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1.
Pediatrics ; 149(Suppl 5)2022 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-35503316

RESUMEN

In recognition of the family as central to health, the concept of family, rather than individual, health has been an important area of research and, increasingly, clinical practice. There is a need to leverage existing theories of family health to align with our evolving understanding of Life Course Health Development, including the opportunities and constraints of the family context for promoting lifelong individual and population health. The purpose of this article is to propose an integrative model of family health development within a Life Course Health Development lens to facilitate conceptualization, research, and clinical practice. This model provides an organizing heuristic model for understanding the dynamic interactions between family structures, processes, cognitions, and behaviors across development. Potential applications of this model are discussed.


Asunto(s)
Salud de la Familia , Relaciones Familiares , Formación de Concepto , Familia , Humanos , Acontecimientos que Cambian la Vida
2.
Pediatrics ; 149(Suppl 5)2022 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-35503321

RESUMEN

BACKGROUND AND OBJECTIVES: Our objective is to identify common family functioning measurement tools and assess their compatibility with family-health development and life-course perspectives. METHODS: Data sources include PubMed, ERIC, CINAHL, Families and Societies Worldwide, PsychInfo, Web of Science, PsychNet, and Health and Psychosocial Instruments. Title and abstract screening and full-text review of articles were conducted by multiple reviewers based on prespecified inclusion criteria. Data extraction focused on features of identified measurements tools, including: (1) name (2) domains of family functioning measured, (3) established psychometric properties, and (4) original context of psychometric evaluation (eg, details about the study sample). RESULTS: Of the 50 measurement tools identified, 94% measured organizational patterns (eg, flexibility, connectedness, or resources), 46% measured belief systems (eg, making meaning of adversity, or positive outlook), and 54% measured communication processes (eg, open emotional sharing, or collaborative problem-solving). CONCLUSIONS: Existing measures of family functioning can aid life-course researchers in understanding family processes as contexts for health and well-being. There also remain opportunities to refine or develop measures of family functioning more compatible with a life-course perspective that assess family processes (1) at various life stages; (2) with various backgrounds, identities, structures, and experiences; and (3) embedded in or impacted by various contexts that may facilitate or hinder family functioning.


Asunto(s)
Salud de la Familia , Acontecimientos que Cambian la Vida , Comunicación , Humanos , Psicometría
3.
BMC Prim Care ; 23(1): 108, 2022 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-35524178

RESUMEN

BACKGROUND: With the release of the Health China Action (2019-2030), family health is receiving increasing attention from experts and scholars. But at present, there is no family health scale in China that involves multidimensional and interdisciplinary commonality. AIM: To translate a Short Form of the Family Health Scale (FHS-SF) and to test the reliability and validity of the Chinese version of the FHS-SF. METHOD: A Short Form of the Family Health Scale was Chinese translated with the consent of the original author. A total of 8912 residents were surveyed in 120 cities across China using a multistage sampling method, with gender, ethnicity, and education level as quota variables. Seven hundred fifty participants were selected to participate in this study, and 44 participants were randomly selected to be retested 1 month later. RESULTS: The Cronbach's alpha of the Chinese version of a Short Form the Family Health Scale was 0.83,the Cronbach's alphas of the four subscales ranged from 0.70 to 0.90, the retest reliability of the scale was 0.75, the standardized factor loadings of the validation factor analysis were above 0.50, GFI = 0.98; NFI = 0.97; RFI = 0.95; RMSEA = 0.07, all within acceptable limits. CONCLUSION: The Chinese version of a Short Form the Family Health Scale has good reliability and validity and can be used to assess the level of family health of Chinese residents.


