Parenting enhancement among Egyptian mothers in a tertiary care setting

Abstract

This study tested the efficacy and effectiveness of systematically planned parenting enhancement program aimed toward breaking the cycle of high-risk mothers producing high-risk babies in Egypt. The assumption is that self-esteem and self-care are requisites to effective parenting, which can be enhanced or impeded by human and environmental forces. Given that parenting is a learned behavior, it can be repatterned by modifying human-environmental processes.

PIP: This evaluation study tested the effectiveness of the parenting enhancement program (PEP) among a convenience sample of 56 Egyptian mothers (28 PEP and 30 non-PEP). The aim of PEP was to halt the process of high-risk parents producing high-risk children. PEP provided health education and parenting competency training and enhanced opportunities for self-direction. The hypotheses were that PEP mothers would improve in self-esteem, self care, and perceive their infants more positively than non-PEP mothers. A brief theoretical discussion is directed to the relationship between parenthood and self-esteem, self-esteem and self-care, and the maternal perception of the infant (MPI). Mothers were selected based on a list of infants registered with a well-baby clinic, which was part of a large teaching hospital in Alexandria, Egypt. Infants were selected at 6 weeks of age and followed for about 10 months. Parenting groups received 5 parenting classes of 1-2 hours duration. Data was collected at 3, 6, and 12 months postpartum. The following questionnaires were used to assess mother's perception, self-esteem, and self-care: the Broussard and Hartner Neonatal Perception Inventory (NPI and NPI II), a background information questionnaire, Rosenberg's Self-Esteem Scale, and Kearney and Fleisher's Self-care Agency Scale. Translations were made to Arabic by a master's level pediatric nurse and reviewed by several nurse professionals. A pilot study was conducted to test the feasibility of the study. The study findings revealed that both mothers' groups had low self-esteem, low self-care at baseline, and negative scores on MPI, and were comparable in age, number of years married, and number of pregnancies. Differences were observed in family income, living arrangements, and length of stay at home address; non-PEP mothers had a slightly higher socioeconomic status. The non-PEP mothers had better scores on self-esteem and self-care at 3 months postpartum, even though PEP mothers' scores improved. MPI was low for both mothers' groups at 3 months. PEP mothers' scores increased at 6 months, but both mothers' scores decreased at 12 months. Differences in socioeconomic status (SES) and low SES are attributed to the results. The implication is that sustaining support is needed after a sustained intervention.