Maternal Coping Strategies in Response to a Child's Chronic and Oncological Disease: a Cross-Cultural Study in Italy and Portugal

Psychological Effects and Quality of Life in Parents and Children with Jia-Associated Uveitis

Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disease common in children and young adults. Uveitis is the most frequent serious extra-articular JIA manifestation and can lead to severe ocular complications, vision loss, and permanent blindness. This study aims to evaluate the psychological condition and the quality of life of children affected by JIA associated with uveitis (JIA-U) and the repercussion of this condition on parents. Thirty children and adolescents with active uveitis (Uveitis group) and comorbid joint symptoms of JIA were referred to the Unit of Ophthalmology, Giovanni XXIII Hospital of Bari, and 30 age-matched healthy controls (Healthy group) were enrolled with their parents. Four questionnaires were administered: Child Behaviour Checklist (CBCL), Parent Stress Index in Short Form (PSI), Pediatric Quality of Life Inventory (PedsQL), and Coping Inventory for Stressful Situations (CISS). The data were collected from February 2021 to December 2021. No significant differences between the two groups in CBCL, PSI, or CISS tests were shown (p > 0.05). Conversely, significant differences between the two groups were observed in the PedsQL (p < 0.05). This study shows how several ocular complications, recurrent eye examinations, and the rigor of long-term treatment may negatively influence health-related quality of life in children with JIA-U.

The relation between maternal locus of control and coping styles of pediatric leukemia patients during treatment

The present study focuses on the relation between coping strategies of children with leukemia during treatment and locus of control of their mothers. In particular, the study aims to determine whether maternal locus of control can influence sick children's coping styles, and if this relation can be used to predict maladjustments. The study analyzed a cohort of 60 pediatric leukemia patients undergoing treatment and a group formed by their mothers. The participants were recruited from two Pediatric Onco- Hematology Units in Italy. The Child Behavioral Style Scale (CBSS) was used to assess children's coping strategies, whereas the Parental Health Locus of Control Scale (PHLCS) was employed to analyze maternal locus of control. A linear regression model was applied to verify a possible interdependent relationship between children's coping styles and maternal locus of control. The differences in mean CBSS scores were analyzed by K-S test. Multivariate analysis of variance was performed to assess any potential effect of child's gender, hospital context and maternal socio-cultural status on children's coping strategies. Our results show a significant relationship between children's coping strategies and maternal locus of control. In particular, the scales mass media, fate and healthcare professionals display a predictive effect on children's monitoring coping style, given the positive correlation observed (F=3.28, P=0.008). In contrast, the same scales negatively correlate with blunting coping style (F=3.5, P=0.005). Our results reveal several interesting resources having a profound impact on the psychological functioning of children with leukemia undergoing treatment as well as their mothers. Furthermore, with regard to the central hypothesis of the study, our findings show both positive and negative correlations between specific scales of maternal locus of control and children's coping style, which could be used to predict children at risk of emotional maladjustment.

Determinants of Drug Adherence on Grade Two and Three Patients with Hypertension

Background: Compliance for taking medication to become an important thing for a patient with hypertension. Compliance is needed to control blood pressure and prevent complication. The purpose of this study was to analyse the factors that influence patients adherence to taking medicine.Method: The study design was observational analytic using a cross-sectional approach. Samples were 225 patients with hypertension class 2 and 3, in Malang district, Indonesia. The sampling technique was done by using a multistage random sampling technique. The research instrument was in the form of a questionnaire. Data analysis was performed using the Pearson test and linear regression.Results: The results showed that patients adherence in taking medicine was 32.9% for the low category, 51.1% in the medium category and 16% in the good category. Factors influencing the adherence were ages (p-value: 0.002), turning to religion (p-value: 0.011), gender (p-value: 0.016) and suppressing competition activities (p-value: 0.063).Discussion: Demographic characteristics and focused emotional mastery influence taking the medication in patients with grade 2 and grade 3 hypertension. Strengthening coping strategies with transporting to coping emotions becomes very important to discuss in patients with grade 2 and grade 3 hypertension, so that adherence to hypertension is needed will be able to control blood pressure and prevent complications.

Disease-related Parenting Stress in the Post-treatment Phase of Pediatric Cancer

Parenting stress is generally associated with poorer psychological adjustment in caregivers and children with chronic illness. Although parenting stress in pediatric cancer has been previously demonstrated, few studies have investigated this problem when treatments end. The present study aimed to describe disease-related parenting stress in the post-treatment phase of pediatric cancer, and to analyze the role of parents' age and education, family functioning, and perceived child vulnerability in predicting disease-related parenting stress. The study comprised 56 parents of children with cancer, in the post-treatment phase, who completed a clinical and demographic questionnaire, as well as the Pediatric Inventory for Parents, assessing parenting stress, the Child Perceived Vulnerability Scale, and the Family Adaptability and Cohesion Evaluation Scale-Version IV. Results revealed that the level of disease-related parenting stress in the post-treatment phase was still significant. Emotional stress scores were especially high, further showing that parents' concerns in this phase focus mainly on the long-term impact of the disease and treatments, involving intense feelings of fear and uncertainty. A model with four predictors was tested using regression analysis, which explained 57% of parenting stress variance. More specifically, findings indicated that parental age and education significantly predicted parenting stress, accounting for over one-third of the variance in this outcome. Family functioning and perceived child vulnerability explained an additional 18% of parenting stress. Findings of this study suggest that even when treatment ends, there is still the need for continued support in order to assist parents' ability to deal with the implications of having a child who had cancer. Importantly, special attention should be given in clinical practice to the family functioning and to parents' beliefs about their child's vulnerability.

