The purpose of this study was to measure perseverance time as related to the individual's need for achievement, past success or failure, the difficulty of a task, and the experimenter's instructions regarding its difficulty. The subjects used in this study were twenty-eight children, fifteen males and thirteen females, who ranged in age from eight years, six months to nineteen years and nine months, with the mean chronological age being twelve years and ten months.

Thesis (Ph. D.)--University of Texas at Austin, 2000. / Vita. Includes bibliographical references (leaves 279-285). Available also in a digital version from Dissertation Abstracts.

Background: Advances in technology have led to an increasing number of CMC-technology dependent children being discharged from hospital to their home communities. Families with CMC-technology dependent children require home care nursing services established prior to discharge. The Family-Managed Home Care model is used by some families to acquire these nursing services. Aim: The study purpose was to explore how families with CMC-technology dependent children describe their use of and experiences with using the Family-Managed Home Care model to coordinate nursing care. Methods: Thorne’s interpretive description method was used. Virtual, in-depth, semi-structured interviews were conducted with nine parents of CMC-technology dependent children. Data was analyzed using Braun and Clarke’s reflexive thematic analysis. Results: Parents of CMC-technology dependent children using the Family-Managed Home Care model became their child’s care manager. The process of managing the child’s care occurs in three interrelated and overlapping phases: (1) transitioning home, (2) building the home care team, and (3) partnering to provide care. Control was identified as a central concept that underpinned each step in the overarching process of managing the child’s care. Parents value the control provided by the Family-Managed Home Care model as this alleviated some stress, anxiety, and uncertainty in caring for a CMC-technology dependent child at home. Conclusion: Parents using this model of home care require enhanced support from LHINs and health care providers. Increasing health care provider knowledge of the Family-Managed Home Care model is needed to further support parents. Improved organization of discharges and policy changes are needed. / Thesis / Master of Science (MSc) / Family-Managed Home Care is a self-directed home care model parents of children with medical complexities that are technology dependent (CMC-technology dependent children) utilize to implement home care nursing services. The consistent presence of home care nurses is vital to preserve family functioning and ensure the safety of the CMC-technology dependent child. This study’s purpose was to understand how parents of CMC-technology dependent children use and describe their experiences of coordinating nursing care under the Family-Managed Home Care model. Nine parents were interviewed. Findings indicated that in the process of managing the child’s care (1) transitioning home is overwhelming, (2) parents take on the role of becoming their child’s care manager, (3) parental control is a valuable aspect of using Family-Managed Home Care, and (4) enhanced support is needed for parents using this home care model. Findings can be used to improve support for families using the Family-Managed Home Care model.

"We will attempt to show in this study that certain children in one County in Georgia are deprived of some economic support at a critical time during their high school education. Aid to Dependent Children, in Georgia as in many other states, terminates automatically when the child attains the age of 16 years. Presumably, this is two years preceding his graduation from high school. It will be shown on the basis of the information obtained that the withdrawal of ADC compelled many of these children to leave school and obtain work in order to contribute toward the family income"--Introduction. / Typescript. / "June 7, 1952." / "Submitted in partial fulfillment of the requirements for the degree of Master of Social Work." / Advisor: Arnold Falk, Professor Directing Study. / Graduate study in social work. / Includes bibliographical references (leaves 29-30).

Prior to the establishment of Aid to Dependent Children in 1935, states offered cash assistance to single mothers and their children through locally administered programs known as mothers' pensions. Since the first mothers' pension law was passed in 1911, the rank-ordering of states' generosity has been remarkably stable, shifting only after welfare reform in 1996. Prior research has neither documented nor explained this remarkable path dependence. In this dissertation, I argue that states' racial and ethnic composition and their state capacity, as measured in the 1930s before the federalization of cash assistance to single mothers, set states on particular trajectories. To see how this operated in practice, I conducted a case study of benefit levels in Massachusetts from 1913 to 1996. I found that a constellation of factors at the beginning of mothers' pensions--the lack of a legislated maximum benefit level, state involvement in funding, and a competent professional bureaucracy--set Massachusetts on a trajectory toward being a generous state. The early years of Aid of Dependent Children reinforced this trajectory, as benefit levels were consistently raised due to cost-of-living increases. Things began to change in the 1960s, however, as the caseload grew, the state experienced a fiscal crisis, and welfare rights activists campaigned for higher benefit levels. Welfare rights activism generated a backlash that resulted in a lack of public support for adequate benefit levels. Benefit levels declined until the early 1980s, when a strong economy, savvy advocates, and sympathetic elected officials combined to increase benefit levels. The early 1990s recession, which began in 1988 in Massachusetts, instigated another decrease in benefit levels. Ultimately, the case study showed that states may appear to have solid trajectories, but these trajectories are contested. Both raising and lowering benefit levels came up in the Massachusetts Legislature many times, and a fundamental change in Massachusetts' state capacity, such as permanently reduced fiscal resources, could have sent Massachusetts down a different path.

The research investigates, qualitatively, the experience of primary caregivers of children who are ventilator-dependent and cared for at home. Advances in medical and nursing knowledge and technology have improved the biological outcome of children who are critically ill. As a result, there is an increasing number of children in hospital who are medically stable, however dependent upon long-term respiratory support. Due to the increasing change from healthcare delivery to home care, some ventilator-dependent children are discharged to their primary caregivers who undertake the medical and technical care of the children in their home. A review of the literature indicates limited research examining and addressing issues of pediatric home ventilation. Information concerning the experience and needs of the primary caregivers of an in-home ventilator-dependent child is thus unavailable for effective and appropriate clinical interventions and policy implementation. To address the gap in the literature, a phenomenographic research approach was used to identify and describe a limited number of qualitatively different ways in which the primary caregivers understood their experience of caring for a ventilator-dependent child at home. An in-depth interview was undertaken with each of those seventeen participants and recorded on audiotape for transcribing verbatim. Data was sorted using a qualitative software program--ATLAS.ti.--and analysed using a series of seven analytical steps recommended for a phenomenographic research (Dahlgren and Fallsberg, 1991). The outcomes of the research are seven categories of description with each representing a conception of the experience, and all categories combined constituting an outcome space that presents the structural relations between conceptions. The seven categories of description representing the care-giving experiences of the primary caregivers are: (1) 'Hospital is another world to me'; (2) 'It's a new world'; (3) An ambiguous social identity;(4) The medical technology associated with my child is frightening but necessary;(5) 'The difficulty is having the carers at home'; (6) Social isolation; and (7) The experience of changing as a person. Discussions on the outcomes of the research indicate a need for increased understanding of the 'new world' of the primary caregivers and a recognition and acknowledgement of the distinctive nature of the experience in caring for a ventilator-dependent child at home. Hence, increased financial, respite, psychological and social support are of central importance, in addition to ongoing healthcare research, education, and practice for appropriate policy development, implementation and evaluation.

Thesis (Ph. D.) -- Virginia Commonwealth University, 2006. / Prepared for: School of Social Work. Date on t.p.: October 2006. Bibliography: leaves 113-134.

京都大学 / 0048 / 新制・課程博士 / 博士(人間健康科学) / 甲第18909号 / 人健博第23号 / 新制||人健||2(附属図書館) / 31860 / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 田村 恵子, 教授 山根 寛, 教授 木原 正博 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

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