Anne H. Salonen

Parenting self-efficacy after childbirth.

TITLEnParenting self-efficacy after childbirth.nnnAIMnThis paper is a report of study of parent, infant and environmental correlates of mothers and fathers perceptions of their parenting self-efficacy.nnnBACKGROUNDnMany parents are not confident in their ability to be good parents. Parenting self-efficacy is important for parents sense of well-being, is a possible predictor of parenting practices and might be an indicator of risk. However, very little evidence exists on factors that influence fathers perceptions of parenting, or comparisons between the parents.nnnMETHODSnThe data were collected by questionnaire in 2006-2007 in two hospitals with a convenience sample of Finnish-speaking parents (N = 1300 families) during the first postpartum week. Multiple-birth and early-discharge parents were excluded. The response rate for mothers was 66% (n = 863) and for fathers 40% (n = 525). Comparisons were made by percentages and means. Statistical significance was determined by Generalized Estimating Equations models and one-way anova. Pearsons and Spearmans correlation coefficients were used to determine correlations, and multiple regression analysis to clarify the effect size.nnnRESULTSnMothers scored higher than fathers on parenting self-efficacy. Parity, self-concept, depressive symptoms and state of mind on discharge contributed to parenting self-efficacy. Experiences of childbirth and life change correlated with mothers, but not with fathers, parenting self-efficacy. Perceptions of infant, family functioning, health and advice from personnel were major contributory factors.nnnCONCLUSIONnAssessments of parenting self-efficacy are recommended to identify at-risk groups and at-risk parents. More research is recommended to look into the effect of rooming-in, feeding practices, fathers presence and social support from personnel and parenting self-efficacy and to evaluate risk scales for at-risk parents. Parent attributes had a greater effect on mothers parenting self-efficacy, while environmental attributes had a greater effect on fathers parenting self-efficacy. At-risk parents can be supported by conducting face-to-face discussions about significant topics.

Development of an internet-based intervention for parents of infants

AIMnThis paper reports on a study to describe the development of an internet-based intervention for parents with infants and to compare the participants and hospitals at baseline.nnnBACKGROUNDnThere is a need for interventions to support parenting and for more research into the use of information technology as an intervention strategy. The design and development of healthcare interventions is a complex task, but these are rarely discussed in research reports.nnnMETHODSnA quasi-experimental study was conducted. The data (N = 1300 families) were collected using a structured questionnaire at the hospital or no later than 1 week after discharge during the winter of 2006. The results were used to develop the intervention and to compare the participants at baseline. Statistically significant differences were determined by chi-squared or Fishers exact tests for percentages and one-way anova for means. The internal consistency relialibility of the scales was analysed using Cronbachs alpha coefficients.nnnFINDINGSnParticipants in the intervention (n = 469 mothers, n = 307 fathers) and control (n = 394 mothers, n = 218 fathers) hospitals were comparable in respect of parent and infant attributes. There were statistically significant differences between the hospitals in fathers overnight stays and their access to social support from professionals on the maternity ward. Exclusive breastfeeding was more common in the intervention hospital. More support for infants cues and behaviour, and day-rhythm and sleep were needed in the intervention hospital.nnnCONCLUSIONnMore research is needed to gain a clearer understanding of the effect size of the differences for a reliable evaluation of the effectiveness of the proposed intervention.

Effectiveness of an internet-based intervention enhancing Finnish parents' parenting satisfaction and parenting self-efficacy during the postpartum period

