Offspring of mothers with bipolar disorder: a systematic review considering personality features

Objective: To examine personality/temperament features and mental health vulnerability in offspring of mothers with bipolar disorders (BD), including dimensions which may impact psychological characteristics or therapeutic measures. Methods: A systematic review, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, was conducted to search for original articles that investigated personality/temperament features of offspring of women with BD and emotional factors involved in the mother-child relationship. The electronic search was performed in the PubMed, Web of Science, and PsycINFO databases from February 2010 to February 2017. Results: Ten quantitative studies were included in the analysis: seven from the United States, two from Brazil, and one from Canada. The narrative synthesis was categorized into three dimensions: 1) reliability of instruments for prediction of future psychopathology in offspring; 2) environmental risk factors for offspring; and 3) early interventions. The findings showed impairments in the offspring's lives, high rates of behavior and temperament problems, and psychiatric disorders. Conclusion: BD is a frequent psychiatric disorder, and the offspring of mothers with this condition are exposed to complex family relationships and psychosocial difficulties. If they are to ensure a good provision of mental health and psychosocial care to this unique population, early interventions must not neglect their contextual specificities. Systematic review registration: PROSPERO CRD-42017039010

Analysis on current situation and influencing factors of filial piety value among children whose parents were advanced cancer patients / 中国实用护理杂志

Objective:To investigate the filial piety value level and the influencing factors of filial piety among children whose parents were diagnosed as advanced cancer.Methods:A convenient sampling method was used to recruit 383 participants in Tumor Hospital, Tianjin Medical University.Results:The total score of Filial Piety Value Scale among children whose parents were advanced cancer patients was (66.50±4.10) . The age of the patient, the number of hospitalization and the degree of awareness of the condition, the age of the children, whether the child was the-only-child, whether the child was living with the patient, and the average daily care time influenced the filial piety values of children whose parents were advanced cancer patients ( Z=16.64-62.94, U=2.04-4.27, P<0.05). Conclusion:Children whose parents were with advanced cancer have a better understanding of filial piety. Nurses understand the values of filial piety of children in the context of traditional filial piety and family care mode in China, which can enhance the experience of filial piety and filial piety of both children and parents, also improve the mental health problems of patients, and finally improve the quality of life of patients with advanced cancer.

An Integrative Literature Review of Resilience in Adult Children of Alcoholics: Focusing on Operational Definitions and Moderators / 정신간호학회지

PURPOSE: The objective of this study was to explore operational definitions and moderators of the resilience of adult children of alcoholics (ACOA) and its associated variables. METHODS: This integrative review was conducted based on a literature review method suggested by Whittemore and Knafl. Databases including PubMed, CINAHL, PsycINFO, and RISS were searched using the combinations of search terms such as; ‘adult children of alcoholics,’ ‘parental alcoholism,’ ‘resilience,’ and ‘children of alcoholics.’ RESULTS: Seventeen studies were selected for this review. Findings of integrative reviews reported operational definitions for the resilience of ACOA and moderators. The operational definition of ACOA's resilience is: (1) having no behavioral and emotional problem, (2) meeting social and developmental expectancies, (3) having the ability to cope with adversity, (4) having high self-concept, and (5) having a meaningful relationship. In addition, the varying environmental moderators include family communication, qualities of caring environment, parental communication, parentification, and social support. Several moderators were identified as positive effect, self-esteem, alcohol-specific coping style, locus of control, spirituality, the image of God, and dyadic cohesion in marital communication. CONCLUSION: Our study findings emphasize comprehensive understanding of diverse definition of resilience and moderators in developing nursing interventions to promote resilience in ACOA.

