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Mendoza AN, Fruhauf CA, Bundy-Fazioli K, Weil J. Understanding Latino Grandparents Raising Grandchildren Through a Bioecological Lens. Int J Aging Hum Dev 2017; 86:281-305. [PMID: 28413885 DOI: 10.1177/0091415017702907] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this article is to provide a summary of the published research addressing the challenges and strengths of Latino grandparents raising grandchildren in the United States. Using the bioecological framework as a guide to organize and understand the published literature addressing Latino grandparent caregivers, we examined refereed articles published over the past 19 years. This framework provides a lens for understanding and situating research on Latino grandparents raising grandchildren to discover Latino grandparents' strengths and challenges. The areas of foci include financial challenges, intergenerational relationships, reasons for caregiving, health status, language barriers, and culture. This article concludes with future research opportunities and a call to action for more research on Latino grandparents raising grandchildren.
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Affiliation(s)
| | | | | | - Joyce Weil
- 2 University of Northern Colorado, Greeley, CO, USA
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2
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Shellman J. “Nobody Ever Asked Me Before”: Understanding Life Experiences of African American Elders. J Transcult Nurs 2016; 15:308-16. [PMID: 15359064 DOI: 10.1177/1043659604268961] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
With the unprecedented growth in the African American elderly population, there exists an urgent need to prepare nurses to deliver culturally competent care. The purpose of this study was to increase the knowledge available about the cultural heritage, worldviews, and life experiences of African American elders. Reminiscence interviews were conducted with African American elders living in a medium-sized northeast urban community. Data were analyzed using Spiegelberg’s phenomenological method. The following themes emerged: (a) nobody ever asked me before, (b) stories of discrimination, (c) coping with discrimination, (d) the hurt of discrimination, and (e) self-discoveries. Nurses, through the use of reminiscence, can gain insight into the cultural heritage, worldviews, and life experiences of African American elders and improve their ability to deliver culturally competent care to this population.
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Beck-Sagué CM, Dévieux JG, Pinzón-Iregui MC, Abreu-Pérez R, Lerebours-Nadal L, Gaston S, Dean AG, Halpern M, Rouzier V, Bertrand R, Rosenberg R, Pape JW, Nicholas SW, Blasini I. Depression in caregivers of status-naïve pediatric HIV patients participating in a status disclosure study in Haiti and the Dominican Republic: preliminary report. J Trop Pediatr 2015; 61:65-8. [PMID: 25389181 PMCID: PMC4375385 DOI: 10.1093/tropej/fmu060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A pilot study is underway to assess safety and acceptability of an intervention to disclose their HIV infection status to status-naïve pediatric antiretroviral therapy patients in Hispaniola [the island shared by Haiti and the Dominican Republic (DR)]. Of 22 Haiti and 47 DR caregivers recruited to date, 68.2% Haiti and 34.0% DR caregivers had clinically significant depressive symptomatology at the time of enrollment (p = 0.008). Depressive symptom prevalence was higher in Haiti caregivers who were female (81.3% vs. 0 in males; p = 0.02) and in DR caregivers who were patients' mothers (50.0%) or grandmothers (66.7%; 56.0% combined) than others (9.1%), (p < 0.001). Internalized stigma was more commonly reported by Haiti (85.7%) than DR (53.2%; p = 0.01) caregivers; 56.4% of Haiti and DR caregivers reporting internalized stigma vs. 26.1% of caregivers denying it had depressive symptoms (p = 0.02). Depression is common in Hispaniola caregivers possibly affecting disclosure timing. Study participation presents opportunities for addressing caregiver depression.
