Psychological Support For Women Research Articles

COVID-19-related stress response among adult females: Relevance of sociodemographics, health-related behaviors and COVID-19 contact

Women were more affected than men during the COVID-19 pandemic. This study aimed to investigate COVID-19-related stress response in adult women and its association with the relevant socioeconomic, lifestyle and COVID-19-related factors. This research was carried out in eight randomly chosen cities from September 2020 to October 2021. To examine stress, we distributed the COVID Stress Scales (CSS) and the Perceived Stress Scale (PSS). Women also fulfilled a general socio-epidemiologic questionnaire. The study included 1,264 women. Most women were healthy, highly educated, employed, married, nonsmokers who consumed alcohol. The average total CSS score suggested a relatively low COVID-19 related stress), while 1.7% of women had CSS ≥ 100. The mean PSS was around the mid-point value of the scale. Older women, who were not in a relationship, didn’t smoke, didn’t drink alcohol, but used immune boosters, had chronic illnesses and reported losing money during the pandemic had higher CSS scores. A higher level of stress was also experienced by women exposed to the intense reporting about COVID-19, had contact with COVID-19 positive people or took care of COVID-19 positive family members. In this sample of predominantly highly educated women few women experienced very high stress level, probably due to the study timing (after the initial wave) when the pandemic saw attenuated stress levels. To relieve women from stress, structural organization and planning in terms of health care delivery, offsetting economic losses, controlled information dissemination and psychological support for women are needed.

Sexual Function and Satisfaction among Women Undergoing In Vitro Fertilization (IVF) in the West of Iran: A Cross-Sectional Study

Background: We haven’t found any reported study that addressed sexual function and satisfaction in infertile women who are undergoing IVF treatment in the west of Iran. Objective: The present study was conducted to investigate sexual performance and satisfaction among women undergoing in vitro fertilization (IVF) in Western Iran. Method: This cross-sectional study was conducted on 170 women from December 2022 to March 2023. The participants were selected by convenience sampling until the sample size was reached. The participants were included in the study as available sampling. Women completed the demographic questionnaire, FSFI (female sexual function index), and Linda Berg’s Sexual Satisfaction Questionnaire. For data analysis, we used the Stata version 14 (StataCorp, College Station, TX) and we considered the P-value less than 0.05 significant. Result: There was a significant relationship between husband occupations, economic status, marriage duration, period of infertility, cause of infertility, and intercourse times with sexual satisfaction (P<0.05). The highest percentage of the obtained score was related to pain (51.6%) and the lowest was related to desire (38%). All of the patients with weak sexual function had weak sexual satisfaction and 60.19% of the patients with good sexual function had good sexual satisfaction (P<0.001). Conclusion: Women with weak sexual function had weak sexual satisfaction. Policymakers should consider strategies, such as counseling and psychological support for women during the treatment process to help them cope with their problems, especially psychological problems.

The psychological support for women who underwent a stillbirth during their pregnancy: the quality of midwifery care.

This review aims to investigate the role of midwifery care in perinatal death. Specifically, it aims to investigate the type and implications in the clinical practice of psychological and psychiatric support interventions for women/couples. A scoping review was conducted following the PRISMA methodology. For this purpose, the following databases were queried: PubMed, APA PsycInfo, CINAHL Plus with Full Text, and ERIC, considering only studies published in the 2002-2022 time frame. 14 studies were found to be eligible by the literature review. These researches were divided into 3 macro-topics representing the most crucial factors in influencing the quality of care: the healthcare setting, the experience and training of caregivers, and the experience of parents. The healthcare figure who experiences such a tragic event most closely is the midwife. The health and geographic context in which care is provided - understood to be low-medium-high resources - have a fundamental impact on the quality of midwifery care and caregiver satisfaction. The training was found to be incomplete, and midwives' experiences revealed how they felt unprepared. Parents' experiences indicate the need for multidisciplinary care, better communicability, and follow-up including psychological/psychiatric support for mothers who are increasingly alone in coping with bereavement. To date, there are no guidelines for psychological support for this specific event in the literature. Birth-death management should be a structured part of professional courses so that new generations of midwives can improve the quality of care for affected families. Future research should focus on how to improve communication processes, and hospital centers should adopt protocols adapted to the needs of parents, including a midwifery-led model policy based on psychological support for the mothers/couples involved, as well as increase follow-ups.

