Measures of Maternal Sensitivity During the First Year of Life: A Systematic Review

Problem:Maternal sensitivity is one of the key elements of secure attachment. It is important for psychologists and pediatric nurses to understand what measures are available to assess maternal sensitivity during the first year of child’s. Measuring levels of maternal sensitivity will assist nurses and health care providers in pediatrics area to assist families with poor attachment and improve growth and development of child’s at any age.

Purpose: The purposes of this study were to evaluate the instruments used to measure maternal sensitivity in the first year of life and to synthesize the literature using these measures.

Methods: An integrative review (1978-2013) was conducted searching Cumulative Index to Nursing and Allied Health Literature (CINAHL), Pub-Med databases. Chosen key words: maternal sensitivity, attachment,  bonding, maternal attachment, and  maternal and infant interaction. Fifty-five articles were reviewed for inclusion, with the following criteria of (a) sample of mother with infant of first year of life; (b) description of the maternal sensitivity as primary research; and (c) using an  instrument measuring maternal sensitivity. Seventeen of the initial 55 articles met the inclusion criteria of this integrative reveiw.

Results of Search: Of the 17 articles, nine instruments that measure maternal sensitivity were identified. The primary theoretical frameworks used were the Bowlby attachment theory and Ainsworth Attachment Theory. The majority of study participants who participated in the reported studies were white middle-class.  Most of studies reported reliability of the instruments. However, most researchers did not report the validity of instrumetn.

Synthesis of Evidence: themes emerged from these studies include: evaluation of instruments, samples and subjects, reliability, validity, description of instrument, and feasibility of instruments.

Implications for Practice: further study of these instruments should be conducted in diverse populations. Development of reliable and valid instruments for measuring maternal sensitivity that are sensitive to change across mothers over time is necessary.