ABSTRACT
OBJECTIVE: The objective of this study was to determine whether a web-based education strategy could improve maternal knowledge of placental complications of pregnancy and reduce maternal anxiety in high risk-pregnancies. METHODS: Prospective study in the Placenta Clinic at Mount Sinai Hospital, Toronto, Ontario. Maternal demographics and Internet usage were recorded at the patient's baseline appointment. Placental knowledge was determined using structured verbal and illustrative assessments. The six-item State-Trait Anxiety Inventory (STAI) was administered to assess baseline maternal anxiety. Women were asked to visit the Placenta Clinic website for a minimum of 15 minutes before their follow-up appointment, at which time their placental knowledge and STAI assessments were repeated. RESULTS: Eighteen women were included in the study. Patient knowledge at the baseline appointment was generally poor (median score 10.5 out of a maximum score of 27, range 1 to 22), with major deficits in basic placental knowledge, placenta previa/increta, and preeclampsia. At the follow-up appointment, placental knowledge was significantly improved (median score 23, range 10 to 27; P < 0.001). Educational status (high school or less vs. college or more) had no effect on either baseline knowledge or knowledge improvement. Maternal anxiety at baseline (median score 12 out of a maximum score of 24, range 6 to 23) was significantly reduced at the follow-up appointment (median score 8.5, range 6 to 20; P = 0.005). CONCLUSION: Deficits in maternal knowledge of placental complications of pregnancy in high-risk pregnant women were substantial but easily rectified with a disease-targeted web-based educational resource. This intervention significantly improved patient knowledge and significantly reduced maternal anxiety.
Objectif : Cette étude avait pour objectif de déterminer si une stratégie pédagogique sur le Web pouvait améliorer les connaissances maternelles en matière de complications placentaires de la grossesse et atténuer l'anxiété maternelle dans le cadre des grossesses exposées à des risques élevés. Méthodes : Tenue d'une étude prospective au sein de la Placenta Clinic du Mount Sinai Hospital à Toronto, en Ontario. Les habitudes d'utilisation d'Internet et les caractéristiques démographiques maternelles ont été consignées au cours de la consultation de départ avec la patiente. Les connaissances quant au placenta ont été déterminées au moyen d'évaluations illustrées et verbales structurées. Le six-item State-Trait Anxiety Inventory (STAI) a été administré pour évaluer l'anxiété maternelle de départ. Nous avons demandé aux femmes de consulter le site Web de la Placenta Clinic pendant un minimum de 15 minutes avant leur consultation de suivi; au cours de celle-ci, leurs connaissances quant au placenta ont été évaluées à nouveau et les évaluations STAI ont été menées une fois de plus. Résultats : Dix-huit femmes ont participé à l'étude. Au moment de la consultation de départ, les connaissances des patientes étaient généralement faibles (score médian de 10,5 sur un score maximal de 27, plage de 1 à 22), des déficits majeurs ayant été constatés en matière de connaissances de base quant au placenta, au placenta prævia/increta et à la prééclampsie. Au moment de la consultation de suivi, les connaissances quant au placenta présentaient une amélioration considérablement accrue (score médian de 23, plage de 10 à 27; P < 0,001). Le niveau de scolarité (études secondaires ou moins vs études postsecondaires ou plus) n'a exercé aucun effet sur l'état des connaissances au départ ni sur l'amélioration des connaissances. L'anxiété maternelle au départ (score médian de 12 sur un score maximal de 24, plage de 6 à 23) avait connu une baisse considérable au moment de la consultation de suivi (score médian de 8,5, plage de 6 à 20; P = 0,005). Conclusion : Les déficits en matière de connaissances maternelles quant aux complications placentaires de la grossesse chez les femmes enceintes exposées à des risques élevés étaient substantiels, mais facilement corrigeables au moyen d'une ressource pédagogique sur le Web axée sur la maladie. Cette intervention a mené à une amélioration significative des connaissances des patientes et à une baisse considérable de l'anxiété maternelle.
