Health Experiences Research Articles

Nurses Navigating Mental Health During Uncharted Times: Self, Others, Systems (S.O.S)!

The nursing profession is facing a multiplicity of stressors that have both predated and been exacerbated by the Covid-19 pandemic. The emotional and physical demands entailed in nursing predispose nurses to suboptimal mental health and burnout. This paper draws upon the narrative interviews of 53 Canadian nurses as part of a larger pan-Canadian, cross disciplinary study that examined the gendered experiences of mental health, leaves of absence, and return to work of 7 professions. Thorne's interpretive descriptive guided Iterative and thematic analysis which identified three predominant themes within the nursing dataset, this paper focuses on the substantive theme of 'Navigating it Alone,'. Nurses expressed a profound sense of isolation at 3 particular levels: at home, at work, and in systems - while simultaneously balancing uniquely gendered familial responsibilities and workplace demands. These results illuminate instrumental pathways for stakeholders to attenuate the personal and professional pressures that continue to be disproportionately carried by nurses as they navigate these particularly challenging times.

Health system-wide access to generative artificial intelligence: the New York University Langone Health experience.

The study aimed to assess the usage and impact of a private and secure instance of a generative artificial intelligence (GenAI) application in a large academic health center. The goal was to understand how employees interact with this technology and the influence on their perception of skill and work performance. New York University Langone Health (NYULH) established a secure, private, and managed Azure OpenAI service (GenAI Studio) and granted widespread access to employees. Usage was monitored and users were surveyed about their experiences. Over 6 months, over 1007 individuals applied for access, with high usage among research and clinical departments. Users felt prepared to use the GenAI studio, found it easy to use, and would recommend it to a colleague. Users employed the GenAI studio for diverse tasks such as writing, editing, summarizing, data analysis, and idea generation. Challenges included difficulties in educating the workforce in constructing effective prompts and token and API limitations. The study demonstrated high interest in and extensive use of GenAI in a healthcare setting, with users employing the technology for diverse tasks. While users identified several challenges, they also recognized the potential of GenAI and indicated a need for more instruction and guidance on effective usage. The private GenAI studio provided a useful tool for employees to augment their skills and apply GenAI to their daily tasks. The study underscored the importance of workforce education when implementing system-wide GenAI and provided insights into its strengths and weaknesses.

Predictors of Suicidal Thoughts and Attempts among School-Going Thai Adolescents: A Sex-Specific Structural Equation Modelling Analysis.

Adolescent suicide is a growing public health concern in Thailand. Identifying predictors of suicidal behaviors is essential for targeted prevention strategies. Using Structural Equation Modeling, this study explores the predictors of suicidal thoughts and attempts among a sample of 5657 Thai adolescents in grades 7-12, typically representing the age group 13-17 years, with nearly equal proportions of males (47%) and females (53%) participants. Data from the Thailand Global School-based Student Health Survey (GSHS) 2021 were analyzed. Explanatory Factor Analysis (EFA) identified key constructs, followed by SEM stratified by sex to examine relationships between constructs and suicidal behaviors. Reliability and validity were assessed using Cronbach's α and SEM fit indices. EFA identified five constructs: current substance use, history of violence, experiences of bullying, parental awareness, and poor mental health. SEM revealed poor mental health as a significant predictor for both sexes. Substance use, experiences of bullying, and a history of violence predicted suicidal behaviors in females. Parental vigilance was only a protective factor for males. The findings underscore the importance of gender-specific interventions and comprehensive mental health support to address the unique vulnerabilities of Thai adolescents, reducing suicidal thoughts and attempts.

How Physician-Insurance Contracting Contributes to the Medical Exodus and Access to Ophthalmic Care in Puerto Rico.

