Evaluation of a brief intervention based on social cognitive theory to develop problem-solving skills among sixth-grade children.

This study evaluated an intervention based on social cognitive theory (SCT) intended to develop problem-solving skills (PSS) in sixth graders. Psychometrically tested measures were developed for (1) constructs of SCT (situational perception of stressors, expectations of PSS, self-efficacy for PSS, self-efficacy in overcoming barriers, and self control when applying PSS), (2) PSS, and (3) application of PSS to real-life problems. Five classrooms (n = 133) were randomly assigned to the SCT-based intervention and five classrooms (n = 127) to an equivalent knowledge-based intervention. Using a partial nested design, statistically significant improvements for expectations of PSS, self-efficacy for PSS, and PSS were found in the SCT-based intervention. At posttest, 36% of the students in the SCT-based intervention reported applying PSS to real-life problems as compared with 1% in the knowledge-based group. This pilot study suggested that an SCT-based intervention was more efficacious in developing PSS than a knowledge-based intervention.     

Training parents in a preventive intervention for transfer children

Parents whose children were identified as being at-risk for academic difficulties following a transfer into a new school were involved in either a school-based tutoring program or a school-based tutoring program with a parent training component. When parents actively worked with their elementary school age children at home, the children evidenced better grades at the end of the school year. A variety of other social adjustment measures also indicated that when parents and school-based personnel worked together in the preventive effort, the outcomes were more favorable.The authors wish to thank the many principals and teachers who have supported this preventive intervention. Funding for this project was provided by the National Institute of Mental Health (Grant Number MH 40851). Requests for reprints should be sent to Leonard A. Jason, Ph.D., Department of Psychology, DePaul University, 2219 N. Kenmore Ave., Chicago, IL 60614.     

An intervention for parents with AIDS and their adolescent children

OBJECTIVES: This study evaluated an intervention designed to improve behavioral and mental health outcomes among adolescents and their parents with AIDS. METHODS: Parents with AIDS (n = 307) and their adolescent children (n = 412) were randomly assigned to an intensive intervention or a standard care control condition. Ninety-five percent of subjects were reassessed at least once annually over 2 years. RESULTS: Adolescents in the intensive intervention condition reported significantly lower levels of emotional distress, of multiple problem behaviors, of conduct problems, and of family-related stressors and higher levels of self-esteem than adolescents in the standard care condition. Parents with AIDS in the intervention condition also reported significantly lower levels of emotional distress and multiple problem behaviors. Coping style, levels of disclosure regarding serostatus, and formation of legal custody plans were similar across intervention conditions. CONCLUSIONS: Interventions can reduce the long-term impact of parents' HIV status on themselves and their children.     

Coping strategies in parents of children with cancer

This study examined 395 parents (224 mothers and 171 fathers) of children with cancer in Sweden in terms of coping, assessed using the Utrecht Coping List. The use of each of seven coping strategies among parents of children with cancer was compared with data from parents of children with no serious or chronic diseases. In addition, the relationship between coping strategies and anxiety/depression was examined. No differences in the frequency of using the seven coping strategies were found between the study group and the reference group. Neither did the use of coping strategies differ among parents of children with various types of cancer, nor among parents at various points in time after the child's cancer diagnosis. A more frequent use of active problem-focusing, and a less frequent use of avoidance behaviour and passive reaction pattern, was related to lower levels of anxiety and depression in parents of children with cancer and in reference parents. Analyses of parents of children at different time points after diagnosis and in different diagnostic groups indicated that contextual demands influence the relation between coping and anxiety/depression.     

