Search Results (154)

Background/Objectives: Despite the importance of parent mental health for child health, there are no global prevalence data on parental mental health symptoms when children are hospitalized. We aimed to describe depression and anxiety symptom prevalence and associated factors among parents of hospitalized children. Methods: We conducted this 14-country prospective cohort survey with parents/primary caregivers staying at a nearby Ronald McDonald House^® during their child’s hospital treatment. We used the Hospital Anxiety and Depression Scale to measure depression and anxiety symptoms and validated scales and theory-based questions to measure parent, family, and child covariates. We calculated the prevalence of clinically significant or concerning symptoms of depression and anxiety, and used multivariable regression analyses to examine associations between covariates and outcomes. Results: Among 3350 participants, 1789 (49.7%) reported depression symptoms and 2286 (69.0%) reported anxiety symptoms. Worry about housing and poorer ratings of their child’s health were associated with increased risk of depression symptoms. Poorer rating of the child’s health, living with a partner, and discrimination in daily life were associated with increased risk of anxiety symptoms. Higher levels of self-care, hospital family-centered care, and social support were associated with reduced risk of depression symptoms. Higher levels of self-care and social support were associated with reduced risk of anxiety symptoms. Conclusions: Clinically significant or concerning depression and anxiety symptoms are common among parents of hospitalized children globally. Hospitals should consider offering routine mental health symptom screening and preventative mental health and support services to all parents. Full article

Background/Objectives: Hypoglycemia occurs when blood glucose levels drop significantly below the normal range leading to unpleasant symptoms and a greater risk of acute complications. Fear of hypoglycemia (FH) is a conditioned psychological response to hypoglycemia frequently experienced by people with type 1 diabetes (T1D) and their loved ones. The present study aimed to examine the psychometric properties of a Portuguese translation of the Hypoglycemia Fear Survey—Parents (HFS-P) for the parents of youths with T1D. Methods: The sample consisted of 102 parents (M = 44.58 years old; SD = 5.01; mothers = 92.2%) of youths with T1D (8 to 17 years of age; M = 12.67; SD = 2.58). Confirmatory Factor Analysis (CFA) and convergent validity were performed to examine the factor structure and the construct validity of the HFS-P. Results: CFA supports a refined two-factor 18-item version of the HFS-P. The results indicate good psychometric properties (χ² [129] = 220.47.; p ≤ 0.001; χ²/DF = 1.71; RMSEA = 0.08; SRMR = 0.07; CFI = 0.93; TLI = 0.91; GFI = 0.93) along with good to excellent internal consistency coefficients (behavior subscale: α = 0.81, total: α = 0.93, and worry: α = 0.94). Conclusions: Our Portuguese version of the HFS-P appears reliable for assessing FH in parents of youths with T1D, and is ready for use in clinical research and to evaluate psychological interventions targeting parental FH in the Portuguese context. Full article

Background: Parents of children with type 1 diabetes play a key role in managing their child’s self-management, which can be stressful and burdensome. High involvement can lead to reactions such as emotional, cognitive, and physical exhaustion in parents. Understanding parents’ psychosocial impact due to their child’s disease is crucial for the family’s overall well-being. The purpose of this study was to describe stress and burden experienced by parents in families with children living with type 1 diabetes. Methods: This study utilized a qualitative approach, analyzing interviews with 16 parents of children aged 10 to 17 years living with T1D through qualitative content analysis. The data collection occurred between January and February 2025. Results: Managing a child’s Type 1 diabetes can be tough on family relationships, affecting how partners interact, intimacy, and sibling relationships. The constant stress and worry might leave parents feeling exhausted, unable to sleep, and struggling to think clearly, on top of the pain of losing a normal everyday life. The delicate balance between allowing a child with type 1 diabetes to be independent and maintaining control over their self-management renders these challenges even more demanding for the parents. Conclusions: Parents’ experiences highlight the need for robust support systems, including dependable school environments, trustworthy technical devices, reliable family and friends, and accessible healthcare guidance. These elements are essential not only for the child’s health and well-being but also for alleviating the emotional and practical burdens parents face. Full article

