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COVID-19 大流行期间围产期女性样本中的应激源、应对方式和所需资源。

Stressors, coping, and resources needed during the COVID-19 pandemic in a sample of perinatal women.

机构信息

College of Nursing, Washington State University Health Sciences Spokane, 412 E. Spokane Falls Blvd, Spokane, WA, 99202-2131, USA.

Elson S. Floyd College of Medicine, Washington State University Health Sciences Spokane, Spokane, WA, USA.

出版信息

BMC Pregnancy Childbirth. 2021 Mar 1;21(1):171. doi: 10.1186/s12884-021-03665-0.

Abstract

BACKGROUND

Psychological stress and coping experienced during pregnancy can have important effects on maternal and infant health, which can also vary by race, ethnicity, and socioeconomic status. Therefore, we assessed stressors, coping behaviors, and resources needed in relation to the COVID-19 pandemic in a sample of 162 perinatal (125 pregnant and 37 postpartum) women in the United States.

METHODS

A mixed-methods study captured quantitative responses regarding stressors and coping, along with qualitative responses to open-ended questions regarding stress and resources needed during the COVID-19 pandemic. Logistic and linear regression models were used to analyze differences between pregnant and postpartum participants, as well as differences across key demographic variables. Qualitative content analysis was used to analyze open-ended questions.

RESULTS

During the COVID-pandemic, food scarcity and shelter-in-place restrictions made it difficult for pregnant women to find healthy foods. Participants also reported missing prenatal appointments, though many reported using telemedicine to obtain these services. Financial issues were prevalent in our sample and participants had difficulty obtaining childcare. After controlling for demographic variables, pregnant women were less likely to engage in healthy stress-coping behaviors than postpartum women. Lastly, we were able to detect signals of increased stressors induced by the COVID-19 pandemic, and less social support, in perinatal women of racial and ethnic minority, and lower-income status. Qualitative results support our survey findings as participants expressed concerns about their baby contracting COVID-19 while in the hospital, significant others missing the delivery or key obstetric appointments, and wanting support from friends, family, and birthing classes. Financial resources, COVID-19 information and research as it relates to maternal-infant health outcomes, access to safe healthcare, and access to baby supplies (formula, diapers, etc.) emerged as the primary resources needed by participants.

CONCLUSIONS

To better support perinatal women's mental health during the COVID-19 pandemic, healthcare providers should engage in conversations regarding access to resources needed to care for newborns, refer patients to counseling services (which can be delivered online/via telephone) and virtual support groups, and consistently screen pregnant women for stressors.

摘要

背景

孕妇在妊娠期间经历的心理压力和应对方式可能对母婴健康产生重要影响,而这种影响可能因种族、民族和社会经济地位的不同而有所差异。因此,我们评估了美国 162 名围产期(125 名孕妇和 37 名产后)女性在 COVID-19 大流行期间经历的应激源、应对行为和所需资源。

方法

一项混合方法研究采集了有关应激源和应对方式的定量反应,以及对 COVID-19 大流行期间压力和所需资源的开放式问题的定性反应。使用逻辑回归和线性回归模型分析了孕妇和产后参与者之间的差异,以及关键人口统计学变量之间的差异。使用定性内容分析方法分析开放式问题。

结果

在 COVID-19 大流行期间,食物短缺和就地避难限制使孕妇难以找到健康食品。参与者还报告错过了产前预约,但许多人报告使用远程医疗获得这些服务。在我们的样本中,财务问题普遍存在,参与者难以获得儿童保育服务。在控制了人口统计学变量后,孕妇比产后妇女更不可能采取健康的应对压力的行为。最后,我们能够检测到 COVID-19 大流行引起的应激源增加的信号,以及种族和民族少数群体和低收入群体的围产期妇女社会支持减少。定性结果支持我们的调查结果,因为参与者表示担心他们的婴儿在医院感染 COVID-19,重要的人错过分娩或关键的产科预约,以及希望得到朋友、家人和分娩课程的支持。财务资源、与母婴健康结果相关的 COVID-19 信息和研究、获得安全医疗保健的机会以及获得婴儿用品(配方奶粉、尿布等)是参与者所需的主要资源。

结论

为了在 COVID-19 大流行期间更好地支持围产期妇女的心理健康,医疗保健提供者应就获得照顾新生儿所需资源的问题进行沟通,将患者转介至咨询服务(可通过在线/电话提供)和虚拟支持小组,并定期对孕妇进行压力筛查。

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