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刚果民主共和国南基伍省的孕产妇心理困扰及其对儿童喂养方式的感知影响

Maternal Psychological Distress and Perceived Impact on Child Feeding Practices in South Kivu, DR Congo.

作者信息

Emerson Jillian A, Tol Wietse, Caulfield Laura E, Doocy Shannon

机构信息

1 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

2 Peter C. Alderman Foundation, New York, NY, USA.

出版信息

Food Nutr Bull. 2017 Sep;38(3):319-337. doi: 10.1177/0379572117714385. Epub 2017 Jun 19.

Abstract

BACKGROUND

Maternal mental health problems are associated with poor child growth and suboptimal child feeding practices, yet little qualitative research has been conducted to understand mothers' perceptions about how maternal mental ill health and child nutrition are related.

OBJECTIVE

The objective of the study was to understand maternal perceptions on sources of psychological distress, and how distress impacts functioning, especially related to childcare and feeding practices among mothers of young children in South Kivu, DR Congo.

METHODS

Mothers of young children who were participating in a larger study were eligible. Using purposive sampling, participants were selected if they had high or low levels of psychological distress, based on their mean item score on measures of symptoms of depression, anxiety, and post-traumatic stress. Twenty in-depth interviews and 2 focus group discussions were conducted, with a total of 35 mothers. Key informant interviews were conducted with 5 local health workers. Audio recordings were transcribed and coded, and the analysis was guided by Grounded Theory methodology.

RESULTS

Major themes to emerge were that women's husbands were a significant source of distress, with husbands' infidelity, abandonment, and lack of financial support mentioned by participants. Psychological distress resulted in appetite and weight loss, and poor nutritional status made it difficult to breastfeed. Participants perceived psychological distress caused milk insufficiency and difficulty breastfeeding.

CONCLUSION

Mothers experiencing psychological distress may need greater support for maternal nutrition and breastfeeding, and engaging fathers through responsible parenting interventions may reduce psychological distress and have a positive impact on child health.

摘要

背景

孕产妇心理健康问题与儿童生长发育不良及不恰当的儿童喂养方式有关,但针对母亲如何看待孕产妇心理健康与儿童营养之间关系的定性研究却很少。

目的

本研究的目的是了解母亲对心理困扰来源的看法,以及这种困扰如何影响其功能,特别是对刚果民主共和国南基伍地区幼儿母亲的育儿和喂养方式的影响。

方法

参与一项更大规模研究的幼儿母亲符合条件。采用目的抽样法,根据抑郁、焦虑和创伤后应激症状测量指标的平均项目得分,选择心理困扰程度高或低的参与者。共进行了20次深入访谈和2次焦点小组讨论,共有35位母亲参与。对5名当地卫生工作者进行了关键 informant 访谈。对录音进行转录和编码,并采用扎根理论方法进行分析。

结果

出现的主要主题是,女性的丈夫是困扰的重要来源,参与者提到了丈夫的不忠、遗弃和缺乏经济支持。心理困扰导致食欲减退和体重下降,而营养不良状况使母乳喂养变得困难。参与者认为心理困扰导致乳汁不足和母乳喂养困难。

结论

经历心理困扰的母亲可能需要在孕产妇营养和母乳喂养方面获得更多支持,通过负责任的育儿干预措施让父亲参与进来,可能会减少心理困扰,并对儿童健康产生积极影响。

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