Maternal functional status is important to capture in the 12 months after childbirth, as this period marks a critical window for both mother and child. In most cases, mothers are the primary caregivers and are, therefore, responsible for the majority of the work related to infant care tasks, such as feeding, diaper changes, and doctor's appointments. Additionally, the quality of mother-child interaction in the year after childbirth affects child development. To date, postpartum functioning has exacted scarce coverage, with only one instrument claiming to measure the concept explicitly. This necessitated the development of the Barkin Index of Maternal Functioning (BIMF), which was designed to measure functioning in the year after childbirth. Three focus groups comprised of 31 new mothers were held to elicit women's concept of functioning in the first postpartum year. Women were asked to discuss the responsibilities associated with new motherhood as well as the circumstances surrounding high and low functioning periods. The qualitative data produced by the focus groups were coded by emotive tone and content and translated into item construction for the BIMF, a 20-item self-report measure of functioning intended for use in the year after childbirth. Before implementation into the screening study, the BIMF was critiqued by a panel of experts and cross-checked with the literature to ensure that no major contextual domains were absent. Psychometric testing revealed adequate internal reliability and construct validity, and the BIMF has been implemented successfully in clinical settings. The high level of patient engagement and psychometric properties associated with the BIMF are indicative of its potential to become a valuable tool for assessing maternal wellness.
The relationship between maternal mental health and infant development has been established in the literature. The Neonatal Intensive Care Unit (NICU) is a particularly challenging environment for new mothers as several natural processes are disrupted. The objective of this study is to elucidate protective factors and environmental deficits associated with the NICU. The experiences of forty-six (n = 46) mothers of infants admitted to a Level III NICU in the Midwestern United States, who responded to a related open-ended question, were analyzed thematically. Five themes related to the NICU environment emerged as being either stressful or helpful: (1) amount and quality of communication with medical staff, (2) bedside manner of medical staff, (3) feeling alienated from infant’s care, (4) support from other NICU mothers and families, and (5) NICU Physical Environment and Regulations. There is a need for medical staff training on awareness, communication, empathy, and other behaviors that might improve maternal (and parental) experiences in the NICU. The physical environment, including rules and regulations of the NICU, should be reexamined with family comfort in mind in addition to the clinical care of the infant.
Extreme weather events (EWEs) are increasing in frequency and severity as the planet continues to become warmer. Resulting disasters have the potential to wreak havoc on the economy, infrastructure, family unit, and human health. Global estimates project that children will be disproportionately impacted by the changing climate – shouldering 88% of the related burdens. Exposure to EWEs in childhood is traumatic, with ramifications for mental health specifically. Symptoms of posttraumatic stress, depression, and anxiety have all been associated with childhood EWE exposure and have the potential to persist under certain circumstances. Conversely, many childhood survivors of EWE also demonstrate resilience and experience only transient symptoms. While the majority of studies are focused on the effects resulting from one specific type of disaster (hurricanes), we have synthesized the literature across the various types of EWEs. We describe psychological symptoms and behavior, the potential for long‐term effects, and potential protective factors and risk factors. What this paper adds: Climate change‐related phenomena such as extreme weather events (EWEs) have the potential to impact mood and behavior in children. Posttraumatic stress (PTS) is the most common mental health consequence in child survivors of EWEs. PTS is often comorbid with depression and/or anxiety in this group.
1 July 2014 in Journal of Obstetric, Gynecologic, & Neonatal Nursing
Assessment of mothers in the year after childbirth is important for a number of reasons, including the well-being of the mother and healthy development of the child. There exists a body of instruments that measure a range of maternal characteristics, such as maternal confidence and self-efficacy. It remains unclear if any of these assessments can be used to measure maternal functioning, which may be a direct indication of potential hazards to the offspring. Accurate assessment of functioning would also aid in identifying women who are struggling in the maternal role. In order to assess whether commonly used maternal assessments extend into the realm of functioning, it is necessary to have an appropriate definition. Therefore, the aims of this analysis are to (1) present a new, patient-centered definition of maternal functional status and (2) evaluate select maternal assessments against this definition. Three new mother focus groups were held in order to understand women's experiences in the year after childbirth. These experiences informed the definition of maternal functional status, which was used to evaluate select instruments for their capacity to assess maternal functioning. None of the instruments covered all seven domains, and all of the instruments covered at least one domain. Although there are means of assessing depression status in the postpartum, there is no comprehensive way of capturing a woman's quality of life. A new measure is required in order to capture this multifaceted, patient-defined construct of maternal functioning.