ABSTRACT
This study examined the association of clinical factors, independent of sex and high psychosocial adversity (HPAd), with the presence of ADHD or other mental disorders, specifically within a middle-income country with a non-Caucasian population. A multi-centric cross-sectional study was conducted in three sites in Colombia. Our study recruited trios of an ADHD proband, one sibling, and one parent. We used valid instruments for assessing parents and siblings. The sample included 223 siblings, an average age of 12.3 (SD 3.9), and 51.1% Females. The ADHD recurrence risk ratio (λ) was 12. The clinical factors mainly associated with the presence of ADHD, independent of sex and HPAd, were 1) Pregnancy and childbirth complications, 2) Delayed psychomotor development, 3) Temperament, and 4) Sleep disturbances. Our research showed that, independently of HPAd and the male sex, there were other clinical factors associated with ADHD and other psychiatric disorders in this population. These findings need to be replicated in similar populations globally.
Subject(s)
Attention Deficit Disorder with Hyperactivity , Mental Disorders , Siblings , Humans , Female , Male , Colombia , Siblings/psychology , Cross-Sectional Studies , Child , Adolescent , Mental Disorders/epidemiology , Sex Factors , Adverse Childhood Experiences/statistics & numerical data , Risk FactorsABSTRACT
BACKGROUND: Forcibly displaced adolescents face increased risks for mental illness and distress, with adolescent girls disproportionately affected in part due to heightened gender inequity. Although the family unit has the potential to promote healthy development in adolescents, few family interventions have employed a gender transformative approach or included male siblings to maximize benefits for adolescent girls. METHODS: This study will assess a whole-family and gender transformative intervention-Sibling Support for Adolescent Girls in Emergencies (SSAGE)-to prevent mental health disorders among adolescent girls in Colombia who were recently and forcibly displaced from Venezuela. The study will employ a hybrid type 1 effectiveness-implementation pilot randomized control trial (RCT) to test the program's effectiveness to explore determinants of implementation to establish the feasibility, acceptability, and fidelity of SSAGE. To address these aims, we will enroll 180 recently arrived, forcibly displaced adolescent girls in an RCT and examine the program's effectiveness in the prevention of mental illness (through reduction in anxiety, depression, interpersonal sensitivity, and somatization symptoms) one-month post-intervention. We will use contextually adapted to collect data on the hypothesized mechanistic pathways, including family attachment, gender-equitable family functioning, self-esteem, and coping strategies. The implementation evaluation will employ mixed methods to assess the program's feasibility, acceptability, fidelity, and barriers and facilitators to successful implementation. DISCUSSION: Findings can support humanitarian program implementation, as well as inform policy to support adolescent girls' mental health and to prevent the myriad disorders that can arise as a result of exposure to displacement, conflict, and inequitable gender norms.
Subject(s)
Mental Disorders , Siblings , Adolescent , Female , Humans , Male , Colombia/epidemiology , Mental Disorders/prevention & control , Mental Disorders/psychology , Pilot Projects , Refugees/psychology , Siblings/psychology , Randomized Controlled Trials as TopicABSTRACT
OBJECTIVES: To investigate the associations between caregivers' burden, family quality of life (QoL), and siblings' QoL in Brazilian families of children with cerebral palsy, and to analyze siblings' QoL using as a parameter the QoL of typically developed Brazilian children. METHODS: It was a cross-sectional study. The 212 families, 212 caregivers and 131 siblings completed the Family Quality of Life Scale, Burden Interview, and KIDSCREEN-27 Child and Adolescent Version and Parents Version questionnaires at a neurorehabilitation center in southeast Brazil. Univariable and multivariable models were used. RESULTS: Family QoL significantly worsened as caregivers' burden increased (95 % CI -0.66 to -0.38). Caregivers' burden was significantly lower with increasing family QoL scores (95 % CI -0.52 to -0.30). Self-reported siblings' QoL was significantly worse than that of their typically developed peers (95 % CI -7.6 to -3.6). Self-reported siblings' QoL was significantly lower as siblings' age (95 % CI -2.52 to -0.59) and caregivers' burden (95 % CI -0.35 to -0.05) increased. Parent-reported siblings' QoL was significantly lower with increasing caregivers' burden (95 % CI -0.45 to -0.16) and higher as family QoL increased (95 % CI 0.09 to 0.37). CONCLUSIONS: The cross-sectional nature of these data precludes any statement of causality. Family QoL worsened with higher caregivers' burden levels. Lower caregivers' burden scores were associated with a higher family QoL. Siblings' QoL was impaired as compared to typically developed peers, worse among older siblings, and as caregivers' burden increased and better with higher family QoL levels. Future multicenter studies may validate the generalizability of the present findings.
Subject(s)
Caregivers , Cerebral Palsy , Quality of Life , Siblings , Humans , Cerebral Palsy/rehabilitation , Cerebral Palsy/psychology , Child , Male , Female , Brazil , Cross-Sectional Studies , Siblings/psychology , Caregivers/psychology , Adolescent , Surveys and Questionnaires , Child, Preschool , Socioeconomic Factors , Caregiver Burden/psychology , Family/psychology , Parents/psychology , Neurological RehabilitationABSTRACT
Resumo Objetivo: compreender, por meio do brinquedo terapêutico dramático, o significado, para o irmão, de visitar a criança hospitalizada em terapia intensiva. Método: pesquisa qualitativa, modalidade fenomenológica, que utilizou o brinquedo terapêutico dramático para acessar às experiências dos irmãos. Foi realizada em Unidade de Terapia Intensiva Pediátrica do interior do estado de São Paulo, Brasil. Participaram das sessões de brinquedo terapêutico 11 irmãos menores de 10 anos, as quais foram analisadas à luz da Teoria do Amadurecimento. Resultados: os irmãos, tendo um lugar para brincar, dramatizaram situações, anteriormente, vividas, de seu cotidiano e da visita à criança hospitalizada. Ao viver, criativamente, revelaram que brincar é fazer a integração das experiências do "eu", favorecendo o continuar a ser diante da situação vivida. Conclusões e implicações para a prática: o Brinquedo Terapêutico Dramático compreendido à luz de um referencial teórico possibilitou que o irmão significasse a visita como uma experiência de integração do "eu", revelando emoções, desejos e preferências do cotidiano. Nesse sentido, o cuidado ao irmão da criança hospitalizada define-se pela oferta do brincar livre, para que ele demonstre o sentimento de continuar a ser em suas interações com o mundo, no qual o contexto hospitalar tornou parte da realidade.
