Family Support Networks Research Articles

Exploring food security among recently resettled Syrian refugees: results from a qualitative study in two Canadian cities

Purpose This study aims to provide a qualitative in-depth account of the status and experience of food insecurity for Syrian refugee households in Toronto and Saskatoon, Canada. The study considers the range of geographic, socio-economic, cultural and gendered components shaping and determining the barriers and management of food insecurity. Design/methodology/approach The study included 54 semi-structured interviews with refugee families in Toronto and Saskatoon who resettled in Canada after November 2015. In addition, 15 semi-structured in-person or telephone interviews were conducted with settlement and support agencies to measure their capacity to respond to issues of food insecurity for Syrian refugees. Findings Syrian refugees reported experiencing food insecurity as part of the broader resettlement journey, including in the transitional phase of refuge and in each settlement context in Canada. Income status in Canada was reported as a key barrier to food security. Low-income barriers to food security were experienced and shaped by factors including food affordability, physical access and availability and the extent of familial or other support networks including sponsorship relationships. Participants also reported how managing food insecurity contributed to the intensification of gender expectations. Originality/value The analysis reveals food insecurity as both an income and non-income based concern for refugees during the process of resettlement. The study also highlights the importance of considering variations between primary barriers to food security identified by Syrian families and key informants as critical to the development of strategies designed to mitigate the impacts of resettlement on food security.

Born into Bondage? Iklan Lives along the Rural-Urban Continuum (Tuareg, Sahel)

ABSTRACT This article considers the predicament of a low-status Tuareg woman living close by her former master’s family in rural central Niger in 2010; for the family, she maintained the status of taklit (“slave descendant,” feminine singular of iklan), somewhere along the spectrum between paid family servant and domestic slave. Analysis focuses on why she and so many like her have not managed to improve their life chances by moving to town, despite the Nigerien ban on slavery. Relevant factors include her lack of a family support network, the continued impact of prejudice against former slaves, a fear of possibly worsening her economic standing via such a move, and the strong moral compulsion of ordained gender roles in contemporary Sahelian cities. Former mistresses/masters also resisted the departure of women like her from wealthy herding households because of their housework contribution and their crucial role in producing the next generation of workers.

From rational to relational: How energy poor households engage with the British retail energy market

In the sociological tradition, markets are understood to be constituted of social relations: relations of trust, friendship, power and dependence, which have moral and emotional qualities. In this paper, we explore how people in energy poor households construct the energy market and its impact on energy policy. Drawing on secondary analysis of a large collection of qualitative interviews on the lived experience of energy poverty carried out from 2003 to 2018 (n = 197 interviews and 20 selected), and the results of an OFGEM quantitative survey on consumer engagement released in 2018, we document the experience of the energy poor as actors in the British retail energy market. We uncover a number of challenges and opportunities facing energy poor participants in the market: having access to good quality information about suppliers, energy tariffs and grants, and having the skills and resources to act on this is important, without these it can be difficult for people to take action. In explaining people’s engagement with the market, we draw on the concept of ‘socio-economic attachments’, showing how a supportive network of family and friends, and people’s trust of and resulting loyalty to their energy supplier mediate their engagement. These findings lead us to relational explanations of the retail energy market, with related policy recommendations: if we are to aim for people to act ‘rationally’, they will need support to navigate the market from intermediaries.

All in the family: A descriptive analysis of family network change in families managing chronic illness

AbstractBackgroundSocial networks can be a source of support, including informational support, in chronic illness management, but can change over time in response to health crises. However, little is known about how families leverage their support networks to manage chronic illness over time—and how these networks may change.MethodsFor 28 families managing either diabetes or HIV, we gathered survey‐based social network data, including network size, exchanges of support, and tie strength, up to 5 times over 2 years. We then used descriptive analysis to examine changes in network size, structure and function (e.g., informational support).FindingsAlthough family networks remained stable in terms of network size and transitivity, these networks experienced regular fluctuations in both tie‐level variables (i.e., tie strength) and density of informational support exchanges.DiscussionObserved changes in these measures indicate that even family support networks are susceptible to change over time, particularly at the tie‐level, indicating a need to expand the way we think of network change beyond whole network measures when looking at small, family networks, especially examining how information exchanges fluctuate over time. Future research should explore tie‐level measures and support exchange networks to understand why networks change over time.

