Barbara Mandleco

Authoritative, Authoritarian, and Permissive Parenting Practices: Development of a New Measure

A 133-item parenting questionnaire was completed by 1251 parents of preschool and school-age children. Items in this measure were reduced using principal axes factor analyses followed by varimax rotation. Three global parenting dimensions emerged consistent with Baumrinds authoritative, authoritarian, and permissive typologies. Internal consistency reliability was assessed with Cronbach alpha and additional items were deleted. A 62-item instrument was retained, and the global parenting dimensions were subsequently analyzed to assess their internal structures using principal axes factor analyses followed by oblique rotation. For each of the three global dimensions a number of specific factors were identified.

The Development of Social and Communicative Competence in Childhood: Review and a Model of Personal, Familial, and Extrafamilial Processes

The purpose of this chapter is to explicate a conceptual model that illustrates how extrafamilial (e.g., sources of stress and support), personal (e.g., inherent psychological child and parent resources), and familial (e.g., parenting, family interactions) processes work together to affect social/communicative peer group outcomes in young children. It is traditionally assumed that proximal factors (e.g., parenting, sibling/family interactions) have the greatest influence on child outcomes. In this review the authors discuss how these proximal factors work in combination with a host of personal and extrafamilial variables in ways that are linked to child social/communicative competence with peers. In addition to explaining possible mechanisms responsible for linkages within and between model components, the authors recommend directions for future research in areas of the framework that have weak empirical support.

Childhood obesity: Prevention practices of nurse practitioners

Purpose: The purposes or this study were to (a) describe the prevention practices of nurse practitioners (NPs) regarding childhood obesity, (b) compare the practices of NPs by specialty, practice setting, and awareness of childhood obesity prevention guidelines, (c) identify relationships between prevention practices and demographic variables of NPs, and (d) examine the resources for and barriers to implementing prevention practices. Data sources: A convenience sample of 99 family NPs (FNPs) and pediatric NPs (PNPs) from the Intermountain area was used. Participants completed a questionnaire based on documented risk factors for childhood obesity as well as prevention guidelines developed by the American Academy of Pediatrics (AAP). Conclusions: NPs working in family practice or general pediatric practice settings were not consistently using the BMI‐for‐age index to screen for childhood obesity, as recommended by the AAP. However, they were teaching parents to promote healthy food choices and physical activity in their families. PNPs and FNPs working in a pediatric practice setting and NPs who were aware of prevention guidelines were more likely to perform several prevention strategies than FNPs working in a family practice setting and those who were unaware of guidelines. Major barriers to implementing childhood obesity prevention strategies included parental attitudes, the American lifestyle, and lack of resources for both the NP and the family. The main resources NPs used in preventing childhood obesity were a dietician, journal articles, and Web sites. Implications for practice: Although the majority of the NPs in this study reported being aware of childhood obesity prevention guidelines (73.7%), most were not consistently using BMI for age or monitoring children at increased risk for obesity. Because childhood obesity is escalating at such a rapid rate, it is critical that NPs working in family practice and pediatric practice settings take the necessary steps to help curtail obesity in childhood, including calculating BMI for age, targeting children at risk, and helping families develop healthy nutrition and physical activity habits. In addition to proper health supervision of children, NPs also need to be advocates in their communities to overcome barriers to childhood obesity prevention.

“This Is a Spiritual Experience”: Perspectives of Latter-Day Saint Families Living With a Child With Disabilities

The presence of a child with disabilities elicits a variety of stress demands on the family. Religion is recognized as a powerful personal, family, and cultural variable. However, little is known about the influence of religion in dealing with disability among families within particular religious groups. This descriptive study explored themes of spiritual belief and religious support among families of the Church of Jesus Christ of Latter-Day Saints (LDS, or Mormon) with a child with developmental disabilities. Parents shared perspectives of meaning that emerged from experiences with religion and family beliefs perceived to be unique. The core theme, “This is a Spiritual Experience,” provides the foundation for a descriptive model that depicts aspects of finding meaning and perceived transcendence.

Daily stressors and coping responses of children and adolescents with type 1 diabetes.

BACKGROUND Youth with type 1 diabetes cope with a variety of stressors related to daily life and disease management. While previous studies have focused on diabetes-related stressors, little research has examined daily stressors. METHODS In this qualitative descriptive study, daily stressors and coping responses of 19 children and 33 adolescents with type 1 diabetes (65% are female) were investigated. Participants recorded their own stressors and coping responses in daily diaries for 2-3 weeks. RESULTS Five broad themes of daily stressors emerged: people, self, context, no stressor and ambiguous. Coping responses included three general themes: submission, personal responsibility and ambiguous. Younger children reported more stressors related to friends/peers and siblings (people), and adolescents described more stressors related to self, parents (people) and school (context). Younger children used more coping that involved choosing an alternate activity, helping others and an emotional response (taking personal responsibility), whereas adolescents used more coping that involved persistence, alternate thinking and talking things over (taking personal responsibility). CONCLUSIONS Youth with diabetes did not report stressors related to diabetes and its management as major themes in their daily lives. Clinical interventions based on perceptions of how youth understand and cope with stress are explored.

