Parent and family factors associated with child adjustment to pediatric cancer

OBJECTIVE: To identify factors that influence the association between parent and child distress among families of children with cancer and comparison peers. METHODS: Parent and child distress, social support, and family environment were assessed among families of 95 children with cancer (94 mothers, 67 fathers) and 98 comparison peers (97 mothers, 77 fathers). RESULTS: Significant associations were found between parent and child distress. For models examining the impact of fathers' distress on children, several moderators were identified (i.e., family environment, child age and gender, a cancer diagnosis, and treatment severity). Family environment also partially mediated father and child distress. CONCLUSIONS: Children whose parents were distressed were more likely to be distressed themselves. Subgroups of children were particularly vulnerable, indicating a need to identify further mechanisms of risk and resilience and to develop family-based interventions. Support was found for including fathers as independent sources of information in pediatric psychology research and clinical practice.     

小组健康教育在哮喘患儿及家属中的应用效果

目的探讨分析小组健康教育在哮喘患儿及家属中的应用效果。方法选取本院2010年11月～2013年9月收治的60例哮喘患儿及家属为研究对象,随机分为两组,对照组采用常规护理方法,观察组在此基础上,采用小组健康教育方法,比较两组患儿家属健康教育知识知晓率、患儿住院时间及半年复发次数。结果观察组患儿家属的哮喘诱发因素、发作先兆症状、心理健康教育及哮喘发作处理知晓率均高于对照组,差异有统计学意义（P〈0．05）;观察组患儿的住院时间短于对照组,半年复发次数少于对照组,差异有统计学意义（P〈0．05）。结论小组健康教育应用于哮喘患儿及家属,可提高患儿家属健康教育知识知晓率,缩短患儿住院时间,减少患儿哮喘复发频率,值得临床推广应用。     

Psychosocial Predictors of Anxiety in Nursing Home Staff

Objectives: Although research shows that nursing home staff experience significant levels of stress and burnout, studies analyzing the relationship of psychosocial variables on their feelings of anxiety are scarce. This study aims to analyze the relationship between psychosocial variables and levels of anxiety among staff.

Method: Participants were 101 nursing home professionals. In addition to anxiety, socio-demographic variables, depersonalization, burden, relationship with families of the residents, and guilt about the care offered to the residents were assessed. A hierarchical regression analysis was carried out to analyze the contribution of the assessed variables to staff anxiety levels.

Results: The obtained model explained 57% of the variance in anxious symptomatology. Guilt about the care offered and poor quality of the relationship with residents’ family were associated with anxiety. Further, working at nursing homes where the staff report higher levels of anxiety symptoms, the presence of depersonalization and burden were also associated with anxiety.

Conclusion: The findings suggest that in addition to work-related variables (burden and burnout), problems with family members and guilt about the care offered are relevant variables for understanding staff’s anxious symptomatology.

Clinical Implications: Interventions that address issues of guilt about the quality of care, and problematic relationships with family members of residents, may have potential to reduce staff anxiety and promote their well-being.     

Witchcraft branding and the abuse of African children in the UK: causes,effects and professional intervention

The branding of children as ‘witches’, capable of harming others is a widespread practice in some countries in Africa and across the world. There is evidence of this within specific communities and faith groups; however, the extent to which this phenomenon occurs in England is unclear as is the response by childcare professionals, statutory agencies and Voluntary Organisations. Between 2000 and 2010, at least six children lost their lives in different parts of the UK following periods of abuse, neglect and trauma linked to what is now known as abuse arising from being labelled ‘witches’. Each of these children, died because their parent or carer believed that they were responsible for ill luck, ill fortune and/or ill health that had befallen them and/or members of their families.Drawing upon a children's rights framework, this paper aims to provide a critical examination of child abuse that is caused by a belief that children can and are ‘witches’ or possess some evil spirits, making them capable of causing harm and discord within a family. Existing literature will be interrogated to provide some background and a historical context to this alarming and abusive practice.     

Connecting experiences of community shared responsibility and collective competence to the well-being of adults in military families

Drawing from the social organization theory of action and change, the role of community-capacity elements (shared responsibility and collective competence) for military members' and their civilian spouses' well-being is examined. With data from 266 active-duty military families, military members and their spouses are classified by theory-based community-capacity type. A path analysis examines associations between community types, elements of military context (rank and transitions), and dimensions of well-being (anxiety, depressive symptoms, self-efficacy, life satisfaction). There were few variations in community capacity across rank and transitions. For military members' and their civilian spouses, community types were differentially associated with well-being, particularly in disengaged and synergetic communities. Well-being was generally highest for those in synergistic communities (high shared responsibility and collective competence) and lowest in disengaged communities (low shared responsibility and collective competence). Findings inform intervention and prevention efforts seeking to activate communities as a mechanism for fostering well-being.     