A COMPREHENSIVE APPROACH TO MEDICAL-PSYCHOLOGICAL SUPPORT FOR SERVICE WOMEN IN MODERN UKRAINE.

The aim: To analyze the current state of the problem and develop a modern methodology for the correction and prevention of stress disorders in female veterans. Materials and methods: The following methods were used during the research: theoretical and interdisciplinary analysis, complex, сlinical and psychopatho¬logical examination and methods of mathematical and statistical data processing. Results: In the course of our work, it was developed an algorithm for medical and psychological support for women who suffered from results of the fighting includes the following components: monitoring of the psychological and mental state of veteran women; increased psychological care; psychological support for veteran women; psychotherapy; psychoeducation; creation of a re-adaptation atmosphere; formation of a health-centred living style and strengthening of psychosocial resources. Conclusions: The complex system of treatment and prevention of stress-social disorders in women veterans should be aimed at decreasing the level of anxiety-depressive symptoms and the excessive nervous and psychological tension; infective re-evaluation of the traumatic experience; building a positive attitude towards the future and creating a new cognitive model of life.

P-492 Characteristics of the psychological care service in Italian ART centres: the point of view of physicians, psychologists and couples

Abstract Study question What is the point of view of physicians, psychologists and patients on the characteristics of the psychological assistance offered by Italian ART centres? Summary answer Physicians, psychologists and patients alike affirm the importance of specialised psychological support during ART treatment What is known already The European Society of Human Reproduction and Embryology (ESHRE) has produced specific recommendations, establishing that all staff members should share the responsibility related to patients’ psychological wellbeing through their treatments. Moreover, when patients show increased risk of negative consequences some specialized services, as psychological counseling or psychotherapy, should be provided. In Italy, the Law 40/2004 regulates ART treatment and also provides the “Guidelines for the application of Assisted Reproductive Technology” (2008, 2015). According to this law, psychological support for women and couples undergoing ART procedures at any step of medical treatment (before, during, after the treatment) should be routinely included. Study design, size, duration To explore opinions on the characteristics of the psychological support service in ART centres: An online questionnaire was sent to the physicians in charge of 341 ART centres. 5 focus groups with psychologists working in ART centres were carried out. An online questionnaire for patients was sent to 195 centres and 8 patient associations. The surveys were conducted over a period from January 2020 to October 2021. Participants/materials, setting, methods Physicians from 113 centres (37%) responded to questionnaires composed of 20 closed-ended and 6 open-ended questions; 28 psychologists working in ART centres in 3 italian regions participated in focus groups with 3 open-ended questions; and 324 patients responded to questionnaires composed of 19 closed-ended and 8 open-ended questions. The questionnaires were created ad hoc for the surveys starting from the characteristics of the services offered in Italian ART centers. Main results and the role of chance Physicians affirm the importance of the psychologist in the ART centre to support their work: managing couples’ emotional difficulties; improving couples’ mood; and reducing couples’ stress (9% of answers). They also ask for an effective psychological intervention protocol to adopt. Concerning the characteristics of psychological services, physicians do not identify priority areas of intervention, but they admit the usefulness of psychological intervention throughout the treatment. Most physicians admit the utility of psychological counseling as defined by the 2015 Guidelines. Psychologists would like more recognition of their function and they affirm the positive contribution of networking among ART psychologists, believing that specific training is needed to work in the field. The psychologists find that multidisciplinary work in the team is functional and improves the quality of service offered in this field. Patients say that ongoing psychological support throughout the treatment could be helpful for them. They believe that psychologists should have specific training in ART and they would like the cost of psychological support to be included in ART treatment. They argue that psychological support should help their relationship with physicians. Despite this, the psychologist is a stable professional figure in only half of the responding ART Centres (47%). Limitations, reasons for caution Physicians’ opinions are based on a 37% response rate  from ART centres and cannot be considered conclusive. The 5 focus groups were conducted with psychologists working in ART centres located in only three Italian regions. There were few responses from male patients. Wider implications of the findings In conclusion, despite the scarce presence of psychological support in ART centres, physicians, psychologists and patients believe that it would be mportant throughout ART treatment. This highlights the importance of further investigation with the aim of sharing information to establish common protocols for psychological interventions in italian ART centres. Trial registration number not applicable

