Page 310 - Encyclopedia of Nursing Research

MATERNAL ANxIETy AND PSyCHOSOCIAL ADAPTATION n 277

(1) psychosocial and behavioral factors in Specific recommendations for increased
PTB, (2) professional education and training, nursing assessment and intervention to pre-
(3) communication and outreach, and (4) qual- vent material anxiety and psychosocial adap- M
ity of care and health services. Conference tion to parenting include the following:
recommendations affecting normal and PTB
are as follows: 1. Assessment and treatment of perinatal
depression and anxiety. High prenatal anxi-
• Identify needs in research, screening, and ety and depression was found among even
clinical care diverse samples. Goodman and Tyer-Viola
• Target African Americans as a priority for (2010) found 23% screened positive for anxiety
research services disorder and high depressive symptoms with
• Make research on the effects of race, rac- very low evidence of treatment. The signifi-
ism, and social injustice a priority cance of fetal programming with changes in
the fetal environment during sensitive devel-
The following are topics of concern in the opment that may cause both long-lasting life
near term: changes, and serious chronic disease is receiv-
ing increasing scientific attention (Schlotz
• Develop a panel to study preterm stress— & Phillips, 2009). Research shows that neo-
definition, conceptualization, measure- natal auditory-evoked responses are related
ment, and biological correlates of PTB to perinatal maternal anxiety, particularly
• Improve measurement of psychosocial in attention allocation (Harvison, Molfese,
and behavioral risk factors and promote Woodruff-Borden, & Weigel, 2009). Depressed
consistency of measures. Preferably use mothers are less responsive to their infants and
instruments with sufficient content to voices (Field, Diego, & Hernandez-Reif, 2009).
provide guidelines for informed psycho- Confirmed maternal anxiety from pregnancy
social interventions (Lederman and Weis, to 5 years postbirth was associated with chil-
(2009) dren experiencing attention problems from 5
• Collect and conduct data analyses to enable to 14 years (Clavarino et al., 2010). Also, high
high quality evaluation of intervention. midpregnancy anxiety was associated with
decreased gray matter density in children 6
Topics of concern in the midterm are: to 9 years old (Buss, Davis, Muftuler, Head,
& Sandman, 2010). Indications are emerg-
• Determine parameters that foster individ- ing that the early prenatal environment
ual decision making of health behaviors may have long life consequences for psy-
and develop interventions to foster the chological development and mental health,
decision-making process. including temperament, adult personality,
mental health, and negative personality con-
Long-term concerns are: sequences (Raikkonen & Pesonen, 2009). The
two- to threefold larger incidence of PTB for
• Shift from a risk-based to an assets-based African American women, the effects of rac-
approach to identify protective factors ism (Gavin, Chae, Mustillo, & Kiefe, 2009;
and alleviate stress factors for decreasing Nuru-Jeter et al., 2009), and the single-mother
stress associated with PTB. homes and/or parental conflict could further
• Develop study methods over the life span compound these negative high-risk PTB and
to obtain multideterminant causal mod- very low birth weight (VLBW) infant health
els: careers factors, measurement meth- disparities (Kramer & Hogue, 2009).
ods, interactions among data, and causal 2. Assessment of prenatal psychologi-
pathways. cal and psychosocial adaptation to pregnancy.