mHealth Family Adaptation Intervention for Families of Young Children with Down Syndrome: A Feasibility Study

Family-based interventions in improving caregivers' psychological-related outcomes: A systematic literature review

ObjectivesThis review aims to identify the content of family-based interventions that are commonly used for primary caregivers of people diagnosed with chronic illness. In addition, the psychological-related outcome measures of the FAMIs will be examined.MethodsPRISMA was adopted for the review process. We searched CINAHL, Scopus, and Web of Science databases for studies that implemented a family-based intervention for family caregivers of patients with chronic illness. We reviewed articles published between January 2000 and January 2021. Two independent reviewers, multiple researcher triangulation, and peer review were employed to ensure the validity and reliability of the data.ResultsWe included 11 studies in this systematic literature review. In total, seven themes emerged under the content of family-based intervention consisting of family elements, skills, information, activities, positive psychology, recovery, and roles and responsibility. The psychological related outcome measures of the intervention include recovery, patient care management, skills improvement, emotional management, family relationships, and self-functioning.DiscussionThe aspect of family functioning may help the family caregivers to empower themselves and build up their inner strength to face unexpected situations. The results highlighted the importance of the involvement of the experts in family therapy in helping family caregivers. Cultural implications were also highlighted.

A Global Provision of Preventive Oral Health Measures for Children With Special Needs: A Scoping Review

BACKGROUND

Policymakers should consider the preventive measures provided to children with special health care needs (CSHCN) to reduce inequalities in dental treatment measures. This scoping review aimed to develop a conceptual framework regarding preventive measures and barriers to implementing them to find the gap in knowledge and the lack of a comprehensive framework of studies published in this area.

METHOD

In this review, nine steps for scoping review were employed. Five electronic databases were searched: PubMed/Medline, EMBASE, Scopus, Web of Science, and EBSCO Host from January 2014 to January 2024. Thematic analysis was developed with the help of data extracted from the included articles, which were divided into categories. Finally, a litmap and conceptual map were developed according to the JBI manual for evidence synthesis.

RESULTS

After analyzing 129 articles that fulfilled inclusion criteria, 44 were included. Four main categories were identified, which were further divided into 19 subthemes. The four main categories were Interventional measures, perspectives of dentists and caregivers, barriers and unmet treatment needs, and Governmental policies. According to these themes, a conceptual map was developed to assess the needs of CSHCN that can help develop preventive measure policies. These policies can eventually help service providers develop proper treatment measures for these vulnerable groups.

CONCLUSION

This scoping review concludes that there is a need for an assessment of treatment needs for CSHCN, which can help develop policies. By analyzing parents' and dentists' perceptions, policymakers can make a policy to support these vulnerable children's oral health care needs. This approach will eventually reduce the barrier and inequality in oral health preventive services provided to CSHCN.

Family adaptation in families of individuals with Down syndrome from 12 countries

Our current understanding of adaptation in families of individuals with Down syndrome (DS) is based primarily on findings from studies focused on participants from a single country. Guided by the Resiliency Model of Family Stress, Adjustment, and Adaptation, the purpose of this cross-country investigation, which is part of a larger, mixed methods study, was twofold: (1) to compare family adaptation in 12 countries, and (2) to examine the relationships between family variables and family adaptation. The focus of this study is data collected in the 12 countries where at least 30 parents completed the survey. Descriptive statistics were generated, and mean family adaptation was modeled in terms of each predictor independently, controlling for an effect on covariates. A parsimonious composite model for mean family adaptation was adaptively generated. While there were cross-country differences, standardized family adaptation mean scores fell within the average range for all 12 countries. Key components of the guiding framework (i.e., family demands, family appraisal, family resources, and family problem-solving communication) were important predictors of family adaptation. More cross-country studies, as well as longitudinal studies, are needed to fully understand how culture and social determinants of health influence family adaptation in families of individuals with DS.

Telehealth services for children with neuro-developmental disabilities in the Asia-Pacific region: A systematic review

BACKGROUND

In recent years telehealth became a popular and a rational health service delivery approach, especially amidst multiple challenges posed while providing health care interventions during the COVID-19 pandemic.

AIM

We synthesized available evidence on telehealth for managing children with NDDs in the Asia-Pacific region with the aim of identifying successful methods.

