Wide Awake Parenting: study protocol for a randomised controlled trial of a parenting program for the management of post-partum fatigue

BMC Public Health

Rebecca Giallo¹  Amanda Cooklin¹  Monique Seymour¹  Melissa Dunning¹ 

[1] Parenting Research Centre, 5/232 Victoria Parade, East Melbourne, VIC, 3002, Australia

关键词: Pycho-educational Intervention;    Post-partum;    Parents;    Fatigue;   

Others  :  1162653
DOI  :  10.1186/1471-2458-13-26

 received in 2012-12-06, accepted in 2012-12-18,  发布年份 2013

【 摘 要 】

Background

Exhaustion and fatigue are commonly experienced by parents during the post-partum period, and can have implications for daily functioning, mental health and parenting practices. There is a need for the development of effective interventions to assist parents with the management of fatigue. This paper outlines the procedure for a randomised controlled study which aims to test the efficacy of Wide Awake Parenting, a program for the management of fatigue in the postnatal period.

Methods/design

Parents with an infant less than 6 months of age, and from seven Local Government Areas in Melbourne, Australia were invited to participate in this study. Parents were randomised to receive the Wide Awake Parenting program (intervention groups) or usual care (control group) offered by health services. The Wide Awake Parenting program provides parents with psycho-education and information about fatigue, and strategies to reduce its effects either via a self-directed method, or professionally led with a home visit and telephone support. Baseline data will be collected prior to randomisation, and further data will be collected at 2- and 6-weeks post intervention.

Discussion

To our knowledge this is the first randomised controlled trial of a program which compares the efficacy of a self-management approach and health professional assistance for the management of fatigue in the early post-partum period. If effective, it could offer an important, universal public health management approach to this common health concern.

Trial registration number

Australian New Zealand Clinical Trials Registry, ACTRN12611000133932.

