Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Centre for Investigation and Treatment of Respiratory Infections in Children and Adults, Westmead Campus, Westmead, New South Wales, Australia.
Aust Occup Ther J. 2023 Dec;70(6):730-744. doi: 10.1111/1440-1630.12899. Epub 2023 Jul 31.
Throughout the transition to motherhood, changes are experienced across a woman's physical, mental, social, and occupational self. Maternal chronic illness adds the complexity of increased healthcare needs and navigating a high-risk, medicalised pregnancy, birth, and post-natal period. Literature concerning motherhood transitions in chronic illness generally focusses on the mother's medical health and pregnancy outcomes; little is known about the impacts on women's occupations, balance, and quality of life. Understanding these issues may help support women in a more tailored and holistic way.
This scoping review aims to gather, analyse, and synthesise existing empirical research on occupational engagement and occupational balance as they impact on wellbeing and quality of life in women with a lifetime chronic illness before and during pregnancy and in early motherhood.
The review follows the nine-stage framework described in the Joanna Briggs Institute Manual for Evidence Synthesis (2020). Five databases were searched: Embase, Medline, PsycINFO, CINAHL, Scopus, and OT Seeker. Data were extracted and examined via content analysis, described in narrative synthesis, summarised into a conceptual framework, and tabulated.
A total of 8,655 papers were discovered on initial search. Following title and abstract screening, 220 full-text studies were assessed for eligibility, and 46 papers were finally included. Analysis generated four major themes: The Disrupted Transition Journey; Adaptation, Compromise and Choice; Outcomes; and Drawing on What's Available. The themes were conceptualised into a framework to explain how women sought to balance motherhood and illness-related occupations. Adequate access to information, social support, expert care, and financial resources improved both quality of life and healthcare compliance.
Findings of this scoping review deepen the understanding of occupational balance during the transition to motherhood in the context of lifetime chronic illness. Healthcare providers and supportive family and friends can use this knowledge to adapt their approach to assisting women with chronic illness on the motherhood journey. These findings may also inform further inquiry into the scope of occupational therapy practice with this population.
在向母亲身份转变的过程中，女性的身体、心理、社会和职业自我都会经历变化。慢性疾病母亲会增加医疗需求的复杂性，并需要应对高风险、医学化的妊娠、分娩和产后阶段。关于慢性疾病母亲身份转变的文献通常侧重于母亲的身体健康和妊娠结局；而对于女性职业、平衡和生活质量的影响则知之甚少。了解这些问题可能有助于以更有针对性和全面的方式支持女性。
本范围综述旨在收集、分析和综合现有关于职业参与和职业平衡的实证研究，这些研究对患有终生慢性疾病的女性在妊娠前和妊娠期间以及在早期母亲身份中对幸福感和生活质量的影响。
综述遵循乔安娜·布里格斯研究所证据综合手册（2020 年）中描述的九个阶段框架。五个数据库进行了搜索：Embase、Medline、PsycINFO、CINAHL、Scopus 和 OT Seeker。通过内容分析提取和检查数据，在叙述性综合中进行描述，总结为概念框架，并制成表格。
初步搜索共发现 8655 篇论文。经过标题和摘要筛选，评估了 220 篇全文研究的合格性，最终纳入了 46 篇论文。分析生成了四个主要主题：中断的过渡旅程；适应、妥协和选择；结果；和利用现有资源。这些主题被概念化为一个框架，解释了女性如何试图平衡母亲和与疾病相关的职业。充分获得信息、社会支持、专业护理和经济资源可以提高生活质量和医疗保健的依从性。
本范围综述加深了对患有终生慢性疾病的女性在向母亲身份转变过程中职业平衡的理解。医疗保健提供者和支持性的家庭和朋友可以利用这些知识来调整他们的方法，帮助患有慢性疾病的女性度过母亲之旅。这些发现也可能为进一步研究职业治疗在这一人群中的实践范围提供信息。
