Showing papers on "Family support published in 2014"

Group‐based parent training programmes for improving parental psychosocial health

Abstract: Parental psychosocial health can have a significant effect on the parent-child relationship, with consequences for the later psychological health of the child. Some parenting programmes aim to improve aspects of parental wellbeing and this review specifically looked at whether group-based parenting programmes are effective in improving any aspects of parental psychosocial health (for example, anxiety, depression, guilt, confidence). We searched electronic databases for randomised controlled trials in which participants had been allocated to an experimental or a control group, and which reported results from at least one scientifically standardised measure of parental psychosocial health. We included a total of 48 studies that involved 4937 participants and covered three types of programme: behavioural, cognitive-behavioural and multimodal. Overall, the results suggested statistically significant improvements in the short-term for parental depression, anxiety, stress, anger, guilt, confidence and satisfaction with the partner relationship. However, only stress and confidence continued to be statistically significant at six month follow-up, and none were significant at one year. There was no evidence of effectiveness for self-esteem at any time point. None of the studies reported aggression or adverse outcomes. Only four studies reported the outcomes for fathers separately. These limited data showed a statistically significant short-term improvement in paternal stress but did not show whether the parenting programmes were helpful in terms of improving depressive symptoms, confidence or partner satisfaction. This review shows evidence of the short-term benefits of parenting programmes on depression, anxiety, stress, anger, guilt, confidence and satisfaction with the partner relationship. The findings suggest that further input may be needed to support parents to maintain these benefits. However, more research is needed that explicitly addresses the benefits for fathers, and that provides evidence of the comparative effectiveness of different types of programme and identifies the mechanisms involved in bringing about change.

The downward spiral of mental disorders and educational attainment: a systematic review on early school leaving

Abstract: Most psychiatric disorders present symptom patterns that cause severe impairment on the emotional, cognitive and social level. Thus, adolescents who suffer from a mental disorder risk finding themselves in a downward spiral caused by the reciprocal association of psychological symptoms and negative school experiences that may culminate in early school leaving. In addition to previous collective work that mainly focused on school refusing behaviour among children and was presented as an expert’s opinion, the following systematic review fills the knowledge gap by providing a structured overview of the bidirectional association between mental health and secondary school dropout based on a sound methodology and with a particular focus on mediating factors. Four electronic databases were searched from January 1990 until June 2014. Selected references were assessed for study details, main results, mediating factors and methodological limitations. Standardized risk of bias assessment was conducted. Mood and anxiety disorders seemed to have a less consequential direct effect on early school leaving than substance use and disruptive behaviour disorders. The association between externalizing disorders and educational attainment was even stronger when the disorder occurred early in life. On the other hand, internalizing disorders were reported to develop as a consequence of school dropout. Only few studies had addressed gender differences, with discrepant results. Socio-economic background, academic achievement and family support were identified as significant mediating factors of the association between mental disorders and subsequent educational attainment. Findings suggested a strong association between mental health and education, in both directions. However, most studies focused on mediating factors that could not be targeted by intervention programs.

Ecological Theory: Preventing Youth Bullying, Aggression, and Victimization

Abstract: Bronfenbrenner's (1977) classic ecological theory is used as a framework to review the documented risk and protective factors associated with involvement in school-related bullying during childhood and adolescence. Microsystems such as peers (socialization during adolescence), family (violence, lack of parental monitoring), community (exposure to violence), and schools (teacher attitudes, climate) contribute to the rates of bullying perpetrated or experienced by youth. The interaction between components of the microsystem is referred to as the mesosystem, and offers insight into how contexts can exacerbate or buffer experiences for youth who are involved in bullying (e.g., family support can buffer impact of peer victimization). Recommendations are provided for teachers and other adults who work with youth.

A Marriage Made in Hell: Early Intervention Meets Child Protection

Abstract: In this article, we will argue for the moral legitimacy of support and its difference from intervention and the need to engage with and develop a family support project for the twenty-first century. We call for a debate on the current settlement between the state and family life and for a recognition that a perfect storm has ensued from the unholy alliance of early intervention and child protection. We will argue for a project that celebrates families’ strengths as well as their vulnerabilities in the context of considerable adversities and (re) locates workers as agents of hope and support. We draw from a diverse set of literatures and disciplines to locate our arguments within a broader project occasioned by the economic crisis and questioning of the verities of neoliberalism.

