Search Results (46)

Background: Fear of childbirth (FOC) or tokophobia has a detrimental impact on women during and after pregnancy. Childbirth fear is multidimensional and may differ across nations and cultures. We aimed to determine the psychosocial determinants of tokophobia among Asians. Methods: We conducted a systematic literature search using the PubMed, Scopus, and Web of Science databases in September 2023. Included were original English-language articles that focused on Asian cohorts. We identified independent variables associated with maternal childbirth fear based on multivariable logistic and linear regression analysis. Results: Twenty-three studies are discussed in this review. We categorized the factors into (1) psychiatry, (2) psychology, (3) perception and experience, (4) relationships and support, (5) spirituality, and (6) COVID-19. The studies involved 10,538 women with overall FOC prevalence ranging between 56.6% to 82.1%. Maternal history of psychiatric disorder, depression, and anxiety were positive predictors of childbirth fear. Childbirth self-efficacy protects Asian mothers against tokophobia. A reduced level of fear was associated with higher maternal psychological and spiritual well-being, as well as stronger maternal resilience. Spousal and social support alongside good family function were shown to exert a protective effect against childbirth fear. Intimate partner abuse was associated with an increased risk of tokophobia in women. Studies during the pandemic indicated that maternal fear, obsession, and anxiety about COVID-19 were positively correlated to fear of childbirth. Conclusions: Childbirth fear among Asian women is greatly influenced by various psycho-social factors. More culturally driven research is needed to help develop relevant interventions that will enhance maternal psychological and spiritual well-being and reduce the fear of childbirth. Full article

Background and Objectives: Pregnant women may experience various difficulties when abnormal conditions are detected in their babies. We examined the relationship between anxiety and depression levels, spousal support, and stress-coping styles in pregnant women diagnosed with fetal anomalies. Materials and Methods: A total of 157 pregnant women, 59 of whom were diagnosed with fetal anomalies and 98 of whom were healthy with no obstetric complications, were included in this study. All participants were administered the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Spousal Support Scale (SSS), and Coping Styles Scale (CSS) questionnaires. The data were compared statistically. Results: The BAI (p < 0.001) and the Submissive Approach (p = 0.004), which is a subdimension of the CSS, were significantly higher in the group of pregnant women diagnosed with fetal anomalies than in the control group. Multivariate logistic regression analysis performed to calculate the risk of fetal anomalies showed that having a high school education or below and living in the city were associated with a higher risk of fetal anomaly than living in the countryside. The cut-off value of 4 for the BAI had a sensitivity of 64.4% and a specificity of 65.3. Additionally, a cut-off value of 6 for the Submissive Approach, a CSS subdimension, had a 66.1% sensitivity and a 57.1% specificity. A significant negative correlation was observed between the Spousal Support Scale, the BDI, and the gravidity in the case group. There was a positive correlation between the BAI and the BDI and a significant negative correlation between the BAI and these CSS subdimensions: Self-Confident Approach, Seeking Social Support, and Optimistic Approach. There was a positive correlation between the BDI and the Helpless Approach subdimension of the CSS and a significant negative correlation between the BDI and the Self-Confident Approach and Optimistic Approach subdimensions, as well as the gestational age at which fetal anomaly was detected. A significant positive correlation was observed between the BDI and the Helpless Approach subdimension of the CSS, while significant negative correlations were observed between the BDI and the Self-Confident Approach and Optimistic Approach subdimensions and the gestational age at which the fetal anomaly was detected. Conclusions: The pregnant women diagnosed with fetal anomalies experienced anxiety, but most tended to use the submissive coping style to deal with stress, and their partners also supported them. Full article

Background/Objectives: The present study aimed to reveal the differences in changes in and risk factors for depressive symptoms between people with and without various psychiatric disorders during the pandemic. Methods: Longitudinal web-based surveys were conducted from 2020 to 2022. The diagnosis of mental disorders was based on self-reports by participants. Depressive symptoms were measured via the Patient Health Questionnaire-9 (PHQ-9), and coping was measured via the Brief Coping Orientation to Problems Experienced Inventory. A linear mixed model of PHQ-9, two-sample t-tests on Brief-COPE, and multiple linear regression for with and without mental disorders were conducted. Results: A total of 1443 participants were analyzed, of whom 9.3% had mental disorders. Depressive symptoms significantly decreased from January 2021 to January 2022, regardless of mental disorder status. Participants with mental disorders used certain coping styles more frequently than those without mental disorders. In a multiple linear regression analysis, no coping strategy was significantly effective for PHQ-9 scores among participants with mental disorders. However, being single was a risk factor, and emotional support use was associated with PHQ-9 scores. Additionally, behavioral disengagement was linked to PHQ-9 scores, regardless of mental disorder status. Conclusions: These results showed depressive symptoms might decrease in the long term regardless of the presence of mental disorders. Although there was no evidence of coping strategies effectively reducing depressive symptoms in people with mental disorders, the presence of a spousal relationship may play an important protective role for people with mental disorders and behavioral guidelines regardless of the presence of mental disorders. Full article

