Increasing physical activity among women with young children: Results from the Proactive Mums Project

Context Evidence from the Australian Longitudinal Study of Women's Health suggests that mothers of young children have lower levels of physical activity (PA) than women of similar age without children. Objectives The aim of the ProActive Mums project was to determine the relative efficacy of two strategies designed to increase the proportion of mothers of young children who are meeting current PA guidelines, utilising child care centres (CCCs) as the setting for recruitment. Study Design The project used a randomised (after stratification to ensure even representation of CCCs from differing socio-economic areas) design incorporating repeated data collection from women in three groups, each consisting of 7 childcare centres (CCCs). Baseline surveys were completed by 554 mothers, with follow-up data collection immediately post-Intervention (8 weeks after baseline) and again 5 months later. Women from CCCs in Group 1 (control) received only the surveys throughout the duration of the project. Women from CCCs in Group 2 (information only) were given a print intervention, and women from CCCs in Group 3 were (in addition to being given the same print intervention as women from CCCs in Group 2) invited to to contribute to the development of, and participate in, strategies for the promotion of PA among mothers of young children. The two intervention strategies were extensively evaluated through a series of surveys and interviews. The Intervention The print intervention prescribed for women from CCCs in Group 2 and Group 3 consisted of an 8-page booklet containing motivational messages and information about physical activity. Women from CCCs in Group 3 were also invited to attend meetings at their CCC to identify strategies for increasing their PA. Contacts were made with key stakeholders in the community, including managers of sporting and recreation facilities, childcare service providers, and local councils. A wide range of strategies was developed during the intervention phase of the project, which specifically focused on the need to increase partner support and self-efficacy (or the confidence to be physically active). Results The mean age of participants was 33 (+ 4.8) years, and the mean number of children per family unit was 2.2 (± 0.9). At baseline, fewer than half the women were meeting current guidelines for adequate PA for health benefit, and there were no significant differences between groups in the proportion of women who were adequately active for health benefit. Women in Group 3 were significantly more likely to meet the guidelines at post-intervention follow-up than controls [OR = 1.71 (1.05-2.77)] after controlling for age and PA at baseline. There was no significant effect of the print intervention alone on meeting guidelines at post-intervention follow-up compared with controls, after controlling for age and PA at baseline [OR = 1.15 (0.70-1.89)]. Changes in Partner Support (PS) and Self Efficacy (SE) significantly predicted meeting current PA guidelines at post-intervention follow-up after controlling for baseline PA [∆ PS: OR = 2.29 (1.46-3.58); ∆ SE: OR = 1.86 (1.17- 2.94)]. The intervention effect in Group 3 was not maintained at long-term follow-up. Conclusions The findings indicate that a community participation approach that facilitates increased partner support and self-efficacy can be effective in increasing PA among mothers of young children. Changes in physical activity were found to be mediated by changes in partner support and self-efficacy for physical activity, suggesting that the intervention successfully targeted the individual characteristics it intended to, and that these variables do play an important role in increasing physical activity among women with young children. It is clear that further work needs to be done to explore methods of translating the short-term intervention effect shown in this study into long-term changes in PA behaviour. This study also provided insight into measurement issues in PA research and raised questions about self-report measures of PA and perceived constraints to being physically active. The results from post-study qualitative interviews suggest that many women at this life-stage experience time constraints which, when accompanied by a lack of partner support and financial constraints, make leisure-time PA virtually impossible for many women. Future strategies might focus on targeting this population immediately prior to this life-stage in an attempt to encourage habitual physical activity before women have children. Increasing PA in this population should also address the entire family unit, and consider the way leisure-time is negotiated among the adults within a household. Social change and increased awareness of the range of benefits of PA for women with children are additional strategies to be considered.

