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Biomedical subjects

D Drotar

Publications and source records attributed to D Drotar.

At least 73 records · Page 4Linked to original sources
PubMed1990

Determinants of parenting stress in home apnea monitoring.

Studied mothers of 30 infants who suffered an apneic episode and were subsequently placed on home apnea monitors, using measures of parenting stress, family resources and support, family coping activities, health locus of control, and maternal coping style involving preferences for information under threat. Comparison groups included mothers of 30 infants with mild congenital heart lesions and 30 mothers of normal healthy infants. Home monitoring was associated with increased levels of parenting stress; monitored infants were perceived as more demanding, and their mothers reported less attachment to the child. However, the magnitude of the differences between mothers of monitored and unmonitored infants was relatively small, and parenting stress outcome was more closely related to preexisting levels of family resources than to the child's health status. No significant relationship was found between stress outcome and family coping or maternal coping style.

Adaptation, Psychological↗
PubMed1989

Prediction of weight for height following intervention in three-year-old children with early histories of nonorganic failure to thrive.

The present study assessed the weight for height outcomes of 59 3-year-old children who had been hospitalized for nonorganic failure to thrive (NOFT) as infants (average age of 5 months) and received time-limited outreach intervention. Although the majority of children attained normal weight for height, nearly one-third demonstrated at least mild wasting. Type of outreach intervention did not affect weight for height at outcome. The predictive efficacy of a variable set which included characteristics of NOFT (age of onset and duration), velocity of weight gain subsequent to diagnosis and environmental characteristics (income and home stimulation) was tested. Shorter duration of NOFT prior to diagnosis and greater initial rate of weight gain following hospitalization predicted weight for height at 36 months. The findings underscore the need for close monitoring of physical growth and nutritional status of NOFT children following hospitalization as well as comprehensive assessment and treatment for children who continue to demonstrate nutritional deficits. Additional studies of factors which affect the prognosis of NOFT children are needed.

Body Height↗
PubMed1989

Psychological research in pediatric settings: lessons from the field.

Described the practical problems that threaten the progress of psychological research conducted in pediatric settings and strategies to manage these problems. Research collaborations with physicians and setting-based constraints on data collection and research participants place strenuous demands on investigators. Special efforts are needed to enhance the quality of interdisciplinary research collaboration, lessen constraints on research participants, set priorities for research activities, and develop necessary support for research. To facilitate the progress of psychological research in pediatric settings, research training and continuing education should equip researchers to deal with the problems of applied research with pediatric populations.

Child↗
PubMed1989

The family environment in nonorganic failure to thrive: a controlled study.

Compared 48 families of nonorganic failure to thrive (NOFT) infants with those of 52 physically healthy infants of similar demographic characteristics using the Family Environment Scale (FES). Families of NOFT infants had more problematic relationships as indicated by lower scores on the Family Relationships Inventory (FRI) components of the FES, including lower Cohesion and Expressiveness, than families of physically healthy infants. Contrary to predictions, families did not differ in level of Conflict or Organization. Families of NOFT infants had lower intellectual and Cultural Orientation. These findings suggest that problematic intrafamilial relationships are associated with NOFT and may influence the psychological outcomes of children with this condition. Studies are needed to document the effects of family functioning on the physical growth and psychosocial development of NOFT children.

Failure to Thrive↗
PubMed1989

Psychological practice in a pediatric rehabilitation hospital.

Described 127 consecutive referrals to a newly formed psychological consultation service in a pediatric rehabilitation hospital. This setting served children whose needs for comprehensive care and long-term hospitalization could not be met effectively elsewhere in the community. The complex patient population included children with permanent mental and/or physical handicaps who had survived due to advances in medical technology, those with traumatic or congenital brain injury, failure to thrive, feeding problems, apnea, tracheostomy, child abuse, and psychosomatic disorders. A range of psychological services were offered, including specialized assessments and treatment planning for rehabilitation, home and school placement, direct treatment and monitoring of behavioral progress, and consultation with staff. Implications for the practice of pediatric psychology and service delivery to patients in pediatric rehabilitation settings are discussed.

Adolescent↗
PubMed1989

Recognition memory as a method of assessing intelligence of an infant with quadriplegia.

The authors demonstrate a test of visual cognitive abilities (Fagan Test of Infant Intelligence) in the assessment and management of a ventilator-dependent infant with quadriplegia. Assessment of visual recognition memory indicated that the infant's cognitive development progressed normally, despite severe physical limitations and a prolonged stay in hospital. The results suggested that the infant would benefit from age-appropriate auditory, visual and social stimulation and a specialized program of rehabilitation. The test may be particularly useful in assessing the intellectual abilities of infants whose motor dysfunction precludes effective response to traditional tests of sensorimotor intelligence.

Aging↗
PubMed1989

Behavioral diagnosis in nonorganic failure-to-thrive: a critique and suggested approach to psychological assessment.

