Family Decision Research Articles

What Is the Recipe for Success in Science?

This article narrates the life journey of a woman in science, drawing parallels between her grandmother’s improvisational apple pie making and her own path to success. Unlike a recipe, her career was shaped by unique, personal ingredients: a fervent love for learning from her parents; the importance of financial independence instilled by her mother; and a supportive network that facilitated both her family and career decisions. Through anecdotes, she emphasizes key life lessons: success is personal and varied; plans can change; guilt over work-life balance is self-imposed; and one should not be confined by traditional career paths. Her story highlights the importance of resilience, adaptability, and the pursuit of meaningful causes over conventional career milestones. Her transformative work in rare disease research underscores her commitment to leveraging her career for the greater good, embodying a blend of scientific curiosity and business acumen. The article concludes with a call to embrace learning, face failures, and build a trustworthy support network.

Household decisions and the gender gap in job satisfaction

AbstractThis paper offers a novel theoretical explanation for the gender gap in job satisfaction, where women typically report higher job satisfaction than men. We argue that rational family decisions can result in divergent job choices for women and men, leading to increased job satisfaction but lower earnings for women, even when their preferences and expectations align with those of men. We develop this explanation within a theoretical model of family household decision‐making that considers relative earnings disparities within households. We provide empirical evidence supporting our model's predictions utilizing survey and administrative data from Canada.

Is patriarchy undermined in urbanization? Rural families and housing properties in relocated villages in the urbanizing northwestern China

China’s urbanization has relocated many rural families, but it remains unclear if such changes undermine patriarchy. This study draws on survey and interview data in northwestern China to examine what prevailing principles families draw on in dividing the newly acquired family wealth (1) between parents and children, (2) between elder and younger children, and (3) between sons and daughters. These family decisions are not triggered by life course changes but are induced by a sudden increase in family wealth, which may differ from what usually happens in rural families. Quantitative comparison and qualitative case analysis suggest the accelerated downstream transfers from parents and the mixed desires to prioritize sons’ housing needs, care for each child’s entitlement, compensate less privileged children, and secure parents’ elderly care. The persisting values and rising desires, as reflected by multiple principles of altruism, exchange, entitlement, son preference, and need, contributed to the persisting gender effect and the ambiguous generation and parity effects—parents and elder children did not have apparent advantages in family property structures when rural families were relocated or enclosed into urban areas.

Gender Role of Household Decision Making (A case study Namobudda Kavre)

Gender roles in household decision making refer to the traditional division of responsibilities and decision-making power between men and women within a family or household. Historically, many societies have adhered to traditional gender roles, where men are often considered the primary decision-makers, particularly in matters related to finances and major family decisions. Women, on the other hand, have often been assigned the roles of managing the household, taking care of children, and dealing with domestic matters. However, it's important to recognize that gender roles are not fixed and vary significantly across cultures, regions, and individual households. Moreover, over time, many societies have witnessed a shift in traditional gender roles, with more emphasis on gender equality and shared decision making. The main purpose of this research was to understand the perception of people regarding the evolvement of gender roles in any household decision making. A Descriptive Cross Sectional study method was used. Altogether, 40 respondents were selected through purposive sampling method, questionnaires, Face to face interview, Informal focused group discussion; Key informant interview method was used using Structured Questionnaire to collect data from respondents. Data analysis was done through MS Excel. It is revealed from the research Gender roles in household decision making refer to the traditional division of responsibilities and decision-making power between men and women within a family or household. Historically, many societies have adhered to traditional gender roles, where men are often considered the primary decision-makers, particularly in matters related to finances and major family decisions. Women, on the other hand, have often been assigned the roles of managing the household, taking care of children, and dealing with domestic matters. However, it's important to recognize that gender roles are not fixed and vary significantly across cultures, regions, and individual households. Moreover, over time, many societies have witnessed a shift in traditional gender roles, with more emphasis on gender equality and shared decision making

Genetics, emotion and care: Navigating future reproductive decisions in families of children with rare genetic conditions.

