Family Decision Research Articles

Violence, responsibility and best interests: children rights in Elizabeth Harrower’s A Few Days in the Country and Other Stories

Abstract In her short story collection of A Few Days in the Country and Other Stories (2015), contemporary Australian novelist Elizabeth Harrower skillfully portrays a cohort of children who have come of age in diverse fractured family settings since the 1960s. This article delves into the realm of child welfare and best interests in Australia, elucidating the intricate web of family laws that govern these principles. It casts a revealing light on the myriad challenges children confront in contexts marked by family violence, parental separation, and child custody and adoption. This analysis exposes the unfortunate reality where children’s rights are frequently subverted by guardians, effectively preventing their meaningful involvement in familial decision-making. In instances of family violence, children are relegated to the role of silent victims, rendered voiceless by their inability to resist. During divorce proceedings, children are relegated to the sidelines, unable to actively participate in the decision-making process, resulting in the neglect or outright harm of their best interests. Children who find themselves in foster care or adoption situations often respond with unprecedented rebellion, asserting their independence and self-determination beneath the facade of silent victimhood. Tragically, their fundamental rights consistently remain inadequately protected. By undertaking a critical examination of the dynamic between adults and children within the framework of family law and by juxtaposing it with the contemporary portrayal of marginalized children in Australia, as exemplified in Harrower’s works, this article offers multifaceted insights that can guide efforts to safeguard children’s rights and enhance the development and implementation of legislation pertaining to children.

Digital inclusive and rural household fertility decision-making

This paper selects data from the CHFS in 2017, 2019, and 2021 to explore the relationship between the development of digital inclusive finance and the fertility decisions of rural families. It is found that digital inclusive finance plays a positive role in rural families' fertility decisions in general; the higher the level of social pension security, the greater the negative effect of digital inclusive finance on rural families' fertility decisions. Digital inclusive finance promotes families' positive fertility decisions by relieving rural families from liquidity constraints.

Palliative care providers' roles in medical assistance in dying decision-making triads with patients and families: A qualitative analysis.

Research on medical assistance in dying (MAiD) decision-making indicates that family members and close friends are often involved in making decisions with patients and their care providers. This decision-making model comprising patients, family members, and palliative care providers (PCPs) has been described as a triad. The objective of this study is to understand PCPs' experiences engaging in MAiD-related decision-making triads with patients and their families in Canada. Semi-structured qualitative interviews were analyzed using interpretive description. We interviewed 48 specialist PCPs in Vancouver (26) and Toronto (22). Interviews were audio-recorded, professionally transcribed, and coded using a coding framework. PCPs take on 5 notable roles in their work with family members around MAiD. They provide emotional support and counseling, balance confidentiality between patients and families, provide education, coordinate support, and mediate family dynamics. PCPs take on multiple roles in working with patients and families to make decisions about MAiD. As patients and families may require different forms of support throughout the MAiD pathway, PCPs can benefit from institutional and interprofessional resources to enhance their ability to support patients and families in decision-making and bereavement.

Book Reviews: Equal Partners? How Dual-Professional Couples Make Career, Relationship, and Family Decisions By Jaclyn Wong

Book Reviews: <i>Equal Partners? How Dual-Professional Couples Make Career, Relationship, and Family Decisions</i> By Jaclyn Wong

Gendered parenting and conjugal negotiation over children’s organised extracurricular activities

Although class differences and intra-class diversity in children’s engagement in organised extracurricular activities have been studied extensively, less attention has been paid to internal family dynamics and conjugal negotiation in enrolling children in these activities. From the perspectives of gendered parenting and relational sociology, this study draws on qualitative data from 134 parents in 81 urban Chinese families to reveal their conjugal disagreements, negotiation and coping tactics in enrolling their children in extracurricular activities. The findings indicate that selecting and managing extracurricular activities for children is an ongoing process marked by constant conjugal negotiation, the relational agency of multiple family members and various coping tactics within the family. These findings enrich the literature by highlighting the complexity of middle-class parenting in negotiating children’s extracurricular educational resources and shed new light on the relational and contested processes of gendered parenting and making familial decisions about children’s education.