MEDICAL AND PSYCHOLOGICAL SUPPORT OF WOMEN WITH THE THREAT OF PRETERM BIRTH IN THE LAST TRIMESTER OF PREGNANCY AND AFTER DELIVERY

Introduction. Throughout life, everyone faces a variety of emotionally complex situations. Pregnancy is one of such situations for a woman. It’s a very strong level of experience and a specific set of sensations in life, the study of which has recently received close attention. Circumstances that have developed in Ukraine in connection with environmental disadvantages mainly determine the low health index of pregnant women, and create preconditions for the increasing frequency of premature pregnancies in future generations. This problem is of great medical and social importance. More than a third of babies born prematurely lag behind in physical and psychomotor development. Considering the above mentioned, it can be argued that the creation of a system of medical and psychological support for pregnant women with a risk of preterm birth in the last trimester of pregnancy is relevant, necessary and timely.
 The purpose of the study is to develop a set of measures for medical and psychological support of women at risk of preterm birth in the last trimester of pregnancy and after childbirth based on a systematic approach to the study of individual psychological, pathopsychological and psychosocial characteristics.
 Material and methods. During 2016-2019 the study was conducted based on Storozhynets Central District Hospital in the Chernivtsi region. 150 pregnant women in the third trimester of pregnancy (23-37 weeks) and their husbands were examined. The main group (MG) included 120 women with the risk of premature birth in the last trimester of pregnancy. The comparison group (CP) included 30 women with a physiological course of pregnancy.
 The main therapeutic group (MTG) consisted of 42 women with a risk of preterm birth in the last trimester of pregnancy with maladaptive (MTG1) and destructive (MTG2) types of interaction in the triad "mother-child-father", who agreed to participate in medical and psychological care. The correctional group (CG) included 12 women with a risk of preterm birth in the last trimester of pregnancy with maladaptive and destructive types of interaction in the triad "mother-child-father", who refused to participate in the proposed measures.
 Results. Analysis of the evaluation of the developed system of medical and psychological support of the family during pregnancy showed the following (p <0.001): a) improvement of psycho-emotional state, well-being and overcoming emotional stress demonstrated by MTG1 women (up to 43.7 ± 0.8 and 42.5 ± 1.5, respectively, and after 20.8 ± 1.5 and 22.1 ± 1.2, respectively), the level of depression and anxiety on the Hamilton scale (up to HDRS 11.4 ± 1.2 and HARS 12.5 ± 1.2 after HDRS 4.2 ± 0.4 and HARS 5.7 ± 0.4) and female MTG2 indicators of RA and PA on the Spielberger-Khanin scale (up to 51.7 ± 0.8 and 50.7 ± 1.5, respectively, and after 21.4 ± 1.8 and 23.1 ± 1.5, respectively), the level of depression and anxiety on the Hamilton scale (up to HDRS 16.3 ± 1.2 and HARS 18.3 ± 1.2 after HDRS 7.6 ± 0.7 and HARS 6.9 ± 0.6). Among CG women indicators RA and PA on the Spielberger-Khanin scale (up to 47.7 ± 0.8 and 46.6 ± 1.5, respectively; after 45.8 ± 1.5 and 42.1 ± 1.2, respectively), the level of depression and anxiety on the Hamilton scale (before HDRS 13.8 ± 1.2 and HARS 15.4 ± 1.2; after HDRS 12.2 ± 0.4 and HARS 14.7 ± 0.4) were higher. b) there was an increased level of social support on the last two scales - "support of colleagues" and "support of public organizations" among MTG1 and MTG2 women (up to 25.3%, after 55.2% / up to 14.8%, after 45, 2%, respectively) compared with CG women (up to 18.5%, after 24.5%). c)  there was a complete reduction of the deformation of marital relations in the majority of MTG1 (83.3%) and MTG2 (75%) women in contrast to the examined CG.
 Conclusions. The implementation of the system of medical and psychological support for women with a risk of preterm birth in the last trimester of pregnancy and after childbirth allowed to optimize the choice of adequate behavioral strategies in a family, improve emotional state and well-being, optimize women's attitudes to pregnancy and harmonize family interaction (72.5%) ˂0.001), to harmonize the relationship in the triad "mother - child - father" in the postpartum period (66.4%) (p˂0.001).

