BACKGROUND: Many families of children who are deaf or hard of hearing (DHH) pursue the development of spoken language through the use of advanced hearing technology and intensive, specialized listening and spoken language (LSL) intervention services. LSL practitioners utilize caregiver coaching to transfer knowledge and skills to parents, equipping them to effectively support their child's listening and language development. Caregiver coaching builds parents' capacity to implement intervention strategies within daily routines to maximize learning opportunities to reach this goal. While caregiver coaching is a hallmark of LSL practice, there is a lack of consensus and paucity of evidence to support its use with children who are DHH learning to listen and talk. The purpose of this research was therefore to gain a greater understanding of caregiver coaching practices in LSL services for families of children ages birth-3 who are DHH. OBJECTIVES: 1) to provide a synthesis of the literature and identify gaps in the existing knowledge base regarding coaching in LSL services, 2) to gain insight into practitioners' and caregivers' experiences with coaching in LSL services, and 3) to gain a better understanding of coaching practices in LSL services with families of children who are DHH. METHODOLOGY: The first objective was addressed by performing a scoping review of the literature to synthesize the relevant research and professional practice recommendations and identify gaps in the knowledge base regarding coaching caregivers in LSL practice. The remaining objectives were addressed through qualitative, semi-structured interviews and video observation discussions with LSL practitioners and caregivers to gain insight into caregivers' perspectives and practitioners' perspectives and practices. Interviews were conducted with 14 practitioners and 13 caregivers at three intervention sites in the US and Canada. These sites represent three different service delivery models of LSL intervention for families of children who are DHH. RESULTS: The scoping review findings revealed a lack of consensus in the literature regarding the principles and practices of caregiver coaching in LSL services. We presented the following topics found in the literature: coaching practices, training for coaching, the effectiveness of coaching, and recommendations for coaching. Caregivers reported coaching as a positive experience; however, coaching practices differed among sites and between practitioners, supporting the results of the scoping review. The caregivers indicated factors that contribute to a positive coaching relationship, including practitioner characteristics, establishing explicit expectations, and adapting to caregivers' changing needs over time. The practitioner interviews also supported a lack of consistency in coaching practices between sites and indicated that underlying beliefs impact how practitioners coach and engage caregivers. CONCLUSION: The findings from this dissertation provide practical, actionable steps that LSL practitioners can implement to develop and support the caregiver coaching relationship. These findings have the potential to inform professional preparation and development activities to better equip practitioners to engage caregivers in the intervention process, and ultimately, positively impact the listening and spoken language outcomes of the children they serve.

Informal caregivers (CG) of persons with dementia can experience increased negative effects and symptoms of burden as the disease progresses, with long-term effects into bereavement. The purpose of this study was to describe staff and attendees’ perceptions of a unique CG psychoeducation program located in a Specialized Care Unit for persons with advanced dementia at end-of-life. This study used a qualitative descriptive design, which aimed to describe a natural experience. Sixteen individual interviews were conducted with current and bereaved CGs who jointly participated in the program, health care professionals (HCP) in the Specialized Care Unit and social work facilitators to understand experiences, perceived benefits and barriers of the program. Thematic content analysis was conducted with data collection following Hamilton Integrated Research Ethics Board approval. Final results indicate that the program was perceived positively, across all participant groups. Caregivers reported that the program contributed to improved emotional well-being, development of a close community, disease preparedness and empowerment. Participants also appreciated the open-ended, informal format of the program with continuity into bereavement. The study findings support the unique characteristics of this psychoeducation program compared to traditional education / support programs, which are closed to bereaved members and time-limited. This program model is translatable to multiple settings including long-term care. Moreover, study findings highlight the movement towards relationship-centered care for persons with dementia and their CGs. A future mixed-method study is warranted to measure quantitative outcomes, such as complicated grief, within CGs attending the program before and after bereavement. / Thesis / Master of Science (MSc) / Family caregivers of persons with dementia can become depressed, anxious and isolated over time from caregiving. These feelings often do not go away even after the person with dementia has died. In this study, caregivers of people with advanced dementia or who had died, described how they felt about a new support and education program in a special unit of the hospital. Findings showed that caregivers believed the program helped them become: more balanced and part of a supportive community, empowered and prepared for end-of-life and occasionally frustrated. Caregivers whose family member had died felt the program gave them continued support, a chance to help others, and a place to continuing learning. Nurses should try to include caregivers in caring for people with dementia, learn about the program, become more involved, encourage people to attend, and help to begin the program in other areas of the hospital and long-term care.

