Social support, parental role competence and satisfaction among Chinese mothers and fathers in the early postpartum period: A cross-sectional study

Social Support, Parenting Self-Efficacy, and Postpartum Depression Among Chinese Parents: The Actor-Partner Interdependence Mediation Model

INTRODUCTION

Postpartum depression affects both mothers and fathers. This study aimed to examine the relationships between social support, parenting self-efficacy, and postpartum depression in Chinese mothers and fathers and assess the mediating effect of parenting self-efficacy using a dyadic perspective.

METHODS

A cross-sectional study was implemented from December 2020 to July 2021 in Guangzhou, China, with 309 pairs of parents. The Edinburgh Postnatal Depression Scale, Social Support Rating Scale, Parenting Sense of Competence Scale-Efficacy subscale, and sociodemographic data sheet were completed by both parents. Dyadic analysis was conducted using the actor-partner interdependence mediation model. An actor effect is the relationship between variables within an individual, whereas a partner effect is the relationship between variables in the individual and the dyadic partner.

RESULTS

In total, 20.7% of mothers and 11.7% of fathers had elevated postpartum depressive symptoms at 6 weeks postpartum. The model revealed 6 actor effects: social support was positively associated with parenting self-efficacy for mothers (β, 0.39; 95% CI, 0.28-0.49) and fathers (β, 0.39; 95% CI, 0.30-0.48) and negatively associated with postpartum depression for mothers (β, -0.22; 95% CI, -0.32 to -0.12) and fathers (β, -0.37; 95% CI, -0.48 to -0.26). Parenting self-efficacy was negatively associated with postpartum depression in mothers (β, -0.41; 95% CI, -0.53 to -0.29) and fathers (β, -0.24; 95% CI, -0.37 to -0.12). Maternal social support had a partner effect on paternal parenting self-efficacy (β, 0.14; 95% CI, 0.04-0.24). Parenting self-efficacy mediated between social support and postpartum depression for both parents (mothers: β, -0.16; 95% CI, -0.23 to -0.10; fathers: β, -0.10; 95% CI, -0.16 to -0.05).

DISCUSSION

Postpartum depression was a dyadic phenomenon. Increasing mother-centered social support has the potential to improve the parenting self-efficacy of both parents and reduce the likelihood of postpartum depression.

Psychometric testing of the Chinese version of the Perinatal Infant Care Social Support tool: a methodological study

PURPOSE

This study aimed to translate the Perinatal Infant Care Social Support (PICSS) instrument into Chinese and to verify the reliability and validity of the translated version.

METHODS

This study used a cross-sectional design to examine the reliability and validity of the Chinese version of the PICSS (C-PICSS). A cohort of 150 first-time mothers in China participated, attending hospital follow-up care at 6 weeks postpartum. Data were collected after obtaining informed consent from the mothers.

RESULTS

The majority of mothers were aged between 20 and 29 years, with a mean age of 26.25 (±3.90) years. An item analysis of the 19 items in the C-PICSS showed that all items had an item-total score correlation above 0.2. This resulted in a Kaiser-Meyer-Olkin value of 0.92 and a significant Bartlett's test of sphericity (χ2=1,778.65, p<.001), confirming the suitability of the data for factor analysis. Correlation analyses revealed a strong positive relationship between infant care social support and general social support (r=.62, p<.001), and a negative relationship between infant care social support and postpartum depression (r=-.38, p<.001). Higher scores for infant care social support were associated with reporting positive relationships with their husbands (t=3.72, p<.001) and high levels of spousal involvement (t=4.09, p<.001). In terms of structural support, spouses were identified as the primary source.

CONCLUSION

The research results indicate that C-PICSS is reliable and valid as an indicator of social support for infant care among Chinese mothers.

Development and Psychometric Testing of the Fathers' Self-Efficacy Scale for Newborn Care

PURPOSE

Fathers' involvement in newborn care positively affects both work sharing between parents, newborn quality of life, and the relationship between father and newborn. However, there is no valid and reliable measurement tool to evaluate fathers' self-efficacy levels for newborn care. This study aimed to develop the fathers' self-efficacy scale for newborn care (FSSNC) and to examine its psychometric properties.

