Parent Facilitation of Condom Access and HIV Testing Associated with Improved Sexual Health Outcomes for Sexual Minority Young Men.

Sexual minority young men experience a high HIV incidence. Parent-based interventions are promising for prevention efforts, but further research is needed to identify specific, replicable parental behaviors associated with improved sexual health outcomes for sexual minority young men. We assessed parental behaviors in the domains of facilitating access to condoms, providing instruction in condom use, and supporting HIV testing, and tested whether parental behaviors were associated with sons' condom use self-efficacy and intentions to get tested for HIV. Data came from the baseline assessment of a pilot trial of a parent-based HIV prevention program, and participants were dyads (n = 61) of sexual minority young men (M. age: 16.87; 46% racial/ethnic minority) and their parents (M. age: 44.31; 26% racial/ethnic minority). Parents and sons reported on parental behaviors in each domain. Results indicated that parents' facilitation of access to condoms was associated with sons' condom use self-efficacy, and parents' facilitation of HIV testing was associated with sons' HIV testing intentions. Findings were robust across both parent and son reports of parental behaviors. Parental condom use instruction was unrelated to sons' condom use self-efficacy. Findings suggest that parent-based HIV prevention programs for sexual minority young men should encourage parents to provide instrumental assistance to their sons in accessing condoms and HIV testing. There is a need for further research to identify underlying mechanisms.

The impact, perceptions and needs of parents of children with epidermolysis bullosa.

BACKGROUND:  Epidermolysis bullosa (EB) is a rare, incurable genodermatosis that presents with blistering and skin fragility. Complications can be localised or generalised, limited to the skin or have systemic effects resulting in death. Caring for a child with this painful condition can have a profound effect on the quality of life of parents and the family. There is currently no published research on the lived experience of parents caring for a child with EB in a resource-limited environment in Africa. METHOD:  This qualitative research used interpretative phenomenological analysis with the aim of understanding the lived experiences of parents caring for children with EB. Semi-structured interviews were conducted with 13 participants between May 2022 and October 2023. Guba's framework of trustworthiness was used to ensure rigour. RESULTS:  Seven experiential themes with associated sub-themes were identified. The themes were (1) grappling with understanding EB, (2) the psychological experience, (3) living with the responsibility, (4) barriers to feeling supported, (5) changing relational dynamics, (6) experience of healthcare professionals and (7) parental needs. CONCLUSION:  Parents caring for children with EB face emotional, physical, psychosocial and financial challenges. Addressing parents' needs and concerns will go a long way in decreasing this burden. A biopsychosocial approach with an awareness of cultural context is essential for family-centred holistic EB care.Contribution: This is the first study in Africa that focussed on the lived experiences of parents caring for a child with EB.

Risk factors for technology addiction in young children ages 2-5 years.

PURPOSE: This study was conducted to determine the factors predictive of technology addiction in young children (aged 2-5 years). The study examined the effects of digital parenting awareness, parental stress, family demographic characteristics and parents' technology use habits on technology addiction in young children. DESIGN AND METHODS: This cross-sectional study was conducted between October 2023 and February 2024 with 401 volunteer parents of children aged 2-5 years in a province in the Western Mediterranean region of Turkey. Data were collected using the Technology Addiction Scale for Ages 2-5, the Digital Parental Awareness Scale, and the Parental Stress Scale. RESULTS: Digital parenting awareness, negative modeling and digital neglect, and parental stress positively and directly affect technology addiction in young children (ß1 = 0.166, ß2 = 0.443, ß3 = 0.087, all p < 0.05). Additionally, parental gender (ß = 0.095), parental marital status (ß = 0.092), and household income (ß = 0.088) were significant predictors of technology addiction in young children (p < 0.05). The level of technology addiction is significantly higher in children who use devices without parental controls (Z = -6.187, p < 0.001). CONCLUSIONS: Low digital parenting awareness, high parental stress, male caregivers, low household income and single-parent families in digital tools increase the risk of technology addiction in young children (2-5 years). Multidisciplinary, family-oriented intervention programs, incorporating consideration of parental risk factors, should be developed to prevent and reduce technology addiction in this group.

