Ramona

MATERNAL ROLE ATTAINMENTBY RAMONA T. MERCER

1929- present

Theoretical framework

microsystem

mesosystem

macrosystem

MotherEmpathy-sensitivity to cues

Self-esteem/self-conceptParenting received as child

Maturity/FlexibilityAttitudes

Pregnancy/ Birth experienceHealth/Depression/Anxiety

Role conflict/strain

ChildTemiperamentAbility to gues

AppearanceCharacteristicsResponsiveness

Health

Maternal Role/identityCompetence/ confidence in role

gratification/satisfactionattachment to the child

Child's OutcomeCognitive/mental

developmentBehavioral/ attachemnt

HealthSocial competence

Mother - father relationship

Model of Maternal Role Attainment

social support

Parent's work setting

Sch

ool

Family functioning

Day care

Transmitted cultural consistencies

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family andfriends

community

society at large

father orintimatepartner

mothera

infant a

Becoming a Mother: A revised model



CONCEPTS

MATERNAL IDENTITYMaternal identity is defined as having an internalized view of

the self as a mother (Mercer, 1995).

PERCEPTION OF BIRTH EXPERIENCEA woman’s perception of her performance during labor and

birth is her perception of the birth experience (Mercer, 1990)

SELF-ESTEEMMercer, May, Ferketich and DeJoseph (1986) describe self-

esteem as “an individual’s perception of how others view one and self-acceptance of the perception “.

SELF-CONCEPT (SELF-REGARD)Mercer (1986) outlines self-concept, or self-regard, as “The

overall perception of self that includes self-satisfaction, self-acceptance, self-esteem, and congruence or discrepancy between self and ideal self “.

FLEXIBILITYRoles are not rigidly fixed; therefore, who fills the roles is not

important (Mercer, 1990). “Flexibility of children attitudes increases with increased development …., Older mothers have infants and to view each situation in respect to the unique nuances”.

CHILDREARING ATTITUDES Childrearing attitudes are material attitudes or beliefs about

childrearing.

HEALTH STATUSHealth status is defined as “ The mother’s and father’s

perception of their prior heath, current health, health outlook, resistance-susceptibility to illness, health worry concern, sickness orientation, and rejection of the sick role” .

ANXIETYMercer and colleagues (1986) describe anxiety as “ a trait in

which there is specific proneness to perceive stressful situation-specific state” .

DEPRESSIONAccording to Mercer and colleagues (1986), depression is

“having a group of depression symptoms and in particular the effective component of the depressed mood”.ROLE STRAIN-ROLE CONFLICT

Role strain is the conflict and difficulty felt by the woman in fulfilling the maternal role obligation.

GRATIFICATION-SATISFACTIONMercer describes gratification as “the satisfaction, enjoyment,

reward, or pleasure that a woman experiences in interacting with her infant and in fulfilling the usual tasks inherent in mothering.”

ATTACHMENTAttachment versus a difficult temperament is related to

whether the infant sends hard-to-read cues, leading to feelings of incompetence and frustration in the mother.

INFANT HEALTH STATUSInfant health status is illness causing maternal infant

separation, interfering with the attachment process.

INFANT CHARACTERISTICS Characteristics include infant temperament, appearance, and

health status.

INFANT CUESInfant cues are infant behaviors that elicit a response from the

mother.

FAMILYMercer and colleagues define family as “a dynamic system

which includes subsystems-in-individuals (mother, father, fetus/infant) and dyads (mother-father, mother-fetus/infant, and father fetus/infant) within the overall family system.

FAMILY FUNCTIONINGFamily functioning is the individual’s view of the activities and

relationships between the family and its subsystems and broader social units.

FATHER OR INTIMATE PARTNERThe father or intimate partner contributes to the process of

maternal role attainment in a way that cannot be duplicated by any other person. The father’s interactions help diffuse tension and facilitate maternal role attainment

STRESSStress is made up of positively and negatively perceived life

events and environmental variables.

SOCIAL SUPPORTAccording to Mercer and colleagues, social support is “the

amount of help actually received, satisfaction with that help, and the persons (network) providing that help”.Four areas of social support area as follows:

Emotional support; “Feeling loved, cared for, trusted, and understood”

Informational support: “Helps the individual help herself by providing information that is useful in dealing with the problem and/or situation”

Physical support: A direct kind of help Appraisal support: “ A support that tells the role taker how she

is performing in the role; it enables the individual to evaluate herself in relationship to others “ performance in the role”

MOTHER-FATHER RELATIONSHIPThe mother-father relationship is the perception of the mate

relationship that includes intended and actual values, goals, and agreement between the two. The maternal attachment to the infant develops within the emotional held of the parent’s relationship

ASSUMPTIONS

A relatively, stable core self, acquired through lifelong socialization, determines how a mother defines and perceive events; her perceptions of her infant’s and others responses to her mothering, with her life situation, are real world to which she responds

In addition to the mother’s socialization, her developmental level and innate personality characteristics also influence her behavioral responses

The mother’s role partner, her infant, will reflect the mother’s competence in the mothering role through growth and development

The infant is considered an active partner in maternal role-taking process, affecting and being affected by the role enactment

The father or mother’s intimate partner contributes to role attainment in a way that cannot be duplicated by any other supportive person

Maternal identity develops concurrently with maternal attachment and each depends on the other

ASSERTIONS

Mercer’s original Theory and Model of Maternal Role Attainment were first introduced in 1991. It was refined and was presented more clearly in her 1995 book, Becoming a Mother: Research on Maternal Identity From Rubin to Present. Her recent revision focuses on woman’s transition in becoming a mother. It involves an extensive change in her life space that requires her ongoing development. According to Mercer, becoming a mother is more extensive than just assuming the role. It is unending and continuously evolving therefore she recommends that the Maternal role attainment be retired.

