Exploring Mothers’ Perspectives About Why Grandparents in Appalachia Give Their Grandchildren Cariogenic Foods and Beverages: A Qualitative Study

BackgroundDental caries is the most common chronic childhood disease. Past studies revealed that grandparents provide their grandchildren with cariogenic foods and beverages (eg, those with free sugars and/or modified starches). Qualitative research can help identify what drives this phenomenon.ObjectiveOur aim was to examine mothers’ explanations for why grandparents in north central and central Appalachia give their grandchildren cariogenic foods and beverages.DesignA qualitative study on children’s oral health in Pennsylvania and West Virginia from 2018 through 2020 was performed. In-person, semi-structured interviews were conducted. Qualitative data from interviews were recorded, transcribed, and then coded using NVivo. Data analysis for this study was performed using thematic analysis with iterative theme development.Participants/settingThe participants were 126 mothers of children aged 3-5 years from West Virginia (n = 66) and Pittsburgh, PA (n = 60).Main outcome measuresMothers’ perspectives about why grandparents give their grandchildren cariogenic foods and beverages were analyzed.ResultsIn the study sample, 85% of mothers (n = 107/126) named at least 1 of their children’s grandparents as a member of their social network responsible for their children’s oral health. From these interviews, 85% of mothers (n = 91/107) discussed that grandparents gave their grandchildren cariogenic foods and beverages. The mothers described the following 4 themes to explain why grandparents gave their grandchildren cariogenic foods and beverages: privilege of the grandparent role; responsibilities of the grandparent role; symbol of care and affection; and limited consideration or understanding of the detrimental impact.ConclusionsGrandparents play a role in giving their grandchildren cariogenic foods and beverages, which could potentially contribute to childhood caries. Research is needed to develop effective social interventions to help some grandparents understand the implications of a cariogenic diet on their grandchildren’s oral health and/or decrease their provision of cariogenic foods and beverages.     

The transition to grandparenthood: a prospective study of mental health implications

Objectives: This study investigated the mental health of a cohort of 262 female and 168 male grandparents across the first two years of their transition to grandparenthood, with particular focus on the impact of providing childcare for the grandchild.

Method: Baseline assessments were made during the pregnancy with the first grandchild, and subsequent assessments were at one and two years after the birth. The influence of demographic and psychosocial variables which could be expected to influence change in mental health from baseline was explored.

Results: The lack of change in mental health measures in this cohort was more prominent than change. Specifically, there was a small significant decrease in anxiety over the first year for females, and a small significant increase in depression for males. Other variables, not unique to the transition to grandparenthood such as physical health and adverse life events, were strongly associated with changes in mental health. Notably, more time spent babysitting the grandchild was associated with improvement in mental health.

Conclusion: The transition to grandparenthood did not have any substantial adverse impact on five well-validated measures of mental health, in contrast to earlier American findings of adverse effects which implied that childcare was burdensome.     

祖辈带养对学龄前儿童饮食行为、身体活动和超重肥胖的影响

目的 探究祖辈带养对学龄前儿童饮食行为、身体活动和超重肥胖的影响。方法 采用文献研究法,检索中国知网、万方数据库、维普数据库和PubMed 数据库中近5年发表的祖辈带养对学龄前儿童饮食行为、身体活动和超重肥胖影响的文献,进行描述性统计分析。结果 最终纳入16篇文献。文献研究结果表明,祖辈带养可能是学龄前儿童超重肥胖的危险因素,可能的原因主要为祖辈带养导致学龄前儿童不健康的饮食行为和身体活动减少。结论 祖辈带养对学龄前儿童饮食行为、身体活动和超重肥胖有影响,对祖辈进行营养健康教育可能对学龄前儿童超重肥胖的防控有着重要作用。     

Grandparents as Parents: Research Findings and Policy Recommendations

This article presents an overview of research on grandparenthood in the latter decades of the twentieth century. Theories contributing to understanding of the grandparenting role are discussed, and significant factors affecting the grandparenting experience—including sex, age, retirement status, race, and ethnicity—are reviewed. The special case of grandparents raising grandchildren is explored through a review of demographics, outcomes for children in grandparent foster care, and the impact of raising grandchildren on grandparents. Interventions supporting custodial grandparents and the grandchildren in their care are examined. Drawing on the findings and implications of this overview, recommendations for policy, clinical practice, professional education, and future research are offered.     

