Spielberger State-Trait Anxiety Inventory Research Articles

Maternal postpartum mental health negatively affects infants' health related quality of life.

To assess the association of early and late postpartum maternal mental health with infants' health related quality of life (HRQoL). The study was embedded within the POST-UP trial (n = 1843). Infants' HRQoL was assessed with the Infant and Toddler Quality of Life Questionnaire Short Form-47 at ages 1 month (1 m), and 12 m. Maternal mental health regarded postpartum depression (PPD), measured with the Edinburgh Postnatal Depression Scale at 1 m and 6 m (early/late), and postpartum anxiety (PPA) with the short version of the state form of the Spielberger State-Trait Anxiety inventory at 1 m and 12 m (early/late). We used linear regression analyses. Early and late PPD and PPA were negatively associated with infants' HRQoL at ages 1 m and 12 m. The negative associations with infants' HRQoL at 1 m were most pronounced for the domain infant temperament (standardized regression coefficient, (95%confidence interval)): -0.30 (-0.34; -0.25), and - 0.37 (-0.41;-0.32) for PPD and PPA respectively, and weakest for the domain bodily pain: -0.14 (-0.19;-0.09), and - 0.22 (-0.26;-0.17) for PPD and PPA respectively. The negative associations of early postpartum maternal health with infants' HRQoL at age 12 months were less pronounced. Moreover, associations with infants' HRQol were weaker for late than for early PPD and PPA. Usage of maternal proxy reports for assessing infant HRQoL. Postpartum maternal mental health is negatively associated with infants' HRQoL at age 1 m and 12 m. This confirms the need for regular screening of maternal mental health in the postpartum period.

Gender Differences in the Association Between Anxiety and Interoceptive Insight.

Anxiety is one of the most common and debilitating mental health disorders, and is related to changes in interoception (perception of bodily states). While anxiety is more prevalent in women than men, gender differences in interoception-anxiety associations are often overlooked. Here, we examined gender-specific relationships between anxiety and interoception in the breathing domain, utilising multicentre data pooled from four study sites (N = 175; 51% women). State anxiety scores were quantified via the Spielberger State-Trait Anxiety Inventory, and breathing-related interoceptive dimensions via an inspiratory load task to quantify sensitivity, decision bias, metacognitive bias (confidence in interoceptive decisions), and metacognitive insight (congruency between performance and confidence). Regression analyses revealed a significant negative relationship between state anxiety and metacognitive bias (β = -0.28; p = 0.01) and insight (β = -0.09; 95% highest density interval [HDI] in a hierarchical Bayesian regression = [-0.18, -0.004]) across the whole sample, while state anxiety did not relate to interoceptive sensitivity nor decision bias. While no mean interoceptive effects relating to gender were observed, the relationship between anxiety and metacognitive insight towards breathing was driven by women (women: β = -0.18; HDI = [-0.31, -0.05]; men: β = 0.02; HDI = [-0.12, 0.15]) with a significant interaction effect (β difference = -0.20; HDI = [-0.37, -0.01]), which did not hold for trait anxiety nor depression measures. In summary, state anxiety was associated with decreased metacognitive bias across all participants, while decreased interoceptive insight was only associated with anxiety in women but not men. Therefore, treatment programmes focusing on interoceptive metacognitive bias may be useful for all anxiety patients, while interoceptive insight might represent a specific treatment target for women with anxiety.

Effect of foot reflexology on pain, anxiety, and physiological indices in leukemia patients undergoing bone marrow aspiration: A randomized clinical trial study.

