Article

First-time mothers: Social support, maternal parental self-efficacy and postnatal depression

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Abstract

To examine the relationships between social support, maternal parental self-efficacy and postnatal depression in first-time mothers at 6 weeks post delivery. Social support conceptualised and measured in different ways has been found to positively influence the mothering experience as has maternal parental self-efficacy. No research exists which has measured the relationships between social support, underpinned by social exchange theory and maternal parental self-efficacy using a domain-specific instrument, underpinned by self-efficacy theory and postnatal depression, with first-time mothers at 6 weeks post delivery. A quantitative correlational descriptive design was used. Data were collected using a five-part questionnaire package containing a researcher developed social support questionnaire, the Perceived Maternal Parental Self-Efficacy Scale and the Edinburgh Postnatal Depression Scale. Four hundred and ten mothers completed questionnaires at 6 weeks post delivery. Significant relationships were found between functional social support and postnatal depression; informal social support and postnatal depression; maternal parental self-efficacy and postnatal depression and informal social support and maternal parental self-efficacy at 6 weeks post delivery. Nurses and midwives need to be aware of and acknowledge the significant contribution of social support, particularly from family and friends in positively influencing first-time mothers' mental health and well-being in the postpartum period. The development of health care policy and clinical guidelines needs to define and operationalise social support to enhance maternal parental self-efficacy. These findings suggest that nurses and midwives need to be cognisant of the importance of social support for first-time mothers in both enhancing maternal parental self-efficacy and reducing postnatal depressive symptomatology in the early postpartum period.

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... It appeared that PSE was actually correlated with social support. These results are consistent with those obtained in previous studies (Cutrona & Troutman, 1986;Leahy-Warren et al., 2012;. ...
... Cette recension complète et réactualise en partie celle de Jones et Prinz (2005 Biehle & Mickelson, 2011 ;Caron & Guay, 2005 ;Kuo et al., 2012 ;Leahy-Warren et al., 2012 ;. En effet, le manque de soutien social est un facteur systématiquement lié à la détresse maternelle, à la dépression du post-partum, à l'anxiété et à l'épuisement (Capponi & Horbacz, 2007 ;Cutrona & Troutman, 1986 ;Guéritault, 2004 ;O'Hara & Swain, 1996). ...
... Le soutien social est important à prendre en considération pour promouvoir à la fois le SEP et le bien-être parental. Plusieurs études ont montré l'effet bénéfique du soutien social sur le SEP (Cutrona & Troutman, 1986 ;Leahy-Warren et al., 2012 ;. Une étude a montré l'effet bénéfique du soutien social sur le bien-être parental (Hogan et al., 2002). ...
Thesis
Devenir parent est un évènement de vie majeur qui est souvent associé à des sentiments de bonheur mais qui peut aussi engendrer une détresse psychologique. Le contexte dans lequel s’effectue l’ajustement parental est défini par les caractéristiques du parent, de l’enfant et de l’environnement socio-culturel dans lequel le parent vit et qui influe sur son état de santé et son bien-être. Le contexte de la première année est particulièrement marqué par les nombreux défis et ajustements liés au développement et aux besoins spécifiques du jeune enfant. De plus, la naissance d’un enfant atteint d’une maladie chronique complexifie l’ajustement parental et peut générer du stress. Pour mener à bien cet ajustement, il est nécessaire que le parent dispose de ressources sur lesquelles il peut s’appuyer, telles que le soutien social et le sentiment d’efficacité parentale (SEP). Ce travail de thèse comporte quatre études. La première étude permet de valider une adaptation française de la Karitane parenting confidence scale (KPCS) qui mesure le SEP auprès de parents d’enfants âgés de moins d’un an. La deuxième étude présente une recension de la littérature portant sur le lien entre le SEP et le bien-être psychologique des parents. La troisième étude met en évidence l’effet de médiation du SEP sur la relation entre le soutien social et le bien-être psychologique des parents. Enfin, la quatrième étude propose une théorisation enracinée rendant compte de l’ajustement parental précoce dans le cas d’une maladie abdomino-thoracique rare chez l’enfant. Les résultats mettent évidence la nécessité de prendre en compte les caractéristiques du contexte dans lequel les parents doivent s’ajuster afin de les accompagner et promouvoir leur état de santé et leur bien-être.
... It does not refer to how well they do as a parent, but rather to how they perceive how well they will be able to do as a parent. This perception (or their parental self-efficacy) then influences their actual parenting practices and thus the outcomes of their parenting (Leahy-Warren et al., 2012). One significant factor influencing parenting practices is divorce. ...
... One significant factor influencing parenting practices is divorce. Many of the negative effects caused by divorce also have an effect on parental-self efficacy, such as depression, anxiety and stress (Finlayson et al., 2007;Leahy-Warren et al., 2012;Zill et al., 1993). Low levels of parental self-efficacy may contribute to the children exhibiting the negative consequences associated with divorce. ...
... Further studies have shown that parental self-efficacy affects the quality of parenting that is delivered. High self-efficacy was shown to be related to increased quality of mother-toddler interactions, sensitivity, warmth and responsiveness The converse has also been found to be true of parenting quality in that parents with low self-efficacy tend to use coercive discipline more as well as discipline practices that are overly harsh, dismissive, too permissive, inconsistent and even abusive (Arnold et al., 1993;Feehan et al., 1991;Holmbeck et al., 1995;Lamborn et al., 1991;Murdock, 2013;Pettit & Bates, 1989;Stifter & Bono, 1998;Teti & Gelfand, 1991;Tucker et al., 1998;Leahy-Warren et al., 2012). Gigy and Kelly (2008) have identified that some of the main reasons that couples divorce is having emotional needs unmet, a high degree of (unhealthy) conflict within the marriage, financial stress and strain as well as boredom inside the marriage. ...
Article
The study explores the contribution that divorce has on parents’ parental self-efficacy. Divorce and self-efficacy of the are areas that have been extensively studied in recent decades. Going through a divorce has an effect on how parents parent their children, which in turn has an effect on the behavioral, emotional, social and academic outcomes of the child. Divorce is considered a significant factor in determining emotional and social problems that children begin to exhibit. However, limited research has been conducted on the relationship between divorce and parental self-efficacy and exploring the perceptions of parenting among divorced parents in South Africa. This study used qualitative interviews to explore the impact of divorce on parental self-efficacy and perceptions of parenting among ten divorced parents from working to middle class community in Cape Town, South Africa. The interviews were analyzed by making use of thematic analysis. Although participants experienced an initial period of elevated emotional distress and feeling overwhelmed at becoming a single parent, their confidence in their parenting increased over time as they began to adjust to their new lives and received adequate and regular support. This was accomplished through various techniques and coping mechanisms employed by the participants, and with their social support structure playing a significant role in contributing to their parental self-efficacy. These results suggest that even though newly divorced parents feel initially overwhelmed and emotionally distressed in the initial stages, if they are given sufficient support and time to stabilize while integrating in to their new lives, their parent self-efficacy increases and they are more confident in their parenting abilities.
... In a focus-group study on mothers' social media use, moms even stressed out that they find more advice, support, and information in the online environment compared to face-to-face interactions (Lupton, 2016;Orton-Johnson, 2017). Social support is essential for a fluent transition into motherhood and for limiting the negative experiences (Leahy-Warren et al., 2012;Montgomery et al., 2012). Having enough social support as a mother has been associated with a better health for the mother, better parenting practices, and a better relationship between the parents (McDaniel et al., 2012). ...
... Applied to a context of parenting the concept of parental self-efficacy arose. Parental self-efficacy actively starts to develop during pregnancy (Brunton et al., 2020;Razurel et al., 2017) and refers to the belief in one's capability to organize and do the tasks that are related to parenting (Leahy-Warren et al., 2012). ...
... Several studies reported that a negative mental state, high stress levels, low feelings of social support, and pregnancy-related anxiety are related with lower parental self-efficacy (e.g. David and Khatib, 2021;Haslam et al., 2006;Leahy-Warren et al., 2012;Razurel et al., 2017;Shorey et al., 2014). Also, cultural background is known to be an important influencer of parenting practices (Celada, 2010). ...
Article
Questions are raised about the potential effects of (future) mothers’ regular exposure to the perfect representations of motherhood by mommy influencers. Due to the regular exposure, mothers might see these images as the norm but are not always able to meet with these standards themselves. Based on a survey among mothers and primigravida this study analyzed the association between visiting mommy influencer profiles on Instagram, comparing oneself with these online mothers and perceived parental self-efficacy. For mothers, it was found that both exposure to the content and comparison with the mommy influencers were related to lower perceived parental self-efficacy. For primigravida, the direction of the relationship was different: Regular exposure to mommy influencer content was related to higher parental self-efficacy, meaning that this exposure was helpful. The implications of this study for (future) mothers, mommy influencers, and practitioners who guide mothers through the transition to motherhood will be discussed.
... Access to formal health services provided by obstetricians, primary care providers, doulas, and midwives help women address potential health concerns, including mastitis, cesarian site pain/infection, heavy bleeding, and postpartum depression [1,2]. The availability of informal supports from partners, family, or friends aids new mothers in balancing the competing demands of early parenthood, supports women's physical recovery, and emotional wellbeing [5][6][7]. Positive socioemotional supports in the postpartum period help to mitigate against depressive symptoms and improve maternal self-efficacy [6,8]. ...
... The availability of informal supports from partners, family, or friends aids new mothers in balancing the competing demands of early parenthood, supports women's physical recovery, and emotional wellbeing [5][6][7]. Positive socioemotional supports in the postpartum period help to mitigate against depressive symptoms and improve maternal self-efficacy [6,8]. ...
... In addition to disrupted healthcare access, COVID-19 restrictions and physical distancing requirements have socially isolated many postnatal women and limited their access to in-person social and informal supports [16][17][18]. Informal supports (e.g., meal preparation, childcare, advice sharing) provided by family, friends, or community members contributes to women's postnatal health, mitigates against postpartum depressive symptoms, and contributes to maternal self-efficacy [6,8]. Limited inperson social contact during the pandemic has left many new mothers isolated and overburdened [19]. ...
Article
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Background Prior to COVID-19, postnatal resettled refugee women in Canada reported barriers to healthcare and low levels of social support, contributing to maternal health morbidities. The COVID-19 pandemic appears to be further exacerbating health inequities for marginalized populations. The experiences of resettled refugee women are not fully known. Aim To understand Syrian refugee women’s experiences accessing postnatal healthcare services and supports during the COVID-19 pandemic. Methods Semi-structured, virtual interviews were conducted with eight resettled Syrian refugee women living in Nova Scotia (Canada) who were postnatal between March and August 2020. Data analysis was informed by constructivist grounded theory. Findings Three themes emerged: “the impacts of COVID-19 on postnatal healthcare;” “loss of informal support;” and “grief and anxiety.” Women experienced difficult healthcare interactions, including socially and physically isolated deliveries, challenges accessing in-person interpreters, and cancelled or unavailable in-home services (e.g., public health nurse and doula visits). Increased childcare responsibilities and limited informal supports due to pandemic restrictions left women feeling overwhelmed and exhausted. Stay-at-home orders resulted in some women reporting feelings of isolation and loss, as they were unable to share in person postnatal moments with friends and family, ultimately impacting their mental wellness. Conclusions COVID-19 and associated public health restrictions had significant impacts on postnatal Syrian refugee women. Data presented in this study demonstrated the ways in which the pandemic environment and related restrictions amplified pre-existing barriers to care and postnatal health inequalities for resettled refugee women—particularly a lack of postnatal informal supports and systemic barriers to care.
... Structural social support refers to the size and extent to which people access their social networks. Functional social support has been defined as the perceived quality of interactions with people who provide sources of care, compassion and solutions to overcome challenging life events (Lakey & Cohen, 2000). There is also literature to suggest that there are other types of social support, including 1) emotional, 2) informational and 3) concrete/financial support (Tracy & Abell, 1994). ...
... The present study examined the role of self-esteem and selfefficacy as mediators between perceived functional support and psychological well-being in people with a mental health diagnosis. The results converge with previous studies (Kleiman & Liu, 2013;Lakey & Cohen, 2000;McDougall et al., 2016), showing a positive association between perceived levels of functional social support and psychological well-being. The present study also indicated that self-esteem and self-efficacy fully mediated the positive association between functional social support and psychological wellbeing. ...
... This would suggest that the sense of being valued by others, who provide functional social support, may increase the extent to which people with a mental health diagnosis value themselves and improve self-esteem. Functional social support refers to the process of interacting with people who are seen to provide sources of encouragement, informational support, advice and facilitate a sense of belonging (Lakey & Cohen, 2000). It has been posited that group activities facilitated by healthcare professionals, such Figure 2. A conditional inference tree for Mental Well-being (box plots), Efficacy ¼ Self-efficacy; Esteem ¼ Self-esteem; Social sup. ...