METHODS

This study is an instrument development and validation study. After a comprehensive literature review, expert opinion, and pilot application stages, an item pool was developed. For validity and reliability analyses, data were collected between March and December 2022 from 442 individuals, including fathers with newborn babies and expectant fathers whose partners are pregnant. Validity assessments included content, exploratory and confirmatory factor analyses, and convergent validity. The scale was also evaluated for its internal consistency, and two-half-test reliability. In this study, the STROBE checklist was used as a guideline.

RESULTS

The final version of the scale consisted of three subdimensions (hygiene, safety, and nutrition). The total number of items is 17. Confirmatory factor analysis results confirm the results of exploratory factor analysis. There was a strong correlation between the scale score and the participants' self-assessment score.

CONCLUSIONS

The study demonstrates that the FSSNC was a valid, reliable, and user-friendly measurement tool used to evaluate fathers' self-efficacy regarding hygiene, safety, and nutrition in newborn care.

The Chinese Parenting Stress Scale for Preschoolers' Parents: Development and Initial Validation

Parenting stress is the experience of discomfort or distress that results from the demands associated with the role of parenting. Although there are numerous parenting stress scales, relatively few scales have been developed with consideration of the Chinese cultural context. This study aimed to develop and validate the Chinese Parenting Stress Scale (CPSS) with a multidimensional and hierarchical structure for Mainland Chinese preschoolers' parents (N = 1,427, Mage = 35.63 years, SD = 4.69). In Study 1, a theoretical model and an initial 118 items were developed, drawing on prior research and existing measures of parenting stress. Exploratory factor analysis yielded 15 first-order factors with 60 items. In Study 2, confirmatory factor analyses supported a higher order solution consisting of 15 first-order factors covering four domains: Child Development (12 items), Difficult Child (16 items), Parent-Child Interaction (12 items), and Parent's Readjustment to Life (20 items). Measurement invariance indicated no gender differences between parents for the scale scores. The convergent, discriminant, and criteria validity of the CPSS scores was supported by its association with related variables in the expected directions. Moreover, the CPSS scores added significant incremental variance in predicting somatization, anxiety, and child's emotional symptoms more so than the Parenting Stress Index-Short Form-15. The CPSS total and subscale scores all had acceptable Cronbach's αs in both samples. The overall findings support the CPSS as a psychometrically sound tool.

Translation and validation of the Czech Republic version of the Birth Satisfaction Scale-Revised (BSS-R)

BACKGROUND

Satisfaction with the birth experience has been established to be critical for the wellbeing of the mother. The Birth Satisfaction Scale-Revised (BSS-R) is a brief and psychometrically robust multi-dimensional self-report tool designed to assess birth experience. The current investigation sought to translate and validate a Czech Republic version of the BSS-R (CZ-BSS-R).

METHODS

Following translation psychometric assessment of the CZ-BSS-R was undertaken using a cross-sectional design. A between-subjects design was incorporated in order to evaluate known-groups validity evaluation of the translated measure. Four hundred and sixty-five Czech-speaking women within the Czech Republic took part in the study. Confirmatory factor analysis was undertaken and divergent and convergent validity and internal consistency characteristics also evaluated.

RESULTS

The CZ-BSS-R was observed to have excellent psychometric properties and conceptually and measurement faithful to the original English-language measure. Consistent with previous investigations using the BSS-R significant differences were found in scores as a function of delivery type.

CONCLUSIONS

The CZ-BSS-R is a valid, robust and reliable measure of birth experience and suitable for use with Czech-speaking women in the Czech Republic. The study highlighted that instrument and emergency Caesarean section were associated with a lower level of birth satisfaction compared to vaginal delivery.

The perception of childbearing sense of coherence among Chinese couples: a qualitative study

BACKGROUND

Although childbearing health care is wellness-based and promotes normal physiology, it is in a medical model and focuses on risk aversion and disease prevention. The salutogenic theory might provide an alternative perspective to health care concerning childbearing, supporting health-promoting factors, not solely on avoiding adverse events. However, there is a dearth of qualitative research exploring couples' perceptions of childbearing from the salutogenic lens. This study aimed to explore perceptions and experiences concerning childbearing among couples in the perinatal period and identify salutogenic aspects of it.

METHODS

The qualitative descriptive study adopted a directed content analysis to analyse data from a semi-structured and individual interview with 25 purposively selected Chinese couples between July 2022 and December 2022. The concepts of the sense of coherence (SOC) from the salutogenic theory were used as the theory framework for coding.

