Family Support Networks Research Articles

Aftercare and Institutionalised Children: A Literature Review of International Best Practices and Lessons for SAARC Countries

Aftercare programming is increasingly recognized as a key factor in successful transitions for institutionalized children to interdependent living. Successful Aftercare programs seek to increase key capacities in institutionalized children while providing the necessary duration of time for healthy transitions out of institutionalized care. Life skills, education and employment attainment, attachment, and permanency are all key program focuses developed between the age of majority (18) and discharge from programs. The challenge faced by Aftercare systems and programs is the continued provision of services to young adults within frameworks that seek to create immediate transitions at the age of 18 years. Young adults around the world are transitioning out of traditional familial support networks at an average age of 24 years, with connectivity to permanent supports, while young adults leaving care are expected to achieve immediate independence at the expiry of government mandates for involvement. This paper provides a literature review of international best practices in Aftercare along with a comparative analysis at program successes and gaps within SAARC member countries. This will be achieved through the use of peer-reviewed research, and individual program reviews of successful Aftercare programs.

Modeling satisfaction amongst the elderly in different Chinese urban neighborhoods

Rapidly aging populations constitute a critical issue for researchers and policymakers across the world; the challenges of a shifting demographic structure are particularly pertinent in the case of China. Population control strategies implemented in China in the late 1970s have substantially changed the social and demographic structure of Chinese cities and the traditional role of families in caring for elderly people. To meet the growing needs of elderly residents “aging in place,” age-friendly environments and new types of senior services are required and encouraged. This research examines the satisfaction of seniors in relation to the elderly services and living environments available to them, through empirical studies of six types of neighborhoods in Beijing. Using structural equation modeling (SEM), a satisfaction model under the Person-Environment Fit (P-E Fit) model framework was developed. This model considered the senior respondent's health status, economic attributes, family and social support networks, and neighborhood living environments. Social support was found to be the primary factor affecting satisfaction amongst the urban elderly in Beijing. The research also highlights the need to differentiate between different types of neighborhoods, which can differ significantly in terms of the socio-economic attributes (i.e., family structure, income, and education) of their senior residents. As such, based on the path coefficients revealed by different structural equation models of various neighborhoods, four types of neighborhoods were identified: in Type 1 neighborhoods, the neighborhood environment and the senior services provided by communities were primary factors in elderly satisfaction; in Type 2 neighborhoods, the satisfaction of inhabitants was strongly influenced by personal attributes such as health and income; Type 3 neighborhoods were residence of low-income people where the level of social support was the foremost factor; and in Type 4, social support and the environment were both essential.

Increased longevity in HIV: caring for older HIV-infected adults.

The demographics of the HIV-infected population in the United States have shifted in a way that few would have predicted 30 years ago when the tide of sick and dying patients largely consisted of young men. Effective ART has allowed those infected to live long, productive lives and to grow old with their disease. With the increase in life expectancy afforded by HIV treatment, the cause of death among HIV-infected individuals is far more likely to be from an HIV-associated non-AIDS condition. Nonetheless, HIV seems to accelerate the aging process, and care providers involved in the treatment of older patients with HIV need to be aware that their patients are at increased risk of developing various common disorders, compared to uninfected same-age patients. Clinicians need to remain vigilant to the possibility of a new diagnosis of HIV among their older patients. Awareness of current or distant risk, frank discussions of sexual practices, and willingness to offer routine testing are crucial to making this diagnosis, with the recognition that longevity for patients with HIV is directly linked to how soon they enter care. HIV infection adds another challenge to the management of older patients; geriatricians and HIV specialists need to coordinate their efforts to provide patients with comprehensive multidisciplinary care. Older patients with HIV also have social and psychological needs that extend beyond the medical office. Maintaining independence, acknowledging limitations, reducing risk of adverse events such as falls or medication errors, and supporting self-acceptance and awareness are only a few of the many areas where care providers outside the medical office can be important for patients' ongoing well-being. Accessing family support, community outreach, church affiliation, or other outpatient support networks can be useful for patients. The remarkable change in prognosis brought about by effective ART in the mid-1990s has meant that HIV is now, for many, a manageable chronic illness. Clinicians and other care providers are changing their approach and goals of care as patients with HIV grow old.

An Evolving Identity: How Chronic Care Is Transforming What it Means to Be a Physician.

