Anxiety, Depression, and Hostility In Mothers of Preterm Infants

Brooten, Dorothy; Gennaro, Susan; Brown, LC; Butts, Priscilla; Gibbons, Ann; Bakewell-Sachs, Susan; Kumar, Sunil

doi:10.1097/00006199-198807000-00008

Cited by 109 publications

(72 citation statements)

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“…It can be both a consequence and a cause of drug use. In these analyses, prematurity was controlled because maternal psychological distress has been found to be related to infant prematurity (Blumberg, 1985;Brooten et al, 1988;Singer, Bruening, Davillier, Hawkins, & Yamashita, 1996).…”

Section: Data Analysesmentioning

confidence: 99%

“…Each outcome variable (MDI or PDI score), was regressed first on age of child at Step 1 test because age at test had been shown to relate to MDI in the correlation analyses. Infant gestational age was controlled on Step 2 because of its relationship to prematurity in prior studies (Brooten et al, 1988;Singer, Davillier, Bruening, Hawkins, & Yamashita, 1996). The GSI scores, the summary distress measure from the BSI, was entered on the third step to assess the effects of severity of maternal psychological distress symptoms.…”

Section: Effects Of Maternal Distress and Drug Exposure On Outcomementioning

confidence: 99%

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Relationship of prenatal cocaine exposure and maternal postpartum psychological distress to child developmental outcome

et al. 1997

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Maternal cocaine use during pregnancy can affect the infant directly through toxic effects or indirectly through cocaine's influence on maternal psychological status. We followed 160 cocaine exposed and 56 nonexposed infants and their mothers identified at birth through interview and/or urine screen. Although cocaine exposure defined the groups, infant exposure to alcohol, marijuana, and tobacco was allowed to vary. Infants were 99% African American and poor. All mothers completed the Brief Symptom Inventory (BSI) and infants were given the Bayley Scales of Mental (MDI) and Motor (PDI) Development at a mean corrected age of 17 ± 8 months. Both MDIs (94 ± 17 vs. 103 ± 16) and PDIs (101 ± 16 vs. 108 ± 12) were lower for cocaine exposed infants. Psychological distress was greater in cocaine using mothers. Hierarchical multiple regression was used to assess the relative effects of gestational age, maternal psychological distress, and cocaine and polydrug exposure on infant outcomes. Both psychological distress and cocaine and alcohol exposure predicted lower MDIs after controlling for prematurity. Neither psychological distress nor alcohol exposure predicted motor outcome, while cocaine had a significant effect. Tobacco and marijuana exposure were unrelated to outcome. These findings provide further support for direct effects of cocaine and alcohol on infant development, as well as highlight the need for studies to document maternal psychological factors, which may increase child risk for poorer outcomes.

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Section: Data Analysesmentioning

confidence: 99%

Section: Effects Of Maternal Distress and Drug Exposure On Outcomementioning

confidence: 99%

Relationship of prenatal cocaine exposure and maternal postpartum psychological distress to child developmental outcome

et al. 1997

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“…The mothers apparently had not retained sufficient knowledge to act upon it or they were too anxious to try. Analysis of the data on maternal anxiety (Brooten, Gennaro et al, 1988) showed that maternal anxiety was highest the week the infant was born and the week of infant discharge when much of the discharge teaching and return demonstration had occurred. The effect of high anxiety on retention of information helped to explain the problem these mothers were experiencing.…”

mentioning

confidence: 99%

Lessons Learned from Testing the Quality Cost Model of Advanced Practice Nursing (APN) Transitional Care

Brooten¹,

Naylor²,

York³

et al. 2002

J of Nursing Scholarship

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110

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Purpose-To describe the development, testing, modification, and results of the Quality Cost Model of Advanced Practice Nurses (APNs) Transitional Care on patient outcomes and health care costs in the United States over 22 years, and to delineate what has been learned for nursing education, practice, and further research.Organizing Construct-The Quality Cost Model of APN Transitional Care.Methods-Review of published results of seven randomized clinical trials with very low birthweight (VLBW) infants; women with unplanned cesarean births, high risk pregnancies, and hysterectomy surgery; elders with cardiac medical and surgical diagnoses and common diagnostic related groups (DRGs); and women with high risk pregnancies in which half of physician prenatal care was substituted with APN care. Ongoing work with the model is linking the process of APN care with the outcomes and costs of care. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptFindings-APN intervention has consistently resulted in improved patient outcomes and reduced health care costs across groups. Groups with APN providers were rehospitalized for less time at less cost, reflecting early detection and intervention. Optimal number and timing of postdischarge home visits and telephone contacts by the APNs and patterns of rehospitalizations and acute care visits varied by group.Conclusions-To keep people well over time, APNs must have depth of knowledge and excellent clinical and interpersonal skills that are the hallmark of specialist practice, an in-depth understanding of systems and how to work within them, and sufficient patient contact to effect positive outcomes at low cost. Keywordsadvanced practice nurses; Quality Cost Model; transitional care; costs; outcomes Dramatic changes in health care have occurred over the past 2 decades resulting in merged health systems, shortened hospital stays, rapid growth of outpatient and home care services and changed systems of reimbursement (Lesser & Ginsburg, 2001). The goal is to provide the most effective health care services at the lowest cost. Examining the effectiveness of health care providers has accompanied these changes. Today's data-driven health care systems require that provider practices are based on evidence and that provider time and number of patient contacts be justified (Delaney, Reed, & Clarke, 2000).In 1980, responding to changes occurring in health care, a team of researchers at the University of Pennsylvania developed a model of transitional care delivered by advanced practice nurses (APNs) that could serve as a safety net for vulnerable patient groups being discharged early from hospitals; this approach might maintain quality care and reduce health care costs . Since 1980 research with this model of care has been conducted in two phases. The first phase, which remains ongoing, focused on testing, refining, and modifying the model for use with different patient groups. Consistent success in improving patient outcomes and reducing health care costs in patient gr...

