Family Stress Research Articles

Perceived barriers of family-centred care in neonatal intensive care units: A qualitative study.

Family-centered care (FCC) approach in neonatal intensive care units (NICUs) has been shown to improve family satisfaction and quality of care. However, several contextual barriers influence its use in NICUs, and these barriers are understudied in Ghana. To describe FCC practice in Ghanaian NICUs in order to understand the contextual barriers. The study employed a descriptive qualitative design. The researchers used a structured interview guide to collect the data in 24 interviews and 12 focus group discussions. We engaged families (n = 42), nurses and midwives (n = 33), and doctors (n = 9) to describe their perspectives on the barriers to FCC in two public tertiary hospital NICUs. The data were mapped, triangulated, and aggregated to inform the findings. Thematic analysis and MAXQDA qualitative software version 2020 were employed to analyse the data. This qualitative study followed the COREQ guidelines and checklist. Perceived family barriers and perceived facility barriers to FCC were the two main themes. The perceived family barriers include family stress and anxiety, inadequate information sharing and education, culture and religion. The perceived facility barriers are inadequate space and logistics, workload and inadequate staff, restricted entry, and negative staff attitudes. The findings of this study shed light on the barriers to FCC practice in neonatal care in Ghanaian NICUs. Family stress and anxiety, a lack of information sharing, cultures and religious beliefs, NICU workload and staffing shortages, restrictions on family entry into NICUs, and staff attitudes towards families are all contextual barriers to FCC practice. Health facility managers and NICU staff may consider addressing these barriers to implement FCC in the NICU in order to enhance family satisfaction and quality neonatal care. The design of future NICUs should consider family comfort zones and subunits to accommodate families and their sick infants for optimal health care outcomes. The development of communication models and guidelines for respectful NICU care may aid in integrating families into ICUs and promoting quality health care outcomes.

Parent Perceptions and Opinions of Universal Free School Meals in Arizona.

To support families during the COVID-19 pandemic, the USDA allowed all US schools to offer meals at no cost regardless of family income, a policy referred to as Universal Free Meals or Healthy School Meals for All (HSM4A). Despite the recognized benefits and popularity of HSM4A during the pandemic, the policy expired in June 2022. The goal of this study was to gather perceptions of parents in Arizona about school meals, the HSM4A program, and the discontinuation of HSM4A. In collaboration with a local anti-hunger group, using an online survey distributed in September and October 2022, we collected data from a diverse sample of over 2000 parents living in Arizona. Parents unequivocally supported HSM4A during the pandemic (97%) and expressed support for continuing to offer HSM4A (95%). High levels of support were seen across all groups in the study, including from individuals who identified as politically conservative. We also analyzed 750 responses to an open-ended question asking respondents to share their thoughts about offering meals to all Arizona students regardless of family income. The majority of emergent themes related to perceived benefits of HSM4A, including reducing financial burden and stress for families. Our findings will be useful for advocates and policy makers considering HSM4A legislation.

Evaluating the efficiency of medical care for children with diabetes mellitus in different regions of Ukraine over the past 20 years (2002–2021) of peacetime

Background. The growing number of children with diabetes creates a global economic problem, including a financial burden on the country’s health care system and economic stress for families of children with diabetes. The purpose was to assess the effectiveness of medical care for children with diabetes in different regions of Ukraine over the last 20 years (2002–2021) of peacetime. Material and methods. The article presents the results of statistical evaluation and epidemiological analysis of data from the Center for Medical Statistics of the Ministry of Health of Ukraine on the rates of disability, hospitalization, and inpatient care among the pediatric population in 2002–2021. Statistical processing of the results was carried out using MS Excel, XLSTAT-Pro. Results. During 2002–2021, an increase in the rate of primary disability due to diabetes mellitus was highest among adolescents — by 4.1 times and lowest among primary schoolchildren — by 3.4 times; among children 0–6 years old, it increased by 3.6 times. The proportion of children with disabilities due to diabetes as of 2017 is 12 % among the age group of 0–6 years, and 25 % in adolescents (15–17 years). In 2013–2021, the hospitalization rate among children with diabetes increased from 1.27 to 1.35 per 1,000 of the relevant population, and the average length of hospital stay decreased by 19 %. The rate of mortality due to diabetes complications among hospitalized children varies and does not have a specific trend (in 2021, it was 0.02 per 100 in-patients). Conclusions. The analysis of the efficiency of medical care for children with diabetes during 2002–2021 in the context of increasing prevalence and incidence of diabetes showed stable trends towards a huge increase in the level of primary and general disability, a slight increase in hospitalization rates, and a decrease in the average length of hospital stay. These results call for a detailed study of the causes, control, and revision of protocol documents for the management of such patients.

