Effectiveness of a Technology-Based Supportive Educational Parenting Program on Parental Outcomes (Part 1): Randomized Controlled Trial

Shefaly Shorey, Yvonne Peng Mei Ng, Esperanza Debby Ng, An Ling Siew, Evalotte Mörelius, Joanne Yoong, Mihir Gandhi, Shefaly Shorey, Yvonne Peng Mei Ng, Esperanza Debby Ng, An Ling Siew, Evalotte Mörelius, Joanne Yoong, Mihir Gandhi

Abstract

Background: Transitioning into parenthood can be stressful for new parents, especially with the lack of continuity of care from health care professionals during the postpartum period. Short hospital stays limit the availability of support and time parents need to be well equipped with parenting and infant care skills. Poor parental adjustment may, in turn, lead to negative parental outcomes and adversely affect the child's development. For the family's future well-being, and to facilitate a smoother transition into parenthood, there is a need for easily accessible, technology-based educational programs to support parents during the crucial perinatal period.

Objective: This study aimed to examine the effectiveness of a technology-based supportive educational parenting program (SEPP) on parenting outcomes during the perinatal period in couples.

Methods: A randomized, single-blinded, parallel-armed, controlled trial was conducted. The study recruited 236 parents (118 couples) from an antenatal clinic of a tertiary hospital in Singapore. Eligible parents were randomly assigned to the intervention group (n=118) or the control group (n=118). The SEPP is based on Bandura's self-efficacy theory and Bowlby's theory of attachment. Components of the intervention include 2 telephone-based educational sessions (1 antenatal and 1 immediately postnatal) and a mobile health app follow-up for 1 month. The control group only received routine perinatal care provided by the hospital. Outcome measures including parenting self-efficacy (PSE), parental bonding, perceived social support, parenting satisfaction, postnatal depression (PND), and anxiety were measured using reliable and valid instruments. Data were collected over 6 months at 4 time points: during pregnancy (third trimester), 2 days postpartum, 1 month postpartum, and 3 months postpartum. Outcomes were standardized using baseline means and SDs. Linear mixed models were used to compare the groups for postpartum changes in the outcome variables.

Results: The intervention group showed significantly better outcome scores than the control group from baseline to 3 months postpartum for PSE (mean difference, MD, 0.37; 95% CI 0.06 to 0.68; P=.02), parental bonding (MD -1.32; 95% CI -1.89 to -0.75; P<.001), self-perceived social support (MD 0.69; 95% CI 0.18 to 1.19; P=.01), parenting satisfaction (MD 1.40; 95% CI 0.86 to 1.93; P<.001), and PND (MD -0.91; 95% CI -1.34 to -0.49; P<.001). Postnatal anxiety (PNA) scores of the intervention group were only significantly better after adjusting for covariates (MD -0.82; 95% CI -1.15 to -0.49; P<.001).

Conclusions: The technology-based SEPP is effective in enhancing parental bonding, PSE, perceived social support and parental satisfaction, and in reducing PND and PNA. Health care professionals could incorporate it with existing hands-on infant care classes and routine care to better meet parents' needs and create positive childbirth experiences, which may in turn encourage parents to have more children.

Trial registration: ISRCTN Registry ISRCTN48536064; http://www.isrctn.com/ISRCTN48536064 (Archived by WebCite at http://www.webcitation.org/6wMuEysiO).

Keywords: parents; social support.

Conflict of interest statement

Conflicts of Interest: None declared.

©Shefaly Shorey, Yvonne Peng Mei Ng, Esperanza Debby Ng, An Ling Siew, Evalotte Mörelius, Joanne Yoong, Mihir Gandhi. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 13.02.2019.

Figures

Figure 1
Figure 1
Consolidated standards of reporting trial flowchart of the study. EPDS: Edinburgh Postnatal Depression Scale; PES: Parenting Efficacy Scale; PIBQ: Parent-to-Infant Bonding Questionnaire; PSSP: Perceived Social Support for Parenting; STAI: State Trait Anxiety Inventory; WPBL: What Being a Parent of a Baby Is Like.
Figure 2
Figure 2
Couples’ (mothers and fathers) population: changes in the standardized estimated mean scores of parental outcomes at 2 days, 1 month, and 3 months postpartum in control and intervention groups.

