Child Care Experiences Research Articles

Institutionalizing innovation in welfare local services through co-production: toward a Neo-Weberian State?

AbstractInnovative practices based on the involvement of citizens as co-producers of welfare local services have been increasingly adopted by the public sector to effectively tackle emerging social problems. Despite the development in the literature on this subject, recent studies still do not clearly indicate which are the challenges for the institutionalization of such practices. By applying a governance lens to the analysis of co-production of local public services, this article aims to contribute to bridging this gap through the empirical analysis of the childcare experience in four European cities. More in detail, it debates the concepts of co-production and innovation in public service delivery within the context of the different waves of public administration reforms; and it investigates how three different sets of conditions – namely, state support and capacity; organizational cultures which support innovation; and integration with facilitative technologies – integrate to facilitate or hinder the institutionalization of co-production initiatives. The findings show that the enabling role of the state actor is a sine qua non to guarantee an institutionalization of these practices, particularly concerning the promotion of trust-building processes. Doing so, the article contributes to the international debate about the possible co-existing of the paradigms of public administration that are arising in the last decades to remedy the problems with the New Public Management; and it provides professionals working in public management and administration with key policy recommendations for the elaboration of new governance systems for the provision of social and welfare services.

Transition to motherhood for Japanese primiparas from delivery to 6 months postpartum: A qualitative study.

AimThis study investigates aspects of the socio‐culturally influenced Japanese primiparas’ transition to motherhood.DesignA qualitative descriptive study approach with interviews of Japanese primiparas was used.MethodsIndividual interviews with 21 Japanese primiparas were conducted, with a focus on their transition to motherhood and familiarization with the maternal role. The interviews were analysed, and categories and subcategories were established. This paper was developed using the COREQ guidelines for reporting qualitative studies.ResultsSeven major categories with 26 subcategories were identified in the transition to motherhood. The seven categories are listed as follows: “confusion with first childcare experience,” “suffering related to childcare,” “clinging to the image of an ideal mother,” “internal conflict while comparing oneself to other mothers,” “undertaking childcare by disengaging from one's stereotype,” “realization of becoming a mother” and “changing relationship with surrounding people.”

He's Working from Home and I'm at Home Trying to Work: Experiences of Childcare and the Work-Family Balance Among Mothers During COVID-19.

This article captures mothers' experiences of the work-family balance and division of household labor during the initial COVID-19 lockdown. Interviews were conducted with twenty-five academics and twenty professionals in other fields. Mothers who split childcare with their partners had a more positive experience of the work-family balance during lockdown, compared with mothers who did the majority of the childcare. The present study adds a new wrinkle into the literature on flexibility and work-family balance: the perception of flexibility and its impact on the division of labor. Academic mothers, who had always had highly "flexible" jobs, were less likely to split childcare with their partners pre-pandemic and thus less likely to have positive experiences of work-family balance during the Spring 2020 lockdown. I argue that perceived flexibility of a partner's job affected allocation of childcare during the initial stages of the pandemic, a moment that wreaked significant harm on women's careers.

Mothers' experience of caring for home-quarantined children after close contact with COVID-19 in Korea: an exploratory qualitative study.

PurposeThe world saw a shift into a new society consequent to the coronavirus disease 2019 (COVID-19), which made home quarantine mandatory for a person in close contact with those who tested positive. For children, however, home quarantine was not limited only to themselves but parents, especially mothers were involved and required to quarantine. This qualitative study aimed to explore and understand mothers’ experience and their related psychosocial issues while caring for their school-aged children in Korea, who had to home quarantine after coming in close contact with COVID-19 positive individuals.MethodsData were collected from October 2020 to January 2021 via in-depth, semi-structured interviews with nine mothers of children who had to home quarantine. Interviews were conducted face-to-face in an independent space near the participant’s home or workplace (n=5) or via online platforms or telephone (n=4). The data were analyzed using thematic analysis through several iterative team meetings.ResultsThematic analysis revealed the following four themes: “Unable to be relieved due to uncertain situations surrounding me,” “Blame and hurt toward me, others, and one another,” “Pulling myself together for my children in my broken daily life,” and “Changes in the meaning of life amid COVID-19.”ConclusionThe narratives show that mothers experienced psychosocial difficulties while caring for their children during home quarantine. It is necessary to reduce the social stigma toward individuals in home quarantine and establish policies to ensure work-family compatibility for such mothers.

