Support Group for Parents Coping with Children with Type 1 Diabetes

Objectives

Type 1 diabetes is one of the most common chronic diseases in childhood. Active parental involvement, parental support in the diabetes management and family functioning are associated with optimal diabetes management and glycemic control. The purpose of this study was to assess parental satisfaction with participation in the group and their perceptions of the impact of the intervention on living and coping with childrens T1D.

Methods

A sample of 34 parents of children with T1D participated in this trend study. The participants’ experience and satisfaction with support group was measured by a self- evaluation questionnaire, designed for the purpose of the present study.

Results

Quantitative data show that parents were overall satisfied with almost all measured items of the evaluation questionnaire (wellbeing in the group, feeling secure, experiencing new things, being able to talk and feeling being heard) during the 4-year period. However, parents from the second and third season, on average, found that the support group has better fulfilled their expectations than the parents from the first season (p = 0,010). The qualitative analysis of the participants’ responses to the open-ended questions was underpinned by four themes: support when confronting the diagnosis, transformation of the family dynamics, me as a parent, exchange of experience and good practice and facing the world outside the family.

Discussion

The presented parent support group showed to be a promising supportive, therapeutic and psychoeducative space where parents could strengthen their role in the upbringing of their child with T1D.     

Anxiety Sensitivity: Its Relationship to Functional Status in Patients with Chronic Pain

Anxiety sensitivity (AS) is the fear of anxiety-related bodily sensations based on the belief that they are harmful. The purpose of this study was to examine how AS contributes to functional status in chronic pain populations. This study examined the relationship between functional status and AS, demographic, work-related, and pain-related variables in 88 chronic pain patients. Dependent measures of functional status were the SF-36 scales for physical functioning, mental health, vitality, and social functioning. Variables were entered into regression analyses according to category. Significant variables were included in subsequent regressions. AS significantly contributed to lower levels of vitality and poorer social functioning, and was the only variable to significantly contribute to poorer psychological functioning. These results suggest that AS plays an important role in several aspects of functioning in chronic pain patients, and therefore may be a useful concept to be included in pain assessment batteries.     

Children and adolescents living with HIV positive parents: Emotional and behavioural problems

Abstract

This study explores the emotional and behavioural problems in children living with an HIV-positive parent, and identifies specific high-risk and protective factors for their psychological well-being. Data were collected on 718 parents living with HIV and on 1136 HIV-affected children in a European multi-centre study (EUROSUPPORT IV) adopting a cross-sectional and retrospective study design. Sociodemographic characteristics, HIV-related stressors, variables relating to caregiving and outcome variables relating to family functioning and children's symptoms were assessed using a self-reported questionnaire. Results indicated a low level of parental HIV disclosure to children, and an elevated level of behavioural symptoms in HIV-affected children as reported by parents. Children had experienced a high degree of distressing life events. In multivariate analysis, perceived healthy family functioning emerged as protective for a low degree of behavioural symptoms in children and adolescents. The results call for a shift towards family-centred service delivery in HIV care and counselling. Service implications are discussed in the light of increasing numbers of women and couples living with HIV who become parents and need tailored support in facing the challenges of being a caregiver living with HIV.     

Determinants of levels and changes of physical functioning in chronically ill persons: results from the GLOBE Study

STUDY OBJECTIVE: Declines in physical functioning are a common result of chronic illness, but relatively little is known about factors not directly related to severity of disease that influence the occurrence of disability among chronically ill persons. The aim of this study was to assess the effect of a large number of potential determinants (sociodemographic factors, health related behaviour, structural living conditions, and psychosocial factors). DESIGN: Longitudinal study of levels and changes of physical functioning among persons suffering from four chronic diseases (asthma/chronic obstructive pulmonary disease (COPD), heart disease, diabetes, chronic low back pain). In 1991, persons suffering from one or more of these diseases were identified in a general population survey. Self reported disabilities, using a subset of the OECD disability indicator, were measured six times between 1991 and 1997. These data were analysed using generalised estimating equations, relating determinants measured in 1991 to disability between 1991 and 1997, and controlling for a number of potential confounders (age, gender, year of measurement, and type and severity of chronic disease). SETTING: Region of Eindhoven (south eastern Netherlands). PARTICIPANTS: 1784 persons with asthma/COPD, heart disease, diabetes mellitus and/or low back pain. MAIN RESULTS: In a "repeated prevalence" model, statistically significant (p<0.05) and strong associations were found between most of the determinants and the prevalence of disabilities. In a "longitudinal change" model, statistically significant (p<0.05) predictors of unfavourable changes in physical functioning were low income and excessive alcohol consumption, while we also found indications for effects of marital status, degree of urbanisation, smoking, and external locus of control. CONCLUSIONS: Other factors than characteristics of the underlying disease have an important influence on levels and changes of physical functioning among chronically ill persons. Reduction of the prevalence of disabilities in the population not only depends on medical interventions, but may also require social interventions, health education, and psychological interventions among chronically ill persons.     

