Characteristics of caregivers submitted to music therapy after the death of loved ones / Características de cuidadores sometidos a la musicoterapia después de la muerte de sus seres queridos / Características de cuidadores submetidos à musicoterapia após a morte de seus entes queridos

ABSTRACT Objective: To describe the characteristics of bereaved caregivers submitted to post-loss music therapy. Method: This is a cross-sectional database from a randomized clinical trial that performed music therapy for caregivers who lost their loved ones to cancer. The following variables were used for this analysis: sociodemographic, religious beliefs, previous sound-musical experiences, and experiences related to care, loss and repair processes. Descriptive statistical analyzes were performed. Results: Of the 69 participants, 85.5% had a strong bond/secure attachment with their loved ones; 68.1% followed a long death and dying process (> 6 months), which was related to a chronic disease; 88.4% did not participate in conspiracy of silence, suggesting a satisfactory communication; 60.9% reported receiving spiritual/religious support, suggesting healthy and continent support; and all participated in funeral rites. Conclusion: The process of elaborating the bereavement of caregivers indicated the presence of protective factors.

RESUMEN Objetivo: Describir las características de los cuidadores sometidos a la musicoterapia durante el luto. Método: Se trata de un corte transversal del banco de datos de un ensayo clínico aleatorizado, en el cual utilizó la musicoterapia en cuidadores que perdieron a sus seres queridos por cáncer. Para este análisis, se utilizaron las siguientes variables: sociodemográficas, creencias religiosas, experiencias sonoras y musicales previas, y vivencias relacionadas a los procesos de cuidado, pérdida y reparación. Se realizó un análisis estadístico descriptivo. Resultados: De los 69 participantes, el 85,5% tenían un vínculo fuerte/apego seguro con sus seres queridos; el 68,1% acompañaron un proceso de muerte y morir largo (> 6 meses), cuya muerte estuvo relacionada a una enfermedad crónica; el 88,4% no participaron en la conspiración de silencio, lo que sugiere una comunicación satisfactoria; el 60,9% estaban recibiendo apoyo espiritual/religioso, lo que sugiere un apoyo sano y contenido; y todos participaron en rituales fúnebres. Conclusión: El proceso de elaboración del luto de los cuidadores indicó la presencia de factores de protección.

RESUMO Objetivo: Descrever as características de cuidadores enlutados submetidos à musicoterapia pós-perda. Método: Trata-se de um corte transversal do banco de dados de um ensaio clínico randomizado que realizou musicoterapia para cuidadores que perderam seus entes queridos por câncer. Para esta análise utilizaram-se as seguintes variáveis: sociodemográficas, crenças religiosas, experiências sonoro-musicais pregressas e vivências relacionadas aos processos de cuidado, perda e reparação. Foram realizadas análises estatísticas descritivas. Resultados: Dos 69 participantes, 85,5% tinham um vínculo forte/apego seguro com os seus entes queridos; 68,1% acompanharam um processo de morte e morrer longo (> 6 meses), cuja morte está relacionada a uma doença crônica; 88,4% não participaram de conspiração de silêncio, sugerindo uma comunicação satisfatória; 60,9% referiram estar recebendo apoio espiritual/religioso, sugerindo apoio saudável e continente; e todos participaram de rituais fúnebres. Conclusão: O processo de elaboração do luto dos cuidadores indicou a presença de fatores de proteção.

Characteristics of caregivers submitted to music therapy after the death of loved ones.

OBJECTIVE: To describe the characteristics of bereaved caregivers submitted to post-loss music therapy. METHOD: This is a cross-sectional database from a randomized clinical trial that performed music therapy for caregivers who lost their loved ones to cancer. The following variables were used for this analysis: sociodemographic, religious beliefs, previous sound-musical experiences, and experiences related to care, loss and repair processes. Descriptive statistical analyzes were performed. RESULTS: Of the 69 participants, 85.5% had a strong bond/secure attachment with their loved ones; 68.1% followed a long death and dying process (> 6 months), which was related to a chronic disease; 88.4% did not participate in conspiracy of silence, suggesting a satisfactory communication; 60.9% reported receiving spiritual/religious support, suggesting healthy and continent support; and all participated in funeral rites. CONCLUSION: The process of elaborating the bereavement of caregivers indicated the presence of protective factors.

Coping with colorectal cancer: a qualitative exploration with patients and their family members.