(1) Background: Human Papillomavirus (HPV)-associated oropharyngeal cancer is the fastest-growing head and neck malignancy, yet vaccination coverage remains suboptimal. (2) Methods: In this cross-sectional survey conducted from April 2022 to April 2023, 400 parents of patients aged 8–18 years (mean ± SD = 12.8 ± 2.6; 59.3% female) reported their child’s HPV vaccination status and willingness to initiate or complete the vaccine series at a dental clinic. For those who were not fully vaccinated, reasons for refusal were documented. (3) Results: Over half (54.5%, n = 218) of the children were not fully vaccinated. Notably, 21% (46/218) of parents indicated an immediate willingness to vaccinate their child if the dentist offered it—a significant potential for improvement compared to general healthcare settings. Reported barriers included preference for a physician’s office (43.6%), indecision (20.3%), unspecified concerns (14.5%), safety worries (8.1%), and religious objections (5.2%). Male and younger patients (9–11 years) showed significantly lower vaccination coverage (p < 0.05). (4) Conclusions: Dentists can substantially impact public health by integrating immunization counseling, interprofessional collaboration, and vaccine administration, thereby addressing critical gaps in HPV-related cancer prevention. These findings highlight the opportunity for dental offices to enhance vaccination rates and prompt further research, education, and policy initiatives to advance the oral and general health of our patients. Full article

Background/Objectives: The transition to motherhood can be particularly challenging for women with limited socioeconomic resources or mental health concerns. The FAmily Clinic And Municipality (FACAM) intervention was designed to provide additional support through health visitors or family therapists, starting in pregnancy and continuing until the child reached school age. This paper evaluates the effects of the FACAM intervention on the secondary outcomes, maternal mental health and parental functioning during the child’s first year of life. Methods: A total of 331 pregnant women were randomized to either the FACAM intervention (n = 163) or usual care (n = 168). Participants completed questionnaires at baseline and at 3 (N = 284) and 12 (N = 248) months postpartum. Outcomes included maternal mental well-being, satisfaction with motherhood, depressive symptoms, parental stress, parental reflective functioning, worries, and breastfeeding duration. Results: At 12 months postpartum, FACAM mothers reported greater concern about housing issues (b = 0.56, 95% CI [0.06, 1.06], p = 0.03). No other significant differences in the reported outcomes were observed between the groups. Conclusion: The FACAM intervention did not demonstrate superiority over usual care in improving maternal mental health and parental functioning during the first year postpartum. The high-quality and needs-based approach of standard care in Denmark may have limited the potential for additional interventions to yield measurable improvements in maternal outcomes. Full article

Online safety guidance is frequently delivered as a specialist technology issue without considering adolescents’ home lives, offline vulnerabilities, or wellbeing. Yet, while the digital world offers connection, autonomy, and entertainment, vulnerable teens also encounter more violent content, sexual exploitation, and content concerning body image, self-harm or suicide than their non-vulnerable peers. Many struggle with social inclusion or less engaged and credible caregiver e-safety support, which may contribute to their negative experiences online. To improve their online safety and resilience, caregivers and educators might consider offline factors that can mediate exposure to online harms. This study compared the experiences of 213 adolescents with family vulnerabilities to 213 age- and gender-matched non-vulnerable adolescents. The contribution of (a) e-safety education, (b) close friendships, (c) a trusted adult at school, and (d) life-affecting worry was considered. No differences were found for exposure to, or engagement with, e-safety education. However, despite having received e-safety education, those with family vulnerabilities were more at risk of encountering severe online harms. This was mediated by life-affecting worry and parental e-safety guidance. These findings provide unique insights into the impact of family vulnerabilities on adolescents’ exposure to online harms and suggest a more holistic intervention framework for caregivers. Full article

Background and Objectives: This study explores gender variations in the associations between lifestyle choices, mental health, and social behaviors among adolescents in the Transylvania region of Romania. The analysis is based on data obtained through the Global School-Based Student Health Survey (GSHS). Materials and Methods: Data on 900 Romanian adolescents aged 11–18 years were obtained via the GSHS. This study evaluated nutritional statuses through BMI Z-scores, employing World Health Organization (WHO) cut-offs applied to self-reported height and weight; furthermore, it assessed well-being and perceived health; worries and sleep anxiety; social connections through having friends, loneliness, peer support, and emotional support; parental bonding relations; experiences of being bullied; safety and protection factors, including distance learning during the COVID-19 pandemic and testing or vaccinations for COVID-19; and social behaviors, including the use of social networks. A multiple logistic regression was used to predict sleep disturbance anxiety, depending on sex, bullying, cyberbullying, loneliness, social network use, and peer support. Results: Results showed that the majority of the adolescents reported having one or more friends (96.8%), with no significant difference between girls and boys (p = 0.071). There were no statistically significant differences in bullying and cyberbullying experiences between sexes (p = 0.063). Notably, gender disparities exist in both health perceptions and risk behaviors, with girls experiencing higher rates of negative health perceptions, sleep anxiety (p < 0.001), and loneliness (p = 0.011) and boys exhibiting more overweight/obesity (p < 0.001) and school truancy (p = 0.027). According to the results, loneliness is significantly associated with a higher likelihood of sleep-disturbing anxiety (p < 0.001). Students who have experienced cyberbullying are more likely to also experience traditional bullying. Students who feel lonely are more likely to be victims of bullying. Conclusions: This study reveals significant gender disparities in adolescent health, particularly in mental health, risk behaviors, and social support. It highlights the need for gender-specific interventions to address these challenges and promote healthy development. Furthermore, this study emphasizes the importance of social connections, family support, and parental involvement in adolescent well-being. Addressing bullying, promoting mental health awareness, and providing accessible support services are crucial for improving adolescent health in Romania. Full article

