published_or_final_version / Nursing Studies / Master / Master of Nursing

Stroke is a medical event that has serious consequences for the survivor, his family, and society. Stroke is the third leading cause of death in the United States, and two-thirds of stroke survivors are permanently disabled with one-half of these survivors considered severely impaired. The economic burden from stroke is estimated to be $30 billion annually in health care costs and lost productivity.This study described the needs of 35 caregivers of stroke survivors within 24 hours of discharge to home from an acute care "safety net" teaching hospital in Indiana and how well those needs were met. Two subscales, (a) the Need for Information and (b) Patient Care Needs, of the Home Caregiver Need Survey were used. The theoretical framework for this study was the Neuman Systems Model.The stroke survivors were over 50 years old (77.1 %), half were African-American and half were Caucasian, and about a quarter were minimally impaired (25.8%) and less than a quarter were very impaired (22.9%) cognitively and/or physically upon discharge to home. Their caregivers were their children (48.6%) or spouses (28.6%), half of whom worked full-time outside the home. Most (85.7%) caregivers were female, in good health, and with no experience (81.8%) in caring for patients at home. / School of Nursing

This study examined the support services offered to kinship providers through the Kinship Family Center and find ways to increase and/or improve these support services for kinship care providers who are caring for children that are dependents of San Bernardino County.

The purpose of this study was to examine the effects short-term respite care had on caregivers of elderly and brain-impaired adults. The study also sought to examine the role that social support plays in determining satisfaction with respite care.

Parenting is a stressful endeavor that can be even more difficult for parents of individuals with Autism Spectrum Disorders (ASD). Autism Spectrum Disorder (ASD) has become increasingly prevalent over the past 15 years, which has baffled researchers and frustrated parents. Respite can be important to help alleviate stress for parents of individuals with ASD, and serve as a break for them from the demands of parenting. The present study utilized a mixed methods design to study the effect of respite on caregiver well-being. Using quantitative data, the study examined the effects of a respite cruise vacation organized by a travel group called Autism on the Seas on various indices of well-being among 20 parents of children with ASD. Parents provided survey responses prior to the cruise (pre-cruise measure) and three months after the cruise (post-cruise measure). Variables included caregiver stress, caregiver self-efficiency, caregiver social network and family quality of life. It was hypothesized that the Autism on the Seas respite vacation experience would be related to increased well-being among caregivers, specifically decreased caregiver reports of stress, increased caregiver reports of social network, increased caregiver reports of family quality of life, and increased caregiver report of self-efficacy. The quantitative study found significant associations among the well-being variables, however no statistical difference between the caregivers’ reports of well-being on pre and post cruise measures. The qualitative component of the study aimed to describe perceptions of respite, barriers to respite-utilization, and aspects of respite that caregivers of children with ASD described as most beneficial. Six couples and one single father participated in the qualitative component of the study. Interview transcriptions were all analyzed through open coding and then axial coding to find data trends and themes. It was hypothesized that respite would bring positive experiences to caregivers, allowing caregivers to take time to maintain their own well-being psychologically and physically. The qualitative study revealed the themes of the centrality of trusted caregivers to parent’s willingness to accept respite, limited social networks of parent with children with ASD, and both caregiver well-being and child well-being and severity of ASD as important to parents’ use of respite programs such that parents of children with more severe ASD reported more trouble accessing respite care. Together, the study points to the need for future studies to investigate a broad range of types of respite programs for individuals with ASD and their families.

