Carolina Digital Repository (University of North Carolina at Chapel Hill), 2009
Objective-To describe the development and evaluation of an observation system to assess the proce... more Objective-To describe the development and evaluation of an observation system to assess the process of mother-infant feeding interaction relevant to infant neuro-behavioral regulation: the Mother-Infant Feeding Tool. Design-Secondary analysis. Setting-Special care nursery just before discharge and in the home at 1 and 4 months postterm age. Participants-Forty-three mother-infant dyads. Methods-Videotaped feeding interactions were examined to assess regulatory processes of mother-infant interaction. Data were collected at three times over the infant's first 4 postterm months: before the infant's discharge from the special care nursery and at 1 and 4 months postterm age in the home. Results-Across all three data points mothers rarely talked to their infants. Conclusion-Further testing is needed, but the Mother-Infant Feeding Tool shows promise in assessing very early mother-infant feeding interactions.
The responses to a survey questionnaire of families who used three family practice residency mode... more The responses to a survey questionnaire of families who used three family practice residency model clinics for obstetric care were examined to determine their perceptions of the usefulness and adequacy of the preparation they received for childbearing and infant care. In this study, variables that often are assumed to be related to adequacy of information, such as parity, attendance at prenatal and in-hospital classes, rooming in, rest, privacy, visitors, and opportunity to ask questions, were also assessed. The educational resource that was rated highest by parents was prenatal discussion with the physician. Ninety-four percent of the respondents reported that clinicians answered their questions adequately. However, for 5 of the 11 issues pertaining to an aspect of family functioning, preparation was rated as inadequate by 40 to 50 percent of the mothers. The only variables that were significantly related to the mean adequacy-of-preparation score were amounts of rest and privacy as well as the opportunity as perceived by the mother to ask questions of clinicians. Furthermore, multiparous and primiparous parents did not differ significantly in the extent to which they perceived themselves to be prepared for infant care.
The meaning for mothers of having an infant was explored during the first 3 months using Lewin's ... more The meaning for mothers of having an infant was explored during the first 3 months using Lewin's life space concept in terms of four aspects: (a) encountered change, (b) desired change, (c) difficult things, and (d) satisfying things. The influence of parental experience (time since the infant's birth and parity of the mother) on these aspects was examined. The 83 mothers of healthy newborns responded to the open-ended items of a questionnaire at approximately 7, 30, and 90 days. Themes or categories of responses were grouped into topical classes for analysis. Initially desired change concerned both reality-bound circumstances and maternal qualities, but later primarily the former. Although some infant care tasks were difficult things and others satisfying, the infant's growth, development, and interaction were clearly satisfying. The effects of both time and parity varied with the aspect and class of meaning assessed. Meaning for primiparous mothers may have more to do with sense of self than it does for multiparous mothers. Other factors that may influence meaning, including social-economic status, should be examined.
Although the literature reports the birth of a baby to be a time of stress for parents, their day... more Although the literature reports the birth of a baby to be a time of stress for parents, their day-to-day experience with the baby in the early months is an understudied area. In this study logs were kept by 62 mothers of newborns (38 primiparas and 24 multiparas), who identified approximately 9,800 issues noted during their babies's first 91 days as well as help used in problem solving. Mothers described their days by recording stressors and supports. Although the perceptions of mothers regarding life with their infants was highly variable from mother to mother, pattern and consistency were demonstrated. Categories of issues changing significantly in frequency over time included development, baby care, parenting, stressors, and illness, the latter dropping steadily across the baby's first three months. Approximately 6 percent of the issues concerned the mother herself in relation to the baby. Illness was the reason for 42 percent of the occasions of help seeking, with clinicians (family physicians and nurses) providing 62 percent of this help. Mothers reported as many supports as stressors and identified both stressors and supports in all categories, using the same set of categories for both. Parity did not influence numbers of issues reported. Primiparas sought help about 1.5 times as frequently as did multiparas.
