Family Care (family + care)

Distribution by Scientific Domains

Selected Abstracts

Measuring Eastern Family Care

Teresa M.L. Chiu BScOT
No abstract is available for this article. [source]

Family care in HIV/AIDS: Exploring lived experience.

Carole Campbell
No abstract is available for this article. [source]

Factors associated with constructive staff,family relationships in the care of older adults in the institutional setting

Emily Haesler BN PGradDipAdvNsg
Abstract Background, Modern healthcare philosophy espouses the virtues of holistic care and acknowledges that family involvement is appropriate and something to be encouraged due to the role it plays in physical and emotional healing. In the aged care sector, the involvement of families is a strong guarantee of a resident's well-being. The important role family plays in the support and care of the older adult in the residential aged care environment has been enshrined in the Australian Commonwealth Charter of Residents' Rights and Responsibilities and the Aged Care Standards of Practice. Despite wide acknowledgement of the importance of family involvement in the healthcare of the older adult, many barriers to the implementation of participatory family care have been identified in past research. For older adults in the healthcare environment to benefit from the involvement of their family members, healthcare professionals need an understanding of the issues surrounding family presence in the healthcare environment and the strategies to best support it. Objectives, The objectives of the systematic review were to present the best available evidence on the strategies, practices and organisational characteristics that promote constructive staff,family relationships in the care of older adults in the healthcare setting. Specifically this review sought to investigate how staff and family members perceive their relationships with each other; staff characteristics that promote constructive relationships with the family; and interventions that support staff,family relationships. Search strategy, A literature search was performed using the following databases for the years 1990,2005: Ageline, APAIS Health, Australian Family and Society Abstracts (FAMILY), CINAHL, Cochrane Library, Dare, Dissertation Abstracts, Embase, MEDLINE, PsycINFO and Social Science Index. Personal communication from expert panel members was also used to identify studies for inclusion. A second search stage was conducted through review of reference lists of studies retrieved during the first search stage. The search was limited to published and unpublished material in English language. Selection criteria, The review was limited to studies involving residents and patients within acute, subacute, rehabilitation and residential settings, aged over 65 years, their family and healthcare staff. Papers addressing family members and healthcare staff perceptions of their relationships with each other were considered for this review. Studies in this review also included those relating to interventions to promote constructive staff,family relationships including organisational strategies, staff,family meetings, case conferencing, environmental approaches, etc. The review considered both quantitative and qualitative research and opinion papers for inclusion. Data collection and analysis, All retrieved papers were critically appraised for eligibility for inclusion and methodological quality independently by two reviewers, and the same reviewers collected details of eligible research. Appraisal forms and data extraction forms designed by the Joanna Briggs Institute as part of the QARI and NOTARI systematic review software packages were used for this review. Findings, Family members' perceptions of their relationships with staff showed that a strong focus was placed on opportunities for the family to be involved in the patient's care. Staff members also expressed a theoretical support for the collaborative process, however, this belief often did not translate to the staff members' clinical practice. In the studies included in the review staff were frequently found to rely on traditional medical models of care in their clinical practice and maintaining control over the environment, rather than fully collaborating with families. Four factors were found to be essential to interventions designed to support a collaborative partnership between family members and healthcare staff: communication, information, education and administrative support. Based on the evidence analysed in this systematic review, staff and family education on relationship development, power and control issues, communication skills and negotiating techniques is essential to promoting constructive staff,family relationships. Managerial support, such as addressing workloads and staffing issues; introducing care models focused on collaboration with families; and providing practical support for staff education, is essential to gaining sustained benefits from interventions designed to promote constructive family,staff relationships. [source]

Attitudes of Egyptian nursing home residents towards staying in a nursing home: a qualitative study

Thomas Boggatz RN
Aim., The aim of this study was to identify the attitudes of Egyptian nursing home residents towards staying in a nursing home and to differentiate between various types of these attitudes. Background., The number of older persons in Egypt who require nursing care is increasing. In response, nursing homes in bigger cities like Cairo were founded, although family care seems to be the prevalent norm. Methods., Semi-structured guideline interviews were performed with 21 residents from four different nursing homes in Cairo. Interviews were analyzed using qualitative content analysis. Findings., One category of resident was those who were sent to the nursing home by persons closely related to them. Another category made their own decision to move to a nursing home. Relationships with social networks and self-help abilities are factors of importance in influencing decision-making. Conclusion., Nursing homes in Egypt fulfil different functions for different types of older persons. Charitable institutions are a last resort for those with no income and a disrupted social network. For better-off older persons, nursing homes may provide the benefits of socialising with peers and receiving medical treatment. [source]

Laws and policies to support the wellbeing of children: an international comparative analysis