Social Work and Adverse Childhood Experiences Research: Implications for Practice and Health Policy

Abstract: Medical research on "adverse childhood experiences" (ACEs) reveals a compelling relationship between the extent of childhood adversity, adult health risk behaviors, and principal causes of death in the United States. This article provides a selective review of the ACE Study and related social science research to describe how effective social work practice that prevents ACEs and mobilizes resilience and recovery from childhood adversity could support the achievement of national health policy goals. This article applies a biopsychosocial perspective, with an emphasis on mind-body coping processes to demonstrate that social work responses to adverse childhood experiences may contribute to improvement in overall health. Consistent with this framework, the article sets forth prevention and intervention response strategies with individuals, families, communities, and the larger society. Economic research on human capital development is reviewed that suggests significant cost savings may result from effective implementation of these strategies.

Family Culture in Mental Health Help-Seeking and Utilization in a Nationally Representative Sample of Latinos in the United States: The NLAAS

Abstract: Considering the central role of familismo in Latino culture, it is important to assess the extent to which familismo affects mental health help-seeking. This study examined the role of behavioral familismo, the level of perceived family support, in the use of mental health services of Latinos in the United States. Data come from the National Latino and Asian American Study (NLAAS), a representative household survey examining the prevalence of mental disorders and services utilization among Latinos and Asian Americans. Analyses were limited to Latino adults with a clinical need for mental health services, indexed by meeting DSM-IV diagnostic criteria for any mood, anxiety, or substance use disorder during the past 12 months (N = 527). One-third of Latinos with a clinical need used any type of service in the past year, including specialty mental health, general medical, and informal or religious services. High behavioral familismo was significantly associated with increased odds of using informal or religious services, but not specialty or medical services. Self-perceived need and social perceptions of need for care within close networks (i.e., told by family/friends to seek professional help) also were significant predictors of service use. These results carry important implications toward expansions of the mental health workforce in the informal and religious services settings.

Loneliness and social support of older people in China: a systematic literature review.

Abstract: Loneliness is a serious problem for older people, which can be alleviated by social support. The dramatic population ageing together with social and economic change in China increases the likelihood of loneliness and the availability of different sources of social support of older people. The aim of this review was to identify the prevalence of loneliness and its related factors and sources of social support of older people in China. Electronic literature searches were conducted in September 2011 using Web of Science, PsycINFO, MEDLINE, PubMed, CINAHL, China Academic Journal and VIP Database for Chinese Technical Periodicals. Twenty-six papers were identified and reviewed. The prevalence of loneliness varied across the studies, reflecting the different measurements and samples. Marital status, gender, age, educational level, economic level, living arrangements, health status and social support were significant factors related to loneliness. The family was the most important source of social support followed by friends. The receipt of family support improved subjective well-being and mental health, but the effects of support from friends were inconsistent. Chinese older people received relatively little support from neighbours, governmental or other social organisations. Further well-designed studies are needed to identify additional factors related to loneliness and to understand the support from friends, neighbours, formal organisations and other sources.

A Double-Edged Sword Race, Daily Family Support Exchanges, and Daily Well-Being

Abstract: This study contributes to research on race and family ties by exploring racial differences in the direct effects of family support exchanges on daily well-being and the extent to which family support buffers/exacerbates stressor reactivity. African Americans and European Americans aged 34 to 84 years (N = 1,931) from the National Study of Daily Experiences reported on family support exchanges (i.e., support received/support provided), daily stressors, and negative affect during 8 days of telephone interviews. On a daily basis, receiving family support was not associated with well-being, whereas providing family support was associated with compromised well-being among African Americans. As expected, receiving family support buffered reactivity to daily tensions for both races, whereas providing emotional support to family exacerbated African Americans’ reactivity to daily tensions. Together, our findings suggest that even after considering the benefits of receiving family support, providing family support ...

A review of the factors associated with the non-use of respite services by carers of people with dementia: implications for policy and practice.

