Parental Confidence Research Articles

Studies of the norm of Karitane Parenting Confidence Scale(KPCS)among parents of infants in urban areas of China

Objective: To establish the norm of the Chinese version of Karitane Parenting Confidence Scale (KPCS) in urban areas of China. Methods: From August to December 2017, the parents of 2 216 children (<36 months old) were selected from 15 cities (Beijing, Lianyungang, Hangzhou, Chengdu, Xi'an, Guangzhou, Changsha, Jinan, Guiyang, Ningbo, Dalian, Qinhuangdao, Maanshan, Chongqing and Wuhan) in 14 provinces by stratified random sampling. The general demographic characteristics and parents' parenting confidence were collected by a self-made questionnaire and KPCS Chinese version. The percentile norm was established. P3, P10 and P25 were used as the criteria to define the degree of lack of parenting confidence. Results: The age of mothers was (30.67±4.29). The age of the father was (32.50±4.99) years old. There were 726 (32.76%), 759 (34.25%) and 731 (32.99%) infants in 6-12, 12-23 and 24-35 months old groups. The total scores of P50, P25, P10 and P3 of KPCS (Chinese version) of infant parents in urban areas in China were 41, 38, 33, and 29 respectively. When the scores of parents were 34-37, 30-33, and ≤ 29, they were judged as mild, moderate, and severe lack of parenting confidence. There was no significant difference in the Chinese version of KPCS between parents of different age groups and parents of different gender (χ²=3.53, P=0.171; χ²=1.41, P=0.236). Each factor score≤P3 is defined as the boundary score, and the corresponding boundary scores of "parenting" "support" and "competence" were 13, 9, and 5 respectively. Conclusion: The Chinese version of KPCS can be used to assess the parenting confidence of infants in urban areas of China. It can used as one of the bases for scientific and objective evaluation of the parenting status of families.

Parental and staff experiences of restricted parental presence on a Neonatal Intensive Care Unit during COVID-19.

AimThe COVID‐19 pandemic had a significant impact on parental presence in the Neonatal Intensive Care Unit (NICU) during the first wave. The NICU team at the Rosie Hospital, Cambridge, endeavoured to explore the impact on parent and staff experiences of supporting parents throughout the period when visiting was restricted, between 13th August and 11th September 2020.MethodsBespoke surveys were designed following the first lockdown to gather information on the impact on staff and parents. The questions were developed in the context of initial observations and conversations with staff and parents.ResultsThe findings of this study have illustrated the extent of the restrictions on parental wellbeing and mood, with the restrictions having had an adverse effect on these. In addition, the findings illustrate the adverse effect that the parents reported due to the restricted presence in terms of their babies’ wellbeing, parent‐infant bonding, partners’ wellbeing, parental confidence, the ability to breastfeed confidently and parents’ access to the medical teams.ConclusionThe findings of this study have a number of clinical implications for parents and staff. Namely, the data supported the decision not to close NICU again during the second and third waves.

Predicting positive outcomes and successful completion in an online parenting program for parents of children with disruptive behavior: An integrated data analysis

Online delivery of parenting support is steadily increasing, yet the factors that influence program engagement and efficacy are still understudied. This study used an integrated data analysis approach to identify family and program-related factors that influence outcomes. We combined individual data from seven published efficacy trials of the web-based version of the Triple P—Positive Parenting Program. Data were analyzed for 985 families with children aged between 2 and 12 years (M = 4.87; SD = 2.14) using a Latent Change Score approach. At post-intervention, sociodemographic factors were not predictive of changes in child behavior problems, while parents of boys and those with higher education showed greater improvements in dysfunctional parenting. Parents who were initially more confident in their parenting showed more overall gains while parents with more initial adjustment difficulties showed less improvement. Only the effect of baseline child behavior problems on changes in dysfunctional parenting was moderated by treatment condition. At follow-up, program variant and completion were the primary outcome predictors, with completion found to be related to initial parenting confidence, internet usage and program variant. The implications of these findings for reaching and retaining parents in online programs across all phases of the engagement process are discussed.

