Studies have shown that pregnant women do understand and value information of their unborn child. However, those providing health promotion services often focus on medical procedures and health education messages, ignoring the cultural, socio-economic and psychological dimensions that impact on women's health. This research aimed to look at a specific component of health promotion, i.e. health promotion messages shared with pregnant women attending Stellenbosch and Klapmuts Community Health Centre Antenatal Health Promotion Programme and their perceptions of how they apply messages in their daily lives.

published_or_final_version / Buddhist Studies / Doctoral / Doctor of Philosophy

Studies have shown that pregnant women do understand and value information of their unborn child. However, those providing health promotion services often focus on medical procedures and health education messages, ignoring the cultural, socio-economic and psychological dimensions that impact on women's health. This research aimed to look at a specific component of health promotion, i.e. health promotion messages shared with pregnant women attending Stellenbosch and Klapmuts Community Health Centre Antenatal Health Promotion Programme and their perceptions of how they apply messages in their daily lives.

This study examined effectiveness of heart rate variability (HRV) biofeedback-assisted stress management training in reducing anxiety and stress in pregnant women and the effect of maternal stress management skills practice on fetal heart rate measures in real time. Participants were seven working pregnant women who volunteered in response to recruitment announcements and invitations from cooperating midwives. Reported state and trait anxiety and pregnancy specific stress were measured during five 45- to 50-minute training sessions. Training included bibliotherapy, instruction in the use of emotion-focused stress management techniques, and HRV biofeedback. Subjects used portable biofeedback units for home practice and were encouraged to practice the skills for 20 minutes a day and for short periods of time during stressful life events. At the end of training, fetal heart rate was monitored and concurrent maternal HRV measures were recorded. Repeated measures ANOVA and paired samples t-test analysis of study data revealed no statistically significant reductions in state or trait anxiety measures or in pregnancy specific stress measures. Partial eta squared (n²) and Cohen's d calculations found small to medium effect sizes on the various test scales. Friedman's analysis of variance of biofeedback measures showed a statistically significant decrease in low HRV coherence scores (X2 = 10.53, p = .03) and medium HRV coherence scores (X2 = 11.58, p = .02) and a statistically significant increase in high HRV coherence scores (X2 = 18.16, p = .001). This change is an indication of improved autonomic function. Results of concurrent maternal and fetal HRV recordings were generally inconclusive. A qualitative discussion of individual subject results is included. During follow-up interviews five subjects reported that they felt they were better able to cope with stress at the end of the study than at the beginning, that they used the stress management skills during labor, and that they continue to practice the skills in their daily lives.

This study investigated the relationships among family environment, demographic measures, the decisions made by unintentionally pregnant adolescents regarding post-delivery plans (stay single, get married, adoption), and the certainty with which these decisions were made. The Information Sheet, Family Environment Scale (Moos & Moos, 1981), and Multiple Affect Adjective Check List (Zuckerman & Lubin, 1965a) were administered to 17 5 pregnant adolescents, ages 14 through 22, who intended to carry their pregnancies to term. Pearson product-moment correlations and multiple regression analyses were utilized to assess the relationships between family environment and certainty of decision and between family environment and negative affect. Greater uncertainty was associated with nonwhite racial status and living with both natural parents or mother only. Higher levels of negative affect were related to lower levels of perceived family cohesion, independence, expressiveness, and intellectualcultural orientation. The demographic variables of age, trimester of pregnancy, and family constellation were also found to be useful in predicting levels of negative affect. Subjects who were older, further along in their pregnancies, and living with both natural parents or mother only tended to report greater negative affect. Findings of greater uncertainty and negative affect associated with living with the natural mother are consistent with previous reports of disturbed mother-daughter relationships among this population. Discriminant analysis revealed that subjects choosing adoption were more likely to be older and to be white than those choosing to keep the child. They also tended to perceive higher levels of expressiveness and independence in their families. Comparisons between the present sample and "normal" families revealed differences which were statistically significant, but quite small in terms of raw score units. Indeed, these groups may be more similar than has often been assumed. The implications of these findings for the delivery of services and for future research efforts in this area were discussed. More intensive assessment of family functioning is needed. Based upon present results, further investigation of the family constellation variable is warranted.

