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Grunberg VA, Presciutti A, Vranceanu AM, Lerou PH. Parental Self-Efficacy and Personal Time Help Explain Impact of Parent-Staff Interactions on Parental Distress and Bonding in the NICU. J Pediatr 2024:114300. [PMID: 39278533 DOI: 10.1016/j.jpeds.2024.114300] [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: 05/28/2024] [Revised: 08/29/2024] [Accepted: 09/09/2024] [Indexed: 09/18/2024]
Abstract
OBJECTIVES To identify factors that help explain associations between parent-staff interactions and: (1) parental depression, anxiety, and posttraumatic stress; and (2) parent-child bonding in the neonatal intensive care unit (NICU). STUDY DESIGN Our cross-sectional mixed methods survey investigated the ways in which parental-staff interactions relate to parental distress and parent-child bonding. Parents with babies in the NICU (N = 165) completed validated measures and open-ended questions about their experiences with staff. Using a sequential explanatory approach, we examined: (1) whether and how parental self-efficacy and personal time mediated parent-staff interactions on distress and bonding; and (2) parental written accounts of experiences with staff. RESULTS Multiple mediation analyses revealed that parent-staff interactions exhibited an: (1) indirect effect on parental depression (b = -.05, SE = .02, CI [-.10, -.01]), anxiety (b = -.08, SE = .04, CI [-.16, -.02]), and parent-child bonding (b = -.26, SE = .08, CI [-.43, -.11]) through parental self-efficacy; and (2) indirect effect on parental posttraumatic stress (b = -.08, SE = .04, CI [-.17, -.00], CSIE= -.06) through parental personal time. Thematic analyses revealed that emotional and instructional support from staff helped build parental self-efficacy. Trust with staff helped parents feel comfortable leaving the bedside and engage in basic needs (eg, eat, sleep). CONCLUSIONS Family-staff dynamics are the foundation for high quality family-centered care. Staff who empower parents to participate in care, engage in parenting tasks, and take care of themselves may reduce their distress and improve relationships among staff, parents, and babies.
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Affiliation(s)
- Victoria A Grunberg
- Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA; Division of Newborn Medicine, Mass General Brigham, Boston, MA.
| | - Alex Presciutti
- Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - Ana-Maria Vranceanu
- Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - Paul H Lerou
- Harvard Medical School, Boston, MA; Division of Newborn Medicine, Mass General Brigham, Boston, MA
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Pudasainee-Kapri S, Shrestha T, Dahan T, Wunnenberg M. Translation, validation, and factor structure of the Nepali version of postpartum bonding questionnaires (PBQ-N) among postpartum women in Nepal. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003469. [PMID: 38995922 PMCID: PMC11244797 DOI: 10.1371/journal.pgph.0003469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 06/19/2024] [Indexed: 07/14/2024]
Abstract
This study aimed to translate and test the psychometric properties of the Nepali version of the PBQ (PBQ-N) among postpartum mothers in Kathmandu, Nepal. Data was collected through semi-structured interviews with postpartum mothers (n = 128) of an infant aged one to six months visiting immunization clinics at two selected hospitals in Kathmandu, Nepal. The PBQ scale was translated into Nepali language and backtranslated to English with the help of language and content experts. The PBQ-N was then assessed for factor structure, validity, and reliability. The exploratory factor analysis (EFA) was conducted to examine construct validity of the PBQ-N in which 16 items (α = .75) of the original 25 items grouped into three subscales and were found suitable to measure mother-infant bonding among Nepalese women. Regarding convergent validity, a statistically significant, positive correlation was found between the PBQ-N and postpartum depression (r = .627, p < .001). In addition, a statistically significant, negative association was found between parenting self-efficacy and the PBQ-N (r = -.496, p < .001). The three subscales demonstrated good internal consistency. Findings indicate adequate estimates of validity and reliability for the PBQ-N in which 16-item measures were considered adequate for screening mother-infant bonding among Nepalese women and are useful for clinical and research purposes. Considering the crucial role of maternal-infant bonding relationships, the use of validated measures is recommended to screen high-risk infants in clinical settings.