【 授权许可】

   
2013 Dunning et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Ansara D, Cohen M, Gallop R, Kung R, Schei B: Predictors of women's physical health problems after childbirth. J Psychosom Obstet Gynecol 2005, 26:115-125.
• [2]Parks P, Lenz E, Milligan R: What happens when fatigue lingers for 18 months after delivery? J Obstet Gynecol Neonatal Nurs 1999, 28:87-93.
• [3]Cooklin A, Giallo R, Rose N: Parental fatigue and parenting practices during early childhood: An Australian community survey. Child Care Health Dev 2011, 38:654-664.
• [4]McQueen A, Mander R: Tiredness and fatigue in the postnatal period. J Adv Nurs 2003, 42:463-469.
• [5]Giallo R, D'Esposito F, Chrstensen D, Mensah F, Cooklin A, Wade C, Lucas N, Canterford L, Nicholson J: Father mental health during the early parenting period: results of an Australian population based longitudinal study. Soc Psychiatry Psychiatr Epidemiol 2012, 47:1907-1916.
• [6]Dunning MJ, Giallo R: Fatigue, parenting stress, self-efficacy and satisfaction in mothers of infants and young children. J Reprod Infant Psychol 2012, 30:145-159.
• [7]Giallo R, Rose N, Vittorino R: Fatigue, wellbeing, and parenting in mothers of infants and toddlers with sleep problems. J Reprod Infant Psychol 2011, 29:236-249.
• [8]North American Nursing Diagnosis Association: NANDA nursing diagnoses: Definitions and classification, 2001-2002. Philadelphia: Nursecom; 2001.
• [9]Herbert P: Support of first-time mothers in the three months after birth. Nurs Times 1994, 90:36-37.
• [10]Glazener C, Abdalla M, Stroud P, Naji S, Templeton A, Russell I: Postnatal maternal morbidity: Extent, causes, prevention and treatment. Br J Obstet Gynaecol 1995, 102:282-287.
• [11]Saurel-Cubizolles M, Romito P, Lelong N, Ancel P: Women's health after childbirth: a longitudinal study in France and Italy. Br J Obstet Gynaecol 2000, 107:1202-1209.
• [12]Brown S, Lumley J: Maternal health after childbirth: Results of an Australian population based survey. Br J Obstet Gynaecol 1998, 105:156-161.
• [13]Elek S, Hudson D, Fleck M: Couples' experiences with fatigue during the transition to parenthood. J Fam Nurs 2002, 8:221-240.
• [14]Gay CL, Lee KA, Lee SY: Sleep patterns and fatigue in new mothers and fathers. Biol Res Nurs 2004, 5:311-318.
• [15]Giallo R, Cooklin A, Zerman N, Vittorino R: The psychological distress of fathers attending an Australian Early Parenting Centre for early parenting difficulties. Clincial Psychologist 2012. advanced online publication
• [16]Pugh L, Milligan R: A framework for the study of childbearing fatigue. Adv Nurs Sci 1993, 15:60-70.
• [17]Gardner D: Fatigue in postpartum women. Appl Nurs Res 1991, 4:57-62.
• [18]Troy N, Dalgas-Pelish P, Vichitsukon K: The natural evolution of postpartum fatigue among a group of primiparous women. Clin Nurs Res 1997, 6:126-139.
• [19]Tulman L, Fawcett J, Groblewski L, Silverman L: Changes in functional status after childbirth. Nurs Res 1990, 39:70-75.
• [20]Troy N: A comparison of fatigue and energy levels at 6 weeks and 14 to 19 months postpartum. Clin Nurs Res 1999, 8:135-152.
• [21]MacArthur C, Lewis M, Knox E: Health after childbirth. Br J Obstet Gynaecol 1991, 98:1193-1195.
• [22]Gardner D, Campbell B: Assessing postpartum fatigue. Am J Matern Child Nurs 1991, 16:264-266.
• [23]Lee K, Zaffke M: Longitudinal changes in fatigue and energy during pregnancy and the postpartum period. J Obstet Gynecol Neonatal Nurs 1999, 28:183-191.
• [24]Fisher J, Feekery C, Rowe H: Treatment of maternal mood disorder and infant behaviour disturbance in an Australian private mothercraft unit: a follow-up study. Arch Womens Ment Health 2004, 7:89-93.
• [25]Carty E, Bradley C, Winslow W: Women's perceptions of fatigue during pregnancy and postpartum: The impact of length of hospital stay. Clin Nurs Res 1996, 5:67.
• [26]Hockey G, Maule A, Clough P, Bdzola L: Effects of negative mood states on risk in everyday decision making. Cognition and Emotion 2000, 14:823-855.
• [27]Torres-Harding S, Jason L: What is fatigue? History and epidemiology. In Fatigue as a window to the brain. Edited by DeLuca J. Massachusetts: A Bradford Book; 2005:3-17.
• [28]Chee MW, Chuah LY, Venkatraman V, Chan WY, Philip P, Dinges DF: Functional imaging of working memory following normal sleep and after 24 and 35 h of sleep deprivation: Correlations of fronto-parietal activation with performance. Neuroimage 2006, 31:419-428.
• [29]van der Linden D, Frese M, Meijman T: Mental fatigue and the control of cognitive processes: effects on perseveration and planning. Acta Psychol 2003, 113:45-65.
• [30]Bayer J, Hiscock H, Hampton A, Wake M: Sleep problems in young infants and maternal mental and physical health. J Paediatr Child Health 2007, 43:66-73.
• [31]Meltzer L, Mindell J: Relationship between child sleep disturbances and maternal sleep, mood, and parenting stress: A pilot study. J Fam Psychol 2007, 21:67-73.
• [32]Milligan R, Lenz E, Parks P, Pugh L, Kitzman H: Postpartum fatigue: Clarifying a concept. Sch Inq Nurs Pract: Intl J 1996, 10:279-291.
