ABSTRACT
BACKGROUND: "Systems of care" are strengths-based approaches to treating adolescents and others with disruptive disorders. However, little is known about why some adolescents improve and others do not. OBJECTIVE: To examine changes in personal strengths and family functioning as predictors of behavioral and social functioning among adolescents with disruptive disorders who participated in a system of care program. DESIGN: Secondary analyses of data from 114 adolescents (12-17 years of age) with disruptive disorders and their caregivers who participated in the Dawn Project Evaluation Study. Caregivers completed in-depth interviews conducted by trained data collectors using standardized questionnaires. Baseline and 12- month data are reported here. RESULTS: Improvement in personal strengths was a significant predictor of improvement in adolescent behavioral and social functioning, controlling for demographics (p < .001). CONCLUSION: In adolescents with disruptive disorders, psychiatric nurses should focus on enhancing adolescents' personal strengths to improve behavioral and social functioning.
Subject(s)
Adolescent Behavior/psychology , Community Mental Health Services/methods , Mental Disorders/therapy , Program Evaluation/methods , Adolescent , Caregivers/psychology , Community Mental Health Services/statistics & numerical data , Family Relations , Female , Follow-Up Studies , Humans , Indiana , Interviews as Topic , Male , Mental Disorders/psychology , Program Evaluation/statistics & numerical data , Social Behavior , Surveys and Questionnaires , Treatment OutcomeABSTRACT
UNLABELLED: Building Our Solutions and Connections (BOSC) focused on enhancing problem-solving skills (PSS) of primary caregivers of children with mental health problems. Aims were determining feasibility, acceptability, and effect size (ES) estimates for depression, burden, personal control, and PSS. METHODS: Caregivers were randomized to BOSC (n=30) or wait-list control (WLC) groups (n=31). Data were collected at baseline, post-intervention, and 3 and 6 months post-intervention. RESULTS: Three-months post-intervention, ES for burden and personal control were .07 and .08, respectively. ES for depressed caregivers for burden and personal control were 0.14 and 0.19, respectively. CONCLUSIONS: Evidence indicates that the intervention had desired effects.
Subject(s)
Caregivers/psychology , Mental Disorders/therapy , Problem Solving , Adolescent , Adult , Caregivers/education , Child , Child Behavior , Cost of Illness , Depression/psychology , Depression/therapy , Female , Humans , Male , Mental Disorders/psychology , Middle Aged , Psychological TestsABSTRACT
PURPOSE: The aim of this study was to describe strategies for recruiting participants into an intervention study that focused on improving problem-solving skills in caregivers of children with mental health problems. BACKGROUND: Caregivers of children with mental health problems report feeling physically and psychologically overwhelmed and have high rates of depression because of the demands of caregiving. Research on the needs of these caregivers and interventions to ameliorate their stress is needed. However, recruiting this population can be particularly difficult because of the stigma of mental illness. Available literature on recruitment of caregivers of persons with physical illness cannot be transferred to caregivers of children with mental health problems because of the different caregiving situations. There is a need to identify effective recruitment strategies to reduce cost and answer research questions. Clinical nurse specialists have the skills to facilitate the recruitment of research participants. We revised and expanded health system referrals, community outreach, and recruiting advertisement (ads). When these strategies did not increase recruitment, radio ads were used. The Andersen's Behavioral Model of Health Services Utilization was selected as a guiding framework. OUTCOME: Radio ads were the most effective strategy for recruiting caregivers of children with mental health problems for this study. CONCLUSION: Recruitment was ultimately successful because we were flexible and made decisions consistent with the Andersen's Behavioral Model of Health Services Utilization. IMPLICATIONS: Clinical nurse specialists who study this population of caregivers should really consider the use of radio ads and systematically track which recruitment strategies lead to the greatest number of participants screened, eligible, and enrolled into studies.
Subject(s)
Caregivers , Mental Disorders/nursing , Nurse Clinicians , Patient Selection , Advertising , Caregivers/psychology , Child , Community-Institutional Relations , Humans , Longitudinal Studies , Nursing Evaluation Research , Nursing Methodology Research , Problem Solving , Radio , Social NetworkingABSTRACT
As primary caregivers of children with mental health problems, mothers face challenges that put them at risk for depression, which is rarely identified or addressed. The aims of this paper were to (a) identify mean differences among demographic, stressor, threat, and resource variables specified in a theoretical model and thought to be associated with maternal depressive symptoms and (b) determine how much variability in depressive symptoms is explained by these variables. High levels and prevalence of depressive symptoms were found within a quality of life study that these data were drawn from. Of 139 mothers participating in this study, 58% had a score of 16 or greater on the CES-D indicating moderate to high levels of depressive symptoms. Significant differences were found between mothers with higher versus lower levels of depressive symptoms for 11 of the 18 variables. Hierarchical regression was used to examine the variance explained in depressive symptoms based upon the conceptual model with 4 composite variables. Income (step 1), behavioral problems (step 2), threat appraisal (step 3), and resource appraisal (step 4) combined explained 42% of the variance.
