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A prospective study of psychological distress among mothers of children admitted to a nutritional rehabilitation unit in Malawi

Author: Stewart RC. et al.
Year: 2011
Resource type: Research

Child Care Health Dev. 2011 Jan;37(1):55-63. doi: 10.1111/j.1365-2214.2010.01111

Abstract

Objectives: Accompanying guardians (usually the mother) have a pivotal role in promoting
recovery from childhood severe acute malnutrition on Nutritional Rehabilitation Units (NRUs). We
describe the prevalence of maternal distress at an NRU in Malawi and identify factors associated
with this. We tested the hypothesis that maternal distress during admission would be associated
with reduced child weight gain over the 4-week post-discharge period.


Methods: Maternal distress was measured using the Self Reporting Questionnaire (SRQ)
administered to mothers of consecutive children during NRU admission. Repeat SRQ was
administered to mothers attending a follow-up clinic 4 weeks post discharge. Maternal, child and
psychosocial variables were also measured. Child weight change from discharge to follow-up was
compared between children of mothers scoring SRQ  8 and those scoring SRQ< 8.


Findings: A total of 244 mothers and their children were recruited. In total, 71% of mothers scored
SRQ  8 during admission. In all, 155 of 222 mothers eligible to complete repeat SRQ did so, and
33.5% scored SRQ  8. Maternal distress at recruitment was associated with older child age, no
con?ding relationship with spouse, having had a previous child die, and the child having diarrhoea. Maternal distress at follow-up was associated with older child age, the child having diarrhoea or fever since discharge, and the child being HIV sero-positive. Maternal distress during admission was not associated with child weight gain at 4-week post-discharge follow-up.


Conclusion: Levels of maternal distress are very high during child admission to an NRU. Persistent
distress is associated with child health factors including HIV. Nutritional rehabilitation programmes
should pay increased attention to carer psychological wellbeing using targeted evidence-based
interventions.

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Stewart RC. et al. (2011). A prospective study of psychological distress among mothers of children admitted to a nutritional rehabilitation unit in Malawi. www.ennonline.net/motherstressmalawi

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