PARADIGMS

NURSINGMercer stated that, “Nurses are the health professionals having the most sustained and intense interaction with women in the maternity cycle. She emphasizes that the kind of help of a woman receives during pregnancy and over the first year following birth can have a lifelong term effects for her and her child.

PERSONShe refers the person as self or core self, view the self as separate from the roles that are played. The mother interacts with her infant and with the father or her significant other; influential and is influenced by both of them.

HEALTHShe defines health status as the mothers and father’s perception of their prior health, current health, health outlook, resistance, susceptibility to illness, worry or concern and rejection of sick role. Health status of newborn is the extent of disease present and infant health status by parental rating of overall health. She also stresses the importance of healthcare during childbearing and childrearing process.

ENVIRONMENTShe conceptualized the environment from Bronfenbrenner’s definition of the ecological environment. Development of a role/ person cannot be considered apart from the environment; there is a mutual accommodation between developing person and the changing properties of the immediate settings, and the larger context in which the settings are embedded.

LIMITATIONSClarityThe concepts, variables and relationships have not always been defined explicitly, but they were described and implied in Mercer’s earlier work. Some interchanging of terms and labels used to identify concepts such as adaptation and attainment, social support and support network, are potentially confusing to the reader. Also the Maternal identity has not been defined consistently. The terms attainment and role identity are confusing. Mercer proposed that using terms derived from nursing researchers that would be understood more clearly.

SimplicityDespite numerous concepts and relationships, the theoretical framework for maternal role attainment or becoming a mother organizes a rather complex phenomenon into an easily understood and useful form. The theory is predictive in nature and readily lends itself to guide practice. Concepts are not specific to time and place and are abstract, but they are described and operationalized to the extent that meanings are not easily misinterpreted.

GeneralityHer theory is derived from and is specific to parent –child nursing but has been used by other disciplines concerned with mothering

and parenting. The theory can be generalized to all women during pregnancy through the first year after birth, regarding less of age, parity, or environment. Empirical Precision Her work has evolved from extensive research efforts. The concepts, assumptions and relationships are grounded predominantly in empirical observations and are congruent. The degree of concreteness and completeness of operational definitions further increase the empirical precision. The theoretical framework for exploring differences among groups of first-time mothers lends itself well to further testing and is being used by others for this purpose.

MICROSYSTEM

MESOSYSTEM

MACROSYSTEM

MOTHER'S TRAITSEmpathy-sensitivity to cues

Self-esteem/self-conceptParenting received as child

Maturity/FlexibilityAttitudes

Pregnancy/ Birth experienceHealth/Depression/Anxiety

Role conflict/strain

NEWBORN'S TRAITTemiperamentAbility to gues

AppearanceCharacteristicsResponsiveness

Health

HOLISTIC NURSING MANAGEMENT- MATERNAL-NEWBORN

-MATERNAL-CHILD RELATIONSHIP

MATERNAL ROLE IDENTITYCompetence/ confidence in role

gratification/satisfactionattachment to the child

NEWBORN'S OUTCOMECognitive/mental development

Behavioral/ attachemntHealth

Social competence

ANTICIPATORY FORMAL INFORMALPERSONAL

SAMPLE SCHEMATIC DIAGRAM



SAMPLE STATEMENT OF THE PROBLEM

The study utilized the Mercer’s Maternal Role Attainment Theory in the care of adolescent patient with severe preeclampsia.Specifically, this sought to answer the following questions1. What were the assessment findings of mother’s trait in terms of:1.1 Empathy- sensitivity cues1.2 self-esteem/ self-concept1.3 ages at first birth1.4 Maturity/ flexibility1.5 Attitude1.6 Pregnancy/ Birth experience1.7Health / depression/anxiety1.8 role conflict strain2 What were the newborn’s traits identified in terms of;2.1 Ability to give cues2.2 Characteristic (Temperament, Appearance, Health Status)2.3 Responsiveness 3. What were the mother’s experiences in the maternal role attainment based on the following stages?3.1 Anticipatory3.2 Formal3.3 Informal3.4 Personal 4. What nursing problems were identified based on the following:4.1 Maternal4.2 Newborn4.3 Maternal – child relationship5. What nursing interventions were implemented to the problems identified?6. What outcomes were achieved based on:6.1 Maternal Role Identity6.2 Newborn’s Outcome6.3 Maternal Child Relationship

BIBLIOGRAPHYTomey, A. & Alligood, M. (2004) Nursing Theorist and Their Work (5th

Ed.) Singapore. Elsevier(Singapore) Pte. Ltd. Paglinawan, J. G. (2010) Mercer’s Maternal Role Attainment Theory in the Care of Adolescent Patient with Severe Preeclampsia. Cebu Normal University. Cebu City, Philippines

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