220名癌症患儿父母养育内疚感现状及影响因素分析

目的 调查癌症患儿父母养育内疚感现状,并分析其影响因素。方法 采用便利抽样法,于2021年11月—2022年4月选取山东省某三级甲等医院儿童肿瘤科的220名癌症患儿父母作为研究对象。采用一般资料调查表、养育内疚感量表、心理适应量表、压力知觉量表和领悟社会支持量表对其进行调查。采用多重线性回归分析癌症患儿父母养育内疚感的影响因素。结果 本组癌症患儿父母养育内疚感总分为（51.37±9.17）分,多重线性回归分析结果显示,子女数量、孕期健康状况、心理适应、压力知觉进入回归方程（P<0.01）,共解释癌症患儿父母养育内疚感总变异的47.9%。结论 本组癌症患儿父母养育内疚感处于中等偏上水平,子女数量、孕期健康状况、心理适应、压力知觉是养育内疚感的主要影响因素,医护人员可通过加强心理疏导、压力应对等措施,减轻癌症患儿父母的养育内疚感水平。     

Hope in parents of adolescents with cancer--factors endangering and engendering parental hope.

The purpose of the study was to describe hope in parents of adolescents with cancer. The data were collected by interviewing nine parents of six families (n=18) and analysed by inductive content analysis. Parents' hope implies an orientation towards life and the future, trust, togetherness and wishes. Hope is associated with suffering and despair and it is a life-promoting factor. Factors associated with parental hope relate to the adolescent, the adolescent's cancer and health status, the care received and the care-giving personnel, continuation of life, the parent him- or herself, economics, other people, faith and pets. The findings confirm the statement that hope appears to be central to parents having a child with cancer. The factors endangering and engendering hope are related to several dimensions of family life, suggesting that hope is a broad, multidimensional phenomenon. Engendering hope is important in nursing: hope is a life-sustaining factor, which helps the person to cope in difficult life situations. In caring for an adolescent with cancer and his or her parents, it is of utmost importance to minimize factors endangering parental hope and to foster factors that engender parental hope.     

Stress and Parents of Children with Autism: A Review of Literature

The purpose of this review is twofold. The first is to synthesize factors that impact parents’ experiences of caring for a child with autism spectrum disorder (ASD); the second is to identify factors that impact parental stress and parental decision-making to use autism services or not. Parents of children with ASD score higher on levels of stress than other groups of parents. The daily challenges of caring for the child are endless and effect all aspects of the child's care as well as the parent's mental health and ability to manage the needs of the child and family. Understanding more about the challenges parents face will provide direction for research, intervention development, and practice. Accordingly, a search was conducted using CINAHL and Medline. Inclusion criteria included articles available in full text, published in English, and focused on children with ASD distinct from other diagnoses, as well as parental experiences of caring for a child with ASD. Articles (N = 132) that met the inclusion criteria were summarized. Challenging aspects of the child's diagnosis and care are discussed, as well as the factors that impact parental stress and decision-making to use autism services. Recommendations for research and practice include interventional development related to early diagnosis, disparity, access to care, parental decision-making to use autism services, and parental stress management.     

Stress and Age: A Comparison of Asian American and Non-Asian American Parents of Children with Developmental Disabilities

This study examined parental stress differences between Asian American and non-Asian American parents of children with developmental disabilities (DD). This study also explored correlations of the age of children with DD and the age of their parents with the level of stress in these parents. Participants were administered the Parental Stress Index and a general questionnaire. Both groups reported high, comparable stress levels. However, Asian American parents experienced a significantly higher level of stress that was related to children’s characteristics of disability than their non-Asian counterparts. Results also indicate that while the age of children with DD is the best correlate of parental stress for non-Asian American parents, the age of parents is the best correlate of parental stress for Asian American parents. Implications of the findings for social work practice are discussed.     

