Search Results (63)

Adverse childhood experiences (ACEs) prompt parentification, which is related to providing regular caregiving as adults. This study examines the association between the number and types of ACEs and caregiving as adults, and to whom caregiving is extended. Analyses were based on 90,666 adults from 13 states in the U.S. in 2020–2024 and involved binomial and multinomial logistic regression, adjusted for selected covariates. Approximately 21% of participants provided regular care and 66% had ≥1 ACEs. Each of 11 ACEs considered was positively associated with providing regular care. As the number of types of ACEs increased, the odds of providing regular care increased. The strongest ACE predictor of providing regular care was living with a parent or adult who was depressed, mentally ill, or suicidal, and the weakest was when the parents were divorced, separated, or an unmarried couple. Among those receiving regular care, if the caregiver had more ACEs versus less, they were significantly less likely to care for a parent or grandparent but more likely to care for a spouse, child, sibling, or friend or non-relative. Full article

Background/Objectives: Hispanic caregivers report higher levels of burden and poorer mental health compared to non-Hispanic caregivers. While problem-solving interventions have shown promise in improving stroke caregiver and patient well-being, they have not been specifically tailored or tested with Hispanic stroke caregivers. This study aimed to evaluate the effectiveness of a telephone- and online-based problem-solving intervention that was culturally adapted for Spanish-speaking Hispanics on caregiver burden. Methods: A two-arm parallel randomized clinical trial (NCT03142841) with repeated measures was conducted with 210 Hispanic caregivers of veterans who had experienced a stroke within the past year. Participants were recruited from three VA medical centers. The intervention consisted of 8-telephone sessions using online materials conducted by a trained interventionist. Participants in the standard group received usual VA resources they would have received as part of routine care such as stroke-related information. Chi-square tests and regression analyses were used to assess outcomes at 9 and 21 weeks. Results: Most participants were female (88%), college-educated (49%), and spouses or partners of a veteran (46%). Caregivers in the intervention group showed significantly greater reductions in caregiver burden (p = 0.011; p < 0.001) compared to the standard care group. Conclusions: Similarly to others reporting positive findings with non-Hispanic caregivers, these findings suggest that the problem-solving intervention can potentially alleviate Hispanic Spanish-speaking stroke caregivers’ burden by improving coping skills, problem-solving, and social support. Further research is needed to address gaps in effective interventions and promote equitable care for this population. Full article

Work–family conflicts (WFCs) and family–work conflicts (FWCs) have been found to be important to worker morale and retention as well as family (as defined by the respondents) well-being, with particular importance within the military, as indicated by a number of studies in the United States, Canada, and European countries. However, few studies have focused on the impact of WFC and FWC for high ranking officers and their families. This study involved two samples of officers attending an advanced leadership course at Fort Leavenworth, Kansas, in 2007, featuring a total of 262 Army officers and another 45 officers from other services and countries. The sample of Army officers included 239 men (85.4% of whom were a parent) and 22 women (63.6% of whom were a parent; Fisher’s Exact Test, p < 0.02), with one missing case for sex. Of the men and women, respectively, most were married for the first time (190/11), with some never married (14/5), married but divorced (10/1), married/divorced/remarried (20/4), married/spouse died/remarried (1/0), married/divorced/remarried/divorced/remarried (4/0), and married/divorced/remarried/divorced/remarried (0/1). Measures for cohabitation or same-sex partnerships were not used. Two modified measures of WFC and FWC of four items each were tested and found to represent different factors and to have high internal consistency reliability. In general we found few sex differences, but female officers seemed to be more influenced by family–work conflict than male officers. One of our most substantial findings was that work–family conflict was more prevalent than family–work conflict within our sample. Also, we found that marital satisfaction tended to be higher than parental satisfaction and that officers usually found their own retention intentions to be higher than their perception of that of their spouses. Satisfaction with the military was consistently and strongly related to lower levels of work–family conflict while similar but weaker trends were found for family–work conflict. Most of our results were found to cross-validate with a subsample of non-Army officers in our sample. We found bias from marital social desirability to be lower for our marital process scale and for FWC than for marital satisfaction and WFC. In sum, our results confirm adverse effects of deployments and other stressors on military families and a continuing need for military support for families, even among higher ranking officer families. Full article