6岁以下发育障碍患儿祖父母创伤后成长体验的质性研究

目的 挖掘6岁以下发育障碍患儿祖父母创伤后成长的体验,为制订干预方案、促进其心理成长提供依据。 方法 采用目的抽样法,选取2021年10月—2022年1月在重庆市某三级甲等医院接受康复治疗的12名发育障碍患儿祖父母作为研究对象,采用半结构式访谈和面对面非语言行为观察法收集资料,借助GooSeeker软件整理资料,并采用Colaizzi 7步分析法对资料进行分析。 结果 共提炼5个主题：①积极心理衍生,包括感知患儿进步、憧憬美好未来、正向应对压力;②新的人生感悟,包括坦然接纳现实、转移生活重心、更加珍视健康;③个人力量增强,包括心理韧性提升、自我效能感增强、乐观与希望;④支持系统增强,包括情感支持和社会支持增强;⑤人际关系和谐,包括利他行为、与他人关系改善。 结论 6岁以下发育障碍患儿祖父母有多方面的创伤后成长体验,医护人员可通过团体心理辅导、组建心理支持小组、加强疾病宣教等方式帮助其获得更多的社会支持,使其有效应对压力,从而促进创伤后成长。     

Do grandparents influence parents’ decision to vaccinate their children? A systematic review

The global reduction in childhood infectious diseases since the 1960s is primarily due to the success of extensive worldwide immunisation campaigns. However, the universal vaccination coverage program appears to have lost momentum in the wake of negative, unfounded claims about the safety of vaccines. While parents of the 21st century have little first-hand knowledge of devastating childhood diseases, grandparents are more likely to remember family and community members who were afflicted. In the current age of vaccine hesitancy and science scepticism, where research-informed arguments are not always persuasive, grandparents, through their experience of the diseases, may positively influence paediatric vaccine uptake. This paper reviews the literature investigating potential direct or indirect influences of grandparents on parents’ decisions to vaccinate their children. A database search using the keywords immunisation, vaccination, children and grandparents resulted in 1988 articles. Titles were screened for relevance and seventy-seven results were retained. After the abstracts were read, only five articles that either explored paediatric vaccines, factors promoting and/or inhibiting paediatric vaccine use and decision-making strategies were reviewed. One paper located through Google Scholar, which failed to show up on database searches, was also retained for a total of six papers. While none of the six papers set out to explore the impact of grandparents on vaccine uptake, they found that grandparents were involved to varying degrees in paediatric vaccine uptake within young families. The research clearly showing that grandparents, and older people more generally, promote vaccination uptake is not currently available. The dearth of literature shows the need for research exploring the perceived and real influences of grandparents on childhood vaccination. This will establish whether grandparents’ memory and knowledge of preventable childhood infectious diseases could be harnessed as a public health measure to counteract the current, ill-informed, negative attention on paediatric vaccines.     

Dental knowledge and awareness among grandparents

AIM: To investigate grandparent’s knowledge and awareness about the oral health of their grandchildren.METHODS: Grandparents accompanying patients aged 4-8 years, who were living with their grandchildren and caring for them for a major part of the day, when both their parents were at work were included in the study. A 20-item questionnaire covering socio-demographic characteristics, dietary and oral hygiene practices was distributed to them. The sample comprised of 200 grandparents (59 males, 141 females). χ² analysis and Gamma test of symmetrical measures were applied to assess responses across respondent gender and level of education.RESULTS: Oral health related awareness was found to be low among grandparents. In most questions asked, grandparents with a higher level of education exhibited a better knowledge about children''s oral health. Level of awareness was not related to their gender.CONCLUSION: Oral hygiene and dietary habits are established during childhood. There is a great need for dental education of grandparents as they serve as role models for young children.     