BACKGROUND: Extensive family coping research has been conducted among breast cancer, prostate cancer and melanoma with lesser emphasis on the coping experiences of colorectal cancer (CRC) patients and their family members. OBJECTIVE: To examine ways in which patients and their family members cope with the diagnosis of CRC. METHODS: A total of 73 participants (21 patients, 52 family members) from 23 families described their experiences during and after a CRC diagnosis, including their coping experiences with the diagnosis. Data from semi-structured interviews were audio recorded and transcribed. The data were analyzed utilizing content analysis with inductive coding methods. RESULTS: Eight major themes were identified: positive reframing, holding on to a sense of normalcy, religion and spirituality, joining a group, creating awareness of CRC, lifestyle change, seeking information and alternative treatments. Maintaining an emotional sense of normalcy through positive thinking, engaging in activities to take one's mind off the diagnosis and believing that there is a higher authority which has control over the diagnosis and life were vital for the patients and their family members. Patients and family members used similar coping strategies. CONCLUSION: Findings from this study have implications for understanding how families blend emotion-based and problem-focused coping strategies in the face of a CRC diagnosis. Further developing evidence-based interventions that target coping and well-being in cancer patients and extending them to family members is necessary and holds great promise for providers who care for patients with familial cancers.

Why fathers are too important to ignore: communication about sexuality between fathers and daughters.

This cross-sectional study examined perceptions of sexual communication between 38 dyads of fathers and daughters. Results indicate agreement about the 3 topics most and least frequently discussed but significant differences in perceived extent of sexual communication. These differences indicate that interventions may be needed to increase fathers' comfort with sexual communication.

Mothers' screening histories influence daughters' vaccination uptake: an analysis of linked cervical screening and human papillomavirus vaccination records in the North West of England.

AIM: Achieving high human papillomavirus (HPV) vaccine coverage is important because cervical screening coverage is declining. As key decision makers, mothers' experiences of, and participation in, the cervical screening programme could affect vaccination consent. We investigate whether mother's screening history influences daughter's participation in the HPV vaccination programme. METHODS: Mothers' cervical screening records from the National Health Authority Information System were linked to the daughters' HPV vaccination records from the Child Health System in North West England by address. Odds ratios for daughter's vaccination were computed using Logistic Regression, adjusting for age, Primary Care Trust and vaccine cohort (AOR). RESULTS: Daughters in both the routine and catch up programmes were more likely to have initiated vaccination and completed the course if their mothers had attended screening. The association was strongest when mothers had attended within the last 5 years (AOR in routine group: 3.5 (95% confidence interval (CI) 3.1-4.0) for initiation and 2.2 (1.6-2.9) for retention). Mothers who had personally decided to cease screening were less likely to have vaccinated daughters than those who had ceased for medical indications. Daughters were more likely to have been vaccinated if their mothers had received an abnormal smear result. CONCLUSIONS: Daughter's HPV vaccination uptake was associated with mother's cervical screening attendance. Daughters of mothers who are not engaged with preventive services are less likely to be vaccinated and may be less likely to engage with screening. This makes mothers central to health interventions to promote both cervical screening and HPV vaccination.

[Body-mind unity in tandem hypnotherapy]. / Test-lélek egység a tandem hipnoterában.

INTRODUCTION: The new bodymind theory describes unity of body and mind as a quantum process, which can go back to embryonic period of life. METHOD: Authors have worked out tandem hypnotherapy method regarding bodymind theory. Tandem has two meanings: (1) a multi-seater bicycle, (2) a mosaic word: Touch of Ancient and New generations with a Dialogue Experiencing Oneness of Minds (TANDEM). Hypnotherapy, psychodrama, family therapy, Hellinger's systemic-phenomenological approach, and, the holding-therapy can be viewed as precedents of the method. More than two persons in a physical closeness touching each other take part in therapy: (1) patient(s), (2) one or more co-therapists; one or more antagonists (in the latter case is of hypnodrama), (3) therapist, who is responsible to take the tandem of patient(s) and co-therapist(s) to trance, while (s)he keeps distance securing neutrality. RESULTS: The method will be illustrated with some case-vignettes. DISCUSSION: Sensory-motor level of development is supposed by the authors as stemmed from fetal period of life. It is suggested to be paralled to associative mode of experiencing, in which object and subject can't be viewed as differenciated from each other resulting unity or oneness experience. The most effective stimulus of associative mode of experiencing is regarded to be physical closeness and touching, which are seen in intimate situations. That is the reason why fundamental rules of therapeutic touching are to be kept. CONCLUSION: The new method can be viewed as a form of bodypsychotherapy having possibilities to resolve pathological consequences of either fetal or intergenerational traumas.

Caring for a daughter with intellectual disabilities in managing menstruation: a mother's perspective.

