Stressful situations in caregiving: Relations between caregiver coping and well-being.

We examined ways in which caregivers cope with stressful caregiving situations and the relations between coping strategies and caregivers' psychosocial well-being. Respondents were 58 family caregivers to patients discharged from a rehabilitation hospital. Caregivers identified a recent stressful event in caregiving and indicated strategies used to cope with this event. After controlling for patients' impairment level, analyses indicated that caregivers engaging in more escape–avoidance coping reported greater depression and more conflict in their personal relationships. Those using more positive reappraisal demonstrated greater positive affect. Younger caregivers, many of whom were women, used more avoidance strategies. Results have implications for therapeutic interventions with family caregivers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family caregiving of hospitalized patients. Caregiver and nurse perceptions at admission and discharge

To ensure patients will be discharged to stable, health-promoting home environments, nurses must understand family caregivers' perceptions of the patients' needs and problems in caring for them. At the time patients were admitted to and discharged from the hospital, there was little agreement between family caregivers and nurses about the kinds of things caregivers needed to care for older patients or about problems that might prevent the continuation of caregiving. There was slightly more overall agreement between family care-givers and admission nurses than discharge nurses, despite the fact that discharge nurses reported spending more time with patients and being more knowledgeable about them. Future discharge planning models should build opportunities for nurses to communicate with other health care colleagues who can contribute to a more accurate and complete picture of patients' and family caregivers' needs and problems in the transition from hospital to home.     

Extending the quasi-steady state approximation by changing variables

The impact of providing care to the frail elderly on individual caregivers and their families has been discussed at length, but few researchers have investigated the events and circumstances preceding the onset of caregiving. In addition, although there is evidence that several family members are usually involved in planning and decision making about caregiving, the majority of studies in this area include only one generation. Based on a larger theoretical framework of preparation for caregiving [1, 2], the extent to which family members anticipate and plan for future caregiving is investigated. In addition, the extent to which they are satisfied with these preparations is studied. Interviews were conducted with mothers, daughters, and granddaughters in thirty-three multigeneration families. While substantial numbers of both mothers and daughters anticipated the need for care for the oldest generation, few made concrete plans about how to organize future care provision. Planners were more satisfied with the amount of discussion and planning in their family than non-planners. Implications for future research and practice applications are discussed.     

Feminist-informed family therapy for the treatment of intrafamily child sexual abuse.

Argues that although the feminist critique of family therapy for treating incest has raised important and irrefutable concerns regarding the political aspects of sexual abuse and family therapy, one of the most effective ways to address these concerns is through family therapy itself. A model for feminist-informed family therapy that integrates the feminist, child sexual abuse, and family therapy literature is explored. It is proposed that protection and empowerment of the incest victim is best done through a gender-sensitive family systems approach to treatment. The model is best suited for equalizing the power base in the parental subsystem and for pushing the abuser to change not only the abusive behavior but also other dysfunctional means of relating to the family. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What Gets Dad Involved? A Longitudinal Study of Change in Parental Child Caregiving Involvement.

Predictors of change in fathers' and mothers' perceptions of child caregiving involvement were examined. Middle-class 2-parent families (131 mothers and 98 fathers) with a target school-age child participated. Fathers and mothers completed annual questionnaires for 3 consecutive years. Latent growth curve modeling suggested that fathers were likely to increase their relative contribution to child caregiving over the course of 3 years when they had a greater proportion of male children in the family and when life events-particularly changes in employment and financial status-were experienced by the family. Although mothers were responsible for more of the caregiving, their relative level of involvement tended to decrease when there were no young children in the family. Two-parent families may adapt to varying family contexts and life circumstances by shifting caregiving roles and responsibilities over the course of years. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pharmacologic inhibition of particulate-induced bone resorption

The traditional hospital-based approach to Australian nurse education curricula was primarily based on the medical model and directed towards the preparation of nurses who were able to give care to individual clients. The major focus was on the needs of the individual. A notable absence in curricula was any consideration of the role or importance of families to individual and family health. This was despite the continuing involvement that nurses have in their practice with the families of their clients. This paper describes the experiences of introducing a family nursing subject in an undergraduate, preregistration nursing programme which focuses on the family as a unit of care. Educational strategies, clinical experiences, and evaluation of the unit of study are discussed.     

Psychology at the Intersection of Work and Family: Recommendations for Employers, Working Families, and Policymakers.

