Browsing by Author "McDonald, Sheila"
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- ItemOpen AccessAn Examination of Mode of Birth, Maternal Postpartum Mental Health, and Childhood Behavioural Problems(2024-01-26) Grisbrook, Marie-Andrée; Letourneau, Nicole; Dewey, Deborah; Cuthbert, Colleen; McDonald, SheilaCesarean section (C-section) deliveries account for 21% of all deliveries worldwide (Betran, Ye, Moller, Souza, & Zhang, 2021). They are frequently considered a medical necessity in labour dystocia, placenta previa, and malpresentation (Caughey, Cahill, Guise, & Rouse, 2014). However, delivery via C-section has been associated with an increased risk of internalizing (anxiousness, depressiveness, withdrawal) and externalizing (aggression, hyperactivity) behavioural problems among children (Rutayisire et al., 2018; Sirvinskiene, Zemaitiene, Jusiene, & Markuniene, 2016). Research evaluating the link between C-section and child behaviour is inconclusive and limited. Delivery via an emergency C-section is the strongest factor linked to a negative perception of the birth experience (Waldenstrom & Schytt, 2009). A negative perception of the birth experience is strongly associated with postpartum post-traumatic stress disorder (PTSD) (Dekel, Ein-Dor, et al., 2019; Soderquist, Wijma, & Wijma, 2002; Verreault et al., 2012), which may be comorbid with postpartum depression (PPD) (Soderquist, Wijma, & Wijma, 2006). Therefore, it is hypothesized that the relationship between C-section and child behaviour depends on the type of C-section, and postpartum PTSD and PPD mediate this association. This manuscript-based dissertation is comprised of five papers. The first and second manuscripts include a review protocol and systematic review outlining the procedures and current evidence regarding the association between C-section delivery and child externalizing and internalizing behavioural problems. The third manuscript presents results regarding the association between C-section delivery and maternal PPD and the role of maternal PTSD in mediating this association. The fourth manuscript presents the study findings on the association between C-section delivery and child behavioural problems and the role of maternal postpartum PTSD and PPD as mediating factors. The final manuscript reviews the current landscape of maternal postpartum mental health screening in Canada and suggests improvements for screening. The dissertation concludes with implications for nursing practice, policy, education, and research.
- ItemOpen AccessDeveloping non-response weights to account for attrition-related bias in a longitudinal pregnancy cohort(2023-12-14) Pitt, Tona M.; Hetherington, Erin; Adhikari, Kamala; Premji, Shainur; Racine, Nicole; Tough, Suzanne C.; McDonald, SheilaAbstract Background Prospective cohorts may be vulnerable to bias due to attrition. Inverse probability weights have been proposed as a method to help mitigate this bias. The current study used the “All Our Families” longitudinal pregnancy cohort of 3351 maternal-infant pairs and aimed to develop inverse probability weights using logistic regression models to predict study continuation versus drop-out from baseline to the three-year data collection wave. Methods Two methods of variable selection took place. One method was a knowledge-based a priori variable selection approach, while the second used Least Absolute Shrinkage and Selection Operator (LASSO). The ability of each model to predict continuing participation through discrimination and calibration for both approaches were evaluated by examining area under the receiver operating curve (AUROC) and calibration plots, respectively. Stabilized inverse probability weights were generated using predicted probabilities. Weight performance was assessed using standardized differences of baseline characteristics for those who continue in study and those that do not, with and without weights (unadjusted estimates). Results The a priori and LASSO variable selection method prediction models had good and fair discrimination with AUROC of 0.69 (95% Confidence Interval [CI]: 0.67–0.71) and 0.73 (95% CI: 0.71–0.75), respectively. Calibration plots and non-significant Hosmer-Lemeshow Goodness of Fit Tests indicated that both the a priori (p = 0.329) and LASSO model (p = 0.242) were well-calibrated. Unweighted results indicated large (> 10%) standardized differences in 15 demographic variables (range: 11 − 29%), when comparing those who continued in the study with those that did not. Weights derived from the a priori and LASSO models reduced standardized differences relative to unadjusted estimates, with the largest differences of 13% and 5%, respectively. Additionally, when applying the same LASSO variable selection method to develop weights in future data collection waves, standardized differences remained below 10% for each demographic variable. Conclusion The LASSO variable selection approach produced robust weights that addressed non-response bias more than the knowledge-driven approach. These weights can be applied to analyses across multiple longitudinal waves of data collection to reduce bias.