References

    1. Jones G. The Japanese Journal of Population. 2012. Mar, [2018-12-07]. Late marriage and low fertility in Singapore: the limits of policy .
    1. Gottvall K, Waldenström U. Does a traumatic birth experience have an impact on future reproduction? BJOG. 2002 Mar;109(3):254–60. doi: 10.1111/j.1471-0528.2002.01200.x.
    1. Waldenström U, Hildingsson I, Rubertsson C, Rådestad I. A negative birth experience: prevalence and risk factors in a national sample. Birth. 2004 Mar;31(1):17–27. doi: 10.1111/j.0730-7659.2004.0270.x.
    1. Ong SF, Chan WC, Shorey S, Chong YS, Klainin-Yobas P, He HG. Postnatal experiences and support needs of first-time mothers in Singapore: a descriptive qualitative study. Midwifery. 2014 Jun;30(6):772–8. doi: 10.1016/j.midw.2013.09.004.
    1. Shorey S, Dennis CL, Bridge S, Chong YS, Holroyd E, He HG. First-time fathers' postnatal experiences and support needs: a descriptive qualitative study. J Adv Nurs. 2017 Dec;73(12):2987–96. doi: 10.1111/jan.13349.
    1. Melnyk BM, Crean HF, Feinstein NF, Fairbanks E. Maternal anxiety and depression after a premature infant's discharge from the neonatal intensive care unit: explanatory effects of the creating opportunities for parent empowerment program. Nurs Res. 2008;57(6):383–94. doi: 10.1097/NNR.0b013e3181906f59.
    1. Ngai FW, Chan SW, Ip WY. The effects of a childbirth psychoeducation program on learned resourcefulness, maternal role competence and perinatal depression: a quasi-experiment. Int J Nurs Stud. 2009 Oct;46(10):1298–306. doi: 10.1016/j.ijnurstu.2009.03.007.
    1. Smart Nation Singapore. 2017. [2017-07-06]. Transforming Singapore .
    1. Gulliver A, Griffiths KM, Christensen H, Brewer JL. A systematic review of help-seeking interventions for depression, anxiety and general psychological distress. BMC Psychiatry. 2012 Jul 16;12:81. doi: 10.1186/1471-244X-12-81.
    1. Plantin L, Daneback K. Parenthood, information and support on the internet. A literature review of research on parents and professionals online. BMC Fam Pract. 2009 May 18;10:34. doi: 10.1186/1471-2296-10-34.
    1. Salonen AH, Kaunonen M, Astedt-Kurki P, Järvenpää AL, Isoaho H, Tarkka MT. Parenting self-efficacy after childbirth. J Adv Nurs. 2009 Nov;65(11):2324–36. doi: 10.1111/j.1365-2648.2009.05113.x.
    1. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977 Mar;84(2):191–215. doi: 10.1037/0033-295X.84.2.191.
    1. Bandura A. Self-efficacy: the exercise of control. New York: WH Freeman and Company; 1997.
    1. Biehle SN, Mickelson KD. Personal and co-parent predictors of parenting efficacy across the transition to parenthood. J Soc Clin Psychol. 2011 Nov;30(9):985–1010. doi: 10.1521/jscp.2011.30.9.985.
    1. Leerkes EM, Burney RV. The development of parenting efficacy among new mothers and fathers. Infancy. 2007 Feb 03;12(1):45–67. doi: 10.1111/j.1532-7078.2007.tb00233.x.
    1. Bowlby J. Attachment and Loss, Volume 1: Attachment. New York: Basic Books; 1969.
    1. Doss BD, Rhoades GK, Stanley SM, Markman HJ. The effect of the transition to parenthood on relationship quality: an 8-year prospective study. J Pers Soc Psychol. 2009 Mar;96(3):601–19. doi: 10.1037/a0013969.
    1. Lawrence E, Rothman AD, Cobb RJ, Rothman MT, Bradbury TN. Marital satisfaction across the transition to parenthood. J Fam Psychol. 2008 Feb;22(1):41–50. doi: 10.1037/0893-3200.22.1.41.
    1. Biehle SN, Mickelson KD. First-time parents' expectations about the division of childcare and play. J Fam Psychol. 2012 Feb;26(1):36–45. doi: 10.1037/a0026608.
    1. Feldman R. Parents' convergence on sharing and marital satisfaction, father involvement, and parent–child relationship at the transition to parenthood. Infant Ment Health J. 2000 Jul 14;21(3):176–91. doi: 10.1002/1097-0355(200007)21:3<176::AID-IMHJ3>;2-4.