Barriers and Supports in Empowering Parents Care for Children with Cancer

Cancer that occurs in children does not only affect children, but also parents. Parents experience anxiety, stress, fear of losing their children, and helplessness in caring for their children, so that parents are less than optimal in caring for their children. Parent empowerment can increase parents' knowledge, confidence, and ability to care for their children. Previous research found several obstacles to parent empowerment carried out by nurses so that parent empowerment was not optimal in its implementation. Knowing barriers and supports in implementation of parent empowerment in caring for children with cancer can support implementation of parent empowerment to be more optimal. The purpose of this study was to explore barriers and supports in parent empowerment in caring for children with cancer based on the nurse's perception. The design of this study was qualitative research design with a phenomenological approach. The data was collected by in-depth interview method using semi-structured interview guidelines on six nurses who were selected by purposive sampling technique. The data analysis was carried out by thematic analysis with the analysis stage according to Colaizzi. The results of this study were resulted in four themes, namely parental attitudes, parental characteristics, attitudes of nurses, availability of nurses and facilities. This study concluded that implementation of empowering parents to care for children with cancer became more optimal by knowing the barrier and supports in empowering parents care for children with cancer and nurses could make more effective planning in caring for children with cancer.

Brief Report: Caregiver Confidence in Reporting Anxiety Symptoms in Children with Autism Spectrum Disorder.

Assessment of anxiety in children with autism spectrum disorder (ASD) most commonly includes parent questionnaires. However, due to the nature of the questions and verbal limitations often present in children with ASD, caregivers may have difficulty completing such measures. Caregivers of 144 children with ASD ages 6 to 12 completed the Child and Adolescent Symptom Inventory-4 ASD Anxiety Scale and rated their level of confidence in responding to each item. Results indicated that parents had a moderate to high level of confidence in rating their children's anxiety symptoms. Parent confidence was not influenced by their child's age, expressive language ability, or intellectual functioning, but was related to their child's anxiety symptom count and ASD severity.

A mixed-method evaluation of video interaction guidance (VIG) delivered by early-years workers in a socially disadvantaged urban community

PurposeThe transition to parenthood can pose challenges for women and men, and these are heightened in the context of social disadvantage (e.g. poverty, deprivation, social exclusion, housing instability and disabilities). There is mounting evidence that video-feedback approaches can provide a valuable buffer against such adverse outcomes. This study aims to evaluate the acceptability and preliminary clinical impact of video interaction guidance (VIG), delivered by health visitors and community support workers in a socially disadvantaged London borough, selected due to its multiple indices of deprivation predicting child and maternal adversity.Design/methodology/approachThe study followed a non-randomised, before-and-after evaluation design. Health visitors and community support workers were trained in VIG delivery following the VIG Association-UK protocol. Families with infants under 12 months were conveniently recruited and received six weekly home-based sessions of VIG. The primary outcome was the acceptability of the intervention, assessing parents’ experiences using semi-structured interviews post-intervention. Clinical outcome measures were recorded pre-and post-intervention to yield preliminary evidence on intervention effectiveness.FindingsIn total, 23 families partook in the study, of which 19 completed the pre- and post-VIG quantitative analysis and 6 also completed the post-VIG qualitative interviews. Qualitative analyses documented high rates of acceptability and perceived improvement in family well-being. Preliminary outcome data indicated that completing the VIG intervention was associated with decreased parental anxiety and depression and increased parental confidence, parent-infant relationship quality, as well as an improvement in infant social and emotional development. However, the selective nature of convenience sampling limits the generalisability of the findings. The non-randomised design of the evaluation implies that findings can only be interpreted as preliminary evidence of intervention effectiveness. These considerations are addressed in the discussion.Originality/valueThe results of this study provide preliminary evidence of the acceptability and effectiveness of VIG delivery by health visitors and community support workers to new parents in socially disadvantaged urban communities. However, this study must be pursued further to be evaluated with larger, randomised samples to further explore the generalisability of VIG effectiveness in such settings.

IDENTIFICATION OF FAMILY ENGAGEMENT IMPLEMENTATION PROGRAM IN EARLY CHILDHOOD EDUCATION UNIT

This research is motivated by the lack of family engagement participation in programs held by the institute of early childhood education. This research is aimed at discovering various family engagement programs in the Early Childhood Education (ECE) unit, supporting factors and barriers to the implementation of the family engagement program, and the benefits of the family engagement program in the ECE unit. The method employed in this research is literature review. Data were collected by studying various journals, books, and other relevant documents from various national and international web. The data analysis technique employed in this research is the MilesHuberman’s model by utilizing stages of analysis process consisting of data reduction, data organization, data display, and data interpretation. The research found that there are some family engagement programs, such as parents meeting to examine the science of parenting, communication development, volunteering in school programs, being involved in decision making, supporting learning at home activities, and collaborating with community. Factors supporting the implementation of the family engagement program in ECE are parents' commitment, solid parent-teacher relationships, parents' awareness, and parents' educational background. On the other hand, factors that become barriers in implementing the program are limited time, limited parents’ financial capability, parents’ low levels of education background, parents’ insecurity, and parents’ lack of understanding of the importance of the program. The benefit of family engagement program perceived by parents is gaining knowledge, information, and confidence in parenting. Furthermore, the program increases children’s performance, learning motivation, discipline, and creates alignment between learning at home and in school

