Family burden, family health and personal mental health

Design of Digital Mental Health Platforms for Family Member Cocompletion: Scoping Review

BACKGROUND

The COVID-19 pandemic placed an additional mental health burden on individuals and families, resulting in widespread service access problems. Digital mental health interventions suggest promise for improved accessibility. Recent reviews have shown emerging evidence for individual use and early evidence for multiusers. However, attrition rates remain high for digital mental health interventions, and additional complexities exist when engaging multiple family members together.

OBJECTIVE

As such, this scoping review aims to detail the reported evidence for digital mental health interventions designed for family use with a focus on the build and design characteristics that promote accessibility and engagement and enable cocompletion by families.

METHODS

A systematic literature search of MEDLINE, Embase, PsycINFO, Web of Science, and CINAHL databases was conducted for articles published in the English language from January 2002 to March 2024. Eligible records included empirical studies of digital platforms containing some elements designed for cocompletion by related people as well as some components intended to be completed without therapist engagement. Platforms were included in cases in which clinical evidence had been documented.

RESULTS

Of the 9527 papers reviewed, 85 (0.89%) met the eligibility criteria. A total of 24 unique platforms designed for co-use by related parties were identified. Relationships between participants included couples, parent-child dyads, family caregiver-care recipient dyads, and families. Common platform features included the delivery of content via structured interventions with no to minimal tailoring or personalization offered. Some interventions provided live contact with therapists. User engagement indicators and findings varied and included user experience, satisfaction, completion rates, and feasibility. Our findings are more remarkable for what was absent in the literature than what was present. Contrary to expectations, few studies reported any design and build characteristics that enabled coparticipation. No studies reported on platform features for enabling cocompletion or considerations for ensuring individual privacy and safety. None examined platform build or design characteristics as moderators of intervention effect, and none offered a formative evaluation of the platform itself.

CONCLUSIONS

In this early era of digital mental health platform design, this novel review demonstrates a striking absence of information about design elements associated with the successful engagement of multiple related users in any aspect of a therapeutic process. There remains a large gap in the literature detailing and evaluating platform design, highlighting a significant opportunity for future cross-disciplinary research. This review details the incentive for undertaking such research; suggests design considerations when building digital mental health platforms for use by families; and offers recommendations for future development, including platform co-design and formative evaluation.

Impact of living with an adult with depressive symptoms among households in the United States

BACKGROUND

The effect of depressive symptoms on individuals has been widely studied but their impact on households remains less explored. This study assessed the humanistic and economic impact of living with an adult with depressive symptoms on adults without depressive symptoms among households in the United States (US).

METHODS

The Medical Expenditure Panel Survey (MEPS) Household Component database was used to identify adults without depressive symptoms living in households with ≥1 adult with depressive symptoms (depression household) and adults without depressive symptoms living in households without an adult with depressive symptoms (no-depression household). Weighted generalized linear models with clustered standard errors were used to compare total income (USD 2020), employment status, workdays missed, quality of life (QoL), and healthcare resource utilization (HRU) between cohorts.

RESULTS

Adults without depressive symptoms living in a depression household (n = 1699) earned $4720 less in total annual income (representing 11.3% lower than the average income of $41,634 in MEPS), were less likely to be employed, missed more workdays per year, and had lower QoL than adults without depressive symptoms living in a no-depression household (n = 15,286). Differences in total annual healthcare costs and for most types of HRU, except for increased outpatient mental health-related visits, were not significant.

LIMITATIONS

Data is subject to reporting bias, misclassification, and other inaccuracies. Causal inferences could not be established.

CONCLUSION

The economic and humanistic consequences of depressive symptoms may extend beyond the affected adults and impact other adult members of the household.

The impact of culture perception on kinship disconnection of Chinese youth: examining the chain mediating effect of kinship support, kinship burnout, and social media interaction

Kinship connections are an essential foundation of social relationships in China, yet in recent years there has been an increasing tendency toward kinship disconnection (Duanqin) among Chinese youth. In this study, based on online survey data of 555 Chinese individuals aged 18-35 years under a comprehensive explanatory framework of culturalism, functionalism, and behaviorism, regression and mediation analyses found that (1) cultural perception based on family-state values is the dominant factor influencing people's tendency to disconnect. (2) Kinship support decreases people's propensity to break off relatives, while kinship burnout increases people's propensity to cut off relatives. Both act as functionalist factors in the chain that mediates the effect of cultural perception on the propensity to break kinship, and kinship burnout obscures the effect of kinship support and becomes a differentiating variable. (3) Both social media kin interaction size and kin group activity significantly reduce people's propensity to disconnect. However, group activities are more significant in cultural perception's mediating effect on disconnection propensity. It indicates that truly "active" social media connections are more important. The study attempts to propose a framework of "cultural perception + functional satisfaction and burnout + social media" to interpret Chinese youth kinship communication activity. On a practical level, more support for young people in social media interactions could slow or even reverse the trend of disconnection.

Mothers' and Children's Mental Distress and Family Strain during the COVID-19 Pandemic: A Prospective Cohort Study

BACKGROUND

The COVID-19 pandemic had a widespread impact on families with dependent children. To better understand the impact of the pandemic on families' health and relationships, we examined the association between mothers' and children's mental distress and family strain.

METHODS

Three waves of the COVID-19 Impact Survey were analyzed, collected from a subsample of mother-child pairs (n = 157) from the Alberta Pregnancy Outcomes and Nutrition (APrON) longitudinal cohort in Alberta, Canada. Latent class analyses were performed to determine patterns and group memberships in mothers' and children's mental distress and family strain. Multivariable logistic regression models were conducted to test associations between mothers' and children's mental distress and family strain trajectory classes.

RESULTS

Mothers with medium/high levels of mental distress were at increased odds of experiencing high family strain compared to those with low levels of distress (medium aOR = 3.90 [95% CI: 1.08-14.03]; high aOR = 4.57 [95% CI: 1.03-20.25]). The association between children's mental distress and family strain was not significant (aOR = 1.75 [95% CI: 0.56-5.20]).

CONCLUSION

Mothers' mental distress, but not children's, was associated with family strain during the pandemic. More distressed individuals experienced greater family strain over time, suggesting that this association may become a chronic problem.

Understanding the burden of mental and physical health disorders on families: findings from the Saudi National Mental Health Survey

OBJECTIVE

To assess prevalence and correlation of factors of family burden associated with mental and physical disorders in the general population of Saudi Arabia.

SETTING AND PARTICIPANTS

A secondary analysis of data from the Saudi National Mental Health Survey (SNMHS).