Background: Loneliness and social isolation among older people are currently widespread and recognized as the foremost public health problems globally and locally. Hong Kong, which exhibits a rapid aging trend and an expanding elderly population, is inevitably facing these issues. This study explored the lived experiences of loneliness among older adults in Hong Kong. Methods: Qualitative interviews were conducted among older adults in the community aged 60 or above who were cared for by migrant domestic workers and presented varying levels of loneliness. Purposive sampling was used to select subjects for face-to-face, semi-structured individual interviews, with consent for audio recording, which led to the inclusion of 19 older adults, among whom five were male, nine lived with a spouse, and three lived with their children. Interpretative phenomenological analysis was adopted. Results: We identified a core theme, “Should I stay at home alone?”, and the following four interrelated themes: (1) experience of inadequate social support and networks, (2) altered family dynamics and support, (3) deterioration in physical functions and mobility limitations, and (4) experience of negative and complex emotions. Conclusions: Based on our investigation into the lived experience of loneliness among older adults locally, we recommend that the government, non-governmental organizations, and healthcare institutions establish appropriate strategies and integrated services to address the social, physical, familial, and emotional issues in this population to foster healthy aging, improve their quality of life, and encourage support from families and communities. Full article

Background: Connubial melanoma, the occurrence of melanoma in non-consanguineous spouses, is rarely described in the literature. This study aimed to evaluate the prevalence of shared risk factors, preventive behaviors, and the influence of couple dynamics on the early diagnosis of cutaneous melanoma (CM). Methods: We conducted a retrospective observational study at the San Gallicano Dermatological Institute IRCCS, Rome, enrolling 52 heterosexual couples diagnosed with CM between 2010 and 2023. Clinical and anamnestic data, including phototype, history of sun exposure, use of tanning devices, and reason for dermatological evaluation, were collected. Dermatological assessments included dermoscopy, total body photography, and histological examination of excised lesions. Statistical analyses were performed using chi-square and Student’s t-tests. Results: Women reported significantly higher use of artificial ultraviolet sources (51.9% vs. 19.2%, p < 0.001) and more frequent histories of sunburn. Phototype II was associated with higher use of tanning devices and a greater prevalence of sunburns. Although the CM stage did not significantly differ between sexes, husbands exhibited a greater Breslow thickness. Melanoma localization differed by sex, with lower limbs more often affected in women and the trunk in men (p < 0.001). In 86.5% of cases, wives initiated their husband’s dermatological evaluation, leading to earlier diagnosis. Conclusions: Despite shared environmental exposures, men and women differ in preventive behaviors and risk profiles. Women play a crucial role in promoting early detection among couples. Couple-based preventive strategies may be instrumental in improving early melanoma diagnosis and outcomes. Full article

Background/Objectives: This study examined differences in physical activity (PA) and sedentary behavior among Korean cancer survivors compared to cancer-free individuals from 2017 to 2021 and identified differences based on their cancer treatment status. Methods: We used data for 28,528 adults (1585 cancer survivors and 26,943 cancer-free individuals) from the 2017–2021 Korea National Health and Nutrition Examination Survey. PA and sedentary behavior were assessed using the Korean version of the Global Physical Activity Questionnaire. We examined adherence to aerobic and resistance training guidelines, domain-specific activity, and sedentary time. We also analyzed the descriptive statistics and conducted chi-square tests, the Mann–Whitney U test, and the non-parametric Kruskal–Wallis test, stratified by demographic and clinical subgroups. Results: Compared with cancer-free individuals, cancer survivors showed significantly lower adherence to aerobic PA guidelines in 2017 (p < 0.01), 2018 (p < 0.05), and 2021 (p < 0.01). Transportation-related activity accounted for the highest share of the total PA (mean: 59.1%). Sedentary time increased among survivors from 8.1 h/day (2017) to 9.0 h/day (2021). In 2021, resistance training adherence was higher among survivors (24.7%) than among non-cancer individuals (22.9%). In the subgroup analyses, male sex, younger age, recent diagnosis, higher income, and living with a spouse were associated with higher adherence. Conclusions: The findings underscore a clear need to address both PA and sedentary behavior in cancer survivors, irrespective of treatment phase. Full article