Physician identity and the professional role physicians play in health care is rapidly evolving. Over 130 million adults and children in the USA have complex and chronic diseases, each of which is shaped by aspects of the patient's social, psychological, and economic status. These patients have lifelong health care needs that require the ongoing care of multiple health care providers, access to community services, and the involvement of patients' family support networks. To date, physician professional identity formation has centered on autonomy, authority, and the ability to "heal." These notions of identity may be counterproductive in chronic disease care, which demands interdependency between physicians, their patients, and teams of multidisciplinary health care providers. Medical educators can prepare trainees for practice in the current health care environment by providing training that legitimizes and reinforces a professional identity that emphasizes this interdependency. This commentary outlines the important challenges related to this change and suggests potential strategies to reframe professional identity to better match the evolving role of physicians today.

Social Support and Social Networks Among the Elderly in Mexico

In Mexico, socioeconomic conditions for the elderly are adverse, and familial and non-familial support networks are one of the most important elements in surviving the lack of income and care needed for the elderly population (Montes de Oca 2001; De Vos et al. in International Journal of Aging and Human Development, 58, 1–27, 2004). Although we highlight the importance of family support towards the elderly, we acknowledge that the elderly provide different forms of support, economic as well as non-economic, to family and non-family members. The aim of this article is to discuss this phenomenon in an attempt to empirically demonstrate the flow of exchanges involving individuals 60 years or older in Mexico. We use the 2005 Encuesta Nacional de la Dinamica Familiar (ENDIFAM; National Family Dynamics Survey) in order to distinguish between supports granted and received among the elderly population. Additionally, we examine variables that measure solidarity among family members and non-family members when facing difficult situations, crises, and everyday difficulties. Thus, we analyze factors that condition the granting and receiving of support among the elderly. Results show that the elderly population is active in a social network that receives and offers social support as a means of maintaining their quality of life. Among the conditioning elements of solidarity, we find that as age increases, the elderly are less likely to grant support. Moreover, results show that women are more likely to receive social support; and, being married or in a civil union increases the likelihood of access to a more extensive support network. Unexpectedly, we found that granting of support in difficult situations occurs in a unidirectional manner. That is, the elderly tend to provide support to others during difficult situations, but are less likely to receive support when facing similar circumstances.

Guerreiras do cárcere: uma rede virtual de apoio aos familiares de pessoas privadas de liberdade

The present paper aims at investigating the roles played by an informal support network for families of incarcerated people. This network is constituted as a group in one of the largest social networks in the world. We selected the posts found in one week in the referred group; these were then grouped in interpretive categories that defi ne the roles usually performed by social support networks, as described in the literature. The data analysis was conducted with the tools provided by Critical Discourse Analysis,

O impacto da hospitalização infantil nas rotinas das famílias monoparentais

This qualitative descriptive study was performed at a pediatric hospitalization unit with the objective to understand the impact of child hospitalization on the daily lives of single parent families. Interviews were conducted with twelve families, represented by the mothers, using a form divided into two parts: construction of the genogram and ecomap and semi-structured questions. Content analysis was used. The results point out that the major factors affecting the everyday lives of single parent families is the dependency on the family support network and the difficulty that both healthcare professionals and institutions have in developing an individualized look at the different family structures when providing their needs. In conclusion, there is a need for thinking and reviewing institutional practices and norms aiming at meeting the true particularities and needs of the everyday lives of today’s families. Descriptors: Single-Parent Family; Child, Hospitalized; Family Nursing.

The experiences of grandparents who have limited or no contact with their grandchildren

Purpose of the studyThe matrilineal advantage theory suggests that paternal grandparents are more at risk of having little or no contact with their grandchildren. However, there is significant family diversity within Australia and we wished to understand the experiences of a wide range of grandparents in order to determine if the matrilineal theory can be effectively used in practice to identify those grandparents most at risk for estrangement. Design and methodsA convenience group of grandparents with little or no contact with grandchildren (n=38) told their stories in their own words using narratives obtained through interview or writing. Results and implicationsWe found that paternal grandparents, as per the matrilineal advantage theory, were more likely to be estranged from their grandchildren when their son divorced, particularly when he was not the resident parent or when he re-partnered. However, in contrast, we found that maternal grandparents who experienced conflict in their relationship with their daughter were also at risk for estrangement. This occurred even when grandparents had previously been highly involved in the lives of their grandchildren. Some estrangements appeared to result from a cultural bias towards the nuclear family form. We argue that practitioners need not only to expand their understanding of the risk categories for estrangement, they also need to actively support parents and grandparents in creating and maintaining wider family support networks in order to improve family resilience.

