Repercusión del envejecimiento en el funcionamiento familiar / Impact of aging in family functioning

Introducción: Las transformaciones demográficas por las que transita la familia cubana afectan su dinámica y composición. El envejecimiento lo visualizan como una carga por sus implicaciones socioeconómicas y psicológicas, y no como una conquista social. Objetivo: Determinar la repercusión del envejecimiento en familias del policlínico Universitario Marcio Manduley durante el segundo semestre del año 2016. Métodos: Se realizó un estudio descriptivo, observacional, y transversal a 125 familias que fueron seleccionadas por conveniencia y deliberadamente, a las que se les aplicó el Instrumento de Impacto de Repercusión Familiar validado por la Dr. C. Patricia María Herrera Santi. La tabulación de los datos se hizo en números y porcentajes, agrupándose en tablas, para facilitar el análisis y discusión de la investigación. Resultados: El envejecimiento tuvo una repercusión negativa en más del 70 por ciento de la muestra estudiada en las áreas del desenvolvimiento de la vida diaria de la familia: el 72 por ciento en el área socioeconómica, el 70,4 por ciento en el área sociopsicológica y el 72,8 por ciento en el funcionamiento familiar y la salud individual de sus miembros. Conclusiones: El proceso de envejecimiento tiene una repercusión negativa en el funcionamiento de las familias con ancianos que precisan de cuidados especiales Los resultados de la investigación evidencian la necesidad de una cultura sobre la vejez para que pueda ser afrontada de forma favorable por las familias(AU)

Introduction: The demographic transformations that the Cuban family has gone through have affected family composition and dynamics. Aging is visualized as a burden due to its psychological and socio-economic implications and not as a social conquest. Objective: To determine the impact's level of aging in families of Marcio Manduley polyclinic during the second semester of 2016. Methods: A descriptive, observational, and cross-sectional study was conducted in 125 families selected by convenience and deliberately to which the Family Impact Instrument validated by Patricia Maria Herrera Santi, PhD was applied. Tabulation of the data was done in numbers and percentages and the results were showed in tables to facilitate the analysis and debate on the research. Results: Aging has a negative impact level in more than 70 percent of the families studied in the development of family daily life's areas: 72 percent in the socio-economic area, 70.4 percent in the socio-psychological area; and 72.8 percent. percent in family functioning and in the individual health of its members Conclusions: Aging process has a negative impact in the functioning of families with elders that need special care. The results of the research evidence the need of a culture on aging for this to be faced in a positive way by the families(AU)

Impacto familiar de la severidad de la dermatitis atópica en menores de 12 años / Family impact of the severity of atopic dermatitis in children under 12 years

Contexto: la dermatitis atópica es una enfermedad de etiología desconocida, con predisposición genética y participación de factores ambientales. Más del 80% de niños afectados debutan antes de los 5 años de edad. No se disponen en el país reportes que demuestren la relación entre la severidad de la enfermedad y el impacto familiar que genera la misma. Objetivo: determinar el grado de afectación familiar en niños diagnosticados de dermatitis atópica que acudieron a la consulta externa del "Centro de la Piel" y su relación con la severidad de la enfermedad. Diseño: estudio epidemiológico analítico transversal de período. Métodos y sujetos: el estudio se realizó en niños menores de 12 años que acudieron a la consulta médica del "Centro de la Piel", con diagnóstico de dermatitis atópica entre julio a noviembre del 2015. Se empleó un muestreo aleatorio simple para universo infinito con objetivo cualitativo. La severidad de la dermatitis atópica se clasificó según la escala validada SCORAD. El impacto familiar se determinó con el cuestionario del impacto familiar de la dermatitis DFI y la funcionalidad familiar con la escala de APGAR familiar. Lasasociaciones entre las variables estudiadas se resumieron con Odds Ratio de prevalencia (OR) y los correspondientes intervalos de confianza del 95% (IC 95%) obtenidos mediante distribución binomial. Para el contraste de hipótesis, se calculó el coeficiente de correlación de Pearson. Resultados: el estudio reveló que de los 145 participantes, 34 (23,45%) presentaron dermatitis atópica leve, 94 (64,83%) moderada y 17 (11,72%) severa. Se encontró que en más de la mitad de familias investigadas (57,24%) el impacto familiar de la enfermedad fue moderado, 33.1% leve y 9,66% severo. Al relacionar las variables, se demostró que el grado de afectación familiar es proporcional a la severidad de la dermatitis, estadísticamente significativa (valor p= <0,01). La esfera familiar de mayor afectación fue la económica evidenciándose la relación existente entre agravamiento del cuadro con el incremento de los gastos derivados del tratamiento (OR: 5,5; IC 95%: 2,4-12,6). Conclusión: la severidad de la dermatitis atópica se relacionó significativamente con el nivel de impacto familiar percibido por el cuidador. (AU)