Patients with leukemia undergoing bone marrow aspiration (BMA) frequently experience considerable pain and anxiety, which may negatively impact physiological outcomes. Reflexology, a complementary therapeutic approach, has demonstrated effectiveness in reducing pain and anxiety across various medical procedures. This randomized clinical trial aimed to evaluate the impact of foot reflexology on pain, anxiety, and physiological indices in leukemia patients undergoing BMA. This randomized clinical trial was conducted at Ayatollah Khansari Hospital in Arak between August 2021 and January 2023. Patients were randomly assigned to either a reflexology intervention group or a control group receiving routine care. The intervention group underwent a 30-min foot reflexology session. Pain was assessed using the Numeric Rating Scale (NRS), and anxiety levels were measured via the Spielberger State-Trait Anxiety Inventory (STAI). Physiological indices, including systolic and diastolic blood pressure, heart rate, and arterial oxygen saturation, were measured before and after the intervention. Of the 72 patients, 68 completed the study (intervention: n=35, control: n=33). Post-intervention, the intervention group showed a significant reduction in systolic (p=0.017) and diastolic blood pressure (p=0.028), while the control group experienced no significant changes. Heart rate significantly increased in the control group (p=0.030), but no significant change was observed in the intervention group (p=0.977). Anxiety levels significantly decreased in the intervention group (p<0.001), with a notable between-group difference (p=0.006). Pain intensity was also significantly lower in the intervention group compared to the control group (p=0.034). Foot reflexology is an effective intervention for reducing pain and anxiety in leukemia patients undergoing BMA. Reflexology may be considered a valuable, non-invasive supportive therapy for managing procedural pain and anxiety in oncology settings.

Predictors of Fetal Attachment, Anxiety, Stress, and Worry in Unintended Pregnancies in the Primary Care Center in Southern Iran

Background: Despite the prevalence of unintended pregnancies, little is known about the connections between psychosocial and sociodemographic characteristics. This study explored the predictors of fetal attachment, worry, anxiety, and stress in unintended pregnancies. Materials and Methods: This descriptive, cross-sectional study was conducted on 229 father and mother pairs from two primary healthcare centers in Fars province in southern Iran. Data were collected in a face-to-face survey using the Parents Fetal Attachment Scale, Spielberger State-Trait Anxiety Inventory (STAI), Cambridge Worry Scale (CWS), Perceived Stress Scale (PSS), and Parental Worry Scale. The participants were selected using the two-stage random cluster sampling method from November 2022 to February 2023. Data were analyzed in SPSS software using binary logistic and multiple linear regression tests. Results: According to the findings, education level and previous parenting experience were found to have a statistically significant effect on the attachment levels of mothers (F4,224 = 5.14; p &lt; 0.05). However, there was no statistically significant difference between the perceived stress of mothers and fathers (p &gt; 0.05). Previous parenting experience significantly affected mothers’ anxiety (odd ratio: 3.20; p &lt; 0.05). The age variable had a significant relationship with the mothers’ perceived stress (p &lt; 0.05). Conclusions: According to the results, unwanted pregnancy had a significant relationship with fetal attachment, anxiety, stress, and worry. It is recommended that to enhance the mental health of couples who have experienced unintended pregnancy, a platform should be provided for the development of their psychosocial environment.

Antenatal detection of pediatric surgical congenital abnormalities and its effect on maternal anxiety: a multicentre prospective study in a middle-income country.

In middle-income countries, healthcare systems face unique challenges in ensuring timely antenatal detection of congenital abnormalities that require pediatric surgical intervention. Early detection can significantly improve outcomes, yet resource constraints often limit access to diagnostic technologies. This study evaluates the antenatal detection rate of congenital abnormalities referred to pediatric surgical services in three Malaysian tertiary centers and examines its effect on maternal anxiety. A prospective observational study was conducted at Hospital Raja Permaisuri Bainun (HRPB), Hospital Sultanah Aminah (HSA), and University of Malaya Medical Centre (UMMC) over a 8month period. Data were collected from mothers of neonates born with congenital abnormalities, and the Spielberg State-Trait Anxiety Inventory (STAI) was used to assess maternal anxiety. A total of 58 patients were recruited. The overall antenatal detection rate for congenital abnormalities was 43.1%, comparable to high-income countries despite resource limitations. Antenatal counselling by pediatric surgeons was rare (6.9%) and showed no significant reduction in maternal anxiety (p = 0.374). The antenatal detection rates at the three Malaysian centers align with those in more developed nations, underscoring the potential of middle-income healthcare systems to deliver high-quality prenatal care. However, improving access to diagnostic technologies and involving pediatric surgical teams in antenatal counselling could further enhance care.

