Emotional Distress In Mothers Research Articles

Emotional distress in mothers of early-preterm infants, late-preterm infants, and full-term infants in Malawi

BackgroundMothers of preterm infants, early or late, report more distress than mothers of full-term infants. Malawi has the highest preterm birth rate in the world, but nothing is known about the relation of preterm birth to maternal mental health. PurposeTo compare emotional distress among mothers of early-preterm, late-preterm, and full-term infants. MethodsWe recruited 28 mothers of early-preterm, 29 mothers of late-preterm, and 28 mothers of full-term infants. Emotional distress was assessed 24-72 hr following birth. One-way ANOVA and regression analysis were used to compare the three groups. FindingsMothers of early-preterm infants reported more distress symptoms than mothers of full-term infants, and scores of mothers of late-preterm infants fell between the other two groups. Having a support person present was associated with lower symptoms and caesarean birth was associated with more symptoms. DiscussionPromoting maternal mental health is important following preterm birth and health care providers need to support mothers.

Adapting a perinatal empathic training method from South Africa to Germany

BackgroundMaternal mental health conditions are prevalent across the world. For women, the perinatal period is associated with increased rates of depression and anxiety. At the same time, there is widespread documentation of disrespectful care for women by maternity health staff. Improving the empathic engagement skills of maternity healthcare workers may enable them to respond to the mental health needs of their clients more effectively. In South Africa, a participatory empathic training method, the “Secret History” has been used as part of a national Department of Health training program with maternity staff and has showed promising results. For this paper, we aimed to describe an adaptation of the Secret History empathic training method from the South African to the German setting and to evaluate the adapted training.MethodsThe pilot study occurred in an academic medical center in Germany. A focus group (n = 8) was used to adapt the training by describing the local context and changing the materials to be relevant to Germany. After adapting the materials, the pilot training was conducted with a mixed group of professionals (n = 15), many of whom were trainers themselves. A pre-post survey assessed the participants’ empathy levels and attitudes towards the training method.ResultsIn adapting the materials, the focus group discussion generated several experiences that were considered to be typical interpersonal and structural challenges facing healthcare workers in maternal care in Germany. These experiences were crafted into case scenarios that then formed the basis of the activities used in the Secret History empathic training pilot. Evaluation of the pilot training showed that although the participants had high levels of empathy in the pre-phase (100% estimated their empathic ability as high or very high), 69% became more aware of their own emotional experiences with patients and the need for self-care after the training. A majority, or 85%, indicated that the training was relevant to their work as clinicians and trainers, that it reflected the German situation, and that it may be useful ultimately to address emotional distress in mothers in the perinatal phase.ConclusionsOur study suggests that it is possible to adapt an empathic training method developed in a South African setting and apply it to a German setting, and that it is well received by participants who may be involved in healthcare worker training. More research is needed to assess adaptations with other groups of healthcare workers in different settings and to assess empathic skill outcomes for participants and women in the perinatal period.

Anxiety Screening During Assessment of Emotional Distress in Mothers of Hospitalized Newborns

ObjectivesTo examine the incremental identification of emotional distress in mothers of hospitalized newborns by screening for anxiety in addition to depression and to provide practical information about anxiety screening scales to facilitate instrument selection and screening implementation by nurses in the NICU. DesignIn this secondary data analysis, screening data from the recruitment phase of a feasibility trial to evaluate a nurse-delivered counseling intervention for emotionally distressed mothers of newborns in the NICU were used to examine the effect of anxiety screening. SettingA Level IV NICU at a large academic medical center in the Midwestern United States. ParticipantsWomen 18 years of age and older (N = 190) with newborns in the NICU. MethodsParticipants completed multiple measures of depression and anxiety symptoms. ResultsOf participants who had negative screening results on a depression-only screening instrument, 4.7% to 14.7% endorsed clinically significant anxiety symptoms depending on the screening instrument used. ConclusionScreening for anxiety in mothers of newborns in the NICU resulted in identification of distressed mothers who would otherwise have been missed during routine depression-only screening. Multiple options for anxiety screening exist that add incremental information to depression-only screening and require little additional burden on providers and mothers of newborns in the NICU.

