Income support for parents of children with chronic conditions and disability: where do we draw the line? A policy review

2021 ◽  
pp. archdischild-2021-322663
Author(s):  
Clara Chua ◽  
Claudia Bull ◽  
Emily Joy Callander
Keyword(s):  
Chronic Conditions ◽  
Chronic Condition ◽  
Information Source ◽  
Eligibility Criteria ◽  
Welfare Policies ◽  
Group Of Seven ◽  
Policy Review ◽  
Paid Employment ◽  
The Usa ◽  
Children With Chronic Conditions

ObjectiveThe aim of this review was to identify and describe whether parents who have had to stop paid employment to care for a child with a chronic condition or disability are eligible for unemployment, family and children, and disability and carer government-provided financial benefits.DesignPolicy review.SettingGroup of seven high-income countries.Main outcome measuresAll policies related to unemployment, family and children, and disability and carer benefits were included. Information regarding the policy type and description, parent/carer qualification, amount of financial support payable, eligibility criteria and information source were extracted. Payment schedules were converted into 2020 US dollars, using Purchasing Power Parities. Maximum monthly benefit payments were compared with standardised per capita monthly costs of living to determine payment support suitability.ResultsFifty-eight policies relevant to unemployment, family and children, and disability and carer benefit supports were identified. Germany had the highest number of welfare policies for individuals not in employment (n=11), followed by the USA (n=6). Parents or carers of children with chronic conditions or disability who were not in employment qualified for 31 of the 58 policies (53.4%). Most policies required a child to have an impaired ability to function, not just a chronic condition or disability.ConclusionsGreater support for parents and carers to continue their paid employment alongside caring responsibilities is necessary. Graded benefit schedules will also be critical to supporting the spectrum of childhood chronic conditions and disability, and the subsequent spectrum of caring responsibility.

scholarly journals Scoring interventions in family relations regarding the care for the child with a chronic condition

2015 ◽  
Vol 24 (1) ◽  
pp. 87-95 ◽  
Author(s):  
Daniele Castro Barbosa ◽  
Francisca Georgina Macedo de Sousa ◽  
Joséte Luzia Leite
Keyword(s):  
Chronic Conditions ◽  
Chronic Condition ◽  
Family Relations ◽  
Family Members ◽  
Structured Interviews ◽  
Family Experiences ◽  
The Family ◽  
Complex Thought ◽  
Children With Chronic Conditions

The study aimed to reveal intervening conditions towards the care of children with chronic condition. The Complex Thought was used as theoretical framework and the Grounded Theory as methodological. Data were collected from January to August 2012, through semi-structured interviews in two follow-up services for children with chronic conditions and in the homes of participants. Participated 16 relatives of children with chronic conditions, divided into three sample groups. The category "Scoring the intervening conditions towards care of the child with chronic condition" reveals that multiple events experienced by the family in the care of children with chronic conditions are determined by the relationships and interactions of family members and influence the forms of organization for the care of child. Highlights the importance of the nurse to know and understand the multiple family experiences in order to encompass child and their family members as care units.

scholarly journals High Levels of Stress Due to the SARS-CoV-2 Pandemic among Parents of Children with and without Chronic Conditions across the USA

Children ◽  
2020 ◽  
Vol 7 (10) ◽  
pp. 193
Author(s):  
Miranda A.L. van Tilburg ◽  
Emily Edlynn ◽  
Marina Maddaloni ◽  
Klaas van Kempen ◽  
Maria Díaz-González de Ferris ◽  
...  
Keyword(s):  
Mental Health ◽  
Marital Satisfaction ◽  
Parental Stress ◽  
Chronic Conditions ◽  
Healthy Children ◽  
Satisfaction Scale ◽  
Stress Scale ◽  
Child Schooling ◽  
The Usa ◽  
Children With Chronic Conditions

