A Video-Based intervention to Overcome Pregnancy Smoking Stigma Among Healthcare Students : A Randomised Controlled Trial

The stigmatisation of pregnant smokers may have a deleterious impact on the care and support these women receive from healthcare providers. This study develops and tests a video intervention that aims to reduce the stigma associated with smoking while pregnant among French healthcare students

Changes in Mothering Ideology After Childbirth and Maternal Mental Health in French Women

The prevailing dominant discourse about motherhood in western societies reflects a set of interconnected beliefs referred to as intensive mothering ideology. Little is known about how intensive mothering ideology changes after childbirth, and the associations between intensive mothering ideology and maternal mental health. The current study aims to explore how intensive mothering ideology may evolve after childbirth in both primiparous and multiparous women, and whether any observed changes in this ideology impact maternal mental health. French women (n = 144) completed a set of study measures during late pregnancy and then again at two months and four months postpartum, which assessed intensive mothering ideology, postpartum depression, and maternal burnout symptoms. As expected, the results indicated that intensive mothering ideology increases after childbirth. However, changes in ideology were not stronger in primiparous women compared to multiparous women. Of note, multiparous women reported stronger challenge and sacrifice beliefs. Finally, linear mixed models showed that changes in intensive mothering ideology were associated with maternal mental health in contradictory ways, while controlling for parity and unemployment. Mainly, growth in sacrificial beliefs seems to be detrimental to maternal mental health. These findings have implications for the well-being of mothers after childbirth and call for challenging the self-sacrifice beliefs that underpin intensive mothering ideology in order to promote self-care

The Pregnant Smoker Stigma Scale - Public Stigma (P3S-PS): development and validation in general French population

While pregnancy smoking stigma is widely acknowledged, no psychometrically sound tool to measure it exists. This study was designed to build the Pregnant Smoker Stigma Scale - Public Stigma (P3S-PS) for assessing the stigma of pregnancy smoking in the general French population. A total of 342 adults were recruited online to take the P3S-PS and some items (condemnation/rejection, and support for punitive actions) from other scales. Exploratory factor analysis was performed. Measurement invariance was tested according to gender and smoking status. Temporal reliability was checked after two weeks (n = 72). The P3S-PS has 26 items and four dimensions: "derogatory cognitions," "negative emotions and behaviors," "personal distress," and "information provision." All dimensions were correlated (r = .36 to .75) and have good internal consistency (α.>.70), temporal reliability (ICC>.75), and measurement invariance. Validity is exhibited through the P3S-PS's association with condemnation and rejection (r = .32 to .53), support for punitive actions (r = .35 to .65), and presence of pregnant smokers in the close circle (r = -.23 to -.40). The P3S-PS is a promising tool that exhibits good psychometric qualities. This scale will be useful to trigger research regarding the stigma of smoking while pregnant

Healthcare providers perception of therapeutic patient education efficacy according to patient and healthcare provider characteristics

International audienceObjectives Therapeutic patient education improves numerous health and psychological outcomes in patients with chronic diseases. However, little is known about what makes a therapeutic patient education intervention more effective than another one. This study aims to identify in healthcare professionals the perceived determinants of therapeutic patient education efficacy at the individual level. Methods Semi-structured individual interviews have been conducted with healthcare professionals (HCP, n=28, including 20 nurses) involved in therapeutic patient education programs ( n=14) covering various chronic conditions (kidney and cardiovascular diseases, chronic pain, diabetes, etc.). A thematic content analysis following an inductive approach was used (Nvivo.11 software). Results Five themes were retrieved for patient characteristics: understanding and education, personality, readiness and motivation, social environment, and misinformation and beliefs. Four themes were retrieved for healthcare professionals’ characteristics: medical knowledge, appropriate attitude and relational skills, pedagogical skills, and training. Discussion Patient personality is rarely discussed in the literature. Patients who are introverted, lack curiosity, or are not compliant might benefit from specific therapeutic patient education practices or formats. All these potential determinants regarding patients and healthcare professionals should be routinely assessed in future studies about therapeutic patient education efficacy to understand precisely what makes an intervention successful

Stigma Attached to Smoking Pregnant Women: A Qualitative Insight in the General French Population

INTRODUCTION: Cigarette consumption during pregnancy has major health consequences for women and unborn children. The stigma of smoking during pregnancy might hinder mothers-to-be's access to adequate healthcare and smoking cessation, especially in disadvantaged groups. This qualitative study was designed to describe extensively the public stigma associated with smoking during pregnancy. METHOD: Participants were French adults recruited from the general population through social networks (N=100). They were asked to answer three pairs of open-ended questions regarding cognitions, emotions and behaviours elicited in the general population by pregnant smoking women. An inductive thematic analysis was performed and inter-judge agreement was computed on 30% of the corpus analysed deductively. Finally, independence (chi-square) between themes and gender, education, parenthood and smoking status was tested. RESULTS: Themes (n=25) were defined regarding cognitions (n=9, e.g., irresponsible, thoughtless and unmindful, etc.), emotions (n=8, e.g., anger, disgust, etc.) and behaviours (n=8, e.g., inform and persuade, moralise and blame, etc.). Global inter-judge agreement was strong (κ=0.8). No difference was observed in themes according to gender, parental status or education, indicating a heterogenous awareness of stigma. However, some differences were observed according to smoking status (χ2 = 69.59, p = 0.02) (e.g., non-smokers more frequently stressed immorality). CONCLUSION: The stigma associated with smoking during pregnancy includes various components that might be measured and targeted in interventions to improve access to adequate healthcare and smoking cessation in this specific population. IMPLICATIONS: This qualitative study explores the stigma that the general French population attaches to pregnant women who smoke. Themes regarding cognitions (e.g., irresponsible, thoughtless and unmindful, etc.), emotions (e.g., anger, disgust, etc.) and behaviours (e.g., inform and persuade, moralise and blame, etc.) were identified. These themes could guide further research regarding scale development and anti-stigma interventions to support smoking cessation