Resumen Objeto: Comprender por medio del juego terapéutico dramático el significado, para el hermano, de la visita al niño hospitalizado en Terapia Intensiva Pediátrica. Método: Investigación cualitativa, modalidad fenomenológica, que utilizó el juego terapéutico dramático para comprender la experiencia del hermano. Se realizó en Unidad de Terapia Intensiva Pediátrica del interior del Estado de São Paulo, Brasil. Participaron de las sesiones de juego terapéutico 11 hermanos con menos de 10 años, quienes fueron analizados a la luz de la Teoría de la Maduración. Resultados: Los hermanos, al tener un lugar para jugar, dramatizaron situaciones anteriormente vividas, de su cotidiano y de la visita al niño hospitalizado. Al vivir de forma creativa, revelaron que jugar es permitir la integración de las experiencias del "yo", lo que favorece el concepto de seguir siendo, ante la situación vivida. Conclusiones e implicaciones para la práctica: El Juego Terapéutico Dramático comprendido a la luz de un referencial teórico hizo posible que el hermano entendiera la visita como una experiencia de integración del "yo", revelando emociones, deseos y preferencias cotidianas. En este sentido, el cuidado del hermano del niño hospitalizado se define por la oferta de juego libre, para que pueda demostrar su sentimiento de seguir siendo en sus interacciones con el mundo, en el que el contexto hospitalario se ha convertido en parte de la realidad.
Abstract Objective: to understand, by means of dramatic therapeutic play, the meaning, for the sibling, of visiting the child hospitalized in intensive care. Method: a qualitative research, phenomenological modality, which used the dramatic therapeutic play to access the siblings' experiences. It was carried out in a Pediatric Intensive Care Unit in the countryside of the State of São Paulo, Brazil. Eleven siblings under ten years of age participated in the therapeutic play sessions, which were analyzed in the light of the Theory of Maturation. Results: the siblings, having a place to play, dramatized previously lived situations, from their daily life and from the visit to the hospitalized child. By living creatively, they revealed that playing is to integrate the experiences of the "I", favoring the continuity of being in the face of the situation lived. Conclusions and implications for practice: the Dramatic Therapeutic Play understood in the light of a theoretical framework allowed the sibling to mean the visit as an experience of integration of the "I", revealing emotions, desires and preferences of daily life. In this sense, the care for the brother of the hospitalized child is defined by the offer of free play, so that he demonstrates the feeling of continuing to be in his interactions with the world, in which the hospital context has become part of reality.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Play and Playthings/psychology , Visitors to Patients/psychology , Intensive Care Units, Pediatric , Child, Hospitalized , Siblings/psychology , Sibling Relations , Child Health , Creativity , Qualitative ResearchABSTRACT
INTRODUCTION: Health-related quality of life (HRQoL) is a measure of health outcomes. It assesses the subjective and overall impact of diseases on daily life. It also provides multidimensional data about physical wellbeing, family and peers relations. HRQoL studies on siblings are limited. OBJECTIVE: To compare HRQoL among siblings of pediatric patients with chronic rheumatic diseases, kidney or liver transplant and healthy children whose siblings had no chronic conditions. RESULTS: The siblings of children with kidney transplant (n: 65), liver transplant (n: 35), and chronic rheumatic diseases (n: 36) were compared to the healthy children group (n: 51). The total siblings group had a lower, statistically significant score in the physical well-being, social support and peers, and financial resources dimensions. The siblings of kidney transplant patients had a low score in the physical wellbeing (p < 0.02; effect size [ES]: 0.66) andfinancial resources (p < 0.01; ES: 0.66) dimensions. The siblings of liver transplant patients perceived a lower physical well-being (p = 0.04), less social support and peers (p < 0.01), and difficulties in relation to school environment (p < 0.02) and financial resources (p <0.01). The siblings of those with chronic rheumatic diseases had a lower score in the physical well-being (p < 0.05; ES: 0.44) and social support and peers (p <0.01; ES: 0.58) dimensions. CONCLUSION: HRQoL among healthy children whose siblings have a chronic disease was lower in the physical well-being, social support and peers, and financial resources dimensions compared to the healthy children group.