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“…1 Both mothers and fathers of infants in the NICU face many uncertainties, including their infant's future, their reaction to the infant's birth, their ability to safeguard an infant at risk for cardiopulmonary arrest, and the financial impact of the infant's illness on the family. [2][3][4][5][6][7] The highly technical environment of the NICU can overwhelm parents and increase their perception that their baby is abnormal or vulnerable. 8 Because mothers have been the predominant focus of previous research, the purpose of the current study was to compare the psychosocial responses of mothers and fathers to the NICU hospitalization of their infant.…”

mentioning

confidence: 99%

“…2,3,5,7 When both parents have been included, researchers have focused on the post-hospital period. 10,11 As the role of the father has shifted over the last two decades to include more involvement in childrearing, 12 paternal responses to the NICU experience has become of increasing interest to clinicians and researchers.…”

mentioning

confidence: 99%

Comparison of Psychosocial Adjustment of Mothers and Fathers of High-Risk Infants in the Neonatal Intensive Care Unit

1999

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OBJECTIVE:To compare the psychosocial adjustment of mothers and fathers to the birth of a premature or critically ill infant hospitalized in the neonatal intensive care unit (NICU). STUDY DESIGN:Using a comparative design, we studied 165 mother and father pairs of highrisk neonates. Mothers were 29.1 Ϯ 6.7 and fathers were 30.7 Ϯ 6.8 years old. All infants were hospitalized in the NICU. Couples completed questionnaires in either English or Spanish during the infant's NICU stay. RESULTS:Mothers were more poorly adjusted and were more anxious, hostile, and depressed than fathers, but both parents experienced levels of emotional distress significantly above normative values. Mothers and fathers reported equal levels of family functioning and social support and shared similar feelings of control related to the health status of their infant. CONCLUSION:The birth of an infant who requires care in the NICU environment is highly stressful for both parents. Physicians, nurses, and other health professionals working in the NICU should assess the psychosocial adjustment in both parents, but mothers may require more intense education and counseling to reduce the distress they experience.More than 100,000 infants are admitted to neonatal intensive care units (NICUs) each year. 1 Both mothers and fathers of infants in the NICU face many uncertainties, including their infant's future, their reaction to the infant's birth, their ability to safeguard an infant at risk for cardiopulmonary arrest, and the financial impact of the infant's illness on the family. 2-7 The highly technical environment of the NICU can overwhelm parents and increase their perception that their baby is abnormal or vulnerable. 8 Because mothers have been the predominant focus of previous research, the purpose of the current study was to compare the psychosocial responses of mothers and fathers to the NICU hospitalization of their infant.Several researchers have identified specific aspects of the NICU environment that cause distress in parents. 4,9 However, a comparison of mothers' and fathers' stress in relation to the NICU has been the focus of only one study. Miles and colleagues 11 found that mothers reported the NICU to be more stressful than fathers did, and both found the environment more stressful during the first week of NICU hospitalization than 1 week later. Stress related to parental role alteration decreased more in mothers than in fathers. Paternal anxiety was related to adopting the parental role and to uncertainty related to the child's future. In contrast, maternal anxiety was more diffuse and not directly related to these factors. This study was limited by a small sample size (23 couples) and focused on a comparison of mothers' and fathers' anxiety rather than the broader area of psychosocial adjustment.Previous research related to parental psychosocial adaptation to the birth of a premature or critically ill infant has focused almost exclusively on mothers. 2,3,5,7 When both parents have been included, researchers have focused on the post...

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Anxiety, Depression, and Hostility In Mothers of Preterm Infants

Cited by 109 publications

References 0 publications

Relationship of prenatal cocaine exposure and maternal postpartum psychological distress to child developmental outcome

Relationship of prenatal cocaine exposure and maternal postpartum psychological distress to child developmental outcome

Lessons Learned from Testing the Quality Cost Model of Advanced Practice Nursing (APN) Transitional Care

Comparison of Psychosocial Adjustment of Mothers and Fathers of High-Risk Infants in the Neonatal Intensive Care Unit

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