OUTCOME MEASURES

Mental and physical health disorders of first-degree relatives and objective (time, financial) and subjective (distress, embarrassment) family burden.

RESULTS

We found significant caregiver burden for family members with mental health disorders. Around one-third of the sample was providing care for a family member with a health issue. Within this group, 40% had a mental health diagnosis. 73% of the study population reported experiencing some form of burden as a result of the care they are obligated to provide for their family members. We found the highest burden on male caregivers, in providing care for family members with serious memory disorders, mental retardation, schizophrenia or psychosis, followed by, alcohol and drug disorders, anxiety, depression or manic depression.

CONCLUSION

Our findings for family burden were statistically significant, indicating potential negative impact on caregiver coping ability with the demands of caring for family members with health issues. A comprehensive review of national mental health policies is required to integrate aspects of community mental health promotion, scale-up prevention, screening interventions and social support to protect against the difficulties of mental illness and reduce the burden on caregivers, the family, society, health system and the economy.

Mental health problems during the COVID-19 pandemic among residents of Jimma town: a cross-sectional study

The COVID-19 pandemic presents an unprecedented challenge to community wellbeing and mental health. However, quantifiable information on the extent of mental health problems and associated factors due to the pandemic is still lacking in low-income countries. Thus, this study aimed to investigate the levels of depression, anxiety, and stress and their association with risk and resilience factors among residents of Jimma town in Southwestern Ethiopia. A community-based cross-sectional study was conducted between October 2021 and November 2021. Data were collected from 1196 adult Jimma town residents selected through multi-stage sampling. The following scales were used for the cross-sectional assessment of depressions, anxiety and stress and their associations: depression, anxiety, and stress-21(DASS-21), World Health Organization (WHO) wellbeing, University of California, Los Angeles Loneliness Scale (UCLA), Childhood trauma questionnaire, and brief resilience scales. A pre-tested, interviewer-completed questionnaire was used for data collection. Bivariate and multivariate logistic regression analyses were conducted to identify factors associated with depression, anxiety, and stress. Odds ratios consistent with 95% CI were used to report the presence of an association between risk and resilience factors and the outcome variable at a P-value < 0.05. Overall, 963 (80.53%) respondents had divergent DASS-21 score findings. Specifically, 27.68%, 31.52% and 21.32% experienced depression, anxiety, and stress respectively. Higher DASS-21 scores were associated with the presence of one or more COVID-19 risk factors for anyone close to the participants (AOR = 1.53, 95% CI 1.03-2.27), feelings of stress/burden (β = 1.09, 95% CI 1.07-1.12), positive coping (β = 1.044, 95% CI 1.01-1.07), loneliness (β = 1.063, 95% CI 1.04-1.08), and childhood trauma (β = 1.03, 95% CI 1.01-1.04). In contrast, lower DASS-21 scores were associated with beliefs about the necessity of solidarity-based behavior (β = 0.94, 95% CI 0.90-0.98), resilience (β = 0.92, 95% CI 0.87-0.97) and wellbeing (β = 0.90, 95% CI 0.87-0.94). In the course of the COVID-19 pandemic in 2021, symptoms of depression, anxiety, and stress in the study community were prevalent, and associated with numerous risk and resilience factors. Although causality cannot be inferred, these findings underscore the importance of strengthening mental health services and may guide COVID-19 prevention and treatment strategies.

Is the mental health of older adults receiving care from their children related to their children's dual burden of caregiving and work stress? A linked lives perspective

OBJECTIVES

Mental health problems are a major concern in the older population in Sweden, as is the growing number of older adults aging alone in their homes and in need of informal care. Using a linked lives perspective, this study explored if older parents' mental health is related to their children's dual burden of informal caregiving and job strain.

METHODS

Data from a nationally representative Swedish survey, SWEOLD, were used. Mental health problems in older age (mean age 88) were measured with self-reported 'mild' or 'severe' anxiety and depressive symptoms. A primary caregiving adult child was linked to each older parent, and this child's occupation was matched with a job exposure matrix to assess job strain. Logistic regression analyses were conducted with an analytic sample of 334.

RESULTS

After adjusting for covariates, caregiving children's lower job control and greater job strain were each associated with mental health problems in their older parents (OR 2.52, p = 0.008 and OR 2.56, p = 0.044, respectively). No association was found between caregiving children's job demands and their older parents' mental health (OR 1.08, p = 0.799).

CONCLUSION

In line with the linked lives perspective, results highlight that the work-life balance of informal caregiving adult children may play a role in their older parent's mental health.

The mediating effect of family health on the relationship between health literacy and mental health: A national cross-sectional survey in China

BACKGROUND

Mental health problems significantly affect people's well-being and result in a huge health burden. Health literacy and family health are critical to reducing people's mental health problems. However, limited studies have addressed their complex interaction. Thus, this study aims to elucidate the mediating effect of family health on the relationship between health literacy and mental health.

METHODS

A national cross-sectional study based on multistage random sampling was conducted from July 10 to Sep 15, 2021, in China. Information about the public's health literacy, family health, and the level of three common mental health problems (depression, anxiety, and stress) was collected. A structural equation model (SEM) was applied to explore the mediating effect of family health on the relationship between health literacy and mental health.

RESULTS

A total of 11,031 participants were investigated. Approximately 19.93 and 13.57% of participants experienced moderate or severe depressive and anxiety symptoms, respectively. The SEM showed that health literacy was directly associated with mental health, with higher health literacy resulting in lower levels of depression (coefficient: -0.018, p = .049), anxiety (coefficient: -0.040, p < .001), and stress (coefficient: -0.105, p < .001). In addition, family health played a significant mediating effect (p < .001) between health literacy and mental health, contributing to 47.5, 70.9, and 85.1% of the total effect of health literacy on personal stress, anxiety, and depression, respectively.

CONCLUSIONS

This study revealed that the improvement of health literacy is directly and indirectly associated with less likelihood of people's mental health problems via family health. Thus, future mental health interventions should be integrated and targeted both at individual level and the family level.

Role of family in supporting children with mental disorders in Qatar

Background

Mental disorders can significantly impact children's lives and affect their emotional, cognitive, and behavioral development. Family support and care is critical to the well-being of children, particularly children with mental disorders. However, given the "gap" between research and practice"," there have been very few studies in the Arab region that focus on the role of the family in supporting children with mental disorders. The study also examines how families cope with caring for a person with mental disorders and what behaviors may influence the patient's distress. In addition, the study will examine the importance of family rehabilitation and integration of people with mental disorders into society.