Kondisi Psikologis Primigravida dengan Preeklampsia Berat dan Future Direction Strategi Komunikasi Perawat: A Case Report

Background. Preeclampsia is a pregnancy complication with a high risk of maternal and fetal morbidity and mortality. This case report aimed to describe primigravid pregnancies with severe preeclampsia and physical-psychological problems that impact patient-family’s decision-making for the health of the mother and fetus.&#x0D; Research Methods. This case report was conducted to improve understanding of a case primigravida pregnancies with severe preeclampsia. The stages of a case report included: defining the case; choosing a case; collecting and analyzing data; interpreting data; and reporting results. Data was collected through interviews, physical examinations, examination of health documents, discussions with patients and families, and information from other health workers—anxiety assessment using the Hamilton Rating Scale for Anxiety. Data analysis was done by reading the collected data, coding the primary data, comparing it, and summarizing it as a case presentation.&#x0D; Results. Primigravida, 33 weeks, severe preeclampsia and requires hourly monitoring. Complaints of frontal headaches, blurred vision and conveyed the results of high blood pressure examination at a clinic near the house. General condition: composmentis, blood pressure: 160/112 mmHg, N;118 x/min, R;24x/min, Temperature; 36.50 C, dry lips, oedema in the left lower extremity, MEWS score 4-5, fetal heart rate 134x/minute. Anxiety assessment with the Hamilton Rating Scale for Anxiety resulted in moderate-severe anxiety category. Husbands expressed the wishes of the mother and baby to be safe and to be born immediately with surgery.&#x0D; Conclusion. Severe preeclampsia with uncontrolled blood pressure requires appropriate treatment and intensive observation by health workers, especially nurses. Pregnancy with severe preeclampsia raises anxiety for patients and families, which risks further increasing blood pressure and threatening the fetus's well-being. Anxiety impacts interaction situations between patients, families, and caregivers, as well as family decision-making. A therapeutic communication approach by paying attention to comprehensive needs and holistic patient conditions is an effective nurse strategy for families to make maternal and fetal health decisions.

Review of “Equal Partners? How Dual-Professional Couples Make Career, Relationship, and Family Decisions”

Review of “Equal Partners? How Dual-Professional Couples Make Career, Relationship, and Family Decisions”

Impact of household decision makers’ hesitancy to vaccinate children against COVID-19 on other household members: A family-based study in Taizhou, China

BackgroundVaccination is the most effective means of preventing outbreaks of infectious diseases, and family ;decision makers play an important role in decision-making regarding family matters and may influence other family members to take an active role in vaccinating children against COVID-19. PurposeThis study examined the influence of family decision makers on the hesitation of other family members to vaccinate their children against COVID-19. MethodsA population-based, self-administered online questionnaire was administered in Taizhou, China, from September 1, 2021, to September 15, 2021. The questionnaire included demographic information, knowledge, attitudes, and perceptions about the COVID-19 vaccine as well as hesitation regarding the use of the COVID-19 vaccination in children. In total, 490 respondents were included in this study. Logistic regression was used to assess the factors associated with vaccine hesitancy. ResultsIn total, 490 respondents from 190 households were interviewed. Of the 190 family decision makers, 43.7% (83/190) were hesitant to vaccinate their children against COVID-19. When family decision makers were hesitant to vaccinate children against COVID-19, 65.1% (82/126) of the other family members expressed similar hesitancy regarding vaccination. When family decision makers were not hesitant to vaccinate children, only 21.3% (37/174) of other family members were hesitant to do so. In the regression analysis, family decision makers' hesitation to vaccinate their children was associated with other family members' hesitation (OR=6.264, 95% CI:3.132–12.526). In addition, decision makers’ perceptions of the safety of the vaccine (OR=0.422, 95% CI:0.215–0.826) and hesitation to vaccinate themselves (OR=8.967, 95% CI:4.745–16.948) influenced their hesitation to vaccinate their children. ConclusionThe present study found that family decision makers' hesitation to vaccinate children against COVID-19 influenced other family members' hesitation to vaccinate children. In addition, family decision makers' perceptions of the safety of the vaccine and their hesitation to vaccinate themselves influenced other family members’ hesitation to vaccinate their children.