Influence of Offspring on Self-Rated Health among Older Adults: Evidence from the Korean Longitudinal Study of Aging (2006–2012) / 가정의학회지

BACKGROUND: We investigated whether offspring protect or jeopardize in parents. METHODS: We used data from the Korean Longitudinal Study of Aging and performed a longitudinal analysis of 10,236 individuals at baseline (2006) to estimate the association between offspring-related factors and self-rated health among individuals ≥45 years of age. RESULTS: The estimate for self-rated health was 0.612 times lower (95% confidence interval [CI], 0.503–0.746; P < 0.0001) for those with zero offspring. The estimate for self-rated health was 0.736 (95% CI, 0.635–0.853; P < 0.0001) for those with five offspring or more. The estimate for self-rated health was 0.707 (95% CI, 0.528–0.947; P=0.020) for males with zero offspring. The estimate for self-rated health was 0.563 (95% CI, 0.422–0.751; P < 0.001) for females with no offspring and for females with five or more offspring. The estimate for self-rated health was 0.686 times lower (95% CI, 0.573–0.822; P < 0.0001) for those with five or more offspring compared to females with two offspring. CONCLUSION: Those with more offspring (≥5) and those with no offspring tended to have an increased probability of low self-rated health. Overall, our results suggest that offspring have a significant positive effect on self-rated health, which was evident graphically as an inverted U-shape.

Lived Experience of the Mother's Caring of Adult Children with Persistent Vegetative State

PURPOSE: The purpose of this study was to deepen understanding the nature of the care experience by the mothers with adult children in persistent vegetative state. METHODS: Participants were 7 mothers caring for their adult children in persistent vegetative state. Data were collected individually through in-depth interviews on their lived experiences. Also texts were included as data from literary works, novels, movies, essays, and arts containing on patients with persistent vegetative state and their mothers. Data were analyzed by van Manen's phenomenological methodology. RESULTS: The essential themes of caring experiences of the mothers were as follows. The theme in relation to lived time has shown as back to the past and caring experience related lived body has emerged as locked the body in children. The theme related lived space was getting into the swamp and the theme in lived others was derived as lonely struggle into. CONCLUSION: The nature of mothers' caring experiences for adult children in persistent vegetative state is summarized as ‘Do not off hand of hope in a locked state’. This study suggests long-term supports are necessary for mothers to care persistent vegetative state children.

Experiences of stigma and psychological well being among adult children of parents with schizophrenia

Background: Children of parents with schizophrenia are reported to be vulnerable to various kinds of psychological and psychosocial problems. Stigma is one of the significant psychosocial impacts often studied in patients with schizophrenia. However the experiences of stigma and psychological well being of the healthy adult children of the parents with schizophrenia is less explored. Aims: To study the perceived stigma and psychological well being of the adult children of parents having schizophrenia and to assess the relationship between perceived stigma and psychological well being. Methods: The study adopted a two group comparison cross sectional methodology. The study group comprised of 30 adult children of parents with schizophrenia and control group consisted of 30 individuals without the history of any mental illness in the parents. The tools used were Sociodemographic Data Sheet (SDS), the stigma items of Explanatory Model Interview Catalogue (EMIC) and Psychological Well Being scale (PWB). Results: More than 50% of the participants in study group experienced stigma. Perceived stigma was positively correlated with current psychopathology of the parents. Active psychopathology in parents turned out to be a significant predictor of the stigma. The control group had better psychological well being compared to the study group. Conclusion: Even in the absence of any diagnosable psychological problems, children of patients with schizophrenia experience stigma and they have poor psychological well being compared to children of parents without psychiatric illness.

The Experience of Adult Korean Children Caring for Parents Institutionalized with Dementia

PURPOSE: The purpose of the study was to explore and describe the experience of adult Korean children who are caregivers for parents institutionalized with dementia. METHODS: Participants were fourteen adult children caregivers of elders institutionalized with dementia. Data were collected through in-depth unstructured interviews with individual participants from August to November, 2012. Theoretical sampling was used to the point of theoretical saturation. Data were analyzed using Strauss and Corbin's Grounded Theory Method. RESULTS: From open coding, 67 concepts, 29 sub-categories, and 14 categories were identified. Analysis revealed that the core category of the experience of adult children caring for their parents institutionalized with dementia was 'enduring the role of a prop' consisting of four phases: initial turmoil, exploration, role adjustment, and acclimation. To manage the role of a prop, participants utilized various action/interactional strategies such as overcoming the unfamiliarity, overseeing the nursing home care, and counterbalancing the caring roles. As a result, participants experienced ambivalence towards the existence of parents with dementia, changes in family relationships, altered viewpoint towards nursing homes, and restructuring of life. CONCLUSION: In-depth understanding of the experience will guide nurses to promote effective interventions in order to better support the Korean family caregivers of parents institutionalized with dementia.

