Aims/Background: Perceived experiences of childbirth are important for mothers as they affect their self-esteem, mother-child interactions, subsequent mother-child bonding, and their desire for another child. This stu...Aims/Background: Perceived experiences of childbirth are important for mothers as they affect their self-esteem, mother-child interactions, subsequent mother-child bonding, and their desire for another child. This study examined the factor structure and construct validity of Salmon and Drew’s Multidimensional Assessment of Women’s Experience of Childbirth (MAWEC) in Japanese. Design/Methods: This study conducted a questionnaire survey using the Japanese version of the MAWEC and other variables with 759 women with infants in Japan. The participants’ mean (standard deviation [SD], range) age was 31.9 (5.3, 18 - 46) years. A total of 353 (46.5%) participants were primiparous and 384 (50.6%) were multiparous, and 22 (2.9%) did not answer. The data were randomly divided into two groups for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) and separately analyzed the positive- and negative-worded items. I conducted EFA using the maximum-likelihood method with PROMAX rotation from one-through two- and three-factor structures. Different factor structure models were compared in terms of CFAs using, as indicator of goodness-of-fit, chi-square/df, comparative fit index (CFI), and root mean square of error approximation (RMSEA). Results: This study showed that a bifactor model for the MAWEC with four subscales (positive emotion, positive coping, negative emotion, and negative coping) fit the data the best. These four subscales were associated with demographic, obstetric, neonatal, and feeding characteristics. For example, primiparas were more vulnerable to coping aspects of perceived childbirth experiences, including sense of mastery over the delivery process and ability to enjoy the delivery. Gestational age at birth was associated with emotional aspects of perceived childbirth experiences. Conclusion: The Japanese version of the MAWEC consists of four aspects regarding perceived childbirth experience. Perinatal health professionals may examine women’s childbirth experiences from these four pe展开更多
Traditional stepwise approach usually adjusts the treatment regimen based on changes in asthma symptoms and severity to achieve good asthma control.However,due to the generalized heterogeneity and complexity of asthma...Traditional stepwise approach usually adjusts the treatment regimen based on changes in asthma symptoms and severity to achieve good asthma control.However,due to the generalized heterogeneity and complexity of asthma,its therapeutic efficacy in difficultto-treat asthma is limited.Recently,a precision medicine approach based on the identification and intervention of treatable traits of chronic airway disease has been proposed and appears to be of greater benefit to asthmatics.We reported a 71-year-old male with uncontrolled asthma and multiple exacerbations over the past year.He complained of persistent dyspnea despite high-dose of inhaled corticosteroids plus other controllers.Does this patient have some potential treatable traits contributing to difficult-to-treat asthma?Through a multidimensional assessment of three domains including pulmonary,extrapulmonary,and behavioral/risk factors,15 treatable traits were identified in the patient,mainly including airflow limitation,eosinophilic airway inflammation,small airway dysfunction,exacerbation prone,dilated cardiomyopathy,diabetes mellitus,inhaler device polypharmacy,smoking,and the absence of an asthma action plan.After targeted treatment for these treatable traits,the patient experienced significant improvement in dyspnea and he could maintain good asthma control with low-dose inhaled corticosteroids and long-acting β_(2)-agonist.This study shows that,in response to the limitation of a stepwise approach to therapy,treatable traits is a new strategy where patients are individually assessed for a specified set of treatable problems,and an individualized treatment program is developed and implemented based on this multidimensional assessment,especially for difficult-to-treat asthma.展开更多
文摘Aims/Background: Perceived experiences of childbirth are important for mothers as they affect their self-esteem, mother-child interactions, subsequent mother-child bonding, and their desire for another child. This study examined the factor structure and construct validity of Salmon and Drew’s Multidimensional Assessment of Women’s Experience of Childbirth (MAWEC) in Japanese. Design/Methods: This study conducted a questionnaire survey using the Japanese version of the MAWEC and other variables with 759 women with infants in Japan. The participants’ mean (standard deviation [SD], range) age was 31.9 (5.3, 18 - 46) years. A total of 353 (46.5%) participants were primiparous and 384 (50.6%) were multiparous, and 22 (2.9%) did not answer. The data were randomly divided into two groups for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) and separately analyzed the positive- and negative-worded items. I conducted EFA using the maximum-likelihood method with PROMAX rotation from one-through two- and three-factor structures. Different factor structure models were compared in terms of CFAs using, as indicator of goodness-of-fit, chi-square/df, comparative fit index (CFI), and root mean square of error approximation (RMSEA). Results: This study showed that a bifactor model for the MAWEC with four subscales (positive emotion, positive coping, negative emotion, and negative coping) fit the data the best. These four subscales were associated with demographic, obstetric, neonatal, and feeding characteristics. For example, primiparas were more vulnerable to coping aspects of perceived childbirth experiences, including sense of mastery over the delivery process and ability to enjoy the delivery. Gestational age at birth was associated with emotional aspects of perceived childbirth experiences. Conclusion: The Japanese version of the MAWEC consists of four aspects regarding perceived childbirth experience. Perinatal health professionals may examine women’s childbirth experiences from these four pe
基金supported by the National Natural Science Foundation of China(Grants No.81920108002 and 81870027)the 1.3.5 Project for Disciplines of Excellence-Clinical Research Incubation Project,West China Hospital,Sichuan University(Grant No.2018hXFH016)+1 种基金the Science and Technology Bureau of Chengdu,China(Grant No.2021-GH03-00007-HZ)the Sichuan Provincial Science and Technology Agency,Sichuan,China(Grant No.2022YFS0263).
文摘Traditional stepwise approach usually adjusts the treatment regimen based on changes in asthma symptoms and severity to achieve good asthma control.However,due to the generalized heterogeneity and complexity of asthma,its therapeutic efficacy in difficultto-treat asthma is limited.Recently,a precision medicine approach based on the identification and intervention of treatable traits of chronic airway disease has been proposed and appears to be of greater benefit to asthmatics.We reported a 71-year-old male with uncontrolled asthma and multiple exacerbations over the past year.He complained of persistent dyspnea despite high-dose of inhaled corticosteroids plus other controllers.Does this patient have some potential treatable traits contributing to difficult-to-treat asthma?Through a multidimensional assessment of three domains including pulmonary,extrapulmonary,and behavioral/risk factors,15 treatable traits were identified in the patient,mainly including airflow limitation,eosinophilic airway inflammation,small airway dysfunction,exacerbation prone,dilated cardiomyopathy,diabetes mellitus,inhaler device polypharmacy,smoking,and the absence of an asthma action plan.After targeted treatment for these treatable traits,the patient experienced significant improvement in dyspnea and he could maintain good asthma control with low-dose inhaled corticosteroids and long-acting β_(2)-agonist.This study shows that,in response to the limitation of a stepwise approach to therapy,treatable traits is a new strategy where patients are individually assessed for a specified set of treatable problems,and an individualized treatment program is developed and implemented based on this multidimensional assessment,especially for difficult-to-treat asthma.