Article
Full-text available
Background: Previous research has observed positive associations between perceived quality of social support and mental well-being. Having access to functional social support that provides sources of care, compassion and helpful information have shown to be beneficial for mental health. However, there is a need to identify the psychological processes through which functional social support can elicit therapeutic outcomes on mental well-being. Aims: The present cross-sectional study aimed to examine the extent to which self-efficacy and self-esteem mediated the association between functional social support and mental well-being. Method: Seventy-three people with a mental health diagnosis, who attended group-based activities as facilitated by a third sector community mental health organisation, took part in the present study. Participants were required to complete measures that assessed perceived quality of functional social support, self-efficacy, self-esteem, and subjective mental well-being. Results: A multiple mediation analysis revealed that self-efficacy and self-esteem fully mediated the positive association between perceived functional social support and mental well-being. Conclusions: The implications of these results are that social interventions, which aim to facilitate the delivery of functional social support, could enhance mental well-being via their positive effects on self-efficacy and self-esteem.
... Social support refers to the emotional care, instrumental assistance, information, and affirmation provided by social network members when an individual needs support [14]. According to Leahy-Warren, et al. [15] and Cohen and Wills [16], the four types of support can be defined as follows: Emotional support refers to the care, listening, and comfort offered by others. Instrumental support refers to financial, material, or labor assistance. ...
... As social support plays an essential role in the mental health of individuals, several attempts have been made to examine the differential impacts of various types and sources of social support. Postpartum women in different cultures, such as those from Iran, Ireland, and Canada, all consider the support of their spouses and their mothers to be the most crucial factor in building confidence [11,15,20]. Research in Japan has shown that the fewer resources available to mothers, the more unfavorable the connection between mother and baby [21]. ...
... For example, mothers from China and Singapore have indicated receiving more emotional and appraisal support than informational and instrumental support [13,22]. At the same time, research in Ireland has shown that first-time mothers receive less emotional and appraisal support [15]. ...
Article
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The adjustment process to becoming a mother is affected by culture. However, earlier studies have not clarified the relationship between parenting stress, social support, and maternal confidence in non-Western women. This study examined the associations between different types and sources of social support, maternal confidence, and parenting stress experienced by first-time mothers. The sample consisted of first-time mothers with a child under one year of age in northern Taiwan, and a total of 205 valid questionnaires were collected. The results supported the stress-buffering hypothesis, which suggests that social support reduces the adverse effect of stress on maternal confidence. Although previous studies have suggested that spouses and maternal relatives are critical in supporting first-time mothers’ transition into their new roles, each source did not show a mediator effect in our study. The beneficial effect of social support was found only when all social network members collectively participated. Regarding the types of social support, only appraisal support had a significant mediator effect; no effect was found for emotional, instrumental, or informational support. These findings add to our understanding of how different types and sources of social support play a role in helping first-time mothers adapt.
... Sound evidence has identified that MSE is not only the significant indicator of parenting outcomes, but is related to the wellbeing of women and children [13,14]. Considering the important impacts of MSE, related studies have been conducted in various countries worldwide [16][17][18][19]. However, the majority of research has focused on well-educated and employed city women [13,20], and little research is related to rural-to-urban floating women, who exhibit characteristics such as poorer educational qualifications, economically strained conditions, and worse working status [9]. ...
... Functional social support refers to informational, instrumental, emotional and appraisal support [28]. Research findings have highlighted that social support positively affects MSE, and women receiving more social support after delivery were prone to higher MSE levels [18,21,26,29,30]. ...
... For instance, 2659 women in the United Kingdom had mean EPDS scores of 6.80 (4.28) at six weeks postpartum [38]. Another study investigated 410 Irishwomen, and found their mean score on the EPDS to 7.20 (4.40) at six weeks postpartum [18]. In terms of EPDS threshold scores, the proportions of rural-tourban floating women with EPDS scores of 10 or above and 13 or above were 54.4% and 50.6% at 6 weeks postpartum, respectively; the corresponding percentages were 40.1% and 35.4% at 12 weeks postpartum. ...
Article
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China has the largest population of floating rural-to-urban women worldwide, most of whom are of childbearing age. However, few studies have been conducted to monitor the changing trends in parenting outcomes, mental health and social support for these women in the early postpartum period. In this quantitative longitudinal study, 680 primiparous women among the floating population were recruited in Shenzhen, China. Face-to-face collection of socio-demographic questionnaires was completed by researchers in maternity wards on the third postnatal day. Follow-up electronic questionnaires were dispatched to women via email or WeChat at 6 weeks and 12 weeks following childbirth, including the Self-efficacy in Infant Care Scale (SICS), Edinburgh Postnatal Depression Scale (EPDS) and Postnatal Social Support Scale (PSSS), to measure maternal self-efficacy (MSE), postpartum depression (PPD) and social support, respectively. The mean scores of MSE for these floating women were 67.16 (14.35) at 6 weeks postpartum and slightly increased to 68.71 (15.00) at 12 weeks postpartum. The mean scores of EPDS remained almost stable, from 11.19 (4.89) to 11.18 (5.34) at the two time points. The prevalence of mild and severe PPD among floating women at 6 and 12 weeks after childbirth decreased from 54.4% to 40.1% and from 50.6% to 35.4%, respectively. The mean score of social support was 37.04 (10.15) at 6 weeks postpartum and slightly improved to 38.68 (10.46) at 12 weeks postpartum. Primiparous women among the rural-to-urban migrant population had an obviously negative status of parenting outcomes and mental health; and there was a lack of social support after childbirth. In future, tailored evidence-based interventions are highly needed to promote floating women’s parenting outcomes, mental wellbeing and social support in the early stages of motherhood. As a higher-risk group of PPD, primiparous women among the floating population require effective and accessible mental health care after childbirth, such as early PPD screening and timely therapeutic methods.
... Lack of functional support from family, friends or community has frequently been indicated as an issue for mothers admitted to RPS (29,38). This type of support is consistent with that provided to women admitted to RPS and includes informational, instrumental, emotional and appraisal support (39), which has been demonstrated to positively in uence parenting self-e cacy and lessen the likelihood of experiencing postnatal depression symptoms (39). ...
... Lack of functional support from family, friends or community has frequently been indicated as an issue for mothers admitted to RPS (29,38). This type of support is consistent with that provided to women admitted to RPS and includes informational, instrumental, emotional and appraisal support (39), which has been demonstrated to positively in uence parenting self-e cacy and lessen the likelihood of experiencing postnatal depression symptoms (39). ...
Preprint
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Background There is a tiered healthcare system in Australia to support maternal and child health, including, non-psychiatric day stay and residential parenting services (RPS) such as Tresillian and Karitane (in New South Wales [NSW]). RPS are unique to Australia, and currently there is limited information regarding the healthcare trajectory of women accessing RPS and if they are more likely to have admissions to other health facilities within the first-year post-birth. This study aimed to examine differences in hospital co-admissions for women and babies admitted to RPS in NSW in the year following birth compared to non-RPS admitted women. Methods A linked population data study of all women giving birth in NSW 2000-2012. Statistical differences were calculated using chi-square and student t-tests. Results In total 32 071 women and 33 035 babies were admitted to RPS with 5191 RPS women also having one or more hospital admissions (7607 admissions). There were 99 242 women not admitted to RPS but having hospital admissions (136 771 admissions). Women admitted to RPS who had a co-admission to a hospital were significantly more likely to be older, admitted as a private patient, born in Australia, having their first baby and be socially advantaged (p≤.001) compared to non-RPS admitted women also having a hospital admission. They also experienced more labour and birth interventions (induction, instrumental birth, caesarean section, epidural, episiotomy), and were more likely to have multiple births, a male infant and babies admitted to Special Care Nursery/Neonatal Intensive Care (p≤.001). Additionally, these women were more likely to have another admission for mental health and behavioural disorders (p≤.001), and this appeared to increase over time. There was no between cohort differences regarding the number of women admitted to a psychiatric facility; however, women attending RPS were more likely to have mood affective, or behavioural and personality disorder diagnoses. Conclusion Women accessing RPS in the year post-birth were more socially advantaged, had higher birth intervention and more co-admissions and treatment for mental health disorders than those not accessing RPS. More research is needed into the impact of birth intervention and mental health issues on subsequent parenting difficulties.
... Lack of functional support from family, friends or community has frequently been indicated as an issue for mothers admitted to RPS [33,42]. This type of support is consistent with that provided to women admitted to RPS and includes informational, instrumental, emotional and appraisal support [43], which has been demonstrated to positively influence parenting self-efficacy and lessen the likelihood of experiencing postnatal depression symptoms [43]. ...
... Lack of functional support from family, friends or community has frequently been indicated as an issue for mothers admitted to RPS [33,42]. This type of support is consistent with that provided to women admitted to RPS and includes informational, instrumental, emotional and appraisal support [43], which has been demonstrated to positively influence parenting self-efficacy and lessen the likelihood of experiencing postnatal depression symptoms [43]. ...
Article
Full-text available
Background There is a tiered healthcare system in Australia to support maternal and child health, including, non-psychiatric day stay and residential parenting services (RPS) such as Tresillian and Karitane (in New South Wales [NSW]). RPS are unique to Australia, and currently there is limited information regarding the healthcare trajectory of women accessing RPS and if they are more likely to have admissions to other health facilities within the first-year post-birth. This study aimed to examine differences in hospital co-admissions for women and babies admitted to RPS in NSW in the year following birth compared to non-RPS admitted women. Methods A linked population data study of all women giving birth in NSW 2000–2012. Statistical differences were calculated using chi-square and student t-tests. Results Over the 12-year timeframe, 32,071 women and 33,035 babies were admitted to RPS, with 5191 of these women also having one or more hospital admissions (7607 admissions). The comparator group comprised of 99,242 women not admitted to RPS but having hospital admissions over the same timeframe (136,771 admissions). Statistically significant differences between cohorts were observed for the following parameters ( p ≤ .001). Based upon calculated percentages, women who were admitted to RPS were more often older, Australian born, socially advantaged, private patients, and having their first baby. RPS admitted women also had more multiple births and labour and birth interventions (induction, instrumental birth, caesarean section, epidural, episiotomy). Their infants were also more often male and admitted to Special Care Nursery/Neonatal Intensive Care. Additionally, RPS admitted women had more admissions for mental health and behavioural disorders, which appeared to increase over time. There was no statistical difference between cohorts regarding the number of women admitted to a psychiatric facility; however, women attending RPS were more likely to have mood affective, or behavioural and personality disorder diagnoses. Conclusion Women accessing RPS in the year post-birth were more socially advantaged, had higher birth intervention and more co-admissions and treatment for mental health disorders than those not accessing RPS. More research is needed into the impact of birth intervention and mental health issues on subsequent parenting difficulties.
... Another factor that affects the mother's well-being and perceived health is social support (Avrech Bar & Jarus, 2015;Fahey & Shenassa, 2013;Leahy-Warren et al., 2012). Social support is a subjective feeling of being loveable and valued and being able to trust others (McColl & Friedland, 1989). ...
... The human aspects of the environment such as a supportive spouse and colleagues are also important to life satisfaction and indeed, in our study, social support was found to predict life satisfaction. Therefore, social support has an important role in maintaining maternal satisfaction in the postpartum epoch (Leahy-Warren et al., 2012;Tarkka, 2003). ...
Article
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Giving birth to a preterm infant has significant implications on the mother’s life. The purpose of this study was to compare occupational performance (performance of everyday occupations), social support, perceived health (mental and physical) and life satisfaction between mothers of preterm and term infants and to assess whether occupational performance, social support and infant characteristics such as birth weight, explain mothers’ health and life satisfaction. This cross-sectional study included 30 mothers of preterm singletons and 30 mothers of term infants (age 22–41) four months after hospital discharge. The data was gathered using three self-report questionnaires: Satisfaction with life Scale; Short Form Health Survey Questionnaire; and the Maternal Social Support Index and a semi-structured interview (the Occupational Performance History Interview) which was analyzed quantitatively and measured occupational performance by three components: occupational identity, competence and settings. Mothers of preterm infants exhibited lower occupational competence and identity scores and higher perceived physical health. Social support, life satisfaction and perceived total and mental health were comparable between groups. Occupational competence predicted perceived mental health and life satisfaction, and occupational settings and social support predicted life satisfaction among all mothers. The study findings shed new light on occupational aspects pertaining to mothers of preterm infants after discharge. Their ability to engage in varied occupations is lower than mothers of term infants. Therefore, as part of a health promotion agenda, mothers of premature infants may benefit from interventions that are focused on their needs and not only on the infants’.
... Parental self-efficacy, or confidence in one's ability to organize and carry out tasks related to parenting a child, can be limited when a parent does not have a baseline of knowledge about infant care and child-rearing. In a study of 400 mothers, a relationship was found between social support, self-efficacy, and depression rates post-partum (Leahy-Warren et al., 2012). It is hypothesized that caregivers with a higher sense of self-efficacy during the newborn period may have a higher sense of satisfaction in their parenting which leads to improved parent-child relations (Paradis et al., 2011). ...
... Additionally, social support has been documented as advantageously moderating the negative effects of stress on maternal satisfaction (Crnic et al., 1983). These social networks also enhance maternal well-being and parental self-efficacy (Leahy-Warren et al., 2012). Further, the increased access to information online or through parenting apps may be changing the landscape of resources used by parents. ...