Introducción. La calidad de vida relacionada con la salud (CVRS) es una medida de resultado de salud. Evalúa el impacto subjetivo y global de las enfermedades en la vida cotidiana. Brinda información multidimensional sobre el bienestar físico, relación familiar y sus pares. Los estudios de CVRS de hermanos son limitados. Objetivo. Comparar CVRS de los hermanos de pacientes pediátricos con patologías reumáticas crónicas, trasplante renal o hepático con la de niños sanos con hermanos sin enfermedades crónicas. Resultados. Se compararon hermanos de niños con trasplante renal (n: 65), trasplante hepático (n: 35) y patologías reumáticas crónicas (n: 36) con el grupo control de niños sanos (n: 51). El grupo total de hermanos tuvieron puntuación más baj a, estadísticamente significativa, enlas dimensiones bienestar físico, amigos-apoyo social y recursos económicos. Los hermanos de trasplante renal tuvieron baja puntuación en las dimensiones de bienestar físico (p < 0,02; tamaño del efecto -TE-: 0,66) y recursos económicos (p < 0,01; TE: 0,66). Los hermanos de trasplante hepático percibieron menor bienestar físico (p = 0,04), tenían menos amigos y apoyo social (p < 0,01), dificultades en el entorno escolar (p < 0,02) y recursos económicos (p < 0,01). Los hermanos de patologías reumáticas crónicas tuvieron menor bienestar físico (p < 0,05; TE: 0,44) y apoyo social-amigos (p < 0,01; TE: 0,58). Conclusión. La CVRS de niños/as sanos de hermanos con patologías crónicas es menor en bienestar físico, amigos-apoyo social y recursos económicos comparada con el grupo de niños sanos.
Subject(s)
Chronic Disease/psychology , Quality of Life , Siblings/psychology , Adolescent , Argentina , Case-Control Studies , Child , Cross-Sectional Studies , Female , Humans , Kidney Transplantation/psychology , Liver Transplantation/psychology , Male , Peer Group , Rheumatic Diseases/psychology , Social Support , Surveys and QuestionnairesABSTRACT
Studies are increasingly recognizing health-related quality of life (HRQOL) as a key pediatric outcome in both clinical and research settings and an essential health outcome measure to assess the effectiveness of medical treatment. However, it has not yet been studied among the healthy siblings of kidney transplant recipients. The aim of this study, therefore, is to examine HRQOL among this population. We asked the following three groups to complete a validated measure of HRQOL among children (KIDSCREEN-52): siblings of children who had received kidney transplants (n = 50), kidney transplant recipients (n = 43), and a healthy control group (n = 84). We found that siblings of kidney transplant patients exhibited lower scores for financial resources and autonomy than kidney transplant recipients. They also served lower on physical well-being, financial resources, autonomy, and parent relations/home life than the control group. However, they scored higher on social acceptance than kidney transplant recipients. Our study underscores the importance of assessing HRQOL in families including a child diagnosed with a chronic illness. Siblings require social and psychological support to promote coping and adaptation.
Subject(s)
Health Status , Kidney Transplantation , Quality of Life , Siblings , Adaptation, Psychological , Adolescent , Case-Control Studies , Child , Chronic Disease , Cross-Sectional Studies , Family Relations , Female , Health Surveys , Humans , Kidney Transplantation/psychology , Male , Psychological Distance , Quality of Life/psychology , Siblings/psychology , Social Support , Socioeconomic FactorsABSTRACT
BACKGROUND: Obsessive-compulsive disorder (OCD) has a lifetime prevalence of 2-3% and is a leading cause of global disability. Brain circuit abnormalities in individuals with OCD have been identified, but important knowledge gaps remain. The goal of the new global initiative described in this paper is to identify robust and reproducible brain signatures of measurable behaviors and clinical symptoms that are common in individuals with OCD. A global approach was chosen to accelerate discovery, to increase rigor and transparency, and to ensure generalizability of results. METHODS: We will study 250 medication-free adults with OCD, 100 unaffected adult siblings of individuals with OCD, and 250 healthy control subjects at five expert research sites across five countries (Brazil, India, Netherlands, South Africa, and the U.S.). All participants will receive clinical evaluation, neurocognitive assessment, and magnetic resonance imaging (MRI). The imaging will examine multiple brain circuits hypothesized to underlie OCD behaviors, focusing on morphometry (T1-weighted MRI), structural connectivity (Diffusion Tensor Imaging), and functional connectivity (resting-state fMRI). In addition to analyzing each imaging modality separately, we will also use multi-modal fusion with machine learning statistical methods in an attempt to derive imaging signatures that distinguish individuals with OCD from unaffected siblings and healthy controls (Aim #1). Then we will examine how these imaging signatures link to behavioral performance on neurocognitive tasks that probe these same circuits as well as to clinical profiles (Aim #2). Finally, we will explore how specific environmental features (childhood trauma, socioeconomic status, and religiosity) moderate these brain-behavior associations. DISCUSSION: Using harmonized methods for data collection and analysis, we will conduct the largest neurocognitive and multimodal-imaging study in medication-free subjects with OCD to date. By recruiting a large, ethno-culturally diverse sample, we will test whether there are robust biosignatures of core OCD features that transcend countries and cultures. If so, future studies can use these brain signatures to reveal trans-diagnostic disease dimensions, chart when these signatures arise during development, and identify treatments that target these circuit abnormalities directly. The long-term goal of this research is to change not only how we conceptualize OCD but also how we diagnose and treat it.
