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      COVID-19-related stress in postpartum women from Argentina during the second wave in 2021: identification of impairing and protective factors

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          Abstract

          Objective

          : Postpartum women are a vulnerable population to pandemic stressors that challenge their psychological well-being. Thus, reliable and valid instruments are necessary to measure pandemic-related stress and to identify risk and protective factors. This work aimed to assess psychometric properties of the COVID-19 Pandemic-Related Stress Scale (PSS-10-C) and associations of maternal pandemic stress with demographic, reproductive and pandemic factors of Argentinian postpartum women during the second COVID-19 wave.

          Design

          An online cross-sectional survey was conducted from April to June 2021.

          Setting

          Online recruitment of postpartum women was carried out during the second wave of COVID-19 in Argentina. This study was conducted in accordance with the Declaration of Helsinki and had the corresponding ethical approval.

          Participants

          This study was performed on 300 women, aged 18-49 years, up to 12 months postpartum in Argentina.

          Measurements and findings

          Stress was assessed with PSS-10-C, with a sociodemographic questionnaire being used to collect demographic, reproductive and pandemic variables. Statistical analysis included psychometric procedures, structural equation modelling, and multiple regressions. PSS-10-C was a reliable and structurally valid instrument with two subscales, with entire scale, Stress and Coping subscales scoring 17.31 (6.52), 9.70 (4.61) and 7.61 (2.77), respectively. History of mood disorders, pregnancy loss, and unhealthy child during the pandemic predisposed to increased stress (β > 0.10, p < 0.05), whereas having work and practicing breastfeeding promoted coping to face it (β < -0.13, p < 0.05). This situation was impaired by mood changes, loss of happiness, economic changes, fear of contracting COVID-19 -own or by a loved one- (β > 0.11, p < 0.05).

          Key conclusions

          The study highlighted the vulnerability of postpartum women's mental health in the pandemic context, with PSS-10-C being a useful instrument for clinicians and researchers to assess perceived stress. Targeting interventions toward women at higher risk can be highly beneficial for maternal and child health.

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          Most cited references54

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          Is Open Access

          Review of the psychometric evidence of the perceived stress scale.

          The purpose of this study was to review articles related to the psychometric properties of the Perceived Stress Scale (PSS). Systematic literature searches of computerized databases were performed to identify articles on psychometric evaluation of the PSS. The search finally identified 19 articles. Internal consistency reliability, factorial validity, and hypothesis validity of the PSS were well reported. However, the test-retest reliability and criterion validity were relatively rarely evaluated. In general, the psychometric properties of the 10-item PSS were found to be superior to those of the 14-item PSS, while those of the 4-item scale fared the worst. The psychometric properties of the PSS have been evaluated empirically mostly using populations of college students or workers. Overall, the PSS is an easy-to-use questionnaire with established acceptable psychometric properties. However, future studies should evaluate these psychometric properties in greater depth, and validate the scale using diverse populations. Copyright © 2012. Published by Elsevier B.V.
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            Younger people are more vulnerable to stress, anxiety and depression during COVID-19 pandemic: A global cross-sectional survey

            The COVID-19 pandemic has had far-ranging consequences for general physical and mental health. Country-specific research reveals a general reduction in mental and physical well-being, due to measures undertaken to stop the spread of COVID-19 disease. However, research is yet to examine the impact of the pandemic on global psychological distress and its effects upon vulnerable groups. Exploration of the factors that potentially mediate the relationship between stress and mental health during this period is needed, to assist in undertaking concrete measures to mitigate psychological distress and support vulnerable groups. Therefore, this study examined the impact of the COVID-19 pandemic on psychological distress globally, and identified factors that may exacerbate decline in mental health. N = 1653 participants (mean age 42.90 ± 13.63 years; 30.3% males) from 63 countries responded to the survey. Depression and anxiety were assessed using the Patient Health Questionnaire and State Trait Anxiety Inventory, respectively. Other measures included the Perceived Stress Scale, the Pittsburgh Sleep Quality Index, 3-item UCLA Loneliness Scale and the Brief Resilient Coping Scale. Globally, consistently high levels of stress, anxiety, depression and poor sleep were observed regardless of number of COVID-19 cases. Over 70% of the respondents had greater than moderate levels of stress, with 59% meeting the criteria for clinically significant anxiety and 39% reporting moderate depressive symptoms. People with a prior mental health diagnosis experienced greater psychological distress. Poor sleep, lower levels of resilience, younger age and loneliness significantly mediated the links between stress and depression, and stress and anxiety. Age-based differences revealed that younger age-groups were more vulnerable to stress, depression and anxiety symptoms. Results show that these vulnerable individuals need more support. Age-specific interventions for modifiable factors that mediate the psychological distress need to urgently deployed to address the global mental health pandemic.
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              Maternal Psychological Distress & Mental Health Service Use During the COVID-19 Pandemic

              Research Highlights • Maternal depression and anxiety prevalence rates appear elevated during COVID-19 • Risk factors for depression and anxiety were evaluated based on child age ranges • Prior psychopathology, poor marital quality, and financial strain affected risk • Mothers primarily obtained mental health information through online resources
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                Author and article information

                Journal
                Midwifery
                Midwifery
                Midwifery
                Elsevier Ltd.
                0266-6138
                1532-3099
                21 February 2022
                21 February 2022
                : 103290
                Affiliations
                [a ]Universidad Nacional de Córdoba, Facultad de Ciencias Médicas, Escuela de Fonoaudiología, Bv. de la Reforma, Ciudad Universitaria, 5014, Córdoba, Argentina
                [b ]Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET, INICSA. Bv. de la Reforma, Ciudad Universitaria, 5014, Córdoba, Argentina
                [c ]Universidad Nacional de Córdoba, Facultad de Ciencias Médicas, Cátedra de Biología Celular, Histología y Embriología, Instituto de Biología Celular. Bv. de la Reforma, Ciudad Universitaria, 5014, Córdoba, Argentina
                Author notes
                [* ]Corresponding author.
                Article
                S0266-6138(22)00042-0 103290
                10.1016/j.midw.2022.103290
                8860463
                35235890
                5c96834f-70fd-4c6c-aaae-129e219cd502
                © 2022 Elsevier Ltd. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 14 September 2021
                : 7 February 2022
                : 20 February 2022
                Categories
                Article

                Obstetrics & Gynecology
                covid-19,pandemics,stress,postpartum,risk factors,maternal medicine
                Obstetrics & Gynecology
                covid-19, pandemics, stress, postpartum, risk factors, maternal medicine

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