify women’s experiences of care on the postnatal ward. This was followed by a critical literature review of postnatal debriefing which adopted meta-ethnography to analyse the varied research papers retrieved. The literature review was published in a peer-review journal. Finally the fourth research component followed a sequential mixed methods approach. This included a survey to a convenience sample of 447 women following birth and qualitative interviews with 16 women. The findings of the case study showed that women felt unsupported on the hospital postnatal ward and the environment unconducive to recovery. The critical review of the literature showed that postnatal debriefing enabled women to have their birth experiences validated by talking and being listened to and being provided with information. Results from the main research study show that women with a high Impact of Events Score (IES) are more likely to want to talk following their birth experience and more likely to rate their experience of birth more negatively compared with those with those with a low IES. Five themes were identified in the qualitative analysis that illuminated women’s reasons for needing to talk about their birth experience. Women found the postnatal debriefing service of value. Maternity providers should consider offering a postnatal debriefing service to help meet women’s postnatal support needs in advance of further research in this area.
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Jones, David. "Postnatal depression (PND) and neighborhood effects for women enrolled in a home visitation program." University of Cincinnati / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1459438588.
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Gamble, Jennifer Anne. "Improving emotional care for childbearing women an intervention study /." [South Bank, Queensland : Griffith University], 2003. http://www4.gu.edu.au:8080/adt-root/uploads/approved/adt-QGU20030904.154204/public/02Whole.pdf.
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Dell, Erin. "Nurses' attitudes and experiences working with women receiving methadone maintenance therapy in the postnatal period." Thesis, University of British Columbia, 2014. http://hdl.handle.net/2429/50283.
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Abstract
When working with women and infants on methadone maintenance treatment (MMT), obstetrical nurses may encounter an array of challenges concerning preparation, assessment, workload, and fostering a positive relationship with patient families. Obstetrical nurses also have distinct ways in which they work with each woman to build rapport and provide quality, safe, and effective care. Many research studies have focused on how nurses’ attitudes toward addiction and substances use impacts the quality of care provided, but few studies have explored the experiences of obstetrical nurses caring for women on MMT. This study addresses this knowledge gap, providing insight into how obstetrical nurses provide health care to women and infants on MMT.
The findings indicated that most participants drew on personal ideals about mothering, a collaborative team approach, and a non-judgmental attitude to meet the needs of the families on MMT. That said, most participants also recognized their lack of education surrounding MMT and how this impacted the care they provided. Many participants also reported difficulty establishing a positive relationship due to structural constraints - such as workload and staffing - which affected the time required to provide effective bedside care. Finally, this study highlights opportunities to learn how to increase understanding of nurses’ experiences working with women on MMT.Applied Science, Faculty of
Nursing, School of
Graduate
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Owen, Orion. "Towards a normative model of postnatal mood : symptoms of depression and anxiety among women after childbirth." Thesis, Cardiff University, 2011. http://orca.cf.ac.uk/54227/.
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Findings suggest non-pathological postpartum mood is characterised by (1) specific symptoms of anxiety and depression and, more broadly (2) co-existing symptoms that exist most frequently below the threshold for disorder, the rate and severity of which spontaneously diminish over time.
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Tuffery, Eleanor Olga Cushen. "A critical analysis of the factors influencing antenatal and postnatal self-reported diets of primagravid women." Thesis, Bath Spa University, 2004. http://researchspace.bathspa.ac.uk/1455/.
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The study examines the perceptions of diet and nutrition and measures the nutritional consumption of primagravid women, during pregnancy and post partum. The aim was to establish the nutritional knowledge and nutritional status of such women, based on self-reported diet diaries. Quantitative and qualitative data were collected from a sample of 39 primagravid women recruited from five general medical practices in Wiltshire, England, United Kingdom. Thirty-nine participants took part in the study during the first trimester of pregnancy and 37 continued in the study to six months post partum, keeping a self-reported diet diary for one week at the end of the first trimester, third trimester and six months post partum. At the same points in time, participants completed a Likert scale questionnaire based on the Theory of Planned Behaviour (Ajzen, 1985) that measured attitudes and intentions towards eating habits during pregnancy. Interviewer administered questionnaires were conducted at each time point to assess the participants socio-economic status and nutritional knowledge. The self-reported diet diaries were analysed using Dietplan software that measures nutritional intake based on Recommended Daily Allowances (RDAs). Results indicate that some women had under-consumption of a number of nutrients pre and post partum while some participants over-consumed a number of nutrients during their pregnancy. There were gaps in the nutritional knowledge of some participants, suggesting that revised nutritional educational policies should be introduced. Time was the major determinant of poor nutrition post partum, suggesting a need for time management and educational interventions for primagravid women. Small hospitals with Baby Friendly Accreditation were rated more positively than large general hospitals. These results suggest a need for larger hospitals to work towards Baby Friendly Accreditation. The study ascertained that there is a scarcity of research into the effects of over-consumption of nutrients during pregnancy and a recommendation is made to address this issue. A further recommendation is that modifications should be made to the Theory of Planned Behaviour (Ajzen, 1985) on the basis of the findings of this study which suggest that the model should be looked at in reverse, as the influence of a number of factors reduced over time. A modified model of the Theory of Planned Behaviour (Ajzen, 1985) is proposed.
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Friesen, Kira. "Adverse Life Events and Perinatal Depression Among Young Pregnant and Postpartum Women." Thesis, Université d'Ottawa / University of Ottawa, 2016. http://hdl.handle.net/10393/34215.
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Background: Young childbearing women have an increased risk of experiencing perinatal depression when compared to adult childbearing women. Perinatal depression has been associated with adverse life events in the literature and conceptually, in frameworks such as the Lifecycle Approach to Risk Factors for Mental Disorders Model. Purpose: The purpose of this manuscript-based thesis was to (1) determine the prevalence of: (i) adverse life events that have been associated with depression and (ii) depressive symptoms among the young pregnant and parenting women who access specialized services in an urban centre in Ontario, Canada; (2) determine which adverse life events are predictive of depression during the perinatal period, in this population; and (3) examine the psychometric properties of the Edinburgh Postnatal Depression Scale (EPDS) for use in a population of young childbearing women who access specialized services in an urban centre in Ontario, Canada. Methods: A survey was conducted with 102 young women from two agencies that provide specialized services to young parents. The interviewer-administered questionnaire included demographic questions, the Edinburgh Postnatal Depression Scale, the Antenatal Psychosocial Health Assessment, the Centers for Epidemologic Studies Depression Scale, Brown’s Support Behaviour Inventory. Results: 31.4% of the sample screened positive for perinatal depression. The only adverse life events found to predict perinatal depression were satisfaction with support from ‘others’ and intimate partner violence. Another predictor was very young maternal age (14 – 17 years). The EPDS was found to be psychometrically sound when used in this population of young childbearing women.