Asunto(s)
Salud de la Familia , China , Humanos , Psicometría/métodos , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
4.
Nursing ; 52(5): 58-59, 2022 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-35452045
5.
J Pediatr Hematol Oncol Nurs ; 39(3): 185-201, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35467437

RESUMEN

Purpose: Pediatric cancer is a difficult experience for children and their families. It is thus necessary to promote family resilience for the effective treatment and quality of life improvement among children with cancer. The aim of this systematic review was to identify the components of a resilience-promoting program for children with cancer and their families and to synthesize the literature findings on the outcomes of the resilience-promoting program. Method: A systematic search of the literature was conducted using five databases (PubMed, CHIAHL, PsycINFO, Web of Science, and Research Information Sharing Service) up to July 22, 2020. The search was limited to studies published in English and Korean, and to grey literature published in Korea. Studies were critically appraised using the Mixed Methods Appraisal Tool and Cochrane Risk of Bias tool. Extracted data were summarized as tables. Results: Eight studies were selected. The main components of the resilience-promoting program were providing information (on strategies, medical and psychoeducation, and community resources) and emotional coping (expressing feeling, reappraising cognition about adversity, and stress management). The main outcomes of these programs were reinforced outcomes (resilience, benefit finding, coping, positive affect, problem-solving skills, family adaptation, and self-concept) and improved outcomes (in depression, posttraumatic stress, anxiety, impact of illness of the family, and mood). Conclusion: As the components and outcomes of family resilience-promoting programs vary, it is necessary to consistently use valid tools to effectively identify interventions. Additionally, various methodological studies are required to further analyze the effect of these programs.


Asunto(s)
Neoplasias , Resiliencia Psicológica , Adaptación Psicológica , Niño , Salud de la Familia , Humanos , Neoplasias/terapia , Calidad de Vida
6.
Artículo en Inglés | MEDLINE | ID: mdl-35457666

RESUMEN

BACKGROUND: The COVID-19 pandemic has impacted and is still impacting people's lives, including physical and mental health. Family plays an important role in adolescent mental health due to the long staying at home. AIMS: This paper aimed to investigate the impact of family resilience on adolescent mental health during the COVID-19 pandemic, and the mediation role of pandemic stress perception and the moderation role of meta-mood. METHODS: A total of 2691 Chinese adolescents were recruited using convenient sampling. Their mental health, family resilience, pandemic stress perception and meta-mood were surveyed. Multivariate statistics were used to analyze the data. RESULTS: Our results showed that (1) about 36.7% adolescents in our sample have some mental health problems; (2) family resilience can positively predict adolescent mental health, whereas pandemic stress perception can negatively predict mental health; (3) pandemic stress perception mediates the relationship between family resilience and adolescent mental health; (4) meta-mood moderates the relationship between family resilience and pandemic perception, i.e., the first half of the mediation role. CONCLUSIONS: Our results indicate that one can either improve family resilience or improve adolescents' meta-mood to relieve adolescents' mental health problems.


Asunto(s)
COVID-19 , Resiliencia Psicológica , Adolescente , COVID-19/epidemiología , Salud de la Familia , Humanos , Salud Mental , Pandemias , SARS-CoV-2
7.
BMJ Open ; 12(4): e051093, 2022 Apr 20.
Artículo en Inglés | MEDLINE | ID: mdl-35443942

RESUMEN

OBJECTIVE: The aim of this study was to assess the reliability and validity of the Chinese version of the Family Resilience (FaRE) Questionnaire among patients with breast cancer in China. DESIGN: It was a cross-sectional study, which involved translation, back-translation, cultural adjustment and psychometric testing of a 24-item FaRE Questionnaire. SETTING: Three tertiary hospitals in Zhengzhou, China: respectively are the First Affiliated Hospital of Zhengzhou University, Second Hospital Affiliated to Zhengzhou University and Henan Provincial People's hospital. PARTICIPANTS: A total of 559 patients with breast cancer volunteered to participate in the study PRIMARY OUTCOME MEASURES: Data analysis was performed using the IBM SPSS software V.21.0 and AMOS software V.21.0. Cronbach's α coefficient was used to examine the internal consistency. The test-retest reliability was calculated using the intraclass correlation coefficient on 30 participants. The content validity index was calculated based on the values obtained from six expert opinions. Construct validity test was performed using factor analysis including exploratory factor analysis and confirmatory factor analysis. RESULTS: For the Chinese version of FaRE Questionnaire, the Cronbach's α coefficient of the total questionnaire was 0.909, and Cronbach's α coefficients of four factors were 0.902, 0.932, 0.905 and 0.963, respectively. The test-retest reliability index of the total questionnaire was 0.905. The Scale-Content Validity Index was 0.97, and Item-Content Validity Index ranged from 0.83 to 1.00. The questionnaire included 24 items, exploratory factor analysis extracted four factors with loading >0.4, which could explain 72.146% of the total variance. Confirmatory factor analysis showed the Chinese version of FaRE Questionnaire had an excellent four-factor model consistent with the original questionnaire. CONCLUSION: The Chinese version of FaRE Questionnaire has acceptable reliability and validity among patients with breast cancer in China. It can effectively assess family resilience and provide basis for personalised family resilience interventions for patients with breast cancer.


