RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA.
PROFORMA FOR REGISTRATION OF
SUBJECT FOR DISSERTATION
1. NAME OF THE : Mr. VENKATEGOWDA. R
CANDIDATE AND I YEAR M.Sc. NURSING,
ADDRESS GLOBAL COLLEGE OF NURSING,
GAT CAMPUS, IDEAL HOME TOWNSHIP,
R.R NAGAR,
BENGALURU-560098.
2. NAME OF THE : GLOBAL COLLEGE OF NURSING,
INSTITUSION
3. COURSE OF STUDY & : I YEAR M.Sc. NURSING,
SUBJECT PSYCIATRY NURSING.
4. DATE OF ADMISSION : 0/0/2010.
5. TITLE OF THE TOPIC : “A STUDY TO ASSESS THE QUALITY OF LIFE
AND PSYCHOLOGICAL GENERAL WELL BEING
AMONG SPOUSES OF PRIMI MOTHER WITH
COUVADE SYNDROME AT SELECTED
HOSPITAL, IN BANGALORE”.
”.
6. BRIEF RESUME OF THE INTENDED WORK
Introduction:
Couvades syndrome, also called sympathetic pregnancy or phantom pregnancy, is a
condition in which the husband or partner of an expectant mother experiences some of the same
symptoms and behavior as the mother. These most often include minor weight gain, altered
hormone levels, morning nausea, and disturbed sleep patterns in more extreme cases they can
include labor pains, postpartum depression, and nosebleeds. The labor pain symptom is commonly
known as sympathy pain.1
Couvades syndrome refers sympathetic pregnancy experienced by a man, usually the
husband of a pregnant woman. Syndrome mimic those suffered by pregnant women, such as,
weight gain, fatigue , dizziness, nausea, vomiting constipation,abdominal pain, cramping in the
legs, unusal food cravings and changed sexual appetite. Usually, symptoms of couvades first
appear during the partner’s third month of pregnancy .they advance and become severe in the third
trimester. Symptoms usually end with the delivery.2
Generally couvades syndrome begins in the end of the first trimester and increases in
severity until the third trimester. The only known cure for couvades is –birth.
Couvades syndrome, was coined in 1865, but writers and historians have recognized the
phenomenon of sympathetic pregnancy for hundreds of years. In cultures across the world,
expectant fathers have performed certain rituals before and during their wife’s labor, , fathers were
expected to sequester themselves away from the rest of their village , imitate labor pains, or even
feign illness and be waited on by their wives during labor delivery.3
In modern societies, these rituals are no longer observed, but couvades syndrome is still
used as the diagnosis for the many men who claim to be experiencing the symptoms of pregnancy
right along with their wives, such has morning sickness, food cravings, aching limbs, moods
swings, depression, and loss of appetite.4
2
6.1 Need for the Study
Need for the study:
There’s much debate in the medical community about exactly what couvades is. The
diagnosis is included in neither the DSM-IV the diagnostic manual for psychiatry, nor the world
Health Organization’s International Classification of Diseases. Estimates of how many men
experience symptoms of couvades range widely form as low as 16 percent all the way to 90 percent
(according to one CNN study). Some men Experience it at the beginning of pregnancy, some do at
the end. Some men have only mild nausea or weight gain, while others go so far as to mimic actual
stomach pains while their wife is in labor. Theses varying statistics and lack of hard evidence have
led professionals to debate whether couvades is even a medical condition at all, or if if’s a
psychiatric one.5
A British study looked at weight gain as a male pregnancy symptom. In an online survey by
one poll, 5000 expectant fathers were surveyed. Results indicated an average weight gain of 14 ibs
during their partner’s pregnancy; they experienced an increase of two inches in their waist
measurements, with 25% having to buy bigger pants. Only 30% reported joining their partner in
dieting after the birth of the baby.6
Most doctors seem skeptical of male pregnancy symptoms and do no recognize couvades
syndrome as a medical condition, a team at St. George’s University in London interviewed 282
expectant fathers, aged 19 to 55. They concluded “the vast majority” of subjects experienced male
pregnancy symptoms, or sympathetic pregnancy symptoms.7
Swiss researcher Tiziana Perini studied 37 couples to compare couples expecting their first
baby with couples who did not have children. The expectant fathers had mood swings, and
fluctuations in appetite and weight. The men without children did not experience these changes.
