Dissertations / Theses: 'Pregnant women - Mental health'

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Herbell, Kayla. "Social Determinants of Health and Psychophysiological Stress in Pregnant Women: Correlates with Maternal Mental Health." Case Western Reserve University School of Graduate Studies / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=case1534160752855093.

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Bayouh, Fikirte Girma. "Developing antenatal maternal mental health services: Identifying depression in pregnant women attending antenatal care in Sodo district health centres, Ethiopia." Master's thesis, Faculty of Health Sciences, 2020. http://hdl.handle.net/11427/32589.

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Background Major Depressive Disorder is a leading cause of disease burden for women of childbearing age. The prevalence of perinatal depression is significantly higher in women from low and middle income countries than from high income countries. Antenatal depression is associated with low birth weight and preterm delivery. There is also evidence that depression during pregnancy can alter the development of a woman's fetus and her child, with an increased risk for child emotional and behavioral problems. Detection of perinatal depression in primary health care (PHC) is very low. This research gathered evidence on the current practice of detection of pregnant women with moderate-severe depression in the Sodo district and explored potential solutions to the identified challenges. Methods A qualitative study was conducted in four health centres and a primary hospital, located in the Sodo district, Ethiopia. In-depth interviews were carried out with pregnant women diagnosed to have depression. Focus group discussions (FGDs) were conducted with antenatal care (ANC) PHC workers. A framework approach to qualitative data analysis was used. OpenCode computer software was used for data handling during the analysis. Results Nine pregnant women were interviewed in-depth and twelve ANC PHC workers participated in two FGDs. Identified themes were categorized under client, provider and system level barriers, and illness related influences. Women's reluctance to disclose symptoms and seek help and not thinking what they had was an illness and/or not thinking they would get help from ANC clinic were client-side barriers to identifying depression. ANC PHC workers not asking about depressive symptoms, their reluctance to disclose a diagnosis of depression to the affected women and not thinking women with mental health problems are in their clinics were the main provider level barriers. The setting not being conducive for depression assessment, inadequate mental health training and ANC assessment format not having a place for recording mental health assessment were system level barriers raised. Difficulty in differentiating clinical depression from normal emotional reaction emerged as the main illness related influence. ANC PHC workers proposed community awareness-raising, improving communication between women and PHC workers and making mental health assessment part of the routine ANC service, among others, as possible solutions to improve detection of antenatal depression in ANC clinics. Conclusion Multiple client, provider and system level barriers to detection of depression in pregnant women in ANC clinics were identified in the current study. The identified barriers call for interventions at different levels; awareness raising at a community level, training on communicating about emotional concerns and mental health care at a provider level and enabling the health care system to support integration of mental health care into maternal health services at a higher level. Follow-up studies are required to better understand the experiences of women and providers, to quantify the magnitude of the problem and to develop and evaluate contextually appropriate interventions to improve detection of depression in pregnant women.

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Stubbs, Brittney. "PYSCHOSOCIAL WELL-BEING AND EFFORTS TO QUIT SMOKING IN PREGNANT WOMEN OF SOUTH-CENTRAL APPALACHIA." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/honors/479.

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A sample of 1,031 pregnant women from five prenatal practices participated in Tennessee Intervention for Pregnant Smokers (TIPS), an expanded 5A’s (Ask, Advise, Assess, Assist, Arrange) program. Stress, self-esteem, depressive symptoms, and disordered eating were hypothesized to differ among three groups: pregnant women who never smoked, pregnant women who smoked but quit prior to birth, and pregnant women who smoked and did not quit prior to birth. Smokers who quit were lower in stress and higher in self-esteem than those who did not quit. Non-smokers were lowest in stress and depression, and highest in self-esteem. These findings may lead to improved intervention programs and reduction of adverse health effects in children born to mothers who smoke.

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Saad, Ammar. "Improving the Health Equity of Women Now and in the Post COVID-19 Era: Mobile Technology-Assisted Mental Health Interventions for Pregnant and Postpartum Women." Thesis, Université d'Ottawa / University of Ottawa, 2021. http://hdl.handle.net/10393/41953.

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Pregnant and postpartum women often face high levels of psychological stress that increase the risk of common mental disorders (CMDs), such as depression and anxiety. This stress is often not met with timely mental health care and, therefore, may create health inequities. Mobile technology-assisted interventions represent a new opportunity for pregnant and postpartum women that may address health equity, especially during and after the COVID-19 era. We conducted an equity-focused systematic review and included 18 randomized and non-randomized controlled trials for analysis. Our results suggest that mobile interventions can prevent and manage depression across ethnicities and carry the potential to reduce psychological distress. Evidence on anxiety and utilization of care was limited and more research is needed among pregnant adolescents. Our collaborative research approach highlights the potential of mobile technologies and the need for active involvement of patients and other stakeholders in the co-creation and evaluation of mobile interventions.

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Stubbs, Brittney, Valerie Hoots, Andrea D. Clements, and Beth Bailey. "Psychosocial Well-Being and Efforts to Quit Smoking in Pregnant Women of South-Central Appalachia." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7199.

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Introduction: Psychosocial well-being variables from the Tennessee Intervention for Pregnant Smokers (TIPS) study, a longitudinal smoking cessation study in South-Central Appalachia, were investigated as potential predictors of smoking status. Methods: A sample of 1031 pregnant women participated in an expanded 5A's (Ask, Advise, Assess, Assist, Arrange) program, from 2008 to 2011. Measures of stress, self-esteem, depressive symptoms, and disordered eating collected by interview during the first trimester, or during the third trimester in a combined interview if participants began prenatal care late, were hypothesized to differ among three groups of participants: pregnant women who never smoked, pregnant women who smoked but quit prior to birth, and pregnant women who smoked and did not quit prior to birth. Smoking status was measured throughout the study. Whether or not a participant quit smoking was assessed at delivery. Results: Non-smokers were lowest in stress F(2,1027) = 46.38, p < .001) and depression (F(2,1028) = 39.81, p < .001), and highest in self-esteem (F(2,1018) = 29.81, p < .001). Only self-reported stress and self-reported self-esteem predicted quitting. Higher reported stress levels were related to a slightly lower likelihood of quitting (OR = 0.95, 95% CI 0.92, 0.98, p = .003) and higher reported self-esteem predicted a slightly higher likelihood of quitting (OR = 1.05, 95% CI 1.02, 1.08, p = .001). Conclusions: Findings may lead to improved intervention programs and reduction of adverse health effects in children attributable to prenatal smoking. More research should be conducted on smoking cessation in rural pregnant women.

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Sanford, Ashley E. "Trauma-related Distress and Growth| A study of Pregnant and Post-Partum Women in Residential Mental Health and Substance Use Treatment." Thesis, University of California, Santa Barbara, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10192178.

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Positive outcomes associated with traumatic stress have been gaining attention over the past 20 years. Posttraumatic growth (PTG) is one such outcome, characterized by changes resulting from struggling with trauma that leave an individual or community with improved wisdom, strengths, or skills in certain areas that they would not have gained without struggling with trauma. The current study looked at PTG among women in residential treatment for substance use and mental health concerns. All women were also pregnant or had a child under one year of age. Pregnant and new mothers are a particularly high-risk group for negative outcomes related to substance use. This was the first study to assess PTG among women who use substances. Participants were 104 women in a six-month residential treatment in central California from 2012-2015. Services included substance use recovery interventions, trauma interventions, parenting education, and individual and group counseling. Ninety-eight percent reported at least minimal PTG; the mean growth score was the equivalent of between a moderate and great degree of growth. Results demonstrated no relationship between trauma symptoms or change in substance use severity and PTG scores. However, consumer satisfaction was related to PTG, with greater satisfaction being related to higher levels of PTG.

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Gelaye, Bizu, Alan M. Zaslavsky, Jesse R. Fann, et al. "Diagnostic Validity of the Generalized Anxiety Disorder - 7 (GAD-7) among Pregnant Women." PLoS ONE, 2015. http://hdl.handle.net/10757/552241.

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OBJECTIVE: Generalized anxiety disorder (GAD) during pregnancy is associated with several adverse maternal and perinatal outcomes. A reliable and valid screening tool for GAD should lead to earlier detection and treatment. Among pregnant Peruvian women, a brief screening tool, the GAD-7, has not been validated. This study aims to evaluate the reliability and validity of the GAD-7. METHODS: Of 2,978 women who attended their first perinatal care visit and had the GAD-7 screening, 946 had a Composite International Diagnostic Interview (CIDI). The Cronbach's alpha was calculated to examine the reliability. We assessed the criterion validity by calculating operating characteristics. The construct validity was evaluated using factor analysis and association with health status on the CIDI. The cross-cultural validity was explored using the Rasch Rating Scale Model (RSM). RESULTS: The reliability of the GAD-7 was good (Cronbach's alpha = 0.89). A cutoff score of 7 or higher, maximizing the Youden Index, yielded a sensitivity of 73.3% and a specificity of 67.3%. One-factor structure of the GAD-7 was confirmed by exploratory and confirmatory factor analysis. Concurrent validity was supported by the evidence that higher GAD-7 scores were associated with poor self-rated physical and mental health. The Rasch RSM further confirmed the cross-cultural validity of the GAD-7. CONCLUSION: The results suggest that the Spanish-language version of the GAD-7 may be used as a screening tool for pregnant Peruvian women. The GAD-7 has good reliability, factorial validity, and concurrent validity. The optimal cutoff score obtained by maximizing the Youden Index should be considered cautiously; women who screened positive may require further investigation to confirm GAD diagnosis. : This research was supported by an award from the Eunice Kennedy Shriver Institute of Child Health and Human Development (R01-HD-059835) at the National Institutes of Health (NIH). The NIH had no further role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication Revisión por pares

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Martin, Debbie F., and University of Lethbridge Faculty of Health Sciences. "An apple a day won't keep the violence away : listening to what pregnant women living in intimate partner violence say about their health." Thesis, Lethbridge, Alta. : University of Lethbridge, School of Health Sciences, c2009, 2009. http://hdl.handle.net/10133/2514.

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Researchers have provided evidence that living in intimate partner violence while pregnant negatively impacts the health of both the women and their unborn children. The purpose of this narrative study was twofold, first to gain understanding of the meaning of health as described by pregnant women who lived in intimate partner violence, and second to gain strategies for health care professionals. Six purposefully selected women participated in two interviews. The data were arranged under five themes: loss of body health, loss of mind health, loss of spirit health, coping with loss of body, mind and spirit health, and advice for health care professionals. The results revealed that these women’s health was negatively affected by living in intimate partner violence while pregnant. Universal screening, coalition building, further research, changes in health care policies, and changes in nursing education and practice are needed to properly address this serious health issue. xi, 153 leaves ; 29 cm

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Chen, Yang, Liang Wang, Maosun Fu, Jie Wang, Arsham Alamian, and Marc Jr Stevens. "Risk Factors of Mental Health Disorder among Chinese Women in Third Trimester of Pregnancy." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/1401.

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Mental health disorder is the leading cause of disease burden in women worldwide. Pregnant women with mental disorder are especially at risk of having offspring with adverse outcomes. This study aimed to investigate risk factors of mental health disorder among Chinese pregnant women in the third trimester. A total of 462 pregnant women in their third trimester completed interviews at three hospitals in Shandong Province, China from July to December, 2010. The Symptom Checklist-90-R (SCL-90-R) was used to evaluate mental health disorder, and was defined as total score ≥160, or scores of any symptom dimensions ≥3, or total of positive symptoms ≥43. Multiple logistic regression was used to examine the risk factors of mental health disorder, and to adjust for covariates. The total score and scores of somatization, obsessive-compulsive, anxiety, and phobic anxiety were higher than corresponding national norm by SCL-90-R assessment (all p<0.05). Multiple logistic regression showed family income, relationship with parents-in-law, concerns about child's health, fear of delivery, and pregnancy complications were negatively associated with mental health disorder (all p<0.05). More specifically, relationship with parents-in-law, fear of delivery, preference on mode of delivery (Caesarean section), and body image concerns were positively associated with anxiety (all p<0.05); Fear of delivery was positively associated with depression (p=0.023). Family income, relationship with parents-in-law, concern about child's health, fear of delivery, and pregnancy complications were identified as potential risk factors of mental health disorder in this Chinese pregnant women population. Strategies to reduce mental health disorder are needed among Chinese pregnant women.

