Timing theory integrated nursing combined behavior change integrated theory of nursing on primiparous influence

BACKGROUND The comprehension and utilization of timing theory and behavior change can offer a more extensive and individualized provision of support and treatment alternatives for primipara.This has the potential to enhance the psychological well-being and overall quality of life for primipara,while also furnishing healthcare providers with efficacious interventions to tackle the psychological and physiological obstacles encountered during the stages of pregnancy and postpartum.AIM To explore the effect of timing theory combined with behavior change on selfefficacy,negative emotions and quality of life in patients with primipara.METHODS A total of 80 primipara cases were selected and admitted to our hospital between August 2020 and May 2022.These cases were divided into two groups,namely the observation group and the control group,with 40 cases in each group.The nursing interventions differed between the two groups,with the control group receiving routine nursing and the observation group receiving integrated nursing based on the timing theory and behavior change.The study aimed to compare the pre-and post-nursing scores of Chinese Perceived Stress Scale(CPSS),Edinburgh Postpartum Depression Scale(EPDS),Self-rating Anxiety Scale(SAS),breast milk knowledge,self-efficacy,and SF-36 quality of life in both groups.RESULTS After nursing,the CPSS,EPDS,and SAS scores of the two groups was significantly lower than that before nursing,and the CPSS,EPDS,and SAS scores of the observation group was significantly lower than that of the control group(P=0.002,P=0.011,and P=0.001 respectively).After nursing,the breastfeeding knowledge mastery,selfefficacy,and SF-36 quality of life scores was significantly higher than that before nursing,and the breastfeeding knowledge mastery(P=0.013),self-efficacy(P=0.008),and SF-36 quality of life(P=0.011)scores of the observation group was significantly higher than that of the control group.CONCLUSION The integration of timing theory and behavior change integrated theory has been found to be an effective approach in alleviating negative mood and stress experienced by primipara individuals,while also enhancing their selfefficacy and overall quality of life.This study focuses on the key concepts of timing theory,behavior change,primipara individuals,negative mood,and quality of life.

Mediating effect of mindfulness level on the relationship between marital quality and postpartum depression among primiparas

BACKGROUND Postpartum depression refers to a depressive episode or depressive symptoms up to 12 mo after delivery.Trait mindfulness has presented a protective factor for postpartum depressive symptoms and proved efficient in improving relationship satisfaction among couples.AIM To investigate the correlations among mindfulness,marital quality,anxiety,and depression in a large city in western China during the post-corona virus infectious disease-2019 era and determine whether trait mindfulness mediates the relationship between marital quality and postpartum anxiety and depression among primiparas.METHODS A cross-sectional study was conducted.The self-administered questionnaire was submitted online through smartphones.The levels of mindfulness,anxiety,depression,and marital quality were respectively investigated by the mindful attention awareness scale(MAAS),the self-rating anxiety scale(SAS),the selfrating depression scale(SDS),and the marriage perception scale(MPS)in these enrolled Han and Tujia primiparas.RESULTS No statistical significance was observed in the prevalence of postpartum anxiety and depression,nor scores of MAAS and MPS-Total in different regions or ethnicities(P>0.05).However,MPSMarital interaction(P<0.05),MPS-Family relationship(MPS-FR)(P<0.01),and MPS-Marital conflict(MPS-MC)(P<0.01)scores of urban primiparas were higher than those of rural primiparas.The MPS-MC score of Han primiparas was higher than that of Tujia primiparas(P<0.05).Negative correlations were observed between MAAS and SAS(r=-0.457,P<0.01),and MAAS and SDS(r=-0.439,P<0.01).SAS has revealed a highly positive correlation with SDS(r=0.720,P<0.01)and a weak negative correlation with MPS(r=-0.200,P<0.05).Besides,a weak negative correlation was observed between MAAS and MPS-MC(r=-0.184,P<0.05),and a weak positive correlation was noticed between SAS and MPS-MC(r=-0.225,P<0.01).Mediation analysis demonstrated a full mediation effect of mindfulness level on the relationship between MPS-FR and postpartum anxiety(P<0.05,95%CI:-0.384 to 0.033),MPS-MC and postpartum anxiety(P<0.01,95%CI:0.027-0.193),MPS-FR and postpartum depression(P<0.05,95%CI:-0.365 to 0.031),and MPS-MC and postpartum depression(P<0.01,95%CI:0.022-0.206).CONCLUSION Mindfulness demonstrates negative correlations with marital conflict,postpartum anxiety and depression,and it may have cross-ethnic and trans-regional characteristics.Although the mindfulness levels have revealed no significant mediating effect between the total score of marital quality and postpartum depression in this study,it demonstrates a full mediation effect on the relationships between family relationships,marital conflict,and postpartum anxiety and depression.

