Prepartum and postpartum mothers' and fathers' feelings of frustration in response to infant crying

In this cross-sectional study performed in Canada, we evaluated the frustration levels of prepartum and postpartum mother and father couple-pairs. Our goal was to determine if there were differences in frustration levels between mothers and fathers while listening to prolonged infant crying, and further, how frustration levels might differ between prepartum and postpartum samples. Using two discrete groups, prepartum (Sample 1; N = 48) and postpartum (Sample 2; N = 44) mother and father couple-pairs completed 600 s of listening to audio-recorded infant cry sounds. Participants continuously reported their subjective frustration using a computerized Continuous Visual Analog Scale (CVAS). There was no significant difference in frustration responses between mothers and fathers across both prepartum and postpartum samples. Postpartum mothers and fathers experienced greater frustration than their prepartum counterparts, and frustration increased faster in postpartum couples compared to prepartum couples. Informing first-time parents of the universal experiences of frustration to prolonged crying bouts that are characteristic of their infant's early weeks of life may lead to greater understanding towards their infant, and perhaps decreased instances of harmful responses.

Exploring Therapeutic Relationships in Pediatric Occupational Therapy: A Meta-Ethnography

Background. Developing strong therapeutic relationships with families is a crucial aspect of pediatric occupational therapy. However, building such relationships is complex as they involve multiple directions of interaction. Purpose. To provide a thorough interpretation of children's, caregivers', and occupational therapists' experience of the therapeutic relationship. Method. A meta-ethnography was realized to synthesize qualitative studies. A systematic search was carried out using five databases from 2005 to 2022. The CAPS checklist was used to appraise included studies' quality. The analysis was completed using a constant comparison of findings. Findings. Three themes emerged from the 14 studies synthesized. The first theme illustrates that the therapeutic relationship can have different meanings depending on the perspective of children, caregivers, or occupational therapists. The second theme explores the components impacting the experience of the relationship. These include the power dynamics, the communication, and respect for diversity. Finally, the third theme illustrates how the relationship can empower positive change. Implications. Children, caregivers, and occupational therapists each have a perspective that ought to be heard. Occupational therapists should actively ask for children's and caregivers' perspectives to encourage power sharing and effective communication. By doing so, occupational therapists can strengthen the therapeutic relationship, which, in turn, promotes positive change.

Non-pharmacological treatment of Attention Deficit Disorder with or without Hyperactivity (ADHD). Overview and report of the first international symposium on the non-pharmacological management of ADHD

Attention Deficit Disorder with or without Hyperactivity (ADHD is a neurodevelopmental disorder which affects the day-to-day functioning of children and adults with this condition. Pharmacological treatment can reduce the symptoms associated with ADHD, but it has some limitations. The objective of this symposium is to determine the effects of non-pharmacological approaches on ADHD symptoms. Results indicate that the following intervention are promising approaches: cognitive behavioral therapy (CBT), mindfulness-based interventions (MBI), yoga, cognitive and metacognitive intervention, neurofeedback and parental training programs. Current research advocates multimodal approaches in conjunction with school or work accommodations integrating innovative technologies.

[Responding to children's emotional and cognitive needs: Applying the cumulative model to the general population]

OBJECTIVES

Several risk factors are associated with neglectful behaviors. Yet their cumulative effect, which refers to the accumulation of risk regardless of the presence or absence of specific factors, remains unknown. This study aims to determine whether risk accumulation predicts caregivers' responses to children's emotional and cognitive needs in the general population and to examine the presence of clinical thresholds.

METHOD

A total of 1102 maternal figures of children aged 5 to 9 years old living in Quebec were questioned through a telephone survey. The response to children's emotional and cognitive needs was measured using a validated version of the Parent-Report Multidimensional Neglectful Behavior Scale. Ten individual, family and socioeconomic risk factors were combined to compute a cumulative risk index.