A participação da família no processo de cuidado da criança hospitalizada

O adoecimento e a hospitalização de uma criança trazem inúmeras mudanças e requer um grande suporte familiar, pois esta é considerada essencial e apresenta significativa influência durante esse período. Com isso, o presente estudo teve como objetivo analisar a participação da família no processo de cuidado da criança hospitalizada. Para realizá-lo foi utilizado uma abordagem qualitativa, com oito entrevistas semiestruturadas, aplicadas na unidade de pediatria do Hospital de Messejana Dr. Carlos Alberto Studart Gomes – HM, em Fortaleza – Ceará. A coleta de dados ocorreu entre julho a outubro de 2019. Após transcritos, os dados foram analisados e discutidos. Definiram-se três categorias de análise: Mulheres Cuidadoras; Rede de apoio familiar e A importância da família no processo de cuidado. A análise mostrou que as mulheres são as principais cuidadoras das crianças, corroborando para a discussão das relações de gênero e seus desdobramentos. Destarte, conclui-se a necessidade do fortalecimento do vínculo familiar, visto a importância da participação da família durante a hospitalização e a criação de políticas públicas voltadas para ampliação da autonomia das mulheres.

Functional disability in Brazilian octogenarians: data from the 2013 National Health Survey

Abstract Background The impairment of function capacity implies a greater risk of biological and social vulnerability, increasing the demand for healthcare services and caregivers. Objective Estimate the prevalence of functional disability in the performance of basic and instrumental activities of daily living (BADL and IADL) among long-lived Brazilians (≥80 years) according to sociodemographic characteristics and self-rated health. Methods A cross-sectional study was conducted with data from seniors who participated in the 2013 National Health Survey (n = 1498). Functional disability was defined as difficulty performing at least one of the six BADL or five IADL. Independent associations were determined using Poisson multiple regression analysis, with the calculation of prevalence ratios and 95% confidence intervals adjusted for chronic diseases. Results Mean age was 84.8 years (CI95%: 84.5-85.1); 59% were women; 62% were self-declared white; and 63% had no private health insurance. The prevalence of functional disability in BADL and IADL was 33.8% (CI95%: 30.6-37.2) and 66.4% (CI95%: 62.5-70.2), respectively. Only 17.7% participated in organized social activities and only 15.5% rated their health as poor/very poor. Regarding BADL, greater disability was found among those ≥85 years of age, among men and those who rated their health as poor (p < 0.05). Regarding IADL, greater disability was found among those ≥85 years of age, those without a conjugal life, illiterate individuals and those who rated their health as poor (p < 0.05). Conclusions Approximately 1/3 and 2/3 of long-lived Brazilian exhibited restricted skills for maintaining their autonomy and independence regarding the performance of BADL and IADL, respectively. The present findings underscore the importance of family and social support networks to assist older adults in the performance of basic and instrumental activities of daily living as well as activities related to mobility. Key messages The impairment of function capacity increases the demand for healthcare services and caregivers. Approximately 1/3 and 2/3 of long-lived Brazilians have functional disability regarding the performance of basic and instrumental activities of daily living, respectively.

