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Introdução: O desenvolvimento da família é influenciado por diversos fatores de sua organização interna e de ordem ambiental, social, cultural, econômica e política. Em contexto de pobreza os riscos são maiores. Fatores de proteção, como boa organização familiar e rede social de apoio podem diminuir as consequências negativas da pobreza. São escassas as pesquisas longitudinais sobre vulnerabilidade e resiliência nas famílias. Objetivo: Este artigo descreve o desenvolvimento de três famílias ao longo de 15 anos, estudadas por meio de entrevistas em casa, parte de uma coorte populacional de um bairro de Porto Alegre (RS). Buscaram-se associações entre a qualidade das relações nessas famílias e sua saúde física e mental, especialmente a do filho, foco da pesquisa. Métodos: Selecionaram-se no arquivo da pesquisa as três primeiras famílias (do total de 148) das quais se tinham os resultados completos das cinco visitas realizadas aos quatro meses e aos dois, quatro, nove e 15 anos de um filho. Realizou-se análise qualitativa dos registros em busca de categorias para compreender a vida e as relações interpessoais nas famílias. O estudo foi realizado em conjunto por duas pesquisadoras, médicas especialistas em desenvolvimento humano. As categorias identificadas na análise e estudadas nas cinco etapas foram: configuração familiar, situação socioeconômica, situações traumáticas, saúde física, saúde relacional e mental, evolução cognitiva e escolar do filho. Resultados: As três famílias, todas de classe C, com filhos sem problemas de saúde física, tiveram evolução suficientemente boa, apesar de todas enfrentarem múltiplos problemas, inclusive separações e mortes precoces. A relação com o sistema de saúde e escola era boa e similar para as três. A jovem com menos problemas de saúde mental foi aquela que sofreu perdas mais importantes: morte dos pais. Tinha uma estrutura familiar multigeracional sólida desde a primeira infância, com relações interpessoais predominantemente colaborativas e amorosas. Conclusões: O artigo busca avançar na compreensão da resiliência nas famílias em situações de vulnerabilidade. Concluímos que essas três famílias, uma delas mais que as outras, foram suficientemente saudáveis na tarefa de educar seus filhos sem desenvolverem problemas mentais graves. Propomos que o bom desenvolvimento se associa com a adequação e amorosidade dos cuidados com a etapa do ciclo vital, mesmo enfrentando situações problemáticas. Essas qualidades precisam estar associadas à estabilidade socioeconômica básica e a bons serviços de saúde e escola.
Introduction: Family development is influenced by it's internal organization and environmental factors, socioeconomic, cultural and political. In poor contexts there are more risks to development. Protection factors like good family organization and social network may decrease the risks. Longitudinal research about vulnerability and resilience in families is scarse. Objective: This article describes the development of three families over 15 years through interviews at home. The families were part of a populational cohort of a neighborhood in Porto Alegre (RS). We looked for links between the quality of relationships and the physical and mental health of these families, especially of the child focus of the research. Methods: We selected in the research archives the first three families (of a total of 148) for which we had full results of the five interviews at four months and two, four, nine and fifteen years of a child. We did a qualitative analysis of the records looking for parameters to understand the life and interpersonal relationships of these families. This study was done by two researchers, both experts in Human Development. The categories identified in the analysis of the five phases were: family structure, socioeconomic situation, traumatic experiences, physical, mental and relational health and cognitive evolution of the child. Results: All three families belonged to economical class C. The children were in good physical health and had sufficiently good general development, having faced multiple problems, including parental separation and early parental death. The relationship with the health and school systems was good in all of them. The youth with less mental health problems was the one who suffered the heaviest loss: early death of both parents. Her family had strong multigenerational ties since her early days, with predominant collaborative and loving relationships. Conclusions: This article aims to contribute to the comprehension of resilience in families in the context of vulnerability. We can say that these three families were healthy enough in the task of bringing up children without any serious mental health problem. We suggest that healthy development is associated with loving interfamily relationships adequate to each phase of development, notwithstanding dramatic events. This needs to be supported by basic economic stability and adequate school and health systems.
