Self-efficacy and parenting of high-risk infants: The moderating role of parent knowledge of infant development

Parenting Self-Efficacy and Psychological Distress in Parents of Children with an Autism Spectrum Disorder

Research suggests that challenges associated with raising a child with an Autism Spectrum Disorder (ASD) can increase parents' risk for diminished parenting self-efficacy (PSE) and psychological wellbeing. The present study aimed to explore interrelationships between noteworthy predictors of PSE and parental psychological distress, including parental mastery beliefs and the co-parenting relationship amongst 122 Australian parents of children with autism. Results indicated that greater mastery beliefs and more favourable co-parenting relationships predicted greater PSE, and higher PSE predicted less psychological distress. PSE significantly mediated relationships between mastery beliefs and psychological distress, and between the co-parenting relationship and psychological distress. Findings have implications that can aid professionals to more effectively support parents raising children on the autism spectrum.

Parenting knowledge and parenting self-efficacy of mothers with borderline personality disorder and depression: "I know what to do but think I am not doing it"

Borderline personality disorder (BPD) is a complex mental health condition often associated with previous childhood adversity including maladaptive parenting. When becoming a parent themselves, mothers with BPD have difficulties with various parenting cognitions and practices, but unknown is whether they have appropriate knowledge of sensitive parenting. This study explored whether differences in parenting knowledge or self-efficacy are specific to BPD or also found in mothers with depression, and whether symptom severity or specific diagnosis better explain parenting perceptions. Mothers with BPD (n = 26), depression (n = 25) or HCs (n = 25) completed a Q-sort parenting knowledge task and a parenting self-efficacy questionnaire. Results showed mothers with BPD had the same knowledge of sensitive parenting behaviors as mothers with depression and healthy mothers. Self-reported parenting self-efficacy was lower in mothers with BPD and depression compared with healthy mothers, with symptom severity most strongly associated. A significant but low correlation was found between parenting self-efficacy and knowledge. Findings suggest that mothers with BPD and depression know what good parenting is but think they are not parenting well. Mental health difficulties are not associated with parenting knowledge, but symptom severity appears to be a common pathway to lower parenting self-efficacy. Future interventions should test whether reduction of symptom severity or positive parenting feedback could improve parenting self-efficacy.

From co-regulation to self-regulation: Maternal soothing strategies and self-efficacy in relation to maternal reports of infant regulation at 3 and 7 months

This study, conducted in Germany, examines the role of maternal soothing strategies to explain the association of maternal self-efficacy with infant regulation (crying and sleeping behavior). Questionnaire data of 150 mothers, living in Germany, with mixed ethnic and educational backgrounds were collected when infants were 3 and 7 months old. Two types of maternal soothing strategies were distinguished: close soothing, involving close physical and emotional contact, and distant soothing, involving physical and emotional distancing from the infant. A cross-sectional SEM at 3 months indicated that maternal self-efficacy is associated with reported infant regulation through distant soothing strategies. Low maternal self-efficacy was associated with frequent maternal use of distant soothing, which in turn was related to reported infant regulation problems, that is, non-soothability and greater crying frequency. Frequent use of close soothing was associated with reported infant sleeping behavior, that is, frequent night-time awakenings. A longitudinal SEM further indicated that the effects of close soothing persisted at least until the infants' age of 7 months. The study showed how low maternal self-efficacy, increased use of distant soothing, and reported early infant regulation problems are intertwined and that, due to their persisting positive effect on infant soothability, close soothing better supports infant development.

Child development education in the Neonatal Unit: Understanding parent developmental literacy needs, priorities and preferences

OBJECTIVE

To describe child development knowledge needs, priorities, and preferences for education to enhance developmental literacy among parents with children admitted to the neonatal unit (NNU).

METHODS

Two separate cohorts completed a survey; 1) Parents with children graduated from Australian NNUs (n = 316); 2) Parents with infants' inpatient at two South Australian NNUs (n = 209).

RESULTS

Parents considered it extremely important to understand child development (Graduates: 80%; Inpatients: 71%). Inpatient parents reported lower child development knowledge. Almost half (42%) of graduate parents described the child development education provided by neonatal staff as poor or inadequate. There was consistency in preferences for developmental literacy education provision. Parents desired education to commence during NNU and continue post discharge. Priorities included content specific to preterm birth and how to support child development over the first two years of life. Individualised education by a Neonatal Nurse/Midwife was most preferred.

CONCLUSION

Mothers and fathers value guidance to support their child's development during NNU admission and early childhood. Our study highlights the importance of improved early developmental literacy education for parents with children admitted to the neonatal unit.

PRACTICE IMPLICATIONS

Our findings can be used to inform the creation of future educational resources targeting improved parent developmental literacy.

Effect of Neonatal Abstinence Syndrome Treatment Status and Maternal Depressive Symptomatology on Maternal Reports of Infant Behaviors

OBJECTIVE

The objective of this study is to investigate the effects of maternal perinatal depression symptoms and infant treatment status for neonatal abstinence syndrome (NAS) on maternal perceptions of infant regulatory behavior at 6 weeks of age.

METHODS

Mothers and their infants (N = 106; 53 dyads) were recruited from a rural, White cohort in Northeast Maine. Mothers in medication-assisted treatment (methadone) and their infants (n = 35 dyads) were divided based on the infant's NAS pharmacological treatment (n = 20, NAS+ group; n = 15, NAS- group) and compared with a demographically similar, nonexposed comparison group (n = 18 dyads; COMP group). At 6 weeks postpartum, mothers reported their depression symptoms Beck Depression Inventory-2nd Edition) and infant regulatory behaviors [Mother and Baby Scales (MABS)]. Infant neurobehavior was assessed during the same visit using the Neonatal Network Neurobehavioral Scale (NNNS).

RESULTS

Mothers in the NAS+ group showed significantly higher depression scores than the COMP group (p < .05) while the NAS- group did not. Across the sample, mothers with higher depression scores reported higher infant "unsettled-irregularity" MABS scores, regardless of group status. Agreement between maternal reports of infant regulatory behaviors and observer-assessed NNNS summary scares was poor in both the NAS+ and COMP groups.

CONCLUSIONS

Postpartum women in opioid recovery with infants requiring pharmacological intervention for NAS are more at risk for depression which may adversely influence their perceptions of their infants' regulatory profiles. Unique, targeted attachment interventions may be needed for this population.

The effects of a universal short-term home visiting program: Two-year impact on parenting behavior and parent mental health

BACKGROUND

At the time of childbirth, families face heightened levels of unmet need. These needs, if left unmet, can lead parents to engage in less positive parenting practices, which in turn, increase the risk of child maltreatment. Family Connects (FC) is a universal postnatal nurse home-visiting program designed to prevent child maltreatment by supporting all families in a community through one to three visits to improve parent mental health and parenting behaviors. A randomized controlled trial of FC demonstrated improving positive parenting and reducing postpartum depression through age 6 months.