RESULTS

Definitions and content for the salutogenic aspects of Chinese couples' perception of childbearing sense of coherence were developed. For comprehensibility of childbearing, four subthemes were extracted (the challenge to health and endurance; transition to and identification with the new role; conflict and reconciliation in relationships; resistance and compromise between social culture and personal development). For manageability of childbearing, two subthemes were extracted (helplessness and hope of childbearing; self-doubt and self-assurance of childbearing). For meaningfulness of childbearing, three subthemes were extracted (personal realisation; family bonding and harmony; the continuation of life).

CONCLUSIONS

The findings of this study could give a greater understanding in maintaining couples' health in the perinatal period from the salutogenic lens and provide a guide to further research that the salutogenic theory could bring a health and wellness-focused agenda in practice and policy-making in the perinatal period.

Development and validation of a parental competence questionnaire in the paediatric hospital emergency setting (ECP-U)

OBJECTIVE

To develop and validate a parental competence questionnaire for parents of children seeking care in hospital emergency departments.

METHODS

An instrumental study of the development of an assessment questionnaire was carried out in three phases: 1) review of relevant measures and item generation, 2) content validity evaluation, 3) psychometric evaluation. Exploratory factor analysis was performed to examine the factorial structure. Internal consistency was evaluated using ordinal alpha. Hypothesis testing was determined between the resulting factors, the Parental Stress Scale and the State-Trait Anxiety Inventory.

RESULTS

The participants were 270 parents of children aged 0-14 years old from a referral hospital in Valencia (Spain). An 18-item questionnaire was developed, comprising five factors that explain 53.0% of the variance: 1) "emotional management and expression", 2) "passive social support", 3) "parental agency", 4) "basic needs and care" and 5) "active social support". The internal consistency for the different factors was modest (>0.70). A negative correlation between the Parental Stress Scale and the parental competence questionnaire was found for most of the factors.

CONCLUSIONS

This questionnaire on parental competence in the hospital emergency department (ECP-U) is a useful and simple self-report instrument for assessing the parental competence of parents with children in the emergency department.

PRACTICAL IMPLICATIONS

The resulting questionnaire is of practical value to both healthcare professionals and researchers in this field. It can be administered quickly in clinical practice and used to identify parents' levels of parental competence and refer those with difficulties to appropriate support services.

Factor structure and validity of the Parental Competence Questionnaire in the Paediatric Hospital Emergency Setting (ECP-U)

OBJECTIVE

To confirm the structure and examine the psychometric properties of the Parental Competence Questionnaire in the Paediatric Hospital Emergency Setting (ECP-U).

METHODS

An instrumental validation study of the ECP-U questionnaire and an examination of its psychometric properties were carried out.

RESULTS

The participants were 260 mothers and fathers seeking care in the paediatric emergency department of a hospital in Valencia (Spain) with children aged 0 to 14 years old. The five-factor structure of the ECP-U was confirmed with excellent statistical fits. Second-order models and a more parsimonious four-factor structure with adequate but marginal fits are proposed. With the exception of the "parental agency" factor (in both models examined) and the "active social support" factor (in the original five-factor structure), the internal consistency of the different factors was modest (≥ 0.70). A negative correlation was found between the Parental Stress Scale and the ECP-U for most factors.

CONCLUSIONS

Validity and reliability analyses indicate that the ECP-U is an instrument with modest psychometric properties.

IMPLICATIONS FOR PRACTICE

The ECP-U is an instrument that can be used by future researchers to identify different levels of parental competence in paediatric hospital emergency departments. This will enable help to be given to families with parenting issues and problems. The underlying concern is to reduce the number of frequent users and "Non-Urgent Presentations" to paediatric emergency departments due to low parental competence.

Postpartum stress in the first 6 months after delivery: a longitudinal study in Nantong, China

OBJECTIVES

The objective is to to explore the longitudinal change trajectories of postpartum stress and its related factors.

DESIGN

A longitudinal study with follow-ups from 42 days to 6 months after delivery.

SETTINGS AND PARTICIPANTS

A total of 406 postpartum women were recruited at baseline (42 days after delivery) from 6 hospitals in Nantong, Jiangsu Province, China, and followed up at 3 and 6 months. After the follow-ups, 358 postpartum women were retained for further analysis.

