Family roles in informed consent from the perspective of young Chinese doctors: a questionnaire study.

BACKGROUND: Based on the principle of informed consent, doctors are required to fully inform patients and respect their medical decisions. In China, however, family members usually play a special role in the patient's informed consent, which creates a unique "doctor-family-patient" model of the physician-patient relationship. Our study targets young doctors to investigate the ethical dilemmas they may encounter in such a model, as well as their attitudes to the family roles in informed consent. METHODS: A questionnaire was developed including general demographic characteristics, the fulfillment of the obligation to fully inform, who will be informed, and the ethical dilemmas in decision-making. We recruited a total of 421 doctors to complete this questionnaire, of which 368 met the age requirements for this study. Cross tabulation and Pearson's chi-squared test were used to analyze the differences between types of patients for categorical variables, and a p-value < 0.05 was considered statistically significant. RESULTS: Our data shows that only 20 doctors (5.40%) stated "informing the patient alone is sufficient" when it comes to informing patients of their serious conditions. The rest of the participants would ensure that the family was informed. When facing elderly patients with decision-making capacity, the data was statistically different (3.8%; P < 0.001) The primary reason for ensuring that family members be informed differs among the participants. In addition, when family members asked doctors to conceal the patient's medical condition for the best interests of patients, 270 doctors (73.4%) would agree and cooperate with the family. A similar proportion (79.6%) would do so when it comes to elderly patients. CONCLUSIONS: (1) Chinese doctors pay extra attention to informing the patient's family, which may not be in the patient's best interests. (2) Chinese doctors treat adult (but not elderly) patients and elderly patients differently when it comes to informing family members. (3) When family members request that doctors withhold information from patients "in the best interest of the patient," the majority choose to comply with the request, although this may cause them distress.

Pandemic Precarity: COVID-19's Impact on Mexican and Central American Immigrant Families.

Objective: The study examines the association of gender, parenthood, and marriage with reports of perceived pandemic precarity among Mexican and Central American immigrants during the COVID-19 pandemic (Fall 2020) to understand predictors of vulnerability in periods of crisis. Background: Latinos/as, immigrants, parents, and women have faced significant challenges during the COVID-19 pandemic. Family structure, along with social expectations for gender (i.e., self-sacrificing femininity for women and hegemonic masculinity for men), parenthood, and marriage may explain perceptions of pandemic precarity - defined as the material deprivation and economic anxiety resulting from the COVID-19 pandemic. Method: This study used data from the Hispanic COVID-19 Rapid Response Study (n=400), a follow-up of the VidaSana Study of Mexican and Central American immigrants, to examine how family structure is associated with pandemic precarity (i.e., food, housing, and economic insecurity). Using linear regression models, average marginal effects (AMEs), and tests for group differences we investigate the independent and interactive effects of gender, parenthood, and marriage on pandemic precarity. Results: Men and parents reported the highest pandemic precarity. Fathers reported higher pandemic precarity than mothers. For men, marriage is associated with greater precarity, and for women, marriage is associated with less precarity, yet marriage increased precarity for those without children. Conclusion: We discuss the importance and implications of examining gender along with family structure to understand how immigrant families were faring in response to the pandemic.

Evaluating the relationship between family role performance levels and health perceptions of individuals: a cross-sectional study in primary care

The aim of this study is to examine the relationship between family role performance levels and health perceptions of individuals. This cross-sectional study was conducted with 438 participants who appliedto four Family Health Centers between 18 July 2020 and 18 November 2020. The data were collected using Personal Information Form, Family Role Performance Scale, and Perception of Health Scale. ANOVA, independent samples t test and regression test were used for statistics calculations. Ethics Committee approval and institutional permissions were obtained to conduct the study. Scale mean scores of the participants were 30.92 ± 6.41 for Family RolePerformance Scaleand 48.35 ± 7.73 for Perception of Health Scale. As a result of simple linear regression analysis, a significant correlation was found between Family Role Performance and Perception of Health Scale. According to regression analysis, it was determined that family role performance affected health perception at the rate of 15.1%. In this study, it was determined that as family role performance increased, the level of health perception also increased, and there was a correlation between family role performance and health perception. Family role performances and health perception for all participants were at a moderate level.

