Disruption Of Family Life Research Articles

EN to RN: The transition experience pre- and post-graduation

The context for this study is a conversion program for enrolled nurses (ENs) or division 2 level nurses who want to further their career as a registered nurse (RN) or division 1 nurse. While the conversion program is available to both metropolitan and rural nurses, it is designed specifically for experienced rural ENs. The conversion program is able to offer an educational alternative that does not disrupt family life or adversely impact the rural nursing workforce. This alternative is necessary for both the rural EN's career opportunities and for the health outcomes of rural communities in particular. This article reports on the experiences of the first cohort to graduate from the EN to RN conversion program. The conversion program offers three semesters of advanced standing within a seven-semester Bachelor of Science (Nursing) degree. The advanced standing or recognition of prior learning is awarded to applicants with more than one year's clinical experience, regardless of the type of enrolled nurse course completed. Enrolled nurses with a technical college qualification or higher meet university entry criterion but students from a hospital-based program are required to complete a mature-age university entry test. The degree to which the three semesters of advanced standing within an external conversion course for ENs would adversely affect participants' transition to student status and course completion is not known. The conversion program: The two-year, fully external EN conversion program relies on learning centre partnerships with country hospitals and agencies. Teaching strategies consist of a mix of external-mode strategies, including fully web-based units, and a compulsory eight-day on-campus foundation study block at the beginning. The compulsory study block provides the opportunity for students to familiarize themselves with the various areas of the university they need to contact as an external student, prepare for expectations of their first unit, including assessment expectations, and to practise selected nursing skills that are not common to the EN role. With the program being delivered from the metropolitan area of a vast state that occupies one-third of the Australian landmass, a key feature is the establishment of rural learning centres to support students. Apart from two of the seven clinical units in their course, the designated rural academic mentors arrange clinical placements in school-approved health care agencies situated locally or in nearby towns. This later strategy avoids the necessity for students to relocate to the metropolitan area or larger towns to complete the clinical component of the course. The conversion program has enrolled a limited number each year since 2000 and continues to be in high demand. Rural ENs are given preference and metropolitan enrolled nurses are included when quota allows. The purpose of this article is to describe the two aspects of the transition experiences of graduates from an external conversion degree. First, their transition experience from experienced enrolled nurse to undergraduate student and, second, from graduate to novice RN. Participants were volunteer graduates from the Bachelor of Science (Nursing) two-year conversion degree. The 10 study participants were mature-age females, aged between 33 and 53 years (mean = 42 years). Five were from rural areas. Their educational background included hospital-based diploma or technical college certificate. Data were collected using open-ended questions in semi-structured interviews. The interviews were transcribed and thematic analyses of the data were undertaken. Major categories were identified and relationships among them detailed. The four categories identified included adjusting to higher education, achieving academically, becoming critical thinkers and adjusting to the RN role: accepting responsibility. Participant responses in this study have highlighted the necessity for timely responses to email, feedback on assignments and more mentor support for rural students during the course. Participants report changing the way they approached their nursing practice. The transition experiences for participants in the external conversion program are generally positive although, as with other studies, the transition to student status is stressful. However, the course is able to facilitate the career aspirations of the study participants and to contribute to the retention of nursing staff in rural areas. Strategies to provide career opportunities for health-care professionals in rural areas are always a challenge. As one such strategy, the external mode EN to RN conversion program has proven to be effective for experienced ENs.

Brain tumour-related epilepsy: The experience of a nurse-led seizure clinic in Scotland

Brain tumour-related epilepsy is often difficult to control and referral to epilepsy specialists can be very variable. For patients with high-grade tumours life expectancy is limited and the aim of treatment is to prolong survival and maintain quality of life. Seizures are a great concern to patients and can have a negative impact on physical, psychological and social functioning, disrupting family life and adversely affecting the quality of an already compromised life. In an effort to improve the continuity and supportiveness of care, a nurse-led seizure clinic was introduced in the regional cancer centre for this patient group and their carers.

