This essay begins with two stories that depict children with both a lack of care and care in exaggeration. My purpose with essay is to make socialization visible by discussing these scenarios and show how it is affected by both the lack of care and exaggeration of it. This is done by reflecting on and examining how the children in my stories are affected in the socialization process by their parents actions and decisions. But also taking in the educators' view of socialization and the importance of care for the child's well-being and opportunities for learning. As an educator, I Believe that we need to make visible and reflect on the cases that I have presented in my stories. This is to gain a better understanding of how we should respond to children whose social ability is reduced due to both lack of care but also excessive care. I will compare the care the children receive and how this goes together with socialization and also even why the subject is so difficult to talk about in preschool. Otherwise, I will reflect on my questions regarding the educators' knowledge, attitudes and responsibilities. The essay's structure is based on my stories. I will reflect and deepen the reflections by linking them to literature such as "social handling, sociala relationer" and to Mie Josephson's dissertation "Det ansvarsfulla mötet". / Denna essä inleds med två berättelser som speglar barn med brist på omsorg och omsorg i överdrift. Mitt syfte med essän är att synliggöra socialisering genom att diskutera detta och hur det påverkas utifrån både omsorgsbrist och överdrift. Detta görs genom att reflektera över och undersöka hur barnen i mina berättelser påverkas i socialiseringsprocessen av sina föräldrars agerande. Men även hur detta framträder mot bakgrund av pedagogernas syn på socialiseringen och omsorgens betydelse för barnets välmående och möjligheter till lärande. Som pedagog anser jag att vi behöver synliggöra och reflektera över de fall som jag har gestaltat i mina berättelser. Detta för att få en ökad förståelse för hur vi ska bemöta barn vars sociala förmåga reduceras på grund av både brist på omsorg men även överdriven omsorg. Jag kommer att jämföra den omsorg barnen får och hur detta går ihop med socialisering, även varför ämnet är så svårt att prata om i förskolan. Övrigt kommer jag reflektera över mina frågeställningar som handlar om pedagogernas kunskaper, förhållningssätt samt ansvar. Uppsatsens metod är essäskrivandet där jag utifrån mina berättelser reflekterar och fördjupar reflektionerna genom att koppla de till litteratur såsom “social handling, sociala relationer” samt till Mie Josefsons avhandling “Det ansvarsfulla mötet”.

Thesis (DPhil (Environmental Health))--Cape Peninsula University of Technology, 2016. / Informal caregivers play an important role in the well-being of dependent members in a household. The burdens of these caregivers are multiple and pervasive and may contribute to mental health epidemiology as a result of worry, grief, anxiety and stress. The literature review revealed that studies in caregiving and its various facets began from a pragmatically applied interest rather than from theoretical and intellectual curiosity. The majority of the research on caregiver burden involves meta-analysis of qualitative studies with little quantitative research. Also, many of these studies are concentrated on caregivers of chronically ill patients, such as those suffering from dementia, Alzheimer’s disease, and heart disease, without much attention to care burden resulting from caring for those who are not necessarily ill. Similar studies by other researchers did not consider the impact of the physical health of the care recipients or the environmental factors that are critical in the study of female caregiver burden in low-income settings. In addition, existing studies did not adequately evaluate the many potential factors that may vary and influence the lives of the caregivers, especially in a single, comprehensive model. This study attempted to provide a more complete picture of these relationships in low-income and culturally diverse settings. The study population consisted of black/African and coloured populations living in subsidised or low-cost housing settlements. In each of the two different cultural communities, 100 black/African and 100 coloured female caregivers were selected through a systematic random sampling procedure. In addition, data were also collected from caregivers in Tamale, Ghana to assess differences between the socio-demographic profiles of the caregivers in Cape Town, South Africa and Tamale, Ghana. The theoretical paradigm used in this study is the Stress Process Model by Pearlin et al., (1990). The study instrument assessed caregiver burden with both objective and subjective measures through the use of a fully structured questionnaire. The information that was collected according to the constructs of the Stress Process Model included personal and role strains and incorporated the physical health of the care recipients and environmental factors such as kitchen and toilet hygiene. Inclusion criteria for the respondents in both Cape Town and Tamale were the principal female caregivers who were present, willing, and able to give informed consent. The Statistical Package for Social Sciences (SPSS Version 22) was used for the analyses. The Chi-square test was used to assess the relationships between environmental health, the socio-demographics of the female caregivers and the health status of the care recipients. The hierarchical regression analysis in the form of a General Linear Model was used to model caregiving burden. iv The results showed that the majority of the female caregivers were in the age group 40 – 49 years and in both Cape Town and Tamale, a large proportion was in the low-income group. Also, the majority of the informal caregivers in the two samples were in care tasks as a full-time job, providing more than 40 hours of care per week. Regarding the length of time in caregiving, a large proportion of the caregivers in both Cape Town and Tamale had been in the care role for more than three years preceding the survey, and almost all the caregivers in the Cape Town sample (98.4%) did not use any form of caregiving programme to ameliorate the negative effects of caregiving. Further, the results showed statistically significant relationships between the socio-demographic characteristics of female caregivers (age, education, population group and income status) and the diarrhoea status of the care recipients. Also, a significant relationship was shown between environmental health variables of the home (kitchen hygiene and toilet hygiene) and the physical health of the care recipients. The major predictors of female caregiver burden in the samples were the physical health of the care recipients and access to social grants. On the basis of the analyses, it was recommended that the government should recognise the importance of the physical health of the care recipients and increase the amounts of social grants to the caregivers since this could improve the circumstances of both the caregivers and the care recipients. In addition, this could aid in improving the standard of living of caregivers in these households. Future research in similar settings should disaggregate the data to compare the burden of caring for caregivers of physically strong care recipients with physically ill care recipients.