Introducción: El desarrollo de la familia es influenciado por su organización interna y factores ambientales, sociales, culturales, económicos y políticos. En contextos pobres los riesgos son mayores. Factores de protección como buena organización familiar y red social de apoyo pueden disminuir las consecuencias negativas de la pobreza. Son pocas las investigaciones longitudinales de vulnerabilidad y resiliencia de las familias. Objetivo: Este artículo describe el estudio del desarrollo de tres familias a lo largo de 15 años, a través de entrevistas en domicilio, parte de una cohorte poblacional de un barrio de Porto Alegre (RS). Se buscaron correlaciones entre la calidad de las relaciones de esas familias y su salud física y mental, especialmente la del hijo foco de la investigación. Métodos: Fueron seleccionadas en el archivo de la investigación las tres primeras familias (de un total de 148) de las cuales se tenían los resultados completos de las cinco visitas realizadas, a los 4 meses, y a los 2, 4, 9, y 15 años de un hijo. Fue realizado un análisis cualitativo de los registros en busca de categorías para comprender la vida y las relaciones interpersonales en las familias. El estudio fue hecho en conjunto por dos investigadoras, médicas especialistas en desarrollo humano. Las categorías identificadas en el análisis y estudiadas en las cinco etapas fueron: configuración familiar, situación socioeconómica, situaciones traumáticas, salud física, salud relacional y mental, evolución cognitiva y escolar del hijo. Resultados: Las tres familias, todas de clase C, con hijos sin problemas de salud física, tuvieron evolución suficientemente buena, a pesar de que todas enfrentaron múltiples problemas, incluso separaciones y muertes precoces. La relación con el sistema de salud y escuela era buena y similar para las tres. La joven con menos problemas de salud mental fue aquella que sufrió las mayores pérdidas: muerte de los padres. Tenía una estructura familiar multigeneracional sólida desde la primera infancia, con relaciones interpersonales predominantemente colaborativas y amorosas. Conclusiones: El artículo pretende avanzar en la comprensión de la resiliencia en las familias en situaciones de vulnerabilidad. Concluimos que esas tres familias, una de ellas más que las otras, fueron suficientemente saludables en la tarea de educar a sus hijos sin que desarrollaran problemas mentales graves. Proponemos que el buen desarrollo se asocia con el amor y adecuación de los cuidados a la etapa del ciclo vital, aun enfrentando situaciones problemáticas. Esas calidades necesitan estar asociadas a la estabilidad socioeconómica básica y buenos servicios de salud y escuela.
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Humans , Human Development , Mental Health , Resilience, PsychologicalABSTRACT
Abstract Objective: To describe the changes in alcohol and drug use by Brazilian adolescents during the COVID-19 pandemic (April-August 2021), and to analyze the relationship between alcohol use changes and psychiatric symptomatology. Methods: A secondary analysis with a longitudinal approach was performed with data from a cluster-randomized controlled trial, conductedin73publicmiddleschoolsinthreeBrazilian cities, to evaluate the effectiveness of a drug use prevention program. The sample included 535 students (61% girls; Mage = 15.2 years). Data were collected pre-intervention (February-March 2019), after 9 months (November-December 2019), and after 26 months (April-August 2021), when the students were in their first year of high school. The authors analyzed drug use prevalence (alcohol, binge drinking, tobacco, inhalants, marijuana, cocaine, and crack) in a lifetime, past year, and past month periods, and the association between alcohol use change subsamples with psychiatric symptoms. Logistic regressions were adjusted by sex, age, socioeconomic status, city, and group (control and intervention). Results: The present findings suggest that the COVID-19 pandemic led to a decrease in past-year substance use and in past-month substance use frequency, despite the gradually increased (but decelerating) prevalence of lifetime use. However, some adolescents initiated, maintained, or increased the frequency of their alcohol use. Mainly, they were more likely to present behavioral problems, as well as symptoms of inattentive hyperactivity, and peer and emotional problems. Conclusions: Despite the extensive decline in substance use during the pandemic period, these results suggest an association between previous mental health conditions and behavioral risk factors, leading to increased alcohol consumption and behavioral disorders manifestations.
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Objective To investigate the sleep disorders and its effects on the changes in quality of life in patients with liver cancer from the hospital admission to 6 months after surgery and to analyse the correlation between the sleep disorder and quality of life.Methods A total of 214 patients who underwent surgery for liver cancer for the first time were included in the study.Demographic questionnaire,Pittsburgh sleep quality index(PSQI),and functional assessment of cancer therapy-hepatobiliary(FACT-Hep)were used for the investigation at admission and at 1,3 and 6 months after surgery.Multiple linear regression was employed to analyse the correlation between the sleep disorders at the admission and its effect on quality of life up to 6 months after surgery.Results Toally 214 patients finished the study at admission and 209 finished the study 1 month after surgery,and 208 finished the stuoly 3 months after surgery,and 205 patients finished the study 6 months after surgery.The scores of both of PSQI at admission and the quality of life at 6 months after surgery varied across the tested time points with a statistically significant difference(both P<0.001).The overall level of sleep disorder in the patients showed a characteristic pattern with initially increasing and then decreasing,and the quality of life presented a characteristic tendency of starting from high to low and then gradually increasing.It showed that the sleep disorder at admission was attributive to the poorer quality of life at 6 months after surgery.The hierarchical regression analysis showed that among the patients at BCLC Stage A,sleep disorder at admission was the influencing factor of the quality of life at 6 months after surgery.Conclusions The sleep disorder and quality of life in the patients who had surgical operations for hepatocellular carcinoma both changed dynamically from admission to the 6 months after surgery.The quality of life was poor in the patients with sleep disorder at admission.Therefore,medical staff should enhance the sleep management at admission,conduct dynamic assessment of the sleep disorder and quality of life of the patients,and then develop continuity nursing measures to improve the quality of life after surgery.
