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Journal of Affective Disorders Jun 2024In recent years, there has been a wide array of research studies published on parental mental health and stress following very preterm birth. This review aims at... (Review)
Review
BACKGROUND
In recent years, there has been a wide array of research studies published on parental mental health and stress following very preterm birth. This review aims at reviewing the prevalence and risk factors of long-term parental depression, anxiety, post-traumatic stress symptoms and parenting stress following very preterm birth.
METHODS
We searched PubMed, PsychINFO and Web of Science for descriptive, cross-sectional and longitudinal studies published between January 2013 and August 2022.
RESULTS
45 studies met our inclusion criteria. In the first two years, depression, anxiety, post-traumatic stress symptoms and parenting stress were present in ∼20 % of mothers of extreme and very low birth weight (E/VLBW) infants. Long-term psychological distress symptoms could be observed, although few studies have focused on symptoms into school age and longer. Fathers of VLBW infants might experience more psychological distress as well, however, they were only included in ten studies. We found that parental distress is more common when the co-parent is struggling with mental health symptoms. Many risk factors were identified such as social risk, history of mental illness, interpersonal factors (i.e. social support) and child-related factors (i.e. intraventricular hemorrhage, disability, use of medical equipment at home).
LIMITATIONS
Several studies have methodological issues, such as a lack of control of known confounders and there is a large variety of measures employed.
CONCLUSION
Important risk factors for stress and mental health symptoms were identified. More evidence is needed to determine if long-term symptoms persist into school age. Research should focus on taking a family-based approach in order to identify preventive strategies and resilience factors in parents of VLBW infants.
Topics: Infant; Female; Infant, Newborn; Humans; Premature Birth; Infant, Premature; Cross-Sectional Studies; Mothers; Parents; Outcome Assessment, Health Care; Stress, Psychological
PubMed: 38556094
DOI: 10.1016/j.jad.2024.03.154 -
Journal of Medical Internet Research Jul 2023Digital interventions help address barriers to traditional health care services. Fathers play an important parenting role in their families, and their involvement is... (Review)
Review
BACKGROUND
Digital interventions help address barriers to traditional health care services. Fathers play an important parenting role in their families, and their involvement is beneficial for family well-being. Although digital interventions are a promising avenue to facilitate father involvement during the perinatal period, most are oriented toward maternal needs and do not address the unique needs of fathers.
OBJECTIVE
This systematic review describes the digital interventions that exist or are currently being developed for fathers of infants from conception to 12 months postpartum.
METHODS
A systematic search of the MEDLINE, PsycINFO, Cochrane Central Register of Controlled Trials, Embase (using Ovid), and CINAHL (using EBSCO) databases was conducted to identify articles from database inception to June 2022, of which 39 met the inclusion criteria. Articles were included if they were peer-reviewed and described a digital intervention that targeted fathers of fetuses or infants aged ≤12 months. Systematic reviews, meta-analyses, and opinion pieces were excluded. Data from these studies were extracted and themed using a narrative synthesis approach. Quality appraisal of the articles was conducted using the Mixed Methods Appraisal Tool.
RESULTS
A total of 2816 articles were retrieved, of which 39 (1.38%) met the inclusion criteria for eligibility after removing duplicates and screening. Eligible articles included 29 different interventions across 13 countries. Most articles (22/29, 76%) described interventions that were exclusively digital. There were a variety of digital modalities, but interventions were most commonly designed to be delivered via a website or web-based portal (14/29, 48%). Just over half (21/39, 54%) of the articles described interventions designed to be delivered from pregnancy through the postpartum period. Only 26% (10/39) of the studies targeted fathers exclusively. A wide range of outcomes were included, with 54% (21/39) of the studies including a primary outcome related to intervention feasibility. Qualitative and mixed methods studies reported generally positive experiences with digital interventions and qualitative themes of the importance of providing support to partners, improving parenting confidence, and normalization of stress were identified. Of the 18 studies primarily examining efficacy outcomes, 13 (72%) reported a statistically significant intervention effect. The studies exhibited a moderate quality level overall.
CONCLUSIONS
New and expecting fathers use digital technologies, which could be used to help address father-specific barriers to traditional health care services. However, in contrast to the current state of digital interventions for mothers, father-focused interventions lack evaluation and evidence. Among the existing studies on digital interventions for fathers, there seem to be mixed findings regarding their feasibility, acceptability, and efficacy. There is a need for more development and standardized evaluation of interventions that target father-identified priorities. This review was limited by not assessing equity-oriented outcomes (eg, race and socioeconomic status), which should also be considered in future intervention development.
