Maternal Confidence Research Articles

Exploring mothers' perspectives on the early mother-infant relationship to inform midwifery practice: A qualitative study

BackgroundThe mother-infant relationship plays a crucial role in individual and community health. The nature of the mother-infant relationship can influence the social and emotional development of the infant, impacting their lifelong health. Midwives are key in providing health promotion for women and babies and are ideally placed to support women during the early development of the mother-infant relationship. AimsThis study aimed to explore new mothers' perspectives on developing the early mother-infant relationship to inform midwifery practice. MethodsThis study is phase one of a mixed-method, exploratory sequential design project. In this phase, 14 women were interviewed within six weeks of birth to explore experiences that influenced the developing relationship with their baby. To support reflection women were provided with a visual prompt activity. These interviews informed the co-design workshops to develop an intervention to support midwives to promote the early mother infant relationship. A research protocol was published prior to undertaking the study, however as this research did not seek to modify or measure any heath related outcomes it was not registered as a clinical trial. ResultsKey themes from the interviews included: making moments that matter; the role of the village; feeling like I'm winning; supportive health professionals, and forming a new family. These themes underpinned strategies to support the mother-infant relationship. ConclusionThe findings from this study offer ways for midwives to support the emerging mother-infant relationship during the early postnatal period. Facilitating mothers to engage with their baby as well as integrating key people is important. Midwives also play a key role in building maternal confidence and competence. Further research is needed to embed and evaluate strategies in midwifery practice.

Roles of different organizations in implementing patient-reported measures in routine maternity care in Finland

BackgroundThe integration of patient-centered care (PCC) and value-based healthcare (VBHC) principles, emphasizing personalized, responsive care and cost efficiency, is crucial in modern healthcare. Despite advocation from the International Consortium for Health Outcomes Measurement (ICHOM) for the global adoption of these principles through patient-reported measures (PRMs), their implementation, especially the pregnancy and childbirth (PCB) set, remains limited in maternity care. This study focuses on understanding the optimal organizational entity for integrating standard ICHOM-PCB-PRMs into routine maternity care in Finland. It aims to clarify the distribution of tasks among stakeholders and gather Finnish maternity healthcare professionals’ perspectives on organizational responsibility in PRM collection. The emphasis was on identifying the optimal organizational framework for managing PRMs in maternity care.ResultsA total of 66 maternity healthcare professionals participated in the study, reaching a consensus that public maternity care centers in Finland should be the primary entity responsible for managing PRMs in the maternity sector. Key aspects such as confidence with the role as a mother, maternal confidence with breastfeeding, and satisfaction with the result of care were identified as crucial and should be inquired about in both public maternity care centers and hospital maternity wards. The findings highlight the importance of comprehensive and consistent attention to these PRMs across public maternity care centers and hospital maternity settings to ensure holistic and effective maternal care.ConclusionsThe study highlights the central role of public maternity care centers in the collection and management of PRMs within Finnish maternity care, as agreed upon by the professional consensus. It underscores the importance of a consistent and holistic approach to PRM inquiry across different care settings to enhance the quality and effectiveness of maternity care. This finding is crucial for policymakers and healthcare practitioners, suggesting that reinforcing the collaborative efforts between public maternity care centers and hospital maternity wards is vital for a patient-centric, efficient healthcare system. Aligning with PCC and VBHC principles, this approach aims to improve healthcare outcomes for pregnant and postpartum women in Finland, emphasizing the need for a unified strategy in managing maternity care.

The Impact of Mothers’ Smartphone Use, eHealth Literacy, Maternal Role Performance Confidence, and Online Social Support on Health Promotion Behavior for Infants and Toddlers