Abstract: The use of respite services by carers has been shown to extend the length of time people with dementia can remain living in the community with family support. However, the use of respite services by informal carers of people with dementia is often low and does not appear to match carer need. To better understand how to address carers' unmet need for respite, the factors that impede respite service use must be identified. To achieve this, a narrative synthesis of published academic literature (1990-2011) was undertaken regarding factors associated with not utilising different types of respite services utilising Anderson's Behavioural Model of Service Use. The review reinforces the importance of the assessment and matching of services to the needs of individual carers and care recipients at the local level. It also highlights the need to move beyond care pathways for individuals. To support respite use there is a need for local action to be augmented at a community or population level by strategies to address attitudinal and resource barriers that influence sub-groups of the carer population who may be more vulnerable to service non-use.

Scaling up evidence-based practices for children and families in New York State: toward evidence-based policies on implementation for state mental health systems.

Abstract: Dissemination of innovations is widely considered the sine qua non for system improvement. At least two dozen states are rolling out evidence-based mental health practices targeted at children and families using trainings, consultations, webinars, and learning collaboratives to improve quality and outcomes. In New York State (NYS) a group of researchers, policymakers, providers, and family support specialists have worked in partnership since 2002 to redesign and evaluate the children's mental health system. Five system strategies driven by empirically based practices and organized within a state-supported infrastructure have been used in the child and family service system with more than 2,000 providers: (a) business practices, (b) use of health information technologies in quality improvement, (c) specific clinical interventions targeted at common childhood disorders, (d) parent activation, and (e) quality indicator development. The NYS system has provided a laboratory for naturalistic experiments. We describe these initiatives, key findings and challenges, lessons learned for scaling, and implications for creating evidence-based implementation policies in state systems.

Dyadic dynamics of perceived social support in couples facing infertility

Abstract: study question: Is perceived social support from partner, family, and friends associated with increased infertility-related stress? summaryanswer: While men’s perceived support did not seem to influence their partners’ stress, women’s perceptions of spousal and familial support can affect the way men deal with the challenge of infertility. what is known already: Previous studies showed that low levels of social support are associated with poor psychosocial adjustment and treatment termination in women and men. Studies examining the impact of social support using the couple as unit of analysis are lacking. study design, size, duration: A cross-sectional sample of 613 Portuguese patients participated in the research, online over a 3-month period, and in a public fertility clinic over 11 months. participants/materials, setting, methods: The final sample comprised 213 married or cohabiting couples (191 from the fertility clinic) who were actively attempting to have a child, were seeking infertility treatment and had not undergone previous preimplantation genetic diagnosis. Perceived social support was assessed through the Multidimensional Scale of Perceived Social Support and infertility-related stress was assessed with the fertility problem inventory. Hypotheses were tested by applying the actor–partner interdependence model using structural equation modeling. mainresultsandtheroleofchance: Couples had been living together for an average (+SD) of 6+ 3.5 years, and attempting a pregnancy for 3.8+ 2.6 years. Nearly half of the couples had undergone infertility treatment (41.3%). Infertility stress was found to be associated with low family support for women (b ¼ 20.27, P ¼ .003), and low partner support for both men (b ¼ 20.29, P ¼ .001) and women (b ¼ 20.45, P ¼ .006). Both women and men’s perceived friend support were not significantly related to male or female infertility stress. Men infertility stress was also associated with their partners low levels of partner (b ¼ 20.24, P ¼ .049) and family support (b ¼ 20.23, P , .001). No significant partner effects were observed for women. Despite being related to actor effects alone (female partner and family support), the explained variance of the model in women’s fertility stress was greater (R 2 ¼ 21%) than that (R 2 ¼ 15.6%) for the combined actor and partner effects in men’s fertility stress (male partner support, female partner and family support). limitations,reasonsforcaution: The study data are cross-sectional and the generalizability of results is limited by self-selection. The characteristics of non-participants in both the clinical and online samples were not available, the perception of infertility-specific supportive behaviors was not assessed and differential analyses according to infertility diagnosis were not included in this study. widerimplicationsofthefindings: Our data underline the importance of partner support in alleviating the burden of infertility. Men may experience infertility indirectly through the impact that it has on their partners. Our findings reinforce the need to involve the male partner throughout the whole treatment process and for couple-based interventions when providing infertility counseling. Further prospective research should be aimed at investigating the male experience of infertility.

