The physical health of rural mothers and their low birth weight children

The purpose of this research was to examine the physical health of rural mothers and their low birth weight children (< 2,500 gm). The health of rural mothers is of concern because rural families have poorer health than urban ones, and as the primary caregiver for the low birth weight child, mother's health affects the child's care and potentially the child's health. In this cross-sectional, exploratory study, in-home interviews were conducted with 48 mothers between 2 weeks and 18 months after their children were discharged from their birth hospitalization. Mothers' physical health and their perceptions of their children's health were assessed. The mothers were more concerned about their children's health than their own (p = .0005). The concerns included uncertainty about the children's future health, growth, and development. Suggestions for community health care providers are addressed.     

Mothers' explanatory models of lack of child growth

This qualitative study elicited the explanatory models (EMs) of child growth held by mothers of growth-deficient children. EMs are culturally constructed explanations for a specific illness and its treatment (Kleinman, 1980). The EM concept was adapted for this study to focus on a child health condition instead of an illness. The sample comprised 22 mothers of growth deficient children who were interviewed 2 years after the conclusion of an intervention study to promote child growth. Growth deficiency was defined as below the 10th percentile for weight, height, or weight for height on the National Center for Health Statistics (NCHS) growth grids (Hamill, Drzid, Johnson, Reed, & Roche, 1976). Three major domains were identified in the EMs of growth held by mothers: (1) illness or heredity (etiology); (2) keeping track of growth (course); and (3) helping my child grow (treatment). The mothers in this study were concerned about their children's size and growth patterns and they monitored their children's growth with the methods available to them. They identified illnesses and allergies as environmental factors that negatively impact their children's growth. All mothers viewed size as a function of heredity. The findings from this study suggest that an emphasis on size will not encourage mothers to focus on their children's growth. The EMs for growth and size were different. Health care providers may be more effective in enhancing children's growth by teaching parents how to deal with the day-to-day problems of children who are picky eaters, stretching limited food money, creating mealtime schedules, and dealing with illnesses before they become severe.     

Low-Income Mothers' Perceptions of Health in Their Children With Growth Delay

ISSUES AND PURPOSE. Parental characteristics are the strongest predictor of poor health for children. This study examined how low-income mothers of children with growth delay define health for their children, and the behaviors they use to monitor their children's health.
DESIGN AND METHODS. Naturalistic design using Kleinman's Explanatory Model approach and interviews with 22 mothers.
RESULTS. Mothers consider nutritious food as a primary contributor to their children's health and consider healthy children to be chubby. Other indicators of health include children's energy levels, provision of nutritious food, and physical and mental activity balanced with rest.
PRACTICE IMPLICATIONS. A mother's explanatory model of health for her child can guide health promotion targeted to the mother's beliefs.     

Hispanic mothers' knowledge and care of their children with respiratory illnesses: a pilot study.

This pilot study was designed to identify Hispanic mothers' knowledge and health practices regarding caring for their children with respiratory illnesses. Using an interview guide, the researchers identified the mothers' perceptions of their children's health, the etiology and symptoms of asthma and other respiratory illnesses, health practices, folk illnesses, services sought and language barriers when using health services. The findings suggest that Hispanic mothers have limited knowledge of respiratory illnesses and use culturally related practices when caring for their sick children. Implications for pediatric nursing practice are discussed, and strategies to improve care for Hispanic families are presented.     

Health beliefs related to diarrhea in Haitian children: building transcultural nursing knowledge

