Female Primary Caregivers Research Articles

The association between caregiver substance abuse and self-reported violence exposure among young urban children

This study examined the relative importance of caregiver substance abuse as a correlate of child-reported exposure to violence. A total of 407 female African-American primary caregivers and their children age 6 to 7 were evaluated. The association between child report of violence and exposure to substance abuse by others (both within and outside the home) was considered after controlling for variance accounted for by child characteristics, caregiver characteristics, home environment, and neighborhood environment (including neighborhood crime). Caregiver alcohol abuse, children's witnessing of drug use in the home, and children's witnessing of drug deals all explained significant additional variance in violence exposure. These findings suggest that for early elementary-age children, meaningful prevention of violence exposure may be possible via addressing their exposure to substance abuse in their home and community.

Barriers to physical activityQualitative data on caregiver–daughter perceptions and practices

<h3>Background</h3> There is little research on household and physical environment barriers to physical activity, particularly in minority populations at high risk for obesity and inactivity. Few studies include data on caregiver and daughter dyads. Formative data were used to develop intervention strategies and pathways for the <i>Girls Rule!</i> obesity prevention intervention, in under-studied high-risk pre-adolescents. <h3>Methods</h3> Participants included 12 African-American girls (mean age 7.8 years) and their 11 primary female caregivers (mean age 41.8 years)—eight mother–daughter dyads and three grandmother–granddaughter dyads—for a total of 51 interviews across 23 participants interviewed from April to October 2000.A qualitative approach was used for 51 semistructured in-depth interviews with 11 dyads (female caregiver and girl), consisting of up to three interviews per respondent (mean=2.4 interviews per respondent). Interviews were transcribed, coded, and systematically analyzed between January 2002 and January 2003 to identify recurrent patterns and themes related to physical activity. <h3>Results</h3> Findings indicate clear preference of the girls for sedentary, rather than active, behaviors. Caregivers were unaware of the amount of TV viewed and found positive benefits of TV viewing, including safe supervision of their daughters. Barriers to physical activity include perceived lack of affordable and accessible recreation facilities and low caregiver motivation. Potential intervention strategies identified by respondents include walking for exercise and transportation and several low-cost, favored physical activities, such as hopscotch, jumping rope, and dance. <h3>Conclusions</h3> These findings point toward several physical activity and obesity intervention strategies that can guide obesity prevention efforts.

Barriers to physical activity: Qualitative data on caregiver–daughter perceptions and practices

There is little research on household and physical environment barriers to physical activity, particularly in minority populations at high risk for obesity and inactivity. Few studies include data on caregiver and daughter dyads. Formative data were used to develop intervention strategies and pathways for the Girls Rule! obesity prevention intervention, in under-studied high-risk pre-adolescents. Participants included 12 African-American girls (mean age 7.8 years) and their 11 primary female caregivers (mean age 41.8 years)--eight mother-daughter dyads and three grandmother-granddaughter dyads--for a total of 51 interviews across 23 participants interviewed from April to October 2000.A qualitative approach was used for 51 semistructured in-depth interviews with 11 dyads (female caregiver and girl), consisting of up to three interviews per respondent (mean=2.4 interviews per respondent). Interviews were transcribed, coded, and systematically analyzed between January 2002 and January 2003 to identify recurrent patterns and themes related to physical activity. Findings indicate clear preference of the girls for sedentary, rather than active, behaviors. Caregivers were unaware of the amount of TV viewed and found positive benefits of TV viewing, including safe supervision of their daughters. Barriers to physical activity include perceived lack of affordable and accessible recreation facilities and low caregiver motivation. Potential intervention strategies identified by respondents include walking for exercise and transportation and several low-cost, favored physical activities, such as hopscotch, jumping rope, and dance. These findings point toward several physical activity and obesity intervention strategies that can guide obesity prevention efforts.

