Objective To examine inter-relationships among stress due to infant appearance and behavior in the NICU, parental role alteration stress in the NICU, depressive symptoms, state anxiety, post-traumatic stress symptoms, and daily hassles exhibited by African American mothers of preterm infants and to determine whether there were sub-groups of mothers based on patterns of psychological distress. Method 177 African American mothers completed questionnaires on their psychological distress at enrollment during infant hospitalization and 2, 6, 12, 18, and 24 months after term. Results Psychological distress measures were inter-correlated. There were four latent classes of mothers: the low distress class with low scores on all measures; the high NICU-related stress class with high infant appearance and parental role stress and moderate scores on other measures; the high depressive symptoms class with high depressive symptoms and state anxiety and moderately elevated scores on NICU-related stress and post-traumatic stress symptoms; the extreme distress class with the highest means on all measures. Infants in the high stress class were sicker than infants in the other classes. The extreme distress class mothers averaged the lowest educational level. The classes differed on distress measures, worry about the child, and parenting stress through 24 months with the extreme distress class having the highest values. Conclusion Although different types of maternal psychological distress were substantially related, there were distinct sub-groups of mothers that were identifiable in the NICU. Moreover, these sub-groups continued to differ on trajectories of distress and on their perceptions of the infants and parenting through 24 months after term.

This study's purpose was to examine whether child characteristics, child illness severity, maternal characteristics, maternal psychological well-being, and paternal support influenced interactions between 108 premature infants and their mothers. Mothers with singletons or more infant illness stress showed more positive involvement. Mothers with less infant illness stress, less education, or less participation in caregiving by fathers showed more negative control. First-time mothers and mothers of singletons provided more developmental stimulation. Children of younger and White mothers showed more social behaviors. Less maternal education and shorter period of mechanical ventilation were associated with greater developmental maturity. Greater maternal worry was related to more child irritability. These findings are consistent with the developmental science view that the mother-premature relationship is a complex, reciprocal process.

The HIV symptom management intervention has potential as a case management or clinical intervention model for use by public health nurses visiting the home or by advanced practice nurses who see HIV-infected women in primary care or specialty clinics.

Life course theory, a sociological framework, was used to analyze the phenomenon of becoming a mother, with longitudinal narrative data from 34 women who gave birth prematurely after a highrisk pregnancy, and whose infant became medically fragile. Women faced challenges of mistimed birth and mothering a technologically-dependent infant. Before social ties were established, legal and biological ties required mothers to make critical decisions about their infants. Liminality characterized mothers' early involvement with their infants. The mothers worked to know, love, and establish deeper attachments to this baby. The infant's homecoming was a key turning point; it decreased liminality of early mothering, increased mothers' control of infants' care, and gave them time and place to know their infants more intimately. KeywordsAnte/intra partal/post partum care; Attachment/involvement; Birth; Parenting; Parent-child relationships; Pregnancy Nurse scholars frequently borrow theoretical frameworks from other established physical, biological, and social sciences (Munhall, 2007). Although it is important that theoretical foundations distinct to nursing research and practice are developed, the use of extant frameworks from other disciplines may offer unique insights into phenomena of interest to nurses. Life course theory is one such framework. Rooted in sociology, life course theory is congruent with nurses' holistic focus on the lives of individuals and families. The purpose of this study was to assess the usefulness of application of life course theory to the phenomenon of becoming a mother. We describe this phenomenon in women who became mothers after a high-risk pregnancy ended in preterm delivery of an infant who became medically fragile.High-risk pregnancy, a condition in which substantial risks exist to the health of the woman and the fetus, is an important predictor of infant birth outcome (Lobel, DeVincent, Kaminer, & Meyer, 2000). Medically fragile refers to infants with life-threatening chronic illness who are, at least temporarily, technology-dependent, and who have health sequelae requiring extended hospitalization or frequent rehospitalization (Miles, Holditch-Davis, Burchinal, & Nelson, 1999). We first describe the major principles and concepts of life course theory. Then we demonstrate our application of life course theory to this phenomenon. Life Course Framework: PrinciplesPrior to the development of life course theory, social scientists explained human behavior in two ways. First, a social relations approach was used to examine the effects social structures such as marriage and family had on individuals. Subcategories of this approach include functionalism, exchange theory, and ecological systems theory. Second, a temporal approach was used to examine lives that were followed or explained longitudinally . The complexities of lives, however, were not completely captured by these approaches (Giele & Elder); neither alone was adequate to explore the intricate interrelationship between social s...