Evaluation of the effects of avatar on learning temporomandibular joint in a metaverse-based training.

Avatars, representing users in the digital world, can influence users' behavior and attitudes. This study evaluates the impact of representing dental students receiving temporomandibular joint (TMJ) education in the metaverse via an anonymous or identified avatar. Participants included 80 dental students in their fourth and fifth years of study. They were randomly assigned to either the avatar group (identified avatar) or the control group (anonymous avatar). Prior to training, participants completed a demographic questionnaire and a pretraining knowledge assessment. TMJ training was conducted in the metaverse for both groups. Pre- and post-training assessments included the Spielberger State-Trait Anxiety Inventory and a shyness scale to ensure group comparability. A post-test consisting of five questions was administered to both groups after 2 weeks of training. There were no significant differences in pretraining scores for prior knowledge (p=0.67), trait anxiety (p=0.28), state anxiety (p=0.92), or shyness (p=0.42) between the avatar and control groups, indicating comparability at baseline. Post-training analysis revealed significantly higher post-test scores in the avatar group (median=80) compared to the control group (median=60) (p=0.03). Metaverse environments offer various benefits for students, educators, and educational institutions in health education programs. Representing learners and their identities in training environments can enhance learning outcomes.

The Effect of Internet Addiction on Preoperative Anxiety in Adolescents

Internet addiction has been associated with mental health issues such as anxiety, sleep disorders, and depression in adolescents. However, its effects on preoperative anxiety have not been adequately studied. Our goal is to investigate the consequences of internet addiction on preoperative anxiety in adolescents undergoing surgery. The study was carried out by the approval of the Karatay University Ethics Committee at Konya City Hospital between August and December 2023. A total of 150 patients aged 12–18 who would undergo general anesthesia were included. Preoperative anxiety was evaluated utilizing the "Spielberger State-Trait Anxiety Inventory" (STAI-1), and internet addiction was assessed using the "Young Internet Addiction Scale" (IAS). Statistical analyses were performed using SPSS, and Pearson correlation, ANOVA, and regression analyses were used. It was found that 45.3% of the patients were internet addicts, and this group experienced higher levels of preoperative anxiety (r = 0.728, p&amp;lt;0.01). Pairwise comparisons revealed statistically significant differences among all groups. We observed a strong positive connection between internet addiction and preoperative anxiety. Additionally, it was observed that age and easy access to the internet increased anxiety levels, with individuals having more accessible access to the internet experiencing higher anxiety levels compared to those with limited access (β = 0.189, p = 0.018). Internet addiction is an important factor that increases preoperative anxiety levels in adolescents undergoing surgery. Age and ease of internet access are other variables affecting anxiety levels. These findings suggest that internet addiction should be taken into account during preoperative processes.

Changes in Resting-State Functional Connectivity and Cognitive-Affective Symptoms in Patients With Post-Concussion Syndrome Treated With N-Acetyl Cysteine.

Concussion accounts for more than 80% of people experiencing traumatic brain injury. Acute concussion is associated with characteristic cognitive and functional deficits that may persist for weeks to months. A subgroup of these patients (from 10% to 50%) have persistent symptoms referred to as chronic post-concussion syndrome (PCS). There are limited treatment options for these patients and the pathophysiology is poorly understood, though oxidative stress is thought to be a contributing factor. The purpose of this study was to evaluate whether an antioxidant, N-acetylcysteine (NAC), might be beneficial in patients with PCS. Outpatient medicine center. Fifty patients with chronic PCS for at least 3 months post injury. The patients with PCS were enrolled in this randomized unblinded clinical trial to receive the antioxidant NAC as a combination of daily oral and weekly intravenous infusions, or assigned to a waitlist control group where they would continue to receive standard of care. Resting-state functional connectivity (FC) magnetic resonance imaging (rsFC-MRI) was performed pre and post either NAC or the waitlist period along with cognitive, emotional, and sensory symptom assessments. The results demonstrated significant (P <.05) improvements in symptoms as determined by the Rivermead Post-Concussion Symptoms Questionnaire, Spielberger State-Trait Anxiety Inventory, and Profile of Mood Scale in the PCS group receiving NAC as compared to patients receiving ongoing standard care. Importantly, there were significant (P<.01) changes in FC in the NAC group, particularly in networks such as the default mode network, salience network, and executive control network. These changes in FC also correlated with improvements in symptoms. In patients with chronic PCS, NAC treatment was associated with significant changes in resting state FC and improvement in a variety of symptoms, particularly cognitive and affective symptoms.