Background: The 2020 SARS-CoV-2 pandemic led to community-wide measures affecting parents and children such as school/daycare closures, job losses, and interruptions in medical care for children with chronic diseases. This is the first study to describe the level of stress and mental health of parents of either healthy children or children with chronic conditions, during the 2020 pandemic. Methods: A representative sample of US parents was recruited from 10–17 April 2020. Parents completed online questionnaires about the past 7 days, including the Perceived Stress Scale, Resilient Coping Scale, Self-Efficacy Scale, Kansas Marital Satisfaction Scale, Parental Stress Scale, PROMIS Anxiety and Depression scales and various other pandemic-related stress questions Results: Levels of stressors (e.g., job loss, school closures, etc.) were high during this time (e.g., 79% of children attended home/online school) and parents reported being moderately to highly stressed. Rates of clinical anxiety (44.6%) and depression (42.2%) were high. Parents of children with chronic conditions reported higher levels of stress and worse mental health, but did not differ from other parents in dealing with stress or interruptions in work, child schooling, and marital satisfaction. Discussion: The COVID-19 pandemic has introduced unprecedented levels of stress for parents, especially those of children with chronic conditions. Mental health effects are expected to continue for months/years and preparation is needed to meet an increasing demand for mental health care.

scholarly journals Extent of Exclusions for Chronic Conditions in Breast Cancer Trials

2018 ◽  
Vol 2 (4) ◽  
Author(s):  
Ian M Kronish ◽  
Kathleen Fenn ◽  
Laura Cohen ◽  
Dawn L Hershman ◽  
Paige Green ◽  
...  
Keyword(s):  
Breast Cancer ◽  
National Cancer Institute ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Randomized Clinical Trials ◽  
Performance Status ◽  
Phase Iii ◽  
Test Case ◽  
Eligibility Criteria ◽  
Cancer Trials

Abstract Experts have expressed concerns that patients with chronic conditions are being excessively excluded from cancer randomized clinical trials (RCTs), limiting generalizability. Accordingly, we queried clinicaltrials.gov to determine the extent to which patients with chronic conditions were excluded from phase III cancer trials, using National Cancer Institute-sponsored breast cancer RCTs as a test case. Two physicians independently coded for the presence of 19 prevalent chronic conditions within eligibility criteria. They also coded for exclusions based on performance status and vague criteria that could have broadly excluded patients with chronic conditions. The search identified 58 RCTs, initiated from 1993 to 2012. Overall, 88% of trials had at least one exclusion for a chronic condition, performance status, or vague criterion. The three most commonly excluded conditions were chronic kidney disease, heart failure, and ischemic heart disease. Our study demonstrated that patients with prevalent chronic conditions were commonly excluded from National Cancer Institute-sponsored RCTs.

scholarly journals Swāsthya, an integrated chronic condition management programme for families of patients with hypertension and diabetes mellitus: a study protocol for a randomised controlled trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
M D Saju ◽  
Bindiya M Varghese ◽  
Lorane Scaria ◽  
Anuja Maria Benny ◽  
Shilpa V Yohannan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Randomised Controlled Trial ◽  
Social Cohesion ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Controlled Trial ◽  
Risk Groups ◽  
Care Model ◽  
Randomised Controlled

Abstract Background Kerala is known as the diabetes mellitus (DM) and hypertension (HTN) capital of the world, thus compelling health professionals to model strategies, addressing their social, behavioural, and cognitive risk factors and eliminating various barriers to management. This paper describes the protocol of our study that aims to examine the effectiveness and sustainability of an integrated care model for the management of chronic conditions and their risk factors through a family-based intervention. The proposed care model targets to modify systems and processes that predispose to chronic conditions by enhancing social cohesion and social networks, preventing lifestyle risks, developing iterative cognitive interventions, and engaging the family into customised treatment adherence strategies navigated by community health social workers (CHSWs). Methods A cluster randomised controlled trial (RCT) in selected participants will be conducted involving additional assessments prior to the baseline assessment. The assessment will identify and categorise patients into four risk groups, namely behavioural, social, cognitive, and multiple, based on dominant risks identified. Eligible participants will be randomly allocated (at a ratio of 1:1) into the intervention or control arm. The intervention arm will receive social, behavioural, and cognitive or multiple interventions corresponding to the identified risk groups, whereas the control arm will receive general intervention. Both the groups will be followed up at 6 months and 12 months post baseline to measure outcomes. The primary outcome will be the control of HTN and DM, and secondary outcomes include decreased depression and anxiety and improved functioning, social cohesion, and social network linkages. The sustainability and scalability of this intervention will be assessed through cost effectiveness, acceptability, and user friendliness of the integrated approach by performing a qualitative evaluation. Discussion This RCT will inform the potential paradigm shift from a medical model of chronic condition management to a multidimensional, multisystem, and multidisciplinary convergence model navigated by CHSWs. Such a model is not currently considered in the management of chronic conditions in Kerala. Trial registration Trial has been prospectively registered on Clinical Trial Registry of India- CTRI/2020/12/029474 on 1st December 2020.

