Family Support Research Articles

Evaluating quality of life changes in patients with cleft lip or palate: a mixed method pre- and postsurgical analysis in Karachi

BackgroundCleft lip and/or palate (CLP) is the most common orofacial congenital disability, presenting significant medical, psychological, and social challenges. In Pakistan, the incidence of CLP is high, estimated at one in 523 live births, but accurate data are lacking due to the absence of a birth registry. Early diagnosis and intervention are crucial for improving outcomes. This study evaluated the impact of CLP on patients’ quality of life in Karachi, comparing pre- and post-surgical phases.MethodsA sequential exploratory quantitative-qualitative mixed-methods study was conducted at two tertiary care hospitals in Karachi. In the quantitative phase, 280 patients with CLP, either awaiting or post-surgery, completed the Oral Health Impact Profile (OHIP-14) questionnaire to assess oral health-related quality of life (OHRQoL). Based on questionnaire responses, 30 participants were purposively selected for in-depth, semi-structured interviews exploring their experiences. Quantitative data were analyzed using SPSS version 25; qualitative data were analyzed thematically.ResultsQuantitative findings revealed significant gender disparities in cleft types and correction status; females had a higher prevalence of unilateral cleft lip, while males had more cleft palate cases. Dental and oral health issues significantly affected daily activities, with higher impacts in cleft palate patients. OHRQoL varied by gender, cleft type, and correction status, with those post-surgery reporting poorer OHRQoL. Qualitative analysis identified six themes: Diagnosis and Early Treatment, Challenges and Impact, Postsurgical Experiences, Support Systems, Healthcare Experiences, and Future Perspectives. Inconsistencies in psychological support, accessibility and financial burdens were presented as significant issues. Sentiment analysis highlighted varied emotions, from despair to hope and gratitude.ConclusionsCLP significantly affects patients’ quality of life in Karachi across multiple dimensions. Early diagnosis and surgical intervention are essential but often hindered by financial and accessibility issues. Psychological effects, including low self-esteem and social isolation, highlight the need for integrated mental health support. Family and community support are critical for patient resilience. A comprehensive approach addressing medical, psychological, social, and systemic factors is necessary to improve outcomes for individuals with CLP.

Tindak Pidana Sodomi Terhadap Anak

This article or paper aims to analyze the factors that cause deviant behavior in the form of sodomy crimes, as well as identify the impact of sexual deviation on victims, especially children. This study uses a normative juridical method with a doctrinal legal approach combined with empirical juridical. The research subjects include secondary legal materials such as laws and regulations, legal doctrines, and related literature, as well as primary data obtained through interviews with law enforcement officials, victims, or victims' families. The instruments used include interview guides, questionnaires, and official documents to support data collection. The results of the study show that sodomy crimes against children are influenced by past trauma factors, socio-economic conditions, environment, and lack of moral values. The impact includes physical injuries, emotional trauma, and severe social stigma for victims. Legal protections such as prevention, therapy, and rehabilitation require the support of family, community, and government. Preventive measures such as early sex education and environmental surveillance are necessary to protect children. A holistic approach is expected to be able to recover victims and prevent similar incidents in the future.

The Needs and Experiences of Black Families in the Neonatal Intensive Care Unit.

To identify opportunities for improvement in quality of care, we explore Black families' experiences of family support in the neonatal intensive care unit (NICU) during their infant's hospital stay. Semistructured qualitative interviews or focus groups (FGs) were conducted to explore Black families' experiences of NICU hospitalization. Inclusion criteria were self-identification as a Black family member and infant admission to our NICU between January 2020 and February 2022. We conducted reflexive thematic analysis of recorded transcripts using Dedoose software. Three interviews and 2 FGs were conducted with 9 unique families (n = 13 individuals). We organized 10 key themes into "Experiences" and "Recommendations." Experience themes included distrust and fear of the medical setting, hypervigilance and trauma trajectory formation, the myth of "Black hardiness," policing and surveillance, and undermining of Black parenting. Recommendation themes implored NICU staff to earn rather than assume trust, respect family concerns, improve mental health support, provide compassionate care, and support the parenting role. In this single-center qualitative study of Black families' NICU encounters, families continue to experience differential treatment, which reinforces an untrustworthy medical system perpetuating structural racism. Family recommendations for improving care through transparent communication, advocacy and mental health support, increased engagement in their parental role, and decreasing biased treatment and provision of resources may improve their experience and mitigate hypervigilance and trajectory formation in our NICU.

