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Quality of Life and Emotional Distress among HIV-Positive Women during Transition to Motherhood

Published online by Cambridge University Press:  10 January 2013

Marco Pereira  and
Maria Cristina Canavarro
Marco Pereira*
Affiliation:
Universidade de Coimbra (Portugal)
Maria Cristina Canavarro
Affiliation:
Universidade de Coimbra (Portugal)
*
Correspondence concerning this article should be addressed to Marco Pereira. Instituto de Psicologia Cognitiva, Desenvolvimento Vocacional e Social. Faculdade de Psicologia e Ciências da Educação da Universidade de Coimbra. Rua do Colégio Novo, Apartado 6153, 3001-802 Coimbra (Portugal). E-mail: marcopereira@fpce.uc.pt
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Abstract

The purpose of this preliminary study was to describe the quality of life (QOL) and emotional distress during pregnancy and early postpartum, and to examine the ability of psychopathological symptoms to predict QOL at early postpartum.Asample of 75 pregnant women (31 HIV-positive and 44 HIV-negative) was assessed during the second trimester of pregnancy and two to four days postpartum. QOL was assessed with the WHOQOL-Bref. The emotional distress was assessed with the Brief Symptom Inventory, and with the Emotional Assessment Scale. Seropositive women reported increased negative emotional reactivity and lower scores in social relationships and overall QOL during pregnancy than HIV-negative women. Both HIV-positive and HIV-negative women reported better QOL after the birth of their child, when compared with the pregnancy period. Among HIV-positive women, lower anxiety and depressive symptoms during pregnancy were, respectively, significant predictors of better psychological QOL and overall QOL at early postpartum. Less intense somatic symptoms predicted better physical QOL. Longitudinal assessment of QOL and emotional status may provide potentially useful information for tailoring psychological interventions in the maternity care of HIV-infected women, during their transition to motherhood.

El objetivo de este estudio preliminar fue describir la calidad de vida (CdV) y la angustia emocional durante el embarazo y el postparto, y examinar la capacidad de los síntomas psicopatológicos para predecir la CdV después del parto. Una muestra de 75 mujeres embarazadas (31 VIH-positivas y 44 VIH-negativas) fue evaluada en el segundo trimestre del embarazo y de dos a cuatro días después del parto. La CdV fue evaluada con el WHOQOL-Bref. La angustia emocional se evaluó con el Brief Symptom Inventory y con la Escala de Evaluación Emocional. Durante el embarazo, las mujeres seropositivas reportaron una reactividad emocional negativa aumentada y puntuaciones más bajas en las relaciones sociales y CdV general que las mujeres VIH-negativas. Las mujeres VIH-positivas e VIH-negativas reportaron mejor CdV posparto, en comparación con el período de embarazo. Entre las mujeres VIH-positivas, menor ansiedad y síntomas depresivos durante el embarazo fueron, respectivamente, predictores significativos de la mejor CdV psicológica y CdV general en el posparto. Síntomas somáticos menos intensos predijeron mejor la CdV física. La evaluación longitudinal de la CdV y estado emocional puede proporcionar información potencialmente útil para adaptar las intervenciones psicológicas en el cuidado de las mujeres seropositivas, durante su transición a la maternidad.

Keywords

emotional distressHIV infectionpregnancyquality of lifeangustia emocionalinfección por VIHembarazocalidad de vida
Type
Research Article
Information
The Spanish Journal of Psychology , Volume 15 , Issue 3 , November 2012 , pp. 1303 - 1314
Copyright
Copyright © Cambridge University Press 2012