scholarly journals Disease-related disability burden: a comparison of seven chronic conditions in middle-aged and older adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chieh-Ying Chou ◽  
Ching-Ju Chiu ◽  
Chia-Ming Chang ◽  
Chih-Hsing Wu ◽  
Feng-Hwa Lu ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Disability ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Disease Diagnosis ◽  
Rate Of Change ◽  
Middle Aged ◽  
Rates Of Change ◽  
Depression Status ◽  
Stage Disease

Abstract Background Although previous studies have explored the effect of chronic conditions on physical disability, little is known about the levels and rates of change in physical disability after a chronic condition diagnosis in middle-aged and older adults in the Asian population. The aim of this study is to ascertain the average levels and rates of change in the development of disability after disease diagnosis, as well as to determine the influences of sociodemographic and health-related correlates in the development of disability. Methods This is a retrospective cohort study analyzing data of nationally representative participants aged 50 and over with a chronic condition or having developed one during follow-ups based on data from the 1996–2011 Taiwan Longitudinal Study on Aging (TLSA) (n = 5131). Seven chronic conditions were examined. Covariates included age at initial diagnosis, gender, education level, number of comorbidities, and depression status. Physical disability was measured by combining self-reported ADL, IADL, and strength and mobility activities with 17 total possible points, further analyzed with multilevel modeling. Results The results showed that (1) physical disability was highest for stroke, followed by cancer and diabetes at the time of the initial disease diagnosis. (2) The linear rate of change was highest for stroke, followed by lung disease and heart disease, indicating that these diseases led to higher steady increases in physical disability after the disease diagnosis. (3) The quadratic rate of change was highest in diabetes, followed by cancer and hypertension, indicating that these diseases had led to higher increments of physical disability in later stage disease. After controlling for sociodemographic and comorbidity, depression status accounted for 39.9–73.6% and 37.9–100% of the variances in the physical disability intercept and change over time, respectively. Conclusions Despite the fact that a comparison across conditions was not statistically tested, an accelerated increase in physical disabilities was found as chronic conditions progressed. While stroke and cancer lead to disability immediately, conditions such as diabetes, cancer, and hypertension give rise to higher increments of physical disability in later stage disease. Mitigating depressive symptoms may be beneficial in terms of preventing disability development in this population.

scholarly journals Gender disparity between authors in leading medical journals during the COVID-19 pandemic: a cross-sectional review

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e051224
Author(s):  
Vaidehi Misra ◽  
Frozan Safi ◽  
Kathryn A Brewerton ◽  
Wei Wu ◽  
Robin Mason ◽  
...  
Keyword(s):  
Data Extraction ◽  
Gender Disparity ◽  
High Impact ◽  
Original Research ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Medical Journals ◽  
The Usa ◽  
Study Characteristics ◽  
Data Elements

