OJMP  Vol.4 No.2 , April 2015
Stress and Resources in Women Attending an Inpatient Prevention/Rehabilitation Measure for Parents: Secondary Analysis of Quality Assurance Data
Abstract: Questionnaire data from two projects on the development of quality assurance instruments for an inpatient rehabilitation/prevention program for parents were used for a secondary analysis. In this analysis, the associations of gains in a psychosocial resource (parenting self-efficacy) and two types of stressors experienced by mothers at the start of treatment (parenting hassles, depressive symptoms) with general life satisfaction and satisfaction with health at the end of treatment were explored. Structural equation modeling was applied to data from N = 1724 female patients. Potential resource-stressor interactions were tested using the Latent Moderated Structural Equations approach. Results showed that parenting hassles were negatively associated with general life satisfaction and satisfaction with health while self-efficacy gains were weakly positively correlated with both variables. No interaction of parenting hassles and self-efficacy gains was found. Depressive symptoms were negatively associated with both satisfaction measures. In these models, self-efficacy gains were not substantially correlated with life satisfaction, but showed a small association with satisfaction with health. There was no significant interaction of depressive symptoms and self-efficacy gains. The findings imply that interventions for distressed mothers—as exemplarily illustrated by this inpatient setting—should focus on identifying and reducing initial stressors as these may continue to impair mothers’ subjective health despite gains in parenting-related resources.
Cite this paper: Lukasczik, M. , Gerlich, C. , Schuler, M. , Neuderth, S. , Dlugosch, G. and Faller, H. (2015) Stress and Resources in Women Attending an Inpatient Prevention/Rehabilitation Measure for Parents: Secondary Analysis of Quality Assurance Data. Open Journal of Medical Psychology, 4, 23-34. doi: 10.4236/ojmp.2015.42003.

[1]   Byron, K. (2005) A Meta-Analytic Review of Work-Family Conflict and Its Antecedents. Journal of Vocational Behavior, 67, 169-198.

[2]   Franz, M., Lensche, H. and Schmitz, N. (2003) Psychological Distress and Socioeconomic Status in Single Mothers and Their Children in a German City. Social Psychiatry and Psychiatric Epidemiology, 38, 59-68.

[3]   Sallfors, K. and Hallberg, L. (2003) A Parental Perspective on Living with a Chronically Ill Child: A Qualitative Study. Families, Systems, & Health, 21, 193-204.

[4]   Crnic, K.A., Gaze, C. and Hoffman, C. (2005). Cumulative Parenting Stress across the Preschool Period: Relations to Maternal Parenting and Child Behaviour at Age 5. Infant and Child Development, 14, 117-132.

[5]   Ostberg, M., Hagekull, B. and Hagelin, E. (2007) Stability and Prediction of Parenting Stress. Infant and Child Development, 16, 207-223.

[6]   Skreden, M., Skari, H., Malt, U.F., Pripp, A.H., Bjork, M.D., Faugli, A. and Emblem, R. (2012) Parenting Stress and Emotional Wellbeing in Mothers and Fathers of Preschool Children. Scandinavian Journal of Public Health, 40, 596-604.

[7]   Sperlich, S., Peter, R. and Geyer, S. (2012) Applying the Effort-Reward Imbalance Model to Household and Family Work: a Population-Based Study of German Mothers. BMC Public Health, 12, 12.

[8]   Tao, W., Janzen, B.L. and Abonyi, S. (2010) Gender, Division of Unpaid Family Work and Psychological Distress in Dual-Earner Families. Clinical Practice and Epidemiology in Mental Health, 6, 36-46.

[9]   Civic, D. and Holt, V.L. (2002) Maternal Depressive Symptoms and Child Behaviour Problems in a Nationally Representative Normal Birthweight Sample. Maternal and Child Health Journal, 4, 215-221.

[10]   Herwig, J.E. and Bengel, J. (2005) Schweregrad und Storungswert der Belastungen von Frauen in Mutter-Kind-Maßnahmen [Severity and Relevance of Distress in Women Attending a Mother-Child Treatment Program]. Zeitschrift fur Klinische Psychologie Psychiatrie und Psychotherapie, 53, 1-15.

[11]   Mazur, E. (2006) Biased Appraisals of Parenting Daily Hassles among Mothers of Young Children: Predictors of Parenting Adjustment. Cognitive Therapy and Research, 30, 161-175.

[12]   Mistry, R., Stevens, G.D., Sareen, H., De Vogli, R. and Halfon, N. (2007) Parenting-Related Stressors and Self-Reported Mental Health of Mothers with Young Children. American Journal of Public Health, 97, 1261-1268.

[13]   Arnhold-Kerri, S., Sperlich, S. and Collatz, J. (2003) Krankheitsprofile und Therapieeffekte von Patientinnen in Mutter-Kind-Einrichtungen [Disease Profiles and Therapy Effects of Patients in Mother-Child Rehabilitation Centres]. Rehabilitation, 42, 290-300.