Beyond Empathy: Familial Incarceration, Stress Proliferation, and Depressive Symptoms Among African Americans

Abstract Women tend to be more vulnerable to the adverse psychological effects of “network events” (stressors that occur to loved ones). The cost-of-caring hypothesis is regarded as the primary mechanism for this vulnerability and posits that women’s relatively high level of emotional involvement in the lives of network members causes women to experience greater empathetic reactions when loved ones encounter stressors. Drawing on the stress process model, gender theory, and research on the collateral consequences of incarceration, we theorize stress proliferation, the process by which an initial stressor induces secondary stressors, as an additional mechanism and empirically test our theoretical propositions using the case of African Americans with an incarcerated family member. Using data from the National Survey of American Life, we ask: are African American women more vulnerable to the depressive effects of familial incarceration compared to African American men? If so, to what extent might African American women’s heightened vulnerability be explained by their greater susceptibility to stress proliferation? Results suggest that familial incarceration is associated with greater chronic strains, financial strain, and family conflict only among African American women. Further, the magnitude of the association between familial incarceration and depressive symptoms is significantly larger among African American women; however, after adjusting for stress proliferation variables, the gender difference in vulnerability attenuates and becomes statistically nonsignificant. We conclude that the emotional cost of caring may be compounded by social and economic costs of caregiving, heightening women’s vulnerability to depression following disruptive network events.

Gender identity differences in the experiences of family stressors and violence among transgender and non-binary individuals in China.

Emerging research has demonstrated that transgender and non-binary (TNB) individuals face an elevated risk of experiencing family rejection and violence. However, there remains a significant knowledge gap regarding how TNB individuals manage stressors and their gender identity within the family context, particularly in regions where TNB individuals are highly stigmatized and where legal protections against family violence are lacking. The present study represents one of the first pioneering efforts to provide large-scale quantitative data examining the experiences of family stressors, the management of gender identity and expression, and family violence among TNB individuals in China. A national sample of 1063 TNB individuals in China was involved in the study. They completed questionnaires about their experiences of family stressors and violence. The results indicated that 76.0% of TNB individuals reported having encountered at least one form of violence perpetrated by their family members. Transfeminine individuals were more likely to report experiencing emotional and physical abuse, whereas transmasculine individuals were more likely to be subjected to gender identity and/or expression change efforts. Family stressors, including family non-acceptance and the pressure to marry and reproduce, were positively associated with non-disclosure of gender identity, the suppression of gender expression, and family violence. The findings underscore the substantial burden of family violence borne by TNB individuals in China, which warrants immediate legal, institutional, and social responses. Trans-inclusive family violence prevention and intervention are urgently needed, with a focus on Chinese cultural factors and gender identity differences in violence screening and risk assessment.

How food insecurity affects children's behavior problems in early childhood: The nutrition and family stress pathways.

This study examines how household food insecurity shapes young children's behavior problems in Singapore. The analysis is based on two waves of data collected before and during COVID-19 from a nationally representative sample of 2,601 children in the Singapore Longitudinal Early Development Study (SG-LEADS, Mage = 4.5 at wave 1, Mage = 6 at wave 2). Results based on propensity score matching, fixed effects analysis and lagged-variable models show a positive association between household food insecurity and children's behavior problems both concurrently and over a two-year period. Two mediating pathways of this association are identified-children's dietary intake and family stress. Children in food-insecure households tend to consume fewer vegetables and more sugar-sweetened beverages and carbohydrates, which is associated with elevated behavior problems. Parents in food-insecure households exhibit greater emotional distress, diminished parental warmth, and increased punitive parenting practices, also contributing to their children's behavior problems. The family stress pathway has a stronger explanatory power than the nutrition pathway on children's behavior problems. This study reveals that food insecurity is a risk factor for children's behavior problems in early childhood which can lead to later developmental vulnerabilities for children in financially deprived families.

