Family Dyads Research Articles

Ценностные ориентации в семье: социально-психологический анализ

<p style="text-align: justify;"><strong>Objective</strong>. Socio-psychological analysis of value orientations in the main subsystems of the modern family (marital, parent-child, sibling). <br><strong>Background</strong>. The scientific literature notes methodological heterogeneity in the study of intra-family values with the actual request of practice to determine the consistency of value orientations in various subsystems of the family. This becomes especially relevant in the modern historical situation for a deeper understanding of the processes of value-semantic integration and differentiation within the family. <br><strong>Study design.</strong> The differences in actual and reflexive values in the dyads of married couples, parents and children, and siblings were investigated. The validity of differences was tested using statistical criteria for comparing mean (Student, Wilcoxon, Mann-Whitney). To analyze pairwise similarity, correlations of value profiles (po-Spearman, r-Pearson), indices of value-orientation congruence in actual (VOC-A) and reflective (VOC-R) assessments were calculated. <br><strong>Participants</strong>. The study included 4 samples: married couples (<em>n</em> = 58 couples), college youth (<em>n</em> = 193; 44,6% males; 55,4% females), 3 generations of women from the same family (<em>n</em> = 20 triads), and respondents with a sibling (<em>n</em> = 63; 38% males; 62% females). <br><strong>Measurements</strong>. The method “Value orientations-36” (modification of Sh. Schwartz's method) (Kunitsyna, 2005). In the sample of couples and three generations of women actual values were measured. In the sample of young people and respondents with siblings − actual (answers for themselves) and reflexive (young people answered for their mothers, and respondents for their siblings). Adapted PEA questionnaire (Volkova, 2006) to assess the quality of relationships in couples and siblings. <br><strong>Results.</strong> The specificity of value orientations in family subsystems (marital, parent-child, sibling) was revealed. Thus, the differences in family couples reflect the persisting social perception of the division of marital roles: men value independence and self-assertion more, and women value interpersonal relations. Differences in children's actual and reflexive evaluations testify to the selective intergenerational continuity of value orientations in the family. In the three-generation sample, it was found that the dyads of mothers and daughters are closer to each other in terms of value profiles than grandmothers and granddaughters; the dyads of older and middle-generation women are most similar to each other. The values of value-orientation unity in the dyad are higher with higher satisfaction with the child's upbringing. Differences in the values of siblings are related to the values of achievement and ethical and aesthetic orientation. Profile correlations show the similarity of the general structure of values in all subsystems. The indices VOC-A and VOC-R express the degree of value integration in family dyads and are similar in content to the intercorrelations of individual value hierarchies. <br><strong>Conclusions</strong>. In vertical (parent-child) and horizontal (marital and sibling) dyads, the similarity of value orientations is quite high. Comparison of the profiles of family dyads from unrelated samples allows us to speak about the general consistency and selective continuity of value orientations in the modern Russian family. The general orientation of value orientations of spouses, parents and children, and siblings is characterized, on the one hand, by a high importance of family values (in such aspects as the safety of relatives and trustworthiness of interpersonal relations), and, on the other hand, by a pronounced focus on independence and achievement. This configuration can be a source of contradictions and disunity of family members. At the same time, intergenerational and intragenerational cohesion is supported by the continuity of values of moral orientation and normative behavior, with no differences in all dyads.</p>

Participation experiences of young people with limb difference in sports and recreation in Australia: a qualitative study

Purpose The primary objective was to investigate the experiences of young people with limb difference participating in sports and recreation. Materials and methods A qualitative study using an interpretive description approach was undertaken with nine family dyads (n = 9 young people; n = 9 parents) recruited across Australia via convenience sampling. Data were collected via 18 semi-structured interviews and analysed in line with the interpretive description approach. Young people were aged between 9-16 years (mean 14 y 1 m), with unilateral (n = 7) or bilateral (n = 2) limb differences. All participating parents were mothers. Findings Three themes were interpreted from the data: (1) “Just treat me like everyone else”: equitable participation in sports and recreation, (2) “Provide them opportunities and let them take the lead”: genuine choice within activities, and (3) “I wish they were easier to get”: the impact of sports-specific prostheses on participation. Facilitators and barriers to participation were mapped to illustrate the socio-ecological levels at which these influences operate, and a conceptual model was developed to guide application in practice. Conclusions This study provides guidance for practitioners, coaches, and families on how to support participation for young people with limb difference, and future research may operationalise this conceptual model into policy or practice interventions.

