Association of viral loads of influenza A (H3N2) with age and care setting on presentation-a prospective study during the 2022-2023 influenza season in Spain.

OBJECTIVES: The aim of this study was to analyze the viral load (VL) using cycle threshold (Ct) in patients infected with influenza A (H3N2). METHODS: This prospective study was conducted during the 2022-2023 influenza season in sentinel, non-sentinel, and hospitalized patients of Castilla y León (Spain). Respiratory samples were obtained from nasopharyngeal swabs and analyzed by quantitative reverse transcription-polymerase chain reaction specific for influenza A (H3N2) to obtain the Ct value. RESULTS: A total of 1047 individuals were enrolled (174 [16.6%] sentinel, 200 [19.1%] non-sentinel, 673 [64.3%] hospitalized). The mean Ct value was lower in infants, young children, and in the elderly, with a sharp increase in the last from 65 years until 90 years. In addition, the lower Ct values were observed in non-sentinel patients and then in hospitalized patients, probably because non-sentinel are outpatients in the acute phase of the influenza infection. CONCLUSIONS: A higher VL (lower Ct value) is related to the extreme ages of life: children and the elderly. Furthermore, a higher VL is related with the care setting, being probably higher in outpatients because they are in the acute phase of the disease and slightly lower in hospitalized patients because they are attended during the post-acute phase.

Facilitators and barriers to adherence to medical recommendations among adolescents with cancer: A systematic review.

We aimed to systematically review barriers/facilitators of adherence among adolescents with cancer (aged 10-24 years), following a comprehensive approach to adherence that goes beyond medication-taking. Empirical studies published in English exploring determinants of adherence to medical recommendations among adolescents with cancer were identified in MEDLINE, PsycInfo, and Web of Science, up to October 2021. Records and full-text articles were reviewed by two independent reviewers, and results were classified according to the World Health Organization's (WHO) multidimensional adherence model. Eighteen studies were included. Despite heterogeneity in the definition and measurement of adherence, literature supported barriers/facilitators at patient, treatment, condition, healthcare team/system, and social/economic levels. Specifically, patient-related factors (i.e., psychological functioning and beliefs about disease and treatment) and social-related factors (i.e., family functioning) were major determinants of adolescent adherence. Few studies were conducted, and inconsistent findings were displayed for other dimensions (i.e., healthcare team/system, treatment, and condition-related factors). Adherence is a complex and multidetermined phenomenon. More research is needed to provide critical insights for policymakers and healthcare professionals in planning practices and interventions that effectively address meaningful barriers/facilitators of adolescents' adherence.

Economic strain and quality of life among families with emerging adult children: The contributions of family rituals and family problem-solving communication.

Young people and their families around the world are especially vulnerable to macroeconomic hard times. This study sought to provide a more comprehensive view on how families with emerging adult children can successfully overcome economic distress. Specifically, we examined the links between economic strain-that is, the subjective perceptions of one's current and future financial situation-family ritual meaning, family problem-solving communication, and quality of life, as reported by emerging adults and their parents. Data were collected from 1017 individuals nested in 334 families living in Portugal in 2016/2017. Results from multilevel modeling provided evidence for a negative impact of economic strain on family members' quality of life (ß = -0.30, p < 0.001); and for the role of family ritual meaning (ß = 0.01, p = 0.022), but not family problem-solving communication, as a buffer against the negative effect of economic strain on quality of life. Findings also suggested that the subjective evaluations that family members formulated about their financial situations played a greater role than objective economic conditions (e.g., income) in establishing a deeper understanding on the impact of economic demands on individuals and families' lives in today's complex financial world. This study provides a significant contribution to family economic stress research, advancing family ritual meaning as a key family dynamic contributing to positive adaptation to economic distress. The implications of these findings for clinical interventions include the potential benefits of symbolic forms of family communication in the work carried out with economically stressed family members.

Employment Disruption and Wellbeing Among Young Adults: A Cross-National Study of Perceived Impact of the COVID-19 Lockdown.

