RESUMEN
BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is a condition that is characterized by symptoms such as inattentiveness, hyperactivity, and impulsivity. The influence of mothers with ADHD and their attitude towards their wards' oral health has not been explored in the Indian scenario. AIM: The aim of this study was to assess the prevalence of ADHD in mother-child dyads in western Tamil Nadu and the mothers' dental neglect toward their children. METHODOLOGY: The prevalence of ADHD in mothers and children was assessed using the Adult ADHD Self-report Scale screener and ADHD Rating Scale, respectively. The Child Dental Neglect Scale (CDNS) was used to assess dental neglect in children. The responses were recorded on a Likert scale and statistical analyses were done. RESULTS: The prevalence of ADHD in mothers and children was 10.65% and 10.57%, respectively. The impulsivity and hyperactivity type of ADHD was commonly seen in both the mothers and their children. Mothers without ADHD felt that their children maintained their oral health well. Mothers with ADHD deferred the needed dental treatment for their children. CONCLUSION: Mothers with ADHD have four times more risk of having children with ADHD. Maternal ADHD influences their child's oral health. Child dental neglect was more prevalent among mothers with ADHD.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad , Madres , Humanos , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/psicología , Estudios Transversales , Femenino , Niño , India/epidemiología , Madres/psicología , Prevalencia , Adulto , Masculino , Preescolar , Salud Bucal , Maltrato a los Niños/psicología , Maltrato a los Niños/estadística & datos numéricosRESUMEN
Adolescent mothers face numerous challenges while breastfeeding. This study aimed to assess the breastfeeding needs of adolescent mothers. For this systematic review, Web of Science, PubMed, Scopus, Cochrane Library, SID and Magiran databases were searched. The initial search yielded 2,290 studies, of which 41 were included in this review. Adolescent mothers' breastfeeding requirements were grouped into 8 categories: (1) social support from healthcare providers, partners and families; (2) school support for breastfeeding mothers; (3) breastfeeding counselling based on cultural sensitivities; (4) educational assistance from health providers for adolescent mothers' families; (5) changing harmful cultural values and judgments about adolescent mothers' breastfeeding; (6) additional home or outpatient visits in the days following hospital discharge; (7) peer support and counselling; and (8) economic needs. To promote breastfeeding, policymakers and healthcare providers should devise specifically tailored programmes and interventions to cater to the specific requirements of adolescent mothers.
Asunto(s)
Lactancia Materna , Madres , Humanos , Lactancia Materna/psicología , Lactancia Materna/estadística & datos numéricos , Lactancia Materna/métodos , Adolescente , Femenino , Madres/psicología , Madres/estadística & datos numéricos , Apoyo Social , Embarazo en Adolescencia/prevención & control , Embarazo en Adolescencia/estadística & datos numéricos , Embarazo en Adolescencia/psicologíaRESUMEN
OBJECTIVE: This study aims to identify factors associated with excessive screen time among preschoolers in Lima, Peru. METHODS: Cross-sectional analysis from a 2019 panel study in Lima, Peru, was conducted focusing on women, aged 18 and above, who are mothers of 3- to 5-year-olds in mid-high and mid-low districts. There were two outcome variables: excessive TV and excessive electronic devices screen time, defined as ≥ 1 h of screen exposure for each one. Explored factors included the mother's age, education and wealth index and the children's age, sex, physical activity, day care attendance and ultra-processed food consumption. Crude (cPR) and adjusted prevalence ratios (aPR) were estimated for the association between associated factors and excessive screen time using the GLM Poisson of with a logarithmic link. RESULTS: Excessive TV screen time and electronic devices prevalence was 74% and 36.9%, respectively. For TV screen time, a high wealth index (aPR 1.13; 95%CI: 1.03-1.23) and children's age (aPR 1.18; 95%CI: 1.08-1.29 for 4 years, PR = 1.17; 95%CI: 1.07-1.28 for 5 years) were significant. For electronic devices, significant associations included mothers with more than 3 children (aPR 0.77; 95%CI: 0.62-0.96), being single (aPR 1.27; 95%CI: 1.01-1.58) and a high wealth index (aPR 1.38; 95%CI: 1.13-1.68). Furthermore, significant associations were found between excessive electronic device screen time and consumption of candies and chocolates (aPR 1.38; 95%CI: 1.08-1.77). CONCLUSIONS: Seven out of 10 preschool children exceeded the recommended television screen time. Certain characteristics of the children, their mothers and the family's socio-economic situation are related to excessive television screen time and excessive electronic device screen time.
Asunto(s)
Tiempo de Pantalla , Televisión , Humanos , Perú/epidemiología , Preescolar , Femenino , Estudios Transversales , Masculino , Televisión/estadística & datos numéricos , Adulto , Madres/estadística & datos numéricos , Madres/psicología , Conducta Sedentaria , Factores Socioeconómicos , Adulto Joven , Adolescente , PrevalenciaRESUMEN
INTRODUCTION: Postpartum anxiety after childbirth is a common condition among pregnant women due to reasons such as the uncertainty of experiencing pregnancy and childbirth for the first time, or previous negative experiences. Fear of childbirth can affect the mother's baby care process. OBJECTIVE: This study was conducted analytically with a single-subject design to determine the effects of maternal concerns about childbirth and the postpartum period on obsessive and compulsive behaviors related to baby care. MATERIALS AND METHODS: The study was conducted with 260 mothers. Data were collected using a descriptive information form, and the scales 'Fear of Childbirth and Postpartum Period', and 'Obsessive and Compulsive Behaviors of Mothers in the Postpartum Period Related to Baby Care'. The data were analyzed using the SPSS™ software to calculate percentages, mean values, t tests, ANOVA, Pearson's correlation, and simple linear regression analysis. RESULTS: A statistically significant and positive correlation was found between participant scores of the 'Fear of Childbirth and Postpartum Period' and the 'Obsessive and Compulsive Behaviors of Mothers in the Postpartum Period Related to Baby Care' scales (p < 0.01). The regression model showed that 18.0% of the total variance in the obsessive and compulsive behaviors of mothers in the postpartum was explained by the fear of childbirth and the postpartum period (corrected R2 = 0.180). CONCLUSIONS: Fear of childbirth and the postpartum period were moderate. However, as the fear of women regarding childbirth and the postpartum period increased, their postpartum obsessive and compulsive behaviors about baby care also increased.