Post-migration geographical mobility, mental health and health service utilisation among Somali refugees in the UK: A qualitative study

Migration is known to be associated with poor health outcomes for certain marginalised and socially disadvantaged populations. This paper reviews a number of reasons why residential mobility in the ‘host’ country may be associated with poor mental health for refugee populations and reports on a qualitative study of Somalis living in London, UK, and their beliefs about the relationship between residential mobility, poor health and health service use. Two discussion groups were undertaken with 13 Somali professionals and four groups with 21 lay Somalis in East and South London, UK. Lay Somalis did not wish to move accommodation but felt they were forced to move. Some Somali professionals believed that the nomadic history of Somalis made them more likely to elect to move in order to escape problems of living, but this was not supported by the lay group. Frequent geographical movements were seen as stressful and undesirable, disrupted family life and child development and were detrimental to well being. Residential mobility was also perceived to interfere with health care receipt and therefore should be more comprehensively assessed in larger quantitative studies.

Incarcerated Fathers Returning Home to Children and Families: Introduction to the Special Issue and a Primer on Doing Research with Men in Prison

Men are returning to family life following prison experience in record numbers. The accelerated rates of incarceration in the U.S. are contributing to strained federal and state budgets and disrupted family life in communities across the nation. It has been proposed that successful reentry into family life may positively influence rearrest rates. However, there is only sparse research about the familial aspects of the prison, reentry, and rearrest cycle. This study is a report of a pilot study that examines a methodological attempt to obtain data from men in prison about to be released and their partners. The results show that collecting data from the men was much easier than from their partners/spouses. Additionally, it was found that men's ideas about their relationships with their spouses and children may be unrealistic, ambiguous, and unclear. Suggestions are made about future research and research methods with this unique group. Language: en

AIDS/HIV -- When the State Fails: NGOs in Grassroots AIDS Care

In the past quarter century HIV/AIDS has intensified poverty and suffering world wide more so in underdeveloped countries and poor neighborhoods of cities within industrial nations. UNAIDS and WHO estimate that 40-60 million people are living with the disease worldwide. The poorest nations in Africa and the Caribbean in which HIV/AIDS have spread most rapidly also live under political social and economic insecurity. For example Haiti has experienced a brief civil war and a hurricane disaster in 2004; however AIDS is the leading cause of death for adults accounting for 5.9% of deaths and 20% of deaths among adult women. Many of the poorest African countries have also suffered concomitantly from civil wars and high HIV/AIDS prevalence. In the 1980s when Uganda had a civil war this country was the epicenter of the pandemic world-wide with an adult HIV prevalence of 30%. Liberia ended her civil war in 2003 and currently records an HIV prevalence of 8.2%. Sierra Leone also had a civil war which ended officially in 2002 with HIV/AIDS prevalence among the army of 46% and a rise in prevalence among the general population. Finally Rwanda emerged from civil war genocide and mass dislocation in the 1990s and records 11.2% of adult prevalence. The economic crises from poor countries arose from "weak agricultural growth a decline in industrial output poor export production high debt and deteriorating social indicators and institutions." Botswana with 35% prevalence and South Africa with 25% prevalence though relatively more prosperous continue to be weighed down by the legacy of apartheid in the form of a high migrant labor system and disruption of family life. (excerpt)

Parity and Difference: The Value of Parity Legislation for the Seriously Mentally Ill

Mental illness affects the health status of about one in five Americans each year. More than five percent of adult Americans have a “serious” mental illness—an illness that interferes with social functioning. About two and one-half percent have “severe and persistent” mental illness, a categorization for the most disabling forms of mental illness, such as schizophrenia and bipolar disorder. All mental illness interferes to some degree with social activities. Left untreated, serious mental illness can be disabling—disrupting family life, employment status and the ability to maintain housing. Nevertheless, privately insured people in the United States (that is, the majority of insured people in the United States) are not covered for mental health services to the same extent that they are covered for physical health services. Second-class coverage of mental health services reduces access to care for people with mental illness because cost becomes a significant barrier to service. The resulting lack of treatment fuels the disabling potential of mental illness.