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Affiliation(s)
- Consuelo M Beck-Sagué
- Department of Health Promotion and Disease Prevention, Florida International University, Robert Stempel College of Public Health and Social Work, Miami, FL, USA 33199
| | - Jessy G Dévieux
- Department of Health Promotion and Disease Prevention, Florida International University, Robert Stempel College of Public Health and Social Work, Miami, FL, USA 33199
| | - María Claudia Pinzón-Iregui
- Department of Health Promotion and Disease Prevention, Florida International University, Robert Stempel College of Public Health and Social Work, Miami, FL, USA 33199
| | - Rosa Abreu-Pérez
- Robert Reid Cabral Children's Hospital, Santo Domingo, Dominican Republic (DR)
| | | | - Stephanie Gaston
- Groupe Haïtien d'Etude du Sarcoma de Kaposi et des Infections Opportunistes (GHESKIO), Department of Adolescent Medicine, Port-au-Prince, Haiti
| | - Andrew G Dean
- Department of Epidemiology Voluntary Faculty, University of Miami, Miami, FL, USA 33136
| | - Mina Halpern
- Clínica de Familia La Romana, Department of Research, La Romana, DR
| | - Vanessa Rouzier
- Groupe Haïtien d'Etude du Sarcoma de Kaposi et des Infections Opportunistes (GHESKIO), Department of Adolescent Medicine, Port-au-Prince, Haiti
| | - Rachel Bertrand
- Groupe Haïtien d'Etude du Sarcoma de Kaposi et des Infections Opportunistes (GHESKIO), Department of Adolescent Medicine, Port-au-Prince, Haiti
| | - Rhonda Rosenberg
- Department of Health Promotion and Disease Prevention, Florida International University, Robert Stempel College of Public Health and Social Work, Miami, FL, USA 33199
| | - Jean William Pape
- Groupe Haïtien d'Etude du Sarcoma de Kaposi et des Infections Opportunistes (GHESKIO), Department of Adolescent Medicine, Port-au-Prince, Haiti Cornell University School of Medicine, Cornell Medical College Center for Global Health, New York, NY, USA 10065
| | - Stephen W Nicholas
- Clínica de Familia La Romana, Department of Research, La Romana, DR Columbia College of Physicians and Surgeons, New York, NY, USA 10032
| | - Ileana Blasini
- Department of Pediatrics Voluntary Faculty, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico 00931-1839
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Punpanich W, Gorbach PM, Detels R. Impact of paediatric human immunodeficiency virus infection on children's and caregivers' daily functioning and well-being: a qualitative study. Child Care Health Dev 2012; 38:714-22. [PMID: 21851376 PMCID: PMC3392445 DOI: 10.1111/j.1365-2214.2011.01301.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Human immunodeficiency virus (HIV) infection impacts not only upon the physical health of affected children, but also their psychosocial functions, family relationships and economical status. Caregivers are confronted with complex challenges related to the physical, emotional and financial demands of raising these children. The purpose of this study was to enhance our understanding of the impact of HIV disease on both children's and caregivers' well-being, using a qualitative inquiry approach. METHODS A total of 35 primary caregivers of HIV-infected children participated in in-depth interviews. The issues discussed included the major negative impacts on children's daily functioning and well-being, and the perceived caregiver/parental burden. Participants included parents (40%), grandparents (22.8%), other relatives (e.g. uncles, aunts) (34.3%) and one foster parent (2.8%). RESULTS Qualitative analysis revealed that the major negative impacts of HIV/AIDS included physical symptoms, school performance and relationship changes. The major negative impacts on caregivers' well-being included acceptance of the diagnosis, dealing with the financial burden and keeping the diagnosis private. CONCLUSIONS Approaches are needed to address these challenges by enhancing families' coping skills and building supportive networks.
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Affiliation(s)
- W. Punpanich
- Department of Epidemiology, UCLA School of Public Health, Los Angeles, CA, USA,Department of Pediatrics, Queen Sirikit National Institute of Child Health, College of Medicine, Rangsit University, Pathum Thani, Thailand
| | - P. M. Gorbach
- Department of Epidemiology, UCLA School of Public Health, Los Angeles, CA, USA
| | - R. Detels
- Department of Epidemiology, UCLA School of Public Health, Los Angeles, CA, USA
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Moskowitz JT, Shmueli-Blumberg D, Acree M, Folkman S. Positive Affect in the Midst of Distress: Implications for Role Functioning. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2012; 22:502-518. [PMID: 23175617 DOI: 10.1002/casp.1133] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Stress has been shown to deplete the self-regulation resources hypothesized to facilitate effective role functioning. However, recent research suggests that positive affect may help to replenish these vital self-regulation resources. Based on revised Stress and Coping theory and the Broaden-and-Build theory of positive emotion, three studies provide evidence of the potential adaptive function of positive affect in the performance of roles for participants experiencing stress. Participants were students (Study 1), caregivers of ill children (Study 2), and individuals recently diagnosed with HIV (Study 3). In cross sectional analyses, using role functioning as an indicator of self-regulation performance, we found that positive affect was significantly correlated with better self regulation performance, independent of the effects of negative affect. The effects were not as strong longitudinally, however, and there was little evidence of a reciprocal association between increases in positive affect and improvements in role functioning over time. The results provide some modest support for hypotheses stemming from the Broaden and Build model of positive emotion and revised Stress and Coping theory, both of which argue for unique adaptive functions of positive affect under stressful conditions.