Sexual health and function in women with diabetes

Sexual dysfunction for women with diabetes is more common than for women without diabetes. The reasons why women with diabetes are a high-risk group are numerous. For example, lack of vaginal lubrication, pain during sex and inability to orgasm can be a consequence of high or low blood glucose levels. Higher rates of depression in people with diabetes can lead to low sexual drive. Wearing of diabetes devices, such as pumps, glucose monitors or lumps from lipohypertrophy around insulin injection sites may affect body image and self-esteem and the inconvenience of self-managing diabetes may affect the spontaneity of sex. This narrative review provides an overview of the problem of sexual dysfunction in women with diabetes, current methods of assessing sexual dysfunction in women, pharmacological and non-pharmacological interventions to treat it and an example of how psychological support for women with diabetes who experience sexual dysfunction can be integrated into a diabetes service. There are still significant gaps in our knowledge of how best to support women with diabetes and sexual dysfunction. However, raising awareness of the problem may help women with diabetes and healthcare professionals to discuss it as part of diabetes clinical consultations.

Providing psychological support to pregnant women in childbirth by obstetrician service staff

Aims of study. The aim of this study was to investigate the theoretical foundations of psychological support for women in childbirth during midwifery activities.
 Results. An important condition for increasing the efficiency of the treatment process is not only taking into account the patient’s psychological peculiarities, but also providing psychological support to patients during medical care, in particular midwifery activity. Research on different aspects of psychological support is noted in the works of domestic and foreign psychologists who reveal the humanistic ideas of personal development interaction, requiring building a subject-subject relationship in the process of communication. A number of publications are presented in the modern literature concerning the role of psychological support in professional midwifery activities. According to the authors, this area is an important professional responsibility of obstetrician service staff. A special role is played by the psychological support of patients during childbirth. The relationship of the characteristics of the birth process with the emotional state of mothers is noted in modern literature. Psychological support for women in childbirth should be given with the knowledge of the patients’ specific psychological characteristics in this period. The state of consciousness of a woman in childbirth is one of the important psychological factors that require the attention of medical personnel. The altered state of consciousness (ASC) in childbirth, which has an adaptive role, is important for both active labor and reducing pain sensitivity in childbirth. A maladaptive ASC, on the contrary, interferes with the birth process and increase pain sensitivity. Depending on the activity, the psychological component of the generic dominant will manifest itself in an adaptive or maladaptive ASC, with psychological support for women during childbirth contributing to the activation of an  adaptive ASC.
 Conclusion. Analysis of the psychological characteristics of women during childbirth showed the importance of considering the state of consciousness of the patient and the activity of the psychological component of the generic dominant when determining the strategy of psychological support.

Risk factors in pregnant women with an oncological diagnosis and their impact in the post-partum period.

