Perceived social support and prenatal wellbeing; The mediating effects of loneliness and repetitive negative thinking on anxiety and depression during the COVID-19 pandemic

ProblemPrenatal depression and anxiety are linked to poor maternal and infant outcomes. We need to understand predictors of poor mental health to identify at-risk women, and targets for support.BackgroundPrevious research has demonstrated a relationship between low levels of perceived social support, and depression and anxiety in pregnant women. However, there is a lack of research into the factors that may mediate this relationship.AimAs social distancing measures (e.g., lockdown) are likely to negatively affect women’s perceived support in the prenatal period, we investigated the relationship between perceived social support and both anxiety and depression in UK-based pregnant women during the COVID-19 pandemic. Further, we examined two potential mediators that may contribute to psychological symptoms: repetitive negative thinking and loneliness.MethodsWe administered a battery of online measures to a sample of pregnant women (N = 205) between May-June 2020, during the first peak of the pandemic in the UK, when perceived social support was likely to be low.ResultsConsistent with predictions, perceived social support was significantly negatively related to depression, anxiety, loneliness and repetitive negative thinking. Furthermore, repetitive negative thinking and loneliness mediated the relationship between perceived social support and both depression and anxiety. Moreover, perceived social support and loneliness were associated with specific types of online behaviours.ConclusionsTaken together, the findings shed light on the processes through which social support may exert its effects on depression and anxiety and highlight potential therapeutic targets for interventions which aim to prevent and treat mood disorders in perinatal cohorts.     

The Psychosocial Context of Bereavement for Older Women Who Were Caregivers for a Spouse With Advanced Cancer

The psychosocial context of bereavement for older women who were caregivers for a spouse with advanced cancer was explored qualitatively with 13 older women. Interviews and diaries were analyzed using constant comparison. The psychosocial context emerged as the intrapersonal : exhaustion, loneliness, pain, and recovering physical health; the interpersonal: finding a new way through both supportive and difficult relationships; and the community/societal: a loss of identity, pressure to move on, financial concerns, and relying on formal supports. The psychosocial context of bereavement for older women who were caregivers is uniquely challenging and must be considered when providing care and programs of support.     

Life Satisfaction,Self-Esteem,and Loneliness Among LGB Adults and Heterosexual Adults in China

ABSTRACT

Low levels of life satisfaction have been linked to low self-esteem and loneliness, but this association has never been tested directly in LGB (lesbian/gay/bisexual) populations. We compared 275 Chinese LGB adults to 275 demographic-matched Chinese heterosexual controls on life satisfaction, self-esteem, and loneliness. LGB adults reported lower levels of self-esteem and higher levels of loneliness than heterosexuals, but similar levels of overall life satisfaction. Self-esteem partially mediated (but did not moderate) the relationship between loneliness and life satisfaction in both groups. Hierarchical regressions indicated that demographic variables, loneliness, and self-esteem can predict life satisfaction in both LGB and heterosexual adults, but explained more variance of life satisfaction in the LGB group. Thus self-esteem and loneliness play a more important role in life satisfaction for LGB rather than heterosexual Chinese adults.     

Journeys to Knua: displacement,return and translocality in Timor-Leste

ABSTRACT

Return journeys to ancestral lands are a central dimension that underscores contemporary ideas of origin, identity, kinship, custom, health and prosperity for the East Timorese. The material and social reproduction of knua – both in the sense of the ancestral territory and associated kin-based ritual community – is heavily reliant on ongoing place-based and translocal customary reciprocal exchanges. Based on multi-sited fieldwork, this article examines the return journeys to Lesuai, an ancestral settlement in the remote central southern highlands of Timor-Leste, which was abandoned during the Indonesian invasion and restored in the later years of occupation. Lesuai community believes the spirit realm exerts an overwhelming influence over their general well-being, compelling ‘house’ members to renew their connection with knua to maintain family ties and benefit from ancestral protection. Closer ethnographic attention reveals how the motivations, experiences and understandings of ‘return’ to origin places are highly personal, gendered and generational. Broadly, these return mobilities demonstrate the agency, adaptability and resilience of conflict-affected populations. Through prolonged displacement and resettlement, dispersed knua members have created new livelihoods, subjectivities and attachments across multiple places, which are reconfiguring family ties, connections to ancestral places, and how ritual obligations are fulfilled.     