The ‘What Being the Parent of a New Baby is Like-Revised’ (WPL-R) is an instrument designed to me... more The ‘What Being the Parent of a New Baby is Like-Revised’ (WPL-R) is an instrument designed to measure adaptation to parenthood. In the process of pilot testing and validating the WPL-R in a postpartum Dutch population, we became aware of the potentially sensitive nature of the measure. Despite the ethics committee waiving the invasive nature of the measure, we conducted a survey to explore its possible effect on women’s thoughts and emotions by using the Positive And Negative Affect Schedule (PANAS) to measure changes associated with completion of the WPL-R. Two hundred and fifteen questionnaires were returned. Our findings indicated a change in PANAS scores, implying an intervening effect when using the WPL-R, in research. This raises the question of whether it is acceptable to use a questionnaire with postpartum women without any knowledge of the possible effect it may have, even though the ethics committee has approved the study and considers the measure to be non-invasive.
Decision rules used by mothers to determine actions for tasks and events of infant feeding were d... more Decision rules used by mothers to determine actions for tasks and events of infant feeding were described and factors contributing to their use (mothers' functions in regulating the feeding, maternal experience, and feeding method) were explored. A telephone interview surveyed 122 mothers of healthy term infants 14-60 days old. Both Decision Rules and Regulating Function (Maternal-, Infant-, or Mutual-Regulation) varied by feeding task or event examined. Decision Rules and Regulating Functions were associated only for burping during a feeding. Maternal experience (primiparity, multiparity) was not associated with either Decision Rule or Regulating Functions. For several feeding tasks or events, Decision Rule was more likely to be predicted by Regulating Function when feeding method (breast, bottle) was controlled. A mother's agenda for the feeding may be an important component of her internal working model of infant feeding and a factor in making decisions for action.
Journal for Specialists in Pediatric Nursing, Jan 6, 2010
PURPOSE-The purpose of this paper is to examine nursing's contribution to understanding the paren... more PURPOSE-The purpose of this paper is to examine nursing's contribution to understanding the parent-adolescent and the teen parent-child relationships. CONCLUSION-Relationships between parents and adolescents may reflect turmoil and affect adolescents' health and development. The social and developmental contexts for teen parenting are powerful and may need strengthening. Several interventions to help teen mothers interact sensitively with their infants have been developed and tested. PRACTICE IMPLICATIONS-Nurse researchers have begun to provide evidence for practitioners to use in caring for families of adolescents and teen parents to acquire interaction skills that, in turn, may promote optimal health and development of the child. Search terms Nursing; object attachment; parent-child relations; parenting; parents This paper is the fifth in a series of papers published in this journal to examine nursing's contribution to knowledge development about the parent-child relationship. The overall purpose of this integrative review series is to explore published nursing scholarship concerning the parent-child relationship. In this paper, we aim to (a) examine nursing research approaches to the study of parent-child relationships between parents and adolescents, and teens who become parents; (b) critique the substantive and methodological aspects of nursing scholarship about parent-child relationships; and (c) identify directions for future nursing research. The topic, parent-child relationships, is vast, with considerable contribution from many disciplines. Nursing's contribution to knowledge development has not been captured and highlighted. What
This study examined the feeding issues that parents of 11 children with bronchopulmonary dysplasi... more This study examined the feeding issues that parents of 11 children with bronchopulmonary dysplasia (BPD) identified and explored the informational bases or criteria for decisions to initiate, continue, and/or terminate the feeding. An oral feeding by the parents was videotaped and replayed to assist in interviewing the parents regarding the decisions they had made during the feeding. Six types of feeding issues were identified. The smoothness or amenability of the child's feeding behavior was most frequently expressed as important, and about half of the parents mentioned the child's dietary intake as an issue. Most parents consistently tried to maintain the child's eating and to achieve a predetermined amount of nutritional intake. Over half the parents were concerned about adequacy of the child's nutrition, and many were concerned about their child's acceptance of or resistance to food. Parents did not express concern about their child's development but were concerned about their child's somatic growth. Parents' concern about feeding behaviors requires joint problem-solving by nurses and parents. Whether use of decision criteria that refer to the child's behavior rather than a predetermined amount of food is possible for parents and likely to contribute to reduced vomiting and resistive behavior and increased dietary intake needs further study.