Young adulthood (18-30 years old) is a crucial period due to its developmental tasks such as career establishment and financial independence. However, young adults' relative lack of resources makes them vulnerable to employment disruptions (job loss and income loss), which may have both immediate and long-term effects on their financial wellbeing and mental health. The economic impact of COVID-19 restrictions resulted in an increase in unemployment and a decrease in income worldwide, especially for young adults. This study examined to what extent and how job loss and income loss due to the pandemic influenced young adults' perception of their present financial wellbeing, future financial wellbeing, and psychological wellbeing by using cross-sectional survey data collected from six countries (China, Italy, Lithuania, Portugal, Slovenia, and the United States). Results showed that the impact of income loss and job loss on all three types of wellbeing were mediated by young adults' negative perception of the COVID-19 lockdown restriction (i.e., perceived as a misfortune). Cross-country differences existed in the key variables. The association between employment disruptions, young adults' perception of the COVID-19 lockdown restriction, and wellbeing were equivalent across countries except China. Implications for policy and practice are discussed.

Cohesion and conflict for mothers during the pandemic: Results of the Portuguese version of the COVID-19 Household Environment Scale.

The coronavirus disease 2019 (COVID-19) pandemic is a worldwide event that has caused significant changes in the daily lives of individuals and families. The combined effect of the pandemic and the stress associated with major life cycle changes, such as the transition to parenthood, is yet to be understood. The aim of the current study was to validate the Portuguese version of the recently developed COVID-19 Household Environment Scale (CHES) and examine its psychometric properties in a sample of mothers who had given birth during the pandemic. The CHES is a self-report measure assessing the consequences of the COVID-19 pandemic in household cohesion and conflict and includes two sections. Section 1 contains 25 descriptive items pertaining to sociodemographic and household characteristics and COVID-19 stressors. Section 2 encompasses household cohesion and conflict, assessing any change in household experiences and activities following the onset of social distancing. The participants consisted of 342 mothers, aged between 19 and 50 years (M = 31.43; SD = 4.38). A confirmatory factor analysis supported the original CHES bifactor structure of household cohesion and conflict, which obtained an acceptable fit (CFI = 0.900, RMSEA = 0.065). Correlations between household cohesion and conflict and family cohesion and dyadic coping contributed to developing the construct validity of this scale. Furthermore, both CHES subscales demonstrated very good internal consistency. Further research is warranted to assess the CHES in other cultural contexts. This is a useful tool to assess change in family households due to the unprecedented adverse pandemic experience.

Profiles of emerging adults' resilience facing the negative impact of COVID-19 across six countries.

Although emerging adults (i.e., individuals aged 18-29 years old) may be at a lesser risk of COVID-19 severe illness and mortality, studies have found that the negative impact of COVID-19 on mental health and well-being is higher among emerging adults when compared to other age groups. The current study aimed to identify profile(s) based on resilience resources, which could help emerging adults in managing the disruptions to their lives following the pandemic. A cross-national sample of 1,768 emerging adults from China, Italy, Lithuania, Portugal, Slovenia, and the US was utilized to identify profiles based on different resilience dimensions (ego-resiliency, positivity, religiosity, socioeconomic status, family support, peer support). Results of the Latent Profile Analysis suggest the presence of four different profiles: no resources, only peer, only family, and well-equipped. The association of these profiles with demographic variables, adulthood markers, self-perceived COVID-19 impact, present well-being, and future life perception was investigated. Implications for resilience theory as well as for future interventions are discussed. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-022-03658-y.

How culturally unique are pandemic effects? Evaluating cultural similarities and differences in effects of age, biological sex, and political beliefs on COVID impacts.

