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PubMed2004

Parents and their cochlear implanted child: questionnaire development to assess parental views and experiences.

OBJECTIVES: To test the reliability of a validated closed-format questionnaire assessing parental views following cochlear implantation of their child. DESIGN: Parents were surveyed using a closed-format questionnaire developed in earlier work. The same parents were surveyed 1 month later and responses compared. Test-retest reliability was thereby assessed. SETTING: Tertiary referral Pediatric Cochlear Implant Centre in the UK. SUBJECTS AND METHODS: The parents of 20 children who had been born deaf or were deafened by age 3 years and who had been implanted for at least 2 years were drawn at random from patient lists. Parents were surveyed using a closed-format questionnaire whose validity had been previously assessed and re-surveyed 1 month later. Responses over time were compared. RESULTS: For the majority of items in the questionnaire, the replication of the item would lead to the same response on at least 95% of occasions. The text of the closed-format questionnaire is reproduced in full. CONCLUSION: This validated closed-format questionnaire appears to be unique in respect of cochlear implantation, being based explicitly on issues thought important by the parents. The high test-retest reliability indicates that it is capable of eliciting parental views in a meaningful manner. This information that is not currently available by other means can then be used as part of an overall assessment of outcomes, to inform efforts aimed at quality improvement as well as demonstrating accountability to purchasers and policymakers. Moreover, a wider use of this instrument can result in valid comparisons of outcomes among different cochlear implant centres.

Adult↗
PubMedDate not supplied

Parental representations in drug-dependent patients and their parents.

The Parental Bonding Instrument (PBI), a measure of perceived parental care and protection, was administered to drug-dependent patients and their parents with the aim to assess the reliability of the instrument in such samples and to compare the parental representations across generations. Ninety drug-dependent patients and 44 mothers and 35 fathers participated. Reliability indices were calculated, and parental representations of parents and their offspring were compared. Linear regression analyses were performed with the patient's PBI score as the dependent variable and the mother's and father's PBI scores as predictor variables. The reliability indices were highly satisfactory and varied between 0.61 and 0.91. The parental bonding of patients, fathers, and mothers was similar. All three groups reported high maternal and paternal control and low maternal care, a pattern characteristic of an "affectionless control" rearing style. Maternal care received by the fathers and paternal protection received by the mothers predicted the care and protection they themselves gave to their drug-dependent offspring.

Adult↗
PubMed1999

Parenting behaviors and perceived parenting competence of child sexual abuse survivors.

OBJECTIVE: This paper reports data testing two alternative hypotheses: (1) the relationship between child sexual abuse and subsequent parenting attitudes and behaviors is a function of the third variable, growing up experiences other than CSA; and (2) maternal depression mediates the relationship between CSA and the same parenting variables. METHOD: The current study was a retrospective survey of 516 very low-income, urban mothers. Parenting was assessed with three measures: The Parenting Competence Scale and the verbal and severe violence subscales of the Conflict Tactics Scale. RESULTS: Findings for two of the dependent variables, perceived parenting competence and severe violence, supported the third variable hypothesis. The mediational hypothesis was not supported for any of the parenting indicators. CONCLUSIONS: Findings regarding the third variable hypothesis are discrepant from those of the one earlier study that tested this hypothesis, suggesting that before conclusions can be drawn regarding the effect of CSA on parenting further research is in order.

Adolescent↗
PubMed2003

Predictors of the psychosocial adjustment of children living in households of parents in which fathers abuse drugs: the effects of postnatal parental exposure.

The purpose of this study was to examine the relationship between the psychosocial adjustment of children living in households of parents (N=112) in which fathers were entering treatment for substance abuse and the following sets of variables: (a) parents' sociodemographic characteristics, (b) parents' dyadic adjustment, (c) fathers' substance use severity, and (d) parents' psychological adjustment. Mothers did not meet current criteria for a psychoactive substance use disorder on alcohol or other drugs; moreover, based on reports by parents, none of the children was not exposed prenatally to illicit drugs. Results of hierarchical-by-blocks regression analyses revealed that each of the variable sets made a significant unique contribution to the prediction of children's psychosocial adjustment. Furthermore, the following variables within the sets were also found to be significant: (a) parents' age, (b) weekly family income, (c) frequency of male-to-female physical aggression between the parents, (d) frequency of fathers' substance use during the previous year, (e) diagnosis of antisocial personality disorder of fathers, and (f) mothers' level of psychological distress.