Background: This study aimed to identify the factors influencing health promotion behaviors for infants and toddler, focusing on the time spent by mothers using smartphone, eHealth literacy, maternal role performance confidence, and online social support.Methods: This study surveyed 136 women who gave birth to a child in 2023. For this study, recruitment announcements were made on popular parenting websites. Multiple regression analysis was performed to identify the factors affecting health promotion behaviors.Results: The mean age of the participants was 33.8 years, and the mean age of the children was 13.3 months old. Mothers spent 20.2 hours weekly on smartphone to access health information. A total of 86.7% of the respondents indicated that they primarily used the Internet to make health decisions. Factors that influenced health promotion behaviors were role performance confidence (β=0.54, P<0.001), eHealth literacy (β=0.18, P=0.015), online social support (β=0.16, P=0.022), and time spent on smartphone (β=-0.17, P=0.006), with an explanatory power of 51.3% (F=29.43, P<0.001).Conclusions: To improve the health promotion behaviors of mothers for their infants and young children, it is believed that interventions that increase confidence in their roles, online social support, and eHealth literacy are required, and that smartphone screen time should be limited. These baseline data can guide the development of effective intervention programs to improve healthcare for infants and toddlers.

Education And Maternal Self-Confidence In Caring For Premature Babies

Background: The high number of preterm births in 2014-2015, Indonesia is one of the countries that contributes the highest premature rate of 19% and is a major factor in perinatal mortality. RSAB Harapan Kita West Jakarta has a rate of 3.46% about 105 mothers who gave birth to premature babies within 3 months. The formulation of this problem is the health of premature babies who need intensive and special care so that most of them can affect the self-confidence of the baby's parents.Purpose: The purpose of this study was to determine whether there is a relationship between maternal education and maternal confidence in caring for premature babies at RSAB Harapan Kita, West JakartaMethods: This study used quantitative methods and used a cross sectional approach with 38 samples obtained by non-probability sampling method and total sampling technique.Results: The results showed that there was no significant relationship between maternal education and maternal confidence in caring for premature babies with a p-value of 0.721 (? 0.05).Conclusion: There are other factors apart by education that may affect mothers' confidence in caring for premature babies such as health education. Thus, the researcher suggests the future researchers to examine the effect of health education on the confidence of mothers in taking care of premature babies.

Estimating the efficacy of Newborn-Communication, Health, Feeding and Swallowing Education Program (N-CHFSEP) for primiparous mothers

Background Primiparous mothers face diverse challenges during pregnancy and post-childbirth. There is a lack of comprehensive educational programs for primiparous mothers on maternal functioning and newborn care. This study aimed to explore the efficacy of a developed educational program on the attitude of primiparous mothers towards newborn communication, general health, feeding and swallowing. The objectives were (1) to develop an attitude questionnaire (AQ), a parent education program, and a feedback questionnaire (FQ); and (2) to estimate the efficacy of the education program pre- and post-delivery. Methods Ninety-eight primiparous mothers without any obstetric history, proficient in English or Kannada, and delivering healthy newborns were recruited for the study. Phase 1 involved the development and validation of AQ, the parent education program [Newborn Communication, Health, Feeding and Swallowing Education Program (N-CHFSEP)], and FQ; while Phase 2 comprised of administering them on the mothers. Both quantitative (descriptive statistics, paired t-test, and chi-square test) and qualitative analysis were done on the parameters of interest. Results The results of the study demonstrated a notable increase in the number of mothers (not all) reporting heightened confidence levels following receiving the N-CHFSEP (which was observed in all the domains). This observed change (pre and post) was statistically significant as per paired t-test analysis (p <0.05) indicating a significant increase in confidence levels post-N-CHFSEP intervention, as well as recognizing warning signs related to the same. Sociodemographic factors such as age, education, occupation, and family type were reported to have a significant effect (p <0.05) on maternal confidence levels before and after N-CHFSEP administration. Feedback from participants highlighted the effectiveness of the program in enhancing knowledge and awareness, while also suggesting areas for improvement. Conclusions This study demonstrates the effectiveness of N-CHFSEP in enhancing primiparous mothers' confidence in newborn care, thereby improving maternal and infant health.

"It Shook My Whole Parenting Plan": Parents' Experiences of Being at Home with Their Newborn Baby During the COVID-19 Pandemic.