• [33]Thome M, Alder B: A telephone intervention to reduce fatigue and symptom distress in mothers with difficult infants in the community. J Adv Nurs 1999, 29:128-137.
• [34]Giallo R, Wade C, Ward J, Kienhuis K: Fatigue in mothers of infants and young children: Factor structure of the Fatigue Assessment Scale. Melbourne: Parenting Research Centre; 2010.
• [35]Giallo R, Wade C, Ward J, Kienhuis K: Psychometric properties of the Fatigue Assessment Scale for mothers of young children in Australia. Melbourne: Parenting Research Centre; 2008.
• [36]Pugh L, Milligan R: Patterns of fatigue during child bearing. Appl Nurs Res 1995, 8:140-146.
• [37]Corwin E, Brownstead J, Barton N, Heckard S, Morin K: The impact of fatigue on the development of postpartum depression. J Obstet Gynecol Neonatal Nurs 2005, 34:577-586.
• [38]Dennis C, Ross L: Relationships among infant sleep patterns, maternal fatigue, and development of depressive symptomatology. Birth 2005, 32:187-193.
• [39]Nash C, Morris J, Goodman B: A study describing mothers' opinions of the crying behaviour of infants under one year of age. Child Abuse Review 2008, 17:191-200.
• [40]Ward J, Giallo R: Report on the parent wellbeing and fatigue study. Melbourne: Parenting Research Centre; 2008.
• [41]Kienhuis M, Rogers S, Giallo R, Matthews J, Treyvaud K: A proposed model for the impact of parental fatigue on parenting adaptability and child development. J Reprod Infant Psychol 2010, 28:392-402.
• [42]Kahn R, Zuckerman B, Bauchner H, Homer C, Wise P: Women's health after pregnancy and child outcomes at age 3 years: A prospective cohort study. Am J Public Health 2002, 92:1312.
• [43]Taylor J, Johnson M: How women manage fatigue after childbirth. Midwifery 2010, 26:367-375.
• [44]Troy N, Dalgas-Pelish P: The Effectiveness of a self-care intervention for the management of postpartum fatigue. Appl Nurs Res 2003, 16:38-45.
• [45]Rose N, Giallo R, Cooklin A: The experiences and support needs of parents of young children and professionals working with parents in managing fatigue. Melbourne: Parenting Research Centre; 2009.
• [46]Giallo R, Rose N, Cooklin A, McCormack D: In survival mode: Mothers' and fathers' experiences of fatigue in the early parenting period. J Reprod Infant Psycholin press
• [47]Giallo R, Dunning M, Cooklin A, Seymour M, Grassaer H, Zerman N, Vittorino R: Acceptability of Wide Awake Parenting: a brief psycho-educational intervention to manage parental fatigue in the early parenting period. J Reprod Infant Psychol 2012. Advance online publication
• [48]Australian Bureau of Statistics: Family characteristics and transitions, Australia. Canberra: Australian Bureau of Statistics; 2008.
• [49]Trewin D: Socio-economic indexes for areas, Australia 2001. Canberra: Australian Bureau of Statistics; 2003.
• [50]Michielsen H, De Vries J, Van Heck G, Van de Vijver F, Sijtsma K: Examination of the dimensionality of fatigue: the construction of the fatigue assessment scale (FAS). Eur J Psychol Assess 2004, 20:39-48.
• [51]Krupp L, LaRocca N, Muir-Nash J, Steinberg A: The fatigue severity scale: Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol 1989, 46:1121-1123.
• [52]Dittner AJ, Wessely SC, Brown RG: The assessment of fatigue: A practical guide for clinicians and researchers. J Psychosom Res 2004, 56:157-170.
• [53]Lovibond S, Lovibond P: Manual for the depression, anxiety and stress scales (DASS). Sydney: Psychology Foundation; 1995.
• [54]McNair D, Lorr M, Droppleman L: Manual for the profile of mood states. San Diego: Educational and Industrial Testing Service; 1971.
• [55]Buysse D, Reynolds C, Monk T, Berman S, Kupfer D: The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989, 28:193-213.
• [56]Johnston C, Mash EJ: A measure of parenting satisfaction and efficacy. J Clin Child Psychol 1989, 18:167-175.
• [57]Abidin R: Parenting stress index. Charlottesville: Pediatric Psychology Press; 1986.
• [58]Sanson A, Nicholson J, Ungerer J, Zubrick S, Wilson K, Ainley J, Berthelsen D, Bittman M, Broom D, Harrison L, et al.: Introducing the longitudinal study of Australian children. Melbourne: Australian Institute of Family Studies; 2002.
• [59]Pettit G, Bates J: Family interaction patterns and children's behaviour problems from infancy to 4 years. Dev Psychopathol 1989, 25:413-420.
• [60]Rothbaum F, Weisz J: Parental converging and child externalizing behavior in non-clinical samples: A meta-analysis. Psychol Bull 1994, 116:55-74.
• [61]Teti D, Candelaria M: Parental competence. In Handbook of parenting. Edited by Bornstein M. Baltimore: Paul H. Brooks Publishing Co; 2002.
• [62]Zubrick S, Silburn S, Garton A, Burton P, Dalby R, Carlton J, Shepherd C, Lawrence D: Western Australian Child Health Survey: Developing Health and Well-Being in the Nineties. Canberra: Australian Bureau of Statistics and the Institute for Child Health Research; 1995.
• [63]Zubrick S, Williams A, Silburn S, Vimpani G: Indicators of Social and Family Functioning. Canberra: Commonwealth of Australia; 2000.
• [64]Epstein N, Baldwin L, Bishop D: The McMaster Family Assessment Device. J Marital Fam Ther 1983, 9:171-180.