Advanced practice nurse competencies to practice in emergency and critical care settings: A scoping review.

Advanced Practice Nurses are expected to provide lifesaving care to patients with complex acute illnesses in emergency and critical care settings. However, little is known about their competencies and barriers to practice in emergency and critical care settings. This review investigated these nurses' competencies to practice. A scoping review was conducted in accordance with Arksey and O'Malley's framework. Extensive research searches were conducted using seven electronic databases: MEDLINE, CINAHL, Scopus, Web of Science, Ichushi Web, Mednar and GreyNet International. Definitions and explanations of Advanced Practice Nurse competencies were categorized into elements and grouped according to similarity. The database searches identified 2,483 studies, and data were extracted for 23 studies. Analysed studies were published between 2000 and 2021 and conducted in eight countries. Seven competencies were identified: performing advanced practice nursing, acute patient care, diagnostic assessment, interdisciplinary collaboration and consultation, leadership and system management, documenting patient care and supporting patient and family decision-making. This review identified competencies unique to Advanced Practice Nurses in emergency and critical care settings. Further research is required to facilitate understanding of the crucial roles of advanced care nurses among healthcare providers.

Crisis management in family firms: do religion and secularization of family decision-makers’ matter?

PurposeThe unique dynamics of family firms (FFs) shape the management of financial crises. Religious and secular reasons, as a defining characteristic of this type of firm, provide a reference system for key management decisions. This paper aims to explore the under-researched topic of differences in FFs' crisis management between religious and secular family decision-makers (FDMs), considering secularization in developed countries.Design/methodology/approachThe paper draws on a qualitative-empirical study of 14 large FFs from the DACH region (Germany, Austria and Switzerland), through both a media analysis and semi-structured interviews with FDMs who have significant influence on key management decisions.FindingsDespite secularization, religion continues to influence managerial decisions such as crisis management in the DACH region. The findings show that crisis management differs across religious and secular FDMs, demonstrating the substantial impact of religious and secular reasons on operational and financial measures. Thus, religious and secular reasons may partially explain the complex and ambivalent crisis management of FFs. This indicates that religion shapes FF's key management decisions in the increasingly secularized DACH region. Religious FDMs are accountable to both the firm and to God, which fosters their own personal and financial resources during crisis management.Originality/valueThis paper contributes to the existing literature by exploring the impact of religion and secularization within developed countries. Further, it offers deeper insights into FF's crisis management and is one of the first studies to assess the impact of religion and secularization on operational and financial measures. This research derives five propositions for further research and discusses a broad range of original implications for theory and practice.

Parental perspectives on the decision-making process on transport mode choice in adolescents: a qualitative study with mothers and fathers.

The present study aims to understand the familial decision-making process on transport mode choice in adolescents with a focus on the parental perspective within this process. Active travel contributes to adolescents' overall physical activity and its positive health effects. Based on the social-learning theory, especially parents are assigned a central role for adolescents' travel behavior. The aim of the present study was to examine how parents are involved in the decision-making process on transport mode choice in adolescents. The study is part of the cross-sectional mixed-methods ARRIVE study which includes semi-structured interviews with mothers (n = 12) and fathers (n = 7) of 11- to 14-year-old German adolescents. The interviews focused on travel behavior in adolescents and the decision-making process on transport mode choice from the parental perspective. All interviews were analyzed inductively using Thematic Analysis. Our study revealed that parents do not primarily decide for or against active travel in adolescents, but are mostly involved in the decision-making process, especially in case of a deviation from the main transport mode. Different forms of parental involvement in the decision-making process were identified. Some parents acted as main decision makers which is the highest form of involvement while others gave their children complete freedom of choose a transport mode for themselves. These parents accepted their child's choice fully which shows a low involvement in the decision-making process. The results provide a deeper understanding of the familial decision-making process on travel behavior in adolescents. The results indicate an occasionally parental involvement in the decision-making process on the mainly used transport mode by adolescents, and that mothers and fathers are always involved when deviating from the main mode. Further research should investigate changes in travel behavior from childhood to young adulthood to understand long-term travel decisions in families. Due to the findings that parents are often involved in the decision-making process on transport mode choice and that they mainly reported safety concerns as barriers to their children's active travel, further research should focus especially on the social and physical environment of adolescents.

