Good intentions gone awry: Assessing parental "miscarried helping" in diabetes.

Harris, Michael A.; Antal, Holly; Oelbaum, Rhea; Buckloh, Lisa M.; White, Neil H.; Wysocki, Tim

doi:10.1037/a0014232

Cited by 41 publications

(42 citation statements)

References 29 publications

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“…25 Conversely, conflictual family relationships can disrupt children's treatment adherence. 41 One such pattern of conflict, defined as miscarried helping, is characterized by parents' well-intentioned attempts to help their children manage their chronic illness treatment that are perceived by children as intrusive. Over time, such interactional patterns can cause increasing tension and conflict in parent-child relationships that interfere with adaptive family communication and problem solving and eventually disrupt treatment adherence.…”

Section: Refining the Model Of Influences On Adherence To Pediatric Amentioning

confidence: 99%

Influences on Adherence to Pediatric Asthma Treatment: A Review of Correlates and Predictors

Drotar

Bonner

2009

Journal of Developmental &Amp; Behavioral Pediatrics

144

141

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Nonadherence to treatment is an important influence on the health outcomes of children and adolescents with pediatric asthma, which is the most prevalent childhood chronic illness. Because the factors that influence treatment adherence for pediatric asthma are not well understood, a comprehensive review of relevant research is needed. To address this need, research concerning the correlates and predictors of adherence to inhaled corticosteroid treatment for pediatric asthma was reviewed. Significant predictors and correlates of treatment adherence identified in this review were consistent with a conceptual model that included family demographic characteristics and functioning, parent and child characteristics, health care system and provider characteristics, and child health outcomes. Family functioning and parental beliefs about asthma and medication treatment demonstrated consistent relationships with treatment adherence. Future research should test multivariate models of influences on treatment adherence in pediatric asthma in prospective studies using reliable and valid measures of predictors and outcomes. Intervention studies are also needed that target potentially modifiable, empirically supported influences to enhance treatment adherence. The clinical management of pediatric asthma would be enhanced by routine assessment of barriers to treatment adherence and anticipatory interventions that address them to prevent nonadherence.

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Section: Refining the Model Of Influences On Adherence To Pediatric Amentioning

confidence: 99%

Influences on Adherence to Pediatric Asthma Treatment: A Review of Correlates and Predictors

Drotar

Bonner

2009

Journal of Developmental &Amp; Behavioral Pediatrics

144

141

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“…All scores are converted to T-scores; higher scores reflect a more intense mood rating for the respective emotional domain. Internal consistency, test-retest reliability and validity are excellent (McNair et al, 1992 (Harris et al, 2008). For this study, an adapted version of the HHI published for children with chronic pain was used (Fales, et al, 2014).…”

Section: Parent Problem Solving Skills-parents Completed the Social Pmentioning

confidence: 99%

“…Parents completed the Helping for Health Index (HHI), a 15-item questionnaire originally designed to assess miscarried helping among parents of youth with diabetes, and has demonstrated good reliability and validity in that population (Harris et al, 2008). For this study, an adapted version of the HHI published for children with chronic pain was used (Fales, et al, 2014).…”

Section: Parent Miscarried Helping-miscarried Helping Was Originally mentioning

confidence: 99%

Adaptation of problem-solving skills training (PSST) for parent caregivers of youth with chronic pain.

