Effects of the Covid-19 Pandemic on the Prevalence of Insomnia, Anxiety, and Depression During Pregnancy: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis study aims to determine the effects of the Covid-19 pandemic on the prevalence of insomnia, anxiety, and depression symptoms during pregnancy. Reviews were done through PubMed, EBSCO (Medline, CINAHL), Embase (OVID), Web of Science, PsycINFO, TR Index, Turkish Thesis Center databases using (pregnancy OR pregnant) and (sleep OR sleep disorders OR insomnia), and (anxiety OR depression) keywords between April and May 2021. The meta-analysis included 48 articles (sample: 77,299). It was found that the Covid-19 pandemic did not affect the prevalence of depression symptoms and anxiety during pregnancy, but it increased insomnia. While insomnia ratio was reported 39.6% (95% CI: 0.253-0.560) in the studies conducted before the pandemic, it was reported 88.8% (95% CI: 0.821-0.921) in the studies conducted during the pandemic. This study found that the Covid-19 pandemic did not have effects on depression symptoms and anxiety, but it increased insomnia complaints.

Are pregnancy and postpartum oxytocin level a predictive biomarker for postpartum depression?

AIM: This study aims to determine the relationship between the late pregnancy and postpartum oxytocin levels and postpartum depression (PPD) symptoms. METHODS: This longitudinal study was conducted with 70 pregnant women. Data collection was performed through two interviews. While the first interview was conducted in the 30th to 38th gestational weeks, the second interview was conducted in the 4th to 12th weeks in the postpartum period. Oxytocin level measurement was performed with a saliva sample. Saliva samples were analyzed with enzyme-linked immunosorbent assay kits. RESULTS: The prevalence of depressive symptoms in the postpartum period was found significantly higher than the prevalence in late pregnancy. Depression symptoms reached the highest level in the 12th week. The late pregnancy oxytocin level was significantly higher than the postpartum oxytocin level. A weak, negative correlation was found between PPD symptoms and the late pregnancy oxytocin level. However, when linear regression analysis was performed, it was concluded that there was a medium, negative relationship model between PPD symptoms and the late pregnancy oxytocin level. However, no relationships were found between PPD symptoms and oxytocin level. CONCLUSION: In conclusion, this study found that the late pregnancy oxytocin level could be a predictive biomarker for postpartum depression. Predicting the risk of PPD in the pregnancy period could provide an opportunity for early diagnosis and treatment.

An investigation of individuals' health anxiety during the COVID-19 pandemic within the framework of the functional health patterns.

PURPOSE: This study investigates individuals' health perceptions and health anxiety within the framework of functional health patterns (FHP) during COVID-19 pandemic. DESING AND METHOD: This study is a descriptive and cross-sectional design. Data were collected from participants (n = 3464) through a three-part web-based form. FINDINGS: Individuals' health anxiety and perceptions are at a medium level. The participants' health perception and health anxiety scale mean scores demonstrated significant differences according to the FHP except for sexuality. CONCLUSIONS: It can be stated that individuals use the anxiety they experience to be vigilance against a potential health threat. PRACTICE IMPLICATIONS: Researchers can use findings in the examination of psychological health problems that can be seen in individuals after the pandemic.

The Effects of COVID-19 Pandemic on Pregnant Women: Perceived Stress, Social Support and Sleep Quality.

BACKGROUND: This cross-sectional study aims to identify the relationship between perceived stress, social support and sleep quality and the effects of the COVID-19 pandemic on pregnant women's perceived stress, social support and sleep quality. METHODS: The target population of the study was pregnant women who applied to the Family Health Center. After the sample calculation was performed, the study involved 166 participants. The data, which were quantitative in nature, were collected through a web-based, online questionnaire administered within a determined period. Data collection tools included the Multidimensional Scale of Perceived Social Support (MSPSS), the Perceived Stress Scale (PSS), and the Pittsburgh Sleep Quality Index (PSQI). RESULTS: Of all the participating pregnant women, 88% reported to have poor sleep quality during the COVID-19 pandemic. A moderate, negative relationship was found between the Pittsburgh Sleep Quality Index and the Multidimensional Scale of Perceived Social Support and a weak, positive relationship with the Perceived Stress Scale. While statistically significant differences were found between the pregnant women's perceived stress according to their psychological perceptions and perceptions about daily life (P < 0.05), no significant differences were found between the perceived social support level and sleep quality index. CONCLUSION: It was considered that pregnant women's perceived social support levels, sleep quality, and perceived stress levels were affected during the COVID-19 pandemic.

The Effect of Bidet Use on Severity of Constipation and Quality of Life Among Pregnant Women.

