[Best practice--clinical guidelines].
Explore the source record for details and available documents.
Benchmarking↗
Biomedical subjects
Marga Thome
Publications and source records attributed to Marga Thome.
Evaluation of a web-based course for community nurses on postpartum emotional distress.
The purpose of this multicentre and quasi-experimental study is to evaluate the effect of a web-based course for community nurses in Iceland with regard to outcome of postpartum emotional distress. A sample of six community health centres was selected and equally divided into an experimental and a control group. All nurses at the experimental centres attended a web-based course focusing on evidence-based interventions for postpartum emotional distress. All new mothers were screened 9 weeks postpartum using the Edinburgh Postpartum Depression Scale (EPDS). If they scored 12 points or more they were eligible for the study. Mothers answered the EPDS at three different points in time, (9, 15 and 24 weeks postpartum) and the Parent Stress Index: Short Form (PSI/SF) at two times (9 and 15 weeks). Results showed no significant difference in the rate of depressive symptoms between study centres at 9 weeks. At 15 and 24 weeks there was, however, a significant difference between mothers at the experimental and control centres. Nurses at the experimental centres documented significantly more evidence-based interventions than did nurses at the control centres, and they had more frequent contact with new mothers suffering from postpartum emotional distress. There was no significant variation in PSI scores between the groups at any time. More women at the experimental centres were on antidepressants compared to the control centres. Of the total of 32 women eligible for the study, 10 declined participation. The findings are limited by small sample size and a probable confounding effect of antidepressants with the nursing interventions. Findings indicate that the web-based transfer of knowledge to nurses on evidence-based interventions for postpartum emotional distress has a positive effect on distressed women in the postpartum period and warrants further study.
Adult↗
Improving day and night sleep problems in infants by changing day time sleep rhythm: a single group before and after study.
This study explores the duration and timing of day time waking periods required for sleep disturbed infants to improve day and night sleep. Seventy-nine sleep disturbed outpatients with day and night sleep problems were investigated before and two weeks after a brief sleep intervention. Data were collected by interviewing parents on their infants' day and night sleep patterns. Besides instructing the parents on night sleep regulation, they were advised to regulate day sleep. After the intervention, duration of day and night sleep increased and frequency of night waking decreased. The mean duration of the first waking period in the morning did not change, but the range decreased. The mean duration of the last waking period in the evening increased. The frequency of short and irregular day naps and the need for assistance in falling asleep decreased after the intervention. It is recommended that the last waking before night sleep is lengthened to reduce day and night sleep problems.
Analysis of Variance↗
Evaluating a family-centred intervention for infant sleep problems.
AIM: This paper reports a study to describe changes in parents' distress after a family-centred intervention for sleep problems of infants. BACKGROUND: Infant sleep problems are common and are related to depressive symptoms in mothers, but their impact on fathers has rarely been studied. Because childhood sleep problems and parental distress are associated, their interdependence should be recognized in research and in paediatric sleep practice. METHODS: All children hospitalized for sleep problems in a hospital in Iceland in 1997-1998 and their parents were studied using a pre- and post-test quasi-experimental design. The sample consisted of 33 infants (6-23 months of age), 33 mothers and 30 fathers. Parents' distress was assessed before and after treatment with regard to: (1) fatigue and resulting symptom distress; (2) parenting stress; (3) state-anxiety; and (4) depressive symptoms. Infants were treated for a variety of sleep problems by a paediatric nurse. The parents were simultaneously treated for distress by either the paediatric nurse or a specialist, depending on the nature of their problems. RESULTS: Mothers and fathers experienced a high degree of distress before the intervention, with no significant difference between them. Two months after the intervention both parents' distress had significantly improved. Parents' degree of distress was at a psychopathological level before the intervention but was reduced to population norms 2 months after the intervention. The paediatric nurse intervention was sufficient to reduce distress for 83% of parents. CONCLUSIONS: Health care professionals who care for infants with sleep problems should pay attention to the distressed responses of parents and support their recovery. An intervention such as that described here could be used by nurses for this purpose.