A Sibling's Intuition: The Role of Sibling Approval for Romantic Relationships

Research has shown that family and peer relationships have an impact on the stability and quality of one's romantic relationships. According to family systems theory, family dyads are likely to impact the stability of romantic dyads within a system. Yet, little is known if and how one's sibling will impact the development and maintenance of that relationship. Therefore, the goal of this study is to understand how approval of a sibling's romantic relationship impacts the quality of that relationship. Participants ( N = 168) and their siblings ( N = 118) were recruited to participate in an online survey, which included questions regarding their current and previous romantic relationships, if applicable, their relationship with their sibling, and their approval of their sibling's previous and/or current relationship(s). Data was analyzed using moderation analyses and actor–partner interdependence models. Although regression results showed no effects of sibling approval for relationship quality for either current or past relationships, the path analyses revealed that when participants approved their siblings’ relationship, the satisfaction increased, but when the siblings approved of the participant's relationship, the satisfaction trended downward. Path analyses also showed that approval did not predict the satisfaction of either participant's or sibling's last relationship. In both models, sibling and participant approval significantly predicted each other. Last, sibling closeness was not found to moderate any of these relationships. These results show that sibling approval plays a role in romantic relationships, but the impacts vary depending on relationship context.

Abstract B053: A pilot study of a digital weight loss program for cancer prevention among obese individuals from four diverse cohorts

Abstract Background: Obesity and physical inactivity increase the risk of many types of cancer. Effective weight management, healthy diet, and physical activity are critical to reduce cancer risk. This pilot study of a technology-based weight loss program evaluated the program feasibility, weight loss, and improvement of healthy behaviors and quality of life among minority and medically underserved participants with obesity for cancer prevention. Methods: Participants in this pilot study were included from four cohorts: 1) Mano a Mano Mexican American Cohort (MAC; family dyads) 2) Project CHURCH (African-American men), 3) High- Risk Breast Cohort (HRBC; women), and 4) Mammography Cohort (women who participated in mammography screening). A 16-week weight loss program using the Diabetes Prevention Program was provided for healthy eating, physical activity, and portion control. Participants received program materials, text messages, Fitbit, and Wi-Fi connected scale. Weight, physical activity, dietary intake, weight-related health behaviors, and quality of life were assessed at baseline and follow-up. Program feasibility including retention and satisfaction were assessed after the program. Changes in outcomes from pre- to post- program were examined using paired t-tests and chi-squared tests. Results: Among 48 enrolled participants, 37 participants completed the program (total=77%; MAC=59%; Project CHURCH=90%; HRBC=90%; Mammography=90%). During the program, 46% participants measured and recorded their weights at least one day per week (MAC=17%; Project CHURCH=60%; HRBC=80%; Mammography=50%); 65% wore the Fitbit at least 2 days per week (MAC=44%; Project CHURCH=90%; HRBC=80%; Mammography=60%); 77% responded to text messages 15 out of 30 times (MAC=61%; Project CHURCH=90%; HRBC=90%; Mammography=80%); and 92% were satisfied with the program (MAC=100%; Project CHURCH=100%; HRBC=78%; Mammography=89%). After the program, we observed about 2% weight loss in average (self- report: p=0.009; scale measured: p=0.010). There were significant improvements in weight- related eating behaviors (routine restraint: +0.55, p=0.001; compensatory restraint: +0.49, p=0.001; susceptibility to external cues: -0.41, p=0.026; and emotional eating: -0.57, p=0.001). Stage of change for weight control showed significant shifts from action to maintenance stage (p=0.012). Furthermore, dietary habits significantly changed after the intervention with decreased 30% of total energy intake (p<0.001), increased 14% protein intake (p=0.044), and decreased 56% added-sugar intake (p<0.001). Conclusions: This digital weight loss program was determined as feasible and effective for weight loss and improving eating behaviors and dietary intake among minority and medically underserved individuals with obesity. The MAC showed a higher drop-out rate and less engaged in the program compared to other cohort, and therefore, this cohort may need adapted and more support that a low touch digital weight loss program can provide to improve the feasibility. Citation Format: Che Young Lee, Thuan Le, Carrie R Daniel, Larkin L. Strong, Scherezade K Mama, Lorna H McNeill, Abenaa Brewster, Samir Hanash, Karen Basen-Engquist. A pilot study of a digital weight loss program for cancer prevention among obese individuals from four diverse cohorts [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B053.