Quality of life after idiopathic multicentric Castleman disease in China: a cross-sectional, multi-center survey of patient reported outcome and caregiver reported outcome

The majority of multicentric Castleman disease (MCD) patients in China are of the idiopathic subtype (iMCD) with systemic manifestations. However, the impact of iMCD on life quality, mental and psychological status, social function, and caregiving burden is poorly understood. To address this gap, a cross-sectional web-based survey was conducted with 178 iMCD patients and 82 caregivers, including 42 patient-caregiver dyads. Patient-reported outcome measurements were performed using four self-administered questionnaires (MCD-SS, SF-36, PHQ-9, and WPAI:GH). Caregiver-reported outcome measurements were performed using three questionnaires (SF-36, Zarit-22, CRA) to assess the caregiving burden. Correlation analysis was performed in patient-caregiver dyads. Patients reported a median of nine symptoms by MCD-SS, with a high mean score of 4.34 for the Fatigue domain. Their SF-36 scores indicated significant declines in physical and mental health compared to the Chinese general population (p < 0.001). Based on PHQ-9, around 65% of patients exhibited depressive symptoms, with 28.6% of them experiencing mild to severe major depression. Only 47.2% (84/178) of the patients were employed, and 28.5% experienced impaired work time. Caregivers also reported lower SF-36 scores than the general population (p < 0.05) and expressed feeling of self-criticism, lack of family support and financial problems. Correlations were observed between patients’ symptom burden, mental health impairment and caregiving burden (correlation coefficient: 0.31 ~ 0.55). Our study concluded that fatigue and depressive symptoms significantly impact the life quality and social well-being of iMCD patients. The disease also affect the physical and mental health of caregivers, leading to feelings of guilt and a lack of family support.

Lifestyles of university students: analyzing the role of social support and family dynamics

BackgroundYouth is a critical stage for developing healthy lifestyles, as the habits and behaviors formed during this period can persist into adulthood. Understanding the relationship between family factors and the lifestyles of university students can contribute to creating strategies to improve this important health determinant. This research aimed to analyze the relationship between social support, family dynamics, and lifestyles in young university students. Design: A cross-sectional descriptive study.MethodsA probability sample of 530 young university students was analyzed. The main measurements included social support, family dynamics, and lifestyles. Descriptive analysis of quantitative and qualitative variables was performed. Pearson correlation coefficient was used for bivariate analysis, and Student’s t-test was used to analyze differences between male and female participants. Additionally, multivariate analysis was conducted using multiple linear regression.ResultsFor the total sample, a positive and moderate association was found between family dynamics (r = 0.28) and social support (r = 0.32) with the lifestyles of young individuals.ConclusionsOur results indicated that social support and family dynamics are possible protective factors that have a positive effect on the lifestyles of university students. The findings of this study highlight the importance of family and familial support in adopting healthy lifestyles among university students.

Assessment of displaced Sudanese school-age children’s mental health at Ad-Damar, River Nile, Sudan, 2024: a descriptive cross-sectional study

BackgroundThe WHO defines mental health as well-being where individuals manage stress, work productively, and contribute to their community. Children’s mental health is critical, especially among vulnerable groups like refugees. Research shows refugee children, including Sudanese, face PTSD, depression, and anxiety due to conflict and displacement, yet specific studies on Sudanese children are scarce. East Africa faces high prevalence due to poverty, conflict, and inadequate healthcare. Sudan’s situation is exacerbated by ongoing conflict and limited resources, despite efforts from NGOs and international organizations.MethodologyThis cross-sectional descriptive study examines the mental health of Sudanese school-age children (6–18 years) in Ad-Damar, River Nile, Sudan, using a simple random sampling technique. The study included 246 participants. Data were collected using an author-designed questionnaire based on the Strengths and Difficulties Questionnaire (SDQ), supplemented with demographic information. Data management involved secure handling and ethical considerations, including informed consent and confidentiality. Statistical analysis was performed using SPSS V.25 to ensure accuracy and reliability of the findings.ResultsThe sample included children aged 6–18 years, with 54% males and 46% females. Displacement duration varied, with 34% displaced for 1–2 years. Socio-demographic findings indicated 39% lived with both parents, 56% were in urban environments, and 47% were in primary school. Mental health assessments revealed 68% frequently felt sad, 73% felt anxious, and 29% had diagnosed conditions, including PTSD and depression. Correlations showed significant positive relationships between overall mood ratings and both school support (r = 0.45, p < 0.01) and family support (r = 0.35, p < 0.05). Chi-Square tests indicated significant associations between gender and mental health diagnoses (χ²=5.67, p = 0.017) and family structure and perceived support (χ²=12.34, p < 0.05).ConclusionThe study highlights the urgent need for better mental health support for displaced children, given the high prevalence of mental health issues and inadequate support from schools and families. Future research should include longitudinal studies to evaluate long-term effects and intervention effectiveness. Key steps include improving access to mental health services, fostering supportive educational environments, and enhancing family support systems.