METHODS

Postpartum stress was evaluated using the Maternal Postpartum Stress Scale (MPSS) at baseline (42 days) and 3 and 6 months after delivery. MPSS has three dimensions, such as: personal needs and fatigue, infant nurturing and body changes and sexuality. Postpartum depression and anxiety were measured using the Edinburgh Postnatal Depression Scale and the short-form Depression, Anxiety and Stress Scale, respectively. The MPSS scores were normalised using a rank-based inverse normal transformation.

RESULTS

Postpartum stress decreased significantly after 3 months, and postpartum stress reduced further after 6 months. Additionally, the scores for all three dimensions reduced after 6 months, while infant nurturing reduced after both 3 and 6 months. Older age (β=0.028, p=0.049), higher education level (β=0.153, p=0.005) and higher body mass index (BMI) (β=0.027, p=0.008) of the postpartum women were significantly associated with higher postpartum stress levels in corresponding dimensions at 42 days. Older age was also associated with higher postpartum stress at 3 (β=0.030, p=0.033) and 6 months (β=0.050, p<0.001) in the dimension of personal needs and fatigue. Postpartum stress levels were significantly higher in women with depression or anxiety symptoms.

CONCLUSIONS

Postpartum stress continuously declined from 42 days to 6 months after delivery. Postpartum women with older age, higher education levels, higher BMI and anxiety or depression symptoms should be the target population for early intervention.

Parenting self-efficacy and social support among parents in mainland China across the first six months postpartum: A prospective cohort study

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.

The Parental Stress Scale: Psychometric Properties in Pediatric Hospital Emergency Setting

Parental psychological distress has been identified as a predisposing factor in attendance at and the inappropriate use of hospital pediatric emergency departments (PEDs). The aim of the study was to validate the Parental Stress Scale (PSS), a 12-item Spanish scale, in parents seeking care at PEDs. The study involved 270 participants with a mean age of 37.9 (SD = 6.76) years, of which 77.4% were women. The properties of the PSS were analyzed. The scale showed adequate internal consistency for the different factors (0.80 for the "Stressors" factor and 0.78 for the "Baby's Rewards" factor) and optimal model fit (chi-square = 107.686; df = 53; CFI = 0.99; TLI = 0.98; RMSEA = 0.028; 90% CI = 0.00-0.05). The 12-item Spanish version of the PSS is a valid and reliable instrument for assessing the stress levels of parents seeking care in PEDs.

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

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

Childhood maltreatment and sense of parenting competence: The mediating role of parental reflective functioning and perceived social support

OBJECTIVES

Childhood maltreatment has a negative impact on a sense of parenting competition. However, its underlying mechanisms are still unknown. The present research aimed to investigate the roles of parental reflective functioning and social support as mediating factors in the relationship between childhood maltreatment and negative feeling of parenting competence.

METHODS

A cross-sectional study was carried out on 489 parents of children aged 5 to 13 between October 23 and December 12, 2021, in Shiraz, Iran. Participants completed the Childhood Trauma Questionnaire (CTQ), Parenting Sense of Competence Scale (PSOC), Perceived Social Support Scale (PSSS), and Parental Reflective Functioning Questionnaire (PRFQ). Structural equation modeling (SEM) was applied using AMOS 22 to test our conceptual model.

RESULTS

The results of structural equation modeling indicated that childhood maltreatment had a negative direct effect on the sense of parenting competence. Furthermore, childhood maltreatment had a negative indirect effect on the sense of parenting competence through both parental reflective functioning and perceived social support.

CONCLUSIONS

The findings suggested that increased exposure to childhood maltreatment may have decreased parental competence. However, the important role of parental reflective functioning and perceived social support in the relationship between childhood maltreatment and parenting competence should not be ignored. These results can have some implications for counselors working with parents with childhood trauma experiences.