Conclusion: In this study of young childbearing women in Ontario, Canada, we found a high prevalence rate of perinatal depression and adverse life events. Furthermore, we identified specific factors that predict the development of perinatal depression in this group. Nurses can use these findings to help prioritize perinatal screening efforts to identify this condition early on in order to lessen the adversities related to perinatal depression.
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Peralta, Pamela Agudelo. "Why Do Highly Educated Successful Career Women Make the Postnatal Decision To Stay Home with their Infants?" Thesis, Argosy University/Hawai'i, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3583939.
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The purpose of the study was to understand, analyze, and interpret the defining factors that attributed to the decision strategy of highly educated successful career women to stay home upon the birth of a child. As well, the study ascertained the impact on the women’s lives once they stayed home full-time. This research study utilized the qualitative methodology based on a case study approach. The individual interview yielded complex dimensions according to the decision strategies the women employed. As a result of staying home, these women encountered internal and external changes. Additionally, their cultural upbringing influenced their style of mothering. The demographic questionnaire captured their individual profile. Discussion of the study and recommendations for future research were also explored.
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Greenfield, Anne-Mari. "Choices made by women in pregnancy, birth and the early postnatal period, after a previous traumatic birth." Thesis, University of Hull, 2017. http://hydra.hull.ac.uk/resources/hull:17083.
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[From the introduction]: Experiencing childbirth as a traumatic event is a factor that has been highlighted as contributing to poorer psychological outcomes. Up to 30% of women in the UK experience childbirth as a traumatic event, with many consequently going on to experience some form of anxiety, depression, or post-traumatic stress disorder (PTSD) following childbirth (Slade, 2006; Ayers, 2014). When childbirth presents as a traumatic experience it can impose a profound effect on the lives of mothers, fathers (Nicholls & Ayers, 2007), their children (Allen, 1998) and family and friends (Beck, 2004a; Ayers, Eagle & Waring, 2006). If left untreated the effects can last many years (Forssen, 2012). Consequences of traumatic birth include enduring mental health problems (Forssen, 2012; Beck, 2004a), compromised maternal infant relationships (Nicholls & Ayers, 2007), poorer quality marital relationships (Ayers, Eagle & Waring, 2006) concomitant depression in partners (Nicholls & Ayers, 2007) and can present a challenge to future reproductive decisions (Fenech & Thomson, 2014). This is therefore an important area to research, in order to alleviate some of these difficulties. The causes of traumatic birth are complex and multi-faceted (Simpson & Catling, 2016). Predisposing factors include pre-existing psychological issues (Grekin & O'Hara, 2014) or prior traumatic experiences, such as rape and sexual abuse (Ford & Ayers, 2011). Other risk factors include obstetric emergencies and neonatal complications (Grekin & O'Hara, 2014). Poor care during labour can compound these experiences, or be traumatic in its own right (Ford & Ayers, 2011; Elmir, Schmied, Wilkes & Jackson, 2010; Beck, 2004a). Attachment styles and relationships with partners can influence the likelihood of developing psychological disorders following a traumatic birth, and may influence whether a birth is experienced as traumatic too (Iles, Slade & Spiby, 2011). Women who have experienced a traumatic birth are less likely to have a subsequent pregnancy (Fenech & Thomson, 2014; Gottvall & Waldenstrom, 2002). If these women do become pregnant, they are more likely to request a non-medically indicated caesarean section (Kottmel, Hoesli, Traub, Urech, Huang, Leeners & Tschudin, 2012; Gamble & Creedy, 2001). What is less well known is what other choices women make about pregnancy and birth following a previous traumatic birth.
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Cammaroto, Laura J. "Unexpected : identity transformation of postpartum women /." Full-text of dissertation on the Internet (3.19 MB), 2009. http://www.lib.jmu.edu/general/etd/2009/Masters/Cammaroto_LauraJ/cammarlj_masters_12-11-2009.pdf.
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Andrén, Andersson Anna, and Helena Flodén. "Kvinnors upplevelser i samband med BB vård på sjukhus : En litteraturöversikt." Thesis, University of Skövde, School of Life Sciences, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-3557.
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Bakgrund: BB vården i de västerländska länderna har genomgått stora förändringar desenaste decennierna. Trots detta visar studier på att ett stort antal kvinnors inte är nöjda medden vård de fått efter barnets födelse. Syfte: Syftet med denna litteraturöversikt är att beskrivanyförlösta kvinnors upplevelser i samband med BB vård på sjukhus. Metod: Enlitteraturöversikt baserad på tio vetenskapliga artiklar med både kvalitativ och kvantitativmetod. Resultat: Fyra huvudteman framkom vid analysen av artiklarna; information,vårdorganisation och vårdmiljö, bemötande och attityder samt stöd. Det visade sig finnasväldigt många olika faktorer som påverkade kvinnors upplevelser av BB vården. Dessa kundevara mer eller mindre betydelsefulla för olika kvinnor. Kunskapen om detta kan bidra till attvårdpersonalen får en ökad förståelse för att varje nyförlöst kvinna är en unik individ medegna specifika önskemål och behov och att BB vården inte får generaliseras. Diskussion: Densjukhusförlagda BB vården måste bedrivas så att den uppfyller kravet på god vård. Detta föratt förhindra att nyförlösta kvinnor upplever onödigt vårdlidande.
Background: Postnatal care in western countries has undergone major changes in recentdecades. Despite this, studies show that many women are not satisfied with the care theyreceived after the birth. Objective: The purpose of this literature review is to describewomen's experiences of postnatal hospital care. Method: A literature review based on tenscientific articles in both qualitative and quantitative approach. Result: Four major themesemerged from the analysis of the articles; information, health care organization and healthcare environment, encounter and attitudes and support. It proved to be very many differentfactors that influenced women's experiences of postnatal care. These could be more or lessimportant for different women. Knowledge of this can contribute to health care professionalswith a better understanding of that each woman that recently given birth is a unique individualwith their own specific wants and needs and that postnatal care can not be generalized.Discussion: The postnatal hospital care must be conducted so that it meets the requirement ofgood care. This is to prevent unnecessary care suffering among women that recently givenbirth.
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Parsons, Janine, and janine parsons@svhm org au. "The Experiences of Men whose Partners have been Admitted to an Intensive Care Unit (ICU) Immediately after Childbirth." RMIT University. Health Sciences, 2008. http://adt.lib.rmit.edu.au/adt/public/adt-VIT20080805.141158.
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ABSTRACT Naturalistic Inquiry was used to explore, describe and discover the experiences and perceptions of men whose partners have been admitted to an Intensive Care Unit (ICU) immediately after childbirth. The sixteen men's experiences were explored using semi-structured open-ended questions. Data were analysed using thematic content analysis. The research questions driving this study were: What are men's experiences and perceptions of the incidence and impact of their partners being admitted to ICU following the complications of childbirth? What is the nature of the relationships and interactions that men have with healthcare professionals before, during and after their partner's ICU admission following the complications of childbirth? What impact did the experience of their partners being admitted to ICU, following the complications of childbirth, have on the men's relationships with their partners, newborn child, and other children? What impact did the experiences of their partners being admitted to ICU following the complications of childbirth have on their future life plans? During the time of their partners' obstetric crisis the men, in this study, were left isolated, alone and struggling. The current healthcare policy and practice for men with their partners in life-threatening situations intrapartum and immediately postpartum failed 16 families.
