Sister’s Caregiving Experience to a Sibling with Cerebral Palsy- the Impact to Daughter-Mother Relationships

This paper uses a phenomenological method to examine Taiwanese women’s care giving experiences of their brothers or sisters with Cerebral Palsy and how they negotiated daughter-mother relationships when care giving for a sibling with CP. Drawing on stories shared by six women from the northern and the middle part of Taiwan who were recruited via social service agencies and snowball sampling, the results of this study suggest that these sisters internalized the cultural norm of Shan-Shia (superior-subordinate) but also appealed for support from fathers or brothers to transform their mothers’ outdated notions about ways of caring for their sibling with CP and to protect their sibling with CP from mothers’ negligent and abusive behaviors. Greater attention must be given to the promotion of a more equitable sharing of caring tasks by men and women in the family.     

The Commodification of Care

This paper discusses the question whether care work for dependent persons (children, the elderly, and disabled persons) may be entrusted to the market; that is, whether and to what extent there is a normative justification for the “commodification of care.” It first proposes a capability theory for care that raises two relevant demands: a basic capability for receiving care and a capability for giving care. Next it discusses and rejects two objections that aim to show that market‐based care undermines the caring motives essential to care, one of them because of its reliance on contracts and the other because of the corrupting influence of payment on motivation. If market care is in principle legitimate, the commodification question transforms into one about the appropriate combinations of market and non‐market care. This question can be answered only by adding an additional complication: care is to be balanced against other activities, most notably work for the labor market. This brings in the problem of gender inequality, since paid work has been traditionally distributed to men and caring activities to women. I show how the capability theory of caring presented in this paper can help resolve the dispute between competing models for balancing work and caring.     

Reframing caring for parents who struggle with substance-use disorders

Nancy Suchman and the colleagues she influenced have produced ground-breaking and attitude-challenging work in understanding how parenting and substance use come together. Dr Suchman and her colleagues make the claim that there is nothing about a substance-use disorder that precludes effective and sensitive caring for children especially with interventions that focus on the parent–child relationship. Suchman's legacy is to highlight how substance use as an illness pulls individuals away from important, caring relationships and limits their giving themselves to those relationships. Restoring the salience of caring relationships and of the individual's ability to care may be as impactful on their substance use as a strict focus on the reduction of drug use and achieving abstinence.     

Adult Children’s Caregiver Burden and Depression: The Moderating Roles of Parent–Child Relationship Satisfaction and Feedback from Others

The issue of elderly care has generated great interest because today, most of us live in an aging society. It has been found that caring for one’s elderly parents is a stressful experience that is related to negative outcomes. In addition, accompanied with the decline in fertility may make adult children feel heavier caregiver’s burden. Therefore, the current study investigates moderators that may help reduce the caregiver burden. Following the conservation of resources theory (COR), we hypothesized that feedback from others and a good parent–child relationship serve as resources that may help the individual manage the stress associated with caring for his or her elderly parents. To examine our hypotheses, we collected data from 502 adult children who were primary caregivers for their elderly parents. All participants completed the Burden Assessment Scale (BAS), the Center for Epidemiological Studies Depression Scale (CES-D), the Feedback from Others Scale, and the Parent–Child Relationship Satisfaction Scale. Supporting our prediction, we found a positive correlation between the caregiver’s burden and the caregiver’s levels of depression. Furthermore, both moderation effects were significant. Consistent with our hypotheses, the relationship between caregiver burden and his or her level of depression was weaker when participants had high feedback from others or had a better parent–child relationship. Our findings highlight the view that possessing more resources may help the individual manage the stress associated with caring for elderly parents. Implications for issues related to elderly care are discussed.     

Chronic stress and depressive disorders in older adults

Current and lifetime rates of Diagnostic and Statistical Manual (rev. 3rd ed.) disorders were compared in 86 older adults caring for a spouse with a progressive dementia and 86 sociodemographically matched control subjects. Dementia caregivers were significantly more dysphoric than non-care givers. The frequencies of depressive disorders did not differ between groups in the years before care giving, and there were no group differences in first-degree relatives' incidence of psychiatric disorder. During the years they had been providing care, 30% of care givers experienced a depressive disorder (major depression, dysthymia, or depression not otherwise specified) versus 1% of their matched controls in the same time period. Only two care givers who met criteria during care giving had met criteria for a depressive disorder before care giving, and family history was not even weakly related to the identification of at-risk care givers. In contrast to these group differences in depressive disorders, there were no significant differences in other Axis I disorders either before or during care giving. Thus, the chronic strains of care giving appear to be linked to the onset of depressive disorders in older adults with no prior evidence of vulnerability.     

