The Chinese experience of male infertility.

The purpose of this study was to describe the lived experiences of Chinese men who were diagnosed as infertile. Thirty men who had experienced infertility were interviewed in or near the clinic of a large general teaching hospital located in Taiwan. The interviews were analyzed using content analysis. Five categories were generated from the interview data: emotional response after hearing the diagnosis; seeking possible explanations for the diagnosis; using alternative treatments other than those of Western medicine; stressfrom the discovery of the infertility secret by family, relatives, and friends; and grief for discontinuation of the family heritage. Men in this study described infertility as a frustrating and stressful experience. Findings from this study can add to the knowledge base on infertility and contribute to recommendations for improving the ways that health professionals guide, counsel, and support men who are infertile.     

The myth of the replacement child: parents' stories and practices after perinatal death

Parents bereaved by perinatal death adapt to their losses in different ways. When bereaved parents give birth to a child or children subsequent to a perinatal death, their constructions of the family necessarily change. The subsequent child is thought to be at risk of psychopathology (the replacement child syndrome) if parents have not sufficiently grieved their losses. This qualitative interview study examines the family stories told by bereaved parents, with particular attention to how parents represent the dead child and subsequent children in the current family structure. We categorized parents' stories as those which suggested that parents replaced the loss by an emphasis on parenting subsequent children, or maintained a connection to the dead child through storytelling and ritual behavior. The two ways in which parents maintained the connection were to preserve the space in the family that the dead child would have inhabited, or to create an on-going relationship with the dead child for themselves and their subsequent children. There seem to be multiple paths to parenting through bereavement. The place of rituals and memorial behavior is also examined.     

THE MYTH OF THE REPLACEMENT CHILD: PARENTS' STORIES AND PRACTICES AFTER PERINATAL DEATH

Parents bereaved by perinatal death adapt to their losses in different ways. When bereaved parents give birth to a child or children subsequent to a perinatal death, their constructions of the family necessarily change. The subsequent child is thought to be at risk of psychopathology (the replacement child syndrome) if parents have not sufficiently grieved their losses. This qualitative interview study examines the family stories told by bereaved parents, with particular attention to how parents represent the dead child and subsequent children in the current family structure. We categorized parents' stories as those which suggested that parents replaced the loss by an emphasis on parenting subsequent children, or maintained a connection to the dead child through storytelling and ritual behavior. The two ways in which parents maintained the connection were to preserve the space in the family that the dead child would have inhabited, or to create an on-going relationship with the dead child for themselves and their subsequent children. There seem to be multiple paths to parenting through bereavement. The place of rituals and memorial behavior is also examined.     

Evaluating a support group for perinatal loss

PURPOSE: This study attempted to determine if a support group intervention makes a difference in grief reactions of parents who have experienced a perinatal loss, and describes what parents perceived as being helpful and not helpful in handling the loss. DESIGN: A cross-sectional, retrospective, two-group research design was used. The independent variable was having attended or not having attended a perinatal loss support group. METHODS: A convenience sample of 121 participants (n = 67 in support groups; n = 51 not in support groups) was obtained from a mail survey to families who were on a perinatal loss support newsletter mailing list. The participants completed the Hogan Grief Reactions Checklist and a demographic questionnaire. RESULTS: There were no statistically significant differences in parents' grief reaction scores between the two groups, but there were some differences in grief scores by gender and ethnicity. In both groups, the parents perceived their spouse, their extended families, and their friends as "most helpful." Physicians were perceived as "least helpful." CLINICAL IMPLICATIONS: Grief is very individual, and not all individuals may benefit from a support group. When suggesting a support group or any intervention, timing and a caring approach are essential.     

