Introducing a Caring/Relational Framework for Building Relationships With Addicted Mothers

Morton, Jennifer L.; Konrad, Shelley Cohen

doi:10.1111/j.1552-6909.2009.01006.x

Cited by 16 publications

(7 citation statements)

References 30 publications

(54 reference statements)

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“…However, due to a lack of research data to gauge women’s mental and behavioral health needs and to guide gender- or race-specific intervention programs, treatment for postpartum women is not always available, gender-specific, or comprehensive (ABM 2009). Maternal substance abuse can contribute to child abuse or neglect (VanDeMark et al 2005; Morton and Konrad 2009). Abused children are further at risk for substance abuse as adults, and cycles of abuse can become generational (Dunn et al 2002).…”

Section: Discussionmentioning

confidence: 99%

“…Little research has examined the relationship between PPD and substance use (Ross and Dennis 2009), but women with depression in pregnancy may be more likely to consume alcohol than those without (Flynn and Chermack 2008; Marcus 2009), and pregnant women who drink have elevated odds of experiencing PPD (Marcus 2009). Maternal alcohol and drug abuse can contribute to child neglect, abuse, and the number of children in foster care (VanDeMark et al 2005; Morton and Konrad 2009; Pajulo et al 2012). Children of depressed mothers are at increased risk of neglect and abuse (Burke 2003).…”

Section: Introductionmentioning

confidence: 99%

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Postpartum Substance Use and Depressive Symptoms: A Review

Chapman

2013

Women & Health

106

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National survey data suggest that new mothers have high prevalences of alcohol and illicit drug use. Depression correlates with substance use, and new mothers with postpartum depression (PPD) may be at high risk for substance use. Understanding postpartum substance use and its relationship to PPD can inform future research and intervention. A literature search was conducted resulting in 12 studies published from 1999–2012 examining postpartum alcohol use, drug use, or combined postpartum depression and substance use. Postpartum alcohol (prevalence range 30.1%−49%) and drug use (4.5%–8.5%) were lower than use among not pregnant, not postpartum women (41.5%–57.5%; 7.6%–10.6%, respectively) but higher than use among pregnant women (5.4%–11.6%; 3.7%–4.3%, respectively). Correlates of postpartum problem drinking were being unemployed, unmarried, and a cigarette smoker. Prevalence of drug use was highest among white new mothers, followed by Blacks and Hispanics, but Black new mothers appeared at greater risk of drug use. No identified studies examined correlates of postpartum drug use beyond race/ethnicity. Postpartum depressive symptoms were prevalent among postpartum substance users and those with a substance use history (19.7%–46%). The postpartum period is a critical time. Prevalent substance use and the scarcity of studies warrant research to identify means to reduce maternal substance use.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Postpartum Substance Use and Depressive Symptoms: A Review

Chapman

2013

Women & Health

106

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“…Another possible explanation for the better outcomes in the CT group could be inherent in the treatment condition; the women had daily contacts with the study staff with whom they had already built a relationship with, which may already be considered as a psychological intervention possibly having a positive influence on the well‐being of the patient and her unborn child. Morton and Konrad () also stress the importance of building relationships with addicted mothers in health care settings.…”

Section: Discussionmentioning

confidence: 99%

Impact of treatment approach on maternal and neonatal outcome in pregnant opioid‐maintained women

Metz

Jagsch

Ebner

et al. 2011

Human Psychopharmacology

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Objective The objective of this study is to compare maternal and neonatal outcome of opioid-dependent women maintained on buprenorphine or methadone throughout pregnancy in a randomized double-blind double-dummy clinical trial (CT) with a comparison group undergoing a structured standard protocol (SP) at the Medical University of Vienna, Austria. Methods One hundred and fourteen subjects were included in the analysis, with 77 in SP (n=51 methadone, n=26 buprenorphine), and 37 in CT (n=19 methadone, n=18 buprenorphine), comparing maternal concomitant consumption during third trimester, demographic birth data, duration of treatment for neonatal abstinence syndrome (NAS), morphine dose for NAS treatment and length of hospital stay (LOS). Results Both study groups yielded healthy neonates with no significant demographic differences and equivalently low rates of positive maternal urine toxicologies. However, NAS parameters were significantly better in CT regarding total medication dose administered to neonates (p=0.014) and LOS (p=0.015). Superior results were achieved in buprenorphine compared with methadone-exposed neonates regarding gestational age at birth (p=0.003), birth weight (p=0.011), total morphine dose administered (p=0.008), NAS treatment duration (p=0.008) and LOS (p=0.001). Conclusions Comparably favorable outcome for mothers and infants and efficacy and safety of opioid medications were shown in both treatment approaches. Neonatal care could benefit from transferring successful CT procedures into clinical practice. Copyright © 2011 John Wiley & Sons, Ltd.

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“…Building a trusting relationship with opioid-dependent mothers is especially important (Morton & Konrad, 2008). We encourage nurses to offer a referral to enhanced substance abuse services, as is recommended for all patients receiving buprenorphine treatment (Center for Substance Abuse Treatment, 2009).…”

Section: Clinical Nursing Implicationsmentioning

confidence: 99%

Parenting and Concerns of Pregnant Women in Buprenorphine Treatment

Rizzo

Neumann

King

et al. 2014

McN: The American Journal of Maternal/Child Nursing

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Purpose Opioid-dependent pregnant women are characterized by drug use during pregnancy and deficits in knowledge of newborn care and feeding, and of child development. We assessed parenting skills and concerns among pregnant women in buprenorphine treatment for prescription opioid-dependence. Study Design and Methods We interviewed 32 pregnant women who received buprenorphine treatment for prescription opioid dependence in a primary care setting and administered questionnaires, including the Adult-Adolescent Parenting Inventory version 2 (AAPI-2) and Childhood Experience of Care and Abuse Questionnaire. Results AAPI-2 scores revealed medium risk of abuse for all five scales: inappropriate expectations of the child, low level of empathy, strong belief in corporal punishment, reversal of parent-child roles, and oppression of children’s power and independence. Primary concerns of participants were neonatal abstinence syndrome (NAS) and their child’s health. Pregnant women who received buprenorphine for treatment of prescription opioid dependence showed a lack of appropriate parenting skills, but did not express concern about their ability to parent. Clinical Implications Our findings suggest need for nurses to assist prescription opioid-dependent pregnant women in acquiring additional parenting skills, to refer for educational parenting intervention, and to educate patients about NAS.

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Introducing a Caring/Relational Framework for Building Relationships With Addicted Mothers

Cited by 16 publications

References 30 publications

Postpartum Substance Use and Depressive Symptoms: A Review

Postpartum Substance Use and Depressive Symptoms: A Review

Impact of treatment approach on maternal and neonatal outcome in pregnant opioid‐maintained women

Parenting and Concerns of Pregnant Women in Buprenorphine Treatment

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