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Dira PMM, Machailo RJ, Scholtz S. Caregivers' voices: From the world of autism spectrum disorder. Curationis 2024; 47:e1-e11. [PMID: 39099291 PMCID: PMC11304203 DOI: 10.4102/curationis.v47i1.2519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 04/26/2024] [Accepted: 04/27/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND Caring for a child with autism spectrum disorder (ASD) is a challenging and stressful task, especially in countries with limited resources. Additional research is necessary, considering the increasing prevalence of children with ASD, to gain increased knowledge of the complex difficulties faced by caregivers of ASD children and to offer insights into the coping strategies and support networks that parents utilise. OBJECTIVES The objective of this study was to explore and describe the experiences and coping mechanisms of caregivers of children with ASD in Dr Kenneth Kaunda district, North West province, South Africa. METHOD Qualitative explorative, contextual and descriptive design with purposive sampling technique and semi-structured interviews were conducted. Data were analysed following the six steps of reflexive thematic analysis. RESULTS Two themes were identified: Caregivers' experiences in raising a child with autism, and caregivers' coping in raising a child with autism. CONCLUSION The research established caregivers' experiences and coping mechanisms in raising a child with ASD and the effects on different aspects of their lives including emotional, social and financial aspects, which contribute negatively to their holistic well-being. These impediments warrant the establishment of emotional support groups, empowerment of caregivers and awareness-raising through campaigns to educate the family and the community on the diverse challenges.Contribution: The findings of this study contribute to a deeper understanding of the multifaceted challenges faced by caregivers of children with ASD and provide insights into the support systems and coping mechanisms employed by these caregivers within the socio-ecological context.
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Affiliation(s)
- Patience M M Dira
- School of Nursing Science, Faculty of Health Sciences, North-West University, Potchefstroom.
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Abeasi DA, Nkosi NG, Badoe E, Adjeman J. Caring by default: experiences of caregivers of children with developmental disabilities in Ghana mirrored in the context of the stress process model. BMC Nurs 2024; 23:482. [PMID: 39010050 PMCID: PMC11251246 DOI: 10.1186/s12912-024-02142-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 07/01/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Caring for a child with developmental disabilities (DD) is associated with significant stress and burden. Caregivers' experiences are influenced by factors such as poverty, stigma, and the lack of accessibility to services, equipment, and assistive devices. These factors are prevalent in a low-resource setting like Ghana which ultimately influences the experiences of caregivers. The aim of the study was to explore the experiences of caregivers of children with DD in the context of the Stress Process Model. METHODS The study employed a descriptive phenomenological design Caregivers of children with DD attending the Neurodevelopmental Clinic of a Teaching Hospital were purposively sampled. Data collection involved semi-structured interviews, reaching saturation with 14 participants. The interviews were audio-recorded transcribed verbatim and analysed using thematic analysis. RESULTS Four main themes emerged: perception of caregiving, stressors faced by caregivers, negative health outcomes and coping strategies. Perception of caregiving had two sub-themes as stressful nature of caregiving and time-consuming. Six sub-themes were linked to stressors faced by caregivers: the child's ADL needs, communication barrier, managing challenging behaviour, child's health needs, unmet educational needs, and economic burden. Negative health outcomes had three sub-themes: decline in physical, mental and social well-being. While some caregivers used maladaptive coping strategies like blaming, others employed adaptive coping strategies like religious coping through prayer, self-encouragement and support from other family members. CONCLUSION The study highlights the complex interaction between caregivers' perception of their caregiving situation, the stressors they experience, their coping resources, and the negative health outcomes associated with caregiving. These findings underscore the need for context-specific caregiver programmes to mitigate the negative impacts of caregiving.
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Affiliation(s)
- Doreen Asantewa Abeasi
- Department of Nursing Science Education, University of Witwatersrand, Johannesburg, South Africa.
- Department of Nursing and Midwifery, Presbyterian University, Abetifi, Ghana.
| | - Nokuthula Gloria Nkosi
- Department of Nursing Science Education, University of Witwatersrand, Johannesburg, South Africa
| | - Ebenezer Badoe
- Department of Child Health, Korle-Bu Teaching Hospital, Accra, Ghana
- University of Ghana Medical School, Korle-Bu, Accra, Ghana
| | - Josephine Adjeman
- Department of Child Health, Korle-Bu Teaching Hospital, Accra, Ghana
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Hoang AQ, Lerman DC, Nguyen JT. Virtual Training of Medical Students to Promote the Comfort and Cooperation of Patients with Neurodevelopmental Disabilities. J Autism Dev Disord 2024; 54:1249-1263. [PMID: 36648564 PMCID: PMC9844946 DOI: 10.1007/s10803-023-05896-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2023] [Indexed: 01/18/2023]
Abstract
Patients with neurodevelopmental disabilities generally have less access to necessary medical care compared to those without disabilities. Barriers to adequate care include patient fear and uncooperative behavior during routine medical procedures and inadequate preparation of medical professionals to treat this population. Researchers have identified multiple behavior-analytic procedures for promoting comfort and cooperation during medical treatments. Efficient, cost-effective training programs are needed to widely disseminate behavior-analytic procedures to medical students and professionals. The purpose of this study was to assess the efficacy of a virtual training to prepare medical students to implement behavioral procedures that could be easily incorporated into typical wellness examinations. Seven medical students received behavioral skills training (BST) delivered remotely via the Internet. Results showed that the training successfully increased students' correct implementation of the procedures in roleplay with the experimenter and with patients with neurodevelopmental disabilities. Responding also maintained at high levels 2 weeks after the training. These findings suggest that virtual BST is an efficient, practical approach for training health care professionals to implement general behavior management strategies to increase the comfort and cooperation of patients with NDD.
