Mothers' parenting self-efficacy, satisfaction and perceptions of their infants during the first days postpartum

Exploring the relationship between mothers' competence and comfort in sexual and reproductive health discourse with adolescent girls and its related factors

OBJECTIVES

The mothers-adolescent discussion regarding sexual and reproductive health (SHR) issues plays an important role in preventing negative outcome associated with sexual risk behaviors. The present study aimed to explore the relationship between mothers' competence and comfort in SHR discourse with adolescent girls and its related factors.

METHODS

A cross-sectional study was conducted involving 160 mothers from July to September 2020. Data were collected through questionnaires covering demographic characteristics, Mother's Comfort in Sexual Discourse (MCSD), Mother's Interest in Sexual Discourse (MISD), and Parenting Sense of Competence (PSOC). The collected data were analyzed using simple and multiple linear regression models.

RESULTS

The mean scores for MCSD, MISD, and PSOC were 45.49±16.15 (13-78), 7.9±4.2 (0-13), and 64.07±9.44 (45-94), respectively. The primary topics of mother-adolescent discourse on SRH were menstruation (5.61±0.98) and the delivery process (4.55±1.57). The mean age for "sex talks" and age-appropriate "sex talks" with daughters was 11.76±1.85 (range: 6-15) and 17.05±1.86 (range: 14-23) years, respectively. Significant associations were found between MCSD and MISD (β=0.482, p<0.0001), PSOC (β=0.223, p<0.005), self-efficacy (β=0.202, p<0.011), mother's job (β=0.185, p<0.019), mother's education (β=0.173, p<0.029), and father's age (β=0.161, p<0.042). After adjusting for other variables, major influencing factors on MCSD included MISD (β=0.487, p<0.0001), self-efficacy (β=0.143, p<0.039), satisfaction (β=0.169, p<0.015), daughter number (β=-0.235, p<0.014), son number (β=-0.219, p<0.024), birth rank (β=0.263, p<0.008), and residency (β=0.172, p<0.014).

CONCLUSIONS

MISD, PSOC, and certain demographic characteristics emerge as significant factors influencing MCSD in mother-daughter sexual discourse. As such, it is imperative to consider these determinants when devising strategies to maintain and enhance the sexual health of teenage girls.

Doula Support and Pregnancy-Related Complications and Death Among Childbearing Women in the United States: A Scoping Review

INTRODUCTION

The potential benefits of perinatal doula support are many; however, doulas are underutilized, which may heighten pregnancy-related complications. In this scoping review, we assess the influence of perinatal doula support on pregnancy-related complications and death in the United States.

METHODS

We searched PubMed, CINAHL, Scopus, and Alt HealthWatch for literature on doula support and its influence on pregnancy-related complications (maternal fever or infection, postpartum hemorrhage, amniotic fluid embolism, complications from anesthesia, preeclampsia, eclampsia, cardiomyopathy, pulmonary or thrombotic embolism, and cerebrovascular accident). Peer-reviewed articles written in English and conducted in the United States from 1969 to 2021 were included. Screening at all levels was blinded. We extracted data based on title, author, year, design, population, sample size, methods, limitations, recommendations, and definition of doula support.

RESULTS

Following removal of duplicates, review of 3679 article titles and abstracts yielded 42 articles for full-text review; 3 articles met final inclusion criteria. One included study focused on intrapartum doula support and 2 on doula support that extended throughout the perinatal period. Within the included studies, doula support was associated with decreased rates of intrapartum maternal fever and gestational hypertension; however, it was not associated with decreased rates of gestational diabetes or depression.

DISCUSSION

The literature has addressed the benefits of perinatal doula support, but studies with validated tools to examine associations between doula support and pregnancy-related complications and death are lacking. The studies that addressed intrapartum and continuous doula care included large generalizable samples, from which future research can draw to improve the practice of caring for patients during the perinatal period. Extensive research shows that unfavorable conditions can influence perinatal outcomes across generations. Implementing doula support may offer a potential approach to reduce and help alleviate resulting disparities in perinatal health.

The effect of perceived social support on postpartum stress: the mediating roles of marital satisfaction and maternal postnatal attachment

BACKGROUND

Multiple factors may be responsible for the development of postpartum stress, including perceived social support, marital satisfaction, and maternal postnatal attachment. However, the underlying mediation mechanisms remain unclear. This study examined the complex relationships between perceived social support and postpartum stress among Chinese women.

