RESUMO

A weight-inclusive approach to health involves the promotion of intuitive eating, i.e., the individual's ability to be aware of their physiological hunger and satiety cues to determine when and how much to eat, while paying attention to how certain foods affect their body. The second version of the Intuitive Eating Scale (IES-2) evaluates four interrelated traits of intuitive eating: Unconditional Permission to Eat (UPE), Eating for Physical rather than emotional Reasons (EPR), Reliance on internal Hunger/Satiety Cues (RHSC), and Body-Food Choice Congruence (BFCC). In this study, our aim was to evaluate the psychometric properties of a Mexican Spanish adaptation of the IES-2 for pregnant women and examine the relationship between intuitive eating traits and maternal sociodemographic characteristics. A sample of 514 pregnant women answered our IES-2 adaptation and a sociodemographic questionnaire. We determined the quality, validity, and reliability of our adaptation through descriptive measures, frequency distributions, intra-class correlations, and extreme answer group comparison for each item, eliminating those with weak technical properties. We then performed an exploratory principal component analysis and a confirmatory factor analysis. Last, we analyzed the association between intuitive eating and maternal sociodemographic and reproductive variables through correlation tests and multivariable linear regressions. Psychometric tests confirmed the validity and reliability of our IES-2 adaptation, which comprised 18 out of the 23 original items. Notably, both the exploratory and confirmatory factor analyses yielded not four but five factors, due to the EPR subscale splitting in two (the "emotional" and "physical" components of EPR). We attribute this novel finding to the emotional manifestations that naturally accompany pregnancy, which may incline pregnant women to base their eating behaviors more on the emotional than the physical component that would otherwise dominate their EPR trait. Further research is also needed about the UPE subscale during pregnancy, due to item removal and subtle changes in meaning. Finally, the influence of sociodemographic variables on the IES-2 score was extremely low, suggesting that other variables, possibly of a psychological nature, may have greater influence on a pregnant woman's intuitive eating.

Assuntos

RESUMO

Eating behaviors are complex phenomena, entangling physiological signals of hunger and satiety, food choices, emotional states, and social factors and expectations, as well as food availability and sensory appearance. Evaluating eating behaviors is challenging and must cover different motives. One instrument for such evaluation is the Dutch Eating Behavior Questionnaire (DEBQ), composed of three subscales for exploring emotional eating, external eating, and restrained eating. In this article, we aimed to (1) evaluate the psychometric properties of a Mexican Spanish adaptation of the DEBQ; and (2) explore the associations between the three adapted DEBQ scales and the influence of sociodemographic factors on each of the three eating behaviors in Mexican pregnant women. A sample of 514 pregnant women responded to our adapted version of the DEBQ and a questionnaire about sociodemographic information. We performed an exploratory factor analysis using a principal component analysis with varimax rotation; based on this analysis, we removed items that loaded on two factors and then performed a confirmatory factor analysis. The final version of the adapted DEBQ has 26 items, clearly divided into a three-factor structure and satisfactorily reliable (Cronbach's ⍺ = 0.903). We then performed Spearman bivariate correlations and multivariate linear regression with backward variable selection to test the associations and influence of sociodemographic factors on each of the three eating behaviors evaluated with the DEBQ. In pregnant women, emotional eating (EmoE) had a medium-high correlation with external eating (ExtE) and a low correlation with restrained eating (RestE), while ExtE and RestE showed no association. The three eating behaviors are associated with maternal sociodemographic and reproductive variables, which partly explain their variation, most notably maternal schooling. Our adapted version of the DEBQ is suitable for use with Mexican Spanish-speaking pregnant women. Maternal sociodemographic and reproductive factors have an influence on the variance of eating behaviors during pregnancy.

