BackgroundThe neonatal intensive care unit causes maternal stress and postpartum depressive sympt... more BackgroundThe neonatal intensive care unit causes maternal stress and postpartum depressive symptoms in preterm and term mothers. Personal resources like maternal resilience are usually not considered in counselling these women.ObjectiveThis study aims to evaluate the resilience and differences in postpartum depression after admission of newborns at the neonatal intensive care unit.MethodsThis prospective pilot study was conducted in a single teaching hospital in Austria from December 2016 until December 2018. Sixty women completed two internationally validated questionnaires, the Edinburgh Postnatal Depression Scale (EPDS) to evaluate depressive symptoms and the Resilience Scale RS-13 to measure maternal resilience during the postpartum period (3 to 10 days postpartum). Additionally, women answered two open questions about burdens and relief.ResultsTwenty women (34%) showed lower resilience scores. The 39 high-resilient women (66%) showed significantly less depression (p = 0.005). ...
Purpose Preeclampsia (PE) is a serious life event that can change women's psychological profile. ... more Purpose Preeclampsia (PE) is a serious life event that can change women's psychological profile. The aim of this study was to evaluate the physical and mental healthrelated quality of life (HR-QoL) in women after PE and the impact of contributing factors. Methods Ninety-five women who had suffered from PE answered the Short-Form-12 Health Survey on general state of health. Comparison was made with the reference values and among the study cohorts, namely mild (14.7 %), severe (74.7 %) and superimposed PE (10.5 %). Medical parameters were evaluated as additional factors, and age served as covariate. Results Quality of mental life was significantly worse in all patients (p \ 0.01), especially in those after severe PE (p \ 0.01) compared to the reference range. These women demonstrated significantly worse results than those affected by the mild form (p = 0.03). Women who had had superimposed PE were neither physically nor mentally impaired compared to the standard population values (p = 0.94 and p = 0.90, respectively). After controlling for medical parameters and age, differences remained statistically significant. Multiparous women scored significantly worse on the mental scale than primiparous (p = 0.02), and pregnant women scored significantly worse than non-pregnant women on the physical level (p = 0.04). Conclusions This study shows that women who have suffered from severe PE are substantially reduced in their mental quality of life. An extensive medical care including HR-QoL parameters might improve pregnancy outcome.
Etwa 30-50% der Patientinnen und Patienten entwickeln im Lauf einer Krebserkrankung psychische Sy... more Etwa 30-50% der Patientinnen und Patienten entwickeln im Lauf einer Krebserkrankung psychische Symptome. Erst bei länger andauernden emotionalen oder kognitiven Beeinträchtigungen können sich psychische Störungen entwickeln, die nach den Kriterien der internationalen Klassifikation psychischer Störungen diagnostiziert werden können. Etwa 5–10% aller onkologischen Patientinnen gehören einer psychosozialen Risikogruppe an und benötigen neben der medizinischen Versorgung eine professionelle psychologische Behandlung. Die Früherkennung der Behandlungsbedürftigkeit wäre wünschenswert, um komplizierte Krankheitsverarbeitungsverläufe zu verhindern. Ärztliche Aufklärung über Erkrankung und Behandlung ist ein schrittweiser Prozess. Grundsätzlich sollte die Aufklärung dem “Prinzip Hoffnung„ folgen und die Abwehr- und Verarbeitungsmöglichkeiten der Patientin berücksichtigen. Wenn deutlich wird, dass die Patientin nicht mehr aufnahmefähig ist, sollte das Aufklärungsgespräch zu einem späteren Zeitpunkt wieder aufgenommen werden. Krisensituationen treten vorwiegend nach Diagnosemitteilung oder Mitteilung eines Rezidivs auf. Eine Krisenintervention umfasst Gesprächs- und Beziehungsangebot herstellen, Krisenmanagment in und Krisenmanagement nach der Akutsituation. Angehörige sind durch die Krankheit selbst mitbetroffen und durchlaufen ähnlich wie Krebspatienten verschiedene Verarbeitungsphasen. Die Krebsdiagnose kann zum funktionalen Zusammenbruch der Familie führen, v. a., wenn die Patientin ihre Familien- und Haushaltspflichten nicht mehr erfüllen kann. Bezugspersonen sollten daher möglichst früh in die Aufklärung und Therapieplanung miteinbezogen werden, sofern dies dem Wunsch der Patientin entspricht.