Early Detection of Postpartum Depressive Symptoms in Mothers and Fathers and Its Relation to Midwives' Evaluation and Service Provision: A Community-Based Study.

Postpartum parental mental health problems pose a serious risk for child development and often remain undetected in postpartum primary care. Within the framework of the German Midwifes Prevention Study, the aim of this study was to investigate the presence of postpartum emotional distress in mothers and fathers, and the detection of distressed parents by midwives in a primary care setting. We also examined whether a temporal extension of the postpartum midwife care period is associated with greater use of midwife contacts and higher rates of referral to further professional support if needed. Mothers, fathers, and midwives filled out questionnaires at 2 weeks (t 1) and 6 months (t 2) postpartum. Compared to standard care in the control group (CG), midwives in an intervention group (IG) offered extended postpartum care of 6 months postpartum. Parental psychological distress was assessed using the Edinburgh postnatal depression scale (EPDS). Midwives reported on parental psychological distress as well as the number of postpartum contacts and referrals to additional social- and health-care providers. Based on their ratings, midwives identified half of mothers and around one-quarter of fathers with elevated depressive symptoms according to the EPDS at t 1 and t 2. IG mothers used significantly more midwife contacts than CG mothers. IG mothers with high-postnatal psychological distress at t 2 used significantly more contacts than mothers with lower levels of distress. IG mothers with high-psychological distress at t 2 were referred to additional support services more often than mothers with lower levels of distress.

Emotional distress in mothers of preterm hospitalized infants: a feasibility trial of nurse-delivered treatment

ObjectiveMothers of preterm infants in a hospital neonatal intensive care unit (NICU) are at risk for clinically significant depression and anxiety but, for these women, their own treatment is likely a secondary priority. This study evaluated the feasibility, acceptability, and effectiveness of an evidence-based, nurse-delivered, on-site depression treatment: Listening Visits.Study DesignTherapeutic Listening Visits were delivered on site to 23 distressed mothers of NICU infants. The intervention was conducted by a neonatal nurse practitioner; and the outcome examined in an open-trial, pre-post evaluation.ResultsA part-time nurse practitioner delivered six Listening Visits to each participant within a one-month timeframe. Listening Visits were associated with significantly improved mood and well-being in mothers. The majority of eligible women took advantage of Listening Visits and felt satisfied with their care.ConclusionsThis open trial provides “proof of concept”, with results that warrant further evaluation in a multisite randomized controlled trial.

Perceived family burden and emotional distress: similarities and differences between mothers and fathers of children with type 1 diabetes in a population-based study

Parenting children with diabetes entail an extra burden for the families. More information is needed about associations between perceived family burden and emotional distress in both mothers and fathers. To analyze (i) perceived burden and emotional distress in mothers and fathers of children with type 1 diabetes and (ii) associations between parental burden and distress and factors related to the child. Mothers (n = 103) and fathers (n = 97) of 115 children (1-15 yr) with type 1 diabetes participated in this population-based survey. The parents completed the Hopkins Symptom Checklist-25 items (HSCL-25), measuring emotional distress, and the Family Burden Scale, which includes five questions measuring perceived family burden related to the child's diabetes. Both mothers and fathers reported that the greatest burden was related to long-term health concerns. The mothers reported a significantly greater burden related to medical treatment and significantly more emotional distress than the fathers. The mothers' perceived burden was significantly correlated with emotional distress. Nighttime blood glucose measurements were significantly associated with perceived parental burden, and experienced nocturnal hypoglycemia was significantly associated with parental emotional distress. The higher perceived burden related to medical treatment, the more emotional distress, and the correlations between burdens and emotional distress in mothers vs. fathers emphasize the importance of discussing both parents' roles and responsibilities in relation to the child's diabetes in follow-up. In the consultations, emphasizing nighttime caregiving and nocturnal hypoglycemia might also be important to prevent emotional distress.