    1. Bielawska-Batorowicz E, Kossakowska-Petrycka K. Depressive mood in men after the birth of their offspring in relation to a partner's depression, social support, fathers' personality and prenatal expectations. J Reprod Infant Psychol. 2006 Feb;24(1):21–9. doi: 10.1080/02646830500475179.
    1. Harwood K, McLean N, Durkin K. First-time mothers' expectations of parenthood: what happens when optimistic expectations are not matched by later experiences? Dev Psychol. 2007 Jan;43(1):1–12. doi: 10.1037/0012-1649.43.1.1.
    1. Shorey S, Chan SW, Chong YS, He HG. A randomized controlled trial of the effectiveness of a postnatal psychoeducation programme on self-efficacy, social support and postnatal depression among primiparas. J Adv Nurs. 2015 Jun;71(6):1260–73. doi: 10.1111/jan.12590.
    1. Negron R, Martin A, Almog M, Balbierz A, Howell EA. Social support during the postpartum period: mothers' views on needs, expectations, and mobilization of support. Matern Child Health J. 2013 May;17(4):616–23. doi: 10.1007/s10995-012-1037-4.
    1. Brown SG, Hudson DB, Campbell-Grossman C, Kupzyk KA, Yates BC, Hanna KM. Social support, parenting competence, and parenting satisfaction among adolescent, African American, mothers. West J Nurs Res. 2018 Apr;40(4):502–19. doi: 10.1177/0193945916682724.
    1. Seymour M, Giallo R, Cooklin A, Dunning M. Maternal anxiety, risk factors and parenting in the first post-natal year. Child Care Health Dev. 2015 Mar;41(2):314–23. doi: 10.1111/cch.12178.
    1. Liyana Amin NA, Tam WW, Shorey S. Enhancing first-time parents' self-efficacy: a systematic review and meta-analysis of universal parent education interventions' efficacy. Int J Nurs Stud. 2018 Jun;82:149–62. doi: 10.1016/j.ijnurstu.2018.03.021.
    1. Hudson DB, Campbell-Grossman C, Fleck MO, Elek SM, Shipman A. Effects of the New Fathers Network on first-time fathers' parenting self-efficacy and parenting satisfaction during the transition to parenthood. Issues Compr Pediatr Nurs. 2003;26(4):217–29. doi: 10.1080/01460860390246687.
    1. Lindberg I, Christensson K, Ohrling K. Parents' experiences of using videoconferencing as a support in early discharge after childbirth. Midwifery. 2009 Aug;25(4):357–65. doi: 10.1016/j.midw.2007.06.002.
    1. Salonen AH, Kaunonen M, Astedt-Kurki P, Järvenpää AL, Isoaho H, Tarkka MT. Effectiveness of an internet-based intervention enhancing Finnish parents' parenting satisfaction and parenting self-efficacy during the postpartum period. Midwifery. 2011 Dec;27(6):832–41. doi: 10.1016/j.midw.2010.08.010.
    1. Shorey S, Lau Y, Dennis CL, Chan YS, Tam WW, Chan YH. A randomized-controlled trial to examine the effectiveness of the 'Home-but not Alone' mobile-health application educational programme on parental outcomes. J Adv Nurs. 2017 Mar 09;73(9):2103–17. doi: 10.1111/jan.13293.
    1. Haga SM, Drozd F, Brendryen H, Slinning K. Mamma mia: a feasibility study of a web-based intervention to reduce the risk of postpartum depression and enhance subjective well-being. JMIR Res Protoc. 2013 Aug 12;2(2):e29. doi: 10.2196/resprot.2659.
    1. Luu TM, Xie LF, Peckre P, Cote S, Karsenti T, Walker CD, Gosselin J. Web-based intervention to teach developmentally supportive care to parents of preterm infants: feasibility and acceptability study. JMIR Res Protoc. 2017 Nov 30;6(11):e236. doi: 10.2196/resprot.8289.
    1. Danbjørg DB, Wagner L, Kristensen BR, Clemensen J. Intervention among new parents followed up by an interview study exploring their experiences of telemedicine after early postnatal discharge. Midwifery. 2015 Jun;31(6):574–81. doi: 10.1016/j.midw.2015.02.007.