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Affiliation(s)
- Andrea Q Hoang
- Clinical, Health, and Applied Sciences, University of Houston-Clear Lake, 2700 Bay Area Blvd., Campus Box 245, Houston, TX, 77058, USA
| | - Dorothea C Lerman
- Clinical, Health, and Applied Sciences, University of Houston-Clear Lake, 2700 Bay Area Blvd., Campus Box 245, Houston, TX, 77058, USA.
| | - Jennifer Trang Nguyen
- Clinical, Health, and Applied Sciences, University of Houston-Clear Lake, 2700 Bay Area Blvd., Campus Box 245, Houston, TX, 77058, USA
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Chua SY, Abd Rahman FN, Ratnasingam S. Problem behaviours and caregiver burden among children with Autism Spectrum Disorder in Kuching, Sarawak. Front Psychiatry 2023; 14:1244164. [PMID: 37965356 PMCID: PMC10642943 DOI: 10.3389/fpsyt.2023.1244164] [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: 06/22/2023] [Accepted: 10/04/2023] [Indexed: 11/16/2023] Open
Abstract
Objective Caregivers of children with Autism Spectrum Disorder (ASD) often experience emotional and psychological distress, as well as disruptions to family life and employment due to the challenges of caring for children with ASD. This study examines the relationship between problem behaviours and caregiver burden among children with ASD. Method A cross-sectional study using convenience sampling recruited 230 caregivers of children with ASD aged 4 to 18 years from selected autism centres in Kuching, Sarawak. The caregivers completed the Aberrant Behaviour Checklist-2 and the Zarit Burden Interview. Results Univariate analysis revealed a significant difference in caregiver burden for children with ASD receiving medications (p = 0.013), registered with the Social Welfare Department (p = 0.036), and having siblings with ASD (p = 0.046). About 40% of the children exhibited at least one domain of problem behaviour. More than half of the caregivers (53.9%) experienced burden, with the majority experiencing mild burden. Positive associations were seen between irritability (r = 0.458, p < 0.01), social withdrawal (r = 0.439, p < 0.01), stereotypic behaviour (r = 0.392, p < 0.01), hyperactivity/non-compliance (r = 0.467, p < 0.01), and caregiver burden. Child factors, including the duration of problem behaviour (r = 0.182, p = 0.007), medication use (eta = 0.187, p = 0.005), Social Welfare Department registration (eta = 0.138, p = 0.036), and the presence of siblings with ASD (eta = 0.130, p = 0.046) were associated with caregiver burden. Multiple linear regression showed that hyperactivity/noncompliance significantly predicted caregiver burden. Conclusion Specific problem behaviours in children with ASD were associated with caregiver burden. These results highlight the need for interventions for the child with ASD and their caregivers.
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Affiliation(s)
- Shi Yi Chua
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Department of Psychiatry and Mental Health, Hospital Umum Sarawak, Kuching, Sarawak, Malaysia
| | - Fairuz Nazri Abd Rahman
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Child and Adolescent Psychiatric Unit, UKM Specialist Children’s Hospital, Kuala Lumpur, Malaysia
| | - Selvasingam Ratnasingam
- Department of Psychiatry and Mental Health, Hospital Umum Sarawak, Kuching, Sarawak, Malaysia
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Abu Khait A, Menger A, Mahmoud KF, Hamaideh SH. A Moderated Mediation Model of Social Support on the Association between Coping Strategies and Psycho-Emotional Distress of Healthcare Professionals Caring for Children with Autism. Issues Ment Health Nurs 2023; 44:879-890. [PMID: 37616590 DOI: 10.1080/01612840.2023.2232860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
Healthcare professionals caring for children with autism spectrum disorder are more likely to be emotionally and psychologically distressed because of the children's challenging behaviors. This study aimed to investigate whether social support mediates the association between coping strategies and perceived emotional and psychological distress among professionals working with children with autism spectrum disorder. Additionally, this study explored the moderating effect of autism severity on this mediation. The study's design is cross-sectional, correlational, and predictive. An online, self-administered questionnaire was used to recruit a convenience sample of 180 healthcare professionals working with children with autism spectrum disorder. The results revealed a significant mediation effect of family social support on the relationship between problem-focused coping and psychological distress for those dealing with moderate or severe autism. Likewise, there was also a significant mediation effect of family social support on the relationship between avoidant coping and psychological distress for those dealing with moderate autism. Familial social support can serve as a protective factor for healthcare professionals caring for children with autism against accumulated psychological distress. The direct effect of avoidant coping strategies on emotional distress changes depending on autism severity. The study's findings are informative to mental health nurses to create more effective coping strategies as problem-solving interventions or develop new coping strategies based on familial social support for those working with children with autism.
