Psychosocial problems and adjustment of children with beta-thalassemia and their families.

This study explores the psychosocial problems experienced by families with children aged 6 to 14 years suffering from beta-thalassemia major (N = 188). The psychosocial problems and the family's adjustment to the effects of the illness were compared across a number of cultures where the disease is prevalent, namely Cyprus, Greece, and Italy. A small number of migrant children in the United Kingdom was also included in the study. Semi-structured interviews were conducted with parents who also completed the Rutter Parental Questionnaire and the Goldberg General Health Questionnaire. Teachers were asked to complete a Children's Behaviour Questionnaire designed by Rutter. In all countries the disease seemed to have a binding effect on the family, thus mobilizing adaptive mechanisms. Father's low education level and the presence of major medical complications were predictors of poor family adjustment. Differences between and within countries may well reflect differences in health policies, existing level of socio-economic development, and in the cultural patterns in coping with a chronic illness.

Promotion of children's early psychosocial development through primary health care services.

The paper presents the study design of the development and organisation of an EU/WHO multicentre study on the promotion of children's early psychosocial development through primary health care services. The aim of the programme is to develop training for primary health care workers (PHCWs) that improves their ability to assess factors relevant to psychosocial development and gives them preventive approaches to foster that development, building on families' strengths. The focus is on the period from conception to the end of the second year of the child's' life. Two main components are the training of the PHCWs and the semi-structured interviews that guide the workers in practice. The training has content and structure that is feasible within primary health care resources working in collaboration with mental health services. The programme is evaluated in terms of (a) the impact of training on both the PHCWs' knowledge and attitudes with regard to infant behaviour and development, and on practice as assessed by the delivery of the semi-structured interview; and (b) the effect of the intervention on maternal well-being, infant language development and behavior, home environment and mother-infant interaction. The programme is taking place in Cyprus, Greece, the Federal Republic of Yugoslavia, Portugal, Slovenia and Turkey.

Greek fathers' participation in labour and care of the infant.

Greek fathers' (n = 157) reactions to their presence at the delivery, their expectations about the baby and their childcare practices were explored at the 4th-6th week postpartum. Only 10% of the sample attended the delivery. Their non-attendance was attributed, by the greatest number of fathers, to official hospital policy while the rest claimed it was entirely their decision. Half of the non-attenders expressed the desire to have been present while a large percentage of mothers were said to have wanted them to be present. The small number of fathers who attended the birth felt strong and satisfied. In respect to early fatherhood, three main themes were explored: reaction to fatherhood, enjoyment of the child and involvement in childcare. All three dimensions were strongly correlated.

PIP: In Athens, Greece, 157 fathers of 4-to-6-week-old newborns completed a questionnaire as part of a study examining their reactions to being present at delivery (if, indeed, they were present), their expectations about the child, and their child care practices. Just 16 fathers (10%) were present during childbirth. Most of the fathers (68%) who did not attend the delivery claimed the hospital policy forbade their presence during delivery, while most of the remaining fathers (29%) chose not to attend. 64% of the fathers who could not attend for other reasons would have liked to have attended the delivery. Further, 73% of mothers would have preferred the fathers' presence during delivery. The fathers who were present during childbirth reported that their attendance resulted in a closer emotion bond with their partner and newborn. In fact, 71% either cried or felt like crying. Almost none of the fathers believed that a woman's place was in the home. 92% played with the newborn daily. 16% to 25% were actively involved in child care (e.g., walking with the infant, bathing, and changing diapers). 68% wanted to spend more time with the newborn. 92% looked forward to coming home to be with their wife and newborn. On the other hand, 50% felt too tired to care for the infant and 42% though it was difficult to cope with the baby. Reaction to fatherhood, enjoyment of the child, and involvement in child care were all significantly correlated with each other (p .0001), especially enjoyment of the child and involvement in child care. The more emotionally depressed a father was, the more likely it was that he did not like fatherhood (p .0001). In addition, manual laborers and fathers with just a primary education tended to react negatively to fatherhood (p = .06 and p = .09, respectively).