Wellbeing among people with dementia and their next of kin over a period of 3 years

Little is known about the dyadic experience over time of people with dementia and their next of kin. The aim of this study was to investigate the state of mind of people with dementia, their next of kin's experience of burden and satisfaction, and factors associated with these experiences over a 3-year period. The sample consisted of 32 people with dementia living at home with family caregivers in the south of Sweden. Data were collected during the period 2004-2007 and consisted of patients self reports (GDS), dementia nurse assessment (MMSE, Berger and ADL) and next-of-kin assessment (patient's state of mind and care provision). Data also consisted of next-of-kin's self reports concerning health, burden and satisfaction. The result showed that patients' state of mind was mainly positive at baseline but a deterioration was seen over time in the patient's mood and cognitive functioning together with an increase in ADL-dependency and suspected depression. Dependency in personal ADL entailed a higher risk of being in a negative state of mind. For next of kin the experience of burden increased while satisfaction decreased over the 3 years. The inter-relationship between the patients' mood and the caregiver's satisfaction and burden seems to get stronger over time. At baseline caregiver burden was mainly related to the next of kins' general health and to patient behaviours that were difficult to handle. During the progression of the disease caregiver satisfaction becomes increasingly related to patient state of mind and dependency. There is, however, a need for more research focusing on the specific inter-relational aspects as previous studies have mainly focused on either the situation for the person with dementia or on the caregiver.     

Development and testing of the Family Caregiving Factors Inventory (FCFI) for home health assessment in Taiwan

Empathy, the ability to perceive and reason, as well as the ability to communicate understanding of the other person's feelings and their attached meanings, is held to be a core characteristic of a helping relationship. This paper examines some of the observations that motivated the authors' interest in how registered nurses learn how to offer empathy to clients. First, while empathy is crucial to all helping relationships, professional helpers do not normally offer much empathy. Second, while nurses are meant to provide helping relationships, they do not tend to show much empathy to clients. The relevance of empathy to clinical nursing and the potential consequences of low-empathy nursing for clients is considered. It will be shown that, in the past, a low level of empathy has been reported among the helping professions, including nursing, indicating that many professional helpers are not as helpful as they ought to be. While most studies of empathy in professional relationships are more than a decade old, more recent studies report similar results.     

Mental health in international adoptees as teenagers and young adults. An epidemiological study

Sweden has now around 38,000 individuals who have been adopted from other countries. Most often they are transracially adopted and have a different appearance from their new parents—"visible " adoptions. This study was made to explore the mental health of a teenager/young adult group that arrived with their families in the southernmost county of Sweden between 1970 and 1977. They were placed through the largest Swedish adoption agency at that time. One hundred and forty-seven families and their 211 adopted children, who were 13 years of age or older at the time of the investigation, were interviewed in their homes. CBCL, SCL-90, a self-esteem questionnaire, and two family relations inventories were also completed. Compared to nonadopted Swedish young persons of the same ages, who had been investigated with the same inventories in earlier epidemiological studies, the adoptees had as good mental health. The adoptees also reported good self-esteem. The pre-adoption conditions were more important than the age of arrival in itself for the risk of later maladaptation. Family relations, various aspects of identity, and peer relations explained much of the variance of mental health and self-esteem. Those who were most engaged in questions about their identity and felt mostly non-Swedish had more behaviour problems. The association, however, between the factor " Identity " and the mental health variables approached zero for the older subjects (18–27 years of age). The majority (about 90%) of the adoptees felt mostly Swedish. Seventy per cent didn't feel any connection to their country of origin.     

