Search Results (2,018)

The accelerated aging of the population in vulnerable urban contexts poses significant challenges for architecture, particularly with regard to the quality of life of older adults. Within this framework, the present study aimed to analyze the association between sensory architecture and the quality of life of older adults and to translate this empirical evidence into context-informed design criteria for the development of a comprehensive center for older adults. The study adopted a quantitative approach with a non-experimental, cross-sectional, and correlational design. A structured questionnaire on sensory architecture and quality of life was administered to family members and caregivers acting as proxy respondents, demonstrating high internal consistency (Cronbach’s $\mathit{\alpha }>0.90$). Given the ordinal nature of the data, inferential analysis was conducted using Spearman’s rho coefficient. Within the analyzed dataset, the results revealed a statistically significant and strong association between sensory architecture and the quality of life of older adults ($\rho$ > 0.80). At the dimensional level, visual and tactile stimuli exhibited the highest associations, followed by the social relationships dimension, while therapeutic environments showed a moderate association, allowing the identification of an empirical hierarchy among the analyzed dimensions within this dataset. These findings support the interpretation of sensory architecture as a construct statistically associated with indicators of quality of life, from a non-causal perspective. Based on this hierarchy, the results were articulated into an evidence-based architectural structure, serving as analytical input to inform context-specific criteria for spatial organization, materiality, comfort, orientation, and social interaction derived from the observed statistical associations. The study contributes a methodological approach that systematically connects correlational quantitative findings with architectural design considerations, particularly in urban contexts characterized by limited specialized infrastructure. However, a key limitation is the use of proxy respondents (family members and caregivers), which should be considered when interpreting the results. Full article

Background/Objectives: Spinal cord injury (SCI) leads to long-term changes in mobility, bodily function, and everyday participation, extending beyond physical impairment to affect autonomy, identity, and social inclusion. In Greece, limited community-based rehabilitation services, environmental inaccessibility, and fragmented follow-up care further shape the lived experience of individuals with SCI. This study aimed to explore the lived experiences and perceived rehabilitation needs of people with paraplegia living in the community, adopting a phenomenological approach to understand rehabilitation as an ongoing process of reclaiming autonomy, dignity, and participation. Methods: A qualitative phenomenological design was employed. In-depth semi-structured interviews were conducted with fourteen individuals with paraplegia following SCI. Data were analyzed using Braun and Clarke’s reflexive thematic analysis, supported by ATLAS.ti software. Results: Participants described living with SCI as a ‘Socially lived disability: a daily confrontation with an inadequate system and the ongoing struggle for accessibility, autonomy, and dignity’ (Overarching Theme). Participants’ experiences were organized into six themes: (A) facing the new reality, (B) barriers and facilitators of independent living, (C) role and importance of rehabilitation, (D) me and others around me, my difference, (E) the need for adequately trained and informed health professionals and caregivers, (F) ageing as an additional challenge. Conclusions: Living with SCI is experienced as an ongoing process of embodied and social reorientation, in which autonomy, participation, and dignity are continuously negotiated rather than restored once and for all. Rehabilitation emerges as a lifelong, person-centered process that extends beyond functional recovery to support bodily confidence, accessibility, social inclusion, and quality of life across the life course. These findings highlight the need for coordinated, community-based rehabilitation systems, accessible environments, and adequately trained health professionals capable of addressing the evolving functional, social, and existential realities of individuals living with SCI. Full article