Little is known regarding the future reproductive decision-making of parents of children with rare genetic conditions. Our research draws on data from an online survey and qualitative photo-elicitation interviews with families living with Noonan Syndrome. We demonstrate how genetic knowledge and prenatal genetic testing become embedded in reproductive practices. Yet the idea of using selective genetic technologies to influence reproductive outcomes remains highly emotive. Our analysis reveals that for these parents, the rationalities of reproduction, although technologised and biomedicalised, remain centred on caring for their disabled child. Genetic subjectivities become entangled with responsibilities of care-giving and emotion tied to the realities of living with disability. We argue that for these parents, reproductive decisions are relational and affective, situated within families and communities and shaped by access to emotional, financial, physical and temporal resources. Our findings provide new insights into the ontologies of selective genetic technologies and reproductive governance in families living with disability.

Caring for Hindu patients at the end-of-life: A narrative review.

This paper reviews the existing literature to identify specific challenges that may arise in the context of providing palliative and end-of-life (EOL) care for Hindu patients in the physical, psychological, and spiritual domains. We offer practical strategies where appropriate to mitigate some of these challenges. We review how the Hindu faith impacts EOL decision-making, including the role of the family in decision-making, completion of advance directives, pain management, and decisions around artificial nutrition and hydration (ANH) and cardiopulmonary resuscitation (CPR). The PubMed, MEDLINE Complete, Cochrane, and Embase databases were searched for articles using the search strings combinations of keywords such as Palliative care, Hindu, Hinduism, End of Life Care, India, Spirituality, and South Asian. Once inclusion criteria were applied, 40 manuscripts were eligible for review. Our results are organized into the following 4 sections - how Hindu religious or spiritual beliefs intersect with the physical, psychological, and spiritual domains: and decision-making at the EOL. Hindu beliefs, in particular the role of karma, were shown to impact decision-making regarding pain management, ANH and CPR, and advance directive completion. The complexity of Hindu thought leaves a significant role for interpretation and flexibility for individual factors in decision-making at the EOL.

Power positions in the farm family, marrying in, and negative peer pressure: the social relations that impact agricultural practice

AbstractIn this article, we wish to consider relationships internal and external to the farm household, and how these enable and/or mitigate the adoption of better farm practices. We find that internally, members of the farm household (successors or spouses ‘marrying in’), can influence the future direction of agricultural practice in a positive way, that is more profitable and sustainable. It is not a straightforward process though. Interpersonal household relations play a role; status and standing within the family can impact on how decisions about change are made. This relates to both people marrying in and the position of the successor in an inter-generational household. We found that the power of the farming peer group to influence change is underestimated. Our data shows that farming is an occupation subject to strong cultural norms regarding acceptable farming practice. Sometimes farm family decisions to change agricultural practice falter under the weight of sanctions and derision encountered when trying to make adjustments. This paper draws from two data sets in Germany and England. We conclude that understanding internal farm household interactions, and their external relations with farming peer groups is critical to supporting the future of agriculture.

Inappropriate complementary feeding practice and associated factors among children aged 6–23 months in Shashemene, Southern Ethiopia: a community-based cross-sectional study

BackgroundInappropriate complementary feeding is widely practiced in low and middle income countries. These contribute to undernutrition, morbidity and mortality among young children. The incidence of malnutrition in the first two years of life has been directly linked with inappropriate complementary feeding practices along with high infectious disease levels.ObjectiveTo assess the level of inappropriate complementary feeding practice and associated factors among children aged 6 to 23 months in Shashemene, Southern Ethiopia.MethodA community-based cross-sectional study was conducted from July to August 2021 among 609 children aged 6 to 23 months paired with their caregivers. Systematic random sampling was used to identify study participants. Data were analyzed by using SPSS version 25 software. Binary logistic regression analysis was used to identify predictors of inappropriate complementary feeding practice. Statistical significance was determined using Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI).ResultsThe prevalence of inappropriate complementary feeding practice among children aged 6–23 months was 55.3%. Being a mother under the age of 25 years [AOR = 2.07, 95% CI: 1.30, 3.31], aged 25–34 years [AOR = 1.82, 95% CI: 1.14, 2.91], having an occupation [AOR = 2.73, 95% CI: 1.84, 4.05], and households where husbands’ are the sole decision makers on their income [AOR = 2.41, 95% CI: 1.54, 3.77] increased the chance of inappropriate complementary feeding practice. On the other hand, mother’s whose infants were aged 9–11 months [AOR = 0.30, 95% CI: 0.19–0.45] were less likely to practice inappropriate complementary feeding.ConclusionsThe prevalence of inappropriate complementary feeding practice in the study area was high compared to the WHO recommendation. Child’s age, maternal age, maternal occupation, and decision-making role on income were found to be associated with inappropriate complementary feeding practice. Appropriate behavioral change communication to family and community decision-makers, and involvement of husbands in infant and young child feeding practice are recommendable.

