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Draeger-Muenke R. The "well-sibling" syndrome: hypnosis for the siblings of special needs children. Am J Clin Hypn 2023:1-11. [PMID: 37856370 DOI: 10.1080/00029157.2023.2249059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
Often overlooked by caregivers because of their ability to adapt to a challenging home life by making few demands themselves, the siblings of special needs children have unacknowledged needs of their own. They often are reluctant to participate in therapy because of their self-concept of having to be the "normal" or "perfect" child. Therapy with these children requires non-pathologizing and attuned rapport building focused on creative self-exploration without requests for change. Two composite case vignettes illustrate the power and versatility of clinical hypnosis to facilitate new learning about becoming visible in the therapeutic relationship and beyond.
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Maridal HK, Bjørgaas HM, Hagen K, Jonsbu E, Mahat P, Malakar S, Dørheim S. Psychological Distress among Caregivers of Children with Neurodevelopmental Disorders in Nepal. Int J Environ Res Public Health 2021; 18:2460. [PMID: 33801567 DOI: 10.3390/ijerph18052460] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/16/2021] [Accepted: 02/23/2021] [Indexed: 11/25/2022]
Abstract
Parenting a child with neurodevelopmental disorder (NDD) is related to a higher rate of anxiety and depression, increased stress, and reduced quality of life. Although there is reason to believe that parenting children with NDD in low- and middle-income countries (LMIC) can be challenging, there is a lack of knowledge on the psychological distress among these caregivers, especially in rural areas. The aim of the study was to examine the psychological distress among caregivers having children with NDD in rural Nepal. Sixty-three caregivers were visited in their homes and interviewed by experienced mental health professionals. This study examined demographic information, severity of disability, perceived caregiver burden, and psychological distress, measured by the General Health Questionnaire-12 (GHQ-12). The study found a high level of psychological distress in the caregivers (M = 5.38, SD = 2.8). A majority (90.5%) scored two or higher, indicating the presence of a common mental disorder (CMD). Almost half (46%) scored six or higher, indicating a high level of distress. A majority of the caregivers reported that caring for their disabled child had a negative effect on the caregiver’s economy (70%), physical health (65%), social life (64%), and dreams and expectations for the future (81%). There was a significant relationship between the caregiver’s psychological distress (GHQ-12) and degree of disability in the child (Gross Motor Function Classification System), degree of caregiver burden, feeding problems, having health workers as a possible source of help, receiving incentive from the government, having somebody to confide in, and caregiver illiteracy. A forward regression analysis entering the significant factors indicated that caregiver burden, having someone to confide in, and having health workers as a possible source of help were significant related to psychological distress. The final step of the model explained 42.4% of the variance in psychological distress among the caregivers. The study indicates a high level of psychological distress and high overall burden in caregivers of children with NDD in rural Nepal. Further implications for research and service development are discussed.
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Marquis S, Hayes MV, McGrail K. Factors that May Affect the Health of Siblings of Children Who Have an Intellectual/Developmental Disability. Journal of Policy and Practice in Intellectual Disabilities 2019. [DOI: 10.1111/jppi.12309] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Sandra Marquis
- Social Dimensions of HealthUniversity of Victoria Victoria BC Canada
| | - Michael V. Hayes
- School of Public Health and Social Policy University of VictoriaUniversity of Victoria Victoria BC Canada
| | - Kimberlyn McGrail
- Centre for Health Services and Policy ResearchUniversity of British Columbia Vancouver BC Canada
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Lostelius PV, Ståhle-Öberg L, Fjellman-Wiklund A. Pain in children with cerebral palsy – adolescent siblings’ awareness of pain and perceived influence on their family. European Journal of Physiotherapy 2018. [DOI: 10.1080/21679169.2018.1505946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Petra Vikman Lostelius
- Department of Community Health and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
- Psychosomatic Medicine Clinic, Västmanland County Council, Västerås, Sweden
| | - Lena Ståhle-Öberg
- Department of Community Health and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
- Habilitation, Västerbotten County Council, Umeå, Sweden
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Stephenson E, DeLongis A, Steele R, Cadell S, Andrews GS, Siden H. Siblings of Children With a Complex Chronic Health Condition: Maternal Posttraumatic Growth as a Predictor of Changes in Child Behavior Problems. J Pediatr Psychol 2018; 42:104-113. [PMID: 28173141 DOI: 10.1093/jpepsy/jsw053] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 03/21/2016] [Accepted: 05/22/2016] [Indexed: 11/13/2022] Open
Abstract
Objective The present study examined the role of maternal posttraumatic growth in changes in behavioral problems among the siblings of children with complex chronic health conditions. Methods Data were collected from a sample of 70 siblings from 58 families with at least one child diagnosed with a life-threatening genetic, metabolic, or neurological condition. Every 6 months for up to 4 years, sibling behavior problems were assessed through both parent-reports and youth self-reports. At each visit, mothers also completed self-reports of posttraumatic growth. Results Time-lagged multilevel regression analyses revealed that higher levels of maternal posttraumatic growth predicted subsequent declines in parent-reported internalizing, externalizing, and total behavior problems among healthy siblings. These findings were partially replicated using youth self-reports of their own behavior problems. Conclusion The findings suggest that the benefits of posttraumatic growth may extend beyond the self to other family members, particularly to children in the family.
