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Hejl JL, Hulgaard DR, Rasmussen ASD, Larsen LEN, Rask CU. Linking heart and mind - lived experiences of parents to children with congenital heart disease and mental health issues. Clin Child Psychol Psychiatry 2024:13591045241267129. [PMID: 39041634 DOI: 10.1177/13591045241267129] [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] [Indexed: 07/24/2024]
Abstract
Children with congenital heart disease are more likely to receive special educational services in schools and have an increased risk of mental health issues. We explored the lived experiences of parents caring for a child with heart disease and concurrent mental health issues in Denmark. Semi-structured interviews with ten parents (age 39-57 years) to these children (age 5-17 years) were analysed using interpretative phenomenological analysis. Three Group Experiential Themes (GETs) were generated from the analysis: The first GET, Parental roles and caring behaviours, described parental struggles of fulfilling their parenting role ideals and experiences with stigmatization of MHI. GET two, Parental reflections on their illness explanations, portrayed how parents utilize different illness explanations to make sense of their child's MHI. GET three, Differences in access to help and support, captured how the CHD affected overall access to mental health support. The results may inform various topics of importance for health professionals to address in their clinical encounters with these families.
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Affiliation(s)
- Julie L Hejl
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Ditte R Hulgaard
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Regional Health Research, University of Southern Denmark, Aabenraa, Denmark
| | - Anne Sofie D Rasmussen
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Lærke Emilie N Larsen
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Charlotte U Rask
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Botkin TN, Wiggs K, Kipp HL, Lindstrom RA, Joseph HM, Kolko DJ, Pedersen SL, Molina BSG. Highly Involved Parenting of Adolescents With ADHD: Examination of the Psychometric Properties of a Measure of "Helicopter Parenting". J Atten Disord 2024:10870547241258879. [PMID: 38859688 DOI: 10.1177/10870547241258879] [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] [Indexed: 06/12/2024]
Abstract
OBJECTIVE The concept of the "helicopter parent" was popularized in the 2000s and 2010s by Western culture, and it has recently begun to be examined by researchers to describe parental over-involvement and intrusive behavior that impedes transition into adulthood. Research has yet to investigate the viability of this construct for adolescents when parenting is needed to facilitate the development of autonomy. The present study examined the psychometric structure of a modified "helicopter parenting" measure adapted for use in a sample with increased likelihood of highly involved parenting: adolescents with ADHD. METHODS Adolescents (n = 333; age 13-18 years; 25% female) and their parents (n = 341, 91% female) completed a survey for a study on provider training in stimulant diversion prevention in 2016 and 2017. We modified a previously validated measure of "helicopter parenting" for young adults. Other previously established parenting measures were included. We conducted principal component analysis for both informants' reports of the modified measure. We examined associations between the components and informants' demographic characteristics and parenting measures to begin to examine convergent and discriminant validity. RESULTS Two components were identified for adolescent and parent reports and labeled parental Intervention and Day-to-day Monitoring and Planning. These components were differentially associated with demographic characteristics and other measures of parenting. For example, across reporters, parents exhibited less Day-to-Day Monitoring and Planning for older adolescents. Racially/ethnically minoritized parents and male adolescents reported more Intervention parenting. Modest-sized statistically significant associations were found between these indicators of highly involved parenting and the other measures of parenting. CONCLUSION Findings provide initial evidence of construct validity. Future work with more heterogeneous samples should examine if this measure captures adaptive parenting, or behaviors that interfere with developing independence, for adolescents with ADHD and neurotypically developing adolescents.
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Affiliation(s)
| | | | - Heidi L Kipp
- University of Pittsburgh School of Medicine, PA, USA
| | | | | | - David J Kolko
- University of Pittsburgh School of Medicine, PA, USA
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McBride H, Jhawar N, Boucicaut L, Bearden CE, Kates WR, Woolf-King SE, Antshel KM. Mental health, coping, and protective factors in mothers of children with 22q11.2 deletion syndrome. Am J Med Genet B Neuropsychiatr Genet 2024:e32973. [PMID: 38409998 DOI: 10.1002/ajmg.b.32973] [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: 07/03/2023] [Revised: 12/29/2023] [Accepted: 02/07/2024] [Indexed: 02/28/2024]
Abstract
Compared to the large body of maternal mental health research for other pediatric disorders, we know far less about the experience of mothers of children with 22q11DS. This study investigates the coping methods, protective factors, and mental health of this population. These findings might lead to better support for 22q11DS maternal mental health. An international sample of 71 mothers (M = 40.5 years) of children with 22q11DS (M = 9.2 years) was recruited and completed an online survey assessing maternal mental health (symptoms of depression, anxiety, traumatic stress, general stress, and alcohol consumption), coping methods, and mental health protective factors (social support, dyadic adjustment, parenting competence). Maternal ratings of child mental health symptoms were also obtained. Mothers' self-report revealed a high percentage who screened positive for elevated levels of general stress (69%), hazardous alcohol consumption (30.9%), traumatic stress (33.8%), anxiety (26.8%), and depression (26.8%). After controlling for demographic variables and child mental health symptoms, maternal self-reported maladaptive coping methods were positively associated with maternal symptoms of depression, anxiety, stress, and traumatic stress. Reducing maladaptive coping methods may be a promising intervention for improving mental health in mothers of children with 22q11DS.
