The long-term efficacy of a behavioral parent training intervention for families with 2-year-olds

The effectiveness of a behavioral parent training (BPT) intervention for improving maternal self-efficacy, maternal stress, and the quality of mother–toddler interactions has been demonstrated (Gross, Fogg, & Tucker, 1995). The 1-year follow-up of the 46 parents of toddlers (assigned to an intervention or comparison group) who participated in that study is reported. It was hypothesized that (a) BPT would lead to enduring positive changes in parenting self-efficacy, parenting stress, and parent–toddler interactions; and (b) the amount of parent participation in the intervention would be correlated with greater gains in parent–child outcomes at 1 year. All the families were retained and significant gains in maternal self-efficacy, maternal stress, and mother–child interactions were maintained. Minimal BPT effects were found for fathers. BPT dosage was related to reductions in mother critical statements and negative physical behaviors at 1-year postintervention. The findings are consistent with self-efficacy theory and support parenting self-efficacy as a target for BPT in families of young children. © 1998 John Wiley & Sons, Inc. Res Nurs Health 21:199–210, 1998     

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.     

Short‐term in‐home intervention reduces depressive symptoms in Early Head Start Latina mothers of infants and toddlers

Depressive symptoms may compromise the ability of low‐income Latina mothers with limited English language proficiency to parent their infants or toddlers. Eighty Early Head Start Latina mothers with limited English language proficiency were randomized to an advanced practice nurse‐delivered, culturally tailored, in‐home psychotherapy intervention, or to usual care. Repeated measures regression analysis showed a significantly greater decrease in depressive symptoms for intervention mothers compared to the usual care group at 22 and 26 weeks (4 weeks post intervention). Intervention mothers' reports of their child's aggression diminished significantly from T1 to T4 compared to usual care mothers (p = .03). Self‐efficacy appeared to only partially mediate the intervention effect, and maternal health moderated the intervention impact. Results indicate that the intervention reduced depressive symptoms and, compared to previous studies in this population, retention of mothers in both intervention and control conditions was improved. © 2009 Wiley Periodicals, Inc. Res Nurs Health 33:60–76, 2010     

尿毒症儿童父母教养压力调查与分析

目的 调查尿毒症儿童父母教养压力水平,为开展心理干预和社会支持提供科学依据.方法 采取教养压力指标简表对49例尿毒症儿童父母和50例正常儿童父母的教养压力进行调查.结果 尿毒症儿童父亲与母亲教养压力总分和各维度得分均高于正常儿童父母(P<0.01);尿毒症儿童母亲在教养压力总分和亲职愁苦、困难儿童维度得分高于父亲(...     

Interventions with fathers of young children: systematic literature review

AIM: This paper reports a systematic review of the effectiveness of interventions for fathers with infants or toddlers. BACKGROUND: Nurses and other healthcare professionals work closely with families of infants and young children. This contact provides an opportunity to promote positive parent-child interactions and optimal child development. Previous research has demonstrated that interventions with mothers of infants can be effective in promoting sensitive, responsive parent-child interactions and positive child development. Recent research has indicated that fathers also contribute to child development, but little is known about what types of interventions with fathers are effective in promoting sensitive, responsive father-child interactions. METHODS: Literature from 1983 to 2003 in the Medline, CINAHL, and PsycINFO databases was searched to locate intervention studies published in English that included a control group or used a pretest and post-test design; measured an aspect of father-child interaction; analysed father outcomes separately from mother outcomes; had a sample greater than one; and included infants or toddlers. Additional studies were located by cross-checking reference lists. RESULTS: Fourteen papers describing 12 interventions met the inclusion criteria. The interventions included infant massage, observation and modelling of behaviour with infant, kangaroo care, participation with child in a preschool programme, discussion groups, and parent training programmes. CONCLUSION: Although the number of intervention studies is limited, there is evidence that, if interventions involve active participation with or observation of the father's own child, the intervention may be effective in enhancing the father's interactions with the child and a positive perception of the child. There is less information on how interventions influence child development. More research is needed to determine the influence of interventions over time, the differential influence on mothers and fathers, and the optimal dose of intervention required.     

Effects of a father-based in-home intervention on perceived stress and family dynamics in parents of children with autism

Parents of children with autism report high rates of stress. Parental differences in stress are inconsistent, with most research indicating that mothers report higher levels of stress than fathers. We explored parental differences before and after an in-home training program. Fathers were taught an intervention designed to improve their child's social reciprocity and communication; they then trained mothers. Stress was assessed with the Parenting Stress Index-Short Form, and family dynamics was assessed with the Family Adaptability and Cohesion Evaluation Scales II. Both mothers and fathers reported high preintervention levels of stress. After intervention, fathers' stress was reduced, but not significantly, possibly because of the variability in fathers' scores; mothers' stress scores were significantly reduced. Parenting styles were significantly different before and after intervention. Interdisciplinary teams, including occupational therapists, nurses, and special educators, can work.together to have a positive impact on the lives of families of children with autism.     

