Uniwersyteckie Czasopisma NaukowePerceived stress and life satisfaction in pregnant women during the COVID-19 pandemic: the mediating role of fear of childbirth and self-esteem
Słowa kluczowe:
self-esteem, life satisfaction, perceived stress, COVID-19, childbirth anxietyAbstrakt
Background:
The COVID-19 pandemic adversely affected the functioning and well-being of pregnant women. Negative feelings during pregnancy and the difficult pandemic situation may be the reason behind the perceived fear of childbirth, which can nega-tively affect the pregnant women’s life satisfaction. On the other hand, some protective factors, such as self-esteem, might mediate the relationship between perceived stress and well-being in pregnant women.
Participants and procedure:
Our study aimed to determine the relationship between perceived stress, fear of childbirth, self-esteem and life satisfaction. A total of 262 Polish pregnant women participated in this study. The Perceived Stress Scale (PSS-10), Fear of Childbirth Scale (KLP II), Self-Esteem Scale (SES) and Satisfaction with Life Scale (SWLS) were used in the study.
Results:
The results showed that perceived stress, fear of childbirth and self-esteem acted as significant predictors of life satisfaction in the tested group of pregnant women. Additionally, fear of childbirth and self-esteem played a mediational role in the relationship between perceived stress and life satisfaction.
Conclusions:
According to Diener’s concept, life satisfaction is an important component of one’s subjective well-being and health. There-fore, it is important to analyse factors that may mediate the impact of stress on pregnant women’s life satisfaction. The present results might suggest that during pregnancy and preparation for childbirth, women should be provided with appro-priate psychological care. Support from medical and psychological specialists, as well as from relatives, can reduce the level of perceived fears and strengthen personal resources. Based on the present results, we conclude that the fear of childbirth and the self-esteem of pregnant women should not be underestimated, as they are important predictors of their life satisfaction.
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Bibliografia
Boekhorst, M. G., Muskens, L., Hulsbosch, L. P., Van Deun, K., Bergink, V., Pop, V. J., & van den Heuvel, M. I. (2021). The COVID-19 outbreak increases maternal stress during pregnancy, but not the risk for postpartum depression. Archives of Women’s Mental Health, 24, 1037–1043. https://doi. org/10.1007/s00737-021-01104-9.
Brandão, T., Brites, R., Nunes, O., Pires, M., & Hipólito, J. (2020). Anxiety and depressive symptoms during pregnancy, perceived control and posttraumatic stress symptoms after childbirth: a longitudinal mediation analysis. Journal of Health Psychology, 25, 2085–2095. https://doi.org/10.1177/ 1359105318787018.
Brooks, S. K., Weston, D., & Greenberg, N. (2020). Psychological impact of infectious disease outbreaks on pregnant women: rapid evidence review. Public Health, 189, 26–36. https://doi.org/10.1016/ j.puhe.2020.09.006.
Cascardi, M., & O’Leary, K. D. (1992). Depressive symptomatology, self-esteem, and self-blame in battered women. Journal of Family Violence, 7, 249–259. https://doi.org/10.1007/BF00994617.
Central Statistical Office of Poland (2021). Baza demograficzna [Demographics database]. Retrieved from https://demografia.stat.gov.pl/bazademografia/.
Chaaya, M., Osman, H., Naassan, G., & Mahfoud, Z. (2010). Validation of the Arabic version of the Cohen Perceived Stress Scale (PSS-10) among pregnant and postpartum women. BMC Psychiatry, 10, 111. https://doi.org/10.1186/1471-244X-10-111.
Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396. https://doi. org/10.2307/2136404.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Lawrence Erlbaum Associates.
Chen, S. X., Cheung, F. M., Bond, M. H., & Leung, J. P. (2006). Going beyond self‐esteem to predict life satisfaction: The Chinese case. Asian Journal of Social Psychology, 9, 24–35. https://doi.org/10.1111/ j.1467-839X.2006.00182.x.
Çivitci, A. (2010). Moderator role of self-esteem on the relationship between life satisfaction and depression in early adolescents. Emotional and Behavioural Difficulties, 15, 141–152. https://doi.org/ 10.1080/13632752.2010.480885.