'Cocooning' the vulnerable - a main pillar of Malta's COVID-19 response

IssueEarly epidemiology established higher risk of morbidity & mortality amongst infected older individuals or those having specific chronic diseases, consuming most hospital care. Also where demand exceeding supply of healthcare, mortality was very high. As an island nation with one central main hospital, not overwhelming the healthcare system whilst avoiding total lockdown was key.DescriptionOn the 27-03-2020, the Superintendent of Public Health enacted the Protection of Vulnerable Persons Order, specifying that these categories (or subcategories thereof) of persons are to be granted vulnerable status: age >65; pregnant; persons suffering from diabetes; immunosuppressed; cancer; end stage renal failure; respiratory disease; cardiac disease; heart failure. Such persons were entitled to stay at home, to be granted special leave from work, entitled to a monthly allowance by social services. One could go out only to attend to essential or urgent personal matters, e.g. groceries, medicines, medical needs, bank etc. with mitigation measures. Exemptions were only granted to special categories such as healthcare workers, farmers, or headship positions. In addition, the carers & staff of most nursing homes voluntarily decided to isolate themselves inside the homes for periods of 2/3 weeks. Thanks to a very active family support network, offspring, relatives or neighbours ran basic errands for them, or else organised deliveries. This legal status has been lifted on the 5th June 2020.ResultsThis status was granted to 126 000 persons, including 14000 employed persons. Only 9 deaths occurred in Malta out of 664 cases in a population of 500000 up till 20th June 2020, with a case fatality rate of 1.35% - one of the lowest in Europe.LessonsProtection of vulnerable individuals can be a cornerstone of COVID-19 public health response if mobility is effectively restricted in this subpopulation.Key messages Protection of the vulnerable reduces healthcare & mortality burden.Effective legal & economic support measures, & extensive societal engagement required.

Vulnerability and Resilience in a Mobile World

Diverse groups of people experience vulnerability in an increasingly mobile world. Populations relocate to other countries for many and varied reasons including economic, environmental, personal safety and/or educational considerations - generally for a better life.International students form a large and important component of this phenomenon. For international students, education is key to their success. International students are currently facing new challenges, particularly those from China who have been impacted by the Coronavirus situation and the resulting travel restrictions, study implications, visa concerns, and general community ignorance giving rise to xenophobia – all contributing further stresses. These challenges are in addition to long-held pressures including being away from traditional family supports, adapting to a different culture, study pressures and loneliness. 
 For more than 16 years my work has focussed on the safety and security needs of international students. While the vulnerability of international students has been consistently brought to the fore in my research, so too has their resilience. The vulnerability experienced by international students relates to risk and opportunity (Forbes-Mewett, 2020). These dimensions are factored into the decision to leave one’s home country and the security of family and traditional support networks for the opportunity of an international education. Such decisions demonstrate an undeniable aspect of bravery. 
 In a 2015 study, I interviewed 150 key informers including international student support staff and international students across the US, the UK and Australia in relation to the issue of safety from crime (Forbes-Mewett et al., 2015). Importantly, the study acknowledges that most international students do not become victims of crime (Forbes-Mewett et al., 2015, p. 1). The interviewees paint a vivid and nuanced picture of international student vulnerability among many examples of resilience. Their poignant narratives help our understanding of how challenges are overcome and why international education is a crucial part of the contemporary mobile world.
 More recent work explored international students’ vulnerability in relation to food security, housing and campus security in Australia, the US and the UK (Forbes-Mewett, 2019). Once again, it was shown the difficulties international students face and how they navigate and develop coping mechanisms that present examples of great resilience. In relation to food security, the 2019 study presents a case of a student who communicated regularly with her mother at meal times via mobile phone text message to ask and receive cooking instructions. For this student, who had no experience in preparing her own meals, not only did the strategy provide cooking instruction and ways to enjoy culturally appropriate food but it also ensured comforting communication with a close family member at mealtime. 
 The above dimensions, among others, continue to contribute to international student vulnerability and at the same time present challenges to be faced and overcome – in many cases they are. Of recent times, the long existing issue of the psychological well-being/mental health of international students is gaining traction (Forbes-Mewett 2019). This attention is long overdue and crucial for helping international students manage their mental health to enable the successful completion of their studies. The mental health of Singaporean students was explored to find that this group, over a period of time, shifted from perceiving mental health issues as a taboo subject to a level of acceptance that they are a part of everyday life for many people (Gan and Forbes-Mewett, 2019a). Further, the practice of seeking help was found to be desirable, notwithstanding acknowledgement that the help on offer seemed to mismatch what was expected (Gan and Forbes-Mewett, 2019a). This work was extended to show that intercultural adjustment tends to be a stressful process for international studentsand as a consequence it was contributing to a higher risk of vulnerable mental and emotional states (Gan and Forbes-Mewett, 2019b). 
 In summary, the vulnerability of international students is a topic of ongoing concern with many and varied contributing factors such as outlined above. However, the resilience of international students in the face of such vulnerability is to be applauded. Given nations benefit so greatly from international education we all must take responsibility to address the vulnerability of international students and ensure that they are well-supported in their educational pursuits and desires for a better life. To this end, my work relating to international students continues unabated.

