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Bailey S, Hurley J, Plummer K, Hutchinson M. Parenting interventions targeting early parenting difficulty: A scoping review. J Child Health Care 2024; 28:429-450. [PMID: 35930709 DOI: 10.1177/13674935221116696] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Parent and child wellbeing are reciprocal. Attentive, responsive parenting, is contingent on parental wellbeing. Insights into mechanisms of early parenting interventions that seek to improve parent and child outcomes are needed. This scoping review aimed to systematically map research reporting on parenting interventions for parents experiencing early parenting difficulty. A secondary aim was to synthesise existing research using a realist lens, to provide context, mechanism and outcome insights into elements of early parenting interventions. A systematic search was conducted across six databases within the publication period of 2010-2020, to identify evidence on interventions targeting early parenting difficulty. Using pre-determined inclusion criteria, fifteen studies were selected for review. Deductive reflexive thematic analysis identified three themes: conceptual disparities in early parenting difficulty, early parenting intervention diversity and an absence of theory to explain interventions or outcomes. Neither early parenting difficulty nor the theoretical basis for early parenting interventions were well defined. Identification of contexts, mechanisms and outcomes of early parenting interventions is a unique contribution of this study. These insights may be used to inform planning, implementation and evaluation activities to promote context-focused, early parenting interventions targeting a critical phase of child development.
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Affiliation(s)
- Sherryn Bailey
- Faculty of Health, Southern Cross University, Coffs Harbour, NSW, Australia
| | - John Hurley
- Faculty of Health, Southern Cross University, Coffs Harbour, NSW, Australia
| | - Karin Plummer
- School of Nursing and Midwifery, Menzies Health Institute, Griffith University, Gold Coast, QLD, Australia
| | - Marie Hutchinson
- Faculty of Health, Southern Cross University, Coffs Harbour, NSW, Australia
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Padilla-Muñoz EM, Barbancho-Morant MM, Lanzarote-Fernández MD, Sanduvete-Chaves S, Chacón-Moscoso S. Psycho-emotional intervention with parents of very preterm babies during the first year: A single-arm pilot study. FAMILY PROCESS 2024. [PMID: 38659149 DOI: 10.1111/famp.13002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 03/11/2024] [Accepted: 03/17/2024] [Indexed: 04/26/2024]
Abstract
Studies of intervention programs that aim to improve the emotional state of parents of children admitted to the neonatal intensive care units (NICU) are scarce in Spain. The aims of this single-arm pilot study are to get to know the emotional profile of parents of high-risk preterm newborns, and to explore parents' patterns of emotional well-being before and after a psychological program called the Parental Empowerment Program, to increase parental readiness levels. The sample was made up of 100 parents (50 couples) who participated in the program. Measurements were taken of post-traumatic stress, depression, and resilience at 1 month and 12 months. Repeated measurements and dyadic data analyses were performed. One month after the birth of the baby and prior to the start of the program, mothers show more symptoms of stress and depression than fathers. After the intervention, both parents experienced improvements in their mood levels. The evidence obtained seems to show that high resilience levels and low post-traumatic stress symptoms are associated with reduced depression levels after implementing the program. However, the heterogeneity of the responses obtained, the observed associations between stress, resilience, and maternal depression, along with the reciprocal influence between maternal and paternal depression 1 year after the intervention, highlight the need for a more in-depth exploration of the interplay between risk and protective factors in this population. Despite the identified potential threats to validity, further work in this direction is recommended, including the implementation of clinical trials to demonstrate intervention efficacy. The adaptation of the parents' mutual emotional adjustment at each stage would allow them to participate more actively in the baby's care.
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Affiliation(s)
| | | | | | | | - Salvador Chacón-Moscoso
- Faculty of Psychology, Universidad de Sevilla, Sevilla, Spain
- Departamento de Psicología, Universidad Autónoma de Chile, Santiago, Chile
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Orton J, Doyle LW, Tripathi T, Boyd R, Anderson PJ, Spittle A. Early developmental intervention programmes provided post hospital discharge to prevent motor and cognitive impairment in preterm infants. Cochrane Database Syst Rev 2024; 2:CD005495. [PMID: 38348930 PMCID: PMC10862558 DOI: 10.1002/14651858.cd005495.pub5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
BACKGROUND Infants born preterm are at increased risk of cognitive and motor impairments compared with infants born at term. Early developmental interventions for preterm infants are targeted at the infant or the parent-infant relationship, or both, and may focus on different aspects of early development. They aim to improve developmental outcomes for these infants, but the long-term benefits remain unclear. This is an update of a Cochrane review first published in 2007 and updated in 2012 and 2015. OBJECTIVES Primary objective To assess the effect of early developmental interventions compared with standard care in prevention of motor or cognitive impairment for preterm infants in infancy (zero to < three years), preschool age (three to < five years), and school age (five to < 18 years). Secondary objective To assess the effect of early developmental interventions compared with standard care on motor or cognitive impairment for subgroups of preterm infants, including groups based on gestational age, birthweight, brain injury, timing or focus of intervention and study quality. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO and trial registries in July 2023. We cross-referenced relevant literature, including identified trials and existing review articles. SELECTION CRITERIA Studies included randomised, quasi-randomised controlled trials (RCTs) or cluster-randomised trials of early developmental intervention programmes that began within the first 12 months of life for infants born before 37 weeks' gestational age (GA). Interventions could commence as an inpatient but had to include a post discharge component for inclusion in this review. Outcome measures were not prespecified, other than that they had to assess cognitive outcomes, motor outcomes or both. The control groups in the studies could receive standard care that would normally be provided. DATA COLLECTION AND ANALYSIS Data were extracted from the included studies regarding study and participant characteristics, timing and focus of interventions and cognitive and motor outcomes. Meta-analysis using RevMan was carried out to determine the effects of early developmental interventions at each age range: infancy (zero to < three years), preschool age (three to < five years) and school age (five to < 18 years) on cognitive and motor outcomes. Subgroup analyses focused on GA, birthweight, brain injury, time of commencement of the intervention, focus of the intervention and study quality. We used standard methodological procedures expected by Cochrane to collect data and evaluate bias. We used the GRADE approach to assess the certainty of evidence. MAIN RESULTS Forty-four studies met the inclusion criteria (5051 randomly assigned participants). There were 19 new studies identified in this update (600 participants) and a further 17 studies awaiting outcomes. Three previously included studies had new data. There was variability in the focus and intensity of the interventions, participant characteristics, and length of follow-up. All included studies were either single or multicentre trials and the number of participants varied from fewer than 20 to up to 915 in one study. The trials included in this review were mainly undertaken in middle- or high-income countries. The majority of studies commenced in the hospital, with fewer commencing once the infant was home. The focus of the intervention programmes for new included studies was increasingly targeted at both the infant and the parent-infant relationship. The intensity and dosages of interventions varied between studies, which is important when considering the applicability of any programme in a clinical setting. Meta-analysis