Nurturing embodied experience: risk-tolerant parental attitudes towards nature-based children’s learning

ABSTRACT A risk-averse philosophy and practice towards children playing and learning in natural surroundings predominates many parts of the educational world. In schooling, the concepts of risk and risk management have created the false impression that there’s something inherently dangerous about learning in natural surroundings. The purpose of the current study is to examine parental attitudes that involve encouraging their children, ranging from preschool to Grade 8, to experience natural surroundings. A case study approach involving in-depth interviews, using semi-structured questions, with twelve Canadian parents was utilised. A constant comparative analysis identified three broad themes: (1) parents expressed a risk-tolerant approach to children playing and learning outdoors; (2) parental views on the benefits of outdoor playful learning; and (3) parental confidence in allowing children to play and learn in the outdoors. In the discussion section, it is then argued that rather than allowing the concept of risk management to misleadingly dominate this learning environment, this phenomena should be reconceptualised as ‘nurturing embodied experience’.

Reliability and validity test of Chinese version of the Karitane parenting confidence scale

Objective: To translate and revise the Karitane Parenting Confidence Scale (KPCS),which can be used to evaluate the parenting confidence of 0-12 months infant caregivers in China, and evaluate the reliability and validity test of Chinese version of KPCS. Methods: Form a Chinese version of Karitane Parenting Confidence Scale through translation, back translation and expert review. Mothers of 3-month-old infants were recruited from two Maternal and Child Health Hospitals in Beijing and Ma'anshan in April 2019. A total of 165 mothers responded the survey invitations. They were surveyed with self-administered questionnaires, the Chinese version of KPCS, the Parenting Sense of Competence Scale (PSOC) and Self-efficacy in Infant Care Scale (SICS). Item analysis was conducted to select items by using critical value and correlation coefficient. The construct validity was assessed by exploratory factor analysis, confirmatory factor analysis. The criterion validity was assessed by being compared with PSOC and SICS. The reliability analysis was assessed by Cronbach's α the split-half reliability coefficient and rest-retest reliability coefficient. Results: The scores of 15 items were all correlated with the total score of the Chinese version of KPCS with r ranging from -0.283 to 0.643 (P<0.001). The difference of critical values of all items of KPCS among the low and high score groups were statistically significant (P<0.001). Three factors labeled parenting, support, and sense of competence, were obtained by exploratory factor analysis which accounting for 49.52% of the total variance and the factor loading values of all items are more than 0.4. The confirmatory factor analysis confirmed the hypothesized three-factor structure. The total score of KPCS was significantly correlated with the total score of PSOC and SICS(r=0.381, 0.345, P<0.001). The Cronbach's α of the Chinese version of KPCS was 0.769, and each dimension of Cronbach's α were 0.332-0.800, the test-retest reliability coefficient was 0.817, and the split-half reliability coefficient was 0.789. Conclusion: The Chinese version of the Karitane parenting confidence scale has a good reliability and validity among the 0-12 month-old infants' mothers, which can be used to evaluate the parenting confidence of infant caregivers.

Impacts of Neonatal Hospitalization on Families during the 2019 Coronavirus Pandemic.

Limited data are available regarding family and financial well-being among parents whose infants were hospitalized during the 2019 coronavirus (COVID-19) pandemic. The study objective was to evaluate the family and financial well-being of parents whose infants were hospitalized in the neonatal intensive care unit (NICU) during COVID-19. Parents were recruited for this online, cross-sectional survey via support groups on social media. Data collection was completed between May 18, 2020 and July 31, 2020. The final sample consisted of 178 parents, who had an infant hospitalized in an NICU between February 1, 2020 and July 31, 2020. The primary outcomes were impact on family life and financial stability, as measured by the Impact on Family scale, an instrument that evaluates changes to family life as a result of infant or childhood illness. Of the 178 parent respondents, 173 (97%) were mothers, 107 (59.4%) were non-Hispanic White, and 127 (69.5%) of the infants were born prematurely. Parents reported significant family impact and greater financial difficulty. Extremely premature infants, lower household income, parent mental health, and lower parental confidence were predictive of greater impacts on family life. Parents reported significant family and financial impacts during their infant's hospitalization amid COVID-19. Further studies are needed to guide clinical practice and inform family-supportive resources that can mitigate consequences to family well-being. · Impact of infant hospitalization in the context of COVID-19 is largely unknown.. · In a cohort of NICU parents during COVID-19, they reported changes to family life and finances.. · Greater impacts were reported by parents with lower income, confidence, and very premature infants..

