‘I still have difficulties feeling like a mother’: The transition to motherhood of preterm infants mothers

Objective: The premature birth of their infant can constitute a sudden interruption of the transition to motherhood that requires a reorganisation of the process. The present study aimed to analyse the experience of the transition to motherhood of preterm infants’ mothers, framing it within Stern’s transition to motherhood theory.

Method: A semi-structured interview was administered to 30 mothers during the recovery of the infant in the Neonatal Intensive Care Unit. The interview explored the experience of mothers related to pregnancy, the infant’s birth and recovery.

Results: Thematic Analyses evidenced four interrelated themes: disconnection from the child, perception of maternal inadequacy, loss of parental role and temporal suspension. The themes showed that the mothers’ experience of preterm birth not only concerns the traumatic delivery, but is also embedded in the entire process of becoming a mother within an institutional context.

Conclusions: Results were connected to Stern’s theory. Findings revealed difficulties for preterm mothers that could affect the development of the maternal constellation and thus their transition to motherhood. These difficulties may influence the construction of maternal identity, mother’s representation of their child and the bond with their child.     

Parent–child relationships and offspring’s positive mental wellbeing from adolescence to early older age

We examined parent-child relationship quality and positive mental well-being using Medical Research Council National Survey of Health and Development data. Well-being was measured at ages 13–15 (teacher-rated happiness), 36 (life satisfaction), 43 (satisfaction with home and family life) and 60–64 years (Diener Satisfaction With Life scale and Warwick Edinburgh Mental Well-being scale). The Parental Bonding Instrument captured perceived care and control from the father and mother to age 16, recalled by study members at age 43. Greater well-being was seen for offspring with higher combined parental care and lower combined parental psychological control (p < 0.05 at all ages). Controlling for maternal care and paternal and maternal behavioural and psychological control, childhood social class, parental separation, mother’s neuroticism and study member’s personality, higher well-being was consistently related to paternal care. This suggests that both mother–child and father–child relationships may have short and long-term consequences for positive mental well-being.     

Early tactile experience of low birth weight children: links to later mental health and social adaptation

The purpose of this study was twofold: to determine (1) the degree to which specific qualities of maternal touch may contribute to the low birth weight infant's emotional and behavioural problems as well as social adaptation, and (2) the relationship between maternal touch and a mother's other caregiving behaviour. The sample included 114 socioculturally diverse infants and their mothers who were videotaped during an infant feeding when the baby was 3 months old. This videotape was analysed to assess dimensions of mother–infant interaction, including maternal touch. Data on perinatal risk and the mother's acceptance versus rejection of the infant were also acquired. Social adaptation and emotional/behavioural problems were measured when the child was 2 years of age. Hierarchical regression analyses indicated that maternal touch accounted for 15% of the variance in the likelihood of a child having emotional/behavioural problems at age 2. Children who received more nurturing touch had significantly fewer internalizing problems (such as depression) while children receiving both more frequent touch and harsh touch had more externalizing problems (such as aggressive behaviour). Infants who were less responsive to their caregivers were especially at risk of developing aggressive/destructive behaviour as a result of frequent touch. But less responsive infants also appeared to benefit most from greater use of diverse types of maternal touch, accounting for 6% of the variance in superior adaptive behaviour at age 2. Nurturing touch was the only quality that showed even a modest relationship to other caregiving behaviour, suggesting that touch may play a distinct role in the infant's psychosocial development. Copyright © 2001 John Wiley & Sons, Ltd.     

论学习迁移规律在中医教学过程中的地位与作用

学习迁移泛指一种学习对另一种学习的影响,一般指先前学习已获得的知识、技能、方法和态度对以后学习新的知识技能及研究解决问题的影响.通过学习迁移现象在中医教学过程中的不同表现,指出学习迁移规律是符合中医的教学规律的,有意识地应用学习迁移规律能够很好地促进中医教学,并就如何应用学习迁移规律改进中医教学提出了自己的看法.     