Introducción: La ansiedad del parto y el posparto es una condición común entre las mujeres embarazadas por la incertidumbre de vivir el embarazo y el parto por primera vez o por previas experiencias negativas. El miedo al parto puede afectar el proceso del cuidado del bebé de la madre. Objetivo: Determinar el efecto de las preocupaciones maternas sobre el parto y el puerperio y su efecto sobre las conductas obsesivas y compulsivas relacionadas con el cuidado del bebé. Materiales y métodos: El estudio se realizó con 260 madres. Los datos fueron recolectados en el formulario de información descriptiva y se usaron la "Escala de miedo al parto y al período posparto" y la de "Comportamientos obsesivos y compulsivos de las madres en el período posparto relacionados con el cuidado del bebé". Los datos fueron evaluados mediante el software SPSS™ mediante el cálculo de porcentajes, promedio, prueba t, ANOVA, correlación de Pearson y análisis de regresión múltiple. Resultados: Se encontró una correlación positiva y estadísticamente significativa entre la "Escala de miedo al parto y del período posparto" y la de "Comportamientos obsesivos y compulsivos de las madres en el período posparto relacionadas con el cuidado del bebé" (p < 0.01). En el modelo creado por análisis de regresión se observó que el 18,0% del cambio en la escala de comportamientos obsesivos-compulsivos estaba explicado por el miedo al parto y al puerperio (R2 corregido = 0,180). Conclusiones: En el estudio se determinó que el miedo al parto y al puerperio era moderado. Sin embargo, a medida que aumentaba el puntaje de miedo al parto y al período posparto, también aumentaban los comportamientos obsesivos y compulsivos de las madres en el puerperio relacionados con el cuidado del bebé.
Asunto(s)
Conducta Compulsiva , Miedo , Parto , Periodo Posparto , Humanos , Femenino , Conducta Compulsiva/psicología , Periodo Posparto/psicología , Adulto , Miedo/psicología , Embarazo , Parto/psicología , Conducta Obsesiva/psicología , Adulto Joven , Madres/psicología , Cuidado del Lactante/psicología , Ansiedad/psicología , Recién NacidoRESUMEN
BACKGROUND: Despite its known benefits, breastfeeding rates among mothers with perinatal mental health conditions are staggeringly low. Systematic evidence on experiences of breastfeeding among women with perinatal mental health conditions is limited. This systematic review was designed to synthesise existing literature on breastfeeding experiences of women with a wide range of perinatal mental health conditions. METHODS: A systematic search of five databases was carried out considering published qualitative research between 2003 and November 2021. Two reviewers conducted study selection, data extraction and critical appraisal of included studies independently and data were synthesised thematically. RESULTS: Seventeen articles were included in this review. These included a variety of perinatal mental health conditions (e.g., postnatal depression, post-traumatic stress disorders, previous severe mental illnesses, eating disorders and obsessive-compulsive disorders). The emerging themes and subthemes included: (1) Vulnerabilities: Expectations versus reality; Self-perception as a mother; Isolation. (2) Positive outcomes: Bonding and closeness; Sense of achievement. (3) Challenges: Striving for control; Inconsistent advice and lack of support; Concerns over medication safety; and Perceived impact on milk quality and supply. CONCLUSIONS: Positive breastfeeding experiences of mothers with perinatal mental health conditions can mediate positive outcomes such as enhanced mother/infant bonding, increased self-esteem, and a perceived potential for healing. Alternatively, a lack of consistent support and advice from healthcare professionals, particularly around health concerns and medication safety, can lead to feelings of confusion, negatively impact breastfeeding choices, and potentially aggravate perinatal mental health symptoms. Appropriate support, adequate breastfeeding education, and clear advice, particularly around medication safety, are required to improve breastfeeding experiences for women with varied perinatal mental health conditions.