The Effect of Listening to Music on Pain and Anxiety Scores During Office Based Transperineal Prostate Biopsy: A Prospective Study

ObjectiveTo reduce the pain and anxiety during the transperineal prostate biopsy, we aimed to evaluate the effect of listening to music on this condition. MethodsThis study included 97 patients, divided into a music group and a non-music group. Patients in the music group chose from classical, popular, or local folk music, played through speakers during the biopsy. Anxiety was assessed using the Spielberger State-Trait Anxiety Inventory (STAI) and the Beck Anxiety Inventory (BAI), while pain was measured using the Visual Analog Scale (VAS). Patients were also asked about their willingness to undergo another biopsy if needed. ResultsWe showed that music significantly reduced pain and anxiety during TPBx. The music group had lower VAS scores for overall pain and pain during local anesthesia administration (p:0.002 and p:0.003, respectively). Post-biopsy anxiety scores were also significantly lower in the music group. These findings suggest that music enhances patient comfort and increases willingness to undergo repeat procedures. ConclusionMusic is a cost-effective, safe, and proven approach for interventional procedures that is increasingly acknowledged for its ability to ease pain and lower anxiety. The study suggests adding music to TPBx to improve patient experience, reduce pain and anxiety, and boost future biopsy agreement.

The effect of education on pre-operative anxiety in patients undergoing extracorporeal shock wave lithotripsy.

The period before diagnostic and therapeutic procedures is associated with increased anxiety levels in patients due to a lack of sufficient information. This study aimed to determine the effect of education on physiological and psychological anxiety levels in patients before extracorporeal shock wave lithotripsy (ESWL). This randomized clinical trial was conducted at Baharloo Hospital in Tehran on 122 patients, and the samples were selected in two stages. In the first stage, the samples were selected using convenience sampling. In the second stage, they were randomly assigned to the intervention and control groups. The data were collected using demographic information and Spielberger's State-Trait Anxiety Inventory to measure psychological anxiety. Salivary cortisol was measured to evaluate physiological anxiety by both groups before the intervention and entering the room. The intervention group received the information before ESWL via face-to-face lectures and the broadcast of pre-recorded lecture videos. The control group received only the usual care in the ward. The data analysis was performed by SPSS version 25 using descriptive statistics that included the calculation of mean, standard deviation, and frequency distribution and inferential statistics (independent t-test, paired t-test ANOVA, and Chi-square test). There was no significant difference in demographic characteristics between the intervention and control groups (P > 0.05). A significant decrease in the mean salivary cortisol level was found in the intervention group compared with the control group (P < 0.001). The anxiety level was markedly decreased in the intervention group compared with the control group (P < 0.001). Adequately informing patients before ESWL could decrease patients' physiological and psychological anxiety levels. So, people in the field of nursing education can take an important step towards using this method and reducing the anxiety of patients. The existence of such videos and holding training sessions can be a suitable solution for educating the patient.