Czapiński, J. (2004), Psychologia pozytywna. Nauka o szczęściu, zdrowiu, sile i cnotach człowieka [Positive psychology. The science of happiness, health, strength and virtues of man]. Wydawnictwo Naukowe PWN.
Das, K. V., Jones-Harrell, C., Fan, Y., Ramaswami, A., Orlove, B., & Botchwey, N. (2020). Understanding subjective well-being: Perspectives from psychology and public health. Public Health Reviews, 41, 1–32. https://doi.org/10.1186/s40985-020-00142-5.
Dashraath, P., Wong, J. L. J., Lim, M. X. K., Lim, L. M., Li, S., Biswas, A., Choolani, M., Mattar, C., & Su, L. L. (2020). Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. American Journal of Obstetrics and Gynecology, 222, 521–531. https://doi. org/10.1016/j.ajog.2020.03.021.
Diener, E. (1984). Subjective well-being. Psychological Bulletin, 95, 542–575. https://doi.org/10.1037/0033- 2909.95.3.542.
Diener, E. (2009). Subjective well-being. In E. Diener (Ed.), The science of well-being (pp. 11–58). Springer.
Diener, E., & Diener, M. (1995). Cross-cultural correlates of life satisfaction and self-esteem. Journal of Personality and Social Psychology, 68, 653–663. https://doi.org/10.1037//0022-3514.68.4.653.
Diener, E. D., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The satisfaction with life scale. Journal of Personality Assessment, 49, 71–75. https://doi.org/10.1207/s15327752jpa4901_13.
Diener, E., Lucas, R. E., & Oishi, S. (2002). Subjective well-being: The science of happiness and life satisfaction. In C. R. Snyder & S. J. Lopez (Eds.), Handbook of positive psychology (Vol. 2, pp. 63–73). Oxford University Press.
Diener, E., Pressman, S. D., Hunter, J., & DelgadilloChase, D. (2017). If, why, and when subjective well-being influences health, and future needed research. Applied Psychology: Health and WellBeing, 9, 133–167. https://doi.org/10.1111/aphw. 12090.
Diener, E., Suh, E. M., Lucas, R. E., & Smith, H. L. (1999). Subjective well-being: Three decades of progress. Psychological Bulletin, 125, 276–302. https://doi. org/10.1037/0033-2909.125.2.276.
Dolatian, M., Mirabzadeh, A., Forouzan, A. S., Sajjadi, H., Majd, H. A., Moafi, F., & Mahmoodi, Z. (2013). Correlation between self-esteem and perceived stress in pregnancy and ways to coping with stress. Pajoohandeh Journal, 18, 148–155.
Dymecka, J., Gerymski, R., Iszczuk, A., & Bidzan, M. (2021). Fear of coronavirus, stress and fear of childbirth in Polish pregnant women during the COVID-19 pandemic. International Journal of Environmental Research and Public Health, 18, 13111. https://doi.org/10.3390/ijerph182413111.
Dymecka J., Tarczyński, R., & Gerymski, R. (2023a). Stress in emergency telephone number operators during the COVID-19 pandemic: The role of selfefficacy and Big Five personality traits. Health Psychology Report, 11, 145–155. https://doi.org/10. 5114/hpr/115820.
Dymecka, J., Gerymski, R., Machnik-Czerwik, A., & Rogowska, A. M. (2023b). Does positive thinking help during difficult pandemic times? The role of positive orientation in the relationship between fear of COVID-19 and perceived stress. European Journal of Investigation in Health, Psychology and Education, 13, 151–160. https://doi.org/10.3390/ejihpe13010011.
Esteban-Gonzalo, S., Caballero-Galilea, M., González-Pascual, J. L., Álvaro-Navidad, M., & EstebanGonzalo, L. (2021). Anxiety and worries among pregnant women during the COVID-19 pandemic: a multilevel analysis. International Journal of Environmental Research and Public Health, 18, 6875. https://doi.org/10.3390/ijerph18136875.
