Maternal and Child Health Journal最新文献

The study was conducted to determine the effect of a web-based support program based on the Health Promotion Model (HPM) on healthy lifestyle behaviors, self-efficacy, and prenatal distress in pregnant women with preeclampsia. The study was conducted with 82 pregnant women diagnosed with preeclampsia, 41 of whom were in the web-based support group and 41 in the control group. Participant introduction form, Healthy Lifestyle Behaviors Scale-II (HLBS-II), Self-Efficacy Scale (SES), Prenatal Distress Scale (PDS), pregnant women's self-monitoring form, and postpartum assessment form were used for data collection. The increase in the total scores of the HLBS-II and the SES and the decrease in the total score of the PDS was found to be statistically significant in the pregnant women in the web support-based group after the web support. The HPM-based web-based support program improved healthy lifestyle behaviors and self-efficacy and reduced prenatal stress levels of pregnant women with preeclampsia but did not contribute to neonatal outcomes. SIGNIFICANCE: Pregnant women diagnosed with preeclampsia often face heightened physiological and psychological challenges. This study demonstrates that a web-based support program structured around the Health Promotion Model (HPM) significantly improves healthy lifestyle behaviors and self-efficacy while reducing prenatal distress in this high-risk population. These findings suggest that digital health interventions are effective, accessible tools for enhancing maternal well-being. By integrating such platforms into standard obstetric care, healthcare providers can offer continuous, evidence-based support that empowers patients to manage their condition more effectively outside of clinical settings.

Objectives: The study aimed to compare anxiety, stress, sleep quality, occupational pattern and leisure satisfaction of pregnant women in different trimesters.

Methods: Pregnant women who came for routine check-ups (n = 156) were evaluated in clinics and family health centers. The pregnant women's anxiety, perceived stress levels, sleep quality, occupational pattern, occupational balance, and leisure time satisfaction were measured using the Perinatal Anxiety Screening Scale (PASS), Perceived Stress Scale (PSS), Pittsburgh Sleep Quality Inventory (PSQI), Modified Activity Questionnaire (MOQ), Occupational Balance Questionnaire (OBQ11-T), and Leisure Satisfaction Scale (LSS), respectively.

Results: The PASS and PSS total scores in the second and third trimesters were similar, yet higher than in the first trimester (F = 13.496, F = 39.401; p < 0.001, respectively). The PSQI and QBQ11-T total scores were highest in the first trimester and gradually decreased in the second and third trimesters (F = 25.029, F = 30.108; p < 0.001, respectively). The mean sports repetition was similar in the second and third trimesters and lower than in the first trimester (F = 14.087, p < 0.001). The LSS total scores were similar in the second and third trimesters and lower than in the first trimester (p < 0.05).

Conclusions for practice: The anxiety and perceived stress levels increased, and occupational balance and sleep quality deteriorated gradually throughout the trimesters. It may be important for the pregnancy curriculum for health professionals working with pregnant women to consider the impact of the changes on participation in daily life.

Objective: The postpartum period is a critical phase in a woman's life, marked by physical, emotional, and social changes. In Nepal, where labor migration is prevalent, many women experience this transformative period without their husbands' physical presence, who often work abroad to support their families. This study explores the lived experiences of these women, shedding light on the intersection of motherhood, migration, and socio-cultural contexts in Nepal.

Methodology: A deductive and inductive qualitative approach was adopted to capture the subjective lived experiences of women with labor migrant husbands during the postpartum period. Semi-structured interviews were conducted with a purposive sample of 16 participants, and thematic analysis was used to identify patterns, themes, and insights emerging from the data. An interview guide was developed based on the Biopsychosocial Model to explore and gain a deeper understanding of women's postpartum experiences.

Results: The findings reveal a myriad of challenges faced by women with labor-migrant husbands during the postpartum period. Four themes were identified: the emotional landscape of motherhood, the struggles of new mothers facing postpartum challenges without spousal support, the power of community: stories of support during the postpartum journey, and coping strategies.

