Home-based Study Research Articles

The Impact of Relaxation Massage Prior to Bedtime on Sleep Quality and Quantity in People with Symptoms of Chronic Insomnia: A Home-Based Sleep Study.

Background/Objectives: Manual massage is an effective treatment approach for reducing general stress and promoting an overall sense of well-being. Relaxation massage aims to alleviate psychophysiological tension, enhance both blood and lymphatic circulation, and promote mental and physical relaxation. It is particularly beneficial for those with anxiety-related symptoms (such as generalized anxiety disorder and social anxiety) and sleep disorders, aiming to improve calmness and promote sleepiness. Aims: The purpose of the present study was to assess the effectiveness of a single session of relaxation massage prior to bedtime on sleep quality and quantity indices in individuals with symptoms of chronic insomnia. Methods: In total, 20 (N = 20) healthy individuals (aged 25.5 ± 12.0 years; 6F/14M) with a score on the Athens Insomnia Scale of ≥16 participated under three different conditions over one week apart: (1) a 45 min relaxation massage condition (REL), (2) a 45 min sham massage condition (PLA), and (3) a control condition with no massage. Sleep activity was monitored using a portable polysomnographic system. Results: A statistically significant effect was observed between sleep efficiency across the three sessions (p = 0.034), with a notable effect in the relaxation massage (REL) session (p = 0.045). Additionally, sustained sleep efficiency showed a statistically significant difference among the sessions (p = 0.005). Conclusions: Relaxation massage prior to bedtime could be used as an effective and safe non-pharmacological approach for improving sleep efficiency and potentially restoring the fragmented sleep of individuals with symptoms of insomnia. Trial registration number: The trial was registered at clinicaltrials.gov as NCT06781866.

Active cycle of breathing technique versus oscillating positive expiratory pressure therapy: Effect on lung function in children with primary ciliary dyskinesia; A feasibility study.

Background: Primary Ciliary Dyskinesia (PCD) is a rare genetic disorder requiring airway clearance techniques for mucus removal. We aimed to evaluate the feasibility and the effect of the active cycle of breathing technique (ACBT) versus oscillating positive expiratory pressure therapy (OPEP) in improving lung function and functional exercise capacity among children with PCD in Palestine. Methods: 32 PCD children (6-18years) were included in a 12-week home-based feasibility study. They were assigned randomly into two groups: ACBT and OPEP. Data collection included spirometry measurements, and the six-minute walk test (6MWT). Results: After 12weeks of regular airway clearance techniques (ACT), the FEV1, MEF25-75%, and the 6MWT demonstrated statistically significant differences (p = .02, p = .04, and p = .05 respectively) between the two groups, in favor of the OPEP group with the effect size of Cohen's d (0.86, 0.76, and 0.71) respectively. However, there was no significant difference (p > .05) between the two groups in FVC and FEV1/FVC. Additionally, only in the OPEP group, significant differences were recorded between pre and post-tests for FEV1 and 6MWT (p < .05). Conclusion: The randomized study design comparing ACBT and OPEP was feasible and acceptable to patients. OPEP demonstrates potential for managing respiratory health; however, treatments should be individualized to address each patient's specific needs. Further research with larger cohorts is needed to assess the effectiveness of both methods.

C.E.R.E.B.R.O.: A home-based physical activity study for older Latino adults

C.E.R.E.B.R.O.: A home-based physical activity study for older Latino adults

Evaluating Digital Rehabilitation Outcomes in Chronic Musculoskeletal Conditions Across Non-Obesity, Obesity, and Severe Obesity.

