Although the association between maternal gatekeeping and relationship functioning has been explored by a few studies, none of these have focused on fathers' perceptions of these constructs. Given that today's new fathers are challenged by elevated expectations for active parenting and coparenting even as most new mothers remain primary caregivers of infant children, this is a critical omission. This study examined the associations between new fathers' perceptions of maternal gatekeeping and change in dyadic adjustment as mediated through coparenting closeness. Maternal gatekeeping was reported by 182 fathers at 3 months postpartum, coparenting closeness was reported at 3 and 6 months postpartum, and dyadic adjustment was reported during the third trimester of pregnancy and at 9 months postpartum. Fathers' perceptions of relative change in coparenting closeness from 3 to 6 months mediated associations between fathers' perceptions of maternal gatekeeping at 3 months and relative change in dyadic adjustment from the third trimester to 9 months postpartum. In particular, findings indicate that greater perceived maternal gate opening was associated with higher levels of dyadic adjustment through higher levels of coparenting closeness, whereas greater perceived maternal gate closing was associated with lower levels of dyadic adjustment through lower levels of coparenting closeness. This study highlights the importance of studying fathers in the context of the family system and the role of the coparenting relationship at the transition to parenthood in couple relationship functioning.
Early diagnosis and effective use of disease-modifying and curative therapies have resulted in $93% of youth with sickle cell disease (SCD) living into adulthood with less disease morbidity. 1 Consequently, reproductive health (including fertility, contraception, and preimplantation genetic testing) is an emerging area of importance in this population. [2][3][4][5] Specifically in males with SCD, fertility can be diminished by many factors, including priapism, anemia, hypogonadism, and testicular infarction from the disease and/ or antineoplastic treatments, such as hydroxyurea. 2 Long-standing and recent research shows that semen abnormalities occur in males with SCD across the life course, including studies that show impaired semen parameters at baseline in adult males, which further decline after starting hydroxyurea 6 ; abnormal semen parameters in adolescents and young adults (AYAs) irrespective of hydroxyurea treatment 7 ; and reduced spermatogonial cell counts in prepubertal boys who received hydroxyurea. 8 National organizations (eg, the American Academy of Pediatrics) are urging providers to counsel at-risk SCD patients to optimize reproductive outcomes. 9 Experts also recommend fertility testing (ie, semen analysis) in male AYAs with SCD, 10 yet specific guidelines have not been developed. There are limited data on male AYAs with SCD and their caregivers' perspectives on providing semen samples for testing. This information is critical, as AYAs with SCD may face multiple barriers to obtaining testing and to fertility-related decision-making. AYAs with SCD frequently have poor access to health care 11-13 that may limit their opportunities to learn about and obtain testing, compromise their understanding and use of fertility information, and prevent them from getting testing that is not covered under insurance laws in many states. 14 These factors may be particularly impactful as AYAs become increasingly independent, develop life goals, and transition to adult care where they will make their own treatment decisions. 15 In this context, a small pilot study approved by Nationwide Children's Hospital's Institutional Review Board was conducted to examine knowledge and perspectives on fertility testing among male AYAs (14-21 years) with SCD and caregivers of the participating males at a large, midwestern pediatric academic medical center. English-speaking patients were approached during clinic visits and excluded if they had a preexisting developmental or cognitive deficit that would preclude their ability to independently complete electronic surveys or if they had previously undergone hematopoietic stem cell transplantation. After informed consent (assent, if ,18 years of age) was obtained, participants completed the Fertility Knowledge and Attitudes Questionnaire (FKAQ), a survey developed by the research team. The FKAQ was based on constructs from the Health Belief Model (eg, perceived risk of infertility and benefits and barriers to fertility testing) and items from prior fertility-related studies among m...
Aim Little research exists on coronavirus (COVID‐19) vaccine hesitancy among caregivers of children with cancer. We aimed to (a) describe vaccine hesitancy in parents of children with cancer for both their child and self, and (b) examine the mediating role of parent‐reported COVID impact on the association between COVID exposure and vaccine hesitancy. Procedure We conducted a national survey of parents of children with cancer via Facebook and Momcology, a pediatric cancer community‐based organization recruited February–May 2021. Parents completed standardized measures online. A series of mediation models assessed the role of COVID‐19 impact (e.g., effects on parenting and well‐being) on associations between COVID‐19 exposure (e.g., direct/indirect exposure) and vaccine hesitancy. Moderation models examined the role of treatment status, COVID‐19 exposure, impact, and vaccine hesitancy. Results Parents (n = 491; 90% mothers; 93% White) reported moderate vaccine hesitancy (M = 2.08, SD = 0.76). Specifically, 18.5% (n = 90) reported they would not vaccinate their child, and 24.4% (n = 119) would only consider vaccination. Parents expressed higher concerns about vaccine side effects for their children (M = 3.01, SD = 0.95) than for themselves (M = 2.61, SD = 1.03; t[479] = 9.07, p < .01). Mediation analysis revealed a significant indirect effect of impact (95% CI [−0.013, −0.001]) on the association between higher exposure and higher vaccine hesitancy (b = .02, p = .06). There was no moderating effect of treatment status. Income remained a significant covariate (b = −.11, p < .01). Conclusion Lower parent‐reported COVID exposure, higher COVID impact, concern for side effects, and lower income may be important factors related to vaccine hesitancy among parents of children with cancer. Providers of childhood cancer survivors should address vaccine hesitancy and potential health risks.