Garthus-Niegel, S., von Soest, T., Vollrath, M. E., & Eberhard-Gran, M. (2013). The impact of subjective birth experiences on post-traumatic stress symptoms: a longitudinal study. Archives of Women’s Mental Health, 16, 1–10. https://doi.org/10.1007/ s00737-012-0301-3.
Geissbuehler, V., & Eberhard, J. (2002). Fear of childbirth during pregnancy: a study of more than 8000 pregnant women. Journal of Psychosomatic Obstetrics & Gynecology, 23, 229–235. https://doi. org/10.3109/01674820209074677.
Gerymski, R., Cisek, A., & Dymecka, J. (2022). Seksualny dobrostan a satysfakcja z życia osób z niepełnosprawnością ruchową: moderacyjna rola samooceny [Sexual well-being and life satisfaction of people with motor disabilities: the moderating role of self-esteem]. Journal of Sexual and Mental Health, 20, 1–7. https://doi.org/10.5603/SP.2022.0003.
Giesbrecht, G. F., Rojas, L., Patel, S., Kuret, V., MacKinnon, A. L., Tomfohr-Madsen, L., & Lebel, C. (2022). Fear of COVID-19, mental health, and pregnancy outcomes in the pregnancy during the COVID-19 pandemic study: Fear of COVID-19 and pregnancy outcomes. Journal of Affective Disorders, 299, 483–491. https://doi.org/10.1016/j.jad.2021.12.057.
Guszkowska, M., & Langwald, M. (2014). Changes in satisfaction with body in pregnant women par ticipating in physical exercise classes and childbirth classes. Health Psychology Report, 2, 152–161. https://doi.org/10.5114/hpr.2014.44424.
Hairston, I. S., Handelzalts, J. E., Assis, C., & Kovo, M. (2018). Postpartum bonding difficulties and adult attachment styles: The mediating role of postpartum depression and childbirth‐related PTSD. Infant Mental Health Journal, 39, 198–208. https:// doi.org/10.1002/imhj.21695.
Hayes, A. F. (2017). Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. Guilford Publications.
Heron, J., O’Connor, T. G., Evans, J., Golding, J., Glover, V., & ALSPAC Study Team. (2004). The course of anxiety and depression through pregnancy and the postpartum in a community sample. Journal of Affective Disorders, 80, 65–73. https://doi. org/10.1016/j.jad.2003.08.004.
Hong, S. M., & Giannakopoulos, E. (1994). The relationship of satisfaction with life to personality characteristics. Journal of Psychology, 128, 547– 558. https://doi.org/10.1080/00223980.1994.9914912.
Hu, J., Hu, J., Huang, G., & Zheng, X. (2016). Life satisfaction, self-esteem, and loneliness among LGB adults and heterosexual adults in China. Journal of Homosexuality, 63, 72–86. https://doi.org/10.108 0/00918369.2015.1078651.
Hwang, R. H. (2021). Effects of pregnant women’s pregnancy stress and self-esteem on their depression. Journal of Digital Convergence, 19, 469–477.
Ilska, M., Kołodziej-Zaleska, A., Brandt-Salmeri, A., Preis, H., & Lobel, M. (2021a). Pandemic stress and its correlates among pregnant women during the second wave of COVID-19 in Poland. International Journal of Environmental Research and Public Health, 18, 11140. https://doi.org/10.3390/ijerph182111140.
Ilska, M., Kołodziej-Zaleska, A., Brandt-Salmeri, A., Preis, H., & Lobel, M. (2021b). Pandemic-related pregnancy stress assessment: Psychometric properties of the Polish PREPS and its relationship with childbirth fear. Midwifery, 96, 102940. https://doi.org/10.1016/j.midw.2021.102940.
Jamieson, D. J., Theiler, R. N., & Rasmussen, S. A. (2006). Emerging infections and pregnancy. Emerging Infectious Diseases, 12, 1638–1643. https://doi. org/10.3201/eid1211.060152.
