Intimate partner violence and its association with maternal depressive symptoms 6-8 months after childbirth in rural Bangladesh

Background: Intimate partner violence (IPV) is important to be addressed simply because it is a gross violation of human rights. Its prevalence is wide ranging across the world, with higher prevalence reported in low- and middle-income countries. Evidence shows that IPV has both direct and indirect impact on women’s health, mainly related to physical health. Little is known of impact of IPV on mental health of women, particularly after childbirth. Objective: To describe the prevalence of intimate partner violence (IPV) experienced by women 6-8 months after childbirth, and the factors associated with IPV. The study also aims to investigate the association between IPV and maternal depressive symptoms after childbirth. Design: The study used cross-sectional data at 6-8months postpartum. The sample included 660 mothers of newborn children. IPV was assessed by physical, emotional, and sexual violence. The Edinburg Postnatal Depression Scale assessed maternal depressive symptoms. Results: Majority of the women reported experiencing intimate partner violence categorised as physical (52%), sexual (65%) and emotional (84%) violence by spouse. Husband’s education (OR: 0.41, CI: 0.23-0.73), poor relationship with husband (OR: 2.64, CI: 1.07-6.54) and emotional violence by spouse (OR: 1.58, CI: 1.35-1.83) were significantly associated with physical IPV experienced by women. Having a fussy and difficult child (OR: 1.05, CI: 1.02-1.08), poor relationship with husband (OR: 4.95, CI: 2.55-9.62) and experience of physical IPV (OR: 2.83, CI: 1.72-4.64) were found to be significant predictors of maternal depressive symptoms amongst women 6-8 months after childbirth. Neither forced sex nor emotional violence by intimate partner was found to be significantly associated with maternal depressive symptoms 6-8 months after childbirth. Conclusion: It is important to screen for both IPV and depressive symptoms during pregnancy and postpartum. Since IPV and spousal relationships are the most important predictors of maternal depressive symptoms in this study, couple-focused intervention at the community level are suggested

‘‘I can’t stop worrying about everything’’-experiences of rural Bangladeshi women during the first postpartum months

Over recent years, researchers have found evidence which indicates that the prevalence of postpartum depressive symptoms crosses cultural boundaries and is reported to be at least as high in non-Western countries as inWestern countries. However, qualitative studies about new mothers’ experiences from non-Western countries, such as Bangladesh, are rare, particularly in rural areas. This study aims to describe the experiences and concerns of rural Bangladeshi mothers with postpartum depressive symptoms. Open narrative interviews were conducted with 21 mothers with depressive symptoms 2-3 months postpartum, consecutively selected from a longitudinal study about prevalence and risk factors of perinatal depressive symptoms. Inductive content analysis was used to analyse data and three themes emerged: family dynamics, living at the limits of survival, and role of the cultural context after childbirth. These themes were based on six categories and 15 subcategories. The findings show that troublesome family relationships, including intimate partner violence and violence in the family, influenced the mothers’ mental well-being. They and their families lived at the limit of survival and the mothers expressed fear and worries about their insecure situation regarding economic difficulties and health problems. They felt sorry for being unable to give their infants a good start in life and sad because they could not always follow the traditional norms related to childbirth. Thus, it is important to focus on the depressive symptoms among new mothers and offer counselling to those showing depressive symptoms, as the cultural traditions do not always alleviate these symptoms in the changing Bangladeshi society today