Einleitung/Zielsetzung: In den letzten Jahrzehnten kam es in Osterreich sowie weltweit zu einem d... more Einleitung/Zielsetzung: In den letzten Jahrzehnten kam es in Osterreich sowie weltweit zu einem deutlichen Anstieg der Kaiserschnittrate. Unter bonding bzw. early skin-to-skin contact (SSC) versteht man die Phase der Bindungsentwicklung zwischen Mutter und Kind, welche idealerweise gleich nach der Geburt beginnt. Mogliche Bedenken, das bonding auch nach dem Kaiserschnitt im Operationssaal einzufuhren, sind neben Organisatorischen (Anderung des etablierten Ablaufes) auch das veranderte Ambiente im Operationssaal (Temperatur, Helligkeit, Larm). Im Rahmen dieser Studie sollten Effekte des fruhen SSC nach einer Schnittentbindung auf die Mutter und das Neugeborene evaluiert werden. Material & Methoden: Im Rahmen einer prospektiven randomisierten Pilotstudie wurden 35 Frauen eingeschlossen. Randomisiert wurde in eine ‚early bonding‘ Gruppe (n = 17) und eine ‚late bonding‘ Gruppe (n = 18). Evaluiert wurden die kindliche Adaptation, die Ausschuttung von Oxytocin, Cortisol und Chromogranin A bei der Mutter und die Ausschuttung von Cortisol beim Kind, sowie die mutterliche Schmerzverarbeitung und psychische Situation (Edinburgh Postnatal Depression Scale und Postpartum Bonding Questionnaire). Ergebnisse: Die kindliche Adaptation und Temperaturregulation bewegten sich in beiden Gruppen im Normbereich. Die Ausschuttung von Oxytocin, Cortisol und Chromogranin A bei den Muttern war vergleichbar und es gab keinen Unterschied hinsichtlich der mutterlichen Schmerzverarbeitung in den jeweiligen Gruppen. Im Beziehungsverhalten und der Befindlichkeit zwischen den beiden Gruppen konnte kein signifikanter Unterschied festgestellt werden. Zusammenfassung: Sectiobonding kann – falls von den Eltern gewunscht – angeboten werden.
Background/Objective: To examine maternal physical and mental health-related quality of life (HRQ... more Background/Objective: To examine maternal physical and mental health-related quality of life (HRQoL) and depression after early and late preterm and term births in the early postpartum period.Method: In a prospective pilot study, three groups of women whose newborns had to be treated in the neonatal ward during the immediate postpartum period were established and compared with each other: 20 women with extremely to very preterm birth, 20 with moderate to late preterm birth and 20 women with term birth. All participants completed the Short Form-12 Health Survey (SF-12) to measure HRQoL, and the Edinburgh Postnatal Depression Scale (EPDS) to detect depressive symptoms combined with independently developed questions to evaluate anxiety and psychological distress.Results: Maternal psychological HRQoL was significantly worse in the very preterm birth group compared to moderate to late preterm birth (p < 0.001) and full-term birth groups (p = 0.004). There were no differences between t...
International Journal of Environmental Research and Public Health
The objective of this study was to assess associations between maternal health-related quality of... more The objective of this study was to assess associations between maternal health-related quality of life (HRQoL) in early, mid-, and late pregnancy and birth outcomes and to assess the differences in birth outcomes between subgroups of mothers reporting relatively “low” and relatively “high” HRQoL. HRQoL was measured by the 12-item Short Form Health Survey in early (n = 6334), mid- (n = 6204), and late pregnancy (n = 6048) in a population-based mother and child cohort; Physical and Mental Component Summary (PCS/MCS) scores were calculated. Birth outcomes included pregnancy duration, preterm birth, birth weight, low birth weight, and small for gestational age. We defined very high PCS/MCS scores as the >90th percentile and very low score as the <10th percentile. The lower PCS score in late pregnancy was significantly associated with a higher chance of having small-for-gestational-age birth (per 10 points: OR = 1.20, 95% CI: 1.08, 1.33, p value = 0.0006). In early, mid-, and late ...