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Affiliation(s)
- Sangita Pudasainee-Kapri
- School of Nursing-Camden, Rutgers, The State University of New Jersey, New Jersey, United States of America
| | - Tumla Shrestha
- Maharajgunj Nursing Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Thomas Dahan
- School of Nursing-Camden, Rutgers, The State University of New Jersey, New Jersey, United States of America
| | - Mary Wunnenberg
- School of Nursing-Camden, Rutgers, The State University of New Jersey, New Jersey, United States of America
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Dişsiz M, Bayrı Bingöl F, Demirgöz Bal M, Karaçam Yılmaz ZD, Karakoç A, Bilgin Z. The Turkish version of the Postpartum Bonding Questionnaire (PBQ): Examination of the validity and reliability and scale structure. J Pediatr Nurs 2024; 77:131-139. [PMID: 38518689 DOI: 10.1016/j.pedn.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 02/24/2024] [Accepted: 03/06/2024] [Indexed: 03/24/2024]
Abstract
PURPOSE The aim of this study is to investigate the validity and reliability of the Turkish version of the Postpartum Bonding Questionnaire (PBQ). DESIGN AND METHODS This methodological study was conducted with 250 women who presented to three family health centers in Istanbul/Turkey between April and June 2022 and met the sampling criteria. Validity analysis was performed using the content validity index, exploratory factor analysis, and confirmatory factor analysis. Pearson product-moment correlation and Cronbach Alpha reliability coefficients were used for reliability analysis. RESULTS To evaluate invariance of the instrument over time, test-retest measurements were conducted at least two weeks apart and showed no difference in mean scores (p > .05). Adjusted goodness-of-fit index >0.97 and comparative fit index >0.98 confirmed the construct validity of the Turkish PBQ. Each item had a content validity index of 96%. Corrected item-total score correlations ranged from 0.50 to 0.93. The Cronbach Alpha was found to be 0.96, indicating high internal consistency. CONCLUSION The results of this study show that the Turkish version of the PBQ is valid and reliable. It can be used as a measurement tool to determine the degree of maternal bonding in the postpartum period.
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Affiliation(s)
- Melike Dişsiz
- Health Science University, Hamidiye Faculty of Nursing, Department of Obstetrics and Gynecologic Nursing, Uskudar, Istanbul, Türkiye.
| | - Fadime Bayrı Bingöl
- Marmara University Faculty of Health Sciences Department of Midwife, Maltepe, Istanbul, Türkiye
| | - Meltem Demirgöz Bal
- Marmara University Faculty of Health Sciences Department of Midwife, Maltepe, Istanbul, Türkiye
| | | | - Ayşe Karakoç
- Marmara University Faculty of Health Sciences Department of Midwife, Maltepe, Istanbul, Türkiye
| | - Zümrüt Bilgin
- Marmara University Faculty of Health Sciences Department of Midwife, Maltepe, Istanbul, Türkiye
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Kalfon-Hakhmigari M, Segal H, Peled Y, Handelzalts JE. Hebrew validation of the postpartum bonding questionnaire: a study of mothers and fathers. J Reprod Infant Psychol 2023:1-13. [PMID: 37581452 DOI: 10.1080/02646838.2023.2247014] [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: 03/20/2023] [Accepted: 08/07/2023] [Indexed: 08/16/2023]
Abstract
OBJECTIVE The Postpartum Bonding Questionnaire (PBQ) is a self-report questionnaire designed to screen disorders of the mother-infant relationship. The PBQ was adapted to several countries, though there is no agreement on the accepted number of items and factors. This study aimed to assess the validity and reliability of the Hebrew version for both mothers and fathers. METHODS Participants (602 mothers and 144 fathers) from two separate samples were randomly recruited in the maternity ward of a large tertiary health centre. The mothers' samples were combined and redivided to form subsamples A and B. At T1 (1-4 days postpartum), the participants completed demographic questionnaire in person the PBQ and the Edinburgh Postpartum Depression Scale (EPDS) were administered online at T2 (8-12 weeks postpartum). The PBQ was also administrated at T3 (six-months). RESULTS EFA on subsample A resulted in a two-factor structure, which was tested using CFA on subsample B. The model's fit was very good; χ(35)2 = 83.68, p < .001, CFI = .97, TLI = .91, RMSEA = .07, SRMR = .03. Additional reliability and validity analyses showed a very good fit for mothers. Scalar measurement invariance across mothers and fathers yielded satisfactory results. CFA among fathers, revealed adequate goodness of fit; χ2/df = 87.65/46, p < .001, CFI = .95, TLI = .89, RMSEA = .08, SRMR = .05. CONCLUSIONS The Hebrew version of the PBQ demonstrated satisfactory validity for both mothers and fathers. The revised version, with 14 items, measures bonding as a continuum rather than measuring bonding disorders like the original version. These findings emphasise the importance of validating the scale in different cultural contexts.
