臺灣博碩士論文加值系統

本研究目的在探討網路社交平台介入對於孕婦身心症狀、憂鬱、社會支持、母胎依附、及孕期適應的成效。有鑑於台灣女性平均生育率極低、民眾網路普及性高，以及大家庭支持結構的變遷與消逝，孕產照護環境已不同以往，本研究以壓力理論為理論架構 ，介入措施為網路社交平台，進行類實驗性研究設計，於南部某醫學中心產科門診招募研究對象，實驗組66人，於常規照護之外，接受網路社交平台介入；比較組55人，採一般常規照護。兩組於第一孕期接受前測，第二孕期及三孕期再次接受後測一與後測二。測量變項包括孕期身心症狀、憂鬱、社會支持、母胎依附、及孕期適應。研究資料採用獨立樣本t檢定及卡方檢定比較兩組人口學、產科變項，以廣義估計方程式（Generalized Estimating Equations, GEE）分析研究對象於介入後，在孕期身心症狀、憂鬱、社會支持、母胎依附、及孕期適應之成效。研究結果發現兩組個案三個孕期單獨比較，或是整個孕期趨勢比較，皆未在孕期身心症狀、憂鬱、社會支持、母胎依附、及孕期適應具有顯著差異。現今資訊時代虛擬社群已是生活的一部份，尤其許多年輕孕婦仰賴網路問問題、找資料、交朋友、打電話，建議未來研究應逐漸重視這種生活形式的轉變，繼續探討並建立更多資料，以累積此領域的知識與實證資料，逐步加深與增廣孕產照護專業的長遠發展。

The purpose of study is to examine the effectiveness of an Internet social networking site for Taiwanese pregnant mother on their psycho-physical symptoms, depression, social support, maternal fetal attachment, and prenatal adaptation. The study is originally designed from the perspective of intergrating low rates of Taiwan total fertility, the loss of traditional family support network, and the convenience of internet. Stress theory is used as the study framework, and a closed online social networking site is provided for experimental group as intervention. Participants was recruited at a medical-center leveled hospital in southern Taiwan. Fifty-five pregnant women in compare group receives ordinary prenatal care. Sixty-six pregnant women in experiment group receives ordinary prenatal care and are invited to join the internet social networking site to sharing pregnancy related experience with other peer members. Baseline data is collected in the first-trimester, and post measurements are in the second and the third trimester. Instruments including prenatal psycho-physical symptoms, Edinburgh depression scale, social support scale, maternal fetal attachment, and prenatal adaptation questionnaire are used in the study. Generalized Estimating Equations (GEE) is used to analyze the differences between two groups. The study results indicate no significant differences on prenatal psycho-physical symptoms, depression, social support, maternal fetal attachment, and pregnancy adaptation between two groups. More health-related online support studies is needed for developing future knowledge.

中文摘要 I
英文摘要 II
第一章 緒論 1
第一節 研究背景 1
第二節 研究目的 5
第三節 研究假設 5
第四節 名詞定義 6
第二章 理論架構與文獻查證9
第一節 理論架構 9
第二節 文獻查證 14
第三章 研究方法 34
第一節 研究設計 34
第二節 研究對象 35
第三節 研究場所 35
第四節 樣本數估計35
第五節 研究介入措施36
第六節 研究工具 42
第七節 研究步驟 45
第八節 研究對象之權益維護 46
第九節 資料處理與分析 47
第四章 研究結果 49
第一節 資料收集狀況與流失率 49
第二節 個案基本資料與同質性檢定分析 51
第三節 實驗組孕婦使用網路社交平台的情況及滿意度 54
第四節 兩組孕婦在三個孕期之身心症狀、憂鬱、社會支持、母胎依附及孕期適應的差異 58
第五節 兩組孕婦在身心症狀、憂鬱、社會支持、母胎依附及孕期適應之趨勢差異 69
第六節 網路平台使用程度對身心症狀、憂鬱、社會支持、母胎依附及孕期適應的差異 80
第五章 討論 89
第一節 研究對象與流失原因探討 89
第二節 網路社交平台對身心症狀、憂鬱、社會支持、母胎依附及孕期適應的成效 90
第三節 以網路做為介入措施的研究之比較 95
第四節 研究結果的重要性 96
第五節 研究限制 98
第六章 結論與建 99
第一節 研究發現摘要 99