- ItemOpen AccessExperiences of Albertan Families with Young Children during the COVID-19 Pandemic: Descriptive Report(2020-11-30) McDonald, Sheila; Edwards, Sarah; Hetherington, Erin; Racine, Nicole; Mueller, Melissa; McArthur, Brae Anne; Madigan, Sheri; Dewey, Deborah; Letourneau, Nicole; Tough, Suzanne; Geisbrecht, GeraldThis report describes data collected from Albertan families on the COVID-19 Impact Survey implemented in May 2020, which built on a unique collaboration across two longitudinal cohorts in Alberta: The All Our Families study (AOF) and the Alberta Pregnancy Outcomes and Nutrition study (APrON). Our objectives were as follows: (1) Describe household infections of COVID-19 in Alberta among families with school-aged children; (2) Describe urban Albertan family experiences of the pandemic within the first 3-4 months of the outbreak across the areas of financial impact, maternal mental health and well-being, school and daily life, and relationships in the home; and (3) Describe associations among key predictor variables (e.g., financial impact) and outcomes (e.g., maternal anxiety, concern for child’s well-being). Study Sample: AOF and APrON Cohort participants reflect families parenting at least one child in between the ages of 8 and 12. While the respondents represent a broad range of income, education and ethnicity, they are typified by adequate income, food and housing security and partnered marital status. Highlighted Results: Physical Impact: At the time of data collection in May, 2020, over 90% of families did not have personal experience with COVID-19, either through personal infection, infection of a child, extended family member or close friend. Vaccine Intentions: Although over 60% of mothers and their children would obtain a COVID-19 vaccine when available, almost 30% are undecided and 8% would not obtain a vaccine. Financial Impact: In 58% of all families, at least one parent experienced job loss, loss of main income source, or reduced employment hours. One in five mothers reported difficulty meeting financial needs for the household, and 5% of families were experiencing food insecurity. Over 40% of respondents reported at least some impact on their ability to meet financial obligations. Mental Health and Wellness Impact: Mothers reported elevated levels of stress (21%), anxiety (25%) and depression (35%). Approximately 26% of mothers reported having limited coping skills. Almost 90% of mothers have undertaken more domestic tasks in the home. Mothers also reported that their children showed increased sadness and behavioural challenges. The COVID-19 pandemic has had profound financial and mental health impact on some families. Investment in strategies to alleviate financial stress, provide parenting supports, and alleviate mental health concerns is critical. Suggested Citation: McDonald S, Edwards S, Hetherington E, Racine N, Mueller M, McArthur BA, Madigan S, Dewey D, Geisbrecht G, Letourneau N, Tough S. Experiences of Albertan Families with Young Children during the COVID-19 Pandemic: A Descriptive Report. Calgary, Alberta: University of Calgary; 2020.
- ItemOpen AccessFactors Affecting Parental Help seeking for Children with Mental Health Problems(2017) Harvalik, Paula; Kingston, Dawn; Arnold, Paul; McDonald, Sheila; Goldsworthy, SandraBackground. Childhood mental health problems have an early onset, are highly prevalent, and persistent into adolescents’ and adulthood, and left untreated, mental health problems are exacerbated by comorbid disorders. Early screening and intervention for childhood mental health is key to improved outcomes. Very young children that experience emotional or behavioural problems rely primarily on their parents for help-seeking on their behalf. Parents often do not recognize problematic behaviour that requires further evaluation and treatment. Without parental help-seeking, these children’s mental health problems remain undetected and untreated throughout the lifespan. Understanding what perceived barriers and facilitators exist for parents that have children with problematic behaviours, can inform the development of early intervention programs aimed at very young children (i.e., 5 years old and under). The aim of this thesis by publication was to examine the barriers and facilitators to help-seeking for parents with children that have emotional and behavioural problems. Methods. Two published studies of perceived barriers and facilitators to help-seeking for parents of young children were identified through searches using PubMed, PsycINFO, Embase, and CINAHL databases. Data was extracted and summarized in tables. Results. Parents reported perceived barriers to be: (a) child’s problems being identified as transient and part of a stage that will go way on their own, (b) not knowing what services were available, and (c) not knowing what sources were available for help. Conclusions. Increased research and development of early screening and intervention programs that target parents of very young children will improve mental health outcomes for children, their families, and communities.