Asunto(s)
Neoplasias de la Mama , Resiliencia Psicológica , China , Estudios Transversales , Salud de la Familia , Femenino , Humanos , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
8.
Genes (Basel) ; 13(4)2022 03 29.
Artículo en Inglés | MEDLINE | ID: mdl-35456417

RESUMEN

Family health history (FHH) can serve as an entry point for preventive medicine by providing risk estimations for many common health conditions. College is a critical time for young adults to begin to understand the value of FHH collection, and to establish healthy behaviors to prevent FHH-related diseases. This study seeks to develop an integrated theoretical framework to examine FHH collection behavior and associated factors among college students. A sample of 2670 college students with an average age of 21.1 years completed a web-based survey. Less than half (49.8%) reported actively seeking FHH information from their family members. Respondents' knowledge about FHH were generally low. Structural equation modeling findings suggested an adequate model fit between our survey data and the proposed integrated theoretical framework. Respondents who were members of racial/ethnic minority groups exhibited higher levels of anxiety and intention to obtain FHH information but had lower confidence in their ability to gather FHH information than non-Hispanic White respondents. Therefore, educational programs designed to enhance the level of young adults' FHH knowledge, efficacy, and behavior in FHH collection, and change subjective norms are critically needed in the future, especially for these who are members of racial/ethnic minority groups.


Asunto(s)
Grupos Minoritarios , Adulto , Salud de la Familia , Humanos , Análisis de Clases Latentes , Anamnesis , Adulto Joven
9.
Artículo en Inglés | MEDLINE | ID: mdl-35409879

RESUMEN

Family resilience is a construct based on interactive processes occurring in the family, enabling the family to effectively overcome everyday stressors, as well as developmental and unpredictable crises. By observing how the family deals with difficulties using family resilience processes, we are able to support both parents and protect children against the harmful effects of unfavourable conditions. The aim of our research was to carry out the procedure of adaptation to the Polish language and culture of the Walsh Family Resilience Questionnaire. In this study, 930 Poles participated (72.5% women), aged from 18 to 63 (M = 26.94, SD = 9.8). They filled in the questionnaire online. Confirmatory factor analysis confirmed the model with three factors: belief system, organisational processes, and communication processes. The model indicators were found to be well suited to the data: χ2/df = 1.12, RMSEA = 0.01, CFI = 0.99, TLI = 0.99, SRMR = 0.04. The reliability (Cronbach's alpha) of the scales was also satisfactory (0.94 for the belief systems, 0.86 for the organisational processes, and 0.94 for the communication processes). Tool validation with FRAS-PL scales showed convergence. We named the Polish version of the WFRQ Questionnaire Kwestionariusz Preznosci Rodzinnej Walsh (WFRQ-PL) and found it to be a good tool for assessing the processes of family resilience in our country.


Asunto(s)
Salud de la Familia , Resiliencia Psicológica , Niño , Femenino , Humanos , Lenguaje , Masculino , Polonia , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
10.
PLoS One ; 17(4): e0265406, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35446866