BACKGROUNDnThe postpartum period presents several challenges related to learning infant care tasks, getting to know the infant and fulfilling self-expectations as parents. There is a need to evaluate the effectiveness of information-technology-based interventions that support parenting during this period.nnnOBJECTIVEnTo evaluate the effectiveness of an internet-based intervention to support mothers and fathers parenting satisfaction and parenting self-efficacy (PSE).nnnDESIGNnA quasi-experimental design with a non-equivalent control group and repeated measures.nnnSETTINGnTwo public maternity hospitals (intervention/control) in southern Finland.nnnPARTICIPANTSnA convenience sample of mothers and/or fathers (n = 1300 families). The inclusion criteria were primipara or multipara, and at least one parent willing to participate. Multiple birth, non-Finnish speaking and early discharge parents receiving home visits were excluded. A total of 500 mothers and 242 fathers returned complete sets of questionnaires.nnnINTERVENTIONnThe intervention offered online support for parenting, breast feeding and infant care beginning from the middle of pregnancy. It comprised an information database, a peer discussion forum and expert advice.nnnMEASUREMENTSnOutcomes were measured by the Evaluation Subscale of the What Being the Parent of a New Baby is Like-Revised and parenting self-efficacy instruments after childbirth and six to eight weeks post partum.nnnFINDINGSnBoth intervention and control mothers parenting satisfaction and PSE increased significantly during the postpartum period. Fathers parenting satisfaction and PSE also increased, but this change was only significant in the case of PSE. Both parents felt that their affective skills related to PSE were the weakest after childbirth. During the postpartum period, affective skills improved more than cognitive and behavioural skills. Different groups of mothers and different groups of fathers showed an equally positive change in parenting satisfaction and PSE.nnnCONCLUSIONnBoth intervention and control mothers and fathers parenting satisfaction and PSE became more positive during the postpartum period. However, no intervention effects were found. In the future, it would be interesting to study longer-term effects and more specific groups of parents. The results indicate that online support has the potential to reach parents from diverse backgrounds. More research is needed on gender differences and user preferences. More interactive methods are needed to support parents affective skills related to PSE.

Parenting satisfaction during the immediate postpartum period: factors contributing to mothers' and fathers' perceptions

AIMSnTo compare mothers and fathers parenting satisfaction; to identify factors contributing to their parenting satisfaction; and to evaluate the effect of these factors.nnnBACKGROUNDnParenting satisfaction is important for parents motivation to care, nurture and interact with their child. Parenting is influenced by attributes of parent, infant and the environment. However, more research is needed to understand the contributing factors.nnnDESIGNnParenting satisfaction and several parent, infant and environment attributes were measured at hospital or in one week of discharge. A total of 2600 questionnaires were handed out to a convenience sample of Finnish speaking parents in two hospitals during the winter of 2006. Multiple-birth and early-discharge parents receiving support at home were excluded. Responses were received from 863 mothers (66%) and 525 fathers (40%).nnnMETHODSnComparisons were made by percentages and means. Significances were determined by GEE models and One Way anova tests. Pearsons and Spearmans correlations were used to determine correlations and multiple regression analysis to clarify the effect size.nnnRESULTSnMothers were more satisfied than fathers with their parenting. Self-concept, depressive symptoms, infant centrality, state of mind on discharge and perception of infant contributed most to parenting satisfaction. Family functioning, health and advice from personnel were major contributory factors as well.nnnCONCLUSIONnHospital practices and social support from personnel did not correlate with parenting satisfaction. More research is recommended to evaluate them, since they had an effect when combined with other attributes.nnnRELEVANCE TO CLINICAL PRACTICEnOur results will help professionals understand the experiences, resources and challenges faced by parents. Family-oriented care and sound advice have the potential to offer the most supportive environment for both parents. If professionals can identify mothers who are afraid, concerned or insecure during pregnancy, they can also offer them extra support before the child is born.

Impact of an internet-based intervention on Finnish mothers' perceptions of parenting satisfaction, infant centrality and depressive symptoms during the postpartum year

OBJECTIVEnthis study evaluates how an internet-based intervention affects mothers parenting satisfaction, infant centrality and depressive symptoms.nnnDESIGNna quasi-experimental design and repeated measures were used.nnnSETTINGSnthis study was conducted in two Finnish public maternity hospitals (intervention/control).nnnPARTICIPANTSna convenience sample (N=1300) of primiparous and multiparous Finnish-speaking mothers were invited to participate. Multiple-birth and early discharge mothers receiving home visits were excluded. The analysis included 760 mothers.nnnINTERVENTIONnthe intervention offered online support for parenting, breast feeding and infant care beginning from the middle of pregnancy. It consisted of an information database, a peer discussion forum and expert advice.nnnMEASUREMENTSnOutcomes were measured by the Evaluation and Infant Centrality subscales of the What Being the Parent of a New Baby is Like-Revised, and the Edinburgh Postnatal Depression Scale after childbirth, and six weeks, six months and 12 months post partum. Age, parity, parenting self-efficacy, and perception of infant and family functioning were used as the covariates.nnnFINDINGSnduring the first postpartum year, mothers parenting satisfaction increased significantly, whereas infant centrality and depressive symptoms decreased within groups. However, these changes were not linear. The mean difference between groups in parenting satisfaction and depressive symptoms was not significant within any of the four assessments. The mean difference in infant centrality between control and intervention mothers was significant only at six weeks post partum. Primiparas scored significantly higher in infant centrality and significantly lower in depressive symptoms than multiparas.nnnKEY CONCLUSION AND IMPLICATIONS FOR PRACTICEnan internet-based intervention did not significantly affect mothers perceptions of parenting satisfaction and depressive symptoms, but intervention mothers experienced higher infant centrality compared with control mothers at six weeks. Parenting self-efficacy was a significant covariate for all measures. Parity needs to be taken into account when infant centrality and depressive symptoms are used as outcome variables in intervention studies. More research is needed to study the potential of information data bank, professional, and peer online support. This study also highlights the need to pay more attention to the selection of the target population, the selection of outcome measures, and implementation issues in intervention research.