Dyadic Appraisals of Family Decisions and Health Tasks in Midlife-Older Couples.

Shared appraisals and collaboration within couples play important roles in optimizing health. Less is known about concordance regarding collaboration, factors associated with concordance, and implications for health. Data from 2,761 couples from the Health and Retirement Study (2014/2016 and 2016/2018 waves) were examined to determine within-couple concordance in completion of two tasks (family decisions and medical forms). The majority of couples were concordant regarding who makes family decisions (69.7%) and who completes medical forms (64.4%); 62% agreed they make family decisions collaboratively versus 25.5% completing medical forms collaboratively. Concordance was significantly associated with greater marital support and longer marital duration. Concordance was not significantly associated with depressive symptoms 2 years later, but the link between concordance in making major family decisions and self-rated health differed by age and gender. Future research at the intersection of concordance and collaboration may shed important light on how older couples navigate tasks and decisions.

Potential donor family behaviours, experiences and decisions following implementation of the Organ Donation (Deemed Consent) Act 2019 in England: A qualitative study

BackgroundIn May 2020, England implemented “deemed consent” legislation, to make it easier for individuals to donate their organs and convey their decision when alive. Families are supposed to support the decision but can still override it if they disagree. We aimed to learn more about this changed role when families were approached about organ donation. MethodsA qualitative study using semi-structured interviews with families, feedback from nurses, comparisons with audit data, and public involvement. We used framework analysis with a health systems perspective and utilitarian theory to explore if the law worked. Findings103 participants were interviewed representing 83 potential donation cases. In 31/83 (37%) cases donation was fully supported, in 41/83 (49%) cases families supported retrieval of some organs, tissues and procedures, and in 11/83 (13%) cases families declined completely. Themes explaining why the law was not (yet) working included: Understanding and agreeing the family’s role, confusion about deemed consent, not supporting the deceased expressed decisions, organ donation as too much of a harm, the different experiences of donation pathways, transition from end-of-life to organ donation discussions, experiences of ‘consent’, paperwork and processes. Families frequently questioned if their relative wanted to have a surgery rather than supporting the person who died to save lives. ConclusionFamilies use the unique experience of their relative dying in intensive care to create alternate narratives whereby the outcome satisfies their own utility and not necessarily those of the potential donor. New public ongoing media campaigns crafted to be more supportive of organ donation as a benefit to transplant recipients could help families overcome the many difficulties they encounter at the bedside. Implications for clinical practiceThe soft opt-out policy has not empowered nurses to help families at their most vulnerable to increase their support for and consent to deceased organ donation.

Navigating a "Good Death" During COVID-19: Understanding Real-Time End-of-Life Care Structures, Processes, and Outcomes Through Clinical Notes.

The coronavirus disease 2019 (COVID-19) pandemic severely disrupted hospice care, yet there is little research regarding how widespread disruptions affected clinician and family decision-making. We aimed to understand how the pandemic affected structures, processes, and outcomes of end-of-life care. Retrospective narrative chart review of electronic health records of 61 patients referred and admitted to hospice from 3 New York City geriatrics practices who died between March 1, 2020, and March 31, 2021. We linked longitudinal, unstructured medical, and hospice electronic health record notes to create a real-time, multiperspective trajectory of patients' interactions with providers using directed content analysis. Most patients had dementia and were enrolled in hospice for 11 days. Care processes were shaped by structural factors (staffing, supplies, and governmental/institutional policies), and outcomes were prioritized by care teams and families (protecting safety, maintaining high-touch care, honoring patient values, and supporting patients emotionally and spiritually). Processes used to achieve these outcomes were decision-making, care delivery, supporting a "good death," and emotional and spiritual support. Care processes were negotiated throughout the end of life, with clinicians and families making in-the-moment decisions. Some adaptations were effective but also placed extraordinary pressure on paid and family caregivers. Healthcare teams' and families' goals to meet patients' end-of-life priorities can be supported by ongoing assessment of patient goals and process changes needed to support them, stronger structural supports for paid and family caregivers, incentivizing relationships across primary care and hospice teams, and extending social work and spiritual care.