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This review introduces the concept,design and implementation of longitudinal mixed methods research.It summarizes its common applications,including the in-depth exploration of potential causes and association among variables of the complex phenomenon over time,the comprehensive evaluation of intervention effectiveness,the identification of facilitators and challenges for implementation,as well as the exploration of changes in behavior and underlying mechanisms.Moreover,this review analyzes existing challenges and future insights of this method.In conclusion,this review aimed to strengthen the nursing researchers'understanding of longitudinal mixed methods research and provide insights for future related studies.
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Objective@#To investigate the association between self-rated health status and mortality risk, and to evaluate the predictive value of self-rated health status for mortality risk among the elderly.@*Methods@#Based on the China Health and Retirement Longitudinal Study (CHARLS) database, data of sociodemographic information, self-rated health status and mortality of the elderly aged 60 years and older were collected from 2011 to 2018. The association between self-rated health status and mortality risk among the elderly was analyzed using a multivariable Cox proportional risk regression model.@*Results@#Totally 4 850 individuals were included, with an median age of 65 (interquartile range, 8) years. There were 2 485 males (51.24%) and 2 365 females (48.76%). There were 877 individuals (18.08%) rated their health as good, 2 078 individuals (42.85%) as general, 1 895 individuals (39.07%) as poor. A total of 28 955 person-years were followed up, with an average follow-up of 5.97 years per person. There were 855 deaths by the end of follow-up in 2018, and the median survival time was 7 (interquartile range, 3) years. Multivariable Cox proportional risk regression analysis showed that there were interactive effects of age, sex and self-rated health status on mortality, respectively (both P<0.05). The results of gender-stratified analysis showed that there was no significant association between self-rated health status and mortality risk in old women (P>0.05). The mortality risk was higher in old men with poor self-rated health than with good self-rated health (<70 years, HR=5.382, 95%CI: 3.263-8.876; 70 to 79 years, HR=3.536, 95%CI: 1.070-11.686; ≥80 years, HR=3.043, 95%CI: 1.827-5.066).@*Conclusion@#There is an association between self-rated health status and mortality risk among the elderly, the old men with poor self-rated health had a higher mortality risk.
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Resumen Antecedentes: El trastorno de déficit de atención e hiperactividad (TDAH) constituye una condición crónica con riesgos asociados a largo plazo. Objetivo: Analizar el estado clínico, la ocupación y las dificultades de la vida diaria de dos cohortes de niños con diagnóstico de TDAH (2004 y 2009) después cinco y 10 años. Material y método: Estudio descriptivo y longitudinal de la base de datos WOMI correspondiente a Oviedo, Asturias, España. Se incluyeron niños detectados con TDAH por su pediatra de atención primaria. Se solicitó una entrevista telefónica voluntaria de seguimiento. Las variables de resultado fueron estado clínico y ocupacional al momento de la entrevista, síntomas de TDAH según SNAP-IV y Cuestionario de Fortalezas y Dificultades (SDQ). Resultados: La muestra entrevistada estuvo formada por 95 sujetos, de los cuales 71 respondieron a los cuestionarios SNAP-IV y SDQ; 60.7 % de la muestra no recibía tratamiento en el momento del seguimiento, 4.7 % no tenía ninguna ocupación, 25.4 % mantenía síntomas globales de TDAH en nivel superior al punto de corte clínico y 66.2 % presentaba dificultades con interferencia moderada. Conclusiones: Los síntomas del TDAH disminuyen conforme las personas crecen. Las comorbilidades de salud mental y el abandono académico no se confirmaron en la muestra.