ABSTRACT
PROBLEM: Associations of perceptions of social support, personal control, and child behavioral problems to distress in parents of children with mental health problems were examined. METHODS: One hundred and fifty-five parents of children 2-19 years old receiving community mental health services participated. FINDINGS: Stepwise regression analysis identified internalizing and externalizing child behaviors, perceived personal control, and tangible social support as independent predictors of parental distress. Independent predictors of objective distress included internalizing child behaviors, perceived personal control, and intangible social support. CONCLUSIONS: Internalizing and externalizing child behaviors were significantly associated with parental distress. Perceived personal control moderated the relationship between internalizing child behaviors and parental subjective distress.
Subject(s)
Attitude to Health , Caregivers/psychology , Child Behavior Disorders , Parents/psychology , Stress, Psychological/etiology , Stress, Psychological/psychology , Adult , Child , Child Behavior Disorders/prevention & control , Child Behavior Disorders/psychology , Cross-Sectional Studies , Factor Analysis, Statistical , Female , Humans , Internal-External Control , Male , Middle Aged , Midwestern United States , Multivariate Analysis , Nursing Methodology Research , Regression Analysis , Risk Factors , Severity of Illness Index , Social Support , Stress, Psychological/diagnosis , Surveys and Questionnaires , Young AdultABSTRACT
The prevalence and severity of depressive symptoms among 155 primary caregivers of children with mental health problems were examined along with variables that mediated or moderated the association of child behavior problems with caregivers' depressive symptoms. Forty percent of participants scored 22 or higher on the Center for Epidemiological Studies Depression Scale, indicating that they might have a serious depression. Perceived personal control, subjective distress, and role disruption mediated the association between internalizing child behavior problems and depressive symptoms. Tangible social support moderated the association between internalizing behavior problems and depressive symptoms. Intangible social support moderated the association between externalizing behavior problems and depressive symptoms.
Subject(s)
Adaptation, Psychological , Caregivers/psychology , Depressive Disorder/prevention & control , Mental Disorders , Social Support , Adolescent , Adult , Child , Child, Preschool , Cross-Sectional Studies , Depressive Disorder/psychology , Female , Humans , Male , Midwestern United States , Models, PsychologicalABSTRACT
The purpose of this study was to test a model predicting social-psychological determinants of parent satisfaction with children's mental health services. Model concepts were parents' characteristics, definition of situation, desired services, expectations, met desires, met expectations, and satisfaction. The sample included 120 parents of children, ages 3-18 years, admitted to one of five treatment programs. With minor changes, results of structural equation modeling indicated a good fit between the data and the proposed relationships. The strongest predictor of parent satisfaction was met expectations; however, inclusion of the desire concepts was essential in obtaining a strong, acceptable model fit.
Subject(s)
Parents/psychology , Personal Satisfaction , Psychological Theory , Surveys and Questionnaires , Adolescent , Adult , Child , Child Health Services/standards , Child, Preschool , Female , Humans , Male , Mental Disorders/therapy , Mental Health Services/standards , PsychologyABSTRACT
This study tested the psychometric properties of the Parent Satisfaction Scale (PSS), a new scale measuring parents' satisfaction with their child's mental health services, primarily focusing on staff's interpersonal interactions. Data were collected by postal surveys 5 to 10 months after a child's admission to 1 of 5 mental health treatment programs. Completed surveys were received from parents of 120 of a potential 232 children (52% response rate). Internal consistency reliability of the PSS was strong (alpha = .96). Construct validity was supported by significant relationships between the PSS and constructs considered to be antecedent variables influencing parent satisfaction, including met expectations (r = 0.62, P < .001), met desires (r = 0.32, P < .001), and met needs (r = 0.55, P < .001). Convergent validity was supported, with the PSS having Pearson correlations of .86 (P < .001) with the Client Satisfaction Questionnaire-8 and .76 (P < .001) with parents' ratings of satisfaction with specific services received.