Patient- and family-reported experiences of their treating teams in early psychosis services in Chennai, India and Montreal, Canada

BackgroundCross-cultural psychosis research has mostly focused on outcomes, rather than patient and family experiences. Therefore, our aim was to examine differences in patients’ and families’ experiences of their treating teams in early intervention services for psychosis in Chennai, India [low- and middle-income country] and Montreal, Canada [high-income country]. MethodsPatients (165 in Chennai, 128 in Montreal) and their families (135 in Chennai, 110 in Montreal) completed Show me you care, a patient- and family-reported experience measure, after Months 3, 12, and 24 in treatment. The measure assesses the extent to which patients and families view treating teams as being supportive. A linear mixed model with longitudinal data from patient and family dyads was used to test the effect of site (Chennai, Montreal), stakeholder (patient, family), and time on Show me you care scores. This was followed by separate linear mixed effect models for patients and families with age and gender, as well as symptom severity and functioning as time-varying covariates. ResultsAs hypothesized, Chennai patients and families reported more supportive behaviours from their treating teams (β=4.04; β= 9, respectively) than did Montreal patients (Intercept =49.6) and families (Intercept=42.45). Higher symptom severity over follow-up was associated with patients reporting lower supportive behaviours from treating teams. Higher levels of positive symptoms (but lower levels of negative symptoms) over follow-up were associated with families reporting lower supportive behaviours from treating teams. There was no effect of time, age, gender and functioning. ConclusionsThe levels to which treating teams are perceived as supportive may reflect culturally shaped attitudes (e.g., warmer attitudes towards healthcare providers in India vis-à-vis Canada) and actual differences in how supportive treating teams are, which too may be culturally shaped. Being expected to be more involved in treatment, Chennai families may receive more attention and support, which may further reinforce their involvement. Across contexts, those who improve over follow-up may see their treating teams more positively.

Effectiveness of a Patient-Family Carer Partnership Intervention on Blood Pressure Control for People with Hypertension in Rural Communities: A Randomised Controlled Trial