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Rankin, Jean. "Effects of antenatal exercise on psychological well-being, pregnancy and birth outcome." London : Whurr, 2002. http://dx.doi.org/10.1002/9780470699263.

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Laubscher, Jessica. "Perceived barriers to perinatal mental health care utilization : a qualitative study." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/79988.

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Thesis (MA)--Stellenbosch University, 2013. ENGLISH ABSTRACT: The topic of perinatal depression (i.e. depression during and after pregnancy) remains a subject of continued research interest, as a broad literature body reports that a large proportion of women suffering from this mental disorder do not receive appropriate treatment. This is worrisome, firstly, because mental health treatment is often readily available to the public and at no cost. Secondly, untreated perinatal depression not only holds dangerous consequences for the mother but also for the infant and the rest of the family. It is therefore important to identify those factors that act as barriers to mental health care utilization for perinatal depression. Although this is a persistent problem within the South African context, to date, little is known about the barriers to the utilization of available mental health services experienced among pregnant South African women. For this reason, the Perinatal Mental Health Project (PMHP) aims to provide mental health services at the same location where women receive obstetric services. However, despite their efforts, the number of women who decline available treatment is still of great concern. The present study offers a unique perspective on counselling for perinatal depression appointment-keeping barriers as it provides a holistic view of these barriers that exist not only within the women but also in their multi-levelled environments. Secondly, it addresses the problem of nonattendance to mental health care treatment offered by the PMHP and consequently also addresses the gap in South African research on the topic. The sample for this study was selected from PMHP files of those patients who failed to attend scheduled counselling appointments. The participants included in this study were selected by means of purposeful sampling to participate in face-to-face and telephonic semi-structured interviews. Participants were assured of confidentiality and anonymity. The semi-structured interviews were audio-recorded and transcribed after which transcriptions were entered into MS Word for textual analysis. Transcriptions were thematically analysed. The main themes that emerged from the present study included individual-related barriers, social-related barriers, institution-related barriers, community-related barriers and poverty-related barriers. The results of the present study reflect the motivations for depressive pregnant women to decline available and free mental health services provided by the PMHP, according to five main themes. These themes were then discussed according to Bronfenbrenner’s (1977; 1979) Ecological Systems Theory, which categorised the main themes identified according to the different systems operating within the patient’s environment, i.e. the individual-, micro-, meso-, exo-, and macrosystem. The individual system comprised the individual-related barriers, which included poor mental health, and ambivalent feelings toward the pregnancy. The microsystem comprised the social-related barriers, which included low social support and self-help strategies. Community-related barriers were considered within the mesosystem of the patient’s ecological environment, with stigma and pity as sub-barrier. The exosystem comprised the institution-related barriers, including referral protocol barriers, lack of information provided by the nurses, and nurses’ attitudes as experienced by participants. Lastly, poverty-related barriers were considered within the macrosystem, with financial life hardship, constant child-care demands, and transportation barriers as sub-barriers. The significance of this study lies in the original perspective offered on mental health care appointment-keeping behaviour within the South African context. Future research could, in addition to conducting interviews with hospital patients, include health care professionals and focus groups as this will allow for triangulation of the perspectives of all significant players. Also, having identified the problems and concerns with regards to attending counselling appointments, future research direction may be aimed at creating interventions designed to reduce the identified barriers to mental health care service use. AFRIKAANSE OPSOMMING: Perinatale depressie (d.w.s. depressie voor en na swangerskap) bly ŉ onderwerp van voortdurende navorsings belang, aangesien ŉ breë navorsingsveld aandui dat ŉ groot proporsie van vroue wat aan hierdie geestesversteuring lei, nie die gepaste behandeling ontvang nie. Dit is kommerwekkend, eerstens, aangesien behandeling vir geestesgesondheid meestal openlik verkrygbaar is aan almal sonder enige koste. Tweedens, onbehandelde perinatale depressie hou nie slegs gevaarlike gevolge vir die moeder in nie, maar ook vir die baba en die res van die gesin. Dit is daarom belangrik om daardie faktore te identifiseer wat as hindernisse optree tot geestesgesondheid sorg diensgebruik vir perinatale depressie. Alhoewel dit ŉ voortdurende probleem binne die Suid-Afrikaanse konteks is, is daar tot op hede geen navorsing wat hindernisse tot gebruik van beskikbare geestesgesondheidsdienste bekend gemaak nie, veral wat ervaar word onder swanger Suid-Afrikaanse vroue nie. Vir hierdie rede, beoog die Perinatal Geestesgesondheid Projek (Perinatal Mental Health Project - PMHP) om geestesgesondheidsdienste te lewer by dieselfde plek waar vroue verloskundige dienste kan ontvang. Nietemin, ten spyte van hul pogings, is die getal vroue wat beskikbare behandeling van die hand wys steeds van groot kommer. Dié studie bied ŉ unieke perspektief op hindernisse tot berading vir perinatale depressie afspraak-ooreenkoms gedrag, aangesien dit ŉ algehele uitkyk bied op hindernisse wat nie slegs binne die vroue bestaan nie, maar ook in hul veelvlakkige omgewings bestaan. Tweedens, spreek dit die probleem van nie-bywoning van geestesgesondheidsbehandelingsdienste wat aangebied word deur die PMHP aan en gevolglik ook die gaping wat binne Suid-Afrikaanse navorsing rakende dié onderwerp bestaan. Die steekproef vir die studie was gekies van PMHP lêers van daardie pasiënte wat nie hul geskeduleerde terapie afsprake bygewoon het nie. Die deelnemers ingesluit in die studie is deur middel van doelgerigte-steekproefneming geselekteer om aan aangesig-tot-aangesig of telefoniese semi-gestruktureerde onderhoude deel te neem. Deelnemers is van hul vertroulikheid en anonimiteit van die proses verseker. Die semi-gestruktureerde onderhoude was oudio-opgeneem en transkripsies is daarvan gemaak, waarna die transkripsies in MS Word gelaai is vir tekstuele analise. Transkripsies is tematies geanaliseer. Die hooftemas wat na vore gekom het, sluit in individuele-verwante hindernisse, sosiale-verwante hindernisse, institusie-verwante hindernisse, gemeenskapsverwante hindernisse en armoede-verwante hindernisse. Resultate van dié studie reflekteer die motiverings van depressiewe swanger vroue om beskikbare en gratis geestesgesondheidsdienste wat verskaf is deur die PMHP van die hand te wys, volgens die vyf hooftemas. Hierdie temas is toe volgens Bronfenbrenner (1972) se Ekologiese Sisteemteorie verdeel in die verskillende sisteme teenwoording in die pasiënt se omgewing, naamlik die individuele-, mikro-, meso-, ekso-, en makrosisteem. Die individuele sisteem het die individuele-verwante hindernisse ingesluit, wat swak geestesgesondheid, en teenstrydige gevoelens teenoor die swangerskap omvat het. Die mikrosisteem het die sosiale-verwante hindernisse ingesluit, wat swak sosiale ondersteuning, en self-help strategieë omvat het. Gemeenskapsverwante hindernisse is binne die mesosisteem van die pasiënt se ekologiese omgewing beskou, en het stigma en jammerte as sub-hindernisse ingesluit. Die eksosisteem het die institusie-verwante hindernisse ingesluit, wat verwysing protokol hindernisse, gebrek aan inligting verskaf deur die verpleegsters, en verpleegsters se houdings soos ervaar deur die deelnemers omvat het. Laastens is die armoede-verwante hindernisse binne die makrosisteem beskou, en het finansiële lewens swaarkry, konstante kindersorg eise, en vervoer-verwante struikelblokke as sub-hindernisse ingesluit het. Die belang van dié studie lê in die oorspronklike perspektief van geestesgesondheidsbehandeling dienste afspraak-ooreenkoms gedrag binne die Suid-Afrikaanse konteks, wat aangebied is. Toekomstige navorsing kan, bykomend tot die voer van onderhoude met hospitaal pasiënte, fokus daarop om gesondheidsorg kenners en fokus groepe in te sluit, aangesien dit die triangulasie van perspektiewe moontlik maak van al die belangrike rolspelers. Ook, aangesien die probleem en bekommernisse rakende bywoning van terapie afsprake reeds geïdentifiseer is, mag toekomstige navorsing in die rigting beweeg met die doel om intervensies te omskep wat beoog om die geïdentifiseerde hindernisse tot geestesgesondheidsorg diensgebruik te verminder.

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Kroll-Desrosiers, Aimee R. "Understanding the Experience and Evaluating the Occurrence of Depression in a Sample of Pregnant Veterans." eScholarship@UMMS, 2019. https://escholarship.umassmed.edu/gsbs_diss/1006.

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Background: The Veterans Health Administration (VHA) encourages depression screening and treatment for pregnant veterans; however, rates of depression symptoms and treatment utilization during pregnancy have not been well-studied. Methods: We used data from the Maternity Care Coordination for Women Veterans cohort study. Specifically, our aims were to: 1) examine rates and correlates of depression symptoms in a sample of pregnant veterans; 2) understand mental health care treatment utilization and explore the experiences of veterans accessing mental health care at the VHA during pregnancy; and 3) examine VHA mental health provider's perspectives on depression screening and treatment in the perinatal period. Findings: Depression symptoms were present in 28% of pregnant veterans in our sample. Social support and employment decreased odds of symptoms; history of anxiety, antidepressant use, and active duty service resulted in increased odds of symptoms. Nearly 70% of women veterans with prenatal depression symptoms received at least one mental health visit or antidepressant prescription during pregnancy. However, symptomatic pregnant women without a history of depression were less likely to receive care. Mental health providers identified absence of screening protocols and referral procedures and variability in risk/benefit conversations surrounding antidepressant use as areas of weakness for VHA mental health care during the perinatal period. Conclusions: Depression symptoms were present in nearly one in every three pregnant veterans. Depression treatment during pregnancy is complex, requiring individualized care. Policies for depression screening, referrals to providers, and medication review could be better encouraged to improve standardized care across the VHA.

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Nasseh, Lotf Abadi Mozhdeh. "Social support, coping, and self-esteem in relation to psychosocial factors : A study of health issues and birth weight in young mothers in Tehran, Iran." Doctoral thesis, Umeå universitet, Institutionen för socialt arbete, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-61402.

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Introduction: Generally, pregnancy is considered to be a positive period in life in Iranian culture. For the parents, it is important to have a healthy pregnancy and, as a result, a healthy child. A sufficient birth weight of the infant represents one of the crucial conditions of a healthy development of a child during infancy as well as later in life. Ongoing research has been carried out regarding various medical factors related to birth weight, but there is a gap in knowledge about psychosocial factors such as social support, coping, self-esteem, stress and mother’s mental health, and various socio-demographic factors including domestic violence, which may lead to adverse pregnancy outcomes such as low birth weight. This thesis aims to provide knowledge to fill this gap. Methods: A cross-sectional survey was conducted in Tehran, Iran, including 600 young mothers who had delivered in Akbarabadi hospital, one of the main gynaecological hospitals affiliated with Tehran University of Medical Sciences. The investigation included a self-developed socio-demographic form, the Social Support Questionnaire, the Ways of Coping Checklist, Rosenberg’s Self-Esteem Scale, the General Health Questionnaire-12, and a Life Event Checklist. Results: We could not find a significant association between birth weight and mother’s level of education, and there was no substantial relationship between general mental health and birth weight. Verbal abuse was reported by 26.0% of the young mothers, 4.8% reported physical abuse, 5.5% reported sexual abuse, and 1.3% reported all three types of abuse. The abuse-index was significantly negatively associated with satisfaction with social support and with self-esteem. The higher the abuse-index, by trend, the lower was the infants’ birth weight. Weight before pregnancy, current weight, weight gain during pregnancy, and the number of prenatal care visits were significantly positively associated with the weight of the newborn. Mothers who reported having a history of a low birth-weight (LBW) child or were physically abused during pregnancy had infants with significant lower birth weight. The more the pregnant women were satisfied with their social support and the more often they used positive reappraisal as a way of coping, the higher was their infants’ birth weight. The higher the self-esteem, the less often they used escape avoidance and confrontive coping. Conclusion: The results suggest the importance of relationships between a healthy pregnancy and psychosocial as well as socio-demographic factors. Providing pregnant women with social support is a key component for a healthy pregnancy, especially when faced with stressful situations. The number of people available for support did not provide a significant buffering effect on domestic violence (DV), but the perceived quality of social support did. Higher education in the mother and husband, and women’s employment represented protective conditions against the occurrence of DV. Women who reported physical abuse during pregnancy had infants with lower birth weight. Satisfaction with social support and use of positive reappraisal were significantly associated with higher birth weight.