Factors influencing health promoting activities of mothers caring for ventilator-assisted children

The extensive care a ventilator-assisted child (VAC) requires when cared for in the home can impact the mother’s ability to participate in health promotion activities. The purpose of this study was to examine health promotion activities and the relationships among functional status of the child, impact of the illness on the family, coping, social support, and health promotion activities of mothers who care for ventilator-assisted children at home. Thirty-eight primary female caregivers, mostly mothers, participated in the study and completed the Personal Lifestyle Questionnaire (PLQ), measures of child’s functional status, impact of the illness on the family, coping, social support, and demographic data. Findings revealed that the mothers scored low on the nutrition, exercise, relaxation, and general health promotion subscales of the PLQ. Functional status of the child and coping were positively correlated with participation in health promotion activities, whereas impact of the child’s illness on the family was inversely related to health promotion of the mothers. Regression analysis revealed that functional status of the child and coping were significant predictors of mothers’ participation in health promotion activities. The high demands associated with caring for a VAC with poor functioning can be a significant risk factor for not participating in health promotion activities. Nurses need to help mothers with coping and finding resources to help mediate the stress related to caring for their child, thereby helping the mothers to maintain their own health.

The role of caregiver gender and caregiver burden in nursing home placements for elderly Taiwanese survivors of stroke.

The role of caregiver gender in caregiver burden and the association between the level of caregiver burden and institutionalization of elderly stroke survivors in Taiwan were explored using a correlational, descriptive design. The convenience sample was composed of 78 male and 69 female primary caregivers of stroke survivors. Simple multiple regression and t tests were used to test the research questions. Women perceived caregiving as more burdensome than men did. Caregiver burden was most strongly associated with the characteristics of the care recipients and with institutionalization. The proposed model explained 45% and 28% of the variance in caregiver burden for male and female caregivers, respectively. It is recommended that the professional nursing role in Taiwan be expanded to include postdischarge care, respite, and home-care services to allow families to keep their elderly at home as long as possible and to provide culturally sensitive care to families that might be traumatized by having to violate ethnic Chinese cultural norms by institutionalizing family members.

Low back pain in adult female caregivers of children with physical disabilities.

Low back pain (LBP) in occupational settings has been studied extensively. There are fewer studies on LBP in domestic settings, especially in an informal caregiving setting. To compare the prevalence of LBP in adult female primary caregivers of children with physical disabilities who need assistance with transfers (eg, moving from a bed to a wheelchair) with the prevalence of LBP in adult female primary caregivers of children with nondisabling medical illnesses and to evaluate the factors associated with LBP. A 15-minute, self-administered, cross-sectional survey. University-based clinics. Subjects Ninety consecutive adult female caregivers of children presenting to a pediatric physical medicine and rehabilitation clinic and 23 consecutive adult female caregivers of children presenting to a pediatric endocrine clinic were studied. General exclusionary criteria included the following: male sex, a history of back surgery or fracture, the caregiver was younger than 18 years old at the time of the completion of the questionnaire, or the caregiver was caring for any child younger than 2 years old. Caregivers visiting the pediatric endocrine clinic were excluded if they were caring for 1 or more children needing assistance with transfers. The dependent variable was the presence of LBP. The independent variables were mood, work status, amount of lifting at work, physical functioning of the child, demographic variables of the caregiver, and demographic variables of the child. The prevalence of having LBP (71.1%) in the physical medicine and rehabilitation group is higher than the prevalence (43.5%) in the endocrine clinic group (odds ratio, 3.2; 95% confidence interval, 1.25-8.21). The prevalence of having LBP (80.3%) when the child required physical assistance with transfers was significantly higher than the prevalence (40.5%) when the child did not require physical assistance with transfers (odds ratio, 2.56; 95% confidence interval, 2.56-14.0). Forward multiple logistic regression showed that the factors related to LBP in the caregiver were the transferability of the child, mood of the caregiver, and a history of LBP in the caregiver. The prevalence of LBP is higher in caregivers of children needing assistance with transfers. This increased prevalence is associated with the transferability of the child and mood of the caregiver. Results of this study suggest that physical and psychological factors both contribute to the presence of nonoccupational LBP.