Objectives. To examine the effectiveness of a patient-family (carer) partnership intervention on the BP control, self-care and self-efficacy for hypertensive people, and dyadic-relationship quality, depressive and anxiety symptoms, and health-related quality of life for the family dyads (hypertensive people and family carers) in rural communities of mainland China. Design. A randomised controlled trial. Methods. A total of 110 family dyads were randomly recruited from village clinics and randomly allocated to the intervention group (n = 55) or control group (n = 55). Family dyads in the control group received usual care. In addition to the usual care, family dyads in the intervention group received the individual-based, five-session patient-family (carer) partnership intervention. The primary outcomes included SBP, DBP, and the proportion of people with normal controlled BP. EuroQol five-dimensional-five-level (EQ-5D-5L) was adopted to evaluate participants’ health-related quality of life. Data were collected at the baseline (T0), one-month (T1), and three-month postintervention (T2). Generalised estimating equation model was adopted to test the study hypotheses on all study outcomes. Results. Compared with the control group, hypertensive people in the intervention group had a greater reduction in SBP by 10.10 mmHg and DBP by 4.66 mmHg and a larger proportion of people with normal BP at T2, as well as statistically significant improvements at T1 and T2 in dyadic relationship, self-care, antihypertensive drug-titration rate, anxiety symptoms, and health-related quality of life. The intervention also had statistically significant positive effects on family carer’s dyadic relationship and health-related quality of life at T1 and T2. Conclusion. The patient-family (carer) partnership intervention has the potential to improve hypertensive people’s BP control and family dyad’s dyadic-relationship quality and mental health at short-to-medium term follow-ups. Implications for the Profession and/or Patient Care. This study provided evidence and direction to support healthcare providers in developing and implementing patient-family (carer) partnership intervention for hypertension care in rural areas. This trial is registered with ChiCTR1900027087.

Moving together: Increasing physical activity in older adults with an intergenerational technology-based intervention. A feasibility study.

Robust evidence supports the role of physical activity and exercise in increasing longevity, decreasing morbidity and helping older adults maintain the highest quality of life attainable. However, the majority of older adults are not sufficiently physically active and interventions are needed to change their behaviors. Familial or intergenerational contact has been positively linked to health and well-being in older adults. Therefore, this study aimed to i) establish acceptability and test the functionality and useability of a novel technology-driven intergenerational intervention targeting physical activity and age stereotypes, and ii) identify any potential issues with recruitment and retention. Four familial dyads (adult ≥ 65 and child 7-11 years) engaged with the intervention. Working collaboratively during a four-week trial, they combined daily step-counts (acquired via any activity of their choice, using PA trackers) to complete a virtual walk route using online platform World Walking. Thematic analysis of three post-intervention focus groups (one older adult; one child; one additional parental cohort) identified eight subthemes: Engagement; Provision of a Positive Experience; Participant Stimuli; Generated Outcomes; Operationality; Limitations; Mediators; Facilitators, and Perceptions. Participants enjoyed and successfully engaged with the intervention; when designing behaviour change interventions for older adults, flexibility within pre-established routines, individual choice, and avoiding rigidly imposed structures, is important. Strategies to challenge negative perceptions of older adults' engagement with technology and PA should be integrated into recruitment processes.

The shadow of war: Parental competitive victimhood and children's contact intentions in two post‐accord societies

AbstractThe effects of political violence are felt across generations; for example, extent of parental competitive victimhood (feeling that one's ingroup was relatively more victimised during the conflict) predicts adolescent's intergroup discrimination. We extend that research to children, born a generation after the height of violence. Participants were 223 family dyads with children aged 7–11 (M = 9.05, SD = 1.30; 52.4% female): Croatia (n = 82) and Republic of North Macedonia (RNM: n = 141), equally split by group status (i.e., Croatia: Croats/Serbs; RNM: Macedonian/Albanian). Parents reported on competitive victimhood while children reported on intergroup contact intentions (e.g., shared education initiatives). Moderation analysis across sites found a significant status by competitive victimhood interaction; increased parental competitive victimhood was associated with decreased contact intentions among minority, but not majority, children. We review site‐specific findings in relation to their historical context, concluding with the implications for shared education, reconciliation and peacebuilding.

Positive, negative, and ambivalent dyads and triads with family and friends: A personal network study on how they are associated with young adults’ well-being

Although negative ties may cause stress and harm well-being, they are also considered fundamental in close and ongoing relationships. This study distinguishes positive, negative, and – when characterized by both valences – ambivalent ties. Analyzing almost 10,000 personal networks from the Swiss CH-X study shows that: (1) ambivalence among family members is more prevalent than among non-family members, (2) ambivalent family dyads or triads are not negatively associated with well-being, and (3) certain balanced family triads are associated with higher well-being and an unbalanced non-family triad is associated with lower well-being. These results suggest that conflicts are not necessarily detrimental to young adults’ well-being.