Child’s Play: The Role of Play in Mitigating the Fear of Death Among Pediatric Palliative Care Team Patients,Families, and Caregivers

Terror Management Theory (TMT), derived from Ernest Becker’s The Denial of Death (1974), maintains that humans are motivated by the desire to overcome our fear of death by constructing meaning and significance in our lives in various ways, including making light of our mortality. In this paper, we examine the role of play as seriously ill children involved with a hospital-based palliative care team live out what may be the remainder of their lives. We question the function that play has, if any, in mitigating the fear of death among dying children and their caregivers. We explore formal and informal manners of therapeutic play among children and adults occurring in moments of terrible stress, pain, and the looming threat of death. We draw on playful representations of death from popular culture and from extended field research conducted with a pediatric palliative care team in a large regional children’s hospital caring for seriously ill children and their families, as patients, families, and caretakers struggle to make sense of their suffering, fear and loss.     

Social pedagogy and pastoral care in schools

In the context of this paper, social pedagogy concerns how a person trained in social pedagogy can take up the role of a trusted and caring adult to help, support and empower troubled and vulnerable pupils to meet the demands they face in their lives so that they are better able to lead fulfilling and satisfying lives and can, in their turn, contribute to the betterment of society. This paper describes the nature of social pedagogy, highlights its origins and practice in mainland Europe, considers some key developments within the current context in England and outlines its implications for pastoral care in schools. There has been a marked growth in social pedagogy as an aspect of professional practice amongst the pastoral care community in England. Its further development will depend on an increasing recognition that pastoral care needs to follow the pupil into the different social settings they inhabit.     

Revue de la littérature sur les jeunes aidants : qui sont-ils et comment les aider ?

Young carers (YC) are children and teenagers who provide care, help or support to a relative who is ill or has a disability. This literature review aims at presenting an overview on YC. Previously published studies mainly focused on estimating YC prevalence, exploring the areas in which YC provide help, especially caring activities, as well as positive and negative consequences of the caregiving experience (social, academic, physical, and psychological consequences). Specific tools to evaluate YC have been developed for professionals and researchers. Finally, if many interventions have been proposed for YC, they have rarely been evaluated. The limits of these studies are discussed and research perspectives are suggested.     

Happiness and Well-Being of Young Carers: Extent, Nature and Correlates of Caring Among 10 and 11 Year Old School Children

Young carers often take on practical and/or emotional caring responsibilities that would normally be expected of an adult. For many of these children and young people, caring has been shown to have a detrimental effect on their lives. For example, caring at a young age appears to be associated with poor health and well-being, bullying and poorer educational outcomes. However, previous research has tended to be retrospective, carried out using small surveys of secondary school-aged children or to use qualitative methods with young people associated with caring projects. In contrast, little is known about the extent and nature of caring undertaken by younger children. This paper reports findings from a random sample survey of 10 and 11 year old children in the final year of their primary school education. 4,192 children completed the Kids’ Life and Times (KLT) online survey in 2011. Twelve percent of respondents to KLT said they helped look after someone in their household who was sick, elderly or disabled. Supporting previous qualitative research, this survey showed that children who were carers had poorer health and well-being, reported less happiness with their lives, were more likely to be bullied at school and had poorer educational aspirations and outcomes than their peers who were not carers. These findings suggest that teachers need to discuss the issue of caring with children in the classroom in a general and supportive way so that young carers feel able to confide in them and seek support if they need it.     

Motives for Fostering Children with Alcohol-Related Disabilities

A sample of 63 licensed foster parents was asked, “What motivates you to foster a child who has a fetal alcohol spectrum disorder?” The responses to this question were grouped together by licensed foster parents. The grouped data were subjected to multidimensional scaling and cluster analysis. Results indicated that foster parents were motivated to care for children with alcohol-related disabilities by witnessing positive changes in the children in their care, helping children focus on their strengths, using their own parenting experience, earning an income, assisting children who have disabilities, and helping children stay connected to their families and communities. Foster parents who foster children with alcohol-related disabilities foster for similar reasons to those who foster children with special needs in general. Differences between the literature on foster parent motives and study results were described. Foster parents who are caring for children with alcohol-related disabilities see their care as specialized, see their roles as long-term helpers facilitators to children, their birth families and home communities, and emphasize positive experiences of fostering.     

