Trajectory and Determinants of Quality of Life Among Postpartum Women.

BACKGROUND: The postpartum period is a critical phase in which postpartum women experience dynamic changes in their physiology, psychology, and family status. OBJECTIVE: This study investigated the changes in women's quality of life (QoL) during the first, third, and sixth months of the postpartum period and their associated factors. METHODS: A single-group repeated-measure design was used to collect data from 282 postpartum women recruited from a regional hospital in Taiwan. We used the brief World Health Organization Quality of Life scale, Social Support Scale, and Edinburgh Postnatal Depression Scale to assess postpartum women's quality of life, social support, and postpartum depressive symptoms, respectively. The data were analyzed using trajectory analysis and generalized estimating equations. RESULTS: The trajectory analysis indicated that postpartum women could be categorized into low, medium, and high QoL groups. Although the medium and high QoL groups maintained stable QoL levels, the low QoL group experienced a linear decrease in QoL over time. Moreover, the determinants of postpartum women's QoL were immigrant status, employment status, family type, social support, and postpartum depression. CONCLUSIONS: Health care providers should assess these determinants of postpartum QoL in perinatal women to identify those at risk of low postpartum quality of life. Early assessment and intervention by health care providers could significantly improve the health status of women after childbirth.

The mediating effect of pregnancy adaptation between family support and maternal-fetal bonding: a cross-sectional study.

BACKGROUND: Establishing a nurturing bond with the unborn child is essential for expectant mothers throughout pregnancy. While the influence of family support and pregnancy adaptation on maternal-fetal bonding is evident, these factors remain unexplored in the early stages of pregnancy. This study aims to elucidate the dynamic interaction between family support, pregnancy adaptation, and maternal-fetal bonding during the first trimester, explicitly investigating the mediating role of pregnancy adaptation. METHOD: A cross-sectional design was conducted to recruit expectant mothers between 8 and 12 weeks of gestation without significant complications. RESULTS: Family support and pregnancy adaptation emerged as significant predictors of maternal-fetal bonding, and pregnancy adaptation mediated the relationship between family support and maternal-fetal bonding in the first trimester. CONCLUSIONS: The study confirms the critical role of family support and pregnancy adaptation in facilitating maternal-fetal bonding during early pregnancy, with pregnancy adaptation fully mediating this relationship. Healthcare providers are encouraged to involve family members in early interventions, focusing on assessing family support and engaging them in education and activities to strengthen the emotional bond between the mother and her unborn child.

The Relationships Between Multidimensional Symptom Burden, Adaptation, and Depression During Pregnancy: A Cross-sectional Study.

Prenatal depression is highly prevalent, but its relationship with the multidimensional burden of physical symptoms during pregnancy remains underexplored. The aim of this study was to examine the relationship between pregnancy-related physical symptom burden, including frequency, severity, and impact on life and pregnancy adaptation to prenatal depression, and to identify predictors of depression during pregnancy. The study was cross-sectional in design. A hospital-based setting providing comprehensive maternity care services from outpatient to inpatient. The sample consisted of two hundred forty-three pregnant individuals aged 20 and above with no major obstetrical complications. Structured questionnaires including demographic and obstetrical characteristics, depression, symptom burden, and pregnancy adaptation were used for data collection. Multiple linear regression analyses were performed to identify significant predictors of depression. The study revealed that approximately 32% of the variance in depression scores could be explained by the combined effects of pregnancy-related physical symptom burden and pregnancy adaptation. Specifically, low-level pregnancy adaptation, high-level symptom impact on life, unmarried status, and mid-level symptom severity were identified as the main predictors of prenatal depression among low-risk pregnant individuals. The findings contribute to the existing knowledge base, emphasizing the significance of addressing and managing pregnancy-related physical symptom burden while promoting effective adaptation to pregnancy as a means to mitigate the risk of prenatal depression.

Better safe than sorry: Exploring the collective sensemaking process in pregnancy virtual communities through thematic analysis.

Physical symptoms induced by pregnancy are often perceived as a normal part of the physiological process and therefore not commonly discussed in clinical settings during prenatal care. This study aimed to explore how pregnant individuals adapt to physical symptoms related to their pregnancy, using the perspective of collective sensemaking. A retrospective study design with an inductive thematic analysis approach of qualitative data extracted from web-based forum posts was conducted. Among 574 initial posts and 2801 comments, three themes were identified: (i) awareness of changing pregnancy body, (ii) uncertainty about physical symptoms, and (iii) coping with discomforts associated with pregnancy. A shared identity as a group of individuals dealing with similar challenges enables pregnant individuals to develop a better comprehension of their experiences. Healthcare professionals should recognize the importance of individual and collective sensemaking in pregnancy forums and strive to provide a supportive and empathetic environment for pregnant individuals to share their experiences and seek guidance.

Women's trajectories of postpartum depression and social support: A repeated-measures study with implications for evidence-based practice.