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Affiliation(s)
- Haley McBride
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Nandini Jhawar
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Laurie Boucicaut
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences and Psychology, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA
- Department of Psychology, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA
| | - Wendy R Kates
- Department of Psychiatry and Behavioral Sciences, SUNY-Upstate Medical University, Syracuse, New York, USA
| | | | - Kevin M Antshel
- Department of Psychology, Syracuse University, Syracuse, New York, USA
- Department of Psychiatry and Behavioral Sciences, SUNY-Upstate Medical University, Syracuse, New York, USA
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Hou Y, Yan T, Deng M. A Qualitative Study on Parental Experience of Involvement in the Transition from Kindergarten to Primary School for Chinese Children with Intellectual and Developmental Disabilities. J Autism Dev Disord 2023; 53:4872-4887. [PMID: 36109470 PMCID: PMC9483495 DOI: 10.1007/s10803-022-05743-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2022] [Indexed: 11/30/2022]
Abstract
Parental involvement plays a vital role in the transition from kindergarten to primary school among children with intellectual and developmental disabilities (IDDs); this study aims to explore Chinese parents' experiences of parental involvement during this period. Informed by interpretive phenomenological analysis, semi-structured, one-on-one interviews were held with 10 parents. Three major themes were identified: (1) "aggressive" involvement; (2) factors in transforming parental involvement; and (3) "rational" involvement. Participants reported their perceptions, attitudes, and parenting behaviors in different phases of involvement in the transition to primary school. These findings highlight the need to support parents of children with IDDs during this time of change.
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Affiliation(s)
- Yujia Hou
- Early Childhood Education College, Shanghai Normal University, Shanghai, People's Republic of China
| | - Tingrui Yan
- Special Education Department, Faculty of Education, East China Normal University, Zhongshan North Street, No.3663, 200062, Shanghai, People's Republic of China.
| | - Meng Deng
- Special Education Department, Faculty of Education, East China Normal University, Zhongshan North Street, No.3663, 200062, Shanghai, People's Republic of China
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Kruger E. Parent/Caregiver Experiences of a CAMHS ADHD Assessment Pathway: A Qualitative Service Evaluation. J Atten Disord 2023; 27:1618-1629. [PMID: 37501383 PMCID: PMC10637083 DOI: 10.1177/10870547231188923] [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] [Indexed: 07/29/2023]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition characterized by impulsivity, inattention, and hyperactivity. Although the literature has explored the parental impact of living with a child diagnosed with ADHD, less is known about the ADHD assessment journey for children and the parental experiences of this. A recent service evaluation suggested that exploring parental perceptions of a child's ADHD assessment pathway could be beneficial in understanding experiences, gathering ideas for future service development, and collecting service user feedback. AIMS AND OBJECTIVE The aims were to (a) explore the broad experiences of parents/caregivers accessing the ADHD assessment pathway for their child and (b) explore experiences of remote appointments during the assessment process in consideration of the COVID-19 pandemic. METHODS Twelve parents of children who had experienced an ADHD assessment within a CAMHS pathway participated in a telephone-based semi-structured interview. This involved gathering experiences of the CAMHS ADHD pathway from a parental perspective. The evaluation implemented a qualitative design. Qualitative data was analyzed through thematic analysis. RESULTS Results revealed seven main themes. Regarding general experiences of the pathway, parent/caregiver interview responses indicated a sense of relief, feeling understood, and the service being child-focused during the assessment. Difficulties were highlighted within the themes, such as long waiting lists impacting on the child and parent as well as lengthy assessments. In reference to COVID-19 and remote/telephone appointments, interview responses indicated some positives of having remote appointments, such as comfort and convenience. Thus, the strengths of face-to-face communication were highlighted.
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Chaulagain A, Lyhmann I, Halmøy A, Widding-Havneraas T, Nyttingnes O, Bjelland I, Mykletun A. A systematic meta-review of systematic reviews on attention deficit hyperactivity disorder. Eur Psychiatry 2023; 66:e90. [PMID: 37974470 PMCID: PMC10755583 DOI: 10.1192/j.eurpsy.2023.2451] [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: 01/10/2023] [Revised: 05/29/2023] [Accepted: 08/31/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND There are now hundreds of systematic reviews on attention deficit hyperactivity disorder (ADHD) of variable quality. To help navigate this literature, we have reviewed systematic reviews on any topic on ADHD. METHODS We searched MEDLINE, PubMed, PsycINFO, Cochrane Library, and Web of Science and performed quality assessment according to the Joanna Briggs Institute Manual for Evidence Synthesis. A total of 231 systematic reviews and meta-analyses met the eligibility criteria. RESULTS The prevalence of ADHD was 7.2% for children and adolescents and 2.5% for adults, though with major uncertainty due to methodological variation in the existing literature. There is evidence for both biological and social risk factors for ADHD, but this evidence is mostly correlational rather than causal due to confounding and reverse causality. There is strong evidence for the efficacy of pharmacological treatment on symptom reduction in the short-term, particularly for stimulants. However, there is limited evidence for the efficacy of pharmacotherapy in mitigating adverse life trajectories such as educational attainment, employment, substance abuse, injuries, suicides, crime, and comorbid mental and somatic conditions. Pharmacotherapy is linked with side effects like disturbed sleep, reduced appetite, and increased blood pressure, but less is known about potential adverse effects after long-term use. Evidence of the efficacy of nonpharmacological treatments is mixed. CONCLUSIONS Despite hundreds of systematic reviews on ADHD, key questions are still unanswered. Evidence gaps remain as to a more accurate prevalence of ADHD, whether documented risk factors are causal, the efficacy of nonpharmacological treatments on any outcomes, and pharmacotherapy in mitigating the adverse outcomes associated with ADHD.
