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Kumar D, Hameed W, Avan BI. Comparing the effectiveness of mother-focused interventions to that of mother-child focused interventions in improving maternal postpartum depression outcomes: A systematic review. PLoS One 2023; 18:e0295955. [PMID: 38117801 PMCID: PMC10732407 DOI: 10.1371/journal.pone.0295955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/28/2023] [Indexed: 12/22/2023] Open
Abstract
BACKGROUND Most empirically researched interventions for postpartum depression (PPD) tend to target mothers' depression alone. Harmful effects of PPD on physical and mental health of both mother and child has led researchers to investigate the impact of interventions on PPD and child outcomes together. So far, the evidence is limited regarding how these interventions compare with those focusing only on mothers' depression. This review compares the effectiveness of PPD-improving interventions focusing only on mothers with those focusing on mother and child together. METHODS Nine electronic databases were searched. Thirty-seven studies evaluating mother-focused (n = 30) and mother-child focused interventions (n = 7) were included. Under each category, three theoretical approaches-psychological, psychosocial and mixed-were compared using standardized qualitative procedures. The review's primary outcome was maternal PPD. RESULTS A higher proportion of mother-focussed interventions [20/30 (66.7%)] brought significant reduction in PPD outcomes as compared to a lower proportion of mother-child focused interventions [4/7 (57.14%)]. Mother-focused mixed approaches [3/3 (100%)] performed better in improving PPD than psychological [16/24 (67%)] or psychosocial approaches [1/3 (33.3%)] alone. Amongst mother-child focused interventions, psychosocial approaches performed well with two-thirds demonstrating positive effects on PPD. CONCLUSION The evidence strongly favors mother-focused interventions for improving PPD with mixed interventions being more effective. Psychosocial approaches performed better with PPD once child-related elements were added, and also seemed best for child outcomes. Psychological approaches were most practiced and effective for PPD, irrespective of the intervention's focus. Further trials are needed to unpack intervention components that improve PPD and increase uptake, especially in lower-and middle-income countries.
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Affiliation(s)
- Divya Kumar
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, United Kingdom
| | - Waqas Hameed
- Department of Community Health Sciences, Aga Khan University Hospital, Karachi, Sindh, Pakistan
| | - Bilal Iqbal Avan
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, United Kingdom
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Zou W, Huang L, Yan Y. "It Slowly Drained the Life Out of Me, Leaving Me Dead Inside": Coping and Response Patterns Among Chinese Women Experiencing Postpartum Depression. HEALTH COMMUNICATION 2023:1-12. [PMID: 38009473 DOI: 10.1080/10410236.2023.2288382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
The prevalence of postpartum depression (PPD) exceeds 20% in China. In this article, we unpack the coping strategies and involuntary responses to PPD among Chinese women and how such patterns are shaped by family communication dynamics and reflect distinct social, structural, and cultural contexts. Drawing upon the communication accommodation theory and the generic stress and coping model, we analyzed 661 posts collected under the hashtag #PPD (chanhou yiyuzheng) on Zhihu using the phronetic iterative approach. The analysis reveals that women self-identifying as having PPD often find themselves situated within a family environment marked by non-adaptive communication, culminating in insufficient support from their social circles. Furthermore, a significant number of these women lack effective coping mechanisms to manage PPD. Instead, they tend to stifle their expressions and needs through automatic responses, dedicating themselves to constant self-monitoring without practicing self-care. Our findings contribute to informed policymaking for postpartum support, addressing nuanced challenges encountered by new mothers in China.
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Affiliation(s)
- Wenxue Zou
- Department of Communication, Media, & Culture, Coastal Carolina University
| | - Liyao Huang
- School of Journalism and Communication, Xiamen University
| | - Yan Yan
- School of Journalism and Communication, Renmin University of China
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3
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Prina E, Ceccarelli C, Abdulmalik JO, Amaddeo F, Cadorin C, Papola D, Tol WA, Lund C, Barbui C, Purgato M. Task-sharing psychosocial interventions for the prevention of common mental disorders in the perinatal period in low- and middle-income countries: A systematic review and meta-analysis. Int J Soc Psychiatry 2023; 69:1578-1591. [PMID: 37183793 DOI: 10.1177/00207640231174451] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
AIM to assess the efficacy of psychosocial interventions delivered through task-sharing approaches for preventing perinatal common mental disorders among women in low- and middle-income countries. METHODS We conducted a systematic review of randomized controlled trials following a prespecified protocol registered in the Open Science Framework (osf.io/qt4y3). We searched MEDLINE, Web of Science, PsycINFO, and Cochrane Central Register of Controlled Trials (CENTRAL) through June 2022. Two reviewers independently extracted the data and evaluated the risk of bias of included studies using the Cochrane risk of bias tool. We performed random-effects meta-analyses and rated the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. RESULTS We included 23 studies with 24,442 participants. At post-intervention, task-shared psychosocial interventions, were effective in preventing the development of mental disorders in general (RR 0.57, 95% CI [0.35, 0.91]), and specifically depression (RR 0.51, 95% CI [0.35, 0.75]), but not anxiety disorders (RR 0.46, 95% CI [0.06, 3.33]). Similarly, psychosocial interventions reduced psychological distress (SMD -1.32, 95% CI [-2.28, -0.35]), and depressive symptoms (SMD -0.50, 95% CI [-0.80, -0.16]), and increased parenting self-efficacy (SMD -0.76, 95% CI [-1.13, -0.38]) and social support (SMD -0.72, 95% CI [-1.22, -0.22]). No effect was detected for anxiety symptoms at post-intervention. At follow-up the beneficial effects of interventions progressively decreased. CONCLUSIONS Psychosocial interventions delivered through the task-sharing modality are effective in preventing perinatal common mental disorders and fostering positive mental health among women in low- and middle-income countries. However, our findings are tentative, due to the low number of preventative intervention strategies considering outcomes as the incidence of mental disorders, especially in the long-term. This evidence supports calls to implement and scale up psychosocial prevention interventions for perinatal common mental disorders in low- and middle-income countries.
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Affiliation(s)
- Eleonora Prina
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Caterina Ceccarelli
- Global Program Expert Group on Mental Health and Psychosocial Support, SOS Children's Villages, Milan, Italy
| | | | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Camilla Cadorin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Davide Papola
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
- Cochrane Global Mental Health, University of Verona, Italy
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Wietse A Tol
- Department of Public Health, University of Copenhagen, Denmark
- Athena Research Institute, Vrije Universiteit Amsterdam, The Netherlands
| | - Crick Lund
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Corrado Barbui
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
- Cochrane Global Mental Health, University of Verona, Italy
| | - Marianna Purgato
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
- Cochrane Global Mental Health, University of Verona, Italy
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Purgato M, Prina E, Ceccarelli C, Cadorin C, Abdulmalik JO, Amaddeo F, Arcari L, Churchill R, Jordans MJ, Lund C, Papola D, Uphoff E, van Ginneken N, Tol WA, Barbui C. Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries. Cochrane Database Syst Rev 2023; 10:CD014722. [PMID: 37873968 PMCID: PMC10594594 DOI: 10.1002/14651858.cd014722.pub2] [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: 10/25/2023]
Abstract
BACKGROUND There is a significant research gap in the field of universal, selective, and indicated prevention interventions for mental health promotion and the prevention of mental disorders. Barriers to closing the research gap include scarcity of skilled human resources, large inequities in resource distribution and utilization, and stigma. OBJECTIVES To assess the effectiveness of delivery by primary workers of interventions for the promotion of mental health and universal prevention, and for the selective and indicated prevention of mental disorders or symptoms of mental illness in low- and middle-income countries (LMICs). To examine the impact of intervention delivery by primary workers on resource use and costs. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, Global Index Medicus, PsycInfo, WHO ICTRP, and ClinicalTrials.gov from inception to 29 November 2021. SELECTION CRITERIA Randomized controlled trials (RCTs) of primary-level and/or community health worker interventions for promoting mental health and/or preventing mental disorders versus any control conditions in adults and children in LMICs. DATA COLLECTION AND ANALYSIS Standardized mean differences (SMD) or mean differences (MD) were used for continuous outcomes, and risk ratios (RR) for dichotomous data, using a random-effects model. We analyzed data at 0 to 1, 1 to 6, and 7 to 24 months post-intervention. For SMDs, 0.20 to 0.49 represented small, 0.50 to 0.79 moderate, and ≥ 0.80 large clinical effects. We evaluated the risk of bias (RoB) using Cochrane RoB2. MAIN RESULTS Description of studies We identified 113 studies with 32,992 participants (97 RCTs, 19,570 participants in meta-analyses) for inclusion. Nineteen RCTs were conducted in low-income countries, 27 in low-middle-income countries, 2 in middle-income countries, 58 in upper-middle-income countries and 7 in mixed settings. Eighty-three RCTs included adults and 30 RCTs included children. Cadres of primary-level workers employed primary care health workers (38 studies), community workers (71 studies), both (2 studies), and not reported (2 studies). Interventions were universal prevention/promotion in 22 studies, selective in 36, and indicated prevention in 55 RCTs. Risk of bias The most common concerns over risk of bias were performance bias, attrition bias, and reporting bias. Intervention effects 'Probably', 'may', or 'uncertain' indicates 'moderate-', 'low-', or 'very low-'certainty evidence. *Certainty of the evidence (using GRADE) was assessed at 0 to 1 month post-intervention as specified in the review protocol. In the abstract, we did not report results for outcomes for which evidence was missing or very uncertain. Adults Promotion/universal prevention, compared to usual care: - probably slightly reduced anxiety symptoms (MD -0.14, 95% confidence interval (CI) -0.27 to -0.01; 1 trial, 158 participants) - may slightly reduce distress/PTSD symptoms (SMD -0.24, 95% CI -0.41 to -0.08; 4 trials, 722 participants) Selective prevention, compared to usual care: - probably slightly reduced depressive symptoms (SMD -0.69, 95% CI -1.08 to -0.30; 4 trials, 223 participants) Indicated prevention, compared to usual care: - may reduce adverse events (1 trial, 547 participants) - probably slightly reduced functional impairment (SMD -0.12, 95% CI -0.39 to -0.15; 4 trials, 663 participants) Children Promotion/universal prevention, compared to usual care: - may improve the quality of life (SMD -0.25, 95% CI -0.39 to -0.11; 2 trials, 803 participants) - may reduce adverse events (1 trial, 694 participants) - may slightly reduce depressive symptoms (MD -3.04, 95% CI -6 to -0.08; 1 trial, 160 participants) - may slightly reduce anxiety symptoms (MD -2.27, 95% CI -3.13 to -1.41; 1 trial, 183 participants) Selective prevention, compared to usual care: - probably slightly reduced depressive symptoms (SMD 0, 95% CI -0.16 to -0.15; 2 trials, 638 participants) - may slightly reduce anxiety symptoms (MD 4.50, 95% CI -12.05 to 21.05; 1 trial, 28 participants) - probably slightly reduced distress/PTSD symptoms (MD -2.14, 95% CI -3.77 to -0.51; 1 trial, 159 participants) Indicated prevention, compared to usual care: - decreased slightly functional impairment (SMD -0.29, 95% CI -0.47 to -0.10; 2 trials, 448 participants) - decreased slightly depressive symptoms (SMD -0.18, 95% CI -0.32 to -0.04; 4 trials, 771 participants) - may slightly reduce distress/PTSD symptoms (SMD 0.24, 95% CI -1.28 to 1.76; 2 trials, 448 participants). AUTHORS' CONCLUSIONS The evidence indicated that prevention interventions delivered through primary workers - a form of task-shifting - may improve mental health outcomes. Certainty in the evidence was influenced by the risk of bias and by substantial levels of heterogeneity. A supportive network of infrastructure and research would enhance and reinforce this delivery modality across LMICs.
