Determinants of childbirth self-efficacy among multi-ethnic pregnant women in Singapore: A structural equation modelling approach

ObjectiveThis study aims to examine the relationships among sociodemographic and obstetric factors, fear of childbirth, psychosocial well-being and childbirth self-efficacy using a structural equation modelling approach.DesignIt adopted an exploratory cross-sectional study among 205 multi-ethnic pregnant women in Singapore. We used structural equation modelling to examine our hypothetical model, which integrates the concepts of Bandura's self-efficacy theory and previous literature reviews. The Childbirth Self-Efficacy Inventory, the Childbirth Attitudes Questionnaire and the World Health Organisation (Five) Well-Being Index were employed to measure childbirth self-efficacy, fear of childbirth and psychological well-being, respectively.FindingsThe structural equation model showed that multiparous women (β = 0. 24, P < 0.01), with better psychological well-being (β = 0.26, P < 0.001) were more likely to have higher childbirth self-efficacy; whereas Chinese women (β = -0.32, P < 0.01) with previous caesarean section (β = -0.17, P < 0.05) and higher fear of childbirth (β = -0.30, P < 0.001) were more likely to have lower childbirth self-efficacy. The structural equation model had good fit with the data (incremental fit index = 0.925, Tucker-Lewis index = 0.911, comparative fit index = 0.923, and root means square error of approximation = 0.048).ConclusionFindings of this study highlight that ethnic Chinese, multiparous women, previous caesarean section, psychological well-being and fear of childbirth were determinants of childbirth self-efficacy among pregnant women in Singapore. Enhancement of self-efficacy can increase coping ability and reduce fear of childbirth and thus promote normal childbirth. Future self-efficacy enhancing interventions among pregnant women should be tailored by age, ethnicity, parity and prior modes of birth.     

Psychometric Properties of an Instrument to Measure the Quality of Family-Centered Care in NICUs

ObjectiveTo examine the psychometric properties of the Digi Family-Centered Care–Parent Version (DigiFCC-P), which was developed to measure parents’ perceptions of family-centered care (FCC) in NICUs.DesignCross-sectional psychometric study.SettingTwenty-three NICUs in 15 countries in Europe, Canada, and Australia.ParticipantsMothers (n = 565) and fathers (n = 406) of preterm infants hospitalized in NICUs.MethodsParticipants reported their perceptions of the quality of FCC during their infants’ hospitalizations by answering one DigiFCC-P question delivered to their mobile phones every evening. Nine questions rotated in random order. Participants responded on a 7-point Likert scale. We evaluated the instrument’s internal consistency, construct and concurrent validity, and sensitivity.ResultsThe internal consistency of the DigiFCC-P was satisfactory; the Cronbach’s alpha coefficient was .74 (95% confidence interval [.71, .77]), and all the corrected item–total correlations were greater than .30. We identified that the items formed two factors, support from staff and the parent’s active participation, and observed no strong item cross-loadings on the two factors. We discovered some items with weak interitem correlations, and the two factors explained 35.2% of the variance. Scores on the DigiFCC-P and Family-Centered Care Questionnaire were significantly correlated (r = .59, p < .001) and supported the convergent validity of the instrument. In addition, changes were discovered in the participants’ ratings over time, which indicated that the instrument was sensitive to detect changes in their evaluations.ConclusionThe psychometric testing of the DigiFCC-P provided initial support for the convergent validity and reliability of the instrument. The instrument was also sensitive in detecting changes in the evaluations of FCC over time. However, there is a need for further development of the content validity of the instrument.     

Reliability and Validity of a Perinatal Shared Decision-Making Measure: The Childbirth Options,Information, and Person-Centered Explanation

ObjectiveTo develop and test the psychometric properties of a shared decision-making tool: Childbirth Options, Information, and Person-Centered Explanation (CHOICEs).DesignMultiphase instrument development study beginning with item development through a cross-sectional postpartum survey.SettingThe cross-sectional postpartum survey was distributed online through convenience and snowball sampling methods.MethodsWe developed instrument items through an iterative process with key stakeholders. We evaluated reliability based on internal consistency and differential item functioning analysis. We evaluated validity on evidence of construct validity. We used criterion-related item mapping to evaluate whether the measure addressed the full spectrum of shared decision making related to maternity care.ResultsSurveys were completed by 1,171 participants. A Cronbach’s α coefficient of .99 supported internal consistency reliability. Infit and outfit statistics that ranged from 0.92 to 1.55 supported item fit. Differential item functioning analysis showed that CHOICEs scores were invariant between different demographic groups. Significant positive correlations between scores on CHOICEs and the Mothers on Respect index (r = 0.75, p = .01) and the Mothers Autonomy in Decision-Making scale (r = 0.75, p = .01) supported criterion-related validity. Item mapping suggested more items were needed to capture the full spectrum of shared decision making.ConclusionWe recommend using CHOICEs to evaluate shared decision making in maternity care for research and quality improvement projects.     