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Affiliation(s)
- Ashmita Chaulagain
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Ingvild Lyhmann
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Anne Halmøy
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Tarjei Widding-Havneraas
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Olav Nyttingnes
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Ingvar Bjelland
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Arnstein Mykletun
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine, UiT – The Arctic University of Norway, Tromsø, Norway
- Centre for Work and Mental Health, Nordland Hospital, Bodø, Norway
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Lu SV, Leung BMY, Bruton AM, Millington E, Alexander E, Camden K, Hatsu I, Johnstone JM, Arnold LE. Parents' priorities and preferences for treatment of children with ADHD: Qualitative inquiry in the MADDY study. Child Care Health Dev 2022; 48:852-861. [PMID: 35244227 DOI: 10.1111/cch.12995] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 12/21/2022]
Abstract
BACKGROUND Parents' lived experiences of having a child with ADHD may shape their decision making regarding ADHD treatment options for their child. The aim of this study was to explore parents' experiences of living with a child with ADHD in the family and how their experiences influence their perspectives on treatment preferences and priorities. METHODS A phenomenological qualitative design was used. Semistructured interviews were conducted with parents of children with ADHD who were enrolled in a multisite randomized controlled trial. Interviews were transcribed verbatim, and transcripts at each site were double coded. Initial codes were derived directly from the text. Qualitative data were analysed with an inductive approach. RESULTS Twenty-three parents were interviewed: eight from Alberta, Canada; eight from Portland, Oregon, USA; and seven from Columbus, Ohio, USA. Among the parents, 69% were married, 86% completed college education and 52% reported household income over $80,000. Among the children, the mean age was 9.6 years (SD = 1.8 years), 78% were boys and 48% were never medicated for their ADHD. Two major themes emerged from the analysis. Theme 1 was 'impact of ADHD on families within and outside the home' with the following subthemes: 'reconfiguring the home life', 'trial-and-error of accommodations at school' and 'responding to social pressures to fit in'. Theme 2 was 'enabling appropriate and accessible treatments for families' with the following subthemes: 'finding the "right fit" with professionals and treatments' and 'factors influencing inequitable access to treatments'. CONCLUSIONS Parents described shared experiences and identified similar barriers, preferences and priorities for ADHD treatments regardless of demographic differences by site. Families desired access to family-centred, multimodal approaches to ADHD treatment. Further research is needed to identify the specific structural changes to healthcare, services and policies that will better support this approach.
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Affiliation(s)
- Stacy V Lu
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Brenda M Y Leung
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Alisha M Bruton
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
| | - Elizabeth Millington
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada
| | - E Alexander
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, Ohio, USA
| | - Kelsey Camden
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
| | - Irene Hatsu
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, Ohio, USA
| | - Jeanette M Johnstone
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
| | - L Eugene Arnold
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
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Şahinoğlu Keşkek N, Akkoyun İ, Temiz A, Kütük Ö. Hedgehog Signal Defect Leading to Familial Exudative Vitreoretinopathy-Like Disease and Gastrointestinal Malformation. Turk J Ophthalmol 2022; 52:174-178. [PMID: 35770050 PMCID: PMC9249105 DOI: 10.4274/tjo.galenos.2021.72929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objectives: The aim of the study was to present a new genetic association presenting with gastrointestinal tract malformations (GTMs) and familial exudative vitreoretinopathy (FEVR)-like disease and review the genetics of Hedgehog signaling. Materials and Methods: Three neonates were diagnosed with FEVR-like retinal vascular disease upon routine ophthalmological examination during hospitalization in the neonatal surgical intensive care unit for GTMs. Genetic analysis of the neonates was performed. Results: Gestational age of the neonates was 39, 38, and 39 weeks and birth weights were 3,500, 3,600, and 3,300 grams, respectively. All six eyes of the three infants were treated by laser photocoagulation. Recurrence was not seen in any of the eyes. Genetical analysis of all the neonates diagnosed with FEVR-like disease revealed defects in the Hedgehog pathway. Conclusion: FEVR is a genetically well-defined retinal vascular disease. The current study is the first to show an association between FEVR-like retinal vascular disease and GTMs. This study demonstrates the importance of the Hedgehog pathway in retinal vascular and gut development.
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Melegari MG, Muratori P, Bruni O, Donolato E, Giallonardo M, Mammarella I. Externalizing and Internalizing Behaviors in Children with ADHD during Lockdown for COVID-19: The Role of Parental Emotions, Parenting Strategies, and Breaking Lockdown Rules. CHILDREN 2022; 9:children9060923. [PMID: 35740860 PMCID: PMC9221613 DOI: 10.3390/children9060923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/09/2022] [Accepted: 06/16/2022] [Indexed: 11/16/2022]
Abstract
Lockdown experience for COVID-19 pandemic significantly affected children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) exacerbating or promoting the onset of externalizing and internalizing symptoms. However, few studies have considered how externalizing and internalizing behaviors changed in relation to parental emotions and parenting strategies. In the present study, 992 caregivers of children and adolescents with ADHD from 5 to 18 years were presented with an online survey evaluating youths’ externalizing and internalizing behaviors, their non-compliance with lockdown rules, and parental factors related to parental emotions and parenting strategies. Two hierarchical linear regression models were performed to examine the contribution of children’s non-compliance with lockdown rules, parental emotions, and parenting strategies on children’s externalizing and internalizing behaviors. Results revealed that externalizing behaviors were higher in children and adolescents with ADHD non-compliant with lockdown rules. Moreover, positive parenting strategies moderated the relationship between non-compliance with lockdown rules and externalizing behaviors. Differently, higher internalizing behaviors were observed in children with ADHD who had parents reporting more negative emotions and positive parenting strategies. In this case, parents’ negative emotions had a moderator effect in the association between internalizing behaviors and non-compliance to lockdown measures. The clinical implications of these two different patterns of relations are discussed.