The late discovery of adoptive and donor insemination offspring status : ethical implications for conceptual understandings of the ‘best interests of the child’ principle

Late discovery is a term used to describe the experience of discovering the truth of one’s genetic origins as an adult. Following discovery, late discoverers face a lack of recognition and acknowledgment of their concerns from family, friends, community and institutions. They experience pain, anger, loss, grief and frustration. This presentation shares the findings of the first qualitative study of both late discovery of adoptive and donor insemination offspring (heterosexual couple use only) experiences. It is also the first study of late discovery experiences undertaken from an ethical perspective. While this study recruited new participants, it also included an ethical re-analysis of existing late discovery accounts across both practices. The findings of this study (a) draws links between past adoption and current donor insemination (heterosexual couple only) practices, (b) reveals that late discoverers are demanding acknowledgment and recognition of the particularity of their experiences, and (c) offers insights into conceptual understandings of the ‘best interests of the child’ principle. These insights derive from the lived experiences of those whose biological and social worlds have been sundered and secrecy and denial of difference used to conceal this. It suggests that acknowledging the equal moral status of the child may be useful in strengthening conceptual understandings of the ‘best interests of the child’ principle. This equal moral status involves ensuring that personal autonomy and the ability to exercise free will is protected; that the integrity of the relationships of trust expected and demanded between parent/s and children is defended and supported; and that equal access to normative socio-cultural practices, that is; non-fictionalised birth certificates and open records, is guaranteed.

The impact of chronic childhood illness on family stress : a comparison between autism and cystic fibrosis

Compared the different patterns of stress reported by mothers of children (aged 5–12 yrs) with either a chronic physical illness (cystic fibrosis) or a chronic psychological disorder (autism), and children without a physical or psychological disorder. 24 mothers from each of these 3 groups completed a short form of the Questionnaire on Resources and Stress. Each clinical group exhibited different patterns of stressful response consistent with the nature of the disorder and the requirements of care imposed on the families. Autism contributed significantly more to family stress than did cystic fibrosis. The number of children in the family was not a significant variable. Implications for the development of family intervention programs are discussed

Children, young people and their social and spatial citizenship rights

The use of public space by children and young people is a contentious issue in a number of developed and developing countries and a range of measures are frequently deployed to control the public space which usually deny the rights of children and young people to claim the space for their use. Child and youth curfews, oppressive camera surveillance and the unwarranted attentions of police and private security personnel as control measures in public space undermine attempts to secure greater participation by children and young people in constructing positive strategies to address concerns that impact on them and others in a local area. Evidence from research in Scotland undertaken by Article 12 (2000) suggests that young people felt strongly that they did not count in local community matters and decision making and the imposition on them of a curfew by the adult world of the local area created resentment both at the harshness of the measure and disappointment at an opportunity lost to be consulted and involved in dealing with perceived problems of the locality. This is an important cluster of linked issues as Brown (1998:116) argues that young people are ‘selectively constructed as “problem” and “other” with their concerns marginalised, their lifestyles problematised and their voices subdued’, and this flows into their use of public space as their claims to its use as an aspect of social citizenship are usually cast as inferior or rejected as they ‘stand outside the formal polity’ as ‘non persons’. This has major implications for the ways in which young people view their position in a community as many report a feeling of not being wanted, valued or tolerated. The ‘youth question’ according to Davis (1990) acts as a form of ‘screen’ on which observers and analysts project hopes and fears about the state of society, while in the view of Loader (1996:89) the ‘question of young people’ sits within a discourse comprising two elements, the one being youth, particularly young males, as the ‘harbinger of often unwelcome social change and threat’ and the other element ‘constructs young people as vulnerable’. This discourse of threat is further exemplified in the separation of children from teenagers as Valentine (1996) suggests, the treatment of younger children using public space is often dramatically different to that of older children and the most feared stage of all, 'youth'

In defence of Victoria's Children's Court : its value and role in the child protection system

