Changi General Hospital, 2 Simei Street 3, Singapore 529889, Singapore.
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore.
Int J Nurs Stud. 2018 Jun;82:149-162. doi: 10.1016/j.ijnurstu.2018.03.021. Epub 2018 Mar 28.
Poor adjustment during early parenthood often leads to low feelings of parental self-efficacy, which influences parents' behaviours towards their infants. The long-term consequences on infant development warrant the need for more attention on the efficacy of universal parent education interventions to empower parents and enhance their self-efficacy.
To synthesise available evidence and explore the efficacy of universal parent education interventions on the parental self-efficacy of first-time parents.
A systematic review and meta-analysis of randomised controlled trials.
A literature search of 10 databases was conducted to identify randomised controlled trials from each database's point of inception to November 2016.
Based on the inclusion criteria, 24,062 articles were screened for their titles and abstracts. Two hundred and eighty articles were identified for full-text screening. Risks of bias posed by the selected articles were assessed using Cochrane's Risk of Bias instrument. Meta-analyses were conducted using RevMan 5.3. The overall intervention effect was evaluated using z tests at p < 0.05, while I and Cochran Q tests were used to measure heterogeneity.
Ten randomised controlled trials were selected; eight trials were combined in meta-analyses and two trials were synthesised narratively. A meta-analysis revealed that universal parent education interventions significantly enhanced parental self-efficacy (p < 0.001) among first-time parents and these effects were also maintained over time (p < 0.001). The extent of improvement in parental self-efficacy was affected by the duration of the interventions.
This review provides sufficient evidence to support the use of universal interventions to enhance new parents' self-efficacy. While intervention effects were sustained at the two-month follow-up, further research using randomised controlled trials and longitudinal studies are needed to determine long-term effects. The findings serve as an impetus for hospitals and healthcare professionals to integrate universal interventions in perinatal care to guide first-time parents' transition into parenthood.
初为人父母时适应不良往往会导致父母自我效能感降低，进而影响其对婴儿的行为。这些长期后果对婴儿的发展有影响，因此需要更多关注通用父母教育干预措施的效果，以增强父母的能力并提高他们的自我效能感。
综合现有证据，探讨通用父母教育干预措施对初为人父母者父母自我效能感的效果。
对随机对照试验进行系统评价和荟萃分析。
从每个数据库的创建点到 2016 年 11 月，对 10 个数据库进行了文献检索，以确定随机对照试验。
根据纳入标准，对 24062 篇文章的标题和摘要进行了筛选。确定了 280 篇文章进行全文筛选。使用 Cochrane 偏倚风险工具评估所选文章的偏倚风险。使用 RevMan 5.3 进行荟萃分析。使用 z 检验（p<0.05）评估整体干预效果，同时使用 I 和 Cochran Q 检验评估异质性。
选择了 10 项随机对照试验；8 项试验进行荟萃分析，2 项试验进行叙述性综合。荟萃分析显示，通用父母教育干预措施显著提高了初为人父母者的父母自我效能感（p<0.001），并且这些效果在一段时间内仍然存在（p<0.001）。父母自我效能感的改善程度受到干预持续时间的影响。
本综述提供了充分的证据支持使用通用干预措施来提高新父母的自我效能感。虽然干预效果在两个月的随访中得到维持，但需要进一步使用随机对照试验和纵向研究来确定长期效果。这些发现为医院和医疗保健专业人员提供了动力，将通用干预措施纳入围产期护理中，以指导初为人父母者过渡到父母角色。