Prevalence of Social-Emotional and Behavioral Problems in a Community Sample of 1- and 2-Year-Old Children

To examine the prevalence of infant-toddler social-emotional and behavioral problems and associations with social-emotional competence, interference in family life, and parental worry. The sample consisted of 1- and 2-year-old children (mean [MN] age = 24.8 months) from the baseline survey of a representative sample of healthy births (N= 1,280). Parent questionnaires included the Child Behavior Checklist (CBCL/2-3), Parenting Stress Index Short Form (PSI/SF), and Infant-Toddler Social and Emotional Assessment social-emotional competence scales, as well as questions about parental worry and family activities. Approximately 80% of eligible subjects participated. The weighted prevalence of parent-reported subclinical/clinical CBCL/2-3 scores was 11.8% for 2-year-olds. Approximately 6% of parents of 1- and 2-year-olds reported clinical-level scores on the PSI Difficult Child (PSI/DC) scale, which was included as a proxy for behavior problems among 1-year-olds, for whom measures were limited. Sex differences were not observed. CBCL/2-3 and PSI/DC scores were uniquely associated with economic disadvantage (relative risk = 1.89 and 2.24, respectively). Approximately 32% of 2-year-olds with subclinical/clinical CBCL2-3 scores had delayed social-emotional competence. Problems were also associated with parental worry about child behavior and interference in family activities. A significant need for early identification of emotional/behavioral problems in very young children is highlighted by associations with delayed competence and disruptions in family life that may further contribute to risk for persistent problems.

Stressful life events among adolescents in Wuhan, China: Associations with smoking, alcohol use, and depressive symptoms

The associations among stress and adolescent smoking, alcohol use, and depression have been well documented in the United States, but few studies have evaluated the evidence for these associations in Asian cultures. This study developed a scale of stressful life events among 7th-grade adolescents in Wuhan, China. The events reported as most frequent involved bad grades or punishment at school, and the events reported as most severe involved disruptions in family life, such as death, divorce, or disability of parents. Associations were observed between life events (especially negative school-related events) and smoking, alcohol use, and depressive symptoms. Results indicate that school-related stress may lead to substance use and mental health problems among Chinese adolescents.

Theoretical and observed subtypes of DSM-IV alcohol abuse and dependence in a general population sample

The purpose of this study was to quantify the degree of heterogeneity of the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) alcohol abuse and dependence categories by comparing the number of theoretically predicted subtypes of each category with those observed in a nationally representative sample of the US general population. Among respondents classified with a past year diagnosis of abuse, only 11 (47.8%) of the 23 theoretically predicted subtypes of abuse were observed, while 53 (53.5%) of the 99 theoretically predicted subtypes of dependence were observed in this general population sample. Approximately 90% of the respondents classified with abuse could be represented by three subtypes of abuse and 70% of the respondents with current diagnoses of dependence could be characterized by six subtypes of dependence, indicating the relative homogeneity of both diagnostic categories. Sociodemographic differentials were also observed including the reduction in the number of observed subtypes of abuse and dependence with age as well as the larger numbers of subtypes associated with males and whites relative to females and blacks, respectively. Implications of these results are discussed in terms of increased physical morbidity and disruption of family life as persons with alcohol use disorders age, the potential role of physiological and impaired control over drinking indicators of dependence as critical features of the disorder, and the future need to examine the conceptual basis of the abuse category and to conduct longitudinal epidemiological research.

The experience of being an adolescent child of a parent who has a mood disorder.