Fear of hypoglycaemia in mothers and fathers of children with Type 1 diabetes is associated with poor glycaemic control and parental emotional distress: a population‐based study

To analyse, in a population-based study, the association between parental fear of hypoglycaemia and (i) the prevalence of hypoglycaemia and diabetes treatment factors in children with Type 1 diabetes and (ii) emotional distress in mothers and fathers. Mothers (n = 103) and fathers (n = 97) of 115 children with Type 1 diabetes (1-15 years old) participated in the study. In addition to demographic and disease-specific data, the participants completed the Hypoglycaemia Fear Survey-Parent version (HFS-P) (worry and behaviour subscales) and the Hopkins Symptom Checklist-25 items (HSCL-25) to measure emotional distress. A higher HFS-P worry score was associated with higher glycated haemoglobin (HbA(1c)), a higher frequency (>or= 7) of what parents experienced as problematic hypoglycaemic events during the past year and co-morbid disease in the child. A higher HFS-P behaviour score was associated with children receiving insulin injections compared with using an insulin pump and a higher frequency (>or= 7 per day) of blood glucose measurements. The mothers had higher scores than the fathers in both the worry and behaviour subscales. The mothers' and the fathers' HFS-P worry scores correlated significantly with their HSCL-25 scores. The association between a higher level of hypoglycaemic-related fear and parental emotional distress and poorer glycaemic control in the child emphasizes the need for programmes to support and guide parents. The results suggest that future interventions should target both the parents' fear and appropriate ways to prevent hypoglycaemia in children with Type 1 diabetes.

Postpartum Emotional Distress in Mothers With Multiple Sclerosis

ObjectiveTo determine the impact of multiple sclerosis (MS)-related symptoms and both received social support and perceived deficits in social support on emotional distress in mothers with MS at 1, 3, and 6 months postpartum. DesignLongitudinal correlation descriptive study. SettingCommunity-residing women in North America. ParticipantsConvenience sample of 174 postpartum mothers with MS. MethodMothers completed the MS-Related Symptom Scale and Postpartum Support Questionnaire at 1, 3, and 6 months postpartum. Bivariate correlations and hierarchical regression analyses determined relationships between the dependent variable, emotional distress, and independent variables: participant characteristics, MS-related symptoms, and social support. ResultsThe authors found moderately strong positive correlations between MS-related symptoms and emotional distress at each assessment. Significant negative correlations existed between received social support and emotional distress at 1 month but not at 3 and 6 months. Significant positive correlations existed between MS-related symptoms and social support deficits at each assessment. Explained variance in emotional distress across the three assessments ranged between 2% and 4% for participant characteristics, 49% and 60% for MS-related symptoms, 2% and 7% for social support, and 57% and 66% for total variance.Conclusion: MS-related symptoms created considerable emotional distress in mothers that was minimally alleviated by the support given them. In fact, many needed more support than they received.

A measurement model of perinatal stressors: identifying risk for postnatal emotional distress in mothers of high-risk infants.

A measurement model of perinatal stressors was first evaluated for reliability and then used to identify risk factors for postnatal emotional distress in high-risk mothers. In Study 1, six measures (gestational age of the baby, birthweight, length of the baby's hospitalization, a postnatal complications rating for the infant, and Apgar scores at 1 and 5 min) were obtained from chart reviews of preterm births at two different hospitals. Confirmatory factor analyses revealed that the six measures could be accounted for by three factors: (a) Infant Maturity, (b) Apgar Ratings, and (c) Complications. In Study 2, a modified measurement model indicated that Infant Maturity and Complications were significant predictors of postnatal emotional distress in an additional sample of mothers. This measurement model may also be useful in predicting (a) other measures of psychological distress in parents, and (b) measures of cognitive and motor development in infants.