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Teng CJ, Yeh CM, Liu CJ, Chen TJ, Huang N, Chou YJ. Pregnancy among thyroid cancer survivors: do thyroidectomy and radioactive iodine matter? Postgrad Med J 2025:qgae197. [PMID: 39790005 DOI: 10.1093/postmj/qgae197] [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: 09/30/2024] [Revised: 11/21/2024] [Accepted: 12/22/2024] [Indexed: 01/12/2025]
Abstract
BACKGROUND Thyroid cancer primarily affects young women and raises concerns about future fertility due to treatments of thyroidectomy and radioactive iodine (RAI) therapy. This study investigated the effects of these treatments on pregnancy probability in young female patients post-diagnosis. METHODS A nationwide, population-based study using data from Taiwan's National Health Insurance Research Database (2000-2017) examined pregnancy likelihood in women ≤45 years with thyroid cancer. The effects of thyroidectomy and RAI therapy on pregnancy were analyzed using logistic regression and Cox proportional-hazards models. RESULTS In a cohort of 10 937 patients with thyroid cancer, 7022 (64.2%) underwent total thyroidectomy, with 718 receiving RAI treatment. The type of thyroidectomy and RAI treatment, even at doses exceeding 120 millicuries, did not reduce the likelihood of pregnancy. Age was identified as the most critical factor influencing pregnancy; women aged >30 years had a significantly lower likelihood of becoming pregnant than younger women did. Other factors associated with a reduced likelihood of pregnancy included comorbidity with diabetes (HR = 0.65, P = .002) and higher socioeconomic status (HR = 0.69, P = .085). CONCLUSIONS Thyroidectomy and RAI therapy do not diminish pregnancy probability in young women with thyroid cancer. Age remains a crucial factor, with younger women more likely to conceive. These findings are critical for fertility counseling and treatment planning. Key message What is already known on this subjec? Thyroid cancer primarily affects young women, and its standard treatments, including thyroidectomy and radioactive iodine (RAI) therapy, have raised concerns about their potential impact on fertility. Previous studies have shown that RAI treatment may temporarily affect ovarian function but typically does not have a significant long-term effect on fertility. What this study adds? This nationwide population-based study found that neither total nor partial thyroidectomy, nor RAI treatment, adversely affects the likelihood of pregnancy in young women with thyroid cancer. Age was identified as the most significant factor influencing pregnancy, with younger women having a higher probability of becoming pregnant after treatment. How this study might affect research, practice, or policy? Clinicians should recognize that age, rather than the type of thyroidectomy or RAI treatment, is the most critical factor influencing fertility in young women with thyroid cancer. This insight can guide personalized fertility counseling and treatment planning to optimize outcomes.
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Affiliation(s)
- Chung-Jen Teng
- Division of Oncology and Hematology, Department of Medicine, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Road, Banqiao District, New Taipei City 22060, Taiwan
- Institute of Public Health, College of Medicine, National Yang Ming Chiao Tung University, Yang Ming Campus, No. 155, Sec. 2, Linong Street, Beitou District, Taipei 11217, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Beitou District, Taipei 11217, Taiwan
| | - Chiu-Mei Yeh
- Institute of Public Health, College of Medicine, National Yang Ming Chiao Tung University, Yang Ming Campus, No. 155, Sec. 2, Linong Street, Beitou District, Taipei 11217, Taiwan
- Division of Transfusion Medicine, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei 11217, Taiwan
| | - Chia-Jen Liu
- Institute of Public Health, College of Medicine, National Yang Ming Chiao Tung University, Yang Ming Campus, No. 155, Sec. 2, Linong Street, Beitou District, Taipei 11217, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Beitou District, Taipei 11217, Taiwan
- Division of Transfusion Medicine, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei 11217, Taiwan
- Institute of Emergency and Critical Care Medicine, National Yang Ming Chiao Tung University, Yang Ming Campus, No. 155, Sec. 2, Linong Street, Beitou District, Taipei 11217, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital Hsinchu Branch, No. 81, Sec. 1, Zhongfeng Road, Zhudong Township, Hsinchu County 31064, Taiwan
| | - Nicole Huang
- Institute of Public Health, College of Medicine, National Yang Ming Chiao Tung University, Yang Ming Campus, No. 155, Sec. 2, Linong Street, Beitou District, Taipei 11217, Taiwan
- Institute of Hospital and Health Care Administration, College of Medicine, National Yang Ming Chiao Tung University, Yang Ming Campus, No. 155, Sec. 2, Linong Street, Beitou District, Taipei 11217, Taiwan
| | - Yiing-Jenq Chou
- Institute of Public Health, College of Medicine, National Yang Ming Chiao Tung University, Yang Ming Campus, No. 155, Sec. 2, Linong Street, Beitou District, Taipei 11217, Taiwan
- Office of the Deputy Superintendent, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan
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Fu ZW, Wang KL, Du NY, Li YJ, Duan JJ, Zhao SX. Comparative study on emotional behavior and parental job stress of only-child and non-only-child preschool children. World J Clin Cases 2024; 12:4642-4651. [PMID: 39070806 PMCID: PMC11235493 DOI: 10.12998/wjcc.v12.i21.4642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 05/24/2024] [Accepted: 06/07/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Studies have revealed that Children's psychological, behavioral, and emotional problems are easily influenced by the family environment. In recent years, the family structure in China has undergone significant changes, with more families having two or three children. AIM To explore the relationship between emotional behavior and parental job stress in only preschool and non-only preschool children. METHODS Children aged 3-6 in kindergartens in four main urban areas of Shijiazhuang were selected by stratified sampling for a questionnaire and divided into only and non-only child groups. Their emotional behaviors and parental pressure were compared. Only and non-only children were paired in a 1:1 ratio by class and age (difference less than or equal to 6 months), and the matched data were compared. The relationship between children's emotional behavior and parents' job stress before and after matching was analyzed. RESULTS Before matching, the mother's occupation, children's personality characteristics, and children's rearing patterns differed between the groups (P < 0.05). After matching 550 pairs, differences in the children's parenting styles remained. There were significant differences in children's gender and parents' attitudes toward children between the two groups. The Strengths and Difficulties Questionnaire (SDQ) scores of children in the only child group and the Parenting Stress Index-Short Form (PSI-SF) scores of parents were significantly lower than those in the non-only child group (P < 0.05). Pearson's correlation analysis showed that after matching, there was a positive correlation between children's parenting style and parents' attitudes toward their children (r = 0.096, P < 0.01), and the PSI-SF score was positively correlated with children's gender, parents' attitudes toward their children, and SDQ scores (r = 0.077, 0.193, 0.172, 0.222). CONCLUSION Preschool children's emotional behavior and parental pressure were significantly higher in multi-child families. Parental pressure in differently structured families was associated with many factors, and preschool children's emotional behavior was positively correlated with parental pressure.
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Affiliation(s)
- Zhi-Wei Fu
- Department of Children's Health, Shijiazhuang Maternity and Child Healthcare Hospital, Shijiazhuang 050000, Hebei Province, China
| | - Kai-Li Wang
- Department of Children's Health, Shijiazhuang Maternity and Child Healthcare Hospital, Shijiazhuang 050000, Hebei Province, China
| | - Ning-Yu Du
- Department of Children's Health, Shijiazhuang Maternity and Child Healthcare Hospital, Shijiazhuang 050000, Hebei Province, China
| | - Yue-Jing Li
- Department of Children's Health, Shijiazhuang Maternity and Child Healthcare Hospital, Shijiazhuang 050000, Hebei Province, China
| | - Jing-Jing Duan
- Department of Children's Health, Shijiazhuang Maternity and Child Healthcare Hospital, Shijiazhuang 050000, Hebei Province, China
| | - Sheng-Xia Zhao
- Department of Children's Health, Shijiazhuang Maternity and Child Healthcare Hospital, Shijiazhuang 050000, Hebei Province, China
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Villarejo S, Garcia OF, Alcaide M, Villarreal ME, Garcia F. Early Family Experiences, Drug Use, and Psychosocial Adjustment across the Life Span: Is Parental Strictness Always a Protective Factor? PSYCHOSOCIAL INTERVENTION 2024; 33:15-27. [PMID: 38298214 PMCID: PMC10826981 DOI: 10.5093/pi2023a16] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/10/2023] [Accepted: 08/11/2023] [Indexed: 02/02/2024]
Abstract
Objective: This study analyzes whether parental strictness, which is shared by authoritative parenting (strictness and warmth) and authoritarian parenting (strictness without warmth) styles, always acts as a main protective factor against drug use and psychosocial maladjustment in children. This conclusion has already been stated in numerous classic studies, though emergent research suggests that there are benefits to parental warmth regardless of whether strictness is present or not. Method: Sample were 2,095 Spanish participants (1,227 females, 58.6%), 581 adolescent children (aged 12-18 years, 27.7%) and 1,514 adult children (72.3%). The measures were the main parenting style dimensions (warmth and strictness), drug use, and a set of indicators of psychosocial adjustment. A 4 × 2 × 4 MANOVA was applied for all outcomes with parenting style, sex, and age as independent variables. Results: Indulgent parenting (warmth without strictness) was related to less drug use than parenting without warmth (authoritarian and neglectful). Additionally, indulgent and authoritative parenting styles were related to better scores on psychosocial adjustment than authoritarian and neglectful styles, although the indulgent parenting was the only style related to the optimal scores being equal or even more effective than the authoritative style. Conclusion: Contrary to classical studies, present findings suggest that it is the parental warmth instead of the parental strictness that seems to be effective in protecting against drug use and psychosocial maladjustment.