Is Coping with Stigma by Association Role-Specific for Different Family Members? A Qualitative Study with Bipolar Disorder Patients' Relatives.

Trying to cope with stigma by association (SBA) often results in behaviors leading to social isolation and withdrawal. This study aimed at exploring the stigma-related experiences of family members of persons living with bipolar disorder (PW-BD). A semi-structured interview was conducted with relatives of PW-BD. Open-ended questions addressed three issues: awareness of public stigma of bipolar disorder, experiences of associative stigma, and ways of coping with experiences of SBA. Data were collected from a purposive sample of 21 family members. Experiences of SBA were specifically related to the different family roles. Parents had to deal with responsibility, partners with the choice of staying or not, and siblings with "a sort of duty." These specific prejudices enhanced specific coping strategies. This is the first study to highlight specific issues and coping from the perspective of family members. Based on these findings, specific targeted interventions could be developed.

Family Identity and Roles in the Context of Li-Fraumeni Syndrome: "No One's Like Us Mutants".

Li-Fraumeni syndrome (LFS) is a rare hereditary cancer syndrome in which individuals have a significantly increased risk of developing multiple cancers throughout the life span. An LFS diagnosis may shift the individual's sense of self and tolerance of cancer risk as they engage in cancer screening and cancer prevention activities. This study examined the impact of family identity on health decision making, communication, and role function. Forty-five families completed one or more interviews during an annual, protocol-specific cancer screening study. An interdisciplinary team analyzed 66 interviews using interpretive description and modified grounding theory. Thematically, identity emerged as an evolving construct regarding self and/or family, embedded in historical and ongoing experiences with LFS. Notions of individual and shared family identities guided decision making related to healthcare and influenced interpersonal communication and role function between supportive networks and families. Alignment between individual, family, and generational identities may shape engagement in genetic testing, risk management, and family life. Medical teams that are unequipped to address the psychosocial challenges that LFS populations face may include mental health professionals on interprofessional care teams to navigate risk management and consequential familial conflict.

Nonsuicidal self-injury in undergraduate students with major depressive disorder: The role of psychosocial factors.

BACKGROUND: Nonsuicidal self-injury (NSSI) is related to childhood abuse, family relationships, interpersonal relationships, personality, but the interaction between them is still unclear, and how they interact in major depressive disorder (MDD). METHODS: Collected data from 444 undergraduate degree students with MDD participated. Used the Eysenck Personality Questionnaire, Childhood Trauma Questionnaire, Interpersonal Relationship Comprehensive Diagnostic Scale, and Family Assessment Device to assess the patients' psychosocial factors. NSSI behavior was assessed through interviews. Use the Chi-square test, Wilcoxon rank-sum test, Kruskal-Wallis H-test, Distance Correlation, Structural Equation Mode for data analysis. RESULTS: Overall, 34.2% of patients with MDD had a history of NSSI. MDD patients with a history of NSSI had significant differences in psychoticism, neuroticism, emotional abuse, physical abuse, sexual abuse, emotional neglect, troubles in conversation, ability to make friends and family roles. Among these factors, psychoticism was most related to NSSI, and child abuse, interpersonal relationships and family roles played a variety of roles in mediating the relationship with NSSI. CONCLUSIONS: Psychosocial factors affect the occurrence of NSSI through chain intermediary effects.

Fathers' Paternity Leave-Taking and Children's Perceptions of Father-Child Relationships in the United States.

