ResearchPad - human-families https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Familial assimilation in transmission of raw-freshwater fish-eating practice leading to clonorchiasis]]> https://www.researchpad.co/article/elastic_article_15763 Clonorchiasis is caused by the ingestion of raw freshwater fish, which contains the infective larvae of Clonorchis sinensis. It is highly endemic in Asia, where about 15 million people are afflicted. To establish sustainable control strategy, the transmission of raw-eating practice needs to be illuminated. In this study, we conducted a survey in school students from four clonorchiasis endemic provinces in China, covering 23,222 students aged 9–18. The characteristics of raw-eating practice, impact of parents’ raw-eating practice on children, interaction of spouses’ practice was explored. It is demonstrated that raw-eating practice presents familial clustering, which is higher in those families with older children and with boys. Raw-eating practice in children is highly influenced by their parents’ raw-eating practice especially when both parents do. Additionally, there exists interaction between spouses’ raw-eating practice. The impact of husband’s raw-eating practice on his wife is higher than that of wife’s raw-eating practice on her husband. Familial assimilation dominates the transmission of raw-freshwater eating-practice, including the assimilation from parents to their children and that between spouses. This finding indicates the adoption of sustainable strategy against clonorchiasis through blocking raw-freshwater fish-eating practice.

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<![CDATA[Recreational drug use among Nigerian university students: Prevalence, correlates and frequency of use]]> https://www.researchpad.co/article/elastic_article_15734 Given the paucity of data on recreational drug use and the recent media attention on the abuse of drugs such as codeine cough syrups and tramadol, in Nigeria, our study examined the prevalence and frequency of recreational drug use among young adults from two Nigerian universities. We drew from the Socio-ecological Model to examine the influence of factors at the individual and family level on recreational drug use among adolescents and young adults.MethodsThis cross-sectional study was conducted between February and March 2018 among a final sample of 784 male and female university students selected using stratified random sampling. Binary logistic regression was used to identify significant predictors of ever use and current use of drugs.ResultsOur analyses showed that 24.5% of students had ever used drugs for recreational purposes, and 17.5% are current users. The median drug use frequency over the past month was six days among current users (n = 137). In the multivariable analyses, living in the same household as one's mother (AOR 0.28 95% CI 0.16–0.49), adequate family support (AOR 0.48 95% CI 0.26–0.89) and frequent attendance of religious fellowships (AOR 0.13 95% CI 0.07–0.25) were significantly associated with a lower likelihood of recreational drug use. However, male sex (AOR 1.52 95% CI 1.05–2.21) was associated with higher odds of recreational drug use.ConclusionThe family should be considered as an important unit to sensitize young people on the harmful effects of drug use. It is also vital that religious leaders speak against drug use in their various fellowships. There is a need to address recreational drug use on Nigerian campuses by educating students about its adverse impacts. ]]> <![CDATA[Barriers and facilitating factors in the prevention of diabetes type 2 and gestational diabetes in vulnerable groups: A scoping review]]> https://www.researchpad.co/article/elastic_article_13859 Type 2 diabetes mellitus (T2DM) and gestational diabetes (GDM) are globally on the rise, accompanied by comorbidities and associated health costs. Increased physical activity, healthy nutrition, and weight loss have shown the potential to prevent T2DM/GDM. Despite this, reaching vulnerable groups remains a key challenge. The aim of this scoping review was to identify barriers and facilitating factors in the prevention of T2DM/GDM in vulnerable groups.MethodsWe conducted a systematic literature search in May 2018, updated in September 2019, in several databases (e.g. PubMed, Embase) to identify barriers and facilitating factors in the prevention of T2DM/GDM in vulnerable groups. Two reviewers independently screened the results. Extracted data was charted, categorized, and summarized.ResultsWe included 125 articles. Ninety-eight studies were extracted, and eight categories of barriers and facilitating factors were formed. The most common categories of barriers were limited knowledge, family/friends, and economic factors, and the most common categories of facilitating factors were family/friends, social support, and knowledge.ConclusionThis scoping review identified various barriers and facilitating factors in vulnerable groups. Preventive interventions should consider these barriers and facilitating factors in developing preventive interventions or in adapting existing ones. ]]> <![CDATA[Gender norms and mass deworming program access in Comé, Benin: A qualitative assessment of gender-associated opportunities and challenges to achieving high mass drug administration coverage]]> https://www.researchpad.co/article/N0cbc3c85-9c5e-43fe-983c-4afc7d1b8db3