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Affiliation(s)
- Sonia Villarejo
- University of ValenciaValenciaSpainUniversity of Valencia, Spain;
| | - Oscar F. Garcia
- University of ValenciaValenciaSpainUniversity of Valencia, Spain;
| | - Marta Alcaide
- University of ValenciaValenciaSpainUniversity of Valencia, Spain;
| | - Maria E. Villarreal
- Autonomous University of Nuevo LeonMonterreyMexicoAutonomous University of Nuevo Leon, Monterrey, Mexico
| | - Fernando Garcia
- University of ValenciaValenciaSpainUniversity of Valencia, Spain;
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Candan HD, Doğan S. Effectiveness of the positive discipline program applied to parents of preschool children: A randomized-controlled trial. J Pediatr Nurs 2023; 72:e87-e97. [PMID: 37344344 DOI: 10.1016/j.pedn.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 06/07/2023] [Accepted: 06/07/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Although the Positive Discipline Program is used extensively internationally, there are very few evidence-based studies on it. This study aims to examine the experimental results of the Positive Discipline Program. METHOD This randomized-controlled study had the following types of groups: intervention, active control, and non-contact control. The study sample consisted of 72 parents with children aged between 3 and 6 years. The intervention group participated in an eight-session online Positive Discipline Program, the active control group participated in an eight-session online free interaction program, and the non-contact control group received no intervention. RESULTS Parents in the intervention group demonstrated an increase in cooperation with their children after the training and during the follow-up period. In the intervention group, parents' oppressive and authoritarian attitudes decreased after the training and during the follow-up period; spouses' democratic attitudes increased after the training and their overprotective attitudes decreased in the follow-up period. Parent-child communication and unhindered listening increased in the intervention and active control groups. The problem-solving skills of the intervention group increased after the training and during the follow-up period, and sensitivity increased in the follow-up period. CONCLUSION As one of the few experimental studies implementing the Positive Discipline Program, this study revealed the strengths of the program as well as culture-specific aspects that need to be improved. Further, this program was effective in improving parents' relationships with their children, attitudes, and problem-solving skills, and it provided evidence for the program's positive contributions to raising a child. IMPLICATIONS FOR PRACTICE The Positive Discipline Program can guide parents in solving the developmental and school-related problems of preschool children as well as school and adolescence children.
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Affiliation(s)
| | - Satı Doğan
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, Ege University, Izmir, Turkey.