Context: Atopic dermatitis is a disease of unknown etiology, with genetic predisposition and participation of environmental factors. More than 80% of affected children debu-tan before 5 years of age. There are no reports in the country that demonstrate the relationship between the severity of the disease and the family impact generated by it. Objective: to determine the degree of family involvement in children diagnosed with atopic dermatitis who attended the outpatient clinic of the "Skin Center" and its relationship with the severity of the disease. Design: cross-sectional analytical epidemiological study of period. Methods and subjects: the study was conducted in children under 12 years of age who attended the "Skin Center" medical consultation, with a diagnosis of atopic dermatitis from July to November 2015. Simple random sampling was used. for infinite universe with qualitative objective. MAIN MEASUREMENTS: the severity of atopic dermatitis was classified according to the SCORAD scale. The family impact was determined with the family impact questionnaire of DFI dermatitis and family functionality with the family APGAR scale. The associations between the variables studied were summarized with Odds Prevalence Ratio (OR) and the corresponding 95% confidence intervals (95% CI) obtained by binomial distribution. For the hypothesis test, the Pearson correlation coefficient was calculated. Results: the study revealed that of the 145 participants, 34 (23.45%) presented mild atopic dermatitis, 94 (64.83%) moderate and 17 (11.72%) severe. It was found that in more than half of the families investigated (57.24%) the family impact of the disease was moderate, 33.1% mild and 9.66% severe. By relating the variables, it was shown that the degree of family involvement is proportional to the severity of the dermatitis, statistically significant (p value = <0.01). The most affected family sphere was the economic one, showing the relationship between worsening of the table and the increase in the expenses derived from the treatment (OR: 5.5, 95% CI: 2.4-12.6). Conclusion: the severity of atopic dermatitis was significantly related to the level of family impact perceived by the caregiver. (AU)

Qualidade de vida relacionada à saúde bucal em crianças com anemia falciforme e suas famílias: há uma correlação entre o relato de pais e filhos? / Oral Health-related Quality of Life in children with Sickle Cell Disease and your Family: There is a correlation between the reports of parents and children?

O objetivo deste estudo foi determinar a correlação filho-pais na avaliação da qualidade de vida relacionada à saúde bucal de crianças e de suas famílias e determinar as características associadas a essa correlação em uma população pediátrica com anemia falciforme. Foi realizado um estudo transversal com 106 crianças, de 8 a 14 anos, com diagnóstico de anemia falciforme (AF), no estado de Minas Gerais, Brasil, e seus pais/cuidadores. Estas crianças estavam fazendo acompanhamento de saúde na Fundação Centro de Hematologia e Hemoterapia de Minas Gerais (Hemominas). A qualidade de vida relacionada à saúde bucal (QVRSB) foi mensurada, utilizando-se as versões brasileiras dos instrumentos Child Perception Questionnaire para crianças de 8 a 10 anos (CPQ8-10) e de 11 a 14 anos (versão curta do CPQ11-14), o Parental-Caregiver Perceptions Questionnaire (P-CPQ) e o Family Impact Scale (FIS). Um dentista calibrado realizou os exames clínicos bucais para avaliação da experiência de cárie dentária, má oclus¿o e sangramento gengival, segundo os critérios da Organização Mundial de Saúde (OMS). As informações sobre a AF, as características sócio-demográficas e econômicas foram obtidas por meio de entrevistas realizadas com os pais/responsáveis pelas crianças. Os dados foram analisados por meio do teste de correlação de Spearman e regressão linear. Houve uma forte correlação entre P-CPQ e FIS (rs=0,732). Foi observada correlação moderada entre as avaliações de QVRSB realizadas pela criança (CPQ) e pelo pai-proxy (P-CPQ) (rs=0,433). Ao se analisar a correlação entre a avaliação da QVRSB realizada pelas crianças (CPQ) e o impacto na família (FIS) relatado pelos pais, observou-se uma correlação fraca (rs=0,331). Maiores diferenças no z-escore entre P-CPQ e FIS foram associadas com a menor idade do filho (p<0,01), mais baixa espiritualidade/religiosidade (p<0,05), menor renda familiar (p<0,01) e severidade da má oclusão dentária (p<0,05)...

