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1.
Jpn J Nurs Sci ; 22(1): e12629, 2025 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-39419582

RESUMO

BACKGROUND: Tuberculosis (TB) remains one of the leading infectious diseases globally, causing high mortality rates. A significant factor contributing to this issue is nonadherence to treatment, which is influenced by family support and impacts the quality of life (QoL) of patients. AIM: The purpose of this study was to describe the role of family support in enhancing medication adherence and improving QoL in individuals with TB. METHODS: This study utilized a scoping review method to examine literature from the PubMed, Scopus, and EBSCO databases. The keywords used in the search included "social support OR online social support OR perceived social support OR family support" AND "Tuberculosis OR TB OR TBC" AND "medication adherence OR medication compliance OR drug adherence OR drug compliance OR adherence OR compliance OR lost to follow-up" AND "QoL OR HRQoL OR health-related QoL." The inclusion criteria were full-text articles in English, primary research studies, and publications from the last 10 years (2012-2022). RESULTS: Thirteen articles met the inclusion criteria, with sample sizes ranging from 50 to 1342 respondents, predominantly using cross-sectional methods. The study found that family support is crucial in promoting medication adherence and positively influencing the QoL of TB patients. Family members provide emotional and practical support, including supervision of medication intake and encouragement of healthy habits. This support enhances patients' confidence, motivation, and overall treatment outcomes. CONCLUSIONS: The findings underscore the indispensable role of family support in addressing the complex interplay between medication adherence and QoL for individuals with TB.


Assuntos
Família , Adesão à Medicação , Qualidade de Vida , Apoio Social , Tuberculose , Humanos , Tuberculose/tratamento farmacológico , Família/psicologia , Feminino , Masculino , Apoio Familiar
2.
Womens Health Nurs ; 30(3): 226-237, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39385549

RESUMO

PURPOSE: This study aimed to explore the levels of postpartum fatigue, parenting stress, family support, and postpartum depression (PPD) experienced by first-time Chinese mothers and to investigate their impact on PPD. METHODS: This cross-sectional survey involved 150 primigravida women attending postnatal checkups in Hebi City, Henan Province, China. Demographic data and information on environmental variables (living conditions, family relationships), postpartum fatigue, parenting stress, family support (expected vs. actual level), and PPD were collected. RESULTS: The average age of the women was 26.25 years (SD, ±3.90), with 78.7% at risk for PPD (score ≥10). Significant correlations were found between PPD and postpartum fatigue (r=.63, p<.001), parenting stress (r=.59, p<.001), and family support (r=.40, p<.001). In model 1, which examined the influence of women's demographic variables on PPD, significant factors included a poor relationship with parents (ß=.24, p=.001), a poor relationship with parents-in-law (ß=.18, p=.029), and a poor relationship with the husband (ß=.20, p=.013). When the three research variables were incorporated into model 2, the factors contributing to a higher level of PPD included a poor relationship with parents-in-law (ß=.14, p=.033), increased postpartum fatigue (ß=.37, p<.001), increased parenting stress (ß=.33, p<.001), and less family support than expected (ß=.12, p=.048). CONCLUSION: The most critical factors influencing PPD include postpartum fatigue, parenting stress, poor relationships with parents-in-law, and low family support among Chinese primiparas. To mitigate PPD levels, healthcare professionals should screen mothers for depression in outpatient clinics and offer education and counseling to both mothers and their families or companions regarding PPD.


Assuntos
Depressão Pós-Parto , Fadiga , Mães , Poder Familiar , Período Pós-Parto , Apoio Social , Estresse Psicológico , Humanos , Feminino , Estudos Transversais , Adulto , Depressão Pós-Parto/psicologia , Depressão Pós-Parto/epidemiologia , China/epidemiologia , Poder Familiar/psicologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Mães/psicologia , Fadiga/psicologia , Fadiga/epidemiologia , Período Pós-Parto/psicologia , Inquéritos e Questionários , Apoio Familiar
3.
J Dev Behav Pediatr ; 45(5): e422-e430, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39413304

RESUMO

OBJECTIVE: An expert commission has proposed the term "profound" autism for children on the spectrum who are minimally verbal or nonverbal and have intellectual disability (ID), behavioral challenges, and co-occurring conditions. It is unknown whether parents' rating of "severe" autism aligns with the definition of "profound" autism. Using the National Survey of Children's Health, we sought to (1) estimate the prevalence of parent-reported severe autism, (2) identify child characteristics that are associated with severe autism, (3) compare health care utilization, and (4) compare caregiver stress and resilience between families of children with severe versus mild/moderate autism. METHODS: Parent responses on the 2018 to 2019 NSCH were used to compare school-age children with parent-reported severe autism and those with mild/moderate autism. Descriptive statistics, χ 2 tests, and logistic regression were used for statistical analysis. RESULTS: Among parents of 1,368 US children with autism, 10.1% characterized their child's autism as severe, a prevalence of 1 in 333. Parents of children with severe autism were more likely to report ID (45% vs 12.1%, p < 0.001), language delay (88% vs 58.7%, p < 0.001), and difficulties in dressing and bathing (67% vs 19.2%, p < 0.001). Children with severe autism had more behavioral problems and co-occurring conditions but were no more likely to see specialists or receive autism-specific behavioral therapy. Their caregivers reported more stress and less resilience. CONCLUSION: The characteristics of "profound" autism and parent-reported "severe" autism significantly overlap, allowing the use of the NSCH for studies of this vulnerable population. Children with profound/severe autism could benefit from more behavioral therapy, specialty care, and family support.