Abstract Background: Attention deficit/hyperactivity disorder (ADHD) is a chronic condition with long-term associated risks. Objective: To analyze the clinical status, occupation, and daily life difficulties of two cohorts of children diagnosed with ADHD (2004 and 2009) after five and 10 years. Material and method: Descriptive, longitudinal study using the WOMI database corresponding to Oviedo, Asturias, Spain. Children with ADHD detected by their primary care pediatrician were included. A voluntary follow-up telephone interview was requested. Outcome variables were current clinical and occupational status, ADHD symptoms according to SNAP-IV, and Strengths and Difficulties Questionnaire (SDQ). Results: The interviewed sample consisted of 95 subjects, out of whom 71 answered the SNAP-IV and SDQ questionnaires; 60.70% of the sample did not receive treatment at the time of follow-up, 4.7% had no occupation, 25.40% still had ADHD global symptoms above the clinical cutoff point, and 66.2% had difficulties with moderate interference. Conclusions: ADHD symptoms decline as people grow up. Mental health comorbidities and academic dropout were not confirmed in the sample.
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Background: RTA are the sixth leading cause of death in India with a greater share of hospitalization, disabili-ties, deaths and socio-economic losses. The study was conducted to assess the socio-demographic determi-nants associated with households’ economic burden among RTA victims. Methods: A longitudinal study was conducted for 2 years in Puducherry employing simple random sampling to include 169 accident victims. Baseline data was collected with a semi-structured questionnaire on socio-demographic details, direct and indirect costs towards road traffic injuries. Follow up was at 6th and 12thmonth from the day of accident. Data entry and analysis were performed using Epi-data. Written informed consent from each participant was sought. Ethical clearance received. Results: Mean age of the accident victims was 36.2 (11.4) years. The median (IQR) for direct, indirect and to-tal expenses were INR 1500 (1000-22100), 18000 (2400-46500) and 3000 (1037-47125) respectively. Asso-ciation between the median (IQR) indirect expenses and marital status as well as socio-economic status of vic-tims were found to be statistically significant. Conclusion: Accident victims and their family faced financial burden, as a large proportion of victims were from productive age group belonging to lower- and middle-class income group
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Objective:To explore the potential categories of post-operative supportive care demand trajectory for patients with non-small cell lung cancer (NSCLC), analyze the influencing factors, and propose targeted interventions.Methods:This was a prospective observational study. A convenient sampling method was used to select 177 NSCLC patients who received surgical treatment in Shanghai Lung Hospital Affiliated to Tongji University from January 2021 to February 2022. The Supportive Care Demand Scale for cancer patients was used to investigate the level of patients′supportive care demand 1 day before operation, 3 days after operation, 1 day before discharge, 1 week after discharge, 1 month after discharge, and 3 months after discharge, and the potential growth model was used to identify the trajectory category and multi category Logistic regression analysis was used to explore the influencing factors.Results:Three supportive care demand trajectories were fitted out in this study, which were the continuous high demand group (46.33%), the slowly decreasing demand group (30.51%), and the low decreasing demand group (23.16%). With the potential category group 3, low demand reduction group as the reference category, Logistic regression analysis showed that high psychological distress, low social support, high disease stage, high comorbidities were more likely to enter the continuous high demand group ( OR = 0.826 to 18.526, all P<0.05), and high education level (college education and above and high school) were more likely to enter the slowly decreasing demand group ( OR = 6.076, 4.199, both P<0.05). Conclusions:The demand track of NSCLC patients for supportive care after surgery has population heterogeneity. Clinical medical staff should provide personalized social support and emotional support for patients with high disease stage, more complications and low education level in the early postoperative period.
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Objective:To explore the changes and influencing factors of psychological distress in patients with primary acute myocardial infarction (AMI) in different periods, and to provide reference for the management of psychological distress in patients with primary AMI.Methods:This was a longitudinal, prospective, observational study. From June 2021 to September 2022, 118 patients with primary AMI in Peking Union Medical College Hospital and Peking University First Hospital were selected as the research objects. The psychological distress level of patients was investigated on the points of 24 hours after illness (T 1), before discharge (T 2), 1 month after discharge (T 3), 3 months after discharge (T 4), 6 months after discharge (T 5) and 12 months after discharge (T 6), and the influencing factors were analyzed. Results:The detection rate of psychological distress in 6 follow-up survey nodes was 66.95% (79/118), 48.31% (57/118), 29.66% (35/118), 24.58% (29/118), 19.49% (23/118) and 15.25% (18/118) respectively. Education level, family per capita income and disease awareness had significant effects on the psychological distress of patients with primary AMI at the time points from T 1 to T 6 ( β values were - 1.262 to - 0.212, all P<0.05). Conclusions:The level of psychological distress in primary AMI patients decreased with time. Nursing staff should pay attention to the trajectory and influencing factors of psychological pain, and formulate targeted intervention measures to reduce the level of psychological pain and promote the comprehensive rehabilitation of patients.
