Relationship of working mothers' parenting style and consistency to early childhood development: a longitudinal investigation

Title.  Relationship of working mothers' parenting style and consistency to early childhood development: a longitudinal investigation.
Aim.  This paper is a report of a longitudinal study of the relationship of working mothers' parenting style to their children's social competence and vocabulary/motor/intellectual development.
Background.  With an increasing number of women choosing to remain in the workforce after starting a family, there has been a concomitant increase in use of non-parental childcare facilities to help look after the child while the mother is at work. This increase in non-parental care has led to a dramatic change in the traditional child-rearing environment.
Methods.  Long-term investigations were conducted over a period of 2 years in 41 Japanese government-licensed childcare facilities. Child development was evaluated by childcare professionals and parenting style was assessed by questionnaire. A total of 504 children and their mothers participated in the study. Data collection was carried out in 2004 and 2006.
Findings.  We found that the changes in parenting style were statistically significantly related to children's development after 2 years. For instance, changes in the parent-child playing routine contributed to the child's social competence (odds ratio = 11·088). Variation in working mothers' disciplinary practices was also associated with children's vocabulary development after 2 years (odds ratio = 2·246).
Conclusion.  Working mothers should increase interactions with their children in their free time to reduce the risk of developmental delay. Daily childcare support provided by family members or social organizations for long-term working mothers is helpful in mediating the negative relationship of mothers' working with children's development.     

Depression Among a Sample of First-Time Adolescent and Adult Mothers

PROBLEM:  Little is known about the rates, correlates, and consequences of depression among a sample of first-time mothers.
METHODS:  Four-site prospective study of the first 3 years of life among first children born to first-time mothers, including adolescent ( N = 396), lower- ( N = 169), and higher-resource adult ( N = 117). Mothers were administered the Beck Depression Inventory prenatally and 6 months postpartum. Measures of maternal and infant behaviors were taken at 8 months.
FINDINGS:  Adolescent mothers displayed higher prenatal and 6-month rates of depression than lower- and higher-resource adult mothers, with significantly more adolescent mothers "consistently" depressed at the two time points than lower- and higher-resource adult mothers. Further, adolescent mothers were significantly more likely to become depressed after their babies were born than lower- or higher-resource adult mothers. Depression was negatively related to parenting practices and babies' behavior. As depression increased, mothers scored less favorably in maternal warmth and sensitivity, contingent responsiveness, and general verbalness; children scored less favorably in warmth seeking toward their mothers.
CONCLUSION:  Findings signify the need for counseling and nurse-based intervention and prevention services geared at preparing pregnant adolescents for motherhood.     

The importance of transformational leadership style for the well-being of employees working with older people

Title.  The importance of transformational leadership style for the well-being of employees working with older people.
Aim.  This paper is a report of a study to explore the relationships between transformational leadership, followers' perceived working conditions and employee well-being and job satisfaction.
Background.  There is some evidence that transformational leadership style is linked to employee job satisfaction and well-being. However, it is not clear whether this is due to (i) a direct relationship between leadership and job satisfaction and well-being outcomes or (ii) whether followers' perceived working conditions mediate this relationship.
Methods.  A cross-sectional design was applied to data from a questionnaire study of 447 staff caring for older people in Denmark. Data were collected in 2005. A theory-driven model of the relationships between leadership, working conditions, job satisfaction and well-being was tested using structural equation modelling.
Results.  The transformational leadership style was closely associated with followers' working conditions, namely involvement, influence and meaningfulness. Involvement was associated with job satisfaction and meaningfulness was associated with well-being. However, working conditions were closely correlated with each other, and thus the mediating mechanisms may operate through several different working conditions. A direct path between leadership behaviour and employee well-being was also found.
Conclusion.  Considering working conditions in the absence of studying leadership behaviour (or vice versa) may reveal an incomplete picture of the impact of work and work relationships on well-being. Work re-design interventions focused on influence may benefit from the consideration of training managers to exert transformational leadership behaviours.     