Stability and change in family psychosocial risk over 6 months in pediatric cancer and its association with medical and psychosocial healthcare utilization

Purpose: Family psychosocial risk in pediatric oncology can be assessed using the Psychosocial Assessment Tool (PAT), a brief parent report screener based on the Pediatric Psychosocial Preventative Health Model (PPPHM; universal, targeted, and clinical). However, little is known about risk over the course of treatment and its association with medical and psychosocial healthcare utilization. Methods: Primary caregivers of children with cancer participated in this prospective multisite investigation, completing the PAT at diagnosis (T1; n = 396) and 6 months later (T2; n = 304). Healthcare utilization data were extracted from electronic health records. Results: The distribution of PPPHM risk levels at T1 and T2 was highly consistent for the samples. Two‐thirds of families remained at the same level of risk, 18% decreased and 16% increased risk level. Risk was not related to sociodemographic or treatment variables. The PAT risk score correlated with psychosocial contacts over the 6‐month period. Conclusions: Although the majority of families reported universal (low) risk on the PAT and were stable in their risk level over 6 months, reassessing risk is helpful in identifying those families who report higher level of risk during treatment than at diagnosis. PAT scores were related to psychosocial services that are provided to most but not all families and could be tailored more specifically to match risk and delivery of evidence‐based care.     

Expressions of genes related to genome stability and DNA repair in nasopharyngeal carcinoma clustering families

Objective： The aim of the study was to observe the expressions of genes related to genome stability and DNA repair in the members of nasopharyngeal carcinoma （NPC） clustedng families. Methods： In the Zhongshan City where there is highly incidence rate of NPC, we chose the members of the NPC clustering families as objects, and the patients of nasopharyngitis and NPC as the control group. We isolated the RNA from the nasopharyngeal tissue, and synthesized its cRNA, the genome stability and DNA repair genes chip technique, chemiluminescent detection and real-time fluorescence quantita- tive technique were used to examine the genome stability and DNA repair genes in the nasopharyngeal tissue. Results： More genome stability and DNA repair genes were up-regulated in the members of the NPC clustering families than the NPC patients, and the range of up-regulated was high, with the over up-regulated 100 times genes including TEP1, MSH4, PMS2LI. Fewer genome stability and DNA repair genes were down-regulated in the members of the NPC clustering families than the NPC patients, the ubiquitin genes almost were down-regulated, the results also could be confirmed by real-time fluorescence quantitative PCR. Conclusion： There are specially expression character of genome stability and DNA repair genes in the members of NPC clustering families.     

危重患者家属疾病不确定感与生活质量及不良情绪的相关性分析

目的：对危重患者家属疾病不确定感与生活质量的关系进行研究,为提高患者日常生活质量提供可参考依据。方法选取85例危重患者家属作为研究对象,采用疾病不确定感量表（ MUIS）、中文版健康调查简表（ SF-36）对其疾病不确定感及生活质量进行评估,采用SDS和SAS量表进行不良情绪的评价,分析不确定感与生活质量及不良情绪的相关性。结果患者家属MUIS量表总分、不明确性、复杂性、信息缺乏和不可预测性各维度得分分别为（113．65±11．64）,（41．34±4．56）,（23．65±3．46）,（19．64±2．65）,（15．34±2．56）分。 SF-36量表情感职能和活力维度得分最低,分别为（57．65±8．46）,（53．64±8．65）分;SDS与SAS量表得分分别为（57．65±5．46）,（56．64±5．65）分。 MUIS总分、不明确性、复杂性、信息缺乏维度与生活质量各维度呈负相关（r＝-0．532～-0．324,P＜0．05）,与SDS、SAS呈正相关（r＝0．376～0．574,P＜0．05）;不可预测性与总体健康、情感职能、活力、精神健康呈正相关（r＝0．354～0．441,P＜0．05）,与SDS、SAS呈负相关（r分别为-0．476,-0．489;P＜0．05）。结论危重患者的家属有明显的疾病不确定感及不良情绪,生活质量显著降低,在临床工作中护士要积极与其进行沟通,并给予相应支持,以增强患者家属信心。