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Affiliation(s)
- Maria Grazia Melegari
- Department of Developmental and Social Psychology, Sapienza University, 00185 Rome, Italy; (M.G.M.); (O.B.)
| | - Pietro Muratori
- IRCCS Fondazione Stella Maris, 56128 Pisa, Italy
- Correspondence:
| | - Oliviero Bruni
- Department of Developmental and Social Psychology, Sapienza University, 00185 Rome, Italy; (M.G.M.); (O.B.)
| | - Enrica Donolato
- Department of Education, University of Oslo, 0317 Oslo, Norway;
| | | | - Irene Mammarella
- Department of Developmental and Social Psychology, University of Padova, 35122 Padova, Italy;
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Parent training in non-violent resistance for children with attention deficit hyperactivity disorder: a controlled outcome study. Eur Child Adolesc Psychiatry 2022; 31:929-938. [PMID: 33528659 DOI: 10.1007/s00787-021-01723-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 01/15/2021] [Indexed: 10/22/2022]
Abstract
Current forms of parent training for childhood attention deficit hyperactivity disorder (ADHD) are often insufficient. Many families drop out of the training, and treatment gains are often not maintained. Nonviolent resistance parent training (NVR) focuses on helping parents resist the child's negative behaviors without escalating the problem. NVR helps parents to fulfill an anchoring function, supporting the child through presence, self-regulation, structure, and support network. This study is a randomized controlled trial designed to assess the efficacy of NVR in the treatment of childhood ADHD. Participants were Israeli parents of children with primary ADHD diagnosis (N = 101; 5-13 years old; 79% male participants) randomly assigned to either 12-session NVR (N = 50) or waiting list (N = 51). Measures were administered before and after treatment and at a 4-month follow-up. ADHD outcomes included the Conners and Child Behavior Checklist. Parenting outcomes included parental helplessness, emotional regulation, anchoring function, and family chaos. Participants in the NVR condition reported significant improvements in the child's internalizing, externalizing, and ADHD symptoms, as well as improvement in paternal and maternal helplessness and anchoring. Participants in the control condition did not report changes in the child's symptoms or the parents' condition. The results at follow-up revealed maintenance of change in the child's externalizing and internalizing symptoms, but failure to maintain gains in ADHD core symptoms. Maternal helplessness and anchoring, as well as family chaos continued to improve at follow-up. Dropout rates in the treatment group were low (5%), and fathers' engagement was close to 100%. NVR is an efficient treatment for childhood ADHD, with benefits extending beyond the child's symptoms to the entire family. NVR's special focus on parental distress may have contributed to low dropout, high paternal engagement, and maintenance of change.
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[Psychoanalytic Treatments without Medication and Behavioral Therapy Treatments with and without Medication in Children with the Diagnosis of ADHD and/or Conduct Disorder]. Prax Kinderpsychol Kinderpsychiatr 2021; 70:499-519. [PMID: 34519617 DOI: 10.13109/prkk.2021.70.6.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The controlled, prospective intervention study without randomization with a non-inferiority study design investigates the effectiveness of psychoanalytic treatments without medication in comparison to behavioral therapy treatments with and without medication in children aged 6 to 11 years with a diagnosis of ADHD and/or conduct disorder. 73 children (58 boys and 15 girls) were included in the study. Diagnostics before treatment, at end of treatment and at follow-up after 38 months included a standardized clinical interview (DISYPS-KJ), questionnaires for parents, teachers and children (DISYPS-KJ, CBCL, TRF, CPRS, CTRS, ILK), intelligence test and behavioral observation of the child. Primary outcome criterion was disorder-specific symptom reduction at end of treatment and follow-up. Both treatment groups showed significant symptom reductions at end of treatment and at follow-up. There were no significant differences between treatment groups. Parent and teacher ratings showed significant improvements in both groups at end of treatment and at follow-up on the ADHD index, oppositional behavior, and hyperactivity/impulsivity scales, as well as on the externalizing and internalizing behavior problems scales. Quality of life improved for children in both treatment groups.
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Abstract
Objective: The purpose of the study was to create a national profile of parental involvement for parents of children with ADHD in the United States. Method: Using the 2016 Parent and Family Involvement in Education Survey, parents of children with ADHD (N = 1,600) were compared with other parents (N = 11,923) on 32 distinct measures of parental involvement in education. Results: Parents of children with ADHD were more likely to invest more time in communications regarding school and behavior problems, teaching their child time management skills, checking and helping with their homework, whereas they were less likely to engage in athletic sports, attend class or school events, or visit the library. Conclusion: A more systematic approach to encourage and support parental involvement in education for children with ADHD is needed.