Regardless of where they live or under what circumstances, mothers throughout the world seem to have a compelling desire to provide the best possible health care for their children (Huston, 1979). Haitian mothers living in the Dominican Republic were no exception. The health beliefs and practices of these mothers related primarily to diarrhea among their children which demonstrated a concern and resourcefulness that is commendable. The results of this study clearly indicate the importance of transcultural nurses conducting culturally relevant research as a basis to develop sound health programs in developing countries. Diarrhea was identified as the single most important threat to a child's health in these communities. That mothers did not know about the correct ingredients and/or proportions for oral rehydration solutions (Western views) was of interest. Although the Dominican government makes some commercial packets of ORS, most of the women interviewed did not have ready access to this product. This finding reflected the need for transcultural nurses to offer to teach mothers how to make ORS using the sugar, salt, and water they had available. Since the mothers' perception that diarrhea was a dangerous threat to their children's health, was verified by childhood mortality statistics in the bateys, it would seem that ORS could make a significant impact on the health status of the children. Breastfeeding also was a major health belief factor associated with the treatment of diarrhea. Even though the majority of mothers believed breast feeding should be continued if a child had diarrhea, a number believed it should be discontinued. Nurses working with CHWs will need to emphasize the importance of breastfeeding and help them to develop creative ways of communicating this information to the mothers. The second most dangerous threat to the child identified by the mothers was respiratory ailments. This suggests a new area of concentration for future research and training of CHWs. A host of new questions related to respiratory problems such as health beliefs, causative factors, course of disease, traditional treatments, mortality rate, etc. need to be investigated. When transcultural nurses plan health care programs for women and children in other cultures, it is important to recognize the concerns mothers have for their children, and their intense desire to nature and care for them. In this study, mothers willingly participated and demonstrated active interest in learning to use methods to improve the health and well being of their children. It is well documented (Lieban, 1977) that established health beliefs are not automatically discarded when new knowledge is made available, but that exploration and incorporation of new information when presented in a culturally relevant framework does occur. An understanding of local beliefs surrounding health is fundamental to the development of appropriate transcultural nursing interventions.     

Maternal factors associated with child behavior.

BACKGROUND: Knowledge of the relative contributions of risk factors in predicting young children's behavior problems may provide insights for the development of preventive interventions. OBJECTIVE: The purpose of this cross-sectional study was to identify maternal predictors of children's internalizing and externalizing behaviors in a volunteer sample of 205 low-income, single mothers with children between 2 and 6 years of age. METHOD: Data were collected on chronic stressors, self-esteem, negative thinking, depressive symptoms, and child behavior during in-home interviews with the mothers. RESULTS: Mothers' reports of internalizing and externalizing behaviors did not differ by sex or race of the child. Chronic stressors and depressive symptoms, in addition to control variables, explained 27% of the variability in internalizing behavior while these two variables accounted for 21% of the variability in externalizing behavior. For both internalizing and externalizing behavior, chronic stressors exerted the largest total effects. The effects of self-esteem and negative thinking were indirect, with the latter playing a stronger role. The indirect effect of negative thinking on child behavior was exerted through depressive symptoms, while self-esteem was linked with child behavior through both negative thinking and depressive symptoms. CONCLUSIONS: Decreasing mothers' negative thinking, a variable amenable to intervention, may not only decrease a mother's depressive symptoms but also improve her perception of the child's behavior. CLINICAL RELEVANCE: Decreasing mothers' negative thinking may provide a way to reduce their depressive symptoms and result in fewer behavior problems among their young children. Nurses working in primary care and community-based settings are in key positions to address this problem and improve the mental health of low-income mothers and positively affect the behavior of their children.     

Exploring Relationships Among Maternal BMI,Family Factors,and Concern for Child's Weight

PROBLEM: In an effort to better understand child obesity, this study examined the association between family living location, family function, mother's body mass index (BMI), and mothers' attitudes and behaviors concerning child feeding. Recent research on obesity has shown there is limited information on family influence and parental perceptions and attitudes. METHODS: A cross-sectional analysis was performed on data from 47 mothers of school-aged children. FINDINGS: Urban African-American mothers had higher BMIs and were significantly more concerned about their child's weight status than rural white mothers. Additionally, maternal BMI was associated with the total number of individuals in the household. CONCLUSION: Results suggest the importance in understanding the family and community and its influence on childhood obesity. Armed with knowledge about family factors and parents' beliefs and perceptions, nurses can develop interventions that can assist families and communities to focus on healthy children feeding and weight management.     