Conclusion: While the qualitative approach of this study provided valuable insights into women's lived experiences, it may not allow for generalization to the population of postpartum women with labor migrant husbands in Nepal. The results of this study further highlight the need for an inquiry into the long-term impacts of spousal absence on maternal mental health and child development.

Introduction: Black women face several obstacles in breastfeeding promotion, education, support, and continuation. The Black church symbolizes a powerful beacon of health and advocacy within the Black community. However, there are limited studies that investigate the impact of the church on Black women's breastfeeding practices and experiences. This study examines how the Black church influences Black women's breastfeeding experiences.

Methods: Three breastfeeding cohorts of Black women in Kentucky (n = 15) completed 45-60-minute individual semi-structured qualitative interviews on their breastfeeding initiation, sources of support, challenges, successes, and healthcare experiences. Reflexive thematic analysis was used to analyze the data.

Results: Five themes captured how the church influenced Black women's breastfeeding experiences: (1) Reflecting breastfeeding as normal in church, (2) Designated spaces for breastfeeding, (3) Breastfeeding etiquette at church, (4) The role of elders, and (5) Breastfeeding as a natural or spiritual choice.

Discussion: Findings emphasize the Black church's unique and advantageous position in supporting nursing women by normalizing breastfeeding and fostering advocacy through partnerships with health organizations. Such efforts have the potential to address breastfeeding disparities and advance health equity for Black women by aligning support with their cultural and communal values.

Objectives: Military families experience lifestyle and circumstance-specific stressors that may impact their parental stress, family resilience, and emotional support for parenthood. These outcomes may influence parenting behaviors and mental health that have further implications on child development and growth. Research is needed to examine these outcomes among military families in the United States on a national scale due to the importance of potential intergenerational implications.

Methods: This cross-sectional study used data from the 2021-2022 National Survey of Children's Health to investigate the relationship between caregiver military status and outcomes of parental stress, family resilience, and emotional support for parenthood (n = 99,869). Bivariate analyses through chi-square tests were calculated to determine differences between outcomes from military caregivers and civilian caregivers with select covariates. Multivariable regression analyses were calculated to further explore the relationship between caregiver military status and emotional support for parenthood.

Results: The prevalence of emotional support with parenthood was higher among military caregivers compared to civilian caregivers (82.8% vs. 75.0%, p < 0.0001); however, this difference was not statistically significant in adjusted analyses. No statistically significant differences were found between military families and civilian families in parenting stress and family resilience.

Conclusions: This study extended previous research that have focused on state or station specific outcomes in military families by examining these outcomes on a national scale. This study has important implications towards expanding research and interventions that reduce parenting stress and improve family resilience and emotional support for parenthood to ensure continued positive outcomes.

Purpose: The purpose of this paper is to describe the design and implementation of the storytelling component of a multiprong, community-based project that shares the lived experience of Black and Brown women's birthing journey to reduce maternal mortality.

Description: Beginning 2021, the Southeast Michigan Perinatal Quality Improvement Coalition (SEMPQIC) worked with community perinatal care providers to administer a multiprong project to reduce maternal mortality in Detroit. The goal of the project was to build upon existing community assets to examine and replicate circumstances and conditions where Black mothers thrive. This article will focus on one component of this four-part effort that included production of storytelling videos of the birthing journey by Black and Brown women.

Assessment: A partnership with SEMPQIC and trusted, established community perinatal service providers was the operational foundation to identify 110 perinatal women from Detroit, willing to engage in storytelling training to tell their unique birthing journey story. 22 videos were professionally produced for use in Detroit to offer the lived experience of the current perinatal system of care. The engagement of the women for storytelling led to the development of a broader campaign and tool kit about maternal health called Our Voices Our Births: Hear Us! - Detroit Mothers Speak.

Conclusion: SEMPQIC works to reduce maternal mortality and improve the perinatal care system through promotion of racial health equity, using community collaboration for collective impact. This storytelling initiative demonstrates the transformative power of storytelling in addressing the maternal mortality crisis.

Objectives: This study explored how tandem-feeding mothers felt supported or unsupported by their family members, to identify common responses to this breastfeeding practice.

