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Ma H, Ma Y, Ge S, Wang S, Zhao IY, Christensen M. Intrapersonal and interpersonal level factors influencing self-care practices among Hong Kong individuals with COVID-19-A qualitative study. Front Public Health 2022; 10:964944. [PMID: 36091550 PMCID: PMC9449417 DOI: 10.3389/fpubh.2022.964944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/08/2022] [Indexed: 01/24/2023] Open
Abstract
Background The unprecedented crisis during the fifth wave of the COVID-19 pandemic in Hong Kong placed a significant burden on the health care system. Therefore, the Hong Kong government advocated that individuals with no or mild COVID-19 symptoms should self-care at home. This study aimed to understand intrapersonal and interpersonal level factors that shaped self-care practices among home-quarantined individuals with COVID-19 during the peak of the pandemic. Methods This study used convenience and snowball sampling whereby a total of 30 semi-structured telephone interviews were conducted between March and April 2022. Inductive content analysis was used to analyze the data. Results Factors reported at the intrapersonal level included socioeconomic status and housing conditions, information and knowledge about COVID-19, long COVID, and psychological adjustments brought about by home quarantine. Factors identified at the interpersonal level included caregiving responsibilities, family relationships, and social support. Conclusions Findings from this study identified a combination of intra and interpersonal level factors influenced an individual's self-care practices as a result of pandemic-induced quarantine. It was particularly concerning for those individuals in socially and economically deprived groups, where access to services was challenging. This study also raised awareness of the ineffectual and insufficient knowledge individuals held of self-medication and overall COVID-19 management. A key recommendation is developing family-based resilience programmes to support and empower vulnerable families to better cope with the realities of self-quarantine.
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Affiliation(s)
- Haixia Ma
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China,Interdisciplinary Centre for Qualitative Research, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Yajing Ma
- School of Public Policy and Management, China University of Mining and Technology, Xuzhou, Jiangsu, China
| | - Song Ge
- Department of Natural Sciences, University of Houston-Downtown, Houston, TX, United States
| | - Shanshan Wang
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China,WHO Collaborating Center for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Ivy Yan Zhao
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China,WHO Collaborating Center for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Martin Christensen
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China,Interdisciplinary Centre for Qualitative Research, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China,*Correspondence: Martin Christensen
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Hickling A, Dingle GA, Barrett HL, Cobham VE. Systematic Review: Diabetes Family Conflict in Young People With Type 1 Diabetes. J Pediatr Psychol 2021; 46:1091-1109. [PMID: 34313769 DOI: 10.1093/jpepsy/jsab052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To investigate the relationships between diabetes-specific family conflict and health outcomes of young people with type 1 diabetes (T1D). METHODS A systematic review was performed according to the PRISMA statement (registration number: CRD42020164988). PubMed, Embase, PsycNET, reference lists of included studies, and other relevant reviews were searched (1990-2020). Two independent reviewers screened titles, abstracts, and full-texts. Studies were included if they sampled young people with T1D (mean age between 14 and 25 years) and examined the relationship between diabetes-specific family conflict and the following outcomes: glycated hemoglobin (HbA1c), treatment adherence, blood glucose monitoring, depression, anxiety, quality of life, and/or well-being. RESULTS A total of 20 studies met the predetermined inclusion criteria. Greater diabetes-specific family conflict was significantly related to higher HbA1c values in 17 studies. Seven studies reported a significant association between greater diabetes family conflict and suboptimal treatment adherence and/or less frequent blood glucose monitoring. However, significant relationships between conflict and HbA1c and/or treatment adherence were not found in four studies. Seven studies in total reported that greater diabetes family conflict was significantly related to poorer quality of life or well-being and greater depressive and/or anxiety symptoms in young people. CONCLUSIONS Diabetes-specific family conflict is associated with some adverse health outcomes for young people with T1D. However, more longitudinal studies of young people aged older than 16 years are needed. Screening for and addressing diabetes-specific family conflict is recommended, given the growing number of studies linking family conflict to various adverse health outcomes in young people with T1D.