Adult↗
Changes in sleep problems, parents distress and impact of sleep problems from infancy to preschool age for referred and unreferred children.
This article compares and describes changes in sleep problems in 3- to 5-year-old Icelandic children referred and unreferred for sleep problems in infancy and explores changes in parents' distress and the impact of children's sleep problems on families over time. The sample consisted of a clinical group (n = 31) that had been referred to a sleep-disorder clinic in infancy, and a comparative group (n = 150) of age-matched unreferred community children. Self-report scales assessed infant/child sleep pattern, the impact of the sleep problem on family life and parents' distress. Results showed that about half the children in the community group have had a sleep problem in infancy. Nightwakings improved in both the referred and unreferred group over time but remained more frequent in the unreferred group. The referred group had significantly more settling problems in infancy than the other group but settling improved markedly over time. Parents of referred children were more fatigued compared with others despite improvement of children's sleep problems over time. Mothers of referred children were however, less likely to perceive the sleep problem as troublesome for family life than the others. It is concluded that parents of referred children are more fatigued than parents of unreferred children and nightwakings are more likely to persist in children who had sleep problems in infancy than in those with no such problems.
Age Distribution↗
A population-based study of exclusive breastfeeding in Icelandic women: is there a relationship with depressive symptoms and parenting stress?
This study investigated whether postpartum depressive symptoms and parenting stress are related to exclusive breastfeeding in mothers at 2-3 months postpartum. Data were collected from 734 Icelandic mothers postpartum. Parenting stress, depressive symptoms, feeding methods and demographical data were assessed by self-administered questionnaires. A high level of maternal education increased the likelihood of exclusive breastfeeding whereas lower maternal education, high levels of depressive symptoms, twins and single motherhood reduced the likelihood of exclusive breastfeeding. It is concluded that depressive symptoms are related to lower levels of exclusive breastfeeding and that exclusive breastfeeding becomes more likely with higher level of maternal education.
Adaptation, Psychological↗
Severe postpartum distress in Icelandic mothers with difficult infants: a follow-up study on their health care.
This article describes help seeking and health care of mothers with a difficult infant who suffered long-term depressive symptoms and a high degree of parenting stress. A subsample of severely distressed mothers (n = 37) was recruited from a cross-sectional national survey and followed up 2 months later by a semi-structured telephone interview. The survey included all Icelandic women who gave birth during a quarter of a year and had a live baby 2 months later (n = 1053). All distressed mothers with a difficult infant were selected from sample respondents on preset scores of two self-report distress measures. The study sample emerged during the selection process for an intervention study from which it was excluded on grounds of very high distress scores. Results showed that 5% of the surveyed population were postpartum severely distressed. Findings from this follow-up study revealed that only one woman of four received health care for severe distress by various professionals. One woman of six received help from others. Very few women utilized the services available at Health Care Centers. About half of the women held attitudes that hindered them in seeking help and health care. It is concluded that postpartum severely distressed women receive little primary health care for mental health problems and the majority of them show little initiative to seek out for help. More active outreach by health professionals is recommended.
Adult↗
Changes in infant sleep problems after a family-centered intervention.
PURPOSE: To describe a family-centered intervention for sleep disturbed infants and its effect on the infants' sleep pattern. METHODS: The sample consisted of 33 infants (6-23 month of age) hospitalized because of sleep problems in The City Hospital in Reykjavik, Iceland, and 33 mothers and 30 fathers. Infants' sleep patterns were assessed by a 1-week diary and by interviews with parents before hospital admission, 1 week and 2 months after discharge. The intervention was based on correction of day-sleep rhythm, support of self-comforting capabilities of the infant, and education of parents in regard to the infants' characteristics and developmental status. Changes in day naps and infant irritability over daytime also improved significantly. FINDINGS: Night sleep improved significantly 1 week after discharge and even more so 2 months later. CONCLUSIONS: Offering a family-centered intervention improves infants' sleep patterns up to 2 months after discharge.
Adult↗