Swiss the TV interviewed a new father who reported dramatic increasing in eating chocolate. Dr.
Perini, a psychotherapist, hypothesized that means hormones change during their partner’s
pregnancy, to help them feel more involved.8
Canadian researchers Wynne-Edwards and storey looked at hormone levels of men at
various intervals during their partner pregnancy. They found high levels of estradiol, prolactian,
and cortical in the men, which are low in men who are not expectant fathers. This hormone is
3
associated with stress response and aggression. The researchers hypothesize that this elevated
hormones give expectant fathers the drive and endurance to protect and nurture.9
The investigator observed spouses with couvades syndrome whose quality of life and
psychological general well being has been affected. Therefore the investigator rightly felt that
affected spouses who are suffering from couvades syndrome should be adequately informed about
the couvades syndrome. Keeping the above fact in mind the investigator is making an attempt to
assess the quality of life and psychological wellbeing among spouses of primi mother with
couvades syndrome.
6.2 Review of Literature
Sánchez Rodríguez SM, Peláez del Hierro F, Fidalgo de las Heras AM, Morcillo Pimentel
A, Caperos Montalbán JM. (2008) conducted a study on body weight increase in expectant males
and helpers of cotton-top tamarin (Saguinus oedipus): a symptom of the Couvade syndrome. In the
cooperative breeding system of cotton-top tamarin (TCB; Saguinus oedipus) expectant males gain
weight during the last months of pregnancy of their partners as a way to cope with energy costs of
reproduction. This phenomenon was described only in humans as a symptom of Couvade
syndrome. As after infants' birth, TCB male and female helpers lose weight, the same as fathers do,
it might be expected that previously, they also gain weight. In 8 groups of TCB, we explored body
weight changes of the three categories of individuals, in periods of six months, under three different
reproductive conditions: control (no pregnancy and without offspring), pregnancy (pregnancy and
without offspring), and raising (with offspring). We found that across pregnancy, TCBs increase
their weight in the last trimester of that period while across breeding TCBs reduce their weight in
the first trimester. Expectant males and also helpers could be preparing during pregnancy in
relation to the weight losses they experience when raising their young.10
Maio A Masoni S.etal (1994), carried out astudy on The couvade syndrome. The couvade
syndrome can be considered to be the psychosomatic equivalent of primitive rituals of initiation
into paternity. Various symptoms have been described in the husbands of pregnant women with an
incidence from 11% to 65%. Seventy-three couples with the women in the last month of pregnancy
were given a questionnaire; as a reference group, 73 men without pregnant wives or children
under1 year of age were taken. An emotional involvement connected with pregnancy was reported
in 91.78% of the men. This involvement was expressed as changes in sexual habits in 87.67% of
cases, fear and anxiety in 36.98% and curiosity in 47.94%. With the exception of nausea, physical
symptoms were less frequent in the men with pregnant wives than in those without pregnant wives.
4
These data cannot confirm the existence of the couvade syndrome with its own physical symptoms
but we think that some male experiences, which constitute a peculiar imaginary and behavioral
reality of the father-to-be, do exist.11
H Klein (1991); conducted study on; Couvade syndrome: male counterpart to pregnancy.
Couvade is the common but poorly understood phenomenon whereby the expectant father
experiences somatic symptoms during the pregnancy for which there is no recognized physiological
basis. Symptoms commonly include indigestion, increased or decreased appetite, weight gain,
diarrhea or constipation, headache, and toothache. Onset is usually during the third gestational
month with a secondary rise in the late third trimester. Symptoms generally resolve with childbirth.