Social support and psychological well-being in breast cancer patients

many aspects of the role of social support in psychological adaptation to illness have been investigated using different definitions of the construct. The present study focused on the role of instrumental social support and one aspect of emotional social support, namely supportive communication. In addition, the differential role of support provided in these areas by the spouse and significant others (SO) was examined. Subjects were 76 post-mastectomy breast cancer patients treated at a University Hospital in Istanbul. Patients were administered Spielberger's State-Trait Anxiety Inventory and the Beck Depression Inventory, and were interviewed using a structured interview developed by the authors. Results showed that supportive communication with the spouse, positive reaction of the spouse to mastectomy, marital satisfaction and open discussion of emotions concerning cancer were positively associated with psychological well-being. Instrumental support from the spouse or SO was not related to depression or anxiety.     

Community‐Based Provision for Young Deaf Children Aged from Birth to Five Years

A single case study was done on a low functioning, non‐verbal, autistic child, which looked at whether the concept of emotion could be taught successfully. Over a six‐month period four emotions were gradually introduced through the use of visual cues taught within an existing home based behavioural intervention programme. These emotions were happy, angry, sad and surprised and were taught using photographs of known people. The participant was tested using novel photographs of familiar and unfamiliar people, which looked at whether he could demonstrate a learnt concept to the novel photographs. The results showed that the four emotions had been learnt and were able to be successfully generalised to the novel photographs.     

Can Emotions be Taught to a Low Functioning Autistic Child?

A single case study was done on a low functioning, non-verbal, autistic child, which looked at whether the concept of emotion could be taught successfully. Over a six-month period four emotions were gradually introduced through the use of visual cues taught within an existing home based behavioural intervention programme. These emotions were happy, angry, sad and surprised and were taught using photographs of known people. The participant was tested using novel photographs of familiar and unfamiliar people, which looked at whether he could demonstrate a learnt concept to the novel photographs. The results showed that the four emotions had been learnt and were able to be successfully generalised to the novel photographs.     

Adverse Childhood Experiences,Family Functioning,and Resilience in Military Families: A Pattern‐Based Approach

Linkages between adverse childhood experiences and long‐term consequences in servicemen and servicewomen were examined in relation to family‐level resiliency processes predicted to mitigate this link. Using a pattern‐based, multi‐informant approach, resilience was explored through a systemic lens in relation to family‐level processes. Latent family profiles were identified using diverse dimensions of family functioning guided by the circumplex model. Data were collected from parents and their adolescents, age 11 to 18, living in the continental United States (N = 273 military families). Variations in adverse childhood experiences among servicemembers and their partners were related to heterogeneous family functioning typologies (profiles). One adaptive family functioning typology illustrated that a select group of families with higher levels of early adverse experiences evinced adaptive functioning outcomes in multiple domains in adulthood. Implications for examining individual resilience via a family‐level process and applications to educational and clinical contexts are discussed in relation to military and nonmilitary families.     

Complex Interactions Between Tutor Performance,Tutorial Group Productivity and the Effectiveness of PBL Units as Perceived by Students

Aim: Tutor performance and tutorial group productivity interact with each other in a complex manner. The aim of this study was to investigate how tutor performance, tutorial group productivity and the effectiveness of a PBL unit interact with each other. Three hypotheses were tested: (1) Does the tutor performance score differ across different levels of group productivity? (2) Does the group productivity score differ across different levels of tutor performance? and (3) Is the learning effectiveness score of a PBL unit related to tutor performance and group productivity? Method: Students rated the tutor performance, the tutorial group productivity and the effectiveness of the PBL unit. In total 287 unique tutors were involved and were categorized as having a relatively low, average or relatively high score on tutor performance. This was also done for the group productivity score. For each combination, average effectiveness score were computed. Furthermore, partial correlation coefficients were computed. Results: The results demonstrated that the average tutor performance score was higher if the productivity score was higher (hypothesis 1). The results also demonstrated that the average productivity score was higher if the tutor performance score was higher (hypothesis 2). Furthermore it was found that the effectiveness score was higher if the productivity score was higher. The effectiveness score was also higher if the tutor score was higher. The results furthermore demonstrated that the correlation coefficient between tutor performance and effectiveness of the PBL unit is 0.01 (n.s.) if the correlation between the two variables was controlled for group productivity (was 0.36). In addition, the correlation coefficient between group productivity and effectiveness became 0.39 if the correlation between these two variables was controlled for tutor performance (was 0.51) (hypothesis 3). Conclusion: It is concluded that tutor performance differs across different levels of group productivity and that the group productivity score differs across different levels of tutor performance. In addition, it is concluded that both group productivity and the tutor’s performance have an impact on the effectiveness of a PBL unit, although the correlation between group productivity and effectiveness is higher than the correlation between tutor performance and effectiveness. This finding illustrates the importance of the group’s productivity in PBL and the tutor’s importance and implies that schools should put more efforts in improving tutorial group functioning as well as in improving a tutor’s performance.