Family Support Research Articles

Time to initiation of antiretroviral therapy and its predictors among newly diagnosed HIV positive at the selected public health centers in Adama Town, Ethiopia

IntroductionAntiretroviral therapy (ART) has significantly reduced HIV infections, but late initiation remains a major issue. This study aimed to identify predictors of ART initiation among newly diagnosed HIV-positive patients in Adama town.MethodA retrospective cohort study was conducted, with 396 newly diagnosed HIV-positive patients. This study used a survival analysis approach, including Kaplan-Meier plots, the log-rank test, and the Cox proportional hazards model.ResultThe incidence rate was 152 per 1000 person-days for early initiation after HIV positive confirmed. In the adjusted model, gender, VCT test, disclosure status, having children in the home, opportunistic infections, and HIV/TB co-infections were significantly associated with time to ART initiation.ConclusionTo enhance early ART initiation, healthcare programs should prioritize support for women patients, promote HIV serostatus disclosure, and improve access to VCT testing. Targeted interventions for those with comorbidities and support for families with children are also essential.

Reevaluating Locus of Control Among Older Karen Refugees in Long-term Resettlement: An Interpretative Phenomenological Analysis

Abstract Background and Objectives Recent literature has applied locus of control (LOC), a psychological measure for understanding individuals' perceived control, to forcibly displaced populations. An internal LOC is generally considered beneficial for well-being in the Western context. However, the cross-cultural validity of this construct warrants further examination. This study aimed to capture the lived experiences of older Karen refugees in resettlement. Through this open-ended exploration, a narrative of subjective control emerged that diverged from Western assumptions. Notably, findings revealed that a sense of external LOC, viewed positively, was the cultural norm for this group, challenging the universality of Western LOC constructs and their presumed relationship to well-being. Research Design and Methods This qualitative study explored the lived experiences of forced displacement and long-term resettlement among ten older Karen refugees (age 55 and older) from Burma, utilizing in-depth interviews and interpretative phenomenological analysis. Results Findings highlighted four emergent themes that underscore a divergence from the individualistic assumptions underlying the LOC construct, emphasizing an external LOC, collective orientation, familial interdependence, and community support networks. Discussion and Implications Findings underscore a divergence from the individualistic assumptions underlying the LOC construct, emphasizing how older Karen refugees collectively navigate aging and displacement by relying on familial and communal support. This study reveals that traditional applications of the LOC construct may not fully capture the complex realities of refugees from collective cultures, suggesting the need for culturally sensitive research methodologies and culturally adapted psychometric measures and intervention strategies.

Social Determinants and Developmental Factors Influencing Suicide Risk and Self-Injury in Healthcare Contexts

Background: Suicide is a global public health issue, particularly in low- and middle-income countries and among vulnerable groups such as adolescents. Despite increasing research efforts, understanding the psychosocial factors associated with suicidal behavior remains a challenge. This study examines family and personal histories of suicidal behavior, exposure to violence, empathy, and perceived social support in adolescents who have received healthcare services in Ecuador. Methods: A cross-sectional study was conducted with 438 adolescents aged 12 to 18 years. Participants were classified into suicide attempt survivors (AS, n = 58) and non-attempters (NAS, n = 380). A characterization questionnaire was applied (prior hospitalization for suicide attempt, family history, and survivor condition), the Alexian Brother Urge to Self-Injure scale, the Plutchik Suicide Risk Scale, the Multidimensional Scale of Perceived Social Support, and the Cognitive and Affective Empathy Test. Results: Adolescents with a history of suicide attempts exhibited higher levels of self-injurious behavior impulse (OR = 8.90, CI 95% [4.28–18.52], p < 0.001), Gravity attempt (OR = 8.162, CI 95% [4.34–15.37], p < 0.001), and suicide risk (OR = 2.90, CI 95% [1.42–5.94], p = 0.006). A significant association was found between suicide attempts and exposure to domestic (p = 0.000), school (p = 0.000), and sexual violence (p = 0.000). A family history of suicide attempts increased the likelihood of suicidal behavior in adolescents (OR = 2.40, CI 95% [1.12–5.16], p = 0.022). In contrast, perceived family support acted as a potential protective factor (OR = 0.36, CI 95% [0.15–0.91], p = 0.055). Conclusions: These findings highlight the need for prevention strategies that address social and developmental factors.