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Affiliation(s)
- Abdallah Abu Khait
- Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Austin Menger
- Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Khadejah F Mahmoud
- Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Shaher H Hamaideh
- Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
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Faruk MO, Rahman MS, Rana MS, Mahmud S, Al-Neyma M, Karim MS, Alam N. Socioeconomic and demographic risk factors of autism spectrum disorder among children and adolescents in Bangladesh: Evidence from a cross-sectional study in 2022. PLoS One 2023; 18:e0289220. [PMID: 37540667 PMCID: PMC10403138 DOI: 10.1371/journal.pone.0289220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 07/13/2023] [Indexed: 08/06/2023] Open
Abstract
Autism spectrum disorder (ASD) is the assorted uneven conditions of the human brain that lead to developmental disabilities. This cross-sectional study aimed to identify the substantial risk factors of ASD among children in Bangladesh. The data were collected using convenience sampling through a questionnaire filled up by the trained interviewers. Mann-Whitney U and Kruskal-Wallis H tests were applied as bivariate analysis, and generalized beta regression was performed to determine the significant risk factors of autism spectrum disorder. The odds ratio (OR) along with 95% confidence interval (CI) were the measuring parameters of the risk factors of ASD. The result revealed that later birth order children have more risk of ASD (OR = 1.13, CI: 1.014-1.264, p = 0.027) compared to the children whose birth order is first. Premature birth of the child (OR: 0.87, CI: 0.76-1.00, p = 0.05) and father's age (OR: 0.86, CI: 0.76-0.97, p = 0.020) substantially affects ASD. The maternal history of specific illness (diabetes, thyroiditis, and hypertension) during pregnancy also significantly affect ASD (OR: 1.34, CI: 1.14-1.61, p = 0.002). The results of this study would assist policymakers in taking necessary steps to reduce the incidence of this disorder by targeting the potential risk factors.
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Affiliation(s)
- Mohammad Omar Faruk
- Department of Statistics, Noakhali Science and Technology University, Noakhali, Bangladesh
| | - Md Sahidur Rahman
- One Health Center for Research and Action, Chattogram, Bangladesh
- FETPV Technical Officer, Eastern Mediterranean Public Health Network (GHD|EMPHNET), Bangladesh Country Office, Dhaka, Bangladesh
| | - Md Shohel Rana
- Department of Statistics, Noakhali Science and Technology University, Noakhali, Bangladesh
| | - Shohel Mahmud
- Department of Statistics, Noakhali Science and Technology University, Noakhali, Bangladesh
| | - Mahmuda Al-Neyma
- Department of Statistics, Noakhali Science and Technology University, Noakhali, Bangladesh
| | - Md Sazzadul Karim
- Department of Statistics, Noakhali Science and Technology University, Noakhali, Bangladesh
| | - Nazia Alam
- Department of Statistics, Noakhali Science and Technology University, Noakhali, Bangladesh
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Kang S, Jones A, Shaffer RC, Erickson CA, Schmitt LM. Developing improved outcome measures in FXS: Key stakeholder feedback. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 137:104502. [PMID: 37080087 PMCID: PMC10875734 DOI: 10.1016/j.ridd.2023.104502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/27/2023] [Accepted: 04/03/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND There is a critical need for the development of improved outcome measures in Fragile X Syndrome (FXS). Because the majority of respondents of behavior outcome measures are caregivers or individuals with FXS, it is important to consider stakeholders' firsthand experiences when designing a caregiver- or self-report measure. AIMS The current research study aimed to understand experiences of completing commonly used caregiver-/self-report measures of behavior in FXS via focus groups. METHODS AND PROCEDURES This study employed a focus group methodology. Semi-structured focus groups were conducted with 22 caregivers and 3 self-advocates. All interviews occurred via secured videoconferencing. A thematic analysis was used to identify major themes and subthemes. OUTCOMES AND RESULTS We identified four themes: (1) content of measure, (2) structure of the measure, (3) potential accommodations to complete measure, and (4) impact of measure on family. Importantly, focus groups revealed that certain aspects of content, structure, and implementation of the available measures were related to distress and negative emotions of caregivers of FXS and individuals with FXS themselves. CONCLUSIONS AND IMPLICATIONS The focus group data yielded a wide range of feedback and has significant implications, highlighting the critical need to take key stakeholder perspectives into account when using and/or developing caregiver- or self-report measures for FXS.