Emily J. Nicklett
Nicklett EJ, Perron BE. Laws and policies to support the wellbeing of children: an international comparative analysis Int J Soc Welfare 2010: 3,7 © 2009 The Author(s), Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare. The international community has raised concerns regarding the extent to which countries have implemented laws and policies to support the rights and wellbeing of children. This study evaluates the progress of least-developed countries (LDCs) and middle-income countries (MICs) in developing such legislation. Surveys were sent to 131 UNICEF country offices. Items included efforts to promote family preservation and family ties, family-based care over institutionalization, and child participation in placement decisions. A total of 68 surveys were returned, reflecting a 52 percent response rate (LDC, n= 25; MIC, n= 43). Legislation that addressed abuse and neglect of children, maternity leave, removal of children from the family, family care, adoption, and guardianship was widespread. Chi-square tests indicated that MICs had a substantially higher number of laws and policies related to child allowances, school feeding programs, maternity leave, and day care. [source]

Mortality after care among young adult foster children in Sweden

Bo Vinnerljung
This exploratory study looks at mortality after care among 13,100 former Swedish foster children, placed before their teens. Sources used are two national databases, on child welfare interventions and causes of death. Risk ratios of death for foster children are compared with those of their peers in the general population and with a comparison group, consisting of 10,668 young adults from adverse home backgrounds, who never entered foster family care before their teens. Both ex-foster children and the comparison group were young adults (19,26 years old) at time of follow-up. Results show a moderately elevated risk ratio for both groups compared with peers in the general population, mainly due to more frequent unnatural deaths, especially suicides. Time at first placement was not related to mortality among men, but there was a weak tendency of a higher risk ratio for girls placed at age 7,12. Information on time spent in care is used with caution, due to possible problems with reliability. Almost all comparisons between the foster care and the comparison group fell short of statistical significance. For foster children who had spent more than five years in care, the risk ratio tended to be higher than for foster children with shorter care experience, and similar to that of the comparison group. Foster children who had been in care for less then six years thus tended to have a lower risk ratio than the comparison group. [source]

Postdischarge nursing interventions for stroke survivors and their families

Kelly L. McBride MSc RN
Background. The physical, cognitive, and emotional sequelae of stroke underscore the need for nursing interventions across the continuum of care. Although there are several published studies evaluating community interventions for stroke survivors, the nursing role has not been clearly articulated. Aim. The aim of this paper is to report a study to describe, using a standardized classification system, the nursing interventions used with stroke survivors during the initial 6 weeks following discharge home. Methods. In the context of a randomized controlled trial, two nurse case managers provided care to 90 community-dwelling stroke survivors who were assigned to the intervention arm of the trial. The nursing documentation was analysed, using the Nursing Intervention Classification (NIC) system, to identify and quantify the interventions that were provided. Findings. Stroke survivors received, on average, six different interventions. There was a trend for those who were older, more impaired, and who lived alone to receive more interventions. The most commonly reported interventions included those directed towards ensuring continuity of care between acute and community care, family care, and modifying stroke risk factors. The study was limited to the nursing documentation, which may represent an underestimation of the care delivered. Conclusions. The NIC system was useful in capturing the interventions delivered by the nurse case managers. Nursing interventions are often not clearly articulated and less often use standardized terminology. Describing nursing activities in a standard manner will contribute to an increase in nursing knowledge and to evidence-based practice. [source]

The needs of family caregivers of frail elders during the transition from hospital to home: a Taiwanese sample

Yea-Ing Lotus Shyu RN PhD
The needs of family caregivers of frail elders during the transition from hospital to home: a Taiwanese sample This study explored the needs of family caregivers during the transition from hospital to home. Data from 37 face-to-face interviews with 16 caregivers before discharge and at 2 weeks and 1 month after discharge were subjected to constant comparative analysis. Findings revealed changes in family caregivers' needs during the discharge transition. While preparing to take caregiving responsibility, caregivers reported a need for various types of information. After the discharge, but before home caregiving settled into a pattern, they needed help with caregiving practices. After reaching a pattern for providing family care, caregivers frequently reported needs for continuous emotional support. These findings provide a basis for transitional care services such as discharge planning and home health care services. [source]

Metasynthesis: withdrawing life-sustaining treatments: the experience of family decision-makers