Palermo

Law

Essner

et al. 2014

Clinical Practice in Pediatric Psychology

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Research on the experience of parents caring for a child with chronic pain indicates that high levels of parental role stress, feelings of frustration over an inability to help, and psychological distress are common. Moreover, parental distress adversely influences child adjustment to chronic pain. Therefore, intervening with parents of youth with chronic pain may, in turn, result in positive outcomes for children in their ability to engage in positive coping strategies, reduce their own distress, and to function competently in their normal daily lives. Our aim was to adapt an intervention, Problem-Solving Skills Training, previously proven effective in reducing parental distress in other pediatric illness conditions to the population of caregivers of youth with chronic pain. In the first phase, the intervention was adapted based on expert review of the literature and review of parent responses on a measure of pain-related family impact. In the second phase, the intervention was tested in a small group of parents to evaluate feasibility, determined by response to treatment content, ratings of acceptability, and ability to enroll and deliver the treatment visits. This phase included piloting the PSST intervention and all outcome measures at pre-treatment and immediately post-treatment. In an exploratory manner we examined change in parent distress and child physical function and depression from pre-to post-treatment. Findings from this feasibility study suggest that PSST can be implemented with parents of youth with chronic pain, and they find the treatment acceptable. Keywordspediatric chronic pain; parents; intervention; problem solving therapy; caregiver stress Conservative estimates suggest that at least 15% of children and adolescents report chronic pain during childhood, that is, pain lasting up to 3 months (Stanford, Chambers, Biesanz, & Chen, 2008). A subgroup (i.e., 5-10% of otherwise healthy youth) report severe pain associated with functional impairment (Huguet & Miro, 2008). The consequences of chronic pain extend beyond children themselves to potentially include widespread social, relational, Corresponding author: Tonya M. Palermo, Ph.D., Seattle Children's Research Institute, M/S CW8-6, PO Box 5371, Seattle, WA 98145, USA,, tonya.palermo@seattlechildrens.org. NIH Public Access Author ManuscriptClin Pract Pediatr Psychol. Author manuscript; available in PMC 2015 September 01. Published in final edited form as:Clin Pract Pediatr Psychol. 2014 September ; 2(3): 212-223. doi:10.1037/cpp0000067. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript emotional and financial impact on parents. In particular, parents report restrictions in their own lives, unwelcome dependency, marital and financial difficulties, and feelings of hopelessness (Hunfeld et al., 2002). In a clinical sample of youth with chronic pain, Eccleston, Crombez, Scotford, Clinch & Connell (2004) found that average levels of parental role stress were high, with 31% of parents reporting clinically significant di...

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“…The construct of ''miscarried helping,'' when this leads to conflict, has proven to be consistent across a diverse group of families of youth with poorly controlled diabetes. 8 Yet, research suggests that there is no specific ''family profile'' for predicting miscarried helping in families of youth with diabetes. 9 Various studies have demonstrated that diabetes-specific and general family conflicts are both associated with lower treatment adherence in adolescents.…”

Section: Introductionmentioning

confidence: 99%

Contracting and Monitoring Relationships for Adolescents with Type 1 Diabetes: A Pilot Study

Carroll

DiMeglio

Stein

et al. 2011

Diabetes Technology & Therapeutics

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Background: Adolescents are developmentally in a period of transition-from children cared for by their parents to young adults capable of self-care, independent judgment, and self-directed problem solving. We wished to develop a behavioral contract for adolescent diabetes management that addresses some negotiable points of conflict within the parent-child relationship regarding self-monitoring and then assess its effectiveness in a pilot study as part of a novel cell phone-based glucose monitoring system. Methods: In the first phase of this study we used semistructured interview techniques to determine the major sources of diabetes-related conflict in the adolescent-parent relationship, to identify factors that could facilitate or inhibit control, and to determine reasonable goals and expectations. These data were then used to inform development of a behavioral contract that addressed the negotiable sources of conflict between parents and their adolescent. The second phase of this research was a 3-month pilot study to measure how a novel cell phone glucose monitoring system would support the contract and have an effect on glucose management, family conflict, and quality of life. Results: Interviews were conducted with 10 adolescent-caregiver pairs. The major theme of contention was nagging about diabetes management. Two additional themes emerged as points of negotiation for the behavioral contract: glucose testing and contact with the diabetes clinical team. Ten adolescent-parent pairs participated in the pilot test of the system and contract. There was a significant improvement in the Diabetes Self-Management Profile from 55.2 to 61.1 (P < 0.01). A significant reduction in hemoglobin A1c also occurred, from 8.1% at the start of the trial to 7.6% at 3 months (P < 0.04). Conclusions: This study confirms previous findings that mobile technologies do offer significant potential in improving the care of adolescents with type 1 diabetes. Moreover, behavioral contracts may be an important adjunct to reduce nagging and improve outcomes with behavioral changes.

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Good intentions gone awry: Assessing parental "miscarried helping" in diabetes.

Cited by 41 publications

References 29 publications

Influences on Adherence to Pediatric Asthma Treatment: A Review of Correlates and Predictors

Influences on Adherence to Pediatric Asthma Treatment: A Review of Correlates and Predictors

Adaptation of problem-solving skills training (PSST) for parent caregivers of youth with chronic pain.

Contracting and Monitoring Relationships for Adolescents with Type 1 Diabetes: A Pilot Study

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