Half of male childhood cancer survivors experience treatment-related fertility impairment, which can lead to distress. Survivors often regret forgoing fertility preservation (FP), and decisional dissatisfaction is associated with a lower quality of life. This mixed methods study examined short-term FP decisional satisfaction among families of male adolescents newly diagnosed with cancer who received an initial fertility consult and completed an FP values clarification tool. One-two months after the FP decision, thirty-nine families completed the Brief Subjective Decision Quality measure. Decisional satisfaction was compared for participants (mothers, fathers, adolescents) who did and did not attempt to bank. Semi-structured interviews included the following question: How do you/your family feel about the banking decision now/in the future? Decisional quality scores were moderate-high (M = 5.74–6.33 out of 7), with no significant differences between non-attempter (n = 15) and attempter (n = 24) families (adolescents: p = 0.83, d = 0.08; mothers: p = 0.18, d = 0.45; fathers: p = 0.32, d = 0.44). Three qualitative themes emerged among non-attempter families: (1) satisfaction with decision (50% of participants), (2) acceptance of decision (60%), and (3) potential for future regret (40%). Satisfaction with decision was the only theme identified in attempter families (93%). Quantitively, short-term decisional satisfaction was high regardless of the banking attempt. However, the qualitative findings suggest that the experiences of families who did not bank may be more nuanced, as several participants discussed a potential for future regret, highlighting the importance of ongoing support.
Background: Approximately half of male childhood cancer survivors experience fertility impairment, which can cause psychological distress. Sperm banking remains underutilized among adolescent males with cancer. Parent recommendation influences banking decisions, yet multi-informant studies have not been conducted to examine fertility preservation (FP) communication and decision making in this population. This study explored FP communication among mothers, fathers, and their male adolescents newly diagnosed with cancer.Procedure: Thirty-three male adolescents, 32 mothers, and 22 fathers completed semi-structured interviews 1-2 months after cancer diagnosis addressing this question: Tell me more about conversations you had about fertility preservation/sperm banking with your health care providers, parents/son, other family members, or anyone else. Interviews were audio-recorded and transcribed verbatim for thematic content analysis. Results: Five process themes emerged: (1) reliance on health care team and social support networks to facilitate FP decisions (only parents); (2) withholding parental opinion and deferring the decision to the adolescent; (3) ease of communication (primarily adolescents); (4) communication barriers/facilitators; (5) not being present or not remembering details of FP conversations with health care providers (primarily fathers and adolescents). Four content themes included: (1) preference for biological (grand)parenthood; (2) consideration of adolescent's future partner's desire for Abbreviation: FP, fertility preservation.
This study examined the longitudinal associations between fathers' observed parenting behaviors and father-infant attachment (n = 58 father-infant dyads). Fathers were observed playing with their infants at 9 months postpartum and were assessed for stimulating behaviors (i.e., physical and/or object stimulation), as well as their sensitivity and intrusiveness. When the infants were 12 to 18 months of age, fathers and infants participated together in the Strange Situation Procedure (SSP) to assess father-infant attachment security. Logistic regression analyses revealed that higher levels of paternal stimulation at 9 months postpartum were associated with greater odds of classification as a secure father-infant dyad. Additionally, fathers' observed intrusiveness at 9 months postpartum moderated this association; greater paternal stimulation was associated with significantly greater odds of father-infant attachment security at low and average levels of paternal intrusiveness, but not at high levels of paternal intrusiveness. This study provides new insight into the paternal behaviors that may foster secure father-infant attachment.
The primary focus of this study was to understand obesity and depressive symptoms in college women. Using non-obese women as a contrast group, obese and non-obese women were compared on body image and psychological adjustment. Additional analyses further examined the obese women by comparing obese women with high versus low depressive symptoms. A total of 51 obese and 524 non-obese college women completed an online survey. Obese women had significantly lower body image and self-esteem and higher depressive symptoms than non-obese women. Obese women with high depressive symptoms reported more eating problems and poorer body image than obese women with low depressive symptoms. Qualitative coding identified factors linked to low depressive symptoms in obese women including: more positive histories of interpersonal relationships; resisting the internalization of weight bias; and other areas of competence taking the focus off of body image experiences. Implications of these findings for intervention design are considered.
Using data from a sample of 182 dual-earner different-gender couples who were followed across their transition to parenthood, we adopted a dyadic approach to examine associations between expectant mothers’ and fathers’ attachment anxiety and avoidance in the third trimester of pregnancy and their own and their partners’ jealousy of the partner–infant relationship at 3 months postpartum. Results of an actor–partner interdependence model (APIM) revealed that expectant mothers and fathers higher in attachment anxiety reported greater jealousy of the partner–infant relationship at 3 months postpartum. The partners of expectant mothers and fathers higher in attachment anxiety also reported greater jealousy of the partner–infant relationship. There were no parent gender differences in actor or partner paths linking attachment anxiety and jealousy. Attachment avoidance was not associated with one’s own or one’s partner’s jealousy of the partner–infant relationship. An exploratory mediation analysis revealed greater jealousy of the partner–infant relationship as a potential mechanism linking higher attachment anxiety to lower dyadic adjustment at 9 months postpartum. Overall, results suggest that attachment anxiety in either partner may precipitate maladaptive relationship dynamics in the early postpartum period that may ultimately interfere with the establishment and maintenance of healthy parent–child and coparenting relationships.
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