Couvade has been seen as an expression of somatized anxiety, pseudo-sibling rivalry, identification
with the fetus, ambivalence about fatherhood, a statement of paternity, or parturition envy. It is
likely that the dynamics of couvade may vary between individuals and may be multidetermined.12
DC. Longobucco,etal (1989) A comparative study was conducted to determine the
association between the presence of somatic symptoms (couvade syndrome) and the amount of
paternal-role preparation attained by 64 expectant fathers. Thirty-five men in the sample identified
more than two symptoms; most frequently, restlessness, increased appetite, and difficulty sleeping.
Men experiencing symptoms scored higher on scales measuring paternal-role preparation than men
not experiencing symptoms.13
Schodt CM. (1989) conducted study on Parental-fetal attachment and couvade: a study of
patterns of human-environment integrality. The general purpose of the study was to address the
difficulty of explaining fathers' prenatal attachments to their unborn children and the difficulty of
explaining the phenomenon of couvade. Rogers' principle of integrality was used to derive a theory
of the nature of the interactions between fathers and their unborn children as being a human-
environment energy field process. The theory held the possibility of fathers having a relationship
with their unborn children which was not wholly derivative of their relationship with their pregnant
partners; it posited the possible association of fathers' attachment, mothers' attachment, and fathers'
couvade experiences. Couvade experiences, previously studied as male pregnancy-like symptoms,
were conceptualized as fathers' recognition of changes in themselves and their environments which
included their emerging children. Measures of fathers' and mothers' attachments and fathers' ratings
of their couvade experiences were obtained during the third trimester for 110 couples' pregnancies.
The hypothesized relations among parents' fetal attachments and couvade were not supported. An
inverse relation (r = -0.47, p less than 0.001) between fathers' and mothers' attachment scores led to
revisions of the interpretation of integrality as used in this study.14
5
Fawcett J, York R. (1986) This cross-sectional descriptive study investigated the type and
frequency of physical and psychological symptoms experienced by pregnant and postpartal women
and their spouses. The sample of 70 married couples included 23 pairs in an early pregnancy group,
24 in a late pregnancy group, and 23 in a postpartum group. Both spouses completed a symptoms
checklist of 20 physical and 3 psychological symptoms and the Beck Depression Inventory.
Findings indicate that both spouses experienced some physical and psychological symptoms during
pregnancy and the postpartum, although the women reported many more symptoms than did the
men. Women in the late pregnancy group reported the highest number of physical symptoms; those
in the postpartum group, the lowest number. No differences, however, in reports of psychological
symptoms were found among the three groups of women. No significant differences in reports of
either physical or psychological symptoms were found among the three groups of men.15
LY.Bogren (1985); a prospective study conducted on The couvade syndrome and side
preference in child holding. In a prospective study of expectant couples 20% of the men suffered
from the couvade syndrome. About 80% of both women and men hold their newborn infant to the
left and 20% to the right, irrespective of handedness. Compared with others, men with the
syndrome more frequently developed a right-side preference in child holding. Right-holding men
more often had sons than daughters. Right-holders with the couvade syndrome were more often
attached to and more closely identified with their mothers than were right-holding non-sufferers.16
M Jr. Lipkin etal (1982); a study conducted on The couvade syndrome: an epidemiologic
study. A tracer condition, to be used for clinical epidemiologic examination of psychosociogenic
illness, must be common and clearly identifiable These criteria are met by couvade syndrome, the
seeking of care for pregnancy-related symptoms by the mates of expectant women. . Records of the
mates of 267 postpartum women, representing a systemic sample of all births in a health
maintenance organization of 36,000, were rated for the presence of nausea,vomiting, anorexia,
abdominal pain, abdominal bloating, and other symptoms. Each patient was his own control. Sixty
men (225 of 1000) sought care for couvades syndrome; they had a twofold increase in visits (p less
than 0.001); had four times more symptoms than during control periods (p less than 0.001); and
received twice as many prescriptions for medication as the men without this syndrome (p less than
0.05). The health care providers did not tend to recognize the "expectant" status of these patients or
note the presence of the syndrome.17
6
Statement of the Problem
“A study to assess the quality of life and psychological general well being among spouses of Primi
mother with Couvade Syndrome at selected hospital, in Bangalore”.