Biographical continuation: recovery of stroke survivors and their family caregivers in Taiwan.

To explore the experiences pertaining to long-term care services from the perspectives of dyads of stroke survivors and their family caregivers in indigenous and non-indigenous communities. Stroke occurrence is a life-changing event associated with quality of life for stroke survivors and their families, especially those who provide primary support. Indigenous people are more likely to experience a stroke at a younger age and have a higher likelihood of hospitalisation and death due to health disparities. Few studies have investigated family dyads or indigenous populations to understand their experiences of coping with changed body-self and to contextualise their reintegration into communities post-stroke. Ethnographic fieldwork over nine months in 2018-2019 with indigenous, urban-based, and non-indigenous populations, resulting in 48 observations and 24 interviews with 12 dyads in three geo-administrative communities. The post-stroke recovery trajectory is illuminated, delineating the dyads' life transitions from biographical disruption to biographical continuation. The trajectory is shaped by seven states involving four mindsets and three status passages. The four mindsets are sense of loss and worry, sense of interdependence, sense of independence, and wellbeing state. The status passages identified in this study are acceptance, alteration, and identification. A community-based and family-centred long-term care system, aligning with medical healthcare and community resources, underpinned each dyad's biographical continuation by: (1) providing rehabilitation that afforded time and space for recovery adaptation; (2) acknowledging the individuality of family caregivers and helping to alleviate their multitasking; and (3) reintegrating stroke survivors into their communities. Key to determining the quality of recovery for the indigenous participants was their reintegration into their native community and regaining of identity. Therefore, integrating post-stroke care into various care contexts and incorporating indigenous-specific needs into policymaking can support dyads in adapting to their communities.

Researcher turned care partner: Perspectives on lived experience of navigating ADRD

AbstractThis presentation will illustrate the lived experience of a health services researcher who was a care partner for her husband with ADRD. This couple engaged for 11 years with an academic Alzheimer’s center for clinical management and participation in several clinical trials. This care partner was motivated to care out of love and concern, learning by doing and taking on unfamiliar responsibilities. Few people understood the personal time commitment and challenges, and the hours of vigilance to ensure her husband was safe, healthy, and living at home with dignity. She was challenged to maintain her scholarly career.The needs of care partners are often unmet. Caring for a family member can lead to psychological and physical distress. Personal experience highlighted the need for information about ADRD progression, financial and legal advice, routine and respite care, and psychological support. Support programs did not address the advanced stages of disease. COVID‐19 reduced supports and increased isolation. This care partner learned to effectively support and care while navigating the Alzheimer’s disease delivery and research systems, and identifying relevant resources to support the family dyad. Since the husband’s death, the researcher has refocused her research agenda to study strategies, policies and mechanisms to enable care partners, clinicians and researchers to coproduce care systems that better support care partners.This researcher’s experience highlights the need to recognize and value the essential role the care partner plays in supporting the person with ADRD. Care partner resources are frequently determined and designed by expert health and social service providers. Person‐centered health initiatives are enhanced through coproduction where patients, partners, and clinicians develop, deliver, assess and improve the relationships and actions that contribute to the health of the person with ADRD.Coproducing care and support for a person with ADRD requires actively engaging the care partner to represent their personal dyad, and inviting them to articulate the resources, services and supports they need to navigate their journey as a care partner that will complement clinical care. This presentation will frame the context for the three presentations that follow, illustrating approaches to effectively coproducing ADRD care.

