Maternal Life Satisfaction Research Articles

Perception of child vulnerability among mothers of former premature infants.

Parents of premature infants often perceive their infants as medically vulnerable. High parental perception of child vulnerability (PPCV) is associated with disproportionately high health care utilization. The objectives of this study were to determine whether higher PPCV is correlated with worse developmental outcome in premature infants at 1-year adjusted age and to identify factors, present at neonatal discharge, that predict high PPCV. This prospective cohort study assessed mothers of 116 premature infants who were </=32 weeks' gestation and required supplemental oxygen at 36 weeks postmenstrual age. At neonatal discharge, mothers completed the Spielberger State Anxiety Inventory, Beck Depression Inventory, Impact on Family Scale, Life Orientation Test, General Health Survey, and Medical Outcomes Study social support survey. At 1-year adjusted age, child development was assessed using the Bayley Scales of Infant Development and Vineland Adaptive Behavior Scales, and mothers completed the Vulnerable Child Scale, a 16-item self-report measure of PPCV. Chart review was performed to determine the presence or absence of specific indicators of medical vulnerability at 1-year adjusted age. Mean infant gestational age and birth weight were 26.5 +/- 2.5 weeks and 894 +/- 287 g. A total of 69% of mothers were white, and 78% were high school graduates. Higher PPCV (lower Vulnerable Child Scale score) was correlated with lower scores on the Vineland Adaptive Behavior Composite and Bayley Psychomotor Developmental Index but not on the Bayley Mental Developmental Index. After controlling for the presence of 1 or more indicators of medical vulnerability, higher PPCV was still correlated with lower adaptive development. This correlation was stronger in the group of children with no indicators of medical vulnerability. In univariate analyses, higher PPCV was predicted by nonfirstborn status; longer neonatal hospitalization; higher maternal anxiety and depression; greater impact of the illness on the family; and lower maternal optimism, life satisfaction, and social support. PPCV was not associated with maternal age, education, marital status, income, or ethnicity or with child gender, gestational age, birth weight, or length of mechanical ventilation. A linear regression model containing all variables significant at the univariate level explained 29% of the variance in PPCV. Maternal anxiety was the only variable that was statistically significant in the full model. Higher PPCV is associated with worse developmental outcome in premature infants at 1-year adjusted age. Maternal anxiety at neonatal discharge predicts later high PPCV. Interventions to prevent or decrease PPCV in premature infants should be targeted at parents who are more anxious at hospital discharge.

Construction of a Postpartum Depression Model

Purpose: This study has been designed to develop and test the theoretical model to explain postpartum depression. A hypothetical model was constructed on the basis of Neumans system model and review of literature.Methods: Data were collected through a survey over a period of 5 months. Subjects who participated in the study consisted of 265 Korean mothers in their postpartum periods. A total of 19 instruments were used in this model.The analysis of the data was done with SPSS PC+ for descriptive statistics and LISREL 7.16 for covariance structure analysis.Results: 1. The hypothetical model showed a good fit to the empirical data. Chi-square= 265.KP-0.00). df=106. ? /df=2.5. GFI-0.90, AGH-0.82. RMR-0.036. NNFI=0.89, NFI=0.93and CN-117. 2 For constructing the parsimonious best fit model, the exogenous variable (preparation for deliveiy) was excluded from the theoretical model because it did not significantly influence postpartum depression. 5 paths were deleted between the following； relationship to parents and postpartum depression, maternal role strain and stressful life event, postpartum depression and satisfaction to baby, postpartum depression and baby's character, postpartum depression and stressful life event. 11 paths were added between satisfaction to baby and support from others and between maternal role strain and personality trait et al. 3. The final modified model yielded Chi-square = 131.59(P=0.02). df=101, x2/df=1.30. GFI = 0.94, AGFI = 0.90, RMR=0.025.NNFI = 0.94, NFI = 0.97, CN-225 and exhibited definite improved levels of fit indices.Conclusion: Results of this study show that personality trait, maternal role attainment, marital adjustment, maternal role strain and self-esteem influence postpartum depression.Thus, the most effective prevention strategy against postpartum depression must focus on improving maternal role attainment, marital adjustment and self-esteem, modifying emotional state, and reducing the maternal role strain. By comprehensively addressing the factors related to postpartum depression, and comparing each influence, this study can contribute to designing an appropriate postpartum depression prevention strategy in tune with the particular characteristics and problems of a mother.Finally, the author suggests that this model could be adequately applied to mothers during the postpartum period.