Lived Experience of South Korean Pregnant Women at Work During the COVID-19 Pandemic: A Qualitative Study.

This study examined South Korean pregnant women's workplace experiences through Meleis' transition theory. Twenty participants engaged in online focus groups, discussing pregnancy, childbirth, prenatal care, and COVID-19 concerns. Content analysis revealed 15 themes reflecting transition theory's components. Participants were mostly first-time mothers in their second trimester. Transition facilitators included supportive family and health checks, while inhibitors comprised workplace stress and COVID-19 risks. Transition responses included worries about delivery pain and infant expectations. Nursing interventions recommended encompassed diet, exercise, and psychological support. The findings suggest health care providers should understand and address these transitions with tailored prenatal interventions.

Sex, Resilience and Psychological Well-Being in Mexican University Students

Mental health is currently highly relevant in society and one of the factors that could contribute to its improvement is psychological well-being, hence the importance of conducting studies that focus on analyzing variables that predict psychological well-being. Therefore, the goal of this research is to use models of structural equations to analyze the relationships among the variables of sex and resilience for psychological well-being. The total sample was 1190 Mexican university students, with an average age of 20.66 years (SD = 1.89). The results indicate that the resilience factors (strength and confidence, family support, and social support) are the variables with the greatest explanatory power on psychological well-being. It also highlights the mediating capacity of the strength and confidence factor between the other two resilience factors (family support, social support) and perceived psychological well-being. The implications of the study are that sex and two of the dimensions of resilience (family support and social support) show an indirect and positive effect on the perception of psychological well-being through the strength and confidence factor. Therefore, when implementing interventions to improve psychological well-being, these factors should be considered in order to have a greater positive impact on the population that is being studied. Future research should replicate these findings in larger samples.

The relationship between resilience and mental health: mobile phone dependence and its differences across levels of parent-child conflict among left-behind adolescents: a cross-sectional network analysis

BackgroundMobile phone dependence and mental health problems have become increasingly prominent among left-behind adolescents in China. In recent years, some studies have focused on the important role of parent–child relationship and psychological resilience. Therefore, this study aims to explore the multidimensional relationships among resilience, mental health, and mobile phone dependence among left-behind adolescents, and to assess the impact of parent–child conflict level on these relationships.MethodsThe Brief Symptom Inventory (BSI-18), the Chinese version of the Mobile Phone Addiction Index (MPAI), the Resilience Scale for Children and Adolescents (RSCA), and the Parent–Child Conflict Scale were used to investigate 2,100 left-behind adolescents in Sichuan Province, and R was run to make network analysis and network comparison.Results(1) A structurally stable network relationship exists between left-behind adolescents' resilience, mental health, and mobile phone dependence; (2) BSI3 (Anxiety) is the most important node of the network model, followed by MPAI1 (the inability to control cravings subscale); (3) MPAI1 (the inability to control cravings subscale) and RSCA4 (family support) are key to connect resilience, mental health, and smartphone addiction in the study sample; (4) There was a significant difference in the network structure between the high- and low-level groups of parent–child conflict, no significant difference in the global strength of the network, and a significant difference in the centrality of strength and the centrality of bridge strength.ConclusionsChinese left-behind adolescents' resilience and mental health, mobile phone dependence are both independent and interact with each other to some extent. Specifically, high centrality dimensions such as anxiety, the inability to control cravings, and family support can be prioritised for intervention in related treatments, or reducing parent–child conflict and enhancing resilience to mitigate mobile phone dependence among left-behind adolescents, thus improving their mental health.

