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  • 1
    Language: English
    In: Midwifery, January 2015, Vol.31(1), pp.155-163
    Description: to explore the perceptions of primiparas on the contents, delivery and personal impact of postnatal psychoeducation programme. a descriptive qualitative study was conducted in a public tertiary hospital in Singapore in 2013. 18 primiparas who were able to read and speak English were recruited from the intervention group of a randomised controlled trial. a semi-structured interview guide was used to interview participants׳ perceptions on a postnatal psychoeducation programme at participants׳ home, which was developed based on the principles of self-efficacy and social exchange theories, between six and nine weeks post partum. The programme comprised of a 90-minute home visit, three weekly telephone follow-up and an educational booklet. the qualitative interviews revealed that the participants faced many challenges such as negative emotions and difficulties in breast feeding and support issues in the early postpartum period especially after the hospital discharge. However, all the participants in the intervention group perceived the postnatal psychoeducation programme to be helpful in increasing their confidence in newborn care, fostering help-seeking behaviour, improving emotional well-being and increasing their knowledge in newborn and self-care as well as in breast feeding. Suggestions for programme improvements included more home visits, more telephone follow-up and web-based psychoeducation as well as recommending postnatal psychoeducation programme to be offered as a routine care. Overall, there was a high satisfaction and acceptability with the programme. our findings indicate that the programme is beneficial for maternal well-being and confidence in maternal roles and, therefore, is promising to be introduced to the multiracial primiparas in Singapore. the challenges mothers experience during the postnatal period suggest that it would be worthwhile to devote more resources in providing follow-up support to the mothers in the early postpartum period. Midwives could incorporate a self-efficacy enhancing intervention with a family-centred approach to enable women to have a smooth transition to motherhood.
    Keywords: Depression ; Maternal Self-Efficacy ; Postnatal ; Process Evaluation ; Psychoeducation ; Social Support ; Medicine ; Nursing
    ISSN: 0266-6138
    E-ISSN: 1532-3099
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  • 2
    Language: English
    In: The Lancet, 05 May 2012, Vol.379(9827), pp.1684-1685
    Description: Gülmezoglu and colleagues' study1 was supported by the US Agency for International Development and the UN Development Programme/UN Population Fund/WHO/ World Bank Special Programme of Research, Development and Research Training in Human Reproduction, which this year celebrates 40 years of innovations that have improved the sexual and reproductive health of women worldwide.4 One of the main strategies of this programme is task shifting-the process of delegating tasks from more specialised to less specialised health workers to expand and optimise available resources.5 If Millennium Development Goal 5 is to be achieved eventually, care of women in pregnancy and childbirth must be borne partly by community midlevel providers because of the chronic shortage of qualifi ed medical staff in rural areas.6 The fi ndings of this study can be applied across most settings by equipping community birth attendants with a prophylactic uterotonic agent given at delivery.
    Keywords: Medicine
    ISSN: 0140-6736
    E-ISSN: 1474-547X
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  • 3
    Language: English
    In: The Lancet, 2011, Vol.377(9772), pp.1127-1128
    Description: Since 1995, induced abortion rates have fallen worldwide.1 Unfortunately, the rate of unsafe abortion and the consequences of it have not. [...] junior doctors might, in some circumstances, be no better at providing care than are midlevel providers with much clinical experience.