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Affiliation(s)
- Ellen Stephenson
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, British Columbia, Canada
| | - Anita DeLongis
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, British Columbia, Canada
| | - Rose Steele
- School of Nursing, York University, Toronto, Ontario, Canada
| | - Susan Cadell
- School of Social Work, University of Waterloo, Waterloo, ON, Canada
| | - Gail S Andrews
- Developmental Neurosciences & Child Health, Child & Family Research Institute, Vancouver, British Columbia, Canada
| | - Harold Siden
- Developmental Neurosciences & Child Health, Child & Family Research Institute, Vancouver, British Columbia, Canada.,Departments of Pediatrics, University of British Columbia , Vancouver, Canada
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Shivers CM, Dykens EM. Adolescent Siblings of Individuals With and Without Intellectual and Developmental Disabilities: Self-Reported Empathy and Feelings About Their Brothers and Sisters. Am J Intellect Dev Disabil 2017; 122:62-77. [PMID: 28095054 DOI: 10.1352/1944-7558-122.1.62] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Siblings of brothers or sisters with intellectual and developmental disabilities (IDD) are important but understudied family members. As many previous studies have relied on parent report of sibling outcomes, the use of sibling self-report is an important addition to the research. This study assessed the feelings of adolescent siblings toward their brothers or sisters with and without IDD, as well as broader aspects of sibling empathy. Data were collected via a national, online survey from 97 parent-sibling pairs. Siblings of individuals with IDD reported higher levels of anxiety toward the target child than did siblings of typically developing individuals. Sibling feelings toward the target child were related to both parental and target child factors, but only among families of individuals with IDD.
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Affiliation(s)
- Carolyn M Shivers
- Carolyn M. Shivers, Virginia Tech; and Elisabeth M. Dykens, Vanderbilt University
| | - Elisabeth M Dykens
- Carolyn M. Shivers, Virginia Tech; and Elisabeth M. Dykens, Vanderbilt University
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Abstract
INTRODUCTION Sibling relationships have lifelong significance and childhood chronic illness and disability can have considerable impacts on healthy siblings, influencing development into adulthood. Research has not yet assessed well-being in this population using measures of both mental health and mental illness. Thus, this study assessed well-being in a comprehensive manner using the complete mental health (CMH) model. METHOD Participants (N = 144) included both adult siblings of those with chronic illness or disability and adults with healthy siblings. Measures of positive social, psychological and emotional well-being were used to assess mental health and a measure of depression, anxiety, and stress was used to assess mental illness. RESULTS A high proportion of participants, both with and without siblings with a chronic illness or disability, were experiencing symptoms of mental illness, accompanied by high wellbeing. This indicates that many participants fit into the struggling category of the CMH model. DISCUSSION The present research highlights the need for early intervention services to ensure that siblings of those with a chronic illness or disability are well supported in developing strengths, as well as managing difficulties. Results also indicate that targeting students in mental health promotion is important to encourage participation in services. Implications for rehabilitation Siblings of those with a chronic illness or disability need to be included in assessments in order to understand the experience of the family unit. It is important for families and clinicians to be aware of the needs of healthy siblings and encourage them to interact with support services in order to maximise and maintain well-being. Skills-based support could be beneficial, particularly for providing caregivers with strategies to meet the needs of both their child with a chronic illness or disability and their healthy children.