“Ghosts From the Past”: The Re-Emergence of Internalized Religious Stigma Following Diagnosis of HIV Among Northern Irish Gay Men

ABSTRACT

This article explores how previous exposure to religious homonegativity features in the sense-making process following HIV diagnosis in a homogenous sample of six gay men living in Northern Ireland. Interpretive phenomenological analysis was used to identify two key overarching themes: Negotiating authenticity in unsafe space, which relates to the experience of negotiating same-sex attraction within religious environments, and Re-emergence of religious shame in diagnosis, which relates to the way in which the men made sense of diagnosis from the position of having been exposed to religious homonegativity earlier in their lives. Findings demonstrate how the men negotiated their sexual orientation within religious contexts and how a reconstruction of God was necessary to preserve an authentic sense of self. Despite reaching reconciliation, HIV was initially appraised within a retributive religious framework that served to temporarily reinforce previously learned shame-based models of understanding this aspect of the self.     

Gender differences in the experience of loneliness in U.S. Chinese older adults

This study aimed to explore the gender differences in the experiences of loneliness in the U.S. Chinese older population. The data were drawn from the PINE study, a population-based study of U.S. Chinese adults aged 60 years and older. The Revised–University of California at Los Angeles Loneliness Scale (R-UCLA) was used to measure loneliness. Overall, older Chinese women (28.3%) had a higher rate of loneliness than older men (23.3%, p < .001). In particular, women were more likely to sometimes or often experience a lack of companionship than men (22.9% vs. 17.3%, p < .001). Older women living with fewer people, with lower health status, poorer quality of life, and worsening health changes over the past year were more likely than men to experience any loneliness. This study indicates that gender differences exist in the prevalence, symptoms, and correlates of loneliness. Longitudinal studies should be undertaken to understand gender differences in risk factors and outcomes of loneliness.     

The Relationship Between Social Support, Loneliness, and Subjective Well-Being in a Spanish Sample from a Multidimensional Perspective

The aim of this study was to investigate the association between social support, loneliness and well-being from a multidimensional perspective for which two structural models are proposed. The study included 2042 participants from Malaga City (Spain) who were aged between 18 and 95 years. For the dimensions frequency of support and satisfaction with support, the results show that partner support, family support, and support from friends, respectively, significantly decrease romantic loneliness, family loneliness, and social loneliness. On the other hand, community support has little effect on reducing social loneliness. Of the three types of support analyzed (emotional, informational and instrumental), emotional support was significantly more effective in reducing loneliness (family, romantic and social) and increasing well-being. Loneliness partially acts as a mediator variable, although it is affected by social support, but at the same time decreases the effects of social support on subjective well-being. The three types of loneliness have a strong negative impact on subjective well-being. Implications of these results are discussed.     

Sexual health-related training of Canadian midwives and its association with practice outcome

BackgroundAlthough promoting sexual health should be an integral part of midwifery practice, little is known about midwives’ preparation to address their clients’ sexual health concerns.AimsTo assess the formal and self-directed training on sexual health topics relevant to midwifery practice of Canadian midwives as well as the association between training and various practice outcomes.MethodsForty midwives registered in the Province of Ontario, Canada completed an online survey assessing their formal and self-directed sexual health training, knowledge, comfort, and practice related to 10 sexual health issues.FindingsIn terms of formal training, three of the 10 topics were coved in-depth and seven were covered in general terms only or not at all. Participants had received an average of 26.0 hours of formal training related to sexual health. Almost all (90%) participants had engaged in self-directed learning on at least one topic. Participants had asked at least one client about only 5 of the 10 topics and been asked by at least one client about 4.5 of them. Participants who reported more extensive formal training had been asked about more sexual health topics by their clients. More self-directed learning was associated with more positive attitudes toward midwives’ role in addressing sexual health concerns, feeling more knowledgeable, and being asked about and asking about more sexual health topics.ConclusionThe midwives in this sample had limited training in some important sexual health issues relevant to midwifery practice. Likely as a result, they often did not address these issues in practice.     

Use of a Telephone Screener to Identify a Probability Sample of Gays,Lesbians, and Bisexuals

Abstract

Objectives. To examine public response to a telephone screener used to identify a probability sample of lesbians, gays, and bisexuals.

