Biomarkers of stress in caregivers of children with special health care needs: A protocol for systematic review.

BACKGROUND: Children with Special Health Care Needs (CSHCN) require greater attention from family caregivers as they present temporary or permanent physical, developmental, behavioral, or emotional issues. This demand for care generates overload and stress among family caregivers. So far, there is no study that gathers the available literature regarding the use of biomarkers to assess stress among caregivers of CSHCN. Hence, we aimed to synthetize and to assess the scientific evidence on biomarkers associated with stress in caregivers of CSHCN. METHODS: This systematic review and meta-analysis protocol was elaborated following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). The search strategy will be undertaken through 7 electronic bibliographic databases: Embase, MEDLINE/PubMed, Cochrane Library, Web of Science, CINAHL, Scopus, and PsycINFO. In addition, secondary searches in other sources, such as Clinical trials.gov-NIH, The British Library, Pro Quest Dissertations Database, Google Scholar, and medRXiv will be also carried out. The reference section of the included studies will be hand searched for additional relevant studies. There will be no restriction regarding the publication dates or languages for this systematic review. Moreover, in an independently manner, 2 investigators will select studies, perform data extraction, as well as perform a critical appraisal of the risk of bias and overall quality of the selected studies, based on their designs. The heterogeneity among the studies will be assessed using the I2 statistic test. According to the results of this test, we will verify whether a meta-analysis is feasible. If feasibility is confirmed, a random-effect model analysis will be carried out. For data analysis, the calculation of the pooled effect estimates will consider a 95% CI and alpha will be set in 0.05 using the SPSS version 23.0. RESULTS: This systematic review and meta-analysis will provide better insights regarding the biomarkers associated with stress in caregivers of CSHCN. Hence, consistent data and robust evidence will be provided to help practitioners and decision-makers in this area. CONCLUSIONS: To the best of our knowledge this study, will be the first to synthetize and critically evaluate the scientific evidence on biomarkers associated with stress in caregivers of CSHCN.

Psychometric properties and cross-cultural equivalence of the Arabic Social Capital Scale: instrument development study.

BACKGROUND: Social capital, defined as an investment in relationships that facilitates the exchange of resources, has been identified as a possible protective factor for child health in the context of risk factors such as poverty. Reliable and valid measures of social capital are needed for research and practice, particularly in non-English-speaking populations in developing countries. OBJECTIVES: To evaluate the psychometric properties and cross-cultural equivalence of the Arabic translation of the Social Capital Scale (SCS). DESIGN: Descriptive, cross-sectional study for psychometric testing of a translated tool. SETTING: Two metropolitan health clinics in Alexandria, Egypt. PARTICIPANTS: A convenience sample of 117 Egyptian parents of children with chronic conditions. To be eligible to participate, respondents had to be a parent of child with a chronic health condition between the ages of 1 and 18 years. The sample included primarily biological parents between the ages of 20 and 56 years. METHODS: The 20-item Arabic SCS was administered as part of a written survey that included additional measures on demographic information and parent ratings of the child's overall health. Six items were ultimately removed based on item analysis, and exploratory factor analysis was conducted on the resulting 14-item scale. As a measure of construct validity, hypothesis testing was conducted using an independent samples t-test to determine whether a significant difference exists between mean total social capital scores for two groups of respondents based on the parental rating of the child's overall health. RESULTS: Item and factor analysis yielded preliminary support for a revised, 14-item Arabic SCS with four internally consistent factors. The standardized item alpha reliability coefficient for the total 14-item scale was .75. Respondents who reported that their child was in good health had significantly higher social capital scores than those who rated their child's health as poor. CONCLUSIONS: The 14-item Arabic SCS was found to be reliable and valid in this sample, with four internally consistent factors. While the tool may not be appropriate for comparing social capital between cultural groups, it will enable clinicians and researchers to address an important gap in knowledge characterized by a paucity of research on childhood chronic illness in low- and middle-income countries such as Egypt.

Development and testing of the social capital scale for families of children with special health care needs.

The purpose of this study was to develop and psychometrically test the Social Capital Scale for families of children with special health care needs. Researchers have suggested a link between social capital and health, however, psychometrically tested measures of social capital are not described in the literature. The Social Capital Scale (SCS) demonstrated internal consistency, stability over time, and construct validity (as evaluated through factor analysis, correlation with existing measures, and hypothesis testing). Five subscales provide insight into family strengths and areas for improvement related to their investment in relationships that support health. Use of the SCS will contribute to the establishment of consensus and precision in communication about social capital's utility and measurement in the population of families of children with special health care needs.

A developmental approach to understanding drawings and narratives from children displaced by Hurricane Katrina.

Using art as a process to help children externalize complex feelings can add another layer of assessment in the primary care setting. In the face of trauma, drawing may help children gain symbolic control over events that are confusing and frightening. Through examples of children who were affected by Hurricane Katrina, this article describes the use of drawings and narratives to understand children's experiences related to traumatic displacement. Recommendations include using a developmental lens to understanding children's art, asking children to talk about their drawings, and considering the significance of place for children who have been traumatically displaced.

Health and social context: social capital's utility as a construct for nursing and health promotion.

Social capital is a health-related construct that is a way for pediatric nurse practitioners (PNPs) to conceptualize the interconnectedness between health and social relations. Applying the concept of "social capital" to child and family health has the capacity to help PNPs reframe persistent questions and explore health issues in new and creative ways. A health-enabling environment must be built using a bottom-up approach, with participatory health promotion programs and internally driven community health projects. PNPs must create opportunities for networking and diffusing knowledge about community-related health issues. PNPs also must build their own social capital and practice "vision therapy" to develop new interventions to enhance child and family health.