Paternity leave-taking is believed to benefit children by encouraging father-child bonding after a birth and enabling commitments to fathers' engagement. Yet, no known U.S. studies have directly focused on the associations between paternity leave-taking and children's reports of father-child relationships. Understanding the potential consequences of paternity leave-taking in the United States is particularly important given the lack of a national paid parental leave policy. The present study uses five waves of data on 1,319 families, largely socioeconomically disadvantaged, from the Fragile Families and Child Wellbeing Study to analyze the associations between paternity leave-taking and 9-year-old children's reports of their father-child relationships. We also assess the extent to which these associations are mediated by fathers' engagement, co-parenting quality, parental relationship satisfaction, and fathers' identities. Results indicate that leave-taking, and particularly 2 weeks or more of leave, is positively associated with children's perceptions of fathers' involvement, father-child closeness, and father-child communication. The associations are explained, at least in part, by fathers' engagement, parental relationship satisfaction, and father identities. Overall, results highlight the linked lives of fathers and their children, and they suggest that increased attention on improving opportunities for parental leave in the United States may help to strengthen families by nurturing higher quality father-child relationships.

The Family Roles to Prevention of Drug Abuse in Adolescents

@#Drug abuse is one of the problems among adolescents that were found to be increasing every year. Around 2 million people use drugs in Indonesia and most of the users are 13-17 years old. Therefore, the participation of all parties is needed to overcome this, but first and foremost is the role of the family is vital. Based on the above background, the authors investigated the role of families in the prevention of drug abuse in adolescents. Drug abuse is regarded as a threat that sooner or later can destroy the young generation. The research was aimed to analyze the family roles in the prevention of drug abuse among adolescents. A literature search was conducted from journals through Google scholar, proques, and pubmed between 2014-2019. A total of 20 studies were analyzed regarding the roles of the family that influences the prevention of drug abuse among adolescents.

Paternity Leave and Parental Relationships: Variations by Gender and Mothers' Work Statuses.

OBJECTIVE: This study examines the associations between paternity leave and parents' reports of relationship satisfaction and relationship conflict, and whether the associations vary by parent gender and mothers' work statuses. BACKGROUND: Paternity leave research in the U.S. has focused on implications for father involvement, but paternity leave may also help to strengthen parental relationships by promoting a more equitable division of domestic labor. Given gender gaps in childcare, the association between paternity leave and parental relationship outcomes may also vary by gender and mothers' work statuses. METHOD: The sample consists of 4,700 couples (i.e., parent dyads) from the Early Childhood Longitudinal Study, Birth Cohort. Multilevel models are used to assess the associations between paternity leave and both relationship satisfaction and conflict, and whether these associations vary by gender and mothers' work statuses. RESULTS: Paternity leave-taking is positively associated with parents' reports of relationship satisfaction, but length of paternity leave is only positively associated with mothers' reports of relationship satisfaction. Also, among mothers who worked prior to the child's birth, paternity leave-taking and length of leave are negatively associated with their reports of relationship conflict. In contrast, among mothers who did not work in paid labor pre-birth, paternity leave is positively associated with mothers' reports of relationship conflict. CONCLUSION: Paternity leave may have implications for parental relationships (and especially mothers' perceptions of their relationships with fathers).

Crossover of Resources and Well-Being within Employee-Partner Dyads: Through Increased Schedule Control.

This study examined whether one partner's additional resources obtained from a workplace intervention influence the other partner's perception of having those resources at home (crossover of resources). We also examined whether one partner's decreased stress by increased work resources crosses over to the other partner's stress levels (crossover of well-being). Longitudinal data came from IT employees and their married/cohabiting partners in midlife (N=327). A randomized workplace intervention significantly increased employee-reported schedule control at the 6-month follow-up, which, in turn, increased partner-reported employees' work schedule flexibility to handle family responsibilities at the 12-month follow-up. The intervention also decreased partners' perceived stress at the 12-month follow-up through the processes by which increases in schedule control predicted decreases in employees' perceived stress, which further predicted decreased levels of partners' perceived stress. Notably, crossover of resources and well-being were found in couples who lived with children in the household, but not in couples without children. Our findings suggest that benefits of workplace support can permeate into the family domain, by increasing partner-perceived family resources and well-being.

