Family Stress Research Articles

Impact of Neighborhood Disadvantage on Preventive and Acute Care Utilization in Sickle Cell Disease.

Individuals with sickle cell disease (SCD) experience significant healthcare disparities; however, there is little known on the impact of psychosocial stressors and neighborhood disadvantage on preventive and acute care utilization in this population. A retrospective data collection was performed for all patients cared for at a comprehensive pediatric sickle cell center in the Midwest who had also completed the Psychosocial Assessment Tool (PAT), a validated caregiver-reported measurement of family psychosocial risk, from September 2021 through December 2022. Patient age, payor, primary language, frequency of acute and missed preventive care visits, as well as Area Deprivation Index (ADI) and Childhood Opportunity Index (COI) scores were collected for 256 patients. The average state ADI was 6.3 (±2.9), and the majority of patients were in the Very Low or Low COI categories. Total PAT score (p=0.003), state ADI (p<0.001), and state COI (p<0.001) were all significantly correlated with missed SCD clinic visits, with increased odds of a missed visit with increasing neighborhood disadvantage (OR 1.22, p<0.001). The odds of acute care were also increased in those with higher family psychosocial risk (OR 1.76, p<0.011), though this was not seen with ADI or COI, suggesting an additional effect of family stressors and resilience on acute care utilization. This highlights the importance of regular, universal social and psychological risk screening, as well as inclusion of psychosocial team members in SCD programs to identify and readily address risk factors that impact child outcomes in a minoritized chronic disease population.

Quality of life and mental health status in caregivers of pediatric patients with nephropathic cystinosis.

There are few studies assessing psychological burden and quality of life (QoL) in caregivers of pediatric patients with nephropathic cystinosis, a severe chronic disease. This observational, single-center study aimed to explore the levels of anxiety, depression, care burden, and QoL status in caregivers of patients with nephropathic cystinosis. The Hospital Anxiety and Depression Scale (HADS), the Zarit Caregiver Burden Scale, and the Short Form-36 (SF-36) were administered to caregivers of pediatric patients with nephropathic cystinosis. Nine caregivers of pediatric patients with nephropathic cystinosis participated in the study (6 boys and 3 girls; mean age, 12.6 ± 4.2 years). All participating caregivers were the patient's mothers. Of the 9 caregivers, 6 showed anxiety/depression and 4 severe care burden. Overall, SF-36 QoL domains with a worse perception by caregivers were 'general health' and 'health change over time'. Mothers without depression/anxiety and low care burden had better QoL perception (p = 0.02). All caregivers with high care burden showed anxiety/depression. In our study cohort, caregivers of pediatric patients with nephropathic cystinosis showed high levels of anxiety/depression, high care burden, and impaired QoL, highlighting the importance of detecting psycho-social issues to implement strategies that relieve family stress and improve coping strategies.

Changes in economic deprivation and parental self-efficacy: Unemployment, poverty, and the mediating effect of psychological distress

Objective: The article investigates the influence of three aspects of economic deprivation on parental self-efficacy, and whether, or to what extent, these effects are mediated by psychological distress. Background: Scholarship shows that psychological resources such as parental self-efficacy can attenuate the negative repercussions of poverty for families. The article builds on the family stress model that higlights the role of economic deprivation for family functioning by Conger and colleagues. It focuses on the consequences of transitioning into unemployment, objective poverty, and subjective poverty for parental self-efficacy, and the potential mediating effect of psychological distress. Method: Using data from the German Family Panel (pairfam) Waves 4 to 12 (2011–2020), Baron and Kenny mediation analyses are conducted based on fixed effects regressions with standard errors based on clustered bootstrap procedure. Results: The results show that transitioning into subjective poverty significantly decreases parental self-efficacy, and that only a marginal part of this effect is mediated by psychological distress. A transition into objective poverty, by contrast, has no effect on parental self-efficacy. Likewise, unemployment has no direct effect on parental self-efficacy. However, transitioning into short-term unemployment reduces psychological distress and thereby buffers parent’s self-efficacy. This does by contrast not apply for long-term unemployment. Conclusion: The findings demonstrate the importance of differentiating between specific aspects of economic deprivation when investigating its consequences for parental self-efficacy and considering psychological distress as a potential mediator. Moreover, the findings provide longitudinal evidence for the consequences of a transition into economic deprivation for parental self-efficacy and point to the presence of gender effects with regard to unemployment.