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Carr GF. Empowerment: a framework to develop advocacy in african american grandmothers providing care for their grandchildren. ISRN NURSING 2011; 2011:531717. [PMID: 21994894 PMCID: PMC3169837 DOI: 10.5402/2011/531717] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Accepted: 03/06/2011] [Indexed: 11/23/2022]
Abstract
Purpose. Based on a review of the literature, this paper presents a unique and innovative model that offers an empowerment framework, which may be used to develop advocacy in African American (AA) grandmother caregivers. This proposed framework centers on education as a catalyst to the empowerment process in these grandmothers. Application of this model has potential to guide the practice of healthcare providers as they assist these caregivers in managing their own lives. Methodology. Various empowerment definitions and research were used to develop this empowerment framework. Discussion. This framework offers an empowerment education program for AA grandmothers providing care for their grandchildren on topics that they feel are necessary to appropriately care for themselves and their grandchildren. Outcomes of this empowerment education are to develop skills within these grandmothers so that they will be able to advocate for themselves, their grandchildren, and others within their communities. This education will ultimately produce skillful AA grandmothers who will develop abilities to empower themselves and other AA grandmothers who are in similar circumstances.
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Affiliation(s)
- Gloria F Carr
- Loewenberg School of Nursing, The University of Memphis, 610 Goodman Street, Memphis, TN 38152, USA
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Carthron DL, Johnson TM, Hubbart TD, Strickland C, Nance K. "Give me some sugar!" the diabetes self-management activities of African-American primary caregiving grandmothers. J Nurs Scholarsh 2010; 42:330-7. [PMID: 20738744 DOI: 10.1111/j.1547-5069.2010.01336.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare the diabetes self-management activities of African American primary caregiving grandmothers before and after the initiation of caregiving and to compare the diabetes self-management activities of African American primary caregiving grandmothers to diabetic women who were not caring for their grandchildren. DESIGN Using a cross-sectional, descriptive design, 68 African American women 55 to 75 years of age were recruited as part of a larger study examining the impact of caregiving responsibilities on the diabetic health of African American primary caregiving grandmothers. Each participant was asked the frequency of their performance of six self-management activities. Caregiving grandmothers were asked about these activities before and after the initiation of caregiving. RESULTS Dependent and independent t-tests with Bonferroni correction were used to analyze the data. Statistically significant differences were noted in diet (t=4.400, p=.000) and self-monitoring of blood glucose (SMBG; t=3.484, p=.001) before and after the initiation of caregiving. For the caregiver versus non-caregiver comparison, statistically significant differences were noted in SMBG (t=-3.855, p=.000) and eye examinations (t=-3.211, p=.001). CONCLUSIONS The findings provide preliminary data to support further research examining the self-management activities of diabetic African American primary caregiving grandmothers. Diabetic African American primary caregiving grandmothers may have a decreased ability to integrate self-management activities into their daily patterns of living. Additional research is needed to determine what factors prevent this population from performing these tasks routinely. CLINICAL RELEVANCE African American primary caregiving grandmothers were found to have more difficulty performing some of their self-management activities, which may severely impact their overall diabetic health.
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Affiliation(s)
- Dana L Carthron
- Winston-Salem State University, School of Health Sciences, Winston-Salem, NC 27110, USA.
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Zhao G, Zhao Q, Li X, Fang X, Zhao J, Zhang L. Family-based care and psychological problems of AIDS orphans: does it matter who was the care-giver? PSYCHOL HEALTH MED 2010; 15:326-35. [PMID: 20480436 DOI: 10.1080/13548501003623989] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The purpose of this study is to compare psychological symptoms among double AIDS orphans (i.e. children who lost both of their parents to HIV/AIDS) who were in the care of different family-based caregivers (i.e. surviving parent, grandparents, other relatives, and non-relatives) before they were replaced in orphanages. The participants include 176 double AIDS orphans from four AIDS orphanages in rural China. Prior to being replaced in AIDS orphanages, these children had received family-based care by different caregivers, which included surviving parent (38%), grandparents (22%), other relatives (19%), and non-relatives (22%). The psychological measures include traumatic symptoms, depression, and loneliness. Both bivariate and multivariate analyses suggested that children who were previously cared for by non-relatives scored significantly higher in traumatic symptoms, depression, and loneliness scales than children who were previously cared for by their surviving parent, grandparents, and other relatives. Children in the care of grandparents reported the best scores on all psychological measures among children in the care of non-parent relatives. Multivariate analysis, controlling for children's gender, age, length in orphanages, number of household replacements, and total duration of replacement, revealed that the type of caregivers was significantly associated with psychological problems. Results in the current study suggest that children under the care of their grandparents reported the best psychological outcomes when their parents were unable to care for them because of AIDS. Appropriate psychological support and counseling services are needed for AIDS orphans who were either currently or previously under non-relative family-based care in China.
