Aim: To explore parents’ experiences of the transition from hospital to home with their infant, following first stage cardiac surgery for a functionally univentricular heart or systemic shunt dependent cardiac lesion. Background: The process of monitoring a fragile infant at home, in between stage 1 and 2 of cardiac surgery, takes the philosophical perspective of holistic care beyond the borders and boundaries normally expected of parents going home for the first time with their new baby. This neo-transition of becoming a medical parent is superimposed upon the multiple transitions already experienced during the birth and whilst in hospital (new baby, new to parenthood, sick baby, cardiac surgery, ongoing and lifelong care needs). The impact of these transitions, on parents’ wellbeing and the influence of parents’ demographics on their ability to effectively monitor their infant at home, has not previously been studied. Methods: A mixed methods study was conducted in two phases. Phase one was a retrospective survey of 22 families (35% response rate). Phase two prospectively explored parents’ experiences using semi-structured interviews and 3 self-report tools to assess anxiety, depression and confidence; with 13 mothers and 4 fathers of 13 infants. The qualitative data was thematically analysed; descriptive analysis of the quantitative data was undertaken using the Statistical Package for the Social Sciences (IBM SPSS Inc.) version 22 for Windows Results: Most parents felt unprepared for their infant’s discharge home; numerous physical, emotional and social boundaries and borders were evident during the transition from hospital to home, which impacted upon parents’ knowledge and preparedness. Traversing the physical boundary of leaving the hospital for the first time with their infant, was loaded with emotionally traumatic experiences that could not be separated from the specific physical transition of going home. For a while parents were in an uncertain place where they could not visualise what was ahead and how it would feel. This created anxiety and fear, at the same time as excitement to be going home. Liminality as a concept emerged during transition from hospital to home; a crossing point from a comfort zone, safety and security (the ward) into the unknown uncertain place (home). Adjusting to the situation; developing confidence; becoming comfortable with new skills was a threshold concept to mastery of a new normal. Conclusion: Discharge strategies need to be more consistent locally and nationally to ensure that parents are prepared physically, psychologically and socially for discharge home with their infant. Local and community health care professionals need to be better prepared to effectively support these infants and their parents at home.

Many children drift into unplanned long-term foster home care, under conditions unsatisfactory for the child, his own family and the foster parents. Current practice in foster care often contributes to foster children growing up without the necessary love, support and guidance from a family that he can call his own. Recent publications in social work journals have suggested that a lack of consistent family relationships may be injurious to the emotional development of children. Social workers have become increasingly dissatisfied with a "helping process" that may, in fact, generate more harm than help. Originating from the social worker's dissatisfaction with the foster care system is an awareness that some method for evaluation of parenting potential is a critically important factor if the goal of responsible planning for foster home placement is to be attained. One possible method for evaluating parenting potential is to analyze the parents' history of adaptation through an examination of case record material. The purpose of our study is to determine the feasibility of the case analysis method as a tool for the development of predictive criteria designed to evaluate "potential for parenting" and thus, aid in more adequate foster care planning.

The purpose of this practicum is to determine reasons given by former foster parents for their termination of provision of foster care. Research was completed through a survey of the literature in the field of roster care and through inquiries with personnel currently working with foster care programs in Columbia and Multnomah Counties. Utilizing the concerns of the personnel and issues raised in the literature, a questionnaire was developed which was intended specifically for former roster families currently residing in Columbia County. 48.9 percent of the questionnaires were returned. The results showed that fifty percent of the foster families who responded terminated their provision of foster care within two years, with an additional twenty three percent terminating within two more years, making a total of seventy-three percent who discontinued foster care within four years. Sixty-one percent listed "no longer interested" as a reason for terminating. This category included the foster family's own children's reactions; foster child related concerns such as age, sex, and behavior problems, and situational factors such a s recreational limitations, work, or school changes. An area of concern in this study was the relationship of the agency who administers a foster care program and the reasons foster parents give for discontinuing foster care. The data gathered shows that seventy-four percent of these former foster families rated their contact with Columbia County Children's Services Division as either "okay" or "good".

In Norway, first generation immigrant adolescents are overrepresented in out-of-home care by Child Welfare Services (CWS). More than Norwegians, immigrant adolescents themselves take the initiative to contact CWS. In this, immigrant girls seek more CWS help than boys. In this paper, a light is shone upon the lives of immigrants who were once in out-of-home care. The studies presented point to a large impact of migration and family breakdown. Many depict a chaotic family situation with a single mother, large household responsibilities and family relations filled with generational conflicts and violence. The immigrants describe an overall positive out-of-home care experience yet are hesitant to recommend others to take the same step. The possible influence of the child-centric focus of Norwegian CWS workers is discussed. As well as the need for prevention measures such as building a support network for immigrant mothers and organizing school support for immigrant adolescents. This paper concentrates on the need to put the overrepresentation of first generation immigrant adolescents on the policy agenda. More studies are to be carried out to point out the most appropriate and least harmful care for immigrant adolescents.

Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2008. / Full text also available online. Scroll down for electronic link.

Objective: To synthesis evidence from systematic reviews at international level to explore effective community and home based care interventions for family caregivers (FCGs), which may affect quality of life of persons with dementia (PWDs) and their FCGs in China. Methods: A systematic review of reviews was conducted. Studies were identified through Scopus, PubMed and EBSCO databases. Non-pharmacological interventions targeted on FCGs with outcome domains related to psychological health or quality of life of PWDs and/or their FCGs were within this review scope. Quality of systematic reviews was evaluated by AMSTAR. Quality of primary studies included in the systematic reviews was assessed by their internal and external validity. Results: Three systematic reviews of moderate to high quality with 74 publications were included in this systematic review. Among the primary studies, about 60% were conducted by randomized controlled design, and about 85% were carried out in high-income countries. Results at review level suggested that communication skills training, internet-based care management, coping strategy, individual behavioral management techniques were effective interventions for FCGs of PWDs. In contrast, most of the primary studies reported that community or home based interventions positively affected FCGs and/or PWDs. Those interventions included communication skills training, internet-based care management, supportive therapy, educational intervention, coping strategy, behavioral management techniques; yet the effects yielded statistically insignificant in most of the trials. In particular, significant effects of community care interventions were found in 8 of 69 trials on FCGs’ psychological health, 3 of 4 trials on FCGs’ competence, 0 of 2 trials on FCGs’ quality of life, and 3 of 7 trials on PWDs’ quality of life. Combination of those community care intervention components was observed in most of the trials with significant effects. Conclusion: Communication skills training, internet-based care management, supportive therapy, educational intervention, coping strategy, behavioral management techniques had positive effects on FCGs of PWDs living in the community. The combination among those intervention components and designing intervention model in FCG needs-oriented manner underpinned a potential significant effect. Given distinguished social economic contexts in urban and rural areas, implementation of community care interventions specific to FCGs in China should be handled with cautions and strengthened by policy supports to empower aging at home. / published_or_final_version / Public Health / Master / Master of Public Health

No description available.

Thesis (MHlthSc(OccTh))--University of South Australia, 1999

Thesis (Ph. D.)--University of Virginia, 1991. / Includes bibliographical references (leaves 192-206). Also available online through Digital Dissertations.

Thesis (M.S.)--University of Michigan, 1965. / Also issued in print.