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Abstract The present study therefore aims to examine trait and state anxiety, sleep habits and executive functioning during 1 year and a half of the COVID-19 pandemic in children and adolescents through the lens of parents. Assessments were conducted at three different times: April 2020 (T1), October 2020 (T2) and October 2021 (T3). The main sample included 953 children and adolescents aged 6 to 18 years, and scales were used to assess anxiety (STAIC), sleep habits (BEARS) and executive functioning (BRIEF-2). The results showed that 6 months after the outbreak of the pandemic, state and trait anxiety, sleep disturbances and executive dysfunctions increased significantly. One and a half year later, trait anxiety and sleep disturbances have been maintained, while state anxiety and executive dysfunction have decreased their scores obtaining scores similar to those of April 2020. In conclusion, there has been a further decrease in children and adolescents' mental health since the beginning of the pandemic, and it seems to remain at the present time, such as trait anxiety as a part of the personality.
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Humans , Male , Female , Child , Adolescent , Anxiety/psychology , Sleep , Executive Function , COVID-19/psychology , Parents/psychology , Social Perception , Spain , Mental Health , Longitudinal StudiesABSTRACT
Context: Eruption of primary teeth is the most anticipated event in a child’s life. Genetics, gender, socio?economic status, gestational age are a few of the determinants of the primary teeth eruption. However, the effect of gestational age on the timing of primary teeth eruption among the Indian population has not been explored to date. Aim: The study was conducted to evaluate the influence of gestational age on time and sequence of eruption of primary teeth among children of Mysore. Settings and Design: A prospective longitudinal cohort study design was conducted at ‘Baby Oral Health Promotion Clinic’ at the Department of Paediatrics, JSS Hospital, Mysore. Methods and Material: 150 newborn babies were recruited by simple random sampling and followed up from birth to 36 months. Teeth present during each visit were recorded. Data were statistically analysed and interpreted. Statistical Analysis Used: Descriptive statistics, t?test for an independent sample, and Pearson’s Chi?squared test were applied. Results: The mandibular central incisor was the first tooth to erupt. Statistically insignificant early eruption in males was noted in both term and preterm children. When the chronological ages were compared, the preterm group showed a statistically significant delay in the eruption of all the teeth. However, when the age was adjusted for prematurity, only the central incisors and second molars showed a statistically significant delay. Conclusions: Gestational age has a strong significant association with the eruption of primary teeth and maybe one of the strong predictors for delayed eruption among children of Mysore.
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Resumen Introducción: la fragilidad es un indicador del estado de salud en la vejez y un síndrome clínico común en adultos mayores; conlleva un elevado riesgo de resultados deficientes de salud que incluyen caídas, incidentes de discapacidad, hospitalización y mortalidad. Este estudio tuvo como objetivo identificar las diferentes trayectorias de la fragilidad y los factores relacionados con esta entre adultos mayores mexicanos a lo largo del tiempo. Metodología: los datos provienen de un panel de cuatro rondas compuesto por adultos mayores mexicanos y desarrollado de 2001 a 2015 por el Estudio Nacional de Salud y Envejecimiento en México (ENASEM). La fragilidad es la acumulación de déficits a partir de un índice de fragilidad. Se aplicó un análisis multinivel, utilizando modelos jerárquicos para conocer los cambios de trayectorias de fragilidad y qué factores se relacionan con ella. Resultados: ser mujer mayor, viuda y tener un bajo nivel educativo fueron factores de riesgo para un índice de fragilidad alto y una menor satisfacción financiera o realizar actividades en el hogar tienen efectos adversos. Conclusiones: se halló una prevalencia de la fragilidad según la proporción de déficits que poseen los individuos y sus primordiales componentes asociados. Se requiere mejorar las condiciones socioeconómicas de salud en fases previas a la vejez con miras a evitar la presencia de fragilidad en el futuro.
Abstract Introduction: Frailty is an indicator of health status in old age and a common clinical syndrome in older adults that carries an increased risk of poor health outcomes, including falls, incidents of disability, hospitalization, and mortality. This study aimed to identify the different trajectories of frailty and the factors related to frailty among Mexican older adults over time. Methods: Data are from a four-wave panel composed of older Mexican adults from 2001 to 2015 of the Mexican Health and Aging Study (MHAS). Frailty is the accumulation of deficits using a frailty index. A multilevel analysis, using hierarchical models, was applied to know the changes of frailty trajectories and what factors are related to it. Results: Being female, older, being widowhood, and having a lower level of education were risk factors for having a high frailty index and lower financial satisfaction doing activities at home have adverse effects. Conclusion: The findings of this work present information about the prevalence of frailty considering the proportion of deficits that individuals possess and their main associated components in older Mexican adults. It is necessary to improve socioeconomic health conditions in phases before old age to avoid developing frailty in the future.