Association between maternal periodontal disease and preterm delivery and low birth weight

ObjectiveIt has been suggested that periodontal disease is an important risk factor for preterm low birth weight (PLBW). The purpose of this study was to determine the association of maternal periodontitis with low birth weight (LBW) and preterm birth (PB).Materials and MethodsPregnant women (n = 211) aged 22–40 years were enrolled while receiving prenatal care. Dental plaque, probing depth, bleeding on probing, and clinical attachment level were used as criteria to classify three groups: a healthy group (HG; n = 82), a gingivitis group (GG; n = 67), and a periodontitis group (PG; n = 62). At delivery, birth weight was recorded.ResultsMean infant weight at delivery was 3084.9 g. The total incidence of preterm birth and LBW infants was 10.4% and 8.1%, respectively. The incidence of LBW infants was 4.2% for term and 40.9% for preterm gestations. Maternal height was not correlated with infant birth weight (p = 0.245). Significant differences in mean infant birth weight were observed among the HG, GG, and PG groups (p = 0.030). No significant relationship was found between periodontal disease and PB, but the association between periodontal disease and LBW was significant.ConclusionAfter appropriately controlling for confounding variables, our results do not support the hypothesis of an association that was observed in previous studies of maternal periodontal disease and infant PB, but the association between periodontal disease and LBW is significant.     

Release of Oxytocin and Cortisol Is Associated With Neurobehavioral Patterns in Premature Infants

ObjectiveTo examine relationships among salivary oxytocin and cortisol levels in parents and preterm infants and neurobehavioral functioning in preterm infants after skin-to-skin contact.DesignA secondary analysis of a randomized crossover study.SettingNICU.ParticipantsTwenty-eight stable premature infants and their mothers and fathers.MethodsParticipating infants contributed 108 saliva samples that we collected 45 minutes after skin-to-skin contact and tested for oxytocin and cortisol. We randomized data collection by whether the infant was held first by the mother or by the father. We conducted linear regression to test if summary scores on the NICU Network Neurobehavioral Scale were associated with salivary oxytocin and cortisol levels.ResultsWe found a significant negative relationship between infant oxytocin levels and the Stress scores (b = –0.07, p < .01) and the Excitability scores (b = –1.12, p = .04) among infants held skin-to-skin with their mothers. We found a significant positive relationship between infant oxytocin levels and the Self-Regulatory scores (b = 0.38, p = .05) among infants held skin-to-skin with their mothers. We found a significant positive relationship between infant cortisol level and the Stress scores (b = 0.05, p = .04), Excitability scores (b = 1.06, p = 0.05), and Asymmetrical Reflexes scores (b = 1.21, p = .03) among infants held skin-to-skin with their mothers. We only found a negative significant relationship between infant cortisol levels and the Stress scores (b = –0.03, p = .04) among infants held skin-to-skin with their fathers.ConclusionWe found that oxytocin is an important biomarker that may improve infant neurobehavioral functioning. The data showed a difference in oxytocin responses after skin-to-skin contact with mothers compared to fathers.     

Cross-Cultural Adaptation and Psychometric Evaluation of the Neonatal Eating Assessment Tool–Breastfeeding Into Tamil

ObjectiveTo adapt the Neonatal Eating Assessment Tool–Breastfeeding (NeoEAT-Breastfeeding) into Tamil, a language spoken in several South Asian countries, to identify the tool’s factor structure, and to assess its psychometric properties.DesignCross-sectional.SettingTertiary care hospital in South India.ParticipantsA cohort of 323 mothers of infants ages 1 week to 7 months, including infants with and without feeding difficulties.MethodTo adapt the English tool to Tamil, we followed standard procedures specified by the tool developers and international guidelines for tool translation and adaptation, including pilot testing and personal interviews with participants who had infants younger than 7 months. Participants completed the NeoEAT-Breastfeeding (Tamil) after assessment of breastfeeding by professionals. The 62-item tool involves rating each item on a 6-point scale, and higher scores indicate increased feeding difficulties.ResultsAfter exploratory factor analysis, we divided the tool into five subscales in the Tamil version compared to the seven subscales in the original English version. The Tamil version demonstrated high internal consistency reliability (Cronbach’s α = 0.97) and test–retest reliability (intraclass correlation = 0.99) for the total scores. Infants with feeding concerns demonstrated significantly higher total and subscale scores on the NeoEAT-Breastfeeding (Tamil) than infants without feeding concerns (p = .000; construct validity).ConclusionThe NeoEAT-Breastfeeding (Tamil) holds promise as a culturally appropriate, clinically useful parent-report tool with evidence for initial reliability and validity for identifying feeding-related concerns among infants younger than 7 months in the Tamil-speaking population.     

