Evaluation of family functioning and anxiety-depression parameters in mothers of children with asthma

The evaluation of depression and anxiety levels of mothers of patients with periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome and familial Mediterranean fever

OBJECTIVE

Periodic fever, aphthous stomatitis, pharyngitis and adenitis (PFAPA) syndrome and familial Mediterranean fever (FMF) are autoinflammatory disorders typically characterized by recurrent fever attacks. These recurrent fever attacks can lead to depression and anxiety in mothers of these patients. This study aimed to compare the depression and anxiety levels in mothers of PFAPA and FMF patients.

METHODS

This study is a cross-sectional observational study. 48 mothers of children with FMF and 70 mothers of children with PFAPA participated in the study. Mothers in these two groups were compared in terms of anxiety and depression by using the validated Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI).

RESULTS

Depression and anxiety scores of mothers were found to be similar in FMF and PFAPA groups. Moderate or high level of anxiety was seen in 32% of mothers of patients with PFAPA and 27% of mothers of patients with FMF. 23% of mothers of patients with PFAPA were evaluated as having moderate or severe depression, and 18% of mothers of patients with FMF were evaluated as having moderate depression. There was no statistically significant difference between the duration, frequency of attacks, recurrent hospitalizations, sociodemographic characteristics, and inventory scores.

CONCLUSION

Depression and anxiety scores of mothers with children diagnosed with FMF and PFAPA are similar. These two diseases affect families psychosocially at similar levels. It is important to provide psychosocial support to families.

Family function and life satisfaction of postgraduate medical students during the COVID-19 pandemic: the mediating role of meaning in life and depression

Recent studies have documented life satisfaction of people have changed during the COVID-19 pandemic. However, it is unknown about the influential factors and mechanisms of life satisfaction of postgraduate medical students during the COVID-19 pandemic. There is a strong link among life satisfaction and individual quality of life and achievement, so it is important to explore the influence mechanism of life satisfaction of postgraduate medical students and explore ways to improve life satisfaction for the development of postgraduate medical students. The current study was based on the Circumplex Model of Marital and Family System, The Theory of Family Functioning, The Meaning Maintenance Model, The Theory of Personal Meaning and Existential Theory to construct theoretical framework and examine whether meaning in life and depression would mediate the link between family function and postgraduate medical students’ life satisfaction. By convenient sampling method, a total of 900 postgraduate medical students (Mage = 27.01 years, SD = 3.33) completed questionnaires including Family APGAR Scale, Chinese Version of Meaning In Life Questionnaire, Patient Health Questionnaire, and Satisfaction With Life Scale. In this study, SPSS 25.0 was used for correlation analysis, regression analysis and common method bias test, and AMOS 23.0 was used for structural equation modeling analysis. The results showed that (a) family function could predict life satisfaction of postgraduate medical students significantly; (b) both meaning in life and depression mediated the association between family function and life satisfaction in a parallel manner; (c) meaning in life and depression sequentially mediated the link between family function and life satisfaction of postgraduate medical students. The study illuminates the role of meaning in life and depression in improving life satisfaction and implies that it is necessary to focus on the changes of life satisfaction of postgraduate medical students during the COVID-19 pandemic, and medical educator can improve the sense of meaning in life of postgraduate medical students through improving their family function, further decreasing the risk of depression, finally improving their life satisfaction.

Quality of life of working and non-working Jordanian mothers caring for chronically ill child and its associated factors

Background

Balancing work-life and routines of daily life gets complex when a child is chronically ill.

Aim

This study aimed to examine the QOL of working and non-working mothers caring for children with a chronic illness in Jordan and determine predictors of QOL of working mothers.

Design

Descriptive comparative cross-sectional design.

Method

Data from 164 mothers who cared for a child with a chronic disease were collected. The World Health Organization Quality of Life - BREF (WHOQOL-BREF) was used to collect the data on physical, psychological, social relationships, and environment domains.

Results

The quality of life of working mothers was significantly lower than those of non-working mothers on all domains of WHOQOL-BREF. Mother's working status, monthly income, evaluation of their own health explained 41% of the variance. Social, family and employer support may help them overcome the challenges of caring for a child with a chronic illness and maintain good QOL.