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Alcaide M, Garcia OF, Queiroz P, Garcia F. Adjustment and maladjustment to later life: Evidence about early experiences in the family. Front Psychol 2023; 14:1059458. [PMID: 36935989 PMCID: PMC10017455 DOI: 10.3389/fpsyg.2023.1059458] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 02/09/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction Previous parenting studies with European-American families have identified optimal parenting as being based on warmth combined with strictness (i.e., authoritative parenting). The present study analyzes, in adolescents and adults, their adjustment and maladjustment related to age and their early experiences in the family. Methods The sample consisted of 2,158 Spanish people (58.29% women): 624 adolescents, 630 young adults, 504 middle-aged adults, and 400 older adults. The families were classified into one of the four parental typologies (authoritative, indulgent, authoritarian, and neglectful) based on their scores in the two main dimensions (warmth and strictness). Child functioning was measured as components of adjustment (self-esteem, emotional self-concept, and empathy) and maladjustment (aggression and hostile sexism). Results Overall, only adolescents and adult children raised in indulgent families reported the highest self-esteem, emotional self-concept, and empathy, and the lowest aggression and hostile sexism. Authoritative parenting (warmth with strictness) was related to a lower emotional self-concept and greater aggression and hostile sexism than indulgent parenting (warmth without strictness). The worst scores corresponded to authoritarian and neglectful parenting. Discussion The present findings provide new evidence about early experiences in the family, even after parental socialization has ended. Interestingly, contrary to the main findings from classic studies with European-American families, only high parental warmth combined with low parental strictness (i.e., indulgent parenting) is always positive for greater adjustment and less maladjustment in all age groups.
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Affiliation(s)
- Marta Alcaide
- Department of Methodology of the Behavioural Sciences, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Oscar F. Garcia
- Department of Developmental and Educational Psychology, University of Valencia, Valencia, Spain
- *Correspondence: Oscar F. Garcia,
| | - Pablo Queiroz
- Faculty of Health Sciences, Federal University of Rio Grande do Norte, Trairi, Brazil
| | - Fernando Garcia
- Department of Methodology of the Behavioural Sciences, Faculty of Psychology, University of Valencia, Valencia, Spain
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Fuentes MC, Garcia OF, Alcaide M, Garcia-Ros R, Garcia F. Analyzing when parental warmth but without parental strictness leads to more adolescent empathy and self-concept: Evidence from Spanish homes. Front Psychol 2022; 13:1060821. [PMID: 36544447 PMCID: PMC9760939 DOI: 10.3389/fpsyg.2022.1060821] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 11/14/2022] [Indexed: 12/07/2022] Open
Abstract
Introduction Classical research mainly conducted with European-American families has identified the combination of warmth and strictness (authoritative style) as the parenting always associated with the highest scores on developmental outcomes. Additionally, despite the benefits of empathy for prosocial behaviors and protection against antisocial behaviors, most research has considered the contribution of specific practices (e.g., reasoning or power assertion), but not so much the parenting styles. Similarly, family studies tend to study the relationship between parenting and global self-perceptions (self-esteem), but not so much those of each dimension (self-concept). Methods In the present study, 600 Spanish adolescents from 12 to 17 years old (M = 15.25, SD = 2.01) were classified within one of the four household typologies (i.e., authoritative, indulgent, authoritarian, or neglectful). Adolescent developmental outcomes were cognitive empathy (adopting perspectives and emotional understanding), emotional empathy (empathic stress and empathic happiness), and self-concept (academic, social, emotional, family and physical). Results The results showed that the indulgent parenting (warmth but not strictness) was related to equal or even better empathy and self-concept than the authoritative style (warmth and strictness), whereas non-warm parenting (authoritarian and neglectful) was consistently associated with poor results. Discussion Overall, the present findings seriously question that parental strictness combined with parental warmth (authoritative style) is always the parenting style related to the greatest outcomes. By contrast, it seems that reasoning, warmth and involvement, without strictness (indulgent parenting) help adolescents to achieve a good orientation toward others in terms of cognitive and affective empathy and a good self-evaluation in terms of self-concept.