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Affiliation(s)
- Sungeun Kang
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Angelina Jones
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Rebecca C Shaffer
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Craig A Erickson
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Lauren M Schmitt
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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“People Keep Staring At You In Public For No Reason”: Experiences And Coping Strategies Of Parents WITH Autistic Children In Accra, Ghana. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2023. [DOI: 10.1016/j.ijans.2023.100536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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Park JEJ. A Parent-Focused Creative Approach as a Treatment for a High-Functioning Child with Autism Spectrum Disorder (ASD) in Korea: A Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7836. [PMID: 35805495 PMCID: PMC9266258 DOI: 10.3390/ijerph19137836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/17/2022] [Accepted: 06/24/2022] [Indexed: 02/01/2023]
Abstract
This study was conducted on a 6-year-old girl with autism spectrum disorder (ASD) in Korea. The case was initiated in February 2015, and intensive treatment was provided for one year. Then, the case was monitored over the course of 6 years until December 2021. The intervention plan was an art therapy-based treatment plan (Individual Therapeutic Education Plan: ITEP) with two integral foci: (1) creative arts-based parent counseling and education and (2) didactic art therapy with the child. This was a new type of integral approach that was not a standard of care practice in Korea, acknowledging the importance of including parents in therapy and the notion of creative arts therapy. There was no scientific evidence supporting this qualitive approach; however, the intervention was a notable success, sustaining a positive outcome-the intervention (1) reduced the anxiety levels of both the mother and the child in the short term; (2) enhanced the child-parent relationship as well as the home environment of the child while the art therapy-based counseling and education increased the mother's competence; and (3) enhanced the communicative and adaptive functioning of the child and the mother, with art becoming the supportive breakthrough for their emotional obstacles. The findings suggest that a parent-focused creative approach impacts parental changes and child development: the evidence indicates that parent-driven interventions are a viable option for parents and children with ASD to build a better home environment that supports the child's development.
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Affiliation(s)
- Jung Eun Jeanne Park
- Mogul Institute, Seoul 05649, Korea;
- Department of Psychology and Psychotherapy, College of Health & Welfare, Dankook University, Cheonan 31116, Korea
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Flenik TMN, Bara TS, Cordeiro ML. Family Functioning and Emotional Aspects of Children with Autism Spectrum Disorder in Southern Brazil. J Autism Dev Disord 2022; 53:2306-2313. [PMID: 35298757 PMCID: PMC8929243 DOI: 10.1007/s10803-022-05497-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2022] [Indexed: 11/28/2022]
Abstract
Autism spectrum disorder (ASD) affects children and their families. We investigated the family environment of children with ASD in Brazil. Twenty-one families participated. Outcome measures administered to parents included the Strengths and Difficulties Questionnaire, Questionnaire on Resources and Stress—Short Form, and the Family Environment Scale. All families reported a number of difficulties, including social interactions and peer relationships, stress levels, and communication difficulties. Families also reported great concern for their child’s future. Brazil is a developing country, yet there are few national resources and studies related to ASD. The challenges continue from diagnosis through treatment. Our results emphasize the need to understand the family environment of children with autism and their parents’ apprehensions to develop effective coping programs.
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Affiliation(s)
| | - Tiago S Bara
- Faculdades Pequeno Príncipe, Curitiba, Brazil.,Instituto de Pesquisa Pelé Pequeno Príncipe, Av. Silva Jardim, 1632, Curitiba, PR, 80250-200, Brazil
| | - Mara L Cordeiro
- Faculdades Pequeno Príncipe, Curitiba, Brazil. .,Instituto de Pesquisa Pelé Pequeno Príncipe, Av. Silva Jardim, 1632, Curitiba, PR, 80250-200, Brazil. .,Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
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Alenezi S, Almadani A, Al Tuwariqi M, Alzahrani F, Alshabri M, Khoja M, Al Dakheel K, Alghalayini K, Alkadi N, Aljebreen S, Alzahrani R. Burnout, Depression, and Anxiety Levels among Healthcare Workers Serving Children with Autism Spectrum Disorder. Behav Sci (Basel) 2022; 12:15. [PMID: 35049626 PMCID: PMC8773324 DOI: 10.3390/bs12010015] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/28/2021] [Accepted: 01/14/2022] [Indexed: 02/01/2023] Open
Abstract
Burnout in healthcare workers (HCWs) is defined as a state of emotional, physical, and mental exhaustion that results from unmanaged, excessive, and long-term workplace stressors. This study aims to assess the prevalence of burnout and the levels of anxiety and depression among HCWs who primarily work with children who have autism spectrum disorder (ASD). A quantitative cross-sectional survey was conducted utilizing the Arabic version of the Maslach Burnout Inventory (MBI), Areas of Worklife Survey (AWS), Patient Health Questionnaire for Generalized Anxiety Disorder (GAD-7), and Patient Health Questionnaire for Depression (PHQ-9). Among the 381 participants working in autism centers, the majority were young Saudi females (326) working full-time as specialists in the private sector with less than five years of experience. The HCWs' overall mean scores on the three Maslach Burnout Inventory (MBI) subscales: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) were 62%, 23.7%, and 76.5%, respectively. A total of 51.4% of HCWs reported moderate to high anxiety levels on GAD-7, and 47.8% showed moderate to very high levels of depression on PHQ-9. The mean perceived EE converged significantly but negatively on their overall mean perceived satisfaction with AWS (p-value < 0.001), demonstrating that greater emotional fatigue predicts less satisfaction with their work. The PA scores correlated significantly and positively with their overall mean satisfaction with their AWS score (p-value < 0.001). Considering sociodemographic variables, HCWs aged between 20-29 years have significantly lower mean PA scores than HCWs aged thirty and older (p = 0.007). Also, male HCWs perceived significantly higher work-related DP than females. More research is required to determine the nature of variables that contribute to burnout, depression, and anxiety in HCWs helping children with ASD.