An Evolutionary Concept Analysis of Helicopter Parenting

PURPOSE: Helicopter parenting is an emerging concept as a way of rearing adolescents and adult children. However, helicopter parenting from a nursing perspective has not been elucidated. Therefore, we undertook a concept analysis to understand the attributes, antecedents and consequences of helicopter parenting in the context of nursing. METHODS: Using Rodgers' evolutionary concept analysis, we analyzed literature on helicopter parenting to discover critical attributes, antecedents, and consequences of this phenomenon. Data were collected from seven electronic search engines. Twelve studies matching inclusion criteria were reviewed RESULTS: Three core attributes of helicopter parenting were hovering, highly deep involvement, and proxy decision making. The antecedents and consequences were retrieved from three important domains including social, parent, and child aspects. Surrogate terms were black hawk, hummingbird, and hovercraft parenting, and related terms were stealth fighter and Kamikaze parenting. CONCLUSION: Based on the results of this study, helicopter parenting has both positive and negative effects on both children and parents. To enhance the positive effects, measurement tools for helicopter parenting and nursing interventions on parenting need to be developed.

Congenital multiple clustered dermatofibroma and multiple eruptive dermatofibromas - unusual presentations of a common entity / Dermatofibroma multiplo agrupado congenito e dermatofibromas multiplos eruptivos - apresentacoes singulares de uma entidade comum

Dermatofibroma is one of the most common entities seen in dermatology clinical practice. Several clinical subtypes have nevertheless been described, all of them of uncommon occurrence. The authors present two rare clinical variants of dermatofibromas: congenital multiple clustered dermatofibroma (the presented case is the 4th congenital case to be reported so far) and multiple eruptive dermatofibromas developing in the setting of a Sjögren's syndrome. Since the uncommon subtypes may not be clinically evident, dermatologists should familiarize themselves with their main features and we advise a high level of clinical suspicion in order to reach the correct diagnosis.

O dermatofibroma é uma das entidades mais frequentemente observadas na prática clínica dermatológica. No entanto, além do dermatofibroma comum, vários subtipos clínicos de ocorrência incomum têm sido descritos na literatura. Os autores descrevem duas variantes clínicas raras de dermatofibromas: dermatofibroma múltiplo agrupado congênito (o caso apresentado é o quarto caso congênito reportado até hoje) e dermatofibromas eruptivos múltiplos no contexto de uma Síndrome de Sjögren. Estes diagnósticos menos comuns podem não ser clinicamente evidentes portanto os dermatologistas devem estar familiarizados com estas apresentações, sendo de suma importância um elevado índice de suspeita clínica.

Avaliação da capacidade funcional e pulmonar em pacientes pediátricos transplantados renais / Assessment of functional capacity and pulmonary in pediatrics patients renal transplantation

INTRODUÇÃO: Pacientes pediátricos submetidos a transplante renal podem apresentar alterações na função pulmonar, bem como na capacidade funcional para o exercício. OBJETIVO: Avaliar a capacidade funcional e capacidade pulmonar de crianças e adolescentes submetidas a transplante renal. MÉTODO: Foram avaliadas crianças e adolescentes com idade entre 6 e 18 anos em acompanhamento no ambulatório de Nefrologia do Hospital da Criança Santo Antônio, Santa Casa de Porto Alegre-RS, Brasil, no período de junho de 2010 a março de 2011. A capacidade pulmonar foi avaliada por meio da espirometria e das pressões respiratórias máximas e a capacidade funcional pelo Teste da Caminhada dos 6 minutos (TC6). RESULTADOS: A amostra foi composta por 25 pacientes, sendo 14 (56%) do sexo masculino, com média de idade de 13,5 ± 3,3 anos. Destes, 19 (76%) realizaram hemodiálise anterior ao transplante. A média da Capacidade Vital Forçada (CVF) foi 97,91 ± 24,32% e o Volume Expiratório Forçado no primeiro segundo (VEF1) foi 100,53 ± 17,66% do valor predito. No TC6, os pacientes caminharam 229,14 metros menos do que o predito (p < 0,001). A Pressão Inspiratória Máxima (PiMáx) foi significativamente menor que o predito, com uma diferença de -24,63 cmH2O (p = 0,03), assim como a Pressão Expiratória Máxima (Pe-Máx), com uma diferença de 49,27 cmH2O (p < 0,001). Ao correlacionarmos capacidade funcional, espirometria e pressões respiratórias máximas, encontramos associação entre CVF e TC6 (r = 0,52, p = 0,01) e CVF e PiMáx (r = 0,54 e p = 0,01). CONCLUSÃO: Os pacientes transplantados apresentaram diminuição da capacidade funcional, bem como das pressões respiratórias máximas. Quanto melhor a capacidade funcional e a PiMáx, melhor a CVF.