第二節 護理實務或教育的意涵 99
第三節 未來研究方向 100
第七章 參考文獻 102
附錄 一　人體試驗審查委員會證明書 117
附錄 二　參與研究同意書（實驗組） 118
附錄 三　參與研究同意書（比較組） 119
附錄 四　孕期身心症狀量表 120
附錄 五　愛丁堡周產期量表 121
附錄 六　社會支持量表 122
附錄 七　母嬰胎兒親子聯結量表 124
附錄 八　孕期適應量表 126
附錄 九　網路社交平台評價問卷 128
附錄 十　問卷使用同意-孕期身心症狀 129
附錄 十一　問卷使用同意-愛丁堡憂鬱 130
附錄 十二　問卷使用同意-社會支持 131
附錄 十三　問卷使用同意-母親胎兒親子聯結量表 132
附錄 十四　孕期適應量表-專家效度第一次 133
附錄 十五　孕期適應量表-專家效度第二次 135

內政部（2015）‧內政統計年報‧出生數按生母年齡、生母平均年齡及生第一胎平均年齡‧取自http://www.ris.gov.tw/zh_TW/346
林軍廷、周汎澔（2008）‧不同孕次婦女之孕期心理社會適應的比較‧護理雜誌，55(6)，28-36。
師慧娟、李從業、陳惟華、董道興（2005）‧視訊化拉梅茲生產法對產婦生產知識、態度、行為之成效‧護理雜誌，52(2)，27-38。
徐禎美、陳彰惠（2008）‧孕期社會支持的盛行率和預測因子‧實證護理，4(2)，149-156。
翁敏雪、李從業、李文宗（2003）‧產前錄影帶衛教介入措施對產婦分娩自我控制成效之探討‧新台北護理期刊，5(2)，49-58。
財團法人臺灣網路資訊中心（2015年8月27日）‧2010 年台灣寬頻網路使用調查‧取自http://www.twnic.net.tw/ibnews.php
張永興（1989）‧張氏心理學辭典‧台北市：台灣東華。
郭碧照（2008）‧體外受精胚胎植入之台灣婦女懷孕早期母胎依附及其影響因子‧未發表博士論文，台北：國立臺灣大學。
陸洛 (1997) ‧ 工作壓力之歷程：理論與研究的對話‧中華心理衛生學刊，10(4) ，19-51.
楊靜利、陳寬政、李大正（2008年3月28日）‧台灣近二十年來的家庭結構變遷，台灣的社會變遷1985~2005：台灣社會變遷調查計畫第11次研討會，台北：中央研究院社會學研究所。
Aaronson, L. S. (1989). Perceived and received support: Effects on health behavior during pregnancy. Nursing Research, 38(1), 4-9.
Andersson, G., & Kaldo, V. (2004). Internet-based cognitive behavioral therapy for tinnitus. Journal of Clinical Psychology, 60(2), 171-178.
Allen, K., & Rainie, L. (2002). Parents online. Washington.
Barbara, C. (2004). Maternal-fetal attachment: An integraive review. Journal of Avanced Nursing, 50(1), 60-68.
Barclay, L., Everitt, L., Rogan, F., Schmied, V., & Wyllie, A. (1997). Becoming a mother- An analysis of women''s experience of early motherhood. Journal of Advanced Nursing, 25(4), 719-728.
Barrera, M., Glasgow, E., McKay, G., Boles, M., & Feil, G. (2002). Do internet-based support interventions change perceptions of social support?: An experimental trial of approaches for supporting diabetes self-management. American Journal of Community Psychology, 30(5), 637-654.
Bennett, H. A., Einarson, A., Taddio, A., Koren, G., & Einarson, T. R. (2004). Prevalence of depression during pregnancy: Systematic review. Obstetrics & Gynecology, 103(4), 698-709.
Bergink, V., Kooistra, L., Lambregtse-van den Berg, M. P., Wijnen, H., Bunevicius, R., van Baar, A., et al. (2011). Validation of the edinburgh depression scale during pregnancy. [doi: 10.1016/j.jpsychores.2010.07.008]. Journal of Psychosomatic Research, 70(4), 385-389.
Bernhardt, J. M., & Felter, E. M. (2004). Online pediatric information seeking among mothers of young children: Results from a qualitative study using focus groups. Journal of Medical Internet Research, 6(1).
Bond, G. E., Burr, R. L., Wolf, F. M., & Feldt, K. (2010). The effects of a web-based intervention on psychosocial well-being among adults aged 60 and older with diabetes: A randomized trial. The Diabetes Educator, 36(3), 446-456.