The effect of educational- supportive program on the anxiety of mothers of infants admitted to the neonatal intensive care unit (NICU)

IntroductionThe admission of preterm infants to the neonatal intensive care unit (NICU) often causes stress and anxiety in their mothers. Nurses must implement nursing interventions for mothers as the most important caregivers of infants. Accordingly, the present study aimed to explore the effect of Educational- Supportive Program (multi-sensory stimulation) on the anxiety of mothers of preterm infants admitted to neonatal intensive care units. MethodsThe present study used a quasi-experimental design with two groups and pretest and posttest and was conducted on 100 mothers of preterm infants admitted to the neonatal intensive care unit. The mothers who met the inclusion criteria were selected as the participants using convenience sampling and were randomly placed into intervention and control groups (50 persons in each group) by drawing lots. The participants in the intervention group performed multi-sensory interventions for the infant for 12 min at a time, once a day for 5 days a week according to the instructions provided by the researcher. The mothers in the control group did not perform any intervention for their infants. The participants in both groups completed the Spielberger State-Trait Anxiety Inventory (STAI) on the first day and one week after admission. ResultsThe results showed that the mean scores of maternal anxiety for the participants in the intervention and control groups before the intervention were 38.98 ± 3.44 and 35.86 ± 7.16, respectively, showing a statistically significant difference (P = 0.007). Besides, the mean scores of maternal anxiety for the participants in the intervention and control groups one week after the intervention were 33.36 ± 3.46 and 36.22 ± 7.46, respectively, showing a statistically significant difference (P < 0.001). ConclusionThe present study showed that the multisensory stimulation intervention had a positive and significant effect on the anxiety of mothers of preterm infants and reduced it. Therefore, this simple and practical relaxing measure can be used by nurses in clinical settings to reduce maternal anxiety.

Exploring the Association between Anxiety and Atrial Fibrillation using two Quantitative Psychometric Tools: A Systematic Review and Meta-Analysis

Background: Anxiety is widely prevalent, exhibiting higher rates among individuals with chronic health conditions, notably cardiovascular diseases such as atrial fibrillation (AF). Studies have shown interventions targeting anxiety can improve AF outcomes, while AF management can reduce anxiety levels. This study explores the association between AF and anxiety by comparing anxiety levels in AF populations with healthy controls. Materials and Methods: A systematic review adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) principles was conducted to identify relevant studies through medical databases and grey literature sources. Various psychometric tools, including the Spielberger State-Trait Anxiety Inventory (STAI) and Zung's Self-Rating Anxiety Scale (SAS) were considered for assessing anxiety severity. Meta-analysis was performed using a random-effects model to analyse continuous variables, with the overall effect size quantified as the standardized mean difference (SMD). Results: 5 study samples (327 AF patients for STAI-State, 171 AF patients for STAI-Trait) and 3 study samples (209 AF patients) using Zung's SAS were included in the meta-analysis, along with 3 respective control samples. Compared to control groups, AF patients exhibited significantly higher scores for STAI-State (SMD 1.13; CI: 0.57-1.69, p&lt;0.01, I²=81%), STAI-Trait (SMD 0.54; CI: 0.09-0.99, p=0.02, I²=67%), and Zung's SAS (SMD 1.85; CI: 1.58-2.13, p&lt;0.01, I²=22%). Conclusions: AF patients demonstrated elevated levels of anxiety, as indicated by higher STAI and Zung's SAS scores compared to controls. These findings suggest an association between AF and anxiety. The study highlights the importance of addressing mental health disorders in AF patients and vice versa.

Investigating the association between hair progesterone, anxiety, sleep quality, and other determinants in South African females