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Humans , Male , Female , Aged , Aged, 80 and over , Aging , Frailty , Longitudinal Studies , MexicoABSTRACT
Resumen Desde la teoría tridimensional, la ansiedad escolar se define como un conjunto de síntomas que se emiten desde tres sistemas de respuesta. El objetivo de este estudio fue evaluar las respuestas de ansiedad escolar en estudiantes chilenos de educación primaria para determinar los posibles cambios a nivel temporal. Para ello, se contó con 155 niños de tres cursos distintos, a quienes se les evaluó el nivel de ansiedad escolar durante tres años consecutivos. El instrumento utilizado fue el Inventario de Ansiedad escolar para la educación primaria (IAEB), que mide la respuesta de ansiedad de tipo cognitiva, psicofisiológica y motora. Se realizaron análisis de varianza de medidas repetidas para determinar la estabilidad temporal. Los resultados indican que la media no mostró diferencias estadísticamente significativas y se mantuvo la ansiedad escolar en estos niños en el periodo de tres años. Se apoyó la posibilidad de que se presente como un síntoma estable de los estudiantes, más que responder a eventos puntuales del entorno.
Abstract Since the three-dimensional theory, school anxiety is defined as a set of symptoms arising from three response systems. The objective of this study was to evaluate school anxiety responses in Chilean primary school students, during three consecutive years, to determine possible changes over time. To this end, 155 children from three different courses were included; they were evaluated for their level of school anxiety for three consecutive years. The instrument used for this was the School Anxiety Inventory for Primary Education (IAEB), which measures the cognitive, psychophysiological and motor anxiety responses. Analysis of variance of repeated measures was performed to determine temporal stability. The results indicated that the mean did not show statistically significant differences, maintaining school anxiety in these children over the three-year period, supporting the possibility that it appears as a stable symptom of the students, rather than responding to specific events in the environment.
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Humans , Male , Female , Child , Adolescent , Anxiety , Longitudinal Studies , Education, Primary and Secondary , ChileABSTRACT
Resumen Las características de individuos con trastornos del espectro Autista (TEA) persistente (TEA-P) o con TEA remitente (TEA-R) en el tiempo son poco conocidas. Este estudio longitudinal se planteó con tres objetivos: 1) determinar la tasa de persistencia/recuperación en la adolescencia de niños con diagnós tico TEA; 2) comparar el funcionamiento ejecutivo (FE), manifestaciones socio-adaptativas y conductuales de adolescentes TEA-P y TEA-R; y 3) identificar el porcentaje de individuos de los grupos TEA-P y TEA-R con puntuaciones normalizadas en FE y manifestaciones socio-adaptativas y conductuales en la infancia (T1) y en la adolescencia (T2). La muestra en el Tiempo 1 estuvo integrada por 45 niños con TEA (edad 7 a 11 años) de los que 32 mantenían el diagnóstico del trastorno 5 años después. Los padres y profesores cumplimentaron cuestionarios de FE, teoría de la mente (ToM), manifestaciones socio-adaptativas y conductuales en T1 y en T2. El grupo con TEA-P presentó significativamente más problemas y peor evolución en FE, características socio-adaptativas y conductuales que el grupo TEA-R. Los hallazgos destacan la variabilidad de la trayectoria evolutiva del TEA y la necesidad de realizar un seguimiento psicoeducativo y médico frecuente en este trastorno del neurodesarrollo.
Abstract The characteristics of individuals with persis tent ASD (ASD-P) and remittent ASD (ASD-R) are little known. This longitudinal study had threeobjectives1) To determine the persistence and recovery in children with autism spectrum disorder diagnosis in adolescence: 2) To compare executive functioning (EF), socio-adaptive and behavioral manifestations of ASD-P and ASD-R adolescents; and 3) to identify the percentage of normalized individuals in ADS-P and ADS-R groups in EF, socio-adaptive and behavioral manifestation in childhood and adolescence. The sample at T1 was comprised of 45 children with ASD (aged 7-11), maintaining 32 ASD diagnosis five years later. Parents and teachers completed questionnaires on EF, theory of mind, socio-adaptive and behavior difficulties, at both time points. The ASD-P group presented significantly more problems than group ASD-Rand showed worst evolution in EF, socio-adaptive and behavioral domains. Our findings highlight the variability of developmental trajectories of children with ASD.