demonstrated that early developmental intervention may improve cognitive outcomes in infancy (developmental quotient (DQ): standardised mean difference (SMD) 0.27 standard deviations (SDs), 95% confidence interval (CI) 0.15 to 0.40; P < 0.001; 25 studies; 3132 participants, low-certainty evidence), and improves cognitive outcomes at preschool age (intelligence quotient (IQ); SMD 0.39 SD, 95% CI 0.29 to 0.50; P < 0.001; 9 studies; 1524 participants, high-certainty evidence). However, early developmental intervention may not improve cognitive outcomes at school age (IQ: SMD 0.16 SD, 95% CI -0.06 to 0.38; P = 0.15; 6 studies; 1453 participants, low-certainty evidence). Heterogeneity between studies for cognitive outcomes in infancy and preschool age was moderate and at school age was substantial. Regarding motor function, meta-analysis of 23 studies showed that early developmental interventions may improve motor outcomes in infancy (motor scale DQ: SMD 0.12 SD, 95% CI 0.04 to 0.19; P = 0.003; 23 studies; 2737 participants, low-certainty evidence). At preschool age, the intervention probably did not improve motor outcomes (motor scale: SMD 0.08 SD, 95% CI -0.16 to 0.32; P = 0.53; 3 studies; 264 participants, moderate-certainty evidence). The evidence at school age for both continuous (motor scale: SMD -0.06 SD, 95% CI -0.31 to 0.18; P = 0.61; three studies; 265 participants, low-certainty evidence) and dichotomous outcome measures (low score on Movement Assessment Battery for Children (ABC) : RR 1.04, 95% CI 0.82 to 1.32; P = 0.74; 3 studies; 413 participants, low-certainty evidence) suggests that intervention may not improve motor outcome. The main source of bias was performance bias, where there was a lack of blinding of participants and personnel, which was unavoidable in this type of intervention study. Other biases in some studies included attrition bias where the outcome data were incomplete, and inadequate allocation concealment or selection bias. The GRADE assessment identified a lower certainty of evidence in the cognitive and motor outcomes at school age. Cognitive outcomes at preschool age demonstrated a high certainty due to more consistency and a larger treatment effect. AUTHORS' CONCLUSIONS Early developmental intervention programmes for preterm infants probably improve cognitive and motor outcomes during infancy (low-certainty evidence) while, at preschool age, intervention is shown to improve cognitive outcomes (high-certainty evidence). Considerable heterogeneity exists between studies due to variations in aspects of the intervention programmes, the population and outcome measures utilised. Further research is needed to determine which types of early developmental interventions are most effective in improving cognitive and motor outcomes, and in particular to discern whether there is a longer-term benefit from these programmes.
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Affiliation(s)
- Jane Orton
- Royal Women's Hospital, Parkville, Australia
- Department of Physiotherapy, University of Melbourne, Parkville, Australia
| | - Lex W Doyle
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
| | - Tanya Tripathi
- Department of Physiotherapy, University of Melbourne, Parkville, Australia
| | - Roslyn Boyd
- The University of Queensland, Brisbane, Australia
| | - Peter J Anderson
- Department of Clinical Sciences, Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
| | - Alicia Spittle
- Department of Physiotherapy, University of Melbourne, Parkville, Australia
- Murdoch Childrens Research Institute and the University of Melbourne, Parkville, Australia
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Chan SH, Shorey S. Effectiveness of psychosocial interventions on the psychological outcomes of parents with preterm infants: A systematic review and meta-analysis. J Pediatr Nurs 2024; 74:23-34. [PMID: 37988885 DOI: 10.1016/j.pedn.2023.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Parents of preterm infants are often thrown unexpectedly into the care of their vulnerable infant, causing them to be stressed and overwhelmed. Social support has been previously highlighted as a crucial factor in helping parents cope with stress. Several psychosocial interventions have thus been developed to support parents of preterm babies, which warrant further investigations. OBJECTIVES To evaluate the effectiveness of psychosocial interventions in reducing stress (primary outcome), anxiety, depression, pediatric medical traumatic stress (PMTS) and increasing social support among parents with preterm infants. METHODS A systematic-review and meta-analysis were conducted. Eight electronic databases were searched for relevant studies from their respective inception dates till September 2023. Meta-analysis was performed with RevMan, using the random-effects model. Heterogeneity was investigated using Cochran Q and I2 tests, and publication bias was assessed using funnel plots. Subgroup analyses were conducted for follow-up measurement, gender of parent, type of intervention provider, and setting. FINDINGS Eighteen studies were included in this review, and all studies were meta-analysed. Participants who received psychosocial interventions reported significantly lower stress and depression in comparison to control group participants. Psychosocial interventions delivered by psychologists and trained researchers were more effective compared to the nurses. The GRADE assessment indicated that the certainty of evidence for all outcomes were very low. CONCLUSION Psychosocial interventions effectively reduce stress and depression levels in parents with preterm infants. Our findings encourage the implementation of psychosocial interventions to improve parental psychological wellbeing. Future higher quality trials are needed to measure psychological outcomes among parents, especially fathers.
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Affiliation(s)
- Sian Hui Chan
- Nursing Division, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074.
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore.
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Laccetta G, Di Chiara M, De Nardo MC, Terrin G. Symptoms of post-traumatic stress disorder in parents of preterm newborns: A systematic review of interventions and prevention strategies. Front Psychiatry 2023; 14:998995. [PMID: 36970259 PMCID: PMC10032332 DOI: 10.3389/fpsyt.2023.998995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 02/07/2023] [Indexed: 03/11/2023] Open
Abstract
BackgroundPreterm birth and subsequent NICU admission can be a traumatic experience for parents who may subsequently develop post-traumatic stress (PTS) disorder (PTSD). Given that developmental issues are common among children of parents with PTSD, interventions for prevention and treatment are essential.ObjectiveTo assess the most effective non-pharmacological interventions to prevent and/or treat PTS symptoms in parents of preterm newborns.MethodsSystematic review performed in accordance with the PRISMA statements. Eligible articles in English language were searched in MEDLINE, Scopus, and ISI Web of Science databases using the following medical subject headings and terms: “stress disorder, post-traumatic,” “parents,” “mothers,” “fathers,” “infant, newborn,” “intensive care units, neonatal,” and “premature birth.” The terms “preterm birth” and “preterm delivery” were also used. Unpublished data were searched in ClinicalTrials.gov website. All intervention studies published until September 9th, 2022 and including parents of newborns with gestational age at birth (GAb) <37 weeks which underwent ≥1 non-pharmaceutical interventions for prevention and/or treatment of PTS symptoms related to preterm birth were included. Subgroup analyses were conducted by type of intervention. The quality assessment was performed according to the criteria from the RoB-2 and the “NIH Quality Assessment Tool for Before-After studies.”ResultsSixteen thousand six hundred twenty-eight records were identified; finally, 15 articles (1,009 mothers, 44 fathers of infants with GAb ≤ 366/7 weeks) were included for review. A good standard of NICU care (effective as sole intervention: 2/3 studies) and education about PTSD (effective in association with other interventions: 7/8 studies) could be offered to all parents of preterm newborns. The 6-session Treatment Manual is a complex intervention which revealed itself to be effective in one study with low risk of bias. However, the effectiveness of interventions still remains to be definitively established. Interventions could start within 4 weeks after birth and last 2–4 weeks.ConclusionThere is a wide range of interventions targeting PTS symptoms after preterm birth. However, further studies of good quality are needed to better define the effectiveness of each intervention.