The World Health Organization’s Neglected Tropical Disease Roadmap has accelerated progress towards eliminating select neglected tropical diseases (NTDs). This momentum has catalyzed research to determine the feasibility of interrupting transmission of soil-transmitted helminths (STH) using community-wide mass drug administration (MDA). This study aims to identify potential gender-specific facilitators and barriers to accessing and participating in community-wide STH MDA, with the goal of ensuring programs are equitable and maximize the probability of interrupting STH transmission. This research was conducted prior to the launch of community-wide MDA for STH in Comé, Benin. A total of 10 focus group discussions (FGDs) were conducted separately among 40 men, 38 women, and 15 community drug distributors (CDDs). Salient themes included: both men and women believe that community-wide MDA would reduce the financial burden associated with self-treatment, particularly for low income adults. Community members believe MDA should be packaged alongside water, sanitation, and other health services. Women feel past community-wide programs have been disorganized and are concerned these distributions will be similar. Women also expressed interest in increased engagement in the implementation of future community-based public health programs. Men often did not perceive themselves to be at great risk for STH infection and did not express a high demand for treatment. Finally, the barriers discussed by CDDs generally did not align with gender-specific concerns, but rather represented concerns shared by both genders. A door-to-door distribution strategy for STH MDA is preferred by women in this study, as this platform empowers women to participate as health decision makers for their family. In addition, involving women in planning and implementation of community-wide programs may help to increase treatment coverage and compliance.

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<![CDATA[Understanding ambivalence in help-seeking for suicidal people with comorbid depression and alcohol misuse]]> https://www.researchpad.co/article/N5bd48253-819c-499c-aeec-83c12fc90159

Help-seeking prior to a suicide attempt is poorly understood. Participants were recruited from a previous research trial who reported a history of suicidal behaviours upon follow-up. Qualitative interviews were conducted with six adults to understand their lived experience of a suicide attempt and the issues affecting help-seeking prior to that attempt. Participants described being aware of personal and professional supports available; however, were ambivalent about accessing them for multiple reasons. This paper employs an ecological systems framework to better understand the complex and multi-layered interpersonal, societal and cultural challenges to help-seeking that people with suicidal ideation can experience.

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<![CDATA[Matching response to need: What makes social networks fit for providing bereavement support?]]> https://www.researchpad.co/article/5c8accc6d5eed0c48498ff77

The objectives of this study were to explore the goodness of fit between the bereaved peoples’ needs and the support offered by their social networks; to ascertain whether this support was experienced as helpful or unhelpful by bereaved people; and to explore both the types of social networks that offer effective support and the characteristics of the communities that encourage and nurture such networks. This study was based on qualitative interviews from twenty bereaved people, in Western Australia, interviewed in 2013. A framework analysis of these interviews was undertaken using a deductive approach based on the goodness of fit framework. Much of this support is provided informally in community settings by a range of people already involved in the everyday lives of those recently bereaved; and that support can be helpful or unhelpful depending on its amount, timing, function and structure. Improving the fit between the bereaved person’s needs and the support offered may thus involve identifying and enhancing the caring capacity of existing networks. An important strategy for achieving this is to train community members in mapping and developing these naturally occurring networks. Some such networks will include relationships of long standing, others may be circles of care formed during a period of caring. Peer support bereavement networks develop from these existing networks and may also recruit new members who were not part of the caring circle. The findings endorse social models of bereavement care that fit within a public health approach rather than relying solely on professional care. As exemplified by Compassionate Communities policies and practices, establishing collaboration between community networks and professional services is vital for effective and sustainable bereavement care.