Assuntos

RESUMO

Resumen Antecedentes: En México los embarazos adolescentes son 77 por cada 1,000. De los nacimientos anuales, el 17% son de madres adolescentes, con casi 350,000. Objetivo: Explicar por qué las adolescentes se embarazan a pesar del conocimiento de métodos anticonceptivos. Métodos: Con un estudio exploratorio y observacional, se evaluaron a 300 adolescentes embarazadas de 15 a 19 años, que no tenían antecedentes de consumo de sustancias adictivas y cuyos embarazos no fueron resultado de una violación.. Se aplicó el cuestionario de funcionamiento familiar y una entrevista de los antecedentes sociodemográficos. Resultados: El inicio de vida sexual fue a los 12 años para el 1.7%, de las participantes, a los 13 para el 7.3%, a los 14 para el 18.7%, a los 15 para el 36%, a los 16 para el 19.3% y las restantes (17%) tuvieron un inicio a los 19 años. El 100% manifestó que conocía métodos anticonceptivos, incluyendo la píldora del día siguiente. Conclusiones: El embarazo a temprana edad viene acompañado de mitos sociales e individuales sobre el conocimiento de la sexualidad humana, la anticoncepción y la vida amorosa. El embarazo representa para las jóvenes tener un objeto de amor y obtener un lugar en el mundo y dentro sus familias.

Abstract Background: In Mexico, teenage pregnancy is 77 for every 1,000. In terms of annual births, 17% are from teenage mothers, which are almost 350,000. Objective: To explain why teenage girls get pregnant in spite of knowing about contraceptives. Method: An observational and exploratory study by which 300 pregnant teenage girls between 15 and 19 years old were evaluated, with no history of substance abuse and whose pregnancies were not the result of rape. A questionnaire on family dynamics and an interview about their sociodemographic background were applied. Results: The first sexual intercourse for 1.7% of the participants was at 12 years old; for 7.3%, at 13; for 18.7%, at 14; for 36%, at 15; for 19.3%, at 16, and for the remaining 17%, near 19 years old. All of them (100%) stated they knew about contraceptives, including the morning-after pill. Conclusions: Pregnancies at an early age come with individual and social myths about the knowledge of human sexuality, contraception, and love life. For these young women, a pregnancy represents an object of love and obtaining a place in the world and within their families.

RESUMO

La pérdida de un hijo al inicio de la vida constituye uno de los estresores emocionales más intensos que puede experimentar una mujer. La evaluación de este proceso de duelo requiere contar con instrumentos confiables y válidos. El objetivo del presente trabajo fue determinar las características psicométricas de la Perinatal Grief Scale (Escala de Duelo Perinatal, EDP) en una muestra de mujeres mexicanas que habían experimentado pérdidas perinatales. La escala fue traducida, retraducida, piloteada y adaptada, para finalmente aplicarla a 200 mujeres que habían experimentado una o más pérdidas perinatales y que asistían a una clínica especializada. Los datos fueron sometidos a los procedimientos estadísticos usuales de validación (análisis de distribución de frecuencias, comparación de grupos extremos, análisis factorial exploratorio y análisis factorial confirmatorio, así como correlación entre subescalas) y de evaluación de consistencia interna, obteniendo índices adecuados de confiabilidad y validez. La EDP quedó conformada por 27 reactivos, agrupados en cuatro subescalas: duelo activo, depresión, culpa y aceptación. Se discute su utilización en la investigación y en la práctica clínica.

Losing a child at the beginning of life is one of the most intense emotional stressors that may experience a woman. The evaluation of this mourning process requires reliable and valid instruments. This study aimed to determine the psychometric characteristics of the Perinatal Grief Scale (PGS) in a sample of Mexican women who had experienced perinatal loss. The scale was translated, retranslated, tested and adapted to finally be applied to 200 women who had experienced one or more perinatal loss and were attending a clinic. Data were subjected to the usual statistical procedures of validation (analysis of frequency distribution, comparison of extreme groups, exploratory factor analysis and factor analysis confirming, as well as correlation between scales) and evaluation of internal consistency, obtaining appropriate indexes of reliability and validity. The Perinatal Grief Scale (EDP) was formed by 27 items, grouped in four scales: active grief, depression, guilt, and acceptance. Its use in research and clinical practice is discussed.