Nurses’ Knowledge about MCH Services at Primary Health Care Centers in Rural Areas of Babylon Governorate - Iraq

Background: If you truly believe that every mother and every child deserve the best possible care, whetheror not the newborn comes into this world or during that time or after, that means that you are with us on thesame train. The study aims to assess nurses’ knowledge about MCH; and determine the relationship betweennurses’ knowledge and their demographic characteristics.Methods: A descriptive study was used to guide this study. The study included a convenience sample of(98) nurses.Data were collection using a self-report questionnaire. Data were analyzed using the statistical package forsocial science. The descriptive and inferential statistical measures were used.The study results revealed that nurses have a moderate knowledge. Nurses’ education, years of experience,and training courses significantly correlate with their knowledge.Conclusion : Nurses’ knowledge about maternal and childcare were moderate and their knowledge wereinfluenced by educational level, years of experience, and training. Longer years of experiences in maternaland childcare and more training on MCH program help to increase their knowledge.

A balancing act: An interpretive description of healthcare providers’ and families’ perspective on the surgical experiences of children with autism spectrum disorder

Children with an autism spectrum disorder (autism) are vulnerable to negative experiences within the surgical setting. This qualitative study used Interpretive Description. Individual interviews were conducted with 8 parents of children with autism who had recently undergone surgery, and 15 healthcare providers (HCPs) with experience caring for children with autism. Participants were asked open-ended questions on the approaches used to support children with autism around the time of surgery and their effectiveness, how the surgical experience could be improved, and the barriers and facilitators to potential improvements. Results yielded three main themes within an overarching metaphor of a balancing act. The first theme, finding your footing through an uncertain journey, described individual factors (e.g. anticipatory anxiety) that set the foundation for surgery-related experiences. The second theme, relationships can help to keep everyone steady, highlighted how interpersonal dynamics (e.g. collaboration and empathy) influence the experience. Finally, the systems shape the experience theme captured the impact of systemic factors (e.g. the hospital environment) on the balancing act. These findings enriched our understanding of how individual, interpersonal, and systemic factors influence the surgical experiences of children with autism, families, and HCPs. Insights gained from this study can be used to inform future interventions.Lay abstractChildren with an autism spectrum disorder (autism) often have negative experiences within the surgical setting. We conducted individual interviews with 8 parents of children with autism who had recently undergone surgery, and 15 healthcare providers (HCPs) with experience caring for children with autism. We asked open-ended questions on the approaches used to support children with autism around the time of surgery, how effective they were, suggestions for improvement, and the barriers and facilitators to improvement. Three main themes emerged within an overarching metaphor of a balancing act. The first theme, finding your footing through an uncertain journey, described individual factors (e.g. anticipatory anxiety) that set the foundation for experiences. The second theme, relationships can help to keep everyone steady, highlighted how personal interactions (e.g. collaboration and empathy) influence the experience. Finally, the systems shape the experience theme captured how systemic factors (e.g. the hospital environment) affected the balancing act. These findings enriched our understanding of the surgical experiences of children with autism, families, and HCPs by demonstrating the importance of individual characteristics, relationships, and systemic factors. Future interventions should consider this complexity and intervene not just with children, but also their parents, healthcare providers, and in policy to improve experiences.

Parents' experience of caring for children with type 1 diabetes in mainland China: A qualitative study.

BACKGROUNDParents of children with type 1 diabetes mellitus (T1DM) are under heavy caregiving stress, and parental caregivers' experience can affect the health outcomes of children with T1DM.AIMTo describe the true inner feelings of parents caring for children with T1DM.METHODSDescriptive research methods were used to classify and summarize parents' experience when adapting to the role of caregivers for children with T1DM. The data was sorted and analyzed using content analysis. Themes of parents' experience caring for children with T1DM were refined, and their feelings were deeply investigated.RESULTSA total of 4 themes and 12 subthemes were identified: (1) Desire for information (disease-related information, home care information, and channels of information acquisition); (2) Skill guidance needs (insulin injection techniques, skills required for symptom management, and skills for parent-child communication); (3) Seeking emotional support (family support, peer support from other parents of children with T1DM, and professional support); and (4) Lack of social support (needs for financial support and needs for social security).CONCLUSIONExploring the true experience of parents caring for children with T1DM is of great significance for helping them adapt to their role as caregivers. Nurses should provide professional guidance in terms of information, skills, emotion, and social support to parental caregivers.

