Predictors of parental adjustment to children's epilepsy in rural India

BACKGROUND: Negative societal attitudes towards disability affect the adjustment of parents when their child is diagnosed with epilepsy. Recent studies have suggested that parental and child outcomes, including adjustment, can be influenced by non-directed social support to mothers of children with disability. The objective of our study was to test the hypothesis that maternal satisfaction with social support, measured at the beginning of treatment, would predict parental adjustment to the child's epilepsy after 1 year of treatment. METHODS: We enrolled 46 mothers of children aged 6-18 years with epilepsy in the study. We measured social support using the modified Dunst family support scale, and parental adjustment using a locally validated instrument (S-PAM). Correlation was tested using a multiple linear regression model, allowing for confounding variables. RESULTS: Parental adjustment at outcome was positively independently correlated with satisfaction with social support at baseline,and negatively with severity of the child's epilepsy. The regression model explained 34% of the total variance. CONCLUSIONS: Taken together with evidence from previous studies, this finding supports the idea that helping parents to find more satisfaction within their (new or existing) social networks will promote adjustment to their child's disability.     

Social integration of children with epilepsy in rural India

Only a small fraction of people with epilepsy in developing countries has access to medical facilities. Even with effective treatment, their psychosocial needs are often overlooked in the absence of obvious disability. In rural areas, community-based rehabilitation programmes assist in the integration of people with disabilities into employment and the community. However, the functional impairment associated with epilepsy is not well recognised in intervention programmes in developing countries. We report, for the first time, the social activities of children with epilepsy and their peers in rural India. We employed a cross-sectional design using a new age and sex-specific social activity questionnaire. Population screening in the context of a community-based rehabilitation programme identified 88 children with epilepsy and 250 randomly selected controls. A trained interviewer administered the questionnaire to mothers in Bengali. Girls' activities were principally domestic, whilst boys' were mostly outdoors and involved peers. All groups of children with epilepsy had significant social deficits, equally for boys and girls in the age range from 2 to 18 years (p < 0.05). Boys with epilepsy had limited peer group activities, and parents conferred fewer responsibilities to school age and adolescent children compared to controls. The nature and degree of deficits were beyond the constraints imposed by neurological impairment. Our findings in pre-schoolers were consistent with parental attitudes of overprotection found in previous research. We conclude that social integration needs active and early promotion among children with epilepsy. The assessment of remediable risk and protective factors in the family and community is an important practical area for research in community-based rehabilitation.     

Parents' personality and parenting stress in families of children with spina bifida

Background   Spina bifida (SB) can place parents at risk for increased levels of parenting stress. Little is known, however, about the role of parents' intrapersonal resources. Therefore, based on ideas of the Disability-Stress-Coping Model, relations between the severity of SB, parents' personality traits and parenting stress were examined.
Methods   Forty-six mothers and 37 fathers of children with SB (6–14 years) participated. Severity of SB (physical dysfunctions and cognitive functions), parental personality (Big Five) and parenting stress (Parenting Stress Index) were measured. Multiple regression analyses were performed.
Results   The severity of the child's physical dysfunctions was positively associated with parenting stress. Extraversion (mothers only), emotional stability and agreeableness (fathers only) were negatively related to parenting stress. In the final model, 64% of the variance in mothers' and 67% of the variance in fathers' levels of parenting stress was explained. Parents' personality traits explained the largest proportions of variance in parenting stress.
Conclusion   Mobility, bladder and bowel dysfunctions in school-aged children with SB represent ongoing stressors for parents. Parents' intrapersonal resources of positive affectivity, however, are more important determinants of parental adjustment to SB than the child's physical dysfunctions.     

父母迁移模式对农村留守儿童问题行为的影响

农村留守儿童是问题行为的高发群体,在不同父母迁移模式下,留守儿童在问题行为表现上存在差异.通过综述近年来农村留守儿童问题行为的研究,发现相较于非留守儿童,父母均迁移儿童的问题行为总体发生率显著较高;在父亲或母亲一方迁移情况下,母亲迁移儿童的问题行为发生率显著高于父亲迁移.本综述为进一步深入研究农村留守儿童问题行为提供参...     