Assuntos
Transtorno Autístico , Inquéritos Epidemiológicos , Pais , Índice de Gravidade de Doença , Adolescente , Criança , Feminino , Humanos , Masculino , Transtorno Autístico/diagnóstico , Transtorno Autístico/epidemiologia , Transtorno Autístico/psicologia , Transtorno Autístico/terapia , Sobrecarga do Cuidador/psicologia , Distribuição de Qui-Quadrado , Atenção à Saúde/estatística & dados numéricos , Demografia , Deficiências do Desenvolvimento/epidemiologia , Apoio Familiar , Deficiência Intelectual/epidemiologia , Transtornos do Desenvolvimento da Linguagem/epidemiologia , Modelos Logísticos , Pais/psicologia , Prevalência , Resiliência Psicológica , Estados Unidos/epidemiologia , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/psicologia , Transtorno do Espectro Autista/terapia
4.
Antonie Van Leeuwenhoek ; 118(1): 18, 2024 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-39387927

RESUMO

The taxonomy of the Listeriaceae family has undergone substantial revisions, expanding the Listeria genus from 6 to 29 species since 2009. However, these classifications have relied on 16S rRNA gene sequences and conventional polyphasic taxonomy, with limited use of genomic approaches. This study aimed to employ genomic tools, including phylogenomics, Overall Genomic Relatedness Indices (OGRIs), and core-genome phylogenomic analyses, to reevaluate the taxonomy of the Listeriaceae family. The analyses involved the construction of phylogenetic and phylogenomic trees based on 16S rRNA gene sequences and core genomes from 34 type strain genomes belonging to Listeriaceae family. OGRIs, which encompass Average Amino acid Identity (AAI), core-proteome AAI (cAAI), and Percentage of Conserved Proteins (POCP), were calculated, and specific threshold values of 70%, 87%, and 72-73% were established, respectively, to delimitate genera in the Listeriaceae family. These newly proposed OGRI thresholds unveiled distinct evolutionary lineages. The outcomes of this taxonomic re-evaluation were: (i): the division of the Listeria genus into an emended Listeria genus regrouping only Listeria senso stricto species; (ii): the remaining Listeria senso lato species were transferred into three newly proposed genera: Murraya gen. nov., Mesolisteria gen. nov., and Paenilisteria gen. nov. within Listeriaceae; (iii): Brochothrix was transferred to the newly proposed family Brochothricaceae fam. nov. within the Caryophanales order; (iiii): Listeria ivanovii subsp. londonensis was elevated to the species level as Listeria londonensis sp. nov.; and (iiiii): Murraya murrayi comb. nov. was reclassified as a later heterotypic synonym of Murraya grayi comb. nov. This taxonomic framework enables more precise identification of pathogenic Listeriaceae species, with significant implications for important areas such as food safety, clinical diagnostics, epidemiology, and public health.


Assuntos
Genoma Bacteriano , Listeria , Filogenia , RNA Ribossômico 16S , RNA Ribossômico 16S/genética , Listeria/genética , Listeria/classificação , DNA Bacteriano/genética , Genômica , Análise de Sequência de DNA , Apoio Familiar
5.
JMIR Res Protoc ; 13: e64332, 2024 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-39284179

