Psychosocial Adaptation among Adolescent Mothers in Western Kenya: The Role of Antenatal Care Counseling
DOI:
https://doi.org/10.47941/japsy.2298Keywords:
Adolescent motherhood; Psychosocial challenges (PSCs); Psychosocial adaptation (PSA), Psychosocial care; AccessAbstract
Purpose: This study sought to establish the influence of antenatal care counseling on psychosocial adaptation among adolescent mothers in Western Kenya and informed the development of a framework that would enhance psychosocial adaptation.
Method: This health facility-based cross-sectional study was founded on Lazarus and Folkman’s psychosocial coping theory (1986) and Livneh’s psychosocial adaptation to chronic illness and disability framework (2001). It was conducted in three purposively selected County referral hospitals in Western Kenya among 438 sequentially selected adolescent mothers (10-19 years) who had visited antenatal care clinics during antenatal period. Frequency distribution and chi-square analysis were performed to test associations, and correlation (according to Cohen’s guideline of 1988) was included to determine the effect size of counseling provided. Moreover, Multinomial logistic regression (MLR) was run to determine the level of prediction of the variables to psychosocial adaptation (PSA).
Results: Findings indicted that counseling provided for adolescent mothers in Western Kenya did not translate to significant levels of psychosocial adaptation. Specifically, while addressing depression, anxiety child irresponsiveness, and school dropout were significantly associated with respective psychosocial adaptation (p< 0.05), they were weakly correlated (r <.3) and among technical skills employed, only responsiveness and assurance were found to be moderately corelated with self-esteem (r> .3, p< 0.05). Significant predictive variables for the outcome (PSA) from chi square analysis and MLR, occurred singly and not in combination. They included; statistically significant relationship between provision of counseling on child irresponsiveness (x=9.26, df= 1, p=0.002); empathy (x= 5.69, df=1, p=0.017); responsiveness (x= 5.69, df=1, p = 0.005) and self-esteem, while responsiveness (x=17.5, df= 2, p=0.001) and clarity (x= 8.54, df= 2, p <0.014) were significantly associated with societal interaction. In addition, counselling adolescent mothers on acceptance and taking up maternal responsibilities (x=33.12, df=4, p<0.05); assurance (x=10.27, df=4, p=0.036) and responsiveness (x=28.64, df=4, p< 0.05) were found to be significantly associated with love and embrace for child among adolescent mothers. Moreover, Responsiveness exhibited by healthcare workers (HCWs) significantly contributed to love and acceptance for the child (OR, 2.1; 95%CI 0.6 -6.8) and child welfare clinic utilization (OR, 1.7; 95%CI 0.3- 9.2) among adolescent mothers.
Recommendations: Adolescent mothers need individualized and targeted counseling to enhance psychosocial adaptation and which should be integrated into routine antenatal care.
Downloads
References
Asino, F., Mukadi, E., & Nyanga’ra, N. (2023). Counseling on Stigma and Its Influence on Academic Progression and Psychological Wellbeing of Adolescent Student Mothers in Public Secondary Schools in Nakuru County, Kenya. Journal of Humanities and Social Sciences ISSN (2708-504X), 3(1), 74-86.
Calandri, E., Graziano, F., Cattelino, E., & Testa, S. (2021). Depressive symptoms and loneliness in early adolescence: the role of empathy and emotional self-efficacy. The Journal of Early Adolescence, 41(3), 369-393
Charles, J. C., Sivayokan, B., & Kumanan, T. (2024). Decline in empathy among healthcare workers; where have all the flowers gone?
Duby, Z., McClinton Appollis, T., Jonas, K., Maruping, K., Dietrich, J., LoVette, A., ... & Mathews, C. (2021). “As a young pregnant girl… the challenges you face”: exploring the intersection between mental health and sexual and reproductive health amongst adolescent girls and young women in South Africa. AIDS and Behavior, 25, 344-353.
Ehteshami-Afshar, S., & Merchant, N. (2022). The underappreciated role of documentation in improving COPD care. Cleveland Clinic Journal of Medicine, 89(5), 249-251.