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Montgomery, Valda Harris Blessing Daniel L. "The influence of increased physical activity on weight retention, body composition, psychological profiles, and cardiovascular function in postpartum African American women." Auburn, Ala., 2007. http://repo.lib.auburn.edu/EtdRoot/2007/FALL/Health_and_Human_Performance/Dissertation/MONTGOMERY_VALDA_11.pdf.
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Carpenter, Rhiannon. "Influence of regular antenatal physical exercise on cardiovascular, haemodynamic and autonomic nervous system function during and after pregnancy." Thesis, Swansea University, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.678358.
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Smit, Joalida. "Postpartum mood disorders : a feminist critique with specific reference to postnatal depression." Thesis, Stellenbosch : Stellenbosch University, 2002. http://hdl.handle.net/10019.1/53010.
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Thesis (MA)--University of Stellenbosch, 2002ENGLISH ABSTRACT: This review examines the medical model's conceptualisation of postnatal depression (pND) from a feminist perspective. The arguments are fourfold: Firstly, it argues that the fundamental problem underlying the concept of PND is its conception as existing on a continuum with psychosis at the most severe end and maternity blues at the least severe end. The link with psychosis implies that it is potentially pathological requiring medical and psychiatric intervention. On the other hand its link with maternity blues gives scientific credence to continued research on emotional sequelae of reproduction that are below the psychiatric threshold of urgency. Secondly, the medical model's construction of PND implies that women are predisposed to mental illness because of their ability to bear children and thus pathologises normal experiences of childbirth. Thirdly, the medical model's preoccupation with classification and categorisation has become little more than an exercise in labeling that has removed women from their own experiences. Focusing on birth as an activity that is separate from the rest of pregnancy objectify women and ignores the socio-political context within which they give birth and care for their infants. Fourthly, it is argued that a different way of researching postpartum mood disorders is necessary to overcome a reductionistic and pathological model of childbirth. This is important if healthcare delivery hopes to provide adequate treatment for all women in the postnatal period. Especially in South Africa, where the dominant culture has for many years defined the experiences of the 'other', it is important to generate research that should include the 'voices' of the 'other' to prevent hegemonic practice from assuming an expert understanding of PND. This review does not deny the contributions from the medical establishment, but argues that a critique of its underlying assumptions is important to prevent women from being further marginalised by ignoring the socio-political context in which their lives are embedded. The implications for research within South Africa are also addressed.
AFRIKAANSE OPSOMMING: Hierdie oorsig ondersoek die mediese model se konseptualisering van postnatale depressie vanuit 'n feministiese perspektief. Die argument is vierledig: Eerstens blyk die konseptualisering van postnatale depressie, naamlik dat dit op 'n kontinuum bestaan, met psigose aan die mees disfunksionele kant en 'maternity blues' aan die minder ernstige kant, 'n fundamentele, onderliggende probleem te wees. Die verband met psigose impliseer dat postnatale depressie potensieel patologies is en mediese en psigiatriese insette benodig. Die verband met 'maternity blues' aan die ander kant, bied wetenskaplike begronding vir volgehoue navorsing op die gebied van emosionele aspekte van kindergeboorte wat nie van psigiatriese belang is nie. Tweedens impliseer die mediese model se konstruksie van postnatale depressie dat vroue 'n predisposisie tot geestessiektes het bloot deur die feit dat hulle die vermoë het om kinders voort te bring. Sodoende word patologiese kenmerke gekoppel aan normale ervarings van kindergeboorte. Derdens het die mediese model se beheptheid met klassifikasie en kategorisering verval in etikettering wat vroue van hul eie ervarings vervreem. Deur te fokus op geboorte as 'n aktiwiteit wat verwyder is van die res van swangerskap maak van vroue objekte wat verwyderd is van die sosio-politieke konteks waarbinne hulle geboorte skenk en sorg vir hul babas. Vierdens word dit beredeneer dat 'n nuwe benadering tot navorsing oor postpartum gemoedsteurings daar gestel behoort te word om 'n reduksionistiese en patologiese model van kindergeboorte te voorkom. Dit is belangrik as gesondheidsorgdienste hoop om toereikende behandeling te bied vir alle vroue in die postnatale periode. Veral in Suid-Afrika, waar 'n dominante kultuurgroep vir so lank die ervarings van ander omskryf het, is dit belangrik om navorsing voort te bring wat die 'stemme' van die 'ander' insluit om sodoende te verhoed dat die heersende praktykvoeringe van die dag 'n eensydige deskundige-verstaan van postnatale depressie voorveronderstel. Hierdie oorsig ontken nie die bydraes van die mediese model nie, maar beredeneer die feit dat 'n kritiese beskouing van die onderliggende aannames belangrik is om sodoende te verhoed dat vroue verder gemarginaliseer word deurdat die sosio-politieke konteks waarin hul lewens gegrond is, buite rekening gelaat word. Die implikasies vir navorsing binne 'n Suid-Afrikaanse konteks word dus ook ondersoek.
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Sembi, Sukhdev. "Mums4Mums : structured telephone peer-support for women experiencing postnatal depression : a pilot RCT to test its clinical effectiveness." Thesis, University of Warwick, 2018. http://wrap.warwick.ac.uk/114368/.
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Background: Postnatal Depression (PND) is experienced by around 13% of women, who suffer a range of disabling symptoms that can have a negative effect on the mother and infant relationship, with significant consequences in terms of the child's later mental health. Research has shown that providing support to mothers experiencing PND can help reduce their depressive symptoms and improve their coping strategies. This study aimed to evaluate the impact of telephone peer-support for women experiencing PND. Methods/Design: A pilot RCT was conducted in which women who screened positive for postnatal depression using the Edinburgh Postnatal Depression Scale (EPDS > =10) were randomised to receive telephone-based support from peers who had recovered from PND, or standard care. Primary outcome measures included depressive symptomatology measured post-intervention and at six-months using the EPDS, and parent-infant interaction using the CARE-Index. Secondary outcome measures included anxiety and depression, dyadic adjustment, parenting stress, and self-efficacy. Maternal perceptions of the telephone peer-support were being assessed using semi-structured interviews. Quantitative and qualitative data was also collected from the peer-supporters to assess the impact on them of delivering the intervention. Results: Participants: twenty-eight participants were recruited to the study, and there was a fifty-percent dropout rate (intervention group n=6, control group n=8). While there were no differences in EPDS scores between the two groups at post-intervention, the intervention group continued to improve at six-month follow-up, whereas the control group showed signs of relapse. The intervention had no impact on mother-infant interaction. In-depth interview data show that women valued the support that was provided. Peer-Supporters: nineteen peer-supporters were recruited, of whom five left before supporting a participant, and eight left after supporting only one participant. The quantitative results showed a significant non-clinical increase in anxiety at post intervention. The qualitative results indicated that the peer-supporters found the majority of calls challenging, and that delivering the intervention had had a deleterious impact on some peer-supporters. Conclusion: While these findings suggest a positive impact of telephone-based peer-support, further research into ways of improving mother-infant interaction are urgently required. Research is also required into providing effective support for the peer supporters.