METHODS

A convenience sample comprising 406 postpartum women was recruited from six hospitals in Nantong, Jiangsu Province, China. The participants completed general survey questionnaires and were evaluated using the Maternal Postpartum Stress Scale, the Perceived Social Support Scale, the Maternal Postnatal Attachment Scale, and the Marital Satisfaction Scale. Furthermore, we evaluated the relationship between postpartum stress and the various influencing factors by performing a multiple linear regression analysis. The potential mediating roles of marital satisfaction and maternal and infant attachment in the association between perceived social support and postpartum stress were explored by performing a mediation analysis.

RESULTS

According to the multivariate regression analysis, perceived social support, marital satisfaction, and maternal postnatal attachment contributed to postpartum stress levels (P < 0.05). The mediation analysis revealed that marital satisfaction and maternal postnatal attachment played parallel mediating roles in the association between perceived social support and postpartum stress, and the mediating effect of marital satisfaction was - 0.1125 (95% confidence interval [CI]: -0.1784 to -0.0520), accounting for 33.20% of the total effect, and the mediating effect of maternal postnatal attachment was - 0.0847 (95% CI: -0.1304 to -0.0438), accounting for 25.00% of the total effect.

CONCLUSION

Our study revealed that perceived social support could influence postpartum stress not only through direct effect (41.80% of the total effect), but also through the indirect effect (mediation effect) of marital satisfaction and maternal postnatal attachment (58.20% of the total effect), suggesting that improving postpartum women's social support, enhancing maternal and infant attachment, and improving their marital satisfaction could help lower postpartum stress.

'Parentbot - A Digital healthcare Assistant (PDA)': A mobile application-based perinatal intervention for parents: Development study

OBJECTIVE

To describe the development procedure of a mobile application-based parenting support program with integrated chatbot features entitled Parentbot - a Digital healthcare Assistant (PDA) for multi-racial Singaporean parents across the perinatal period.

METHODS

The PDA development process was guided by the combined information systems research framework with design thinking modes, and Tuckman's model of team development. A user acceptability testing (UAT) process was conducted among 11 adults of child-bearing age. Feedback was obtained using a custom-made evaluation form and the 26-item User Experience Questionnaire.

RESULTS

The combined information systems research framework with design thinking modes helped researchers to successfully create a PDA prototype based on end-users' needs. Results from the UAT process indicated that the PDA provided participants with an overall positive user experience. Feedback gathered from UAT participants was used to enhance the PDA.

CONCLUSION

Although the effectiveness of the PDA in improving parental outcomes during the perinatal period is still being evaluated, this paper highlights the key details of developing a mobile application-based parenting intervention which future studies could learn from.

PRACTICE IMPLICATIONS

Having carefully planned timelines with margins of delays, extra funds to resolve technical issues, team cohesion, and an experienced leader can facilitate intervention development.

Effects of health promotion program on maternal attachment, parenting self-efficacy, infant development: a randomised controlled trial

This study was designed to test the efficacy of the health promotion program used on maternal-infant attachment, parental self-efficacy, infant development. For this experimental study parallel-group randomised control design was used. Data was collected from 64 mother and their infants. The intervention group received the health promotion program in addition to standard care, the control group received only the standard care. Family Information Form, Prenatal Attachment Inventory, Maternal Attachment Inventory, Parenting Self-Efficacy Scale, and Denver II Developmental Screening Tests were used for the collection of the data. Pearson χ2 test, Yates corrected χ2 test, independent t-test, and Mcnemar test were used for analysing the collected data. The groups on maternal-infant attachment (d:1.20 [CI:0.671-1.736]), parental self-efficacy (d:1.37 [CI:0.835 to 1.925]), and development delays of infants (p = .003, C.V: 0.41) were found to be statistically significant. Health promotion program positively influenced the maternal attachment, parental self-efficacy, the development of the infants.IMPACT STATEMENTWhat is already known on this subject? Pregnancy and postpartum is a difficult period for mothers. Mothers need support. Parenting self-efficacy and maternal attachment are important for improving infant health. Infant should be supported to prevent developmental delays.What do the results of this study add? With the education and support program applied before and after birth, mother and baby were evaluated together and multi-faceted support was provided.What are the implications of these findings for clinical practice and/or further research? Supporting parenting self-efficacy, maternal attachment and infant development should be started during pregnancy and should be continued in the postpartum period.