OBJECTIVE

To determine sustained (2-year) impact of random assignment to FC on parenting behavior and parent mental health and identify heterogeneity of effects.

PARTICIPANTS AND SETTING

A representative subsample of 496 families that had been randomized to FC (255 treatment; 241 control) of infants born between July 1, 2009, and December 31, 2010, in Durham County, North Carolina.

METHODS

Demographic characteristics were collected through hospital discharge data. Treatment-blinded interviewers collected maternal reports of parenting behavior and mental health at infant age two years. Moderation and subgroup analyses were conducted to estimate heterogeneity in impact of FC.

RESULTS

Mothers assigned to FC engaged in more self-reported positive parenting relative to control mothers (B = 0.21; p < 0.05). Hispanic mothers assigned to FC reported greater sense of parenting competence (B = 1.28; p < 0.05). No significant main effect differences were identified for negative parenting, maternal depression, or father involvement.

CONCLUSIONS

Assignment to FC was associated with improvements in population-level self-reported scores of positive parenting 2 years post-intervention.

Social Determinants of Health and Parenting Self-Efficacy Among Mothers of Preterm Infants

Objective

To explore the relationships between social and environmental factors and parenting self-efficacy (PSE) among mothers of preterm infants hospitalized in neonatal intensive care units (NICUs) using a social determinants of health (SDoH) framework.

Method

We analyzed data from a prospective cohort study that included 187 mother-infant dyads admitted to four NICUs in the Mountain West region between June 2017 and December 2019. We used multivariable linear regression models to assess the independent associations between maternal and infant characteristics and PSE.

Results

Our final multiple linear regression model predicting the efficacy score including maternal race/ethnicity, age, insurance, employment status before giving birth, gestational age, depression, and having other children was significant (F(12,160) = 3.17, p = .0004, adjusted R¬2 = .131). Significant predictors of PSE were race/ethnicity (β= 3.3, p = .022), having another child/children (β= 4.2, p = .005), and depression (β= -4.2, p = .004).

Conclusions

Findings suggest that social workers and medical practitioners should consider SDoH, such as insurance type, household income, and employment, along with traditional clinical indicators when assessing families' infant care needs. Social workers, medical practitioners, and researchers should be mindful of how implicit bias may influence the allocation of care and parental supports.

Information Available to Parents Seeking Education about Infant Play, Milestones, and Development from Popular Sources

Parents commonly seek information about infant development and play, yet it is unclear what information parents find when looking in popular sources. Play, Milestone, and Development Searches in Google identified 313 sources for content analysis by trained researchers using a standardized coding scheme. Sources included websites, books, and apps created by professional organizations, commercial entities, individuals, the popular press, and government organizations/agencies. The results showed that for popular sources: (1) author information (i.e., qualifications, credentials, education/experience) is not consistently provided, nor is information about the developmental process, parents' role in development, or determining an infant's readiness to play; (2) milestones comprise a majority of the content overall; (3) search terminology impacts the information parents receive; (4) sources from the Milestone and Development Searches emphasized a passive approach of observing developmental milestones rather than suggesting activities to actively facilitate learning and milestone development. These findings highlight the need to discuss parents' online information-gathering process and findings. They also highlight the need for innovative universal parent-education programs that focus on activities to facilitate early development. This type of education has potential to benefit all families, with particular benefits for families with children who have unidentified or untreated developmental delays.

Ayres Sensory Integration® for Addressing Play in Autistic Children: A Multiple-Baseline Examination

IMPORTANCE

Play is an area of difficulty for autistic children, and occupational therapy practitioners need evidence to guide interventions to improve play for this population. Ayres Sensory Integration® (ASI) intervention has not yet been studied for its impact on play outcomes.

OBJECTIVE

To examine the impact of ASI intervention on play types in autistic children.

DESIGN

Nonconcurrent, multiple-baseline design across subjects.

SETTING

Outpatient occupational therapy clinic in New England.

PARTICIPANTS

Three autistic children, ages 5, 6, and 6 yr.

INTERVENTION

Twenty-four ASI sessions.

OUTCOMES AND MEASURES

Frequency of play type was coded using partial interval coding. Progress monitoring used Goal Attainment Scaling.

RESULTS

All three participants demonstrated changes in the frequency of specific types of play, but changes varied among them.

CONCLUSIONS AND RELEVANCE

Findings suggest that ASI intervention may alter a child's patterns of play. What This Article Adds: This study is the first to examine the impact of ASI on play and the third that documents the feasibility of single-subject research for studying ASI. If confirmed in future studies, ASI could become an evidence-based intervention for improving play, an important outcome for autistic children and the profession of occupational therapy. Positionality Statement: This article uses the identity-first language autistic people. This nonableist language describes their strengths and abilities and is a conscious decision. This language is favored by autistic communities and self-advocates and has been adopted by health care professionals and researchers (Bottema-Beutel et al., 2021; Kenny et al., 2016).

Family-level factors of early childhood development: Evidence from rural China

Family-level factors that characterize the home environment are critical inputs to early language and cognitive development, and potential mechanisms for improving developmental outcomes in vulnerable populations. Many studies conducted in high-income and Western settings highlight stimulating parenting, the home language environment, and parental self-efficacy as possible mechanisms of early development, though less is known about how these family-level factors impact child development in low- or middle-income settings. Even less is known about these family-level factors and early childhood development in rural China, where rates of cognitive and language delay in children aged 0-3 years are as high as 45% and 46%, respectively. Using data collected from 77 rural households with children aged 18-24 months in Southwestern China, this study examines the associations between stimulating parenting, the home language environment, and parental self-efficacy, and early cognitive and language development. The results indicate that stimulating parenting was significantly associated with cognitive, language, and overall development; the home language environment was only significantly associated with language development; and parental self-efficacy was not significantly associated with any developmental outcomes. The implications of such findings reveal mechanisms for supporting healthy child development in rural China.

App-based support for parental self-efficacy in the first 1,000 days: A randomized control trial

Parental self-efficacy is key for guiding parents' interactions with their child and is an important target for early intervention. This study reports a pilot randomized control trial (RCT) of a parenting application (app) with 79 parents of children aged 0-6 months in the United Kingdom. The app includes 1,026 daily age-appropriate activities across eight areas of child development, using resources accessible at home. While controlling for pre-test scores, parents who used the parenting app (Treatment Group) had significantly higher parental self-efficacy, after the 4-week intervention period, compared to the Active Control Group. Partial correlation analyses indicated that higher frequency of self-reported use of the parenting app was associated with greater parental self-efficacy outcomes. This evidence establishes proof of concept that parenting apps can have significant benefits on parental self-efficacy in early childhood. Limitations to the interpretation and generalization of the findings, as well as directions for future research are discussed.