Cognitive, behavioural and familial maintenance mechanisms in childhood obsessive compulsive disorders: A systematic review

Cognitive Behavioural Therapy (CBT) for preadolescent children with obsessive compulsive disorder (OCD) is typically derived from adult cognitive behavioural models of OCD; however, it is unknown whether these adult models apply to preadolescent children. This systematic review examined whether 11 cognitive, behavioural and familial maintenance mechanisms identified from adult cognitive behavioural models of OCD and descriptions of how family factors may maintain OCD applied to preadolescent children with obsessive compulsive symptoms/disorder (OCS/OCD; Prospero:CRD42019153371). PsycINFO, MEDLINE and Web of Science Core Collection were searched in March 2019, with forward citation handsearching conducted in March/April 2020. Twenty-nine studies were synthesised. Studies were identified for only six of the 11 proposed maintenance factors. Of the cognitive and behavioural factors, only inflated responsibility and meta-cognitive beliefs showed evidence of independent and/or specific associations with childhood OCS. Of the family factors, only less frequent displays of parental confidence, positive problem solving and rewarding of children’s independence showed some evidence of specificity to childhood OCD. Notably, findings across studies were inconsistent and existing studies have considerable methodological limitations. Experimental and prospective longitudinal studies are needed to determine whether the proposed factors maintain childhood OCS/OCD, to improve the effectiveness and efficiency of CBT for preadolescent children with OCD.

Parenting self-efficacy in fathers of medically complex infants: A longitudinal study

IntroductionInfants with medical complexity have multiple complex chronic conditions and require specialized intensive care. One important factor in optimizing infant health and development is parenting self-efficacy (PSE). The purpose of this study was to examine parental self-efficacy in fathers over time. MethodsA longitudinal survey study was conducted with fathers of medically complex infants. We used the validated Karitane Parent Confidence Scale to assess PSE and multivariable linear regression examined the associations between father and infant characteristics on PSE. ResultsFathers (n = 27) were white (74%), married (85%), high school educated (37%), with incomes ≥ $US50,000 (66%). Father's mean PSE score was 39.28 (±3.9). Hispanic ethnicity and total number of chronic conditions were significant predictors of lower PSE in fathers. ConclusionsFathers of medically complex infants reported low PSE. More strategic interventions need to focus on self-efficacy and creating opportunities for connection between fathers and infants.

Barriers and facilitators to mood and confidence in pregnancy and early parenthood during COVID-19 in the UK: mixed-methods synthesis survey.

Parental well-being during pregnancy and early parenthood is critical for child development. Environmental stressors can significantly challenge parental well-being. To investigate how COVID-19 and associated restrictions influence mood and parenting confidence of expectant parents and those in early parenthood, identifying barriers and facilitators. We used a cross-sectional online survey to collect data from 590 expectant parents and parents of infants (564 women) during the most restrictive phase of lockdown in the UK. We included a mixture of forced-choice and open-ended questions pertaining to mood, perceived social support, media use, online interactions and parenting expectations. Quantitative data were analysed with multiple linear regression and proportional odds models; an inductive thematic analysis was used for qualitative data. Quantitative and qualitative data were qualitatively synthesised. Since COVID-19, expectant parents and parents of new-borns reported a decrease in mood and parenting confidence. Barriers included practical difficulties (finding essentials, reliable health information), social difficulties (loss of physical contact, decreased support) and uncertainty during pregnancy. Facilitators included support from others and, for first-time parents, loss of child care resulting in greater parenting confidence. Although online resources and communication were not preferable to face-to-face interactions, technology was a helpful tool for communicating, getting support, and finding essentials and information during lockdown. By mid-May 2020, mood and parenting confidence among expectant and parents of new-borns in the UK were significantly reduced. Consideration of barriers and facilitators in healthcare and psychological support provided is likely important for promoting parental mental health and healthy parent-child relationships.

