Perceived Collective Efficacy and Parenting Competence: The Roles of Quality of Life and Hope

The mediating role of hope in the relation between uncertainty and social support with self-management among patients with ESKD undergoing hemodialysis

BACKGROUND

Self-management behaviours are critical for patients requiring regular hemodialysis (HD) therapy. This study aimed to test the relationship between social support, uncertainty and self-management among HD patients and to explore whether hope plays a mediating role.

METHODS

In a cross-sectional study, a convenience sample of 212 HD patients from two hospitals completed the Perceived Social Support Scale (PSSS), Herth Hope Index (HHI), Short form Mishel Uncertainty in Illness Scale (SF-MUIS), and hemodialysis Self-Management Instrument (HD-SMI). Data were analysed using structural equation modelling.

RESULTS

The main finding indicated that social support positively affected self-management (β = 0.50, t = 4.97, p < 0.001), and uncertainty negatively affected self-management (β =-0.37, t=-4.12, p = < 0.001). In mediational model analysis, the effect of social support on self-management was fully mediated [(β = 0.12; 95% BC CI (0.047, 0.228)] by hope. Also, the effect of uncertainty on self-management was fully mediated [(β=- 0.014; 95% BC CI (-0.114, -0.003)] by hope.

CONCLUSIONS

"Considering factors influencing self-management in HD patients is crucial for improving quality of life. Receiving support and informational resources can not only foster hope but also reduce their uncertainty, thus aiding in enhancing clinical outcomes, quality of life, and reducing complications. "Health care providers, especially nurses were advised to accept the existence of uncertainty, help patients make optimal use of support resources, and give more importance to disambiguation to reassure them. Therefore, well-designed interventions that enhance social support and hope and reduce uncertainty may help improve self-management behaviour in HD patients.

Mediation effect of hope on the relationship between inner strength and self-management in patients after percutaneous coronary intervention

Background

Effective self-management can enhance a patient's quality of life and delay disease progression. However, motivating patients to adhere to self-management behavior following percutaneous coronary intervention (PCI) remains a challenge. With the robust development of positive psychology and interdisciplinary research, the role of psychology factors in patients' health behavior has increasingly garnered attention. This study, focusing on positive psychological qualities, aims to investigate the relationship between inner strength, hope, and self-management in patients post-PCI, and to analyze the mediating role of hope between inner strength and self-management.

Methods

A cross-sectional survey was conducted among 216 PCI patients from a tertiary hospital in Nanjing. Research instruments included a self-designed general information questionnaire, the Inner Strength Scale (ISS), the Herth Hope Index (HHI), and the Coronary Self-Management Scale (CSMS). T-test, analysis of variance, Pearson's correlation analysis, and mediating effect test were utilized for statistical analysis.

Results

The average scores of the ISS, HHI, and CSMS were 81.46 ± 12.00, 35.94 ± 5.38, and 86.79 ± 14.84, respectively. Inner strength was positively correlated with hope and self-management (r = 0.867, r = 0.630, respectively; all P < 0.05), and hope was positively correlated with self-management (r = 0.671, P < 0.05). Moreover, hope had a complete mediating effect between inner strength and self-management (β = 0.630, P < 0.01).

Conclusion

The inner strength, hope, and self-management of patients with PCI are at a moderate level. Inner strength primarily influences patients' self-management behavior through hope, suggesting that medical staff can target hope to help patients build confidence in life after illness, form and accumulate inner strength, thereby promoting their self-management and improving prognosis.

Child Maltreatment During COVID-19: Key Conclusions and Future Directions Based on a Systematic Literature Review

The COVID-19 pandemic has had a far-ranging impact. As societies struggled to minimize infection, questions arose regarding the consequences for children. Initial research reported the urgent need for child protective services worldwide to adapt existing policies and practices to protect children from maltreatment during this time, which is the rationale for the current systematic literature review. This review examined studies published in peer-reviewed journals from March 2020 to October 2020 on child maltreatment (CM) in the context of COVID-19. Twenty-five manuscripts met the inclusion criteria and were predominantly from the United States, with three international studies. The majority of the studies included CM reports during COVID-19 based on official data. The results clearly demonstrated an increased risk for children alongside a worrisome international decrease in CM reports. Only two studies addressed interventions during the pandemic. The current review highlights that, along with the obligation of scholars to advance the protection of children during COVID-19, there is much that is unknown. Future studies should examine the impact of the pandemic on children and their surrounding systems as well as child protective services' responses, which face enormous challenges during a pandemic. An additional conclusion is that, since children were not identified as a health risk group during the pandemic, their protection rights may have been jeopardized. Furthermore, the variance identified in the policies of different countries pinpoints the urgent need to establish an international protocol for protecting children from maltreatment during COVID-19, a protocol that will hopefully be a basis for policymakers worldwide.

