Subject(s)
Infant Health , Mental Health , Object Attachment , Parent-Child Relations , Humans , InfantABSTRACT
PROBLEM: About 10-15% of women experience postpartum depression (PPD). Doulas provide support and education about PPD. METHODS: This qualitative study used focus groups with mothers, doulas, and doula trainers to develop educational materials for doulas to help mothers identify symptoms of depression and seek treatment. FINDINGS: All participants preferred materials that use simple language and avoid psychiatric jargon. Three themes emerged: someone to talk to, flexibility, and interactivity. Materials developed include tri-fold brochure and content for an application for smartphones and digital tablets. CONCLUSIONS: Doulas can use these interactive materials to provide supportive, relationship-based care that complements nursing care.
Subject(s)
Depression, Postpartum/therapy , Doulas/education , Doulas/psychology , Models, Educational , Mothers/education , Mothers/psychology , Adult , Computers, Handheld/statistics & numerical data , Female , Focus Groups , Humans , Information Services/supply & distribution , Pamphlets , Patient Acceptance of Health Care/psychology , Practice Guidelines as Topic , Qualitative Research , TelephoneABSTRACT
OBJECTIVE: To describe the domains of postpartum doula care and illustrate how doulas facilitate development of maternal responsiveness and competence. DESIGN: Qualitative study using ethnographic method of participant observation. SETTING: Homes of mothers who received postpartum doula care. PARTICIPANTS: Thirteen women and their infants; 4 postpartum doulas. RESULTS: Eleven domains emerged: emotional support, physical comfort, self-care, infant care, information, advocacy, referral, partner/father support, support mother/father with infant, support mother/father with sibling care, and household organization. Emotional support was used consistently and in combination with the other domains. Activities in all of the domains were used to facilitate the development of maternal responsiveness and maternal competence with 3 issues: resolution of infant feeding, integrating the infant into the family, and supporting developmental care and attachment. CONCLUSIONS: Data suggest that by using 11 domains of care, postpartum doulas facilitate maternal responsiveness and competence. Development of a long-term relationship, mother-centered care, and education and support related to infant feeding, integrating the infant into family, and developmental care and attachment may contribute to these outcomes.
Subject(s)
Mothers/education , Nurse's Role , Nurse-Patient Relations , Nursing Assistants , Patient Satisfaction , Postnatal Care/methods , Adult , Anecdotes as Topic , Female , Humans , Infant Care/methods , Infant, Newborn , Michigan , Middle Aged , Mothers/psychology , Nursing Methodology Research , Social Environment , Social SupportABSTRACT
Psychotherapeutic treatment of people with borderline personality disorder (BPD) is one of the greatest challenges confronting mental health professionals today. Clients with BPD are often difficult for nurses to work with, perhaps due to a lack of understanding of the underlying dynamics of the disorder. This article describes effective treatment strategies for BPD with a central focus on dialectical behavioral therapy (DBT). In typical mental health settings, nurses can effectively implement interventions using the concepts of DBT to help people with BPD build effective coping strategies and skillful behavioral responses for improved quality of life.
Subject(s)
Borderline Personality Disorder/rehabilitation , Cognitive Behavioral Therapy/methods , Adult , Borderline Personality Disorder/nursing , Borderline Personality Disorder/psychology , Combined Modality Therapy , Female , Humans , Psychotropic Drugs/therapeutic useABSTRACT
Until recently, few programs were available for children whose mothers are in recovery. A refinement of the gender-specific model of substance abuse treatment, the "family-focused" approach, has placed increased emphasis on the needs of children and other family members. However, because these programs are relatively new, little is known about the effectiveness of this type of treatment for either the mother or her children. This article presents findings from a three-year evaluation of a family-focused residential treatment program for women and their children. Longitudinal assessment of the mothers indicated that their psychosocial status and parenting attitudes improved over time. Additionally, the mothers remained in treatment longer. At intake, as a group, the children who were birth to three years of age did not exhibit developmental delay. However, developmental concerns were identified for some children in the areas of motor and/or language development. The results reported here provide beginning evidence that family-focused treatment improves retention, psychosocial functioning, and parenting attitudes of pregnant and parenting women. It also provides a mechanism for early identification and intervention for children.
Subject(s)
Family , Maternal Behavior/drug effects , Pregnancy Complications/therapy , Residential Treatment , Self-Help Groups/organization & administration , Substance-Related Disorders/therapy , Child Development , Child of Impaired Parents/psychology , Child, Preschool , Education , Family/psychology , Female , Humans , Infant , Length of Stay , Mother-Child Relations , Mothers/psychology , Parenting , Pregnancy , Pregnancy Complications/psychology , Program Evaluation , Substance-Related Disorders/psychologyABSTRACT
Most women in substance abuse treatment have experienced significant losses. This preliminary study examined the effectiveness of a therapy group addressing grief and loss among women enrolled in a gender-specific residential substance abuse treatment program. The intervention group consisted of 24 grief group participants and the comparison group consisted of 31 nonparticipants. Qualitative analysis revealed a pattern: participants identified traumatic loss, moved to emotional loss and abandonment by their own mothers, then focused on their own children. Data obtained at induction and at exit or follow-up were used for quantitative analysis. Length of stay, self-esteem, depression, mood, and parenting attitudes were assessed using standardized instruments. Women who participated in the grief group remained in treatment longer. While both groups were depressed and had low self-esteem at induction, the self-esteem of nonparticipants was significantly lower than that of participants. Both groups improved over time on mood, depression, and parenting. At exit or follow-up, participants had higher self-esteem. Based on these findings, we hypothesized that higher self-esteem at induction made it possible for women to participate in and benefit from the grief group, thus contributing to length of stay. To test this hypothesis we conducted regression analyses which found that, individually, group status (participation) and self-esteem explained 11% of the variance in length of stay. However, since the number of women with available data varied for group status and self-esteem, group status was a significant predictor of length of stay and self-esteem showed only a trend toward significance. These findings support our hypothesis. The women's pattern of disclosure and the hypotheses drawn from the results of this preliminary analysis will be examined further in an evaluation of a series of groups focused on loss and grief.