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Fletcher J, Dimitropoulos G, Martino D, Wilcox G, MacMaster F, Arnold P, Pringsheim T. Developing a provincial patient support network for children and families affected by Tourette syndrome and/or obsessive-compulsive disorder: results of a stakeholder consultation. Child Adolesc Psychiatry Ment Health 2021; 15:29. [PMID: 34134722 PMCID: PMC8208059 DOI: 10.1186/s13034-021-00383-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 06/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tourette syndrome and OCD are disorders that frequently occur in children and cause a high level of disability. In Alberta there is a huge delivery gap in providing healthcare services for children with TS and OCD. A stakeholder consultation was performed to ascertain how service delivery could be improved across the province and to inform the development of a provincial information and support organization, the Tourette OCD Alberta Network. METHODS A mixed-methods study was employed: 10 parents were recruited for interview and 140 parents responded to a survey. RESULTS Qualitative data showed there was often an absence of a clear pathway to access healthcare for people with TS and OCD. The negative impact of not receiving treatment, information, and resources in a timely and prompt manner was also revealed. Good clinical practice existed across the province but too often it was hindered by a shortage of knowledge about TS and OCD. In schools, learning for students with TS and OCD was also impaired by educators' lack of knowledge and preparedness in relation to the disorders. CONCLUSIONS This study identified ways that challenges with healthcare access, school learning, and seeking information can be overcome. Skills-based training webinars, educational outreach in schools, and peer support were recognized as actions for improving healthcare outcomes for people with TS and OCD. The aim of the Tourette OCD Alberta Network is to provide services and support that directly address the healthcare service delivery shortfalls shown in this study.
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Affiliation(s)
- Julian Fletcher
- grid.22072.350000 0004 1936 7697Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Gina Dimitropoulos
- grid.22072.350000 0004 1936 7697Faculty of Social Work, University of Calgary, Calgary, Canada
| | - Davide Martino
- grid.22072.350000 0004 1936 7697Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Gabrielle Wilcox
- grid.22072.350000 0004 1936 7697Werklund School of Education, University of Calgary, Calgary, Canada
| | - Frank MacMaster
- grid.22072.350000 0004 1936 7697Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Paul Arnold
- grid.22072.350000 0004 1936 7697Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Tamara Pringsheim
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada. .,Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada. .,Mathison Centre for Mental Health Education and Research, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
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Abstract
Objective: The aim of this study is to examine the role of parental emotion regulation (ER) and parental mentalization as possible contributors to hostile and coercive parenting in families of children with ADHD. Method: Seventy-four Israeli families (64 mothers and 48 fathers) seeking parent training for child ADHD completed measures during the intake session. Measures included parental ER; parental mentalization; hostile, coercive, and submissive parenting; and child symptoms. Results: Findings suggested a relationship between parental ER and coercive parenting independent of child age, symptom level, and parental mentalization. Parental mentalization appeared to buffer against hostility specifically among parents with low ER capacities. Patterns were parallel for mothers and fathers. Conclusion: Study findings highlight the importance of evaluating and addressing parental ER in interventions attempting to reduce coercive parenting. The findings also highlight the potential role of parental mentalization as a protective mechanism against hostile parenting in families of children with ADHD.
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Markowitz JT, Oberdhan D, Ciesluk A, Rams A, Wigal SB. Review of Clinical Outcome Assessments in Pediatric Attention-Deficit/Hyperactivity Disorder. Neuropsychiatr Dis Treat 2020; 16:1619-1643. [PMID: 32669845 PMCID: PMC7335865 DOI: 10.2147/ndt.s248685] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 05/28/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Various clinical outcome assessments (COAs) are used in clinical research to assess and monitor treatment efficacy in pediatric attention-deficit/hyperactivity disorder (ADHD) trials. It is unclear whether the concepts assessed are those that are important to patients and their caregivers. The concepts measured by commonly used COAs in this population have not been explicitly compared. METHODS We conducted reviews of the qualitative literature to extract information on pediatric ADHD-related concepts reported by pediatric patients, parents, and teachers. Using these concepts, we developed a conceptual framework of pediatric ADHD using both the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria and the additional symptoms and behavioral impacts identified in the literature. We searched for COAs that have been used in pediatric ADHD research and mapped their items based on their conceptual underpinning. RESULTS Of the 27 COAs found in the empirical literature, 4 COAs assessed only DSM symptoms. The most comprehensive coverage of our conceptual framework was seen in the Swanson, Nolan, and Pelham Rating Scale-DSM-IV (SNAP-IV). Eighteen COAs were used in at least 1 clinical trial: ADHD-Rating Scale-IV (ADHD-RS-IV) was used most often (n=77), followed by SNAP-IV (n=50), Swanson, Kotkin, Agler, M-Flynn, and Pelham Scale (SKAMP; n=31), Weiss Functional Impairment Rating Scale (WFIRS; n=24), and Vanderbilt ADHD Diagnostic Rating Scale (VADRS; n=15). CONCLUSION We identified symptoms and behavioral impacts from qualitative studies in pediatric ADHD that are not included in DSM-based criteria. Most COAs used in pediatric ADHD clinical trials measure only those symptoms listed in the DSM. While these COAs can measure symptom severity, they may not assess the full range of symptoms and impacts important to patients and their caregivers. Future research is needed to measure all concepts important to patients and caregivers within ADHD clinical trials.
