Narrative Review of Use and Continued Relevance of the Maternal Infant Responsiveness Instrument.

BACKGROUND: The Maternal Infant Responsiveness Instrument (MIRI) was developed in 2002 to measure a critical aspect of maternal-infant health. The objective of this analysis was to examine use, results, and continued relevance of the MIRI 20 years after its creation. METHODS: For the completion of this narrative review, 5 electronic databases were accessed using key search terms. Inclusion criteria were English-language, peer-reviewed research using the MIRI. Hand searches of reference lists were conducted. Five authors performed screening, data extraction, appraisal, and summarized findings. RESULTS: Fifteen studies were included. All studies reported an internal consistency of α > 0.70 for the MIRI. Positive correlations were reported with self-efficacy, infant temperament, and life satisfaction. Inverse relationships were reported with stress, depression, and experiential avoidance. Depressive symptomatology, life satisfaction, self-esteem, self-efficacy, and previous childcare experience were predictors of maternal responsiveness. DISCUSSION: Maternal well-being (postpartum depression and stress) can affect maternal responsiveness. Given the pervasive disparities in maternal health and well-being, it is important to have reliable measures of the effects of those disparities. The MIRI, a valid and reliable measure, may be useful for assessing the effectiveness of interventions designed to improve infant and maternal well-being.

Thoughts About Nursing Curricula: Dark Clouds and Bright Lights.

In this essay, several nurse scholars who are particularly concerned about the contemporary state of nursing science present their concerns about the inclusion of nursing conceptual models and theories in the curricula of nursing programs (dark clouds) and ways in which the concerns have been addressed (bright lights). This essay is the second of two essays that were catalyzed by Barrett's paper, "Again, What Is Nursing Science?" The first essay was published in the previous issue of Nursing Science Quarterly.

CREATING PROTOCOLS FOR TRUSTWORTHINESS IN QUALITATIVE RESEARCH.

be provided within the document. One option is the creation of a trustworthiness protocol with details noting the characteristic of rigor, the process used to document the rigor, and then a timeline directing the planned time for conducting trustworthiness activities. After reviewing several documents, an actual plan of conducting trustworthiness as not found. Thus, these authors set out to create a trustworthiness protocol designed not only for the dissertation, but aframework for others who must create similar trustworthiness protocols for their research. The purpose of this article is to provide a reference for the trustworthiness plan, a dissertation example and showcase a trustworthiness protocol that may be used as an example to other qualitative researchers embarking on the creation of a trustworthiness protocol that is concrete and clear.

Predictors of maternal responsiveness.

PURPOSE: To explore maternal responsiveness in the first 2 to 4 months after delivery and to evaluate potential predictors of maternal responsiveness, including infant feeding, maternal characteristics, and demographic factors such as age, socioeconomic status, and educational level. DESIGN AND METHODS: A cross-sectional survey design was used to assess the variables of maternal responsiveness, feeding patterns, and maternal characteristics in a convenience sample of 177 mothers in the first 2 to 4 months after delivery. The 60-item self-report instrument included scales to measure maternal responsiveness, self-esteem, and satisfaction with life as well as infant feeding questions and sociodemographic items. An online data-collection strategy was used, resulting in participants from 41 U.S. states. FINDINGS: Multiple regression analysis showed that satisfaction with life, self-esteem, and number of children, but not breastfeeding, explained a significant portion of the variance in self-reported maternal responsiveness scores. In this analysis, sociodemographic variables such as age, education, income, and work status showed little or no relationship to maternal responsiveness scores. CONCLUSIONS: This study provides additional information about patterns of maternal behavior in the transition to motherhood and some of the variables that influence that transition. Satisfaction with life was a new predictor of maternal responsiveness. However, with only 15% of the variance explained by the predictors in this study, a large portion of the variance in maternal responsiveness remains unexplained. Further research in this area is needed.

Measuring maternal responsiveness.

The purpose of this study was to review current research studies examining maternal responsiveness to locate self-report instruments, and to identify variables in these self-report instruments used to describe maternal responsiveness. The electronic databases, Medline, PsychLit, SocLit, and Cinahl were searched with the following key words: maternal responsiveness, maternal sensitivity, maternal attachment, maternal response, and responsiveness. Articles were obtained, assessed, and agreed upon for their usefulness to the study by the researcher and research assistant. Criteria included: articles must include key word, maternal responsiveness, in the title or a self-report instrument measuring maternal responsiveness. Fifty-two eligible studies were identified from the literature, read by two reviewers and both reviewers confirmed its applicability. All included studies were summarized in tabular form. References with the key words in the title were extracted from the literature to examine the measurement strategies. Specifically, the researchers were looking for self-report measures of maternal responsiveness. The trials identified by this review addressed limited aspects of communication and focused solely on antenatal care. Current self-report instruments do not contain the variables of maternal awareness, maternal recognition, and maternal reflection. Future research is needed in this area of instrumentation and maternal responsiveness.

First-time fathers and stressors in the postpartum period.

The purpose of this pilot study was to examine the everyday stressors of first-time fathers during the postpartum period and to begin the process of establishing reliability and validity for the use of the Everyday Stressors Index with a sample of first-time fathers. A convenience sample of 19 participants included first-time fathers ranging in age from 18 to 45 years and mostly living in medium-sized cities. The results indicated that factors such as a feeling of not having enough time for too many responsibilities, financial issues, and concerns about the health of the child and other family member(s) were sources of stress. However, with the exception of slight differences in the ranking, everyday stressors among first-time fathers closely resembled previously reported stressors of first-time mothers. Although the sample was small and the results nongeneralizable, these findings suggest that educational efforts by health-care professionals could beneficially be directed toward fathers as well as mothers throughout the prenatal and postpartum periods. Policy implications for nursing and new directions for future research are discussed.

Postpartum depression among African-American women.

The purpose of this qualitative study was to describe the nature of postpartum depression (PPD) among African-American women. Twelve women, who had experienced PPD within the last three years, were interviewed for approximately one hour at two intervals. Nudist-4 software and the constant comparative method were used to analyze the data. Five themes "Stressing Out," "Feeling Down," "Losing It," "Seeking Help," and "Feeling Better" represented aspects of PPD as experienced by the participants. The last theme, "Dealing with It," represented the cultural ways in which African-American mothers managed their depression. These included Keeping the Faith, Trying to Be a Strong Black Woman, Living with Myths, and Keeping Secrets. Suggestions for future directions in nursing research are included.

Public display of affection in couples attending childbirth education classes: implications for practice in Thailand.

The purpose of this article is to describe couples' touch behaviors and positions during their interactions in childbirth education class exercises in the United States-practices that might be construed differently among couples in Thailand. Using observations collected at childbirth education classes conducted in the United States during the fall of 2002, the author found four positions that would be considered culturally sensitive with her Thai experiences. Perhaps with some modifications in the technique, mothers and their partners in Thailand will more readily accept childbirth education classes.