RESUMO

El objetivo de este trabajo es presentar una propuesta de intervención psicoterapéutica con mujeres con embarazo de alto riesgo atendidas en una institución de salud reproductiva Ciudad de México. Por llevarse a cabo dentro de una institución, se plantea un modelo de intervención breve, focalizado, basado en el enfoque integrador de la psicoterapia. Se describen las principales características del grupo, la conflictiva presentada por estas mujeres, los temas abordados, así como las técnicas empleadas más relevantes.

The aim of this work is to present a proposal for a psychotherapeutic intervention with women with high-risk pregnancies that are attending a reproductive health facility from México City. Because it was carried out within a health institution, this is a model of brief intervention, focused, and based on the integrative approach to psychotherapy. It describes the main features of the group, the conflict presented by these women, the topics that emerged, and the most relevant techniques used.

Assuntos

RESUMO

Pregnancies with congenital defects cause a grief reaction in future parents, that in many cases can get complicated and to progress to pathological emotional conditions. Due to this grief process psychological evaluation and intervention is important during prenatal diagnose, pregnancy course, and pregnancy end. This article reviews emotional manifestations in couples who undergo a pregnancy diagnosed with congenital malformation, and shows that perinatal and neonatal losses produces an emotional response with all characteristics and symptoms of grief. However, personal factors (both internal and external) can facilitate or complicate it, and evolve to a pathological grief. This pathological grief requires a psychotherapeutic process to avoid clinically meaningful psychological health impacts. The proposal to parents' cope with grief consists in psychological work since prenatal diagnosis until pregnancy end.

Assuntos

RESUMO

Objetivo: Establecer la relación entre la percepción de las relaciones familiares y el malestar psicológico en adolescentes embarazadas. Material y métodos: El malestar psicológico se evaluó aplicando el Cuestionario General de Salud de Goldberg a 213 adolescentes embarazadas primigestas, con 17 años de edad o menos. El criterio para "caso probable" de malestar psicológico fue a partir de un puntaje de 8 o más. La percepción de las relaciones familiares se evaluó con un cuestionario que exploró cuatro aspectos: dinámica familiar, relación entre los padres, relación con la madre y con el padre. Resultados: En los casos con malestar psicológico, se observó una asociación de dependencia con la percepción de las relaciones familiares: dinámica familiar de mala a regular (p < 0.001); relación disarmónica entre los padres (p = 0.006); relación regular con la madre (p = 0.018); y, relación con el padre de mala a muy mala (p = 0.008). Para los no casos, la dependencia se estableció en: dinámica familiar de buena a excelente (p < 0.001) y la relación con el padre de buena a muy buena (p = 0.018). Conclusiones: La percepción de la dinámica familiar, la relación entre los padres, y las relaciones afectivas con la madre y el padre, se asociaron directamente con la presencia de malestar psicológico.

Objective: To establish the relationship between family relationship's perception and the psychological malaise in pregnant teenagers. Material and methods: Psychological malaise was evaluated using Goldberg's general health questionnaire on 213, seventeen-year-old or younger first pregnancy teenagers, basing the criteria on a score of 8 or more for a "probable case" of psychological malaise. The notion about the family's relationship was evaluated by a questionnaire that measured four aspects: family dynamics, the relationship between the parents and the relationship with the mother and with the father. Results: There were statistically significant differences when the Chi Square Test was used on the proposed comparisons. When there was a psychological malaise, we noticed a dependency when the family's relationship ranged from average to negative (a .000); when the relationship between parents was not harmonious (a .006); the relationship with the mother was average (a 0.018); and the relationship with the father, from negative to extremely negative (a 0.008). For the no cases, dependency was established as a: familiar dynamics ranging from good to excellent (a .000) and the relationship with the father, from good to very good (a .018). Conclusions: The family's dynamics perception, the relationship between the parents and the sentimental relationship with mother and father is associated with a psychological malaise. If the familiar dynamics is perceived with a range from bad to average, then the perception of relation with the father and the mother was perceived to range from very bad to average, contrasting with the perception from good to excellent, then the perception of the relationship with both ranges from good to very good.