Family Health Problems Research Articles

Correlates of Drug Dealing in Female Methamphetamine Users

Female drug dealers have been a neglected population despite their potentially elevated risk for social, legal, family, and psychological health problems. This study examined correlates of drug-dealing behavior in a sample of 209 female methamphetamine users in San Diego, CA. Twenty-five percent of the sample reported dealing methamphetamine in the past 2months. Women who dealt methamphetamine were significantly more likely than their nondealing counterparts to have started using illicit drugs before the age of 13years (68% versus 44.7%, p = .003); to have been introduced to methamphetamine by a parent (15.1% versus 5.8%, p = .037); and to report currently using methamphetamine to stay awake (84.9% versus 64.7%, p = .004), enhance self-confidence (62.3% versus 45.5%, p = .025), and feel more attractive (54.7% versus 38.5%, p = .029). In a multivariate logistic regression, factors independently associated with methamphetamine dealing were: having a spouse or live-in partner (Adjusted Odds Ratio, AOR = 2.89), using methamphetamine with a broader range of types of person (AOR = 1.46), and reporting lower levels of emotional support (AOR = 0.57). These findings suggest that female methamphetamine dealers are in urgent need of access to substance use treatment, therapies to enhance self-worth and emotional support, and family-based substance use prevention interventions for dependent children and those at risk.

Family Function of the Families Consisting of Asian Immigrant Women Living in South Korea

Marriages between Korean men and immigrant women from elsewhere in Asia have increased rapidly during recent years. The aim of this study was to analyze the relationship within families consisting of immigrant women and to identify the relevant factors. The study subjects were 62 Asian immigrant women married to South Korean men living in South Korea. In a baseline study in August 2008, the socioeconomic factors and family APGAR (adaptation, partnership, growth, affection, and resolve) scores were measured. Family APGAR has been widely used to study the relationship of family function and health problems in the busy clinician's office. A 3-year follow-up study was then conducted in August 2011, and the results were compared with the baseline study results. Family APGAR scores were higher at the 3-year follow-up than those at baseline. Changes in family APGAR scores were found to be influenced by the birthplace, reported subjective ability to read Korean, and Center for Epidemiologic Studies-Depression Scale score.

Abstract 285: An Assessment of Factors Associated With Caregiver Burden in Atrial Fibrillation

Background: Nearly one-third of the unpaid adult caregivers in the United States aid in managing heart or cerebrovascular disease. Atrial fibrillation (AF) is the most common cardiac arrhythmia, increasing patients' stroke risk. To date, the burden on caregivers supporting AF patients has not been evaluated. We sought to examine the interrelationship between caregiver, patient and anti-clot treatment characteristics and perceived caregiver burden in AF. Methods: We conducted a cross-sectional survey study of AF patient-caregiver dyads recruited from the cardiology clinics of a large, urban teaching hospital. Eligible patients had AF, were receiving antithrombotic agents for stroke prevention, lived in the community and had an unpaid, English-speaking, adult caregiver. Hierarchical multivariate linear regression was used to evaluate the association between caregiver, patient and anti-clot treatment characteristics and caregiver burden as measured by the validated Caregiver Reaction Assessment (CRA). Results: Eighty AF patient-caregiver dyads completed the survey. The mean (±SD) scores for the 5 CRA domains were: Disrupted schedule (2.4±1.0), Financial problems (2.1±0.8), Lack of family support (1.9±0.7), Health problems (1.9±0.7) and Self-esteem (0.9±0.5). Significantly greater caregiver burden due to Disrupted schedule was seen in those spending >4 hours/week providing care and when caring for frail, sick or disabled patients, with higher CHADS2 scores and requiring help with their medications (p<0.05). Financial problems burden scores were significantly associated with caring for frail patients and those requiring more frequent office follow-up (p<0.05). Lack of family support scores increased as patients' CHADS2 score increased and were inversely associated with having another individual to assist with care. Worse Health problem burden scores were associated with female gender and the need to spend >4 hours/week providing care. Conclusion: Our results suggest that caregivers of AF patients incur the greatest burden due to disruption in schedule. Health care professionals should be cognizant of this, and the other sources of caregiver burden, when managing AF patients.