Australian child protection systems have been subject to sustained and significant criticism for many decades. As a central part of that system Children’s Courts have been implicated: three recent inquiries into the child protection system in Victoria all criticised the Family Division of the Children’s Court.1 In the resulting debate two diametrically opposed points of view surfaced about the Children’s Court and the role that legal procedures and professionals should play in child protection matters. On one side bodies like the Children’s Court of Victoria, Victoria Legal Aid (‘VLA’), the Law Institute of Victoria (‘LIV’), and the Federation of Community Legal Centres (‘FCLC’) argued that the Children’s Court plays a vital role in child protection and should continue to play that role.2 On the other side a coalition of human service and child protection agencies called for major change including the removal of the Children’s Court from the child protection system. Victoria’s Department of Human Services (‘DHS’) has been critical of the Court3 as have community sector organisations like Anglicare, Berry Street, MacKillop Family Services and the Salvation Army — all agencies the DHS funds to deliver child protection services.4 Victoria’s Child Safety Commissioner has also called for major reform, publicly labelling the Court a ‘lawyers’ playground’ and recommending abolishing the Court’s involvement in child protection completely.

Preliminary reliability and validity testing of a self-efficacy questionnaire for Chinese family caregivers

Objectives: To develop and test preliminary reliability and validity of a Self-Efficacy Questionnaire for Chinese Family Caregivers (SEQCFC). Methods: A cross-sectional survey of 196 family caregivers (CGs) of people with dementia (CGs) was conducted to determine the factor structure of a SEQCFC of people with dementia. Following factor analyses, preliminary testing was performed, including internal consistency, 4-week test retest reliability, and construct and convergent validity. Results: Factor analyses with direct oblimin rotation were performed. Eight items were removed and five subscales(selfefficacy for gathering information about treatment, symptoms and health care; obtaining support; responding to behaviour disturbances; managing household, personal and medical care; and managing distress associated with caregiving) were identified. The Cronbach’s alpha coefficients for the whole scale and for each subscale were all over 0.80. The 4-week testretest reliabilities for the whole scale and for each subscale ranged from 0.64 to 0.85. The convergent validity was acceptable. Conclusions: Evidence for the preliminary testing of the SEQCFC was encouraging. A future follow-up study using confirmatory factor analysis with a new sample from different recruitment centres in Shanghai will be conducted. Future psychometric property testings of the questionnaire will be required for CGs from other regions of mainland China.

Creating 'saviour siblings' : the notion of harming by conceiving in the context of healthy children

Over the past decade there have been a number of families who have utilised assisted reproductive technologies (ARTs) to create a tissue-matched child, with the purpose of using the child’s tissue to cure an existing sick child. This inevitably brings such families a sense of hope as the ultimate aim is to overcome a family health crisis. However, this specific use of reproductive technologies has been the subject of significant criticism, most of which is levelled against the potential harm to the ‘saviour’ child. In Australia, families seeking to access reproductive technologies in this context are therefore required to justify their motives to an ethics committee in order to establish, amongst other things, whether the child will suffer harm once born. This paper explores the concept of harm in the context of conception, focusing on whether it is possible to ‘harm’ a healthy child who has been conceived to save another. To achieve this, the paper will evaluate the impact of the ‘non-identity’ principle in the ‘saviour sibling’ context, and assess the existing body of literature which addresses ‘harm’ in the context of conception. As will be established, the majority of such literature has focused on ‘wrongful life’ cases which seek to address whether an existing child who has been born with a disability, has been harmed. Finally, this paper will distinguish the harm arguments in the ‘saviour sibling’ context based on the fact that the harm evaluation concerns the ‘future-life’ assessment of a healthy child.

'Pretend I was Mummy': Children's Production of Authority and Subordinance in Their Pretend Play Interaction During Disputes

Purpose – This chapter examines an episode of pretend play amongst a group of young girls in an elementary school in Australia, highlighting how they interact within the membership categorization device ‘family’ to manage their social and power relationships. Approach – Using conversation analysis and membership categorization analysis, an episode of video-recorded interaction that occurs amongst a group of four young girls is analyzed. Findings – As disputes arise amongst the girls, the mother category is produced as authoritative through authoritative actions by the girl in the category of mother, and displays of subordination on the part of the other children, in the categories of sister, dog and cat. Value of paper – Examining play as a social practice provides insight into the social worlds of children. The analysis shows how the children draw upon and co-construct family-style relationships in a pretend play context, in ways that enable them to build and organize peer interaction. Authority is highlighted as a joint accomplishment that is part of the social and moral order continuously being negotiated by the children. The authority of the mother category is produced and oriented to as a means of managing the disputes within the pretend frame of play.