INTRODUCTION: Pediatric patients undergoing kidney transplantation can present changes in pulmonary function and functional capacity for exercise. OBJECTIVE: To evaluate the functional capacity and pulmonary function in children and adolescents undergoing kidney transplantation. METHOD: Children and adolescents aged six to 18 years of age were evaluated in Outpatient Clinic of Nephrology, Hospital da Criança Santo Antônio, Santa Casa de Porto Alegre, RS, Brazil in period the june of 2010 the march of 2011. Pulmonary capacity was assessed by spirometry and maximal respiratory pressures and functional capacity through 6-minute walk test (6MWT). RESULTS: The sample comprised 25 patients, 14 (56%) males with a mean age of 13.5 ± 3.3 years. From, 19 (76%) underwent dialysis before transplantation. Mean forced vital capacity (FVC) was 97.91 + 24.32% and forced expiratory volume in one second (FEV1) 100.53 + 17.66% from predicted value. In the 6MWT, the patients walked 229.14 meters less than predicted (p < 0.001). The maximum inspiratory pressure (MIP) was significantly lower than predicted, and the difference in cmH2O -24.63 (p = 0.03), as the maximum expiratory pressure (MEP), with a difference of 49.27 cmH2O (p < 0.001). By correlating, functional capacity, spirometry and maximal respiratory pressures, find an association between FVC and 6MWT (r = 0.52, p = 0.01) and FVC and MIP (r = 0.54, p = 0.01). CONCLUSION: Reduced functional capacity and maximum respiratory pressures were diagnosed in a small cohort of pediatric patients after kidney transplantation. Better the functional capacity and PiMáx better the FVC.

Nursing Home Placement: The Process of Decision Making and Adaptation among Adult Children Caregivers of Demented Parents in Korea

PURPOSE: The goal of this study was to explore and describe the process of nursing home placement decision making and adaptation among adult children caregivers of demented parents in Korea and to generate a substantive theory grounded in their experiences. METHODS: The participants were 16 adult children caregivers who had placed their demented elders into nursing homes. Data were collected by in-depth unstructured interviews with individual participants. Data were analyzed by Strauss and Corbin's Grounded Theory methodology. RESULTS: Analysis revealed that the core category of the process of nursing home placement decision making and adaptation among adult children caregivers was accepting the inevitable and reorienting to changes. It consisted of four phases: realizing a dead end, seeking a way out, accepting the inevitable decision, and reorienting to changes. Participants were driven to the corner of making the inevitable decision by the overwhelming care situation and confronted by various challenges in dealing with the decision. But they managed to accept the inevitableness of the decision and further learned to reorient themselves to the changed care situation utilizing various action/interaction strategies. CONCLUSION: The findings of the study provide the basic information for developing proactive strategies to support family caregivers better in the difficult period of nursing home placement.

