Mental health and wellbeing during the transition to fatherhood: a systematic review of first time fathers' experiences.
Mental health and wellbeing during the transition to fatherhood: a systematic review of first time fathers' experiences.
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DOI：
10.11124/jbisrir-2017-003773
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发表时间：
2018-11-01
期刊：
影响因子：
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通讯作者：
Bick, Debra
中科院分区：
文献类型：
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作者：
Baldwin, Sharin;Malone, Mary;Bick, Debra
目的：本系统综述的目的是确定和综合关于第一次父亲的经验和需求的最佳证据，这些经验和需求与他们向父亲过渡期间的心理健康和福祉有关。引言：男性向父亲过渡期间的心理健康和福祉是一个重要的公共卫生问题，目前从定性角度研究不足，了解不多。纳入了健康婴儿的第一次父亲（生物和非生物），这些婴儿出生时没有确定的终末或长期疾病。感兴趣的现象是他们在向父亲过渡期间，从怀孕开始到出生后一年，在心理健康和福祉方面的经历和需求。基于定性数据的研究，包括但不限于现象学，扎根理论，民族志和行动research.METHODS设计：三步搜索策略。检索策略探索了1960年至2017年9月期间已发表和未发表的定性研究。所有纳入的研究均由两名独立评审员进行评估，任何分歧均通过共识或第三名评审员解决。推荐的乔安娜布里格斯研究所（JBI）的方法，以批判性评价，研究选择，数据提取和数据synthesized.Results：22项研究符合资格标准，并被列入审查，然后被评估为中等到高质量（分数5-10）的基础上，JBI批判性评价清单定性研究。这些研究发表于1990年至2017年之间，所有研究都使用定性方法来实现调查准爸爸或新爸爸经历的总体目标。9项研究来自英国，3项来自瑞典，3项来自澳大利亚，2项来自加拿大，2项来自美国，1项来自日本，1项来自中国台湾，1项来自新加坡。研究中包括的第一次做父亲的总人数为351人。从纳入的研究中提取了144项结果。其中，142项支持性研究结果被汇总为23个类别和7项综合研究结果：1）新父亲身份，2）新父亲身份的竞争挑战，3）负面情绪和恐惧，4）压力和应对，5）缺乏支持，6）新父亲想要什么，7）父亲身份的积极方面。根据综合调查结果，确定了影响第一次父亲在向父亲过渡期间的心理健康和幸福的三个主要因素：父亲身份的形成，新的父亲角色的竞争挑战以及与之相关的负面情绪和恐惧。角色限制和生活方式的改变往往导致压力感，对于这些问题，父亲们使用否认或逃避活动，如吸烟、延长工作时间或听音乐，作为应对技巧。父亲们希望得到更多的指导和支持，为做父亲做准备，改变伴侣关系。获得支持的障碍包括缺乏有针对性的信息资源和卫生专业人员的认可。更好地为父亲做准备，并在向父母过渡期间支持夫妻关系，可以为新父亲提供更好的体验，并有助于新父亲更好地调整和心理健康。
OBJECTIVE: The aim of this systematic review was to identify and synthesize the best available evidence on first time fathers' experiences and needs in relation to their mental health and wellbeing during their transition to fatherhood.INTRODUCTION: Men's mental health and wellbeing during their transition to fatherhood is an important public health issue that is currently under-researched from a qualitative perspective and poorly understood.INCLUSION CRITERIA: Resident first time fathers (biological and non-biological) of healthy babies born with no identified terminal or long-term conditions were included. The phenomena of interest were their experiences and needs in relation to mental health and wellbeing during their transition to fatherhood, from commencement of pregnancy until one year after birth. Studies based on qualitative data, including, but not limited to, designs within phenomenology, grounded theory, ethnography and action research were included.METHODS: A three-step search strategy was used. The search strategy explored published and unpublished qualitative studies from 1960 to September 2017. All included studies were assessed by two independent reviewers and any disagreements were resolved by consensus or with a third reviewer. The recommended Joanna Briggs Institute (JBI) approach to critical appraisal, study selection, data extraction and data synthesis was used.RESULTS: Twenty-two studies met the eligibility criteria and were included in the review, which were then assessed to be of moderate to high quality (scores 5-10) based on the JBI Critical Appraisal Checklist for Qualitative Research. The studies were published between 1990 and 2017, and all used qualitative methodologies to accomplish the overall aim of investigating the experiences of expectant or new fathers. Nine studies were from the UK, three from Sweden, three from Australia, two from Canada, two from the USA, one from Japan, one from Taiwan and one from Singapore. The total number of first time fathers included in the studies was 351. One hundred and forty-four findings were extracted from the included studies. Of these, 142 supported findings were aggregated into 23 categories and seven synthesized findings: 1) New fatherhood identity, 2) Competing challenges of new fatherhood, 3) Negative feelings and fears, 4) Stress and coping, 5) Lack of support, 6) What new fathers want, and 7) Positive aspects of fatherhood.CONCLUSIONS: Based on the synthesized findings, three main factors that affect first time fathers' mental health and wellbeing during their transition to fatherhood were identified: the formation of the fatherhood identity, competing challenges of the new fatherhood role and negative feelings and fears relating to it. The role restrictions and changes in lifestyle often resulted in feelings of stress, for which fathers used denial or escape activities, such as smoking, working longer hours or listening to music, as coping techniques. Fathers wanted more guidance and support around the preparation for fatherhood, and partner relationship changes. Barriers to accessing support included lack of tailored information resources and acknowledgment from health professionals. Better preparation for fatherhood, and support for couple relationships during the transition to parenthood could facilitate better experiences for new fathers, and contribute to better adjustments and mental wellbeing in new fathers.