Thesis (MCur (Interdisciplinary Health Sciences. Nursing Science))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: Background & rationale: South Africa is faced with the major challenge of HIV/AIDS. Every South African has a vital role to play in managing this public health problem. One of the best ways of managing it is by informing and educating the communities about HIV/AIDS, as the communities lack knowledge about it. Problem statement: Due to the increase in the number of patients infected with HIV/AIDS, an informal caregiver’s programme was introduced to ensure that patients are better cared for at home, in a familiar environment and by their family members. Purpose and objectives: The purpose of the study was to evaluate the effect of an informal caregiver’s programme on the care of patients with HIV/AIDS. The objectives included evaluating the effect of care, physically, socially, spiritually, emotionally, information and educational support given. Methodology: A phenomenological research design was applied to evaluate the effects of an informal caregiver’s programme implemented for the care of patients infected with HIV/AIDS at Mfuleni Township in the Cape Metropolitan area. Population and sampling: The population of this study were HIV/AIDS infected patients who were participating in the informal caregiver’s programme. Ten of these patients, who gave consent, participated in the study. Reliability, validity & pilot study: The trustworthiness of this study was assured with the use of Lincoln and Guba criteria of credibility, transferability, dependability and conformability. A pre-test study was also completed. Ethical considerations: Ethical approval was obtained from the Stellenbosch University and the required consent from the individual participants. Data collection, analysis and results: Data was collected through an interview using an interview schedule based on the objectives. Data was analysed and the findings show that the care given to patients infected by HIV/AIDS at home through an informal caregiver’s programme has a positive outcome. Recommendations and conclusion: On the spot training of participants and their family members is recommended. The community health workers form a very strong support base for the participants. / AFRIKAANSE OPSOMMING: Agtergrond en rasionaal: Suid-Afrika kom te staan voor ’n reuse uitdaging t.o.v. HIV/VIGS. Elke Suid-Afrikaner het ’n belangrike rol te speel in die beheer van hierdie openbare gesondheidsprobleem. Een van die beste maniere om dit te beheer, is om gemeenskappe in te lig en op te voed aangaande MIV/VIGS, aangesien daar ’n gebrek aan kennis hieromtrent is. Probleemstelling: Weens die toename in die aantal pasiënte wat deur MIV/VIGS geaffekteer word, is ’n informele versorgingsprogram daarop ingestel om te verseker dat pasiënte beter tuis versorg word in ’n bekende omgewing en deur hul familielede. Doel en doelwitte: Die doel van hierdie studie was om die effek van ’n informele versorgingsprogram in die versorging van pasiënte met MIV/VIGS te evalueer. Die doelwitte is uiteengesit om die effek van die versorging wat gegee is, te evalueer met verwysing na die fisiese, sosiale, geestelike, emosionele, inligting en opvoedingsondersteuning te evalueer. Metodologie: ’n Fenomenologiese navorsingsontwerp is toegepas om die effekte te evalueer van ’n informele versorgingsprogram wat geïmplementeer is vir die versorging van pasiënte wat deur MIV/VIGS geaffekteer is in die Mfuleni woonbuurt in die Kaapse Metropolitaanse area te evalueer. Bevolking en steekproef: Die bevolking van hierdie studie is MIV/VIGS geaffekteerde pasiënte wat deelgeneem het aan die informele versorger se program. Tien van hierdie pasiënte wat toestemming verleen het, het deelgeneem aan hierdie studie. Betroubaarhied, geldigheid en loodsondersoek: Die betroubaarheid van hierdie studie is verseker deur die gebruik van Lincoln en Guba se kriteria van geloofwaardigheid, oordraagbaarheid, afhanklikheid en ooreenstemmigheid. ’n Aanvoortoets is ook voltooi. Etiese oorwegings: Etiese goedkeuring is van die Stellenbosch Universiteit en die vereiste toestemming van die individuele deelnemers verkry. Dataversameling, analise en uitslae: Data is ingesamel deur gebruik te maak van ’n onderhoudskedule wat gebaseer is op die doewitte. Data is geanaliseer en die bevindinge het bewys dat versorging wat by die huis deur ’n informele versorgingsprogram aan pasiënte gegee word wat met MIV/VIGS geaffekteer is, ’n positiewe uitkoms het. Aanbevelings en gevolgtrekkings: Op-die-plekopleiding van HIV geïnfekteerde pasiente en hul familielede word aanbeveel. Die gemeenskap se gesondheidswerkers bied ’n sterk ondersteuningsbasis aan die deelnemers.