Long-term effects of respiratory syncytial virus (RSV) bronchiolitis in infants and young children: a quantitative review

One of the major questions regarding long-term side effects of bronchiolitis by respiratory syncytial virus (RSV) is whether or not it induces asthma in later life. In this quantitative review, the data of 10 controlled studies are analysed. METHODS: Follow-up studies of RSV bronchiolitis published between January 1978 and December 1998 were identified through a MEDLINE search. Studies were selected if (i) postnatal age at the time of the initial illness was below 12 mo, (ii) all children were hospitalized for RSV bronchiolitis, (iii) the diagnosis RSV was virologically confirmed in all cases, and (iv) a control group was used. RESULTS: Six studies met all selection criteria. Up to 5 y of follow-up after RSV bronchiolitis in infancy, 40% of children reported wheezing as compared to only 11% in the control group (p <0.001). Between 5 and 10 y of follow-up 22% of the bronchiolitis group reported wheezing against 10% of the control group (p = 0.19). The incidence of recurrent wheezing as defined by three or more wheezing episodes also decreased with increasing years of follow-up: at 5 or more years of follow-up the difference between the RSV group and the control group was no longer significant. Furthermore, the presence of either a personal and/or a family history of either atopy and/or asthma did not differ between the two groups. CONCLUSIONS: Wheezing is common after RSV bronchiolitis in infancy. It may persist for > or = 5 y of follow-up. However, no significant difference between the RSV bronchiolitis and the control group was observed regarding recurrent wheezing by 5 y of follow-up. No significant difference between the RSV bronchiolitis and the control group were found regarding a personal history of atopy, a family history of atopy and/or asthma. Therefore it seems unlikely that RSV bronchiolitis is a cause of atopic asthma in later life.     

Lipid profiles in Polish adolescents from high- and low-risk families: tracking unfavourable lipid levels over a one-year period

In a country with a high cardiovascular mortality rate, lipid profiles were studied in 929 adolescents (440 from affected and 489 from non-affected families for cardiovascular disease and hypercholesterolaemia). In 334 children with elevated or borderline total cholesterol level, lipid profiles were re-measured after a 1-y period. In boys from affected families, in contrast to boys from non-affected families, significantly higher total cholesterol levels (4.36 +/- 0.81 vs 4.19 +/- 0.78 mmol/L, p < 0.05) and LDL-C level (2.1 +/- 0.72 vs 1.89 +/- 0.79 mmol/L, p < 0.05) and significantly lower HDL-cholesterol levels (1.81 +/- 0.34 vs 1.93 +/- 0.38 mmol/L, p < 0.05) were found. The odds ratio for being in the most unfavourable decile for LDL-cholesterol was significantly higher for girls from affected families (2.17, p = 0.02). A relatively high HDL-C level as well as a favourable TC/HDL-C ratio was demonstrated in all groups, being lowest in boys from affected families. A significant correlation was found between baseline lipids and their values re-measured after 1 y. It is concluded that (1) adolescents with a positive family history are at increased risk for unfavourable lipid profile, (2) adolescents with elevated total cholesterol and LDL-cholesterol levels remain hypercholesterolaemic after a 1-y period and are therefore candidates for further biochemical and clinical monitoring, and (3) children with elevated total cholesterol may not be at high risk for cardiovascular disease owing to the favourable TC/HDL-C ratio. The study results do not indicate that general cholesterol screening in Polish adolescents is necessary, as the proportion of children with elevated LDL-cholesterol is relatively low.     

The influence of childhood atopic dermatitis on health of mothers,and its impact on Asian families