Submission to National Inquiry into Children in Immigration Detention from The Australian Psychological Society

Executive Summary The Australian Psychological Society categorically condemns the practice of detaining child asylum seekers and their families, on the grounds that it is not commensurate with psychological best practice concerning children’s development and mental health and wellbeing. Detention of children in this fashion is also arguably a violation of the UN Convention on the Rights of the Child. A thorough review of relevant psychological theory and available research findings from international research has led the Australian Psychological Society to conclude that: • Detention is a negative socialisation experience. • Detention is accentuates developmental risks. • Detention threatens the bonds between children and significant caregivers. • Detention limits educational opportunities. • Detention has traumatic impacts on children of asylum seekers. • Detention reduces children’s potential to recover from trauma. • Detention exacerbates the impacts of other traumas. • Detention of children from these families in many respects is worse for them than being imprisoned. In the absence of any indication from the Australian Government that it intends in the near future to alter the practice of holding children in immigration detention, the Australian Psychological Society’s intermediate position is that the facilitation of short-term and long-term psychological development and wellbeing of children is the basic tenet upon which detention centres should be audited and judged. Based on that position, the Society has identified a series of questions and concerns that arise directly from the various psychological perspectives that have been brought to bear on estimating the effects of detention on child asylum seekers. The Society argues that, because these questions and concerns relate specifically to improvement and maintenance of child detainees’ educational, social and psychological wellbeing, they are legitimate matters for the Inquiry to consider and investigate. • What steps are currently being taken to monitor the psyc hological welfare of the children in detention? In particular, what steps are being taken to monitor the psychological wellbeing of children arriving from war-torn countries? • What qualifications and training do staff who care for children and their families in detention centres have? What knowledge do they have of psychological issues faced by people who have been subjected to traumatic experiences and are suffering high degrees of anxiety, stress and uncertainty? • What provisions have been made for psycho-educational assessment of children’s specific learning needs prior to their attending formal educational programmes? • who are suffering chronic and/or vicarious trauma as a result of witnessing threatening behaviour whilst in detention? • What provisions have been made for families who have been seriously affected by displacement to participate in family therapy? • What critical incident debriefing procedures are in place for children who have witnessed their parents, other family members, or social acquaintances engaging in acts of self-harm or being harmed while in detention? What psychotherapeutic support is in place for children who themselves have been harmed or have engaged in self- harmful acts while in detention? • What provisions are in place for parenting programmes that provide support for parents of children under extremely difficult psychological and physical circumstances? • What efforts are being made to provide parents with the opportunity to model traditional family roles for children, such as working to earn an income, meal preparation, other household duties, etc.? • What opportunities are in place for the assessment of safety issues such as bullying, and sexual or physical abuse of children or their mothers in detention centres? • How are resources distributed to children and families in detention centres? • What socialization opportunities are available either within detention centres or in the wider community for children to develop skills and independence, engage in social activities, participate in cultural traditions, and communicate and interaction with same-age peers and adults from similar ethnic and religious backgrounds? • What access do children and families have to videos, music and entertainment from their cultures of origin? • What provisions are in place to ensure the maintenance of privacy in a manner commensurate with usual cultural practice? • What is the Government’s rationale for continuing to implement a policy of mandatory detention of child asylum seekers that on the face of it is likely to have a pernicious impact on these children’s mental health? • In view of the evidence on the potential long-term impact of mandatory detention on children, what processes may be followed by Government to avoid such a practice and, more importantly, to develop policies and practices that will have a positive impact on these children’s psychological development and mental health?