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Affiliation(s)
| | - Hila Segal
- School of Behavioral Sciences, Academic College of Tel-Aviv-Yaffo, Tel-Aviv, Israel
| | - Yoav Peled
- The Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Jonathan E Handelzalts
- School of Behavioral Sciences, Academic College of Tel-Aviv-Yaffo, Tel-Aviv, Israel
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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Townsel C, Irani S, Nguyen BH, Hallway A, Shuman CJ, Waljee J, Jaffe K, Peahl AF. Use of Opioid-Sparing Protocols and Perceived Postpartum Pain in Patients with Opioid Use Disorder and Chronic Prenatal Opioid Exposure. Matern Child Health J 2023:10.1007/s10995-023-03710-8. [PMID: 37266855 DOI: 10.1007/s10995-023-03710-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2023] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Opioid-sparing protocols reduce postpartum opioid prescribing in opioid-naïve patients; however, patients with opioid use disorder (OUD) and complex pain needs who may benefit from these protocols are typically excluded from them. We assessed postpartum pain experiences of patients with OUD and chronic prenatal opioid exposure after implementation of an opioid-sparing protocol. METHODS A phone survey assessed postpartum pain experiences for people with chronic prenatal opioid exposure who delivered between January 2020 and August 2021 at an academic hospital. Analyses included descriptive statistics, qualitative content analysis, and a joint display comparing themes. RESULTS Of 25 patients, 18 (72%) participated; most were non-Hispanic White (100%, 18/18), publicly insured (78%, 14/18), multiparous (78%, 14/18), with OUD (100%, 18/18). No patients with a vaginal birth received an opioid prescription; half (4/8) with a cesarean birth received one at discharge. Over one-third (7/18, 39%) reported poor pain control (≥ 5/10) in the hospital and one week post-discharge; scores were higher for cesarean versus vaginal birth. Qualitative sub-analyses of open-ended responses revealed patient perceptions of postpartum pain and treatment. The most effective strategies, stratified by birth type and pain level, ranged from non-opioid medications for vaginal births and minor pain to prescription opioids for cesarean births and moderate-to-intense pain. DISCUSSION Postpartum opioid prescribing for patients with chronic prenatal opioid use was low for vaginal and cesarean birth following implementation of an opioid-sparing protocol. Patients with OUD reported good pain management with opioid-sparing pain regimens; however, many reported poorly controlled pain immediately postpartum. Future work should assess approaches to postpartum pain management that minimize the risks of opioid medication-particularly in at-risk groups.
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Affiliation(s)
- Courtney Townsel
- Department of Obstetrics and Gynecology, University of Michigan, 1540 East Hospital Drive SPC 4262, Ann Arbor, MI, 48109, USA.