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Affiliation(s)
- Anna Hickling
- School of Psychology, The University of Queensland.,Mater Research Institute, The University of Queensland.,Children's Hospital Foundation (Queensland)
| | | | - Helen L Barrett
- Mater Research Institute, The University of Queensland.,Department of Endocrinology, Mater Health Services, Mater Hospital
| | - Vanessa E Cobham
- School of Psychology, The University of Queensland.,Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service
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Psihogios AM, Fellmeth H, Schwartz LA, Barakat LP. Family Functioning and Medical Adherence Across Children and Adolescents With Chronic Health Conditions: A Meta-Analysis. J Pediatr Psychol 2020; 44:84-97. [PMID: 29982694 DOI: 10.1093/jpepsy/jsy044] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 06/03/2018] [Indexed: 12/16/2022] Open
Abstract
Objectives A meta-analysis examined family functioning and medical adherence in children and adolescents with chronic health conditions. Family functioning was evaluated at the level of the family unit, as well as parent-child interactions. Methods We conducted literature searches using PubMed, PsycINFO, SCOPUS, Web of Science, and Cochrane. After reviewing 764 articles, 62 studies met eligibility criteria. Pearson's r correlations were the effect size of interest. We conducted both omnibus and domain-specific (e.g., family conflict, cohesion) meta-analyses. Meta-regressions examined whether relevant covariates related to the magnitude of the effect. Results The omnibus meta-analysis showed that family functioning was significantly related to medical adherence across a variety of pediatric chronic health conditions. Lower family conflict, greater family cohesion, greater family flexibility, more positive communication, and better family problem-solving were each associated with better adherence. There were no significant differences in the magnitude of the omnibus effect based on child age, measurement features (subjective vs. objective or bioassay adherence; family unit vs. parent-child interactions), or study quality. Conclusions Consistent with social-ecological frameworks, findings supported links between family functioning and medical adherence. This study highlights several limitations of the extant research, including absence of a guiding theoretical framework and several methodological weaknesses. We offer clinical and research recommendations for enhancing scientific understanding and promotion of adherence within the family context.
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Affiliation(s)
| | | | - Lisa A Schwartz
- The Children's Hospital of Philadelphia.,Perelman School of Medicine of the University of Pennsylvania
| | - Lamia P Barakat
- The Children's Hospital of Philadelphia.,Perelman School of Medicine of the University of Pennsylvania
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Distelberg B, Tapanes D, Emerson ND, Brown WN, Vaswani D, Williams-Reade J, Anspikian AM, Montgomery S. Prospective Pilot Study of the Mastering Each New Direction Psychosocial Family Systems Program for Pediatric Chronic Illness. FAMILY PROCESS 2018; 57:83-99. [PMID: 28299791 DOI: 10.1111/famp.12288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Psychosocial interventions for pediatric chronic illness (CI) have been shown to support health management. Interventions that include a family systems approach offer potentially stronger and more sustainable improvements. This study explores the biopsychosocial benefits of a novel family systems psychosocial intervention (MEND: Mastering Each New Direction). Forty-five families participated in a 21-session intensive outpatient family systems-based program for pediatric CI. Within this single arm design, families were measured on five domains of Health-Related Quality of Life (HRQL) self-report measures; Stress, Cognitive Functioning, Mental Health, Child HRQL, Family Functioning. Both survey and biological measures (stress: catecholamine) were used in the study. Results from multivariate general linear models showed positive pre-, post-, and 3-month posteffects in all five domains. The program effects ranged from small to moderate (η2 = .07-.64). The largest program effects were seen in the domains of cognitive functioning (η2 = .64) and stress (η2 = .27). Also, between disease groups, differences are noted and future implications for research and clinical practice are discussed. Conclusions suggest that the MEND program may be useful in helping families manage pediatric chronic illnesses. Study results also add to the growing body of literature suggesting that psychosocial interventions for pediatric chronic illness benefit from a family systems level of intervention.
