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ABSTRACT: PURPOSE: The purpose of this study was to examine the relationships between family sense of coherence, social support, stress, quality of life and depressive symptoms among Chinese pregnant women. METHODS: A cross-sectional design was used. A convenience sample of 267 Chinese pregnant women was recruited at the antenatal clinic and completed the Family Sense of Coherence Scale, Medical Outcomes Study Social Support Survey, Social Readjustment Rating Scale, Medical Outcome Study Short Form 12-Item Health Survey and General Health Questionnaire. Path analysis was employed. RESULTS: Family sense of coherence and social support had a direct impact on the mental health component of quality of life and depressive symptoms during pregnancy. Family sense of coherence also mediated the effect of stress on quality of life and depressive symptoms. CONCLUSIONS: The study provides evidence that family sense of coherence and social support play a significant role in promoting quality of life and reducing depressive symptoms during the transition to motherhood. Culturally competent healthcare should be developed to strengthen women's family sense of coherence and foster social support to combat the stress of new motherhood, thereby promoting quality of life during that period of their lives.
Quality of Life Research 12/2012; · 2.30 Impact Factor
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ABSTRACT: Postnatal depression is a major health problem that can have detrimental effects on infants' psychosocial development; however, there are few longitudinal studies on the protective role of learned resourcefulness against the development of postnatal depression.
The aims of this study were to examine the relationships among learned resourcefulness, social support, stress, and depressive symptoms across the perinatal period and to determine the mediating role of learned resourcefulness and social support between stress and depressive symptoms in the perinatal period.
A longitudinal design was used. A convenience sample of 170 first-time Chinese mothers completed the assessment during pregnancy and were followed up at 6 weeks and 6 months postpartum. The Self-Control Schedule, Medical Outcomes Study Social Support Survey, Social Readjustment Rating Scale, and Edinburgh Postnatal Depression Scale were used. Path analysis was employed.
Learned resourcefulness had a direct impact on depressive symptoms and mediated the effect of stress on depressive symptoms during pregnancy and at 6 weeks postpartum. Social support had a direct impact on depressive symptoms and mediated the effect of stress on depressive symptoms during pregnancy. Learned resourcefulness and social support directly predicted depressive symptoms at 6 months postpartum.
Learned resourcefulness and social support serve to protect against the development of depressive symptoms and mediate the relationship between stress and depressive symptoms in the perinatal period. Culturally competent healthcare should be developed to equip women with learned resourcefulness skills and foster support network to combat the stress of new motherhood, thereby minimizing the risk of perinatal depression.
Nursing research 03/2012; 61(2):78-85. · 1.80 Impact Factor
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ABSTRACT: The changes in and relationships among stress, maternal role competence, and satisfaction in the perinatal period were examined using a longitudinal design. A convenience sample of 78 first-time Chinese mothers completed assessments of stress and maternal role competence during pregnancy and at 6 weeks and 6 months postpartum. Maternal stress increased and role competence declined during early motherhood, which highlighted the potential influence of stress on maternal role competence and satisfaction in the perinatal period. Culturally competent health care interventions should be developed to promote maternal competence and satisfaction, in particular during early motherhood, and to equip women with effective coping skills to deal with the stress of maternal role transition.
Research in Nursing & Health 02/2012; 35(1):30-9. · 1.71 Impact Factor
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ABSTRACT: The aim of the study was to evaluate the psychometric properties of the Chinese version of Medical Outcomes Study Family and Marital Functioning Measures (C-MOS-FMFM) in Hong Kong Chinese childbearing families. A cross-sectional survey was conducted using a convenience sample of 128 childbearing couples recruited from antenatal clinics. The C-MOS-FMFM demonstrated good internal consistency (Cronbach's alpha = 0.79) and test-retest reliability (intraclass correlation coefficient = 0.74). Significant correlations with Medical Outcomes Study-Social Support Survey (r = 0.38, P < 0.01) and Trait Anxiety Inventory (r = -0.48, P < 0.01) supported construct validity. Factor analysis identified one factor corresponding to family functioning and two factors corresponding to marital functioning. The C-MOS-FMFM has satisfactory psychometric properties. It has the potential to be used as a clinical and research instrument for measuring family and marital functioning in the Chinese population.