Obesity is a known risk factor and aggravator of musculoskeletal (MSK) conditions. The rising prevalence of obesity calls for scalable solutions to address MSK conditions in this population, given their complex clinical profile and barriers to accessing care. To evaluate the engagement and clinical outcomes of a fully remote digital care program in patients with MSK conditions, focusing on those with and without comorbid obesity. A post-hoc analysis of a prospective, longitudinal, single-arm observational home-based study conducted between August, 2023, and August, 2024. Adults suffering from chronic MSK pain were categorized according to their body mass index (BMI) into non-obesity, obesity and severe obesity. Outcomes included completion rates, engagement, satisfaction, pain (minimal clinically important change: 30%), impairment in daily activities, and patient global impression of change (PGIC). Depending on the clinical outcomes, latent basis growth analysis and logistic regression were used. Completion rates were high across all groups (77.5-85.6%), although slightly lower in the obesity groups. Fairly similar engagement was observed with both exercise sessions and the educational content (1.9-2.2 exercise sessions per week; 8.10-9.31 educational content videos watched). Obesity groups interacted more with the physical therapists than the non-obesity group (severe obesity: 24.6 (SD 10.1); obesity: 23.2 (SD 10.46) vs non-obesity: 22.4 (SD 9.8), P < 0.001). Despite higher baseline risk and clinical impairment in the obesity groups, all groups showed significant pain reductions, with pain responder rates ranging from 56.6 to 63.6%, slightly lower in the severe obesity group. Improvements in daily activities were significant across groups, alongside a positive PGIC (50.4-53.6%). Satisfaction was very high (>9/10) in all BMI groups. Despite worse baseline clinical presentations, obesity groups achieved high completion rates, engagement, and significant clinical improvements comparable to the non-obesity group, highlighting the potential of a digital program for this population.

Electroencephalography Longitudinal Markers of Central Neuropathic Pain Intensity in Spinal Cord Injury: A Home-Based Pilot Study.

It is well known from cross-sectional studies that pain intensity affects brain activity as measured by electroencephalography (EEG) in people with neuropathic pain (NP). However, quantitative characterisation is scarce. In this longitudinal study, ten people with spinal cord injury-related NP recorded their home EEG activity ten days before and after taking medications over a period of several weeks. The reduction in pain due to medications was accompanied by changes in the resting state EEG and its reactivity to eyes opening (EO) and closing (EC). There was a significant positive correlation between the frontal theta band and the intensity of pain (visual numerical scale) pre-medication (p = 0.007, Pearson R = 0.29) and theta, alpha, and lower beta (6-15 Hz) band power and the intensity of pain after post-medication over the frontal, central, and parietal cortices. Reactivity had a negative correlation with pain intensity at all locations and frequency bands and showed similar behaviour in wider frequency bands like 8-15 Hz at the occipital cortex and 2-12 Hz at the frontal cortex. EEG could be used to detect the intensity of NP to serve as a surrogate or pharmacodynamic marker.

Community health workers supporting diverse family caregivers of persons with dementia: Preliminary qualitative results from a randomized home-based study.

Culturally diverse informal caregivers of community-dwelling persons with dementia face challenges in accessing dementia care resources due to language barriers and cultural stigmas surrounding dementia. This study presents the perceived intervention experiences of a home-based approach which considers the cultural and linguistic needs of diverse family caregivers in dementia care. The intervention model includes home visits by trained bilingual, non-licensed community health workers (CHWs) whose cultural histories and understandings reflect that of the caregivers. The purpose of the present study was to understand family caregivers' experience in caregiving and their feedback on the intervention, which includes caregiver support through education and skill development. The present study thematically analyzed qualitative data from exit interviews with caregivers who participated in a CHW-led, 12-week home visit-based intervention program. Among 57 caregivers (mean age = 63.5, SD = 14.3) who participated in the 3-month home-visit intervention and completed the exit interviews, 33% were Korean Americans, 28% Vietnamese Americans, 21% non-Hispanic Whites, and 17.5% Latino/Hispanic. The majority were females (81%) and spouses (51%). Main themes include, (a) Individual Level: Improvements in Caregiving Self-efficacy and Self-care Awareness, (b) Relational Level: Enhanced Communications and Relationships with Persons with Dementia, and (c) Community Level: Connection and Access to Community Resources and Support. Interview data show that the culturally and linguistically tailored program supported diverse caregivers by increasing self-care awareness, improving knowledge about dementia and dementia care, strengthening communication skills, and facilitating access to community resources. Strong rapport between CHWs and caregivers enhanced the effectiveness of the intervention. Future approaches can focus on supporting caregivers with especially limited resources.

Evaluating the Home-Based Intervention Study (HIS-UK) to Improve Condom Use Skills and Experience: A Qualitative Study

Objectives We explored participants’ experiences in a randomized controlled trial that evaluated the Home-Based Intervention Strategy (HIS-UK) to improve male condom use skills/experiences. Methods 25 men (18–25 years) who had reached the first 6 months of the intervention were interviewed. We used a codebook approach to thematic analysis to analyze the data. Results Four themes were identified: Perceived benefits of online versus in-clinic recruitment; Perceptions of the educational content; Benefits of the condom kit; Acceptability of condom testing and monthly questionnaire. Conclusion Participants valued the intervention, especially the condom kit that provided a range of different condoms and lubricants.