Psychometric Testing of the Modified Breastfeeding Self‐Efficacy Scale (Short Form) Among Mothers of Ill or Preterm Infants

ObjectiveTo psychometrically assess the modified Breastfeeding Self‐Efficacy Scale–Short Form (BSES‐SF) among mothers of ill or preterm infants.DesignMethodological study.SettingThree neonatal intensive care units (NICUs) located in two hospitals in a central Canadian city.ParticipantsOne hundred forty‐four (144) breastfeeding mothers of ill or preterm infants.MethodsMothers completed the BSES‐SF modified for mothers of ill or preterm infants, the Hill and Humenick (H&H) Lactation Scale, and demographic questions.ResultsThe Cronbach's alpha coefficient for internal consistency for the BSES‐SF revised for mothers of ill or preterm infants was 0.88. Construct validity was assessed using comparison of contrasted groups (mothers who continued to breastfeed and those who discontinued) and correlation with the construct of maternal perceptions of insufficient milk supply. Support for predictive validity was demonstrated through significant mean differences between mothers who were breastfeeding (M = 83.44, SD = 8.23) and those who discontinued breastfeeding and breast pumping (M = 75.51, SD = 10.08) at 6‐weeks post–infant hospital discharge.ConclusionDemographic response patterns suggest that the modified BSES‐SF is a unique tool to identify breastfeeding mothers of ill or preterm infants at risk of prematurely discontinuing. This study provides evidence that the modified BSES‐SF may be a valid and reliable measure of breastfeeding self‐efficacy among a sample of mothers of ill or preterm infants.     

Risk Factors and Birth Outcomes Associated with Teenage Pregnancy: A Canadian Sample

Study ObjectiveTo examine the extent to which socioeconomic status, mental health, and substance use are associated with teenage pregnancies in Southwestern Ontario (SWO), and whether these pregnancies are at an elevated risk for adverse birth outcomes, after controlling for medical, behavioral, and socioeconomic status factors.DesignRetrospective cohort study using perinatal and neonatal databases.SettingTertiary care hospital in SWO.ParticipantsWomen residing in SWO who gave birth to singleton infants without congenital anomalies between 2009 and 2014. Teenage pregnancies (19 years of age or younger) were compared with pregnancies of women 20-34 years and 35 years or older.InterventionsNone.Main Outcome MeasuresLow birth weight (LBW), very LBW, term LBW, preterm birth, very preterm birth, low and very low Apgar score, and fetal macrosomia.ResultsOf 25,263 pregnant women, 1080 (4.3%) were 19 years of age or younger. Approximately 18% of teenage mothers lived in socioeconomically disadvantaged neighborhoods, compared with 11% of mothers aged 20-34 and 9% of women 35 years of age or older (P < .001). Teenage mothers had higher rates of depression during pregnancy (9.8%) than mothers 20-34 years (5.8%) and those 35 years of age or older (6.8%; P < .001). Young mothers self-reported higher tobacco, marijuana, and alcohol use during pregnancy than adult mothers (P < .001). Teenage pregnancy increased the risk of a low Apgar score (adjusted odds ratio, 1.56; 95% confidence interval, 1.21-2.02), but was not associated with other birth outcomes after adjusting for covariates.ConclusionTeenage pregnancy is associated with a higher risk of socioeconomic disadvantage, mental health problems, and substance use during pregnancy, but is largely unrelated to adverse birth outcomes in SWO.     