Ajustes entre pais e filhos adultos coabitantes: limite e transgressão / Adjustments between cohabiting parents and adult children: boundary and transgression / Ajustes entre padres e hijos adultos cohabitantes: límite y transgresión

O objetivo deste trabalho é investigar a relação entre pais e filhos adultos coabitantes no ambiente doméstico familiar e sublinhar os aspectos transformadores dessa dimensão interativa. Empreendemos uma discussão teórica interdisciplinar, incluindo autores como Singly, Giddens, Berger e Luckman. Pesquisamos esse universo por meio de um estudo de campo, realizando entrevistas semiestruturadas com oito famílias cariocas de classe média. Foram entrevistadas, separadamente e depois em conjunto, quatro díades mãe-filho, três díades mãe-filha e uma díade pai-filha. Entre os temas que emergiram da análise dos dados, destacamos os ajustes cotidianos nas instâncias relacionais. Verificamos que, na dinâmica interativa, diferentes ajustes cotidianos são estabelecidos. Pais e filhos se autorizam a romper ou esticar as regras de convivência, revelando o aspecto poroso da relação e estabelecendo um contexto propício para se jogar com as regras. Evidencia-se um jogo de reconstrução constante em um movimento ilimitado de avanços e recuos na esfera relacional.

The study presents a theoretical synthesis about the logic and forms of thought in practical activity as a consequence of relations between man and objective reality and its implications in the pedagogical process. The theoretical and methodological aspects of the study focus on the cultural-historical psychology and the historical dialectical materialism.It is concluded that the active processes of appropriation of knowledge, when it is not considered the logical historical development of relationships and the constitution of the human psyche, create limitations for the thought and language which are enhanced by the educational process. It follows from this the need to review the theoretical frameworks present in the l training of professionals in education and psychology for the higher purpose of education that is the development of human potential.

El objetivo de este trabajo es investigar la relación entre padres e hijos adultos cohabitantes en el ambiente doméstico familiar y subrayar los aspectos transformadores de esa dimensión interactiva. Emprenderemos una discusión teórica interdisciplinar, incluyendo autores como Singly, Giddens, Berger y Luckman Pesquisamos ese universo por medio de un estudio de campo, realizando entrevistas semi-estructuradas con 8 familias de clase media carioca. Fueron entrevistadas, separadamente y después en conjunto, 4 pares madre-hijo, 3 pares madre-hija y 1 par padre-hija. De entre los temas que emergieron del análisis de los datos, destacamos, en este trabajo, los ajustes cotidianos en las instancias relacionales, por ser una categoría más abarcadora. Verificamos que, en la dinámica interactiva, diferentes ajustes cotidianos son establecidos. Padres e hijos se autorizan a romper o estirar las reglas de convivencia, revelando el aspecto poroso de la relación y estableciendo un contexto propicio para jugar con las reglas. Se evidencia un juego de reconstrucción constante, un movimiento ilimitado de adelantos y retrocesos en la esfera relacional.

Um jogo interativo: a relação entre pais e filhos adultos no cotidiano familiar contemporâneo / One interactive game:the relationship between parents and adult children in the contemporary family quotidian / Un juego interactivo: la relación entre padres e hijos adultos en el cotidiano familiar contemporáneo

O objetivo deste trabalho é investigar a relação pais-filhos adultos coabitantes, na esfera doméstica familiar. Pesquisamos esse universo por meio de um estudo de campo, realizando entrevistas semiestruturadas com oito famílias de classe média da cidade do Rio de Janeiro. Foram entrevistadas, separadamente e depois em dupla, quatro díades mãe-filho, três díades mãe-filha e uma díade pai-filha. Dentre os temas que emergiram da análise dos dados, destacamos, para apresentar neste trabalho, o jogo interativo nas instâncias relacionais, por considerá-lo como agregador dos demais. Verificamos que, na dinâmica interativa, um jogo relacional é estabelecido. Os membros destas díades instituem os limites entre os espaços pessoais e os coletivos na relação e, ao mesmo tempo, mostram-se capazes de alternar posições, acomodando interesses do momento. Assim, estabelecem um contexto propício para um interjogo, que transforma o espaço familiar em um espaço dinâmico, que faz sentido e gera reconstruções de significados...