Redes de apoio no cuidado domiciliar ao recém-nascido prematuro: um relato de experiência

Este é um relato de experiência de um caso como de mãe de um neonato prematuro e teve como objetivo relatar a experiência da visita domiciliar no âmbito da Atenção Primária à Saúde, ressaltando a importância das redes de apoio no cuidado ao recém-nascido prematuro. Realizado em uma cidade do interior do Estado de São Paulo no primeiro semestre de 2018, usou o Mapa Mínimo da Rede Pessoal Social. As visitas domiciliares possibilitaram fortalecimento do vínculo no binômio mãe-filho e identificação de uma rede pessoal social fragilizada, indicando também dois problemas emergentes: família em isolamento social e pouco empoderamento individual. Percebe-se uma rede média, pouco densa, homogênea, com predominância de vínculos sociais ausentes e/ou rompidos. Os resultados denotam a importância da visita domiciliar para a continuidade do cuidado hospital-domicílio, trazendo à reflexão a relevância das redes de apoio às famílias de recém-nascidos prematuros.

Family-based social capital of emerging adults with and without mild intellectual disability.

BackgroundFamily is recognised as an important context for the self‐development of young adults in emerging adulthood, although very little research has addressed the perspective of young people with intellectual disability about their families by using self‐report. This study examined how emerging adults with mild intellectual disability define their family support networks, compared with definitions of students without intellectual disability, within a social capital theoretical framework.MethodsFifty‐three participants with mild intellectual disability and 53 students without intellectual disability were interviewed individually using the Family Network Method – Intellectual Disability (FNM‐ID). Data from the FNM‐ID relate to key social network measures on how individuals define their family groups, and how they perceive existing supportive relationships within their families. Participants with mild intellectual disability and students were compared on the FNM‐ID social network measures.ResultsParticipants with mild intellectual disability reported fewer family members who they considered significant to them than students without intellectual disability. They were less likely to include peers (i.e. friends and partners) and siblings in their significant family networks, had fewer relationships with family members in which they received or gave support, had fewer reciprocal support relationships and had a less central position in their family network.DiscussionThe family‐based social capital of emerging adults with mild intellectual disability differed from that of students without intellectual disability. They may remain more dependent on their natural family for emotional support as their supportive networks have not necessarily made the transition to networks with emotionally close peer relationships.

Income distribution in family networks by gender and proximity

AbstractWhereas the significance of family networks for support and well‐being has been shown in previous research, few studies have analysed the income distribution within family networks. The aim of this study is to examine income distribution within family networks and how they have changed over time for women and men in different parts of the income distribution and if the incomes are more similar in the geographically proximate family network. The analysis is based on register data and by use of ordinary least squares (OLS) and quantile regressions. The results indicate that men in the lowest income group tend to have become more similar to their family network over time. Gender differences have decreased, possibly as an effect of women's higher labour market participation rate leading to decreased income disparity. This paper contributes by highlighting how the uneven distribution of economic resources in family networks adds to individual's own resources.

The social threats of COVID-19 for people with chronic pain.

K. Karos is a postdoctoral researcher supported by the Research Foundation, Flanders, Belgium (grant 1244820N). F. P. Kapos is a PhD candidate who is supported by the Patrick-Beresford Fellowship in Social Epidemiology and the P.E.O. International Peace Scholarship. H. Devan is a Postdoctoral Fellow supported by the Centre for Health, Activity and Rehabilitation Research (CHARR) Postdoctoral Fellowship at the School of Physiotherapy, University of Otago, New Zealand. This review was an initiative of the Social Aspects in Pain Special Interest Group (SocSIG) of the International Association of Pain (IASP).

Family: The Bedrock of Support for American Indian Women Cancer Survivors.