Body Mass Index and Thoracic Expansion in Post-COVID Dyspnea: A Secondary Analysis.

Dyspnea secondary to lung impairment can persist following the acute phase of COVID-19. Thoracic expansion measurements have been used as a diagnostic tool to evaluate chest wall mobility, respiratory function, and the effects of respiratory muscle strength training. Changes in chest wall mobility may occur because of altered chest biomechanics in individuals with respiratory diseases and an elevated body mass index (BMI). The purpose of this secondary analysis was to evaluate whether BMI influences thoracic expansion or forced expiratory volume over 1 second (FEV1) in individuals with persistent dyspnea following COVID-19. This study assessed the relationship between BMI and thoracic expansion, pulmonary symptoms, and exercise capacity following a home-based pulmonary rehabilitation intervention. A secondary data analysis was conducted with a sample of 19 adults with persistent dyspnea following COVID-19 infection who participated in a 12-week, home-based pulmonary rehabilitation study. Participants received expiratory muscle strength training devices and were instructed to perform pulmonary rehabilitation exercises three times per week over the study period. Pulmonary function, pulmonary symptoms, exercise capacity, and BMI measurements were collected. For analysis, study participants were divided into obese (BMI > 30 kg/m2) or nonobese (BMI < 30 kg/m2) categories. Correlations using the change scores from baseline to 12 weeks between thoracic expansion, FEV1, pulmonary symptoms, and exercise capacity were assessed. In addition, the minimal detectable change (MDC) in thoracic expansion was explored. Thoracic expansion was significantly improved after 12 weeks of training (p = .012) in the nonobese group. There was a significant correlation between the change in walking distance and pulmonary symptoms (r = -.738, p < .001) and in thoracic expansion (r = .544, p = .020), and walking distance, when controlling for BMI, but no change in FEV1. Average MDC was 1.28 for inspiration and 0.91 for expiration. Measurements of thoracic expansion were significantly lower in post-COVID individuals with an increased BMI. Individuals with persistent dyspnea and a higher BMI may require additional measures to increase chest mobility or to detect pulmonary changes following COVID-19.

Balancing family, education and work: a qualitative study of mature women studying in higher education

This article explores the transformative experiences of ten mature, female, widening participation students, and their families, as they merged higher education (HE) study into the home to manage diverse demands. Set in a university in Northwest England, this smallscale, qualitative approach, influenced by social constructionism and feminism, incorporated semi-structured interviews (10) and a focus group. It explores experiences of work-life balance (WLB) and wellbeing as HE study was added to daily life and merged into the home sphere. The findings reveal the benefits of home-based study and work-based learning for mature learners with varied responsibilities. The women developed academically and practically, and transformed as they experienced university life to gain an increased sense of belonging, which normalised university attendance in households, a change here referred to as the 'l earning family'.

Are Virtual Laboratories and Remote Laboratories Enhancing the Quality of Sustainability Education?

Sustainability education, a multidisciplinary field demanding a profound understanding of intricate scientific, engineering, social and economic systems, necessitates innovative approaches. Laboratory experimentation plays a pivotal role in engineering and scientific education. The emergence of the COVID-19 pandemic heightened the importance of remote learning and home-based study in pedagogical practices. However, engineering education has faced challenges in adapting to novel teaching methodologies. A significant challenge during lockdowns was the effective delivery of laboratory experiences in virtual spaces. Virtual and remote laboratories, while not substituting the hands-on experience of physical labs, offered promising avenues to enhance learning during the disruption of in-person education. While most teaching activities transitioned seamlessly to online formats, laboratory sessions presented unique logistical challenges, including cancellations of fieldwork. Additionally, concerns arose regarding disparities in student achievement based on income levels. This study seeks to provide an overview of the implementation status of virtual and remote laboratories during the lockdown period in education. Its goal is to offer practical insights to improve the quality of learning experiences at home and in online settings.