Asunto(s)
Lactancia Materna , Trastornos Mentales , Humanos , Lactancia Materna/psicología , Femenino , Embarazo , Trastornos Mentales/psicología , Madres/psicología , Depresión Posparto/psicología , AdultoRESUMEN
Women with a history of Gestational diabetes mellitus (GDM) have a high risk of developing Type 2 diabetes mellitus (T2DM) in their future life. Lifestyle interventions are known to reduce this progression. The success of a lifestyle intervention mainly depends on its feasibility. Therefore, this study aimed to evaluate the feasibility of a lifestyle intervention programme aimed to attenuate the development of T2DM in mothers with a history of GDM. This qualitative phenomenological study was carried out in selected Medical offices of Health (MOH) areas in Sri Lanka. Postpartum mothers with a history of GDM who have undergone a comprehensive, supervised lifestyle intervention program for 1 year, their family members, and public health midwives (PHM) were recruited for this study. Focus group discussions (FGD) were carried out with mothers and PHM while In-depth interviews (IDI) were conducted with family members. Framework analysis was used for the analysis of data. A total of 94 participants (45 mothers, 40 healthcare workers, and 9 family members) participated in FGDs and IDIs to provide feedback regarding the lifestyle intervention. Sixteen sub-themes emerged under the following four domains; (1) Feelings and experiences about the lifestyle intervention programme for postpartum mothers with a history of GDM (2) Facilitating factors (3) Barriers to implementation and (4) Suggestions for improvement. Spouse support and continued follow-up were major facilitating factors. The negative influence of healthcare workers was identified as a major barrier to appropriate implementation. All participants suggested introducing continuing education programmes to healthcare workers to update their knowledge. The spouse's support and follow-ups played a pivotal role in terms of the success of the programme. Enhancing awareness of the healthcare workers is also essential to enhance the effectiveness of the programme. It is imperative to introduce a formal intervention programme for the postpartum management of mothers with a history of GDM. It is recommended that the GDM mothers should be followed up in the postpartum period and this should be included in the national postpartum care guidelines.
Asunto(s)
Diabetes Mellitus Tipo 2 , Diabetes Gestacional , Madres , Periodo Posparto , Investigación Cualitativa , Humanos , Femenino , Diabetes Gestacional/prevención & control , Embarazo , Adulto , Madres/psicología , Diabetes Mellitus Tipo 2/prevención & control , Diabetes Mellitus Tipo 2/terapia , Ejercicio Físico , Sri Lanka , Grupos Focales , Estilo de Vida , Dieta , Personal de SaludRESUMEN
BACKGROUND: Uptake of HIV early infant diagnosis (HEID) among HIV-exposed infants is the key to timely initiation of Antiretroviral Treatment (ART). However, despite the availability of HEID services in Tanzania, its uptake is low. We aimed to determine predictors of mothers living with HIV' with HIV-exposed infants' uptake of HEID services in Iringa District, Tanzania. METHODS: A health facility-based cross-sectional study was conducted in Iringa District from May to June 2023. Mothers with HIV-exposed infants were recruited in the study through a multistage sampling technique and interviewed using pre-tested structured questions. Logistic regression analysis was employed to determine potential predictors of HEID uptake. RESULTS: A total of 309 mothers with HIV-exposed infants participated in the study. About 78.3% of the HIV-exposed infants had initial DNA PCR for HEID within 6 weeks of age and 86.1% within 8 weeks. Most mothers had high perceived benefits on uptake of HEID with a mean score of 4.3, high perceived self-efficacy with a mean score of 3.8 and 2.7 perceived risk of HIV infection on their HIV-exposed infants on the 5 scale Likert scale with 5 showing the highest perceived benefit, self-efficacy and risk. High perceived self-efficacy and being a businesswoman were the predictors of uptake of HEID. The odds of self-efficacy on the uptake of HEID by 2.4 times (aOR 2.4 95% CI 1.6-3.2) within 6 weeks of age and 1.9 (aOR 1.9 95% CI 1.3-2.7) within 8 weeks. The odds of being a businesswoman were 0.4 for 6 weeks and 0.3 for 8 weeks (aOR 0.4 95% CI 0.2-0.8) and (aOR 0.3 95% CI 0.1-0.8) respectively. CONCLUSION: Over three-quarters of the HIV-exposed infants had initial DNA PCR for HEID testing as recommended. Perceived self-efficacy was the main factor influencing HEID uptake. These findings highlight the need for strengthening HIV-positive mother's self-efficacy for improved uptake of HEID services.
Predictors of mothers living with HIV' uptake of HIV early infant diagnosis services in Iringa District, TanzaniaThis study aimed to find out the factors associated with the uptake of HIV early infant diagnosis (HEID) services among mothers living with HIV in Iringa District, Tanzania. The uptake of HEID in Tanzania is still below the 95% national and global target of ending AIDS as a public health by 2030 We employed a cross-sectional study design and collected data from May to June 2023 to determine predictors of mothers with HIV-exposed infants' uptake of HEID in Iringa District, Tanzania. The analysis was done by descriptive statistics and logistic regression analysis. A total of 309 mothers with HIV-exposed infants participated in the study. About 78.3% of the HIV-exposed infants had initial DNA PCR for HEID within 6 weeks of age and 86.1% within 8 weeks. Most mothers had high perceived benefits on uptake of HEID with a mean score of 4.3, high perceived self-efficacy with a mean score of 3.8 and 2.7 perceived risk of HIV infection on their HIV-exposed infants. High perceived self-efficacy was positively associated These findings highlight the need for strengthening HIV-positive mother's self-efficacy for improved uptake of HEID services.
Asunto(s)
Diagnóstico Precoz , Infecciones por VIH , Transmisión Vertical de Enfermedad Infecciosa , Madres , Humanos , Tanzanía , Infecciones por VIH/diagnóstico , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/psicología , Femenino , Estudios Transversales , Adulto , Lactante , Madres/psicología , Madres/estadística & datos numéricos , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Adulto Joven , Aceptación de la Atención de Salud/estadística & datos numéricos , Recién Nacido , Masculino , Conocimientos, Actitudes y Práctica en Salud , Modelos Logísticos , EmbarazoRESUMEN
This study aims to measure the level of entry into motherhood among internally displaced adolescent girls in Kaya and Kongoussi communes, Burkina Faso, and to analyze the factors associated with it. Data were collected from 404 adolescent girls aged 12-19 years in a cross-sectional survey conducted between July and August 2021. The proportion of internally displaced adolescent girls who had started childbearing was 26.5%. Age, marital status and current use of modern contraception were found to be significantly associated with entry into motherhood among internally displaced adolescent girls. Marital status mediates the effect of religion and employment on entry of the adolescents into motherhood. The results suggest that actions aimed at preventing early marriage and improving employment opportunities among adolescent girls could potentially prevent their early entry into motherhood.
