Internal and External Resources and the Adjustment of Parents of Premature Infants

Perceived stress mediates the association between perceived control and emotional distress: The moderating role of psychological resources and sex differences

Studies have confirmed that perceived control is strongly negatively correlated with emotional distress. However, few studies have explored whether perceived stress plays a potential mediating role in this relationship and whether the association between perceived stress and emotional distress is moderated by psychological resources, such as self-esteem and social support. Furthermore, it is unclear whether there are sex differences in the moderating effects of psychological resources on emotional distress. A total of 951 healthy adults (51.84% females) from different regions of mainland China participated in the study and completed questionnaires in early December 2022, when prevention and control policies concerning COVID-19 in China underwent rapid change. Perceived control negatively correlated with emotional distress, and perceived stress mediated the association between perceived control and emotional distress. In addition, both internal (i.e., self-esteem) and external psychological resources (i.e., social support) moderated the association between perceived stress and emotional distress, and the positive correlation between perceived stress and emotional distress was higher in individuals with low social support (and self-esteem) than in those with high social support (and self-esteem). We found sex differences in the moderating roles of psychological resources. Specifically, self-esteem had a moderating effect on both men and women, whereas social support had a moderating effect only on women. These findings improve understanding of the relationship between perceived control and emotional distress and suggest that intervention programs should be designed to target men and women differently.

One uncertainty added on top of another: Challenges and resources of mothers of preterm infants during the COVID-19 pandemic

Aims and objectives

To qualitatively explore COVID-19-related experiences of mothers of preterm infants in the Neonatal Intensive Care Unit (NICU), the main challenges they face, and the resources available for them.

Background

The birth of a preterm infant is a stressful event under otherwise normal circumstances. The outbreak of COVID-19, the uncertainty about the virus and how it spreads, and the restrictions imposed, may have exacerbated the stress of caring for a preterm infant.

Design

Retrospective interviews.

Methods

In-depth interviews with 12 mothers of preterm infants who were hospitalized in the NICU at the time of study. The interview addressed challenges and resources related to coping with the pandemic. The interviews were transcribed and content analyzed, based on Lieblich et al’s model for narrative analysis. This research was conducted in accordance with the COREQ checklist.

Results

The overarching experience shared by all mothers was accumulative stress caused by a combination of factors related to the infant’s health and COVID-19-related stressors. A central theme was the dissonance between the mothers’ expectations from the birth and infant, and the reality they encountered. Other themes included fear of infecting the infant, loneliness, and stress caused by the restrictions that disrupted daily routines. Resources included a sense of shared fate regarding the pandemic, improvements in the infant’s condition, religious faith, emotional support from the partner, and support from professional staff.

Conclusion

Caring for a preterm infant during a pandemic is a challenging experience on many levels. The loss of significant support resources puts mothers of these infants at a higher risk for psychological distress.

Relevance to clinical practice

Awareness of mothers’ accumulative stress due to the COVID-19 pandemic may assist the staff in developing procedures that can alleviate parental stress, for example by enabling mothers to connect to each other, giving clear information to compensate for physical and social distancing and providing professional mental health support.

Interpersonal sensitivity on college freshmen's depression: A moderated moderation model of psychological capital and family support

BACKGROUND

The prevalence of depressive symptoms has become very high among college freshmen, with interpersonal sensitivity serving as an important predictor of depression. Combining internal and external positive resources can effectively prevent and alleviate depression. This study explores the moderating role of psychological capital (PsyCap) in the relationship between interpersonal sensitivity and depression, as well as the moderating effect of familial support on the conditional influence of PsyCap among Chinese college freshmen.

METHODS

A cross-sectional mental health survey was performed and the anonymous self-reported questionnaires, including the Patient Health Questionnaire, interpersonal sensitivity subscale of Symptom Checklist-90, Psychological Capital Questionnaire 24, and Perceived Social Support from Family, were distributed to the freshmen. Pearson's coefficient was employed to describe correlations between variables. The PROCESS macro and slope difference tests were used to explore the moderating role of PsyCap and family support in the relationship between interpersonal sensitivity and depression.

RESULTS

The prevalence of depression among freshmen was 30.89% (694/2,247). The correlation analysis revealed that depression negatively related to PsyCap (r = -0.187, p < 0.001) and family support (r = -0.193, p < 0.001) and positively related to interpersonal sensitivity (r = 0.399, p < 0.001). The moderation analysis showed that PsyCap negatively moderated the positive relationship between interpersonal sensitivity and depression (β = -0.159, p < 0.001). We also found that family support played a moderating role in the conditional influence of PsyCap (β = 0.076, p < 0.01). The slope difference test further showed that family support weakened the effect of interpersonal sensitivity on depression in freshmen when they had low PsyCap.