Brattberg, G. (2006). Internet-based rehabilitation for individuals with chronic pain and burnout: A randomized trial. International Journal of Rehabilitation Research, 29(3), 221-227.
Bromberg, Ryan, Surette, Zacharoff, & Chiauzzi (2011). A randomized trial of a web-based intervention to improve migraine self-management and coping. Headache, 52(2), 244-261.
Campbell-Grossman, C. K., Hudson, D. B., Keating-Lefler, R., & Heusinkvelt, S. (2009). New mothers network. Journal of Family Nursing, 15(2), 220-236.
Chou, F. H., Avant, K. C., Kuo, S. H., & Fetzer, S. J. (2008). Relationships between nausea and vomiting, perceived stress, social support, pregnancy planning, and psychosocial adaptation in a sample of mothers: A questionnaire survey. [Article]. International Journal of Nursing Studies, 45(8), 1185-1191.
Clarke, G., Reid, E., Eubanks, D., O’Connor, E., DeBar, L., Kelleher, C., Lynch, F., & Nuley, S. (2002). Overcoming depression on the internet (ODIN): A randomized controlled trial of an internet depression skills intervention program. Journal of Medical Internet Research, 4(3), e14.
Cohen, J. (1988). Statistical power analysis for behavioral science (2nd edition ed.). New Jersey: Lawrence Erlbaum Associates.
Cohen, S. (2004). Social relationships and health. American Psychologist, 59(8), 676-684.
Correia, L. L., & Linhares, M. B. M. (2007). Maternal anxiety in the pre- and postnatal period: A literature review. Revista Latino-Americana de Enfermagem (RLAE), 15(4), 677-683.
Cox, J. L., Chapman, G., Murray, D., & Jones, P. (1996). Validation of the edinburgh postnatal depression scale (epds) in non-postnatal women. [doi: 10.1016/0165-0327(96)00008-0]. Journal of Affective Disorders, 39(3), 185-189.
Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item edinburgh postnatal depression scale. The British Journal of Psychiatry, 150(6), 782-786.
Cranley, M. S. (1981). Development of a tool for the measurement of maternal attachment during pregnancy. Nursing Research, 30 (5), 281-284.
de Jong-Pleij, E. Ribbert, L., Pistorius, L., Tromp, E., Mulder, E., & Bilardo, C. (2012). Three-dimensional unltrasound and maternal bonding, a third trimester study and a review. Prenatal Diagnosis, 33(1), 81-88.
Declercq, E. R., Sakala, C., Corry, M. P., & Applebaum, S. (2007). Listening to mothers II: Report of the second national U.S. survey of women''s childbearing experiences. Journal of Perinatal Education, 16, 9-14.
Declercq E. R., Sakala. C., Corry. M. P., & Appkbaum, S. Herrlich, A. (2013). Listening to mothers III: Pregnancy and Birth. New York: Childbirth Connection
Deutsch, F. M., Ruble, D. N., Fleming, A., Brooks-Gunn, J., & Stangor, C. (1988). Information-seeking and maternal self-definition during the transition to motherhood. Journal of Personality and Social Psychology, 55(3), 420-431.
Dickerson, S. S. (2006). Women''s use of the internet: What nurses need to know. Journal of Obstetric Gynecologic and Neonatal Nursing, 35(1), 151-156.
Dunham, P. J., Hurshman, A., Litwin, E., Gusella, J., Ellsworth, C., & Dodd, P. W. D. (1998). Computer-mediated social support: Single young mothers as a model system. American Journal of Community Psychology, 26(2), 281-306.
Evans, J., Heron, J., Francomb, H., Oke, S., & Goling, J. (2001). Cohort study of depressed mood during pregnancy and after childbirth. BMJ, 323(4), 257-260.
Eysenbach, G., Powell, J., Englesakis, M., Rizo, C., & Stern, A. (2004). Health related virtual communities and electronic support group: Systematic review of the effects of online peer to peer interactions.BMJ, 328, 1166.
Fawcett, J., & York, R. (1986). Spouses'' physical and psychological symptoms during pregnancy and the postpartum. Nursing Research, 35(3), 144-148.
Feldman, P. J., Dunkel-Schetter, C., Sandman, C. A., & Wadhwa, P. D. (2000). Maternal social support predicts birth weight and fetal growth in human pregnancy. Psychosom Med, 62(5), 715-725.
