Adaptação da fatigue assessment scale em mães de bebés até dois anos

Inexistenteinfo:eu-repo/semantics/publishedVersio

Avaliação da ligação parental ao bebé após o nascimento: Análise fatorial confirmatória da versão portuguesa do Postpartum Bonding Questionnaire (PBQ)

A existência de perturbações na relação mãe/pai-bebé pode ter implicações prejudiciais para ambos os membros da díade. O Postpartum Bonding Questionnaire (PBQ, designado por nós como Questionário de Ligação ao Bebé após o Nascimento) foi desenvolvido com o objetivo de avaliar a existência de perturbações na relação que mães e pais estabelecem com o seu bebé. No entanto, entre os diversos estudos já realizados com este instrumento, verificam-se resultados inconsistentes relativamente à sua estrutura fatorial. No presente trabalho, conduzimos os estudos psicométricos da versão portuguesa do PBQ, um instrumento de autorresposta composto por 25 itens e com uma escala de resposta de seis pontos (de 0 – Nunca e 5 – Sempre). Uma amostra comunitária de 229 casais, cujos bebés tinham aproximadamente 6 meses, respondeu a uma bateria de questionários. A realização de análises fatoriais confirmatórias permitiu comparar seis modelos definidos com base nos estudos já realizados com este instrumento. Foi identificada como mais adequada aos nossos dados uma estrutura de um só fator, que difere da versão original do instrumento. A versão final do PBQ é constituída por 12 itens, tendo sido necessário alterar a tradução de um deles, de maneira a favorecer a sua compreensibilidade. O questionário apresentou bons índices de consistência interna e temporal, bem como valores adequados de validade convergente e discriminante. Verificou-se que os homens tendem a apresentar pontuações significativamente superiores no questionário. O PBQ constitui um instrumento de avaliação fiável e válido, passível de ser utilizado em contexto clínico e de investigação

Parental psychological distress and confidence after an infant’s birth: The role of attachment representations in parents of infants with congenital anomalies and parents of healthy infants.

The present study aimed to examine parental psychological distress and confidence after the infant’s birth, when parenting an infant with a diagnosis of a congenital anomaly, and to understand the role of attachment representations on parental adjustment. Parents of infants with a congenital anomaly (44 couples) and parents of healthy infants (46 couples) completed measures of adult attachment representations and of psychological distress and parental confidence (one month after the infant’s birth). Results showed no group differences in psychological distress. Mothers in the clinical group presented lower confidence than mothers in the comparison group, while for fathers the inverse pattern was found, showing their involvement in the caretaking of the infant. Insecure attachment representations predicted parental psychological distress, and a moderator role of group was found only for fathers; these results highlight the role of secure attachment representations as an individual resource in stress-inducing situations

Parental psychological distress and quality of life after a pre- or postnatal diagnosis of congenital anomaly: A controlled comparison study with parents of healthy babies.

Background: Parental early adjustment to a pre- or postnatal diagnosis of congenital anomaly has been studied mainly within a pathological and deterministic perspective, giving us an inadequate view of the impact of the diagnosis. Objectives: Adopting a comprehensive approach on parental adjustment, we aimed to characterise the impact of the diagnosis on psychological distress and quality of life, in the early post-diagnosis stage. The effects of gender and the timing of the diagnosis were also examined. Methods: In this cross-section study, 42 couples with healthy babies and 42 couples whose babies were pre- or postnatally diagnosed with a congenital anomaly responded to the Brief Symptom Inventory-18 and to the World Health Organization Quality of Life-Bref instrument. Results: In the early post-diagnosis stage, parents whose babies were diagnosed with a congenital anomaly presented higher levels of psychological distress than the parents of healthy babies (F2,79= 6.23, p = .003), although they displayed similar levels of quality of life (F4,78= 0.62, p = .647). Mothers reported more adjustment difficulties than fathers in both groups. Receiving the diagnosis in the prenatal period was associated with higher maternal psychological quality of life (Z= -2.00, p = .045). Conclusion: The occurrence of a diagnosis of congenital anomaly during the transition to parenthood adds to an accumulation of stress-inducing events and manifests itself in psychopathological symptoms. Maintaining a positive evaluation of well-being may be understood as a parental resource to deal with the diagnosis. The importance of adopting a comprehensive perspective on parental adjustment is highlighted

O tempo cura tudo? Adaptação à experiência de interrupção médica da gravidez por anomalia fetal durante o primeiro ano

Objetivo: Avaliar a prevalência de reações clinicamente significativas de luto e de trauma, no primeiro (M1) e no segundo semestre (M2) após uma interrupção médica da gravidez (IMG) por anomalia fetal. Metodologia: Vinte e três casais responderam à Escala de Luto Perinatal e à Escala de Impacto de um Evento – Revista. Resultados: A maioria da amostra mostrou adaptação em ambas as avaliações. A prevalência de luto foi igual no M1 e M2: 21.7% (mulheres) e 0.0% (homens). A prevalência de trauma no M1 foi de 17.4% (mulheres) e 22.7% (homens), descendo para 14.3% (mulheres) e 9.5% (homens) no M2. Em 13.0% (M1) e 14.3% (M2) das mulheres verificaram-se reações clinicamente significativas de luto e de trauma. Em 4.5% (M1) e 4.8% (M2) dos casais, ambos os membros manifestaram reações clinicamente significativas de trauma. Discussão: Após a IMG, a avaliação psicológica é necessária, atendendo à prevalência de reações clinicamente significativas de luto e de trauma, em particular nas mulheres

Parental psychological distress and confidence after an infant’s birth: The role of attachment representations in parents of infants with congenital anomalies and parents of healthy infants.