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Affiliation(s)
- Marianna Purgato
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Eleonora Prina
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Caterina Ceccarelli
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Camilla Cadorin
- Department of Neurosciences, Biomedicine and Movement Sciences, Verona, Italy
| | | | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | | | - Rachel Churchill
- Cochrane Common Mental Disorders, Centre for Reviews and Dissemination, University of York, York, UK
| | - Mark Jd Jordans
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Crick Lund
- King's Global Health Institute, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Davide Papola
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Eleonora Uphoff
- Cochrane Common Mental Disorders, Centre for Reviews and Dissemination, University of York, York, UK
| | - Nadja van Ginneken
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Wietse Anton Tol
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Corrado Barbui
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
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Wang X, Qiu Q, Shen Z, Yang S, Shen X. A systematic review of interpersonal psychotherapy for postpartum depression. J Affect Disord 2023; 339:823-831. [PMID: 37459968 DOI: 10.1016/j.jad.2023.07.067] [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: 10/13/2022] [Revised: 05/16/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND The current study endeavored to systematically integrate and quantitatively evaluate the effectiveness of interpersonal psychological interventions for postpartum depression patients. METHODS Four electronic databases Pubmed, Embase, Cochrane and Web of Science were employed for literature retrieval, and the search time was from the inception of the database to May 30, 2022. Literature screening and data extraction were performed independently by two researchers. RESULTS A total of 528 studies were screened, and 9 of them were finally included. There were 1012 subjects, 518 of them were assigned in experimental group and 494 in control. Evidence from interpersonal psychological interventions indicated that the data on postpartum depression, satisfaction with family, and social support in both groups after intervention included: depression score [MD = -2.80, 95%CI (-3.86 to -1.74), P < 0.05], satisfaction score [MD = 8.41, 95%CI (1.49 to -15.33), P < 0.05], and social support score [MD = 1.83, 95%CI (-2.10 to -5.76)] of postpartum depression patients. P values < 0.05 indicated substantial improvement as compared to control. LIMITATIONS During the research process, it is impossible for the experimental group and the researchers to use double-blind trials simultaneously, which may present a Hawthorne effect, but this can be avoided by general psychological intervention for the control. CONCLUSIONS Interpersonal psychotherapy could improve depression in patients with postpartum depression, but the appropriate intervention time was between 4 and 8 weeks, and it also improved satisfaction with family of patients, and the longer the intervention, the higher the satisfaction with the family.
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Affiliation(s)
- Xing Wang
- Department of Neurosis and Psychosomatic Diseases, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, China
| | - Qinming Qiu
- Department of Neurosis and Psychosomatic Diseases, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, China
| | - Zhongxia Shen
- Department of Neurosis and Psychosomatic Diseases, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, China
| | - Shengliang Yang
- Department of Neurosis and Psychosomatic Diseases, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, China
| | - Xinhua Shen
- Department of Neurosis and Psychosomatic Diseases, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, China.
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6
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Lin Y, Zhang X, Zhou T, Xu F, Zhu X, Zhou H, Wang X, Ding Y. Identifying the common elements of psychological and psychosocial interventions for preventing postpartum depression: Application of the distillation and matching model to 37 winning protocols from 36 intervention studies. Early Interv Psychiatry 2023; 17:947-962. [PMID: 37680169 DOI: 10.1111/eip.13462] [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: 03/18/2023] [Revised: 07/16/2023] [Accepted: 08/21/2023] [Indexed: 09/09/2023]
Abstract
AIM Postpartum depression is prevalent worldwide and seriously endangers maternal and child health. Previous studies have demonstrated the effectiveness of psychological and psychosocial intervention programmes in preventing postpartum depression. However, the literature offers limited practice guidance. Therefore, this study aimed to deeply analyse prior findings to gather rich evidence-based information on this topic. METHODS Using the distillation and matching model, we conducted a systematic review of psychological and psychosocial interventions used to effectively prevent postpartum depression. Four researchers trained in coding system independently read eligible studies and identified reliable (Cohen's kappa >0.40) and frequently occurring (frequency ≥3 winning study groups) practice elements. RESULTS Our review included 36 studies containing 37 winning study groups. Fourteen practice elements were identified and subsequently divided into six categories: postpartum practical problems-related, social support-related, interpersonal psychotherapy-related, cognitive behavioural therapy-related, labour trauma-related and non-specific techniques. The most common practice elements were baby care skills and mother-infant bonding/interaction enhancement. Inter-rater reliability averaged 0.86, ranging from 0.48 to 1. CONCLUSION The practice elements identified in this study provide rich evidence-based information that can guide clinical practitioners in selecting or developing effective, realistically available intervention programmes.
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Affiliation(s)
- Yuping Lin
- School of Nursing, Fudan University, Shanghai, China
- Nursing Department, Obstetrics and Gynaecology Hospital of Fudan University, Shanghai, China
| | | | - Tianchun Zhou
- School of Nursing, Fudan University, Shanghai, China
- Nursing Department, Obstetrics and Gynaecology Hospital of Fudan University, Shanghai, China
| | - Feng Xu
- Nursing Department, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Xinli Zhu
- Department of Obstetrics, Obstetrics and Gynaecology Hospital of Fudan University, Shanghai, China
| | - Huixin Zhou
- Department of Obstetrics, Obstetrics and Gynaecology Hospital of Fudan University, Shanghai, China
| | - Xiao Wang
- Department of Obstetrics, Obstetrics and Gynaecology Hospital of Fudan University, Shanghai, China
| | - Yan Ding
- Nursing Department, Obstetrics and Gynaecology Hospital of Fudan University, Shanghai, China
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Tang L, Xu F, Yu G, Li C, Wen S, Zheng W. Efficacy of interpersonal psychotherapy in mainland China: a systematic review and meta-analysis. Front Psychiatry 2023; 14:1160081. [PMID: 37502817 PMCID: PMC10370272 DOI: 10.3389/fpsyt.2023.1160081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/19/2023] [Indexed: 07/29/2023] Open
Abstract
Objective Interpersonal Psychotherapy (IPT) is an evidence-based therapy. There have been increasing demand and training opportunities of IPT in China. Reviewing current evidence on its use in Chinese patients can help us understand the applicability of IPT in China and identify knowledge gaps to encourage and better future research in this field. Method We did a comprehensive search of three major electronic databases: PubMed (English), Chinese National Knowledge Infrastructure (CNKI) and WanFang Data (Chinese). We examined overall study design, outcome measures, data analyses and other parameters. We only selected articles of Randomized Clinical Trials (RCT) for this review. All study findings were grouped and summarized per psychiatric diagnoses. The meta-analysis and forest plots were performed whereas studies could be combined. Results After a full text review of 132 articles, 40 were selected for the final review. Comparing with control groups, evidences supported the efficacy of IPT in Chinese patients with Major Depressive Disorder (MDD), Postpartum depression, Generalized Anxiety Disorder (GAD), Social Anxiety Disorder, Post Stress Traumatic Disorder (PTSD), and Post-psychotic Depression. It was also beneficial to college students and Chinese first-time mothers. Meta-analysis using a random-effects model consistently yielded significant score differences between the IPT and control groups (p < 0.0001) on MDD. Conclusion This systematic review has identified the current best evidence for IPT efficacy in Chinese population. The findings support IPT as an effective treatment in Chinese with certain psychiatric conditions, consistent with those from many other studies throughout the world.
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Affiliation(s)
- Luhan Tang
- Department of Clinical Psychology, Tong De Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Fangzhong Xu
- Department of Clinical Psychology, Tong De Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Ge Yu
- Department of Clinical Psychology, Tong De Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Chong Li
- Department of Mathematics, West Virginia University, Morgantown, WV, United States
| | - Sijin Wen
- Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, WV, United States
| | - Wanhong Zheng
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV, United States
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Ong QEO, Ong JW, Ang MQ, Vehviläinen-Julkunen K, He HG. Systematic review and meta-analysis of psychoeducation on the psychological and social impact among first-time mothers. PATIENT EDUCATION AND COUNSELING 2023; 111:107678. [PMID: 36871401 DOI: 10.1016/j.pec.2023.107678] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 01/16/2023] [Accepted: 02/18/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE This systematic review aimed to synthesise evidence of the effectiveness of psychoeducation in improving self-efficacy and social support and reducing depression and anxiety in first-time mothers. METHODS A comprehensive search was conducted on nine databases, grey literature, and trial registries for randomised controlled trials published from the databases' inception to 27 December 2021. Two independent reviewers screened studies, extracted data, and appraised the risk of bias. RevMan 5.4 was used for the meta-analyses of all outcomes. Sensitivity and subgroup analyses were conducted. Overall evidence quality was appraised using GRADE approach. RESULTS Twelve studies involving 2083 first-time mothers were included. The meta-analyses favoured psychoeducation as compared to control groups. At immediate post-intervention, statistically significant increments were seen in self-efficacy and social support, while a significant reduction in depression was observed but not in anxiety. At three months postpartum, a statistically significant decrease in depression was observed, but the effects on self-efficacy and social support were insignificant. CONCLUSION Psychoeducation improved first-time mothers' self-efficacy, social support, and depression. However, the evidence was very uncertain. PRACTICE IMPLICATIONS Psychoeducation might be incorporated into patient education of first-time mothers. More studies with familial and digital-based psychoeducation interventions, especially in non-Asian countries, are needed.
