HAPPY MAMA Project (PART 1). Assessing the Reliability of the Italian Karitane Parenting Confidence Scale (KPCS-IT) and Parental Stress Scale (PSS-IT): A Cross-Sectional Study among Mothers Who Gave Birth in the Last 12 Months.

Alice Mannocci,Giuseppe La Torre,Azzurra Massimi,Michela Scollo,Claudia Scaglione,Franca Scaglietta,Sara Ciavardini

doi:10.3390/ijerph18084066

Abstract

The purposes of this study were: (1) to adapt two validated questionnaires used to evaluate maternal confidence (KPCS-IT) and maternal stress (PSS-IT) to the Italian context, in order to (2) measure the stress level and the self-efficacy in an Italian sample of mothers. The validation process has provided the construction of an online questionnaire. It was administered on a convenience mothers sample with at least a child aged 0–12 months, twice (T0 and T1) with a two day interval. Assessment of instrument stability over time was estimated by applying test–retest reliability between T0 and T1, and the Cronbach’s alpha coefficient. A cross-sectional study was carried out to assess the second aim. Italian mothers with at least one child living at home aged between 0–12 months were recruited. Statistical reliability methods were applied to assess the internal validity of the two questionnaires. PSS-IT was analyzed using univariate and multivariate statistical analyses in order to study the association between KPCS-IT, demographic and maternal characteristics. Statistical significance was established as p < 0.05. The Cronbach’s alpha reported a good level of internal consistency of the questionnaires: PSS-IT alpha = 0.862; KPCS-IT alpha = 0.801. 32% of the mothers declared low maternal confidence and the mean value of PSS-IT was 35.4 (SD = 8). The significant inverse correlation was found between the PSS-IT and the KPCS-IT (coeff = −0.353; p < 0.001): this means that a high level of perceived self-efficacy reduces the maternal stress level. The study identifies that interventions on maternal confidence can be useful to support mothers in the first months after delivery in order to prevent stress risk: the perceived self-efficacy is as a modifiable factor and the results of the study indicate that it significantly reduces the PSS-IT and EPDS scores. In future, more field trials are necessary in order to assess the realistic and feasible interventions on maternal confidence and competence to prevent maternal distress.

Highlights

IntroductionDuring a child’s first year, mothers often feel overwhelmed by the new situation and need help and support from their partners, their network and health professionals [3]
The findings indicated that the covariates significantly associated to the high Parental Stress Scale (PSS)-IT level were: days from delivery and risk of depression; while the covariates significantly associated to the low PSS-IT level were having only one child and a high self-efficacy score
About one third of the mothers involved in the study declared low maternal confidence and 31% had a high risk of depression

Summary

Introduction

During a child’s first year, mothers often feel overwhelmed by the new situation and need help and support from their partners, their network and health professionals [3]. This need for help and guidance is often under-reported, underestimated [4] and usually unmet [5,6,7]. It is fundamental for health professionals involved in primary care who work to promote well-being among new families (i.e., family health nurses and midwives) to identify mothers with low confidence, low mood and high stress in the post-partum

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