The Will to Care: Performance,Expectation, and Imagination

This article addresses the world's contemporary crisis of care, despite the abundance of information about distant others, by exploring motivations for caring and the role of imagination. The ethical significance of caring is found in performance. Applying Victor Vroom's expectancy theory, caring performances are viewed as extensions of rational expectations regarding the efficacy of actions. The imagination creates these positive or negative expectations regarding the ability to effectively care. William James's notion of the will to believe offers a unique twist on rational expectations in that he regards humans as having the capacity to work within uncertainty to take decisive action. Applying this idea to caring performance is, this article argues that people can have the will to care, beyond strict rational calculations or limits of social norms. Historically, caring has been associated with the imagination's ability to empathize, but the will to care offers another role for the imagination in envisioning effective action. Given the significance of the imagination for ethical behavior, this article explores the implications for cultivating care in terms of what educating for care might look like. The work of feminist care ethicists, particularly Nel Noddings, is discussed, and contemporary case examples of caring performances are investigated.     

The relationships between parenting stress,parenting behaviour and preschoolers' social competence and behaviour problems in the classroom

Young children develop social and emotional competence through interactions with others in the two major contexts in which they spend time: home and preschool. This study examined whether parenting stress in the home context is related to the children's behaviour while in preschool. Previous research has suggested that parenting stress negatively influences parenting behaviour, which in turn has been shown to impact children's development. This study examined the direct relationship between parenting stress and children's behaviour in two types of preschool programmes: private day care centres and Head Start. Parenting stress was significantly related to teacher ratings of social competence, internalizing behaviours, and externalizing behaviours, and the effects of parenting behaviour do not appear to mediate this relationship. Parenting stress was most strongly related to children's social competence. Parents' reports of expectations for their child's behaviour appear to weakly moderate the relationship between externalizing behaviour and parenting stress. This study suggests that examination of a parent's level of stress, in addition to parenting practices, may be important in research and interventions with preschool children's behaviour and social competence. Copyright © 2005 John Wiley & Sons, Ltd.     

胎儿产前超声诊断中的人文关怀

随着医学的进步,医学模式的转变,越来越提倡医学对人们心理和社会因素的关怀。同时随着产前诊断技术和超声诊断技术的迅速发展和日臻完善,以及社会、经济的发展和变革,也越来越重视对孕妇及家属的人文关怀。胎儿产前超声诊断中的人文关怀不仅是对人的关怀,也是对技术、对心理健康、对生命的关怀。     

Stress and coping in mothers caring for a child with severe learning difficulties: A test of Lazarus' transactional model of coping

The literature on psychological stress among women consistently points to the adverse effects of child rearing on mothers, particularly those caring for children with physical or mental handicaps. Early studies of the effects on family functioning of caring for a child with severe learning difficulties adopted a pathological approach in which it was assumed that psychological distress was inevitable among family members, particularly mothers. Recent research has emphasised that many families cope with and adapt to the stress they experience, and seeks to discover how they do so. The paper reports on a study of 166 mothers caring for a child with severe learning difficulties. The aim of the study was to investigate both the factors associated with maternal stress and those which might mediate or buffer the effects of stress. The study used the Folkman and Lazarus' (1979) transactional model of stress. Stress is the condition that results when person/environment transactions lead the individual to perceive a discrepancy between the demands of a situation and his/her resources or ability to cope with those demands. The nature and type of coping generated by a person will be determined by the coping resources in the person's environment. The model identifies five categories of coping resource: utilitarian resources, health/morale, social networks, general and specific beliefs, and problem solving skills. In our study, the five coping resources were represented by the mother's social class and appraisal of her financial worries, physical health, social support, acceptance of and adjustment to the child, and assessment of coping skills. Stress was measured by the Malaise Inventory (Rutter, 1970). Four of the five coping resources were found to be significant contributors in a hierarchical regression analysis of stress scores, contributing additional variance beyond that of behavioural and other child characteristics. Altogether, 55% of the variance in stress scores was explained.     

The ‘Connection’ Health Care Providers Make with Dying Patients

SUMMARY

The literature confirms illness and hospitalisation can become spiritual encounters for patients and their families. Further, it has been established that both patients and their families are better equipped to deal with loss and change if they have a healthily developed spiritual sense of self. The aim of the study sought to determine the benefit or otherwise of a previous model of spiritual care. It asked ‘from the perspective of the nurse and other health care providers, what constitutes spiritual care giving?’ An ethnography was undertaken where data consisted of field notes, interviews, records, and diary entries. This paper reports on interview data, from which themes were derived. The major theme titled their space is expressed via a new model of spiritual care. It was shown that when caring for patients and their relatives, nurses and other health care professionals enter the world of the other to determine the other's needs. In so doing they typify agapé (altruistic love), where the individual cares for a complete stranger as if that stranger were family. This connection with the patient and their family is the foundation for spiritual care.     