Telemedicine can address access barriers in childhood obesity management by supporting continuity of care and caregiver engagement. This randomized controlled trial compared a telemedicine-based program with guideline-based usual care among 70 children with obesity (aged 5–15 years) and their caregivers, randomized to telemedicine (n = 35) or usual care (n = 35) for 6 months. The telemedicine program included online consultations, digital caregiver education, remote monitoring, and secure messaging via the SUTH application integrated with the hospital information system. The control group received standard outpatient care with routine counseling and printed materials; baseline characteristics were similar between groups. Baseline demographic and clinical characteristics were comparable between groups. After 6 months, both groups showed modest reductions in BMI; however, ANCOVA-adjusted analyses indicated no significant between-group difference in post-intervention BMI. Weight-for-height decreased in both groups, with a slightly greater percentage reduction in the telemedicine group. Caregiver satisfaction and knowledge were significantly higher in the telemedicine group at follow-up (all p < 0.01; knowledge p < 0.001). These findings suggest that telemedicine-based care may contribute to modest improvements in anthropometric outcomes while substantially enhancing caregiver knowledge and healthcare service satisfaction, supporting its role as a scalable adjunct in pediatric obesity management. Full article

Digital transformation has profoundly reshaped caregiving practices, yet its influence on family cohesion within disability contexts remains underexplored, particularly in Arab societies. This qualitative phenomenological study examines how digital technologies shape family cohesion among Jordanian caregivers of children with disabilities. In-depth, semi-structured interviews were conducted with 22 primary caregivers, and data were analyzed using reflexive thematic analysis. The findings reveal a central tension of being “between connectivity and care,” articulated through four interrelated themes: (1) a digital double-bind in which online support networks function as a vital “virtual village” while simultaneously contributing to intra-familial fragmentation; (2) the reconfiguration of care labor, whereby digital management emerges as an invisible and gendered form of caregiving work, often positioning mothers as primary digital coordinators; (3) the translation of traditional social capital (wasta) into digital spaces to navigate systemic resource constraints, producing new moral and emotional burdens; and (4) the strategic use of digital platforms to preserve cultural, religious, and familial identity in the face of stigma, thereby reinforcing internal cohesion. These findings suggest that digital technologies do not merely facilitate connection but actively reconfigure family dynamics through ongoing negotiation between support and strain. The study underscores the need for family-centered digital inclusion policies and support interventions that mitigate digital burdens while harnessing technology’s potential to strengthen culturally grounded resilience among families of children with disabilities. Full article

Cancer caregiving is increasingly recognized as a major psychosocial challenge, yet the mental health needs of caregivers remain insufficiently addressed in oncology research and practice. This narrative review examines the experiences of cancer caregivers within the context of rising cancer incidence and prolonged survival, conditions frequently accompanied by sustained psychological burden and anticipatory grief, with particular attention to depressive symptoms. Relevant qualitative and quantitative studies were identified through targeted searches of major databases (PubMed, Scopus, PsycINFO, and Google Scholar), including studies published up to January 2026. Study selection was guided by conceptual relevance and applied significance to the intersection between religiosity, spirituality, caregiving, and mental health outcomes. The reviewed literature highlights substantial psychological burden among caregivers, with depression affecting approximately 20–40% of cancer caregivers and identifies religiosity and spirituality as potentially supportive resources. Across studies, recurrent themes include meaning-making, hope maintenance, emotional regulation, moral orientation, and perceived social support as mechanisms through which these dimensions are associated with lower levels of depression and improved psychological adjustment. Evidence suggests that both religiosity, understood as the lived engagement with religious values, and spirituality, defined as a broader existential orientation toward meaning and purpose, contribute to coping in caregiving contexts; however, findings remain heterogeneous and largely based on cross-sectional analyses. Notable gaps persist, including limited caregiver-specific research, conceptual imprecision, and a lack of longitudinal designs. By integrating conceptual clarification with empirical synthesis, this review outlines potential psychological pathways linking religiosity and spirituality to caregiver mental health outcomes. In summary, religiosity and spirituality are considered adjunctive, non-exclusive resources that complement conventional psychological and psychiatric care within comprehensive models of caregiver support. Full article