P003 Home-based sleep study paediatric model of care

Abstract Introduction An innovative service that was developed within a tertiary paediatric centre, involved the use of a home-based sleep study model of care (MOC) between March 2022 to September 2022. This MOC allowed low risk children to be able to undergo a sleep study earlier than, when compared to the traditional in-house sleep studies conducted within the hospital setting. Methods The MOC involved a sleep technician travelling to the patients’ home and then attaching sensors onto the child’s body. The at home sleep system used is a full, portable polysomnography system that gently simplifies the task of performing a sleep study while delivery secure and precise measurements from the comfort of the patient’s home. The system provides data collection via the use of electrocardiogram (ECG), electroencephalography (EEG), oximeter, plethsmography belts and facial electroculargraphs which are attached comfortably onto the patient’s body. An outpatient’s service run by Clinical Nurse Consultants then provided 24 hour support to families for troubleshooting overnight. Results A total of 49 home based sleep studies were performed during this period. Almost 90% of children tested had an abnormal sleep study result and 1 in 3 had moderate to severe findings. Eight studies (19%) were below the expected quality. This is comparable to in-hospital poor quality sleep study rates. Discussion The MOC reduced hospital admission for a diagnostic sleep study, provided quicker assessment and in the comfort of the child’s home.

Spontaneous infant crying modulates vagal activity in real time.

Porges' polyvagal theory (1991) proposes that the activity of the vagal nerve modulates moment-by-moment changes in adaptive behavior during stress. However, most work, including research with infants, has only examined vagal changes at low temporal resolutions, averaging 30+ s across phases of structured stressor paradigms. Thus, the true timescale of vagal regulation-and the extent to which it can be observed during unprompted crying-is unknown. The current study utilized a recently validated method to calculate respiratory sinus arrhythmia (RSA) dynamically at a high resolution of 5Hz (updated every 200ms) in a home-based infant study. Using an event-related analysis, we calculated the relative change in RSA around the onset of naturally occurring unprompted instances of n=41 infants' 180 crying events. As predicted, RSA significantly decreased after the onset of crying compared to non-crying chance changes in RSA. Decreasing trends in RSA were driven by infants with higher pre-cry RSA values, infants rated lower in Negative Affectivity, and those rated both high and low in Orienting by their mothers. Our results display the timescale of RSA in spontaneous and naturalistic episodes of infant crying and that these dynamic RSA patterns are aligned with real-time levels of RSA and also caregiver-reported temperament.

A Novel Home-Based Study of Circadian Rhythms: Design, Rationale, and Methods for the Circadia Study.

The Circadia Study (Circadia) is a novel "direct-to-participant" research study investigating the genetics of circadian rhythm disorders of advanced and delayed sleep phase and non-24 hour rhythms. The goals of the Circadia Study are twofold: (i) to create an easy-to-use toolkit for at-home circadian phase assessment for patients with circadian rhythm disorders through the use of novel in-home based surveys, tests, and collection kits; and (ii) create a richly phenotyped patient resource for genetic studies that will lead to new genetic loci associated with circadian rhythm disorders revealing possible loci of interest to target in the development of therapeutics for circadian rhythm disorders. Through these goals, we aim to broaden our understanding and elucidate the genetics of circadian rhythm disorders across a diverse patient population while increasing accessibility to circadian rhythm disorder diagnostics reducing health disparities through self-directed at-home dim light melatonin onset (DLMO) collections.