This study aims to explore the link between exposure to tobacco smoke among nonsmokers and the risk of lung cancer in the United States. We searched six databases for studies on second-hand smoke (SHS) and lung cancer following PRISMA guidelines. Following the random effects model and specific statistical methods, our meta-analysis analyzed studies based on SHS exposure type. A total of 19 eligible studies were included in the review and 15 in the meta-analysis. We covered exposure from parents (childhood), spouses and partners (household), and work-related exposure (colleagues), with higher risk among non-smoking children and domestic partners. Findings reveal a consistent link between SHS exposure and increased lung cancer risk for this population (exposure effect sizes: 1.05–3.11). Analysis of childhood SHS exposure reveals a distinct increased risk associated with parental exposure. For nonsmokers living with smoking spouses, there is a marked 41% increase in risk. Higher risk was associated with more and more prolonged SHS exposure. Exposure to SHS in the workplace shows a correlation with lung cancer risk. Our findings highlight increased SHS-related lung cancer risk, particularly among non-smoking children and domestic partners, intensifying with the amount and duration of exposure, indicating the significant impact of SHS within domestic environments. Full article

Despite steady economic and social development in Bangladesh, women are in an underprivileged situation in many ways. This study explores the association between the use of information and communication technology (ICT) and women’s empowerment in Bangladesh. This study employs ordinary least squares regression, the ordered logit model, and the multinomial logit model, using Financial Inclusion Insights (2017) Survey data, to investigate the relationship between mobile phone use and women’s empowerment. The study’s main result indicates that mobile phone use facilitates women’s empowerment in general, but the impact needs to be considered for different groups of women. Housewives who are restricted within the household are impacted less than non-housewives by mobile phone use, contrary to our expectations. Also heads of households and spouses of heads of households, who are in very different positions in a patriarchal family structure, are similarly impacted by mobile phone use. This result implies that ICT only affects the empowerment of women who are not restricted to the household, and we conclude that ICT access alone is not enough to ensure women’s awareness about their rights. Full article

High-risk pregnancies not only heighten concerns about the baby’s health but also have the potential to impact the mother–infant relationship by shifting the mother’s focus towards her own health needs. This study aims to delve into the intricacies of motherhood roles among women experiencing high-risk pregnancies compared to those with uncomplicated pregnancies, aiming to shed light on the disparities between the two groups. The participants of this descriptive, comparative, and correlational study consisted of literate mothers admitted to a hospital in Eastern Turkey, diagnosed with high-risk pregnancies, and with no prior history of psychological support. Due to an inability to reach the entire population, an unknown sampling method was employed for sampling calculation. The sample comprised 133 mothers with high-risk pregnancies and an equal number of healthy mothers, totaling 266 participants. Data were collected using the “Maternal Introduction Form” and the “Maternal Role Gaining Scale”, and analyses were conducted using the SPSS Statistical Programme. Given the non-normal distribution of the variables, nonparametric tests were applied post reliability analysis. There is a statistically significant difference (p < 0.05) in the scores of maternal attitude and anxiety, as well as maternal role and the Maternal Role Gaining Scale, based on various demographic factors such as marriage duration, spouse’s education, family economic status, pre-pregnancy health issues, medication use, hospitalization status and reason, assigned sex of the baby and desired gender, total pregnancies, mode of delivery, postpartum difficulties, support for baby care, feeding method, high-risk pregnancy diagnosis, and week of diagnosis. A Bonferroni corrected analysis also revealed significant differences between mothers with and without high-risk pregnancies. Full article

