Mexican immigrant mothers face many challenges that put them at increased risk for poor mental he... more Mexican immigrant mothers face many challenges that put them at increased risk for poor mental health. To understand the factors that lead to the development of depressive symptoms among Mexican immigrant mothers, we analyzed data from 20 qualitative, semistructured interviews. Participants included low-income, Mexican-born mothers of young children living in North Carolina. Most of the mothers in our study reported experiencing depressive symptoms after becoming parents. They expressed their symptoms as feelings of sadness, depression, loneliness, shame, and anxiety. Economic stressors contributing to their emotional health included financial obligations, work, and child care. Social stressors included family separation, social isolation, and discrimination. To cope with these stressors, mothers relied heavily on social networks and community resources. Our results suggest that a combination of both risk and resiliency factors shape the emotional health of Mexican immigrant mothers.
Maternal mental health is a key factor affecting the quality of parenting and, ultimately, a chil... more Maternal mental health is a key factor affecting the quality of parenting and, ultimately, a child's developmental outcomes. Thus, the persistence of mental health problems such as chronic depressive symptoms or addiction in low-income mother-child dyads may be the critical determinant of their collective future. This review examines the research conducted by nurses that focuses on maternal mental health, mothering, and child outcomes in the context of rearing children in poverty. Multiple methods were used for the search. Four programs showed evidence of sustained, related studies focused on the mental health of low-income mothers and their parenting. Two of these programs included intervention studies aimed at improving the mental health of mothers and developmental outcomes for their children. There were four newer programs of research in which the research teams had begun to focus on mothers rearing children in poverty and five other researchers who conducted single studies ...
Low-income mothers develop depressive symptoms at higher rates than the general population, addin... more Low-income mothers develop depressive symptoms at higher rates than the general population, adding to the existing risk that economic hardship places on their infants and toddlers. Emphasizing a few key intervention targets, an approach that is especially relevant to mothers when depressive symptoms compromise their energy and concentration, can improve interventions with populations facing adversity. The goal of this study was to identify contextual risk factors that significantly contributed to depressive symptoms and that, in combination with depressive symptoms, were associated with compromised parenting. Using baseline data from 251 ethnically diverse mothers from six Early Head Start programs in the Northeastern and Southeastern US, who were recruited for a clinical trial of an in-home intervention, Belsky's ecological framework of distal to proximal levels of influence was used to organize risk factors for depressive symptoms in hierarchical regression models. Under stres...
Research is the key to pursue answers to critical questions in psychiatric-mental health nursing ... more Research is the key to pursue answers to critical questions in psychiatric-mental health nursing in order to continue to meet the health needs of individuals and society in an effective, humane, and holistic manner. The Research Council of the American Psychiatric ...
The development of problem behaviors among adolescents is affected by complex interactions betwee... more The development of problem behaviors among adolescents is affected by complex interactions between risk and protective factors. This study was designed to determine whether selected risk and protective factors described among participants in the National Longitudinal Study of Adolescent Health predicted problem behavior cluster membership. Approximately, 13,000 adolescents from the Add Health study were examined. Three clusters of adolescents (exhibiting normal, problem, and deviant behaviors) and changes in cluster membership over 1 year were examined for relationships to specific risk and protective factors. Findings revealed that factors for current behavior problems differ from those for changes in cluster membership. These results suggest that approaches to preventing problems may differ from those required to help adolescents who are already manifesting problems.
Linear mixed models (LMMs) can be used to analyze continuous longitudinal response variables of r... more Linear mixed models (LMMs) can be used to analyze continuous longitudinal response variables of research studies. Specific aims are then addressed through tests of fixed effects comparing means. However, generated fixed effects results can vary according to the choice of the covariance structure, and so strategies for selecting a model should be utilized first to identify an appropriate covariance structure. We describe alternative LMMs for analyzing continuous longitudinal data and discuss a strategy for using model selection criteria to choose among those models. This is accomplished through the analysis of an exemplar data set considering a wide variety of alternative models for the means, variances, and correlations.
Depressive symptoms may compromise the ability of low-income Latina mothers with limited English ... more Depressive symptoms may compromise the ability of low-income Latina mothers with limited English language proficiency to parent their infants or toddlers. Eighty Early Head Start Latina mothers with limited English language proficiency were randomized to an advanced practice nurse-delivered, culturally tailored, in-home psychotherapy intervention, or to usual care. Repeated measures regression analysis showed a significantly greater decrease in depressive symptoms for intervention mothers compared to the usual care group at 22 and 26 weeks (4 weeks post intervention). Intervention mothers' reports of their child's aggression diminished significantly from T1 to T4 compared to usual care mothers (p = .03). Self-efficacy appeared to only partially mediate the intervention effect, and maternal health moderated the intervention impact. Results indicate that the intervention reduced depressive symptoms and, compared to previous studies in this population, retention of mothers in both intervention and control conditions was improved.