Parents who catastrophize about their child's pain prioritize attempts to control pain

How parents respond to their child in pain is critically important to how both parent and child attempt to cope with pain. We examined the influence of parental catastrophic thinking about child pain on their prioritization for pain control. Using a vignette methodology, parents reported, in response to different pain scenarios, on their imagined motivation for 2 competing goals: to control their child's pain (ie, pain control) or to encourage their child's participation in daily activities (ie, activity engagement). The effects of parent gender, pain intensity, and duration on parental goal priority were also explored. Findings indicated that higher levels of parental catastrophic thoughts were associated with the parents prioritizing child pain control over activity engagement. This effect was significantly moderated by pain duration. Specifically, pain control was more of a priority for those high in catastrophic thinking when the pain was more acute. In contrast, parental catastrophic thoughts had no effect on the pain control strategy favored by parents in situations with longer-lasting pain. Furthermore, independently of parental catastrophic thoughts, heightened priority for pain control was observed in highly intense and chronic pain situations. Moreover, in highly intense pain, priority for pain control was stronger for mothers compared with fathers. Theoretical and clinical implications and directions for future research are discussed.     

Loss of parents in childhood - associations with depression, loneliness, and attitudes towards life in older Finnish people

Aim. This study examines the prevalence of parental loss in childhood of older generations in Finland and how it is associated with demographic variables, depression, feelings of loneliness and attitudes towards life in old age. Background. A parental loss is a significant trauma in a child's life. It has long‐term consequences in late adulthood, such as depression in middle age. Loss of parent/parents has not been under concern in the nursing literature. Little is known about the prevalence of parental loss and its consequences in old age such as depression, inner feelings of loneliness and life attitudes. Methods. The data were collected with a postal questionnaire from a random sample of 3728 older people (≥75 years) in Finland who responded to a question concerning loss of a parent when respondent was age ≤17 years. Results. Of those responding to the question concerning parental loss, 31.2% had lost their mother and/or father in the childhood (at age ≤17 years). Loss of parents was associated with lower level of education, physically heavy lifetime work, and not being married. There was no statistically significant relation between the loss of parent/parents in the childhood and self‐reported depression or loneliness in the old age. In addition, loss of parent/parents was not associated with any attitudes towards life, such as life satisfaction, plans for the future, zest for life or happiness. Conclusions. Surprisingly many people from older generations had lost their parent/parents in their childhood, but it is not associated with depression, feelings of loneliness or other attitudes towards life. Several explanations for this are discussed. Relevance to clinical practice. Loss of parents does not necessarily lead to older people's psychological frailty. Nurses should be cautious when making interpretations about older people's early life history. Among older people early losses may be a source of successful coping skills rather than a risk factor for depression, loneliness and pessimistic life attitudes.     

Care of sick children by parents: a meaningful role

Parental involvement in their child's care in hospital has undergone great change over the last century. Studies have shown how 'maternal deprivation' and 'separation anxiety' expressed by children are detrimental to a child's recovery in hospital. Striving efforts have been made to develop family-centred care, promote normality of the family unit and continue with the normal routine of the child's life within the limitations of a hospital environment and the child's illness. Expectations of the parental role in hospital need to be identified and expressed from both the parents and staff to establish an understanding that will ultimately be best for the child. Many studies have highlighted benefits to both parent and child from parental participation in hospital. However, disadvantages have been identified from resident parents who feel captive to their new situation and role. Efforts for family-centred care are highly advocated now. Care-by-Parent units have been set up in some areas to promote this idea and, although many advantages have been identified, they are not without their problems. The success of parental involvement is dependent on both parents' and staff's attitudes, enthusiasm and willingness to work together.     