Cancer disparities among American Indian (AI) women are alarming, yet a dearth of research focuses on the role of family support for such women. The purpose of this research was to examine the composition of AI women cancer survivors' family support networks and the types of support that they provided. We used a qualitative descriptive methodology with 43 AI women cancer survivors and qualitative content analysis, which indicated that 38 participants (approximately 90%) reported that their families provided integral and varied forms of support, especially instrumental support throughout cancer experiences. Families were the bedrock of support for AI women cancer survivors.

Cyberbullying and Adolescents.

Cyberbullying is an aggressive behavior involving a type of electronic communication intending to harm a victim that can have profound effects on adolescents. This review examines the epidemiology, issues from cyberbullying, presentation to care of its victims and proposed interventions to this behavior. There are a variety of physical and psychological effects on victims of cyberbullying that can include recurrent abdominal pain, headaches and difficulty with sleep. In addition, victims have higher rates of anxiety, depression, suicidal ideation and a lower level of well-being. Unfortunately, victims may remain silent, so screening for cyberbullying is encouraged in a variety of settings. Interventions can be designed at the level of the victim (and perpetrator), family, school and other support networks. Prevention of cyberbullying can be a focus for providers of healthcare. Cyberbullying can have profound biopsychosocial effects on its victims. There are strategies currently in use and under development to identify and intervene on behalf of those affected by these behaviors.

A Qualitative Assessment of Factors That Children, Parents, and Clinicians Prioritize in the Setting of Elective Anesthesia and Surgery.

Assessing the postoperative recovery of pediatric patients is challenging as there is no validated comprehensive patient-centered recovery assessment tool for this population. A qualitative investigative approach with in-depth stakeholder interviews can provide insight into the recovery process and inform the development of a comprehensive patient-centered postoperative assessment tool for children. We conducted open-ended, semistructured interviews with children 6-12 years old undergoing elective surgery (n = 35), their parents (n = 37), and clinicians (n = 23) who commonly care for this population (nurses, anesthesiologists, and surgeons). A codebook was developed and analyzed using NVivo 12 Plus. The codebook was iteratively developed using a qualitative content analysis approach with modifications made throughout to refine codes. We report the results of this thematic analysis of patient, parent, and clinician transcripts. Postoperative recovery priorities/concerns overlapped and also diverged across the 3 groups. Topics prioritized by children included mobility and self-care, as well as access to a strong social support network following surgery. The majority of children reported feeling anxious about the surgery and separating from their parents, as well as sadness about their inability to participate in activities while recovering. Although children highly valued familial support during recovery, there was variable awareness of the impact of surgery on family members and support network. In contrast, parents focused on the importance of clear and open communication among themselves and the health care team and being equipped with appropriate knowledge and resources on discharge. The immediate repercussions of the child's surgery, such as pain, confusion, and nausea, appeared to be a primary focus of both parents and clinicians when describing recovery. Clinicians had a comprehensive awareness of the possible psychological impacts of surgery in children, while parents reported varying degrees of awareness or concern regarding longer-term or more latent impacts of surgery and anesthesia (eg, anxiety and depression). Prior experience with pediatric surgery emerged as a distinguishing characteristic for parents and clinicians as parents without prior experience expressed less understanding of or comfort with managing a child's recovery following surgery. A patient-centered qualitative investigative approach yielded insights regarding the importance of various aspects of recovery in pediatric patients, their parents, and members of the health care team. Specifically, this investigation highlighted the importance of clear communication providing anticipatory guidance for families presenting for elective surgery in an effort to optimize patient recovery. This information will be used in the development of a patient-centered recovery assessment tool.