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Keely, Alice. "A qualitative exploration of the experiences of clinically very severely obese women during pregnancy and the postnatal period." Thesis, Edinburgh Napier University, 2018. http://researchrepository.napier.ac.uk/Output/1255699.
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Very severe maternal obesity (BMI > 40kg/m2) increases significantly the risks of poor pregnancy outcomes for both mothers and babies. In light of the limited success of behavioural interventions to date in improving outcomes in very severely obese women, this study sought to gain an understanding of women's beliefs and experiences regarding weight, health and pregnancy, within the context of their everyday lives. Qualitative serial interviews were conducted with eleven very severely obese women during pregnancy and the postnatal period. Seven partners of the women took part in one semi-structured interview during the woman's pregnancy. Analysis took place in several stages using a thematic approach. Themes were identified within and between individual women's accounts, as well as within and between the accounts of members of couples. Participants' narratives demonstrated the ways in which they navigated the experience of high-risk pregnancy, and stigma emerged as a key theme. This research contributes new knowledge about the complex ways in which women experience ‘very severe obese' pregnant embodiment, relating to both formal and informal discourses around weight and health in pregnancy. Most undertook ‘moral accounting' in response to stigma, and several accounts resonated with Monaghan's (2006) categorisations of excuses, justifications, contrition and repudiation, in both accounting for their weight and in demonstrating their ‘fitness' for pregnancy and motherhood. Following birth, high levels of motivation to enact behaviour change were expressed, in some cases alongside repudiatory accounting regarding the associated risks and the medicalisation of very severe obesity. Participants experienced a lack of formal healthcare support in the postnatal period. Future approaches to policy and practice should consider ways in which to engage women and partners during pregnancy, exploring ways which in which stigma can be acknowledged and neutralised, in order to provide support and advice during and after pregnancy and birth, and into parenthood.
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Claesson, Ing-Marie. "Weight gain restriction for obese pregnant women : An Intervention study." Doctoral thesis, Linköpings universitet, Obstetrik och gynekologi, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-56390.
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Introduction: Obesity is a growing global public health problem and is as prevalent among pregnant women as in the general population. It is well known that obese women have an increased risk for several complications during pregnancy and delivery and this is also true for the neonate. Excessive gestational weight gain among obese women seems to further increase these risks for adverse outcomes. It has not been known up to the time of this study whether a behavioral intervention program designed for obese pregnant women could result in a reduction of gestational weight gain. Aim: The overall aim of the present thesis was to study the effect of an intervention program designed to control weight gain among obese pregnant women during pregnancy and to then observe the outcomes of their pregnancies. In addition we wanted to learn if this behavioral intervention program could result in a weight gain of less than seven kilograms. Material and methods: The intervention group consisted of 155 obese (BMI >30 kg/m2) pregnant women at the antenatal care clinic (ANC) in Linköping; the control group consisted of 193 obese pregnant women in two other cities. The women in the intervention group were offered, in addition to regular care at the ANC, motivational interviewing in weekly visits to support them in making this behavioral change. They were also offered aqua aerobic class once or twice a week. The women in the control group attended the routine antenatal program in their respective ANCs. Outcome measures were: weight in kg, pregnancy-, delivery and neonatal outcomes, prevalence of anxiety- and depressive symptoms and attitudes and experiences of participating in an intervention program. Results: The women in the intervention group had a significantly lower gestational weight gain and also had a lower postnatal weight than the women in the control group. The percentage of women in the intervention group who gained <7 kg was greater than the percentage in the control group. There were no differences between the two groups in pregnancy-, delivery- and neonatal outcomes. In addition, there was no difference in prevalence of symptoms of anxiety and depressions between the intervention- and control group and the gestational weight gain did not have any effect on symptoms of depression or anxiety. The women in the intervention group with gestational weight gain <7 kg, weighed less at the two years follow-up than the women in the control group. Most of the women who participated in the intervention program expressed positive attitudes and were positive towards their experiences with the intervention program and their efforts to manage the gestational weight gain. Conclusion: The intervention program was effective in controlling weight gain during pregnan-cy and did not change the pregnancy, delivery or neonatal outcomes or the prevalence of anxie-ty- and depressive symptoms. The group with a gestational weight gain <7 kg showed the same distribution of complications as the group with a higher weight gain. The intervention program seems to influence the development of weight in a positive direction up to two years after childbirth. The women were also satisfied with their participation in the intervention program.
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Lau, Ying. "The roles of social support in antenatal and postnatal depressive symptoms and family conflicts among Hong Kong Chinese women a three-wave prospective longitudinal study /." Click to view the E-thesis via HKUTO, 2006. http://sunzi.lib.hku.hk/hkuto/record/B37686392.
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Gamble, Jennifer Anne, and n/a. "Improving Emotional Care For Childbearing Women: An Intervention Study." Griffith University. School of Nursing, 2003. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20030904.154204.
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Childbirth can be associated with short and long-term psychological morbidity including depression, anxiety and trauma symptoms. Some previous studies have used psychological interventions to reduce postpartum distress but have primarily focussed on attempting to relieve symptoms of depression with little recognition of trauma symptoms. Furthermore, the intervention used in these studies has generally been poorly documented. The first aim of the present study was to develop a counselling framework, suitable for use by midwives, to address psychological trauma following childbirth. Multiple methods were used to develop the intervention including focus groups with women and midwives. Both the women and midwives gave unequivocal support for postpartum debriefing. Themes that emerged from the focus groups with women included the need for opportunities to talk about their birth experience, an explanation of events, an exploration of alternative courses of action that may have resulted in a different birth experience, talking about their feelings such as loss, fear, anger and self-blame, discussing social support, and discussing possible future childbearing. There was a high level of agreement between the women's and midwives' views. These themes were synthesized with contemporary literature describing counselling interventions to assist in reconciling a distressing birth experience and a model for understanding women's distressing birth experiences to develop a counselling framework. The counselling intervention was then tested using a randomised controlled study involving 400 women recruited from antenatal clinics of three public hospitals. When interviewed within seventy-two hours of birth, 103 women reported a distressing birth experience and were then randomised into either the treatment or control group. Women in the intervention group had the opportunity to debrief at the initial postpartum interview (< 72 hours postpartum) and at four to six weeks postpartum. The prevalence of posttraumatic stress disorder was quite high; 9.6% of participants meeting the diagnostic criteria for acute PTSD at four to six weeks postpartum. Fewer participants (3.5%) met the diagnostic criteria for chronic PTSD at three months postpartum. As with previous research relating to childbearing women, few demographic factors or antenatal psychological factors were associated with the development of a PTSD symptom profile following childbirth. The development of PTSD symptom profile was strongly associated with obstetric intervention and a perception of poor care in labour. This finding is also consistent with previous research. Emotional distress was reduced for women in the intervention group in relation to the number of PTSD symptoms [t (101) = 2.144, p = .035], depression [c2 (1) = 9.188, p = .002], stress [c2 (1) = 4.478, p = .029] and feelings of self-blame [t (101) = -12.424, p <.001]. Confidence about a future pregnancy was higher for these women [t (101) = -9.096, p <.001]. Although there was not a statistically significant difference in the number of women with a PTSD symptom profile at three months postpartum, fewer women in the intervention group (n=3) than in the control group (n=9) met PTSD criteria. Likewise, there were fewer women in the intervention group (n=1) with anxiety levels above mild than in the control group (n=6). Importantly, this study found that offering women who have had a traumatic birth the opportunity for counselling using the framework documented in this dissertation was not harmful. This finding is in contrast to previous findings of other studies. The intervention was well received by participants. All the women in the intervention group found the counselling sessions helped them come to terms with their birth experience. Maternity service providers need to be cognizant of the prevalence of this debilitating condition and be able to identify women at risk for early intervention and referral to a mental health practitioner if appropriate. This research offers further support for the compelling need to implement changes to the provision of maternity services that reduce rates of obstetric intervention and humanise service delivery as a means of primary prevention of birth-related PTSD.
