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This study examines the clinical profile of women admitted to a psychiatric mother-baby unit as well as change in their clinical, parenting, attachment and quality of life outcomes. Data was collected from 191 mothers through self-report measures at admission and discharge. Change was analysed in terms of Edinburgh Postnatal Depression Scale (EPDS) score, parenting confidence, maternal attachment to the infant and overall functioning. Psychosocial factors impacting on symptom severity and recovery were examined. Most women (64.8 %) were admitted in the first 3 months after birth with an ICD-10 unipolar depressive episode (52.3 %) or anxiety disorder (25.7 %), and 47.6 % had comorbid diagnoses. Improvement from admission to discharge was seen with large effect sizes (≥one standard deviation, i.e. μ) in terms of clinical symptoms (EPDS, μ = 1.7), parenting confidence (Karitane Parenting Confidence Scale (KPCS), μ = 1.1) and attachment to their infant (Maternal Postpartum Attachment Scale (MPAS), μ = 0.9) as well as overall level of functioning (SF-14, μ = 1.9). The majority (73.3 %) recovered symptomatically, and this was associated with increasing maternal age (odds ratio (OR) = 1.129, p = 0.002) and lower levels of psychosocial risk at admission (OR = 0.963, p = 0.008). Improvement in parenting confidence was associated with increasing maternal age (OR = 1.17, p = 0.003). No predictive factors were found for improvement in maternal attachment after controlling for admission scores. In the short term, joint admission of mothers with their infants is highly beneficial in terms of clinical, functional and parenting outcomes, but follow up studies are needed to assess the longer term benefits for mother-infant dyads. The use of an observational tool to enhance our assessment of maternal-infant interaction and some measure of maternal emotional dysregulation-both important mediators of development of secure infant attachment-would also enhance our ability to tailor therapeutic interventions. [ABSTRACT FROM AUTHOR]

This study aims to investigate the (1) pattern of psychosocial risk factors among mothers of unsettled infants, (2) the relationship between these risk factors and current mental health status and (3) acceptability of psychosocial risk assessment in the parentcraft setting. Women with unsettled infants aged up to 12 months were assessed using the Edinburgh Postnatal Depression Scale, a diagnostic interview (Mini-International Neuropsychiatric Interview (MINI)) and a psychosocial assessment tool, the Postnatal Risk Questionnaire (PNRQ). Of the women, 27.5 % met the MINI diagnostic criteria for a current (predominantly) anxiety disorder, and 43.1 %, for a past psychiatric diagnosis. On the Edinburgh Postnatal Depression Scale, 29.9 % of women scored above 12 (mean 9.8; SD 5.1). The most common psychosocial risk factors were high trait anxiety (40.9 %), past mental health problems (40.7 %), perfectionistic traits (38.1 %) and 'abuse trauma' of any kind (31.6 %). The likelihood of meeting diagnostic criteria for a current mental illness was significantly increased for women who experienced emotional abuse during childhood (adj. odds ratio (OR) 3.386; p = 0.006), had high trait anxiety (adj. OR = 2.63, p = 0.003) or had a negative birth experience (adj. OR 2.78; p = 0.015). The majority of women (78 %) felt moderately to very comfortable completing the PNRQ. The results showed high rates of current anxiety disorders (almost twice that of the general postnatal population) and multiple significant psychosocial risk factors among mothers with unsettled infants. Identification of specific psychosocial risk factors in mothers of unsettled infants can help to address issues beyond infant settling difficulties such as mother-infant interaction, especially for mothers with unresolved issues around their own parenting or trauma history. [ABSTRACT FROM AUTHOR]

Lifestyle modification interventions in primary health care settings are an important means of addressing lifestyle risk factors. An essential factor for the success of lifestyle advice is the client's acceptance. Lifestyle interventions offered in general practice are well accepted by clients. However, little is known about how lifestyle interventions are accepted if offered by community nurses in the client's home. This study investigates the experience and perspectives of clients who were offered brief lifestyle interventions from community nurses, based on the 5As model. Semi-structured interviews were conducted with 20 clients who had received brief lifestyle interventions from community nurses as part of a larger intervention trial. All clients perceived the provision of lifestyle interventions to be an appropriate part of the community nurses' role. The advice and support offered was useful only to some, depending on personal preferences, experiences, perceived lifestyle risk and self-rated health. Offering brief lifestyle interventions did not affect the rapport between client and nurse and this puts community nurses in an ideal place to address lifestyle issues that can sometimes be sensitive. However, client-centredness must be emphasised to improve clients' uptake of lifestyle advice and support. [ABSTRACT FROM AUTHOR]