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Journal of Pediatric Psychology Nov 2018This study aimed to characterize mothers' communication with their children in a sample of families with a new or newly relapsed pediatric cancer diagnosis, first using...
OBJECTIVE
This study aimed to characterize mothers' communication with their children in a sample of families with a new or newly relapsed pediatric cancer diagnosis, first using factor analysis and second using structural equation modeling to examine relations between self-reported maternal distress (anxiety, depression, and posttraumatic stress) and maternal communication in prospective analyses. A hierarchical model of communication was proposed, based on a theoretical framework of warmth and control.
METHODS
The sample included 115 children (age 5-17 years) with new or newly relapsed cancer (41% leukemia, 18% lymphoma, 6% brain tumor, and 35% other) and their mothers. Mothers reported distress (Beck Anxiety Inventory, Beck Depression Inventory-II, and Impact of Events Scale-Revised) 2 months after diagnosis (Time 1). Three months later (Time 2), mother-child dyads were video-recorded discussing cancer. Maternal communication was coded with the Iowa Family Interaction Ratings Scales.
RESULTS
Confirmatory factor analysis demonstrated poor fit. Exploratory factor analysis suggested a six-factor model (root mean square error of approximation = .04) with one factor reflecting Positive Communication, four factors reflecting Negative Communication (Hostile/Intrusive, Lecturing, Withdrawn, and Inconsistent), and one factor reflecting Expression of Negative Affect. Maternal distress symptoms at Time 1 were all significantly, negatively related to Positive Communication and differentially related to Negative Communication factors at Time 2. Maternal posttraumatic stress and depressive symptoms each predicted Expression of Negative Affect.
CONCLUSIONS
Findings provide a nuanced understanding of maternal communication in pediatric cancer and identify prospective pathways of risk between maternal distress and communication that can be targeted in intervention.
Topics: Adolescent; Adult; Anxiety Disorders; Child; Child, Preschool; Communication; Depressive Disorder; Factor Analysis, Statistical; Female; Humans; Male; Mental Disorders; Midwestern United States; Mother-Child Relations; Mothers; Neoplasms; Prospective Studies; Recurrence; Stress Disorders, Post-Traumatic
PubMed: 30016505
DOI: 10.1093/jpepsy/jsy054 -
American Journal of Obstetrics and... May 2023More than a decade ago, the United Nations Human Rights Council passed a resolution recognizing maternal health as a human right. Subsequently, global advocates... (Review)
Review
More than a decade ago, the United Nations Human Rights Council passed a resolution recognizing maternal health as a human right. Subsequently, global advocates mobilized to establish the right to respectful maternity care, which has since been formally recognized by the World Health Organization and endorsed by more than 90 international, civil society, and health professional organizations. Despite widespread acknowledgment of this right, traditional approaches to maternity care do not adequately address aspects of quality care that are highly valued by mothers and birthing people, such as respect, dignity, and shared decision-making, and high numbers of women and birthing people worldwide continue to experience disrespect and mistreatment during childbirth. Efforts to reduce maternal mortality have historically overemphasized clinical approaches while failing to listen to mothers and pregnant people, threatening patient autonomy, and contributing to persistent racial disparities and high levels of preventable maternal mortality. This article shares the birth story and evolution of Every Mother Counts, an organization dedicated to making pregnancy and childbirth safe, respectful, and equitable for every mother, everywhere, and provides tangible examples of how storytelling and listening to women-in film, media, research, advocacy, education, and patient care-can serve as powerful vehicles to create awareness of maternal health issues and transform our maternity care system into one that centers mothers in labor and childbirth and elevates equity and birth justice. There are concrete steps that every participant in the maternity care system can take to help make respectful, equitable care a reality, including implementing patient-reported experience measures as part of standard clinical practice, using individualized care plans and shared decision-making tools in patient care, and developing a grievance process to address instances of disrespectful care and mistreatment. Most importantly, we can listen to mothers, women, and birthing people, hear their concerns, and act promptly to provide the care and support that they deserve.
Topics: Female; Pregnancy; Humans; Mothers; Maternal Health Services; Parturition; Delivery, Obstetric; Health Personnel; Attitude of Health Personnel; Quality of Health Care; Professional-Patient Relations
PubMed: 37164500
DOI: 10.1016/j.ajog.2022.12.306 -
BMC Pregnancy and Childbirth Jul 2019Improved understanding of vegetable intake changes between pregnancy and postpartum may inform future intervention targets to establish healthy home food environments....
BACKGROUND
Improved understanding of vegetable intake changes between pregnancy and postpartum may inform future intervention targets to establish healthy home food environments. Therefore, the goal of this study was to explore the changes in vegetable intake between pregnancy and the postnatal period and explore maternal and sociodemographic factors that are associated with these changes.