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Affiliation(s)
- Qian-Er Oriana Ong
- National University of Singapore, Yong Loo Lin School of Medicine, Alice Lee Center for Nursing Studies, Singapore, Singapore; KK Women's and Children's Hospital, Division of Nursing, Singapore, Singapore
| | - Jing Wen Ong
- National University of Singapore, Yong Loo Lin School of Medicine, Alice Lee Center for Nursing Studies, Singapore, Singapore; KK Women's and Children's Hospital, Division of Nursing, Singapore, Singapore
| | - Mei Qi Ang
- KK Women's and Children's Hospital, Division of Nursing, Singapore, Singapore
| | - Katri Vehviläinen-Julkunen
- University of Eastern Finland, Department of Nursing Science, Kuopio, Finland; Kuopio University Hospital, Department of Nursing, Kuopio, Finland
| | - Hong-Gu He
- National University of Singapore, Yong Loo Lin School of Medicine, Alice Lee Center for Nursing Studies, Singapore, Singapore; National University Health System, Singapore, Singapore.
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9
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Zheng J, Gao LL. Parenting self-efficacy and social support among parents in mainland China across the first six months postpartum: A prospective cohort study. Midwifery 2023; 123:103719. [PMID: 37210792 DOI: 10.1016/j.midw.2023.103719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 04/01/2023] [Accepted: 05/09/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVE Knowledge of parenting self-efficacy and social support can help healthcare professionals to facilitate the parents' transition to parenthood. However, few studies have explored parenting self-efficacy and social support in Chinese mothers and fathers across six months postpartum. Thus, this study aimed to (a) investigate changes in parenting self-efficacy and social support over the six months postpartum; (b) explore the relationships between parenting self-efficacy and social support; and (c) compare the differences in parenting self-efficacy and social support between the mothers and fathers. DESIGN, SETTING, AND PARTICIPANTS A prospective cohort study was carried out from September 24, 2020, to October 8, 2021, at a local teaching hospital in Guangzhou, China. One hundred and sixteen pairs of Chinese parents who gave birth to a single full-term newborn were included in this study. MEASUREMENTS The Parenting Self-Efficacy Subscale of the Parenting Sense of Competence Scale and Social Support Rating Scale were completed within 2-3 days after delivery (T1), six weeks postpartum (T2), three months postpartum (T3), and six months postpartum (T4). Demographic and obstetric information was collected at T1. FINDINGS Maternal parenting self-efficacy decreased from T1 to T2 and then increased to T3 and T4, while paternal parenting self-efficacy remained stable throughout the six months postpartum. Overall, maternal and paternal social support declined during the six months postpartum. Parenting self-efficacy had a positive correlation with social support. Moreover, maternal subjective support was significantly lower than that of fathers at T1 and T4. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The present study highlighted the changes and relationships between parenting self-efficacy and social support in mothers and fathers across six months postpartum in mainland China. Healthcare professionals should treat mother and father as a system to help their transition to parenthood.
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Affiliation(s)
- Jie Zheng
- School of Nursing, Peking University, Beijing, China
| | - Ling-Ling Gao
- Professor, School of Nursing, Sun Yat-sen University, 74#, Zhongshan Road II, Guangzhou 510089, China.
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Huang J, Zheng J, Ling-Ling G. Individual and dyadic network analyses of depressive symptoms in Chinese postpartum couples: A cross-sectional study. Midwifery 2023; 116:103529. [PMID: 36323077 DOI: 10.1016/j.midw.2022.103529] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 09/10/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The network approach to psychopathology is symptom oriented and may open new possibilities for intervention development and health care practices in postpartum depression. OBJECTIVE To investigate the individual and dyadic symptom network of postpartum depression in Chinese mothers and fathers in the very early postpartum period. DESIGN A cross-sectional study was conducted. SETTINGS AND PARTICIPANTS A total of 457 couples in the 2∼3 days postpartum period was recruited consecutively from a hospital in Guangzhou, China from September 2020 to April 2021. METHODS The Edinburgh Postnatal Depression Scale and socio-demographic and obstetric data sheet were used to collect data. We estimated the individual symptom networks of postpartum mothers and fathers separately and a dyadic symptom network that consisted of symptoms of both spouses. Network characteristics including global strength and node centralities were analyzed and systematically compared. RESULTS Strength centralities in the individual networks showed acceptable stability [Correlation stability coefficient (CS) for mothers = 0.60; CS for fathers = 0.52]. The central depressive symptoms in mothers were Crying (Zstrength = 1.32), Overwhelmed (Zstrength = 1.01) and Sad mood (Zstrength = 0.93). The central depressive symptom in fathers was Sad Mood (Zstrength = 1.35). The symptom "Crying" had a distinctive link to thoughts of self-harm in fathers. The symptom network of mothers (global strength = 4.15) was more interconnected than that of fathers (global strength = 3.74). There was a statistically significant but unstable within-couple connection of thoughts of self-harm (CS = 0.21). CONCLUSIONS Postpartum mothers are more vulnerable to activation spreads of depressive symptoms than postpartum fathers. Symptoms including "Sad mood", "Overwhelmed" and "Crying" warrant the attention of health care providers. Investigations with larger sample sizes and gender-sensitive instruments are needed to further unfold the individual and dyadic symptom dynamics of postpartum depression.
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Affiliation(s)
- Jiasheng Huang
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Jie Zheng
- School of Nursing, Peking University, Beijing, China
| | - Gao Ling-Ling
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
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Ngai FW, Gao LL. Effect of couple-based interpersonal psychotherapy on postpartum depressive symptoms: A randomised controlled trial. Asian J Psychiatr 2022; 78:103274. [PMID: 36215873 DOI: 10.1016/j.ajp.2022.103274] [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: 08/01/2022] [Revised: 09/11/2022] [Accepted: 09/28/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVES Interpersonal psychotherapy (IPT) is one of the most effective interventions for postnatal depression. Few studies have evaluated the effect of IPT on postnatal depression for both mothers and fathers. This aimed to examine the effect of couple-based IPT on postpartum depressive symptoms among Chinese mothers and fathers at 6 weeks and 6 months postpartum. METHODS A randomised controlled trial was conducted with 455 childbearing couples recruited from two hospitals and randomly allocated to the couple-based IPT (n = 224) and usual care (n = 231) groups. Postpartum depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). RESULTS Both mothers and fathers in the couple-based IPT demonstrated significant and sustained reduction in depressive symptoms at 6 weeks (mean difference in mothers = 1.91, p < .001; mean difference in fathers = 1.14, p = .005) and 6 months postpartum (mean difference in mothers = 0.89, p = .039; mean difference in fathers = 1.29, p = .003), compared to those in usual care. The proportions of mothers and fathers who were at risk of postnatal depression (EPDS > 9) were significantly lower in the IPT group than in the usual care group at 6 weeks postpartum (difference in mothers = 21.9%, p < .001; difference in fathers = 10.7%, p = .005), but no significant differences were found at 6 months postpartum. CONCLUSIONS The benefits of the couple-based IPT in this study highlights the importance of incorporating IPT into perinatal services to promote perinatal mental health for both partners.
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Affiliation(s)
- Fei-Wan Ngai
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Ling-Ling Gao
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
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Dadhwal V, Sagar R, Choudhary V, Kant S, Perumal V, Misra P, Bhattacharya D. A Single-Arm Pilot Study of Multicomponent Psychoeducational Intervention for Postpartum Depression and Anxiety in a Rural Community. Indian J Psychol Med 2022; 44:567-574. [PMID: 36339693 PMCID: PMC9615458 DOI: 10.1177/02537176211072690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The prevalence of postpartum depression (PPD) and anxiety (PPA) is rising in India and efforts at generating local evidence for psychological intervention are scanty. We conducted a single-arm pilot study in an Indian rural community to test the impact of multicomponent psychoeducational intervention (MCPI) on women with PPD and PPA. METHODS Forty-three women with PPD/PPA/both received MCPI, which comprised three phases with in-person sessions held once weekly for a minimum of six and a maximum of ten weeks. Primary outcome variables were scores on depression and anxiety, assessed using the Edinburg postnatal depression scale and the state and trait anxiety inventory, along with evaluating the compliance rate to the intervention. The Mini-international neuropsychiatric interview (MINI) neuropsychiatric interview was used to confirm the diagnosis of depression and anxiety. Secondary outcome variables assessed were social support, functionality, parental stress, interpersonal violence, and marital satisfaction. We used Cohen's d effect size method for assessing the mean differences. RESULTS MCPI resulted in the improvement of 72% women (95% CI = 56.3%-84.7%). The overall compliance rate to the intervention was 85.63%, which was higher for responders than nonresponders (92.9% vs. 69.8%; P < 0.001). MCPI resulted in statistically significant improvement in the mean score of depression (P = 0.001, d = 0.95) and anxiety (P = 0.001, d = 1.30). On secondary outcome variables, significant improvement was obtained in the overall present social support (P = 0.001; d = 4.65), present social support from partner (P = 0.027; d = 0.45) and parents (P = 0.001; d = 0.74), future social support from parents (P = 0.001; d = 0.81), the performance of household responsibility (P = 0.001; d = 0.97), lifestyle in the last two weeks (P = 0.001; d = 3.57), parental stress (P = 0.001; d = 1.04), and marital satisfaction (P = 0.014; d = 0.52). CONCLUSION This pilot study shows that MCPI has a promising role in relieving depression and anxiety. It also improved the perception of social support from partner and parents, functionality, marital satisfaction, and reduced parental stress.