Bakgrund: Schizofreni är en allvarlig psykossjukdom som påverkar 0,4–1 procent av befolkningen. Anhörigvårdare, som utgör nästan en femtedel av den vuxna befolkningen i Sverige, ger vård eller stöd till någon nära. Att vara anhörigvårdare till en person diagnostiserad med schizofreni innebär en stor utmaning och påverkar olika aspekter av livet i större eller mindre utsträckning. För sjuksköterskor är det viktigt att förstå anhörigvårdarnas upplevelser för att kunna stödja anhörigvårdarna effektivare.  Syfte: Syftet med denna litteraturöversikt var att beskriva upplevelser av att vara en anhörigvårdare till en person diagnostiserad med schizofreni.  Metod: För att besvara syftet har en litteraturöversikt valts som metod. Artikelsökningen genomfördes i två databaser, CINAHL Complete och PubMed, vilket resulterade i tolv kvalitativa originalartiklar som därefter analyserades enligt Fribergs beskrivning av analysarbete.  Resultat: Författarna identifierade fyra huvudteman: Anhörigvårdares upplevelser av otillräckliga stödresurser, Anhörigvårdares känslomässiga utmaningar, Anhörigvårdares livsförändringar och anpassningar samt Den positiva påverkan av att vara anhörigvårdare.  Slutsats: Anhörigvårdare för personer med schizofreni stöter på en del utmaningar i sin vårdarroll och behöver stöd från både vården och familjemedlemmar. De behöver också kunskap för att ge adekvat stöd till personen med schizofreni. Trots känslomässiga utmaningar och livsförändringar upplevde anhörigvårdare även positiva upplevelser, där de kände sig emotionellt starkare och har ökat tålamod för andra. Enligt transitionsteori är sjuksköterskan den första som möter en person och dess familj under en transition och därför är det viktigt att sjuksköterskan erbjuder stöd och tillhandahåller information som främjar en framgångsrik transition, där vårdandet inte blir en börda för anhörigvårdaren utan istället en möjlighet till att bli en starkare person. / Background: Schizophrenia is a severe psychotic disorder that affects 0.4–1 percent of the population. Caregivers, constituting nearly one-fifth of the adult population in Sweden, provide care or support to someone close. Being a family carer for a person diagnosed with schizophrenia is a big challenge and affects various aspects of life to a greater or lesser extent. For nurses, understanding the experiences of caregivers is crucial for providing more effective support for family caregiver.  Aim: The purpose of this literature review was to describe experiences of being a family caregiver to a person diagnosed with schizophrenia.  Method: To answer the purpose, a literature review has been chosen as the method. The article search was conducted in two databases, CINAHL Complete and PubMed, resulting in twelve qualitative original articles that were subsequently analyzed according to Friberg´s description of the analysis work  Results: The authors identified four main themes: Family caregivers' experiences of insufficient support resources, Emotional challenges of family caregivers, Life changes and adjustments of family caregivers, and The positive impact of being a family caregiver.  Conclusion: Family carers for people with schizophrenia encounter some challenges in their carer role and need support from both healthcare and family members. They also need knowledge to provide adequate support to the person with schizophrenia. Despite emotional challenges and life changes, family caregivers also experienced positive experiences, where they felt emotionally stronger and have increased patience for others. According to transition theory, the nurse is the first to meet a person and their family during a transition, and therefore it is important that the nurse offers support and provides information that promotes a successful transition, where care does not become a burden for the family caregiver, but instead an opportunity to become a stronger person.

Geographical isolation and a lack of gender-sensitive and caregiver-friendly workplace policies (CFWPs) in work settings lead to adverse impacts on the economic, emotional, and physical health of Transnational Carer-Employees (TCEs). TCEs are employed immigrants who engage in caregiving to their loved ones across borders while residing in the host country. The secondary analysis conducted herein looked at the experiences, commonalities, and differences among 29 TCEs from Pakistani, Syrian, African, and South American backgrounds living in London, Ontario, before and after COVID-19. Constructivism and intersectionality informed thematic analysis of the data highlighted that among the respondents, care is a religious obligation, influenced by culture as the eldest child or those living abroad are expected to help family back home and that men provide more financial caregiving whereas women divulge in higher physical and emotional care. Results also exhibit that TCEs work in low-skilled jobs due to a lack of English proficiency, care is limited because of financial barriers, and employer support, financial relief, and increased vacation time are the recommendations by TCEs for workplace policies. This thesis further showcases that there are more similarities than differences between the four visible minority cohorts. Most participants observed satisfaction after providing transnational care, whereas a few interviewees of Syrian and African origin reported feeling overwhelmed. While many TCEs observed low income and decreased work opportunities after COVID-19, a few participants of African ethnicity, working in essential services, disclosed an increased workload post-pandemic. This research reveals that to manage their care and work duties, visible minority TCEs apply four common coping strategies in their lives: praying, keeping busy, staying active, and family support. Implications of this thesis include the promotion of CFWPs in places of employment to sustain the welfare of TCEs and the Canadian economy. / Thesis / Master of Science (MSc) / Transnational Carer-Employees (TCEs) are immigrants who provide caregiving to their families or friends in other nations while being employed in the country of resettlement. Immigrants are an integral part of the Canadian population growth and economy; however, their simultaneous work and unpaid care outside Canada have negative impacts on their well-being. The goal of this thesis was to explore the experiences of visible minority TCEs living in London, Ontario, before and after COVID-19. This research determines that many participants experience deskilling, are unaware of carer-friendly policies, and believe that caregiving is a cultural expectation. Findings also illuminate that care varies by gender, can lead to both feelings of reward and frustration, and that TCEs are unable to provide their desired level of care due to financial constraints. This research urges employers to accommodate TCEs through Care-Friendly Workplace Policies (CFWPs) in work settings such that the health of TCEs can be improved.