METHODS
We examined sociodemographic, dietary, and health characteristics of healthy mothers 18-43y from the prospective Infant Feeding Practices II cohort (n = 847) (2005-2012). Mothers completed a modified version of the diet history questionnaire, a food-frequency measure, developed by the National Cancer Institute. We created four categories of mothers, those that were: meeting vegetable recommendations post- but not prenatally (n = 121; improved intake), not meeting vegetable recommendations during pregnancy and postnatally (n = 370; stable inadequate), meeting recommendations pre- but not postnatally (n = 123; reduced intake), and meeting recommendations at both time points (n = 233; stable adequate). To make our results more relevant to public health recommendations, we were interested in comparing the improved vegetable intake group vs. stable inadequate vegetable intake group, as well as those that reduced their vegetable intake compared to the stable adequate vegetable intake group. Separate multivariable-adjusted logistic regression were used to examine sociodemographic predictors of improved vs. stable inadequate and reduced vs. stable adequate vegetable intake.
RESULTS
Women with improved vegetable intake vs. stable inadequate smoked fewer cigarettes while women with reduced vegetable intake vs. stable adequate were more likely to experience less pregnancy weight gain. In adjusted models, employed women had greater odds of reduced vegetable intake (OR = 1.64 95% CI 1.14-2.36). In exploratory analyses, employment was associated with greater odds of reduced vegetable intake among low-income (OR = 1.79; 95% CI 1.03-3.1), but not higher income women (OR = 1.31; 95% CI 0.94-1.84). After further adjustment for paid maternity leave, employment was no longer associated with vegetable intake among lower income women (OR: 1.53; 95% CI: 0.76-3.05).
CONCLUSIONS
More women with reduced vs. stable adequate vegetable intake were lower income and worked full time. Improved access to paid maternity leave may help reduce disparities in vegetable quality between lower and higher income women.
Topics: Adult; Diet; Feeding Behavior; Female; Health Behavior; Humans; Maternal Health; Mothers; Postpartum Period; Pregnancy; Prospective Studies; Vegetables; Young Adult
PubMed: 31349808
DOI: 10.1186/s12884-019-2353-0 -
Sexual & Reproductive Healthcare :... Mar 2023Breastfeeding practices remain globally suboptimal despite many known maternal and neonatal health benefits and the Baby-Friendly Hospital Initiative as a global effort... (Clinical Trial)
Clinical Trial
BACKGROUND
Breastfeeding practices remain globally suboptimal despite many known maternal and neonatal health benefits and the Baby-Friendly Hospital Initiative as a global effort to support breastfeeding.
OBJECTIVE
We aimed to evaluate the effects of the implementation of the Baby-Friendly Hospital Initiative for a proportion of mothers who exclusively breastfed during a 6-month period, including breastfeeding problems, and maternal breastfeeding attitudes.
METHODS
Using a quasi-experimental non-equivalent two-group design, we recruited two independent samples of postpartum mothers in a maternity hospital to compare the situation before (N = 162) and after (N = 163) the implementation. We measured breastfeeding status and possible breastfeeding problems via text-message questions at 2 weeks, 1, 4 and 6 months after birth. We measured Mothers' attitudes toward breastfeeding at the maternity hospital and 4 months after birth using the Iowa Infant Feeding Attitude Scale.
RESULTS
The implementation of the Baby-Friendly Hospital Initiative had no effect on the proportion of mothers who exclusively breastfed, and we found no significant differences in exclusive breastfeeding at 6 months (41.3 % vs 52.9 %, p =.435). The intervention did not influence the reported number of breastfeeding problems (p =.260) or maternal breastfeeding attitudes (p =.354). More favourable breastfeeding attitudes (p <.001) and less problematic breastfeeding (p <.001) were associated positively with exclusive breastfeeding.
CONCLUSION
Exclusive breastfeeding rates did not increase after the intervention; however, the rates at baseline were already high. Ensuring the Baby-Friendly Hospital Initiative practices through pre- and postnatal periods and preparing mothers to manage common breastfeeding problems might improve breastfeeding rates. This trial was registered (0307-0041) with ClinicalTrials.gov on 03/03/2017.
Topics: Female; Humans; Infant; Infant, Newborn; Pregnancy; Breast Feeding; Health Promotion; Hospitals, Maternity; Mothers; Postpartum Period
PubMed: 36521260
DOI: 10.1016/j.srhc.2022.100806 -
Evolutionary Psychology : An... Feb 2010The recent emphasis on humans as cooperative breeders invites new research on human family dynamics. In this paper we look at maternal guilt as a consequence of...