"A Different Ride": A Qualitative Interview Study of Parents' Experience with Early Diagnosis and Goals, Activity, Motor Enrichment (GAME) Intervention for Infants with Cerebral Palsy

Cerebral palsy is the most common physical disability of childhood, and early diagnosis followed by best practice early intervention is important for optimizing child and family outcomes. We investigated parents' views of an early diagnosis of cerebral palsy (CP), followed by Goals, Activity, Motor Enrichment (GAME) intervention. Semi-structured interviews were conducted within a pilot randomised clinical trial. Transcriptions were analyzed using grounded theory. Participants were nine mothers whose infants had received GAME intervention because they were identified as being at high risk for cerebral palsy early in infancy. The parenting experience was described as a "different ride". The diagnosis was devastating with many time-consuming challenges, but acceptance ensued. Parents wanted an early diagnosis, prognosis, and early intervention, despite the anxiety and workload, because it meant they could help. Parents perceived that GAME was beneficial because they were taught how to help; it was goal-based and home-based. They believed the collaboration and communication skills of the therapist shaped success. Future research should focus on a broader range of participants to understand parent's experiences with key aspects of early intervention more fully.

Effects of health promotion program on maternal attachment, parenting self-efficacy, infant development: a randomised controlled trial

This study was designed to test the efficacy of the health promotion program used on maternal-infant attachment, parental self-efficacy, infant development. For this experimental study parallel-group randomised control design was used. Data was collected from 64 mother and their infants. The intervention group received the health promotion program in addition to standard care, the control group received only the standard care. Family Information Form, Prenatal Attachment Inventory, Maternal Attachment Inventory, Parenting Self-Efficacy Scale, and Denver II Developmental Screening Tests were used for the collection of the data. Pearson χ2 test, Yates corrected χ2 test, independent t-test, and Mcnemar test were used for analysing the collected data. The groups on maternal-infant attachment (d:1.20 [CI:0.671-1.736]), parental self-efficacy (d:1.37 [CI:0.835 to 1.925]), and development delays of infants (p = .003, C.V: 0.41) were found to be statistically significant. Health promotion program positively influenced the maternal attachment, parental self-efficacy, the development of the infants.IMPACT STATEMENTWhat is already known on this subject? Pregnancy and postpartum is a difficult period for mothers. Mothers need support. Parenting self-efficacy and maternal attachment are important for improving infant health. Infant should be supported to prevent developmental delays.What do the results of this study add? With the education and support program applied before and after birth, mother and baby were evaluated together and multi-faceted support was provided.What are the implications of these findings for clinical practice and/or further research? Supporting parenting self-efficacy, maternal attachment and infant development should be started during pregnancy and should be continued in the postpartum period.

Predictors of maternal knowledge on early childhood development in highly marginalized communities in Mexico: Implications for public policy

INTRODUCTION

Efforts to identify the predictors of maternal knowledge on Early Child Development (ECD) have proven inconclusive thus far, particularly with respect to socially deprived contexts in Low- and Middle-Income Countries (LMICs). We quantified the extent of ECD knowledge among mothers who were the primary caregivers of 0-38-month-old infants in marginalized communities in Mexico. We also explored the characteristics of the children, both individually and with regard to their households, given the influence of these factors on childhood development.

METHODS

We analyzed primary data obtained through a questionnaire administered to mothers who were the primary caregivers of 1045 girls and boys 0-38 months of age. The instrument was specifically designed for our study in order to explore the knowledge of participants about physical, neurological and psycho-affective development during childhood. We performed fractional regression analysis to assess the predictors of ECD knowledge.

RESULTS

The mean score of maternal ECD knowledge increased with their age and schooling as well as with their levels of cognitive ability and self-esteem. Irrespective of age at first birth, mean knowledge was relatively high for women with high school education and low for women with elementary or no formal education, a gradient with respect to age at fist birth was more marked among women with middle school education. ECD knowledge scores increased among mothers from households enjoying higher socioeconomic levels and from households with health insurance. Scores were lower for indigenous households regardless of their participation in social programs.

CONCLUSION

Public policies on ECD should promote programs that are not only adapted to specific contexts, but also designed to improve shared child-rearing, early childhood care and as well as psycho-emotional education skills as a pathway to healthier ECD. The participation of families and communities in sensitive childhood care should form part of multisectoral programs involving education, health and wellbeing.

Maternal childhood trauma and prenatal stressors are associated with child behavioral health

Maternal adversity and prenatal stress confer risk for child behavioral health problems. Few studies have examined this intergenerational process across multiple dimensions of stress; fewer have explored potential protective factors. Using a large, diverse sample of mother-child dyads, we examined associations between maternal childhood trauma, prenatal stressors, and offspring socioemotional-behavioral development, while also examining potential resilience-promoting factors. The Conditions Affecting Neurocognitive Development and Learning and Early Childhood (CANDLE) study prospectively followed 1503 mother-child dyads (65% Black, 32% White) from pregnancy. Exposures included maternal childhood trauma, socioeconomic risk, intimate partner violence, and geocode-linked neighborhood violent crime during pregnancy. Child socioemotional-behavioral functioning was measured via the Brief Infant Toddler Social Emotional Assessment (mean age = 1.1 years). Maternal social support and parenting knowledge during pregnancy were tested as potential moderators. Multiple linear regressions (N = 1127) revealed that maternal childhood trauma, socioeconomic risk, and intimate partner violence were independently, positively associated with child socioemotional-behavioral problems at age one in fully adjusted models. Maternal parenting knowledge moderated associations between both maternal childhood trauma and prenatal socioeconomic risk on child problems: greater knowledge was protective against the effects of socioeconomic risk and was promotive in the context of low maternal history of childhood trauma. Findings indicate that multiple dimensions of maternal stress and adversity are independently associated with child socioemotional-behavioral problems. Further, modifiable environmental factors, including knowledge regarding child development, can mitigate these risks. Both findings support the importance of parental screening and early intervention to promote child socioemotional-behavioral health.

Differences in sibling temperament are associated with differences in maternal use of food to soothe during infancy: A sibling analysis

BACKGROUND

Firstborn children are more likely to have obesity than secondborns, which may partially be explained by differential use of food to soothe (FTS) infant distress, which has been inked to higher weight status.

OBJECTIVES

To test associations between the birth order and maternal FTS and whether differences in sibling temperament and body mass index (BMI) z-scores were associated differences in maternal FTS.

METHODS

Random effect models assessed associations between birth order and FTS. Linear regressions examined associations between differences in maternal FTS and sibling differences in temperament at 16 weeks and BMI z-scores at 1 year.

RESULTS

Mothers (n = 117) used contextual-based FTS more with firstborns than secondborns (2.70 vs. 2.38, p < 0.0001). Sibling differences in negative affect were associated with differences in maternal contextual-based (R2  = 0.09, p = 0.002) and emotion-based (R2  = 0.09, p = 0.001) FTS. Sibling differences in effortful control were associated with differences in maternal emotion-based FTS (R2  = 0.04, p = 0.04). Finally, differences in maternal emotion-based FTS were associated with sibling differences in BMI z-scores at age 1 year (R2  = 0.14, p = 0.006).