BackgroundAnxiety symptoms and poor sleep quality are common in women. The role of sex hormones, particularly progesterone, in anxiety and sleep quality in women is understudied. Measurement of hair progesterone concentrations (HPC) is a promising method to investigate the effects of progesterone on anxiety symptoms and sleep quality in women. ObjectivesWe analysed sociodemographic, hair-related, and clinical factors associated with HPC and investigated the association between HPC and anxiety severity and sleep quality in a sample of 159 South African women (mean age: 46.5 years; range: 18–79 years). MethodsData were obtained from control participants from the SHARED ROOTS study. HPC were determined using an established liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. Unadjusted and adjusted multiple linear regression models were used to investigate whether sleep quality, measured with the Pittsburgh Sleep Quality Index (PSQI), and anxiety, measured with the Spielberger State-Trait Anxiety Inventory (STAI), were associated with HPC. Significant sociodemographic, hair-related, and clinical factors were adjusted for. ResultsHPC was significantly associated with age, duration of sample storage, hormonal treatment, postmenopausal status, and the number of different types of trauma exposures in adjusted models. Neither anxiety severity nor sleep quality was significantly associated with HPC. ConclusionsCertain demographic, hair related, and clinical factors were associated with HPC and need to be considered in future research using HPC. Although anxiety and sleep were not associated with HPC, greater trauma exposure was associated with higher HPC, suggesting an association between severe stress and hypothalamic-pituitary-gonadal (HPG) axis functioning.

Yoga, Physical Therapy and Home Exercise Effects on Chronic Low Back Pain: Pain Perception, Function, Stress, and Quality of Life in a Randomized Trial.

Low back pain is a common health problem. In this study, we investigated the effects of yoga, physical therapy (PT), and home exercise (HE) on pain perception, function, stress, and quality of life in chronic low back pain (cLBP). We randomly assigned 54 participants to three distinct treatment groups: (a) a physical therapy group (PT) who received spinal stabilization exercises (SSE) combined with local heat and transcutaneous electrical stimulation; (b) a home exercise group (HE) who received SSE as part of the home program; and (c) a yoga group who received yoga exercises. The primary outcome measures were a Visual Analog Scale (VAS) for measuring pain, and the Oswestry Disability Index (ODI) to measure function. Secondary outcome measures were the Tampa Kinesiophobia Scale (TKS), Central Sensitization Inventory (CSI), pain sensitivity (L3 and deltoid R/L PPTs), Spielberger State-Trait Anxiety Inventory (STAI), plasma cortisol and DHEA-S levels, Transversus Abdominis (TrA) muscle activation, and the Nottingham Health Profile (NHP). Assessments were conducted before and after a six-week intervention period. All three groups demonstrated improvements in pain on the VAS, function on the ODI, pain sensitivity on the L3 and deltoid R/L PPTs, CSI, anxiety on the STAI, TrA muscle activation, and quality of life on the NHP (p < .05). The PT group exhibited a more pronounced improvement on the ODI score (p < .05) than the other groups. Cortisol levels only decreased in the PT group (p < .05). The exercises did not impact DHEA-S and NHP-S parameters. Thus, all interventions resulted in decreased stress, pain intensity, pain sensitivity, central sensitization, and improved function and quality of life; there was no singularly superior approach between interventions. These findings will aid in tailoring treatment programs for managing cLBP according to individual needs.

Effectiveness of a peer-to-peer, self-management intervention for young people with depression and anxiety in Denmark: an observational study and a propensity score-matched comparison.

This study investigated the effectiveness of a 7-weeks peer-to-peer program for young people aged 15 to 25 years with depression or anxiety symptoms in Denmark. A total of 483 participants (72% women) participated in the program and the evaluation. The participants completed questionnaires at baseline, postintervention, and at 5-month follow-up to assess changes in depression symptoms (using Beck's Depression Inventory-II), anxiety symptoms (using Spielbergers State-Trait Anxiety Inventory for Adults) and self-efficacy in controlling or managing the illness (using the personal control subscale from the Illness Perception Questionnaire-Revised). Analyses were done using repeated measures mixed linear regression models. Moreover, a register-based matched comparison group was derived as a comparison to assess changes in being in education and employment at 8-month follow-up. Within the intervention group, both depression and anxiety scores declined across the 5-month follow-up compared to baseline (b = -9.6, 95% CI: -11.2, -8.1 for depression symptoms). The self-efficacy score increased from baseline to post-intervention (b = 1.4, 95% CI: 1.0, 1.8) and this level was maintained at follow-up. More than half of the participants were in education at baseline while 24% received social transfer payments. Compared with matched comparison group, a lower proportion of the intervention group remaining in education (71% vs. 80%). Among participants who were employed at baseline, a higher proportion of the intervention group were enrolled in education (27% vs. 19%) and were unemployed (14% vs. 4%) compared to the matched comparison group. This study supports the effectiveness of a peer-to-peer intervention for depression and anxiety symptoms, and self-efficacy in symptom control. However, mixed effects on education and employment were observed, indicating a negative impact on education among those initially enrolled and a higher proportion of employed participants starting education.

