RESUMEN
OBJECTIVE: The present study had two aims: first, to identify developmental patterns of burnout in middle-aged women from the working population and, second, to evaluate whether work-related and individual factors are associated with concurrent changes in burnout. METHODS: The study design was longitudinal and used a random, population-based sample of urban middle-aged women. One baseline and two follow-up assessments were carried out during a 9-year period. At baseline, 142 women participated. Complete data were available for 116 women, who constituted the sample of the present study. Burnout was assessed using the Shirom-Melamed Burnout Questionnaire (SMBQ). In order to identify typical developmental patterns (trajectories) hierarchical cluster analysis was used. Within-group changes in burnout levels over time were analyzed using repeated-measures analysis of variance (ANOVA). RESULTS: When using a variable-based approach, the results showed no significant changes in burnout over time. However, underlying these levels, six trajectories were identified. These clusters represented four different developmental patterns: high levels followed by recovery, increasing levels, increasing and diminishing levels, and stable levels. CONCLUSIONS: In contrast to previous research suggesting that burnout is a stable construct over time, the present study identified distinct subgroups of women showing different developmental patterns of burnout during a 9-year period. Furthermore, our findings showed that the development of burnout was accompanied by concurrent changes in life stress as well as work-related and individual factors.
Asunto(s)
Agotamiento Profesional/epidemiología , Estrés Psicológico/psicología , Mujeres Trabajadoras/psicología , Análisis de Varianza , Agotamiento Profesional/psicología , Análisis por Conglomerados , Femenino , Humanos , Estudios Longitudinales , Persona de Mediana Edad , Vigilancia de la Población , Escalas de Valoración Psiquiátrica , Sentido de Coherencia , Apoyo Social , Factores Socioeconómicos , Encuestas y Cuestionarios , Población UrbanaRESUMEN
The psychological functioning of fathers with children born after in vitro fertilization (IVF) has received little attention. Among men in general, little is known about predictors of early father-infant relationship (here also defined as attachment). The first aim was to compare IVF fathers and control fathers regarding personality traits, state anxiety, depressive symptoms and early father-infant attachment. The second aim was to assess whether early father-infant relationship is explained by the father's prenatal relationship with the unborn infant, his personality traits, state anxiety and symptoms of depression. Fifty-three IVF fathers and 36 controls filled in self-rating scales measuring father-infant attachment, personality, anxiety and symptoms of depression at 2 months postpartum. At gestational week 26 their prenatal relationship to the unborn infant was assessed. It was found that IVF fathers rated more somatic and psychic anxiety, indirect aggression and less assertiveness. They were as strongly attached to their infant as the controls. Fathers, who had rated higher attachment to their unborn infant during pregnancy, who were less anxious, more assertive and less irritable, were more attached to their infants than men who had been less attached to their unborn infants and who were more anxious, less assertive and more irritable. In conclusion, although IVF fathers are as strongly attached to their infants as other fathers, they may benefit from emotional support as they have elevated levels of anxiety proneness and indirect aggression. It is important to pay attention during pregnancy to fathers who have a less optimal attachment to their unborn infant and who have high levels of anxiety and irritability, as those three factors are related to a weak emotional father-infant relationship.
Asunto(s)
Actitud Frente a la Salud , Relaciones Padre-Hijo , Padre/psicología , Fertilización In Vitro/psicología , Adulto , Agresión/psicología , Ansiedad/diagnóstico , Ansiedad/etiología , Ansiedad/psicología , Asertividad , Estudios de Casos y Controles , Depresión/diagnóstico , Depresión/etiología , Depresión/psicología , Fertilización In Vitro/efectos adversos , Humanos , Lactante , Genio Irritable , Acontecimientos que Cambian la Vida , Estudios Longitudinales , Masculino , Investigación Metodológica en Enfermería , Apego a Objetos , Responsabilidad Parental/psicología , Personalidad , Análisis de Regresión , Índice de Severidad de la Enfermedad , SueciaRESUMEN
CONCLUSION: Hormone replacement therapy (HRT) may have a protective effect on hearing impairment in postmenopausal women. New guidelines for classification of audiometric configuration in age-related hearing loss are suggested. OBJECTIVES: To describe prevalence of hearing loss and audiometric configuration in a group of middle-aged women with respect to menopausal stage and HRT. SUBJECTS AND METHODS: A total of 143 women around menopause were sampled through the Swedish population register. The mean hearing threshold levels were compared according to menopausal status. The audiograms in the 57 women with hearing loss were classified according to audiometric configuration. RESULTS: In all, 57 women (40%) had any kind of hearing loss; 42 had very minute hearing loss; 15 had a 4FA (average of thresholds at 0.5, 1, 2, and 4 kHz) of at least 20-39 dB HL in at least one ear. Two of these had a 4FA of 40-69 dB HL in at least one ear. The most common configurations were: gently sloping (47%), steeply sloping (14%), and high-frequency U-shaped (14%). The postmenopausal women who were not on HRT had poorer hearing mainly at 2 and 3 kHz, compared with pre- and perimenopausal women, and postmenopausal women on HRT.