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Affiliation(s)
- Guoxiang Zhao
- Department of Psychology, Henan University, Kaifeng, China
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Muliira JK, Musil CM. Relationship Between Methods of Coping, Social Support and Receipt of Preventive Care Procedures by Primary Grandmother Caregivers. J Community Health 2009; 35:479-86. [DOI: 10.1007/s10900-009-9216-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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10
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King S, Kropf NP, Perkins M, Sessley L, Burt C, Lepore M. Kinship Care in Rural Georgia Communities: Responding to Needs and Challenges of Grandparent Caregivers. JOURNAL OF INTERGENERATIONAL RELATIONSHIPS 2009. [DOI: 10.1080/15350770902852369] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Sharon King
- a Georgia State University Gerontology Institute , Atlanta, Georgia, USA
| | - Nancy P. Kropf
- b Georgia State University School of Social Work , Atlanta, Georgia, USA
| | - Molly Perkins
- c Rollins School of Public Health , Emory University , Atlanta, Georgia, USA
| | - Leslie Sessley
- d Division of Aging Services, Georgia Department of Human Resources , Atlanta, Georgia, USA
| | - Cliff Burt
- d Division of Aging Services, Georgia Department of Human Resources , Atlanta, Georgia, USA
| | - Michael Lepore
- e Brown University Center for Gerontology and Healthcare Research , Providence, Rhode Island, USA
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Older Persons Parenting Children Who Have Lost a Parent Due to HIV. JOURNAL OF INTERGENERATIONAL RELATIONSHIPS 2008. [DOI: 10.1300/j194v05n04_06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Thampanichawat W. Maintaining love and hope: caregiving for Thai children with HIV infection. J Assoc Nurses AIDS Care 2008; 19:200-10. [PMID: 18457761 DOI: 10.1016/j.jana.2007.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2007] [Accepted: 12/18/2007] [Indexed: 11/15/2022]
Abstract
In this grounded theory study, the author explored how primary caregivers dealt with problems in caring for children with HIV infection in Thailand. A total of 27 family caregivers of HIV-infected children participated in open-ended interviews. Maintaining love and hope represented a condition for the continuing process of caregiving. Caregivers had to deal with the stigma of AIDS while providing care for children with HIV. They had high anxiety and fear of loss, bore much burden of care, and faced many difficulties because of limited resources. The results suggest that psychosocial care and informational support are needed to enable these caregivers to provide better care for children with HIV infection.
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Abstract
Health care providers who want to make a difference in today's health care environment must support the idea of collaboration. To address the concerns of a university, a major medical center, and the community, a collaborative group shared their vision and developed creative strategies to serve the community. The critical components of this project included gaining the services of a nurse practitioner and nurse case manager, establishing physician liaison, assessing congregational health care needs, providing for both primary health and continuity of care needs, and maintaining the spiritual component of the faith community. Essential to the success of this program was the achievement of pastor and congregational support, enthusiasm, and involvement.