e23166 Background: An oncological diagnosis during pregnancy, or the choice of motherhood following cancer may be accompanied by anxiety, distress and depression. The aim of the study is to explore the possible risk factors in the perinatal period in women who experienced an oncological diagnosis before or during pregnancy. Methods: 32 pregnant women (25 breast, 3 cervix, 1 lung, 1 Hodgkin's lymphoma, 1 perivascular epithelial cell neoplasia, 1 epatic PEComa) were assessed during their 3rd trimester (T1) and three months’ post-partum (T2). At T1 mood states and post-traumatic symptoms were evaluated, at T2 parenting stress and perceived quality of life (QoL). Results: Depression, anger and anxiety correlated with lower physical and psychological QoL in the post-partum. Moreover, mothers who expressed higher levels of fatigue and confusion during pregnancy are associated to lower levels of perceived psychological QoL. Women who manifested hypervigilance and hyperarousal during pregnancy were more likely to perceive lower psychological QoL three months after birth. Finally, post-traumatic symptoms of intrusiveness during pregnancy correlated with higher levels of parenting stress and higher risk of dysfunctional parenting, together with a stronger perception of having a child with a difficult temperament in the post-partum period. Conclusions: Mood states and post-traumatic symptoms can decrease the mother’s quality of life and heighten parental distress. These preliminary results suggest implementing psychological support for women with current or previous oncological diagnosis during pregnancy in order to prevent the onset of dysfunctional parenting and/or problem behaviours in their children. [Table: see text]

Gender and Time-Related Differences in a Large Cohort of Heavy Smokers Applying for Treatment to a Tobacco Centre in Italy

Introduction: Attempts to quit smoking have increased in recent years, but the patterns of variations over time are unknown. We aimed at describing time- and sex-related changes in a population of 2,231 subjects who adhered to a smoking-cessation programme lasting 13 years in Italy.Methods: We measured baseline expired carbon monoxide (expired-CO), Fagerstrom nicotine dependence, Q-MAT test, Zung depression and anxiety scale, Hospital anxiety and depression scale (HADS).Results: Study population included 1,278 men and 953 women who smoked a median of 25 (interquartile range, IQR: 20–32) and 20 (IQR: 20–30) cigarettes/day, respectively (p < 0.001). The proportion of female smokers increased from 37.5% in 2001–2003 to 46.9% in 2010–2013 (p = 0.003). There was a significant time-related reduction of median daily cigarette consumption, with a more noticeable decrease in men. Median expired-CO (parts per million (ppm)) increased only in women, from 18 (IQR: 14–23) in 2001–03 to 20 (IQR: 14–28) in 2010–13 (p = 0.001), whereas Fagerstrom test for nicotine dependence did not vary. Differences in psychological characteristics in the last 3 years showed that women were more clinically depressed than men (16.6% versus 7.6%, p < 0.001).Conclusions: Despite a decrease in the number of daily cigarettes with time, expired-CO tends to increase in women, who are also more clinically depressed and anxious than men. A personalised approach to specific subgroups of smokers, with special emphasis on a psychological support for women, seems appropriate.

Assessing depression, anxiety and couple psychological well-being in pregnancy: a preliminary study

Objective: The aim of the study was to evaluate symptoms of depression and anxiety and psychological well-being in men and women in their third trimester of pregnancy, and to compare them with two control groups of men and non-pregnant women, both with children and without children. Background: Perinatal research has largely focused on maternal depression, anxiety and the state of the marital relationship, but few studies exist including partners and comparisons with control groups of men and women both with and without children. Methods: The study was a cross-sectional survey. The total sample was 156 participants. Approximately equal numbers of participants in each group were recruited through a local community health centre in Zaragoza (Spain) and completed questionnaires in the presence of a psychologist. Anxiety, depression and the couple’s self-ratings of their well-being were assessed with the Beck Depression Inventory, the State-Trait Anxiety Inventory, and Psychological Well-being in the couple Scale, respectively. Results: The results show higher levels of depression symptoms in the ‘pregnancy group’; specifically, pregnant women reported higher levels of depression than their male partners. Also, the ‘pregnancy group’ (men and women) show lower scores on psychological well-being in the couple compared with the control groups. No significant differences in anxiety-state between the groups and sex were obtained. Conclusion: These findings are important for both researchers and clinicians in practice, in order to improve the identification of women with antenatal depressive symptoms and offer more psychological support for women and their partners during and after pregnancy.