Path Analysis on Determinants Affecting Adherence to Pharmacological Treatment of Type 2 Diabetes Mellitus in Farmers

Type 2 diabetes mellitus is a non-communicable disease and is a major chronic and long-term health problem in society. If uncontrolled, it tends to worsen due to complications. Diabetes mellitus requires long-term treatment. This study aims to determine the factors that affect adherence to pharmacological treatment of type 2 diabetes mellitus in farmers. This study used a quantitative method with a cross-sectional approach. The sample size was 165 farmers who were selected by purposive sampling. This study was conducted from May to June 2024 in the working area of Sukadamai Community Health Center, Natar, South Lampung, Indonesia. Data were collected based on questionnaires. The results showed that adherence to pharmacological treatment of type 2 diabetes mellitus is directly related to age (b=-1.601; 95%CI=-3.260-0.583; p=0.059), self-motivation (b=2.500; 95%CI=0.856-4.144; p=0.003), duration of illness (b=1.587; 95%CI=0.209-0.964; p=0.024), and family support (b=2.840; 95%CI=1.311-4.369; p=0.000). There is an indirect relationship between education and adherence through the knowledge variable (b=0.962; 95%CI=0.307-1.617; p=0.004). Indirectly, education is related to adherence through income (b=2.363; 95%CI=1.618-3.107; p=0.000), self-efficacy to adherence through self-motivation (b=0.261; 95%CI=-0.657-1.180; p=0.577), and family support through self-motivation (b=2.287; 95%CI=1.361-3.214; p= 0.000). Healthcare workers should repeatedly provide counseling on primary education materials, such as the importance of continuous control, pharmacological and non-pharmacological interventions, and other secondary prevention measures to prevent complications in patients diagnosed with type 2 diabetes mellitus.

Enhancing Family Readiness to Prevent Relapse in Individuals with Severe Mental Disorders in Indonesia

Objective: Effective relapse prevention for individuals with severe mental disorders requires understanding the role of psychosocial factors in readiness-relapse. This study evaluates the impact of family support, motivation, coping mechanisms, and experience on readiness-relapse. Methods: A correlational study was conducted with 150 respondents from three primary healthcare centers in Kebumen Regency, Central Java, Indonesia. Participants were selected using proportional random sampling and completed validated questionnaires. Data were analyzed for validity, reliability, normality, and hypothesis testing using T-tests and F-tests. Results: Motivation was identified as a significant predictor of readiness-relapse (p =0.0001), demonstrating its crucial role in preventing relapse.

TRANSGENDER PERSPECTIVES ON SOCIAL ENTREPRENEURSHIP: AN EXPLORATION IN THE ASIAN CONTEXT

In many walks of life, the transgender people faces marginalization and humiliation. Transgender individuals have found it challenging to fit-in with the mainstream society due to social rejection. Following the enforcement of the Transgender Protection Act of 2018, transgender individuals in Pakistan have experienced a significant surge in support from civil society. In result, the transgender people in small numbers have laid the foundation for the employment or self-employment. So that they can also prove themselves as useful citizen of this country and participating positively in the ongoing economic progress of Pakistan. Many of the transgender people has chosen entrepreneurship as career and started their own business. The primary aim of this study is to investigate the entrepreneurial motivators that transgender entrepreneur experience, prior to launching their business or get self-employed. The fifteen transgender entrepreneur interviewee are included in the study, who had quit dancing, acting, begging and commercial sex work and founded a business or self-employment. The major findings of the grounded theory revealed six significant drivers, cognitive drivers including: personal fulfilment and autonomy, passion for the chosen industry, and desire to make a positive impact. On the other hand, the environmental drivers consisting of financial independence and stability, family background and support, and societal recognition and acceptance. This article expand our understanding of transgender entrepreneurship and also magnify the core forces that make transgender individuals as a useful citizen of this country. The findings of this study will also suggest the role of policymakers, advocacy/support groups, and none governmental organizations (NGOs) in promoting entrepreneurship among the transgender community of Pakistan. Finally, the study’s limitations and future direction for potential research were also covered.

Conceptualizing the effects of COVID-19 on eating and physical activity in people with type 2 diabetes and hypertension in Ecuador using the social ecological model.