Latinx caregivers and autism identification: what we know a scoping review.

This is a scoping review driven by the broad research question: What are Latinx caregivers' specific facilitators and challenges, if any, in getting a timely diagnosis/identification for their child with autism? Our search resulted in 128 articles across various disciplines. A total of 43 articles were included in the final article set. Employing an inductive process, the experiences of Latinx caregiver(s) in obtaining a diagnosis/identification were coded and categorized. From that process, three broad themes were identified: (1) Diagnosis/identification barriers and facilitators (2) System changes and (3) Cultural adaptations and intersectionality. These themes represent the myriad of considerations that have been purported in the existing body of literature to frame an understanding of the experiences that Latinx/Hispanic caregivers encounter as they seek to obtain an autism diagnosis/identification for their child.

Single parenthood and depression: A thorough review of current understanding.

Background: Single parenthood is becoming increasingly common in today's society for various reasons such as divorce, the death of a spouse, or the choice of parenthood. Regrettably, there seems to be no significant concern among world leaders regarding depression arising from single parenting. Aim: This article aimed to explore the prevalence of depression in single parents, the factors contributing to it, and its effects on their physical and emotional well-being. Additionally, it aims to investigate the long-lasting effects of depression in single parents, effective therapeutic approaches to tackle these issues and offer proactive suggestions for relevant global stakeholders. Methodology: A selection of studies was identified through electronic databases such as PubMed, Embase, and PsycINFO databases. The search strategy encompassed terms related to single parenthood, depression, mental health, prevalence, risk factors, and treatment modalities. Included studies comprised of peer-reviewed research articles, systematic reviews, meta-analyses, and observational studies published in English. Result: Today, there is a growing prevalence of single parenthood due to a range of factors, including divorce, the loss of a partner, and intentional decisions regarding single parenthood. However, this transition comes with challenges, including the risk of developing depression. Depression is a serious mental health condition affecting many individuals worldwide. Raising a child alone increases the likelihood of developing depression for the parent due to the increased burden and responsibilities. Such parents tend to have low self-esteem, suicide/suicide attempts, and so forth and children born by those parents are vulnerable to depression, physical abuse, infections, etc. Conclusion: Future research should focus on identifying effective interventions for treating depression among single parents and improving the availability of mental health facilities for this vulnerable population, especially in places with a high prevalence of depression. Mental health physicians in collaboration with obstetricians and gynecologists across the globe should offer counseling and mediation services during pre-conception care visits for both single and partnered parents.

Affiliate Stigma, Resilience and Quality of Life among Parents of Children with Autism Spectrum Disorder in Two Public Hospitals in Kelantan, Malaysia.

Background: Often, the indirect impact of autism spectrum disorder (ASD) presents the family with significant challenges. One of these challenges is affiliate stigma due to parental affiliation with their child. This study aimed to explore affiliate stigma, resilience and quality of life (QoL) among parents of children with ASD. Methods: Cross-sectional study of 144 parents of children with ASD were recruited from two main tertiary hospitals in Kelantan, Malaysia, a developing country in Southeast Asia. Pearson correlation was used to examine the relationship between parental affiliate stigma, resilience and QoL. Simple and multiple linear regression analyses were used to identify the significant associated factors of affiliate stigma, resilience and QoL. Results: Correlational analyses revealed that perceived affiliate stigma demonstrated an inverse relationship with resilience and QoL. Additionally, resilience had a positive relationship with QoL. Regression analyses revealed that the father's employment status, the mother's level of education, having a disability card, the child's age at ASD diagnosis, comorbidities of the child and ASD severity perceived by parents were associated with parental affiliate stigma, resilience and QoL. Conclusion: Study findings highlight the contribution of socio-demographic characteristics of children with ASD and their families in the determination of affiliate stigma, resilience and QoL.