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Affiliation(s)
- Shuliweeh Alenezi
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia; (A.A.); (M.A.T.); (F.A.); (M.A.); (M.K.); (K.A.D.); (K.A.); (N.A.); (S.A.); (R.A.)
- Department of Psychiatry, King Saud University Medical City, King Saud University, Riyadh 11362, Saudi Arabia
- SABIC Psychological Health Research and Applications Chair (SPHRAC), Department of Psychiatry, College of Medicine, King Saud University, Riyadh 12372, Saudi Arabia
| | - Ahmad Almadani
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia; (A.A.); (M.A.T.); (F.A.); (M.A.); (M.K.); (K.A.D.); (K.A.); (N.A.); (S.A.); (R.A.)
- Department of Psychiatry, King Saud University Medical City, King Saud University, Riyadh 11362, Saudi Arabia
| | - Maram Al Tuwariqi
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia; (A.A.); (M.A.T.); (F.A.); (M.A.); (M.K.); (K.A.D.); (K.A.); (N.A.); (S.A.); (R.A.)
- Department of Psychiatry, King Saud University Medical City, King Saud University, Riyadh 11362, Saudi Arabia
- SABIC Psychological Health Research and Applications Chair (SPHRAC), Department of Psychiatry, College of Medicine, King Saud University, Riyadh 12372, Saudi Arabia
| | - Fahad Alzahrani
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia; (A.A.); (M.A.T.); (F.A.); (M.A.); (M.K.); (K.A.D.); (K.A.); (N.A.); (S.A.); (R.A.)
| | - Meshari Alshabri
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia; (A.A.); (M.A.T.); (F.A.); (M.A.); (M.K.); (K.A.D.); (K.A.); (N.A.); (S.A.); (R.A.)
| | - Mohammed Khoja
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia; (A.A.); (M.A.T.); (F.A.); (M.A.); (M.K.); (K.A.D.); (K.A.); (N.A.); (S.A.); (R.A.)
| | - Khalid Al Dakheel
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia; (A.A.); (M.A.T.); (F.A.); (M.A.); (M.K.); (K.A.D.); (K.A.); (N.A.); (S.A.); (R.A.)
| | - Khalil Alghalayini
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia; (A.A.); (M.A.T.); (F.A.); (M.A.); (M.K.); (K.A.D.); (K.A.); (N.A.); (S.A.); (R.A.)
| | - Norah Alkadi
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia; (A.A.); (M.A.T.); (F.A.); (M.A.); (M.K.); (K.A.D.); (K.A.); (N.A.); (S.A.); (R.A.)
| | - Shahad Aljebreen
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia; (A.A.); (M.A.T.); (F.A.); (M.A.); (M.K.); (K.A.D.); (K.A.); (N.A.); (S.A.); (R.A.)
| | - Razan Alzahrani
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia; (A.A.); (M.A.T.); (F.A.); (M.A.); (M.K.); (K.A.D.); (K.A.); (N.A.); (S.A.); (R.A.)