CONCLUSIONS

To promote healthy child weight, mothers should learn to respond to each child's temperament and use alternatives to FTS infant distress.

Parenting beliefs about attunement and structure are related to observed parenting behaviours

We compared self-reported parenting beliefs about caring for infants with observed parenting behaviours during play interactions between 32 parents and their infants. We measured parenting beliefs about the value of attunement and structure in caring for infants using the Baby Care Questionnaire (BCQ) (Winstanley & Gattis, 2013; Winstanley, Sperotto, Putnick, Cherian, Bornstein & Gattis, 2014). We used a micro-coding approach to distinguish between responsive parenting behaviours (maintaining infant attention) and demanding parenting behaviours (introducing or redirecting infant attention) (Landry, Garner, Swank & Baldwin, 1996). Attunement beliefs were positively related to responsive parenting behaviours and negatively related to demanding parenting behaviours. Structure beliefs were weakly related to demanding parenting behaviours. These results are an important first step toward identifying relations between self-reported parenting beliefs about attunement and structure and observed parenting behaviours.

Evaluation of the Polish version of the Parenting Sense of Competence Scale in parents of typically developing children and children with autism spectrum disorders

BACKGROUND

Parental self-efficacy describes parents' self-perceived competence in fulfilling their roles. The Parenting Sense of Competence Scale (PSOC) is one of the most commonly used self-report instruments, allowing for parental self-efficacy measurement.

METHODS

This paper summarizes the results of three studies (total N = 2088) conducted to examine factor structure, internal consistency, test-retest reliability and criterion validity of the Polish version of PSOC (PSOC-PL). The studies were carried out among parents (mothers and fathers) of typically developing 14- and 15-year-olds (Study 1, n = 1404) as well as among parents of typically developing children aged 6-16 (Study 2, n = 248), parents of typically developing children and children with a diagnosis of autism spectrum disorder (Study 3, n = 436, ages ranged from 6 to 13).

RESULTS

Confirmatory factor analysis (Study 1) demonstrated an acceptable fit of the theorized two-factor model, with theorized Satisfaction and Efficacy factors. The subscales' internal consistencies were satisfactory across all studies (Studies 1-3), and PSOC's test-retest reliability (Study 2) over a 3-week interval was very high. Parents of children with developmental disorders (Study 3) reported lower efficacy than parents of typically developing children.

CONCLUSIONS

The results of these three studies attest that the Polish version of PSOC is a reliable and valid measure of parental self-efficacy beliefs.

Increasing Parental Knowledge About Child Feeding: Evaluation of the Effect of Public Health Policy Communication Media in France

Background

Unhealthy eating behaviors are risk factors for non-communicable diseases. Parents largely influence the development of eating behaviors during childhood through their feeding practices. Parental feeding practices in line with recommendations are more likely to turn into healthier outcomes in children. From a public health perspective, it should be first ascertained whether providing parents with recommendations about child feeding is a useful approach for increase parental knowledge. Recently, the French health authorities developed a brochure covering updated child feeding recommendations. The present study aims to evaluate the short-term effects of reading this brochure on parental knowledge about child feeding, distinguishing knowledge accuracy and certainty.

Methods

A brochure containing updated child feeding recommendations for 0-3 years old was developed by the French public health agency. A representative sample of French parents (n = 400) was targeted to complete an online questionnaire (T0) comprising 30 statements regarding child feeding. For each statement, parents indicated whether it was true/false and how certain they were of their answer (4-point scale). After receiving and reading the brochure, the same parents completed the same questionnaire 3 weeks later (T1). Accuracy (number of correct answers) and certainty (number of mastered answers: correct answers given with the maximal degree of certainty) were compared at T1 vs. T0 using paired t-tests. Knowledge evolution based on parental age, parity and education level was tested with linear models.

Results

A total of 452 parents responded at T0 and T1 and were considered for analysis. Between T0 and T1, the number of correct answers [median 22-25, t(451) = 17.2, p ≤ 0.001] and mastered answers [median 11-17, t(451) = 18.8, p ≤ 0.001] significantly increased. The median of the difference between T1 and T0 was larger for mastered than for correct answers. The observed evolution in knowledge was independent of parental age, parity or education level.

Conclusions

A brochure containing child feeding recommendations has the potential to increase the accuracy and, to an even greater degree, the certainty of parental knowledge. This increase was observed even for younger or less educated parents.

Bills, babies, and (language) barriers: Associations among economic strain, parenting, and primary language during the newborn period

OBJECTIVE

The goal of this study was to examine associations among economic strain, parenting self-efficacy, parenting satisfaction, and parent primary language in a universally low-income sample of parents with newborns.

BACKGROUND

Previous research links increased economic strain to lower levels of parenting self-efficacy and parenting satisfaction among socioeconomically diverse parents with older children. Little research has examined whether primary language shapes the associations among economic strain, parenting self-efficacy, and parenting satisfaction.

METHOD

Parents (n = 194, M _age = 30.91) completed self-report surveys measuring economic strain, parenting self-efficacy, and parenting satisfaction. Parents' ethnic self-identification and primary language were used to stratify parents into three groups: Latinx Spanish speakers, Latinx English speakers, and non-Latinx English speakers.

RESULTS

Regression analyses revealed that economic strain was negatively associated with both parenting self-efficacy and parenting satisfaction. Further, the negative association between economic strain and parenting self-efficacy was stronger for Latinx Spanish speakers.

CONCLUSION

Economic strain may negatively influence parenting self-efficacy and parenting satisfaction during the newborn period. Parents whose primary language is Spanish may be disproportionately affected by economic strain.

IMPLICATIONS

Parents of newborns may benefit from increased economic supports in linguistically responsive pediatric care and social service settings.

Perceived maternal parenting self-efficacy scale: Factor structure and psychometric properties among Portuguese postpartum women

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= 0.95) and for the three factors (α from 0.88 to 0.94). 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.

Knowledge of Infant Development and Parent Well-Being: Cross-Sectional Analysis of Toddlers

OBJECTIVE

Knowledge about child development is associated with parenting and children's outcomes. Parents with less accurate knowledge about developmental milestones may have unrealistic expectations for their child's behavior, which may affect parent well-being. Limited research has examined this topic relative to depression, but other aspects of parent well-being (e.g., parenting stress) are unexplored.

METHODS

Cross-sectional analysis of an ongoing prospective cohort study of 300 families in central Ohio enrolled when children were a mean (SD) calendar age of 18.2 (0.7) months. Children of all gestational ages at birth are included, and 37% were born preterm (<37 weeks' gestation.) Primary caregivers (93% mothers) completed the 20-item Knowledge of Infant Development Index (KIDI) and questionnaires for child temperament and 3 aspects of parent well-being (depressive and anxious symptoms, parenting stress, and general health). Covariate-adjusted regression models assessed relationships between the KIDI score and each well-being outcome. We hypothesized that parents with less knowledge would have more symptoms of depression and anxiety, greater parenting stress, and poorer health. Whether associations were stronger for parents of children born preterm or who had high negative affect was explored.