International Journal of Environmental Research and Public Health
Having good health-related quality of life (HRQoL) is essential, particularly for women after chi... more Having good health-related quality of life (HRQoL) is essential, particularly for women after childbirth. However, little is known about its determinants. We aimed to identify the determinants of HRQoL after childbirth in a large community sample in the Netherlands. We have included 4312 women in the present study. HRQOL was assessed by a 12-Item Short Form Survey (SF-12) at around two months after childbirth; Physical and Mental Component Summary scores were calculated. Information on 27 potential determinants of HRQoL was collected through questionnaires and medical records. Multivariate linear regression models were applied to assess significant determinants of physical and mental HRQoL. Our study showed that older maternal age, shorter time since childbirth, elective/emergency cesarean delivery, loss of energy, maternal psychopathology, and the hospital admission of the infant were significantly associated with worse physical HRQoL (p < 0.05); older maternal age, non-western ...
The objective of this study was to identify distinct trajectories and their predictors of health-... more The objective of this study was to identify distinct trajectories and their predictors of health-related quality of life (HRQOL) of women during pregnancy in a prospective mother and child cohort. Analyses were based on 3936 Dutch pregnant women in Rotterdam area, the Netherlands. Information on potential predictors was collected in early pregnancy by questionnaire. Latent Class Mixture Modelling and Multinomial Logistic Regression were applied to assess the trajectory and predictors of HRQOL during pregnancy. HRQOL was measured by SF-12 in early, mid- and late pregnancy; physical and mental component summary (PCS-12/MCS-12) scores were calculated. Four physical HRQOL trajectories were identified: a healthy trajectory ('healthy') in 63.3%, consistently low ('vulnerable') in 10.8%; a small increase ('recovering') in 12.8% and a large decrease ('at risk') in 13.1%. Three mental HRQOL trajectories were identified: a healthy trajectory ('healthy')...
Early bonding by skin-to-skin contact (SSC) has been demonstrated to be beneficial for mothers an... more Early bonding by skin-to-skin contact (SSC) has been demonstrated to be beneficial for mothers and newborns following vaginal delivery. The aim of this study was to investigate the impact of intraoperative bonding (early SSC) after cesarean section on neonatal adaptation, maternal pain and stress response. This prospective, randomized-controlled pilot study was performed at a single academic tertiary hospital (Department of Obstetrics and Gynecology, Medical University of Graz, Austria) between September 2013 and January 2014. Women were randomly assigned to intraoperative ("early") SCC (n = 17) versus postoperative ("late") SCC (n = 18). Main variables investigated were neonatal transition (Apgar score, arterial oxygen saturation, heart rate and temperature), maternal pain perception and both maternal and neonatal stress response by measuring the stress biomarkers salivary free cortisol and salivary alpha amylase. There was no evidence for differences in paramet...
The objective of this study was to evaluate the independent associations between nausea, vomiting... more The objective of this study was to evaluate the independent associations between nausea, vomiting, fatigue and health-related quality of life of women in early pregnancy in the Generation R study, which is a prospective mother and child cohort. Analyses were based on 5079 women in early pregnancy in the Rotterdam area, the Netherlands. The information on nausea, vomiting and fatigue in the previous three months was measured in the questionnaire at enrollment, as well as potential confounders (i.e., maternal/gestational age, ethnic background, educational level, parity, marital status, body mass index, tobacco and alcohol use, chronic/infectious conditions, uro-genital conditions/symptoms, sleep quality, headache, anxiety, and depression). Health-related quality of life was assessed by the 12item Short Form Health Survey and physical and mental component summary scores were calculated. Multivariate regression models were performed to evaluate the independent associations of the presence of nausea, vomiting and fatigue with health-related quality of life, adjusting for potential confounders. 33.6% of women experienced daily presence of nausea, 9.6% for vomiting and 44.4% for fatigue. Comparing with women who never reported nausea, vomiting and fatigue, women with daily presence of at least one of these symptoms had significantly lower scores of physical component summary and mental component summary, after adjusting for potential confounders. Our study shows how common nausea, vomiting and fatigue are among women in early pregnancy and how much each of these symptoms negatively impact on health-related quality of life. We call for awareness of this issue from health care professionals, pregnant women and their families.