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Affiliation(s)
| | - Dorothee Oberdhan
- HEOR and Outcomes Management, Otsuka America Pharmaceutical, Inc, Rockville, MD20850, USA
| | - Anna Ciesluk
- Research Department, Modus Outcomes, Cambridge, MA02142, USA
| | - Alissa Rams
- Research Department, Modus Outcomes, Cambridge, MA02142, USA
| | - Sharon B Wigal
- Department of Pediatrics, University of California School of Medicine, Irvine, CA92697–4089, USA
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Laugesen B, Lauritsen MB, Jørgensen R, Sørensen EE, Rasmussen P, Grønkjær M. The Complexities of Everyday Life and Healthcare Utilization in Danish Children With ADHD: A Mixed Methods Study. J Pediatr Nurs 2020; 52:e33-e41. [PMID: 32008832 DOI: 10.1016/j.pedn.2020.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 01/07/2020] [Accepted: 01/08/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE To explore and describe everyday life and hospital-based healthcare experiences and utilization in families of children with ADHD in Denmark. DESIGN AND METHODS The present work is a multistage, mixed methods study. The design consists of three individual studies: a meta-synthesis, a focused ethnographic study, and a historical cohort study. RESULTS The integrated findings show that: 1) parental stressors affect everyday life and hospital-based service use; 2) parents have concerns for their child from early childhood and fight to have their concerns recognized; and 3) healthcare professionals are important for parents to navigate the persistent challenges of everyday life. CONCLUSIONS Having a child with ADHD pervades everyday life and children with ADHD use more medical and psychiatric services in hospitals during the first 12 years of life than children without ADHD. The findings demonstrate a vulnerable everyday life experience and highlight the importance of the families being recognized, accepted, and respected in hospital-based healthcare services from early childhood. PRACTICE IMPLICATIONS Healthcare professionals need to recognize the challenges the family of a child with ADHD faces and to acknowledge that ADHD pervades all aspects of everyday life and all other healthcare issues. It is important for healthcare professionals, regardless of specialty, to engage with individual families and to positively contribute to the medical and psychiatric healthcare experience.
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Affiliation(s)
- Britt Laugesen
- Clinical Nursing Research Unit, Aalborg University Hospital, Denmark; Department of Clinical Medicine, Aalborg University, Denmark.
| | | | - Rikke Jørgensen
- Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aalborg University Hospital, Denmark
| | - Erik Elgaard Sørensen
- Clinical Nursing Research Unit, Aalborg University Hospital, Denmark; Department of Clinical Medicine, Aalborg University, Denmark
| | | | - Mette Grønkjær
- Clinical Nursing Research Unit, Aalborg University Hospital, Denmark; Department of Clinical Medicine, Aalborg University, Denmark
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Chou WJ, Liu TL, Hsiao RC, Chen YM, Chang CC, Yen CF. Caregiver-Attributed Etiologies of Children's Attention-Deficit/Hyperactivity Disorder: A Study in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051652. [PMID: 32143281 PMCID: PMC7084299 DOI: 10.3390/ijerph17051652] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 02/29/2020] [Accepted: 03/03/2020] [Indexed: 02/07/2023]
Abstract
The aim of this survey study was to examine the etiologies of attention-deficit/hyperactivity disorder (ADHD) attributed by caregivers of Taiwanese children with ADHD, particularly factors affecting such attribution. This study had 400 caregivers of children with ADHD as participants. We examined the caregiver-attributed etiologies of ADHD and factors affecting such attribution. Caregivers completed the self-report questionnaire to rate how likely they perceived various etiologies of ADHD to be; the Affiliate Stigma Scale for the level of affiliate stigma; and the short Chinese version of the Swanson, Nolan, and Pelham, Version IV Scale for child’s ADHD and oppositional symptoms. Brain dysfunction (84.8%) was the most commonly attributed etiology, followed by failure of caregivers in disciplining the child (44.0%); a poor diet, such as a sugar-rich diet (40.8%); a poor living environment (38.8%); the child imitating their peers’ improper behavior (37.3%); failure of school staff in disciplining the child (29.0%); the education system’s overemphasis on academic performance (27.3%); and supernatural beings or divination-based reasons (3.8%). Caregivers’ affiliate stigma was significantly associated with the attribution of several nonbiological etiologies other than brain dysfunction. Caregivers’ education level and children’s sex, hyperactivity/impulsivity, and oppositional symptoms were significantly associated with various caregiver-attributed etiologies. Therefore, to deliver more accurate knowledge about ADHD in educational programs, health professionals should consider those etiologies that are attributed by caregivers of children with ADHD.
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Affiliation(s)
- Wen-Jiun Chou
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan;
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan
| | - Tai-Ling Liu
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan; (T.-L.L.); (Y.-M.C.)
- Department of Psychiatry, School of Medicine, and Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Ray C. Hsiao
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195-6560, USA;
- Department of Psychiatry, Children’s Hospital and Regional Medical Center, Seattle, WA 98105, USA
| | - Yu-Min Chen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan; (T.-L.L.); (Y.-M.C.)
| | - Chih-Cheng Chang
- Department of Psychiatry, Chi Mei Medical Center, Tainan 70246, Taiwan
- Department of Health Psychology, College of Health Sciences, Chang Jung Christian University, Tainan 71101, Taiwan
- Correspondence: (C.-C.C.); (C.-F.Y.); Tel.: +886-6-2812811 (ext. 58604) (C.-C.C.); +886-7-3121101 (ext. 6816) (C.-F.Y.)
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan; (T.-L.L.); (Y.-M.C.)
- Department of Psychiatry, School of Medicine, and Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Correspondence: (C.-C.C.); (C.-F.Y.); Tel.: +886-6-2812811 (ext. 58604) (C.-C.C.); +886-7-3121101 (ext. 6816) (C.-F.Y.)
