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Yıl:2016; Cilt: 53; Sayı: 2>> Özet
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Nöropsikiyatri Arşivi; 2016;53(2):152-157
Pakistanlı Kadınlarda Antenatal Psikolojik Stresi Etkileyen Faktörler
Z ud Din, S Ambreen, Z Iqbal, M Iqbal, S Ahmad
University of Agriculture, Pakistan
Amaç: Zayıf antenatal psikolojik sağlığın hamilelikte olumsuz sonuçlara yol açabileceğine dair gittikçe artan sayıda kanıt bulunmaktadır. Çeşitli ülkelerde yapılan çalışmalarda, hamilelikte karşılaşılan psikolojik stres ile ilişkili çok sayıda faktör ortaya konulmuştur. Yöntem: Bu kesitsel çalışma, Eylül 2011 ve Aralık 2012 tarihleri arasında Kuzeybatı Pakistan, Peshawar bölgesinde yapıldı. Hamileliğinin üçüncü trimester dönemindeki 230 kadın çalışma kriterlerini karşıladıkları için çalışmaya dahil edildi. Kadınların antenatal psikolojik sağlık durumları, Depresyon Anksiyete Stres Ölçeği (DASS-42) kullanılarak ölçüldü. Sağlık ve demografik sosyoekonomik durum ile ilgili veriler, standardize edilmiş anketler kullanılarak kişisel görüşmelerle elde edildi. Bulgular: Genel olarak, kadınların %45’inde kompozit depresyon, anksiyete ve stres (kompozit DAS) semptomları görüldü. Tek değişkenli analizde, annelik yaşı, eş desteği, aylık gelir, ailenin genişliği, stresli olaylar, özgüven eksikliği, aile içi şiddet ve hamilelikle ilgili kaygının antenatal kompozit DAS ile oldukça ilişkili olduğu tespit edildi (p<0,01). Çok değişkenli analiz maternal kompozit DAS semptomları ile yaş, aylık gelir, ailenin genişliği ve özgüven eksikliği arasında anlamlı bir ilişki ortaya koydu (p<0,01). Sonuç: Kadınların büyük bir bölümünde, antenatal kompozit DAS semptomları görüldü ve psikolojik stresleriyle ilişkili birçok faktör olduğu bulundu. Zayıf antenatal psikolojik duruma yol açan bu faktörler arasında, genç hamilelik yaşı, yetersiz eş desteği, düşük gelir, geniş aile, olumsuz olaylar, özgüven eksikliği, hamilelikle ilgili kaygılar ve aile içi şiddet yer almaktadır. Çalışmanın bulgularına dayanarak söyleyebiliriz ki, hükümet düzeyinde yasa yapıcılar, hamile bir kadının perinatal mental ve psikolojik sağlığını toplum düzeyinde geliştirmek için özel müdahale programları başlatmalıdırlar.
Determinants of Antenatal Psychological Distress in Pakistani Women
Introduction: An increasing number of evidence has demonstrated that poor antenatal psychological health can lead to adverse pregnancy outcomes. Studies conducted in various countries demonstrated a wide range of factors associated with psychological distress during pregnancy. Methods: A cross-sectional study was conducted between September 2011 and December 2012 in Peshawar, north-west Pakistan. A total of 230 women in their third trimester of pregnancy fulfilled the inclusion criteria. The antenatal psychological health status of women was measured using the Depression Anxiety Stress Scale. Relevant data regarding health and demographic–socioeconomic status were collected through personal interviews using standardized questionnaires. Results: Overall, 45% (n=104) of women exhibited symptoms for composite depression, anxiety, and stress (composite DAS). In the univariate analysis, maternal age, husband support, monthly income, family size, stressful life events, lack of confidence, domestic violence, and pregnancy-related concerns were strongly associated with antenatal composite DAS (p<0.01). The association of maternal composite DAS symptoms with age, monthly income, family size, and lack of confidence remained significant in the multivariate analysis (p<0.01). Conclusion: A major proportion of women exhibited symptoms of antenatal composite DAS, and various factors were found to be related to their psychological distress. A young maternal age, low husband support, low income, large family size, adverse life events, lack of confidence, pregnancy-related concerns, and domestic violence were stronger determinants of poor antenatal psychological status. The study findings concluded that policymakers at the government level should launch special intervention programs to improve maternal perinatal mental and psychological health at the community level.

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