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Singh, Robyn. "Exploring psychological distress among a sample of pregnant women from a low income area who self-identify as being distressed." University of the Western Cape, 2018. http://hdl.handle.net/11394/6256.

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Magister Artium - MA (Psychology) Psychological distress during pregnancy has been a fairly neglected phenomenon and has only recently started emerging as an area of research interest. The existing body of scholarship on distress during pregnancy has largely been conducted from a positivist paradigm, emphasising the identification, incidences and risks. There is thus a dearth of qualitative inquiry into pregnant women's experiences and accounts of distress. In an attempt to address these gaps within the literature, my study explored psychological distress among a group of pregnant women from socio-economically disadvantaged contexts. The specific objectives of my study was to explore how pregnant women conceptualised psychological distress within the context of pregnancy; the feelings or symptoms of psychological distress; what pregnant women perceived as its causes; and the psychosocial needs of pregnant women in relation to antenatal distress. This study was guided by a feminist approach and a feminist standpoint epistemology in particular. This lent itself to exploring the phenomenon while departing from a clinical, decontextualised position which translated into an investigation with pregnant women who subjectively perceived themselves to be distressed.

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Hernandez, Julieta P. "Maternal-Fetal Attachment and Health Behaviors among Women with HIV/AIDS." FIU Digital Commons, 2014. http://digitalcommons.fiu.edu/etd/1119.

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Background: Mothers with HIV often face personal and environmental risks for poor maternal health behaviors and infant neglect, even when HIV transmission to the infant was prevented. Maternal-fetal attachment (MFA), the pre-birth relationship of a woman with her fetus, may be the precursor to maternal caregiving. Using the strengths perspective in social work, which embeds MFA within a socio-ecological conceptual framework, it is hypothesized that high levels of maternal-fetal attachment may protect mothers and infants against poor maternal health behaviors. Objective: To assess whether MFA together with history of substance use, living marital status, planned pregnancy status, and timing of HIV diagnosis predict three desirable maternal health behaviors (pregnancy care, adherence to prenatal antiretroviral therapy–ART, and infant’s screening clinic care) among pregnant women with HIV/AIDS. Method: Prospective observation and hypothesis-testing multivariate analyses. Over 17 consecutive months, all eligible English- or Spanish-speaking pregnant women with HIV ( n = 110) were approached in the principal obstetric and screening clinics in Miami-Dade County, Florida at 24 weeks’ gestation; 82 agreed to enroll. During three data collection periods from enrollment until 16 weeks after childbirth (range: 16 to 32 weeks), participants reported on socio-demographic and predictor variables, MFA, and pregnancy care. Measures of adherence to ART and infant care were extracted from medical records. Findings: Sociodemographic, pregnancy, and HIV disease characteristics in this sample suggest changes in the makeup of HIV-infected pregnant women parallel to the evolution of the HIV epidemic in the USA over the past two decades. The MFA model predicted maternal health behaviors for pregnancy care (R2 = .37), with MFA, marital living status, and planned pregnancy status independently contributing ( = .50, = .28, = .23, respectively). It did not predict adherence to ART medication or infant care. Relevance: These findings provide the first focused evidence of the protective role of MFA against poor maternal health behaviors among pregnant women with HIV, in the presence of adverse life circumstances. Social desirability biases in some self-report measures may limit the findings. Suggestions are made for orienting future inquiry on maternal health behaviors during childbirth toward relationship and protection.

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Nash, Michelle C. "Deployment, Post-Traumatic Stress Disorder and Hypertensive Disorders of Pregnancy among U.S. Active-Duty Military Women." Scholar Commons, 2017. http://scholarcommons.usf.edu/etd/6914.

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Introduction. Today women comprise 15% of the U.S. active-duty military, but are often overlooked in research of the Armed Forces. While some of the challenges faced by women are similar to men, they encounter unique stressors related to childcare while deployed, sexual harassment and assault, and gynecological needs. Women are also more likely than men to develop post-traumatic stress disorder (PTSD). Both stress and PTSD have been linked to the development of chronic hypertension and some adverse birth outcomes. We hypothesized that post-9/11/2001 era military women who deployed or who had indicators of PTSD would be at greater risk of developing a hypertensive disorder of pregnancy (HDP) than non-deployed or non-PTSD military women. Methods. We conducted a retrospective cohort study using a U.S. Department of Defense database comprised of all active-duty women who gave birth to their first, live-born singleton infant using Tricare from January 1, 2004 to December 31, 2008. The database included maternal and infant birth hospitalization records, maternal mental health visits, and post-9/11/2001 deployment information which included Post-Deployment Health Assessment (PDHA) and Reassessment (PDHRA) screening responses. HDP was defined with ICD-9-CM codes in the maternal birth hospitalization record. We evaluated the risk of HDP associated with overall deployment and timing of deployment ending compared to non-deployed women, in addition to cumulative months of deployment. We also conducted Classification Tree Analysis (CART) to determine appropriate cut-points for categorization of deployment variables among mothers who deployed: cumulative weeks of deployment, percent of study time spent deployed, and dwell time between two most recent pre-birth deployments. We explored effect modification by covariates postulated to potentially modify the relationship between deployment history and risk of HDP. New variables were defined and used in multivariable logistic regression models for each deployment measure. Women fit into four PTSD case-definition categories: confirmed (ICD-9-CM diagnosis), probable (possible plus endorsement of “high risk” items on the PDHA), possible (endorsement of ≥3 PTSD items on the PDHA), or none (no PTSD indicators). We compared mothers with PTSD to non-cases using multivariable logistic regression to quantify the risk of HDP, and repeated the analyses using a ≥2 PTSD item endorsement case-definition criteria. All logistic regression models were adjusted for known confounders and important covariates. Results. There were a total of 36,675 births, 13.4% of mothers experienced at least one HDP, and 35% of mothers deployed. No increased risk of HDP was observed for deployment overall (OR=1.02, 95% CI: 0.95-1.09), but black mothers who deployed were 13% more likely to develop an HDP (OR=1.13, 95% CI: 1.00-1.27). CART revealed an important cut-point for cumulative deployment length of ≥1 year, which was statistically significant among mothers <35 years old. Mothers with ≥1 year cumulative deployment were 17% more likely to have an HDP than mothers deployed <1 year (OR=1.17, 95% CI: 1.01-1.36). The prevalence of confirmed PTSD was 1.6% in the overall cohort. The prevalence of any PTSD among deployed mothers who completed a PDHA was 6.2%. Overall, PTSD was not significantly associated with HDP except among probable PTSD cases using the ≥2 item criteria (OR=1.30, 95% CI: 1.01-1.67) and among confirmed PTSD mothers identifying as “other” race (OR=6.62, 95% CI: 1.72-25.47). Conclusion. Results are suggestive of an elevated risk of HDP among the military population among women who deployed for a year or longer and for black mothers. Although PTSD did not clearly confer additional risk in the overall cohort, there is evidence to support further research using more thorough screening especially across racial/ethnic groups. Our study likely underestimated PTSD and possibly attenuated results since individuals may purposely report inaccurately on the PDHA in order to go home sooner after deployment. Future studies should include information related to deployment-specific experiences and screen all participants for evidence of PTSD.

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Lau, Ying, and 劉櫻. "The roles of social support in antenatal and postnatal depressive symptoms and family conflicts among Hong Kong Chinese women: a three-wave prospective longitudinal study." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B37686392.

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Storkey, Karen. "The prevalence of depressive symptoms in the prepartum and postpartum period : a study of low-income women in the Western Cape, South Africa." Thesis, Stellenbosch : University of Stellenbosch, 2006. http://hdl.handle.net/10019.1/2268.

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Thesis (MA (Psychology))--University of Stellenbosch, 2006. This study aimed to determine whether low-income women residing in a rural community in South Africa experienced any significant difference in the prevalence rates of depressive symptoms postpartum as compared to depressive symptoms prepartum. Thirty women between the ages of 16 and 38 were recruited during pregnancy from the local community clinic in Kylemore, South Africa. The women where assessed for elevated levels of depressive symptomatology using the Beck Depression Inventory (BDI) during pregnancy and again at three and six months postpartum. It was found that 18 (60%) of the women reported elevated levels of depressive symptomatology during the prepartum assessment, with 11 (37.9%) and 12 (48%) women reporting elevated levels of depressive symptomatology at the three months and six month postpartum assessment respectively. It was further found that the sample from the current study did not experience any significant difference in the rate of depressive symptomatology from the prepartum assessment to either of the postpartum assessments. The results also suggests that a relationship exists between the levels of depressive symptomatology prepartum and the levels of depressive symptomatology postpartum, as those women who experienced high levels of depressive symptomatology during pregnancy continued to show high levels of depressive symptomatology at the postpartum assessments. The findings from the current study thus suggest that the classification of postpartum depression as a unique and separate entity, that differs from depression occurring in women at other times and from depression as experienced by men, may be misleading. The term suggests a depression that develops following childbirth, while in the current study it seemed that when depressive symptoms were reported postpartum, they were also already apparent during pregnancy. The findings from the current study therefore suggest that the existence of postpartum depression as a distinct diagnosis or illness is problematic – a suggestion that has frequently been suggested in the literature (Aderibigbe, Gureje, & Omigbodun, 1993; Chandran, Tharyan, Muliyil & Abraham, 2002; Cooper, Campbell, Day, Kennerly & Bond, 1988; Cox, Murray & Chapman, 1993; O’Hara, Zekoski, Phillips & Wright, 1990; Patel, Rodrigues, & DeSouza, 2002).

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Treisman, Karen. "The experiences and meaning for UK-based African women after being diagnosed with HIV during their pregnancy." Thesis, Canterbury Christ Church University, 2011. http://create.canterbury.ac.uk/10200/.

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Section A provides a conceptual critical review of the literature pertinent to the consideration of Mothers living with HIV/AIDS (MLWHA), with a particular focus on African mothers. This review first highlights relevant contextual factors, including discussing prevalence rates and the current reconceptualisations of HIV. This is followed by theories and research relevant to MLWHA, whilst considering wider contextual, social and cultural factors. Thirdly, the theoretical links of the reviewed literature to coping models and strategies are made, and specific cultural factors considered. Finally, suggestions for future research are highlighted. Section B provides the findings of a qualitative investigation conducted to explore the experience of African women living in the UK after being diagnosed with HIV during their pregnancy. Twelve participants completed a short demographic questionnaire, and participated in a one-to-one semi-structured interview. The interview was designed to address multiple personal, interpersonal, and systemic issues related to their HIV status, and HIV in the context of motherhood. Data were analysed using interpretative phenomenological analysis (IPA). Themes which emerged included: HIV being part of one’s wider tapestry, community and systemic influences and responses to HIV, experiencing a different story of HIV, and the mother-child relationship. Strikingly, the aspect of HIV that these women reported finding most distressing was their inability to breastfeed, which seemed central to their cultural identity as mothers. While the generalisability of these findings is clearly limited, nevertheless it seems important for clinicians to (i) recognise that HIV may not always be the primary difficulty facing their clients, and may be amongst numerous other factors, (ii) consider systemic and contextual factors, including cultural influences and past trauma, (iii) focus on client resources and capacity for resilience, and (iv) support clients to access local resources, including support groups, (v) attend to issues around confidentiality, disclosure decisions and breastfeeding, and (vi) hold in mind the potentially powerful and helpful affect for these women of witnessing different narratives around HIV. The continuing need to counteract stigma and discrimination, including from health professionals and from the media, was also apparent. Section C provides a critical appraisal and reflection on the research process, including, evaluating what research skills were learned, which research skills the researcher wishes to develop in the future, what would the researcher have done differently given the chance, how will the research shape or inform the researcher’s clinical practice, and what future research related to the studied area would the researcher consider carrying out.