Cette étude vise à mesurer le niveau de l'entrée en vie féconde chez les adolescentes déplacées internes dans les communes de Kaya et Kongoussi, Burkina Faso, et d'analyser les facteurs qui y sont associés. Les données étaient recueillies auprès de 404 adolescentes âgées de 12-19 ans dans une enquête transversale réalisée entre juillet et août 2021. Le niveau de l'entrée en vie féconde chez les adolescentes déplacées internes était de 26,5%. L'âge, le statut matrimonial et l'utilisation actuelle de la contraception moderne ont été trouvés être significativement associés à l'entrée en vie féconde chez les adolescentes déplacées internes. Nous avons montré que le statut matrimonial médiatise l'effet de la religion et de l'emploi sur l'entrée en vie féconde. De tels résultats suggèrent que les actions visant à prévenir le mariage précoce et à améliorer les possibilités d'emploi chez les adolescentes pourrait potentiellement prévenir leur entrée précoce en vie féconde.
Asunto(s)
Refugiados , Humanos , Femenino , Adolescente , Burkina Faso , Estudios Transversales , Refugiados/psicología , Adulto Joven , Madres/psicología , Niño , Embarazo , Embarazo en Adolescencia/psicología , Conducta Anticonceptiva/psicología , Conducta Anticonceptiva/estadística & datos numéricos , Estado Civil , Factores SocioeconómicosRESUMEN
BACKGROUND: Despite the many benefits of exclusive breastfeeding to infants and mothers, only 33% of Jamaican infants are exclusively breastfed up to the recommend six months. This study was conducted to identify factors affecting mothers' feeding choices focusing on barriers to exclusive breastfeeding of infants six weeks to less than six months old. METHODS: A qualitative study consisting of four focus group discussion sessions was conducted among 22 mothers attending postnatal clinics in western Jamaica from May to August 2016. The transcripts were coded by three independent coders and content analysis conducted to generate themes. RESULTS: Four themes were identified namely, perceived advantages of breastfeeding centered mainly on the benefits of breastfeeding for the infant and mother, perceived barriers of breastfeeding highlighting physical pain and fatigue, supplementing culturally acceptable complementary foods and herbal remedies, and cultural norms including perception of how breastfeeding affects a woman's body, societal sources of breastfeeding information, satiation of infants, and family and other support. Mothers overwhelmingly agreed that breastfeeding was inexpensive, allowed them to bond with their infants and was good for the overall health and intellectual development of the infants. They identified painful nipples, engorged breasts, lack of sleep, physical exhaustion and pressure to return to work as barriers to breastfeeding. Mothers named a number of complementary foods, such as pumpkin, carrots, potato, banana, and chocho (Chayote), that were culturally accepted for feeding infants in Jamaica and discussed herbs that were considered to aid in infants' nutrition and overall health. Other cultural factors that were noted to influence exclusive breastfeeding were mothers feeling that breastfeeding would help their bodies, especially their bellies, go back to their pre-maternity figure, sources of breastfeeding information in the society including the internet, belief that breast milk alone does not satisfy babies, and family and other support. CONCLUSION: Mothers in this study identified unique challenges to exclusive breastfeeding that if addressed, would help to increase exclusive breastfeeding so that the World Health Organization's exclusive breastfeeding recommendations can be achieved.
Asunto(s)
Lactancia Materna , Grupos Focales , Madres , Investigación Cualitativa , Humanos , Lactancia Materna/psicología , Jamaica , Femenino , Adulto , Lactante , Recién Nacido , Madres/psicología , Adulto Joven , Masculino , Conducta de Elección , Conocimientos, Actitudes y Práctica en SaludRESUMEN
BACKGROUND: Immigrant Latinas (who are foreign-born but now reside in the USA) are at greater risk for developing postpartum depression than the general perinatal population, but many face barriers to treatment. To address these barriers, we adapted the Mothers and Babies Course-an evidence-based intervention for postpartum depression prevention-to a virtual group format. Additional adaptations are inclusion of tailored supplemental child health content and nutrition benefit assistance. We are partnering with Early Learning Centers (ELC) across the state of Maryland to deliver and test the adapted intervention. METHODS: The design is a Hybrid Type I Effectiveness-Implementation Trial. A total of 300 participants will be individually randomized to immediate (N = 150) versus delayed (N = 150) receipt of the intervention, Mothers and Babies Virtual Group (MB-VG). The intervention will be delivered by trained Early Learning Center staff. The primary outcomes are depressive symptoms (measured via the Center for Epidemiologic Studies-Depression Scale), parenting self-efficacy (measured via the Parental Cognition and Conduct Towards the Infant Scale (PACOTIS) Parenting Self-Efficacy subscale), and parenting responsiveness (measured via the Maternal Infant Responsiveness Instrument) at 1-week, 3-month, and 6-month post-intervention. Depressive episodes (Structured Clinical Interview for DSM-V- Disorders Research Version) at 3-month and 6-month post-intervention will also be assessed. Secondary outcomes include social support, mood management, anxiety symptoms, perceived stress, food insecurity, and mental health stigma at 1-week, 3-month, and 6-month post-intervention. Exploratory child outcomes are dysregulation and school readiness at 6-month post-intervention. Intervention fidelity, feasibility, acceptability, and appropriateness will also be assessed guided by the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. DISCUSSION: This study will be one of the first to test the efficacy of a group-based virtual perinatal depression intervention with Latina immigrants, for whom stark disparities exist in access to health services. The hybrid effectiveness-implementation design will allow rigorous examination of barriers and facilitators to delivery of the intervention package (including supplemental components) which will provide important information on factors influencing intervention effectiveness and the scalability of intervention components in Early Learning Centers and other child-serving settings. REGISTRATION: ClinicalTrials.gov NCT05873569.
