An analysis of Haitian parents' perceptions of their children with disabilities

Parental involvement is an integral part of the educational system in the U.S. Yet, parents from non-mainstream racial/ethnic backgrounds have not fully grasped the nature of parental involvement expectations in the educational process and how these expectations may impact student achievement. The purpose of this study was to identify Haitian parents’ perceptions of their children with disabilities and the education these children were receiving. Several authors have conducted studies on parents of children with disabilities to better gain an understanding of the level of their involvement with their children’s education, their perceptions of the children, and their views on the school system (Harry, 1992a, 1992b). In this study, Haitian parents of children with disabilities were interviewed using an interview protocol. Through these interviews, this study explored 10 Haitian parents’ perceptions of their child with a disability, the education the child was receiving, their interaction with the school system, and how the disability had affected their relationship with their child and their involvement with the school. Findings of the present study revealed that these Haitian parents seldom disagreed with school personnel and did not seem to fully grasp the different methods available to address their concerns as parents of children with disabilities nor the role they were expected to play in the process. The majority did not have basic literacy skills in Creole or English. The parents in this study were overwhelmed by school written communication. Additionally, this study discovered that parents’ perceptions were guided by two core concepts: coping mechanisms and locus of control. Parents with an internal locus of control, who tended to be more educated, focused inward to find solutions to problems encountered. Those with an external locus of control relied on outside influences to resolve their problems. Parental involvement was strongly influenced by their values, beliefs, customs, and conceptual knowledge about disability; all closely aligned with culture and acculturation. Overall, these parents’ perceptions greatly influenced their thoughts and behaviors when they realized that their children with disabilities might fall short of their immigrant dreams of success they held for these children.

Hindutva meets globalization: The impact on Hindu urban media women

This study examines the impact of globalization and religious nationalism on the personal and professional lives of urban Hindu middle class media women. The research demonstrates how newly strengthened forces of globalization and Hindutva shape Indian womanhood. The research rests on various data that reveal how Indian women interpret and negotiate constructed identities. The study seeks to give voice to the objectified by scrutinizing and challenging the stereotypical modern faces of Indian womanhood seen in the narratives of globalization and Hindutva. Feminist open-ended interviewing was conducted in English and Hindi in New Delhi, the capital of India, with 23 Hindu women, employed by electronic and print media corporations. Accumulated data were analyzed and interpreted using feminist critical discourse analysis. Findings from the study indicate that while the Indian middle class women have embraced professional opportunities presented by globalization, they remain circumscribed by mutating gender politics. The research also finds that as academic and professional progress empower the women within their homes, their public lives have become fraught with increasing gender violence and decreasing recourse to justice. Therefore, women accept the power stratification of their lives as being dependent on spatial and temporal distinctions, and have learnt to engage and strategize with the public environment for physical safety and personal-professional progress. While the media women see systemic masculine domination as being symbiotic with tenets of religious nationalism, they exhibit an unquestioned embracing of capitalism/globalization as the means of empowerment. My research also strongly indicates the importance of the media’s role in shaping gender dynamics in a global context. In conclusion, my research shows the mediawomen’s immense agency in pursuing academic and professional careers while being aware of deeply ingrained gender roles through their strong commitment towards their families. The findings of this study contribute to the literature on Third World nationalism, urban globalization and understandings of reworked-renewed masculine domination. Finally, the study also engages with recent scholarship on the Indian middle class (See Nanda 2010; Shenoy 2009; Lukose 2005; and Radhakrishnan 2006) while simultaneously addressing the notions of privilege and disengagement levied at the middle class woman, a symbiosis of idealization and imprisonment.