Effect of Mother/Infant Skin‐to‐Skin Contact on Postpartum Depressive Symptoms and Maternal Physiological Stress

ObjectiveTo investigate the effect of mother/infant skin‐to‐skin contact (SSC) on mothers’ postpartum depressive symptoms during the first 3 postpartum months and their physiological stress during the first postpartum month.DesignLongitudinal quasi‐experiment.SettingData were collected during home visits.ParticipantsMothers in the SSC group (n = 30) provided approximately 5 hours per day of SSC with their infants in the infants’ first week and then more than 2 hours per day until the infants were age one month. Mothers in the control group (n = 60) provided little or no SSC. All mothers had full‐term infants.MethodsMothers completed self‐report depression scales when infants were 1 week, 1 month, 2 months, and 3 months of age.ResultsCompared to mothers in the control group, mothers in the SSC group had lower scores on the depression scales when the infants were one week and marginally lower scores when the infants were one month; when the infants were age 2 and 3 months, there were no differences between groups in the mothers’ depression scores. Over their infants’ first month, mothers in the SSC group had a greater reduction in their salivary cortisol than mothers in the control group.ConclusionMother/infant SSC benefits mothers by reducing their depressive symptoms and physiological stress in the postpartum period.     

Inadequate gestational weight gain contributes to increasing rates of low birth weight in Taiwan: 2011–2016 nationwide surveys

ObjectiveLow birth weight (LBW) is associated with adverse health outcomes. Incidence of LBW in Taiwan grew from 5% in 1997 to 8.4% in 2016. This study aims to identify the role of pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) in LBW rate changes during 2011–2016.Materials and methodsWe analyzed 66 135 postpartum women from 6 cross-sectional national surveys. Data were collected through telephone interviews with randomly selected mothers. Logistic regression was applied to assess contribution of maternal characteristics to LBW time changes.ResultsLBW increased from 5.3% to 7.0% during 2011–2016 (crude odds ratio (OR) = 1.04/year, p-value for trend = 0.001). Inadequate GWG increased from 27.9% to 41.5% (p-value for trend <0.001). Along with the increase in overweight (9.7%–11.1%) and obese (4.8%–7.4%), prevalence of underweight fluctuated between 16.0% and 17.8%. LBW increased in underweight group from 6.3% to 9.5% (crude OR = 1.09/year, p-value for trend<0.001). Adjustment for GWG attenuated odds ratio per year in total sample (adjusted OR = 1.03, p-value for trend = 0.04) and in underweight (adjusted OR = 1.08, p-value for trend = 0.002).ConclusionsIncreasing percentage of women with inadequate GWG could contribute to LBW increase in Taiwan during 2011–2016, especially for the underweight. Prenatal advice on GWG should be individualized according to pre-pregnancy BMI.     

The Flow-Clutch Scale: Translation and validation study of the Chinese version

PurposeThe integrated model of flow and clutch provides a multistate perspective to the optimal experiences during physical exercises. Based on this model, the Flow-Clutch Scale (FCS) was developed. The current study is the first step to test the psychometric properties of a Chinese version of the FCS (FCS–C).MethodA confirmatory factor analysis (CFA) with Maximum Likelihood estimate was performed in Chinese athletes (N = 426) to explore the structural validity of the FCS-C . The Pearson correlations between the subscales of the FCS-C and “non-reactivity to inner experiences”, “cognitive flexibility”, and “self-consciousness” were explored to examine the concurrent validity. Cronbach's alpha coefficients were used to assess the internal consistency of the total scale and subscales. Moreover, the test-retest reliability was examined in a subsample (N = 53) using a two-week interval.ResultsThe results of CFA suggested that the three-factor model showed an acceptable model fit (χ² = 459.40, df = 120, CFI = 0.95, GFI = 0.90, SRMR = 0.03, RMSEA = 0.082 [90% CI = 0.074–0.09]). Concerning the correlations between the factor “characteristics of flow” and “self-consciousness”, the concurrent validity was not satisfactory. Moreover, the test-retest coefficients ranged from 0.75 to 0.78 (p < .01) and Cronbach's alpha ranged from 0.87 to 0.96.ConclusionResults indicated that the three-factor model of FCS-C is acceptable, whereas its validity is not satisfactory to appropriately examine flow and/or clutch states in Chinese athletes. In summary, the current translation and validation study of the FCS-C allows for future research on optimal exercise experiences in Chinese-speaking cohorts including a further cultural adaptation of the questionnaire.     

Time trends,projections, and spatial distribution of low birthweight in Australia, 2009–2030: Evidence from the National Perinatal Data Collection

Introduction

Infants with low birthweight (LBW, birthweight <2500 g) have increased in many high-resource countries over the past two decades. This study aimed to investigate the time trends, projections, and spatial distribution of LBW in Australia, 2009–2030.

