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Li J, Shao D, Xu X, Zhang Y, Jiang Y, Hall J. Cognitive behavior stress management during pregnancy: a randomized controlled trial. Contemp Nurse 2020; 55:543-553. [PMID: 32063222 DOI: 10.1080/10376178.2020.1729827] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Pregnancy stress could lead to adverse health outcomes for both mother and child. Few studies have explored the effectiveness of stress management strategy among pregnant women. OBJECTIVES/AIMS/HYPOTHESES To examine the effectiveness of cognitive-behavioral stress management for pregnant women. DESIGN Randomized Controlled Trial. METHODS 100 pregnant women (at 6-8 week of pregnancy) were selected by convenience sampling. Participants in the control group (N = 50) received routine prenatal examination and health education, while those in the intervention group (N = 50) received cognitive-behavioral stress management. Pregnancy Pressure Scale was measured at baseline and 39th weeks of pregnancy. RESULTS Pregnancy Pressure Scale score increased in both intervention and control groups. However, the score in the intervention group was significantly lower than those in the control group (p < 0.01). CONCLUSIONS Cognitive-behavioral stress managment can effectively reduce pregnant women's stress levels. IMPACT STATEMENT Nurses and midwives should conduct cognitive-behavioral stress management to help pregnant women reduce their stress.
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Affiliation(s)
- Jinzhi Li
- Nursing of School, Bengbu Medical College, Bengbu City, People's Republic of China
| | - Dongfang Shao
- Department of Obstetrics, The First Affiliated Hospital of Bengbu Medical College, Bengbu City, People's Republic of China
| | - Xiaoyue Xu
- Faculty of Health, University of Technology, Sydney, Australia
| | - Yu Zhang
- Department of Obstetrics, The First Affiliated Hospital of Bengbu Medical College, Bengbu City, People's Republic of China
| | - Yumin Jiang
- Nursing of School, Bengbu Medical College, Bengbu City, People's Republic of China
| | - John Hall
- School of Public Health & Community Medicine, University of New South Wales, Sydney, Australia
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Barnes J, Stuart J, Allen E, Petrou S, Sturgess J, Barlow J, Macdonald G, Spiby H, Aistrop D, Melhuish E, Kim S, Pink J, Datta J, Elbourne D. Results of the First Steps study: a randomised controlled trial and economic evaluation of the Group Family Nurse Partnership (gFNP) programme compared with usual care in improving outcomes for high-risk mothers and their children and preventing abuse. PUBLIC HEALTH RESEARCH 2017. [DOI: 10.3310/phr05090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundFamily Nurse Partnership (FNP) is a home-based nurse home-visiting programme to support vulnerable parents. Group Family Nurse Partnership (gFNP) has similar aims and materials and was demonstrated to be feasible in implementation evaluations.ObjectivesTo determine whether or not gFNP, compared with usual care, could reduce risk factors for maltreatment in a vulnerable group and be cost-effective.DesignA multisite randomised controlled parallel-group trial and prospective economic evaluation, with eligible women allocated (minimised by site and maternal age group) to gFNP or usual care.SettingCommunity locations in the UK.ParticipantsExpectant mothers aged < 20 years with one or more previous live births, or expectant mothers aged 20–24 years with no previous live births and with low educational qualifications (defined as General Certificate of Education at grade C or higher in neither mathematics nor English language or, if they had both, no more than four General Certificates of Education at grade C or higher).InterventionForty-four sessions of gFNP (14 during pregnancy and 30 in the first 12 months after birth) were offered to groups of between 8 and 12 women with similar expected delivery dates (the difference between the earliest and latest expected delivery date ranged from 8 to 10 weeks depending on the group) by two family nurses (FNs), one of whom had notified her intention to practise as a midwife.Main outcome measuresParenting was assessed by a self-report measure of parenting opinions, the Adult Adolescent Parenting Inventory Version 2 (AAPI-2), and an objective measure of maternal sensitivity, the CARE-Index. Cost-effectiveness was primarily expressed in terms of incremental cost per quality-adjusted life-year (QALY) gained.Data sourcesInterviews with participants at baseline and when infants were aged 2, 6 and 12 