Methods.A telephone screener was designed to provide a representative sample of self-identified lesbians, gays, and bisexuals (LGB) in the 30 central cities of the 15 largest Consolidated Metropolitan Areas.

Results. Of 14,458 households contacted, 11,612 completed at least part of the survey. Of these, only 2.6% refused or responded “don't know” to the sexual orientation screener question. Respondents from the northeast were more reluctant to answer than respondents from the west.

Conclusions. The use of a screener on a national telephone survey to screen households for self-identified lesbian, gay, and bisexual adults was a successful way to generate a representative sample.     

Knowing your audience: Investigating stillbirth knowledge and perceptions in the general population to inform future public health campaigns

BackgroundThe prevalence of stillbirth in many high income countries like Australia has remained unchanged for over 30 years. The 2018 Australian government Senate Select Committee on Stillbirth Research and Education highlighted the need for a public health campaign to encourage public conversations and increase awareness. However, there is little evidence about the community’s knowledge and perceptions towards pregnancy and stillbirth, nor their aspirations for a public health campaign.AimsTo assess the general knowledge, perceptions, myths and attitudes towards stillbirth to inform future public health campaigns.MethodsAustralian participants (n = 344; predominately women n = 294 (85.5%)) were recruited via Facebook.com. They completed a cross-sectional online survey designed to assess their knowledge of pregnancy and stillbirth, with additional questions on socio-demographic characteristics.ResultsStillbirth knowledge and awareness of incidence was low in this sample. Prominent myths, such as baby runs out of room in the uterus (n = 112, 33%) and baby slows down when preparing for labour (n = 24, 27%) were endorsed. Only 25% (n = 85) knew the prevalence of stillbirth in Australia (six per day). Almost two-thirds (n = 205; 62%) agreed that there needs to be a public health campaign, however one in five (n = 65; 20%) were concerned that talking about stillbirth with pregnant women may cause them to worry.Discussion and conclusionOur findings reinforce the need for a targeted campaign, which educates the general population about the definition and prevalence of stillbirth, stillbirth risks and modifiable health behaviours. Appropriate messaging should target pregnant women during antenatal care as well as their support and care systems (family, friends, and care providers).     

Consequences of Overnight Work Travel for Personal Social Relations: Problems,Promises, and Further Repercussions

Abstract

The article uses survey data from Sweden to examine social consequences of the mobile society. Key questions tackled include the implications of overnight work travel for the travellers’ ability to cultivate locally based and long‐distance friendships and the potential of travel to provide a source of new acquaintances. Data analysis indicates that widening social networks and increasing opportunities to achieve co‐presence with long‐distance friends, as brought by mobility, represent significant consequences of overnight work travel from an individual’s standpoint. This experience was salient even among those respondents who travelled no more than occasionally, while only the most frequent travellers perceived their travel as something impeding with their chances of sustaining local social ties. While the benefits deriving from travel thus seem incontestable, it may therefore not be possible either to entirely discard the prevalent notion of mobile lifestyles as a factor undermining social cohesion and promoting isolation and loneliness.     

Older Women,Their Children,and Grandchildren: A Feminist Perspective on Family Relationships

SUMMARY

Using gerontological and feminist frameworks, we explored the relationships older women have with their children and grandchildren. In-depth, qualitative interviews were conducted with 34 women, ranging in age from 55 to 88. From our analyses of the women's perceptions of their family relationships, two themes were prevalent: the centrality of children and the peripherality of grandchildren in their everyday lives. The women had varying degrees of involvement with their children and grandchildren, and these relationships contributed to their sense of self and family. Their relationships were not stagnant, but were continually reshaped as both the women and their family members proceeded through the life course.     

Lockdown babies: Birth and new parenting experiences during the 2020 Covid-19 lockdown in South Africa,a cross-sectional study