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Affiliation(s)
- Madeleine Hallion
- a School of Psychology , The University of Adelaide , Adelaide , Australia
| | - Amanda Taylor
- a School of Psychology , The University of Adelaide , Adelaide , Australia
| | - Rachel Roberts
- a School of Psychology , The University of Adelaide , Adelaide , Australia
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Fothergill K, Ensminger ME, Doherty EE, Juon HS, Green KM. Pathways from Early Childhood Adversity to Later Adult Drug Use and Psychological Distress: A Prospective Study of a Cohort of African Americans. J Health Soc Behav 2016; 57:223-39. [PMID: 27284077 PMCID: PMC5787376 DOI: 10.1177/0022146516646808] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Drawing on the life course perspective, this research addresses the direct and indirect pathways between childhood adversity and midlife psychological distress and drug use across a majority of the life span in an African American cohort (N = 1,242) followed from age 6 to 42 (1966 to 2002). Results from structural equation models highlight the impact of low childhood socioeconomic status (SES), poor maternal mental health, and the role of first-grade maladaptation in launching a trajectory of social maladaptation from age 6 to 42. Specifically, for men, we found a direct pathway from early low SES to drug use in mid adulthood and an indirect pathway to psychological distress through first-grade maladaptation and adolescent poor mental health. For females, early SES affected first-grade maladaptation and low school bonds, which then predicted later drug use.
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Zajicek-Farber ML, Lotrecchiano GR, Long TM, Farber JM. Parental Perceptions of Family Centered Care in Medical Homes of Children with Neurodevelopmental Disabilities. Matern Child Health J 2016; 19:1744-55. [PMID: 25724538 DOI: 10.1007/s10995-015-1688-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Life course theory sets the framework for strong inclusion of family centered care (FCC) in quality medical homes of children with neurodevelopmental disabilities (CNDD). The purpose of this study was to explore the perceptions of families with their experiences of FCC in medical homes for CNDD. Using a structured questionnaire, the Family-Centered Care Self-Assessment Tool developed by Family Voices, this study surveyed 122 parents of CNDD in a large urban area during 2010-2012. Data collected information on FCC in the provision of primary health care services for CNDD and focused on family-provider partnerships, care setting practices and policies, and community services. Frequency analysis classified participants' responses as strengths in the "most of the time" range, and weaknesses in the "never" range. Only 31 % of parents were satisfied with the primary health care their CNDD received. Based on an accepted definition of medical home services, 16 % of parents reported their CNDD had most aspects of a medical home, 64 % had some, and 20 % had none. Strengths in FCC were primarily evident in the family-provider partnership and care settings when focused on meeting the medical care needs of the child. Weaknesses in FCC were noted in meeting the needs of families, coordination, follow-up, and support with community resources. Improvements in key pediatric health care strategies for CNDD are recommended. CNDD and their families have multifaceted needs that require strong partnerships among parents, providers, and communities. Quality medical homes must include FCC and valued partnerships with diverse families and community-based providers.
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Affiliation(s)
- Michaela L Zajicek-Farber
- National Catholic School of Social Service (NCSSS), The Catholic University of America (CUA), Shahan Hall #112, 620 Michigan Ave., NE, Washington, DC, 20064, USA,
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Carter S, Cook J, Sutton-Boulton G, Ward V, Clarke S. Social pedagogy as a model to provide support for siblings of children with intellectual disabilities: A report of the views of the children and young people using a sibling support group. J Intellect Disabil 2016; 20:65-81. [PMID: 25999397 DOI: 10.1177/1744629515586516] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/15/2015] [Indexed: 06/04/2023]
Abstract
The experiences of non-disabled children growing up with a sibling with an intellectual disability vary considerably, with reported impact ranging from increased mental health problems through evaluations of life enhancement. However, there is evidence that the net impact is neutral to positive, which was supported by the findings of this report of a service evaluation survey. The value of providing support to those young siblings is however clear. An established method of support is within a group of peers who also have a sibling with an intellectual disability, though no specific method for running this type of group has yet been fully explored. This article reports the views of 39 children taking part in such a group, analysing their perspective through a proposed model for the operation of sibling groups: social pedagogy. It was found that the closer the group's activities were to social pedagogy, the more supported the children and young people felt.