BACKGROUND: Constipation is a common problem in pregnancy. This study aims to elucidate the efficacy of using a bidet before defecation to reduce the severity of constipation and improve the quality of life in pregnancy. METHODS: The sample consisted of an experimental group (n = 30) and a control group (n = 30), a total of 60 pregnant women. Randomization was performed using the pitch-and-toss method from simple probability randomization methods. The research data were collected using the Personal Information Form, the Constipation Assessment Scale for Pregnancy, and the Constipation Quality of Life Scale. RESULTS: There was a statistically significant difference between the pregnant women's mean scores on the Constipation Assessment Scale for Pregnancy due to the intervention of bidet before defecation. Although the members of the intervention group had severe constipation at first, they reported only "some problems" on defecation after the intervention. In addition, statistically significant improvements were observed in the intervention group via all subscales of the Constipation Quality of Life Scale except the satisfaction subscale. CONCLUSION: Providing pregnant women with training on constipation and information about how to control constipation using a bidet is very important in terms of reducing the severity of constipation, enabling them to feel better and continue their daily activities, and thus to improve their quality of life.

The Use of Oxytocin by Healthcare Professionals During Labor.

BACKGROUND: Oxytocin is widely used in perinatal medicine, but it can cause serious side effects. Health professionals should be familiar with the pharmacokinetics, dosing regimen, and fetal effects of oxytocin. This study aims to explore the use of oxytocin by healthcare professionals during labor. METHODS: This study was conducted in one medical faculty, one training and research hospital, one maternity hospital, and one private hospital in Adana, Turkey. The sample group included 107 participants. The data were gathered using a survey prepared in line with the literature. The survey was comprised of 30 questions. These questions concern the social demographic information of the participants, the knowledge and actual oxytocin use, and the views of the participants. The data were analyzed using descriptive statistics. RESULTS: The average age of the participants was 36.76 ± 8.70 years, the mean of working experience in the delivery room was 7.79 ± 7.73 years. 85.6% of the participants who answered the question of possible effects of oxytocin as contraction, 57.9% of the possible side effects as fetal distress. 69.2% of the participants stated that they applied oxytocin after dilution in a fluid while 47% stated that they applied it after dilution in fluid with 5% Dextrose. While 40% of the participants responded that they sometimes forgot to administer medication, 39.2% stated that they did not register medication in their survey responses. CONCLUSION: It was determined that most of the participants answered the questions about the effect of oxytocin correctly, but they could not respond to all the side effects of oxytocin. It was found that most of the participants could not answer the storage conditions that are important for the effectiveness of the drug correctly. In addition, the importance level given to the principles of drug administration by the participants was generally found to be high.

The effect of ice pressure applied on large intestinal 4 on the labor pain and labor process.

PURPOSE: This study was designed as an experimental controlled study, aiming to identify the effect of ice massage with short duration (40 min) and long duration (80 min) applied on Large Intestinal 4 (LI4) acupressure point on labor process and perception of labor pain. METHODS: The participants, who met the research criteria according to the results of power analysis, were 72 healthy pregnant women divided into experiment and control group. RESULTS: Results show that ice massage applied on the LI4 region was effective in the 80th minute. Moreover, in terms of the effect of ice massage on labor duration, the application was found to reduce the labor duration of the women in the experimental group approximately 1 h on average. CONCLUSION: It was found that the ice massage applied by midwives on the LI4 point during the active phase of delivery could reduce pain and shorten the delivery duration.

The effect of music on pain and anxiety of women during labour on first time pregnancy: A study from Turkey.

OBJECTIVE: This study aims at analyzing the effect of music on pain and anxiety felt by women in labor during their first pregnancy. METHOD: When the pregnant women in the experimental group progressed into the active phase of the labor, they were made to listen to music in Acemasiran mode with earplugs for 3 h (20 min of listening with 10-min breaks). FINDINGS: It was observed that after the first-hour women indicated that their pain was statistically less in the experimental group. Trait anxiety scores of the women in labor were similar for experimental and control groups. Following the practice, state anxiety average scores became lower in favor of the experimental group and the correlation was statistically significant. CONCLUSION: In order to facilitate women's coping with labor pain and improve their wellbeing with the activity during the labor, musicotherapy, a non-pharmacological method, is an effective, simple and economical method.

Sexual function and quality-of-life-related problems during the menopausal period.

This study aims to evaluate the relationship between the sexual functions and quality of life and the problems during menopausal period. This descriptive, cross-sectional study included a total of 317 women. The mean total Female Sexual Function Index score was 18.8 ± 8.7, while the mean total Sexual Quality of Life Questionnaire-Female score was 72.7 ± 13.7. Sexual dysfunction was found in 82 percent. There was a positive significant correlation between the total Female Sexual Function Index scores and total Sexual Quality of Life Questionnaire-Female scores ( p < 0.05). Our study results suggest that women do not often experience serious menopausal symptoms, but have sexual dysfunction with a moderate sexual quality of life.