Journal for Specialists in Pediatric Nursing, Oct 1, 2009
PURPOSE-Understanding the parent-child relationship is fundamental to nursing of children and fam... more PURPOSE-Understanding the parent-child relationship is fundamental to nursing of children and families. The purpose of this integrative review is to explore nursing scholarship published from 1980-2008 concerning parent-child relationships. Study approaches are examined, critiqued, and future directions for research identified. CONCLUSIONS-A historical review of nursing research is presented and methods described as an introduction to a review series of the parent-child relationship. IMPLICATIONS-Definition and explication of the parent-child relationship is a first-step in understanding factors amenable to nursing intervention. A clear definition of the concept of parentchild relationship will support further study using appropriate theoretical frameworks, and enable development and testing of supportive nursing interventions. Search terms Nursing; object attachment; parents; parent-child relations; parenting Understanding the parent-child relationship is fundamental to nursing of children and families (Blake, 1954). Since Florence Blake's seminal work, The Child, His Parents and the Nurse, and the case studies that Blake or her students published, pediatric nursing scholarship has emphasized the parent-child relationship as the context in which parenting occurs and the child's health and development is supported. Understanding this relationship was vital, Blake maintained, to understanding the child's challenges in dealing with health problems and to supporting the child in negotiating developmental tasks and becoming competent in all aspects of functioning within the context of those problems. This idea, some 50 years after Blake expressed it, continues to garner support from developmental and social science research. The
Journal for Specialists in Pediatric Nursing, Oct 1, 2009
PURPOSE-The purpose of this integrative review is to systematically and critically synthesize nur... more PURPOSE-The purpose of this integrative review is to systematically and critically synthesize nursing scholarship on parents' perspectives of the parent-child relationship during infancy. CONCLUSION-Research has shown that the process of establishing the parent-child relationship is highly individualized and complex. Numerous barriers and facilitators influencing this relationship have been identified that are relevant to nursing. PRACTICE IMPLICATIONS-Nurses have an important opportunity to positively affect the developing parent-infant relationship. Screening parents for depression and providing parents with resources and support are key nursing interventions supporting the parent-infant relationship. Search terms Nursing; object attachment; parents; parent-child relation; parent-infant relation; parenting Parental perceptions of parenting and the parent-child relationship have been an early and ongoing focus of nursing research. Across disciplines, the impact of events that occur during infancy on child development is debated, with some arguing for the importance of early events and others against (Bornstein, 2002). Regardless of whether events in infancy are perceived as foundational or not, the parenting of infants is viewed as integral to the development and cultivation of family relationships. Further, infants depend on their parents for survival in a way unlike that of all other developmental stages, which both engages and challenges parents. The parent-child relationship refers to the connection between parent and child and includes attributes such as closeness, influence, attachment, and investment. Our conceptualization of
Research and Theory for Nursing Practice, May 1, 2023
Background and Purpose:Parents of an infant with complex congenital heart disease report caregivi... more Background and Purpose:Parents of an infant with complex congenital heart disease report caregiving challenges in the infant’s first half year. We studied the issues parent dyads (mothers and fathers) were dealing with and their effect on their coparenting competencies in interactive problem-solving.Methods:The issues 31 parent dyads identified for interactive problem-solving at either or both infants aged 2 and 6 months were typed as caregiving or relational/support. The parent dyad’s interactive competencies were assessed from video recording for two types of tasks (i.e., caregiving and the parent dyad’s relationship as caregivers). Constructs of Iowa Family Interaction Rating Scales were applied to assess the competencies of mothers, fathers, and the parent dyad for a group that received guided participation (n= 17) and a group that received usual care (n= 8).Results:Pie charts showed feeding, most frequently identified for interactive problem-solving at 2 months, was surpassed at 6 months by growth and development. The time parents spent together was the most mentioned relationship issue at 2 and 6 months. Forest plots showed caregiving issues were associated with at least medium effect sizes for dyadic problem-solving for both parents at 2 and 6 months and for problem-solving for fathers at 2 and 6 months. Relational/support issues were associated with higher hostility and communication hindering than caregiving issues.Implications for Practice:Intervention to aid parents in interactive problem-solving for both caregiving and relationship/support issues merits development and testing.