Effects of Communication Skills Training on Parents and Young Adolescents From Extreme Family Types

PROBLEM What were the effects of a communication skills training intervention among a sample of young adolescents and parents who scored in the “extreme” range of the Circumplex Model of Family Systems? METHODS Thirty‐seven young adolescents and a parent (intervention group) participated in communication skills training 2 hours/week for 6 weeks. Their responses on measures of satisfaction with the family system and perceptions of communication were compared with those of 47 young adolescents and a parent who scored in the extreme range but did not participate in the training (control group). FINDINGS Fathers and young adolescents demonstrated no change as a result of the program. Mothers who participated in skills training perceived communication with their young adolescent as more open than control mothers, but became increasingly dissatisfied with the family system. CONCLUSION This universal, community‐based, family‐focused intervention may not be indicated for extreme families.     

Stress and well-being among parents of children with rare diseases: a prospective intervention study

AIM: This paper reports a study to assess stress, well-being and supportive resources experienced by mothers and fathers of children with rare disabilities, and how these variables were affected by an intensive family competence intervention. BACKGROUND: Despite diagnosis-specific studies, little overall knowledge exists about life-consequences for families of children with rare disorders. METHOD: We used a prospective design with baseline data and two follow-ups (at 6 and 12 months) after an intervention. The intervention aimed at empowering parents in managing their child's disability. Parents from all parts of Sweden visiting a national centre for families of children with rare disabilities were consecutively selected (n = 136 mothers, 108 fathers). Instruments of parental stress, social support, self-rated health, optimism and life satisfaction and perceived physical or psychological strain were used. Stratified analyses were carried out for mothers and fathers, and related to parental demands: single mothers, full-time employment, participation in a parent association, child's age and type of disability. RESULTS: We found high parental stress, physical and emotional strain among mothers, especially among single mothers. Fathers showed high stress related to incompetence, which decreased after the intervention. Decreased strain was found among full-time working mothers and fathers after the intervention. Parents' perceived knowledge and active coping and mothers' perceived social support were increased at follow-up. Factors related to parents' overall life satisfaction (57-70% explained variance) changed after the intervention, from being more related to internal demands (perceived strain, incompetence and social isolation) to other conditions, such as problems related to spouse, paid work and social network. CONCLUSION: Parents, especially fathers and full-time working parents, may benefit from an intensive family competence programme.     

Mothers’ and fathers’ involvement in intervention programs for deaf and hard of hearing children

Purpose: Parental involvement in the rehabilitation process of deaf and hard of hearing (DHH) children is considered vital to children's progress. Today, fathers are more likely to be involved in their children’s care. Nevertheless, father involvement has been understudied and relatively little is known about their involvement in families with children who are deaf or hard of hearing. In addition, there are scant data on the correlates of parents’ involvement. This study explored similarities and differences in parental involvement between mothers and fathers in intervention programs for their D/HH children and tested a set of personal and social contextual variables that posited to affect parental involvement in a unique socio-cultural group.

Methods: Thirty Israeli-Arab couples (mothers and fathers) of young D/HH children took part. Each parent completed four self-report measures of parental involvement, parenting stress, parental self-efficacy, and social support.

Results: Mothers were significantly more involved than fathers in their child's intervention. Specifically, they report on higher interest and attendance and overall being more actively engaged with professionals in the child’s intervention. Both mothers and fathers had a rather passive style of involvement in their child's intervention. Parental self-efficacy and informal and formal social support were associated with father involvement. For mothers, only formal social support was associated with involvement.

Conclusion: For the Israeli-Arab population, the findings underscore the differences between mothers’ and fathers’ multiple dimensions of involvement in the intervention program of their D/HH children and their predictors. The results suggest important avenues for prevention and intervention activities when working with families of children who are D/HH.

• Implications for rehabilitation

• Parental involvement in intervention programs for children who are deaf or hard of hearing (D/HH) is vital to children's progress and an essential component of implementing family-centered service provision.

• Understanding of both mothers and fathers multiple dimensions of involvement and the factors that facilitate or hinder their parental involvement in their children’s intervention programs, will equip professionals to better support parents of D/HH children aligned with the principles of family centered care service delivery.

• Mothers and fathers style of involvement reflects on gaps between the goals of family centered care and their implementation in the realities of everyday practice.

• The experiences and behaviors of mothers and fathers should not be seen as interchangeable.

