Effects of Coresidence and Caregiving on Health of Thai Parents of Adult Children with AIDS

Purpose: To explore potential effects on the health of older parents living with and caring for people infected with HIV.
Design: Comparison of health outcomes between affected parents and matched nonaffected parents, and between principal caregivers and nonprincipal caregivers in Thailand.
Methods: Survey data from 394 affected households and 376 nonaffected households; qualitative data from 18 interviews of affected older parents.
Results: A large proportion of older people with HIV-infected children provided time-consuming and strenuous caregiving services to them. Mothers shouldered most of this burden. Mothers who had a child die from AIDS reported lower levels of overall happiness than did others who had not. Mothers and fathers of PHAs (persons with HIV/AIDS) who died reported lower levels of overall happiness compared to 3 years previously (before the time of the death of their child) and compared to parents from households that did not experience an adult child's death. Many parents of children with AIDS experienced anxiety, insomnia, fatigue, muscle strain, and head and stomach aches during the time they cared for their ill children.
Conclusions: Many older people suffered adverse health outcomes related to living with and caring for their children with AIDS. Recommendations indicate a variety of programs that might help such older parents.     

How Parents Maintain Healthy Involvement with Their Adult Children: A Qualitative Study

In a review of 129 adults with developmental disabilities at a day training and habilitation program, 64 of these individuals received continuity of care and services for at least 10 straight years. In a review of these 64 clients, 42% (27) have had no regular family support. 58% (37) of the 64 clients have had some regular family support. Of those 37 clients, 29 of them have had at least one parent providing regular family support. 20 of these 29 parents were selected as interviewees by an administrative board of professionals based on a level of parental success defined by the following criteria: (a) this person is considered to be a caring parent who has maintained an active involvement with the comprehensive services of their adult child; (b) this parent has routinely invested with documented attendance in all three types of interdisciplinary team meetings: conflict resolution, emergency situations, and regular meetings; and (c) professionals such as social workers, psychiatrists, medical physicians, group home coordinators, and day programs view this parent as very reasonable in their approach to their adult child. Results suggest that healthy parents: (a) trust professionals; (b) rebuild trust after trust has been lost; (c) accept the reality of needing help; (d) successfully transition their children; (e) provide passionate advocacy efforts; (f) live a balanced life; (g) have experienced healing from shame; (h) maintain supportive contact; (i) facilitate the support of professionals; (j) allow professionals to be the provider; (k) give and receive support from other parents; and (l) listen, encourage, and learn from providers. Results were compared to interview data from mental health clinicians (van Ingen, Moore, & Fuemmeler Journal of Physical and Developmental Disabilities 20:449–465, 2008) and recommendations for future research are discussed.     

How Children and Parents Evaluate the Headache Centre's Intervention

Background.— While adult headache patients' satisfaction with treatments has been widely investigated, less attention has been paid to children and adolescent headache patients' opinions and their parents' views. Objective.— The aim of our follow‐up survey was to analyze the outcomes of the Headache Centre's intervention and the evolution of headache according to patients until the age of 16 and their parents. Methods.— We studied all outpatients suffering from episodic primary headache according to International Classification of Headache Disorders 2nd edition criteria, seen for the first time in 2005‐2006 at the Headache Centre of the University Hospital of Modena (Italy), and at least one of their parents. The duration of the follow‐up ranged from 1 to 3 years. For the purpose of the study, a specific questionnaire was created and administered by a telephone interview. Results.— We enrolled 84 patients (38 females, 45%; 46 males, 55%; mean age ± SD: 12.9 ± 2.9 years) with primary headache: migraine without aura 66%, episodic tension‐type headache 23%, migraine with aura 11%. At the follow‐up, 70% of the patients reported that headache had improved; frequency had decreased significantly more than severity (P = .000, Fisher's exact test), both in those who had followed a prophylactic treatment and in those who had not. A high percentage of the children and parents could precisely indicate trigger factors for headache: especially excessive worrying and studying. The patients reporting an improvement attributed it to pharmacological prophylactic treatment, but also to other factors: first of all, better school results and more happiness than before. Seventy‐seven percent of the parents thought that the Headache Centre's intervention had helped them to better understand and manage their children's headache. Conclusions.— Children's and adolescents' headache has in most cases a favorable prognosis; the Headache Centre's intervention is considered effective by most parents. We must increase and focus therapeutic efforts addressed to the few patients with worsening headaches in spite of treatment, since these children's/adolescents' headache also is at risk to progress in the adult age.     