RESUMO

BACKGROUND: Internalizing disorders (IDs), primarily depression and anxiety, are highly prevalent among adolescents receiving community-based treatment for substance use disorders (SUDs). For such clients, interventions that do not holistically address both SUDs and IDs are less effective. OBJECTIVE: This pilot treatment development study aims to develop and test a modular treatment protocol for addressing cooccurring IDs among adolescents (aged 13 to 18 years) enrolled in routine care for substance use problems: Family Support Protocol for Adolescent Internalizing Disorders (Fam-AID). As an adjunctive protocol, Fam-AID will not require clinicians to markedly alter existing base practices for SUD. It will be anchored by 3 evidence-based foundations for treating cooccurring adolescent IDs: family engagement techniques, transdiagnostic individual cognitive behavioral therapy techniques, and family psychoeducation and safety planning. METHODS: This quasi-experimental study will proceed in 2 stages. The pilot stage will use rapid-cycle prototyping methods in collaboration with end-user stakeholders to draft protocol delivery and fidelity guidelines adapted from existing resources, solicit provider and client input on protocol content and delivery via cognitive interviewing, and pilot prototype components on 4 to 6 cases. The second stage will be an interrupted time series study for 60 comorbid SUD+ID cases across 2 sites serving diverse adolescents: 30 will receive treatment as usual (TAU); following clinician training in the protocol, 30 new cases will receive TAU enhanced by Fam-AID. For aim 1, the focus is on evaluating the acceptability of the Fam-AID protocol through therapist and client interviews as well as assessing fidelity benchmarks using therapist- and observer-reported protocol fidelity data. For aim 2, the plan is to compare the effects of TAU only cases versus TAU+Fam-AID cases on family treatment attendance and on adolescent ID and substance use symptoms, with measurements taken at baseline and at 3-month and 6-month follow-ups. RESULTS: Study recruitment will begin in April 2025. CONCLUSIONS: We anticipate that Fam-AID will contain 5 treatment modules that can be delivered in any sequence to meet client needs: family engagement of primary supports in treatment planning and services; relational reframing of family constraints, resiliencies, and social capital connected to the adolescent's ID symptoms; functional analysis of the adolescent's ID symptoms and related behaviors; cognitive behavioral therapy to address the adolescent's ID symptoms and functional needs, featuring 3 core techniques (emotion acceptance, emotional exposure, and behavioral activation) to address negative affect and emotional dysregulation; and family psychoeducation and safety planning focused on education about comorbid SUD+ID and prevention of adolescent self-harm. If the abovementioned modules are found to be feasible and effective, Fam-AID will offer a set of pragmatic interventions to SUD clinicians for treating cooccurring IDs in adolescent clients. TRIAL REGISTRATION: ClinicalTrials.gov NCT06413979; https://www.clinicaltrials.gov/study/NCT06413979. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/64332.


Assuntos
Terapia Familiar , Humanos , Adolescente , Projetos Piloto , Feminino , Masculino , Terapia Familiar/métodos , Transtornos Relacionados ao Uso de Substâncias/terapia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Terapia Cognitivo-Comportamental/métodos , Apoio Familiar
6.
Nutrients ; 16(16)2024 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-39203782

RESUMO

The main objective of this study was to examine the actor and partner effects between Perceived Workplace Support for Families (PWSFs) and family support (PFS), diet quality, and satisfaction with food-related life (SWFoL) in households with both parents working and adolescents, along with the role of the three family members' diet quality as a mediator. During the second year of the pandemic in Chile, 860 dual-earner parents of different sexes and their adolescent child (average age 13 years, with 50.7% being male) were recruited from two cities. Parents responded to a measure of PWSFs and the Perceived Family Support Scale. Mothers, fathers, and adolescents answered the Adapted Healthy Eating Index (AHEI) and the satisfaction with food-related life Scale. The examination employed the mediation Actor-Partner Interdependence Model and structural equation modeling for the analyses. Results showed that mothers' PWSFs improved their and their teenage children's SWFoL, while fathers' PWSFs only improved their SWFoL. The mothers' PFS improved their and the fathers' diet quality while enhancing their SWFoL and the adolescents' SWFoL. The fathers' PFS enhanced their and the adolescents' SWFoL. The mothers' PFS also indirectly enhanced their and the fathers' SWFoL via each parent's diet quality. Each family member's diet quality was positively related to their SWFoL, while mothers' diet quality was positively related to the fathers' SWFoL. These results imply that resources obtained by parents from PFS positively impact the SWFoL of the three family members through different mechanisms. They also highlight the importance of maternal family support for SWFoL during the pandemic.


Assuntos
COVID-19 , Satisfação Pessoal , Local de Trabalho , Humanos , Feminino , Masculino , Adolescente , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/psicologia , Local de Trabalho/psicologia , Chile , Adulto , Apoio Social , Dieta Saudável/psicologia , Família/psicologia , Dieta/psicologia , Pandemias , Inquéritos e Questionários , SARS-CoV-2 , Pais/psicologia , Apoio Familiar
7.
Trials ; 25(1): 568, 2024 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-39198900

RESUMO

The FICUS trial is a cluster-randomized superiority trial to determine the effectiveness of a nurse-led, interprofessional family support intervention (FSI) on the quality of care, family management and individual mental health of family members of critically ill patients, compared to usual care. This paper describes the statistical analysis plan of the FICUS trial. The primary outcome is quality of family care, assessed by the Family Satisfaction in ICU Questionnaire (FS-ICU-24R) at patient discharge from the ICU. Several secondary outcomes are additionally assessed 3, 6, and 12 months thereafter. Sixteen clusters (ICUs) were randomly assigned 1:1 to FSI or usual care using minimization (8 per treatment). The target sample size is 56 patients per cluster (896 in total). Recruitment has been completed in January 2024. The follow-up of the last participant will be completed in early 2025. The primary and secondary outcomes will be analyzed by linear mixed-effects models (LMM). The main model for the primary outcome will include a random intercept per cluster with treatment (FSI vs. usual care) as the only explanatory variable due to the relatively small number of clusters. In addition, covariate-adjusted analyses will be conducted, including two cluster-level characteristics used in the minimization as well as participant-level characteristics. Moreover, a number of subgroup analyses by cluster- and participant-level characteristics are pre-specified.Trial registration ClinicalTrials.gov NCT05280691 . Registered on February 20, 2022.