Not just another ball game : young adult and adult football fictions are different

Current media attention on the crossover novel highlights the increasing permeability of the boundaries between young adult and adult fiction. This paper will focus upon some of the difficulties around definitions of young adult fiction before considering the fiction of football, or soccer as it is more commonly known in Australia. The football genre exhibits a number of discrete and identifiable differences between young adult and adult readerships including, for example, the role of the protagonist, and the narrative’s distance from the game. This paper will use Franco Moretti’s Mapping as Distant Reading model of abstraction to highlight and unpack these and other characteristic differences in the narratological and stylistic techniques employed across adult and young adult texts. Close reading analysis of the adult football fiction Striker (1992) by Hunter Davies and young adult football fiction Lucy Zeezou’s Goal (2008) by Liz Deep-Jones’ will further illustrate the range of tensions and divergences as they are reflected across those readerships. The texts have been selected because they speak to themes of fear and safety; Joe Swift (Striker) is driven by a need to move away from childhood poverty and insecurity, while Lucy Zeezou shelters a homeless friend. With both protagonists being kidnapped for ransom for example, the texts have also been selected for their striking similarities in form and content.

Child sexual abuse prevention education : A review of school policy and curriculum provision in Australia

The past four decades have seen increasing public and professional awareness of child sexual abuse. Congruent with public health approaches to prevention, efforts to eliminate child sexual abuse have inspired the emergence of prevention initiatives which can be provided to all children as part of their standard school curriculum. However, relatively little is known about the scope and nature of child sexual abuse prevention efforts in government school systems internationally. This paper assesses and compares the policies and curriculum initiatives for child sexual abuse prevention education in primary (elementary) schools across state and territory Departments of Education in Australia. Using publicly available electronic data, a deductive qualitative content analysis of policy and curriculum documents was undertaken to examine the characteristics of child sexual abuse prevention education in these school systems. It was found that the system-level provision of child sexual abuse prevention education occurs unevenly across state and territory jurisdictions. This results in the potential for substantial inequity in Australian children’s access to learning opportunities in child abuse prevention education as a part of their standard school curriculum. In this research, we have developed a strategy for generating a set of theoretically-sound empirical criteria that may be more extensively applied in comparative research about prevention initiatives internationally.

The family participation in child care project : educator views

The capacity of educators to work in partnership with families is considered to be a hallmark of quality practice in education and care. The rationale is that ‘children thrive when families and educators work together in partnership to support young children’s learning’ (DEEWR 2009, p. 9).To support genuine partnerships, the Brisbane South Professional Support Network (PSN) is leading a collaborative project, with the Health and Community Services Workforce Council and Queensland University of Technology (QUT), known as the ‘Family Participation in ECEC project’. The overarching aim of the project is to investigate different perspectives of family partnership in ECEC, with a focus on information sharing, information seeking and family participation,to build educator capacity to establish and maintain genuine partnerships with families. Maintaining a practical focus, and linking to the National Quality Framework for Early Childhood Education and Care (Quality Area 6), the study findings offer insight into the different ways that diverse families and educators may view and experience partnership, and as such provide a sound basis for critical reflection, professional learning and improved practice.