A comprehensive assessment of self -report experiences of adoptive parents of special needs children in Florida

Adoption of special needs children is now seen as a life long event whereby the adoptive child and family have unique needs. The need for postplacement resources throughout the life cycle of the adoption process is evident. This exploratory-descriptive research employed a random stratified cross-sectional design. The purpose of the study was to describe, identify, examine, and assess the relative influence of identified empirically and conceptually relevant variables of self-report experiences of adoptive parents of special needs children. Primary areas of exploration included: (1) adoptive children and families' characteristics, (2) postplacement service needs, utilization and satisfaction, and (3) adoptive parents' perceptions of their adoption experiences. A proportionate stratified random mail survey was used to obtain 474 families who had adopted special needs children from the 15 geographic districts which make up the state adoption social service agency in Florida. A 144-item survey questionnaire was used to collect basic information on demographic data, service provision, and adoption experiences. Four research questions were analyzed to test the effect the predictor variables had on willingness to adopt another special needs child, successful adoption, satisfying experience, and realism about problems. All four research questions revealed that the full model and the child's antecedent and the adoptive parents' intervening variable blocks were significant in explaining the variance in the dependent variables. The child's intervening variables alone were only significant in explaining the variance for one of the dependent variables. The results of the statistical analysis on the fifth research question and the three hypotheses determined that (1) only one postplacement service, crisis intervention, had a statistically significant impact on the adoptive parents' perceived level of satisfaction with the adoption experience; (2) adoptive parents who rate their adoption as successful are more likely to express a desire to adopt another special needs child; (3) the more adequate information on the child the adoptive parents perceived that they had prior to placement, the more they perceived they were realistic about the problems they would encounter; and (4) six specific postplacement services were found to be significant in predicting successful adoptions--crisis intervention, outpatient drug/alcohol treatment, maintenance subsidy, physical therapy, special medical equipment, and family counseling. Implications for the social work field and future research are discussed. ^

Middle -class immigrant identities: Dominican-Americans in South Florida

Identity studies of immigrants are complex because of multiple influences affecting identity reconstruction during immigration and acculturation: nationality, socio-cultural differences, occupations, education, spatial and geographic locations, age, gender, and personal attributes. Most immigrant identity studies deal with lower-income immigrants, who do not have the resources of middle- and upper-middle-class immigrants. South Florida is “home” to many middle-class immigrants, including Dominican-Americans. This dissertation interviewed sixty-six Dominican immigrants in South Florida, in order to determine their reconstructed identities after immigration/resettlement and to discover what influences contributed to these changes in identities. ^ The research design of this dissertation utilized an inductive, qualitative model, with the “grounded theory” method of data collection, categorization, and analysis. Participants were selected by a snowball sampling and interviewed with an informal questionnaire. Results were transcribed, categorized, tabulated, and analyzed for conclusions and theorization on immigrant identity. ^ The dissertation addressed numerous influences relating to identity reconstruction: the differing circumstances of immigration, the unique resources of middle- and higher-class immigrants, the nurturing environment of South Florida for immigrants with education and professional skills, and the boundary protection offered by suburban spaces. The interviewees displayed a wide range of age, length of residence in the United States, reasons for immigration, entry ports, settlement, relocations, occupations, and claimed identities. Identity was cross-tabulated with the various influences, as a means of invalidating certain influences and indicating possible trends. ^ The dissertation concluded that middle-class immigrant identities are diverse and multiple, as are the related influences. None of these immigrants had become totally assimilated, nor have they retained dual, non-overlapping attachments or frames of reference. Instead, many of the immigrants seemed to have developed or negotiated two or more identities, according to need, context, and personal interest. A cosmopolitan community such as South Florida seems to have encouraged such multiplicity of identity. However, rather than forming free-flowing identities, most of these immigrants eventually developed diverse and hybrid identities that have bounded attachments to various networks, groups, and places in South Florida. ^

Children with special health care needs: Comparison of the effects of home care setting, prescribed pediatric extended care setting, and long-term care setting on child and family health outcomes and health care service use

