Although limited in number, reported research studies indicate a relationship between maternal perceptions of infant temperament and postpartum depression. Excessive crying in particular and the extent of adaptability and predictability have been implicated as infant behavioral indices. In this article, we present the results of a review of the literature linking early infant temperament to postpartum depression. Measurement issues for both infant temperament and depression are discussed. Recommendations for future research are offered.

Crying↗

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Worry: conceptual dimensions and relevance to childbearing women.

Worry is a cognitive activity that can be a behavioral expression to better understand how a person is coping and will adapt to his or her situation. The content and expression of worries are influenced by characteristics, such as personality, coping styles, cultural orientation, and social environment. Women experience multiple worries during the childbearing period, such as how pregnancy affects one's body image, whether the baby will be normal and healthy, how being pregnant affects the relationship with spouse/mate, whether to continue employment during or after pregnancy, and uncertainties about adequate finances to support the new or growing family. In this article we present the conceptual dimensions of worries with application to women's childbearing adaptation. Implications for development of research studies and the design of clinical practice strategies are identified.

Adaptation, Psychological↗

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Prenatal and postpartum care in Hawaii: a community-based approach.

Given the problems of access, retention, and relevant prenatal care content, supplements to existing programs for health-care delivery during pregnancy and after birth are necessary. This article describes a community-based approach to prenatal and postpartum care that has been developed to address these issues. Culturally sensitive strategies were created for use with Hawaiian, Filipino, and Japanese women living on the island of Hawaii. Six nursing care and community outreach interventions were used. Local public health nurses assisted in developing the program and are responsible for its coordination and implementation.

Community Participation↗

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Physiologic measures of kangaroo versus incubator care in a tertiary-level nursery.

OBJECTIVE: To determine the safety and feasibility of kangaroo care in a tertiary-level nursery as defined by apnea, bradycardia, and oxygen desaturation. DESIGN: Prospective, long-term, repeated measures with a convenience sample. SETTING: A 20-bed, tertiary-level nursery with approximately 400 admissions a year. PARTICIPANTS: Eight mother-infant pairs. INTERVENTIONS: Researchers compared incubator care with kangaroo care for 4 hours a day, 6 days a week, for 3 weeks. Physiologic variables were monitored daily and recorded continuously on a polygraph for 8 hours each week. MAIN OUTCOME MEASURES: Amount of apnea, bradycardia, and oxygen desaturation. SECONDARY OUTCOME MEASURES: Heart rate, respiratory rate, percent sleep time, and skin temperature. RESULTS: Apnea, bradycardia, oxygen saturation, heart rate, and respiratory rate were similar during both kangaroo (K) and incubator (I) care. The infants experienced a lower percent (mean +/- standard deviation, K versus I) of total sleep (47 +/- 15 versus 64 +/- 19, p < .003) during kangaroo care. The infants' mean +/- standard deviation temperature during the kangaroo care (36.5 degrees C +/- 0.64 degrees C) was lower (p < .03) than that of the control periods before (36.8 degrees C +/- 0.27 degrees C) or after (36.7 degrees C +/- 0.26 degrees C). Percent sleep time and skin temperature were slightly lower during kangaroo care, but the differences were not clinically significant. CONCLUSION: Kangaroo care is safe and feasible for selected mothers and infants in a tertiary-level nursery.

Adult↗

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Hawaiian-style "talkstory": psychosocial assessment and intervention during and after pregnancy.

Standard health care services generally limit the psychosocial assessment and management provided for women during and after pregnancy. Recommendations for improving prenatal care include the need for evaluating different approaches for addressing culturally sensitive care. In an innovative prenatal and postpartum program developed by public health nurses in Hawaii, the use of local "talkstory" has been integrated successfully as a caregiving strategy for participating women from Asian and Pacific Islander ethnic groups. This article describes the use of talkstory for delivering psychosocial care and its application in the design of health care services for pregnant women in the general population.

Asian↗

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Cognitive adaptation to stressful events during pregnancy and postpartum: development and testing of the CASE instrument.

The purpose of this article is to describe the development and testing during pregnancy and postpartum of a new instrument, the Cognitive Adaptation to Stressful Events Scale (CASE). The conceptual framework for the CASE is based on Taylor's theory of cognitive adaptation to threatening events using the dimensions of meaning, mastery, and self-esteem. A convenience sample of 202 primigravida women completed the CASE at six assessment points: 10 to 12, 20 to 22, and 30 to 32 weeks of pregnancy and 1 to 2, 8, and 14 weeks postpartum. Regression analysis conducted with CASE scores at each of the assessment points in relation to psychological symptom distress as measured with the SCL-90R Global Severity Index (GSI) indicated a strong relationship during each time period. Although replication with multiethnic, high-risk pregnancy and clinically depressed groups is needed, the CASE is a promising tool for examining the cognitive adaptation process occurring during pregnancy and postpartum.

Adaptation, Psychological↗

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Mother-child relationships. Infant behavior and maternal attachment: two sides to the coin.

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Child Behavior↗