[14]   Fassmann, H., Gruninger, M., Schneider, A.H. and Steger, R. (2008) Bedarfsund Bestandsanalyse von Vorsorgeund Rehabilitationsmaßnahmen fur Mutter und Vater in Einrichtungen des Deutschen Muttergenesungswerks. Projektabschlussbericht. Materialien aus dem Institut fur empirische Soziologie an der Friedrich-Alexander-Universitat Erlangen-Nurnberg [Demand and Status Analysis of Rehabilitation and Prevention Measures for Mothers and Fathers in Institutions of the Muettergenesungswerk (Mothers’ Convalescence and Recuperation Scheme)]. Project Report, Friedrich Alexander University at Erlangen and Nuremberg.

[15]   Vogel, H. and Zdrahal-Urbanek, J. (2004) Rehabilitation in Germany: New Challenges of a Structured Social Security Scheme. International Journal of Rehabilitation Research, 27, 93-98.

[16]   De Montigny, F. and Lacharite, C. (2005) Perceived Parental Efficacy: Concept Analysis. Journal of Advanced Nursing, 49, 387-396.

[17]   Bloomfield, L. and Kendall, S. (2012) Parenting Self-Efficacy, Parenting Stress and Child Behaviour before and after a Parenting Programme. Primary Health Care Research and Development, 13, 364-372.

[18]   Farris, J.R., Carothers Bert, S.S., Nicholson, J.S., Glass, K. and Borkowski, J.G. (2013) Effective Intervention Programming: Improving Maternal Adjustment through Parent Education. Administration and Policy in Mental Health and Mental Health Services Research, 40, 211-223.

[19]   Lindsay, G., Strand, S. and Davis, H. (2011) A Comparison of the Effectiveness of Three Parenting Programmes in Improving Parenting Skills, Parent Mental Well-Being and Children’s Behaviour When Implemented on a Large Scale in Community Settings in 18 English Local Authorities: The Parenting Early Intervention Pathfinder (PEIP). BMC Public Health, 11, 962.

[20]   Salonen, A.H., Kaunonen, M., Astedt-Kurki, P., Jarvenpaa, A.L., Isoaho, H. and Tarkka, M.T. (2011) Effectiveness of an Internet-Based Intervention Enhancing Finnish Parents’ Parenting Satisfaction and Parenting Self-Efficacy during the Postpartum Period. Midwifery, 27, 832-841.

[21]   Katholische Arbeitsgemeinschaft fur Muttergenesung KAG [Catholic Working Group on Maternal Health] (2012) Rahmenkonzept zur stationaren Vorsorge und Rehabilitation fur Mutter, Mutter/Kind und Vater/Kind, uberarbeitete Fassung 2012 [Conceptual Framework for Inpatient Prevention and Rehabilitation of Mothers, Mothers with Children and Fathers with Children. Revised Version 2012]. KAG, Freiburg.

[22]   Hobfoll, S.E. (1989) Conservation of Resources: A New Attempt at Conceptualizing Stress. American Psychologist, 44, 513-524.

[23]   Wells, J.D., Hobfoll, S.E. and Lavin, J. (1999) When It Rains, It Pours: The Greater Impact of Resource Loss Compared to Gain on Psychological Distress. Personality and Social Psychology Bulletin, 25, 1172-1182.

[24]   Lukasczik, M., Gerlich, C., Musekamp, G., Saupe-Heide, M., Lobmann, R., Vogel, H. and Neuderth, S. (2014) Externe Qualitatssicherung in Einrichtungen der stationaren Vorsorge und Rehabilitation fur Mutter und Vater einschließlich Mutter-/Vater-Kind-Einrichtungen: Einrichtungsvergleichende Analysen im Bereich Ergebnisqualitat [External Quality Assurance in Inpatient Prevention and Rehabilitation Centers for Mothers, Fathers and Children: Comparative Outcome Quality Analyses across Rehabilitation/Prevention Centers]. Gesundheitswesen, 76, 56-64.

[25]   Neuderth, S., Lukasczik, M., Musekamp, G., Gerlich, C., Saupe-Heide, M., Lobmann, R. and Vogel, H. (2013) Entwicklung von Verfahrensweisen und Instrumenten zur externen Qualitatssicherung in Einrichtungen der stationaren Vorsorge und Rehabilitation fur Mutter und Vater einschließlich Mutter-/Vater-Kind-Einrichtungen [Development of Procedures and Instruments for External Quality Assurance in Inpatient Rehabilitation and Prevention Centers for Mothers, Fathers and Children]. Rehabilitation, 52, 10-19.

[26]   Johnston, C. and Mash, E.J. (1989) A Measure of Parenting Satisfaction and Efficacy. Journal of Clinical Child Psychology, 18, 167-175.