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Coast, Mary Jo Ciancio. "Understanding respect through the lived experience of postpartum women /." Connect to full text via ProQuest. Limited to UCD Anschutz Medical Campus, 2008.
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Thesis (Ph.D. in Nursing) -- University of Colorado Denver, 2008.Typescript. Includes bibliographical references (leaves 151-159). Free to UCD Anschutz Medical Campus. Online version available via ProQuest Digital Dissertations;
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Giglia, Roslyn Carmel. "Alcohol consumption and cigarette smoking by Australian women: changes with pregnancy and lactation." Curtin University of Technology, School of Public Health, 2007. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=18768.
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The consumption of alcohol and smoking of cigarettes are both common practices in Australian society. With continued public health efforts exposure to both alcohol and nicotine during pregnancy has diminished, however little is known about exposure to these toxins in the postnatal period and the effect on the breastfed infant. To investigate the pattern of alcohol consumption and cigarette smoking in the postnatal period and the effect on breastfeeding outcomes, a longitudinal study was conducted in two public hospitals with maternity wards in Perth, Australia. Data for the Perth Infant Feeding Study (PIFSII) were collected from 587 mothers between mid-September 2002 and mid-July 2003. While in hospital participating mothers completed a self-administered baseline questionnaire. Follow-up telephone interviews were conducted at 4, 10, 16, 22, 32, 40 and 52 weeks. Data collected included sociodemographic, biomedical, hospital related and psychosocial factors. Further analysis of alcohol data was undertaken on the 1995 and 2001 National Health Survey (NHS) data sets to provide a national perspective. Alcohol and smoking related data were analysed and described using frequency distributions, means and medians. Univariate logistic regression was used to screen for potentially significant variables for subsequent incorporation in the multivariate analysis. Multivariate logistic regression analysis was employed to determine the effect of alcohol consumption and cigarette smoking on breastfeeding outcomes prenatally, antenatally and postnatally, after adjusting for factors identified in the literature as being associated with breastfeeding initiation and duration. The relationship between smoking status and breastfeeding duration was determined using survival analysis.Analysis of the relationship between breastfeeding duration and the level of postpartum intake was investigated using a Cox hazards model with repeated measures for alcohol consumption. Results showed that: 1. PIFSII. During pregnancy approximately 32% of women stopped drinking alcohol. Thirty five percent of pregnant women continued to consume alcohol during their pregnancy with 82.2% of these women consuming two or fewer standard drinks per week. At 4, 6 and 12 months postpartum, 46.7%, 47.4% and 42.3% of breastfeeding women were consuming alcohol, respectively. 2. NHS. Sixteen point four percent and 1.3% of pregnant women from the 1995 and 2001 NHS, respectively were consuming more than that recommended in ‘Guideline 11’ from the National Health and Medical Research Council of Australia (ie >7 standard drinks/week). 3. NHS. Thirteen percent of lactating mothers from the 1995 NHS and 16.8% from the 2001 NHS were consuming seven or more standard drinks of alcohol in the reference week, thus exceeding the NHMRC recommended level. 4. PIFSII. After 6 months of follow up, women who consumed alcohol at levels of more than two standard drinks per day were almost twice as likely to discontinue breastfeeding earlier than women who drank below these levels (HR 1.9, 95% CI 1.1, 3.0). 5. PIFSII. With regard to smoking, 226 (39%) of mothers reported smoking pre- pregnancy. Mothers who smoked were more likely to have a partner who smoked, to have consumed alcohol prior to pregnancy and less likely to attend antenatal classes.
They were also less likely to know how they were going to feed their baby before conception and be more inclined to consider stopping breastfeeding before four months postpartum. 6. PIFSII. Women who smoked during pregnancy had a lower prevalence and shorter duration of breastfeeding than non-smoking mothers (28 weeks versus 11 weeks, 95% CI: 8.3-13.7). This effect remained even after adjustment for age, education, income, father’s smoking status, mother’s country of birth, intended duration of breastfeeding >6 months and birth weight (risk ratio HR 1.59, 95% CI 1.22 to 2.08). 7. PIFSII. Two hundred and twenty six (39%) mothers reported smoking prior to pregnancy and 77 (34%) of these stopped smoking during pregnancy. Quitting smoking during pregnancy was significantly associated with breastfeeding for longer than six months (OR = 3.70, 95% CI 1.55 to 8.83; p<0.05). The results of the present study suggest a negative association between drinking alcohol in the postpartum period and breastfeeding outcomes. Similarly, smoking cigarettes before, during and after pregnancy negatively affects breastfeeding. There is a need for guidelines outlining the safe intake of alcohol during lactation and for the cessation of cigarette smoking in the prenatal and antenatal period.
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Bell, Kerry Jane. "Should women be screened for postnatal depression? : exploring the effects of undiagnosed maternal mental health problems on child development." Thesis, University of York, 2014. http://etheses.whiterose.ac.uk/7446/.
