| Objective1.Describe the level and course of postpartum fatigue during the three time points and determine associated factors during the same period.2.Explore the correlation between postpartum fatigue and postpartum depression over time.Method1.Obtain the permission to use the Multidimensional Assessment of Fatigue Scale（Mandarin Chinese for China）for this study.The internal consistency reliability,split-half reliability,content validity,convergent validity,discriminant validity and concurrent validity were calculated.2.A convenience sample of women who underwent a routine 6-week postpartum follow-up visit at a tertiary A general hospital in Changchun between November 2019 and January 2020 were invited to participate in this research.Data were collected by using a combination of on-site questionnaires at 4～6 weeks postpartum（T1）and telephone follow-up at 9（T2）and 12 weeks postpartum（T3）.3.Postpartum fatigue and postpartum depression were assessed by using the Multidimensional Assessment of Fatigue Scale and Edinburgh Postnatal Depression Scale,respectively.4.Repeated measurement variance was applied to compare the longitudinal trends of postpartum fatigue and postpartum depression at three time points,and multiple linear regression analysis were used to examine the factors associated with postpartum fatigue.Pearson correlation coefficient was used to describe the correlation between postpartum fatigue and postpartum depression over time.Results1.The Cronbach’s alpha of the Multidimensional Assessment of Fatigue Scale was0.870 and split-half reliability was 0.732 at initial data collection.The internal consistency reliability,split-half reliability,content validity,convergent validity,discriminant validity and concurrent validity were all good.2.Of the 200 women who met baseline eligibility criteria and returned a completed baseline questionnaire,187（93.5%）and 182（91%）completed the 9-week and 12-week postpartum questionnaires,respectively.3.Across three time points,the global fatigue index of 182 participants was（25.28±7.25）,（22.43±5.73）and（20.85±5.20）.35.7%,18.7%,and11.0%of the participants who experienced fatigue,when using 28 as the cut-off score for fatigue,respectively.4.The results of multiple linear regression analysis showed that the main factors associated with postpartum fatigue at T1 time point included financial burden,mode of birth,worry about parenting,sleep quality and effects of infant’s sleep patterns,the main factors associated with postpartum fatigue at T2 time point included financial burden,mode of birth,worry about parenting,parity,sleep quality,and assistance with infant care,the main factors associated with postpartum fatigue at T3 time point included financial burden,mode of birth,sleep quality,effects of infant’s sleep patterns and birth weight of the infant.5.All correlations between postpartum fatigue and postpartum depression at the three time points were significant.A complex relationship between postpartum fatigue and postpartum depression was observed,where fatigue at earlier time points predicted fatigue at later time points,so was postpartum depression,and postpartum depression predicted postpartum fatigue at the same time points.Conclusion1.Satisfactory validity and reliability of the Multidimensional Assessment of Fatigue scale were confirmed among postpartum women.2.At three time points,the level of postpartum fatigue was highest at 4～6 weeks postpartum and significantly decreased from puerperal to 12 weeks postpartum.When 28was used as the threshold score for postpartum fatigue,the incidence of postpartum fatigue also showed a downward trend.3.Several factors included financial burden,parity,mode of birth,sleep,worry about parenting,and assistance with infant care were related to postpartum fatigue.4.All correlations between postpartum fatigue and postpartum depression at the three time points were significant. |