A cross-sectional online survey was undertaken (July-August 2020) to ascertain parents' experiences during the COVID-19 pandemic of being at home with their newborn baby in the first 6 weeks. Participants (n = 371) were mostly biological mothers (n = 369, 99.4%), white British (n = 351, 94,5%), first baby (n = 186, 50%). A statistically significant positive correlation was found between maternal confidence and number of children (rho (369) = 0.295, p < .001) and baby's age at time of participation (rho (369) = 0.139, p = .009). Participants without higher educational qualifications (median = 62, SIQR = 3.5) had statistically significant higher confidence (U = 11831.500, p < .001) than participants with higher educational qualifications (median = 58, SIQR = 2). Parents of babies without health issues at birth (median, 61, SIQR = 3.5) had statistically significant higher confidence (U = 13213.500, p < .001) than parents of babies with health issues at birth (median = 58, SIQR = 5). Three qualitative themes have emerged: the impact of "no partner" restrictions; mixed emotions and lack of information and support. In conclusion, parenting during a pandemic created anxiety and fear, affected by "no partner" restrictions, not being allowed to appointments, scans, and during labor. Some parents were more confident and indicated benefits including heightening bonding with baby and partner during social distancing.

Overview of mom's confidence when planning to return low birth weight baby from the hospital

Introduction: Babies with low birth weight are one of the health problems often faced by mothers and families in various countries, including Indonesia. The return of babies with low birth weights from the hospital became a critical stage in their care after a period of intensive hospitalization. Objective: Describe the mother's confidence level when planning to return a baby with a low birth weight to the hospital. Method: quantitative research with a descriptive design involving 29 respondents. This study used non-probability and consecutive sampling techniques to determine subjects who met the inclusion criteria. The measuring instrument uses the Maternal Confidence Questionnaire Instrument, and the analysis results are descriptive data equipped with tables. Results: Most of the self-confidence of mothers planning to return home with high-birth-weight babies from the hospital was high among 16 respondents (55.2%). Factors that influence a mother's confidence include previous experience caring for a child, social support from family and friends, information and education provided by medical personnel, and an adequate financial condition and environment for the care of the baby. Conclusion: The mother's self-confidence plays a crucial role in planning the return of a low-birthweight baby from the hospital. Social support, knowledge of baby care, interaction with health workers, and understanding of the baby's health condition contribute to the mother's confidence. A holistic approach involving adequate social support, information and education, and financial and environmental readiness to increase maternal confidence in caring for a low-birth-weight baby after discharge from the hospital

Maternal Reports of Preterm and Sick Term Infants' Settling, Sleeping and Feeding in the 9 Months after Discharge from Neonatal Nursery: An Observational Study.

The effects of preterm birth, neonatal morbidities and environmental influences on infant sleep development is an important yet under-researched topic, with little known about normative sleep for infants born sick or preterm. The aim of this prospective, observational longitudinal study was to evaluate maternal perceptions and degree of bother with infant sleep behaviours and feeding outcomes across the first 9 months after discharge for sick/preterm infants cared for in the neonatal intensive care unit (NICU) and for healthy term-born infants. This paper reports outcomes for the sick/preterm cohort (I = 94) that were recruited from two NICUs in Perth, Western Australia. Total bother scores were on average 20.2% higher at 9 months than at two weeks post-discharge (p < 0.001). Increased night waking frequency, evening settling duration and crying duration were all positively associated with total bother scores. Maternal confidence scores were negatively associated with maternal bother scores; with each unit increase in confidence, maternal bother decreased by 8.5% (p < 0.001). Covariates such as birth gestation, breastfeeding status and multiple births were not associated with maternal bother. Families may benefit from additional support when experiencing increased night waking frequency and crying and settling durations in the first 9 months after discharge from NICU.

Childbirth experience and maternal role confidence among postpartum mothers from maternity units in Jolo

The study aims to evaluate postpartum women' birthing experiences and maternal role confidence in Jolo maternity facilities. A quantitative-descriptive cross-sectional survey methodology was used to investigate the relationship between delivery experience and maternal role confidence. The study included 100 postpartum mothers who gave birth within six weeks of delivery or in the early postpartum period. The respondents were largely young adults who were literate, earning below monthly income, had two pregnancies, gave birth in government hospitals, and were treated institutionally by qualified health professionals. They were moderately satisfied with their delivery experience and quite confident in their maternal role. There were no significant variations in the extent of delivery experience or maternal role confidence across socio-demographic groups. A positive correlation was identified between childbirth experience and maternal role confidence.