Factors implicated in moderating the risk for depression and anxiety in high risk pregnancy

Objective: The aim of the study was to evaluate depressive and anxious symptoms while examining the impact of self-esteem, social support and coping strategies on these symptoms in women who have been hospitalised for high-risk pregnancies. Method: Fifty-five women from the south of France area hospitalised or on bed rest for high-risk pregnancy completed five scales: the Edinburgh Post-Natal Depression Scale (EPDS), the High Risk Pregnancy Stress Scale (HRPSS), the Revised Prenatal Coping Inventory (NuCPI), the ‘Questionnaire du Soutien Social Perçu’ (QSSP), and the Rosenberg Self-Esteem Scale (RSES). Results: The results show that over half of these women manifest symptoms characteristic of pre-natal depression and the entire sample showed high levels of anxiety symptoms. Predictive factors for depression included informational support and self-esteem; for anxiety, predictive factors were patient age and EPDS scores. Conclusion: This study underscores the importance of providing appropriate psychological support for women with high-risk pregnancies in order to avoid depressive disorders and any potential negative consequences on the perinatal period.

Posttraumatic Stress Disorder and psychological distress following medical and surgical abortion

Objective: Abortion can be a difficult event to cope with and can lead to the development of psychological disturbance. The aim of this prospective and longitudinal study was to assess and to predict Posttraumatic Stress Disorder (PTSD) symptoms following abortion. Moreover, this study aimed to assess whether the type of abortion had an impact on women’s experience. Method: Eighty-six women were approached a few hours after the abortion and then 6 weeks later. Several questionnaires were completed: the Impact of Event Scale Revised (IES-R), the Multidimensional Scale of Social Support (MSPSS), the Peritraumatic Dissociative Experience Questionnaire (PDEQ), the Peritraumatic Emotions List (PEL), the Hospital Anxiety and Depression Scale (HADS), the Perinatal Grief Scale (PGS) and the Texas Grief Inventory (TGI). Results: Six weeks after the abortion, 38% of women reported a potential PTSD and a significant decrease of the anxious symptomatology was also highlighted. Peritraumatic dissociation and peritraumatic emotions were the main predictors of the intensity of post-abortum PTSD symptoms. Compared to surgical abortion, medical abortion was associated with increasing the risk of developing a possible PTSD. Conclusion: By providing evidence on some of the main risk factors, this study highlights the need for psychological support for women and strategies of prevention to be developed.

Menace d’accouchement prématuré, stress, soutien psychosocial et psychothérapie : revue de la littérature

From the hypothesis that preterm labour is a physical expression of a difficulty to have a cheerful pregnancy, we wanted to assess from a literature review: - the link between stress, anxiety, and preterm birth for one part - and the medical advantage of psychosocial or psychological support among women having a high risk of preterm birth for another. According to the available publications, stress, psychological disturbances, and anxiety can increase the risk of preterm birth. However, psychosocial support is not associated with an improvement of the perinatal outcome. On the other hand, psychological support for women having a preterm labour, with or without hospitalisation, seems an interesting medical approach to reduce the preterm birth rate.

Previous stress and acute psychological defence as predictors of perinatal grief—An exploratory study

We evaluated whether the emotional reactions of women at 2–6 weeks after the prenatal diagnosis of a lethal anomaly and at 3 months after perinatal loss might be predicted by previous stress and acute psychological defence reactions to the diagnosis. Previous stress was defined objectively as a history of major life event(s) and having received professional mental health treatment in the past, and subjectively as the disposition for feelings of inadequacy and anxiety. Forty-one women were interviewed and completed measures on their history of major life events, whether they had received professional mental health treatment in the past, inadequacy, acute psychological defence reactions and perinatal grief. Regression analyses showed that inadequacy was the most strongly positive predictor of perinatal grief shortly after receiving the unfavourable diagnosis and three months after perinatal loss. In addition to inadequacy, having received professional mental health treatment in the past led to significantly more intense grief, but only shortly after receiving the unfavourable diagnosis. Previous life events intensified grief three months after perinatal death. The grieving process was significantly moderated by the defence of ‘principalization’ while it was significantly intensified by ‘turning aggression against oneself’, but only shortly after receiving the unfavourable diagnosis. These effects were not contaminated by relationships with pregnancy-related variables. Our findings imply that psychological support for women with perinatal loss should particularly be offered to those who have been identified as generally anxious, who have reported previous major life events and have received professional mental health treatment in the past.