The adverse consequences of unmet need among older persons living in the community: dual-eligible versus Medicare-only beneficiaries.

Abstract: One of the most disadvantaged subgroups of older Americans is the population of persons who are covered by both Medicare and Medicaid health insurance, often referred to as the “dual eligible” population. A recent report reveals them to be significantly poorer, less educated, and to have lower levels of social support than their “Medicare only” counterparts (Congressional Budget Office, 2013). The social and economic disadvantage of dual eligibles relative to Medicare-only beneficiaries is mirrored in disparities in both physical and cognitive health status. Compared to older adults who are eligible for Medicare only, dual eligible persons have a higher prevalence of physical and cognitive impairments, including mental illness, are more likely to have multiple chronic conditions, and are more likely to have qualified for Medicare due to disability or kidney disease before the age of 65 (Congressional Budget Office, 2013; Meyer, 2012). Rates of potentially preventable hospitalization and rehospitalization are high in this population, suggesting problems of access to and quality of care (Jiang, Wier, Potter, & Burgess, 2010; Konetzka, Karon, & Potter, 2012; Walsh et al., 2012; Wysocki, Kane, Dowd, et al., 2014). Utilization of both institutional and community-based long-term services and supports (LTSS) is also high among dual eligibles. In 2009, more than half of dual eligible persons over the age of 65 used home and community-based services (HCBS), and one-quarter lived in an institution (Congressional Budget Office, 2013). Considerable research indicates that dual eligible beneficiaries are served in poorer quality nursing homes, both for short term and permanent placement (Harrington, Zimmerman, Karon, Robinson, & Beutel, 2000; Rahman et al., 2014; Rahman, Grabowski, Gozalo, Thomas, & Mor, 2014), with higher rates of hospitalization (Carter & Porell, 2003) than is the case for nursing homes in which Medicare-only residents are predominant. Despite rapidly growing emphasis on the development of HCBS and recent policies to encourage discharge of nursing home residents who can manage in the community with HCBS (Reinhard, 2010; Watts, Reaves, & Musumeci, 2014), little is known about the adequacy of such care to meet the disability-related assistance needs of dual eligible persons given lower levels of family support and financial resources in comparison to persons covered by Medicare only (Congressional Budget Office, 2013). However, given the complex care needs of persons eligible for both Medicare and Medicaid, and in light of poor coordination between acute and long-term care systems, adequate assistance may be lacking for a substantial proportion of this population (Gold, Jacobson, & Garfield, 2012; Meyer, 2012). Prior research has demonstrated that unmet need for assistance among adults with disabilities can result in a range of adverse consequences that can compromise health status (Allen & Mor, 1997; Desai, Lentzner, & Weeks, 2001; LaPlante, Kaye, Kang, & Harrington, 2004). More recent research indicates an increased risk of preventable hospitalizations among dual eligibles receiving Medicaid HCBS than among comparable dual eligible nursing home residents (Wysocki, Kane, Golberstein, et al., 2014), and among dual eligibles following transition from the nursing home to the community, likely due to situations in which available HCBS are inadequate to meet these older persons’ assistance needs (Wysocki, Kane, Dowd, et al., 2014). The purpose of this article is to estimate and compare the prevalence of need for assistance and selected adverse consequences associated with unmet need for assistance among older adults who are dually eligible for Medicare and Medicaid with those who are eligible for Medicare only. Implications for current and emerging care models that integrate health care and LTSS are discussed. Conceptual Framework The Commission on the Social Determinants of Health (CSDH) clearly delineates the mechanisms by which low socioeconomic position in a given nation, indicated in the United States by one’s education, income, occupation, gender, and ethnicity, has implications for their living and working conditions, food adequacy, health behaviors, and psychosocial factors that lead to population differences in both exposure to, and vulnerability to, health compromising conditions. Unhealthy exposures and high vulnerability to illness and injury, in turn, lead to disparities in health, disabilities, and well-being (World Health Organization, 2010). We extend CSDH’s framework to incorporate the impact of the greater severity of illness and impairment experienced by disadvantaged social groups on the level of need for assistance required to perform everyday tasks. More severe impairment necessarily requires a higher level of need for assistance than lower levels of impairment (Figure 1). In the case of dual eligibles, a group that is characterized by a composite of factors indicating socioeconomic and health status disadvantage, with a resulting high burden of disease and impairment, levels of need for assistance are higher than are those experienced by the Medicare only population. Whether or not needs for assistance are adequately met is dependent on the availability of adequate family care and/or access to sufficient LTSS, a moderating effect. The challenge of adequately meeting the assistance needs of dual eligibles is compounded by the low levels of social support available to them, resulting in disparities in unmet need and their adverse consequences relative to the Medicare only population. It is this challenge that emerging models of care that integrate health care and LTSS are attempting to meet. Figure 1. Pathway to unmet need and its adverse consequences.

