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1.
OBJECTIVE: To examine the importance of illness severity, child functional status, psychosocial stress, intrapersonal factors, stress processing, and social-ecological factors in predicting psychological symptoms among mothers of children with juvenile rheumatoid arthritis (JRA). METHODS: Mothers of 92 children with JRA completed surveys while waiting with their children for physician appointments or during JRA meeting breaks. RESULTS: Mothers reported higher mean levels of psychological symptoms than a normative group. Higher levels of psychosocial stress predicted increased psychological symptoms after accounting for disease severity and functional status. Maternal appraisal of the illness tended to moderate the relationship between illness stress and psychological symptoms, and maternal education moderated the relationship between daily hassles stress and psychological symptoms. CONCLUSIONS: These data indicate that mothers of children with JRA are at risk for psychological distress. Inteventions that take into account the buffering effects of maternal education and appraisal may serve to decrease the effects of maternal stress.  相似文献   

2.
OBJECTIVE: To examine the relation of children's pain severity, perceived pain threat, and passive coping to maternal worry and family activities. METHODS: We assessed pain severity, perceived threat (conceptualized as beliefs about pain seriousness and coping ability), and coping strategies in 130 patients with chronic abdominal pain. Mothers rated the impact of the child's health on maternal worry and family activities. RESULTS: Controlling for pain severity, higher pain threat was associated with maternal reports of greater worry and limitations in family activities due to the child's health. Children's use of passive-coping strategies was not related to maternal worry or family activity limitations. CONCLUSIONS: Health care providers should assess patients' pain beliefs, correct misperceptions about pain seriousness, and help increase patients' perceived efficacy in coping with pain.  相似文献   

3.
Insightfulness is seen as the mental capacity that provides the context for a secure child-parent attachment. It involves the ability to see things from the child's perspective and is based on insight into the child's motives, a complex view of the child and openness to new information about the child. To test our hypothesis that maternal insightfulness is related to maternal depression, we utilized the Insightfulness Assessment (IA) developed by Oppenheim and Koren-Karie to conduct and analyse interviews in which mothers discussed their perceptions of video segments of their interactions with their children. We compared the results of a control group of 30 mothers without a diagnosis of depression with a sample of 23 mothers diagnosed with depression (International Classification of Diseases, 10th Revision). As expected, depression was negatively related to maternal insightfulness. Oppenheim and Koren-Karie have argued that the IA might be used as a diagnostic instrument; our work suggests that the IA might show ways of aiding mothers in improving the quality of mother-infant interaction while they are being treated for depression. Copyright ? 2011 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE: Insightfulness is seen as the mental capacity that provides the context for a secure child-parent attachment. Maternal depression was negatively related to maternal insightfulness. The Insightfulness Assessment might be used as a diagnostic instrument. The Insightfulness Assessment might show ways of aiding mothers in improving the quality of mother-infant interaction while they are being treated for depression.  相似文献   

4.
OBJECTIVE: To assess the importance of disability severity and child functional status as predictors of maternal depressive symptoms and the moderating effects of maternal appraisal, social support, and family income on the relationship between disability factors (severity and functional status) and maternal depressive symptoms. METHOD: Mothers of 270 children with cerebral palsy completed surveys on their appraisal of the child's disability, social support, and family demographics. Physicians assessed the severity of the disability and the child's functional status. RESULTS: Thirty percent of the mothers had depressive symptoms above the cutoff on a depression screening instrument. Disability severity and child's functional status did not predict maternal depression. Perceived social support moderated the relationship between the child's functional status and maternal depressive symptoms. CONCLUSIONS: Mothers of children with cerebral palsy may be at risk for depression. Interventions that take into account the moderating effects of social support may increase maternal adaptation.  相似文献   

5.
Evaluated a 15-month social support intervention for mothersof children with JRA. Five mentors (mothers of young adultswho have had JRA since childhood) were linked to mothers ofchildren with JRA ages 2 to 11 for purposes of enhancing specifictypes of social support and overall mental health. The totalnumber of reported mental health symptoms decreased in the experimentalgroup and remained the same in the control group. The experimentalgroup showed greater improvement on all indices of support relativeto the control group. Trends in the data consistently favoredthe experimental group, but differences between the experimentaland control group were statistically significant on few of theoutcome measures. Results provide tentative evidence for positiveeffects of mentoring interventions for this population of parents.  相似文献   