Este estudio examinó si los recursos adicionales a un miembro de la pareja obtenidos a través de una intervención en el lugar de trabajo influyen la percepción del otro miembro de tener esos recursos en la casa (cruce de recursos). También examinamos si la disminución de estrés en un miembro de la pareja al aumentar los recursos laborales se traslada a los niveles de estrés del otro miembro (cruce de bienestar). Los datos longitudinales provinieron de empleados de TI (Tecnología Informática) y sus parejas casadas/convivientes en la mediana edad (N = 327). Una intervención aleatoria en el lugar de trabajo aumentó significativamente el control del horario reportado por empleados en el seguimiento de 6 meses, lo que, a su vez, aumentó la flexibilidad del horario laboral de los empleados para manejar las responsabilidades familiares, según reportaron las parejas de los empleados en el seguimiento de 12 meses. La intervención también disminuyó el estrés percibido por las parejas de los empleados en el seguimiento de 12 meses, a través de los procesos mediante los cuales los aumentos en el control programado predijeron disminuciones en el estrés percibido de los empleados, lo que también predijo niveles más bajos de estrés percibido de las parejas de los empleados. En particular, el cruce de recursos y bienestar se encontró en parejas que vivían con niños en el hogar, pero no en parejas sin niños. Nuestros hallazgos sugieren que los beneficios de apoyo en el lugar de trabajo pueden penetrar el dominio familiar, al aumentar los recursos familiares y bienestar percibidos por la pareja.

Gender, Socioeconomic Status, and Diet Behaviors within Brazilian Families.

Existing literature documents the key role that parents play in transmitting diet behaviors to their children; however, less is known about differences by parent and child gender within families, especially with attention to household socioeconomic status (SES). We use nationally representative household data from Brazil and ask how parent-child associations of diet behavior differ by gender within lower- and higher-SES households. Results indicate that both maternal and paternal diet behaviors are associated with sons' and daughters' diet behaviors, but the strength of these associations differs depending on the gender of both the parent and the child. Moreover, gender differences in parent-child diet resemblance exist primarily in lower-, but not in higher-SES households. These findings are important for understanding health processes that occur within families and lead to disparities across generations, especially in a middle-income country undergoing sharp economic and nutritional changes.

Structural stability, quantitative change: A latent class analysis approach towards gender role attitudes in Germany.

Since the 1960s, social science surveys have aimed to assess respondents' attitudes towards gender roles. In this paper, a model-based clustering approach towards gender role attitudes is proposed in contrast to commonly used dimensional methods. Working from a role theory perspective, we expect different profiles in the population when it comes to role expectations. Using data from the German General Social Survey in 1991 and 2012, we identify attitude patterns via multi-group latent class analysis, taking differences between Eastern and Western Germany into account. Five latent classes representing different combinations of role expectations towards couples and parents and varying levels of intensity are distinguished. Attitude change is assessed by comparing latent class prevalence over time, while statistically testing for measurement equivalence. The analysis reveals a regionally variable decrease in traditional role models: Eastern Germany exhibits a faster pace of 'de-traditionalization' and less potential for role conflicts regarding working mothers.

[The professional and family characteristics, difficulties, contentment and resources of physicians working at level 3 neonatal intensive care centres. General overview in Hungary]. / A III. szintu neonatális intenzív centrumokban dolgozó orvosok szakmai és családi jellemzoi, nehézségei, elégedettsége, eroforrásai. Magyarországi helyzetkép.

INTRODUCTION: A survey that investigates the situation of physicians working at neonatal intensive care (NIC) centres has not been made since 1997. AIM: To give an overview of the sociodemographic characteristics; personal and professional problems; the satisfaction with their job and family roles; their levels of healthy lifestyle; resources in the families of physicians working at NIC. METHOD: We have made an examination in Hungary at NIC among physicians from April 2015 till January 2016, with an anonym self-fill-in questionnaire. RESULTS: The physicians involved in the research (n = 111) are representatively middle-aged people. They are well-qualified and hold a subordinate post. Most of them have second jobs. The manager and deputy-manager positions are characteristic for the men. Most of them live in family. The main problems for them are financial and professional difficulties, not the family or personal problems. They have conflicts in families because of finding partners and having children as well as job problems. They are satisfied with their parenting, partnership and professional roles but they are not contented with their family role as a financial safety provider person and as a person living a healthy life. In difficult situations in their life, they can count on friends and family members, furthermore they can rely on their workmates and superiors. CONCLUSION: It is the first research that focuses on the general situation of physicians working at level 3 NIC centres. This is the first time when a survey investigates their professional-personal-family life. Orv Hetil. 2018; 159(16): 628-635.

