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OBJECTIVES: To identify factors that help explain associations between parent-staff interactions and: (1) parental depression, anxiety, and post-traumatic stress; and (2) parent-child bonding in the neonatal intensive care unit. STUDY DESIGN: Our cross-sectional mixed methods survey investigated the ways in which parental-staff interactions relate to parental distress and parent-child bonding. Parents with babies in the neonatal intensive care unit (n = 165) completed validated measures and open-ended questions about their experiences with staff. Using a sequential explanatory approach, we examined: (1) whether and how parental self-efficacy and personal time mediated parent-staff interactions on distress and bonding; and (2) parental written accounts of experiences with staff. RESULTS: Multiple mediation analyses revealed that parent-staff interactions exhibited an: (1) indirect effect on parental depression (b = -0.05, SE = 0.02, CI [-0.10, -0.01]), anxiety (b = -0.08, SE = 0.04, CI [-0.16, -0.02]), and parent-child bonding (b = -0.26, SE = 0.08, CI [-0.43, -0.11]) through parental self-efficacy; and (2) indirect effect on parental post-traumatic stress (b = -0.08, SE = 0.04, CI [-0.17, -0.00], completely standardized indirect effect = -0.06) through parental personal time. Thematic analyses revealed that emotional and instructional support from staff helped build parental self-efficacy. Trust with staff helped parents feel comfortable leaving the bedside and engage in basic needs (eg, eat, sleep). CONCLUSIONS: Family-staff dynamics are the foundation for high quality family-centered care. Staff who empower parents to participate in care, engage in parenting tasks, and take care of themselves may reduce their distress and improve relationships among staff, parents, and babies.

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AIM/BACKGROUND: Both mental maternal health and breastfeeding difficulties impact maternal and infant health. The present study analyses the association between psychosocial and breastfeeding variables and maternal mental health. DESIGN/METHODS: The participants were 107 first-time mothers from Chile. Sociodemographic variables and breastfeeding difficulties were assessed at 6 weeks postpartum. Depression and anxiety symptoms, parental self-efficacy, and perceived social support were measured using validated, self-report questionnaires at 6 weeks and 5 months postpartum. This study is a secondary analysis of an intervention trial. RESULTS: 76% of the women reported having experienced some breastfeeding difficulty in the first postpartum weeks. The number of breastfeeding difficulties was associated with maternal mental health symptoms at 6 weeks postpartum and parental self-efficacy at both assessment times. Women who did not experience breastfeeding difficulties presented significantly fewer depressive (t(102) = 2.5, p = .015) and anxiety symptoms (t(50) = 2.3, p = .028) at 6 weeks postpartum than those who did. Mothers who exclusively breastfed at 5 months postpartum presented significantly higher parental self-efficacy (t(94) = 2.4, p = .044). A higher number of breastfeeding difficulties and low perceived social support contributed to higher depressive symptoms (R2 = .30; F(3,103) = 14.6, p < .001), anxiety symptoms (R2 = .32, F(3.103) = 17.27, p < .001) and lower parental self-efficacy at 6 weeks postpartum (R2 = .39; F(2,103) = 9.4, p < .001). CONCLUSION: Breastfeeding difficulties and social support are associated with fewer mental health symptoms and higher parental self-efficacy during early postpartum in first-time mothers.

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Background. Haiti lacks early childhood development data and guidelines in malnourished populations. Literature shows that developmental interventions are crucial for improving developmental outcomes malnourished children. This study examines the prevalence of early childhood development delays in a cohort of malnourished Haitian children and their associations with parental depression and self-efficacy. Methods. We used cross-sectional data from 42 patients 6 months to 2 years old in Saint-Marc, Haiti. We assessed their developmental status using the Ages and Stages Questionnaire. Parents were surveyed on depression symptoms and self-efficacy using validated surveys developed for low-resource settings. Demographic and socio-economic data were included. Prevalence of early childhood development delays and high parental depression risk were calculated. Multivariable logistic regression analyses were used to test whether parental depression risk and low self-efficacy were associated with a higher risk for childhood developmental delays. Results. Among participants, 45.2% (SD = 7.7%) of children with a recorded ASQ met age-specific cutoffs for developmental delay in one or more domains. 64.3% (SD = 7.4%) of parents were at high risk for depression. 47.6% (SD = 7.7%) of parents reported relatively low self-efficacy. Multivariable analysis showed that low parental self-efficacy was strongly associated with developmental delays (OR 17.5, CI 1.1-270.0) after adjusting for socioeconomic factors. Parental risk for depression was associated with higher odds (OR 4.6, CI 0.4-50.6) of children having developmental delays but did not reach statistical significance in this study. Conclusion. Parental self-efficacy was protectively associated with early childhood developmental delays in malnourished Haitian children. More research is needed to design contextually appropriate interventions.

