Virtual reality interventions designed to support parents during and throughout the first year after birth:A scoping review

ObjectiveVirtual reality (VR) has become increasingly popular in clinical and health settings where it has been used for a wide range of purposes. A recent scoping review explored VR applications to assist pregnant women and found that VR was a useful method to be used for a range of different purposes in both pregnancy and labour. However, no such review exists for the period after birth.MethodWe aimed to search for studies that used VR to support parents during birth and in the first year postpartum (Population) in different settings (Context), and finally provided data on the characteristics, reported effectiveness and experience of VR interventions (Concept). Two hundred and fifty-one studies were identified, of which ten were eligible. Two authors independently extracted data including study design, participants and results.ResultsFindings indicate that VR has been used effectively in this context to alleviate depression anxiety, and multiple domains of pain and to improve childbirth satisfaction. The majority of the studies explored the use of VR technology on outcomes such as pain and anxiety during labour and birth. The studies included used a broad range of VR hardware and software. All of the studies reported positive experiences of using VR.ConclusionsAcross these studies, VR was found to be effective in terms of both physiological and psychological outcomes. There are many unexplored maternal and infant focused applications of VR which warrant further investigation as emerging evidence indicates this is becoming an increasingly accessible method to improve maternal and infant health outcomes from pregnancy through to parenthood

Care, Connection, and Social Distancing:The challenges of baby loss during the COVID-19 pandemic in Aotearoa New Zealand

Problem: The COVID-19 pandemic hindered access to routine healthcare globally,prompting concerns about possible increases in pregnancy loss and perinatal death.Background: PUDDLES is an international collaboration exploring the impact of theCOVID-19 pandemic on parents who experience pregnancy loss and perinatal death in seven countries, including Aotearoa New Zealand.Aim: To explore parents’ experiences of access to healthcare services and supportfollowing baby loss during the COVID-19 pandemic in Aotearoa New Zealand.Methods: We conducted in-depth, semi-structured interviews with 26 bereavedparents, including 20 birthing mothers, and six non-birthing parents (one mother and five fathers). Types of loss included 15 stillbirths, four late miscarriages, and oneneonatal death. Participant ethnicities were broadly representative of Aotearoa NewZealand’s multi-ethnic society. Data were analysed using Template Analysis.Findings: Analysis revealed five themes relating to pandemic impact on bereavedparent’s experiences. These were: ‘Distanced and Impersonal care’; ‘NavigatingHospital Rules’; Exclusion of Non-birthing Parents; ‘Hindered Access to SocialSupport’; and ‘Continuity of Relational Care’.Discussion: The COVID-19 pandemic exacerbated isolation of bereaved parentsthrough perceived impersonal care by healthcare professionals and restrictions onmovement hindered access to social and cultural support. Compassionate bending ofthe rules by healthcare professionals and community postnatal visits by continuity ofcare midwives following the bereavement appeared to be mitigating factors.Conclusion: Social isolation is an added challenge for parents experiencing baby lossduring a pandemic, which may be mitigated by flexible and compassionate care fromhealthcare professionals, especially continuity of care midwives

General Practitioners’ Experiences of Providing Lifestyle Advice to Patients with Depression:A Qualitative Focus Group Study

Objective: Depression is an increasingly common mental health disorder in the UK,managed predominantly in the community by GPs. Emerging evidence suggestslifestyle medicine is a key component in the management of depression. We aimed toexplore GPs’ experiences, attitudes, and challenges to providing lifestyle advice topatients with depression.Method: Focus groups were conducted virtually with UK GPs (May-July 2022). A topicguide facilitated the discussion and included questions on experiences, currentpractices, competence, challenges, and service provision. Data were analysed usingtemplate analysis.Results: ‘Supporting Effective Conversations’; ‘Willing, but Blocked from EstablishingRelational Care’; ‘Working Towards Patient Empowerment’; and ‘Control Over thePrognosis’ were all elements of how individualised lifestyle advice was key to themanagement of depression. Establishing a doctor-patient relationship by building trust and rapport was fundamental to having effective conversations about lifestylebehaviours. Empowering patients to make positive lifestyle changes required tailoringadvice using a patient-centred approach. Confidence varied across participants,depending on education, experience, type of patient, and severity of depression.Conclusions: GPs play an important role in managing depression using lifestylemedicine and a patient-centred approach. Organisational and educational changes arenecessary to facilitate GPs in providing optimal care to patients with depression