Etwa 30-50% der Patientinnen und Patienten entwickeln im Lauf einer Krebserkrankung psychische Sy... more Etwa 30-50% der Patientinnen und Patienten entwickeln im Lauf einer Krebserkrankung psychische Symptome. Erst bei länger andauernden emotionalen oder kognitiven Beeinträchtigungen können sich psychische Störungen entwickeln, die nach den Kriterien der internationalen Klassifikation psychischer Störungen diagnostiziert werden können. Etwa 5–10% aller onkologischen Patientinnen gehören einer psychosozialen Risikogruppe an und benötigen neben der medizinischen Versorgung eine professionelle psychologische Behandlung. Die Früherkennung der Behandlungsbedürftigkeit wäre wünschenswert, um komplizierte Krankheitsverarbeitungsverläufe zu verhindern. Ärztliche Aufklärung über Erkrankung und Behandlung ist ein schrittweiser Prozess. Grundsätzlich sollte die Aufklärung dem “Prinzip Hoffnung„ folgen und die Abwehr- und Verarbeitungsmöglichkeiten der Patientin berücksichtigen. Wenn deutlich wird, dass die Patientin nicht mehr aufnahmefähig ist, sollte das Aufklärungsgespräch zu einem späteren Zeitpunkt wieder aufgenommen werden. Krisensituationen treten vorwiegend nach Diagnosemitteilung oder Mitteilung eines Rezidivs auf. Eine Krisenintervention umfasst Gesprächs- und Beziehungsangebot herstellen, Krisenmanagment in und Krisenmanagement nach der Akutsituation. Angehörige sind durch die Krankheit selbst mitbetroffen und durchlaufen ähnlich wie Krebspatienten verschiedene Verarbeitungsphasen. Die Krebsdiagnose kann zum funktionalen Zusammenbruch der Familie führen, v. a., wenn die Patientin ihre Familien- und Haushaltspflichten nicht mehr erfüllen kann. Bezugspersonen sollten daher möglichst früh in die Aufklärung und Therapieplanung miteinbezogen werden, sofern dies dem Wunsch der Patientin entspricht.
BackgroundThe neonatal intensive care unit causes maternal stress and postpartum depressive sympt... more BackgroundThe neonatal intensive care unit causes maternal stress and postpartum depressive symptoms in preterm and term mothers. Personal resources like maternal resilience are usually not considered in counselling these women.ObjectiveThis study aims to evaluate the resilience and differences in postpartum depression after admission of newborns at the neonatal intensive care unit.MethodsThis prospective pilot study was conducted in a single teaching hospital in Austria from December 2016 until December 2018. Sixty women completed two internationally validated questionnaires, the Edinburgh Postnatal Depression Scale (EPDS) to evaluate depressive symptoms and the Resilience Scale RS-13 to measure maternal resilience during the postpartum period (3 to 10 days postpartum). Additionally, women answered two open questions about burdens and relief.ResultsTwenty women (34%) showed lower resilience scores. The 39 high-resilient women (66%) showed significantly less depression (p = 0.005). ...
Purpose Preeclampsia (PE) is a serious life event that can change women's psychological profile. ... more Purpose Preeclampsia (PE) is a serious life event that can change women's psychological profile. The aim of this study was to evaluate the physical and mental healthrelated quality of life (HR-QoL) in women after PE and the impact of contributing factors. Methods Ninety-five women who had suffered from PE answered the Short-Form-12 Health Survey on general state of health. Comparison was made with the reference values and among the study cohorts, namely mild (14.7 %), severe (74.7 %) and superimposed PE (10.5 %). Medical parameters were evaluated as additional factors, and age served as covariate. Results Quality of mental life was significantly worse in all patients (p \ 0.01), especially in those after severe PE (p \ 0.01) compared to the reference range. These women demonstrated significantly worse results than those affected by the mild form (p = 0.03). Women who had had superimposed PE were neither physically nor mentally impaired compared to the standard population values (p = 0.94 and p = 0.90, respectively). After controlling for medical parameters and age, differences remained statistically significant. Multiparous women scored significantly worse on the mental scale than primiparous (p = 0.02), and pregnant women scored significantly worse than non-pregnant women on the physical level (p = 0.04). Conclusions This study shows that women who have suffered from severe PE are substantially reduced in their mental quality of life. An extensive medical care including HR-QoL parameters might improve pregnancy outcome.