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<![CDATA[Utilization of modern contraceptives and predictors among women in Shimelba refugee camp, Northern Ethiopia]]> https://www.researchpad.co/article/5c897721d5eed0c4847d2504

Women living in refugee camps, in addition to the common hardships, such as drought, and famine, are also prone to another peculiar problem: an unintended pregnancy. The impact of unintended pregnancy is so severe that the rate of women who die or suffer an injury while giving birth in crisis settings is almost double the world average death rate. Thus, this study was aimed to investigate the utilization of modern contraceptive and associated factors among women in the reproductive age group in Shimelba refugee camp, Northern Ethiopia. A community-based cross-sectional study was employed and 329 study subjects were selected using simple random sampling technique with a face-to-face interview. The prevalence of using modern contraceptive was 47.7% and the study showed that being older [AOR = 0.017, 95%CI: 0.001, 0.467], being single [AOR = 0.17, 95%CI:0.031,0.914], being unemployed [AOR = 0.21, 95% CI:0.001,0.392], having no partner support [AOR = 0.006, 95% CI:0.001,0.044], and inconvenient service site AOR = 0.089,95% CI:0.013, 0.595] were factors that contributed to women not using modern contraceptive methods. Receipt of counseling on family planning utilization was more likely to helps women to use it [AOR = 3.37, 95% CI: 1.1095, 10.236]. Our study concluded that the current prevalence rate of contraceptive use is fairly good. However, much effort has to be made to improve this result. The situations in refugee can exacerbate the existing barriers to the use of contraceptives. Given its grave consequence on the livelihood of women, the contraceptive issue should be given due emphasis using several techniques including education to expand the awareness on modern contraceptive so as to augment access to family planning.

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<![CDATA[Assessment of factors affecting diabetes management in the City Changing Diabetes (CCD) study in Tianjin]]> https://www.researchpad.co/article/5c6c758cd5eed0c4843cfe89

Objective

This study aimed to identify the local levels of vulnerability among patients with Type-II diabetes (T2DM) in Tianjin. The study was aimed at curbing the rise of T2DM in cities.

Methods

229 participants living with T2DM were purposively sampled from hospitals in Tianjin. Collected data were coded and analysed following well-established thematic analysis principles.

Results

Twelve themes involving 29 factors were associated with diabetes patients’ vulnerability: 1. Financial constraints (Low Income, Unemployment, No Medical Insurance/Low ratio reimbursement); 2. Severity of disease (Appearance of symptoms, complications, co-morbidities, high BMI, poor disease control); 3. Health literacy (No/Low/Wrong knowledge of health literacy); 4. Health beliefs (Perceived diabetes indifferently, Passively Acquire Health Knowledge, Distrust of primary health services); 5. Medical environment (Needs not met by Medical Services); 6. Life restrictions (Daily Life, Occupational Restriction); 7. Lifestyle change (Adhering to traditional or unhealthy diet, Lack of exercise, Low-quality sleep); 8. Time poverty (Healthcare-seeking behaviours were limited by work, Healthcare-seeking behaviours were limited by family issues); 9. Mental Condition (Negative emotions towards diabetes, Negative emotions towards life); 10. Levels of Support (Lack of community support, Lack of support from Friends and Family, Lack of Social Support); 11. Social integration (Low Degree of Integration, Belief in Suffering Alone); 12. Experience of transitions (Diet, Dwelling Environment).

Conclusion

Based on our findings, specific interventions targeting individual patients, family, community and society are needed to improve diabetes control, as well as patients’ mental health care and general living conditions.

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<![CDATA[Mental health in individuals with spinal cord injury: The role of socioeconomic conditions and social relationships]]> https://www.researchpad.co/article/5c76fe0dd5eed0c484e5b386

Objectives

To evaluate socioeconomic inequalities in social relationships, and to assess whether socioeconomic conditions and social relationships are independently related to mental health problems in individuals with a physical disability due to spinal cord injury (SCI).

