National Clinical Scholars Program, Institute for Healthcare Policy and Innovation, University of Michigan, 2800 Plymouth Ave, Ann Arbor, MI 48109, United States of America; University of Michigan School of Nursing, 400 N Ingalls, Ann Arbor, MI 48109, United States of America.
Duke University School of Nursing, 307 Trent Drive, Durham, NC 27710, United States of America.
Early Hum Dev. 2020 Feb;141:104946. doi: 10.1016/j.earlhumdev.2019.104946. Epub 2019 Dec 31.
The aim of this prospective, longitudinal study was to (1) examine the development of parenting self-efficacy (PSE), (2) explore the influence of contextual factors (e.g., family functioning, family centered care, and infant medical caregiving complexity) on PSE development, and (3) whether PSE and contextual factors predict parent and infant health outcomes in a high-risk infant population.
Mothers (n = 67) of infants diagnosed with a complex medical condition following birth were enrolled within 3 weeks of their infant's diagnosis and admission to intensive care. Participants completed an online study survey at study enrollment (T1), infant discharge (T2), and 3 months after discharge (T3). Change in PSE was examined using mixed modeling and predictors of parent and infant health outcomes were explored using multiple regression.
PSE significantly increased over time (b = 2.08, p < .0001). Family functioning was the only significant contextual factor, where worse family functioning at enrollment was associated with lower confidence over time. Mothers who were older and had more than one child were significant predicators of higher PSE. Interestingly, being married, compared to being single, was associated with decreased PSE. Higher PSE was also predictive of positive maternal psychological wellbeing at 3 months after discharge and a decrease in infant's medical complexity was associated with higher maternal psychological well-being.
These are important findings given that PSE is known to contribute to infant development and health status.
本前瞻性纵向研究的目的是：(1) 考察育儿自我效能感 (PSE) 的发展；(2) 探索情境因素（如家庭功能、以家庭为中心的护理和婴儿医疗护理的复杂性）对 PSE 发展的影响；(3) PSE 和情境因素是否能预测高危婴儿群体中父母和婴儿的健康结果。
在婴儿出生后被诊断出患有复杂疾病并住院后 3 周内，招募了患有此类疾病的婴儿的母亲（n=67）。参与者在研究开始时（T1）、婴儿出院时（T2）和出院后 3 个月时（T3）完成了一项在线研究调查。使用混合模型检查 PSE 的变化，使用多元回归探索父母和婴儿健康结果的预测因素。
PSE 随时间显著增加（b=2.08，p<.0001）。家庭功能是唯一显著的情境因素，入学时家庭功能较差与随时间推移信心降低有关。年龄较大且有一个以上孩子的母亲是 PSE 较高的显著预测因素。有趣的是，与单身相比，已婚状态与 PSE 降低有关。较高的 PSE 还与母亲在出院后 3 个月时的心理健康状况呈正相关，婴儿的医疗复杂性降低与母亲的心理健康状况呈正相关。
鉴于 PSE 已知会影响婴儿的发育和健康状况，这些发现很重要。