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.

Determination of mothers' thoughts and adaptation behaviors regarding the infant: A descriptive study

BACKGROUND

With motherhood, women focus on their new baby. They begin to develop new adaptation behaviors to provide the best care for the infant. The study aims to describe the adaptive behaviors and concerned thoughts of first-time and repeat mothers.

METHODS

The study was designed in descriptive and cross-sectional type. Data were collected from mothers using a questionnaire and "The scale of being the mother of a baby." The study was completed with 112 mothers who were reached by snowball sampling method and agreed to participate. The data were analyzed at the 95% confidence interval at the p˂.05 significance level.

RESULTS

66.1% of the mothers had a baby for the first time, and 73.2% of the mothers received information/education about baby care. It was determined that they wanted to receive information on topics such as maternal and infant nutrition, diseases, and immunization. A statistically significant difference was found between the age of pacifier use (p = .032). It was determined that mothers got 130.7 points in total from the scale, 88.3 points from the evaluation of motherhood sub-dimension, and 42.3 points from the life change sub-dimension. A statistically significant difference was found between the baby care knowledge/training status and the scale scores.

CONCLUSION

The importance and continuity of education during and after pregnancy has emerged. Nurses are competent people with a key role in this regard, and it is recommended to use individualized care protocols for the training provided.

Bills, babies, and (language) barriers: Associations among economic strain, parenting, and primary language during the newborn period

OBJECTIVE

The goal of this study was to examine associations among economic strain, parenting self-efficacy, parenting satisfaction, and parent primary language in a universally low-income sample of parents with newborns.

BACKGROUND

Previous research links increased economic strain to lower levels of parenting self-efficacy and parenting satisfaction among socioeconomically diverse parents with older children. Little research has examined whether primary language shapes the associations among economic strain, parenting self-efficacy, and parenting satisfaction.

METHOD

Parents (n = 194, M _age = 30.91) completed self-report surveys measuring economic strain, parenting self-efficacy, and parenting satisfaction. Parents' ethnic self-identification and primary language were used to stratify parents into three groups: Latinx Spanish speakers, Latinx English speakers, and non-Latinx English speakers.

RESULTS

Regression analyses revealed that economic strain was negatively associated with both parenting self-efficacy and parenting satisfaction. Further, the negative association between economic strain and parenting self-efficacy was stronger for Latinx Spanish speakers.

CONCLUSION

Economic strain may negatively influence parenting self-efficacy and parenting satisfaction during the newborn period. Parents whose primary language is Spanish may be disproportionately affected by economic strain.

IMPLICATIONS

Parents of newborns may benefit from increased economic supports in linguistically responsive pediatric care and social service settings.

Perceived maternal parenting self-efficacy scale: Factor structure and psychometric properties among Portuguese postpartum women

OBJECTIVE

The aim of this study was to investigate the factor structure and psychometric properties of the Perceived Maternal Parenting Self-Efficacy (PMPS-E) Scale among Portuguese postpartum women.

DESIGN

Quantitative cross-sectional study.

SETTING

Data were collected through an online survey placed on social media websites targeting Portuguese adult women in the postpartum period (0-12 months after delivery).

PARTICIPANTS

The total sample consisted of 893 participants who gave birth after 37 weeks of gestation.

RESULTS

After conducting exploratory and confirmatory factor analyses, our results revealed that a correlated three-factor model yielded a significantly better fit to the data than the original four-factor model. High reliability was found for the total scale (α= 0.95) and for the three factors (α from 0.88 to 0.94). The PMPS-E presented significant and moderate to large correlations with other measures related to maternal self-efficacy. Participants who were multiparous, had older infants (>5 months old) and perceived their infant temperament as easy reported higher maternal parenting self-efficacy than those who were primiparous, had younger infants (≤5 months old) and perceived their infant temperament as difficult.

CONCLUSIONS

The results of this study showed that the European Portuguese version of the PMPS-E is a valid and reliable instrument for assessing maternal parenting self-efficacy among postpartum women.

IMPLICATIONS FOR PRACTICE

The PMPS-E may be a valuable instrument to detect parenting self-efficacy difficulties among postpartum women and thus contribute to strategies to improve women's overall psychological adjustment to the postpartum period, with a possible impact on the mother-infant relationship.

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.