Early adversity and family resilience factors in children with autism spectrum disorder: A narrative review

Global estimates indicate that autism is a neurodevelopmental condition that is currently diagnosed in 1 in 100 people across the world. Autistic children can experience deficits in social communication, often linked to difficulties with joint attention and facial emotion recognition. Restrictive repetitive behaviors and interests (RRBIs) are also part of the diagnostic criteria of autism and are associated with lower adaptive skills. Due to social challenges and RRBIs exhibited by autistic children, they may be at higher risk for experiencing social and familial stressors. In non-autistic children, early adversity is predictive of deficits in executive functioning, neurological changes, and poor adult health. However, resilience factors have been identified, which can offset the negative impacts of adversity. In autistic children, these protective factors may have differential downstream influences on children's outcomes due to cognitive and social difficulties. In this narrative review, we report that autistic children are more likely to experience familial and environmental stressors compared to non-autistic children. Resilience factors such as positive parenting, sleep, social relationships, and executive functioning skills were identified as key areas for future research. Lay summary Children with autism are statistically more likely than their peers to be exposed to adverse childhood events including bullying, parental divorce, and poverty. The more severely affected a child is by autism the greater the likelihood they will be exposed to early life stress. This indicates that the most vulnerable children with autism who have limited adaptive skills to promote resilience to stress may have the highest exposure to stressful events during their childhood. In turn, a better understanding of how early adversity impacts children with autism is needed as well to characterize resilience factors that promote optimal outcomes. In this review of the literature, it was found that children with autism may experience more stress from their family and surroundings compared to children without autism. Factors that can help these children cope better were identified, including supportive parenting, getting enough sleep, having friends, and having good problem-solving skills. This research could help parents and teachers better understand how to support children with autism who are experiencing early adversity.

Diagnostic services for developmental coordination disorder: Gaps and opportunities identified by parents.

Affecting one in 20 children, Developmental Coordination Disorder (DCD) is a common neurodevelopmental disorder impacting a child's ability to learn motor skills. Despite its high prevalence, DCD is under-recognized and under-diagnosed, causing unnecessary frustration and stress for families who are seeking help for their child. This study aimed to understand how parents procure diagnostic services and their perspectives on needed supports and services to improve early identification and diagnosis of DCD. Using a multi-pronged recruitment strategy, we circulated the impACT for DCD online questionnaire to parents of children (<18 years) in British Columbia with suspected or diagnosed DCD. Data were analysed descriptively using medians/interquartile ranges for continuous data and frequencies/percentages for categorical data. Open-ended questions were analysed using exploratory content analysis. A total of 237 respondent data were analysed. Parents identified poor awareness and understanding of health care professionals and educators regarding aetiology, symptomology, and impacts of DCD, affecting timely access to diagnostic services. Long waitlists were also a barrier that often led families with financial means to procure private diagnostic assessments. A standard of care is needed for streamlined diagnostic services, enabling early identification and early intervention. A publicly funded, family-centred, collaborative care approach is critical to assess, diagnose, and treat children with this disorder and to mitigate the secondary physical and mental health consequences associated with DCD.

СЕМЕЙНЫЕ РИТУАЛЫ КАК СТРЕССОРЫ: СОЦИАЛЬНО-ПСИХОЛОГИЧЕСКИЙ И МАРКЕТИНГОВЫЙ АНАЛИЗ

The article considers the main stages of the family’s life path and the boundary events separating them from each other, which, in turn, are accompanied by family stressors and rituals. Two events were selected for a more detailed analysis: the discharge of the mother and child from the maternity ward and the child’s baptism. Those events were described from the standpoint of the theory of family stress, as well as some socio-demographic parameters and socio-psychological attitudes of spouses who experienced the discharge of the mother and child from the maternity ward or the child’s baptism. The marketing aspect of the events is analyzed by using the results of interviews with representatives of the target audience (to clarify its features) and content analysis of social networks. Within the framework of the academic societal science on the family the prospects for studying a wider range of boundary events separating one stage of the family’s life path from another, and stressors and/ or rituals from the perspective of the theory of family stress, as well as factors of marriage success, are outlined. In addition, the information obtained can be used to more effectively promote the products accompanying those events.

Gender discrimination and family stressors: Perceptions and experiences of women police officers

Abstract Women police officers may experience discrimination and work–life balance challenges that can impede their entry into and advancement and retention within police organizations. This study used in-depth interviews with 14 women police officers in the St. Louis, MO, metropolitan region to examine workplace stressors, experiences within policing, and perceptions of whether and how gender influenced those stressors and experiences. Participants expressed that they experienced discrimination based on gender, including direct discrimination, such as denial of specialized training, denial of lateral changes in duty assignments, and barriers to career advancement, and indirect discrimination in the form of teasing, harassment, and higher expectations. Many participants also reported they deployed coping strategies to insulate themselves from those experiences, isolated themselves from situations that might result in discrimination or harassment, or sought ways to mitigate the harm of those experiences. Police departments must create environments that support not just gender representation but gender equity.