Positive parenting of children with developmental disabilities: A meta-analysis

Although a large body of literature exists supporting the relationship between positive parenting and child outcomes for typically developing children, there are reasons to analyze separately the relevant literature specific to children with developmental disabilities. However, that literature has not been synthesized in any systematic review. This study examined the association between positive parenting attributes and outcomes of young children with developmental disabilities through meta-analytic aggregation of effect sizes across 14 studies including 576 participants. The random effects weighted average effect size was r=.22 (SE=.06, p<.001), indicative of a moderate association between positive parenting attributes and child outcomes. Publication bias did not appear to be a substantial threat to the results. There was a trend for studies with more mature parents to have effect sizes of higher magnitude than studies with young parents. The results provide support for efforts to evaluate and promote effective parenting skills when providing services for young children with disabilities.

Type 1 diabetes: children and adolescents’ knowledge and questions

AIM This paper is a report of a study conducted to describe what children and adolescents who have type 1 diabetes know and want to know about the disease. BACKGROUND Research indicates that young peoples knowledge of diabetes may minimize their health complications, because with greater knowledge they may engage in more effective management practices and adherence. METHODS In this qualitative study, a purposive sample of 58 children and adolescents with type 1 diabetes were interviewed in 2005 about what they knew and wanted to know about their disease. Through a process of induction, major themes were identified from the data. FINDINGS The six major themes were: (a) Care, including both physical and emotional care, (b) Physiology, (c) Consequences, including both short- and long-term, as well as positive and negative consequences, (d) Cure, (e) Effects on the Family and (f) Experience at Diagnosis. Themes related to the unique challenges associated with type 1 diabetes were also identified. CONCLUSION Nurses, diabetes educators and parents should provide developmentally appropriate information about diabetes care and management, scaffolding on existing knowledge. They should provide child-centred contexts in which children and adolescents can freely ask questions about their condition and problem-solve. Programmes that allow young people to develop coping skills and share experiences could also prove beneficial.

Support, Communication, and Hardiness in Families With Children With Disabilities

The purpose of this study was to examine how support and communication are related to hardiness in families who have young children with disabilities. A sample of 108 parents (54 couples) of preschool-age children with disabilities completed the measures. Among demographic variables, family income was positively correlated with family hardiness. Hierarchical regression analyses revealed perceived family support as a predictor of family hardiness for both parents. Incendiary communication was negatively related to family hardiness for mothers, whereas income was positively associated with fathers’ assessments of hardiness. Results provide family nurses with a foundation for exploring constructs important to help families with children with disabilities.

Metabolic Control, Self-care Behaviors, and Parenting in Adolescents With Type 1 Diabetes A Correlational Study

Purpose The purpose of this pilot study was to explore relationships among metabolic control, self-care behaviors, and parenting in adolescents with type 1 diabetes. Methods Twenty-nine adolescents (mean age, 14.1 years) and their parents participated. Metabolic control was determined by an average of 4 A1C values taken prior to study enrollment; self-care behaviors were measured with a 12-item self-report questionnaire; parenting style was evaluated using the Parenting Practices Report. Results The mean for A1C values was 8.5%; the mean for overall self-care behaviors was 4.93 (5 = usually). Participants rated themselves highest on the self-care behaviors of giving insulin shots when indicated and adjusting insulin when eating a lot. They ranked themselves lowest on eating a low-fat diet and testing urine for ketones. Parents tended to be more authoritative in their approaches to parenting than either authoritarian or permissive. A significant relationship was found between authoritative mothering and adolescent self-care behaviors and metabolic control. Regression analyses controlling for age and length of time with diabetes confirmed the significance of these relationships. Authoritative fathering positively correlated with the self-care behaviors of monitoring blood glucose, taking insulin, and not skipping meals. A relationship was also noted between permissive parenting by mothers/fathers and poorer metabolic outcomes. However, the permissive parenting correlations did not remain significant when controlling for age and length of time with diabetes. Conclusions Clinicians may help prevent declining participation in self-care behaviors and metabolic control in adolescents with type 1 diabetes by working with parents, particularly mothers, and encouraging authoritative parenting.

Parental perceptions of sibling relationships in families rearing a child with a chronic condition.

This study examined sibling relationships in families raising children with autism, Down syndrome, orthopedic conditions, and diabetes. Parents from 108 families independently completed the 28-item Schaefer Sibling Inventory of Behavior. Parents rated siblings as very empathetic, fairly often kind and involved, and rarely avoidant. Mothers rated sibling empathy higher than fathers did and older siblings more avoidant than younger siblings. Fathers rated male siblings kinder than female siblings; they also rated siblings of children with Down syndrome or autism more kind and involved than siblings of children with orthopedic conditions or diabetes. Sibling intervention efforts should consider these findings and be individualized according to the need of each child and family.