More recently, there has been increasing interest in the oral health-related quality of life (OHRQoL) of children, since pediatric oral disorders are likely to have a negative effect on the child quality of life (QoL). One issue that receives a great deal of attention is the comparison of the measurement of children OHRQoL reports with those of their parents. In this way, three systematic reviews were carried out to review the literature on valid and reliable informations from children and parents concerning child OHRQoL, and to identify the pattern of agreement/disagreement between their reports. The literature was searched using Medline, ISI, Lilacs and Scielo, from 1985-2007. Two researchers independently checked and then selected only articles that used well-validated instruments, provided quantitative measurements of child clinical oral health status, and presented children and parental perceptions of child OHRQoL. In the first systematic review, from 89 records found, thirteen fulfilled the criteria. All selected studies suggested good construct validity. However, child understanding of oral health and well-being are affected by age, age-related experiences, gender, race, education, culture, experiences related to oral conditions, opportunities for treatment, childhood period of changes, back-translating questionnaire and child self-perceived treatment need. Twelve of 402 articles originally identified were included in the second systematic review. The results showed that the relationships between clinical oral health status and QoL in children were not direct, but mediated by a variety of personal, social and environmental variables, as well as by the child development, which have influence on the comprehension about the relationship among health, illness and QoL. In the third one, out of 87 articles that were critically assessed, five studies were selected ...

Impacto familiar e ajustamento de pais de crianças com diagnóstico de anomalia congênita: influência dos determinantes da criança / Family impact and individual adjustment of parents of children with a diagnosis of congenital anomaly: the influence of the child's determinants

INTRODUÇÃO: A ocorrência de diagnóstico pré ou pós-natal de anomalia congênita (AC) num filho pode implicar mudanças na dinâmica e no funcionamento da família, bem como ter um importante impacto no ajustamento individual dos pais. OBJETIVOS: Este estudo teve como objetivos avaliar a sobrecarga parental e ajustamento individual de pais de crianças com diagnóstico de AC e compreender a variabilidade da adaptação dos pais (sobrecarga e ajustamento individual) em função dos determinantes da criança. MÉTODOS: A amostra foi constituída por 124 participantes (62 casais), pais de crianças com diagnóstico de AC. O protocolo de avaliação incluiu a Escala de Impacto Familiar, o Brief Symptom Inventory e o Instrumento de Avaliação de Qualidade de Vida da Organização Mundial de Saúde (WHOQOL-Bref). RESULTADOS: As mães reportaram maiores níveis de sintomatologia psicopatológica e menor percepção de qualidade de vida. Encontraram-se, ainda, efeitos significativos dos determinantes da criança, nomeadamente da idade da criança no ajustamento paterno e da percepção de gravidade da anomalia no ajustamento paterno e na sobrecarga materna. O conhecimento do diagnóstico após o nascimento e as anomalias cromossômicas mostraram-se, em ambos os pais, correlacionados com maior percepção de sobrecarga global e financeira. CONCLUSÃO: Os resultados salientam a complexidade do ajustamento dos pais ao diagnóstico de anomalia congênita de um filho, na qual interagem diversos fatores, em particular os associados com o diagnóstico da criança.

