Participation of fathers and siblings in home rehabilitation programmes for children with neuro-developmental delay: a scoping review

BACKGROUND

The role of, and impact on, mothers caring for children with neuro-developmental delay (NDD) is well documented. However, the role of fathers and siblings in families of children with NDD remains significantly understudied, particularly in low- and middle-income countries (LMICs). There has been an increased call for holistic rehabilitation of children with NDD at the family level. This study aimed to explore the involvement of fathers and siblings in the home rehabilitation programmes of children with NDD.

METHODS

A scoping review was conducted using the Joanna Briggs Institute (JBI) Peters et al.'s methodology and reported according to Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Articles were retrieved from PUBMED, ScienceDirect, PsycINFO, SCOPUS, PEDro, and Google Scholar. Reference lists of relevant studies were also manually searched.

RESULTS

Thirty research articles were identified. Father and sibling participation in home-based rehabilitation and caregiving is low in LMICs compared to high-income countries due to economic factors and cultural beliefs. Reduced participation stresses mothers and reduces developmental outcomes in children with NDD.

CONCLUSIONS

This review highlights the need for rehabilitation professionals to encourage father and sibling participation in caregiving for children with NDD in home rehabilitation programmes.

"As a parent, I want to do more for my child": A phenomenological approach to understanding the experiences of parents involved in surgical decision-making for children with congenital hand anomalies

BACKGROUND

A congenital anomaly of the hand can affect both function and appearance, and places a stressful psychological burden on the family, especially parents. Surgery during infancy may prevent later disabilities, but little is known of the importance of parents' involvement in these decisions in terms of psychological adjustment or treatment satisfaction.

OBJECTIVE

To understand parents' perceptions of involvement in their child's surgery for limb anomaly, and their preferences for the support of healthcare professionals. Results should lead to recommended interventions to improve familial adjustment to the child's condition.

METHODS

Qualitative data was collected from semi-structured confidential self-reported interviews of 35 parents (65.7 % mothers) of children who had received reconstructive surgery for congenital hand anomaly (at age 24.89 ± 9.26 months); interviews were coincident with the 1-month postoperative follow-up. The parents ranged in age, gender, educational background, economic status, and type of anomaly. Data analysis referenced Colaizzi's phenomenological approach.

RESULTS

The concerns of the parents were consolidated into three themes: attitudes toward Parental involvement in surgical decision-making; status of parental involvement in Surgical decision-making; and need for help and support.

CONCLUSION

Some parents were comfortable leaving surgical decisions entirely to the medical staff, but most preferred active participation and were disappointed at their lack of inclusion. The maximum benefit from surgery for congenital abnormalities in infancy is achieved when the parents and extended families have access to the expertise, skills, encouragement, and psychological support of healthcare providers.

Silk fibroin/chitosan-based anal fistula scaffolds loaded with curcumin and 5-aminosalicylic acid

The present work describes the development of silk fibroin (SF)/chitosan (CS)-based porous composite anal fistula scaffold (SCAFS) with anti-inflammatory and healing functions. The SCAFS comprises an inner layer made from degummed silk fiber using a vertical braiding machine, and an outer layer created by freeze-drying a mixture of short SF fibers and curcumin (CUR)/5-aminosalicylic acid (5-ASA) loaded SF/CS solution. Results revealed that the SCAFS has high porosity of 42.4 %, remarkable water absorption rate of 370.5 %, robust dry/wet compression resistance of 12.28 ± 2.61 N/3.08 ± 0.43 N. The in vitro & in vivo biocompatibility and anti-inflammatory effect of SCAFS were further examined. The expression of pro-inflammatory cytokine TNF-α, anti-inflammatory cytokine IL-10, CD31 and CD68 was determined by immunohistochemistry (IHC) staining, H&E staining, Immunofluorescence (IF) staining and Masson assay. The results showed that the scaffolds possess a sustainable drug release above 400 h, better biocompatibility and anti-inflammatory effect than the control groups (p < 0.05). Thus, the SCAFS has potential application in the treatment of Crohn's disease.

Nationwide study of fathers' involvement in the rehabilitation of children with disabilities in the United Arab Emirates

Purpose

Parental involvement is fundamental to the successful inclusion of children with disabilities in social, academic and communities' services. However, very little is known about UAE fathers' involvement in the support, care, and treatment. and facilitation of engagement in the social, academic, and recreational activities of children with disabilities. Importantly, the role of fathers in facilitating children's participations in social services within the community is unknown. The aim of the current study was to learn father's involvement in the life of children with disabilities in the United Arab Emirates (UAE).

Materials and methods

A total of 1027 parents (fathers = 469, and mothers = 558) completed the revised Fathers' Involvement in Development and Rehabilitation Scale, with three sub-scales (support, attitudes, and participation in training). The Statistical Package for Social Science (SPSS) version 29 was used to calculate means, t-tests, and moderation analyses.

Results

The mean scores showed high involvement of fathers; fathers rated themselves highly on attitudes and support towards their children with disabilities compared to mothers. Also, parental type (fathers vs mothers) significantly moderated the relationship between the support needs of children and paternal support to children with disabilities.

