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PubMed2003

Important aspects of care and assistance for siblings of children treated for cancer: a parent and nurse perspective.

Aspects of care and assistance important for siblings of children treated for cancer were examined. Parents (n = 97) and nurses (n = 105) were asked: "What aspects of care are important for the siblings to feel cared for?" and "What help, if any, do the siblings need outside the hospital?" Data were analyzed by content analysis. The following care aspects were identified: amusement, emotional support, family life, information, normal life, participation, social competence, and time. Most parent and nurse answers were categorized as participation, information, and social competence. Parents more frequently than nurses (chi2 = 6.1; df = 1; P =.05) mentioned answers categorized as information and nurses more often than parents (chi2 = 12.3; df = 1; P =.001) mentioned that they did not know about any important care aspects. The following assistance aspects were identified: emotional support, fair attention, family life, normal life, practical support, and school support. Most parent and nurse answers were categorized as emotional support, fair attention, and family life. Parents more often than nurses (chi2 = 7.9; df = 1, P =.01) mentioned answers categorized as practical support and siblings not needing any assistance (chi2 = 8.3; df = 1; P =.05). Nurses more frequently than parents (chi2 = 25.1; df = 1; P =.001) mentioned that they did not know about any important aspects of assistance. Parents and nurses agree fairly well on what aspects of care and assistance are important for siblings of children with cancer.

Child↗
PubMed1999

Impaired but undiagnosed.

OBJECTIVE: To investigate the prevalence and outcomes of individuals with psychosocial impairment not meeting DSM-III-R criteria for any of 29 well-defined disorders and to suggest operational definitions for not otherwise specified (NOS) diagnoses and V codes. METHODS: Two-stage general population sampling resulted in 1,015 youths aged 9, 11, and 13 years being interviewed in the first wave of the Great Smoky Mountains Study. They were reinterviewed 1 year later using the Child and Adolescent Psychiatric Assessment. RESULTS: The weighted prevalence of sibling relational problems was found to be 1.4%. That of parent-child relational problems was 3.6% and that of relational problems NOS was 0.6%. The overall rate of symptomatic impairment was 9.4%. Across a variety of "caseness measures," those with symptomatic impairment proved to be more disturbed than those without either a diagnosis or impairment, and as disturbed as those with a diagnosis but without impairment. CONCLUSION: Children and adolescents who do not meet DSM-III-R criteria for any well-defined disorder but who have symptoms associated with psychosocial impairment should be regarded as suffering from a psychiatric disorder. It is suggested that researchers adopt this definition for the many NOS diagnoses included in the DSM nosology and implement it in their research diagnostic algorithms.

Adolescent↗
PubMed2003

Sibling relationships and behavior after pediatric traumatic brain injury.

To evaluate long-term outcomes for siblings of children with traumatic brain injury (TBI), measures of sibling relationships and sibling behavior were collected an average of 4 years postinjury. The study sample included participants in a larger longitudinal study who had school-aged siblings, including 34 with severe TBI, 30 with moderate TBI, and 39 with orthopedic injuries not involving brain insult (ORTHO group). Group comparisons revealed more negative sibling relationships in families of children with TBI than in families of children in the ORTHO group, but only for mixed-gender sibling pairings. Behavior problems in children with TBI predicted both sibling relationships and sibling behavior problems. The findings indicate a need to monitor the adjustment of siblings and sibling relationships after TBI and to include siblings in family interventions.

Adaptation, Psychological↗
PubMed2002

Mycophenolate mofetil suppresses the production of anti-blood type anitbodies after renal transplantation across the abo blood barrier: ELISA to detect humoral activity.