Assuntos
Unidades de Terapia Intensiva , Humanos , Família , Saúde Mental , Interpretação Estatística de Dados , Estudos Multicêntricos como Assunto , Estado Terminal , Fatores de Tempo , Ensaios Clínicos Controlados Aleatórios como Assunto , Cuidados Críticos/métodos , Qualidade da Assistência à Saúde , Apoio Social , Estudos de Equivalência como Asunto , Relações Profissional-Família , Apoio Familiar
8.
JAMA Pediatr ; 178(9): 914-922, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-38949835

RESUMO

Importance: Lesbian, gay, bisexual, transgender, queer, and/or questioning (LGBTQ+) youth face worse mental health outcomes than non-LGBTQ+ peers. Family support may mitigate this, but sparse evidence demonstrates this in clinical settings. Objectives: To compare depression and suicide risk between LGBTQ+ and non-LGBTQ+ youth in primary care settings and to investigate whether family support mitigates these negative mental health outcomes. Design, Setting, and Participants: This cross-sectional study uses data from well care visits completed by adolescents aged 13 to 19 years from February 2022 through May 2023, including the Patient Health Questionnaire-9 Modified for Teens (PHQ-9-M) and the Adolescent Health Questionnaire (AHQ; an electronic screener assessing identity, behaviors, and guardian support), at 32 urban or suburban care clinics in Pennsylvania and New Jersey. Exposures: The primary exposure was self-reported LGBTQ+ status. Family support moderators included parental discussion of adolescent strengths and listening to feelings. Race and ethnicity (determined via parent or guardian report at visit check-in), sex, payer, language, age, and geography were covariates. Main Outcomes and Measures: PHQ-9-M-derived mental health outcomes, including total score, recent suicidal ideation, and past suicide attempt. Results: The sample included 60 626 adolescents; among them, 9936 (16.4%) were LGBTQ+, 15 387 (25.5%) were Black, and 30 296 (50.0%) were assigned female sex at birth. LGBTQ+ youth, compared with non-LGBTQ+ youth, had significantly higher median (IQR) PHQ-9-M scores (5 [2-9] vs 1 [0-3]; P < .001) and prevalence of suicidal ideation (1568 [15.8%] vs 1723 [3.4%]; P < .001). Fewer LGBTQ+ youth endorsed parental support than non-LGBTQ+ youth (discussion of strengths, 8535 [85.9%] vs 47 003 [92.7%]; P < .001; and listening to feelings, 7930 [79.8%] vs 47 177 [93.1%]; P < .001). In linear regression adjusted for demographic characteristics and parental discussion of strengths, LGBTQ+ status was associated with a higher PHQ-9-M score (mean difference, 3.3 points; 95% CI, 3.2-3.3 points). In logistic regression, LGBTQ+ youth had increased adjusted odds of suicidal ideation (adjusted odds ratio, 4.3; 95% CI, 4.0-4.7) and prior suicide attempt (adjusted odds ratio, 4.4; 95% CI, 4.0-4.7). Parental support significantly moderated the association of LGBTQ+ status with PHQ-9-M score and suicidal ideation, with greater protection against these outcomes for LGBTQ+ vs non-LGBTQ+ youth. Conclusions and Relevance: Compared with non-LGBTQ+ youth, LGBTQ+ youth at primary care visits had more depressive symptoms and higher odds of suicidal ideation and prior suicide attempt. Youth-reported parental support was protective against these outcomes, suggesting potential benefits of family support-focused interventions to mitigate mental health inequities for LGBTQ+ youth.


Assuntos
Atenção Primária à Saúde , Minorias Sexuais e de Gênero , Humanos , Adolescente , Masculino , Feminino , Minorias Sexuais e de Gênero/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Estudos Transversais , Adulto Jovem , Saúde Mental , Apoio Social , Ideação Suicida , Depressão/psicologia , Apoio Familiar
9.
JAMA Pediatr ; 178(9): 870-878, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-39008285

RESUMO

Importance: Transgender youth are at an elevated risk for adverse mental health outcomes compared with their cisgender peers. Identifying opportunities for intervention is a priority. Objective: To estimate differences in the association between gender identity milestones and mental health outcomes among transgender youth, stratified by level of family support. Design, Settings, and Participants: This retrospective cohort study compares changes in mental health outcomes among transgender youth who initiate gender identity milestones compared with those who initiate the same milestones 1 year later, stratified by level of family support, using the 2015 US Transgender Survey. The analytic samples included 18 303 transgender adults aged 18 and older who had initiated at least 1 gender identity milestone between ages 4 and 18 years. Exposure: Four gender identity milestones: feeling one's gender was different, thinking of oneself as transgender, telling another that one is transgender, and living full-time in one's gender identity, stratified by 3 levels of family support: supportive, neutral, and adverse. Main Outcomes: Age at first suicide attempt and at running away. Results: Study participants included 18 303 transgender adults (10 288 [56.2%] assigned female at birth; 14 777 [80.7%] White). Initiating a gender identity milestone was associated with a higher risk of suicide attempt and running away from home among transgender youth. This finding was driven by children who live in unsupportive families. For example, thinking of oneself as transgender was associated with a meaningful increase in the overall probability of attempting suicide among those in either adverse families (estimate = 1.75 percentage points; 95% CI, 0.47-3.03) or neutral families (estimate = 1.39 percentage points; 95% CI, 0.72-2.05). Among youth living with supportive families, there were no statistically significant associations between gender identity milestones and adverse mental health outcomes and 95% CIs generally ruled out any meaningful associations. Conclusion: These results demonstrate that without a supportive family environment, gender identity development increases the risk of transgender youth attempting suicide or running away from home. Social services and community resources to establish supportive relationships between transgender children and their parents are essential.