Parent conversations with young children: Implications for child well-being during the COVID-19 pandemic.

Parent-child conversations may minimize the impact of stressful situations on children's well-being. Parents were encouraged to talk with their children about the coronavirus (COVID-19) pandemic, yet research suggests that parent stress in response to the pandemic was associated with disruptions in parenting and increased child emotional distress. In the present study, 205 parents of children aged 3-6 years (50.7% girls, 56.6% White) reported on conversations about the pandemic and responded to measures of parent stress and child emotional distress in the fall of 2020. Qualitative analysis revealed that talk about mitigation strategies was frequent; most parents offered an explanation for pandemic changes, whereas fewer parents reported communicating support. Guided by the family stress model, we then examined whether different conversation types moderated the association between parent stress and child emotional distress. Only talk about pandemic changes and explanations that COVID-19 was dangerous acted as moderators, suggesting that these conversation types strengthened the association between parent stress and child emotional distress. A main effect of self-protective explanations being associated with lower child emotional distress was also found. We discuss the implications of these findings for future research on parent-child conversations about stressful situations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Smartphone addiction among medical students in the University of Monastir, Tunisia

Abstract Background Smartphone addiction is a global mental health issue with diverse psychological and socioeconomic concerns. The aim of this study was to determine the prevalence of smartphone addiction and its associated factors among medical students in the university of Monastir, Tunisia. Methods We conducted a cross-sectional survey among medical students of the faculty of medicine of Monastir in October 2020. The data were collected through a self-administered anonymous questionnaire that included the SAS-SV scale to assess smartphone addiction levels. A multivariate logistic regression model was employed to identify associated factors. The threshold of statistical significance was set at p &amp;lt; 0.05. Results A total of 626 medical students participated in this study, with an average age of 21.76 ± 3.12 years and a sex ratio of 0.41. The prevalence of smartphone addiction was 30.2% (95% CI: 26.0% - 33.79%). Associated factors with smartphone addiction included academic repetition(OR = 4.30; 95% CI [1.38 - 13.42]), fast food consumption scores (OR = 1.55; 95% CI [1.21 - 2.00]),addiction to the Facebook social network (OR = 6.36; 95% CI [1.92 - 21.07]), cohabitation with colleagues (OR = 2.13; 95% CI [1.03- 4.43]), cohabitation with family members(OR = 2.10; 95% CI [1.01 - 4.36]) and stress level (OR = 1.13; 95% CI [1.07 - 1.18]). Conclusions This study identified associations between smartphone overuse and other behavioral and mental health indicators. Based on these findings, several interventions should be undertaken to address this growing concern. Key messages • The prevalence of smartphone addiction among medical students in the University of Monastir was 30.2% (95% CI: 26.0% – 33.79%). • The main associated factors with smartphone addiction were academic repetition, fast food consumption, addiction to Facebook, cohabitation with colleagues and with family members and stress level.

Examining the Relationship Between Socio-Demographic Variables and Eco-Anxiety A Systematic Review