Background: Cervical cancer remains a leading cause of cancer-related deaths among women in Nigeria. In 2023, the Government of Nigeria, with support from Gavi and partners, introduced the single-dose human papillomavirus (HPV) vaccine through a phased, school-based campaign. The first phase was launched in October 2023 across 16 states, followed by a second phase in May 2024 that expanded coverage to the remaining states and the Federal Capital Territory. This study evaluates the additional impact of a behavioral insights–informed digital intervention, comprising a social media campaign amplified by trained pharmacists serving as local influencers, implemented in 2025 to increase acceptance and uptake of HPV vaccination during routine immunization. Methods: A pre-test/post-test quasi-experimental design with a control group was implemented in three Nigerian states in 2025 to assess the additional impact of a behavioral insights–informed social media campaign designed to strengthen social approval for HPV vaccination, increase awareness of vaccination locations, and reinforce caregivers’ recognition of their adolescent daughters’ desire to be vaccinated. Messages were amplified by trained pharmacists who served as local influencers. Caregivers of adolescent girls aged 9–17 years were recruited online through targeted Facebook and Instagram advertisements during Nigeria’s transition from school-based HPV vaccination campaigns to routine immunization. Caregivers in treatment areas were exposed to geofenced social media advertisements on Facebook and Instagram and pharmacist counseling, while those in control areas were not. Logistic regression models using a difference-in-difference approach estimated the campaign’s effect on HPV vaccination, controlling for caregiver and adolescent characteristics. Additional statistical models assessed the campaign’s impact on caregivers’ motivation and ability—key drivers of behavior according to the Fogg Behavior Model. Results: HPV vaccination increased at a significantly higher rate in the treatment compared to the control area. The adjusted odds of an adolescent girl being vaccinated were 1.48 times higher in the treatment area at follow-up (95% CI: 1.14–1.92). Adjusted marginal effects indicated that exposure to the campaign increased the probability of vaccination by 8.9 percentage points relative to the control group. The rate at which caregivers’ motivation (aOR = 1.31, 95% CI: 1.00–1.70) and ability (knowing where to get vaccinated: aOR = 1.38, 95% CI: 1.07–1.79; ease of vaccination: aOR = 1.59, 95% CI: 1.22–2.06) increased was also higher in the treatment area. There was no relative increase in intervention versus control groups in factual knowledge regarding HPV vaccination. Conclusions: A behavioral insights–informed social media campaign in which pharmacists served as influencers was associated with higher HPV vaccine uptake during routine immunization. The higher rate of vaccination observed in intervention areas was associated with higher rates of caregiver motivation and ability but not with higher rates of caregiver knowledge. These findings are consistent with the potential of behavioral insights–informed digital campaigns to complement routine immunization efforts and improve vaccine uptake in low- and middle-income countries. Full article

Background/Objectives: Cerebral palsy (CP) is the most prevalent physical disability in the pediatric population, resulting in functional limitations and restrictions in participation, with higher prevalence rates in low- and middle-income countries. Caregivers of children and adolescents with CP face both physical and emotional challenges, and their perceptions of the body may act as contextual and cultural indicators shaping children’s participation, care practices, and well-being within the family environment. This study aimed to understand the perceptions, values, and cultural beliefs of family caregivers about the bodies of children and adolescents with CP. Methods: A qualitative study was conducted using six focus groups with 22 mothers and grandmothers of children and adolescents with CP. Participants were recruited from rehabilitation services. Discussions were audio-recorded, transcribed verbatim, and analyzed using content analysis. The analytical process involved systematic coding, categorization, and thematic interpretation to identify recurring meanings and patterns across narratives. Results: Three thematic categories emerged: (1) perceptions of the body within social interactions; (2) viewing the body as capable of performing activities independently when stimulated/taught; and (3) viewing the body as dependent, requiring constant supervision and support. Conclusions: The findings highlight the need to expand family caregivers’ knowledge about CP to promote children’s participation and mitigate beliefs related to limitations, dependence, fragility, and vulnerability. Full article