Researchers, educators and clinicians have long recognized the profound influence of the mid-twen... more Researchers, educators and clinicians have long recognized the profound influence of the mid-twentieth century focus on interpersonal relations and relationships on nursing. Today, in nursing, as well as in medicine and other social sciences, neuroanatomy, neurobiology and neurophysiology have replaced interpersonal dynamics as keys to understanding human behavior. Yet concerns are being raised that the teaching, research and practice of the critical importance of healing relationships have been overridden by a biological focus on the experiences of health and illness. As a way to move forward, we return to Hildegard Peplau's seminal ideas about the transformative power of relationships in nursing. We propose that Peplau's formulations and, in particular, her seminal Interpersonal Relations in Nursing can provide direction. We do not propose that her formulations or her book be simply transposed from the 1950s to today's classroom and clinic. But we do believe that her ideas and writings are dynamic documents containing concepts and derived operations that can be brought to life in clinical practice. Finally, we explore Peplau's transformative idea that nursing is, at its core, an interpersonal process both to acknowledge an idea that has shaped our past and can guide us into our future.
This qualitative descriptive study describes the concerns and issues of rural African-American mo... more This qualitative descriptive study describes the concerns and issues of rural African-American mothers with prematurely born infants. Mothers were part of a larger nurse-parent support intervention. The 18 mothers lived in rural areas in the Southeast, and their infants were younger than 35 weeks gestational age at birth and at high risk for developmental problems because they either weighed less
Journal of the American Psychiatric Nurses Association, 2011
As co-chairs of the American Psychiatric Nurses Association (APNA) Research Council, we would lik... more As co-chairs of the American Psychiatric Nurses Association (APNA) Research Council, we would like to call attention to an article we published in Contemporary Nurse on invitation from the guest editor of a 2010 spe-cial edition focused on current advances in mental health nursing. ...
Journal of the American Psychiatric Nurses Association, 2013
... Nancy G. Buccola1, Mary Rosedale2, and Tami Bryan3 ... Both the ERCAAP and WHO studies used a... more ... Nancy G. Buccola1, Mary Rosedale2, and Tami Bryan3 ... Both the ERCAAP and WHO studies used a sequen-tial sampling method, and although this is not a random-ized sample, it can becomeclose to representative of a population when the numbers are large, as they are in ...
Journal of Obstetric, Gynecologic, and Neonatal Nursing, 2005
The visit to the nurse can become a vehicle for low-income mothers to develop one of the most cri... more The visit to the nurse can become a vehicle for low-income mothers to develop one of the most critical health resources available to them: social support. Economic limitations require low-income mothers to create social support structures that are functional but may not match notions of ideal social support. Extensive experience of two advanced practice psychiatric mental health nurse-clinicians revealed that low-income mothers' social support was characterized by concern for basic necessities, precarious situations, self-replicating patterns, entrepreneurial requirements, and demonstrations of strengths. Five key questions during the encounter between nurse and mother can assist the nurse in planning interventions that fit these mothers' needs and benefit their health and that of their children.
Journal of Developmental & Behavioral Pediatrics, 2009
To examine inter-relationships among stress due to infant appearance and behavior in the neonatal... more To examine inter-relationships among stress due to infant appearance and behavior in the neonatal intensive care unit (NICU), parental role alteration stress in the NICU, depressive symptoms, state anxiety, posttraumatic stress symptoms, and daily hassles exhibited by African-American mothers of preterm infants and to determine whether there were subgroups of mothers based on patterns of psychological distress. One hundred seventy-seven African-American mothers completed questionnaires on their psychological distress at enrollment during infant hospitalization and 2, 6, 12, 18, and 24 months after term. Psychological distress measures were intercorrelated. There were four latent classes of mothers: the low distress class with low scores on all measures; the high NICU-related stress class with high infant appearance and parental role stress and moderate scores on other measures; the high depressive symptoms class with high depressive symptoms and state anxiety and moderately elevated scores on NICU-related stress and posttraumatic stress symptoms; the extreme distress class with the highest means on all measures. Infants in the high stress class were sicker than infants in the other classes. The extreme distress class mothers averaged the lowest educational level. The classes differed on distress measures, worry about the child, and parenting stress through 24 months with the extreme distress class having the highest values. Although different types of maternal psychological distress were substantially related, there were distinct subgroups of mothers that were identifiable in the NICU. Moreover, these subgroups continued to differ on trajectories of distress and on their perceptions of the infants and parenting through 24 months after term.