Asunto(s)
Depresión Posparto , Hispánicos o Latinos , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Femenino , Hispánicos o Latinos/psicología , Depresión Posparto/etnología , Depresión Posparto/terapia , Depresión Posparto/psicología , Depresión Posparto/prevención & control , Depresión Posparto/diagnóstico , Embarazo , Responsabilidad Parental/psicología , Responsabilidad Parental/etnología , Relaciones Madre-Hijo , Madres/psicología , Lactante , Resultado del Tratamiento , Factores de Tiempo , Maryland , Emigrantes e Inmigrantes/psicología , Autoeficacia , Recién NacidoRESUMEN
OBJECTIVES: This study was the first to apply a socio-narratology framework to the narratives about child pain as told by youth with chronic pain and their parents, all of whom experience chronic headaches. BACKGROUND: Storytelling is a powerful social transaction that occurs within systems (eg, families, clinical encounters) and is both shaped by, and can shape, the pain experience. Narrative can be harnessed as a clinical tool to aid in the ability to listen, understand, and improve clinical encounters. METHODS: Twenty-six youth (aged 11 to 18 y) and their mothers, both with chronic headaches, recruited from a tertiary level pediatric pain clinic separately completed in-depth interviews about children's pain journey narratives. Data were analyzed using narrative analysis, which incorporated elements of socio-narratology to compare similarities and differences between and within dyads' narratives. RESULTS: Five narrative types were generated: (1) The trauma origin story-parents, but not youth, positing traumatic events as the causal link to children's pain; (2) mistreated by the medical system-neglect, harm, and broken promises resulting in learned hopelessness or relying on the family system; (3) the invalidated-invalidation of pain permeated youth's lives, with mothers as empathic buffers; (4) washed away by the pain-challenges perceived as insurmountable and letting the pain take over; and (5) taking power back from pain-youth's ability to live life and accomplish goals despite the pain. CONCLUSION: Findings support the clinical utility of narrative in pediatric pain, including both parents' and youths' narrative accounts to improve clinical encounters and cocreate more youth-centred, empowering narratives.
Asunto(s)
Dolor Crónico , Trastornos de Cefalalgia , Madres , Narración , Humanos , Adolescente , Femenino , Madres/psicología , Niño , Masculino , Trastornos de Cefalalgia/psicología , Dolor Crónico/psicología , Adulto , Investigación CualitativaRESUMEN
Objectives: To analyse the phenomenon of "giving birth" on the basis of the lived experiences of women and midwives. METHODS: The qualitative study was conducted in the delivery room of a mother-friendly hospital in western Turkey from March 1 to December 30, 2019, and comprised primiparous women aged 18-35 years having a spontaneous vaginal birth, and midwives who delivered the babies. Data was collected through indepth interviews that were audiorecorded. Additionally, women's written birth stories and researcher's observation regarding the participants were used. Data was subjected to content analysis using NVIVO 12 Pro software. RESULTS: Of the 28 subjects 15(53.6%) were lay women with mean age 24.2±3.87 years (range: 18-30 years), and 13(46.4%) were midwives with mean age 42.61±4.50 years (range: 37-50 years). The most referred conceptual themes in Kolcaba's Theory of Comfort were "enhanced comfort", "mother-friendly hospital policy", and "midwives' comforting interventions." Under the theme of "Increasing Comfort", women cared about psychological and environmental comfort. Women had the most psychospiritual comfort and environmental comfort as well as physical and sociocultural comfort. Women cared about psychological and environmental comfort that facilitated birth. CONCLUSIONS: The mother-friendly hospital policy increased and contributed to the support and comfort provided to women. Kolcaba's Comfort Theory was an appropriate and working theory for birth and midwifery care, indicating that women's comfort should be ensured in the psychospiritual, environmental, physical and sociocultural contexts.