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Khamker, Nadira. "Psychiatric sequelae and mental health aftercare experiences in women who had a life-threatening complication in pregnancy and those with uncomplicated pregnancies : an explorative-descriptive study." Thesis, University of Pretoria, 2018. http://hdl.handle.net/2263/66021.

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Introduction Studies in the literature indicate that women are vulnerable to develop psychiatric conditions during the perinatal period. Mental health is a neglected topic and that of women’s mental health to a greater extent, with limited attention paid to these women in the South African public health sector. Furthermore, maternal mortality persists as a major public health problem in developing countries, despite global initiatives and strategies aimed at improving maternal health and decreasing mortality. An improvement in maternal health can ensue if together with a decrease in the number of maternal deaths, a reduction in the complications during pregnancy and the postpartum period occurs. Recognition and treatment of severe complications are important as they can have an adverse effect on women’s health not only from a biological but a psychosocial perspective too. The study set out to determine whether women who experience severe life-threatening stressors during pregnancy are more vulnerable to develop psychiatric complications and what are their lived experiences after discharge from hospital? Methods A mixed-method study conducted at two hospitals in Pretoria, South Africa consisted of two arms, a qualitative and a quantitative arm executed in a parallel convergent manner. Data collection occurred concurrently and merging of the data occurred at the level of interpretation. Two groups of participants namely women who experienced life-threatening complications and those with uneventful pregnancies were selected and interviewed at fourtime intervals namely, shortly after delivery, at six weeks, three months and six months postpartum. The quantitative arm consisted of completion of Level 1, symptom appropriate Level 2 cross-cutting symptoms measures and a WHO Disability Assessment. The qualitative arm consisted of in-depth semi-structured interviews of sixteen participants who were purposefully sampled to obtain maximum variation and richness of information. Results A total of eighty-nine women participated in the study. (Forty-six of whom were women with life-threatening complications and forty-three were women with uneventful pregnancies.) Women with life-threatening complications were more vulnerable to develop psychiatric sequelae and presented with a greater variation in their levels of functioning as compared to women with uneventful pregnancies. Psychiatric sequelae included major depressive disorder, anxiety disorders, somatic symptoms, and cognitive impairments; sleep disturbances, anger, psychotic disorders and substance abuse. Common themes identified from the lived experiences included amongst others, feelings of inadequacy, guilt, loss and disappointment, fear of rejection, abandonment, and infidelity and feelings of anger. Conclusion Women in the present study were not only susceptible to risk that predisposed them to develop postpartum psychiatric complications, but also experienced life-threatening complications. These women displayed resilience in that they were able to adapt despite experiencing severe stressors and adversity. The women displayed acceptance, a will to survive and cope as well as strong belief and unwavering faith in God. Thesis (PhD)--University of Pretoria, 2018. School of Health Systems and Public Health (SHSPH) PhD Unrestricted

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Kassada, Danielle Satie. "Gestantes na atenção primária à saúde: transtornos mentais comuns, qualidade de vida e uso de drogas." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/22/22131/tde-25012018-112411/.

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Essa pesquisa teve por objetivo geral identificar a prevalência de Transtornos Mentais Comuns (TMC), uso de drogas e a qualidade de vida (QV) em gestantes atendidas na atenção primária à saúde (APS) no município de Campinas, São Paulo. Trata-se de estudo quantitativo, de caráter correlacional, realizado de agosto de 2015 a agosto de 2016 com plano amostral estratificado e proporcional (n=287). Cada estrato foi formado pela Unidade Básica de Saúde sorteada, na área de abrangência de cada um dos cinco distritos de saúde da cidade. Foram instrumentos de pesquisa: questionário sociodemográfico, econômico, farmacoterapêutico e de histórico de saúde; o Alcohol Use Disorders Identification Test (AUDIT) para o rastreamento do uso do álcool; o Self Reporting Questionnaire (SRQ-20), para estimar a prevalência de TMC e o World Health Organization Quality of Life Assessment-Brief (WHOQOL-brief), para mensurar escores de QV na amostra. TMC, QV e uso de drogas lícitas não prescritas e/ou ilícitas foram considerados variáveis dependentes. Para análise das variáveis TMC e uso de drogas lícitas não prescritas e/ou ilícitas foi utilizado o teste de regressão logística simples e múltipla e QV a regressão linear múltipla. Das 287 gestantes entrevistadas 30% foram positivas para TMC. As variáveis associadas à TMC foram: idade (OR 6,63), situação conjugal (OR 2,15), histórico de transtorno mental (OR 4,34), gravidez desejada (OR 3,33), idade gestacional (OR 5,86), relato de ter sofrido violência (OR 18,47) e uso de chá (OR 2,47). Identificou-se que 95,8% declararam ter utilizado pelo menos um medicamento durante a gravidez e desses 2,09% utilizaram sem prescrição. Em relação à classificação de risco, 58,47% dos medicamentos utilizados são da classe A; 30,87% da classe B; 8,84% da classe C, 1,09% da classe D e 0,73% sem classificação. Quanto ao uso de drogas lícitas não prescritas e/ou ilícitas 19,5% relataram o uso sendo a droga mais utilizada o álcool (8,71%), seguido do tabaco (6,61%); sete (2,43%) usaram essas duas substâncias concomitantemente e quatro (1,4%) utilizaram drogas ilícitas associadas ao álcool e/ou tabaco. Por meio do AUDIT, identificou-se que durante a gestação, 2,8% das mulheres foram classificadas como em uso de risco e 0,7% em provável dependência. As variáveis associadas ao uso de drogas lícitas não prescritas e/ou ilícitas foram idade (OR 6,91) e idade gestacional, sendo no segundo trimestre (OR 2,68) e no terceiro trimestre (OR 2,81). Quanto a QV, a média dos escores foi maior no domínio relações sociais enquanto o mais baixo foi no domínio meio ambiente.O preditor mais significativo para menor QV foi TMC. Assim, os achados desta pesquisa poderão ser utilizados na sensibilização dos profissionais da atenção primária, com vistas a maior adequação das ações desenvolvidas no pré-natal e redução de complicações tanto para a gestante quanto para o feto. Além disso, esses indicadores poderão subsidiar a elaboração e implementação de políticas públicas que proporcione uma assistência pré-natal mais integral e qualificada The objective of this research was to identify the prevalence of Common Mental Disorders (CMD), drug use and quality of life (QoL) in pregnant women treated at primary health care in the city of Campinas, São Paulo. It is a quantitative, correlational study, carried out from August 2015 to August 2016 with a stratified and proportional sampling plan (n = 287). Each stratum was formed by the Basic Health Unit drawn in the area of coverage of each of the five health districts of the city. They were research instruments: socio-demographic, economic, pharmacotherapeutic and health history questionnaire; The Alcohol Use Disorders Identification Test (AUDIT) for tracking alcohol use; Self-Reporting Questionnaire (SRQ-20), to estimate the prevalence of TMC and World Health Organization Quality of Life Assessment-Brief (WHOQOL-brief), to measure QoL scores in the sample. TMC, QV, and use of nonprescription and / or illicit drugs were considered dependent variables. The simple and multiple logistic regression test and multiple linear regression were used to analyze the MCT variables and use of nonprescription and / or illegal drugs. Of the 287 pregnant women interviewed, 30% were positive for CMD. The variables associated with CMD were: age (OR 6.63), marital status (OR 2.15), history of mental disorder (OR 4.34), desired pregnancy (OR 3.33), gestational age 86), suffered violence (OR 18.47) and tea (OR 2.47). It was identified that 95.8% reported having used at least one drug during pregnancy and 2.09% used no prescription. Regarding the classification of risk, 58.47% of the drugs used are class A; 30.87% of class B; 8.84% of class C, 1.09% of class D and 0.73% without classification. Regarding the use of nonprescription and / or illicit drugs, 19.5% reported the use of alcohol (8.71%), followed by tobacco (6.61%), seven (2.43%) Used these two substances concomitantly and four (1.4%) used illicit drugs associated with alcohol and / or tobacco. Through the AUDIT, it was identified that during pregnancy, 2.8% of the women were classified as using risk and 0.7% in probable dependence. The variables associated with nonprescription and / or illicit drug use were age (OR 6.91) and gestational age being in the second trimester (OR 2.68) and in the third trimester (OR 2.81). Regarding QOL, the mean of the scores was higher in the social relations domain while the lowest was in the environmental domain. The most significant predictor for lower QOL was CMT. Thus, the findings of this research may be used to raise awareness among primary care professionals, with a view to improving the adequacy of the actions developed during prenatal care and reducing complications for both the pregnant and the fetus. In addition, these indicators may support the development and implementation of public policies that provide more comprehensive and qualified prenatal care

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Fertig, Adriana. "Histórias de vida de mulheres usuárias de crack." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2013. http://hdl.handle.net/10183/85189.