Adaptation, Psychological↗
PubMed1995

Compensatory parenting: how mothers describe parenting their 3-year-old, prematurely born children.

Premature infants and their mothers experience difficulties in establishing their relationships. The effect of these early problems on later parenting is not known. This study explored whether mothers' recollections surrounding the birth and hospitalization of a preterm infant affected their perceptions and their parenting of these children at 3 years of age. Twenty-seven primary caregivers of 30 prematurely born children completed three questionnaires on their perceptions of their children and were interviewed about parenting experiences. The core concept identified in analysis was compensatory parenting, a parenting style in which mothers provided special experiences and avoided others in an attempt to compensate the children for their neonatal experiences. Compensatory parenting was influenced by the view of these prematurely born children as both special and normal and by salient prenatal, labor, and delivery experiences; memories of the neonatal intensive care unit experience; the sequelae of emotional responses to these experiences; and subsequent health problems after discharge. Prospective research is needed to further study compensatory parenting and to develop interventions.

Adaptation, Psychological↗
PubMed1995

Adolescent social competence, parental qualities, and parental satisfaction.

Dimensions of adolescent social competence and parental qualities were examined as predictors of parental satisfaction using a sample of 736 parents. Several aspects of adolescent social competence and parental qualities were found to predict parental satisfaction. Of these, parental support was the strongest predictor, while the use of induction (rational control) was related only to fathers' well-being. Perceptions of adolescent social competence evidenced some differences between mothers and fathers in parental satisfaction. Implications for intervention strategies are discussed.

Adolescent↗
PubMed2003

The parenting competency framework: learning to be a parent of a child with asthma.

Every parent who faces an illness in their child might doubt their competence to care. When a chronic illness is diagnosed, competence can be severely challenged because of the sustained and multiple disruptions to daily life. A conceptual framework entitled 'Learning to be a Parent of a Child with Asthma' was developed from the results of a descriptive phenomenological study completed in Perth, Western Australia. It describes the stages of challenges to competency that parents experience as they learn to care for their asthmatic children. The impact of this illness on parents and the extent to which they are able to help their children respond to the demands of asthma are critical components in understanding the effect of this disease on parental competency. Insight into parental competency and the relationship to chronic illness will help health professionals provide the support and information needed by parents to manage asthma in their children.

Adaptation, Psychological↗
PubMedDate not supplied

Parent-child interaction: a comparison of parents' perceptions in three groups.

PURPOSE: To evaluate a children's version of the ICF that takes children's dependency on their parents and a developmental perspective into consideration. METHOD: This study explored how 91 parents perceived child participation in terms of parent/child immediate interaction, and desires for ideal interaction in relation to body impairments and activity limitations. Similarities and differences were investigated in three matched groups of families through questionnaires. Group 1 consisted of parents of children with profound multiple disabilities, Group 2 was developmentally matched and Group 3 was matched according to chronological age. RESULTS: The children with profound multiple disabilities expressed the same amount of emotions as the other groups, but they had difficulties expressing more complex emotions. Parents perceived the children's behaviour styles in a similar way in the three groups. There were significant differences in how the immediate interaction was perceived with parents to children of Group 1 perceiving difficulties in maintaining joint attention and directing attention. CONCLUSIONS: The results suggest that parental perceptions of the interaction with their children with profound multiple disabilities in the immediate setting to a certain extent are related to the body impairments of the children but not strongly to communicative skills /activity limitations. Thus, to focus communication intervention on participation and interaction, assessment and questions to parents have to be focused directly on these issues.

Abnormalities, Multiple↗
PubMed2005

Depression in the young, parental depression and parenting stress.