    Keywords: Medicine
    ISSN: 0140-6736
    E-ISSN: 1474-547X
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  • 4
    In: Journal of Advanced Nursing, June 2015, Vol.71(6), pp.1260-1273
    Description: To purchase or authenticate to the full-text of this article, please visit this link: http://onlinelibrary.wiley.com/doi/10.1111/jan.12590/abstract Byline: Shefaly Shorey, Sally Wai Chi Chan, Yap Seng Chong, Hong-Gu He Keywords: depression; midwifery; nurses; nursing; postnatal; primiperas; psychoeducatoin; self-efficacy; social support Abstract Aim To examine the effectiveness of a postnatal psychoeducation programme in enhancing maternal self-efficacy and social support and reducing postnatal depression among primiparas. Background Primiparas experience various challenges during the early postnatal period with low self-efficacy, depression and lack of social support. Support in the form of postnatal educational programmes is needed to improve these outcomes of primiparas. Design A randomized controlled two-group pre-test-post-test design was adopted. Methods Data were collected from June-December 2012 in a public hospital in Singapore from 122 primiparas, who were randomly assigned to the intervention (n = 61) or control group (n = 61). The intervention group received postnatal psychoeducation programme and routine care while the control group received routine care only. The Maternal Parental Self-Efficacy scale, Perinatal Infant Care Social Support scale and Edinburgh Postnatal Depression Scale were used to measure outcomes of maternal parental self-efficacy, social support and postnatal depression. The mean percentage changes of all three outcome variables from baseline to 6 and 12 weeks postpartum between groups were used when performing repeated measures multivariate analysis of covariance. Results The intervention group had significantly higher scores of maternal parental self-efficacy and social support and lower scores of postnatal depression at 6 and 12 weeks postpartum when compared with the control group. Conclusion The postnatal psychoeducation programme was effective in improving maternal outcomes and hence could be introduced as routine care with ongoing evaluation in the postnatal period. Future studies could focus on the effects of this programme on other populations. Trial registration no: ISRCTN15886353.
    Keywords: Depression ; Midwifery ; Nurses ; Nursing ; Postnatal ; Primiperas ; Psychoeducatoin ; Self‐Efficacy ; Social Support
    ISSN: 0309-2402
    E-ISSN: 1365-2648
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  • 5
    In: Journal of Advanced Nursing, January 2015, Vol.71(1), pp.193-203
    Description: To purchase or authenticate to the full-text of this article, please visit this link: http://onlinelibrary.wiley.com/doi/10.1111/jan.12461/abstract Byline: Shefaly Shorey, Wai-Chi Sally Chan, Yap Seng Chong, Hong-Gu He Keywords: maternal parental self-efficacy; midwifery; nursing; postnatal depression; psychoeducation intervention; social support Abstract Aim To report a trial protocol that evaluates the effectiveness of postnatal psychoeducation programme in improving maternal parental self-efficacy and social support and in reducing postnatal depression among primiparas. Background Primiparas encounter physical, psychosocial and newborn care challenges in the early postnatal period. However, primiparas do not receive adequate professional support after early discharge from hospitals, thus hindering their adaptation to new role as mothers and smooth transition to motherhood. Postnatal psychoeducation programmes have been shown to be effective in improving pregnant women's health. However, there is a lack of theory-based, postnatal psychoeducation interventions for primiparas. Design A randomized controlled trial of two-group pretest and repeated posttests is proposed. Methods The study will recruit a minimum of 114 primiparas on the day of discharge from a Singaporean public hospital (protocol approved in May 2012). Eligible participants will be randomly allocated to either a control group (receiving routine care) or an experimental group (receiving a postnatal psychoeducation programme besides routine care). Outcome measures include maternal parental self-efficacy, social support and postnatal depression. Data will be collected at baseline (on the day of discharge), 6 and 12 weeks postpartum. Discussion This will be the first study of its kind that will use rigorous study design to evaluate a theory-based innovative postnatal psychoeducation programme on maternal outcomes. The study may identify a potentially effective way of enhancing primiparas' self-efficacy and social support, which may in turn reduce their risk of postnatal depression. The Sigma Theta Tau International Upsilon Eta Chapter funded this study.