Asunto(s)
Partería , Madres , Parto , Investigación Cualitativa , Humanos , Femenino , Adulto , Embarazo , Adulto Joven , Turquía , Madres/psicología , Parto/psicología , Adolescente , Persona de Mediana Edad , Parto Obstétrico/psicologíaRESUMEN
BACKGROUND: There are many factors effective on occurrence of post-partum anxiety and depression. COVID-19 pandemic, as a major health crisis, affected many countries and had undesirable mental health outcomes, especially for the vulnerable population. The aim of this study was to evaluate the prevalence of post-partum anxiety and depression and their related factors during COVID-19 pandemic. METHODS: The present descriptive cross-sectional study was conducted on 360 mothers who delivered their child during COVID-19 pandemic and had referred to the comprehensive urban health canter of Lenjan city two months after their delivery (from November 10th, 2021, until March 19th, 2022). Data were gathered using 3 questionnaires including demographic characteristics, Edinburgh Postnatal Depression Scale (EPDS), and Beck Anxiety Inventory (BAI). Data were analyzed using SPSS software version 24 and the level of significance was set at p < 0.05. RESULTS: The prevalence of anxiety and post-partum depression was 27% and 20%, respectively. None of the demographic characteristics had a significant relationship with anxiety and depression. Related factors to post-partum anxiety included desired pregnancy, premenstrual syndrome, marital conflicts, history of mother's hospitalization due to COVID-19, compliance rate with preventive health measures for COVID-19, stressful events, and social support. CONCLUSION: It is suggested to screen mothers to detect significant related factors of post-partum anxiety and depression in other future pandemics or epidemics to support them.
Asunto(s)
Ansiedad , COVID-19 , Depresión Posparto , Madres , Humanos , COVID-19/epidemiología , COVID-19/psicología , Femenino , Estudios Transversales , Adulto , Prevalencia , Depresión Posparto/epidemiología , Depresión Posparto/psicología , Madres/psicología , Madres/estadística & datos numéricos , Ansiedad/epidemiología , Adulto Joven , Pandemias , Factores de Riesgo , Encuestas y Cuestionarios , Periodo Posparto/psicologíaRESUMEN
BACKGROUND: The COVID-19 pandemic contact restrictions considerably changed maternal visiting contacts during the time in which breastfeeding is initiated. We wanted to know how maternity ward staff and mothers rated the conditions of starting breastfeeding under contact restrictions. METHODS: In the Breastfeeding in North Rhine-Westphalia (SINA) study, Germany, 2021/22, chief physicians as well as ward staff from 41 (out of 131) maternity hospitals (82 members of the healthcare sector in total) were surveyed by telephone concerning structural and practical conditions for breastfeeding support before and during the pandemic; 192 (out of 426 eligible) mothers answered an online-questionnaire about their breastfeeding experiences at 2 weeks and 2 months after birth. RESULTS: In almost all of the hospitals, visits were restricted due to the pandemic, with the exception of the primary support person. After more than one year of pandemic experience, the ward staff were convinced that the restrictions were mostly positive for the mothers (97.6%) and for the ward staff themselves (78.0%). A total of 80.5% of the ward staff would maintain the restrictions beyond the pandemic. The mothers themselves mostly rated the restrictions in the hospital as being just right; moreover, many mothers voluntarily maintained the restrictions at home, at least in part. CONCLUSIONS: The unprecedented visiting restrictions in hospitals during the pandemic were like an "experiment" born out of necessity. Restricting visiting arrangements may be an underestimated beneficial component for the development of the mother-infant dyad in perinatal breastfeeding care, particularly in healthcare systems where almost all births occur in the maternity hospital. TRIAL REGISTRATION: German Clinical Trials Register (DRKS) (DRKS00027975).
Asunto(s)
Lactancia Materna , COVID-19 , Madres , Humanos , Lactancia Materna/psicología , Alemania , Femenino , COVID-19/prevención & control , COVID-19/epidemiología , Adulto , Madres/psicología , Encuestas y Cuestionarios , Recién Nacido , SARS-CoV-2 , Pandemias , Maternidades , Lactante , EmbarazoRESUMEN
BACKGROUND: Access to appropriate obstetric and under-5 healthcare services in low-resource settings is a challenge in countries with high mortality rates. However, the interplay of multiple factors within an ecological system affects the effectiveness of the health system in reaching those in need. OBJECTIVE: This study examined how multiple factors concurrently affect access to obstetric and child healthcare services in resource-poor settings. METHODS: The research used social autopsies [in-depth interview] with mothers who experienced newborn death [n = 29], focus group discussions [n = 8] with mothers [n = 32], and fathers [n = 28] of children aged 6-59 months, and the author's field observations in Eastern Uganda's rural settings. The research employed narrative and inductive thematic analysis, guided by concepts of social interactions, behaviour, and health institutional systems drawn from system theory. RESULTS: The study unmasked multiple concurrent barriers to healthcare access at distinct levels. Within families, the influence of mothers-in-law and gender dynamics constrains women's healthcare-seeking autonomy and agency. At the community level, poor transport system, characterised by long distances and challenging road conditions, consistently impede healthcare access. At the facility level, attitudes, responsiveness, and service delivery of health workers critically affect healthcare access. Negative experiences at health facilities profoundly discourage the community from seeking future health services. CONCLUSION: The findings emphasise the persistent influence of structural and social factors that, although well documented, are often overlooked and continue to limit women's agency and autonomy in healthcare access. Enhancing universal access to appropriate healthcare services requires comprehensive health systems interventions that concurrently address the healthcare access barriers.
Main findings: The findings highlight the persistent influence of structural and social factors that have been well documented yet often overlooked.Added knowledge: While the barriers to and essential components of an effective health system are well known, the current global health space requires an understanding of how the structural, cultural, and social nuances have persistently affected the marginalised communities.Global health impact for policy and action: For a transformative health system, promoting equitable and accessible appropriate healthcare for all necessitates a holistic approach that identifies and addresses healthcare access barriers.