OBJECTIVE: To examine the relationship between depression in children and adolescents, parental depression and parenting stress. METHODS: Fifty-three depressed youths, 9-16 years, were matched for age and gender and compared with 53 non-depressed controls. Depression was diagnosed using the Diagnostic Interview for Children and Adolescents-Revised (DICA-R). Parents completed questionnaires on depression and parenting stress. RESULTS: Parents of depressed children reported higher parenting stress and were more likely to perceive their children as 'difficult'. Univariate analysis demonstrated a relationship between children's depression and maternal depression but not with paternal depression. This became non-significant with multivariate analysis, implying that maternal depressive symptoms may have been due to caring for a depressed, thus 'difficult' child. CONCLUSIONS: Depressed youth were more likely to be perceived by mothers as 'difficult' and caused them significant parenting stress. The same phenomenon did not occur among the fathers. Clinicians need to consider the presence of depression among 'difficult' children and look for early depression in mothers of depressed youth.

Adolescent↗
PubMed2002

How good are parents at assessing melanocytic nevi on their children? A study comparing parental counts, dermatologist counts, and counts obtained from photographs.

The objective of this study was to evaluate agreement among counts of melanocytic nevi made by parents, counts made by a dermatologist, and counts made by assessment of photographs. In 1990, 421 schoolchildren aged 6-15 years from Townsville, Queensland, Australia (latitude 19.16 degrees S), participated in the Eastern Australian Childhood Nevus Study. In an agreement study, parents were asked to mark on an anatomic diagram any melanocytic nevi greater than or equal to 2 mm in diameter and greater than or equal to 5 mm in diameter they observed on their child's back prior to the child's examination by a dermatologist; 324 parents responded (a 77% response rate). Standardized slide photographs of each child's back were taken, and melanocytic nevi were counted by an experienced non-medical-examiner upon projection. Agreement was assessed graphically and with the concordance correlation coefficient (r(c)). Parental counts of melanocytic nevi were similar to counts made by the dermatologist (n = 77; for nevi >or=2 mm, r(c) = 0.51; for nevi >or=5 mm, r(c) = 0.78) and counts obtained from the photographs (n = 324; for nevi >or=2 mm, r(c) = 0.68; for nevi >or=5 mm, r(c) = 0.68). Few parents reported false-positive lesions. Parents tended to underestimate the number of melanocytic nevi greater than or equal to 2 mm in diameter (mean difference from dermatologist: -3.2, standard deviation 6.8; mean difference from photographs: -1.1, standard deviation 5.1), particularly when the density of melanocytic nevi was high. Agreement between dermatologist counts and photograph counts was high (for nevi >or=2 mm, r(c) = 0.80; for nevi >or=5 mm, r(c) = 0.87). The authors conclude that parents are capable of counting melanocytic nevi on their children's skin with some validity. In epidemiologic studies of children, counts of melanocytic nevi obtained from standardized photographs have the potential to replace counts made by physicians.

Adolescent↗
PubMed2006

Parental resources, parental stress, and socioemotional development of deaf and hard of hearing children.

In recent years, empowerment and resource orientation have become vital guidelines for many of the sciences. For the field of deaf education, it is also highly important to look carefully at these guidelines if we are to acquire a better understanding as regards both the situation of the parents involved and the development of the deaf and hard of hearing children themselves. A resource-oriented approach to deaf education has therefore proved especially helpful. If both the theoretical and practical aspects of educating deaf and hard of hearing children are to benefit, research on parental experience with deafness and research on the socioemotional development of the children must always be combined and studied in the context of resource availability. In a study of 213 mothers and 213 fathers of deaf and hard of hearing children, we used an array of different questionnaires (PSI, SDQ, SOC, F-SozU, etc.) to examine the correlation between parental resources, sociodemographic variables, parental stress experience, and child socioemotional problems by way of a path analysis model. The results show that high parental stress is associated with frequent socioemotional problems in the children, thus emphasizing the importance of a resource-oriented consulting and support strategy in early intervention, because parental access to personal and social resources is associated with significantly lower stress experience. Child development seems to profit enormously from a resource-oriented support concept. In addition, the results confirm two earlier findings: parents with additionally handicapped children are especially stressed and the child's communicative competence makes for a more sound prediction than its linguistic medium (spoken language or sign). The path models for mothers and fathers agree in all essential factors. The results are discussed with a view to their meaning for pedagogical practice, and recommendations for further research are given (longitudinal data, more representative samples, cochlear implant).

Adult↗
PubMed1991

Like parent like child? Associations between drinking and smoking behaviour of parents and their children.