The resources of parents with a child in psychiatric inpatient care

The purpose of this study was to analyse and describe the resources of parents with a child in psychiatric inpatient care. The factors associated with parental coping were also assessed. The data were collected from 19 hospitals with a child psychiatry unit. At the time of data collection, all the parents of the children in psychiatric inpatient care in these hospitals were invited to participate in the study (N = 268). The method of data collection was a questionnaire including open-ended questions. The response percentage was 30% (N = 79). The data were analysed using SPSS software. The replies to the open-ended questions were analysed utilizing data-based content analysis. The findings indicated that the parents received more emotional than instrumental support. Few got financial support. The parents got support from their spouses, families, friends and fellow-workers and the health care personnel. Nearly half of the parents wanted more support from health care personnel. Of the different kinds of social support reported, emotional support, support in the care and rearing of the child in inpatient care, love and acceptance correlated most strongly with parental coping.     

Parents' experiences of living through their child's suffering from and surviving severe meningococcal disease

The aim of this study was to describe the lived experience of parents whose child had suffered from and survived severe meningococcal disease. A Heideggerian phenomenological approach was used within the study and data were collected from long focused interviews. In total, eight parents took part in the study; one was a woman recruited as a pilot interview and the other seven were recruited for the main study. The data were analysed using Colaizzi's (1978) method. Eleven themes emerged: (1) complications/side effects; (2) emotional turmoil; (3) child's physical appearance; (4) family disruption; (5) fear of death; (6) loss of parenting role; (7) need for support and understanding; (8) need and value of communication, information and publicity; (9) parental intuition; (10) technological interventions and (11) the impact of care delivery. A review of the literature arising out of the data was undertaken, and a final synthesis statement as perceived by the parents was achieved. Living through this experience is perceived as a major emotional stressor, and although health professionals have some insight into the experience, they are largely naive to the enormity of the situation.     

Parent perceptions of the psychological functioning of their children diagnosed with pediatric motility disorders and that of family members.

The aim of our study was to characterize the parental perceptions of the behavioral and emotional functioning of their children and families coping with gastrointestinal motility disorders. The American Pseudo-obstruction and Hirschsprung's disease Society sponsored an educational meeting for parents of children afflicted with a variety of pediatric gastrointestinal motility disorders. During the conference, parents completed a questionnaire pertaining to the behavioral and emotional functioning of the afflicted child and other family members. Parents perceived that the child's illness was more difficult on the parents than on the affected child or their siblings. Also, parents perceived support from professionals, family, and friends increased after the children were diagnosed with pediatric gastrointestinal motility disorders. Parents worried most about the health and medical management of their afflicted child. The most common behavioral problem of the afflicted children was fear of separation, whereas the most common behavioral problem of their siblings was jealousy. The majority of referrals to mental health professionals resulted from parental emotional problems or marital discord.     

Life after breast cancer: Australian women's stories of support

Quality support is crucial to the care of women diagnosed with breast cancer. Little qualitative research has been conducted in this area. Semi-structured interviews were conducted with six women in New South Wales, Australia, to explore their experiences of breast cancer. Specifically the study focused on the support the women felt they needed at different times during their illness experience, how this was given and by whom. The qualitative data from the interviews supported previous research in that the diagnosis of breast cancer was devastating. Their primary source of support was family and friends with their surgeon and general practitioner providing some support. Overall the women felt they received physical support. However, emotional support was lacking, especially from nurses.     

Needs,expectations and consequences for children growing up in a family where the parent has a mental illness

The lack of pan–European guidelines for empowering children of parents with mental illness led to the EU project CAMILLE – Empowerment of Children and Adolescents of Mentally Ill Parents through Training of Professionals working with children and adolescents. The aim of this initial task in the project was to analyse needs, expectations and consequences for children with respect to living with a parent with mental illness from the perspective of professionals and family members. This qualitative research was conducted in England, Finland, Germany, Italy, Norway, Poland and Scotland with 96 professionals, parents with mental illness, adult children and partners of parents with mental illness. A framework analysis method was used. Results of the study highlighted that the main consequences described for children of parental mental illness were role reversal; emotional and behavioural problems; lack of parent's attention and stigma. The main needs of these children were described as emotional support, security and multidisciplinary help. Implications for practice are that professionals working with parents with mental illness should be aware of the specific consequences for the children and encourage parents in their parental role; multi‐agency collaboration is necessary; schools should provide counselling and prevent stigma.     