Home intervention with parents of severely subnormal pre-school children: a final report*

Summary A 3-year intervention programme with parents of severely subnormal pre-school children is described. Two experimental groups, one visited individually at 2-week intervals and one similarly at 8-week intervals are compared with a third distal contrast group receiving no intervention. Analyses of successive IQ changes in all three groups showed that the less frequently visited group made greater progress after 2 years than that receiving more visits but that this difference disappeared after 3 years. The contrast non-intervention group made fewer gains overall than either of the two experimental groups. Four questions are discussed: the maintenance of early gains, the influence of social class, the optimal level of intervention and the meaning of successful intervention to parents. Evaluation of the project is concerned with experimental efficiency, methodology, and the problems of partnership.     

Understanding the health impact of caregiving: a qualitative study of immigrant parents and single parents of children with cancer

Purpose

Research looking at the health of parents of children with cancer typically uses outcome measures focused on symptoms of anxiety, depression, or post-traumatic stress. Our team builds on this literature to provide a more comprehensive understanding of the health impact of caregiving.

Methods

Interviews were conducted with 79 Canadian parents of children with cancer at least 6?months post-diagnosis. Line-by-line coding was used to establish categories and themes. Constant comparison was used to examine relationships within and across codes and categories. Interviewing continued until no new themes emerged.

Results

Parents described health concerns as including sleep disturbance, daytime fatigue, anxiety, depression, social isolation, and changes in social roles. Parents described the positive impacts of caregiving as including gaining a greater appreciation for child and family and developing compassion, empathy, patience, inner strength, and new perspectives on life.

Conclusion

Parents of children with cancer can experience a range of health problems due to the emotional impact of a cancer diagnosis and the intensive and often prolonged nature of treatment and aftercare. Given the central role parents play as caregivers, it is crucial to understand the health impact of caregiving so that supportive interventions can be implemented as necessary.     

Influences of a supermarket intervention on the food choices of parents and their children

The Nutrition for a Lifetime System (NLS) is a public access, interactive information system that was located in a supermarket and designed to help shoppers alter their purchases to meet National Cancer Institute (NCI) guidelines. This study investigated the influence of the NLS on parents' food choices, and assessed how changes in parental food choices and preferences affected their children. During the intervention phase, experimental participants (parents only) received nutrition education and feedback. Participants were 24 families, parents and their children ages 10 to 13 years, who were recruited from the larger sample of 77 NLS participant families. The results showed that parents and children reported making similar changes that followed NCI guidelines. This was most evident for increases in the consumption of fruit. These results provide evidence of the impact of a parent-based intervention on their children's food choices. Future interventions should enhance the components of an overall program directed toward children and other family members.     

Sources of support perceived by parents of children with cancer: implications for counselling

Providing social support for families of pediatric cancer patients remains a challenge. The perceived helpfulness of 11 potential support sources was assessed by 107 parents of children with cancer. They rated the spouse, the medical community, and parents from a mutual help group as the most helpful. Mental health professionals and the church were seen less frequently and perceived as less helpful. No significant differences were found in the patterns of social support among parents with children in different stages of treatment. More than half the parents responding to a question on what they needed most during their children's illness mentioned emotional support and counselling. Mental health professionals may find that crisis/supportive and educative models and frequent contact are useful counselling approaches in dealing with families of cancer patients. A team approach to pediatric oncological treatment, consisting of a primary physician, nurse, and psychological consultant, may be a way to optimize the early and flexible involvement of psychosocial staff in total care.     