BACKGROUND: The introduction of novel immunosuppressive drugs has made it possible to achieve dramatic improvement in graft survival rates. In particular, the current immunosuppressive regimen including mycophenolate mofetil (MMF) has yielded excellent results including a nearly 100% 1-year graft survival rate at our institution in 2001. We used enzyme-linked immunosorbent assay (ELISA) to analyze humoral activity after ABO-mismatched renal transplantation using the MMF regimen. METHODS: The patient received an ABO-mismatched graft from a living related sibling. Preoperatively, he underwent plasma exchange (PEX) and double-filtration plasmapheresis (DFPP) several times to remove anti-blood type antibodies. Mycophenolate mofetil was used as one of the induction regimens, but a switch was made to other drugs because of persistent gastrointestinal tract discomfort. Mycophenolate mofetil was restarted, however, because of graft dysfunction caused by severe humoral rejection. Humoral activity in this patient was investigated by ELISA during the postoperative follow-up. RESULTS: Anti-blood type antibody immunoglobulin (Ig) M and IgG decreased immediately before the operation because of repeated PEX and DFPP. Both IgM and IgG were postoperatively stable and graft function was excellent. However, after switching from MMF to mizoribine (MZ), renal graft function gradually deteriorated, and the deterioration was associated with elevation of anti-blood type antibody, predominantly IgG. IgM antibody production was parallel to that of IgG, but was weaker. The elevated activity of anti-blood type antibody IgG decreased to the normal level as renal function recovered after MMF was restarted. CONCLUSIONS: Anti-blood type antibody IgG decreased after the administration of MMF after ABO-mismatched renal transplantation, and it increased after withdrawal of MMF. MMF seems to affect B-cell populations that produce anti-blood type antibodies after renal transplantation across the blood barrier.

ABO Blood-Group System↗
PubMed1991

Judy's nurse.

Explore the source record for details and available documents.

Breast Neoplasms↗
PubMedDate not supplied

Impact on the family: psychosocial adjustment of siblings of children who survive serious burns.

This study examined the psychosocial adjustment of 79 siblings of children suffering from burn injuries. Nonparametric statistics were used to compare psychosocial adjustment of the study group, as measured by the Child Behavior Checklist with an age-matched and gender-matched reference groups. Analyses found that the study group was better adjusted than the normative group on psychological dimensions; however, the study group fared worse than the normative group on overall competence, particularly social competence. Further analyses found significant differences in sibling adjustment as a function of the severity of the burn injury. The siblings of children with moderate burn injuries did significantly better on psychological adjustment than the normative group, and siblings of children with moderate and severe burn injuries did significantly poorer on social competence. Descriptive analysis of measures developed for the study for parent and sibling reports supported findings of the Child Behavior Checklist quantitative analysis and offered insight into reasons for findings. Results indicate that the burn injury to one child in a family significantly impacts the siblings of that child. The noninjured child may be strengthened in the process of adapting to the changes imposed on the family, but it is also possible that the sibling's growth in one dimension is at the cost of success in another dimension.

Adaptation, Psychological↗
PubMed2006

Child, parent and family factors as predictors of adjustment for siblings of children with a disability.

BACKGROUND: Siblings adjust to having a brother or sister with a disability in diverse ways. This study investigated a range of child, parent and family factors as predictors of sibling adjustment outcomes. METHODS: Forty-nine siblings (aged 7-16 years) and parents provided information about (1) sibling daily hassles and uplifts; (2) sibling coping; (3) parent stress; (4) parenting; and (5) family resilience. Multiple regression techniques were used. RESULTS: It was found that parent and family factors were stronger predictors of sibling adjustment difficulties than siblings' own experiences of stress and coping. Specifically, socio-economic status, past attendance at a sibling support group, parent stress, family time and routines, family problem-solving and communication, and family hardiness-predicted sibling adjustment difficulties. Finally, siblings' perceived intensity of daily uplifts significantly predicted sibling prosocial behaviour. CONCLUSIONS: The results revealed that the family level of risk and resilience factors were better predictors of sibling adjustment than siblings' own experiences of stress and coping resources, highlighting the importance of familial and parental contributions to the sibling adjustment process. The implications of these results for the design of interventions and supports for siblings are discussed.

Adaptation, Psychological↗
PubMed1994

Direct mutational analysis in a family with hereditary non-polyposis colorectal cancer.