Family functioning style and health: opportunities for health prevention in primary care

The relationship between family and health has not been studied in detail in primary care. To evaluate the association between family functioning style and health problems among families receiving primary care. Cross-sectional study in an underserved primary care clinic in Santiago, Chile. Families registered at the Juan Pablo II Primary Care Clinic in Santiago, Chile from 2006 to 2010 formed the study sample. Each family selected an adult family member to answer a questionnaire to provide data on: family sociodemographics; health problems among family members; and the family functioning style, as assessed with the Family Functioning Style Scale (FFSS). The t-test was used to assess differences in family functioning styles between families with and without health problems, and analysis of variance was used to study the relationship between the family functioning style and the number of health problems present. A total of 6202 families, comprising 25 037 people, were assessed. The following diseases and conditions were examined: in children--asthma or recurrent bronchitis, delayed development, enuresis or encopresis, behavioural problems, overweight; in adolescents and adults--teenage pregnancy, asthma or chronic obstructive pulmonary disease, smoking, hypertension, type 2 diabetes, major depression, alcohol or drug abuse, and frailty. Families with health problems had a significantly lower FFSS score than families without health conditions. Mental health diseases had the strongest association with family functioning style. An inverse relationship between the number of health problems and the FFSS score was also observed. A better family functioning style was associated with a lower prevalence of health problems in families. Bases for further research considering the family as a target for clinical interventions are provided.

A study of family health problems in Iran from the stakeholders' perspective.

Background:Family health is one of the World Health Organization's (WHO) programs concerning individuals’ and families’ health and development. If properly implemented, family health may ensure the health of human beings and support their self-fulfillment; and may pave the way for bringing up a healthier and better generation by achieving two important and specific quantitative and qualitative results. This study aims at establishing the existing problems in the medical education system with respect to family health, which may be managed by the family health professional if a Masters’ course educational program is developed.Materials and Methods:In this cross-sectional, descriptive study, five Type-1 and four Type-2 and Type-3 universities were randomly selected. Then, the faculty members of health services/public health departments, health managers, health and treatment networks managers, personnel of provincial health centers in family health units, and also public health B. S. students were surveyed on the existing problems in the national health system which can be solved by family health professional. A questionnaire containing one open-ended and several demographic questions was sent by mail for some and personally handed over to some others. Since the data were of a qualitative nature, first the categories were specified through content analysis and then the opinions of each category of individuals were differentiated based on the relevant categories.Results:Results obtained from the comments of the study population led to specification of problems in health system, which could be solved by the family health senior expert. Such problems were categorized into six groups as: Planning and implementation, research, education, management, service-providing, and cultural problems.Conclusion:Given the problems in our nation concerning various family health issues, the field of family health in the levels of associate and bachelor degrees cannot respond to all public requirements, and health personnel in these levels do not possess various professional, planning, research, and educational skills required to analyze family health problems. Therefore, it is suggested that a Masters’ course educational program be developed.

Are Doctors Who Have Been Ill More Compassionate? Attitudes of Resident Physicians Regarding Personal Health Issues and the Expression of Compassion in Clinical Care

Compassion is an attribute central to professionalism and modern clinical care, yet little is known about how compassion is acquired and preserved in medical training. We sought to understand whether personal illness experiences are thought by residents to foster compassion. The authors surveyed 155 (71% response rate) second- and third-year residents at the University of New Mexico School of Medicine regarding their views of the relationship of personal life experience with illness to compassion and empathy for patients. Residents believe that experience with personal health issues enhances physician compassion for patients. Residents who report more personal health concerns, such as physical or mental health problems and family health problems, endorse the connection between direct experience with illness and empathy. Health care trainees' own illness experiences may increase compassionate patient care practices and foster empathy.