Puerto Rico (PR) has experienced significant demographic changes, characterized primarily by an aging population and an unprecedented exodus of medical doctors. Ophthalmologists are of particular concern as they commonly serve older populations, and the island has high rates of some age-related eye diseases in the United States (US). Our research aims to investigate the factors driving ophthalmologists in PR to emigrate to the mainland US. This is a cross-sectional study among ophthalmologists in PR, using survey data collected from May to June 2023. This study recruited a convenient sample of all ophthalmologists practicing in PR via outreach in person and online communities. The survey covered various types of challenges faced by ophthalmologists, their demographics, and practice details. STATA/BE 18 statistical software was used for data analysis. Statistical tests, such as chi-square and proportion tests, were performed, stratifying results by age, gender, subspecialty, geographic health districts, experience, and practice type. Among 130 of the estimated 218 ophthalmologists in PR, insurance/billing issues were identified as the primary challenge to practicing in PR and the primary reason to leave PR. The challenges that were identified included required authorizations for patient care, unjustified claim rejections, and threats of contract cancellation. We found that new ophthalmologists (≤15 years of practice) faced more specific challenges than experienced ophthalmologists (>15 years of practice), such as difficulty in obtaining insurance contracts. Insurance/billing issues are a pervasive concern for ophthalmologists in PR. New ophthalmologists are disproportionately affected by these challenges, potentially leading some to find employment outside of PR. There is a need for targeted policies-regulation of insurance contracting and increased reimbursement from private insurance plans-to reduce insurance contracting barriers for keeping a sustainable physician workforce in PR.

Healthcare dashboard technologies and data visualization for lipid management: A scoping review

BackgroundLipid disorders significantly increase cardiovascular disease (CVD) risk, the leading cause of mortality worldwide. Effective lipid management is critical for improving health outcomes. Traditional screening methods face challenges due to data complexity and the need for timely decision-making. Data visualization and dashboard technologies offer clear, actionable insights and supporting informed decision-making. This study investigates the use of these technologies in lipid management and their impacts on the quadruple aim of healthcare.MethodsThis scoping review followed the Joanna Briggs Institute (JBI) approach, focusing on studies involving dashboard technologies or data visualization in lipid management. A comprehensive search across multiple databases (Embase, Web of Science, PubMed, Scopus, CINAHL) and gray literature was conducted, including English-language publications from 2014 to 2024. Data were analyzed using quantitative descriptive and qualitative content analysis to evaluate the key features, clinical applications, and outcomes.ResultsTwenty-seven studies met the inclusion criteria, primarily focusing on dashboard utilization by physicians for managing diabetes and CVD, utilizing electronic medical records and clinical guidelines. Key analysis methods included comparing key performance indicators (KPIs) (85.2%) and trend analysis (74.1%). Lipid management workflows emphasized prevention (88.9%) and treatment planning (77.8%). Interventions included care packages (comprehensive sets of interventions for patient care), decision support systems, web-based tools, and mobile health solutions. Regarding Quadruple Aim outcomes: 12 studies focused on improving population health (8 positive, 4 no change), 9 on clinical outcomes (5 positive, 4 no change), 6 on provider work life (5 positive), 5 on patient experience (positive changes in education and time management), and 2 on cost reduction (1 positive, 1 negative).ConclusionsDashboards are important tools in managing lipid disorders in managing lipid disorders, integrating with educational tools, collaborative care models, and decision support systems. Although they are effective in enhancing population health and clinical experiences, their impact on patient outcomes and cost reduction requires further exploration. Future research should focus on detailed evaluations of dashboard impacts on patient outcomes and cost-effectiveness, emphasizing precision prevention of chronic diseases.

Perinatal Depression and Breastfeeding Outcomes: A Systematic Review from South Asian Countries