The (un)controlled body:A grounded theory analysis to conceptualise stigma for women with gestational diabetes mellitus

Health-related stigma is associated with adverse outcomes including depression, stress and reduced engagement in health behaviours which are particularly harmful in pregnancy and the postpartum. Women with gestational diabetes mellitus (GDM) report negative psychosocial experiences and may be at risk of stigma related to the condition. We aimed to understand women’s experiences of GDM-specific stigma. Individual interviews were conducted with n = 53 women living in the UK with a current or past (within 4 years) GDM. Grounded theory methodology was used to analyse the data. Four themes were identified: (1) Preconceptions and misconceptions; (2) Locating, regaining, and negotiating agency; (3) Tension about and resisting the dominant discourse of stigma; and (4) Reclaiming control over the body. GDM-specific stigma was diverse and far reaching and may have broader implications for perinatal mental health and postnatal wellbeing. It is pertinent to investigate possible prospective associations between GDM-specific stigma, and biomedical and mental health outcomes.</p

Psychometric evaluation and validation of the Postpartum Specific Anxiety Scale for the Spanish-speaking population:PSAS-ES

ObjectiveThe transition to motherhood is a period of risk for the development of mood disorders. Postpartum anxiety has not been as thoroughly studied as other emotional disorders despite its impact on mothers and their babies. The absence of standardized programmes for early detection and specific tools for its diagnosis means postpartum anxiety is often underestimated or overshadowed. This study aimed to translate and validate the Postpartum Specific Anxiety Scale [PSAS] for the Spanish population and to analyse its reliability as an exploratory tool for specific anxiety in mothers.MethodFour stages were followed in this research: translation and back-translation to obtain the Spanish version [PSAS-ES]; preliminary pilot study to explore the comprehensibility and ease of responding the items (n = 53); convergent validity analyses (n = 644); and test-retest reliability (n = 234).ResultsThe PSAS-ES has shown to have good acceptability, convergent validity and high internal consistency with a Cronbach's α coefficient of 0.93 for the overall scale of PSAS. The four factors had good reliability. The results of test-retest was 0.86, indicating excellent stability over time in the first 16 weeks.ConclusionThe psychometric results show that the PSAS-ES is a valid tool to explore and detect anxiety in Spanish mothers between 0 and 16 weeks postpartum

The disequilibrium of hope: A grounded theory analysis of parents' experiences of receiving a "no primary finding" result from genome sequencing

Genome sequencing (GS) has the potential to reduce the "diagnostic odyssey" that many parents of children with rare undiagnosed conditions experience. While much research has considered the impact of receiving a diagnostic result, research has rarely focused solely on the impact of receiving a "no primary finding" (NPF) result. This study aimed to investigate the experience of parents of children with rare and undiagnosed conditions following an NPF result from GS. Nine parents whose child had an NPF result from GS were recruited through the social media platform of the charity SWAN (Syndromes Without A Name) UK. Semi-structured telephone interviews were conducted, transcribed verbatim, and analyzed using grounded theory. Analysis led to the emergence of two main themes. The first theme "Striving to Solve the Unsolved Puzzle" concerned the experience of striving to end the "diagnostic odyssey." The second theme "Navigating Hope, Lost then Found" plots the trajectory of hope raised by the promise of a new technology, dashed by the NPF, and the eventual return of small and distant hope for the future. Taken together, these themes allowed for a proposed theory: "The Disequilibrium of Hope," which highlights the dynamic and modifiable experience of hope participants experience in their GS journey. These results suggest GS can be an emotional rollercoaster for parents. While hope plays an important role in coping with the day-to-day life of living with a rare disease, careful management of expectations from GS is important during pre-test counseling, and continued follow-up and support are needed beyond result disclosure. An understanding of the disappointment and distress caused by an NPF result is valuable for healthcare professionals in this field to ensure counseling can be tailored. Further research should consider how to support parents after an NPF result