Topics: Female; Pregnancy; Humans; Infant; Parenting; Mothers; Postpartum Period
PubMed: 37494086
DOI: 10.2196/43219 -
Brain and Behavior Nov 2023Preterm infants are at high risk for developmental disabilities, and their parents are at increased risk for high stress. Early intervention programs are applied to... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Preterm infants are at high risk for developmental disabilities, and their parents are at increased risk for high stress. Early intervention programs are applied to reduce these adverse outcomes. The primary aim is to compare the efficacy of the novel Explorer Baby early intervention program for the holistic development of preterm infants. The second objective was to compare the stress levels of their mothers.
METHODS
Randomized clinical trial with 38 weeks-6 months corrected age preterm infants at low risk for cerebral palsy, randomly assigned to experimental (Explorer Baby) or active control neurodevelopmental therapy (NDT) groups. Fifty-seven infants were enrolled in the study, and 51 (26 Explorer Baby, 25 NDT) completed it. Bayley III was used as a primary outcome before, during, and after the intervention.
RESULTS
When we compared the changes between the groups before and after therapy, no significant differences were found in any of the primary or secondary outcomes (between-group comparisons). When comparing the changes in both groups before and after therapy (in-group comparison), the Explorer Baby group demonstrated significant improvements in cognitive (Hedges' g = .83) and explorative language skills (Hedges' g = .65), whereas the NDT group showed improved parent-child dysfunctional interaction (Hedges' g = 2.66) between T0-T1 and T0-T2.
CONCLUSIONS
The Explorer Baby early intervention program may be a preferred option to support premature infants without brain injury, as it shows greater skill acquisition than NDT, although not statistically significant. Both methods are safe as they support premature babies without negatively affecting mothers' overall stress levels.
Topics: Infant; Female; Infant, Newborn; Humans; Infant, Premature; Exploratory Behavior; Parents; Mothers; Research Design; Child Development
PubMed: 37798860
DOI: 10.1002/brb3.3266 -
Palliative Medicine Oct 2023Spirituality refers to the dynamic dimension of human life that relates to the way that persons experience meaning, purpose, and transcendence. The complex task of... (Review)
Review
BACKGROUND
Spirituality refers to the dynamic dimension of human life that relates to the way that persons experience meaning, purpose, and transcendence. The complex task of parenting a child with a life-limiting condition may raise existential questions, which are easily overlooked by healthcare professionals.
AIM
We explored how the spiritual dimension becomes manifest in parents of children in pediatric palliative care.
DESIGN
A mixed-methods systematic review was conducted, registered in Prospero (2021 CRD42021285318).
DATA SOURCES
PubMed, CINAHL, Embase, PsycInfo, and Cochrane were searched for articles published between January 1, 2015 and January 1, 2023. We included original empirical studies that reported on spirituality of parents of seriously ill children, from parents' perspectives.
RESULTS
Sixty-three studies were included: 22 North-American, 19 Asian, 13 European, 9 other. Studies varied in defining spirituality. We identified five different aspects of spirituality: religion, hope, parental identity, personal development, and feeling connected with others. All aspects could function as source of spirituality or cause of spiritual concern. Sources of spirituality helped parents to give meaning to their experiences and made them feel supported. However, parents also reported struggling with spiritual concerns. Several parents highlighted their need for professional support.
CONCLUSIONS
Although studies vary in defining spirituality, reports on spirituality focus on how parents connect to their faith, others, and themselves as parents. Healthcare professionals can support parents by paying attention to the spiritual process parents are going through. More research is needed into how healthcare professionals can support parents of seriously ill children in this process.
Topics: Child; Humans; Parenting; Religion; Palliative Care; Spirituality; Parents
PubMed: 37461310
DOI: 10.1177/02692163231186173 -
Drug and Alcohol Review Jul 2023Numerous studies have explored alcohol consumption in pregnancy, but less is known about women's drinking in the early parenting period (EPP, 0-5 years after... (Review)
Review
ISSUES
Numerous studies have explored alcohol consumption in pregnancy, but less is known about women's drinking in the early parenting period (EPP, 0-5 years after childbirth). We synthesise research related to three questions: (i) How are women's drinking patterns and trajectories associated with socio-demographic and domestic circumstances?; (ii) What theoretical approaches are used to explain changes in consumption?; (iii) What meanings have been given to mothers' drinking?
APPROACH
Three databases (Ovid-MEDLINE, Ovid-PsycINFO and CINAHL) were systematically searched. Citation tracking was conducted in Web of Science Citation Index and Google Scholar. Eligible papers explored mothers' alcohol consumption during the EPP, focusing on general population rather than clinical samples. Studies were critically appraised and their characteristics, methods and key findings extracted. Thematic narrative synthesis of findings was conducted.