Demographic data show that major changes have been occurring in the everyday lives of families over the last generation, with the majority of mothers of young children in the workforce and an increasing number of men and women assuming caregiving responsibilities for older relatives. Thus, the 2 primary identities of most adults, defined by their multiple family and work roles, need to be coordinated in ways that promote positive family outcomes, returns on investments for employers, and societal values. Despite changes in the workforce, the world of work is still largely organized for a family model that is increasingly rare--one with a stay-at-home caregiver. Recommendations based on psychological and other social science research are offered to align the needs of working families and employers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Symposium: Family caregiving to dependent older adults: Stress, appraisal, and coping.

Articles presented in this 1987 APA symposium adopt a stress, appraisal, and coping framework for conceptualizing the experience of family caregiving. Each article emphasizes 2 themes: (a) caregivers' adaptation to the chronic demands of in-home caregiving and (b) factors that mediate the relationship between caregiving stress and caregiver's adaptation. The articles presented in this symposium illustrate both the utility of this theoretical approach to studying caregiving stress and the difficulty inherent in its use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of organizational downsizing on the job satisfaction of nurses

Professional nurses across Canada are being affected by health reform initiatives designed to deinstitutionalize the health care system. This panel study examined the impact this restructuring has had on nurses' overall job satisfaction as well as their satisfaction with various aspects of their job and work environment. The participants consisted of 345 nurses employed in 3 community hospitals in southwestern Ontario. Hospital downsizing had relatively little effect on overall job satisfaction, satisfaction with kind of work, amount of work, and physical work conditions. However, compared to before the downsizing, nurses reported a significant deterioration in satisfaction with their career future, hospital identification, supervision, and co-workers following the implementation of restructuring initiatives. We discuss the organizational and management implications of these findings and suggest ways that hospital administrators can minimize the negative effects of downsizing on nursing professionals.     

The practical implications of a critique of traditional science

Patti Lather writes of the convincing critique of traditional science that has amassed in the past 2 decades. The displacement of the assumptions of traditional science makes space for some interesting and exciting developments in the human sciences. However this theoretical rearrangement is not matched in practical spheres. While Lather is referring to education research I would include nursing when she writes, '...positivism retains its hegemony over practice'. There is ample evidence of the effects of this domination in nursing. Nurses work closely with the medical profession, which is still predominantly influenced by 'scientific' research, and health administrators who are in organizations which are bureaucratic and preoccupied with rationally. Medical practitioners control research ethics committees and funding bodies, which have relatively few nursing representatives and continue to judge proposals for qualitative projects by applying standard 'scientific' criteria. The administrators control budgetary matters and impose standards in the organizations. The dominance of traditional science needs to be challenged if nurses wish to make a place for different ways of knowing in their practice.     

Organizational effectiveness: toward an integrated model for schools of nursing

This study of the caregiving arrangements of 214 disabled elderly people in a large northeastern city found that the recipients of care were severely disabled, particularly in instrumental activities of daily living, yet had limited sources of informal care and used formal services minimally. The authors discuss the need to use a structural adaptation approach and to develop social services that are culturally sensitive and acceptable to both elders and their caregivers.     

African-American caregiving for a relative with Alzheimer's disease

This study explored the meaning of caregiving to nine African-American caregivers of family members with Alzheimer's disease. Open-ended questions were used. Four major themes emerged from the study: caregiving is a traditional family value, caregiving is an act of love, social support is a mediator of the caregiver burden, and caregiving is a female role.     

The practice of nursing theory in the operating room

Nursing theory is a set of ideas, experiences, or observations regarding how and why nurses engage in certain activities and exhibit various behavioral attributes in providing patient care. The individualized caregiving activities perioperative nurses express during all phases of the surgical experience are supported by nursing theory.     

Environmental context of caregiving for severely mentally ill adults: an African American experience

Most people with severe mental illness depend on family to provide care. Although an increasing amount of research has examined caregiving, there is much to be discovered about the caregiving experience of African American families. This ethnographic study reports findings from 16 African American caregivers, presenting a picture of how they navigate through their environment to meet the needs of caregiving. Formal resource selection and use, and perceived barriers to and facilitators of care within an urban environment, are discussed. The impact of the African American community's perception of mental illness on caregiving and involvement in policy change also is discussed.     

The role of play therapists in children’s transitions: From residential care to foster care.