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Affiliation(s)
- Vatsla Dadhwal
- Dept. of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Rajesh Sagar
- Dept. of Psychiatry, All India institute of Medical Sciences, New Delhi, Delhi, India
| | - Vandana Choudhary
- Dept. of Psychiatry (Clinical Psychology), All India institute of Medical Sciences, New Delhi, Delhi, India
| | - Shashi Kant
- Dept. of Community Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Vanamail Perumal
- Dept. of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Puneet Misra
- Dept. of Community Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Debabani Bhattacharya
- Dept. of Psychiatry (Clinical Psychology), All India institute of Medical Sciences, New Delhi, Delhi, India
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Sharifipour F, Javadnoori M, Behboodi Moghadam Z, Najafian M, Cheraghian B, Abbaspoor Z. Interventions to improve social support among postpartum mothers: A systematic review. Health Promot Perspect 2022; 12:141-150. [PMID: 36276421 PMCID: PMC9508393 DOI: 10.34172/hpp.2022.18] [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: 12/26/2021] [Accepted: 05/15/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Poor and insufficient social support to the mother in the post-partum period impairs the effective functioning of her new role as a mother, and it is an important risk factor for the maternal depression and stress after childbirth. Thus, interventions to improve social support to mothers in their postpartum period are required. The present review aimed to investigate the effectiveness of the existing interventions aimed at improving social support among postpartum women. Methods: In this systematic review, PubMed, Scopus, Science Direct, Cochrane Library, Web of Science, EMBASE, Google Scholar, IranDoc, IranMedex, MagIran and SID were searched until January 2022. Full-text articles on the social support outcome, published in English or Persian, which used the design of randomized controlled trials (RCTs) or comparison groups and involved postpartum or pregnant women as participants were included. The quality of the studies was assessed based on the seven criteria offered by Cochrane guidelines. Results: Our review included 10 studies involving 3328 women. According to our results, the following interventions were successful in increasing social support compared to the controlled conditions: counseling with men in the prenatal period, interventions based on interpersonal psychotherapy (IPT), advanced practice nurse (APN), internet support, and home visiting in the postpartum period. Conclusion: These interventions could be provided to mothers during their prenatal or postpartum care. However, which one of these interventions is the most effective in improving social support among postpartum mothers was not identified in the present study.
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Affiliation(s)
- Foruzan Sharifipour
- Reproductive Health Promotion Research Center, Department of Midwifery, Faculty of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mojgan Javadnoori
- Reproductive Health Promotion Research Center, Department of Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Mahin Najafian
- Department of Obstetrics and Gynecology, School of Medicine, Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahman Cheraghian
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Department of Biostatistics and Epidemiology, school of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Abbaspoor
- Reproductive Health Promotion Research Center, Department of Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Zheng J, Gao L, Li H, Zhao Q. Postpartum depression and social support: A longitudinal study of the first six months as parents. J Clin Nurs 2022; 32:2652-2662. [PMID: 35538627 DOI: 10.1111/jocn.16351] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/20/2022] [Accepted: 04/19/2022] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES The study aimed to (1) investigate the changes in maternal and paternal depression, along with social support, across the 6-month postpartum period; (2) explore the relationships between maternal and paternal depression and social support during the 6-month postpartum period; and (3) compare the differences in postpartum depression and social support between mothers and fathers at 2-3 days, 6 weeks, 3 months and 6 months postpartum. BACKGROUND An increasing body of evidence now shows that postpartum depression affects both mothers and fathers. The notable increase in postpartum depression in China is particularly concerning. DESIGN A longitudinal study was conducted, guided by the STROBE checklist. METHODS 122 pairs of parents were recruited from September 2020 to October 2021 at a teaching hospital in Guangzhou, China. Data were collected from each parent at 2-3 days, 6 weeks, 3 months and 6 months postpartum, using the Edinburgh Postnatal Depression Scale and the Social Support Rating Scale. We also acquired socio-demographic and obstetric data at 2-3 days postpartum. RESULTS Maternal depression was lowest at 2-3 days postpartum compared with that measured at 6 weeks, 3 months and 6 months postpartum. Maternal and paternal social support was highest at 2-3 days postpartum compared with that measured at 6 weeks, 3 months and 6 months postpartum. Maternal depression was significantly correlated with paternal depression while maternal social support was significantly correlated with paternal social support at different time points. CONCLUSION Postpartum depression in mothers and social support in both mothers and fathers, showed significant changes during the 6-month postpartum period. RELEVANCE TO CLINICAL PRACTICE Healthcare providers should pay attention to the mental health of both parents, view them as a team and provide both family-based and women-cantered interventions.
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Affiliation(s)
- Jie Zheng
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Lingling Gao
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Hanbing Li
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Qian Zhao
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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15
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McNab SE, Dryer SL, Fitzgerald L, Gomez P, Bhatti AM, Kenyi E, Somji A, Khadka N, Stalls S. The silent burden: a landscape analysis of common perinatal mental disorders in low- and middle-income countries. BMC Pregnancy Childbirth 2022; 22:342. [PMID: 35443652 PMCID: PMC9019797 DOI: 10.1186/s12884-022-04589-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 03/17/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Mental health has long fallen behind physical health in attention, funding, and action-especially in low- and middle-income countries (LMICs). It has been conspicuously absent from global reproductive, maternal, newborn, child, and adolescent health (MNCAH) programming, despite increasing awareness of the intergenerational impact of common perinatal mental disorders (CPMDs). However, the universal health coverage (UHC) movement and COVID-19 have brought mental health to the forefront, and the MNCAH community is looking to understand how to provide women effective, sustainable care at scale. To address this, MOMENTUM Country and Global Leadership (MCGL) commissioned a landscape analysis in December 2020 to assess the state of CPMDs and identify what is being done to address the burden in LMICs. METHODS The landscape analysis (LA) used a multitiered approach. First, reviewers chose a scoping review methodology to search literature in PubMed, Google Scholar, PsychInfo, and Scopus. Titles and abstracts were reviewed before a multidisciplinary team conducted data extraction and analysis on relevant articles. Second, 44 key informant interviews and two focus group discussions were conducted with mental health, MNCAH, humanitarian, nutrition, gender-based violence (GBV), advocacy, and implementation research experts. Finally, reviewers completed a document analysis of relevant mental health policies from 19 countries. RESULTS The LA identified risk factors for CPMDs, maternal mental health interventions and implementation strategies, and remaining knowledge gaps. Risk factors included social determinants, such as economic or gender inequality, and individual experiences, such as stillbirth. Core components identified in successful perinatal mental health (PMH) interventions at community level included stepped care, detailed context assessments, task-sharing models, and talk therapy; at health facility level, they included pre-service training on mental health, trained and supervised providers, referral and assessment processes, mental health support for providers, provision of respectful care, and linkages with GBV services. Yet, significant gaps remain in understanding how to address CPMDs. CONCLUSION These findings illuminate an urgent need to provide CPMD prevention and care to women in LMICs. The time is long overdue to take perinatal mental health seriously. Efforts should strive to generate better evidence while implementing successful approaches to help millions of women "suffering in silence."
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Affiliation(s)
- Shanon E McNab
- MOMENTUM Country and Global Leadership, Washington, DC, USA.
| | - Sean L Dryer
- MOMENTUM Country and Global Leadership, Washington, DC, USA
| | | | - Patricia Gomez
- MOMENTUM Country and Global Leadership, Washington, DC, USA
| | - Anam M Bhatti
- MOMENTUM Country and Global Leadership, Washington, DC, USA
| | - Edward Kenyi
- MOMENTUM Country and Global Leadership, Washington, DC, USA
| | - Aleefia Somji
- MOMENTUM Country and Global Leadership, Washington, DC, USA
| | - Neena Khadka
- MOMENTUM Country and Global Leadership, Washington, DC, USA
| | - Suzanne Stalls
- MOMENTUM Country and Global Leadership, Washington, DC, USA
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16
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Consales A, Colombo L, Zanotta L, Morniroli D, Sannino P, Rampini S, Piccoli G, Donghi M, Marchisio P, Mosca F, Plevani L, Giannì ML. Pilot Feasibility Study of a Hospital-Based Post-Natal Educational Intervention on New Mothers in a BFHI-Compliant Tertiary Referral Center for Neonatal Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042020. [PMID: 35206209 PMCID: PMC8871806 DOI: 10.3390/ijerph19042020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/07/2022] [Accepted: 02/09/2022] [Indexed: 11/16/2022]
Abstract
The immediate post-partum period offers a valuable opportunity for parental education on various health topics. The aim of this study was to pilot test the feasibility in a tertiary referral center for neonatal care of a post-natal educational intervention (the Diary) designed to provide mothers with basic information concerning newborn care and breastfeeding. Furthermore, we aimed to evaluate its effect on exclusive breastfeeding rates at discharge and at 48 h post-discharge, and on maternal perceived support during hospital stay, compared to standard care. A single-center two-phase interventional study was carried out from 1 December 2018 to 2 June 2019. The Diary was given to mothers enrolled in Phase 2, together with the Nurse-Parent Support Tool (NPST). The Diary-NPST couples analyzed were 269. The Diaries filled out and returned were 62.2%. Overall, mothers rated the information received through the Diary as "clear and comprehensive". Exclusive breastfeeding rates at discharge resulted in being higher in Phase 1 than in Phase 2 (80.6% vs. 72.5%, p = 0.04), whereas no difference emerged in terms of exclusive breastfeeding rates at 48 h. In both phases, the median NPST total score (4.05) was high. In conclusion, we propose a new instrument of in-hospital post-natal maternal education and, in line with the current literature, we support well-designed written educational materials to promote mothers' knowledge and satisfaction with post-partum hospital assistance. Further studies that are multicentric and with a longer follow-up period are needed to evaluate the potential impact of the Diary on exclusive breastfeeding duration.
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Affiliation(s)
- Alessandra Consales
- Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122 Milan, Italy; (A.C.); (G.P.); (M.D.); (F.M.); (M.L.G.)
| | - Lorenzo Colombo
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Via della Commenda 12, 20122 Milan, Italy; (L.C.); (L.Z.); (L.P.)
| | - Lidia Zanotta
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Via della Commenda 12, 20122 Milan, Italy; (L.C.); (L.Z.); (L.P.)
| | - Daniela Morniroli
- Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122 Milan, Italy; (A.C.); (G.P.); (M.D.); (F.M.); (M.L.G.)