Abstract Background Eco-anxiety is a rising concern among young people, characterized by persistent feelings of fear, helplessness, and despair stemming from the looming and uncertain threats of climate change. Understanding how socioeconomic status and demographic factors influence the development of eco-anxiety is crucial in addressing this issue. This study aimed to analyze the literature to elucidate this relationship and its public health implications. Methods We conducted a systematic literature review using PubMed, Scopus, Web of Science, and APA PsycInfo databases. A total of 1,170 articles were initially retrieved, with 10 meeting the inclusion criteria. Quality assessment was performed using the AXIS Tool modification for cross-sectional studies. Data extraction was systematically carried out to analyze the relationship between socioeconomic and demographic determinants and young people’s emotional responses to climate change. Results Preliminary findings indicated that various socioeconomic and demographic factors influence young people’s emotional responses to climate change. Family stressors, economic instability, cultural beliefs, and social influences were identified as significant determinants, contributing to eco-anxiety, ecological distress, and climate change grief among youth. Conclusions The study underscores the importance of considering socioeconomic and demographic factors in addressing eco-anxiety among young people. By recognizing these influences, policymakers, educators, and mental health professionals can develop tailored interventions to mitigate the adverse effects of eco-anxiety. Public health actions may include enhancing mental health services, implementing educational programs, and addressing social determinants of health to alleviate eco-anxiety and promote resilience among youth facing climate-related challenges. This review is produced as part of the PRIN P2022JJ3LB project, funded by the Italian Ministry of University and Research. Key messages • Socioeconomic and demographic factors significantly influence young people’s emotional responses to climate change, including the development of eco-anxiety and ecological distress. • Understanding family stressors, economic instability, and social influences is crucial for tailored interventions for youth.

Residential Mobility in Childhood and Union Dissolution Later in Life

The limited existing literature studying the effects of childhood residential mobility suggests that it influences a range of life outcomes, at least in young adulthood. Little is known about how the frequency of moving in childhood is related to later-life demographic behaviour in Europe. Drawing on residential and partnership histories from the Survey of Health, Ageing and Retirement in Europe (SHARE), this paper examines whether moving in childhood relates to union dissolution in adulthood. It empirically addresses two theoretical explanations underlying the potential association: First, according to the confounding hypothesis, effects of childhood residential mobility differ by family background and resources. Second, the family stress model suggests that the accumulated stress and conflicts associated with frequent residential mobility disrupt the family and child’s social ties, resulting in worse relationship skills in later life (mediation hypothesis). Applying discrete-time event history analysis to individuals born between 1945 and 1965 in Sweden, Denmark, and Finland, we find a significant association between childhood moves (prior to age 17) and adult union dissolution. The effect’s strength varies based on the number of childhood moves, demonstrating a clear gradient. Notably, adults with three or more childhood moves exhibit a 55% higher likelihood of union dissolution compared to non-movers. These associations persist even after accounting for childhood background factors, while family stress mediates the link partially. Our findings shed light on the role of spatial mobility in shaping demographic outcomes and underscore its potential contribution to the accumulation and reproduction of life disadvantages.

Parent-child communication and educational anxiety: a longitudinal analysis based on the common fate model

BackgroundIn the face of family stress and emerging family problems, the transactional model of stress and coping provides new perspectives for solving stress problems in the family. This study integrates it with the common fate model to reveal new paths for coping with educational anxiety problems from the level of parent-child dichotomous interaction in the family environment, aiming to provide some theoretical and practical support for alleviating parents’ education anxiety.MethodsThis study used a combination of interviews and questionnaires to stratify students and their parents from a public junior high school in Jinan City to participate in the study. Data were collected in two time periods (T1, T2; one year apart), and the demographic characteristics of parents and children, parent-child communication quality, education anxiety, and parent-child trust relationship of 495 families were finally analysed by SPSS 27.0.ResultsThe results found that (1) based on the Common Fate Model, quality of parent-child communication negatively predicted parents’ education anxiety; (2) quality of parent-child communication positively predicted parent-child trust relationship; (3) parent-child trust relationship negatively predicted parents’education anxiety; (4) parent-child trust relationship mediated quality of parent-child communication and education anxiety.ConclusionsThis study sheds light on research related to stress coping and anxiety relief in the family environment, and provides theoretical and practical support for understanding the interaction between parents and children at the family level, and coping with stressful events together. It implies that future researchers should not only focus on one aspect when coping with and dealing with family problems, but should analyse the family as a whole, including the communication status and parent-child relationship between parents and children.