BACKGROUND: The concerns of mothers and their experiences while providing help to their daughters with intellectual disability (ID) and considerable support needs during menstruation have rarely been addressed. This qualitative study explored mothers' experiences and perceptions of managing their daughters' menstruation. METHOD: Twelve Taiwanese mothers of 13 daughters with ID (1 mother had twins) were interviewed to explore their experiences of providing help to their daughters with high support needs during menstruation. RESULTS: Support networks were limited and mothers developed their own strategies for managing their daughter's menstruation. Surgical hysterectomy or use of medication to cease or postpone menstrual bleeding was never considered by the mothers. The financial cost of menstrual pads and nappies was significant. CONCLUSIONS: Both an appropriate allowance for families involved in the menstrual care of women with ID and access to appropriate support are needed. More information and educational programs need to be provided to relevant professionals and carers.

Effects of three caregiver interventions: support, educational literature, and creative movement.

The primary focus of this study is to compare the effectiveness of three distinct intervention techniques in relieving some of the stress experienced by midlife daughters' caregiving for their frail mothers. The three techniques are: (a) a home-based literature "tip of the week" group, (b) a caregiver's support group, and (c) a creative-movement group. Based on a review of caregiving literature, no other studies have utilized a home-based literature intervention or a creative-movement intervention with midlife daughters providing informal care to frail mothers. As part of the weekly assessment evaluation, participants were asked to rate how helpful the previous week's session was with respect to five mental health variables: irritability, depression, anxiety, stress, and concentration. Overall, the support-based group had higher average scores for each of the five mental health variables and the highest overall mental health score. Future research and promising applications of future intervention programs are discussed.

Post-traumatic growth and psychosocial adjustment of daughters of breast cancer survivors.

PURPOSE/OBJECTIVES: To examine post-traumatic growth, or positive life changes, and its correlates among adult daughters of breast cancer survivors and to compare their psychosocial adjustment to women with healthy parents. DESIGN: Descriptive, cross-sectional survey. SETTING: Outpatient oncology units in two urban hospitals and two breast cancer organizations. SAMPLE: 30 adult daughters of breast cancer survivors (mean age = 38.1 years) and 16 women with healthy parents. METHODS: Participants were recruited by hospital or research staff or responded to an announcement in a newsletter. Respondents completed the Post-Traumatic Growth Inventory and standardized assessments of psychosocial adjustment. MAIN RESEARCH VARIABLES: Post-traumatic growth and demographic, stressor, and psychosocial variables. FINDINGS: Women who cared for their mothers following breast cancer diagnosis and perceived their mothers' illness to be stressful reported greater post-traumatic growth. Life satisfaction, social support, emotional processing strategies, and problem-focused coping strategies also were positively associated with growth. Women with maternal histories of breast cancer and those with healthy parents did not differ in psychosocial well-being, including affect, life satisfaction, and social support. CONCLUSIONS: Findings suggest that some daughters of breast cancer survivors experience positive life changes following their mothers' illness. IMPLICATIONS FOR NURSING: For nurses seeking to adopt a holistic approach to practice, the personal growth of women following life-threatening familial illness warrants attention.

Beginning treatment for paediatric acute myeloid leukaemia: diagnosis and the early hospital experience.

Despite the plethora of clinical literature on the medical treatment for paediatric acute myeloid leukaemia (AML), there is a dearth of psycho-social literature on how families cope with either the disease or its treatments. The present article seeks to make a contribution by placing psychosocial aspects of childhood AML on the agenda. The findings are from a 5-year longitudinal, qualitative study on the psychosocial aspects of paediatric leukaemia. Qualitative data is gathered from open-ended interviews at three points in time on the experience of illness. The holistic findings from T1 present the impact of diagnosis and early treatment for childhood AML from the perspective of mothers, father, sibling and child patients. The study is also following up families with related disorders, thus it is possible to assess difference to other haematological groups. The findings indicate that the families bring scant prior understanding of the illness, and experience the diagnosis with fear and seriousness as a confrontation with death. At the point of entering treatment they are in a profound sense of shock and grief, which is exacerbated by a distressing, all pervading, sense of uncertainty. Families can be overwhelmed by the exhaustion of attending to the escalating practical demands of the situation combined with fatigue, worry and poor nutrition. All families find dealing with the invasive procedures and aggressive drug protocols emotionally challenging. However, in spite of the difficulties, parents have a strong desire to be with their child and find any separation painful. Families come to view the ward as a comfort zone where they have the support of the health and allied health team and the camaraderie of others experiencing a similar situation. However, even this support has to be qualified by the need for personal space, the difficulty of handling complex emotions, and the fear of being overwhelmed by difficulties other families face. The insights argue strongly for sensitive support for all individuals coping with childhood AML.

Patterns of knowing as a method of assessment and intervention for children exposed to family-member homicide.