Methods

We used standard aggregate data on 3 346 808 births from 2009 to 2019 from Australia's National Perinatal Data Collection. Bayesian linear regression model was used to estimate the trends in the prevalence of LBW in Australia.

Results

Wefound that the prevalence of LBW was 6.18% in 2009, which has increased to 6.64% in 2019 (average annual rate of change, AARC = +0.76%). If the national trend remains the same, the projected prevalence of LBW in Australia will increase to 7.34% (95% uncertainty interval, UI = 6.99, 7.68) in 2030. Observing AARC across different subpopulations, the trend of LBW was stable among Indigenous mothers, whereas it increased among non-Indigenous mothers (AARC = +0.81%). There is also an increase among the most disadvantaged mothers (AARC = +1.08%), birthing people in either of two extreme age groups (AARC = +1.99% and +1.53% for <20 years and ≥40 years, respectively), and mothers who smoked during pregnancy (AARC = +1.52%). Spatiotemporal maps showed that some of the Statistical Area level 3 (SA3) in Northern Territory and Queensland had consistently higher prevalence for LBW than the national average from 2014 to 2019.

Conclusion

Overall, the prevalence of LBW has increased in Australia during 2009–2019; however, the trends vary across different subpopulations. If trends persist, Australia will not achieve the Sustainable Development Goals (SDGs) target of a 30% reduction in LBW by 2030. Centering and supporting the most vulnerable subpopulations is vital to progress the SDGs and improves perinatal and infant health in Australia.     

Does Stigma Toward Anal Sexuality Impede HIV Prevention Among Men Who Have Sex With Men in the United States? A Structural Equation Modeling Assessment

IntroductionMen who have sex with men (MSM) are suboptimally engaged in efficacious HIV interventions, due in part to stigma.AimWe sought to validate the Anal Health Stigma Model, developed based on theory and prior qualitative data, by testing the magnitude of associations between measures of anal sex stigma and engagement in HIV prevention practices, while adjusting for covariates.MethodsWe conducted a cross-sectional online survey of 1,263 cisgender MSM living in the United States and analyzed data with structural equation modeling. We tested a direct path from Anal Sex Stigma to Engagement in HIV Prevention alongside 2 indirect paths, 1 through Anal Sex Concerns and another through Comfort Discussing Anal Sexuality with Health Workers. The model adjusted for Social Support, Everyday Discrimination, and Sociodemographics.Main Outcome MeasureEngagement in HIV Prevention comprised an ad hoc measure of (i) lifetime exposure to a behavioral intervention, (ii) current adherence to biomedical intervention, and (iii) consistent use of a prevention strategy during recent penile-anal intercourse.ResultsIn the final model, anal sex stigma was associated with less engagement (β = −0.22, P < .001), mediated by participants' comfort talking about anal sex practices with health workers (β = −0.52; β = 0.44; both P < .001), adjusting for covariates (R² = 67%; χ²/df = 2.98, root mean square error of approximation = 0.040, comparative fit index = 0.99 and Tucker-Lewis index = 0.99). Sex-related concerns partially mediated the association between stigma and comfort (β = 0.55; β = 0.14, both P < .001). Modification indices also supported total effects of social support on increased comfort discussing anal sex (β = 0.35, P < .001) and, to a lesser degree, on decreased sex-related concerns (β = −0.10; P < .001).Clinical ImplicationsHigher stigma toward anal sexuality is associated with less engagement in HIV prevention, largely due to discomfort discussing anal sex practices with health workers.Strength & LimitationsAdjustment for mediation in a cross-sectional design cannot establish temporal causality. Self-report is vulnerable to social desirability and recall bias. Online samples may not represent cisgender MSM in general. However, findings place HIV- and health-related behaviors within a social and relational context and may suggest points for intervention in health-care settings.ConclusionProviders' willingness to engage in discussion about anal sexuality, for example, by responding to questions related to sexual well-being, may function as social support and thereby bolster comfort and improve engagement in HIV prevention.Kutner BA, Simoni JM, King KM, et al. Does Stigma Toward Anal Sexuality Impede HIV Prevention Among Men Who Have Sex With Men in the United States? A Structural Equation Modeling Assessment. J Sex Med 2020;17:477–490.     