Psychological Sequelae in Parents of Extreme Low and Very Low Birth Weight Infants

The current study evaluated the psychological sequelae in 66 parents of extreme low and very low birth weight infants (mean weight of 842 g). Parents who had given birth within a 3-year period prior to the study were chosen from the archives of a neonatal ward and surveyed regarding posttraumatic stress, coping strategies, and social support. Thirty-five percent of the parents reported that their child had a handicap. Twenty percent of the women met the criteria of posttraumatic stress disorder (PTSD) at the time of the study, and an additional 10% met the criteria for a subclinical PTSD diagnosis. Female gender, handicap of the child, general distress during hospitalization, distressing contact with hospital staff, experienced distress at homecoming, and emotional coping, explained 72% of the degree of traumatization. Psychological support and intervention is recommended during the hospital stay of a premature infant who has a handicap and after the homecoming to prevent the development of chronic PTSD and reduce the associated distress.     

Stress Processes in Pregnancy and Preterm Birth

ABSTRACT— Preterm birth (PTB) is of epidemic proportions in the United States, particularly among African Americans. Its consequences range from risk of infant mortality to lifelong disease and disability. Stress is a contributor to preterm labor and delivery. This article summarizes research on stress as a risk factor for PTB. As is evident in considering the complex mechanisms, psychological science has much to contribute to addressing this important health issue.     

Visual configural processing in adults born at extremely low birth weight

Being born at extremely low birth weight (ELBW; ≤1,000 g) is associated with enduring visual impairments. We tested for long‐term, higher order visual processing problems in the oldest known prospectively followed cohort of ELBW survivors. Configural processing (spacing among features of an object) was examined in 62 adults born at ELBW (M_age = 31.9 years) and 82 adults born at normal birth weight (NBW; ≥2,500 g: M_age = 32.5 years). Pairs of human faces, monkey faces, or houses were presented in a delayed match‐to‐sample task, where non‐matching stimuli differed only in the spacing of their features. Discrimination accuracy for each stimulus type was compared between birth weight groups, adjusting for neurosensory impairment, visual acuity, binocular fusion ability, IQ, and sex. Both groups were better able to discriminate human faces than monkey faces (p < .001). However, the ELBW group discriminated between human faces (p < .001), between monkey faces (p < .001), and to some degree, between houses (p < .06), more poorly than NBW control participants, suggesting a general deficit in perceptual processing. Human face discrimination was related to performance IQ (PIQ) across groups, but especially among ELBW survivors. Coding (a PIQ subtest) also predicted human face discrimination in ELBW survivors, consistent with previously reported links between visuo‐perceptive difficulties and regional slowing of cortical activity in individuals born preterm. Correlations with Coding suggested ELBW survivors may have used a feature‐matching approach to processing human faces. Future studies could examine brain‐based anatomical and functional evidence for altered face processing, as well as the social and memory consequences of face‐processing deficits in ELBW survivors.     

On Hope and Hard Choices

In Handle with Care (2009), novelist Jodi Picoult presents a heartbreaking case involving the question of wrongful birth. This essay examines Ronald M. Green's writings in the field of bioethics to see what wisdom they might bring to this case. I argue that Green's contributions to bioethics exemplify some of the best of ethical argumentation: attention to facts, discernment of morally relevant differences, enunciation and justification of principles, originality, and compassion. I then draw from his work three foci that illuminate aspects of the dilemma presented by Picoult: the importance of parental love, the possibility that the dilemma might be reframed away from wrongful birth, and the need to shift our focus to questions of justice. While appreciating Green's contributions to bioethics, I also indicate several places of nuanced disagreement.     

论医学模式转变对助产土在产程守护中角色转变的影响

伴随着医学模式的转变,助产士在产程守护中的角色由单一守护者的角色向全面、多重角色转变,助产士的工作内容与职责也相应发生变化。现代医学模式下助产士的角色转变对医疗效果有良好的改进,体现了“以人为本”的医疗文化理念,同时也对助产士的要求更为全面。     

关于低出生体重儿诊疗最优化原则的思考

出生体重及低出生体重发生率是衡量社会发展和妇幼保健状况的重要指标。低出生体重不仅直接增加新生儿和婴儿的患病率和死亡率,而且与儿童的远期预后如生长发育落后、智力低下、脑瘫及成年期胰岛素抵抗密切相关。通过运用诊疗最优化的原则,对低出生体重儿进行预防,及早干预治疗,可提高其生命质量。