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McCarty DB, Letzkus L, Attridge E, Dusing SC. Efficacy of Therapist Supported Interventions from the Neonatal Intensive Care Unit to Home: A Meta-Review of Systematic Reviews. Clin Perinatol 2023; 50:157-178. [PMID: 36868703 DOI: 10.1016/j.clp.2022.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
Infants born preterm or with complicated medical conditions requiring care in the neonatal intensive care unit (NICU) are at high risk for long-term developmental disabilities. The transition from NICU to early intervention/outpatient settings results in a disruptive gap in a therapeutic intervention during a period of maximal neuroplasticity and development. This meta-review evaluated evidence from existing systematic reviews regarding therapeutic interventions that start in the NICU and continue at home with the goal of improving developmental outcomes for infants at high risk for cerebral palsy. We also evaluated the impact of these interventions on parents' mental health outcomes.
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Affiliation(s)
- Dana B McCarty
- Division of Physical Therapy, Department of Health Sciences, The University of North Carolina at Chapel Hill, 3024 Bondurant Hall, CB#7135, Chapel Hill, NC 27599-7135, USA
| | - Lisa Letzkus
- Division of Neurodevelopmental and Behavioral Pediatrics, Department of Pediatrics, University of Virginia, 101 Hospital Drive, Charlottesville, VA, 22903 USA
| | - Elaine Attridge
- Claude Moore Health Sciences Library, University of Virginia, PO Box 800722, Charlottesville, VA 22908, USA
| | - Stacey C Dusing
- Division of Biokinesiology and Physical Therapy, University of Southern California, 1540 East Alcazar Street, CHP 155, Los Angeles CA 90033, USA.
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Larsson J, Nyborg L, Psouni E. The Role of Family Function and Triadic Interaction on Preterm Child Development-A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1695. [PMID: 36360423 PMCID: PMC9689109 DOI: 10.3390/children9111695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 10/31/2022] [Accepted: 11/02/2022] [Indexed: 09/22/2023]
Abstract
Preterm infants are at high risk of developmental disability/delay and are more dependent on their caregiving environment for regulation due to their neurological immaturity. A premature birth is also a major stressor to the family system that constitutes the infant's caregiving environment. The following systematic review investigates whether families with preterm children differ from families with full-term children in their interactions, and what impact the quality of family interaction has on child development. Using the Cochrane model, we conducted a systematic review of quantitative studies published in psycINFO, socINDEX, and PubMed, concerning family quality in triadic interactions in families with premature infants and children, and at least one child development outcome variable. The quality of these studies was assessed using the Newcastle-Ottawa scale assessment form for cohort studies (NOS). Eleven studies were included in the review. Quality of family interactions is either equal to or poorer in families with preterm children, compared with families with full-term children. Importantly, the link between quality of family interactions and child development outcome is stronger in preterm children compared with full-term children, regarding both positive and negative influence. Our results highlight the importance of strengthening family interactions in order to promote development in preterm children. Notably, this review provides the first systematic overview of family function and the quality of triadic interactions in preterm families. The limited number of studies with a family-system focus makes it difficult for us to draw any definitive conclusions, while underscoring the need for more observational studies, particularly post-infancy, to be able to identify specific aspects of family interactions that may be critical for preterm child development.
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Affiliation(s)
| | | | - Elia Psouni
- Department of Psychology, Lund University, 221 00 Lund, Sweden
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8
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da Cunha AFS, de Brito Brandão M, Gontijo APB, de Miranda DM, de Melo Mambrini JV, Mancini MC. Parental priorities in the home care of preterm and full term newborns. Early Hum Dev 2022; 173:105658. [PMID: 36007454 DOI: 10.1016/j.earlhumdev.2022.105658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND The initial weeks after hospital discharge is a period of adaptation when parents assume great responsibility for the care of their child. Preterm birth may impact their demands of care. AIMS To compare parental priorities in the care of preterm and full-term newborns in the first two months after hospital discharge and to identify changes in priorities over time. METHODS Parents of 22 full-term and 19 preterm infants were followed for two months after hospital discharge, with three timepoint evaluations of the parental priorities. They reported on infant care demands in a semi-structured interview. RESULTS Despite prematurity, demands were similar between groups. Within-group changes occurred over time. Priorities related to bathing and caring for the navel showed significant reduction (p < 0.01); demands related to children's health care increased in the groups (p < 0.01). Feeding and sleep priorities were reduced in the full-term group (p < 0.02). Children's adaptation to routine increased significantly in the preterm group (p = 0.04). CONCLUSION Knowledge of parents' priorities in caring for preterm or full-term newborns at home helps health care teams develop appropriate support strategies and improve specialized assistance to the families.
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Affiliation(s)
- Agnes Flórida Santos da Cunha
- Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Campus Pampulha, Belo Horizonte 31270-901, MG, Brazil
| | - Marina de Brito Brandão
- Department of Occupational Therapy, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Campus Pampulha, Belo Horizonte 31270-901, MG, Brazil
| | - Ana Paula Bensemann Gontijo
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Campus Pampulha, Belo Horizonte 31270-901, MG, Brazil
| | - Débora Marques de Miranda
- Departament of Medicine, Universidade Federal de Minas Gerais, , Av. Antônio Carlos 6627, Campus Pampulha, Belo Horizonte 31270-901, MG, Brazil
| | | | - Marisa Cotta Mancini
- Department of Occupational Therapy, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Campus Pampulha, Belo Horizonte 31270-901, MG, Brazil.