The Impact of a Fmaily-Centered Case Management Approach

Two urban programs of family-centered case management services were established for families of children with both a developmental disability and a chronic health condition. These are children who present significant caregiving demands due to the long-term and severe nature of their disabilities. Thirty-two mothers were interviewed within the family's first month in the project and reinterviewed approximately one year later. The results indicate that more families received respite care, nursing services, training in the care of the child, educational services and transportation to school at follow-up than had been receiving those services at baseline. However, families still indicated high service needs for recreational activities, life planning, regular day care, legal services, and speech therapy at follow-up. Mothers indicated that program services were helpful in obtaining services, financing, information, support, and advocacy. Although maternal life satisfaction improved with program participation, non-handicapped siblings continued to have difficulties coping. The model employed is described and the practice and policy implications of the findings discussed.

62 MATERNAL DISTRESS AND DURATION OF NEONATAL INTENSIVE CARE

Maternal distress with neonatal ICU care has received little study. In a study to relate maternal distress to care duration as well as infant outcome, we interview mothers weekly during ICU care and 6 months after ICU discharge. Distress intensity is rated by mother on a 0-10 scale(0=none;10=unbearable distress) and compared to that of prior distressing life events (Rahe Scale). Statistics deferred until sample completed, but data to date include: Among distress sources, infant appearance was very distressing to 33% in 1st wk but only 8% in 3rd wk; upset with infant caregivers, 10% in 1st wk but 46% in 3rd wk. Reasons for infant illness remained highly distressing at 1-3 wks (>40%). In 11 six mo. interviews to date, moderate distress (rated by mother and by psychologist) but high scores (≥7) on 10 point life satisfaction scale are generally noted. Duration ICU care may affect both intensity and sources of maternal distress. Followup distress is not necessarily correlated with maternal life satisfaction.

Effects of Stress and Social Support on Mothers and Premature and Full-Term Infants

This study examined the relationships of stress and social support to maternal attitudes and early mother-infant interactive behavior. 52 mother-premature infant pairs and 53 mother-full-term infant pairs were seen for structured home interviews at 1 month, and behavioral interactions at 4 months. Maternal life stress, social support, life satisfaction, and satisfaction with parenting were assessed at the 1-month home visit. Although no group differences were found, both stress and support significantly predicted maternal attitudes at 1 month and interactive behavior at 4 months when data were pooled. Mothers with greater stress were less positive in their attitudes and behavior, while mothers with greater support were significantly more positive. Intimate support proved to have the most general positive effects. Additionally, social support moderated the adverse effects of stress on mother's life satisfaction and on several behavioral variables. Maternal social support was further found to have several significant effects on infant interactive behavior. Results are discussed in terms of the ecological significance of social support to parenting and infants' early development.

Effects of Stress and Social Support on Mothers and Premature and Full-Term Infants

This study examined the relationships of stress and social support to maternal attitudes and early mother-infant interactive behavior. 52 mother-premature infant pairs and 53 mother-full-term infant pairs were seen for structured home interviews at 1 month, and behavioral interactions at 4 months. Maternal life stress, social support, life satisfaction, and satisfaction with parenting were assessed at the 1-month home visit. Although no group differences were found, both stress and support significantly predicted maternal attitudes at 1 month and interactive behavior at 4 months when data were pooled. Mothers with greater stress were less positive in their attitudes and behavior, while mothers with greater support were significantly more positive. Intimate support proved to have the most general positive effects. Additionally, social support moderated the adverse effects of stress on mother's life satisfaction and on several behavioral variables. Maternal social support was further found to have several significant effects on infant interactive behavior. Results are discussed in terms of the ecological significance of social support to parenting and infants' early development.