Background and Purpose:Parents’ competencies in coparenting are critical to adaptive and competen... more Background and Purpose:Parents’ competencies in coparenting are critical to adaptive and competent caregiving of an infant with complex congenital heart disease. To date, feasible interventions to support parents in working together—coparenting—for caregiving of these infants have not been developed and systematically examined. The purpose of this feasibility study was to examine the efficacy of the participatory teaching/learning intervention, Guided Participation (GP) on parent dyads’ competencies in interactive problem-solving tasks in preparation for a randomized controlled trial.Methods:Nurse guides used GP to support mother and father couples in developing coparenting competencies through the first 6 months after birth. Couples, enrolled from two regional heart centers, were randomly assigned either to the usual care group (n= 10) or the GP group (n= 24). Intervention involved nurse guided GP in hospital and, following the infant’s discharge, monthly telephone GP sessions betw...
Background and PurposeParents’ communication and problem-solving interaction with each other and ... more Background and PurposeParents’ communication and problem-solving interaction with each other and with clinicians influences the caregiving of infants with a chronic health problem, making in-depth study of this interaction critical for design of interventions to support caregiving. This study, however, has been severely limited by lack of observational methods that can be applied in home, clinic and community settings. The Iowa Family Interaction Rating Scales provide comprehensive description of communicative and problem-solving behavior and emotion, but have only been applied to video-recorded interaction. Audio recording, in contrast to video recording, has the advantage of being unobtrusive, readily accessible, and generally acceptable, increasing the opportunity for focused examination and intervention of parents’ interaction with each other or with clinicians. Our study objective was to examine the agreement of scores obtained on parents’ interactive problem-solving behavior c...
Background: Controlling feeding practices are associated with negative child eating behaviors and... more Background: Controlling feeding practices are associated with negative child eating behaviors and an increased risk of obesity. Parental stress may be related to feeding practices. Children with developmental disabilities have increased obesity prevalence, and families may also experience increased stress. This study examined the relationship between family stress and parental feeding practices in children with developmental disabilities and how concern for the child's weight may moderate this relationship. Methods: Secondary analysis using a descriptive cross-sectional design was employed. Parents of children aged 5 to 15 years, with autism spectrum disorder (ASD), Down syndrome (DS), or spina bifida (SB) were recruited nationally. Demographics, the Child Feeding Questionnaire, and the Questionnaire on Resources and Stress were completed online. Analysis included regression with an empirical Bayesian effects model. Results: Five hundred twenty-three parents, 186 (ASD), 173 (DS)...
Carolina Digital Repository (University of North Carolina at Chapel Hill), 2009
Objective-To describe the development and evaluation of an observation system to assess the proce... more Objective-To describe the development and evaluation of an observation system to assess the process of mother-infant feeding interaction relevant to infant neuro-behavioral regulation: the Mother-Infant Feeding Tool. Design-Secondary analysis. Setting-Special care nursery just before discharge and in the home at 1 and 4 months postterm age. Participants-Forty-three mother-infant dyads. Methods-Videotaped feeding interactions were examined to assess regulatory processes of mother-infant interaction. Data were collected at three times over the infant's first 4 postterm months: before the infant's discharge from the special care nursery and at 1 and 4 months postterm age in the home. Results-Across all three data points mothers rarely talked to their infants. Conclusion-Further testing is needed, but the Mother-Infant Feeding Tool shows promise in assessing very early mother-infant feeding interactions.
The responses to a survey questionnaire of families who used three family practice residency mode... more The responses to a survey questionnaire of families who used three family practice residency model clinics for obstetric care were examined to determine their perceptions of the usefulness and adequacy of the preparation they received for childbearing and infant care. In this study, variables that often are assumed to be related to adequacy of information, such as parity, attendance at prenatal and in-hospital classes, rooming in, rest, privacy, visitors, and opportunity to ask questions, were also assessed. The educational resource that was rated highest by parents was prenatal discussion with the physician. Ninety-four percent of the respondents reported that clinicians answered their questions adequately. However, for 5 of the 11 issues pertaining to an aspect of family functioning, preparation was rated as inadequate by 40 to 50 percent of the mothers. The only variables that were significantly related to the mean adequacy-of-preparation score were amounts of rest and privacy as well as the opportunity as perceived by the mother to ask questions of clinicians. Furthermore, multiparous and primiparous parents did not differ significantly in the extent to which they perceived themselves to be prepared for infant care.