Subject(s)
Brain Mapping , Brain/diagnostic imaging , Diffusion Tensor Imaging , Internationality , Magnetic Resonance Imaging , Multicenter Studies as Topic/methods , Obsessive-Compulsive Disorder/diagnostic imaging , Adolescent , Adult , Brain/pathology , Brain/physiopathology , Brazil , Case-Control Studies , Female , Humans , India , Male , Middle Aged , Netherlands , Obsessive-Compulsive Disorder/pathology , Obsessive-Compulsive Disorder/physiopathology , Research Design , Siblings/psychology , South Africa , United States , Young AdultABSTRACT
OBJECTIVE: To describe children's anxiety, depression, behaviors, and school performance at 2-13 months after sibling neonatal/pediatric intensive care unit (NICU/PICU) or emergency department (ED) death and compare these outcomes by child age, sex, race/ethnicity, whether the child saw their sibling in the NICU/PICU/ED, and attended the sibling's funeral. STUDY DESIGN: Children in 71 families were recruited for this longitudinal study from 4 children's hospitals and 14 other Florida hospitals. Children rated anxiety (Spence Children's Anxiety Scale) and depression (Children's Depression Inventory); parents rated child behaviors (Child Behavior Checklist) and reported school performance (detentions, suspensions, requested parent-teacher meetings) at 2, 4, 6, and 13 months post-sibling death. Analyses included repeated measures-ANOVA, t-tests, and 1-way ANOVA. RESULTS: In total, 132 children and 96 parents participated. More children were female (58%), black (50%), and school-age (72%). Of the children, 43% had elevated anxiety and 6% had elevated depression over 13 months post-sibling death. Child-rated anxiety was higher for girls and black vs white children. Child-rated anxiety and depression were lower if they saw their sibling in the NICU/PICU/ED before and/or after the death, and/or attended the funeral. Teens were more withdrawn than school-age children at all time points. Children who did not see their deceased sibling in the NICU/PICU/ED after death had more requests for parent-teacher conferences. CONCLUSIONS: Children's anxiety was more common than depression, especially in girls and black children. Children who saw their siblings in the NICU/PICU/ED before/after death and/or attended funeral services had lower anxiety and depression over the first 13 months after sibling death.
Subject(s)
Death , Racial Groups , Siblings/psychology , Academic Success , Adolescent , Adult , Anxiety/epidemiology , Attention , Attitude to Death , Child , Child Behavior Disorders/epidemiology , Child, Preschool , Depression/epidemiology , Emergency Service, Hospital , Female , Florida/epidemiology , Humans , Infant , Intensive Care Units, Neonatal , Intensive Care Units, Pediatric , Longitudinal Studies , Male , Psychophysiologic Disorders/epidemiology , Sampling Studies , Sex FactorsABSTRACT
Siblings of children with autism spectrum disorders (ASD) present greater susceptibility to developmental problems, in comparison with siblings of typically developing children. The greater prevalence of mental health disorders among parents of children with ASD increases younger siblings' vulnerability to emotional problems. The aim of this study is to compare the interaction between carers and babies aged 2 to 26 months (M = 11.7, SD = 6.9) who are siblings of children with ASD (ASD dyads) with the interaction of dyads of siblings of typically developing children (TD dyads). The protocol of Clinical Indicators of Risk for Child Development and the Coding Interactive Behaviour measures were used to evaluate interaction. ASD dyads presented higher scores of constriction in their interaction, P = .024, with babies presenting higher scores of withdrawal behavior, P = .003, and carers presenting higher scores of depressive mood, P = .008, when compared to TD dyads. The ASD dyads have interactive impairments more frequently than do the TD dyads.
Trasfondo: Los hermanos de niños con trastornos dentro de la gama del autismo (ASD) presentan una mayor susceptibilidad a problemas del desarrollo, en comparación con los hermanos de niños que se desarrollan de una manera típica. La mayor prevalencia de trastornos de salud mental entre padres de niños con ASD aumenta la vulnerabilidad de los hermanos más jóvenes a problemas emocionales. El objetivo de este estudio es comparar la interacción entre cuidadores y bebés de edad entre 2 y 26 meses (Media: 11.7 meses/ SD: 6.9) hermanos de niños con ASD (díadas ASD), con las interacción de díadas de hermanos de niños que se desarrollan típicamente (díadas TD). Método: Para evaluar la interacción se usó el protocolo de los Indicadores Clínicos de Riesgo para el Desarrollo del Niño y la Codificación Interactiva de Conducta. Resultados: Las díadas ASD presentaron puntuaciones más altas de constricción en su interacción (p = 0.024), con los bebés que presentaron más altas puntuaciones de conducta de despego (p = 0.003) y los cuidadores que presentaron más altas puntuaciones de estados de ánimo depresivos (p = 0.008) cuando se les comparó con las díadas TD. Conclusiones: Las díadas ASD tienen impedimentos interactivos más frecuentemente que las díadas TD.
Contexte: Les frères et sÅurs d'enfants avec des troubles du spectre autistique (TSA) présentent une plus grande susceptibilité à des problèmes comportementaux, comparés aux frères et sÅurs d'enfants se développant typiquement. La plus grande prévalence de troubles de santé mentale avec les parents d'enfants avec TSA augmente la vulnérabilité aux problèmes émotionnels des jeunes frères ou sÅurs. Le but de cette étude est de comparer l'interaction entre les parents ou personnes prenant soin des enfants et les bébés âgés de 2 à 26 mois (Moyenne: 11, 7 mois/ DS: 6,9), frères et sÅurs d'enfants avec des TSA (dyades-TSA), avec l'interaction de dyades de frères et sÅurs d'enfants se développant typiquement (dyades-DT). Méthode: Le protocole d'Indicateurs Cliniques de Risque pour le Développement de l'Enfant et le Codage des Comportements Interactifs ont été utilisés pour évaluer l'interaction. Résultats: les dyades TSA ont présenté des scores plus élevés de constriction (p = 0,024) de leur interaction avec les bébés présentant des scores de comportement de retrait (p = 0,003) et les personnes prenant soin des enfants ont présenté des scores plus élevés d'humeur dépressive (p = 0,008) quand comparées aux dyades-DT. Conclusions: Les dyades-TSA ont des insuffisances interactives plus fréquemment que les dyades-DT.