Conclusion

The study concludes with suggestions for targeted training programmes to enable fathers to better support the development of their children with disabilities.

Fathers' involvement in raising children with intellectual disabilities: Mothers' ratings of the contribution of their spouses

BACKGROUND

Intellectual disability (ID) is a lifelong condition characterized by individuals' inability to perform cognitive tasks and participate in daily living activities. While parenting children with ID has been reported to be demanding, studies draw mainly on mothers. In contexts such as the United Arab Emirates (UAE), there is little literature on fathers' involvement in raising children with IDs.

OBJECTIVES

The purpose of this study was to explore, from the perspectives of mothers, the extent of fathers' involvement in raising children with ID in the UAE.

METHODS

One hundred and fifty-eight (N = 158) mothers with children with ID completed the fathers' involvement in disability and rehabilitation scale. Mothers who had enrolled their children with ID in special schools or receiving services at rehabilitation centres were invited to participate in this study. The data were subjected to the following analyses: mean computation, multivariate analysis of variance, hierarchical regression, and moderation analysis.

RESULTS

The results showed high fatherly support, participation in training, and contribution to the development of their children with ID. However, the mothers' ratings showed the fathers' ambivalence toward parenting children with ID. A relationship was found between attitude and support, as well as marital status and the educational level of mothers, providing insight into the involvement of fathers.

CONCLUSION

The study recommends training programs aimed at improving the attitudes of fathers toward raising children with ID and other study implications.

Exploring fathers' perspectives on family-centered services for families of children with disabilities

BACKGROUND

Family-centered service is recognized as a recommended approach to help families of children with disabilities. However, the Israeli family-centered program does not explicitly propose intervention strategies for fathers of children with disabilities.

AIMS

This study explored fathers' perspectives on family-centered services for families of children with disabilities and focused on their use of the services and experiences with them.

METHODS AND PROCEDURES

We employed a mixed-methods design using an online survey completed by 33 fathers of children with disabilities who participated in the Israeli family-centered program for families of children with disabilities. Data analyses included descriptive statistics and conventional content analysis.

OUTCOMES AND RESULTS

The majority of fathers said the Israeli family-centered program fit their needs. Participation in the program yielded psychological, familial, and social benefits. Psychologically, the program allowed fathers to mentally recharge and grow. In addition, more than three-quarters of the fathers thought their participation strengthened their family, as evidenced in more shared experiences, more effective family communication, and positive feelings. They also appreciated society's recognition of their unique life circumstances.

CONCLUSIONS AND IMPLICATIONS

Family-centered services should make special efforts to reach out to fathers and create father-friendly services.

Fathers' Involvement in Rearing Children With Profound Intellectual and Multiple Disabilities

The aim of this study was to explore father's involvement in rearing a child with profound intellectual and multiple disabilities (PIMD). In-depth, semi-structured interviews were conducted with seven fathers in Japan, and the data were analyzed using a qualitative inductive method. The relationship between the parents, in the context of childrearing, influenced father's involvement with their child with PIMD. Fathers improved their self-confidence in childrearing by discussing and sharing about their child's conditions and caregiving approaches with their spouse. Moreover, fathers' experience of being acknowledged and entrusted by their spouse with childrearing motivated and enhanced their involvement. On the contrary, fathers struggled with concerns regarding their family's future, the balance between childrearing and work, and their own health status. The current findings contribute to nurses' understanding of father's involvement in childrearing a child with PIMD and the development of support focusing on the parental dyadic relationship and coparenting behavior.

Family quality of life for families of children with disabilities in African contexts: a scoping review

BACKGROUND

Family Quality of Life (FQOL) is an important outcome for families of children with disabilities and is influenced by context and culture. Minimal research explores FQOL in African contexts.

PURPOSE

This scoping review identifies factors contributing to FQOL for families of children with disabilities in African contexts.

METHOD

We were guided by Arksey and O'Malley's scoping review framework, searching for research papers from the following electronic databases: CINAHL, Embase, Medline, Global Health, and PsycINFO. Using pre-determined eligibility criteria, two authors independently reviewed articles for inclusion via Covidence, a reference manager that facilitates blind reviewing. Two other authors independently extracted data from studies using a data-charting form based on Zuna and colleagues' FQOL framework. Reviewers met regularly for discussion to reach consensus.

RESULTS

Fifty-three articles met the inclusion criteria, and findings demonstrated a broad variety of factors contributing to FQOL within the FQOL framework related to family unit factors, individual member factors, and external support factors. We found that poverty, stigma, and spirituality were particularly prominent factors affecting FQOL negatively and positively in African contexts.

CONCLUSION

Whilst there are universal factors that contribute to FQOL, recognising the influence of context-specific factors (i.e. poverty, stigma, spirituality) is important in order to provide effective, culturally relevant support that enhances FQOL for families of children with disabilities in African contexts.

Maternal Caregiving for Children Newly Diagnosed with Acute Lymphoblastic Leukemia: Traditional Chinese Mothering as the Double-Edged Sword

AIMS AND OBJECTIVES

To explore the meaning of maternal caregiving in the Chinese culture for children newly diagnosed with acute lymphocytic leukemia (ALL).