Asunto(s)
Grupos Focales , Accesibilidad a los Servicios de Salud , Humanos , Accesibilidad a los Servicios de Salud/organización & administración , Uganda , Femenino , Lactante , Masculino , Preescolar , Adulto , Población Rural , Servicios de Salud del Niño/organización & administración , Adulto Joven , Recién Nacido , Servicios de Salud Rural/organización & administración , Embarazo , Investigación Cualitativa , Servicios de Salud Materna/organización & administración , Madres/psicologíaRESUMEN
BACKGROUND: Diabetes in pregnancy is associated with short and long-term adverse health outcomes for mothers and babies. The condition disproportionately impacts Pacific, Maaori, and Indian pregnancies. Those with diabetes are offered intensive support during pregnancy, but in many centres, no additional support following birth beyond routine care. The aim of this study was to determine the postpartum needs for mothers and whaanau (family) impacted by diabetes in pregnancy, to inform co-design of a new service to improve metabolic and developmental outcomes for infants. METHODS: Pregnancies complicated by diabetes were identified using a local diabetes registry. Mothers with a diagnosis of GDM or T2DM and gave birth between January 2022 -June 2022 were eligible for the study. A total of 19 parents (18 mothers, 1 father) were interviewed. Participants primarily identified as Maaori (6), Pacific (6), Indian (3), Asian (2), and New Zealand European (2). Interviews took place between December 2022 and February 2023, between 5-13 months post-pregnancy. Interviews facilitated by an externally contracted local Pacific mother, with a professional background in social work were conducted using Koorero and Talanoa, Maaori and Pacific methods of qualitative data collection, to capture the lived experiences of participants. A multidisciplinary group reviewed and coded interview transcripts. Themes were presented back to participants and stakeholders for feedback and refinement. Four over-arching themes were illustrated with exemplar quotes. RESULTS: Four themes described the importance of 1) Finding a balance between what is "best practice" and what is best for me, my baby and my whaanau, 2) The need for individualised and culturally appropriate care, 3) Centrality of whaanau and family to the pregnancy and postpartum journey, 4) The pervasive negative impact of diabetes on taha hinegaro (well-being) beyond childbirth. CONCLUSION: People who are affected by diabetes in pregnancy have ongoing physical, psychological, and social needs. A holistic, whaanau-centred approach is required to ensure optimal health and well-being outcomes of mothers, infants and whaanau. The findings of this study will inform a new targeted model of care for infants and whaanau affected by diabetes in pregnancy.
Asunto(s)
Diabetes Gestacional , Madres , Periodo Posparto , Embarazo en Diabéticas , Humanos , Femenino , Embarazo , Periodo Posparto/psicología , Adulto , Madres/psicología , Diabetes Gestacional/psicología , Nueva Zelanda , Embarazo en Diabéticas/psicología , Lactante , Investigación Cualitativa , Masculino , Estilo de Vida , Recién Nacido , Diabetes Mellitus Tipo 2/psicologíaRESUMEN
This case study describes the design, implementation, and evaluation of an initiative to increase COVID-19 vaccine confidence and uptake among refugee and immigrant women in Clarkston, Georgia. Applying the principles and practices of human-centered design, Mothers x Mothers was co-created by Refugee Women's Network and IDEO.org as a series of gatherings for refugee and immigrant mothers to discuss health issues, beginning with the COVID-19 vaccine. The gatherings included both vaccinated and unvaccinated mothers and used a peer support model, with facilitation focused on creating a trusting environment and supporting mothers to make their own health decisions. The facilitators for Mothers x Mothers gatherings were community health workers (CHWs) recruited and trained by Refugee Women's Network. Notably, these CHWs were active in every phase of the initiative, from design to implementation to evaluation, and the CHWs' professional development was specifically included among the initiative's goals. These elements and others contributed to an effective public health intervention for community members who, for a variety of reasons, did not get sufficient or appropriate COVID-19 vaccine information through other channels. Over the course of 8 Mothers x Mothers gatherings with 7 distinct linguistic/ethnic groups, 75% of the unvaccinated participants decided to get the COVID-19 vaccine and secured a vaccine referral.
Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Madres , Refugiados , Humanos , Femenino , Madres/psicología , COVID-19/prevención & control , Georgia , Adulto , Emigrantes e Inmigrantes , Aceptación de la Atención de Salud , Reuniones Masivas , Agentes Comunitarios de Salud , SARS-CoV-2RESUMEN
Foster parents have been shown to report higher levels of parenting stress but also more dyadic coping (DC) behaviors in their partnership than biological parents, which might be an important protective factor that helps them cope with daily stressors. Here, we examined how parenting stress and DC are related in foster and biological parents and whether these are reflected in long-term alterations of hypothalamic-pituitary-adrenocortical (HPA) axis activity. A total of 79 foster mothers and 131 biological mothers participated in a longitudinal study. At the initial assessment, children were aged 2-7 years and lived for an average of 18 months in their current foster family. Mothers' cortisol and dehydroepiandrosterone (DHEA) concentrations and their cortisol/DHEA ratios were assessed in scalp hair twice with approximately 11 months in between, while their perceived parenting stress and DC were measured by self-report questionnaires. Results showed no significant differences between foster mothers and biological mothers in cortisol, DHEA and cortisol/DHEA concentrations. While more DC was longitudinally related to lower levels of parenting stress across both study groups, no significant associations were found to endocrine markers. Thus, these findings indicate that increased parenting stress levels were not, or not strongly, reflected in HPA axis alterations as assessed in hair. Our findings thus add evidence for non-significant associations between self-reported perceived stress and chronic HPA axis markers. Future studies may explore whether early interventions, including those aimed at promoting and maintaining positive DC, are beneficial in preventing the development of stress-related illnesses in foster parents.