In Sweden as well as internationally, the demographic development is moving towards an increasingly older population. At the same time the risk for dementia increases with age. This implies a future increased need for care and support for the elderly and for those diagnosed with dementia. Currently, family members already take a substantial responsibility for their relatives´ care and support, which can impose both physical and psychological burdens on the caregivers. The purpose of this study is therefore to explore the experience of informal caregiving. This is achieved through a thematic analysis of three authors´narratives of their relationship with a parent with dementia. The results indicating that informal caregiving is demanding and exhausting while the satisfaction with the relationship provides a sense of purpose, which influence the experience of caregiving. Furthermore, an effective communication and positive interactions with care professionals facilitate the process. Continued research is necessary to assess the specific support that adult children of parents with dementia require.

Background: Autism and other neurodevelopmental disorders (NDD) are common in low- and middle-income countries (LMIC). However, services to address the needs of this group in LMIC are almost non-existent. The World Health Organization (WHO) developed the Caregiver Skills Training (CST) programme to be suitable for delivery in diverse global contexts. Ethiopia, the country of focus in this study, has a largely rural population and a lack of specialist service providers. Additional contextual challenges, including poverty, low literacy, limited access to healthcare and a lack of specialist child mental health services, may undermine the delivery of CST in this setting. This thesis, therefore, seeks to explore the acceptability and feasibility of non-specialist delivery of the WHO-CST from the perspective of providers and caregivers in rural Ethiopia. Methods: In Chapter one, a general literature review of neurodevelopmental disability and caregiver skills training is presented, with a focus on sub-Saharan Africa, to help contextualise the main qualitative study, outlined in chapter two. In-depth interviews were conducted with caregivers (n=19) who were all participants in two rural pilot studies of the WHO-CST programme. In addition, three focus group interviews were conducted with non-specialist facilitators (n=8), who facilitated the CST programme in two rural pilot tests. Data were analysed using the framework approach. Results: Findings were mapped onto the three framework themes created for this analysis: 1) Programme content: caregivers and facilitators uniformly indicated that the adapted programme addressed a need and was relevant for their context; caregivers emphasised how the programme helped them understand their child's problems and improve their skills to support their children; facilitators highlighted having acquired new knowledge and skills relating to NDD; 2) Programme facilitation: caregiver responses suggested that programme facilitation by non-specialists was acceptable; non-specialist facilitators emphasised the importance of support and supervision for the facilitators and simplification and modification of some concepts, such as the concept of play, and 3) CST training approach and delivery: participants indicated that the training modalities, including home visits and group training, were acceptable and feasible in the local context. Conclusions: This study suggested that, with some contextually appropriate modifications of programme content and delivery and continuing supervision of facilitators, the WHO-CST programme facilitated by non-specialists would be acceptable and feasible in rural Ethiopia. Results from this study may be useful to fine-tune the implementation of non-specialist delivery of the CST programme in Ethiopia, as well as other LMIC.

Teaching conversational strategies has been effective for a wide array of clients with acquired neurologic disorders and their caregivers. Research indicates positive results for Supported Conversation in adults with Aphasia (SCA) secondary to stroke. Applying this method to work with caregivers of persons with memory impairment could prove to be a valid intervention tool. This investigation will examine the applicability of SCA with persons with memory impairment and their familial caregivers. This pilot study is intended to create a conversation regarding SCA and its implementation with persons with memory impairment who still live in the community with their caregivers. Analysis between the pre-training and post-training scores showed a trend to wards significance for Time (F(1, 9) = 0.064), no significance for Measure (F(3, 9) = 0.558), and no significance for the interaction of Time*Measure (F(3, 9) = 0.276). The effect size for Time was 0.732, for Measure was 0.494 and for Time*Measure was 0.956.

No description available.

No description available.

No description available.