ObjectivesEvaluate gender differences in authorship of COVID-19 articles in high-impact medical journals compared with other topics.DesignCross-sectional review.Data sourcesMedline database.Eligibility criteriaArticles published from 1 January to 31 December 2020 in the seven leading general medical journals by impact factor. Article types included primary research, reviews, editorials and commentaries.Data extractionKey data elements were whether the study topic was related to COVID-19 and names of the principal and the senior authors. A hierarchical approach was used to determine the likely gender of authors. Logistic regression assessed the association of study characteristics, including COVID-19 status, with authors’ likely gender; this was quantified using adjusted ORs (aORs).ResultsWe included 2252 articles, of which 748 (33.2%) were COVID-19-related and 1504 (66.8%) covered other topics. A likely gender was determined for 2138 (94.9%) principal authors and 1890 (83.9%) senior authors. Men were significantly more likely to be both principal (1364 men; 63.8%) and senior (1332 men; 70.5%) authors. COVID-19-related articles were not associated with the odds of men being principal (aOR 0.99; 95% CI 0.81 to 1.21; p=0.89) or senior authors (aOR 0.96; 95% CI 0.78 to 1.19; p=0.71) relative to other topics. Articles with men as senior authors were more likely to have men as principal authors (aOR 1.49; 95% CI 1.21 to 1.83; p<0.001). Men were more likely to author articles reporting original research and those with corresponding authors based outside the USA and Europe.ConclusionsWomen were substantially under-represented as authors among articles in leading medical journals; this was not significantly different for COVID-19-related articles. Study limitations include potential for misclassification bias due to the name-based analysis. Results suggest that barriers to women’s authorship in high-impact journals during COVID-19 are not significantly larger than barriers that preceded the pandemic and that are likely to continue beyond it.PROSPERO registration numberCRD42020186702.

Neighbourhood effects in cross-Atlantic perspective: A longitudinal analysis of impacts on intergenerational mobility in the USA and Germany

Urban Studies ◽  
2018 ◽  
Vol 56 (2) ◽  
pp. 434-451 ◽  
Author(s):  
Junia Howell
Keyword(s):  
Social Welfare ◽  
Housing Market ◽  
Longitudinal Analysis ◽  
Intergenerational Mobility ◽  
Neighbourhood Effects ◽  
Welfare Policies ◽  
Policy Interventions ◽  
The Us ◽  
The Usa ◽  
Cross National

Research in the USA provides evidence that neighbourhood conditions affect intergenerational mobility. However, what remains unclear is the extent to which the US context is unique in producing this influence. To examine this question, the present study directly compares neighbourhood effects on intergenerational mobility in the USA versus those in Germany – a country whose housing market and social welfare policies differ significantly from those in the USA. Results provide a blueprint for conducting cross-national neighbourhood effects studies and illuminate how the nature and severity of neighbourhood effects are nationally specific. These findings underscore the importance of considering how broader political contexts shape neighbourhood effects on intergenerational mobility – a consideration that has implications for proposed policy interventions.

scholarly journals Medication understanding and health literacy among patients with multiple chronic conditions: a study conducted in Bangladesh

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Fahad Imtiaz Rahman ◽  
Farina Aziz ◽  
Sumaiya Huque ◽  
Sadia Afruz Ether
Keyword(s):  
Health Literacy ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Healthcare Providers ◽  
Poor Health ◽  
Multiple Chronic Conditions ◽  
Multiple Chronic Condition ◽  
Convenience Sample ◽  
Individual Interviews ◽  
Reduce Medication Error

Objectives: Medication understanding is critical for patients who suffer from multiple chronic conditions in order to reduce medication error and is often associated with poor health outcomesand low adherence. This study aims to identify the gap of medication knowledge among multiple chronic condition patients in Bangladesh, in order to aid physicians and other healthcare providers in improving health literacy.Methods: Individual interviews of a convenience sample of multiple chronic condition patients in Bangladesh were heldwhere they were asked a number of questions for assessing medication related literacy.Results: More than 26% patients failed to cite the brand name of all their prescribed medications while the rate of patients not knowing the generic names was far worse (88.1%). Nearly 1 out of every 4 patients did not know the purpose of all their medications and more than half of the participants (55%) did not know the strengths of their drugs. While knowledge about medication routes and regimen was satisfactory, awareness regarding risk factors of medicine was lowest of all. Only 1 out of every 4 patients had a habit of reading drug information leaflet. Patient’s ability to correctly state the purpose of their medication seemed to be positively associated with age (p=0.004) and negatively associated with number of medicines taken (p=0.03).Conclusions: Many patients demonstrated poor health literacy regarding medication. Routine review of medications from physician or health provider can significantly improve their health literacy, leading to better treatment outcome and medication adherence.

Sign in / Sign up

Export Citation Format

Share Document