Factors that influence the quality of maternal care : a systemic conceptualization

Previous research has suggested that the quality of mother infant interactions may be conceptualized as falling along a continuum from high-quality/optimal care to low-quality /abusive care. Similarly, these early patterns of interaction may be viewed as the center of an interrelated system of environmental variables. The major purpose of the present study then was to examine variations in the quality of early mother-infant interactions in relation to the following aspects of the systemic environment: infant characteristics, maternal personal characteristics, the social network, and the broader social environment.

Forty-four mothers and their 3 to 6 month old infants were recruited through introductory letters issued by social-service and medical staff as well as personal as sociates of the investigator. The income status of the 34 families with complete data was distributed in the following manner: 35 percent poverty, 18 percent low-middle income, 29 percent middle income and 18 percent upper-middle income families. Primary procedures involved five 1 hour visits to each subject's home by trained observer/interviewers. The first visit entailed collection of the infant characteristics information. Second, third, and fourth visits each in volved a 25 minute observation of mother-infant interactions followed by a structured Interview concerning support from the social network experienced over the past 24 hours. The final visit involved mothers completing a personal characteristics inventory and listening to a study debriefing.

Using a coding system devised by Bakeman and Brown (1977), the observational data were coded into a series of dyadic states and indices of interaction quality were formed. These indices of interaction quality then served as the criterion variables for correlations, multiple regressions and canonical discriminate analyses involving the measured aspects of the systemic environment. Results indicated that one index of interaction quality, the social responsiveness index, was related to two aspects of the systemic environment, infant activity and social support quality. The other index of interaction quality, the social continuation index, was related to one aspect of the systemic environment, infant activity.

Results were interpreted as supportive of a general systemic framework that emphasizes direct and indirect levels of influence, rather than a framework indicating specific levels of influence. Further research also was indicated in order to determine other important aspects of the systemic environment and other forms of measurement for indexing the mother-infant interaction quality construct.