BACKGROUND: Postpartum depression is one of the most common psychological disorders of women after childbirth. Despite the importance of social support as an influencing factor, there have been few studies on the trends and characteristics of social support as it relates to postpartum depression. AIMS: To explore the trends in postpartum depression and social support, to cross-analyze the correlation between the postpartum depression trajectory and the social support trajectory, and to investigate predictors of changes in postpartum depression trajectories. METHODS: A prospective repeated-measure study and convenience sampling were used to recruit 230 women at 1, 3, and 6 months after childbirth. Structured questionnaires were used for data collection. Trajectory analysis was used to explore the trajectories of postpartum depression and social support during the 6 months after childbirth, and polynomial logistic regression was used to explore predictors of the trajectory of postpartum depression. RESULTS: Postpartum depression was at its most serious in the third month after childbirth, showing patterns of low-risk, moderate-risk, and high-risk trajectories. Social support also showed low, moderate, and high patterns, and the trajectory of postpartum depression was significantly related to the trajectory of social support. The predictors of moderate-risk and high-risk postpartum depression were also found in this study. LINKING EVIDENCE TO ACTION: Postpartum mental health education and online learning systems should be used to increase social support for women after childbirth and reduce the incidence of postpartum depression.

Predictors of post-partum stress in Vietnamese immigrant women in Taiwan.

AIM: The post-partum period is a stressful time of change, particularly for immigrant women, but, to the best of the present authors' knowledge, the subject has not been explored. This study aimed to examine immigrant women's post-partum stress, depression, and levels of social support, and to determine the predictors of post-partum stress for Vietnamese immigrant women in Taiwan. METHODS: A cross-sectional design was used. In this descriptive survey, 208 Vietnamese immigrant women were telephone interviewed by a trained Vietnamese research assistant during one of their 6 weeks post-partum. Data were collected through telephone interviews using three questionnaires, including the Hung Postpartum Stress Scale, Beck Depression Inventory, and Social Support Scale. RESULTS: The result shows that Vietnamese women had low level post-partum stress scores. Participants' family support rated higher than friend support. The incidence of depression was 0.5%. Social support, number of post-partum days, and family income were found to be predictors for post-partum stress, accounting for 26.6% of the variance. The Vietnamese immigrant women experienced significant stress regarding their maternal roles and received most of their support from their families rather than from friends. CONCLUSION: Nurses caring for this cohort should therefore consider these factors in order to help them cope with their post-partum stress. Healthcare providers should offer available resources to these immigrant women and their spouses during this critical period in their lives. For instance, antenatal education classes could be provided to help immigrant women manage and overcome post-partum issues.

Learned resourcefulness, quality of life, and depressive symptoms for patients with breast cancer.

PURPOSE/OBJECTIVES: To investigate the relationships among learned resourcefulness, quality of life, and depressive symptoms of women with breast cancer. In addition, the direct and indirect effects of learned resourcefulness among disease characteristics and quality of life and depressive symptoms were examined. DESIGN: Descriptive, correlational, and predictive. SETTING: Two teaching hospitals in southern Taiwan. SAMPLE: 150 women with breast cancer. METHODS: Participants completed demographic information concerning disease characteristics and learned resourcefulness via the Center for Epidemiological Studies-Depression questionnaire and the SF-36 health survey during visits to the outpatient oncology department. MAIN RESEARCH VARIABLES: Learned resourcefulness, depressive symptoms, and quality of life. FINDINGS: About 35% of the participants had depressive symptoms. Participants with lower income and those undergoing adjuvant therapy displayed more depressive symptoms. Learned resourcefulness was a strong predictor of depressive symptoms and quality of life, but no mediating effects of resourcefulness on depressive symptoms existed. In addition, when participants had better income and were at a lower stage, a better quality of life was evident. CONCLUSIONS: A high amount of patients with breast cancer experience depressive symptoms. Learned resourcefulness can be a method of helping patients to improve their self-control behaviors and change their negative thoughts. IMPLICATIONS FOR NURSING: Nurses and healthcare professionals can apply resourcefulness strategies to promote quality of life and to prevent depressive symptoms in women with breast cancer.

[The affect of gender on caregiving: a study of male nurses].

Caring, the essence of nursing, is widely viewed as a feminine activity. Therefore, determining the existence and extent of differences in caring shown by male nurses in comparison with their female counterparts is a matter that requires further discussion. This article discusses the effects of gender differences on nursing care provided by male nurses according to analyzing the essential elements of caring. Findings indicate that certain caring behaviors performed by male nurses differ from their female colleagues due to extant internal conflicts between masculine and caring concepts. This article proposes two suggestions to nursing educators: 1. When training male nurses, in addition to emphasizing the value of caring, instructors should also emphasize teaching caring competence; 2. Based on an acceptance of diversity, instructors should accept the existence of differences between male and female nurse caring behaviors due to fundamental gender differences.

[Immigrant women & postpartum depression].