    1. Dunham PJ, Hurshman A, Litwin E, Gusella J, Ellsworth C, Dodd PW. Computer-mediated social support: single young mothers as a model system. Am J Community Psychol. 1998 Apr;26(2):281–306. doi: 10.1023/A:1022132720104.
    1. Slomian J, Bruyère O, Reginster JY, Emonts P. The internet as a source of information used by women after childbirth to meet their need for information: a web-based survey. Midwifery. 2017 May;48:46–52. doi: 10.1016/j.midw.2017.03.005.
    1. Evans M, Donelle L, Hume-Loveland L. Social support and online postpartum depression discussion groups: a content analysis. Patient Educ Couns. 2012 Jun;87(3):405–10. doi: 10.1016/j.pec.2011.09.011.
    1. Lee EW, Denison FC, Hor K, Reynolds RM. Web-based interventions for prevention and treatment of perinatal mood disorders: a systematic review. BMC Pregnancy Childbirth. 2016 Feb 29;16:38. doi: 10.1186/s12884-016-0831-1.
    1. Slomian J, Emonts P, Vigneron L, Acconcia A, Reginster JY, Oumourgh M, Bruyère O. Meeting the needs of mothers during the postpartum period: using co-creation workshops to find technological solutions. JMIR Res Protoc. 2017 May 03;6(5):e76. doi: 10.2196/resprot.6831.
    1. Urbaniak G, Plous S. Research Randomizer. [2018-04-17].
    1. Shorey S, Ng YP, Siew AL, Yoong J, Mörelius E. Effectiveness of a technology-based supportive educational parenting program on parental outcomes in Singapore: protocol for a randomized controlled trial. JMIR Res Protoc. 2018 Jan 10;7(1):e4. doi: 10.2196/resprot.8062.
    1. Leerkes EM, Crockenberg SC. The impact of maternal characteristics and sensitivity on the concordance between maternal reports and laboratory observations of infant negative emotionality. Infancy. 2003 Oct 01;4(4):517–39. doi: 10.1207/S15327078IN0404_07.
    1. Berle JØ, Mykletun A, Daltveit AK, Rasmussen S, Holsten F, Dahl AA. Neonatal outcomes in offspring of women with anxiety and depression during pregnancy. A linkage study from the Nord-Trøndelag Health Study (HUNT) and Medical Birth Registry of Norway. Arch Womens Ment Health. 2005 Sep;8(3):181–9. doi: 10.1007/s00737-005-0090-z.
    1. Taylor A, Atkins R, Kumar R, Adams D, Glover V. A new mother-to-infant bonding scale: links with early maternal mood. Arch Womens Ment Health. 2005 May;8(1):45–51. doi: 10.1007/s00737-005-0074-z.
    1. Bienfait M, Maury M, Haquet A, Faillie JL, Franc N, Combes C, Daudé H, Picaud JC, Rideau A, Cambonie G. Pertinence of the self-report mother-to-infant bonding scale in the neonatal unit of a maternity ward. Early Hum Dev. 2011 Apr;87(4):281–7. doi: 10.1016/j.earlhumdev.2011.01.031.
    1. Pridham KF, Chang AS. What being the parent of a new baby is like: revision of an instrument. Res Nurs Health. 1989 Oct;12(5):323–9. doi: 10.1002/nur.4770120508.
    1. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987 Jun;150:782–6.
    1. Edwards H, Phillips C, Esterman A, Buisman-Pijlman F, Gordon A. Risk factors and assessment tools for mother-infant bonding: a scoping review to assist future research. Evidence Based Midwifery. 2017 Dec 01;15(4):128–34.
    1. Edmondson OJ, Psychogiou L, Vlachos H, Netsi E, Ramchandani PG. Depression in fathers in the postnatal period: assessment of the Edinburgh Postnatal Depression Scale as a screening measure. J Affect Disord. 2010 Sep;125(1-3):365–8. doi: 10.1016/j.jad.2010.01.069.
    1. Spielberger CD. Manual for the state-trait anxiety inventory. Palo Alto, California: Consulting Psychologists Press; 1983. Jan,
    1. Julian LJ. Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A) Arthritis Care Res (Hoboken) 2011 Nov;63(Suppl 11):S467–72. doi: 10.1002/acr.20561. doi: 10.1002/acr.20561.