Article
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Parenting knowledge affects parenting practices and child development, yet more information is needed about “where” parents of infants turn for information and “why” they choose these sources. Using a mixed-methods approach, the authors captured and analyzed the cited resources that 38 parents turn to when seeking information about parenting. The present study utilized an innovative interview design which invited parents to consider and compare the people, places, and tools (“where”) they turn for support and their relative preference for each by thinking of their resources within “Circles of Support”. Parents were also asked to provide insight into “why” they make these choices. The Survey of Parental Expectations and Knowledge (SPEAK) was used as a measure of parenting knowledge. Descriptive information about parents (years of education and parenting knowledge) were also considered in relation to stated preferences for resource categories. Findings indicated that “informal” sources of information, such as family and friends, are commonly sought out with parent education level being significantly correlated with some resource categories (i.e., books, professionals). As to why they choose certain resources, parents prioritized “relational” and “informational” reasons, over “personal” reasons. Implications for avenues to provide parents with parenting knowledge and information are discussed.
... To cope with stressors in the postpartum period, mothers often search for information and support from a variety of sources, including public health departments, formal support groups, community drop-in centers, online chat spaces, social media, family and friends [9][10][11][12][13][14]. However, it is difficult to determine the degree to which these programs and supports effectively address the wide spectrum of urgent and ongoing needs of new mothers and their families, especially mothers who have been mandated by the justice system to enroll in parenting classes and work with Child Protection Services. ...
Article
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Background: The postpartum period is often portrayed as a blissful, calm and loving time when mothers, partners and family members bond with their newborn babies. However, this time may be experienced quite differently when mothers are monitored by Child Protection Services. Having a baby under these circumstances can be very difficult and traumatizing. While all new parents require support and information to help them through the transition to parenthood and address physical and psycho-social changes, mothers who are involved with Child Protection Services require more specialized support as they encounter higher incidences of postpartum stressors and higher rates of poverty, mental illness and substance abuse. The impact of support for mothers involved with Child Protection Services is not well-understood from the perspective of mothers. Aim: The aim of the study was to understand how new mothers in Nova Scotia prioritized their postpartum needs and where they went to obtain information and support. Methods: Feminist poststructuralism was the methodology used to understand how the experiences of five mothers who accessed a family resource center and had been involved with Child Protection Services in Nova Scotia Canada had been personally, socially and institutionally constructed. Results: Themes include: (1) We are Mothers, (2) Being Red Flagged, (3) Lack of Trust, (4) Us Against Them and (5) Searching for Supportive Relationships. Conclusion: Personal stories from all participants demonstrated how they experienced stigma and stereotypes from healthcare workers and were often not recognized as mothers. They also struggled to find information, supports and services to help them keep or regain their babies.
... Prior studies of both domestic and foreign populations have found the Social Support Scale score to be negatively correlated with a postpartum depression symptom score during the postpartum period (24)(25)(26). Also, in this current study, the CES-D score was significantly and negatively correlated with the Social Support Scale score in all four time periods as was the STAI score. ...
Article
The aim of this study was to clarify the relationship between maternal mental status and social supports during pregnancy and until one month after childbirth in order to evaluate the actual situation in a local city. A survey was conducted on 78 pregnant women who completed the CES-D (depression score), STAI (anxiety score) and Social Support Scale. Data were collected four times : during the second trimester, the third trimester, postpartum hospitalization, and 1 month after childbirth. The CES-D and STAI scores were initially high during pregnancy and decreased during the postpartum period. The Social Support Scale score, however, was initially low during pregnancy and increased during the postpartum period. The CES-D and STAI scores was significantly and negatively correlated with The Social Support Scale score during all four time periods. Participants ≧ 35 years of age scored lower on The Social Support Scale than did participants < 35 years of age in the second trimester, third trimester, and 1 month after childbirth. These findings should assist with the implementation of a comprehensive support center and may be useful for a local city in Japan. J. Med. Invest. 68 : 265-270, August, 2021
... This effect was likely achieved through improving caregivers' parenting skills, enhancing sensitive and responsive parenting behaviors, and increasing caregivers' self-efficacy. Caregivers with high levels of depressive symptoms tend to exhibit low self-efficacy and confidence in parenting tasks, experience more parenting stress, and show more negative parenting behaviors (Caldwell, Shaver, Li, & Minzenberg, 2011;Leahy-Warren, McCarthy, & Corcoran, 2012;Lovejoy et al., 2000;Vreeland et al., 2019). FIND, as a strengthbased intervention, focuses on promoting the naturally occurring serve and return interactions between parent-child dyads that are innate to caregivers. ...
Article
Informed by the National Institute of Mental Health's Research Domain Criteria (RDoC) and developmental psychopathology frameworks, the current study used cortisol area under the curve with respect to ground (AUCg) as an index of differential sensitivity to context, which was expected to predispose young children with elevated vulnerability to adverse caregiving experiences and adaptive sensitivity to intervention effects. Particularly, the study aimed to determine whether improving caregivers’ responsive parenting through the Filming Interactions to Nurture Development (FIND) intervention would buffer children's biologically embedded vulnerability to caregivers’ depressive symptoms. Data were derived from a randomized controlled trial using pretest–posttest design with low-income families of children aged 4 to 36 months ( N = 91). Young children's differential sensitivity was measured using cortisol AUCg during a structured stress paradigm. As hypothesized, children whose cortisol AUCg indicated greater sensitivity to social context exhibited more internalizing and externalizing behaviors in relation to caregivers’ elevated depressive symptoms. Critically, the intervention program was effective in attenuating psychopathology symptoms among the more biologically sensitive children. As proven by rigorous statistical tests, the findings of this study partially supported the differential susceptibility hypotheses, indicating both greater vulnerability to adverse conditions and responsiveness to intervention among children with high levels of cortisol AUCg.
... Interventions to increase social support may help improve maternal mental health (Schwab-Reese et al., 2017). Leahy-Warren et al. (2011) found that informal social support from family and friends was associated with increased parental self-efficacy and decreased depression symptoms. ...
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Objective To examine the relationships among depression and anxiety symptomatology, stigma of mental illness, levels of social support, and select demographics among hospitalized women in the postpartum period. Design Descriptive, cross-sectional, correlational. Setting A convenience sample of 105 English-speaking and Spanish-speaking women was recruited and enrolled from a 208-bed free-standing Southern California women’s community hospital postpartum unit serving a diverse community. Measurements Data were collected on potential covariates including participants’ characteristics, depression and anxiety symptomatology, social support, and stigma. Results Sixteen participants were classified as high risk for depression or anxiety based on the Edinburgh Postnatal Depression Scale and GAD-7. Anxiety was significantly associated with all stigma subscales; the strongest association was with Internal Stigma (r = .46, p < .001, moderate effect), followed by Disclosure Stigma (r = .36, p < .001, moderate effect) and External Stigma (r = .30, p = .002, moderate effect). All social support subscales were negatively associated with depression and anxiety; the Friends subscale had the strongest correlations with depression (r = –.27, p = .006, small effect) and anxiety (r = .34, p = .001, moderate effect). Firth (penalized likelihood) logistic regression analysis was conducted to ascertain the effects of study covariates on the likelihood of participants being at risk for postnatal depression or anxiety. The significant factor that increased the odds of participants being in the high-risk group was decreased social support (adjusted OR = 0.46, 95% CI [0.24, 0.76], p = .003). Conclusion These results show the enduring prevalence of postnatal depression and anxiety and the relevance of stigma and social support in aggravating or mitigating symptomatology. There is a need for comprehensive standardized screening to ensure the identification of and referral to treatment for women at risk. https://authors.elsevier.com/c/1emGT6EFTeXhOd
... Maternal self-efficacy refers to an individual psychological factor that affects the parenting experience. Maternal self-efficacy in the postpartum period is inversely related to symptoms of depression, stress, and anxiety (Razurel et al., 2017) and is positively related to perceptions of the infant (Leahy-Warren et al., 2012;Troutman et al., 2012) and attunement to the infant's signals and needs (Bolten et al., 2012;Fulton et al., 2012). With a small sample (N ¼ 53), Xue et al. (2021) examined parenting self-efficacy and quality of life of new mothers during the COVID-19 pandemic lockdown in Switzerland. ...
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Objective To examine the associations of maternal self-efficacy (MSE) and perceived social support with parenting stress during the postpartum period during the COVID-19 pandemic and whether these two psychosocial factors account for variance in parenting stress in addition to the effects of COVID-19-related experiences and sociodemographic factors. Design Cross-sectional survey. Setting Online survey, the Perinatal Experiences and COVID-19 Effects (PEACE) Study, launched in May 2020. Participants Participants included 310 women who gave birth in the past 24 weeks. Methods The survey included self-report quantitative measures of MSE, social support, COVID-19-related experiences, parenting stress, symptoms of depression and anxiety, and a range of sociodemographic factors. Results Hierarchical multiple regression analysis indicated that MSE and social support were negatively associated with postpartum parenting stress in addition to the effects of COVID-19-related experiences, maternal symptoms of depression and anxiety, and a range of demographic factors. Furthermore, MSE interacted with the COVID-19-related experiences such that higher levels of MSE mitigated the effects of the COVID-19-related experiences on parenting stress. Conclusion Our findings underscore the importance of protective factors at the individual and interpersonal levels and provide insights for prevention and intervention programs aimed at mitigating postpartum parenting stress during a wide scale disaster such as the COVID-19 pandemic.
... In addition, significant and negative correlations between the PMPS-E subscales and total scores and postpartum depressive symptoms were found. This result is consistent with previous studies showing a negative association between maternal self-efficacy and depressive symptoms (e.g., Albanese et al., 2019 ;Leahy-Warren et al., 2012 ) and corroborates the assumption that higher maternal parenting self-efficacy is associated with a better psychological adjustment of mothers. ...
Article
Objective: The aim of this study was to investigate the factor structure and psychometric properties of the Perceived Maternal Parenting Self-Efficacy (PMPS-E) Scale among Portuguese postpartum women. Design: Quantitative cross-sectional study. Setting: Data were collected through an online survey placed on social media websites targeting Portuguese adult women in the postpartum period (0-12 months after delivery). Participants: The total sample consisted of 893 participants who gave birth after 37 weeks of gestation. Results: After conducting exploratory and confirmatory factor analyses, our results revealed that a correlated three-factor model yielded a significantly better fit to the data than the original four-factor model. High reliability was found for the total scale (α= .95) and for the three factors (α from .88 to .94). The PMPS-E presented significant and moderate to large correlations with other measures related to maternal self-efficacy. Participants who were multiparous, had older infants (>5 months old) and perceived their infant temperament as easy reported higher maternal parenting self-efficacy than those who were primiparous, had younger infants (≤5 months old) and perceived their infant temperament as difficult. Conclusions: The results of this study showed that the European Portuguese version of the PMPS-E is a valid and reliable instrument for assessing maternal parenting self-efficacy among postpartum women. Implications for practice: The PMPS-E may be a valuable instrument to detect parenting self-efficacy difficulties among postpartum women and thus contribute to strategies to improve women's overall psychological adjustment to the postpartum period, with a possible impact on the mother-infant relationship.
... Therefore, official government programs that send a person to each woman to help with her baby and simply to talk could eventually reduce peripartum depression. Furthermore, significant relationships of maternal confidence and maternal parental self-efficacy with postpartum depression were found [49,50]. Thus, interventions promoting maternal self-confidence are needed to prevent peripartum depression. ...
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Purpose The psychosocial health of mother is crucial for healthy prenatal period and early childhood. We investigated the prevalence and risk factors of maternal depression during pregnancy and postpartum among women who participated in a home visitation program in Seoul, South Korea (Seoul Healthy First Step Project, SHFSP). Methods We analyzed 80,116 women who participated in the SHFSP, which was launched by Seoul metropolitan government in 2013, and defined peripartum depression as a score ≥ 10 on the Korean version of the Edinburgh Postnatal Depression Scale (EPDS). Sociodemographic factors and psychosocial health status were evaluated through a standardized questionnaire completed by participants upon program registration. We calculated the prevalence of women at risk for peripartum depression and evaluated associated factors by multivariable logistic regression analysis. Results Prevalence of women at risk for peripartum depression was 17.7% (prepartum depression: 14.2%, postpartum depression: 24.3%). Younger maternal age, low income (OR 2.40, 95% CI 2.03–2.84), disability (2.61, 1.96–3.47), single parenthood (3.27, 2.69–3.99), and smoking (2.02, 1.44–2.83) increased the peripartum depression risk. Furthermore, experience of stress, change, or loss over the past 12 months (3.36, 3.22–3.50), history of treatment for emotional issues (2.47, 2.27–2.70), experience of child abuse (1.91, 1.74–2.11), and domestic violence (2.25, 1.81–2.80) increased the risk for peripartum depression, whereas having helpers for the baby (0.62, 0.58–0.67), having someone to talk with (0.31, 0.27–0.35), and considering oneself confident (0.30, 0.29–0.31) decreased the risk. Conclusions Policies to reduce and manage peripartum depression should be strengthened, with a focus on high-risk pregnant and puerperal women.
... Many researchers have investigated the relationship between social support and PPD. Almost all of them found that lack of social support was negatively correlated with PPD [11][12][13][14][15]. ...