6.
Investigated the conceptions of illness and accuracy of understandingabout their disease for children with juvenile rheumatoid arthritis(JRA). 54 children between the ages of 6 and 17 were interviewedindividually about various aspects of JRA, with results suggestingthat accuracy and illness conceptions could be reliably measured.As predicted, children's understanding about their disease followeda developmental progression, with older children demonstratinga more sophisticated understanding of JRA than younger children(significant differences between age groups on 3 of the 5 questions).Multiple regression analysis indicated that conceptual level(p < .001) was a better predictor of the child's accuracyof knowledge than was age (ns). Despite the developmental progression,there were a significant number of children functioning belowthe level expected for their age. In fact, the majority (75%)of children exhibited an understanding of JRA at the concreteoperational level of cognitive development. The within-subjectvariability and striking misconceptions argue for ongoing evaluationof each child's understanding as a way to improve educationalefforts.  相似文献   

7.
OBJECTIVE: To evaluate predictions from professionals in pediatric rheumatology regarding the child-rearing practices of caregivers of children with juvenile rheumatoid arthritis (JRA) and healthy classmates. METHODS: Sixteen professionals identified items from the Child-Rearing Practices Report (CRPR) that were expected to differentiate between caregivers of children with JRA (64 mothers, 45 fathers) and caregivers of healthy classmates (64 mothers, 40 fathers). Families were interviewed, and physician ratings of disease severity were obtained. RESULTS: Experts predicted difficulties in protectiveness, discipline, and worry. Ratings from parents of children with JRA showed modest agreement with the professionals, surprising similarity to controls, and a limited association with disease factors. CONCLUSIONS: Contrary to expert opinion, JRA has only a modest influence on some child-rearing practices. Educating health care providers may minimize misperceptions about caring for children with JRA, and screening parents of children with more severe disease may assist in allocating education and services for families.  相似文献   

8.
The aim of our study was to investigate the impact of maternal exposure to family violence, maltreatment, and related posttraumatic stress disorder (PTSD) on young children's mental representations of self and caregivers. Participant mothers (n=24) and children (n=25) were recruited from a referred sample when they were 4-7 years old. Maternal report and child story stem narratives were used. Mother's experience of domestic violence and severity of violence-related PTSD symptoms robustly predicted more dysregulated aggression, attentional bias to danger and distress, as well as more avoidance of and withdrawal from conflicts presented in the children's story stems. Less narrative coherence was also noted. Traumatized mothers experience and symptoms prior to their child's turning 4 years old adversely affected their child's mental representations from 4-7 years.  相似文献   

9.
OBJECTIVE: To examine the impact of the severity of a child's chronic condition on family functioning from the perspectives of mothers and fathers and to compare their reports with the functioning of families with healthy children. METHODS: Mothers and fathers in two-parent families of 160 infants and 102 pre-adolescents with a wide range of chronic health conditions (noncategorical approach) completed standard self-report inventories. RESULTS: The families of children with chronic conditions functioned as well or better compared with normative data for families with healthy children. The only significant differences between mothers' and fathers' reports of family functioning were a greater negative impact on role performance reported by mothers of infants and pre-adolescents and a great negative impact on affective expression reported by fathers of pre-adolescents. CONCLUSIONS: Overall, very little of the variance in family functioning was explained by severity of the child's chronic condition in this sample of middle-class, two-parent families.  相似文献   

10.
Optimal maternal–fetal attachment (MFA) is believed to be beneficial for infant well-being and dyadic interaction, but research is scarce in general and among risk populations. Our study involved dyads living in war conditions and examined how traumatic war trauma associates with MFA and which factors mediate that association. It also modeled the role of MFA in predicting newborn health, infant development, mother–infant interaction, and maternal postpartum mental health. Palestinian women from the Gaza Strip (N = 511) participated during their second trimester (T1), and when their infants were 4 (T2) and 12 (T3) months. Mothers reported MFA (interaction with, attributions to, and fantasies about the fetus), social support, and prenatal mental health (post-traumatic stress disorder, depression, and anxiety) at T1, newborn health at T2, and the postpartum mental health, infant’s sensorimotor and language development, and mother–infant interaction (emotional availability) at T3. Results revealed, first, that war trauma was not directly associated with MFA but that it was mediated through a low level of social support and high level of maternal prenatal mental health problems. Second, intensive MFA predicted optimal mother-reported infant’s sensorimotor and language development and mother–infant emotional availability but not newborn health or maternal postpartum mental health.  相似文献   

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