BACKGROUND: It is now known that a proportion of cases of hereditary non-polyposis colorectal cancer (HNPCC) is caused by mutations in the human homologue of the yeast DNA mismatch repair gene MSH2. A proline to leucine change due to a C to T transition in codon 622 of hMSH2 has been identified in a large HNPCC family of over 240 individuals. AIM: To develop an assay to detect the family-specific mutation and apply the findings to genetic screening. METHODS: The C to T change in codon 622 creates a new Mae I site (CTAG) allowing a simple, non-radioactive assay to be developed in order to detect this mutation. The assay was applied to affected members of the family and their first degree relatives (siblings and offspring) between the ages of 17 and 77 years, a total of 75 subjects within two generations (IV and V). RESULTS: 13/13 (100%) subjects with cancer were mutation positive, 7/7 (100%) elderly subjects from generation IV and with no evidence of cancer were mutation negative, 23/57 (40%) subjects from generation V were mutation positive and 0/50 (100%) unrelated subjects were mutation negative. Following the demonstration of perfect segregation of the disease with the mutation, family members were invited to receive the results of the test. Sixty-three (84%) responded within six weeks of receiving the invitation. Genetic screening and counselling members of HNPCC families was perceived as beneficial overall, allowing non-carriers of the mutant gene (as well as their descendants) to be removed from a programme of colonoscopic surveillance.

Adolescent↗
PubMed1976

Balance theory: possible consequences of number of family members.

This paper outlines one theoretical issue involved in considering the relationships that may exist in a family. The usual approach is to treat the family as a whole, made up of n members. The main issue here is the effects of the numerical size of the family and the many possible total and sub-total relationships that may exist within family constellations. Family structure and function is multivariate, but the focus here is the numberical factor.

Family Characteristics↗
PubMed1982

Changes in family structure after a renal transplant.

It is suggested that the study and diagnosis of family structure before a renal transplant, increases the possibility of selecting the most suitable donor candidate from a biological as well as from a psychological point of view. It will allow a greater possibility of success, not only in the medical aspects, but also in regard to better structural functioning of the family after the transplant. Furthermore, the diagnosis of the family structure before the transplant may help to predict what changes will appear within the family after the renal transplant. This would raise the level of consciousness for detecting family dysfunction as soon as possible and thus make it possible to respond more quickly with psychotherapeutic assistance to bring the family back to a functional level.

Adult↗
PubMed1985

The missing triad: the case of two-child families.

Families, as they grow, become more complex in their psychosocial development. They also become more complex in their dyadic/triadic structure through the simple addition of another child. This article traces some of the structural changes that families undergo with the entry of each new child. It also raises several questions about how these very structures may, in turn, influence development of the children. By comparing two- and three-children families with different dyadic/triadic structures, these questions offer some basis for possible future research, as well as some speculation for the clinician.

Decision Making↗
PubMed1986

Coping in families with a retarded child.

The impact of a retarded child on a family has previously been described by individual family members' reports. This study of 40 families, 10 in each of four critical periods during the life of the retarded child, utilized videotaped interviews with whole families, with subsequent clinical observation and analysis based on the Beavers family assessment model. Healthy and problematic adaptations are delineated, with specific attention to systems concepts such as family structure and power, member individuation, feeling expression, and values. The report includes data analysis and a summary of pattern differences in family functioning.

Adaptation, Psychological↗
PubMed1996

Family themes: transmission and transformation.

This article describes a method for doing therapy that uses multisystemic themes that combine meaning and action to facilitate therapeutic change. By identifying central themes that operate at the individual, dyadic, triadic, whole family, intergenerational, and sociocultural levels, the therapist is able to develop effective interview questions and design useful interventions. In this method, behavioral symptoms are framed as a current manifestation of an overarching theme. This orientation enables family and therapist to de-pathologize symptoms and work collaboratively toward change. Case examples from a wide variety of families with differing presenting problems, interactional patterns, three-generational histories, and cultural backgrounds, illustrate the efficacy of the method.

Adolescent↗
PubMed1979

Childhood fear and anxiety states in relation to dental treatment.

Five years experience by the authors in organizing a dental psychology clinic has impressed on them that many excessively fearful child patients have a history of untoward dental and medical experiences which might have been prevented. A background to an understanding of fear and anxiety in children is presented, and two cases are described to illustrate straight-forward behavior modification techniques which can be used to help the fearful or excessively anxious child cope with dental treatment.

Anxiety↗