From ADHD symptoms to parental stress: The roles of functional impairment, family functioning, and parental ADHD

by Nitchawan Jongrakthanakij, Thanavadee Prachason, Nida Limsuwan, Komsan Kiatrungrit, Masatha Thongpan, Passaporn Lorterapong, Pattarabhorn Wisajun, Sudawan Jullagate

Background

Raising a child with Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with significant parental stress. However, the complex relationships between factors in the child and family in shaping this stress are not well understood. This study aimed to elucidate these interrelationships and identify the key determinants of parental stress.

Methods

A cross-sectional study included 127 children and adolescents with ADHD (70.9% males; mean age 9.6 ± 3.3 years) and their caregivers, recruited from the ADHD Registry at Ramathibodi Hospital, Bangkok (2019–2023). Caregivers completed standardized measures of parental stress, child ADHD symptoms, child functional impairment, family functioning, and parental ADHD symptoms. Structural equation modeling was used to examine pathways from child and parental ADHD symptoms to parental stress, with functional impairment and family functioning specified as mediators.

Results

Examining child- and family-related factors separately, child ADHD symptoms indirectly influenced parental stress via functional impairment, whereas parental ADHD symptoms significantly influenced parental stress both directly and indirectly via family functioning. In the integrated model examining both child- and family-related factors concurrently, the direct and indirect pathways from parental ADHD symptoms to parental stress via family functioning remained significant, but not the pathway from child ADHD symptoms to parental stress via functional impairment.

Conclusions

Functional impairment, parental ADHD, and family functioning, rather than child ADHD symptoms, are key determinants of parental stress in families of children with ADHD. These factors should be routinely assessed and targeted to alleviate parental stress more effectively than focusing on child ADHD symptoms alone.

Retention of CPR skills learnt in a brief educational video with short-time self-training versus mastery learning among lay responders in Thailand: an assessment of a training system

Objectives

To evaluate the effectiveness of short-duration self-learning (SSL) and mastery learning (ML) strategies on the acquisition and 6-month retention of cardiopulmonary resuscitation (CPR) skills and basic life support (BLS) knowledge among hospital administrative staff in Thailand.

Design

Comparative assessment of two CPR training strategies.

Setting

Tertiary-level academic institution in Thailand.

Participants

A total of 163 hospital administrative staff aged ≥18 years without prior BLS certification were enrolled and randomly allocated to either the SSL group (n=82) or the ML group (n=81). Participants with previous CPR certification, medical limitations preventing chest compressions or those unwilling to attend the 6-month retention test were excluded. 71 participants in each group completed the 6-month follow-up.

Interventions

All participants viewed an 8 min self-directed instructional video on BLS and subsequently performed CPR practice using real-time feedback manikins. The SSL group practised independently for up to five 1 min sessions, while the ML group practised until achieving a predefined mastery threshold (QCPR (Quality Cardiopulmonary Resuscitation) score >90%).

Primary and secondary outcome measures

The primary outcome was CPR skill retention at 6 months, measured by QCPR overall performance score. Secondary outcomes included observational BLS performance (scene safety, responsiveness, emergency activation, breathing assessment and correct hand placement), knowledge retention scores and the number of attempts required to achieve mastery in the ML group.

Results

Both SSL and ML groups demonstrated significant improvement in CPR performance and BLS knowledge immediately after training (p

Conclusions

Both SSL and ML effectively enhanced CPR performance and knowledge retention among non-medical hospital staff. SSL offers a practical, resource-efficient and scalable approach for CPR training in large-scale community or institutional settings. Future studies should investigate the cost-effectiveness and optimal refresher frequency for sustaining CPR competency.

Trial registration number

TCTR20210521003.

Functional beverage development from traditional Thai polyherbal tonic: Antioxidant-rich microcapsules and comprehensive sub-chronic toxicity assessment

by Thammarat Kaewmanee, Acharaporn Issuriya, Piyapong Choochana, Pinanong Na-Phatthalung, Surasak Limsuwan, Sasitorn Chusri

This study aimed to optimize microencapsulation conditions for Phy-Blica-O (PBO), a traditional Thai polyherbal tonic, and to assess the safety of its consumer-accepted herbal tea formulation, Phy-Blica-D (PBD). PBO decoction and its phenolic-rich extract were spray-dried at different inlet temperatures (140°C, 180°C) and maltodextrin-gum Arabic ratios. Encapsulation efficiency was highest at 140°C with maltodextrin alone, while antioxidant activity was greatest in microcapsules prepared at 180°C with a 6:4 maltodextrin to gum Arabic ratio, as shown by DPPH, ABTS, and FRAP assays. PBD demonstrated strong in vitro antioxidant activities and was subsequently assessed in a 90-day subchronic toxicity study in Wistar rats. No treatment-related mortality, clinical abnormalities, organ toxicity, or hematological or biochemical disruptions were seen at doses up to 300 mg/kg/day, indicating a NOAEL above this level. These findings suggest that optimized PBO microcapsules and the PBD tea blend are safe, antioxidant-rich functional ingredients with strong potential for commercialization in complementary and integrative medicine.