Chronic Illness In Family Research Articles

Prevalence, associated risk factors of depression and mental health needs among geriatric population of an urban slum, Cuttack, Odisha.

To find the prevalence of depression among elderly population of urban slum of Cuttack and to study its association with sociodemographic factors, comorbidities, and various life events and also to explore the mental health needs of the study subjects as perceived by them. It was a cross-sectional study carried out in the urban slum, Jobra of Cuttack city in Odisha. Simple random sampling was done using random number table to select the study subjects. Predesigned pretested questionnaire including Geriatric Depression Scale, Lawton's Instrumental Activities of Daily Living, and Katz Index of Independence in Activities of Daily living and questions on important life events including their perceptions regarding existing mental health services were used for data collection. Data were analyzed using SPSS, and binary logistic analysis was done to find the independent determinants of severe depression among elderly. Out of 354 study subjects, 249 (70.3%) were males. Depression in severe and mild form was present among 44.9% and 36.2%, respectively. Independent risk factors of severe depression by multiple logistic regression analysis were low socioeconomic class, female gender, diabetes mellitus, hypertension, death in family members, conflicts in family, and chronic illness in family members. The prevalence of depression among the elderly in the urban slum was close to 80% with 45% being at risk of severe depression. Females from low socioeconomic class with comorbidities and having life stressors need to be screened regularly in the community level, and facility for counseling should be provided to them.

Development assessment of HIV exposed children aged 6–18 months: a cohort study from North India

ABSTRACTHIV exposed children are vulnerable to developmental delay irrespective of their HIV status due to combined effect of risk factors like poverty, prenatal drug exposure, stress and chronic illness in family and malnutrition. This cohort study assessed the development of 50 HIV exposed children aged 6–18 months at a Pediatric Centre of Excellence in HIV care in India. The development was assessed using Development Assessment Scale for Indian Infants (DASII) at enrolment, 3 and 6 months later. The development quotient (DQ) scores and proportion of children with developmental delay (DQ ≤ 70) were compared among two sub-groups, HIV infected (HI) and HIV exposed uninfected (HEU) children. The various social and clinical factors affecting development were studied by univariate and multivariate analysis. Prevalence of developmental delay was 2.4% in the HEU (n = 41), and 33.3% in HI (n = 9). The DQ of HI was significantly lower than that of HEU at all three assessments. The DQ of HI were also significantly lower compared to the HEU at ages 12.1–18 months (83.37 ± 20.73 vs 94.68 ± 5.13, p = 0.005) and 18.1–24 months (84.55 ± 15.35 vs 94.63 ± 5.86, p = 0.006) respectively. The development of HEU was adversely affected by lower socioeconomic status and presence of wasting. In addition, development of HI was also adversely influenced by presence of stunting and opportunistic infections, advanced disease stage and shorter ART duration. We conclude that with optimum care, HEU can have a normal development, while a considerable proportion of HI may continue to have delayed development.

A investigação do impacto do autismo na família: revisão crítica da literatura e proposta de um novo modelo

Os Transtornos Globais do Desenvolvimento, dos quais o autismo faz parte, caracterizam-se pelo comprometimento severo em três áreas do desenvolvimento: habilidades de interação social recíproca, habilidades de comunicação e presença de comportamentos, interesses e atividades estereotipadas (DSM-IV-TR, 2002). As características próprias do comportamento, somadas à severidade do transtorno podem constituir estressores em potencial para familiares e/ou cuidadores. O presente estudo tem como objetivo revisar as pesquisas sobre o impacto dos Transtornos Globais do Desenvolvimento, em especial do autismo, na família. A partir da noção de que este fenômeno envolve uma série de fatores interatuantes, intra e extrafamiliares os quais afetam a família ao longo de seu ciclo vital, conclui-se que a sua compreensão não pode ocorrer com base em relações lineares entre possíveis causas e seus efeitos, de forma reducionista. Como alternativa, o estudo aponta para a necessidade da adoção de um modelo explicativo que contemple as diversas variáveis envolvidas no processo de adaptação da família frente a uma condição crônica. Destaca-se o modelo de Bradford (1997), o qual propõe uma abordagem psicossocial, que integra concepções cognitivas e sistêmicas, na área da Psicologia da Saúde, num metamodelo especificamente desenvolvido para o estudo do impacto da doença crônica na família.Palavras-chave: Autismo; estresse familiar; impacto na família.