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Background Numerous studies suggest that interpersonal relationships and social support influence the development of postpartum depression and sleep quality for women. However, the effect of support from the husband or the mother-in-law has not been thoroughly validated. The current study examined the relative contribution of marital satisfaction, perceived caring of the mother-in-law, and social support on postpartum depression and sleep quality simultaneously in a path model. Methods A cross-sectional study was conducted from March to June 2017 in Hebei, China, using a self-report questionnaire. A total of 817 women participated at 6 weeks postpartum. Sociodemographics and information about marital satisfaction, perceived caring of the mother-in-law, social support, postpartum depression, and sleep were collected. Path analysis was used to analyze the cross-sectional data. Results The final model had a highly satisfactory fit. Marital satisfaction and perceived caring of mother-in-law had both direct and indirect effects on postpartum depression through social support, but these two variables had only an indirect effect on sleep quality through social support and postpartum depression. Sleep quality is a consequence of postpartum depression at 6 weeks after delivery. The prevalence of minor and major postpartum depressive symptoms at 6 weeks postpartum was 41.49 and 23.13%, respectively. A total of 371 (45.41%) women experienced sleep disturbance at 6 weeks postpartum. Conclusions These findings suggest that interpersonal relationships with family members play important roles in postpartum depression and sleep quality through social support in Chinese women. Improving the relationship between new mothers and their husbands or mothers-in-law and then enhancing social support might reduce postpartum depression and sleep disturbance.
... For example, mothers experiencing higher levels of stress have been found to report lower levels of parenting self-efficacy and satisfaction (Rogers & Matthews, 2004;Sevigny & Loutzenhiser, 2009). Several studies have also found that mothers experiencing postpartum depressive symptoms reported lower levels of parenting selfefficacy and satisfaction (Azmoude et al., 2015;Leahy-Warren et al., 2011;Salonen et al., 2010). One study by Khajehei and Lee (2019) found that mothers with moderate to severe symptoms of postpartum depression were nearly 12 times as likely to report low parenting confidence compared to mothers with lower levels of depressive symptoms. ...
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Patterns of parenting behaviors tend to persist across generations, but less is known about the associations between mothers’ perceived histories of parenting and their current parenting attitudes. The present study examined stress and depression as potential mechanisms through which mothers’ perceived histories of maternal and paternal support and psychological control may be associated with their current parenting self-efficacy and satisfaction. Participants were 192 mothers of infants who participated in early home visiting services. Participants reported on their mothers’ and fathers’ use of support and psychological control during childhood, as well as their own current levels of stress and depression. Two months later, participants completed questionnaires assessing their parenting self-efficacy and satisfaction. Results indicated both direct and indirect associations between mothers’ perceived histories of parenting and their current parenting attitudes. Mothers’ perceptions of maternal support predicted higher parenting self-efficacy, and their perceptions of paternal psychological control predicted lower parenting satisfaction. Mothers’ experiences of depression fully mediated the associations between their perceptions of both maternal and paternal psychological control and their parenting satisfaction. Additionally, mothers’ experiences of stress and depression fully mediated the association between their perceptions of paternal psychological control and their parenting self-efficacy. Our findings highlight stress and depression as potential underlying mechanisms in the association between mothers’ early parenting experiences and their current parenting attitudes. Preventive interventions targeting parenting behaviors during childhood and mothers’ emotional experiences during their transition to parenthood may promote more positive parenting attitudes.
... Numerous studies have identified the protective role of social support during pregnancy and beyond. Maternal perceptions of having strong social support are associated with decreased perceived stress and anxiety, increased parenting warmth, and increased parenting self-efficacy (Thoits 2011;Leahy-Warren et al. 2012;Green et al. 2007;Reid and Taylor 2015;Cutrona and Troutman 1986;Tani and Castagna 2017). Since social support may change over time, social support during both the antenatal and postpartum periods may be an important buffer against perinatal depression (Zhang and Jin 2016;. ...
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The primary objective of this study was to delineate classes of individuals based on depression trajectories from the antenatal period through 54-month postpartum and internal and external resources that are associated with low depression risk. Participants came from the Growing Up in New Zealand (GUiNZ) study (n = 5664), which is a pregnancy cohort study and is nationally representative of the ethnic and socioeconomic diversity of contemporary New Zealand births. Growth curve mixture modeling was used to identify distinct subgroups based on depression scores from the antenatal period through 54-month postpartum. Logistic regression models were run to investigate socioeconomic factors and internal and external resources that were associated with depression class membership. A two-class model, “low risk” and “high risk,” resulted in the best model fit. Most of the sample (n = 5110, 90%) fell into the “low-risk” class defined by no-to-mild depression symptoms during pregnancy and decreasing depressive symptoms over time (bintercept = − .05, bslope = − .05). Approximately 10% of the sample fell into the “high-risk” class (n = 554, 10%) defined by mild-to-moderate depressive symptoms during pregnancy and increasing depressive symptomology over time (bintercept = .39, bslope = .57). More positive parenting-related attitudes, better pre-pregnancy self-reported health, informal social supports, and community belonging were significantly associated with greater odds of being in the “low-risk” class, after controlling for socioeconomic factors. These findings suggest that targeting internal and external resources for individuals across the perinatal and early childhood periods is important to mitigating maternal depression.
... 8,9 Even in uncomplicated pregnancies and births, women may struggle with developing their parenting self-efficacy 10 and may feel unsupported by both informal and formal sources of support. 10,11 Additionally, 17% of women report postpartum depression symptoms 12 and 15% report postpartum anxiety symptoms. 13 Previous work has shown that primiparous women are more at risk, being more likely to have lower maternal self-efficacy and higher postpartum anxiety than multiparous women. ...
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Objective To determine the effectiveness of the Essential Coaching for Every Mother program on maternal self-efficacy, perceived social support, postpartum anxiety, and postpartum depression at six-weeks postpartum. Methods Participants from Nova Scotia were randomized, stratified by parity, to receive either the Essential Coaching for Every Mother postpartum text-message program or usual care, from birth to six-weeks postpartum. Participants completed surveys at enrollment (after birth) and at 6 weeks. Differences between groups were analyzed using analysis of covariance, considering parity and group allocation. Results Of the 171 participants recruited (53% primiparous), 150 completed the baseline survey (intervention n = 78, control n = 72). At baseline, newborns were on average 4.4 days old (SD: 3.9) and mothers 31.4 years old (SD: 4.5). Controlling for maternal age, primiparous women in the intervention group had a greater increase in maternal self-efficacy than primiparous women in the control group (mean difference [MD] = 4.84 (standard error [SE] = 0.75) vs. MD = 2.13 (SE = 0.81), p = 0.034). Women allocated to the intervention group had a greater reduction in postpartum anxiety symptoms than women in the control group for both multiparous and primiparous women (MD = −3.91 (SE = 1.82) vs. 2.81 (SE = 1.86), p = 0.011). There was no significant change in postpartum depression scores or perceived social support for either group. Discussion This study presents the results of the first Canadian postpartum text message program, which found improved psychosocial outcomes for postpartum women. Given the potential to reach numerous women at a low cost across geographical locations, the scalability of this intervention can improve maternal self-efficacy and reduce postpartum anxiety.
... Furthermore, their negative attitudes might be influenced by sexual preferences and fear of breast deformity due to breastfeeding, thereby leading husbands to the refusal of breastfeeding. [41] Hawley et al. concluded that the beliefs such as the safety of formula, insufficiency of breast milk, ease of SSQN=Social support questionnaire-network, SSQS=Social support questionnaire-satisfaction, SD=Standard deviation use of formula, insufficient milk production by mothers, pain during breastfeeding, and the role of family support were effective factors in the non-exclusive breastfeeding. [42] Moreover, Susin et al. examined the grandmothers' roles in breastfeeding and reported that the grandmothers' recommendations for adding water, tea, or other foods to a baby's feeding significantly reduced exclusive breastfeeding to a month after delivery and the complete cessation of breastfeeding after 6 months. ...
Article
Background: Breastfeeding is beneficial for the health of infants and mothers. It is a complex social behavior that may be influenced by social support. The study aimed to determine the relationship between perceived social support of breastfeeding women and their breastfeeding patterns. Materials and methods: The research was a cross-sectional study on 300 mothers with 6-month infants or younger who were selected randomly. The data collection tool consisted standard social support and breastfeeding patterns questionnaires. We analyzed data using descriptive and analytical tests and SPSS 18 at a significance level of < 0.05. Results: The results indicated that 85%, 82.2%, and 38% of the infants were exclusively breastfed at 1 week, 4, and 6 months after delivery, respectively. The result of post hoc LSD test indicated that the mean number of supporters for mothers, who were in the 6th month of delivery, was significantly lower than other times (P = 0.001). The one-way analysis of variance indicated no significant difference between perceived satisfaction of social support at different periods after delivery (P = 0.92). Despite the present results, which indicated that the number of supporters and scores of satisfaction with support in exclusive breastfeeding were higher than other groups, the differences were not statistically significant. Conclusions: The mean number of supporters was less in women, who had 6-month-old infants, than mothers who had just given birth. It seems mothers with supplements and formula feeding patterns, such as breastfeeding mothers, may be supported to use these methods. Therefore, more studies are suggested on this field.
... Also in this study, it was determined that the physical support by the spouse was the most important type of support affecting the readiness for discharge from the hospital. In a study conducted on first-time mothers, it was reported that spousal support increased mother's self-confidence on providing care and ability to provide care (35). In a study conducted in Vietnam, it was found that fathers' presence in both health institutions and home care increased the rate of mothers who considered breastfeeding for the first 6 months (36). ...
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Aim: The study was conducted to determine the relationship between puerperal hospital readiness for discharge and social and spousal support. Materials and Methods: The descriptive and correlational study was conducted with 388 women over the age of 18 who were hospitalized in the puerperium ward of a public hospital between October 2018 and March 2019. Personal Information Form, Multidimensional Scale of Perceived Social Support (MSPSS), Spouse Support Scale Perceived by Women in Early Postpartum Period (SSSPWEPP) and Readiness for Hospital Discharge Scale–New Mother Form (RHD-NMF) were used to collect the data. Results: The mean score of postpartum women from RHD-NMF was 171.41±28.55 with 89.9% of them to be ready for discharge. It was found that there was a weak positive correlation between total scores from RHD-NMF and MSPSS and its sub-dimensions (family, friends) (r=.164, r=.177, r=.156, respectively; p<0.01); it was determined that there was a weak positive correlation between total scores from RHD-NMF and SSSPWEPP and its sub-dimensions (emotional, physical, social) (r=.249, r=.199, r=.194, r=.232, respectively; p<0.01). Conclusion and Suggestions: In the study, it was determined that most of the puerperant women were ready for discharge. Readiness for discharge and social support, family support and friend support. In addition, it was determined that as the physical, emotional and social support of the spouse increased, the readiness for discharge from the hospital increased. In addition, it was found that the most important variables affecting readiness for discharge from the hospital were the support of friends and physical support of the spouse.
... Support served an important function across the women's accounts of distress and wellbeing. Studies have found that social support is an important predictor of wellbeing for mothers in the general population [49,50]. Individuals living with RA also report enhanced wellbeing to be associated with social support [51]. ...
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Background Rheumatoid arthritis (RA) can result in difficulties for mothers when undertaking daily care activities and increased psychological distress. However, few studies have examined how women with RA subjectively experience coping and wellbeing as part of their motherhood. Methods Twenty mothers with a diagnosis of RA and a dependent child (18 years or younger) who were living in Australia took part in a semi-structured interview between June and November 2017. Purposive sampling was undertaken to include participants across degree of current RA severity, number and age of children, and having received a diagnosis before or after a first child to take account of variability across these experiences. A qualitative thematic analysis was conducted on the interview transcripts. Results The following themes were identified: ‘Burden and complexity in the mothering role’, ‘Losing control: Women’s experiences of distress’, and ‘Adjusting and letting go: Women’s experiences of wellbeing’. Experiences of distress, including feelings of failure, were associated with accounts of a loss of control over mothering practices among women, regardless of child age. In contrast, accounts of adjusting mothering practices and relinquishing control were associated with reports of enhanced wellbeing. In addition, some mothers reported greater ease due to increased independence of older children. The absence of social support exacerbated burden and distress in the women’s accounts, while the availability of support alleviated burden and was associated with reports of wellbeing. Conclusion Health professionals and services can provide support to mothers with RA by addressing feelings of failure, acknowledging strategies of adjustment and letting go, and encouraging access to social support.
... They also received social support from both the formal and informal sources. Family members especially their mothers and husbands provided the most support (Leahy-Warren, Mccarthy & Corcoran, 2012;Leahy-Warren ,2005;Freund, 2007). For adolescent mothers, their mothers were their major source of support as partners denied pregnancies and some of them were not working to support them (Story et al., 2016). ...
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Background: Motherhood is cherished and defines the identity of a woman in most African societies. However, new mothers have to adjust physically, socially, psychologically, and even spiritually in their transition. Social support has been identified in a number of studies to help first-time mothers adjust in picking up their new maternal responsibilities. The main aim of this study was to explore first-time mothers’ lived experiences and their prenatal and postnatal support systems. Methodology: Twenty participants were purposively selected. Sixteen first-time mothers and four social support providers from three communities in Asikuma Odoben Brakwa District participated. Data were collected using in-depth interviews with the aid of a semi-structured interview guide over a period of three weeks. Interviews were transcribed verbatim and analysed using thematic analysis. Results: Results from the data showed that, most unmarried mothers had unintended pregnancies. Mothers reported a lot of physical and psycho-social distress during pregnancy and after childbirth. Different kinds of social support were received by mothers: physical, informational, emotional and spiritual. Most of the young and unmarried mothers had less social support compared to the older and married mothers. Maternal mothers of primiparous women provided the most support. For most of the mothers, social support weakened with time. Conclusion: This study shows that childbirth is a defining point in women’s lives and it is coupled with physical, emotional, and other life-changing challenges. Social support served many purposes for the sample of first-time mothers as it helped them to recuperate from their birthing experience, gained maternal childcare self-efficacy and also gave them hope for the future. It is recommended that a state-sponsored social security scheme be designed by the government for first-time mothers who have no or limited social support networks.