Family Stress and the Intergenerational Correlation in Self-Control

Family Stress and the Intergenerational Correlation in Self-Control

Factors associated with the occurrence of adult acne in African tropical environment

Aim To identify the risk factors associated with the occurrence of adult acne in tropical Africa. Materials and methods This was a matched case-control study at the Dermatology-Venerology Department of the Treichville University Hospital from January 5 to September 24, 2021. Cases were patients aged 25 years and older seen in consultation for recent acne. Controls were patients consulting in the same department without acne. We recruited two controls for one case by matching them on sex and age. SAS software version 9.4 was used for statistical analyses. Results We interviewed 1089 patients, of whom 144 were men and 945 were women. The cases consisted of 48 men and 315 women. The acne patients had a professional activity that exposed them to the sun most frequently (73%) and were mostly single (70%). The median age of the patients was 29.64 years, the median body mass index was 24.03 kg/m2. The median number of lesions was 10 (forehead), 15 (right cheek), 15 (left cheek), 10 (chin) and 8 (lower lip). After adjustment, variables associated with acne were sun exposure (OR = 2.19), low seafood consumption (OR = 6.74), family stress (OR = 2.53) and skin depigmentation (OR = 14.17). Conclusion The factors associated with adult acne in tropical environments are numerous. In our study, seafood seems to have protective effects against acne.

Association between Socioeconomic Position of the Family and Adolescent Obesity in Germany-Analysis of the Mediating Role of Familial Determinants.

Obesity's negative impact on young people's health has long been known. The family and its socioeconomic position (SEP) are key determinants in adolescent obesity. However, understanding which familial determinants explain the association remains limited. The analyses are based on data from the "German Health Interview and Examination Survey for Children and Adolescents" (KiGGS) (1,384 females and 1,332 males aged 11 to 17 years). Logistic regression models explored how familial determinants (family stress, family cohesion, parental smoking, parental sporting activity, and parental overweight) mediated the association between family SEP (parental education, occupational status, and household income) and adolescent obesity. Significant total effects for the associations between family SEP in childhood and adolescent obesity were found. Splitting the total effect of the family SEP on obesity into direct and indirect effects, all direct effects turned out to be significant. However, all associations involved also indirect effects of familial determinants, except for household income for female adolescents. Parental smoking and overweight were the most relevant mediators for males and females. For male adolescents, parental sporting activity additionally mediated the association between SEP and obesity. A low SEP in childhood was associated with adolescent obesity. Parental health and health behaviors partly explained the association. For increasing health equality in adolescent health, the consideration of parental health behavior in the planning and implementation of health promotion programs seem to be important.

The Intersection of Childcare and Health Among Women at a U.S. Safety-Net Health System During the COVID-19 Pandemic: A Qualitative Study.

Lack of childcare has been linked to missed health care appointments for adult women, especially for lower-income women. The COVID-19 pandemic created additional stressors for many low-income families that already struggled to meet childcare and health care needs. By exploring the experiences of women who were referred for childcare services at a U.S. safety-net health system, we aimed to understand the challenges women faced in managing their health and childcare needs during the COVID-19 pandemic. We conducted semistructured interviews with participants in Dallas County, TX between August 2021 and February 2022. All participants were referred from women's health clinics at the county's safety-net hospital system to an on-site drop-off childcare center by hospital staff who identified lack of childcare as a barrier to health care access. Participants were the primary caregiver for at least one child ≤age 13. Interviews were conducted in English or Spanish. We analyzed data using thematic content analysis. We interviewed 22 participants (mean age 34); participants were adult women, had on average 3 children, and primarily identified as Hispanic or African American. Three interrelated themes emerged: disruptions in access, competing priorities, and exacerbated psychological distress. Findings demonstrate how low-income women with young children in a safety-net health system struggle to address their own health needs amid childcare and other household demands. Our study advances our understanding of childcare as a social domain of health, a necessary step to inform how we build structural support systems and drive policy interventions.

Parental Stress and Coping Mechanisms in Families with Children on The Autism Spectrum

Parental Stress and Coping Mechanisms in Families with Children on The Autism Spectrum

Impact of Familial and Social Stressors on University Students’ Learning Outcomes, Satisfaction, and Academic Achievements

Impact of Familial and Social Stressors on University Students’ Learning Outcomes, Satisfaction, and Academic Achievements

U.S. Mexican-origin young adults' mental health relative to interpersonal stressor transitions from childhood to adolescence.