Technological advances during the past 30 years have dramatically improved survival rates for children with life-threatening conditions (preterm births, congenital anomalies, disease, or injury) resulting in children with special health care needs (CSHCN), children who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who require health and related services beyond that required by children generally. There are approximately 10.2 million of these children in the United States or one in five households with a child with special health care needs. Care for these children is limited to home care, medical day care (Prescribed Pediatric Extended Care; P-PEC) or a long term care (LTC) facility. There is very limited research examining health outcomes of CSHCN and their families. The purpose of this research was to compare the effects of home care settings, P-PEC settings, and LTC settings on child health and functioning, family health and function, and health care service use of families with CSHCN. Eighty four CSHCN ages 2 to 21 years having a medically fragile or complex medical condition that required continual monitoring were enrolled with their parents/guardians. Interviews were conducted monthly for five months using the PedsQL™ Generic Core Module for child health and functioning, PedsQL™ Family Impact Module for family health and functioning, and Access to Care from the NS-CSHCN survey for health care services. Descriptive statistics, chi square, and ANCOVA were conducted to determine differences across care settings. Children in the P-PEC settings had a highest health care quality of life (HRQL) overall including physical and psychosocial functioning. Parents/guardians with CSHCN in LTC had the highest HRQL including having time and energy for a social life and employment. Parents/guardians with CSHCN in home care settings had the poorest HRQL including physical and psychosocial functioning with cognitive difficulties, difficulties with worry, communication, and daily activities. They had the fewest hours of employment and the most hours providing direct care for their children. Overall health care service use was the same across the care settings.

Development of an online role-play assessment initiative for nursing students in their bioscience studies

Devising assessment tasks for large units that embrace academic goals of authenticity and assessment variety can be a challenge. We developed an online Role-Play Assessment Initiative for first year nursing students in bioscience. Students responded to a case study by preparing two role-play dialogues: as a nurse with the patient, and between two nurses. The aims were to assess whether the students could: 1) understand the underlying disease process (pathophysiology) and relate it to clinical practice; 2) use language appropriate for lay and medical conversation; and 3) apply information using active learning. We conducted a student survey using quantitative questions (Likert scale: 1=strongly disagree to 5=strongly agree), and qualitative questions. 65 completed surveys were received. 80% of respondents agreed (includes agree or strongly agree) that it was a useful way to learn and understand pathophysiology of the case study. 86% agreed that it was useful to apply pathophysiology from lectures to a clinical setting. Overall, students found it enjoyable, which is beneficial for enhanced student engagement, and agreed that it allowed them to work well in a group (74% and 85%, respectively). Most qualitative suggestions for improvement related to group work, despite the encouraging response to group work in quantitative questions. Most positive comments surrounded different communication with a nurse compared with a patient. These results demonstrate that students developed deeper understanding of pathophysiology through active learning and were able to expand their nursing career skills during the role-play. Learning using role-play to simulate the workforce has fostered active learning.

Comparison of health behaviors of Mexican American and non -Hispanic White females: Implications for health promotion programs

Hispanics form the second-largest minority group in the United States totaling 22 million people. Health data on this population are sparse and inconsistent. This study seeks to determine use of preventative services and risk factor behaviors of Mexican American and non-Hispanic White females residing in South Texas.^ Baseline data from female respondents in household surveys in six South Texas counties (Ramirez and McAlister, 1988; McAlister et al., 1992) were analyzed to test the following hypotheses: (1) Mexican American and Non-Hispanic White females exhibit different patterns of health behaviors; (2) Mexican American females will exhibit different health behaviors regardless of age; and (3) the differences between Mexican American women and non-Hispanic White females are due to education and acculturation factors.^ Over the past decade, the traditional behaviors of Mexican American females have begun to change due to education, acculturation, and their participation in the labor force. The results from this study identify some of the changes that will require immediate attention from health care providers. Results revealed that regardless of ethnicity, age, education, and language preference, non-Hispanic White females were significantly more likely to participate in preventive screening practices than were Mexican American females. Risk factor analysis revealed a different pattern with Mexican American females significantly more likely to be non-smokers, non-alcoholic drinkers, and to have good fat avoidance practices compared to non-Hispanic White females. However, compared to those who are less-educated or Spanish-speaking, Mexican American females with higher levels of education and preference for speaking English only showed positive and negative health behaviors that were more similar to the non-Hispanic White females. The positive health behaviors that come with acculturation, e.g., more participation in preventive care and more physical activity, are welcome changes. But this study has implications for global health development and reinforces a need for "primordial" prevention strategies to deter the unwanted concomitants of economic development and acculturation. Smoking and drinking behaviors among Mexican American females need to be kept at low levels to prevent increased morbidity and premature deaths in this population. ^