Adult Children of Alcoholics

Adult children of alcoholics are increasingly recognized as a population facing greater risk for developing emotional and physical problems. This article describes characteristics of adult children of alcoholics and presents a method for identifying those most at risk. Implications for practice are also discussed.     

Beliefs Held by Parents of Autistic Children

Autism is an unusual disorder that offers varied and complex challenges. Recent shifts in educational and treatment foci have left many parents of autistic children floundering regarding how best to view and interact with their children. Furthermore, it has become clinically evident that these parents often maintain beliefs that may influence parent-child interactions and even the prognoses of the children. To date, no published research exists that examines how parental beliefs may affect autistic children. The author's purpose is to identify several common beliefs held by parents of autistic children and discuss implications for clinical practice and research.     

儿科ICU患儿家长的需求及其影响因素

目的分析儿科重症监护室(intensive care unit,ICU)患儿家长的需求现状,探讨其影响因素。方法便利抽样法选取2015年6-10月在长春市某三级甲等医院儿科ICU住院患儿的家长100名为研究对象,应用一般资料调查表、中文版重危患者家属需求量表对其进行问卷调查。结果儿科ICU患儿家长总体需求得分为(138.34±16.96)分,儿童重症监护室(pediatric intensive care unit,PICU)与新生儿重症监护室(neonatel intensive care unit,NICU)患儿家长一致认为保证患儿的病情是最重要的需求;文化程度、家庭月收入及患儿是否早产是儿科ICU患儿家长需求的影响因素,可解释患儿家长需求得分29.0%的变异量。结论儿科ICU患儿家长的需求总体处于较高水平,护理人员应根据不同影响因素给予针对性的健康指导,尽可能满足患儿家长的需求。     

Helping Children of Aged Parents Achieve Filial Maturity

Clinical nurse specialists working for a county nursing home made preadmission home visits as one of their functions to determine individuals in need of placement. The elderly were prioritized with the use of a rating scale according to their need for 24-hour nursing care. These home visits helped to identify certain problems in the aged. It was evident that the identification and possible resolution of some of these problems depended on the accomplishment of the developmental task of filial maturity on the part of the children, or on the children understanding that they can no longer depend on their parents but, rather, that their parents may need them (Blenkner, 1965). This article suggests that nurses working in the community should assess the elderly's middle-aged children for their level of filial maturity. It is also suggested that the accomplishment of this developmental task can clearly help families identify the appropriateness of nursing home placement or life in the community with support from area resources.     

Genetic Knowledge of Parents and Children With Inherited Cardiac Syndromes

Although genetic knowledge related to sudden arrhythmia death syndromes (SADS) has enhanced risk prediction and treatment, it is challenging to assess genetic literacy of individual patients and families. To address this, participants attending the 2015 SADS conference were asked to complete a survey measuring general knowledge of genes and heredity. Correct responses averaged 85 ± 9% with correct responses of ≥ 80% for 17 of 21 questions. However, attitudes toward genetic testing varied markedly. These results suggest that understanding motivations or disincentives to pursue genetic testing is as important as enhancing genetic knowledge for providing effective treatments for SADS.     

糖尿病患儿家长焦虑状况的调查

目的了解糖尿病患儿家长的焦虑状况,为采取针对性的干预措施提供依据。方法便利抽样法选择2009年2月至2011年2月第二军医大学长征医院内分泌科收治的34例糖尿病患儿的家长(父母双方共68名)为研究对象,采用Zung氏焦虑自评量表(self-rating anxiety scale,SAS)对其进行调查。结果糖尿病患儿家长的SAS评分为(48.52±1.31)分,高于国内常模的(29.78±0.46)分(t=11.715,P0.01);糖尿病患儿家长、父亲及母亲的SAS评分分别为(48.52±1.31)、(46.63±1.78)、(50.41±1.19)分,差异有统计学意义(F=4.213,P0.01);除对工作有无影响外,不同年龄、职业、文化程度、居住地及家庭年收入的糖尿病患儿家长的SAS评分差异均有统计学意义(P0.05或P0.01)。结论糖尿病患儿家长的焦虑水平相对较高,护理工作者应考虑糖尿病患儿家长焦虑状况的影响因素,对重点人群予以关注;同时采取针对性、个性化的干预措施,缓解患儿家长的焦虑情绪,促进糖尿病患儿生活质量的提高。     

患儿家长参与患儿安全体验的访谈研究

目的 了解患儿家长参与患儿安全的体验,分析其原因并提出应对策略.方法 采用目的抽样方法,对某三级甲等儿童医院的16名住院患儿家长通过焦点人群座谈会形式,进行半结构访谈,并对访谈的内容进行分析整理,提炼主题.结果 被访谈的16名家长参与患儿安全的意愿强烈;16名家长表示非常愿意主动询问医护人员患儿的疾病诊疗问题,14名家长表示很愿意向医护人员提供患儿详尽的病史资料;16名家长提出尤其关注患儿的用药疗效、 手术效果及疾病转归情况;7名外科住院患儿家长认为医护人员掌握了较多的医疗资源,手术相关决策完全依赖于医护人员.结论 建议对家长开展患儿安全教育,指导家长参与患儿治疗过程中的核对程序,提高家长对患儿诊疗过程中告知内容的理解,实现医患双方共同参与医疗决策,从而更好地保障患儿安全.     