Subject(s)
Autism Spectrum Disorder , Child Development , Family Relations/psychology , Parents/psychology , Siblings/psychology , Adult , Autism Spectrum Disorder/epidemiology , Autism Spectrum Disorder/psychology , Brazil/epidemiology , Child , Child of Impaired Parents , Female , Humans , Infant , Male , Prevalence , Problem Behavior/psychologyABSTRACT
Objective: A first-degree relative affected by obsessive-compulsive disorder (OCD) and obsessive-compulsive symptoms (OCS) in childhood is an important risk factor for developing the disorder in adulthood. The relationship between a family history of OCD and the presence of OCS and its correlates in childhood is not well established. Methods: A total of 66 children whose parents or siblings have been diagnosed with OCD were assessed for the presence of OCS and clinical correlates. Results: Three children (4.5%) were reported to have received an OCD diagnosis and another 26 (39.4%) were identified as having OCS. Children with OCS had higher rates of coercive behavior and came from families with lower socioeconomic status. Contamination/cleaning dimension symptoms in the proband were associated with OCS in the assessed children. Conclusion: OCS are frequent among family members of individuals with OCD and are associated with socioeconomic status, coercive behaviors and proband contamination/cleaning symptoms. Future longitudinal studies should test the risk of developing OCD in association with these characteristics.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Family/psychology , Child of Impaired Parents/psychology , Obsessive-Compulsive Disorder/epidemiology , Parents/psychology , Socioeconomic Factors , Prevalence , Surveys and Questionnaires , Coercion , Age of Onset , Risk Assessment , Siblings/psychology , Obsessive-Compulsive Disorder/diagnosis , Obsessive-Compulsive Disorder/psychologyABSTRACT
OBJECTIVE: The objective is to identify the variables that influence the impact of cancer on healthy siblings. METHOD: This is a quantitative, descriptive and correlational study with 83 families of children with cancer. We used the "Questionnaire to Assess the Impact of the Children's Cancer on the Family", "Social Support Satisfaction Scale", "Graffar Scale" and "Apgar Scale". RESULTS: The results show a relation between social support (X²=5.031, gl=1, p=0.025), expenses (t=-2.009, gl=81, p=0.048), disease impact on family structure (t=-3.210, gl=81, p=0.002) and the impact of the disease on healthy siblings. CONCLUSION: Social support plays an important role in these families, especially in the impact of the disease on healthy siblings. Nurses should identify the support systems that families have available, as well as their family functionality and the implications for healthy siblings.
Subject(s)
Family Relations/psychology , Neoplasms/psychology , Siblings/psychology , Adaptation, Psychological , Adolescent , Adult , Child , Correlation of Data , Cost of Illness , Female , Humans , Male , Neoplasms/complications , Social Support , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To analyze the perception of relatives of patients with mental disorders about the support group in a psychiatric hospitalization ward. METHOD: This is a research with a qualitative, exploratory an descriptive approach, performed at a General Hospital in Rio Grande do Sul with ten relatives of patients who had been participating in a weekly support group. Data collection took place in October 2016, through semi-structured interviews. A thematic content analysis was used for the treatment of data, whence emerged the category: Perception of family members about the support group. RESULTS: The relatives perceive the group as a space that gives them strength and support, allowing for listening and experience exchange among its members, giving information on the disease and treatment, safety, and inserting the family in the treatment. FINAL CONSIDERATIONS: The support group can be understood as a strategic action of caring for the family, affecting their lives and the treatment of those who are hospitalized.
Subject(s)
Deinstitutionalization , Family/psychology , Mentally Ill Persons , Psychiatric Department, Hospital , Self-Help Groups , Social Perception , Adult , Adult Children/psychology , Brazil , Caregivers/psychology , Deinstitutionalization/legislation & jurisprudence , Female , Health Policy , Health Services Needs and Demand , Hospitals, General , Humans , Interviews as Topic , Male , Mental Disorders/psychology , Mental Disorders/rehabilitation , Mental Disorders/therapy , Middle Aged , Mothers/psychology , Qualitative Research , Siblings/psychology , Spouses/psychologyABSTRACT
ABSTRACT Objective: The objective is to identify the variables that influence the impact of cancer on healthy siblings. Method: This is a quantitative, descriptive and correlational study with 83 families of children with cancer. We used the "Questionnaire to Assess the Impact of the Children's Cancer on the Family", "Social Support Satisfaction Scale", "Graffar Scale" and "Apgar Scale". Results: The results show a relation between social support (X²=5.031, gl=1, p=0.025), expenses (t=-2.009, gl=81, p=0.048), disease impact on family structure (t=-3.210, gl=81, p=0.002) and the impact of the disease on healthy siblings. Conclusion: Social support plays an important role in these families, especially in the impact of the disease on healthy siblings. Nurses should identify the support systems that families have available, as well as their family functionality and the implications for healthy siblings.
RESUMEN Objetivo: El objetivo fue identificar las variables que influencian el impacto de la enfermedad oncológica en los hermanos sanos. Método: Estudio de naturaleza cuantitativa, descriptiva y correlacional, con 83 familias de niños con enfermedad oncológica. Se recurrió a la utilización de "Cuestionario de evaluación del impacto de la enfermedad oncológica del niño en la familia", "Escala Satisfacción del Soporte Social", "Escala de Graffar" y "Escala de Apgar". Resultados: Los resultados evidencian una asociación entre el soporte social (X²= 5,031; gl= 1; p= 0,025), los gastos económicos (t= -2,009; gl= 81; p= 0,048); el impacto de la enfermedad en la estructura familiar (t= -3,210; gl= 81; p= 0,002) y el impacto de la enfermedad en los hermanos sanos. Conclusión: El soporte social desempeña un papel importante en estas familias, especialmente en el impacto de la enfermedad en los hermanos sanos. Los enfermeros deben identificar los sistemas de apoyo que las familias tienen disponibles, así como su funcionamiento familiar y las implicaciones en los hermanos sanos.