Characteristics of effective clinical and theory instructors as perceived by LPN to RN versus generic students in an associate degree nursing program

The purpose of this study was to compare the characteristics of effective clinical and theory instructors as perceived by LPN/RN versus generic students in an associate degree nursing program.^ Data were collected from 508 students during the 1996-7 academic year from three NLN accredited associate degree nursing programs. The researcher developed instrument consisted of three parts: (a) Whitehead Characteristics of Effective Clinical Instructor Rating Scale, (b) Whitehead Characteristics of Effective Theory Instructor Rating Scale, and (c) Demographic Data Sheet. The items were listed under five major categories identified in the review of the literature: (a) interpersonal relationships, (b) personality traits, (c) teaching practices, (d) knowledge and experience, and (e) evaluation procedures. The instrument was administered to LPN/RN students in their first semester and to generic students in the third semester of an associate degree nursing program.^ Data was analyzed using a one factor mutivariate analysis of variance (MANOVA). Further t tests were carried out to explore for possible differences between type of student and by group. Crosstabulations of the demographic data were analyzed.^ There were no significant differences found between the LPN/RN versus generic students on their perceptions of either effective theory or effective clinical instructor characteristics. There were significant differences between groups on several of the individual items. There was no significant interaction between group and ethnicity or group and age on the five major categories for either of the two instruments. There was a significant main effect of ethnicity on several of the individual items.^ The differences between the means and standard deviations on both instruments were small, suggesting that all of the characteristics listed for effective theory and clinical instructors were important to both groups of students. Effective teaching behaviors, as indicated on the survey instruments, should be taught to students in graduate teacher education programs. These behaviors should also be discussed by faculty coordinators supervising adjunct faculty. Nursing educators in associate degree nursing programs should understand theories of adult learning and implement instructional strategies to enhance minority student success. ^

The knowledge and use of critical thinking teaching strategies of faculty in associate degree nursing education programs

The purpose of this study was to determine the knowledge and use of critical thinking teaching strategies by full-time and part-time faculty in Associate Degree Nursing (ADN) programs. ^ Sanders CTI (1992) instrument was adapted for this study and pilot-tested prior to the general administration to ADN faculty in Southeast Florida. This modified instrument, now termed the Burroughs Teaching Strategy Inventory (BTSI), returned reliability estimates (Cronbach alphas of .71, .74, and .82 for the three constructs) comparable to the original instrument. The BTSI was administered to 113 full-time and part-time nursing faculty in three community college nursing programs. The response rate was 92% for full-time faculty (n = 58) and 61% for part-time faculty (n = 55). ^ The majority of participants supported a combined definition of critical thinking in nursing which represented a composite of thinking skills that included reflective thinking, assessing alternative viewpoints, and the use of problem-solving. Full-time and part-time faculty used different teaching strategies. Full-time faculty most often used multiple-choice exams and lecture while part-time faculty most frequently used discussion within their classes. One possible explanation for specific strategy choices and differences might be that full-time faculty taught predominately in theory classes where certain strategies would be more appropriate and part-time faculty taught predominately clinical classes. Both faculty types selected written nursing care plans as the second most effective critical thinking strategy. ^ Faculty identified several strategies as being effective in teaching critical thinking. These strategies included discussion, case studies, higher order questioning, and concept analysis. These however, were not always the strategies that were used in either the classroom or clinical setting. ^ Based on this study, the author recommends that if the profession continues to stress critical thinking as a vital component of practice, nursing faculty should receive education in appropriate critical teaching strategies. Both in-service seminars and workshops could be used to further the knowledge and use of critical thinking strategies by faculty. Qualitative research should be done to determine why nursing faculty use self-selected teaching strategies. ^

