Paternal adverse childhood experiences are associated with a low risk of atopy in the offspring.

AIM: Parental adverse childhood experiences (ACE) might affect the offspring health through intergenerational inheritance. The aim of this study was to investigate how paternal ACE associate with offspring sensitisation and allergic rhinitis (AR). METHODS: The study included 590 Finnish father-child dyads from the FinnBrain Birth Cohort Study. Outcomes were offspring sensitisation against allergens and AR at age 5.5 years. Paternal ACE up to 18 years were assessed using the Trauma and Distress Scale (TADS) with the lowest quarter as the reference group. RESULTS: Of the children, 317 (54%) were males. Sensitisation occurred in 162/533 (30%) and AR in 122/590 (21%). Paternal TADS (median 17 points; interquartile range 11-27) was inversely associated with the risk of sensitisation. Children whose fathers scored the highest quarter had the lowest risk of sensitisation (adjusted odds ratio 0.42; 95% confidence interval 0.24-0.75), followed by those in the second highest quarter (0.58; 0.34-0.99). The association between the highest quarter and reduced risk of AR was similar. CONCLUSION: Paternal ACE were associated with a low risk of offspring sensitisation and AR, suggesting paternal childhood stress might influence immune responses in their offspring.

Nurses on shacking ground-A qualitative study of Danish dermatology and allergology nurses' experiences of relocation during the COVID-19 pandemic.

AIM: To investigate dermatology and allergology nurses' experiences of relocation from an outpatient clinic to a newly established COVID-19 infectious disease ward. DESIGN: A phenomenological-hermeneutical approach was applied. METHODS: Three focus groups with nurses were conducted from June to August 2020. Data were analysed in accordance with Ricoeur's theory of interpretation. RESULTS: The relocation represented a challenging period that involved uncertainty and evoked feelings of excitement and dedication towards the nursing profession. Nurses felt obligated to help; however, they also experienced that they did not have a say in the relocation. The placement on the infectious disease ward was characterized by adaptations in three areas: unfamiliar working environment, unfamiliar team competencies and inadequate nursing training. E-learning training was experienced as insufficient, as it did not enhance the nurses' specific competencies or confidence in caring for patients with COVID-19. CONCLUSION: The relocation of nurses from an outpatient clinic to a new COVID-19 infectious disease ward created a dilemma between nurses' sense of duty and their right to self-determination. A prompt relocation into a newly established unfamiliar field caused frustrations because there were no unspoken rules to rely on. Managers should take nurses' experiences and perceptions under careful consideration and strive for more involvement in future scenarios. PATIENT OR PUBLIC CONTRIBUTIONS: No patient or public contribution.

Parental Identity and Lived Experiences when Parenting a LGBTQIA+2 Child: A Critical Narrative Synthesis of Current Evidence.

PURPOSE: Most LGBTQIA + 2 studies focus on the core sexually and gender diverse population without exploring the peripheral familial perspectives. Current research needs to explore parental experiences of parenting a LGBTQIA+2 child, since parents undergo an identity change after their child's disclosure. This parental identity change may affect parental well-being and add to the existing stress of parenting a LGBTQIA + 2 child. METHODS: This paper uses the identity process theory (IPT) to review 18 studies on parental narratives to highlight the change in parental identity. Databases were searched for first-hand parenting experiences and shortlisted articles were qualitatively synthesized. FINDINGS: We identified six main themes: I) Parental identity change is triggered by a child's disclosure. II) Parental identity change drives parental emotions that evolve from initial anger, shock, fear, concern, grief, etc. to eventual acceptance of their child. III) Parental identity and emotions change, as for any life change process, across assimilation, accommodation, adjustment, and evaluation phases of the IPT. IV) Parental identity change is motivated by continuity, coherence, self-efficacy, belongingness, distinctiveness, meaning and self-esteem principles of the IPT. V) Parental identity influences parental micro-individual, meso-interactional and macro-societal interactions of the IPT framework. VI) Parental mental well-being may be affected across the assimilation, accommodation, adjustment phases of the IPT before eventual acceptance of the child in the evaluation phase. CONCLUSIONS: Parental lived experiences require a stronger consideration today within the wider, non-white, contexts. The effect of identity change on parental mental well-being and its intergenerational effect needs to be explored within the context of the IPT. Parental narratives will contribute towards creating appropriate counselling toolkits and interventions for health care providers and parents of LGBTQIA + 2 children.