RESULTS

Knowledge of Infant Development Index scores were associated with sociodemographic characteristics, child temperament, and gestational age (more knowledge: higher socioeconomic position, less child negative affect, and full-term birth). KIDI scores did not predict any aspect of parent well-being, and there was no evidence that child temperament or preterm birth altered these findings.

CONCLUSION

In this sample of parents of toddlers assessed in 2018/19, greater knowledge of infant development was not associated with parent well-being.

A Randomized Control Trial of Using Baby Books to Reduce New Mothers' Feelings of Stress and Depression

OBJECTIVE

To determine whether embedding educational information about child development and optimal parenting practices from the Bright Futures Guidelines for Health Supervision into baby books can reduce women's depressive symptoms and parenting stress during the first 18 months of motherhood.

METHODS

A sample of 167 low-income, primarily African-American, first-time mothers were randomized into three conditions while pregnant: an educational book group, a non-educational book group, or a no-book group. Depressive symptoms and parenting stress were assessed using two questionnaires during home visits when women were in their third trimester of pregnancy (baseline) and when their child was 2, 4, 6, 9, 12, and 18 months of age.

RESULTS

Hierarchical Linear Models showed that women who received books with educational information shed depressive symptoms and parenting stress at a faster rate than women who received similar books without educational information and women who did not receive books.

CONCLUSIONS

These findings indicate that providing women with child development and parenting information via baby books can be an effective strategy for promoting new mothers' emotional wellbeing. Since feelings of sadness and stress are risky for both mothers and their infants, this easy to implement intervention holds great promise.

Change the Things You Can: Modifiable Parent Characteristics Predict High-Quality Early Language Interaction Within Socioeconomic Status

Purpose Understanding variability sources in early language interaction is critical to identifying children whose development is at risk and designing interventions. Variability across socioeconomic status (SES) groups has been extensively explored. However, SES is a limited individual clinical indicator. For example, it is not generally directly modifiable. The purpose of this study was to examine if child language ability, input quantity and quality, and dyadic interaction were associated with modifiable caregiver characteristics-self-efficacy and developmental knowledge. Method We conducted secondary analyses using the baseline data (n = 41 dyads enrolled, n = 30 analyzed) from a longitudinal study. Mothers and children (1;0-2;3 [years;months]) in low-income households completed demographic questionnaires, self-efficacy and developmental knowledge measures, child language assessments, and interaction samples. We used linear regression models to examine the relationship between self-efficacy, developmental knowledge, and outcomes. Results Child receptive and expressive language scores were significantly associated with mothers' self-efficacy, knowledge, and Efficacy × Knowledge interaction. Specifically, maternal self-efficacy was positively associated with child language only in the context of high developmental knowledge. Neither self-efficacy nor developmental knowledge was significantly associated with the number of total or different words mothers produced. However, self-efficacy was significantly and positively associated with the rate of child-initiated conversational turns per minute, controlling for the number of child utterances. Mothers with higher self-efficacy responded more readily to their children than those with lower self-efficacy. Conclusions Child language ability and interaction quality vary based on modifiable parent characteristics. Modifiable individual characteristics should be considered in early language interaction within and across SES groups.

The effect of bibliotherapy on the development of self-efficacy of women with disabled children

The aim of this study is to reveal the effect of the bibliotherapy technique on the development of general self-efficacy of women with disabled children. The specific objective of the study is to draw attention to bibliotherapy as a method in the library and information science area. The research was conducted with 18 volunteers from 80 mothers of disabled children who received service from ZİÇEV (Mentally Handicapped Education and Protection Foundation) in the 2019-2020 academic year. Group work and the general self-efficacy scale was used to collect data. In the research, 2x2 mixed design (experiment – control – pre-test – post-test) was conducted. The self-efficacy level of the women was chosen as the dependent variable while the independent variable was bibliotherapy activity. 9 women were assigned to the experimental group and the other 9 were the control group. The bibliotherapy program, designed by the researcher, was in six sessions. Each session took 2 hours. The general self-efficacy scale was conducted again at the last session. Statistically significant results were observed between the experimental and control groups. The results of the study showed that bibliotherapy increased the self-efficacy of women with disabled children. The research drew attention to the importance of bibliotherapy in the process of tackling the low self-efficacy levels of women with disabled children. It is expected that the study will contribute to the literature by encouraging interdisciplinary research based on bibliotherapy.

Learned Experience and Resource Dilution: Conceptualizing Sibling Influences on Parents' Feeding Practices

Studies from diverse cultures report mixed results in the relationship between birth order and risk for obesity. Explanations may thus lie in the postnatal period when growth is shaped by the family environment, including parental feeding practices, which may be affected by siblings. Consistent with a family systems perspective, we describe two processes that may explain birth order effects on parental feeding practices and child outcomes: learned experience and resource dilution. Parents learn from experience when earlier-born children influence their parents’ knowledge, expectations, and behavior toward later-born siblings through their behaviors and characteristics—which can have both positive and negative implications. Resource dilution is a process whereby the birth of each child limits the time, attention and other resources parents have to devote to any one of their children. The goal of this review is to provide a theoretical basis for examining potential sibling influences on parental responsive feeding toward developing recommendations for future research and practice aimed at preventing obesity throughout family systems.

Development and Functionality of an Internet-Based, Self-Managed Parent Training Program

Purpose This research note evaluated a self-managed, Internet intervention (i.e., Success With Stories) designed to facilitate parental reading practices and beliefs. Method Twelve reviewers were composed of parents of young children, speech-language pathologists, and experts in self-managed, Internet intervention. Satisfaction of usability, content, presentation, suitability, and exercises of Success With Stories was examined using an intervention satisfaction rating. Value and usefulness of content was evaluated via a survey. Results Reviewers found content to be valuable and useful for facilitating parental reading practices and beliefs. Results indicated high satisfaction across all reviewers. Conclusion Results point toward strengths and limitations of the protocol and future directions.

Neonatal sleep development and early learning in infants with prenatal opioid exposure

The aim of this chapter is to examine the role of sleep and cognition in the context of the cumulative risk model examining samples of at-risk infants and maternal-infant dyads. The cumulative risk model posits that non-optimal developmental outcomes are the result of multiple factors in a child's life including, but not limited to, prenatal teratogenic exposures, premature birth, family socioeconomic status, parenting style and cognitions as well as the focus of this volume, sleep. We highlight poor neonatal sleep as both an outcome of perinatal risk as well as a risk factor to developing attentional and cognitive capabilities during early childhood. Outcomes associated with and contributing to poor sleep and cognition during infancy are examined in relation to other known risks in our clinical population. Implications of this research and recommendations for interventions for this population are provided.

Comparison of time-use patterns and self-efficacy in family caregivers of patients with chronic disease

Background/Aims

Caregivers perform an important role but caring affects other roles they perform, resulting in poor time management and reduced quality of life. This study aimed to compare the time-use patterns and self-efficacy of caregivers of two groups of patients with chronic disease: those with a diagnosis of mental illness and those without a diagnosis of mental illness.