Background: Breastfeeding is very beneficial to both mothers and infants. However, perinatal depression, encompassing both antenatal and postnatal depression, can significantly impact breastfeeding. Prior research suggests a link between postpartum depression and breastfeeding difficulties. This systematic review focuses on the duration of breastfeeding, the duration of exclusive breastfeeding (EBF), initiation, as well as the early cessation of breastfeeding among mothers in South Asian countries with unique sociocultural practices and mental health experiences. Methodology: The searched databases were PubMed, Ovid MEDLINE, ProQuest PsycINFO, EBSCOhost CINAHL, and Bielefeld Academic Search Engine (gray literature) for relevant records till February 2024. Studies conducted in South Asian countries with cross-sectional, cohort, or case–control designs were included, and all interventional studies, qualitative studies, case reports, and case series were excluded. The review examined breastfeeding duration among mothers with perinatal depression. Two reviewers independently screened and selected studies, extracted data, and used the Newcastle–Ottawa Scale for quality assessment. Results: This systematic review identified 109 records, of which 14 were eligible. Ten studies were cross-sectional and 4 were cohort studies. It involved 11,944 perinatal women, with sample sizes ranging from 100 to 8189 participants. Conclusion: Perinatal depression was associated with shorter breastfeeding duration, especially EBF and early cessation of all breastfeeding. However, any association between perinatal depression and the initiation of breastfeeding was unclear. Overall, supporting mothers suffering from perinatal depression is crucial for successful breastfeeding practice. Certain limitations of the review were data heterogeneity, risk of recall bias in breastfeeding practices, and different data collection time points. Future research could study the various sociocultural and economic factors and biological mechanisms in breastfeeding and maternal depression.

Exploring intimacy and family planning in Inflammatory Bowel Diseases: a qualitative study

Background Inflammatory bowel diseases (IBD), comprising ulcerative colitis and Crohn’s disease, have a profound impact on people’s lives. This study aims to investigate the perceived impact of IBD on sexual life and family planning to enhance understanding of the interplay between IBD, sexuality, intimacy and family planning to foster a better quality of life for those living with the condition. Materials and methods The study used the qualitative DIPEx method (Database of Personal Experiences of Health and Illness) developed by the Health Experiences Research Group at the University of Oxford, standardized for the Czech Republic. Semi-structured interviews with 36 participants (19 with Crohn’s disease, 17 with ulcerative colitis) were conducted, employing open coding and thematic analysis. The maximum variation sampling was utilized, considering various factors, such as disease stage, medications, treatments, age, age at diagnosis and sociodemographic characteristics. Results Five main topics emerged: sexual activity, body image and discomfort, partner relationships, family planning, and the role of gastroenterologists in family planning decisions. Participants’ perceptions of sexuality varied, with some experiencing reduced sexual activity during acute phases of the disease. IBD had contrasting effects on partner relationships, and family planning was an important concern, with women valuing support and collaboration with their gastroenterologists in making pregnancy decisions. Information dissemination and open communication from professionals are highly needed. Conclusions This is the first study concerning the sexuality and family planning of people with IBD in the Czech Republic. It highlights the need for information and open communication from professionals.

Data analysis software for medical wearables

Abstract. The medical wearable device data analysis software of this product analyzes the measurement data through the data connection with various types of medical wearable devices, compares the standard values of various data of each age group, and a number of data that do not meet the standard values or a certain item that does not meet their daily average value for many days will be identified as an abnormal situation, and the user will be reminded to do a personalized physical examination, and the software will recommend a suitable time for the user to conduct a personalized physical examination according to the users location. And through the introduction of blockchain technology, the safe storage and sharing of medical wearable device data is realized while protecting user privacy. In addition, the medical wearable device data analysis software is built into a social health management platform, where users can share and exchange health data, experiences and recommendations. By socializing the app, you can increase user engagement and loyalty, and attract more users to use the app.

Using Time in Tight Glucose Range as a Health-Promoting Strategy in Preschoolers With Type 1 Diabetes.