Parents are primary “supporters” for helping their children cope with feelings of anxiety, a significant concern for many young children. The current study examined parents’ perceptions of an anxiety management manual. Parents reviewed an anxiety coping manual for elementary school-aged children. This manual explained how anxiety influences the body and emotions, as well as presenting cognitive-behavioral anxiety management strategies. The strategies included breathing, imagery (superhero to fight worries and imagine your favorite place), relaxation, talking to supportive others, and using distraction. Convenience samples of 15 parents completed virtual interviews and 6 completed in-person interviews to determine their perceptions of the manual and of worry for today’s children. Qualitative analyses were performed to determine themes in the data. Results indicated that parents would use the manual and key themes, which were (1) learning new strategies for helping their child, (2) discussing children’s worries, and (3) sharing why the worry strategies would be useful (e.g., for emotion regulation). Parents felt that today’s children are worrying more about serious things like school performance and family stressors. Future research needs to examine parent implementation of the strategies over time to determine if the use of anxiety management strategies is related to lower levels of worry for young children, if the strategies reduce anxiety-related stress, and if prevention minimizes the impact of anxiety on emotional functioning. Full article

Background/Objectives: Early predictive assessments for CP are recommended for infants with medical risk factors after birth. For parents of children with CP, receiving an early diagnosis is important. But most children with risk factors who have not yet developed CP are labeled “high-risk infants” and repeatedly assessed for abnormal signs. We aim to investigate the experience of parents of high-risk infants and describe the meaning that “early predictive assessments for CP” has for them before they know whether their children have CP. Methods: This was a qualitative study conducted using a phenomenological, reflective lifeworld approach. Fourteen individual in-depth interviews were conducted with parents who received different GMA results to learn about their experiences involving early predictive assessments. The interviews were analyzed for meaning. Results: Early predictive assessments take place over time while parents process the traumatic experience of becoming parents to an infant at risk. “Early predictive assessment” is perceived as any examination or assessment intended to unveil signs of illness or disability. The child’s future well-being and fulfillment, and the demands of parenthood, are at stake. Essential meaning structures are (1) on a spectrum from death to insignificancies, (2) living with uncertainty of what the parental role will entail, and (3) seeing one’s own child through the eyes of strangers, just in case. Conclusions: For months following the birth of a high-risk child, parents experience uncertainty and worrying, affecting the parent–infant relationship. Predictive assessments reduce their sense of alarm when the GMA result indicates a low risk of CP. But when the GMA result is uncertain, the burden of uncertainty is amplified and prolonged. Full article

Background/Objectives: The climate crisis has been associated with significant and complex challenges for youth mental health. Anxiety, sadness, and anger have been identified as core emotional responses to the climate crisis and its impacts. However, there are limited data on how these emotions correlate with climate awareness and engagement in pro-environmental behaviors. The present study explores parental accounts on climate crisis-related emotional responses, awareness levels, and engagement in climate actions among Greek youth, as well as the role of their parents’ emotional responses. Methods: This study employed a cross-sectional online survey of parents with children aged 10–18 years in Greece. A total of 186 parents completed questionnaires assessing their children’s and their own climate crisis-related emotional responses (worry, sadness, and anger), levels of climate awareness, and engagement in mitigating actions. Logistic regression analyses were conducted to examine associations between children’s emotions and sociodemographic factors, parental emotions, and climate-related behaviors. Results: The children in our study exhibited lower levels of climate-related worry, sadness, and anger compared to their parents. While 33.3% of parents reported worrying “very much”, only 7.5% of children were reported as experiencing this level of distress. Parental emotional responses were significant predictors of children’s emotions, with high parental worry associated with increased odds of child worry (adjusted OR: 7.80, 95% CI: 1.71–35.62). Climate awareness was higher among parents (64%) than children (44.7%), and children engaged less frequently in climate-mitigating behaviors than parents. Family communication about climate change was also strongly associated with children’s emotional responses. Conclusions: According to their parents’ accounts, children and adolescents in Greece exhibit moderate levels of overall climate distress, while parental emotions and communication within the family influence their responses. The present study’s findings support the need for climate education and policy initiatives that enhance emotional resilience and encourage active engagement among youth. Full article