Water Safety Education Programs in Culturally and Linguistically Diverse Seattle Communities: Program Design and Pilot Evaluation

Drowning is a public health concern that disproportionally affects children and minorities in Washington State. Community health educators from Seattle Children’s Hospital designed a Water Safety Education and Lifejacket Giveaway Program for low-income parents of preschool-aged children from culturally and linguistically diverse backgrounds. The program was interpreted into multiple languages and parents and children in attendance received free lifejackets. The mixed-methods pilot evaluation of this program found statistically significant relationships between language and self-reported parent swim skill level (English-speaker OR 4.6; 95%CI: 1.84 – 11.54); and confidence of keeping one’s child safe (English-speaker OR 3.34; 95%CI: 1.10 – 10.4). Additionally, parents who self-reported that they could swim had four times the odds of feeling confident in keeping their children safe around the water (95% CI: 1.21 - 13.28). Qualitative data from follow-up interviews identified that the program boosted parent knowledge and confidence in safe water practices. Multi-lingual delivery and the role of partner preschools was critical to this program’s success. Specific programmatic focus on adult parent/caregiver skills and knowledge that reduce risk around the water should be a priority for future efforts to reduce drowning.

Exploring parents’ experiences: Parent-focused intervention groups for communication needs

Perceptions of a convenience sample of 10 parents (one father, nine mothers) who had completed one or more group-based, parent-focused interventions for their children’s communication needs were explored during semi-structured interviews. Nine different intervention groups (EarlyBird programmes, early communication skills training, or Makaton training) were discussed. Inductive and grounded theory approaches were used during thematic analysis to focus on parents’ priorities. Themes identified were: (1) intervention purposes, including initial session purposes; (2) groups as supportive/safe spaces; (3) personal change (behaviours and self-perception); (4) challenges of groups; (5) costs and benefits, including emotional costs. Parents supported previously reported findings about changes in knowledge, understanding, and perception of their role. Parents provided insights into how changes occurred, including helpful processes and professional strategies. They described emotional impacts of parent-focused intervention, particularly parental guilt. Participants perceived peer groups as contributing safe spaces and opportunities, but also challenges. Two parents experienced reduced benefits due to significant individual differences relating to their child’s more complex needs. Participants confirmed some speech and language therapists’ (SLTs’) perceptions about how interventions work and challenged others. Key findings were that (1) parents’ experiences during intervention facilitate personal change; (2) parents experience personal costs and benefits of intervention; (3) peer groups contribute to intervention effectiveness. These findings indicated that parents experience significant personal impacts from parent-focused intervention groups, and that groups provide a specific intervention type that differs from individual input. Clinical implications are that professionals need awareness of impacts on parents to support effective intervention and avoid harm; peer groups can facilitate learning and parental agency; dissimilarity to peers can make group intervention inappropriate. Study limitations included fewer perspectives from parents of children with primary communication needs. Further exploration of interventions’ emotional impacts, how group processes support parental confidence and agency, and effects of individual differences on suitability of group intervention are suggested.

Pro-and Anti-vaccination among Mothers in Deciding Children’s Immunization: A Qualitative Study

BACKGROUND: Society participation in the mandatory basic immunization program has declined in the last 2 years in Indonesia. One of the causes is the widespread of anti-vaccine issue, which has recently been debated on social media. This study aimed to explore the perspectives, backgrounds, experiences, and aspects that underlie the mother’s confidence in anti-vaccine and pro-vaccine groups who join the Facebook social media forum. METHODS: A phenomenology qualitative design was undertaken. The data were collected from June to August 2020. We conducted in-depth structured interviews with 5 anti-vaccine participants and 5 pro-vaccine participants. We obtained saturation data with ten participants. The data managed by NVIVO 12 software and analyzed using the thematic analysis method. RESULTS: We obtained 4 themes, including social media values, perceptions of immunization, immunization barriers, and knowledge about immunization. Anti-vaccine parents were firm not to immunize their children even though they knew the purpose of immunization and were perceived that there were no barriers to taking immunization. Pro-vaccine parents were determined to take basic immunization despite experiencing various barriers. CONCLUSION: This study showed that social media, perceptions, knowledge, and barrier about immunization affect mothers in considering the decision to give immunization to their children. Nurses and other healthcare workers should be provided positive communication and mutual trust between parents and health services are required to develop parental vaccine confidence so that basic immunization coverage can increase.