P01-75 - Influence of alexithymia, self-concept and health locus of control on alcohol consumption of young Portuguese

Portugal still holds a leading place in the per capita consumption of alcohol at a world level, with high mortality rates due to hepatic cirrhosis, high indexes of road/work killings, besides a vast range of physical and mental, family and occupational health problems caused by alcohol. The narrow connection between juvenile/academic events and alcohol consumption makes youngsters vulnerable to this consumption.A descriptive-correlational and transversal study was conducted with a 552 students’ sample of the Nursing degree aiming to determine some psychological characteristics that might influence/predict alcohol use/abuse in youngsters: alexithymia, self-concept and health control locus. The data collection instrument comprehended: Graffar Social Classification; Toronto Alexithymia Scale (TAS20), What Do I Think Of Health, Self-Concept Clinical Inventory (SCCI) and Alcohol Involvement Scale (AIS).Male gender is related to alcohol involvement (rho = −0.276; p = .000), revealing that 35% of the male gender and 7% of the female are normally drinkers with problems.Externally oriented thought (F3-TAS20) (rho = .084; p = .048), the impulsiveness (F4-SCCI) (rho = .119; p = .005) and the external control locus (rho = .118; p = .005) are correlated to the involvement with alcohol.Hierarchic multiple regression revealed as behaviour predictor variables of that involvement: gender (3.8%; p = .000), impulsiveness (1.4%; p = .005) and self-efficiency with inverse relation (F2-SCCI) (1.0%; p = .015).It is concluded that the choice of preventive strategies must be focused in actions that facilitate personal and social development, that promote personal and social skills, culminating in a freedom of choice by healthy behaviours and life-styles, diminishing the risk of PLA.

일부 초등학생에서 아토피 피부염 증상 관련요인

본 연구는 아토피의 증상정도에 영향을 미치는 요인을 분석하여 초등학생들의 건강관리에 도움을 주는 기초자료를 제시하고자 시도된 연구이다. 연구의 대상자로는 아토피 피부염의 있는 학생의 어머니 273명을 대상으로 하였고 2006년 11월 한 달 간 조사하였다. 연구결과는 연령이 증가할수록 아토피 피부염의 중증도가 높았다(p<0.05). 유병기간이 길수록(p<0.01), 전신에 아토피 증상을 보일수록 중증도가 심했고(p<0.01), 식생활 습관에 있어서는 육식을 많이 할수록 피부염의 증상이 심했으며(p<0.05), 패스트푸드를 자주 섭취할수록 증상이 심해졌다(p<0.05). 아토피성 피부염의 증상정도를 종속변수로 다중 로지스틱 회귀분석을 실시한 결과, 유병기간이 길수록, 패스트푸드 섭취가 잦을수록 아토피 피부염의 증상이 심하였다. 아토피 피부염의 증상이 심할수록 치료를 위한 어머니의 노력정도나 아토피 피부염으로 인해 자녀가 긁기 증상을 보일 때의 애정도, 월평균 관리비용, 부모정서 및 학생의 신체건강 정서 교우관계에 미치는 영향이 큰 것으로 나타났다. 결과적으로 아토피 피부염의 증상악화를 예방하기 위해서는 육식 위주의 식생활 습관의 교정과 패스트푸드 섭취 제한 등 올바른 식생활 습관을 형성하기 위한 교육을 실시하고 또한 아토피 피부염은 가족 전체의 문제로 인식하여 어머니를 포함한 가족 모두를 대상으로 건강관리가 이루어져야 한다. This study was conducted to provide the basic data for the health management of the primary school, by finding and analyzing the factors affecting the degrees of atopic dermatitis symptom's severeness. The subjects of our study were collected 273 pupils mothers, whose children are undergoing through the atopic symptoms. The investigation process took the entire month of the November in 2006. The result of the older the pupils, the severer their symptoms(p<0.05). The longer the period(p<0.01), the more widely spread over the body, and the severer the symptoms(p<0.01). In the dietary habit, the more meat they eat, the severer the symptom(p<0.05). and in relation to the eating the food outside home, the more frequently they eat the fast-food, the severer the symptom. In the multiple logistic regression analysis, using the degrees of atopic dermatitis symptom's severeness as the dependent variables. it is discovered that the longer infection period they have and the more frequently they have the fast-food, the severer the symptom of the atopic dermatitis. The parent's love for the child, the monthly cost for the management of the infection, and the parent's feeling toward the child, can have a greate influence on the physical health, the feelings and the relation with the friends of the infected child, when the child shows the symptoms of scratching his skin. The conclusions of When all the results above are put together, the dietary habit of eating the meals mostly prepared with the meat should be corrected, and the education to form the pupil's right dietary habit, such as, putting the limit on the fast-food, must be made, in order to prevent the symptom of the atopic dermatitis from getting worse. And by the recognizing the atopic dermatitis as the family health problem, the comprehensive family health management, including the mother should be made.