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Via della Commenda 12, 20122 Milan, Italy; (L.C.); (L.Z.); (L.P.)
- Correspondence: ; Tel.: +39-0255032907
| | - Patrizio Sannino
- Direzione Professioni Sanitarie, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 28, 20122 Milan, Italy; (P.S.); (S.R.)
| | - Serena Rampini
- Direzione Professioni Sanitarie, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 28, 20122 Milan, Italy; (P.S.); (S.R.)
| | - Giulia Piccoli
- Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122 Milan, Italy; (A.C.); (G.P.); (M.D.); (F.M.); (M.L.G.)
| | - Michaela Donghi
- Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122 Milan, Italy; (A.C.); (G.P.); (M.D.); (F.M.); (M.L.G.)
| | - Paola Marchisio
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Pediatric Unit, 20122 Milan, Italy;
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Fabio Mosca
- Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122 Milan, Italy; (A.C.); (G.P.); (M.D.); (F.M.); (M.L.G.)
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Via della Commenda 12, 20122 Milan, Italy; (L.C.); (L.Z.); (L.P.)
| | - Laura Plevani
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Via della Commenda 12, 20122 Milan, Italy; (L.C.); (L.Z.); (L.P.)
| | - Maria Lorella Giannì
- Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122 Milan, Italy; (A.C.); (G.P.); (M.D.); (F.M.); (M.L.G.)
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Via della Commenda 12, 20122 Milan, Italy; (L.C.); (L.Z.); (L.P.)
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Maleki M, Mardani A, Harding C, Basirinezhad MH, Vaismoradi M. Nurses’ strategies to provide emotional and practical support to the mothers of preterm infants in the neonatal intensive care unit: A systematic review and meta-analysis. WOMEN'S HEALTH 2022; 18:17455057221104674. [PMID: 35735784 PMCID: PMC9234836 DOI: 10.1177/17455057221104674] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aim: To synthesize and integrate current international knowledge regarding nursing strategies for the provision of emotional and practical support to the mothers of preterm infants in the neonatal intensive care unit. Methods: A systematic review and meta-analysis was undertaken. Four English-language databases including EMBASE, PubMed (including MEDLINE), Scopus, and Web of Science were searched from January 2010 to October 2021. Original quantitative studies that were written in English and focused on nursing strategies for the provision of emotional and practical support to the mothers of preterm infants in the neonatal intensive care unit were included. Eligibility assessment, data extraction, and methodological quality appraisal were conducted independently by the review authors. A narrative synthesis of the review results and a meta-analysis were performed. Results: Twenty studies that were published from 2010 to 2021 were included in the review. Three categories concerning the review aims were identified: ‘nursing strategies related to mothers’ emotions and infant-mother attachment’, ‘nursing strategies related to mothers’ empowerment’, and ‘nursing strategies related to mothers’ participation in care process and support’. Eight interventional studies that reported mothers’ stress as the study outcome were entered into the meta-analysis. Interventions consisted of the educational programme, spiritual care, telenursing, parent support programme, skin-to-skin care, and guided family centred care. Significantly lower maternal stress was found in the intervention group compared with that of the control group (g: −1.06; 95% confidence interval: −1.64, −0.49; Z = 3.62, p < 0.001). Conclusion: This review identified and highlighted key nursing strategies used to provide emotional and practical support to the mothers of preterm infants in the neonatal intensive care unit. They included family centred care, skin-to-skin care, parent support and education programmes, interpersonal psychotherapy, spiritual care, newborn individualized developmental care and assessment programme, and telenursing.
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Affiliation(s)
- Maryam Maleki
- Pediatric and Neonatal Intensive Care Nursing Education Department, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Mardani
- Nursing Care Research Center, Department of Medical Surgical Nursing, School of Nursing & Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Celia Harding
- Department of Language and Communication Science, City, University of London, London, UK
| | - Mohammad Hasan Basirinezhad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway; Faculty of Science and Health, Charles Sturt University, Orange NSW, Australia
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Predictors of postpartum depression among Chinese mothers and fathers in the early postnatal period: A cross-sectional study. Midwifery 2021; 105:103233. [PMID: 34968820 DOI: 10.1016/j.midw.2021.103233] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 12/02/2021] [Accepted: 12/18/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Postpartum depression is a serious mental health problem in early parenthood. The prevalence of postpartum depression is currently increasing. However, no studies have yet examined and compared maternal and paternal psychological health during the early postpartum period. The objectives of this study were therefore to explore the prevalence of postpartum depression and identify its predictors among Chinese mothers and fathers in the early postpartum period. DESIGN A cross-sectional study was conducted from September 24, 2020 to April 7, 2021 in Guangzhou, China. SETTING A regional teaching hospital in Guangzhou, China, with approximately 3000 births per year. PARTICIPANTS Four hundred and fifty-four married couples in the 2, 3 days postpartum period following a singleton, full-term birth. MEASUREMENTS AND FINDINGS Participants completed the Edinburgh Postnatal Depression Scale, Parenting Satisfaction Subscale and Parenting Efficacy Subscale, Social Support Rating Scale, and the demographic and obstetric datasheet. The prevalence of depressive symptoms (Edinburgh Postnatal Depression Scale score ≥ 13) was 13.0% and 7.5% in mothers and fathers, respectively, in the early postpartum period. The predictors of maternal depression were maternal parenting satisfaction, paternal depression, maternal social support and maternal relationship with mother-in-law (adjusted R2= 0.34, F = 58.40, df = [4, 449], P < 0.001). While the predictors of paternal depression were paternal parenting satisfaction and self-efficacy, maternal depression and whether the pregnancy was planned (adjusted R2= 0.28, F = 44.85, df = [4, 449], P < 0.001). KEY CONCLUSIONS Maternal and paternal depression were positively correlated and were predictive factors for one another. IMPLICATIONS FOR PRACTICE Healthcare professionals should screen both mothers and fathers for depression in the early postpartum period and provide targeted support during time in hospital following birth. In addition, the focus of future interventions should be on both parents rather than just mothers.
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Vargas-Porras C, Roa-Díaz ZM, Hernández-Hincapié HG, Ferré-Grau C, de Molina-Fernández MI. Efficacy of a multimodal nursing intervention strategy in the process of becoming a mother: A randomized controlled trial. Res Nurs Health 2021; 44:424-437. [PMID: 33682146 DOI: 10.1002/nur.22123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 02/01/2021] [Accepted: 02/20/2021] [Indexed: 11/05/2022]
Abstract
The lack of knowledge and skills for transitioning to motherhood places first-time mothers at greater risk of depression and stress, may lower their perceived self-efficacy and satisfaction with the maternal role, and potentially affects the mother-infant bond. The purpose of this study was to test the efficacy of a multimodal nursing intervention (AMACOMPRI), based on Mercer's Becoming a Mother Theory, in supporting the process of becoming a mother in first-time mothers of term infants. This study was a parallel-group, double-blind, randomized, controlled trial with a 4-month postpartum follow-up. The outcome measures were the process of becoming a mother, functional social support, mother-infant bond, and perceived maternal self-efficacy. Sixty-six first-time mothers completed the study: 33 in the intervention group and 33 in the control group. The intervention was effective in supporting the process of becoming a mother, with a large effect size (Cohen's d = 1.50) and higher scores on the Becoming-a-Mother Scale in the intervention group compared with the control group (intergroup difference 13.04 points; 95% confidence interval: 8.72-17.34). Participants in the intervention group demonstrated higher scores in functional social support, perceived maternal self-efficacy, and mother-infant bond. This study provides evidence for the efficacy of an innovative nursing intervention that supports the process of becoming a mother. Further testing of the intervention is required in different settings and first-time mothers of low and high risk newborns.
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Affiliation(s)
- Carolina Vargas-Porras
- Department of Nursing, Advanced Nursing Research Group, Universitat Rovira i Virgili, Tarragona, Catalunya, Spain.,Faculty of Health, School of Nursing, Universidad Industrial de Santander, Bucaramanga, Santander, Colombia
| | - Zayne M Roa-Díaz
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | | | - Carme Ferré-Grau
- Department of Nursing, Advanced Nursing Research Group, Universitat Rovira i Virgili, Tarragona, Catalunya, Spain
| | - María I de Molina-Fernández
- Department of Nursing, Advanced Nursing Research Group, Universitat Rovira i Virgili, Tarragona, Catalunya, Spain
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Interpersonal Psychotherapy to Reduce Psychological Distress in Perinatal Women: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228421. [PMID: 33203014 PMCID: PMC7697337 DOI: 10.3390/ijerph17228421] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Interpersonal psychotherapy (IPT) is a psychological intervention with established efficacy in the prevention and treatment of depressive disorders. Previous systematic reviews have not evaluated the effectiveness of IPT on symptoms of stress, anxiety, depression, quality of life, relationship satisfaction/quality, social supports, and an improved psychological sense of wellbeing. There is limited information regarding moderating and mediating factors that impact the effectiveness of IPT such as the timing of the intervention or the mode of delivery of IPT intervention. The overall objective of this systematic review was to evaluate the effectiveness of IPT interventions to treat perinatal (from pregnancy up to 12 months postpartum) psychological distress. METHODS MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily (Ovid), EMBASE (Ovid), PsycINFO (Ovid), Cochrane Central Register of Controlled Trials (OVID), CINAHL with Full Text (Ebsco), Social Work Abstracts (Ebsco), SocINDEX with Full Text (Ebsco), Academic Search Complete (Ebsco), Family & Society Studies Worldwide (Ebsco), Family Studies Abstracts (Ebsco), and Scopus databases were searched from inception until 31 January 2019. Two researchers independently screened articles for eligibility. Of the 685 screened articles, 43 met the inclusion criteria. The search was re-run on 11 May 2020. An additional 204 articles were screened and two met the inclusion criteria, resulting in a total of 45 studies included in this review. There were 25 Randomized Controlled Trials, 10 Quasi-experimental studies, eight Open Trials, and two Single Case Studies. All included studies were critically appraised for quality. RESULTS In most studies (n = 24, 53%), the IPT intervention was delivered individually; in 17 (38%) studies IPT was delivered in a group setting and two (4%) studies delivered the intervention as a combination of group and individual IPT. Most interventions were initiated during pregnancy (n = 27, 60%), with the remaining 18 (40%) studies initiating interventions during the postpartum period. LIMITATIONS This review included only English-language articles and peer-reviewed literature. It excluded government reports, dissertations, conference papers, and reviews. This limited the access to grassroots or community-based recruitment and retention strategies that may have been used to target smaller or marginalized groups of perinatal women. CONCLUSIONS IPT is an effective intervention for the prevention and treatment of psychological distress in women during their pregnancy and postpartum period. As a treatment intervention, IPT is effective in significantly reducing symptoms of depression and anxiety as well as improving social support, relationship quality/satisfaction, and adjustment. Systematic Review Registration: PROSPERO CRD42019114292.