Parental Involvement in Computer Science Education and Computing Attitudes and Behaviours in the Home: Model and Scale Development

This work is situated in research on Parental Involvement (PI) in Computer Science (CS) Education. While the importance of PI in children's education is well established, most parents have little experience in CS and struggle to facilitate the learning of a child in the area. If PI in CS Education is to happen, then we argue that parents need support and that understanding the current behaviours and attitudes toward CS in the family context is important to discerning the form that support should take. This article therefore describes the development of an instrument to identify factors relating to parental attitudes toward and motivation for PI in CS education. Relevant variables situated in the context of parental computing behaviours and attitudes in the home were identified using a literature review and expert focus group. These include computing usage, availability, confidence, and experience. To measure these variables, a survey instrument was developed and administered to a large sample of parents ( n = 1228). Results of exploratory and confirmatory factor analysis confirm that the instrument measures five constructs, namely “Confidence,” measuring parental confidence levels with computing; “Attitude to PI”; “Motivation for PI”; and two types of “Usage”: Creation and Consumption. Results of Pearson correlation revealed significant positive relationships between confidence and both positive attitudes toward, and motivation for, PI, with linear regressions confirming that confidence was a significant predictor of both. Regression analysis also identified that creative usage was a predictor of positive attitudes to PI, and that programming experience was a predictor of attitude to, and motivation for, PI. These findings were further validated through triangulation with qualitative data from focus groups with the target population. We conclude that this understanding of the predictors of PI attitudes and motivation should inform the design of initiatives to address parental engagement in CS Education.

Easing Human Papillomavirus Vaccine Hesitancy: A Communication Experiment With U.S. Parents

The Announcement Approach using presumptive announcements increases human papillomavirus vaccine uptake. This study seeks to understand the impact of the final Announcement Approach steps-easing parents' vaccine concerns and then encouraging them to get human papillomavirus vaccine for their children-on parents' human papillomavirus vaccine hesitancy and confidence in the vaccine's benefits. In 2017-2018, investigators recruited an online national sample of 1,196 U.S. parents of children aged 9-17 years who had not yet completed the human papillomavirus vaccine series. Following the steps of the Announcement Approach, participants viewed brief videos of a pediatrician announcing that a child was due for human papillomavirus vaccine (shown to all the parents). In the 2 × 2 experiment, parents saw (1) a video of the pediatrician attempting to ease a concern that the parent had raised earlier in the survey (Ease video), (2) a video of the pediatrician encouraging the parent to get their child vaccinated (Encourage video), (3) both videos, or (4) neither of the videos. Data analysis was conducted in spring 2020. Seeing the Ease video message led to lower human papillomavirus vaccine hesitancy than not seeing it (mean=2.71, SD=1.29 vs mean=2.97, SD=1.33; p<0.001). The beneficial impact of easing concerns on lower vaccine hesitancy was explained by higher confidence (p<0.05). By contrast, the Encourage video had no impact on human papillomavirus vaccine hesitancy or confidence. Addressing parents' concerns can decrease human papillomavirus vaccine hesitancy and increase confidence. On the basis of these findings, the Announcement Approach retained its emphasis on announcing that children are due for vaccination and easing parent concerns.

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.

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.

Transition From the Neonatal Intensive Care Unit to Home: A Concept Analysis.

A successful transition from the neonatal intensive care unit to home is fundamental for the long-term health and well-being of preterm infants; however, the process parents' experience during their transition home is poorly understood. An improved understanding of this concept will allow nurses to offer families comprehensive and collaborative discharge preparation. To describe the defining attributes, antecedents, and consequences for the concept of transition in the context of the neonatal intensive care unit to home. Databases, MEDLINE, CINAHL, PsycINFO, and EMBASE were searched for articles containing "transition" in combination with "neonatal intensive care unit" or variants of these terms. The Walker and Avant method was used for this concept analysis. The defining attributes of transition in the context of the neonatal intensive care unit to home are "mix of emotions," "uncertainty," and "coming into parenthood." The principal antecedent is "hospital discharge preparation" and consequences include "feeding and medical needs," "family life changes," and "parental confidence." Gradually increasing parents' participation in their infant's care and forming a partnership and collaborative plan with families will help ease the uncertainty parents experience during their transition home. Further investigation is needed to determine how best to provide emotional support for parents during their transition home and to explore a feasible option for neonatal nurses to follow up with parents after hospital discharge.