... The postpartum period is a time of learning new skills while developing the new identity of "mother" and it is therefore unsurprising that a woman's perceived ability to be a mother and care for her infant, or self-efficacy, could impact on a mother's mental wellbeing. Previous research has identified that support from family and friends (119) and marital support (120) are positively associated with maternal self-efficacy postpartum and negatively associated with maternal depression. Although risk factors were treated as separate entities for the purposes of this review, these associations between support and postpartum self-efficacy highlight the interconnectedness of the risk factors for maternal suicide, and in turn, the complex nature of teasing out the causal and mediational relationships. ...
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Suicide is a leading cause of maternal death during pregnancy and up to a year after birth (perinatal period). Many psychological and psychosocial risk factors for maternal suicidal ideation and behaviour have been investigated. Despite this, there have been no attempts to systematically search the literature on these risk factors. Additionally, few studies have described how the risk factors for suicidal ideation, attempted suicides and suicide deaths differ, which is essential for the development of tools to detect and target suicidal ideation and behaviour. Seven databases were searched up to June 2021 for studies that investigated the association between suicidal ideation and/or suicidal behaviour and psychological/psychosocial risk factors in pregnant and postpartum women. The search identified 17,338 records, of which 59 were included. These 59 studies sampled a total of 49,929 participants and investigated 32 different risk factors. Associations between abuse, experienced recently or during childhood, and maternal suicide ideation, attempted suicide and death were consistently reported. Social support was found to be less associated with suicide ideation but more so with suicide attempts. Identifying women who have experienced domestic violence or childhood abuse and ensuring all women have adequate emotional and practical support during the perinatal period may help to reduce the likelihood of suicidal behaviour.
... The correlation of the item with each factor is displayed above the arrow between the item and the error. The squared loadings (R 2 ) are shown to the right of the error and denote the proportion of variance explained by each factor for each item for encouragement and advice in parenting to strengthen PSE, and can be protective against parental stress and mental health issues (Jennings et al., 1991, Leahy-Warren et al., 2012, Sheldon, 2002. On the other hand, a lack of support, positive feedback and encouragement may undermine PSE. ...
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Parental Self Efficacy (PSE) is a key predictor of positive parenting practices and child outcomes. The Karitane Parenting Confidence Scale (KPCS) is a global measure of PSE that has been validated for use with mothers, but not fathers. The aims of the study were to assess the construct validity and internal consistency reliability of the KPCS with 110 fathers of young children (aged 0–4 years) in an Australian parenting program. Confirmatory Factor Analysis (CFA) of the KPCS items revealed good model fit for a two-factor structure of parenting self-efficacy: self-efficacy for parenting tasks and self-efficacy for parental role. Overall KPCS reliability was strong, with each factor demonstrated to have acceptable internal reliability. Preliminary analysis suggests that the KPCS is a reliable and valid tool for use with fathers of children aged 0–4 years. Further validation of the KPCS in a larger sample of fathers is warranted.
... 29 Several studies have thus focused merely on the perceptions of first-time mothers. 30,31 The results of these studies are different, which may be due to differences in the study environment or data collection tools. In contrast, the findings of another research revealed no significant difference in the mothers' perceptions of the quality of postnatal care according to parity and gravidity. ...
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Background: Postnatal care plays a great role in the health of mothers and their neonates. This study aimed to evaluate the mothers' perceptions of the provided postnatal care and the associated factors. Methods: In this cross-sectional study, the health centers of Sirik city in Hormozgan province, Iran, were selected using convenience sampling. The study was conducted on 160 mothers who had referred to the selected centers for postnatal care from 7 August 2018 to 2 August 2020 and had given birth to live full-term neonates (>37 weeks of gestation) 40 days to 12 months before sampling. The Mothers' Perceptions of the Quality of Postnatal care questionnaire was designed by the research team; it included 18 questions about mothers' perception of care. The collected data were analyzed using the SPSS software, version 21. Results: The mothers' mean score of perception was 69.84±16.04; most mothers rated the provided postnatal care and their relationship with the personnel as good or excellent. The mean total scores of the mothers' perceptions were not different based on their satisfaction with postnatal care (P=0.646) and time of the first referral after birth (P=0.251), but they were significantly different according to the number of referrals (P=0.023) and their satisfaction with the health personnel (P<0.001). Conclusion: The study results revealed that mothers had a good perception about postnatal care provided by health center staff. Hence, it is necessary to educate all health staff in this regard to provide high-quality postnatal care to all mothers who refer to these centers.
... Each approach deserves further study. For example, lower social support is associated with both lower PSE and higher depressive symptom levels (Leahy-Warren et al., 2012;Manuel et al., 2012) and, thus, is well justified in expecting interventions to enhance social support to be associated with increases in PSE. Further, Bandura (1997) argued that increasing knowledge leads to increased selfefficacy. ...
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Numerous cross-sectional studies confirm the long-theorized association between mothers’ depression and lower parenting self-efficacy (PSE) beliefs. However, cross-sectional studies leave unanswered the direction of this association: Does depression predict PSE? Does PSE predict depression? Are both true? Does the strength of the association between depression and PSE, regardless of the direction, generalize across participant characteristics and study design features? How stable is PSE over time? And how effective are interventions at enhancing PSE? To answer these questions, we conducted a meta-analytic review of longitudinal studies. With 35 eligible studies (22,698 participants), we found support for both models: there was a significant pooled effect of both depression on PSE and of PSE on depression, with nearly identical effect sizes (d = − 0.21 and − 0.22, respectively). The association was stronger in samples with mothers’ younger average age and studies that measured PSE among mothers relative to during pregnancy. We found a medium degree of stability in the index of PSE, d = 0.60. Finally, the estimated pooled effect size between being in an intervention group versus control group and PSE was 0.505. Overall, we found support for (1) bidirectional associations between depression and PSE in mothers, (2) the stability of PSE over time, and (3) the strength of the relationship between PSE and depression with intervention. These results suggest the importance of continuing to develop, test, and disseminate interventions to enhance PSE. We interpret these findings in the context of both depression and low PSE having serious consequences for child outcomes and maladaptive parenting.
... Social support including family and community contexts are mini universes of complex social, political, associational, economic, power and cultural dynamics, providing a different direction for encouraging the use of health services and facilitating behavior change than in a health facility [21][22][23][24][25]. One frequent criticism of research on social support is the lack of consensus in terms of its definition and how best to measure it [7,[17][18][19]. ...
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Background Maternal mortality continues to decrease in the world but remain the most important health problems in low-income countries. Although evidence indicates that social support is an important factor influencing health facility delivery, it has not been extensively studied in Ethiopia. Therefore, this study aimed to assess the effect of maternal social support and related factors on health facility delivery in southwest Ethiopia. Methods A cross-sectional survey data on 3304 women aged 15–47 years in three districts of Ethiopia, were analyzed. Using multivariable logistic regression, we assessed the association between health facility birth, social support, and socio-demography variables. Adjusted odds ratios with 95% confidence intervals were used to identify statistically significant associations at 5% alpha level. Result Overall, 46.9% of women delivered at health facility in their last pregnancy. Average travel time from closest health facility (AOR: 1.51, 95% CI 1.21 to 2.90), mean perception score of health facility use (AOR: 1.83, 95% CI 1.44 to 2.33), involvement in final decision to identify their place of childbirth (AOR: 2.12, 95% CI 1.73 to 2.58) had significantly higher odds of health facility childbirth. From social support variables, women who perceived there were family members and husband to help them during childbirth (AOR: 3.62, 95% CI 2.74 to 4.79), women who received continuous support (AOR: 1.97, 95% CI 1.20 to 3.23), women with companions for facility visits (AOR: 1.63, 95% CI 1.34 to 2.00) and women who received support from friends (AOR: 1.62, 95% CI 1.16 to 3.23) had significantly higher odds of health facility childbirth. Conclusions Social support was critical to enhance health facility delivery, especially if women’s close ties help facility delivery. An intervention to increase facility delivery uptake should target not only the women’s general social supports, but also continuous support during childbirth from close ties including family members and close friends as these are influential in place of childbirth. Also actions that increase women’s healthcare decision could be effective in improving health facility delivery.
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The postpartum period is a challenging transition period with almost one in ten mothers experiencing depression after childbirth. Perceived social support is associated with mental health. Yet empirical evidence regarding the causal effects of social support on postpartum mental health remains scarce. In this paper, we used a nationally representative panel data of women to examine causality between perceived social support and postpartum mental health. We used fixed-effect method and included dependent variable lags to account for past mental health condition before birth (i.e., the pre-pregnancy and prenatal periods). The study also used an instrumental variable approach to address endogeneity. We find a declining trend in postpartum mental health between 2002 to 2018. Our study also showed that past mental health (i.e., before childbirth) is positively correlated with postpartum mental health. A universal routine mental health screening for expectant and new mothers should remain a key priority to ensure mental wellbeing for the mothers and their infants.
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Postpartum psychopathology has an adverse impact on parenting behaviors and, consequently, on the mother–infant relationship. This study aimed to explore whether the relationship between maternal anxiety and depression symptomatology in the postpartum period and the ability of mothers to adopt a mindful parenting approach is indirect and can be explained by parental reflective functioning. Two hundred ninety five Portuguese mothers of infants aged up to 12 months completed self‐report measures assessing anxiety/depression symptoms, mindful parenting, and parental reflective functioning. Mothers who reported clinically significant anxious and/or depressive symptomatology levels (21%) showed lower levels of mindful parenting and of certainty about the mental states as well as higher levels of prementalizing modes of mental states than mothers with normal symptomatology levels. An indirect effect of depressive symptomatology on mindful parenting through the two dimensions of parental reflective functioning and a direct effect of anxious symptomatology on mindful parenting were found. The results suggest that parental reflective functioning is an important explanatory mechanism of the relationship between depressive symptomatology and mindful parenting, as well as that anxious symptomatology is directly associated with mindful parenting. This study suggests that reducing anxious and depressive symptoms in the postpartum period can promote reflective and mindful parenting skills.
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Early adversity predicts increased risk for mental and physical health problems. As such, intervention efforts, such as home-based parenting programs, have been initiated with vulnerable families to reduce adversity exposure and promote child well-being. The present randomized clinical trial had a parallel design and 1:1 allocation ratio of SafeCare augmented for an urban high-risk population (SC+) compared to standard home-based mental health services (SAU) to examine risk and protective factors proximal to child maltreatment. Parents (N=562) of young children (5 years or less) at risk of depression, intimate partner violence, or substance abuse were randomized to SC+ or SAU. A significant program effect was found in favor of SC+ for parental depression and social support, as well as within-group improvements for both groups in depression, intimate partner victimization, family resources, and social support. Promising next steps include future trials examining how improvements in parental depression and social support impact child well-being over time and further augmentation of SafeCare to enhance healthy relationships and address cultural congruency of services.
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Objective We aimed to understand the maternal experience of breastfeeding onset and how psychological, social and clinical variables as pain during breastfeeding, may interfere with it. Methods A cross-sectional study investigated 395 post-delivery women able to breastfeed from 48 hours to 6 days for unpleasant breastfeeding, maternal stress during pregnancy and postnatal mental state. Social Readjustment Rating Scale evaluated prenatal maternal stress. Perceived Maternal Parenting Self-Efficacy Scale, Pain Catastrophizing Scale – Parent version, and Edinburgh Postnatal Depression Scale evaluated maternal mental state. Results Unpleasant breastfeeding experience showed to be positively related to the longer number of days the pain lasts; late onset of breastfeeding; less search for information about pregnancy and baby care (p < .01); lower catastrophizing behaviour towards infant´s stress and C-section delivery (p < .04). Pain levels were positively correlated to longer periods of pain, later onset of antenatal consultations and depression (p < .05). Binary logistic regression pointed to the effects of lower self-efficacy and pain in breastfeeding, higher depression levels, gestational stress, labour adversities and success in breastfeeding. Conclusions The relationship among maternal perceived self-efficacy, anxious and depressive thoughts, catastrophizing behaviours, and unpleasant breastfeeding need to be evaluated to elucidate the best health professional intervention.