The recent emphasis on humans as cooperative breeders invites new research on human family dynamics. In this paper we look at maternal guilt as a consequence of conditional maternal investment. Solicited texts written by Finnish mothers with under school-aged children in 2007 (n = 63) described maternal emotions perceived as difficult and forbidden. Content analysis of guilt-inducing situations showed that guilt arose from diverging interest and negotiations between the mother and child (i.e., classic parent- offspring conflict). Also cultural expectations of extensive and perpetual high-quality maternal investment or the "motherhood myth" induced guilt in mothers. We argue that guilt plays an important role in maternal-investment regulation. Maternal guilt is predicted to vary with social and cultural context but also to show universal characteristics due to parent-offspring conflict and allomaternal manipulation. Results are preliminary and intended to stimulate research into the mechanisms, gender differences and cultural variations of guilt and other social emotions in human parenting.
Topics: Adult; Female; Finland; Guilt; Humans; Mother-Child Relations; Mothers; Qualitative Research; Young Adult
PubMed: 22947781
DOI: 10.1177/147470491000800108 -
Cognitive, Affective & Behavioral... Feb 2023Racial disparities in maternal health are alarming and persistent. Use of electroencephalography (EEG) and event-related potentials (ERPs) to understand the maternal... (Review)
Review
Racial disparities in maternal health are alarming and persistent. Use of electroencephalography (EEG) and event-related potentials (ERPs) to understand the maternal brain can improve our knowledge of maternal health by providing insight into mechanisms underlying maternal well-being, including implications for child development. However, systematic racial bias exists in EEG methodology-particularly for Black individuals-and in psychological and health research broadly. This paper discusses these biases in the context of EEG/ERP research on the maternal brain. First, we assess the racial/ethnic diversity of existing ERP studies of maternal neural responding to infant/child emotional expressions, using papers from a recent meta-analysis, finding that the majority of mothers represented in this research are of White/European ancestry and that the racially and ethnically diverse samples that are present are limited in terms of geography. Therefore, our current knowledge base in this area may be biased and not generalizable across racially diverse mothers. We outline factors underlying this problem, beginning with the racial bias in EEG equipment that systematically excludes individuals of African descent, and also considering factors specific to research with mothers. Finally, we highlight recent innovations to EEG hardware to better accommodate diverse hairstyles and textures, and other important steps to increase racial and ethnic representativeness in EEG/ERP research with mothers. We urge EEG/ERP researchers who study the maternal brain-including our own research group-to take action to increase racial diversity so that this research area can confidently inform understanding of maternal health and contribute to minimizing maternal health disparities.
Topics: Female; Infant; Child; Humans; Racial Groups; Mothers; Electroencephalography; Brain
PubMed: 36414837
DOI: 10.3758/s13415-022-01040-w -
PeerJ 2022Low maternal self-efficacy and high levels of anxiety, depression, and stress can be triggered in adolescent mothers due to an incomplete development process that makes...
BACKGROUND
Low maternal self-efficacy and high levels of anxiety, depression, and stress can be triggered in adolescent mothers due to an incomplete development process that makes them physically or psychologically unprepared for the responsibilities of motherhood and parenting. These factors may be linked to difficulties with their children's social-emotional development. The present study aims to: (a) analyze the relationship between maternal self-efficacy and stress, depression, and anxiety levels in low-income adolescent mothers; (b) examine the relationship between maternal self-efficacy and well-being with children's social-emotional development; and (c) describe the effects of maternal self-efficacy on children's social-emotional development, mediated by maternal well-being.
METHODS
A sample of 79 dyads comprising low-income Chilean adolescent mothers aged from 15 to 21 years old (M = 19.1, SD = 1.66) and their children aged 10 to 24 months (M = 15.5, SD = 4.2) participated in this research. A set of psychometric scales was used to measure maternal self-efficacy (Parental Evaluation Scale, EEP), the mothers' anxiety and depression (Hospital Anxiety and Depression Scale, HADS), maternal stress (Parental Stress Scale, PSS), and the children's social-emotional development (Ages and Stages Questionnaire Socio-emotional, ASQ-SE). Bivariate analyses and mediation models were employed to estimate and test the relevant relationships.
RESULTS
A bivariate analysis showed that maternal self-efficacy was negatively related to the mother's anxiety, depression, and stress. Moreover, there was a significant relationship between maternal self-efficacy and maternal stress, and children's self-regulation and social-emotional development. Maternal self-efficacy, mediated by maternal anxiety, depression, and stress scores, had a significant effect on the development of children's self-regulation.
CONCLUSIONS
The results confirm the importance of adolescent mothers' emotional well-being and maternal self- efficacy with respect to their children's social-emotional development. This makes it necessary to have detailed information about how emotional and self-perception status influences a mother's role in the development of her children.