This study sought to describe latent transitions in developmentally and culturally salient interpersonal stressors from late childhood to late adolescence and examine whether different transition patterns predicted early adult mental health problems. Data from four waves (Grades 5, 7, 10, 12) of a study of 749 U.S. Mexican-origin youth were used for a latent transition analysis (LTA) of family, peer, and community stressors; distal outcomes of externalizing and internalizing problems were measured 5 years after Grade 12. Latent class analysis (LCA) and LTA were conducted for investigating underlying subgroups of interpersonal stress at each wave and transitions between subtypes over waves. For the LCA, two latent classes emerged at all four waves, representing low and high interpersonal stress. The LTA model with two classes at all waves was conducted with good fit. Six prominent transition classes emerged and related to young adult internalizing and externalizing problems. Transition class related to young adult internalizing and externalizing problems, such that youth who consistently had exposure to interpersonal stress or who had transitions from low to high exposure had more internalizing and externalizing problems. Findings are discussed relative to the developmental salience of these transitions and opportunities to intervene during adolescence to mitigate later mental health problems. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Factors associated with concurrent alcohol, tobacco and illicit drug use: 2019 National School-Based Health Survey.

The aim of this study was to analyze the factors associated with concurrent alcohol, tobacco and illicit drug use among Brazilian schoolchildren aged 13-17. We conducted a cross-sectional study using data from the 2019 National School-Based Health Survey. The outcome was use of the three substances during the last 30 days. Hierarchical multiple logistic regression was carried out with independent variables grouped into four blocks: sociodemographic characteristics; family context; behavioral aspects; and stressors. Variables with p<0.05 were retained in the final model. The prevalence of concurrent substance use was 3.3%. Being male, living in the Midwest, South and Southeast, skipping school without parent permission, parents not knowing what their children do in their free time, having parents who smoke, having experienced physical aggression from parents, feeling that life is not worth living, trying drinking and illicit drugs before the age of 13, and having friends who drink alcohol, smoke and use drugs in their presence remained associated with the outcome in the final model. The findings reveal high prevalence of concurrent alcohol, cigarette and illicit drug use among adolescents and that poly use is associated with sociodemographic, family, and behavioral factors and stressors.

Fatores associados ao policonsumo de álcool, tabaco e drogas ilícitas: Pesquisa Nacional de Saúde do Escolar 2019

Abstract The aim of this study was to analyze the factors associated with concurrent alcohol, tobacco and illicit drug use among Brazilian schoolchildren aged 13-17. We conducted a cross-sectional study using data from the 2019 National School-Based Health Survey. The outcome was use of the three substances during the last 30 days. Hierarchical multiple logistic regression was carried out with independent variables grouped into four blocks: sociodemographic characteristics; family context; behavioral aspects; and stressors. Variables with p&lt;0.05 were retained in the final model. The prevalence of concurrent substance use was 3.3%. Being male, living in the Midwest, South and Southeast, skipping school without parent permission, parents not knowing what their children do in their free time, having parents who smoke, having experienced physical aggression from parents, feeling that life is not worth living, trying drinking and illicit drugs before the age of 13, and having friends who drink alcohol, smoke and use drugs in their presence remained associated with the outcome in the final model. The findings reveal high prevalence of concurrent alcohol, cigarette and illicit drug use among adolescents and that poly use is associated with sociodemographic, family, and behavioral factors and stressors.

Health Crowding-Out Effect of Family Migration on First Cohort Migrant Workers: An Empirical Analysis.

In the dynamic panorama of China's shifting social mobility, characterized by a transition from individual to family mobility, the migration of the first cohort of migrant workers and their families has taken center stage. However, the scholarly discourse on how family migration influences the health of migrant workers remains contentious. This study uses data from the China Migrants Dynamic Survey (CMDS) of 2017 to focus on the first cohort of migrant workers. Drawing on the theories of family stress and life course, the empirical analysis incorporated heterogeneity tests, total effects, robustness tests, mediation effects, and propensity score matching to explore the mechanisms underlying the impact of family migration on migrant workers' health. Data analysis reveals a substantial negative impact of family migration on the health status of the first cohort of migrant workers. Variations in health outcomes were identified across different family migration patterns. Further analysis indicates that the first cohort of migrant workers, when confronted with family livelihood pressures, tends to prioritize economic resources to support urban family life over their own health. This is because they are influenced by a family-centered culture. Our findings reveal a nuanced landscape. While family migration provides potentially enhances social support systems, it also imposes significant health trade-offs due to increased life stressors. These stressors include economic instability, increased responsibility for family care, and the psychological impacts of adapting to new urban environments. There are the health crowding-out effect of family migration on first cohort migrant workers.