Obesogenic habits among children and their families in response to initiation of gluten-free diet

Initiation of a lifelong, gluten-free diet (GFD) in children with celiac disease (CD) influences the child's life in many ways. The aim of this study was to assess the influence of GFD on the child and his/her family's eating habits and lifestyle behaviors. To study this, we asked children and their parents completed the Family Eating and Activity Habits Questionnaire (FEAHQ) at the time of diagnosis of CD and at least 6 months after initiation of GFD and a questionnaires assessing symptoms related to CD and adherence to the GFD diet. We analyzed questionnaires from 40 children with CD and their families. There were 21 females, ranging in age from 4 to 15.7 years (median age 7.4 years±2.8 years). The control group comprised 15 healthy children. After initiation of GFD the family ate more junk food including snacks and candies (p = 0.05), with the significant change reported by children and fathers (p = 0.001 and 0.03 respectively). All family members in the control group had significantly less snacks. Parents and children reported a significant increase in obesogenic eating styles, such as eating from the cooking pot and eating while doing other activities (mothers, p = 0.001; fathers, 0.02; and children, 0.02 respectively).

CONCLUSIONS

Our study shows that initiation of GFD in children with CD leads to changes in eating habits and staple food eating that may lead to a more obesogenic environment. Care givers, pediatricians, gastroenterologists, and dieticians alike should be aware of these implications and educate families towards a healthier lifestyle and diet beyond the GFD itself. What's Known: • Gluten-free diet has been shown to affect various psychosocial aspects of children with celiac disease. • Obesity and celiac are associated. What is New: • Initiation of gluten-free diet led to increased eating of junk food both in the patient and his/her family. • After initiation of GFD pro-obesogenic eating habits is increased.

Coping Strategies and Locus of Control in Childhood Leukemia: A Multi-Center Research

Acute lymphoblastic leukemia (ALL) is a very distressing experience for children and requires a special effort of adjustment. Therefore, it seems to be crucial to explore coping resources for the experienced risk condition. In this sense, the study focuses on coping strategies and locus of control in children with ALL during the treatment phase, and on their possible relation. The correlation between children and maternal coping strategies is also investigated. The participants involved were an experimental group of 40 children with ALL and their mothers, and 30 healthy children as the control group. The tools used were: the Child Behavioral Style Scale and the Monitor-Blunter Style Scale to assess the coping strategies of children and mothers; the locus of Control Scale for Children to analyze the children's perception of controlling the events. Both children with ALL and their mothers resorted to monitoring coping strategies with a statistically significant rate of occurrence (children: M=17.8, SD=3.8; mothers: M=10.48, SD=3.4). The data concerning the locus of control show this tendency towards internal causes (M=53.1, SD=4.7). There were statistically significant correlations between monitoring coping strategies and external locus of control (r=0.400, P<0.05). The results gained from the control group are almost equivalent. The outcomes show several interesting resources of the psychological functioning of children as well as of their mothers.

Early precursors of low attention and hyperactivity in moderately and very preterm children at preschool age

The low attention and hyperactivity are major morbidities associated with very and moderately preterm birth. The study has been aimed at investigating the likely occurrence of early precursors of Attention Deficit and Hyperactivity Disorder (ADHD) in very and moderately preterm children at preschool age. The involved children were: 25 very preterm children (M=29.4 weeks of gestational age, SD=2), with low birth weight (M=1200 g, SD=250 g); 35 moderately preterm children (M=34.6 weeks of gestational age, SD=1) with low birth weight (M=2100 g, SD=250 g); 60 healthy full-term children as the control group. Parents of children have been administered specific questionnaires to detect low attention and hyperactivity of their children at home. The data have shown the risk of precursors of ADHD, highlighting statistically significant birth-related differences in both hyperactivity/impulsivity [F(2,119)=3.5, P=0.03, η(2)=0.06] and inattention [F(2,119)=2.4, P=0.04, η(2)=0.04], where very preterm children have got higher scores in these two dimensions compared with full-term and moderately preterm children. The very preterm children have got higher scores of impulsivity and inattention than the full-term children (Tukey'HSD - Honestly Significant Difference; P<0.001).

Parenting stress and impact of illness in parents of children with coeliac disease

Coeliac disease (CD) is a chronic disease which could stress patients and their family. Although, poor attention has been paid to the quality of life in CD children and to the functioning of families with CD children. The study aims to evaluate the parenting perception of the CD impact and the parenting distress level. A group of 74 parents of CD children compiled the Impact Childhood Illness Scale and the Parenting Stress Index which is also compiled by 74 parents of health children. The assessment does not reveal a significant impact of CD on patient's personal life although some critical areas emerged. Results evidenced an higher level of parenting stress in parents of CD children than parents of healthy children. CD, if suitably managed, has not a critical impact on parenting perception. Although, CD certainly put parents through an higher risk of a distress related to parenting role than parents with health children. A early identification of parenting distress in a pediatric chronic illness could facilitate the adjustment to pathology.