Distress and Growth Outcomes in Mothers of Medically Fragile Infants

Miles, Margaret Shandor; Holditch‐Davis, Diane; Burchinal, Peg; Nelson, Deborah B.

doi:10.1097/00006199-199905000-00003

Cited by 141 publications

(133 citation statements)

References 48 publications

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“…These observations concur with earlier studies suggesting that maternal postpartum depression may be further exacerbated by the infant's ill health. 17,62,63 Maternal stress is correlated with their lactation performance Our second aim investigated the associations that may exist among various psychosocial factors, lactation-enhancing interventions and lactation performance. Studies have addressed these issues.…”

Section: Subjects' Compliancementioning

confidence: 99%

Ethnic/racial diversity, maternal stress, lactation and very low birthweight infants

et al. 2007

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Objective: (1) To compare maternal characteristics and psychological stress profile among African-American, Caucasian and Hispanic mothers who delivered very low birthweight infants. (2) To investigate associations between psychosocial factors, frequency of milk expression, skin-to-skin holding (STS), and lactation performance, defined as maternal drive to express milk and milk volume.Study Design: Self-reported psychological questionnaires were given every 2 weeks after delivery over 10 weeks. Milk expression frequency, STS, and socioeconomic variables were collected.Result: Infant birthweight, education, and milk expression frequency differed between groups. Trait anxiety, depression and parental stress in a neonatal intensive care unit (PSS:NICU) were similar. African-American and Caucasian mothers reported the lowest scores in state anxiety and social desirability, respectively. Maternal drive to express milk, measured by maintenance of milk expression, correlated negatively with parental role alteration (subset of PSS:NICU) and positively with infant birthweight and STS. Milk volume correlated negatively with depression and positively with milk expression frequency and STS.Conclusion: Differences between groups were observed for certain psychosocial factors. The response bias to self-reported questionnaires between groups may not provide an accurate profile of maternal psychosocial profile. With different factors correlating with maintenance of milk expression and milk volume, lactation performance can be best enhanced with a multi-faceted intervention program, incorporating parental involvement in infant care, close awareness and management of maternal mental health, and encouragement for frequent milk expression and STS.

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Section: Subjects' Compliancementioning

confidence: 99%

Ethnic/racial diversity, maternal stress, lactation and very low birthweight infants

et al. 2007

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“…Establishing positive interactions may be more difficult for mothers of medically fragile infants, those fullterms or preterms with severe chronic illnesses, technological dependence for survival, and long or frequent hospitalizations, than for mothers with healthy newborns (Holditch-Davis, Tesh, Burchinal, & Miles, 1999;Patterson & Barnard, 1990). Mothers experience stress and alterations in parental roles during their infants' long hospitalizations (Lau & Morse, 2003;Miles, Holditch-Davis, Brunssen, Burchinal, & Wilson, 2002;Miles, Holditch-Davis, Burchinal, & Nelson, 1999). After hospital discharge, caring for the infant's severe health conditions can be overwhelming (Landry, Chapieski, Richardson, Palmer, & Hall, 1990;Singer et al, 2003).…”

mentioning

confidence: 99%

The influence of maternal and child characteristics and paternal support on interactions of mothers and their medically fragile infants

Lee

Holditch‐Davis

Miles

2007

Research in Nursing & Health

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The influences of maternal characteristics, infant characteristics, and paternal support on maternal positive involvement and developmental stimulation were examined over time in 59 mothers and their medically fragile infants using an ecological framework. Higher maternal education was associated with greater maternal positive involvement. More maternal depressive symptoms, more infant technological dependence, and lower birthweights were associated with less maternal positive involvement at 6 months but greater involvement at 12 months. Higher paternal helpfulness facilitated positive involvement in mothers with low depressive symptoms but not in those with elevated symptoms. Higher maternal education and more depressive symptoms were associated with more developmental stimulation. Thus, maternal interactive behaviors are affected by maternal, infant, and environment factors, and these effects change over time.

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“…16 In a series of studies from the University of North Carolina, investigators surveyed various cohorts of mothers of premature infants requiring mechanical ventilation, premature infants classified as VLBW, medically fragile infants (defined as requiring hospitalization for a life-threatening illness) and infants seropositive for HIV. [17][18][19][20] Nearly one-fifth of the mothers of premature infants and those of HIV-positive infants were at serious risk for depression, even approaching 2 years after delivery. 17,18 Among mothers of premature infants, the greatest risk factor for depression was rehospitalization of the infant, rather than the initial NICU course, suggesting that the disruptions in daily life caused by readmission to the hospital were a major source of stress.…”

Section: Physical Healthmentioning

confidence: 99%

“…The authors did report that these mothers also experienced personal growth, a positive and important finding. 19 Finally, they surveyed African-American mothers of premature VLBW infants and examined the inter-relationships between different types of emotional distress. Mothers were assigned to one of the four classes, 'low distress,' 'high stress,' 'high depressive' or 'extreme distress,' based on their scores on tests indicating their source of stress (low overall, primarily infant-related, primarily due to maternal depressive symptoms or high overall, respectively).…”

Section: Physical Healthmentioning

confidence: 99%

Biopsychosocial risks of parental care for high-risk neonates: implications for evidence-based parental counseling

Placencia

McCullough

2011

J Perinatol

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Objective: Provide an evidence base for counseling parents of high-risk neonates about the biopsychosocial impact of providing long-term care.Study Design: A review of the effects of long-term care on families of high-risk neonates. Our search was limited to 1993-2010. We used the terms 'long-term care,' 'family,' 'neonate' and 'technology dependence.' Results were organized based on Engel's biopsychosocial model.Result: PhysicalFparental caregivers reported more health problems, had fewer health-promoting behaviors and lower vitality.PsychologicalFparental caregivers had higher rates of post-traumatic stress disorder and depressive symptoms, although some improved with time. Siblings reported greater stress and depression. SocialFparental caregivers achieved fewer years of education, higher unemployment and lower incomes. Couples reported greater family strain. The effect on divorce was mixed. Siblings reported disruption in their academic and social lives. Conclusion:Providing long-term care involves biopsychosocial risks. Counseling of parents should identify them and advocate strategies for prevention.

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Distress and Growth Outcomes in Mothers of Medically Fragile Infants

Abstract: Nurses should consider personal characteristics and level of parental role attainment as well as characteristics of the child and illness-related distress in their approaches to intervention with mothers of critically ill infants.

Cited by 141 publications

References 48 publications

Ethnic/racial diversity, maternal stress, lactation and very low birthweight infants

Ethnic/racial diversity, maternal stress, lactation and very low birthweight infants

The influence of maternal and child characteristics and paternal support on interactions of mothers and their medically fragile infants

Biopsychosocial risks of parental care for high-risk neonates: implications for evidence-based parental counseling

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