Influence of family, friend and coworker social support and social undermining on weight gain prevention among adults

Abstract: Objective Examine longitudinal associations between sources of social support and social undermining for healthy eating and physical activity and weight change. Methods Data are from 633 employed adults participating in a cluster-randomized multilevel weight gain prevention intervention. Primary predictors included social support and social undermining for two types of behaviors (healthy eating and physical activity) from three sources (family, friends, and coworkers) obtained via self-administered surveys. The primary outcome (weight in kg) was measured by trained staff. Data were collected at baseline, 12 months, and 24 months. Linear multivariable models examined the association of support and social undermining with weight over time, adjusting for intervention status, time, gender, age, education, and clustering of individuals within schools. Results Adjusting for all primary predictors and covariates, friend support for healthy eating (β = −0.15), coworker support for healthy eating (β = −0.11), and family support for physical activity (β = −0.032) were associated with weight reduction at 24 months (P-values<0.05). Family social undermining for healthy eating was associated with weight gain at 24 months (β = 0.12; P = 0.0019). Conclusions Among adult employees, friend and coworker support for healthy eating and family support for physical activity predicted improved weight management. Interventions that help adults navigate family social undermining of healthy eating are warranted.

Work, family, support, and depression: employed mothers in Israel, Korea, and the United States.

Abstract: Our research revealed differences in work-family constructs for employed mothers in 3 countries, Israel (N = 105), Korea (N = 298), and the United States (N = 305). Although levels of work-family conflict were comparable, the Korean women had the lowest levels of work-family enrichment compared with the Israeli and American mothers. Moreover, Korean women reported the most depression and the least support from both spouses and employers. Spousal support mediated the relationship between work-family conflict and depression for employed mothers in Israel, Korea, and the United States. As hypothesized by conservation of resources theory (Hobfoll, 1989, 1998, 2001), threat of resource loss (operationalized as work-family conflict) was related to depression more strongly than was resource gain (i.e., work-family enrichment).

Child welfare for the twenty-first century : a handbook of practices, policies, and programs

Abstract: This up-to-date and comprehensive resource by leaders in child welfare is the first book to reflect the impact of the Adoption and Safe Families Act (ASFA) of 1997. The text serves as a single-source reference for a wide array of professionals who work in children, youth, and family services in the United States-policymakers, social workers, psychologists, educators, attorneys, guardians ad litem, and family court judges& mdash;and as a text for students of child welfare practice and policy. Features include: * Organized around ASFA's guiding principles of well-being, safety, and permanency * Focus on evidence-based "best practices" * Case examples integrated throughout * First book to include data from the first round of National Child and Family Service Reviews Topics discussed include the latest on prevention of child abuse and neglect and child protective services; risk and resilience in child development; engaging families; connecting families with public and community resources; health and mental health care needs of children and adolescents; domestic violence; substance abuse in the family; family preservation services; family support services and the integration of family-centered practices in child welfare; gay and lesbian adolescents and their families; children with disabilities; and runaway and homeless youth. The contributors also explore issues pertaining to foster care and adoption, including a focus on permanency planning for children and youth and the need to provide services that are individualized and culturally and spiritually responsive to clients. A review of salient systemic issues in the field of children, youth, and family services completes this collection.