Singing-Oriented Language and Music Education (SOLME) is an accessible, low-resource pedagogical and cognitive framework in which singing serves as the primary interface through which musical activities support both first and foreign language acquisition processes. Early vocalizations in infancy make the overlap between singing and speech highly perceptible, forming a continuum rather than clearly separable domains. Child-directed speech similarly shares key features with singing—such as repetition, emotional engagement, exaggerated pitch variation and rhythm—and both input forms inherently combine musical and linguistic elements. Research has shown that the overlap between singing and language abilities persists throughout the lifespan, positioning singing as a valuable facilitator of language learning processes. Singing, integrated as a musical tool, has proven effective in enhancing key abilities for (foreign) language learning—including phonological awareness, pronunciation, and verbal memory, among others—and in supporting language functioning across diverse communication disorders, from developmental fluency challenges to acquired impairments. This entry outlines the benefits of singing as an integrated means to support musical development as well as first and second language acquisition processes. It outlines functional and structural similarities between singing and language development, from early caregiver–infant interaction to formal foreign-language instruction, and then discusses the many advantages of embedding singing as a musical tool in the (foreign) language learning process. Full article

Canine cognitive dysfunction (CCD) is a progressive neurodegenerative condition affecting aging dogs, characterized by impairments in learning, memory, spatial orientation, and behavior. Despite its substantial negative impact on dogs’ quality of life and owners’ emotional well-being, CCD is frequently underrecognized or diagnosed at a late stage. This study explored how challenges in CCD recognition and veterinary communication influence dog owners’ ability to identify symptoms and make informed decisions about care. Semi-structured interviews were conducted with 22 dog owners whose dogs were suspected of having CCD, based on elevated scores on the Canine Cognitive Dysfunction Rating Scale (CCDR) and owner-reported behavioral changes. Interview data were analyzed using reflexive thematic analysis. Four main themes emerged: (1) difficulties in recognizing CCD-related symptoms, (2) communication challenges between owners and veterinarians, (3) owners’ adaptation to gradually emerging symptoms, and (4) the emotional and practical burden of caregiving. Owners frequently interpreted behavioral changes as normal aging or other health problems, which delayed the recognition of cognitive decline. Participants also described limited guidance from veterinary professionals regarding CCD, contributing to uncertainty, emotional distress, and challenges in end-of-life decision-making. Together, these findings suggest that owners’ experiences follow a progressive caregiving trajectory, from initial symptom uncertainty to increasing emotional and practical burden. Improving awareness of CCD, strengthening veterinary communication, and providing targeted support for caregivers may facilitate earlier recognition and more effective management of cognitive decline, ultimately benefiting both dogs and the people who care for them. Full article

Background/Objectives: Social development in children is a significant aspect that supports appropriate behavior in the community, and parents, as the main caregivers, play a central role in developing social skills in children. However, caregivers experiencing mental health problems—such as depression, anxiety, and stress—may find it challenging to provide a nurturing rearing environment. This one-year follow-up study examined whether the baseline mental health of caregivers was associated with social skills in children 1 year later in an urban Indonesian context. Methods: A one-year follow-up study was conducted in an urban area of Indonesia in 2023–2024, inviting all nine kindergartens in the area to participate. Caregivers completed the demographic questionnaire and the Depression, Anxiety, Stress Scale (DASS-21), while teachers assessed social skills in children using the Social Skills Scale (SSS). Linear mixed-effects models with random intercepts for kindergarten were estimated to account for clustering. Results: Finally, a total of 270 parent–child dyads were included. After adjusting for baseline social skills and covariates, higher levels of baseline caregiver depression (B = −0.15, p < 0.001), anxiety (B = −0.22, p < 0.001), and stress (B = −0.27, p < 0.001) were associated with lower social skills in children in the follow-up. Conclusions: Even subclinical variations in caregiver mental health problems may be meaningfully associated with social development in children over time. The findings highlight mental health in caregivers as a potentially important factor associated with early social development in an urban setting of Indonesia. Full article