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A multiplicidade de fatores imbricados na questão do consumo de substâncias psicoativas e do sofrimento psíquico, levando-se em consideração o contexto onde se inserem as mulheres usuárias de crack, despertou-me para essa problemática no intuito de conhecer as histórias de vida e relacionar o fenômeno do crack com a questão de gênero e outras facetas socioculturais. O objetivo deste estudo foi conhecer as trajetórias de mulheres que fazem uso abusivo de crack, a partir de suas histórias de vida. Trata-se de um estudo qualitativo realizado por meio do Método História de Vida, em uma unidade de internação psiquiátrica em um hospital materno-infantil do município de Porto Alegre, Brasil. A escolha das entrevistadas foi intencional e o número de participantes da pesquisa foi definido quando houve convergência das informações, totalizando seis histórias de vida. A coleta dos dados foi realizada por meio de entrevistas abertas com a questão norteadora: “Fale-me a respeito de sua vida que tenha relação com o uso do crack”. A análise dos relatos apontou para as seguintes categorias: As mulheres e o significado de fazer uso abusivo de crack; As alterações ocorridas na vida das mulheres, repercussões e perdas ocasionadas pelo uso abusivo de crack e; Expectativas das mulheres usuárias de crack e o futuro, tratamento e apoio familiar. Os resultados encontrados revelaram que ocorre um início precoce no uso de drogas e crack, que a maioria das entrevistadas sofreu abuso sexual, físico e emocional por parte de algum familiar, que todas as entrevistadas se encontravam em situação de gestação, já tendo tido outros filhos com pais diferentes, que duas entrevistadas já estiveram em regime carcerário, que a maioria relatou ter cometido furtos para obter a droga e que todas já se prostituíram para conseguir o crack. O abandono por parte da família e sentimentos de culpa também foram relatados pelas entrevistadas. A expectativa em relação ao tratamento e ao futuro, abordados neste estudo, possibilitou descrever a esperança que as usuárias possuem e o desejo reiterado em vários momentos, em todos os depoimentos, de viverem sem o crack. Ao contar essas histórias, pretendemos dar voz a quem realmente necessitava deste espaço de acolhimento e promover subsídios para o trabalho da enfermagem em saúde mental, buscando auxiliar nos processos de interação entre usuários e trabalhadores da área de saúde mental. The multiplicity of interwoven factors on the issue from the consumption of psychoactive substances and of psychic suffering, taking into consideration the context where women are users of crack, awakened me to this problem in order to meet the life stories and relate the phenomenon of crack with the issue of gender and other social and cultural facets. The objective of this study was to know the trajectories of women who make abusive use of crack, from their life stories. This is a qualitative study performed through the Life History Method. The survey was developed in a psychiatric unit in a mother-child hospital of the city of Porto Alegre, Brazil. The choice of subjects was intentional and the number of participants in the survey was defined when there was convergence of information, totaling six life stories. The data collection was accomplished through open interviews with the guiding question: "Tell me about your life that is related to the use of crack". The analysis of the reports pointed to the following categories: Women and the meaning of being addicted to crack; The changes in women's lives, Consequences and losses caused by the abuse of crack and Expectations of women users of crack and the future, treatment and family support. The results found in this research showed that early-onset occurs in drug use and crack, which most respondents suffered sexual abuse, physical and emotional on the part of any family; who all interviewed were in a situation of pregnancy, having already had other children with different fathers; who interviewed two been in prison regime, that the majority reported having committed thefts to obtain the drug and that all already committed prostitution to get the crack. The abandonment by the family and feelings of guilt were also reported by the interviewed. The expectation in relation to the treatment and to the future, addressed in this study made it possible to describe the hope that users have and the desire, the wish reiterated at various times, on all the evidence, to live without the crack. In telling these stories, we want to give voice to those who really need this space to host and promote support for the work of the mental health nursing, seeking help in the processes of interaction between users and workers in the mental health area. La multiplicidad de factores entretejidos en el tema del consumo de sustancias psicoactivas y de sufrimiento psíquico, tomando en consideración el contexto donde las mujeres son las usuarias de crack, me despertó a este problema con el fin de conocer las historias de vida y se refieren al fenómeno de crack con la cuestión de género y otros aspectos sociales y culturales. El objetivo de este estudio fue conocer las trayectorias de las mujeres que hacen uso abusivo de crack, a partir de sus historias de vida. Este es un estudio cualitativo realizado a través del método de historia de vida. La encuesta fue desarrollada en una unidad psiquiátrica en el hospital materno-infantil de la ciudad de Porto Alegre, Brasil. La elección de temas fue intencional y el número de participantes en la encuesta se definió cuando hubo convergencia de las informaciones, por un total de seis historias de vida. La recolección de datos se realizó mediante entrevistas abiertas con la pregunta guía: " Háblame a respecto de su vida que tenga relación con el uso del crack". El análisis de los informes señalaron a las siguientes categorías: Las mujeres y el significado de ser adicto al crack; Los cambios en las vidas de las mujeres, consecuencias y pérdidas causadas por el uso indebido de crack y; Expectativas de las mujeres usuarias de crack y el futuro, tratamiento y apoyo de la familia. Los resultados encontrados en esta investigación mostraron que ocurre un inicio temprano en el uso de drogas y crack, que la mayoría de las encuestadas sufrieron abuso sexual, físico y emocional por parte de algún familiar, que todas las entrevistadas estaban en una situación de embarazo, ya habían otros niños con padres diferentes, que dúas entrevistadas ya estuvieron en régimen de cárcel, que la mayoría reportó haber cometido robos para obtener la droga y que todos ya cometieron prostitución para conseguir el crack. El abandono de la familia y sentimientos de culpa también fueron divulgadas por las entrevistadas. La expectativa en relación con el tratamiento y al futuro, abordada en este estudio hizo posible describir la esperanza de que las usuarias tienen y la ambición, el deseo reiterado en varias ocasiones, en todas las declaraciones, de vivir sin el crack. Al describir estas historias, pretendemos dar voz a aquellas que realmente necesita de este espacio de acogimiento y promover el apoyo para el trabajo de enfermería en salud mental, buscando ayudar en los procesos de interacción entre usuarios y trabajadores en el área de salud mental.

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Gabaldon, Nikolas P. "Health education for pregnant women| An influential factor." Thesis, California State University, Long Beach, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=1526910.

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Healthy nutrition is essential for everyone but in some periods, including pregnancy, people are more susceptible and demand attention for nutrition. According to the United States Food and Drug Administration (FDA), approximately 300 extra calories are needed daily to maintain a healthy pregnancy for women. This study analyzes the effects of health education that is provided to pregnant women who are either seeking an office visit for routine or high-risk pregnancy. This study predicted there is no difference in being referred for any type of health education offered to pregnant women between those who received routine pregnancy care and those with high-risk care. It also predicted there is no difference in whether pregnant women are offered nutrition health education/exercise for receiving routine prenatal care and high-risk care. The Statistical Package for Social Services (SPSS) was applied to analyze the 2010 National Ambulatory Medical Care Survey (NAMCS) data using Chi Square statistics. The results from this study indicated no significant relationship between pregnant women who are either seeking an office visit for routine or high-risk pregnancy, as it relates to health education. These results reassure the importance of health education.

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O'Daniel, Linda D. "Referral and Treatment Settings for Pregnant Women." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3191.

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Drug and alcohol addiction in pregnant women is a significant public health issue. The purpose of this study was to assess drug and alcohol addiction in pregnant women and the setting in which they sought service or treatment to determine whether U.S. census regions and race data could predict the type of addiction service or treatment that pregnant addicts chose. The theories of self-efficacy, cognitive behavioral therapy, and rational emotive behavioral therapy were used as the theoretical framework for this study. The research questions were used to examine whether there was a relationship between the source of addiction treatment referral and the type of addiction service or treatment setting for pregnant addicts that reside in the United States at the time of their initial admission for treatment. This quantitative study used archival data from the 2012 Treatment Episode Dataset – Admission from the Substance Abuse and Mental Health Services Administration. Data analysis included the Chi square (χ2) test of independence and a multinomial regression. There was a significant relationship (p < .001) between the source of treatment program referral and type of service/treatment setting for pregnant women who were diagnosed with only an alcohol addiction and both an alcohol and illicit drug addiction. U.S. census region and race did predict the type of addiction service/treatment setting for pregnant addicts diagnosed with an alcohol addiction, as well as those diagnosed with a drug addiction, at the time of treatment admission. Results from this study can be used to address an under researched area of addiction treatment and could aid in changing the behaviors of pregnant addicts, thereby potentially promoting positive social change.

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Johnson, Marckdaline. "An Exploration of the Lived Experience of Women who had Abortions and the Effects of the Abortion Secret on their Relationships: An Interpretive Phenomenological Analysis." Diss., NSUWorks, 2019. https://nsuworks.nova.edu/shss_dft_etd/40.

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The United States Supreme Court decision in the Roe v. Wade (1973) case provides women with a right to privacy and the liberty to make decisions concerning their reproductive lives. With this, women who become pregnant are offered the right to choose between keeping their pregnancy and terminating the pregnancy by way of abortion. Since Roe v. Wade (1973), many women have exercised their reproductive liberties, as evidenced by the termination of over 60 million pregnancies via legal abortion in the United States. Still, secrecy among women with a history of abortion remains a common phenomenon. Studies conducted on abortion and reasons for abortion are innumerable and literature on reasons women keep abortion secret are readily available. However, research lacks in the area of examining the lived experience of women with history of abortion secret. Thus, this research examines this phenomenon from women’s lived experiences and the effects of the secret on their relationship(s) when kept from at least one person(s) with whom the post-abortive women are/were in relationship. Purposive sampling was used to select five female participants for this study. To examine participants’ lived experience with abortion secret history as it relates to its effects on relationship(s), the researcher employed qualitative method Interpretative Phenomenological Analysis (IPA) in conjunction with Bowen Family Systems Theory approach. Seven superordinate themes emerged from the data analysis: self-sacrifice, emotional aftermath of abortion secret; secrecy as protection; dance of anxiety; effects on relationships; generational experiences; and, finding freedom. The collaborative use of IPA and Family Systems Theory provided an understanding of participants’ experiences, the effects of the secret on participants, as well as their emotional systems. The data collected added to the limited research available on this phenomenon providing space for post-abortive women’s secrecy experience to be heard.

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Goderwis, Allison. "HEALTHCARE PROVIDERS’ PERCEPTIONS OF PREGNANT WOMEN." UKnowledge, 2018. https://uknowledge.uky.edu/hes_etds/60.

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Health care providers’ (N = 421) implicit perceptions of pregnant women based on age, race or ethnicity, marital status, and socioeconomic status are assessed through a true-experiment design. Ordinal and binary regression analyses revealed that respondents felt more pity for an unmarried than married pregnant woman and more anger toward an unemployed pregnant woman without health insurance compared to a pregnant woman who was employed with health insurance. Male, Asian, and Hispanic respondents were less likely to help the pregnant woman, Black and protestant respondents were more likely to express some degree of anger toward the pregnant woman, and male and protestant respondents assigned more responsibility to the woman for her pregnancy. Additionally, respondents’ open-ended suggestions varied based on the pregnant woman’s characteristics. Implications and future directions are discussed.

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Ma, Shuk-wah Helen. "Health beliefs of pregnant women who will undergo caesarian section." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1987. http://hub.hku.hk/bib/B29653459.

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Wattar, Bassel. "Improving health outcomes for pregnant women with metabolic risk factors." Thesis, Queen Mary, University of London, 2018. http://qmro.qmul.ac.uk/xmlui/handle/123456789/33934.

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The epidemic of maternal obesity is increasing worldwide. Simple, effective and acceptable interventions are needed to combat obesity and improve pregnancy outcomes in women with metabolic risk factors such as dyslipidaemia and obesity. Dietary and lifestyle interventions reduce gestational weight gain, however, their effect on maternal and fetal outcomes is not clearly known. I conducted a large pragmatic randomised trial to evaluate the effectiveness of a Mediterranean-based dietary intervention to reduce the risk of adverse maternal and fetal outcomes in pregnant women with metabolic risk factors (The ESTEEM trial). The intervention significantly reduced gestational diabetes and gestational weight gain by an average of 1.2 Kg with some protective effect on fetal outcomes. I analysed the methodological challenges encountered in the trial and discussed applied solutions. I conducted a systematic review on the commonly used dietary assessment tools in trials involving pregnant women to assess their characteristics, validity, and applicability. Self-reporting dietary tools were the most commonly used to assess dietary intake in pregnancy such as food frequency questionnaires. Only 8% of studies validated the chosen tools and applied a defined adherence criterion. I applied the findings of this review to develop and validate a custom designed food frequency questionnaire, and a short 12 items questionnaire, to assess the participants' adherence in the ESTEEM study. I assessed the dietary intake in a randomised cohort from the ESTEEM study and compared the questionnaires' accuracy to 24 hour dietary recalls as the reference method. Both the FFQ and the short questionnaire performed well for assessing the adherence to and the intake of key foods in the Mediterranean diet. I systematically reviewed available online information sources on the risks and management of obesity in pregnancy in the English language. I assessed 53 websites for their information credibility, accuracy, readability, content and technological quality. Overall I found that non-governmental funded websites that are obesity-specific and targeting healthcare users presented better overall information quality.

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McClain, PhD Janelle S. "Pregnant African American Women Breastfeeding Intentions, Beliefs, Attitudes and Perspectives." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6353.

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Breastfeeding is the best infant feeding source of nutrition for infants in their early stages of development. However, there is a fundamental gap in the number of African American women that initiate breastfeeding compared to White, Asian, and Hispanic mothers. Social cognitive theory was used to explore the breastfeeding intentions, beliefs, perceived barriers, and perceptions on breastfeeding through a basic qualitative research method. To capture the essence of the lived experiences of African American pregnant women, a purposeful sample of 13 African American pregnant women were invited to participate in the study. Two focus groups discussions pertaining to breastfeeding intentions and perceptions were conducted. Data were collected using hand-written notes and audio-taped responses from participants. The data were analyzed using NVivo12 Plus qualitative software program to discover themes and patterns. The findings resulted in 3 themes and 2 subthemes. The themes that emerged from the responses were (a) breastfeeding is the best feeding option, (b) breastfeeding barriers, and (c) breastfeeding intentions and duration. There was identified support in terms of intentions to initiate breastfeeding immediate postpartum and continuing some breastfeeding through 6 months. Further results include subthemes of encouragement and outside influences and recommended future breastfeeding support. Breastfeeding barriers ranged from previous negative experiences, negative comments and advice from family and friends, perceived lack of milk, and pain. This study contributes to positive social change within the community by providing some insight into possible interventions or approaches to improve breastfeeding intentions and to ultimately improve the lives of infants.