Breaking the maternity mold: navigating the return to work and challenging rigid maternal beliefs through an online psychological intervention.

Working mothers must often balance work and family responsibilities which can be affected by rigid and irrational beliefs about motherhood. The present study had two aims: (a) to provide psychometric evidence for a shortened Italian version of the Rigid Maternal Beliefs Scale (RMBS) and (b) to facilitate mothers' return to work after maternity leave by reducing perceptions of anxiety and stress related to rigid maternal beliefs (i.e., perceptions and societal expectations of mothers, maternal confidence, maternal dichotomy) and by teaching specific recovery strategies (e.g., relaxation, mastery experiences) to manage anxiety and stress through an online psychological intervention. Results replicated the three-factor structure of the original RMBS and showed good psychometric properties. The online psychological intervention resulted in decrease in the rigidity of maternal beliefs, perceived anxiety and stress, and increase in recovery strategies. These initial results are promising and encourage further investigation into online psychological interventions for improving the well-being of working mothers.

Baby-friendly workplace initiatives in child feeding practice as predictors of infant and young child anthropometric indices in public health facilities of Southern Ethiopia

BackgroundBaby-friendly workplace is an effective evidence based initiative developed by the World Health Organization to protect and support maternal knowledge, beliefs, and confidence in infant and young child feeding practices. However, studies that show the effect of the baby-friendly workplace initiative on the nutritional status of infant and young children are not available in Ethiopia. Therefore, this study aimed to assess the nutritional status among baby friendly initiatives service utlizers and non utlizers children age 6–24 months in public health facilities of Southern Ethiopia.MethodsWe conducted a comparative cross-sectional study from 1 to 30 June 2022 among 220 mothers with children aged 6–24 months. Data were collected through face-to-face interviews using a structured questionnaire. Data were entered into Epidata Software version 4.2 and then exported to IBM SPSS version 26 software for analysis. Chi-square and Fisher exact test were used to assess the differences between users and non-users of the baby friendly workplace initiative. Logistic regression model was used to determine the association between dependent and independent variables. Adjusted odds ratio (AOR) with a 95% confidence interval was computed. P-values < 0.05 at a 95% confidence level were considered statistically significant.ResultThe mean (SD) scores of weight for age (WAZ), height for age (HAZ), and weight for height (WHZ) were − 0.38 (1.34),-0.17(2.62) and-0.35 (1.84) respectively. After adjusting for covariates, children aged 6–24 months who did not use baby friendly workplace initiatives were 2.26 times more likely to have stunting compared to the users of baby friendly workplace initiative (AOR 2.26, 95% CI: 1.05, 4.88). However, both wasting (AOR: 0.42; 95% CI:0.13, 1.37) and underweight (AOR: 1.09; 95% CI: 0.45, 2.60) were not significantly associated with the use of baby friendly workplace initiatives.ConclusionThe use of baby friendly work place initiatives was successful in improving nutritional status, specifically chronic malnutrition in children. Strengthening and scaling up the baby friendly work place initiative program has the potential to reduce chronic malnutrition in Ethiopia and other similar settings with high burden of malnutrition areas, by implementing it in public facilities.

LATCH score: a tool for identification and correction of breastfeeding problems in a tertiary care hospital of North Karnataka

Background: Breastfeeding, a vital childhood intervention, faces challenges despite being a natural process. Factors such as maternal confidence, latching issues, breast pain, perceived milk insufficiency, and inadequate encouragement contribute to early discontinuation. Assessing breastfeeding in postpartum mothers prior to discharge is important for successful breastfeeding. The LATCH charting system designed by Jensen et al was used to assess the score. Objectives were to determine early breastfeeding problems using LATCH score and to study the impact of breastfeeding supportive measures on LATCH score. Methods: Hospital-based prospective observational study was conducted among 100 mothers who delivered in hospitals attached to Mahadevappa Rampure Medical College, Kalaburagi. The LATCH score was assessed twice, first within 24 hrs after birth and second 48 hrs after intervention. Results: Good LATCH score was found among the rural mothers, multiparous mothers and those who had a normal vaginal delivery. After providing breastfeeding support, a majority (81%) of the mothers transitioned from poor or moderate to a good LATCH score group. The overall mean LATCH score increased from 5.83±1.64 to 9.31±1.5 following intervention. Improvement was seen in all the individual components of LATCH. Conclusions: This LATCH assessment tool can identify mothers and infants who are at risk of early breastfeeding cessation and serve as a guide to initiate appropriate intervention.