The reintegration of survivors and their children born because of war rapes is a major issue in the eastern Democratic Republic of the Congo. This study analyzed survivors’ posttraumatic stress disorder (PTSD) and the support received from their spouses, both in terms of their own well-being and that of their children. The PTSD form, DAS-16, Marital Support Survey, Sexual Desire Scale, and Connor–Davidson Resilience Scale tests were administered to 28 survivor couples and 32 control couples selected from the Kabamba cluster in Kabare, South Kivu. Over 70% of the respondents had PTSD scores above 34, required clinical assistance, and were not satisfied with their marital relationships. Based on survivors’ perceptions, the balance of marital support and the coherence of couple responses were negative. The survivors typically feel that they provide more support to their husbands than they receive. Unlike husbands, survivors presented low individual sexual desire and high dyadic sexual desire scores, while husbands’ dyadic desire decreased, and they no longer wished to have sexual relations with their partners. Rape survivors derive resilience from prayer and internal self-control, as they live in an environment in which war-related stress causes chronic trauma. Full article

Objective: To investigate primiparous women’s knowledge, attitudes, and practices regarding the physical home food environment (PHFE) and to assess if the first pregnancy provides a teachable opportunity to enhance the PHFE of first-time pregnant couples. Design: Longitudinal in-depth qualitative study involving questionnaires and individual interviews during and after pregnancy. Participants: Fifteen primigravida women. Main outcome measures: Knowledge, attitudes, and behaviors concerning PHFE; lifestyle and dietary habits; and interest in guidance regarding healthy PHFE during the first pregnancy and the transition to motherhood. Analysis: Thematic analysis for qualitative data and descriptive statistics. Results: Key findings include the significance of health, nutrition, and spousal support in the transition to motherhood. The first pregnancy was recognized as a critical period for establishing a healthy PHFE, while noting the physical and emotional challenges involved. A gap was found in guidance regarding PHFE for first-time pregnant women despite their interest in practical advice. Conclusions and Implications: The first pregnancy presents a significant opportunity to improve PHFE. ‘Nestrition’ (nutritional nesting), a new health-promotion strategy, incorporates nutrition education to enhance this process. These data support future research encompassing partners and diverse at-risk populations prior to the development of effective nutrition education for PHFE in the first pregnancy. Full article

(1) Background: Illness perception (IP) is an important psychological construct for couples dealing with cancer, which impacts health outcomes and the psychological adjustment to cancer. More research is needed to explore the traits of IP and the efforts of couples coping with cancer. Thus, this study was designed to explore the coping experiences and features of the IPs of couples dealing with cancer. (2) Methods: A total of 24 patients with colorectal cancer (CRC) and 20 spousal caregivers (SCs) participated in semi-structured interviews. All interviews were recorded digitally, transcribed, and analyzed by using an inductive thematic analysis. (3) Results: Two themes (individualized and predominant IP; IP sharing and restructuring) were developed. A preliminary framework was formulated to illustrate the relations among subthemes and the relations between themes with an adjustment of a positive IP to CRC. In this framework, based on multiple sources and factors, the natural disparities formed the IPs of the partners of couples and determined the incongruence of IPs. The effects of IP incongruence on lives under the disease guided the three directions of coping approaches (i.e., information and available support, appropriate disclosure and reflection, and leaving the CRC diagnosis behind) which were adopted by couples dealing with CRC to share and restructure the IP with their spouses for effective dyadic coping. (4) Conclusions: This study provides insights to healthcare providers into the experiences of couples dealing with CRC and the development of couple-based IP intervention programs: (a) it initially provides adequate factual knowledge for enhancing beliefs in the ability to control illness, (b) encourages illness-centered conversations and disclosure regarding thoughts and emotions for promoting positive congruence of IP between the partners of couples dealing with a hard dilemma, and (c) guides couples to perceive positive changes and explore the illness’s meaning. Understanding each theme of personalized IP and adopting effective IP coping approaches can help guide couples dealing with CRC to efficiently promote constructive IP and better health outcomes. Full article

