The Long-Term Effects of Living in a Shared and Continuous Traumatic Reality: The Case of Israeli Families on the Border With Gaza

This article presents a literature review of the concept of intergenerational transmission of traumatic stress among a specific population of Israeli parents and children living near the Israeli/Gaza border, an area that can essentially be viewed as a laboratory of shared, continuous, and stressful reality resulting from ongoing political violence. The Google Scholar database was used to search only for peer-reviewed articles written in English and published between 2002 and 2020, and the particular focus of the study was Israeli families living in the “Gaza envelope”: communities that have been on the receiving end of rockets and mortars from Gaza for the past 20 years. The review was based on 35 articles and sheds light on the existence of studies using a variety of perspectives (e.g., psychological, biopsychosocial, and behavioral). Findings demonstrate the effects of continuous stress situations on the family dynamic, even before birth, among this small population. In addition, they show that to understand the unique process of intergenerational trauma transmission in a shared continuous traumatic reality, it is important to adopt a comprehensive perspective so as to understand the reciprocal, long-lasting, and transgenerational effects of being exposed to traumatic stress. This perspective can be used as a basis for developing family intervention strategies that are appropriate for preventing stress outcomes that derive from living in the context of persistent violence.

The Effects of Service Coordination on Disadvantaged Parents’ Participation in Activation Programs and Employment: A Randomized Controlled Trial

Purpose This randomized controlled study evaluates the effects of coordinated follow-up within a family intervention project on parents’ participation in activation programs and employment. The trial has been registered on Clinicaltrials.gov (Identifier: NCT03102775). Methods Of 2634 families, 1429 families were randomized to be offered follow-up by a family coordinator, while 1205 families participated in ordinary follow-up without a family coordinator. An analysis of longitudinal administrative data was performed to estimate the effects of the intervention on parents’ participation in activation programs and employment by comparing the two follow-up methods. Results Based on fixed effects logistic models, the follow-up with a family coordinator is associated with non-significant effects on participation in activation programs (OR = 1.05, 95% CI [0.81, 1.37]) and employment (OR = 1.11, 95% CI [0.67, 1.82]). Discussion The results provide no significant evidence on the effectiveness of coordination efforts for disadvantaged families on activation and employment.

Through COVID-19 and beyond: developing a multidisciplinary telehealth family intervention in first episode psychosis

The COVID-19 pandemic presents unique challenges to high quality, safe Early Intervention in Psychosis (EIP) service provision. Due to the necessity to ensure EIP continues despite this, we developed a multidisciplinary, blended, telehealth intervention, incorporating psychoeducation and peer support, for family members of first episode psychosis service users: PERCEPTION. This perspective article aims to: describe PERCEPTION; offer reflections on our experience of delivering it; make recommendations for future research; and synthesise key learning to assist the integration of similar interventions in other EIP services. We provide a descriptive account of PERCEPTION’s development and implementation, with reflections from the clinicians involved, on supporting families using this approach. We experienced telehealth as patient-focused, safe, and efficient and believe the intervention’s blended nature augmented families’ engagement. The approach adopted can assist service providers to attain balance between protecting public health and offering a meaningful, therapeutic intervention to support families in the current epoch.

Neurocognitive Disorders

This chapter discusses the prevalence, characteristics, risk factors, assessment, management, and short- and long-term neurologic outcomes for survivors of critical illness and critically ill survivors of COVID-19 including neurocognitive disorders with an emphasis on the role of delirium. The psychologist’s role in caring for survivors of critical illness is discussed along with coverage of integrative concepts that require collaboration between members of the interdisciplinary team. Interventions to improve outcomes are reviewed, including environmental management, tracking mental status, pharmacologic intervention, family intervention, and support and rehabilitation interventions are also reviewed. The chapter also discusses future goals and research to improve outcomes following critical illness.