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The study aimed to analyze the quality of life, oral health impact on daily activities and its association with adherence to dental treatment, and other factors, among vulnerable adolescents. It is a longitudinal analytical study performed with 15- to 19-year-old adolescents in the city of Piracicaba, São Paulo, from 2014 to 2015. The sample consisted of 476 adolescents referred for the treatment of caries and/or periodontal disease in family health units (initial phase). After 18 months, 325 individuals were assessed to investigate the dental treatment provided (final phase). The response variables considered in the final phase were the Quality of Life (WHOQOL-bref) and the Oral Impacts on Daily Performances (OIDP) questionnaires. The independent variables analyzed were sex, age, treatment adherence, and family cohesion and adaptability. A multiple regression model was used. The data on the physical (p<0.0001), social (p=0.0003), environmental (p<0.0001), and psychological (p<0.0001) domains of the WHOQOL collected in the initial phase had a positive relationship with the same domains assessed in the final phase. The WHOQOL data of the initial phase were associated with the WHOQOL data of the final phase (p=0.0341). The OIDP data of the initial phase were associated with the OIDP data of the final phase (p<0.0001). The OIDP of volunteers who did not adhere to dental treatment showed a higher impact (p=0.0234). The quality of life and impacts on daily performances of adolescents improved between the evaluation periods.
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Quality of Life , Dental Care , Adolescent HealthABSTRACT
ObjectiveTo analyze the effect of frailty status on the risk of mortality in a community-based population aged 45 years and above in Shanghai with different characteristics, and to provide further basis for population-based interventions for frailty and prevention of adverse outcomes. MethodsData were derived from baseline data from the Shanghai prospective study on AGEing and adult health (2009-2010) and cohort follow-up of causes of death up to October 30, 2021. Frailty index (FI) scores were constructed from 40 variables. Those with frailty index FI≥0.2 were judged to be in a frail state, and a multifactorial Cox regression model was used to calculate the hazard ratio (HR) to evaluate the effect of frailty status on the risk of death in different age groups by gender. Socioeconomic characteristics (age, residence, marital status, education and family economic level, etc.) and health-related behaviors (smoking, alcohol consumption, fruit and vegetable intake, social participation, etc.) were included as control variables. ResultsThe study included 7 978 subjects, 777 (9.7%) of whom were in a frail state. After (11.3±1.8) years of follow-up, 1 043 (13.1%) individuals were dead, including 214 (27.5%) who were frail. The results of the multifactorial Cox regression analysis showed that the effect of frailty on the risk of death in each subgroup was in descending order of men in the middle-aged group (45‒ years) (HR=2.92, 95%CI: 1.38-6.19), women in the low-aged elderly group (60‒ years) (HR=1.68, 95% CI: 1.08-2.60), and women in the old-aged elderly group (≥75 years and older) (HR=1.59, 95%CI: 1.22‒2.06). ConclusionFrailty is associated with the risk of death, and we should focus on the frailty status of men aged 45~59 years and women aged 60 years and above. Early screening and assessment of frailty status and taking appropriate preventive interventions may reduce the occurrence of adverse outcomes and premature death.
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Objective:To understand the incidence, severity and the change trajectory of symptoms in adult patients with acute leukemia during treatment, so as to provide a reference for clinical medical staff to conduct specific symptom screening and management.Methods:From March 2017 to August 2018, 69 patients who were newly diagnosed with acute leukemia at the Nanfang Hospital of Southern Medical University were conveniently selected. The Memory Symptom Assessment Scale was used to investigate the patients before chemotherapy (T1), after the first chemotherapy (T2), after the second to third chemotherapy (T3) and after the fourth to fifth chemotherapy (T4).Results:The severity score of psychological symptoms in adult patients with acute leukemia at T1, T2, T3, and T4 were 1.00(0.58, 1.42), 1.00(0.83, 1.67), 0.67(0.33, 1.00) and 0.67(0.33, 1.00). The severity score of physical symptoms at T1, T2, T3, and T4 were 0.50(0.21, 0.83), 1.00(0.54, 1.33), 0.75(0.58, 1.17) and 0.92(0.63, 1.08), respectively. The score difference was statistically significant ( H = 28.34, 27.14, both P<0.01) at different time points. The score of physical symptoms reached a peak at T2. In the psychological dimension, the severity and incidence of energy deficiency were higher in T1-T4. Conclusions:Adult acute leukemia patients have different focal symptoms in different treatment stages. Clinical medical staff should provide effective and personalized nursing intervention for patients in different treatment stages.