published_or_final_version / abstract / Social Work and Social Administration / Doctoral / Doctor of Philosophy

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2017-11-09T11:21:00Z No. of bitstreams: 1 Magda Guerato Garbo.pdf: 1336074 bytes, checksum: 2ccd54bd1ec0e1d932bfd51f034eee59 (MD5) / Made available in DSpace on 2017-11-09T11:21:00Z (GMT). No. of bitstreams: 1 Magda Guerato Garbo.pdf: 1336074 bytes, checksum: 2ccd54bd1ec0e1d932bfd51f034eee59 (MD5) Previous issue date: 2017-09-26 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Teenage pregnancy has always existed, and will probably continue to exist. Adolescence is a moment of transformation, an explosion of hormones, an explosion of desires, longings, challenges, dreams, search for answers, rebellion, a moment of living emotions with great intensity. Also the moment where the discoveries of a new world are being delineated, generating fears, insecurities, challenges, need to love and be loved, need for belonging, the pursuit of adventures and to live each moment as if it were unique. We look at this mix of feelings, emotions, life conflicts, intergenerational differences, the teenager ’s misunderstanding, lack of goals and the thought that nothing will happen to them. In this sense, this dissertation studies the consequences of the free and uncompromised life, typical attitude of some adolescents that often result in pregnancy, and how they begin to administer their lives from there. Our view focuses on the theory of the Life Cycle developed by Cerveny (1994). The aim of the present study is to understand how the relationship in adolescence that results from adolescent pregnancy is built, for which we seek to investigate: whether teenage pregnancy is part of a family repetition, if the adolescents had a support network, the challe nges and difficulties of the postpartum couple, understand whether pregnancy can be a way to transition into adulthood for the teenage couple. IBGE studies show that sexual initiation has occurred early in pre-adolescence. We used semi-structured interviews. The interviews were transcribed and we analyzed the narratives. The results confirmed our initial hypotheses that an intergenerational view helps us to understand the repetition of adolescence pregnancy, we find the conjugality influenced by the typical emotional phase of the adolescent, and we were able to confirm that teenage pregnancy was a maturing factor for the young women intervie wed. Our experience has shown that a work of sensitization and information with families could help in the prevention of teenage pregnancy / A gravidez na adolescência sempre existiu, e provavelmente continuará existindo. A adolescência é um momento de transformações, explosão de hormônios, explosão de desejos, anseios, desafios, sonhos, busca de respostas, rebeldia, momento de viver emoções com grandes intensidades, mas também o momento onde as descobertas de um mundo novo estão sendo delineados, gerando medos, inseguranças, desafios, necessidade de amar e ser amado, necessidade de pertencimento, a busca de aventuras e de viver cada momento como se fosse único. Olhamos essa mistura de sentimentos, emoções, conflitos existenciais, diferenças intergeracionais, a sensação de incompreensão do adolescente, a falta de objetivos e o pensamento de que nada vai acontecer com ele. Neste sentido esta dissertação estuda as consequências da vida livre e descompromissada, atitude típica de alguns adolescentes, que muitas vezes resultam em gravidez, e como passam a administrar suas vidas a partir daí. Nosso olhar se foca na teoria do Ciclo Vital desenvolvida por Cerveny(1994). O objetivo do presente trabalho é entender como é construído o relacionamento na adolescência que resulta da gravidez adolescente, para isso buscamos investigar: se gravidez na adolescência faz parte de uma repetição familiar, se os adolescentes tiveram alguma rede de apoio, os desafios e dificuldades do casal pós-gravidez, compreender se a gravidez pode ser uma forma de passagem para a vida adulta para o casal adolescente. Estudos do IBGE mostram que a iniciação sexual tem acontecido no início da pré-adolescência. Utilizamos entrevista semiestruturada. As entrevistas foram transcritas e realizamos análise das narrativas. Os resultados confirmaram nossas hipóteses inicias de que uma visão intergeracional nos auxilia na compreensão da repetição da gravidez adolescente, encontramos a conjugalidade influenciada pela fase emocional típica do adolescente, e pudemos confirmar que a gravidez na adolescência foi um fator de amadurecimento para as jovens entrevistadas. Nossa experiência mostrou que um trabalho de sensibilização e informação com famílias poderiam auxiliar na prevenção da gravidez na adolescência