Community Mental Health Journal 10/2011; 48(5):634-42. · 1.03 Impact Factor
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ABSTRACT: This qualitative study explored the coping strategies used by first-time Hong Kong Chinese mothers in adjusting to the demands of early motherhood. A purposive sample of 26 first-time Chinese mothers who had participated in a childbirth psycho-education program was interviewed in-depth at six weeks postpartum in respect to their coping strategies. Two main categories emerged: making personalized and achievable decisions and seeking emotional and spiritual solace. Implications for health professionals are discussed, including the need to support individual women's personal resources and foster social networks to optimize maternal and infant health.
Journal of Health Psychology 07/2011; 17(2):189-96. · 1.22 Impact Factor
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ABSTRACT: The aim of this study was to explore Chinese women's perceptions of maternal role competence and factors contributing to maternal role competence during early motherhood.
Developing a sense of competence and satisfaction in the maternal role are considered critical components in maternal adaptation, which have a significant impact on parenting behaviours and the psychosocial development of the child. However, qualitative studies that address maternal role competence are limited in the Chinese population.
This was an exploratory descriptive study.
A purposive sample of 26 Chinese primiparous mothers participated in a childbirth psychoeducation programme and was interviewed at six weeks postpartum. Data were analysed using content analysis.
Women perceived a competent mother as being able to make a commitment to caring for the physical and emotional well-being of child, while cultivating appropriate values for childhood. Personal knowledge and experience of infant care, success in breastfeeding, infant's well-being, availability of social support and contradictory information from various sources were major factors affecting maternal role competency.
The findings highlight the importance of understanding Chinese cultural attitudes to childrearing and maternal role competence. New Chinese mothers need information on child care, positive experiences of infant care, social support and consistent information to enhance their maternal role competency. Recommendations are made for Chinese culturally specific guidelines and healthcare delivery interventions to enhance maternal role competence in early motherhood.
Nursing and midwifery care should always take into account the cultural beliefs and enable adaptation of traditional postpartum practices. Providing consistent information and positive experience on parenting skills and infant behaviour as well as enhancing effective coping strategies could strengthen Chinese women's maternal role competency.
Journal of Clinical Nursing 02/2011; 20(9-10):1481-9. · 1.12 Impact Factor
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ABSTRACT: Developing a sense of well-being and achieving competence and satisfaction in the maternal role have a tremendous impact on the quality of parenting behaviour and the child's psychosocial development. Little is known about the mechanisms through which learned resourcefulness, social support and stress affect postnatal depression and women's sense of competence and satisfaction in the maternal role.
To test a conceptual model that examines the relationships between learned resourcefulness, social support, stress, maternal role competence and satisfaction, and postnatal depression in first-time Chinese mothers.
A predictive correlational study using secondary analysis of data from an intervention study.
The study was conducted in two regional public hospitals in Hong Kong.
A total of 181 first-time Chinese mothers were followed at six weeks post-partum.
Participants completed five instruments at six weeks post-partum: the Self-Control Schedule, Medical Outcomes Study Social Support Survey, Social Readjustment Rating Scale, Parenting Sense of Competence Scale and Edinburgh Postnatal Depression Scale. Path analysis was employed.
The findings indicate that learned resourcefulness and social support have a direct impact on maternal role competence and satisfaction and on postnatal depression. Stress affected postnatal depression directly and maternal role competence and satisfaction indirectly, via learned resourcefulness and social support. Both learned resourcefulness and social support mediated the effects of stress on maternal role competence and satisfaction and postnatal depression.
This study establishes potential mechanisms through which learned resourcefulness, social support and stress contribute to maternal role competence and satisfaction and postnatal depression during early motherhood. Culturally competent healthcare should be developed to provide support and equip women with learned resourcefulness skills to combat the stress of early motherhood, thereby enhancing maternal role competence and satisfaction and minimizing the risk of postnatal depression.
International journal of nursing studies 12/2010; 48(6):725-31. · 1.91 Impact Factor
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ABSTRACT: Learned resourcefulness plays a significant role in facilitating maternal coping during the transition to motherhood. Given the growing evidence of perinatal depression and the frequent feeling of incompetence in the maternal role, the implementation of an effective intervention to promote maternal role competence and emotional well-being is essential.