0982 Atrial fibrillation diagnosed from a home-based sleep study in a patient with REM behavior disorder

Abstract Introduction Atrial fibrillation (A-Fib) is the most common form of cardiac arrhythmia and is a major cause of stroke. Obstructive sleep apnea (OSA) is an established risk factor of A-Fib, but sleep disruption with frequent awakenings was recently identified as another risk factor, independent from OSA. Home sleep apnea test (HSAT) is widely used to diagnose OSA with low cost and short wait time, and HSAT that uses peripheral arterial tonometry (PAT) can reveal cardiac arrhythmia. Here we report a case of A-Fib detected by PAT-based HSAT in a patient with REM sleep disorder. Report of case(s) A 60-year-old man with hypertension, depression, anxiety, tobacco and alcohol use disorders presented to sleep clinic for frightening vivid dreams and violent dream enactments that gradually developed over the last two years. A diagnostic polysomnography study showed mild OSA, normal heart rhythm, and no epoch of REM sleep without atonia (RSWA). In the following four years, he used CPAP therapy, imagery rehearsal therapy, high-dose melatonin, doxepin and hydroxyzine. However, the frightening dreams and dream enactments persisted despite full adherence to CPAP. To reassess OSA, the patient took a PAT-based HSAT, which showed not only mild OSA, but one episode of irregularly irregular PAT-derived pulsation variations that lasted three hours and started and stopped abruptly. We therefore ordered longitudinal cardiac monitoring, which showed multiple asymptomatic episodes of A-Fib during nighttime. After treatments for A-Fib were started, a polysomnography study with effective CPAP titration showed one episode of A-Fib with rapid ventricular response that lasted 2.5 hours during non-REM sleep, and multiple epochs of RSWA. The diagnosis of REM sleep behavior disorder (RBD) was thus established. Conclusion We reported concurrent developments of RBD and asymptomatic paroxysmal A-Fib in a man in his early sixties. Our case suggests a potential association between RBD and A-Fib, which has not been studied but is conceivable, given that RBD causes frequent awakenings with surges of sympathetic activity. Our case also highlights the advantage of PAT in capturing not only OSA but cardiac arrhythmia. Clinical interpreters of PAT-based HSAT can seize the opportunity to diagnose A-Fib and prevent stroke. Support (if any)

0411 Long-term efficacy of lemborexant on objective sleep measures in clinical practice

Abstract Introduction In the treatment of insomnia, both subjective and objective evaluations are essential. The orexin receptor antagonist, lemborexant, has a favorable profile in terms of efficacy, acceptability, and tolerability for adults diagnosed with insomnia. To date, the long-term efficacy of lemborexant has been evaluated solely on a subjective basis, with no long-term objective measures under natural sleeping conditions. Therefore, a small, lightweight sleep electroencephalograph monitor was used to evaluate sleep objectively at home after 4 and 12 weeks of lemborexant treatment. Methods Adults and elderly subjects with insomnia disorder per DSM-5 were enrolled in an open-label, single-arm, single-center trial. Participants took lemborexant (5/10 mg) at bedtime for 12 weeks. In addition, they underwent a home-based sleep study at baseline and weeks 4 and 12. Sleep ­efficiency (SE), total sleep time (TST), latency to persistent sleep (LPS), and wake after sleep onset (WASO) were ­evaluated at home. Sleep disturbance (Pittsburgh sleep quality index: PSQI), ­sleepiness (Epworth sleepiness scale: ESS), and depressive symptoms (Beck depression index: BDI) were examined. Results 31 subjects completed the 4-week and 29 completed the 12-week assessments. Subjects showed significant improvements in objective SE at weeks 4 and 12 of treatment compared to untreated baseline. Objective TST tended to increase with the treatment at week 12. Mixed-effects linear analysis revealed that the poorer the sleep measures (SE, TST, LPS, and WASO) were at baseline, the more these measures improved with lemborexant. Scores of PSQI, ESS, and BDI significantly decreased (improved) with lemborexant treatment compared to those at baseline. Conclusion The findings from the analyses demonstrate objective improvement of SE with lemborexant treatment across 12 weeks and support the previously reported benefit of lemborexant using polysomnography. Support (if any)

Delaying feedback during pre-device training facilitates the retention of novel myoelectric skills: a laboratory and home-based study

Objective. The objective of this study was to assess the impact of delayed feedback training on the retention of novel myoelectric skills, and to demonstrate the use of this training approach in the home environment. Approach. We trained limb-intact participants to use a motor learning-based upper-limb prosthesis control scheme called abstract decoding. A delayed feedback paradigm intended to prevent within-trial adaptation and to facilitate motor learning was used. We conducted two multi-day experiments. Experiment 1 was a laboratory-based study consisting of two groups trained over a 4 day period with concurrent or delayed feedback. An additional follow-up session took place after 18 days to assess the retention of motor skills. Experiment 2 was a home-based pilot study that took place over five consecutive days to investigate delayed feedback performance when using bespoke training structures. Main Results. Approximately 35 000 trials were collected across both experiments. Experiment 1 found that the retention of motor skills for the delayed feedback group was significantly better than that of their concurrent feedback counterparts. In addition, the delayed feedback group improved their retention of motor skills across days, whereas the concurrent feedback group did not. Experiment 2 demonstrated that by using a bespoke training protocol in an environment that is more conducive to learning, it is possible for participants to become highly accurate in the absence of feedback. Significance. These results show that with delayed feedback training, it is possible to retain novel myoelectric skills. Using abstract decoding participants can activate four distinct muscle patterns without using complex algorithms. The accuracy achieved in the pilot study supports the feasibility of motor learning-based upper-limb prosthesis control after home-based myoelectric training.