Despite being bio-epidemiological phenomena, the causes and effects of pandemics are culturally influenced in ways that go beyond national boundaries. However, they are often studied in isolated pockets, and this fact makes it difficult to parse the unique influence of specific cultural psychologies. To help fill in this gap, the present study applies existing cultural theories via linear mixed modeling to test the influence of unique cultural factors in a multi-national sample (that moves beyond Western nations) on the effects of age, biological sex, and political beliefs on pandemic outcomes that include adverse financial impacts, adverse resource impacts, adverse psychological impacts, and the health impacts of COVID. Our study spanned 19 nations (participant N = 14,133) and involved translations into 9 languages. Linear mixed models revealed similarities across cultures, with both young persons and women reporting worse outcomes from COVID across the multi-national sample. However, these effects were generally qualified by culture-specific variance, and overall more evidence emerged for effects unique to each culture than effects similar across cultures. Follow-up analyses suggested this cultural variability was consistent with models of pre-existing inequalities and socioecological stressors exacerbating the effects of the pandemic. Collectively, this evidence highlights the importance of developing culturally flexible models for understanding the cross-cultural nature of pandemic psychology beyond typical WEIRD approaches.

Economic stress among couples with emerging adult children in Portugal.

Macroeconomic crises occur cyclically, entailing devastating social consequences for individuals and families. Previous research addressing families' responses to socioeconomic upheavals has been mainly conducted with couples with young or adolescent children. Less research attention has been given to middle-aged couples with emerging adult children who might be struggling to support their offspring's transition to adulthood emotionally and financially. The present study examines the impact of economic stressors on family and individual functioning reported by couples with emerging adult children in Portugal. Using a sample of 317 heterosexual middle-aged couples, structural equation models were built to assess the links between economic hardship, economic pressure, and family functioning and psychological well-being. Following an actor-partner interdependence model (APIM) approach, both actor and partner effects were tested. The results showed that greater economic hardship was indirectly linked with (a) poor family functioning as reported by men and women, via the economic pressure felt by men, revealing an actor and a partner effect and (b) poor psychological well-being via each partner's own feeling of economic pressure, revealing only actor effects. Findings also indicated that economic stress processes may operate differently across socioeconomic status (SES) groups, with men from low/medium-low SES reporting a more pronounced association between economic pressure and family functioning. This study added support to previous literature on the adverse impact of economic stressors on family and individual functioning, extending family economic stress research to the Portuguese cultural setting and to an understudied stage of the family life cycle. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Left behind parents: A qualitative study on the experience of parental abduction of a child in Portugal.

Parental abduction of a child occurs when the child is removed, by one parent, from the custody of the other parent or legally appointed guardians. The absence of the child has a profound impact on family members and significantly affects their lives. Also, parental abduction of a child is a relevant social problem which calls for further understanding. The aim of this research was to characterize the experiences of left behind parents in the context of parental abduction of a child. The data for this exploratory qualitative study were analyzed through thematic analysis of the semi-structured interviews carried out with eight male participants in Portugal. Participants' perceptions were organized around three main themes: the impact of this adverse event on different areas of their lives, recovery strategies, and perspectives regarding the future. Findings and their implications for professionals working with these families are discussed in light of the ambiguous loss and ambiguous boundaries frameworks.

Assessing the Relationship between PTSS in Childhood Cancer Survivors and Their Caregivers and Their Quality of Life.

Childhood cancer is a traumatic experience for survivors and their families. The experience of this disease affects survivors' and families' quality of life, even years after it occurs. The purpose of the present study was to assess if the caregivers' posttraumatic stress symptoms mediated the associations between survivors' posttraumatic stress symptoms and caregivers' quality of life, in a sample of 46 dyads of caregivers and childhood cancer survivors. Survivors and caregivers completed the PCL-5, and caregivers completed the WHOQOL-bref. Results showed that survivors' and caregivers' posttraumatic stress symptoms scores and caregivers' quality of life were associated. The caregivers' posttraumatic stress symptoms mediated the relationship between survivors' posttraumatic stress symptoms and caregivers' quality of life. Knowing posttraumatic stress symptoms direct and indirect effects on caregivers' quality of life contributes to understand their experience and to develop intervention strategies with this population.

Measurement invariance of the moral vitalism scale across 28 cultural groups.

