Psychosocial and Cultural Determinants of Maternal Burnout and Perinatal Depressive Symptoms

Alors qu’une maternité heureuse est une aspiration collective, il est établi que de nombreuses femmes souffrent de détresse psychologique dans la période périnatale. Or, la santé psychologique des femmes ne peut être considérée indépendamment de leurs rôles au sein de la société et des normes qui y sont attachées. Ce travail de recherche vise à tester un modèle psychosocial et culturel de compréhension des troubles de l'adaptation à la maternité, (symptômes dépressifs postpartum et burnout). Dans une première étude, différentes étapes auprès de plusieurs populations (N = 250, 22, 474, 249 et 231) ont mené à la validation en langue française d’une échelle de mesure des croyances associées au rôle maternel. Dans un second temps, un suivi longitudinal a été mis en place auprès de femmes rencontrées en fin de grossesse puis à 2 et 4 mois postpartum (N = 129). Ces travaux ont permis d’établir la validité convergente, prédictive et de construit du concept de burnout maternel. Par ailleurs, le poids des caractéristiques psychosociales et normatives du rôle maternel dans le développement de symptômes dépressifs et de burnout a été exploré. Pour finir, des analyses en cluster ont permis de dégager des profils d’articulation, plus ou moins adaptatifs, entre investissement dans la maternité et dans la vie professionnelle. Ces travaux ouvrent des perspectives de recherche concernant le concept de burnout maternel dans la période postpartum et la prise en compte des aspects socio-normatifs du rôle maternel dans la prévention et la prise en charge de ces troubles.Whereas a happy motherhood is a collective aspiration, it is known that many women are reporting psychological distress during the perinatal period. Yet, women’s psychological health can not be considered regardless of their roles in society and norms associated. This research work aims to test a psychosocial and cultural model to understand adjustment disorder regarding motherhood (postpartum depressive symptoms and burnout). In a first study, various steps with different populations (N = 250, 22, 474, 249 and 231) have led to the validation in French of a scale assessing beliefs associated with the maternal role. Then, a longitudinal follow up was settled with women who were seen during late pregnancy and at 2 and 4 months postpartum (N = 129). This work has served to demonstrate the convergent, predictive and construct validity of maternal burnout. Furthermore, the impact of motherhood psychosocial and normative characteristics in the development of depressive and burnout symptoms have been explored. Finally, cluster analyses were conducted to identify more or less adaptive patterns regarding articulation of investment in motherhood and working life. This research work has opened research avenues regarding maternal burnout in the postpartum period and considerations of socio-normative aspects of the mothering role regarding prevention and care of those troubles

Déterminants Psychosociaux et Culturels du Burnout Maternel et des Symptômes Dépressifs Périnataux

Whereas a happy motherhood is a collective aspiration, it is known that many women are reporting psychological distress during the perinatal period. Yet, women’s psychological health can not be considered regardless of their roles in society and norms associated. This research work aims to test a psychosocial and cultural model to understand adjustment disorder regarding motherhood (postpartum depressive symptoms and burnout). In a first study, various steps with different populations (N = 250, 22, 474, 249 and 231) have led to the validation in French of a scale assessing beliefs associated with the maternal role. Then, a longitudinal follow up was settled with women who were seen during late pregnancy and at 2 and 4 months postpartum (N = 129). This work has served to demonstrate the convergent, predictive and construct validity of maternal burnout. Furthermore, the impact of motherhood psychosocial and normative characteristics in the development of depressive and burnout symptoms have been explored. Finally, cluster analyses were conducted to identify more or less adaptive patterns regarding articulation of investment in motherhood and working life. This research work has opened research avenues regarding maternal burnout in the postpartum period and considerations of socio-normative aspects of the mothering role regarding prevention and care of those troubles.Alors qu’une maternité heureuse est une aspiration collective, il est établi que de nombreuses femmes souffrent de détresse psychologique dans la période périnatale. Or, la santé psychologique des femmes ne peut être considérée indépendamment de leurs rôles au sein de la société et des normes qui y sont attachées. Ce travail de recherche vise à tester un modèle psychosocial et culturel de compréhension des troubles de l'adaptation à la maternité, (symptômes dépressifs postpartum et burnout). Dans une première étude, différentes étapes auprès de plusieurs populations (N = 250, 22, 474, 249 et 231) ont mené à la validation en langue française d’une échelle de mesure des croyances associées au rôle maternel. Dans un second temps, un suivi longitudinal a été mis en place auprès de femmes rencontrées en fin de grossesse puis à 2 et 4 mois postpartum (N = 129). Ces travaux ont permis d’établir la validité convergente, prédictive et de construit du concept de burnout maternel. Par ailleurs, le poids des caractéristiques psychosociales et normatives du rôle maternel dans le développement de symptômes dépressifs et de burnout a été exploré. Pour finir, des analyses en cluster ont permis de dégager des profils d’articulation, plus ou moins adaptatifs, entre investissement dans la maternité et dans la vie professionnelle. Ces travaux ouvrent des perspectives de recherche concernant le concept de burnout maternel dans la période postpartum et la prise en compte des aspects socio-normatifs du rôle maternel dans la prévention et la prise en charge de ces troubles

