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Biomedical subjects

D D Affonso

Publications and source records attributed to D D Affonso.

At least 19 recordsLinked to original sources
PubMed2000

An international study exploring levels of postpartum depressive symptomatology.

OBJECTIVE: Differences in postpartum depressive symptomatology (PPDS) among an international sample of 892 women from nine countries representing five continents were explored. METHOD: Edinburgh Postnatal Depression Scale (EPDS) and Beck Depression Inventory (BDI) were used to assess PPDS among a convenience sample that completed the two questionnaires twice, yielding a total of four sets of scores per subject. Women sampled were primiparae with no obstetrical complications, and had a healthy baby. Depression history and therapy were ruled out as exclusion criteria. RESULTS: Mean scores for EPDS and BDI varied across sites at both time points (P value<.001). European and Australian women had the lowest levels of PPDS, USA women fell at the midpoint, and women from Asia and South America had the highest depressive symptom scores. The moderate concordance between the EPDS and BDI suggested that the measures have complementary uses for screening and assessment. CONCLUSION: Utility of EPDS and BDI for yielding profiles of postpartum women's depressive symptomatology was demonstrated. Further research to validate depressive symptom measures with diverse international populations is indicated.

Adult↗
PubMed1999

Cognitive adaptation: a women's health perspective for reducing stress during childbearing.

The purpose of this study is to evaluate psychological changes in women of three minority ethnic groups in a program of psychosocial services that promoted positive cognitive adaptation to childbearing throughout pregnancy and the postpartum period. In this prospective longitudinal study, both cognitive adaptation and generalized stress were measured at each trimester of pregnancy as well as after birth and 3 months postpartum. The mean scores at each time are first compared with first trimester scores for women in the program and then with scores for comparable women in a cross-sectional sample tested before the program. For women in the program, results of the psychological adaptation measures and the stress measures had improved from their first trimester value by the time of birth. Stress levels of women in the program were less than for women in the corresponding comparison sample from the third trimester on. Enhanced perinatal services that include interventions and monitoring strategies aimed at improving the cognitive adaptation of women to childbearing are important in promoting stress reduction in women and infants.

Adaptation, Psychological↗
PubMed1999

Integrating cultural values, beliefs, and customs into pregnancy and postpartum care: lessons learned from a Hawaiian public health nursing project.

Determining the elements of culturally competent health care is an important goal for nurses. This goal is particularly integral in efforts to design better preventive health care strategies for pregnant and postpartum women from multiple cultural and ethnic backgrounds. Learning about the values, beliefs, and customs surrounding health among the targeted groups is essential, but integrating this knowledge into the actual health care services delivery system is more difficult. The success of a prenatal and postpartum program developed for native Hawaiian, Filipino, and Japanese women in Hawaii has been attributed to the attention on training, direct care giving, and program monitoring participation by local cultural and ethnic healers and neighborhood leaders living in the community, with coordination by public health nurses. This article profiles central design elements with examples of specific interventions used in the Malama Na Wahine or Caring for Pregnant Women program to illustrate a unique approach to the delivery of culturally competent care.

Adult↗
PubMed1995

Influence of marital relationship and child-care stress on maternal depression symptoms in the postpartum.

The predictive influence of two psychosocial factors (marital adjustment and child-care stress) on maternal depressive symptoms at 6, 9 and 12 months postpartum, was investigated. Seventy-one women from a sample of 202 primiparae from a larger study were included. The women were primarily educated, white, middle-class, married women in their early 30s who returned to work within the first postpartum year. Regression analyses indicated that the interaction of marital adjustment and child-care stress significantly influenced maternal depression symptoms at 9 months postpartum. The findings from this study support the necessity for following women beyond the early weeks and months of postpartum in subsequent research.

Adult↗
PubMed1995

Neighborhood Women's Health Watch: partners in community care.

A successful program for delivering prenatal care in rural Hawaii incorporated women volunteers from the local community known as the "Neighborhood Women's Health Watch" (NWHW). Knowledgeable about the cultural mores among the various Asian American and Pacific Islander ethnic groups within the community, these respected women established strong collegial relationships with a public health nursing team to assist in various monitoring and care activities designed for pregnant and postpartum women. This article will address recruitment, training, and role functions of the NWHW, including recommendations for the development of similar programs.

Community Health Nursing↗
PubMed1992

Adaptation themes for prenatal care delivered by public health nurses.

An adaptation process involving three cognitive themes provides the framework for community nursing model for prenatal care on the island of Hawaii. The themes are based on the cognitive adaptation model developed by Taylor (1983) and include search for meaning, sense of mastery, and self-esteem. Each theme is used to guide public health nurses and is identified during designated encounters between the nurse and woman throughout the duration of prenatal care. A focus on adaptation themes for each trimester of pregnancy expands on the medical model of prenatal care to highlight developmental processes of childbearing and broaden the scope of practice for public health nurses responsible for assessment and intervention in the community.

Adaptation, Psychological↗
PubMed1992

Postpartum depression: a nursing perspective on women's health and behaviors.

Postpartum depression is examined from different disciplinary perspectives including obstetrics, psychiatry, psychology and nursing. These perspectives are compared in relation to knowledge development, research designs and interventions for clinical practice. Nursing's contributions to understanding women's health and behaviors are highlighted in three areas: exploring women's experiences with symptoms of depression; delineating the character of women's affective changes during childbearing; and further study of another form of symptom distress conceptualized as dysphoria. Three alternative hypotheses are presented as new directions for future nursing research.

Adaptation, Psychological↗
PubMed1992

Dysphoric distress in childbearing women.