The present study aimed to examine parental psychological distress and confidence after the infant’s birth, when parenting an infant with a diagnosis of a congenital anomaly, and to understand the role of attachment representations on parental adjustment. Parents of infants with a congenital anomaly (44 couples) and parents of healthy infants (46 couples) completed measures of adult attachment representations and of psychological distress and parental confidence (one month after the infant’s birth). Results showed no group differences in psychological distress. Mothers in the clinical group presented lower confidence than mothers in the comparison group, while for fathers the inverse pattern was found, showing their involvement in the caretaking of the infant. Insecure attachment representations predicted parental psychological distress, and a moderator role of group was found only for fathers; these results highlight the role of secure attachment representations as an individual resource in stress-inducing situations

Trauma following TOPFA: Is this the path from guilt to grief?

Termination of pregnancy for fetal abnormality (TOPFA) is a potentially traumatic event that may lead to intense grief symptomatology. The present study included 41 couples who were assessed 1-6 months after TOPFA. No gender differences were found regarding the intensity of trauma symptomatology or the prevalence of clinically relevant trauma symptomatology, present in about a third of the sample. Most couples were congruent regarding trauma symptomatology. Women experienced guilt with significantly more frequency than men. For both genders, guilt influenced both trauma and grief symptomatology. For women only, guilt influenced grief symptomatology indirectly, through trauma symptomatology. Clinical implications are discussed

Clinical determinants of parents’ emotional reactions to the disclosure of a diagnosis of congenital anomaly.

Objective: To examine the variability of parents’ patterns of emotional reactions (high intensity vs. low intensity) and of the intensity of each emotion when a prenatal or postnatal diagnosis of a congenital anomaly is disclosed, as a function of gender and clinical variables (diagnosis characteristics and obstetric history). Design: Cross-sectional study. Setting: Two urban Portuguese hospitals. Participants: The parents (60 mothers and 50 fathers) of 60 infants prenatally or postnatally diagnosed with a congenital anomaly. Methods: One month after the disclosure of the diagnosis, the parents answered questionnaires regarding sociodemographic and clinical variables and their emotional experience at the disclosure. Results: Gender differences in the parents’ emotional reactions were not found, and intra-couple congruence was frequent. When there was uncertainty regarding the diagnosis, no prior knowledge about the diagnosis (for fathers only), and no history of pregnancy loss (for mothers only), parents presented significantly more frequently with a pattern of high intensity negative emotional reactions to the disclosure. Type of congenital anomaly, timing of diagnosis, and parity were not found to be significantly associated with the patterns of emotional reactions, but differences in the intensity of specific emotions were found for all variables. Conclusion: Both parents’ emotional experience should be acknowledged at the disclosure. Clinical variables were found to define the stressful situation (the diagnosis). When the diagnosis was perceived as more threatening (i.e., more unexpected, less controllable and predictable), parents presented a pattern of high intensity emotional reactions

Grief following termination of pregnancy for fetal abnormality: Does marital intimacy foster short-term couple congruence?

Objective: This study aimed to 1) compare women and men in congruent and incongruent couples regarding the intensity of grief responses and the prevalence of clinically relevant grief responses following a termination of pregnancy for fetal abnormality; and to 2) assess the role of marital intimacy in fostering couple congruence on grief responses. Background: In spite of the detrimental effects of incongruent grief on the marital relationship, previous studies have seldom compared congruent and incongruent couples. Furthermore, little is known regarding the predictors of incongruent grief. Studying such topics will allow for the implementation of effective clinical interventions aiming at decreasing the negative consequences of incongruent grief. Methods: 31 couples answered the Perinatal Grief Scale and the Personal Assessment of Intimate Relationships, one to six months after a termination of pregnancy for fetal abnormality. Results: The majority of couples were found to display congruent grief reactions. Women had significantly more intense grief reactions than men in both groups. Women’s scores were significantly higher in incongruent couples than in congruent couples, while no such difference was found for men. Clinically relevant grief symptoms were particularly prevalent in women in incongruent couples. Women’s perception of marital intimacy, but not men’s, positively predicted couple congruence. Conclusion: Given the normativity of gender differences regarding grief responses, clinicians should foster couple communication and acceptance. As couple incongruence may signal difficulties adapting to the loss, psychological assessment is warranted. Marital intimacy is a resource for women which should be fostered in clinical interventions. Keywords: couple congruence; grief responses; incongruent grief; marital intimacy; termination of pregnancy for fetal abnormality