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Post-partum Women’s Anxiety and Parenting Stress: Home-Visiting Protective Effect During the COVID-19 Pandemic. Matern Child Health J 2022; 26:2308-2317. [PMID: 36153448 PMCID: PMC9510513 DOI: 10.1007/s10995-022-03540-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2022] [Indexed: 12/05/2022]
Abstract
Objectives The COVID-19 pandemic resulted in a particularly adverse and stressful environment for expecting mothers, possibly enhancing feelings of anxiety and parenting stress. The present work assesses mothers' anxiety levels at delivery and parenting stress after 3 months as moderated by home-visiting sessions. Methods Women (n = 177) in their second or third trimester of pregnancy during the COVID-19 lockdown were enrolled in northern Italy and split into those who did and did not receive home visits. After 3 months, the association between anxiety at delivery and parenting stress was assessed with bivariate correlations in the whole sample and comparing the two groups. Results Higher anxiety at birth correlated with greater perceived stress after 3 months. Mothers who received at least one home-visiting session reported lower parenting stress at 3 months than counterparts who did not receive home visits. Conclusions for Practice The perinatal period is a sensitive time window for mother-infant health, especially during a critical time like the COVID-19 pandemic. We suggest that home-visiting programs could be beneficial during global healthcare emergencies to promote maternal well-being after delivery.
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Martínez-Shaw ML, Sánchez-Sandoval Y. Effective stress intervention programs for parents of premature children: A systematic review. Stress Health 2022; 39:236-254. [PMID: 36029285 DOI: 10.1002/smi.3194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 07/25/2022] [Accepted: 08/16/2022] [Indexed: 11/10/2022]
Abstract
The birth of a child alters family dynamics and can be stressful for parents, especially in the case of prematurity. This article carried out a systematic review on interventions in parents to reduce the stress experienced by the birth of a premature infant. The aims were to describe and classify the different interventions and to have an overview of their effectiveness. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guide and the PICO model. For searching the bibliography, we used Web of Science, Science Direct, PubMed and PsycINFO databases. From a total of 450 articles identified, this review finally included 46 studies with empirical evidence. The articles clustered into different types of interventions, such as psychoeducational and parental or maternal support programs, relaxation techniques, expressive writing, art therapy, music therapy and interventions related to interaction and tactile stimulation. There is a wide range of effectiveness in reducing parental stress to a greater or lesser degree. There is a great heterogeneity of interventions. Despite that, they all have a parental educational component that needs to be studied in greater depth.
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Affiliation(s)
- Melissa Liher Martínez-Shaw
- Departamento de Psicología, Instituto de Investigación e Innovación Biomédica de Cádiz (INIBICA), Universidad de Cádiz, Cádiz, Spain
| | - Yolanda Sánchez-Sandoval
- Departamento de Psicología, Instituto de Investigación e Innovación Biomédica de Cádiz (INIBICA), Universidad de Cádiz, Cádiz, Spain
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Trumello C, Ballarotto G, Ricciardi P, Paciello M, Marino V, Morelli M, Tambelli R, Babore A. Mothers and fathers of pre-school children: a study on parenting stress and child's emotional-behavioral difficulties. CURRENT PSYCHOLOGY 2022; 42:1-12. [PMID: 36035250 PMCID: PMC9395769 DOI: 10.1007/s12144-022-03599-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 07/31/2022] [Accepted: 08/01/2022] [Indexed: 11/29/2022]
Abstract
The present study aimed to analyze the differences between maternal and paternal parenting stress and children's behavioral functioning, as determined by teacher and parent reports. In addition, it sought to evaluate the presence of clusters based on parenting stress and to determine whether perceptions of children's behavioral functioning varied across these clusters. The sample was composed of the parents and teachers of N = 201 children. Parents completed a self-report questionnaire on parenting stress and parents and teachers filled out report-form questionnaires assessing children's emotional and behavioral functioning. The results showed that mothers had higher levels of parenting stress than fathers, and both parents reported more prosocial behavior in children than did teachers. Furthermore, middle stressed parents had children who expressed more prosocial behavior than did parents in other clusters. The findings also showed that parenting stress influenced partners' perceptions of children's behavioral functioning. The multiplicity of child observers facilitated a better understanding of how parenting stress, linked to parent-child interactions, may play an important role in shaping parents' perceptions of their children.
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Affiliation(s)
- Carmen Trumello
- Department of Psychological, Health and Territorial Sciences, University G. d’Annunzio of Chieti, Chieti, Italy
| | - Giulia Ballarotto
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, via degli Apuli 1, 00185 Rome, Italy
| | - Piera Ricciardi
- Department of Psychological, Health and Territorial Sciences, University G. d’Annunzio of Chieti, Chieti, Italy
| | - Marinella Paciello
- Faculty of Psychology, International Telematic University Uninettuno, Rome, Italy
| | - Valentina Marino
- Department of Psychological, Health and Territorial Sciences, University G. d’Annunzio of Chieti, Chieti, Italy
| | - Mara Morelli
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, via degli Apuli 1, 00185 Rome, Italy
| | - Renata Tambelli
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, via degli Apuli 1, 00185 Rome, Italy
| | - Alessandra Babore
- Department of Psychological, Health and Territorial Sciences, University G. d’Annunzio of Chieti, Chieti, Italy
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Rodrigues AL, Ericksen J, Watson B, Gemmill AW, Milgrom J. Interventions for Perinatal Depression and Anxiety in Fathers: A Mini-Review. Front Psychol 2022; 12:744921. [PMID: 35126228 PMCID: PMC8810528 DOI: 10.3389/fpsyg.2021.744921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 12/28/2021] [Indexed: 11/18/2022] Open
Abstract
Background and Objectives Up to 10% of fathers experience perinatal depression, often accompanied by anxiety, with a detrimental impact on the emotional and behavioural development of infants. Yet, few evidence-based interventions specifically for paternal perinatal depression or anxiety exist, and few depressed or anxious fathers engage with support. This mini-review aims to build on the evidence base set by other recent systematic reviews by synthesising more recently available studies on interventions for paternal perinatal depression and anxiety. Secondarily, we also aimed to identify useful information on key implementation strategies, if any, that increase the engagement of men. Methods We drew upon three major previous systematic reviews and performed an updated search of PubMed/Medline; Psycinfo; Cochrane Database; Embase and Cinahl. The search was limited to trials, feasibility studies or pilot studies of interventions published between 2015 and 2020 that reported on fathers' perinatal mental health. We included psychological, educational, psychosocial, paternal, couple-focused, or group therapies, delivered face-to-face, via telephone and/or online that reported on either paternal depression, anxiety or both. Results Eleven studies satisfied search criteria (5 of which were not included in previous reviews). The majority were randomised controlled trials. Most interventions incorporated counselling, therapy or psychoeducation and took an indirect approach to perinatal mental health through antenatal or postnatal education and were couple-focused. No studies reported a presence of diagnosed depression or anxiety at baseline, although five studies reported a positive effect on sub-threshold symptoms. Discussion There was some evidence that these approaches may be useful in the initial engagement of fathers with perinatal supports and improve depression and anxiety scores. No studies targeted the explicit treatment of clinically depressed or anxious men, and this remains the most substantial gap in the peer-reviewed evidence base. Our results highlight the need to deliver perinatal interventions specifically designed for men and evaluate them in populations with clinical levels of depressive and anxious symptomatology.
