The aim of this dissertation is to investigate the incidence of instability in out-of-home care for children and how children experience this instability. The dissertation consists of two studies. The quantitative study is based on an examination of social work case files of 213 children who began 317 placements in 2005 and 2006. Every placement was followed for a maximum of two years. The qualitative study used interpretive phenomenology as method and is based on interviews with 12 purposively selected children who had experienced placement breakdown at some point during 2011 or 2012.   The quantitative study shows that the majority of children had experienced problems in their home environments prior to placement. Most commonly reported was parents’ substance abuse or mental health problems. Preschool and schoolchildren were more often placed in care due to neglect whereas adolescents were placed because of their own behavior problems or relational problems. Children in the qualitative study described that the problems they experienced prior to coming into care continued to influence them during their time in care. The quantitative study indicates that different types of instability are associated with children’s ages. That is, breakdown was most common for adolescents whereas preschool children more often experienced planned placements changes. Children in the qualitative study gave similar descriptions of planned placement changes and placement breakdown. The difficulty with which these children experienced the move from a foster family or group home depended on their relationship to caregivers. Therefore, planned placement changes from foster homes or institutional settings in which children reported being happy were described as more difficult than breakdown in placements from which children wanted to move. In children’s views, breakdown was caused by mismatches between them and caregivers, mistreatment in care settings, and their own behavior problems. However, children explained that when social workers did not listen to them, behavior problems in the form of running away, self-harming or behaving badly, were the only way of ending placements in which they were miserable. All children in the qualitative study described a wish for close relationships with consistent adults and an opportunity to feel that they belong somewhere. These fundamental needs were difficult for them to have satisfied due to their parents’ problematic life histories, instability in care which repeatedly placed children in new care situations, and a lack of continuity of social workers.

Aktiviteter är betydelsefulla för ungdomar som vistas på institution. Forskning visar att ungdomar som har en meningsfull tillvaro med aktiviteter och en variation av sysselsättning under sin institutionsvistelse har större möjlighet att lyckas förändra ett problembeteende. En institutionsmiljö bör tillgodose ungdomarnas behov av en hemlik miljö och kontakt med pro-sociala ungdomar i övriga samhället. Syftet med denna studie är att belysa aktivteters betydelse för ungdomar som är placerade på institution, relationen mellan schemalagda och icke schemalagda aktiviteter samt vilken roll personalen har i utövandet av aktiviteter för ungdomar som vistas på institution. Studiens metodansats bygger på kvalitativa intervjuer med professionella som tjänstgör på ett HVB-hem (Vård och boende) för ungdomar. Studiens resultat har analyserats utifrån relevant forskning inom området och med utgångspunkt i Piagets utvecklingspsykologi. Resultatet bidrar med förståelse för aktivteters betydelse för ungdomar som vistas på institution, samt vikten av personal som är utbildad och insatt i verksamhetens teoretiska grunder och valda metoder. Personalen har en viktig roll på flera olika sätt i utförandet av aktiviteter på en institution. / Activities are significance for adolescents who reside at institutions. Science indicates that adolescents who have a meaningful existence with activities and a variation of occupations at the institution have greater opportunity to succeed in changing behavioral problems. An institutional environment should satisfy the adolescent’s need of a homelike environment and the need of meeting other pro-social adolescents from the society. The intention with this research is to highlight the importance of activities for the adolescents who are placed at institutions, the relation between scheduled activities and non scheduled activities as well as to see what role the staff has during the exercise of activities at the institution. This research is based on qualitative interviews with professional staff at an institutional accommodation for adolescents. The research result has been analyzed with relevant science in the specific field and from Piaget’s developmental psychology. The result contributes with an understanding for the activities significance for the adolescents who residing in institution and for the importance of that the staff are educated and has knowledge in the institutions selected theoretical methods. The staff has an important role in several ways during the exercise of activities at the institution.

Thesis (M.S.W.)--University of Hong Kong, 1983.