6.3 Objectives of the Study
i. To assess the quality of life among spouses of primi mother with couvades syndrome.
ii. To assess the psychological general well being among spouses of primi mother with
couvades syndrome.
iii. To assess the factor contributing to couvades syndrome.
iv. To correlation between quality of life and psychological general well being among
spouses of primi mother with couvades syndrome.
6.3 Null Hypothesis
H01: There is no significant relationship between quality of life and couvades syndrome of
spouses of primi mother.
H02: There is no significant relationship between psychological general well being and
among couvades syndrome spouses of primi mother.
HO3: There is no significant association between quality of life, psychological general well
being and selected socio demographic variables.
6.5 Operational Definitions
ASSESS: Refers to find out the Quality Of Life And Psychological General Well Being
Among Spouses Of Primi Mother With Couvade Syndrome.
COUVADES SYNDROME: also called sympathetic pregnancy, is a condition in which
the husband or partner of an expectant mother experiences some of the same symptoms and
behavior as the mother or which is also known as sympathetic pregnancy, male pregnancy
experience, or "pregnant dad syndrome," refers to a condition in which a father-to-be
experiences some of the physical symptoms of pregnancy prior to the baby s birth.
QUALITY OF LIFE: (QOL) is used in healthcare to refer to an individual’s emotional,
social and physical wellbeing, including their ability to function in the ordinary task of
living. it is a term used most frequently in the context of medicine and health care, where
the impact of a disease may reduce “ health related quality of life”.
PRIMI MOTHER: A women who is pregnant for the first time.
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7. MATERIALS AND METHODS
7.1 Source of Data : Spouses with couvades syndrom at selected hospital,
Bangalore.
7.2 Method of Collection : A structured interview scheduled is used
of Data for the collection of data.
7.2.1 Definition of the Study : Spouses of prime mother who are visiting OPD of hospital
subjects in Bangalore.
7.2.2 Inclusion and Exclusion Criteria
(a) Inclusion Criteria : (i) Spouses of primi mother with symptoms couvades
syndrome
(ii) Who knows to read and understand kannada and
English.
(iii) Spouses between the age of 25-35years.
(b) Exclusion Criteria : (i) Spouses of multi gravid mother.
7.2.3 Research Design : Exploratory study design.
7.2.4 Setting : Selected hospitals of Bengaluru.
7.2.5 Sampling Technique : Purposive Sampling.
7.2.6 (a) Sample Size : 100 Spouse with couvade syndrome
(b) Duration of Study : 8 Weeks.
7.2.7 Tools of Research : Tools of research consists of
Section A- Structured questionnaires on demographic
profile of the respondents
Section B- Rating scale to assess the factor contributing to
couvades syndrome.
Section C- Lehman quality of life interview(QOLI)
Section D- Psychological general well being scale.
8
7.2.8 Collection of Data : The investigator himself collect the data from the
respondents using above mentioned tools.
7.2.9 Method of Data Analysis : (i) The investigator will use appropriate
and Presentation descriptive statistics and inferential
statistics like correlational and chi-square test.
(ii) The analyzed data will be presented in the form of
tables, diagrams and graphs where ever necessary.
7.3 Does the study require any investigation or interventions to be conducted on patients
or other humans or animals? If so please describe briefly.
No
7.4 Has ethical clearance been obtained from your institution in case of 7.3?
Yes, ethical clearance has been obtained from the concerned authority of institution.
Informed written consent will be obtained from the participants prior to the study.