Vulnerable children in families affected by parental mental illness: The role of theory in programme development

Abstract

People who experience mental illness frequently undertake parenting duties. While this group of parents can parent well, they often experience challenges that are associated with adverse impacts upon their children's mental health. A robust body of evidence does not currently exist to indicate interventions for this group that are most effective in promoting positive outcomes. We argue that, in this context, theory and the use of theoretical models are advantageous for practitioners to increase the effectiveness of interventions. This paper presents an analysis of the explicitly stated theoretical models used to guide published evaluations targeting this vulnerable group of children and young people. Almost half (46%) of the published evaluations examined failed to state explicitly or describe a theoretical underpinning for the intervention programme. Of those programmes that did use theory there was an emphasis on individual-focused theories drawn from psychology, psychiatry and social work rather than mainstream health promotion theories.     

Living with children who have coeliac disease: a parental perspective

Background This study explores how a child's coeliac disease (CD) influences the daily life of families because such knowledge can enhance the understanding of how to support family adjustment to a gluten‐free diet (GFD). Methods We used an interpretative phenomenological approach, interviewing 20 parents of 14 children diagnosed with CD about their individual thoughts and beliefs. Results Once parents know, especially when their children are young, they seem to have the capacity to rapidly adapt to GFD, mainly because they notice how quickly their children recover. Parents may have problems controlling how staff at daycare and at school complies with their information about a GFD. Conclusions To ensure that children with CD are given a GFD at daycare and school, it is necessary for municipalities to educate staff about the disease and to give them the prerequisites for serving a GFD. There is also a need of early identification of children who may have CD. When parents express their worries, not just at the hospital but also at the well‐baby clinic and primary care units, supporting treatment could prevent children from suffering from inappropriate food.     

农村留守儿童心理健康状况及人格发展特征

目的调查农村留守儿童心理健康状况及人格发展特征。方法采用症状自评量表(SCL-90)和儿童14种人格因素问卷(CPQ),随机抽取农村670名留守儿童和708名非留守儿童进行心理健康、人格特征调查。结果在症状自评量表得分中,小学留守儿童焦虑得分显著高于非留守儿童,而初中留守儿童有10个因子得分显著高于非留守儿童;在儿童14种人格因素问卷得分中,小学留守儿童兴奋性得分显著高于非留守儿童,初中留守儿童乐群性、聪慧性、稳定性得分均显著低于非留守儿童,而忧虑性、次级因素Ⅰ(焦虑性)、次级因素Ⅲ(神经过敏性)得分均显著高于非留守儿童。结论留守现象对儿童心理健康和人格发展有消极影响,初中留守儿童心理问题更为严重。     

HIV-related stigma: adapting a theoretical framework for use in India

Stigma complicates the treatment of HIV worldwide. We examined whether a multi-component framework, initially consisting of enacted, felt normative, and internalized forms of individual stigma experiences, could be used to understand HIV-related stigma in Southern India. In Study 1, qualitative interviews with a convenience sample of 16 people living with HIV revealed instances of all three types of stigma. Experiences of discrimination (enacted stigma) were reported relatively infrequently. Rather, perceptions of high levels of stigma (felt normative stigma) motivated people to avoid disclosing their HIV status. These perceptions often were shaped by stories of discrimination against other HIV-infected individuals, which we adapted as an additional component of our framework (vicarious stigma). Participants also varied in their acceptance of HIV stigma as legitimate (internalized stigma). In Study 2, newly developed measures of the stigma components were administered in a survey to 229 people living with HIV. Findings suggested that enacted and vicarious stigma influenced felt normative stigma; that enacted, felt normative, and internalized stigma were associated with higher levels of depression; and that the associations of depression with felt normative and internalized forms of stigma were mediated by the use of coping strategies designed to avoid disclosure of one's HIV serostatus.     

The psychological adjustment of children from separated families: The role of selected social support variables

This study investigates the impact of social support on children's psychological adjustment following the divorce of their parents. Seventy-one (71) children from separated families and 120 children from intact families participated in the study. Data were collected twice. Children from separated families listed support networks of lower density with more sitters and teachers contributing both to emotional support and to negative interactions. Social support variables contribute more in predicting the psychological status of children from separated families than of children from intact families. Insufficient income, dissatisfaction with family life, lower density of the support network and higher ratio of negative interactions are predictive of children behavior problems.     