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OBJECTIVE: To test whether parents of premature infants less than 37 weeks of gestation provided with a unique smartphone app designed to support parents had greater parenting self-efficacy, a key element in parenting confidence, compared with controls. STUDY DESIGN: Using a quasiexperimental, time-lagged study design, parents were assigned to either usual care (control) or NICU2HOME app (intervention) groups. Both groups completed the validated Parenting Sense of Competence (PSOC) scale at 4 time points (approximately day of life 7, 1 day before discharge, and at 14 and 30 days after discharge) representing the neonatal intensive care unit, discharge, and home contexts. App use was described and categorized. Univariate group differences were assessed, and linear mixed effect regression models were used to assess treatment group effect on PSOC score across time, adjusted for covariates and controlling for overall family effect. RESULTS: We enrolled 298 parents (123 control, 175 intervention) with 256 completing 1 or more PSOC screenings. The intervention group had sustained higher PSOC scores than those of the control group (estimate, 4.3; P = .0042) from the first measurement onward with no significant change in PSOC score across time for either group. Average app use was 15 taps per average day; average and above-average users had significantly higher PSOC scores (estimate, 5.16; P = .0024; estimate, 5.16; P = .014) compared with controls or below-average users. CONCLUSIONS: Compared with controls, parents assigned to use the NICU2HOME app reported greater parenting self-efficacy while in the neonatal intensive care unit and this continued once discharged to home. Novel technologies such as point-of-care smartphone applications may hold promise for supporting parents in difficult and stressful situations. TRIAL REGISTRATION: ClincalTrials.gov: NCT03505424.

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Las capacidades prácticas de los padres para cuidar, proteger y educar a sus hijos, asegurándoles un desarrollo sano, son los aspectos centrales de las competencias parentales. La intervención del Programa de Prevención Focalizada en Chile (PPF) y de Triple P en su 4to nivel (grupal) -de origen Australiano- tiene entre sus propósitos, fortalecer las competencias parentales en personas que tengan a cargo un niño/a. La presente investigación de diseño cuasi experimental, de tipo pre-post con grupo control equivalente, comparó la eficacia de ambos programas en la intervención de competencias parentales, en una muestra de 15 padres y cuidadores de niños/as entre 2 y 12 años. Los resultados muestran que no hay diferencias significativas en las variables estilos de crianza, autoeficacia parental y dificultades de ajuste en la infancia entre las intervenciones realizadas a través del modelo Triple P versus PPF, así como tampoco en la evaluación de estas variables pre y post intervención en ninguna de las dos estrategias. Aunque los resultados resultan interesantes en términos de discusión sobre la efectividad de estas estrategias de intervención en las variables descritas, las dificultades asociadas a la adherencia de las familias a las citaciones y el bajo número de sujetos con el que contó la investigación deben tomarse en cuenta al analizar nuestros resultados. Se recomienda incluir análisis cualitativos e investigaciones con un N mayor que permitan comparar los resultados y mejorar la evidencia sobre la efectividad de estos programas de intervención.

The practical abilities of parents to care for, protect and educate their children, ensuring their healthy development, are the central aspects of parental competencies. The intervention of the Chilean Focused Prevention Programme (PPF) and Triple P in its 4th level (group) - of Australian origin - has, among its purposes, to strengthen parental competencies in people who are in charge of a child. The present research of quasi-experimental design, of pre-post type with an equivalent control group, compared the effectiveness of both programmes in parenting skills in a sample of 15 parents and caregivers of children between 2 and 12 years old. The results show no significant differences in the variables of parenting styles, parental self-efficacy, and adjustment difficulties in childhood between the interventions carried out through the Triple P model versus PPF, nor in assessing these variables pre and post intervention in either of the two strategies. Although the results are interesting as a discussion of the effectiveness of these intervention strategies on the variables described, the difficulties associated with families' adherence to the citations and the low number of subjects in the research should be considered when analysing our results. It is recommended to include qualitative analyses and research with a higher N to compare the results and improve the evidence on the effectiveness of these intervention programmes.

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INTRODUCCIÓN: El número de consultas de urgencias pediátricas en los últimos años han experimentado un aumento notable. Muchos son los factores que influyen en el uso de los servicios sanitarios y en el uso que los padres hacen de estos servicios. Se ha demostrado que la autoeficacia parental juega un papel fundamental en el manejo de la salud y la enfermedad de los niños, y puede que también lo esté haciendo en el uso de los servicios de salud. OBJETIVO: Se plantea esta revisión narrativa de la literatura, con el propósito de explorar el papel que la autoeficacia parental tiene en el cuidado de los niños y el uso de los servicios sanitarios. MÉTODO: Se realizó una búsqueda bibliográfica en Pubmed, Cinhal y Psyc-Info. RESULTADOS: No se encontraron estudios que explorasen de manera directa la autoeficacia parental y el uso de los servicios sanitarios. Sin embargo, la relación existente entre el concepto de autoeficacia y el manejo de la salud infantil y las enfermedades menores conduce a pensar que la autoeficacia parental puede estar jugando un papel importante en el uso de los servicios sanitarios. CONCLUSIÓN: Es necesario llevar a cabo estudios que ayuden a explorar la relación entre la autoeficacia parental y el uso de los servicios. Esta información puede ser de gran ayuda para planificar acciones de educación para la salud acordes con las necesidades de esta población y contribuir a la sostenibilidad del sistema, reduciendo las visitas innecesarias a los servicios de urgencias.