The purpose of this phenomenological study was to describe the experiences of adolescent children living with a parent who has a mood disorder. Three female adolescents each participated in two unstructured, tape-recorded interviews. Interviews were analysed using the Giorgi (1985) method. Three themes emerged. First, participants experienced a serious disruption in family life due to the unavailability of the ill parent, which evoked feelings of an intense sense of responsibility, fear and loss. This disruption led to the adolescent taking on parental roles and tasks. Second, participants perceived themselves to lack knowledge and understanding, leading to frustration and fears that their parents may not get better, and that they themselves may become ill like their parents. They sought information in order to better adjust to and understand the illness. Third, participants struggled to come to terms with the burden of having a psychiatrically ill parent. The effort of trying to cope and make sense of the experience involved a variety of cognitive and affective responses. Implications for nursing practice and research are discussed.

Relocated Citizens' Perceptions and Attitudes Regarding Indoor Application of Toxic Agricultural Pesticides

This study investigates the viewpoints of relocated citizens regarding the effects of relocation, perceptions of the potential hazards of indoor application of a toxic agricultural pesticide – methyl parathion – and the efficacy of the risk information emphasizing the adverse health effects of this inappropriate use of the pesticide. The surveyed citizens were those relocated because the levels of the pesticide contaminant in their homes were high. Despite the extensive information – through the mass media and face‐to‐face warnings and activities such as assessment of contamination levels, decontamination of homes and relocation – the respondents, regardless of race, consistently perceived relatively low levels of risks from the indoor application of methyl parathion. The disruption of family life, loss of peace of mind and the loss of contaminated property were the most mentioned problems caused by the relocation. In contrast to past research, the disruption of social ties or networks was hardly mentioned. The results of this study suggest that the perceived personal benefits of home‐use of methyl parathion, and the voluntariness and controllability of exposure may have been the overriding factors of the respondents' risk perception, more than the clarity, content, consistency, and credibility of the risk information. The fact that the relocation was temporary must have contributed to the low level of importance attached by the respondents to the disruption of social ties as one of the adverse effects of the relocation.

A Demonstration of Behavioral Support for Young Children with Autism

Young children with autism sometimes display severe behavior problems that can cause great disruptions in family life and interfere with attempts to provide needed services. Strategies are needed to resolve these behavior problems in a manner that is effective, durable, and consistent with current approaches to positive, comprehensive, and inclusionary practice in early childhood intervention. This article provides a description of behavioral support as applied in the context of a family-centered early intervention program for young children with autism. Demonstration data are presented to illustrate the effects of the approach in reducing the problem behaviors of six children. The practices and data are discussed in the context of changing perspectives toward early intervention and the prospects of developing effective preventive strategies and functional deterrents to the emergence and occurrence of serious problem behaviors.

Depression in late life. Diagnosis, course, and consequences.

Both major depression and dysthymia are common disorders in late life. However, making an accurate diagnosis may be more challenging than diagnosing depression in younger persons both because of comorbid general medical conditions and because of the illnesses, cognitive disturbances, and myriad adverse life experiences the elderly face. Often, dysphoria is sloughed off as an understandable response to adversity, and the diagnosis of depression is missed. Thus, elderly persons with major depression and dysthymia may be exposed to unnecessary prolonged suffering and to the disruptions of family life, impairment of functioning, worsening of comorbid general medical illness, and premature death that are the hallmarks of untreated depression.

Risk factors in the adjustment of siblings of children with cancer.

The study investigated the psychological adjustment of 99 siblings of children with cancer. At 6 months post-diagnosis, 24 siblings had scores in the borderline or clinical range on parent- and teacher-completed measures of behavioural adjustment and were reported to have shown negative changes in behaviour since diagnosis. The results of logistic regression analysis indicated that problems in adjustment were related to the degree of disruption of family life occasioned by the illness, the resources available to the family to cope with the effects of such disruption on siblings and siblings' perceptions of negative interpersonal effects on their lives.