Becoming parents again: Challenges affecting grandparent primary caregivers raising their grandchildren

BackgroundA growing number of Canadian children live in the care of their grandparents, called skip-generation families. Reasons for this include teen pregnancy, death of a parent, mental/physical illnesses, and addictions. These grandparents and grandchildren are at increased risk of physical and mental illness, yet have few resources available to them.ObjectiveOur study aims to describe the lived experiences of skip-generation families to better identify their needs.MethodsWe conducted semistructured interviews of grandparent primary caregivers from ten households in our community to chronicle their experiences raising their grandchildren. Participants were recruited by paediatricians using convenience sampling. Interviews were recorded, transcribed, and coded using Atlas Ti software, and classified into themes by consensus.ResultsFive primary themes emerged from the interviews: (1) Changes in family dynamics, (2) Psychosocial impact on grandchild and grandparent, (3) Lack of resources for grandparent caregivers, (4) The challenges of parenting later in life, and (5) Resilience inspired by the love of family. Many participants (n=10) described feeling unsupported after assuming care of their grandchildren and identified a need for additional counselling services, financial support and respite care. All (n=11) highlighted that caring for their grandchildren changed their lives in positive ways.ConclusionWhen grandparents are prioritized as primary caregivers for their grandchildren, our study suggests they receive insufficient community resources to meet their emotional, respite and financial needs. Further research involving this population in Canada is required. Paediatricians can play an essential role in recognizing these vulnerable families and advocating for additional supports and services.     

L’aviolicide,un parricide de substitution ? À propos d’un cas clinique

Aviolicide is a specific form of parricide, referring to the act of killing one's grandparents. It appears to be a rare event, although no precise data can be found about its occurrence, since it has not been often studied in medical literature.ObservationWe report the case of M. X, 31 years old, hospitalized in a high secure unit after killing both his paternal grandparents. This patient was born in Eastern Europe and raised by his grandparents in France. In his early twenties, he started consuming alcohol and drugs (mainly cannabis) and isolating from his relatives. He was diagnosed with paranoid schizophrenia when hospitalized at the age of 24, after a psychotic episode, with delusions of persecution towards his grandparents, aggressiveness and agitation. The delusions got more and more intense in the next years, as the patient did not take his medication. One day, after 3 days of hesitation trying to resist delusional injonctions, triggered by a minor comment from his grandmother, he violently assaulted his grandparents and killed them. He did not run away from the crime scene and went back to his everyday activities right after the assault.DiscussionWhen compared to the socio-demographic and clinical profile of the few cases of aviolicide found in literature, M. X appears to have a lot in common with them. Indeed, many of his features have been previously described: the fact that his parents suffered from alcoholism; his migration; the fact that he suffered from paranoid schizophrenia; addiction to cannabis and alcohol; a context of long lasting fight over money; the homicide happening at the victim's place; the extreme violence. Furthermore, most of the aviolicide cases happened in families where the grandparents had a parental role (after the parents died – as in M. X's case –, or the parents being symbolically absent), or were the result of the hatred towards the parents shifting to the grandparents. Based on this observation, we then compared M. X's profile and acting out to those found in the literature about parricide. We realized they were very similar, since M. X is a male in his early thirties, single, not working, diagnosed with paranoid schizophrenia several years ago and not taking his prescribed medication. As parricides often do, his acting out happened at the victims’ home, brutally triggered by a seemingly minor event, in a disorganized way, and the perpetrator does not try to run away.ConclusionThe similarities to parricide and the fact that the grandparents played a parent-like role on both a symbolical and legal level lead us to conclude that aviolicide has a similar psychopathology to parricide, and can be understood as a substitutive parricide. However, we have to underly the fact that this parricide/aviolicide profile is non specific. It is highly similar to the profile found in literature about dangerousness in schizophrenia. We end up stressing the major suicidal risk in the aftermath of such an act, as the delusion of persecution ceases after treatment and the patient starts realizing his act.