The aim of this study was to examine the relationship between the stressors of caregiving for a schizophrenic patient and related outcomes. The Caregiver Stress Model was used as the conceptual framework for the current study. The sample of the study was composed of 98 Turkish caregivers of schizophrenic patients who were treated at psychiatry clinics of hospitals in Ankara. Twelve mediation models were tested using marital satisfaction and social support as mediators. The models contained primary stressor (basic needs), secondary stressor (activities of living), and intrapsychic strain (parental efficacy) as independent variables / and depression and general psychological health as dependent variables. The results suggested both social support and marital satisfaction as significant mediators of the relationships of both primary and secondary stressors with the outcome variables / however, social support and marital satisfaction were not significant mediators of the relationships between parental efficacy and outcome variables. The significant implications and limitations of the study were also discussed.

This study hypothesized that fathers and surrogates (male role models) contribute a unique set of factors that help guide African American male youths (N=496) during their normal developmental stages. This study hypothesized that surrogate caregivers would have an impact on the overall level of delinquent behavior of this population. A path analysis tested direct and mediated effects of exposure to violence on delinquent behavior, with anger/aggression level as a potential mediator for all three levels of caregiver presence or absence as a moderator. In the analysis of archival data from 496 African American male youths, the findings did not support these hypotheses consistently. Exposure to family violence as a mediator consistently predicted level of anger, and level of anger negatively predicted delinquent behavior for the fatherless sample. However, exposure did not have a direct positive effect on delinquent behavior in any of the three samples. Implications of these findings as well as other unpredicted findings with these three groups are explored.

Over the last several decades there has been a growing recognition that children with serious emotional disturbances are considerably underserved. The Comprehensive Community Mental Health Services for Children and Their Family Program is the largest federal grant program to help communities to implement, advance, and evaluate the system of care approach to service delivery. One of the goals of the evaluation has been to determine if children who participate in system of care services demonstrate improved clinical and functional outcomes over time. Prior research has revealed that children do display significant improvements over time. While this research is promising, it is also important to explore the variability in the rates of improvement to determine who benefits the most from system of care services. This dissertation explores the predictive role of a selected group of variables (behavioral and emotional strengths, caregiver strain, and demographic variables) on differential rates of improvements in clinical and functional outcomes over time for children who participate in systems of care. These variables were also examined in relation to differences in levels of clinical and functional impairments at intake into system of care services. The results from the latent variable quadratic growth models indicated that children who are served by systems of care displayed significant improvements in clinical and functional outcomes over time, with the greatest improvement occurring in the first six months. Children's behavioral and emotional strengths, caregiver strain, sex, age, and race significantly predicted differences in instantaneous growth, as well as rates of deceleration, for clinical and functional outcomes. Clinical implications, limitations of the study, and directions for future research are discussed. / text

Background: Research exploring the developmental of adolescent antisocial behaviour suggests that a secure attachment style is a protective factor against problem behaviour (Bowlby, 1969). It is theorised that disruptions in the attachment relationship can increase the likelihood of adjustment difficulties in adolescence, including antisocial behaviour (MacDonald, 1985). Such relationships have been inferred by cross-sectional research studies, but have yet to be tested in a longitudinal sample. Aims: This research is a secondary data analysis, using data from the Avon Longitudinal Study of Parents and Children cohort study, to explore the relationship between attachment and adolescent antisocial behaviour at age 15.5 years. Attachment was measured using three component measures; maternal sensitivity in infancy (sample 1), separations from main caregiver in early childhood, age 3-5 years (sample 2) and the presence of separation anxiety in middle childhood, age 81 months, 6.75 years (sample 3). Results: Logistic regression analyses were used to explore the relationships. Using available data, in sample 1 (n=456 complete cases) no evidence was found to support an association between non-positive maternal sensitivity in infancy and an increased incidence of adolescent antisocial behaviour (OR=0.79 [CI=0.42-1.48], p=0.46). In sample two (n=3,961), the number of separations in infancy were not found to significantly increase the risk of adolescent antisocial behaviour (OR=1.26 [CI=0.94-1.71], p=0.17). Separation anxiety in middle childhood was not found to have an effect on adolescent antisocial behaviour (OR=1.01 [CI=0.80-1.26], p=0.96). Conclusions: The findings suggest that although components of attachment, as measured in this study, were hypothesised to be associated with an increased risk of adolescent antisocial behaviour, this was not statistically supported in this study. In this study effects may be limited due to attrition, leading to the loss of antisocial adolescents from the study, creating a bias in the sample studied.