    1. Leerkes EM, Crockenberg SC. The development of maternal self-efficacy and its impact on maternal behavior. Infancy. 2002 Apr 01;3(2):227–47. doi: 10.1207/S15327078IN0302_7.
    1. Deave T, Johnson D. The transition to parenthood: what does it mean for fathers? J Adv Nurs. 2008 Sep;63(6):626–33. doi: 10.1111/j.1365-2648.2008.04748.x.
    1. Figueroa Leigh F, Binda Vergara V, Pía Santelices M. Enhancing early attachment: design and pilot study of an intervention for primary health care dyads. J Child Health Care. 2013 Mar;17(1):82–91. doi: 10.1177/1367493512447533.
    1. Bartholomew MK, Schoppe-Sullivan SJ, Glassman M, Kamp Dush CM, Sullivan JM. New parents' Facebook use at the transition to parenthood. Fam Relat. 2012 Jul;61(3):455–69. doi: 10.1111/j.1741-3729.2012.00708.x.
    1. Danaher BG, Milgrom J, Seeley JR, Stuart S, Schembri C, Tyler MS, Ericksen J, Lester W, Gemmill AW, Kosty DB, Lewinsohn P. MomMoodBooster web-based intervention for postpartum depression: feasibility trial results. J Med Internet Res. 2013 Nov 04;15(11):e242. doi: 10.2196/jmir.2876.
    1. Porter CL, Hsu HC. First-time mothers' perceptions of efficacy during the transition to motherhood: links to infant temperament. J Fam Psychol. 2003 Mar;17(1):54–64. doi: 10.1037/0893-3200.17.1.54.
    1. Abarashi Z, Tahmassian K, Mazaheri MA, Panaghi L, Mansoori N. Parental self-efficacy as a determining factor in healthy mother-child interaction: a pilot study in Iran. Iran J Psychiatry Behav Sci. 2014;8(1):19–25.
    1. Shorey S, He HG, Morelius E. Skin-to-skin contact by fathers and the impact on infant and paternal outcomes: an integrative review. Midwifery. 2016 Sep;40:207–17. doi: 10.1016/j.midw.2016.07.007.
    1. Feldman R, Gordon I, Schneiderman I, Weisman O, Zagoory-Sharon O. Natural variations in maternal and paternal care are associated with systematic changes in oxytocin following parent-infant contact. Psychoneuroendocrinology. 2010 Sep;35(8):1133–41. doi: 10.1016/j.psyneuen.2010.01.013.
    1. Gao LL, Chan SW, Sun K. Effects of an interpersonal-psychotherapy-oriented childbirth education programme for Chinese first-time childbearing women at 3-month follow up: randomised controlled trial. Int J Nurs Stud. 2012 Mar;49(3):274–81. doi: 10.1016/j.ijnurstu.2011.09.010.
    1. Razurel C, Antonietti JP, Rulfi F, Pasquier N, Domingues-Montanari S, Darwiche J. The impact of pre- and post-natal psycho-educational intervention on the construction of parenthood. Arch Womens Ment Health. 2017 Jun;20(3):469–72. doi: 10.1007/s00737-017-0720-2.
    1. Doherty WJ, Erickson MF, LaRossa R. An intervention to increase father involvement and skills with infants during the transition to parenthood. J Fam Psychol. 2006 Sep;20(3):438–47. doi: 10.1037/0893-3200.20.3.438.
    1. Serçekus P, Baskale H. Effects of antenatal education on fear of childbirth, maternal self-efficacy and parental attachment. Midwifery. 2016 Mar;34:166–72. doi: 10.1016/j.midw.2015.11.016.
    1. Niela-Vilén H, Axelin A, Salanterä S, Melender HL. Internet-based peer support for parents: a systematic integrative review. Int J Nurs Stud. 2014 Nov;51(11):1524–37. doi: 10.1016/j.ijnurstu.2014.06.009.
    1. Hannula L, Kaunonen M, Tarkka MT. A systematic review of professional support interventions for breastfeeding. J Clin Nurs. 2008 May;17(9):1132–43. doi: 10.1111/j.1365-2702.2007.02239.x.
    1. Chan SW, Levy V, Chung TK, Lee D. A qualitative study of the experiences of a group of Hong Kong Chinese women diagnosed with postnatal depression. J Adv Nurs. 2002 Sep;39(6):571–9. doi: 10.1046/j.1365-2648.2002.02326.x.
