Ling-ling Gao

Depression, perceived stress, and social support among first-time Chinese mothers and fathers in the postpartum period.

We compared the prevalence of depression in the postpartum period and its relationship with perceived stress and social support in first-time mothers and fathers. A cross-sectional study was conducted in mainland China with a convenience sample of 130 pairs of parents. Measures taken at 6-8 weeks after delivery included the Edinburgh Postnatal Depression Scale, the Perceived Stress Scale, and the Social Support Rating Scale. Eighteen (13.8%) of the mothers and 14 (10.8%) of the fathers were suffering from depression. No signficant differences were found in their prevalence rates. Perceived stress, social support, and partners depression were significantly associated with depression. These findings suggest counseling, support, and routine screening for depression should be provided to both mothers and fathers.

Internet use by Chinese women seeking pregnancy-related information

OBJECTIVE to investigate whether and how Chinese pregnant women used the Internet to retrieve pregnancy-related information. DESIGN AND SETTING a descriptive, cross-sectional design using a waiting-room questionnaire was employed to obtain information from Chinese pregnant women attending the antenatal clinic of a general hospital in Guangzhou, mainland China from September to October in 2011. PARTICIPANTS a total of 335 Chinese women pregnant at least 32 weeks participated in the study with the response rate 85%. FINDINGS the great majority of the women (91.9%) had access to the Internet. Most of them (88.7%) used it to retrieve health information and began from the beginning of the pregnancy. Fetal development and nutrition in pregnancy were the two most often mentioned topics of interest. More than half of the women regarded the information as reliable. The first most important criterion for judging the trustworthiness of web-based information was if the facts were consistent with information from other sources; the second most important criterion was if references were provided. Most (75.1%) of the women did not discuss the information they retrieved from the Internet with their health professionals. CONCLUSION the Internet was a common source for pregnancy related information among Chinese pregnant women, the same as that in the western countries. Health professionals should be able to guide Chinese pregnant women to high-quality, web-based information and then take the opportunity to discuss this information with them during antenatal visits, consultations and childbirth education classes.

Evaluation of an interpersonal-psychotherapy-oriented childbirth education programme for Chinese first-time childbearing women: A randomised controlled trial

OBJECTIVE This study investigated the effects of an interpersonal-psychotherapy-oriented childbirth psychoeducation programme on postnatal depression, psychological well-being and satisfaction with interpersonal relationships in Chinese first-time childbearing women. METHOD A randomised, controlled trial was conducted in the maternity clinic of a regional hospital in China. The intervention was based on the principles of interpersonal psychotherapy, and consisted of two 90-min antenatal classes and a telephone follow-up within 2 weeks after delivery. One hundred and ninety-four first-time pregnant women were randomly assigned to the intervention group (n=96) or a control group (n=98). Outcomes of the study included symptoms of postnatal depression, psychological well-being and satisfaction with interpersonal relationships, which were measured by the Edinburgh Postnatal Depression Scale (EPDS), General Health Questionnaire (GHQ) and Satisfaction with Interpersonal Relationships Scale (SWIRS), respectively. RESULTS Women receiving the childbirth psychoeducation programme had significantly better psychological well-being (t=-3.33, p=0.001), fewer depressive symptoms (t=-3.76, p=0.000) and better interpersonal relationships (t=3.25, p=0.001) at 6 weeks postpartum as compared with those who received only routine childbirth education. CONCLUSION An interpersonal-psychotherapy-oriented childbirth psychoeducation programme could be implemented as routine childbirth education with ongoing evaluation. Replication of this study with more diverse study groups, such as mothers with high risks to depression, those with multiple, complicated or multiparas pregnancies, would provide further information about the effects of the programme.

Effects of an interpersonal-psychotherapy-oriented childbirth education programme for Chinese first-time childbearing women at 3-month follow up: randomised controlled trial.

BACKGROUND Developing a sense of well-being and achieving maternal role competence are considered critical components of maternal adaptation. Given the growing evidence of postpartum depression and its devastating effects, effective childbirth psychoeducation programme to promote maternal role competence, psychological well-being and prevent postpartum depression is essential and of an urgent priority. OBJECTIVE To examine the effects of an interpersonal psychotherapy oriented childbirth education programme on social support, maternal role competence, postpartum depression and psychological well-being in Chinese first-time childbearing women at three-month postpartum. DESIGN, SETTING AND PARTICIPANTS Randomised controlled trial in a regional teaching hospital, Guangzhou, China with 194 first-time pregnant women, of whom 96 received interpersonal-psychotherapy-oriented childbirth education programme and 98 standard care. The intervention was developed from principles of interpersonal psychotherapy which consisted of two 90-min antenatal classes and a telephone follow-up within two weeks after delivery. Outcomes measurements included Perceived Social Support Scale, Parenting Sense of Competence Scale-Efficacy subscale, Edinburgh Postnatal Depression Scale and General Health Questionnaire, were compared over three-month follow up. RESULTS The study group had significantly better improvement on perceived social support (p<0.01), maternal role competence (p<0.01), postpartum depressive symptoms (p<0.01) and psychological well-being (p<0.01) when compared with the control group. The study group also had significantly higher level of social support (t=2.33, p=0.021), maternal role competence (t=2.43, p=0.016) and less depressive symptoms (t=-2.39, p=0.018) at three-month postpartum when compared with the control group. DISCUSSION The childbirth psychoeducation programme can substantially benefit first time Chinese mothers. It could be implemented as a routine care with ongoing evaluation. Future studies could focus on women in lower social classes, with multiple pregnancy and complicated pregnancy.