This paper examines the association between the smoking and drinking behaviours of parents and their adolescent children, and the effect of gender and social class upon this association. It is based on data collected from a cohort of young people and their parents, resident in the west of Scotland. Both social class and parental smoking behaviour were independently associated with young people's smoking, with young people from lower social class households or whose parents smoked being most likely to smoke. Social class and gender were independently associated with young people's drinking, with males and young people from non-manual households being most likely to drink. Parental drinking behaviour was associated positively with young people's drinking only in non-manual classes and among daughters. We conclude that it is important to take social class and gender into account since it may influence whether or not there is an association between the behaviour of young people and that of their parents, and it may influence young people's behaviour in addition to influences from parental behaviour.

Adolescent↗
PubMed2005

The relationship between maternal self-efficacy and parenting practices: implications for parent training.

The present study examined the relationship between maternal self-efficacy, dysfunctional discipline practices and child conduct problems. Specifically, three levels of self-efficacy, global, domain and task-specific self-efficacy, were assessed in mothers of 2- to 8-year-old children with conduct problems (clinic group, n=45) and non-clinic mothers from the community (non-clinic group, n=79). Measures of global, domain and task-specific self-efficacy were completed by mothers. Clinic mothers reported significantly lower self-efficacy than non-clinic mothers for all but one of the parenting tasks assessed. Both groups of mothers reported lowest self-efficacy for similar parenting tasks. In the sample as a whole self-efficacy measures were significant predictors of maternal discipline style after controlling for other parent, child and risk factors. Of the self-efficacy variables behavioural self-efficacy was the best predictor of mothers discipline style. The findings support the importance of developing parenting strategies that enable parents to generalize their parenting skills to a diverse range of diverse parenting contexts both in the home and in the community.

Adult↗
PubMed2004

Satisfaction with care: a study of parents of children with congenital heart disease and parents of children with other diseases.

AIM: We compared parents of children with congenital heart disease (PCCHD, n=1092) with parents of children with other diseases (PCOD, n=112) regarding satisfaction with their children's care (SCC). We also examined the association between parental/patient characteristics and SCC. METHOD: The parents completed a questionnaire about such areas as satisfaction with care, children's health status, and financial situation. The design was cross-sectional and data were gathered over 20 consecutive days. RESULTS: The univariate and multivariate analyses showed that PCCHD were more satisfied with their children's medical care and waiting period for treatment of their ill children than PCOD, although the difference was only modest. Furthermore, mothers were less satisfied with staff attitudes than fathers, with the lowest satisfaction among mothers of children with CHD. However, the multivariate analysis indicated that less satisfaction with care was more associated with decreasing child age, unemployment, financial burden of disease, social isolation and psychological distress than with children's diseases, their severity and parental gender. CONCLUSION: We corroborated some previous findings and may have provided new insights regarding determinants of SCC among parents. Interventions to improve SCC may need to address issues of parental psychological distress, socialization, and financial burden of illness. Possible ways of achieving this are discussed. Finally, research in a longitudinal format is needed to further scrutinize determinants of parental SCC.

Adult↗
PubMed2001

Parents' Perceptions of Primary Care: measuring parents' experiences of pediatric primary care quality.

OBJECTIVE: A measure of pediatric primary care quality that is brief, practical, reliable, and valid would be useful to patients and pediatricians, policymakers, and health system leaders. Parents have a unique perspective from which to report their experiences with their child's primary care, and these reports may be valid indicators of pediatric primary care quality. The research objective was to develop a brief parent report of their children's primary care, the Parent's Perceptions of Primary Care measure (P3C), and to test its reliability and validity as a measure of pediatric primary care quality. STUDY DESIGN: The P3C was based on the elements of primary care as defined by the Institute of Medicine. Pretesting of domain content and item clarity was accomplished via focus interviews. The P3C was developed in English and translated to Spanish, Vietnamese, and Tagalog. The 23-item P3C yields a total score, as well as subscale scores for continuity, access, contextual knowledge, communication, comprehensiveness, and coordination. The P3C was administered to 3371 parents of children in kindergarten through sixth grades in a large, urban school district. PRINCIPAL FINDINGS: The percentage of missing values for the overall sample was 1.88%, indicating acceptable feasibility. Range of measurement, assessed via floor and ceiling effects, was moderate to good. Cronbach's coefficient alpha, an indicator of scale internal consistency reliability, was 0.95 for the P3C total scale. Factor analysis supported the subscale structure, and P3C scores were higher for children with health insurance, whose parents completed the survey in English, and who had a regular physician. P3C scores were positively related to parent reports of the child's health-related quality of life. CONCLUSIONS: The P3C is a practical, reliable, and valid measure of parents' reports of pediatric primary care quality. This brief measure could be used alone, or in conjunction with other measures, to enhance outcomes and evaluate the impact of systems changes on the delivery of the main elements of primary care.