Mexican immigrant mothers face many challenges that put them at increased risk for poor mental he... more Mexican immigrant mothers face many challenges that put them at increased risk for poor mental health. To understand the factors that lead to the development of depressive symptoms among Mexican immigrant mothers, we analyzed data from 20 qualitative, semistructured interviews. Participants included low-income, Mexican-born mothers of young children living in North Carolina. Most of the mothers in our study reported experiencing depressive symptoms after becoming parents. They expressed their symptoms as feelings of sadness, depression, loneliness, shame, and anxiety. Economic stressors contributing to their emotional health included financial obligations, work, and child care. Social stressors included family separation, social isolation, and discrimination. To cope with these stressors, mothers relied heavily on social networks and community resources. Our results suggest that a combination of both risk and resiliency factors shape the emotional health of Mexican immigrant mothers.
Maternal mental health is a key factor affecting the quality of parenting and, ultimately, a chil... more Maternal mental health is a key factor affecting the quality of parenting and, ultimately, a child's developmental outcomes. Thus, the persistence of mental health problems such as chronic depressive symptoms or addiction in low-income mother-child dyads may be the critical determinant of their collective future. This review examines the research conducted by nurses that focuses on maternal mental health, mothering, and child outcomes in the context of rearing children in poverty. Multiple methods were used for the search. Four programs showed evidence of sustained, related studies focused on the mental health of low-income mothers and their parenting. Two of these programs included intervention studies aimed at improving the mental health of mothers and developmental outcomes for their children. There were four newer programs of research in which the research teams had begun to focus on mothers rearing children in poverty and five other researchers who conducted single studies ...
Low-income mothers develop depressive symptoms at higher rates than the general population, addin... more Low-income mothers develop depressive symptoms at higher rates than the general population, adding to the existing risk that economic hardship places on their infants and toddlers. Emphasizing a few key intervention targets, an approach that is especially relevant to mothers when depressive symptoms compromise their energy and concentration, can improve interventions with populations facing adversity. The goal of this study was to identify contextual risk factors that significantly contributed to depressive symptoms and that, in combination with depressive symptoms, were associated with compromised parenting. Using baseline data from 251 ethnically diverse mothers from six Early Head Start programs in the Northeastern and Southeastern US, who were recruited for a clinical trial of an in-home intervention, Belsky's ecological framework of distal to proximal levels of influence was used to organize risk factors for depressive symptoms in hierarchical regression models. Under stres...
Research is the key to pursue answers to critical questions in psychiatric-mental health nursing ... more Research is the key to pursue answers to critical questions in psychiatric-mental health nursing in order to continue to meet the health needs of individuals and society in an effective, humane, and holistic manner. The Research Council of the American Psychiatric ...
The development of problem behaviors among adolescents is affected by complex interactions betwee... more The development of problem behaviors among adolescents is affected by complex interactions between risk and protective factors. This study was designed to determine whether selected risk and protective factors described among participants in the National Longitudinal Study of Adolescent Health predicted problem behavior cluster membership. Approximately, 13,000 adolescents from the Add Health study were examined. Three clusters of adolescents (exhibiting normal, problem, and deviant behaviors) and changes in cluster membership over 1 year were examined for relationships to specific risk and protective factors. Findings revealed that factors for current behavior problems differ from those for changes in cluster membership. These results suggest that approaches to preventing problems may differ from those required to help adolescents who are already manifesting problems.
Linear mixed models (LMMs) can be used to analyze continuous longitudinal response variables of r... more Linear mixed models (LMMs) can be used to analyze continuous longitudinal response variables of research studies. Specific aims are then addressed through tests of fixed effects comparing means. However, generated fixed effects results can vary according to the choice of the covariance structure, and so strategies for selecting a model should be utilized first to identify an appropriate covariance structure. We describe alternative LMMs for analyzing continuous longitudinal data and discuss a strategy for using model selection criteria to choose among those models. This is accomplished through the analysis of an exemplar data set considering a wide variety of alternative models for the means, variances, and correlations.
Depressive symptoms may compromise the ability of low-income Latina mothers with limited English ... more Depressive symptoms may compromise the ability of low-income Latina mothers with limited English language proficiency to parent their infants or toddlers. Eighty Early Head Start Latina mothers with limited English language proficiency were randomized to an advanced practice nurse-delivered, culturally tailored, in-home psychotherapy intervention, or to usual care. Repeated measures regression analysis showed a significantly greater decrease in depressive symptoms for intervention mothers compared to the usual care group at 22 and 26 weeks (4 weeks post intervention). Intervention mothers' reports of their child's aggression diminished significantly from T1 to T4 compared to usual care mothers (p = .03). Self-efficacy appeared to only partially mediate the intervention effect, and maternal health moderated the intervention impact. Results indicate that the intervention reduced depressive symptoms and, compared to previous studies in this population, retention of mothers in both intervention and control conditions was improved.