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Affiliation(s)
- Andre L. Rodrigues
- Parent-Infant Research Institute, Heidelberg Repatriation Hospital, Heidelberg Heights, VIC, Australia
| | - Jennifer Ericksen
- Parent-Infant Research Institute, Heidelberg Repatriation Hospital, Heidelberg Heights, VIC, Australia
| | - Brittany Watson
- Parent-Infant Research Institute, Heidelberg Repatriation Hospital, Heidelberg Heights, VIC, Australia
| | - Alan W. Gemmill
- Parent-Infant Research Institute, Heidelberg Repatriation Hospital, Heidelberg Heights, VIC, Australia
| | - Jeannette Milgrom
- Parent-Infant Research Institute, Heidelberg Repatriation Hospital, Heidelberg Heights, VIC, Australia
- University of Melbourne School of Psychological Sciences, Parkville, VIC, Australia
- *Correspondence: Jeannette Milgrom
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The Influence of Maternal Cognitions Upon Motor Development in Infants Born Preterm: A Scoping Review. Pediatr Phys Ther 2021; 33:137-147. [PMID: 34151889 DOI: 10.1097/pep.0000000000000806] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE This scoping review summarizes the extent, nature, and type of evidence linking broadly defined maternal cognitions to motor outcomes in infants born preterm. Maternal cognitions are beliefs, perceptions, or psychosocial attributes that inform parenting practices. METHODS Arksey and O'Malley's 5-step method was applied. Thirteen articles between 1980 and November 2019 met inclusion criteria. RESULTS Two key themes emerged with infants born preterm: (1) quality of the social and physical caregiving environment influence developmental outcomes with implications for motor development; and (2) complex interactions between environmental factors, prematurity-related biomedical risks, and maternal cognitions contribute to eventual motor outcomes. CONCLUSION Further research is needed to understand how maternal cognitions either scaffold or constrain early motor opportunities for infants born preterm and at risk for motor delays. WHAT THIS ADDS TO THE EVIDENCE This review summarizes studies that explore potential links between maternal cognitions and motor development in infants born preterm.
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Mousavi SS, Keramat A, Chaman R, Mohagheghi P, Mousavi SA, Khosravi A. Impact of Maternity Support Program on the Stress of Mothers in the First Encounter with the Preterm Infants. Int J Prev Med 2021; 12:68. [PMID: 34447510 PMCID: PMC8356949 DOI: 10.4103/ijpvm.ijpvm_314_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 04/18/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Mothers of premature infants experience a high level of stress. The current study was conducted aiming at investigating the impact of maternity support program on the stress of mothers in the first encounter with infants. METHODS This experimental study began in neonatal intensive care units (NICUs) of two hospitals of Tehran; that is, Mahdieh (intervention) and Shahid Akbar-Abadi (control), from Feb 14, 2016, to May 14, 2016. Both are educational and referral centers including three levels of NICU that were randomly allocated to intervention and control sites. In the span of study period all 75 infants and mothers with inclusion/exclusion criteria in the Mahdieh hospital were included in the intervention group and vis-à -vis all 68 infants and mothers in Shahid-Akbar-Abadi were enrolled in the control group. The designed intervention was conducted based on the support system pattern of mothers with premature infants in the interventional group. In the first stage of intervention, in the intervention group, mothers were provided informational, emotional, and spiritual support before and during the first exposure and were empowered for comfortable interactions. The control group received routine care. After the first exposure, the mothers' stress was measured by the Parental Stressor Scale: Neonatal Intensive Care Unit (PSS: NICU). The data were analyzed by STATA software as well as t-test, Chi-square, and average treatment effects (ATEs) were estimated using inverse probability treatment weights (IPTW). RESULTS After adjusting pre-treatment variables by IPTW, the adjusted average difference in the stress score over the NICU environment, infant's behavior and appearance, the special treatments on him/her, and the change in the parental role and total stress were 1.47 (1.19-1.75), 1.06 (0.73-1.14), 1.21 (0.93-1.49), and 1.18 (0.93-1.44), which were lower than the control group (P < 0.001). CONCLUSIONS The intervention reduced significantly the stress of mothers. The policy-makers are suggested to conduct this method.
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Affiliation(s)
- Seyedeh S. Mousavi
- Nursing Care Research Center (NCRC), Department of Midwifery and Reproductive Health, Iran University of Medical Sciences, Tehran, Iran
| | - Afsaneh Keramat
- Department of Reproductive Health, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Reza Chaman
- Department of Epidemioligy, School of Health, Shiraz University of Medical Science, Shiraz, Iran
| | - Parisa Mohagheghi
- Hazrate Rasoul Medical Center, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed A. Mousavi
- Department of Psychiatry, Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ahmad Khosravi
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
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Girabent-Farrés M, Jimenez-Gónzalez A, Romero-Galisteo RP, Amor-Barbosa M, Bagur-Calafat C. Effects of early intervention on parenting stress after preterm birth: A meta-analysis. Child Care Health Dev 2021; 47:400-410. [PMID: 33559337 DOI: 10.1111/cch.12853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 12/18/2020] [Accepted: 02/03/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Preterm infants have a higher risk of development disorders. Prematurity can be considered a source of stress, in both children and their parents, due to the high number of interventions that they require. Early intervention (EI) programmes have shown to have a positive influence on the neurodevelopment of children with neurological risk. On the other hand, parenting stress has a negative influence on the development of any child. This systematic review aimed to identify the effect of EI programmes on decreasing parenting stress suffered by parents of preterm babies. METHODS Systematic review and meta-analysis of experimental studies in accordance with the PRISMA declaration guidelines were applied in this work. RESULTS Fifteen randomized clinical trials were included whose methodological quality was assessed using the PEDro scale. Stress data extraction was meta-analysed using the inverse variance method in a random effects model. Statistical heterogeneity was assessed with the I2 heterogeneity statistic. The domains most commonly reported in the trials were the childcare-related stress (Child Domain), personal discomfort (Parent Domain) and computation of both (Total Stress). The results showed significant (P < 0,05) and clinically relevant differences in favour of the EI programme group at 18 months and 5 years. CONCLUSIONS This review found moderate to strong evidence of the impact of EI programmes on the reduction of parenting stress in parents of preterm babies. These findings offer useful insights regarding the delivery of current support and the development of future family interventions. Finally, recommendations are provided for future intervention evaluation studies in this area.