Assuntos
Identidade de Gênero , Pessoas Transgênero , Humanos , Pessoas Transgênero/psicologia , Pessoas Transgênero/estatística & dados numéricos , Adolescente , Masculino , Feminino , Estudos Retrospectivos , Criança , Adulto Jovem , Saúde Mental , Adulto , Estados Unidos/epidemiologia , Tentativa de Suicídio/estatística & dados numéricos , Tentativa de Suicídio/psicologia , Apoio Social , Pré-Escolar , Apoio Familiar
10.
Reprod Health ; 21(1): 86, 2024 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-38886725

RESUMO

BACKGROUND: To discuss the current status of reproductive concerns and its correlation with fear of recurrence and level of family support in patients of childbearing age with gynecologic malignancies. METHODS: A convenient sampling method was used to enroll 188 patients with gynecologic malignancies in Nanjing Maternity and Child Health Care Hospital, Nanjing Drum Tower Hospital, General Hospital of Ningxia Medical University, and Haian Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from September 2022 to April 2023. Patients were assessed using general information questionnaire, Reproductive Concerns After Cancer Scale (RCAC), Fear of Cancer Recurrence Inventory (FCRI) questionnaire, and Perceived Social Support-Family (PSS-FA) Scale. RESULTS: Among patients of childbearing age with gynecologic malignancies, the total RCAC score was (54.35 ± 7.52), indicating a moderate level of reproductive concerns. Patients scored (20.98 ± 4.51) on FCRI, implying a moderate level of fear of recurrence. The PSS-FA score was (9.57 ± 2.76), denoting a moderate level of family support. The total score and each dimensional score of RCAC were positively correlated with FCRI total score (P < 0.05), and negatively correlated with PSS-FA total score (P < 0.05). Fear of recurrence, family support level, number of children, educational background, treatment modality, and fertility intention were influencing factors for reproductive concerns in patients of childbearing age with gynecologic malignancies (all P < 0.05). CONCLUSION: The reproductive concerns, fear of recurrence and family support are all at moderate levels in patients of childbearing age with gynecologic malignancies, and reproductive concerns are positively correlated with fear of recurrence and negatively correlated with family support.


Assuntos
Apoio Familiar , Medo , Neoplasias dos Genitais Femininos , Recidiva Local de Neoplasia , Adolescente , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem , China/epidemiologia , Medo/psicologia , Neoplasias dos Genitais Femininos/psicologia , Recidiva Local de Neoplasia/psicologia , Inquéritos e Questionários
11.
J Adolesc Health ; 75(2): 261-266, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38842989

RESUMO

PURPOSE: This study investigated the association between positive and negative family support and psychosocial outcomes among transgender and gender diverse (TGD) youth. METHODS: A retrospective analysis was performed using psychological data collected from 175 TGD youth (aged 13-18 years) at time of hormone readiness assessment within a multispecialty gender clinic between May 2021 and February 2023. As part of this assessment process, TGD youth provided responses to a variety of measures, including the Youth Self-Report and the Family Environment Scale. RESULTS: Negative family support scales were more strongly associated with more outcomes than positive support scales. The exclusion and abuse, viewing gender expression as morally wrong, and trying to change gender scales were each associated with significantly higher Youth Self-Report T-scores for internalizing problems (ßs = 6.86, 6.26, 5.56, all p < .01), externalizing problems (ßs = 4.58, 4.42, 4.19, all p < .02), and total problems (ßs = 6.70, 6.45, 5.34, all p < .02). The explicit care and support scale was associated with significantly lower T-scores for externalizing problems (ß = -3.54 p = .02) and total problems (ß = -3.35, p = .04). Overall support was also associated with higher T-scores in internalizing problems (b = -2.90, p = .02), externalizing problems (ß = -2.40, p = .03), and total problems (ß = -2.79, p = .03). DISCUSSION: Family support plays a critical role in the psychosocial wellbeing of TGD youth. TGD youth reporting positive family support reported fewer mental health concerns, less experiences of nonaffirmation, and lower levels of internalized transphobia. TGD youth reporting negative family support were found to have an increased risk of suicidal ideation.