Bakgrund: Palliativ vård i hemmet är en ökande företeelse. Närstående vill ofta delta i vården som informella vårdgivare trots att det innebär stor påverkan på deras livssituation. Den palliativa vårdens uppgift är att i livets slutskede lindra och möjliggöra ett så bra liv som möjligt inte bara för patienten utan också för dennes närstående. Syfte: Syftet med studien var att belysa hur närstående upplever sin situation i den palliativa hemsjukvården. Metod: En litteraturstudie har genomförts med sökning i databaserna Cinahl, Pubmed och Medline. Tolv artiklar valdes ut för resultatet. I sju av de utvalda artiklarna användes kvalitativ metod, i två artiklar kvantitativ metod och i tre både kvalitativ och kvantitativ metod. Sju studier var svenska och övriga från Canada, Italien, Japan och Australien. Resultat: Resultatet visade att närståendevårdare hade både positiva och negativa upplevelser av att delta i vården av patienten och att de ofta kände otillräcklighet, osäkerhet och trötthet, vilket sedan gav upphov till många andra symtom såväl fysiska som psykiska och existentiella. Resultatet visade också att  närståendevårdarna hade ett stort behov av att få stöd, information och utbildning av sjuksköterskan i det professionella vårdteamet såväl under pågående vård som efter att patienten avlidit. Diskussion: Det blir ofta en svår balansgång för närståendevårdare mellan att ta hand om patienten och de egna behoven av vila och egen tid. De närstående behöver därför mycket stöd från det professionella vårdteamet för att kunna hantera sin roll som informell vårdare. Sjuksköterskan måste kunna uppmärksamma den enskilde individens unika behov genom att vara behjälplig i att finna omvårdnadsåtgärder som kan hjälpa de närstående att få så bra balans som möjligt i sitt dagliga liv trots vårdbördan. Jag anser att Carnevalis omvårdnadsmodell kan vara ett stöd i detta arbete. / Background: Palliative homecare is a growing phenomenon. Next of kins often participate in the care as informal caregivers, although it means a major impact on their lives. The goal of palliative care is to relieve and allow as good a life as possible, not only for the patients but also for their next of kins. Aim: The aim of the study was to shed light on how next of kins perceive their situation in palliative homecare. Methods: A literature study has been accomplished through searches in the databases Cinahl, Pubmed and Medline. Twelve articles were selected for the result. In seven of the articles qualitative method was used, in two articles quantitative method and and three articles both qualitative and quantitative method were used. Seven studies were Swedish and the others were from Canada, Italy, Japan and Australia. Results: The result showed that informal caregivers had both positive and negative experiences of taking part in the care of the patient and they often felt insufficiency, uncertainty and fatigue, which caused other symptoms, both physical and psychological and spiritual. The result also showed that the informal caregivers had a great need to get support, information and training from the nurse in the professional care team both during treatment and after the patient had died. Discussion: There is often a difficult balance for the next of kins between taking care of the patient and their own personal needs of rest and personal time. Next of kins therefore need support from the professional care team to manage their role as informal caregivers. The nurse must be able to pay attention to the individuals unique needs and to assist in finding nursing interventions that can help next of kins to get the best possible balance in their daily lives despite the care burden. I consider that Carnevalis nursing model can be supportive in this work.

Caring for an elder with dementia at home is considered a challenging and complex process. The purpose of this study was to describe the impact of family caregiving upon caregivers of elders with dementia on caregiver's health in the context of Chinese family caregiving. The investigation also describes the roles of caregiving appraisal, coping, familism, and perceived social support on the relationship between caregving stressors and caregiver outcomes.A cross-sectional correlational design was used to examine relationships among the variables. Ninety-six family caregivers of elders with dementia in China were recruited. Self-reported questionnaires were utilized to measure the variables.Results from bivariate correlational analysis found that ADL impairments had no any significant relationship with other variables and was not used in model testing.. Path analysis indicated that the proposed Dementia Caregiving Model did not fit the data well. Model modifications were performed based on AMOS 5.0 output and the theoretical rationale for the potential modifications. The modified final model fit the data perfectly. It explained 21.1% and 39.7% of the variance in caregiver physical health and psychological health respectively. In the final models, behavioral problems of care-recipients and perceived social support of caregivers had direct and indirect effects on caregiver physical health and psychological health. Familism and caregiving satisfaction only had indirect effects on caregiver psychological health and no effects on caregiver physical health. Conversely, caregiving subjective burden and coping had direct effects on caregiver health; burden had direct effects on both physical and psychological health of caregivers, whereas coping had a direct effect on caregiver psychological health.The findings enrich knowledge of dementia family caregiving in the context of China and Chinese culture and add the important variables of caregiver appraisal of caregiving satisfaction and familism to existing theories and models of stress and coping on family caregiving cross culturally. This study not only contributes to Chinese nursing research by introducing a conceptual model for family caregiving of elders with dementia, but also can be a basis for formulating interventions to help family caregivers of elders with dementia cope with their caregiving situations.

Persons with aphasia (PWA) have language difficulties and their Quality of Life (QoL) has most likely been affected. Because of their loss of language abilities, it is difficult to use PWA in QoL studies. This can lead to the use of proxy responses (a person who answers for the PWA). The aim of this study was to compare the rankings from QoL questionnaires for PWA with the rankings from their spouses/caregivers (i.e., proxyresponse). We also wanted to find out which of the 11 aspects of life PWA andspouses/caregivers ranked as the most respectively the least impacted ones. A totalnumber of 57 persons participated in the study. The participants consisted of two groups, one group with PWA and one group of their spouses/caregivers. A questionnaire-based cross-sectional survey completed via a face-to-face interview was used to collect data from both groups. The results showed that there was poor internal consistency and a weak correlation between the two groups. The two groups ranked different aspects of life as “most impacted” and “least impacted”. The PWA ranked Vocation/Occupation as the “most impacted” and Family life as the “least impacted”aspects of life. The spouses/caregivers ranked Overall ability to communicate as the“most impacted” and Ability to self-care as the “least impacted” aspects of life. The results indicate that proxy responses may not be appropriate and should be interpreted with caution in QoL studies with PWA.

This thesis explores the role of media in the lives of live-in caregivers in Montréal by looking at two Filipino newspapers and mainstream news coverage on Filipinas and the Philippines. While Filipino newspapers elaborate Filipino identity and speak back to stereotypes in mainstream news, their impact is curtailed by limited distribution and content range. Live-in caregivers in Montréal were selected as a special audience group through which to examine media representations of Filipinos because they are ‘othered’ through interlocking processes of gender and race. The live-in caregiver program (LCP), through which they migrate to Canada, lays bare the price that third world women immigrants are asked to pay for citizenship rights in Canada. LCP work is often underpaid, demeaning, and exploitative. Examining the lives and media habits of LCP workers ethnographically breaks new ground in studies of both domestic work and minorities and media in Canada.

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