The relationship of social support perceived by mothers and fathers and dyadic adjustment with maternal and paternal attachment in the postpartum period

This descriptive, correlational, and cross-sectional study included mothers (n = 170) and fathers (n = 173) with 6- to 12-month-old babies. A personal information form, the Multidimensional Scale of Perceived Social Support (MSPSS), the Revised Dyadic Adjustment Scale (RDAS), the Maternal Attachment Inventory (MAI), and the Postnatal Paternal-Infant Attachment Questionnaire (PPAQ) were used to gather information. Mothers' median scores were 64 (27-84) for MSPSS, 57 (21-69) for RDAS, and 102 (92-104) for MAI. Fathers' median scores were 53 (24-84) for MSPSS, 57 (40-69) for RDAS, and 84 (57-94) for PPAQ. In mothers, a significant, moderate, positive correlation was found between the median scores of MSPSS and RDAS (r = .521; p < .001) and MAI (r = .362; p < .001). This relationship was also the same for the RDAS and MAI median scores (r = .299; p < .001). For fathers, a significant, low-level, positive correlation was found between median scores of MSPSS and RDAS (r = .53; p = .044) and PPAQ (r = .164; p = .031). A significant, moderate, positive correlation was also found between RDAS and PPAQ median scores (r = .468; p < .001). This study found that baby attachment increases with increasing social support for mothers and fathers and dyadic adjustment. In postnatal follow-ups, women's health nurses and midwives should assess the social support, dyadic adjustment, and attachment levels of mothers and fathers.

Well-being, self-esteem and body satisfaction in new mothers

BACKGROUND

How mother's recall their experience of childbirth, their concerns about body image, their sense of competence in parenting, and their combined sense of self-esteem are all factors with the potential to impact on mental well-being.

METHOD

A total of 234 women, who had given birth within the past 3 years, completed a survey comprised of the Birth Memories and Recall Questionnaire, the Parenting Sense of Competence Scale, the Warwick-Edinburgh Mental Well-being Scale, the Rosenberg Self-Esteem Questionnaire and the Body Shape Questionnaire.

RESULTS

Mothers who have higher body dissatisfaction show significantly lower well-being, self-esteem and perceived parenting competence. Mothers who experienced higher levels of mental well-being were found to have higher levels of perceived parenting competence and self-esteem, and those who experienced higher levels of self-esteem were also found to have higher levels of perceived parenting competence.

CONCLUSION

Memories of the birth experience, perceived postpartum body image, parenting sense of competence and self-esteem have a combined and complex relationship with mental well-being. Health care professionals should inform mothers about the body changes which may occur throughout the postpartum period, to encourage mothers not to be deceived by media images and to stress the importance of realistic expectations following giving birth.

Parenting sense of competence and its predictors among primiparous women: a longitudinal study in China

BACKGROUND

Parenting sense of competence significantly affects the quality of parenting behaviours and healthy infant development. However, primiparous women without parenting experience may lack confidence and feel stress. This study aimed to explore the status of parenting sense of competence and identify its predictors among primiparous women.

METHODS

A longitudinal study design was used. Primiparous women were recruited by using a convenience sample from two women's and children's hospitals in two cities in China. All primiparous women completed questionnaires on demographic characteristics, infant characteristics, family function, and parenting sense of competence at 1 month postpartum. At 3 months postpartum, each women's parenting sense of competence was re-assessed. Generalised linear regression was applied to identify the predictors of parenting sense of competence at 3 months postpartum.

RESULTS

A total of 743 Chinese primiparous women were included in the analysis. The average parenting sense of competence score of the participants at 3 months postpartum was 70.18 (SD = 12.33). According to the generalised linear regression analysis, higher levels of parenting sense of competence at 3 months postpartum were significantly associated with older age (β = 0.13, P = 0.005), better family function (β = 0.37, P <  0.001), and higher levels of parenting sense of competence (β = 0.35, P <  0.001) at 1 month postpartum. In contrast, lower levels of parenting sense of competence at 3 months postpartum were associated with poorer self-rated economic status (β = - 0.16, P = 0.027), poorer infant health (β = - 0.26, P = 0.007), and mixed or formula feeding (β = - 0.11, P = 0.018) at 1 month postpartum.

CONCLUSIONS

Chinese primiparous women have a relatively good parenting sense of competence, but there is still room for improvement. Maternal age, economic status, family function, infant health, and feeding patterns were significant predictors. To improve their parenting sense of competence, more attention should be paid to primiparous women who are young, with poor economic status, having an unhealthy infant, and mixed or formula feeding. In addition, measures should also be taken during the early postpartum period to improve family function.

Postpartum depression and social support: A longitudinal study of the first six months as parents

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.