Culturally Adapted Family Intervention for People With Schizophrenia in Indonesia (FUSION): A Development and Feasibility Study Protocol

Background Mental illnesses comprise the single largest source of health-related economic burden globally and low-and middle-income countries are disproportionately affected. The majority of people with schizophrenia who need treatment do not receive it and are often wholly reliant on family caregivers for daily care and support. Family interventions have an exceptionally robust evidence base for their efficacy in high resource settings, but it is unknown whether they can produce equivalent effects in some low resource settings where cultural beliefs, explanatory models of illness and contextual socio-economic issues differ. Methods This protocol describes methods to culturally adapt and refine an evidence-based, family intervention for relatives and caregivers of people with schizophrenia in Indonesia. The feasibility and acceptability of implementing an adapted, co-produced intervention via task-shifting in primary care settings will be evaluated using the Medical Research Council framework for complex interventions. The development and preliminary testing of the adapted intervention will occur in three phases utilising mixed methods; stakeholder and key informant interviews will inform consensus workshops using nominal group techniques to develop a testable intervention. The feasibility of testing the intervention in a larger trial and the acceptability of the intervention will be explored in a feasibility trial of adapted family interventions compared to standard treatment. Participants in Phase 1 consultation groups will comprise service-users (n = 10-15), carers (n=10-15) and key stakeholders including lay and healthcare workers (n=10-15) and semi-structured interviews with key informants to identify implementation challenges and facilitators (n= 10). Phase 2 participants will include expert stakeholders including experts by experience to achieve consensus on the essential elements of the intervention (n = 20) and a separate group to develop training methods and materials for our task-shifted intervention. Phase 3 will comprise 60 carer-service-user dyads participating in a randomised feasibility trial. Discussion National healthcare policy in Indonesia supports the delivery of mental health services in a complex network of primary care centres. This study will provide important information on the feasibility of delivering family interventions for people with schizophrenia via task-shifting in primary care settings in Indonesia.

Application Effect of Medical Care Integration Combined with Family Intervention under the Evidence-Based Nursing Mode on Child Patients with Severe Hand-Foot-Mouth Disease and Its Influence on Intestinal Function

Objective. To explore the application effect of medical care integration combined with family intervention under the evidence-based nursing mode on child patients with severe hand-foot-mouth disease (HFMD) and its influence on intestinal function. Methods. 120 child patients with severe HFMD admitted to Qilu Children’s Hospital of Shandong University from January 2019 to January 2020 were selected as the research object and randomly divided into group A and group B, with 60 cases each. Conventional nursing was performed on patients in group B, and medical care integration combined with family intervention under the evidence-based nursing mode was performed on patients in group A. Patients were assessed after the intervention using the hospital-made treatment adherence scale, PedsQLTM 4.0 (Pediatric Quality of Life Inventory Version 4.0) scale, and the faces pain scale-revised (FPS-R). The levels of gastrointestinal function indicators such as serum endotoxin (ET), diamine oxidase (DAO), and d-lactic acid (D-LA) were measured before and after the intervention, and recovery such as time to clear fever and time to relief of oral pain were recorded in both groups. Results. Children in group A had significantly higher compliance in diet, behaviour, exercise, and medication than group B ( P < 0.05 ); the time to clear fever, time to relief of oral pain, time to healing of oral ulcers, time to relief of skin herpes, time to hospitalization, and time to eating were shorter in group A than those in group B ( P < 0.001 ); all scores on the PedsQLTM 4.0 scale were higher in group A than those in group B after the intervention ( P < 0.001 ); ET, DAO, and D-LA levels decreased in both groups after the intervention, with group A having lower levels than group B ( P < 0.001 ), in addition, group A had lower eating pain scores after the intervention ( P < 0.05 ). Conclusion. Medical care integration combined with family intervention under the evidence-based nursing mode can effectively improve the treatment compliance of child patients with severe HFMD, accelerate their recovery progress, ensure a better prognostic quality of life and gastrointestinal tract function, and reduce the eating pain, indicating that such comprehensive nursing intervention mode should be promoted in practice.