Improved Child Mental Health Following Brief Relationship Enhancement and Co-Parenting Interventions During the Transition to Parenthood.

The transition to parenthood has been identified as a significant relationship stressor. Many couples report declines in relationship satisfaction and difficulty with individual stress and co-parenting-problems that have been associated with both child temperament as well as emotional and behavioral problems. Several parenting and relationship interventions have been developed to buffer against these difficulties. In the current study, we report secondary analyses of a randomized controlled trial of brief (6-hr) interventions that focused on improving either relationship satisfaction or co-parenting, delivered during pregnancy and the early postpartum period. In this trial, 90 opposite-sex couples (180 participants), who were pregnant with their first child, and were assessed as being at high risk for declines in relationship satisfaction, were randomized to receive either (1) a relationship intervention, (2) a co-parenting intervention, or (3) an information control. At 12 months postpartum, couples who received either the relationship or co-parenting intervention rated their infants as having lower negative emotionality and as having fewer externalizing symptoms compared to the information-only control. Lower externalizing symptoms at 12 months were, in turn, associated with reduced externalizing symptoms at 24 months postpartum. Whereas, lower ratings of child negative emotionality at 12 months were associated with reduced internalizing symptoms at 24 months postpartum. These results indicate that brief relationship or co-parenting interventions delivered during the transition to parenthood have secondary benefits for child mental health.

Maternal Prenatal Anxiety and Children's Externalizing and Internalizing Behavioral Problems: The Moderating Roles of Maternal-Child Attachment Security and Child Sex.

BACKGROUND: Prenatal anxiety is associated with child behavioral problems. Prenatal anxiety is predictive of postnatal anxiety which can interfere with the security of maternal-child attachment and further raise the risk of child behavior problems. Secure maternal-child attachment is essential for optimal emotional health. Sex influences the type of behavior problem experienced. There is a gap in understanding whether attachment security and the sex of the child can moderate association between prenatal anxiety and children's behavioral problems. PURPOSE: To examine the association between prenatal anxiety and child behavioral problems and to test the moderating effects of attachment security and child sex on the association between prenatal anxiety and child behavioral problems. METHODS: Secondary analysis of data from 182 mothers and their children, enrolled in the Alberta Pregnancy Outcomes and Nutrition Study using Hayes' (2013) conditional process modeling. RESULTS: Prenatal anxiety was associated with both externalizing (b = -0.53; standard error (SE) = 0.20; p = 0.009) and internalizing (b = -0.32; SE = 0.13; p = 0.01) behaviors only in children with an insecure style of attachment. Child sex did not moderate the association between prenatal anxiety and children's behavioral problems. CONCLUSIONS: Attachment security moderated the association between prenatal anxiety and children's externalizing and internalizing behavioral problems.

Evaluation of an evidence-based education program for pressure ulcer prevention.

OBJECTIVE: The purpose of this study was to implement and evaluate a standardized education workshop for 2 levels of nursing staff. DESIGN: The quasi-experimental design required that nurses' knowledge be measured before and after education. SETTING AND SUBJECTS: The convenience sample included registered nurses (N = 595) and licensed practical nurses (N = 59) employed in three acute care hospitals with a total bed capacity of 1,760. INSTRUMENTS: The Pressure Ulcer Knowledge Test, including true-false questions, was selected and compared with updated literature and the evidence-based standards developed for the acute care hospitals. Minor changes resulted in a revised 53-item questionnaire for which content validity and reliability were established. The questionnaire was pilot tested before use. METHODS: The intervention, the standardized education workshop, included risk assessment, prevention, and wound staging, as described in the literature. The dependent variable, knowledge of pressure ulcer prevention and treatment, was measured at 3 time points: immediately before (pre) and after (post 1) the workshop and 3 months later (post 2). Data were analyzed using descriptive statistics and repeated measures. RESULTS: Overall, knowledge scores for the total group were significantly higher from pre to post 1 and from pre to post 2 but significantly lower from post 1 to post 2. Registered nurses' scores were significantly higher than those of licensed practical nurses from pre to post 1. CONCLUSION: The evidence-based pressure ulcer education was effective in increasing registered nurses' and licensed practical nurses' knowledge and was presumed to increase consistency of the knowledge and awareness of practice standards.