Parents Of Dependent Children Research Articles

Development of an intervention to support parents receiving treatment in psychiatric inpatient hospital using participatory design methods.

When parents of dependent children are treated in psychiatric inpatient hospital, it typically involves separation of parent and child for the duration of treatment, which can be highly distressing to the dyad and can result in disruption to the parent-child relationship. Parents who have experienced hospitalisation have expressed a desire for their parenting identity to be recognized and appropriately engaged with during their treatment. This recognition includes provision of interventions which support them as parents to limit the impact of their mental health on their children. The current study, the first of its kind known to have taken place, details a collaborative intervention development project for parents receiving inpatient care. The current study, the first of its kind known to have taken place, details a collaborative intervention development project for parents receiving inpatient care. This project involved the adaptation and extension of a prior parenting-focused course for parents high in anxiety to meet the needs of parents being treated in inpatient settings. In the first two stages of the three-phase project, patients, carers and mental health practitioners contributed to the revision and delivery plan for the course including developing new content for the intervention. In the final stage, which took the form of a participatory evaluation, the intervention was delivered to 11 parents receiving inpatient treatment who then provided extensive feedback. A series of iterative adaptations to the intervention were made in response to this feedback alongside stakeholder input. The final intervention comprises five modules focused on exploring the experience of parents alongside specific learning and skills orientated toward boosting their connection with their children during hospitalisation and in readiness for discharge. Preliminary feedback from patients and ward staff has been positive and the process of delivering the project on inpatient wards was associated with no increase in negative clinical outcomes. The successful development of a targeted intervention within inpatient psychiatric units offers a signal that parents treated in this setting welcome the opportunity to be supported in their parenting role. As the first known UK intervention of its kind to be developed in partnership with patients, ward staff and management, it is specifically tailored to the context and needs of this group with the potential to be delivered by a range of health professionals in this setting.

Health and social care professionals' views and experiences of supporting parents with serious mental illness.

A significant number of individuals with a serious mental illness (SMI) such as schizophrenia or bipolar disorder are also parents of dependent children. Despite the risk of adverse psychological, behavioral, and social outcomes their needs often go unmet. To better understand the needs of parents with SMI and their children it is necessary to gain insight into the perspectives and experiences of the professionals in adult mental health and children's services who work with them, and who, ultimately, are best placed to meet those needs. To explore the views and experiences of health and social care professionals working with parents with SMI to understand the needs of, and their role supporting, parents with SMI and their children. Semi-structured interviews were conducted with seventeen professionals from six NHS and Local Authority settings in England, UK. Participants were included if they were employed in adult mental health or local authority children's services and had experience of working with parents with SMI. Sampling was purposive, including a wide range of professions in these settings. Interview data were analyzed using template analysis taking a critical realist perspective. Three top-level themes were generated: (1) Impact of parental SMI on the child, (2) Accessing support from services, (3) Role of professionals working with parents with SMI. Themes highlight diverse, wide-ranging effects of SMI on the child and a reluctance from parents to seek help due to stigma and fear. Available services are reported to be inaccessible and unacceptable to parents with SMI and practitioners experience conflict when balancing the needs of the parent and child. A whole-family approach facilitated by improved communication between services is advocated. Participants believed that parents with SMI experience complex parenting challenges over and above other parents, describing a largely detrimental impact on the child. Support services were deemed inadequate, and participants stressed the need to develop specialist services tailored toward the needs of parents with SMI and their children. Although participants endorsed joined up working across health and social care settings to facilitate a whole family approach, they required greater service knowledge and training in parental SMI.