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Background: Evidence of a relationship between maternal postnatal depression and child development is consistently growing, but there has been no distinction between depression that is clearly diagnosed and treated, and depression that is never identified by health professionals. Previous models assessing the cost-effectiveness of screening for postnatal depression have been unable to account for child outcomes and the effects of undiagnosed maternal depression due to a lack of research in this area. Without these outcomes, screening for maternal postnatal depression is not currently considered to be cost-effective. Methods: Longitudinal survey data from the Millennium Cohort Study is used to explore the differential effects of undiagnosed and diagnosed maternal depression on child cognitive and behavioural development over time, and to re-examine whether screening for postnatal depression could be considered cost-effective once longer term child outcomes are included. Results: Depression that is undiagnosed has a substantial effect on the behavioural development of children. Children of mothers who are depressed but not diagnosed at 9 months are at least equally likely as those of mothers with diagnosed and treated depression to have behavioural problems later on in childhood. Identifying and treating maternal depression showed some short-term beneficial effect for child behavioural development up to age 5, but this was not maintained at age 7. Higher levels of persistent depression were identified in women who were diagnosed and treated for depression and this persistency was found to have an additive effect on child outcomes, with longer-term maternal mental health problems much more strongly associated with child outcomes than postnatal depression alone. Conclusions: This research highlights the limited success of current treatments for maternal depression, both in benefiting child development and providing long-term symptom remediation for mothers. As current treatments lack benefit for children over the longer-term, the recommendation that screening for postnatal depression appears not to be cost-effective remains unchanged.
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Hoosen, Nikhat. "Interventions for Improving Adherence and Retention in HIV-Infected Women on ART During Antenatal and Postnatal Care: A Systematic Review." Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/33814.
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Introduction Universal access to antiretroviral therapy (ART) during pregnancy and breastfeeding has implications for retention in HIV care and adherence to ART. Retention and adherence may be especially challenging during antenatal and postnatal periods, where women living with HIV have competing responsibilities between infant care, self-care and personal responsibilities. Lifelong ART also highlights the role interconception care (ICC) and preconception care (PCC) interventions can play in improving maternal outcomes. While the latter exist for other health topics, ICC and PCC interventions targeting women living with HIV has the potential to maintain retention in care and adherence to ART during, after, and in between pregnancies. This systematic review evaluates interventions that aim to improve retention and adherence in pregnant and postpartum women. Methods The Cochrane Library; MEDLINE via PubMed; Web of Science; and EBSCOHOST (Africa Wide, Academic Search Premier, CINAHL, PsychArticles, Health Source Nursing Academic, PsychInfo) and conference databases were searched for articles in English published between 1990 to 2020. All study designs, intervention types and geographic locations were included. Data were extracted using a standardized tool, and effect sizes recalculated for all studies. Risk of bias was conducted using tools suited to specific study designs, and the PRECIS-2 tool assessed intervention applicability in real-world settings. The protocol was registered with PROSPERO (ID: CRD42020185196). Results Thirty-one studies were identified, of which 31 and 16 provided retention and adherence data, respectively. No interconception or preconception care interventions were found. Interventions were predominantly from Sub-Saharan Africa, except one from the USA. Intervention types varied and included integration of services, peer support, mhealth and multicomponent interventions. The definitions of retention and adherence used for outcome assessment varied widely across studies, but almost all were scored as pragmatic in real-world settings. Due to high heterogeneity, a narrative approach was used based on study reported data and the effect sizes. Conclusion Overall, heterogeneity of identified studies make definitive recommendations for interventions scale up difficult. Future interventions will benefit from consistent study designs, outcome definitions, outcome measurements, validated tools, and longer retention time points will strengthen the evidence base. Ongoing studies being conducted show promise in addressing some of these points.
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Grönoset, Linda. "En känsla av otillräcklighet : En litteraturstudie om kvinnors upplevelse av förlossningsdepression." Thesis, Röda Korsets Högskola, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-1390.
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Bakgrund: Förlossningsdepression drabbar cirka 8-15 procent av nyblivna mödrar och uppstår vanligtvis inom en till tre månader efter förlossningen. Förlossningsdepression ses som ett tabubelagt problem, vilket gör det svårt att upptäcka kvinnor som drabbats. Syfte: Belysa kvinnors upplevelse av förlossningsdepression. Metod: Kvalitativ litteraturstudie. Resultat: Resultatet visade att kvinnor har orealistiska ideal och förväntningar under graviditeten som hamnar i konflikt med verkligheten efter förlossningen. Rädsla för stigmatisering är en orsak till att kvinnor har svårt att söka hjälp samt acceptera sitt tillstånd. Känslor av skuld och misslyckande var centrala delar för många kvinnor när de genomgick förlossningsdepression, vilket yttrade sig i ett lidande. Kvinnor upplevde det svårt att tala om sina känslor, både med partnern och med personer utanför familjen, i tron att ingen skulle förstå, vilket leder till ensamhet och isolering. Stödet kvinnor får av sin omgivning är av stor betydelse och ofta avgörande för hur hon tar sig an moderskapet. Slutsats: Upplevelsen av förlossningsdepression kan vara omfattande och mångfacetterad för kvinnor världen över. För många nyblivna mödrar kan stressen över sina egna och andras förväntningar bli genomgripande. Omställningen till föräldraskapet och inte minst de höga kraven på att vara en perfekt förälder kan effektivt motarbeta glädjen. Klinisk betydelse: Resultatet i studien skulle kunna bidra till hur hälso- och sjukvårdspersonal kan identifiera och hjälpa nyblivna mödrar med psykisk ohälsa. Resultatet skulle också kunna bidra till diskussion och reflektion över attityder och förhållningssätt inom hälso- och sjukvården när det kommer till psykisk ohälsa i samhället.Background: Postpartum depression affects about 8-15 percent of new mothers and usually occur within one to three months after childbirth. Postpartum depression is seen as a taboo issue, making it difficult to detect women affected. Aim: Illustrate women´s experience of postpartum depression. Method: Qualitative literature review. Results: Results showed that women have unrealistic ideals and expectations during pregnancy that conflict with reality after birth. Fear of stigmatization is a reason why women find it difficult to seek help and accept their condition. Feelings of guilt and failure were key elements for many women when they went through postpartum depression, which led to suffering. Women experienced it difficult to talk about their feelings, both with their partners and with people outside the family, in the belief that no one would understand, leading to loneliness and isolation. The support women receive from their environment is of great importance, and often determine how she tackles motherhood. Conclusion: The experience of postpartum depression can be extensive and multifaceted for women worldwide. For many new mothers stress over their own and others' expectations become pervasive. The transition to parenthood and not least the high demands of being a perfect parent can effectively shatter the joy. Clinical significance: The results of this study could contribute to how health professionals can identify and help parents with mental illness. The result could also contribute to discussion and reflection on the attitudes of health care when it comes to mental illness in the community.
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Thornton, Jill M. "Moments marked : an exploration into the ways in which women are choosing to mark aspects of their rite of passage into motherhood." Thesis, University of Manchester, 2016. https://www.research.manchester.ac.uk/portal/en/theses/moments-marked-an-exploration-into-the-ways-in-which-women-are-choosing-to-mark-aspects-of-their-rite-of-passage-into-motherhood(1205e519-4ee0-4ff5-ba3c-1be40a366087).html.