Computer-based brief intervention a randomized trial with postpartum women

BACKGROUND: Drug use among parenting women is a significant risk factor for a range of negative child outcomes, including exposure to violence, child maltreatment, and child behavior problems. Implementation of brief interventions with this population may be greatly facilitated by computer-based interventions. DESIGN: Randomized clinical trial with 4-month follow-up. SETTING/PARTICIPANTS: Participants were 107 postpartum women recruited from an urban obstetric hospital primarily serving a low-income population. Women were randomized into assessment only versus assessment plus brief intervention conditions; 76 (71%) returned for follow-up evaluation. INTERVENTION: A 20-minute, single-session, computer-based motivational intervention (based on motivational interviewing methods), combined with two nontailored mailings and voucher-based reinforcement of attendance at an initial intake/treatment session. MAIN OUTCOME MEASURES: Illicit drug use as measured by qualitative urinalysis and self-report. RESULTS: Frequency of illicit drug use other than marijuana increased slightly for the control group, but declined among intervention group participants (p<0.05, between-group Mann-Whitney U; d=0.50); the magnitude of intervention effects on changes in marijuana use frequency was similar, but did not reach statistical significance. Point-prevalence analysis at follow-up did not show significant group differences in drug use. However, trends under a range of assumptions regarding participants lost to follow-up all favored the intervention group, with most effect sizes in the moderate range (odds ratios 1.4 to 4.7). CONCLUSIONS: Results tentatively support the efficacy of this high-reach, replicable brief intervention. Further research should seek to replicate these findings and to further develop the computer as a platform for validated brief interventions.     

Improvement of nightblindness situation in children through simple nutrition education intervention with the parents

The impact of a simple nutrition education intervention was studied on the nightblind situation of children under 6 years of age in a coastal area of Bangladesh. Parents were given nutritional education and motivation by various means for 18 months to grow more vegetables and fruits rich in vitamin A and to feed these to their children. Treatment of the already nightblind children to full recovery with vitamin A capsules created confidence in the study personnel. A follow‐up survey after the intervention period showed that the level of nutritional knowledge of the parents on vitamin A improved highly significantly. Vegetable production per family and actual vegetable consumption per child increased. Intake of cooking oil also increased and the type of the oil consumed changed from mustard to soybean, the latter being half as costly as the former. As a consequence of these improvements, the prevalence of nightblindness amongst children under 6 years dropped from 4.1% to 0.47% and there was no new case of total blindness in the study population. Analysis of the results indicate that this improved nightblindness situation was due to increased nutritional knowledge of the household heads irrespective of their occupation, income, and the level of their formal education in school. The success of such a simple education intervention programme was considered dependent on the confidence established in the household heads and the consequent positive response made to the projected messages.     

Development of a tool to measure the life situation of parents of children with cancer

The aim of this study was to test the validity and reliability of the recently developed Life Situation Scale for Parents (LSS-P) among parents of children with cancer. One hundred and ten parents of seventy-four children and adolescents who visited three paediatric wards in Sweden filled out three instruments: The LSS-P, the Quality of Life Scale and the Family Support Scale. The reliability co-efficient, Cronbach's alpha, was found to be 0.82 for the LSS-P. A factor analysis with orthogonal varimax rotation of 37 items of the LSS-P gave twelve factors. A higher order factor analysis reduced the factors to four (Care, Well-being, Social life and Preparedness), explaining the underlying dimensions to 57.9%. The total LSS-P correlated significantly with the Quality of Life Scale, and the higher order factor Care with the Family Support Scale. The LSS-P discriminated, in some aspects, between two-parent and single parent families and between parents visiting the ward for treatment or check-up. The conclusion is that this first version of the LSS-P was valid and reliable (internal consistency) to a certain extent, but that the instrument should be tested on larger samples and during different phases of the disease.     

Similarities and differences between children with asthma wnd children with cancer: Implications for preventive intervention

A substantial increase in the prevalence of chronic health conditions among children in the U.S. has led to growing concern with preventing the psychosocial and economic problems engendered by such illness. This exploratory study examined the validity of the recently proposed non-categorical approach to physical illness versus the traditional disease-specific perspective as the basis for the content and organization of preventive services for children with chronic illness. No significant disease-specific differences were found in measures of psychological and social adaptation between children with asthma and children with cancer, lending support to a non-categorical approach to the provision of preventive services.Susan Farquar and Daniela Wittmann were Clinical Social Workers, Pediatric Pulmonary and Pediatric Oncology Clinics, University of Michigan Medical Center at the time of this study.     