KEY FINDINGS
Fourteen quantitative and six qualitative studies were identified. The (sub)samples ranged from n = 77,137 to n = 21 women. Mothers' consumption levels were associated with older age, being White and employed, not being in a partnered relationship, higher education and income. Three theoretical approaches were employed to explain these consumption differences: social role, role deprivation, social practice theories. By drinking alcohol, mothers expressed numerous aspects of their identity (e.g., autonomous women and responsible mothers).
IMPLICATIONS AND CONCLUSION
Alcohol-related interventions and policies should consider demographic and cultural transformations of motherhood (e.g., delayed motherhood, changes in family structures). Mothers' drinking should be contextualised carefully in relation to socio-economic circumstances and gender inequalities in unpaid labour. The focus on peer-reviewed academic papers in English language may limit the evidence.
Topics: Pregnancy; Humans; Female; Male; Parenting; Mothers; Alcohol Drinking; Qualitative Research; Demography
PubMed: 36974380
DOI: 10.1111/dar.13643 -
BMC Public Health Jul 2023Adolescent parents experience worse health and socioeconomic outcomes compared to older parents. Little is known about the factors that can lead to better health and...
BACKGROUND
Adolescent parents experience worse health and socioeconomic outcomes compared to older parents. Little is known about the factors that can lead to better health and well-being among teen-headed families. A city-wide collaborative conducted a comprehensive well-being assessment of expectant and parenting teens in Washington, DC.
METHODS
An online, anonymous survey was conducted with adolescent parents in Washington, DC, using convenience sampling. The survey consisted of 66 questions adapted from validated scales of quality of life and well-being. Descriptive statistics were used to describe the data overall, by subgroups of mother and father, and by subgroups of parent age. Spearman's correlations were utilized to demonstrate associations of social supports with well-being metrics.
RESULTS
A total of 107 adolescent and young adult parents from Washington, DC, completed the survey; 80% of respondents identified as mothers and 20% as fathers. Younger adolescent parents rated their physical health better compared to older adolescent and young adult parents. Adolescent parents reported accessing various governmental and community-based resources in the preceding 6 months. The most used resources were supplemental food programs, with 35% receiving Supplemental Nutrition Assistance Program benefits and 24% receiving support from the Special Supplemental Nutrition Program for Women, Infants and Children. There was no significant difference in health-related well-being metrics among those who did and did not receive resources. Having higher self-reported social support was positively correlated with higher self-rated physical health, mental health, and well-being, as well as experiencing positive emotions, and was negatively correlated with experiencing negative emotions.
CONCLUSION
This snapshot of the well-being of expectant and parenting teens in Washington, DC, showed overall positive physical, mental, and emotional health. Greater social support was correlated with better outcomes in these areas. Future work will leverage the multidisciplinary collaborative to translate these findings into policies and programs that meet the needs of this population.
Topics: Child; Infant; Young Adult; Humans; Adolescent; Female; Quality of Life; District of Columbia; Parents; Parenting; Social Support; Surveys and Questionnaires
PubMed: 37400757
DOI: 10.1186/s12889-023-16185-7 -
Seminars in Oncology Nursing Oct 2023Cancer has a major impact on the individual patient and their family, especially children. However, little is known about the needs of adolescents (10-19 years) whose...
PURPOSE
Cancer has a major impact on the individual patient and their family, especially children. However, little is known about the needs of adolescents (10-19 years) whose parent is diagnosed with cancer, especially breast cancer. Insights into psychosocial needs are important to develop appropriate guidance and support for these adolescents. The aim of this study is to explore the psychosocial needs of adolescents whose parent is diagnosed with breast cancer to improve the support for these adolescents.
DATA SOURCES
This is an exploratory, qualitative study. In-depth interviews were conducted, and an interview guide was designed with the following topics: experiences, needs, and support. Participants were selected purposively and approached via the parent(s) after consultation. Interviews were audiotaped, transcribed, and thematically analyzed by using the software program NVivo.
CONCLUSION
Fourteen adolescents (12-19 years) were interviewed, which resulted in five themes: distraction, support, being able to talk about it, information, and continuing a normal life. Adolescents whose parent is diagnosed with breast cancer need the best possible preservation of their normal lives. It is important for them to be able to share their story and find support from someone close to them.
IMPLICATION FOR NURSING PRACTICE
The route to the adolescent is always through the parent. Healthcare professionals can discuss the well-being of the adolescent during regular consultation with the parent. If there are concerns, healthcare professionals can advise the parent about the possible needs of the adolescent and could coach the parent in supporting the adolescent to discuss their needs.
Topics: Child; Humans; Adolescent; Female; Breast Neoplasms; Social Support; Parents; Qualitative Research
PubMed: 37633761
DOI: 10.1016/j.soncn.2023.151475 -
Scientific Reports Nov 2023Guided by Beck's cognitive model of depression, this study comprehensively explores the mechanisms linking harsh parenting, rumination, and victimization to the...