Methods

The study adopts the descriptive-analytical method and uses a questionnaire to gather data from the participants. The 350-parents sample (with 113 boys, 237 girls) was selected from the Shafallah Center for Integrating People with Disability. Morgan's law is used to determine the sample size.

Results

The results show that there are statistically significant differences in the role of family members in supporting people with mental disorders due to two variables: Gender and Work. Age has no statistically significant effect on the role of family members in supporting people with mental disorders.

Conclusion

This study is the first study conducted to investigate the role of family in supporting children with mental disorders in the Gulf Cooperation Council (GCC) in general and Qatar in particular. The results show that families should cope with the needs of a person with a mental disorder. Family rehabilitation is important in the care of people with mental disorders. There are certain behaviors of family members that can increase or decrease stress for the person. The results suggest that the family plays an essential role in supporting and promoting the lives of people with mental disorders and recommending effective ways to cope with them.

An Exploratory Study of Verbal and Non-Verbal Communication in Saudi Arabian Families

This exploratory study investigated whether factors such as gender, age, level of education, monthly income, and the number of family members are associated with verbal and non-verbal communication in Saudi Arabian families. A convenience sampling procedure was used to recruit 182 Saudi Arabian adults who responded to a self-report survey. Verbal and non-verbal communication was categorized into positive and negative communication. Descriptive and ordinal regression analyses were conducted to assess the relationships of familial variables with communication. Female gender status had a small negative association with positive communication, whereas the number of family members, level of education, monthly income, and age did not correlate with positive communication or negative communication. The Discussion section addresses the limitations of the current study and identifies several directions for future research, with special attention to the Saudi Arabian family context.

Can Following Paleolithic and Mediterranean Diets Reduce the Risk of Stress, Anxiety, and Depression: A Cross-Sectional Study on Iranian Women

Background

Psychiatric disorders have been a challenge for public health and will bring economic problems to individuals and healthcare systems in the future. One of the important factors that could affect these disorders is diet.

Objective

In the current study with a cross-sectional design, we investigated the association of Paleolithic and Mediterranean diets with psychological disorders in a sample of adult women.

Methods

Participants were 435 adult women between 20 and 50 years old that refer to healthcare centers in the south of Tehran, Iran. The diet scores were created by the response to a valid and reliable semiquantitative food frequency questionnaire (FFQ), and the psychological profile was determined by response to the Depression, Anxiety, and Stress Scale (DASS-21). The multivariable-adjusted logistic regression was applied to compute the odds ratio (OR) and 95% confidence interval (CI).

Results

After adjusted for potential confounders, it is evident that participants in the highest Paleolithic diet tertile had lower odds of depression (OR = 0.21; 95% CI: 0.12, 0.37: P < 0.001), anxiety (OR = 0.27; 95% CI: 0.16, 0.45: P < 0.001), and stress (OR = 0.19; 95% CI: 0.11, 0.32; P < 0.001) in comparison to the lowest tertile. Furthermore, those in the third tertile of the Mediterranean diet score were at lower risk of depression (OR = 0.20; 95% CI: 0.11, 0.36; P < 0.001), anxiety (OR = 0.22; 95% CI: 0.13, 0.38; P < 0.001), and stress (OR = 0.23; 95% CI: 0.13, 0.39; P < 0.001) compared with those in the first tertile.

Conclusion

The result of the current study suggests that greater adherence to Paleolithic and Mediterranean dietary patterns may be related with a decreased risk of psychological disorders such as depression, anxiety, and stress.

The influence of internet use frequency, family atmosphere, and academic performance on adolescent depression: Based on the chain mediating effect of self-adjustment and campus deviant behavior

Introduction

Depression has become a prominent psychological problem among young people. The purpose of this study was to investigate the potential relationship between the frequency of Internet use, family atmosphere, academic performance, self-adjustment, campus deviant behavior, and depressive symptoms among adolescents.

Methods

Based on the survey data of the fifth wave (2017~2018) and the sixth wave (2019~2020) of the China Family Panel Studies (CFPS), this study used LISREL8.8 software to analyze 1,577 10~15 data on adolescents.

Results

In this study, the mean score of self-adjustment was 42.40 (SD = 6.79), the mean score of campus deviant behavior was 12.59 (SD = 4.00), the mean score of depressive symptoms in 2018 was 11.88 (SD = 3.04), and the mean score of depressive symptoms in 2020 was 7.64 (SD = 2.20). Secondly, the frequency of Internet use had no direct effect on the depressive symptoms of adolescents, family atmosphere was negatively correlated with depressive symptoms (p < 0.005), and academic performance was positively correlated with depressive symptoms (p < 0.005). Depressive symptoms in 2020 had a direct effect (β = 0.37, p < 0.001), and also had a negative effect on depressive symptoms in 2020, with a total effect of-0.07 (p < 0.001); self-adjustment had no direct effect on depressive symptoms in adolescents in 2018, However, the total effect was -0.14 (p < 0.001), which had a significant positive effect on 2020 depressive symptoms, and the total effect was 0.18 (p < 0.001), and self-adjustment had a significant negative effect on adolescent campus deviant behavior (β = -0.38, p < 0.001); in addition, the frequency of Internet use, family atmosphere, and academic performance all had indirect effects on adolescents' 2020 depressive symptoms, with total effects of -0.60, 0.01, and 0.02 (p < 0.001), respectively. This study also found depressive symptoms in adolescents have a certain persistence in time.

Discussion

Based on this study, it is necessary to pay more attention to the depression of adolescents, strengthen the training of self-adjustment, improve the anti-frustration ability and psychological resilience, and reduce the campus deviant behavior of adolescents. It is recommended to try to start from emotional self-adjustment to promote the personality health of adolescents.

Chatbot as an emergency exist: Mediated empathy for resilience via human-AI interaction during the COVID-19 pandemic

As a global health crisis, the COVID-19 pandemic has also made heavy mental and emotional tolls become shared experiences of global communities, especially among females who were affected more by the pandemic than males for anxiety and depression. By connecting multiple facets of empathy as key mechanisms of information processing with the communication theory of resilience, the present study examines human-AI interactions during the COVID-19 pandemic in order to understand digitally mediated empathy and how the intertwining of empathic and communicative processes of resilience works as coping strategies for COVID-19 disruption. Mixed methods were adopted to explore the using experiences and effects of Replika, a chatbot companion powered by AI, with ethnographic research, in-depth interviews, and grounded theory-based analysis. Findings of this research extend empathy theories from interpersonal communication to human-AI interactions and show five types of digitally mediated empathy among Chinese female Replika users with varying degrees of cognitive empathy, affective empathy, and empathic response involved in the information processing processes, i.e., companion buddy, responsive diary, emotion-handling program, electronic pet, and tool for venting. When processing information obtained from AI and collaborative interactions with the AI chatbot, multiple facets of mediated empathy become unexpected pathways to resilience and enhance users’ well-being. This study fills the research gap by exploring empathy and resilience processes in human-AI interactions. Practical implications, especially for increasing individuals’ psychological resilience as an important component of global recovery from the pandemic, suggestions for future chatbot design, and future research directions are also discussed.