RESULTS

Results indicate that the cumulative index predicts the response to children's emotional and cognitive needs in the general population. This effect is observed for families exposed to at least two risk factors and it increases considerably when risk exposure reaches 5 factors.

CONCLUSIONS

This study supports the cumulative risk hypothesis, which until now had mainly been examined in vulnerable or clinical samples. It fosters a better statistical understanding of contexts compromising an optimal response to school age children's emotional and cognitive needs in the general population. This breakthrough is particularity important considering the challenges of identifying children at risk of having their needs neglected.

Requirements for tele-health in children with obstetric brachial plexus palsy during Covid-19-like situations

The purpose of the study was to investigate families’ concerns and service requirements during the Covid-19 lockdown. In case of tele-consultation, we also aimed to assess the effects of this service on coping and the family’s worries. At end of lockdown, we contacted the parents of 67 obstetric brachial plexus palsy patients (0–10 years age) by e-mail. During lockdown, 42 of the families had had a tele-consultation with our team, while 25 reported that not receiving any service. A questionnaire consisting of 6 questions was sent to the families, and data were analyzed according to 4 age-groups. Parents' concerns varied according to the children’s age group (p = 0.001). All families replied that their children should receive remote services during Covid-19-like situations (p = 0.173). Parents of the 42 children who had tele-consultations reported that this had alleviated their worries, independently of age-group (p = 0.160). The usefulness of tele-consultation to manage the lockdown situation differed according to age-group (p = 0.002). The parents of under-3-year-olds experienced more worry during lockdown, but all respondents reported needing remote services. Although the tele-consultation alleviated the worries of almost all families, it was most useful in managing lockdown in families with under-3-year-olds.

[CONFAMI study: Effects of home confinement during the COVID-19 epidemic on the lives of children and their families]

Objectifs

L’objectif est de comprendre les changements au sein des familles durant le confinement motivé par la pandémie de la COVID-19 et explorer le vécu psychoaffectif des enfants et de leurs parents face à cette situation.

Méthode

Il s’agit d’une enquête en ligne anonyme avec méthodologie associant des analyses quantitatives et qualitatives. Les questions ciblaient plusieurs thèmes tels que le contexte de vie, le vécu émotionnel et les répercussions sur les habitudes quotidiennes chez les enfants et adolescents, tels que perçus par les parents.

Résultats

Au total, 439 parents ont répondu au questionnaire. Les familles sont globalement restées dans leur lieu de vie habituel et ont réussi à bien s’adapter. En moyenne, le niveau d’inquiétude des enfants (estimé par les parents) était moins élevé que celui que les parents s’attribuent. L’état psychologique des enfants et adolescents était globalement stable mais pour ceux qui ont vécu davantage d’émotions négatives que d’habitude, il s’agissait d’une augmentation de l’ennui, de l’irritabilité et de la colère. Une baisse de la qualité de sommeil a aussi été constatée par un tiers des répondants. En revanche, une progression de l’autonomie a été soulignée. Les parents ont aussi rapporté une amélioration des relations familiales, mais aux dépens des liens sociaux habituels induisant un sentiment de privation.

Conclusion

Malgré des émotions négatives ressenties chez certains enfants, le confinement a permis de développer de nouvelles ressources dans la plupart des familles. Certains facteurs rapportés, tels que le renforcement des liens, pourraient être des facteurs protecteurs et constituent de bonnes pistes dans les interventions à proposer aux enfants et leur famille.

How do patients and health professionals perceive the role of family members in the decision-making process regarding the choice of a dialysis method? A qualitative study

BACKGROUND

Therapeutic decisions often seem to be the product of interaction between health professionals and patients alone. However, some realities make it essential to consider family members when examining care of patients, especially in the construction of therapeutic choices. Implementation of measures such as therapeutic patient education to make the patient an actor in his own healthcare, and the impact of disease on the patient's social and professional activities mean there is an important place for family members in a patient's care pathway. This study aims to examine the role of family members and the family environment in decision-making on treatment for patients with chronic kidney disease. It also analyzes how they contribute to the construction of patients' choices on dialysis methods through their involvement in a therapeutic patient education program.