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Affiliation(s)
| | - Daniel Tapanes
- Department of Counseling and Family Sciences, Loma Linda University Health Behavioral Medicine Center, Loma Linda, CA
| | | | - Whitney N Brown
- Department of Psychology, Loma Linda University, Loma Linda, CA
| | - Deepti Vaswani
- Loma Linda University Health Behavioral Medicine Center, Loma Linda, CA
| | | | - Ara M Anspikian
- Loma Linda University Health Behavioral Medicine Center, Loma Linda, CA
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Whittemore R, Liberti LS, Jeon S, Chao A, Minges KE, Murphy K, Grey M. Efficacy and implementation of an Internet psychoeducational program for teens with type 1 diabetes. Pediatr Diabetes 2016; 17:567-575. [PMID: 26611663 PMCID: PMC4882266 DOI: 10.1111/pedi.12338] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 10/18/2015] [Accepted: 10/23/2015] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE The purpose of the study was to evaluate the participation and preliminary efficacy of an Internet psychoeducational program (Teens.Connect) shown to be efficacious under controlled conditions compared with an open-access diabetes website for youth (Planet D) on the primary outcomes of A1C and quality of life (QoL), and secondary outcomes of psychosocial and behavioral factors. RESEARCH DESIGN AND METHODS Teens with type 1 diabetes (n = 124, 11-14 yr) from two clinical sites were randomly prescribed one of the programs and completed baseline, 3-month and 6-month data. A1C was obtained from clinic records. Participation data included number of log ins, posts to the discussion board, and lessons completed (Teens.Connect only). Descriptive and mixed model analyses were used. RESULTS Eighty-five percent (85%) of consented teens registered for their prescribed program. Satisfaction and log ins were similar between groups (satisfaction ranged 3.3-3.5/5; mean log ins = 14/teen). Posts to the discussion forum were higher in Planet D (mean = 28 vs. 19). Participation in the Teens.Connect lessons was low, with only 69% of teens completing any lesson. After 6 months there were no significant differences in A1C, QoL or secondary outcomes between groups. Teens in the Teens.Connect group reported lower perceived stress over time (p < 0.01). CONCLUSIONS Teens do not actively participate in an Internet psychoeducational program when they do not have frequent reminders, which may have contributed to a lack of treatment effect. Teens have many competing demands. Strategic implementation that includes targeted reminders and family support may be necessary to assure participation and improvement in health outcomes.
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Affiliation(s)
| | | | | | - Ariana Chao
- Yale University School of Nursing, Orange, Connecticut
| | | | - Kathryn Murphy
- The Division of Endocrinology & Diabetes at the Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Margaret Grey
- Yale University School of Nursing, Orange, Connecticut
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Distelberg BJ, Emerson ND, Gavaza P, Tapanes D, Brown WN, Shah H, Williams-Reade J, Montgomery S. A Cost-Benefit Analysis of a Family Systems Intervention for Managing Pediatric Chronic Illness. JOURNAL OF MARITAL AND FAMILY THERAPY 2016; 42:371-382. [PMID: 27282311 PMCID: PMC4938762 DOI: 10.1111/jmft.12166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Despite recent increases of psychosocial programs for pediatric chronic illness, few studies have explored their economic benefits. This study investigated the costs-benefits of a family systems-based, psychosocial intervention for pediatric chronic illness (MEND: Mastering Each New Direction). A quasi-prospective study compared the 12-month pre-post direct and indirect costs of 20 families. The total cost for program was estimated to $5,320. Families incurred $15,249 less in direct and $15,627 less in indirect costs after MEND. On average, medical expenses reduced by 86% in direct and indirect costs, for a cost-benefit ratio of 0.17. Therefore, for every dollar spent on the program, families and their third payers saved approximately $5.74. Implications for healthcare policy and reimbursements are discussed.