Family Burden in Adolescents With Refractory Postconcussion Symptoms

OBJECTIVE

A significant minority of adolescents will have persistent postconcussion symptoms after an injury, potentially having a negative impact on family functioning. However, the reasons for a family's negative impact are not clearly understood. The objective of this study was to determine whether preinjury/demographic factors, injury characteristics, and/or worse postinjury symptoms are associated with higher levels of family stress in youth with refractory postconcussion symptoms.

SETTING

Pediatric refractory concussion clinic in a tertiary care center.

PARTICIPANTS

A total of 121 adolescents (13-18 years old) who were 1 to 12 months postconcussion.

MEASURES

Primary outcome was the mean stress rating on the Family Burden of Injury Interview (FBII), a 27-item questionnaire rating the impact on a family as a result of an injury. Preinjury/demographic and injury details were collected. Youth and their parents also completed measures of postconcussion symptoms, depression, anxiety, and behavioral problems.

RESULTS

Participants had a mean age of 16.0 years (SD = 1.3), of which, 65% identified as female, and were on an average 5.2 months (SD = 2.4) postconcussion. FBII ratings were not significantly correlated with demographics, preinjury functioning, injury severity, duration of persistent postconcussion problems (ie, time since injury), or self-reported postconcussion symptoms. Greater family burden (higher FBII ratings) significantly correlated with worse parent-reported postconcussion symptoms, worse psychological functioning (self-reported depression, parent-reported anxiety, and depression), and worse behavioral functioning (parent-reported conduct problems and peer problems). A multiple linear regression model revealed that parent-perceived postconcussion cognitive symptoms (β = .292, t = 2.56, P = .012) and parent-perceived peer problems (β = .263, t = 2.59, P = .011) were significantly associated with family burden ( F8,105 = 6.53; P < .001; R2 = 0.35).

CONCLUSION

Families of youth with refractory postconcussion symptoms can experience a negative impact. The severity of reported family burden in those with slow recovery from concussion was significantly associated with parents' perception of their child's cognitive symptoms and peer problems. These results could provide support for family-based interventions in this population.

The effect of Covid-19 on sleep quality, anxiety and depression on healthcare staff at a tertiary hospital in Turkey

BACKGROUND

The Covid-19 pandemic has forced healthcare staff into an unprecedented situation, such as making tough decisions and practising under enormous pressure.

AIM

This study was designed to investigate the effect of Covid-19 on sleep quality, anxiety and depression in healthcare staff at a tertiary hospital.

METHODS

This descriptive and cross-sectional study recruited healthcare staff working at a tertiary hospital. Those who had given their informed consent participated in this study between April 17 and May 17, 2020. Data were collected using the introductory information form, the Pittsburg Sleep Quality Index (PSQI), and the Hospital Anxiety Depression Scale (HADS). The data were then analyzed on the Statistical Package for the Social Sciences (SPSS) v.24.

RESULTS

The mean scores of the respondents derived from the HADS-Anxiety (HADS-A) and HADS-Depression (HADS-D) scales were 7.89 ± 4.60 and 7.22 ± 4.13, respectively. Their depression levels were established to be at risk, though their anxiety levels were not. The mean PSQI score turned out to be 8.42 ± 2.30 for the participants, most of whom (92.9%) experienced poor sleep quality. Total sleep quality of the respondents exhibited a moderate positive correlation with HADS-A scores and a weak positive correlation with HADS-D scores (p < 0.05).

CONCLUSION

Our major conclusion from the collected data is that healthcare staff suffered from poor sleep quality, and that their depression levels, but not anxiety levels, were at risk. Providing appropriate information about the health care of patients diagnosed with Covid-19 as well as offering regular psychoeducation-psychological support services and resting areas can reduce the susceptibility of healthcare staff to anxiety and depression and improve their overall sleep quality.

Self-Reported Symptoms of Depression, Anxiety, and Stress Among Healthcare Workers in Ethiopia During the COVID-19 Pandemic: A Cross-Sectional Study

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency that has affected many world nations, including Ethiopia. Aside from its implications on the community as a whole, COVID-19 has also been associated with a variety of mental health problems among healthcare workers (HCWs). In this study, we aim to assess the prevalence of self-reported symptoms of depression, anxiety, and stress during the COVID-19 pandemic among HCWs in central Ethiopia.

METHODS

An institutional-based cross-sectional study was conducted using an online survey from June 25, 2020, to July 25, 2020, in Ethiopia. Data were collected using a self-reported Depression, Anxiety, and Stress Scale (DASS-21). Data were cleaned, coded, and analysed using SPSS Version 23. A multivariable logistic regression analysis was done to identify the associated factors for mental health outcomes at a p-value of less than 0.05.

RESULTS

A total of 816 HCWs completed the self-report questionnaire. The percentage of HCWs who had moderate to extremely severe symptoms of depression, anxiety, and stress were 60.3%, 78%, and 33.8%, respectively. Female participants, HCWs in the Oromiya Special Zone, medical laboratory professionals, and HCWs working in the COVID-19 treatment isolation centers were significantly more likely to have symptoms of depression, anxiety, and stress.

CONCLUSION

In this study, HCWs reported a high prevalence of depression, anxiety, and stress symptoms. Female participants, HCWs in the Oromiya Special Zone, medical laboratory professionals, and HCWs working in the COVID-19 treatment isolation centers were significantly more likely to have symptoms of depression, anxiety, and stress. It is imperative that the Ethiopian Federal Ministry of Health should develop psychological interventions to address the specific needs of HCWs who have been impacted by the COVID-19 pandemic.

Working alliance among mental health nurses in Indonesia: A comparative analysis of socio-demographic characteristics

Background

Working alliance between therapist and client in psychotherapy practice has become proven to compensate for a significant difference in various psychotherapy modalities. However, few studies have investigated the structure of alliance in the context of nurses working at mental health hospitals in Indonesia.

Objective

This study aimed to compare the working alliance of mental health nurses according to socio-demographic characteristics.