The role of social cognition skills and social determinants of health in predicting symptoms of mental illness

Social factors, such as social cognition skills (SCS) and social determinants of health (SDH), may be vital for mental health, even when compared with classical psycho-physical predictors (demographic, physical, psychiatric, and cognitive factors). Although major risk factors for psychiatric disorders have been previously assessed, the relative weight of SCS and SDH in relation to classical psycho-physical predictors in predicting symptoms of mental disorders remains largely unknown. In this study, we implemented multiple structural equation models (SEM) from a randomized sample assessed in the Colombian National Mental Health Survey of 2015 (CNMHS, n = 2947, females: 1348) to evaluate the role of SCS, SDH, and psycho-physical factors (totaling 17 variables) as predictors of mental illness symptoms (anxiety, depression, and other psychiatric symptoms). Specifically, we assessed the structural equation modeling of (a) SCS (emotion recognition and empathy skills); (b) SDH (including the experience of social adversities and social protective factors); (c) and classical psycho-physical factors, including psychiatric antecedents, physical–somatic factors (chronic diseases), and cognitive factors (executive functioning). Results revealed that the emotion recognition skills, social adverse factors, antecedents of psychiatric disorders and chronic diseases, and cognitive functioning were the best predictors of symptoms of mental illness. Moreover, SCS, particularly emotion recognition skills, and SDH (experiences of social adversities, familial, and social support networks) reached higher predictive values of symptoms than classical psycho-physical factors. Our study provides unprecedented evidence on the impact of social factors in predicting symptoms of mental illness and highlights the relevance of these factors to track early states of disease.

Introduction: European Family Support Network (EuroFam-Net)

Introduction: European Family Support Network (EuroFam-Net)

Foundation Document for the European Family Support Network (EFSN)

Foundation Document for the European Family Support Network (EFSN)

Effects of a peer educator program for HIV status disclosure and health system strengthening: Findings from a clinic-based disclosure support program in Mozambique.

In Mozambique, HIV counseling and testing (HCT) rates are low and the cascade (or continuum) of care is poor. Perhaps more importantly, low disclosure rates and low uptake of joint testing are also related to both (1) limitations on access to services and (2) the availability of trained staff. We describe the implementation and impact of a disclosure support implemented by peer educators (PE). Ten PEs, previously trained in basic HIV and post-test counseling, completed additional training on providing disclosure support for newly-diagnosed persons living with HIV (PLH). Of the 6,092 persons who received HCT, 677 (11.1%) tested positive. Any newly-diagnosed PLH who was tested when PEs were present (606 / 677) was approached about participating in the disclosure program; of these, 94.2% of PLH (n = 574) agreed to participate. Of these, at follow-up (between 1 day and 3 months later, depending on client inclination and availability) 91.9% (n = 528) said that they had disclosed their HIV infection, of whom 66.9% (n = 384) were female and 24.1% (n = 144) male. In turn, 92.7% of partners (n = 508) who had received HIV-related exposure information were tested; of these, 78.7% (n = 400) were found to be HIV-positive. Of the latter, 96.3% (n = 385) were then seen by health care providers and referred for further diagnosis and treatment. Supporting newly-diagnosed PLH is important both for their own health and that of others. For the newly-diagnosed, there are extensive challenges related to understanding the implications of their illness; social support from clinical care teams can be vital in planning and coping. Our study has shown that such support of PLH is also crucial to disclosure, in part via improving awareness of positive health implications for (and from) family, friends and other support networks.

ESTRATÉGIAS NA CONTINUIDADE DO CUIDADO A NEONATOS APÓS A ALTA

Objective: to identify in articles published by nurses in the database, the strategies used in the continuity of nursing care for premature or low-birth weight newborns after hospital discharge. Methodology: study of Integrative Literature Review, with a qualitative approach, the research being carried out in the CINAHL, MEDLINE, MEDICLATINA and SciELO data-bases with the 2009-2017 timeline. The PICo method was used in the elaboration of the research question and in the definition of inclusion criteria for the selection of articles. Results: after analyzing the articles, four themes emerged: Discharge planning; Parents' concerns and difficulties in home care; Strategies for continuity of care after discharge; Family and social support network in the transition of care. Conclusions: home visits is an important and effective strategic component of care after discharge, always including the assessment of the newborn's health status and parental skills. It must be performed in the first week after discharge, by a nurse from the Neonatal Intensive Care Unit, in conjunction with Primary Health Care, maintaining follow-up by telephone contact in the 2nd and 4th weeks. Descriptors: prematurity; hospital discharge; continuity of care; parental training; nursing.