An interpretive phenomenological analysis of the experiences of mothers who continue to breastfeed despite facing difficulties

BackgroundBreastfeeding offers many health benefits to mother and infant. ProblemBreastfeeding difficulties are common and are linked with postnatal distress. AimTo explore the lived experiences of breastfeeding continuation despite facing difficulties. MethodsQualitative semi-structured interviews were conducted with eight women who had experienced breastfeeding difficulties yet continued breastfeeding. Interviews were analysed using Interpretative Phenomenological Analysis (IPA). FindingsThe first superordinate theme, ‘Radical acceptance of the imperfect’ included sub-themes of: ‘Taking it day-by-day’, ‘Breastfeeding takes a community’, and, ‘Finding what works for you’. The second superordinate theme, ‘Determination and persistence’ included sub-themes of: ‘Adopting a headstrong attitude’ and ‘Transient challenges versus lifelong achievement’. DiscussionParticipants found radical acceptance of breastfeeding as an imperfect, variable process which enabled them to sustain breastfeeding despite challenges. Participants proactively drew on social and personal resources to navigate guidance and to find solutions which worked for their individual circumstances. Finally, open-mindedness, optimism, self-compassion, and being headstrong and determined were all personal qualities which facilitated breastfeeding during exceptionally difficult moments on their breastfeeding journey. ConclusionRecommendations are made for healthcare professionals: to provide emotional counselling during routine care (with an aim to instil breastfeeding self-efficacy) and to encourage breastfeeding advocacy among fathers and the maternal social support network (with an aim to further scaffold successful breastfeeding). Recommendations are also made for mothers: to develop and refine maternal confidence, patience, flexibility, self-compassion, and trust.

Mothering occupations: A review identifying mothering occupations.

This review aimed to retrieve and collate a list of culturally relevant mothering occupations in the New Zealand context with mothers positioned as experts of their experience. Mothering occupations influence wellbeing and this study aimed to better inform on the daily occupations mothers participate in that contribute to feelings of maternal confidence. Two main sources were used to identify mothering occupations: A systematic search of mothering literature, and participant additions. The first step involved mothering literature being searched, collated and condensed. The second step involved presenting the compiled list of mothering occupations to a panel of mothers for review and to invite additions. Mothers were asked to consider the occupations they participate in that evoke feelings of confidence and mastery in their mothering. Fifteen mothers with infants 12 to 18 months old were recruited, eight contributed to the mothering occupations list. A list of 203 items was collated then condensed based on the inclusion criteria for the participant group, and was tracked in a table. The list was reduced to 36 items. Eight participants added to the mothering occupations list, bringing the total number of items to 47. Mothers indicated through their contributions to the list that some types of mothering occupations are more relevant to them when considering feelings of maternal confidence and mastery. The mothers of this study indicated that connecting with their infant, their culture and nature are of high value to them. Developing a list of culturally relevant and relatable mothering occupations is a significant undertaking, highlighting the subjective experiences of mothers. Mothering occupations are vast and influenced by context. Mothers valuing some types of occupation more in relation to maternal confidence indicates a role for occupational therapy with this population to support with engagement and participation in occupations that promote wellbeing.