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Meléndez-Figueroa, Leocadio. "Relationships of smoking behavior, health beliefs, and health values to intention to smoke among pregnant women in a military health care setting /." Digital version accessible at:, 1998. http://wwwlib.umi.com/cr/utexas/main.

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Strychar, Irene. "The relationship between learning, health beliefs, weight gain, alcohol consumption, and tobacco use of pregnant women." Thesis, University of British Columbia, 1988. http://hdl.handle.net/2429/29241.

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Understanding how women learn during pregnancy is the foundation for planning prenatal education programs. To date, adult educators have not investigated, in any depth, the learning process during pregnancy. The purpose of this study was to examine learning during pregnancy and relate this learning to learning outcomes. The principal research questions were: "What are the learning patterns of pregnant women?" and "What is the relationship between learning and health behavior of pregnant women?" It is unknown whether learning during pregnancy is directly associated with behavior or mediated through health beliefs. The objectives of this research were to identify pregnant women's health behaviors, learning patterns, and health beliefs. The three health behaviors examined in this study were eating, drinking, and smoking. These behaviors were operationalized in terms of their outcomes: weight gain, alcohol consumption, and tobacco use. These factors are amenable to an education intervention and are behavioral risk factors associated with low birth weight. The process of investigating learning patterns consisted of identifying: what was learned during the pregnancy, which resources were utilized, what advice was given, what amount of time was spent in learning, who initiated the learning episodes, and what learning transaction types emerged. Determining learning transaction types was based upon an adaptation of Tough's (1979) concept of planners and Knowles's concept of self-directed learners. The process of investigating health beliefs consisted of identifying pregnant women's concerns, perceived risk, perceived use of the information, and perceived barriers, defined according to an adaptation of the Health Belief Model. The principal hypotheses of the study were: (1) self-initiated learning will be positively correlated with knowledge scores, (2) self-initiated learning will be positively correlated with ideal health behaviors, and (3) health beliefs will be positively correlated with ideal health behaviors: ideal weight gain during pregnancy, reduced alcohol consumption, and reduced cigarette smoking. The research, an ex post facto design, involved a one hour structured interview with women within the week following delivery of their infants in hospital. A proportional sample of 120 primigravidas was selected from seven hospitals with average number of monthly births greater than 100. Reporting of results was based upon 120 interviews conducted as part of the main sample and eight interviews conducted during the pilot study. Pilot responses were included because these responses were similar to responses provided by the main sample, with the exception of health belief data. One case was excluded from the sample, making for N = 127. Data analyses were based upon the entire sample N = 127, with the exception of health belief measures. Since alcohol and smoking health belief questions were administered to drinkers and smokers and since health belief measures related to weight gain, alcohol, and smoking were missing data, health belief analyses were based upon N=123 for weight gain, N = 88 for alcohol, and N = 43 for smoking. Women had spent an average of forty-one hours learning about weight gain, alcohol consumption, and tobacco use during pregnancy. The principal resources used were: reading materials, physicians, family members, and prenatal classes. The majority of pregnant women had engaged in other-initiated learning episodes in the one to one setting, that is with a health professional, family member, or friend. Self-initiated learning about weight gain was associated with higher knowledge scores and ideal prenatal weight gain (p≤0.05); and, weight gain health beliefs were negatively correlated with ideal prenatal weight gain (p≤0.05). Finding a negative correlation, in contrast to the predicted positive correlation, may have been due to the fact that in a retrospective study the behavior precipitated reporting of health beliefs. Other-initiated learning about alcohol was associated with higher knowledge scores and reduced alcohol intake (p≤0.05); however, alcohol health beliefs were not associated with reduced alcohol intake. For smoking, neither self-initiated nor other-initiated learning was associated with knowledge scores or reduced cigarette smoking; however, a low degree of perceived risk was predictive of reduced cigarette smoking (p≤0.05). Knowledge about tobacco use was positively correlated with health beliefs, suggesting that learning may be indirectly related to smoking behaviors. This study contributes to the knowledge about learning during pregnancy by providing a descriptive profile of learning patterns during pregnancy, and by examining the relationship between learning, health beliefs, and behavior. Fostering a learning environment which stimulates self-initiated learning may assist women reach ideal weight gain during pregnancy. For alcohol, encouraging health professionals, family members, and friends to initiate learning about the hazards of consuming alcohol during pregnancy seems warranted. Self-initiated learning may not be superior to other-initiated learning but may be topic specific, due to the nature of the health behaviors examined. Identification of women's smoking health beliefs seems warranted during prenatal education. Further research is required to better understand the role of learning with respect to changing smoking behaviors during pregnancy. Education, Faculty of Educational Studies (EDST), Department of Graduate

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Cyphers, Natalie A., Andrea D. Clements, and Glenda Lindseth. "The Relationship Between Religiosity and Health-Promoting Behaviors in Pregnant Women." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/7202.

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Pender’s health promotion model guided this descriptive/correlational study exploring the relationship between religiosity and health-promoting behaviors of pregnant women at Pregnancy Resource Centers (PRCs). A consecutive sample included women who knew they were pregnant at least 2 months, could read/write English, and visited PRCs in eastern Pennsylvania. Participants completed self-report surveys that examined religiosity, demographics, pregnancy-related variables, services received at PRCs, and health-promoting behaviors. Women reported they “sometimes” or “often” engaged in health-promoting behaviors, Hispanic women reported fewer health-promoting behaviors than non-Hispanic women, and women who attended classes at the centers reported more frequent health-promoting behaviors than those who did not attend classes. In separate multiple linear regressions, organized, non-organized, and intrinsic religiosity and satisfaction with surrender to God explained additional variance in health-promoting behaviors above and beyond what Hispanic ethnicity and attending classes at the PRCs explained in pregnant women at PRCs.

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Montgomery, Robert A., Tifani R. Fletcher, Andrea D. Clements, and Beth A. Bailey. "Religious Commitment Predicts Substance Use in Pregnant Women." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/7261.

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Introduction: Substance use, including cigarette smoking, while pregnant can lead to a plethora of health concerns for both the mother and unborn child including premature birth, low birth weight, and stillbirth. Compared with women nationally, pregnant women in Tennessee are more than three times as likely to smoke during pregnancy. Preliminary findings suggest high levels of religious commitment may be reliable predictors of negative health behaviors. However, the association between religious commitment and substance use has not been thoroughly investigated in pregnant populations. Using a brief measure of religious commitment, it was hypothesized that pregnant women with higher levels of religious commitment would be significantly less likely to engage in cigarette smoking and other substance use. Methods: Participants included 654 pregnant women involved in the Tennessee Intervention for Pregnant Smokers program who completed multiple interviews during pregnancy. Of interest in the current investigation, participants’ religious commitment was measured using two items from the 12-item Surrender Scale, and a 1-item church attendance measure from the Brief Multidimensional Measure of Religiousness/Spirituality. Participants also completed a background information form assessing demographic characteristics, smoking habits, and drug use, with final substance use variables composites of both self-report and urine drug screen results. Results: Direct logistic regression was performed to assess associations between religious commitment and both smoking status (at conception and delivery) and other substance use. All models included level of education, age, marital status, and insurance status. The full direct model predicting smoking status at conception was statistically significant, χ2 (5, n = 654) = 178.76, p < .001, indicating the model could distinguish between participants who did and did not report smoking early in pregnancy. The model as a whole explained between 24% and 32% of the variance in smoking status, and correctly classified 71% of cases. All variables made statistically significant and unique contributions to the model, including religious commitment (OR=.857). A similar pattern was found in the model predicting smoking status at delivery χ2 = 157.01, p < .001. A third regression, using the same predictors, examining the impact of religious commitment on any illicit drug use prior to or during pregnancy, was also statistically significant, χ2 = 58.46, p < .001. Conclusions and Implications: In this sample, religious commitment predicted smoking status and other drug use during and prior to pregnancy. Inquiry into religious commitment as an additional gauge of health behaviors may be beneficial to healthcare professionals. Future research should investigate the possible mechanism of how religious commitment influences health behaviors in pregnancy.

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Saenyakul, Pimpanitta. "Depression Classification Among HIV–Infected Pregnant Women in Thailand." Kent State University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=kent1448031641.

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Mengsteab, Elsabeth. "Skilled attendance at delivery the case of zoba Anseba, Eritrea /." Bloemfontein : Centre for Development Support, University of the Free State, 2006. http://books.google.com/books?id=dQDbAAAAMAAJ.

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Fong, Choi-ching, and 方賽貞. "Factors affecting influenza vaccination among pregnant women : a systematic review." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193774.

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Objective: Pregnancy has been recognized as a risk factor for severe pandemic influenza illness and this “vulnerable” group is suggested to be heightened alertness to the disease by WHO. This systemic review aims to identify the factors affecting the uptake of influenza vaccination among pregnant women as the immunization uptake among this particular group of population is low or suboptimal worldwide. Methods: Systematic literature reviews were conducted by using MEDLINE and PubMed with the key words: “influenza vaccination uptake” and “pregnant women” in the period of January 2004 to January 2013. It was further supplemented by a manual search for literatures and articles on the WHO website, Centers for Disease Control and Prevention (CDC) website, Google Scholar, and reference lists of reviews captured by initial searches. Results: Of the 222 articles identified, 10 studies were found to be relevant in this system literature review. Influenza vaccine coverage among pregnant women was highly diverse (6.2-76%) among the 10 studies. Overall, pregnant women were more likely to take the vaccination against influenza if they: (1) believed the benefits of the vaccine outweighed the potential barriers, (2) believed the influenza was severe and they were highly susceptible to the disease, and (3) were influenced by the positive cues to action such as recommendation from health care professionals and the experience of the influenza vaccination uptake. Conclusion: Overall, greater emphasis on vaccine effectiveness and safety, and the recommendation from health care providers is needed to increase the number of pregnant women influenza immunization in the future public health campaigns. published_or_final_version Medicine Master Master of Public Health

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Nelson, Chantal. "Smoking Behaviours Among Pregnant Women in the Baffin Region of Nunavut." Thèse, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/23341.

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This thesis examined three different research questions to help build a knowledge base for future intervention strategies by better understanding the reasons behind smoking among pregnant women in Nunavut. The first study focused more at the individual level and investigates clinical and socioeconomic factors and their relationship to readiness to quit smoking. The second manuscript moved beyond the individual level to the broader social and structural environment to identify a broader range of barriers and facilitators to smoking and smoking cessation among Inuit women. This second manuscript draws upon in-depth interviews focusing on perceptions of smoking, and perceived barriers and facilitators of smoking behaviours. Finally, the third manuscript investigated the perspectives of health care providers regarding the barriers and facilitators of smoking cessation for pregnant women in the Baffin Region of Nunavut and describes perceptions of smoking cessation resources available to health care providers in the Baffin Region.

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Deighton-Smith, Nova. "Body image, health, and physical activity in pregnant women : a composite analysis." Thesis, Leeds Beckett University, 2014. http://eprints.leedsbeckett.ac.uk/2644/.