Hope and parenting

Parenting provides daily opportunities for growth. Hopeful thinking provides many of the skills that parents need to successfully navigate parenting challenges. Hopeful parents think intentionally about parenting goals, create pathways to reach these goals, and find ways to stay motivated to use the pathways when challenges arise. Research suggests that high hope parents report better psychological adjustment to parenthood than low hope parents. They also engage in more active coping with parenting stressors and show high levels of emotional connection to their children. To date, research on hope and parenting is limited with the literature primarily focusing on parents of children with developmental disabilities and behavioral issues. This article reviews the literature on hopeful parenting, hope based parenting interventions, and the development of domain specific measurement of hope for parenting. Limitations of the existing literature and future directions for research are discussed.

Changes in Collective Efficacy's Preventive Effect on Intimate Partner Violence during the COVID-19 Pandemic

Following the logic of studies showing that collective efficacy within neighborhoods deters intimate partner violence (IPV), the promotion of social distancing during the COVID-19 pandemic may have weakened that effect. To examine that possibility, we analyzed panel data from 318 adults in Japan regarding IPV victimization and perceived collective efficacy at four time points. A latent growth model (LGM) analysis for each measure revealed that informal social control, a subscale of collective efficacy, has declined since the pandemic began, whereas no significant changes have occurred in social cohesion and trust, another subscale of collective efficacy, and IPV victimization. Furthermore, two parallel LGM analyses revealed that although collective efficacy before the pandemic suppressed subsequent IPV victimization, changes in collective efficacy during the pandemic have been positively associated with changes in IPV. Those results suggest that collective efficacy's protective effect on IPV is moderated by whether interactions between intimate partners and their neighbors are socially normative.

Online social support and collective empowerment: Serial mediation effect on self-efficacy among mothers of children with type 1 diabetes

AIM

To identify a serial multiple mediation effect of social support in online health communities and collective empowerment on the relationship between diabetes-related burden (DRB) and self-efficacy, among mothers using a continuous glucose monitoring device for children with type 1 diabetes (T1D).

DESIGN

A secondary analysis, cross-sectional, descriptive study.

METHODS

Data were obtained from 198 mothers of children with T1D via a web survey, from August to September 2020. Measures used were the Collective Empowerment in the Online Health Community Scale, a modified version of the Multidimensional Scale of Perceived Social Support, Problem Areas in Diabetes Survey-Parent Revised version and a modified version of the Maternal Self-efficacy for Diabetes Management Scale. Data were analysed using SPSS 25.0, and PROCESS MACRO for SPSS v3.5.

RESULTS

A serial multiple mediation model was used. The indirect effects of both social support in online health communities and collective empowerment were identified in the relationship between DRB and diabetes self-efficacy (DSE). However, there was no indirect effect of social support in online health communities on these relationships.

CONCLUSION

These findings suggest that online social support alone has a limited role in chronic disease management self-efficacy. Collective empowerment should be a strategic component in intervention development using online health communities to strengthen DSE in mothers of children with T1D.

IMPACT

This study provides novel insights into the functional mechanism of online health communities for T1D. Peer mentor coaching by parents of children with T1D effectively helps other children's parents with its recent diagnosis. The findings recognize a need for strategies enhancing collective empowerment among parents of children with T1D. Along with peer coaching, these strategies should strengthen knowledge of resources and methods to impact social change as well as resource mobilization for collective actions.

What factors influence feeling competent as a parent with multiple sclerosis?

OBJECTIVE

To identify factors that influence the perception parents with multiple sclerosis have of their competence in parenting.

METHOD/DESIGN

Subjects were parents of a child with a maximum of 18 years of age recruited through a national multiple sclerosis organization's social media channels. Data on demographic and disease information, mood, coping, quality of life and perceived social support were collected using an anonymous online questionnaire. Univariate and multivariate analyses were performed to assess associations between these variables and subjects' perception of parenting sense of competence.