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Results of an Interdisciplinary Intervention to Improve the Psychosocial Well-Being and Physical Functioning of African American Grandmothers Raising Grandchildren. JOURNAL OF INTERGENERATIONAL RELATIONSHIPS 2007. [DOI: 10.1300/j194v05n03_04] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Get Thee Behind Me: African-American Grandparents Raising Grandchildren Who Experienced Domestic Violence. ACTA ACUST UNITED AC 2006. [DOI: 10.1007/978-0-387-29598-5_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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Rempusheski VF, O'Hara CT. Psychometric Properties of the Grandparent Perceptions of Family Scale (GPFS). Nurs Res 2005; 54:419-27. [PMID: 16372397 DOI: 10.1097/00006199-200511000-00009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Veronica F Rempusheski
- University of Kansas School of Nursing, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
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Abstract
BACKGROUND For the majority of grandparents, rarely are their perceptions of family assessed, acknowledged, or viewed in the context of potential effect on individual and family health. OBJECTIVE To develop and test an instrument to measure grandparent perceptions of family. METHOD An inductively derived semantic differential instrument comprising 112 items, 8 stimuli, and 27 adjective pairs within 2 domains and framed by the Becoming a Grandparent theoretical model was content validated by an expert panel, revised, and evaluated on a convenience sample of 306 community-dwelling grandparents, aged 41-92 years (M = 64, SD = 9.8), 72% female, 93% U.S. born, 62% college educated, 55% economically comfortable, and 71% living with a spouse or partner. Assessment procedures included internal consistency reliability, item and scale correlation coefficients, and principal components factor analysis with varimax rotation to evaluate construct validity, structure, and magnitude of the scale. RESULTS The final scale consists of 25 items using 3 stimuli (grandparent's view of grandchild, mother of grandchild, father of grandchild) measuring a single domain (overall view of family). The Grandparent Perceptions of Family Scale (GPFS) includes 5 factors for a total explained variance of 60%. Coefficient alpha for the total scale is .90. DISCUSSION The GPFS should be helpful to clinicians and researchers in their assessment of grandparents within multigenerational families and in planning appropriate interventions to address the roles and relationships of grandparents within families. Further GPFS evaluation is suggested with grandparents of diverse racial or ethnic identification; social economic position; education; and family definition, roles, composition, and structure.
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Abstract
PURPOSE To describe the experience of grandmothers who are parenting their grandchildren, and determine the amount of caregiver burden felt by the grandmothers. STUDY DESIGN AND METHODS This descriptive correlational study had a sample of 104 grandmothers, reporting on 249 custodial grandchildren. Grandmothers completed the Caregiver Reactions Assessment to determine perceived physical health, family support, financial status, and caregiver burden. RESULTS Overall, grandmothers perceived the health of their grandchildren as excellent. Of the grandchildren who had been born prematurely (30%), the primary health problems were hyperactivity and asthma. Parental drug use was reported as the reason for child placement with the grandmother in 80% of the cases. The range of time grandchildren had been living with the grandmother was 6 months to 15 years. Low ratings of grandchild physical health correlated with low ratings of grandmother physical health, which correlated strongly with low levels of self-esteem, a strong perception of poor family support, and poor financial status, all of which represent measures of caregiver burden. CLINICAL IMPLICATIONS This study demonstrated that the well being of the grandmother and grandchild are both linked to good physical health. Thus, indicators of poor health for both grandchild and grandmother must be identified early. Grandmothers in this study were surprised at how much had changed in every aspect of child health since they had raised their own children. Nurses working with grandmothers who have custody of grandchildren should understand the dynamics of the relationship, the possibility of caregiver burden, provide anticipatory guidance about the changes in child care and child healthcare in the 21st century, and help link grandmothers who have little support to community programs.
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Green G, Smith R. The psychosocial and health care needs of HIV-positive people in the United Kingdom: a review. HIV Med 2004; 5 Suppl 1:5-46. [PMID: 15113395 DOI: 10.1111/j.1468-1293.2004.00210.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- G Green
- Department of Health and Human Sciences, University of Essex, Colchester, UK.
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21
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Pathways into Caregiving for Rural Custodial Grandparents. JOURNAL OF INTERGENERATIONAL RELATIONSHIPS 2004. [DOI: 10.1300/j194v02n01_05] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Abstract
AIM To provide a critical review of research literature on the health of grandparents raising grandchildren, and identify directions for future research. METHODS Approaches used to access the research studies for this review included a comprehensive search using relevant electronic databases and a thorough examination of the references in each published study. FINDINGS All studies but one were published after 1990. Samples consisted primarily of African-American and Caucasian grandmothers in the United States of America. Earlier studies tended to describe health and other related concepts while more recent studies began to examine relationships between concepts. Most of the studies had a cross-sectional design and only one evaluated interventions. Inconsistencies in the results of these studies were prevalent. CONCLUSIONS Evaluation studies, longitudinal designs, and more varied study samples including cross-cultural comparisons are needed to advance knowledge about grandparent caregivers' health.