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Yin J, Nisar A, Waqas A, Guo Y, Qi WL, Wang D, Rahman A, Li X. Psychosocial interventions on perinatal depression in China: A systematic review and meta-analysis. J Affect Disord 2020; 271:310-327. [PMID: 32479331 DOI: 10.1016/j.jad.2020.03.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 02/28/2020] [Accepted: 03/04/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND The prevalence of perinatal depression is 16.3% in China and has shown a rising trend in the last decade. However, few studies summarized psychosocial interventions for perinatal depression in this country. This study aimed at evaluating and characterizing psychosocial interventions for perinatal depression in Mainland China. METHODS Ten major English and Chinese language electronic bibliographic databases were searched for RCTs examining the effect of psychosocial interventions for perinatal depressed women in Mainland China. Studies meeting eligibility criteria and published before 25th February 2019 were included, while those focusing on a very specific sub-population or reporting non-psychosocial interventions were excluded. Data was extracted by a standard form. Meta-analysis was conducted to obtain a summary measure of the effectiveness of the interventions in reducing perinatal depressive symptoms. The theoretical underpinnings and implementation processes of the interventions were also characterised. RESULTS A total of 6857 articles were identified in the initial database searching, of which, 26 studies were eligible for data analysis, representing a sample size of 4673. Meta-analysis indicated that psychosocial interventions in China significantly reduced perinatal depressive symptoms (standard difference in means 0.81, 95% confidence intervals -1.03 to -0.58, P < 0.001). However, the overall evidence presented substantial heterogeneity (I2 = 91.12%). Most interventions were implemented in hospitals in urban areas by non-specialist health care providers. Few studies reported details of implementation procedures or scale-up strategies. LIMITATIONS The evidence in this review is of moderate to low quality and therefore, should be interpreted with caution. Some of the trials were inadequately powered and tended to overestimate effect sizes. CONCLUSIONS Current psychosocial interventions in China are somewhat effective in reducing perinatal depressive symptoms. High quality RCTs on scale-up interventions are required, especially in rural areas.
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Affiliation(s)
- Juan Yin
- School of nursing, Xi'an Jiaotong University, 76 West Yanta Road, 710061 Xi'an, China
| | - Anum Nisar
- School of Public Health, Xi'an Jiaotong University, Xi'an, China
| | - Ahmed Waqas
- Human Development Research Foundation, Rawalpindi, Pakistan; University of Liverpool, Liverpool, UK
| | - Yan Guo
- School of nursing, Xi'an Jiaotong University, 76 West Yanta Road, 710061 Xi'an, China
| | - Wen Li Qi
- Department of obstetrics, Xi'an Aerospace general hospital, Xi'an, China
| | - Duolao Wang
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - Atif Rahman
- Institute of Life and Human Sciences, University of Liverpool, Liverpool, UK
| | - Xiaomei Li
- School of nursing, Xi'an Jiaotong University, 76 West Yanta Road, 710061 Xi'an, China.
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McCoy A, Melendez-Torres GJ, Gardner F. Parenting interventions to prevent violence against children in low- and middle-income countries in East and Southeast Asia: A systematic review and multi-level meta-analysis. CHILD ABUSE & NEGLECT 2020; 103:104444. [PMID: 32171126 DOI: 10.1016/j.chiabu.2020.104444] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 02/23/2020] [Accepted: 03/01/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Currently, the strongest evidence for preventing violence against children lies with social learning theory-based parenting interventions. An increasing number of experimental studies on such interventions have been conducted in low- and middle-income countries (LMICs) in East and Southeast Asia. OBJECTIVE To conduct a systematic review and meta-analysis on the effectiveness of parenting interventions in preventing violence against children. PARTICIPANTS AND SETTING Parents and primary caregivers living in LMICs in East and Southeast Asia. METHODS Eleven studies were retrieved through electronic databases, expert contacts, and the reference sections of previous reviews. Studies were appraised for risk of bias and effect estimates pooled using random effects multilevel meta-analysis. RESULTS Forty-four effect estimates were meta-analyzed based on five outcome category models, finding a small effect on abusive, harsh, or negative parenting (n = 3, d = -0.42, 95 % CI [- 0.81, -0.02], p < .01, I2 = 72 %); a large, non-significant effect on parental knowledge or attitudes (n = 5, d = 1.40, 95 % CI [-0.30, 3.10], I2 = 95 %); a small effect on positive parent-child interactions (n = 5, d = 0.25, 95 % CI [0.19, 0.32], p < .001, I2 = 0); a small, non-significant effect on parental stress (n = 2, d = -0.13, 95 % CI [-0.38, 0.11], I2 = 0); and a small, non-significant effect on family environment (n = 3, d = 0.21, 95 % CI [-0.12, 0.53], I2 = 85 %). CONCLUSIONS The results suggest that parenting interventions can reduce rates of particular forms of violence against children, as well as promote positive parent-child interactions.
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Affiliation(s)
- Amalee McCoy
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, Barnett House, 32 Wellington Square, University of Oxford, Oxford, OX1 2ER, United Kingdom; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok, 10400, Thailand.
| | - G J Melendez-Torres
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, 1-3 Museum Place, Cardiff University, Cardiff, CF10 3BD, United Kingdom
| | - Frances Gardner
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, Barnett House, 32 Wellington Square, University of Oxford, Oxford, OX1 2ER, United Kingdom
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Jin Q, Mori E, Sakajo A. Nursing intervention for preventing postpartum depressive symptoms among Chinese women in Japan. Jpn J Nurs Sci 2020; 17:e12336. [PMID: 32250045 PMCID: PMC7586781 DOI: 10.1111/jjns.12336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 01/31/2020] [Accepted: 03/01/2020] [Indexed: 11/28/2022]
Abstract
Aim We evaluated the effectiveness of a nursing intervention program for Chinese women who are giving birth in Japan to reduce cross‐cultural stressors during the postpartum period and prevent postpartum depressive symptoms. Methods A prospective, before‐and‐after study incorporating a longitudinal mixed‐method design was conducted. Thirty‐eight participants underwent this program from August 2016 to July 2017. The program comprised a maternity class, conversation cards, and a social‐network group. Data collection was initially performed using questionnaires administered in the third trimester (T1)—before the intervention—to obtain participants' basic information, stress levels, depressive symptoms, and cognitive appraisals. Then, stress levels, depressive symptoms, and social support were measured during hospitalization after having given birth (T2) and during the first month postpartum (T3). Finally, through semi‐structured interviews, cognitive appraisal, coping, stress, social support, participants' evaluations of the intervention were determined. Results Post‐intervention, all participants showed positive cognitive appraisals, although eight also showed some negative appraisals. At T3, 36 participants did not report experiencing stress owing to cross‐cultural stressors. Furthermore, post‐intervention, participants who returned scores that were suggestive of depression remained identical to that at pre‐intervention (21.1%). Among the eight participants who showed postpartum depressive symptoms during T3, seven did not report experiencing cross‐cultural stressors, but did report encountering maternity stressors. Conclusion The nursing intervention program may be effective for preventing postpartum depressive symptoms in Chinese women who give birth in Japan. Since this was a pre‐post study in which one group was measured pre‐intervention and again post‐intervention, we did not register in a publicly assessible database.
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Affiliation(s)
- Qiongai Jin
- School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Emi Mori
- Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Akiko Sakajo
- Faculty of Nursing, Musashino University, Tokyo, Japan
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Mahdi A, Dembinsky M, Bristow K, Slade P. Approaches to the prevention of postnatal depression and anxiety - a review of the literature. J Psychosom Obstet Gynaecol 2019; 40:250-263. [PMID: 30204522 DOI: 10.1080/0167482x.2018.1512577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Introduction: Poor maternal mental health during the perinatal period has been shown to have potentially long-lasting effects for mother and child. In recognition of this, maternal mental health is receiving increased attention from political and healthcare organizations, with a growing focus on preventing the onset of common mental health disorders. Objective: The objective for this review is to provide an update of randomized controlled trials examining the use of interventions targeted to prevent the onset of postnatal depression and anxiety in nondiagnostic populations with universal or selected samples. Methods: A total of four databases, EBSCO Host, Science Direct, Scopus, and Web of Science, incorporating PsychINFO were searched and papers selected according to clearly specified inclusion criteria. A large Health Technology review was published in 2016, for which the final search was conducted in December 2012. Therefore inclusion criteria were studies published from January 2013 onwards, available in English language, had a focus on prevention of postnatal maternal depression and anxiety, and used psychological interventions. Drug intervention trials were excluded. Findings: 12 studies were identified as examining antenatal or postnatal intervention trials with an aim of preventing maternal postnatal depression and/or anxiety. There continues to be limited evidence to recommend specific prevention strategies for universal samples without further testing. There is evidence to suggest the use of rational-emotive behavioral therapy in an antenatal sample may have some utility, and the use of psychotherapy-based interventions in a postnatal setting is also supported although both require further investigation. Additionally, there is a need to gather information on acceptability, as many trials were hindered by poor adherence to interventions and high attrition that were otherwise unexplained.
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Affiliation(s)
- Amy Mahdi
- NHS Foundation Trust, Liverpool Women's Hospital , Liverpool , UK
| | - Melanie Dembinsky
- Institute of Psychology Health and Society, University of Liverpool , Liverpool , UK
| | - Katie Bristow
- Institute of Psychology Health and Society, University of Liverpool , Liverpool , UK.,Improving Mental Health, NIHR CLAHRC North West Coast, University of Liverpool , Liverpool , UK
| | - Pauline Slade
- Institute of Psychology Health and Society, University of Liverpool , Liverpool , UK
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Dol J, Campbell-Yeo M, Tomblin Murphy G, Aston M, McMillan D, Gahagan J, Richardson B. Parent-targeted postnatal educational interventions in low and middle-income countries: A scoping review and critical analysis. Int J Nurs Stud 2019; 94:60-73. [PMID: 30933873 DOI: 10.1016/j.ijnurstu.2019.03.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 03/10/2019] [Accepted: 03/12/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To identify and map existing postnatal educational interventions targeting parents in low and middle-income countries. A secondary objective is to conduct a critical analysis of the strengths and limitations of the educational strategies used for parent-targeted postnatal education. Design & data sources: Using scoping review methodology, MedLine, CINAHL, and SCOPUS were searched in October 2017. REVIEW METHODS All studies published after 2000 reporting on educational interventions that targeted parents from the period of birth to 6 weeks postnatally in low and middle-income countries were included. Studies were excluded if they targeted healthcare professionals or were community interventions that spanned antenatal to postnatal care. Title, abstract and full-text screening was conducted by two reviewers. RESULTS We initially identified 9284 articles with 77 articles included after title, abstract and full-text screening. Most of the studies were quantitative (94%) with over half published after 2014. Most studies (61%) targeted a single newborn care education intervention, of which 75% targeted breastfeeding. Interventions used on average three different methods of implementation (e.g., verbal, written information, counselling). Interventions were provided in the hospital (76%), at home (23%), at a clinic/hospital (8%), and/or virtually through an eHealth intervention, including phone or text messages (12%). Maternal outcomes primarily included knowledge, self-efficacy, anxiety and stress while newborn outcomes primarily included exclusive breastfeeding, weight gain at follow-up, and morbidities. Positive changes were found to occur for reported maternal outcomes (89%) and newborn outcomes (56%). CONCLUSIONS Parent-targeted education varied in terms of educational topics covered, method and location of intervention, and outcomes examined. While the best strategies of implementing postnatal education interventions to parents in low and middle-income countries is yet to be determined, evidence suggests that current interventions had a positive impact on parents' outcomes using a combined approach. Further work is needed to evaluate the impact on newborn outcomes and to identify the most effective methods and timing of the interventions.
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Affiliation(s)
- Justine Dol
- Faculty of Health, Dalhousie University, 6299 South St., Halifax, NS, 902-470-2638, Canada; World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, 6299 South St., Halifax, NS, Dalhousie University, Canada.
| | - Marsha Campbell-Yeo
- Faculty of Health, Dalhousie University, 6299 South St., Halifax, NS, 902-470-2638, Canada; School of Nursing, Faculty of Health, Dalhousie University, 6299 South St., Halifax, NS, Canada; Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, 6299 South St., Halifax, NS, Canada; World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, 6299 South St., Halifax, NS, Dalhousie University, Canada
| | - Gail Tomblin Murphy
- School of Nursing, Faculty of Health, Dalhousie University, 6299 South St., Halifax, NS, Canada; World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, 6299 South St., Halifax, NS, Dalhousie University, Canada
| | - Megan Aston
- School of Nursing, Faculty of Health, Dalhousie University, 6299 South St., Halifax, NS, Canada; World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, 6299 South St., Halifax, NS, Dalhousie University, Canada
| | - Douglas McMillan
- Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, 6299 South St., Halifax, NS, Canada
| | - Jacqueline Gahagan
- School of Health and Human Performance, Faculty of Health, 6299 South St., Halifax, NS, Dalhousie University, Canada
| | - Brianna Richardson
- School of Nursing, Faculty of Health, Dalhousie University, 6299 South St., Halifax, NS, Canada
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Chung FF, Wan GH, Kuo SC, Lin KC, Liu HE. Mother-infant interaction quality and sense of parenting competence at six months postpartum for first-time mothers in Taiwan: a multiple time series design. BMC Pregnancy Childbirth 2018; 18:365. [PMID: 30189849 PMCID: PMC6127995 DOI: 10.1186/s12884-018-1979-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 08/13/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND For first-time mothers, not knowing how to interact with newborn infants increases anxiety and decreases the quality of the parent-infant interactions. A substantial lack of interactional knowledge can ultimately limit the adjustments necessary for a stable transition into motherhood. This study investigated how postpartum parenting education influenced first-time mothers' mother-infant interaction quality and parenting sense of competence. METHODS Eighty-one healthy first-time-mother and infant dyads were recruited. The control group (n = 40) received postpartum care based on the medical and cultural norms practiced in Taiwan, while the experimental group (n = 41) received, on top of typical care, education by way of a 40-min videotape on infant states, behaviors, and communication cues, as well as a handout on play practices. Data were collected at five points: within the first week, and during follow-ups in the first, second, third, and sixth months after birth. We administered the Chinese versions of the Parenting Sense of Competence Scale and Edinburgh Perinatal Depression Scale, and used the Nursing Child Assessment Teaching Scale to score videotaped mother-infant interactions. RESULTS We observed an increase in the quality of mother-infant interaction within the experimental group only. Furthermore, at the five assessment points, we observed no significant changes in perceived parenting competence. Among all subjects, there were correlations between postpartum depression scores, parenting competency, and quality of mother-infant interaction. CONCLUSIONS Our results indicate that first-time mothers in Taiwan who are provided with extra education on infants' abilities and how to effectively play with infants are likely to exhibit improvements in quality of interaction.
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Affiliation(s)
- Fen-Fang Chung
- Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Department of Nursing, Linkuo Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Gwo-Hwa Wan
- Department of Respiratory Therapy, College of Medicine, Chang Gung University, 259, Wen-Hwa 1st Road, Kwei-Shan, Taoyuan, 333 Taiwan, Republic of China
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan
- Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, Taiwan
| | - Su-Chen Kuo
- Department of Midwifery and Women Health Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Kuan-Chia Lin
- Institute of Hospital and Health Care Administration, Community Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Hsueh-Erh Liu
- Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- School of Nursing, College of Medicine, Chang Gung University, 259, Wen-Hwa 1st Road, Kwei-Shan, Taoyuan, 333 Taiwan, Republic of China
- Department of Rheumatology, Linkuo Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Kim SJ, Seo JM. Effects of a Maternal Role Adjustment Program on First-time Mothers. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2018; 24:322-332. [PMID: 37684938 DOI: 10.4069/kjwhn.2018.24.3.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 09/01/2018] [Accepted: 09/04/2018] [Indexed: 09/10/2023] Open
Abstract
PURPOSE To investigate the effect of a maternal role adjustment program on first-time mothers. METHODS The research was quasi-experimental with a non-equivalent control group non-synchronized design. Participants were first-time mothers admitted to two postpartum clinics at women's hospitals. The experimental group had 38 mothers and the control group had 35 mothers. A maternal role adjustment program was applied individually to the experimental group between the 1st and 2nd weeks after childbirth. Assessing Adaptation to Motherhood, Semantic Differential Scale-Myself as Mother, and Edinburgh Postnatal Depression Scale were used to measure effects of the program. A pre-test was conducted in the 1st week after childbirth while post-tests were conducted in the 4th and 6th weeks. Data were analyzed with χ2 test, Fisher's exact test, t-test, and repeated measures ANOVA using SPSS 24.0. RESULTS Maternal role adjustment (F=6.17, p=.015) and maternal identity (F=6.63, p=.012) were significantly increased in the experimental group compared to those in the control group. However, the difference in postpartum depression (F=1.11, p=.335) was not statistically significant between the two groups. CONCLUSION The maternal role adjustment program can be utilized as an effective nursing intervention program to enhance maternal role adjustment and maternal identity for first-time mothers.
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Affiliation(s)
- Su Jeong Kim
- Graduate Student, College of Nursing, Pusan National University, Yangsan, Korea
| | - Ji Min Seo
- Graduate Student, College of Nursing, Pusan National University, Yangsan, Korea
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Sockol LE. A systematic review and meta-analysis of interpersonal psychotherapy for perinatal women. J Affect Disord 2018; 232:316-328. [PMID: 29501991 DOI: 10.1016/j.jad.2018.01.018] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 01/05/2018] [Accepted: 01/29/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND Interpersonal psychotherapy (IPT) has demonstrated efficacy for the prevention and treatment of perinatal depression. Previous systematic reviews have not evaluated the effects of IPT on other outcomes, most notably symptoms of anxiety and interpersonal functioning, or assessed moderators of treatment efficacy specific to IPT. METHOD A systematic review identified 28 studies assessing the efficacy of IPT during pregnancy or the first year postpartum. Random effects meta-analyses assessed the average change in outcomes (depression, anxiety, relationship quality, social adjustment, and social support) from pre- to post-treatment, the difference in the change in outcomes between treatment and comparison conditions, and the difference in prevalence of depressive episodes between treatment and comparison conditions. Study, intervention, and sample characteristics were evaluated as potential moderators of effect sizes. RESULTS In prevention studies, IPT was effective for reducing depressive symptoms and the prevalence of depressive episodes. In treatment studies, IPT reduced symptoms of depression and anxiety and improved relationship quality, social adjustment and social support. Few significant moderators were identified, and results of moderation analyses were inconsistent across outcomes. LIMITATIONS There are insufficient studies to evaluate the effects of preventive IPT on anxiety and interpersonal outcomes. Analyses of potential moderators were limited by the number of studies available for subgroup comparisons. CONCLUSIONS IPT is an effective preventive intervention for perinatal depression. IPT is clearly effective for treating depressive symptoms and promising as a treatment for anxiety and improving interpersonal functioning. Further research is necessary to assess whether adaptations to IPT enhance its efficacy.
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Affiliation(s)
- Laura E Sockol
- Department of Psychology, Davidson College, Davidson, NC 28035, USA.
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Liyana Amin NA, Tam WWS, Shorey S. Enhancing first-time parents' self-efficacy: A systematic review and meta-analysis of universal parent education interventions' efficacy. Int J Nurs Stud 2018; 82:149-162. [PMID: 29656206 DOI: 10.1016/j.ijnurstu.2018.03.021] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 03/27/2018] [Accepted: 03/27/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Poor adjustment during early parenthood often leads to low feelings of parental self-efficacy, which influences parents' behaviours towards their infants. The long-term consequences on infant development warrant the need for more attention on the efficacy of universal parent education interventions to empower parents and enhance their self-efficacy. OBJECTIVES To synthesise available evidence and explore the efficacy of universal parent education interventions on the parental self-efficacy of first-time parents. DESIGN A systematic review and meta-analysis of randomised controlled trials. DATA SOURCES A literature search of 10 databases was conducted to identify randomised controlled trials from each database's point of inception to November 2016. METHODS Based on the inclusion criteria, 24,062 articles were screened for their titles and abstracts. Two hundred and eighty articles were identified for full-text screening. Risks of bias posed by the selected articles were assessed using Cochrane's Risk of Bias instrument. Meta-analyses were conducted using RevMan 5.3. The overall intervention effect was evaluated using z tests at p < 0.05, while I2 and Cochran Q tests were used to measure heterogeneity. RESULTS Ten randomised controlled trials were selected; eight trials were combined in meta-analyses and two trials were synthesised narratively. A meta-analysis revealed that universal parent education interventions significantly enhanced parental self-efficacy (p < 0.001) among first-time parents and these effects were also maintained over time (p < 0.001). The extent of improvement in parental self-efficacy was affected by the duration of the interventions. CONCLUSION This review provides sufficient evidence to support the use of universal interventions to enhance new parents' self-efficacy. While intervention effects were sustained at the two-month follow-up, further research using randomised controlled trials and longitudinal studies are needed to determine long-term effects. The findings serve as an impetus for hospitals and healthcare professionals to integrate universal interventions in perinatal care to guide first-time parents' transition into parenthood.
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Affiliation(s)
| | - Wilson W S Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore.
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore.
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Yang X, Ip WY, Gao LL. Maternal intention to exclusively breast feed among mainland Chinese mothers: A cross-sectional study. Midwifery 2017; 57:39-46. [PMID: 29169075 DOI: 10.1016/j.midw.2017.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 11/01/2017] [Accepted: 11/03/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE to examine postpartum maternal recall of their intentions to exclusively breast feed among breastfeeding women and identify its predictors. DESIGN AND SETTING a cross-sectional descriptive study was conducted in a regional teaching hospital at Guangzhou, China between April 1 and July 14, 2014. PARTICIPANTS 571 mothers who were within four days after delivery were recruited to the study. MEASUREMENTS data were collected by four research assistants with maternal intention to breast feed data sheet, the Network Support for Breastfeeding Scale (NSBS), and a socio-demographic data sheet. FINDINGS greater than half of the mothers (69.5%) intended to exclusively breast feed. The logistic regression analysis revealed six variables which predicted postpartum maternal recall of their intentions to exclusively breast feed. They were support from husband, being breast-fed as an infant, previous breast feeding experience, attending antenatal breast feeding class, time of decision to breast feed, and the rating of the importance of my baby's health. CONCLUSION AND IMPLICATIONS FOR PRACTICE health care professionals could develop strategies to enhance mothers' intention to exclusively breast feed, such as providing antenatal breast feeding class on internet, a strong focus on the benefits of exclusive breast feeding on the baby's health in the education programme, and more efforts directed toward educating school-aged children and adolescents to modify societal perceptions of what are considered normal infant feeding. Mothers' husband could be encouraged in supporting exclusive breast feeding.
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Affiliation(s)
- Xiao Yang
- School of Nursing, Zhengzhou University, Henan, China.
| | - Wan-Yim Ip
- New Asia College, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
| | - Ling-Ling Gao
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
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Singla DR, Kohrt BA, Murray LK, Anand A, Chorpita BF, Patel V. Psychological Treatments for the World: Lessons from Low- and Middle-Income Countries. Annu Rev Clin Psychol 2017; 13:149-181. [PMID: 28482687 PMCID: PMC5506549 DOI: 10.1146/annurev-clinpsy-032816-045217] [Citation(s) in RCA: 390] [Impact Index Per Article: 55.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Common mental disorders, including depression, anxiety, and posttraumatic stress, are leading causes of disability worldwide. Treatment for these disorders is limited in low- and middle-income countries. This systematic review synthesizes the implementation processes and examines the effectiveness of psychological treatments for common mental disorders in adults delivered by nonspecialist providers in low- and middle-income countries. In total, 27 trials met the eligibility criteria; most treatments targeted depression or posttraumatic stress. Treatments were commonly delivered by community health workers or peers in primary care or community settings; they usually were delivered with fewer than 10 sessions over 2-3 months in an individual, face-to-face format. Treatments included common elements, such as nonspecific engagement and specific domains of behavioral, interpersonal, emotional, and cognitive elements. The pooled effect size was 0.49 (95% confidence interval = 0.36-0.62), favoring intervention conditions. Our review demonstrates that psychological treatments-comprising a parsimonious set of common elements and delivered by a low-cost, widely available human resource-have moderate to strong effects in reducing the burden of common mental disorders.
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Affiliation(s)
- Daisy R Singla
- Sinai Health Network, Toronto, Ontario, Canada M5G 1X5
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada M5T 1R8;
| | - Brandon A Kohrt
- Duke Global Health Institute, Department of Psychiatry, Duke University, Durham, North Carolina 27710;
| | - Laura K Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205;
| | | | - Bruce F Chorpita
- Department of Psychology, University of California, Los Angeles, California 90095;
| | - Vikram Patel
- Sangath, Goa, India 403501;
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts 02115;
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurgaon India 122022
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Sampaio FMC, Sequeira C, Lluch Canut T. Content Validity of a Psychotherapeutic Intervention Model in Nursing: A Modified e-Delphi Study. Arch Psychiatr Nurs 2017; 31:147-156. [PMID: 28359426 DOI: 10.1016/j.apnu.2016.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 09/08/2016] [Accepted: 09/09/2016] [Indexed: 12/17/2022]
Abstract
AIM To estimate the content validity of a psychotherapeutic intervention model in nursing. BACKGROUND Mental health nurses encounter great extrinsic difficulties when it comes to providing psychotherapeutic interventions due to the fact that they are not allowed to perform such practice in some countries. In this light, the pursuit of a psychotherapeutic intervention model in nursing seems germane to guide the professionals' psychotherapeutic practice, contributing hereof to increase mental health nurses' professional autonomy. DESIGN Modified e-Delphi. METHODS Data were collected from October 2015 to January 2016 by means of three rounds of online questionnaires. The initial questionnaire was structured into five sections: general structure of the model, patients' exclusion criteria, assessment framework, nursing diagnoses, and nursing psychotherapeutic interventions. From the 42 experts invited, at least twenty (20) participated in each round. RESULTS The experts achieved consensus with regard to the conclusion that nursing psychotherapeutic interventions should always seek to address a nursing diagnosis. These defined furthermore that a psychotherapeutic intervention model in nursing should be exercised by means of 3 to 12 sessions using Nursing Interventions Classification (NIC) as a resource. Finally, experts deemed that the model should follow the principles of integrative psychotherapy, so that techniques from different schools of psychotherapy could therefore be used in conjunction to promote the resolution of a nursing diagnosis. CONCLUSION Achieving consensus about the structure of a psychotherapeutic intervention model in nursing is imperative to guide nurses in the provision of nursing psychotherapeutic interventions and to enable an effective evaluation of the health gains associated with its implementation.
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Affiliation(s)
- Francisco Miguel Correia Sampaio
- Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal; Psychiatry Department, Hospital de Braga, Braga, Portugal; Nursing School of Porto, Porto, Portugal; Center for Health Technology and Services Research, Porto, Portugal.
| | - Carlos Sequeira
- Nursing School of Porto, Porto, Portugal; Center for Health Technology and Services Research, Porto, Portugal.
| | - Teresa Lluch Canut
- Department of Public Health, Mental Health and Perinatal Nursing, Barcelona University School of Nursing, Feixa Llarga, s/n, 08907 L'Hospitalet Ll., Barcelona, Spain.
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Yang X, Gao LL, Ip WY, Sally Chan WC. Predictors of breast feeding self-efficacy in the immediate postpartum period: A cross-sectional study. Midwifery 2016; 41:1-8. [DOI: 10.1016/j.midw.2016.07.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Revised: 06/15/2016] [Accepted: 07/15/2016] [Indexed: 11/29/2022]
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Transported Versus Homegrown Parenting Interventions for Reducing Disruptive Child Behavior: A Multilevel Meta-Regression Study. J Am Acad Child Adolesc Psychiatry 2016; 55:610-7. [PMID: 27343888 DOI: 10.1016/j.jaac.2016.05.003] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 05/04/2016] [Accepted: 05/05/2016] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Children's disruptive behavior problems place children at high risk for oppositional defiant disorder and conduct disorder, and carry a high burden for individuals and society. Policy makers and service providers aiming to reduce children's disruptive behavior problems must often choose between importing an intervention developed abroad or instead developing or using a "homegrown" (i.e., local) intervention. No comprehensive comparison of these interventions exists. METHOD We performed a multilevel meta-regression of 129 randomized trials (374 effect sizes) of transported and homegrown parenting interventions. We identified trials by searching the included trials lists of systematic reviews, found through searches in 6 databases (e.g., MEDLINE, EMBASE). Trials that had not yet been reviewed were found by searching the same databases. Primary outcome was the mean difference in effectiveness between transported and homegrown interventions to reduce disruptive child behavior. We also compared this differential effectiveness for various intervention "brands" (e.g., Incredible Years and Triple P Positive Parenting Program) and geographical regions (e.g., North America and Europe). RESULTS Transported and homegrown interventions did not differ in their effectiveness to reduce disruptive child behavior (d = 0.10, not significant). Results were robust across intervention brands and geographical regions. Six trials on transported interventions in Hong Kong, Iran, and Panama suggest promising results for transporting interventions to "nonwestern" countries, whereas one trial in Indonesia does not. CONCLUSION Parenting interventions based on the same principles led to similar outcomes, whether transported or homegrown. This finding supports the selection of interventions based on their evidence base rather than on cultural specificity.
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