Attitudes of prehospital emergency care professionals toward refusal of treatment: A regional survey in Turkey.

INTRODUCTION: Prehospital emergency medicine is a specific field of emergency medicine. The basic approach of prehospital emergency medicine is to provide patients with medical intervention at the scene of the incident. This special environment causes health professionals to encounter various problems. One of the most important problems in this field is ethics, in particular questions involving refusal of treatment and the processes associated with it. OBJECTIVE: The objective of this study is to identify emergency health professionals' views regarding refusal of treatment. METHODS: This study was conducted with 356 health professionals who were on active duty in prehospital emergency health services. The data were collected through a form which included 10 statements. The participants were asked to indicate their level of agreement with the statements given by rating them between 0 and 10. ETHICAL CONSIDERATIONS: Before conducting the research, permission was received from the local ethics committee. Participants were given written information about the purpose of the study. Participants were assured that their participation was voluntary. RESULTS: The healthcare professionals with fewer years of experience in the profession and female participants adopted an attitude of giving priority to providing care. Young participants, in general, respected patient autonomy. However, paradoxically, when it comes to emergency medical cases, they expressed an opinion closer to paternalism. CONCLUSIONS: This study has found that prehospital emergency health professionals generally respect the patient's right to refuse treatment; however, they do not prioritize this right when there is a life-threatening situation or when the person does not have decision-making capacity. In these cases, prehospital emergency health professionals tended to adopt a more paternalistic approach.

Health-promoting lifestyle behaviours in pregnant women in Turkey.

This study aims to describe the health-promoting lifestyle behaviours of pregnant women. The study was carried out with pregnant women who applied to the polyclinics in different maternity and children hospitals located in Adana, Turkey, between 1 March and 30 May 2009. The data collection tools used in the study were (i) a questionnaire that was used to collect sociodemographic data from the participants and (ii) the Health Promoting Lifestyle Profile II (HPLP II). The results obtained from the study showed that total HPLP II scores were moderate; the highest scores were obtained on the spiritual growth dimension and the lowest scores on the physical activity dimension. Pregnant women with older age, those with a higher educational level, those with a better socioeconomic status and those living in a nuclear family were found to be more likely to have health-promoting lifestyles. Health promotion and healthy lifestyle need to be an integral part of health services provided for pregnant women. Midwives and nurses have prominent roles in encouraging pregnant women to engage in health-promoting behaviours.

An evaluation of knowledge of pharmacovigilance among nurses and midwives in Turkey.

This study aimed to evaluate the awareness of nurse/midwives regarding pharmacovigilance as well as their knowledge and experience in identifying and reporting adverse reactions of drugs. Nurse/midwives (n = 329), working in four state hospitals, were provided a questionnaire with a view of identifying their knowledge and skills pertaining to pharmacovigilance. Around 45% of the participants claimed to have knowledge of pharmacovigilance but only 23.3% of them could define it correctly. Although 24.3% of the participants acknowledged that adverse reactions should be reported to a centre, only 1.2% of them named this centre (Turkey Pharmacovigilance Centre-TUFAM). The present study indicates that nurse/midwives have insufficient knowledge of pharmacovigilance practices. Hence, it is essential to include pharmacovigilance training in their undergraduate and graduate education programs, and to promote reporting of adverse reactions.

A case study from the perspective of medical ethics: refusal of treatment in an ambulance.

This paper will examine a sample case encountered by ambulance staff in the context of the basic principles of medical ethics. An accident takes place on an intercity highway. Ambulance staff pick up the injured driver and medical intervention is initiated. The driver suffers from a severe stomach ache, which is also affecting his back. Evaluating the patient, the ambulance doctor suspects that he might be experiencing internal bleeding. For this reason, venous access, in the doctor's opinion, should be achieved and the patient should be quickly started on an intravenous serum. The patient, however, who has so far kept his silence, objects to the administration of the serum. The day this is taking place is within the month of Ramadan and the patient is fasting. The patient states that he is fasting and that his fast will be broken and his religious practice disrupted in the event that the serum is administered. The ambulance doctor informs him that his condition is life-threatening and that the serum must be administered immediately. The patient now takes a more vehement stand. 'If I am to die, I want to die while I am fasting. Today is Friday and I have always wanted to die on such a holy day,' he says. The ambulance physician has little time to decide. How should the patient be treated? Which type of behaviour will create the least erosion of his values?