功能性腹痛儿童人格特点和父母教养方式评价

【目的】探讨功能性腹痛(functional abdominal pain,FAP)儿童人格特点及父母教养方式,为临床诊治提供参考。【方法】对52例FAP患儿和41例健康儿童,分别进行艾森克人格问卷、父母教养方式问卷调查。对腹痛症状和父母教养方式、艾森克人格各因子进行相关分析。【结果】FAP儿童具有不良的父母教养方式和人格特点。FAP症状积分与教养方式因子F1、M1值及人格因子E值呈显著负相关(P0.05);与教养方式因子F3、M2值及人格因子P、N值呈显著正相关(P0.05)。【结论】儿童FAP与人格个性特点、父母教养方式密切相关     

An open trial of equine‐assisted therapy for children exposed to problematic parental substance use

Children exposed to problematic parental substance use (PPSU) often face a number of deleterious developmental outcomes, yet these children are less likely to become known to child protection and welfare services. Although there is a growing evidence base for equine‐assisted therapy (EAT) as an effective treatment modality for atypically developing children and adolescents, scant research has explored the benefit of EAT for children exposed to PPSU. The current study is the first to explore the benefit of EAT for children exposed to PPSU in Victoria, Australia. Five 12‐week EAT programmes were delivered from 2012 to 2015 with a total of 41 children (mean age of 10.26 years) taking part. Children's parents (n = 41) and schoolteachers (n = 31) completed the Strengths and Difficulties Questionnaire pre‐ and post‐intervention. Parents reported that children's total difficult behaviour and emotional problems decreased following the 12‐week EAT programme. In addition, parents and teachers observed a significant decrease in children's hyperactivity. The findings obtained highlight the benefit of EAT for children exposed to PPSU and thus, extends the existing evidence base for this treatment modality.     

Physical activity in young children: a systematic review of parental influences

The primary aim of this review was to identify and evaluate the strength of associations of the key parental factors measured in studies examining early childhood physical activity (PA). A systematic review of the literature, using databases PsychINFO, Medline, Academic Search Complete, PSYCHinfo, and CINHAL, published between January 1986 and March 2011 was conducted; 20 papers were relevant for the current review. While 12 parenting variables were identified, only 5 of these had been investigated sufficiently to provide conclusive findings. There were inconsistencies in the findings involving the social learning variable parental enjoyment and variables involving parental behaviours such as maternal depression and self-efficacy, and rules for sedentary behaviour, and parental perceptions, which included perceived importance of PA, fear of safety, and perception of child's motor competence. Given these inconsistencies, a meta-analysis was conducted to determine whether the method of measuring PA (objective or subjective) influenced the strength of associations between the parental factors and young children's PA. There was no difference in the strength of associations in the studies that used objective or subjective measurement (via parent self-report). Further investigation is needed to clarify and understand the specific parental influences and behaviours that are associated with PA in young children. In particular, longitudinal research is needed to better understand how parental influences and PA levels of children during the formative preschool and early elementary school years are associated.     

A longitudinal investigation of Western Australian families impacted by parental cancer with adolescent and young adult offspring

Objective : Parental cancer is a significant problem for adolescent and young adult offspring. To understand the extent of the problem of parental cancer for Australian offspring, data regarding those impacted are required. The aim of this study was to enumerate and describe the characteristics of Western Australian adolescent and young adult offspring (12–24 years) and their parents with cancer using linked population data. Methods : A retrospective cohort study was conducted using data from the Western Australia Data Linkage System, which provided results generalisable at a national level. Results : Between 1982 and 2015, 57,708 offspring were impacted by 34,600 parents’ incident malignant cancer diagnoses. The most common diagnosis was breast cancer. Of the 36.4% of parents who died, this was mostly a result of cancer. Most families resided in regional areas and were of high or middle socioeconomic status. Significant predictors of earlier parent death included low socioeconomic status, remoteness, age, having more children and having older children. Conclusion : A considerable number of adolescent and young adult offspring are impacted by parental cancer at a potentially vulnerable age. This research provides knowledge to better understand who is affected by parental cancer in Australia. Implications for public health : These results may be useful for planning and implementation of Australian supportive services.     