Our aim was to explore patients' perceptions of changes in diet and physical activity in people with type 2 diabetes mellitus and/or arterial hypertension in two low-income districts of Ecuador. We carried out a qualitative study of 19 telephone interviews in August-September 2020 with people with type 2 diabetes mellitus and/or arterial hypertension. Interviews were recorded, anonymized and transcribed verbatim for analysis using the social ecological model. Within the context of poor access to the health services, participants identified a lack of social policies to address food insecurity and income stability. Food insecurity was related to mobility restrictions and loss of income, particularly among vulnerable populations, such as migrants and women. Changing work environments influenced physical activity patterns and food availability. Family support was crucial to overcome economic shortfalls allowing for better eating habits. Despite recognizing overeating as detrimental to disease management, participants reported increased desire to binge eat due to emotional distress and anxiety. The lack of social policies dealing with poverty and food insecurity during the pandemic made non-communicable disease self-care with physical activity and diet challenging for vulnerable populations.

Therapeutic Guidelines for the Self-Management of Major Depressive Disorder: Scoping Review.

Major depressive disorder contributes to the global burden of mental illness. Therapeutic guidelines promote treatment self-management and support caregivers and family members in this process. We aimed to identify therapeutic guidelines for the symptoms of major depressive disorder. This scoping review followed the assumptions established by the Joanna Briggs Institute and the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) protocol, carried out in 12 databases (LILACS, PubMed, SciELO, Scopus, Web of Science, b-on, BDENF, AgeLine, Cochrane, BVS, IBECS, and CINAHL) and 5 secondary gray literature sources (Google Scholar, Global ETD Search, EBSCO Open Dissertations, CAPES Catalog of Theses and Dissertations, and the Digital Library of Theses and Dissertations of the University of Sao Paulo). The eligibility criteria were based on the population, concept, and context framework: people diagnosed with major depressive disorder aged >18 years (population), therapeutic guidelines for self-management of major depressive disorder symptoms (concept), and symptoms of major depressive disorder (context). Data collection was carried out from March to July 2022 and updated in June 2024. The included studies were experimental, quasi-experimental, analytical observational, descriptive observational, qualitative, or quantitative studies; systematic reviews and meta-analyses; and scoping and literature reviews published in full without time restrictions in English, Spanish, or Portuguese. All the information, as well as the studies captured, was stored in a Microsoft Excel spreadsheet using Rayyan and the JBI Manual for Evidence Synthesis. The titles, abstracts, and full texts were carefully read and classified, extracting the results. After review by 2 independent researchers, 62 studies were selected. The results are presented descriptively, including characterization of the studies and mapping and categorization of groups and subgroups of therapeutic guidelines for self-management of major depressive disorder. In total, 62 studies published between 2011 and 2023 were included, where 44 (71%) came from indexed data sources and 18 (29%) were gray literature indexed on Google Scholar (13/62, 21%), doctoral theses (3/62, 5%), and master's dissertations (2/62, 3%). Among the therapeutic guidelines identified, mapped, and categorized, 7 major groups were identified for self-management: psychotherapy (32/62, 52%), adoption of healthy habits (25/62, 40%), integrative and complementary practices (17/62, 27%), relaxation techniques (9/62, 14%), consultation with a health professional (14/62, 22%), pharmacological therapy (9/62, 14%), and leisure or pleasurable activities (4/62, 6%). It was possible to identify therapeutic guidelines to promote self-management of major depressive disorder in the adult population. Therapeutic guidance is an important resource for patients, their families, and the community, making patients the protagonists of their own health. For health professionals, therapeutic guidelines become tools that help develop skills and competencies for care among patients, thus ensuring their ability to self-manage major depressive disorder.