白血病患儿及家长的心理状况及干预

目的调查白血病患儿及家长心理健康状况和疾病应对方式,为心理干预提供依据。方法采用焦虑性情绪障碍筛查表、抑郁障碍自评量表、患病行为问卷、SCL-90症状自评量表、医学应对方式和应对方式问卷,对60例白血病患儿（初治和强化组各30例）、39例非恶性血液病患儿（对照组）及52例健康组儿童和家长,进行心理卫生和应对方式调查。结果与健康组相比,白血病组患儿及家长存在较多负性情绪,初治组更明显;白血病组较对照组更多采用回避和放弃方式来应对疾病,其家长的自责、求助和幻想的分数高于对照组。结论白血病儿童及家长存在较多的心理问题及消极应对方式。有效的心理干预有助于提高患儿的生活质量和改善家长的身心健康。     

Patterns of change in marital relationships among parents of children with cancer

This study examined changes in marital relationships among parents of children with cancer. Data for both parents of 35 children treated for cancer for less than a year to more than five years showed changes in marital relationships across 10 dimensions of the relationship. The findings showed that some aspects of the relationship (for example, communication and trust) tended to be strengthened, whereas others (especially sexuality) were prone to deterioration. Second, changes in the marital relationship were examined in relation to the duration of illness. The data showed a slight decrease in relationship satisfaction within one year of diagnosis, an increase in marital strength in cases of children who had been ill for two or three years, and a deterioration in the marital relationship after more than four years of children's illness.     

Quality of life among parents of children with congenital heart disease,parents of children with other diseases and parents of healthy children

We compared quality of life among parents of children with congenital heart disease (PCCHD, n = 1092), parents of children with other diseases (PCOD n = 112) and parents of healthy children (PHC, n = 293). We also identified determinants of quality of life among the parents. The parents completed a questionnaire about such areas as quality of life and financial situation. The design was cross-sectional and data were collected during 20 consecutive days. The univariate analyses showed that PCCHD tended to report lower quality of life than PHC. Mothers reported lower quality of life than fathers, with the lowest levels among mothers of children with CHD. The multivariate analyses revealed however that variables such as distress, hopelessness and financial situation were more important in explaining the reduced quality of life than parental gender and the presence/severity of the children's heart diseases. We corroborated previous findings and may have provided new insights into the quality of life experiences of parents of children with CHD that may be important when considering interventions to improve their situation.     

营养干预对肾病综合征儿童的影响

目的 研究不同营养干预对肾病综合征儿童营养状况及血脂水平的影响.方法 新确诊的肾病综合征患儿随机分3组:对照组、动物蛋白组、部分大豆蛋白组.对照组自由进食;动物蛋白组和部分大豆蛋白组患儿总膳食原则相同,只有蛋白质来源不同,动物蛋白组的蛋白来源为动物性食物,部分大豆蛋白组的蛋白来源50%为动物性食物,50%为大豆食品.分别于试验前后(共4周)测定营养相关实验室指标(总蛋白、白蛋白、血红蛋白、血钙)和血脂系列,并进行比较分析.结果 各组患儿试验后血清总蛋白均较试验前增高(对照组t=4.245,P<0.001;动物蛋白组t=5.876,P<0.001;部分大豆蛋白组t=6.312,P<0.001);血清白蛋白也较试验前增高(对照组t=8.034,P<0.001;动物蛋白组t=3.977,P<0.001;部分大豆蛋白组t=6.823,P<0.001).动物蛋白组和部分大豆蛋白组患儿膳食干预后总蛋白、白蛋白均较对照组高(总蛋白F=6.198,P=0.004;白蛋白F=5.675,P=0.006).部分大豆蛋白组患儿的甘油三酯、总胆固醇、低密度脂蛋白胆固醇较干预前降低(t值分别为2.731、5.817、3.516,均P<0.01),而高密度脂蛋白胆固醇较干预前增高(t=2.169,P<0.05).结论 科学合理的膳食干预可改善肾病综合征患儿的营养状况,有效改善脂代谢紊乱.