Jesse, D. E., Kim, H., & Herndon, C. (2014). Social support and self‐esteem as mediators between stress and antepartum depressive symptoms in rural pregnant women. Research in Nursing & Health, 37, 241–252. https://doi.org/10.1002/nur.21600.
Jesse, D. E., & Swanson, M. S. (2007). Risks and resources associated with antepartum risk for depression among rural southern women. Nursing Research, 56, 378–386. https://doi.org/10.1097/01. NNR.0000299856.98170.19.
Jomeen, J., & Martin, C. R. (2005). Self-esteem and mental health during early pregnancy. Clinical Effectiveness in Nursing, 9, 92–95. https://doi.org/ 10.1016/j.cein.2004.09.001.
Juczyński, Z., & Ogińska-Bulik, N. (2009). Narzędzia pomiaru stresu i radzenia sobie ze stresem [Tools for measuring stress and coping with stress]. Laboratory of Psychological Tests of the Polish Psychological Association.
Juczyński, Z. (2001). Narzędzia pomiaru w promocji i psychologii zdrowia [Measurement tools in health promotion and psychology]. Laboratory of Psychological Tests of the Polish Psychological Association.
Kazemi, A., Ghaedrahmati, M., & Kheirabadi, G. (2021). Partner’s emotional reaction to pregnancy mediates the relationship between pregnancy planning and prenatal mental health. BMC Pregnancy and Childbirth, 21, 168. https://doi.org/ 10.1186/s12884-021-03644-5.
Khoury, J. E., Atkinson, L., Bennett, T., Jack, S. M., & Gonzalez, A. (2021). COVID-19 and mental health during pregnancy: The importance of cognitive appraisal and social support. Journal of Affective Disorders, 282, 1161–1169. https://doi.org/ 10.1016/j.jad.2021.01.027.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer.
Lebel, C., MacKinnon, A., Bagshawe, M., TomfohrMadsen, L., & Giesbrecht, G. (2020). Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic. Journal of Affective Disorders, 277, 5–13. https://doi. org/10.1016/j.jad.2020.07.126.
Lok, K. Y., Ko, R. W. T., Fan, H. S. L., Wong, J. Y., Choi, E. P., Shek, N. W. M., Ngan, H. Y. S., Tarrant, M., Li, J., Huang, Y. Y., Ouyang, Y. Q., & Fong, D. Y. T. (2021). International survey on fear and childbirth experience in pregnancy and the postpartum period during the COVID-19 pandemic: Study protocol. BMJ Open, 11, e050132. https:// doi.org/10.1136/bmjopen-2021-050132.
Łaguna, M., Lachowicz-Tabaczek, K., & Dzwonkowska, I. (2007). Skala samooceny SES Morrisa Rosenberga – polska adaptacja metody [The Rosenberg Self-Esteem Scale: Polish adaptation of the scale]. Psychologia Społeczna, 2, 164–176.
Maisona, D., Oleksya, T., & Wnuk, A. (2020). Uwarunkowania objawów depresji i lęku uogólnionego u dorosłych Polaków w trakcie epidemii COVID-19: raport z pierwszej fali badania podłużnego [Determinants of depression symptoms and generalized anxiety disorder in adult Poles during the COVID-19 epidemic: report from the first wave of a longitudinal study]. University of Warsaw.
Masjoudi, M., Aslani, A., Seifi, M., Khazaeian, S., & Fathnezhad-Kazemi, A. (2022). Association between perceived stress, fear and anxiety of COVID-19 with self-care in pregnant women: a cross-sectional study. Psychology, Health & Medi cine, 27, 289–300. https://doi.org/10.1080/13548506. 2021.1894344.
Mikolajkow, A., & Małyszczak, K. (2023). Stress level and general mental state in Polish pregnant women during COVID-19 pandemic. Journal of Reproductive and Infant Psychology, 41, 165–182. https:// doi.org/10.1080/02646838.2021.1976402.
Naidu, S. A., Clemens, R. A., Pressman, P., Zaigham, M., Kadkhoda, K., Davies, K. J., & Naidu, A. S. (2022). COVID-19 during pregnancy and postpartum: I) Pathobiology of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) at maternal-fetal interface. Journal of Dietary Supplements, 19, 115– 142. https://doi.org/10.1080/19390211.2020.1834049.