Parental Adaptation to Adolescent Drug Abuse: An Ethnographic Study of Role Formulation in Response to Courtesy Stigma

Community based nurses have increasingly been involved in caring for the parents of drug abusing adolescents. They are in need of research data about how parents are coping with the problem. This study analyzed parental role formulation in response to their position as parents of deviant children. The method of inquiry was ethnographic. Data were gathered from nonparticipant observations, parent informant journals, and interviews with parents involved in a survival group. Parents move through three phases of role formation, the content of which has implications for nursing assessments. The similarities of these parents to those of physically and mentally handicapped children is striking. Both are outside the conventional norm and are constantly involved in interpreting situations with others as to their different parenting role. A pecularity in the findings is that the parents were less discredited by their family and friends than had been anticipated. They met their greatest discreditation from community institutions, including the school, police, and court systems, institutions that were expected to assist them in bringing their child's drug abuse under control.     

Parents' experiences of collaboration with community healthcare professionals

Over the last decades there has been a reduction in the number of institutional beds in psychiatric care in Norway. This has led to more psychiatric patients being dependent on community care and consequently an increased need for collaboration with the parents of these patients. In most cases parents are an important source of support in helping patients manage their everyday life. The aim of this study was to explore how parents of adult psychiatric patients experience collaboration with health professionals in the community healthcare services. The data collection in this study is based on 12 interviews with six parents, and a qualitative analysis method was employed. Four themes emerged: (1) communication and relationship between parents and health professionals; (2) lack of information; (3) parents' participation in the treatment of their son or daughter; and (4) the need for guidance and support. It was reported that health professionals are suspicious of parental involvement and often refuse to allow them to participate in the care. Further research on parents' experiences of collaboration is necessary. The value of parents as an important source of support can be enhanced by means of increased collaboration.     

Parents of Adults with Intellectual Disabilities: Quality of Life and Experiences of Caring

This study examined a UK sample of parents caring for their adult offspring with intellectual disabilities, and the factors contributing to their quality of life and experiences of caregiving. Structured interviews were conducted with 62 parents of adults with intellectual disabilities. On several indices of quality of life, parents did not seem to be functioning as well as caregiving parents in the US, or as well as adults in the general US population.The offspring's level of challenging behaviour and physical dependency and the parent's satisfaction with informal support were associated with parental quality of life. The salience that parents placed on their post‐parental life style was also associated with quality of life, with ‘captive’ parents faring more poorly than ‘captivated’ parents.     

Parental support and condom use among transgender female youth

Evidence suggests that transgender female youth (TFY), much like their adult transgender female peers, are at high risk for HIV. Yet little attention has been given to important developmental experiences of TFY that may impact HIV risk for this youth population. The overall purpose of this study was to explore HIV risk in TFY. A reoccurring theme from the qualitative data was the importance of parents. To better understand the impact of parents on HIV risk among TFY, in-depth individual interview data from 21 TFY in Los Angeles and Chicago were analyzed, suggesting a potential link between HIV-related risk behavior and parental support. Youth with parental support in this sample reported regular condom use, while those without such support reported inconsistent condom use. Implications for the unique research and interventions needs of TFY related to parental support and sexual risk behaviors are discussed.     

Parental influence on models of primary prevention of cardiovascular disease in children.

BACKGROUND: Lifestyle behaviors such as overeating and physical inactivity contribute significantly to CVD, the leading cause of morbidity and mortality among adults globally. CVD risk factors that begin in children often track into adulthood. Parents are believed to influence the health behaviors of their children. OBJECTIVE: To review the literature on parental influence on children's health beliefs and behaviors, particularly eating and exercise behaviors as indicators of CV health, school-based CVD risk reduction programs, and racial/ethnic, gender and socioeconomic considerations for models of primary prevention of CVD in children. METHODS: Seventeen studies that included parents as either a source of information, change agent or participant in a CVD risk reduction intervention were identified searching the Medline, CINAHL and PsycINFO databases from 1980 through 2002. RESULTS: Children's lifestyle health beliefs and behaviors are significantly influenced by positive parental modeling and involvement in exercise and healthy eating; parental influence on children's behavior lasts beyond adolescence; parents are effective teachers of health habits at home when prompted by health educators; and parental influences vary by ethnicity/race, socioeconomics and gender. CONCLUSIONS: A broader base of knowledge that is socioculturally sensitive must be developed about what parents and children believe is healthy, how parents model beliefs and behaviors for their children, and how to build self-efficacy for positive health behaviors.     