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Affiliation(s)
- Montserrat Girabent-Farrés
- Department of Physiotherapy, School of Health Sciences, TecnoCampus-Pompeu Fabra University, Barcelona, Spain
| | | | | | - Marta Amor-Barbosa
- Physiotherapy Department, Universitat Internacional de Catalunya, Barcelona, Spain
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White-Traut R, Brandon D, Kavanaugh K, Gralton K, Pan W, Myers ER, Andrews B, Msall M, Norr KF. Protocol for implementation of an evidence based parentally administered intervention for preterm infants. BMC Pediatr 2021; 21:142. [PMID: 33761902 PMCID: PMC7988259 DOI: 10.1186/s12887-021-02596-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/07/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Multi-sensory behavioral interventions for preterm infants have the potential to accelerate feeding, growth, and optimize developmental trajectories and increase parents' interactive engagement with their infants. However, few neonatal intensive care units (NICUs) provide evidence-based standardized early behavioral interventions as routine care. Lack of implementation is a major gap between research and clinical practice. H-HOPE, is a standardized behavioral intervention with an infant- directed component (Massage+) and a parent-directed component (four participatory guidance sessions that focus on preterm infants' behaviors and appropriate responses). H-HOPE has well documented efficacy. The purpose of this implementation study is to establish H-HOPE as the standard of care in 5 NICUs. METHODS The study employs a Type 3 Hybrid design to simultaneously examine the implementation process and effectiveness in five NICUs. To stagger implementation across the clinical sites, we use an incomplete stepped wedge design. The five participating NICUs were purposively selected to represent different acuity levels, number of beds, locations and populations served. Our implementation strategy integrates our experience conducting H-HOPE and a well-established implementation model, the Consolidated Framework for Implementation Research (CFIR). The CFIR identifies influences (facilitators and barriers) that affect successful implementation within five domains: intervention characteristics, outer setting (the hospital and external events and stakeholders), inner setting (NICU), implementers' individual characteristics, and the implementation process. NICUs will use the CFIR process, which includes three phases: Planning and Engaging, Executing, and Reflecting and Evaluating. Because sustaining is a critical goal of implementation, we modify the CFIR implementation process by adding a final phase of Sustaining. DISCUSSION This study builds on the CFIR, adding Sustaining H-HOPE to observe what happens when sites begin to maintain implementation without outside support, and extends its use to the NICU acute care setting. Our mixed methods analysis systematically identifies key facilitators and barriers of implementation success and effectiveness across the five domains of the CFIR. Long term benefits have not yet been studied but may include substantial health and developmental outcomes for infants, more optimal parent-child relationships, reduced stress and costs for families, and substantial indirect societal benefits including reduced health care and special education costs. TRIAL REGISTRATION ClinicalTrials.gov registration number NCT04555590 , Registered on 8/19/2020.
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Affiliation(s)
- Rosemary White-Traut
- Department of Nursing Research and Evidence-Based Practice, Children's Wisconsin, Milwaukee, WI, USA.
- Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.
| | - Debra Brandon
- School of Nursing, Duke University, Durham, North Carolina, USA
| | - Karen Kavanaugh
- Department of Nursing Research and Evidence-Based Practice, Children's Wisconsin, Milwaukee, WI, USA
- Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Karen Gralton
- Department of Nursing Research and Evidence-Based Practice, Children's Wisconsin, Milwaukee, WI, USA
| | - Wei Pan
- School of Nursing and Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Evan R Myers
- Division of Women's Community and Population Health, Department of Obstetrics & Gynecology, Duke University School of Medicine, Duke University, Durham, North Carolina, USA
| | - Bree Andrews
- College of Medicine, Department of Pediatrics, University of Chicago, Chicago, IL, USA
| | - Michael Msall
- College of Medicine, Department of Pediatrics, University of Chicago, Chicago, IL, USA
| | - Kathleen F Norr
- Department of Nursing Research and Evidence-Based Practice, Children's Wisconsin, Milwaukee, WI, USA
- Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
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Kang SR, Cho H. Research Trends of Follow-Up Care after Neonatal Intensive Care Unit Graduation for Children Born Preterm: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3268. [PMID: 33809933 PMCID: PMC8004188 DOI: 10.3390/ijerph18063268] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/16/2021] [Accepted: 03/19/2021] [Indexed: 11/23/2022]
Abstract
The purpose of this study was to describe the trends of research on follow-up care after neonatal intensive care unit (NICU) graduation for children born preterm. This scoping review was conducted according to Arksey and O'Malley's guidelines. Reviewed studies were searched in PubMed, CHINAHL, and Web of Science. Fifteen studies were analyzed according to general characteristics, elements of follow-up care after NICU graduation, and characteristics of follow-up care intervention after NICU graduation. Most research was conducted in the medical field (60%), with experimental studies (40%) being the majority, and a few studies focused on families (3%) and parents (3%). The major follow-up care after NICU graduation elements were growth/developmental monitoring and support, continuity of care, parent- and family-centered elements, and a multidisciplinary approach. The intervention methods included home visits, phone calls, video calls, and applications. In addition, the intervention period ranged from two weeks to three years. It is suggested that multidisciplinary research with interactive media for a various age of children over longer periods for further study.
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Affiliation(s)
- So Ra Kang
- College of Nursing, Ewha Womans University, Seoul 03760, Korea;
| | - Haeryun Cho
- Department of Nursing, Wonkwang University, Iksan 54538, Korea
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Gorman G, Toomey E, Flannery C, Redsell S, Hayes C, Huizink A, Kearney PM, Matvienko-Sikar K. Fidelity of Interventions to Reduce or Prevent Stress and/or Anxiety from Pregnancy up to Two Years Postpartum: A Systematic Review. Matern Child Health J 2020; 25:230-256. [PMID: 33237506 DOI: 10.1007/s10995-020-03093-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Intervention fidelity refers to whether an intervention is delivered as intended and can enhance interpretation of trial outcomes. Fidelity of interventions to reduce or prevent stress and anxiety during pregnancy and postpartum has yet to be examined despite inconsistent findings for intervention effects. This study systematically reviews use and/or reporting of intervention fidelity strategies in trials of interventions, delivered to (expectant) parents during pregnancy and postpartum, to reduce or prevent stress and/or anxiety. METHODS MEDLINE, Embase, CINAHL, PsychINFO, and Maternity and Infant Care were searched from inception to March 2019. Studies were included if they were randomised controlled trials including pregnant women, expectant fathers and/or partners during pregnancy, and/ or parents within the first two years postpartum. The National Institutes of Health Behavior Change Consortium checklist was used to assess fidelity across five domains (study design, provider training, delivery, receipt, enactment). RESULTS Sixteen papers (14 interventions) were identified. Average reported use of fidelity strategies was 'low' (45%), ranging from 17.5 to 76%. Fidelity ratings ranged from 22% for provider training to 54% for study design. CONCLUSIONS Low levels of intervention fidelity may explain previous inconsistent effects of stress and anxiety reduction interventions. Important methodological areas for improvement include intervention provider training, fidelity of comparator conditions, and consideration of non-specific treatment effects. Increased methodological rigour in fidelity enhancement and assessment will improve intervention implementation and enhance examination of stress and anxiety reduction and prevention interventions delivered during pregnancy and the postpartum.