Objectives: Severe hypoglycemia is more common among young children with type 1 diabetes mellitus (T1DM) than older youth, and parents report significant hypoglycemia fear (HF). Parents experiencing HF describe constant and extreme worry about the occurrence of hypoglycemia and may engage in potentially risky behaviors to avoid hypoglycemia. Our team developed and tested a behavioral intervention, Reducing Emotional Distress for Childhood Hypoglycemia in Parents (REDCHiP), to decrease HF in parents of young children with T1DM. Here, we qualitatively analyzed parent feedback to refine and optimize future intervention iterations. Methods: The randomized pilot study included parents (n = 73) of young children with T1DM who participated in the 10-session video-based intervention. We qualitatively analyzed 21 recordings of the final intervention session, where parents provided feedback about intervention content. Trained coders independently reviewed each session. The frequency of parent quotes regarding active REDCHiP treatment components were calculated. Results: The coded themes reflected active treatment components [viz., Use of Cognitive Behavioral Therapy (CBT) Skills, Coping, Behavioral Parenting Strategies]. Also, two secondary process codes were identified: Appreciate REDCHiP Content and Challenges in Applying REDCHiP Strategies. Parents provided examples of skills or concepts they applied from REDCHiP, the challenges they encountered, and if they planned to apply these skills in the future. Conclusions: A qualitative analysis provided insight into parent perceptions of the active treatment components within the REDCHiP intervention, their acceptability, and parents’ intention to apply REDCHiP skills/concepts within daily T1DM cares. Future iterations of the intervention that trial alternative formats (i.e., individual vs. group and asynchronous vs. telehealth) may increase accessibility and scalability. Full article

Congenital heart diseases (CHDs) lead to psychological and social repercussions for parents of affected children: the diagnosis, screenings, surgeries, and hospitalization, as well as ongoing difficulties bring with them stress, anxiety, fear, stigmatization, and isolation. Studies investigating parents’ direct perspective on these issues lack in the field literature. Our research aims to leverage parents’ narratives in order to explore how they describe their role as parents of a child with CHD and the impact of its social and clinical repercussions on their lives. We recruited 45 parents and analyzed their narratives through the MADIT approach, focusing on the discursive modalities and content cores employed. Parents describe and judge their role as ‘worried-protective’, ‘heroic’, ‘normal-untroubled’, and ‘unfortunate’, in a way that strongly characterizes the person, leaving limited possibilities for assuming different features. The clusters ‘state of ordeal’, ‘state of alert-overprotection’, and ‘personal identity changes’ are connoted as inevitable and established component of parents’ lives, while ‘limitation of life experiences’ is less monolithic and more open to change. Current narratives assume a totalizing form in the life of these parents, that can lead to stigma and exacerbate the already present difficulties and challenges, that need targeted psychological intervention by field professionals. Full article