Parents’ Journeys of Mastery and Knowledge Construction After Their Infant’s First Stage of Surgery for Complex Congenital Heart Disease

ABSTRACT Background A growing body of conceptual evidence over the last decade has increased our understanding of parents’ experiences of having an infant with complex congenital heart disease. These concepts include parents’ feelings of uncertainty, fear, excitement, and mastery. However, little is known about parents’ experiences, confidence, and knowledge acquisition during transition from hospital to home with their infant after the first stage of complex cardiac surgery. A theoretical framework to assess, plan and implement child and family centered care would assist children’s cardiac nurses responsible for parental education, discharge planning and coordination. Aim To explore parents’ experiences of the transition from hospital to home with their infant, following the first stage of cardiac surgery. Design A prospective mixed methods longitudinal design. Semi-structured interviews were undertaken, including administration of the Maternal Confidence Questionnaire at four timepoints: before discharge following stage one cardiac surgery (T0), 2 weeks’ post discharge (T1), 8 weeks’ post discharge (T2) and after stage two surgery (T3). Qualitative data were thematically analyzed. Descriptive statistics were used to characterize the sample and non-parametric repeated measures analysis of variance was used to analyze changes over time in maternal confidence scores. Results Sixteen parents of 12 infants participated. Four “patterns of transition experience” emerged, the fourth “Mastery”, is discussed in this paper. Mastery can be contextualized in terms of the parents’ journeys of knowledge construction, gaining confidence and reflection. Learning was dynamic and transformational, but successful learning and acquisition of knowledge was also dependent upon the parents’ ability to absorb, integrate and adjust at any given time. Confidence at T0 was significantly lower than at T1 (p = .011), T2 (p = .018) and T3 (p = .012). There were no significant differences between scores at T1, T2 and T3. Liminality, as a concept, described the between and betwixt time that parents experienced as they were preparing for discharge from hospital; excitement to be going home balanced with the fear of being alone and confidence in looking after their fragile infant. Conclusion Parents of infants with complex congenital heart disease obtain knowledge, confidence, and mastery dependent upon their transition experience and their personal journey through pre-liminal, liminal, and post-liminal phases of discharge from hospital to home. A conceptual framework “Parenting through Transitions – hospital to home” emerged that could assist in structuring assessment of parents’ knowledge and support needs within a coordinated discharge process. Identifying individualized support would promote adaptation and adjustment during transition from the pre to post liminal phase, following their infant’s first stage of complex cardiac surgery.

In-Hospital Formula Feeding Hindered Exclusive Breastfeeding: Breastfeeding Self-Efficacy as a Mediating Factor.

Breastfeeding self-efficacy (BSE), defined as a mother's confidence in her ability to breastfeed, has been confirmed to predict the uptake of exclusive breastfeeding (EBF). Early experiences during the birth hospital stay, especially in-hospital formula feeding (IHFF), can impact both EBF and maternal breastfeeding confidence. Therefore, our objective was to examine the association between IHFF and EBF outcomes and investigate whether this association is influenced by BSE. The study included 778 infants from a larger cohort study conducted in 2021, with a one-year follow-up in rural areas of Sichuan Province, China. We used a causal mediation analysis to estimate the total effect (TE), natural direct (NDE), and nature indirect effects (NIE) using the paramed command in Stata. Causal mediation analyses revealed that IHFF was negatively associated with EBF (TE odds ratio = 0.47; 95% CI, 0.29 to 0.76); 28% of this association was mediated by BSE. In the subgroup analysis, there were no significant differences in the effects between parity subgroups, as well as between infant delivery subgroups. Our study found that IHFF hindered later EBF and that BSE mediated this association. Limiting the occurrence of in-hospital formula feeding or improving maternal breastfeeding self-efficacy is likely to improve exclusive breastfeeding outcomes.

Completeness of Immunization in Infants Aged 0-9 Months: The Role of Mother's Knowledge and Belief