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Distelberg B, Williams-Reade J, Tapanes D, Montgomery S, Pandit M. Evaluation of a family systems intervention for managing pediatric chronic illness: Mastering Each New Direction (MEND). FAMILY PROCESS 2014; 53:194-213. [PMID: 24635346 PMCID: PMC4486080 DOI: 10.1111/famp.12066] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Family systems play a crucial, albeit complex, role in pediatric chronic illness. Unfortunately, very few psychosocial interventions are available to help these stressed families navigate the developmental steps of chronic illness. A new intervention (MEND) addresses the needs of these families and applies to a broad range of chronic illnesses. This article presents this family systems intervention as well as includes preliminary program evaluation data on 22 families that graduated from the program. Results show consistently strong effects across an array of psychosocial measures. Conclusions from this preliminary study suggest that families entering MEND present with high levels of stress due to the child's chronic illness, but after MEND, the level of stress and other functioning measures are comparable to those seen in healthy families, suggesting that the program offers a significant benefit to families with pediatric chronic illness.
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Affiliation(s)
- Brian Distelberg
- Department of Counseling and Family Sciences, Loma Linda University, Loma Linda, CA
| | | | - Daniel Tapanes
- Department of Counseling and Family Sciences, Loma Linda University, Loma Linda, CA
| | | | - Mayuri Pandit
- Behavioral Medical Center, Loma Linda University, Loma Linda, CA
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Neylon OM, O'Connell MA, Skinner TC, Cameron FJ. Demographic and personal factors associated with metabolic control and self-care in youth with type 1 diabetes: a systematic review. Diabetes Metab Res Rev 2013; 29:257-72. [PMID: 23364787 DOI: 10.1002/dmrr.2392] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Revised: 12/02/2012] [Accepted: 01/02/2013] [Indexed: 11/11/2022]
Abstract
Optimal use of recent technological advances in insulin delivery and glucose monitoring remain limited by the impact of behaviour on self-care. In recent years, there has been a resurgence of interest in psychosocial methods of optimizing care in youth with type 1 diabetes. We therefore sought to examine the literature for demographic, interpersonal and intrapersonal correlates of self-care and/or metabolic control. Studies for this systematic review were obtained via an electronic search of Medline, Embase, Cumulative Index to Nursing and Allied Health Literature and PsycINFO databases. Seventy studies fulfilled the inclusion criteria. These studies have indicated that identifiable individual characteristics in each domain are robustly associated with metabolic control and/or self-care in children and adolescents. We present these characteristics and propose a theoretical model of their interactions and effect on diabetes outcomes. There is currently no consensus regarding patient selection for insulin pump therapy. In this era of scarce healthcare resources, it may be prudent to identify youth requiring increased psychosocial support prior to regimen intensification. The importance of this review lies in its potential to create a framework for rationally utilizing resources by stratifying costly therapeutic options to those who, in the first instance, will be most likely to benefit from them.
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Affiliation(s)
- Orla M Neylon
- University of Tasmania, Burnie, Tasmania, Australia.
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The concept of bootstrapping of structural equation models with smaller samples: an illustration using mealtime rituals in diabetes management. J Dev Behav Pediatr 2011; 32:619-26. [PMID: 21900827 DOI: 10.1097/dbp.0b013e31822bc74f] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study was to offer a practical demonstration of the use of bootstrapping in structural equation modeling (SEM) with smaller samples by evaluating family dinnertime rituals at the intersection between the family social environment and pediatric type 1 diabetes mellitus management. METHOD Participants were 77 children and adolescents aged 6 to 18 years and their mothers from a larger study of child and parental challenges related to managing the treatment regimen and correlates of adherence. SEM was used to test a model of maternal reports of the family social environment as exogenous variables with mealtime rituals and child hemoglobin A1c levels as endogenous variables. The bootstrapping procedure and the Bollen-Stine bootstrapped χ test were then applied to test the stability and appropriateness of this model. RESULTS Using SEM, the final model had robust goodness-of-fit indicators and revealed that the family social environment characteristics of control and cohesion were related to mealtime rituals, which was associated with hemoglobin A1c levels. The bootstrapping procedure indicated that the parameter estimates were very stable, thus lending greater credence to the model. The Bollen-Stine approach provided evidence that the entire hypothesized model was not significantly different from the model derived from bootstrapping. CONCLUSIONS This investigation offers a practical demonstration of the bootstrapping technique and the Bollen-Stine approach for testing models on smaller samples in SEM. These techniques may be used with relatively small samples, which are common in developmental/behavioral pediatrics and pediatric psychology research.