More than three decades after the outbreak of the AIDS pandemic, sub-Saharan Africa is home to the largest epidemic in the world. Over 70% of infected people live in this region and are aged 15–49 years. Given that it is at this age that young adults are more likely to start families, their death as a result of AIDS gives rise to the crisis of AIDS-orphaned children. Several studies show that the number of AIDS orphans is on the rise and can reach up to 18 million throughout the continent. Generally, patients expect to be admitted in formal health care facilities for adequate treatment but the absence of cure and an increasing number of infected make it difficult for them to be treated as in-patients. In order to fill the gap, the elderly care for AIDS patients and take on the parenting role of AIDS orphans. However, there is not much information on the implications of caregiving on the well-being of the elderly. This dissertation aims at shedding light on this issue – using data from an informal settlement in the province of KwaZulu-Natal – in order to highlight the risks to the health of elderly caregivers. The elderly are the primary caregivers to thousands of AIDS patients and AIDS-orphaned children across sub-Saharan Africa. Their caregiving activities are strenuous and repetitive on a daily basis. Through qualitative data collected from 14 elderly caregivers, this project found that their well-being was compromised by several caregiving activities and the expectations placed upon them were unbearable. The vulnerability of caregivers was emphasized by the high number of dependents that resulted in lowered standard of living. There was also the risk of contracting HIV during caregiving since the elderly were not able to afford protective equipment. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2012.

The purpose of the study was to investigate the lived experiences of young people living with mental healthcare users (MHCUs) in order to gain insight into their needs and how their daily coping can be maximised. A qualitative, descriptive phenomenology study was undertaken, with face-to-face, audiorecorded individual in-depth interviews conducted with 10 participants aged between 19 and 23 years, at their homes. Participants were recruited from one of the local health clinics in Dikgale area, Limpopo province, where the MHCUs collect medication and attend follow-up medical reviews. Non-probability purposive sampling technique was used to select the sample size. The following were the objectives of the study:  To explore and describe the lived experiences of young people living with MHCUs.  To determine the coping strategies of young people living with MHCUs. Five themes and 12 sub-themes emerged from the study. The findings of the study revealed that young people were faced with psychological effects, caring demands and responsibilities, effects on their schooling performance, and lack of coping and support. The study results informed recommendations to the psychiatric nursing services on the needs and support to be provided to these young people in order to ensure maximum coping in their life situation. / Health Studies / M.A. (Nursing Science)

M.Ed. (Educational Psychology) / Please refer to full text to view abstract

Indiana University-Purdue University Indianapolis (IUPUI) / Type 2 diabetes, a chronic condition affecting millions, continues to rise in epidemic proportions. Type 2 diabetes, managed through lifestyle changes, affects the entire family. Family caregivers provide vital support to these individuals; however, little research has been conducted surrounding the perceived difficulty or ease of caregiver activity and supportive behaviors. The purpose of this dissertation was to develop and psychometrically test a scale that measures this difficulty or ease of activities and behaviors. This was accomplished through the compilation of three distinct manuscripts. First, an integrative review was conducted to identify what is known regarding needs and concerns of family caregivers of persons with type 2 diabetes; findings revealed a need for more research. Then, based on these recommendations, a qualitative study was conducted that explored the needs and concerns identified by 33 American Indian, African American, and White family caregivers. All these caregivers had similar concerns related to needing general diabetes information, providing support to the family member, and taking care of their own health. Study themes were used to develop items for a new instrument, the Diabetes Caregiver Activity and Support Scale (D-CASS) that was psychometrically tested with 101 American Indian, African American, and White family caregivers of persons with type 2 diabetes. This study used a cross-sectional, descriptive-correlational design and provided evidence of internal consistency reliability (α = .82) and two-week test-retest reliability (intraclass correlation coefficient = .70) for the D-CASS. Criterion-related validity was established using a single-item criterion measuring overall how easy or difficult it was for caregivers to provide care for their loved ones (r = .65, p < .01). Unidimensionality was supported by factor analysis, with loadings ranging from .45 to .70, with 32% of the variance explained by the first factor (eigenvalue = 4.02). Model testing through a series of three hierarchical multiple regressions guided by a conceptual model provided further evidence of construct validity for the D-CASS. This dissertation provided better understanding of needs and concerns of family caregivers of persons with type 2 diabetes and led to the development of a psychometrically sound diabetes-specific instrument for future research.