To determine the impact of a childbirth psychoeducation program based on the concept of learned resourcefulness on maternal role competence and depressive symptoms in Chinese childbearing women.
A pretest-posttest, control group quasi-experimental design with repeated measures was used.
The study was conducted in two regional public hospitals in Hong Kong that provide routine childbirth education programs with similar content and structure. One hospital was being randomly selected as the experimental hospital.
A convenience sample of 184 Chinese pregnant women attending the childbirth education was recruited between October 2005 and April 2007. Inclusion criteria were primiparous with singleton and uneventful pregnancy, at gestation between 12 and 35 weeks, and did not have a past or familial psychiatric illness.
The intervention was a childbirth psychoeducation program that was incorporated into the routine childbirth education in the experimental hospital. The experimental group (n=92) received the childbirth psychoeducation program and the routine childbirth education. The comparison group (n=92) received the routine childbirth education alone in the comparison hospital. Outcomes were measured by the Self-Control Schedule, Parenting Sense of Competence Scale-Efficacy subscale and Edinburgh Postnatal Depression Scale at baseline, immediately post-intervention, at 6 weeks and 6 months postpartum. Analysis was by intention to treat.
Women receiving the childbirth psychoeducation program had significant improvement in learned resourcefulness at 6 weeks postpartum (p=0.004) and an overall reduction in depressive symptoms (p=0.01) from baseline to 6 months postpartum compared with those who only received the routine childbirth education after adjusting for baseline group differences on age and social support. No significant group difference was found on maternal role competence.
The childbirth psychoeducation program appears to be a very promising intervention for promoting learned resourcefulness and minimizing the risk of perinatal depression in first-time Chinese childbearing women. Future empirical work is required to determine the effectiveness of extending the childbirth psychoeducation program into the early postpartum for the promotion of maternal role competence in Chinese childbearing women.
International journal of nursing studies 05/2009; 46(10):1298-306. · 1.91 Impact Factor
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ABSTRACT: The aims of this study were to translate and evaluate the psychometric properties of the Chinese version of the Self-Control Schedule (C-SCS) in Chinese childbearing women.
The SCS was developed to measure learned resourcefulness, which facilitates people's coping under adversity. Promoting learned resourcefulness in childbearing women facilitates positive adaptation to motherhood, which is essential to both maternal and child health. Thus, a reliable and valid C-SCS is crucial for the development of interventions to promote learned resourcefulness in Chinese childbearing women.
In phase one, the SCS was translated into Chinese using the technique of translation and back-translation and was reviewed by an expert panel for cultural equivalence. In phase two, psychometric testing of the C-SCS was conducted by using a convenience sample of 360 childbearing women recruited from an antenatal clinic of a regional hospital. Four instruments including the C-SCS, General Self-Efficacy Scale (GSE), Rosenberg's Self-Esteem Scale (RSES) and Edinburgh's Postnatal Depression Scale (EPDS) were administered to the participants. Ninety-two women participated in the four-week retest.
The C-SCS demonstrated good internal consistency (Cronbach's alpha = 0.83) and test-retest reliability (ICC = 0.91). Factor analysis revealed the presence of three factors supporting the conceptual dimension of the original instrument. Significant correlations with GSE (r = 0.48, p < 0.01), RSES (r = 0.41, p < 0.01) and EPDS (r = -0.46, p < 0.01) demonstrated good construct validity.
The findings suggest that the C-SCS is a reliable and valid instrument for measuring learned resourcefulness in Chinese childbearing women.
The C-SCS provides midwives with a useful tool in the evaluation of interventions designed to strengthen Chinese women's learned resourcefulness and promote maternal well-being during childbearing.
Journal of Clinical Nursing 03/2008; 17(3):323-32. · 1.12 Impact Factor
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ABSTRACT: Women's sense of competence and satisfaction in the maternal role are essential for positive parenting practices and child development. Measures of maternal role competence and satisfaction are limited in the Chinese population.
To translate the Parenting Sense of Competence Scale into Chinese (C-PSOC) and to examine the psychometric properties of the C-PSOC.