Subject(s)
Internet , Patient Education as Topic/methods , Placenta Diseases/psychology , Pregnancy Complications/psychology , Pregnancy, High-Risk/psychology , Adult , Anxiety/complications , Anxiety/prevention & control , Female , Humans , Placenta Accreta/psychology , Placenta Previa/psychology , Pre-Eclampsia/psychology , Pregnancy , Prospective StudiesSubject(s)
Adaptation, Psychological , Midwifery/organization & administration , Mother-Child Relations , Mothers/psychology , Placenta Previa , Adult , Anesthesia, Obstetrical/psychology , Emergency Service, Hospital/organization & administration , Female , Humans , Maternal Health Services/organization & administration , Narration , Placenta Previa/psychology , PregnancyABSTRACT
BACKGROUND: While approximately 700,000 women experience pregnancy complications and are treated with bed rest in the hospital each year, little is known about negative affect in these women. OBJECTIVES: The study purpose was to describe dysphoria, a composite of symptoms of negative affect across the antepartum and postpartum and to identify the relationship between dysphoria and the length of pre-admission home bed rest, hospital bed rest, and maternal and fetal/neonatal indices of risk. METHODS: The convenience sample for this longitudinal repeated measures study consisted of 63 high-risk pregnant women admitted on antepartum bed rest to one of three university-affiliated hospitals. Women were included if they were diagnosed with (a) preterm labor, (b) premature rupture of membranes, (c) incompetent cervix, (d) placenta previa, (e) placental abruption or multiple gestation, and (f) did not have a psychiatric disorder. The Multiple Affect Adjective Checklist-Revised (MAACL-R) was used to assess dysphoria. Obstetric risk status was assessed by both the Hobel and Creasy Risk Assessment tools. RESULTS: Dysphoria was highest upon hospital admission and decreased significantly across time (F (5) = 23.58, p <.001). Positive Affect-Sensation Seeking significantly increased across time (F (5) = 53.16, p <.001). Dysphoria scores were significantly greater for those with highest Hobel obstetric risk scores (F (1, 60) = 4.53, p =.037). Antepartum dysphoria was not correlated with gestational age upon hospital admission, length of bed rest, or Creasy risk status. However, gestational age at birth was significantly correlated with postpartum dysphoria. DISCUSSION: The stimulus for antepartum dysphoria is unclear. However, postpartum dysphoria appears to be related to indicators of the infant's state of health at birth.
Subject(s)
Anxiety/psychology , Bed Rest/psychology , Depression/psychology , Hospitalization , Inpatients/psychology , Pregnancy Complications/psychology , Pregnancy, High-Risk/psychology , Abruptio Placentae/psychology , Adolescent , Adult , Analysis of Variance , Anxiety/diagnosis , Bed Rest/adverse effects , Depression/diagnosis , Female , Fetal Membranes, Premature Rupture/psychology , Gestational Age , Humans , Longitudinal Studies , Obstetric Labor, Premature/psychology , Placenta Previa/psychology , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Complications/prevention & control , Psychiatric Status Rating Scales , Risk Factors , Time Factors , Uterine Cervical Incompetence/psychologyABSTRACT
BACKGROUND: Placenta previa occurs in approximately 1 of every 200 pregnancies. No research examining women's experiences of this condition has been published. The objective of this study was to describe the experience of women hospitalized with placenta previa. METHODS: A descriptive study was conducted using a convenience sample of 10 pregnant women who had been hospitalized with placenta previa. Women were recruited from a tertiary care hospital and participated in two semistructured interviews during the pregnancy and one after the baby's birth while in hospital. They were admitted to hospital from 28 weeks' gestation and remained in hospital until delivery, generally at 36 weeks' gestation. Transcripts of the interviews were analyzed using content analysis to describe their experience. RESULTS: Six themes were identified from the descriptions of the experience as related by the participants. They encompassed the experience from the first symptoms to feelings about the experience after the baby was born. CONCLUSIONS: Women with placenta previa experience significant stressors while in hospital. Health caregivers should be aware of the loss of control and isolation these women feel and be mindful of the potential for sequelae in the postpartum period.
