School of Nursing, University of North Carolina, Chapel Hill, NC, 27599-7460.
Res Nurs Health. 2014 Aug;37(4):276-91. doi: 10.1002/nur.21604. Epub 2014 Jun 19.
Low-income mothers develop depressive symptoms at higher rates than the general population, adding to the existing risk that economic hardship places on their infants and toddlers. Emphasizing a few key intervention targets, an approach that is especially relevant to mothers when depressive symptoms compromise their energy and concentration, can improve interventions with populations facing adversity. The goal of this study was to identify contextual risk factors that significantly contributed to depressive symptoms and that, in combination with depressive symptoms, were associated with compromised parenting. Using baseline data from 251 ethnically diverse mothers from six Early Head Start programs in the Northeastern and Southeastern US, who were recruited for a clinical trial of an in-home intervention, Belsky's ecological framework of distal to proximal levels of influence was used to organize risk factors for depressive symptoms in hierarchical regression models. Under stress, mothers of toddlers reported more severe depressive symptoms than mothers of infants, supporting the need for depressive symptom screening and monitoring past the immediate postpartum period. Multivariate models revealed intervention targets that can focus depression prevention and intervention efforts, including helping mothers reduce chronic day-to-day stressors and conflicts with significant others, and to effectively handle challenging toddler behaviors, especially in the face of regional disciplinary norms. Presence of a live-in partner was linked to more effective parenting, regardless of participants' depressive symptom severity.
低收入母亲比一般人群更容易出现抑郁症状，这增加了经济困难对她们的婴儿和幼儿所带来的现有风险。强调一些关键的干预目标，这种方法特别适用于那些因抑郁症状而影响精力和注意力的母亲，可以改善面临逆境的人群的干预措施。本研究的目的是确定对抑郁症状有显著影响的情境风险因素，并结合抑郁症状，确定与育儿受损相关的因素。本研究使用了来自美国东北部和东南部六个早期开端项目的 251 名种族多样化的母亲的基线数据，这些母亲是为一项家庭干预的临床试验而招募的，Belsky 的生态框架从远端到近端的影响水平用于组织抑郁症状的风险因素，以分层回归模型进行分析。在压力下，幼儿的母亲报告的抑郁症状比婴儿的母亲更严重，这支持了对抑郁症状进行筛查和监测的需要，以避免产后立即出现抑郁症状。多变量模型揭示了可以集中预防和干预抑郁的干预目标，包括帮助母亲减少日常慢性压力源和与重要他人的冲突，并有效处理具有挑战性的幼儿行为，尤其是在面对区域纪律规范时。有同住伴侣与更有效的育儿方式有关，而与参与者的抑郁症状严重程度无关。