RESUMO Objetivo: O objetivo foi identificar as variáveis que influenciam o impacto da doença oncológica nos irmãos saudáveis. Método: Estudo de natureza quantitativa, descritivo e, correlacional, com 83 famílias de crianças com doença oncológica. Recorreu-se à utilização de "Questionário de avaliação do impacto da doença oncológica da criança na família", "Escala Satisfação do Suporte Social", "Escala de Graffar" e "Escala de Apgar". Resultados: Os resultados evidenciam uma associação entre o suporte social (X²=5,031; gl=1; p=0,025), os gastos econômicos (t=-2,009; gl=81; p=0,048), o impacto da doença na estrutura familiar (t=-3,210; gl=81; p=0,002) e o impacto da doença nos irmãos saudáveis. Conclusão: O suporte social assume um papel importante nessas famílias, nomeadamente no impacto da doença nos irmãos saudáveis. Os enfermeiros devem identificar os sistemas de apoio que as famílias têm disponíveis, bem como o seu funcionamento familiar e as implicações nos irmãos saudáveis.
Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Family Relations/psychology , Neoplasms/psychology , Social Support , Adaptation, Psychological , Surveys and Questionnaires , Cost of Illness , Siblings/psychology , Correlation of Data , Neoplasms/complicationsABSTRACT
OBJECTIVE: A first-degree relative affected by obsessive-compulsive disorder (OCD) and obsessive-compulsive symptoms (OCS) in childhood is an important risk factor for developing the disorder in adulthood. The relationship between a family history of OCD and the presence of OCS and its correlates in childhood is not well established. METHODS: A total of 66 children whose parents or siblings have been diagnosed with OCD were assessed for the presence of OCS and clinical correlates. RESULTS: Three children (4.5%) were reported to have received an OCD diagnosis and another 26 (39.4%) were identified as having OCS. Children with OCS had higher rates of coercive behavior and came from families with lower socioeconomic status. Contamination/cleaning dimension symptoms in the proband were associated with OCS in the assessed children. CONCLUSION: OCS are frequent among family members of individuals with OCD and are associated with socioeconomic status, coercive behaviors and proband contamination/cleaning symptoms. Future longitudinal studies should test the risk of developing OCD in association with these characteristics.
Subject(s)
Child of Impaired Parents/psychology , Family/psychology , Obsessive-Compulsive Disorder/epidemiology , Adolescent , Age of Onset , Child , Child, Preschool , Coercion , Female , Humans , Male , Obsessive-Compulsive Disorder/diagnosis , Obsessive-Compulsive Disorder/psychology , Parents/psychology , Prevalence , Risk Assessment , Siblings/psychology , Socioeconomic Factors , Surveys and QuestionnairesABSTRACT
A fratria, apesar de estar presente em grande parte das famílias, é um tema pouco estudado, principalmente quando se trata da relação entre irmãos. O "tornar-se irmão" provoca muitas mudanças nas relações familiares, até mesmo durante a gestação da mulher, que são sentidas principalmente pela criança que se tornará primogênita. Esta pesquisa buscou compreender 1- Como o filho primogênito percebe a segunda gravidez da mãe e a chegada de um irmão; 2- Quais as fantasias e sentimentos que surgem no primogênito em relação ao irmão que está sendo gestado. Tendo como referencial a teoria psicanalítica, e tendo como participante a criança, as informações foram colhidas através da aplicação dos instrumentos projetivos "Teste do Desenho da Família" e "Teste Desenho-Estória" em três filhos primogênitos de mães gestantes. Observou-se através da pesquisa que o nascimento de um irmão provoca grande impacto na vida do primogênito, gerando ansiedade e conflitos de sentimentos em relação à sua família. Os conteúdos despertados em cada criança a partir desse tema são singulares, porém evidentes, de modo que em cada criança são manifestados de formas diferentes. Os resultados oferecem subsídios para que pais, familiares e profissionais possam auxiliar a criança a atravessar essa fase de uma forma elaborada, beneficiando também aqueles que a rodeiam.
The fratria, brotherhood, although present in most families, is a subject that is very little studied, especially when it comes to the relationship between siblings. Becoming a brother generates many changes in family relationships, even during pregnancy, which are felt mainly by the child who is to become the firstborn. This research sought to understand 1- How the eldest son perceives the second pregnancy of the mother and the arrival of a brother; 2- What fantasies and feelings arise in the firstborn relative to the brother who is being gestated. Based in the psychoanalytic theory, and with the child as a participant, the information was collected through the application of the projective instruments "Family Drawing Test" and "Drawing-Story Test" in three first-born children of pregnant mothers. Research showed that the birth of a brother causes great impact in the life of the firstborn, generating anxiety and conflicts of feelings in relation to his family. The contents aroused in each child from this theme are singular but evident, so that in each child they are manifested in different ways. The results provide support for parents, family members and professionals to help the child through this stage in a sophisticated way, benefiting those around him.
La fratría, a pesar de estar presente en gran parte de las familias, es un tema poco estudiado, principalmente cuando se trata de la relación entre hermanos. El "convertirse en hermano" provoca muchos cambios en las relaciones familiares incluso durante la gestación de la mujer pueden ser sentidas, principalmente, por el niño que se volverá primogénito. Esta investigación buscó comprender 1- ¿cómo el hijo primogénito percibe el segundo embarazo de su madre y la llegada de un hermano?; 2- ¿Cuáles son las fantasías y sentimientos que surgen en el primogénito en relación al hermano que está siendo gestado? Teniendo como referencial la teoría psicoanalítica, y teniendo como partici- pante al niño, las informaciones fueron recolectadas a través de la aplicación de los instrumentos proyectivos "Prueba del Diseño de la Familia" y "Prueba Dibujo-Estatura" en tres hijos primogénitos de madres gestantes. Se observó a través de la investigación que el nacimiento de un hermano provoca gran impacto en la vida del primogénito, generando ansiedad y conflictos de sentimientos en relación a su familia. Los contenidos despertados en cada niño a partir de ese tema son singulares, pero evidentes, de modo que en cada niño se manifiestan de formas diferentes. Los resultados ofrecen subsidios para que padres, familiares y profesionales puedan ayudar al niño a atravesar esa fase de una forma elaborada, beneficiando también a aquellos que lo rodean.
Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Sibling Relations , Pregnancy/psychology , Child Behavior , Siblings/psychologyABSTRACT
Parents' differential treatment (PDT) is a common family dynamic that has been linked to youth development and well-being, including adjustment problems and poor sibling relationships. Much less is known, however, about the developmental course of PDT and the conditions under which parents treat their children differently in adolescence and young adulthood. This study examined longitudinal changes in mothers' and fathers' differential warmth and conflict with their two offspring from early adolescence through young adulthood and examined parents' experiences of individual stress (depressive symptoms and role overload) and marital difficulties as time-varying correlates of (changes in) PDT. We also tested crossover effects to determine whether mothers' experiences of individual stress and marital difficulties were linked to fathers' differential treatment, and vice versa. Participants were mothers, fathers, and two siblings from 246 Mexican-origin families who were interviewed in their homes on three occasions over 8 years. Multilevel models revealed that mothers' and fathers' differential conflict with their two children increased until middle adolescence and then declined into young adulthood, but there were no changes over time for parents' differential warmth. In general, both mothers' and fathers' levels of differential treatment were exacerbated by their own experiences of individual stress and marital difficulties and also by the experiences of their spouses. However, in some cases, greater stress than usual was linked to less differential treatment than usual.
Subject(s)
Father-Child Relations , Mexican Americans/psychology , Mother-Child Relations/psychology , Parenting/psychology , Parents/psychology , Siblings/psychology , Adolescent , Adult , Child , Depression/psychology , Father-Child Relations/ethnology , Female , Humans , Longitudinal Studies , Male , Marriage/psychology , Mother-Child Relations/ethnology , Spouses/psychologyABSTRACT
Resumo OBJETIVO Objetiva analisar a percepção de familiares de pacientes com sofrimento psíquico acerca do grupo de apoio em uma internação psiquiátrica. MÉTODO Pesquisa com abordagem qualitativa, exploratória, descritiva, realizada em hospital geral do Rio Grande do Sul com dez familiares que participavam de grupo de apoio semanal. A coleta de dados ocorreu no mês de outubro de 2016 através de entrevistas semiestruturadas. Empregou-se a análise de conteúdo temática para tratamento dos dados, na qual emergiu a categoria: Percepção dos familiares sobre o grupo de apoio. RESULTADOS Os familiares percebiam o grupo como um espaço de apoio e fortalecimento, de escuta e trocas entre os integrantes, de informação sobre a doença e tratamento e de segurança e inserção da família no tratamento. CONSIDERAÇÕES FINAIS Portanto, o grupo de apoio pode ser entendido como uma ação estratégica de cuidado ao familiar, repercutindo na sua vida e no tratamento de quem está internado.
Resumen OBJETIVO Analizar la percepción de familiares de pacientes con trastorno mental acerca del grupo de apoyo en una internación psiquiátrica. MÉTODO Investigación con abordaje cualitativo, exploratorio y descriptivo, realizada en el hospital General de Rio Grande do Sul, con diez familiares que participaban en un grupo de apoyo semanal. La recolección de datos ocurrió en el mes de octubre de 2016 por medio de entrevistas semiestructuradas. Se empleó al análisis temático de contenido para tratar a los datos, y emergió la categoría: Percepción de los familiares sobre el grupo de apoyo. RESULTADOS Los familiares perciben al grupo como un espacio de apoyo y fortalecimiento, de escucha e intercambios entre los integrantes, de información sobre la enfermedad y tratamiento, y de seguridad e inserción de la familia en el tratamiento. CONSIDERACIONES Finales El grupo de apoyo puede ser entendido como una acción estratégica de cuidado al familiar, repercutiendo en su vida y en el tratamiento de quien está internado.
Abstract OBJECTIVE To analyze the perception of relatives of patients with mental disorders about the support group in a psychiatric hospitalization ward. METHOD This is a research with a qualitative, exploratory an descriptive approach, performed at a General Hospital in Rio Grande do Sul with ten relatives of patients who had been participating in a weekly support group. Data collection took place in October 2016, through semi-structured interviews. A thematic content analysis was used for the treatment of data, whence emerged the category: Perception of family members about the support group. RESULTS The relatives perceive the group as a space that gives them strength and support, allowing for listening and experience exchange among its members, giving information on the disease and treatment, safety, and inserting the family in the treatment. FINAL CONSIDERATIONS The support group can be understood as a strategic action of caring for the family, affecting their lives and the treatment of those who are hospitalized.
