Patterns of Distress in African American Mothers of Preterm Infants

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, posttraumatic 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. Originally published Journal of Developmental and Behavioral Pediatrics, Vol. 30, No. 3, June 200

Headache and Health-Related Job Loss Among Disadvantaged Women

AbstractHeadache is a significant public health issue and a major cause of work-related disability. Given that lower-income groups suffer more frequent and more severe headaches, this study examined the associations between headaches, comorbid conditions, symptom management, and health-related job loss in 432 low-income women. The presence of headaches, headaches and allergy symptoms combined, and a higher number of comorbid conditions were significantly associated with health-related job loss. Medication use and emergency department use patterns suggest further research related to day-to-day headache symptom management strategies, and role functioning among this vulnerable group is needed

Parenting Enhancement, Interpersonal Psychotherapy to Reduce Depression in Low-Income Mothers of Infants and Toddlers: A Randomized Trial

Depressive symptoms and clinical depression are highly prevalent in low-income mothers and negatively affect their infants and toddlers

Patterns of Distress in African-American Mothers of Preterm Infants

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

Using appreciative inquiry to implement person-centred dementia care in hospital wards

The quality of care of persons with dementia in hospitals is not optimal and can be challenging. Moreover, staff may find difficulty in translating what they have learned during training into practice. This paper report the development and evaluation of a set of workshops using an Appreciative Inquiry (AI) approach to implement person-centred dementia care in two hospital wards. Staff worked collaboratively to develop a ward vision and to implement a number of action plans. Using AI approach, staff attitudes towards persons with dementia improved, inter-professional collaboration was enhanced and small changes in staff practices were noted. Dementia care in hospitals can be enhanced by empowering staff to take small but concrete actions after they engage in AI workshops, during which they are listened to and appreciated for what they can contribute

Advancing Long-Term Care Science Through Using Common Data Elements: Candidate Measures for Care Outcomes of Personhood, Well-Being, and Quality of Life

To support the development of internationally comparable common data elements (CDEs) that can be used to measure essential aspects of long-term care (LTC) across low-, middle-, and high-income countries, a group of researchers in medicine, nursing, behavioral, and social sciences from 21 different countries have joined forces and launched the Worldwide Elements to Harmonize Research in LTC Living Environments (WE-THRIVE) initiative. This initiative aims to develop a common data infrastructure for international use across the domains of organizational context, workforce and staffing, person-centered care, and care outcomes, as these are critical to LTC quality, experiences, and outcomes. This article reports measurement recommendations for the care outcomes domain, focusing on previously prioritized care outcomes concepts of well-being, quality of life (QoL), and personhood for residents in LTC. Through literature review and expert ranking, we recommend nine measures of well-being, QoL, and personhood, as a basis for developing CDEs for long-term care outcomes across countries. Data in LTC have often included deficit-oriented measures; while important, reductions do not necessarily mean that residents are concurrently experiencing well-being. Enhancing measurement efforts with the inclusion of these positive LTC outcomes across countries would facilitate international LTC research and align with global shifts toward healthy aging and person-centered LTC models

Short-term in-home intervention reduces depressive symptoms in early head start Latina mothers of infants and toddlers

Depressive symptoms may compromise the ability of low-income Latina mothers with limited English language proficiency to parent their infants or toddlers. Eighty Early Head Start Latina mothers with limited English language proficiency were randomized to an advanced practice nurse-delivered, culturally tailored, in-home psychotherapy intervention, or to usual care. Repeated measures regression analysis showed a significantly greater decrease in depressive symptoms for intervention mothers compared to the usual care group at 22 and 26 weeks (4 weeks post intervention). Intervention mothers’ reports of their child's aggression diminished significantly from T1 to T4 compared to usual care mothers (p= .03). Self-efficacy appeared to only partially mediate the intervention effect, and maternal health moderated the intervention impact. Results indicate that the intervention reduced depressive symptoms and, compared to previous studies in this population, retention of mothers in both intervention and control conditions was improved

Digital tools for delivery of dementia education for healthcare providers: a systematic review

Continuing education on dementia for healthcare providers has been shown to have positive effects on diagnostic confidence, knowledge, and care management. Technological approaches to educational delivery have been found to have comparable effects in terms of quality and efficacy. The purpose of the systematic review was to compose and present an evidence base for technology-delivered dementia education for healthcare providers. The review used PRISMA guidelines and Cochrane methods focusing on studies with a pre- and post-intervention evaluation. Technology-based delivery of dementia education was broadly defined as any technology-based medium delivered in real time or asynchronously. Ten studies were identified and analyzed using content analysis. The review revealed positive outcomes post-intervention, for dementia knowledge, readiness to change, receptiveness to training, communication skills, and self-efficacy. Studies were rated as medium to high quality on a scale for measurement of published data in research, and there was generally an unknown risk of bias due to a lack of a control group in most studies (N = 7). The findings revealed benefits of digitally-based, asynchronous continuing education for healthcare providers, which allow schedule flexibility and the ability to deliver remotely. Findings also revealed benefits of presentations using a variety of interactive educational materials via videos, voice recordings, textual medium and online discussion groups. Suggestions for intervention improvements include tailoring training for the specific needs and knowledge levels of healthcare practitioners and using validated scales to measure outcomes

A community-engaged approach to investigate cardiovascular-associated inflammation among American Indian women: A research protocol

American Indian women are more likely to die from cardiovascular disease (CVD) than White or African American women. Inflammatory processes may underlie CVD disparities by gender and race and may be critical to understanding population-specific drivers and potential buffers. Exposure to environmental air pollutants, especially particulate matter (PM), is known to be an important catalyst in CVD-associated inflammation. Positive psychological states, associated with low levels of inflammatory gene expression, could serve to moderate the inflammatory response to environmental air pollutants and ultimately lead to better cardiovascular health outcomes. The aim of the ongoing community-engaged and NIH-funded study described in this study protocol is to address the racial and gender gaps in CVD mortality by investigating the contextually relevant and culturally important determinants of health among American Indian women. In this paper we describe the procedures used to examine the relationship between environmental air pollutant exposures (PM 10-2.5 and PM 2.5 ), psychological factors (e.g., depressive symptoms, posttraumatic stress symptoms, eudemonic well-being, and positive emotions), and cardiovascular-associated inflammation (hs-CRP, IL-6, Amyloid A, CBCs with differentials) in a sample of 150 women 18–50 years of age from the Lumbee Tribe in southeastern North Carolina. We describe lessons learned and strategies used in developing a community-engaged approach to enhance recruitment of American Indian women in biomedical research. The empirical data and community infrastructure resulting from this study will be foundational in designing and testing future interventions to reduce CVD-associated morbidity and mortality in American Indian women

Improving the Nurse-Family Partnership in Community Practice

Evidence-based preventive interventions are rarely final products. They have reached a stage of development that warrant public investment but require additional research and development to strengthen their effects. The Nurse-Family Partnership (NFP), a program of nurse home visiting, is grounded in findings from replicated randomized controlled trials