The goal of this work is to investigate the relationship between parents and adult children cohabitants in the domestic family sphere. This universe was researched through a field study, conducting semi-structured interviews with eight middle-class families in the city of Rio de Janeiro. There were interviewed – separately and then in pairs – four mother-son dyads, three mother-daughter dyads, and one father-daughter dyad. Among the themes that emerged in data analysis, we emphasize the interactive game in the relational instances, because we consider them aggregating other themes. We noticed that in the interactive dynamics there is the establishment of a relational game. Members of these dyads institute the limits between personal and collective spaces in the relationship and, at the same time, display capability to alternate positions, accommodating instant interests. Thus, these members establish an opportune context for the intergame, which turns the family space into a dynamic space that makes sense and enables meaning reconstructions...

El objetivo de este trabajo es investigar la relación padres/hijos adultos que cohabitan en la esfera domestica familiar. Investigamos ese universo a través de un estudio de campo, realizando entrevistas parcialmente estructuradas con ocho familias de clase media de la ciudad de Rio de Janeiro. Han sido entrevistadas, por separado y luego en duplas, cuatro díadas madre/hijo; tres díadas madre/hija y una díada padre/hija. De los temas que han emergido del análisis de datos, destacamos en esta presentación el juego interactivo en las instancias relacionales, por considerarlo como un eje que agrega a los demás. Hemos verificado que, en la dinámica interactiva, un juego relacional es establecido. Los integrantes de estas díadas instituyen los límites entre los espacios personales y los espacios colectivos en la relación y, al mismo tiempo, se muestran capaces de alternar posiciones, acomodando a los intereses del momento. Así, se establece un entorno propicio para un inter-juego, que transforma al espacio familiar en un espacio dinámico, que hace sentido y genera reconstrucciones de significados...

Parents' Drinking Behavior and Factors Related to Mental Health of their University Student Offspring / 정신간호학회지

PURPOSE: This study was conducted to investigate factors related to mental health of university student offspring according to their parents' drinking behavior. METHODS: A cross-sectional design was used in this study. A convenience sample of university students were recruited from three universities in Seoul and Gyeonggi Province, Korea. Data were collected using self-report questionnaires with 547 university students. The scales used for this study were the Korean version of the Children of Alcoholics Screening Test (CAST-K), Symptom Checklist-90-Revision (SCL-90-R), Rosenberg's Self-esteem Scale, and the Way of Coping Checklist. RESULTS: Participants were classified into three groups; nondrinking-parents group (53.5%), social drinking-parents group (21.8%), and problem drinking-parents group (24.7%). Participants whose parents were problem drinkers had significantly higher scores on all the subcategories of SCL-90-R compared to those of other groups. In the participants group whose parents were problem drinkers, mental health problem had a significant positive correlation to passive coping methods and a negative correlation to self-esteem. There was a significant negative relationship between self-esteem and positive coping methods. CONCLUSION: The results of this study indicate the mental health of university students may be negatively affected by their parents' drinking behaviors. Special attention and early interventions are needed for university students whose parents have drinking problems.

Factors Influencing Resilience of Adult Children of Alcoholics among College Students

PURPOSE: The purpose of this study was to explore the resilience of adult children of alcoholics (ACOA) who are college students, and examine factors contributing to their resilience. METHODS: A total of 459 college students from a university in Incheon, participated in this study. Data were collected between April 6 to 30, 2010 using the Korean version of the Children of Alcoholics Screening Test (CAST-K), CAGE, Social Support, Self-Esteem, Family Adaptability and Cohesion, and Resilience measurements. Data were analyzed using the SPSS/WIN 18.0 program. RESULTS: Overall, ACOA group showed lower scores of resilience, social support, self-esteem and family adaptability and cohesion compared to non-ACOA group. Resilience among the ACOA group showed significant relationships with self-esteem (r=.53, p<.001), social support (r=.43, p<.001), and family adaptability and cohesion (r=.25, p<.013). Multiple regression analysis showed that 45% of the variance for resilience in the ACOA group was accounted for by age, gender, social support, self-esteem, and religion. CONCLUSION: The results of the study show that self-esteem and social support are important determinants of resilience in ACOA, thus it is recommend that further resilience training programs for ACOA be developed to enhance their social support and self-esteem, and ultimately to increase their resilience.