Methods: Free-text data were collected via an online questionnaire from a global sample of 1,209 tandem-feeding mothers. An emergent content analysis was conducted on 795 statements describing supportive experiences and 1,342 statements describing unsupportive experiences. Coding categories were developed inductively from the data.

Results: Five coding categories emerged from supportive comments and seven from unsupportive comments. The most prevalent supportive categories were normalisation of breastfeeding and respect for the mother's choice (52%), emotional support and encouragement (19%), and support provided without specific context (11%). The most prevalent unsupportive categories were questioning, challenging or pressuring mothers to stop tandem feeding (34%); disapproving comments, gestures or insults that caused mothers to feel uncomfortable (22%); and misinformed comments about tandem feeding (18%).

Conclusions for practice: Tandem-feeding mothers frequently experience both support and opposition from family members, with unsupportive responses often characterised by judgment and misinformation. These findings highlight the need for increased education and visibility of tandem feeding to normalise this practice and reduce stigma. Improving family understanding of tandem feeding may enhance social support for mothers and contribute to more positive breastfeeding experiences.

Objectives: To explore the practices and preferences of perinatal and infant mental health (PIMH) clinicians, towards the clinical assessment of the parent-infant relationship in mental health settings.

Methods: A cross-sectional, multilingual, 36-item survey was distributed globally from December 2019 to June 2020. Data from 321 qualified health professionals (Medicine, Nursing, Psychology, Social Work, Occupational Therapy, Speech Pathology) from 16 countries were examined. The survey captured participants' own assessment preferences and practices (clinician perspective) and their perceptions of the attitudes and practices of the service in which they work (service perspective). Differences between clinician and service perspectives were examined using Chi-squared tests of proportions.

Results: Respondents endorsed the clinical importance of assessing parent-infant relationship quality across outpatient and inpatient settings. A dyadic focus to assessment, evaluating the parent-infant relationship as a unit rather than assessing the parent or infant separately, was more popular as a personal preference (52.6%) than as a service preference (31.7%), PD = 20.9% [95% CI 12.6-28.8], χ²(1, N = 268) = 24.0, p < .0001. Most respondents endorsed partner involvement in PIMH care; however, a minority belonged to a service that provided partner-infant assessments (49.2%). Only a small proportion reported family-focused assessment as their individual preference (14%) or service preference (7%).

Conclusions: The positive attitudes suggest overall support among clinicians for the assessment of parent-infant relationship quality as a routine practice within PIMH service delivery. Survey findings also suggest efforts should be made to include greater partner involvement and a family focus.

Objective: SPARK36 is a structured interview tool for nurse-led consultations with parents of 3-year-olds in Youth Health Care. Previous studies demonstrated its feasibility, reliability and known-groups validity. This study examined its convergent validity.

Methods: In a cross-sectional study during the COVID-19 period, associations between scores on 12 SPARK36 domains and conceptually related subscales of three parent-reported instruments were explored. Correlations were assessed using Kendall's Tau-C.

Results: Of the 599 parents of children attending a SPARK36 consultation, 286 (41.7%) did not return a questionnaire. These parents more often had lower educational levels, non-Belgian nationalities, less often spoke Dutch at home, and more often showed increased or high risk based on the SPARK36 (19.9% vs. 13.7% respectively; p = 0.04), indicating potential selection bias. None of 32 tested correlation coefficients (e.g., SPARK36 'child behavior' with SDQ scales) exceeded 0.20.

Conclusion for practice: Convergent validity could not be demonstrated possibly due to the overall response rate, selective non-reporting, and the fact that most children showed no developmental or parenting problems. Three lessons emerged: (1) equity challenges occur, when parent-report tools are used among higher-risk families; (2) ongoing support may be needed to ensure consistent data collection by the nurses, given the large variation in data collection across them; (3) crisis situations disturb data collection, though a 50% questionnaires response rate may still be achievable during adverse contexts. The lessons also suggest that interview formats like SPARK36 may help reduce inequities that arise when preventive care relies on parent-report questionnaires.