Alexandra Chong

Anxiety across the transition to parenthood: change trajectories among low-risk parents

Background and Objectives: A number of sources suggest changes in anxiety across the transition to parenthood may be experienced by parents in different ways, yet no studies have examined whether new parents experience changes in anxiety in distinct subgroups. Design: We conducted a longitudinal study of 208 first-time parents (104 couples) from a low-risk population. Parents were interviewed from the third trimester of pregnancy to nine-months postpartum. Methods: The current study utilized latent class growth analysis to explore subgroups of change in symptoms of anxiety. Based on stress and coping theory, we also examined a number of personal and social prenatal predictors of subgroup membership. Results: We identified two distinct change trajectories: (1) moderate and stable and (2) low and declining. We also found prenatal depression, expected parenting efficacy, and relationship satisfaction were significantly associated with subgroup membership. Conclusions: Our results suggest a majority of new parents adjust well to parenthood in terms of anxiety, while a smaller subgroup of parents experience continually higher levels of anxiety months after the baby is born.

Healthcare Resource Use and Costs in Long-Term Survivors of Acute Respiratory Distress Syndrome: A 5-Year Longitudinal Cohort Study

Objective: To evaluate the time-varying relationship of annual physical, psychiatric, and quality of life status with subsequent inpatient healthcare resource use and estimated costs. Design: Five-year longitudinal cohort study. Setting: Thirteen ICUs at four teaching hospitals. Patients: One hundred thirty-eight patients surviving greater than or equal to 2 years after acute respiratory distress syndrome. Interventions: None. Measurements and Main Results: Postdischarge inpatient resource use data (e.g., hospitalizations, skilled nursing, and rehabilitation facility stays) were collected via a retrospective structured interview at 2 years, with prospective collection every 4 months thereafter, until 5 years postacute respiratory distress syndrome. Adjusted odds ratios for hospitalization and relative medians for estimated episode of care costs were calculated using marginal longitudinal two-part regression. The median (interquartile range) number of inpatient admission hospitalizations was 4 (2–8), with 114 patients (83%) reporting greater than or equal to one hospital readmission. The median (interquartile range) estimated total inpatient postdischarge costs over 5 years were

Perceived Fairness and Relationship Satisfaction During the Transition to Parenthood The Mediating Role of Spousal Support

58,500 (

Return to work and lost earnings after acute respiratory distress syndrome: a 5-year prospective, longitudinal study of long-term survivors

19,700–157,800; 90th percentile,

Postnatal Depression: The Role of Breastfeeding Efficacy, Breastfeeding Duration, and Family–Work Conflict

328,083). Better annual physical and quality of life status, but not psychiatric status, were associated with fewer subsequent hospitalizations and lower follow-up costs. For example, greater grip strength (per 6 kg) had an odds ratio (95% CI) of 0.85 (0.73–1.00) for inpatient admission, with 23% lower relative median costs, 0.77 (0.69–0.87). Conclusions: In a multisite cohort of long-term acute respiratory distress syndrome survivors, better annual physical and quality of life status, but not psychiatric status, were associated with fewer hospitalizations and lower healthcare costs.

The Influences of Work and Home Interference and Facilitation on Job Satisfaction

The current study examined the influence of perceived fairness of household labor and childcare on relationship satisfaction among new parents. Emotional spousal support and negative spousal interactions were analyzed as potential mediators, using cross-sectional and longitudinal data from couples transitioning to parenthood (N = 92). At 9 months postpartum, mothers’ perceived fairness of household labor and childcare were related to their relationship satisfaction through emotional spousal support. Negative interactions mediated the association between mothers’ perceived fairness of childcare and relationship satisfaction, concurrently and longitudinally across the transition. For fathers, there was no evidence of mediation. However, spousal effects of fathers’ perceived fairness of childcare on mothers’ relationship satisfaction was found longitudinally. Overall, the results demonstrate the importance of emotional spousal support and negative spousal interactions when understanding the influence of new mothers’ perceived fairness of family labor on their relationship satisfaction.

Health-related behaviors: A study among former young caregivers.

Background Delayed return to work is common after acute respiratory distress syndrome (ARDS), but has undergone little detailed evaluation. We examined factors associated with the timing of return to work after ARDS, along with lost earnings and shifts in healthcare coverage. Methods Five-year, multisite prospective, longitudinal cohort study of 138 2-year ARDS survivors hospitalised between 2004 and 2007. Employment and healthcare coverage were collected via structured interview. Predictors of time to return to work were evaluated using Fine and Grey regression analysis. Lost earnings were estimated using Bureau of Labor Statistics data. Results Sixty-seven (49%) of the 138 2-year survivors were employed prior to ARDS. Among 64 5-year survivors, 20 (31%) never returned to work across 5-year follow-up. Predictors of delayed return to work (HR (95% CI)) included baseline Charlson Comorbidity Index (0.77 (0.59 to 0.99) per point; p=0.04), mechanical ventilation duration (0.67 (0.55 to 0.82) per day up to 5 days; p<0.001) and discharge to a healthcare facility (0.49 (0.26 to 0.93); p=0.03). Forty-nine of 64 (77%) 5-year survivors incurred lost earnings, with average (SD) losses ranging from US

Perceived Stigma of Postpartum Depression Symptoms in Low-Risk First-Time Parents: Gender Differences in a Dual-Pathway Model

38 354 (21,533) to US

Emotional Support from Parents and In-Laws: the Roles of Gender and Contact

43 510 (25,753) per person per year. Jobless, non-retired survivors experienced a 33% decrease in private health insurance and concomitant 37% rise in government-funded coverage. Conclusions Across 5-year follow-up, nearly one-third of previously employed ARDS survivors never returned to work. Delayed return to work was associated with patient-related and intensive care unit/hospital-related factors, substantial lost earnings and a marked rise in government-funded healthcare coverage. These important consequences emphasise the need to design and evaluate vocation-based interventions to assist ARDS survivors return to work.

To thine own self be true: Impact of gender role and attitude mismatch on new mothers' mental health

Although breastfeeding has multiple benefits for baby and mother, including maternal mental well-being, many mothers terminate breastfeeding earlier than they desire. We examined two key factors in breastfeeding duration and maternal mental health––breastfeeding efficacy and family–work conflict. Specifically, we examined the moderating role of family–work conflict in the process of breastfeeding efficacy as a predictor of maternal depression by way of duration. In a sample of 61 first-time mothers, we found that breastfeeding duration mediated the relation between prenatal breastfeeding efficacy and depression at 9 months postpartum for working mothers who experienced low levels of family-to-work conflict. That is, for mothers with low family-to-work conflict, higher expected breastfeeding efficacy during pregnancy predicted a longer duration of breastfeeding, which in turn was associated with lower depression at 9 months postpartum. However, for working mothers with high family-to-work conflict, breastfeeding duration did not emerge as an indirect effect on the relation between efficacy and depression. These findings have important implications for a healthy family–work balance to help new mothers adjust when they return to the workforce and as they transition to parenthood.