MSc (Nursing), Faculty of Health Sciences, University of the Witwatersrand / The purpose of this study was to elicit and compare nurses’ and families’ perception of family needs in intensive care unit. A quantitative non-experimental, comparative and descriptive research design was used to achieve research objectives. Participants (nurses, n= 65; family members, n= 61) were drawn from three intensive care units. Data were collected using a questionnaire developed from the Critical Care Family Needs Inventory (CCFNI). Descriptive and inferential statistics were used to analyze the data. Majority (more than 50%) of both groups agreed with 42 out of 45 family need statements. All the nurses (100%, n=65) agreed with the need ‘to have explanations that are understandable’ while most family members (98%, n=58) agreed with the need ‘to feel that health care professionals care about the patient’. Seven out of ten statements agreed by majority of both groups were similar. Most of these statements were related to assurance and information need categories. In addition, both groups scored high on the two categories, assurance and information. However, family members scored higher than nurses in two categories, assurance and proximity with statistically significant difference (p-value < 0.05). Based on the research findings, it can therefore be concluded that generally there were similarities between nurses’ and families’ perception of family needs. These findings support evidence in literature resulting from previous studies.

What are the factors that shape views and attitudes toward the family, and how are these views and attitudes influenced in changing cultures? Do culture, social change/economic development, childhood experiences, and gender influence family centredness and democratisation? Are there different levels of factors that impact on family centredness and democratisation? If so, how are these factors interlinked? The studies discussed in detail in this thesis investigated family perceptions across cultures and generations, looking closely into specific aspects of family views and attitudes and various factors that impact on them. This thesis attempts to answer these questions by conducting three experiments. Study I (described in Chapter 3), which was conducted in Hungary, South Korea, and Canada (total N=403), tested a hypothesised model based on the literature review (Chapter 2). The study looked at cultural differences in family centredness and democratisation, and the impact of cultural orientation, gender, economic growth (national-level), Postmodernist Values, and political beliefs on perceptions of family centredness and democratisation. Study II (described in Chapter 4), conducted in the US and South Korea amongst young individuals in their late teens or early twenties, and their parents' generations, mostly in their forties and fifties (total N= 230). It expanded on the model by adding Schwartz' value dimensions, self-beliefs, and broader aspects of family perceptions. Furthermore, Study II investigated the intergenerational differences and the impact of childhood experiences by comparing data from two generational groups. Study III (Chapter 5) was conducted in four cultures, Canada, Britain, South Korea, and Japan on 539 university students, in order to ascertain cultural influences on values, beliefs, and family centredness and democratisation. Study III also investigated the interlinks between the factors in each culture more specifically using multi-group analysis method in SEM (Structural Equation Modelling). The final chapter summarises and discusses the implications of the major findings from these studies, and makes note of possible methodological issues. Overall, cross-cultural differences in value priorities, self-beliefs, political beliefs, and perceptions of family centredness and democratisation were found. Generation/age, country-level economic growth and gender were significant predictors for values, beliefs and family views and attitudes discussed in this work. Women and younger generations were more likely to endorse the Autonomous-Related Self-belief, believe in the importance of family democratisation. Stronger belief in the Autonomous-Related self led to higher emphases on family centredness and democratisation. Significant relationship was also found between family centredness and democratisation and individual-level values and beliefs, where stronger democratic beliefs led to stronger belief in the importance of family democratisation, higher endorsement of Self-Transcendence values predicted higher levels of family centredness and democratisation, and stronger Consevation Values predicted higher level of family centredness. By investigating factors influencing family centredness and democratisation, the current work probed into the family in the contemporary world. In line with Kagitcibasi's new model of family change, this thesis demonstrates that certain features of family views and relationship, including perceptions of family centredness, are likely to persist, and contends the individualisation theorists' (e.g., Beck, 1997; Giddens, 1992) negative predictions for the future of the family.

Purpose: To describe family perceptions about pediatric primary care management following diagnosis of type 1 diabetes mellitus (T1DM) in preschool-aged children living in the Pacific Northwest region of the United States. Study Design and Method: Mothers of children diagnosed with T1DM before the fifth birthday and within the past two years were recruited anonymously through two regional support groups. Perceptions about pediatric primary care management following T1DM diagnosis were elicited through an anonymous 30-item online survey. Demographic characteristics of mother and child were obtained as well as information about five important domains of health care management for a young child with T1DM: (1) multidisciplinary, (2) holistic and compassionate, (3) accessible and communicative, (4) uses current standards and technology, and (5) actively promotes safe self-management. Results: Twenty-one biological mothers participated in this study, each on behalf of a child diagnosed with T1DM who fit inclusion criteria. Overall mothers held positive perceptions about care management by PCPs and endocrinologists within context of each of the five domains. Most mothers felt included in care planning, valued periodic well-child exams, and believed the child's providers were accessible, communicated effectively, and usually demonstrated consideration/compassion for the family. Although a majority of mothers at least somewhat agreed that the PCP used current standards and technology to care for the child, and functioned as the center of his/her health care coordination, these domains elicited a slightly greater number of responses indicating uncertainty or disagreement. Clinical Implications: Nurses and pediatric practitioners can use findings from this study to plan continued exploration into the perceptions and care management needs of families following diagnosis of a very young child with T1DM. The domains of care used to assess mothers' perceptions about care management-based on tenets of the Chronic Care Model (CCM) and Patient Centered Medical Home (PCMH)-can be used by pediatric PCPs and endocrinologists to dialogue with patients and staff about how care management may be improved for these families. Providing opportunities for feedback to the families of young children with T1DM should be encouraged so future research can examine relationships between care management variables and clinical outcomes.