CONCLUSION

More attention should be paid to freshmen's mental health and interpersonal interaction problems. For freshmen with interpersonal sensitivity and depression, mental health departments can conduct PsyCap development interventions to alleviate psychological symptoms. Freshmen themselves should also seek family support in time, but those individuals with high PsyCap should seek an appropriate level of family support to maintain their autonomy.

Needs and Perceptions Relative to Emotional Support in Parents With Preterm Infants

Objectives of this study were to explore parents' needs for emotional support and how such support could be best delivered during admittance to a neonatal unit. This study took place at 6 neonatal units in Sweden. Forty-two semistructured interviews were analyzed using qualitative content analysis: 26 individual telephone interviews with mothers of preterm infants 6 to 10 months after discharge and 16 face-to-face interviews with parents of preterm infants admitted to neonatal units. The main category to emerge was needs and preferences for emotional support , which consisted of 2 generic categories: emotional needs and preferences for potential support interventions . Emotional needs define the importance of comprehending the new situation, finding meaning, and managing the situation through resources. Preferences for potential support interventions identify possible ways to deliver emotional support in the form of parental group, diary writing, professional counseling, and Internet support. The results highlight the importance of supporting parents' sense of coherence in their situation and parenthood by offering different interventions according to parent preferences. Parental groups could serve as a keystone for emotional support with the possibility to combine with other support mechanisms.

Problem-solving and coping in family adaptation of children with Down Syndrome

OBJECTIVE

To analyze problem-solving and coping strategies of parents of children with Down Syndrome in family adaptation.

METHOD

This is a qualitative research that used the Resiliency Model of Family Stress, Adjustment, and Adaptation. Participants were mothers and/or fathers from 40 families of children aged 1 to 7 years diagnosed with DS. Directed content analysis was performed, supported by software and considering a code dictionary.

RESULTS

Problem-solving and coping proved to be a set of actions, behaviors, efforts, and communications that contributed to family adaptation and favored balance between the demands imposed by Down Syndrome and the acquisition of resources by the family.

CONCLUSION

In the first moment, which corresponds to the time of news or diagnosis of the syndrome and the first days after birth, internal and external resources, which represent coping, are developed to accept and refocus ideas and feelings towards Down Syndrome. Over time these resources have an effect and cause changes in family functioning patterns and in the relationship of these families with the outside world, as they seek child development.

The experiences of mothers with preterm infants within the first-year post discharge from NICU: social support, attachment and level of depressive symptoms

BACKGROUND

The estimated global premature birth rate for 2014 was 10.6%, equating to an estimate of 14.84 million live premature births. The experience of premature birth does not impact solely on the infant and mother as individuals but occurs in the context of a critical point in time when they are developing a relationship with one another. The aim of this study was to investigate the relationships between social support, mother to infant attachment, and depressive symptoms of mothers with preterm infants within the first 12 months' post discharge from the Neonatal Intensive Care Unit (NICU).

METHODS

A correlational cross-sectional study design was used. Data were collected using a four-part online survey which included the Perinatal Social Support Questionnaire (PICSS), Maternal Postnatal Attachment Scale (MPAS) and the Edinburgh Postnatal Depression Scale (EPDS) with mothers of preterm infants (n = 140).

RESULTS

The prevalence of postnatal depression was 37.9% (95% CI: 29.8 to 46.4%). In univariable analyses, history of depression (p = 0.005), aged 35-39 years (p = 0.006), no formal social support (p = 0.040), less informal social supports (p = 0.018), lower overall maternal attachment (p < 0.001) and lower overall functional social support (p < 0.001) were significantly associated with a higher level of depressive symptoms. Lower scores on two of the maternal attachment subscales (quality of attachment and absence of hostility) and all four of the functional social support subscales were significantly associated with a higher level of depressive symptoms (p < 0.001 for all). In the multivariable analysis, prior history of depression (p = 0.028), lower score of maternal attachment (p < 0.001) and lower emotional functional social support (p = 0.030) were significantly associated with a higher level of depressive symptoms.

CONCLUSION

Women who experience a premature birth, have a prior history of depression, poor infant attachment and poor emotional social support have a higher level of depressive symptoms. Results emphasise the need for professionals to encourage mobilisation of maternal formal and informal social supports. It is important to intervene early to address maternal emotional well-being and enhance the developing mother-preterm infant relationship.