Methods

A cross-sectional research was performed at the Mental Health Hospital in West Java, Indonesia, as a referral hospital in Indonesia from May to December 2019. The inclusion criteria were nurses with a minimum of one year of working experience and a Diploma III certificate in nursing. Convenience sampling was used to recruit 120 nurses who agreed to join in this study. The working alliance was measured using Working Alliance Inventory-Short Revised-Therapist (WAI-SRT).

Results

The majority of the respondents were female (77.5%), holding a Diploma III degree in nursing (49.17%), having working experience ranged from 11 to 15 years (34.17%), and working at the chronic unit (32.5%). The mean score of the working alliance was 44.46 (SD = 11.32). The domain of agreement on goals had a higher mean score (17.65 ± 3.45), followed by the task domain (16.56 ± 5.81) and bond domain (22.10 ± 7.23). There was a significant difference in working alliance according to education level and working experience (p < 0.05), while no significant differences in terms of gender and working unit.

Conclusion

Mental health nurses with higher education levels and more vast working experience had higher working alliances. Thus, nurse managers and hospital policymakers should provide Continues Nursing Education (CNE), working alliance training, and therapeutic strategies for nurses to improve their working alliances. It is also essential to cooperate with nursing schools to include working alliances as learning objectives.

Governing families that care for a sick relative: the contributions of Donzelot's theory for nursing

According to the literature, the family is now considered to be the most important resource for the care and support of a sick family member. Families are being increasingly invited and trained to play a utilitarian role, not just as family caregivers, but as healthcare agents. Healthcare institutions, based on neoliberal health policies, are encouraging them to perform increasingly complex and professionalized tasks. The burden associated with this expanded healthcare function, however, is significant (fatigue, emotional distress and exhaustion). The aim of this article was to present French sociologist Jacques Donzelot's theoretical perspective on governing through the family. According to Donzelot, such a government is exercised through various power techniques, including the instrumentalization of the family role and the transfer to families of the responsibility for health care. This author describes how healthcare institutions call on the family to perform hospital and biomedical practices within the home. A spin-off of neoliberalism, the practices of governing through families specifically target women, who are considered to be the pillar of the family. Donzelot's perspective is very relevant to nursing, but is still rarely mobilized in the discipline. His critical perspective allows for a re-reading of relations of power and mechanisms of surveillance and control of families, issues that are often overlooked in nursing research.

Is caring for grandchildren good for grandparents' health? Evidence from a fourteen-wave nationwide survey in Japan

Background

Enhanced female labor force participation is raising the importance of grandparents’ caring for their grandchildren. However, previous studies have reported mixed results of the association between grandchild care and grandparents’ health.

Methods

Longitudinal data of 33,204 individuals born between 1946 and 1955 were collected from a 14-wave nationwide panel survey conducted from 2005 to 2018. We examined how caring for at least one co-residing grandchild aged <6 years was associated with grandparents’ psychological distress (defined by five or higher Kessler 6 score) and poor self-rated health in pooled cross-sectional, fixed-effects, and 3-year follow-up logistic models.

Results

While pooled cross-sectional models showed a positive association between grandchild care and grandparents’ health, the fixed-effects or follow-up logistic models did not find any significant association between them. In the case of grandmothers, the odds ratio of reporting psychological distress in response to caring for grandchildren was 0.98 (95% confidence interval [CI], 0.89–1.08) and 1.04 (95% CI, 0.85–1.27) observed from fixed-effects and 3-year follow-up models, respectively, compared to 0.86 (95% CI, 0.81–0.91) in the pooled cross-sectional model. Similar patterns were observed for self-rated health for grandmothers, while grandfathers’ health outcomes were not sensitive to grandchild care. These results contrasted with those of caring for parents, which had almost consistently a negative association with grandparents’ health.

Conclusion

The results suggest that caring for grandchildren does not have a beneficial or detrimental effect on grandparents’ health.

COVID-19 pandemic: Psychological impact on anaesthesiologists

Background and Aim:

The anaesthesiologists are at the highest risk of contracting infection of coronavirus disease 2019 (COVID-19) in emergency room, operation theatres and intensive care units. This overwhelming situation can make them prone for psychological stress leading to anxiety and insomnia.

MATERIALS AND METHODS

We did an online self-administered questionnaire-based observational cross-sectional study amongst anaesthesiologists across India. The objectives were to find out the main causes for anxiety and insomnia in COVID-19 pandemic. Generalised Anxiety Disorder-7 (GAD-7) scale and Insomnia Severity Index (ISI) were used for assessing anxiety and insomnia.

Results:

Of 512 participants, 74.2% suffered from anxiety and 60.5% suffered from insomnia. The age <35 years, female sex, being married, resident doctors, fear of infection to self or family, fear of salary deductions, increase in working hours, loneliness due to isolation, food and accommodation issues and posting in COVID-19 duty were risk factors for anxiety. ISI scores ≥8 was observed in <35 years, unmarried, those with stress because of COVID-19, fear of loneliness, issues of food and accommodation, increased working hours and with GAD-7 score ≥5. Adjusted odd's ratio of insomnia in participants having GAD-7 score ≥5 was 10.499 (95% confidence interval 6.097–18.080; P < 0.001).

Conclusion:

The majority of anaesthesiologists on COVID-19 duty suffer from anxiety and insomnia. Addressing risk factors identified during this study with targeted interventions and psychosocial support will help them to cope better with the stress.

The state of mental digi-therapeutics: A systematic assessment of depression and anxiety apps available for Arabic speakers

BACKGROUND

Mental disorders are a major public health problem leading to premature mortality, homelessness, addiction problems, poor physical health, and suicide. The prevalence of mental disorders in Arab countries, is high. The proliferation and ubiquity of smartphones and their apps in the Arab world may be the long-awaited for digital therapeutic for mental health disorders. However, the evidence about the availability and characteristics of mental health apps available to Arabic speakers remains poor.

OBJECTIVE

To conduct a systematic assessment of the features of depression and anxiety mobile apps available for Arabic speakers.

METHODS

A critical review of all the currently available depression and anxiety apps, available free of charge to Arabic speakers. The apps are evaluated using the Mobile App Rating Scale (MARS). Further, a categorization of apps' main functions, inspired by the mhGAP guidelines, is developed to classify the apps based on their main functions.

RESULTS

A total of 23 apps are identified with far more apps available on the Google Play Store (n = 21) versus only two apps on the iOS App Store. The majority of the apps (n = 16) provide general information about either anxiety, depression, or both. Six apps are of spiritual nature mainly referring to the Islamic faith and the Holy Quran, with one app referring to the Christian faith. Another five apps provide advice on alternative treatments, mainly concerning herbal medicine recipes. Only two apps provided utilities for users, specifically about medication reminders.