Topics: Humans; Child; Female; Adolescent; Young Adult; Adult; Infant; Child, Preschool; Mothers; Adolescent Mothers; Mother-Child Relations; Self Efficacy; Chile
PubMed: 35433128
DOI: 10.7717/peerj.13162 -
Journal of Family Psychology : JFP :... Apr 2023The relations between maternal sensitivity and infant negative emotionality have been tested extensively in the previous literature. However, the extent to which these...
The relations between maternal sensitivity and infant negative emotionality have been tested extensively in the previous literature. However, the extent to which these associations reflect unidirectional or bidirectional effects over time remains somewhat uncertain. Further, the possibility that maternal characteristics moderate the extent to which infant negative emotionality predicts maternal sensitivity over time has yet to be tested in cross-lag models. The goal of the present study is to address these gaps. First time mothers ( = 259; 50% White; 50% Black) and their infants participated when infants were 6, 14, and 26 months of age. Infant negative emotionality was assessed via maternal report and direct observation during standardized laboratory tasks, which were subsequently combined to yield a multimethod measure at each wave. Maternal sensitivity was observationally coded at each wave and mothers self-reported emotion dysregulation at 6 and 14 months. A random intercepts cross-lagged model with maternal emotion dysregulation specified as a moderator revealed that infant negative emotionality at 6 months was negatively associated with maternal sensitivity at 14 months, but only among mothers higher in emotion dysregulation. Higher maternal sensitivity was in turn associated with lower infant negative emotionality when infants were 26 months of age. The indirect pathway was significant, lending support for the transactional model. Implications for future research and prevention/intervention are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Topics: Female; Humans; Infant; Emotions; Mothers; Infant Behavior; Mother-Child Relations
PubMed: 36689388
DOI: 10.1037/fam0001060 -
Breastfeeding Medicine : the Official... May 2020To explore infant-feeding intentions and behavior of physician mothers as well as their breastfeeding enablers and obstacles. A cross-sectional online survey was...
To explore infant-feeding intentions and behavior of physician mothers as well as their breastfeeding enablers and obstacles. A cross-sectional online survey was conducted among female physicians with at least one biological child recruited through the Academy of Breastfeeding Medicine. The main outcomes were duration of exclusive breastfeeding (EBF) and duration of any breastfeeding (BFD). We determined predictors of EBF and BFD. The 570 participants reported intention to breastfeed at least 12 months in 78.1% of cases. Breastfeeding rates were 97.8%, 85.5%, and 55.4% at birth, 6, and 12 months. EBF rates were 88.5%, 76.3%, and 40.9% at birth, 3, and 6 months. Younger participant age, breastfeeding discontinuation not due to work-related demands, and heightened maternal satisfaction with BFD were associated with longer EBF and BFD. EBF at birth, less maternal stress, availability of time to express milk, and collegial support were associated with longer EBF. Longer maternal BFD goal, longer maternity leave, existence of laws or regulations to support breastfeeding among working mothers, later child order, and lower level of maternal depression were associated with longer BFD. Maternal infant-feeding intentions and work-related factors both play important roles in physician mothers' infant-feeding behavior. Longer maternity leave, regulations to support breastfeeding among working mothers, and workplace support might significantly improve physician mothers' BFD.
Topics: Adult; Aged; Breast Feeding; Cross-Sectional Studies; Female; Humans; Infant; Infant, Newborn; Intention; Maternal Behavior; Middle Aged; Mothers; Physicians, Women; Pregnancy; Women, Working; Workload; Workplace
PubMed: 32182122
DOI: 10.1089/bfm.2019.0193 -
Child Development Mar 2017Depression in mothers is a significant risk factor for the development of maladjustment in children. This article focuses on modifiable risk processes linking depression... (Review)
Review
Depression in mothers is a significant risk factor for the development of maladjustment in children. This article focuses on modifiable risk processes linking depression in mothers and adaptation in their young children (i.e., infancy through preschool age). First, the authors present evidence of the efficacy of interventions for reducing the primary source of risk: maternal depression. Second, they describe a central mechanism-parenting behaviors-underlying the relation between maternal depression and children's adjustment. Third, the authors recommend two different integrated interventions that successfully treat mothers' depression and enhance parenting skills with infants and young children. Finally, the authors note the possible need for supplementary interventions to address severity and comorbidity of mothers' depression, barriers to engaging in treatment, and the sustainability of program benefits.
Topics: Child of Impaired Parents; Child, Preschool; Depressive Disorder, Major; Evidence-Based Practice; Humans; Infant; Mother-Child Relations; Mothers; Parenting; Psychotherapy
PubMed: 28160275
DOI: 10.1111/cdev.12732