Ecological factors influencing parenting self-efficacy among working mothers with a child under 36 month old in South Korea: a cross-sectional and correlational study

BACKGROUND

Parenting self-efficacy is an essential component for parents to successfully perform their role and is important for mother and child well-being. To support parenting self-efficacy amongst working mothers, it is necessary to understand the factors influencing parenting self-efficacy amongst this group. However, the majority of previous studies regarding factors influencing parenting self-efficacy did not focus on working mothers. Therefore, this study aimed to identify the factors influencing parenting self-efficacy of working mothers using an ecological framework.

METHODS

The research design was a cross-sectional, correlational study. The participants were 298 working mothers with a child under 3 years of age, who were recruited from ten nurseries. Data were collected from August 8 to September 22, 2017 using structured questionnaires, including the Parenting Sense of Competency scale, a one-item Short Form Health Survey scale, the Maternal Role Satisfaction scale, the Parenting Stress Inventory, the Work and Parent Role Conflict scale, the Parenting Alliance Inventory, the Social Support scale, and the Childbirth and Parenting Friendly System scale. The study process of this study was approved by the Institutional Review Board. Collected data were analyzed by SPSS 23.0 Win program with descriptive statistics, t-test, one way ANOVA, Pearson correlation coefficient, and hierarchical multiple regression.

RESULTS

Working mothers who were the primary caregiver had higher parenting self-efficacy compared to those who were not the primary caregiver (β = .13, p = .022). At the individual level, the higher maternal role satisfaction, the higher parenting self-efficacy of working mothers (β = .27, p < .001). In the micro-system level, higher parenting support by a spouse was associated with higher parenting self-efficacy of working mothers (β = .19, p = .002).

CONCLUSIONS

Educational interventions for increasing the awareness and satisfaction of maternal role and various strategies for fathers' active participation in parenting should be developed. In addition, practical interventions that reduce the burden of parenting while supporting parenting self-efficacy of working mothers who are the primary caregiver should also be considered.

Relationship between social support and parenting sense of competence in puerperal women: Multiple mediators of resilience and postpartum depression

BACKGROUND

Maternal role competence is an important marker of achievement in the role of the mother, but parenting sense of competence (PSOC) among puerperal women is not high. Psychosocial factors, particularly social support, postnatal depression and resilience, have been identified as significant predictors of maternal role competence. However, information is limited regarding the mechanisms through which these psychosocial factors affect maternal role competence.

OBJECTIVE

To evaluate the multiple mediators of resilience and postpartum depression (PPD) in the relationship between social support and PSOC in puerperal women.

METHODS

A cross-sectional study was performed in a tertiary general hospital in Yangzhou, China. A total of 234 puerperal women at 6-8 weeks after birth completed the socio-demographic questionnaires, Social Support Rating Scale, Connor-Davidson Resilience Scale, Edinburgh Postnatal Depression Scale, and PSOC Scale.

RESULTS

Resilience and PPD mediated the relationship between social support and PSOC. The mediation effect of resilience and PPD and the total mediation effect were significant, individually accounting for 22.96, 21.70, and 44.65%, respectively, of the total effect. Moreover, pairwise contrast between the two indirect effects was not significant. The difference between the two pathways suggests that resilience and PPD play different roles in the relationship between social support and PSOC.

CONCLUSIONS

This study showed that social support may exert its effects on PSOC in puerperal women with multiple mediators of resilience and PPD. This therefore highlights potential intervention targets to improve PSOC.

Predictors of postpartum depression among Chinese mothers and fathers in the early postnatal period: A cross-sectional study

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.

Prenatal intervention program for Japanese first-time fathers to adapt to the paternal role: a mixed methods study

This study aimed to develop a prenatal intervention program focused on the formation of paternal identity for adapting to paternal role. The intervention program allowed participants to create a postpartum schedule using a uniquely developed paternity portfolio. Pre and post-intervention effects were evaluated using a convergent design of mixed methods. This intervention effect was quantitatively evaluated between the two groups. To qualitatively examine the intervention's effects, participants were interviewed for effective prenatal education, and their paternal role behaviors were identified by the intervention. Details of actual postpartum paternal role behavior and effective prenatal education were collected. Obtained data were inductively analyzed and compared with those in the proposed prenatal intervention program. There were 10 pairs in the intervention group and 31 pairs in the control group. Intergroup comparison of evaluation data showed no significant difference. However, qualitative results clarified the effective nursing intervention, confirming the achievement of intervention goals by all participants. Intervention expressions were adjusted based on the results, and a revised prenatal intervention program was developed. This article is protected by copyright. All rights reserved.