Associations between violence in childhood, depression and suicide attempts in adolescence: evidence from a cohort study in Luwero district, Uganda

BackgroundMany studies have documented an association between violence victimisation and poor mental health. However, few studies use longitudinal data from low- and middle-income countries with attention to how associations differ by experiencing specific types of violence or alongside different contexts of peer and family support. In this study, we quantify the association between experiences of violence in early adolescence and depression and suicide attempts in late adolescence and explore whether this association is modified by family and peer connectedness.MethodsData came from the Contexts of Violence Against Children (CoVAC) cohort study in Luwero District, Uganda, involving 2773 participants aged 11–14 years at Wave 1 (2014) and 15–18 years at Wave 2 (2018). Physical, sexual, and emotional violence were measured at Wave 1. Mental health outcomes, depression symptoms in the past two weeks, and lifetime suicide attempts were measured at Wave (2) We used logistic regression models, stratified by sex, to estimate adjusted odds ratios with an interaction term to test for effect modification by peer and family connectedness at Wave 1.FindingsAt Wave 1, the prevalence of any violence from any perpetrator was 90% (physical violence: 87%, physical violence excluding caning: 68%, sexual violence: 6.3%, emotional violence: 56.8%). At Wave 2, 13.3% of participants had scores indicative of depression and 4.3% reported ever attempting suicide. Physical violence excluding caning, emotional violence, and sexual violence during early adolescence increased the odds of depression and attempting suicide in late adolescence for both boys and girls. Experiencing any violence (including caning) in early adolescence was not associated with depression in late adolescence, including in sex-stratified models. Childhood experience of any violence was associated with a suicide attempt violence in early adolescence (aOR: 2.60; 95%CI: 1.08, 6.27). High peer support mitigated the effect of any violence and physical violence on depression.ConclusionsFindings highlight the importance of efforts to prevent violence and improve access to response and support services for violence and mental health for young people. Findings also underscore the important role friends and peer networks can play in mitigating the effects of violence as young people grow up.

Cultural and religious structures influencing the use of maternal health services in Nigeria: a focused ethnographic research

BackgroundCultural and religious structures encompass a set pattern of values, beliefs, systems and practices that define a community's behaviour and identity. These structures influence women's health-seeking behaviour and access to maternal health services, predisposing women to preventable maternal health complications. However, most maternal health policies have focused on biomedical strategies, with limited attention to women’s cultural challenges around childbirth. The overall aim of this paper is to provide a thick description and understanding of cultural and religious structures in Nigeria, their meaning and how they influence women’s use of maternal health services.MethodsRoper and Shapira’s (2000) focused ethnography comprising 189 h of observation of nine women from the third trimester to deliveries. Using purposive and snowballing techniques, 21 in-depth interviews and two focus group discussions comprising 13 women, were conducted in two Nigerian primary healthcare facilities in rural and urban area of Kogi State. Data was analyzed using the steps described by Roper and Shapira.ResultsUsing the PEN-3 cultural model, nine themes were generated. Positive factor, such as the language of communication, existential factor, such as religion, and negative factors, such as the use of prayer houses and lack of women’s autonomy, were either positive or negative enablers influencing women’s use of maternal health services. Additionally, women's perceptions, such as their dependency on God and reliance on cultural norms were significant factors that influence the use of maternal health services. We also found that the use of herbal medicine was a negative enabler of women’s access to facility care. At the same time, family support was also a positive and a negative nurturer that could influence how women use facility care. Finally, factors such as religion, Ibegwu, and male child syndrome were negative nurturers influencing women’s contraceptive use.ConclusionCultural and religious structures are significant factors that could promote or limit women’s use of maternal health services. Further studies are needed to understand culturally focused approaches to enhance women’s use of maternal health services in Nigeria.