Perceived Stress During COVID-19 Pandemic: The Malaysian Nurses Experience

Research shows that nurses are one of the most vulnerable categories of professionals to develop stress and other problems due to the nature of their job. Thus the objective of this study is to describe the perceived stress experienced during the COVID-19 pandemic among Malaysian nurses. A cross-sectional study was conducted through an online form involving 319 randomly selected nurses from a teaching hospital on the east coast of Pahang, Malaysia, between January to December 2022. The perceived stress was measured using the Malay version 10-item Perceived Stress Scale, PSS-10 questionnaire. Descriptive and linear regression analysis was applied to measure the mean score of perceived stress and the association between perceived stress scores and other factors in this population. The study found that the total mean score of PSS-10 among the respondents was 19.1 ± 5.8. The three items with the highest mean scores were under the subscales “lack of self-efficiency” of the questionnaire (item-4, item-7, and item 5), while the item with the lowest mean scores belonged to subscales “perceived helplessness” (item-10). However, further analysis performed shows no significant association between perceived stress towards COVID-19 with sociodemographic and work-related factors among respondents. This study concluded that lack of self-efficiency was perceived as the main stress experienced by Malaysian nurses during the COVID-19 pandemic. Thus, it is pivotal that the nurse’s manager and higher authority of the organization focus on improving the efficiency of these nurses through targeted programs focusing on problem-solving, emotional and on-the -job management plan, along with accessibility to resources, a positive work environment and support

'The clock keeps ticking' - the role of a community-based intervention in reducing delays in seeking emergency obstetric care in rural Bangladesh: a quasi-experimental study

Objective: To explore the role of a community-based intervention in reducing delays in accessing emergency obstetric care (EmOC) in rural Bangladesh, and the factors associated with delayed decision making, reaching the health facility and receiving treatment. Study design: Quasi-experimental study. Methods: Multistage random sampling was used to select 540 villages, from which 1200 women who reported obstetric complications in March–April 2010 were interviewed. Results: The median time taken to make the decisions to access health care was significantly lower in the intervention areas compared with the control areas (80 vs 90 min). In addition, the median time taken to reach the health facility was significantly lower in intervention areas compared with the control areas (110 vs 135 min). However, no difference was found in the median time taken to receive treatment. Multiple linear regressions demonstrated that community intervention significantly reduced decision making and time taken to reach the health facility when accessing EmOC in rural Bangladesh. However, for women experiencing haemorrhage, the delays were longer in the intervention areas. Protective factors against delayed decision making included access to television, previous medical exposure, knowledge, life-threatening complications during childbirth and use of primary health facility. Financial constraints and traditional perceptions were associated with delayed decision making. Complications during labour, use of a motorized vehicle and use of a primary health facility were associated with faster access to EmOC and poverty, distance, transportation difficulties and decision making by male guardian were associated with slower access to EmOC. Conclusions: The intervention appeared to reduce the time taken to make the decision to access health care and time taken to reach the health facility when accessing EmOC. This study provides support for a focus on emergency preparedness for timely referral from the community

Can community level interventions have an impact on equity and utlization of maternal health care : Evidence from rural Bangladesh

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Nicotine dependence and quit smoking: a preliminary survey among adult males in Kuantan, Malaysia

Introduction: Most of the smokers remain as active smokers and unrecognized their nicotine dependence (ND) level. ND was an important reason to addict smoking. The study determined the prevalence of smoking and ND among adult males and their difficulties to quit smoking. Methods: A cross-sectional study was conducted among 296 males aged 18 years and above from Felda Bukit Goh at Kuantan, Malaysia in 2015. Socio-economic status, history of smoking, quit attempt and reasons for failing quit were explored by using a self-administered questionnaire. Level of ND was assessed by validated Malay version of Fagerstrom Test for ND questionnaires. Stratified analysis on relationship among socio-economic status and current smoking status, level of ND was done. Results: The prevalence of current smokers was 61.1% and the prevalence of low and moderate to high ND level was 76.2 % and 23.8 % respectively. Among them 54.1% of smokers were tried to quit smoking ranging from 1 to 30 times by self-awareness (48%) and their main reason to fail was addiction (71.9%). Smokers with monthly household income (RM2000-2999) was independently associated with moderate to high ND with AOR=4.73 (95% CI 1.83-12.18) compared to those with income (less than RM2000). Conclusion: Despite high prevalence of smoking, majority of smokers have low ND and addiction was the main reason to fail quit attempt. Household income was a contributing factor for moderate to high ND. The finding provides hope for the success of smoking cessation programme if it is to be done in this locality

Prevalence of risk for eating disorder amongst International Islamic University Malaysia medical students and its associated factors