    Keywords: Maternal Parental Self‐Efficacy ; Midwifery ; Nursing ; Postnatal Depression ; Psychoeducation Intervention ; Social Support
    ISSN: 0309-2402
    E-ISSN: 1365-2648
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  • 6
    In: Journal of Clinical Nursing, August 2014, Vol.23(15-16), pp.2272-2283
    Description: To purchase or authenticate to the full-text of this article, please visit this link: http://onlinelibrary.wiley.com/doi/10.1111/jocn.12507/abstract Byline: Shefaly Shorey, Sally Wai-Chi Chan, Yap Seng Chong, Hong-Gu He Keywords: correlational; midwifery; mothers; postnatal; postpartum; self-efficacy; Singapore; social support Aim and objective To examine the correlation between maternal parental self-efficacy and social support as well as predictors of self-efficacy in the early postpartum period. Background Maternal parental self-efficacy is important for mothers' adaptation to motherhood. Lack of support could result in decreased maternal parental self-efficacy in newborn care. Limited studies have focused on maternal parental self-efficacy in the postpartum period in Asia and none in Singapore. Study design A correlational study design was adopted. Methods Data were collected from both primiparas and multiparas during the first to third days postpartum in a public hospital, using the Perceived Maternal Parental Self-efficacy and Perinatal Infant Care Social Support Scales. The data were analysed using descriptive and inferential statistics. Results Maternal parental self-efficacy in newborn care and the level of social support that mothers received were moderate. In terms of the social support subscales, informational and instrumental support was lower than emotional and appraisal support. Informal support from husbands, parents and parents-in-law was the main source of support. A significant correlation was found between maternal parental self-efficacy and total social support in addition to the informational, instrumental and appraisal subscales of functional support. The predictors of maternal parental self-efficacy were parity, social support and maternal age. Conclusion The findings highlight the predictors and correlates of maternal parental self-efficacy in newborn care and the social support needs of mothers in the early postpartum period. Healthcare professionals could provide more information and instrumental support and involve family members to enhance maternal parental self-efficacy. Relevance to clinical practice Because maternal parental self-efficacy and social support in the early postpartum period are interrelated components, they could be assessed to identify at-risk mothers. There is a need to develop perinatal educational programmes to provide culturally competent individualised support to mothers in need.
    Keywords: Correlational ; Midwifery ; Mothers ; Postnatal ; Postpartum ; Self‐Efficacy ; Ingapore ; Social Support
    ISSN: 0962-1067
    E-ISSN: 1365-2702
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  • 7
    Language: English
    In: The Lancet, 2010, Vol.375(9713), pp.440-442
    Description: [...] as operative vaginal delivery rates continue to fall, there should be no compromise in the level of training in the conduct of and careful selection of patients for instrumental deliveries.
    Keywords: Medicine
    ISSN: 0140-6736
    E-ISSN: 1474-547X
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  • 8
    Language: English
    In: Diabetologia, 2016, Vol.59(7), pp.1385-1390
    Description: Gestational diabetes mellitus (GDM), a common pregnancy complication, continues to be a significant public health and clinical problem. It carries significant short-term and long-term adverse health outcomes for both mother and offspring, which reinforces the significance of understanding risk factors, in particular modifiable factors, for GDM and of preventing the condition. Research in the past decade from observational studies has identified a few diet and lifestyle factors that are associated with GDM risk and demonstrated that time frames both before and during pregnancy may be relevant to the development of GDM. Findings from intervention studies on the effect of diet and lifestyle on the prevention of GDM have been largely controversial and inconsistent. Variations in study population, types of intervention, timing and duration of intervention and diagnostic criteria for GDM may all at least partly account for the large heterogeneity in the findings from these intervention studies. This review provides an overview of emerging diet, lifestyle, and other factors that may help to prevent GDM, and the challenges associated with prevention. It also discusses major methodological concerns about the available epidemiological studies on GDM risk factors. Findings from both observational and intervention studies are discussed. This review summarises a presentation given at the ‘Gestational diabetes: what’s up?’ symposium at the 2015 annual meeting of the EASD. It is accompanied by two other reviews on topics from this symposium (by Peter Damm and Colleagues, DOI: 10.1007/s00125-016-3985-5 , and by Marja Vääräsmäki, DOI: 10.1007/s00125-016-3976-6 ) and an overview by the Session Chair, Kerstin Berntorp (DOI: 10.1007/s00125-016-3975-7 ).
