Noriko Tabuchi

Relationship between Sense of Coherence in Final Stage of Pregnancy and Postpartum Stress Reactions

ObjectiveIn this study, we evaluated postpartum stress using a postpartum depression scale and by measuring the level of a stress-related substance, to clarify the relationship between the stresscoping capabilities of women in the final stage of pregnancy and their postpartum stress reactions.MethodsBetween April 2004 and October 2004, 54 women participated in a question naire survey and the measurement of their secretory immunoglobulin A (s-IgA) level as a stress-related substance two times in the final stage of their pregnancy (prepartum) and in their early puerperium (postpartum) was carried out. The questionnaire used in the prepartum stage included the following parameters: “basic features”, “Sense of Coherence (SOC)” and “Japanese version of the self-assessment depression scale” of Zung. The questionnaire employed in the postpartum stage included the following parameters: “course of delivery”, “Self-evaluation of delivery experience”, and “Postpartum depression scale”.ResultsThe depression score was higher and the s-IgA level was lower in the low-SOC score group than in the high-SOC score group, indicating that stress reactions were more intense in the low-SOC score group.ConclusionIt was revealed that stress reactions were more intense for women with a low SOC score. Moreover, the finding of a relationship between the low SOC score in the prepartum stage and depressive tendency suggests that women who are likely to develop depressive tendency can be predicted in the prepartum stage, and the significance of measuring SOC in the prepartum stage is thus suggested.

Immaturity in puberty and negative attitudes toward reproductive health among Indonesian adolescents.

Abstract Background: Complex factors influence adolescents’ attitudes. Secondary sexual development and emotional changes are markers of puberty and affect attitudes toward reproductive health (RH). This is especially evident in the society and culture of Indonesia. This study examined the presence of immaturity at puberty and factors associated with negative attitudes toward RH among Indonesian adolescents. Methods: We conducted a cross-sectional study with 1040 students (aged 11–16 years) selected using multistage random cluster sampling. Data were collected using a self-administered questionnaire that included the illustrative questionnaire for interview surveys with young people and the pubertal development scale (PDS), modified in accordance with the Indonesian context. Data analysis used descriptive and comparative statistics and logistic regression analyses. Results: Immature pubertal development was higher in boys [22.7%, 95% confidence interval (CI): 14.7%–30.7%] than girls (18.4%, 95% CI: 11%–25.7%). However, negative attitudes were higher in girls (40.6%, 95% CI: 34.3%–46.8%) than boys (37.1%, 95% CI: 29.9%–44.7%). Factors associated with negative attitudes toward RH in both boys and girls were age, RH communication with parents, and pubertal development. Smoking was an additional factor in boys, whereas living in an urban area was an additional factor in girls. High knowledge about RH was associated with less negative attitudes toward RH in both boys and girls. Conclusion: Immaturity and factors that influence negative attitudes toward RH should be explored during puberty. Improving knowledge about RH may help to prevent negative attitudes toward RH, especially for girls in urban areas and boys with smoking habits.

Prevalence of factors related to active reproductive health behavior: a cross-sectional study Indonesian adolescent

OBJECTIVES Complex and diverse factors are related to reproductive health (RH) behavior among adolescents according to the social and cultural context of each countries. This study examined the prevalence of active RH and factors related to active RH behavior among Indonesian adolescents. METHODS A cross-sectional study was conducted among 1,040 of students who were selected through a multi-stage random sampling technique. A self-administered questionnaire was developed, including the World Health Organization Illustrative Questionnaire for Interview-Surveys with Young People, pubertal development scale, and sexual activity scale, modified in accordance to the Indonesian context. The data were analyzed using descriptive and comparative statistics, as well as logistic regression analyses. RESULTS The prevalence of active RH behavior were more higher in boys (56.6%; 95% confidence interval [CI], 50.6% to 62.6%) than in girls (43.7%; 95% CI, 37.6% to 49.8%). Negative attitudes towards RH were a factor related to active RH behavior in both boys and girls. Smoking and kind relationship envisioned before marriage (pacaran [courtship] and nikah siri [non-registered marriage]) were factors related to active RH behavior in boys; whereas the absence of access to information on substance abuse was an additional factor in girls. Moreover, an interaction was found between access to information on development and smoking (boys) and attitudes on RH (girls) as independent variables associated with active RH behavior. CONCLUSIONS Sex education for adolescents in Indonesia, particularly in the context of a health promotion program, should be developed based on prevalent social, cultural, and religious values to prevent active RH behavior. Such programs should focus on the kind of relationship envisioned before marriage and smoking for boys and access to information on subtance abuse for girls.

Low serum secretory immunoglobulin A level and sense of coherence score at an early gestational stage as indicators for subsequent threatened premature birth

ObjectivesThe purpose of this study was to assess the validity of the candidate indicators secretory immunoglobulin A (s-IgA) and sense of coherence (SOC) as predictors of threatened premature birth.MethodsThis was a panel study conducted on women in their first and latter half of pregnancy during survey period. The survey period was from December 2005 to June 2006 and from December 2007 to June 2008. The women enrolled in the study were asked to complete the survey questionnaire and provide blood samples for the determinations of physiological indicators. The questionnaire consisted of questions related to the stress perception scale (SPS), SOC score as an indicator of modifiers of stress, demographic data, complications in a previous pregnancy, and the course of the current pregnancy. We used s-IgA and high-sensitivity C-reactive protein as a physiological stress indicator and a marker of infection, respectively. Seventy-two eligible subjects were included in the analysis.ResultsTwenty-eight (38.9%) subjects had undergone treatment for threatened premature birth, and 44 (61.1%) subjects had not. In the logistic analysis, we set the course of pregnancy as a dependent variable, and age, birth history, smoking habits, a history of miscarriage, premature birth or threatened premature birth, SPS, SOC, and s-IgA in the first half of pregnancy as independent variables. We found that low serum s-IgA levels and low SOC scores in the first half of pregnancy were associated with threatened premature birth.ConclusionsOur results suggest that low serum s-IgA level and SOC score at an early gestational stage are significant indicators for a threatened premature birth.

Development and Testing of the Family Structure and Family Functions Scale for Parents Providing Adolescent Reproductive Health Based on the Friedman Family Assessment Model

Background and Purpose: To describe the development and testing of a psychometric of Family Structure and Functions (FSF) that measures parents’ ability to provide adolescent reproductive health (ARH). Methods: A cross-sectional study of Indonesian parents (n = 525). Multifactors FSF-ARH were examined using construct validity (exploratory factor analysis [EFA] and confirmatory factor analysis [CFA]) and content validity (Content Validity Index [CVI]). Internal consistency was explored using Cronbach’s α coefficient. Results: EFA revealed nine factors with 26 items accounting for 61.64% of explained variance and CFA validity testing fit for the construct validity of FSF-ARH. The CVI indicated adequate content validity (0.80–0.10) and acceptable internal consistency (0.70). Conclusions: FSF-ARH contains valid, reliable, and robust measures although some subscales performed moderate reliability, establishing the purpose for further research.