Technological advances during the past 30 years have dramatically improved survival rates for children with life-threatening conditions (preterm births, congenital anomalies, disease, or injury) resulting in children with special health care needs (CSHCN), children who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who require health and related services beyond that required by children generally. There are approximately 10.2 million of these children in the United States or one in five households with a child with special health care needs. Care for these children is limited to home care, medical day care (Prescribed Pediatric Extended Care; P-PEC) or a long term care (LTC) facility. There is very limited research examining health outcomes of CSHCN and their families. The purpose of this research was to compare the effects of home care settings, P-PEC settings, and LTC settings on child health and functioning, family health and function, and health care service use of families with CSHCN. Eighty four CSHCN ages 2 to 21 years having a medically fragile or complex medical condition that required continual monitoring were enrolled with their parents/guardians. Interviews were conducted monthly for five months using the PedsQL TM Generic Core Module for child health and functioning, PedsQL TM Family Impact Module for family health and functioning, and Access to Care from the NS-CSHCN survey for health care services. Descriptive statistics, chi square, and ANCOVA were conducted to determine differences across care settings. Children in the P-PEC settings had a highest health care quality of life (HRQL) overall including physical and psychosocial functioning. Parents/guardians with CSHCN in LTC had the highest HRQL including having time and energy for a social life and employment. Parents/guardians with CSHCN in home care settings had the poorest HRQL including physical and psychosocial functioning with cognitive difficulties, difficulties with worry, communication, and daily activities. They had the fewest hours of employment and the most hours providing direct care for their children. Overall health care service use was the same across the care settings.

This dissertation studies the socio-economic challenges and the survival mechanisms of female-headed households in Bophelong Township. The study focuses on three areas namely, female-headed households, their socio-economic challenges and survival strategies. The study followed a literature survey first, then an empirical study. The literature study was undertaken to provide a theoretical framework for the empirical work. The survey process was undertaken in two phases. In the first phase, a sample survey of the whole area of Bophelong was undertaken. This was the sample from which female-headed households were identified. In the second phase, a household survey on the female-headed households serving the purpose of this study was undertaken. The method used in the measure of poverty is the Household Subsistence Level (HSL). The HSL measures the minimum amount needed by a household to maintain subsistence. It takes account of the sex and ages of household members. According to the study outcome, poverty levels amongst female-headed households in Bophelong are high. About 77% of sampled female-headed households in Bophelong were poor. The poverty gap index in these households was 0.53; meaning that on average poor households needs 53% of their income to reach their poverty line. High unemployment rate has been found to be prevalent amongst female-headed households in Bophelong, where the rate of 65% was recorded. This high unemployment rate was possibly the cause of poverty in these households together with low educational qualifications among households members; only 2% were found to have a post graduate qualification. Female-headed households in Bophelong township are engaged in a daily struggling to survive. These households have devised various means for survival. These include the search for wild fruits in the nearby areas, immigration to another region and the benefit of school feeding schemes. When it comes to the sources of household income, government grants were found to play an important role in the sustenance of these households. The average household income was calculated at R1760 per month. The average dependency ratio, which measures the number of unemployed who depend on one income earner, was 5.5. Finally, the investigation recommends a more detailed and deeper study relating to the socio-economic challenges faced by the female-headed households. There is also a need to explore on their survival means so as to direct policy actions aimed at addressing socio-economic issues relating to female-headed households in general. / Thesis (M.Com. (Economics))--North-West University, Vaal Triangle Campus, 2011

This dissertation studies the socio-economic challenges and the survival mechanisms of female-headed households in Bophelong Township. The study focuses on three areas namely, female-headed households, their socio-economic challenges and survival strategies. The study followed a literature survey first, then an empirical study. The literature study was undertaken to provide a theoretical framework for the empirical work. The survey process was undertaken in two phases. In the first phase, a sample survey of the whole area of Bophelong was undertaken. This was the sample from which female-headed households were identified. In the second phase, a household survey on the female-headed households serving the purpose of this study was undertaken. The method used in the measure of poverty is the Household Subsistence Level (HSL). The HSL measures the minimum amount needed by a household to maintain subsistence. It takes account of the sex and ages of household members. According to the study outcome, poverty levels amongst female-headed households in Bophelong are high. About 77% of sampled female-headed households in Bophelong were poor. The poverty gap index in these households was 0.53; meaning that on average poor households needs 53% of their income to reach their poverty line. High unemployment rate has been found to be prevalent amongst female-headed households in Bophelong, where the rate of 65% was recorded. This high unemployment rate was possibly the cause of poverty in these households together with low educational qualifications among households members; only 2% were found to have a post graduate qualification. Female-headed households in Bophelong township are engaged in a daily struggling to survive. These households have devised various means for survival. These include the search for wild fruits in the nearby areas, immigration to another region and the benefit of school feeding schemes. When it comes to the sources of household income, government grants were found to play an important role in the sustenance of these households. The average household income was calculated at R1760 per month. The average dependency ratio, which measures the number of unemployed who depend on one income earner, was 5.5. Finally, the investigation recommends a more detailed and deeper study relating to the socio-economic challenges faced by the female-headed households. There is also a need to explore on their survival means so as to direct policy actions aimed at addressing socio-economic issues relating to female-headed households in general. / Thesis (M.Com. (Economics))--North-West University, Vaal Triangle Campus, 2011

本研究旨在探討智能障礙者雙老家庭之照顧負荷、家庭復原力與家庭生活品質的關係，並檢驗家庭復原力對照顧負荷與家庭生活品質之調節情形。 本研究採取問卷調查法，採便利取樣方式進行資料蒐集工作，研究對象為79戶雙老家庭。資料分析以t考驗、單因子變異數分析、皮爾森積差相關分析與階層迴歸分析進行。研究主要結果如下： 一、雙老家庭的照顧負荷程度高，然家庭復原力及家庭生活品質的現況表現也普遍較高； 二、照顧負荷與家庭復原力具有顯著負相關； 三、照顧負荷與家庭生活品質具有顯著的負相關； 四、家庭復原力與家庭生活品質具有顯著的正相關； 五、家庭復原力可調節照顧負荷對家庭生活品質之負向效果。 本研究根據問卷調查結果，提出實務與後續研究之建議。 / The purpose of this study was to probe into the relations between care burden, family resilience and family quality of life of the double-ageing families that contain old parents and their children with intellectual disability, and to examine the moderating effects of the family resilience of care burden and the family quality of life. A questionnaire survey was used in the study which recruited 79 double-ageing families. The data of questionnaire survey were analyzed by t-test, one-way ANOVA, Pearson product-moment analysis, and hierarchical regression analysis. The results of the study were described as the followings： 1.Care burden of caregiver is in high-level；Family resilience and family quality of life levels of double-ageing families are positive, between mid-level and high-level. 2.There was significant negative correlation between care burden and family resilience. 3.There was significant negative correlation between care burden and family quality of life. 4.There was significant positive correlation between family resilience and family quality of life. 5.The family resilience moderated the negative effects of the family quality of life caused from care burden. Based on the results from the questionnaire survey, some suggestions for practice and future studies were proposed.