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Karimirad MR, Noghani F, Oghli SH, Noorian S, Amini E. Quality of Life in the Mothers of Children With Attention Deficit Hyperactivity Disorder and its Effective Factors. INTERNATIONAL JOURNAL OF EPIDEMIOLOGIC RESEARCH 2019. [DOI: 10.15171/ijer.2019.28] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background and aims: Having a child with attention deficit hyperactivity disorder (ADHD) may have an impact on the quality of life of his/her parents, particularly his/her mother. However, very limited studies have addressed this issue in Iran and the world. Therefore, the aim of this study was to examine the quality of life in the mothers of children with ADHD and its effective factors. Methods: The present descriptive-analytic study was carried out in Tehran from April to September 2016. A total of 110 mothers of ADHD children were enrolled in the study through a convenience sampling method, who referred to psychiatric centers of Tehran University of Medical Sciences. An informed consent form was obtained from all the participants as well. In addition, a researcher-made checklist for demographic characteristics and the 36-item Short Form of Health Survey Questionnaire (SF-36) were utilized for data collection. The collected data were then entered into SPSS 16 statistical software. Finally, descriptive tests (mean and median) and statistical tests including Pearson correlation test, independent t test, and one-way analysis of variance (ANOVA) were used for data analysis. Results: The mean age of participated mothers was 39.5 years and most children were males (76.4%). The mean overall score of the quality of life was 60.6±20.4. Among the eight dimensions of the questionnaire, participants achieved the lowest score regarding the dimension of "the role limitations due to emotional problems" with the mean score of 52.43, while the highest score was observed in terms of "the physical function" dimension with the mean score of 77.30. No significant relationship was observed between any of the demographic characteristics and the mean overall score of the quality of life (P>0.05). Conclusion: In the present study, the quality of life of the mothers was not significantly different from the quality of life of normal mothers. However, the healthcare team should pay more attention regarding some dimensions of the quality of life. Eventually, similar studies are recommended to be conducted due to the lack of sufficient evidence regarding this issue among the mothers of ADHD children.
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Affiliation(s)
| | - Fatemeh Noghani
- Department of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeid Hossein Oghli
- School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Sajad Noorian
- Department of Statistics, Faculty of Science, University of Qom, Qom, Iran
| | - Ehsanolah Amini
- Psychology MSc Student in West Tehran Islamic Azad University, Tehran, Iran
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Leitch S, Sciberras E, Post B, Gerner B, Rinehart N, Nicholson JM, Evans S. Experience of stress in parents of children with ADHD: A qualitative study. Int J Qual Stud Health Well-being 2019; 14:1690091. [PMID: 31713473 PMCID: PMC6853214 DOI: 10.1080/17482631.2019.1690091] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/21/2019] [Indexed: 11/01/2022] Open
Abstract
Purpose: Qualitative research aimed at understanding the stress of parents of children with ADHD is limited and few interventions have been designed to directly target their stress. The study aim was to explore the stress of parents of children with ADHD using qualitative methodology.Methods: Thirteen parents of children with ADHD participated in two focus groups. Open-ended questions explored parents' experiences of stress. Focus groups were recorded, transcribed, and coded using thematic analysis. Parents also completed the Parenting Stress Index-Short Form.Results: Four primary themes were identified: The child's behaviour feels like a "wrecking ball"; Coping with the "war at home"; A divided family: "relationships don't survive"; and Craving support: "it's goddamn hard work". Five of eleven participants who completed the PSI-SF scored in the clinically significant range indicating levels of stress that require professional support.Conclusions: Parents attribute their high stress to their children's behaviour, unmet needs for support, and social stigma. Parents request support to enable them to cope and appear to represent a clinical population who require mental health care and support themselves. Future interventions directly targeting the stress of parents of children with ADHD may provide wide-ranging benefits for their children and families.
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Affiliation(s)
- Sophie Leitch
- School of Psychology, Deakin University, Burwood, Australia
| | - Emma Sciberras
- School of Psychology, Deakin University, Burwood, Australia
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Australia
| | - Brittany Post
- School of Psychology, Deakin University, Burwood, Australia
| | - Bibi Gerner
- School of Psychology, Deakin University, Burwood, Australia
| | | | - Jan M. Nicholson
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Australia
- Judith Lumley Centre, La Trobe University, Bundoora, Australia
| | - Subhadra Evans
- School of Psychology, Deakin University, Burwood, Australia
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Taylor A, Novo D, Foreman D. An Exercise Program Designed for Children with Attention Deficit/Hyperactivity Disorder for Use in School Physical Education: Feasibility and Utility. Healthcare (Basel) 2019; 7:E102. [PMID: 31487932 PMCID: PMC6787573 DOI: 10.3390/healthcare7030102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 08/28/2019] [Accepted: 08/30/2019] [Indexed: 12/11/2022] Open
Abstract
Moderate to high intensity exercise can improve cognitive function and behavior in children including those with attention-deficit/hyperactivity disorder (ADHD). However, exercise with long periods of the same activity, or inactivity can fail to engage or maintain their attention. This study examined the effect of exercise sessions developed to engage children with ADHD. Twelve children (10-11 years), six with a diagnosis of ADHD and six with no diagnosis, undertook 40-minute sessions of short-duration, mixed activities bi-weekly for eleven weeks. ADHD symptoms and exercise enjoyment were recorded before six and eleven weeks of intervention. Teacher-reported data showed ADHD symptoms were significantly decreased in the children with ADHD, with a moderate to large effect size. There were no changes in the control group. All children indicated equal enjoyment of the exercise sessions. Specially designed exercise sessions stimulate and maintain engagement by children with ADHD and may reduce ADHD symptom levels in the school environment. The method that supports inclusive practice in physical education (PE) was successfully transferred to the study school and led by the usual class teacher. Children evaluated the exercises as acceptable and enjoyable for those with and without ADHD. This inclusive exercise method might help children manage ADHD symptoms.
