ArticleArchives of public health = Archives belges de sante publique2023
A structural equation modelling of the direct and indirect factors associated with functional status over time as measured by WHODAS-32 items among postpartum women in Northwest Ethiopia.
Article in Archives of public health = Archives belges de sante publique, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.
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Who cites it
5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 6 citations in OpenAlex.
- Measurement characteristics of WHODAS 2.0 and WHODAS-Child: a systematic review of global psychometric studies in specific populations since 2010.Frontiers in psychiatry · 2026Pooled it
- Prevalence of Perinatal Anxiety and Related Disorders in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.JAMA network open · 2023Pooled it
- A psychosocial intervention for prenatal anxiety decreases functional disability among pregnant Pakistani women: A moderated mediation approach using data from a randomized controlled trial.Journal of psychosomatic research · 2025Trial
- The direct and indirect factors of health related quality of life of postpartum women using structural equation modelling.Scientific reports · 2025Article
- Family concerns and relationship problems in anxious pregnant women and their associations with postnatal functional disability in Pakistan.Journal of psychosomatic research · 2024Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
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Abstract
introductionFull functional status recovery which is a multidimensional concept, that includes personal care, infant and family care, social and occupational activities and adjusting to the role of motherhood may require several months to achieve. However, most study designs on postpartum maternal functional status were cross-sectional, providing limited insights into functional status patterns over time and the mediating relationships among variables associated with it during the postpartum period.
objectiveTo investigate the patterns of functional status over time and the mediating relationships among variables associated with functional status after childbirth.
methodsFrom October 2020 to March 2021, 775 women in Northwest Ethiopia participated in a community-based follow-up study that was linked to a health institution. Functional status was measured by the Amharic version of WHODAS 2.0 instrument. Structural equation modelling was used to determine the direct and indirect effects of predictor variables on individual domains of functional status as measured by WHODAS 2.0 instrument.
resultsHigher fear of childbirth score, anxiety and PTSD score had a direct deleterious effect (increased risk of functional disability) on the overall functional status and six domains of WHODAS 2.0 (cognition, mobility, self-care, getting along with people, household life activities and community participation) at the first, second and third follow up periods. Higher social support had a direct protective effect (decreased risk of functional disability) on all domains of WHODAS 2.0 and the overall functional status at the three follow up periods. Higher social support had also an indirect protective effect through fear of birth on the six domains of WHODAS 2.0 and the overall functional status throughout the follow up period. Higher PTSD symptom score had also an indirect deleterious effect (increased risk of functional disability) through fear of birth on the overall functional status and six domains of WHODAS 2.0 (higher disability) throughout the follow up period. Complications of delivery management had a direct deleterious effect (increased disability score) on the domains of getting along with people, household life activities, mobility, self-care and community participation and on the overall functional status disability score.
conclusionMaternal functioning in the postpartum period is initially impaired, but improves over time. Despite improvement, maternal morbidities are correlated with worse functioning scores compared to women without these morbidities. Interventions should target on the mediating role of fear of child birth, life threatening event of health risk and PTSD with the deleterious effects of complications of delivery management, poor social support, vaginal mode of delivery, anxiety, poor physical and mental quality of life on functional status of postpartum women.
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