Caregiving and Support Issues Identified by Parents of an Infant With Congenital Heart Disease for Interactive Problem-Solving.

Background and Purpose: Parents of an infant with complex congenital heart disease report caregiving challenges in the infant's first half year. We studied the issues parent dyads (mothers and fathers) were dealing with and their effect on their coparenting competencies in interactive problem-solving. Methods: The issues 31 parent dyads identified for interactive problem-solving at either or both infants aged 2 and 6 months were typed as caregiving or relational/support. The parent dyad's interactive competencies were assessed from video recording for two types of tasks (i.e., caregiving and the parent dyad's relationship as caregivers). Constructs of Iowa Family Interaction Rating Scales were applied to assess the competencies of mothers, fathers, and the parent dyad for a group that received guided participation (n = 17) and a group that received usual care (n = 8). Results: Pie charts showed feeding, most frequently identified for interactive problem-solving at 2 months, was surpassed at 6 months by growth and development. The time parents spent together was the most mentioned relationship issue at 2 and 6 months. Forest plots showed caregiving issues were associated with at least medium effect sizes for dyadic problem-solving for both parents at 2 and 6 months and for problem-solving for fathers at 2 and 6 months. Relational/support issues were associated with higher hostility and communication hindering than caregiving issues. Implications for Practice: Intervention to aid parents in interactive problem-solving for both caregiving and relationship/support issues merits development and testing.

Parents' Interactive Problem-Solving Behavior and Emotion Studied With Audio Compared With Video Source.

BACKGROUND AND PURPOSE: Parents' communication and problem-solving interaction with each other and with clinicians influences the caregiving of infants with a chronic health problem, making in-depth study of this interaction critical for design of interventions to support caregiving. This study, however, has been severely limited by lack of observational methods that can be applied in home, clinic and community settings. The Iowa Family Interaction Rating Scales provide comprehensive description of communicative and problem-solving behavior and emotion, but have only been applied to video-recorded interaction. Audio recording, in contrast to video recording, has the advantage of being unobtrusive, readily accessible, and generally acceptable, increasing the opportunity for focused examination and intervention of parents' interaction with each other or with clinicians. Our study objective was to examine the agreement of scores obtained on parents' interactive problem-solving behavior coded with the Iowa Family Interaction Rating Scales using an audio-recorded source for coding compared with coding from a video-recorded source. METHOD: In secondary analysis, audio-recordings were derived from video recordings of 15 parent-parent interactions. Audio recordings were created and coded blind of the original video recording and coding. RESULTS: Using Gwet's AC1 coefficient, agreement was at least moderate (0.61 - 0.80) for 69.1% of paired codes, signifying reliability of coding from audio recording for most codes. IMPLICATIONS FOR PRACTICE: Selected Iowa Family Interaction Rating Scales can be used with acceptable reliability for coding parents' interactive problem-solving behavior from audio source, advancing the study of parent interactive-problem solving behavior and potentially parents' problem solving with clinicians.