Environmental education through listening to children

Environmental education centres contribute to schools and communities in Environmental Education and Education for Sustainability through nature and urban -based, experiential learning and action learning approaches. An underlying assumption of these centres is that intensive, short-term, outdoor/environmental education experiences can change key attitudes and/or actions leading to positive environmental behaviour. This study reflects the interests of a researching professional who investigated aspects of a program that he designed and implemented as principal of an environmental education centre. Most evaluations of similar programs have used quasi-experimental designs to measure the program outcomes. However, this study considered the experiences of the program from the perspectives of a group of key stakeholders often overlooked in the literature; the children who participated in the program. This study examined children’s accounts of their own experiences in order to contribute new understandings of children’s perspectives and how they can be considered when designing and implementing environmental education programs. This research drew on key theoretical assumptions derived from the sociology of childhood. Within sociology of childhood, children are considered to be competent practitioners within their social worlds, who, through their talk and interaction, participate actively in the construction of their own social situations. This approach also views children as capable and competent learners who construct their knowledge through everyday participation in social experiences. This study set out to generate children’s own accounts of their experiences of a five day residential program at the Centre. In total, 54 children participated in the study that used a multi-faceted data collection approach that included conversations, drawings, photographs and journal writing. Using content analysis, data were analysed by means of an inductive approach to develop themes related to the children’s perspectives of their experiences. Three interrelated and co-dependent components of the experience emerged from the analysis; space and place; engagement and participation; and responsiveness and reflection. These components co-exist and construct the conditions for effective experiences in environmental education at the Centre. The first key finding was the emphasis that the children placed on being provided with somewhere where they could feel safe and comfortable to interact with their environment and engage in a range of outdoor experiences. The children identified that place was an outdoor classroom where they could participate in first-hand experiences and, at times, explore out-of-bound spaces; that is, a place where they had previously been limited, often by adults, in their opportunities to interact with nature. A second key finding was the emphasis that the children placed on engagement and participation in environmental experience. The children described participating in a range of new primary experiences that involved first-hand, experiences and also described participating in collaborative experiences that involved interacting with peers and with teachers, who appeared to behave differently to how they behaved at school. Finally, the children described a different type of interactional relationship with teachers, comparing the active educational role they played on camp to a more passive role at school where they sat at a table and the teacher wrote on the board. The final key finding was the emphasis that the children placed on responsiveness and reflection in the experience. In responding to their experiences, the children described the fun and excitement, confidence and satisfaction that they gained from the experience. The children also identified how their experiences contributed to the development of a caring-for-nature attitude and the value of a disorienting dilemma in promoting responsiveness to the environment. This disorienting dilemma was an event that caused the children to reassess their own beliefs and attitudes. From the three main findings, a theoretical framework that represented the children’s accounts of their experiences and a pedagogic approach that respected their accounts was developed. This pedagogic approach showed how a disorienting dilemma could create a disequilibrium in relation to a child’s existing ideas and experiences. As a result, children were challenged to reflect upon their existing environmental beliefs and practices. The findings of this research have implications for the field of environmental education. Adopting sociology of childhood provides an alternative foundation to research and can present a deeper understanding of what children believe, than an approach that relies solely on using scientific methods to undercover and analyse these understandings. This research demonstrates the value of gaining children’s accounts to assist educators to design environmental education programs as it can offer more than adult and educator perspectives. This study also provides understandings of environmental education practice by describing how the children engaged with informal learning situations. Finally, two sets of recommendations, drawn from this study, are made. The first set considers nine recommendations about and for future research and the second relates to redesigning of the environmental educational program at the research site, with six recommendations made.

The lost boys : creating appealing and engaging fiction for adolescent male reluctant readers & Duende a young adult novella

Reading plays an important role in establishing lifelong learning and providing the reader with an avenue to new experiences and a language with which to express their ideas and feelings (Owen 2003; Hamston & Love 2005). In particular adolescents need a language that allows them to 'play with their identities in a safe and controlled manner to explore who they want to be in this ever changing world' (Koss & Teale 2009, 569). Block (1995) advances that there is a distinct correlation between what we read and how we live in the world, and argues 'if what we read influences our identity in the world, the ways we are able to imagine and live in the world, then there is some responsibility to address these various texts, their readers and possible reading experiences' (Koss & Teale 2009, 569). Within my research I attempt to take on this responsibility by establishing a connection between reluctant adolescent male readers, and their reading experiences and by using their opinions to create a novella that seeks to more fully engage them. Centred within the larger debate about boys and books are two central discussions: why don't boys read and what should boys read? While a number of reasons why adolescent boys don't read are mentioned in this paper and it might not be possible to fully account for why many are reluctant readers, it is possible to argue that specific forms of literature addressing certain themes and topics relevant to the age group might appeal to reluctant readers. The conceptual framework for this research was structured using a mixed-method approach consisting of four phases. In positioning my research for determining literature that reluctant readers may want to read I draw on a variety of material which tends to support the longevity of S.E Hinton's (1967) argument that 'teenagers today, want to read about teenagers today' (cited in Smith & Wilhelm 2002, 6). My practice-based research was conducted within a high school in Brisbane, Australia. Six participants were selected and required to read three recently published Australian Young Adult novels, and opinion was collected via semi-structured interviews on these case studies. Grounded Theory (Charmaz 2003; Charmaz 2006; Glaser & Strauss 2011) informed the design of the questions, and the process of concurrent interviews and analysis of opinion. This analysis led to construction of my theory: adolescent male reluctant readers want to read about female relationships and family conflict within a story that consists of an adventure that, although unlikely to happen, could happen. From this study there are two main contributions, which have theoretical and practical implications for stakeholders with a vested interest in the discussion regarding boys and books. First, this study, through the research methodology, presents key findings that indicate that reluctant readers are interested in realistic texts addressing themes that will help with the construction of, and understanding of, their own lives. Secondly, the grounded theory derived from these findings is applied to my own praxis and my creative artefact (Duende) is included with this exegesis as a text intended to create a connection between engaging texts and adolescent male reluctant readers.