REPRESENTASI GENDER PEREMPUAN DALAM PENGAMBILAN KEPUTUSAN PADA KELUARGA DI KABUPATEN SIMALUNGUN

Decision making is a definite step taken in looking for something solutions to problems that occur. In the family the decisions are usually taken over by men. However, at this time the decision was not only for men, but also for women also participate in decision making in the family. Research has a purpose to analyze gender representation in family decision making. This research uses a case study in Simalungun Regency, North Sumatra. Method the research used is a qualitative method. Collection of data sources is done using interview techniques directly to 10 respondents. Research result raises new conclusions where the female gender does not have a deep gap take decisions or policies in the family that are carried out jointly between husband and wife on domestic roles and public roles in society. In this case women share in the problems that exist in the family. With each other support and cooperation between husband and wife. So there is no difference between female and male.

Pride, prejudice and pragmatism: family language policies in the UK

In this study, we examine how mobility and on-going changes in sociocultural contexts impact family language policy (FLP) in the UK. Using a questionnaire and involving 470 transnational families across the UK, our study provides a descriptive analysis of different family language practices in England and establishes how attitudes influence the different types of FLP in these families. Complementing the descriptive analysis, we use interview data to understand the driving forces behind the different types of language practices and language management activities, and explore how ideological constructs of ‘pride’, ‘prejudice’ and ‘pragmatism’ are directly related to negative or positive attitudes towards the development of children’s heritage language. The findings indicate that migration trajectories, social values, raciolinguistic policing in schools, and linguistic loyalty have shaped family decisions about what languages to keep and what languages to let go. Our paper responds to the linguistic and demographic changes in British society, and makes an important contribution to our knowledge about multilingual development of children in transnational families. Critically, this study shows that FLPs alone cannot save the minority languages; institutionally sanctioned language practices and ideologies have to make a move from limiting the use of these languages in educational contexts to legitimising them as what they are: linguistic resources and languages of pride.

Raising bilingual autistic children in the UK: at the intersection between neurological and language diversity.

While research shows no negative effects of bilingualism on autistic children's development, due to misconceptions around both autism and bilingualism, bilingual parents and educational/clinical practitioners who advise them often express unfounded concerns that exposing autistic children to more than one language will cause confusion and developmental delays. To understand the reasons that drive these misconceptions, this study focuses on: identifying factors that impact family decisions about (not) raising autistic children bilingually; attitudes toward bilingualism expressed by the community, doctors, family members, and teachers; sources of information about bilingualism and autism available to families. Through a mixed-method online survey, we explored these questions in 31 UK-based bilingual families with 34 autistic children (age M = 10.6 years; SD = 7.1). The families reported choosing bilingualism for their autistic child primarily so that the child can communicate with family and community members. Attitudes toward bilingualism in their networks were predominantly positive, with a large portion of individuals not having opinions possibly due to lack of information. Only about 1/3 of parents had access to information on bilingualism and autism, mostly found on the internet. We discuss these findings and offer future directions for research, practice, and battling stigmas around bilingualism and autism.

Preferences and end of life care for residents of aged care facilities: a mixed methods study

BackgroundResidential aged care facilities is one of the most common places to deliver of end of life care. A lack of evidence regarding preferred place for end of life care for residents of aged care facilities impacts on delivery of care and prevents assessment of quality of care. This paper reports the preferences, current status of end of life care and enablers and barriers of care being delivered in line with the wishes of residents of participating aged care facilities.MethodsWe collaborated with six equally sized aged care facilities from the Greater Newcastle area, New South Wales, Australia. An audit of the quality of end of life care for residents was conducted by retrospective medical record review (n = 234 deceased patients). A retrospective review of emergency department transfers was conducted to determine the rate of transfer and assign avoidable or not. Qualitative focus group and individual interviews were conducted and analysed for barriers and enablers to end of life care being delivered in accordance with residents’ wishes.ResultsMost residents (96.7%) wished to remain in their residential aged care facility if their health deteriorated in an expected way. Residents of facilities whose model of care integrated nurse practitioners had the lowest rates of emergency department transfers and timelier symptom management at end of life. Family decision making influenced location of death (either supporting or preventing care in place of patient preference).Conclusion(s)To better provide care in accordance with a person’s wishes, aged care facilities need to be supported to enable end of life care insitu through integrated care with relevant palliative care providers, education and communication strategies. Family and community health and death literacy interventions should accompany clinical innovation to ensure delivery of care in accordance with residents’ preferences.