Socidemographic and health characteristics and their relationship with the perception of family support of elderly residents in peripheral areas

ABSTRACTObjective: to determine the influence of sociodemographic and health variables on the perception of family support of elderly residents in peripheral areas. Method: this is an analytical study with a cross-sectional design, using a sample of 150 seniors, mean age of 74.47 (± 9.42) years, enrolled in four Health Units in the municipality of Jequié, Brazil. The instruments used were: sociodemographic data, health conditions, Mini-Mental State Examination (MMSE) and the Perception of Family Support Inventory (PFSI). The research protocols were reviewed and approved by the Ethics in Human Research of the State University of Southwest Bahia (Opinion No. 189/2008). Results: with the application of Student t test between the mean areas of the Inventory of Perceived Family support and sociodemographic variables and health, there was statistical difference between the domain Autonomy and occupation of free time (p = 0.047) and between the domain adaptation and Family health problems (

A Medicina Geral e Familiar e a saúde mental infantil: Um encontro necessário

The general practice is usually the first point of medical contact with the health system, providing open and unlimited access to their clients and dealing with all health problems regardless of age, gender or any other characteristic of the person in question . The family physician occupies in Primary Health Care a key place in any health care system, which provides him with a unique understanding of the health problems of individuals, families and populations, including the child population, which follows from the pregnancy and during the growth and development since the first year of life. The family doctor should still efficiently use health resources by coordinating care, working with other professionals in the context of primary health care and management of interface with other specialties, including three in the child mental health .

Gender Differences Among Older Heroin Users

Objectives: This purpose of this study was to explore the following question: Are there gender differences among older individuals with a history of heroin addiction with regard to social and family relationships and health problems? Methods: Eight gender-specific focus groups were conducted with 38 (19 women, 19 men) older (50+ years) individuals with long-term histories of heroin dependence. Four groups were conducted in a methadone maintenance (MM) clinic and four groups were derived from the Los Angeles community. Results: Modest gender differences were observed, but mainly in the focus-group dynamics. Women typically described the impact of their addiction on their families, while men typically described their surprise at still being alive. Hepatitis C was the primary health concern in all groups; mental health issues were also discussed. Discussion: Remarkable gender differences were not apparent in the qualitative experiences of these participants. Instead, we found overriding similarities related to the interactive effects of drug use and aging. Longitudinal studies of this population as they age and interact with the health-care system and other social systems will help to untangle the complicated relationship between aging, drug addiction, gender, and health.

Tales From Grades 1 Through 12: Understanding the Complex Web of Multiple Life Forces Located in Schools

This study is a qualitative autoethnographical narrative of my grades 1 through 12 experiences in a Catholic school system in Alberta. Autoethnographical research interprets a culture by producing highly personalized and revealing texts; it examines social phenomena holistically and underscores how social histories influence identity development. To this end, this study brings clarity and understanding to the complex web of multiple societal forces in life that are located in schools (e.g., educational policy, hegemonic masculinity and femininity, play and recreation, family history, family health problems, youth identity development, popular culture, care theory, socioeconomic status, extracurricular school clubs) and in making difficult decisions related to improving the ecology of schooling.