Children who develop diabetes in their first years of life risk being exposed to many decades of hyperglycemia, hence having a high risk of early complications and premature death. An additional age-dependent risk is that dysglycemia, especially hyperglycemia, negatively affects the developing brain. In evaluating the outcome of insulin treatment at an individual and group level, cutoff thresholds for glucose values are needed. Time in tight range (TITR) was defined as a measurement of time spent in a state of normoglycemia. The International Society of Pediatric and Adolescent Diabetes recommended that for preschoolers with type 1 diabetes (T1D), either >70% of time with glucose in range 70-180 mg/dL (3.9-10 mmol/L) or >50% of time in a tighter range 70-140 mg/dL (TITR) can be used as continuous glucose monitoring targets. In Sweden, over the past two decades, pediatric diabetes teams set glycemic targets to 70-140 mg/dL (3.9-7.8 mmol/L). Swedish registry data show that >50% of children <7 years old have >50% TITR. The purpose of this review is to share and discuss international knowledge and experiences of working with TITR as a health-promoting strategy in preschoolers with T1D on a structural and individual level. We conclude that as insulin treatment improves, a reasonable goal is to strive for as much time in a state of normoglycemia as possible, and this can easily be explained to families of children with diabetes. For children with access to an experienced health care team and diabetes technologies a currently realistic target can be at least half of the time in normoglycemic range, i.e., TITR >50%.

"Instead of Building More Buildings, They Should Plant More Trees", a Photovoice Study of Determinants of Happiness and Sadness Among East London Adolescents.

Globally, mental health problems in adolescents, alongside associated morbidity and mortality, have never been higher. Local living, working and environmental conditions, socio-economics, and intra-individual and inter-individual processes impact mental health. The risk of developing mental health problems is higher in certain areas, including East London. However, limited research explores East London adolescents' experiences of mental health. An in-depth and locally situated understanding of determinants shaping East London adolescents' happiness and sadness is needed. This study used Photovoice, a qualitative method within a community-based participatory research methodology, to generate photographic and textual data, which was analyzed using reflexive thematic analysis. This method allows participants to be part of knowledge production and authors to present the data. Our findings underscore the bidirectional interplay between environmental factors and adolescents' happiness and sadness. Gratitude for nature was described as increasing happiness: adolescents connected to nature to memories, appreciation, and leisure opportunities. Adolescents were concerned about the fragility of nature in response to urban development. The urban environment was perceived as imposing, inspiring, and offering therapeutic benefits blighted by pollution. Beautiful areas were described as paradisical and lacking, revealing urban development and economic productivity disparities. Our research documents the voices of an under-researched group, revealing novel insights while empowering adolescents as co-producers of mental health research. This study indicates participatory research is valuable for granting adolescents autonomy and addressing misrepresentation. The findings implicate multiple stakeholders, including "Health in All Policies." By deepening our understanding of adolescent mental health in East London, our study can be leveraged to bolster the effectiveness and relevance of interventions for East London adolescents.

Allyship or coalition?

Allyship is regarded as an important role in the academic setting to support the inclusion of people with Lived Experience (LE) of mental health and addiction challenges. Understanding the context within which the allies in academia work requires further scrutiny to ensure power sharing. Mental health academics have created a body of published literature on LE in academia, presenting both the successes and barriers to authentic allyship. This narrative provides a dialogue between a person in an LE role in a university setting and a nursing academic regarding their experiences of allyship. These reflections present the potential challenges the LE role and their academic ally can face in establishing and sustaining these roles. The structures within the university setting that impact on the success or not of the role of ally are also considered. This narrative further contributes to the contested role of allies and offers a closer analysis of allyship and the power dynamics in play. We conclude by offering the notion of coalition as an alternative to allyship and an alternative approach to the success of the LE roles in academic institutions.

Reaching people who use drugs with sexual and reproductive healthcare through syringe services programs: potential promise and missed opportunities