恶性淋巴瘤患儿家属心理历程的质性研究

目的了解恶性淋巴瘤患儿的家属在陪伴子女诊断、治疗、康复过程中的真实心理感受，为临床护理人员对患儿家属进行心理支持提供借鉴。方法通过访谈形式，访问了6位恶性淋巴瘤患儿的家属，将获得的资料进行分析，整理，提出主题。结果患儿的家属在子女患有恶性肿瘤过程中承受着巨大的心理压力和经济压力，表现过程为初诊时的震惊、困惑、拒绝，逐渐转变成无奈接受，对未来持悲观心理。支持系统主要来自家人以及其他恶性淋巴瘤患儿家属。结论恶性淋巴瘤患儿家属需要深切人文关怀和情感支持，护理人员应采取个性化的护理措施，帮助、指导患儿及其家属提高生活质量，度过这一艰辛历程。     

Vigilance: the experience of parents staying at the bedside of hospitalized children

Although the incorporation of a family-centered model of care delivery and open visitation policies have supported parents at the bedside of hospitalized children, little research has been conducted exploring the daily experience of vigilant parents. The purpose of this qualitative ethnographic study was to explore the experience of vigilance and specifically to examine the meaning, patterns, and day-to-day rhythms of parents who stay at the bedside of their hospitalized children. Ten parents of hospitalized children on a general pediatric unit were purposively selected to participate in the study. Qualitative data analysis supported the themes generated by previous studies of vigilance: commitment to care, resilience, emotional upheaval, dynamic nexus, and transition (Carr & Clarke, 1997; Carr & Fogarty, 1999). The knowledge generated from this study helps to support the theoretical understanding of vigilance and enhances the ability of health care providers to provide care that is congruent with the needs of parents and their children.     

Important aspects of care and assistance for children 0–7 years of age being treated for cancer

Aspects of care and assistance that are important for children aged 0-7 years who are being treated for cancer were examined. Parents ( N=57) and nurses ( N=59) were asked: "What caring aspects are important in ensuring that your child/the child feels cared for?" and "What help, if any, does your child/the child need outside the hospital?". Data were analysed by content analysis. The following aspects of care were identified: amusement, clinical competence, continuity, emotional support, family participation, honest communication, information, participation in decision making, satisfaction of basic needs, social competence, the parents are well cared for, and time. Parents most frequently mentioned social competence and amusement, while nurses most frequently mentioned continuity and information. The following aspects of assistance were identified: accessible care, amusement, emotional support, family life, meeting friends, normal life, practical support, rehabilitation and school support. At least a third of the children did not need any assistance, according to parents and nurses. Parents most frequently mentioned family life, meeting friends and practical support. Nurses most frequently mentioned normal life and family life. Taken together, the results indicate that not only a family but many more people need to be involved to help children with cancer to be cured not only in a biological but also a psychosocial sense.     

Social Networks of Women Caregivers

Abstract Social networks and the support that network members provide are important resources for family caregivers in sustaining their caregiving role. Caregivers' perceptions of support from family and friends have been linked to their health status (R. Kahn & T. Antonucci, 1980; I. Sandler & M. Barrera, 1984). The purpose of this study was to explore the social networks and types of perceived support described by women who are caregivers of cognitively impaired older adults. Content analysis was used to examine interview data from a longitudinal qualitative study of 20 women caregivers of cognitively impaired older persons. An important finding of this study was the identification of a typology of social networks of the women caregivers. The caregivers' perceptions of satisfaction with support received and experience of conflict with network members varied according to the characteristics of their social network. Those caregivers who belonged to diverse social networks reported high satisfaction with the support that they received and little or no conflict. Those caregivers with kin-dominated social networks reported little satisfaction with support received and a high degree of conflict.     