Women and opioid use disorder treatment: A scoping review of experiences, use of patient-reported experience measures, and integration of person-centred care principles.

BACKGROUND: Patient-reported experience measures (PREMs) are an important aspect of assessing and improving women's experiences of person-centred care during treatment for Opioid Use Disorder (OUD). This scoping review aimed to 1) examine the extent, type, and characteristics of evidence regarding women's OUD treatment experiences, and 2) describe the extent to which PREMs and person-centred care principles are incorporated within research methods. METHODS: Following Joanna Briggs Institute guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), we conducted a scoping review to identify peer-reviewed articles on women's OUD treatment experiences. Data were extracted from 39 included studies and synthesised based on study design, method of assessment/analysis (including use of PREMs), key findings, and the integration of person-centred care principles. RESULTS: Analysis of included studies revealed a predominance of qualitative research focused on women's experiences of pharmacological OUD treatment (methadone and/or buprenorphine) in Western countries. Women in these studies reported predominantly negative or mixed experiences of treatment. Few studies used validated PREMs and there was a lack of direct assessment or focus on recognised person-centred care principles. However, common categories of outcomes/findings identified in results across studies broadly aligned with person-centred care principles (e.g., fast access to reliable healthcare, effective treatment by trusted professionals), emphasising their applicability to women's experiences of treatment. CONCLUSIONS: Although there has been an increased focus on women's experiences of treatment for OUD in recent years, results highlighted room for improvement regarding the systematic and comprehensive assessment of women's experiences across different contexts. Given the often negative or mixed experiences reported by women, an increased focus on assessing service provision through a person-centred care lens (including utilising PREMs) may allow for service improvements or adaptations targeted towards the needs and experiences of women.

Associations between positive childhood experiences (PCEs), discrimination, and internalizing/externalizing in pre-adolescents.

OBJECTIVES: This study aimed to investigate the relationships between four types of perceived discrimination (based on race/ethnicity, nationality/country of origin, gender identity, weight/body size), individually and cumulatively; positive childhood experiences (PCEs); and behavioral symptoms among pre-adolescent youth. METHODS: This study was a secondary analysis of data from the Adolescent Brain Cognitive Development (ABCD) Study, a US-based cohort study of pre-adolescent youth in the United States (N=10915). Our outcome was emotional/behavioral symptoms measured by the Child Behavior Checklist. Primary exposures were four types of discrimination, a count of 0-5 PCEs, and other adverse childhood experiences (ACEs). Multiple logistic regression models were used to estimate the relationship between perceived discrimination and clinical-range behavioral symptoms, including the role of PCEs and ACEs. RESULTS: Weight discrimination was the most frequent exposure (n=643, 5.9%). Race and weight perceived discrimination were associated with clinical-range externalizing and internalizing symptoms, respectively, but these associations were nonsignificant once other ACEs were added to models. Cumulative discrimination was associated with clinical-range CBCL scores, even when accounting for other ACEs (aOR=1.47, 95% CI=1.2-1.8). PCEs slightly reduced the strength of this relationship and were independently associated with reduced symptoms (aOR=0.82, 95% CI= 0.72-0.93). CONCLUSIONS: Results of this national study suggest cumulative discrimination can exert emotional/behavioral health harm among youth. PCEs were independently associated with reduced behavioral symptoms. There is a need for further research on how to prevent discrimination and bolster PCEs by targeting upstream social inequities in communities.

Patient-Provider Trust as a Key Component of Prenatal Screening for Adverse Childhood Experiences (ACES): A Concept Analysis.