Relationship between sleep quality during pregnancy and postpartum anxiety: a prospective birth cohort study

The present study aimed to determine the relationship between sleep quality during pregnancy and postpartum anxiety.A total of 237 pregnant women participated in this birth cohort study, using the sequential sampling method. The data collection tools included a demographic information form, Pittsburgh Sleep Quality Inventory, and Spielberger State-Trait Anxiety Inventory. The PSQI was completed by the participants at 28 and 40 weeks of gestation, and the STAI was completed in two stages, that is, once in the third trimester and once at eight weeks postpartum.The mean global PSQI score of the participants was 8.11 (SD=5.41) in this study. Overall, 138 (58.2%) women had poor sleep quality. The mean score for overt anxiety was 36.58 (SD=9.37), and the mean score for latent anxiety was 37.56 (SD=9.44). There was a significant positive correlation between the total score of sleep quality during pregnancy and the scores of overt anxieties (r=0.314, P&lt;0.001) and latent anxiety (r=0.344, P&lt;0.001) after delivery.The results of the present study indicated a significant relationship between sleep quality during pregnancy and postpartum anxiety. Therefore, it is recommended to evaluate the quality of sleep of pregnant women and design appropriate interventions during pregnancy to reduce postpartum anxiety. Keywords: Sleep; pregnant woman; postpartum period.

Comparison of State-Trait Anxiety and Fear of Childbirth According to Attachment Styles of Pregnant Women.

Fear of childbirth (FoC) and its extreme form, tokophobia, is a clinical condition that can lead to many negative consequences, and its importance is increasingly understood. This article aims to assess the severity of FoC and anxiety levels according to different attachment styles and to investigate the relationships between these factors. A cross-sectional study was conducted in a state hospital in the largest city in Turkey. Three hundred pregnant women attending the Antenatal Outpatient Clinic were included. A sociodemographic questionnaire, Wijma Delivery Expectancy/Experience Questionnaire-version-A (W-DEQ), Spielberger State-Trait Anxiety Inventory and Adult Attachment Style Scale were administered. 8.1% of participants had tokophobia (W-DEQ sum score ≥85). FoC was significantly higher in pregnant women who had a history of pregnancy loss and past psychiatric history. For multiparous women, adverse birth outcomes were also associated with higher FoC. State and trait anxiety were positively correlated with FoC levels. Regarding the attachment patterns, pregnant women with avoidant attachment styles presented with higher levels of FoC than those with secure attachment styles. In logistic regression analysis, higher anxiety levels, adverse birth outcomes, and insecure attachment styles were found to predict severe and clinical FoC. FoC has a considerable effect on pregnant women, albeit at different clinical levels. Adverse birth outcomes, high anxiety levels, and insecure attachment styles were associated with higher FoC. Therefore, antenatal patients with adverse birth outcomes and higher anxiety levels, which are risk factors for FoC, should be carefully evaluated in terms of tokophobia and referred to mental health professionals when necessary.