Reflective team in caring for people living with dementia: a base for care improvement

A reflective team (RT) is a team of professional carers who reflect on a specific caring issue under the direction of an RT leader. The goal for the reflective process is to accomplish care improvement based on research and proven experience, and the first step is to reflect upon the competence that already exists in the context in which RT takes place. This study aims to bring previous unarticulated competence in caring for people living with dementia to the surface after it has been reflected during RT sessions. Ten assistant nurses who work closely with patients who have dementia and attend RT sessions on a regular basis were interviewed about their competence for caring for people living with dementia. Using a phenomenographic analysis, two qualitatively separate categories emerged: general caring skills and dementia-specific caring skills. It was concluded that specific skills in caring for people living with dementia build in caring skills and that tacit knowledge can be explicit and be expressed when it has been reflected in RT.     

Reflective team in caring for people living with dementia: a base for care improvement

A reflective team (RT) is a team of professional carers who reflect on a specific caring issue under the direction of an RT leader. The goal for the reflective process is to accomplish care improvement based on research and proven experience, and the first step is to reflect upon the competence that already exists in the context in which RT takes place. This study aims to bring previous unarticulated competence in caring for people living with dementia to the surface after it has been reflected during RT sessions. Ten assistant nurses who work closely with patients who have dementia and attend RT sessions on a regular basis were interviewed about their competence for caring for people living with dementia. Using a phenomenographic analysis, two qualitatively separate categories emerged: general caring skills and dementia-specific caring skills. It was concluded that specific skills in caring for people living with dementia build in caring skills and that tacit knowledge can be explicit and be expressed when it has been reflected in RT.     

Invisible or Involved Fathers? A Content Analysis of Representations of Parenting in Young Children��s Picturebooks in the UK

Although gender-role stereotyping in children??s books is a consistent focus of research, the study of the gender role stereotyping of parenting in particular is less common, despite a developing academic interest in the changing social meanings of fathering and mothering in contemporary societies. Previous analysis has suggested that fathers are under-represented in children??s books and when present, are less likely than mothers to be featured expressing affection towards, or caring for, children. This paper reports the results of a content analysis of a sample of best-selling young children??s picturebooks in the UK which feature representations of parents. It was predicted that fathers would feature less often, particularly at home, and be less likely to be depicted sharing physical contact with other family members, involved in domestic chores or childcare activity, or expressing emotion. The results upheld a number of the hypotheses, indicating that fathers remain ??invisible?? in an important sense. However scenes featuring fathers with children, some forms of physical contact, or caring for children were not significantly less likely to feature in these picturebooks than equivalent scenes featuring mothers; perhaps reflecting a more progressive portrayal of ??involved?? fatherhood. The findings are discussed in terms of their methodological, social, and political implications.     

老年人照料孙子女对农村家庭代际矛盾的影响研究

本研究利用“安徽省老年人生活福利状况”调查数据,建立多水平Tobit模型分析老年人照料孙子女对农村家庭代际矛盾的影响。研究结果发现照料孙子女与高水平代际矛盾相关,且高强度照料的影响更为明显。由于照料角色的性别差异,照料孙子女对老年父亲的代际矛盾有显著影响,而提供低强度照料对老年母亲没有影响。女儿与老年父母的代际矛盾水平低于儿子,且向女儿提供低强度孙子女照料显著降低了老年父亲的代际矛盾。上述结果支持了“角色负担”的理论解释,且性别偏好对家庭代际矛盾有显著影响。     

Moral injury and the priesthood of all believers1

This article proceeds from the conviction that moral injury suffered by many combat veterans is a deeply spiritual matter requiring spiritual resources for healing. The tradition of the care of souls commends itself. It takes into account that the “soul” is an expression of the whole person in all its physical, spiritual, and social realities. Moral injury affects all those dimensions of personhood or soul. Since the Reformation the care of souls has been a vocation for the ministry of the whole people of God under the theology of the priesthood of all believers. A caring community is essential to healing for many dealing with moral injury. Indeed, the veterans themselves, in sharing their stories and their pain, become part of that ministry of the priesthood of all believers and may well find healing in the meaningfulness of their mutual ministry.