School of Nursing, Columbia University, 560W 168th Street, New York, NY, USA.
Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, USA.
Midwifery. 2024 Oct;137:104115. doi: 10.1016/j.midw.2024.104115. Epub 2024 Jul 24.
Birthing parents, defined as postpartum women and people with various gender identities who give birth, commonly experience challenging postpartum symptoms. However, many report feeling uninformed and unprepared to navigate their postpartum health.
To identify typologies of postpartum symptom informedness and preparedness using latent class analysis (LCA) and to examine the associated patient and healthcare characteristics.
We used survey data from a large, multi-method, longitudinal research project Postnatal Safety Learning Lab. Participants were recruited using convenience sampling and enrolled between November 2020 and June 2021. LCA was used to identify subgroups of birthing parents with different symptom informedness and preparedness using 10 binary variables (N = 148). Bivariate analysis was conducted to examine the association between characteristics and each typology.
The 3-class models had better fit indices and interpretability for both informedness and preparedness typologies: High, High-moderate, and Moderate-low. The sample characteristics were different by typologies. In the modified discrimination in medical settings assessment, we found higher discrimination scores in the moderate-low informedness and preparedness typologies. The moderate-low preparedness typology had a higher percentage of birthing parents who did not have private insurance, underwent cesarean section, and planned for formula or mixed infant feeding. The median PHQ-4 scores at 4 weeks postpartum were lower among those in high informedness and preparedness typologies.
In our sample, 18 to 21 % of birthing parents were in the moderate-low informedness or preparedness typologies. Future research and practice should consider providing tailored information and anticipatory guidance as a part of more equitable and supportive care.
分娩父母,定义为产后女性和各种性别认同的人,他们生育,通常会经历具有挑战性的产后症状。然而,许多人表示感到信息不足,无法为自己的产后健康状况做好准备。
使用潜在类别分析(LCA)确定产后症状知晓度和准备度的类型,并检查相关的患者和医疗保健特征。
我们使用了一个大型、多方法、纵向研究项目产后安全学习实验室的调查数据。参与者通过便利抽样招募,并于 2020 年 11 月至 2021 年 6 月期间入组。使用 10 个二项变量(N=148)使用潜在类别分析(LCA)确定具有不同症状知晓度和准备度的分娩父母亚组。使用双变量分析检查特征与每个类型之间的关联。
对于知晓度和准备度类型,3 类模型的拟合指数和可解释性都更好:高、高-中度和中度-低度。样本特征因类型而异。在修改后的医疗环境评估中,我们发现中度-低度知晓度和准备度类型的区分度评分更高。中度-低度准备度类型中,没有私人保险、接受剖腹产手术、计划配方或混合喂养的分娩父母比例更高。在产后 4 周时,高知晓度和准备度类型的 PHQ-4 中位数得分较低。
在我们的样本中,18%至 21%的分娩父母处于中度-低度知晓度或准备度类型。未来的研究和实践应该考虑提供定制化的信息和预期指导,作为更公平和支持性护理的一部分。