The management of Monochorionic Monoamniotic (MCMA) twin pregnancy

HIGHLIGHTS Monochorionic monoamniotic (MCMA) twin pregnancy has a significant risk of perinatal morbidity and mortality, including intrauterine fetal death (IUFD). The risk of prematurity, the risk of death due to MCMA complications, the availability of the NICU, also high costs on preterm care were factors in deciding to terminate the pregnancy. The ideal time to deliver monochorionic twins in order to reduce the risks of cord entanglement, growth discrepancies, and intrauterine fetal death is still a point of controversy. Early diagnosis, intensive antenatal monitoring, patient and family decision would contribute to antenatal mortality reduction. ABSTRACT Objectives: To present the management of monochorionic monoamniotic (MCMA) twin pregnancy. Case Report: Advanced prenatal treatment has improved the prognosis for Monochorionic Monoamniotic (MCMA) pregnancies; however, there is still no agreement on how to handle MCMA twins. The authors report 2 cases of monoamniotic monochorionic twin pregnancies. In the first case, a 30-years-old primi pregnant woman detected MCMA at 14 weeks of gestation; no complications related to MCMA were found; she planned delivery at 32 weeks, but one of the babies died in the womb at 31/32 weeks pregnant, a live baby born by cesarean section. The second case was a 36-year-old pregnant woman, on her third pregnancy, diagnosed with MCMA after 12 weeks of pregnancy, no complications related to MCMA, the baby was born at 32 weeks pregnant, and both babies survived. The management was the same in both cases, but different outcomes were obtained; in case 1, the baby died allegedly due to cord entanglement, which could not be detected during pregnancy.

NURSING TECHNOLOGY SUPPORTING FAMILY INVOLVEMENT IN CRITICALLY ILL PATIENTS: A SYSTEMATIC REVIEW

Background: Family involvement in the care of critically ill patients positively impacts treatment outcomes and patient well-being. Nursing technology has become an essential tool in facilitating family engagement Aims: This study aims to conduct a systematic review of nursing technology that supports family involvement in critically ill patients. Methods: This article utilized a systematic review method. Articles were assessed using the JBI Critical Appraisal Checklist. The instruments were the JBI Critical Appraisal Checklist for Randomized Controlled Trials and the JBI Critical Appraisal Checklist for Cohort Studies. Literature from the past five years was obtained from four databases: Science Direct, Scopus, Springer Link, and ProQuest. Results: Out of 148 articles, 15 were analyzed. Various technologies (such as web-based platforms, tablets, SMS tools, and video conferencing) were used to provide information, enhance decision-making, and provide virtual access to family conferences. Although interventions varied, "Information sharing" and "Activation and participation" were most commonly implemented in the family involvement model. In studies that discussed the components of family involvement more comprehensively, interventions allowed for information adjustment through two-way communication and active family participation in the decision-making process. Conclusion: Based on the findings of this systematic review, it can be concluded that nursing technology has great potential in supporting family involvement in critically ill patients. This technology can significantly improve family well-being, communication, and decision-making. Further research can focus on a deeper understanding of the emotional impact experienced by families of critically ill patients due to the use of technology.