Introduction: Over 1.4 million children have died from Immunization-Preventable Diseases (PD3I). The lack of socialization provided by health workers has an impact on the lack of understanding, admonition, and understanding of mothers when participating in immunization programs. Purpose: to determine the relationship between the knowledge and confidence of mothers on the completeness of immunization in infants aged 0-9 months. Method: using a cross-sectional research design, with a population of 216 infants, sampling using purposive sampling techniques totaling 54 respondents with inclusion criteria: infants aged 0-9 months and residing in the study area, while the exclusion criteria were babies who were sick during the study. The research was conducted in Kombo. Using questionnaires and using chi-square tests of vaccine availability. Results: there were 83.3% of respondents who had good knowledge and had complete immunization 75.9% and there were 16.6% who had less knowledge, had complete immunization of 9.1% with a value of ρ=0.006. Conclusion: there is a relationship between knowledge and maternal confidence in the completeness of immunization in infants aged 0 – 9 months. Parents should pay attention to their children's basic immunizations and public health guarantees the availability of vaccines

The Influence of Confinement Location on Maternal Psychological and Role Adaptation: A Six-Month Follow-Up Study

Approximately 70% of postpartum women in Taiwan choose postpartum care institutions for their postpartum confinement. However, few studies have explored the follow-up relationship between confinement location and, respectively, maternal psychological and role adaptation. To explore the differences in psychology and maternal role adaptation between postpartum women in two different confinement locations and to analyze the predictors of maternal confidence and maternal competence at six-months postpartum. A comparative and follow-up research design was adopted. We recruited a convenience sample of two groups of women confined, respectively, at postpartum nursing centers and at home. One hundred fifty-seven mothers recruited after G-power estimation were enrolled as participants and completed demographic data and six scales at one-week, one-month, and six-months postpartum. The statistical analysis was performed mainly using generalized estimating equations. For all participants, maternal confidence was positively associated with time, being multipara, having religious beliefs, and having better mother-infant bonding (p < .05). In addition, being confined at home, being unemployed, having religious beliefs, perceiving lower levels of stress and depression, having better sleep quality, and having better mother-infant bonding were associated with higher maternal competence (p < .05). Based on the findings of this study, postpartum nursing institutions should actively promote strategies to improve maternal competence to help mothers staying in postpartum nursing centers strike an optimal balance between recuperation and parenting preparation. Furthermore, obstetric health professionals should implement policies related to mother-infant bonding to increase maternal confidence and competence and, subsequently, facilitate maternal role adjustment.

Development and Effects of Mobile-Application-Based Parenting Support Program for Premature Infants' Mothers.

Premature infants are separated from their parents after birth and are admitted to the neonatal intensive care unit. Separation of babies from mothers causes various problems. Therefore, as the number of premature infants increases every year, educational programs to continuously support baby care are needed. In this study, a nonequivalent control group non-synchronized design was employed. The subjects of the study were 52 mothers of premature infants (16 in the app-based program group, 18 in the electronic document group, and 18 in the control group) using a portal site for parents from February to April 2023. The app-based program and electronic document group followed a parenting support program for two weeks. There were significant differences in maternal confidence between the app-based, electronic document, and control groups (F = 7.354, p = 0.002). Providing necessary information and emotional support through professional counseling centers' app-based programs for premature infants' mothers, and providing interaction through member community bulletin boards, are proposed to form an effective educational program.

Associating Parental Efficacy with the Utility of Smart Devices: A Cross-Sectional Study of Their Role in Alleviating Maternal Parenting Concerns among Infants Aged 6-11 Months.

In digital societies, the use of smart devices to solve childcare problems has become commonplace. Mothers are influenced both positively and negatively by smart devices used to resolve childcare concerns. Focusing on parental self-efficacy, this study identified the factors associated with relief and anxiety caused by the use of smart devices to eliminate parenting concerns among mothers with infants. A random sampling cross-sectional survey was administered to 257 Japanese mothers with infants aged 6-11 months. Structural equation modeling was used to explain the relief and anxiety caused by their use of smart devices in terms of maternal demographics, parental self-efficacy, smart-device dependence, and confidence in their ability to discriminate information. Mothers with high parental self-efficacy experienced increased relief and reduced anxiety by using smart devices to address concerns about child-rearing practices. Mothers who were highly dependent on smart devices felt more secure with their use of smart devices. Homemakers and highly educated mothers who used smart devices because of concerns regarding child health and development experienced more anxiety. Parenting professionals need to recognize the effectiveness of smart devices as a tool to relieve anxiety in parenting and provide additional support for parents to improve their parenting self-efficacy.