Self‐rated health – what does it capture at 1 year after childbirth? Investigation of a survey question employing thinkaloud interviews

Aim:  This paper reports an investigation of how the survey question 'How would you summarize your state of health at present' is interpreted and what it captures when asked at 1 year after childbirth.
Background:  Self-rated health measured by a single item question is a well-established patient outcome as it predicts morbidity and the use of health services. However, there is limited understanding of what the question captures in early motherhood.
Method:  A qualitative design combining data collection by means of a short form, concurrent and retrospective thinkaloud interviews, and a semi-structured interview, with 26 Swedish women during 2005 was employed. The text was analysed by qualitative content analysis. A theoretical framework describing four cognitive tasks usually performed when a respondent answers a survey question guided the analysis: interpretation of the question, retrieval of information, forming a judgement and giving a response.
Findings:  The questions of self-rated health left open for the new mothers to evaluate what was most important for her. It captured a woman's total life situation, such as family functioning and well-being, relationship with partner, combining motherhood and professional work, energy, physical symptoms and emotional problems affecting daily life, stressful life events, chronic disease with ongoing symptoms, body image, physical exercise and happiness. Neither childbirth-related events nor childbirth-related symptoms were included in the responses. Less than 'good' self-rated health represented a high burden of health problems.
Conclusion:  Our results showed that the question on self-rated health was a measure of women's general health and well-being in their present life situation, but it did not seem to measure recovery after childbirth specifically.     

Roles and well-being among healthy women and women with rheumatoid arthritis

Title.  Roles and well-being among healthy women and women with rheumatoid arthritis.
Aim.  This paper is a report of a study examining the relationships among number of roles, role quality, role stress, role balance, and psychological well-being in women diagnosed with rheumatoid arthritis.
Background.  A substantial literature exists examining multiple roles in healthy women. However, less is known about multiple roles and well-being in women with a chronic illness such as rheumatoid arthritis.
Methods.  A questionnaire study was conducted in 2003 examining four role-related constructs (number of roles, quality of roles, role stress, and role balance) and psychological well-being in healthy women ( n  = 47) and women diagnosed with rheumatoid arthritis ( n  = 50). Correlation coefficients and multiple regression analyses were calculated to determine the nature of the relationships among the variables.
Findings.  The two groups were similar in demographics except for employment, with fewer women with rheumatoid arthritis employed. The two groups differed statistically significantly on psychological well-being. Women with rheumatoid arthritis had a lower mean psychological well-being score than healthy women. Regression analyses revealed that role stress was the only unique predictor of psychological well-being in healthy women, while role balance was the sole unique predictor among women with rheumatoid arthritis.
Conclusion.  Women with rheumatoid arthritis experienced lower levels of well-being than their healthy counterparts. Examination of the relationships among the variables can facilitate the development of interventions to improve these women's mental health. Nurses are in a position to assess the psychosocial needs of women with rheumatoid arthritis and assist those experiencing role stress and role imbalance.     

孤独症患儿母亲的亲职压力与社会支持、应对方式的相关性研究

目的 探讨孤独症患儿母亲的亲职压力与社会支持、应对方式的关系.方法 采用亲职压力指标简表、社会支持评定量表和简易应对方式问卷对105名孤独症患儿母亲(观察组)和100名正常儿童母亲(对照组)的亲职压力进行调查,并分析亲职压力与社会支持、应对方式的相关性.结果 孤独症患儿母亲的亲职压力总分和各维度得分均显著高于正常儿童母亲;亲职压力与社会支持成负相关.结论 孤独症患儿母亲普遍存在较高水平的亲职压力,社会支持系统可降低亲职压力水平.     

Sense of Coherence,Parenting Attitudes and Stress among Mothers of Children with Autism in Hong Kong

Background The moderating and mediating relationships among sense of coherence, parental attitudes and parenting stress for caregiving parents of children with autism were tested. Materials and Methods One hundred and fifty‐seven mothers of children with autism recruited from representative community service centres in Hong Kong completed the Chinese versions of Sense of Coherence Scale (SOC), Confidence and Acceptance subscales of Parent‐Attitude Survey Scales and Parenting Stress Index Short Form. Results Accounting for mothers’ demographic background, SOC showed a moderating effect with child's symptoms and parenting stress. Mothers with a strong SOC perceived lower stress than their counterparts even when their children presented with more severe autistic symptoms. Two proximal factors in parenting, parental confidence and acceptance of the child, were found to partially mediate SOC and stress. Conclusions The stress experience of mothers of children with autism is related strongly to a global sense of coherence as well as more specific parenting attitudes.     