RESULTS

The sample consisted of 285 parents with multiple sclerosis, with a mean age of 41 years and a mean disease duration of 10.4 years. In the multivariate analysis, independent determinants of lower parenting sense of competence were anxiety (p = 0.012), depression (p = 0.001) and dysfunctional coping (p = 0.005). Problem-focused coping (p = 0.029) and higher physical and mental scores on the SF-12 (p = 0.006, p < 0.001, respectively) were related to a higher parenting sense of competence. Higher parent age correlated with a lower sense of parenting competence (p = 0.002).

CONCLUSIONS

The perception parents with multiple sclerosis have of their parenting competence was most strongly correlated with mood, coping strategies and health-related quality of life, factors that are potentially modifiable.

Parental, child and socio-contextual factors associated with parenting self-efficacy among parents of children aged 0-7 years old: the CIKEO study

BACKGROUND

A high parenting self-efficacy (PSE) has been associated with positive parenting and positive child development. However, there is limited and inconsistent information on factors associated with PSE.

OBJECTIVE

To investigate factors associated with PSE in parents of children aged 0-7 years old, and to explore whether the associations were different between mothers and fathers.

METHODS

We performed a cross-sectional analysis of the baseline data from a prospective cohort study: the CIKEO study. A total of 1012 parents (mean age = 33.8, SD = 5.0) completed self-reported measure of PSE and 18 potential factors associated with PSE.

RESULTS

Multivariable models revealed that lower parenting stress, fewer child behavior problems, better eating behavior, better parental and child general health, a smaller number of children living in the household, higher perceived level of social support and having a migration background were associated with higher levels of PSE (p < 0.05). The association between family functioning and PSE differed between mothers and fathers (p for interaction = 0.003): with beta and 95% confidence interval being: 1.29 (- 2.05, 0.87), and 0.23 (- 0.46, 3.29), respectively.

CONCLUSIONS

A range of parental, child and social-contextual factors in relation to PSE were identified. The patterns of associations for most of the factors were similar among mothers and fathers. However, the association between family functioning and PSE might differ for mothers and fathers. Our findings are relevant for tailoring and implementing successful interventions and effective policy making in child care.

TRIAL REGISTRATION

Netherlands National Trial Register number NL7342. Date of registration: 05-November-2018, retrospectively registered.

Parenting, child development and primary care-'Crescer em Grande!' intervention (CeG!) based on the Touchpoints approach: a cluster-randomised controlled trial protocol

INTRODUCTION

Despite support for parenting being already recognised as a priority, there remains a paucity of evidence on how to facilitate its adoption in regular visits of maternal and child health primary care (PC). We describe the protocol for a study to assess the effect of an innovative universal Touchpoints-based intervention-'Crescer em Grande!' (CeG!) - when supporting the process of transition to parenthood and early infancy, at multiple PC units.

METHODS AND ANALYSIS

A cluster-randomised trial will be conducted in 12 PC units (clusters) from the Lisbon metropolitan area, Portugal. Participants will be a minimum of three family physicians and one nurse/unit, as well as 216 expecting parents and future babies until 18 months who are using the PC services. Sites will be randomised to either the CeG! or usual care. The CeG! will consist of: (1) the integration of the Touchpoints approach in PC maternal and well-child visits, with the support of 28 leaflets for parents to file in a folder; plus (2) training for PC providers on how to perform the CeG! into existing practice. Parents will be required to fill in questionnaires at point throughout their child's 18-month, mostly online. The primary outcome will be the self-perception of parental competence (Parenting Sense of Competence Scale). Other outcomes include: family functioning, couple dynamics, mental health, well-being/quality of life, psychological experience of pregnancy, attachment, child development. Acceptability, satisfaction and feasibility of CeG! will also be obtained from providers' and parents' perspectives. Costs associated with delivering the CeG! will be calculated. Study analyses will be under the principle of intention-to-treat.

ETHICS AND DISSEMINATION

Approval was obtained from the Ethics Committee of the Regional Health Administration. The results will be shared with participants and disseminated via peer-reviewed published papers, presentations at scientific and professional conferences.

TRIAL REGISTRATION NUMBER

ISRCTN90692907.

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.