The prevalence of geriatric problems in the Chilean patient with cancer

Introduction: Chile shows a marked aging of the population and therefore in the future we will be faced with an increasing number of older adults with cancer. Unfortunately in our country is not very currently common the concept of the oncogeriatrics, and only exist two oncology centers in which is usually carried out a comprehensive assessment to the elderly patients. In this scenario to show the high prevalence of vulnerability in the Chilean elderly with cancer and demonstrate the usefulness of the CGA as diagnostic tool, is an essential first step to draw attention to Geriatrics and Oncology societies on a growing problem that involves them directly and eventually lead changes in the public health policies. Objectives: To determine the demographic and clinical characteristics of geriatric patients with cancer through Comprehensive Geriatric Assessment (CGA). Methods: Between July 2011 and May 2013, there was evaluated a random sample of patients of 65 years and older, with recently diagnosed cancer, previous to receive therapy and treated at Cancer Center of the Pontificia Universidad Catolica of Chile. A geriatrician applied the VGA (which included MMSE, MNA, Barthel, Lawton, Charlson, Geriatric depression scale (GDS)), plus Balducci and Rockwood fraiity score, and VES-13. Results: 130 patients patients entered the study. Age average 76 years (66-88).Considered frail 72%, 35% and 58% when assessed by criteria of Balducci, Rockwood and VES-13 respectively. On average, the number of new problems researched was 4 per patient, 52% required assistance with instrumental activities, 22% were dependent in ADL, 52% used inappropriate medications (according to Beers` criteria) 30% had cognitive impairment and 35% met the criteria for depression. 30 % hadmalnutrition. 10 % had an inadequate family support network. 22 % had three or more comorbidities. ECOGwas between 0 and 1 in 85 % of the patients. By comparing these values with a representative sample of Chilean people over 65 years living in the community, it is possible to observe the increased vulnerability of the patient with cancer (Table 1)

Etxadi–Gangoiti scale: a proposal to evaluate the family contexts of two-year-old children†

This paper makes a proposal for the comprehensive assessment of the family context of children aged two years. It offers an updated resource based on recent research into the assessment of family contexts and their influence on children's psychological development. The proposal explores the following areas: Presence of learning materials; Potential for play; Stimulation of cognitive development; Stimulation of language development; Emotional expressiveness; Setting of limits and optimal frustration; Enhancement of self-esteem and autonomy; Observation of mother–child interactions; Father's involvement; Quality of non-parental care; Relations with the extended family and social support network; Stability of the child's social relationships; Relations with the school; Diversity of experiences; Absence of exposure to conflict; Absence of parental stress; and Quality of the physical context. The areas explored are grouped into three blocks: Stimulation of cognitive and linguistic development; Stimulation of socio-emotional development; and Organisation of the social context and physical environment.

Racial and Ethnic Differences in Extended Family, Friendship, Fictive Kin and Congregational Informal Support Networks.

This study examined differences in kin and nonkin networks among African Americans, Caribbean Blacks (Black Caribbeans), and non‐Hispanic Whites. Data are taken from the National Survey of American Life, a nationally representative study of African Americans, Black Caribbeans, and non‐Hispanic Whites. Selected measures of informal support from family, friendship, fictive kin, and congregation/church networks were utilized. African Americans were more involved in congregation networks, whereas non‐Hispanic Whites were more involved in friendship networks. African Americans were more likely to give support to extended family members and to have daily interaction with family members. African Americans and Black Caribbeans had larger fictive kin networks than non‐Hispanic Whites, but non‐Hispanic Whites with fictive kin received support from them more frequently than African Americans and Black Caribbeans. The discussion notes the importance of examining kin and nonkin networks, as well as investigating ethnic differences within the Black American population.