Long-Term Supports and Services Planning for the Future: Implications From a Statewide Survey of Baby Boomers and Older Adults

Abstract: Purpose of the study Little is known about adults' future planning for long-term supports and services (LTSS), and no studies have examined how LTSS planning compares between Baby Boomers and their parents' generation. The primary aim of this study is to examine the potential influences of birth cohort and gender on LTSS planning. Drawing on Andersen's Behavioral Model of Health Services Use, birth cohort and gender are viewed as predisposing characteristics, and several additional predisposing, enabling, and need characteristics are included as independent variables. Design and methods Cross-sectional design; data obtained from a statewide survey of 2,522 randomly selected Baby Boomers (born between 1946 and 1964) and older adults (born before 1946). Results Two thirds of respondents expected to need LTSS, but few reported saving for such services. Controlling for other independent variables, compared with older adults, Baby Boomers were significantly more likely to plan to move to an apartment, live in a retirement community or assisted living, and live with an adult child. Conversely, women were more likely than men to report planning to use specific LTSS such as homecare, but specific LTSS plans did not vary by birth cohort. Implications Policymakers and providers should prepare for a shift in community planning to accommodate the changing plans and expectations of Baby Boomers, large numbers of whom plan to age in existing homes and retirement communities, or live with adult children, with increasing demand for informal family support. The LTSS industry should also adapt to meet the need for formal services, which will likely continue to grow.

Family Policy and Fertility Intentions in 21 European Countries

Abstract: The debate over whether policies influence childbearing decision making continues, and, in contexts of very low fertility, questions of how policies may support higher fertility are central to understanding future fertility patterns. Some comparative macro-level analyses support the idea that family policies can influence fertility (Blanchet & Ekert-Jaffe, 1994; Castles, 2003; Ferrarini, 2006; Gauthier & Hatzius, 1997; Rovny, 2011; Winegarden & Bracy, 1995), and research on single policies within one or a few countries also suggests that generous family policies may increase fertility rates (see Gauthier, 2007, for an overview). Few studies, however, have comprehensively evaluated broader sets of family policies and how they relate to fertility decision making at the indi- vidual level, making use of contextual variation across a wide range of countries. Earlier studies have also not sufficiently considered the conse- quences of different family policies. Therefore, a policy perspective that is multidimensional and considers different policy orientations is needed in the discussion (Korpi, 2000; Korpi, Ferrarini, & Englund, 2013; Sainsbury, 1996).In this study, we evaluated whether and in what ways family policies are related to women's and men's intentions to have a child. In the process of fertility decision making and behavior, intentions follow childbearing desires and precede actual behavior; "intended or expected births reflect the combined effect of fertility demand and situational constraints on achieving desired fertility" (Ajzen & Fishbein, 1980; Thomson & Brandreth, 1995, p. 82). Because fertility intentions reflect internal and external influences, they are an important stage in the fertility decision-making and behavior process to observe in relation to macro-level conditions (Philipov, Thevenon, Klobas, Bernardi, & Liefbroer, 2009). To date, how intentions are influenced by family policy has yet to be explored, even though finding a link between policies and intentions is essential for validating the more complex relationship between policies and behavior.Using multidimensional family policy indices, we quantitatively represented the complexity of a comprehensive set of legislated family policies. The two dimensions of family policy we argue to be the most relevant to fertility intentions-(a) traditional family support, which sustains a gendered division of labor, and (b) support to earner-carer families (in which both members of a couple are earners and carers)-reflect another increasingly important debate within fertility research: the role of gender equality or gender equity (see Mason & Oppenheim, 1998; McDonald, 2000; Mills, 2010; Neyer, 2006; Neyer, Lappega rd, & Vignoli, 2011). The implications of family policies for fertility cannot be discussed without addressing the role of gender (in)equality, because different policy orientations influence how men and women divide care and paid work.In contrast to the vast majority of research, we analyzed fertility intentions of both men and women. Including men is important because of their influence in a couple's fertility decision- making process (Thomson, 1997; Thomson & Hoem, 1998). How gender equality influences men's fertility intentions has recently been subject to debate, in which conflicting evidence has emerged suggesting that gender equality can both positively (Mills, 2010; Neyer et al., 2011; Puur, Olah, Tazi-Preve, & Dorbritz, 2008) and negatively influence men's fertility intentions (Westoff & Higgins, 2009), depending on how gender equality is supported (Goldscheider, Olah, & Puur, 2010).In this study, we used comparable data for 21 countries,whichcoverhighandlowfertilitycon- texts in Europe. Over the 2000s, the period total fertility rate in 10 of these countries fluctuated mostly between 1.6 and 2 children per women (Belgium, France, Ireland, the Netherlands, the Nordic countries, and the United Kingdom), and the total fertility rate in the other 11 fluctuated between 1. …