Social support and acute care facility providers need information about how to help improve the practices and knowledge of caregivers related to the stages of palliative care. The purpose of this study was to examine whether there was a significant association between social support and psychological distress and behavioral outcomes among palliative care caregivers, and to determine to what extent social support buffered psychological distress and behavioral outcomes. The quality-of-life model guided the study. The study used a quantitative cross-sectional research design with secondary data analyses. The sample included 320 adult family caregivers who were part of a telephone survey on caregiver burden collected in 2000 representing the U.S. population. The independent variable was social support (caregivers' awareness of resources and receipt of direct support) and the dependent variables were psychological distress (anxiety, stress, and depression) and behavioral outcomes (sleep deprivation and patient abuse). Caregivers' receipt of direct social support significantly predicted reduction of psychological distress: anxiety (OR = .434, p < .001), stress (OR = .603, p < .041), and depression (OR = .464, p < .013). Social support was not a predictor of behavioral outcomes. The positive social change implications of this study include use of findings by healthcare providers and social service agents to formulate services to aid caregivers in reducing the burden of negative behavioral outcomes and improve quality of life of caregivers and their families.

Individuals who receive residential mental health services rely on caregivers for support, supervision, and a safe living environment. Residential clients exposed to workplace conflict among staff may feel insecure and mistrust their caregivers, which in turn could negatively impact quality of life and treatment outcomes. The theory of therapeutic alliance proposed by Zetzel, emphasizing the client's perception of the therapist as a nurturing beneveolent figure, was used as the conceptual framework for this phenomenological study. Semi-structured interviews were conducted with 6 adults, recruited with homogenious sampling, who had experienced conflict among staff members and who had been discharged from residential mental health services within the last two years. Participants were asked about treatment satisfaction and perceptions of their safety while in treatment. Open-coding, categorizing, and interpretation were used to create theoretical categories for interpretation and analysis. The themes that emerged in situations involving staff conflict included reporting of increased mental health symptoms, feeling ignored by staff, feeling fear, perceiving their basic needs as unmet, and noticing staff splitting. The social change implications of this study include findings can be used to benefit the clients of these facilities and also staff through education about how relationships among staff members impact treatment; these findings may result in improved treatment outcomes that would benefit not only the clients and their families, but also the staff and facility through improved treatment outcomes and satisfaction. In turn, improved mental health outcomes benefit society in general through reduced financial costs and increased productivity.