BackgroundPeople who use drugs are at elevated sexual and reproductive health risk but experience barriers to services. Syringe services programs (SSP) are an important venue to provide integrated health services. Few studies have examined SSP use within intersecting gender, racial, and ethnic groups, including by injection drug use (IDU), and differences in sexual and reproductive health among these groups.MethodsWithin a cohort study among people who use unprescribed opioids in New York City, we conducted a nested cross-sectional study from November 2021-August 2022 assessing sexual health with a survey (n = 120). The parent study measured baseline characteristics, and the cross-sectional study survey measured self-reported past-year SSP use and sexual and reproductive health. We estimated SSP use within gender, racial, and ethnic groups by IDU, and the prevalence of sexual and reproductive health outcomes by gender, race, ethnicity, and SSP use.ResultsAmong men (n = 61) and women (n = 54), SSP use was disproportionately low among Black participants irrespective of IDU. Women reporting SSP use had a higher prevalence of multiple, new, sex trade, and/or casual sex partners, history of STI symptoms, and lack of effective STI prevention, although women who did not use SSP had non-negligible levels of risk with variation between racial and ethnic groups. Among men, sexual and reproductive health varied across racial and ethnic groups but not as clearly by SSP use.ConclusionsSSP offer opportunity to address elevated STI risk among people who use drugs but may miss certain intersecting gender, race, and ethnic groups.

Implementation of peer specialists in Veterans Health Administration primary care: Improving program fidelity through enhanced preimplementation support.

Peer specialists (PS) in the Veterans Health Administration are veteran employees with lived mental health experience supporting others in recovery. While PS worked in traditional mental health settings for many years and demonstrated benefits to veteran engagement and satisfaction with health care, little is known about the best strategies to support implementation in novel, complex settings like primary care (PC). Implementation facilitation, which combined external facilitation plus national resources, was chosen to promote uptake when the VA MISSION Act of 2018 required the Veterans Health Administration to implement PS into PC. Using a mixed-methods, formative program evaluation approach, we examined the effects of implementation facilitation across two cohorts of 15 sites. Due to startup timing, Cohort 1 received minimal implementation facilitation during preimplementation compared with Cohort 2. Outcome measures included qualitative evaluation of facilitator notes, time to attain implementation milestones, and PS productivity and program fidelity (percent of total PS encounters in PC). Results suggested that overall productivity was similar across cohorts, but Cohort 2 demonstrated high program fidelity in Month 1 of implementation, while Cohort 1 required 12 months to attain similar fidelity. Qualitative findings indicated implementation facilitation that fostered team cohesion, clarified roles, supported supervisor training, and encouraged sites to guard against competing demands smoothed transitions for PS into PC. During preimplementation, implementation facilitation that focused on these findings resulted in the rapid attainment of program fidelity. Policymakers should consider the value of investing in preimplementation support for speeding the attainment of high-fidelity implementation of novel and complex practices such as PS in PC. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Dance for Wellness: Indigenous adolescents’ Perspectives on Mental Health, Wellness, and Dance

ABSTRACT Purpose Indigenous adolescents living on reservations in Canada experience mental health disparities, and there is an urgent need to address this as mental illness and suicide increase. Therefore, a dance program was initiated to attempt to improve mental health and wellness for Indigenous adolescents The reaearch purpose was to gain insight into theexperiences of mental health and wellness in Indigenous adolescents and identify if and how a four-week dance program affected their mental health and wellness. Design A trauma-informed, qualitative, single-case study design was used. Method Semi-structured interviews and symbol-based data were used to interview eight adolescents aged 11 – 16 years living in a Denesuliné community from February to June 2022. Findings Three multidimensional themes emerged: It Helped My Mental Health and Everything (Dance Helps Me Escape, Dance Makes Me Feel Good, and Dance Is Just Really Fun); A Little Bubble Around Me When I Dance (I Can Be More Confident and I Can Be Myself), and We Won’t Judge You Here (Creation of Friendship, He Said I Was Really Good, and Improved School Attendance). Conclusions The dance program impacted the participants’ mental health and wellness by providing positive activities to engage the adolescents. Clinical Evidence Community health nurses (CHNs) assist in promoting health and wellness in Indigenous adolescents living on reservation and can use these findings to advocate for funding for the development of dance-based mental health and wellness programs.