Applying Kumpfer's resilience framework to understand the social adaptation process of the trailing parents in China.

BACKGROUND: Trailing parents, a distinct group emerging from China's rapid social change and urbanization, are experiencing migration in old age, posing challenges for their social adaptation. Existing research has mainly focused on the hardships faced by this group, but few studies have focused on how they cope with change and achieve some degree of successful social adaptation. This study aimed to understand the coping and social adaptation process of trailing parents in China. METHODS: This study used a qualitative research approach. A total of 24 trailing parents were invited to participate in a semi-structured interview and share their experiences and efforts to cope with the many challenges. Kumpfer's resilience framework was used as the theoretical framework for the study design, data collection, and data analysis. RESULTS: This study identified several intra-family and community stressors that trailing parents may face when moving to a new environment and uncovered five key resilience characteristics that may be triggered or fostered in the presence of these stressors, including physical fitness, psychological stability, open-mindedness, learning ability, and nurturing hobbies. Individuals with resilience traits have been observed to engage in positive cognitive processing and transform the new environment. Consistent with Kumpfer's resilience framework, this study revealed the dynamics of the stressors faced by trailing parents in the new environments, the role of resilience characteristics, and the critical influence of social support in shaping the interplay between the individual and the environment that enabled them to adapt positively. CONCLUSIONS: This study highlights the importance of fostering resilience traits and leveraging positive coping mechanisms to facilitate a smoother adaptation process for trailing parents. Meanwhile, there is an urgent need to focus on creating opportunities that strengthen their social support networks.

Autism spectrum: parents' perspectives reflecting the different needs of different families.

BACKGROUND: Parents of children on the autism spectrum often face great challenges in the care of their child. Early support tailored to families' individual needs is therefore crucial for the development and quality of life of both children on the autism spectrum and their families. However, to date it is unclear whether the support available meets the parents' needs. STUDY AIM: To investigate how the system of care, support, and therapies for children on the autism spectrum is perceived by their parents. METHOD: A total of 57 parents of Swiss children on the autism spectrum participated in an online survey, and 20 of them participated in additional semi-structured interviews. RESULTS: We found that parents of children on the autism spectrum may face substantial challenges and that social support is essential. Two thirds of the participating parents reported a long and difficult diagnostic process as challenging, and 60% expressed their need for closer follow-up after diagnosis and more support. Only one third of the parents stated that they manage their everyday lives well, whereas 17.5% felt exhausted, and more than half of the parents responded that they felt challenged. One fifth indicated that they had poor family support, and half reported substantial financial challenges. At the same time, most families also emphasize how important their neurodivergent children are to the family`s life together. CONCLUSION: It is important that primary pediatricians not only initiate the diagnostic process, but also assess the different needs of the different family independent of the diagnosis and, if necessary, initiate adequate measures or guide parents to institutions in charge. Parents who do not actively express their individual needs should nevertheless be advised about support services, including financial counseling. The positive aspects mentioned by families can be emphasized and used as resources to improve their quality of life.

Well-being in parents of children with cancer: illness perceptions' mediating role for hope and social support.

Introduction: Parents of children with cancer may experience enormous physical and emotional pressures. During such times, perception of the situation can be important in mediating the link between one's basic resources (mainly cognitive and social) and the well-being one attains as an emotional and cognitive response. This study aimed to explore the role of illness impact perceptions in mediating the link between hope, social support and subjective well-being in parents of children with cancer. Methods: The cross-sectional study included 108 parents of children aged 7-18 diagnosed with cancer at least 6 months prior to the study. The parents completed one questionnaire comprising five instruments: perceived impact of illness, hope, social support, positive and negative affect (the emotional component of well-being) and life satisfaction (the cognitive component of well-being). Descriptive statistics and Pearson correlations were conducted for all study variables. SEM analysis was performed to examine the study's theoretical model. Results: The current sample included 108 parents of children with cancer recruited from two pediatric hematology-oncology wards in two different hospitals in central Israel. Most participants were mothers (70.4%), and the mean age was 44.46. The main results indicated that hope and social support correlated negatively with perceptions of the illness' impact. Illness impact perceptions mediated the relations between hope, social support and positive emotions, which means that when the parents perceived their child's illness as less impactful on the family, they experienced higher levels of emotional well-being. Conclusion: A parent with social support resources and higher levels of hope experiences higher levels of positive perceptions regarding their child's illness. Higher levels of positive perceptions allow the parent to express more positive than negative emotions, thus maintaining a more optimal level of subjective emotional well-being. The findings offer implications for healthcare teams to enhance sensitivity to parents' needs and to help parents attain more resources, positive perceptions, and well-being.