Emotional neglect and family structure: impact on student functioning

Objective: The goal of this study was to demonstrate the relationship between retrospective reports of child neglect, family of origin functioning, and current psychological distress. It was hypothesized that experience of childhood emotional neglect would be associated with lower levels of cohesion and adaptability in participants’ family of origin and greater levels of current psychological distress. Gender effects were explored. Method: Retrospective reports of emotional neglect in childhood were quantified by use of a parental bonding measure, specifically by assessing level of perceived parental care. Participants were assigned to one of three groups based on level of care scores: neglect by a primary male caregiver, neglect by a primary female caregiver, and no neglect. These groups were compared on three variables: current psychological functioning, retrospective report of family of origin adaptability, and retrospective report of family of origin cohesiveness. Amount of time left in the care of others was used as a covariate based on attachment theory literature. Results: Data were analyzed for 69 female and 22 male undergraduate students. Participants who reported a childhood experience of emotional neglect by a primary female caregiver described greater current psychological distress than those reporting no neglect or neglect by a primary male caregiver. Participants who experienced emotional neglect by a primary female caregiver, as compared to those reporting emotional neglect by a primary male caregiver and those reporting no neglect, described lower cohesion and adaptability in their family of origin. There were no differences between male and female participants in terms of impact of emotional neglect. Conclusions: This study suggests potential caregiver gender effects, regardless of respondent gender. Perceived neglect by female, but not male caregivers, led to psychological distress in adulthood and was associated with lower cohesion and adaptability in one’s family of origin. Future research should attempt to account for the participants’ expectations regarding male and female caregiver roles.

Representation of the gender of human faces by infants: a preference for female.

Six experiments based on visual preference procedures were conducted to examine gender categorization of female versus male faces by infants aged 3 to 4 months. In experiment 1, infants familiarized with male faces preferred a female face over a novel male face, but infants familiarized with female faces divided their attention between a male face and a novel female face. Experiment 2 demonstrated that these asymmetrical categorization results were likely due to a spontaneous preference for females. Experiments 3 and 4 showed that the preference for females was based on processing of the internal facial features in their upright orientation, and not the result of external hair cues or higher-contrast internal facial features. While experiments 1 through 4 were conducted with infants reared with female primary caregivers, experiment 5 provided evidence that infants reared with male primary caregivers tend to show a spontaneous preference for males. Experiment 6 showed that infants reared with female primary caregivers displayed recognition memory for individual females, but not males. These results suggest that representation of information about human faces by young infants may be influenced by the gender of the primary caregiver.

Informal costs of dementia care: estimates from the National Longitudinal Caregiver Study.

The purpose of the study was to examine on a national level the informal costs of caring for elderly community-dwelling male veterans with dementia by female caregivers and the relationships between informal costs and disease severity, and between informal costs and dementia problem behaviors. Female primary caregivers were drawn from the first wave (N = 2043) of the National Longitudinal Caregiver Study, a survey of informal caregivers of elderly male veterans diagnosed with probable Alzheimer's disease or vascular dementia. Cost measures include the following four items: value of caregiving time, caregiver's lost income, out-of-pocket expenditures for formal caregiving services, and caregiver's excess health costs. Disease severity was indexed by the number of impairments in activities of daily living. Patient's problem behaviors were measured using the Behavior Rating Scale-Dementia. The annual cost of providing informal care to elderly community-dwelling veterans with dementia was estimated to be $18,385 per patient in 1998. The larger components of this cost are caregiving time ($6,295) and caregiver's lost earnings ($10,709). All aspects of costs increase with disease severity and problem behavior. Most of this cost increase derives from the increased caregiving time required for the provision of physical care. This study provides a comprehensive estimate of the excess costs that result from providing informal dementia care in the community. Unlike previous studies, our estimates excluded costs that caregivers would have incurred if they had not been caregivers. Therefore, results reported here reflect only costs due to informal dementia care.

Impact of Caregiver-Receiver Relationship Quality on Burden and Satisfaction

ABSTRACT The purpose of this study was to investigate, through an interview process, both the burden and satisfaction of the caregiving relationship between female primary caregivers and female care-receivers living in the same home. The ten cases were families involved in a caregiver/care-receiver shared-residence situation of at least one year's duration. The primary method of data collection was semi-structured interviews. The results of the qualitative approach called for a reversal of perspective. The intent was to examine how burden and satisfaction impacted the caregiver-receiver relationship quality. However, it was the quality of the relationship between the caregiver and care-receiver which distinguished low burden and high satisfaction.