Understanding the healthcare provider role on post abortion contraception adoption in India using National Family Health Survey-5

BackgroundPost abortion contraceptive use is an important area in provisioning of services associated with child birth planning. This study examines the factors related to the type and timing of initiation of contraception adoption among women who had undergone induced abortion. Study also tries to identify the role of personnel who provided the abortion service on decision of family planning adoption using complementary log–log model in India.MethodologyThe study uses the secondary data from the fifth round of the National Family Health Survey conducted during 2019–21. For, the analysis, we have used five-year women’s reproductive calendar to extract information on contraceptive use, post last induced abortion among women. We used complementary log–log regression models, to estimate relative risk ratios and its 95% Confidence intervals (CI).ResultsAccording to NFHS-5, out of all the last pregnancies (2,55,549), about three percent resulted in abortion. Most of the abortion occurred in private facilities (55%), with the help of health professionals (71%). From the women’s reproductive calendar, it was found that around 40% of the women adopted modern methods of contraception, with maximum adopting spacing method (33%), and only handful adopted permanent method (7%). It was also found that the likelihood of early adoption of permanent method increased to two times when the abortion is done by health professional compared to others [95% CI (1.25–3.30)].ConclusionThis emphasises a need for quality counselling related to timing and types of family planning as an essential part of the family planning program ensuring client centric approach suited to their needs and contexts that helps in alleviating any apprehensions associated with adverse effects of modern contraceptive methods.

Space use in Central Business District of emerging economies: Regulation or rationale?

The Central Business District (CBD)[1] mimics a jungle where businesses and people compete for the best space and use because of its socioeconomic and political roles in a city. This zone attracts many users and uses, making it a focus of regulative planning, which is perceived as a useful behavioural control tool. However, whether a CBD's space user behaviour and use patterns are attributable solely to zoning guidelines and planning standards is not established. Using a case study design with Kumasi's CBD as the geographic scope, the study explored the patterns in space use within the lens of Ghana's Zoning Guidelines and Planning Standards and the factors informing user behaviour. The study found that space use in the CBD conforms extensively to the permissible activities enshrined in the guidelines, though open spaces and recreational parks are going extinct. However, some use prohibitions outlined in the Zoning Guidelines disconnect from reality and user rationality amid space use competitions. The study suggests that profit maximisation is the critical factor informing use patterns and user behaviour, aside factors like location, statutory demand, inheritance, social influence, and family decisions. The paper concludes that users’ subjective profit motives inform the user behaviour in CBDs of developing economies as against the perceived behavioural control embedded in guidelines and planning standards. It is recommended that attaining and maintaining inclusive and operative space use in the CBDs should integrate routine updating of regulatory frameworks and guidelines underpinned by rational choice models.[1] Central Business District.

Factors influencing parent-child relationships in chinese nurses: a cross-sectional study

BackgroundWith the development of the social economy, the effective coordination of the conflict between work and family has become an urgent problem for most parents. Such conflicts are especially acute in the families of nurses with children. Therefore, a timely understanding of the status quo of the parent-child relationship and associated risk factors among nurses will assist in improving their family harmony and the healthy growth of their children.MethodsA total of 350 nurses with children at a general tertiary hospital in Sichuan Province, China, were interviewed using a structured questionnaire between June 23 and July 9, 2022. The results were analyzed by multiple linear regression using the stepwise method.ResultsThe results showed that the parent-child relationship received a middle-level mean score of 77.74 (SD = 10.77). The factors that influenced the parent-child relationship among nurses included the parents’ character type (β = 0.143, P = 0.002), feeling tired due to dealing with patients (β=-0.150, P = 0.002), the nurse-patient relationship (β = 0.137, P = 0.004), the age of older children (β=-0.153, P = 0.001), number of children (β=-0.093, P = 0.041), sleep quality (β = 0.116, P = 0.014), and family adaptability (β = 0.308, P = 0.000); these factors accounted for 31.3% of the variance in parent-child relationships among nurses.ConclusionThe findings of this study will help policy makers and nursing managers to better understand parent-child relationships in Chinese nurses. The results highlighted the importance of the creation of a family-oriented work environment while paying more attention to the parent-child relationships of nurses who are introverted and have more or older children. After busy workdays, nurses should also be encouraged to participate more in family decision-making and strategic parent-child interactions to avoid negative effects on children caused by work-related emotional exhaustion, physical and mental fatigue, and other reasons. The development of good parent-child relationships may help maintain both their and their children’s mental health while enhancing their enthusiasm for work and their professional identity.