Development and Evaluation of a Web-Based Family-Centered Decision Support Tool About Firearm Storage.

BACKGROUND: Many youth in the USA have access to a loaded and unlocked firearm in their home. Discussions between adult family members have the potential to positively influence firearm storage. PURPOSE: Work with firearm-owning parents to develop and obtain preliminary data about the efficacy of a family-centered decision support tool about firearm storage. METHODS: We adapted the Ottawa Personal Decision Guide for Two to the issue of firearm storage, producing the Family Safety Check-In. Subsequently, we evaluated its acceptability and impact on intentions to make a plan with their partner (or other adult sharing parental duties) about safer firearm storage. Participants were parents/guardians of at least one school-aged child, had firearms in their home, and resided in the USA (n = 402). They completed a web-based pre-test survey, were randomized to the Family Safety Check-In or an American Academy of Pediatrics (AAP) informational resource about firearm storage for families, and then completed a post-test survey. RESULTS: The Family Safety Check-In had higher ratings for acceptability (B = 1.24, 95% CI = 0.58-1.90) and appropriateness (B = 1.46, 95% CI = 0.72-2.19) than the AAP resource. Participants in the Family Safety Check-In condition also had greater intentions to make a plan with their partner about storing firearms more safely (OR = 1.90, 95% CI = 1.26-2.87). CONCLUSIONS: The Family Safety Check-In is a promising direction for harm reduction that warrants further evaluation.

The purpose of this study was to develop and obtain preliminary data about the efficacy of the Family Safety Check-In, a family-centered decision support tool about firearm storage. To develop this family-centered intervention, we adapted the Ottawa Personal Decision Guide for Two to the issue of firearm storage. Subsequently, we evaluated its acceptability and impact on intentions to make a plan with their partner (or other adult sharing parental duties) about safer firearm storage. Participants were parents/guardians of at least one school-aged child, had firearms in their home, and resided in the USA (n = 402). They completed a web-based pre-test survey, were randomized to the Family Safety Check-In or an American Academy of Pediatrics (AAP) informational resource about firearm storage for families, and then completed a post-test survey. The Family Safety Check-In had higher ratings for acceptability and appropriateness than the AAP resource. Participants in the Family Safety Check-In condition also had greater intentions to make a plan with their partner about storing firearms more safely. The Family Safety Check-In is a promising direction for harm reduction that warrants further evaluation.

Family-Centered Care Experiences in Elderly with Chronic Diseases in Communities: Qualitative Study of Patients, Families, Nurses, and Volunteers.

Introduction: The family, at community, must be an important part of elderly care. However, most of the elderly experience a decrease in psychological well-being and quality of life. This is not in accordance with the concept of the family-centered care (FCC) model and can endanger the continuity of the elderly with chronic illnesses. Objective: The aim of this study was to explore experience of FCC among patients with chronic illness, nurses, families, and volunteers. Methods: This study examines the contextual-based FCC model qualitatively. In-depth interviews and focus group discussions were conducted by 12 elderly people, 3 nurses, 10 family members, and 3 volunteers. In total, 36 people, where several were FGD participants, were also interviewed in depth. Data were analyzed using thematic analysis, with codes organized into larger themes. Result: In total, 36 interviews and FGDs were conducted. The concept of information interaction, the phenomenon of emotional interaction, the practical interaction, and various factors that can either facilitate or impede interaction, were considered the four significant themes. Conclusion: FCC acceptance is found in interactions between parents, nurses, family, and volunteers who are not optimistic. Lack of communication and collaboration was noted between community nurses and volunteers. Offer a new perspective on developing and implementing interventions that facilitate positive interactions, reduce family burdens, provide high-quality treatment for parents with chronic diseases, and improve the quality of care for those with advanced chronic conditions. Recommendation: These insights provide a fresh perspective on how to develop and implement effective interventions in this context. It is recommended that future research should employ multiple methodologies to investigate FCC across diverse health practices for the elderly population.