Obesity is a global issue whose prevalence continues to rise at a concerning rate. Over the past 30 years, many countries have witnessed the doubling or tripling of obesity rates. The growing prevalence of obesity in children is particularly worrying given that it indicates a future burden on healthcare systems. Herein, we aim to evaluate the knowledge, attitudes, and practices related to childhood obesity among parents of school children in Ras Al-Khaimah (RAK) and Fujairah, United Arab Emirates (UAE). This cross-sectional study was conducted between January and May 2024 and involved parents/guardians of children from grades 1 to 12 in governmental schools in RAK and Fujairah. A standardized questionnaire adapted from the “We Can Program” was used after modification to make it suitable for the study participants. The appropriate sample size was calculated and found to be 471. A total of 510 questionnaires were included in the analysis. The study participants comprised 89.6% females, 77.6% middle-aged individuals, and 61.8% RAK residents. The results show that 96.3% of parents have good knowledge; 88.4% have a positive attitude; and 97.8% have good practices. Younger and less educated parents have a less positive attitude {odds ratio (OR) = 0.052 (0.28–0.98), p = 0.03 and OR = 0.057 (0.33–1.009), p = 0.03, respectively}. In contrast, having good knowledge increases the chances of having a positive attitude {OR = 3.81 (1.39–10.45), p = 0.015}. Males were found to have a lower probability of having good practices {OR = 0.29 (0.07–0.15), p = 0.09}. However, having good knowledge and a positive attitude increases the chances of having good practices {OR = 6.30 (1.26–31.41), p = 0.05 and OR = 23.42 (6.02–91.09, p = 0.00), respectively}. In conclusion, overall, parents/guardians from RAK and Fujairah have good knowledge, positive attitudes, and good practices with regard to childhood obesity. Young parents with lower educational levels tend to have a negative attitude. In general, living in RAK or Fujairah is not a contributing factor affecting the levels of overall knowledge, attitudes, and practices. However, parents in Fujairah have worse practices according to the majority of the individual practice questions related to physical activity and healthy food compared to parents in RAK. Particular emphasis should be placed on walking, biking, and using the stairs, when possible, among parents in Fujairah. National programs should be developed, targeting young parents with lower educational levels to improve their attitudes and hence their practices. Full article

Background: The COVID-19 pandemic affected access to healthcare and social support. This especially impacted vulnerable populations like pregnant and postpartum women. Purpose: The specific aims of the project are the following: (1) examine the impact of COVID-19 on pregnancy experiences and outcomes; (2) examine the mental health impact of COVID-19 in pregnant women and mothers of children 12 months or younger; (3) identify risk and protective factors among this population in Puerto Rico. Methods: Participants were recruited from the Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) cohort, which is composed of pregnant women and mothers from the northern karst region of Puerto Rico. This research has a mixed methods approach with a quantitative survey (n = 184) and qualitative interviews (n = 10); data collection was performed remotely. Findings: Results from the survey (n = 184) show that 20% of the cohort gave birth alone, 39% were separated from their baby after birth, 21% experienced isolation before birth, and 20% were separated after birth. In the study, 54% of the women were very worried about giving COVID-19 to their baby and avoided going out, receiving visits, and even canceling baby showers. The most reported sources of stress were their health status, work situation, and childcare, while the most reported coping mechanisms were watching TV or playing video games, using social media, and talking with loved ones. Forty-two percent reported that they frequently stopped enjoying activities that used to make them happy, and only 21% considered seeking mental health support. Conclusion: COVID-19 restrictions changed initial plans for baby showers, births, and childcare, and impacted the participants’ mental health. Physical distance measures have resulted in isolation and stress. We expect these findings to lead to developing interventions for community health centers and parents/caretakers in Puerto Rico. Full article

Increased life expectancy and reduced fertility mean more generations are living simultaneously but with fewer members. There is also a growing group of older people (aged 80 and over) who need care and support. This impacts mutual support within families and the care provided by public or private care organisations. Across OECD countries, on average, 60% of people aged 65 years and older in 2020 reported receiving support from family members, friends and people in their social network, living inside or outside their household but not care organisations. European research shows that when older persons do not have a partner (anymore), they rely on their adult children for care and support. Given that adult children frequently serve as primary providers of informal care, our study examines their perspectives and motivations to provide future care alongside the demands and expectations of their old parents. Our study adopts a multi-actor interview approach and simultaneously looks at the perspective of 40 adult children and one of their older aged parents (65 years or older). We apply the distributive justice theory to understand how children and parents assess the expectation and fairness of support. This paper contributes to the existing literature about support behaviour between parents and children, expanding insights about the fairness of support, expectations and willingness from a multi-actor approach. Through the lens of child–parent dyads, it is seen that the principles of the distributive justice theory can be perceived as not so strict, and within family relationships, one or more principles can coexist and have underlying mechanisms. This study shows the complexity and often ambivalence of family solidarity by adopting a multi-actor approach. One of the main findings is that contrasting dyads who reject the reciprocal act of support experience feelings of guilt or misunderstanding, resulting in stress and worry. A child may not follow the expected support pattern from the parent due to competing demands such as work or the prioritisation of young children, which can reduce the support given to the older parent. Besides general contrasts and similarities between child–parent support perspectives, the analysis looked into differences regarding gender and legal relationships. Our findings only found gendered care expectations. Future research should entangle this by looking into feelings of closeness, emotional connection and considering the dynamic character of filial support over time, especially between siblings. Full article