Researchers, educators and clinicians have long recognized the profound influence of the mid-twen... more Researchers, educators and clinicians have long recognized the profound influence of the mid-twentieth century focus on interpersonal relations and relationships on nursing. Today, in nursing, as well as in medicine and other social sciences, neuroanatomy, neurobiology and neurophysiology have replaced interpersonal dynamics as keys to understanding human behavior. Yet concerns are being raised that the teaching, research and practice of the critical importance of healing relationships have been overridden by a biological focus on the experiences of health and illness. As a way to move forward, we return to Hildegard Peplau's seminal ideas about the transformative power of relationships in nursing. We propose that Peplau's formulations and, in particular, her seminal Interpersonal Relations in Nursing can provide direction. We do not propose that her formulations or her book be simply transposed from the 1950s to today's classroom and clinic. But we do believe that her ideas and writings are dynamic documents containing concepts and derived operations that can be brought to life in clinical practice. Finally, we explore Peplau's transformative idea that nursing is, at its core, an interpersonal process both to acknowledge an idea that has shaped our past and can guide us into our future.
This qualitative descriptive study describes the concerns and issues of rural African-American mo... more This qualitative descriptive study describes the concerns and issues of rural African-American mothers with prematurely born infants. Mothers were part of a larger nurse-parent support intervention. The 18 mothers lived in rural areas in the Southeast, and their infants were younger than 35 weeks gestational age at birth and at high risk for developmental problems because they either weighed less
Journal of the American Psychiatric Nurses Association, 2011
As co-chairs of the American Psychiatric Nurses Association (APNA) Research Council, we would lik... more As co-chairs of the American Psychiatric Nurses Association (APNA) Research Council, we would like to call attention to an article we published in Contemporary Nurse on invitation from the guest editor of a 2010 spe-cial edition focused on current advances in mental health nursing. ...
Journal of the American Psychiatric Nurses Association, 2013
... Nancy G. Buccola1, Mary Rosedale2, and Tami Bryan3 ... Both the ERCAAP and WHO studies used a... more ... Nancy G. Buccola1, Mary Rosedale2, and Tami Bryan3 ... Both the ERCAAP and WHO studies used a sequen-tial sampling method, and although this is not a random-ized sample, it can becomeclose to representative of a population when the numbers are large, as they are in ...
Journal of Obstetric, Gynecologic, and Neonatal Nursing, 2005
The visit to the nurse can become a vehicle for low-income mothers to develop one of the most cri... more The visit to the nurse can become a vehicle for low-income mothers to develop one of the most critical health resources available to them: social support. Economic limitations require low-income mothers to create social support structures that are functional but may not match notions of ideal social support. Extensive experience of two advanced practice psychiatric mental health nurse-clinicians revealed that low-income mothers' social support was characterized by concern for basic necessities, precarious situations, self-replicating patterns, entrepreneurial requirements, and demonstrations of strengths. Five key questions during the encounter between nurse and mother can assist the nurse in planning interventions that fit these mothers' needs and benefit their health and that of their children.
Journal of Developmental & Behavioral Pediatrics, 2009
To examine inter-relationships among stress due to infant appearance and behavior in the neonatal... more To examine inter-relationships among stress due to infant appearance and behavior in the neonatal intensive care unit (NICU), parental role alteration stress in the NICU, depressive symptoms, state anxiety, posttraumatic stress symptoms, and daily hassles exhibited by African-American mothers of preterm infants and to determine whether there were subgroups of mothers based on patterns of psychological distress. One hundred seventy-seven African-American mothers completed questionnaires on their psychological distress at enrollment during infant hospitalization and 2, 6, 12, 18, and 24 months after term. Psychological distress measures were intercorrelated. There were four latent classes of mothers: the low distress class with low scores on all measures; the high NICU-related stress class with high infant appearance and parental role stress and moderate scores on other measures; the high depressive symptoms class with high depressive symptoms and state anxiety and moderately elevated scores on NICU-related stress and posttraumatic stress symptoms; the extreme distress class with the highest means on all measures. Infants in the high stress class were sicker than infants in the other classes. The extreme distress class mothers averaged the lowest educational level. The classes differed on distress measures, worry about the child, and parenting stress through 24 months with the extreme distress class having the highest values. Although different types of maternal psychological distress were substantially related, there were distinct subgroups of mothers that were identifiable in the NICU. Moreover, these subgroups continued to differ on trajectories of distress and on their perceptions of the infants and parenting through 24 months after term.
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