Methods

We analyzed cross-sectional data from 511 individuals with SCI aged over 16 years who participated in the community survey of the Swiss SCI Cohort Study (SwiSCI). Indicators for socioeconomic conditions included years of formal education, household income, and financial strain. Social relationships were operationalized by three structural (partner status; social contact frequency; number of supportive relationships) and four functional aspects (satisfaction with: overall social support; family relationships; contacts to friends; partner relationship). General mental health was assessed by the Mental Health Inventory (MHI-5) of SF-36 and depressive symptoms were measured by the Hospital Anxiety and Depression Scale (depression subscale, HADS-D). Established cut-offs for general mental health problems (MHI-5 ≤56) and depressive symptomatology (HADS-D ≥8) were used to dichotomize outcomes. Associations were assessed using logistic regressions.

Results

Lower household income was predominantly associated with poor structural social relationships, whereas financial strain was robustly linked to poor functional social relationships. Financial strain was associated with general mental health problems and depressive symptomatology, even after controlling for social relationships. Education and household income were not linked to mental health. Poor structural and functional social relationships were related to general mental health problems and depressive symptomatology. Notably, trends remained stable after accounting for socioeconomic conditions.

Conclusion

This study provides evidence for socioeconomic inequalities in social relationships as well as for independent associations of financial strain and poor social relationships with mental health problems in individuals with SCI. Further research may develop strategies to improve mental health in SCI by strengthening social relationships. Such interventions may be especially beneficial for individuals with low income and financial strain.

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<![CDATA[Violence against Afghan women by husbands, mothers-in-law and siblings-in-law/siblings: Risk markers and health consequences in an analysis of the baseline of a randomised controlled trial]]> https://www.researchpad.co/article/5c65dce9d5eed0c484dec55d

Background

Violence by mothers-in-law, as well as husbands, is a recognised problem in many countries. It has been given little attention in research on violence and its importance as a health problem, and aggravator of husband violence, has not been well established. Our aim was to describe patterns and the frequency of mother-in-law and sibling-in-law/sibling physical violence in relation to physical violence from husbands, and to describe risk characteristics and associated health behaviours of women with different abuse exposures.

Methods

1,463 women aged 18–48 were recruited into a randomised controlled trial (RCT) to evaluate a women empowerment intervention in 6 villages of Kabul and Nangarhar provinces. The women were interviewed at baseline. The analysis uses bi-variable and multivariable logistic regression.

Results

932 of the women were currently married. Of these, 14% of women experienced mother-in-law physical violence and 23.2% of women experienced physical spousal violence in the previous 12 months. For 7.0% of women, these exposures were combined. Physical violence was associated with food insecurity and having to borrow for food, being in a polygamous marriage, living with their mother-in-law, as well as province of residence (higher in Nangarhar). Women who had earnings were relatively protected. Whilst most mothers-in-law were described in positive terms, those who used physical violence were much less likely to be described so and a quarter were described as very strict and controlling and 16.8% as cruel. Overall slightly more women described their husband in positive terms than their mother-in-law, but there was a very strong correlation between the way in which husbands were perceived and the violence of their mothers.

Women’s mental health (depression, suicidal thoughts and PTSD symptoms score), self-rated general health, disability and beating of their children were all strongly associated with intimate partner violence (IPV) exposure. The strength of the association was much greater for all of these problems if the IPV was combined with physical violence from a mother-in-law or sibling-in-law/sibling. Experienced alone, violence from the mother-in-law or a sibling-in-law/sibling was associated with an elevated risk of all of these problems except depression.

Interpretation

Mother-in-law and sibling-in-law/sibling physical violence is an appreciable problem among the women studied in Afghanistan, linked to poverty. It has a major impact on women’s health, componding the heath impact of IPV. In this setting conceptualising women’s risk and exposure to violence at home as only in terms of IPV is inadequate and the framing of domestic violence much more appropriately captures women’s risks and exposures. We suggest that it may be fruitful for many women to target violence prevention at the domestic unit rather than just at women and their husbands.

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<![CDATA[Impact of severe polyhandicap on parents’ quality of life: A large French cross-sectional study]]> https://www.researchpad.co/article/5c61e8dfd5eed0c48496f2bd

Background

Polyhandicap (PLH) is a condition of severe and complex disabilities and is defined by a combination of profound intellectual impairment and serious motor deficits. Parents of PLH individuals are chronically confronted with stressful situations. The aims of this study are i) to assess and compare the quality of life (QoL) of a large panel of parents of PLH individuals with age- and gender-matched controls and ii) to identify potential determinants of parents’ QoL.