RESUMEN

OBJECTIVE: We aimed to explore factors affecting family health management during home quarantine as well as the effects of variations in family health management (FHM) on individuals' health status. METHODS: Using stratified random sampling, 618 families in Wuhan as well as cities within its surrounding provinces were recruited and surveyed online. Latent class variables were extracted from four modules: disinfection, space layout, physical exercise, and food reserves. The analysis was conducted using the poLCA package in R software (v.4.1.0). Chi-squared tests, Fisher's exact tests, and non-parametric Kruskal-Wallis tests were used to compare groups as appropriate. RESULTS: We found an overall questionnaire reliability of 0.77 and a total omega of 0.92, indicating that the survey results were credible. The Bayesian information criterion and Akaike information criterion were used to identified four latent class variables, namely latent non-family health management (18.9%) and latent low, medium, and advanced FHM (30.93%, 29.49%, and 20.59%, respectively). Gender, household income level, body mass index, the presence of a nearby community hospital, and self-rated health status showed statistically significant differences with respect to latent FHM. Moreover, we found a statistically significant difference in emotional reactions when comparing latent advanced and low to mid-level latent FHM. Compared with latent non-family health managers, we detected statistically significant differences in individual energy levels between potential family health managers at latent low and medium levels. Additionally, we found statistically significant differences in individual energy levels between latent advanced and low level family health managers. CONCLUSIONS: We found that multiple factors, including gender, household income, and body mass index, were correlated with latent FHM during home quarantine. We conclude that FHM can meaningfully improve individuals' health. Thus, increasing social support for individuals can improve FHM as well as individuals' health during home quarantine.


Asunto(s)
Salud de la Familia , Cuarentena , Teorema de Bayes , Humanos , Reproducibilidad de los Resultados , Apoyo Social
11.
Rev. latinoam. cienc. soc. niñez juv ; 20(1): 55-75, ene.-abr. 2022. tab, graf
Artículo en Español | LILACS | ID: biblio-1365865

RESUMEN

Resumen (analítico) Se caracteriza el fenómeno del colecho en términos sociodemográficos, socioeconómicos y en relación con las vulnerabilidades específicas de los hogares, tales como la violencia intrafamiliar y los consumos nocivos. A través de la Encuesta de la Deuda Social Argentina y un análisis multivariado cuantitativo, se abordan los siguientes interrogantes: ¿el colecho es una práctica asociada únicamente a los bebés?, ¿resulta más frecuente en contextos de pobreza o se trata de una práctica que atraviesa a diferentes infancias? Se concluye que el colecho no es un fenómeno exclusivo de los y las bebés; que en la adolescencia es más regresivo para las mujeres y que el factor socio-económico remite a un «colecho forzoso¼ que se especifica en interacción con el hacinamiento, la monoparentalidad, los consumos nocivos y la violencia intrafamiliar.


Abstract (analytical) This paper analyses the phenomenon of bed-sharing in terms of sociodemographic and socioeconomic variables, but also considers specific vulnerabilities like domestic violence and addictions. It is worth examining whether this practice is associated only with babies, or else if vulnerable contexts also have an impact on children's and adolescent's co-sleeping. The information was obtained through Social Debts in Argentina Survey, and this quantitative research concludes that in this country not only early years bed-share, the phenomenon impairs teenage girls more often and that the socio-economic factor plays a decisive role. For this reason, we propose the term "forced-bed-sharing", which refers to when co-sleeping is intensified by variables like overcrowding, single-parent family type, addictions and domestic violence.


Resumo (analítico) O artigo caracteriza o fenómeno do coleito considerando variáveis sócio demográficas e socioeconómicas, mas também vulnerabilidades específicas como a violência doméstica ou vícios. Neste contexto, perguntamo-nos: associa-se só aos bebés? Tem mais frequência em condições de vulnerabilidade? Esta prática tem um impacto ou motivações diferentes em relação ás características das crianças? A informação foi obtida através do Questionário da Dívida Social Argentina, e o desenho de pesquisa quantitativo conclui que não é somente um fenómeno exclusivo da primeira infância, na adolescência é mais frequente em meninas e que o fator socioeconómico é decisivo. Por isso, propomos o termo "coleito forçoso", que refere a quando a regularidade da cama compartilhada se intensifica por variáveis como a superlotação, o tipo de família monoparental, vícios e violência doméstica.