From ‘the New Man’ to care‐leaver activists—Communist and contemporary discourses shaping 50 years of leaving care in Romania

AbstractThis paper explores discourses that have informed debates concerning care leavers in Romania over the last 50 years to understand why rights‐based reforms introduced in the mid‐2000s have been difficult to implement. The discussion is based on the analysis of a maximum variation sample of 40 documents published between 1951 and 2018. Across two historical periods during and after communism, framed by three political events which changed significantly the context of public childcare and leaving care, this paper explores how dominant discourses on ‘public childcare’, ‘care leavers’ and ‘children's rights’ have evolved, what mechanisms established them and with what consequences. The analysis revealed the stealthy presence of a ‘dinosaur discourse’ of deficit and ‘undeserving’, unsuccessfully challenged by the rights discourse, which alongside a neglectful attitude to social protection, informs the practice and ultimately the experience of public childcare and leaving care. However, the growing and increasingly clear voice of care‐leaver activists counterbalances this through a new narrative of strengths, value and capability aiming towards concrete change from below. The paper proposes a number of ‘absent discourses’ that could offer a powerful context for this new voice and avenues for meaningful action, with implications for research.

Early child care experiences and attachment representations at age 18 years: Evidence from the NICHD study of Early Child Care and Youth Development.

The role of early child care experiences on the development of the mother-child attachment relationship has been studied extensively. However, no prospective studies of early child care have addressed how these experiences might be reflected in the content of attachment representations during adolescence and beyond. The goal of this study was to estimate relatively precise associations between child care quality, child care quantity, and type of care in the first 54 months of life and the content of adolescents' attachment representations around age 18 years (N = 857; 51% female; 78% White, non-Hispanic; M income-to-needs ratio = 4.13), leveraging data from the longitudinal NICHD Study of Early Child Care and Youth Development (SECCYD). We identified a small positive association between the observed quality of early child care (but not quantity or type of care) and secure attachment states of mind as measured by the Adult Attachment Interview (but not the Attachment Script Assessment) at age 18 years that was robust to demographic covariates and observations of maternal and paternal sensitivity during childhood. We observed no significant interactions among child care variables. Associations between early child care experiences and indicators of adolescent attachment were likewise not moderated by maternal sensitivity from infancy to mid-adolescence or by maternal reports of child temperament in early childhood.

The Impact of Center-Based Childcare Attendance on Early Child Development: Evidence From the French Elfe Cohort.

Proponents of early childhood education and care programs cite evidence that high-quality center-based childcare has positive impacts on child development, particularly for disadvantaged children. However, much of this evidence stems from randomized evaluations of small-scale intensive programs based in the United States and other Anglo/English-speaking countries. Evidence is more mixed with respect to widespread or universal center-based childcare provision. In addition, most evidence is based on childcare experiences of 3- to 5-year-old children; less is known about the impact of center-based care in earlier childhood. The French context is particularly suited to such interrogation because the majority of French children who attend center-based care do so in high-quality, state-funded, state-regulated centers, known as crèches, and before age 3. We use data from a large, nationally representative French birth cohort, the Étude Longitudinale Français depuis l'Enfance (Elfe), and an instrumental variables strategy that leverages exogenous variation in both birth quarter and local crèche supply to estimate whether crèche attendance at age 1 has an impact on language, motor skills, and child behavior at age 2. Results indicate that crèche attendance has a positive impact on language skills, no impact on motor skills, and a negative impact on behavior. Moreover, the positive impact on language skills is particularly concentrated among disadvantaged children. This implies that facilitating increased crèche access among disadvantaged families may hold potential for decreasing early socioeconomic disparities in language development and, given the importance of early development for later-life outcomes, thereby have an impact on long-term population inequalities.