Family dyads, emotional labor, and holding environments in the simulated encounter: co-constructive patient simulation as a reflective tool in child and adolescent psychiatry training

BackgroundPatient simulation has been used in medical education to provide a safe and supportive learning environment for learners to practice clinical and interpersonal skills. However, simulation involving pediatric populations, particularly in child and adolescent psychiatry, is rare and generally does not reflect the child-caregiver dyad or the longitudinal aspects of this care, nor does it provide learners with an opportunity to engage with and reflect on these dynamics.MethodsWe organized as an educational opportunity a series of seven observed patient simulation sessions with a cohort of a dozen child and adolescent psychiatrists (eight fellows approaching graduation and four senior educators). In these sessions, we utilized the co-constructive patient simulation model to create the simulation cases. We included the use of at least two patient actors in most sessions, and two of the case narratives were longitudinally followed across multiple simulation sessions. We approached the data collected during the simulations and their respective debriefings by using thematic analysis informed by a symbolic interactionist approach.ResultsBased on data from the debriefing sessions and longitudinal narratives, we identified four overarching themes: (1) Reflecting on dyadic challenges: role reversal and individuation; (2) Centering the child, allying with the parent, and treating the family system; (3) Ambivalence in and about the parent-child dyad; and (4) Longitudinal narratives and ambivalence over time.ConclusionThe emotional experience of the simulations, for interviewers and observers alike, provided an opportunity to reflect on personal and professional experiences and triggered meaningful insights and connections between participants. These simulated cases called for emotional labor, particularly in the form of creating holding environments; in this way, the simulated encounters and the debriefing sessions became dialogic experiences, in which the patient and provider, parent and child, and learner and instructor could co-construct meaning and foster professional development as reflective practitioners.

A near-mint view toward integration: Are adolescents more inclusive than adults?

The increasing ethnic and cultural diversity of contemporary societies has raised the importance of integration policies for people with a migrant background. Tools like the Migrant Integration Policy Index have been developed to evaluate different countries' integration approaches. If, on the one hand, focusing on what governments are doing to promote integration is necessary, on the other hand, it is of utmost importance to consider individuals' attitudes toward these policies. Study 1: A pilot study with 356 adolescents (41.1% female, 58.9% male; Mage = 15.38) and 200 adults (69% female, 31% male; Mage = 47.43) was conducted to test the psychometric proprieties of the Attitudes Toward Migrant Integration Policies scale. Study 2: A total of 1,156 adolescents (51.6% female, 48.4% male; Mage = 15.69), 1,288 parents (56.9% mothers, 43.1% fathers; Mage = 49.39), and 284 teachers (68.3% female, 31.7% male; Mage = 45.55) were involved in a study to evaluate how attitudes toward integration policies differ within generations (e.g., ethnic majority and minority groups), within families (e.g., adolescents vs. their fathers), and across generational groups (i.e., adolescents, parents, and teachers). Latent mean comparisons indicated that attitudes toward integration policies varied significantly across sex (for adolescents and parents), ethnic background (parents only), and school track (adolescents) groups. Regarding differences within family dyads, adolescents reported more positive attitudes toward integration policies than their fathers and mothers. Finally, teachers showed more positive attitudes compared to adolescents and their parents. Overall, this study highlights nuanced intergenerational differences, with adolescents standing in between the different positions of their parents and teachers. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Interdependency of relationships in stepfamilies – Variation across residence arrangements

This study investigates how the quality of family relationships and children’s residence arrangements are associated with stepparent-child relationship quality. Prior literature has studied these factors separately, with the role of family relationships often studied only among stepfamilies with co-resident children. Little is known about how the relevance of family relationships varies depending on where children reside. The opportunity structure (e.g., contact frequency) within which various family relationships influence each other can differ across residence arrangements. This study, therefore, investigates the roles of multiple family relationships across children’s various residence arrangements - including the more contemporary arrangement of shared residence. Multiple regression analyses with moderation techniques were conducted using the New Families in the Netherlands (NFN) survey, large-scale data collected in 2020 among divorced and separated parents with a minor or (young) adult focal child ( N = 1829). We found for each family dyad (between the biological parent and the focal child, between the biological parent and the stepparent, and between the stepparent and the other biological parent of the focal child) that a high relationship quality was associated with higher stepparent-child relationship quality. Their importance, however, varied across residence arrangements. Poor relationship quality of the biological parent-child dyad and the stepparent-other biological parent dyad was associated with a poor stepparent-child relationship, especially when the focal child was nonresident. Whereas, there was a positive association between the stepcouple relationship and stepparent-child relationship quality primarily for children living full-time with the stepfamily. Altogether, the relationship quality of various family dyads spills over to the stepparent-child dyad - though the extent of this spillover differs depending on the opportunity structure determined by children’s residence.