The experience of South American mothers who have a child being treated for malignancy in the United States

This phenomenological study examined the experience of South American mothers who brought their children to the United States for cancer treatment. Five mothers were interviewed twice about their subjective experiences. Data were analyzed using Colaizzi's method of phenomenology. Thirty-two significant statements were grouped into eight themes. The South American mothers brought their children to the United States in hopes of finding effective treatment, illustrating the major theme of our findings that no effort or sacrifice was too great to save their children's lives. The diagnosis of cancer had an over-whelming impact on the child and the family. This was made worse by the uncertainty of treatment outcome. Although the decision to come disrupted family life and caused economic and cultural hardship, it was uniformly believed to have been the right decision. The greatest challenges experienced by the mothers were language difficulties and the constant preoccupation with the child's illness. Through faith and a variety of coping strategies, these South American mothers succeeded in adapting. They transcended life disruption and focused on the critical goal of restoring their child's health. Central to their experience is that everything humanly possible be done to preserve the life of their child.

The experience of South American mothers who have a child being treated for malignancy in the United States.

This phenomenological study examined the experience of South American mothers who brought their children to the United States for cancer treatment. Five mothers were interviewed twice about their subjective experiences. Data were analyzed using Colaizzi's method of phenomenology. Thirty-two significant statements were grouped into eight themes. The South American mothers brought their children to the United States in hopes of finding effective treatment, illustrating the major theme of our findings that no effort or sacrifice was too great to save their children's lives. The diagnosis of cancer had an overwhelming impact on the child and the family. This was made worse by the uncertainty of treatment outcome. Although the decision to come disrupted family life and caused economic and cultural hardship, it was uniformly believed to have been the right decision. The greatest challenges experienced by the mothers were language difficulties and the constant preoccupation with the child's illness. Through faith and a variety of coping strategies, these South American mothers succeeded in adapting. They transcended life disruption and focused on the critical goal of restoring their child's health. Central to their experience is that everything humanly possible be done to preserve the life of their child.

Children of Migrant Fathers: The Effects of Father Absence on Swazi Children's Preparedness for School

This article investigates the effects of prolonged father absence of Swazi migrant workers on their young children's preparedness for a formal school setting. As the role of formal schooling gains importance in Swaziland, so too does the impact that the home environment has on the formal schooling of Swazi children. The disruption of family life because of migrant labor may affect the development of Swazi children, and possibly their cognitive preparedness for school. Formal education as it is known today is not indigenous to Swazi society. At independence, most African countries inherited educational systems designed by Europeans who applied Western criteria. An important consequence of this is that institutions of formal learning today remain based on cultures which are quite distinct from those of Africans. Western formal education strives for change and creates discontinuities. By contrast, traditional education strives for continuity between generations, whereby parents and older relatives teach youth about their accumulated knowledge, ways, and traditions. Felix Boateng stresses that the success of traditional African education is in its ability to promote intergenerational communication. Even though traditional education may often be conducted using such abstract messages as proverbs, the intended lesson is always pertinent to a child's immediate environment.1 Traditional education is less verbal and less theoretical, placing more emphasis on active participant observation than does imported European education, which relies on curriculum and an abstract examination system often in conflict with the child's immediate surroundings. For instance, John Gay and Michael Cole's research in Liberia reveals that Kpelle children begin formal schooling using cognitive constructs, language patterns, and a knowledge base that hinder their learning certain mathematical concepts using Western-biased methods. The significance of traditional learning at

Psychosocial Assessment and Intervention in Cardiac Rehabilitation

Coronary artery disease can result in varying degrees of psychosocial distress for some patients because of the demands imposed by chronic illness, disruptions in family life, employment and economic uncertainty, and the threat of future cardiac dysfunction. These challenges can result in the development of anxiety and depressive disorders, patterns of noncompliance, and difficulties in lifestyle modification that can interfere with the rehabilitation process. Following a thorough psychosocial assessment, pharmacologic, psychotherapeutic, and behavioral interventions can be used to help patients and their families cope with cardiac illness.