Fewtrell, M. S., Kennedy, K., Singhal, A., Martin, R. M., Ness, A., Hadders-Algra, M., Koletzko, B., & Lucas, A. (2013). How much loss to follow-up is accetble in long-term randomised trial and prospective studies? Archives of Disease in Childhood, 93(6), 458-461.
Finfgeld, D. L. (2000). Therapeutic groups online: The good, the bad, and the unknown. Issues in Mental Health Nursing, 21(3), 241 - 255.
Gavin, N., Gaynes, B., Lohr, K., Meltzer-Brody, S., Grtlehner, G., & Swinson, T. (2005). Perinatal depression: A systematic review of prevalence and incidence. Obstetrics & Gynecology, 106(1), 1071-1083.
Gerhard, A., & Viktor, K (2004). Internet-bsed cognitive behavioral therapy for tinnitus. Journal of Clinical Psychology, 60(2), 171-178.
Griffiths, F., Lindenmeyer, A., Powell, J., Lowe, P., & Thorogood, M. (2006). Why are health care interventions delivered over the internet? A systematic review of the published literature. Journal of Medical Internet Research, 8(2), 29.
Haas, J. S., Jackson, R. A., Fuentes-Afflick, E., Stewart, A. L., Dean, M. L., Brawarsky, P., et al. (2005). Changes in the health status of women during and after pregnancy. Journal of Genernal Internal Medicine, 20(1), 45-51.
Heh, S. S. (2001). Validation of the chinese version of the edinburgh postnatal depression scale: Detecting postnatal depression in taiwanese women. The Journal of Nursing Research, 9(2), 105-113.
Herman, J., Mock, K., Blackwell, D., & Hulsey, T. (2005). Use of a pregnancy support web site by low-income african american women. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 34(6), 713-720.
Hsu, T. L., & Chen, C. H. (2001). Stress and maternal-fetal attachment of pregnant women during their third trimester. The Kaohsiung journal of medical sciences, 17(1), 36-45.
Hudson, D. B., Elek, S. M., Westfall, J. R., Grabau, A., & Fleck, M. O. (1999). Young parents project: A 21st-century nursing intervention. Issues in Comprehensive Pediatric Nursing, 22(4), 153-165.
Hung, C. H. (2005). Measuring postpartum stress. Journal of Advanced Nursing, 50(4), 417-424.
Hung, C. H. Chang, S. H., & Ching, C. C. (1993). Correlates of stressors perceived by women during puerperium. The Journal of Public Health, 20, 29-45.
Hung, C. H., & Chung, S. H. (2001). The effects of postpartum stress and social support on postpartum women''s health status. Journal of Advanced Nursing, 36, 676-684.
Hung, C. H., Hsu, Y. Y., & Lee, S. F. (1997). Couples'' satisfaction with health care service during labor and delivery. kaohsiung Journal of Medical Science, 13(4), 255 -262.
Internet World Status (November 30, 2015). Asia internet use, population data and facebook statistics. retrived from http://www.internetworldstats.com/stats3.htm
Kiehl, E. M., & White, M. A. (2003). Maternal adaptation during childbearing in norway, sweden and the united states. Scandinavian Journal of Caring Sciences, 17(2), 96-103.
Koniak-Griffin, D., Logsdon, M. C., Hines-Martin, V., & Turner, C. C. (2006). Contemporary mothering in a diverse society. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 35(5), 671-678.
Kristman, V., Manno, M., & Cote, P. (2004). Loss to follow-up in cohort studies: how much is too much? European Journal of Epidemiology, 19, 751-760.
Kuo, S. H., Wang, R. H., Tseng, H. C., Jian, S. Y., & Chou, F. H. (2007). A comparison of different severities of nausea and vomiting during pregnancy relative to stress, social support, and maternal adaptation. Journal of Midwifery & Women''s Health, 52(1), e1-e7.
Ladewig, P. W., London, M. L., & Davidson, M. R. (2009). Contemporary maternal-newborn nursing care. Upper Saddle River, NJ: Pearson.
Langer, A., Farnot, U., Garcia, C., Barros, F., Victora, C., Belizan, J. M., Villar, J. (1996) The Latin American trial of psychosocial support during pregnancy: Effects on mothers'' wellbeing and satisfaction. Social Science and Medicine, 42(11), 1589-1597.
Larsson, M. (2009). A descriptive study of the use of the internet by women seeking pregnancy-related information. [doi: DOI: 10.1016/j.midw.2007.01.010]. Midwifery, 25(1), 14-20.