This study clarified the negative aspects of the self-imposed evacuation of mothers of small children seeking to avoid radiation exposure from the Fukushima Daiichi Nuclear Power Station accident on 11 March 2011. We conducted semi-structured interviews with 27 mothers, employing open-ended inquiries based on an interview guide. Our analysis of their responses using the Ka-Wakita-Jiro (KJ) method categorized the results into eight distinct groups comprising 142 labels. These categories included continued anxiety about the health effects of radiation, differences in risk perception, changes in spousal relationships, the inability to make friends and find support, living as a single parent, financial concerns, the unfamiliar feel of the area to which they evacuated, and uncertainty about the future. Despite their hardships, the mothers continued their self-imposed evacuation to avoid radioactivity. Our findings underscore that their anxieties about radiation exposure persisted even after self-imposed evacuation, leading to deteriorated relationships with key individuals who would have been involved in raising their children. These results offer valuable insights into the challenges experienced by the indirect victims of the nuclear accident, such as the mothers of small children. Full article

This study explored the association of spousal support and marital satisfaction with the subjective well-being of fathers and mothers using a mediation analysis. Data were gathered from 360 fathers and 338 mothers (aged 25–50 years). Subjective well-being was measured as an outcome using the Japanese version of the World Health Organization-Five Well-Being Index. Marital satisfaction was measured as a mediating variable using the Japanese version of the Marital Relationship Satisfaction Scale. Spousal social support (including instrumental, emotional, and appraisal support) was measured as an independent variable using four-point scales. Control variables were the father’s and mother’s ages, number of children, age of the youngest child, children going to nursery school or kindergarten, use of childcare services, self-evaluated low economic status, and weekday working hours. Among fathers, instrumental and emotional support had significant direct and indirect effects, with the latter mediated by the impact of marital satisfaction on subjective well-being; appraisal support had only significant indirect effects. Among mothers, instrumental support had significant direct and indirect effects; emotional and appraisal support had only significant indirect effects. Our findings indicate that social support from spouses has protective direct and indirect effects on subjective well-being among parents and suggest the need for mutual support between spouses to facilitate effective co-parenting. Full article

Background: Fear of Childbirth (FOC) can significantly impact women’s physical and psychological health; therefore, healthcare providers must provide proactive care, which means they have to intervene before FOC becomes tokophobia. This study’s purpose is to evaluate the determinants of prenatal childbirth fear during the third trimester among low-risk expectant mothers. Methods: A cross-sectional comparative study was conducted at the Maternal and Children Hospital’s outpatient clinics in Najran City, Saudi Arabia, from April to July 2023. The study involved 377 nulliparous and multiparous women, using a systemic random sampling technique. The data were collected using an interview schedule composed of questions related to demographic and obstetrics characteristics, the FOC questionnaire, and a multidimensional scale of perceived social support. Significant FOC predictors were examined using a binary logistic regression model. Results: There was a statistically significant difference between nulliparous and multiparous participants concerning FOC; 80.0% of nulliparous participants had significant FOC compared to 67.8% of multiparous participants (p = 0.011). A binary logistic regression clarified that regular antenatal care and family and spousal support were significantly negatively correlated with significant FOC among multiparous and nulliparous women (p < 0.05). For multiparas, FOC was associated with pregnancy planning and previous labor-related complications. In addition, friends’ support was an important predictor of significantly lower FOC among nulliparous women (p < 0.05). Conclusions: Significant FOC was higher in nulliparous women when compared to multiparous women. Numerous obstetric variables and different types of social support play important roles in significant FOC. Special attention and support should be provided to high-risk women for proper FOC management during prenatal classes to improve their childbirth experiences. Full article

