Coping strategies used by Pakistani parents living in the United Kingdom and caring for a severely disabled child

Purpose: This study explores the coping strategies of Pakistani parents living in the UK and caring for children with severe learning disabilities. It examines factors that influenced participants' choice or ability to use the different strategies identified. Method: Qualitative design using in-depth interviews. Results: Coping strategies included sharing care with others, using external support and recognizing and enjoying the rewards of caregiving. Parents used different strategies according to their appraisal of resources available and the perceived consequences of their action within their social milieu. Conclusions: Findings relating to cultural difference fit with a universalist approach. Coping strategies are not specific to the Pakistani population but certain characteristics of the strategies may be distinct to those used by parents with a different heritage. Antonovsky's work suggests that maintaining a sense of coherence makes a key difference to staying psychologically healthy in an apparently disordered world. Findings from this study fit with this theory. Parents derived meaning and a sense of purpose from the idea that their child's disability was from God. The rewards of caregiving and the strong moral imperative to care for one's own child contributed to understandings of caregiving as an activity worthy of investment. [Box: see text].     

Coping strategies and styles assessed by the Jalowiec Coping Scale in a random sample of the Swedish population

A random sample of the Swedish general population (n = 1,200), age range 18-80 years, was studied with regard to coping strategies and styles used for handling stressful situations. The total response rate was 65% (n = 519), and coping was assessed by the Jalowiec Coping Scale (JCS). The three most frequently used coping styles were the confrontative, the optimistic and the self-reliant. The three least used styles were the emotive, the supportant and the palliative. There were few differences between the age groups for the total material or for each gender separately. Young (18-29 years) and middle-aged (30-59 years) groups used confrontative and emotive styles significantly more than did the elderly (60-80 years) group. Young and middle-aged women used significantly more optimistic, evasive, emotive and supportant coping than did elderly women. All subscales except the self-reliant showed significant gender differences, with women reporting more frequent use than men. Ethnicity is a major determinant of the use of the emotionally-oriented coping styles. Those of Swedish origin used less of these styles than did those of non-Swedish origin. The results illustrate the importance of using different norm values for the JCS for groups differering in these demographic variables.     

Developing a unified language for children's nurses, children and their families in the United Kingdom

This paper presents a taxonomy of Infant, Child and Adolescent (ICA) nursing diagnoses and clinical outcomes that has been developed with the co-operation of nurses caring for children in the United Kingdom. Three focus group interviews were conducted in one acute care NHS trust in London (referred to as the host trust in this paper) in 1998/99, in which participants were asked to consider nursing and family factors relevant for identifying and providing care. A total of 28 ICA diagnoses, including definitions, defining characteristics and outcomes, were identified for clinical testing and included in the ICA taxonomy. The ICA diagnostic labels and outcomes for care were further tested for their relevance for clinical practice in a Delphi Survey carried out in 1999 and their use in clinical practice began in 1999. This research augments the findings from an initial Delphi survey carried out in 1993 and case study research in 1996. The previous research initiated the development of a unified language for children's nurses, children and their families, to aid communication and decision-making. Implications of this and future research for clinical practice, nationally and internationally, are also discussed.     

Factors associated with the coping of parents with a child in psychiatric inpatient care

The purpose of this study was to establish the parental coping' factors associated with having a child in psychiatric inpatient care. The data were collected from 19 hospitals with child psychiatry units. At the time of data collection, all parents of children in psychiatric inpatient care in these hospitals were recruited. The method of data collection was a questionnaire (n = 79). The data were analysed with the Statistical Package for the Social Sciences (SPSS) for Windows statistical software. The connections between variables were studied with cross-tabulation, and the chi2 test was used to determine significance. Changes in internal and external family relationships and matters related to the upbringing of the child with mental problems statistically correlated significantly with parental coping (P < 0.001). Problem-oriented and emotionally-oriented coping strategies, skills and palliative strategies correlated significantly with parental coping (P < 0.001). Emotional support, support for the care and upbringing of the child in inpatient care, and love and acceptance also had statistically significant associations with parental coping (P < 0.001).     

Stresses and coping strategies of mothers living with a child with cystic fibrosis: implications for nursing professionals

BACKGROUND: Cystic fibrosis (CF) is the most common inherited disease of childhood. Caring for a child with CF is stressful and this has implications for the main carer, the parental relationship, well siblings, family functioning as well as the affected child. AIM: This study aimed to explore current stresses and coping strategies used by mothers and to identify roles and strategies that nursing professionals could extend or adopt to support them and families of children with CF. METHOD: Semi-structured interviews were carried out with 17 mothers of children with CF who attended the regional cystic fibrosis hospital clinic. Interviews were analysed using the Framework method of analysis. FINDINGS: The study suggests that major stresses for many mothers are feeling in the middle in terms of decision-making particularly concerning the genetic implications of CF, the burden of responsibility for parenting a child with a chronic illness, and coming to terms with a personal change in identity. The most commonly used coping strategy was seeking support from others including nursing professionals. Relationships with health professionals in secondary care were generally positive, with nurses often the first people mothers turned to when they had concerns and also key in interpreting medical information. Relationships with primary care health professionals appeared to be more limited with a role reversal described by some mothers who felt it their responsibility to educate and inform primary care professionals about CF. CONCLUSIONS: This study suggests that nursing professionals in primary and secondary care need to look beyond the care of the child to the needs of the mother. It provides evidence to suggest that nursing professionals in primary and secondary care have a number of important roles to play as holders of hope, bridge builders and in providing continuity of care for such families. It also suggests strategies to strengthen nurse-patient relationship.     