INTRODUCTION: The concept of patient-provider trust in prenatal adverse childhood experiences (ACEs) screening remains unexplored. This concept analysis illuminates the role of trust in prenatal ACE screening to improve patient-provider relationships, increase patient uptake of ACE screening, and ensure that ACE screening is implemented in a strengths-based, trauma-informed way. METHODS: A concept analysis was conducted using the Rodgers' evolutionary method to define the antecedents, attributes, and consequences of this construct. The databases searched were PubMed, PsychInfo, and Scopus between 2010 and 2021. A total of 389 articles were retrieved using the search terms prenatal, adverse childhood experiences screening, adverse childhood experiences, and adverse childhood experiences questionnaire. Included articles for detailed review contained prenatal screening, trauma screening (ACE or other), trust or building trust between patient and health care provider, patient engagement, and shared decision making. Excluded articles were those not in the context of prenatal care and that were exclusively about screening with no discussion about the patient-provider relationship or patient perspectives. A total of 32 articles were reviewed for this concept analysis. RESULTS: We define trust in prenatal ACE screening as a network of evidence-based attributes that include the timing of the screening, patient familiarity with the health care provider, cultural competence, demystifying trauma, open dialogue between the patient and health care provider, and patient comfort and respect. DISCUSSION: This concept analysis elucidates the importance of ACE screening and provides suggestions for establishing trust in the context of prenatal ACE screening. Results give insight and general guidance for health care providers looking to implement ACE screening in a trauma-informed way. Further research is needed to evaluate pregnant patients' attitudes toward ACE screening and how a health care provider's trauma history might influence their care. More inquiry is needed to understand the racial, ethnic, and cultural barriers to ACE screening.

The Role of Adverse Childhood Experience in the Relationship Between Autism Severity and Early Intervention and Special Education Plan.

The purpose of this study is to examine the association between autism spectrum disorder (ASD) severity and having a special education or early intervention plan and the impact of adverse childhood experiences (ACEs) on this association. This study used the 2020-2021 National Survey of Children's Health (NSCH) and included 2,537 children aged 3-17 years old who currently have ASD. Multivariable logistic regression, controlling for demographic and family characteristics and health status, was used to explore the association between autism severity and having an early intervention plan. The analysis was stratified by the number of ACEs to explore their role in the association. Children with moderate or severe ASD were more likely to have a special education or early intervention plan than those with mild ASD in the crude and adjusted models. This association continued to be true for children who experienced 1 ACE (aOR: 2.28, 95%CI: 1.09-4.77) but not true for those who experienced no ACEs (aOR: 1.16, 95%CI: 0.70-1.94) and 2 or more ACEs (aOR: 1.84, 95%CI: 0.92-3.69). Results demonstrate that children with moderate or severe autism were more likely to receive early intervention or special education. This association changed depending on the number of ACEs experiences.

Qualitative exploration of home life experiences and care needs among elderly patients with temporary intestinal stomas.

BACKGROUND: This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs. Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer. However, the ileostomy is susceptible to peri-stoma skin complications, as well as fluid, electrolyte, and nutritional imbalances, posing challenges to effective management. The successful self-management of patients is intricately linked to their adjustment to temporary colostomy; nonetheless, there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront. AIM: To investigate the lived experiences, perceptions, and care requirements of temporary colostomy patients within their home environment, with the ultimate goal of formulating a standardized management protocol. METHODS: Over the period of June to August 2023, a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai, China. Employing a phenomenological research approach, a semi-structured interview guide was developed, and qualitative interviews were conducted using in-depth interview techniques. The acquired data underwent coding, analysis, organization, and summarization following Colaizzi's seven-step method. RESULTS: The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes: Firstly, Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression; secondly, patients exhibit limited self-care capabilities and face information deficits, resulting in heightened reliance on healthcare professionals; thirdly, patients demonstrate the potential for internal motivation through proactive self-adjustment; and finally, patients express a significant need for emotional and social support. CONCLUSION: Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens, inadequate self-care abilities, informational deficits, and emotional needs. Identifying factors influencing patients' self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.