Etwa 30-50% der Patientinnen und Patienten entwickeln im Lauf einer Krebserkrankung psychische Sy... more Etwa 30-50% der Patientinnen und Patienten entwickeln im Lauf einer Krebserkrankung psychische Symptome. Erst bei länger andauernden emotionalen oder kognitiven Beeinträchtigungen können sich psychische Störungen entwickeln, die nach den Kriterien der internationalen Klassifikation psychischer Störungen diagnostiziert werden können. Etwa 5–10% aller onkologischen Patientinnen gehören einer psychosozialen Risikogruppe an und benötigen neben der medizinischen Versorgung eine professionelle psychologische Behandlung. Die Früherkennung der Behandlungsbedürftigkeit wäre wünschenswert, um komplizierte Krankheitsverarbeitungsverläufe zu verhindern. Ärztliche Aufklärung über Erkrankung und Behandlung ist ein schrittweiser Prozess. Grundsätzlich sollte die Aufklärung dem “Prinzip Hoffnung„ folgen und die Abwehr- und Verarbeitungsmöglichkeiten der Patientin berücksichtigen. Wenn deutlich wird, dass die Patientin nicht mehr aufnahmefähig ist, sollte das Aufklärungsgespräch zu einem späteren Zeitpunkt wieder aufgenommen werden. Krisensituationen treten vorwiegend nach Diagnosemitteilung oder Mitteilung eines Rezidivs auf. Eine Krisenintervention umfasst Gesprächs- und Beziehungsangebot herstellen, Krisenmanagment in und Krisenmanagement nach der Akutsituation. Angehörige sind durch die Krankheit selbst mitbetroffen und durchlaufen ähnlich wie Krebspatienten verschiedene Verarbeitungsphasen. Die Krebsdiagnose kann zum funktionalen Zusammenbruch der Familie führen, v. a., wenn die Patientin ihre Familien- und Haushaltspflichten nicht mehr erfüllen kann. Bezugspersonen sollten daher möglichst früh in die Aufklärung und Therapieplanung miteinbezogen werden, sofern dies dem Wunsch der Patientin entspricht.
Einleitung/Zielsetzung: In den letzten Jahrzehnten kam es in Osterreich sowie weltweit zu einem d... more Einleitung/Zielsetzung: In den letzten Jahrzehnten kam es in Osterreich sowie weltweit zu einem deutlichen Anstieg der Kaiserschnittrate. Unter bonding bzw. early skin-to-skin contact (SSC) versteht man die Phase der Bindungsentwicklung zwischen Mutter und Kind, welche idealerweise gleich nach der Geburt beginnt. Mogliche Bedenken, das bonding auch nach dem Kaiserschnitt im Operationssaal einzufuhren, sind neben Organisatorischen (Anderung des etablierten Ablaufes) auch das veranderte Ambiente im Operationssaal (Temperatur, Helligkeit, Larm). Im Rahmen dieser Studie sollten Effekte des fruhen SSC nach einer Schnittentbindung auf die Mutter und das Neugeborene evaluiert werden. Material & Methoden: Im Rahmen einer prospektiven randomisierten Pilotstudie wurden 35 Frauen eingeschlossen. Randomisiert wurde in eine ‚early bonding‘ Gruppe (n = 17) und eine ‚late bonding‘ Gruppe (n = 18). Evaluiert wurden die kindliche Adaptation, die Ausschuttung von Oxytocin, Cortisol und Chromogranin A bei der Mutter und die Ausschuttung von Cortisol beim Kind, sowie die mutterliche Schmerzverarbeitung und psychische Situation (Edinburgh Postnatal Depression Scale und Postpartum Bonding Questionnaire). Ergebnisse: Die kindliche Adaptation und Temperaturregulation bewegten sich in beiden Gruppen im Normbereich. Die Ausschuttung von Oxytocin, Cortisol und Chromogranin A bei den Muttern war vergleichbar und es gab keinen Unterschied hinsichtlich der mutterlichen Schmerzverarbeitung in den jeweiligen Gruppen. Im Beziehungsverhalten und der Befindlichkeit zwischen den beiden Gruppen konnte kein signifikanter Unterschied festgestellt werden. Zusammenfassung: Sectiobonding kann – falls von den Eltern gewunscht – angeboten werden.