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Women’s appearances are often judged by stringent, societal expectations, notably that of the thin-ideal. Pregnancy presents a definitive, yet naturally-occurring deviation from this norm. Research findings on how pregnant women cope with bodily changes however, are equivocal. Some feel protected from appearance-related concerns, whilst others experience increased body dissatisfaction. The aim of the present research was to build a composite understanding of factors that have an influence on body image attitudes and coping strategies in nulliparous women. Underpinned by a new realist and pragmatic approach, the research comprised of qualitative and quantitative components. The first aim was to explore messages about the pregnant body, and the role of exercise in UK magazines and online news sites. A qualitative, thematic examination of articles revealed a stark “invisibility” of the pregnant body in fashion magazines and a disparity in exercise messages and bodily portrayals among news and magazine publications. Overwhelmingly, beauty equated with the thin-ideal, not the pregnant body in news sites and fashion magazines. Study 1’s findings and existing pregnancy research guided Study 2; an exploration of women’s thoughts about their pregnant bodies, the role of exercise, and media-related, bodily descriptions. Semi-structured interviews were conducted with nine pregnant women. Thematic analysis revealed that although women accepted their pregnant bodies, they experienced unwelcomed appearance-related comments, comparisons, and physical contact by others. Their pregnant bodies were perceived as being persistently scrutinised. Finally, a quantitative exploration of appearance-related experiences was conducted, using an online questionnaire administered to 181 pregnant women. Guided by Cash’s (2011a) theoretical model, a multitude of complex factors were examined using path analysis. The model revealed that body appreciation / acceptance, body shame and surveillance, fitness / health attitudes, and appearance evaluation / investment were influenced by historical (e.g., self-esteem, public self-consciousness) and proximal factors (e.g., social comparison). Exercise participation, clothing for concealment, and avoidance / fixing behaviours were associated with shame and surveillance, appearance comparisons, and physical discomforts in pregnancy. The present research indicates that women experience complex appearance- and fitness-related issues in pregnancy. The research concludes by highlighting the importance of nurturing self-esteem in pregnancy to increase body confidence and protect against negative coping strategies through the transition towards motherhood.

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Alkhamis, Suad S. A. E. "Oral health behaviour among pregnant women in Kuwait : a social cognitive approach." Thesis, King's College London (University of London), 2015. https://kclpure.kcl.ac.uk/portal/en/theses/oral-health-behaviour-among-pregnant-women-in-kuwait(4298427b-2b98-4776-ac4a-248b0819f61a).html.

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Background: Oral health is a concern in pregnancy because of local oral effects such as gingivitis and the potential to have an adverse effect on pregnancy outcomes. In Kuwait, evidence suggests that expectant mothers have poor oral health, are fearful of dentistry, have little awareness of oral health and are in need of dental health education (DHE). In order to design an intervention aiming to change the oral health behaviours of pregnant Kuwaiti women, it was important to have contemporary evidence on the relationship between periodontal disease (PD) and adverse birth outcomes (ABOs), and an understanding of the social and cultural context in Kuwait in which oral health behaviours take place. Aim: The aim of the thesis was to design, implement and evaluate a DHE intervention for Kuwaiti pregnant women. In order to achieve the aim of the thesis three studies were undertaken: 1) A systematic review and meta-analysis to assess the association between PD and ABO, and the efficacy and the safety of non-surgical periodontal treatment (NSPT) during pregnancy to prevent ABOs. 2) A qualitative study amongst Kuwaiti women to investigate perceptions, beliefs, attitudes and expectations about oral health and maintaining and improving oral health during pregnancy. The data were also used to identify social cognition constructs which might be helpful to promote oral health behaviour in this group of women. 3) A randomised controlled trial to assess the efficacy of dental health education (DHE) with or without a planning intervention on adherence to dental health related behaviours amongst Kuwaiti pregnant women. Results: Study 1) The majority of individual cohort studies support an association between ABOs and PD, the meta-analyses support the association [(PTB: RR1.63 (95% CI: 1.06, 2.50, P=0.03), LBW: RR 2.35 (95% CI: 1.21-4.57, P=0.01) and PLBW: RR 3.53 (95% CI: 1.51 -8.20, P=0.003)] but are compromised by high levels of heterogeneity associated with the insecurity of definition of periodontal disease. The meta-analyses of 13 RCTs found that NSPT during pregnancy did not prevent PTB and PLBW but may prevent LBW (RR 0.75 (95% CI: 0.56-0.99, P=0.05) and stillbirth (RR 0.48 (95% CI: 0.25-0.90, P=0.02). The meta-analyses for PTB, LBW and PLBW were characterised by high levels of heterogeneity also attributable to uncertainty about definition of periodontal disease. None of the RCTs assessed robustly the safety of the periodontal treatment during pregnancy, though no significant adverse events were reported. There remains uncertainty in relation to the efficacy and safety of NSPT to prevent ABOS. Study 2) The qualitative study found that women had low levels of oral health knowledge and information. They had unhelpful cultural beliefs concerning oral health during pregnancy, and were unaware of the effect of pregnancy on oral health. Pregnant women lacked motivation to seek dental care even when they considered dental treatment safe during pregnancy. Dentists, unhelpful cultural beliefs, and lack of motivation were identified as barriers to accessing oral health care and seeking oral health knowledge. A number of social cognition constructs were identified from the qualitative study: knowledge; attitudes; subjective norms; barriers; and intentions. These together with the findings from the first study were used to frame, inform and design the intervention reported upon in study 3). Study 3) At T1 154 women were eligible and randomly allocated to the three groups respectively: Treatment as Usual (TAU) =53; DHE=53; DHE & Planning=48. At T2 the number of women in each group completing the intervention (N=90) was respectively: TAU=28; DHE=30; DHE&P=32. SCM constructs and self-report of behaviours were assessed at T1 and T2 through a questionnaire assessing knowledge, attitudes, subjective norms, barriers, intentions and self-report of oral health behaviours in relation to oral hygiene. Plaque scores (PI ) and gingival scores (GI) were recorded by a trained and calibrated examiner blind to group allocation. There were no demographic differences between the groups at baseline. The mean age of women was 27.80±SD 5.40, 43% (n=38) had a high school level education and 10% no formal education. Twenty eight per cent were in their first pregnancy, the remainder had 2.06±1.98 or more children. A mixed factor ANOVA analysis demonstrated that all women improved their PI (F=94.343 df=1 p=0.001) and GI (F=73.138 df=1 p=0.001) scores. There were no differences in self-reported oral hygiene and PI and GI by intervention group. The SCM constructs changed over time in all women (N=90) except barriers to attendance (F=1.067 df=1 p=0.305). There were no differences in SCM constructs by intervention group at T2. All women reported increasing the frequency of tooth brushing and flossing. Conclusion: Providing a basic oral hygiene leaflet was sufficient to motivate women to change their behaviour in relation to tooth-brushing and dental flossing resulting in improved PI and GI scores. In this study where women had very limited oral health knowledge, information giving was as efficacious as an intervention underpinned by SCMs in influencing behaviour change, but these results must be interpreted with caution given the high attrition rates and possible influence of a Hawthorne effect.

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陸袁楨德 and Yuen Jean Tak Alice Loke. "Exposure of pregnant women to passive smoking and a randomized controlled trial of the effectiveness of doctor's advice to non-smoking pregnant women in Guangzhou, China." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1998. http://hub.hku.hk/bib/B31237496.

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Roos, Anna. "The importance of diet for uptake of phthalates in pregnant women." Thesis, Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-56675.

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Glivar, Nicole. "Descriptive Study of the Nutrition Outcomes of a Community Program for Pregnant Women." The Ohio State University, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=osu1429622134.

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Katirai, Whitney Jeanne. "FACTORS ASSOCIATED WITH TOBACCO USE AMONG RURAL AND URBAN PREGNANT WOMEN." UKnowledge, 2011. http://uknowledge.uky.edu/gradschool_diss/811.

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The purpose of this study was to investigate the influences of smoking on rural and urban pregnant women. More specifically, the variables of the knowledge of health effects, health provider recommendations, subscores from the Health Belief Model (HBM), and social support were explored in relation to the smoking behavior of pregnant women. A secondary purpose was to investigate the accuracy of self-reported smoking during pregnancy using biochemical validation. Pregnant women (N=71) completed an anonymous questionnaire, designed by the researcher, to identify variables that predicted smoking for urban and rural women. Participants also gave a saliva sample for cotinine testing. Approximately 47% of rural participants and 49% of urban participants were classified as smokers. The overall smoking deception rate for the current study was 5.6%. The deception rate for rural and urban participants in this study was 2.8% and 8.6%, respectively. Variables were entered into a standard multiple regression analysis to predict smoking status of the pregnant women. Participants reporting barriers (a component of the HBM) to stopping smoking during pregnancy were significantly less likely to be smokers. Through t-test and chi-square analyses, other variables related to smoking status during pregnancy included: Marital status, financial source for the pregnancy, living with husband or boyfriend, mean scores of the participants‘ knowledge of the health effects of smoking during pregnancy, susceptibility and benefits (constructs of the HBM). Many healthcare providers performed 1A, 2A, and 3A; however, few completed the last step of 4A and none completed 5A. Implications for health promotion specialists include an increase in the education of pregnant women about the health risks of maternal smoking. Additional training for pre-natal healthcare providers is necessary in order to increase the number of healthcare providers that implement all of the 5A‘s. It is important to include the husband/boyfriend in any smoking cessation interventions since they have daily influence on the smoking status of the pregnant woman. Money used to conduct biochemical verification of maternal smoking status could be better spent on patient education of the health risks of smoking during pregnancy and physician education in implementing all 5A‘s in daily practice.

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Bennett, Cheryl Lynn. "Social Capital, Health and Mental Health in African American Women." VCU Scholars Compass, 2006. http://scholarscompass.vcu.edu/etd/725.

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Cultural and social influences on mental and physical health are increasingly recognized by social science researchers. Researchers have found that specific, Afrocultural factors are related to the functioning of African Americans. The current research considered whether interdependence is especially salient for African American women since women and African Americans tend to define themselves within the context of social relationships. The study outlines processes affecting the mental and physical health of African American women including communalism, collective efficacy, and social capital. The also study examined the relationship between socioeconomic status and both mental and physical health among African American women in a low-income residential area. The effect of social capital and collective efficacy on mental and physical health above income was analyzed using hierarchical regression. One-hundred-thirty African-American women in a low-income area of Richmond, Virginia completed surveys between October 2002 and October 2004 measuring social capital, collective efficacy and general health and mental health. Level of education served as a proxy for socioeconomic status. The study's central hypothesis was that social capital and collective efficacy, an indicator of social capital, would moderate rather than mediate the association between socioeconomic status and the outcome variables in this population due to the importance of relationships in the African American culture and in the lives of women. Both moderation and mediation models were tested. Significant relationships were found between income and both physical health and mental health. There were no significant relationships found between social capital and physical health, mental health, or socioeconomic status and mediation was not established. The results also did not establish social capital as a moderator between socio-economic status and the outcome variables. This lack of relationship may be related to several factors including the homogeneity of the sample in terms of socioeconomic status and challenges associated with the use of a new measure for social capital. Meaningful comparisons of social capital between socioeconomic levels could not be made.

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Robinson, Rachel Elizabeth. "Living knowledge : embodied health care research practice /." Thesis, Connect to this title online; UW restricted, 2007. http://hdl.handle.net/1773/11187.

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Rochat, Tamsen Jean. "Depression among pregnant women testing for HIV in rural South Africa." Thesis, Stellenbosch : University of Stellenbosch, 2011. http://hdl.handle.net/10019.1/6843.