METHODS

This study involved thirty-six semi-structured interviews: sixteen with patients and twenty with health professionals. Therapeutic patient education sessions, interactions and information exchanges between patients and health professionals, as well as participant behaviours, were also observed. Analysis was thematic.

RESULTS

Results indicate that the factors influencing the patient's choice of dialysis methods include the family environment as the place where the disease is experienced, the need to maintain family ties, the advice provided by family members and their active participation in therapeutic patient education sessions and partnership between family members and health professionals in the decision-making process.

CONCLUSION

This study highlights the reality of decision-making processes that can start from a non-hospital setting. Furthermore, it argues for greater consideration of the needs, values, and preferences of family members in mechanisms designed to promote patient participation in therapeutic decisions.

[How do children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) experience lockdown during the COVID-19 outbreak?]

Objectifs

Le confinement général de la population française dans le contexte de la pandémie de COVID-19, liée au nouveau Coronavirus SARS-COV-2, est une situation potentiellement à risque pour les enfants avec un développement atypique. L’objectif de notre étude est de mieux comprendre l’état de santé mentale des enfants et adolescents avec le trouble déficit d’attention hyperactivité (TDAH) en période de confinement.

Méthodes

Cinq cent trente-huit patients ont répondu à un sondage anonyme en ligne, proposé via les réseaux sociaux et relayé ou posté sur le site des associations de personnes concernées par le TDAH durant la période de confinement.

Résultats

Une majorité des enfants et adolescents de notre enquête a connu soit un mieux-être soit un état général psychologique stable d’après leurs parents. Une diminution de l’anxiété est mise en lien avec l’interruption de la scolarité présentielle et un rythme « sur-mesure ». Pour certains, l’abandon des aménagements et le volume de tâches ont posé problème avec des attitudes d’opposition et d’évitement. Les parents décrivent également une prise de conscience des difficultés de leurs enfants, ce qui ressort comme un élément constructif. Les enfants dont l’état se dégrade ont à la fois des difficultés comportementales et émotionnelles. En ce qui concerne le recours aux soins, la téléconsultation comme outil de continuité de soins a été largement appréciée.

Conclusions

Avant les contraintes liées à la crise sanitaire, les aspects scolaires sont cités comme principaux facteurs influençant l’état émotionnel de l’enfant et de l’adolescent avec TDAH dans le contexte de confinement.

[Factors associated with Internet addiction among Tunisian adolescents]

INTRODUCTION

Internet addiction, a relatively new phenomenon, is a field of recent research in mental health, particularly within young populations. It seems to interact with several individual and environmental factors.

OBJECTIVES

We aim to spot internet addiction in a Tunisian adolescent population, and to study its relationship with personal and family factors, as well as with anxious and depressive comorbidities.

METHODS

We conducted a cross-sectional study of 253 adolescents recruited in public places in the city of Sfax in the south of Tunisia. We collected biographical and personal data as well as data describing family dynamics. The internet addiction was assessed by Young's questionnaire. Depressive and anxious co-morbidities were assessed using the HADS scale. The comparative study was based on the chi-square test and the Student's test, with a significance level of 5 %.