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11
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Anderson LS, Riesch SK, Pridham KA, Lutz KF, Becker PT. Furthering the understanding of parent-child relationships: a nursing scholarship review series. Part 4: parent-child relationships at risk. J SPEC PEDIATR NURS 2010; 15:111-34. [PMID: 20367782 PMCID: PMC3048028 DOI: 10.1111/j.1744-6155.2009.00223.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this integrative review is to synthesize nursing scholarship on parent-child relationships considered fragile because of parent-child's chronic condition or occurrence within a risky context. CONCLUSIONS Most reviewed studies demonstrated negative effects of risk conditions on parent-child relationships and documented importance of child, parent, and contextual variables. Studies were predominately single investigations. Varying theoretical perspectives complicated interpretation. Mainly White, middle-class, and small samples limited generalizability. Important areas for further research were identified. PRACTICE IMPLICATIONS Nurse researchers identified factors that may interfere with the parent-child relationship. Nurses are in a position to support families under these circumstances.
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Affiliation(s)
- Lori S Anderson
- University of Wisconsin-Madison School of Nursing, Madison, Wisconsin, USA.
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Lehmkuhl HD, Storch EA, Cammarata C, Meyer K, Rahman O, Silverstein J, Malasanos T, Geffken G. Telehealth behavior therapy for the management of type 1 diabetes in adolescents. J Diabetes Sci Technol 2010; 4:199-208. [PMID: 20167185 PMCID: PMC2825642 DOI: 10.1177/193229681000400125] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Poor management of type 1 diabetes mellitus (T1DM) may result in serious medical complications. Psychological intervention may improve adherence to medical regimens; however, access to trained professionals is limited, particularly in rural communities. Telehealth interventions may address this by allowing families to access services at home; however, little is known about the efficacy of such services. METHOD This study presents results from a pilot trial of a randomized waitlist controlled trial of Telehealth Behavioral Therapy (TBT) for youths with T1DM. Primary outcome measures were adherence to the diabetes regimen, glycemic control, and level of family discord. Thirty-two youths (23 female) with T1DM (aged 9 to 17 years) and one parent or caregiver participated. Telehealth Behavioral Therapy sessions were conducted thrice weekly for 12 weeks by phone and lasted an average of 15 min each. RESULTS Results indicated that youths in treatment decreased their hemoglobin A1c by 0.74 compared to 0.09 in the waitlist, though this was not statistically significant. Youths in treatment reported increased unsupportive and decreased caring parental behaviors. CONCLUSION Telehealth Behavioral Therapy improves access to knowledgeable providers and results in a clinically significant improvement in glycemic control. Despite some youths experiencing an increase in unsupportive parental behaviors, TBT is a promising method of service delivery that warrants further investigation.
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Affiliation(s)
- Heather D Lehmkuhl
- Department of Psychology, Nationwide Children's Hospital, Columbus, Ohio 43205, USA.