Acute Effects of New Zealand Blackcurrant Extract on Cycling Time-Trial Are Performance Dependent in Endurance-Trained Cyclists: A Home-Based Study.

The intake of anthocyanin-rich New Zealand blackcurrant (NZBC) extract (300 mg per day) over a week enhanced 16.1 km cycling time trial (TT) performance in endurance-trained cyclists without acute performance effects. In the present study, the acute effects of an intake of 900 mg of NZBC extract 2 h before performing the 16.1 km cycling TT were examined. A total of 34 cyclists (26 males; 8 females) (age: 38 ± 7 years, V˙O2max: 57 ± 5 mL·kg-1·min-1) completed 4 16.1 km TTs (2 familiarization and 2 experimental trials) over 4 mornings on a home turbo-trainer connected with the online training simulator ZWIFT. There was no difference in time to complete the 16.1 km TT between conditions (placebo: 1422 ± 104 s; NZBC extract: 1414 ± 93 s, p = 0.07). However, when participants were split between faster (<1400 s; 1 female; 16 males) and slower (>1400 s; 7 females; 10 males) cyclists based on average familiarization TTs, a difference in TT performance was observed only in the slower group (placebo: 1499 ± 91 s; NZBC extract: 1479 ± 83 s, p = 0.02). At 12 km (quartile analysis), power output (p = 0.04) and speed (p = 0.04) were higher compared to the placebo with no effects on heart rate and cadence. The acute effects of 900 mg of NZBC extract on a 16.1 km cycling time-trial may depend on the performance ability of male endurance-trained cyclists. More work is needed to address whether there is a sex-specific time-trial effect of NZBC extract independent of performance ability.

Development and utilization of a smartphone app for data collection and monitoring in the context of a home-based multimodal nutrition and physical exercise intervention study with advanced tumour patients

Development and utilization of a smartphone app for data collection and monitoring in the context of a home-based multimodal nutrition and physical exercise intervention study with advanced tumour patients

Accurate Post-Calibration Predictions for Noninvasive Glucose Measurements in People Using Confocal Raman Spectroscopy.

In diabetes prevention and care, invasiveness of glucose measurement impedes efficient therapy and hampers the identification of people at risk. Lack of calibration stability in non-invasive technology has confined the field to short-term proof of principle. Addressing this challenge, we demonstrate the first practical use of a Raman-based and portable non-invasive glucose monitoring device used for at least 15 days following calibration. In a home-based clinical study involving 160 subjects with diabetes, the largest of its kind to our knowledge, we find that the measurement accuracy is insensitive to age, sex, and skin color. A subset of subjects with type 2 diabetes highlights promising real-life results with 99.8% of measurements within A + B zones in the consensus error grid and a mean absolute relative difference of 14.3%. By overcoming the problem of calibration stability, we remove the lingering uncertainty about the practical use of non-invasive glucose monitoring, boding a new, non-invasive era in diabetes monitoring.

A Preliminary Study of Voicebot to Assist ADHD Children in Performing Daily Tasks

Attention Deficit Hyperactivity Disorder (ADHD) child patients have difficulty in starting and completing daily tasks successfully on time due to executive function impairment. As a result, issues arise due to the patient having low self-efficacy and frequent troubles with parents. This study is a parallel pilot randomized controlled trial that suggests the usefulness of a voicebot to assist children with ADHD in performing daily tasks. A dialogue structure to help children’s self-instruction training and a token-based economies method for task performance were applied to the voicebot. Sixteen children and their parents [Intervention group (n = 7), Control group (n = 9)] participated in an 8-week, home-based field study. We developed the voicebot using Raspberry Pi and allowed children with ADHD to use it four times a day through voice interaction. We found that children’s use of the voicebot helped them to increase their self-efficacy, decrease the inattentiveness, increase self-control in completing daily tasks, and decrease the severity of behavioral problems. The study also revealed that it can help improve parent-child relationships. This study will be informative for researchers who engage in future studies that seek to provide insights into the area of assistive care for children with ADHD.