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12
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Calleja S, Kingsley J, Amirul Islam FM, McDonald R. Barriers to Accessing Healthcare: Perspectives from Autistic Adults and Carers. QUALITATIVE HEALTH RESEARCH 2022; 32:267-278. [PMID: 34906008 DOI: 10.1177/10497323211050362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Autistic adults have higher health needs compared to most, yet they continue to experience barriers to accessing appropriate healthcare. Presently, no qualitative research exists exploring these barriers which impact overall physical and mental health. We conducted a qualitative analysis in Victoria (Australia) of the perceived experiences of healthcare access for autistic adults (n = 9) and primary caregivers of autistic adults (n = 7). Specifically, a three-staged phenomenological approach was applied involving: (i) a communicative checklist, (ii) a health status survey and (iii) face-to-face interviews. Elements such as support, responsibilities and protective factors exhibited by caregivers, may impact healthcare access for autistic adults. Results indicate the need for further research exploring interdependent factors that impact healthcare access by caregivers, so evidence-based interventions can be developed to support caregivers in the future.
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Affiliation(s)
- Shenae Calleja
- Faculty of Health, Arts and Design, 3783Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Jonathan Kingsley
- Faculty of Health, Arts and Design, 3783Swinburne University of Technology, Hawthorn, VIC, Australia
- Centre of Urban Transitions, 3783Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Fakir M Amirul Islam
- Faculty of Health, Arts and Design, 3783Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Rachael McDonald
- Faculty of Health, Arts and Design, 3783Swinburne University of Technology, Hawthorn, VIC, Australia
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13
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Nighat A, Ahmer Z, Ovais M, Athar FB, Baig LA. Caregiver strain and its predictors among parents of autistic children: a cross-sectional study. J Child Adolesc Ment Health 2022; 34:70-82. [PMID: 38504648 DOI: 10.2989/17280583.2023.2279637] [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: 03/21/2024]
Abstract
Objective: This study estimates the frequency and predictors of caregiver strain (CGS) among parents of autistic children.Methods: Demographic details and CGS were collected through a validated tool from 403 parents of autistic children in Karachi, Pakistan. Regression modelling was performed to report associations between social, behavioural, and communication problems and socioeconomic predictors of CGS. Results were reported using adjusted beta-coefficients with 95% confidence intervals.Results: In total, 88.3% of the parents reported moderate to severe CGS. A high family income (β = -4.31, 95% CI -7.55, -0.11), and caregiver's higher level of education (β = -4.73, 95% CI -8.84, -0.61), along with care-recipient age group (β = -9.35, 95% CI -15.17, -3.52) significantly predicted lower CGS. Diagnosis of more than 5 years (β = 7.57, 95% CI 2.36, 12.79), tendency to self-harm (β = 10.75, 95% CI 6.62, 14.88), and social withdrawal in the care-recipient (β = 4.56, 95% CI 1.68, 7.44) were significantly associated with higher CGS.Conclusion: Parents of children on the autistic spectrum suffer from high CGS. There is a need to introduce tailored parenting interventions at the individual and community levels to help parents reduce the CGS, ultimately benefiting their child.
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Affiliation(s)
- Aroosa Nighat
- APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Zaeema Ahmer
- APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Mohammad Ovais
- Sindh Government Hospital, Liaquatabad, Karachi, Pakistan
| | | | - Lubna Ansari Baig
- APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi, Pakistan
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14
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Montenegro MC, Abdul-Chani M, Valdez D, Rosoli A, Garrido G, Cukier S, Paula CS, Garcia R, Rattazzi A, Montiel-Nava C. Perceived Stigma and Barriers to Accessing Services: Experience of Caregivers of Autistic Children Residing in Latin America. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 120:104123. [PMID: 34798480 DOI: 10.1016/j.ridd.2021.104123] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 10/21/2021] [Accepted: 10/27/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Relationship of perceived stigma and barrier to service access among Latino populations with autism in cross-cultural settings has not been fully explored. AIM The present study explored the relationship between difficulty accessing services and perceived stigma among caregivers of autistic children in Latin America. Additionally, explore contextual factors that better explain the perception of stigma when accessing services. METHODS AND PROCEDURE Approximately 2500 caregivers from six Latin American countries completed an online survey. Descriptive inferential analysis and a pointbiserial correlation were conducted to understand direct relationship between difficulty accessing services and perceived stigma and to test their relationship. Added contextual factors contributing to this relationship were examined through a binary logistic regression. OUTCOMES AND RESULTS Barriers to accessing services predicted stigma. Contextual factors such as country of residence, frustration experienced by caregivers, gender of autistic child and challenging behaviours had higher odds of experiencing some form of perceived stigma. CONCLUSIONS AND IMPLICATIONS These results suggest experiences with stigma to be heavily influenced by environmental factors such cultural differences which in combination with contextual factors could further increase the likelihood of perceiving stigma. When observing stigma within a social-cognitive approach, it is possible that a strong-held adherence to cultural norms, in addition to negative experiences (e.g., frustration) when accessing services, could be influencing caregivers perceived stigma.