Support for mothers, fathers and families after perinatal death

Provision of an empathetic, sensitive, caring environment and strategies to support mothers, fathers and their families experiencing perinatal death are now an accepted part of maternity services in many countries. Interventions such as psychological support or counselling, or both, have been suggested to improve outcomes for parents and families after perinatal death. To assess the effect of any form of intervention (i.e. medical, nursing, midwifery, social work, psychology, counselling or community-based) on parents and families who experience perinatal death. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (28 January 2013) and article bibliographies. Randomised trials of any form of support aimed at encouraging acceptance of loss, bereavement counselling, or specialised psychotherapy or counselling for mothers, fathers and families experiencing perinatal death. Two review authors independently assessed eligibility of trials. No trials were included. Primary healthcare interventions and a strong family and social support network are invaluable to parents and families around the time a baby dies. However, due to the lack of high-quality randomised trials conducted in this area, the true benefits of currently existing interventions aimed at providing support for mothers, fathers and families experiencing perinatal death is unclear. Further, the currently available evidence around the potential detrimental effects of some interventions (e.g. seeing and holding a deceased baby) remains inconclusive at this point in time. However, some well-designed descriptive studies have shown that, under the right circumstances and guided by compassionate, sensitive, experienced staff, parents' experiences of seeing and holding their deceased baby is often very positive. The sensitive nature of this topic and small sample sizes, make it difficult to develop rigorous clinical trials. Hence, other research designs may further inform practice in this area. Where justified, methodologically rigorous trials are needed. However, methodologically rigorous trials should be considered comparing different approaches to support.

Family and friendship support networks among retirees

PurposeThe purpose of this paper is to provide an empirical analysis of factors that affect support networks among retirees in 13 countries.Design/methodology/approachIt examines two propositions drawing from support network theory and the classification of countries by welfare systems. It uses fixed‐effect causal models to examine how retirement and socio‐demographic variables influence kinship and friendship support networks. Data are drawn from the Social Relations and Support Systems module of the International Social Survey Programme 2001.FindingsThe results show that retirees' friendship‐based support networks are almost one‐third smaller than those of working persons. Furthermore, this difference is greater in welfare systems that spend more on social well‐being.Research limitations/implicationsHowever, the relationship between informal support networks and welfare systems is complex, which indicates a need to further the debate on the co‐existence of formal and informal aid systems.Originality/valueThis study's main sociological confirmation is that the relationship between the size of support networks and the type of welfare system is irregular and complex. The results make a significant contribution to the debate on the relationship between formal and informal care among a group of people during a critical life‐cycle phase, such as retirement.

Where Are All the Ecomasculinists in Mining?

Where Are All the Ecomasculinists in Mining?

2705 – Cultural issues in the prevention and treatment of perinatal disorders

The birth of a child is a crucial event in the woman life, generally is a moment of joy and fulfillment, but instead often experienced by new mother with concern, fear and anxiety. The psychological vulnerability of women during the postnatal period is commonly referred to a “postpartum depression”, a term that is actually referred to a cluster of symptoms with a very different clinical level, severity and duration. If a network of family and social support, which is active in caring for new mothers and newborns, is usual for the European women, for the migrant woman in most cases this support is totally lacking. The absence of a social support, with economic and housing precariousness, frequently brings foreign women into a particular vulnerability situation, with an increased risk for the development of postnatal depression. Many studies clearly show an increased postpartum depression risk for migrant women than for women living in their country of origin.

Social networking in support of child development according to the family health team

Objective: To identify the social support networks for families for the promotion of child development from the perspective of the Family Health Strategy team. Methods: Qualitative, descriptive research. The subjects were twelve health professionals, three from each of the professional categories working in the health centers studied (nurse, doctor, auxiliary nurse, and community health worker). The data was collected through semi-structured interviews, and analyzed through thematic categorical analysis. Results: The results evidenced three empirical categories: Elements of the social support network; Functions of support for the families; Difficulties and gaps in the social support network for the families. Conclusion: It is considered that the social networks have an important role in the linking of the families, strengthening their potential for healthy child development. It is recommended that health professionals should articulate actions capable of influencing these elements, soas to promote appropriate child development.

Geographical access to treatment for sex offenders under community supervision in Kentucky

As sex offenders are probated or paroled into the community, sex offender treatment and monitoring is often a condition of their release. In Kentucky, sex offenders are required to participate in community-based treatment for two years or more. However, some sex offenders are disadvantaged in accessing mandated treatment. This is a result of decisions concerning the placement of treatment programmes, the sex offenders' preference to return to communities where they can rely on family and other indigenous support networks, and some statutes (e.g. sex offender registration and residency restriction laws). This study utilises spatial methodologies, including an origin–destination (OD) matrix, to determine the time, in minutes, that sex offenders travel to sex offender treatment providers and non-spatial ordinary least squares (OLS) regression techniques to determine the association between family, neighbourhood and community characteristics on sex offenders’ travel time to treatment. Findings suggest that there is substantial disadvantage in treatment access, measured by travel time, for sex offenders who live in impoverished rural communities.