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Kylmä J, Vehviläinen-Julkunen K, Lähdevirta J. Dynamics of Hope in HIV/AIDS Affected People: An Exploration of Significant Others’ Experiences. Res Theory Nurs Pract 2003; 17:191-205. [PMID: 14655973 DOI: 10.1891/rtnp.17.3.191.53183] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Hope is an important protective phenomenon in human life, particularly given that long-lasting despair or hopelessness may threaten human existence. However, previous knowledge on the topic related to people affected by HIV/AIDS is scant. The purpose of this study was to explore the dynamics of hope in significant others of people living with HIV/AIDS and persons living with HIV (PLWH) or AIDS (PLWA) from the perspective of significant others in Finland. Eleven interviews were conducted with six significant others. The data were analyzed using the grounded theory method. The dynamics of hope, as it emerged from the data, is constructed of three main elements: hope, despair, hopelessness, and their reciprocal relationships. An alternating balance between hope, despair, and hopelessness based on the factors contributing to them emerged as central in the dynamics of hope. The dynamics of hope are closely connected to the basic process of searching for one’s own way with HIV/AIDS, in becoming HIV-positive, and living with HIV/AIDS. In significant others, the dynamics of hope are closely connected to the basic process of HIV, changing from abstract to concrete in a relationship with a PLWH/PLWA.
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Affiliation(s)
- Jari Kylmä
- University of Kuopio, Department of Nursing Science, Finland.
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Strug DL, Burr CK. Service needs of male caretakers of HIV-infected and affected children: policy and practice implications. SOCIAL WORK IN HEALTH CARE 2003; 38:73-92. [PMID: 15022735 DOI: 10.1300/j010v38n02_04] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The number of male caretakers (biological fathers and other men) of HIV-infected and affected children is substantial and may increase in the US and elsewhere as more women become infected. Little information exists about the needs these men have for support services to help them better perform their parenting roles as male caretakers (MCs). This paper discusses the service needs of MCs at Ryan White CARE Act Title IV programs, the challenges providers at these programs face in serving MCs, and the strategies they have found effective in working with MCs. Providers report that MCs have specific service needs including the need for emotional support. Title IV programs meet these needs in a limited way because they are organized primarily around the needs of female rather than male caretakers. We discuss how Title IV programs can tailor existing service delivery and implement organizational change to facilitate MCs' service access and utilization. Further research directly with MCs is necessary to learn more about their service needs and the barriers MCs face in accessing services.
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Affiliation(s)
- David L Strug
- Wurzweiler School of Social Work, Yeshiva University, 2495 Amsterdam Avenue, New York, NY 10033, USA.
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Flaskerud JH, Lesser J, Dixon E, Anderson N, Conde F, Kim S, Koniak-Griffin D, Strehlow A, Tullmann D, Verzemnieks I. Health disparities among vulnerable populations: evolution of knowledge over five decades in Nursing Research publications. Nurs Res 2002; 51:74-85. [PMID: 11984377 DOI: 10.1097/00006199-200203000-00003] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Considerable attention has been focused recently on conducting research on the health disparities experienced by some Americans as the result of poverty, ethnicity, and/or marginalized social status. Nursing research has a major role to play in developing this body of knowledge. PURPOSE The purpose of this paper is to review the contributions that Nursing Research made through its publications over the last five decades in developing the body of tested knowledge about health disparities in vulnerable groups and to analyze the progress made. METHODS Criteria for reviewing the literature were established. All Nursing Research publications between 1952 and 2000 were searched manually, indexes of each year's bound volumes were reviewed, and computer searches were conducted. Included in the review were research reports, research briefs, and methodology articles. RESULTS Seventy-nine papers were found that met basic criteria for inclusion. The number of relevant publications increased each decade, with a sizable increase in numbers since 1990, and may be related to the social, political, and economic climate of each decade. The research questions asked and the methods used became more complex over time. CONCLUSIONS Nursing Research has made a significant contribution in disseminating the body of tested knowledge related to the health disparities experienced by vulnerable populations and the methodologies associated with vulnerable populations research. Areas for future research are community-based studies, intervention studies that provide tangible resources, and methodologic approaches that involve participants in the research process.
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Abstract
There is an increasing prevalence in the United States of intergenerational surrogate parenting. In fact, grandmother-headed households that include grandchildren without their parents are the fastest growing intergenerational surrogate family combination. This article reviews the intergenerational surrogate family phenomenon relative to its impact on the grandmothers' health and offers resources and implications for nursing.
