Explanatory Variables of Infant Care Competence among Mothers with Postpartum Depression
Creators: name: Jones, Debbie Annette
Publisher: name: Graduate Studies
Year: 2018
Subjects: subject: mother-infant interaction
subject: postpartum depression
subject: infant care competence
subject: Mental Health
subject: Nursing
subject: FOS: Health sciences

description: Abstract Introduction. Postpartum Depression (PPD), characterized by feelings of sadness, guilt, decreased energy, decreased mood and appetite, occurs in 10-15% of new mothers with onset in the three months postpartum. Although it can last into the second postpartum year, symptoms have been shown to decrease with treatment. The impact of the mother’s depressive symptoms has negative consequences that can affect her infant care competence (ICC), i.e. how a mother perceives and performs her ability to care for her infant, potentially explaining the observed negative health and developmental outcomes of children whose mothers were affected by PPD. Aim. The aim of this master’s thesis is to complete two papers; both examining explanatory variables that impact/influence ICC in mothers with PPD. The first paper addresses the question: What are explanatory variables of perceived infant care competence in mothers affected by PPD? The second paper addresses the question: “How do depression and other variables influence and/or explain perceived ICC?” Methods. For paper one, a secondary correlational study of women aged 16 to 45 years (n = 55), who were initially recruited for a peer support intervention on women with PPD from May 2011-October 2013 was conducted. Perceived ICC was measured using the Infant Care Questionnaire (ICQ), which is comprised of three domains called responsiveness, emotionality, and mom &amp; baby. The predictor variables that were examined include: severity of depressive symptoms measured using Edinburgh Postnatal Depression Scale (EPDS), social support using the Social Provisions scale (SPS), child development measured using the Ages and Stages Questionnaire (ASQ), family functioning measured using the Family Functioning Scale (FFS) and sociodemographic covariates. Regression analysis was used to determine associations between outcomes (responsiveness, emotionality, mom &amp; baby) on the ICQ and explanatory variables. For paper two, a narrative systematic review was undertaken employing the following six databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycINFO, PubMed, SocINDEX, and the Cochrane Library. The search was conducted examining articles about depressed mothers’ feelings and perceptions of their abilities to care for and interact with their infants as well as performed infant care abilities. After reviewing the selected articles, data were grouped identifying ICC (performed and perceived), how depression was measured, study designs, samples, and explanatory variables. Knowledge Transfer. Two papers were derived for this thesis, one entitled: “Explanatory variables of perceived infant care competence among mothers with postpartum depression” and the other entitled “A narrative systematic review of explanatory variables of infant care competence for mothers with PPD.” These will be prepared for publication in peer-reviewed journals. Papers will also be presented at peer-reviewed national conferences. Results. In the secondary analysis paper, child development across all domains, but perhaps most robustly fine motor skills, predicted responsiveness as an aspect of ICC. The best model fit was for responsiveness with 37% of the variance explained by infant fine motor skills, family functioning and nurturance. The second best model fit was for emotionality, with gross motor, problem solving, social interaction and reliable alliance explaining 16% of the variance. In the systematic review paper, 21 papers yielded variables that explained ICC in mothers including: depression, depression severity, timing of symptoms, social support, maternal adversities, infant characteristics, as well as demographic variables such as education and income. Conclusion. Identifying variables that explain ICC can ultimately give guidance to early preventative measures for mothers, and ultimately decrease possible negative influences on children’s health and development. Depressed mothers with children who have developmental deficits may influence a mother’s perceptions, perhaps further decreasing her confidence in performed infant care tasks. Interventions are needed to enhance a mother’s perceptions by educating mothers on detection of early infant milestones and to respond to infant cues and signals of responsiveness. Perinatal healthcare professionals can advocate for, increase awareness and educate mothers and families about predictors of and interventions to improve ICC. Keywords: postpartum depression, infant care competence, maternal competence, maternal-infant interaction, predictors