The Association between Adult Sport, Fitness, and Recreational Physical Activity and Number and Age of Children Present in the Household: A Secondary Analysis Using NHANES.

Only one in three adults in the United States meets the weekly recommendation for physical activity (PA). The presence of children in the home may restrict adult PA. The purpose of this study was to examine the association between adult moderate and vigorous sport, fitness, and recreational physical activities and the number and age (0-5 and 6-17) of children in their household. Secondary data were drawn from the National Health and Nutrition Examination Survey (NHANES) from 2007-2016. Adults with complete survey data for self-reported moderate (MPA) and vigorous physical activities (VPA), number of children in the home, and other sociodemographic variables were included. The final sample included 2034 adults from 22-65 years of age. Analyses included ANOVAs and separate multivariable regression analyses to determine if the number of children in the household aged 0-5 and 6-17 were significant predictors of weekly moderate-to-vigorous physical activity (MVPA) after controlling for covariates. For MPA, no differences were found between adult PA regardless of the number and age of children in the home. For VPA, adults with two or more children aged 0-5 reported 80 fewer minutes of weekly VPA (p < 0.05) compared to those with no children or just one child in this age group after controlling for all covariates. Finally, adults with three or more children in the household aged 6-17 reported fifty fewer minutes of weekly VPA (p < 0.05) compared to those with no children, one, or just two in the household. These findings highlight a need to support the vigorous PA behaviors of this population, as the majority of the family-based PA intervention studies to date have primarily focused on family dyads.

Advanced heart failure patients and family caregivers health and function: randomised controlled pilot trial of online dignity therapy

ObjectivesThis research investigated the effectiveness of the caregiver-mediated online dignity therapy in enhancing dyadic health and family function.MethodsHeart failure (HF) family dyads were recruited between May and December 2021 from...

Empathy Expression in Interpreted and Noninterpreted Care Conferences of Seriously Ill Children.

Clinician empathy is associated with improved communication and clinical outcomes. We hypothesized that, when clinicians express empathy, families are more likely to deepen discussions, and that clinicians express less empathy in care conferences with language interpretation. Prospective, mixed methods cohort study of English and interpreted audio-recorded transcripts of care conferences for pediatric patients with serious illness hospitalized at a single urban, quaternary medical institution between January 2018 and January 2021. Directed content analysis identified empathic opportunities, clinician empathetic statements or missed opportunities, and family responses. Clinician empathic statements were "buried" if immediately followed by more clinician medical talk. Descriptive analyses summarized demographics and codes. χ2 analyses summarized differences among language interpretation and family responses. Twenty-nine patient-family dyads participated. Twenty-two (81%) family members were female. Eleven (39%) used language interpretation (8 Spanish, 2 Vietnamese, 1 Somali). Families created 210 empathic opportunities. Clinicians responded with unburied empathy 80 times (38%, no differences for English versus interpreted care conferences, P = .88). When clinicians buried empathy or missed empathic opportunities, families responded with alliance (agreement, gratitude, or emotional deepening) 14% and 15% of the time, respectively. When clinicians responded with unburied empathy, families responded with alliance 83% of the time (P < .01). Our study suggests that clinician empathic expression does not differ when language interpretation is used in pediatric care conferences. Clinicians often miss opportunities to express empathy, or they bury it by medical talk. Although unburied empathy created opportunities for relationship-building and family-sharing, buried empathy negatively impacted these domains similarly to no empathic expression.