Navigating (gendered) social worlds: A qualitative exploration of Canadian young people’s social relationships and mental health

The purpose of this qualitative study was to explore the gendered ways that youth in Canada are navigating their social relationships, and in turn, how this may be shaping their mental health experiences. Twenty young people between the ages of 11 and 17 (nine self-identified as girls, ten self-identified as boys, and one self-identified as non-binary) were recruited from across Canada and each participated in a virtual individual semi-structured interview. Social relationships were reported as highly important by all participants, and study findings illuminated the strong, persistent, and often implicit ways that these relationships are shaped by gender. This includes the ways that youth describe gender and social relationships influencing experiences and behaviours; how youth manage conflict; and the dissatisfaction that girls express regarding gendered stereotypes, expectations, and norms that they perceive their boy and non-binary peers to experience. Study findings provide context to understanding the gendered disparities that disadvantage all young people. Along with providing new evidence, this paper is a call to action to the adult duty bearers in society to lead changes in how young people are socialized so that they are better equipped to navigate relationships and conflict in positive and healthy ways.

The Same Storm, but Different Boats: Unpicking the ‘Housing Crisis’

This state-of-the-art paper begins to unpack the concept of a housing crisis. Whilst it may be a useful starting point in recognising the presence of problems within UK housing provision and allocation, its generic and umbrella coverage papers over the diversity of experiences. Similarly, as a concept it neither suggests the causes of the crisis nor possible solutions. With this in mind, this paper explores commodification within housing and uses this to recognise that our relationship to housing and our relationship to the crisis, can be shaped by our relationship to capital. However, the paper takes this further by arguing that the presence of vulnerability should also be borne in mind when considering commodification, where vulnerability includes experiences of discrimination, mental health, and legal status.

Examining dimensions of career intentions: insights from medical and nursing students at a private not-for profit university in Vietnam

BackgroundUnderstanding students’ career intentions through evidence-based approaches is crucial for developing effective career guidance and intervention strategies. Although there has been considerable attention in this field, research remains limited, particularly in low- and middle-income countries (LMICs) in Asia. These regions have unique socioeconomic conditions and cultural norms that potentially shape decision-making processes. This study provides insights into the career intentions of medical and nursing students and identifies the key determinants influencing their choices at a newly established private institution (VinUniversity) in Vietnam.MethodsThis study employs a mixed-methods design. The quantitative phase involved a survey of all undergraduate medical and nursing students. The qualitative phase consisted of in-depth 11 individual interviews with a purposive sample until data saturation.ResultsA total of 198 students (77%) participated in the quantitative phase. The majority of students (75.8%) expressed interest in clinical practice, with preferences notably high for surgical specialties (30.9%), internal medicine (10.1%), and pediatrics (10.1%). 22.7% of students expressed a desire to work overseas, and a significant number (70.7%) indicated the lack of a career guidance program. Qualitative data revealed that personal interest, family influence, financial stability, and societal appreciation were primary influencers in career choice.DiscussionThe study underscores the complex interplay between personal interests, family influence, financial considerations, and societal expectations in shaping career choices. The persistent low interest in family medicine and primary care continued to be a concern.ConclusionThis study provides further insights into the career intentions and influencing factors among medical and nursing students at VinUniversity. The implications for practice include implementing tailored career guidance programs, offering diverse elective tracks that incorporate global health experiences, and establishing structured mentorship programs. It is also recommended to measure the impact of these interventions through longitudinal follow-up studies to enhance career satisfaction, better prepare future healthcare professionals, and contribute to the improvement of healthcare systems.

Older Adults' Perspectives and Experiences With Digital Health in Singapore: Qualitative Study.

Technology use among older adults is increasingly common. Even though there is potential in leveraging technology to help them manage their health, only a small fraction of them use it for health-related purposes. This study seeks to understand the perspectives of and experiences with digital health (DH) among older adults in Singapore. A total of 16 participants (age range 60-80 years; n=11, 69% female) were interviewed for approximately an hour (range 27-64 minutes) about their health, DH use, and DH experiences. The interviews were recorded, transcribed verbatim, and thematically analyzed. Five main themes emerged from the interview: support in developing DH literacy, credibility, cost and benefit considerations, intrinsic drive to be healthy, and telehealth. Older adults need support in familiarizing themselves with DH. When considering DH options, older adults often relied on credible sources and preferred DH to be free. Monetary incentives were brought up as motivators. The intrinsic drive to live longer and healthily was expressed to be a huge encouragement to use DH to help obtain health-related knowledge and achieve healthy living goals. The idea of telehealth was also appealing among older adults but was seen to be more suited for individuals who have issues accessing a physical clinic. Our findings offer insights into the various aspects that matter to older adults in the adoption of DH, which in turn can help reshape their health-seeking behavior and lifestyle. As such, policy makers and DH implementors are encouraged to take these into consideration and align their strategies accordingly.