Psychosocial and Cultural Determinants of Maternal Burnout and Perinatal Depressive Symptoms

Alors qu’une maternité heureuse est une aspiration collective, il est établi que de nombreuses femmes souffrent de détresse psychologique dans la période périnatale. Or, la santé psychologique des femmes ne peut être considérée indépendamment de leurs rôles au sein de la société et des normes qui y sont attachées. Ce travail de recherche vise à tester un modèle psychosocial et culturel de compréhension des troubles de l'adaptation à la maternité, (symptômes dépressifs postpartum et burnout). Dans une première étude, différentes étapes auprès de plusieurs populations (N = 250, 22, 474, 249 et 231) ont mené à la validation en langue française d’une échelle de mesure des croyances associées au rôle maternel. Dans un second temps, un suivi longitudinal a été mis en place auprès de femmes rencontrées en fin de grossesse puis à 2 et 4 mois postpartum (N = 129). Ces travaux ont permis d’établir la validité convergente, prédictive et de construit du concept de burnout maternel. Par ailleurs, le poids des caractéristiques psychosociales et normatives du rôle maternel dans le développement de symptômes dépressifs et de burnout a été exploré. Pour finir, des analyses en cluster ont permis de dégager des profils d’articulation, plus ou moins adaptatifs, entre investissement dans la maternité et dans la vie professionnelle. Ces travaux ouvrent des perspectives de recherche concernant le concept de burnout maternel dans la période postpartum et la prise en compte des aspects socio-normatifs du rôle maternel dans la prévention et la prise en charge de ces troubles.Whereas a happy motherhood is a collective aspiration, it is known that many women are reporting psychological distress during the perinatal period. Yet, women’s psychological health can not be considered regardless of their roles in society and norms associated. This research work aims to test a psychosocial and cultural model to understand adjustment disorder regarding motherhood (postpartum depressive symptoms and burnout). In a first study, various steps with different populations (N = 250, 22, 474, 249 and 231) have led to the validation in French of a scale assessing beliefs associated with the maternal role. Then, a longitudinal follow up was settled with women who were seen during late pregnancy and at 2 and 4 months postpartum (N = 129). This work has served to demonstrate the convergent, predictive and construct validity of maternal burnout. Furthermore, the impact of motherhood psychosocial and normative characteristics in the development of depressive and burnout symptoms have been explored. Finally, cluster analyses were conducted to identify more or less adaptive patterns regarding articulation of investment in motherhood and working life. This research work has opened research avenues regarding maternal burnout in the postpartum period and considerations of socio-normative aspects of the mothering role regarding prevention and care of those troubles