Background and Objectives: Before COVID-19 vaccinations became available, adhering to non-pharmaceutical interventions (NPIs), like social distancing (SD), wearing masks, and hand hygiene, were crucial to mitigating viral spread. Many studies reported that younger individuals were more reluctant to follow these measures compared with older ones. We hypothesized that it would be worthwhile to find factors that influenced SD compliance among young people during the pre-vaccination phase of a pandemic. Materials and Methods: We analyzed data of adults aged 19–44 from the 2020 South Korean Community Health Survey and compared socio-demographic, health-related behavioral, and psychological factors between compliant and non-compliant cohorts. Results: A total of 59,943 participants were enrolled and we found that older age groups (30–39 and 40–44) and safety concerns (such as viral infection, virus-related death, economic damage, and transmitting virus to vulnerable people) were significantly associated with adherence to SD. Conversely, participants who were not living with a spouse, were unable to stay at home despite symptoms, smoked, drank, and had a negative attitude toward government policy statistically correlated with non-compliance. Conclusions: In times when NPIs were the primary defense against the pandemic, it is essential to identify factors that positively or negatively affect individual compliance with them, especially among young people. Using a large-scale, well-designed national survey, we could gain insights into the early recognition of risk factors for non-compliance and appropriate follow-up interventions (i.e., education campaigns, clear communication of public guidelines, and implementation of guidelines), which will help people to avoid suffering from other waves of future infectious diseases. Full article

The link between marriage and migration is usually considered in terms of international migration. However, domestic migration provides another lens in which to view this connection. In Brazil, despite the large migration from the northeast to the southern regions in the twentieth century, the role of domestic migration in race-mixing has been unacknowledged. Since race in Brazil is highly regionalized, with black and brown Brazilians comprising most northern regions and white Brazilians being in the majority of the southern areas of the country, migration can open possibilities for interracial marriage that are less likely to occur for non-migrants. At the same time, as gender plays an important role in opportunities for intermarriage, the effects of migration likely vary according to intersections of race and gender. An examination of the data on marital unions from the 2009 Brazilian National Household Survey, which includes large numbers of earlier cohorts of mass migration, demonstrates the influence of migration on interracial marriage. This study finds that the effect of migration on the odds of being interracially married (in comparison with being in a same-race marital union) vary according to the race and gender of the spouse. This study is one of the first to tie together two demographic phenomena—migration and interracial marriage—that have not previously been examined in the Brazilian context. It also provides a new lens through which to understand interracial marriage in Brazil and has implications for future studies of family formation in Latin America and the Caribbean. Full article

Objective: This research aimed to determine the smoking frequency and smoking-related gestational and postpartum health problems in our study population. We investigated the quit rate during pregnancy and relapse after giving birth. The study was conducted in two university family health centers. A total of 270 women aged 18–45 with children were included in the study. Following receipt of verbal consent, the cases’ demographic data, previous obstetric information, smoking status, and gestational weight gain (GWG) were collected through face-to-face interviews and electronic records. The participants’ mean age was 35.75 ± 6.9 years and 28.1% were current smokers. Forty-one participants (16%) smoked during pregnancy, while the secondhand smoking rate was 30%. Ex-smokers experienced greater GWG (17.5 ± 1.7 kg (p = 0.003)) than current smokers and non-smokers. Small gestational age (SGA) and health problems in the first year of life were more frequent in the babies of smoker mothers (p < 0.05). The relapse rate was 81.4%, and the mean relapse interval was 13.9 ± 1.85 months. Having a smoker spouse (0.42 Exp(B), p = 0.035) and high GWG (0.98 Exp(B), p = 0.01) were identified as independent risk factors for relapse. Our results indicate that many of the smoker women quit during pregnancy. Special interventions may increase the quitting rate in pregnancy and reduce the subsequent relapse rate. Full article