孤独症患儿母亲的亲职压力与社会支持、应对方式的相关性研究

目的探讨孤独症患儿母亲的亲职压力与社会支持、应对方式的关系。方法采用亲职压力指标简表、社会支持评定量表和简易应对方式问卷对105名孤独症患儿母亲（观察组）和100名正常儿童母亲（对照组）的亲职压力进行调查,并分析亲职压力与社会支持、应对方式的相关性。结果孤独症患儿母亲的亲职压力总分和各维度得分均显著高于正常儿童母亲;亲职压力与社会支持成负相关。结论孤独症患儿母亲普遍存在较高水平的亲职压力,社会支持系统可降低亲职压力水平。     

Is a healthy lifestyle related to stress, parenting confidence, and health symptoms among new fathers?

A healthy lifestyle is widely recognized as important in preventing disease and disability. This study examined whether in the transition to fatherhood a healthy lifestyle was related to perceived stress, parenting confidence, and physical health symptoms. Survey data from 87 fathers were examined for relationships between lifestyle, measured by 6 subscales of the Health Promoting Lifestyle Profile (HPLP), and perceived stress, parenting confidence, and health symptoms. In general, a healthier lifestyle, especially HPLP self-actualization and stress-management subscales, was related to less perceived stress, more parenting confidence, and fewer health symptoms. Higher HPLP nutrition and exercise scores were related to fewer health symptoms; higher exercise and seeking-interpersonal-support scores were related to higher parenting confidence. Also, higher social desirability scores, a confounding influence, were related to less perceived stress. The authors conclude that health-promotion behaviours may be an important personal resource in maintaining health and promoting well-being among new fathers.     

Heteronormative communication with lesbian families in antenatal care, childbirth and postnatal care

Title.  Heteronormative communication with lesbian families in antenatal care, childbirth and postnatal care.
Aim.  This paper is a report of a study of lesbian parents' experience of antenatal care, childbirth and postnatal care.
Background.  In a strictly heteronormative-based care system, 'parents' naturally implies a man and a woman, and all communication and routines are based on heterosexual couples.
Method.  A qualitative interview study was carried out in 2008. Ten mothers, eight of whom were in a relationship with another woman, participated. The participants had experience from several care facilities from three different cities in central Sweden.
Findings.  Most participants had positive experiences but also complained that the focus was not always on the pregnancy and that no parenthood education had been offered. Heteronormativity was communicated by midwives and nursing staff throughout the process – from antenatal care to postnatal care, via forms, journals, verbal communication and orientation visits. This was experienced as embarrassing for the participant parents, and they also described encountering what they interpreted as embarrassment on the part of care providers. Participants called for increased knowledge about lesbian parenting, since they believed this would influence and facilitate communication, not least with midwives in antenatal care.
Conclusion.  Midwives educated in lesbian issues could ask questions and communicate in a more neutral way at the first meeting, and thereby make prospective parents feel less insecure. Special parenthood education groups for lesbians are recommended so that lesbian couple can meet others with similar experiences and so that the focus will be on prospective parenthood and not on their sexual orientation.     

Current Sexual Trauma Among High-Risk Teen Mothers

PROBLEM:  The highest rate of reported intimate partner violence (IPV) is among women 15–45 years old ( Hart & Jamieson, 2001 ) with 20% of pregnant teens reporting abuse ( Campbell, 1999 ); however, little research on IPV and American Indian teen mothers has been done.
METHOD:  The purpose of this paper is to describe the degree of IPV and current sexual trauma among a group of Northern Plains adolescents being served by an American Indian teen mother program.
FINDINGS:  The relationship of trauma, substance abuse, and trauma symptoms are described. IPV was reported by 61% of the participants, with 37.5% reporting IPV during pregnancy and 22.5% reporting current sexual trauma.
CONCLUSIONS:  Development and testing of interventions for American Indian teen mothers, specifically related to trauma, are needed in addition to primary mental health services by agencies caring for this population.     

The health of children with cerebral palsy and stress in their parents

Title.  The health of children with cerebral palsy and stress in their parents.
Aim.  This paper is a report of a study conducted to describe the health of children with cerebral palsy and investigate predictors of stress in their parents.
Background.  Children with severe cerebral palsy tend to have poorer health than their able-bodied peers, and their parents are more likely to be stressed and have poorer health.
Method.  A cross-sectional survey with home visits using standard questionnaires was administered to parents in 2004–05. A total of 102/199 (51%) children and parents participated. The children were compared with a normative sample.
Results.  Children with cerebral palsy had poorer physical health, and 79% of parents reported that their child had moderate to severe pain. Their poorer health, in comparison with the normal sample and measured by the Child Health Questionnaire, was related to feeding problems and seizures, general health perceptions to intellectual and feeding impairment, and family activities with severe motor, intellectual and feeding impairment. Poorer psychological well-being on the hyperactivity domain of the Strengths & Difficulties Questionnaire was related to feeding difficulties, on the prosocial domain to more severe forms of all child impairments, and on the social impairment scale to intellectual impairment. Children with psychological problems had statistically significantly increased odds (OR = 7·2, 95% CIs 2·6–20·3) of having parents with high stress.
Conclusion.  Children with cerebral palsy and associated impairments are at higher risk of poorer health and family well-being. A family-centred approach to the care of children with cerebral palsy and their families is essential to ensure both receive adequate care and support.     