The Relationships Among Service Quality, Emotional Satisfaction and Behavioural Intention In Childcare Provider Choice: Evidence From Malaysia

This study discusses the factors affecting parents’ behavioral intention with respect to the service quality of childcare settings. Childcare quality is essential for parents nowadays and relies heavily on accessible, affordable, and reasonable quality. Meantime, there are some of the issues arising in the childcare industry when there are many cases of injury, neglect, or death in childcare. Therefore, the study presents the shortfall inputs from the childcare centers’ customers on the service factors that require further attention. The primary data of 364 questionnaires were collected from respondents of four regions in Peninsular Malaysia. The Statistical Package for Social Sciences (SPSS) version 23.0 and Partial Least Square Structural Modeling (PLS-SEM) were used for this study’s data analysis. Dimensions of service quality with 21 items were observed in this paper. The behavioral intention was measured using seven items. The results confirmed that service quality was the antecedent for behavioral intention. In addition, emotion satisfaction embarked on the role of mediation factor between service quality and behavioral intention. All the hypotheses' relationships were supported. The originality of the study gives valuable comprehension with regard to emotional satisfaction in childcare experience since it contributes significantly to the prediction of behavioral intention. The implication of the study is further discussed in this paper.

Examining frequent emergency department use among children and adolescents with autism spectrum disorder.

This study used data for 5.9 million individuals with 9.1 million emergency department visits from all hospitals in the state of New York to explore frequent emergency department use between children and adolescents with autism spectrum disorders and those without autism spectrum disorders. We found that children and adolescents with autism spectrum disorders had larger shares of comorbidities and diagnoses related to attention-deficit/hyperactivity disorder, intellectual disability, and epilepsy. Children and adolescents with autism spectrum disorders were also more likely to utilize emergency departments and to exhibit frequent use. These results emphasize the need for using family-centered care to improve the care experiences of children and youth with autism spectrum disorders and their families. In addition, the education of emergency department staff of processes and practices as it relates to delivery of care and the care experience.

Perceived maternal parenting self-efficacy as a predictor maternal responsiveness in infants and toddlers.

Maternal responsiveness seems to be necessary for a child to develop a safe attachment. However, even after many years of research on maternal responsiveness, only a few attempts have been made to find ways of promoting mother and child interaction. This study aimed at determining the association between maternal responsiveness and parenting self-efficacy variables and at identifying the factors that correlated with maternal responsiveness. A cross-sectional correlation study design was adopted and a convenience sampling method was used to recruit 213 mothers in Irbid city, Jordan from August to November 2019. The sample population filled in a sociodemographic and perinatal datasheet, the Perceived Maternal Parenting Self-Efficacy (PMP S-E) Scale and the Maternal Infant Responsiveness Instrument (MIRI). The results revealed a significant relationship between maternal responsiveness and PMP S-E. Other factors; besides, self-efficacy were also found to have some correlation on maternal responsiveness (B=1.913, P=.049). Only previous experience of caring for children (B=9.56, P=.05). This study found that the sociodemographic factors considered in this study had an insignificant correlation on perceived self-reported maternal responsiveness. On the other hand, it did find that PMP S-E had a significant correlation on maternal responsiveness. Healthcare professionals need to recognise these variables in their endeavours to meet the needs of mothers and their newborns.

Supplemental Material for Early Child Care Experiences and Attachment Representations at Age 18 Years: Evidence From the NICHD Study of Early Child Care and Youth Development

Supplemental Material for Early Child Care Experiences and Attachment Representations at Age 18 Years: Evidence From the NICHD Study of Early Child Care and Youth Development

A Social-Ecological Model of Grandparenting Experiences: A Systematic Review.

Grandparenting trends have been increasing due to rises in female employment, economic stressors, and single-parent families. Because the level of grandparental involvement could either result in beneficial or adverse physical and mental health outcomes, this review aims to use a social-ecological model to compare the childcare experiences of primary and nonprimary grandparent caregivers and the effects of childcare on their physical and emotional health. This is a systematic review. CINAHL, Embase, PsycINFO, PubMed, and Scopus were searched for qualitative papers. A thematic analysis was conducted, and data were framed using the social-ecological model. Seventy-four qualitative studies were included. Four themes were generated: intrapersonal: attitudes and motivations (obligation and sense of responsibility, limited physical health, and emotional resources), interpersonal: relationships with grandchildren and adult children (grandparental roles and gendered differences, forging bonds with grandchildren, role ambiguities, conflicts and drawing boundaries, and support and relationships with others), organizational: social services and educational needs, and policy: financial and legal issues. Grandparental well-being is likely to be dependent on the context of the childcare provided, relational bonds with adult children and grandchildren, and the availability of a community and institutional, legal, and financial support. The act of grandparenting is laden with cost and reward. To ensure a better quality of life in grandparents' later years, joint efforts between policymakers, educators, and organizations are required to meet their childcare support needs such that they can fulfill their grandparenting roles with ease.