Features and Patterns of Primipara Delivery in a Cameroon Semi-Rural Area: The Case of Ayos Locality

Introduction: The delivery of a primipara, a woman giving birth for the first time, is challenging and may lead to complications and influence the obstetrical future of a woman. Materials and Methods: We carried out a cross-sectional and analytical study at the maternity of the regional hospital annex of Ayos, a semi-rural locality in Cameroon, for the period between January 2012 and December 2020. The objective was to determine the frequency and the determinants of primipara delivery. Results: We recruited 440 cases. The frequency of primipara delivery was 31.8%. The ages of the participants ranged from 12 to 35 years with a mean age of 18.01 ± 3.52 years. Single women contributed to 95.5% of cases while 97.5% were unemployed. The delivery occurred at term in 90.2% and 98.4% of pregnancies were singleton. The delivery was vaginal in 91.6%, while caesarean delivery was done in 8.4% (8% emergency and 0.4% elective). The most frequent maternal complications were genital tract tears (15.7%), post-partum hemorrhage (12.5%) and endometritis (2.7%). The birth weight of newborns ranged from 1070 to 4500 g with a mean of 3024.5 ± 511.4 g. The single marital status, a gestational age between 37 and 42 weeks and a birth weight between 1500 g and 2499 g were significantly associated with vaginal delivery. Conclusion: The frequency of primiparous delivery was relatively high (31.8%) in the Ayos semi-rural health district of Cameroon. Major complications associated with delivery included genital tract tears, post-partum hemorrhage, cesarean section and neo-natal infection.

Nursing model of midwifery and postural and psychological interventions:Impact on maternal and fetal outcomes and negative emotions of primiparas

BACKGROUND Primiparas are usually at high risk of experiencing perinatal depression,which may cause prolonged labor,increased blood loss,and intensified pain,affecting maternal and fetal outcomes.Therefore,interventions are necessary to improve maternal and fetal outcomes and alleviate primiparas’negative emotions(NEs).AIM To discusses the impact of nursing responsibility in midwifery and postural and psychological interventions on maternal and fetal outcomes as well as primiparas’NEs.METHODS As participants,115 primiparas admitted to Quanzhou Maternity and Child Healthcare Hospital between May 2020 and May 2022 were selected.Among them,56 primiparas(control group,Con)were subjected to conventional midwifery and routine nursing.The remaining 59(research group,Res)were subjected to the nursing model of midwifery and postural and psychological interventions.Both groups were comparatively analyzed from the perspectives of delivery mode(cesarean,natural,or forceps-assisted),maternal and fetal outcomes(uterine inertia,postpartum hemorrhage,placental abruption,neonatal pulmonary injury,and neonatal asphyxia),NEs(Hamilton Anxiety/Depressionrating Scale,HAMA/HAMD),labor duration,and nursing satisfaction.RESULTS The Res exhibited a markedly higher natural delivery rate and nursing satisfaction than the Con.Additionally,the Res indicated a lower incidence of adverse events(e.g.,uterine inertia,postpartum hemorrhage,placental abruption,neonatal lung injury,and neonatal asphyxia)and shortened duration of various stages of labor.It also showed statistically lower post-interventional HAMA and HAMD scores than the Con and pre-interventional values.CONCLUSION The nursing model of midwifery and postural and psychological interventions increase the natural delivery rate and reduce the duration of each labor stage.These are also conducive to improving maternal and fetal outcomes and mitigating primiparas’NEs and thus deserve popularity in clinical practice.

Direct Interventional Discussion Effectively Improves Awareness and Knowledge about Modern Contraceptive Methods

Objectives: Determination of influence of direct interview of postpartum women about their awareness and knowledge regarding contraception and modern contraceptive methods. Patients & Methods: 1437 women joined the intervention and underwent evaluation of their knowledge about the concept and methods of contraception. Then, an interview was conducted with each woman to clarify advantages and appropriateness of various contraceptives and the proper time for initiation of contraception. All women were asked to discuss these data with their families and return to give their decision. Study outcomes included evaluation of women’s knowledge about contraception and its modalities, frequency of non-users who accepted to use contraception and is considered as success of the intervention and frequency of requesting each modality of contraception. Results: TV programs and discussion with local health provider, relatives or friends are the main sources of knowledge of primiparas. 182 primiparas had good knowledge and chose the appropriate method of contraception during the 1st session of discussion, and 81 primiparas required >2 sessions to choose the method appropriate for them, while 21 primiparas insisted not to use contraception for an acceptance rate of 92.6% among primipara. Among multiparas, 222 multiparas were non-users, but after discussion 133 couples accepted to use contraception. Thus, 396 non-users had accepted to use contraception for an intervention success rate of 78.3%. Collectively 692 women (52.1%) received IUD and 635 women (47.9%) received hormonal contraception;432 orally (32.6%) and 203 parenterally (15.3%). Conclusion: Ignorance, low financial status and cultural beliefs deleteriously affect knowledge about contraception options and its methods, so direct interview is mandatory. The applied intervention succeeded to replenish women’s knowledge about benefits of using contraception. Primiparas had knowledge about contraception but their knowledge about methods is deficient or hazy. Contraception using IUD is the most acceptable method especially for primiparas.