Strengthening Family Resilience For Micro, Small and Medium Enterprises

Work Family Conflict (WFC) is a pressure or imbalance between roles at work and roles in the family. Entrepreneurial families are very vulnerable to WFC, even more vulnerable than working families. Even though entrepreneurs are known to have flexible working hours, in reality entrepreneurs' working hours are unlimited. This service aims to provide assistance in strengthening the resilience of entrepreneurial families by focusing on managing stress and conflict in entrepreneurial families, building effective communication and balancing the roles of husband/wife of business actors in the family. The service partners are members of the Kaliurang Connection, which is an MSME community in Yogyakarta. The service method is training and counseling from a team of psychologists according to the participants' needs and problems.

47 Association between unmet social needs and parental stress in a paediatric asthma clinic

Abstract Background There are well documented associations between unmet social needs and undesirable health outcomes, but little data exist on the association between unmet social needs and stress in families of children with asthma. Objectives To document the relationship between unmet social needs and parental stress in a Canadian paediatric asthma clinic. Design/Methods Ongoing prospective observational study to determine the association between unmet social needs and parental stress was conducted in a tertiary care paediatric asthma clinic, between September 2022 and September 2023. Participants were parents of children with a diagnosis of asthma, treated with at least one controller medication. Unmet social needs were collected by parental self-report using a questionnaire assessing 8 domains: employment, housing, ability to pay for utilities, financial resources, food security, transportation, childcare, and education. The four-item Perceived Stress Scale was used to assess how parents perceived stress and how they felt they were able to manage situations in their lives. Chi-square tests compared our independent variable, the presence vs. absence of unmet social needs, to our dependent variables; each measure of stress (control over important aspects of ones’ life, confidence in ability to overcome problems, feeling that everything was going well, ability to overcome too many accumulated difficulties). Results Of 162 participants, seventy-seven (48%) reported at least one unmet social need. Compared to participants without unmet social needs, those with unmet needs were more likely to report having no control over important aspect of their work or main activity (p&amp;lt; 0.001); less likely to report having confidence in their ability to overcome problems (p&amp;lt; 0.001); less likely to report having the feeling that everything was going well (p&amp;lt; 0.001); and less likely to report having the ability to overcome too many accumulated difficulties (p&amp;lt; 0.001). Conclusion Findings suggest significant association between unmet social needs and parental stress of asthmatic children. Parental stress and unmet needs may concomitantly increase the burden of adhering to asthma controller medication, making adherence more challenging through pathways related to the interactions between cognitive burden and precarious living situations. This ongoing Canadian study seeks to elucidate the mechanisms by which these factors make adherence to asthma medication more challenging for families, so these challenges can be addressed.

A Study On Effects Of Work-Life Balance And Women Employees Job Productivity In It Organizations

This study examined just at work-life balance and women productivity in only few IT sectors in Chennai. The study was stimulated by the IT sectoring industry's high rate of work-life unequal distribution. The study specifically examined the impact of workload pressure, role conflict, family stress, and work flexibility on female productivity. The relevant conceptual, theoretical, and empirical literatures were investigated. This work examined the work life balance and ladies productivity in selected IT sectors in Chennai city. The study was necessitated by high rate of work-life unbalance in the IT sectoring industry. Specifically the study determined the effect of workload pressure, role conflict, family stress and Work flexibility on ladies productivity. Relevant conceptual, theoretical and empirical literatures were examined. A total of fifteen IT sectors were studied, and the population of study was 2021, with the sample size of total sample size evaluated using the statistical formula SPSS. The research also revealed that family stress has a significant impact on female productivity. The study concluded that work load pressure, role conflict, and family-related stress all have a negative impact on female productivity. According to the study, people should relax in ways that do not interfere with their work; it can be an efficient way to recover from identified work-life balance issues. Management must take note of the volume of work assigned to women in order to deal with work-life balance issues in the workplace. Management must act immediately to rectify the issue; work should be delegated accordingly to ensure that no one is overloaded. Ladies should be given appropriate breaks and vacation time.

Child-friendly family reduces parenting stress in Chinese families: the mediating role of family resilience.