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Thomas JL, Sperry L, Yarbrough MS. Grandparents as parents: research findings and policy recommendations. Child Psychiatry Hum Dev 2001; 31:3-22. [PMID: 11033926 DOI: 10.1023/a:1001969920389] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This article presents an overview of research on grandparenthood in the latter decades of the twentieth century. Theories contributing to understanding of the grandparenting role are discussed, and significant factors affecting the grandparenting experience--including sex, age, retirement status, race, and ethnicity--are reviewed. The special case of grandparents raising grandchildren is explored through a review of demographics, outcomes for children in grandparent foster care, and the impact of raising grandchildren on grandparents. Interventions supporting custodial grandparents and the grandchildren in their care are examined. Drawing on the findings and implications of this overview, recommendations for policy, clinical practice, professional education, and future research are offered.
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Affiliation(s)
- J L Thomas
- College of Behavioral and Social Sciences, California State University, Chico 95929-0450, USA
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Hughes CB, Caliandro G. Empowerment: a case study of a grandmother caring for her HIV-positive grandchild. J Assoc Nurses AIDS Care 2000; 11:29-38. [PMID: 11022330 DOI: 10.1016/s1055-3290(06)60382-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A case study methodology is used to explore the meaning and development of empowerment in a grandmother who is the primary caregiver of a child with HIV infection. Empowerment to this grandmother meant being strong, coming to grips with life's challenges, and then moving on. Empowerment developed over the grandmother's life span as a result of developmental and situational experiences such as motherhood, disclosure of the HIV diagnosis, sharing her positive and negative feelings with others, gaining knowledge about HIV, making management decisions, and her increasing sense of spirituality. This grandmother manifests her empowerment through her public commitment to influence others positively about HIV infections through speaking, writing, and leadership in groups. Clinical implications are discussed.
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Affiliation(s)
- C B Hughes
- California State University, Los Angeles, USA
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Kelley SJ, Whitley D, Sipe TA, Yorker BC. Psychological distress in grandmother kinship care providers: the role of resources, social support, and physical health. CHILD ABUSE & NEGLECT 2000; 24:311-21. [PMID: 10739075 DOI: 10.1016/s0145-2134(99)00146-5] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
OBJECTIVE The purpose of the present study was to investigate predictors of psychological distress in grandmother kinship care providers. More specifically, it was hypothesized that social support, family resources, and physical health would predict psychological distress in grandmothers raising grandchildren. METHOD One hundred and two grandmothers raising grandchildren in parent-absent homes completed the Brief Symptom Inventory, Short Health Form-36, Family Resource Scale, Family Support Scale, and a questionnaire requesting background and demographic data. RESULTS Results indicated that psychological distress was predicted by family resources, participants' physical health, and to a lesser extent, social support. CONCLUSION The findings indicate that family resources, social support, and physical health affected psychological distress in grandmothers raising grandchildren. Grandmothers who reported fewer resources, less social support, and poorer physical health tended to experience higher levels of psychological distress. This study suggests that greater attention be given to interventions aimed to decrease psychological distress and improve the financial resources and physical health of grandmothers raising grandchildren.
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Affiliation(s)
- S J Kelley
- College of Health and Human Sciences, Georgia State University, Atlanta 30303, USA
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Abstract
Caring for children with HIV infection is a much more optimistic process than in the beginning of the epidemic. Antiretroviral therapies are available, and additional drugs are receiving approval from the US Food and Drug Administration. Cautious optimism must be tempered with an understanding that living with the disease is a complicated and daunting process for these children and their families. Although scientific knowledge and medical treatments are moving forward, the social and environmental uncertainties remain for families. Comprehensive care is a balance of health care services and supportive, community-based services offered in a compassionate manner.
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Affiliation(s)
- M G Boland
- François-Xavier Bagnoud Center, University of Medicine and Dentistry of New Jersey, Newark, USA.
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Abstract
For many grandparents in America, caring for grandchildren has become a full-time responsibility that has led to multiple stresses. Raising grandchildren may cause financial stress, cramped living quarters, role restriction, and social isolation among this group. However, advantages to this role among grandparents can include greater life satisfaction and a positive influence on the other generations within the family. Nurses and other health providers can play an essential role in assisting grandparents caring for grandchildren by strategically building family strengths and cohesiveness.