Perception of novice nurses in an emergency box: A qualitative approach to their experiences and needs.

BACKGROUND: Nurses play an essential role in the care of emergency hospital patients, being the ones who have the most contact with the patient and the first to be able to detect their imminent deterioration. However, the literature shows the impact that this can have in terms of stress and insecurity among new nurses, with the consequent risk of resignation in the institution and in their learning process. AIMS: To explore the process of incorporation of new nurses in the emergency room, as well as to identify and understand their emotions, difficulties, needs and proposals for improvement. METHODS: Qualitative research aimed at emergency room nurses in a tertiary level university hospital in Catalonia, between April 2022 and March 2023. Twelve semi-structured interviews were conducted with content analysis. RESULTS: Four categories emerged: identification of deficiencies, emotional dimension, competencies of the expert nursing professional, and needs and proposals for improvement, as main themes. CONCLUSIONS: Insufficient training and deficit of interdisciplinary communication skills appear as main stressors. The analysis of the results suggests the need to create an intervention program that protects the mental and emotional health of new nurses and ensures the integrity of their patients. Innovative and multimodal training adapted to generational change is called for, with virtual, immersive, and contextualized simulation scenarios, together with the implementation of tools such as debriefing and nursing clinical sessions.

Turning Points in Professional Commitment Development: The Case of Novice Nurses.

We investigated the development of professional commitment over time and its relation to work experiences of novice nurses. We used a longitudinal mixed-method approach based on weekly reported quantitative commitment scores and qualitative descriptions of experiences. Specifically, we examined turning points in commitment trajectories and analyzed qualitative characteristics of the turning point. To determine a turning point, we firstly computed a smoothed trajectory for each individual and defined each point beyond the 95% interval of this smoothed trajectory as exceptional. Secondly, we explored whether the commitment development changed after an exceptional point with regard to the slope-valence or commitment strength. The sample consisted of 18 novice nurses. Two third of them revealed at least one turning point, thus the professional commitment development of novice nurses was characterized by peaks and dips that were followed by changes in the commitment development. The analysis showed that turning points followed by positive commitment development typically were characterized by positive experiences. These experiences often concerned relatedness or competence. Turning points followed by a negative development were not consistent: they could be positive, negative, or ambiguous experiences. Many of the negative experiences concerned negative organizational issues. We concluded that there is not a simple relation between commitment development and positive or negative characteristics of an experience. The context and underlying meaning of the experiences should be taken into account to interpret the commitment changes.

Family resilience mediates exposure to adverse childhood experiences on insufficient sleep among children: findings from a population-based study.

Background: Sleep plays a vital role in the well-being of children and adolescents. Researchers have identified adverse childhood experiences (ACEs) as an important factor associated with poor sleep among adolescents. The objective of this study was to examine the mediating role of family resilience on the association between ACEs and insufficient sleep among adolescents in the United States. Methods: Data for this study came from the 2018-2019 National Survey of Children's Health (N = 28,097). The outcome variable in this study was insufficient sleep, and the main explanatory variable was exposure to ACEs. The mediating variable was family resilience. Data were analyzed using binary logistic regression. Results: Based on parent reports, one in five (22.4%) adolescents did not meet the recommended sleep hours on an average night. About half of the adolescents had no ACEs, 24.2% had one ACE, and 14.6% had three or more ACEs. Controlling for the effect of other factors and family resilience, the odds of having insufficient sleep were 1.63 times higher for children exposed to three or more ACEs (AOR = 1.63, 95% CI = 1.30-2.05). Family resilience partially mediates the association between exposure to ACEs and insufficient sleep. Each additional increase in family resilience decreased the odds of having insufficient sleep by a factor of 12% (AOR = 0.88, 95% CI = 0.86-0.91). Conclusions: Family resilience partially mediated exposure to ACEs on insufficient sleep. There are modifiable factors that may improve sleep outcomes among adolescents who have been exposed to adversity. Future research can help elucidate findings and establish the directionality of this association.