Moral vitalism refers to a tendency to view good and evil as actual forces that can influence people and events. The Moral Vitalism Scale had been designed to assess moral vitalism in a brief survey form. Previous studies established the reliability and validity of the scale in US-American and Australian samples. In this study, the cross-cultural comparability of the scale was tested across 28 different cultural groups worldwide through measurement invariance tests. A series of exact invariance tests marginally supported partial metric invariance, however, an approximate invariance approach provided evidence of partial scalar invariance for a 5-item measure. The established level of measurement invariance allows for comparisons of latent means across cultures. We conclude that the brief measure of moral vitalism is invariant across 28 cultures and can be used to estimate levels of moral vitalism with the same precision across very different cultural settings.

Effectiveness of a combined surf and psychological preventive intervention with children and adolescents in residential childcare: a randomized controlled trial / Efectividad de una intervención preventiva psicológica y de surf combinada con niños y adolescentes en cuidado residencial: un ensayo controlado aleatorizado

Children and adolescents living in residential childcare have a higher prevalence of mental health problems as a result of a history of adverse childhood experiences. Therefore, this population should be a priority target for mental health preventive interventions. The current study analyses the effectiveness of the Wave by Wavesurf therapy program, that combines surfing with a psychological group intervention, through a randomized controlled trial. Seventy-three youth (7-17 years) living in residential care participated in the study. Main mental health outcomes (adjustment problems, depression, anxiety, and wellbeing) and secondary outcomes (self-efficacy, self-regulation, sleep quality, physical activity, pro-social behavior, and social connectivity) were assessed at pre- and post-intervention. The results indicated a significant impact of the intervention on mental health outcomes reported by the key residential worker, with medium to large effect sizes. Specifically, after the intervention, there was a significant reduction in the total emotional and behavioural problems, and a significant increase of youth pro-social behaviour and quality of life that was not observed for the waiting list group. There were no significant effects on other measures reported by the children (e.g., depression and anxiety, self-esteem, emotion regulation, social connectedness, sleep quality, physical activity) and on executive functions measures. The Wave by Wave program seems to be an effective intervention to reduce behavior problems and to promote pro-social behavior in a high-risk sample. The absence of significant effects on other dimensions may indicate the need of some complementary support to address specific difficulties of this population

Los niños y adolescentes que viven en acogimiento residencial tienen una mayor prevalencia de problemas de salud mental. Por lo tanto, esta población debe ser un objetivo prioritario para las intervenciones preventivas de salud mental. El estudio actual analiza la efectividad del programa Wave by Wave, que combina el surf con una intervención psicológica grupal, a través de un ensayo controlado aleatorio. Setenta y tres jóvenes (7-17 años) que viven en acogimiento residencial participaron en el estudio. Los principales resultados de salud mental (problemas de ajuste, depresión, ansiedad y bienestar) y los resultados secundarios (autoeficacia, autorregulación, calidad del sueño, actividad física, comportamiento prosocial y conectividad social) se evaluaron antes y después de intervención. Los resultados indicaron un impacto significativo de la intervención sobre los resultados de salud mental reportados por el cuidador en la residencia. Específicamente, después de la intervención, hubo una reducción significativa en los problemas emocionales y conductuales totales, y un aumento significativo del comportamiento prosocial de los jóvenes y de la calidad de vida que no se observó en el grupo control. No hubo efectos significativos en otras medidas reportadas por los niños (ex., depresión y ansiedad, autoestima) y en las medidas de las funciones ejecutivas. El programa Wave by Wave parece ser una intervención efectiva para reducir los problemas de comportamiento y promover el comportamiento prosocial en una muestra de alto riesgo. La ausencia de efectos significativos en otras dimensiones puede indicar la necesidad de algún apoyo complementario para abordar las dificultades específicas de esta población

Do parents of children with cancer want to participate in treatment decision-making?