Low‐Income Rural Mothers’ Perceptions of Parent Confidence: The Role of Family Health Problems and Partner Status*

Abstract: Parenting confidence can be undermined by the presence of frequent or persistent health problems, particularly for people living in rural communities that have limited access to adequate health care. However, little is known about how minor health problems in the family impact parenting. The current study examined single and coresident mothers’ parent confidence in relation to family health problems and parental support in a sample of 303 low‐income, rural mothers with young children from 14 states. Results show that the presence of family health problems was negatively associated with parent confidence. For coresident mothers, there was an indirect relationship through perceived parental support.

Understanding Clinical Complexity in Delinquent Youth: Comorbidities, Service Utilization, Cost, and Outcomes

This study describes the extent and severity of multiple comorbidities in a juvenile detention center population, and explores how these numerous problems impact the utilization of treatment services, costs, and outcomes including those for substance abuse, mental illness, and criminal activity. Cluster analyses of the outcome scales at intake yielded two groups: youth high (42%) and youth lower (58%) on all factors. Girls experienced the most significant impairments across emotional problems, behavior complexity, internal mental distress, and victimization domains, utilized significantly more units of residential treatment, individual counseling and case management, and had the highest treatment costs. The total cost of services ($1,171,290, N = 114) was significantly related to substance problems in the past year (r = .219, p < .05), emotional problems (r = .237, p < .05), behavior complexity (r = .318, p < .05), internal mental distress (r = .263, p < .05), environmental risk (r = .205, p < .05), and conflict tactics (r = .240, p < .05). Despite initial differences in measures of baseline severity, high and low cluster youth, and boys and girls in general, achieved similar results on the key outcome variables 12 months later. Study implications include a need for co-occurring, integrated treatment efforts that address family, emotional, and mental health problems of delinquent youth (especially females) in order to improve their ability to successfully attend to substance abuse problems and interpersonal conflicts.

Mental Health Problems in Children and Caregivers in the Emergency Department Setting

Although mental health problems are increasing in the primary care sector, the prevalence of mental health problems in families presenting for nonpsychiatric complaints in the emergency department (ED) setting is generally unknown. As such, we set out to assess the frequency of mental health concerns and associated risk factors in children presenting for care in a pediatric ED. A total of 411 mother-child dyads were randomly selected during a 2-year period from the less acute area of a large pediatric ED. Mothers were interviewed for child mental health concerns using structured diagnostic instruments. Mothers were also interviewed for their own mental health symptoms. Risk factor analysis for the outcome of a pediatric mental health concern was performed using bivariate and multivariate techniques. Of all children, 45% met criteria for a mental health concern, with 23% of all children meeting criteria for two or more mental health concerns; 21% of mothers screened positive for a mental health problem themselves. Once adjusted, children whose mothers' screened positive for a mental illness were more likely to have a mental health concern themselves. There is a large burden of mental health concerns in children and their mothers presenting to the ED for medical care. Efficiently and accurately identifying mental illness in children presenting to a pediatric ED is the first step in the intervention process for a population that might otherwise slip through the system.

Factors Influencing Agreement in Symptom Ratings By Lung Cancer Patients and Their Significant Others

Comparisons of symptom ratings and health-related quality of life between significant others and patients have been the focus of numerous studies during the past decades. Additional studies are needed to assess the discrepancies identified in this work. In the present cross-sectional exploratory study, focus has been on evaluating the accuracy of significant other proxy ratings and on investigating factors that influence agreement between lung cancer patients and significant others based on dyadic assessments from 52 patients and 54 significant others. Results indicate that the levels of agreement are fair to good, but that significant others consistently rate the patients' symptoms higher and functioning lower than the patients do themselves. Factors found to influence agreement in various dimensions of symptoms and functioning were gender, patient age, and significant others' self-reported lack of family support, health problems, and caregiver esteem.