[27]   Miller, Y. (2001) Erziehung von Kindern im Kindergartenalter: Erziehungsverhalten und Kompetenzuberzeugungen von Eltern und der Zusammenhang zu kindlichen Verhaltensstorungen [Parenting of Kindergarten-Aged Children: Parenting Behavior, Parental Self-Efficacy and Their Relation to Child Behavior Problems]. Dissertation, Technical University of Braunschweig, Braunschweig.

[28]   Hall, L.A. (1990) Prevalence and Correlates of Depressive Symptoms in Mothers of Young Children. Public Health Nursing, 7, 71-79.

[29]   Jakel, J. and Leyendecker, B. (2008) Tagliche Stressfaktoren und Lebenszufriedenheit turkischstammiger Mutter in Deutschland [Everyday Stressors and Life Satisfaction of Mothers of Turkishorigin in Germany]. Zeitschrift fur Gesundheitspsychologie, 16, 12-21.

[30]   Kroenke, K., Spitzer, R.L. and Williams, J.B. (2001) The PHQ-9: Validity of a Brief Depression Severity Measure. Journal of General Internal Medicine, 16, 606-613.

[31]   Lowe, B., Spitzer, R.L., Zipfel, S. and Herzog, W. (2002) PHQ-D. Manual, Komplettversion und Kurzform [Patient Health Questionnaire, German Version. Manual, Full Version and Short Version].

[32]   Henrich, G. and Herschbach, P. (2000) Questions on Life Satisfaction (FLZM)—A Short Questionnaire for Assessing Subjective Quality of Life. European Journal of Psychological Assessment, 16, 150-159.

[33]   McArdle, J.J. and Hamagami, F. (2001) Latent Difference Score Structural Models for Linear Dynamic Analysis with Incomplete Longitudinal Data. In: Collins, L.M. and Sayer, A.G., Eds., New Methods for the Analysis of Change, American Psychological Association, Washington DC, 139-175.

[34]   Schuler, M. and Jelitte, M. (2012) Messen wir bei allen Personen das Gleiche? Zur Invarianz von Messungen und Response Shift in der Rehabilitation—Teil 1 [Do We Measure the Same in All Persons? On Measurement Invariance and Response Shift in Rehabilitation Research, Part 1]. Rehabilitation, 51, 332-339.

[35]   Muthen, L.K. and Muthen, B.O. (2007) MPlus User’s Guide. 5th Edition, Muthen & Muthen, Los Angeles.

[36]   Klein, A. and Moosbrugger, H. (2000) Maximum Likelihood Estimation of Latent Interaction Effects with the LMS Method. Psychometrika, 65, 457-474.

[37]   Burnham, K.P. and Anderson, D.R. (2002) Model Selection and Multimodel Inference: A Practical Information-Theoretic Approach. Springer, New York.

[38]   Enders, C.K. (2010) Applied Missing Data Analysis. Guilford, New York.

[39]   Herwig, J.E., Wirtz, M. and Bengel, J. (2004) Depression, Partnership, Social Support, and Parenting: Interaction of Marital Factors with Behavioral Problems of the Child. Journal of Affective Disorders, 80, 199-208.

[40]   Holt-Lunstad, J., Birmingham, W. and Jones, B.Q. (2008) Is There Something Unique about Marriage? The Relative Impact of Marital Status, Relationship Quality, and Network Social Support on Ambulatory Blood Pressure and Mental Health. Annals of Behavioral Medicine, 35, 239-244.

[41]   Haslam, D.M., Pakenham, K.I. and Smith, A. (2006) Social Support and Postpartum Depressive Symptomatology: The Mediating Role of Maternal Self-Efficacy. Infant Mental Health Journal, 27, 276-291.

[42]   Howell, E.A., Mora, P.A., DiBonaventura, M.D. and Leventhal, H. (2009) Modifiable Factors Associated with Changes in Postpartum Depressive Symptoms. Archives of Women’s Mental Health, 12, 113-120.

[43]   Sevigny, P.R. and Loutzenhiser, L. (2010) Predictors of Parenting Self-Efficacy in Mothers and Fathers of Toddlers. Child: Care, Health and Development, 36, 179-189.

[44]   Smith, K.E., Landry, S.H. and Swank, P.R. (2005) The Influence of Decreased Parental Resources on the Efficacy of a Responsive Parenting Intervention. Journal of Consulting and Clinical Psychology, 73, 711-720.

[45]   Barlow, J., Smailagic, N., Huband, N., Roloff, V. and Bennett, C. (2014) Group-Based Parent Training Programmes for Improving Parental Psychosocial Health. Cochrane Database of Systematic Reviews, 6, CD002020.

[46]   Muzik, M., Rosenblum, K.L., Alfafara, E.A., Schuster, M.M., Miller, N.M., Waddell, R.M. and Kohler, E.S. (2015) Mom Power: Preliminary Outcomes of a Group Intervention to Improve Mental Health and Parenting among High-Risk Mothers. Archives of Women’s Mental Health, Epub Ahead of Print.