Lau, Y., & Wong, D. F. K. (2008). The role of social support in helping chinese women with perinatal depressive symptoms cope with family conflict. Journal of Obstetric Gynecologic and Neonatal Nursing, 37(5), 556-571.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York, NY: Springer Publishing Company.
Lederman, R., & Weis, K. (2009). Psychosocial adaptation in pregnancy: Assessment of seven dimensions of maternal development.
Leung, B. M. Y., & Kaplan, B. J. (2009). Perinatal depression: Prevalence, risks, and the nutrition link—a review of the literature. [doi: 10.1016/j.jada.2009.06.368]. Journal of the American Dietetic Association, 109(9), 1566-1575.
Lieberman, M. A., Winzelberg, A., Golant, M., Wakahiro, M., Diminno, M., Aminoff, M., & Christine, C. (2006). Online support groups for Parkinson''s patients. Social Work in Health Care, 42(2), 23-38.
Lima-Pereira, P., Bermudez-Tamayo, C., & Jasienska, G. (2012). Use of the Internet as a source of health information amongst participants of antenatal classes. Journal of Clinical Nursing, 21(3-4),322-330.
Logsdon, M. C., & Davis, D. W. (2003). Social and professional support for pregnant and parenting women. The American Journal of Maternal and Child Nursing, 28(6), 371-376.
Marcus, S. M., Flynn, H. A., Blow, F. C., & Barry, K. L. (2003). Depressive symptoms among pregnant women screened in obstetrics settings. [doi: 10.1089/154099903765448880]. Journal of Women''s Health, 12(4), 373-380.
Mercer, R. T. (2004). Becoming a mother versus maternal role attainment. Journal of Nursing Scholarship, 36(3), 226-232.
Mercer, R. T. (2006). Nursing support of the process of becoming a mother. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 35(5), 649-651.
Morhason-Bello, I. O., Adedokun, B. O., Ojengbede, O. A., Olayemi, O., Oladokun, A., & Fabamwo, A. O. (2009). Assessment of the effect of psychosocial support during childbirth in ibadan, south-west nigeria: A randomised controlled trial. Australian & New Zealand Journal of Obstetrics & Gynaecology, 49(2), 145-150.
Muller, M. E. (1993). Development of the prenatal attachment inventory. Western Journal of Nursing Research, 15(2), 199-215.
Murry, S. S., & Slone, M. E. (2009). Foundations of maternal-newborn and women''s health nursing. Maryland Heights, MI: Saunders.
Nakamura, Y. (2009). Encouraging positive reactions to pregnancy in first-time mothers. British Journal of Midwifery, 17(1), 6.
Newman, P. R., & Newman, B. M. (1981). Living-the process of adjustment. Homewood, IL: The Dorsey Press.
Nicholson, W. K., Setse, R., Hill-Briggs, F., Cooper, L. A., Strobino, D., & Powe, N. R. (2006). Depressive symptoms and health-related quality of life in early pregnancy. Obstetrics & Gynecology, 107(4), 798-806 710.1097/1001.AOG.0000204190.0000296352.0000204105.
Norwood, S. L. (1996). The social support apgar: Instrument development and testing. Research in Nursing & Health, 19(2), 143-152.
Ohman, S. G., Grunewald, C., & Waldenstrom, U. (2003). Women''s worries during pregnancy: Testing the cambridge worry scale on 200 swedish women. [Article]. Scandinavian Journal of Caring Sciences, 17(2), 148-152.
Pearlin, L. I. (2010). The life course and the stress process: Some conceptual comparisons. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 65B(2), 207-215.
Pearlin, L. I., Menaghan, E. G., Morton, A. L., & Mullan, J. T. (1981). The stress process. Journal of Health and Social Behavior, 22(4), 337-356.
Plantin, L., & Daneback, K. (2009). Parenthood, information and support on the internet. A literature review of research on parents and professionals online. Bmc Family Practice, 10, 12.
Rains, S. A., & Young, V. (2009). A meta-analysis of research on formal computer-mediated support groups: Examining group characteristics and health outcomes. Human Communication Research, 35(3), 309-U305.
Raphael-Leff, J. (1991). Psychological processes of childbearing. New York: Chapman and Hall.
Reid, H., Power, M., & Cheshire, K. (2009). Factors influencing antenatal depression, anxiety and stress. British Journal of Midwifery, 17(8), 501-508.
Righetti, P. L., Dell’Avanzo, M., Grigio, M., & Nicolini, U. (2005). Maternal/paternal antenatal attachment and fouth-dimensional ultrasound technique: A preliminary report. British Journal of Psychology, 96(pt 1), 129-137.