Methods

Family caregivers of patients with a chronic disease who were aged between 20–60 years, resident in Arak, not taking care of another patient and literate were eligible to participate. The presence of mental illness was based on a psychiatrist's diagnosis at least 6 months before the study. The Mothers' Time Use Questionnaire, Sherer Self-efficacy Scale and a demographic questionnaire were used to capture data relating to time-use, self-efficacy and participant characteristics. Data were analysed using independent t-test and Mann–Whitney U test to identify and compare time-use patterns and self-efficacy.

Results

There were no significant between-group differences in demographics or mean time-use scores in six domains (rest/sleep, leisure, housework, work/occupation, social participation and satisfaction with time management). Self-care time-use scores (time, quality, importance and enjoyment) were significantly higher for caregivers of patients with chronic disease with a diagnosis of mental illness. Patient care time-use scores were significantly higher for caregivers of patients with chronic disease without a diagnosis of mental illness. Mean self-efficacy score was significantly higher in the group caring for patients with a diagnosis of psychiatric disease.

Conclusions

Chronic physical illnesses may result in greater dependence on caregivers than mental illness, increasing the amount of time spent on care and reducing caregiver self-efficacy.

Parental Knowledge of Children's Developmental Milestones in Riyadh, Saudi Arabia

Objective

Parental recognition of children's developmental milestones has been correlated with more effective childcare strategies and overall better outcomes for children. However, the knowledge that parents have about children's development remains uncertain which reflects serious concerns about children's health in Saudi Arabia. Therefore, this study was undertaken to identify parents' knowledge levels about children's developmental milestones and the information sources they rely on for this knowledge. Study Design. We recruited 1471 parents aged ≥18 with at least one child under 14 and living in Riyadh to participate in an online survey between July of 2019 and January of 2020.

Results

Most respondents showed a poor level of knowledge (80.0%) in all of four domains. However, mothers had more acceptable levels of knowledge (21.0%) than fathers (10.0%) (p ≤ 0.01). There was a significant association between knowledge and age at first child's birth; respondents who had their first child between 39 and 50 had the highest levels of knowledge (37.5%; p ≤ 0.01). In the four domains of development, parents were found to have the most knowledge about physical development (52.3%), followed by cognitive development (21.6%), social development (21.5%), and emotional development (21.2%). Only a few parents (5%) claimed to always rely on their healthcare professionals for information.

Conclusion

There is a lack of appropriate knowledge about developmental milestones among parents, which reflects serious concerns about children's health in Saudi Arabia. Healthcare institutions and pediatricians currently play a minimal role in health education. Effective health education programs and strategies should be implemented to improve child development outcomes in the community.

'Caring for children who have experienced trauma' - an evaluation of a training for foster parents

BACKGROUND

Foster children, mostly maltreated in their birth families, may be fostered by parents who know little about the impact of traumatic experiences.

OBJECTIVE

The present study investigated whether the training Caring for Children who Have Experienced Trauma for foster parents can break the negative circle of traumatic stress. The hypothesis was that improvement in parents' knowledge on trauma and mind-mindedness would be associated with a reduction of their parenting stress, children's post-traumatic stress symptoms, and behaviour problems.

METHOD

Forty-eight foster parents (n female = 35) participated in a pre-test (T1), post-test (T2), and follow-up (T3) assessment. Questionnaires on knowledge on trauma, parenting stress, child post-traumatic stress symptoms, the child's behaviour, and the evaluation of the training were administered. Parents' mind-mindedness was assessed using the describe-your-child interview.

RESULTS

Foster parents highly appreciated the training, their knowledge on child trauma increased at T2 and this growth persisted at T3. The parents who gained most knowledge experienced a small decrease in parenting stress at T2. Although the general mind-mindedness did not significantly change, foster parents' mind-mindedness with positive valence substantially increased at T2 and T3, while their mind-mindedness with neutral valence decreased. Foster parents' report on child PTSS declined at T3 compared to T2, but not compared to T1. No changes were found in children's behaviour as reported by the foster parents. The proportion of foster children receiving trauma-focused treatment increased at T2 and T3.

CONCLUSION

This study provides evidence that training in trauma-informed parenting can be effective in improving foster parents' knowledge on the impact of traumatic experiences and in increasing a positive mental representation of their foster child as well as in reducing children's post-traumatic symptoms.

Parenting paused: Pathological video game use and parenting outcomes

For most people, playing video games is a normal recreational activity, with little disruption to gamers' emotional, social, or physical health and well-being. However, for a small percentage of gamers, video gaming can become pathological (Fam, 2018). Substantial research has examined pathological gaming in teens and young adults (Cheng, Cheung, & Wang, 2018; Choo, Gentile, Sim, Khoo, & Liau, 2010), yet pathological gaming in adults (c.f. Holgren, 2017), especially in the context of parenthood, has been relatively ignored. The current study sought to address this limitation by studying associations between pathological gaming characteristics and parenting outcomes in a sample of men and women who have had a child in the last year. Fathers spent more time than mothers playing video games and displayed more pathological video gaming tendencies. Pathological gaming for mothers and fathers was related to increased depressive symptoms. Depressive symptoms mediated the relationship between pathological gaming and decreased feelings of parental efficacy, perceived parental competence, increased parenting stress, and increased perceived impact of parenting. Pathological video game playing was also directly related to decreased feelings of parental efficacy for mothers and fathers. Implications of the results and directions for future research are discussed.

The role of maternal psychosocial perceptions in parent-training programs: a preliminary randomized controlled trial

Parent-child interaction is critical for early language and literacy development. Parent training programs have proliferated to support early interactions. However, many environmental and psychosocial factors can impact the quality of parent-child language and literacy interactions as well as training program outcomes. This preliminary randomized controlled trial examined maternal perceived self-efficacy and locus of control during a language and literacy parent training program. Thirty mother-child dyads (mother age 21-40; children 2;6-4;0) were assigned in parallel to the training or control group. The training was efficacious for mothers and children - training-group dyads made significantly greater gains in maternal strategy use, responsivity, and child print awareness than the control group. Gains were maintained one month post-training. Children whose mothers had more external baseline control perceptions identified significantly fewer print targets at baseline and made greater gains than those with more internal control perceptions. Future directions and implications are discussed.

South Korean mothers' childhood abuse experience and their abuse of their children with intellectual and developmental disabilities: Moderating effect of parenting self-efficacy

BACKGROUND

A history of childhood abuse has been found to adversely affect the transition to motherhood. Compared to other children, children with intellectual and developmental disabilities are at higher risk of being maltreated at home. However, maternal parenting self-efficacy has been found to improve mothers' positive interactions with their children.

OBJECTIVE

Given that, this study examined the moderating effect of maternal parenting self-efficacy on the relationship between mothers' childhood abuse experience and their abuse of their children with IDDs.

