Families Systems & Health最新文献

Introduction: In Japan, approximately 90% of kidney transplantations involve living donors who are relatives. Selection of a living donor from potential family member donors could affect the entire family. However, reports focusing on preliving-related kidney transplant (LRKT) family functioning are lacking. Family functioning comprises ways that family members communicate and cooperate with each other. The Family Assessment Device (FAD) was used to measure family functioning from the perspective of donors and recipients just prior to LRKT.

Method: A total of 122 donor-recipient pairs (244 participants in total) who planned to have LRKT were recruited consecutively from July 2020 to July 2021 and included in the analysis.

Results: There was no significant difference in FAD scores between donors and recipients, with approximately 20% of both groups reporting poor family functioning. Differences in family functioning according to types of relatives were shown in recipients. The rate of poor family functioning was significantly lower in the spouse group than in the parent-to-child group (recipient: 6.6%, 29.3%; donor: 8.2%, 34.1%, respectively). However, agreement regarding good or poor family functioning assessment was high in the parent-to-child pairs and low in the spouse pairs.

Discussion: Most LRKT donors and recipients reported good family functioning; however, some perceived poor family functioning. Evaluations by donors did not always align with that of recipients, especially among spouse pairs. It is important to treat them as independent entities. Preoperative assessment to connect them with appropriate support can enhance recovery after LRKT. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: The purpose of our research was to explore how parents and their adolescent children make decisions about the human papillomavirus (HPV) vaccine, and to inform future interventions that aim to facilitate inclusive decision-making processes.

Method: Purposive and snowball sampling strategies targeted parents and their adolescent children (ages = 11-13) in a large city in Australia. We conducted separate and joint semistructured interviews in 2013 with six mother-adolescent dyads (50% female adolescents and 50% male). Interviews were analyzed using a grounded theory approach.

Results: Factors that both facilitate and impede decision making emerged, including: background knowledge, values, historical experiences, parenting style, and opinion weights.

Discussion: New interventions, strategies, and tools that are informed by these decision-making factors can be used to aid productive, mutual decision making between parents and adolescents and support adolescent autonomy and self-sufficiency in health decision making. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: Young adulthood is a time when persons with Type 1 diabetes (T1D) become more fully responsible for diabetes management. Establishing healthy diabetes routines during this period is foundational for successful management across adulthood. Although partner support is generally considered helpful in T1D management, less is known about specific partner behaviors that could benefit glucose levels. The aim of this study was to explore associations between communal coping behaviors and T1D glucose management.

Method: During 2018-2020, 23 young married opposite-sex couples (M_age = 25.7 years), wherein one spouse had T1D, completed daily measures of communal coping for 9 consecutive days. Daily average glucose and time-in-range were computed from the person with T1D's glucose meter or continuous glucose monitor.

Results: Multilevel model results suggested that higher time-in-range on a given day was predicted by reports of lower daily spousal instrumental support, lower overprotective and controlling behaviors, and by higher emotional support. Controlling spousal behavior on one day was associated with higher time-in-range the next day. At the same time, patient reports of higher average spousal controlling behavior (across all days) were associated with lower time-in-range and higher average glucose. Average glucose was also predicted by communal coping behaviors (especially within-person higher instrumental support), yet results were less robust after covariates were considered.

Discussion: Some young romantic partners may engage in behaviors that are associated with higher average blood glucose and lower time-in-range for the person with T1D. Persons with T1D could communicate to their partners types of support that are helpful versus not. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Due to the rapid proliferation of vape stores and their ubiquity across the country, many consumers assume that their products are safe, well-studied, and accurately labeled. However, there is rapidly emerging evidence that Delta 8, sold as an alternative to high concentrate tetrahydrocannabinol (THC) marijuana (still illegal in most states) is associated with severe depression, psychosis, and even suicide, particularly in vulnerable adolescent and young adult populations. This trend is well-known to emergency room physicians and psychiatry, and the number of online family advocacy groups is increasing. Delta 8 effects have recently been featured in popular media by the New York Times, Discover, USA Today, and more. The United States Food and Drug Administration (FDA) has reported an increase in complaints and Substance Abuse and Mental Health Services Administration (SAMHSA) released an advisory warning in 2023 about cannabidiol which included Delta 8. For those already affected and their families, however, any regulation will come too late as they face an uncertain future and much anxiety about whether the psychosis will abate or prove permanent. This 55-word story illustrates one mother's rage at the devastation Delta 8 has caused her family. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The author presents a short story about doctors listening to patients and remaining committed to to their patients health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Reviews the book, Connections in the Clinic: Relational Narratives from Team-Based Primary Care edited by Randall Reitz, Laura E. Sudano, and Mark P. Knudson (2021). This book is an edited collection of poems and stories reflecting the personal nature of the mission, vision, and practice of integrated primary care. This collection reflects the biopsychosocial model, which has been growing steadily in research and practice over the last few decades. These stories from the frontlines illustrate the increased awareness of the strong mind-body-interpersonal and team connections that are a critical part of a successful primary care system. This book is intended to be inspirational for anyone working in a primary care clinic. The editors describe the central purpose of the book is to find meaning in the relationships that are created in team-based primary care. This is a book where these stories are collected to expand our recognition and appreciation of the full diversity of patterns in our personal and work lives. The collection of stories is intended to inspire readers to actively practice their own reflections and learnings and encourages sharing them with others. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Comments on the article by Shaidullah, et al. (see record 2024-13778-001). Shahidullah and team describe the utilization of the hospital-school-community telepartnership (HSCT), a telehealth program aimed to increase rapid crisis response and interagency care coordination for students with suicidality safety risk. The HSCT team followed both crisis mental health (SAFE-T) and telebehavioral health best practices, with a licensed teleclinician conducting virtual crisis evaluation at the student's school, often on the same day. The HSCT maximized telebehavioral health by simultaneously supporting and consulting with school staff who often serve as de facto crisis mental health with little training or supported time. This collegial cross-system approach resonates with the current author team's experience of the importance of training, including opportunities to validate the supports that school personnel have provided as well as problem solving together to support students in crisis. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: We (a) describe the development of a hospital-school-community telepartnership (HSCT) program targeting suicidality crisis response implemented in the immediate aftermath of the COVID-19 pandemic, (b) report on service utilization outcomes from the first year and half of program implementation, and (c) share early lessons learned and implications for future directions.