Nilsson, C., Lundgren, I., Karlström, A., & Hildingsson, I. (2012). Self-reported fear of childbirth and its association with women’s birth experience and mode of delivery: a longitudinal population-based study. Women and Birth, 25, 114–121. https://doi. org/10.1016/j.wombi.2011.06.001.
Pazzagli, C., Laghezza, L., Capurso, M., Sommella, C., Lelli, F., & Mazzeschi, C. (2015). Antecedents and consequences of fear of childbirth in nulliparous and parous women. Infant Mental Health Journal, 36, 62–74. https://doi.org/10.1002/imhj.21483.
Poprawa, R. (2003). Skala spostrzeganego stresu. Tymczasowy podręcznik do interpretacji wyników [The Perceived Stress Scale. Temporary manual for interpreting results]. Instytut Psychologii Uniwersytetu Wrocławskiego.
Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40, 879–891. https:// doi.org/10.3758/brm.40.3.879.
Preis, H., Mahaffey, B., Heiselman, C., & Lobel, M. (2020). Pandemic-related pregnancy stress and anxiety among women pregnant during the coronavirus disease 2019 pandemic. American Journal of Obstetrics & Gynecology, 2, 100155. https://doi.org/10.1016/j.ajogmf.2020.100155.
Putyński, L. (1997). Lęk porodowy. Jego istota i metoda pomiaru [Labour anxiety. Its essence and method of measurement]. Acta Universitatis Lodziensis. Folia Psychologica, 1, 147–152.
Putyński, L. (2012). Lęk porodowy jako istotny modyfikator jakości porodu – implikacje dla profilaktyki, terapii i diagnostyki [Labour anxiety as a significant modifier of delivery quality – implications for prevention, therapy and diagnosis]. In M. Wojciechowska & Z. Tokarski (Eds.), Kobieta podmiotem działań zespołu interdyscyplinarnego. Ewaluacja kształcenia pielęgniarek i położnych [Woman as the subject of the activities of the interdisciplinary team. Evaluation of the education of nurses and midwives] (pp. 151–162). Publishing House of the Academy of Humanities and Economics in Łódź.
Putyński, L., & Paciorek, M. (2008). Kwestionariusz lęku porodowego (KLP II) wersja zrewidowana – konstrukcja i właściwości psychometryczne [The revised labour anxiety questionnaire (KLP II) – the construction and psychological validation]. Acta Universitatis Lodziensis. Folia Psychologica, 12, 129–133.
Rosenberg, M. (1979). Conceiving the self. Basic Books.
Roman, M., Bostan, C. M., Diaconu-Gherasim, L. R., & Constantin, T. (2019). Personality traits and postnatal depression: The mediated role of postnatal anxiety and moderated role of type of birth. Frontiers in Psychology, 10, 1625. https://doi.org/10.3389/ fpsyg.2019.01625.
Rosenberg, M., Schooler, C., Schoenbach, C., & Rosenberg, F. (1995). Global self-esteem and specific selfesteem: Different concepts, different outcomes. American Sociological Review, 60, 141–156. https:// doi.org/10.2307/2096350.
Rugh, R., Shettles, L. B., & Einhorn, R. (1971). From conception to birth: The drama of life’s beginnings. HarperCollins.
Ryding, E., Wijma, B., Wijma, K., & Rydhström, H. (1998). Fear of childbirth during pregnancy may increase the risk of emergency cesarean section. Acta Obstetricia et Gynecologica Scandinavica, 77, 542–547. https://doi.org/10.1080/j.1600-0412.1998. 770512.x.
Saisto, T., & Halmesmäki, E. (2003). Fear of childbirth: a neglected dilemma. Acta Obstetricia et Gynecologica Scandinavica, 82, 201–208. https://doi. org/10.1034/j.1600-0412.2003.00114.x.