PURPOSE: This study aimed to describe parents' preferences regarding their role in treatment decision-making when a child has cancer and examines whether their preferences were related to parents sociodemographic characteristics (sex and education level), patients' characteristics (age group and treatment status), and healthcare context features (parents' perception of family-centered care). METHODS: Two hundred and twenty-eight parents of children/adolescents with cancer were recruited from two Portuguese pediatric oncology wards. Participants provided sociodemographic and clinical information. The Control Preferences Scale for Pediatrics was used to assess the parents' preferred role in treatment decision-making. The Measure of Process of Care assessed the parents' perception of family-centered care (family-centered services and providing general information subscales). RESULTS: Results showed that parents preferred a passive-collaborative role (45.2%), followed by collaborative (27.2%), passive (21.0%), and active-collaborative (6.6%). None preferred an active role. Chi-square test showed that the group of parents preferring a passive role had a lower proportion of more-educated parents, compared to those preferring active-collaborative or collaborative roles. Additionally, groups did not proportionally differ according to the parents' sex, patients' age, and treatment status. A multivariate analysis of variance showed that parents preferring an active-collaborative role reported lower mean scores on family-centered services compared to those preferring passive-collaborative and passive roles. Finally, no significant differences were found concerning providing general information. CONCLUSIONS: This study's findings may guide professionals in identifying parents' preferences regarding their participation in treatment decision-making process. Mapping their preferences may support professionals in promoting desirable levels of parental involvement in decisions in pediatric oncology context.

Explaining illness with evil: pathogen prevalence fosters moral vitalism.

Pathogens represent a significant threat to human health leading to the emergence of strategies designed to help manage their negative impact. We examined how spiritual beliefs developed to explain and predict the devastating effects of pathogens and spread of infectious disease. Analysis of existing data in studies 1 and 2 suggests that moral vitalism (beliefs about spiritual forces of evil) is higher in geographical regions characterized by historical higher levels of pathogens. Furthermore, drawing on a sample of 3140 participants from 28 countries in study 3, we found that historical higher levels of pathogens were associated with stronger endorsement of moral vitalistic beliefs. Furthermore, endorsement of moral vitalistic beliefs statistically mediated the previously reported relationship between pathogen prevalence and conservative ideologies, suggesting these beliefs reinforce behavioural strategies which function to prevent infection. We conclude that moral vitalism may be adaptive: by emphasizing concerns over contagion, it provided an explanatory model that enabled human groups to reduce rates of contagious disease.

Parents' psychological well-being when a child has cancer: Contribution of individual and family factors.

OBJECTIVE: The aim of this study was to examine the contribution of individual (positive reappraisal) and family factors (parenting satisfaction, couple relationship quality, and family life difficulty) to the psychological well-being (PWB) of parents of children/adolescents diagnosed with cancer. METHODS: This cross-sectional study was conducted at two pediatric oncology wards in Portugal. Two-hundred and five parents of pediatric patients with cancer completed self-report questionnaires assessing the use of positive reappraisal as a coping strategy, parenting satisfaction, relationship quality, family life difficulty, and PWB. Sociodemographic and clinical data were also assessed. RESULTS: Standard multiple regression analysis showed a significant contribution of both individual- and family-level factors to parents' PWB. Specifically, the use of positive reappraisal as a coping strategy, parenting satisfaction, and relationship quality were associated with higher PWB; conversely, family life difficulty was linked to lower PWB. Sociodemographic (child's age and family's socioeconomic status) and clinical variables (time since diagnosis and treatment status) were not associated with PWB. CONCLUSIONS: The present study identified potential resources for parents' adaptation to this stressful situation, contributing with insightful conclusions for both research and clinical practice. Screening and addressing both individual- and family-level aspects may be crucial to foster parents' well-being when a child is diagnosed with cancer.

Family Management of Pediatric Cancer: Links with Parenting Satisfaction and Psychological Distress.

Research has long acknowledged the disruptions posed by pediatric cancer diagnosis and treatment to family life. Nonetheless, the mechanisms through which the family response influences parents' mental health in this adverse context are not fully understood. The main goal of the present study was to examine the direct and indirect links, via parenting satisfaction, between family condition management and psychological distress of parents of children with cancer. Participants were 201 parents (86.6% mothers) of children/adolescents diagnosed with cancer who completed self-report questionnaires assessing family condition management (family life difficulty and parental mutuality), parenting satisfaction, and psychological distress (anxiety and depression). Structural equation modeling was used to test the proposed mediation model. The results showed that parenting satisfaction mediated the association between both the family condition management dimensions (family life difficulty and parental mutuality) and depression. Specifically, greater family life difficulties and lower parental mutuality were associated with lower parenting satisfaction, which, in turn, was associated with higher levels of depression. Additionally, greater family life difficulties and lower parental mutuality were directly linked to higher levels of anxiety. Multigroup analyses suggested that the model was valid across patient age groups (children vs. adolescents) and treatment status (on vs. off-treatment). These findings reinforce the need for family- and parent-based interventions in the pediatric oncology field. Interventions that target families' difficulties and promote their resources are likely to foster parenting satisfaction and psychological adjustment.

