Infant illness severity and family adjustment in the aftermath of NICU hospitalization

Up to 15% of parents have an infant who will spend time in a neonatal intensive care unit (NICU). After discharge, parents may care for a medically fragile infant and worry about their development. The current study examined how infant illness severity is associated with family adjustment. Participants included parents with infants who had been discharged from the NICU 6 months to 3 years prior to study participation (N = 199). Via a Qualtrics online survey, parents reported their infants’ medical history, parenting stress, family burden, couple functioning, and access to resources. Multivariable regression analyses revealed that more severe infant medical issues during hospitalization (e.g., longer length of stay and more medical devices) were associated with greater family burden, but not stress or couple functioning. Infant health issues following hospitalization (i.e., medical diagnosis and more medical specialists) were associated with greater stress, poorer couple functioning, and greater family burden. Less time for parents was associated with increased stress and poorer couple functioning. Surprisingly, parents of infants who were rehospitalized reported less stress and better couple functioning, but greater family burden. Family-focused interventions that incorporate psychoeducation about provider−patient communication, partner support, and self-care may be effective to prevent negative psychosocial sequelae among families.     

RELATIONSHIP SATISFACTION, AFFECTIVITY, AND GAY-SPECIFIC STRESSORS IN SAME-SEX COUPLES JOINED IN CIVIL UNIONS

Relationship satisfaction, affect, and stress were examined in 313 same-sex couples who had had civil unions in Vermont during the first year of this legislation. Similarity between partners on age and on positive/negative affectivity was related to relationship satisfaction whereas there was no association with similarity in income, education, and outness. Lesbian couples ( n = 199), compared to gay male couples, reported experiencing more stress related to family reaction to their sexuality, whereas gay male couples ( n = 114) reported more stress surrounding the issues of HIV/AIDS and violence/harassment than did lesbian couples. This study is the first to examine within-couple factors among same-sex couples with legalized relationships.     

“Finding Beauty in Everyday Life”: A Photo‐Elicitation Study of Play Across the Life Span

Play is part of people's lives. Across the life span, play is viewed as central to healthy growth and development, although how individuals play and what play means to them changes with different stages of life. In this qualitative study using photo elicitation, children, college students, and retirees photographed 9 play concepts (connection, creativity, discovery, freedom, fun, growth, inner self, risk, and play as an overarching concept). The thematic analysis showed convergent (each theme within the concepts of discovery, freedom, growth, inner self, and play were represented by all groups) and divergent (within the concepts of connection, creativity, fun, and risk) conceptualizations of play concepts across the life span. Implications for working with all groups are also discussed.     

Genetic Risk Assessment for Women with Epithelial Ovarian Cancer: Referral Patterns and Outcomes in a University Gynecologic Oncology Clinic

Little is known about genetic service utilization and ovarian cancer. We identified the frequency and outcome of genetic counseling referral, predictors of referral, and referral uptake for ovarian cancer patients. Using pathology reports, we identified all epithelial ovarian cancer patients seen in a university gynecologic oncology clinic (1/04–8/06). Electronic medical records (EMR) were used to document genetic service referral, time from diagnosis-to-referral, point-in-treatment at referral, personal/family cancer history, demographics, and genetic test results. Groups were compared using chi-squared and Fisher’s exact test for categorical variables and t-tests for continuous variables. The study population consisted of 376 women with ovarian cancer, 72 (19 %) of who were referred for genetic counseling/testing, primarily during surveillance. Of those referred, 42 (58 %) had personal or family genetic counseling and 34 (47 %) were ultimately tested or identified due to known family mutation. Family history and prior cancer were associated with referral. Family history, living in a larger community, higher-stage disease, and serous histology were associated with undergoing genetic counseling. Risk assessment identified 20 BRCA1/2 (5.3 %) and 1 HNPCC (0.3 %) mutation carriers. Based on recent estimates that 11.7–16.6 % of women with ovarian cancer are BRCA carriers and 2 % are HNPCC carriers, results suggest under-identification of carriers and under-utilization of genetic services by providers and patients. Interventions to increase medical providers’ referrals, even in a specialized oncology clinic, are necessary and may include innovations in educating these providers using web-based methods. Ease of referral by the introduction of an electronic cancer genetic referral form represents another new direction that may increase genetic risk assessment for high-risk women with ovarian cancer.