A Pilot Survey of Patient Perspectives on an Artificial Intelligence-Generated Presenter in a Patient Information Video about Face-Down Positioning after Vitreoretinal Surgery

Introduction: Video education is a commonly used patient education tool. However, the impact of integrating artificial intelligence (AI) into video education remains unexplored. This study aimed to examine the acceptability of an AI-generated presenter in a patient information video about face-down positioning after vitreoretinal surgery. Method: We prospectively enrolled participants who were planned for vitreoretinal surgery in which postoperative face-down positioning was recommended at the Royal Adelaide Hospital between December 2022 and September 2023. Participants were preoperatively provided with an educational video presented by an AI-generated presenter, incorporated into a surveyredcap. A pre- and post-video questionnaire was administered electronically. Results: There were 15 participants included in the study. In the pre-video questionnaire, most participants rated their awareness of special equipment for positioning as “not aware” (33%) and “slightly aware” (33%). The median pre-video six-item Spielberger State-Trait Anxiety Inventory Score was 12 (interquartile range 12–15). In the post-video questionnaire, most participants rated the video’s quality as “excellent” (73%) and would recommend it to others (73%). The majority of participants strongly agreed that they understood the AI presenter (60%), felt at ease with the presenter (60%), and trusted the presenter (60%). Four participants (22%) disagreed with the statement: “I was aware the presenter was computer generated.” Conclusions: Video-based education may provide information that patients find useful, particularly for physical maneuvers such as face-down positioning. The use of an AI-generated presenter was well-received by the majority of patients. Further research regarding the use of AI to develop educational video content is warranted.

Mindfulness-based therapy for insomnia in Black women: a pilot randomized controlled trial.

The purpose of the study was to evaluate the feasibility, acceptability, and preliminary efficacy of mindfulness-based therapy for insomnia (MBT-I) among Black women. The MBT-I group received weekly sessions that included mindfulness meditation and behavioral sleep strategies. The time and attention control group received lifestyle health education (HE) that included healthy eating, physical activity, and sleep hygiene. The primary outcome was post-intervention changes in insomnia severity score by the Insomnia Severity Index (ISI) at week 10. Other measures included: Pittsburgh Sleep Quality Index, Sleep Hygiene Practice, Spielberger State-Trait Anxiety Inventory (STAI), and Patient Health Questionnaire-9 (PHQ-9). Objective sleep was measured by Actiwatch™ at baseline and week 10. Thirty Black women completed the interventions with no attrition. About 97% of all participants attended 6-8 out of 8 sessions. The ISI scores were reduced at week 10 (MBT-I vs. HE: -7.67 vs. -7.22, p < .05). Anxiety and depression symptoms were significantly improved only in the MBT-I group. This is the first MBT-I for Black women with insomnia. Online MBT-I may be feasible and acceptable for Black women. The MBT-I and HE showed a clinically significant improvement in insomnia symptoms (ISI reduction > 7). MBT-I may be more effective in improving anxiety and depression symptoms than HE. Our findings encourage further study efforts with a longer follow-up and larger sample size to address sleep health disparities among Black women.

How Does the Anxiety of Primiparae Affect Their Readiness for Newborn Care? Ethnic Primiparous Experiences.

The study was conducted to investigate the relationship between pregnancy-related anxiety levels of primiparae living in an ethnic region and their readiness for postnatal hygienic care of newborns. The study conducted between February and May 2023 included 201 "18-40-year-old primiparae" who lived in an ethnic region and volunteered to participate in the study. The population of the study consisted of all pregnant women who presented to the Gynecology and Obstetrics Clinic, Pregnancy Outpatient Clinic of a city hospital. The "Pregnant Women Personality and Obstetric Characteristics Form," "Pregnant Women's Readiness for Newborn Hygienic Care Scale," and "Spielberg State-Trait Anxiety Inventory" were used as data collection tools. The mean age of the 201 primiparae participating in the study was 26.11 ± 3.05years. Although 71.1% of them felt confident about baby care before the baby was born, 95.5% needed help with baby care after birth. Their readiness for stress and newborn hygienic care was at a "medium" level. There was a statistically significant negative relationship between the scores they obtained from the Pregnant Women's Readiness for Newborn Hygienic Care Scale and Spielberg State-Trait Anxiety Inventory (p = 0.011; r = - 0.180). The participating primiparae experienced moderate levels of anxiety, and the increase in their anxiety levels negatively affected their readiness for the hygienic care of their newborn babies. Thus, when primiparae are provided with healthy newborn care, their anxiety levels should.