Mothers' emotional states and attitudes regarding their children with asthma

OBJECTIVES

The aim of this study was to investigate the associations of asthma with the psychological profile (depression and anxiety) of children with asthma and their mothers as well as the attitudes of these mothers toward their children and their family relationships.

METHODS

Sixty-four children with asthma, 60 healthy children and their mothers were included in the study. The Children's Depression Inventory (CDI) and Childhood Anxiety Sensitivity Index (CASI) were applied to the children. All mothers completed the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Parental Attitude Research Instrument and the Family Assessment Device.

RESULTS

CASI scores were significantly higher in children with asthma (p < 0.001) than in healthy children. The increasing duration and severity of asthma were associated with increasing anxiety levels in children with asthma. Depression and anxiety scores were significantly higher in the mothers of children with asthma than in the comparison group. The mothers of children with asthma did not have supportive and friendly relationships with their children. In addition, these mothers had significantly higher Attitude of Hostility and Rejection, Attitude of Over-parenting and Authoritarian Attitude scores than those of the comparison group. Increasing duration and severity of asthma influenced family functions and the attitude of the mothers of children with asthma. There was a correlation between an increasing number of emergency department visits and increasing depression in the mothers of children with asthma.

CONCLUSIONS

This cross-sectional study revealed that the disease may negatively affect the lives of children with asthma and their mothers and their family relationships.

Evaluation of anxiety and depression in mothers of children with asthma

Background

Asthma is the most common chronic disease in childhood. Parents have an important role in managing asthma in children. Studies have shown a higher degree of depression and anxiety and lower family performance in mothers of asthmatic children in comparison with the control group.

Objective

The aim of this study was to evaluate the parenting styles and also depression, anxiety and stress parameters in mothers of children with asthma.

Methods

This case-control study was performed on 45 mothers of 3 to 15 years old asthmatic children in the allergy clinic of Mashhad University of Medical Sciences, Mashhad, Iran, during the years of 2014 to 2016. The control group was 45 mothers of non-asthmatic children who were matched for the age of their children with the case group in the same population. The parenting styles, as well as depression and anxiety of mothers were evaluated using parenting scales, and the depression-anxiety-stress scales (DASS). The mothers were also asked to fill a strengths and difficulties questionnaire (SDQ) for their children. Furthermore, parenting styles in the case group were compared to mothers of children without asthma as the control group. The data were then analyzed by SPSS 11.5, using Chi-square, ANOVA, and independent-samples t-test.

Results

The results of this study showed that 21 mothers (74.6%) were normal, but 12 mothers (26.7%) had a mild −, 9 (20%) a moderate - and 3 (6.7%) a severe degree of abnormality according to DASS. Independent-samples t-test showed a significant difference between the case and control groups regarding depression in mothers and laxness (p<0.001), over reactivity (p<0.013) and verbosity (p<0.031) in children with asthma.

Conclusion

The results of this study demonstrated that anxiety and depression are partially frequent in mothers of children with asthma, and parenting styles are less affective in these families.

Caregiver's depressive symptoms and asthma control in children from an underserved community

Caregiver's or maternal depression has been associated with increased asthma morbidity in children from prosperous nations, but little is known about this link in low and middle-income countries.

OBJECTIVE

To examine if caregiver's depressive symptoms are associated with poor asthma control and abnormal immune responses in school-aged children.

METHODS

Case-control study of 87 asthmatic children (aged 4-11 years) attending a primary care clinic in an underserved area of Santiago (Chile). Cases were children with poor asthma control (Child Asthma Control Test [cACT] <20 points) and controls were children with adequate asthma control (cACT ≥20 points). The Beck Depression Inventory-II (BDI) and a locally validated family health vulnerability test (SALUFAM) were used to assess caregivers' depression and family health vulnerability. Serum from participating children was assayed for IFN-γ, IL-4, IL-13, TGF-β, cortisol, and total IgE.

