Quality of attachment as a predictor of maternal visitation to young hospitalized children

An Alternative to Mother and Infants Behind Bars: How One Prison Nursery Program Impacted Attachment and Nurturing for Mothers Who Gave Birth While Incarcerated

The number of women in United States prisons has increased, with the most rapid growth among women of childbearing age. Detrimental effects on maternal-infant attachment have been shown to exist when mothers and infants are separated at birth. The purpose of this exploratory study was to examine the impact of an out-of-prison nursery program, Baby and Mother Bonding Initiative (BAMBI), on maternal-infant attachment and nurturing competencies among women who gave birth while incarcerated. A sample of 41 participants was recruited through a "Closed" BAMBI Alumni Facebook page and nonprobability snowball sampling. Participants were surveyed, and responses were submitted online or via mail. Data were analyzed using descriptive statistics, correlation coefficients, multiple regression, and logistic regression. Results indicated that the number of children living in the mother's household was a significant predictor of positive maternal nurturance. Inversely, the high number of children in the household was the most significant predictor of increased risk for infants to have insecure attachment to mothers. As the number of women giving birth in prisons continues to trend upward, the need for more programs to promote best outcomes for both mother and infants is crucial.

Parental experiences of a developmentally focused care program for infants and children during prolonged hospitalization

This study investigates parental experiences and perceptions of the care received during their child's prolonged hospitalization. It relates this care to the Beanstalk Program (BP), a develop-mentally focused care program provided to these families within an acute care hospital setting. A total of 20 parents (of children hospitalized between 1-15 months) completed the Measures of Processes of Care (MPOC-20) with additional questions regarding the BP. Scores rate the extent of the health-care provider's behaviour as perceived by the family, ranging from 'to a great extent' (7) to 'never' (1). Parents rated Respectful and Supportive Care (6.33) as highest, while Providing General Information (5.65) was rated lowest. Eleven parents participated in a follow-up, qualitative, semi-structured interview. Interview data generated key themes: (a) parents strive for positive and normal experiences for their child within the hospital environment; (b) parents value the focus on child development in the midst of their child's complex medical care; and (c) appropriate developmentally focused education helps parents shift from feeling overwhelmed with a medically ill child to instilling feelings of confidence and empowerment to care for their child and transition home. These results emphasize the importance of enhancing child development for hospitalized infants and young children through programs such as the BP.

Unaccompanied hospitalized children: a review of the literature and incidence study

The aim of this study was to review literature on unaccompanied hospitalized children and report the incidence at a pediatric hospital over 2 weeks. The philosophical model of most pediatric hospitals is family-centered care (FCC) and reducing separation effects. Although the FCC model includes parents/guardians as collaborators and participants in the care of the child, parents cannot always be present. Nurses try to meet the needs of unaccompanied children. Children and parents express that they want to be together, but many parents have obstacles to participation including increased expectations. The incidence study found that about one third of children were sometimes unaccompanied.

Coping strategies for hospital-related fears in pre-school-aged children

AIM

The aim of this study was to describe the child-reported coping strategies for hospital-related fears in 4-6-year-old children.

METHOD

The data were collected by semi-structured interviews of 4-6-year-old volunteering children (n= 82) in Finland. Thirty-four children were interviewed in hospital, and 48 in kindergarten. The children were chosen through a purposive sampling method, in which volunteers were asked to take part in the study. The data were analysed with quantitative and qualitative methods.

RESULTS

The most frequent child-reported coping strategies were: the presence of parents and other family members (81/517, 15.7%), the help of the hospital personnel (58/517, 11.2%), positive images and humour (57/517, 11%), play (57/517, 11%) and the child's own safety toy (45/517, 8.7%). The children interviewed in hospital mentioned significantly more often play (P= 0.000) as their coping strategy than children interviewed in a kindergarten. Children interviewed in kindergarten expressed significantly more often the presence of parents (P= 0.032) and the help of the doctor (P= 0.012) as their coping strategy than the children interviewed in the hospital.

CONCLUSIONS

The results showed that children have many coping strategies, especially ones in which the children themselves play an active role. Besides, the traditional methods for alleviating fear, children need possibilities to use coping methods in which they have an active role giving them a feeling of some control over the hospital environment and medical procedures.

Implications of attachment style for patterns of health and illness

There is substantial evidence that health status and health outcomes are related to the availability and quality of personal relationships. The proposition that attachment relationships in childhood and adolescence have health-related implications fits within this research tradition, and has guided recent attempts to develop models linking attachment style with emotional regulation, coping mechanisms, and illness behaviours. The present paper discusses these theoretical models, together with relevant empirical findings. It is argued that measures of attachment security are related to symptom-reporting, health-care utilization, and restriction of normal activities, and that these links can be explained, in part, by individual differences in emotional and behavioural responses to stress. It is further noted that researchers have proposed physiological and biochemical pathways which may explain some of the effects of attachment style on physical health. The quality of parent-child attachment also predicts family responses to children's illness, as reflected in parents' visitation rates and in family participation in studies of health and illness. The implications of the findings for research and for practice in the health professions are briefly discussed.