The Relationship Between Family Support and Anxiety of Breast Cancer Patients undergoing Chemotherapy at Dr. H. Abdul Moeloek Hospital, Lampung Province, 2019

Background : According to WHO, breast cancer sufferers will increase by 20% every year and 84 million people will die worldwide. One of the treatments for breast cancer is chemotherapy. However, chemotherapy has physical and psychological side effects that will cause anxiety in patients, which will actually complicate the healing process, so family support is needed so that patients will not think that the chemotherapy they are undergoing is something threatening. Research objective: to determine the relationship between family support and anxiety in breast cancer patients undergoing chemotherapy at Abdul Moeloek Hospital, Bandar Lampung. Type of research : analytical survey, with a cross-sectional design . The population is all breast cancer patients undergoing chemotherapy at RSUD. Abdul Moeloek Bandar Lampung in 2018, totaling 120 people, and the sample uses accidental-sampling . This study uses univariate and bivariate analysis with statistical tests, namely chi square . Results: found from 120 breast cancer patients, the majority had good family support of 84.2%, and patients who were not anxious were 58.3%. The results of statistical tests with Chi Square on Pearson Chi Square p value (0.000) <0.05. Conclusion : There is a relationship between family support and anxiety in breast cancer patients undergoing chemotherapy at Abdul Moeloek Hospital, Bandar Lampung in 2018.

Risk Factors Related to Anemia in Oil Palm Plantation Workers in Ogan Komering Ilir Regency

Anemia is a common health problem worldwide, especially in developing countries. Oil palm plantation workers are at high risk of developing anemia due to various factors such as diet, working conditions, and pesticide exposure. This study analyzes the risk factors associated with anemia in oil palm plantation workers in Ogan Komering Ilir Regency. The research method used was an analytical survey with a cross-sectional approach. Data were collected through structured interviews and questionnaires with 33 oil palm plantation workers. The variables studied included age, occupation, level of knowledge, family support, and specific exposure. Statistical analysis was performed using the chi-square test. The results showed that the incidence of anemia in plantation workers reached 14.7%. Occupational factors (p = 0.011) and family support (p = 0.005) had a significant relationship with the incidence of anemia. However, no significant relationship was found between age (p = 0.414), level of knowledge (p = 1.000), and exposure (p = 0.634) with the incidence of anemia. This study concludes that occupational factors and family support contribute to the incidence of anemia in oil palm plantation workers. Further research is needed to explore other risk factors that may influence the incidence of anemia in this group.

The Resilience on Amphetamine Relapse Youth Scale: development and psychometric properties

There is a lack of valid instruments to measure resilience among adolescents with amphetamine relapse. This study aimed to develop a standard instrument for measuring resilience to amphetamine relapse among adolescents. The study was carried out in two stages: item development through in-depth interviews and pilot testing, followed by validation with a sample of 405 adolescent amphetamine users aged 12 to 24 years via a cross-sectional survey. The resulting 41-item the Resilience on Amphetamine Relapse Youth (RARY) Scale consisted of six components: using life skills and other strategies independently (13 items), relying on family support (9 items), demonstrating self-reliance or hardiness (7 items), seeking other forms of support (5 items), anticipating negative consequences of amphetamine use (3 items), and expecting future success (4 items). The key statistical metrics, including the 5-point Likert scale, internal consistency (Cronbach’s Alpha = 0.966), and factor loadings (KMO = 0.935 and Bartlett’s Test is significant p-value < 0.001) are excellent. The scale’s validity—content, concurrent, congruent, convergent, and discriminant—was confirmed through Pearson correlation coefficients with other relevant instruments. The exploratory factor analysis confirmed these components. This scale is deemed valid and reliable for use in Thailand and other similar sociocultural contexts.

Exploring factors that influence the knowledge and awareness of breastfeeding among Saudi mothers: a qualitative study