months. Cost information from nurse weekly logs and other service delivery data.ResultsIn total, 166 women were enrolled (99 to the intervention group and 67 to the control group). Adjusting for site and maternal age group, the intention-to-treat analysis found no effect of gFNP on either of the primary outcomes. AAPI-2 total was 7.5/10 [standard error (SE) 0.1] in both arms [difference also adjusted for baseline 0.08, 95% confidence interval (CI) –0.15 to 0.28;p = 0.50]. CARE-Index maternal sensitivity mean: intervention 4.0 (SE 0.3); control 4.7 (SE 0.4) (difference –0.76, 95% CI –1.67 to 0.13;p = 0.21). The sensitivity analyses supported the primary analyses. The probability that the gFNP intervention was cost-effective based on the QALY measure did not exceed 3%. However, in terms ofchangein AAPI-2 score (baseline to 12 months), the probability that gFNP was cost-effective reached 25.1%. A separate discrete choice experiment highlighted the value placed by both pregnant women and members of the general population on non-health outcomes that were not included in the QALY metric.LimitationsSlow recruitment resulted in smaller than ideal group sizes. In some cases, few or no sessions took place owing to low initial group size, and small groups may have contributed to attrition from the intervention. Exposure to gFNP sessions was below maximum for most group members, with only 58 of the 97 intervention participants receiving any sessions; FNs were experienced with FNP but were mainly new to delivering gFNP.ConclusionsThe trial does not support the delivery of gFNP as a means of reducing the risk of child abuse or neglect in this population.Future workA randomised controlled trial with modified eligibility to enable first-time mothers aged < 20 years to be included, and a modified recruitment strategy to enable faster identification of potential participants from antenatal medical records.Trial registrationCurrent Controlled Trials ISRCTN78814904.FundingThis project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full inPublic Health Research; Vol. 5, No. 9. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Jacqueline Barnes
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
| | - Jane Stuart
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
| | - Elizabeth Allen
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Stavros Petrou
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Joanna Sturgess
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Jane Barlow
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Helen Spiby
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
| | - Dipti Aistrop
- Sheffield Children’s NHS Foundation Trust, Sheffield, UK
| | - Edward Melhuish
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
| | - Sungwook Kim
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Joshua Pink
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Jessica Datta
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Diana Elbourne
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
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Smith GC, Strieder F, Greenberg P, Hayslip B, Montoro-Rodriguez J. Patterns of Enrollment and Engagement of Custodial Grandmothers in a Randomized Clinical Trial of Psychoeducational Interventions. FAMILY RELATIONS 2016; 65:369-386. [PMID: 27667888 PMCID: PMC5030076 DOI: 10.1111/fare.12194] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Accepted: 08/25/2015] [Indexed: 05/27/2023]
Abstract
The authors used Andersen's (2008) behavior model to investigate patterns of enrollment and treatment engagement among 343 custodial grandmothers who participated in a randomized clinical trial of three psychosocial interventions:(a) a behavioral parenting program, (b) a cognitive behavioral coping program, or (c) an information-only condition. Treatment completion was superior to that typically found with birth parents, even though the grandmothers and their target grandchildren both had high levels of mental and physical health challenges. Compliance did not differ significantly by condition but was higher among grandmothers who self-reported less positive affect, were older, and were using mental health professionals. Treatment satisfaction was highest in grandmothers who attended more treatment sessions, reported lower annual family income, had a health problem, and were using mental health professionals. The practice and policy implications of these findings are discussed, especially in terms of strategies for enhancing the engagement of custodial grandfamilies in future psychoeducational interventions.
