Download - Maternal role attainment theory
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MATERNAL ROLE ATTAINMENT
THEORY
RAMONA T. MERCER, Ph.D, RN, FAAN
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Born in 1929
CREDENTIALS AND BACKGROUND
Mercer began her nursing career in 1950 and she graduated from St. Margaret’s school of nursing, Montgomery, alabama.
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For the next 10 years she worked as a nurse and instructor in pediatric and obstetrical nursing in addition to the field of contagious diseases (Meighan, 2010).
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Her early nursing experience molded her interests toward pediatric and obstetrics. returned to school in 1960 and earned her master’s degree specializing in maternal-child nursing at the University of New Mexico in 1964 (Meighan, 2010).
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She continued pursuing her passion for maternity nursing and completed her Ph.D. at the University of Pittsburgh in 1973.
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Dr. Mercer then moved to California and worked as a nursing professor at the University of California until she retired in 1987. Even in her retirement, she still continues to revise and clarify her work because she believes that “theory building is a continual process” (Mercer, 2004, p.226).
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Ramona Mercer’s early work in the 1970’s was focused on the
1.needs of breastfeeding mothers
2.teenage mothers3.postpartum illness4.mothers bearing
children with defects.
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She had also a deep interest in the development of the
1.maternal role2.self-esteem3.self-concept of
mothers
(Meighan, 2010)
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During the span of Mercer’s career, her work expanded further in the area of maternal-child nursing.
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She authored books such as:
1. Perspectives on Adolescent Health Care
2. Transitions in a Woman’s Life
3. Parents at Risk
(Ramona Mercer, 2011)
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She has written a total of six books, published six book chapters and numerous journal articles.
Throughout her career Dr. Mercer has received a great deal of awards and is a member of several professional organizations and national committees (Meighan, 2010).
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Maternal Role Attainment
Theory
Defined as an interaction and developmental process occurring over time, in which the mother becomes attached to her infant, acquires competence in the care-taking tasks involved in the role, and expresses pleasure and gratification in the role.
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Maternal Role Attainment is also as defined a process of binding in or being attached to the child and Maternal Role Identity or seeing oneself in the role and having a sense of comfort about it.
(Rubin)
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FACTORS THAT DIRECTLY OR INDIRECTLY INFLUENCE ON THE
MATERNAL ROLE
The maternal factors included:
•age at first birth•birth experience•early separation from the infant•social stress• social support personality traits,self-concept
•child-rearing attitudes•health
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FACTORS THAT DIRECTLY OR INDIRECTLY INFLUENCE ON THE
MATERNAL ROLE
She also included the infant variables:
•temperament•appearance•responsiveness•health status, and ability to give cues
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FACTORS THAT DIRECTLY OR INDIRECTLY INFLUENCE ON THE
MATERNAL ROLE
She also noted the importance of the father's role, the
mother-father relationship. She also noted the importance of the father's role and applied many of her previous findings
in studying the paternal response to parenthood.
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CONCEPTS
MATERNAL IDENTITYMaternal identity is defined as
having an internalized view of the self as a mother (Mercer, 1995).
PERCEPTION OF BIRTH EXPERIENCE
A woman’s perception of her performance during labor and birth is her perception of the birth experience (Mercer, 1990)
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CONCEPTS
SELF-ESTEEMMercer, May, Ferketich and DeJoseph
(1986) describe self-esteem as “an individual’s perception of how others view one and self-acceptance of the perception “.
SELF-CONCEPT (SELF-REGARD)Mercer (1986) outlines self-concept, or
self-regard, as “The overall perception of self that includes self-satisfaction, self-acceptance, self-esteem, and congruence or discrepancy between self and ideal self “.
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CONCEPTS
FLEXIBILITYRoles are not rigidly fixed; therefore,
who fills the roles is not important (Mercer, 1990). “Flexibility of children attitudes increases with increased development …., Older mothers have infants and to view each situation in respect to the unique nuances”.
CHILDREARING ATTITUDES Childrearing attitudes are material
attitudes or beliefs about childrearing.
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CONCEPTS
HEALTH STATUSHealth status is defined as “ The
mother’s and father’s perception of their prior heath, current health, health outlook, resistance-susceptibility to illness, health worry concern, sickness orientation, and rejection of the sick role” .
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CONCEPTS
ANXIETYMercer and colleagues (1986)
describe anxiety as “ a trait in which there is specific proneness to perceive stressful situation-specific state” .
DEPRESSIONAccording to Mercer and colleagues
(1986), depression is “having a group of depression symptoms and in particular the effective component of the depressed mood”.
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CONCEPTS
ROLE STRAIN-ROLE CONFLICTRole strain is the conflict and
difficulty felt by the woman in fulfilling the maternal role obligation.
GRATIFICATION-SATISFACTIONMercer describes gratification as
“the satisfaction, enjoyment, reward, or pleasure that a woman experiences in interacting with her infant and in fulfilling the usual tasks inherent in mothering.”