Polychlorinated biphenyl congeners (PCBs) in nursing primiparous and multiparous women

Impact of PCBs was studied as a major source of physiological effects even very low concentration of PCBs transferred to the infants by mother’s milk. Milk samples were collected from primipara and multipara women. A significant variation pattern was observed in the level of PCB congeners, as PCBs are lipophilic in nature, another possibility arises that great deals of residues are passed on to infants through mother’s milk. A technique was developed to find out polychlorinated biphenyls (PCB) in breast milk. PCBs were extracted by Matrix Solid-Phase Dispersion (MSPD) and analyzed by Gas Chromatography with Electron Capture Detector. The precision (RSD < 10%, n = 125), recovery (85% to 110%) and limit of quantification (between 0.50 and 3.00 μg&middotL-1), the chi square analysis at p ≤ 0.05 has shown that the PCB level was higher in multipara as compared to primipara. The analysis of the thirty samples revealed PCB levels above 6.85 μg&middotL-1 in breast milk samples by analyses of a mixture of PCB congeners. All PCB congeners (28, 52, 101, 123 (+149), 118, 114, 153, 105, 138 (+163), 167, 156 (+171), 157, 180, 170, 189) were found at high level in primiparous and multiparous. Thus, a high correlation between the contamination of breast milk and environmental pollution of PCBs was observed.

Materno-Foetal Morbidity in the Second Stage of Labour: A Cohort Study in Primiparous Women in Yaounde

Introduction: Prolonged Second Stage of Labor (SSL) is known to increase maternal and foetal morbidity. We, therefore, aimed to assess for the occurrence of complications of the SSL in relation to its duration in primiparous women in Yaounde. Methods: It was a cohort study carried out at the Yaounde Gynaeco-Obstetric and Paediatric Hospital over a period of 6 months, from December 19, 2018 through May 3, 2019. We included for the study nulliparous pregnant women with singleton pregnancies and normal uteri. Data collected were analysed using EPI info 7 and SPSS version 2.0 software. Results: Amongst 327 nulliparas, the SSL lasted more than one hour in 120 (36.7%), and more than two hours in 42 (12.8%). The most common maternal complications observed were genital lacerations (23.6%;28/120), instrumental deliveries (20.2%, 24/120), post-partum haemorrhage (8.9%). Foetal complications included caput succedaneum (15.2%;18/120) and perinatal asphyxia (7.5%;9/120). Maternal complications were significantly increased in women with an SSL lasting 1 - 2 hours (44.9% versus 22.7%;p < 0.001) and >2 hours (42.9% versus 22.7%;p = 0.007). Similarly, for foetal complications 23.1% occurred with SSLs between 1 - 2 hours (versus 6.3%;p < 0.001) and 19.0% for SSLs > 2 hours (versus 6.3%;p = 0.007). Conclusion: Maternal and foetal complications increase when the SSL exceeds 1 hour in primiparas. Identifying factors that predispose to a prolonged SSL and indicating appropriate interventions could help prevent morbidity.

Morita Therapy Combined with Transcranial Magnetic Stimulation in the Treatment of Postpartum Depression in Primiparas and its Effect on Prolactin

Objective:To explore the treatment of Morita therapy combined with transcranial magnetic stimulation in postpartum depression of primipara and its effect on prolactin.Method:From May 2018 to November 2019,92 cases of postpartum depression and postpartum women who were treated in our hospital were randomly divided into 2 groups,46 cases each.The control group was treated with transcranial magnetic stimulator,and the observation group was treated with Morita therapy on the basis of the control group.Both groups were treated continuously for 6 weeks.The degree of depression and prolactin levels of the two groups was observed.Results:After 6 weeks of treatment,the HAMD scores of the two groups were lower than before the treatment,and the observation group was the lowest.The prolactin levels of the two groups were higher than before the treatment,and the observation group was the highest.The difference was statistically significant(P<0.05).Conclusion:Morita therapy combined with transcranial magnetic stimulation can effectively improve the postpartum depression of primiparas,increase the level of prolactin,and have a good clinical effect.