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Objective:To explore the changing track of cancer-related fatigue in patients with lung cancer during perioperative period and analyze its influencing factors.Methods:From December 2020 to May 2021, 162 eligible patients with lung cancer were selected in the First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital by convenient sampling method. Mental resilience and social support were investigated before operation (T0);and cancer-related fatigue was investigated before operation (T0),3 days after operation (T1), 1 week after operation (T2), 2 weeks after operation (T3) and 1 month after operation (T4), and Latent Class Growth Model was used to identify the track categories. Logistic regression analysis was used to analyze the influencing factors.Results:Three cancer-related fatigue tracks were fitted in this study, which were no fatigue group (31.7%), increased fatigue group (36.0%) and sustained fatigue group (32.3%). Univariate analysis showed that smoking history ( χ2=14.83, P<0.05), BMI ( χ2=29.67, P<0.05), hemoglobin count ( F=4.57, P<0.05), mental resilience ( F=35.53, P<0.05), social support ( F=47.53, P<0.05) were related to the track category of cancer-related fatigue. Logistic regression analysis showed that smoking history, over weight/obesity, resilience and social support were the predictors of cancer-related fatigue locus ( P<0.05). Conclusions:Perioperative cancer-related fatigue of patients with lung cancer has different change trajectories, patients with higher BMI and lower resilience are more likely to have a tendency of persistent fatigue. Patients with smoking history and lower social support are more likely to have an upward trend of fatigue. For this kind of lung cancer patients, medical staff should take timely and effective intervention measures to improve their cancer-related fatigue.
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Objective:To investigate the longitudinal trajectory and influencing factors of cancer-related fatigue (CRF) in breast cancer patients during chemotherapy.Methods:From March 2019 to January 2020, breast cancer patients in Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine and Peking Union Medical College Hospital were selected as the research objects to conduct follow-up investigation. The survey tools included general information questionnaire, Cancer-related Fatigue Assessment Scale, International Physical Activity Questionnaire, and the Pittsburgh Sleep Quality Index Scale.Results:A total of 91 patients were included in the study. The incidence of severe CRF at each time point before chemotherapy, 3 weeks after chemotherapy and 6 weeks after chemotherapy were 1.1% (1/91), 8.8% (5/57) and 2.1% (1/48), respectively. The results of the generalized estimation equation showed that the trajectory of the total score CRF firstly increased and then decreased, reaching a peak at 3 weeks after chemotherapy (35.45±13.07), and mild CRF change showed statistical difference ( P<0.05). In addition, BMI and sleep and daytime dysfunction were the influencing factors of the total score of CRF. Disease stage, sleep disturbance and daytime dysfunction were the influencing factors of CRF with different severity. Conclusions:CRF is a prominent problem in breast cancer patients during chemotherapy. Attention should be paid to high-risk individuals with abnormal BMI and daytime function by medical staff.
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OBJECTIVES@#After renal transplantation, patients need to take various immunosuppressant, but the drug compliance is poor. The theory of planned behavior suggests that the past medication behavior and subjective norms of individuals are closely related to medication compliance. This study aims to explore the change of medication compliance behavior and its influenting factors for renal transplantation patients at different stages.@*METHODS@#This study was a prospective longitudinal study. The Basel Assessment of Adherence with Immunosuppressive Medication Scale (BAASIS), Medication Belief Scale, Social Support Scale and Quality of Life Scale were used to dynamically follow up renal transplantation patients at pre-operation and 1-month, 6-month, and 12-month after transplantation.@*RESULTS@#A total of 300 patients completed the whole follow-up. The percentage of patients with good medication compliance was 97.60%, 87.30% and 84.30% at 1-month, 6-month and 12-month after transplantation respectively. The life quality of the patients was decreased at 6 months after the operation, and the patients with better self-reported life quality had poor medication compliance. After adjusting for demographic data, the risk of medication incompliance in patients with poor medication compliance before operation was 37.646 times than those with good compliance. Patients who did not use medication reminders had high risk (odds ratio=2.467) of drug non-adherence. The risk of drug non-adherence in patients with more postoperative misgivings was 1.265 times compared with that in patients with less postoperative misgivings.@*CONCLUSIONS@#The medication compliance decreases with the time of transplantation, but the medication compliance of patients with good self-reported life quality is poor. Medication concerns reduce the compliance behavior. Preoperative medication behavior has a significant predictive effect on postoperative behavior. Medication reminder is a protective factor for promoting compliance. Medical staff should pay more attention to preoperative medication belief, behaviors and reminder of using drug so as to provide precise intervention in the renal transplantation patients.