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孟加拉国城市贫民窟中曾有堕胎史的妇女的抑郁症状和焦虑。

Depressive symptoms and anxiety among women with a history of abortion living in urban slums of Bangladesh.

机构信息

Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212, Mohakhali, Bangladesh.

Reproductive Health Services Training and Education Program (RHSTEP), Mirpur, 1216, Dhaka, Bangladesh.

出版信息

BMC Psychol. 2023 Jul 4;11(1):197. doi: 10.1186/s40359-023-01224-0.

Abstract

BACKGROUND

Globally, major emphasis has been placed on understanding the physiological consequences of losing a pregnancy. However, its mental health impact on socially disadvantaged women remains unexplored. To further inform the field the present study investigated the prevalence and factors associated with the development of depressive symptoms and anxiety among women with a history of spontaneous abortion living in the urban slums of Dhaka, Bangladesh.

METHODS

Information was obtained from 240 women who experienced a spontaneous abortion from July 2020 to December 2021. It was obtained through the urban health and demographic surveillance system (UHDSS) survey. Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9) were used to measure mental health symptoms. Bivariate and multivariate linear regression analyses were performed to assess the associated factors with the mental health outcomes.

RESULTS

Of the 240 women, majority (77.50%) of the women experienced mild to severe depressive symptoms and more than half (58.75%) of the respondants experienced mild to severe anxiety, within one and half years of experiencing spontaneous abortion. A higher level of education and being employed were protective factors for anxiety and depressive symptoms, respectively. However, women with higher sexual and reproductive health rights (SRHR) knowledge had significantly increased anxiety and depressive symptoms. In contrast, receiving post-abortion care (PAC) was associated with decreased anxiety and depressive symptoms.

CONCLUSION

The findings indicate that ensuring access to affordable PAC services and integrating mental health services into the standard PAC service package is crucial. This study also emphasizes the importance of providing education for women living in urban slums and encouraging them to participate in economic activities.

摘要

背景

在全球范围内,人们主要强调了解怀孕失败的生理后果。然而,其对社会弱势群体女性的心理健康影响仍未得到探索。为了进一步为该领域提供信息,本研究调查了孟加拉国达卡市贫民窟中经历过自然流产的妇女中,抑郁症状和焦虑症状的发展与哪些因素相关。

方法

本研究于 2020 年 7 月至 2021 年 12 月期间,通过城市健康和人口监测系统(UHDSS)调查,从 240 名经历过自然流产的妇女那里获得了信息。使用广泛性焦虑障碍量表(GAD-7)和患者健康问卷(PHQ-9)来衡量心理健康症状。进行了双变量和多变量线性回归分析,以评估与心理健康结果相关的因素。

结果

在 240 名妇女中,大多数(77.50%)妇女在经历自然流产后 1.5 年内经历了轻度至重度抑郁症状,超过一半(58.75%)的妇女经历了轻度至重度焦虑。较高的教育水平和就业是焦虑和抑郁症状的保护因素,而较高的性与生殖健康权利(SRHR)知识则与焦虑和抑郁症状的增加显著相关。相比之下,接受流产后护理(PAC)与焦虑和抑郁症状的减少相关。

结论

这些发现表明,确保获得负担得起的 PAC 服务,并将心理健康服务纳入标准的 PAC 服务套餐中至关重要。本研究还强调了为居住在城市贫民窟的妇女提供教育以及鼓励她们参与经济活动的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d7f/10318742/0d05e57c3ee4/40359_2023_1224_Fig1_HTML.jpg

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