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Thesis (PhD)--University of Stellenbosch, 2011. ENGLISH ABSTRACT: Pregnancy is a vulnerable time in settings such as sub-Saharan Africa, and is associated with exposure to a multitude of physiological, social and psychological risks. High HIV prevalence, and the fact that many women will test for HIV for the first time during their pregnancy, has raised concern about women‘s psychological health during pregnancy. Depression during the antenatal period is of public health concern as it has been shown to be associated with poorer foetal and delivery outcomes, risky behaviours, and poorer uptake of antenatal care. Antenatal depression is a predictor of postnatal depression, and postnatal depression has been associated with poor maternal sensitivity and attachment in mothers which is known to result in increased behavioural and developmental difficulties in children. The aim of this research was to provide a clear, in depth and culturally sensitive understanding of the manifestation of depression in pregnant women in a rural area with high HIV prevalence in South Africa. The research method included a diagnostic assessment of depression in 109 women in their third trimester of pregnancy, and an in-depth qualitative examination of the contextual framework within which HIV testing and depression are experienced with a sub-sample of 56 women. The quantitative results demonstrated that the prevalence of antenatal depression was high (46.7%), with close to half of the women being diagnosed with depression. Presentations of depression most frequently included disturbances in mood, loss of interest and suicide ideation. Symptoms which overlap with common side effects of pregnancy such as loss of energy and weight change did not result in an overestimation of depression. Likewise, very little evidence of the somatisation of depression, or particular cultural barriers to the diagnosis of depression based on DSM-IV criteria was found. Rates of suicide ideation were high and equally common among HIV positive as HIV negative women. Factors significantly associated with depression included living within a family homestead, access to a regular source of income and practical support from a partner. Both income and partner support had a negative association with depression. Living away from a family or parental home had a positive association with depression. The results showed that the Edinburgh Postnatal Depression Scale (EPDS) was effective in identifying depression and that a shorter three item version was as effective as longer versions. A positive score for depressed mood on the EPDS was significantly associated with HIV, suggesting that the EPDS is a good screening tool for elevated psychological risks among HIV positive women post HIV testing. Qualitative results showed that having an unsupportive partner and the occurrence of relationship or familial conflict played an important role in the development of emotional distress during pregnancy and resulted in a high number of unwanted pregnancies. Partner and familial conflict was intertwined with cultural practices which govern the acceptability of childbearing among unmarried women and the social recognition of partnerships and paternal responsibilities. Testing for HIV was considered a stressful life event for all women regardless of their HIV status and was a particularly negative life event for women who tested HIV positive or for women who had concerns over partner infidelity. Disclosure among HIV positive women frequently lead to increased partnership conflict. Qualitative findings suggested that depression and emotional distress after HIV testing did interfere with women‘s ability to engage with prevention messages. Women who were coping well with learning their HIV positive status had high levels of family disclosure and subsequent family support in common. The implication of this research is that it is important that public health programmes screen for depression among childbearing women. These data suggests that a shorter three item version of the EPDS along with screening for partner and family support or conflict would effectively detect most women at high risk for depression. Likewise, public health interventions for women with depression which are implemented in primary health care facilities and in isolation of the partnership and familial context within which depression occurs are not likely to be effective. Further research is needed to establish the precise prevalence of antenatal and postnatal depression in women at high risk for HIV; to validate the effectiveness of a shorter screening tool in resource limited settings; and to establish risk and protective factors, and trimester specific risks which could inform the design of cost effective interventions in poorly resourced settings. AFRIKAANSE OPSOMMING: Swangerskap in Afrika, suid van die Sahara, is ŉ kwesbare tydperk met blootstelling aan ŉ menigte fisiologiese, sosiale en sielkundige risiko‘s. Die hoë voorkoms van HIV en die feit dat baie vrouens gedurende swangerskap vir die eerste keer vir HIV wil toets, het ‗n besorgdheid oor vrouens se sielkundige gesondheid gedurende swangerskap laat ontstaan. Depressie gedurende die voorgeboortelike periode is van belang vir publieke gesondheid, want daar is bewyse wat dui op ‗n verband tussen depressie en swakker fetale en geboorte resultate, riskante gedrag en verminderde gebruik van voorgeboortelike sorg . Voorgeboortelike depressie is ŉ indikasie van moontlike nageboortelike depressie en nageboortelike depressie word geassosieer met swak moederlike sensitiwiteit en die gebrekkige vorming van ‗n band tussen moeder en kind; wat reeds bewys is om te lei tot verhoogde gedrags- en ontwikkelingsprobleme in kinders. Die doel van hierdie navorsing was om ŉ duidelike, indiepte en kulturele-sensitiewe begrip van die manifestasie van depressie in swanger vroue in ŉ landelike omgewing met hoë HIV voorkoms in Suid Afrika te verkry. Die navorsingsmetode sluit in ŉ simptomatiese beraming van depressie by 109 vroue in hul derde trimester van swangerskap en ŉ indiepte kwalitatiewe ondersoek na die kontekstuele raamwerk waarbinne HIV toetse en depressie ondervind word met ŉ sub-steekproef van 56 vrouens. Die bevinding was dat die voorkoms van voorgeboortelike depressie hoog was, 46.7 %, met feitlik die helfte van die vrouens wat met depressie gediagnoseer is. In die meeste gevalle het die voorkoms van depressie gepaard gegaan met ŉ verandering in gemoedstoestand, ŉ verlies aan belangstelling en selfmoordgedagtes. Simptome wat ooreenstem met algemene newe-effekte van swangerskap, soos verlies aan energie en verandering in gewig, het nie bygedra tot ŉ oorberekening van depressie nie. Soortgelyk is baie min bewyse gevind dat somatosasie van depressie, of spesifieke kulturele grense, tot die diagnose van depressie gebaseer op DSM-IVkriteria bydra. Die oorweging van selfmoord was hoog en algemeen tussen beide HIV-positiewe en HIV-negatiewe vouens. Faktore wat aansienlik met depressie geassosieer word, sluit in om in ŉ familiegroep te bly, toegang tot ŉ vaste bron van inkomste en die praktiese ondersteuning van ŉ lewensmaat. Beide inkomste en die ondersteuning van ŉ lewensmaat het ŉ negatiewe verbintenis met depressive. Om nie by familie of in ŉ ouerhuis te bly nie het ŉ positiewe assosiasie met depressive. Alhoewel HIV-status verband hou met depressie, was dit nie uitermate die geval nie, alhoewel daar ŉ gebrek aan statistiese kragdoeltreffendheid was om die effek van HIV vas te stel, gegee die beperkte grootte van die steekproef. Die resultate het getoon dat die EPDS graderingsinstrument effektief was om depressie te identifiseer en dat ŉ korter driepunt weergawe daarvan net so effektief was soos die langer weergawe. ŉ Positiewe telling vir ŉ depressiewe gemoedstoestand op die EPDS het ŉ betekenisvolle assosiasie met HIV en dui daarop dat die EPDS ŉ goeie graderingsinstrument is vir verhoogde sielkundige risiko by HIV-positiewe vrouens, selfs al is HIV-positiewe vrouens in dié steekproef statistieksgewys nie meer geneig tot depressie as HIV-negatiewe vrouens nie. Kwalitatiewe resultate toon dat ŉ lewensmaat wat nie ondersteunend is nie en die voorkoms van verhoudings- of familiekonflik ŉ belangrike rol speel in die ontwikkeling van emosionele angs gedurende swangerskap en dit het gelei tot ŉ groot aantal ongewenste swangerskappe. Konflik met ŉ lewensmaat en met familie was verweefd met kulturele gebruike wat die aanvaarbaarheid van geboortes onder ongetroude vrouens beheer en die sosiale erkenning van verhoudings en die vader se verantwoordelikhede. ŉ HIV-toets is as ŉ stresvolle lewensgebeurtenis beskou deur alle vroue, ongeag van hulle HIV-status en was ŉ besondere negatiewe lewensgebeurtenis vir vroue wat HIV-positief getoets het of vir vroue wat bekommerd was oor hulle lewensmaats se getrouheid. Onthulling van die HIV-status van positiewe vrouens het gereeld tot verhoogde konflik in verhoudings gelei. Kwalitatiewe bevindings dui daarop dat depressie en emosionele angs na ŉ HIV-toets inmeng met ŉ vrou se vermoë om ag te slaan op voorkomingsboodskappe. Vroue wat die kennis van hulle HIV-positiewe status goed hanteer het, het hoë vlakke van bekendmaking van hulle status en die ondersteuning van hulle familie in gemeen. Die implikasie van die navorsing is dat dit belangrik is vir publieke gesondheidsorgprogramme om te toets vir depressie onder swanger vroue. Die resultate dui daarop dat ŉ korter driepunt weergawe van die EPDS, saam met ŉ ondersoek na die ondersteuning van of konflik met ŉ lewensmaat en familie, effektief kan wees om vroue met ŉ hoë risiko vir depressie te identifiseer. Soortgelyk, publieke gesondheidsingryping in primêre gesondheidsorg fasiliteite vir vroue met depressie wat in isolasie van die lewensmaat en familie konteks, waar depressie voorkom geadministreer word, is onwaarskynlik om te slaag. Bevindings onderskryf die belangrikheid van ondersteuning vir die familie om effektief te kan reageer en herstel van stresvolle faktore soos onbeplande swangerskappe en HIV-diagnose, in ŉ konteks wat swaar deur HIV geaffekteer word, aangesien dit ŉ voorkomende effek op depressie kan hê. Verdere navorsing is nodig om die presiese voorkoms van voorgeboortelike en nageboortelike depressie in vrouens met ŉ hoë blootstelling aan HIV vas te stel; om die sukses van ŉ korter graderingsinstrument in arm omgewings te staaf; en om die risiko en beskermende faktore vas te stel en trimester spesifieke risiko‘s wat die ontwerp van ŉ koste-effektiewe ingryping in gebiede met ontoereikende hulpbronne kan beïnvloed.

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Han, Jenny. "A Self-determination Theory Based Prenatal Care Intervention for Low-income Pregnant Women." Scholarship @ Claremont, 2017. http://scholarship.claremont.edu/scripps_theses/954.

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Self-determination Theory postulates that there are innate psychological needs for autonomy, competence, and relatedness, and that satisfaction of these needs fosters the development of autonomous motivation. Research suggests that autonomous forms of motivation are important for behavior change and maintenance. With increasing research on Self-determination Theory and its possible applications, there is a demand for research that develops and tests behavioral interventions. This study seeks to apply Self-determination Theory to a prenatal care intervention for low-income pregnant women in the Los Angeles area. The Self-determination Theory based and the non-Self-determination Theory based prenatal care interventions will be compared. Perceived autonomy, competence, relatedness, and autonomous motivation will be measured as well as health care behaviors (healthy behavior habits, prenatal care return rates, and adherence to doctor’s regimen). Perceived autonomy competence, relatedness, autonomous motivation, and healthy behavior will be measured before and after the intervention. Return rate and adherence to doctor’s regimen will be measured post-intervention. The Self-determination Theory based intervention group is expected to report higher levels of autonomous motivation, perceived autonomy, competence, relatedness, and healthy behavior, higher return rates, and better adherence to doctor’s orders than the control group. The findings may help shape prenatal care interventions for low-income pregnant women resulting in healthier pregnancies and reduced risk factors for infant disease and mortality.

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Everett, Lindsey L. "Spatial modeling of health facility utilization by pregnant women in Kalomo district, Zambia." Thesis, Boston University, 2012. https://hdl.handle.net/2144/12367.

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Thesis (M.A.)--Boston University PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. Together, maternal and neonatal mortality rates account for more than four million deaths worldwide, with the overwhelming majority of fatalities occurring in sub-Saharan Africa. Ensuring pregnant women deliver at health facilities assisted by skilled birth attendants is considered a primary solution for improving the survival and health of both mothers and newborns. By employing spatial analysis tools, this study examines the availability of emergency obstetrical and neonatal care (EmONC) and accessibility of 31 health facilities in Kalomo district, Zambia. Only three facilities had EmONC available (two basic and one comprehensive) in Kalomo's two largest towns situated slightly over 40 kilometers (km) apart. Buffers surrounding the EmONC facilities include 11 centers and hospitals administering minimal levels of emergency delivery care, but fail to incorporate the other 60% ofthe district's medical centers. While primary and secondary road networks cover the majority of Kalomo's territory, isolated areas remain unserved by the transit system and 20% of health centers are located outside the boundaries of 5 km road buffers. Motorized ambulatory transport is available at only three health facilities located in the district's two largest towns. The clustered distribution of EmONC facilities in the most populated urban centers provides professional medical assistance for the immediate surrounding communities, but leaves the majority of the population who reside in rural settings without access to emergency delivery services. Results from this study are useful for examining, monitoring, and targeting the availability and accessibility ofhealth facilities in attempt to lower maternal and neonatal fatalities.

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Hardi, Choman. "The mental health of Kurdish women surviving migration." Thesis, University of Kent, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.445705.

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Fletcher, Tifani A., Andrea D. Clements, Lana McGrady, and Beth A. Bailey. "Intimate Partner Violence Screening Tools: Validation for Rural Pregnant Women." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/7259.

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This attempt to validate the brief AAS and WAST against the gold-standard CTS2 resulted in sensitivities of 34.8% (AAS) and 45.5% (WAST) for physical IPV; however both identified a much smaller number of cases of sexual violence than the CTS2 in a rural pregnant population.

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Dissertations / Theses on the topic 'Pregnant women - Mental health'

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