Mary Ann Meeker
Aim., The present study was undertaken to synthesise findings from qualitative investigations of family participation in decisions to withdraw and/or withhold life-sustaining treatment from a seriously ill family member. Background., As a consequence of increasing effectiveness and sophistication of available medical interventions, death is commonly preceded by a decision to withdraw or withhold potentially life-sustaining treatments. These decisions take place in a bioethical context characterised by the preeminence of self-determination, but patients are typically too ill to make their own decisions. Thus, family members are called upon to participate in these morally consequential decisions on the patient's behalf. Design., Metasynthesis Method., Metasynthesis is a form of inquiry that provides for integration of qualitative studies' findings to strengthen knowledge for practice and advance theoretical development. This metasynthesis was conducted using the constant comparative methods of grounded theory. Results., Family members engage in a process of participation in decision-making that is comprised of three major categories: reframing reality, relating and integrating. Surrogates used both cues and information as they reframed their understanding of the patient's status. Relationships with providers and with other family members powerfully influenced the decision-making process. Integrating was characterised by reconciling and going forward. This part of the process has both intrapersonal and interpersonal aspects and describes how family decision-makers find meaning in their experience and move forward in their lives. Conclusions., This synthesis provides a more comprehensive and empirically supported understanding of family members' experiences as they participate in treatment decisions for dying family members. Relevance to clinical practice., This metasynthesis provides evidence to improve family care during treatment withdrawal/withholding decision-making and a theoretical model that can be used to guide creation of clinical practice guidelines. Through increased understanding of family members' experiences, clinicians can more effectively support family decision-making processes. [source]

The impact of an ICU liaison nurse: a case study of ward nurses' perceptions

Wendy Chaboyer MN
Aims and objectives., To provide a description of ward nurses perceptions of the intensive care unit liaison nurse role. Background., Critical care outreach services have become commonplace over recent years. In Australia, the intensive care unit liaison nurse, developed at a local level by healthcare providers, has emerged as a way of improving the continuity of care offered to this patient group. As a relatively new development in critical care services, evaluation of this role has been limited, particularly in relation to the perceptions of ward nurses who receive patients on discharge from intensive care unit. Design., Case study of one Australian hospital that utilizes an intensive care unit liaison nurse. Methods., Ten ward nurses were purposefully selected for their representativeness of the population and for their experience with the intensive care unit liaison nurse role. Each of these nurses participated in semi-structured in-depth interviews. Thematic analysis was used to analyse the data. Findings., Three major themes emerged from the interviews, highlighting role behaviours, contextual demands and outcomes associated with the intensive care unit liaison nurse role. The role behaviours of the liaison nurse included the professional characteristics of the individual and the primacy of clinical liaison as a role descriptor. Contextual demands were environmental characteristics relevant to providing patient, family and staff support. Outcomes of the role were perceived to include environmental preparation and education. Conclusions., This qualitative study has presented an overview of ward nurses perceptions of the intensive care unit liaison nurse role within one Australian hospital, illustrating the educative and empathic support that the liaison nurse role can provide to ward nurses. Relevance to clinical practice., Collaboration with ward nurses in developing specialist roles such as the intensive care unit liaison nurse is essential in ensuring improvements in patient and family care across the continuum. [source]

Leadership and management skills of first-line managers of elderly care and their work environment

abdelrazek f., skytt b., aly m., el-sabour m.a., ibrahim n.& engström m.(2010) Journal of Nursing Management 18, 736,745 Leadership and management skills of first-line managers of elderly care and their work environment Aim, To study the leadership and management skills of first-line managers (FLMs) of elderly care and their work environment in Egypt and Sweden. Background, FLMs in Egypt and Sweden are directly responsible for staff and quality of care. However, FLMs in Sweden, in elderly care, have smaller units/organizations to manage than do their colleagues in Egypt. Furthermore, family care of the elderly has been the norm in Egypt, but in recent years institutional care has increased, whereas in Sweden, residential living homes have existed for a longer period. Methods, A convenience sample of FLMs, 49 from Egypt and 49 from Sweden, answered a questionnaire measuring leadership and management skills, structural and psychological empowerment, job satisfaction and psychosomatic health. Results, In both countries, FLMs' perceptions of their leadership and management skills and psychological empowerment were quite high, whereas scores for job satisfaction and psychosomatic health were lower. FLMs had higher values in several factors/study variables in Egypt compared with in Sweden. Conclusion and implications, The work environment, both in Egypt and Sweden, needs to be improved to increase FLMs' job satisfaction and decrease stress. The cultural differences and levels of management have an effect on the differences between the two countries. [source]

Asymmetry in the intensive care unit: redressing imbalance and meeting the needs of family