Experiences of the Parents of Children Admitted to PICU.

Introduction: A pediatric intensive care unit (PICU) is a highly technological and fast-paced setting in a hospital. Objective: To explore the experiences of the parents in the critical care area of a selected tertiary care facility. Materials and methods: In a qualitative study, we interviewed 10 purposively selected parents of the children admitted to PICU using a pre-validated in-depth interview schedule. All parents, whose children were admitted to PICU for more than 5 days, who understood Hindi or English and were willing to participate in the study, were enrolled in the study. Parents of critically ill children having readmission to PICU or prolonged stay of more than 15 days and not accompanied by parents were excluded. Results: Parents had unmet needs, such as the need for information, counseling and education from the healthcare team (HCT) members, having trusting relationship with the HCT, and expecting receiving orientation of the routines and the protocols of PICU, and empathy from the various levels of PICU team. The majority of subjects expressed the desire to talk to a dedicated person for their queries. The parents had multiple feelings of distress, hopelessness, helplessness, guilt, and the fear of losing the child and used various coping strategies. Conclusion: Parents of critically ill children in the PICU have unmet needs. Healthcare team members should take initiative in relieving parental distress and improving their coping abilities. How to cite this article: Kichu S, Joshi P, Bhandari S, Lodha R, Jaykrishnan K. Experiences of the Parents of Children Admitted to PICU. Indian J Crit Care Med 2024;28(7):696-701.

Trauma-informed training as a means of stabilizing the negative impact of stressful and destructive factors of war on the inner world of future specialists.

OBJECTIVE: Aim: To determine the conditions for the implementation of trauma-informed training as a means of stabilizing the negative impact of stressful and destructive factors of war on the inner world of future specialists. PATIENTS AND METHODS: Materials and Methods: 1,100 students studying in the conditions of martial law took part in the experimental work. RESULTS: Results: As a result of the negative impact of the stressful and destructive factors of the war on the inner world, the future specialists the following manifestations of the deterioration of the health were established: depression (99%), sudden change of mood (92%), worsening of well-being during sudden changes in the weather (66%), irritability (52%), aggressiveness (11%), anger (7%). It was found that future specialists wanted to postpone completing the educational task until later, as they perceived it as very difficult (79%). CONCLUSION: Conclusions: The conditions for the implementation of trauma-informed studying were formulated as a means of stabilizing the negative impact of stressful and destructive factors of war on the inner world of future specialists. 1. During the organization of learning, teachers take into account the fact that psycho-traumas, which are caused by stressful and destructive factors of war, disturb students until they experience them. 2. Teachers take into account the traumatic experience of future specialists. 3. The teachers' actions aim to restore future professionals' sense of security, reestablish contact with other study participants, and regain control over their own lives and studies.

Women's Experiences Following Peripartum Hysterectomy: A Qualitative Study.

Objective: Peripartum hysterectomy is a major operation and is inevitably performed where certain indications require removal of the uterus at the time of delivery or in the immediate postpartum period. It is a traumatic birth event that affects women's physical, physiological, psychological, social, and sexual health. This study aimed to explore the lived experiences of women undergone peripartum hysterectomy. Materials and methods: Qualitative phenomenological design was adopted to explore the lived experiences of women undergone peripartum hysterectomy. Purposive sampling technique was adopted to enroll the participants and 19 women were interviewed before saturation of responses was reached. All interviews were audio recorded and then transcribed into verbatims. Colaizzi's thematic analysis method was used to analyze the data. Results: Based on participants' verbatims eight major themes emerged: Awareness status regarding peripartum hysterectomy; Body's response to peripartum hysterectomy; Perceived need of support; Facilitators in overcoming post-hysterectomy challenges; Relational turbulence; financial burden; Perceived psychological adaptation; Disturbed body image and low self-esteem. Conclusion: Derived themes in the present study highlighted the multidimensional effects of peripartum hysterectomy. Peripartum hysterectomy affected physical, psychological, sexual and financial health of the women. Increased dependence and changes in the self concept are the other problems faced by peripartum hysterectomy women. Need based individualized psychological therapeutic interventions will facilitate the successful adaptation to the traumatic situation by the reinforcement of positive coping mechanisms.