Studies of behavioral diagnosis in children with nonorganic failure-to-thrive (NOFTT) are critically reviewed. Prior studies have been based on several problematic assumptions: (1) specific behavioral abnormalities are associated with NOFTT, (2) NOFTT is a homogeneous population, and (3) a strict dichotomy between organic and environmental influences on physical growth is a valid distinction. An alternative way to organize data from behavioral assessment is presented which emphasizes the heterogeneity of NOFTT and the consequences of environmental and biologic risk factors on psychological development. A comprehensive approach to behavioral assessment can facilitate the clinical management of NOFTT and encourage research concerning the developmental processes which affect the psychological outcomes of NOFTT children.

Child Behavior Disorders↗
PubMed1989

Influences on the home environment of preschool children with early histories of nonorganic failure-to-thrive.

The home environments of 58 children with early histories of nonorganic failure-to-thrive (NOFTT) who received time-limited outreach intervention after hospitalization were assessed from 12 to 36 months of age. The type of outreach intervention did not affect the quality of home environment as assessed by the Home Observation for Measurement of the Environment inventory (HOME). We tested the efficacy of three sets of variables: characteristics of NOFTT (age of onset and duration), nutritional status (weight for height) at time of diagnosis, and family characteristics (maternal IQ and income) in predicting HOME scores at 36 months. Family characteristics (income and maternal IQ) were the only variables to predict HOME scores. HOME scores were less stable than in the standardization sample. A subgroup of NOFTT children (n = 7) whose HOME scores decreased over the 2-year follow-up period were more likely to have subsequent siblings than children whose HOME scores improved over the same time period (n = 11). Findings suggest the need to identify and provide preventive intervention for NOFTT children whose home environments are vulnerable to deterioration following diagnosis.

Child, Preschool↗
PubMed1989

Psychological impact of home apnea monitoring: temporal effects, family resources, and maternal coping style.

Mothers of 30 infants who had experienced an emergency apnea episode and were placed on a home apnea monitor were studied longitudinally, using measures of mood disturbance (anxiety, depression, hostility, fatigue, vigor and confusion). Mothers were assessed at the time of hospitalization immediately following the apnea episode, after approximately one month of home monitoring, and after three months of home monitoring. Measures of family resources, health locus of control, and coping style, involving preference for information under situations of threat, were obtained as predictor variables. A high level of mood disturbance was seen initially, but this was transient, diminishing significantly after the first month of monitoring. Level of family resources was highly predictive of mood disturbance throughout the study period, while health locus of control beliefs were predictive of changes in mood disturbance over time. These findings suggest a means for identifying families at higher risk for maladaptive responses, and in need of more intensive psychosocial support.

Adaptation, Psychological↗
PubMed1988

Psychosocial management of chronic lung disorders.

Chronic lung disorders are increasingly prevalent and account for the most of the disabilities and deaths in infants and young children. The pediatrician has a unique opportunity in the early detection, counseling and referral of psychosocial problems related to chronic lung disease, as well as in assuring continuity of appropriate medical care. The present paper outlines ways the pediatrician might effectively address psychological or behavioral aspects of management of several common pediatric pulmonary disorders, namely, asthma, cystic fibrosis, bronchopulmonary dysplasia and infant tracheostomy.

Asthma↗
PubMed1987

Correlates of psychosocial adjustment among young adults with cystic fibrosis.

Young adults with cystic fibrosis (CF) (n = 73) were found to have age-adequate psychological functioning. Psychological adjustment, as measured by the Psychological Screening Inventory (PSI) and the Tennessee Self-Concept Inventory (TSCI), correlated with coping style as measured by the Repression-Sensitization (R-S) scale. A repressive or avoidant coping style was associated with higher self-esteem, lower alienation and discomfort, and greater social activity, but not with employment status or school attendance. Severely ill patients were less likely to be employed or in school, and showed higher levels of psychological discomfort. Physicians' ratings of coping effectiveness were positively related to a repressive illness-related coping style. Prospective assessment of psychological functioning would yield useful information concerning the coping strategies used by young adults with CF to ameliorate the psychological distress associated with physical deterioration.

Adolescent↗
PubMed1985

Psychological adaptation of siblings of chronically ill children: research and practice implications.

Studies of the psychological adjustment of physically healthy siblings to their sibling's chronic illness indicate that there is no one-to-one correspondence between the presence of a chronic illness and risk for psychological disturbance in nonafflicted children. Although the presence of a chronic illness may increase siblings' subjective distress, effects of a chronic illness on the psychological adjustment of siblings are selective and vary with age, sex, and type of illness. Chronic illness is a stressor which, in interaction with other variables, may contribute to increased risk of psychological disturbance for some siblings. Although the variables which mediate the effects of a chronic illness on siblings are as yet poorly understood, the quality of family functioning and relationships has both direct and indirect effects on siblings and deserves primary consideration in the comprehensive care of chronically ill children. Future research might profitably focus on individual differences in sibling adaptation, especially on factors which contribute to positive adjustment, the role of the family context as a mediating influence, and evaluation of preventive interventions designed to enhance sibling adaptation.

Adaptation, Psychological↗