Which factors impact on clinician-rated impairment in children with ADHD?

To describe the associations between a range of demographic, family and clinical factors and clinician-rated measures of global impairment in children with ADHD symptoms obtained at the baseline assessment in the ADHD Observational Research in Europe (ADORE) study. Global impairment was measured by clinicians using the Clinical Global Impression-Severity (CGI-S) scale and the Children's Global Assessment Scale (CGAS). Associations with independent variables were investigated using forward-stepwise regression models. For the CGI-S and CGAS analyses, complete data sets were available for 1,265 and 985 children, respectively. The baseline mean CGI-S score in this population was 4.4 (SD 0.9) and the mean CGAS score was 55.0 (SD 10.6). Factors significantly associated with increased impairment on both outcome measures were: increased severity of ADHD symptoms, increased peer relationship problems and presence of oppositional defiant disorder and/or conduct disorder. Also, the presence of anxiety and/or depression and the presence of somatic symptoms were associated with increased impairment on CGI-S,while family health problems and premature birth were associated with increased impairment on CGAS. The severity of clinician-rated impairment in the ADORE sample is increased by the presence of disruptive behaviour problems and emotional problems, somatic symptoms, peer relationship difficulties, family health problems and premature birth.

The Impact of Multiple Losses on the Grieving Process: An Exploratory Study

ABSTRACT Twenty-eight responders (23 women, 5 men) to an invitation in Mothers Against Drunk Driving (MADD) publications were interviewed by telephone to assess the impact of multiple losses on the grieving process. All had experienced death(s). Most had also experienced self- or family injury, health problems, divorce or separation, or other problems. Grief lasted longest for losses close in time, was completed soonest when losses were more spaced apart, and required an intermediate amount of time for simultaneous losses. People generally grieved one loss at a time, even for simultaneous losses. Personal injuries altered grieving patterns. Multiple losses affected individuals' health, marriages, faith, finances, jobs, emotions, and personalities.

Predictors of Missed First Appointments at Community Mental Health Centers After Psychiatric Hospitalization

This study was conducted to determine the practical, readily accessible predictors of missed first outpatient appointments in a community mental health setting after psychiatric hospitalization. Data were collected from treatment team members and from charts of 234 consecutively discharged patients from two inpatient units in a large, urban, county hospital. Data on whether the patient attended the first scheduled outpatient community mental health appointment were gathered by telephone contact with outpatient clinics. Outcome data were available for 221 patients. Bivariate tests examined a variety of demographic, psychosocial, and clinical characteristics that may be associated with nonadherence. Significant predictors were entered into a logistic regression model to determine effect estimates (adjusted odds ratios). In bivariate tests, a number of variables were predictive of nonadherence with the first scheduled outpatient appointment. In the logistic regression model, the four characteristics that were independently significant predictors included involuntary legal status at discharge or leaving against medical advice, not having an established outpatient clinician, axis IV problems related to the primary support group (for example, death of a family member or health problems in the family), and number of days from hospital discharge to the follow-up appointment. Clinical, policy, and programmatic implications may be elaborated by studying risk factors for nonadherence in a community mental health setting. Given the multitude of problems associated with nonadherence, interventions should be tailored around specific characteristics that elevate the risk of nonadherence, especially nonadherence in the form of failure to attend the first appointment after psychiatric hospitalization.

Running on Empty: Families, Time, and Workplace Injuries

Over the past 5 decades, more women have entered the labor force, and more households have been headed by single parents. Both trends have substantially reduced parents' free time, creating added strain in the event of family health problems, including work-related injuries and illnesses. This commentary presents evidence about the impact of occupational injuries on today's families. In addition to losing considerable income, injured parents are less able to do household work, and other family members are often called on to care for them. Family members cut back on their paid, school, and household work to fill in for the injured parent. This suggests the importance of policies to help today's time-strapped families cope with major family health events.