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References

Anderson, J. R. (2001). HIV and reproduction. In Anderson, J. R. (Ed.), A guide to the clinical care of women with HIV (pp. 213–273). Rockville, MD: U.S. Department of Health Resources and Services Administrators. HIV/AIDS Bureau.Google Scholar
Aranda-Naranjo, B. (2004). Quality of life in the HIV-positive patient: Implications and consequences. Journal of the Association of Nurses in AIDS Care, 15, 20–27. http://dx.doi.org/10.1177/1055329004269183CrossRefGoogle ScholarPubMed
Bedimo, A. L., Bessinger, R., & Kissinger, P. (1998). Reproductive choices among HIV-positive women. Social Science & Medicine, 46, 171–179 ttp://dx.doi.org/10.1016/S0277-9536(97)00157-3CrossRefGoogle ScholarPubMed
Belsky, J. (1984). The determinants of parenting: Aprocess model. Child Development, 55, 83–96. http://dx.doi.org/10.1111/j.1467-8624.1984.tb00275.xCrossRefGoogle Scholar
Bernatsky, S., Souza, R., & de Jong, K. (2007). Mental health in HIV-positive pregnant women: Results from Angola. AIDS Care, 19, 674–676. http://dx.doi.org/10.1080/09540120601012705CrossRefGoogle ScholarPubMed
Boss, P. (2002). Family stress management: A conceptual approach. Thousand Oaks, CA: Sage Publications.CrossRefGoogle Scholar
Carlson, C. R., Collins, F. L., Stewart, J. F., Porzelius, J., Nitz, J. A., & Lind, C. O. (1989). The assessment of emotional reactivity: A scale development and validation study. Journal of Psychopathology and Behavioral Assessment, 11, 313–325. http://dx.doi.org/10.1007/BF00961530CrossRefGoogle Scholar
Carney, J. S. (2003). Understanding the implications of HIV disease in women. Family Journal, 11, 84–88. http://dx.doi.org/10.1177/1066480702238480CrossRefGoogle Scholar
Chesney, M. A., & Folkman, S. (1994). Psychological impact of HIV disease and implications for intervention. Psychiatric Clinics of North America, 17, 163–182.CrossRefGoogle ScholarPubMed
Cohen, J. (1992). A power prime. Psychological Bulletin, 112, 155–159. http://dx.doi.org/10.1037//0033-2909.112.1.155CrossRefGoogle Scholar
Cohen, J., Cohen, P., West, S. G., & Aiken, L. S. (2003). Applied multiple regression/correlation analysis for the behavioral sciences (3rd Ed.). Mahwah, NJ: Lawrence Erlbaum.Google Scholar
Collins, N. L., Dunkel-Schetter, C., Lobel, M., & Scrimshaw, S. C. (1993). Social support in pregnancy: Psychosocial correlates of birth outcomes and postpartum depression. Journal of Personality and Social Psychology, 65, 1243–1258. http://dx.doi.org/10.1037//0022-3514.65.6.1243CrossRefGoogle ScholarPubMed
Cowan, P. A., & Cowan, C. P. (1988). Who does what when partners become parents: Implications for men, women and marriage. Marriage & Family Review, 12, 105–131. http://dx.doi.org/10.1300/J002v12n03_07CrossRefGoogle Scholar
Cowan, C. P., & Cowan, P. A. (2000). When partners become parents: The big life change for couples. New Jersey, NJ: Lawrence Erlbaum.Google Scholar
Cowdery, J. E., & Pesa, J. A. (2002). Assessing quality of life in women living with HIV infection. AIDS Care, 14, 235–254. http://dx.doi.org/10.1080/09540120220104730CrossRefGoogle ScholarPubMed
Da Costa, D., Dritsa, M., Larouche, J., & Brender, W. (2000). Psychosocial predictors of labor/delivery complications and infant birth weight: A prospective multivariate study. Journal of Psychosomatic Obstetrics and Gynaecology, 21, 137–148. http://dx.doi.org/10.3109/01674820009075621CrossRefGoogle ScholarPubMed
Da Costa, D., Larouche, J., Dritsa, M., & Brender, W. (2000). Psychosocial correlates of prepartum and postpartum depressed mood. Journal of Affective Disorders, 59, 31–40. http://dx.doi.org/10.1016/S0165-0327(99)00128-7CrossRefGoogle ScholarPubMed