Maternal factors associated with prematurity in public maternity hospitals at the Brazilian Western Amazon

ObjectiveTo analyse maternal factors associated with prematurity in public maternity hospitals.DesignRetrospective unmatched case-control study on two public maternity hospitals in the State of Acre, Brazil.Setting and ParticipantsA sample of 341 newborn infants of premature birth (< 37 weeks; case group) and 388 newborn infants of term delivery (≥ 37 weeks; control group).MethodsA validated instrument was used for interviews, and information was collected from hospital records. The variables were divided into five blocks: (1) maternal sociodemographic and economic characteristics, (2) maternal biological and reproductive characteristics, (3) maternal habits, (4) pregnancy complications, and (5) neonatal characteristics. The hierarchical analysis was performed using multiple logistic regression.ResultsThe risk factors associated with premature birth were as follows: newborn infants of mothers who were born premature (p = 0.005), with low BMI (p = 0.006), history of a previous preterm child (p<0.003), who had stress (p = 0.020) and physical injury during pregnancy (p = 0.025), with quality of prenatal care classified as inadequate II (p = 0.001), which presented abnormal amniotic fluid volume (p<0.001), pre-eclampsia/eclampsia (p<0.001), bleeding (p = 0.013) and hospitalization during pregnancy (p = 0.001).ConclusionThe variables that were associated with premature birth were mother born preterm, low BMI, previous premature child, stress and physical injury during pregnancy, prenatal care inadequate II, bleeding, abnormal amniotic fluid volume, pre-eclampsia/eclampsia and hospitalization during pregnancy. It is important to properly perform prenatal care, having a multidisciplinary approach as support, with the objective of keep up with changes in nutritional classification and monitoring of adverse clinical conditions.     

The Effect of Maternal Presence on Premature Infant Response to Recorded Music

ObjectiveTo determine the effect of maternal presence on the physiological and behavioral status of the preterm infant when exposed to recorded music versus ambient sound.DesignRepeated‐measures randomized controlled trial.SettingSpecial care nursery (SCN) in a tertiary perinatal center.ParticipantsClinically stable preterm infants (22) born at > 28 weeks gestation and enrolled at > 32 weeks gestation and their mothers.MethodsInfants were exposed to lullaby music (6 minutes of ambient sound alternating with 2x 6 minutes recorded lullaby music) at a volume within the recommended sound level for the SCN. The mothers in the experimental group were present for the first 12 minutes (baseline and first music period) whereas the mothers in the control group were absent overall.ResultsThere was no discernible infant response to music and therefore no significant impact of maternal presence on infant's response to music over time. However during the mothers’ presence (first 12 minutes), the infants exhibited significantly higher oxygen saturation than during their absence p = .024) and less time spent in quiet sleep after their departure, though this was not significant.ConclusionInfants may have been unable to detect the music against the ambient soundscape. Regardless of exposure to music, the infants’ physiological and behavioral regulation were affected by the presence and departure of the mothers.     

Maternal Satisfaction with Administering Infant Interventions in the Neonatal Intensive Care Unit

ObjectiveTo examine mothers’ satisfaction with administering interventions for their preterm infants and with the helpfulness of the study nurse by comparing massage with auditory, tactile, visual, and vestibular stimulation (ATVV intervention), kangaroo care, and education about equipment needed at home and to explore whether mother and infant characteristics affected maternal satisfaction ratings.DesignThree‐group experimental design.SettingFour neonatal intensive care units (NICUs) (two in North Carolina, two in Illinois).ParticipantsTwo hundred and eight (208) preterm infants and their mothers.MethodsWhen the infant was no longer critically ill, mother/infant dyads were randomly assigned to ATVV, kangaroo care, or the education group all taught by study nurses. At discharge and 2 months corrected age, mothers completed questionnaires.ResultsAll groups were satisfied with the intervention and with nurse helpfulness, and the degree of satisfaction did not differ among them. Intervention satisfaction, but not nurse helpfulness, was related to recruitment site. Older, married, and minority mothers were less satisfied with the intervention but only at 2 months. Higher anxiety was related to lower intervention satisfaction at discharge and lower ratings of nurse helpfulness at discharge and 2 months. More depressive symptoms were related to lower nurse helpfulness ratings at 2 months.ConclusionsMothers were satisfied with interventions for their infants regardless of the intervention performed. Maternal satisfaction with the intervention was related to recruitment site, maternal demographic characteristics, and maternal psychological distress, especially at 2 months. Thus, nursing interventions that provide mothers with a role to play in the infant's care during hospitalization are particularly likely to be appreciated by mothers.