The general purpose of this research was to investigate physical activity levels as a correlate of selected aspects of psychological health among pregnant women. Specifically, the aims of the study were (1) to provide a cross-sectional description of changes in physical self-concept, mood, and perceived stress during pregnancy; (2) to evaluate physical activity patterns of pregnant women over time during pregnancy; and (3) to determine if there is a difference between physical activity and physical self-concept, mood, perceived stress and/or burnout symptoms during pregnancy. Participants were pregnant women from various antenatal clinics at King Edward Memorial Hospital. The women completed a questionnaire package containing questions on physical activity levels and measures of physical self-concept, social physique anxiety, perceived stress, mood and burnout symptoms. A series of ANOVAs was used to provide a descriptive profile of how these psychological variables change during the course of pregnancy. Significant time-related differences were found for the perceived health subscale of the PSDQ and the tension subscale for the BRUMS. Findings also suggested a significant association between physical activity, and physical self-perceptions, most importantly self-esteem. Higher levels of physical activity were also found to be closely related to positive mood states, lower levels of perceived stress and fewer burnout symptoms. No significant association was found between physical activity and social physique anxiety.

M.Cur. / The primigravida's experience of childbirth is influenced by the knowledge and expectations she has of childbirth. Her expectations of childbirth are based on the information she got from the antenatal clinic, the nursing staff, her mother, friends and family. The purpose of this research was to determine the knowledge and expectations the primigravida has of childbirth. An exploratory, descriptive design was used within the context of an academic hospital in Johannesburg. The survey method was used. The method of research firstly consisted of a literature study of the primigravida's knowledge and expectations of childbirth. This was done in order to put the problem in perspective and also to serve as a theoretical framework for the study. Secondly, a structured questionnaire was used to make a survey of the primigravida's knowledge and expectations of childbirth. The test sample comprised all white primigravidas between the ages of 15 and 39 years with a pregnancy duration of 37 weeks and more who visited the antenatal clinic of an academic hospital in Johannesburg. Over a period of 11 weeks, from 15 october to 30 December 1989, 29 primigravidas participated in this research project. The questionnaires were completed with their visit to the antenatal clinic and then returned to the clinic staff. Descriptive statistics and frequency tables were used to interpret the results of the research. From this research it is clear that the respondents had insufficient knowledge of childbirth and the handling of pain during childbirth. This insufficient knowledge can mainly be attributed to the poor attendance of antenatal . preparation classes, inadequate professional counselling and the mother of the primigravida as the primary source of information on childbirth. The respondents, however, had realistic expectations· with regard to their handling of labour, as well as of the role of the midwife and the doctor.