The impact of female caregivers' employment status on patterns of formal and informal eldercare.

This article uses data from the 1989 National Long-Term Care Survey and its companion Informal Caregivers Survey to investigate how the employment of female primary caregivers (FPCGs) affects hours of care received by disabled elderly care recipients (CRs). Multivariage analyses controlling for key FPCG and CR characteristics indicate that when FPCGs are employed they provide significantly fewer hours of care personally; however, their CRs also receive significantly more hours of help from other sources. When FPCGs work more than 17 hours per week, their CRs receive significantly fewer total weekly hours of care than would otherwise be the case.

Normative sexual behavior in children: a contemporary sample.

Sexual behavior in children can cause uncertainty in the clinician because of the relationship between sexual abuse and sexual behavior. Consequently, it is important to understand normative childhood sexual behavior. Sexual behavior in 1114 2- to 12-year-old children was rated by primary female caregivers. These children were screened for the absence of sexual abuse. A 38-item scale assessing a broad range of sexual behavior (Child Sexual Behavior Inventory, Third Version) was administered along with the Child Behavior Checklist and a questionnaire assessing family stress, family sexuality, social maturity of the child, maternal attitudes regarding child sexuality, and hours in day care. Sexual behavior was related to the child's age, maternal education, family sexuality, family stress, family violence, and hours/week in day care. Frequencies of sexual behaviors for 2- to 5-, 6- to 9-, and 10- to 12-year-old boys and girls are presented. A broad range of sexual behaviors are exhibited by children who there is no reason to believe have been sexually abused. Their relative frequency is similar to two earlier studies, and this reinforces the validity of these results.

'I often think I wish he were here' Why do primary carers institutionalise family members with dementia?

While the topic of why family carers institutionalise persons with dementia has received much publicity in the overseas literature, little is known in Australia about this issue and about the processes involved in the permanent placement of a relative with dementia in a nursing home. This paper reports on the experiences of 39 female primary caregivers (24 wives, 12 daughters and three others) who recently institutionalised their family member. The sample was recruited from a Brisbane metropolitan population and interviewed in depth about a wide range of issues pertaining to home versus institutional care. Factors explored included the service needs and service uses of primary caregivers in the period leading up to the placement, the placement procedure itself including the role of wait-lists and the extent to which carers perceived they had a choice in the selection of the long term care facility. The data show that decisions to institutionalise are not made easily and are generally only arrived at after a range of other alternative care plans are exhausted. Findings from the research are discussed against the background of current community care policy for the aged with dementia in Australia.

Gender roles and caregiving stress: An examination of subjective appraisals of specific primary stressors in Alzheimer's caregivers

Family caregivers of patients with dementia face numerous, severe stressors in the course of caring for their relatives. While women are more likely than men to take on the caregiving role, evidence is mixed concerning how traditional gender roles influence response to caregiving. In the present study, male (n with Alzheimer's disease reported on their appraisals of the subjective stressfulness of 44 common primary caregiving stressors, including patient memory and behavior problems and self-care deficits. Male and female caregivers did not differ in length of caregiving service or hours per week spent in caring for their relatives, and there were no differences in terms of overall impairment in patients cared for by males and females. Males and females showed no differences in their stressfulness appraisals of any of the 44 primary caregiving stressors. Memory and self-care deficits, while relatively common, were rated as less stressful by male and female caregivers than behavioral problems. It appears that in the context of caregiving in Alzheimer's disease, gender roles may be less important than the nature of the stressor in determining reaction to primary stressors. Interventions to alleviate caregiver distress should target behavioral problems, such as dangerous behavior and agitation, which are most stressful to caregivers. =67) and female (n=130) primary caregivers of patients

Typologies of caregiving families: family congruence and individual well-being.

