Family caregivers of children with disabilities might face high risks of depression, whereas the existing literature focused more on parents neglecting grandparents. This study investigated 380 parents and 108 grandparents of children with disabilities to identify depression and associated factors. Descriptive statistics, Chi-square test, Mann–Whitney U test, and multivariable logistic regression were performed to describe the participants’ characteristics and risks of depression and identify significant factors. Results showed that parents (35.5%) had higher risks of depression than grandparents (32.4%), but statistical differences were not found. Children’s sleep problems (AOR = 1.751, 95%CI = 1.019, 3.008), harmonious family relationships (AOR = 0.694, 95%CI = 0.569, 0.846), and better barrier-free construction (AOR = 0.742, 95%CI = 0.568, 0.970) were significantly associated with depression among parents. As for grandparents, higher education (AOR = 4.108, 95%CI = 1.526, 11.057) and caring for children who experience frequent mood swings (AOR = 2.242, 95%CI = 1.161, 4.329) were associated with higher risks of depression. Further, house ownership (AOR = 0.167, 95%CI = 0.031, 0.887), higher family cohesion (AOR = 0.545, 95%CI = 0.297, 1.000), and better barrier-free construction (AOR = 0.401, 95%CI = 0.185, 0.869) were associated with lower odds of depression. Therefore, both parents and grandparents of children with disabilities had high risks of depression and thus required urgent attention. Healthcare providers and policymakers should develop and implement interventions considering intergenerational differences to reach optimal efficiency.

Background: Due to the diversity and high sensitivity of the treatment, there were difficulties and uncertainties in the breast cancer surgical decision‐making process. We aimed to describe the patient's decision‐making behaviour and shared decision‐making (SDM)‐related barriers and facilitators in breast cancer surgical treatment.Methods: We searched eight databases for qualitative studies and mixed‐method studies about breast cancer patients' surgical decision‐making process from inception to March 2021. The quality of the studies was critically appraised by two researchers independently. We used a ‘best fit framework approach’ to analyze and synthesize the evidence.Results: Twenty‐eight qualitative studies and three mixed‐method studies were included in this study. Four themes and 10 subthemes were extracted: (a) struggling with various considerations, (b) actual decision‐making behaviours, (c) SDM not routinely implemented and (d) multiple facilitators and barriers to SDM.Conclusions: Patients had various considerations of breast surgery and SDM was not routinely implemented. There was a discrepancy between information exchange behaviours, value clarification, decision support utilization and SDM due to cognitive and behavioural biases. When individuals made surgical decisions, their behaviours were affected by individual‐level and system‐level factors. Therefore, healthcare providers and other stakeholders should constantly improve communication skills and collaboration, and emphasize the importance of decision support, so as to embed SDM into routine practice.Patient and Public Contribution: This systematic review was conducted as part of a wider research entitled: Breast cancer patients' actual participation roles in surgical decision making: a mixed method research. The results of this project helped us to better analyze and generalize patients' views.

Background/Objectives: Childhood disability is a major stressor for caregivers. There are many problems and challenges in relation to satisfying the psychological support needs of caregivers. This study aims to explore the modifiable psycho-behavioral and social–environmental factors of psychological support needs and need satisfaction, their interaction effects, and their configuration paths. Methods: This was a cross-sectional survey of 363 caregivers using instruments such as the psychological support needs subscale of the Care Needs Assessment Tool for Children with Disabilities. Multivariable logistic regression with interaction terms and crisp-set qualitative comparative analysis were performed. Results: The overall rate of psychological support needs was 78.29%, and the overall need satisfaction was 49.94%. Multivariable logistic regression analysis showed that the caregiver’s need was mainly influenced by anxiety, while need satisfaction was primarily predicted by public policy support and social attitudes. There was an interaction effect between caregiver anxiety and social attitude on need satisfaction. Qualitative comparative analysis indicated that six paths were identified as potentially leading to high levels of psychological support need, while five paths were associated with low levels of need satisfaction. Conclusions: The psychological support need rate among caregivers was high, and the level of need satisfaction was low. There were significant differences in psychological support needs and need satisfaction among different psycho-behavioral and social–environmental characteristics. It is recommended that caregivers with negative emotions be given more attention. The enhancement of social attitudes and the adoption of more supportive policies will contribute to the improvement of need satisfaction.