The increasing prevalence of parenting stress has significant implications for the psychological well-being of both parents and children. In view of this, our study sought to examine the mediating and moderating role of family resilience in the association between child-friendly family and parenting stress. Our analysis involved a sample of 316 parents who dedicated a minimum of 14 h per week to caring for their children. The parents were invited to complete three validated instruments-the parenting stress index short form (PSI), the family resilience assessment scale (FRAS), and inventory of the child-friendly family (ICF)-to evaluate their level of parenting stress, family resilience, and child-friendly family, respectively. We tested the mediation model by applying structural equation model analysis. It was found that child-friendly family negatively correlated with parenting stress (path coefficient = -0.56, p < 0.001). This relationship is mediated by family resilience. That is "child-friendly family" leads to increased "family resilience" (path coefficient = 0.68, p < 0.01), which in turn leads to lower "parenting stress" (path coefficient = -0.30, p < 0.05). The mediation effect ratio was 26.70%. We used multiple regression analysis to test the moderation model and found that family resilience did not play a moderating role between child-friendly family and parenting stress. This study holds particular significance for two key reasons: Firstly, it elucidates the relationship between child-friendly family, family resilience, and parenting stress, highlighting the potential of creating a child-friendly family to reduce parenting stress through the enhancement of family resilience. Secondly, our findings provide valuable evidence for the development of innovative approaches that effectively and sustainably alleviate parenting stress.

Parent and adolescent perspectives on family problems during the COVID‐19 pandemic: Implications for family resilience

AbstractObjectiveTo understand how parents and adolescents perceive the major family problems they faced during a global pandemic, focusing on implications for family resilience.BackgroundFamilies are challenged by the upheaval in contemporary life due to a global health pandemic and unrelenting changes to work, school, civic, and home routines. Family resilience theory guided our understanding of how families perceive and understand the problems they faced during a major disruption in their lives.MethodA diverse sample of parent–adolescent pairs was surveyed at two points in time. Qualitative content analysis was used to analyze open‐ended questions asking about family members' perceptions of the major problems they faced as a family during the pandemic.ResultsMost participants reported a major family problem during the pandemic (e.g., unemployment, online learning, isolation, fear of COVID‐19), with financial issues being the most prevalent problem. Parents were more likely to identify a major family tension, compared with adolescents, who were more likely to say they were unaware of any major family problems.ConclusionParents and adolescents reported substantial family stress and tension, especially around financial strain and social isolation, indicating their heightened awareness of the new risks they were facing. Both parents and adolescents also described a willingness to pull together on behalf of family well‐being and adaptation.ImplicationsSupport mechanisms through public policy and from family life practitioners can help families navigate pandemic‐related stressors, assess adverse events in adolescence, promote new pathways in navigating disrupted routines, and enhance family resilience.

Evaluating Educational Outcomes: A Comparative Analysis of Tutoring Institutes and Formal Schools

Background and Aims: A comparative analysis of tutoring institutes and formal schools is essential because it identifies the strengths and weaknesses of each educational setting, guiding improvements in teaching methods and resource allocation. This understanding informs policymakers, educators, and parents about how to improve educational strategies to help students succeed. This paper analyzes the educational outcomes of tutoring institutes and formal schools. Methodology: The methodology effectively combines various data sources and structured analysis tools to compare educational outcomes in tutoring institutes and formal schools. By combining detailed document reviews and thematic analysis, the study provides a thorough understanding of how these educational settings compare to one another. Results: the finding found that the comparative analysis demonstrates that formal schools provide a broad, structured educational framework, whereas tutoring institutes provide personalized support that improves individual academic outcomes. Formal schools benefit from a comprehensive curriculum and standardized assessments, but they may lack flexibility in meeting specific needs. Tutoring, on the other hand, excels at personalized instruction and immediate feedback, even though it can increase costs and stress for students and families. Conclusion: The findings show that formal schools provide a broad, structured education, whereas tutoring institutes provide tailored support that improves individual academic performance. Although formal schools provide a consistent curriculum, tutoring's personalized approach, despite the potential for additional costs and stress, frequently results in more targeted outcomes.