Matern Child Health J

Introduction According to many studies, anxiety in the perinatal period is widespread and has many detrimental effects. Thus, screening measures should not be limited to assessing depression symptoms. The widely used Edinburgh Postnatal Depression Scale (EPDS) might assess depression but also anxiety symptoms. This study explores whether an anxiety dimension (EPDS-3A) was found and valid in French women during pregnancy and the postpartum period. Methods French women were followed-up at late pregnancy and 2 and 4 months postpartum (N = 144, 138 and 129). They completed the EPDS and the Hospital Anxiety and Depression Scale (HADS-A). Exploratory factor analyses were performed. Then to test its validity, the EPDS-3A was correlated with anxiety (HADS-A) and depression (EPDS-D) scores. Finally, prevalence estimates were computed according to recommended cut off. Results The anxiety dimension assessed through the EPDS-3A was observed during the postpartum period but not during pregnancy. A two-factor structure (depression and anxiety) increases the variance explained at 2 and 4 months postpartum (respectively 6 and 12%). The EPDS-3A shows good internal consistency (≥ .70) and was more strongly associated with anxiety scores (HADS-A) (.48–.57) than with depression scores (EPDS-D) (.30–.39). Nearly 28% of mothers had scores that exceeded the EPDS-3A cut off (≥ 4) but not the full EPDS cut off (≥ 13 or more). Discussion The EPDS contains an anxiety component (EPDS-3A) that can be found in French women during the postnatal period but not during pregnancy. It shows signs of internal consistency and validity. The EPDS-3A could be considered when screening for postpartum anxiety

The Pregnant Smoker Stigma Scale - Self Stigma (P3S-SS): development and validation in pregnant smoking women in France

International audiencePregnancy smoking self-stigma may be associated with mental health and smoking cessation. This study aims to validate the Pregnant Smoker Stigma Scale – Self-Stigma (P3S-SS) assessing perceived and internalized stigma. Between May 2021 and May 2022, French pregnant smokers recruited online (n = 143) took the P3S-SS and other scales assessing depressive symptoms (EPDS), social inclusion (SIS), dissimulation, dependence (CDS-5), cessation self-efficacy (SEQ), and intention. The two versions of the scale include four dimensions: derogatory cognitions (“People think/I feel I am selfish”), negative emotions and behaviors (“People make me feel/smoking makes me feel guilty”), personal distress (“People/I feel sorry for me/myself”), and information provision (“People tell me/I think about the risks of smoking”). Confirmatory factor analyses and multiple regressions have been computed. Model fit was good for perceived stigma and internalized stigma (X2/df = 3.06, RMSEA = .124, AGFI = .982, SRMR = .068, CFI = .986, NNFI = .985; X2/df = 3.31, RMSEA = .14, AGFI = .977, SRMR = .087, CFI = .981, NNFI = .979). Controlling for dependence, cessation intention was positively predicted by perceived and internalized personal distress and negatively predicted by perceived negative emotions and behaviors (Adj R2 = .143, F(8,115) = 3.567, p = .001). Controlling for dependence, dissimulation was positively predicted by internalized negative cognitions and perceived personal distress and negatively predicted by internalized personal distress (Adj R2 = .19, F(9,98) = 3.785, p = .000). The P3S-SS opens up exciting avenues for further research. Stigma does not motivate women to stop smoking but increases distress and dissimulation

Tailored patient therapeutic educational interventions: A patient‐centred communication model

International audienceBackground: Tailoring therapeutic education consists of adapting the intervention to patients' needs with the expectation that this individualization will improve the results of the intervention. Communication is the basis for any individualization process. To our knowledge, there is no guide or structured advice to help healthcare providers (HCPs) tailor patient education interventions.Objectives: We used a data-driven qualitative analysis to (1) investigate the reasons why HCPs tailor their educational interventions and (2) identify how this tailoring is effectively conducted. The perspective aimed to better understand how to individualize therapeutic patient education and to disentangle the different elements to set up studies to investigate the mechanisms and effects of individualization.Design: Individual semistructured interviews with 28 HCPs involved in patient education were conducted. The present study complied with the COREQ criteria.Results: Why individualization is necessary: participants outlined that the person must be thought of as unique and that therapeutic education should be adapted to the patient's personality and cognitive abilities. The first step in the individualization process was formalized by an initial patient assessment. Several informal practices were identified: if needed, giving an individual time or involving a specific professional; eliciting individual objectives; reinforcing the relationship by avoiding asymmetrical posture; focusing on patients' concerns; leading sessions in pairs; and making the patient the actor of decisions.Conclusion: From our thematic data analysis, a model for tailoring patient education interventions based on the Haes and Bensing medical communication framework is proposed. The present work paves the way for evaluation, then generation of recommendations and finally implementation of training for individualization in educational interventions.Short informative: Tailoring in therapeutic education consists of an adaptation to patients' needs. Communication is the basis for any individualization process. There is no model of patient-centred communication in educational interventions. From semistructured interviews with HCPs, we propose a patient-centred communication model for tailoring patient education intervention