CONCLUSIONS

Mental health digi-threaputics have huge potentials to transform mental health care delivery. However, more empirical studies are needed to assure their quality and efficacy. The results of this study clearly highlight the current gaps to address the needs of Arabic speakers; only 23 apps were identified in this study, mostly with low app quality scores. There is a need to involve expert healthcare professionals in the development of mental health apps and for healthcare providers to empower patients through discussing apps that are useful and discern them from those that can potentially cause harm.

[Perception of happiness associated to family life in Bogotá- Colombia]

OBJECTIVE

To demonstrate the association between happiness and family functionality in order to promote healthy family relationships and the biopsychosocial health of the people.

MATERIALS AND METHODS

Cross-sectional, descriptive study developed over a span of three years. A questionnaire was applied to 8 885 people from Bogotá selected by convenience sampling. The population was divided into those who said they were happy and those who said they felt sad at the time of the survey. Explanatory variables included sex, age, socioeconomic status, functionality (based on the family APGAR), family structure (members of the household), and support network. Odds ratios were obtained and the significant results were subjected to the regression process.

RESULTS

The logistic regression analysis of the odds ratios showed that the perception of happiness decreases with age (60 and over vs. 7 to 10 years; OR: 0.09, 95% CI: 0.03-0.26), that there is a stronger significant association with functionality (severe dysfunction vs. normal functionality; OR: 0.05, 95% CI: 0.03-0.08) than with family structure (extended vs. nuclear home; OR: 0.60, 95% CI: 0.37-0.96), and that happiness is related to support networks (low network vs. high network; OR: 0.52 95% CI: 0.31-0.88).

CONCLUSION

This research confirms the importance of the family in happiness perception, which is a sentiment considered as a health benchmark. Based on these results, strengthening family coexistence is essential to promote the health of people.

Effects of 12-Week Resistance Exercise on Electroencephalogram Patterns and Cognitive Function in the Elderly With Mild Cognitive Impairment: A Randomized Controlled Trial

OBJECTIVE

To investigate the effects of a 12-week resistance exercise program with an elastic band on electroencephalogram (EEG) patterns and cognitive function in elderly patients with mild cognitive impairment (MCI).

DESIGN

Randomized controlled trial.

SETTING

Community center.

PARTICIPANTS

Twenty-two subjects with MCI and 25 healthy volunteer subjects were randomly assigned to 1 of 4 groups: subjects with MCI who undertook the exercise program (MCI-EX; n = 10), an MCI control group (MCI-Con; n = 12), a healthy volunteer exercise group (NG-EX; n = 12), and a healthy volunteer control group (NG-Con; n = 13).

INTERVENTION

The exercise group engaged in a 15-repetition maximum (15RM; 65% of 1RM) resistance exercise program for 12 weeks.

MAIN OUTCOME MEASURES

Electroencephalograms, neuropsychological tests, and Senior Fitness Test.

RESULTS

The 12-week 15RM (65% of 1RM) resistance exercise program significantly improved variables related to the physical fitness of the elderly subjects. Furthermore, for the EEG test, the MCI and NG groups showed significant differences at baseline in relative beta waves on electrodes Fp1 (P < 0.05) and F3 (P < 0.05), as well as in relative beta2 waves on F3 (P < 0.05). In addition, after the 12-week exercise intervention, differences in a region that benefits from exercise were observed between (1) the MCI-EX group in the relative theta power on F3 (P < 0.05) and the relative alpha power on T3 (P < 0.05) and in (2) the NG-EX group in the relative theta power on P3 (P < 0.05) and P4 (P < 0.01). In addition, only the score of the digit span backward in the MCI-EX group changed significantly (P < 0.05).

CONCLUSIONS

The 12-week resistance exercise with an elastic band had a positive effect on EEG patterns in elderly subjects with MCI, along with providing physical benefits and slight changes in cognitive function in MCI-EX group.

SIGNIFICANCE

A 15RM resistance exercise program can be an effective treatment for delaying cognitive decline and improving physical fitness.

A comparative study to identify factors of caregiver burden between baby boomers and post baby boomers: a secondary analysis of a US online caregiver survey

Background

Baby boomers’ position in the caregiving context is shifting from caregiver to care recipient as the population ages. While the unique characteristics of baby boomer caregivers are well established in caregiving literature, there is limited information about the next caregiving group after the baby boomers. In this study, the sociodemographic and caregiving-related characteristics of the two generations are compared and specific factors contributing to caregiver burden between baby boomer and post baby boomer caregivers are identified.

Methods

This cross-sectional and correlational study used secondary analysis of data from the National Alliance for Caregiving and the American Association of Retired Persons. A structured online survey was conducted in 2014 with randomly selected samples (n = 1069) in the United States focusing on sociodemographics, caregiving-related characteristics, and burden of care. Descriptive statistics, multivariate linear regression analyses, and Steiger’s Z-test were used to identify group differences in multivariate factors related to caregiver burden in two generational groups.

Results

Baby boomers and post baby boomers experienced caregiver burden to a similar degree. Caregiving-related factors are more likely to increase burden of care than sociodemographics in both groups. Caregiving without choice and spending longer hours on caregiving tasks were common factors that increased the burden in both generational groups (all p values < 0.01). However, post baby boomer caregivers reported additional challenges, such as unemployment during caregiving, the dual responsibility of both adult and child care, and a family relationship with the care recipient.

Conclusions

Due to the aging population of baby boomers, post baby boomers encounter different challenges related to caregiving burden, which is often considered an additional workload in their life course. Current policy and program tailored to baby boomers should be re-designed to meet the different needs of emerging caregivers. Specific vulnerable subgroups should have priority to receive the benefits of specific policies, such as those without choice and younger, working caregivers.

Impact of parents' need for care on middle-aged women's lifestyle and psychological distress: evidence from a nationwide longitudinal survey in Japan

BACKGROUND

Many studies have separately addressed the associations of informal caregiving with coresidence, a caregiver's work status, and health conditions, but not jointly. We examined how their parents' need for care affects middle-aged women's lifestyle and psychological distress, considering the potential simultaneity of decisions on caregiving and living adjustments.

