Carol Dashiff

Parent–adolescent communication and diabetes: an integrative review

AIM This paper presents a synthesis of findings from empirical studies about communication and interaction between parents and their adolescents with diabetes. BACKGROUND Communication between parent and adolescent is essential in transitioning the adolescent to increased responsibility for diabetes self-management. Nurses are in a pivotal position to enhance the type of parent-adolescent communication that facilitates this transition. DATA SOURCES A search of published studies from 1985 to 2006 featuring communication or interaction between parents and adolescents with type 1 diabetes was implemented through a computerized search. REVIEW METHODS Papers were organized by type of evidence and were analysed sequentially. Sources were described based on data elements which were extracted. Findings in the areas of productive and problematic parent-adolescent communications were included. Data elements were compared and critiqued, noting consistencies, and findings were summarized and evaluated. RESULTS Studies across several countries indicate that maternal support, conflict, control, involvement and emotional expression are important communication concepts that are linked to diabetes outcomes in adolescents. The influences of different family structures and cultural and socioeconomic circumstances, as well as developmental status and gender of adolescents on these types of communication, have not been systematically studied. CONCLUSION Nurses caring for adolescents with type 1 diabetes need to consider family relationships and communication patterns in achieving health outcomes. Studies of communication, including perspectives of mothers and fathers, and the influence of family structure, economics and culture are needed to build a framework of parent-adolescent interaction and health outcomes for adolescents with type 1 diabetes.

Poverty and Adolescent Mental Health

PROBLEM Poverty and accelerations of inequality, manifested by the increasing difference between the richest and poorest populations, have significant effects on the mental health of vulnerable groups. Adolescents are vulnerable to the effects of poverty. As a time of change and transition for youth and their families, adolescence creates both challenges and opportunities to intervene in the effects of poverty. PURPOSE The purpose of this article is to discuss the significance of poverty and its impact on adolescent mental health and mental health services. SOURCES An interdisciplinary literature search was conducted on the topic of poverty and adolescent mental health. CONCLUSIONS Results indicated that nurses need to remain active participants in the provision of mental health services to adolescents in poverty and increase their advocacy for the creation of policy changes that address mental health needs of this population.

Relações entre modelos de pais e comportamentos de risco na saúde do adolescente: uma revisão integrativa da literatura

Pesquisas realizadas durante os ultimos 20 anos sugerem que a qualidade da relacao entre pais e adolescentes tem obtido impacto significante no desenvolvimento de comportamentos de risco a saude dos adolescentes. A finalidade deste estudo e apresentar uma revisao bibliografica de estudos publicados entre o ano de 1996 e 2007, que analisam relacoes especificas entre modelos de pais e seis principais comportamentos de risco em adolescentes. Os adolescentes crescidos sob disciplina autoritaria demonstraram consistentemente mais comportamentos seguros e menos comportamentos de risco comparados a adolescentes vindos de familias nao autoritarias. O modelo dos pais e comportamentos relacionados a afetividade, comunicacao familiar e praticas disciplinares, predizem importantes mediadores na formacao do adolescente, incluindo o desenvolvimento academico e o ajuste psico-social. Avaliacoes cuidadosas de modelos padroes de pais em diversas populacoes, sera uma proxima etapa critica no desenvolvimento de intervencoes eficazes e culturalmente adaptadas, na promocao de saude a adolescentes.Research over the past 20 years suggests that the quality of the parent-adolescent relationship significantly affects the development of risk behaviors in adolescent health. The purpose of this paper is to present a review of studies published between 1996-2007 that address specific relationships between parenting styles and six priority adolescent risk behaviors. The review supports the substantial influence of parenting style on adolescent development. Adolescents raised in authoritative households consistently demonstrate higher protective and fewer risk behaviors than adolescents from non-authoritative families. There is also considerable evidence to show that parenting styles and behaviors related to warmth, communication and disciplinary practices predict important mediators, including academic achievement and psychosocial adjustment. Careful examination of parenting style patterns in diverse populations, particularly with respect to physical activity and unintentional injury, will be a critical next step in the development of efficacious, culturally tailored adolescent health promotion interventions.Research over the past 20 years suggests that the quality of the parent-adolescent relationship significantly affects the development of risk behaviors in adolescent health. The purpose of this paper is to present a review of studies published between 1996-2007 that address specific relationships between parenting styles and six priority adolescent risk behaviors. The review supports the substantial influence of parenting style on adolescent development. Adolescents raised in authoritative households consistently demonstrate higher protective and fewer risk behaviors than adolescents from non-authoritative families. There is also considerable evidence to show that parenting styles and behaviors related to warmth, communication and disciplinary practices predict important mediators, including academic achievement and psychosocial adjustment. Careful examination of parenting style patterns in diverse populations, particularly with respect to physical activity and unintentional injury, will be a critical next step in the development of efficacious, culturally tailored adolescent health promotion interventions.

Development and testing of a scale to measure separation anxiety of parents of adolescents.

Separation anxiety as an experience of parents of adolescents remains underinvestigated. The purpose of this study was to develop an instrument to assess parental separation anxiety of mothers and fathers of adolescent sons and daughters, that is, the Parental Separation Anxiety Scale (PSAS). The Maternal Separation Anxiety Scale was adapted to address this purpose. Three studies were conducted to assess item performance, internal consistency and test–retest reliability, and construct and predictive validity. Internal consistency reliability ranged from 0.91 to 0.93 across samples. Factor analysis indicated four factors with a primary factor (70% of variance) that was consistent with attachment theory. Parental separation anxiety was negatively associated with global relationship quality (r = –0.23, p = .01). Maternal separation anxiety was negatively associated with cognitive autonomy of sons (r = –0.34, p = .05), while paternal separation anxiety was positively associated with cognitive autonomy of daughters (r = 0.20, p = .05). It was concluded that the final 18-item PSAS has good psychometric qualities and is appropriate for use with parents of chronically ill and healthy adolescents.

Family stress, family adaptation, and psychological well-being of elderly coronary artery bypass grafting patients.

As our population ages, more elderly patients will undergo coronary artery bypass grafting. The psychological well-being of a patient is influenced by many factors, including family support. This descriptive, correlational pilot study was conducted to examine the relationship between family characteristics and psychological well-being in elderly coronary artery bypass grafting patients. The results of this study, which consists of 42 participants, are presented, as well as implications for critical care nursing.