BACKGROUND

Recurrence of and death associated with ALL remain the main concerns for mothers. Mothers experience guilt and anxiety towards their child's cancer.

DESIGN

Descriptive phenomenological study.

METHODS

Twelve mothers were recruited from a medical centre in Central Taiwan. The mothers were primary caregivers for their child diagnosed as having ALL in the past 3 months to 1 year. Data were collected through semi-structured interviews and analysed using Colaizzi's method.

RESULTS

Four main themes emerged: feeling this world crashing by knowing the diagnosis, feeling the double-edged sword of mothering, worrying about potential risks for their vulnerable child, and passing through difficulties with power of support.

CONCLUSIONS

Most mothers felt this world crashing due to potential loss of their child and seeing their child's suffering. The mother was blamed for her child's cancer but was also required to shoulder all caregiving for their child. The mothers needed to compromise their lives to protect their child from potential infection. Perceived power of support helped the mothers overcome difficulties.

RELEVANCE TO CLINICAL PRACTICE

Findings support that nurses encouraging mothers to tell their stories, regardless of culture, will facilitate healing. Establishing trust and providing support from nurses, physicians, psychologists and social workers will lead mothers' readiness to deal with care of their sick child. Increasing visiting time for parental support for children hospitalized in the PICU is suggested as well.

Stress-mediated quality of life outcomes in parents of disabled children: A case-control study

BACKGROUND

The purpose of the present study was to resolve whether caregiving for a child with disability influences the physical and mental health of the caregivers and whether stress is related to the quality of life of the caregivers.

METHODS

The Parental Stress Scale questionnaire for the assessment of parental stress and the Short Form-12 version 2 questionnaire for the assessment of physical and mental health quality of life were distributed among 69 parents of developmentally disabled children and 137 parents of healthy children (control group). Various sociodemographic factors were also included.

RESULTS

A significant difference was seen between the two groups in terms of employment, presence of disabled sibling, smoking, and physical activity. Parents of developmentally disabled children had significantly higher stress levels and worse mental health-related quality of life. Overall physical health quality of life was similar between cases and controls. Stress had a negative correlation with both mental and physical health quality of life of the parents.

CONCLUSION

Stress related to raising a child with disability negatively influences the parental quality of life. Stress management aiming at its prevention and reduction might be significant aspects of intervention for the improvement of the quality of life of the caregivers.

Postnatal paternal involvement and maternal emotional disturbances: The effect of maternal employment status

BACKGROUND

Recently, studies have begun emphasizing paternal involvement during the perinatal period and its impact on maternal health. However, most studies have assessed maternal perception and focused on adolescents or minority groups in Western countries. Therefore, the current study investigated the association between paternal involvement and maternal postnatal depression and anxiety, along with the effects of maternal job status in the Asian society of Taiwan.

METHODS

This study recruited pregnant women in the first trimester of pregnancy as well as their partners on prenatal visits from July 2011 to September 2013 at four selected hospitals in metropolitan areas of Taipei, Taiwan. In total, 593 parental pairs completed the first interview and responded to the follow-up questionnaires until 6 months postpartum. Self-reported data were collected, and multiple logistic regression models were used for analyses.

RESULTS

Lower paternal childcare and nursing frequency was independently associated with an increased risk of maternal postpartum depression (adjusted odds ratio (OR) =4.33, 95% confidence interval (CI)=1.34-13.98), particularly among unemployed mothers. Furthermore, among unemployed mothers, the risk of postnatal anxiety was 3.14 times higher in couples with fathers spending less time with the child, compared with couples with fathers spending more time (95% CI=1.10-8.98). However, no significant findings were obtained for employed mothers.

CONCLUSIONS

The high prevalence of maternal postnatal emotional disturbances warrants continual consideration. Higher paternal involvement in childcare arrangements should be emphasized to aid in ameliorating these maternal emotional disturbances, particularly among unemployed mothers.

Stressors and Barriers to Services for Immigrant Fathers Raising Children with Developmental Disabilities

This narrative review examines research on the experiences of immigrant fathers raising children with developmental disabilities, and considers the findings within the Canadian context. Applying Green, Johnson & Adams’ (Journal of Chiropractic Medicine, 5(3), 101–117, 2006) methodology, a step-by-step process was followed to conduct the review. Four databases (PsychINFO, PubMed, CINAHL and Sociological Abstracts) were used for the search. A total of 39 articles were found to be relevant after applying the inclusion/exclusion criteria. Also 20 articles from published reference lists and peer-reviewed journal articles, located through Google Scholar, complimented the initial search. Along with House’s (1981) four dimensions of social support, an intersectional approach underpinned the analysis of findings. Four themes were identified which included: economic challenges, social influences, cultural influences, and the changing gender roles of fathers. Stressors and barriers to accessing health services in the post-migration setting were examined. Based on the review’s findings, the paper recommends 1) addressing income inequality, 2) improving access to health care, social and developmental services, 3) improving cultural-sensitivity of health care, social and developmental services, and 4) increasing participation of fathers. Overall, a more systemic understanding of immigrant fathers’ experiences is called for, taking into account their multiple social locations.