METHODOLOGY

We systematically reviewed six electronic databases: MEDLINE, AMED, EMBASE, PsychInfo, Web of Science, and (CINAHL plus) using the keywords and database-specific subject headings from their inception to 25th August 2021. Review findings were synthesized narratively, and harvest plots were used to demonstrate the effect of interventions. The protocol and reporting the findings of this review adhered to PRISMA 2020 guidelines. PROSPERO registration: CRD 340690.

RESULTS

We harvested 30,823 records; 17,563 duplicates were removed, and 196 full-text articles were assessed for eligibility. 16 studies with multiple research designs were included in the review. Eight were from the Pacific region and eight represented Asia. The interventions targeted families and children with a variety of NDDs (autism spectrum disorder, Down syndrome, cleft lip and palate, hearing impairment, cerebral palsy etc.) via telehealth. Telehealth packages consisted of direct and indirect methods of synchronous, asynchronous, and hybrid approaches. All studies used parent-led intervention strategies. Telehealth reported a positive effect in 7/16 studies while five showed a neutral effect.

CONCLUSIONS

According to published evidence telehealth for children with NDDs is an evolving, evidence-based service facilitation modality in the Asia-Pacific region, with only a few published randomized controlled trials. The systematic review shows promising telehealth practices emerging across the region despite the diversity in NDDs studied.

Adaptation at the Family Level in Families of Individuals With Down Syndrome: A Scoping Review

Down syndrome (DS) is a chromosomal disorder associated with intellectual and physical disabilities and has historically been viewed by health care providers through a negative lens when considering the effect the condition has on the individual, family, and community. The purpose of this scoping review was to provide an overview of recent research concerning adaptation in families of individuals with DS with a focus on family adaptation rather than individual or dyadic adaptation. Three literature indexes were searched from 2017 to 2022, with 41 articles included. Foci of the studies included strength/resilience, stress/coping, and negative/challenge. Thirteen studies reported using a family framework. Multiple methodological approaches and family measures were used in the studies and are outlined. Findings from this review show there has been a shift in focus when researching families of individuals with DS from a negative and challenging experience to one of strength and resilience.

Bridging the Communication Gap Between People With Cognitive Impairments and Their Caregivers Using mHealth Apps: User-Centered Design and Evaluation Study With People With 22q11 Deletion Syndrome

BACKGROUND

In families with children with cognitive impairments, both parents and children experience tension and have questions because of a lack of communication and adequate information. Therefore, there is a great need to develop tools that can help bridge the communication gap between patients and caregivers by stimulating conversations and providing psychoeducational tools. mHealth apps show great potential in this context.

OBJECTIVE

The objective of this research is to discover the specific ways young people with cognitive impairments and their families interact with mHealth apps in the context of bridging the communication gap. This newly discovered information leads to potentially more impactful mHealth interventions in the future. Therefore, this paper documents the design and development of a mHealth app for a specific group of people with cognitive impairments-people with 22q11 deletion syndrome (22q11 DS)-and their caregivers, as well as key learnings from the evaluation of this app.

METHODS

An iterative, user-centered design approach is used to design and develop the app. Design and evaluation happens in 2 phases. During the design phase, feedback is gathered from 2 medical experts and 3 human computer interaction (HCI) experts using a low-fidelity paper prototype. During the evaluation phase, feedback is gathered from 8 families with a child with 22q11 DS using a fully working proof of concept. This phase consists of a semistructured interview, a 2-4-week trial period, and a concluding semistructured interview.

RESULTS

The evaluation results of the fully working proof of concept led to design recommendations related to four different topics: (1) overcoming usage barriers, (2) stimulating conversation through a mHealth app, (3) providing information, and (4) bringing continual added value. Results are presented according to six different categories obtained in a thematic analysis: (1) feedback about the app "as is," (2) difficulties, (3) comparison between physical and digital tool, (4) extensions, (5) intention, and (6) other.