Parental bereavement: Looking beyond grief

Bereaved parents have higher morbidity and mortality rates when compared to nonbereaved parents. Although parental grief is well studied, the complexities of challenges bereaved parents face are not understood. This study describes parental bereavement challenges during the first 6 months following the death of their child. The complex parental bereavement challenges are characterized by the absence of the child, their emotional response, and the changed relationships with family and friends. The adaptive leadership framework is a useful framework to identify and classify challenges. Future research can use this framework to provide a structure that test interventions to address the challenges.     

Coping in parents of children who are chronically ill: strategies for assessment and intervention

Estimates indicate that approximately 31% of children are affected by one or more chronic illnesses. Furthermore, caring for a chronically ill child imposes a host of long-term stressors for parents that need to be addressed by sensitive, evidence-based interventions. This article will: (a) review stressors of childhood chronic illness for parents over time; (b) provide a summary of tools that can be used to assess parental coping, (c) delineate important nursing assessments, (d) review interventions that have resulted in improved parental coping outcomes, and (e) describe a theoretical framework that can be used to assess and intervene with parents of chronically ill children.     

Immunisation: are parents making informed decisions?

In some countries childhood immunisation is compulsory but in the United Kingdom the decision on whether or not to immunise is made by the child's parents. Fears about the safety of vaccines have been exacerbated by media stories and information on the internet which parents may not be able to interpret appropriately. This has contributed to the uptake of MMR in the UK falling to below 90 per cent. To support parental decision making, healthcare professionals should be listening carefully to parental concerns, understanding their perspective and discussing both positive and negative information with them.     

Parental fever phobia and its evolutionary correlates

Aims. This study aimed to identify parental views of fever in their children aged 1–6 years and to consider these and associated behaviours from an evolutionary perspective. Background. Fever is a common symptom of illness in children; however, many parents express high levels of anxiety. This has previously been reported in several countries, most notably the USA. The purpose behind this study was to look at parental views and examine these from an evolutionary perspective to explain the persistence and ubiquity of parental fears of fever. Method. A questionnaire was administered to 181 parents of children attending a paediatric outpatients department at a London teaching hospital. Results. Many parents expressed high levels of worry and its possible complications. These manifest themselves in the frequency with which parents measured their child's temperature, and the aggressive nature of their treatment. Many reported over‐using antipyretic drugs, or using non‐evidence based practices such as sponging. However, in many cases they were also making appropriate behavioural alterations, for example, encouraging fluids and rest. Conclusion. While many parents expressed high levels of worry about fever and used inappropriate treatments, this must be balanced against benefits such as increased vigilance and close attention to hydration. Lay health beliefs, such as those reported in this study, may be judged unduly negatively if individual aspects are seen in isolation. Relevance to clinical practice. High levels of worry have been reported internationally, suggesting that they may form part of a conserved response to fever. Although many parents reported aggressive treatment of fever, they also used appropriate symptomatic interventions. Nurses and other healthcare professionals should act to reduce the fear of fever and concentrate upon accurate diagnosis and the appropriate treatment of the underlying illness.     

Parental grieving and perceptions regarding health care professionals' interventions.

The death of a neonate, infant, or child is a tragedy that greatly impacts on many individuals' lives. Nurses and other health-care professionals provide care for not only the dying child but also the grieving parents and families. It is imperative that health care professionals are cognizant of the components and intensity of parental grieving and the critical role that they must assume in supporting bereaved parents prior to, at the time of, and after the child's death. The purpose of this study was to measure the intensity of parental grieving and collect information from bereaved parents regarding their perception of health care professionals' interventions. The results indicated that bereaved parents' intensity of grieving scores were generally higher than those reported on the TRIG norms. In response to The Bereavement Questionnaire, they were able to identify what health care professionals did or said that was helpful or unhelpful before, during, and after their child's death.