Subject(s)
Humans , Male , Female , Adult , Psychiatric Department, Hospital , Self-Help Groups , Social Perception , Family/psychology , Mentally Ill Persons , Brazil , Interviews as Topic , Caregivers/psychology , Spouses/psychology , Deinstitutionalization/legislation & jurisprudence , Adult Children/psychology , Siblings/psychology , Qualitative Research , Health Policy , Health Services Needs and Demand , Hospitals, General , Mental Disorders/psychology , Mental Disorders/rehabilitation , Mental Disorders/therapy , Middle Aged , Mothers/psychologyABSTRACT
Este artigo discute a percepção dos pais a respeito das repercussões do divórcio nos filhos, tendo como foco a comemoração do aniversário destes. Foi desenvolvida uma pesquisa qualitativa com quatro pais e quatro mães separados, a partir da realização de entrevistas semiestruturadas. Os resultados foram estudados de acordo com o método de análise de conteúdo. Verificou-se que o divórcio implica em uma ferida narcísica importante para os sujeitos envolvidos, podendo gerar uma tendência a recalcar as representações do ex-cônjuge. Esse movimento pode dificultar a elaboração do luto pelo fim da conjugalidade, trazendo dificuldades centrais para o exercício da parentalidade, uma vez que os filhos permanecem envolvidos em conflitos. Os filhos podem experimentar uma divisão em suas vivências com seus dois objetos de amor, pai e mãe, o que é ilustrado pelas comemorações de aniversários realizadas pelos genitores, em alguns casos em conjunto, e em outros, em separado. (AU)
This article seeks to discuss the repercussions of parental divorce on children from the parents' perception. The current study aims to discuss parents' perceptions about the repercussions of divorce on their children, focusing on children's birthday celebrations. The authors conducted a qualitative research with four fathers and four mothers, performing semi-structured interviews and studying the results using the content analysis method. Evidence shows that divorce inflicts a major narcissistic wound in the subjects involved, which may generate a tendency to repress representations of the former spouse. This movement may hinder the elaboration of grief caused by the end of marital relations, since the children remain involved in conflicts. The children may suffer a division in their experiences with both love objects, father and mother, a condition illustrated by birthday celebrations held by parents, in some cases together, and in other, separately. (AU)
Este artículo pretende discutir las repercusiones del divorcio en los hijos, a partir de la percepción de los padres. Em este artículo se analiza la percepción de los padres sobre el impacto del divorcio en los niños, centrándose en la celebración del cumpleaños de éstos. desarrolló una investigación cualitativa con cuatro padres y cuatro madres separados, a partir de la realización de entrevistas semiestructuradas. Los resultados fueron estudiados según el método de análisis de contenido. Se verificó que el divorcio implica en una herida narcisista importante para los sujetos involucrados, lo que puede generar una tendencia a reprimir las representaciones del ex-cónyuge. Ese movimiento puede dificultar la elaboración del luto por el fin de la relación conyugal, aportando dificultades centrales para el ejercicio de la parentalidad, una vez que los hijos permanecen involucrados en conflictos. Los hijos pueden experimentar una división en sus vivencias con sus dos objetos de amor, padre y madre, lo que es ilustrado por las celebraciones de cumpleaños realizadas por los genitores, en algunos casos juntos, y en otros, por separado. (AU)
Subject(s)
Parent-Child Relations , Divorce/psychology , Anniversaries and Special Events , Parenting , Siblings/psychologyABSTRACT
Research on European and European American families suggests that parents' differential treatment of siblings has negative implications for youths' adjustment, but few studies have explored these dynamics in minority samples. This study examined parents' differential acceptance and conflict in a sample of mothers, fathers, and two adolescent siblings in 179 African American families who were interviewed on three annual occasions. In an effort to replicate findings from European and European American samples, we assessed the longitudinal associations between differential treatment and adolescent adjustment and tested three sibling characteristics (birth order, gender, and dyad gender composition) as potential moderators of these linkages. To illuminate the sociocultural context of differential treatment and its implications, we also explored parents' cultural socialization practices and experiences of financial stress as potential moderators of these links. Multilevel models revealed that, controlling for average parent-child relationship qualities, decreases in parental acceptance and increases in parent-youth conflict over time-relative to the sibling-were associated with increases in youths' risky behavior and depressive symptoms. Links between differential treatment and adjustment were not evident, however, when mothers engaged in high levels of cultural socialization and in families under high financial stress. The discussion highlights the significance of sociocultural factors in family dynamics.
Subject(s)
Black or African American/psychology , Parent-Child Relations/ethnology , Parenting/psychology , Parents/psychology , Siblings/psychology , Adolescent , Adolescent Behavior/ethnology , Adolescent Behavior/psychology , Adult , Culture , Depression/psychology , Family Conflict/ethnology , Family Conflict/psychology , Female , Humans , Longitudinal Studies , Male , Parenting/ethnology , Risk-Taking , SocializationABSTRACT
Objective: To assess cognitive performance and psychosocial functioning in patients with bipolar disorder (BD), in unaffected siblings, and in healthy controls. Methods: Subjects were patients with BD (n=36), unaffected siblings (n=35), and healthy controls (n=44). Psychosocial functioning was accessed using the Functioning Assessment Short Test (FAST). A sub-group of patients with BD (n=21), unaffected siblings (n=14), and healthy controls (n=22) also underwent a battery of neuropsychological tests: California Verbal Learning Test (CVLT), Stroop Color and Word Test, and Wisconsin Card Sorting Test (WCST). Clinical and sociodemographic characteristics were analyzed using one-way analysis of variance or the chi-square test; multivariate analysis of covariance was used to examine differences in neuropsychological variables. Results: Patients with BD showed higher FAST total scores (23.90±11.35) than healthy controls (5.86±5.47; p < 0.001) and siblings (12.60±11.83; p 0.001). Siblings and healthy controls also showed statistically significant differences in FAST total scores (p = 0.008). Patients performed worse than healthy controls on all CVLT sub-tests (p < 0.030) and in the number of correctly completed categories on WCST (p = 0.030). Siblings did not differ from healthy controls in cognitive tests. Conclusion: Unaffected siblings of patients with BD may show poorer functional performance compared to healthy controls. FAST scores may contribute to the development of markers of vulnerability and endophenotypic traits in at-risk populations.