CONCLUSIONS

In this research, the need for apps that help bridge the communication gap between a person with cognitive impairment and their caregiver is confirmed. All participating families express their gratitude and mention the added value for other families. Therefore, it is highly encouraged for clinics and institutions to take action and develop an app to be used in practice. Furthermore, considerations when developing for people with 22q11 DS, or more broadly, people with cognitive impairments, are proposed. First, one should keep design principles in mind to overcome usage barriers. Next, recognition is a key concept when stimulating conversations through mobile apps. Third, information should be provided by a trusted source, and more than just clinical information can be considered valuable. Finally, having the possibility of using a digital tool that can be personalized brings continual added value.

The effect of family cohesion and adaptability on career choice self-efficacy of graduates: The mediating effect of State Anxiety

BACKGROUND:

As one of the most significant background factors affecting individuals’ growth and development, family environment has a specific and essential impact on individuals’ career choices.

OBJECTIVE:

To examine the effect of family cohesion and adaptability on career choice self-efficacy

METHOD:

This study was conducted with 584 graduates. Self-report questionnaires were used to collect data.

RESULTS:

The results showed that: (1) There is a significant positive correlation between family cohesion and adaptability; (2) State anxiety is significantly negatively correlated with career choice self-efficacy and family cohesion and adaptability; (3) State anxiety plays a completely mediating effect between family cohesion and career choice self-efficacy, and (4) State anxiety plays a partial mediating role in the relationship between family adaptability and career choice self-efficacy.

CONCLUSION:

The current study focused on the two aspects of family function and revealed the relationship between family cohesion and adaptability and career choice self-efficacy of graduates.

Efficacy of the Use of the Calgary Family Intervention Model in Bedside Nursing Education: A Systematic Review

Objective

To objectively analyze the research for empirical evidence of the efficacy of the use of the Calgary Family Intervention Model (CFIM) in assisting bedside education by nurses and to identify facilitators and barriers to the use of the Model.

Methods

Four research databases (PubMed [MEDLINE], CINAHL, Web of Science, and Science Direct) were queried for studies commensurate with the objective statement from 1990 to 2021. In total, 169 articles were initially identified in the search, 135 were screened after duplicates and ineligible articles were removed, ultimately leaving the sample of 24 articles for the review.

Results

There is significant evidence to conclude that the CFIM is a very useful model to be used by nurses for bedside education and to improve overall patient and family outcomes. It enables communication, collaboration, and therapeutic conversations. The use of CFIM by nurses serves as a resource for both them and families and patients involved. There are some concerns to the use of CFIM as there are family dynamic issues, which result in problems providing care to patients. A lack of family sharing can result in inadequate care to the patient as well as unrealistic expectations from family members involved.

Conclusion

The CFIM is an excellent tool to enable nurses to provide education at the bedside and to enable improved patient and family outcomes. The use of the tool is suggested in situations where it would improve the level of care provided to patients and families.

Care Coordination Needs of Families of Children with Down Syndrome: A Scoping Review to Inform Development of mHealth Applications for Families

Care coordination is a critical component of health management aimed at linking care providers and health-information-involved care management. Our intent in this scoping review was to identify care coordination needs of families of children with Down syndrome (DS) and the strategies they used to meet those needs, with the goal of contributing to the evidence base for developing interventions by using an mHealth application (mHealth apps) for these families. Using established guidelines for scoping reviews, we searched five databases, yielding 2149 articles. Following abstract and full-text review, we identified 38 articles meeting our inclusion criteria. Studies incorporated varied in regard to research designs, samples, measures, and analytic approaches, with only one testing an intervention by using mHealth apps. Across studies, data came from 4882 families. Common aspects of families' care coordination needs included communication and information needs and utilization of healthcare resources. Additional themes were identified related to individual, family, and healthcare contextual factors. Authors also reported families' recommendations for desirable characteristics of an mHealth apps that addressed the design of a personal health record, meeting age-specific information needs, and ensuring access to up-to-date information. These results will further the development of mHealth apps that are tailored to the needs of families with a child with DS.

The Potential of mHealth as a Game Changer for the Management of Sickle Cell Disease in India

Sickle cell disease (SCD) is a chronic genetic disease that requires lifelong therapy and monitoring. Low drug adherence and poor monitoring may lead to an increase in morbidities and low quality of life. In the era of digital technology, various mobile health (mHealth) apps are being tested for their potential in increasing drug adherence in patients with SCD. We herewith discuss the applicability and feasibility of these mHealth apps for the management of SCD in India.