Caring for children with physical disabilities can be a daunting responsibility, often placing significant financial, psychological, social and health-related strains on the primary caregivers. This qualitative study explored the experiences of caregivers caring for children with physical disabilities in the Hardap region of Namibia. Using purposive sampling, twenty caregivers were selected as participants in the study. Data was collected using semi-structured interview schedules. Following the interviews, the data were manually analysed and categorised into distinctive themes and sub-themes and summarised in the final report as verbatim quotations. Study findings reveal that caregivers are motivated and determined to provide optimum care for children with physical disabilities under their care by acquiring assistive devices for them and assisting the children with activities of daily living. However, poverty and the general shortage of assistive devices, mostly wheelchairs, provide adverse conditions that are inimical to the development of children’s functional independence in daily living tasks. The burden of carrying the children was noted to be potentially deleterious to the caregivers’ physical health. The study concluded that providing assistive equipment for the children will ease the caregivers’ burden of care while equalising socioeconomic opportunities for both children with physical disabilities and their caregivers. The study only covered a small sample size in a small geographical area of Namibia. Therefore, interpretation and generalisation of the findings need to account for the specific context in the Hardap region of Namibia. Therefore, there remains scope for conducting further research with a larger sample size and one that is more geographically representative of Namibia. Full article

Background: A paediatric cancer diagnosis is a profound stressor for the entire family system. Although coping strategies are well-studied, their link to the quality of the parent–child attachment relationship remains less explored. In this study, we investigated whether dyadic attachment dynamics—specifically closeness and conflict between parent and child—are associated with the use of adaptive or maladaptive coping strategies in caregivers of children undergoing active treatment for oncohaematological diseases. Methods: We conducted a multicentre, cross-sectional study across three Italian paediatric oncohaematology centres. A total of 165 caregivers of 91 paediatric patients aged 3–17 years completed self-report measures assessing parent–child relationship quality (Child–Parent Relationship Scale-CPRS), coping strategies (COPE-NVI), perceived social support (MSPSS), and resilience (RS-14). We tested whether the quality of the parent–child attachment relationship is associated with caregivers’ coping strategies. We hypothesised that Attachment Closeness would be associated with adaptive coping (Positive Attitude, Social Support, Problem Orientation), whereas Attachment Conflict would be associated with maladaptive coping (Avoidance). We conducted multiple linear regression models, adjusted for key covariates and with robust standard errors clustered at the family level, to test these hypotheses. Results: Higher levels of emotional closeness (CPRS) were significantly associated with greater use of adaptive coping strategies, specifically Positive Attitude (β = 0.20, p = 0.049) and Problem Orientation (β = 0.26, p = 0.002), even after controlling for sociodemographic factors, social support, and resilience. Conversely, higher levels of relational conflict were significantly associated with greater use of the maladaptive Avoidance strategy (β = 0.14, p = 0.015). The hypothesis linking closeness to Social Support seeking was not supported. Conclusions: The findings suggest that the parent–child attachment relationship is a significant correlate of caregiver coping strategies in caregivers of children with cancer. Interventions aimed at supporting the caregiver–child dyad by fostering emotional closeness and reducing conflict may promote more adaptive parental coping mechanisms, thereby enhancing family resilience and psychological adjustment throughout the treatment journey. Full article