Changing Gender Norms and Marriage Dynamics in the United States.

Using a regional measure of gender norms from the General Social Surveys together with marital histories from the Panel Study of Income Dynamics, this study explored how gender norms were associated with women's marriage dynamics between 1968 and 2012. Results suggested that a higher prevalence of egalitarian gender norms predicted a decline in marriage formation. This decline was, however, only true for women without a college degree. For college-educated women, the association between gender norms and marriage formation became positive when gender egalitarianism prevailed. The findings also revealed an inverted U-shaped relationship between gender norms and divorce: an initial increase in divorce was observed when gender norms were predominantly traditional. The association, however, reversed as gender norms became egalitarian. No differences by education were found for divorce. The findings partially support the gender revolution framework but also highlight greater barriers to marriage for low-educated women as societies embrace gender equality.

Family Communication about End-of-Life Decisions and the Enactment of the Decision-Maker Role.

End-of-life (EOL) decisions in families are complex and emotional sites of family interaction necessitating family members coordinate roles in the EOL decision-making process. How family members in the United States enact the decision-maker role in EOL decision situations was examined through in-depth interviews with 22 individuals who participated in EOL decision-making for a family member. A number of themes emerged from the data with regard to the enactment of the decision-maker role. Families varied in how decision makers enacted the role in relation to collective family input, with consulting, informing and collaborating as different patterns of behavior. Formal family roles along with gender- and age-based roles shaped who took on the decision-maker role. Additionally, both family members and medical professionals facilitated or undermined the decision-maker's role enactment. Understanding the structure and enactment of the decision-maker role in family interaction provides insight into how individuals and/or family members perform the decision-making role within a cultural context that values autonomy and self-determination in combination with collective family action in EOL decision-making.

Mothers with Physical Disabilities Caring for Young Children.

Seventy-one U.S. mothers with a physical disability who had a child aged 0 to 3 years responded to a survey about the system of care used for their child. Results indicated that mothers participated in all different types of care (physical, comforting, playing, limit setting, and taking the child outside the home). Partners and participants' mothers provided the most assistance with care. Mothers were generally satisfied with assistance received from others. This article explores how mothers remain central to their children with others assisting with the child's care and the impact of such assistance on mothers' relationships with partners and children.

Father's Perceptions of their Role and Involvement in the Family: A Qualitative Study in a Colombian Sample / Percepciones del padre sobre su rol e involucramiento en la familia: un estudio cualitativo en una muestra colombiana

Abstract The purpose of this study was to explore fathers' perceptions about their role in the family, and the characteristics of their involvement in their children's lives in the Colombian context. The sample consisted of 12 Colombian fathers. The study used a qualitative methodology, one-hour in depth interviews were conducted with the participants. Results indicated important changes in the role of fathers and mothers in Colombian families. Fathers' perceptions departed to some extent from the traditional pattern attributed to nuclear families, where men are considered as the only economic provider and authority figure in the family. This departure places fathers in a category we would call "in transition", which includes perceptions of more equitable parental roles within the family and a combination of features from other typologies of fatherhood proposed in the literature. Fathers also reported a desire to participate more at home and to be more involved in their children's lives; they also emphasized the importance of expressing love and affection to their children. Work-family conflict and the impact of the quality of the father-child relationship emerged as important categories in the fathers' perceptions of their role and involvement in the family. In Colombia research on fathers is scarce and family policies mainly focus on mothers as the principal caregiver. A better understanding of fathers' roles and involvement in the family and with children will contribute to the development of programs and policies oriented toward all family members and family relationship systems.