PARTICIPANTS AND SETTING

Participants include 134 South Korean mothers with children between 2 and 8 years of age with intellectual and developmental disabilities.

METHOD

Mothers' childhood abuse experience was assessed using the Childhood Trauma Questionnaire, which measures the extent of mothers' exposure to parental abuse in their childhood. Parenting self-efficacy was measured using the Echelle Globle du Sentiment de Competence Parentale (EGSCP). The Abusive Parenting scale was used to assess mothers' abusive parenting; it measured the degree to which mothers had ever either physically or emotionally abused their children.

RESULTS

The moderating effects of parenting self-efficacy on the relationships between childhood emotional abuse and abusive parenting (B = -.06, t(126) = -2.33, p = .022, 95 % CI[-.1142, -.0092]) and between childhood physical abuse and abusive parenting (B = -.07, t(126) = -2.64, p = .009, 95 % CI[-.1283, -.0184]) were significant.

CONCLUSIONS

These findings emphasize the importance of helping mothers with a history of abuse alleviate parental stress arising from raising children with IDDs by enhancing their parenting self-efficacy.

Are parental changes related to improvements in preschool children's disruptive behaviours?

OBJECTIVE

To investigate whether changes in parenting after behavioural parent training in routine clinical care are associated with improvements in preschool children's disruptive behaviours.

METHOD

We evaluated changes after parent training in maternal and paternal self-reports of parental discipline practices parenting sense of competence, and parents' ratings of child disruptive behaviours in parents of 63 children, with a one group pretest-posttest design. We also compared parenting parameters in this clinical sample with a nonclinical sample (n = 121).

RESULTS

Mothers' self-reports of parental discipline practices and parenting sense of competence significantly improved after behavioural parent training. Less over-reactivity in both mothers and fathers was associated with fewer disruptive behaviours in children. After parent training, mothers' ratings of their discipline techniques did not differ anymore from those in the nonclinical sample.

CONCLUSION

Positive changes in parental discipline practices, particularly less over-reactive parental behaviours, were related to a decrease of disruptive child behaviours.

Caregiver perceptions of child development in rural Madagascar: a cross-sectional study

Background

Human capital (the knowledge, skills, and health that accumulate over life) can be optimized by investments in early childhood to promote cognitive and language development. Parents and caregivers play a crucial role in the promotion and support of cognitive development in their children. Thus, understanding caregiver perceptions of a child’s capabilities and attributes, including intelligence, may enhance investments early in life. To explore this question, we asked caregivers to rank their child’s intelligence in comparison with other children in the community, and compared this ranking with children’s scores on an assessment of developmental abilities across multiple domains.

Methods

Our study examined cross-sectional data of 3361 children aged 16–42 months in rural Madagascar. Child intelligence, as perceived by their caregiver, was captured using a ladder ranking scale based on the MacArthur Scale for Subjective Social Status. Children’s developmental abilities were assessed using scores from the Ages and Stages Questionnaire: Inventory (ASQ-I), which measures cognitive, language, and socio-emotional development. Ranked percentiles of the ASQ-I were generated within communities and across the whole sample. We created categories of under-estimation, matched, and over-estimation by taking the differences in rankings between caregiver-perceived child intelligence and ASQ-I. Child nutritional status, caregiver belief of their influence on child intelligence, and sociodemographic factors were examined as potential correlates of discordance between the measures using multinomial logistic regressions.

Results

We found caregiver perceptions of intelligence in Madagascar did not align consistently with the ASQ-I, with approximately 8% of caregivers under-estimating and almost 50% over-estimating their children’s developmental abilities. Child nutritional status, caregiver belief of their influence on child intelligence, caregiver education, and wealth were associated with under- or over-estimation of children’s developmental abilities.

Conclusions

Our findings suggest parents may not always have an accurate perception of their child’s intelligence or abilities compared with other children. The results are consistent with the limited literature on parental perceptions of child nutrition, which documents a discordance between caregiver perceptions and objective measures. Further research is needed to understand the common cues caregivers that use to identify child development milestones and how these may differ from researcher-observed measures in low-income settings.

Trial registration

Current Controlled Trials ISRCTN14393738. Registered June 23, 2015.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-7578-3) contains supplementary material, which is available to authorized users.

The role of parental self-efficacy in parent and child well-being: A systematic review of associated outcomes

BACKGROUND

For decades, parental self-efficacy (PSE), or parents' belief in their ability to influence their child in a healthy and success-promoting manner, has been understood as a key factor in promoting healthy functioning for parents and their children. In that time, an extensive collection of research examining the specific impact of PSE on parents and their children has developed. However, to the authors' knowledge, no comprehensive and systematic review of the outcomes linked to this factor exists, and the two most closely related non-systematic reviews were published over 10 years ago.

METHODS

Therefore, by utilizing an iteratively optimized set of search terms applied across four databases, the current review sought to systematically collect, synthesize, and present the extant literature concerning the role of PSE in parent and child well-being.

RESULTS

This search strategy yielded a total of 115 studies, the results of which were organized into three broad thematic categories relating to: the parent and child relationship, parental mental health, or child development.

CONCLUSIONS

These results recapitulate the clinical relevance of PSE, and provide an updated and comprehensive understanding of both the role PSE plays in the welfare of parents and children, as well as the gaps in the literature as it currently stands.

Joint observation in NICU (JOIN): study protocol of a clinical randomised controlled trial examining an early intervention during preterm care

INTRODUCTION

Preterm birth may generate significant distress among the parents, who often present with difficulties in appropriating their parental role. Parental stress and low perceived parental self-efficacy may interfere with the infant's socioemotional and cognitive development, particularly through disrupted parent-infant interactions. Perceived parental self-efficacy represents the belief of efficacy in caring for one's own infant and successful incarnation of the parental role, as well as the perception of one's own abilities to complete a specified task. Interventions to support parental role, as well as infant development, are needed, and parental self-efficacy represents a useful indicator to measure the effects of such early interventions.

METHODS AND ANALYSIS

This study protocol describes a randomised controlled trial that will test an early intervention in the neonatal intensive care unit (NICU) (JOIN: Joint Observation In Neonatology) carried out by an interdisciplinary staff team. Mothers of preterm neonates born between 28 and 32 6/7 weeks of gestational age are eligible for the study. The intervention consists of a videotaped observation by a clinical child psychologist or child psychiatrist and a study nurse of a period of care delivered to the neonate by the mother and a NICU nurse. The care procedure is followed by an interactive video guidance intended to demonstrate the neonate's abilities and resources to his parents. The primary outcome will be the difference in the perceived maternal self-efficacy between the intervention and control groups assessed by self-report questionnaires. Secondary outcomes will be maternal mental health, the perception of the parent- infant relationship, maternal responsiveness and the neurodevelopment of the infant at 6 months corrected age.

ETHICS AND DISSEMINATION

Ethical approval was granted by the Human Research Ethics Committee of the Canton de Vaud (study number 496/12). Results from this study will be disseminated at national and international conferences, and in peer-reviewed journals.

