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Pregnancy-related anxiety: A concept analysis
Hamideh Bayrampour1, Elena Ali2, Deborah A McNeil3
1Department of Family Practice, Midwifery Program, University of British Columbia, Canada V6T 1Z3.
International Journal of Nursing Studies
|December 3, 2015
Summary
Pregnancy-related anxiety, distinct from general anxiety, impacts maternal and child health. This concept analysis identified key attributes, antecedents, and consequences, revealing a need for comprehensive assessment tools.
Area of Science:
- Reproductive Health
- Maternal Mental Health
- Psychological Science
Background:
- Pregnancy-related anxiety (PRA) is increasingly recognized as a significant factor affecting maternal and child well-being, potentially distinct from general anxiety and depression.
- Limited conceptualization has hindered the accurate measurement and assessment of PRA, impacting theoretical development and clinical practice.
- Understanding PRA is crucial for developing targeted interventions and improving perinatal mental health outcomes.
Purpose of the Study:
- To clarify the concept of pregnancy-related anxiety (PRA), identifying its core characteristics and dimensions.
- To analyze existing measures of PRA to assess their alignment with the conceptualized construct and identify any measurement gaps.
- To contribute to the theoretical advancement of PRA for improved clinical assessment and management.
Main Methods:
- A comprehensive concept analysis was performed using a modified Walker and Avant approach.
- Extensive literature searches were conducted across multiple databases (MEDLINE, PsycINFO, CINAHL, SCOPUS, EMBASE, etc.).
- Included studies were qualitative or quantitative, published in English, and focused on anxiety during pregnancy and its dimensions.
Main Results:
- Thirty-eight studies informed the analysis, identifying three critical attributes (affective, cognitive, somatic), three antecedents (threat perception, low control, cognitive activity), and four consequences (negative attitudes, concentration difficulties, reassurance seeking, avoidance).
- Nine dimensions of PRA were identified, with common themes including concerns about fetal health, fetal loss, childbirth, and infant care.
- Analysis of five scales indicated the Pregnancy-Related Anxiety Scale and Pregnancy Outcome Questionnaire as potentially useful for assessing PRA existence and severity, though gaps remain.
Conclusions:
- The critical attributes of PRA overlap with general anxiety disorders, but specific behavioral consequences may indicate severity in certain individuals.
- Current assessment tools can identify the presence of PRA and capture some dimensions, but a comprehensive instrument is needed.
- Further development of assessment tools is required to encompass all dimensions of PRA and accurately measure its severity for better clinical application.
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