BACKGROUND: The occurrence of a pre- or postnatal diagnosis of a congenital anomaly may imply changes in the family dynamics and functioning, and may have an important impact on the parents' individual adjustment. OBJECTIVES: This study aimed to assess the perceived burden and individual adjustment of parents whose child has a congenital anomaly, and to examine the variability of parental adaptation (burden and individual adjustment) as a function of the child's characteristics. METHODS: The sample comprised 124 parents (62 couples), whose child has a congenital anomaly. The assessment protocol included the Impact on Family Scale, the Brief Symptom Inventory, and the World Health Organization quality of life instrument (WHOQOL-Bref). RESULTS: Mothers reported higher scores on psychopathological symptoms and lower scores on quality of life than fathers. A significant effect of child's age in the paternal adaptation was found; the perception of the severity of the anomaly was significantly associated with paternal adjustment and with maternal burden. In both parents, the timing of diagnosis and the type of congenital anomaly were significantly correlated with global and financial burden. DISCUSSION: These findings support the complexity of the parents' adaptation when parenting a child with a congenital anomaly, in which several factors interact, particularly those associated with the child's diagnosis.

Quality of Life and the Family Impact of Atopic Dermatitis in Children / 대한피부과학회지

BACKGROUND: Atopic dermatitis (AD) in children may profoundly affect their quality of life (QOL), in addition to familial life plus cause financial burden. OBJECTIVE: The aim of this study was to show how AD affects children's QOL, family life and contributes to financial burden, and to evaluate this relationship with severity of AD. METHODS: The target population comprised of children aged 0~6 years with AD who visited our out-patient department between May 2004 and October 2005. The Infants' Dermatologic Quality of Life Index (IDQOL), the Dermatitis Family Impact questionnaire (DFI) and the Financial Impact questionnaire (FI) were used to quantify the impact of AD on each area. Eczema severity was assessed using the Eczema area and severity index (EASI) score. The student' T-test and simple linear regression were used for statistical analysis. RESULTS: A total of 101 children completed all the questionnaires. The mean score for IDQOL was 11.50, DFI was 10.05 and FI was 16.10. The highest scoring question for IDQOL was itching and scratching, the lowest one was family activities. For the DFI they were main carer's life effect and shopping. The mean score of EASI was 8.81 and this was linearly related with IDQOL (R2=0.126, p<0.001), DFI (R2=0.154, p<0.001) and FI (R2=0.145, p<0.001), but not as highly. CONCLUSION: We have shown that children's quality of life, family life and financial burden are related to the severity of AD. The IDQOL, DFI and FI may potentially be of value to help guide appropriate management of AD and can be used as an added parameter in clinical trials involving AD management.

The Impact of Childhood Atopic Dermatitis on their Families / 대한피부과학회지

BACKGROUND: Childhood atopic dermatitis(AD) has a profound effect on the quality of life, disturbing family and social relationships. Stressful familial condition from the child's AD may aggravate AD itself but no information concerning the effect of childhood AD on family function is available in Korea. OBJECTIVES: The aim of this study was to show how AD effects families, to identify the areas of life most affected and to evaluate the relationship between the effect and severity of AD. METHOD: The 10-questionnaire item(Dermatitis Family Impact questionnaire[DFI]) with assessment of severity of AD was studied in AD patients and compared with control subjects. RESULTS: The average of the total score of the DFI questionnaire in the AD group was significantly higher than that of the control group (P<0.05) and was linearly related with AD severity, but not as highly (R2=0.161, P=0.003). The highest scoring question in the 10 questions of the DFI questionnaire was that of causing physical tiredness or mental exhaustion, and the lowest, that of time spent on shopping for the family. CONCLUSION: There is an obvious need to identify and to reduce the suffering of families of children with AD. The DFI may potentially be of value to help guide appropriate management of AD and as an added parameter in clinical trials concerning AD management.