TRIAL REGISTRATION NUMBER

NCT02736136, Pre-results.

The forgotten mothers of extremely preterm babies: A qualitative study

AIMS AND OBJECTIVES

To explore the experiences of mothers of extremely premature babies during their Neonatal Intensive Care Unit stay and transition home.

BACKGROUND

Mothers of extremely preterm infants (28 weeks' gestation or less) experience a continuum of regular and repeated stressful and traumatic events, during the perinatal period, during the Neonatal Intensive Care Unit stay, and during transition home.

METHOD

An interpretive description method guided this study. Ten mothers of extremely premature infants who had been at home for less than six months were recruited via a Facebook invitation to participate in semi-structured telephone interviews exploring their experiences in the Neonatal Intensive Care Unit and the transition home. The data were examined using a six-phase thematic analysis approach. The COREQ checklist has been used.

RESULTS

Two main themes emerged: (a) things got a bit dire; and (b) feeling a failure as a mother. Participants had a heightened risk of developing a mental disorder from exposure to multiple risk factors prior to and during birth, as well as during the postnatal period in the Neonatal Intensive Care Unit and their infant's transition to home. Mothers highlighted the minimal support for their mental health from healthcare professionals, despite their regular and repeated experience of traumatic events.

CONCLUSION

The mothers were at high risk of developing post-traumatic stress symptoms and/or other mental health issues. Of note, study participants relived the trauma of witnessing their infant in the Neonatal Intensive Care Unit, demonstrated hypervigilance behaviour and identified lack of relevant support needed when their infant was at home.

RELEVANCE TO CLINICAL PRACTICE

This study highlights the need for nurses to include a focus on the mothers' psychosocial needs. Supporting maternal mental health both improves maternal well-being and enables mothers to be emotionally available and responsive to their extremely preterm infant.

Relationship between maternal self-efficacy and functional status four months after delivery in Iranian primiparous women

INTRODUCTION

Postpartum women experience changes in their physiological and psychological functions as they adapt to their parenting role. The objective of this study was to examine the association between maternal self-efficacy and functional status in postpartum period.

METHODS

In this cross-sectional study, 305 Iranian women were selected randomly via a two-stage cluster sampling method at the end of the fourth month postpartum in 25 healthcare centers of Tabriz-Iran, 2016. Data were collected using the socio-demographic characteristics questionnaire, self-efficacy scale and inventory of functional status after childbirth. The statistical tests including Pearson correlation, Independent sample t-test, one-way ANOVA and General linear model were used for data analysis.

RESULTS

A significant positive relationship was observed between functional status and self-efficacy (p < 0.001, r = 0.359). According to the adjusted general linear model, self-efficacy, mother's age, income status and planned pregnancy have statistically significant relationships with functional status and explain 33.5% of the variance in the functional status score.

CONCLUSION

The findings of the present study showed that increased postpartum maternal self-efficacy is associated with improved functional status, which requires health providers to evaluate postpartum maternal self-efficacy and make the necessary interventions if it is low.

Social support, acculturation stress, and parenting stress among marriage-migrant women

PURPOSE

The purpose of this study was to identify the relationships between social support, acculturation stress, and the parenting stress of marriage-migrant women.

BACKGROUND

Marriage-migrant women with preschool children appear to experience acculturation and parenting stress. Persistent stress conditions could lead to serious psychological problems. Nevertheless, little is known about the relationship between their stress and social support alleviating stress.

METHODS

A questionnaire survey was conducted among 284 marriage-migrant women with preschool children in South Korea, using a questionnaire translated into Chinese, Vietnamese, English, and Korean. A trained research assistant read the questionnaire and asked participants to provide their responses.

RESULTS

A hierarchical regression analysis revealed that acculturation stress was associated with parenting stress among marriage-migrant women with preschool children, and that acculturation stress was mostly associated with social support. A Sobel test indicated that the effect of social support on parenting stress significantly declined when acculturation stress was treated as a mediator of that relationship. Acculturation stress was a mediator between social support and parenting stress.

CONCLUSION

Nurses must understand the dual stress of acculturation and parenting among marriage-migrant women with preschool children. Furthermore, efforts to support the parenting of marriage-migrant women with preschool children must consider acculturation stress as a major risk factor of parenting stress. Mental health nurses are recommended to conceive programs that reduce the dual stress of acculturation and parenting, which could help improve the mental health of this group.

Parental perception of child vulnerability and parental competence: The role of postnatal depression and parental stress in fathers and mothers

Introduction

Parents' perception that their child may be vulnerable to serious life-threatening illnesses can have negative effects on how they exercise their parenting. No studies have yet been carried out on parent´s perception of their child’s vulnerability, when the child has not suffered a severe illness. This study tries to analyze the relationship between parent´s perception of their children´s vulnerability and parental competence, and analyzes the mediating role of postnatal depression and parental stress.

Method

The study was carried out on mothers and fathers of full-term infants who did not have any serious illnesses. A total of 965 people (385 fathers and 580 mothers) participated in the study.

Results

The results revealed an association between parental perception of their child’s vulnerability and parent’s perception of parental competence through depression and parental stress. However, this association was different for fathers and mothers.

Conclusion

The variable of perception of child’s vulnerability was a relevant factor to understand parental competence.

Psychometric Properties of the Italian Perceived Maternal Parenting Self-Efficacy (PMP S-E)

To validate the Italian Perceived Maternal Parenting Self-Efficacy (PMP S-E), the first questionnaire specifically developed for mothers of preterm neonates hospitalized in the Neonatal Intensive Care Unit. Two hundred mothers filled the PMP S-E, the General Self-Efficacy Scale (GSES), the Edinburgh Postnatal Depression Scale (EPDS), the Parental Distress Index (PSI-SF/Pd). The Explanatory Factor Analysis outlined four factors: care-taking procedures, evoking behaviours, reading and managing bodily cues, reading and managing emotional cues. This factor-solution demonstrated adequate goodness of fit when the Confirmatory Factor Analysis was carried out. Internal consistency was high for the overall scale (α = 0.932), and the all the factors (all α > 0.80). There was a moderate correlation with GSES (r = .438; p < .001), while the associations with EPDS (r = .295; p < .001) and PSI-SF/Pd (r = .193; p = .006) were low. Good test-retest reliability was found over 2 weeks (r = .73; p < .001). These findings support the validity and reliability of the Italian PMP S-E.

Delineating Among Parenting Confidence, Parenting Self-Efficacy, and Competence

This article examined the concepts of parenting self-efficacy, parenting confidence, and competence. Using Morse's method of concept delineation, a literature review of each concept was conducted to uncover commonalities, distinctions, and measurement overlaps between concepts and provide conceptual boundaries. Findings revealed that parenting confidence and parenting self-efficacy describe a parents' internal attribution or beliefs about their ability to engage in parenting behaviors. Both terms have similar antecedents, attributes, and consequences, whereas competence is a concept that should be used as an objective measure by someone other than the parent to assess parenting quality.