Documenting maternal and childcare information of mothers presented to substance use treatment services: A qualitative study of reports in a clinical case register

BackgroundMothers compose a significant proportion of women in substance use treatment services. These women have needs that, if not addressed, can negatively impact their capacity to parent. This study explores the feasibility of using free-text notes from electronic health records (EHRs) to identify factors that impair mothers' ability to care for their children. MethodThis study is a qualitative analysis of EHRs of 50 women attending substance use services in Southeast London who were parents of dependent children (defined as mothers of children aged <18 years independent of living together). We developed a sampling stratification process to ensure an adequate volume of data were available and analyzed per case. The study identified and tested search terms. We extracted data from clinical notes and letters of communication with other services/agencies (free-text notes) using the identified search terms and conducted deductive thematic analysis. ResultsThe mean number of documents per case was 92.17 (SD = 18.51). The study identified five themes with subthemes: childcare arrangements, family context, safeguarding issues, factors that might impact the treatment plan and care of the child, and communication between the health care and child welfare systems. ConclusionThe study demonstrates a novel approach for exploring parenting-related characteristics of mothers in substance use treatment. Despite a range of maternal and childcare-related information available on EHRs, the type of treatment and support being offered to patients in response to the reported information is less well documented. Findings highlight the need for further investments in implementing effective family centered strategies within substance use services.

Familydemic Cross Country and Gender Dataset on work and family outcomes during COVID-19 pandemic

Here we present the Familydemic Cross Country and Gender Dataset (FCCGD), which offers cross country and gender comparative data on work and family outcomes among parents of dependent children, before and during the COVID-19 pandemic. It covers six countries from two continents representing diverse welfare regimes as well as distinct policy reactions to the pandemic outbreak. The FCCGD was created using the first wave of a web-based international survey (Familydemic) carried out between June and September 2021, on large samples of parents (aged 20–59) living with at least one child under 12 in Canada, Germany, Italy, Poland, Sweden, and the US. While individual datasets are not available due to country-level restriction policies, the presented database allows for cross-country comparison of a wide range of employment outcomes and work arrangements, the division of diverse tasks of unpaid labour (housework and childcare) in couples, experiences with childcare and school closures due to the pandemic and subjective assessments of changes to work-life balance, career prospects and the financial situation of families (234 variables).

Irish experiences of parenting with early inflammatory arthritis: a qualitative study

<h2>Abstract</h2><h3>Background</h3> Symptoms of inflammatory arthritis affect human functioning. The impact of arthritis on parenting has mainly been considered in individuals with established disease and those who had arthritis before becoming parents. We aimed to explore the impact of early inflammatory arthritis on participation in parenting roles, which has not been widely studied. <h3>Methods</h3> In this qualitative study done in Ireland, one-off semi-structured interviews were used to gather personal insights into daily lived experiences of managing parenting roles in people with early arthritis and the perceived impact of the disease on parenting participation. Participants aged 32–62 years with early inflammatory arthritis (<2 years duration) and who were parents of dependent children (aged 21 years or younger) were interviewed. All participants were parents before the onset of arthritis symptoms and subsequent diagnosis. Qualitative description and thematic methods were used in the data analysis. <h3>Findings</h3> Between Nov 29, 2019, and June 25, 2020, 24 individuals with inflammatory arthritis were interviewed. The median age of participants was 46·5 years (IQR 40·0–53·8) and 20 (83%) were women. Participants discussed parenting experiences and words such as mother or father were used first by the participant and not assigned by the interviewer (who asked about parenting). The study was open to parents of all genders and self-identifiers, explicit assessment of gender was not sought. Parenting roles were substantially affected in early disease, and extensive parenting restrictions were identified, regardless of age and gender. Physical symptoms hampered everyday activities. Parent–child interactions were altered by the emotional impact of early arthritis, including low mood and increased irritability. Parents emphasised remorse at the negative impact of arthritis on their children's childhood. Parent-role identity and parents' perception of how they were viewed by their children were negatively impacted by early disease with considerable self-imposed pressure to shield children from the consequences of arthritis. Parents described feeling forced to delegate parenting roles to other people (ie, family members, siblings, and other children) due to inflammatory arthritis. Women predominantly discussed day-to-day parenting and the practical and emotional impacts on nurture, care, and play elements. Men predominantly discussed the impact on masculine identity as a provider and the fear of not being able to sustain this parenting role in the future. Men appeared to judge self-perceived success as a father on the basis of their ability to provide financially now and in the future. <h3>Interpretation</h3> Inflammatory arthritis has a negative impact on parenting, which appears to differ in early versus established arthritis. Men and women have different parent-focused priorities that require distinct health-care approaches. Understanding factors that influence parenting in people with arthritis is important to identify appropriate health-care interventions. <h3>Funding</h3> None.

