Ethical questions in adolescent contraception.
(58/2108)
Ethical problems often revolve around the conflicts of the models of beneficence and autonomy. Adolescents present a particular complication in their own struggle for autonomy. The physician is confronted with the further dilemma of sorting out the role of parents and the role of the adolescent patient in decision making. Furthermore, as adolescents develop their own moral code, they may lack consistency in their actions and opinions. The physician must examine the total context in arriving at a decision. The prescription of contraception is taken as an example of a common ethical dilemma. (+info)
Support from children, living arrangements, self-rated health and depressive symptoms of older people in Spain.
(59/2108)
OBJECTIVE: To assess the association between emotional and instrumental support from children and living arrangements with the physical and mental health of older people in Spain. METHODS: A face-to-face home interview was carried out with 1284 community-dwelling people over 65 (response rate = 83%) randomly sampled according to an age- and sex-stratified sampling scheme in 1993 at Leganes (Spain). Close to 93% of the participants had children and 45% of them coresided with them. Depressive symptoms were assessed by the CES-D (Center for Epidemiologic study depression scale) and self-rated health (SRH) by a single-item question. Emotional support was measured with a six-item scale on affection and reciprocity. Instrumental support was assessed by help received from children in 17 activities of daily living. Four living arrangements were considered: Living with spouse only, living with a spouse and children, widower living alone, and widower living with children. RESULTS: Multivariate analysis controlling for age, gender, education and functional status showed that low emotional support and reception of instrumental aid were significantly associated with poor SRH. Being a widower and sharing living arrangements with children was associated with good SRH. Living arrangements modify some of the associations of support of children with SRH. Depressive symptoms were associated with low emotional support, reception of instrumental help and being a widower who did not share living arrangements with children. For widowers who do not cohabit with children, reception of instrumental aid is associated with low depressive symptomatology. DISCUSSION: Emotional support from children seems to play an important role in maintaining the physical and mental health of elderly people in Spain. Instrumental support is widely available. Coresidence with children is very common and it is associated with good self-perceived health and low prevalence of depressive symptoms in a culture where family interdependence is highly valued. Families should be protected and encouraged to continue care-giving through a variety of community services and respite care, adapted to their needs and preferences. Research should be undertaken to find more efficient ways to help family caregivers in the Mediterranean context. (+info)
Adolescent views of diabetes-related parent conflict and support: a focus group analysis.
(60/2108)
PURPOSE: To increase understanding of adolescent-parent diabetes-related conflicts and supports in the management of type 1 diabetes by means of a focus group research approach. METHODS: Twenty-four adolescents (10 boys and 14 girls, age 13-15 years; 97% white) participated in three same-sex focus groups at two diabetes summer camps. The focus group leader used a prepared set of open-ended questions to guide the 90-minute sessions. Sessions were tape-recorded, transcribed, and analyzed by a set procedure for qualitative analysis to identify the adolescents' perspectives on parent-adolescent sources of diabetes-related conflict and support. RESULTS: Adolescents reported the following sources of diabetes-related conflict: parental worry and intrusive behaviors; parental lack of understanding and blaming behaviors, and the parents focus on the future vs. the adolescent focus on the present. With regard to diabetes-related support, the teens identified parental understanding of the demands of diabetes and parental provision of reassurance about their child's illness and normative functioning. CONCLUSIONS: Adolescents' perceptions of parental worry, lack of understanding, and resulting intrusive and blaming behaviors are major areas of conflict that need to be addressed in the management of type 1 diabetes. (+info)
Mental health aspects of emergency medical services for children: summary of a consensus conference.
(61/2108)
OBJECTIVE: To address the mental health needs of children involved in emergency medical services (EMS). METHODS: A multidisciplinary consensus conference convened to identify mental health needs of children and their families related to pediatric medical emergencies, to examine the impact of psychological aspects of emergencies on recovery and satisfaction with care, and to delineate research questions related to mental health aspects of medical emergencies involving children. RESULTS: The consensus group found that psychological and behavioral factors affect physical as well as emotional recovery after medical emergencies. Children's reactions are critically affected by age and developmental level, characteristics of the emergency medical event, and parent reactions. As frontline health care providers, EMS staff members are in a pivotal position to recognize and effectively manage the mental health needs of patients and their families. CONCLUSIONS: Ecological changes in emergency departments, such as linkages to mental health follow-up services, training of EMS providers and mental health professionals, and focused research that provides an empirical basis for practice, are necessary components for improving current standards of health care. (+info)
Review: psychosocial well-being of parents and their children born after assisted reproduction.
(62/2108)
OBJECTIVE: To critically review the empirical literature published from 1980 through June 2000 on the psychosocial well-being of parents and their children born after assisted reproduction. METHODS: A computer-based literature search of PsycINFO and Medline was conducted. Empirical studies were reviewed to document the psychosocial impact of infertility and its treatment on the families involved in terms of quality of parenting, family functioning, and child development. RESULTS: Several common findings appeared across the studies reviewed. With regard to quality of parenting and family functioning, mothers of children born using assisted reproduction report less parenting stress and more positive mother- and father-child relationships than mothers of naturally conceived children. In most cases, no statistically significant differences in child functioning in terms of emotions, behavior, self-esteem, or perceptions of family relationship have been reported. CONCLUSIONS: The summary findings are positive and reassuring for parents and their children born after assisted reproduction. This critique of the published literature provides interpretative and methodological refinements for future research. (+info)
Identification of family variables in parents' groups of children with epilepsy.
(63/2108)
OBJECTIVE: To verify the effectiveness of the support group in the identification of family variables linked to epilepsy. METHOD: Pre-test were applied to parents of 21 children with benign epilepsy of childhood recently diagnosed, from 5 to 15 years, who participated in the groups at HC/Unicamp. There was a presentation of an educational video, discussion and application of the post-test 1. After six months, the post-test 2 was applied. RESULTS: The beliefs were: fear of swallowing the tongue during the seizures (76.19%) and of a future mental disease (66.67%). Facing the epilepsy, fear and sadness appeared. 76.19% of the parents presented overprotection and 90.48%, expected a new seizure. In the post-test 1, the parents affirmed that the information offered had modified the beliefs. In the post-test 2, 80.95% didn't report great doubts about epilepsy and 90.48% considered their relationship with their children better. CONCLUSIONS: The demystification of beliefs supplied from the groups influenced the family positively, prevented behavior alterations and guaranteed effective care in the attendance to the child with epilepsy. (+info)
Guiding and managing the child dental patient: a fresh look at old pedagogy.
(64/2108)
Society's approach to children during the past half-century has changed dramatically, and a transformation of medical and hospital pediatric care has followed. Dentistry has been slower to incorporate sound, child-friendly approaches to care. Nonetheless, much has changed in dental practice pertaining to children. The regular involvement of parents in the surgical/therapeutic suite is one such change. Expanded communication to ensure informed consent for treatment as well as consent for type of management approach to children is the standard of care. Since sedation policies are becoming more complex, enhancing the skills of all dentists and staff members in the best methods of nonpharmacological child management will be essential in the next decades. Biobehavioral methods will gain prominence, along with better communication skills of the dental team. These changes will occur only if more time and resources are positioned to teach dental students, dentists, and staff the necessary skills. Emphasis must be placed on early, timely intervention; parental involvement; effective communication; cultural competence; and the "medical/dental home" concept as methods to reduce negative dental attitudes and behaviors of children. (+info)