Life is better but not without challenges: experiences following discharge from community-based residential mental health rehabilitation-a qualitative content analysis.

PURPOSE: Community-based residential mental health rehabilitation units for people experiencing severe and persistent mental illness are increasingly available in Australia. Research completed 20 years ago suggested that people leaving these services often experienced impoverished social lives and other challenges in the community. It is unclear whether contemporary consumers experience similar difficulties. This qualitative study explored contemporary consumers' experiences after leaving community-based residential services. METHODS: An inductive qualitative content analysis of individual interviews was completed with consumers 12-18 months following discharge from three community care units (CCUs) in Queensland, Australia. The interview schedule explored three questions: (1) What does life look like after leaving the CCU, (2) Has the CCU impacted their life, and (3) How could the CCU experience be improved? A convenience sample was used, with sampling continuing until thematic saturation was achieved. A member of the research team who had relevant lived experience actively supported the analysis and interpretation. RESULTS: Seventeen interviews were completed. Three themes were identified: 'life is better but not without challenges', 'the CCU helps you get ready to go out into the world', and 'strict rules are important but rigid expectations can be hard; things could be better'. CONCLUSION: Consumers reflected positively on their lives post-discharge from a community-based residential rehabilitation unit and viewed the service as having supported improvements in their lives. The findings suggest the appropriateness of optimism about the possibility of sustained improvements in quality of life after leaving community-based transitional residential rehabilitation support.

Patient attitudes and experiences towards exercise during oncological treatment. A qualitative systematic review.

PURPOSE: Exercise and physical activity (PA) during oncological treatment have many benefits. However, PA levels and adherence are often low. This systematic review of qualitative literature aims to explore the experience and the perceived barriers and facilitators to exercise and physical activity during treatment. METHODS: A systematic search of the published literature was carried out in the Embase and Medline databases; full details for the protocol can be found in the Prospero database (CRD42022371206). Studies eligible for inclusion were qualitative and included participants that were either currently undergoing oncological treatment or had finished treatment within the last 6 months. The findings from each study were tabulated and synthesised into analytical themes. RESULTS: Eighteen full texts from 309 studies met inclusion criteria with a total of 420 participants including both curative and palliative treatment intents. Four overarching themes were generated: (1) Facilitators; (2) Barriers; (3) Experience of PA/exercise and (4) Transforming attitudes. Sub-themes that showed perceptions of PA or exercise during treatment were positive, and seeing personal positive change was highly motivating, especially in a group class setting. Barriers included lack of support or guidance from healthcare professionals (HCPs), environmental challenges and disease burden/fear or worsening symptoms. CONCLUSIONS: Despite having positive perceptions of exercise and PA during oncological treatment, there are significant barriers impacting participation. Lack of support from HCPs and fear of worsening symptoms were significant barriers. Future research should focus on impacting these barriers to ultimately improve PA and exercise levels in those undergoing oncological treatment.

Multisensory Food Experiences in Northern Norway: An Exploratory Study.