Denise Blanchard
Abstract Aims and objectives:, The purpose of this study was to develop a way for nurses to understand how they negotiate and work with families in the intensive care unit (ICU). Background:, The importance of family to the critically ill patient is described in previous research; however, research exploring how to work with families in the clinical context of ICU is modest and there is little information and research to understand how the nurse might work to integrate family and understand family needs in the clinical context. Design:, The study was designed using action research methodology where an action research group of registered nurses from ICU proposed changes to how the family are defined, assessed and understood. Methods:, In the action research group and reflective conversations, the group planned new assessment tools to use in ICU to work with the family. Results:, Exploring their pragmatic knowledge of the context, the action research group suggested ways of working with families that did not impede the clinical work of the ICU. Families provided information about themselves and the patient that helped the nurse to plan care that redressed some of the asymmetrical nature of the relationship in the ICU. Conclusions:, This research created novel ways of viewing family and offers strategies to address asymmetry between families and ICU professionals. Relevance to clinical practice:, Positive steps to redress asymmetrical relationships can help ensure that family care is better integrated into ICU practice. [source]

Similar and Yet So Different: Cash-for-Care in Six European Countries' Long-Term Care Policies

Context: In response to increasing care needs, the reform or development of long-term care (LTC) systems has become a prominent policy issue in all European countries. Cash-for-care schemes,allowances instead of services provided to dependents,represent a key policy aimed at ensuring choice, fostering family care, developing care markets, and containing costs. Methods: A detailed analysis of policy documents and regulations, together with a systematic review of existing studies, was used to investigate the differences among six European countries (Austria, France, Germany, Italy, the Netherlands, and Sweden). The rationale and evolution of their various cash-for-care schemes within the framework of their LTC systems also were explored. Findings: While most of the literature present cash-for-care schemes as a common trend in the reforms that began in the 1990s and often treat them separately from the overarching LTC policies, this article argues that the policy context, timing, and specific regulation of the new schemes have created different visions of care and care work that in turn have given rise to distinct LTC configurations. Conclusions: A new typology of long-term care configurations is proposed based on the inclusiveness of the system, the role of cash-for-care schemes and their specific regulations, as well as the views of informal care and the care work that they require. [source]


Jo Wainer
Objectives: To identify the impact of family life on the ways women practice rural medicine and the changes needed to attract women to rural practice. Design: Census of women rural doctors in Victoria in 2000, using a self-completed postal survey. Setting: General and specialist practice. Subjects: Two hundred and seventy-one female general practitioners and 31 female specialists practising in Rural, Remote and Metropolitan Area Classifications 3,7. General practitioners are those doctors with a primary medical degree and without additional specialist qualifications. Main outcome measure: Interaction of hours and type of work with family responsibilities. Results: Generalist and specialist women rural doctors carry the main responsibility for family care. This is reflected in the number of hours they work in clinical and non-clinical professional practice, availability for oncall and hospital work, and preference for the responsibilities of practice partnership or the flexibility of salaried positions. Most of the doctors had established a satisfactory balance between work and family responsibilities, although a substantial number were overworked in order to provide an income for their families or meet the needs of their communities. Thirty-six percent of female rural general practitioners and 56% of female rural specialists preferred to work fewer hours. Female general practitioners with responsibility for children were more than twice as likely as female general practitioners without children to be in a salaried position and less likely to be a practice partner. The changes needed to attract and retain women in rural practice include a place for everyone in the doctor's family, flexible practice structures, mentoring by women doctors and financial and personal recognition. [source]

The design and development of an instrument for assessing the quality of partnership between mother and social worker in child and family care

M. Sheppard
Partnership with parents has become a central feature of child care policy and practice. It is related to a general emphasis on the importance of parents evident in issues such as parental responsibility and family support. As such it would be extremely helpful to have an instrument which provides a measure of the quality of partnership. It would be useful both in individual cases, where it could be used to help strengthen partnerships between social workers and parents, and on a wider basis, providing authorities with data with which to assess, in general, the quality of partnership. This paper reports on the design and development of an instrument for assessing the quality of partnership with mothers. First it focuses on key conceptual elements of partnership, which are considered to be role, and role relationship (of social worker and mother), and power. The paper then identifies key dimensions to the notion of partnership, dimensions which are generally agreed, and relate to the key conceptual elements. The ways these are operationalized are described, and the use of the instrument is analysed. The findings go some way to showing the instrument has both validity and reliability, when considered in the context of practice. It is suggested that this instrument may be used both in research and in practice. [source]

Double trouble: maternal depression and alcohol dependence as combined factors in child and family social work

CHILDREN & SOCIETY, Issue 4 2002
Johanna Woodcock
This study, part of a large programme of research incorporating four child and family care teams, focuses on the combined effects of alcohol dependence alongside clinical depression in mothers. A comparison is made between women who were clinically depressed and women who were both clinically depressed and alcohol dependent. The latter group had significantly higher levels of difficulty in social relationship, health, child, and particularly parenting problems. When considered alongside the intensity, duration and range of intervention required, the results indicated that there is considerable concern about the ,dangerousness' of this particular group with major implications for policy and practice. Copyright © 2002 John Wiley & Sons, Ltd. [source]