Problem Behavior in Children of Chronically Ill Parents: A Meta-Analysis

The aim of this meta-analysis is to examine whether children of chronically ill parents differ from norm groups in problem behavior. We report moderator effects and overall effect sizes for internalizing, externalizing and total problem behavior assessed by children and parents. In fixed effect models, we found a significant overall effect size for internalizing problem behavior (number of studies k = 19, total sample size N = 1,858, Cohen’s d = .23, p < .01) and externalizing problem behavior (k = 13, N = 1,525, d = .09, p < .01) but not for total problem behavior (k = 7; N = 896). Effects for internalizing and externalizing problem behavior were larger in non-cancer studies, in samples including younger children and younger ill parents, in samples defined by low average SES and in studies including parents with longer illness duration. In addition, effects for externalizing problem behavior were larger in studies characterized by a higher percentage of ill mothers and single parents. With exclusive self-report, effect sizes were significant for all problem behaviors. Based on these results, a family-centered approach in health care is recommended

Social activity contributes independently to life satisfaction three years post stroke

Objective: To determine social activity and life satisfaction three years post stroke and to investigate the contribution of social activity to life satisfaction controlled for the influence of demographic, physical and cognitive disabilities and social support. Design: Cross-sectional study. Subjects: One hundred and sixty-five patients with a stroke. Main measures: The Life Satisfaction questionnaire (LiSat-9), the Social Support List – Interaction (SSL-12-I), the Barthel Index, the Mini-Mental State Examination (MMSE) and the Frenchay Activities Index. Results: In total, 165 stroke patients participated, of whom 112 (67.9%) reported that they were satisfied with life as a whole. Socially inactive patients were significantly less often satisfied (50%, n = 26) than socially moderately (74.4%, n = 64) and socially highly active (81.5%, n = 22) patients. Lowest satisfaction ratings were found for sexual life (40.6%, n = 58). The socially inactive group was most satisfied with their partner relationship (85.1%, n = 40), the moderately and highly socially active group with their self-care ability (87.2%, n = 75 and 96.3%, n = 26, respectively). ADL and social activity were moderately correlated with life satisfaction. Social activity was found to explain an additional variance of the LiSat-9 total score (6.9%) and overall life satisfaction item (5.2%) after controlling for demographic variables, social support, ADL and cognitive functioning. Conclusions: Three years post stroke, many patients report ongoing dissatisfaction with various life domains. Social activity was related to life satisfaction. </jats:p

A validation study of the Caregiver Mastery Scale for partners of patients with acquired brain injury

OBJECTIVE: To validate the Caregiver Mastery Scale for partners of patients with acquired brain injury. DESIGN: The score distributions, internal consistency and convergent validity of the Caregiver Mastery Scale were determined. SUBJECTS: A total of 92 partners (53% male, age 62 years) of patients with acquired brain injury (91% stroke) discharged from inpatient rehabilitation (time since injury 32 months). MAIN MEASURES: Outcome measure: Caregiver Mastery Scale. Reference measures: Caregiver Strain Index, Hospital Anxiety and Depression Scale and CarerQoL. RESULTS: The Caregiver Mastery Scale has a normal distribution, with no floor or ceiling effects. Its internal consistency is acceptable (Cronbach's alpha: 0.75). The convergent validity analyses confirmed our hypothesis that higher scores on the Caregiver Mastery Scale correlate with less burden, lower levels of anxiety and depression and greater well-being. Furthermore, partners scoring high on the Caregiver Mastery Scale mostly scored below the clinical cut-off scores on the Caregiver Strain Index and the anxiety and depression subscales of the Hospital Anxiety and Depression Scale, whereas partners scoring low on the Caregiver Mastery Scale were more likely to score above the cut-off points. CONCLUSION: The Caregiver Mastery Scale is a valid instrument to assess the caregiver mastery of partners of patients with acquired brain injury