Developing supportive care for family members of people with lung cancer: a feasibility study

Purpose Families provide crucial support, yet their own needs often go unrecognised and, as a consequence, remain unmet. The purpose of this study was to evaluate a newly developed supportive intervention for family members of patients with lung cancer. Materials and methods A consecutive convenience sample of 25 family members of people with lung cancer received an individualised supportive intervention from a support nurse over a period of 12 weeks. This involved in-depth assessment followed up with a tailored plan of ongoing support to address informational, emotional, social and practical needs. A concurrent mixed method design explored perceptions and outcomes of those receiving the intervention and assess its appropriateness, acceptability and feasibility. Data were collected through a semi structured telephone interview with family members, and support nurses maintained a contact log. A questionnaire addressed emotional well-being [general health questionnaire (GHQ-12)], quality of life [quality of life family version (Family QoL)] and needs for care [family inventory of needs (FIN)]—at baseline and week 12. Results Family members perceived they had derived benefit from the intervention. Certain elements clearly emerged as important for participants, including being listened to by someone who could facilitate emotional expression, being provided with individually tailored information and receiving practical help and advice. Outcomes mapped to five main areas: information needs, communication between family members, emotional well-being, being supported and facilitating family member’s role. There was a trend for more needs to be met and quality of life and emotional well-being to improve at week 12. Conclusion This study has demonstrated that a supportive intervention for family members of patients with lung cancer can be delivered to good effect by experienced cancer nurses. The active components of the intervention have been distinguished and provide the basis for development of a larger sufficiently powered trial.     

Family attitudes about tobacco smoke exposure of young children at home

PURPOSE: To explore families' attitudes about smoking and their perceptions of the effects of environmental tobacco smoke (ETS) exposure on their children. STUDY DESIGN AND METHODS: Qualitative study using face-to-face interviews with a semistructured guide in 20 households containing a child under age 5. Content analysis was done on the interview data. RESULTS: Families identified "health protection" as the parental responsibility for children and emphasized helping children make decisions not to smoke. Some reported negative experiences with ETS exposure as children themselves or health problems in their children, reinforcing their opposition to smoke exposure for their children. Most parents said they did not allow smoking in their homes, but some later disclosed that they made exceptions for family and friends. Some parents, however, limited their children's contact with smoking members of their families. Smoking parents expressed guilt about ETS exposure of their children and tried to limit smoking to certain areas of their houses, such as the basement. Other parents, mostly the nonsmokers, did not identify ETS as a problem. Families who maintained smoke-free households identified that family and friends had to "respect" their wishes. CLINICAL IMPLICATIONS: To protect children from the negative effects of ETS exposure, nurses should discuss not only if parents smoke but also if family members and friends are allowed to smoke in the home. It would be helpful to assess the priority that parents set on ETS and how they attempt to prevent it in their daily lives.     

Bereaved parents' perception of the grandparents' reactions to perinatal loss and the pregnancy that follows

This article presents bereaved parents' perceptions of their parents' (the grandparents) reactions at the time of loss and in the pregnancy that follows. Data originated from two phenomenological studies conducted to understand bereaved parents' experiences during their loss and subsequent pregnancy. However, this article reports a secondary thematic analysis focused on bereaved parents perceptions of the grandparents' support (or lack of) at the time of loss and during the pregnancy following loss. Our findings illustrate some families found the means to share their grief at the time of loss in a constructive manner, while in others the intergenerational relationship was strained. Most important to parents was intergenerational acknowledgment of the ongoing relationship to the deceased child as an important, though absent family member, especially during the pregnancy that followed. Those supporting bereaved families can play an important role in helping intergenerational communication around perinatal loss and the subsequent pregnancy.