Method

We conducted a cross-sectional study. Parents were recruited from 4 specialized rehabilitation centres, 9 residential facilities, and a specialized paediatric/neurological department. The selection criteria were age above 18 years and being the mother/father of a PLH individual. The data collected from the parents included sociodemographic, health status, and psycho-behavioural data (including QoL); additionally, the health status of the PLH individuals was collected.

Results

The QoL scores of all dimensions were significantly lower for parents than for controls. The main factors modulating parents’ QoL were financial issues, health status, and coping strategies. The PLH individuals’ health status was not associated with parents’ QoL.

Conclusions

Some QoL determinants might be amenable. These findings should help health care workers and health decision makers to implement specific and appropriate interventions.

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<![CDATA[A systematic review of ethnic minority women’s experiences of perinatal mental health conditions and services in Europe]]> https://www.researchpad.co/article/5c59fed4d5eed0c4841356fe

Background

Women from ethnic minority groups are at greater risk of developing mental health problems. Poor perinatal mental health impacts on maternal morbidity and mortality and can have a devastating impact on child and family wellbeing. It is important to ensure that services are designed to meet the unique needs of women from diverse backgrounds.

Aim

The aim of the review was to explore ethnic minority women's experiences of perinatal mental ill health, help-seeking and perinatal mental health services in Europe.

Data sources

Searches included CINAHL, Maternity and Infant Care, MEDLINE and PsycINFO with no language or date restrictions. Additional literature was identified by searching reference lists of relevant studies.

Design

This was a mixed method systematic review. Study selection, appraisal and data extraction were conducted by two researchers independently. A convergent approach was adopted for the analysis and the data were synthesised thematically.

Results

The 15 eligible studies included women from a range of minority ethnic backgrounds and were all undertaken in the United Kingdom (UK). Seven overarching themes were identified; awareness and beliefs about mental health, isolation and seeking support, influence of culture, symptoms and coping strategies, accessing mental health services, experiences of mental health services and what women want.

Conclusion

Lack of awareness about mental ill health, cultural expectations, ongoing stigma, culturally insensitive and fragmented health services and interactions with culturally incompetent and dismissive health providers all impact on ethnic minority women's ability to receive adequate perinatal mental health support in the UK. Future research should focus on in-depth exploration of the experiences of these women across multiple European settings and interventions to reduce health inequalities among vulnerable mothers and families affected by perinatal mental ill health.

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<![CDATA[Perceived impact of community kitchens on the food security of Syrian refugees and kitchen workers in Lebanon: Qualitative evidence in a displacement context]]> https://www.researchpad.co/article/5c57e670d5eed0c484ef31b2

Community kitchens (CKs) have been recommended as public health strategies with social and nutritional health benefits for low-income participants and their families in different settings. The benefit of CKs in improving the food security status of participants in the context of conflict and displacement is less conclusive. This study aimed to qualitatively explore the impact of CKs on the food security status of community kitchen workers (CWs) and Syrian refugee (SR) families in Lebanon. An exploratory qualitative descriptive approach was adopted. Focus group discussions were conducted with 15 CWs and 49 SRs, and transcripts were analyzed thematically. Emerging themes included: motivation to join the CKs (CWs only), perception towards CKs, impact of these CKs, and their sustainability (both groups). Motivating factors for CWs included financial, internal and societal drivers, and the favorable type of work in kitchens. The perception towards CKs was overall positive among CWs and SR beneficiaries. Both groups reported the positive impact of CKs on their food security and financial status, which in turn affected positively their psychological health. At the social level, CWs indicated that the kitchen’s friendly atmosphere increased social cohesion and companionship between Syrians and Lebanese within the kitchen. In addition, CWs reported increased sense of empathy towards SRs benefiting from the CK services. According to study participants, the positive impact of the CKs was almost completely reversed when their operation and services were interrupted for two months. Both CWs and SRs identified facilitators and barriers that can affect the sustainability of the kitchens, including financial and entrepreneurial skills. In conclusion, findings from this study highlight that CKs can be promising programs to improve the food security and livelihoods of participants, while also increasing social cohesion and integration of refugees within host communities in protracted crisis contexts.