“My role as a parent, to me, it has narrowed” the impact of early inflammatory arthritis on parenting roles: a qualitative study

Purpose To explore the impact of early inflammatory arthritis on participation in parenting roles. Materials and methods Twenty-four individuals (20 female) aged between 32 and 62 years with early inflammatory arthritis (<2 years duration) and who were parents of dependent children (≤21 years) were interviewed. A qualitative description study design was used, and thematic analysis methodologies were employed in the data analysis. Results Parenting roles were significantly impacted in early disease and extensive parenting restrictions were identified regardless of age and gender. Physical symptoms hampered “everyday mammy activities.” Parent-child interactions were altered by the emotional impact of early arthritis including low mood and irritability. Participants emphasised remorse at the negative impact of their arthritis on their children’s childhood. Parent-role identity and parents’ perception of how they were viewed by their children were negatively impacted by early disease with considerable self-imposed pressure to shield children from the consequences of arthritis. A forced “role switch” requiring relinquishing of some parenting tasks was identified as an unwanted burden associated with inflammatory arthritis. Conclusion Inflammatory arthritis has a negative impact on parenting which is present from disease onset. Understanding factors which influence parenting with arthritis is important to identify appropriate healthcare interventions. Implications for rehabilitation An early diagnosis of inflammatory arthritis is synonymous with considerable challenges in performing parenting tasks and activities which are present despite early medical management and drug therapy. Physical and psychosocial sequelae of early inflammatory arthritis result in restrictions in the execution of parenting activities and are accompanied by a forced “role switch”. The disease impact on parenting differs in early and established inflammatory arthritis and requires distinct healthcare approaches and interventions to adequately address the needs. Parent role identity and perceived lack of control are intrinsically linked to the degree of perceived negative impact on parenting and these factors should be considered in the design and evaluation of appropriate healthcare interventions for this population.

Occurrence, prevention, and management of the psychological effects of emerging virus outbreaks on healthcare workers: rapid review and meta-analysis

ObjectiveTo examine the psychological effects on clinicians of working to manage novel viral outbreaks, and successful measures to manage stress and psychological distress.DesignRapid review and meta-analysis.Data sourcesCochrane Central Register of...

Understanding health-related quality of life in adult women with metastatic cancer who have dependent children.

Cancer is a leading cause of death among women of parenting age in the United States. Women living with advanced or incurable cancer who have dependent children experience high rates of depression and anxiety as well as unique parenting challenges. To the authors' knowledge, few studies to date have examined the parenting factors associated with health-related quality of life (HRQOL) in women with advanced cancer. The authors conducted a cross-sectional, Web-based survey of the psychosocial concerns of 224 women with a tumor-node-metastasis staging system of the AJCC stage IV solid tumor malignancy who had at least 1 child aged <18 years. Participants completed validated measures of HRQOL (Functional Assessment of Cancer Therapy-General [FACT-G]); depression and anxiety symptom severity; functional status; parenting concerns; and investigator-designed questions to assess demographic, communication, and parenting characteristics. Multiple linear regression models were estimated to identify factors associated with FACT-G total and subscale scores. The mean FACT-G score was 66 (standard deviation, 16). The mean Emotional Well-Being subscale scores were particularly low (13; standard deviation, 5). In multivariable linear regression models, parenting variables explained nearly 40% of the HRQOL model variance. In the fully adjusted model, parenting concerns and the absence of parental prognostic communication with children both were found to be significantly associated with HRQOL scores. For each 1-point increase in parenting concern severity, FACT-G scores decreased by 4 points (P = .003). Women with metastatic cancer who are parents of dependent children are at risk of high psychological distress and low HRQOL. Parenting factors may have a negative influence on HRQOL in this patient population. Cancer 2018;124:2629-36. © 2018 American Cancer Society.