Is Small Beautiful? Work-Family Tension, Work Conditions, and Organizational Size

Although 55.4% of the U.S. private sector workforce is employed in establishments with fewer than 100 employees (U.S. Bureau of the Census, 1992), little is known about the implications of small workplaces for workers and their families. Although a large body of research examines the connections between family and employment (see reviews by Hoffman, 1989; Menaghan & Parcel, 1990; Piotrkowski, Rapoport, & Rapoport, 1987), studies either ignore workplace size (Bell, 1382) or focus exclusively on large workplaces (e.g., Friedman, 1991; see Loscocco & Leicht, 1993, for a recent exception). Our purpose in the present research was to compare, for the first time, the connections between women's feelings of tension between family and and conditions in small and large workplaces. Work-family tension as used here is a broad term including feelings that work and family interfere with each other...or...disrupt family life (Voydanoff, 1987, p. 62). We believe that because of some unique features of smaller workplaces, employment there will generate stronger links--both positive and negative--between certain conditions and work-family tensions. Two such unique features were proposed by Bell (1982). The first concerns the nature of supervision and its impact on job experiences. Although large firms are more likely to have more formal structures, rules, and administrative layers, small firms are likely to be less formal and more personal, and to have variable practices for employees (see also Astley's [1985] evolutionary model of bureaucratization). As a result, employees' experiences in small firms may be more subject to the arbitrary influence and discretion of particular superordinates. Although such influences could lead toward either more responsiveness or more exploitiveness toward employees, there is evidence that the greater flexibility of smaller workplaces is associated with greater employee satisfaction (Gunsch, 1991; Idson, 1990), participation, and emotional involvement (Wicker, 1973). The second unique feature proposed by Bell concerns the nature of co-worker relationships. Small employers are more likely than large ones to recruit new employees by relying on informal referrals from family, friends, and current employees. In turn, these preexisting affinities among employees will promote closer interpersonal relationships at work. Manning theory suggests another difference between small and large workplaces. Because small workplaces are more likely to be undermanned, they may provide that is more substantively complex, and employees may be more likely to make decisions, coordinate with each other, and perceive themselves as needed (Greenberg, Wang, & Dossett, 1982; Wicker, 1973). In this scenario, workers will benefit, as suggested by data based on socialization theory. Jobs that are more substantively complex (i.e., less routinized, more autonomous, more multi-faceted, and more likely to involve working with people) enhance workers' intellectual flexibility (i.e., the range and complexity of cognitive reasoning [Kohn & Schooler, 1978; Miller, Schooler, Kohn, & Miller, 1979]) as well as their satisfaction (Gunsch, 1991). Not all features of smaller workplaces will redound to the greater satisfaction of workers. In larger workplaces, the greater rigidity of the bureaucratic structure may protect the worker from the exploitive tendencies of certain superordinates, who at smaller workplaces may have the power to more arbitrarily create the rules, rather than simply up. hold them. And at smaller workplaces employees receive lower wages (Idson, 1990) and fewer benefits (Ferber & O'Farrell, 1991; Small Business Administration [SBA], 1990) than their counterparts in larger firms; low wages may exacerbate work-family tension Menaghan & Parcel, 1990). Although small business employees are less likely to have certain benefits (e. …

Psychosocial Aspects of Genetic Disorders: Implications for Practice

Generic disorders can potentially interfere with interpersonal relationships and normal social develop' ment as well as disrupt family life. As scientific and technological advances in medical genetics provide health professionals with a more comprehensive understanding of the origin, implications, and management of genetic disorders, professionals acquire expanded responsibilities. Social workers, who are often involved with individuals and families on a long-term basis, play an instrumental role in helping individuals and families make the necessary emotional and social adjustments following diagnosis of a genetic disease, understand the ramifications of the diagnosis, cope with the accompanying concerns, and find me appropriate services.