Further evidence of psychological factors underlying choice of elective cesarean delivery (ECD) by primigravidae

Objective: Requests for elective cesarean delivery (ECD) have increased in Iran. While some sociodemographic and fear-related factors have been linked with this choice, psychological factors such as self-esteem, stress, and health beliefs are under-researched. Methods: A total of 342 primigravidae (mean age = 25 years) completed questionnaires covering psychological dimensions such as self-esteem, perceived stress, marital relationship quality, perceived social support, and relevant health-related beliefs. Results: Of the sample, 214 (62.6%) chose to undergo ECD rather than vaginal delivery (VD). This choice was associated with lower self-esteem, greater perceived stress, belief in higher susceptibility to problematic birth and barriers to an easy birth, along with lower perceived severity of ECD, fewer perceived benefits from VD, lower self-efficacy and a lower feeling of preparedness. No differences were found for marital relationship quality or perceived social support. Conclusions: The pattern suggests that various psychological factors such as self-esteem, self-efficacy, and perceived stress underpin the decision by primigravidae to have an ECD

Psychosocial determinants of sustained maternal functional impairment: longitudinal findings from a pregnancy-birth cohort study in rural Pakistan

Function is an important marker of health throughout the life course, however, in low-and-middle-income-countries, little is known about the burden of functional impairment as women transition from pregnancy to the first year post-partum. Leveraging longitudinal data from 960 women participating in the Share Child Cohort in Pakistan, this study sought to (1) characterize functional trajectories over time among women in their perinatal period and (2) assess predictors of chronic poor functioning following childbirth. We used a group-based trajectory modeling approach to examine maternal patterns of function from the third trimester of pregnancy through 12 months post-partum. Three trajectory groups were found: persistently well-functioning (51% of women), poor functioning with recovery (39% of women), and chronically poor functioning (10% of women). When compared to mothers in the highest functioning group, psychosocial characteristics (e.g., depression, stress, and serious life events) were significantly associated with sustained poor functioning one-year following child-birth. Mothers living in nuclear households were more likely to experience chronic poor functioning. Higher education independently predicted maternal function recovery, even when controlling for psychosocial characteristics. Education, above and beyond socio-economic assets, appears to play an important protective role in maternal functional trajectories following childbirth. Public health implications related to maternal function and perinatal mental health are discussed

Social support and optimism in relation to the oral health of young adults

BACKGROUND: Psychosocial factors largely external to the individual—such as social support and those that are inherently dispositional, like optimism—may both play a role in determining oral health outcomes and serve to buffer the effect of each other. PURPOSE: The aim of this study was to assess associations of social support and optimism on oral health. METHOD: In 2005–2006, n=1,859 persons around 30 years old were surveyed to collect data on social support, optimism, oral health-related quality of life, and caries experience. RESULTS: Unadjusted analyses found high social support associated (P<0.05) with fewer (mean±SE) decayed teeth(0.6±0.1) and less negative impact on quality of life (2.7± 0.2) compared to low support (1.0±0.2 and 4.5±0.4 respectively). High optimism was associated with fewer missing teeth (2.1±0.2) and less negative impact on quality of life (2.1±0.2) compared to low optimism (2.9±0.2 and 3.8±0.2, respectively). Multivariate regressions adjusted for dental visiting, toothbrushing, sex, income, work status and education showed social support and optimism had (P<0.05) negative associations with missing teeth (β=−1.0) and caries experience (β=−1.5) for high support/high optimism compared to low support/low optimism. All three non-reference combinations of support/optimism showed negative associations(β=−1.6 to −2.4) with impact of problems compared to low support/low optimism. CONCLUSIONS: Social support and optimism were associated with oral health. Impact of dental problems showed buffering of high support when optimism was low, and high optimism when support was low.David Simon Brennan and A.J. Spence

Life events and oral-health-related quality of life among young adults

Purpose: Life-course approaches to understanding the determinants of health have led to a greater focus on the effects of life events on health. Life events may be construed as either positive or negative, and may have differential health effects. The aims of the study were to assess the association of positive and negative life events with oral-health-related quality of life (OHRQoL). Methods In 2005–2006, 1,859 study participants aged around 30 years old were surveyed by mailed self-complete questionnaire and invited to attend a dental examination. Data collected included life events, social support (MSPSS) and OHRQoL (OHIP-14). A total of 632 people responded (43% response). Results: Multivariate analysis controlling for sex, education, income, dental behaviour and social support showed that the lower (OR = 0.4, 0.2–0.6) and middle tertiles (OR = 0.6, 0.4–0.9) for negative life events were associated with lower prevalence of problems related to OHRQoL compared to the higher tertile. Conclusions: OHRQoL among young adults was associated with negative life events, but not positive life events. This suggests that negative life events involving social readjustment need to considered as determinants of health in life-course oral epidemiology frameworks.David Simon Brennan and A. John Spence

The use of social media as a mechanism of social support in parents

The increasing use of social media has changed communication habits among parents and provides the opportunity to access social support online. This paper explored parents’ use of different social media sources and examined potential factors that motivate parents’ use of social media for parenting support. A total of 523 parents completed the Australia-wide online survey. Results indicated that parents endorsed Facebook, parenting websites and blogs as the most frequently used social media sources. Getting specific information and advice were the top ranked reasons parents accessed social media for parenting purposes. A series of multiple regression analyses were conducted to investigate predictors of social media use (Model 1) and parents’ perceived level of online social support (Model 2). Analyses of Model 1 revealed that after controlling for demographic variables, parents’ social media use was predicted by internet self-efficacy, perceptions towards the social media and online support. Analyses of Model 2 revealed that after controlling for demographic variables, parents’ perceptions toward social media, and their use of social media predicted levels of online social support, such that the more parents used social media, the greater the online support they reported receiving. Child maladjustment and parenting self-efficacy did not predict either social media use or online social support. The results indicate that parents do use social media for parenting purposes, and that it can serve as a type of social support

Posttraumatic growth following a first episode of psychosis: a mixed methods research protocol using a convergent design

BACKGROUND: The suffering people experience following a first episode of psychosis is great, and has been well-investigated. Conversely, potential positive outcomes following a first episode of psychosis have been under-investigated. One such outcome that may result from a first episode of psychosis is posttraumatic growth, or a positive aftermath following the trauma of a first psychotic episode. While posttraumatic growth has been described following other physical and mental illnesses, posttraumatic growth has received very little attention following a first episode of psychosis. To address this research gap, we will conduct a mixed methods study aimed at answering two research questions: 1) How do people experience posttraumatic growth following a first episode of psychosis? 2) What predicts, or facilitates, posttraumatic growth following a first episode of psychosis? METHODS/DESIGN: The research questions will be investigated using a mixed methods convergent design. All participants will be service-users being offered treatment for a first episode of psychosis at a specialized early intervention service for young people with psychosis, as well as their case managers.. A qualitative descriptive methodology will guide data-collection through semi-structured interviews with service-users. Service-users and case managers will complete questionnaires related to posttraumatic growth and its potential predictors using quantitative methods. These predictors include the impact a first episode of psychosis on service-users’ lives, the coping strategies they use; the level of social support they enjoy; and their experiences of resilience and recovery. Qualitative data will be subject to thematic analysis, quantitative data will be subject to multiple regression analyses, and results from both methods will be combined to answer the research questions in a holistic way. DISCUSSION: Findings from this study are expected to show that in addition to suffering, people with a first episode of psychosis may experience positive changes. This study will be one of few to have investigated posttraumatic growth following a first episode of psychosis, and will be the first to do so with a mixed methods approach