Maternal-Fetal Attachment and Health Behaviors among Women with HIV/AIDS

Background: Mothers with HIV often face personal and environmental risks for poor maternal health behaviors and infant neglect, even when HIV transmission to the infant was prevented. Maternal-fetal attachment (MFA), the pre-birth relationship of a woman with her fetus, may be the precursor to maternal caregiving. Using the strengths perspective in social work, which embeds MFA within a socio-ecological conceptual framework, it is hypothesized that high levels of maternal-fetal attachment may protect mothers and infants against poor maternal health behaviors. Objective: To assess whether MFA together with history of substance use, living marital status, planned pregnancy status, and timing of HIV diagnosis predict three desirable maternal health behaviors (pregnancy care, adherence to prenatal antiretroviral therapy–ART, and infant’s screening clinic care) among pregnant women with HIV/AIDS. Method: Prospective observation and hypothesis-testing multivariate analyses. Over 17 consecutive months, all eligible English- or Spanish-speaking pregnant women with HIV ( n = 110) were approached in the principal obstetric and screening clinics in Miami-Dade County, Florida at 24 weeks’ gestation; 82 agreed to enroll. During three data collection periods from enrollment until 16 weeks after childbirth (range: 16 to 32 weeks), participants reported on socio-demographic and predictor variables, MFA, and pregnancy care. Measures of adherence to ART and infant care were extracted from medical records. Findings: Sociodemographic, pregnancy, and HIV disease characteristics in this sample suggest changes in the makeup of HIV-infected pregnant women parallel to the evolution of the HIV epidemic in the USA over the past two decades. The MFA model predicted maternal health behaviors for pregnancy care (R2 = .37), with MFA, marital living status, and planned pregnancy status independently contributing ( = .50, = .28, = .23, respectively). It did not predict adherence to ART medication or infant care. Relevance: These findings provide the first focused evidence of the protective role of MFA against poor maternal health behaviors among pregnant women with HIV, in the presence of adverse life circumstances. Social desirability biases in some self-report measures may limit the findings. Suggestions are made for orienting future inquiry on maternal health behaviors during childbirth toward relationship and protection.

An Examination of Psychological Meaningfulness, Safety, and Availability as the Underlying Mechanisms linking Job Features and Personal Characteristics to Work Engagement

The present study tested a nomological net of work engagement that was derived from its extant research. Two of the main work engagement models that have been presented and empirically tested in the literature, the JD-R model and Kahn’s model, were integrated to test the effects that job features and personal characteristics can have on work engagement through the psychological conditions of meaningfulness, safety, and availability. In this study, safety refers to psychological perceptions of safety and not workplace safety behaviors. The job features that were tested in this model included person-job fit, autonomy, co-worker relations, supervisor support, procedural justice, and interactional justice, while the personal characteristics consisted of self-consciousness, self-efficacy, extraversion, and neuroticism. Thirty-four hypotheses and a conceptual model were tested in order to establish the viability of this nomological net of work engagement in which it was expected that meaningfulness would mediate the relationships between job features and work engagement, safety would mediate the relationships that job features and personal characteristics have with work engagement, and availability (physical, emotional, and cognitive resources) would mediate the relationships that personal characteristics have with work engagement. Furthermore, analyses were run in order to determine the factor structure of work engagement, assess whether or not it exhibits differential validity from organizational commitment and job satisfaction, and confirm that it is positively related to the outcome variable of organizational citizenship behavior (OCB). The final sample consisted of 500 workers from an online labor market who responded to a questionnaire composed of measures of all constructs included in this study. Findings show that work engagement is best represented as a three-factor construct, composed of vigor, dedication and absorption. Furthermore, support was found for the distinction of work engagement from the related constructs of organizational commitment and job satisfaction. With regard to the proposed model, meaningfulness proved to be the strongest predictor of work engagement. Results show that it partially mediates the relationships that all job features have with work engagement. Safety proved to be a partial mediator of the relationships that autonomy, co-worker relations, supervisor support, procedural justice, interactional justice, and self-efficacy have with work engagement, and fully mediate the relationship between neuroticism and work engagement. Findings also show that availability partially mediates the positive relationships that extraversion and self-efficacy have with work engagement, and fully mediates the negative relationship that neuroticism has with work engagement. Finally, a positive relationship was found between work engagement and OCB. Research and organizational implications are discussed.