Data from 252 female primary caregivers, their husbands, and children living in multigenerational households were used to create family typologies based on the extent of similarity among reports of elder behaviors. Analysis of variance indicates that families characterized by high agreement and those characterized by low agreement were significantly different from one another on a number of dimensions. When the relationship between caregiver-reported stressors and mental health was examined as a function of family typology, results indicate that for high agreement families there were significant correlations between the caregiver's report of the elder's behaviors and her burden; satisfaction with caregiving; relationships with her husband, child, and elder; and depression. Similar relationships characterize data reported by husbands and children in high agreement families. For families characterized by low agreement, the majority of these relationships were not significant.

Mood regulation expectancies, coping responses, depression, and sense of burden in female caregivers of Alzheimer's patients.

This study focused on the role of generalized expectancies for negative mood regulation in coping among caregivers to Alzheimer's disease patients. Self-report measures were used to obtain information on expectancies, hassles, coping strategies, depressive symptoms, and sense of burden from 73 female primary caregivers in support groups. Stronger expectancies for negative mood regulation were associated with less severe depressive symptoms, even with stress levels and coping responses controlled. These expectancies were also associated with less avoidant coping, but were unrelated to active coping. Burden and depressive symptoms were strongly related, but correlated differently with other variables.

Models for Female Loyalty: The Biblical Ruth in Jeanette Winterson's Oranges Are Not the Only Fruit

Literary models of development, from simple fairy tales such as Snow White to complex bildungsromans such as Joyce's A Portrait of the Artist as a Young Man, generally posit physical and/or emotional separation from home and family as a necessary step in the process of maturation. For conventional stories of male development (the paradigmatic Bildungsroman as established by Goethe), such models play out the dynamics of the oedipal phase; the male infant recognizes physiological differences be? tween himself and a female primary caregiver and learns to define his gender and identity in terms of that opposition. Leaving home simply re? peats this process for the adolescent. However, as psychologists from Sig? mund Freud to Carol Gilligan have been telling us, the process is not so simple for the female child. Not only does the female infant experience less physiological difference, but connection to home and family generally remain much more important to the girl during and after adolescence. In an effort to stay connected to their families, adolescent girls frequently resort to what Gilligan terms the voice option, meaning that, instead of leaving, they speak out to express their dissatisfaction with the family while still preserving the relationship.1 In other words, girls narrate their concerns precisely so that those concerns will not destroy the familial relationship. Traditional stories of maturation, with their emphasis on an exit solu? tion, cannot speak to the need for connection within female development, nor can they provide a literary model for its occurrence in fiction. Yet. as critics often warn, many alternative models for female development in? stead advocate passivity and patience, encouraging Sleeping Beauty or Rapunzel merely to await her rescuing prince and thus not to seek agency or maturity on her own.2 More significantly, such models often posit the relationship between women?particularly mother and daughter?as one of competition, not companionship. While obviously such paradigms are

‘I THINK HE MIGHT HAVE HIT ME ONCE’: AGGRESSION TOWARDS CAREGIVERS IN DEMENTIA CARE

ABSTRACTLittle is known about aggression in caregiving relationships in the Australian context, although the topic has received considerable attention in recent overseas literature. This paper reports on a sample of 39 female primary caregivers recruited from the Brisbane metropolitan area and interviewed about a range of aggressive acts directed against them by dementing dependents, while they were providing care in the community. Results show that aggression against caregivers was reported in 89 per cent of cases. Serious violence was experienced by 26 per cent of the sample. In order to provide a coordinated policy an intersectoral approach may be useful.

The Mother as Container: Placental Process and Inner Space

An unconscious paradigm informing psychosocial structuring of mothers is explored: the initial placental interchange of nutrients and waste between pregnant woman and foetus, serves as metaphor/model for postnatal interaction, when a mother contains and metabolizes her preverbal infant `s unbearable anxieties, returning them in tolerable form. Unconscious conflation of placental process with maternal functioning perpetuates female primary care, privileging biological mothers. On a societal level, unconscious residues of universal early transactions with female primary caregivers, promote women as nurturing/waste-disposing `placental containers'. This projection has wider cultural manifestations in the simultaneous idealization of mothers and devaluation of both women and maternal function. Creative inner space, attainable by internalizing the primary caregiver-as-container is confounded with female procreative space resulting in women being exploited as repositories for containment of male cultural productivity and waste.