Social support provided to Finnish mothers and fathers by nursing professionals in the postnatal ward

OBJECTIVESnto evaluate the amount of social support offered to Finnish mothers and fathers by nursing professionals in the postnatal ward, identify the type of additional support that mothers and fathers desire, and analyse the factors associated with support that mothers and fathers received in the postnatal ward.nnnMETHODSndata were collected as part of a larger collaborative project called Urban Parenthood-Enhancing Well-being of Infants Families involving the well-being of families in the postnatal wards of two Finnish university hospitals during the winter of 2006-2007. Data were collected using a questionnaire designed to measure social support on a scale from 1 to 6. The questionnaire included two open-ended questions. Mothers and fathers completed the questionnaire independently, either in the postnatal ward or immediately after discharge.nnnFINDINGSnquestionnaires were returned by 863 (66%) mothers and 525 (40%) fathers. The amount of support received from nursing professionals was moderate or little. Of the three types of support, mothers and fathers experienced affectional support most strongly [mothers mean 4.12, standard deviation (SD) 1.04; fathers mean 3.98, SD 1.25] and concrete support least strongly (mothers mean 3.08, SD 1.17; fathers mean 3.03, SD 1.43). Least social support was received by parents in families where the mother was multiparous (p < 0.001) or older (p ≤ 0.001), and by fathers who were not able to stay in the ward around the clock (p < 0.001). Open-ended questions indicate that mothers and fathers desire greater social support in all its forms.nnnKEY CONCLUSIONSnhealth care during the postnatal period should be developed such that it becomes more family centred, encouraging and resource strengthening.nnnIMPLICATIONS FOR PRACTICEnAttention must be paid to the support received by older mothers and parents in families where the mother is multiparous. In addition, possibilities for fathers to participate in postnatal care must be increased.

Primiparous and multiparous mothers' perceptions of social support from nursing professionals in postnatal wards

OBJECTIVEnthe study aimed at evaluating primiparous or multiparous mothers perceptions of social support from nursing professionals (SSNP) in postnatal wards and factors associated with SSNP.nnnDESIGNna cross-sectional and correlational design was used.nnnMETHODSndata was collected in 2007-2008 in two maternity hospitals with a convenience sample of Finnish-comprehending primiparous and multiparous mothers (N=1300). Multiple-birth and early discharge mothers were excluded. The amount of SSNP including affection, affirmation and concrete aid was measured. Questionnaires were returned from 754 mothers (58%). Fishers exact test, t-test, Pearsons correlation coefficients, ordinal regression and multiple regression were used in the analyses.nnnFINDINGSnmothers perceived the amount of SSNP as moderate. The amount of affirmational support was perceived as the highest compared with concrete and affectional support. Multiparas received statistically significantly less concrete aid compared with primiparas. The number of mother- and infant-related factors was substantial and their association was stronger among primiparas. Depressive symptoms were a significant factor among multiparas. Advice from nursing professionals, parenting self-efficacy, mothers age and infant age explained 54.0% of the variation in SSNP for primiparas. Correspondingly, advice from nursing professionals, state of mind on hospital discharge and family functioning explained 49.3% of the variation in SSNP for multiparas.nnnKEY CONCLUSION AND IMPLICATIONS FOR PRACTICEnprimiparas that are vulnerable for a scarce amount of SSNP were easier to recognise on the basis of their background information, infant characteristics, childbirth-related factors, and sense of efficacy. Challenges lie in taking into account the whole family, especially among multiparas, and in developing professionals guidance skills. Among primiparas the model of postpartum care may matter. Our results give professionals a better understanding of the resources and challenges faced by mothers in order to develop postnatal SSNP.