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Affiliation(s)
- Gregory Gorman
- School of Public Health, University College Cork, Western Gateway Building, Western Road, Cork, Ireland
| | - Elaine Toomey
- School of Allied Health, University of Limerick, Limerick, Ireland
| | - Caragh Flannery
- School of Public Health, University College Cork, Western Gateway Building, Western Road, Cork, Ireland
| | - Sarah Redsell
- School of Medicine, University of Nottingham, Nottingham, England
| | | | - Anja Huizink
- Department of Clinical, Neuro- and Developmental Psychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Patricia M Kearney
- School of Public Health, University College Cork, Western Gateway Building, Western Road, Cork, Ireland
| | - Karen Matvienko-Sikar
- School of Public Health, University College Cork, Western Gateway Building, Western Road, Cork, Ireland. .,School of Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland.
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Dickinson C, Whittingham K, Sheffield J, Wotherspoon J, Boyd RN. Efficacy of interventions to improve psychological adjustment for parents of infants with or at risk of neurodevelopmental disability: A systematic review. Infant Ment Health J 2020; 41:697-722. [DOI: 10.1002/imhj.21871] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Corrine Dickinson
- Faculty of Medicine Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre The University of Queensland South Brisbane Australia
- Queensland Children's Hospital Children's Health Queensland South Brisbane Australia
| | - Koa Whittingham
- Faculty of Medicine Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre The University of Queensland South Brisbane Australia
| | - Jeanie Sheffield
- The School of Psychology The University of Queensland Brisbane Australia
| | - Jane Wotherspoon
- Faculty of Medicine Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre The University of Queensland South Brisbane Australia
| | - Roslyn N Boyd
- Faculty of Medicine Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre The University of Queensland South Brisbane Australia
- Queensland Children's Hospital Children's Health Queensland South Brisbane Australia
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Goldstein Z, Rosen B, Howlett A, Anderson M, Herman D. Interventions for paternal perinatal depression: A systematic review. J Affect Disord 2020; 265:505-510. [PMID: 32090778 DOI: 10.1016/j.jad.2019.12.029] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 12/20/2019] [Accepted: 12/20/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND The prevalence of paternal perinatal depression (PPD) is approximately 10%. Despite this epidemiology and what is known about the importance of paternal mental health to family functioning, there is limited research on evidence-based interventions for PPD. This systematic review aimed to investigate the literature for randomized-controlled trials (RCT) of interventions for PPD. METHODS This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases searched included Medline, EMBASE, EBM Reviews, PubMed, PsycInfo, and CINAHL. Search terms included depression, depressive disorder, fathers, pregnancy, and peripartum period, etc. RESULTS: The search strategy identified 2949 items. A total of 10 interventions over the course of 25 years of research met inclusion criteria. Three of the included studies found a small but significant effect on paternal depression scores. However, none of the included studies exclusively targeted paternal mental health. Instead, they addressed paternal well-being indirectly by focusing on the mother, infant, or couple relationship. LIMITATIONS Studies did not require fathers to meet criteria for depression at baseline. This may have resulted in a selection bias, whereby the included fathers may not have required any treatment. We were also unable to perform additional statistical analyses because of the limited research available as well as the inconsistent outcome measures. CONCLUSIONS There remains limited research on interventions assessing paternal depressive symptomatology, and none have targeted diagnosed PPD. Because of the prevalence and impact of this disorder, it is imperative to identify and offer treatments and interventions specifically tailored towards this population.
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Affiliation(s)
- Zoë Goldstein
- Mount Sinai Hospital. University of Toronto. Toronto, Canada.
| | - Ben Rosen
- Mount Sinai Hospital. University of Toronto. Toronto, Canada
| | - Andrew Howlett
- Mount Sinai Hospital. University of Toronto. Toronto, Canada
| | | | - David Herman
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
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Matvienko-Sikar K, Flannery C, Redsell S, Hayes C, Kearney PM, Huizink A. Effects of interventions for women and their partners to reduce or prevent stress and anxiety: A systematic review. Women Birth 2020; 34:e97-e117. [PMID: 32107141 DOI: 10.1016/j.wombi.2020.02.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 02/09/2020] [Accepted: 02/09/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND The period from conception to two years postpartum (the first 1000 days) represents a normative transitional period, which can be potentially stressful for some parents. Parental stress and anxiety adversely impacts psychological and physical health for parents and children. AIM The aim of this review is to systematically examine effects of interventions for women and their partners to reduce or prevent stress and/or anxiety during the first 1000 days. METHODS MEDLINE, Embase, CINAHL, PsychINFO, and Maternity and Infant Care were searched from inception to March 2019. Randomised controlled trials examining intervention effects on parental stress and/or anxiety during first 1000 days were eligible for inclusion. Data were independently extracted by two reviewers and narratively synthesised. FINDINGS Fifteen interventions, reported in 16 studies, met inclusion criteria (n=1911 participants). Overall, findings were inconsistent and the majority of trials demonstrated high risk of bias. Interventions were predominantly delivered to women during pregnancy and only two studies included fathers. There was some evidence that adapting interventions to the pre and postnatal periods provided benefits for stress and anxiety reduction, however there was limited evidence for individual intervention types or approaches. CONCLUSIONS There is currently inconsistent evidence of what interventions are most effective for women during the first 1000 days and there is insufficient evidence for any interventions for male partners during this period. There is a clear need for rigorous development and examination of interventions developed specifically to reduce or prevent stress and/or anxiety across the first 1000 days.