PurposeBreastfeeding provides short- and long-term benefits for mothers and babies. Despite these advantages, the prevalence of breastfeeding among Saudi mothers is low. We explored factors affecting the knowledge and awareness of breastfeeding among Saudi mothers in Riyadh.MethodsThis qualitative study included 17 mothers. The inclusion criteria were Saudi mothers aged 18–50 years, with at least one child, living in Riyadh. Semi-structured interviews of approximately 20–40 min were conducted online or in person between March and April 2024. Data were analyzed using the constant comparative method with NVivo 11. Ethical approval was obtained from an academic institutional review board prior to data collection.ResultsTwo key themes emerged from the data. Theme 1 concerned factors facilitating knowledge and awareness of breastfeeding; subthemes included positive experience with breastfeeding, knowledge of breastfeeding, family support, and financial considerations. Theme 2 concerned factors limiting knowledge and awareness of breastfeeding; subthemes included negative experiences of breastfeeding, work situations, misconceptions, and mental health issues.ConclusionDespite the low prevalence of breastfeeding in Saudi Arabia, mothers were aware of its benefits. Physicians and midwives should provide ongoing education and support for mothers during ante- and post-natal periods to minimize misconceptions regarding breastfeeding and promote its use.

Exploring Farmers’ Motivators and Barriers to Adopting Stress Management Behaviors

Farmers experience high levels of stress, with negative sequelae including physical illness, depression, anxiety, and suicide. Despite this, farmers are often reluctant to adopt stress management behaviors. This study collected survey data on motivators and barriers to stress management behavior change among farmers from 162 participants at a regional fruit and vegetable growers’ conference. Survey findings were analyzed using the Health Beliefs Model (HBM) as an organizing framework, calculating the frequency of survey item endorsement, identifying items above the median, and sorting these into the major constructs of the HBM. The study revealed that farmers seldom endorsed getting information about perceived susceptibility to and severity of unmanaged stress as factors that would move them to behavior change; only one survey item—a health crisis--rose above the median. Participants identified learning about stress management benefits from others, particularly other farmers, and family support for changing behavior as potent motivators. In addition, they frequently identified discomfort in talking about feelings and internalized stigma grounded in pride and embarrassment as barriers to change. Most frequently, they identified the time and labor demands of farming as barriers to change. In addition to these findings, during analyses, we noted parallels between the frequently endorsed items in the survey and two core constructs from the Interpersonal Theory of Suicide (IPTS)—thwarted belongingness (e.g., long hours of farming) and perceived burdensomeness (e.g., embarrassment at feeling stress and needing support). Study findings suggest that stress management interventions should consider both behavior change and addressing factors that can be risks for suicide. These include: 1) education provided by trusted others, including family and peers; 2) messaging that stress is normal and asking for support is not a burden; 3) opportunities for connection and decreased isolation; 4) programs that recognize and respect the harsh demands of farming life.

The impact of social determinants of health on chronic kidney disease risk: evidence from the CHARLS study

BackgroundEmpirical evidence regarding the relationship between social determinants of health (SDH) and renal outcomes remains limited. Consequently, the objective of this study was to investigate the potential association between SDH and the development of chronic kidney disease (CKD) across various levels.MethodsData were sourced from the 2011 China Health and Retirement Longitudinal Study (CHARLS), which included 6,290 Chinese participants aged 40 years and older. Among these participants, 4,115 underwent a follow-up assessment in the 2015 survey. The primary outcome measure was the incidence of CKD, operationally defined as a reduction in estimated glomerular filtration rate to &amp;lt;60 ml/min/1.73 m2. To analyze the association between varying levels of SDH and renal outcomes, a Cox proportional hazards regression model was employed.ResultsThe findings indicate that, in comparison to individuals with a pension, higher education, and no need for family support, the risk of developing CKD increased by 43, 49, and 52%, respectively. Furthermore, the combination of requiring family support, being unmarried, and lacking medical insurance was associated with an elevated incidence of CKD. Utilizing the counting model of adverse SDH indicators, it was observed that when the number of adverse SDH was equal to or greater than four, there was a significant increase in the risk of CKD. The incidence density of CKD was found to rise in correlation with the severity of adverse SDH, with the incidence density in the adverse SDH group being 0.06 per person-year higher than that in the favorable SDH group. After adjusting for multiple variables, the hazard ratio (HR) for incident CKD was 2.47 [95% confidence interval (CI): 1.46–4.16] in the adverse SDH group compared to the favorable SDH group, a finding that persisted across various subgroups.ConclusionResearch indicates that financial support, pensions, education, marital status, and health insurance significantly impact CKD risk. Higher income, pension coverage, education, marital stability, and insurance lower this risk. Evaluating adverse SDH indicators helps assess individual SDH levels and CKD risk, with four or more indicators suggesting high risk. Therefore, adverse SDH measures can predict CKD.