'Don't abandon me': Young people's experiences of child and adolescent psychiatric inpatient care supporting recovery described in blogs.

Child and adolescent psychiatric (CAP) inpatient care has the potential to support or hinder young people’s mental‐health recovery. Research describing inpatient care from the perspective of young people is rare. Personal blogs provide an opportunity to further understand how inpatient care relates to young people’s recovery processes. This study aimed to explore young people’s experiences of CAP inpatient care supporting mental‐health recovery. The study is reported in accordance with the COREQ guidelines. Data were created during 2018 from twenty‐seven personal blogs describing first‐hand experiences of being a patient in a CAP inpatient care facility in Sweden and analysed using a method for interpretive description. Information in blogs suggests they were written by women, a majority of which had experienced eating disorders. Findings describe young people’s experiences of CAP inpatient care supporting mental‐health recovery in an interpretive explanation with one theme, ‘Don’t abandon me’, and three sub‐themes: ‘Listen to me’, ‘Believe in me’, and ‘Allow me to feel safe’. This study adds to the growing body of empirical work suggesting the importance of the concept of recovery in young people’s mental health. To support recovery, CAP inpatient care needs to focus on developing the content of care rather than minimizing the length of the stay. User experience should be at the heart of efforts aimed at improving services.

Multisystem Inflammatory Syndrome in Children Associated With Coronavirus Disease 2019 in a Children's Hospital in New York City: Patient Characteristics and an Institutional Protocol for Evaluation, Management, and Follow-Up.

The disease caused by severe acute respiratory syndrome coronavirus 2, known as coronavirus disease 2019, has resulted in a global pandemic. Reports are emerging of a new severe hyperinflammatory syndrome related to coronavirus disease 2019 in children and adolescents. The Centers for Disease Control and Prevention has designated this disease multisystem inflammatory syndrome in children. Our objective was to develop a clinical inpatient protocol for the evaluation, management, and follow-up of patients with this syndrome. The protocol was developed by a multidisciplinary team based on relevant literature related to coronavirus disease 2019, multisystem inflammatory syndrome in children, and related inflammatory syndromes, as well as our experience caring for children with multisystem inflammatory syndrome in children. Data were obtained on patients with multisystem inflammatory syndrome in children at our institution from the pre-protocol and post-protocol periods. Our protocol was developed in order to identify cases of multisystem inflammatory syndrome in children with high sensitivity, stratify risk to guide treatment, recognize co-infectious or co-inflammatory processes, mitigate coronary artery abnormalities, and manage hyperinflammatory shock. Key elements of evaluation include case identification using broad clinical characteristics and comprehensive laboratory and imaging investigations. Treatment centers around glucocorticoids and IV immunoglobulin with biologic immunomodulators as adjuncts. Multidisciplinary follow-up after discharge is indicated to manage continued outpatient therapy and evaluate for disease sequelae. In nearly 2 months, we admitted 54 patients with multisystem inflammatory syndrome in children, all of whom survived without the need for invasive ventilatory or mechanical circulatory support. After institution of this protocol, patients received earlier treatment and had shorter lengths of hospital stay. This report provides guidance to clinicians on evaluation, management, and follow-up of patients with a novel hyperinflammatory syndrome related to coronavirus disease 2019 known as multisystem inflammatory syndrome in children. It is based on the relevant literature and our experience. Instituting such a protocol during a global pandemic is feasible and is associated with patients receiving treatment and returning home more quickly.

A systematic review exploring palliative care for families who are forced migrants.