Desde hace tiempo, las investigaciones han reconocido las dificultades que plantea el diagnóstico de cáncer infantil y el tratamiento para la vida familiar. No obstante, los mecanismos a través de los cuales la respuesta de la familia influye en la salud mental de los padres en este contexto adverso no se comprenden totalmente. El objetivo principal del presente estudio fue analizar los vínculos directos e indirectos, mediante la satisfacción con la crianza, entre el manejo de la enfermedad por parte de la familia y el distrés psicológico de los padres de niños con cáncer. Los participantes fueron 201 padres (86.6% madres) de niños/adolescentes diagnosticados con cáncer quienes contestaron cuestionarios de autoinforme que evaluaban el manejo de la enfermedad por parte de la familia (la dificultad para la vida familiar y la reciprocidad parental), la satisfacción con la crianza y el distrés psicológico (ansiedad y depresión). Se utilizó el modelo de ecuaciones estructurales para evaluar el modelo de mediación propuesto. Los resultados demostraron que la satisfacción con la crianza medió la asociación entre las dimensiones de manejo de la enfermedad por parte de la familia (la dificultad para la vida familiar y la reciprocidad parental) y la depresión. Específicamente, una mayor dificultad para la vida familiar y una menor reciprocidad parental estuvieron asociadas con una menor satisfacción con la crianza, la cual, a su vez, estuvo asociada con niveles más altos de depresión. Además, una mayor dificultad para la vida familiar y una menor reciprocidad parental estuvieron asociadas directamente con niveles más altos de ansiedad. Los análisis multigrupo sugirieron que el modelo era válido entre los grupos etarios de pacientes (niños frente a adolescentes) y el estado del tratamiento (en tratamiento frente a sin tratamiento). Estos hallazgos reafirman la necesidad de realizar intervenciones para la familia y los padres en el ámbito de la oncología pediátrica. Probablemente, las intervenciones que se ocupen de las dificultades de las familias y promuevan sus recursos fomentarán la satisfacción con la crianza y la adaptación psicológica.

Vital Signs: Zika-Associated Birth Defects and Neurodevelopmental Abnormalities Possibly Associated with Congenital Zika Virus Infection - U.S. Territories and Freely Associated States, 2018.

INTRODUCTION: Zika virus infection during pregnancy causes serious birth defects and might be associated with neurodevelopmental abnormalities in children. Early identification of and intervention for neurodevelopmental problems can improve cognitive, social, and behavioral functioning. METHODS: Pregnancies with laboratory evidence of confirmed or possible Zika virus infection and infants resulting from these pregnancies are included in the U.S. Zika Pregnancy and Infant Registry (USZPIR) and followed through active surveillance methods. This report includes data on children aged ≥1 year born in U.S. territories and freely associated states. Receipt of reported follow-up care was assessed, and data were reviewed to identify Zika-associated birth defects and neurodevelopmental abnormalities possibly associated with congenital Zika virus infection. RESULTS: Among 1,450 children of mothers with laboratory evidence of confirmed or possible Zika virus infection during pregnancy and with reported follow-up care, 76% had developmental screening or evaluation, 60% had postnatal neuroimaging, 48% had automated auditory brainstem response-based hearing screen or evaluation, and 36% had an ophthalmologic evaluation. Among evaluated children, 6% had at least one Zika-associated birth defect identified, 9% had at least one neurodevelopmental abnormality possibly associated with congenital Zika virus infection identified, and 1% had both. CONCLUSION: One in seven evaluated children had a Zika-associated birth defect, a neurodevelopmental abnormality possibly associated with congenital Zika virus infection, or both reported to the USZPIR. Given that most children did not have evidence of all recommended evaluations, additional anomalies might not have been identified. Careful monitoring and evaluation of children born to mothers with evidence of Zika virus infection during pregnancy is essential for ensuring early detection of possible disabilities and early referral to intervention services.