Models of Support for Caregivers and Patients with the Post-COVID-19 Condition: A Scoping Review.

In December 2019, an outbreak of the coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), occurred in the city of Wuhan, China. On 30 January 2020, the World Health Organization declared the outbreak a public health emergency of international concern. In October 2021, with the advancement of the disease, the World Health Organization defined the post-COVID-19 condition. The post-COVID-19 condition occurs in individuals with a history of probable or confirmed infection with SARS-CoV-2, usually 3 months after the onset of the disease. The chronicity of COVID-19 has increased the importance of recognizing caregivers and their needs. We conducted a scoping review following international guidelines to map the models of support for caregivers and patients with the post-COVID-19 condition. The searches were conducted in electronic databases and the grey literature. The Population, Concept, and Context framework was used: Population: patients with the post-COVID-19 condition and caregivers; Concept: models of caregiver and patient support; and Context: post-COVID-19 condition. A total of 3258 records were identified through the electronic search, and 20 articles were included in the final sample. The studies approached existing guidelines and health policies for post-COVID-19 condition patients and support services for patients and home caregivers such as telerehabilitation, multidisciplinary care, hybrid models of care, and follow-up services. Only one study specifically addressed the home caregivers of patients with this clinical condition. The review indicates that strategies such as telerehabilitation are effective for training and monitoring the patient-family dyad, but the conditions of access and digital literacy must be considered.

Dyadic Peer Support to Improve Diet and Physical Activity Among African American Church Members: An Exploratory Study.

This study examined how African American church members communicated and cooperated as dyads to attain health goals. Participants completed nine weeks of group classes then worked as dyads for nine weeks. Communication logs and interviews were used to assess: (1) dyad communication and (2) dyad cooperation. Thirty-two dyads from three churches completed the study. Dyads communicated an average of two times per week. Dyads experienced challenges and provided encouragement. Findings indicate African American church members cooperate and communicate as family, friend, and acquaintance dyads to achieve health goals.

Unmet Social Needs and Patterns of Hair Cortisol Concentration in Mother–Child Dyads

Background Mothers and their children demonstrate dyadic synchrony of hypothalamic–pituitary–adrenal (HPA) axis function, likely influenced by shared genetic or environmental factors. Although evidence has shown that chronic stress exposure has physiologic consequences for individuals—including on the HPA axis—minimal research has explored how unmet social needs such as food and housing instability may be associated with chronic stress and HPA axis synchrony in mother–child dyads. Methods We conducted a secondary analysis of data from 364 mother–child dyads with low-income recruited during a randomized trial conducted in an urban pediatric clinic. We used latent profile analysis (LPA) to identify subgroups based on naturally occurring patterns of within-dyad hair cortisol concentration (HCC). A logistic regression model predicted dyadic HCC profile membership as a function of summative count of survey-reported unmet social needs, controlling for demographic and health covariates. Results LPA of HCC data from dyads revealed a 2-profile model as the best fit. Comparisons of log HCC for mothers and children in each profile group resulted in significantly “higher dyadic HCC” versus “lower dyadic HCC” profiles (median log HCC for mothers: 4.64 vs 1.58; children: 5.92 vs 2.79, respectively; P < .001). In the fully adjusted model, each one-unit increase in number of unmet social needs predicted significantly higher odds of membership in the higher dyadic HCC profile when compared to the lower dyadic HCC profile (odds ratio = 1.13; 95% confidence interval [1.04-1.23]; P = .01). Conclusion Mother–child dyads experience synchronous patterns of physiologic stress, and an increasing number of unmet social needs is associated with a profile of higher dyadic HCC. Interventions aimed at decreasing family-level unmet social needs or maternal stress are, therefore, likely to affect pediatric stress and related health inequities; efforts to address pediatric stress similarly may affect maternal stress and related health inequities. Future research should explore the measures and methods needed to understand the impact of unmet social needs and stress on family dyads.