8. LIST OF REFERENCES
1. Couvade syndrome. [online]. 2010 [cited 2010 Nov 25]; Available From: URL:
http://www.en.wikipedia.org/wiki/couvade_syndrome
2. Understand Couvade Syndrome. [online].2010 [cited 2010 Nov 25]; Available From:
URL:http://www.gratdad.com/tertiary/59/1235/pregnancy-dos-and-don-ts-the-dont-s.html
3. Psychosom Obstet Gynaecol. [online]. 1994 [cited 2010 Nov 25]; Available From:
URL:http://www.childbirth.org/articles/couvade.html
4. Couvade Syndrome-Male Pregnancy Symptoms. [online]. 2010 [cited 2010 Nov 25];
Available From: URL:http://hubpages.com/hub/couvade-syndrome-male-pregnancy-
symptoms
5. Couvade Syndrome-Male Pregnancy Symptoms. [online]. 2010 [cited 2010 Nov 25];
Available From: URL:http://hubpages.com/hub/Couvade-Syndrome-
MalePregnancySymptoms
6. What is Couvade Syndrome. [online]. 2010 [cited 2010 Nov 25]; Available From:
URL:http://www.wisegreek.com/what-is-couvade-syndrome.htm
9
7. Couvade Syndrome. [online]. 2009 [cited 2010 Nov 25]; Available From:
URL:http://www.pregnancy-info.net/couvade.html
8. Couvade Syndrome. [online]. 2009 [cited 2010 Nov 25]; Available From:
URL:http://frontierpsychiatrist.co.uk/couvade-syndrome/
9. The Free Dictionary by Farlex. [online]. 2010 [cited 2010 Nov 25]; Available From:
URL:http://medical-dictionary.thefreedictionary.com/couvade+syndrome
10. Sánchez Rodríguez SM, Peláez del Hierro F, Fidalgo de las Heras AM, Morcill Pimentel A,
Caperos Montalbán JM. Body weight increase in expectant males and helpers of cotton-top
tamarin (Saguinus oedipus): a symptom of the Couvade syndrome. [online]. 2008 Nov
[cited 2010 Nov 30]; Available From:
URL:http://www.ncbi.nlm.nih.gov/pubmed/%2018940090
11. Maio A, Masoni S, Trimarchi G, de Punzio C, Fioretti P. The couvade syndrome. [online].
1994 Sep [cited 2010 Nov 25]; Available From:
URL:http://www.ncbi.nlm.nih.gov/pubmed/8000469
12. Klein H. Couvade syndrome: male counterpart to pregnancy. [online]. 1991 [cited 2010
Nov 25]; Available From: URL: http://www.ncbi.nlm.nih.gov/pubmed/2066258
13. Longobucco DC, Freston MS. Relation of somatic symptoms to degree of paternal-role
preparation of first-time expectant fathers. [online]. 1989 [cited 2010 Nov 25]; Available
From: URL:http://www.ncbi.nlm.nih.gov/pubmed/2600686
14. Schodt CM. Parental-fetal attachment and couvade: a study of patterns of human-
environment integrality. [online]. 1989 [cited 2010 Nov 25]; Available From:
URL:http://www.ncbi.nlm.nih.gov/pubmed/2717099
15. Fawcett J, York R. Spouses' physical and psychological symptoms during pregnancy and
the postpartum. [online]. 1986 [cited 2010 Nov 25]; Available From:
URL:http://www.ncbi.nlm.nih.gov/pubmed/3486406
16. Bogren LY. The couvade syndrome and side preference in child holding. [online]. 1985
[cited 2010 Nov 25]; Available From: URL:http://www.ncbi.nlm.nih.gov/pubmed/3984773
17. Lipkin M Jr, Lamb GS. The couvade syndrome: an epidemiologic study. [online]. 1982
[cited 2010 Nov 25]; Available From: URL:http://www.ncbi.nlm.nih.gov/pubmed/7199885
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9. SIGNATURE OF
CANDIDATE
10. REMARKS OF THE GUIDE Study recommended.
11.1 NAME AND DESIGNATION Mr Rajasudhakar. K MSN (Psy) (NIMHANS)
OF GUIDE HOD Psychiatric Nursing
Global College of Nursing.
11.2 SIGNATURE
11.3 CO-GUIDE (IF ANY)
11.4 SIGNATURE
11.5 HEAD OF THE Mr Rajasudhakar. K MSN (Psy) (NIMHANS)
DEPARTMENT
HOD Psychiatric Nursing
Global College of Nursing.
11.6 SIGNATURE
12.1 REMARKS OF THE
PRINCIPAL
12.2 SIGNATURE
11