METHODS

We used 22,305 observations of 7037 female participants (aged 54-67 years) from a nationwide longitudinal survey in Japan conducted during 2009 and 2013. We considered the occurrence of parents' need for care (OPNC) as an external event and estimated regression models to explain how it affected the probabilities of the participants becoming caregivers, coresiding with parents, and working outside the home. We further conducted the mediation analysis to examine how the impact of OPNC on participants' psychological distress measured by Kessler 6 (K6) scores was mediated by caregiving and living adjustments.

RESULTS

OPNC made 30.9% and 30.3% of middle-aged women begin informal caregiving for parents and parents-in-law, respectively, whereas the impact on residential arrangement with parents or work status was non-significant or rather limited. OPNC raised middle-aged women' K6 scores (range: 0-24) by 0.368 (SE: 0.061) and 0.465 (SE: 0.073) for parents and parents-in-law, respectively, and informal caregiving mediated those impacts by 37.7% (95% CI: 15.6-68.2%) and 44.0% (95% CI: 22.2-75.4%), respectively. By contrast, the mediating effect of residential arrangement with parents or work status was non-significant.

CONCLUSIONS

Results underscore the fact that OPNC tends to promote middle-aged women to begin informal caregiving and worsen their psychological distress.

Predictors of Family Stress in Taking Care of Patients with Schizophrenia

Introduction: Taking care of schizophrenia patients is challenging and causes stress for the family involved. The study was conducted to identify the predictors of family stress present when taking care of a patient with schizophrenia. The ABCX Stress Theory of Hill was used as the theoretical framework.Methods: This study used a correlational design. The sample was 137 families who were caring for patients with schizophrenia at the Menur Mental Hospital, Surabaya, Indonesia. The sample was obtained by way of purposive sampling. The data was collected by a questionnaire and analysed by multiple regression to determine the relationship of the family’s structure, family knowledge, the burden of care, stigma, social support, the patient's illness duration, the patient’s frequency of relapse and the patient's severity level with family stress.Results: The results showed that the family’s stress was predicted by the family’s structure (p=0.029), stigma (p=0.000), the burden of care (p=0.000), and the patient’s frequency of relapse (p=0.005). The burden of care was the strongest predictor of family stress (Beta= 0.619).Conclusion: The patient's frequency of relapse and stigma were other kinds of family stressor. The stressors stimulated a negative perception, called the care burden. Limited adequacy of the family structure-function will inhibit the family in using other resources, creating family stress. Nurses may develop an assessment format that consists of the family stress predictors in order to create a nursing care plan specific to reframing the techniques of family stress management.

Views of Caregivers on the Ethics of Assistive Technology Used for Home Surveillance of People Living with Dementia

This paper examines the ethics of using assistive technology such as video surveillance in the homes of people living with dementia. Ideation and concept elaboration around the introduction of a camera-based surveillance service in the homes of people with dementia, typically living alone, is explored. The paper reviews relevant literature on surveillance of people living with dementia, and summarises the findings from ideation and concept elaboration workshops, designed to capture the views of those involved in the care of people living with dementia at home. The research question relates to the ethical considerations of using assistive technologies that include video surveillance in the homes of people living with dementia, and the implications for a person living with dementia whenever video surveillance is used in their home and access to the camera is given to the person’s family. The review of related work indicated that such video surveillance may result in loss of autonomy or freedom for the person with dementia. The workshops reflected the findings from the related work, and revealed useful information to inform the service design, in particular in fine-tuning the service to find the best relationship between privacy and usefulness. Those who took part in the workshops supported the concept of the use of camera in the homes of people living with dementia, with some significant caveats around privacy. The research carried out in this work is small in scale but points towards an acceptance by many caregivers of people living with dementia of surveillance technologies. This paper indicates that those who care for people living with dementia at home are willing to make use of camera technology and therefore the value of this work is to help shed light on the direction for future research.

Relationships Between Problem-Gambling Severity and Psychopathology as Moderated by Income

Background and aims Problem and pathological gambling have been associated with elevated rates of both Axis-I and Axis-II psychiatric disorders. Although both problem gambling and psychiatric disorders have been reported as being more prevalent among lower income vs. middle/higher income groups, how income might moderate the relationship between problem-gambling severity and psychopathology is incompletely understood. To examine the associations between problem-gambling severity and psychopathology in lower income and middle/higher income groups. Methods Data from the first wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) (n = 43,093) were analyzed in adjusted logistic regression models to investigate the relationships between problem-gambling severity and psychiatric disorders within and across income groups. Results Greater problem-gambling severity was associated with increased odds of multiple psychiatric disorders for both lower income and middle/higher income groups. Income moderated the association between problem/pathological gambling and alcohol abuse/dependence, with a stronger association seen among middle/higher income respondents than among lower income respondents. Discussion and conclusions The findings that problem-gambling severity is related to psychopathology across income groups suggest a need for public health initiatives across social strata to reduce the impact that problem/pathological gambling may have in relation to psychopathology. Middle/higher income populations, perhaps owing to the availability of more "disposable income," may be at greater risk for co-occurring gambling and alcohol-use psychopathology and may benefit preferentially from interventions targeting both gambling and alcohol use.

How do social activities mitigate informal caregivers' psychological distress? Evidence from a nine-year panel survey in Japan

BACKGROUND

It is well known that informal caregiving negatively affects caregivers' mental health, while social activities improve mental health outcomes among middle-aged and elderly individuals. The goal of the present study was to examine how participation in social activities affected the trajectory of an informal caregiver's psychological distress.

METHODS

We used the data from a nationwide nine-wave panel survey of the middle-aged individuals (aged 50-59 years at baseline) in Japan conducted in 2005-13 (N = 24,193 individuals;12,352 women and 11,841 men), mainly focusing on the respondents beginning to provide informal caregiving during the survey period. We employed linear mixed-effects models to explain how the trajectory of psychological distress, measured by Kessler 6 (K6) scores, was associated with caregiving commencement and duration, as well as social activity participation.

RESULTS

Participation in social activities was associated with mitigated K6 scores at caregiving commencement by 66.2 and 58.2 % for women and men, respectively. After caregiving started, participation in social activities reduced the average rise in K6 scores, per year, by 65.6 and 89.6 % for women and men, respectively. We observed similar results when focusing on participation before caregiving commencement to avoid endogeneity problems.

CONCLUSION

Results suggest that participation in social activities can alleviate caregivers' psychological distress. Policy measures to support social activities are recommended for the health and well-being of current and potential caregivers.

