This thesis is concerned with families and chronic illness in childhood. The specific focus of the study is the nursing contribution to support of the family. A longitudinal study of the experience of four families caring for a child with cystic fibrosis was carried out using the ethnographic approach. Analysis of the four case studies provides insight to the effect of cystic fibrosis on each family member and on family interaction. The psychosocial transition by which the families moved from seeing themselves as healthy families to accepting the reality of a long-term health problem is described. The complexity of the effect of the genetic aspects and the grim prognosis is explored. The importance of finding meaning in suffering, the experiences of crisis and the chronic burden of care during the long-term adaptive stage of the illness are described. The support networks used by the families, and the nurse's contribution to that support are analysed. The research arose from practice and raises issues for nursing - issues relating to the level of interpersonal skill and the emotional investment required. The theoretical underpinning of nursing interaction is elaborated and the utility of systems theory in the understanding of the nursing situation is discussed. The importance of synchrony in the parents' adaptation to the child's illness is an emergent theme. The implications of the findings for nursing practice, management and research are discussed. The case for the development of a concept of family nursing to meet contemporary health care needs is argued.

There is no abstract available for this dissertation. / Department of Educational Psychology

The purpose of this focused ethnographic study was to describe the patterns of a good death held by elderly Japanese Americans living in Hawaii. Eighteen "healthy active" elderly Japanese Americans were interviewed individually. In addition, supplementary data, such as interviews with experts and field observations were collected for triangulation of the data. Four themes were derived from 1224 keywords, 56 categories, and 13 patterns. These were: being a burden to the family, process of life and death, individual views on death, and Japanese culture in Hawaii. Being a burden to the family was the largest concern in the participants' idea of dying a good death. Having secure financial resources were key for adequate preparation. The elderly Japanese Americans believed that suffering at the end-of-life should be avoided in order to achieve a good death. Their concept of suffering included: unmanageable pain, being ill for a long time, and being bedridden. Several participants preferred a sudden type of death because they would not have to suffer and not be burdens their family. Contentment in life was also an important aspect of a good death. There was a common belief that the way a person lived was connected with the way he/she died. A number of the participants preferred to die in their own home. Hospitals and retirement homes were other alternatives for the place of death. Individual views on death contributed to establish the concept of good death among elderly Japanese American participants. They shared similar attitudes toward death which were a part of life and inevitable. These attitudes were influenced by religious beliefs and past experiences with death. Different generations of elderly Japanese Americans had different views. The Shin-Issei (first generation who immigrated after World War II) and the Nisei (second generation) held more Japanese views compared to the Sansei (third generation) who were more acculturated. Although the Japanese American parents and children might have different views on life and death, the importance of close family relations and family support was passed on to younger generations.

The purpose of this study was to evaluate Leventhal, Nerenz, and Steele’s (1984) self-regulation model of adaptation to chronic illness when applied to children with asthma and their parents. The self-regulation model posits that illness representations influence coping, and via coping, adaptive outcomes. In the adult literature, illness representations or perceptions of symptoms, cause, time-line, consequences and control of illness have been found to be important determinants of coping and adjustment. No study, however, has examined illness representations in relation to coping and adjustment in children with a chronic illness or their parents. A second goal was to examine the influence of parents on the coping processes of their children. One hundred and twenty-eight children (7-13 years) with asthma and their 120 primary caregivers (96% mothers) were individually interviewed regarding their illness representations, and completed self-report questionnaires of coping and psychological adjustment. For both children and parents, illness representations had a direct association with psychological adjustment that was not mediated by coping. Children and parents who considered the child’s asthma to be a serious condition with frequent symptoms and serious consequences reported poor psychological adjustment, over and above any effect of the clinical severity of the illness itself. Parental illness representations and adjustment were significantly related to these same variables for children. However, after controlling for relevant demographic/asthma variables in regression analyses, only children’s illness representations remained significantly associated with parental illness representations. Children who demonstrated more negative illness representations had parents who also held more negative beliefs about asthma. These findings suggest illness representations to be an important target for psychological interventions.

Thesis (M.Psych.(Clin.)) -- University of Adelaide, Dept. of Psychology, 2003. / "17 April 2003" "Research report attachments submitted in partial fulfilment of the requirements for the Master of Psychology (Clinical). Includes bibliographical references.

Thesis (Ph. D.)--University of Hong Kong, 1995. / Includes bibliographical references.

Thesis (Ph. D.)--University of Texas at Austin, 2000. / Vita. Includes bibliographical references (leaves 219-234). Available also in a digital version from Dissertation Abstracts.

Theses (Ph. D.)--Marquette University, 2009. / Marilyn Frenn, Robert Fox, Marge Sebern, Pippa Simpson, Advisors.

No description available.

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