• Adolescent mothers: Functioning after bereavement

      Shaefer, Sarah Jane McDermott; Parks, Peggy L. (1996)
      Adolescents who become parents are at high risk for low educational attainment, unemployment, and poor mental health. This study investigated the differences in depression for adolescent mothers whose infants live and adolescent mothers whose infants die. Cleiren's (1993) theory of bereavement was the framework used to examine these differences because depression was a measurable component of functioning after bereavement. The 1988 National Maternal and Infant Health Survey (NMIHS) conducted by NCHS is a population-based data set that provided the opportunity to determine the predictors of depression for pregnant adolescent and adolescents who experienced an infant death. Results were based on 2307 adolescents, including 917 whose infant had died. Questionnaires were completed between seven and thirty-seven months after the birth. Depression was measured by the Center for Epidemiological Studies Depression Scale (CES-D) and adolescents were classified as depressed if their score was twenty-four or greater (out of a possible 60). Results of the univariate analysis revealed that 41% in the infant death group and 24% in the live infant group were depressed and this was in excess of the number previously reported in community-based samples. Social and demographic predictors of depression were determined using logistic regression. Results indicated that some mothers whose infants had died were depressed if they were not pregnant at the time of NMIHS completion, wanted the index pregnancy, and did not have a prior infant death. In contrast, mothers whose infant was alive were depressed if they were pregnant at the time of NMIHS completion and had a prior infant death. The findings of this study indicated that many adolescent mothers were depressed and further screening of the pregnant adolescent is needed. Depression is treatable and associated factors were identified for both groups. The results suggested that infant death had a substantial and independent impact on adolescent depression and was associated with additional risk factors beyond those caused by socioeconomic disadvantage. These findings demonstrated that these adolescent mothers should be targeted for immediate and intense intervention. A qualitative study to describe the adolescent's grief response and an intervention study was recommended.
    • Mothers' interpretations of their children's behavior during mother-child interaction

      Remsburg, Robin Elaine; Parks, Peggy L. (1994)
      The purpose of this study was to gain understanding about mothers' motivations, intentions, and the meaning they ascribe to their children's behavior by exploring and describing mothers' interpretations of their children's behavior during interaction and how it impacts on mother-child interaction. Mothers' interpretations of their children's behavior were examined using qualitative research methodology. A grounded theory approach was used to collect, code, and analyze data with a goal to generate theoretical statements regarding the contribution of mothers' interpretations of their children's behaviors during mother-child interaction. Ten mothers of preterm infants participated in this study. Mothers were shown a videotape of themselves interacting with their 18 month old children during the Ainsworth-Wittig Strange Situation Procedure and were asked to discuss the behavior they observed. Interviews, field notes and investigator observations were transcribed, reviewed, and coded for content and process. Analysis revealed that the interpretation process involves three steps: recognition, determination of meaning, and management. Interpretation is the compilation of all the relevant and influencing factors necessary to decide what the behavior is, what it means, and results in the identification of a management strategy. Three categories of influencing factors were revealed: (1) child-related, (2) mother-related, and (3) situation-related. Mothers relied upon their personal knowledge of their children's usual behavior in explaining their children's behavior. Mothers' interpretations of their children's behavior fell into three basic areas: (1) harm/danger producing behavior, (2) undesired/disruptive behavior, and (3) desired/growth enhancing behavior. While mothers' specific interpretations were for the most part unique and personal, there were a number of areas in which their interpretations and the context in which they occurred that were similar among all mothers interviewed. Desired/growth enhancing behaviors cited by most mothers included talking, walking, eating, potty training, playing independently, and sharing and getting along with other children. Undesired/disruptive behaviors cited by most mothers included hitting, banging, or throwing objects. Temper tantrums and crying were also cited.
    • A study of maternal employment and family contexts: Influences on maternal health and mother-infant interaction

      Wendt, Linda Elaine; Parks, Peggy L. (1991)
      The purpose of this study was to examine relationships between selected employment, family, mother and infant characteristics, and mother-infant interaction in a sample of 81 mothers who were employed by three-months postpartum. The goal of the study was to identify family and employment variables that indirectly predicted mother- infant interaction through maternal health. A longitudinal design was used to test the Lerner-Galambos model of maternal employment. Family context variables included family social support, spousal support, and child care arrangements. Employment context variables included reasons for working, employment incongruence, hours worked and employment changes. Maternal health variables included depressive symptomatology, general health status, and number of health conditions. Mother-Infant interaction was measured by the Clark ERA dyad subscales. Variables were measured at three times: in the hospital following birth, at three-months postpartum, and at six-months postpartum. Employment context, family context, and mother and infant health variables were factor analyzed for purposes of data reduction. The factor scores were entered into hierarchical regressions. Neither employment context, nor family context, nor a combination of employment context and family context variables predicted mother-infant interaction through maternal health at six months. Maternal and infant health did not predict mother-infant interaction at six months. Family context at three months and at six months predicted maternal employment at three and six months. Exploratory analyses indicated that family context factors at three months predicted maternal health at six months. Employment context at three months predicted maternal health at six months. These findings are important for nurses who work with employed mothers during the perinatal period.