Family resilience in a social-ecological context - emotional difficulties and coping strategies.

Introduction: This research explored how crises such as the pandemic influence the family dynamic and the way that the parents and the children face new difficulties and challenges. The present study investigates children's and young people's emotional states, the dimensions of family resilience, and the types of coping strategies and parents' emotional states during the coronavirus pandemic. The final sample for the research was represented by 1,010 parents from Romania. Methods: The present scientific research is a transversal study with the scope to understand the emotional difficulties that parents and children/ young people face and the coping strategies that they adopt in a crisis, such as the time of the coronavirus pandemic. Results: Parents with maladaptive coping strategies are more affected by the pandemic. Also, the results indicate that there is a significant correlation between parental coping strategies and the children's emotional states, and the adaptability level. Therefore, the high scores on the subscales which measure maladaptive coping indicate high scores of the levels of depression, anxiety, and stress of the parents. Family resilience, through the dimension of 'communication and problem-solving in the family' has a moderation role in the relationship between parental depression and the maladaptive coping strategy of rumination. Family resilience through 'maintaining a positive attitude' has a moderation role in the relationship between catastrophizing and the teenagers' level of adaptability. Discussion: The results of the study pointed out the role and place of family resilience within the family system and how a period of crisis can affect this system.

The ParentingWell Practice Approach: Facilitating implementation in U.S. adult mental health services.

Background: To address the need for interventions for families with parents with mental illness, the evidence-based intervention Let's Talk about Children (LTC) was adapted in the context of adult mental health services in the United States and reframed as the ParentingWell Practice Approach. This study focuses on the early implementation phase of the adapted practice in Massachusetts. Methods: As part of the adaptation and implementation process, practitioners from provider agencies serving adults with mental illness were invited to participate in the ParentingWell Learning Collaborative (PWLC), which included in-person learning collaborative sessions and follow-up virtual coaching sessions. This paper focuses on data obtained during and in response to the PWLC virtual coaching sessions, from 29 participants. Specific research questions included: (1) What themes emerged in coaching sessions related to practitioners' experiences during the early implementation of the ParentingWell Practice Approach (2) In what ways are coaching sessions helpful to the practitioners as they implement the ParentingWell Practice Approach? Coaching sessions were recorded, and transcribed, and the data were analyzed qualitatively to identify early implementation themes. Practitioners completed feedback surveys online (which included Likert scale items and open-ended questions) following virtual coaching sessions to evaluate the usefulness of coaching sessions. Results: Coaching sessions reflected the following themes related to practitioners' experiences during the early implementation of ParentingWell: (1) practitioners identify and share concrete approaches to supporting parents; (2) practitioners reflect on parents' needs related to support, advocacy, problem-solving, and parenting skills; (3) practitioners reflect on their own personal experiences; and (4) practitioners' recognize the importance of self-care strategies for themselves and for parents served. Practitioners indicated that coaching sessions were useful in supporting the implementation of a new practice. Conclusion: This study provides preliminary evidence for the benefits of coaching in the implementation of ParentingWell. Future research will explore the impact of ParentingWell on outcomes for parents and families served.

Parents' experiences of family and daily life after their child's stay in the pediatric intensive care unit: a qualitative descriptive study.