Asunto(s)
Pérdida Auditiva/epidemiología , Pérdida Auditiva/fisiopatología , Terapia de Reemplazo de Hormonas , Menopausia/fisiología , Audiometría de Tonos Puros , Umbral Auditivo/fisiología , Femenino , Humanos , Persona de Mediana Edad , Sistema de Registros , Muestreo , Suecia/epidemiologíaRESUMEN
BACKGROUND: Investigators have pointed out that long-awaited pregnancies, such as those after in vitro fertilization (IVF), are emotionally vulnerable. In addition, higher pregnancy-related distress has been found among women pregnant after in vitro fertilization compared with women with "naturally" achieved pregnancy. The aim of this study was to compare prenatal attachment among IVF mothers and control mothers (women who conceived naturally), and to study relationships between prenatal attachment and psychosocial variables. METHODS: Fifty-six IVF women from IVF clinics and 41 control women from antenatal clinics in Stockholm were assessed in gestational weeks 26 and 36. They completed self-rating scales measuring prenatal attachment, personality, marital relationship, anxiety, and depression. RESULTS: Prenatal attachment increased as the pregnancy progressed in both groups. Prenatal attachment rated in gestational week 26 was significantly associated with that in gestational week 36. Multiple regression analyses showed that, in gestational week 26, prenatal attachment was explained by satisfaction with the partner relationship, whereas in gestational week 36 the factors contributing to high prenatal attachment were low scores of the personality trait detachment, low ambivalence, and younger age. Method of conception was unrelated to prenatal attachment at either assessment time point. CONCLUSIONS: In vitro fertilization mothers are attached to their unborn children to the same extent as other mothers. Prenatal attachment increases during pregnancy. At the same time, however, individual scores on prenatal attachment seem to be relatively stable. Significant contributors to prenatal attachment are marital satisfaction, age, ambivalence, and detachment.
Asunto(s)
Fertilización In Vitro/psicología , Infertilidad/psicología , Salud Mental , Embarazo/psicología , Estrés Psicológico/epidemiología , Adulto , Factores de Edad , Ansiedad/epidemiología , Ansiedad/etiología , Estudios de Casos y Controles , Emociones , Femenino , Edad Gestacional , Humanos , Estado Civil , Personalidad , Atención Prenatal , Estrés Psicológico/etiologíaRESUMEN
OBJECTIVE: The aim of the present study was to investigate whether there is an association between serum cortisol and work-related stress, as defined by the demand-control model in a longitudinal design. METHODS: One hundred ten women aged 47-53 years completed a health questionnaire, including the Swedish version of the Job Content Scale, and participated in a psychological interview at baseline and in a follow-up session 2 years later. Morning blood samples were drawn for analyses of cortisol. RESULTS: Multiple stepwise regression analyses and logistic regression analyses showed that work demands and lack of social support were significantly associated with cortisol. CONCLUSIONS: The results of this study showed that negative work characteristics in terms of high demands and low social support contributed significantly to the biological stress levels in middle-aged women. Participation in the study may have served as an intervention, increasing the women's awareness and thus improving their health profiles on follow-up.