Postpartum depression and postpartum post-traumatic stress disorder: prevalence and associated factors

BACKGROUND

Despite the increased global interest from researchers in postpartum depression (PPD) and postpartum post-traumatic stress disorder (PP-PTSD), studies of PPD in China have shown a wide range of variability. Indeed, the prevalence and risk factors for PP-PTSD have received little attention in China.

AIM

To determine the prevalence of PPD and PP-PTSD in China, and to examine the relationships between a range of sociodemographic, pregnancy-related, and newborn-related variables, and PPD and PP-PTSD.

METHODS

A cross-sectional study involving 1136 women who returned to the obstetrics clinic for routine postpartum examination were enrolled. The sociodemographic, pregnancy-related, and newborn-related characteristics were collected. Social support, and PPD and PP-PTSD symptoms were measured by the Perceived Social Support Scale (PSSS), the Edinburgh Postnatal Depression Scale (EPDS), and the Perinatal Post-traumatic Stress Questionnaire (PPQ).

RESULTS

The prevalence rates of PPD and PP-PTSD symptoms were 23.5 and 6.1%, respectively. A multivariate model showed that the presence of PP-PTSD was the strongest risk factor for PPD symptoms and vice versa. Other risk factors for PPD included low sleep quality, low social support and newborn's incubator admission. In terms of PP-PTSD symptoms, risk factors included the presence of PPD symptoms, non-Han ethnicity, and low social support, while having one child was a protective factor.

CONCLUSIONS

This study addressed some gaps in the literature and provided a better understanding of PPD and PP-PTSD in China, which may contribute to early detection and intervention. Attention should be paid to women who are most susceptible to PPD and/or PP-PTSD, including those with low social support, low sleep quality, newborn's incubator admission, non-Han ethnicity, and women with siblings.

What are the factors affecting parents' postnatal sense of security?

INTRODUCTION

The postpartum period is part of an important process for mothers and fathers. A sense of security is central as it might influence a parent's journey towards becoming a successful parent. The aim was to determine factors affecting parents' postnatal sense of security (PPSS) before postpartum discharge from a hospital in Konya, Turkey.

METHODS

A descriptive study was conducted. From January 2019 to March 2019, a questionnaire was given to a convenience sample of 188 couples discharged from a regional hospital in Turkey. The sense of security was assessed using the PPSS instrument, with low scores defined as those less than the mean.

RESULTS

Low and high sense of security was based on the mean in the population, for mothers 49.36 and for fathers 34.90. It was found that 43.6% of mothers and 69.7 % of fathers had a low score, which was linked to some specific factors in the postpartum period. These were the type of birth, being ready to take responsibility for baby care, being ready to be discharged, being healthy, having any concern about the baby's health, social support presence, having professional support, and presence of a sense of security.

CONCLUSIONS

Many parents, particularly fathers, have a low postnatal sense of security. In the postpartum period, it is very important for midwives, who are always with the family, to identify the risks for a low sense of security during this period and provide effective care. More studies in different settings with larger samples are recommended.

Factors associated with parenting self-efficacy: A systematic review

Aims

To provide an overview of the parental, child, and socio‐contextual factors related to general parenting self‐efficacy (PSE) in the general population.

Design

Systematic review.

Data sources

Medline Ovid, Web of Science, Embase, and PsycINFO Ovid were systematically searched for studies published between January 1980‐June 2020.

Review Methods

Studies were included if they described associations between factor(s) and PSE among parents of children aged 0–18 years old in the general population, and published in an English language peer‐reviewed journal. Studies with participants from specific populations, studies describing the development of instruments for PSE, qualitative studies, reviews, theses, conference papers and book chapters were excluded. Belsky's process model of parenting guided the data synthesis.

Results

Of 3,819 articles, 30 articles met the inclusion criteria. Eighty‐nine factors were identified. There was evidence of associations between child temperament, maternal parenting satisfaction, parenting stress, maternal depression, household income, perceived social support and PSE. Evidence was inconsistent for an association of educational level, parity, number of children in the household and PSE in mothers. There was no evidence of an association for child gender, age, marital status and PSE in both mothers and fathers; ethnicity, age, employment status in mothers; household income in fathers; and educational level, parenting fatigue in parents.