The past, present and future of nursing education in the People’s Republic of China: a discussion paper

AIM   This article presents a discussion of nursing education development in the Peoples Republic of China in its historical, economic and sociopolitical contexts. BACKGROUND   China has a population of 1·3 billion with about 2·18 million nurses. With the recent surging economic and social development in China, nursing education has undergone transformation changes in the past two decades. DATA SOURCES   Online bibliographical databases from 1990 to 2010 were searched including CINAHL, MEDLINE, Wan Fang Data and Chinese National Knowledge Infrastructure. Search terms included nursing education, China and development. METHODS   Thematic analysis and narrative synthesis were used to identify and report themes from literature. RESULTS   Database searches yielded 1674 papers, and 34 met the inclusion criteria for review. The standard of nursing education varies greatly in different parts of China, because of its huge size and population, with pre-registration programmes offered at the secondary, associate degree and baccalaureate level. Multi-level nursing education is one of the major barriers for professional development. There is a need to upgrade the pre-registration education to at least associate degree level. There is also a need to enhance graduate nursing education at master and doctoral level to prepare advanced practice nurses, nurse scientists and nursing faculty. conclusion:  The challenges for nursing education development in China are echoed and encountered in many parts of the world. The experience in China and the lessons learned would be relevant to developing countries. Nursing in China must continue to develop in parallel to international trends. Promoting communication and maintaining international links are important for the global development of nursing practice.

Social support and parenting self-efficacy among Chinese women in the perinatal period

OBJECTIVE to examine the changes in and relationship between perceived social support and parenting self-efficacy in the perinatal period among pregnant women in mainland China. DESIGN AND SETTING this was a secondary analysis with data from part of an experimental study of the effects of an interpersonal-psychotherapy-oriented childbirth psychoeducation programme on maternal adaptation. A longitudinal design was employed in the present study. The study was carried out from July 2008 to May 2009 in one general hospital in Guangzhou, China. PARTICIPANTS a convenience sample of 68 first-time mothers in mainland China completed measurement of social support and parenting self-efficacy during pregnancy and at six weeks and three months post partum. FINDINGS perceived social support and parenting self-efficacy declined during early motherhood. Parenting self-efficacy increased from six weeks post partum to three months post partum. Perceived social support positively correlated with parenting self-efficacy. CONCLUSION culturally competent health-care intervention should be developed during early motherhood to promote perceived social support and parenting self-efficacy for the new mothers.

Validation of the short form of the chinese childbirth self-efficacy inventory in Mainland China†

Self-efficacy increasingly has been reported as an important outcome measure in childbirth care. The purpose of this study was to evaluate the psychometrics of the short form of the Chinese Childbirth Self-Efficacy Inventory (CBSEI-C32) in mainland China. A convenience sample of 297 pregnant Chinese women who were attending the out-patient clinic of the study hospital in Guangzhou participated in the study. The participants were asked to complete the CBSEI-C32, the Chinese Self-Rating Anxiety Scale (CSAS), the Chinese Self-Efficacy Scale (CSE) and the socio-demographic questionnaire. A subgroup of 75 pregnant women was selected randomly from the total sample using a table of random numbers for test-retest reliability assessment. The findings demonstrate high internal consistency (Cronbachs α = .96) and test-retest reliability (intraclass correlation coefficient = .88) for the CBSEI-C32. Confirmatory factor analysis showed some support for a two-factor structure of the CBSEI-C32, and construct validity was further supported by a significant relationship with CSAS. The CBSEI-C32 has the potential to be used as a clinical and research instrument for measuring childbirth self-efficacy in women in mainland China.

Predictors of childbirth fear among pregnant Chinese women: A cross-sectional questionnaire survey

OBJECTIVE to examine childbirth fear and identify its predictors among pregnant Chinese women. DESIGN AND SETTING a cross-sectional descriptive questionnaire survey was conducted in a regional teaching hospital in Guangzhou, China, between October and November 2013. PARTICIPANTS 353 pregnant Chinese women who were at least 18 years old, with a singleton fetus, in the third trimester of pregnancy, not at high risk for complications of pregnancy, and not having had a previous caesarean section. MEASUREMENTS a social-demographic data sheet; the Chinese version of the Childbirth Attitude Questionnaire and the Spielberger׳s State-Trait Anxiety Inventory; and the short form of 32-item Chinese Childbirth Self-Efficacy Inventory. FINDINGS the pregnant Chinese women reported moderate levels of childbirth fear. The pregnant Chinese women who were younger, with lower educational level, not satisfied with their husbands׳ support, and with previous experience of miscarriage reported higher level of childbirth fear. Pregnant women׳s childbirth self-efficacy, state anxiety and trait anxiety were correlated with childbirth fear. The best-fit regression analysis revealed four variables that explained 28% of variance in childbirth fear: trait anxiety, state anxiety, age and previous experience of miscarriage. CONCLUSION this study highlighted the connection between childbirth fear, state and trait anxiety, childbirth self-efficacy, age, education and previous miscarriage among pregnant Chinese women. IMPLICATIONS FOR PRACTICE the CAQ was an appropriate method to measure childbirth fear in pregnant Chinese women. The health-care professionals should be sensitive toward issues that could affect levels of childbirth fear in pregnant Chinese women, including age, education and previous miscarriage.