Intrinsic and extrinsic sensory elements influence our food experiences. However, most research on extrinsic multisensory aspects of food has centered on WEIRD (White, Educated, Industrialized, Rich, and Democratic) urban participants. This study breaks from this trend by investigating multisensory food experiences in the context of Northern Norway, a region characterized by distinct seasonal shifts, harsh arctic weather, unique atmospheric phenomena (e.g., the midnight sun and northern lights), limited food growth opportunities, and a rich Sámi cultural heritage. Our aim was to unravel the formation and development of multisensory food experiences within a culturally and environmentally specific framework. Our exploratory research used participant observation and interviews, involving four researchers from diverse backgrounds who closely examined multisensory food experiences within four Northern Norwegian food-related tourism businesses, all infused with Sámi cultural elements. Our findings suggest four major themes: (1) Experience elements, involving elements associated with plants, animals, and inanimate objects; (2) Bipolar concepts, which refer to opposing dimensions where experience elements varied, notably in the interplay between Sámi and Norwegian traditions; (3) Sensory stories, which highlight the narratives, enriching the eating experience with context, such as tales of dining under the captivating northern lights; and (4) Values, which indicate guiding principles shaping these experiences on a broader scale, emphasizing support for local traditions and culture. Our main contribution is the presentation of a new contextual framework of multisensory food experiences, which can be applicable to studying food experiences in other contexts.

Caring by default: experiences of caregivers of children with developmental disabilities in Ghana mirrored in the context of the stress process model.

BACKGROUND: Caring for a child with developmental disabilities (DD) is associated with significant stress and burden. Caregivers' experiences are influenced by factors such as poverty, stigma, and the lack of accessibility to services, equipment, and assistive devices. These factors are prevalent in a low-resource setting like Ghana which ultimately influences the experiences of caregivers. The aim of the study was to explore the experiences of caregivers of children with DD in the context of the Stress Process Model. METHODS: The study employed a descriptive phenomenological design Caregivers of children with DD attending the Neurodevelopmental Clinic of a Teaching Hospital were purposively sampled. Data collection involved semi-structured interviews, reaching saturation with 14 participants. The interviews were audio-recorded transcribed verbatim and analysed using thematic analysis. RESULTS: Four main themes emerged: perception of caregiving, stressors faced by caregivers, negative health outcomes and coping strategies. Perception of caregiving had two sub-themes as stressful nature of caregiving and time-consuming. Six sub-themes were linked to stressors faced by caregivers: the child's ADL needs, communication barrier, managing challenging behaviour, child's health needs, unmet educational needs, and economic burden. Negative health outcomes had three sub-themes: decline in physical, mental and social well-being. While some caregivers used maladaptive coping strategies like blaming, others employed adaptive coping strategies like religious coping through prayer, self-encouragement and support from other family members. CONCLUSION: The study highlights the complex interaction between caregivers' perception of their caregiving situation, the stressors they experience, their coping resources,  and the negative health outcomes associated with caregiving. These findings underscore the need for context-specific caregiver programmes to mitigate the negative impacts of caregiving.

Identifying Protective and Risk Factors for Non-Suicidal Self-Injury Among Young Adults in Korea: Insights From Problem Behaviour Theory.

This study aimed to identify protective and risk factors related to non-suicidal self-injury (NSSI) behaviour among young adults in their 20s in Korea, providing an integrated perspective based on the Problem Behaviour Theory (PBT). The subjects were 650 young people in their 20s recruited through the promotion of mental health welfare centres in Seoul, Gyeonggi-do and Jeju-si in Korea. A self-report scale was used to measure NSSI and resilience, social support, self-compassion, childhood adversity, depression, anxiety and anger. The collected data were analysed using the SPSS 27.0 program, and hierarchical logistic regression analysis was performed to identify the protective and risk factors related to NSSI behaviour. As a result of this study, out of 650 participants, 107 (16.46%) were found to have experienced NSSI. The NSSI group was younger and had a higher proportion of females compared with the non-NSSI group. In addition, self-compassion was identified as a protective factor and childhood adversity and depression were identified as risk factors associated with NSSI behaviour. The lower the self-compassion, the higher the childhood adversity and the higher the depression, the higher the likelihood of NSSI behaviour. Based on the results, mental health services should be provided to young people with childhood adversity and high levels of depression, and efforts should be made to respond appropriately to self-injury crises. In addition, it is considered necessary to develop a program to increase the level of self-compassion to protect against the NSSI behaviour of young people in their 20s in Korea.