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Affiliation(s)
| | - Frederick Strieder
- University of Maryland School of Social Work, 525 W. Redwood St., Baltimore, MD 21201
| | - Patty Greenberg
- University of Maryland School of Social Work, 525 W. Redwood St., Baltimore, MD 21201
| | - Bert Hayslip
- Department of Psychology, University of North Texas, Denton, TX 76203
| | - Julian Montoro-Rodriguez
- Gerontology Program, University of North Carolina, 9201 University City Blvd., CHHS No. 481, Charlotte, NC 28223
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Palmer ML, Henderson M, Sanders MR, Keown LJ, White J. Erratum to: study protocol: evaluation of a parenting and stress management programme: a randomised controlled trial of triple P discussion groups and stress control. BMC Public Health 2015; 15:256. [PMID: 25884304 PMCID: PMC4363455 DOI: 10.1186/s12889-015-1507-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Melanie L Palmer
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, 4 Lilybank Gardens, Glasgow, G12 8RZ, UK. .,School of Learning, Development, and Professional Practice, Faculty of Education, The University of Auckland, Private Bag 92601 Symonds St, Auckland, 1150, New Zealand.
| | - Marion Henderson
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, 4 Lilybank Gardens, Glasgow, G12 8RZ, UK.
| | - Matthew R Sanders
- School of Learning, Development, and Professional Practice, Faculty of Education, The University of Auckland, Private Bag 92601 Symonds St, Auckland, 1150, New Zealand.
| | - Louise J Keown
- School of Learning, Development, and Professional Practice, Faculty of Education, The University of Auckland, Private Bag 92601 Symonds St, Auckland, 1150, New Zealand.
| | - Jim White
- STEPS Primary Care Mental Health Team, National Health Service Greater Glasgow and Clyde, 60 Florence Street, Glasgow, G5 0YX, UK.
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Morrison J, Pikhart H, Ruiz M, Goldblatt P. Systematic review of parenting interventions in European countries aiming to reduce social inequalities in children's health and development. BMC Public Health 2014; 14:1040. [PMID: 25287010 PMCID: PMC4203958 DOI: 10.1186/1471-2458-14-1040] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 09/09/2014] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Early child development influences many aspects of wellbeing, health, competence in literacy and numeracy, criminality, and social and economic participation throughout the life course. Children from disadvantaged groups have less possibilities of achieving full development. By providing a positive start for all children across the social gradient, improved developmental outcomes will be seen during later childhood and throughout their lives. The objective of this systematic review was to identify interventions during early childhood in countries from the World Health Organisation European Region in 1999-2013 which reduced inequalities in children's health and development. METHODS A systematic review was carried out adhering to the PRISMA guidelines. The review examined universal, targeted and proportionate universalism interventions, programs and services using an electronic search strategy in PubMed and the International Bibliography of the Social Sciences [IBSS] databases. A further search was performed in the grey literature. Interventions were included only if they were aimed at children or their parents and had been evaluated. RESULTS We identified 23 interventions in total: 6 in the PubMed data base, 5 in IBSS and 12 in grey literature. All but 1 intervention-delivered in Sweden-were carried out in the United Kingdom and the Republic of Ireland. These aimed to improve parenting abilities, however, some had additional components such as: day-care provision, improving housing conditions and speech or psychological therapies. Programmes offering intensive support, information and home visits using a psycho-educational approach and aimed at developing parent's and children's skills showed more favourable outcomes. These were parenting behaviours, overall children's health and higher level of fine motor skills and cognitive functioning. Child injuries and abuse were also reduced. Two interventions were universally proportionate and all others were aimed at a specific target population. CONCLUSIONS Interventions with better outcomes and a higher level of evidence combined workshops and educational programmes for both parents and children beginning during early pregnancy and included home visits by specialised staff. Further evaluation and publication of early years interventions should be carried out also within a wider range of countries than just the UK and Ireland.
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Affiliation(s)
- Joana Morrison
- />Department of Epidemiology and Public Health, University College London, London, UK
| | - Hynek Pikhart
- />Department of Epidemiology and Public Health, University College London, London, UK
| | - Milagros Ruiz
- />Department of Epidemiology and Public Health, University College London, London, UK
| | - Peter Goldblatt
- />Institute of Health Equity, Department of Epidemiology and Public Health, University College London, London, UK
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