Advancing Patient Safety Culture: A Systematic Review of Strategies and Best Practices in Riyadh, Saudi Arabia

This research study is an important contribution to that critical argument of how to develop patient safety culture in health care settings in Riyadh, Saudi Arabia. Having understood the pivotal role played by culture in the improvement of patient outcomes, very systematically lays down a literature review looking for the prevalent gaps and inefficiencies occurring in the present practices. That is to mean, the paper duly critically appraises different approaches and interventions that have greatly contributed to making a huge difference in the organizational climate, regarding the culture of safety through a systematic and rigorous manner. These findings, therefore, underline the need for full-fledged deployment of safety protocols, fostering a transparent atmosphere through which healthcare providers should learn from their mistakes, and demand quality enhancement programs. Presents a summary of such findings, and their general meanings with regards to health policy, leadership, and practice that suggest a way for healthcare institutions in Riyadh, to draw a more resilient and patient-centered safety culture. This research contributes to the academic void of discourse of patient safety by offering practical insights to the health leaders and policy-makers in Riyadh that, when implemented, will optimize the quality of care in health care and experience that patients have in it

The Effect of Hypnobirthing Method to Prevent Imminent Prematural Delivery Through Reducing Stress Levels in Factory Working Mothers

Every day, a total of 800 women die from complications that occur during pregnancy and childbirth. Preterm birth is a major challenge in perinatal health care. In the United States, one in eight babies (12%) is born prematurely; of these, 80% are born at 32-36 weeks of gestation and 20% are born at 22-32 weeks. Premature babies (&lt;32 weeks) are at increased risk of neonatal mortality and morbidity. One of the factors causing premature birth is antenatal depression. A systematic review of studies conducted in developed and low-income countries reported the prevalence of antenatal depression in the range of 5% to 30% and 15.6% to 31.1%). Increased risk of premature birth 1.2 times premature birth and 1.3 times risk of low birth weight. Sociodemographic factors play a major role in the incidence of imminent premature labor. The results of a study in 2014 showed that 54.8% of mothers giving birth at Sidoarjo Regional Hospital had a heavy workload. The results of the study showed that there was a relationship between the workload of pregnant women and the incidence of preterm labor with a p value = 0.008 (P &lt;0.05). Pregnant women with heavy workloads are caused by mothers having jobs with a shift work system, long working hours &gt;7 hours/day or &gt;49 hours/week, working in factories with an average break time of 1 hour and activities such as lifting or pushing goods. In addition, after working outside the home, mothers still do household chores such as cooking, sweeping, washing without the help of others. The reason mothers work on average is to help the family economy. Other factors are anxiety in pregnancy, health risks, domestic violence, length of work per day, nutritional factors during work, length of rest at work, partner support, household income, mother's education level, mother's age, parity Hypnobirthing relaxation provides positive suggestions to the mother. This suggestion changes beta brain waves (conscious mind) into alpha waves (unconscious mind) in the cerebral cortex, then a sensory association process occurs which causes stimuli to be analyzed, understood and arranged into an object and the meaning of the stimulus. The provision of one hypnosis session referring to The Creative Psychosocial Genomic Healing Experience protocol can significantly increase immediate-early gene expression (Zif-268), increase stem cell activity, reduce stress and inflammation at the cellular level. This study aims to explain the effectiveness of the influence of hypnobirthing on reducing the scale of depression in Partus Prematurus Imminens. The expected benefits in this study are to develop the potential for preventing premature labor with the hypnobirthing method.