Asunto(s)
Nivel de Alerta/fisiología , Hidrocortisona/sangre , Medio Social , Carga de Trabajo/psicología , Lugar de Trabajo , Concienciación , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Terapia de Reemplazo de Hormonas , Humanos , Control Interno-Externo , Entrevista Psicológica , Estilo de Vida , Estudios Longitudinales , Menopausia/sangre , Persona de Mediana Edad , Ausencia por Enfermedad , Apoyo Social , Estrés Psicológico/sangre , Estrés Psicológico/complicaciones , SueciaRESUMEN
OBJECTIVE: There is currently little longitudinal data available on the serum hormonal characteristics of the menstrual cycles observed in women as they approach their final menstrual period (FMP) or menopause. We sought to determine whether the onset of irregular menses, marking the menopause transition, signifies the occurrence of anovulatory, potentially infertile cycles. DESIGN: We studied 12 subjects, initially aged 45 to 47 years, who provided daily menstrual diaries, and had blood samples collected annually, three times weekly for 4 consecutive weeks, over a period of 36 to 98 months until FMP, for measurements of serum follicle-stimulating hormone (FSH), luteinizing hormone, estradiol, and progesterone. The definition of entry into the early menopause transition was the occurrence of more than two cycles, in any consecutive sequence of 10, where cycle length was less than 23 or more than 35 days. Entry into the late transition was determined from the first observation of either 60-day or 90-day amenorrhea. Cycles were characterized endocrinologically as normal ovulatory, abnormal luteal phase, and anovulatory with evidence of ovarian follicular activity. RESULTS: The early transition had an average duration of 47 months from onset until FMP. Ten of the 12 subjects had one or more ovulatory cycles during the transition. Anovulatory cycles with ovarian activity were noted in 9 of the 12 subjects, only after entry into early and/or late transition. CONCLUSIONS: Ovulatory cycles occurred both before and after entry into the early and/or late menopause transition in subjects older than 45 years of age, whereas anovulatory cycles were observed only during the transition. The ovulatory cycles were generally associated with normal menses, whereas anovulatory cycles showed long duration and/or abnormal bleeding patterns. The occurrence of cycle irregularity is associated with an increasing frequency of anovulatory cycles, which herald the occurrence of FMP. No conclusion could be drawn regarding the appropriate definition of entry into the late transition. The definition adopted for entry into the early transition merits further validation.
Asunto(s)
Hormonas/sangre , Menopausia/fisiología , Ciclo Menstrual/metabolismo , Ovario/metabolismo , Anovulación/sangre , Anovulación/metabolismo , Estradiol/sangre , Femenino , Hormona Folículo Estimulante/sangre , Humanos , Estudios Longitudinales , Hormona Luteinizante/sangre , Ciclo Menstrual/sangre , Persona de Mediana Edad , Progesterona/sangreRESUMEN
To examine the hormonal characteristics of menstrual cycles in healthy women approaching menopause, serum hormone profiles were investigated annually in this longitudinal study of 13 healthy women between 4 and 9 yr before menopause and the year of the menopause. Serum FSH, LH, estradiol, progesterone, total inhibin, inhibins A and B, and prolactin were determined in blood samples collected annually three times weekly for 4 wk beginning with the onset of menses. Menstrual bleeding diaries covering this 4- to 9-yr period were also collected allowing the prospective identification of the final menstrual period. A change in serum hormone patterns was observed in cycles approaching menopause, exemplified by an increasing number of cycles of prolonged length with a prolonged follicular phase resulting in a failure to detect a luteal phase rise in serum progesterone within the 4-wk collection period. These prolonged cycles (designated B cycles based on a previous work) were analyzed separately and compared with the remaining ovulatory (D) cycles. No B cycles were identified in any women earlier than 27 cycles from menopause. The proportion of B cycles increased as menopause approached, reaching 62% in the last 10 cycles. The proportion of D cycles decreased accordingly. The B cycles during the initial 4-wk collection period were characterized by elevated FSH, LH, FSH/inhibin A and FSH/inhibin B ratios, and longer duration, although cycle length/subject was not significantly different presumably due to the small number of B cycles. The D cycles showed no changes in hormonal profiles over the 4- to 9-yr time period. These data indicate that there is a time-related change in the character of menstrual cycles as menopause approaches, with an increasing proportion of cycles observed with prolonged follicular phases that may either be delayed ovulatory cycles or anovulatory cycles. The increase in the proportion of B cycles with elevated early follicular phase FSH levels and low inhibin/FSH ratios toward menopause provides a basis for the apparent early increase in serum FSH and decrease in serum inhibins observed previously in studies of the menopause transition based on sampling confined to the follicular phase only. The data amplify and clarify current concepts of the endocrine basis of the menopause transition.