To explore the palliative care experiences of forced migrant children, families, and healthcare professionals (HCPs) highlighting successes, challenges, and associated practice implications. Systematic literature review. The following search engines were searched from 2008 - 2018: Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health, MEDLINE, Embase, ProQuest, Scopus, Psycinfo, and Web of Science. Extensive reference and citation checking were also conducted. Systematic review followed PRISMA guidelines with prepared PROSPERO registered protocol #CRD42019129200. English language qualitative, quantitative, or mixed methods studies were eligible for inclusion. Study quality was appraised using the Mixed Methods Appraisal Tool (MMAT). Eighteen studies (reported in 20 articles) met the final inclusion criteria. Most focused on challenges to care provision. Thematic analysis following methods proposed by Braun and Clarke was undertaken. Five themes were identified: (a) divergence of beliefs and expectations; (b) communication; (c) navigating healthcare systems; (d) burdens and coping strategies; and (e) training and knowledge. A compassionate, collaborative approach with mutual respect crossed themes and was linked to high-quality care. Forced migrant families have multiple needs including physical and emotional support and help in navigating complex systems. Professional interpreters can ease communication barriers when resourced appropriately. Individualized care is crucial to addressing the intricate mosaic of culture such families present. A cultural sensitivity/insensitivity framework is presented that may help guide future interactions and priorities for those working in children's palliative care. This systematic review explored the international experiences of palliative care for forced migrant families. The findings highlight the plight of families who experience multiple traumas and increased levels of grief and loss through their migration experiences and when caring for a child with a life-limiting condition. This research has potential to have an impact on professionals working with culturally diverse families in all palliative care settings.

Working households: Challenges in balancing young children and the farm enterprise

ABSTRACT Childcare is a critical issue for working families in the United States; however childcare needs in the agriculture sector have been absent from both childcare and agricultural policy discussions. This study empirically examines the relationship between childcare, the farm business, and the farm family while probing larger questions related to quality of life, labor market outcomes, and the gendered nature of work as families negotiate on-and off-farm roles and household needs. Using data from a national survey of farm families at the Rural-Urban Interface, we highlight differences in childcare experiences among multi-generation and first-generation farmers, and men and women farmers. The majority of farmers in this sample report challenges with childcare and that these challenges affect farm business decisions. Additionally, childcare is a prevalent issue for first-generation and women farmers. To address childcare needs in rural communities and the farm population, we call for new research and engagement collaborations across community development, work and family, and farm family scholars and practitioners.

Unmet family planning needs among female refugees and asylum seekers in Germany \u2013 is free access to family planning services enough? Results of a cross-sectional study

BackgroundAfter the 1968 United Nations International Conference on Human Rights, access to family planning services became a human right. Such a service is of central importance to women’s empowerment and is empirically needed to provide adequate healthcare. For registered refugees and asylum seekers in Germany complementary family planning services, including all forms of contraception, are free of charge. Yet, the success of these services remains unclear. The aim of this study is to describe the current reproductive health status of female refugees and to provide an initial overview of their existing unmet family planning and contraception needs.MethodsOver the course of 2 years, from December 2015 to December 2017, a set of 50 female-only discussion groups were conducted in community shelters for registered refugees in Berlin. A total of 410 women between the ages of 14 and 74 participated. A convenience sampling strategy was then applied and a total of 307 semi-structured questionnaires covering 41 items related to demographic data and women’s health were distributed to volunteering female participants over the age of 17. The statistical analysis of the questionnaires was performed using SPSS (IBM, PASW, Version 24). P-values less than or equal to 0.05 were considered statistically significant.ResultsOf the 307 participants, the majority were from Syria and Afghanistan (30% respectively). The mean age was 33 years (range: 18–63). On average, each woman had 2.5 births (range: 0–10). Twenty-four women (8%) were pregnant and fifty-four of the women (18%) were trying to become pregnant. The majority of women were classified as “requiring contraception” (n = 195; 63%) of which 183 gave further information on if and how they used family planning methods. The calculated unmet need for family planning in this group was 47%. Of the remaining 53% of the women who used contraception, many utilised “traditional” methods (34% withdrawal method; 8% calendar method) which have a pearl index of 4–18 and can therefore be classified as rather insufficient birth control methods. Intrauterine contraceptive devices were used by 30%.ConclusionOur study revealed that despite the provision of complementary family planning services, there remains unmet family planning and education needs in the female refugee community in Berlin. This study indicates that there is a major access gap to these services. Further research needs to be carried out to evaluate the access gap and clearly identify and implement action plans to address possible causes such as language barriers, lack of childcare and traumatic experiences.