A longitudinal study of grieving in family caregivers of people with dementia

A longitudinal study of grieving in family caregivers of people with dementia Recent research into dementia has identified the long term impact that the role of care giving for a relative with dementia has on family members This is largely due to the cognitive decline that characterises dementia and the losses that can be directly attributed to this. These losses include loss of memories, relationships and intimacy, and are often ambiguous so that the grief that accompanies them is commonly not recognised or acknowledged. The role and impact of pre-death or anticipatory grief has not previously been widely considered as a factor influencing health and well-being of family caregivers. Studies of grief in caregivers of a relative with dementia have concluded that grief is one of the greatest barriers to care giving and is a primary determinant of caregiver well-being. The accumulation of losses, in conjunction with experiences unique to dementia care giving, place family caregivers at risk of complicated grief. This occurs when integration of the death does not take place following bereavement and has been associated with a range of negative health outcomes. The aim of this research was to determine the influence of grief, in addition to other factors representing both positive and negative aspects of the role, on the health related quality of life of family caregivers of people with dementia, prior to and following the death of their relative with dementia. An exploratory research project underpinned by a conceptual framework of caregivers’ adaptation in the context of subjective appraisal of the strains and gains in their role was undertaken. The research comprised three studies. Study 1 was a scoping study that involved a series of semi-structured interviews with thirteen participants who were family caregivers of people with severe dementia or whose relative with dementia had died in the previous twelve months. The results of this study in conjunction with factors identified in the literature informed data collection for the further studies. Study 2 was a cross sectional survey of fifty caregivers recruited when their relative was in the moderate to severe stage of dementia. This study provided the baseline data for Study 3, a prospective cohort follow up study. Study 3 consisted of seventeen participants followed up at two time points after the death of their relative with dementia: six weeks and then six months following the death of the relative with dementia. The scoping study indicated that differences in appraisal of the care giving role and encounters with health professionals were related to levels of grief of caregivers prior to and following the death of the relative with dementia. This was supported in the baseline and follow up studies. In the baseline study, after adjusting for all variables in multivariate regression models, subjective appraisal of burden was found to make a significant contribution (p<.05) to mental health related quality of life. The two dependent variables, anticipatory grief and mental health related quality of life, were significantly (p<.01) correlated at a bivariate level. In the follow up study, linear mixed modelling and multiple regression analysis of data found that subjective appraisal of burden and resilience were significantly associated (p<.05 and p<.01, respectively) with mental health related quality of life over time. In addition, bereavement and complicated grief were significantly associated (p<.05) with mental health following the death of the relative. In this study social support and satisfaction with end of life care were found to be statistically associated (p<.05) with physical health related quality of life over time. The strong relationship between grief of caregivers and their health related quality of life over the entire care giving trajectory and period following the death of their relative highlights the urgent need for further research and interventions in this area. Overall results indicate that addressing the risk and protective factors including subjective appraisal of their care giving role, resilience, social support and satisfaction with end of life care of their relative, has the potential to both ameliorate negative health outcomes and to promote improved health for these caregivers. This research provides important information for development of targeted and appropriate interventions that aim to promote resilience and reduce the personal burden on caregivers of people with dementia.