Thesis (Ph.D.)--Virginia Commonwealth University, 2009. / Prepared for: Dept. of Health Administration. Title from title-page of electronic thesis. Bibliography: leaves 182-192.

Objective: The current study aimed to examine the psychological distress of family caregivers of patients with psychosis following a stress-coping model as well as a self-regulation model. Methods: A cross-sectional correlational study was conducted in a psychiatric out-patient clinic of a local hospital. 26 caregivers were recruited. Associations among their psychological distress, appraisal of caregiving experience, illness perception, coping style and care burden were explored. Results: Psychological distress was found to be significantly correlated to negative appraisal of caregiving, perceived consequences on patient, perceived consequences on relative, perceived control by relative and care burden. Preliminary analysis showed that a combination of four factors, including negative appraisal of caregiving, perceived consequences on relative, perceived control by relative and care burden, significantly predicted psychological distress (〖R 〗^2= 0.36, F(4,21) = 2.97, p < 0.05). Among the predictors, negative appraisal of caregiving was the single strongest predictor of distress (〖R 〗^2 = 0.28, F(1,24) = 9.18, p < 0.01). Conclusion: The psychological wellbeing of family caregivers were influenced by both factors suggested by the stress-coping model and the self-regulation model. Findings from the present study provided preliminary evidence for developing caregiver-centered intervention that focused on appraisal of caregiving experience and illness perception in order to reduce the distress of caregivers. Further studies would be recommended to explore and differentiate the impact of appraisal of caregiving, coping style and illness perception on psychological distress in the caregiving experience for patients with psychosis. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

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This study explores the coping mechanisms of mothers caring for adolescent children with cerebral palsy. This study attempted to address a gap in the literature pertaining to understanding negative and positive ways of coping related to mothers and the specific pr oblems they have to deal with when caring for adolescents with cerebral palsy . The qualitative study foc uses on experiences and feelings directly obtained from mothers and it looked at what coping mechanisms benefit mothers whilst they are caring for their adolescent child with cerebral p alsy, what factors could compromise the mother’s coping style and how adolescence impacts on the mother’s ways of coping. The research revealed that mothers tended to use either emotion - focused ways of coping which was more maladaptive, or problem - focused ways of coping which were more adaptive ways of coping. A number of coping mechanisms were identified which appeared to benefit mothers, some of these include obtaining support from the medical profession as well as obtaining so cial support. The findings illustrated that there were particular ‘poor’ facilitative factors that could compromise the mothers coping style. Facilitative factors either influenced mothers to use more problem - focused ways of coping or more emotion - focused ways of coping. It was found that both these ways of coping were link ed to different defenc e mechan isms. This study found that adolescence placed more stress on the mother since new issues relating to adolescence emerged and had to be managed. The implications of these findings for management and care of mothers in these situations are discussed. It i s hoped that the present findings will contribute to assisting clinicians in being able to focus on the important areas when working in this field. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

Although much has been written in the field of family history since Phillipe Aires' Centuries of Childhood (1962), the study of foster care in its various forms has received less attention. Themes concerning orphans and foster children do, however, appear guite often in literature and dramatic works. Two academic articles from Iceland and Brazil respectively discuss historical material relating to foster children and orphans in the 19th century. Themes from these articles, about the role of kin and neighbours in foster care, and the use of orphans to meet labour shortages, are discussed as background to the B.C. study. The constitutional-legal framework and social welfare policies adopted in British Columbia in the 1900-1930 period were under Anglo-American influence, with influences from Ontario being most direct. B.C. established some level of economic security for women and children with the establishment of women's pensions in 1920 and in 1927 the B.C. Survey of Child Welfare made recommendations for supervised foster care, that is, foster care subsidized by government and supervised by social workers. Although the legislation mandated "approved foster homes" as early as 1901, and envisaged temporary placement with children's aid societies (CAS) until such homes could be found, the annual reports and discharge summaries of the CASs, and the records of the Superintendent of Neglected Children show that this option was largely ignored. Not until overcrowding and medical crises forced the issue did CASs turn to foster care as an option.