    1. Leung SS, Martinson IM, Arthur D. Postpartum depression and related psychosocial variables in Hong Kong Chinese women: findings from a prospective study. Res Nurs Health. 2005 Feb;28(1):27–38. doi: 10.1002/nur.20053.
    1. Burke CT, Goren J. Self-evaluative consequences of social support receipt: the role of context self-relevance. Pers Relatsh. 2014 Jul 25;21(3):433–50. doi: 10.1111/pere.12039.
    1. Burke CT, Perndorfer CC. Negative emotional responses to motherhood-related support receipt during pregnancy predict postpartum depressive symptoms. Anxiety Stress Coping. 2016 Sep;29(5):580–8. doi: 10.1080/10615806.2015.1092023.
    1. Falah-Hassani K, Shiri R, Dennis CL. Prevalence and risk factors for comorbid postpartum depressive symptomatology and anxiety. J Affect Disord. 2016 Jul 01;198:142–7. doi: 10.1016/j.jad.2016.03.010.
    1. Lamers F, van Oppen P, Comijs HC, Smit JH, Spinhoven P, van Balkom AJ, Nolen WA, Zitman FG, Beekman AT, Penninx BW. Comorbidity patterns of anxiety and depressive disorders in a large cohort study: the Netherlands Study of Depression and Anxiety (NESDA) J Clin Psychiatry. 2011 Mar;72(3):341–8. doi: 10.4088/JCP.10m06176blu.
    1. O'Mahen HA, Richards DA, Woodford J, Wilkinson E, McGinley J, Taylor RS, Warren FC. Netmums: a phase II randomized controlled trial of a guided internet behavioural activation treatment for postpartum depression. Psychol Med. 2014 Jun;44(8):1675–89. doi: 10.1017/S0033291713002092.
    1. O'Brien AP, McNeil KA, Fletcher R, Conrad A, Wilson AJ, Jones D, Chan SW. New fathers' perinatal depression and anxiety-treatment options: an integrative review. Am J Mens Health. 2017 Jul;11(4):863–76. doi: 10.1177/1557988316669047.
    1. Giallo R, D'Esposito F, Cooklin A, Mensah F, Lucas N, Wade C, Nicholson JM. Psychosocial risk factors associated with fathers' mental health in the postnatal period: results from a population-based study. Soc Psychiatry Psychiatr Epidemiol. 2013 Apr;48(4):563–73. doi: 10.1007/s00127-012-0568-8.
    1. Kwan RW, Kwok SY, Ling CC. The moderating roles of parenting self-efficacy and co-parenting alliance on marital satisfaction among Chinese fathers and mothers. J Child Fam Stud. 2015 Feb 13;24(12):3506–15. doi: 10.1007/s10826-015-0152-4.
    1. Pinto TM, Figueiredo B, Pinheiro LL, Canário C. Fathers’ parenting self-efficacy during the transition to parenthood. J Reprod Infant Psychol. 2016 Jun 09;34(4):343–55. doi: 10.1080/02646838.2016.1178853.
    1. Shapiro AF, Nahm EY, Gottman JM, Content K. Bringing baby home together: examining the impact of a couple-focused intervention on the dynamics within family play. Am J Orthopsychiatry. 2011 Jul;81(3):337–50. doi: 10.1111/j.1939-0025.2011.01102.x.
    1. Midmer D, Wilson L, Cummings S. A randomized, controlled trial of the influence of prenatal parenting education on postpartum anxiety and marital adjustment. Fam Med. 1995 Mar;27(3):200–5.
    1. Feinberg ME, Kan ML. Establishing family foundations: intervention effects on coparenting, parent/infant well-being, and parent-child relations. J Fam Psychol. 2008 Apr;22(2):253–63. doi: 10.1037/0893-3200.22.2.253.
    1. van Bussel JC, Spitz B, Demyttenaere K. Three self-report questionnaires of the early mother-to-infant bond: reliability and validity of the Dutch version of the MPAS, PBQ and MIBS. Arch Womens Ment Health. 2010 Oct;13(5):373–84. doi: 10.1007/s00737-009-0140-z.
    1. Yoshida K, Yamashita H, Conroy S, Marks M, Kumar C. A Japanese version of mother-to-infant bonding scale: factor structure, longitudinal changes and links with maternal mood during the early postnatal period in Japanese mothers. Arch Womens Ment Health. 2012 Oct;15(5):343–52. doi: 10.1007/s00737-012-0291-1.

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit