A narrative review of parental education in preparing expectant and new fathers for early parental skills

'Been there, experienced that': A qualitative study on the experiences and perceptions of online peer volunteers in supporting Singaporean mothers at risk of depression

BACKGROUND

Online peer support is a useful source of support for parents during the perinatal period, associated with improved psychological outcomes. Past research has found that peer support providers themselves gain from providing peer support as well, making it mutually beneficial. As current maternity care services are insufficient to meet the support needs of parents, the Supportive Parenting App (SPA) intervention was developed to offer them informational, appraisal and emotional support during the perinatal period. It consists of mobile health application-based educational support and online peer support provided by trained peer volunteers, to prevent the development of postnatal depression.

OBJECTIVE

To explore the experiences of peer volunteers with providing online peer support to parents during the perinatal period, as well as to identify areas of improvement for the SPA intervention.

METHODS

A qualitative descriptive design was adopted. This study took place from October 2020 to August 2021 in two tertiary public healthcare institutions in Singapore. A total of 18 peer volunteers were invited for individual semi-structured interviews. The interviews were audio recorded and transcribed verbatim, and thematic analysis was used to analyse the data.

RESULTS

Four themes were emerged as follows: (1) 'Being there': Reminiscing about and healing of own postnatal depression experience; (2) Building rapport with parents; (3) Parents in mind: Mutual sharing of knowledge and how to support new parents better; (4) Ensuring good quality peer support.

CONCLUSIONS

The peer volunteers felt that their experience was fulfilling and healing. Frequent contact, sharing of SPA resources and self-disclosure were found to help engage the new parents and build rapport between peer volunteers and parents. Challenges described by the peer volunteers have identified possible areas in which the SPA intervention can be improved.

IMPLICATIONS FOR CARE

Communication between peer program facilitators, managers and peer volunteers can be enhanced to ensure that peer volunteers are more sensitive and precise when providing support or information. This can improve rapport building between parents and peer volunteers, which will in turn maximize the benefits that parents can reap through online peer-to-peer support.

IMPACT

This study explored the perceptions of peer volunteers who provided online peer support to parents across the perinatal period. Peer volunteers felt that the SPA intervention was meaningful and that providing peer support was a healing experience. They were able to learn about the experiences of other mothers with postpartum depression while sharing their own past experiences. Thus, both parents and peer volunteers can benefit from engaging in online peer support programs. Technology-based interventions like the Supportive Parenting App (SPA) can be a suitable complement to maternity care services by providing parents access to medically accurate information and social support. Additionally, more experienced mothers can engage in fulfilling experiences through volunteering for new mothers who may benefit from informational, appraisal and emotional support.

REPORTING METHOD

This study follows the reporting guidelines as stated by the Consolidated criteria for reporting qualitative research (COREQ) checklist.

PATIENT OR PUBLIC CONTRIBUTION

Parents and peer volunteers contributed ideas that aided with the design of the mobile app. Many topics added to the educational materials were suggested by these parents as well. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: This study showed that sufficient training can be provided to lay peer volunteers to help them support other parents, buffering the pressure exerted on the healthcare industry due to the rising demand for healthcare services. The provision of such support is also beneficial for the peer volunteers themselves, as they find it meaningful and educational. Program developers of parenting and peer volunteering interventions can draw on the findings of this study to improve the effectiveness of these programs.

Partners' experiences of breastfeeding: a qualitative evaluation of a breastfeeding support intervention in Sweden

BACKGROUND

The World Health Organization states that women and their families need breastfeeding support from the healthcare system. However, knowledge about the most effective way to involve the partner in breastfeeding is lacking. A qualitative evaluation can provide insight and knowledge about the partner's experiences towards a breastfeeding support intervention and thus contribute to how forthcoming breastfeeding support policies are designed. The aim of this study was to explore partners' experiences regarding breastfeeding while participating in The Breastfeeding Study.

METHODS

An exploratory, longitudinal and qualitative design was used. This study was part of The Breastfeeding Study, which took place in Sweden. The intervention was performed in line with the Ten Steps to Successful Breastfeeding. Partners in the in the intervention group (IG) were part of a structured breastfeeding support programme. An individual breastfeeding plan was established in cooperation with the parents-to-be during pregnancy, and the plan was followed up at the child healthcare centre. A purposive sample was recruited from March to December 2021. Interviews and diary entries from IG (n = 8) and control group (CG) (n = 8) during pregnancy and 2 months after birth were analysed by content analysis, in accordance with the COREQ guidelines.

RESULTS

Partners' experiences can be summarised under the main category of 'Striving to be part of the family and important that the family's everyday life was well-functioning'. IG partners experienced that both parents were involved and cooperated in the breastfeeding process and that guidance from healthcare professionals (HCPs) helped them to feel secure. CG partners experienced feeling excluded and not receiving support from HCPs.

CONCLUSION

Both parents need to be targeted in breastfeeding support policies to meet the support needs. Midwives at antenatal care and child healthcare nurses at the child healthcare centre have important roles to play in providing structured breastfeeding support and a breastfeeding plan. Both IG and CG partners strived to become a part of the infant's life and to make family life work. Midwives should involve both parents in a reflective dialogue on how the partner can be involved, apart from just feeding the infant.

TRIAL REGISTRATION

Retrospectively registered in ACTRN12623000648628.

Increasing Vaccine Uptake during Pregnancy by Using Prenatal Education Classes: An Effective Tool for Health Communication and Promotion

Childbirth education classes represent an antenatal tool for supporting pregnant women and couples in increasing knowledge on pregnancy, delivery, breastfeeding, and newborn care. The aim of this study was to investigate the impact of an additional lesson during the prenatal course regarding the advantage of vaccination to mitigation of maternal anxiety. An observational study was designed that included participants in childbirth education classes and compared courses enhanced by the extra lesson on vaccination during pregnancy versus those who did not receive it. Assessment of the impact of prenatal educational on vaccination was measured by using validated questionnaires (State-Trait Anxiety Inventory, STAI; Perceived Stress Scale, PSS; World Health Organization- Five Well-Being Index, WHO-5). A total of 145 pregnant women participated to the investigation by answering to the online survey. Of them, 33 patients (22.8%) belonged to the course without a lesson on vaccine, while 112 (77.2%) participated to online prenatal education that included an additional meeting on the usefulness of getting vaccinated during pregnancy. No statistical differences were found between study groups in terms of demographics and perinatal outcomes. Participants in the enriched course reported lower basal anxiety levels than those without the vaccine lesson (STAI-State, normal score < 40, 30 vs. 19%, p-value 0.041; STAI-State, mild score 40-50, 78 vs. 67%, p-value 0.037). With reference to the prior two weeks, maternal wellbeing level was improved by the added class (score > 13 as measurement of wellbeing: 62% vs. 80%, p-value < 0.05). Moderate perceived stress assessed by PSS was found in those pregnant women without prenatal education on vaccination (64 vs. 50%, p-value 0.042). The introduction of a lesson regarding vaccination during pregnancy in the program of prenatal education courses improved maternal anxiety levels and wellbeing, in addition to reducing perceived stress.

How to support fathers of preterm infants in early parenthood - An integrative review

PROBLEM

Preterm birth is a stressful event. Paternal experiences of having a preterm infant indicate a need for tailored support. However, it is unclear which interventions work best. This review presents the evidence on existing healthcare interventions to support fathers of preterm infants in early parenthood, how effective they are and paternal experiences with the interventions.

ELIGIBILITY CRITERIA

The integrative review process of Whittemore and Knafl was used to guide the study. A structured and comprehensive literature search was conducted in PubMed (MEDLINE), Embase, CINAHL, PsycInfo, Cochrane, Scopus, Web of Science, SweMed+, and Proquest Dissertation & Thesis Global.

SAMPLE

A total of 18 qualitative and quantitative studies were included in the review. The Mixed Methods Appraisal Tool was used to assess quality.

RESULTS

Three overall themes were identified in the analysis: 1) Skin-to-skin contact supported interaction between infant and father, 2) information impacted paternal experiences of stress, anxiety, and development of fatherhood, 3) fathers' relationships with the nurses oscillated between conflict and assistance.

CONCLUSIONS

Our findings show that targeted interventions could support father-infant interaction and reduce stress among fathers of preterm infants.

IMPLICATIONS

Fathers of preterm infants rely on nurses to support their engagement in early parenthood, while nurses facilitate the interventions that engage the fathers. It is also essential to develop a culture within the neonatal intensive care unit that encourages the presence of fathers and enhances educational nursing strategies for supporting fathers of preterm infants during early parenthood.

Effects of a hybrid online and offline program for facilitating father-infant interactions in South Korea: a quasi-experimental study

Purpose

This study examined the effects of an educational program for fathers on improving father-infant interactions, child-rearing knowledge, and attachment.

Methods

In this quasi-experimental study, the participants were recruited by convenience sampling among fathers with infants (2-6 months of age) residing in three districts of Seoul. Fifteen participants in the experimental group and 17 participants in the control group completed the follow-up investigation. A 5-week online and offline intervention program with five sessions was provided to the experimental group. The data were analyzed using generalized estimating equations (GEEs).

Results

There was a significant difference in the change in father-infant interaction scores of the experimental group, especially in the caregiver aspect with a significance level of .100 in time and group-to-group interactions (B=6.46, p=.051, 95% confidence interval [CI]=-0.02-12.94). The changes between the groups and times were not statistically significant when it came to infant development knowledge and father-infant attachment.

Conclusion

We conclude that hybrid online and offline education should be implemented as an effective method to improve fathers’ interactions with their children based on accurate knowledge about infant development.

Mental fitness during transition to fatherhood

Transition into fatherhood is often marked by a period of adjustment, uncertainty and psychological distress and challenges for many men, along with social isolation and relationship problems. Risk factors for paternal mental health issues are maternal depression, marital distress, parenting stress, gender role stress, mismatched expectations for pregnancy and after childbirth, poor physical health, inadequate self-care behaviours, avoiding seeking help for mental health issues, and having a child with sleeping, feeding and temperament problems. Paternal depression, anxiety and post-traumatic stress disorder can have negative impacts on the social and emotional wellbeing of fathers, their partners and their children. Nevertheless, these issues are not widely acknowledged, recognised or treated. Men’s mental health illness is a silent crisis. They often fail to seek help due to their feeling of shame, stigma for a lack of emotional control, distress or anxiety related to utilising mental health support services, and underrating the severity of their symptoms. These necessitate the need for timely attention, psychological support and proper education to minimise their risk of mental health issues. Although research has indicated fathers’ inclination toward being included in practices such as the mental health assessment, perinatal education and postnatal educational approaches need to be inclusive of fathers and encourage them to seek support for their paternal mental health issues and parenting difficulties.

First-time fathers' experiences during their transition to parenthood: A study of Korean fathers

Purpose

This study was conducted to explore first-time fathers' experiences during their transition to parenthood in South Korea.

Methods

Data were collected from September 2019 to February 2020 through in-depth interviews that were conducted individually with 12 participants. First-time fathers with children under 2 months of age were recruited. Verbatim transcripts were analyzed using Colaizzi's phenomenological method.

Results

Four theme clusters were identified: Preparing to become a father, challenges of becoming a father, motivation to foster familial bonds, and acknowledgement of fatherhood.

Conclusion

These findings suggest that Korean first-time fathers prepared to practice parenthood through prenatal education, taegyo, and feeling bonds with their new baby. They recognized their identity as fathers and experienced self-growth. These results would be beneficial for health professionals in developing perinatal care programs, and the results provide basic data for studies on fathers and families during the transition to parenthood.

Does Antenatal Education Affect Level Of Empathy And Attachment Of Fathers?

OBJECTIVE

The study aimed to determine the effects of antenatal education on the paternal bonding and empathic tendency levels of men who would become fathers for the first time.

BACKGROUND

There are a limited number of studies in the literature that have investigated the effects of antenatal education programmes on fathers.

METHODS

This prospective, controlled quasi-experimental study was conducted in a hospital in Istanbul. The men in the antenatal educational group (EG) and their wives participated in training in antenatal classes. The men in the control group (CG) came for routine prenatal follow-up examinations with their wives. The Empathic Tendency and Paternal Postnatal Attachment Scales were used to collect the data.

RESULTS

The Empathic Tendency Scale was applied before the education (1) - after the education (2) and at the 6th postpartum week (3), whilst the Paternal Postnatal Attachment Scale was used at the 6th postpartum month (4). EG had higher emphatic tendency levels in the 2nd and 3rd measurements and higher paternal bonding levels in the 4th measurement in comparison to CG (p < 0.05).

CONCLUSION

Antenatal education increased the emphatic tendency of the fathers and the effects of this education continued in the postpartum period and affected paternal bonding positively.

Fatherhood group sessions: A descriptive and summative qualitative study

The aim of this qualitative study of fatherhood group sessions offered as part of child health care services for new parents was to examine the activities, roles, and topics initiated by the leader and describe fathers' participation. Eight new fathers took part in three audio‐ and video‐recorded sessions led by a male leader. Three qualitative content analysis approaches were used to analyze the data. The analysis showed that the group leader took on four leadership roles, mainly that of discussion leader, but also expert, friend, and organizer. When the group leader acted as discussion leader, fathers participated by discussing challenges and changes in their new situation. Challenges were related to raising the child, partner relationships, everyday life, and gender equality. Fathers also discussed changes in their partner relationships and an increased focus on practicalities in daily life. Fatherhood groups can help new fathers form social networks and can create space for fathers to work through challenging topics, such as gender equality in parenting. The discussion leader's choice of role is crucial to creating the space for such discussions.

Enhanced Antenatal Care: Combining one-to-one and group Antenatal Care models to increase childbirth education and address childbirth fear

BACKGROUND

We designed and implemented a new model of care, Enhanced Antenatal Care (EAC), which offers a combined approach to midwifery-led care with six one-to-one visits and four group sessions.

AIM

To assess EAC in terms of women's satisfaction with care, autonomy in decision-making, and its effectiveness in lowering childbirth fear.

METHODS

This was a quasi-experimental controlled trial comparing 32 nulliparous women who received EAC (n=32) and usual antenatal care (n=60). We compared women's satisfaction with care and autonomy in decision-making post-intervention using chi-square test. We administered a Fear of Birth Scale pre- and post-intervention and assessed change in fear of birth in each group using the Cohen's d for effect size. To isolate the effect of EAC, we then restricted this analysis to women who did not attend classes alongside maternal care (n=13 in EAC and n=13 in usual care).

FINDINGS

Women's satisfaction with care in terms of monitoring their and their baby's health was similar in both groups. Women receiving EAC were more likely than those in usual care to report having received enough information about the postpartum period (75% vs 30%) and parenting (91% vs 55%). Overall, EAC was more effective than usual care in reducing fear of birth (Cohen's d=-0.21), especially among women not attending classes alongside antenatal care (Cohen's d=-0.83).

CONCLUSION

This study is the first to report findings on EAC and suggests that this novel model may be beneficial in terms of providing education and support, as well as lowering childbirth fear.