Hope, self-efficacy, spiritual well-being and job satisfaction

Title.  Hope, self-efficacy, spiritual well-being and job satisfaction.
Aim.  This paper is a report of a study of the relations of spiritual well-being, global job satisfaction, and general self-efficacy to hope in Continuing Care Assistants.
Background.  Healthcare providers have described their hope as an important part of their work and a form of work motivation. Hope may be an important factor in preventing burnout and improving job satisfaction.
Methods.  A concurrent triangulation mixed method design was used. Sixty-four Continuing Care Assistants (personal care aides) who registered for a 'Living with Hope' Conference completed a demographic form, Herth Hope Index, Global Job Satisfaction Questionnaire, Spiritual Well-Being Scale, General Self-Efficacy Scale, and a hope questionnaire. Data were collected in 2007. The response rate was 58%.
Results.  Using linear regression, 29·9% of the variance in Herth Hope Index score was accounted for by scores from the General Self-Efficacy Scale and Spiritual Well-Being Scale. General Self-efficacy scores (positive relationship) and Spiritual Well-Being scores (negative relationship) accounted for a significant part of the variance. Qualitative data supported all findings, with the exception of the negative relationship between hope and spiritual well-being; participants wrote that faith, relationships, helping others and positive thinking helped them to have hope. They also wrote that hope had a positive influence on their job satisfaction and performance.
Conclusion.  Hope is an important concept in the work life of Continuing Care Assistants. Supportive relationships, adequate resources, encouragement by others, and improving perceptions of self-efficacy (ability to achieve goals in their workplace) may foster their hope.     

Multiple perspectives on the psychological functioning of children with and without migraine

Objective.— To use a case–control design to evaluate the emotional and behavioral functioning of children with migraine.
Background.— Research has indicated that children with migraine are at increased risk for emotional and behavioral problems such as depression and anxiety; however, methodological limitations in sample definitions, measurement strategies, and comparison groups remain problematic.
Method.— Forty-seven participants diagnosed with migraine at a pediatric headache center participated in a home-based study of child functioning using standardized measures. Mothers and fathers of these children participated, as did control families recruited from among classmates.
Results.— Indications of increased emotional and behavioral difficulties for children with migraine were found, primarily from the perspective of mothers. Exploratory analyses found several associations between mother and child perceptions of difficulties and persistence of headache symptoms following initiation of multidisciplinary headache treatment.
Conclusions.— Continued concern regarding emotional well-being of children with migraine is warranted, but more work is needed to understand the differing perspectives of family members. Particular attention to emotional well-being is needed for children whose headache symptoms persist despite multidisciplinary treatment.     

The Association Between Internet Use and Depressive Symptoms Among South Korean Adolescents

PURPOSE.  This study explores the cross-sectional relationship between Internet use and depressive symptoms in South Korean adolescents.
DESIGN AND METHODS.  Existing data, the three-wave Korean Youth Panel Survey, were analyzed. The sample was a cohort representing the population of second-year students at Korean middle schools in 2003 ( N  = 3,449). Multivariate logistic regression was used.
RESULTS.  A one-unit increase in Internet use was positively associated with a 20.7% increase in risk for depressive symptoms.
PRACTICE IMPLICATIONS.  It may be worthwhile for nursing professionals to inquire about Internet use as part of a measure of screening for depressive symptoms in teens.     