Asunto(s)
Demografía , Salud , Salud de la Familia , Análisis Multivariante , Violencia Doméstica , Familia de Padres Solteros
12.
BMJ Open ; 12(4): e052955, 2022 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-35365518

RESUMEN

OBJECTIVES: Family physicians are usually patients' first point of contact with primary healthcare. This study aims to understand the experiences of family physicians who were infected with the COVID-19 and started working again. STUDY DESIGN AND SETTING: This qualitative study was conducted on 18 different family health centres in Adana. Data collection was performed through 18 interviews, each lasting an average of 46.6 min. The data were analysed using the qualitative content analysis method. PARTICIPANTS: The study included 18 family physicians (9 women and 9 men), and there were no significant differences between them by gender or seniority. RESULTS: The results of the study have shown that family physicians who were infected with the COVID-19 and started working again have experienced high levels of anxiety at work. In addition, due to the fear of being reinfected, family physicians' social relations with their colleagues have decreased. The results are discussed under two themes: anxieties and social relationships. CONCLUSION: In primary healthcare services, family physicians play a vital role during the pandemic. Many family physicians either lost their lives or got infected with the virus, recovered and worked in difficult conditions for a long time. Understanding the experiences of family physicians during the pandemic when they underwent COVID-19 and after they recovered could help to protect their psychological health and improve their work conditions.


Asunto(s)
COVID-19 , Médicos de Familia , Salud de la Familia , Femenino , Humanos , Masculino , Pandemias , Investigación Cualitativa
13.
Acad Pediatr ; 22(2S): S22-S27, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-35248244

RESUMEN

Families of children and youth with special health care needs (CYSHCN) can face challenges with regard to health and well-being. Health systems are designed to support CYSHCN but do not often consider the health and well-being of their family. Despite a growing body of literature, substantial gaps remain in our understanding of the impact of caregiving on family health and well-being and mechanisms of supporting families. In order to better understand and address these gaps, a national CYSHCN network developed a national research agenda to prioritize key areas of insufficient understanding of health and well-being for families of CYSHCN. Questions identified by the research agenda include: 1) How can family resiliency and adaptability be measured and improved? 2) How can we better assess family mental health needs and implement appropriate interventions? 3) What is the impact of family health on CYSHCN health outcomes? This paper describes a review of what is currently known regarding health for families of CYSHCN, gaps in the literature focused on the research agenda questions, and recommendations for future research. Based on the research agenda and current state of research for family health of CYSHCN, the authors recommend focusing on resiliency and adaptability as outcomes, using implementation science to address mental health concerns of family members and to further assess the impact of family health on health outcomes of CYSHCN. In addition, research should have a special focus on diverse populations of families and consider these questions in the context of different family structures.


Asunto(s)
Atención a la Salud , Salud de la Familia , Adolescente , Niño , Promoción de la Salud , Humanos
14.
BMJ Open ; 12(3): e048897, 2022 03 04.
Artículo en Inglés | MEDLINE | ID: mdl-35246414

RESUMEN

OBJECTIVES: Considering the expansion of primary care in areas of difficult access in the Brazilian territory in recent decades, the aim of this study to evaluate the effect of the Family Health Strategy (FHS) expansion on hospitalisations due to ambulatory care-sensitive conditions (ACSCs) and mortality in children under 5 years of age in the state of Pará, Brazilian Amazon. METHODS: A longitudinal analysis from 2008 to 2017 was conducted for data collected from the SUS's database (DATASUS) using panel regression methods to determine the association between the expansion FHS coverage, ACSC rate, under 5 mortality rate and child mortality rate in municipalities of the state of Pará. RESULTS: There was an expansion of 40% of the population coverage of the FHS, in the same period there were 347 468.55 hospitalisations due to ASCSs of children under 5 years of age in the public health network in the state of Pará, which represented a reduction of almost 28% (p value <0001), and significant reduction of almost 57.67% in government hospital expenditures with hospitalisations between 2008 and 2017. In this period, there was also a significant decrease in the mortality rate in children under 5 years of age. CONCLUSIONS: Our findings reinforce the importance of the public health protection for the child population and the positive impacts of FHS in the state of Pará, in the Brazilian Amazon. The government actions aimed at reducing regional health disparities and the effort to strengthen primary care can improve health indicators of children and be an important strategy to developing countries.