Assuntos
Funcionamento Psicossocial , Apoio Social , Pessoas Transgênero , Humanos , Adolescente , Feminino , Pessoas Transgênero/psicologia , Masculino , Estudos Retrospectivos , Família/psicologia , Autorrelato , Apoio Familiar
12.
Am J Intellect Dev Disabil ; 129(4): 308-325, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38917996

RESUMO

Understanding factors that can improve the quality of life (QOL) of older caregivers of people with intellectual and developmental disabilities (IDD) is important in broadening participation in family empowerment interventions. The purpose of this study was to identify the factors influencing the QOL of older caregivers (50+) of adults with IDD who participated in a peer-mediated state-wide family support project. The research study used a quasi-experimental research design grounded in the family quality of life (FQOL) framework, with pretest and posttest data gathered from 82 caregivers. Correlation and regression analyses were conducted to identify factors influencing changes in the QOL of study participants. Findings indicated that improvements in caregiver QOL after participating in the project could be explained by caregiver's employment status, increased global FQOL, and decreased caregiver stress and depression.


Assuntos
Cuidadores , Deficiências do Desenvolvimento , Deficiência Intelectual , Qualidade de Vida , Humanos , Cuidadores/psicologia , Qualidade de Vida/psicologia , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Deficiência Intelectual/enfermagem , Deficiência Intelectual/psicologia , Deficiências do Desenvolvimento/enfermagem , Apoio Social , Família/psicologia , Estresse Psicológico/psicologia , Depressão/psicologia , Idoso de 80 Anos ou mais , Apoio Familiar
13.
BMC Palliat Care ; 23(1): 142, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38849809

RESUMO

BACKGROUND: Dignity is integral to palliative care. Illness can diminish it, causing hopelessness and the wish to hasten death. Yet, dignity is a complex multidimensional phenomenon, influenced by values and context. Understanding its varying interpretations can inform practice and policy. The aim of the study is to explore the understanding of dignity in adult patients with palliative care needs from a Lebanese perspective and how it is preserved during illness and while receiving health services. DESIGN: Qualitative interview study underpinned with a social constructionist lens. Fourteen patients recruited from home-based hospice and outpatient clinics in Lebanon. Data analysed using reflexive thematic analysis. RESULTS: Four themes were developed across all the interviews: (a) Dignity anchored through faith in God and religious practices; (b) Family support in maintaining physical, psychological wellbeing, and social connectedness; (c) Physical fitness, mental acuity, and healthy appearance through which patients may escape the stigma of disease, (d) accessible, equitable, and compassionate healthcare. DISCUSSION: Dignity is elusive and difficult to define but faith and religious beliefs play a significant contribution in this study. For the participants, illness is seen as a natural part of life that does not necessarily diminish dignity, but it is the illness related changes that potentially affect dignity. Findings show the importance of family and children in preserving dignity during illness and how their active presence provide a sense of pride and identity. Participants aspired to restore physical, social, and mental well-being to reclaim their dignity and normalize their lives. Challenges related to physical appearance, memory loss, vitality, and social stigma associated with illness diminished dignity. Accessible, equitable and compassionate healthcare services are also crucial in preserving dignity. Participants valued clear communication, respect, and empathy from healthcare providers and identified affordability of care essential for maintaining dignity. CONCLUSION: Faith in God, and strong family ties are dominant elements to maintaining dignity in the Lebanese context. Relational connectedness with family, children or God is also a need in maintaining dignity in other communal countries with variations in emphasis. The study indicates that religious and cultural context shapes the needs and perceptions of dignity during illness. These findings are likely to be transferable to many Middle Eastern countries but also countries with strong religious and family ties globally.


Assuntos
Cuidados Paliativos , Pesquisa Qualitativa , Humanos , Masculino , Feminino , Cuidados Paliativos/psicologia , Cuidados Paliativos/métodos , Cuidados Paliativos/normas , Pessoa de Meia-Idade , Idoso , Líbano , Adulto , Família/psicologia , Apoio Social , Idoso de 80 Anos ou mais , Respeito , Pessoalidade , Entrevistas como Assunto/métodos , Apoio Familiar
15.
Telemed J E Health ; 30(9): 2520-2523, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38916878

RESUMO

Background: Family support (FS) is a key social determinant of health for transgender and gender-diverse (TGD) young adults. We examined the association between FS and health outcomes in young adults seeking gender-affirming hormone therapy (GAHT) from a US telehealth service. Methods: Cross-sectional data from TGD young adults ages 18-24 (n = 7,740) who provided demographic information and information on FS at intake were analyzed. Relationships between FS, geography, insurance status, rates of depression, and smoking status were examined. Results: Less than half of respondents reported having FS. Patients with FS reported lower rates of depression and higher incidence of previous gender-affirming medical care (e.g., hormone therapy, surgeries), had lower rates of being uninsured, and were more likely to reside in the Northeast or Western United States. Young adults assigned female at birth had higher rates of FS. Conclusion: FS may mitigate mental health disparities in TGD young adults including rates of depression. FS and insurance status are closely related in a geographically diverse population seeking telehealth services. The finding underscores the importance of FS as a social determinant of health and the unique characteristics of patients seeking telehealth services.