Effectiveness of multimedia education on the childbearing intention in one-child women: a field trial study

Backgroundchildbearing is a key component of population movements and sustainable development in low-fertility nations. This study was conducted with the aim of determining the impact of multimedia education on the childbearing intention in One-child women of Maragheh city.MethodIn this intervention study in Maragheh in 2023, 94 women with one child were randomly selected and placed in two intervention and control groups. Before the intervention, people were examined using demographic information and Miller’s questionnaire of desire to have children. Then, For the intervention group, three 60-minute multimedia training videos were shown in person for three weeks, and the control group did not receive any training. The data were collected using the researcher’s demographic questionnaire and Miller’s childbearing questionnaire in three stages before the intervention, immediately after and six weeks after the intervention. Data analysis was done with SPSS version 16 software.ResultsThere was no significant difference between the two groups in terms of the average score of desire to have children and demographic variables (p > 0.05). Before the intervention, there was no significant difference between the intervention and control groups in terms of the demographic characteristics of the subjects and the average score of women’s willingness to have children in the positive and negative dimensions. While after the multimedia educational intervention, the average score of desire to have children in positive and negative dimensions, immediately after the intervention and six weeks after the intervention, had a significant difference compared to before the intervention (p < 0.001).ConclusionThe findings of the study showed that carrying out multimedia educational interventions to single-child women can have a positive effect on their desire to have children. It seems that the implementation of such programs is effective in the conscious decision of families to have children and ultimately increases the intention of the individual to carry out the behavior.Trial registrationIranian Registry of Clinical Trials: IRCT20230227057549N1. Date of registration: 16/04/2023. URL: https://irct.behdasht.gov.ir/.

Bereaved parent preferences on quality end-of-life care for children with cancer in the South.

The authors sought to understand bereaved family preferences for end-of-life (EOL) care, particularly among Black families and those in the South. Semi-structured interviews were conducted with parents of children who died of cancer ≥6 months before at Children's of Alabama. Themes were identified via content analysis. Quotes related to medical intensity, chemotherapy, and location of death (LOD) were scored on 5-point Likert scales, ranging from 1 (comfort care, chemotherapy, or home death) to 5 (medically intense care, avoidance of chemotherapy, or hospital death). Twenty-seven bereaved parents (12 Black) were interviewed. Children died at a mean of 13.1 years (SD=6.1 years) and a median of 3 years before the interview (range=1-12 years). Ten children (42%) had central nervous system tumors and the majority (63%) died in the hospital. Family decision-making involved maintaining hope, not causing harm, doing what was best for their child and themselves, and religious beliefs. There was no clear preference for home versus hospital death (3.0 [1.8-4.0]). Instead, parents considered their child's desires and/or medical needs, siblings, and prior experiences with death. To have a comfortable death, parents highlighted the need for comprehensive education about their child's EOL, a caring and comfortable environment, and 24/7 access to their care team. Families expressed a dual preference for comfort care (1.8 [1.3-2.8]) and chemotherapy (3.5 [2.7-4.1]) at EOL. Families did not see chemotherapy and comfort care as conflicting goals. They sought quality care emphasizing flexibility, quality time with their child, and open access to their care team, regardless of LOD.