Day-to-day living with severe chronic obstructive pulmonary disease: Towards a family-based approach to the illness impacts

Abstract: Objective: This study explores the perspectives of both patients and family members regarding the impact of chronic obstructive pulmonary disease (COPD) in their family life.Design: An exploratory qualitative study was conducted with patients and their family members in the chronic phase of COPD. Individual interviews were performed to explore participants’ perspectives and submitted to thematic analysis.Results: Six major themes emerged from patients’ perspective: (1) impact of COPD symptoms on personal and family daily life; (2) (over)protective family support; (3) difficulties in couple communication; (4) sense of identity loss; (5) fear of COPD progression; and (6) coping resources. Five main themes emerged from the family members’ perspective: (1) restrictions in family’s social life; (2) emotional distress related to COPD exacerbations; (3) tension in couple relationship; (4) financial strain of COPD; and (5) coping resources.Conclusions: The overall findings illustrate the complex interaction betwe...

Perceived family support, depression, and suicidal ideation among people living with HIV/AIDS: a cross-sectional study in the Kathmandu Valley, Nepal.

Abstract: BACKGROUND: Depression and suicidal thinking occur frequently alongside HIV/AIDS triggering profound detrimental impacts on quality of life treatment adherence disease progression and mortality Yet the psychosocial factors contributing to these psychiatric comorbidities remain underexplored particularly in the developing country context This study thus examined different dimensions of perceived family support in relation to depression and suicidal ideation among people living with HIV/AIDS (PLWHA) in Nepal METHODS: A cross-sectional survey of 322 adult PLWHA residing in the Kathmandu Valley Nepal was conducted Data were analyzed using multiple logistic regressions for correlates of Beck Depression Inventory (BDI)-Ia-defined depressive symptoms and suicidal ideation in the past 2 weeks Perceived family support measured using the 10-item Nepali Family Support and Difficulty Scale was entered into separate models in turn as a composite score for each sub-scale (emotional instrumental and negative support) and for each individual item RESULTS: Overall 255% of participants registered BDI-Ia-defined depression with significantly lower rates among those with perceived family support scores in the highest (AOR = 019; 95% CI = 007 055) and middle (AOR = 038; 95% CI = 017 086) tertiles relative to those with lowest-tertile scores Meanwhile 140% reported suicidal thinking with significantly lower rates among those in the highest perceived family support tertile relative to the lowest (AOR = 025; 95% CI = 007 091) Broken down by support sub-scale only negative support (ie family difficulty) was significant in its correlations with both outcomes - a trend similarly reflected in the item-wise analyses CONCLUSIONS: Our findings highlight an important role for family support in determining experiences of depression and suicidality among PLWHA Incorporating family counseling and support services - with special focus on ameliorating negative interaction and bolstering emotional support - into HIV care and treatment services may help to improve mental health along with overall wellness and treatment outcomes for HIV-positive populations in Nepal and similar settings

Young children’s perspectives of ideal physical design features for hospital-built environments:

Abstract: Recently, increased recognition has been attributed to the requirement to include the views of child patients in the planning of new health care services so that contemporary buildings can be designed to enhance future experience. This is important, especially since the voices of young children are so often under-represented or represented through adult proxies. The purpose of this article is to share young children's perspectives of what constitutes ideal physical design features for hospital-built environments. Using a participatory art-based approach, data were collected from 55 children (aged five-eight years) across three children's hospitals in Ireland. Emergent findings revealed three broad themes: personal space, physical environment and access. This study is important for nurses, clinicians and environmental designers because it outlines what a supportive child health care environment should constitute. Hospital environments need to be constructed not just to be child friendly, but to also respect children's right to dignity, privacy, family support and self-control.