Asunto(s)
Salud del Niño , Atención Primaria de Salud , Brasil/epidemiología , Niño , Preescolar , Ciudades , Salud de la Familia , Hospitalización , Humanos
16.
Rev Bras Enferm ; 75(4): e20201105, 2022.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-35352778

RESUMEN

OBJECTIVES: to understand the experience of nurses with nursing consultations in the context of the Family Health Strategy and propose a representative model. METHODS: qualitative research using Grounded Theory, with 14 nurses working through non-directive interviews. For data analysis, three stages were used: open, axial and selective coding, which originated phenomena, themes, categories and subcategories, which supported the construction of the central category and, consequently, the theoretical model. RESULTS: the interrelation of phenomena emerged from the essence of the nurse's experience, revealing the central category: From nursing education to the practice of Nursing Consultation, unveiling learning, challenges and autonomy as intervening components. Final Considerations: the nurse's experience is positive and, despite numerous challenges in daily life, the nurse has been performing it based on comprehensive care. New studies may add new understandings that enable the expansion of working conditions, valuing the nursing consultation.


Asunto(s)
Salud de la Familia , Atención de Enfermería , Teoría Fundamentada , Humanos , Percepción , Derivación y Consulta
17.
Rev Bras Enferm ; 75(3): e20210636, 2022.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-35239827

RESUMEN

OBJECTIVES: to analyze the teamwork in the Family Health Strategy from the perspective of professionals from the Primary Care Department and the municipal manager/secretary of health of a Municipal Health Secretariat. METHODS: an exploratory/qualitative study. All professionals of the Department and municipal manager/municipal health secretary/interior of Minas Gerais participated. Data collection was through semi-structured interviews/May to November/2019. Data analysis: Content analysis/thematic mode and work process theoretical referential. RESULTS: three categories emerged: Inter-professional relations permeated by non-material instruments of work; Professional training, experience, and profile influence teamwork; and Proposals for the realization of teamwork in the Family Health Strategy. Results revealed assumptions for teamwork in the referred Strategy, facilitators/difficulties/strategies for its realization, according to the professionals. Final Considerations: collaboration/communication/proactivity to facilitate teamwork. Need for approximation between municipal management and Family Health Strategy to achieve teamwork.


Asunto(s)
Comunicación , Salud de la Familia , Brasil , Humanos , Relaciones Interprofesionales , Percepción , Investigación Cualitativa
18.
Biomed Res Int ; 2022: 5365363, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35355824

RESUMEN

Background: The aim was to evaluate the association between the professional training of dentists and their outpatient production (OP) of clinical and collective/preventive procedures and the total number of procedures registered in a health information system. Methods: It included all 19,947 primary dental care units participating in the Program for Improvement of Access and Quality of Primary Care (PMAQ-AB 2nd cycle) and the number of clinical procedures (CP), collective/preventive procedures (PP), and total procedures (TP) registered in the ambulatory information system between November 2013 and July 2014 for each participant oral health team. The outcome was being above the national median of procedures. The main variables related to training were the dentists specialising in family health, the level of training, and participation in permanent education. Effect estimates were calculated by multiple logistic regression. Results: In the final model, controlled by contextual factor work process, family health specialists had higher chances (odds ratio (OR) = 1.13, 95% CI: 1.00; 1.27) of producing above the national median of CP than nonspecialists, OR = 1.06 (0.96; 1.18) for PP and OR = 1.17 (1.08; 1.27) for TP. Dentists taking permanent education had higher chances than those not taking it of producing above the national median for CP, PP, and TT, respectively, with OR = 1.40 (1.20; 1.62), OR = 1.24 (1.09; 1.40), and OR = 1.28 (1.18; 1.39). Conclusion: Training in family health performs more procedures in primary care settings than those without training. However, this OP is influenced by variables related to the municipality and the work process, especially for PP. If the highest production observed is a consequence of training, then public health managers can not only encourage training policies such as permanent education policies to expand the use of services.


Asunto(s)
Salud Bucal , Pacientes Ambulatorios , Odontólogos , Salud de la Familia , Humanos
19.
JAMA ; 327(11): 1042-1050, 2022 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-35179564