How do school experiences in adolescence affect educational investment in adulthood? The case of parental investment in private tutoring in Germany

AbstractThis article examines the role of parents’ school experiences in adolescence on their educational investment strategies for their own children in middle adulthood. We focus our analysis on the parents’ decision to organize private tutoring (also called shadow education) for their children. Previous international research largely agrees that families with a high socioeconomic status (SES) are more likely to invest in tutoring to achieve competitive advantages in the educational race for higher credentials and maintain a high social status. In Germany, however, recent studies suggest that tutoring in Germany primarily serves underperforming children from les educated families to acquire relatively higher school degrees by compensating the higher demands of academic school tracks. We propose a theoretical decision model based on rational choice and life course theory incorporating psychological factors related to school performance of the parents (such as performance anxiety and ability self-concept) and operationalize four components that are intended to explain the (un)equal use of tutoring: (1) children’s school background, (2) parents’ cost and (3) benefit considerations, as well as (4) parents’ school biography. In addition, we hypothesize on the intergenerational transmission of performance-related factors from parents to their children and how this affects SE investment. We test our hypotheses quantitatively through logit regressions and a structural equation model using unique longitudinal data for 558 families (parents and their children) from the German “LifE” study (1979–2012). Our study produced two key findings: On the one hand, the parents’ previous school performance plays a direct role in the extent to which they themselves are able to provide their children with the necessary support in the event of poor performance. On the other hand, the performance-related experiences of the parents during school are to a certain extent transmitted to their children and thus influence their grades, ability self-concept and performance anxiety. These factors, in turn, are decisive for the decision to organize SE. Our findings indicate that instead of reducing the decision-making process for SE to absolute dimensions of student performance and parents’ SES and related cost-benefit calculations, dynamic factors behind this family decision related to intergenerational transmission and individual characteristics should be considered.

Game Theoretic Analysis of School and Family Decision-Making in the Context of China’s after-School Services after the Double Reduction Policy

Game Theoretic Analysis of School and Family Decision-Making in the Context of China’s after-School Services after the Double Reduction Policy

Women's Economic Empowerment and COVID-19 Pandemic: A Study on Women Entrepreneurs in Bangladesh

This paper aims to explore the impact of COVID-19 pandemic on women's economic empowerment in Bangladesh. Based on the available literature, this paper develops a holistic framework for economic empowerment and measures how COVID-19 pandemic has contributed to changes in the framework. The study adopts a quantitative research method to address the research question; of whether and to what extent women entrepreneurs were economically empowered by their businesses during COVID-19 pandemic. The empirical data was collected from 52 Bangladeshi women entrepreneurs via telephone interviews and online surveys using a structured questionnaire in February–March 2022, and respondents were chosen randomly from various online social groups and pages. The findings suggest that women entrepreneurs have contributed to family spending, resource allocation, and decision-making. However, their role has diminished significantly in asset ownership during the pandemic. In addition, women's attitudes toward violence, social stigma, and education have shifted dramatically. Furthermore, women entrepreneurs face several challenges, including a lack of government support, limited availability of credit, a lack of entrepreneurial education, and an increased responsibility in the family. Although numerous research studies have demonstrated how COVID-19 pandemic affected women during the pandemic, the impact of COVID-19 pandemic on economic empowerment through gender lenses has frequently been disregarded in Bangladesh context. This study bridges that gap, particularly in developing economies context and the framework constructed in this study is instrumental for understanding the dynamics of economic empowerment that can be applied in future research.

Family Satisfaction of Polytrauma Patients in Intensive Care Unit at a Tertiary Care Center.