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Background The diagnosis of Opioid Use Disorder (OUD) during pregnancy has increased 2-to-5-fold over the past decade and barriers to treatment are significant. Technology-based solutions have the potential to overcome these barriers and deliver evidence-based treatment. However, these interventions need to be informed by end-users. The goal of this study is to gain feedback from peripartum people with OUD and obstetric providers about a web-based OUD treatment program. Methods Qualitative interviews were conducted with peripartum people with OUD (n=18) and focus groups were conducted with obstetric providers (n=19). Feedback from these interviews informed the development of text message-based screening, brief phone-based intervention and referral to treatment program, called Listening to Women and Pregnant and Postpartum People (LTWP). Once developed, further qualitative interviews with peripartum people with OUD (n=12) and obstetric providers (n=21) were conducted to gather feedback about the LTWP program. Results Patients reported that a relationship with a trusted provider is paramount for treatment engagement. Providers reported that time constraints and complex patient needs prohibit them from treating OUD and that evidence-based Screening, Brief Intervention and Referral to Treatment (SBIRT) are not implemented effectively in routine prenatal care. Neither patients nor providers were enthusiastic about our web-based intervention for OUD; thus, results were used to guide the development of LTWP to improve implementation of SBIRT during prenatal care. Conclusions End-user informed, technology-enhanced SBIRT has the potential to improve the implementation of SBIRT during routine prenatal care, and in turn, improve maternal and child health.
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Mothers' social integration with other mothers in the same residential area has been shown to be beneficial for their health and well-being. The socio-psychological resources afforded by other mothers aid the transition to motherhood. However, much less is known about the processes whereby mothers integrate with other local mothers. Therefore, we analysed first-time mothers' experiences of social integration with other mothers in the same neighbourhood. Through three waves of semi-structured interviews, we followed eight Finnish first-time mothers' everyday lives for a year. The narrative analysis of these longitudinal interviews revealed three story types – social integration, social exclusion and social disconnection – that depicted mothers' different experiences of integration with other local mothers. The perceived similarity of experiences, goals and interests related to motherhood enhanced the development of a shared sense of identity and supported integration with other local mothers. We discuss our findings in relation to the social identity model of identity change (SIMIC).
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Background The decreased marriage satisfaction has become one of the main reasons for the rising divorce rate. However, few studies have focused on the relationship between mother's parenting stress, mental health, and marriage satisfaction. This study addressed this research gap by examining the direct influence of mothers’ parental stress on their marital satisfaction, and the indirect influence of depression and marital conflict. Additionally, we explored the moderating effect of fathers’ empathy tendency. Methods Using a sample of parenting couples in Southwest China (n=2,979) to conduct a questionnaire survey, a moderated mediation analysis was performed to simultaneously analyze the chain mediation of depression and marital conflict, and the moderating role of fathers’’ empathy. Results The mother's childcare pressure was negatively correlated with marital satisfaction (β= -0.478, p < 0.001). Depression and marital conflict have a chain mediating effect in explaining the relationship between mothers’’ parenting stress and marital satisfaction (b= -0.064, 95% CI [-0.075, -0.053]). It is important to note that fathers with cognitive empathy can alleviate depression and marital conflict caused by the mothers’ parental stress and a decrease in marital satisfaction, while fathers with high empathy can exacerbate these negative effects. Conclusion The study's findings identify the serious impact of contemporary female parenting pressure on marital satisfaction and confirm the important role of husbands’ empathy. Limitations : The scope of the survey is single, the parenting period is not staged, and there may be limitations such as overlapping stressors, which can be corrected in future research.
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Objective Postpartum depression is a serious mental health problem in early parenthood. The prevalence of postpartum depression is currently increasing. However, no studies have yet examined and compared maternal and paternal psychological health during the early postpartum period. The objectives of this study were therefore to explore the prevalence of postpartum depression and identify its predictors among Chinese mothers and fathers in the early postpartum period. Design A cross-sectional study was conducted from September 24, 2020 to April 7, 2021 in Guangzhou, China. Setting A regional teaching hospital in Guangzhou, China, with approximately 3000 births per year. Participants Four hundred and fifty-four married couples in the 2-3 days postpartum period following a singleton, full-term birth. Measurements and findings Participants completed the Edinburgh Postnatal Depression Scale, Parenting Satisfaction Subscale and Parenting Efficacy Subscale, Social Support Rating Scale, and the demographic and obstetric datasheet. The prevalence of depressive symptoms (Edinburgh Postnatal Depression Scale score ≥ 13) was 13.0% and 7.5% in mothers and fathers, respectively, in the early postpartum period. The predictors of maternal depression were maternal parenting satisfaction, paternal depression, maternal social support and maternal relationship with mother-in-law (adjusted R² = 0.34, F = 58.40, df = [4, 449], P < 0.001). While the predictors of paternal depression were paternal parenting satisfaction and self-efficacy, maternal depression and whether the pregnancy was planned (adjusted R² = 0.28, F = 44.85, df = [4, 449], P < 0.001). Key conclusions Maternal and paternal depression were positively correlated and were predictive factors for one another. Implications for practice Healthcare professionals should screen both mothers and fathers for depression in the early postpartum period and provide targeted support during time in hospital following birth. In addition, the focus of future interventions should be on both parents rather than just mothers.
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Introduction: A discharge plan is required to be included in the care plan of patients who underwent cardiac valve replacement surgery. Therefore, this study aimed to determine the efficacy of a proposed discharge plan on the self-efficacy of patients with cardiac valve replacement. Materials & Methods: This clinical trial study included 65 patients who underwent cardiac valve replacement at Shahid Chamran Hospital, Isfahan, Iran. The participants were then randomly assigned to intervention and control groups using a random allocation method. In the intervention group, the proposed discharge plan was implemented at the time of the patients' admission and continued one month after discharge based on a five-stage nursing process. The duration of hospitalization and the level of self-efficacy of patients before the intervention, one month, and three months after discharge in two groups were analyzed in SPSS software (version 22) through the Chi-square test, Mann-Whitney U test, independent t-test, and analysis of variance. Findings: The mean score of self-efficacy increased significantly over time in the intervention (53.18±4.3) and control groups (32.9±7.4) (P=0.001). However, the intervention group obtained significantly higher self-efficacy scores after one and three months post -discharge, compared to the control group (P=0.001). Furthermore, according to the Least Significant Difference test, the most significant level of effect was after three months post-discharge. Discussion & Conclusions: The discharge plan as a method of providing ongoing care increases the level of self-efficacy of patients. Therefore, it is recommended that the discharge plan be used as an effective way to provide patients who underwent cardiac valve replacement with ongoing care.
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Purpose: The purpose of this study was to develop and test the validity and reliability of the Korean version of the Perinatal Infant Care Social Support (K-PICSS) for postpartum mothers.Methods: This study used a cross-sectional design. The K-PICSS was developed through forward-backward translation. Online survey data were collected from 284 Korean mothers with infants 1-2 months of age. The K-PICSS consists of functional and structural domains. The functional domain of social support contains 19 items that measure the infant care practices of postpartum mothers. Exploratory factor analysis (EFA) and known-group comparison were used to verify the construct validity of the K-PICSS. Social support and postpartum depression were also measured to test criterion validity. Psychometric testing was not applicable to the structural social support domain.Results: The average age of mothers was 32.76±3.34 years, and they had been married for 38.45±29.48 months. Construct validity was supported by the results of EFA, which confirmed a three-factor structure of the scale (informational support, supporting presence, and practical support). Significant correlations of the K-PICSS with social support (r=.71, p<.001) and depression (r=–.40, p<.001) were found. The K-PICSS showed reliable internal consistency, with Cronbach’s α values of .90 overall and .82–.83 in the three subscales. The vast majority of respondents reported that their husband or their parents were their main sources of support for infant care. Conclusion: This study demonstrates that the K-PICSS has satisfactory construct validity and reliability to measure infant care social support in Korea.
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Screening for postpartum mental health has a crucial role in identifying women needing psychological support. The present study aims to evaluate the psychometric properties of the Postpartum Distress Measure (PDM) in Italian women in the first six months postpartum (n = 818). The PDM is a 10-item self-report questionnaire composed of two subscales assessing general distress and obsessive-compulsive symptoms. CFA supported the two-dimensional structure of the PDM, showing good fit indices as well as high internal consistency. Furthermore, ROC analysis revealed high sensitivity and specificity of the PDM in detecting possible cases of postnatal distress with an optimal cutoff of 9. Given its good psychometric properties and its sensitivity, the PDM may be confidently used as a screening tool for maternal distress in the first six months postpartum, covering a wide range of typical perinatal psychological symptoms.
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Background Low maternal self-efficacy and high levels of anxiety, depression, and stress can be triggered in adolescent mothers due to an incomplete development process that makes them physically or psychologically unprepared for the responsibilities of motherhood and parenting. These factors may be linked to difficulties with their children’s social-emotional development. The present study aims to: (a) analyze the relationship between maternal self-efficacy and stress, depression, and anxiety levels in low-income adolescent mothers; (b) examine the relationship between maternal self-efficacy and well-being with children’s social-emotional development; and (c) describe the effects of maternal self-efficacy on children’s social-emotional development, mediated by maternal well-being. Methods A sample of 79 dyads comprising low-income Chilean adolescent mothers aged from 15 to 21 years old (M = 19.1, SD = 1.66) and their children aged 10 to 24 months (M = 15.5, SD = 4.2) participated in this research. A set of psychometric scales was used to measure maternal self-efficacy (Parental Evaluation Scale, EEP), the mothers’ anxiety and depression (Hospital Anxiety and Depression Scale, HADS), maternal stress (Parental Stress Scale, PSS), and the children’s social-emotional development (Ages and Stages Questionnaire Socio-emotional, ASQ-SE). Bivariate analyses and mediation models were employed to estimate and test the relevant relationships. Results A bivariate analysis showed that maternal self-efficacy was negatively related to the mother’s anxiety, depression, and stress. Moreover, there was a significant relationship between maternal self-efficacy and maternal stress, and children’s self-regulation and social-emotional development. Maternal self-efficacy, mediated by maternal anxiety, depression, and stress scores, had a significant effect on the development of children’s self-regulation. Conclusions The results confirm the importance of adolescent mothers’ emotional well-being and maternal self- efficacy with respect to their children’s social-emotional development. This makes it necessary to have detailed information about how emotional and self-perception status influences a mother’s role in the development of her children.
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Objectives To examine racial and ethnic differences in maternal social support in infancy and the relationship between social support and mother-infant health behaviors. Methods Secondary analysis of baseline data from a multisite obesity prevention trial that enrolled mothers and their two-month-old infants. Behavioral and social support data were collected via questionnaire. We used modified Poisson regression to determine association between health behaviors and financial and emotional social support, adjusted for sociodemographic characteristics. Results 826 mother-infant dyads (27.3% Non-Hispanic Black, 18.0% Non-Hispanic White, 50.1% Hispanic and 4.6% Non-Hispanic Other). Half of mothers were born in the U.S.; 87% were Medicaid-insured. There were no racial/ethnic differences in social support controlling for maternal nativity. U.S.-born mothers were more likely to have emotional and financial support (rate ratio [RR] 1.14 95% confidence interval [CI]: 1.07, 1.21 and RR 1.23 95% CI: 1.11, 1.37, respectively) versus mothers born outside the U.S. Mothers with financial support were less likely to exclusively feed with breast milk (RR 0.62; 95% CI: 0.45, 0.87) yet more likely to have tummy time ≥12min (RR 1.28; 95% CI: 1.02, 1.59) versus mothers without financial support. Mothers with emotional support were less likely to report feeding with breast milk (RR 0.82; 95% CI: 0.69, 0.97) versus mothers without emotional support. Conclusions Nativity, not race or ethnicity, is a significant determinant of maternal social support. Greater social support was not universally associated with healthy behaviors. Interventions may wish to consider the complex nature of social support and population-specific social support needs.
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Background End-of-Life care and experiencing death of infants, children, and teenagers remain one of the most difficult and traumatic events for nurses and nursing students, potentially leading to personal and professional distress. Although efforts have been made to alleviate stressors in these settings, improvements remain slow. Understanding nurses and nursing students' experiences of pediatric End-of-Life care and death in multiple care settings may direct interventions to better support quality of care and healthcare professionals in these areas. Objective This review aimed to qualitatively synthesize existing literature to examine the nurses and nursing students' experiences of providing End-of-Life care to children and the death of pediatric patients. Design The qualitative systematic review was conducted using Sandelowski and Barroso's guidelines. The included studies were appraised using the Critical Appraisal Skill Program. Data sources This qualitative systematic review was registered with the International Prospective Register of Systematic Reviews. Six electronic databases (Cumulative Index of Nursing and Allied Health Literature, PubMed, Embase, PsychINFO, Scopus, and Mednar) were searched from the database inception date through May 2021. Results Thirty articles were included to form three key themes: (1) Emotional impact of pediatric End-of-Life care and death, (2) Perspective of delivering optimal care: What works and what does not, and (3) The complex role of nurses in pediatric End-of-Life care. Overall, the findings suggested that in an emotionally taxing environment, clinical and emotional support were paramount. Furthermore, there is a need to examine nurses' role in End-of-Life decision making and provide more discussion on professional boundaries. Conclusion This review offered nurses' and nursing students' perceptions of pediatric End-of Life care and death in the nursing profession. Findings can provide useful insights towards the planning of educational programs and institutional changes that supports nurses and nursing students in these settings.