Effect of Work-Family Conflict on Job Performance: Moderating Effect of Social Support among Teleworkers

The pressing economic situation that has made the Sri Lankans work remotely or work from home is highlighted as a tremendous challenge for businesses. Thus, the current study's primary purpose is to explore whether work-family conflict; both work-interference family and family-interference work affects the job performance among the selected teleworkers of Finance companies, while they were forced to work from home. In addition, the role of social support in this dynamic remains underexplored, particularly in high-stress environments like finance. Thus, the study focuses on the moderating effect of social support gained from both supervisor and family support in examining the relationship. The research utilized a mixed research approach to meet the objectives of the current study, where 125 workers of finance companies in the Colombo region who worked from home provided data through structured questionnaires and interviews. The sample was extracted using stratified random sampling. The statistical methods for analyzing the data were hierarchical regression and thematic analysis. In this study, the authors examined work-interference family and family-interference work as being negatively correlated with job performance. Furthermore, the results indicated that the social support received from supervisors and family members moderated the effect of work-family conflict on job performance, where it showcased a tactic to lessen the teleworkers' work-family friction. This study fills in gaps in the literature and assists employers in addressing issues that WFC employees experience.

Difficulty in financing fracture care in south-western Nigeria: a prospective cohort study of predictors and recommendations for improvement

BackgroundBone fractures remain a significant global public health issue despite preventive measures, leading to substantial health and economic consequences. Effective treatment options are difficult to access in most sub-Saharan African countries, leading to reliance on unqualified practitioners and resulting in serious complications that worsen poverty. In Nigeria, the main challenge is the need for out-of-pocket payment for healthcare, which is the primary method of health financing. However, anecdotal evidence suggests that some patients find it easier to finance their fracture care than others. This study aimed to identify the factors that predict difficult fracture-care financing among patients treated operatively for long-bone fractures (LBFs) in southwestern Nigeria.MethodsThe study collected socio-demographic and clinical data on 690 consecutive adult patients with LBFs treated with SIGN nails between July 2014 and June 2024 at a mission teaching hospital in southwestern Nigeria. A literature review and preliminary interviews were conducted with patients, caregivers, and hospital staff to understand potential risk factors for difficult fracture-care financing. The patients were divided into two cohorts – easy fracture-care financing (EF) and difficult fracture-care financing (DF) – based on their promptness in paying the in-patient care bills. Potential risk factors for DF identified in the initial univariate analysis were entered as covariates into a binary logistic regression to determine the significant predictors of DF.ResultsThe mean age of the patients was 45.1 years (SD = 17.52). The DF cohort comprised 321 (46.5%) patients. Significant predictors of DF included younger age (p = 0.018), male gender (p = 0.002), lack of formal education or low level of education (p < 0.001), residence in the hospital city (p < 0.001), absence of health insurance (p = 0.013), lack of extended family support (p < 0.001), previous traditional bone setting treatment (p = 0.005), concomitant injury (p = 0.017), and a post-operative hospital stay longer than one week (p = 0.036).ConclusionsThe findings suggest that improving people’s socioeconomic status through job creation, women’s empowerment, reduction of gender inequality, higher education, comprehensive health insurance coverage, and stronger family bonds, as well as preventive strategies to reduce the occurrence and severity of injuries, can improve fracture-care financing in low-resource settings.

Pathway analysis of the impact of family function and self-efficacy on depression and anxiety in patients undergoing in vitro fertilization-embryo transfer