Differences in plans for living at home between temporary residents of a health-care facility for the elderly and their family caregivers in Japan

Aim: Older residents in Japan requiring rehabilitation often reside in health‐care facilities for the elderly (HCFE) prior to being discharged to home. The return home can be very stressful for both the elder and family caregiver. The purpose of this study was to clarify the differences in plans for home life between the residents of a HCFE who were scheduled for discharge home and their family caregivers. Method: Semistructured interviews were conducted with eight pairs of elders and caregivers. Results: Differences were seen in several areas, including dietary preferences, recognition of the elder’s independence, preconceptions or not knowing about the elder’s pleasurable activities, and the way of care. Conclusions: Differences with regard to enjoyable activities for the elderly arose from a lack of understanding of the lives of the elderly on the part of their families.     

沿海地区失能老年人家庭照护品质与照护者社会支持的相关研究

目的:探讨沿海地区失能老年人居家照护品质与照护者社会支持系统的相关性。方法:采用分层整群随机抽样法,收集唐山市沿海地区2 155名失能老年人及其家庭照顾者的一般情况,应用失能老年人家庭照护品质量表、社会支持量表进行不同维度测评,应用方差分析法对不同分级社会支持的照护品质单项评分和总分进行比较,应用Pearson相关分析法分析失能老年人家庭照护品质与社会支持的相关性。结果:照护者高水平与低水平社会支持的照护品质各单项评分及总分相比较,差异均有统计学意义(P<0.01),高水平与中等水平社会支持比较,除水分获得、家庭成员的需求满足2项评分,其余项目差异均有统计学意义(P<0.01);中水平与低水平社会支持比较,除去舒适程度、皮肤的完整性、照顾者与残病老人的关系品质、照护者获得个人成长、照顾者情绪的影响5项,其余项目差异均有统计学意义(P<0.01)。失能老年人家庭照护品质评分与照护者的社会支持程度呈正相关(r=0.608,P<0.01)。结论:照护者受社会支持程度影响失能老年人家庭照护品质,注重照护者的社会支持,提高失能老年人家庭照护质量。     

Informed decision making regarding antenatal screening for fetal abnormality in the United Kingdom: A qualitative study of parents and professionals

The aim of this study was to explore the views of parents and health professionals regarding informed decision making for antenatal screening for Down syndrome. This qualitative study was based on thematic analysis and conducted in England, where screening for Down syndrome is universally offered to all pregnant women. Four focus groups were held with pregnant women and/or their partners (n = 22), and another four groups were held with health professionals who offer antenatal screening (n = 22). Data were analyzed through coding of the transcribed focus group discussions and extraction of main themes. Extracted themes were: information overload, gaps in information, challenges in providing information and involvement of both parents in the decision. Parents and professionals believed that burdening parents with untimely information on a wide range of topics in the first trimester detracted from decision making about screening. Many parents also reported they were not sufficiently informed and wanted individualized discussion with a health professional. To ensure parents make informed decisions, information on screening should be provided at the appropriate time, with opportunity for personal discussion with a knowledgeable health professional.     

Developing a non-aversive intervention strategy in the management of aggression and violence for people with learning disabilities using natural therapeutic holding

This paper builds upon a previous piece of research regarding the development of 'natural therapeutic holding' as a non-aversive alternative to control and restraint (C and R) in managing aggression and violence in people with learning disabilities. This paper represents aspects of an ongoing programme of research and explains the aims and values which underpin natural therapeutic holding by describing the theory, aims, values and practical application. The concepts of individual risk management and pro-active intervention strategies are discussed with illustrations of practical application given by means of a case study. The case study shows that over a relatively short period of time, an individual with severe learning disabilities who is aggressive and violent, learns alternative coping strategies to aggression and violence through the application of natural therapeutic holding. The article concludes that natural therapeutic holding is a very effective intervention strategy in the management of violence in people with learning disabilities from two perspectives: (a) it provides staff with safe, professional and ethical skills with which they can manage aggressive and violent clients and (b) as a therapy, natural therapeutic holding gives clients the opportunity to learn coping strategies which are more effective than violence.     

Supporting 'expert' parents--professional support and families caring for a child with complex health care needs in the community

In the United Kingdom a new group of children with intensive and complex health care needs are now being cared for at home as a result of medical advances and government policies emphasising the community as the arena for care. This has led their parents to become involved in providing care of a highly technical and intensive nature that would previously have been considered to be the domain of professionals. In-depth qualitative interviews were conducted with parents and professionals to discover parents' and professionals' experiences of receiving and providing support in a context where parents rather than professionals are the expert caregivers. This paper describes the elements of professional 'support' that were particularly valued by parents and concludes with a discussion of the implications for professional education and roles.     

The use of acupuncture by chartered physiotherapists in the United Kingdom: a review of undergraduate students' attitudes and knowledge

Abstract

The use of acupuncture by chartered physiotherapists has expanded in recent years. It is now readily available in many private and National Health Service (NHS) physiotherapy departments. In spite of acupuncture's increasing popularity, few physiotherapy or medical undergraduate syllabuses in the UK include acupuncture. This paper reviews the attitudes and knowledge of undergraduate physiotherapy and medical students towards acupuncture. Findings from studies on students' attitudes, their knowledge of acupuncture and its evidence base and correlations between knowledge and attitudes are discussed. Whilst students' attitudes towards acupuncture were generally very positive, students have been found to have very little actual knowledge of acupuncture. The willingness of future practitioners to accept (with very little prior knowledge) this treatment approach, raises a number of pertinent issues for the profession.