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Background: Risky drinking is prevalent among women of childbearing age. Although many women reduce their drinking during pregnancy, more than half return to prepregnancy levels during the early postpartum period. Risky drinking in new mothers may be associated with negative child and maternal health outcomes; however, new mothers are unlikely to seek treatment for risky drinking because of stigma and fear of child protective service involvement. SMS text messaging is a promising approach for reaching non-treatment-seeking new mothers at risk because of risky drinking. SMS text messaging interventions (TMIs) are empirically supported for alcohol use, but a tailored intervention for new mothers does not exist. This study aims to fill this gap by developing a just-in-time adaptive TMI for postpartum risky drinking. Objective: The objectives of this paper are to present a preliminary conceptual model of postpartum risky drinking and describe the protocol for conducting an ecological momentary assessment (EMA) study with new mothers to inform the refinement of the conceptual model and development of the TMI. Methods: This paper presents a preliminary conceptual model of postpartum risky drinking based on the motivational model of alcohol use, social cognitive theory, and temporal self-regulation theory. The model proposes three primary intervention targets: motivation, self-efficacy, and self-regulation. Theoretical and empirical literature in support of the conceptual model is described. The paper also describes procedures for a study that will collect EMA data from 30 participants recruited via social media and the perinatal Central Intake system of New Jersey. Following the baseline assessment, EMA surveys will be sent 5 times per day for 14 days. The assessment instruments and data analysis procedures are described. Results: Recruitment is scheduled to begin in January 2022 and is anticipated to conclude in March 2022. Study results are estimated to be published in July 2022. Conclusions: The study findings will enhance our understanding of daily and momentary fluctuations in risk and protective factors for risky drinking during the early postpartum period. The findings will be used to refine the conceptual model and inform the development of the TMI. The next steps for this work include the development of intervention components via an iterative participatory design process and testing of the resulting intervention in a pilot microrandomized trial. International registered report identifier (irrid): PRR1-10.2196/36849.
Article
Objetivo: Evaluar las propiedades psicométricas de un instrumento para medir la autoeficacia para amamantar al segundo día postparto en población chilena. Sujetos y Método: Se tomó una muestra por conveniencia de 320 puérperas que voluntariamente participaron en una entrevista al segundo día postparto. La confiabilidad se evaluó por medio del coeficiente alfa de Cronbach. Para valorar su estructura factorial, se realizó un análisis factorial exploratorio. Resultados: Los resultados indican que el instrumento final, que posee dos factores “Pensamientos Intrapersonales” compuesto por seis reactivos y “Técnicas de Amaman tamiento” compuesto por ocho reactivos, cuya consistencia interna por factor y total de la escala fue: F1 = 0,90, F2 = 0,91 y Total = 0,94. Conclusión: La escala de autoeficacia de la lactancia materna mostró buenas características psicométricas en puérperas chilenas de segundo día.
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Background The cost-effectiveness of interventions has attracted increasing interest among researchers. Although web-based and home-based psychoeducational interventions have been developed to improve first-time mothers’ postnatal health outcomes, very limited studies have reported their cost-effectiveness. Objective The aim of this study was to evaluate the cost-effectiveness of web-based and home-based postnatal psychoeducational interventions for first-time mothers during the early postpartum period. Methods A randomized controlled 3-group pretest and posttest design was adopted, and cost-effectiveness analysis from the health care’s perspective was conducted. A total of 204 primiparas were recruited from a public tertiary hospital in Singapore from October 2016 to August 2017 who were randomly allocated to the web-based intervention (n=68), home-based intervention (n=68), or control (n=68) groups. Outcomes of maternal parental self-efficacy, social support, postnatal depression, anxiety, and health care resource utilization were measured using valid and reliable instruments at baseline and at 1 month, 3 months, and 6 months after childbirth. The generalized linear regression models on effectiveness and cost were used to assess the incremental cost-effectiveness ratios of the web-based and home-based intervention programs compared to routine care. Projections of cumulative cost over 5 years incurred by the 3 programs at various coverage levels (ie, 10%, 50%, and 100%) were also estimated. Results The web-based intervention program dominated the other 2 programs (home-based program and routine care) with the least cost (adjusted costs of SGD 376.50, SGD 457.60, and SGD 417.90 for web-based, home-based, and control group, respectively; SGD 1=USD 0.75) and the best improvements in self-efficacy, social support, and psychological well-being. When considering the implementation of study programs over the next 5 years by multiplying the average cost per first-time mother by the estimated average number of first-time mothers in Singapore during the 5-year projection period, the web-based program was the least costly program at all 3 coverage levels. Based on the 100% coverage, the reduced total cost reached nearly SGD 7.1 million and SGD 11.3 million when compared to control and home-based programs at the end of the fifth year, respectively. Conclusions The web-based approach was promisingly cost-effective to deliver the postnatal psychoeducational intervention to first-time mothers and could be adopted by hospitals as postnatal care support. Trial Registration ISRCTN registry ISRCTN45202278; https://www.isrctn.com/ISRCTN45202278
Article
Introduction Perceived parental self-efficacy (PSE) is thought to play a crucial role in parental well-being, the parent-infant relationship, and other aspects of infant development, particularly in the early postnatal period. The Karitane Parenting Confidence Scale (KPCS) is a 15-item self-report questionnaire designed for parents with infants aged 0–12 months. Objective To explore the factor structure of a French translation of the KPCS and assess its psychometric qualities. Method Using a French-language translation of the KPCS (KPCS-F), 257 parents of children aged 0–12 months were recruited via childcare structures (e.g. nurseries, community centers, mother and child protection centers). Confirmatory factor analyses (CFA) were conducted to examine 2- and 3-factor solutions for the KPCS-F scale. Internal reliability and convergent validity were evaluated. Results The best model was a two-factor solution (PSE “infant care” and PSE “parental role”) restricted to 12 items. Sound internal consistency was indicated, with a Cronbach's alpha coefficient of 0.80 and a McDonald's omega coefficient of 0.80. Test-retest reliability was good. KPCS-F score was correlated with social support and psychological well-being scores. Conclusion The KPCS-F showed substantial validity and reliability for this sample. The translated scale should therefore improve assessment and intervention processes for professionals working with parents of young children.
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Objective: To follow mothers' mood through pregnancy and after childbirth and compare reported symptoms of depression at each stage. Design: Longitudinal cohort study. Setting: Avon. Participants: Pregnant women resident within Avon with an expected date of delivery between 1 April 1991 and 31 December 1992. Main outcome measures: Symptom scores from the Edinburgh postnatal depression scale at 18 and 32 weeks of pregnancy and 8 weeks and 8 months postpartum. Proportion of women above a threshold indicating probable depressive disorder. Results: Depression scores were higher at 32 weeks of pregnancy than 8 weeks postpartum (difference in means 0.88, 95% confidence interval 0.79 to 0.97). There was no difference in the distribution of total scores or scores for individual items at the four time points. 1222 (13.5%) women scored above threshold for probable depression at 32 weeks of pregnancy, 821 (9.1%) at 8 weeks postpartum, and 147 (1.6%) throughout. More mothers moved above the threshold for depression between 18 weeks and 32 weeks of pregnancy than between 32 weeks of pregnancy and 8 weeks postpartum. Conclusions: Symptoms of depression are not more common or severe after childbirth than during pregnancy. Research and clinical efforts need to be moved towards understanding, recognising, and treating antenatal depression.
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The average prevalence rate of non-psychotic postpartum depression based on the results of a large number of studies is 13%. Prevalence estimates are affected by the nature of the assessment method (larger estimates in studies using self-report measures) and by the length of the postpartum period under evaluation (longer periods predict high prevalences). A meta-analysis was undertaken to determine the sizes of the effects of a number of putative risk factors, measured during pregnancy, for postpartum depression. The strongest predictors of postpartum depression were past history of psychopathology and psychological disturbance during pregnancy, poor marital relationship and low social support, and stressful life events. Finally, indicators of low social status showed a small but significant predictive relation to postpartum depression. In sum, these findings generally mirror the conclusions from earlier qualitative reviews of postpartum depression risk factors.
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The relationship of social support, role satisfaction, and self-efficacy to measures of role strain was explored in a sample of 129 married, employed women with at least 1 preschool-aged child. Self-efficacy in work and parental roles proved to be a significant predictor of these women's work-family conflict and role overload, respectively. In addition, satisfaction with their child care was related to significantly less anxiety about being separated from their young children. Spousal and supervisor support also accounted for significant variation in work-family conflict, but the impact of organizational support on role conflict was fully mediated by job self-efficacy.
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Relationships among parenting self-efficacy, general self-efficacy, child and maternal characteristics, and parenting satisfaction in 145 mothers of school-aged children were examined. Higher parenting self-efficacy was observed in mothers of less emotional and more sociable children, and among mothers who were better educated, had higher family incomes, and reported more previous experience with children. Higher parenting self-efficacy and several mother and child variables predicted greater satisfaction with parenting. Influences of mothers' experience with children other than their own and maternal education on parenting satisfaction were mediated by parenting self-efficacy. Suggestions concerning the conceptualization and measurement of parenting self-efficacy are provided.
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Research shows that social support and maternal self-efficacy are inversely related to postpartum depression; however, little is known about the mechanisms by which these variables impact on depressive symptomatology. This study uses path analysis to examine the proposal that maternal self-efficacy mediates the effects of social support on postpartum depressive symptomatology. Primiparous women (n=247) completed questionnaires during their last trimester and then again at 4 weeks' postpartum (n=192). It was hypothesized that higher levels of parental support, partner support, and maternal self-efficacy would be associated with lower levels of depressive symptomatology postpartum and that the relationship between social support and depressive symptomatology would be mediated by maternal self-efficacy. Results indicated that as expected, higher parental support and maternal self-efficacy were associated with lower levels of depressive symptomatology postpartum. Partner support was found to be unrelated to both depressive symptomatology and maternal self-efficacy. Results from the path analysis supported the mediation model. Findings suggest that parental support lowers depressive symptomatology by the enhancement of maternal self-efficacy.
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We compared the prevalence of depression in the postpartum period and its relationship with perceived stress and social support in first-time mothers and fathers. A cross-sectional study was conducted in mainland China with a convenience sample of 130 pairs of parents. Measures taken at 6-8 weeks after delivery included the Edinburgh Postnatal Depression Scale, the Perceived Stress Scale, and the Social Support Rating Scale. Eighteen (13.8%) of the mothers and 14 (10.8%) of the fathers were suffering from depression. No signficant differences were found in their prevalence rates. Perceived stress, social support, and partner's depression were significantly associated with depression. These findings suggest counseling, support, and routine screening for depression should be provided to both mothers and fathers.
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Demographic, psychosocial and medical risk factors for postpartum depression (PPD) were studied prospectively in a community cohort of 288 Israeli women. An Edinburgh Postnatal Depression Scale score of > or = 10 at 6 weeks postpartum was the criterion for PPD. Psychosocial risk factors were found to be the most potent. Lack of social support, marital disharmony, depressive symptoms during pregnancy, history of emotional problems and prolonged infant health problems were most predictive of PPD. The major role of psychosocial factors in PPD was similar to that found in other countries. The results were somewhat different for new Russian immigrants. These findings indicate that early identification of women at risk for PPD is feasible, and that consideration should be taken of subgroups that may be at heightened risk, or for whom risk factors play different roles.
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Priebe et al ([2003][1]) have questioned whether the findings of the Pan-London Assertive Outreach Study can be generalised to assertive outreach services in the rest of the UK. Cornwall & Haveman ([2003][2]) evaluated the Newcastle and North Tyneside assertive outreach service using the same
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Current research suggests that women married to military service members may experience difficulty during the transition to motherhood attributable to the additional stressors of military life and inability to access traditional support systems. To test the effects of a nursing intervention on prenatal and postpartum maternal role adaptation among military wives. Primigravid military wives were assigned randomly to either a traditional childbirth education program (n = 47) or Baby Boot Camp (n = 44). The Baby Boot Camp is a 4-week childbirth-parenting preparation program based on a resilience paradigm. The strategies of Baby Boot Camp include identification of nontraditional external resources and development of internal resources to facilitate maternal role adaptation. The Prenatal Self-Evaluation Questionnaire, Personal Resource Questionnaire, and Resilience Scale were administered at baseline (32 to 37 weeks gestation), immediately after the intervention, and at 6 weeks postpartum. The outcomes suggest that Baby Boot Camp strategies to enhance external and internal resources may have been successful in facilitating maternal role adaptation. An independent t-test showed that, as compared with the military wives who attended traditional childbirth education courses, the Baby Boot Camp participants experienced significantly greater prenatal and postpartum adaptation. As demonstrated by repeated measure analysis of variance, the Baby Boot Camp participants experienced an increase in external and internal resources immediately after the intervention. However, these differences in resources were not sustained at 6 weeks postpartum. The findings may lead to wider development and use of childbirth-parenting programs designed to meet the unique strengths and needs of the childbearing military wife.
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The World Health Report 2005 – Make Every Mother and Child Count, says that this year almost 11 million children under five years of age will die from causes that are largely preventable. Among them are 4 million babies who will not survive the first month of life. At the same time, more than half a million women will die in pregnancy, childbirth or soon after. The report says that reducing this toll in line with the Millennium Development Goals depends largely on every mother and every child having the right to access to health care from pregnancy through childbirth, the neonatal period and childhood.