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<![CDATA[The impact of the Family Medicine Model on patient satisfaction in Turkey: Panel analysis with province fixed effects]]> https://www.researchpad.co/article/5c5b52d2d5eed0c4842bd0b7

Background

In this study, we aim to establish the impact of the introduction of the Family Medicine Model patient satisfaction in the Turkish health system.

Methods

We use data on data 69,028 primary health care (PHC) patients over the period 2010–2012. We estimate the impact of the Family Medicine Model in panel regressions with province fixed effects, exploiting the sequential introduction of this health systems transformation across Turkey's 81 provinces. We use principal component analysis to reduce the dimensionality of the data from the European Patients Evaluate General/Family Practice (EUROPEP) patient satisfaction survey, to focus on the fundamental dimensions of patient satisfaction and to decrease the need for multiple hypothesis testing. We identified two key principal components. The first captured primarily information on satisfaction with provider behavior and the second on satisfaction with the organization of care. We then use these two principal components as outcome variables in our panel analysis to estimate the causal impact of the introduction of the Family Medicine Model.

Results

The Family Medicine Model significantly improved patient satisfaction across a range of dimensions. The coefficient results showed a positive and statistically significant impact (p-values<0.05) of the Family Medicine Model on the outcome variables representing the satisfaction dimensions clinical behaviour and the organization of care even after controlling for calendar time fixed effects.

Conclusions

The introduction of the Family Medicine Model in Turkey, which was primarily aimed at achieving universal health coverage goals, substantially improved patient satisfaction. This study provides some of the first national-level evidence that the introduction of a Family Medicine Model can substantially improve patient satisfaction.

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<![CDATA[Prevalence and determinant factors of unintended pregnancy among pregnant women attending antenatal clinics of Addis Zemen hospital]]> https://www.researchpad.co/article/5c5b52cfd5eed0c4842bd074

Introduction

Unintended pregnancy is a pregnancy which is not wanted and/or not planed at the time of conception. It has a major consequence on mothers’ and newborns’ health and its prevalence remains a major health problem in Ethiopia. This study was aimed to assess the prevalence and determinants of unintended pregnancy among pregnant women attending antenatal clinics of Addis Zemen hospital.

Methods

An institutional-based cross-sectional study was employed in Addis Zemen hospital from April 01 to May 30, 2018. The sampled 398 pregnant mothers were selected by systematic random sampling. The data were collected using a-pretested structured questionnaire via face to face interview and the collected data were analyzed by using SPSS Version-20. The data were summarized with frequency and cross-tabulation. Both binary and multiple logistic regressions were used in order to identify predictor variables using odds ratio at 95% confidence interval.

Results

All of 398 mothers answered the questionnaire making the response rate 100%. The prevalence of unintended pregnancy was 26.1% (CI;22.1, 30.4). Women who were multigravid (AOR; 4.7: CI; 2.3, 6.8), women who were multipara (AOR; 2.8: CI; 2.6, 9.7), and women who were from rural (AOR; 2.6: CI; 1.5, 4.6) were more likely experienced unintended pregnancy than their counterparts. Women who were Muslim (AOR; 0.79: CI; 0.6, 0.90) and women who attended secondary education (AOR; 0.58: CI; 0.42, 0.78) were less likely experienced unintended pregnancy.

Conclusion and recommendation

The prevalence of unintended pregnancy is high in the study area. Educational status, parity, gravity, residence, and religion were the most important predictor variables of unintended pregnancy. Reducing the prevalence of unintended pregnancy especially in the rural area is recommended.

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<![CDATA[Development and psychometric testing of the Chinese version of the Resilience Scale for Southeast Asian immigrant women who divorced in Taiwan]]> https://www.researchpad.co/article/5c61e8d2d5eed0c48496f1e5

Background

Only a few studies exist on the resilience of divorced women. Furthermore, relevant instruments for assessing the resilience of divorced immigrant Southeast Asian women are rare. Accordingly, the aim of this study was to develop and examine a new Resilience Scale-Chinese version (RS-C) that is specific to divorced immigrant Southeast Asian women in Taiwan.