Permanency planning operates on the belief that all children have the right to stable housing. This approach to child welfare has been implemented as a way to protect children from the negative outcomes associated with long-term residential care and multiple foster home placements. When a child is ready to leave residential care and return to a family living environment, there are multiple steps involved in the selection of a family and a child’s preparation for discharge. Play therapists perform many roles in these cases, all of which are critically important to children’s success in their new environments. This article’s aims are to (a) describe the various roles of play therapists in the residential-to-foster care transition process, (b) highlight several therapeutic techniques play therapists can use in their work with children preparing to leave residential care and enter a new foster home, and (c) discuss some of conflicting feelings that accompanies such sensitive work. A case study will further illustrate the ways in which play therapists can advocate for children who are ready to leave residential care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acquisition of Ly49 receptor expression by developing natural killer cells

This article focuses on (1) the dimensionality of the caregiving concept; (2) the relation between the identified caregiving dimensions and characteristics of the patient, the caregiver, and their relationship; and (3) the relation between caregiving dimensions and caregiver distress. Findings are based on data from 480 members of the Dutch family organization for patients with schizophrenia/chronic psychosis who completed (1) the Involvement Evaluation Questionnaire (IEQ), which assesses general information (e.g., household characteristics), caregiving, help seeking, coping and distress, and (2) a questionnaire comprising questions on onset and course of the patient's disorder and symptoms characteristic of schizophrenic disorders. Four caregiving domains were found: tension, supervision, worrying, and urging. These domains were strongly related to the patient's symptomatology, contact between the relative and the patient's mental health professional, and the number of hours of mutual contact between the patient and the relative. The connection between patient, caregiver, and relationship variables and the caregivers' distress could be explained substantially by the overall caregiving score. Our findings suggest that caregiving tasks and problems may be diminished and related distress lowered by reducing the patient's symptomatology, increasing relatives' coping capacities, and decreasing the number of contact hours. If distress is reduced, relatives may use less psychotropic medication and may visit their general practitioner less often.     

Developing curricula in spirituality and medicine

In recent years patients and some members of the medical community have expressed the concern that doctors have forgotten about compassion and too often ignore their patients' spiritual concerns. Patients can and should expect their physicians to respect their beliefs and be able to talk with them about spiritual concerns in a respectful and caring manner. Medical schools must teach their students how to meet these expectations, and health care systems need to provide practice environments that foster compassionate caregiving. Medical educators are recognizing the need to bring the art of compassionate caregiving back into the medical school curriculum. This paper focuses on one approach to achieving this goal, the study of spirituality and medicine. The authors discuss the relationship of spirituality and healing, and describe studies that have shown patients' desire to have spiritual issues addressed by their physicians and the potential health benefits of spiritual beliefs. Finally, they describe common elements of the spirituality courses offered by approximately 50 U.S. medical schools, including 19 schools that have been awarded grants from the National Institute for Healthcare Research for the development of curricula in spirituality and medicine.     

Enmeshed Lives: Adult Children With Developmental Disabilities and Their Aging Mothers.

This article uses equity theory to examine the ways in which aging mothers and their adult children with developmental disabilities support each other and the effects that this exchange has on the caregiving satisfaction and burden of the mothers. Data from 305 mothers revealed that exchange flows both from mother to child and from child to mother. Results indicate that caregiving satisfaction increased when affection from child to mother was greater. Caregiving burden was not affected by either functional support or affection from child to mother. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Immunocytochemical detection of advanced glycated end products in rat renal tissue as a function of age and diabetes

Lifestyle practices and the health promoting environment of hospital nurses This paper examined the lifestyle practices of hospital nurses and the impact of specific interventions in the hospital environment. The perception of nurse as health promoter and as carer of AIDS patients was also examined. A self-administered questionnaire was used to collect data at two different time periods. The sample represented 729 nurses (at pre- and post-time periods), both qualified and student nurses. Qualified nurses reported the highest stress levels while student nurses reported more negative lifestyle practices such as smoking, alcohol consumption and drug use. A greater number of current smokers (29%) consumed alcohol and used drugs than non-smokers. The impact of intervention strategies around compliance with smoking policy and work-site walk routes reduced exposure to passive smoking at work for qualified nurses and increased exercise participation for both groups of nurses. Workplace was identified as the main source of stress which included relationships at work and demands of the job. Hospital nurses experiencing high work stress were more likely to use professional support and personal coping (discuss problems with friends/family, have a good cry and eat more) than others. Nurses believed in the importance of health promotion as part of their work; however, qualified nurses felt more confident and gave more health related information than student nurses. Student nurses perceived a lower risk of contacting AIDS through work and a higher concern/worry in caring for AIDS patients than qualified nurses.