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The threefold purposes of our study were to determine differences between first-time mothers' and fathers' development of infant care self-efficacy and parenting satisfaction, relationships between mothers' and fathers' infant care self-efficacy and parenting satisfaction, and the effect of infant sex on the development of mothers' and fathers' infant care self-efficacy and parenting satisfaction during the first 4 months following the infant's birth. A convenience sample of 44 couples in a midwestern state completed the Demographic Questionnaire, the Infant Care Survey, and What Being the Parent of a New Baby is Like-Revised. Fathers' reports of infant care self-efficacy increased linearly during the first 4 months following the infant's birth while mothers' reports of infant care self-efficacy increased linearly during the first 3 months. At all data collection times, fathers reported significantly lower infant care self-efficacy than mothers. Reports of parenting satisfaction increased over time for mo...
BACKGROUND: Postpartum depression can be a significant disability for women if left untreated. The context of seeking social support for this population has not been examined. OBJECTIVE: The purpose of this study was to generate a theory of how women experiencing postpartum depressive symptoms mobilize social supports. STUDY DESIGN: Strauss and Corbin’s grounded theory methodology was used to discover the context and process of seeking social support of women with postpartum depression. RESULTS: Postpartum women with depressive symptoms have a natural desire to connect with others for symptom normalization. These connections occurred with other women, groups, or health care providers. The process of normalizing through connection included four components: initiating socialization, staying with, drifting away, and incorporating self into new role. CONCLUSIONS: Nurses can assist postpartum women in developing positive connections with other individuals or groups in their lives. Psychoeducation about postpartum depression may empower women to seek assistance for their depression.
Article
Considering the limited amount of time for postpartum stays, mothers may not acquire sufficient knowledge and experience to comfortably care for themselves and their infant until they are home. It is not known how confident mothers are at the time of hospital discharge or how confident they will feel after a couple of weeks at home. A convenience sample of 104 postpartum women, 16 to 44 years of age, participated in a study to determine mothers' confidence with self-care and infant care in the hospital and 2 weeks after discharge. Confidence with self- and infant care was measured using the Maternal and Infant Care Confidence Scale (MICCS). Findings indicated that mothers' perceived confidence with self-care and infant care skills was significantly greater at home than in the hospital. Specifically, primiparas were significantly more confident at home with the exception of skills related to nutrition, activity, car seat and safety, and recognizing signs of infection in the infant. Multiparas were significantly more confident at home with all aspects of care with the exception of skills concerning nutrition. Implications for using the MICCS to develop a plan of care based on mothers' confidence needs are discussed.
Article
Research findings on the causes and correlates of postnatal depression divide into two explanatory frameworks The clinical/medical model identifies the mothers as being ‘ill’, and the social science model suggests a particular vulnerability to additional social stress factors Despite attempts to predict those women at risk, and develop preventative programmes, most treatment initiatives are reactive, which is a direct result of the inconclusive nature of available evidence The study reported here suggests that the concept ‘postnatal depression’ needs to be re-examined and that rather than it being an individual illness or vulnerability, it is more akin to a normal grief reaction and part of a normal postnatal profile It only becomes a problem when it is defined and treated inappropriately The implications from this research lead to a new approach to understanding the mother's experience of postnatal depression, and types of counselling and support which might effectively be employed by midwives and health visitors
Article
This study tests the idea that mothers' self-efficacy beliefs mediate the effects on parenting behavior of variables such as depression, perceptions of infant temperamental difficulty, and social-marital supports. Subjects were 48 clinically depressed and 38 nondepressed mothers observed in interaction with their 3–13-month-old infants (M= 7.35 months). As predicted, maternal self-efficacy beliefs related significantly to maternal behavioral competence independent of the effects of other variables. When the effects of self-efficacy were controlled, parenting competence no longer related significantly to social-marital supports or maternal depression. In addition, maternal self-efficacy correlated signficantly with perceptions of infant difficulty after controlling for family demographic variables. These results suggest that maternal self-efficacy mediates relations between maternal competence and other psychosocial variables and may play a crucial role in determining parenting behavior and infant psychosocial risk.
Article
Successive policy documents have referred to the need to support parents as an approach to reducing social exclusion, behaviour problems among young people and crime rates. Much of the rhetoric focuses on professional intervention, and there is less attention paid to the views and experiences of parents themselves. The present study explores the experiences and views of mothers, health visitors and family support centre workers who work with parents on the challenges and difficulties of parenting children under the age of 6 years. It provides an appreciation of their views on effective parenting and how parents can be helped to feel more effective in the parenting role. Focus groups, which were exploratory and interactive in form, were conducted across three primary care trusts in Hertfordshire, UK. Three samples were purposively selected in order to examine the range and diversity of experiences and views about parenting, and included the parents of children up to the age of 6 years, health visitors and family support centre workers. The mothers were those waiting to attend a parenting programme, and included first-time mothers and those with more than one child. The health visitors and family support workers had a range of experience in working with parents and children, and included those who were facilitating parenting programmes and those who were not. A number of themes emerged surrounding the challenges and difficulties of parenting and effective parenting, including expectations of others, establishing routines, play, behavioural issues and discipline, empathy, and communication. Similar themes emerged from all groups; however, there were qualitative differences between parents and professionals in the way in which these issues were expressed. Key statements from the parent focus groups have been developed into self-efficacy statements, which will be used as input to the development of a tool to measure the effectiveness of parenting programmes.
Article
This article presents an overview of research on postnatal depression conducted with postnatal women only. Research spanning three areas is reviewed, namely, prevalence, mothers' experiences ,and treatments. The review shows prevalence rates varying from 4.4% to 73.7%, with the most recent systematic review suggesting a rate of 13%, indicating a serious clinical issue for nurses providing postnatal care to mothers. Mothers' experiences of living with postnatal depression exemplify such feelings as loneliness, anxiety, hopelessness, and loss of control at a time when expectations of joyousness are anticipated. Results of research on treatment options show limited success with antidepressant medications, some success with psychotherapeutic options, and the importance of social support for mothers with postnatal depression. Comparisons of studies are made from methodological perspectives, drawing on their strengths and limitations. Overall, this review highlights the high prevalence rates of postnatal depression, negative feelings exemplified by mothers' living with this condition, and the limited success of treatment options available to mothers. Postnatal depression is a significant clinical issue for nurses providing postnatal care for mothers and is underassessed, misunderstood, and very often poorly treated.
Article
Little is known of the behavioural adjustment of children of postnatally depressed mothers. Previous studies have relied on maternal reports, and have produced inconsistent findings. In a prospective, longitudinal study of the five-year-old children of a community sample of postnatally depressed and well women, evidence was collected concerning the children's adjustment in the context of school, teachers being asked to complete questionnaires after the children had finished their first term. Family social class and the child's gender had the most pervasive influences on adjustment. However, both postnatal and recent maternal depression were associated with significantly raised levels of child disturbance, particularly among boys and those from lower social class families. The findings indicate a persistent effect of postnatal depression on child adjustment. They highlight the need for resources devoted to supporting mothers of young children and particularly routine screening and treatment for postnatal mood disorder.
Article
The aim of the present study was to examine the relationship between symptoms of postpartum depression and social support in new mothers in a semi-rural province (Malatya) of Eastern Turkey. This is a descriptive, cross-sectional study. The study was conducted with a 12-item Multidimensional Scale of Perceived Social Support (MSPSS) questionnaire, a 10-item Edinburgh Postnatal Depression Scale (EPDS) questionnaire, and a 16-item demographic/obstetric questionnaire designed by the authors. 364 women who were between 6 to 48 weeks postpartum were included in the study. Symptoms of postpartum depression were negatively correlated with social support (-0.39, P = 0.000). The frequency of the prevalence of symptoms of postpartum depression was 33.2%. The study showed that EPDS mean score was related to several factors, including age, woman's education, woman's occupation, socioeconomic status of family, spouse's education, number of years married, parity, planned pregnancy, method of delivery, knowledge of infant care, sharing of problems with a close person, past psychiatric history and family support during the postnatal period in an Eastern province of Turkey. Symptoms of postpartum depression were negatively correlated among Turkish women living in the Malatya province of Eastern Turkey and were associated with the level of social support. The prevalence of postpartum depression was higher than in the published reports regarding most regions of Turkey, with the exception of Northeastern Turkey.
Article
Self-efficacy in early parenting is the confidence that a mother has in her ability to meet the demands of the role of new parent. The Parent Expectations Survey (PES) was developed to measure perceptions of self-efficacy in early parenting. This article traces the development and psychometric testing of the PES. The PES was tested on 82 primiparas at 1 and 3 months postpartum. It demonstrated internal consistency reliability and concurrent validity. Those mothers who had higher self-efficacy early in the transition to parenthood had greater confidence in parenting and less stress 1 year after delivery, thus establishing the predictive validity of the instrument. The PES, both easy to use and to score, may be used by clinicians during the perinatal period to ascertain a mother's early perceptions of self-efficacy in parenting. For those mothers with low self-efficacy, interventions to empower them in that new role may then follow.
Article
The purpose of this phenomenological study was to describe the essential structure of the lived experience of postpartum depression. Seven mothers who had suffered from postpartum depression were interviewed regarding their subjective experiences. Data were analyzed using Colaizzi's (1978) method of phenomenology. Forty-five significant statements were extracted and clustered into 11 themes. These results were integrated into the essential structure of postpartum depression. Postpartum depression was a living nightmare filled with uncontrollable anxiety attacks, consuming guilt, and obsessive thinking. Mothers contemplated not only harming themselves but also their infants. The mothers were enveloped in loneliness and the quality of their lives was further compromised by a lack of emotions and all previous interests. Fear that their lives would never return to normal was all-encompassing.
Article
New mothers' confidence in their infant care skills are important concerns for maternity nurses. In this study, correlates of mothers' self-efficacy ratings on 52 infant care behaviors included in the Infant Care Scale were identified. Data on demographic variables and nurses' ratings of mothers' skill on five selected tasks were collected from 200 mothers and their nurses. Results from bivariate and multivariate analyses pointed to predictors of maternal feelings of efficacy and to discrepancies between mothers' and nurses' ratings. Maternal age, number of children, and nurses' ratings of mothers' skills were the strongest predictors of self-efficacy for infant care. Mothers of male infants showed slightly lower efficacy perceptions than did mothers of females. Implications for assessing mothers' educational needs before discharge and focusing teaching efforts are discussed.
Article
To determine whether counselling by health visitors is helpful in managing postnatal depression. Controlled, random order trial. Health centres in Edinburgh and Livingston. Sixty women identified as depressed by screening at six weeks post partum and by psychiatric interview at about 13 weeks post partum. Five women did not wish to participate, and a further five did not complete the trial. Age, social and obstetric factors, and diagnosis were similar in women who completed the trial and those who withdrew. Eight weekly counselling visits by health visitors who had been given a short training in counselling for postnatal depression. Reduction of depression. MEASUREMENTS and main results--Standardised psychiatric interviews and a 10 point self report scale were used to identify depression before and after intervention. The psychiatrist was not told to which group women were allocated. After three months 18 (69%) of the 26 women in the treatment group had fully recovered compared with nine (38%) of the 24 in the control group. The difference between the groups was thus 32% (95% confidence interval 5 to 58). Counselling by health visitors is valuable in managing non-psychotic postnatal depression.
Article
The development of a 10-item self-report scale (EPDS) to screen for Postnatal Depression in the community is described. After extensive pilot interviews a validation study was carried out on 84 mothers using the Research Diagnostic Criteria for depressive illness obtained from Goldberg's Standardised Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity, and was also sensitive to change in the severity of depression over time. The scale can be completed in about 5 minutes and has a simple method of scoring. The use of the EPDS in the secondary prevention of Postnatal Depression is discussed.
Article
A model of maternal postpartum depression was tested in which difficult infant temperament was construed as a stressor and supportive interpersonal relationships were construed as a protective resource. It was hypothesized that both infant temperamental difficulty and level of social support would affect maternal depression through the cognitive mediation of perceived self-efficacy in the parenting role. Participants were 55 married women who were assessed during pregnancy and again 3 months postpartum. Infant temperament was assessed through observation, maternal crying records, and the Revised Infant Temperament Questionnaire. Results of a path analysis indicated that infant temperamental difficulty was strongly related to the mothers' level of postpartum depression, both directly and through the mediation of parenting self-efficacy. Consistent with predictions, social support appeared to exert its protective function against depression primarily through the mediation of self-efficacy. Both practical implications for identifying women at risk for postpartum depression and theoretical implications for understanding the mechanisms through which stressful events and social support affect adjustment are discussed.
Article
A meta-analysis of 19 studies was conducted to determine the magnitude of the effect of postpartum depression on maternal-infant interaction during the first year after delivery. Maternal-infant interaction was divided into three subcategories: maternal interactive behavior, infant interactive behavior, and dyadic interactive behavior. Substantive, methodological, and miscellaneous variables were extracted and coded by both the researcher and two research assistants. Combinations were calculated as unweighted, weighted by sample size, and weighted by the quality index score. Effects for maternal interactive behavior ranged from .32 to .36 for the r index, .68 to .78 for the d index, and .33 to .38 for the Fischer's Z. For infant interactive behavior, effects ranged from .35 to .38, .75 to .83, and .37 to .41 for the r, d, and Fisher's Z indexes, respectively. Effects for dyadic interactive behavior ranged from .47 to .50 for the r index, 1.07 to 1.15 for the d index, and .51 to .55 for Fisher's Z. Results of the meta-analysis indicate that postpartum depression has a moderate to large effect on maternal-infant interaction. Nursing interventions for depressed mother-infant dyads during the first year after delivery are addressed.