RESULTS

The mean (SD) age of study participants was 8.23 (2.15 years), and 55.2% were females. Use of inhaled corticosteroids (ICS), family health vulnerability, and caregiver's depressive symptoms were significantly more common in cases than in controls (65.4% vs. 34.6%, p = 0.003; 41.3% vs. 24.8%, p = 0.07; and 39.1% vs. 19.5%, p = 0.04, respectively). There was no significant difference in the level of any serum biomarkers between groups. In a multivariate analysis, only ICS use was significantly associated with better asthma control (OR = 3.56 [1.34-9.48], p = 0.01).

CONCLUSIONS

Presence of caregiver's depressive symptoms is associated with poor asthma control among children from an underserved community, but this association was no longer significant after accounting for ICS use.

Measuring family functioning in families with parental cancer: Reliability and validity of the German adaptation of the Family Assessment Device (FAD)

OBJECTIVE

The concept of family functioning is gaining importance in psycho-oncology research and health care services. The Family Assessment Device (FAD) is a well-established measure of family functioning. Psychometric properties inherent in the German 51-item adaptation of the FAD are examined in different samples of families with parental cancer.

METHODS

Acceptance, reliability, and validity of FAD scales are analysed in samples from different study settings (N=1701 cancer patients, N=261 partners, N=158 dependent adolescent children 11 to 18years old).

RESULTS

Missing items in the FAD scales (acceptance) are rare for adults (<1.1%) and adolescent children (<4.4%). In samples of adults and older adolescents (15 to 18years), all FAD scales except for the Roles scale are significantly reliable (0.75≤Cronbach's α≤0.88). The scales correlate highly (0.46≤Pearson's r≤0.59) with the criterion satisfaction with family life (convergent validity), and have smaller correlations (0.16≤r≤0.49) with measures of emotional distress and subjective well-being (divergent validity). In most FAD scales, adults seeking family counselling report worse family functioning (0.24≤Cohen's d≤0.59) than adults in other samples with parental cancer (discriminative validity).

CONCLUSION

Overall, the German 51-item adaptation of the FAD reveals good acceptance, reliability, and validity for cancer patients and their relatives. Particularly the scale General Functioning shows excellent psychometric properties. The FAD is suitable in the assessment of families with parental cancer for adults and adolescents older than 11years.

Parents' reactions to children's stuttering and style of coping with stress

PURPOSE

The aim of the research was to determine: (a) how parents react to their child's stuttering, (b) what stress coping strategies they utilise, as well as (c) whether stress coping style depends on parents' reaction to their child's stuttering.

METHODS

The research involved 23 mothers and 23 fathers of children who stutter (CWS) at the age of three to six years old. The Reaction to Speech Disfluency Scale (RSDS), developed by the authors, was used in the research. To determine the parents' coping the Coping Inventory in Stressful Situations (CISS) by N.S. Endler and D.A Parker was applied.

RESULTS

The strongest reactions are observed on the cognitive level. Stronger cognitive, emotional and behavioural reactions are observed in the mothers towards their disfluently speaking sons and in the fathers towards their daughters. Having analysed the profiles of coping styles, it can be noticed that the task-oriented coping is most frequently adapted by the fathers. The mothers most often use the avoidance-oriented coping. No relevant correlation was observed between the fathers' coping style and their reactions to the child's disfluent speech. As far as the mothers are concerned, it has been proved that an increase in behavioural reactions correlates with the avoidance-oriented coping.

CONCLUSION

The cognitive reactions of the parents' towards their child's stuttering were most frequent, while the emotional ones were the least frequent. Confronted with a stressful situation, the fathers most often adapt the task-oriented coping, whereas the mothers use the avoidance-oriented coping.

EDUCATIONAL OBJECTIVES

the reader will be able to (1) learn what the key reactions of parents to their children's stuttering are, (2) describe stuttering as a stress factor for the parents, (3) describe the factors which influence parents' reactions to their child's stuttering and their coping style.

Children with bronchial asthma assessed for psychosocial problems in a teaching hospital in Nigeria

BACKGROUND

Paediatric bronchial asthma causes respiratory related mortality and morbidity globally and elevates the risk of psychological and social problems (psychosocial problems); which may result in poorer asthma control. The rate of and associated factors for psychosocial problems among our asthmatic children was assessed in this study.

METHODS

Seventy five (75) children aged 7 to 14 years with bronchial asthma who were attending clinics at the University of Ilorin Teaching Hospital, Ilorin, Nigeria, were assessed with Child behaviour questionnaire and a semi-structured questionnaire.