The meaning for mothers of having an infant was explored during the first 3 months using Lewin's ... more The meaning for mothers of having an infant was explored during the first 3 months using Lewin's life space concept in terms of four aspects: (a) encountered change, (b) desired change, (c) difficult things, and (d) satisfying things. The influence of parental experience (time since the infant's birth and parity of the mother) on these aspects was examined. The 83 mothers of healthy newborns responded to the open-ended items of a questionnaire at approximately 7, 30, and 90 days. Themes or categories of responses were grouped into topical classes for analysis. Initially desired change concerned both reality-bound circumstances and maternal qualities, but later primarily the former. Although some infant care tasks were difficult things and others satisfying, the infant's growth, development, and interaction were clearly satisfying. The effects of both time and parity varied with the aspect and class of meaning assessed. Meaning for primiparous mothers may have more to do with sense of self than it does for multiparous mothers. Other factors that may influence meaning, including social-economic status, should be examined.
Although the literature reports the birth of a baby to be a time of stress for parents, their day... more Although the literature reports the birth of a baby to be a time of stress for parents, their day-to-day experience with the baby in the early months is an understudied area. In this study logs were kept by 62 mothers of newborns (38 primiparas and 24 multiparas), who identified approximately 9,800 issues noted during their babies's first 91 days as well as help used in problem solving. Mothers described their days by recording stressors and supports. Although the perceptions of mothers regarding life with their infants was highly variable from mother to mother, pattern and consistency were demonstrated. Categories of issues changing significantly in frequency over time included development, baby care, parenting, stressors, and illness, the latter dropping steadily across the baby's first three months. Approximately 6 percent of the issues concerned the mother herself in relation to the baby. Illness was the reason for 42 percent of the occasions of help seeking, with clinicians (family physicians and nurses) providing 62 percent of this help. Mothers reported as many supports as stressors and identified both stressors and supports in all categories, using the same set of categories for both. Parity did not influence numbers of issues reported. Primiparas sought help about 1.5 times as frequently as did multiparas.
The ‘What Being the Parent of a New Baby is Like-Revised’ (WPL-R) is an instrument designed to me... more The ‘What Being the Parent of a New Baby is Like-Revised’ (WPL-R) is an instrument designed to measure adaptation to parenthood. In the process of pilot testing and validating the WPL-R in a postpartum Dutch population, we became aware of the potentially sensitive nature of the measure. Despite the ethics committee waiving the invasive nature of the measure, we conducted a survey to explore its possible effect on women’s thoughts and emotions by using the Positive And Negative Affect Schedule (PANAS) to measure changes associated with completion of the WPL-R. Two hundred and fifteen questionnaires were returned. Our findings indicated a change in PANAS scores, implying an intervening effect when using the WPL-R, in research. This raises the question of whether it is acceptable to use a questionnaire with postpartum women without any knowledge of the possible effect it may have, even though the ethics committee has approved the study and considers the measure to be non-invasive.
Decision rules used by mothers to determine actions for tasks and events of infant feeding were d... more Decision rules used by mothers to determine actions for tasks and events of infant feeding were described and factors contributing to their use (mothers' functions in regulating the feeding, maternal experience, and feeding method) were explored. A telephone interview surveyed 122 mothers of healthy term infants 14-60 days old. Both Decision Rules and Regulating Function (Maternal-, Infant-, or Mutual-Regulation) varied by feeding task or event examined. Decision Rules and Regulating Functions were associated only for burping during a feeding. Maternal experience (primiparity, multiparity) was not associated with either Decision Rule or Regulating Functions. For several feeding tasks or events, Decision Rule was more likely to be predicted by Regulating Function when feeding method (breast, bottle) was controlled. A mother's agenda for the feeding may be an important component of her internal working model of infant feeding and a factor in making decisions for action.
