Open Adoption: Adoptive Parents' Experiences of Birth Family Contact and Talking to Their Child about Adoption

The trend towards more open adoption presents adopters with unique parenting challenges associated with satisfying the child’s curiosity about their origins, and maintaining relationships with birth family through contact. This paper focuses on the experiences of 20 sets of adoptive parents who were interviewed as part of the Northern Ireland Care Pathways and Outcomes Study. Interviews were analysed following the principles of Interpretative Phenomenological Analysis (IPA). It explores adoptive parents’ experience of talking to their child about adoption, and of post-adoption contact with members of the birth family. Adopters discussed adoption sensitively with their child, but were concerned that difficult and complex family histories would present a risk to the child’s self-esteem and emotional well-being. All forms of contact proved emotionally and practically burdensome, however adopters were committed to making it work for the child’s benefit, and were open to increased contact should the child wish it in the future. There was little relationship with birth family outside of formal contact. The study reveals a need for a mechanism to facilitate communication with birth family if adopters are to be able to respond to the child’s changing need for contact and information.

Posting Incognito ... Males with Eating Problems: Online Emotional Expression and Support

Qualitative research in the area of eating disorders (eds) has predominantly focused on females,whilst the experiences of males’ remains poorly understood. due to the secretive nature of eating problems/eds it can be difficult to explore the experiences of males with these problems; however, online support groups/message boards, which are common and popular, provide a non-invasive
forum for researchers to conduct research. This study analyzed naturally occurring discussions on an internet message board dedicated to males and eating problems using content analysis. Two major overarching themes of emotional expression (sharing feelings of disturbed eating attitudes and emotions; being secretive) and support (informational and emotional) were identified. The message board provided a vital support system for this group, suggesting that online message boards may be an important avenue for health professionals to provide information, support, and advice.

Betwixt spaces: Students’ accounts of turning point experiences in first-year transitions

'Not belonging' is becoming a prevalent theme within accounts of the first-year student experience at university. In this study the notion of not belonging is extended by assuming a more active role for the idea of liminality in a student's transition into the university environments of academic and student life. In doing so, the article suggests that the transition between one place (home) and another (university) can result in an 'in-between-ness' - a betwixt space. Through an interpretative methodology, the study explores how students begin to move from this betwixt space into feeling like fully-fledged members of university life. It is concluded that there is a wide range of turning points associated with the students' betwixt transition, which shapes, alters or indeed accentuates the ways in which they make meaningful connections with university life. Moreover, transitional turning point experiences reveal a cast of characters and symbolic objects; capture contrasting motivations and evolving relationships; display multiple trajectories of interpersonal tensions and conflicts; highlight discontinuities as well as continuities; and together, simultaneously liberate and constrain the students' transition into university life.

“It’s like a problem that doesn’t exist”: The emotional well-being of mothers caring for a child with brain injury.

Background: Although research has shown that significant burden and adverse psychological impact are associated with caring for a child with brain injury, limited knowledge exists concerning the qualitative experience and impact of this burden.
Objective: To provide an account of the experiences of mothers who care for a childhood survivor of brain injury.
Research design: Postal survey.
Methods and procedures: A self-report questionnaire was sent to a consecutive sample of mothers (n=86) of children (aged 8-28) with acquired brain injury, registered with a UK children’s brain injury charity. Five essay style questions enabled mothers to reflect on and describe at length their caring experiences, with particular emphasis placed on the perceived impact on emotional well-being.
Main outcomes and results: Thematic analysis identified five key themes: Perpetually Anxious, The Guilty Carer, The Labour of Caring, A Self-Conscious Apologist and Perpetually Grieving. Collectively, these themes highlight two core processes shaping mothers’ caring experiences and concomitant mental well-being. Firstly, the collective and enduring nature of caregiver burden over time. Second, the crucial role played by socio-cultural values in perpetuating caregiver burden.
Conclusions: Societal norms, particularly those relating to the nature and outcome of brain injury and motherhood, serve to marginalise mothers and increase feelings of isolation. Findings suggest the value of peer support programs as an effective means of providing appropriate social support.

Enquiring about traumatic experiences in bipolar disorder: A case note and self- report comparison

Objectives: This study examined: (i) the prevalence of lifetime trauma, childhood trauma and trauma related to civil unrest in a Bipolar Disorder sample, and (ii) the agreement between rates of disclosure of trauma in case notes and self-report questionnaires.

Methods: The case notes of sixty participants, recruited from a geographically well-defined mental health service in Northern Ireland, were examined for reports of experiences of lifetime, childhood and traumatic events related to civil conflict. The participants also completed self-report measures of trauma.