Mediating functions of maternal anxiety and participation in care on young children's posthospital adjustment

The purpose of this study was to determine whether maternal anxiety and mothers' participation in their children's care during hospitalization mediated the effects of a child behavior informational intervention for mothers on their children's posthospital negative behavioral change. Participants were 49 mothers and their young children, ages 24-68 months, who were unexpectedly hospitalized with unplanned medical or surgical conditions. These participants were drawn from a larger study of the separate and combined effects of child behavior information and parent role information on the process and outcomes of maternal and child coping with unplanned hospitalization. Findings indicated that the effects of child behavior information on children's posthospital negative behavioral change were mediated by maternal anxiety and participation in their children's care during hospitalization. Results of this study provide support for targeting mothers with informational interventions in order to enhance outcomes in hospitalized children.     

Validation of a measure of protective parent responses to children's pain

OBJECTIVES: To assess the validity of the Protect Scale of the Adult Responses to Children's Symptoms (ARCS) Questionnaire with regard to mothers' responses to their children's abdominal pain. METHODS: Mothers with High (n=32) and Low (n=35) Protect scores on the ARCS questionnaire were recruited from participants in a larger study of family illness behavior. Mothers completed a 28-day diary report of responses to their children's abdominal pain episodes. Records of their children's annual health service utilization and costs were obtained from their health maintenance organization (HMO). RESULTS: Mothers' scores on the ARCS Protect Scale were significantly correlated with their subsequent diary reports of protective responses to their children's abdominal pain. Compared to children of mothers in the Low Protect group, children of mothers in the High Protect group made significantly more health care visits for gastrointestinal symptoms and had significantly higher health care costs. CONCLUSIONS: Results supported the validity of the Protect Scale of the ARCS and demonstrated that mothers' protective responses to children's abdominal pain complaints at home predicted subsequent health service use for gastrointestinal symptoms.     

Exploration of variables related to children's behavioral distress during electrodiagnosis.

To investigate variables potentially related to children's distress during electromyography/nerve conduction studies (EMG/NCS), mothers of 39 children ages two to 17 years reported the child's gender, experience with EMG/NCS, previous negative medical/dental experiences, general response to painful procedures, information-seeking style prior to procedures, health care fears, and information about the mothers' own health care fears and their anxiety regarding EMG/NCS. Physicians who performed the studies completed a behavioral distress checklist for each child. Results indicated that children exhibiting more behavioral distress were younger, had been uncooperative with previous painful procedures, were more likely to have had more negative medical/dental experiences, and had mothers who themselves reported greater fear and anxiety about undergoing EMG/NCS. Regression analyses indicated that previous negative medical/dental experiences accounted for additional variance in distress beyond that attributed to the child's age. Significant positive correlations between children's distress and specific previous negative medical/dental experiences were found.     

Mothers' decision-making processes regarding health care for their children

This research study explored mothers' decision-making processes regarding health care for their children. Identifying how decisions are made by mothers about health care for their children will assist health care professionals to be appropriate advocates for mothers, to improve quality of life, and to contain costs of health care for children. A sample of 114 rural mothers (51 with one child, 63 with more than one child) completed questionnaires identifying demographics, social support, client and professional interaction elements, self-determinism, competence in problem-solving skills, and relationships to responses to health care scenarios. Qualitative data were also gathered by structured in-depth interviews of 7 subjects. ANOVA, correlations, and factor analysis were completed to analyze data. Most of the mothers' decisions were based on the perceived degree of seriousness, mother's degree of fear of the child's condition, attitude of the health care provider, previous experience with the situation, and social support for the mother. There were no significant differences in decision-making processes by first time mothers and by mothers with more than one child. Implications include teaching mothers assessment skills to identify serious versus nonserious situations and to utilize other social supports.     

Correlates of mothers who prefer control over their hospitalized children's care.

The purpose of this study was to profile mothers who prefer control over their hospitalized children's care. The subjects were 100 mothers in a private community hospital pediatric unit and 284 mothers in a children's hospital. The findings showed significant correlations in both groups between the desire for control and four of the six variables studied: age of the mother, age of the child, number of children in the family, and amount of time the mother spent in the hospital. The other two variables, ethnic background and prior experience with a hospitalized child, were each significant in only one of the two samples. The study provided guidelines for the pediatric nurse to use in assessing mothers' preferences for control over their hospitalized children's care.     