Rini, C. K., Dunkel-Schetter, C., Wadhwa, P. D., & Sandman, C. A. (1999). Psychological adaptation and birth outcomes: The role of personal resources, stress, and sociocultural context in pregnancy. [doi:10.1037/0278-6133.18.4.333]. Health Psychology, 18(4), 333-345.
Romano, A. M. (2007). A changing landscape: Implications of pregnant women''s internet use for childbirth Educators. The Journal of Perinatal Education, 16(4), 18-24.
Roy, S. C., & Andrews, H. A. (2008). The roy adaptation model (3 ed.). Upper Saddle River: Pearson Education.
Rustico, M. A., Mastromatteo, C., Grigio, M., Maggioni, C., Gregori, D., & Nicolini, U. (2005). Two-dimensional vs. two- plus four-dimensional ultrasound in pregnancy and the effect on maternal emotional status: a randomized study. Untrasound Obsterrics and Gynecology, 25(5), 468-472.
Ryan, D., Milis, L., & Misri, N. (2005). Depression during pregnancy. Canadian Family Physician, 51(8), 1087-1093.
Schaffer, M. A., & Lia-Hoagberg, B. (1997). Effects of social support on prenatal care and health behaviors of low-income women. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 26(4), 433-440.
Serçekuş, P., & Mete, S. (2010). Effects of antenatal education on maternal prenatal and postpartum adaptation. Journal of Advanced Nursing, 66(5), 999-1010.
Setse, R., Grogan, R., Pham, L., Cooper, L. A., Strobino, D., Powe, N. R., et al. (2009). Longitudinal study of depressive symptoms and health-related quality of life during pregnancy and after delivery: The health status in pregnancy (hip) study. Maternal and child health journal, 13(5), 577-587.
Shieh, C., Kravitz, M., & Wang, H. H. (2001). What do we know about maternal-fetal attachment. JKaohsiung Journal of Medical Science, 17(9), 6.
Sieber, S., Germann, N., Barbir, A., & Ehlert, U. (2006a). Emotional well-being and predictors of birth-anxiety, self-efficacy, and psychosocial adaptation in healthy pregnant women. Acta obstetricia et gynecologica Scandinavica, 85(10), 1200.
Sieber, S., Germann, N., Barbir, A., & Ehlert, U. (2006b). Emotional well-being and predictors of birth-anxiety, self-efficacy, and psychosocial adaptation in healthy pregnant women. Acta Obstetricia et Gynecologica Scandinavica, 85, 1200-1207.
Smilkstein, G. (1978). The family apgar: A proposal for a family function test and its use by physicians. The Journal of Family Practice, 6(6), 1231-1239.
Smilkstein, G., Ashworth, C., & Montaon, D. (1982). Validity and reliability of the family apgar as a test of family function. The Journal of Family Practice, 15(2), 303-311.
Stark, M. A. (1997). Psychosocial adjustment during pregnancy: The experience of mature gravidas. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 26(2), 206-211.
Straten, A., Cuijpers, P., & Smits, N. (2008). Effectiveness of a web-based self-help intervention for symptoms of depression, anxiet, and stress: randomized controlled trial. Journal of Medical Internet Research, 10(1), e7.
Su, K. P., Chiu, T. H., Huang, C. L., Ho, M., Lee, C. C., Wu, P. L., et al. (2007). Different cutoff points for different trimesters? The use of edinburgh postnatal depression scale and beck depression inventory to screen for depression in pregnant taiwanese women. General hospital psychiatry, 29(5), 436-441.
Torgersen, C. K. L., & Curran, C. A. (2006). A systematic approach to the physiologic adaptations of pregnancy. Critical Care Nursing Quarterly, 29(1), 2-19.
Wellman, B. (2001). Computer networks as social networks. [Editorial Material]. Science, 293(5537), 2031-2034.
White, M., & Dorman, S. M. (2001). Receiving social support online: Implications for health education. Health Education. Research, 16(6), 693-707.
Yarcheski, A., Mahon, N. E., Yarcheski, T. J., Hanks, M. M., & Cannella, B. L. (2009). A meta-analytic study of predictors of maternal-fetal attachment. International Journal of Nursing Studies, 46(5), 708-715.
Zachariah, R. (2009). Social support, life stress, and anxiety as predictors of pregnancy complications in low-income women. Research in Nursing & Health, 32(4), 391-404.