Hospital nursing staff primary prevention with new mothers

At times a simple intervention, put into place at the right time and in the right place could have lasting effects. This may be the case with interventions for mothers that take in the maternity ward. Mothers may be especially interested in obtaining help in coping with their problems in the period right after birth, which is an uncertain and exhausting period in the new mother's life. We suggest that the motivation of the mother and the novelty of the situation for new mothers, will make mothers amenable to information and influence.

This is a new project which is an outgrowth of the Well-Baby clinic project. We have been searching for ways to reach mothers earlier than the Well-Baby clinics are able to do. This project aims to assess a new intervention program in maternity wards at both hospitals (Ein Karem and Mt. Scopus) of the Hadassah Hebrew University Medical Center. The new program will add important elements to an ongoing demonstration for new mothers in the maternity ward of each hospital. This demonstration and discussion of elementary child care includes the teaching of feeding, diapering and bathing infants. This program has been in place for many years but there is no assessment of its effects.

The psychological component of the program will be presented by developmental psychologists in Ein Karem and by maternity ward nurses at Mt. Scopus. The project will train the nurses in making the presentation and in leading the discussion. Our goal is to eventually enable nurses to carry out the program.

The Harris Foundation will introduce new elements into the demonstration of early physical child care by adding emphasis on the awareness of psychological development, including the need for acceptance of the infant, fostering attachment and bonding, and encouraging development through age-appropriate play with the infant. Mothers will receive this information both verbally and in writing through a special brochure. All parents in the experimental group will be exposed both to the verbal demonstration and to a written brochure that briefly describes what the mother can do to foster psychological development of the infant.

An additional element in the intervention consists of notifying mothers of an opportunity to obtain psychological first aid through calling a special number at the Department of Psychiatry that will serve as a hot-line for mothers who are feeling distressed. Mothers who call the hot-line will be screened and referred for treatment according to the needs of the mother. Some will be given counseling on a one-time basis over the phone, some will be referred to Department staff, and some will be referred to appropriate intervention programs, such as Mom to Mom, a Harris Foundation Project.

The program at this point calls for the participation of 100 mothers. Half of the mothers will receive the intervention (early care demonstration, brochure and hot-line information). The control group will not receive any element of the program at this time. We are considering the introduction of a later intervention program for the control group.

We will contact both the intervention and control group mothers by telephone three months after the birth to assess the effects of the program. The assessment will consist of a short interview consisting of three elements: the information the mother has about physical care of the infant; attitudes of the mother concerning the contribution of the program concerning her behavior and attitudes toward the child; and the use of the hot-line, including frequency of use and assessment of the help given the mother. We are especially interested in particular groups in the population for which the program has relatively strong effects (e.g., lower-class, immigrant groups).

The professional literature reports that it is difficult to find effects for such early interventions. However, interventions could have positive effects for certain kinds of people, for example mothers who have no child-rearing experience, young mothers or mothers in some cultures rather than others. We know little about the kinds of people for whom the program could have effects. Since the program is easily administered and could have far-reaching effects for some mothers if properly administered we feel that assessment of such programs is essential.

This program is now in the pre-test stage.

Staff

  • Prof. Charles W. Greenbaum
  • Dr. Esther Galili
  • Ms. Nurit Schmitt




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Last updated: September, 2002