Social support is particularly important for new mothers. The perinatal period is a time of significant change in personal relationships, including changes in support derived from partners, other family members, and from peers (Gao et al.,2014, Leahy-Warren, 2011). It is also a time of significant personal and interpersonal change, including changes in social support derived from partners, other family members, and peers (Gao et al., 2014, Leahy-Warren, 2011).
Outcomes associated with high social support for new mothers in the perinatal period include: increased confidence (Leahy-Warren 2005), high maternal parental self-efficacy (MPSE) (Leahy-Warren et al. 2011, Shorey et al. 2014), decreased risk of antenatal (Zeng et al., 2015), and postnatal depression (PND) (Leahy-Warren et al. 2012), and an increase in infant bonding (Kinsey et al. 2014) and infant attachment (Condon and Corkindale 1998). Furthermore, low social support for mothers is associated with low family resilience (Lennon and Heaman, 2015). As mothers are predominantly the primary caregivers, low social support may have a knock on effect on the early environment for infant and toddler health and well-being, including building resilience (Lemery-Chalfant et al., 2013). In line with best clinical practice (NICE, 2017), it is incumbent upon healthcare professionals to discuss the importance of social support with pregnant women in the antenatal period and to provide opportunity for identifying strategies to enhance the availability of social support throughout the perinatal and postpartum periods. Although a number of instruments have been developed to measure social support, none are underpinned by theory in the context of perinatal infant care practices. This short paper outlines the development of The Perinatal Infant Care Social Support (PICSS) scale, which is informed by social support and social exchange theories (Leahy-Warren et al., 2011, 2012).
The PICSS scale
The PICSS scale was designed to measure both (a) structural and (b) functional social supports in the context of perinatal infant care practices (infant feeding, bathing, changing and settling). The functional support component comprises 22 items across four subscales: (1) seven items for informational support, (2) seven items for instrumental support, (3) four items for emotional support and (4) four items for appraisal support. Each item is rated by respondent mothers on a 4-point Likert Scale, with 1 indicating ‘totally disagree’ and 4 indicating ‘totally agree’.
The structural social support scale included six items that identified the individuals who provided support to mothers. Structural social support from both formal nurses/midwives, doctors and nannies) and informal (husband/partner, maternal parents and parents-in-law) sources was considered. Participants responded to whether they received informational, instrumental, emotional or appraisal support from any of the aforementioned sources. Participants were considered to have received formal support and/or informal structural support if they confirmed receiving any of the four support types. Each affirmative answer scored one point, and the number of affirmative answers was equated to the total score on the structural support scale. The total structural social support scores ranged between 0–24. A score of 0 meant that both informal support and formal structural support were absent from all four functional subscales. A score of 24 meant that structural support was available on all four functional subscales from all six informal and formal sources. Validity and reliability are established in studies to date (Leahy-Warren, 2005, 2011, Shorey et al., 2014). The PICSS is a coherent and valid measure of social support specific to the perinatal period in the context of parental infant care practices. Health care professionals can develop a care plan for women with low levels of structural and functional support, to meet their needs. For example, public health nurses may identify and mobilise social support resources in the community for women in the postnatal period.
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