- ItemOpen AccessMaternal perceptions of childhood vaccination: explanations of reasons for and against vaccination(2019-01-10) McNeil, Deborah A; Mueller, Melissa; MacDonald, Shannon; McDonald, Sheila; Saini, Vineet; Kellner, James D; Tough, SuzanneAbstract Background Understanding reasons for and against vaccination from the parental perspective is critical for designing vaccination campaigns and informing other interventions to increase vaccination uptake in Canada. The objective of this study was to understand maternal vaccination decision making for children. Methods Mothers participating in a longitudinal community-based pregnancy cohort, the All Our Babies study in Calgary, Alberta, completed open-ended survey questions providing explanations for the vaccination status of their child by 24 months postpartum. Qualitative responses were linked to administrative vaccination records to examine survey responses and recorded child vaccination status. Results There were 1560 open-ended responses available; 89% (n = 1391) provided explanations for vaccinating their children, 5% (n = 79) provided explanations for not vaccinating/delaying, and 6% (n = 90) provided explanations for both. Themes were similar for those vaccinating and not vaccinating/delaying; however, interpretations were different. Two broad themes were identified: Sources of influence and Deliberative Processes. Sources of influence on decision making included personal, family, and external experiences. Deliberative Processes included risk, research, effectiveness, and balancing risks/benefits. Under Deliberative Processes, responsibility was a category for those vaccinating; while choice, instrumental/practical, and health issues were categories for those not vaccinating/delaying. Mothers’ levels of conviction and motivation provided a Context for understanding their decision making perspectives. Conclusions Vaccination decision making is complex and impacted by many factors that are similar but contribute to different decisions depending on mothers’ perspectives. The results of this study indicate the need to examine new intervention approaches to increase uptake that recognize and address feelings of pressure and parental commitment to choice.
- ItemOpen AccessMental health outcomes of mothers who conceived using fertility treatment(BioMed Central, 2014-02-28) Raguz, Nikolett; McDonald, Sheila; Metcalfe, Amy; O'Quinn, Candace; Tough, Suzanne C
- ItemOpen AccessQuality of attachment and history of suicidal behavior in clinical adolescents(1996) McDonald, Sheila; West, Malcolm
- ItemOpen AccessThe role of feeding practices in the relationship between postpartum depression and child growth: Analysis of the All Our Babies study(2017-12-20) Lee, Yoon Shin; Fenton, Tanis; Sauve, Reginald; Rose, Marianne; McDonald, Sheila; Benzies, KarenThe purpose of this study was to examine the relationships among postpartum depression at 4 months of age, feeding practices and child growth at age 2 years. This study used data from 1881 mothers participating in the All Our Babies Study in Calgary. The mothers participated in five surveys between 24 weeks gestation and 2 years of child age. Multivariable regression analysis was done. Postpartum depression was negatively related to exclusive breastfeeding duration (β = -2.30 weeks, 95% CI: -4.39, -0.22). Postpartum depression and feeding practices were unrelated to child growth at age 2 years. We found mothers with postpartum depression at 4 months terminated exclusive breastfeeding earlier (2.3 weeks) than mothers without postpartum depression whose average exclusive breastfeeding duration was 20.2 weeks. The findings suggest a need for breastfeeding support for mothers with postpartum depression to sustain breastfeeding to the recommended duration.