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Affiliation(s)
- María Cecilia Montenegro
- Department of Psychological Science-University of Texas Rio Grande Valley, 1201 W University Dr, Edinburg, 78539, TX, United States
| | - Monica Abdul-Chani
- Department of Psychology-University of Alabama at Birmingham, 1720 University Blvd, Birmingham, 35294, AL, United States
| | - Daniel Valdez
- Facultad Latinoamericana de Ciencias Sociales Sede Argentina (FLACSO), Tucumán 1966, C1050 AAN, Buenos Aires, Argentina
| | - Analia Rosoli
- Organización Estados Iberoamericanos para la Educación, la Ciencia y la Cultura (OEI), Av. Sarasota #20, Torre AIRD, 2do. Piso, 10109, Santo Domingo, Dominican Republic
| | - Gabriela Garrido
- Universidad de la República, Av. 18 de Julio 1824, 11100, Montevideo, Uruguay
| | - Sebastian Cukier
- PANAACEA, Domingo Repetto 1145, CP B1640EMQ, Buenos Aires, Argentina
| | - Cristiane Silvestre Paula
- Programa de Pós-Graduação em Distúrbios do Desenvolvimento Universidade Presbiteriana Mackenzie (UPM), Rua da Consolacão, 930 Consolacão, 01302-907, São Paulo, Brazil
| | - Ricardo Garcia
- Universidad de Chile, Avenida Libertador Bernardo o'Higgins 1058, 8330111. Santiago, Chile
| | - Alexia Rattazzi
- PANAACEA, Domingo Repetto 1145, CP B1640EMQ, Buenos Aires, Argentina
| | - Cecilia Montiel-Nava
- Department of Psychological Science-University of Texas Rio Grande Valley, 1201 W University Dr, Edinburg, 78539, TX, United States.
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15
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Friesen KA, Weiss JA, Howe SJ, Kerns CM, McMorris CA. Mental Health and Resilient Coping in Caregivers of Autistic Individuals during the COVID-19 Pandemic: Findings from the Families Facing COVID Study. J Autism Dev Disord 2021; 52:3027-3037. [PMID: 34240291 PMCID: PMC8265288 DOI: 10.1007/s10803-021-05177-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2021] [Indexed: 12/13/2022]
Abstract
Many caregivers of autistic people experience mental health issues, and the impact of disruptions due to COVID-19 may present additional challenges for these individuals. This study characterized caregiver stress, anxiety, and resilient coping during COVID-19 and investigated the impact of COVID-19 disruptions, demographic variables, and resilient coping on mental health. The majority of caregivers reported some degree of disruption associated with COVID-19, and more than half reported moderate levels of stress and high anxiety. Resilient coping did not emerge as a moderator between COVID-19 disruptions and caregiver mental health, but instead had a direct effect on outcomes. Future research is needed to understand additional factors impacting the mental health of caregivers of autistic people during the COVID-19 pandemic.
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Affiliation(s)
- Kelsey A Friesen
- Werklund School of Education, University of Calgary, EDT 508, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Jonathan A Weiss
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Stephanie J Howe
- Werklund School of Education, University of Calgary, EDT 508, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Connor M Kerns
- Department of Psychology, University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Carly A McMorris
- Werklund School of Education, University of Calgary, EDT 508, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada.
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, T2N 1N4, Canada.
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16
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Baumgarten A, Hilgert JB, Rech RS, Cunha-Cruz J, de Goulart BNG. Caries experience in caregiver-intellectual deficient pair: Influence of caregiver's psychological morbidity. SPECIAL CARE IN DENTISTRY 2021; 41:707-715. [PMID: 34057228 DOI: 10.1111/scd.12617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 04/24/2021] [Accepted: 05/18/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Evaluate how determinants of psychological morbidity were associated with dental caries experience in the caregiver-intellectual deficient pair. METHODS A cross-sectional study with 299 pair, who had their oral health status assessed using the DMFT index (decayed, missing and filled teeth). Symptoms of anxiety, depression, stress, quality of sleep, and socioeconomic variables were measured in caregivers. Adjusted prevalence ratios were estimated using Poisson regression with the caregiver and children's caries index as outcome. RESULTS The average prevalence of DMFT/dmft was 7.48 (SD ± 3.9) for students with ID and DMFT was 14.7 (SD ± 8.1) for their caregivers. For the caregiver's oral health, the following psychic comorbidities were associated with worse oral health condition: anxiety (PR = 1.48; 95%CI 1.07-2.06), depression (PR = 1.39; 95%CI 1.05-1.85), high level of stress (PR = 1.58; 95%CI 1.17-2.13) and sleep disorders (PR = 1.59; 95%CI 1.18-2.14). For people with ID, the caregiver's psychic comorbidities also showed association with a worse oral health condition, including anxiety (PR = 1.31; 95%CI 1.03-1.74), depression (PR = 1.28; 95%CI 1.01-1.67) and high level of stress (PR = 1.63; 95%CI 1.14-2.32), as well as mother's high level of DMFT (PR = 1.96; 95%CI 1.28-3.03). CONCLUSION Symptoms of depression, anxiety and stress were associated with higher levels of dental caries experience for caregivers and for people with intellectual disabilities.