Perceptions of the use of complementary therapy and Siddha medicine among rural patients with HIV/AIDS: a case study from India

Allopathic practitioners in India are outnumbered by practitioners of traditional Indian medicine, such as Ayurveda and Siddha. These forms of traditional medicine are currently used by up to two‐thirds of its population to help meet primary healthcare needs, particularly in rural areas. Gandeepam is one of the pioneering Siddha clinics in rural Tamil Nadu that is specialized in providing palliative care to HIV/AIDS patients with effective treatment. This article examines and critically discusses the perceptions of patients regarding the efficacy of Siddha treatment and their motivation in using this form of treatment. The issues of gender equality in the access of HIV/AIDS treatment as well as the possible challenges in complementing allopathic and traditional/complementary health sectors in research and policy are also discussed. The article concludes by emphasizing the importance of complementing allopathic treatment with traditional medicine for short‐term symptoms and some opportunistic diseases present among HIV/AIDS patients. Copyright © 2012 John Wiley & Sons, Ltd.     

Children's adjustment in non‐traditional families in Israel: the effect of parental sexual orientation and the number of parents on children's development

Objectives This study examined differences in children's psychological and social indicators in non‐traditional families in Israel, focusing on fatherless families headed by lesbian mothers and single mothers by choice. Although Israel is considered an industrialized westernized country, centrality of the traditional nuclear family predominates this country. Methods This factorial design study included four family types: lesbian and heterosexual mothers, each in both single and coupled parenthood. Children's measures included the Child Behavior Checklist, perception of peer relations and perceived self‐competence. Results Children from single parent as opposed to two‐parent families exhibited more externalizing behaviour problems and aggressiveness. Children of lesbian mothers reported more prosocial behaviours and less loneliness than children from heterosexual families. No differences emerged for perceived self‐competence across family types. Conclusion Mother's sexual orientation did not affect children's adjustment negatively, whereas single parenthood placed children at greater risk for some difficulties. Implications include the need for apprising health professionals of effects of family types on children's development.     

A health-related quality of life measure for use in patients with onychomycosis: a validation study

Onychomycosis is a common nail disorder associated with pain, discomfort and varying degrees of physical impairment and loss of dexterity. Psychological and social limitations result from reactions of others to visible impairment. The goal of this research is to validate a questionnaire to measure the impact of toenail onychomycosis on health-related quality of life (HRQoL). One hundred and fifty onychomycosis patients were enrolled in an observational study at eight sites in the US. Attending physicians reported information on clinical status at enrolment. Patients completed a questionnaire covering HRQoL that included general and disease-specific items measuring the impact of onychomycosis on activities and appearance, plus problems and symptoms associated with toenail infection. The subscales of the instrument showed high internal consistency reliability (range=0.63–0.95). Construct validity reflected the close association of physical functioning scores with onychomycosis impairment. Test–Retest reliability was good to excellent for all scales (ICC=0.52–0.89). Discriminant validity was evidenced by persons who are younger and female reporting worse disease-specific HRQoL. Responsiveness to clinical change was noted for all disease-specific scale scores for improved patients. This instrument has demonstrated reliability, validity and responsiveness for use in observational and clinical studies of toenail onychomycosis patients. Data indicate that onychomycosis patients report significant pain and discomfort reflecting the need for HRQoL measurement.     

注意缺陷多动障碍儿童父母养育方式与自我意识特征研究

【目的】 探讨注意缺陷多动障碍患儿的父母养育方式和自我意识特征,以便更好地促进患儿身心健康发展。 【方法】 采用父母养育方式和儿童自我意识量表对ADHD儿童和正常儿童分别进行评估。 【结果】 ADHD 儿童的父母在理解及温暖的情感养育儿童方面得分明显低于正常组(P<0.05),ADHD儿童父亲更多拒绝和否定患儿,母亲则更多严厉惩罚患儿(P<0.05),差异有统计学意义。而在偏爱、过度保护、干涉方面两组差异无统计学意义(P>0.05)。ADHD患儿行为、智力与学校情况、躯体外貌与属性、合群、幸福满足及总分低于对照组,焦虑分高于对照组。患儿的自我意识水平与父母养育方式中的多个因子相关。 【结论】 ADHD儿童的父母不能理解患儿,不能以温暖的情感养育患儿,更多的采用拒绝和否定,严厉惩罚儿童,同时ADHD患儿的自我意识发展不良,自我评价低。患儿的自我意识低下与父母养育方式不当相关。