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This thesis frames the transition into motherhood as a rite of passage; proposes a new model for the rite of passage into motherhood based on the four seasons; and highlights the importance of contextual and specific ritual actions or sequences to navigate the transition. Qualitative data from semi-structured interviews with ten western women, from a middle class, Christian background, who had all become mothers through childbirth, are examined under three main headings. Firstly, the women’s experiences of their transition are explored using rites of passage theory as a lens. Although significant differences emerge, particularly from a gender perspective, important themes within the women’s experiences are highlighted, including the nature of relationships; the importance of support; journaling; and the telling of birthing stories. The influences of contemporary cultural aspects such as the medicalization of childbirth and myths about motherhood are also taken into account. Secondly, the field of ritual studies is explored in order to provide a framework in which to situate the women’s ritualizing. Existing rituals associated with motherhood are analysed and gaps are identified in existing Christian liturgical resources for this area, specifically for ritual actions or sequences marking motherhood as a rite of passage, and for the expression of birthing stories. A working definition of ritualizing is also established and the research findings are divided according to time frame, exploring the women’s ritualizing before birth, around birth and after birth. Thirdly, spirituality in relation to childbirth and the transition into motherhood is explored and its place within healthcare and theological literature examined. Nicola Slee’s theory on women’s faith development is used to draw out some of the patterns that emerge from the interviewees’ experiences, and the sacramental nature of birthing is considered. The thesis concludes with a critique of implications and associated suggestions for those within a church or healthcare context with responsibility for the pastoral and spiritual care of women during their transition into motherhood.
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Campbell, Erica Basora. "The nurse's role in postpartum depression assessment, education and referral for women and their support system." Honors in the Major Thesis, University of Central Florida, 2010. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/1376.
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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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Zheng, Xujuan. "An exploration of factors which influence maternal self-efficacy in primiparous women in China during the initial postnatal period : a longitudinal study." Thesis, University of Nottingham, 2015. http://eprints.nottingham.ac.uk/30784/.
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Background: There are many problems of parenting during infancy for Chinese primiparous women. As an important determinant of good parenting, maternal self-efficacy (MSE) should be paid more attention by researchers. At present, the limitations of previous research examining MSE during infancy are that most studies were related to a homogeneous sample (approximately 90% white) and lacked the consideration of cultural effect; the influencing factors remained poorly explored; and there were few studies related to Chinese women. Therefore, it is necessary to assess MSE and to thoroughly explore the factors influencing MSE among Chinese primiparous women in consideration of the Chinese postnatal culture of “Doing the month” to fill the research gap. Aim: The aim of this study was to describe MSE and to explore factors which may influence MSE in primiparous women in China in the first three months postnatally. Methods: A quantitative longitudinal study using questionnaires was conducted. In total, 420 primiparous women were recruited in obstetric wards at three hospitals in Xiamen City, China. Initial baseline questionnaires to measure socio-demographic and clinical characteristics at three days postnatally were distributed to participants face-to-face by the researcher on the postnatal ward. Participants’ contact details were also collected. Follow-up questionnaires at six and 12 weeks were sent via email by the researcher to participants, including the Self-efficacy in Infant Care Scale (SICS), the Edinburgh Postnatal Depression Scale (EPDS) and the Postpartum Social Support Scale (PSSS) to measure MSE, postnatal depression symptoms and social support, respectively. These were returned by participants via email. Quantitative data were analysed using SPSS. Results: The mean MSE score at six weeks postnatally was 74.92 (SD=11.05), and increased to 77.78 (SD=11.13) at 12 weeks postnatally. The mean social support scores at six and 12 weeks postnatally were 40.99 (SD=9.31) and 43.00 (SD=9.55). The mean EPDS scores decreased from 9.09 (SD=4.33) at six weeks postnatally to 8.63 (SD=4.40) at 12 weeks postnatally; the proportion of women with an EPDS score of ten or more at the two time points declined from 47.4% to 38.3%. The mean score of how satisfied women were with “Doing the month” was 68.73 (SD=17.65) at six weeks postnatally, with most women (91.4%) thinking that “Doing the month” after childbirth was necessary. In the multivariate analysis, the variables: social support scores, women’s satisfaction with “Doing the month” scores, EPDS scores, maternal education, maternal occupation, baby health scores, and baby fussiness scores affected MSE scores during the initial postnatal period. Conclusions: In this study, Chinese primiparous women had a moderate level of MSE and received a moderate level of social support at six and 12 weeks postnatally, and a higher proportion of Chinese women had postnatal depression symptoms than did women in Western countries. From six to 12 weeks postnatally, the mean MSE scores and social support scores had a statistically significant increase; the mean EPDS scores had a statistically significant decrease. “Doing the month” was still popular in Chinese modern society and almost half of the women felt satisfied about their experience of “Doing the month”. Obstetric nurses and women’s family members need to be aware of the significant contribution of social support, women’s satisfaction level with “Doing the month” in positively influencing primiparous women’s MSE, and the significant effect of postnatal depression symptoms in negatively impacting on first-time mothers’ MSE; they should pay more attention to primiparous women with less education, unemployed mothers, women with unskilled occupations, women with an unhealthy baby, and women with a baby with a difficult temperament to improve their comparatively lower MSE levels during the initial postnatal period.
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Matji, Joan Nteboheleng. "Association between postnatal maternal nutritional status, maternal HIV disease progression and infant feeding practices in 4 clinics in Pretoria, South Africa." Pretoria: [s.n.], 2009. http://upetd.up.ac.za/thesis/available/etd-03082010-090805/.
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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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Mandima, Patrica Fadzayi. "Determining the level of non-booking for antenatal care and associated barriers as well as risk for mother to child transmission of HIV among pregnant women in Chitungwiza city, Zimbabwe." University of Western Cape, 2020. http://hdl.handle.net/11394/7671.
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Master of Public Health - MPHPMTCT is an effective strategy in preventing paediatric HIV infection. In Zimbabwe the success of PMTCT is entirely dependent on pregnant women accessing antenatal care services and through that, getting linked to PMTCT. Failure of pregnant women to book for antenatal care through the course of pregnancy presents a missed opportunity for PMTCT and a high risk for maternal HIV transmission. It is therefore important to determine the burden of unbooked women and the factors associated with it, if elimination of maternal HIV transmission is to be achieved in the country.
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Zhong, Qiu-Yue, Bizu Gelaye, Sixto E. Sánchez, Gregory E. Simon, David C. Henderson, Yasmin V. Barrios, Pedro Mascaro Sánchez, Michelle A. Williams, and Marta B. Rondón. "Using the Patient Health Questionnaire (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS) to assess suicidal ideation among pregnant women in Lima, Peru." Pubmed Central (PMC), 2015. http://hdl.handle.net/10757/610658.