Family and social aspects associated with depression among older persons in a Chinese context

This study aims to explore the factors associated with depression among older persons in Macau, in relation to family and social aspects. Depression among community-dwelling older persons in Macau has been shown to be present at high rates. In Chinese culture, depression leads to social stigmatisation, suggesting a need to better understand depression as a sociocultural phenomenon. A mixed methods study was undertaken to identify the key influences on depression among Chinese older persons in Macau. Quantitative (standardised tests) and qualitative (collection of narratives) data were collected from 31 purposively selected participants, all community-dwelling older persons with depression. Depression was common among the participants. The paper reports on the family and social aspects, one of the findings of the study. Informants readily described their thoughts and judgements of themselves in graphic language. As they explored their life stories, family and social aspects emerged as significant influences that associated with depression. In a society and culture that relies on and values filial support, experiences of being widowed, having poor family support and weak social networks appeared to compound and exacerbate depression. These findings highlight that filial support, valued in Chinese culture, is seriously strained by the realities of contemporary society. Yet current government policies rely on and confirm the role of family support. Findings from this study suggest a need for such policies to be reviewed to address the realities of family and social support. The findings have several implications for clinical practice. Firstly, the cultural context of Chinese older persons should be considered and emphasised in nursing practice. Secondly, the root of depression among Chinese older persons is seen to lie in their social, family, cultural and day-to-day living issues.

Social support differentially moderates the impact of neuroticism and extraversion on mental wellbeing among community-dwelling older adults

BackgroundPersonality affects psychological wellbeing, and social support networks may mediate this effect. This may be particularly pertinent in later life, when social structures change significantly, and can lead to a decline in psychological wellbeing.AimTo examine, in an older population, whether the relationships between neuroticism and extraversion and mental wellbeing are moderated by available social support networks.MethodWe gathered information from 536 community-dwelling older adults, regarding personality, social support networks, depressive symptomatology, anxiety and perceived stress, as well as controlling for age and gender.ResultsNeuroticism and extraversion interacted with social support networks to determine psychological wellbeing (depression, stress and anxiety). High scores on the social support networks measure appear to be protective against the deleterious effects of high scores on the neuroticism scale on psychological wellbeing. Meanwhile, individuals high in extraversion appear to require large social support networks in order to maintain psychological wellbeing.ConclusionLarge familial and friendship social support networks are associated with good psychological wellbeing. To optimise psychological wellbeing in older adults, improving social support networks may be differentially effective for different personality types.

Strategic approaches to enhanced health service delivery for Aboriginal and Torres Strait Islander people with chronic illness: a qualitative study.

BackgroundAboriginal and Torres Strait Islander people with chronic illness confront multiple challenges that contribute to their poor health outcomes, and to the health disparities that exist in Australian society. This study aimed to identify barriers and facilitators to care and support for Aboriginal and Torres Strait Islander people with chronic illness.MethodsFace-to-face in-depth interviews were conducted with Aboriginal and Torres Strait Islander people with diabetes, chronic heart failure or chronic obstructive pulmonary disease (n-16) and family carers (n = 3). Interviews were transcribed verbatim and the transcripts were analysed using content analysis. Recurrent themes were identified and these were used to inform the key findings of the study.ResultsParticipants reported both negative and positive influences that affected their health and well-being. Among the negative influences, they identified poor access to culturally appropriate health services, dislocation from cultural support systems, exposure to racism, poor communication with health care professionals and economic hardship. As a counter to these, participants pointed to cultural and traditional knowledge as well as insights from their own experiences. Participants said that while they often felt overwhelmed and confused by the burden of chronic illness, they drew strength from being part of an Aboriginal community, having regular and ongoing access to primary health care, and being well-connected to a supportive family network. Within this context, elders played an important role in increasing people’s awareness of the impact of chronic illness on people and communities.ConclusionsOur study indicated that non-Indigenous health services struggled to meet the needs of Aboriginal and Torres Strait Islander people with chronic illness. To address their complex needs, health services could gain considerably by recognising that Aboriginal and Torres Strait Islander patients have a wealth of cultural knowledge at their disposal. Strategies to ensure that this knowledge is integrated into care and support programs for Aboriginal and Torres Strait Islander people with chronic illness should achieve major improvements.