Background/Objective: To examine maternal physical and mental health-related quality of life (HRQ... more Background/Objective: To examine maternal physical and mental health-related quality of life (HRQoL) and depression after early and late preterm and term births in the early postpartum period.Method: In a prospective pilot study, three groups of women whose newborns had to be treated in the neonatal ward during the immediate postpartum period were established and compared with each other: 20 women with extremely to very preterm birth, 20 with moderate to late preterm birth and 20 women with term birth. All participants completed the Short Form-12 Health Survey (SF-12) to measure HRQoL, and the Edinburgh Postnatal Depression Scale (EPDS) to detect depressive symptoms combined with independently developed questions to evaluate anxiety and psychological distress.Results: Maternal psychological HRQoL was significantly worse in the very preterm birth group compared to moderate to late preterm birth (p < 0.001) and full-term birth groups (p = 0.004). There were no differences between t...
International Journal of Environmental Research and Public Health
The objective of this study was to assess associations between maternal health-related quality of... more The objective of this study was to assess associations between maternal health-related quality of life (HRQoL) in early, mid-, and late pregnancy and birth outcomes and to assess the differences in birth outcomes between subgroups of mothers reporting relatively “low” and relatively “high” HRQoL. HRQoL was measured by the 12-item Short Form Health Survey in early (n = 6334), mid- (n = 6204), and late pregnancy (n = 6048) in a population-based mother and child cohort; Physical and Mental Component Summary (PCS/MCS) scores were calculated. Birth outcomes included pregnancy duration, preterm birth, birth weight, low birth weight, and small for gestational age. We defined very high PCS/MCS scores as the >90th percentile and very low score as the <10th percentile. The lower PCS score in late pregnancy was significantly associated with a higher chance of having small-for-gestational-age birth (per 10 points: OR = 1.20, 95% CI: 1.08, 1.33, p value = 0.0006). In early, mid-, and late ...
International Journal of Environmental Research and Public Health
Having good health-related quality of life (HRQoL) is essential, particularly for women after chi... more Having good health-related quality of life (HRQoL) is essential, particularly for women after childbirth. However, little is known about its determinants. We aimed to identify the determinants of HRQoL after childbirth in a large community sample in the Netherlands. We have included 4312 women in the present study. HRQOL was assessed by a 12-Item Short Form Survey (SF-12) at around two months after childbirth; Physical and Mental Component Summary scores were calculated. Information on 27 potential determinants of HRQoL was collected through questionnaires and medical records. Multivariate linear regression models were applied to assess significant determinants of physical and mental HRQoL. Our study showed that older maternal age, shorter time since childbirth, elective/emergency cesarean delivery, loss of energy, maternal psychopathology, and the hospital admission of the infant were significantly associated with worse physical HRQoL (p < 0.05); older maternal age, non-western ...
The objective of this study was to identify distinct trajectories and their predictors of health-... more The objective of this study was to identify distinct trajectories and their predictors of health-related quality of life (HRQOL) of women during pregnancy in a prospective mother and child cohort. Analyses were based on 3936 Dutch pregnant women in Rotterdam area, the Netherlands. Information on potential predictors was collected in early pregnancy by questionnaire. Latent Class Mixture Modelling and Multinomial Logistic Regression were applied to assess the trajectory and predictors of HRQOL during pregnancy. HRQOL was measured by SF-12 in early, mid- and late pregnancy; physical and mental component summary (PCS-12/MCS-12) scores were calculated. Four physical HRQOL trajectories were identified: a healthy trajectory ('healthy') in 63.3%, consistently low ('vulnerable') in 10.8%; a small increase ('recovering') in 12.8% and a large decrease ('at risk') in 13.1%. Three mental HRQOL trajectories were identified: a healthy trajectory ('healthy')...