HIV diagnosis and poor HIV management have various detrimental impacts on the lives of people living with HIV (PLHIV). As a part of a large qualitative study investigating HIV risk factors and impacts, of which the topic of suicide is not a focus, this paper describes the factors contributing to suicidal ideation and attempts that arose naturally in the stories of women living with HIV (WLHIV; n = 52) in Yogyakarta and Belu districts, Indonesia. The participants were recruited using the snowball sampling technique. Guided by a qualitative data analysis framework, the data were thematically analysed. The findings were grouped into four main themes: (i) the women experienced immense psychological challenges due to the infection, spousal transmission, fear of mother-to-child transmission, and losing a child due to AIDS, which triggered suicidal ideation and attempts; (ii) the lack of awareness of HIV management strategies resulted in them feeling trapped and overwhelmed, and the associated negative thoughts and the anticipation and experience of HIV stigma influenced their thoughts of suicide; (iii) the lack of social support from family and friends during the early stages of HIV diagnosis, compounded with pre-existing financial difficulties, lack of income, unemployment, and feeling overburdened, also triggered the women’s thoughts of suicide; and (iv) family breakdown following HIV diagnosis, concern about future relationships, and fear of being rejected or abandoned by their partner were also influencing factors for suicidal ideation and attempts among the women. The findings indicate the need for a nuanced approach to counselling within HIV care interventions for couples to support the acceptance of each other’s HIV status whilst maintaining psychological wellbeing. Additionally, the findings indicate the importance of HIV education and awareness among community members for the de-stigmatisation of HIV and to increase the acceptance of PLHIV by their families and communities. Full article

This article investigates the experience of male spousal carers for women living with dementia. While cultural discourses on care are highly gendered, social scientific research often addresses care relationships in gender-neutral terms. Setting out to address this matter, this qualitative research study incorporated semi-structured joint interviews with 10 couples in which a male spouse cared for a woman with dementia. The aim was to explore how couples negotiate relationships and care following a diagnosis of dementia. The focus of this paper is on the perspectives expressed in these joint interviews by the male carers. A thematic analysis was undertaken to establish the key content of the men’s accounts. Three principal themes were identified: making sense of the condition; treating dementia as a problem to be solved; and engaging with professionals and support. The gendered basis of experience for male carers is explored within these themes, demonstrating how societal norms of masculinity intersect with caring roles. The paper concludes that a nuanced research approach to dementia care must continue to be developed, accounting for how gender shapes personal responses to the navigation of care relationships. Practitioners and policymakers must also consider how gendered experience shapes the identities and strategies of male carers. Full article

Objectives: The burden of postpartum depression (PPD) is significant because it remains unrecognized, and it not only affects the mother adversely but also has a negative consequence on the family life and the development of the infant. The aim of the study was to measure the prevalence of PPD and identify the risk factors of PPD among mothers attending the well-baby clinic of six Primary Health Care centers in Abha city, Southwest Saudi Arabia. Materials and Methods: A total of 228 Saudi women having a child aged between two weeks to one year were recruited in the study by using a consecutive sampling technique. The Arabic version of the Edinburgh Postnatal Depression Scale (EPDS) was used as a screening tool to measure the prevalence of PPD. The mothers were also inquired about their socio-demographic characteristics and risk factors. Results: The prevalence rate of postpartum depression was 43.4%. Family conflict, and lack of support by spouse and family during pregnancy were found to be the strongest predictors of developing PPD. Women who had reported family conflict were at six times higher risk for developing PPD compared to those who did not have a family conflict (aOR = 6.5, 95% CI = 2.3–18.4). Women who reported a lack of spousal support during pregnancy encountered 2.3 fold increased risk for PPD (aOR = 2.3, 95% CI = 1.0–4.8) and women who had not received family support during pregnancy period were more than three times (aOR = 3.5, 95 % CI 1.6–7.7) likely to experience PPD. Conclusion: The risk of PPD among Saudi postnatal women was high. PPD screening should be an integral part of postnatal care. Awareness of women, spouses and families about potential risk factors can be a preventive strategy. The early identification of high-risk women during the antenatal and post-natal period could help to prevent this condition. Full article