INTRODUCTION: The number of visits to emergency departments in recent years has increased significantly. There are many factors that influence the use of health services and the use that parents make of these services. It has been shown that parental self-efficacy plays a fundamental role in the management of children's health and illness and may also be the case in the use of health services. OBJECTIVE: The purpose of this narrative review was to explore the role that parental self-efficacy plays in the care of children and the use of health services. METHODS: To this end, a bibliographic search was carried out in Pubmed, Cinhal and PsycINFO. RESULTS: No studies were found that directly explored parental self-efficacy and the use of health services. However, the relationship between the concept of self-efficacy and the management of children's health and minor illnesses shown in the literature points out towards the idea that parental self-efficacy may be playing an important role in the use of health services. CONCLUSION: Future observational studies are necessary to explore the relationship between parental-self-efficacy and use of service. This information can be of great help in planning health education actions according to the needs of this population and contributing to the sustainability of the system, decreasing unnecessary visits to the emergency departments.

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En el artículo se analizan las diferencias entre equilibrio trabajo-familia, corresponsabilidad y autoeficacia parental en trabajadores de una empresa chilena. A 224 trabajadores les fueron aplicados tres instrumentos: el cuestionario de interacción trabajo-familia, el cuestionario de participación en el trabajo familiar y la escala de autoeficacia parental. Se observa que no existe diferencia en el nivel de equilibrio trabajo-familia entre hombres y mujeres (t [222] = -0,83, p > 0,05). En corresponsabilidad se evidencian diferencias estadísticamente significativas (t [220,28] = -7,27, p < 0,05), indicando que las mujeres realizan más tareas en el hogar, a pesar de su jornada laboral. En relación con la autoeficacia parental existen diferencias entre hombres y mujeres (t [215] = -8,76, p <0,05), indicando que las mujeres se perciben a sí mismas como mejores madres.

This article analyzes the differences between work-family balance, joint responsability and parental self-efficacy in employees of a Chilean company. 224 professional workers were administered three instruments: the work-family interaction questionnaire, the participation in family work questionnaire and the parental self-efficacy scale. It is observed that there is no difference in the level of work-family balance between men and women (t [222] = -0.83, p > 0,05). On joint responsibility, there are evident statistically differences (t [220,28] = -7,27, p < 0,05), indicating that women do more housework, despite their working day. Regarding parental self-efficacy, there are differences between men and women (t [215] = -8,76 p < 0,05), indicating that women perceive themselves as better mothers.

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Se analiza la relación existente entre los niveles de conflicto trabajo-familia, autoeficacia parental y estilos parentales percibidos en un grupo de 43 niños estudiantes y ambos padres trabajadores, controlando las variables sociodemográficas. Así mismo, se identifican las diferencias por género en las variables, y la relación que existe entre ellas con respecto al número de hijos. A la muestra le fueron aplicados tres instrumentos de medición de las variables referidas. Se observa una relación significativa y negativa entre los niveles de conflicto trabajo-familia y la autoeficacia parental (r= -0,484; p<0,001). El estilo parental autoritario presenta mayor asociación con autoeficacia (r=0,301; p=0,005). Se reporta una relación significativa y negativa entre autoeficacia y número de hijos (r=-0,257; p=0,017). Finalmente se reporta que las mujeres presentan mayor conflicto trabajo-familia que los hombres.

The relationship between levels of work-family conflict, parental self-efficacy and perceived parenting styles in a group of 43 school children and both working parents is analyzed, controlling for socio-demographic variables. Also, gender differences are identified in the variables and the relationship between them in relation to the number of children. Three instruments were applied to the sample for measuring the referred variables. A significant and negative relationship is observed between levels of work-family conflict and parental self-efficacy (r = -0.484, P <0.001). The authoritarian parenting style has greater association with self-efficacy (r = 0.301, P = 0.005). A significant and negative relationship between self-efficacy and number of children (r = -0.257, P = 0.017) is reported. Finally, it is concluded that women have greater work-family conflict than men.

Analisa-se a relação existente entre os níveis de conflito trabalho-família, auto eficácia parental e estilos parentais percebidos em um grupo de 43 crianças estudantes de pais trabalhadores, controlando as variáveis sociodemográficas. Assim mesmo, identificam-se as diferenças por gênero nas variáveis, e a relação que existe entre elas com respeito ao número de filhos. Foram aplicados à mostra três instrumentos de medição das variáveis referidas. Observa-se uma relação significativa e negativa entre os níveis de conflito trabalho-família e a auto eficácia parental (r= -0,484; p<0,001). O estilo parental autoritário apresenta maior associação com autoeficácia (r=0,301; p=0,005). Reporta-se uma relação significativa e negativa entre autoeficácia e número de filhos (r=-0,257; p=0,017). Finalmente reporta-se que as mulheres apresentam maior conflito trabalho-família que os homens.

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