L’annonce des résultats du diagnostic d’une maladie grave est toujours un moment difficile à vivre pour le patient et, dans une moindre mesure, pour le médecin. Lorsqu’il s’agit du VIH/SIDA, la difficulté est d’autant plus importante que bien souvent, cette maladie véhicule honte et culpabilité avec risque de stigmatisation de la personne séropositive. Chez les femmes enceintes burundaises, cette situation est encore plus préoccupante. Des barrières liées au contexte socio-culturel les poussent à des conduites d’évitement du test du VIH, alors que le dépistage constitue une porte d’entrée pour les soins de prévention de la transmission du VIH de la mère à l’enfant. <p><p>L’objectif de cette thèse était de comprendre l’état psychologique des femmes enceintes lors du dépistage du VIH dans les services de Prévention de la Transmission Mère-Enfant (PTME) du VIH à Bujumbura. Cette compréhension permettrait d’optimiser la prise en charge psychologique de ces femmes enceintes au moment du dépistage du VIH et de mettre en place un accompagnement psychosocial dans leur milieu de vie. De façon spécifique, ce travail visait à :(1) analyser le contenu verbal des entretiens de conseils pré et post-test tels qu’ils sont faits dans les services de PTME, et de les comparer avec les normes proposées en la matière par l’OMS ;(2) évaluer l’anxiété chez les femmes enceintes à différents moments du dépistage du VIH; (3) analyser les raisons du refus du dépistage et du renoncement aux soins par les femmes enceintes séropositives à VIH. <p><p>La recherche a été réalisée principalement auprès des femmes enceintes rencontrées dans les services de consultation prénatale à Bujumbura, capitale du Burundi. Les outils de récolte des données étaient des entretiens conseillers-femmes enceintes au cours des activités de dépistage, les échelles d’évaluation de l’anxiété (HADS et STAI), des questionnaires de rétention/impact de l’information, des focus groups et un récit de vie. Ces outils nous ont permis de recueillir des données que nous avons traitées qualitativement par analyse de contenu et quantitativement par des analyses statistiques avec le logiciel SPSS.<p><p>Les résultats sont présentés dans cinq études. Notre première étude a montré que l’adaptation locale du schéma proposé par l’OMS pour les conseils pré et post-test en dépistage prénatal du VIH est une nécessité. Cela permettrait aux conseillers de mieux communiquer avec les femmes enceintes. Les trois autres études portant sur l’évaluation de l’anxiété ont montré que les besoins psychologiques des femmes enceintes au cours du dépistage du VIH devraient être reconnus et pris en compte. La détection de l’anxiété devrait être systématique afin de commencer une prise en charge psychologique dès le début du processus de dépistage et ainsi aller au devant des conduites d’évitement. La cinquième et dernière étude a montré que la stigmatisation et ses conséquences seraient à la base du refus du dépistage du VIH et du traitement en cas de séropositivité. Dès lors, le suivi médical doit être associé à un suivi psychologique pour réaliser une prise en charge intégrée des femmes enceintes dans les services de PTME. En continuité avec cette prise en charge au niveau des structures de santé, des stratégies d’accompagnement psychosocial adéquates devraient être planifiées au niveau des communautés. En outre, nous recommandons des études visant les problématiques psychologiques et sociales liées au VIH/SIDA chez la femme enceinte au Burundi. <p><p>Abstract:The announcement of the diagnosis of a serious illness is always a difficult experience for the patient and to a lesser extent, to the doctor. When it comes to HIV / AIDS, the challenge is even more important that in many cases, this disease vehicle with shame, guilt and risk of stigmatization of HIV-positive person. For pregnant women in Burundi, the situation is even more worrying. Socio-cultural barriers cause avoidance of HIV testing, while the screening is a gateway to care for the prevention of HIV transmission from mother to child.<p><p>The objective of this thesis was to understand the psychological state of pregnant women in HIV testing services in the Prevention of Mother to Child Transmission (PMTCT) of HIV in Bujumbura. This understanding would maximize the psychological care of pregnant women at the time of HIV testing and to develop psychosocial support in their living environment. Specifically, this work aimed to: (1) analyzing the verbal content of counseling interviews pre and post-test as they are made in PMTCT services, and compare them with the proposed standards in this area by WHO, (2) assess anxiety in pregnant women at different stages of HIV testing, (3) analyze the reasons for refusal of screening and seeking care for pregnant HIV-positive.<p><p>The research was conducted mainly among pregnant women encountered in antenatal clinics in Bujumbura, Burundi's capital. Tools for data collection were interviews between counselors and pregnant women during routine screening, rating scales of anxiety (HADS and STAI), questionnaires of retention / impact of information, focus groups and a life story. These tools have allowed us to collect data that we have treated qualitatively by content analysis and quantitatively by statistical analysis using SPSS.<p><p>The results are presented in five studies. Our first study showed that local adaptation of the scheme proposed by the WHO for counseling pre and post-test in antenatal HIV testing is a necessity. This would allow counselors to better communicate with pregnant women. The other three studies of anxiety assessment showed that the psychological needs of pregnant women in HIV testing should be recognized and taken into account. Anxiety screening should be systematic to begin psychological support early in the process of HIV testing. The fifth and final study showed that stigma and its consequences would be the causes for refusal of HIV testing and treatment in HIV positive cases. Therefore, medical care should be combined with psychological support to achieve an optimal management of pregnant women in PMTCT services. In continuity with this support in the structures of health, psychosocial support strategies should be planned at the community level. In addition, we recommend studies related to psychological and social issues of HIV / AIDS among pregnant women in Burundi.<p> / Doctorat en Sciences Psychologiques et de l'éducation / info:eu-repo/semantics/nonPublished