Nursing curriculum: Changing students' knowledge and biases towards older adults

Caring for the older adult is a topic debated and discussed at all levels of today's society. Nurses are expected to educate patients and family members about their medications and care following hospitalization or contact with the health care system. The majority of these patients are elderly. The purpose of the study was to determine if a course on aging would affect the knowledge and biases of nursing students in a Baccalaureate nursing program at a Southeast Florida University. Nursing students (N = 52) were surveyed at the beginning of the semester using Palmore's Facts on Aging Quiz that is structured to determine the knowledge and biases of individuals towards the older adult. Students were surveyed before and after the nursing course that had a didactic and clinical component in the hospital setting. Analysis of the data by Chi square and repeated measure ANOVA supported the hypothesis that a course segment on aging would affect the knowledge level of the nursing students and result in changes of their biases toward the older adult. ^

Falls and the Social Isolation of Older Adults in the National Health and Aging Trends Study

Thesis (Ph.D.)--University of Washington, 2016-08

Adolescent depressive disorders and family based interventions in the family options multicenter evaluation: study protocol for a randomized controlled trial

Background
There is increasing community and government recognition of the magnitude and impact of adolescent depression. Family based interventions have significant potential to address known risk factors for adolescent depression and could be an effective way of engaging adolescents in treatment. The evidence for family based treatments of adolescent depression is not well developed. The objective of this clinical trial is to determine whether a family based intervention can reduce rates of unipolar depressive disorders in adolescents, improve family functioning and engage adolescents who are reluctant to access mental health services.

Methods/Design
The Family Options study will determine whether a manualized family based intervention designed to target both individual and family based factors in adolescent depression (BEST MOOD) will be more effective in reducing unipolar depressive disorders than an active (standard practice) control condition consisting of a parenting group using supportive techniques (PAST). The study is a multicenter effectiveness randomized controlled trial. Both interventions are delivered in group format over eight weekly sessions, of two hours per session. We will recruit 160 adolescents (12 to 18 years old) and their families, randomized equally to each treatment condition. Participants will be assessed at baseline, eight weeks and 20 weeks. Assessment of eligibility and primary outcome will be conducted using the KID-SCID structured clinical interview via adolescent and parent self-report. Assessments of family mental health, functioning and therapeutic processes will also be conducted. Data will be analyzed using Multilevel Mixed Modeling accounting for time x treatment effects and random effects for group and family characteristics. This trial is currently recruiting. Challenges in design and implementation to-date are discussed. These include diagnosis and differential diagnosis of mental disorders in the context of adolescent development, non-compliance of adolescents with requirements of assessment, questionnaire completion and treatment attendance, breaking randomization, and measuring the complexity of change in the context of a family-based intervention.

Association between temperament and physical activity in a population of minority women

Physical activity has been, and remains, a significant public health issue. Thus, increasing physical activity has been identified as a top priority according to Healthy People 2010. Various behavioral variables have been associated with participation in physical activity, including the Type A behavior pattern (TABP). This study was a secondary data analysis of the Women On The Move pilot study data and examined the relationship between Type A behavior with physical activity. The study population consisted of fifty-six (56) adult minority women 40 years of age and above. The Thurstone Activity Scale was adapted for use in this study to measure TABP. Physical activity behavior was measured using an accelerometer (Computer Science Application, [CSA]) and a physical activity diary. All study questions were examined using multiple linear regression analysis. In all analyses age, household income, and level of education were entered as covariates. The results found no association with TABP and exercise or physical activity. More research involving a larger, more active study population is recommended in order to more precisely determine the relationship of TABP and physical activity. ^

Seclusion of children and adolescents: Psychopathological and family factors

This paper describes the use of seclusion in a child and adolescent inpatient unit, including precipitating events, management strategies, details of seclusion episodes and individual and family risk factors. Inpatient ward documentation of seclusion episodes, demographic data and measures of individual psychopathology and impairment, parent mental health, life events and family functioning were used to compare secluded, non-secluded and outpatient groups. Secluded individuals had elevated psychopathology compared with non-secluded inpatients and outpatients. Their families reported poorer parental mental health and family functioning and more recent stressful life events. The results indicate that seclusion is most common among high-risk inpatients.