A care ethical perspective on family caregiver burden and support.

Family care-when partners, relatives, or other proxies care for each other in case of illness, disability, or frailty-is increasingly considered an important pillar for the sustainability of care systems. For many people, taking on a caring role is self-evident. Especially in a palliative care context, however, family care can be challenging. Witnessing caregivers' challenges may prompt compassionate nurses to undertake actions to reduce burden by adjusting tasks or activities. Using a care ethical approach, this theoretical paper aims to provide nurses with an alternative perspective on caregiver burden and support. Drawing on the concepts of relationality and contextuality, we explain that family care often is not a well-demarcated or actively chosen task. Instead, it is a practice of responding to an all-encompassing "call" to care flowing from a relationship, within a social and cultural context where norms, motivations, and expectations shape people's (sometimes limitless) care. We consider relational interdependence at the root of persisting in care provision. The question is then whether self-sacrifice is a problem that nurses should immediately solve. In ideal circumstances, self-sacrifice is the result of a conscious balancing act between values, but family care in the context of serious illness barely provides room for reflection. Yet, instant attempts to alleviate burden may overlook family caregivers' values and the inherent moral ambiguities and/or ambivalent feelings within family care. Family care is complex and highly personal, as is finding an adequate balance in fulfilling one's sometimes conflicting values, motivations, and social expectations. Therefore, we suggest that caregiver experiences should always be interpreted in an explorative dialogue, focused on what caring means to a particular family caregiver. Nurses do not have to liberate family caregivers from the situation but should support them in whatever overwhelms or drives them in standing-by their loved ones until the end.

The use of video feedback to promote developmentally supportive parent–child interactions with young children with ASD or at risk: study protocol for a randomized controlled trial (VIFEPOPA-RCT)

BackgroundAutism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by difficulties in social communication and interaction, and repetitive and restrictive behaviors and interests from an early age. ASD often negatively affects caregiver-child interactions, caregiver emotional well-being and self-efficacy, and quality of family life. Positive caregiver–child interactions are crucial for good developmental outcomes, leading to the development of Parent-Mediated Interventions (PMIs). PMIs tend to follow an expert model where professionals provide direct instruction on treatment techniques and parental behaviors. However, research supports a shift towards a more collaborative and reflective approach, using coaching strategies that highlight caregiver strengths and encourage self-reflection. This study tests a video-feedback intervention (VFI) with parents of young children at risk of ASD.MethodsA randomized controlled trial (RCT) with 60 families, recruited from Early Intervention Centers in Spain, meeting inclusion criteria: adequate use of internet, child aged 24–36 months with a high risk of ASD (M-CHAT-R score ≥ 8), and participant primary caregiver (mother or father) with high anxiety, depression, or parental stress (score ≥ 1 SD above M), and low or medium–low developmentally supportive parental behaviors (PICCOLO score ≤ 40). Families will be randomly assigned to an intervention group (receiving usual services plus VFI) or a control group (usual services). The intervention includes twelve bi-weekly 90-min sessions over six months, with the caregiver. Outcome measures include parenting behaviors, emotional state, self-efficacy, family quality of life, and child development collected at pre-intervention, post- intervention and six-month follow-up.DiscussionThe study will assess whether the intervention enhances developmentally supportive parental behaviors, emotional well-being, self-efficacy, and family quality of life, with a secondary positive impact on child development. If proven effective, it could be a cost-effective intervention with both short and long-term benefits.Trial registrationClinicalTrials.gov Identifier NCT06604988. Registered on September 17, 2024. Retrospectively registered.

Collaboratively Supporting Families: A Rapid Coaching Intervention for Caregivers

Collaboratively Supporting Families: A Rapid Coaching Intervention for Caregivers