Intervention Value of Unprotected Midwifery Nursing in Natural Delivery of Primipara

Objective:This paper mainly explores the application value of unprotected midwifery care for primipara natural childbirth.Methods:120 primiparas in our hospital from January 2017 to February 2019 were divided into routine group and Research Group,60 cases in each group.The routine group was given routine perineal protection midwifery,and the Research Group was given routine midwifery nursing.The nursing intervention effects of the two groups were compared statistically.Results:After statistics,VAS score and bleeding volume of perineal pain in the Research Group were lower than those in the conventional group,and the length of hospital stay in the Research Group was less than that in the conventional group,P<0.05;There was no significant difference in the time of the first stage of labor,the second stage of labor and the third stage of labor between the Research Group and the conventional group(P>0.05);The incidence of complications in the Research Group was lower than that in the conventional group(P<0.05).Conclusion:The application value of unprotected midwifery nursing intervention in primipara natural childbirth is significant.

Risk of gestational diabetes recurrence and the development of type 2 diabetes among women with a history of gestational diabetes and risk factors: a study among 18 clinical centers in China

Background:Gestational diabetes mellitus(GDM)brings health issues for both mothers and offspring,and GDM prevention is as important as GDM management.It was shown that a history of GDM was significantly associated with a higher maternal risk for GDM recurrence.The incidence of GDM recurrence was unclear because of the incidence of second-child was low before 2016 in China.We aim to investigate the prevalence of GDM recurrence and its associated high-risk factors which may be useful for the prediction of GDM recurrence in China.Methods:A retrospective study was conducted which enrolled participants who underwent regular prenatal examination and delivered twice in the same hospital of 18 research centers.All participants were enrolled from January 2018 to October 2018,where they delivered the second baby during this period.A total of 6204 women were enrolled in this study,and 1002 women with a history of GDM were analyzed further.All participants enrolled in the study had an oral glucose tolerance test(OGTT)result at 24 to 28 weeks and were diagnosed as GDM in the first pregnancy according to the OGTT value(when any one of the following values is met or exceeded to the 75-g OGTT:0 h[fasting],≥5.10 mmol/L;1 h,≥10.00 mmol/L;and 2 h,≥8.50 mmol/L).The prevalence of GDM recurrence and development of type 2 diabetes mellitus were calculated,and its related risk factors were analyzed.Results:In 6204 participants,there are 1002 women(1002/6204,16.15%)with a history of GDM and 5202 women(5202/6204,83.85%)without a history of GDM.There are significant differences in age(32.43±4.03 years vs.33.00±3.34 years vs.32.19±3.37 years,P<0.001),pregnancy interval(4.06±1.44 years vs.3.52±1.43 years vs.3.38±1.35 years,P=0.004),prepregnancy body mass index(BMI)(27.40±4.62 kg/m^(2)vs.23.50±3.52 kg/m^(2)vs.22.55±3.47 kg/m^(2),P<0.001),history of delivered macrosomia(22.7%vs.11.0%vs.6.2%,P<0.001)among the development of diabetes mellitus(DM),recurrence of GDM,and normal women.Moreover,it seems so important in the degree of abnormal glucose metabolism in the first pregnancy to the recurrence of GDM and the development of DM.There are significant differences in OGTT levels of the first pregnancy such as area under the curve of OGTT value(18.31±1.90 mmol/L vs.16.27±1.93 mmol/L vs.15.55±1.92 mmol/L,P<0.001),OGTT fasting value(5.43±0.48 mmol/L vs.5.16±0.49 mmol/L vs.5.02±0.47 mmol/L,P<0.001),OGTT 1-hour value(10.93±1.34 mmol/L vs.9.69±1.53 mmol/L vs.9.15±1.58 mmol/L,P<0.001),OGTT 2-hour value(9.30±1.66 mmol/L vs.8.01±1.32 mmol/L vs.7.79±1.38 mmol/L,P<0.001),incidence of impaired fasting glucose(IFG)(fasting plasma glucose≥5.6 mmol/L)(31.3%vs.14.6%vs.8.8%,P<0.001),and incidence of two or more abnormal OGTT values(68.8%vs.39.7%vs.23.9%,P<0.001)among the three groups.Using multivariate analysis,the factors,such as age(1.07[1.02-1.12],P=0.006),prepregnancy BMI(1.07[1.02,1.12],P=0.003),and area under the curve of OGTT in the first pregnancy(1.14[1.02,1.26],P=0.02),have an effect on maternal GDM recurrence;the factors,such as age(1.28[1.01-1.61],P=0.04),pre-pregnancy BMI(1.26[1.04,1.53],P=0.02),and area under the curve of OGTT in the first pregnancy(1.65[1.04,2.62],P=0.03),have an effect on maternal DM developed further.Conclusions:The history of GDM was significantly associated with a higher maternal risk for GDM recurrence during follow-up after the first pregnancy.The associated risk factors for GDM recurrence or development of DM include age,high pre-pregnancy BMI,history of delivered macrosomia,the OGTT level in the first pregnancy,such as the high area under the curve of OGTT,IFG,and two or more abnormal OGTT values.To prevent GDM recurrence,women with a history of GDM should do the preconception counseling before preparing next pregnancy.