The immigrant population in Taiwan has increased significantly over the past decade, and immigrants now comprise a significant proportion of the women in Taiwan receiving maternal care. Postpartum stress and depression are important physical and mental health issues. This article used a systemic review of published articles to understand the general incidence of postpartum depression amongst immigrant women. Articles reviewed included those published in MEDLINE, PubMed, Proquest and CEPS in either English or Chinese. A systematic literature review of 20 identified original research papers was conducted to explore postpartum depression in immigrant women. One article addressed the experience of healthcare providers responsible to care for immigrant women suffering from postpartum depression. Other articles discussed factors of influence on postpartum depression in immigrant women or related experiences. Results show that immigrant women have a higher incidence of postpartum depression than the overall population. This incidence is even higher amongst immigrant women from minority groups. In addition to socioeconomic influence factors, social support and acculturation abilities were also found to be significant predictive factors of postpartum depression in immigrant women in Taiwan.

Prenatal examination utilization and its determinants for immigrant women in Taiwan: an exploratory study.

The purpose of this study was to understand and explore determinants of prenatal examination utilization by pregnant immigrant women in Taiwan. This cross-sectional study surveyed 101 pregnant Vietnamese women living in northern Taiwan. Data collection employed face-to-face interviews using a structured questionnaire. Main findings included that participants were relatively young (M +/- SD = 23.3 +/- 3.15 years old) and that length of residency in Taiwan averaged just over 1 year (M +/- SD = 13.3 +/- 9.48 months). Results also indicated the prenatal examination rate for this target group to be relatively high. First prenatal examinations were conducted, on average, 10.8 weeks into pregnancy (SD = 4.37 weeks). Most participants (83.2%) received prenatal examinations in accordance with the recommended schedule. Regional hospitals (35.6%) and local obstetrics clinics (35.6%) were the most frequently chosen locations for prenatal examinations followed by medical centers (15.8%) and district hospitals (12.9%). Participant spouses and/or mother-in-laws heavily influenced the decision regarding where to conduct prenatal examinations. The average general language ability score was 9.5 (SD = 2.05, range = 4-16), indicating a low to moderate average language ability. However, only 9.9% (n = 10) of participants utilized translation services offered by the hospital. In terms of factors influencing utilization of the prenatal examination service, this study identified significantly positive relationships between utilization and the variables life adaptation and perceived importance of the examination. In contrast, results showed loneliness to be negatively related to prenatal examination utilization. On the basis of these results, we suggest that more accessible information on the prenatal examination service needs to be provided to improve adaptation by immigrant women to life in Taiwan and that psychiatric support be offered to help reduce the feelings of depression felt by these women. The importance of prenatal examination to enable women to acquire more appropriate and comprehensive prenatal care and to improve prenatal care quality should be emphasized.

Initial formation of nursing philosophies following fundamental clinical practice: the experience of male nursing students.

The purpose of this preliminary study was to explore male nursing students' development of nursing philosophies during their fundamental nursing primary clinical practice. Purposive sampling was conducted at a department of nursing in a university in southern Taiwan between September and October 2005. Researchers gave each of the ten subjects selected for this study a semi-structured, in-depth interview. The interviews were tape recorded and then transcribed word by word, before the content analysis method was used to analyze data. The analysis results can be classified into three major categories and various associated themes. The first category, professional ambition choice, incorporates the four themes of: (1) acceptance of family members' or friends' recommendations; (2) consideration of career development factors; (3) eagerness to care for others; and (4) limitations imposed by academic achievements. The second category, professional gender expectations, incorporates the following four themes: (1) gender role revolutions; (2) expectations that "something rare is valued highly" ; (3) courage in addressing public misgivings about untraditional professional roles; and (4) formulaic gender gap problems. The third category, development of nursing philosophy following a primary clinical internship, incorporates the following five themes: (1) doubt regarding personal ability to master the complex tasks necessary to become a competent nurse; (2) translation of one's field of vision from the visible to the invisible; (3) stimulation of learning upon recognition of inadequacies; (4) pride in being engaged in the "sacred" work of caring; and (5) increased confidence in continuing a nursing career. The results of this study may guide nursing educators in promoting an active approach toward training and professional education.

[Care at school: health care needs and coping strategies among children whose mothers are foreign wives].

Families formed as a result of a marriage involving an immigrant are a new phenomenon in Taiwan. School children whose mothers are foreign wives are increasing. Because of differences in lifestyle and culture, and because of stereotyping, such families are vulnerable and prone to experiencing unequal treatment. How will they fare when their children start elementary school? This article explores the physical and psychosocial health needs and health care utilization of school-aged children whose mothers are foreign wives. It also explores factors which might arise in the case of these children because of social inequality. The authors emphasize the importance of school health and raise suggestions for school nurses. Such nurses should provide health promotion programs to promote the health of children whose mothers are foreign wives. This will enable these children to grow up happily and healthily, and develop into healthy, well-educated adults with a positive attitude and good health-related behavior.