BackgroundPerceived birth experiences of parents can have a lasting impact on children. We explored the birth and new parenting experiences of South African parents in 2020 during the Covid-19 lockdown.MethodsWe conducted a cross-sectional online survey with consenting parents of babies born in South Africa during 2020. Factors associated with negative birth emotions and probable depression were estimated using logistic regression.ResultsMost of the 520 respondents were females (n = 496, 95%) who gave birth at private hospitals (n = 426, 86%). Mothers reported having overall positive birth emotions (n = 399, 80%). Multivariable analysis showed that having a preterm baby (aOR 2.89; CI 1.51–5.53) and the mother self-reporting that Covid-19 affected her birth experience (aOR 4.25; CI 2.08–8.68) increased the odds of mothers reporting predominantly negative emotions about their birth. The mother having her preferred delivery method reduced the odds of having negative birth emotions (aOR 0.41; CI 0.25–0.66). Multivariable analysis showed that having predominantly negative emotions about the birth increased the odds of probable minor depression (aOR 3.60; CI 1.93–6.70). Being older reduced the odds of having probable minor depression (25?34 years aOR 0.36; CI 0.10–1.32; 35 years or older aOR 0.25; CI 0.06?0.91).ConclusionsLockdown exacerbated many birth and parenting challenges including mental health and health care access. However, overall experiences were positive and there was a strong sense of resilience amongst parents.     

Midwifery Student Evaluation of Practice: The MidSTEP tool — Perceptions of clinical learning experiences

BackgroundLittle emphasis has been given to the standardised measurement of midwifery students’ perceptions of their clinical learning experiences.AimTo develop a tool that evaluates students’ perceptions of their clinical learning experiences according to environment and impact of preceptors on professional development.MethodsA cross-sectional design was used. Tool development had three phases: item generation; expert review to assess clarity, apparent internal consistency and content validity; and psychometric testing. All Bachelor of Midwifery students at one university in Australia were invited to complete the online survey. Psychometric testing included dimensionality, internal consistency and test-retest reliability.ResultsA 74% (n = 279) response rate was achieved. Factor analysis revealed the Clinical Learning Environment Scale and Impact of the Midwifery Preceptor Scale accounting for 53.6% and 71.5% of variance respectively. Both scales were reliable (Cronbach’s alpha = .92 and .94) and valid. Overall, students positively rated the clinical learning environment and preceptors’ abilities to foster their sense of identity as a midwife. Students were less satisfied with preceptors’ understanding of the academic program.DiscussionThe new tool consists of two scales that reliably measure midwifery students’ perceptions of how the clinical learning environment develops their skills and reflects a midwifery philosophy. Preceptors had a positive influence on students’ skills and professional development.ConclusionsThe Midwifery Student Evaluation of Practice tool is the first valid and reliable measure of students’ perceptions of their clinical learning experiences. Students’ feedback provides valuable information to educators and preceptors on how best to optimise clinical learning.     

The experience of loneliness of battered old women

The present article is part of a larger study examining the life stories of battered old women (Buchbinder & Winterstein, 2003; Winterstein, 2002). It is based on long in-depth interviews with twenty-one aging women who lived with violence for a significant portion of their lives. While the larger study examines a broad range of their experience, including loneliness, regret, expectations of the future, and an attempt to build a monument to their suffering, the present study focuses on loneliness, which appears to constitute the central theme of their existential experience. Content analysis of the interviews shows that loneliness is experienced on all ecological levels, including the self, the family of origin, the violent partner, the children, and the extended family. It also permeates the social relationships of the women and becomes the predominant motif of their social interactions. The combination of loneliness, violence, and old age creates suffering that colors everyday life and becomes not only the constant background against which life unfolds but also the governing variable in their experience. Their cognitive maps, emotional world, and overall sense of self, as well as their sense of existential continuity in the world are all affected by loneliness.     

Women's knowledge of options for birth after Caesarean Section

ObjectiveIn Australia, the Caesarean Section rate has risen from 21.8% to 31.1% (2010) in a decade; in South Australia the rate was 32.2% in 2009. Caesarean Section is a life saving intervention in certain circumstances, but also a major surgical procedure with potential adverse effects on both mother and baby. The aim of this study was to ascertain the determinants of knowledge regarding options for subsequent birth in women who have experienced a previous Caesarean Section with a live baby.MethodA sample of 33 women in South Australia who had a previous Caesarean Section were surveyed to assess their awareness of birth options and their advantages versus disadvantages as well as the possible factors influencing their information gathering and decision-making on birth options for their subsequent pregnancy.FindingsMost women perceived Caesarean Section to be major surgery but 69.6% were not aware that babies might have problems with breastfeeding, 60.6% did not know the rarity of uterine rupture during labour and/or birth and 48.5% were not aware that a caesarean may involve any complications for the baby at or after birth.ConclusionWomen's knowledge deficits relating to risks and benefits of birth options after previous caesarean can constrain them as most women chose caesarean rather than normal birth in their subsequent pregnancy.     