RESULTS

Probable psychological morbidity was present in 25% of the children. The most frequently reported social impairments associated with the disease were: interference with play (60%), domestic work (49%), fear of dying anytime (29%) and feeling of being a burden on the family (25%). Psychological morbidity was significantly associated with lower maternal education (p=0.020) and occupation (p=0.038), polygamy (p=0.012), fathers having more than 5 children (p=0.027) and mothers having inadequate spousal support (p=0.012). Inadequate spousal support and lower maternal occupational level were the significant predictors of morbidity following logistic regression.

CONCLUSION

Routine psychosocial assessment and care for children with asthma needs to be introduced into our clinics to help protect them and their families from avoidable suffering.

Systematic Review and Meta-Analysis of Anxious and Depressive Symptoms in Caregivers of Children With Asthma

OBJECTIVE

To provide a review of the literature comparing anxious and depressive symptoms in caregivers of children with asthma with caregivers of healthy children.

METHOD

A systematic search identified 25 studies from 17 articles, reporting outcomes on 4,300 caregivers of children with asthma and 25,064 caregivers of healthy children.

RESULTS

Overall, anxious (d = 0.50) and depressive symptoms (d = 0.44) were higher in caregivers of children with asthma compared with caregivers of healthy children. Age, site of recruitment, and whether the asthma diagnosis was medically confirmed were included as potential moderators. The relationship between parental psychopathology and asthma was stronger in those with medically confirmed asthma and participants recruited from clinical settings. Other moderators were not significant.

CONCLUSIONS

Caregivers of children with asthma appear to have greater anxious and depressive symptoms than caregivers of healthy children, but the reasons are unclear. More research that investigates modifiable factors that may moderate this association is urgently needed.

Child asthma and change in elevated depressive symptoms among mothers of children of a birth cohort from Quebec

The authors examined the association between maternal reports of child asthma attacks since birth and occurrence of elevated maternal depressive symptoms at seventeen months postpartum in the present study. The modifying role of poverty in this association was also examined. Data from n = 1,696 mother-child dyads from the Quebec Longitudinal Study of Child Development, a birth cohort of children born in 1998, were used. Maternal depressive symptoms were measured with an abridged and validated twelve-item version of the Center for Epidemiologic Studies Depression Scale. Maternal reports of child asthma attacks since birth in relation to the occurrence of maternal depressive symptoms at 17 months postpartum and the potential modifying role of poverty were tested using multiple logistic regression models. When mothers reported child asthma attacks, those without elevated depressive symptoms at 5 months postpartum had lower odds of elevated depressive symptoms one year later (OR = 0.2, 95% CI: 0.1-0.7). Poverty was associated with increased odds of elevated maternal depressive symptoms (OR = 2.4, 95% CI: 1.5-3.9), without interacting with child asthma. Through this study, the authors suggest that in mothers without elevated symptoms at 5 months, reported child asthma attacks since birth did not contribute one year later to new occurrence of depressive symptoms.

Use of complementary and alternative medicine and the anxiety levels of mothers of children with chronic diseases

AIMS

This study aimed to determine the use of complementary and alternative medicine (CAM) by mothers with a chronically ill child and their anxiety levels.

METHODS

This study used a descriptive design. The study was conducted with 135 mothers of a chronically ill child at a general pediatric and oncology unit in Uludağ University Hospital, Bursa, Turkey. A questionnaire, including sociodemographic items and the State-Trait Anxiety Inventory, were given to the mothers.

RESULTS

In the study, 42.29% of the mothers reported using one or more CAM therapies for their child with a chronic disease, including herbal medicine, taking the child to hodja (prayers), a special diet, and a special massage. The mothers experienced anxiety and the presence of a disease within the close family circle increased the anxiety level of the mothers.

CONCLUSION

Herbs and other alternative supplements were used by some children with a chronic disease in Turkey. The most commonly used CAM therapies included oral herbal medicine, taking the child to hodja, massage, and diets. Therefore, it is important to consider the implications of the popularity of complementary therapies. Most of the mothers used more than one of these therapies for their child and the anxiety level of the mothers was found to be moderate.