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Affiliation(s)
- Alexandre Baumgarten
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Juliana Balbinot Hilgert
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,Postgraduate Program in Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rafaela Soares Rech
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Joana Cunha-Cruz
- School of Dentistry and School of Public Health, University of Washington, Seattle, Washington
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El-Monshed AH, Amr M. Perceived stress among mothers of children with autism spectrum disorder in Egypt. ADVANCES IN AUTISM 2021. [DOI: 10.1108/aia-02-2020-0014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Children diagnosed with autism spectrum disorder (ASD) and their families especially their mothers face numerous and pervasive challenges. Difficulties to access quality care, financial burden, issues of adulthood and their child’s behaviors may produce significant stressors to mothers. This study aims to assess perceived stress among mothers of children with ASD in Egypt.
Design/methodology/approach
A cross-sectional study was conducted in Mansoura University Hospital, Egypt on 94 mothers of children with ASD using a structured questionnaire of the socio-demographic and clinical features of the studied mothers and their children and the perceived stress scale (PSS).
Findings
The mean total PSS score of mothers was 31.97 ± 12.39 and the level of autism had a statistically significant relation with stress perceived by the studied mothers.
Research limitations/implications
The findings in this study were based on caregivers’ self-reporting. As such, inaccurate reporting might have biased the findings. The main limitations of this study include non-participation and dropout. During data collection, some mothers declined to participate in the study. Also, the current study was conducted in one hospital. This represents a loss of valuable information and may weaken the generalizability of the current study findings. Another limitation is the use of a convenience sample in the study. With the use of convenience sampling, there is an increased risk of bias, as study participants may not accurately reflect the characteristics of the total population.
Practical implications
Caregivers’ education programs through media and press should be developed for mothers of children with ASD to help those who experience levels of stress by presenting knowledge about ASD and treatment and training on adaptive coping methods and teaching communication and problem-solving. Recognizing levels of stress and parent counseling may be a useful strategy. Regular periodic meetings should be conducted between mothers and hospital personnel to promote proper communication. One key policy implication, this paper can derive from this study is the need for cooperation between the Ministry of Health, social welfare and other relevant governmental and non-governmental organizations to provide support for families of individuals with ASD such as financial aids. It is also recommended that future study would benefit a larger sample to enhance external validity. As well, future qualitative research is recommended to more fully understand the lived experience of mothers of children with ASD.
Originality/value
This study provides evidence that mothers of children with ASD experienced high perceived stress. Caregivers’ education programs through media and press should be developed in Egypt for mothers of children with ASD.
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Roche GC, Fung P, Ransing R, Noor IM, Shalbafan M, El Hayek S, Koh EBY, Gupta AK, Kudva KG. The state of psychiatric research in the Asia Pacific region. Asia Pac Psychiatry 2021; 13:e12432. [PMID: 33145988 DOI: 10.1111/appy.12432] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 10/10/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION This study aims to review recent scientific publications and research output in the field of psychiatry, from a series of countries in the Asia-Pacific region (Australia, India, Indonesia, Iran, Lebanon, Malaysia, and Nepal), with a view to identify themes and similarities across regions, as well as to examine the barriers and challenges in mental health research faced by countries in the region. METHODS Seven psychiatrists from seven countries reviewed recent published and ongoing research in psychiatry in their respective nations, with respect to themes, as well as any barriers or challenges faced by mental health researchers. RESULTS While the seven nations included in this review vary in terms of research capabilities and economic development level, they share many similarities both in terms of research direction, and with regards to challenges faced. Limitations in the form of sociocultural differences from the West, and a lack of funding were some of the barriers identified. DISCUSSION Mental health research in the region has been progressing well. However, more varied research in the form of qualitative or economic studies are lacking, as are multi-center studies. The similar issues that nations face with regards to research could perhaps benefit from collaborative efforts and initiatives for the furtherance of research in the region.
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Affiliation(s)
- Glen Cedric Roche
- Department of Psychological Medicine, Changi General Hospital, Singapore
| | - Paul Fung
- Paramatta Mission, Parramatta, New South Wales, Australia.,Health Education and Training Institute Higher Education, North Paramatta, New South Wales, Australia
| | - Ramdas Ransing
- Department of Psychiatry, BKL Walawalkar Rural Medical College, Ratnagiri, Maharashtra, India
| | - Isa Multazam Noor
- Department of Psychiatry, Dr. Soeharto Heerdjan Mental Hospital, Jakarta, Indonesia
| | - Mohammadreza Shalbafan
- Mental Health Research Center, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Samer El Hayek
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
| | - Eugene Boon Yau Koh
- Department of Psychiatry, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | | | - Kundadak Ganesh Kudva
- Early Psychosis Intervention Programme and East Region, Institute of Mental Health, Singapore
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