    Keywords: Diet ; Gestational diabetes ; Intervention ; Lifestyle ; Prevention ; Review ; Risk factors
    ISSN: 0012-186X
    E-ISSN: 1432-0428
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  • 9
    In: Journal of Advanced Nursing, December 2017, Vol.73(12), pp.2987-2996
    Description: To purchase or authenticate to the full-text of this article, please visit this link: http://onlinelibrary.wiley.com/doi/10.1111/jan.13349/abstract Byline: Shefaly Shorey, Cindy-Lee Dennis, Shiho Bridge, Yap Seng Chong, Eleanor Holroyd, Hong-Gu He Keywords: early postnatal period; experiences; fathers; interviews; midwives; nurses; nursing; support needs Abstract Aim To explore first-time fathers' postnatal experiences and support needs in the early postpartum period. Background The postnatal period is a stressful transition period for new fathers. It is imperative to understand their needs and experiences to provide appropriate support for them. The majority of previous studies were based in Western countries and explored fathers' needs during pregnancy and childbirth, with few studies conducted in the postnatal period. In Singapore, a multiracial society with differing paternal cultural values from its Western counterparts, there is considerable need to examine the experiences and needs of first-time fathers. Design A descriptive qualitative design was used. Methods Data were collected from November 2015-January 2016. Fifteen first-time fathers were recruited from two postnatal wards of a public hospital, using a purposive sampling method. A semi-structured interview guide was used to conduct face-to-face interviews. A thematic analysis was conducted and ethics approval was sought for this study. Results Four overarching themes and seventeen subthemes were generated. The four overarching themes were: (1) No sense of reality to sense of responsibility; (2) Unprepared and challenged; (3) Support: needs, sources, experience and attitude; and (4) Future help for fathers. Conclusion Fathers undergo a transition phase where they have unmet support needs during the early postnatal period. Understanding and addressing these needs may facilitate smooth transition to fatherhood. This study's findings can be used to involve fathers and design future supportive educational programs to promote positive parenting experiences and family dynamics. Article Note: Funding information The study is funded by the National University of Singapore Start-up Grant, Reference Number: NUHSRO/2015/063/SU/01
    Keywords: Early Postnatal Period ; Experiences ; Fathers ; Interviews ; Midwives ; Nurses ; Nursing ; Support Needs
    ISSN: 0309-2402
    E-ISSN: 1365-2648
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  • 10
    Language: English
    In: American Journal of Clinical Nutrition, 2015, Vol.102(5), p.1104(9)
    Description: Background: Maternal obesity and hyperglycemia increase risk of obesity and diabetes in offspring later in life. Objective: We examined the relation between gestational glycemia and prepregnancy body mass index (ppBMI) with offspring growth in an Asian mother-offspring cohort. Design: Pregnant mothers undertook a 75-g 2-h oral-glucose-tolerance test at 26-28 wk of gestation. In 937 singleton offspring, [less than or equal to] 9 serial measurements of weight and length were obtained from birth until 36 mo of age. Results: Gestational fasting plasma glucose (FPG) was positively associated with birth weight (B: 0.17; 95% Cl: 0.10, 0.24; P 〈 0.001) and birth BMI (B: 0.15; 95% Cl: 0.06, 0.40; P = 0.001) but not at [greater than or equal to] 3 mo of age. In contrast, maternal ppBMI was positively associated with birth variables and conditional growth in weight and BMI in the first 36 mo of life. However, gestational FPG and pre-pregnancy obesity status interacted significantly for the association with offspring growth and overweight status in the first 36 mo of life (P-interaction 〈 0.01). In nonobese mothers, each unit increase in gestational FPG was associated with increased offspring weight (B: 0.08; 95% Cl: 0.008, 0.16; P = 0.03) and BMI (B: 0.08; 95% Cl: 0.003, 0.15; P = 0.04) as well as increased risk of overweight in the first 36 mo of life (OR: 1.36; 95% Cl: 1.10, 1.68). However, in obese mothers, each unit increase in gestational FPG was associated with decreased offspring weight (B: -0.01; 95% Cl: -0.02, -0.003) and BMI (B: -0.008; 95% Cl: -0.01, -0.002) velocity (P 〈 0.01 for both) and decreased risk of overweight (OR: 0.59; 95% Cl: 0.41, 0.86) in the first 36 mo of life. Conclusions: Prepregnancy adiposity was associated with offspring growth in early childhood. Although pooled analyses showed no demonstrable difference by 3 mo of age, there were contrasting and opposite associations of gestational glycemia with weight and BMI in the first 36 mo of life in offspring of nonobese and obese mothers separately. This study was registered at clinicaltrials.gov as NCT01174875. Am J Clin Nutr 2015;102:1104-12. Keywords: gestational glycemia, offspring growth and body com position, prepregnancy obesity doi: 10.3945/ajcn.115.117614
    Keywords: Gestational Diabetes – Complications and Side Effects ; Obesity – Risk Factors ; Maternal-Fetal Exchange – Health Aspects
    ISSN: 0002-9165
    E-ISSN: 19383207
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