Salehi, L., Rahimzadeh, M., Molaei, E., Zaheri, H., & Esmaelzadeh‐Saeieh, S. (2020). The relationship among fear and anxiety of COVID‐19, pregnancy experience, and mental health disorder in pregnant women: a structural equation model. Brain and Behavior, 10, e01835. https://doi.org/10.1002/ brb3.1835.
Taubman-Ben‐Ari, O., Chasson, M., & Abu‐Sharkia, S. (2021). Childbirth anxieties in the shadow of COVID‐19: Self‐compassion and social support among Jewish and Arab pregnant women in Israel. Health & Social Care in the Community, 29, 1409–1419. https://doi.org/10.1111/hsc.13196.
Villar, J., Ariff, S., Gunier, R. B., Thiruvengadam, R., Rauch, S., Kholin, A., Roggero, P., Prefumo, F., do Vale, M. S., Cardona-Perez, J. A., Maiz, N., Cetin, I., Savasi, V., Deruelle, P., Easter, S. R., Sichitiu, J., Soto Conti, C. P., Ernawati, E., Mhatre, M., Teji, J. S., … Papageorghiou, A. T. (2021). Maternal and neonatal morbidity and mortality among pregnant women with and without COVID-19 infection: The INTERCOVID multinational cohort study. JAMA Pediatrics, 175, 817–826. https://doi.org/10.1001/ jamapediatrics.2021.1050.
Vismara, L., Sechi, C., Neri, M., Paoletti, A., & Lucarelli, L. (2021). Maternal perinatal depression, anxiety, fear of birth, and perception of infants’ negative affectivity at three months. Journal of Reproductive and Infant Psychology, 39, 532–543. https://doi.org/10.1080/02646838.2020.1843612.
Wang, Z., Liu, H., Yu, H., Wu, Y., Chang, S., & Wang, L. (2017). Associations between occupational stress, burnout and well-being among manufacturing workers: Mediating roles of psychological capital and self-esteem. BMC Psychiatry, 17, 364. https:// doi.org/10.1186/s12888-017-1533-6.
Webster, J., Nicholas, C., Velacott, C., Cridland, N., & Fawcett, L. (2011). Quality of life and depression following childbirth: Impact of social support. Midwifery, 27, 745–749. https://doi.org/10.1016/ j.midw.2010.05.014.
Woods, S. M., Melville, J. L., Guo, Y., Fan, M. Y., & Gavin, A. (2010). Psychosocial stress in pregnancy. American Journal of Obstetrics & Gynecology, 202, 61e1–61e7. https://doi.org/10.1016/ j.ajog.2009.07.041.
Woody, C. A., Ferrari, A. J., Siskind, D. J., Whiteford, H. A., & Harris, M. G. (2017). A systematic review and meta-regression of the prevalence and incidence of perinatal depression. Journal of Affective Disorders, 219, 86–92. https://doi.org/10.1016/ j.jad.2017.05.003.
Yokokura, A. V. C. P., Silva, A. A. M. D., Fernandes, J. D. K. B., Del-Ben, C. M., Figueiredo, F. P. D., Barbieri, M. A., & Bettiol, H. (2017). Perceived Stress Scale: confirmatory factor analysis of the PSS14 and PSS10 versions in two samples of pregnant women from the BRISA cohort. Cadernos de Saude Publica, 33, e00184615. https://doi. org/10.1590/0102-311X00184615.
Yu, M., Qiu, T., Liu, C., Cui, Q., & Wu, H. (2020). The mediating role of perceived social support between anxiety symptoms and life satisfaction in pregnant women: a cross-sectional study. Health and Quality of Life Outcomes, 18, 223. https://doi.org/10.1186/s12955-020-01479-w.
Zaigham, M., & Andersson, O. (2020). Maternal and perinatal outcomes with COVID‐19: a systematic review of 108 pregnancies. Acta Obstetricia et Gynecologica Scandinavica, 99, 823–829. https://doi. org/10.1111/aogs.13867.
Zhang, L., & Leung, J. P. (2002). Moderating effects of gender and age on the relationship between self‐ esteem and life satisfaction in mainland Chinese. International Journal of Psychology, 37, 83–91. https://doi.org/10.1080/00207560143000252.
