Measurement of Swanson's Theory of Caring with Primiparous Mothers
Background - Transitioning into the role of motherhood is associated with increased anxiety, maternal depression, and maternal stress threatening mother's confidence resulting in negatively impacting mother-infant bonding and maternal empowerment. There are no studies which tested Swanson's Theory of Caring in evaluating the relationship between the nurse caring behaviors and first-time mother's maternal confidence.
Objective - Identify predictors of maternal confidence and measure the relationship between the nurse caring behaviors, selected maternal factors (postpartum stress, lack of social support, depression, and perception of difficult infant temperament) and maternal confidence.
Methods - In a convenience sample, 104 first-time mothers were recruited from prenatal education classes and hospital tours of two participating hospitals within the mid-Atlantic region. In addition, a snowball sampling was utilized. Survey instruments were completed by the first-time mothers 1-2 weeks postpartum. Analyses of descriptive statistics and multiple regressions were conducted to determine the relationship between nurse caring behaviors, selected maternal factors (postpartum stress, lack of social support, depression, and infant temperament), and maternal confidence.
Results - This study supports Swanson's Theory of Caring. Nurses caring behaviors had a weak to moderate relationship (r = .248, p < .05) with maternal confidence. The selected maternal factors, postpartum stress (r = -.593, p < .001), lack of social support (r = -.577, p < .001), depression (r = -.541, p < .001), and difficult infant temperament (r = -.407, p < .001), had moderate inverse relationships with maternal confidence. The caring behaviors of respect (r = .258, p < .05), connectedness (r = .277, p < .01), and assurance (r = .202, p < .05) had weak to moderate relationships with maternal confidence. Respect (β = .618, p < .05), depression (β = -.291, p < .05), and difficult infant temperament (β = -2.481, p < .05) significantly predicted maternal confidence. Maternal confidence demonstrated a negative weak to moderate relationship (r = .249, p < .05) with maternal age.
Implications - Applying Swanson's Theory of Caring, especially the enabling behaviors, promotes maternal confidence. Older first-time mothers perceive themselves as less confident. Difficult infant temperament negatively affects maternal confidence. However, mothers who received excellent nurse caring behaviors perceived their infants as less temperamental, thus promoting mother-infant bonding. Depression cognitively distorts mother's perception of the caring of the nurses, social support, postpartum stress, and maternal confidence. Further study is needed to test different population groups, and understand the inverse relationship between maternal confidence and age.