INTRODUCTION: The stay of a critically ill child in a pediatric intensive care unit (PICU) is a significant experience for the family. Thus far, little is known regarding the impact of this stay on parents and their healthy children for whom no continuous aftercare services are offered. This study aimed to capture the post-stay experience and needs of parents after this traumatic event so that they could return to family and everyday life. METHODS: This qualitative descriptive study was conducted in collaboration with four pediatric intensive care units in Switzerland. It included parents whose children had fully recovered after a stay and who did not require continuous medical follow-up. All children were hospitalized in the PICU for at least 48 h. Data were collected through narrative pairs (n = 6) and individual interviews (n = 8). Interviews were audio recorded, transcribed, coded inductively according to Saldaña, and analyzed. RESULTS: The results showed three related phases that influence each other to restore normality in daily life: Trust and inclusion in the treatment process during the stay (1), processing after the stay (2), and returning to everyday life (3). CONCLUSION: Follow-up meetings should be available to all parents whose children have been hospitalized in the PICU. In particular, it should also be available to parents whose children have fully recovered and no longer have any medical disabilities.

Parental impact during and after neonatal intensive care admission.

Parents play a pivotal role in neurodevelopmental outcomes of their children in the neonatal intensive care unit (NICU) and beyond. Integration of parents in clinical care and research is synergistic. Engaged parents yield more comprehensive clinical care and more robust and meaningful research products. Subsequently, successful clinical and research efforts improve outcomes for children. We review strategies for parental integration into NICU clinical care and research, including parental involvement in therapeutic interventions and neurodevelopmental care, and effective communication strategies for clinicians and researchers. We discuss challenges in neonatal trials and emphasize the need for building a culture of research, collaborative partnerships with patient advocacy organizations, and ongoing support beyond the NICU. Overall, we call for recognizing and fostering the impactful role of parents as teammates with clinicians and researchers in optimizing neurodevelopmental outcomes in the NICU and beyond.

Navigating parenthood in the face of amyotrophic lateral sclerosis: A qualitative exploration of partner experiences.

INTRODUCTION: Among people diagnosed with Amyotrophic Lateral Sclerosis (ALS), there are parents with children living at home. Children in families experiencing severe illness are exposed to stress and health risks. Since 2010, healthcare personnel in Norway must assess whether patients have children under 18 years of age and make sure the children's needs for support are met. A child's ability to cope with family life affected by a serious illness depends on how the parent without the disease manages the situation. Little is known about how the partner of someone affected by ALS manages being next of kin and a parent simultaneously, and what kind of support they need. METHODS: During 2021-2022, six semi-structured interviews were conducted with partners to persons with ALS, whom had children living at home. The interviews were transcribed verbatim and analysed through qualitative content analysis. RESULTS: Three themes with subthemes emerged: (1) Together, yet alone; (a) restricted home life, (b) missing the sharing of responsibilities and tasks as equal parents, and (c) caught between children's and partner's needs; (2) Experience of coping while waiting for death; (a) cherishing the moments, (b) sense of coping and concern, and (c) ensuring to get recharged; and (3) Support in times of need; (a) difficult to ask the network for help and (b) the healthcare system does not see the whole family. CONCLUSIONS: Our respondents felt alone, caught between the needs of their children and partner, without necessary support from the services, and were left to handle everyday life with all new challenges on their own. Future healthcare services need to consider the challenges faced by families dealing with life-limiting illnesses. A family-focused perspective is needed, so is peer support and interventions that address both emotional and practical aspects of life with an ill partner.

Prevalence and Associations of Depression in Parents of Children With Congenital Talipes Equinovarus: A Single-Centre Study.

