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Kim H, Lee A, Park M, Choi EK. Investigating family resilience factors for enhancing family adaptation in children with epilepsy. Epilepsy Behav 2024; 156:109817. [PMID: 38714000 DOI: 10.1016/j.yebeh.2024.109817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/09/2024]
Abstract
PURPOSE To identify and understand the key family resilience factors that contribute to the improved family adaptation of children with epilepsy. METHODS Parent of children with epilepsy treated in the outpatient unit and general ward at Severance Children's Hospital in Seoul, Korea, completed a structured online questionnaire between April and May 2023. This study examined risk (epilepsy severity, time since diagnosis, parental depression, and perceived stigma) and protective factors (child temperament, epilepsy knowledge, family communication skills, parent's educational level, monthly household income, and social support) of family adaptation based on Patterson's Family Resilience Model. Furthermore, general characteristics such as daily caregiving time, perceived parental health, family type, and primary caregiver role were analyzed. RESULTS This study included 131 participants with a mean age of 41.79 ± 5.77 years, with children having an average age of 9.19 ± 4.94 years. The regression model was significant, and revealed the impact of communication skills, social support, and primary caregivers other than parents. Moreover, a shorter time since diagnosis has a more positive impact on family adaptation. CONCLUSIONS To improve family adaptation in children with epilepsy, the focus should be placed on improving communication skills, increasing social support, and providing access to external support services. Furthermore, families expecting longer illness duration require proactive measures to support them. These findings could guide future strategies to enhance adaptation in families with children with epilepsy.
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Affiliation(s)
- Hyejun Kim
- Severance Children's Hospital, Yonsei University Health System, Seoul, Republic of Korea; Graduate School of Nursing, Yonsei University, Seoul, Republic of Korea.
| | - Anna Lee
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Mina Park
- School of Nursing, Soonchunhyang University, Cheonan, Republic of Korea
| | - Eun Kyoung Choi
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea.
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Wang D, Scherffius A, Ouyang X, Deng Q. Family Functioning and Depressive Symptoms Among HIV-Positive Men Who Have Sex with Men: Mediating Roles of Stigma and Resilience. Psychol Res Behav Manag 2024; 17:755-764. [PMID: 38434956 PMCID: PMC10906277 DOI: 10.2147/prbm.s449825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/08/2024] [Indexed: 03/05/2024] Open
Abstract
Background Depressive symptoms are common among HIV-positive men who have sex with men (MSM). This study aims to explore (1) the relationship between family functioning and depressive symptoms and (2) the mediating roles of stigma and resilience in the relationship among HIV-positive MSM. Methods We used data from a cross-sectional study of a convenience sample in Hunan Province, China, conducted in 2019. The data analysis included 191 HIV-positive MSM with an average age of 26.98 years. All participants completed self-report questionnaires on demographic variables, family functioning, stigma, resilience, and depressive symptoms. Results Better family functioning was significantly associated with lower depressive symptoms. Both stigma (Indirect effect = -0.04, 95% CI, -0.10 ~ -0.001) and resilience (Indirect effect = -0.06, 95% CI, -0.12 ~ -0.01) were significant partial mediators in the relationship between family functioning and depressive symptoms. A parallel and chain mediating role of stigma and resilience in the relationship between family functioning and depressive symptoms was also supported (Indirect effect = -0.03, 95% CI, -0.08 ~ -0.01). Conclusion Improving family functioning is crucial for alleviating depressive symptoms among HIV-positive MSM in China. Depression assessment and reduction should be an integral part of prevention and treatment programs targeting stigma and resilience.
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Affiliation(s)
- Dongfang Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, People’s Republic of China
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, People’s Republic of China
| | - Andrew Scherffius
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Xuan Ouyang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, People’s Republic of China
| | - Qijian Deng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, People’s Republic of China
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Chen C, Wu Q, Zhao J, Zhao G, Li X, Du H, Chi P. Enacted Stigma Influences Bereavement Coping Among Children Orphaned by Parental AIDS: A Longitudinal Study with Network Analysis. Psychol Res Behav Manag 2023; 16:4949-4958. [PMID: 38089527 PMCID: PMC10712676 DOI: 10.2147/prbm.s423707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/27/2023] [Indexed: 02/01/2024] Open
Abstract
Purpose The study aims to understand how enacted stigma influences bereavement coping at the style (scale) level and the specific pathways at the strategy (item) level. Methods The longitudinal data of 755 children orphaned by parental Acquired Immune Deficiency Syndrome (AIDS) in rural China were used. Grief processing and deliberate grief avoidance were measured at wave 1 (baseline) and wave 2 (one-year follow-up) to reflect bereavement coping in the contexts of being with family members, being with friends, being with community members, and being alone. Enacted stigma that measured at wave 1 was used to assess the experienced stigma of these AIDS-orphaned children. Network analyses were run following regressions. Results Controlling for demographics and baseline-level bereavement coping, multivariate regressions revealed that enacted stigma at wave 1 significantly predicted grief processing and deliberate grief avoidance at wave 2. Network analyses showed that, for grief processing, stigma increased searching for meaning alone and with friends and expressing feelings to community members, which then provoked the same strategy across contexts. Meanwhile, stigma triggered the deliberate grief avoidance network by initially suppressing the expression of feelings to community members. Conclusion Enacted stigma contributes to bereavement coping. Stigma stirs up complex feelings but forces AIDS-orphaned children to suppress expressions, and it increases needs to process grief through meaning making but cuts supporting forces by promoting avoidance. Interventions are imperative to reduce stigma, improve emotion regulation, and facilitate meaning making for people bereaved by stigmatized deaths.