Family rituals when children have cancer: A qualitative study.

Family rituals serve important functions for families, especially at times of change and stress, such having a child diagnosed with cancer. No studies have investigated how family rituals may be impacted during pediatric cancer treatment. This qualitative study explored the impact of pediatric cancer and its treatment on family rituals. Semistructured interviews with 19 mothers of children with cancer, ages 8-17 years old, were conducted and analyzed using grounded theory strategies. The interviews revealed two main types of changes in rituals: Loss; and Transformation. The Loss of Family Rituals included two subcategories (Nonattendance at Ongoing Family Rituals, Disruption of Family Rituals). The Transformation of Family Rituals included three subcategories (Readjustment of Family Rituals, Creation of New Family Rituals, Reestablishing Old Family Rituals). Seven general functions of family rituals were identified (Celebrating, Family Cohesion, Family Communication, Respite, Sense of Predictability, Sense of Security, Rhythm of Life) and five illness-related functions (Grounding in Life, Hope, Marking the Course of Treatment, Sense of Normalcy, Treatment Adherence). Although pediatric cancer may compromise family rituals (nonattendance and/or disruption) and their functions, families develop adaptive strategies (readjustment, creation, and/or reestablish) to transform rituals and facilitate their potentially protective functions. Discussion of rituals can be integrated into interventions to optimize family interactions in the adverse context of pediatric cancer, via the readjustment of existing rituals, the creation of new ones and the reestablishing of old rituals. (PsycINFO Database Record

Psychometric study of the Portuguese version of the Family Distress Index (FDI).

INTRODUCTION: The current study examined the psychometric properties of the Portuguese version of the Family Distress Index (FDI). The FDI is an 8-item self-report measure that assesses family maladaptation, providing an index of family outcomes within the resiliency model of family stress, adjustment, and adaptation. METHOD: Participants were 459 adults, who completed measures of family distress (FDI) and family functioning (Systemic Clinical Outcome Routine Evaluation; SCORE-15). RESULTS: Exploratory and confirmatory factor analyses supported a unidimensional factorial structure. Results also indicated that the FDI has good internal consistency and temporal stability. The positive and significant correlation between FDI and SCORE-15' scores demonstrated its convergent validity. Through receiver operating characteristic (ROC) analysis, we determined a cut-off score of 12 for identifying probable family distress. DISCUSSION: In sum, the Portuguese version of the FDI is a valid and reliable instrument, which can foster the development of future empirical studies focused on family adaptation in diverse contexts of adversity, namely in health care settings. (PsycINFO Database Record

Family rituals in pediatric epilepsy: Links to parental competence and adaptation.

This cross-sectional study examined the associations between family ritual meaning and 3 indicators of parental adaptation (anxious and depressive symptoms and quality of life) via 2 dimensions of parental competence-satisfaction and efficacy-in parents of children with epilepsy. Two hundred Portuguese parents of children diagnosed with epilepsy for at least 6 months completed self-report measures assessing the main study variables. Our results showed that when parents reported stronger family ritual meaning, they also reported higher levels of parental satisfaction and efficacy, which were in turn were associated with lower psychological distress (anxious and depressive symptoms) and better quality of life of parents. This pattern of results was significant regardless of the severity of children's epilepsy, age group, and family socioeconomic level. In the context of pediatric epilepsy, empirical evidence was found for the role of family ritual meaning in being directly and indirectly associated with parents' adaptation outcomes by higher levels of parental satisfaction and efficacy. Focusing intervention targets on what families naturally do and recognize as their own ritual meaning may be a favorable route to address those at risk of psychological distress and lower quality of life. (PsycINFO Database Record