Asunto(s)
Hormonas/sangre , Menopausia/metabolismo , Ciclo Menstrual/metabolismo , Estradiol/sangre , Femenino , Hormona Folículo Estimulante/sangre , Humanos , Inhibinas/sangre , Estudios Longitudinales , Hormona Luteinizante/sangre , Persona de Mediana Edad , Ovario/fisiología , Progesterona/sangre , Prolactina/sangreRESUMEN
OBJECTIVE: To assess the emotional impact of infertility after successful IVF and to compare parents who have undergone IVF (IVF parents) and parents who have not undergone IVF (non-IVF parents) regarding parental stress and the marital relationship during the transition to parenthood. DESIGN: A study with qualitative and longitudinal quantitative assessments. SETTING: University IVF clinics and antenatal clinics in Stockholm. PATIENT(S): Fifty-five IVF mothers, 53 IVF fathers, 40 non-IVF mothers, and 36 non-IVF fathers. INTERVENTION(S): IVF parents were interviewed. All subjects completed self-rating scales in early pregnancy and at 2 and 6 months postpartum. MAIN OUTCOME MEASURE(S): Interviews about perception of infertility and scalar measurement of parental stress and the marital relationship. RESULT(S): Negative feelings related to infertility were not easily overcome among the IVF parents. Their levels of stress related to parenthood were similar to those of non-IVF parents, and both groups reported decreased satisfaction with the marital relationship during the transition to parenthood. CONCLUSION(S): The inability to conceive naturally continues to affect the current lives of a proportion of IVF parents. The results suggest that IVF parents may benefit from counseling with regard to the potential long-term impacts of infertility, disclosure issues, and decisions regarding future children. However, levels of parental stress and patterns of partner satisfaction are similar to those of parents with children conceived "naturally."
Asunto(s)
Adaptación Psicológica , Fertilización In Vitro/psicología , Adulto , Emociones , Femenino , Humanos , Infertilidad/psicología , Estudios Longitudinales , Masculino , Matrimonio , Persona de Mediana Edad , Responsabilidad ParentalRESUMEN
BACKGROUND: Little is known as to whether negative experiences associated with infertility and IVF treatment persist after successful treatment. The aim of the study was to compare couples who have conceived after IVF and couples who have conceived naturally regarding personality factors and emotional responses to pregnancy. METHODS: Fifty-seven women pregnant after IVF and 55 male partners and 43 women who had conceived naturally and 39 male partners were recruited from university IVF clinics and antenatal clinics in Stockholm. The subjects were interviewed about their socio-demographic background. They completed scales of personality traits, anxiety, emotional responses to pregnancy, marital adjustment and reactions to recalled infertility while in pregnancy week 13 (range 11-17). RESULTS: The results showed that the IVF women had more muscular tension and were more anxious about loosing the pregnancy than the control women. The IVF women with high infertility distress were more anxious about loosing the pregnancy and less ambivalent than the women with lower distress. The IVF men had more somatic anxiety, indirect aggression, guilt, and were more detached and more anxious about loosing the pregnancy and less ambivalent than the control men. The IVF men with high infertility distress were more anxious about the baby not being normal than the men with lower infertility distress. CONCLUSIONS: The women and men who had conceived after IVF differed on a number of personality dimensions and emotional responses to the pregnancy from that of the women and the men who had conceived naturally. The results suggest that IVF couples may need additional emotional support in early pregnancy.
Asunto(s)
Emociones , Fertilización In Vitro/psicología , Infertilidad/psicología , Relaciones Interpersonales , Estrés Psicológico/etiología , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Infertilidad/terapia , Masculino , Personalidad , Embarazo , Resultado del Embarazo , Primer Trimestre del Embarazo , Esposos/psicología , Estrés Psicológico/psicología , Encuestas y CuestionariosRESUMEN
UNLABELLED: One hundred and forty-three women born 1942 were followed for 5 years during transition to menopause (49--54 years of age). Changes in menopausal status, body mass index (BMI) and circulating lipoproteins cholesterol, (chol), low density lipoprotein (LDL), high density lipoprotein, (HDL) and total triglycerides (TG) were measured, once yearly and compared with a control group of normally menstruating healthy, non-smoking women 23--39 years old. RESULTS: Chol was significantly higher P<0.0001 in the study group visits 1--5 when compared with the controls and higher at visit 4 compared with visit 1(P<0.05) LDL was significantly lower in the study group and at visit 5 compared with visit 2 (P<0.05) HDL was significantly lower at visits 1--3 and 5 when compared with the controls (P<0.001) and to visit 4 (P<0.0001). TG was significantly higher in the study group (P<0.0001) and increased significantly during the 5-year study. BMI was significantly higher in the older women (P<0.001) and increased during 5-years of study (P<0.0001). When multiple stepwise regression analyses were performed at visit 5 using education, menopausal status, use of hormone replacement therapy (HRT), BMI and smoking as predictor variables, postmenopausal status was found to be significantly associated with high LDL (P<0.3), while high BMI significantly predicted low HDL and high TG levels. Perimenopausal status was significantly associated with high HDL levels. CONCLUSION: Age, BMI and menopausal status are significant predictors of circulating lipoprotein levels during transition to menopause.