Feltham, C., Hanley, T., & Winter, L. A. (Eds.). (2017). The SAGE handbook of counselling and psychotherapy. Sage
Gorenko, J. A., Moran, C., Flynn, M., Dobson, K., & Konnert, C. (2021). Social isolation and psychological distress among older adults related to COVID-19: a narrative review of remotely-delivered interventions and recommendations. Journal of Applied Gerontology, 40(1), 3-13.
Govender, D., Naidoo, S., & Taylor, M. (2020). Antenatal and postpartum depression: Prevalence and associated risk factors among adolescents’ in KwaZulu‐Natal, South Africa. Depression research and treatment, 2020(1), 5364521.
Hall, S., Reed, M., & Covers, T. C. (2024). 25 THERAPEUTIC ENGAGEMENT FOR MENTAL HEALTH CARE. Essentials of Mental Health Nursing.
Hughes, J. W., Serber, E. R., & Kuhn, T. (2022). Psychosocial management in cardiac rehabilitation: current practices, recommendations, and opportunities. Progress in Cardiovascular Diseases, 73, 76-83
Ibworo, A. A., & Ibworo, V. (2020). Factors influencing compliance to Focused Antenatal Care in Kisumu County Referral Hospital, Kenya. Journal of Nursing and Health sciences, 9(4), 38-43
Isah, E. E., & Byström, K. (2020). The mediating role of documents: information sharing through medical records in healthcare. Journal of Documentation, 76(6), 1171-1191.
Jain, A., Hassard, J., Leka, S., Di Tecco, C., & Iavicoli, S. (2021). The role of occupational health services in psychosocial risk management and the promotion of mental health and well-being at work. International journal of environmental research and public health, 18(7), 3632.
Jochim, J., Cluver, L. D., & Meinck, F. (2021). Learner pregnancy in South Africa’s Eastern Cape: The Factors affecting adolescent girls' school withdrawal during pregnancy. International Journal of Educational Development, 87, 102484.
Kassa, G. M., Arowojolu, A. O., Odukogbe, A. T. A., & Yalew, A. W. (2021). Adverse maternal outcomes of adolescent pregnancy in Northwest Ethiopia: A prospective cohort study. Plos one, 16(9), e0257485.
Kazal, H. R., Flanagan, P. J., Mello, M. J., Monteiro, K., & Goldman, R. E. (2021). Birth stories, support, and perinatal emotional health among minority adolescent mothers: A mixed methods study. Journal of Pediatric and adolescent gynecology, 34(6), 847-856
Kenga, M. (2019). Using Community Health Volunteers in Child’s Growth Monitoring and Promotion: A Cross-Sectional Study of Facilitators and Barriers in Kitui County, Kenya. EC Nutrition, 14, 600-613
KNBS. Kenya Demographic and Health Survey. 2022. Available from https://www.knbs.or.ke/reports/kdhs
Kohrt, B. A., Turner, E. L., Rai, S., Bhardwaj, A., Sikkema, K. J., Adelekun, A., ... & Jordans, M. J. (2020). Reducing mental illness stigma in healthcare settings: proof of concept for a social contact intervention to address what matters most for primary care providers. Social Science & Medicine, 250, 112852.
Kuczynski, A. M., Halvorson, M. A., Slater, L. R., & Kanter, J. W. (2022). The effect of social interaction quantity and quality on depressed mood and loneliness: A daily diary study. Journal of Social and Personal Relationships, 39(3), 734-756.
Laurenzi, C. A., Gordon, S., Abrahams, N., Du Toit, S., Bradshaw, M., Brand, A., ... & Skeen, S. (2020). Psychosocial interventions targeting mental health in pregnant adolescents and adolescent parents: a systematic review. Reproductive health, 17, 1-15.
Li, J., Imam, S. Z., Jing, Z., Wang, Y., & Zhou, C. (2021). Suicide attempt and its associated factors amongst women who were pregnant as adolescents in Bangladesh: a cross-sectional study. Reproductive health, 18, 1-9.
Livneh, H. (2001). Psychosocial adaptation to chronic illness and disability: A conceptual framework. Rehabilitation counseling bulletin, 44(3), 151-160.