Methods

The study was conducted in two phases. In phase 1, 20 items were used to evaluate face and content validities. In phase 2, a cross-sectional study was conducted. In total, 118 immigrant women participated in this study and were recruited from three nongovernmental organizations providing services for immigrants in Taipei City and Miaoli and Chiayi Counties. Psychometric properties of the instrument (i.e., internal consistency, test–retest reliability, item-to-total correlation, construct validity, and convergent validity) were examined. Significance was set at p < 0.05 for all statistical tests.

Results

The final 16-item RS-C resulted in a three-factor model. The three factors, namely personal competence, family identity, and social connections, were an acceptable fit for the data and explained 54.60% of the variance. Cronbach’s α of the RS-C was 0.85, and those of its subscales ranged from 0.77 to 0.82. The correlation value of the test–retest reliability was 0.87. The RS-C was significantly associated with the General Self-Efficacy scale and the Chinese Health Questionnaire-12.

Conclusion

The RS-C is a brief and specific self-report tool for evaluating the resilience of divorced immigrant Southeast Asian women and demonstrated adequate reliability and validity in this study. This RS-C instrument has potential applications in both clinical practice and research with strength-based resiliency interventions. However, additional research on the RS-C is required to further establish its reliability and validity.

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<![CDATA[Out-of-pocket expenditures and care time for children with Down Syndrome: A single-hospital study in Mexico City]]> https://www.researchpad.co/article/5c40f7d7d5eed0c484386ac2

Aim

To examine the burden of out-of-pocket household expenditures and time spent on care by families responsible for children with Down Syndrome (DS).

Methods

A cross-sectional analysis was performed after surveying families of children with DS. The children all received medical care at the Hospital Infantil de México Federico Gomez (HIMFG), a National Institute of Health. Data were collected on out-of-pocket household expenditures for the medical care of these children. The percentage of such expenditure was calculated in relation to available household expenditure (after subtracting the cost of food/housing), and the percentage of households with catastrophic expenditure. Finally, the time spent on the care of the child was assessed.

Results

The socioeconomic analysis showed that 67% of the households with children with DS who received medical care in the HIMFG were within the lower four deciles (I-IV) of expenses, indicating a limited ability to pay for medical services. Yearly out-of-pocket expenditures for a child with DS represented 27% of the available household expenditure, which is equivalent to $464 for the United States dollars (USD). On average, 33% of families with DS children had catastrophic expenses, and 46% of the families had to borrow money to pay for medical expenses. The percentage of catastrophic expenditure was greater for a household with children aged five or older compared with households with younger children. The regression analysis revealed that the age of the child is the most significant factor determining the time spent on care.

Conclusions

Some Mexican families of children with DS incur substantial out-of-pocket expenditures, which constitute an economic burden for families of children who received medical care at the HIMFG.

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<![CDATA[Methodologic approach to sampling and field-based data collection for a large-scale in-depth interview study: The Social Position and Family Formation (SPAFF) project]]> https://www.researchpad.co/article/5c478c74d5eed0c484bd26a6

Over the past several decades there have been dramatic shifts in demographic patterns pertaining to family formation, with declining and delayed marriage and childbearing, and increased cohabitation in the United States and other Western industrialized nations. These trends in family demography have been predominantly studied using large-scale datasets, which have identified total population and subgroup trends over time, including differences by age, gender, racial/ethnic, economic, educational, religious, and other characteristics. However, there is limited knowledge and understanding of how individuals across different levels of social position, as well as other important characteristics, make decisions around forming families. This lack of qualitative data on contemporary attitudes regarding family formation has hampered our ability to more completely understand the factors driving behaviors pertaining to the large-scale (ie, international) shifts in demographic trends. The Social Position and Family Formation (SPAFF) project is an in-depth interview study that used quantitative data to guide recruitment of a large sample for qualitative interview data collection on factors influencing different aspects of family formation among heterosexual females and males (18–35 years) in the context of individuals’ social position. This methodological paper describes the use of a ‘quantitatively-informed’ purposive sampling approach in a large metropolitan area to collect qualitative data (through in-depth interviews) from a large sample (n = 200), utilizing web-based tools for successful community-based recruitment and project management.