Da Costa, D., Dritsa, M., Rippen, N., Lowensteyn, I., & Khalifé, S. (2006). Health-related quality of life in postpartum depressed women. Archives of Women's Mental Health, 9, 95–102. http://dx.doi.org/10.1007/s00737-005-0108-6CrossRefGoogle ScholarPubMed
DDI-URVE (2009). Infecção VIH/SIDA: A situação em Portugal a 31 de Dezembro de 2008. [HIV/AIDS Infection: The situation in Portugal on December 31 2008/. Lisboa, Portugal: Departamento de Doenças Infecciosas - Unidade de Referência e Vigilância Epidemiológica. Retrieved from www.sida.ptGoogle Scholar
Derogatis, L. R. (1993). BSI: Brief Symptom Inventory: Administration, scoring and procedures manual. Minneapolis, MN: Natural Computers System.Google Scholar
Fawzi, M. C., Kaaya, S. F., Mbwambo, J., Msamanga, G. I., Antelman, G., Wei, R., … Fawzi, W. W. (2007). Multivitamin supplementation in HIV-positive pregnant women: Impact on depression and quality of life in resource-poor setting. HIV Medicine, 8, 203–213.CrossRefGoogle Scholar
Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175–191. http://dx.doi.org/10.3758/BF03193146CrossRefGoogle ScholarPubMed
Heinonen, H., Aro, A. R., Aalto, A.-M., & Uutela, A. (2004). Is the evaluation of the global quality of life determined by emotional status? Quality of Life Research, 13, 1347–1356. http://dx.doi.org/10.1023/B:QURE.0000040788.12947.b9CrossRefGoogle ScholarPubMed
Hill, P.,Aldag, J. C., Hekel, B., Riner, G., & Bloomfield, P. (2006). Maternal postpartum quality of life questionnaire. Journal of Nursing Measurement, 14, 205–220. http://dx.doi.org/10.1891/jnm-v14i3a005CrossRefGoogle ScholarPubMed
Jomeen, J. (2004). The importance of assessing psychological status during pregnancy, childbirth and the postnatal period as a multidimensional construct: A literature review. Clinical Effectiveness in Nursing, 8, 143–155. http://dx.doi.org/10.1016/j.cein.2005.02.001CrossRefGoogle Scholar
Jomeen, J., & Martin, C. R. (2005). The factor structure of SF-36 in early pregnancy. Journal of Psychosomatic Research, 59, 131–158. http://dx.doi.org/10.1016/j.jpsychores.2005.02.018CrossRefGoogle ScholarPubMed
Larrabee, K.D., Monga, M., Eriksen, N.,& Helfgott, A. (1996). Quality of life assessment in pregnant women with the human immunodeficiency virus. Obstetrics & Gynecology, 88, 1016–1020.CrossRefGoogle ScholarPubMed
Magee, L. A., Chandra, K., Mazzotta, P., Stweart, D., Koren, G., & Guyatt, G. H. (2002). Development of a health-related quality of life instrument for nausea and vomiting of pregnancy. American Journal of Obstetrics and Gynecololy, 186, 232–238. http://dx.doi.org/10.1067/mob.2002.122604CrossRefGoogle ScholarPubMed
Martinez-Schallmoser, L., Telleen, S., & MacMullen, N. J. (2003). The effect of social support and acculturation on postpartum depression in Mexican American women. Journal of Transcultural !ursing, 14, 329–338. http://dx.doi.org/10.1177/1043659603257162CrossRefGoogle ScholarPubMed
McKee, M. D., Cunningham, M., Jankowski, K. R. B., & Zayas, L. (2001). Health-related functional status in pregnancy: Relationship with depression and social support in a multi-ethnic population. Obstetrics and Gynecology, 97, 988–993. http://dx.doi.org/10.1016/S0029-7844(01)01377-1Google Scholar
Menéndez, S., Hidalgo, M. V., Jiménez, L., & Moreno, M. C. (2011). Father involvement and marital relationship during transition to parenthood: Differences between dual and single-earner families. The Spanish Journal of Psychology, 14, 639–647. http://dx.doi.org/10.5209/rev_SJOP.2011.v14.n2.12CrossRefGoogle ScholarPubMed