Analysis of Variance↗
PubMed2005

Child health care clinicians' use of medications to help parents quit smoking: a national parent survey.

BACKGROUND: Smokers who use cessation medications when they attempt to quit double their likelihood of success. No prior survey has assessed the acceptability to parents of receiving smoking cessation medication prescriptions in the context of their child's primary care visits. OBJECTIVE: To assess acceptability to parents of receiving smoking cessation medication prescriptions and to compare that with the reported rate of actually receiving smoking cessation medication prescriptions in the context of the child's health care visit. METHODS: Data were collected through a national random-digit dial telephone survey of households from July to September 2003. The sample was weighted according to race and gender, on the basis of the 2002 US Census, to be representative of the US population. RESULTS: Of 3990 eligible respondents contacted, 3010 (75%) completed surveys; 1027 (34%) of those were parents. Of those parents, 211 (21%) were self-identified smokers. One half would consider using a smoking cessation medication and, of those, 85% said that it would be acceptable if the child's doctor prescribed or recommended it to them. In contrast, of the 143 smoking parents who accompanied their child to the doctor, only 15% had pharmacotherapy recommended and only 8% received a prescription for a smoking cessation medication. These results did not vary according to parent age, gender, race, or child age. CONCLUSIONS: Child health care clinicians have low rates of recommending and prescribing cessation therapies that have proved effective in other settings. The recommendation or provision of cessation medications would be acceptable to the majority of parents in the context of their child's health care visit.

Child↗
PubMedDate not supplied

Parent-to-parent support: a critical component of health care services for families.

Families of children with chronic medical conditions or disabilities face many unique difficulties. It is often necessary for them to assimilate technical medical information and participate in important decisions regarding their children's care before they have had time to adjust to their children's condition. Health care providers are not always available to help parents learn how to function in their dramatically changed roles. To adjust to their new parenting roles and work through feelings of confusion, denial, anxiety, guilt, anger, and depression, parents of children with special health care needs need opportunities to fully vent feelings, and to experience the grieving processes in their own way and at their own pace, in a nonthreatening, nonjudgmental environment. An informal support network is a powerful tool for accomplishing these tasks, for teaching day-to-day coping skills, and for supporting the establishment of new value systems that incorporate families' unique needs. The literature on family support documents ways in which parents of children with special health care needs are particularly qualified to help each other. This article briefly describes the philosophy of parent-to-parent support, its unique contributions in the health care setting, and the ways that health care providers can assist in creating an environment in which parents and professionals can work together more effectively.

Child Health Services↗
PubMed1981

Parents' reactions to unrestricted parental contact with infants in the intensive care nursery.

In order to determine parental attitudes and reactions to a policy in which the quality and quantity of parental contact with their preterm or critically-ill infants in the intensive care nursery were determined by the parents, 20 parental pairs were studied regarding their pattern of involvement with their infants, the emotional stress which they experienced, and their responses to the nursery environment during the first fortnight after their infants' birth. This study demonstrated that early and extended parent-infant contact was possible for infants admitted to the intensive care nursery. Both parents chose to maintain a high level of involvement with their infants despite the associated anxiety and anticipatory grief experienced during this period. All felt more reassured with repeated visits, and most believed their infants also felt more loved and secure with the increased contact. The majority would have been opposed to restricted visiting hours and restricted contact with their infants. An open visiting policy and an organized parental-care programme is an important component of neonatal intensive care, since every preterm or critically-ill infant has a family whose psychosocial needs must be recognized and supported.

Attitude↗