Objective: To investigate sexual behavior changes adopted by People Living with Human Immunodeficiency Virus (PLHIV) on Antiretroviral therapy (ART) in the Northern Region of Ghana. Methods: We employed a cross-sectional survey with a questionnaire to collect data from 900 clients from 9 major ART centers within the region. Chi-square and logistic regression analyses were applied to the data. Results: More than 50% of PLHIV on ART use condoms, reduce sexual partners, practice abstinence, reduce unprotected sex with married/regular partners, and avoid casual sex. Fear of others getting to know patients’ HIV-positive status (χ² = 7.916, p = 0.005), stigma (χ² = 5.201, p = 0.023), and fear of loss of family support (χ² = 4.211, p = 0.040) significantly predict non-disclosure of HIV-positive status among the participants. Change in sexual behavior is influenced by the following: “to avoid spreading the disease to others” (R² = 0.043, F (1, 898) = 40.237, p < 0.0005), “to avoid contracting other STIs” (R² = 0.010, F (1, 898) = 8.937, p < 0.0005), “to live long” (R² = 0.038, F (1, 898) = 35.816, p < 0.0005), “to hide HIV-positive status” (R² = 0.038, F (1, 898) = 35.587, p < 0.0005), “to achieve good results from ART treatment” (R² = 0.005, F (1, 898) = 4. 282, p < 0.05), and “to live a Godly life” (R² = 0.023, F (1, 898) = 20. 880, p < 0.0005). Conclusions: High self-disclosure rate of HIV-positive status was identified, with participants disclosing to their spouses or parents. Reasons for disclosure and non-disclosure differed from person to person. Full article

Caregivers experience high levels of emotional stress and must cope with several clinical and hospital-related environmental factors that seriously impact their night’s rest. The purpose of this study was to establish the prevalence of insomnia symptoms in a sample of caregivers of adult hospitalized patients and to examine the relationships between insomnia symptoms and patient and caregiver-associated factors. A total of 152 caregivers were enrolled from the two main hospitals in Granada, Spain. Sociodemographic, economic, and care-related data were collected. Insomnia symptoms, burden, anxiety and depression, social support, and resilience were assessed. Information on patients’ hospital admission, dependence, and neuropsychiatric symptoms was also obtained. Most caregivers were middle-aged women caring for their spouses. Self-reported insomnia prevalence was set at 45.4%. Comparison analyses between caregivers suffering from insomnia symptoms and non-insomniacs showed significantly higher burden, anxiety and depression and patients’ neuropsychiatric symptoms (p < 0.05) and lower resilience and social support in the former (p < 0.01). A regression analysis showed that anxiety (ORa = 1.15; p < 0.05) and higher caregiver education level (ORa = 5.50; p < 0.05) were factors significantly associated with insomnia symptoms. Patients’ neuropsychiatric symptoms showed a trend toward statistical significance as well (ORa = 1.09; p = 0.06). There is an acute need to address, prevent and treat insomnia problems in caregivers. Full article

Co-residential care is associated with poor caregiver health and a high burden. Although Portugal relies heavily on co-residential care by individuals aged 50 and over, studies on the impact of co-residential care provision on Portuguese caregivers’ healthcare use are lacking. This study aims to analyze the impact of co-residential care (spousal and non-spousal care) on healthcare use of the Portuguese population aged 50 plus. Data from waves 4 (n = 1697) and 6 (n = 1460) of the Survey of Health, Ageing and Retirement in Europe (SHARE) were used. Negative Binomial Generalized Linear Mixed Models with random (individual level) and fixed (covariates) effects were performed. The results show that the number of visits to the doctor decrease significantly over time for the co-residential spousal caregivers as compared to the non-co-residential caregivers. This result highlights the fact that the Portuguese co-residential spousal caregiver group is at a higher risk of not using healthcare, thus jeopardizing their own health and continuity of care. Promoting more accessible healthcare services and implementing public policies adjusted to the needs of informal caregivers are important to improve the health and healthcare use of Portuguese spousal co-residential caregivers. Full article