Guided by Beck's cognitive model of depression, this study comprehensively explores the mechanisms linking harsh parenting, rumination, and victimization to the development of adolescent depression. A total of 5047 adolescents were assessed using the Harsh Parenting Scale, Rumination Scale, Olweus Bullying/Victimization Questionnaire, and Beck Depression Inventory. The results indicated that harsh parenting positively influences adolescent depression. Moreover, rumination emerged as an important mediator between harsh parenting and adolescent depression, similar to victimization. Additionally, we found that both rumination and victimization act as chain mediators in the relationship between harsh parenting and adolescent depression. These findings demonstrate that harsh parenting impacts adolescent depression mediated by rumination and victimization. By shedding light on these mechanisms, this study improves our comprehension of how harsh parenting influences adolescent depression and offers valuable insights for designing interventions to alleviate depression in this population.
Topics: Humans; Adolescent; Parenting; Depression; Bullying; Surveys and Questionnaires; Crime Victims
PubMed: 38001270
DOI: 10.1038/s41598-023-48138-w -
PloS One 2023Research indicates increases in coercive parenting towards children and increases in child externalizing behavior during COVID-19 as compared to the pre-pandemic period....
Research indicates increases in coercive parenting towards children and increases in child externalizing behavior during COVID-19 as compared to the pre-pandemic period. In this preregistered study, we extended previous knowledge by investigating to what extent, and under what conditions, changes in coercive parenting and child externalizing behavior are interrelated. Ninety-five mothers and fathers of children (of age 3 prior to the pandemic) reported on coercive parenting and child externalizing behavior before and during the pandemic, and trained assistants observed the quality of mother-child and father-child attachment relationship prior to the pandemic. We employed latent change score modeling to test the extent to which changes in maternal and paternal coercive parenting and changes in child externalizing behavior across the pre-pandemic period and the onset of the first COVID-19 lockdown are interrelated. Moreover, we tested whether these linkages are moderated by changes in the other parent's coercive parenting and the quality of parent-child attachment relationship. Specifically, we tested the moderation by mother-child (father-child) attachment relationship quality in the relation between changes in mothers' (fathers') coercive parenting and changes in child externalizing behavior. We found that changes in mothers', but not fathers' coercive parenting were positively associated with changes in child externalizing behavior. We found no moderation by changes in the other parent's parenting or by parent-child attachment relationship quality. Our findings provide support for the transactional processes underlying mothers' and children's behavior in the context of non-normative stressful conditions. We recommend incorporating evidence-based (parenting) support for mothers, fathers, and young children in prevention strategies and recovery tools employed during and after future lockdowns and non-normative stressful events.
Topics: Male; Female; Child; Humans; Child, Preschool; Parenting; COVID-19; Communicable Disease Control; Parent-Child Relations; Child Behavior; Mothers
PubMed: 37824556
DOI: 10.1371/journal.pone.0290089 -
Journal of Experimental Child Psychology Mar 2024Preterm birth is a risk factor for language difficulties. To better understand the language development of preterm-born infants, the current study investigated the...
Preterm birth is a risk factor for language difficulties. To better understand the language development of preterm-born infants, the current study investigated the concurrent associations between parent-infant conversations and the development of 22 preterm-born and 25 term-born infants at 2 years of age. Conversations occurring during mother/father-infant free-play interactions were analyzed to characterize features of parental speech (volubility, speech rate, lexical diversity, and morphosyntactic complexity) and parent-infant exchanges (parent responsiveness, turn-taking, and conversational balance). The infants' language development (receptive communication and expressive communication) and non-language development (cognitive, social-emotional, and executive function) was assessed using standardized measures. Parent-infant conversations were associated with both language and non-language development. This suggests that parent-infant conversations may support language development directly and/or through advancing non-language skills that could promote language learning. The associations between parent-infant conversations and development varied as a function of birth status (preterm or term). This finding may signal the operation of different developmental processes within preterm- and term-born groups. Finally, infant development was differentially associated with mother-infant and father-infant conversations. This may point to the distinct contributions made by mothers and fathers to the development of both preterm- and term-born infants. To optimize language outcomes, these findings indicate that families should be guided to tailor parent-infant conversations to the unique developmental needs and processes of preterm-born infants. Families should also be supported to leverage the distinct developmental contributions of mothers and fathers. Future recommendations are made regarding how to investigate the proposed preterm-term differences in language development processes and the differential developmental contribution of mothers and fathers.
Topics: Child; Female; Humans; Infant; Infant, Newborn; Communication; Infant, Premature; Mothers; Parent-Child Relations; Parents; Premature Birth; Child Development
PubMed: 37967481
DOI: 10.1016/j.jecp.2023.105809