Moyer, C. A., Ekpo, G., Calhoun, C. L., Greene, J., Naik, S., Sippola, E. … Anderson, F. J. (2008). Quality of life, optimism/pessimism, and knowledge and attitudes toward HIV screening among pregnant women in Ghana. Women's Health Issues, 18, 301–309. http://dx.doi.org/10.1016/j.whi.2008.02.001CrossRefGoogle ScholarPubMed
Nuwagaba-Biribonwhoa, H., Mayon-White, R. T., Okong, P., Carpenter, L. M., & Jenkinson, C. (2006). The impact of HIV on maternal quality of life in Uganda. AIDS Care, 18, 614–620. http://dx.doi.org/10.1080/09540120500359298CrossRefGoogle Scholar
Paalberg, K. M., Vingerhoets, A. J., Passchier, J., Heiner, A. G., Dekker, G.A., & Vangeijn, H. R. (1996). Psychosocial factors as predictors of maternal well-being and pregnancy related complaints. Journal of Psychosomatic Obstetrics and Gynaecology, 17, 93–102. http://dx.doi.org/10.3109/01674829609025669CrossRefGoogle Scholar
Pereira, M., & Canavarro, M. C. (2009). Relational contexts in adjustment to pregnancy of HIV-positive women: Relationships, social support and personal adjustment. AIDS Care, 21, 301–308. http://dx.doi.org/10.1080/09540120802183453CrossRefGoogle ScholarPubMed
Sandelowski, M., & Barroso, J. (2003a). Motherhood in the context of maternal HIV infection. Research in Nursing & Health, 26, 470–482 http://dx.doi.org/10.1002/nur.10109CrossRefGoogle ScholarPubMed
Sandelowski, M., & Barroso, J. (2003b). Toward a metasynthesis of qualitative findings on motherhood in HIV-positive women. Research in Nursing & Health, 26, 153–170. http://dx.doi.org/10.1002/nur.10072CrossRefGoogle Scholar
Sanders, L. B. (2008). Women's voices: The lived experience of pregnancy and motherhood after diagnosis with HIV. Journal of the Association of Nurses in AIDS Care, 19, 47–57. http://dx.doi.org/10.1016/j.jana.2007.10.002CrossRefGoogle ScholarPubMed
Sherr, L. (2005). Women and HIV. In Citron, K., Brouillette, M. J., & Beckett, A. (Eds.), HIV and Psychiatry: A training and resource manual (pp. 215–235). Cambridge, MA: Cambridge University Press.Google Scholar
Simon, G., Von Korff, M., Piccinelli, M., Fullerton, C., & Ormel, J. (1999). An international study of the relation between somatic symptoms and depression. New England Journal of Medicine, 341, 1329–1335. http://dx.doi.org/10.1056/NEJM199910283411801CrossRefGoogle Scholar
Skevington, S., & O'Connell, K. (2003). Measuring quality of life in HIV and AIDS: A review of the recent literature. Psychology & Health, 18, 331–350. http://dx.doi.org/10.1080/0887044031000084030CrossRefGoogle Scholar
Symon, A., MacDonald, A., & Ruta, D. (2002). Postnatal quality of life assessment: Introducing the Mother Generated Index. Birth, 29, 40–46. http://dx.doi.org/10.1046/j.1523-536X.2002.00154.xCrossRefGoogle ScholarPubMed
UNAIDS (2009). AIDS epidemic update. Geneva, Switzerland:Google Scholar
World Health Organization, Joint United Nations Programme on HIV/AIDS. Retrieved from http://data.unaids.org/pub/Report/2009/JC1700_Epi_Update_2009_en.pdfGoogle Scholar
Wallace, P., & Gotlib, I.A. (1990). Marital adjustment during the transition to parenthood: Stability and predictors of change. Journal of Marriage and the Family, 52, 21–29. http://dx.doi.org/10.2307/352834CrossRefGoogle Scholar
WHOQOL Group (1998). Development of World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine, 28, 551–558. http://dx.doi.org/10.1017/S0033291798006667CrossRefGoogle Scholar
Zhou, S.-Z., Wang, X.-L., & Wang, Y. (2009). Design of a questionnaire or evaluating the quality of life of postpartum women (PQOL) in China. Quality of Life Research, 18, 497–508. http://dx.doi.org/10.1007/s11136-009-9466-2CrossRefGoogle ScholarPubMed