Family members play a crucial role in ICU patients' treatment and decision-making, despite the stress and uncertainty they may experience, ensuring high-quality medical care. Providing comfortable spaces with noise-reducing techniques can boost family satisfaction. Further research is needed to support families in intensive care units (ICU). This study aims to evaluate family satisfaction and decision-making in polytrauma patients in the ICU, identify improvement opportunities, and analyze demographic and socioeconomic factors influencing satisfaction. This cross-sectional study was conducted at King George's Medical University, Lucknow, over a period of one year. A total of 66 patients, aged between 20 and 70, their family members, and those who gave written informed consent were included. Exclusion criteria included those who died within 48 hours of ICU admission or did not give consent. Patient characteristics, such as age, sex, Acute Physiology and Chronic Health Evaluation (APACHE) II score, and hospital stay length, were also collected. The family satisfactionin the intensive care unit (FS-ICU) questionnaire, consisting of 24 items with five Likert response options, was used to assess satisfaction levels in ICU care and decision-making. A study of 66 patients which included 78.79% male and 21.21% female. The majority of the patients (66.67%) lived with their family members. The mean ICU stay was 13.03 days, with an APACHEscore of 17.39. The results showed that families were very satisfied with a considerable portion of the ICU stay. The overall satisfaction score was 57.00. Families were less satisfied with the atmosphere in the ICU and involvement in the decision-making process. The satisfaction scores were comparable for both genders, except for the time taken to respond to questions, which was significantly higher for women. Although families were very satisfied with the ICU stay, several areas were identified as having potential for improvement. The present study shows that the quality of treatment and communication during hospitalization is a major factor in the need for follow-up care. This underlines the need for a constant focus on communication skills in the training of nurses and doctors and in their practical training in the ICU. Participation in decision-making, especially by family members of survivors, was identified as an area for improvement. We recommend more research to be conducted in India focusing on family satisfaction with involvement in the decision-making in ICU considering the unique racial, cultural, ethnic, and linguisticdifferences in India.

Reproductive health care seeking behavior in Bangladesh: Asystematic literature review.

Maternal health, in terms of pregnancy and childbirth, is an important aspect of women's reproductive health and remains a public health concern in underdeveloped countries of the world. Reproductive health care seeking behavior (RHSB), in both men and women in society, is influenced by a variety of social and environmental factors that needs to be summarized. This review aims to enhance understanding and perception of services in relation to RHSBs in several domains such as antenatal care (ANC), delivery care, postnatal care (PNC), and family planning (FP) services, for married women of reproductive age in Bangladesh. In major databases, for example, Medline, Ovid, PubMed, Web of Science, ProQuest and Google Scholar following keywords, timeline set as 2010 up to December 30, 2022. Articles that included discussion on married women of reproductive age, and their type of care seeking behavior for reproductive health. A systematic literature search was carried out and expected outcome was health care seeking behavior in the aspects of ANC, delivery care, PNC, and FP services. A data extraction form and quality appraisal form were used for data on RHSB of married women of the reproductive age group in Bangladesh and associated factors. A total of 245 articles were retrieved from databases; stepwise screening was done and finally 23 full-text articles were included for analysis. Descriptive statistics were used based on the included articles for narrative synthesis. In the selected articles, 17 (73.91%) were cross-sectional studies and more than half discussed both urban and rural women. Ante- and postnatal visits have proven to have positively influenced overall RHSB, as seen in Bangladesh. Grass root level workers play a major role in upgrading RHSB in women. Many factors limit rural access to mother and child health services including distance of the health facility and cost of the health service. In particular, education level, women's autonomy in family decision making and distance from health service can be considered as factors influencing RHSBs in Bangladesh. Exposure to mass media and TV watching are likely to positively impact RHSB patterns for women in Bangladesh.

Child Freedom as Ecofeminist Praxis: Navigating Gender, Reproductive Choice, and Climate Action

This research explores the decision to have child freedom, namely the choice not to have children, as a form of ecofeminist praxis in supporting climate change action. By integrating ecofeminist theory, this study aims to analyze the individual impact of child freedom decisions on climate change and explore the gender dimensions that may be involved. Adopting a literature study approach, this research details how these decisions can be understood through an ecofeminist lens, linking issues of gender and reproductive choices to the ecological responsibility of individuals. Through an in-depth literature analysis, this research strengthens the argument that child freedom can be articulated as a positive action in reducing an individual's ecological footprint and consideringthe social impact of gender in the context of climate change. This discussion highlights ecofeminist perspectives in the context of child freedom and explores how policy and society can support this choice as a concrete contribution to environmental sustainability. It is hoped that the results of this research can deepen our understanding of the relationship between gender issues, family decisions, and climate change action. The implications of these findings can provide a basis for the development of more inclusive policies and support concrete steps in overcoming the challenges of climate change. Keywords: Child Freedom; Gender; Ecofeminism; Climate Change Action.

Formation of expression of will when making family decisions by spouses

Formation of expression of will when making family decisions by spouses