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Sanz Aliaga SA, Sancho Izquierdo E, Asensi Botet F, Otero Reigada MC. [Social and family characteristics in children born to women infected by the human immunodeficiency virus]. Aten Primaria 2000; 25:5-10. [PMID: 10730451 PMCID: PMC7683976 DOI: 10.1016/s0212-6567(00)78455-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/1999] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVES To evaluate the social and family characteristics of children born to women infected by the human immunodeficiency virus (HIV). As secondary objectives, to analyse their schooling and the number of hospital admissions and lengths of stay that these children required. DESIGN A prospective observation study. SETTING HIV unit in a children's hospital. PARTICIPANTS INCLUSION CRITERIA all the children recruited from the HIV unit who had their infection status defined during the study period, understood as between the first known case in 1985 and April 1994. The sample included 177 children (62 HIV-infected and 115 not infected). MEASUREMENTS AND MAIN RESULTS Through an interview the social, family and school variables were collected. On comparison between infected and non-infected children, there were no important differences as to the lack of protection of the new-born (8.1% vs 13%), scant mother-child relationship (31.2% vs 36.5%) or people responsible for the custody of these children. Less schooling and greater problems of school integration were detected in infected cases, with odds ratios of 2.68 (p = 0.004) and 11.36 (p = 0.004), respectively. Children infected also needed more admissions (4.3 +/- 5.7) than the non-infected (1.7 +/- 0.9) (p = 0.001), and more days of hospital stay (75.1 +/- 110.3 vs 23.3 +/- 19.6) (p = 0.0003). CONCLUSIONS Infected children and non-infected children had similar social and family characteristics. However, less schooling, problems of school integration, and more and longer hospital admissions were related to HIV infection in children, and not so much to their status as children of seropositive mothers.
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Affiliation(s)
- S A Sanz Aliaga
- Universitat de Valencia, Hospital Universitario La Fe, Valencia.
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Ledlie SW. Diagnosis disclosure by family caregivers to children who have perinatally acquired HIV disease: when the time comes. Nurs Res 1999; 48:141-9. [PMID: 10337845 DOI: 10.1097/00006199-199905000-00004] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Children with perinatally acquired HIV disease (PAHD) can be relatively symptom-free and live to school age and older. These children often confront their caregivers with questions about the illness and complex treatments; however, caregivers may try to avoid disclosing the diagnosis of PAHD to the child. PURPOSE To generate a substantive theory that describes and explains how family caregivers manage diagnosis disclosure to a child who has PAHD. METHOD Using grounded theory, a substantive theory was constructed based on the accounts of 18 ethnically diverse families. Eight families had 10 children with PAHD who had been told their diagnosis. Ten families had 10 children with PAHD who had not been told their diagnosis. RESULTS The basic social psychological problem was identified as caregiver readiness to disclose the diagnosis. When the Time Comes was identified as the central phenomenon linked to the problem of caregiver readiness. Causal conditions, intervening conditions, and strategic responses of caregivers and children were discovered and are inextricably linked to the central phenomenon. CONCLUSIONS The process by which family caregivers respond to diagnosis disclosure to children with PAHD is based on the perceived self-readiness of the caregiver to disclose the diagnosis and illness-related information to their child.
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Affiliation(s)
- S W Ledlie
- International Center of Research for Women, Children, and Families, University of Pennsylvania, School of Nursing, Philadelphia, USA.
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Rodgers-Farmer AY. HIV risk factors, HIV antibody testing, and AIDS knowledge among African Americans age 55 years and older. SOCIAL WORK IN HEALTH CARE 1999; 29:1-17. [PMID: 10777114 DOI: 10.1300/j010v29n03_01] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This study uses data from the 1992 AIDS Knowledge and Attitudes Supplement to the National Health Interview Survey to assess AIDS knowledge, prevalence of HIV testing, and HIV risk factors among 745 African Americans age 55 years and older. The results revealed that only one of the six respondents who reported an HIV risk factor had been tested for HIV. Overall, the respondents were very knowledgeable about the major modes of transmission, but they still had misconceptions about the likelihood of transmission through casual contact. Prevention programs aimed at African Americans age 55 years and older should focus on dispelling misconceptions about the transmission of HIV through casual contact, and enhancing their knowledge about the effectiveness of condoms in preventing the spread of AIDS.
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Affiliation(s)
- A Y Rodgers-Farmer
- Rutgers, The State University of New Jersey, School of Social Work, New Brunswick 08903, USA.
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Deatrick JA, Knafl KA. Acknowledging sources in scholarly work. Nurs Res 1998; 47:260. [PMID: 9766453 DOI: 10.1097/00006199-199809000-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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