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Affiliation(s)
| | | | | | - Vicki Ward
- Dorset HealthCare University NHS Foundation Trust, UK
| | - Steve Clarke
- Dorset HealthCare University NHS Foundation Trust, UK
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Giné C, Gràcia M, Vilaseca R, Salvador Beltran F, Balcells-Balcells A, Dalmau Montalà M, Luisa Adam-Alcocer A, Teresa Pro M, Simó-Pinatella D, Maria Mas Mestre J. Family Quality of Life for People With Intellectual Disabilities in Catalonia. Journal of Policy and Practice in Intellectual Disabilities 2015. [DOI: 10.1111/jppi.12134] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gettings S, Franco F, Santosh PJ. Facilitating support groups for siblings of children with neurodevelopmental disorders using audio-conferencing: a longitudinal feasibility study. Child Adolesc Psychiatry Ment Health 2015; 9:8. [PMID: 25866558 PMCID: PMC4392474 DOI: 10.1186/s13034-015-0041-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 03/16/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Siblings of children with chronic illness and disabilities are at increased risk of negative psychological effects. Support groups enable them to access psycho-education and social support. Barriers to this can include the distance they have to travel to meet face-to-face. Audio-conferencing, whereby three or more people can connect by telephone in different locations, is an efficient means of groups meeting and warrants exploration in this healthcare context. This study explored the feasibility of audio-conferencing as a method of facilitating sibling support groups. METHODS A longitudinal design was adopted. Participants were six siblings (aged eight to thirteen years) and parents of children with complex neurodevelopmental disorders attending the Centre for Interventional Paediatric Psychopharmacology (CIPP). Four of the eight one-hour weekly sessions were held face-to-face and the other four using audio-conferencing. Pre- and post-intervention questionnaires and interviews were completed and three to six month follow-up interviews were carried out. The sessions were audio-recorded, transcribed and thematic analysis was undertaken. RESULTS Audio-conferencing as a form of telemedicine was acceptable to all six participants and was effective in facilitating sibling support groups. Audio-conferencing can overcome geographical barriers to children being able to receive group therapeutic healthcare interventions such as social support and psycho-education. Psychopathology ratings increased post-intervention in some participants. Siblings reported that communication between siblings and their family members increased and siblings' social network widened. CONCLUSIONS Audio-conferencing is an acceptable, feasible and effective method of facilitating sibling support groups. Siblings' clear accounts of neuropsychiatric symptoms render them reliable informants. Systematic assessment of siblings' needs and strengthened links between Child and Adolescent Mental Health Services, school counsellors and young carers groups are warranted.
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Affiliation(s)
- Sheryl Gettings
- Florence Nightingale Faculty of Nursing and Midwifery, King’s College London, London, UK
| | - Fabia Franco
- Department of Psychology, School of Science and Technology, Middlesex University, London, UK
| | - Paramala J Santosh
- Centre for Interventional Paediatric Psychopharmacology (CIPP), Maudsley Hospital; and Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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Kowalewski K, Spilger T, Jagla M, Podeswik A, Hampel P. „Supporting Siblings“: Evaluation eines Lebenskompetenztrainings für Geschwister von chronisch kranken und/oder behinderten Kindern. Präv Gesundheitsf 2014; 9:312-20. [DOI: 10.1007/s11553-014-0442-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mazaheri MM, Rae-Seebach RD, Preston HE, Schmidt M, Kountz-Edwards S, Field N, Cassidy S, Packman W. The impact of Prader-Willi syndrome on the family's quality of life and caregiving, and the unaffected siblings' psychosocial adjustment. J Intellect Disabil Res 2013; 57:861-873. [PMID: 23057501 DOI: 10.1111/j.1365-2788.2012.01634.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/03/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND Prader-Willi syndrome (PWS), a complex multisystem genetic disorder, is characterised by developmental abnormalities leading to somatic and psychological symptoms. Symptoms of PWS include infantile hypotonia and failure-to-thrive, followed by life-long hyperphagia, developmental delays and moderate-to-severe behavioural problems and several physical problems that impact health. This study examined the effects of caring for a child diagnosed with PWS on the mothers and unaffected siblings. We assessed overall family functioning, the mothers' psychological health, the psychosocial and behavioural functioning of siblings, and the quality of life of siblings. METHODS Participants included 12 mothers and 13 siblings of a child with genetically confirmed PWS. Self-report measures administered to the mothers evaluated overall family functioning (PedsQL - Family Impact Module), the mothers' psychological health (Brief Symptom Inventory), and the mothers' perception of the sibling's quality of life (PedsQL - Parent Proxy). Self-report measures administered to the siblings evaluated their perceived quality of life (PedsQL) and symptoms of post-traumatic stress disorder (PTSD) (UCLA PTSD Index). RESULTS Families/mothers/siblings with children with PWS showed poorer perceived quality of life compared with general inpatient and outpatient samples of children with complex health conditions. Families/mothers/siblings with children with PWS reported difficulties in family functioning, communication problems, and an increased number of conflicts. They appeared to be experiencing significant behavioural distress symptoms, with higher than average levels of depression and feelings of isolation, anger and worry. Ninety-two per cent of the siblings indicated moderate-to-severe symptoms of PTSD. Compared with normative populations, siblings demonstrated poorer quality of life, with mothers perceiving more significant deficits in the sibling. CONCLUSION This study reaffirms that PWS affects the entire family system. Mothers and siblings would benefit from psychosocial support due to the multiple challenges of living with and caring for a child/young adult with PWS.