Early bonding by skin-to-skin contact (SSC) has been demonstrated to be beneficial for mothers an... more Early bonding by skin-to-skin contact (SSC) has been demonstrated to be beneficial for mothers and newborns following vaginal delivery. The aim of this study was to investigate the impact of intraoperative bonding (early SSC) after cesarean section on neonatal adaptation, maternal pain and stress response. This prospective, randomized-controlled pilot study was performed at a single academic tertiary hospital (Department of Obstetrics and Gynecology, Medical University of Graz, Austria) between September 2013 and January 2014. Women were randomly assigned to intraoperative ("early") SCC (n = 17) versus postoperative ("late") SCC (n = 18). Main variables investigated were neonatal transition (Apgar score, arterial oxygen saturation, heart rate and temperature), maternal pain perception and both maternal and neonatal stress response by measuring the stress biomarkers salivary free cortisol and salivary alpha amylase. There was no evidence for differences in paramet...
The objective of this study was to evaluate the independent associations between nausea, vomiting... more The objective of this study was to evaluate the independent associations between nausea, vomiting, fatigue and health-related quality of life of women in early pregnancy in the Generation R study, which is a prospective mother and child cohort. Analyses were based on 5079 women in early pregnancy in the Rotterdam area, the Netherlands. The information on nausea, vomiting and fatigue in the previous three months was measured in the questionnaire at enrollment, as well as potential confounders (i.e., maternal/gestational age, ethnic background, educational level, parity, marital status, body mass index, tobacco and alcohol use, chronic/infectious conditions, uro-genital conditions/symptoms, sleep quality, headache, anxiety, and depression). Health-related quality of life was assessed by the 12item Short Form Health Survey and physical and mental component summary scores were calculated. Multivariate regression models were performed to evaluate the independent associations of the presence of nausea, vomiting and fatigue with health-related quality of life, adjusting for potential confounders. 33.6% of women experienced daily presence of nausea, 9.6% for vomiting and 44.4% for fatigue. Comparing with women who never reported nausea, vomiting and fatigue, women with daily presence of at least one of these symptoms had significantly lower scores of physical component summary and mental component summary, after adjusting for potential confounders. Our study shows how common nausea, vomiting and fatigue are among women in early pregnancy and how much each of these symptoms negatively impact on health-related quality of life. We call for awareness of this issue from health care professionals, pregnant women and their families.
Etwa 30-50% der Patientinnen und Patienten entwickeln im Lauf einer Krebserkrankung psychische Sy... more Etwa 30-50% der Patientinnen und Patienten entwickeln im Lauf einer Krebserkrankung psychische Symptome. Erst bei länger andauernden emotionalen oder kognitiven Beeinträchtigungen können sich psychische Störungen entwickeln, die nach den Kriterien der internationalen Klassifikation psychischer Störungen diagnostiziert werden können. Etwa 5–10% aller onkologischen Patientinnen gehören einer psychosozialen Risikogruppe an und benötigen neben der medizinischen Versorgung eine professionelle psychologische Behandlung. Die Früherkennung der Behandlungsbedürftigkeit wäre wünschenswert, um komplizierte Krankheitsverarbeitungsverläufe zu verhindern. Ärztliche Aufklärung über Erkrankung und Behandlung ist ein schrittweiser Prozess. Grundsätzlich sollte die Aufklärung dem “Prinzip Hoffnung„ folgen und die Abwehr- und Verarbeitungsmöglichkeiten der Patientin berücksichtigen. Wenn deutlich wird, dass die Patientin nicht mehr aufnahmefähig ist, sollte das Aufklärungsgespräch zu einem späteren Zeitpunkt wieder aufgenommen werden. Krisensituationen treten vorwiegend nach Diagnosemitteilung oder Mitteilung eines Rezidivs auf. Eine Krisenintervention umfasst Gesprächs- und Beziehungsangebot herstellen, Krisenmanagment in und Krisenmanagement nach der Akutsituation. Angehörige sind durch die Krankheit selbst mitbetroffen und durchlaufen ähnlich wie Krebspatienten verschiedene Verarbeitungsphasen. Die Krebsdiagnose kann zum funktionalen Zusammenbruch der Familie führen, v. a., wenn die Patientin ihre Familien- und Haushaltspflichten nicht mehr erfüllen kann. Bezugspersonen sollten daher möglichst früh in die Aufklärung und Therapieplanung miteinbezogen werden, sofern dies dem Wunsch der Patientin entspricht.
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