Assuntos
Depressão , Telemedicina , Pessoas Transgênero , Humanos , Feminino , Adulto Jovem , Telemedicina/estatística & dados numéricos , Masculino , Estudos Transversais , Adolescente , Pessoas Transgênero/psicologia , Pessoas Transgênero/estatística & dados numéricos , Estados Unidos , Depressão/epidemiologia , Apoio Social , Adulto , Família/psicologia , Terapia de Reposição Hormonal/estatística & dados numéricos , Terapia de Reposição Hormonal/métodos , Cobertura do Seguro/estatística & dados numéricos , Apoio Familiar
16.
J Res Adolesc ; 34(3): 1107-1114, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38858819

RESUMO

This study examined Latinx adolescents' daily family assistance (assistance day, assistance time, language brokering) in relation to their daily affect and investigated whether the associations changed following the outbreak of the COVID-19 pandemic. Two waves of 14-day daily diary data collected from 13 18-year-old Latinx adolescents (ndays = 284; 77% Mexican American, 77% female) before and amid the pandemic were analyzed using multilevel modeling. Three main findings emerged: (1) assisting the family on a given day was associated with higher levels of same-day positive affect both before and during COVID-19, and with lower levels of negative affect during COVID-19; (2) longer than usual family assistance time was associated with higher levels of same-day positive affect and lower levels of negative affect only during COVID-19; (3) language brokering on a given day was associated with higher levels of same-day positive affect both before and during COVID-19. These findings suggest a positive link between daily family assistance and Latinx youth's daily emotional well-being, particularly during the COVID-19 pandemic.


Assuntos
Saúde do Adolescente , COVID-19 , Hispânico ou Latino , Bem-Estar Psicológico , Adolescente , Feminino , Humanos , Masculino , Afeto , COVID-19/psicologia , COVID-19/epidemiologia , Apoio Familiar , Hispânico ou Latino/psicologia , Saúde Mental , Pandemias , Projetos Piloto
17.
Am J Geriatr Psychiatry ; 32(10): 1187-1199, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38839462

RESUMO

OBJECTIVES: Cognitive impairment poses considerable challenges among older adults, with the role of family support becoming increasingly crucial. This study examines the association of children's residential proximity and spousal presence with key modifiable risk factors for dementia in cognitively impaired older adults. METHODS: We analyzed 14,600 individuals (35,165 observations) aged 50 and older with cognitive impairment from the Health and Retirement Study (1995-2018). Family support was categorized by spousal presence and children's residential proximity. Modifiable risk factors, including smoking, depressive symptoms, and social isolation, were assessed. Associations between family support and the modifiable risk factors were determined using mixed-effects logistic regressions. RESULTS: A significant proportion of older adults with cognitive impairment lacked access to family support, with either no spouse (46.9%) or all children living over 10 miles away (25.3%). Those with less available family support, characterized by distant-residing children and the absence of a spouse, had a significantly higher percentage of smoking, depressive symptoms, and social isolation. Moreover, we revealed a consistent gradient in the percentage of the risk factors by the degree of family support. Relative to older adults with a spouse and co-resident children, those without a spouse and with all children residing further than 10 miles displayed the highest percentage of the risk factors. These findings were robust to various sensitivity analyses. CONCLUSIONS: Family support from spouses and nearby children serves as a protective factor against modifiable dementia risk factors in cognitively impaired older adults. Policies that strengthen family and social support may benefit this population.


Assuntos
Disfunção Cognitiva , Demência , Apoio Social , Humanos , Masculino , Feminino , Demência/epidemiologia , Idoso , Disfunção Cognitiva/epidemiologia , Fatores de Risco , Pessoa de Meia-Idade , Cônjuges/psicologia , Cônjuges/estatística & dados numéricos , Depressão/epidemiologia , Isolamento Social/psicologia , Idoso de 80 Anos ou mais , Fumar/epidemiologia , Família/psicologia , Apoio Familiar
18.
J Pediatr Nurs ; 77: e356-e365, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38735803

RESUMO

PURPOSE: We describe and evaluate the introduction of a trauma family support service (TFSS) in an Australian tertiary paediatric hospital. DESIGN AND METHODS: A longitudinal mixed-methods cohort study evaluated the effectiveness of the TFSS on quality of life. PedsQL4.0 and EuroQol 5D-Y scores were collected at 6 and 12 months at intervention and non-intervention sites and outcomes were compared using a two-sample t-test. Qualitative data from field notes collected during the administration of the quality-of-life measures were analysed using inductive content analysis. Data were integrated during the interpretation of results to expand and strengthen findings. RESULTS: Data from 192 children were collected (intervention site: 104, control site: 88). Significant increases were seen in the PedsQL and EQ-5D-Y scores at the intervention site compared to the control site at both timepoints, indicating an increase in overall health related quality of life. Two main categories were generated from the qualitative analysis: "Psychosocial impact of trauma" and "Access to psychosocial services." CONCLUSIONS: The introduction of a dedicated family support service after paediatric injury improved well-being up to 12 months post injury. PRACTICE IMPLICATIONS: Healthcare providers should emphasise dedicated family support services for paediatric trauma patients, focusing on their psychosocial needs and ensuring access to suitable resources. Paediatric nurses are a major part of this service and should contribute to future research, co-designing and implementing these improved family support services to better serve families affected by paediatric trauma.