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Affiliation(s)
- Alyx Taylor
- Department of Physiology, School of Psychology, Sport and Physical Activity, AECC University College, Bournemouth BH5 2DF, UK.
| | - Dario Novo
- Department of Physiology, School of Psychology, Sport and Physical Activity, AECC University College, Bournemouth BH5 2DF, UK
| | - David Foreman
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
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21
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Laugesen B, Mohr-Jensen C, Boldsen SK, Jørgensen R, Sørensen EE, Grønkjær M, Rasmussen P, Lauritsen MB. Attention Deficit Hyperactivity Disorder in Childhood: Healthcare Use in a Danish Birth Cohort during the First 12 Years of Life. J Pediatr 2018; 197:233-240. [PMID: 29580680 DOI: 10.1016/j.jpeds.2018.01.078] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 01/22/2018] [Accepted: 01/29/2018] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To compare the mean number of medical and psychiatric hospital-based services in children with and without attention deficit hyperactivity disorder (ADHD) and to assess the effect of ADHD on hospital-based service use, including child-, parental-, and socioeconomic-related risk factors. STUDY DESIGN A Danish birth cohort was followed through 12 years, and children with ADHD were identified using Danish nationwide registries. Poisson regression analyses were used to assess the association of ADHD with service use and to adjust for a comprehensive set of explanatory variables. RESULTS Children diagnosed with ADHD used more medical and psychiatric hospital-based healthcare than those without ADHD. In children with ADHD, intellectual disability and parental psychiatric disorder were associated with increased medical and psychiatric service use. Low birth weight and low gestational age were associated with increased medical service use. Psychiatric comorbidity and having a divorced or single parent were associated with increased psychiatric service use. CONCLUSIONS ADHD independently affected medical and psychiatric hospital-based service use even when adjusting for a comprehensive set of explanatory variables. However, the pattern of medical and psychiatric hospital-based service use is complex and cannot exclusively be explained by the child-, parental-, and socioeconomic-related variables examined in this study.
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Affiliation(s)
- Britt Laugesen
- Clinical Nursing Research Unit, Aalborg University Hospital, Denmark.
| | - Christina Mohr-Jensen
- Research Unit for Child and Adolescent Psychiatry, Psychiatry, Aalborg University Hospital, Denmark
| | - Søren Kjærgaard Boldsen
- Research Unit for Child and Adolescent Psychiatry, Psychiatry, Aalborg University Hospital, Denmark
| | - Rikke Jørgensen
- Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aalborg University Hospital, Denmark
| | - Erik Elgaard Sørensen
- Clinical Nursing Research Unit, Aalborg University Hospital, Denmark; Department of Clinical Medicine, Aalborg University, Denmark
| | - Mette Grønkjær
- Clinical Nursing Research Unit, Aalborg University Hospital, Denmark; Department of Clinical Medicine, Aalborg University, Denmark
| | | | - Marlene Briciet Lauritsen
- Research Unit for Child and Adolescent Psychiatry, Psychiatry, Aalborg University Hospital, Denmark; Adelaide Nursing School, The University of Adelaide, Australia
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Laugesen B, Lauritsen MB, Jørgensen R, Sørensen EE, Grønkjær M, Rasmussen P. ADHD and Everyday Life: Healthcare as a Significant Lifeline. J Pediatr Nurs 2017; 35:105-112. [PMID: 28728760 DOI: 10.1016/j.pedn.2017.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 03/09/2017] [Accepted: 03/10/2017] [Indexed: 01/19/2023]
Abstract
AIM The aim of this qualitative study was to explore parental experiences of how healthcare practices and healthcare professionals in hospital clinics in Denmark influence everyday life of parents with a child with ADHD. DESIGN AND METHODS The methodology was focused ethnography. Participant observation and interviews were used as the primary data collection methods. Fifteen families of children with ADHD were included from somatic and psychiatric hospital clinics. RESULTS Three main themes emerged from the experiences of the families: When the house of cards collapses in everyday life, Treading water before and after receiving the ADHD diagnosis, and Healthcare as a significant lifeline. CONCLUSIONS Accessibility to healthcare, trusting relationships and healthcare professionals recognizing how ADHD pervades all aspects of everyday life appear to be important factors in providing a lifeline for parents to help them regain confidence and control in disruptive phases. The parents depend on help from healthcare professionals and family-centred care to manage the complex challenges in everyday life.
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Affiliation(s)
- Britt Laugesen
- Clinic for Woman and Child Diseases and Urology, Aalborg University Hospital, Denmark.
| | | | - Rikke Jørgensen
- Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aalborg University Hospital, Denmark
| | - Erik Elgaard Sørensen
- Clinical Nursing Research Unit, Aalborg University Hospital, Denmark & Department of Clinical Medicine, Aalborg University, Denmark
| | - Mette Grønkjær
- Clinical Nursing Research Unit, Aalborg University Hospital, Denmark & Department of Clinical Medicine, Aalborg University, Denmark
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Randomized Clinical Trial of Mindfulness Skills Augmentation in Parent Training. CHILD & YOUTH CARE FORUM 2017. [DOI: 10.1007/s10566-017-9411-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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