Mothers' developmental expectations for young children in the Philippines

The purpose of the study was to investigate the developmental timetables of rural and urban mothers in the Central Visayas, Philippines. Examined were mothers' expectations for children's development (physical/perceptual-motor, cognitive, and psychosocial) and mothers' child rearing practices, as influenced by four selected variables (child's gender and ordinal position, mother's education, and rural or urban residence). The total sample size was 303 mothers [153 of rural residence and 150 urban] in two provinces. Mothers responded to a structured questionnaire which was read to them aloud by trained interviewers who then recorded the responses. All the mothers had children between 4-6 years old; equal numbers of male and female children were included, and the entire economic and educational ranges were represented. MANOVA results showed significant main effects of all four variables on maternal expectations of child development and on maternal child rearing practices. Also, significant interaction effects of residential location and maternal education on mothers' expectations of children's physical/perceptual motor development were found (F[2, 256]=3.05, P=0.05). Significant interaction effects also were found of maternal education and the child's ordinal position (F[4,256]=2. 95, P=0.02) on maternal expectations of children's psychosocial development.     

Variability in Adjustment of Children of Battered Women: The Role of Child Appraisals of Interparent Conflict

The present study evaluates relations between children's appraisals of interparent conflict and child adjustment problems in families characterized by extreme interparent violence. Participants were 154 children (age 8–12) and their mothers. Children completed measures of their appraisals of interparent conflict (self-blame, threat, fear of abandonment) and mothers and children completed indices of child adjustment. Our results indicate that child self-blaming for interparent conflict correlates positively with mothers' reports of externalizing child problems. Self-blame, threat, and fear of abandonment appraisals each correlate positively with child self-reports of anxiety/depression. In addition, child age moderates relations between each of the measured child appraisals and mothers' reports of child adjustment problems, with the appraisals being more positively related to problems of older children.     

Family functioning when children have cystic fibrosis.

The purpose of this study was to compare family functioning between 32 mothers with a child who had been diagnosed with cystic fibrosis (Group 1) and 32 mothers with a child who did not have cystic fibrosis (Group 2). The children's ages ranged from 4 months to 3 years. The mothers' perceptions of their family's functioning was measured by the Feetham Family Functioning Survey. There were no significant differences found between the groups on the total score of the Feetham Family Functioning Survey. Both groups of mothers reported that they were quite satisfied with their family functioning.     

Maternal stresses and depressive symptoms: correlates of behavior problems in young children

In a sample of 115 mothers of 5- and 6-year-old children maternal everyday stressors, stressful life events, and maternal depressive symptoms were compared with mothers' reports of children's behavior problems. Maternal depressive symptoms did not mediate the relationship between either form of stress and child behavior problems. Maternal everyday stressors were more strongly associated with child behavior problems than were life events. Children of mothers indicating a high level of everyday stressors were 13 times more likely to be rated as having behavior problems than children of mothers reporting a low level of everyday stressors. The best prediction of mothers' reports of children's behavioral problems was provided by maternal everyday stressors and stressful life events considered simultaneously.     

The influence of mothers' health beliefs on use of preventive child health care services and mothers' perception of children's health status

During the first three years of life, many health problems are preventable, and health maintenance visits present an excellent opportunity to prevent disease and disability. Unfortunately, preventive child health care services are underutilized. Children who do not adequately use preventive health care services are often seen late in the course of an illness. Thus, they do not receive the continuing care that could eliminate the onset of preventable health problems. In our research, we sought to determine whether mothers' health beliefs influence their use of preventive child health care services and whether their use of preventive child health care services influence their perceptions of the child's health status. The sample was composed of low-income mothers living in an urban environment. No significant relationships were found between the variables. These results indicate the need to develop more sensitive tools to measure these variables in a similar sample.