Journal for Specialists in Pediatric Nursing, Jan 6, 2010
PURPOSE-The purpose of this paper is to examine nursing's contribution to understanding the paren... more PURPOSE-The purpose of this paper is to examine nursing's contribution to understanding the parent-adolescent and the teen parent-child relationships. CONCLUSION-Relationships between parents and adolescents may reflect turmoil and affect adolescents' health and development. The social and developmental contexts for teen parenting are powerful and may need strengthening. Several interventions to help teen mothers interact sensitively with their infants have been developed and tested. PRACTICE IMPLICATIONS-Nurse researchers have begun to provide evidence for practitioners to use in caring for families of adolescents and teen parents to acquire interaction skills that, in turn, may promote optimal health and development of the child. Search terms Nursing; object attachment; parent-child relations; parenting; parents This paper is the fifth in a series of papers published in this journal to examine nursing's contribution to knowledge development about the parent-child relationship. The overall purpose of this integrative review series is to explore published nursing scholarship concerning the parent-child relationship. In this paper, we aim to (a) examine nursing research approaches to the study of parent-child relationships between parents and adolescents, and teens who become parents; (b) critique the substantive and methodological aspects of nursing scholarship about parent-child relationships; and (c) identify directions for future nursing research. The topic, parent-child relationships, is vast, with considerable contribution from many disciplines. Nursing's contribution to knowledge development has not been captured and highlighted. What
This study examined the feeding issues that parents of 11 children with bronchopulmonary dysplasi... more This study examined the feeding issues that parents of 11 children with bronchopulmonary dysplasia (BPD) identified and explored the informational bases or criteria for decisions to initiate, continue, and/or terminate the feeding. An oral feeding by the parents was videotaped and replayed to assist in interviewing the parents regarding the decisions they had made during the feeding. Six types of feeding issues were identified. The smoothness or amenability of the child's feeding behavior was most frequently expressed as important, and about half of the parents mentioned the child's dietary intake as an issue. Most parents consistently tried to maintain the child's eating and to achieve a predetermined amount of nutritional intake. Over half the parents were concerned about adequacy of the child's nutrition, and many were concerned about their child's acceptance of or resistance to food. Parents did not express concern about their child's development but were concerned about their child's somatic growth. Parents' concern about feeding behaviors requires joint problem-solving by nurses and parents. Whether use of decision criteria that refer to the child's behavior rather than a predetermined amount of food is possible for parents and likely to contribute to reduced vomiting and resistive behavior and increased dietary intake needs further study.
Journal for Specialists in Pediatric Nursing, Oct 1, 2009
PURPOSE-Understanding the parent-child relationship is fundamental to nursing of children and fam... more PURPOSE-Understanding the parent-child relationship is fundamental to nursing of children and families. The purpose of this integrative review is to explore nursing scholarship published from 1980-2008 concerning parent-child relationships. Study approaches are examined, critiqued, and future directions for research identified. CONCLUSIONS-A historical review of nursing research is presented and methods described as an introduction to a review series of the parent-child relationship. IMPLICATIONS-Definition and explication of the parent-child relationship is a first-step in understanding factors amenable to nursing intervention. A clear definition of the concept of parentchild relationship will support further study using appropriate theoretical frameworks, and enable development and testing of supportive nursing interventions. Search terms Nursing; object attachment; parents; parent-child relations; parenting Understanding the parent-child relationship is fundamental to nursing of children and families (Blake, 1954). Since Florence Blake's seminal work, The Child, His Parents and the Nurse, and the case studies that Blake or her students published, pediatric nursing scholarship has emphasized the parent-child relationship as the context in which parenting occurs and the child's health and development is supported. Understanding this relationship was vital, Blake maintained, to understanding the child's challenges in dealing with health problems and to supporting the child in negotiating developmental tasks and becoming competent in all aspects of functioning within the context of those problems. This idea, some 50 years after Blake expressed it, continues to garner support from developmental and social science research. The
Journal for Specialists in Pediatric Nursing, Oct 1, 2009