A Study On Effects Of Work-Life Balance And Women Employees Job Productivity In It Organizations

This study examined just at work-life balance and women productivity in only few IT sectors in Chennai. The study was stimulated by the IT sectoring industry's high rate of work-life unequal distribution. The study specifically examined the impact of workload pressure, role conflict, family stress, and work flexibility on female productivity. The relevant conceptual, theoretical, and empirical literatures were investigated. This work examined the work life balance and ladies productivity in selected IT sectors in Chennai city. The study was necessitated by high rate of work-life unbalance in the IT sectoring industry. Specifically the study determined the effect of workload pressure, role conflict, family stress and Work flexibility on ladies productivity. Relevant conceptual, theoretical and empirical literatures were examined. A total of fifteen IT sectors were studied, and the population of study was 2021, with the sample size of total sample size evaluated using the statistical formula SPSS. The research also revealed that family stress has a significant impact on female productivity. The study concluded that work load pressure, role conflict, and family-related stress all have a negative impact on female productivity. According to the study, people should relax in ways that do not interfere with their work; it can be an efficient way to recover from identified work-life balance issues. Management must take note of the volume of work assigned to women in order to deal with work-life balance issues in the workplace. Management must act immediately to rectify the issue; work should be delegated accordingly to ensure that no one is overloaded. Ladies should be given appropriate breaks and vacation time.

The Associations between Depressive Symptoms and Self-Rated Health in Relation to Sense of Coherence among Adolescents: Cross-Sectional Study.

We investigated the predictors of poor SRH in a representative sample of Lithuanian mainstream school students in grades 7-8. We also checked for gender differences in the associations between SRH and depressive symptoms and other predictors. A total of 2104 7th-8th-grade students participated (response rate 73.95%) and were asked about depressive symptoms, psychosomatic health complaints, negative acts at school, feeling at school, family stress and violence, sense of coherence, self-esteem, and lifestyle. We used a hierarchical regression analysis including a variety of self-rated health predictors. Boys scored significantly higher on physical activity and smoking, whereas girls scored significantly higher on SRH, depressive symptoms, psychosomatic health complaints, and family stress and violence, though the significance was lost in the hierarchical regression. Depressive symptoms were the strongest predictor of poor SRH (standardized β = 0.309, p < 0.001), though other investigated predictors were also significant but had lower effect sizes. Strong evidence was found supporting the buffering role of sense of coherence in the relationship between depressive symptoms and SRH (standardized β = -0.266, p < 0.001). We can conclude that the magnitude of the relationship between depressive symptoms and self-rated health is dependent on the levels of sense of coherence. We did not find gender differences in those associations. As poor SRH is easy to determine, especially with a one-item question, the cases of poorly rated health should be detected early and corrected by interventions in order to prevent poor health outcomes in the future.

Homicide-Suicides in Pakistan: An analysis of Newspaper reports of two years

Background and Objective: Our understanding of homicide-suicide (H-S), a rare yet tragic event, is sparse. While the phenomenon has been studied in the West for many years, only limited literature is available from Asia and none to our knowledge from Pakistan. There is evidence of complexity of the interaction between cultural, societal, and psychological mechanisms underlying this phenomenon; therefore, research findings from the Western countries cannot be directly applied in non-Western societies. Our objective was to study homicide-suicides in Pakistan, describe the characteristics of offenders and victims, determine the types of H-S, and examine possible motives and any events prior to the offense. Methods: In the absence of any official data on homicide-suicides, we used newspaper surveillance approach of four most widely circulated Pakistani newspapers (one Urdu and three English Daily) for two years (1st January 2019 to 31st December 2020). Each case was categorized using the modified Marzuk et al., Tardiff, and Hirsch’s classification of homicide-suicides. Descriptive statistics were used to analyze the data that was then compared with published literature. Results: There were 114 H-S incidents with 198 victims of homicide during the study period, reported in the newspapers. Familial H-S particularly filicide-suicide were predominant, followed by spousal/ consortial H-S. Forty-one (36%) H-S involved multiple victims. The perpetrators across all categories of H-S were predominantly male (67%); the victims were predominantly women and children. Firearms were used in most incidents. The primary motive for the majority of H-S cases was familial, financial, and social stressors. Conclusions: The study highlights several unique patterns (predominance of familicide, multiple victims including high proportion of children) and a series of vulnerabilities (incidents related mostly to familial/ financial and social stressors) that overlap each other and ultimately lead to this tragic end. There is need to increase our understanding and develop effective evidence-based prevention strategies for H-S in Pakistan. It is also very important to have a national surveillance network and national violent death reporting system in the country for studying H-S cases, and for evaluating the impact of prevention programs. doi: https://doi.org/10.12669/pjms.40.10.9812 How to cite this: Imran N, Ayub M, Haider II, Rafiq B, Tahir SM, Naveed S, et al. Homicide-Suicides in Pakistan: An analysis of Newspaper reports of two years. Pak J Med Sci. 2024;40(10):2196-2201. doi: https://doi.org/10.12669/pjms.40.10.9812 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Family Resilience and Its Influencing Factors in Patients With Cancer and Their Family Members: A Systematic Review.