RESUMEN

IMPORTANCE: Persistent physical and mental disorders are frequent in survivors of COVID-19-related acute respiratory distress syndrome (ARDS). However, data on these disorders among family members are scarce. OBJECTIVE: To determine the association between patient hospitalization for COVID-19 ARDS vs ARDS from other causes and the risk of posttraumatic stress disorder (PTSD)-related symptoms in family members. DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort study in 23 intensive care units (ICUs) in France (January 2020 to June 2020 with final follow-up ending in October 2020). ARDS survivors and family members (1 family member per patient) were enrolled. EXPOSURES: Family members of patients hospitalized for ARDS due to COVID-19 vs ARDS due to other causes. MAIN OUTCOMES AND MEASURES: The primary outcome was family member symptoms of PTSD at 90 days after ICU discharge, measured by the Impact of Events Scale-Revised (score range, 0 [best] to 88 [worst]; presence of PTSD symptoms defined by score >22). Secondary outcomes were family member symptoms of anxiety and depression at 90 days assessed by the Hospital Anxiety and Depression Scale (score range, 0 [best] to 42 [worst]; presence of anxiety or depression symptoms defined by subscale scores ≥7). Multivariable logistic regression models were used to determine the association between COVID-19 status and outcomes. RESULTS: Among 602 family members and 307 patients prospectively enrolled, 517 (86%) family members (median [IQR] age, 51 [40-63] years; 72% women; 48% spouses; 26% bereaved because of the study patient's death; 303 [50%] family members of COVID-19 patients) and 273 (89%) patients (median [IQR] age, 61 [50-69] years; 34% women; 181 [59%] with COVID-19) completed the day-90 assessment. Compared with non-COVID-19 ARDS, family members of patients with COVID-19 ARDS had a significantly higher prevalence of symptoms of PTSD (35% [103/293] vs 19% [40/211]; difference, 16% [95% CI, 8%-24%]; P < .001), symptoms of anxiety (41% [121/294] vs 34% [70/207]; difference, 8% [95% CI, 0%-16%]; P= .05), and symptoms of depression (31% [91/291] vs 18% [37/209]; difference, 13% [95% CI, 6%-21%]; P< .001). In multivariable models adjusting for age, sex, and level of social support, COVID-19 ARDS was significantly associated with increased risk of PTSD-related symptoms in family members (odds ratio, 2.05 [95% CI, 1.30 to 3.23]). CONCLUSIONS AND RELEVANCE: Among family members of patients hospitalized in the ICU with ARDS, COVID-19 disease, as compared with other causes of ARDS, was significantly associated with increased risk of symptoms of PTSD at 90 days after ICU discharge. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04341519.


Asunto(s)
COVID-19 , Salud de la Familia , Trastornos por Estrés Postraumático/etiología , Adulto , Femenino , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Alta del Paciente , Estudios Prospectivos , Medición de Riesgo , Trastornos por Estrés Postraumático/epidemiología
20.
Transl Behav Med ; 12(3): 466-479, 2022 03 17.
Artículo en Inglés | MEDLINE | ID: mdl-35192704

RESUMEN

To describe how social disruptions caused by the COVID-19 pandemic impacted child access to healthcare and child health behaviors in 2020. We used mixed-methods to conduct surveys and in-depth interviews with English- and Spanish-speaking parents of young children from five geographic regions in the USA. Participants completed the COVID-19 Exposure and Family Impact Survey (CEFIS). Semistructured telephone interviews were conducted between August and October 2020. Of the 72 parents interviewed, 45.8% of participants were Hispanic, 20.8% Black (non-Hispanic), and 19.4% White (non-Hispanic). On the CEFIS, the average (SD) number of social/family disruptions reported was 10.5 (3.8) out of 25. Qualitative analysis revealed multiple levels of themes that influenced accessing healthcare during the pandemic, including two broad contextual themes: (a) lack of trustworthiness of medical system/governmental organizations, and (b) uncertainty due to lack of consistency across multiple sources of information. This context influenced two themes that shaped the social and emotional environments in which participants accessed healthcare: (a) fear and anxiety and (b) social isolation. However, the pandemic also had some positive impacts on families: over 80% indicated that the pandemic made it "a lot" or "a little" better to care for their new infants. Social and family disruptions due to COVID-19 were common. These disruptions contributed to social isolation and fear, and adversely impacted multiple aspects of child and family health and access to healthcare. Some parents of infants reported improvements in specific health domains such as parenting, possibly due to spending more time together.


Asunto(s)
COVID-19 , Niño , Preescolar , Atención a la Salud , Salud de la Familia , Humanos , Lactante , Pandemias , SARS-CoV-2
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