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published_or_final_version / Social Work / Master / Master of Social Work

Thesis (M. Arch.)--Ball State University, 2009. / Title from PDF t.p. (viewed on Dec. 14, 2009). Includes bibliographical references.

Thesis (Psy. D.)--Wheaton College, 2005. / Abstract. Includes bibliographical references (leaves 193-198).

Thesis (Ed.D.)--University of Tulsa, 1987. / Bibliography: leaves 188-193.

Thesis (M.S.W.)--University of Hong Kong, 1993. / Includes bibliographical references (leaves 119-130).

Thesis (Psy. D.)--Wheaton College, 2005. / Abstract. Includes bibliographical references (leaves 193-198).

This dissertation addresses gaps in the child welfare literature from a systemic perspective. The extant literature focuses primarily on children in care, which excludes 90% of children and families involved with the system. In addition, foster parent retention has become an area of primary concern because there are fewer individuals who are willing to foster. Research that examines all children involved with the child welfare system and ways to improve foster parent experiences is imperative to address these areas of need. The two studies herein address these gaps in the literature by examining children who are in contact with the child welfare system but largely remain out of care, children who are in care, and foster caregivers. The first study compared two groups of children in the Ontario child welfare system: those who remain with their natural family and those in out-of-home care. The emotional and behavioural functioning, prosocial behaviour, education, health, and resources (internal and external) of these two groups of children were examined and relatively few significant differences were identified. However, it was found that, despite having comparable mental health and educational functioning, children who remained in their natural homes had significantly fewer external resources than children in out-of-home care. Children in out-of-home care may have increased access to community resources despite having similar needs to children who remain in their natural home environments. Additional research is needed to replicate and better understand these findings so that the child welfare system can best meet the needs of its children. The second study examined how foster child characteristics, as well as other foster parent and agency factors, impact Canadian foster parents’ experience of fostering, particularly related to agency workers, the fostering system, training, and foster children and their placements. Results identified that foster children’s needs and maltreatment histories, as reported by foster parents, were not significantly associated with perceptions about fostering. The factors that were the most highly associated with positive perceptions about fostering were increased practical and emotional support. These findings indicate that child welfare agencies can improve foster parents perceptions about fostering by providing sufficient practical and emotional support. A monitoring system that allows foster parents to provide regular feedback would be beneficial in continuing to evaluate their fostering experiences, assess the impact of interventions targeting foster parent support, and address any areas of concern. As a whole, the results of this dissertation highlight the importance of providing both children and foster parents in the child welfare system with appropriate supports that promote positive child functioning and foster parent experiences.

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.

Seven cerebral palsied children living in the home and their mothers were involved in this study. The mothers attended eight weekly sessions and were instructed in basic nutrition and feeding skill development. A Food and Nutrition Education Curriculum was developed for this instruction. Each of the eight lessons in the curriculum included discussions of nutrition based on the Basic Four Food Groups and the development of a feeding skill. Certain measurements were made before and after the nutrition education intervention to determine the benefits to the cerebral palsied children. These included a 24-hour dietary recall, food frequency check, height and weight measurements and a feeding evaluation. The mothers' nutrition knowledge was determined before and after the nutrition classes by way of a practical nutrition quiz. Nutrient intakes were compared to the 1974 Recommended Dietary Allowances (RDA). Intakes above 67% of the RDA were considered adequate. Energy intakes were compared to a suggested requirement based on height in centimeters. Height and weight measurements were plotted on the National Center for Health Statistics (NCHS) Growth Charts (1976). Five subjects, three girls and two boys fell below the 5th percentile on the NCHS Growth Charts. Intakes of five subjects exceeded two-thirds of the RDA for protein, calcium, iron, thiamin, riboflavin, niacin and ascorbic acid both before and after the nutrition education classes for their mothers. Protein and vitamin A intakes exceeded 100% of the RDA in many cases. The feeding evaluation was divided into three categories: gross motor skills, oral skills and eye-hand coordination. All seven subjects made improvements in the post test. The group as a whole made significant improvements (P <. 05) in gross motor skills. Significant improvements (P <. 05) were made by the mothers as a group in the practical nutrition quiz post test. / Graduation date: 1977