Results: Considerable differences were found between the prevalence of trauma as measured by self-report questionnaires and case notes reports. The prevalence of lifetime trauma as measured by the Trauma History Questionnaire was 61.7% (compared to case notes prevalence of 33.3%). The prevalence of moderate and severe levels of childhood trauma as measured by the Childhood Trauma Questionnaire was 65% (case notes 21.7%). Rates of trauma related to civil unrest were 35% (case notes 3.3%). Poor levels of agreement were found between all self-report trauma measures and case notes reports. Agreement on two categories of trauma (childhood emotional neglect and childhood physical neglect) reached statistical significance but kappa scores suggest this agreement was poor (kappa = .14. p<.05; kappa = .127, p<.05). © 2011 Elsevier B.V. All rights reserved.

Conclusions: It is probable that the increased rate of trauma disclosed in the self-report questionnaire arises because clinicians during initial assessment and subsequent treatment do not consistently enquire about trauma. The need for staff training is discussed. (C) 2011 Elsevier B.V. All rights reserved.

Nurses' experiences providing palliative care to individuals living in rural communities aspects of the physical residential setting

Introduction: Efforts are needed to improve palliative care in rural communities, given the unique characteristics and inherent challenges with respect to working within the physical aspects of residential settings. Nurses who work in rural communities play a key role in the delivery of palliative care services. Hence, the purpose of this study was to explore nurses’ experiences of providing palliative care in rural communities, with a particular focus on the impact of the physical residential setting.

Methods: This study was grounded in a qualitative approach utilizing an exploratory descriptive design. Individual telephone interviews were conducted with 21 community nurses. Data were analyzed by thematic content analysis.

Results: Nurses described the characteristics of working in a rural community and how it influences their perception of their role, highlighting the strong sense of community that exists but how system changes over the past decade have changed the way they provide care. They also described the key role that they play, which was often termed a ‘jack of all trades’, but focused on providing emotional, physical, and spiritual care while trying to manage many challenges related to transitioning and working with other healthcare providers. Finally, nurses described how the challenges of working within the physical constraints of a rural residential setting impeded their care provision to clients who are dying in the community, specifically related to the long distances that they travel while dealing with bad weather.

Women’s Perceptions and Experiences of Fetal Macrosomia

Objective
to explore women's perceptions and experiences of pregnancy and childbirth following birth of a macrosomic infant (birth weight ≥4000 g).

Methods
a qualitative design utilising interviews conducted 13–19 weeks post partum in women's homes. The study was conducted in one Health and Social Care Trust in Northern Ireland between January and September 2010. Participants were identified from a larger cohort of women recruited to a prospective study exploring the impact of physical activity and nutrition on macrosomia. Eleven women who delivered macrosomic infants participated in this phase of the study.

Findings
four overarching themes emerged: preparation for delivery; physical and emotional impact of macrosomia; professional relations and perceptions of macrosomia. Findings highlighted the importance of communication with health professionals in relation to both prediction of macrosomia and decision making about childbirth, and offers further understanding into the physical and emotional impact of having a macrosomic infant on women. Furthermore, there was evidence that beliefs and perceptions relating to macrosomia may influence birth experiences and uptake of health promotion messages.

Key conclusions and implications for practice
this study provides important insight into women's experiences of macrosomia throughout the perinatal period and how they were influenced by previous birth experiences, professional relations and personal perceptions and beliefs about macrosomia. Pregnant women at risk of having a macrosomic infant may require extra support throughout the antenatal period continuing into the postnatal period. Support needs to be tailored to the woman's information needs, with time allocated to explore previous birth experiences, beliefs about macrosomia and options for childbirth.

'Every pregnant woman needs a midwife'--the experiences of HIV affected women in maternity care

TITLE: 'Every pregnant woman needs a midwife'-the experiences of HIV affected women in Northern Ireland.

OBJECTIVE: to explore HIV positive women's experiences of pregnancy and maternity care, with a focus on their interactions with midwives.

DESIGN: a prospective qualitative study.

SETTING: regional HIV unit in Northern Ireland.

PARTICIPANTS: 22 interviews were conducted with 10 women at different stages of their reproductive trajectories.

FINDINGS: the pervasive presence of HIV related stigma threatened the women's experience of pregnancy and care. The key staff attributes that facilitated a positive experience were knowledge and experience, empathy and understanding of their unique needs and continuity of care.

KEY CONCLUSIONS: pregnancy in the context of HIV, whilst offering a much needed sense of normality, also increases woman's sense of anxiety and vulnerability and therefore the need for supportive interventions that affirm normality is intensified. A maternity team approach, with a focus on providing 'balanced care' could meet all of the woman and child's medical needs, whilst also emphasising the normalcy of pregnancy.