The Development of Trust in Parents of Hospitalized Children

ISSUES AND PURPOSE The purpose of this study was to investigate the development of trust in parents of hospitalized children. METHODS Using grounded theory, semistructured interviews were conducted with 15 parents of children previously hospitalized, focusing on parents' experiences during their child's hospitalization. Data were analyzed using a constant comparative process. Themes and the core variable were identified and a model of trust developed. RESULTS The core variable related to the development of trust in healthcare providers was whether parents' expectations for care were met. Thematic areas that influenced whether expectations for care were met included preexisting trust; evaluation of care, including evaluation of technical skills and the meeting of parental and child needs; and behaviors of nurses and other healthcare providers that inhibited and fostered trust. PRACTICE IMPLICATIONS Strategies to enhance trust are discussed.     

癫痫患儿家长抑郁水平及相关因素的调查分析

目的了解癫痫患儿家长抑郁水平以及相关的影响因素,为其有效的减轻心理负担提供依据.方法对48例确诊癫痫的患儿家长进行问卷调查,问卷包括自设相关因素调查问卷和流调中心用抑郁量表两部分.结果癫痫患儿家长抑郁量表得分为(29.37±9.04),超过16分的67.2%,抑郁程度与父母的文化程度及癫痫知识掌握程度成负相关,与患儿癫痫的类型和发作频率等无关.结论癫痫患儿家长的抑郁水平较高,心理负担较重,对癫痫知识掌握不足,急需得到更多的疾病知识和心理支持.     

Separation of Parents Raising Children with Autism Spectrum Disorders

We examined the occurrence and timing of separation of parents raising children with Autism Spectrum Disorders followed over a 10-year period (n?=?119). We also compared the clinical characteristics of children and sociodemographic variables between parents who remained as a couple versus parents who separated. The results showed that after 10 years of follow-up 74.8 % of the couples remained together (n?=?89), representing a separation rate of 25.2 %. This rate remained stable over the study period. There was no significant difference in any of the clinical and sociodemographic variables between comparison groups. Our results suggest that raising a child with autism does not often lead to the dissolution of the parents’ relationship, as is commonly believed. The occurrence of parental separation in children with Autism Spectrum Disorders does not appear to vary according to their stage of life (childhood or adolescence). Lastly, the clinical profile of children and sociodemographic variables do not seem to influence the relationship status of parents.     

Teaching Parents of Children with Autism to Evaluate Interventions

Children with autism are participating in a variety of interventions that are believed to be effective by their parents; however, a majority of these interventions are not empirically supported. In this study, we assessed the efficacy of a parent education program to teach parents of children with autism to evaluate their child’s interventions. Parents’ acquisition, generalization, and maintenance of evaluation behaviors were examined. Additionally, we looked at parents’ understanding of information regarding evaluating interventions and decision-making patterns regarding treatments in comparison to controls. A multiple baseline design across parent participants was used to assess parents’ evaluation skills. After completion of a parent education program, parents increased in their evaluative behaviors relative to individual baseline measures. In addition, parents in the experimental group increased their understanding of information regarding evaluating interventions and empirically based decisions regarding treatments in comparison to controls.     

癫痫患儿家长抑郁水平及相关因素的调查分析

目的　了解癫痫患儿家长抑郁水平以及相关的影响因素 ,为其有效的减轻心理负担提供依据。方法　对 4 8例确诊癫痫的患儿家长进行问卷调查 ,问卷包括自设相关因素调查问卷和流调中心用抑郁量表两部分。结果　癫痫患儿家长抑郁量表得分为 (2 9.37± 9.0 4 ) ,超过 16分的 6 7.2 % ,抑郁程度与父母的文化程度及癫痫知识掌握程度成负相关 ,与患儿癫痫的类型和发作频率等无关。结论　癫痫患儿家长的抑郁水平较高 ,心理负担较重 ,对癫痫知识掌握不足 ,急需得到更多的疾病知识和心理支持