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CONCEPTS
ATTACHMENTAttachment versus a difficult
temperament is related to whether the infant sends hard-to-read cues, leading to feelings of incompetence and frustration in the mother.
INFANT HEALTH STATUSInfant health status is illness causing
maternal infant separation, interfering with the attachment process.
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CONCEPTS
INFANT CHARACTERISTICS Characteristics include infant
temperament, appearance, and health status.
INFANT CUESInfant cues are infant behaviors
that elicit a response from the mother .
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CONCEPTS
FAMILYMercer and colleagues define
family as “a dynamic system which includes subsystems-in-individuals (mother, father, fetus/infant) and dyads (mother-father, mother-fetus/infant, and father fetus/infant) within the overall family system.
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CONCEPTS
FATHER OR INTIMATE PARTNERThe father or intimate partner
contributes to the process of maternal role attainment in a way that cannot be duplicated by any other person. The father’s interactions help diffuse tension and facilitate maternal role attainment
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CONCEPTS
FAMILY FUNCTIONINGFamily functioning is the individual’s
view of the activities and relationships between the family and its subsystems and broader social units.
STRESSStress is made up of positively and
negatively perceived life events and environmental variables.
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CONCEPTS
MOTHER-FATHER RELATIONSHIP
The mother-father relationship is the perception of the mate relationship that includes intended and actual values, goals, and agreement between the two. The maternal attachment to the infant develops within the emotional held of the parent’s relationship.
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CONCEPTSSOCIAL SUPPORTAccording to Mercer and colleagues, social support is “the amount of help actually received, satisfaction with that help, and the persons (network) providing that help”.
Four areas of social support area as follows:
•Emotional support; “Feeling loved, cared for, trusted, and understood”
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• Informational support: “Helps the individual help herself by providing information that is useful in dealing with the problem and/or situation”
• Physical support: A direct kind of help
• Appraisal support: “ A support that tells the role taker how she is performing in the role; it enables the individual to evaluate herself in relationship to others “ performance in the role”
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ASSUMPTIONS
•A relatively, stable core self, acquired through lifelong socialization, determines how a mother defines and perceive events; her perceptions of her infant’s and others responses to her mothering, with her life situation, are real world to which she responds.
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ASSUMPTIONS
•In addition to the mother’s socialization, her developmental level and innate personality characteristics also influence her behavioral responses.
•The mother’s role partner, her infant, will reflect the mother’s competence in the mothering role through growth and development.
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ASSUMPTIONS
•The infant is considered an active partner in maternal role-taking process, affecting and being affected by the role enactment.
•The father or mother’s intimate partner contributes to role attainment in a way that cannot be duplicated by any other supportive person.
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ASSUMPTIONS
•Maternal identity develops concurrently with maternal attachment and each depends on the other.
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ASSERTIONS
•Mercer’s original Theory and Model of Maternal Role Attainment were first introduced in 1991. It was refined and was presented more clearly in her 1995 book, Becoming a Mother: Research on Maternal Identity
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ASSERTIONS
•From Rubin to Present. Her recent revision focuses on woman’s transition in becoming a mother. It involves an extensive change in her life space that requires her ongoing development.
.
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ASSERTIONS
•According to Mercer, becoming a mother is more extensive than just assuming the role. It is unending and continuously evolving therefore she recommends that the Maternal role attainment be retired.
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PARADIGMS
NURSINGMercer stated that, “Nurses are the health professionals having the most sustained and intense interaction with women in the maternity cycle. She emphasizes that the kind of help of a woman receives during pregnancy and over the first year following birth can have a lifelong term effects for her and her child.
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PARADIGMS
PERSONShe refers the person as self or core self, view the self as separate from the roles that are played. The mother interacts with her infant and with the father or her significant other; influential and is influenced by both of them.
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PARADIGMS
HEALTHShe defines health status as the mothers and father’s perception of their prior health, current health, health outlook, resistance, susceptibility to illness, worry or concern and rejection of sick role. Health status of newborn is the extent of disease present and infant health status by parental rating of overall health. She also stresses the importance of healthcare during childbearing and childrearing process.
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PARADIGMS
ENVIRONMENTShe conceptualized the environment from Bronfenbrenner’s definition of the ecological environment. Development of a role/ person cannot be considered apart from the environment; there is a mutual accommodation between developing person and the changing properties of the immediate settings, and the larger context in which the settings are embedded.
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Proposed Model of Maternal Role Attainment
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1.) The microsystem is the immediate environment where maternal role attainment occurs.This indicates the family and factors such as family functioning, mother-father relationships, social support and stress. The infant is an individual embedded within the family system. This system is the most influencial on maternal role attainment and attainment is achieved within the microsystem through the interactions of father, mother and infant.
Proposed Model of Maternal Role Attainment
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Proposed Model of Maternal Role Attainment
2.) The mesosystem encompasses, influences, and delimits the microsystem. The mother-infant unit is not contained within the mesosystem, but the mesosystem may determine in part what happens to the developing maternal role and the child. It includes extended family, school, work church and other entities within the mother's more immediate community.