     

Effect of nursing interventions on stressors of parents of premature infants in neonatal intensive care unit

Aim. This study was planned for the purpose of determining the effect of stress‐reducing nursing interventions on the stress levels of mothers and fathers of premature infants in a Neonatal Intensive Care Unit (NICU). Design. Randomised intervention. Background. The physical and psychosocial environment of the NICU is a major factor in the stress experienced by the family. Method. Interviews were conducted with the parents of premature infants who agreed to participate in the research. An approximately 30‐minute educational programme about their infant and the intensive care unit was held for the mothers and fathers in the intervention group within the first week after their infant was admitted to the intensive care unit. Then they were introduced to the unit and personnel. They were given the information they requested and their questions were responded to. The parents in the control group received nothing in addition to the routine unit procedures. The mothers and fathers’ stress scores were measured for both groups after their infants’ 10th day in the NICU with the Parental Stress Scale: NICU (PSS:NICU). Results. The difference between the intervention group and the control group mothers’ mean stress score was found to be statistically significant (t = 4·05, p < 0·05). It was determined that the stress scores for the fathers in the treatment group in this research were lower, but the difference between the two groups was not found to be statistically significant (p > 0·05). Conclusion. It has been determined that parents experience very high stress levels when their infants are admitted to an NICU and that there are nursing interventions which can be implemented to decrease their levels of stress. Relevance to clinical practice. Determining the sources of stress experienced by parents can help NICU nurses use appropriate interventions in cooperation with other members of the team to decrease the stress that parents experience.     

Maternal confidence during toddlerhood: comparing preterm and fullterm groups

The purposes of this study were to explore predictors of maternal confidence during toddlerhood among mothers of children born preterm and fullterm and to determine if mothers of toddlers born preterm were less confident in parenting than mothers of toddlers born fullterm. Mothers of children born preterm (n = 62) and fullterm (n = 70) aged 12 months through 36 months (postnatal age) completed a measure of maternal confidence during toddlerhood, the Toddler Care Questionnaire (TCQ), and a family background form. Major predictor variables included the extent of the mother's prior childcare experience, toddler birth order, and maternal report of toddler handicaps and major health problems. Data on neonatal condition were collected from hospital records. There was no difference in mean TCQ score between the preterm and fullterm groups. In the preterm group, prior childcare experience, birth order, and maternal report of the toddler having cerebral palsy explained 33% of the variance. In the fullterm group, prior childcare experience, maternal age and toddler's birthweight explained 38% of the variance. The findings are discussed in light of Bandura's theory of self-efficacy (1982).     

Evaluation of a clinic-based parent education program to reduce the risk of infant and toddler maltreatment

Community-based parent education programs are a common component of service plans for abusive and potentially abusive parents. Despite their widespread use, few studies have evaluated the effect of such programs to change actual parenting behavior even though this is a key intervention goal. The purpose of this study was to evaluate whether a relatively brief and inexpensive clinic-based education program could benefit parents of infants and toddlers by alleviating parental stress and improving parent-child interaction. Participants were 199 parents of children 1 through 36 months of age who were at risk for parenting problems and child maltreatment due to serious life stress including poverty, low social support, personal histories of childhood maltreatment, and substance abuse. Program effects were evaluated in terms of improvement in self-reported parenting stress and observed parent-child interaction. Positive effects were documented for the group as a whole and within each of three subgroups: two community samples and a group of mothers and children in residential drug treatment. Additional analyses illustrated a dose-response relationship between program attendance and magnitude of gain in observed parenting skills.     

Parent-to-parent support initiated in the neonatal intensive care unit

A preliminary quasi-experimental, longitudinal study was conducted to explore differences in maternal mood states, self-esteem, family functioning, maternal-infant interaction, and home environment between mothers of preterm infants who participated in a nurse-managed program of parent-to-parent support and those who served as a comparison group. Mothers who participated in the intervention scored significantly higher on the Barnard NCATS interaction measure and the HOME total scale and subscales of maternal responsiveness and organization (N = 58) at 12 months following discharge from a neonatal intensive care unit. Using repeated measures analysis for a subset of mothers (n = 32), there were significant differences between the two groups on the mood state anxiety-tension (POMS) during the first 4 months postdischarge, with the treatment group having less anxiety. There was also a group by time interaction effect on self-esteem during the first 4 months, with self-esteem of the treatment group mothers increasing and comparison mothers decreasing. Findings suggest that one-to-one veteran parent support, in a nurse-managed program, may influence maternal and maternal-infant interaction outcomes. ©1995 John Wiley & Sons, Inc.     