Relatives of Inpatients Suffering from Severe Depression: Their Burden and Encounters with the Psychiatric Health Services

The aim was to investigate relatives of inpatients with severe depression - their perceptions of encountering psychiatric specialist health services and their degree of burden. Sixty-eight relatives recruited via hospital wards and community specialist health centers responded to a questionnaire, with questions from the Quality from the Patients Perspective modified to relatives and the Burden Assessment Scale. Relatives recruited via community specialist health centers perceived less received information and support than those recruited via hospital wards. Higher burden was reported among relatives receiving less information and support than they needed from the psychiatric specialist health services. Healthcare professionals are recommended to give relatives the information and support according to their needs.

Sources, Outcomes, and Resolution of Conflicts in Marriage among Iranian women: A qualitative study

INTRODUCTION

Family's conflict is the important determinant of the quality and quantity of relationships among family members. No study of which we are aware has assessed conflicts, especially among normal or apparently satisfied couples in the Iranian context. This study explored that how women deal with different points, ideas and behaviors in marital life.

METHODS

For the study, we recruited 30 to 45-year-old housewives who visited health centers in Tehran, Iran. The participants (n = 45) were selected using purposefully convenient sampling. In-depth interviews and focus group discussions were used. The data were analyzed qualitatively using MAXQDA 10.

RESULTS

Themes, including conflicting situations, causes of conflict, consequences of conflict, and conflict resolution styles were extracted.

CONCLUSION

Although Iranian women were dissatisfied with their lives, they tried to protect their marriages.

Previous experiences and emotional baggage as barriers to lifestyle change - a qualitative study of Norwegian Healthy Life Centre participants

Background

Changing lifestyle is challenging and difficult. The Norwegian Directorate of Health recommends that all municipalities establish Healthy Life Centres targeted to people with lifestyle issues. Little is known about the background, experiences and reflections of participants. More information is needed about participants to shape effective lifestyle interventions with lasting effect. This study explores how participants in a lifestyle intervention programme describe previous life experiences in relation to changing lifestyle.

Methods

Semi-structured qualitative in-depth interviews were performed with 23 participants (16 women and 7 men) aged 18 – 70 years. The data were analysed using systematic text condensation searching for issues describing participants’ responses, and looking for the essence, aiming to share the basis of life-world experiences as valid knowledge.

Results

Participants identified two main themes: being stuck in old habits, and being burdened with emotional baggage from their previous negative experiences. Participants expressed a wish to change their lifestyles, but were unable to act in accordance with the health knowledge they possessed. Previous experiences with lifestyle change kept them from initiating attempts without professional assistance. Participants also described being burdened by an emotional baggage with problems from childhood and/or with family, work and social life issues. Respondents said that they felt that emotional baggage was an important explanation for why they were stuck in old habits and that conversely, being stuck in old habits added load to their already emotional baggage and made it heavier.

Conclusions

Behavioural change can be hard to perform as psychological distress from life baggage can influence the ability to change. The study participants’ experience of being stuck in old habits and having substantial emotional baggage raises questions as to whether or not Healthy Life Centres are able to help participants who need to make a lifestyle change.

Consensus statement on preventive and symptomatic care of leukodystrophy patients

Leukodystrophies are inherited disorders whose primary pathophysiology consists of abnormal deposition or progressive disruption of brain myelin. Leukodystrophy patients manifest many of the same symptoms and medical complications despite the wide spectrum of genetic origins. Although no definitive cures exist, all of these conditions are treatable. This report provides the first expert consensus on the recognition and treatment of medical and psychosocial complications associated with leukodystrophies. We include a discussion of serious and potentially preventable medical complications and propose several preventive care strategies. We also outline the need for future research to prioritize clinical needs and subsequently develop, validate, and optimize specific care strategies.

A new model of the role of psychological and emotional distress in promoting obesity: conceptual review with implications for treatment and prevention

The lack of significant treatment and prevention progress highlights the need for a more expanded strategy. Given the robust association between socioeconomic factors and obesity, combined with new insights into how socioeconomic disadvantage affects both behaviour and biology, a new causal model is proposed. The model posits that psychological and emotional distress is a fundamental link between socioeconomic disadvantage and weight gain. At particular risk are children growing up in a disharmonious family environment, mainly caused by parental socioeconomic disadvantage, where they are exposed to parental frustrations, relationship discord, a lack of support and cohesion, negative belief systems, unmet emotional needs and general insecurity. Without adequate resilience, such experiences increase the risk of psychological and emotional distress, including low self-esteem and self-worth, negative emotions, negative self-belief, powerlessness, depression, anxiety, insecurity and a heightened sensitivity to stress. These inner disturbances eventually cause a psycho-emotional overload, triggering a cascade of weight gain-inducing effects including maladaptive coping strategies such as eating to suppress negative emotions, chronic stress, appetite up-regulation, low-grade inflammation and possibly reduced basal metabolism. Over time, this causes obesity, circular causality and further weight gain. Tackling these proposed root causes of weight gain could potentially improve both treatment and prevention outcomes.

[Cohesion and family adaptability in women with epilepsy: cross-sectional study]

Objetivo

Probar la hipótesis de que las mujeres con epilepsia pertenecen a familias con deficiencias en la cohesión y adaptabilidad a la enfermedad, en comparación con mujeres sanas.

Diseño

Estudio transversal analítico.

Emplazamiento

Se incluyó de forma retrospectiva a 263 mujeres de la consulta externa del servicio de neurología y una unidad de medicina familiar del Instituto Mexicano del Seguro Social en Sonora (México), entre 2010 y 2011.

Participantes

Ochenta y dos mujeres epilépticas (casos) y 181 mujeres sanas (grupo control). Muestra apareada por edad y zona de residencia (1:2,2).

Mediciones principales

Se realizó un análisis univariado para variables sociodemográficas, tipología familiar, nivel socioeconómico y nivel de cohesión-adaptabilidad familiar con el cuestionario FACES III. Un análisis con regresión logística se realizó para aquellas variables asociadas a disfunción familiar en mujeres con y sin epilepsia.

Resultados

Se encontró disfunción familiar en el 22% de las mujeres epilépticas (RM = 2,91 [2,17-3,89]; p = 0,0001). El análisis univariado sugirió asociación para presencia de epilepsia, edad, evolución mayor a 15 años con epilepsia, tipología familiar (rural, urbana y tradicional) contra la presencia de disfunción familiar. El modelo de regresión logística confirmó asociación solo para la presencia de epilepsia (RM = 7,30 [4,00-13,33]; p = 0,0001).

Conclusión

El estudio responde la hipótesis de que mujeres con epilepsia viven con familias con mayor deterioro psicosocial, manifestado por deficiencias en la cohesión y adaptabilidad a la enfermedad, en comparación con mujeres sanas.