Conclusion

A range of factors studied in relation to PSE was identified in this systematic review. However, the majority of the factors was reported by one or two studies often implementing a cross‐sectional design.

Impact

There is some evidence for an association between some potentially modifiable factors and PSE in the general population, this information may be used by health and social professionals supporting child health and well‐being. Future longitudinal studies are recommended to study parental, child and socio‐contextual factors associated with PSE to inform the development of intervention strategies.

Prevalence and Associated Factors of Postpartum Anxiety and Depression Symptoms Among Women in Shanghai, China

BACKGROUND

Postpartum anxiety (PPA) and postpartum depression (PPD) are associated with immediate and long-term health risks for both mothers and babies. The purpose of this paper was to evaluate relationships between sociodemographic, perinatal variables, and PPA and PPD symptoms of parturients 6 weeks postpartum.

METHODS

A cross-sectional survey with 1204 women who had a healthy and term birth in a baby-friendly hospital, Shanghai, China. PPA and PPD symptoms were measured by using the Self-Rating Anxiety Scale (SAS) and the Edinburgh Postnatal Depression Scale (EPDS).

RESULTS

The mean score of SAS and EPDS was 40.79 ± 8.48 and 8.18 ± 5.80, respectively. The estimated prevalence of PPA and PPD symptoms was 15.2% and 23.2%, respectively. Multivariable logistic regression analysis showed that the presence of fatigue and PPD symptoms were risk factors for PPA symptoms, whereas having support from family and being satisfied with labor experience were protective factors. In terms of PPD symptoms, its risk factors included smoking before pregnancy, maternal separation from baby, fatigue, encountering difficulties in breastfeeding, and the presence of PPA symptoms. In contrast, the protective factors for PPD symptoms were having support from family and having support from colleagues or friends.

LIMITATIONS

Convenience sampling and voluntary participation may have led to a selection bias.

CONCLUSION

PPA and PPD symptoms occur commonly among parturients in Shanghai, China. The findings from this research provide a better understanding of factors associated with PPA and PPD symptoms and will help guide personalized approaches to the management of postpartum anxiety and depression.

"I was worried about not being good enough". Experiences and perspectives on pregnancy, childbirth and parenthood when living with a neuromuscular disorder - an exploration of everyday life challenges

PURPOSE

The aim of this study was to explore the everyday life experiences and perspectives on challenges related to pregnancy, childbirth and parenthood when living with neuromuscular disorders (NMDs) and identify important elements to take into consideration for parents and their health professionals.

MATERIALS AND METHODS

In all, 27 people (17 with a NMD and 10 partners without a NMD) were included in this study. The participants were all parents or expecting parents. Both mothers and fathers and ambulant and non-ambulant participants were included to broaden the perspective. Three types of semi-structured interviews were applied. The analysis was guided by the Interpretive Description methodology and Antonovsky's Sense of Coherence theory.

RESULTS

The findings illuminated insights to ongoing challenges in the everyday lives of parents with NMD. Enforced Dilemmas represented guilt and dilemmas on the possibility of passing on the NMD. Reflections on Bodily Ability symbolized the effect that pregnancy and parenthood had on the body. Concept of Normality signified the concerns the parents had about "not being normal enough." Experience of Dependency addressed being dependent on others and No One to Emulate how the rarity of the NMD made it difficult to find peers or seek advice.

CONCLUSION

The study emphasizes the importance of the professionals providing counseling and support on pregnancy, childbirth, and parenthood either during consultations, online or in structured professional and peer-support rehabilitation groups for expecting parents or for new parents with a NMD.IMPLICATIONS FOR REHABILITATIONProfessionals must provide knowledge and counselling on pregnancy, childbirth, and parenthood to support families with NMD who are expecting a child or have already become parents and address the illusion of normal.Professional centralized and specialized units where people with NMD can get advice on pregnancy and give birth should be an option.Structured professional and peer-support rehabilitation groups (physical meetings or online) on pregnancy, childbirth, and parenthood may be of value for the parents due to the rarity of the diagnosis.Online information and knowledge on pregnancy, childbirth, and parenthood and NMD should be widely available.Health professionals and peers can help ensure and support an experience of comprehensibility, manageability, and meaningfulness among the parents with NMD and develop rehabilitation services that meet the needs and preferences of people considering getting a child or who are already parents with NMDs or other disabilities.