Method: Using program evaluation data collected from September 2020 to December 2021, demographic, usage outcomes, care coordination, and support outcomes are reported. Representative case vignettes are also illustrated.

Results: Students (N = 258) were referred to the HSCT program for suicidality from partnering school districts in the large metropolitan area of Austin, Texas. Students referred were adolescents, 12 years of age and older (n = 196, 76%). Sixty-two (24%) of the students referred for suicidal ideation entered the HSCT program through urgent same-day assessment. Medication evaluations were offered for 125 (48%) of the students. The most frequently prescribed medications included antidepressants (e.g., SSRIs; n = 29, 64%). Program clinicians referred 12 (5%) students identified as high risk for suicide for hospitalization. Of the 258 total students, 212 (82%) were referred to community providers for therapy.

Conclusions: By providing rapid access to crisis response with mental health specialists and care coordinators, at-risk students received timely evidence-based care and referral to mental health resources in their communities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: Mothers are key influencers in daughters' decision making about risk behaviors. Much research on parent-child relationships and communication has been conducted among predominantly White, nonimmigrant families. However, parent-child relationships and communications about risk behaviors may significantly differ for Black immigrant families. In particular, transnational behaviors that serve to maintain multiple social identities with attributes from both the receiving and sending nations may shape communication about risky behaviors. The current study evaluated the association between transnational behavior and risk communication mediated by the mother-daughter relationship.

Method: A total of 285 first- and second-generation Afro-Caribbean women, most of whom (80%) identified as Black, were recruited via purposeful sampling from Caribbean organizations, Caribbean-focused social media, and Caribbean festivals. Participants (daughters) completed a survey assessing their transnational behavior, perceptions of their relationship with their mother (in terms of interdependence, connectedness, and trust in hierarchy), and perceptions of their mother's communication about sex, alcohol use, and other drug use.

Results: Only the relationship between transnational behavior and communication about drugs was fully mediated by connectedness. The relationship between transnational behavior and communication about both alcohol use and other drug use was partially mediated by other facets of the mother-daughter relationship.

Discussion: Findings confirm previous research on parent-child closeness and communication about difficult topics and suggest that such relationships can promote healthy communication in multiple cultures. Children who stay connected to their country of origin stay connected to parents and, therefore, may have greater opportunity to engage in integrated communication about possible risk behaviors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: People with serious mental illness (SMI) have low rates of primary care (PC) use and die years prematurely, mostly because of medical illnesses such as cardiovascular disease or cancer. To meet the needs of these individuals, a novel, specialized patient-centered medical home with care coordination ("SMI PACT") was developed and implemented in PC. This study qualitatively examined patients' experiences with this innovative care model.

Method: After implementation of the medical home in 2018, one-on-one semistructured interviews were conducted with 28 patients (32% women, 43% Black, and 25% Hispanic). Interviews were professionally transcribed and coded prior to thematic analysis.

Results: Patients overwhelmingly described positive experiences with SMI PACT because of the qualities of interpersonal communication displayed by SMI PACT staff (e.g., nonjudgment, good listening, patience), structural features of the SMI PACT collaborative care model (e.g., frequent follow-up communication), and other unique aspects of the SMI PACT model tailored for SMI, such as easy-to-understand language. For these reasons, most patients expressed a desire to continue care in SMI PACT. Patients also self-reported improved engagement with their healthcare and self-management of diet, exercise, blood pressure, and diabetes control as a result of SMI PACT participation.

Discussion: Patients enrolled in a specialized PC medical home identified clinician characteristics and behaviors that informed an overwhelmingly positive impression of the program model. Their experiences can guide dissemination of specialized PC models and integrated services for people with SMI. (PsycInfo Database Record (c) 2024 APA, all rights reserved).