Coping strategies during legally enforced quarantine and their association to psychological distress level: a cross-sectional study

OBJECTIVES

The non-pharmacological measures to contain the COVID-19 pandemic may lead to considerable psychological distress. The aim of the CoCo-Fakt study was to investigate possible coping strategies and their effects on psychological distress during legally enforced quarantine of infected persons (IPs) and their close contacts (CPs).

STUDY DESIGN

This was a cross-sectional cohort study.

METHODS

From 12 December 2020 to 6 January 2021, all IPs and their CPs (n = 8232) registered by the public health department (Cologne, Germany) were surveyed online. Psychosocial distress and coping were measured using sum scores; free-text answers related to specific strategies were subsequently categorised.

RESULTS

Psychosocial distress was higher in IPs than in CPs (P < .001). Although the mean coping score did not differ between both groups, it was influenced by the reason for quarantine (IP vs CP) besides gender, age, socio-economic status, living situation, psychological distress, resilience, physical activity and eating behaviour. This final regression model explained 25.9% of the variance. Most participants used active coping strategies, such as contact with the social environment, a positive attitude and hobbies.

CONCLUSIONS

Although psychological distress was higher in IPs than in CPs during the quarantine period, the mean coping score did not differ. The strategies most frequently used by IPs and CPs were activating social networks, a healthy lifestyle and professional support systems, such as the health department helpline. Appropriate advice should be implemented to prevent long-term psychological consequences when supporting affected people.

Essential case management services for young children in foster care

A growing number of children in the United States are being placed into foster care. Past studies indicate that effective case manager interventions have helped foster families with a variety of different problems. This study enrolled a randomly selected sample of 130 children under age four who had been newly placed into foster care. The purpose of this study was to identify the services needed by foster care families and determine which services require the most case manager effort. Consistent with other research, many foster care children in this study exhibited developmental, medical and psychosocial concerns. Nevertheless, we found that it was services aimed at the foster care parents, rather than the foster care children, that required the most labor-intensive case management services.

Foster care children and family homelessness

OBJECTIVES

This study examined the association between family homelessness and children's placement in foster care.

METHODS

The prevalence of homelessness in a random sample of 195 young foster children was examined.

RESULTS

Almost half of the birth parents of the foster children had experienced homelessness. Those children were more likely than other foster children to have siblings in foster care and to be place with nonrelatives.

CONCLUSIONS

An extremely high prevalence of family homelessness was found among children in foster care. Policy implications of the association between family homelessness and placement into foster care are discussed.

Foster care's youngest: a preliminary report

The impact of welfare reform on foster care is examined in relation to children's mental health. Initial assessment of 125 young foster children randomly assigned to a special program found that half rated below normal on mental and psychomotor development, with two-thirds below normal on emotional regulation and motor quality. Implications for social policy and program planning, and the need for ongoing research, are discussed.

Combining methods to identify new measures of women's drinking problems. Part I: The ethnographic stage

In recent years, some researchers in the alcohol survey field have raised concerns about the shortcomings in severity/frequency scales for drinking and drinking problems used for both clinical and household survey purposes, especially with regard to women. This article reports on Part I of a two-part study that used ethnographic and survey methods to assess indicators of drinking problems among women across various US subcultures. Methodology for the ethnographic component consisted of three steps: analysis of findings in literature on indicators of women's drinking problems, and analysis of indicators addressed in the most commonly used standard instruments for alcohol assessment; semi-structured interviews with 12 specialists in treatment and/or research who focused on alcohol problems of women; and semi-structured interviews with 65 women from four ethnic populations who were clients in alcohol treatment centers. Analysis of these data from the ethnographic component produced a taxonomy of indicators of women's drinking problems and fourteen novel indicators that are not included or are inadequately examined in the most commonly used alcohol assessment instruments. The novel indicators were then incorporated into a questionnaire used for a county-wide survey of men and women that assessed indicators of drinking problems. Report of findings from the survey are presented in the second paper of this series.

Development of an integrated case management program for vulnerable children

Although case management is a recognized technique to organize and coordinate human services, its use with high-risk children is relatively new. This article describes the development of a case management program for children at the Center for the Vulnerable Child at Children's Hospital, Oakland, California, a health care setting that brings together health, social work, and child welfare services. Case management was introduced into multidisciplinary clinical programs for foster children, drug-exposed infants, and adolescent mothers and their infants. Case management activities differed in each of the clinical programs in relation to the unique characteristics of each population and the different obstacles encountered. A time management analysis indicated consequent differences in case management time allocations. The implications of these findings are discussed.