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Proposed Model of Maternal Role Attainment
The exosystem, the previously used term, is an extension of the mesosystem. It is the interrelationships of two or more settings or subsystems that more directly influences the mother such as interactions between works setting, daycare,local laws and rules, community and church.
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Proposed Model of Maternal Role Attainment
3.) The macrosystem refers to the general prototypes existing in a particular culture or transmitted cultural consistencies which include the social, political and cultural influences on other two systems. It is in the macrosystem where the health care environment and the impact of current health care system on maternal role attainment originate.
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Proposed Model of Maternal Role Attainment
Maternal role attainment is a process that follows four stages of role acquisition;these stages have been adapted from Thornton and Nardi's 1975 research. These four stages are indicated as microsystem within the evolving model of Maternal Role Attainment.
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Proposed Model of Maternal Role Attainment
a. Anticipatory Stage: Begins ion the pregnancy and includes the initial social and psychological adjustments to pregnancy. The mother learns the expectations of the role, fantasizes about the role, related to the fetus in the uterus, and begins role play.
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b. Formal Stage: Begins with the birth of the infant and includes learning and taking of the role of the mother. Role behaviors are guided by formal, consensual expectations and others in the mother's social system.
Proposed Model of Maternal Role Attainment
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c. Informal Stage: Begins as the mother develops unique way of dealing with the role not conveyed by the social system. The woman makes her new role fit within her existing lifestyle based on past experiences and future goals.
Proposed Model of Maternal Role Attainment
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Proposed Model of Maternal Role Attainment
d. Personal Stage: Role Identity Stage occurs as the woman internalizes her role. The mother experiences harmony, confidence and competence in the way she performs the role and the maternal role is achieved.
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These four stages of role acquisition overlap and are altered as the infant grows as and develops. The final stage of maternal role identity may be achieved in many period of time. The stages are influenced by social support, stress, family functioning,and the relationship between the mother and father or significant others.
Proposed Model of Maternal Role Attainment
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Traits and behaviors of both the mother and the infant may influence maternal role identity and child outcome. Maternal traits and behaviors included Mercer's model are empathy, sensitivity to infant cues, self-esteem and self-concept,parenting received as a child, maturity and flexibility, attitude, pregnancy and birth experience, health, depression and role conflict.
Proposed Model of Maternal Role Attainment
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Proposed Model of Maternal Role Attainment
Infant traits having an impact on maternal role identity include temperament, ability to send cues, appearance, general characteristics, responsiveness and stress.
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Proposed Model of Maternal Role Attainment
According to Mercer, the maternal role is attained when the mother feels internal harmony with the role and its expectations and described three major components of the role:
1. attachment to the infant 2. gaining competence in mothering
behaviors 3. expressing gratification in
maternal-infant interactions.
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Outcome for the child includes cognitive, mental development attachment, health, and other social competence.
Proposed Model of Maternal Role Attainment
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Refer to the given diagram.
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Theoretical Underpinnings
•Mercer believes that nurses can play a vital role in promoting health of families and children. Mercer stated in her book Becoming a Mother: Research on Maternal Identity from Rubin to the Present that “nurses are the health professionals having the most sustained and intense interaction with women in the maternity cycle” (1995, p. xii).
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Theoretical Underpinnings
Mercer’s theory is practice oriented and has consistently evolved over time because of her commitment to connect research to practice (Meighan, 2010).
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Theoretical Underpinnings
•In addition to the renaming of maternal role attainment stages, the model has undergone ongoing revision since its original publication. The work of Walker, Crain, and Thompson indicated that a change was needed because the term role attainment indicated an end to the process as a final goal.
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Theoretical Underpinnings
Mercer began to reexamine her theory and felt the need to revise the model’s title to “Becoming a Mother” in order to connote a continued growth in mothering throughout the lifespan (Mercer, 2004).
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Stages of Becoming a Mother
• The concepts of Mercer’s theory center on the bond between mother and child which fosters competency, confidence and joy in the motherhood role (Role Attainment, 2005).
• Mercer’s original maternal role attainment theory follows a process that has four stages. In 2004 Mercer revised the terms of these stages although the stages themselves remain basically the same.
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Stages of Becoming a Mother
• “Commitment, attachment, and preparation” stage during pregnancy when the mother makes psychological adjusts and prepares for the expectations of her new role.
•“Acquaintance, learning, and physical restoration” stage which begins with the infant’s birth when the role of mother is assumed and learned in the contexts of her social system.
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Stages of Becoming a Mother
• “Moving toward a new normal” stage in the first few months of the infant’s life where the mother makes her new role fit her lifestyle in a personal way instead of in context with a social system.
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Stages of Becoming a Mother
“Achievement of maternal identity” stage when the mother internalizes her role and experiences a sense of harmony, competence and confidence which usually occurs about 4 months after birth.
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Stages of Becoming a Mother
These stages can overlap and the timing is highly variable however the stages usually progress in a sequential, predictable manner (Mercer, 2004).
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Thank you for
listening!
ABDUL AZIZ JAJA AHID, RN