BackgroundPatients undergoing assisted reproductive technology (ART) experience significant psychological distress due to infertility, with depression and anxiety being the most common manifestations. This study investigates the influence of family support and self-efficacy on the mental health of patients undergoing in vitro fertilization-embryo transfer (IVF-ET). The aim is to assess the direct and indirect effects of family function and self-efficacy on depression and anxiety in IVF-ET patients through pathway analyses, thereby providing novel insights for improving patients’ psychological well-being.MethodsA cross-sectional study was conducted from March to July 2021, employing convenience sampling to recruit 291 participants from a tertiary care hospital’s reproductive medicine center. Data were collected using the Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), General Self-Efficacy Scale (GSES), Family APGAR index (APGAR), and a Demographic Characteristics Form. Descriptive analysis, Pearson correlation analysis, and multiple linear regression analysis were performed. A Structural Equation Model (SEM) was utilized for pathway analysis to evaluate the direct and indirect influences of family function and self-efficacy on anxiety and depression.ResultsThe scores for the SAS and SDS were 46.15 ± 7.35 and 51.71 ± 8.65, respectively. Multiple regression analysis indicated that family function, self-efficacy, and economic status significantly predicted anxiety and depression. Path analysis revealed that economic status directly (β=-0.447, -0.232) and indirectly (β=-0.066, -0.068) affected anxiety and depression, while family function both directly and indirectly affected depression (β=-0.323, -0.104), directly affected anxiety (β=-0.351), and self-efficacy directly influenced only depression (β=-0.509).ConclusionThe findings underscore the pivotal role of a supportive family environment and self-efficacy in alleviating anxiety and depression among IVF-ET patients. The mediating role of family function between economic status and mental health highlights the importance of integrated support systems. Enhancing family function and self-efficacy as part of comprehensive care for individuals undergoing ART is crucial for promoting patient well-being.

Experiences of patient delay among lung cancer patients in South China

BackgroundLung cancer is a commonly diagnosed cancer and the leading cause of cancer-related mortality worldwide. Cancer delay pose significant challenges for health systems globally, with patient delay being a primary factor contributing to late diagnoses, ultimately resulting in adverse outcomes and reduced survival rates. However, the underlying reasons for patient delay are not well understood, and there is a scarcity of studies that specifically examine the experiences related to patient delay among lung cancer patients. Therefore, this study aims to explore the experiences of lung cancer patients and identify potential strategies to mitigate their delays in seeking care.MethodsThe interview framework was developed based on the Theory of Planned Behavior. Face-to-face semi-structured interviews were conducted with participants. Data analysis was performed using Colaizzi’s phenomenological analysis method.ResultsA total of 30 lung cancer patients participated in the interviews, which lasted between 26 and 42 min (with an average duration of 33 min). The duration of patient delay varied from 90 to 213 days. Four themes were identified: (1) reasons for patient delay, (2) health-seeking triggers, (3) perception of patient delay, and (4) potential solutions.ConclusionLung cancer patients exhibited varying degrees of patient delay attributed to factors such as ignoring or dismissing symptoms, lack of family support, poor access to health services, and the COVID-19 pandemic. Promoting disease knowledge, optimizing resources and implementing technology-based solutions may serve as effective measures to address these issues.

The Support Needs of Parents of Children With Autism Spectrum Disorder: A Qualitative Study Based on the Nurturing Care Framework.

To explore the support needs of parents of children with autism spectrum disorder (ASD) in China under the guidance of the nurturing care framework (NCF). A descriptive qualitative study design was used. Fourteen parents of 2-6-year-old children with autism were recruited for face-to-face individual interviews in Chongqing between July and November 2023. NVivo 12.0 software was used to manage the data, and a directed content analysis was performed to extract themes. Five nurturing care needs of parents of children with autism were extracted, including acquisition of health- and disorder-related knowledge and information, maintenance of psychological and physical wellbeing, desire for individualised caregiver skills training, creation of multi-agent social support network, and accessibility of high-quality and coordinated services. Parents of children with autism have multidimensional unmet nurturing care needs. It is crucial to address these needs and develop targeted family support programs with consideration of the extracted need components. This study implies that health education, parental empowerment and psychological support should be prioritised in future family support programs. The findings also emphasise the importance of establishing a cross-departmental coordination mechanism and building a multi-agent social support network for families of children with autism. This study expands our understanding on the support needs of families of children with autism and enriches the theoretical connotation of nurturing care framework, and the results may inform the development of tailored support programs for families of children with autism in China. The results are reported in accordance with the reporting guidelines of the Consolidated Criteria for Reporting Qualitative Studies (COREQ). No patient and public contribution.

Caregiving in Asia: Priority areas for research, policy, and practice to support family caregivers.