Asunto(s)
Adaptación Psicológica , Deshidroepiandrosterona , Hidrocortisona , Madres , Responsabilidad Parental , Estrés Psicológico , Humanos , Femenino , Estrés Psicológico/metabolismo , Estrés Psicológico/psicología , Madres/psicología , Hidrocortisona/metabolismo , Hidrocortisona/análisis , Adulto , Responsabilidad Parental/psicología , Niño , Adaptación Psicológica/fisiología , Preescolar , Deshidroepiandrosterona/metabolismo , Estudios Longitudinales , Masculino , Biomarcadores/metabolismo , Resiliencia Psicológica , Cabello/química , Sistema Hipotálamo-Hipofisario/metabolismo , Sistema Hipófiso-Suprarrenal/metabolismo , Sistema Hipófiso-Suprarrenal/fisiopatología , Cuidados en el Hogar de Adopción/psicologíaRESUMEN
AIM: Mothers' digital game addiction awareness and their health literacy levels are critical factors for addiction prevention strategies in children. Therefore, the present study is significant. This study examines the relationship between awareness of digital game addiction, health literacy, and the sociodemographic characteristics of mothers. METHOD: This cross-sectional study was conducted with 457 mothers of children aged 5-11 years in Turkey. The data were collected using a personal information questionnaire, the Awareness of Digital Game Addiction Scale, and the Health Literacy Scale between May and September 2021. RESULTS: This study revealed that mothers are highly aware of digital game addiction and have high health literacy. Furthermore, health literacy was determined to significantly and directly affect awareness of digital gaming addiction. Awareness of digital gaming addiction significantly and directly affects children owning their own technological devices and how much time mothers spend with their children. CONCLUSION: The study's results confirmed that mothers' health literacy had a positive and statistically significant effect on awareness of digital gaming addiction. As the health literacy levels of mothers increased, the internal and external awareness of digital gaming addiction increased. It is recommended to design intervention programs that increase mothers' awareness of digital game addiction. These programs should be planned according to the health literacy levels of mothers.
Asunto(s)
Alfabetización en Salud , Madres , Juegos de Video , Humanos , Turquía , Femenino , Madres/psicología , Estudios Transversales , Niño , Encuestas y Cuestionarios , Adulto , Juegos de Video/psicología , Preescolar , Trastorno de Adicción a Internet/psicología , Análisis de Clases Latentes , Concienciación , Masculino , Conducta Adictiva/psicologíaRESUMEN
BACKGROUND: The benefits of exclusive breastfeeding (EBF) have been universally documented, with evidence of positive impacts on a child's optimal growth, development, and survival. However, EBF practices in Nepal have fluctuated and declined over the last 25 years. In addition to the individual factors of mothers and infants, EBF practices are affected by multiple community-level factors. Understanding these factors is essential for designing breastfeeding promotion programs to improve child nutritional status in Nepal. This study investigated the individual- and community-level determinants of EBF practices among young infants aged 0-5 months in Nepal. METHOD: We used the dataset from the Nepal Demographic and Health Survey 2022. Information on EBF in the past 24 h was available for 540 infants aged 0-5 months. A multilevel mixed-effect logistic regression was used to identify individual- and community-level factors associated with EBF among infants aged 0-5 months in Nepal. RESULTS: The 24-hour prevalence of EBF among infants aged 0-5 months was 57.46% (95% confidence interval (CI): 52.18, 62.57). The infant's age was inversely associated with EBF prevalence at the individual level. Compared with infants aged < 1 month, infants aged three months (adjusted odds ratio (AOR): 0.14, 95% CI: 0.05, 0.40), four months (AOR: 0.11, 95% CI: 0.04, 0.28), and five months (AOR: 0.07, 95% CI: 0.03, 0.20) were less likely to receive EBF. At the community level, community-level variables such as ≥ 4 ANC visits coverage, maternal employment status, and poverty level were generated by aggregating the individual characteristics in a cluster and were categorized using quartiles into low ("< 25%"), moderate (25-75%), and high (≥ 75%). Mothers from communities with moderate ≥ 4 ANC visits (AOR: 3.30, 95% CI: 1.65, 6.57) and high ≥ 4 ANC visits (AOR: 2.70, 95% CI: 1.40, 5.22) coverage had higher odds of EBF practices than did those from communities with low ≥ 4 ANC visits coverage. Similarly, communities with moderate (AOR: 2.67, 95% CI: 1.34, 5.30) and high (AOR: 2.34, 95% CI: 1.10, 4.99) levels of maternal employment status and moderate levels of poverty (AOR: 2.20, 95% CI: 1.13, 4.28) were associated with a higher likelihood of EBF practices. Subnational level variation was evident, with infants in Lumbini province having lower odds of EBF (AOR: 0.32, 95% CI: 0.13, 0.77) relative to Koshi province. Approximately 9% of the variation in EBF practices was observed among mothers while mapping across clusters in this study. CONCLUSION: Various individual- and community-level factors influence the uptake of EBF in Nepal, underscoring the need to improve the approaches and strategies of EBF programs. This study highlighted the significant association of community-level factors (≥ 4 ANC visits coverage, poverty level, and maternal employment status) with EBF among infants under 6 months. It revealed approximately 9% variability in EBF across clusters. Future efforts to promote EBF should focus on older infants and communities with low poverty levels and low coverage of recommended ≥ 4 ANC visits. Furthermore, context-specific adaptation of such efforts might be required considering the variation observed between the communities in the present study.