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We sought to examine the concordance of two suicidal ideation items from the Patient Health Questionnaire-9 (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS), to evaluate the prevalence of suicidal ideation among pregnant women, and to assess the co-occurrence of suicidal ideation with antepartum depressive symptoms. A cross-sectional study was conducted among 1,517 pregnant women attending prenatal care clinics in Lima, Peru. Item 9 of the PHQ-9 assesses suicidal ideation over the last 14 days while item 10 of the EPDS assesses suicidal ideation in the past 7 days. The two suicidal ideation items have a high concordance rate (84.2 %) but a moderate agreement (the Cohen's kappa = 0.42). Based on the PHQ-9 and the EPDS, 15.8 and 8.8 % of participants screened positive for suicidal ideation, respectively. Assessed by the PHQ-9, 51 % of participants with suicidal ideation had probable depression. In prenatal care clinics, screening for suicidal ideation is needed for women with and without depressive symptoms. Future studies are needed to identify additional predictors of antepartum suicidality, determine the appropriate duration of reporting period for suicidal ideation screening, and assess the percentage of individuals with positive responses to the two suicidal ideation items at high risk of planning and attempting suicide.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 the 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 Especializado Materno Perinatal, Peru for their expert technical assistance with this research. The authors would like to thank Kathy Brenner for her help with revising this manuscript.
Revisión por pares
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Parvin, A. A. "Investigating the meanings of maternal distress following childbirth : comparing the understandings and accounts of general practitioners and Bangladeshi women with a diagnosis of postnatal depression." Thesis, University of East London, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.532477.
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Lau, Ying, and 劉櫻. "The roles of social support in antenatal and postnatal depressive symptoms and family conflicts among Hong Kong Chinese women: a three-wave prospective longitudinal study." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B37686392.
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Jha, Paridhi. "‘Two Sides of a Coin’ : Quality of Childbirth Services in Indian Public Health Facilities, from the Perspectives of Women and their Care Providers." Doctoral thesis, Uppsala universitet, Institutionen för kvinnors och barns hälsa, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-331673.
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Background: Skilled birth attendance, usually available by promoting childbirth at health care institutions in low-resource settings, is known to prevent maternal and neonatal morbidity and mortality. While institutional childbirths in India have increased at an exponential rate, the infrastructure, material and manpower resources to support this practice are lagging, raising concerns about the quality of childbirth services. Methodology: A mixed-method approach was used in this project: in-depth interviews with women (n= 13); and focus-group-discussions with the care providers (n=27) were conducted and analysed using Grounded Theory. A cross-sectional survey (n= 1004) assessed prevalence of Fear of Birth (FoB) and postnatal depressive symptoms (PND), along with satisfaction with childbirth services among women in the immediate postpartum period. Results: The system of cashless childbirth provided at the public health facilities, in the women’s experiences, came at the hidden cost of them having to make themselves subordinate to the offered services. The prevalence of FoB and PND was 13.1% and 17.1%, respectively, and these were significantly associated (p < 0.001). Among women with vaginal births (VB), 41.2% had experienced a perineal wound and 59% of them underwent repair without local anaesthesia. While the majority of the women were satisfied (VB 68.7%; Caesarean births 79.2%) with the services; women having VBs at Community Health Centres (nearly 81%) were more commonly satisfied compared to those at the District Hospitals (nearly 60%) (p < 0.001). From the care providers’ perspective, maintaining quality of childbirth services was like a balancing act between the realities of low-resource settings with stakeholders’ expectations. While the providers remained proud and committed; the challenges often left them fatigued, disillusioned, irritable and sceptical. Conclusion: There is a need to improve the sensitivity with which childbirth services are being delivered to women coming to public health facilities; as well as towards improving the care providers’ work conditions. Suboptimal birth experiences are associated with the women’s perinatal mental health and satisfaction, while perpetual work challenges may make the care providers frustrated and/or apathetic. Improving manpower resources could reduce work-stress in care providers and thereby improve childbirth processes.
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Tsivos, Zoe-Lydia. "A pilot randomised controlled trial to evaluate the efficacy and acceptability of the Baby Positive Parenting Programme compared with 'treatment as usual' in women with postnatal depression." Thesis, University of Manchester, 2013. https://www.research.manchester.ac.uk/portal/en/theses/a-pilot-randomised-controlled-trial-to-evaluate-the-efficacy-and-acceptability-of-the-baby-positive-parenting-programme-compared-with-treatment-as-usual-in-women-with-postnatal-depression(c70add1c-d93d-4eef-93c0-baf7f1d31260).html.
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Postnatal depression (PND) is an episode of major depression which occurs within the postnatal period. It has major implications for maternal wellbeing, the mother-infant relationship and child development. Whilst there is considerable evidence demonstrating the impact of PND on parenting, there has been limited focus on parenting as an intervention target. Therefore, the foremost aim of this thesis was to assess the efficacy and acceptability of the Baby Positive Parenting Programme (Baby Triple P) in women with Postnatal Depression. In Chapter 1 a broad overview of the PND treatment literature is undertaken. The treatments represent a range including anti-depressant medication, antenatal group interventions, psychoeducation, cognitive behaviour therapy (CBT), interpersonal psychotherapy (IPT), interventions which focus on the mother-infant relationship and baby massage. Chapter 1 highlights the poverty of interventions focusing on parenting as well as limited assessment of dyadic and child developmental outcomes. Therefore, a systematic review in Chapter 2 sought to evaluate the quality and efficacy of treatments which did include the aforementioned outcomes. Having identified the little attention to parenting within the context of PND, Chapter 3 outlines the rationale for targeting parenting in PND and introduces the Triple P Positive Parenting Programme, its evidence base and details Baby Triple P. Self-regulation is also introduced as a possible mechanism for explaining the improvements and maintenance associated with Triple P programmes. Since there is no measure to assess self-regulation, one was designed for the purpose of this study. Chapter 4 presents the methodology for the two aforementioned empirical papers. Chapter 5 presents a Factor Analysis (FA) and psychometric properties of the Brief Parenting Beliefs Scale-baby version, designed to measure self-regulation in new parents. The result was a three-factor, brief reliable measure of self-regulation. Chapter 6 presents the findings from the pilot randomised controlled trial (RCT) of Baby Triple P, compared with treatment as usual (TAU) in a sample of women with PND. Twenty-seven women and their infants (under 12 months) from primary care services in Greater Manchester, UK, were randomised to either receive the eight-session Baby Triple P programme in addition to TAU or to TAU only. Participants were assessed prior to randomisation at Baseline (Time 1), post-treatment (eight weeks for TAU) (Time 2) and three-month follow-up (Time 3). Self-report measures were used to compare groups, including symptoms of depression, happiness, the parenting experience, subjective bonding and self-regulation. An assessor-rated observational measure of mother-infant interaction, the Care Index, and a measure of intervention acceptability were also included. Significant improvements from baseline to post-treatment and baseline to three-month follow-up were found across both Baby Triple P and TAU conditions. However, the present study failed to demonstrate an additive effect of Baby Triple P. Despite the non-significant findings Baby Triple P was found to be highly acceptable to women with PND.Reasons for the non-significant findings are explored. The final Chapter (7) is a general discussion summarising the preceding chapters and provides a critical analysis of the pilot RCT of Baby Triple P.