This review aims to explore factors influencing family resilience in families providing care for patients with cancer and to provide suggestions for future research directions. Six electronic databases were searched including Web of Science, CINAHL, EMBASE, PsycINFO, PubMed and CNKI from their inception to December 2023. The article reference lists were also manually searched. The Mixed Method Appraisal Tool was used to assess the included studies in this review. The 27-item checklist Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed to report this review. Twenty-one studies from six online databases reported that either individual or family factors have effects on family resilience and were described into five clusters on the basis of the Walsh model of family resilience, including demographic and clinical factors, personal strengths and resources, family stressors, family resilient coping processes and family resilient adaptation outcomes. Family resilience in cancer families plays a pivotal role in coping with family stressors and facilitating positive outcomes through domains of coping. Future researches need to explore factors related to family resilience from dyadic perspectives and to establish multidisciplinary intervention strategies for developing levels of family resilience in cancer families. PROSPERO: CRD42024535349.

Classification of Factors Causing the Decline in Student Learning Achievement in The Post-Pandemic Period Using the C4.5 Algorithm (Case Study: STMIK Kaputama)

The COVID-19 pandemic that has hit Indonesia since 2020 has brought significant changes to various aspects of life, including the learning system in universities. Universities, which originally implemented face-to-face learning processes, were forced to adapt to online learning. However, this change causes various obstacles, especially for students who experience learning loss, namely a decrease in interest and motivation to learn which has an impact on academic achievement. This research aims to classify the factors that cause the decline in student learning achievement in the post-pandemic period at STMIK Kaputama using the C4.5 algorithm. Using data from STMIK Kaputama students as a sample, this research analyzes various factors such as access to technology, involvement in online learning, participation in face-to-face learning, social support, learning motivation, economic conditions, family, college, and academic stress levels. It is hoped that the results of this research will provide a deeper understanding of the dominant factors that cause a decline in learning achievement, as well as become a reference for educational institutions in developing strategies to overcome the negative impacts of online learning during the pandemic Keywords: C4.5 Algorithm, Decrease in Achievement, Data Classification

Identifying Potentially Modifiable Factors To Reduce Hospital Readmissions In A Tertiary Care Hospital In Sri Lanka

Identifying potentially modifiable factors associated with hospital readmissions would lead to reduction of the burden on healthcare expenditure and improvement of quality of life of patients. A cross sectional descriptive study was carried out on medical inpatients of University Medical Unit, National Hospital of Sri Lanka. Among the 425 participants, 178 (41.9%) had at least one prior admission over the preceding year. Participants with readmissions were significantly older than those with single admissions. The onset of illness/time since diagnosis, number of chronic illnesses, number of long-term medications, compliance with medications, compliance with follow-up, availability of family support, depression, anxiety, stress and alcohol use were associated with readmissions, whereas the location of follow-up, living arrangement and level of activity was not. A significant proportion of the study population had readmissions. Interventions aiming to reduce pill burden and to improve compliance with medications and follow-up are suggested, and further studies are recommended to assess their impact. Where appropriate, patients should be directed to local hospitals/clinics for follow-up. Early identification of depression, anxiety and stress among patients and assessing each patient’s alcohol intake, and making recommendations for them to obtain necessary help would be beneficial.