PURPOSE-The purpose of this integrative review is to systematically and critically synthesize nur... more PURPOSE-The purpose of this integrative review is to systematically and critically synthesize nursing scholarship on parents' perspectives of the parent-child relationship during infancy. CONCLUSION-Research has shown that the process of establishing the parent-child relationship is highly individualized and complex. Numerous barriers and facilitators influencing this relationship have been identified that are relevant to nursing. PRACTICE IMPLICATIONS-Nurses have an important opportunity to positively affect the developing parent-infant relationship. Screening parents for depression and providing parents with resources and support are key nursing interventions supporting the parent-infant relationship. Search terms Nursing; object attachment; parents; parent-child relation; parent-infant relation; parenting Parental perceptions of parenting and the parent-child relationship have been an early and ongoing focus of nursing research. Across disciplines, the impact of events that occur during infancy on child development is debated, with some arguing for the importance of early events and others against (Bornstein, 2002). Regardless of whether events in infancy are perceived as foundational or not, the parenting of infants is viewed as integral to the development and cultivation of family relationships. Further, infants depend on their parents for survival in a way unlike that of all other developmental stages, which both engages and challenges parents. The parent-child relationship refers to the connection between parent and child and includes attributes such as closeness, influence, attachment, and investment. Our conceptualization of
Research and Theory for Nursing Practice, May 1, 2023
Background and Purpose:Parents of an infant with complex congenital heart disease report caregivi... more Background and Purpose:Parents of an infant with complex congenital heart disease report caregiving challenges in the infant’s first half year. We studied the issues parent dyads (mothers and fathers) were dealing with and their effect on their coparenting competencies in interactive problem-solving.Methods:The issues 31 parent dyads identified for interactive problem-solving at either or both infants aged 2 and 6 months were typed as caregiving or relational/support. The parent dyad’s interactive competencies were assessed from video recording for two types of tasks (i.e., caregiving and the parent dyad’s relationship as caregivers). Constructs of Iowa Family Interaction Rating Scales were applied to assess the competencies of mothers, fathers, and the parent dyad for a group that received guided participation (n= 17) and a group that received usual care (n= 8).Results:Pie charts showed feeding, most frequently identified for interactive problem-solving at 2 months, was surpassed at 6 months by growth and development. The time parents spent together was the most mentioned relationship issue at 2 and 6 months. Forest plots showed caregiving issues were associated with at least medium effect sizes for dyadic problem-solving for both parents at 2 and 6 months and for problem-solving for fathers at 2 and 6 months. Relational/support issues were associated with higher hostility and communication hindering than caregiving issues.Implications for Practice:Intervention to aid parents in interactive problem-solving for both caregiving and relationship/support issues merits development and testing.
Background and Purpose:Parents’ competencies in coparenting are critical to adaptive and competen... more Background and Purpose:Parents’ competencies in coparenting are critical to adaptive and competent caregiving of an infant with complex congenital heart disease. To date, feasible interventions to support parents in working together—coparenting—for caregiving of these infants have not been developed and systematically examined. The purpose of this feasibility study was to examine the efficacy of the participatory teaching/learning intervention, Guided Participation (GP) on parent dyads’ competencies in interactive problem-solving tasks in preparation for a randomized controlled trial.Methods:Nurse guides used GP to support mother and father couples in developing coparenting competencies through the first 6 months after birth. Couples, enrolled from two regional heart centers, were randomly assigned either to the usual care group (n= 10) or the GP group (n= 24). Intervention involved nurse guided GP in hospital and, following the infant’s discharge, monthly telephone GP sessions betw...
Background and PurposeParents’ communication and problem-solving interaction with each other and ... more Background and PurposeParents’ communication and problem-solving interaction with each other and with clinicians influences the caregiving of infants with a chronic health problem, making in-depth study of this interaction critical for design of interventions to support caregiving. This study, however, has been severely limited by lack of observational methods that can be applied in home, clinic and community settings. The Iowa Family Interaction Rating Scales provide comprehensive description of communicative and problem-solving behavior and emotion, but have only been applied to video-recorded interaction. Audio recording, in contrast to video recording, has the advantage of being unobtrusive, readily accessible, and generally acceptable, increasing the opportunity for focused examination and intervention of parents’ interaction with each other or with clinicians. Our study objective was to examine the agreement of scores obtained on parents’ interactive problem-solving behavior c...
Background: Controlling feeding practices are associated with negative child eating behaviors and... more Background: Controlling feeding practices are associated with negative child eating behaviors and an increased risk of obesity. Parental stress may be related to feeding practices. Children with developmental disabilities have increased obesity prevalence, and families may also experience increased stress. This study examined the relationship between family stress and parental feeding practices in children with developmental disabilities and how concern for the child's weight may moderate this relationship. Methods: Secondary analysis using a descriptive cross-sectional design was employed. Parents of children aged 5 to 15 years, with autism spectrum disorder (ASD), Down syndrome (DS), or spina bifida (SB) were recruited nationally. Demographics, the Child Feeding Questionnaire, and the Questionnaire on Resources and Stress were completed online. Analysis included regression with an empirical Bayesian effects model. Results: Five hundred twenty-three parents, 186 (ASD), 173 (DS)...
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Papers by Karen Pridham