Livneh, H., & Antonak, R. F. (2005). Psychosocial adaptation to chronic illness and disability: A primer for counselors. Journal of Counseling & Development, 83(1), 12-20
Ma, R., Mann, F., Wang, J., Lloyd-Evans, B., Terhune, J., Al-Shihabi, A., & Johnson, S. (2020). The effectiveness of interventions for reducing subjective and objective social isolation among people with mental health problems: a systematic review. Social psychiatry and psychiatric epidemiology, 55, 839-876.
Mabetha, K., Soepnel, L., Klingberg, S., Mabena, G., Motlhatlhedi, M., Norris, S. A., & Draper, C. E. (2022). Social Support during pregnancy: A phenomenological exploration of young women’s experiences of support networks on pregnancy care and wellbeing in Soweto, South Africa. medRxiv, 2022-04
Maharaj, N. R. (2022). Adolescent pregnancy in sub-Saharan Africa–a cause for concern. Frontiers in Reproductive Health, 4, 984303.
Mahmoudi, P., Elyasi, F., Nadi, A., & Ahmad Shirvani, M. (2023). The Effect of Maternal–Foetal Attachment–Based Training Programme on Maternal Mental Health Following an Unintended Pregnancy. Journal of Reproductive and Infant Psychology, 41(1), 26-42.
Marici, M., Clipa, O., Runcan, R., & Pîrghie, L. (2023, June). Is rejection, parental abandonment or neglect a trigger for higher perceived shame and guilt in adolescents?. In Healthcare (Vol. 11, No. 12, p. 1724). MDPI.
McGorry, P. D., Mei, C., Chanen, A., Hodges, C., Alvarez‐Jimenez, M., & Killackey, E. (2022). Designing and scaling up integrated youth mental health care. World Psychiatry, 21(1), 61-76
Miller, W. R., & Rollnick, S. (2012). Motivational interviewing: Helping people change. Guilford press.
Mokoena, P., & Van Breda, A. D. (2021). School dropout among female learners in rural Mpumalanga, South Africa. South African Journal of Education, 41(3).
Moudatsou, M., Stavropoulou, A., Philalithis, A., & Koukouli, S. (2020, January). The role of empathy in health and social care professionals. In Healthcare (Vol. 8, No. 1, p. 26). MDPI
Musyimi, C. W., Mutiso, V. N., Nyamai, D. N., Ebuenyi, I., & Ndetei, D. M. (2020). Suicidal behavior risks during adolescent pregnancy in a low-resource setting: A qualitative study. PLoS one, 15(7), e0236269.
Mutahi, J., Larsen, A., Cuijpers, P., Peterson, S. S., Unutzer, J., McKay, M., ... & Kumar, M. (2022). Mental health problems and service gaps experienced by pregnant adolescents and young women in Sub-Saharan Africa: a systematic review. EClinicalMedicine, 44.
Mutai, K. T., & Otieno, G. O. (2021). Utilization of focused antenatal care among expectant women in Murang'a County, Kenya. Pan African Medical Journal, 39(1).
Patterson, L. E., & Welfel, E. R. (1994). The counseling process. Thomson Brooks/Cole Publishing Co.
Raby, C., Dowse, T., & Bennet, L. (2008). Postpartum/newborn patients: who are they and do they all need the same amount of nursing care?. Journal of Nursing Management, 16(2), 198-203.
Rangachari, P., & L. Woods, J. (2020). Preserving organizational resilience, patient safety, and staff retention during COVID-19 requires a holistic consideration of the psychological safety of healthcare workers. International journal of environmental research and public health, 17(12), 4267.
Remien, R. H., Stirratt, M. J., Nguyen, N., Robbins, R. N., Pala, A. N., & Mellins, C. A. (2019). Mental health and HIV/AIDS: the need for an integrated response. AIDS (London, England), 33(9), 1411
Roupetz, S., Stein, J. Y., Anderson, K., Kaiser, M., Mitreuter, S., & Glaesmer, H. (2023). Mother-child relationship representations of children born of sexual violence in Post-WWII Germany. Journal of Child and Family Studies, 32(5), 1398-1410.
Ruzibiza, Y. (2021). ‘They are a shame to the community…’stigma, school attendance, solitude and resilience among pregnant teenagers and teenage mothers in Mahama refugee camp, Rwanda. Global public health, 16(5), 763-774.