Population aging presents a growing societal challenge and imposes a heavy burden on the healthcare system in many Asian countries. Given the limited availability of formal long-term care (LTC) facilities and personnel, family caregivers play a vital role in providing care for the increasing population of older adults. While awareness of the challenges faced by caregivers is rising, discussions often remain within academic circles, resulting in the lived experiences, well-being, and needs of family caregivers being frequently overlooked. In this review, we identify four key priority areas to advance research, practice, and policy related to family caregivers in Asia: (1) Emphasizing family caregivers as sociocultural navigators in the healthcare system; (2) addressing the mental and physical health needs of family caregivers; (3) recognizing the diverse caregiving experiences across different cultural backgrounds, socioeconomic status, and countries of residence; and (4) strengthening policy support for family caregivers. Our review also identifies deficiencies in institutional LTC and underscores the importance of providing training and empowerment to caregivers. Policymakers, practitioners, and researchers interested in supporting family caregivers should prioritize these key areas to tackle the challenge of population aging in Asian countries. Cross-country knowledge exchange and capacity development are crucial for better serving both the aging population and their caregivers.

Smartphone Adoption and Healthcare Usage Among Older Adults in India

ABSTRACT The growing aging population globally requires accessible digital healthcare services to maintain a healthy lifestyle. Smartphones have the potential to connect individuals with digital healthcare services. However, whether older adults perceive smartphones as a convenient means of accessing these services remains uncertain. This study aimed to investigate the perspectives of older Indian adults regarding smartphone adoption and its usage in healthcare services. For this, a mixed-methods approach combining quantitative and qualitative methods was employed. A total of 59 older adults participated in the study, of whom 54 completed survey questionnaires, 15 engaged in semi-structured interviews, and 10 participated in both studies. The findings reveal that older adults have adopted smartphones for various purposes after initially facing hindrances, often with assistance from family members. However, the use of smartphone-based healthcare applications remains minimal. These findings suggest that addressing the challenges older adults face with user interface design will enhance their use of healthcare applications. Thus, healthcare applications must feature a user-friendly interface specifically tailored for older adults. Additionally, familiar and popular application-inspired interfaces, social and family support, co-designing, digital health awareness, and training programmes can further promote the adoption of smartphone-based healthcare applications among older adults.

How Chinese Nurses Cope With Acculturation Challenges in Japan: A Qualitative Descriptive Study.

Chinese nurses in Japan face difficulties owing to differences in language, interpersonal behaviors, and nursing roles. This study examined how Chinese nurses in Japan cope with acculturation challenges. This study employed a qualitative descriptive design using individual semi-structured interviews with 10 Chinese nurses. Thematic content analysis was performed. Chinese nurses performed their tasks despite language barriers. Furthermore, they behaved according to Japanese social norms and adjusted their perceptions by focusing on the favorable aspects of different nursing roles. They used the same approach to overcome the psychological stress due to these differences. They learned these coping strategies through interactions with Japanese individuals in work settings. Providing support for learning language expression, behavior, and family nursing in accordance with Japanese social norms could facilitate Chinese nurses' adjustment. Moreover, a deeper understanding of each other's cultures is crucial for a successful cross-cultural collaboration.

Digital Exclusion and Depressive Symptoms among Older People: Findings from Five Aging Cohort Studies across 24 Countries.

Background: Digital exclusion is a global issue that disproportionately affects older individuals especially in low- and middle-income nations. However, there is a wide gap in current research regarding the impact of digital exclusion on the mental health of older adults in both high-income and low- and middle-income countries. Methods: We analyzed data from 5 longitudinal cohorts: the Health and Retirement Study (HRS), the English Longitudinal Study of Aging (ELSA), the Survey of Health, Ageing and Retirement in Europe (SHARE), the China Health and Retirement Longitudinal Study (CHARLS), and the Mexican Health and Aging Study (MHAS). These cohorts consisted of nationwide samples from 24 countries. Digital exclusion was defined as the self-reported lack of access to the internet. Depressive symptoms were assessed using comparable scales across all cohorts. We used generalized estimating equation models, fitting a Poisson model, to investigate the association between the digital exclusion and depressive symptoms. We adjusted for the causal directed acyclic graph (DAG) minimal sufficient adjustment set (MSAS), which includes gender, age, retirement status, education, household wealth, social activities, and weekly contact with their children. Results: During the study period (2010-2018), 122,242 participants underwent up to 5 rounds of follow-up. Digital exclusion varied greatly across countries, ranging from 21.1% in Denmark to 96.9% in China. The crude model revealed a significant association between digital exclusion and depressive symptoms. This association remained statistically significant in the MSAS-adjusted model across all cohorts: HRS [incidence rate ratio (IRR), 1.37; 95% confidence interval (CI), 1.28 to 1.47], ELSA (IRR, 1.32; 95% CI, 1.23 to 1.41), SHARE (IRR, 1.30; 95% CI, 1.27 to 1.33), CHARLS (IRR, 1.62; 95% CI, 1.38 to 1.91), and MHAS (IRR, 1.31; 95% CI, 1.26 to 1.37); all Ps < 0.001. Notably, this association was consistently stronger in individuals living in lower wealth quintile households across all 5 cohorts and among those who do not regularly interact with their children, except for ELSA. Conclusions: Digital exclusion is globally widespread among older adults. Older individuals who are digitally excluded are at a higher risk of developing depressive symptoms, particularly those with limited communication with their offspring and individuals living in lower wealth quintile households. Prioritizing the provision of internet access to older populations may help reduce the risks of depression symptoms, especially among vulnerable groups with limited familial support and with lower income.