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Cammarata C, Meyer KJ, Geffken G, Felipe D, Franz D, Vargas A, Kamps JL. Psychosocial Issues That Affect Youth with Diabetes. AMERICAN JOURNAL OF HEALTH EDUCATION 2009. [DOI: 10.1080/19325037.2009.10599102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Christina Cammarata
- Christina Cammarata is a post doctoral associate in the Department of Psychiatry/Department of Pediatrics, PO Box 100234, University of Florida, Gainesville Florida 32610
| | - Kara J. Meyer
- Kara J. Meyer is a postdoctoral associate in the Department of Psychiatry, PO Box 100234, University of Florida, Gainesville Florida 32610
| | - Gary Geffken
- Gary Geffken is an associate professor in the Department of Pediatrics, PO Box 100234, University of Florida, Gainesville Florida 32610
| | - Dania Felipe
- Dania Felipe is a senior fellow in the Department of Pediatrics - Division of Endocrinology, Louisiana State University Health Sciences Center Children’s Hospital, New Orleans, LA 70118
| | - Diane Franz
- Diane Franz is a licensed clinical psychologist, Children’s Hosptial of New Orleans, Department of Psychology
| | - Alfonso Vargas
- Alfonso Vargas is a professor and vice-chairman for Education and International Affairs Department of Pediatrics/Division of Endocrinology Louisiana State University Health Sciences Center Children’s Hospital, Louisiana State University, New Orleans, LA 70118
| | - Jodi L. Kamps
- Jodi L. Kamps is a licensed clinical psychologist, Children’s Hosptial of New Orleans, Department of Psychology
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Alderfer MA, Fiese BH, Gold JI, Cutuli JJ, Holmbeck GN, Goldbeck L, Chambers CT, Abad M, Spetter D, Patterson J. Evidence-based assessment in pediatric psychology: family measures. J Pediatr Psychol 2007; 33:1046-61; discussion 1062-4. [PMID: 17905801 PMCID: PMC2639492 DOI: 10.1093/jpepsy/jsm083] [Citation(s) in RCA: 165] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To provide a review of the evidence base of family measures relevant to pediatric psychology. METHOD Twenty-nine family measures were selected based upon endorsement by Division 54 listserv members, expert judgment, and literature review. Spanning observational and self-report methods, the measures fell into three broad assessment categories: Family functioning, Dyadic family relationships, and Family functioning in the context of childhood chronic health conditions. Measures were categorized as: "Well-established", "Approaching well-established", or "Promising." RESULTS Nineteen measures met "well-established" criteria and the remaining ten were "approaching well-established." "Well-established" measures were documented for each of the broad assessment categories named above. CONCLUSIONS Many measures deemed "well-established" in the general population are proving to be reliable and useful in pediatric samples. More evidence of the validity of family measures is needed in this context. This review should prove helpful to clinicians and researchers as they strive to make evidence-based decisions regarding family measures.
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Affiliation(s)
- Melissa A Alderfer
- The Children's Hospital of Philadelphia, Civic Center Blvd, Philadelphia, PA 19104, USA.
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Kyngäs HA. Predictors of good adherence of adolescents with diabetes (insulin-dependent diabetes mellitus). Chronic Illn 2007; 3:20-8. [PMID: 18072695 DOI: 10.1177/1742395307079191] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The purpose of this study was to identify the factors that predict good adherence to health regimens by adolescents with diabetes (insulin-dependent diabetes mellitus). METHODS Altogether, 300 individuals aged 13-17 years were randomly selected from the Finnish Social Insurance Institution's register. Ninety-seven per cent (N=289) of the selected adolescents returned the questionnaire. The data were analysed using the SPSS (Statistical Package for Social Sciences) for Windows software package. Logistic regression was used to find the factors that predict good adherence to health regimens. RESULTS About one-fifth (19%) of the respondents with diabetes felt that they complied fully with the health regimens, while 75% placed themselves in the category of satisfactory adherence, and the remaining 6% reported poor adherence. The most powerful predictor was the threat to mental wellbeing. The likelihood that adolescents who felt the disease to be a threat to their mental wellbeing would comply with health regimens was 7.68-fold as compared to those who did not regard the disease as a threat to their mental wellbeing. The next most powerful predictor was support from physician. The support from nurses, and the motivation, energy and willpower to take care of themselves and the threat to physical wellbeing, also predicted good adherence. The logistic regression model explained 82% of the variance, and the model predicted correctly 88% of the adolescents with good adherence. DISCUSSION This paper shows that adolescents with diabetes show quite good adherence. It also indicates the factors that predict good adherence to health regimens. To improve adherence, these factors should be given special attention in the care of adolescents.
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Affiliation(s)
- Helvi A Kyngäs
- University of Oulu, Department of Nursing and Health Administration, Box 5300, 90014 Oulu, Finland.
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Greening L, Stoppelbein L, Reeves CB. A Model for Promoting Adolescents' Adherence to Treatment for Type 1 Diabetes Mellitus. CHILDRENS HEALTH CARE 2006. [DOI: 10.1207/s15326888chc3503_4] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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