- University of Michigan, Program on Women's Healthcare Effectiveness Research, Ann Arbor, USA.
| | - Sanaya Irani
- Medical School, University of Michigan, Ann Arbor, USA
| | - Buu-Hac Nguyen
- College of Literature Science and Arts, University of Michigan, Ann Arbor, USA
| | - Alexander Hallway
- Michigan Opioid Prescribing Engagement Network, Ann Arbor, USA
- Michigan Surgical Quality Collaborative, Ann Arbor, USA
| | - Clayton J Shuman
- University of Michigan, Program on Women's Healthcare Effectiveness Research, Ann Arbor, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, USA
- School of Nursing, University of Michigan, Ann Arbor, USA
- Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan, Ann Arbor, USA
| | - Jennifer Waljee
- University of Michigan, Program on Women's Healthcare Effectiveness Research, Ann Arbor, USA
- Michigan Opioid Prescribing Engagement Network, Ann Arbor, USA
- Department of Surgery, University of Michigan, Ann Arbor, USA
- Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, USA
| | - Kaitlyn Jaffe
- Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, USA
| | - Alex F Peahl
- Department of Obstetrics and Gynecology, University of Michigan, 1540 East Hospital Drive SPC 4262, Ann Arbor, MI, 48109, USA
- University of Michigan, Program on Women's Healthcare Effectiveness Research, Ann Arbor, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, USA
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Hoegholt NF, Bonetti L, Stevner ABA, Andersen CE, Hughes M, Fernandes HM, Vuust P, Kringelbach ML. A magnetoencephalography study of first-time mothers listening to infant cries. Cereb Cortex 2022; 33:5896-5905. [PMID: 36460612 DOI: 10.1093/cercor/bhac469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 11/06/2022] [Accepted: 11/07/2022] [Indexed: 12/05/2022] Open
Abstract
Abstract
Studies using magnetoencephalography (MEG) have identified the orbitofrontal cortex (OFC) to be an important early hub for a “parental instinct” in the brain. This complements the finding from functional magnetic resonance imaging studies linking reward, emotion regulation, empathy, and mentalization networks to the “parental brain.” Here, we used MEG in 43 first-time mothers listening to infant and adult cry vocalizations to investigate the link with mother–infant postpartum bonding scores and their level of sleep deprivation (assessed using both actigraphy and sleep logs). When comparing brain responses to infant versus adult cry vocalizations, we found significant differences at around 800–1,000 ms after stimuli onset in the primary auditory cortex, superior temporal gyrus, hippocampal areas, insula, precuneus supramarginal gyrus, postcentral gyrus, and posterior cingulate gyrus. Importantly, mothers with weaker bonding scores showed decreased brain responses to infant cries in the auditory cortex, middle and superior temporal gyrus, OFC, hippocampal areas, supramarginal gyrus, and inferior frontal gyrus at around 100–300 ms after the stimulus onset. In contrast, we did not find correlations with sleep deprivation scores. The significant decreases in brain processing of an infant’s distress signals could potentially be a novel signature of weaker infant bonding in new mothers and should be investigated in vulnerable populations.