A longitudinal model of maternal self-efficacy,depression, and difficult temperament during toddlerhood

The purpose of this study was to test a model of maternal self-efficacy during toddlerhood using a longitudinal sequential design. Participants were 126 mothers of 1-year olds (Cohort 1) and 126 mothers of 2-year olds (Cohort 2) who completed questionnaires measuring maternal self-efficacy, depression, and perceived difficult toddler temperament three times over 1 year. Data were analyzed using structural equation modeling and maximum likelihood estimation. Findings support a model whereby (a) the more depressed the mother feels, the more likely she is to rate her toddler's temperament as difficult, (b) the more difficult the child's temperament is perceived to be, the lower the mother's estimates of her parenting self-efficacy, (c) the lower the mother's self-efficacy, the greater her depression, and (d) the more depressed the mother feels at one point in time, the more likely she is to remain depressed 6 months later. Implications of the findings are discussed as they relate to self-efficacy theory and nursing intervention with parents of difficult toddlers.     

The effect of an emotional support training program on acute stress disorder among mothers of preterm infants hospitalized in neonatal intensive care units

Many mothers experience acute stress disorder after hospitalized their infant in NICU. The objective was to assess the impact of an emotional support training program on acute stress disorder level among mothers of preterm infants admitted to a neonatal intensive care unit. A pretest-posttest experimental randomized controlled trial design using the Stanford Acute Stress Reaction Questionnaire was used on 48 mothers (24 each in two groups) of premature infants in a level III NICU in the largest public teaching hospital in Amman at Jordan. The results revealed statistically significant differences between the interventional and control group for mean post intervention scores [t (23) = 6.07, p = .01], with mean scores of 18.53 (9.33) and, 25.588 (4.99) respectively. Hence, the emotional support training programs effectively reduce acute stress disorder symptoms in mothers of premature infants in neonatal intensive care units.     

Fathers' Perceptions of Their Roles During In‐Home Training for Children With Autism

PROBLEM: Currently, most research related to parents of children with autism has focused on mothers, and little is known about the fathers' interaction with their children. PURPOSE: The purpose of the qualitative study is to assist in more fully describing and understanding fathers' perceptions of their roles, relationships with their children with autism, and participation in an in‐home training intervention designed to enhance parent–child interactions as well as child language and social interactions. METHODS: In depth semi‐structured interviews with 10 fathers were conducted at home, videotaped, transcribed, and reviewed for common themes and significant statements FINDINGS: Five common themes were discovered, fathers expressed their view of their roles, and fathers reported the father‐directed in‐home intervention was effective in enhancing father–child relationships. CONCLUSION: Communication between fathers and their children appears to be the key to a successful relationship. Although verbal communication deficit is a predominant feature of autism, these fathers noted other ways of effective communicating including time spent playing or just being with the child.     

Effects of infant massage on HIV‐infected mothers and their infants

Purpose. To determine the feasibility of implementing an infant massage intervention and to evaluate the preliminary effects of infant massage on HIV‐infected mothers and their infants. Design and Methods. In this two‐group, randomized controlled pilot study, intervention group mothers were taught to perform infant massage daily for 10 weeks. Results. Infant massage training had a positive impact on maternal depression, parental distress, and infant growth along with facilitating more optimal parent–child interactions. Practice Implications. Infant massage, a quick, easy, and inexpensive intervention, is feasible in a clinic setting and may benefit human immunodeficiency virus‐infected mothers and their infants.     

初产妇产后育儿自我效能、影响因素及护理措施的研究

目的探讨初产妇产后育儿自我效能、影响因素及护理干预措施。方法选取2011年1～12月分娩的180例初产产妇为研究对象,将其随机分为对照组（常规护理组）和观察组（针对I生指导组）各90例。于干预前采用BSES量表对不同社会支持度、文化程度、相关培训参与情况、工作隋况及生产方式的产妇进行分析,观察组接受根据分析结果制订的针对陛的护理措施,对照组接受常规护理。然后将2组产妇干预前及干预后6周的评分情况进行比较。结果产妇中高社会支持度、高文化程度、参与过相关培训及无工作者的BSES量表评分高于其他产妇,干预后观察组的BSES量表各维度及总分均显著高于对照组。结论初产妇产后育儿自我效能受社会支持度、文化程度、相关培训参与情况、工作情况影响,给予针对性干预后可显著提高其产后育儿自我效能。     

Evaluation of a training program to assist care staff to better recognize and manage depression among palliative care patients and their families

This study was designed to evaluate the effectiveness of a training program to improve the knowledge, attitudes, and self-efficacy of palliative care staff and thus enable them to better detect and manage depression among palliative care patients and their families. Participants were 90 professional carers who completed a four-session training program. Knowledge, attitudes, self-efficacy, and barriers to working with depressed patients were assessed preintervention, post-intervention, and at a three-month follow-up. The results demonstrated that compared to the control group, the intervention group had improved in all of these areas. Improvements were maintained at the three-month follow-up in all areas except attitudes. The results of this study indicate the importance of training in managing depression among palliative care staff. Booster sessions will likely be needed to ensure that training program gains are maintained.