Patient preferences, knowledge and beliefs about kidney allocation: qualitative findings from the UK-wide ATTOM programme

ObjectiveTo explore how patients who are wait-listed for or who have received a kidney transplant understand the current UK kidney allocation system, and their views on ways to allocate kidneys...

Developing family rooms in mental health inpatient units: an exploratory descriptive study.

BackgroundFamily-friendly spaces for children and families to visit inpatient mental health units are recommended in international mental health guidelines as one way to provide service delivery that is responsive to the needs of parent-consumers and families. There is a lack of evidence on the implementation of family-friendly spaces or Family Rooms. This study aimed to explore the development, role, and function of Family Rooms in four mental health inpatient units in a local health district in NSW Australia.MethodsAn exploratory descriptive inductive-deductive design using multiple data sources was employed. Methods included Family Room usage and parental status data over a 12 week period, an open-ended questionnaire, and semi-structured interviews with 20 nurses.ResultsAvailable parental status data indicated that between 8–14 % of inpatients were parents of dependent children under 18. Family Room usage was multipurpose and used specifically for children & families 29 % of the time. As spaces in the units, Family Rooms were perceived as acknowledging of the importance of family, and providing comfortable, secure spaces for parent-consumers and their children and family to maintain connections. Units did not have local policies or guidelines on the development, maintenance, and/or use of the rooms.ConclusionsDespite long-standing recognition of the need to identify consumers’ parental status, there remains a lack of systematic processes for identifying parents in mental health inpatient services nationally. Family Rooms as spaces within inpatient units acknowledge the importance of families and are a step towards provision of family-focused mental health care. Recommendations for establishing and maintaining Family Rooms are outlined.

Standards of practice for the adult mental health workforce: meeting the needs of families where a parent has a mental illness.

This article outlines the development of practice standards for the adult mental health workforce for addressing the needs of families where a parent has a mental illness (FaPMI). The practice standards recommended here were formulated using a modified cooperative inquiry process with a group of senior clinical leaders in adult mental health services in Australia, following consultation with the available literature and policy documents. The aim of the project was to generate, align, and operationalize family-inclusive practice standards within the core activities of the adult mental health workforce and integrate into the continuum of care and recovery for service users who are parents of dependent children. As part of a modified Delphi method, the standards were also ranked by the senior clinical leaders to determine what they believe to be essential and recommended practices for the adult mental health workforce they manage. We argue that developing practice standards that provide practical and realistic expectations of the adult mental health service workforce enable services and workers to better adapt practice to respond to FaPMI.

Impact of caregiver and parenting status on time trade-off and standard gamble utility scores for health state descriptions

BackgroundThe purpose of this study was to examine the effect of caregiver status on time trade-off (TTO) and standard gamble (SG) health state utility scores. Respondents were categorized as caregivers if they reported that either children or adults depended on them for care.MethodsThis study was a secondary analysis of data from three studies in which general population samples rated health state descriptions. Study 1: UK; four osteoarthritis health states. Study 2: UK; three adult ADHD health states. Study 3: US; 16 schizophrenia health states. All three studies included time trade-off assessment. Study 1 also included standard gamble. Descriptive statistics were calculated to examine willingness to trade in TTO or gamble in SG. Utilities for caregivers and non-caregivers were compared using t-tests and ANCOVA models.ResultsThere were 364 respondents including 106 caregivers (n = 30, 47, and 29 in Studies 1, 2, and 3) and 258 non-caregivers. Most caregivers were parents of dependent children (78.3%). Compared to non-caregivers, caregivers had more responses at the ceiling (i.e., utility = 0.95), indicating less willingness to trade time or gamble. All utilities were higher for caregivers than non-caregivers (mean utility difference between groups: 0.07 to 0.16 in Study 1 TTO; 0.03 to 0.17 in Study 1 SG; 0.06 to 0.10 in Study 2 TTO; 0.11 to 0.22 in Study 3 TTO). These differences were statistically significant for at least two health states in each study (p < 0.05). Results of sensitivity analyses with two caregiver subgroups (parents of dependent children and parents of any child regardless of whether the child was still dependent) followed the same pattern as results of the primary analysis. The parent subgroups were generally less willing to trade time or gamble (i.e., resulting in higher utility scores) than comparison groups of non-parents.ConclusionsResults indicate that caregiver status, including being a parent, influences responses in time trade-off health state valuation. Caregivers (i.e., predominantly parents) were less willing than non-caregivers to trade time, resulting in higher utility scores. This pattern was consistent across multiple health states in three studies. Standard gamble results followed similar patterns, but with less consistent differences between groups. It may be useful to consider parenting/caregiving status when collecting, interpreting, or using utility data because this demographic variable could influence results.