This study explores and examines the roles of caregivers within rest home facilities in New Zealand; and specifically, how they unpack and deal with managing the tensions associated with end of life (EOL) care. It adopted a qualitative perspective to enable an exploration of how the experiences of caregivers help guide their practice and understanding of their roles in relation to EOL care. A grounded theory framework was utilised in order to explore how caregivers make meaning and find value in the roles they perform within rest home facilities. This study offers insights into some of the tensions that caregivers face in a working environment where life and death occur simultaneously. It was apparent that caregivers are aware of the many social taboos they must negotiate in order to conduct their work. It was also apparent that they understood that others might perceive their work as dirty but that this did not prevent them from finding job satisfaction and create meaning in their work. Instead, they created meaning by using the conceptual tool the imagination of care. This involved utilising their imagination and past experiences to enable EOL care which represented the dying rites of individual residents but also fitted within their ethic of care.

Objective – Some of the most vulnerable children and youths in our country are those in out of home care, and these children demonstrate higher rates of psychopathology and fare more poorly in school and in social relationships than their peers. Typically, when studying at risk populations, negative outcomes are examined, thereby ignoring those who do well despite their vulnerability. These children, who demonstrate positive patterns of functioning and development despite their exposure to adversity, are considered resilient. The objective of this study was to identify factors associated with a resilient outcome among children and youths in out of home care. Method – The study sample was comprised of 417 children 10 to 15 years old in Ontario who had been removed from their homes of origin and placed in out of home care. Predictor variables were selected based on previous research findings in the area of resilient outcome. In the cross-sectional study, a series of sequential logistic regression analyses were conducted to identify factors associated with a resilient outcome among children in out of home care. These children were then followed one year later. In the longitudinal study, another series of sequential logistic regression analyses were used to identify variables that were related to future resilient outcomes among the same children in out of home care. Results – The findings showed that many of the independent variables predicted resilient outcome on the different dimensions. Furthermore, overall resilient outcome was best predicted by the foster parental report of high sociability. Conclusion – The findings in the present study confirmed that there exists a subset of resilient children among children in out of home care. The findings allowed for the identification of some factors related to resilient outcome among this population. The practical implications of these findings are discussed.

As the population ages, older adults managing chronic conditions and associated functional impairments will turn to family members and friends to obtain assistive help as informal caregivers. Formal services are often commissioned to provide additional care to complex older adults, creating a network that requires effective information sharing and communication in order to provide optimal care. Unfortunately, important formal-informal care relationships are often not formed and care is not coordinated as effectively as possible. As we enter the information age, services that were once only offered within the community, such as banking and support groups, are now available online. Services now exist to facilitate care coordination for informal caregivers in a shared network of care. Using these tools may show additional benefit if service providers are invited to contribute. Although these tools are currently used by some service providers, there are barriers to gaining widespread user buy-in to this model of use. This study used focus group interviews to conduct a qualitative study on the potential to improve care using an online network to connect informal caregivers and service providers. Case managers, service providers, and informal caregivers were interviewed in order to determine perceptions towards an online network to facilitate communication between caregivers, as well as barriers to supporting online network use by service providers. Interview participants felt that online networks had the potential to improve care delivery through better communication and information sharing, specifically for complex clients who have larger, more complicated care networks. Barriers to the implementation of online networks included the perception that network use would be time-consuming, communication restrictions set by regulating bodies, and the potential for privacy, security, and information ownership issues. Additionally, logistical issues would need to be addressed before the network can be adopted by home care agencies. Widespread inclusion of service providers in online network services will hinge on support from informal caregivers, home care agencies, and regulating organizations. A future pilot study could explore the potential roles and impacts of using online networks to link formal care providers and informal caregivers.

Thesis (MA)--University of Stellenbosch, 2007. / Bibliography. Also available via the Internet.

Thesis (Ph. D.)--University of Oregon, 2007. / Typescript. Includes vita and abstract. Includes bibliographical references (leaves 83-89). Also available for download via the World Wide Web; free to University of Oregon users.