INTRODUCTION: Congenital talipes equinovarus (CTEV) is a congenital deformity that requires weekly visits to the hospital for manipulation and corrective cast application, followed by an intensive bracing regimen requiring multiple visits to the hospital spread over the years. Parents of children with clubfoot are known to undergo a range of negative emotions. The objective of this study was to identify the prevalence of depression and the factors associated with depression in parents of children with idiopathic CTEV. METHODS: This cross-sectional study consecutively enrolled 190 parents of children with idiopathic CTEV undergoing treatment at King George Medical University. Parents with conditions that preclude the assessment of mental status were not included. These conditions include a history of head injury or psychiatric illness, parents with ongoing treatment of psychiatric illness, ongoing chronic illness, chronic neurological disease, and parents with clinically established intellectual disability. Information was recorded on certain parent-related characteristics and certain child-related characteristics. Parent-related information included age and sex of the parent, religion, area of residence, number of children in the family, degree of perceived social support (using the Multidimensional Scale of Perceived Social Support, MSPSS), level of education, socio-economic status, depression subscale score of DASS 21 (Depression, Depression Anxiety, and Stress Scale -21), chronic pain (visual analogue scale, VAS), family history of clubfoot or depression, and level of stress caused by a major life event during the past year using the Presumptive Stressful Life Event Scale (PSLES). Child-related information included the sex of the child, phase of treatment (casting or bracing), limb involvement (unilateral or bilateral), relapse of the deformity, and Pirani score of the deformity. Bivariate analysis and logistic regression were used to identify factors associated with a score ≥10 on the depression subscale of DASS 21. RESULTS: One hundred forty-five subjects were males (76.3%). The mean age of the enrolled parents was 28.47±4.89 years. The mean score on the depression subscale of DASS-21 was 4.87±6.3. Thirty-two parents (16.8%) had a score of ≥10 on the depression subscale of the DASS-21. On bivariate analysis, female sex, being Hindu, having studied up to class 12th, relapse, MSPSS score, and PSLES score were found to be associated with a score ≥10 on the depression subscale of the DASS-21. On logistic regression, female sex, lack of graduate education and above, and MSPSS scores were found to be significantly associated with a score of ≥10 on the depression subscale of the DASS 21 score. CONCLUSION: The prevalence of depression in parents of children with idiopathic clubfoot was 16.8%. Female gender, lack of college education, and the level of perceived social support (MSPSS) are independently associated with a score ≥10 on the depression subscale of DASS 21. We recommend screening parents of children with clubfoot and referring those with abnormal scores to a psychiatrist for a confirmed diagnosis.

Children of parents with a mental illness - stigma questionnaire: validation and revision.

Introduction: Mental disorders are often stigmatized in society. The stigma of mental illness affects people with a mental illness themselves as well as their family members-a phenomenon called stigma by association (SBA). Children of parents with a mental illness (COPMI) are a particular vulnerable group for SBA. In our systematic review, experienced SBA, anticipated SBA, affiliate SBA, and structural discrimination were identified as relevant stigma dimensions for children of parents with a mental illness. To assess SBA in adolescents who grow up with a parent with a mental illness, the COPMI-SQ was developed. Methods: N = 930 adolescents completed the study. Of those, N = 380 adolescents (sample 1; 72.6% female, mean age 17.12 (SD = 2.01) years) reported growing up with at least one parent with a mental illness. Using confirmatory (CFA) and exploratory factor analyses (EFA) as well as standard item and reliability analyses, we analyzed and revised the COPMI-SQ in the first sample. To validate the factorial structure of the revised COPMI-SQ, CFA was also conducted in the independent sample of the other N = 550 adolescents (sample 2; 80.0% female, mean age 16.36 (SD = 1.98) years) who reported not growing up with a parent with a mental illness. To test four measurement invariance, a multiple-group CFA was conducted in the combined sample of adolescents who reported growing up with and without a parent with a mental illness (sample 1 and sample 2). Results: CFA in sample 1 resulted in an inadequate model fit for the theoretically assumed four-factor structure (CFI = .687; RMSEA = .064 (90% CI = .062-.066); SRMR = .092; AIC = 229 155.63). Following EFA and item and reliability analyses in sample 1, the COPMI-SQ was reduced to four scales ("Experienced SBA," "Affiliate SBA," "Shame," and "Anticipated SBA") and two additional screening scales ("Healthcare" and "Social support"). To facilitate questionnaire use, only the three best items were retained in each scale, reducing the total item number to 12 plus five additional screener items. CFA in sample 2 also resulted in an inadequate model fit for the theoretically assumed four factor structure (CFI = .667; RMSEA = .065 (90% CI = .063-.066); SRMR = .101; AIC = 335 651.99). In comparison, the final version of the COPMI-SQ-r showed the best model fit (CFI = .945; RMSEA = .062 (90% CI = .052-.072); SRMR = .049; AIC = 60 008.05). In the multiple-group CFA (sample 1 and sample 2), metric invariance was established (χ2 (208) = 481.58, p < .001; CFI = .939; RMSEA = .053 (90% CI = .047-.059); SRMR = .056). In sample 2, internal consistency was found to be good for the total scale (α = .84) and almost acceptable to almost good for the subscales (α = .64 to.78). Discussion: The revised version of the COPMI-SQ (COPMI-SQ-r) is a reliable and economic questionnaire to assess SBA in adolescents who grow up with a parent with a mental illness. The COPMI-SQ-r can be used to help develop and evaluate anti-stigma and general interventions for affected adolescents.