Mental health literacy and help-seeking behaviour among adolescents in Kerala, India

Purpose Adolescence is a stage where genetic and environmental vulnerabilities can emerge as behavioural and emotional disorders. Early detection and seeking professional help are critical for these groups. This study aims to explore how mental health literacy (MHL) and other demographic variables impact help-seeking behaviour among adolescents in India. Design/methodology/approach This quantitative study used a structured questionnaire comprising demographic variables and standardized measurement tools to assess MHL, and help-seeking behaviour among adolescent pupils. Two hundred students aged 14 and above were randomly selected, with informed consent of themselves and their parents, from selected public and private schools in Ernakulam district, Kerala, India. Findings The mean age of the sample was 14.5 and 67% belonged to nuclear families with the majority being male (64%). The help-seeking attitude was negatively associated with the ability to recognize disorders among male students and positively associated with attitudes that promote recognition or appropriate help-seeking behaviour among female students. Additionally, hailing from extended families was associated with help-seeking behaviour among adolescent boys, but this relationship was not significant for girls. Originality/value The current study has identified that targeted interventions for male adolescents should focus on enhancing disorder recognition and leveraging family support, while those for female adolescents, the programs should promote positive attitudes towards recognizing mental health issues and help-seeking behaviours, integrating families and schools in the process.

AGING AND ADDICTION: A MULTIFACETED APPROACH TO TREATMENT AND RECOVERY IN THERAPEUTIC COMMUNITIES

Objective: To analyze the effects of substance use disorder on treatment and recovery across different age groups in a Therapeutic Community in Paraná. Method: This was a qualitative, exploratory, and descriptive study. Data collection was carried out in a therapeutic community using a nonprobabilistic sample of 57 inpatients; the data were collected through semistructured interviews and analyzed via Bardin's content analysis. Results: The results demonstrated diverse perceptions and experiences related to the treatment of substance use disorder. Young people discussed the impact of social and group contexts on their substance dependence trajectories. Adults focused on the impact of dependence on their professional and family lives, while elderly adults reflected on the consequences and their desire for change. Conclusion: This study highlights the need for personalized interventions that integrate psychological, social, and spiritual support, emphasizing the importance of family support and adapting public health policies to effectively meet the needs of this population.

Rendimiento académico y deserción en estudiantes universitarios

Dropping out of school can be influenced by a variety of factors, such as academic difficulties, lack of motivation, personal problems, lack of family support or lack of financial resources. Understanding these factors is crucial to developing effective student retention strategies and promoting successful college completion. In this context, the present study aimed to know the relationship between academic performance and school dropout in university students in southern Sonora. The sample consisted of 120 students of social sciences and administrative sciences from a public university, selected in a non-probabilistic manner. The instrument used was the Questionnaire for university students designed by Artunduaga (2004), which consists of 66 questions, both open and closed, in order to identify the factors that affect academic performance and student dropout. The study followed a quantitative approach and a non-probabilistic correlational design. The data collected through the questionnaire was analyzed using IBM SPSS V. 26 software, applying descriptive statistics to obtain a detailed understanding of the results. It is concluded that there is a weak correlation between academic performance and school dropout; however, good academic performance can be a protective factor against other influences that support dropout.