Ho RCM, Giam YC, Ng TP, Mak A, Goh D, Zhang MWB, Cheak A, Van Bever HP. The influence of childhood atopic dermatitis on health of mothers, and its impact on Asian families.
Pediatr Allergy Immunol 2010: 21: 501–507.
© 2010 John Wiley & Sons A/S This study examines maternal perceptions of paediatric atopic dermatitis (AD) on family and determines risk factors including severity of AD, maternal physical and mental health (MH), quality of life of patients and sociodemographics which predict a negative family impact. A cross‐sectional assessment using the Dermatitis Family Impact Questionnaire Scale to assess the impact of AD on family, Infant’s Dermatitis Quality of Life Index (<5‐yrs old) or Children’s Dermatitis Life Quality Index (5–17 yrs old) was used to measure health‐related quality of life (HRQOL) of paediatric patients with AD. A 12‐item Short‐Form Health Survey (SF‐12) was used to assess physical and MH of their mothers. Risk factors of adverse family impact were assessed using multiple regression analysis. One hundred and four patients with AD and their mothers were studied. Their mean ages (±s.d.) were respectively 6.4 ± 4.3 and 37.2 ± 6.6 yrs. In multiple regression analysis, Severity Scoring of Atopic Dermatitis (SCORAD) appeared to be associated with negative family impact and the association remained significant after adjustment for bio‐psycho‐social factors and HRQOL of patients. The association remained insignificant after adjustment for physical and MH of the mothers. Our results show that the severity of paediatric AD leads to negative family impact through reduction of physical and MH of the mothers, and is independent of patients’ HRQOL and sociodemographics. The current approach for managing paediatric AD in Asian society could include early multidisciplinary intervention, aiming at enhancing physical and MH of mothers while minimizing negative impact on family and social isolation. Further research will be welcomed as the results of this study mainly applied to Asian society which could be different to populations from other geographic areas.     

Detailed family history of diabetes identified children at risk of type 2 diabetes: a population‐based case‐control study

Wei J‐N, Li H‐Y, Wang Y‐C, Chuang L‐M, Lin M‐S, Lin C‐H, Sung F‐C. Detailed family history of diabetes identified children at risk of type 2 diabetes: a population‐based case‐control study. Objectives: Recently, the incidence of type 2 diabetes (T2D) in children has increased dramatically. Mass screening is suffering and costly. It remains unknown if a detailed family diabetes mellitus history (FDMH) can identify children with different risks of T2D. This study investigated how FDMH was associated with childhood T2D. Methods: From 1992 to 1997, a nationwide survey conducted in Taiwan for all 3 000 000 school children aged between 6 and 18 yr identified 1966 children with diabetes. For comparison, 1780 children were randomly selected as the control group from all students with normal fasting glycemia (NFG). Telephonic Interviews were conducted using questionnaire for detailed FDMH. In the present analysis, 505 children with T2D and 619 children with NFG were enrolled. Results: Children with more family members having diabetes were more likely to have T2D. Children with the parental FDMH had a higher risk for T2D than children with the grandparental FDMH; the odds ratios (ORs) were 2.61 (95% confidence interval (CI) 1.25–5.48, p < 0.05) for boys and 6.47 (95% CI 2.69–15.6, p < 0.05) for girls, adjusting for age, birth weight, gestational age and body mass index (BMI) z‐score. Children with maternal FDMH had a higher risk for T2D than children with paternal FDMH, and much greater in boys (OR = 29.5, 95% CI 3.67–237, p < 0.05) than in girls (OR = 7.63, 95% CI 2.05–28.4, p < 0.05), adjusted for age, birth weight, gestational age, BMI z‐score, and FDMH in grandparents. Conclusions: Children with parental FDMH, especially the maternal FDMH, have an elevated risk for T2D. Detailed FDMH is a convenient alternative to identify children with different risks of T2D.     

Ethnic differences in relations between family process and child internalizing problems

BACKGROUND: Family process variables have been linked to child problem behavior, but recent research suggests that child ethnicity may moderate relations between family process and child outcomes. The current study examined how ethnicity moderates relations between parent conflict, parent-child relationship quality, and internalizing problems. METHODS: A sample of 101 mother-child dyads was drawn from a larger longitudinal study of childhood-onset depression. Maternal reports of family process factors were used with child reports of anxiety and depressive symptoms. RESULTS: The results indicated a moderating effect of ethnicity for multiple indicators of internalizing symptoms, such that child-rearing disagreement and low levels of mother-child openness were associated with internalizing problems only for European American (not African American) children. CONCLUSIONS: Findings suggest that ethnicity moderates the effects of family process factors on child psychopathology. Ethnic differences may be accounted for by the normativeness of family processes and the meaning that children of different ethnic backgrounds assign to these processes.