An emerging model of maternity care: Smartphone,midwife, doctor?

BackgroundMobile technology in the form of the smartphone is widely used, particularly in pregnancy and they are an increasing and influential source of information.AimTo describe the diverse nature of pregnancy related applications (apps) for the smartphone and to flag that these apps can potentially affect maternity care and should be considered in future planning of care provision.MethodsThe 2 smartphone platforms, Apple and Android, were searched for pregnancy related apps and reviewed for their purpose and popularity.FindingsiTunes and Google Play returned 1059 and 497 pregnancy related apps respectively. Forty percent of the apps were informative, 13% interactive, 19% had features of a medical tool and 11% were social media apps. By far the most popular apps, calculated as the number of reviews multiplied by average reviewer rating, were those with interactive features.DiscussionThe popularity of pregnancy-related apps could indicate a shift towards patient empowerment within maternity care provision. The traditional model of ‘shared maternity care’ needs to accommodate electronic devices into its functioning. Reliance on healthcare professionals may be reduced by the availability of interactive and personalised information delivered via a smartphone. This combined with the fact that smartphones are widely used by many women of childbearing age, has the potential to modify maternity care and experiences of pregnancy. Therefore it is important that healthcare professionals and policy-makers are more aware of these new developments, which are likely to influence healthcare and alter health-seeking behaviour. In addition healthcare professionals need to consider whether to discuss the use of apps in pregnancy with the women in their care.     

The self reported confidence of newly graduated midwives before and after their first year of practice in Sydney, Australia

BackgroundGraduates from a new, 3-year Bachelor of Midwifery program joined those educated through the 1 year, postgraduate route (for those already qualified as nurses) for the first time in New South Wales (NSW) Australia in 2007. Many hospitals offer transition support programs for new graduates during their first year of practice though there is little evidence available to inform these programs.ObjectivesTo establish the new midwife's confidence in working to the 14 “National Competency Standards for the Midwife”¹ and the International Confederation of Midwives (ICM) Definition of a Midwife and to explore whether the new midwife's confidence changed over the new graduate year. In particular the study set out to determine whether there were any differences in the confidence of new graduates from undergraduate or postgraduate programs.DesignPre and post survey with comparisons longitudinally and within undergraduate and postgraduate cohorts.SettingsThree Area Health Services in Sydney and surrounding areas, Australia.ParticipantsA convenience sample of all new graduate midwives employed in the three Area Health Services in the early months of 2008.MethodsNew graduate midwives rated their level of confidence (1–10) in working to the 14 National Competency Standards for the Midwife and the ICM Definition of a Midwife during their first weeks of employment and after the completion of their first year of practice.ResultsMidwives prepared through the undergraduate and postgraduate routes commenced their first year of practice with similar levels of confidence. The confidence of these midwives increased modestly over the first year of practice. Those from postgraduate programs were significantly more confident than those from undergraduate programs on four competencies after the first year of practice. Participant's self reported confidence in working to the ICM Definition of a Midwife was low.ConclusionsOur profession and community need strong, confident midwives and it is in all our interests to look to ways we can best achieve this. While the findings of this study should be treated with caution, this study suggests that there is room for improvement in the way we support newly graduated midwives to build their confidence over their first year of practice. Further research is needed to identify the needs of newly graduated midwives and how best we can support them to develop as strong and confident practitioners through their first year of practice.     

Internalized Homonegativity,Sense of Belonging,and Depressive Symptoms Among Australian Gay Men

Internalized homonegativity has been directly linked to depression among gay men. The aim of the study was to test whether internalized homonegativity is indirectly related to depressive symptoms via a sense of belonging to the broad gay community, gay groups, gay friends, and the general community. A sample of 246 self-identified Australian gay men, aged 18–82 years, completed the Internalized Homophobia Scale, the Psychological subscale of the Sense of Belonging Instrument, the Sense of Belonging Within Gay Communities Scale, and the Centre for Epidemiological Studies Depression Scale. Results indicated that the final model was an excellent fit to the data. Internalized homonegativity was indirectly related to depressive symptoms via sense of belonging to gay groups, with gay friends, and to the general community. Interventions aimed at reducing internalized homonegativity among gay men have the potential to enhance sense of belonging and, in turn, decrease depressive symptoms.