Children in foster care in California: an examination of Medicaid reimbursed health services utilization

The number of children in foster care in California doubled from 27,534 in 1980 to more than 62,419 in 1988, representing approximately 1% of the child population in the state. Past studies have demonstrated that children in foster care have high rates of medical and mental health problems. An examination of all Medi-Cal-paid claims was undertaken to describe the utilization of health services by children in foster care. Although children in foster care represent 4% of Medi-Cal-eligible children younger than 18 years of age, they account for approximately 5% of children using Medi-Cal services and 6.7% of expenditures, representing a 23% greater utilization rate and 41% greater expenditure rate than all children covered by Medi-Cal. Using the entire Medi-Cal population younger than 18 years of age as comparison group, examination of inpatient and outpatient service utilization for specific condition categories showed few differences between children in foster care and the comparison group except for mental health service utilization, where children in foster care were much higher users of services.

Mental health service utilization by children in foster care in California

An examination of Medi-Cal-paid claims was undertaken to assess the utilization of mental health services by children in California's foster care system. Using unduplicate counts of service use and diagnoses, it was determined that children in foster care account for 41% of all users of mental health services even though they represent less than 4% of Medi-Cal-eligible children. When partitioned into specific service categories, children in foster care account for 53% of all psychologist visits, 47% of psychiatry visits, 43% of Short Doyle/Medi-Cal inpatient hospitalization in public hospitals, and 27% of inpatient psychiatric hospitals. Expenditure for services paralleled utilization frequency. When compared to the non-foster care Medi-Cal-eligible child population, children in foster care have 10 to 20 times the rate of utilization per eligible child for selected services. For children in foster care, 75% of all diagnoses for billed service were accounted for by four diagnoses: adjustment disorders (28.6%), conduct disorders (20.5%), anxiety disorders (13.8%), and emotional disorders (11.9%), with clear age-related differences in the distribution of diagnoses.

Indicators of women's alcohol problems: what women themselves report

In-depth interviews with 65 women in treatment contributed to a taxonomy of indicators of women's alcohol problems, with five major categories and numerous subcategories. The largest number of client indicators appeared in the Individual (psychological and behavioral) category. The Physiological category included unique indicators regarding physical appearance. Within the Social category, family/partner relationships were emphasized. The taxonomy can be useful in therapeutic assessments, to develop survey items, in comparative research, or in alcohol program development.

Review and analysis of literature on indicators of women's drinking problems

Our goal is to identify more relevant indicators of women's drinking problems. We first reviewed the literature on women's drinking problems to uncover the major issues and research problems that previous studies have raised. We then systematically analyzed 464 indicators of women's alcohol problems cited in the literature from 1970-86. We calculated the frequency of their appearance by source (literature review, clinical studies, research articles, or surveys) and organized them into a comprehensive indicator taxonomy that included physiological, social, psychological and behavioral categories. The resulting taxonomy can serve as a baseline for grounding indicators of women's alcohol problems collected from other sources, such as ethnographic studies of particular populations or surveys of the general population.

Health services for California's foster children: current practices and policy recommendations

The organization and delivery of health services to children in foster care was investigated in 14 California counties in 1985. Foster care administrators, child welfare workers, foster parents, and health care providers responded to questionnaires and structured interviews performed by two pediatricians knowledgeable about the child welfare system. The organization of health services demonstrated a high degree of variability between counties. Although some counties initially evaluate all dependent children using specific protocols and examinations sites, more often services were poorly organized, fragmented, and had few safeguards to ensure delivery of appropriate health care. Use of recommended Early Periodic Screening Diagnosis and Treatment services was also variable, and counties could not provide documentation of use rates by foster children. Even less consistent was the performance of routine initial mental health assessments. Financial disincentives, fewer available providers, difficulties in obtaining and using Medicaid-reimbursed services, and fragmentation of services were frequently identified as barriers to access. To improve the organization and delivery of services, access barriers must be diminished, services must be better organized and integrated, and new financing mechanisms must be developed. Specific policy recommendations are presented.

Reevaluating risk factors for women's drinking: a study of blue-collar wives

Social indicators for problem drinking among women are based on studies of women seeking treatment for alcoholism or alcohol-related problems. Prior studies of risk factors have focused on life history, personality, genetic predisposition, and sociocultural factors. Virtually no attention has been paid to antecedents of drinking patterns in nonclinical populations of women. In this study of alcohol use among 31 industrial workers and their families, most of the wives clearly exhibited known sociocultural risk factors for heavy or problem drinking among women, yet most were light or moderate drinkers. Based on an ethnographic and case study research design, we propose four explanations for this anomaly in relation to cultural characteristics of working-class life. Beliefs, attitudes, and other social constraints that appear to significantly inhibit the development of problem drinking among women in this apparently high-risk population are identified.

Home away from home: the alternative birth center

Hospital alternative birth centers (ABCs) were established in response to consumer demands for 'family-centered maternity care'. This paper considers the controversy among advocates of different childbirth alternatives, including ABCs, home birth and conventional hospital birth. The expectations and evaluations of a sample of women who chose ABC births are compared to attitudes towards the ABC of women who selected home births or conventional hospital births. Women who choose the ABC and those who select home birth share some critical views of conventional labor and delivery, but not the same overall ideology of childbirth. Women who choose the ABC and women who choose conventional labor and delivery share beliefs in the authority of hospital obstetrics and the expertise of physicians.