The Effects of Behavioral Parent Training on Placement Outcomes of Biological Families in a State Child Welfare System

Behavioral parent training has proven effective in improving the skill performance of foster caregivers and biological parents of dependent children during role-play assessments. To date, however, no studies have examined the impact of behavioral parenting skills training on child placement outcomes. We conducted a quasi-experimental archival analysis of the case files of 171 biological parents who completed a behavioral parent training program and 171 control families who did not participate in the program but were matched on the county of service and time of Child Protective Services involvement in Alabama. Results indicate that parents were not only able to demonstrate use of the new skills after behavioral parent training, but that skill acquisition was associated with better placement outcomes for their children compared to control families and a greater number of closed cases for the state service-delivery system.

Do Nurses Support the Patient in His or Her Role as A Parent in Adult Psychiatry?: A Survey of Mental Health Nurses in Finland

This study describes the extent to which registered and practical mental health nurses support, and consider the support in the units on parental responsibility in adult psychiatry, with regard to clients who are parents of dependent children and the predictors for this. A questionnaire survey was carried out in 2005 with Finnish practical and registered mental health nurses. Most nurses claimed that they support the well-being of parent clients and discuss with them about their children. At the units there is offered a support for parents in the therapeutic milieu and with managing at home with their parental duties. Nurses' ability to support their clients as parents and to recognize the support at the units increases through personal experiences such as being parent, professional experience, and further professional education.

Parenting is a Mental Health Issue

Increasing numbers of adults with a psychiatric disorder are also parents of dependent children. The present article aims to outline ways in which Fellows of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) can assist in enhancing psychiatric care when a person with a mental illness also has parenting responsibilities. The national Children of Parents With A Mental Illness (COPMI) initiative undertook consultations with consumers, carers, young people and a range of professionals to assist in development of documents and resource materials to enhance policy and practice. Communication and interaction with key psychiatrists' professional bodies to seek their advice and participation has been maintained throughout the project. The RANZCP Fellows have assisted the COPMI project in the development and dissemination of draft principles and recommended actions for services and people working with children of parents with a mental illness and their families, and in the development of associated resource materials. They are now considering a College position statement on this issue. If children of parents with a mental illness are to benefit from proposed enhancements to practice relating to services provided to their families, it is essential that psychiatrists themselves are involved in the development, implementation and review of good practice in this area.

Does Having Children Affect Adult Smoking Prevalence and Behaviours at Home?