Synergies and tensions in child protection and parent support: policy lines and practitioners cultures

Abstract: Social workers' interventions in support of children and their families have often proved a minefield of sort, filled up with conflicting demands, expectations and tasks. This paper sets the resulting debate in the context of both social policy orientations and social work cultures. It argues that partnerships between families and practitioners have to be understood as the result of a complex set of factors. Data from a qualitative study of social work professional cultures suggest that among practitioners, policy orientations intertwine with different styles of conceiving social work; accordingly, professional cultures play an important part in connecting, or failing to connect, child protection and family support. Language: en

‘Islamic Capital’ and Family Life: The Role of Islam in Parenting

Abstract: Much sociological research using Bourdieu’s theory to analyse intergenerational reproduction tends to focus on the educational rather than the familial aspect of this process. Instead, this article explores habitus and the family field within South Asian Muslim communities in the UK as the site of intergenerational transmission and seeks to understand how these parents pass on values to their children. Based on 52 semi-structured interviews with 15 South Asian Muslim families, the findings suggest that Islam was mobilised by parents to inform the transmission of a sense of morality, support children’s education and reinforce family ties. The concept of ‘Islamic capital’ was developed to add specificity to Bourdieu’s ideas of family spirit and cultural capital in order to capture the dynamics between parents and their children. In the context of multicultural Britain, these findings shed light on the diversity of parenting to inform family support grounded in the understanding of different communities.

Benefit finding and resilience in child caregivers

Abstract: Objectives A substantial number of children are involved in informal caregiving and make a significant contribution to health care delivery. While this places high levels of demand on their coping resources, there is some evidence that these children find benefit in their caring role. Design A survey design using questionnaire data collection was used with a sample of 442 children (174 boys and 268 girls) between the ages of 12 and 16. Methods The role of benefit finding and resilience was explored within a stress and coping model of the impact of caregiving. Results Hierarchical multiple regression analysis (HMRA) identified resilience and benefit finding as accounting for significant amounts of variance in positive health and mediating the impact of caregiving. In regard to negative health, only benefit finding played a significant role. Conclusions Young caregivers do experience benefit finding and exhibit resilience although the relationship with caregiving burden was inverse. Benefit finding seems to be related to social recognition of the caregiving role and to family support. Statement of contribution What is already known on this subject? There is some emerging evidence that child caregivers experience some positive effects or benefits from their caring in spite of the demands of the role. However, the main focus has been on reducing negative outcomes rather than on building resilience. What this study adds? This study provides evidence that young caregivers do experience benefit finding in situations where the role demand is not overly excessive and where the role is socially recognized.

A systematic review of interventions to promote social support and parenting skills in parents with an intellectual disability

Abstract: The family support needs of parents with an intellectual disability (ID) are relatively unknown. This paper reviewed two types of intervention for parents with ID: those designed to strengthen social relationships and those teaching parenting skills. A literature search was conducted using electronic databases and a limited number of evaluative studies were found. The evidence for interventions aimed at strengthening social relationships was inconclusive; although positive changes were observed, there were limitations in study design which restricted the generalizability of the results. The evidence for parental skills teaching suggested that behavioural based interventions are more effective than less intensive forms such as lesson booklets and the provision of normal services, although these studies also had limitations. There is a need for further large scale controlled studies in this area to provide clearer evidence and to explore additional factors relating to child, parent and family which may impact on outcomes.

Family Support and Loneliness among Older Persons in Multiethnic Malaysia

Abstract: This study investigates factors affecting older persons' state of loneliness in multiethnic Malaysia using data from the 2004 Malaysian Population and Family Survey, the first nationally representative sample in Malaysia. The study sample was extracted to include Malays, Chinese, Indians and other Indigenous groups aged 60 and above, and who had children (n = 1791). Cross tabulations and ordinal logistic regression methods were used in the analysis. Among the ethnic groups, older Malays were more likely than their Chinese and Indian counterparts to experience loneliness. Loneliness was found to be associated with age, marital status, education level, sources of income, health status, and physical limitations. Among older people, feelings of loneliness were inversely related with coresidence with adult children and participation in religious activities. Sociodemographic changes have eroded the traditional family support system for the elderly, while social security remains inadequate. This study shows the important role of family in alleviating loneliness among older people. Hence the need to promote and facilitate coresidence, as well as participation in religious activities, and a healthy lifestyle as a priority strategy is in line with the objectives of the National Policy for the Older People.