Interaction between healthcare providers and parents of children or adolescents with epilepsy: A qualitative systematic review and meta-synthesis.

AIMS: This study aimed to explore the interactions between healthcare providers and parents of children or adolescents with epilepsy. A qualitative systematic review based on the theory-generating meta-synthesis research approach proposed by Finfgeld-Connett (2018) was applied. MATERIALS AND METHODS: We searched for empirical qualitative studies in five electronic databases (PubMed, Embase, CINAHL, Cochrane Library, and Web of Science), from January 1, 2003 to February 9, 2023. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to guide the selection process, and two researchers independently assessed the methodological quality of the articles using the Critical Appraisal Skills Programme Qualitative Studies Checklist. RESULTS: Of the 4,768 studies initially imported for screening, 27 studies were reviewed and synthesized. Only one qualitative study directly focused on the interactions between parents and healthcare providers, but various studies mentioning such interaction as themes or sub-themes of other phenomena allowed us to draw out common attributes. Defining attribute, "journey through the three stages of interaction," were derived as follows: Stage 1: trust vs. mistrust; Stage 2: autonomy vs. doubt; Stage 3: adaptation. The antecedents included encounters with healthcare providers and parent empowerment. A patient-centered approach was found to be the consequence. CONCLUSION: It is important for parents of children or adolescents with epilepsy to empower themselves and increase their interactions. Considering the stage of interaction, healthcare providers and researchers should explore strategies to promote effective communication. Further research is required to develop strategies aimed at supporting parents and healthcare providers to achieve the tasks at each stage and maintain Stage 3, "adaptation."

A relational approach to youth healthcare: Examining young people's, parents' and clinicians' experiences in the context of variations in sex characteristics.

According to popular understandings, children grow from a state of dependence to eventually become independent adults. Interdependence helps to disrupt the in/dependence binary and is a useful concept for making sense of the experiences young people with variations in sex characteristics in relation to healthcare. This study used semi-structured interviews with 32 health professionals, 33 caregivers and 12 young people recruited in the UK and Sweden. The analysis is guided by the questions: (1) how do young people, carers and health professionals position themselves in the adult/young person relationship in the context of healthcare? (2) how is the (in/ter)dependence of young people imagined when young people, carers and health professionals talk about healthcare? Our analysis shows how carers and health professionals might support dominant understandings about young people growing towards independence while providing little opportunity for young people's agency and voice. Interviews with young people gave clear examples of their negotiating relational ways of being, seeking agency in the context of healthcare and not simply becoming independent of adults. This analysis also draws attention to the ways young people might be silenced within healthcare contexts. The present paper is based on secondary analysis of data from the SENS. It works with concepts of relationality and interdependence to draw out the possibilities of voice and agency for young people with variations in sex characteristics in healthcare contexts.