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Affiliation(s)
- M M Mazaheri
- San Diego Functional Restoration Program, San Jose, CA, USA
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Abstract
OBJECTIVE The purpose of this study was to empirically test if siblings of children with disability had higher levels of parent-reported behavioral and emotional functional impairment compared with a peer group of siblings residing with only typically developing children. METHODS This was a retrospective secondary analysis of data from the Medical Expenditure Panel Survey. We included only households with at least 2 children to ensure sibling relationships. Two groups of siblings were formed: 245 siblings resided in households with a child with disability and 6564 siblings resided in households with typically developing children. Parents responded to questions from the Columbia Impairment Scale to identify functional impairment in their children. RESULTS On the basis of parent reports and after adjusting for sibling demographic characteristics and household background, siblings of children with disability were more likely than siblings residing with typically developing children to have problems with interpersonal relationships, psychopathological functioning, functioning at school, and use of leisure time (P < .05). The percentage of siblings of children with disability classified with significant functional impairment was 16.0% at the first measurement period and 24.2% at the second (P < .001). For siblings of typically developing children there was a smaller percentage increase from 9.5% to 10.3% (P < .001). CONCLUSIONS Functional impairment is a key indicator for the need of mental health services and, as such, early assessment and interventions to limit increasing severity and short- to long-term consequences need to be addressed. Health care professionals need to consider a family-based health care approach for families raising children with disability.
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Affiliation(s)
- Anthony Goudie
- Center for Applied Research and Evaluation, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
| | - Susan Havercamp
- Nisonger Center, The Ohio State University, Columbus, Ohio; and
| | - Barry Jamieson
- Government Resource Center, Ohio Colleges of Medicine, Columbus, Ohio
| | - Timothy Sahr
- Government Resource Center, Ohio Colleges of Medicine, Columbus, Ohio
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Li WHC, Chung JOK, Ho EKY. Effectiveness of an adventure-based training programme in promoting the psychological well-being of primary schoolchildren. J Health Psychol 2012; 18:1478-92. [DOI: 10.1177/1359105312465102] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study tested the effectiveness of an adventure-based training programme in promoting the psychological well-being of primary schoolchildren. A randomised controlled trial was conducted, with 56 primary school pupils randomly assigned to the experimental group participating in the adventure-based training programme and 64 to the attention placebo control group. Children in the experimental group reported significantly fewer depressive symptoms, lower anxiety levels and higher self-esteem than those in the attention placebo control group. This study provides some evidence that the adventure-based training programme is effective in promoting the psychological well-being of Hong Kong Chinese schoolchildren.
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Affiliation(s)
| | | | - Eva KY Ho
- The University of Hong Kong, Hong Kong
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Abstract
Children with disabilities and their families have multifaceted medical, developmental, educational, and habilitative needs that are best addressed through strong partnerships among parents, providers, and communities. However, traditional health care systems are designed to address acute rather than chronic conditions. Children with disabilities require high-quality medical homes that provide care coordination and transitional care, and their families require social and financial supports. Integrated community systems of care that promote participation of all children are needed. The purpose of this clinical report is to explore the challenges of developing effective community-based systems of care and to offer suggestions to pediatricians and policy-makers regarding the development of partnerships among children with disabilities, their families, and health care and other providers to maximize health and well-being of these children and their families.
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