Sallay, V., Martos, T., Lucza, L., Papp-Zipernovszky, O., & Csabai, M. (2023). Health Psychology Services for People in Disadvantaged Regions of Hungary: Experiences from the Primary Health Care Development Model Program. International Journal of Environmental Research and Public Health, 20(5), 3900.
Sender, A., Friedrich, M., Schmidt, R., & Geue, K. (2020). Cancer-specific distress, supportive care needs and satisfaction with psychosocial care in young adult cancer survivors. European Journal of Oncology Nursing, 44, 101708
Sheikh, A., Anderson, M., Albala, S., Casadei, B., Franklin, B. D., Richards, M., ... & Mossialos, E. (2021). Health information technology and digital innovation for national learning health and care systems. The Lancet Digital Health, 3(6), e383-e396
Sheridan Rains, L., Johnson, S., Barnett, P., Steare, T., Needle, J. J., Carr, S., ... & Simpson, A. (2021). Early impacts of the COVID-19 pandemic on mental health care and on people with mental health conditions: framework synthesis of international experiences and responses. Social psychiatry and psychiatric epidemiology, 56, 13-24.
Sloan, M., Naughton, F., Harwood, R., Lever, E., D’cruz, D., Sutton, S., ... & Gordon, C. (2020). Is it me? The impact of patient–physician interactions on lupus patients’ psychological well-being, cognition and health-care-seeking behaviour. Rheumatology Advances in Practice, 4(2), rkaa037.
SmithBattle, L., & Freed, P. (2016). Teen mothers' mental health. MCN: The American Journal of Maternal/Child Nursing, 41(1), 31-36.
Sobngwi-Tambekou, J. L., Tsague-Agnoux, M., Fezeu, L. K., & Ndonko, F. (2022). Teenage childbearing and school dropout in a sample of 18,791 single mothers in Cameroon. Reproductive Health, 19(1), 10.
Stabouli, S., Sommer, A., Kraft, S., Schweer, K., Bethe, D., Bertholet-Thomas, A., ... & Oh, J. (2024). Addressing the psychosocial aspects of transition to adult care in patients with cystinosis. Pediatric Nephrology, 1-14
Sultana-Grixti, S., Cassar, O. A., & Savona-Ventura, C. (2024). Evidence-Based Clinical Practice in Contraceptive Counselling and Care. Textbook of Contraception, Sexual and Reproductive Health, 71
Teela, L., Haverman, L., Burgess, C., Buckova, P., Vandenabeele, K., Golan, G., ... & Torres‐Ortuño, A. (2023). The results of a survey about psychosocial care throughout Europe. Haemophilia, 29(3).
Teisberg, E., Wallace, S., & O’Hara, S. (2020). Defining and implementing value-based health care: a strategic framework. Academic Medicine, 95(5), 682-685.
Thwala, S. L. K., Okeke, C. I., Matse, Z., & Ugwuanyi, C. S. (2022). Teachers' perspectives on the implementation of teenage mothers' school re‐entry policy in Eswatini Kingdom: Implication for educational evaluators. Journal of community psychology, 50(2), 684-695.
Toyama, M., Castillo, H., Galea, J. T., Brandt, L. R., Mendoza, M., Herrera, V., ... & Miranda, J. J. (2017). Peruvian mental health reform: a framework for scaling-up mental health services. International journal of health policy and management, 6(9), 501.
UNICEF. Trends in early childbearing, UNICEF data, monitoring the situation of women and children. 2022. Available from https://data.unicef.org/
Wainaina, C. W., Sidze, E. M., Maina, B. W., Badillo-Amberg, I., Anyango, H. O., Kathoka, F., ... & Okoror, C. E. (2021). Psychosocial challenges and individual strategies for coping with mental stress among pregnant and postpartum adolescents in Nairobi informal settlements: a qualitative investigation. BMC pregnancy and childbirth, 21, 1-11.
Winter, L. A., & Hanley, T. (2023). The SAGE handbook of counselling and psychotherapy.
World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience. World Health Organization; 2016.
Xavier, C., Benoit, A., & Brown, H. K. (2018). Teenage pregnancy and mental health beyond the poartum period: a systematic review. J Epidemiol Community Health, 72(6), 451
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Anne A. Ibworo, Jane Owenga, PhD, Dickens Omondi Aduda
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.