Women's thoughts about sexual life after childbirth: focus group discussions with women after childbirth

Background:  To give birth and become a parent is a source of many emotions and expectations. Several studies show that women experience different problems after giving birth. It can bring many physical, emotional and social changes that may alter the woman's sexual needs and impact on her relationship. The aim of this study was to elucidate how some women experienced their sexual life with their partner after giving birth.
Methods:  Twenty-seven women participated in six focus group discussions (FGDs). These discussions took place 3–24 months postdelivery. The midwives at their antenatal clinics selected them. A discussion guide with broad questions related to the subject was used and an observer took notes during the FGD.
Results:  Four themes were identified: body image after childbirth, how sexual patterns are altered following new stresses of family life, discordance of sexual desire with the partner and the necessity for reassurance. The women did not feel comfortable with the physical changes that had taken place and their body image. Childbirth meant less sleep and less free time; consequently, instead of having sex, women wanted to sleep or have time for themselves and that led to a changed sex pattern. Discordance of sexual desire with the partner was a problem but most of the women expressed confidence that their sexual desire would return shortly. Reassurance and confirmation that they were physically alright and back to normal was essential.
Conclusion:  New mothers are concerned with their body image and the ability to adapt to parenting. They need sensitive, professional counselling and reassurance about their body, as well as about sexual life after childbirth. This level of professional counselling is presently not widely available to new mothers, while midwives and gynaecologists should be the key persons to provide this service.     

Stress and coping in high-risk mothers: difficult life circumstances,psychiatric-mental health symptoms,education, and experiences in their families of origin

A pilot study was conducted to test methods and measures used to assess factors related to stress and coping in high-risk mothers and their effect on parenting. Twenty mothers with 12-month-old toddlers were recruited from a WIC population; they came into an observational laboratory where they were interviewed about stressors in their lives and their symptoms of stress and were videotaped interacting with their children. Maternal difficult life circumstances, psychiatric-mental health symptoms, education, maternal experiences in their families of origin, and parenting stress explained 74% of the variance in maternal sensitive-responsiveness with their toddlers in the laboratory setting. The findings support the methods of the study. Clinical implications and implications for future research to assist in the development of interventions for this population are discussed. Increased attention to screening for maternal psychiatric-mental health symptoms and for negative experiences in mothers' families of origin may provide important opportunities for intervention with these mothers.     

Stress and coping in Australian nurses: a systematic review

LIM J., BOGOSSIAN F. & AHERN K. (2010) Stress and coping in Australian nurses: a systematic review. International Nursing Review 57 , 22–31
Aim:  To identify factors that contribute to stress in Australian nurses, consider the coping strategies they use and examine the effects of stressors on nurses' health and well-being.
Background:  Stress is a major concern in the nursing profession with work overload, nurse shortages and high turnover rates as the common stressors. Although nursing stress has been studied extensively, there is a lack of clarity on the nursing situation in Australia.
Methods:  A systematic review of the current literature was conducted on stress and coping strategies within the Australian nursing population.
Results:  Stressors included work overload, role conflicts and experiences of aggression. Coping strategies included seeking support, problem solving and self-control. The majority of the studies reported detrimental effects on nurses' physical and mental well-being with little consideration given to the spillover effects of nursing work stress to their family and social relationships.
Conclusion:  Recommendations included factoring in personal and work stresses, promoting the use of effective coping strategies and maintaining supportive social relationships.     

The parent–nurse relationship in the neonatal intensive care unit context – closeness and emotional involvement

Aim and background:  Family-centred care, which acknowledges parents as partners in care, is a desirable and essential part of neonatal nursing. There has been extensive research on parents' experiences of parenting in neonatal intensive care units (NICU), but there is little research on nurses' experiences of being in these enduring close relationships. The aim of this paper is to explore parents' and nurses' experiences of the close parent–nurse relationship when a premature child is hospitalized.
Method:  The design was exploratory with a hermeneutic approach. The methods used were participant observation and in-depth interviews with six mothers, six fathers and six nurses in a Norwegian 13-bed NICU. Eighteen individual interviews and 160 hours of observations were conducted over 27 weeks from 2003 to 2004. This study complies with the principles of the Declaration of Helsinki. The Regional Committee for Medical Research Ethics, the Ombudsman for Privacy in Research at the Norwegian Social Science Data Services and the hospital's research department approved the study protocol.
Results:  The NICU context is a technological environment where human interaction is a crucial issue. The character of the context and the ongoing interactions drive parents and nurses into close relationships. Closeness increases the emotional involvement and the boundary between the professional and the personal approach is threatened. The commitment of being close, combined with the emotional involvement, can be an emotional burden to both parents and nurses.
Conclusion:  Parent–nurse closeness in NICU is desirable; however, the emotional burden of this closeness seems to be seldom problematized. Awareness about the need to strike a balance between closeness and distance can positively influence parents' independence and nurses' ability to maintain professional relationships with their primary care parents.