A cross-sectional survey was conducted using a convenience sample of 170 mothers recruited from a postnatal unit. Participants completed the C-PSOC, Rosenberg's Self-Esteem Scale, and the Edinburgh Postnatal Depression Scale. A randomly selected subsample of 57 mothers participated in the 4-week retest.
The C-PSOC demonstrated good internal consistency (Cronbach's alpha = .85) and test-retest reliability (intraclass correlation coefficient = .87). Factor analysis supported the two-factor structure reflecting the efficacy and satisfaction dimensions of the original instrument. The scale discriminated between primiparas and multiparas (t = 2.2, p < .05). Significant correlations with Rosenberg's Self-Esteem Scale (r = .60, p < .01) and the Edinburgh Postnatal Depression Scale (r = -.48, p < .01) demonstrated good construct validity.
The C-PSOC has satisfactory psychometric properties. It has the potential to be used as a clinical and research instrument for measuring maternal role competence and satisfaction in the Chinese population.
Nursing Research 56(5):348-54. · 1.40 Impact Factor
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ABSTRACT: Developing a sense of competence and satisfaction in the maternal role enhances positive parenting and healthy development of the child. There is limited longitudinal research on the predictive factors influencing maternal role competence and satisfaction.
The aim of this study was to determine the predictive and concurrent associations of prenatal perceived maternal role competence, learned resourcefulness, social support, stress, and depression to perceived maternal role competence and satisfaction at 6 weeks postpartum.
A longitudinal, descriptive design was used. A convenience sample of 184 first-time pregnant women with a singleton and uneventful pregnancy were recruited from two regional public hospitals in Hong Kong. The Parenting Sense of Competence Scale, Self-control Schedule, Medical Outcomes Study Social Support Survey, Social Readjustment Rating Scale, and Edinburgh Postnatal Depression Scale were used to assess maternal role competence and satisfaction, learned resourcefulness, social support, stress, and depressive symptoms, respectively. Data were collected during pregnancy and at 6 weeks postpartum.
Multiple regression analysis showed that perceived maternal role competence and satisfaction at 6 weeks postpartum were predicted by prenatal perceived maternal role competence and learned resourcefulness and were associated with postnatal learned resourcefulness and depression. Social support and stress were not associated directly with perceived maternal role competence and satisfaction at 6 weeks postpartum.
The present findings suggest that maternal learned resourcefulness and depression are important factors affecting perceived maternal role competence and satisfaction at postpartum. Culturally competent healthcare should be developed to promote the psychological well-being of women and to equip women with the learned resourcefulness skills to facilitate maternal role taking and enhance women's sense of competence and satisfaction in the maternal role.
Nursing research 59(3):185-93. · 1.80 Impact Factor
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ABSTRACT: Family sense of coherence is central to successful coping with family stressors and facilitates positive adaptation. Little is known about the implications of family sense of coherence for family adaptation during the transition to parenthood in Chinese society.
The aims of this study were to translate the Family Sense of Coherence Scale-Short Form (FSOC-S) into Chinese FSOC-S (C-FSOC-S) and to evaluate the psychometric properties.
In Phase 1, the FSOC-S was translated into Chinese using the translation/back-translation technique and was reviewed by an expert panel for cultural equivalence. In Phase 2, a cross-sectional survey was conducted using a convenience sample of 128 Chinese childbearing couples recruited from the antenatal clinics. Participants completed the C-FSOC-S, Sense of Coherence Scale, Medical Outcomes Study Family and Marital Functioning Measures, and State-Trait Anxiety Inventory.
The C-FSOC-S showed good internal consistency (Cronbach's α = .83) and test-retest reliability (intraclass correlation coefficient = .75). Significant correlations with Sense of Coherence Scale (r = .55, p < .01), Medical Outcomes Study Family and Marital Functioning Measures (r = .71, p < .01), and State-Trait Anxiety Inventory (r = -.50, p < .01) indicated good construct validity. Exploratory factor analysis revealed a single-factor structure of the C-FSOC-S.
The C-FSOC-S has satisfactory psychometric properties and has the potential to be used as a clinical and research instrument for measuring family sense of coherence in Chinese childbearing families.
Nursing research 60(5):295-301. · 1.80 Impact Factor