Previous research on depression in childbearing women has focused on the presence or absence of clinical depression. Little attention has been paid to the distress caused by the presence of depressive symptoms in the absence of the full syndrome of clinical depression. A convenience sample of 202 healthy, married, primigravid women who were free of psychiatric symptoms were assessed at 10 to 14 weeks and 30 to 32 weeks of pregnancy and at 1 to 2 weeks and 14 weeks post partum. Depression symptoms were measured by using the Schedule of Affective Disorders and Schizophrenia, the standardized clinical interview for research and depression of The National Institute of Mental Health. Data from the Schedule of Affective Disorders and Schizophrenia indicated that only 5% of the women met criteria for clinical depression but approximately 50% of the sample reported clinical levels of three or more depressive symptoms. Anger, fatigue, psychic anxiety, and worry were the most frequently endorsed symptoms at each assessment point. The implications of these findings for symptom management and health promotion for childbearing women are discussed.

Adult↗
PubMed1990

A personality measure of Erikson's life stages: the Inventory of Psychosocial Balance.

The development and initial validation of the Inventory of Psychosocial Balance (IPB), designed to assess all eight Eriksonian psychosocial stages, is described. A pool of 208 items that survived a clinical analysis was administered to 528 subjects and then factor analyzed. The resulting eight factors parallel the eight stages and account for 72.34% of the total variance. Subsequent administrations of the IPB to various samples indicate adequate internal consistency and high test-retest reliability; significant correlations with the California Psychological Inventory (CPI) Social Maturity Index; consistent Q-sort portraits of high-scoring and low-scoring women; negligible correlations with test taking response styles, intelligence, and measures of psychopathology; and moderate developmental trends.

Adolescent↗
PubMed1990

Common stressors reported by a group of childbearing American women.

A study was conducted on a group of 221 women (81 in the first trimester, 80 in the third trimester, and 60 in the postpartum period) to identify stressors common to pregnancy and to quantify their intensity using an interval rating scale. The most frequent stressors were related to physical symptoms, body image, baby welfare, changes in living patterns, emotional disturbances, and pregnancy-technological concerns. Stressors of high intensity targeted the baby's welfare, labor and delivery, pregnancy, newborn behaviors, and relationship with the baby's father. The frequency and intensity of stressors changed across pregnancy and postpartum, suggesting a need to tailor prenatal care to the different childbearing phases. Additional findings suggest that the normal physical changes of pregnancy can trigger disruptions in body image, relationship with the baby's father, and emotional functioning.

Adult↗
PubMed1990

A standardized interview that differentiates pregnancy and postpartum symptoms from perinatal clinical depression.

In a prospective longitudinal study, 202 primigravidas were assessed for depression using the National Institute of Mental Health's (NIMH) standardized clinical interview, the Schedule for Affective Disorders and Schizophrenia (SADS), and Research Diagnostic Criteria (RDC) at four periods: 10 to 14 weeks of pregnancy, 30 to 32 weeks of pregnancy, 1 to 2 weeks postpartum, and 14 weeks postpartum. Women's responses did not fit the SADS standardized questions and prescribed ratings because pregnancy and postpartum symptoms often mimicked depression symptoms. This was addressed by adding questions and scoring criteria to separate out pregnancy and postpartum symptoms from depression symptoms. Results showed that, after accounting for pregnancy-postpartum symptoms, women consistently claimed eight symptoms with high frequency and higher mean ratings: dysphoric mood, worrying, somatic and psychic anxiety, insomnia, fatigue, anger, and irritability. The findings suggest that 1) depression in pregnant and newly delivered women may be underdiagnosed if caregivers attribute their complaints or symptoms to time-limited somatic conditions; 2) depression may be overdiagnosed if clinicians use self-report measures solely, or without carefully interviewing women to separate the symptoms of depression from symptoms of pregnancy and postpartum; and 3) women's reactions to perinatal symptoms may have some bearing on the development of depression then or later. Simple clinical and social amelioration of the symptoms of distress might reduce their effect and diminish the rate of mistaken diagnoses of depression.

Adult↗
PubMed1989

Maternal cognitive themes during pregnancy.

This preliminary study explored possible cognitive themes endorsed by pregnant women. A goal was to ascertain whether a concept proposed by Reva Rubin known as "Cognitive Style of Pregnancy" had beginning empirical support. A sample of 50 women with normal pregnancies responded to a 56-item questionnaire known as the Cognitive Adaptation to Pregnancy Scale, specifically developed to assess three constructs based upon a conceptual model known as "Cognitive Adaptation." Items on this scale were obtained in a pilot study from open-ended interviews. Items endorsed suggest a process involving a search for meaning, sense of mastery, and self-enhancement as conceptualized in the model. Items suggestive of a search-for-meaning process supported Rubin's early descriptions of inconclusive questioning and a sense of uncertainty during the experience of being pregnant.

Adaptation, Psychological↗
PubMed1987

Stressful events related to pregnancy and postpartum.

This study represents a preliminary attempt to identify the psychosocial stressors of childbearing. A convenience sample of 221 women were used to identify these stressors. They represented three groups: first trimester women (n = 81), third trimester women (n = 80), and postpartum women (n = 60). Stressors were rated according to their frequency and intensity. The results focused both on the most intense stressors for each group as well as the changes in stressor intensity across the groups. The most intense stressors common to all groups were concerns regarding baby's welfare, labor and delivery, and issues related to their mate/spouse. One unexpected pattern was the continued stress due to thoughts of labor and delivery among postpartum women. The authors suggest a possible explanation for this phenomenon.

Adaptation, Psychological↗