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divorce

Epidemiology: - physicians (24%) are less likely to divorce than nurses (33%), lawyers (27%) & other nonhealthcare professionals (35%) [1] Complications: - increased risk of myocardial infarction (MI) - multiple divorces increase risk of MI in women similar to that of established MI risk factors like smoking, diabetes, & hypertension - men who divorce & remarry do not have an increased of MI - women who divorce & remarry do have an increased of MI Management: - clinicians (pediatricians) should: - be aware of signs of dysfunctional coparenting relationships - consider asking about family changes at each pediatric healthcare encounter - emphasize to parents that their behavior during & after a divorce is important for their child's adjustment. - always be the child's advocate - refer families to mental health services, as needed. - refer the child to protective services if there's a concern about current or future abuse or neglect [3]

References

  1. Ly DP et al. Divorce among physicians and other healthcare professionals in the United States: Analysis of census survey data. BMJ 2015 Feb 18; 350:h706 PMID: 25694110 http://www.bmj.com/content/350/bmj.h706
  2. Dupre ME et al Association Between Divorce and Risks for Acute Myocardial Infarction. Circ Cardiovasc Qual Outcomes (CIRCOUTCOMES). April 14, 2015 PMID: 25872508 http://circoutcomes.ahajournals.org/content/early/2015/04/13/CIRCOUTCOMES.114.001291.abstract
  3. Cohen GJ, Weitzman CC, COMMITTEE ON PSYCHOSOCIAL ASPECTS OF CHILD AND FAMILY HEALTH, SECTION ON DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS. Helping Children and Families Deal With Divorce and Separation. Pediatrics. November 2016 PMID: 27940730 http://pediatrics.aappublications.org/content/early/2016/11/24/peds.2016-3020