There are 15.9 million adults in the United States providing care to a family member diagnosed with Alzheimer's disease. Family member caregivers experience detrimental physical and mental health stress because of their caregiving role. The purpose of this study was to determine if the independent variables of marital status, perceived social support, and gender of family member caregivers of patients with Alzheimer's disease were related to the dependent variable of caregiver burden. The variables were examined through the lens of John Bowlby's attachment theory using archival data (n = 586) from the REACH II program. The results of the analysis of variance indicated that marital status did not affect level of burden. The outcome of a correlational analysis indicated a positive linear association between burden and social support. The result of an independent samples t test was that females reported higher burden than males. The outcome of a linear regression identified marital status, social support, and gender as predictors of caregiver burden. Positive social change implications of this study include contributing to scholarly literature, providing information for families to consider when implementing a plan for long-term care, and encouraging caregivers to seek professional support to minimize burden and maximize quality of life for themselves and the care receiver. Female caregivers with many social supports were identified as high risk for severe burden, an important factor for clinicians, agencies, and healthcare providers who work with family caregivers to consider. Identifying factors that contribute to burden and developing strategies to manage these factors may reduce severity of burden and improve quality of life for both caregivers and care recipients.

With increased life expectancy, more individuals will need to rely on caregivers and/or caregiving services. Filipino Americans are reluctant to depend on outside help when it comes to caring for their family members. There was a gap in the literature concerning the specific impact of the caregiving role on Filipino Americans and how cultural values affect the care provided to their family members. The purpose of this qualitative study was to gain understanding of how Filipino cultural values and life roles affected Filipino Americans' experiences of caregiving. The conceptual framework included the sociocultural stress and coping model. The central research question for the study was used to explore the personal impact of caregiving for Filipino Americans and the sociocultural factors affecting this role. A phenomenological research design guided the data collection and analysis process. Individual, semistructured interviews were conducted with 8 participants, recruited from several Catholic Church groups and Filipino community groups located in the Southwestern region of Houston, Texas. Data were analyzed using Moustakas' steps for phenomenological data analysis and 7 themes were identified: responsibility of caregiving, impact of caregiving on employment status, impact and importance of religion to caregivers, impact of Filipino heritage on caregivers, impact of care recipient's illness on the caregiver and recipient, resources for caregivers, and reflections on the caregiver experience. Filipino Americans are unique in their practices to provide care for their family members rather than relying on outside providers and institutions. This study may result in positive social change by understanding how societal supports can encourage a model of care based on cultural and familial values rather than outside institutional care.

Researchers have documented the increasing role of grandparents who provide care for their grandchildren; however, few have studied extended family reconciliation after grandparents assumed their primary care. This study explored the reconciliation experiences of 12 grandparents who were primary caretakers of their grandchildren. Using Moustakas's phenomenological research approach, the participants were interviewed about their experiences of the relationship triad (grandparent-grandchild, grandparent-adult child, parent-child). Attachment theory and family systems theory were the conceptual frameworks to explore the central research question, which addressed the meaning of extended family reconciliation for grandparents who become primary caregivers of grandchildren. Using NVivo, the interview data were coded and grouped into themes of shared meaning. The results revealed 4 distinct themes: watching my adult child struggle; recognizing challenges; my grandchild's wellbeing; and communicating with my grandchild. Further, the lived experience revealed that extended family reconciliation was largely dependent upon the adult child's willingness, readiness, and capability to participate in the reconciliation process. Results of this study have the potential to benefit children in their grandparents' care by providing insights into the reconciliation experience, with meaningful results to be shared with the professional community and grandparents who care for their grandchildren.