Resumen El propósito de este estudio fue explorar las percepciones de los padres sobre su rol en la familia y las características de su involucramiento en la vida de los hijos en el contexto colombiano. La muestra estuvo conformada por 12 padres colombianos. El estudio siguió una metodología cualitativa en la cual se llevaron a cabo entrevistas en profundidad de una hora de duración con los participantes. Los resultados indicaron cambios importantes en el rol de los padres y las madres en las familias colombianas. Las percepciones de los padres se alejaron en alguna medida del patrón tradicional atribuido a las familias nucleares en las cuales los hombres son considerados como los proveedores exclusivos y las figuras de autoridad de la familia. Esta separación ubica a los padres en una categoría que nosotros llamaríamos "en transición", la cual incluye percepciones de roles parentales más equitativos dentro de la familia y una combinación de rasgos de otras tipologías de la paternidad propuestos en la literatura. Los padres también reportaron un deseo por participar más en sus hogares y por estar más involucrados en la vida de sus hijos. Adicionalmente, ellos enfatizaron en la importancia de expresar amor y afecto a sus hijos. El conflicto entre el trabajo y la familia y el impacto de la calidad de la relación padre-hijo emergieron como categorías fundamentales en las percepciones de los padres sobre su rol e involucramiento en la familia. En Colombia, la investigación sobre los papás es escasa y las políticas de familia se centran principalmente en las madres como cuidadoras principales. Una mayor comprensión del rol de los papás y de su involucramiento en la familia y con los hijos contribuirá al desarrollo de programas y las políticas orientadas hacia todos los miembros de la familia y hacia los diferentes sistemas de relación en el contexto familiar.

Diverse Family Structures and the Care of Older Persons.

Demographic and social trends lead to a variety of micro-level and internal structural contexts that influence caregiving in families with older members. The results of macro-level changes have received little focused attention in the aging literature, where much of the caregiving research has addressed issues within the context of traditional family structure. Yet the conventional nuclear family model is increasingly uncommon as new, pluralistic models of family life are emerging in contemporary society. The majority of elder care is provided by relatives, albeit with varying patterns of involvement and responsibility across family structures. Both conventional and pluralistic families face challenges in meeting the care needs of their oldest members, leaving some older adults at risk of having unmet needs. Additional research on family risk and resilience related to the care of older relatives is warranted, particularly with respect to pluralistic models of family life.

Gender Equity, Opportunity Costs of Parenthood, and Educational Differences in Unintended First Births: Insights from Japan.

We examine educational differences in the intendedness of first births in Japan using data from a nationally representative survey of married women (N = 2,373). We begin by describing plausible scenarios for a negative, null, and positive educational gradient in unintended first births. In contrast to well-established results from the U.S., we find evidence of a positive educational gradient in Japan. Net of basic demographic controls, university graduates are more likely than less-educated women to report first births as unintended. This pattern is consistent with a scenario emphasizing the high opportunity costs of motherhood in countries such as Japan where growing opportunities for women in employment and other domains of public life have not been accompanied by changes in the highly asymmetric roles of men and women within the family. We discuss potential implications of this suggestive finding for other low-fertility settings.

The family roles of siblings of people diagnosed with a mental disorder: heroes and lost children.

In order to cope with the diagnosis of mental illness in a family member, siblings may be forced to adjust their roles in the family. Taking into account the crucial role that some siblings play in caregiving for the mentally ill especially when the parents are no longer available, it is imperative to develop awareness of their unique needs and address them. Thirty-three adult siblings of people diagnosed with a mental disorder completed the Role Behaviour Inventory (RBI) and a general questionnaire including open-ended questions regarding the roles they played in their families of origin. Findings from the inventory and general questionnaire suggest that the well siblings score higher on two roles, the Hero and Lost Child, and lower on the Mascot and Scapegoat roles relative to a comparison group (N = 33). Being a sibling caregiver emerged as a risk factor to assume certain dysfunctional roles in the family. Implications for future research and therapy are discussed.