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Affiliation(s)
- Chuqian Chen
- Department of Medical Humanities, Southeast University, Nanjing, Jiangsu, People’s Republic of China
| | - Qinglu Wu
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University, Zhuhai, Guangdong, People’s Republic of China
| | - Junfeng Zhao
- Institute of Psychology and Behavior, Henan University, Kaifeng, Henan, People’s Republic of China
| | - Guoxiang Zhao
- Department of Psychology, Henan Normal University, Xinxiang, Henan, People’s Republic of China
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA
| | - Hongfei Du
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University, Zhuhai, Guangdong, People’s Republic of China
| | - Peilian Chi
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macau, People’s Republic of China
- Centre for Cognitive and Brain Sciences, University of Macau, Macau, People’s Republic of China
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Yang TW, Kim YS, Kim DH, Yeom JS, Kwon OY. Felt stigma proportion in people living with epilepsy: A systematic review. Seizure 2023; 111:87-97. [PMID: 37556985 DOI: 10.1016/j.seizure.2023.07.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/31/2023] [Indexed: 08/11/2023] Open
Abstract
PURPOSE Numerous inventories to identify felt stigma (FS) in people living with epilepsy (PLWE) have been developed. Past studies have mainly focused on the relationship between FS scores and clinical factors, making it challenging to delineate FS proportions and compare FS between groups. We aimed to integrate FS proportions in PLWE and compare them by continent. METHODS We searched MEDLINE, EMBASE, the Cochrane Library, Web of Science, and Scopus. Among the identified studies, we chose the ones providing an FS proportion measured by Jacoby's Stigma Scale (JSS) and its revised version (JSS-R) in PLWE. We applied the random-effects model. RESULTS A total of 63 datasets from 47 studies were included. There were 29,924 PLWE, with 14,323 of them experiencing FS. The overall FS proportion was 48.4%. Of these datasets, 51 used JSS, and 12 used JSS-R. The FS proportions were 44.9% for the former and 62.1% for the latter, with significant heterogeneity. In the intercontinental comparison with 51 datasets employing JSS, the difference in FS proportions was insignificant: 51.2% in Africa, 47.2% in Europe, 35.4% in Asia, and 28.8% in the Middle East. Furthermore, the meta-regression revealed that the year of each primary study did not influence the FS proportion. CONCLUSION Among PLWE, FS proportions depended on the choice of a measurement tool. When measured using JSS, the FS proportion was 44.9%, while it was 62.1% when evaluated with JSS-R. Even though the FS proportions were integrated differently, no substantial differences were observed between continents.
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Affiliation(s)
- Tae-Won Yang
- Department of Neurology, Gyeongsang National University College of Medicine, Jinju, Republic of Korea; Department of Neurology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Young-Soo Kim
- Department of Neurology, Gyeongsang National University College of Medicine, Jinju, Republic of Korea; Department of Neurology, Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Do-Hyung Kim
- Department of Neurology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Jung Sook Yeom
- Department of Pediatrics, Gyeongsang National University College of Medicine, Jinju, Republic of Korea; Department of Pediatrics, Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Oh-Young Kwon
- Department of Neurology, Gyeongsang National University College of Medicine, Jinju, Republic of Korea; Department of Neurology, Gyeongsang National University Hospital, Jinju, Republic of Korea; Institute of Medical Science, Gyeongsang National University College of Medicine, Jinju, Republic of Korea.
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Lee SA, Im K, Choi EJ. Felt stigma may potentiate the relationship between perceived stress and depressive symptoms in persons with epilepsy. Epilepsy Behav 2022; 134:108765. [PMID: 35908417 DOI: 10.1016/j.yebeh.2022.108765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE This study assessed the strengths of association among perceived stress, felt stigma, and depression in adults with epilepsy, and evaluated whether felt stigma altered the association between perceived stress and depression. METHODS This multicenter, cross-sectional study included adults with epilepsy. Depression was assessed using the Beck Depression Inventory (BDI), and perceived stress was evaluated using the 10-item Perceived Stress Scale. Felt stigma was determined using the three-item Stigma Scale for Epilepsy, with individuals categorized as positive for felt stigma if they answered "yes" to at least one of these items. A hierarchical linear regression analysis and an analysis of covariance with interaction terms were performed. RESULTS The 316 adults with epilepsy included 171 men and 145 women; of these, 109 (34.5%) reported felt stigma. A hierarchical linear regression analysis showed that perceived stress was the most important correlate of depressive symptoms, followed by felt stigma, being unemployed, recurrence of generalized or focal to bilateral tonic-clonic seizures, and being married. The model explained 54.0% of the variance of BDI scores. Significant interactions between felt stigma and perceived stress on BDI scores was identified in both crude and adjusted models (p < 0.05 each). Specifically, in an adjusted model, BDI scores were more strongly associated with perceived stress in persons with (p < 0.001, partial eta2 = 0.225) than without (p < 0.001, partial eta2 = 0.205) felt stigma. CONCLUSIONS Perceived stress was the most significant correlate of depressive symptoms in adults with epilepsy, followed by felt stigma. The interaction between perceived stress and felt stigma on depressive symptoms was significant. These findings may help in developing cognitive behavioral therapy for stigma and stress management in persons with epilepsy.
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Affiliation(s)
- Sang-Ahm Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Kayeong Im
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Eun Ju Choi
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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