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<![CDATA[Socio-demographic, clinical, and psychosocial factors associated with primary caregivers’ decisions regarding HIV disclosure to their child aged between 6 and 12 years living with HIV in Malawi]]> https://www.researchpad.co/article/5c478c77d5eed0c484bd27fa

The World Health Organisation (WHO) recommends that children living with HIV should be informed about their HIV status within the ages of 6 to 12 years using age-appropriate resources. The aim of this study was to assess the socio-demographic, clinical and psychosocial factors associated with primary caregivers’ decisions to disclose HIV to children living with HIV aged 6 to 12 years in Malawi. A cross-sectional study of 429 primary caregivers of children living with HIV were systematically recruited from all regions of the country. Information on HIV disclosure, family and child socio-demographic characteristics, child clinical characteristics, and child and family psychosocial characteristics was collected using validated instruments. Logistic regression was used to analyse data. The prevalence of non-disclosure of HIV status to children was 64 per cent. Concerns about the child’s inability to cope with the news (29%), a lack of knowledge on how to disclose HIV status (19%), and fear of stigma and discrimination (17%) were the main reasons for non-disclosure. On multivariate analysis, the odds of non-disclosure were higher among primary caregivers who were farmers (aOR 3.0; 95% CI: 1.1–8.4), in younger children (6–8 years) (aOR 4.1; 95% CI: 2.3–7.4), in children who were in WHO HIV clinical stage one (aOR 3.8; 95% CI: 1.4–10.2), and in children who were not asking why they were taking ARVs (aOR 2.9; 95% CI: 1.8–4.8). On the other hand, nondisclosure of HIV status was less likely in underweight children (aOR 0.6; 95% CI: 0.3–0.9). Many children living with HIV in Malawi are unaware of their HIV status. Non-disclosure is associated with a number of clinical and demographic characteristics. The findings highlight the need to provide guidance and support to primary caregivers to help them to effectively disclose HIV status to their children.

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<![CDATA[Experiences, needs, and perceptions of paternal involvement during the first year after their infants’ birth: A meta-synthesis]]> https://www.researchpad.co/article/5c3d00ffd5eed0c4840376b1

Objectives

Fatherhood has evolved in recent decades from ‘a moral teacher’ to ‘an involved father’. However, fatherhood experiences have not been examined in detail. This meta-synthesis aimed to examine fathers’ experiences, needs, and perceptions of their involvement with their infants during the first 12 months of birth.

Method

Six electronic databases were systematically searched: PubMed, CINAHL, Embase, Scopus, PsycINFO, ProQuest (grey literature). The search resulted in 13 studies that met the inclusion criteria. Quality appraisal was conducted using the Critical Appraisal Skills Programme Checklist. All 13 studies met the appraisal criteria and were included in the meta-synthesis. The findings of the 13 studies were synthesized using the steps of Sandelowski and Barroso in conducting meta-synthesis.

Results

The 13 included studies comprised studies conducted in the West, Africa, and Asia. Fatherhood experiences differed according to different sociocultural contexts. Three themes were identified: (1) trajectory of the father-infant relationship, (2) reinforcements and hindrances to involvement, and (3) change from self-oriented to family-oriented behavior. Changes in a father’s relationship with his infant were influenced by relationships with his spouse and family members after the birth of the infant. Reinforcements, hindrances, and needs to fathers’ involvement were identified. Fathering responsibility and parenting satisfaction that developed overtime influenced a father’s behavior, changing from self-oriented to family-oriented.

Significance

This is the first meta-synthesis that examined fathers’ experiences, needs, and perceptions of their involvement with their infants during the first 12 months of birth. Multiple factors were found to influence the socially-defined fathering ideology. Cultural practices of fatherhood and fathers’ own perceptions shaped their actual fathering behaviors. The findings of this study may guide healthcare professionals as frontline personnel to understand fathers’ needs and experiences in order to promote fathers’ involvement in the early days after their infants’ birth.

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