The patterns of knowing identified by Carper in 1978, specifically empirics, aesthetics, ethics, and personal knowing, continue to be applied to the expanding role of nursing. Sociopolitical knowing and unknowing add important dimensions, as well. Knowing is an individual process and a metamorphosis of interplay among theory, research, and practice. These patterns of knowing are inherently applicable to any specialty within the profession of nursing. As nursing specialties such as forensic nursing emerge, the patterns of knowing can provide a foundational approach to comprehensive assessment and intervention for victims of interpersonal violence. As an example, forensic nurses confronted with children who have witnessed family-member homicide can use all of the patterns of knowing for comprehensive nursing assessment and intervention.

Effects of ethanol administration and induction of anxiety-related affective states on the acoustic startle reflex in sons of alcohol-dependent fathers.

BACKGROUND: The high rate of comorbidity between alcoholism and anxiety disorders suggests some causal link. This study used the startle reflex to investigate whether increased reactivity to stimuli inducing fear or related affective states might be one mechanism by which a family genetic risk promotes the development of alcohol use disorders. METHODS: Thirty-one sons of alcoholics (PH+) were recruited from the participants of a longitudinal epidemiologic survey representative of the Munich area population between 18 and 25 years. Thirty male low-risk participants without parental alcoholism (PH-) were matched for age and history of psychiatric disorders. The baseline acoustic startle reflex was elicited before and after subjects drank 0.6 g/kg ethanol or placebo in a randomized, double-blind, placebo-controlled crossover design. Thereafter, the startle response was investigated while the subjects' affective state was manipulated by announcement of aversive electric finger stimuli to induce fear potentiation and by presentation of photographic slides previously rated to be pleasant, unpleasant, or neutral in their emotional valence. RESULTS: Plain startle response was lower in PH+ than PH- participants and was equally dampened by alcohol in PH+ and PH- subjects. Threat of finger shocks increased the startle response to the same extent in both groups. This fear potentiation effect was significantly attenuated by alcohol given on the second experimental day but not if alcohol was administered first and placebo on the second day. Pleasant and unpleasant slides decreased and increased startle response, respectively, and this effect was influenced by neither risk group nor alcohol. CONCLUSIONS: The acoustic startle reflex seems to be reduced in sons of alcoholics. The nonsignificant results during startle modification do not support the concept of increased reactivity to anxiety-related environmental stimuli as a mechanism promoting alcohol use disorders in subjects at increased family genetic risk for alcoholism.

Lower high-density lipoprotein cholesterol and increased omega-6 polyunsaturated fatty acids in first-degree relatives of bipolar patients.

BACKGROUND: Lower serum high-density lipoprotein cholesterol and increased ratio of omega-6/omega-3 fatty acids have been reported in unipolar and bipolar depressed patients. Changes in cholesterol and fatty acids have been suggested to affect membrane viscosity and consequently serotonergic neurotransmitter expression. The goal of this study was to investigate whether lower baseline cholesterol and increased omega-6 and lower omega-3 fatty acids are present in healthy first-degree relatives of bipolar patients compared with controls and whether these changes were associated with neuroendocrine responses to an i.v. tryptophan challenge or mood. METHOD: Baseline cholesterol, fatty acids and mood were determined in healthy first-degree relatives of patients with bipolar disorders (N = 30) and healthy matched controls (N = 15) (parallel-group design). Prolactin and cortisol were measured following tryptophan infusion. RESULTS: First-degree relatives showed significantly lower plasma high-density lipoprotein cholesterol and increased total omega-6 fatty acids in phospholipids. Lower total omega-3 and higher total omega-6 fatty acids in phospholipids were positively correlated with peak prolactin response to tryptophan. Lower total omega-3 fatty acids in phospholipids and cholesteryl esters were associated with lower mood. CONCLUSIONS: Abnormalities of lower plasma high-density lipoprotein cholesterol and increased total omega-6 fatty acids in phospholipids in these subjects are in agreement with findings in bipolar and major depressed patients. Changes in fatty acids show an association with central serotonergic parameters. It is suggested that these abnormalities in cholesterol and fatty acids may constitute a trait marker for bipolar disorders.

Twins dispute memory ownership: a new false memory phenomenon.

In three experiments, we examined a new memory phenomenon: disputed memories, in which people dispute ownership of a memory. For example, in one disputed memory each of two twins recollected being sent home from school for wearing too short a skirt, although only one of them was actually sent home. In Experiment 1, 20 sets of same-sex adult twins were asked to produce a memory for each of 45 words, and most twins spontaneously produced at least one disputed memory. In Experiment 2,20 different sets of same-sex adult twins rated disputed memories as higher in recollective experience, imagery, and emotional reliving than nondisputed memories. In Experiment 3, siblings who were close in age as well as same-sex friends were also found to have disputed memories, but less often than twins.