Postpartum maternal functioning is a multidimensional concept defined as how a woman manages her daily activities and emotional health after giving birth. This study aimed to determine the predictors of postpartum maternal functioning. This cross-sectional study was conducted on 564 women within one to four months after giving birth (with registered medical records in health centers of Tabriz, Iran) from 2020–2021. The participants were selected based on the cluster sampling method, and data were collected using a standard questionnaire inclusive of sociodemographic and obstetric characteristics, obstetric history, and Barkin Index of Maternal Functioning (BIMF). The adjusted general linear model was employed to estimate the effect of each independent variable (sociodemographic and obstetric characteristics) on the dependent variable (maternal functioning). The mean total score of maternal functioning was 93.1 (±SD = 14.8) out of 120. Based on the adjusted generalized linear model (GLM), “spouse support” and “family support” were strong predictors of maternal functioning. The total score of maternal functioning in women with moderate (B: −4.44; 95% CI: −7.71 to −1.17; p < 0.001) and low (B: −4.77; 95% CI: −8.90 to −1.47; p < 0.001) spousal support was significantly lower compared to women who received a high level of spousal support. Additionally, this score in women with moderate (B: −5.22; 95% CI: −8.56 to −1.87; p < 0.001) and low (B: −3.90; 95% CI: −7.31 to −0.48; p < 0.001) family support was significantly lower compared to women who received a high level of family support. Study results suggest that receiving support from both a spouse and family members can improve maternal functioning. Full article

The participation of males in joint spousal decisions is urgently needed in achieving the fundamental indicators of reproductive health. The low involvement of males in family planning (FP) decision-making is a major determining factor in low FP usage in Malawi and Tanzania. Despite this, there are inconsistent findings regarding the extent of male involvement and the determinants that aid male participation in FP decisions in these two countries. The objective of this study was to assess the prevalence of male involvement in FP decisions and its associated determinants within the household context in Malawi and Tanzania. We used data from the 2015–2016 Malawi and Tanzania Demographic and Health Surveys (DHSs) to examine the prevalence and the determinants inhibiting male involvement in FP decisions. The total sample size of 7478 from Malawi and 3514 males from Tanzania aged 15–54 years was employed in the analysis by STATA version 17. Descriptive (graphs, tables and means), bi-variate (chi-square) and logistic regression analyses (unadjusted (U) and adjusted odds ratio (AOR)) were performed to identify the determinants associated with male involvement in FP decisions. The mean age of respondents in Malawi was 32 years (±8 SD) and in Tanzania, 36 years (±6 SD), with the prevalence of male involvement in FP decisions being 53.0% in Malawi and 26.6% in Tanzania. Being aged 35–44 years [AOR = 1.81; 95% CI: 1.59–2.05] and 45–54 years [AOR = 1.43; 95% CI: 1.22–1.67], educated (secondary/higher) [AOR = 1.62; 95% CI: 1.31–1.99], having access to media information [AOR = 1.35; 95% CI: 1.21–1.51] and having a female head of household [AOR = 1.79; 95% CI: 1.70–1.90] were determinant factors of male involvement in FP decisions in Malawi. Primary education [AOR = 1.94; 95% CI: 1.39–2.72], having a middle wealth index ranking [AOR = 1.46; 95% CI: 1.17–1.81], being married [AOR = 1.62; 95% CI: 1.38–1.90] and working [AOR = 2.86; 95% CI: 2.10–3.88] were higher predictors of male involvement in FP decisions in Tanzania. Increasing the role of males in FP decisions and involvement in FP utilization may improve uptake and continuity of FP usage. Therefore, the findings from this cross-sectional study will support redesigning the ineffective strategic FP programs that accommodate socio-demographic determinants that may increase the likelihood of male involvement in FP decisions, especially in the grassroots settings in Malawi and Tanzania. Full article

Inspired by the caregiver stress process model emphasising the role of resources for caregiving outcomes, the aim of this study was to investigate the prevalence of subjective caregiver burden (SCB) and its associations with individual social, economic, and political resources among older spousal caregivers in a Nordic regional setting. Cross-sectional survey data collected in 2016 in the Bothnia region of Finland and Sweden were used, where 674 spousal caregivers were identified and included in the analyses. The descriptive results showed that about half of the respondents experienced SCB. SCB was more common among Finnish-speaking caregivers. Results from the multivariate logistic regression analysis showed that none of the assessed political resources were significantly associated with SCB when controlling for other variables. Experiencing financial strain was associated with SCB, while personal income was not. Frequent contact with family members was statistically significantly associated with SCB. Future research could use longitudinal data to determine causal relationships, and when data allow, test the full caregiver stress process model to investigate the role of mediating factors in different comparative settings. Accumulated evidence on risk factors for negative outcomes of informal caregiving can contribute to effective screening tools for identifying and supporting vulnerable caregivers, which is becoming increasingly important with the ageing population. Full article