Using extant data from the Cache County Dementia Progression Study, this study examined the association of dementia caregivers’ personality traits (as assessed by the NEO Personality Inventory/Five Factor Inventory) and use of coping strategies (as reported on the Ways of Coping Checklist) with their care recipients’ outcomes including time to developing severe dementia, being institutionalized, and mortality. Up to 244 dyads of individuals with dementia and a primary caregiver were followed for a maximum of fifteen semi-annual visits, during which time information was collected on other potential caregiver and care recipient factors. The caregiver covariates analyzed in models included caregiver age, gender, kin relation to the care recipient, relationship closeness, and co-residency with care recipient. Potential care recipient covariates analyzed included gender, estimated onset age of dementia, completed education, and neuropsychiatric symptoms. Individual caregiver personality traits were not predictive of the examined care recipient outcomes. Among the caregivers’ coping strategies, more frequent caregiver use of Avoidance predicted care recipient time to severe dementia (hazard ratio (HR)=1.065,p=.034). More frequent use of Counting Blessings predicted 36% lower hazard of care recipient mortality (HR=0.648,p=.017) when also accounting for the increased risk of mortality with older care recipient age at dementia onset (HR=1.052,p=.004). Analyses revealed only low to moderate associations between some caregiver personality traits and coping strategies, with Neuroticism having the greatest number of significant associations with five emotion-focused coping strategies. Personality traits did not modify the associations between caregiver coping strategies (Avoidance and Counting Blessings) reported above. Generally, the examined caregiver characteristics often assumed to be more stable (i.e. personality traits) were not predictive of care recipient outcomes, while caregivers’ use of some coping strategies was predictive of development of severe dementia and mortality in care recipients. This allows for the possibility that interventions aimed at encouraging dementia caregivers to use effective coping strategies may promote better outcomes for care recipients.

The aim of this study was to make changes to how occupational therapists in a transitional care unit setting provide education about Cognitive Performance Test (CPT) scores to caregivers of those patients with dementia or suspected dementia. Caregiver education for this population is important, as the incidence of persons living with Alzheimer's disease and other dementias is expected to grow dramatically in the coming two decades. This study used a Participatory Action Research (PAR) approach to gather input from occupational therapists and caregivers of patients evaluated with the CPT. Interviews of caregivers indicated that they were unhappy with the education they received from therapists. Caregivers wanted a more collaborative relationship with therapists, and were sensitive to the experience of their loved one in occupational therapy in general, as well as to the approach to the education and the tone and language used to convey information about CPT scores. Therapists, with the caregiver input, worked together to develop education that reflected the needs of the caregivers, creating a new process, new tools and more opportunities for therapist- caregiver interactions. Interviews with a second group of caregivers who experienced the new education process revealed that they had a different, more positive experience overall with the new caregiver education process. This finding suggests that PAR as a methodology is well suited to facilitate changes to support development of client centered occupational therapy practice.

Indiana University-Purdue University Indianapolis (IUPUI) / The study examined the impact of the “big 5” personality traits on caregiver burden during the period when individuals with ASD transition from high school. Participants (N = 117) were caregivers of individuals with ASD who either will graduate within two years or graduated from high school within the past two years. Participants completed questionnaires measuring study variables predicted to be associated with caregiver burden as guided by the Double ABCX model of family adaptation, i.e., autism symptom severity, problem behaviors, pile-up of life demands, personality traits, social support, cognitive appraisals, and coping strategies. Primary caregivers reported moderate burden in the transition period. Specifically, although caregivers experienced stress in the transition period, they were less overwhelmed than the period when one’s child first receive the ASD diagnosis. Increased problem behaviors, higher neuroticism, lower extraversion, conscientiousness, and agreeableness, lower levels of social support, fewer use of challenge appraisals, and greater use of threat appraisals and passive-avoidance coping strategies predicted greater caregiver burden. Passive-avoidance coping mediated the relationship between caregiving stress and four personality traits respectively (i.e., neuroticism, extraversion, conscientiousness, and agreeableness). The results support the potential importance of personality traits in explaining differences in caregiver stress in families of those with ASD and further indicated that the association between personality and burden was mediated by caregivers’ use of maladaptive coping strategies, i.e., passive-avoidance coping. The findings also have potential applicability for interventions to reduce caregiver burden. Several factors were identified that could help alleviate the stress. For example, parents should be encouraged to avoid using threat appraisals and passive-avoidance coping strategies. In addition, interventions could be developed to provide support or strategies to parents to handle child’s behavioral problems and thus reduce stress.