RESULTS

The prevalence of internet addiction was 43.9 %. The average age of internet-addicts was 16.34 years, the male sex was the most represented (54.1 %) and increased the risk of internet addiction (OR a=2.805). The average duration of connection among Internet addicts was 4.6hours per day and was significantly related to internet addiction; P<0.001). Socializing activities were found in the majority of the internet-addicted adolescents (86.5 %). The type of online activity was significantly associated with internet addiction (P=0.03 and OR a=3.256). Other behavioral addictions were frequently reported: 35.13% for excessive use of video games and 43.25 % for pathological purchases. These two behaviors were significantly associated with internet addiction (with respectively P=0.001 and P=0.002 with OR=3.283). The internet-addicted adolescents lived with both parents in 91.9 % of cases. The mother's regular professional activity was significantly associated with internet addiction risk (P=0.04) as was the use of the Internet by parents and siblings (with respectively P=0.002 and P<0.001 with OR=3.256). The restrictive attitude of the parents was significantly associated with internet addiction risk (P<0.001 OR=2.57). Family dynamics, particularly at the level of adolescent-parent interactions, were a determining factor in internet addiction. Anxiety was more frequently found than depression among our cyber-dependent adolescents with frequencies of 65.8 % and 18.9 %, respectively. Anxiety was significantly correlated with the risk of internet addiction (P=0.003, OR a=2.15). There was no significant correlation between depression and the risk of internet addiction.

CONCLUSION

The Tunisian adolescent seems at great risk of internet addiction. Targeted action on modifiable factors, especially those affecting family interactions, would be very useful in prevention.

[Medico-legal implications of coronary angioplasty among seniors]

It's commonplace to declare that seniors are more fragile, because of a higher rate of comorbidities and complex coronary lesions. However, they take great benefit from angioplasty during acute coronary syndrome, with a higher rate of complications. Based on the study of claims reported to a French medical insurer, it is found that people over 75 years old among victims of interventional cardiology accidents is proportional to the population of seniors in the French population (around 10%). Conversely, the mortality of those seniors was much higher than patients under 75 (83% versus 30%). A strategy, which involves families and anticipates the risks of those fragile patients (fragility of structures, risk of decompensation of comorbidities [kidneys, hemostasis]) can help to prevent the risk of accidents, but may also reduce medico-legal implications of cardiologists.

Substance use capital: Social resources enhancing youth substance use

BACKGROUND

Social capital is described as a protective factor against youth substance use, but it may also be associated with behaviours that do not enhance health. The present study hypothesized that 'substance use capital', i.e. resources favourable to substance use, is a risk factor for substance use and misuse.

METHODS

We used baseline data from the ongoing Cohort Study on Substance Use Risk Factors (C-SURF) that included a representative sample of young Swiss men (n=5623). Substance use (alcohol, cannabis, 15 illicit drugs, lifetime use, hazardous use and dependence), substance use capital (parental and peer attitudes towards substance use, parental and peer drug use, perceived norms of substance use) and aspects of social capital (relationships with parents and peers) were assessed. Logistic regressions were used to examine the associations between substance-related resources and social resources, and substance use.

RESULTS

Results showed that substance-related resources were associated with an increased risk of substance use (OR between 1.25 and 4.67), whereas social resources' associations with substance use were commonly protective but weaker than substance-related resources. Thus, a drug-friendly environment facilitated substance use and misuse. Moreover, the results showed that peer environments were more drug-friendly than familial environments.

CONCLUSION

In conclusion, this study highlighted a concept of 'substance use capital', which may be useful for advancing both theoretical and applied knowledge of substance use. Indeed, substance use is not only associated with a lack of social resources, but also with specific drug-friendly social resources coming from environment and background.

[Being a family today - ethics for assisted reproductive techniques]

Currently in France, all the children born as a result of an assisted reproduction procedure, represent 2.5% of all births. Although this proportion is not high, it is not to be neglected, particularly with regard to the sociological issues raised by assisted reproduction technologies (ART) - i.e. removing anonymity of gamete donation, post mortem insemination, ART access to single women and gay couples, surrogacy - to name four of the most prominent debates. What is new with ART is that a new therapeutic target of medicine is being developed, in other words procreation. Now it is no longer necessary for a man and a woman to resort to sex to have a child. This is a profound questioning of the representation of what appeared to be intangible, with some sort of divine aura. How, in this context, developing an ethics for ART? From a fethnographic field survey, we show here how this ethos of ART develops and how, therefore, we consider the multiple ways of being a family today.