Assuntos
Qualidade de Vida , Ferimentos e Lesões , Humanos , Masculino , Feminino , Criança , Estudos Longitudinais , Ferimentos e Lesões/terapia , Ferimentos e Lesões/psicologia , Austrália , Pré-Escolar , Adolescente , Estudos de Coortes , Apoio Social , Hospitais Pediátricos , Apoio Familiar
19.
J Psychopathol Clin Sci ; 133(5): 358-367, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38722593

RESUMO

Sexual and gender minority (SGM) adolescents are at elevated risk for depression. This risk is especially pronounced among adolescents whose home environment is unsupportive or nonaffirming, as these adolescents may face familial rejection due to their identity. Therefore, it is critical to better understand the mechanisms underlying this risk by probing temporally sensitive associations between negative mood and time spent in potentially hostile home environments. The current study included adolescents (N = 141; 43% SGM; 13-18 years old), oversampled for depression history, who completed clinical interviews assessing lifetime psychiatric history and depression severity as well as self-report measures of social support. Participants also installed an app on their personal smartphones, which assessed their daily mood and geolocation-determined mobility patterns over a 6-month follow-up period. Over the 6-month follow-up period, SGM adolescents reported elevated depression severity and lower daily mood relative to non-SGM youth. Interestingly, SGM adolescents who reported low family support experienced lower daily mood than non-SGM adolescents, particularly on days when they spent more time at home. Current findings reinforce evidence for disparities in depression severity among SGM adolescents and highlight family support as a key factor. Specifically, more time spent in home environments with low family support was associated with worse mood among SGM adolescents. These results underscore the need for clinical interventions to support SGM youth, particularly interventions that focus on familial relationships and social support within the home environment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Afeto , Depressão , Minorias Sexuais e de Gênero , Smartphone , Apoio Social , Humanos , Adolescente , Masculino , Feminino , Minorias Sexuais e de Gênero/psicologia , Depressão/psicologia , Depressão/epidemiologia , Família/psicologia , Apoio Familiar
20.
Ann Behav Med ; 58(7): 477-487, 2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38795386

RESUMO

BACKGROUND: Latino/a/x families experience persistent Type 2 diabetes mellitus (T2DM) disparities, including higher rates of diagnosis and mortality due to disease complications than their non-Hispanic White counterparts. Though greater social support is associated with improved disease outcomes for Latino/a/x patients with diabetes, research has yet to identify the specific pathways through which social support, and specifically family support, influences self-management. PURPOSE: This study tested a theoretical model highlighting the mechanisms and pathways linking social support and physical health. Specifically, self-efficacy and depression were tested as psychological pathways connecting family support to diabetes self-management behaviors and diabetes morbidity in Latino/a/x patients with T2DM. METHODS: Data from 177 patients were analyzed using structural equation modeling. Measures included diabetes-specific family support needed and received, depressive symptoms, self-efficacy in diabetes management, diabetes self-management behaviors, health appraisal, and hemoglobin A1c. RESULTS: Greater diabetes-specific family support was significantly associated with more frequent engagement in diabetes self-management behaviors, both directly (p < .001) and through diabetes self-efficacy's partial mediation of this relationship (p = .013). Depression was not significantly associated with either family support (support received, p = .281; support needed, p = .428) or self-management behaviors (p = .349). CONCLUSIONS: Family support and diabetes self-efficacy may be important modifiable psychosocial factors to target via integrated care interventions aimed at supporting Latino/a/x patients with T2DM. Future research is needed to test empirically based, culturally adapted interventions to reduce T2DM-related health disparities in this population.


Latino/a/x families experience persistent diabetes disparities, including higher rates of diagnosis and mortality due to disease complications than their non-Hispanic White counterparts. Though greater social support is associated with improved disease outcomes for Latino/a/x patients with diabetes, research has yet to identify the specific pathways through which social support, and specifically family support, influences self-management. This study examined diabetes self-efficacy and depression as potential links in the relationship between family support and diabetes self-management behaviors. Analyses revealed a significant association between greater diabetes-related family support and more frequent engagement in diabetes self-management behaviors, both directly and through diabetes self-efficacy's partial mediation of the relationship. This points to family support and diabetes self-efficacy as important modifiable psychosocial factors that can be targeted in integrated care interventions aimed at supporting Latino/a/x patients with diabetes.


Assuntos
Depressão , Diabetes Mellitus Tipo 2 , Apoio Familiar , Hispânico ou Latino , Autoeficácia , Autogestão , Apoio Social , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Depressão/terapia , Depressão/psicologia , Depressão/etnologia , Diabetes Mellitus Tipo 2/terapia , Diabetes Mellitus Tipo 2/psicologia , Diabetes Mellitus Tipo 2/etnologia , Hemoglobinas Glicadas/metabolismo , Comportamentos Relacionados com a Saúde , Hispânico ou Latino/psicologia , Hispânico ou Latino/estatística & dados numéricos , Populações Vulneráveis
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