Background: Dependent older adults experience a high burden of preventable oral conditions, particularly gingivitis, while caregivers’ preventive practices remain insufficiently explained by conventional single-factor models. This study aimed to develop and validate a theory-informed structural equation model (SEM) to explain how oral health literacy and psychosocial determinants shape preventive behaviors for gingivitis among caregivers of dependent older adults in Sisaket Province, Thailand. Methods: A cross-sectional analytical study was conducted among 420 caregivers selected using multistage random sampling. Data were collected using a validated questionnaire based on the Health Belief Model and Social Cognitive Theory, covering knowledge, attitude, perceived severity, perceived benefits, self-efficacy, preventive behaviors, and social support. Reliability was excellent. Descriptive statistics, Pearson’s correlation, and SEM with maximum likelihood estimation were applied. Results: The SEM demonstrated excellent fit (χ²/df = 0.80, p = 1.000; CFI = 1.000; TLI = 1.008; RMSEA = 0.000; SRMR = 0.092). Knowledge directly influenced attitude (β = 0.355, p = 0.013) and self-efficacy (β = 0.381, p = 0.003). Attitude (β = 0.406, p < 0.001), self-efficacy (β = 0.384, p < 0.001), and social support (β = 0.260, p < 0.001) were significant predictors of preventive behaviors. The model explained 68.3% of variance in behaviors, with knowledge exerting significant total effects through mediated pathways (β_total = 0.290, p < 0.001). Conclusions: A theory-based SEM effectively explains caregiver preventive oral health behaviors in a rural, resource-limited setting. Interventions should integrate literacy-focused education with strategies that strengthen attitudes, self-efficacy, and social support to achieve sustainable improvements in dependent older adults’ oral health. Full article

This study explores how gender roles shape transnational caregiving among Nigerian immigrants between northern BC and Nigeria. It examines the persistence or renegotiation of traditional caregiving expectations and how carers navigate societal norms, professional roles, and personal motivations. It also investigates how the elder care recipient’s gender influences caregiving dynamics, including cultural taboos, communication, and family interactions. This qualitative study employed a narrative inquiry approach, guided by a care and gender (Gender+) lens, to explore the caregiving experiences of 10 Nigerian immigrant carers (five women, five men) residing in northern BC and supporting elderly relatives in Nigeria. Participants were recruited through snowball and purposive sampling. A pre-interview survey captured demographic and caregiving background data. In-depth semi-structured interviews elicited personal caregiving narratives, and thematic analysis was used to identify key patterns related to gender, culture, and transnational caregiving dynamics. The study revealed four key themes regarding caregiving practices among Nigerian immigrant families: gendered cultural caregiving expectations, perceptions of caregiving abilities based on gender, resistance to traditional norms, and cultural taboos and gendered caregiving assignments. Caregiving experiences of Nigerian immigrants are influenced primarily by gender, with migration stage, class, and birth order acting as contextual modifiers. Centering a Gender+ lens, this research underscores the need for culturally responsive policies that address the challenges of immigrant carers and support their efforts to fulfil caregiving responsibilities within transnational settings. Full article

Background: Pediatric cancer is a highly stressful and potentially traumatic condition affecting physical health, emotional well-being, developmental trajectories, and family functioning. Hospitalization and intensive treatments often exacerbate emotional distress and symptom burden, negatively impacting quality of life (QoL). Integrating psychosocial and expressive interventions into pediatric oncology care is increasingly recognized as essential. Clay therapy is a multisensory, hands-on creative intervention that may promote emotional regulation, coping, and a sense of agency in hospitalized children. Objectives: This prospective pilot study evaluated the effects of clay therapy on emotional and physical well-being in pediatric oncology patients and explored potential indirect effects on caregivers’ emotional status. Methods: From December 2023 to December 2024, forty hospitalized children with onco-hematological diseases and one parent per patient were enrolled. Each child participated in a one-hour clay therapy workshop led by a professional ceramist. Emotional outcomes were assessed before (T0) and immediately after (T1) the intervention using the Visual Analog Scale (VAS) and the ArtsObs observational scale. Physical symptoms, including pain, fatigue, and nausea, were also evaluated. Results: Following clay therapy, children showed statistically significant improvements across all VAS emotional domains, independent of age and gender. ArtsObs assessments confirmed a significant increase in observed mood, with high levels of relaxation and engagement; female patients demonstrated greater mood improvement than males. Significant reductions in pain, fatigue, and nausea were also observed. Parents exhibited a significant improvement in mood following their child’s participation. Conclusions: These findings suggest that clay therapy is feasible and could be an effective supportive intervention in pediatric oncology, benefiting both emotional and physical well-being. Its integration into multidisciplinary, family-centered care models may enhance QoL during hospitalization and provide holistic support for children with cancer and their families. Full article