BackgroundSmoking prevalence and smoking behaviours have changed in society and an increased awareness of the importance of protecting children from environmental tobacco smoke (ETS) is reported. The aim of this study was to find out if smoking prevalence and smoking behaviours were influenced by parenthood, and if differences in health-related quality of life differed between smoking and non-smoking parents.MethodsQuestionnaires were sent to a randomly selected sample, including 1735 men and women (20–44 years old), residing in the south-east of Sweden. Participation rate was 78%. Analyses were done to show differences between groups, and variables of importance for being a smoker and an indoor smoker.ResultsParenthood did not seem to be associated with lower smoking prevalence. Logistic regression models showed that smoking prevalence was significantly associated with education, gender and mental health. Smoking behaviour, as well as attitudes to passive smoking, seemed to be influenced by parenthood. Parents of dependent children (0–19 years old) smoked outdoors significantly more than adults without children (p < 0.01). Logistic regression showed that factors negatively associated with outdoor smoking included having immigrant status, and not having preschool children. Parents of preschool children found it significantly more important to keep the indoor environment smoke free than both parents with schoolchildren (p = 0.02) and adults without children (p < 0.001). Significant differences in self-perceived health-related quality of life indexes (SF-36) were seen between smokers and non-smokers.ConclusionAs smoking behaviour, but not smoking prevalence, seems to be influenced by parenthood, it is important to consider the effectiveness of commonly used precautions when children's risk for ETS exposure is estimated.

Does having children affect adult smoking prevalence and behaviours at home?

BackgroundSmoking prevalence and smoking behaviours have changed in society and an increased awareness of the importance of protecting children from environmental tobacco smoke (ETS) is reported. The aim of this study was to find out if smoking prevalence and smoking behaviours were influenced by parenthood, and if differences in health-related quality of life differed between smoking and non-smoking parents.MethodsQuestionnaires were sent to a randomly selected sample, including 1735 men and women (20–44 years old), residing in the south-east of Sweden. Participation rate was 78%. Analyses were done to show differences between groups, and variables of importance for being a smoker and an indoor smoker.ResultsParenthood did not seem to be associated with lower smoking prevalence. Logistic regression models showed that smoking prevalence was significantly associated with education, gender and mental health. Smoking behaviour, as well as attitudes to passive smoking, seemed to be influenced by parenthood. Parents of dependent children (0–19 years old) smoked outdoors significantly more than adults without children (p < 0.01). Logistic regression showed that factors negatively associated with outdoor smoking included having immigrant status, and not having preschool children. Parents of preschool children found it significantly more important to keep the indoor environment smoke free than both parents with schoolchildren (p = 0.02) and adults without children (p < 0.001). Significant differences in self-perceived health-related quality of life indexes (SF-36) were seen between smokers and non-smokers.ConclusionAs smoking behaviour, but not smoking prevalence, seems to be influenced by parenthood, it is important to consider the effectiveness of commonly used precautions when children's risk for ETS exposure is estimated.

Implementing Equal Justice for Parents in Washington: A Dual Approach

ABSTRACTIn many states, legal representation for parents of dependent children is inadequate and can be a source of delays in securing permanency for children and unnecessarily protracted court proceedings. Often, such parents also face barriers to accessing services and independent evaluators. These issues are being addressed in the state of Washington through two approaches. The first is a successful enhanced legal representation program that has substantially improved case outcomes. The second is a statewide committee using innovative means to examine systemic responses to the challenges of the Adoption and Safe Families Act.

Identifying the Family, Job, and Workplace Characteristics of Employees Who Use Work‐Family Benefits*

A contextual effects perspective is used to identify family, job, and workplace characteristics associated with the use of work‐family benefits by 527 employees in 83 businesses. Parents of dependent children are no more likely than other employees to use benefits but particular family problems predict female employee use of paid leave and mental health benefits. Workplace size, sector, and culture are better predictors of employee use than are employee job characteristics.

Psychiatric emergencies: assessing parents of dependent children

Frameworks within which services are delivered to people with mental health problems neglect the specific needs of those with dependent children. These children have been identified as having risks to their development and well-being. A system of monitoring social assessments of mental health crisis is used to examine the characteristics of parents assessed in seven Local Authorities across 3 calendar years. Parents of dependent children are underrepresented, and are more likely to be women and to suffer from affective psychosis. Ethnic minorities are over-represented. Parents are less likely to be detained following assessment. Further work is needed to establish whether the needs of the family as a whole are addressed.