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Affiliation(s)
- N F Hoegholt
- Aarhus University & The Royal Academy of Music Aarhus/Aalborg Center for Music in the Brain, Department of Clinical Medicine, , 8000 Aarhus , Denmark
- Linacre College, University of Oxford Centre for Eudaimonia and Human Flourishing, , Oxford OX37JX , United Kingdom
- Emergency Department at Randers Regional Hospital , 8930 , Denmark
| | - L Bonetti
- Aarhus University & The Royal Academy of Music Aarhus/Aalborg Center for Music in the Brain, Department of Clinical Medicine, , 8000 Aarhus , Denmark
- Linacre College, University of Oxford Centre for Eudaimonia and Human Flourishing, , Oxford OX37JX , United Kingdom
- University of Oxford Department of Psychiatry, , Oxford OX37JX , United Kingdom
| | - A B A Stevner
- Aarhus University & The Royal Academy of Music Aarhus/Aalborg Center for Music in the Brain, Department of Clinical Medicine, , 8000 Aarhus , Denmark
- Linacre College, University of Oxford Centre for Eudaimonia and Human Flourishing, , Oxford OX37JX , United Kingdom
| | - C E Andersen
- Aarhus University Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, , 8000 Aarhus , Denmark
| | - M Hughes
- Linacre College, University of Oxford Centre for Eudaimonia and Human Flourishing, , Oxford OX37JX , United Kingdom
| | - H M Fernandes
- Aarhus University & The Royal Academy of Music Aarhus/Aalborg Center for Music in the Brain, Department of Clinical Medicine, , 8000 Aarhus , Denmark
- Linacre College, University of Oxford Centre for Eudaimonia and Human Flourishing, , Oxford OX37JX , United Kingdom
| | - P Vuust
- Aarhus University & The Royal Academy of Music Aarhus/Aalborg Center for Music in the Brain, Department of Clinical Medicine, , 8000 Aarhus , Denmark
| | - M L Kringelbach
- Aarhus University & The Royal Academy of Music Aarhus/Aalborg Center for Music in the Brain, Department of Clinical Medicine, , 8000 Aarhus , Denmark
- Linacre College Centre for Eudaimonia and Human Flourishing, , University of Oxford, Oxford OX37JX, United Kingdom
- University of Oxford Department of Psychiatry, , Oxford OX37JX , United Kingdom
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Hailemeskel HS, Kebede AB, Fetene MT, Dagnaw FT. Mother-Infant Bonding and Its Associated Factors Among Mothers in the Postpartum Period, Northwest Ethiopia, 2021. Front Psychiatry 2022; 13:893505. [PMID: 35911218 PMCID: PMC9326158 DOI: 10.3389/fpsyt.2022.893505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/23/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The emotional bond that a mother senses to her infant is essential to their social, emotional, and cognitive development. Understanding the level of mother-infant bonding plays an imperative role in the excellence of care. However, in Ethiopia, there is a paucity of information about mother-infant bonding in the postpartum period. OBJECTIVE This study aimed to assess the level of mother-infant bonding and its associated factors among mothers in the postpartum period, Debre Tabor Town Northwest Ethiopia, 2021. METHODS A community-based cross-sectional study was conducted with 422 postpartum mothers. The postpartum Bonding Questionnaire was used to assess mother-infant bonding. The Edinburgh Postnatal Depression Scale was used to assess postnatal depression. The level of marital satisfaction was assessed by using Kansas marital satisfaction scale. Social support was assessed by Oslo social support scale. A simple random sampling technique was applied to select study participants. Simple and multiple linear regression were used to identify potential factors associated with the mother-infant bonding scale. A P-value of <0.05 was considered to declare statistical significance. RESULTS In this study, out of 420 postpartum mothers,53 (12.6%) had a risk for the quality of mother-infant bond difficulties between mother and an infant; 8.1% of mothers had a risk for rejection and pathological anger; 3.6% of mothers had a risk for infant-focused anxiety and 1.9% of mothers had risk for incipient abuse of an infant. Maternal depression status [adjusted β coefficient (β) = 2.31, 95% CI: (1.98, 2.64)], non-union marital status [β = 15.58, 95% CI: (9.88, 21.27)], being government employee [β = -5.68, 95% CI: (-9.71, -1.64)], having current pregnancy complication [β = -7.28, 95% CI: (-12.27, -2.29)], being non-breastfeeding mother [β = 7.66, 95% CI: (2.94, 12.38)], substance use history [β = -6.55, 95% CI: (-12.80, -0.30)], and social support [β = -2, 95% CI: (-2.49, -1.50)] were statistically significant factors for mother-infant bonding. CONCLUSION Generally, a significant number of mothers had mother-infant bonding difficulties in the postpartum period. Preventing strategies for bonding difficulties focus on social support during pregnancy, screening postpartum mothers for postpartum depression, and special attention to substance users, non-union maternal status, and non-breastfeeding mothers.
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Affiliation(s)
- Habtamu Shimels Hailemeskel
- Department of Pediatrics and Neonatal Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | | | | | - Fentaw Teshome Dagnaw
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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