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Affiliation(s)
- Maria C. Fuentes
- Department of Methodology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Oscar F. Garcia
- Department of Developmental and Educational Psychology, University of Valencia, Valencia, Spain,*Correspondence: Oscar F. Garcia,
| | - Marta Alcaide
- Department of Methodology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Rafael Garcia-Ros
- Department of Developmental and Educational Psychology, University of Valencia, Valencia, Spain
| | - Fernando Garcia
- Department of Methodology, Faculty of Psychology, University of Valencia, Valencia, Spain
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Chiș R, Ignat S, Rad D, Macsinga I. The Mediation Role of an Individual's and Couple's Psychological Factors, Including Parenting in the Prediction of Relational and Marital Satisfaction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11011. [PMID: 36078727 PMCID: PMC9518425 DOI: 10.3390/ijerph191711011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 08/21/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
The goal of this study was to widen the scope of the social component of family sustainability. The fundamental goal of this non-experimental, quantitative study was to look at the links between parenting correlates, personality characteristics, marital satisfaction, and well-being in couples, as well as to construct explanatory prediction models for relational and marital satisfaction. The study focused on the effects of personality traits, parental self-efficacy, and attachment to marital and relational satisfaction. The test instruments applied were: the Experiences in Close Relationships-Revised, Marital Adjustment Test, Couple Satisfaction Index, Relationship Satisfaction Scale, Family Distress Index, Generalized Self-Efficacy Scale (adapted to the role of a parent), Mowen's Personality Scale, and demographic data. A total of 238 Romanians answered the online survey, recruited based on a convenience sampling method. Participants in this research were individuals who were both married and had at least one child. The main findings show that agreeableness, openness, conscientiousness, anxious and avoidant attachment, and marital adjustment predict the satisfaction in the relationship, and openness partially mediates the association between marital adjustment and relationship satisfaction. Parental self-efficacy appears to influence the association between relationship satisfaction and marital satisfaction. An increased parental self-efficacy score predicts an increased relationship satisfaction and marital satisfaction. The higher the parental self-efficacy, the higher the satisfaction in the relationship, which leads to an increase in satisfaction in the couple. These results show that marital adjustment and adaptation are related to relational satisfaction, and these relationship are partially mediated by an individual's openness. Despite some limitations, the current study significantly contributes to couples therapies and interventions in terms of physical and mental health, and the study provides insight into the experiences and perspectives of married individuals with children in Romania.
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Affiliation(s)
- Roxana Chiș
- Faculty of Educational Sciences Psychology and Social Sciences, Aurel Vlaicu University of Arad, 310032 Arad, Romania
- Department of Psychology, West University of Timisoara, 300223 Timisoara, Romania
| | - Sonia Ignat
- Faculty of Educational Sciences Psychology and Social Sciences, Aurel Vlaicu University of Arad, 310032 Arad, Romania
| | - Dana Rad
- Faculty of Educational Sciences Psychology and Social Sciences, Aurel Vlaicu University of Arad, 310032 Arad, Romania
| | - Irina Macsinga
- Department of Psychology, West University of Timisoara, 300223 Timisoara, Romania
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Luo S, Lin L, Chen W, Li C, Ren Y, Zhang M, Guo VY. Association between maternal intimate partner violence and health-related quality of life in their preschool children: The mediating role of maternal parenting styles. Front Psychiatry 2022; 13:996971. [PMID: 36424988 PMCID: PMC9679020 DOI: 10.3389/fpsyt.2022.996971] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/25/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Although intimate partner violence (IPV) against women is a public health issue around the world, there is a lack of evidence regarding the impact of maternal IPV on preschool children's health-related quality of life (HRQOL). Therefore, the aim of this study was to investigate the association between maternal IPV and HRQOL among Chinese preschool children, as well as the mediating role of maternal parenting styles. METHODS A cross-sectional study was conducted with 4,243 mother-child dyads who attended preschools. Mothers self-reported their parenting styles and experience of IPV. Children's HRQOL was collected through mother-proxy report with the Pediatric Quality of Life Inventory version 4.0 (PedsQL 4.0). Multivariate linear regression analysis was conducted to evaluate the association between maternal IPV and children's HRQOL. Mediation models were further applied to explore the possible mediating role of maternal parenting styles. RESULTS Of the included mothers, 7.4% had experience of IPV. Compared to children of mothers without any IPV exposure, those of mothers with experience of IPV had significantly lower scores in all HRQOL dimensions and summary scales. After adjustment for covariates, maternal IPV was significantly associated with children's lower physical health summary score, psychosocial health summary score, and total scale score. Mediation analysis showed that both rejection and overprotection mediated such associations, but not for the emotional warmth. CONCLUSION Our findings indicated the need to screen maternal IPV supplemented with targeted interventions focusing on parenting styles, in order to mitigate the negative impact of maternal IPV on children's HRQOL.
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Affiliation(s)
- Shengyu Luo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Li Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Weiqing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chunrong Li
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yan Ren
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Meng Zhang
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Vivian Yawei Guo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
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