Introduction: Eating disorders are a poorly understood condition characterised by severe psychiatric and medical manifestations, in which eating habits, physical health and psychosocial functioning are disturbed. College and university students are among the population who are prone to eating disorder. The aim of this study is to determine the prevalence of eating disorders risk in the International Islamic University Malaysia (IIUM), Kuantan campus amongst the medical students and to identify its associated factors. Materials and Methods: A cross sectional study involving 200 medical students of IIUM Kuantan campus session 2014/2015 of all years (20-26 years old) of both genders using a self-administered questionnaire through an online website which is a Google drive between 29th June till 10th July 2015. Result: This study revealed that the prevalence of risk for eating disorder among IIUM Kuantan campus medical students is 15.0 percent. On the same note, the risk is noted to be higher among single female of Malay ethnicity, being middle child, overweight and physically inactive; albeit none of these factors significantly associated with risk of eating disorder among this population. Conclusion: The prevalence of those who have the risk of eating disorder in this study is comparable to the result from the previous studies conducted among college and university students in Malaysia. Nevertheless, the risk of eating disorder is documented among IIUM medical students and warrant a closer look and appropriate reference for those who have the risk

Nicotine dependence and quit smoking: a preliminary survey among adult males in Kuantan, Malaysia

Most of the smokers remain as active smokers and unrecognized their nicotine dependence (ND) level. ND was an important reason to addict smoking. The study determined the prevalence of smoking and ND among adult males and their difficulties to quit smoking. A cross-sectional study was conducted among 296 males aged 18 years and above from Felda Bukit Goh at Kuantan, Malaysia in 2015. Socio-economic status, history of smoking, quit attempt and reasons for failing quit were explored by using a self-administered questionnaire. Level of ND was assessed by validated Malay version of Fagerstrom Test for ND questionnaires. Stratified analysis on relationship among socio-economic status and current smoking status, level of ND was done. The prevalence of current smokers was 61.1% and the prevalence of low and moderate to high ND level was 76.2 % and 23.8 % respectively. Among them 54.1% of smokers were tried to quit smoking ranging from 1 to 30 times by self-awareness (48%) and their main reason to fail was addiction (71.9%). Smokers with monthly household income (RM2000-2999) was independently associated with moderate to high ND with AOR=4.73 (95% CI 1.83-12.18) compared to those with income (less than RM2000). Despite high prevalence of smoking, majority of smokers have low ND and addiction was the main reason to fail quit attempt. Household income was a contributing factor for moderate to high ND. The finding provides hope for the success of smoking cessation programme if it is to be done in this locality

Nicotine dependency of adult male smokers and it’s socio-economic determinants

INTRODUCTION: Most smokers become dependent both physically and psychologically within a few years of daily smoking because of its major chemical component of nicotine in tobacco. Nicotine dependence is occurred at any time which affects on successful smoking cessation. The aim of the study was to measure the prevalence of nicotine dependence (ND) among adult male smokers and influences of socio-economic characteristics on it. METHODS: A cross-sectional study was conducted among 297 adult males participants with aged ≥18 years and who were recruited purposively from the house-holds which were selected using simple random sampling at FELDA Bukit Goh, Kuantan, Pahang in February 2015. Smoking and nicotine dependence status of the participants were assessed using a self-administered questionnaire in which consisted of modified smoking and tobacco use questions used in National Health Interview Survey and validated Malay version of Fagerstrom Test for Nicotine Dependence (FTND-M) assessment questionnaires. Fishers’ exact test, ANOVA and median test were applied to infer association between nicotine dependency and socio-economic (SE) variables (age, education, occupation, income and marital status). RESULTS: In the study, 61.3% (182 /297) was current smokers. Among them, the prevalence of low, moderate and high nicotine dependence level were 76.4% (139 /182), 22.5 % (41 /182) and 1.1% (2/182) respectively. The smokers aged 31-40 years old with secondary education, self employed, moderate monthly family income (1000-3000 RM) and married person were lower ND; however, these findings were no statistically significant when a cross analysis and comparing mean or median ND score among different SE background. CONCLUSIONS: High prevalence of low nicotine dependency is a favorable condition to obtain successful smoking cessation among the adult male smokers. No significant socio-economic determinants on level of ND indicated that level of ND should be assessed before engaging in the quit smoking program to provide tailored NRT