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Affiliation(s)
| | | | - Sarah Redsell
- School of Medicine, University of Nottingham, United Kingdom
| | | | | | - Anja Huizink
- Department of Clinical, Neuro- and Developmental Psychology, VU University Amsterdam, Amsterdam, The Netherlands
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Kang NR, Kim DH, Kwack YS. The Effect of Community-Based Parent Education Program on Parenting Stress According to Adult Attachment Styles. Soa Chongsonyon Chongsin Uihak 2019; 30:178-184. [PMID: 32595339 PMCID: PMC7298908 DOI: 10.5765/jkacap.190026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 08/29/2019] [Accepted: 09/16/2019] [Indexed: 11/05/2022] Open
Abstract
Objectives The aim of this study was to measure the effect of a group-based parent education program on parenting stress and attitude and comparing the same according to adult attachment styles. Methods Twenty-two mothers who enrolled in the parent education program participated in our study. The participants filled in the Korean version of the Experience in Close Relationship Revised (ECR-R), Korean-Parenting Stress Index-Short Form (K-PSI-SF), Maternal Behavior Research Instrument (MBRI), and Symptom Checklist-90-Revised (SCL-90-R) before and after the program. We compared the pre-and post-scores of the groups and compared the differences in effect according to adult attachment styles. Results For all study participants, the Parent Distress (p=0.023) and Total Parenting Stress (p=0.018) significantly declined after the parent education program. There were no differences in other variables. Within the secure attachment group, the Total Parenting Stress (p= 0.008), Parent Distress (p=0.015), and Difficult Child (p=0.011) scores in the K-PSI-SF significantly decreased after participating in the program. The Difficult Child scores (p=0.040) significantly dropped in the K-PSI-SF post program within the secure attachment group, compared to the insecure attachment group. Conclusion The group-based parent education program impacted parenting stress. Depending on the adult attachment styles, the effect of the program varied.
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Affiliation(s)
- Na Ri Kang
- Department of Psychiatry, Jeju National University School of Medicine, Jeju, Korea
| | - Do Hoon Kim
- Department of Psychiatry, Kyungpook National University Hospital, Daegu, Korea
| | - Young Sook Kwack
- Department of Psychiatry, Jeju National University School of Medicine, Jeju, Korea
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Finlay‐Jones A, Varcin K, Leonard H, Bosco A, Alvares G, Downs J. Very Early Identification and Intervention for Infants at Risk of Neurodevelopmental Disorders: A Transdiagnostic Approach. CHILD DEVELOPMENT PERSPECTIVES 2019. [DOI: 10.1111/cdep.12319] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Gray PH, Edwards DM, Hughes IP, Pritchard M. Social-emotional development in very preterm infants during early infancy. Early Hum Dev 2018; 121:44-48. [PMID: 29775884 DOI: 10.1016/j.earlhumdev.2018.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 04/23/2018] [Accepted: 05/03/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Peter H Gray
- Growth and Development Unit, Mater Mothers' Hospital, South Brisbane, Queensland, Australia; Mater Research Institute, University of Queensland, South Brisbane, Queensland, Australia.
| | - Dawn M Edwards
- Growth and Development Unit, Mater Mothers' Hospital, South Brisbane, Queensland, Australia
| | - Ian P Hughes
- Mater Research Institute, University of Queensland, South Brisbane, Queensland, Australia.
| | - Margo Pritchard
- Mater Research Institute, University of Queensland, South Brisbane, Queensland, Australia; Australian Catholic University, Mater Health Services, South Brisbane, Queensland, Australia.
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Gray PH, Edwards DM, Gibbons K. Parenting stress trajectories in mothers of very preterm infants to 2 years. Arch Dis Child Fetal Neonatal Ed 2018; 103:F43-F48. [PMID: 28659361 DOI: 10.1136/archdischild-2016-312141] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 04/25/2017] [Accepted: 04/26/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To examine levels of parenting stress in mothers of preterm and term infants when the children were 2 years old; to determine the trajectory of stress over three time periods and to examine the association of maternal and neonatal factors and developmental outcomes with parenting stress. DESIGN It is a prospective longitudinal study to determine parenting stress in mothers of preterm and term infants with outcomes having been previously obtained at 4 and 12 months. At 2 years, 79 preterm mothers (96 babies) and 64 term mothers (77 babies) participated. The mothers completed the Parenting Stress Index-Short Form (PSI-SF), the Depression, Anxiety, Stress Scale (DASS) and the Child Behaviour Checklist (CBCL). The infants had a neurological examination and the Bayley-III scales were administered. RESULTS The mean total PSI-SF at 2 years was significantly higher for the preterm group compared with the term group of mothers (p=0.007). There was a significant increase in the mean total PSI over time for the preterm mothers (p<0.001). For mothers at 2 years, there was an association with high levels of parenting stress and abnormal scores on the DASS (p<0.001) and high total T-scores on the CBCL (internalising p<0.001; externalising p=0.006). There was no association between parenting stress and maternal demographics, neonatal factors or Bayley-III results. CONCLUSIONS Parenting stress in mothers of preterm infants continues to be high at 2 years having increased over time. Maternal mental health problems and infant behavioural issues contribute to the stress.
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Affiliation(s)
- Peter H Gray
- Growth and Development Unit, Mater Mothers' Hospital, South Brisbane, Queensland, Australia.,Mothers, Babies and Women's Health Programme, Mater Research Institute-University of Queensland, South Brisbane, Queensland, Australia
| | - Dawn M Edwards
- Growth and Development Unit, Mater Mothers' Hospital, South Brisbane, Queensland, Australia
| | - Kristen Gibbons
- Mothers, Babies and Women's Health Programme, Mater Research Institute-University of Queensland, South Brisbane, Queensland, Australia
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Tarullo AR, St John AM, Meyer JS. Chronic stress in the mother-infant dyad: Maternal hair cortisol, infant salivary cortisol and interactional synchrony. Infant Behav Dev 2017; 47:92-102. [PMID: 28391126 PMCID: PMC5493894 DOI: 10.1016/j.infbeh.2017.03.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Revised: 03/29/2017] [Accepted: 03/29/2017] [Indexed: 01/06/2023]
Abstract
Stress physiology is shaped by early experience, with enduring effects on health. The relation of chronic maternal physiological stress, as indexed by hair cortisol, to infants' stress systems and to mother-infant interaction quality has not been established. We examined maternal hair and salivary cortisol, six-month-old infants' salivary cortisol, and mother-infant interaction in 121 mother-infant dyads. High maternal hair cortisol was related to higher infant average salivary cortisol concentration. Maternal hair cortisol and bedtime salivary cortisol were both uniquely related to infant bedtime salivary cortisol. Mothers with higher hair cortisol were more intrusive and had lower positive engagement synchrony with their infants. Maternal intrusiveness moderated the association of maternal hair cortisol and infant salivary cortisol, such that maternal hair and infant average salivary cortisol were related only when mothers were more intrusive. Maternal chronic physiological stress may upregulate infants' developing stress systems, particularly in the context of lower mother-infant interaction quality.
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Affiliation(s)
- Amanda R Tarullo
- Department of Psychological and Brain Sciences, Boston University, United States.
| | - Ashley Moore St John
- Department of Psychological and Brain Sciences, Boston University, United States
| | - Jerrold S Meyer
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, United States
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