Not available / text

published_or_final_version / Architecture / Master / Master of Architecture

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

The present study aims to explore the experiences of caregivers working with children living with HIV/AIDS in the context of a children's home. While there has been research conducted on family members as well as community based caregivers of people living with HIV/AIDS, there has been a paucity of research on caregivers of children living with HIV/AIDS in Children's homes. There is a strong need to address this area of deficit in order to identify and tackle areas of difficulty as well as rewarding aspects to enhance the caregiving experience This pilot study adopted the interpretive research paradigm, is qualitative in nature and utilized in depth interviews as a means of data collection. Four women working as caregivers at the children's home were interviewed and the data obtained was analysed using thematic content analysis. The present study highlights the positive as well as the negative aspects of caregiving from the perspective of the caregivers. While caregivers identify the difficulties that they face as a result of caregiving, they also acknowledge the rewards that they attain from their line of work. Furthermore the present study emphasises the coping strategies employed by the caregivers on a personal and an organisational level as well as the resources that aid coping and the constraints against utilising the coping resources. In addition issues of attachment and detachment associated with caring for children, that are particularly pertinent to these non -familial caregivers have been explored. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2005.

No description available.

This dissertation looks at old age homes in British Columbia between 1920 and 1960. It describes and explains how changes in institutional care for aging men and women intersected with professional ideals, welfare state economics and political imperatives. It also considers how broader developments altered the physical and cultural world of the institution and the strategies employed by the elderly. / Facilities for the elderly changed significantly during the period. In 1920 provision of residential care for older British Columbians was extremely limited, and existing institutions operated under a poorhouse model, providing only custodial care. By 1960 a sizeable network of provincially regulated facilities had developed. Medical professionals urged that these establishments be medical facilities and that the elderly receive compassionate, therapeutic care. / However, circumstances inside these facilities limited change. While some institutions were run along medical lines, new policy initiatives were modified by strong historical links with older systems of custodial care and punitive poorhouse ethics.

The aim of the present study was to investigate all long-term institutions in the county of Västerbotten, Northern Sweden, to give a detailed description of the institutionalized population with respect to motor functions, vision, hearing, speech, ADL-functions, prevalence of psychiatric symptoms and behavioral disturbances, staff work load, use of psychoactive drugs and prevalence of dementia. Another aim was to select some specific 'problem areas' in the nursing care of demented patients for further descriptive and interventional studies. For this reason, morning care procedure (hygiene, dressing), meal behavior (eating, communication), nutrition, constipation and relocation between institutions were selected. The results of the study have been reported in six papers summarized below: I.The study has shown that the proportion of demented patients is increasing in longterm institutions in Sweden. Furthermore, demented patients were shown to be more impaired in all rated functioning abilities and exhibited more psychiatric symptoms and behavioral symptoms. A high proportion of the demented probands were also prescribed psychoactive drugs, i.e. neuroleptics. II. Five patients with Alzheimer-type dementia were monitored during morning care. A 12-step classification system was developed to be used as a guide to understand and determine abilities essential for performance of morning care for demented patients. The quantitative assessment showed that none of the patients were able to manage morning care independently, but there was a wide variation in their highest level of performance. III. Five patients with Alzheimer-type dementia were observed (video taped) during their meals in a changed meal milieu and with new meal routines. When the patients ate without staff participation, the two least demented patients became 'caregivers'. When two mental nurses joined the group, first in civil clothes and then in white uniforms, the patients dropped their roles as helpers. The patients were able to compose complete meals in 0-79 per cent of the meals. The conversation during the meals could be characterized as incomplete, with short sentences and a lot of breaks. Sixty-three per cent of all utterances were about food and eating and almost all conversation concerned the present time. IV. Thirty-three psychogeriatric patients, with severe constipation were given a high- bran bread instead of their accustomed laxatives. During the high-bran treatment period, the number of bowel evacuations and the volume of faeces increased. The total laxative consumption decreased by 93 per cent. V. Nutritional status and dietary intake were studied in a sample of severely demented, institutionalized patients. Energy and /or protein malnutrition was found in 50 per cent of the patients. The mean energy intake was 2059 kcal. Malnourished patients had had four times as many infectious periods during their hospital stay as patients without malnutrition. Thirty-nine of 44 patients lost weight during their hospital stay. VI. Thirty-three psychogeriatric patients were followed for 36 weeks after relocation from a mental hospital to two newly built nursing homes. An intensive pre-relocation program was performed. No negative effects of the relocation were found. On the contrary, the relocated group improved their ADL-functions after the transfer. Based upon the above cited studies, a model for nursing care of demented patients is presented. / <p>S. 1-45: sammanfattning, s. 46-192: 6 uppsatser</p> / digitalisering@umu