OLDER WOMEN’S LIFELONG EXPERIENCES OF DOMESTIC VIOLENCE IN NORTHERN IRELAND

Violence against women is a serious criminal and public health issue with devastating consequences for women, families and society. To date, little international research has been given to understanding the needs of older women, who are experiencing domestic violence; that is, physical, sexual, emotional or financial abuse carried out by a spouse or partner. This study fills a significant gap in the literature as the needs of older women who have experienced a lifetime of domestic violence in Northern Ireland are unknown. Health professionals, service providers and policy makers often assume that violence stops at age 55 and there is a noticeable lack of literature, research and guidelines on the issue. The greatest challenge for health visitors is that abuse remains hidden, with women remaining silent and finding it difficult to speak openly or seek help.

Hearing the voices of kinship foster carers in Northern Ireland: An inquiry into characteristics, needs and experiences

This study describes an investigation into the characteristics, needs and experiences of kinship foster carers in Northern Ireland. By adopting a mixed-methods approach with 54 carers, a number of salient themes was captured. The respondents were predominantly grandparents who experienced a significant incidence of health-related issues. The cohort also endured high levels of stress, particularly at the beginning stage of the foster placement. Consequently, their need for practical, emotional and respite support was most evident. In terms of the children for whom they cared, many required help at school, and some presented with challenging emotions and behaviours. Overall, these findings emphasised the importance of relationship-based social work and demonstration of accurate empathy to the carer.

Towards a positive cross-cultural lexicography: Enriching our emotional landscape through 216 ‘untranslatable’ words pertaining to well-being

Although much attention has been paid to culture-specific psychopathologies, there have been no comparable attempts to chart positive mental states that may be particular to certain cultures. This paper outlines the beginnings of a positive cross-cultural lexicography of ‘untranslatable’ words pertaining to wellbeing, culled from across the world’s languages. A quasi-systematic search uncovered 216 such terms. Using grounded theory, these words were organised into three categories: feelings (comprising positive and complex feelings); relationships (comprising intimacy and pro-sociality); and character (comprising personal resources and spirituality). The paper has two main aims. First, it aims to provide a window onto cultural differences in constructions of wellbeing, thereby enriching our understanding of wellbeing. Second, a more ambitious aim is that this lexicon may help expand the emotional vocabulary of English speakers (and indeed speakers of all languages), and consequently enrich their experiences of wellbeing. The paper concludes by setting out a research agenda to pursue these aims further.

Projective Identification and the Fear of Failing: Making Sense of Practice Educators' Experiences of Failing Social Work Students in Practice Learning Settings

The paper focuses on emotions and processes that may arise for practice educators when working with a struggling or failing student in a practice learning setting.1 The paper firstly documents a previously undertaken thematic review of the literature, which explored why practice educators appeared to find it difficult to fail students in practice learning settings. Secondly, the paper draws on two UK qualitative studies that highlighted the emotional distress experienced by practice educators when working with a marginal or failing student. The paper documents key findings using a case study approach from both studies. We argue that the concept of projective identification offers a plausible and illuminating account of the states of mind experienced by practice educators and in making explicit, unconscious states of mind, our aim is that practice educators will feel confident to make appropriate assessment decisions when required.

An after-school literacy program : investigating the experiences of students with literacy difficulties, their volunteer tutors, and the tutors' transition into the teaching profession

This research responds to a pervasive call for our educational institutions to provide students with literacy skills, and teachers with the instructional supports necessary to facilitate this skill acquisition. Questions were posed to gain information concerning the efficacy ofteaching literacy strategies to students with learning difficulties, the impact of this training on their volunteer tutors, and the influence of this experience on these tutors' ensuing instructional practice as teacher candidates in a preservice education program. Study #1 compared a nontreatment group of students with literacy difficulties who participated in the program and found that program participants were superior at reading letter patterns and at comprehending the elements of story grammar. Concurrently, the second study explored the experiences of 19 volunteer tutors and uncovered that they acquired instructional skills as they established a knowledge base in teaching reading and writing, and they affirmed personal goals to become future teachers. Study #3 tracked 6 volunteer tutors into their pre-service year and identified their constructions, and beliefs about literacy instruction. These teacher candidates discussed how they had intended to teach reading and writing strategies based on their position that effective teaching ofthese skills in the primary grades is integral to academic success. The teacher candidates emphasized the need to build rapport with students, and the need to exercise flexibility in lesson plan delivery while including activities to meet emotional and developmental requirements of students. The teacher candidates entered their pre-service education with an initial cognition set based on the limited teaching context of tutoring. This foundational ii perception represented their prior knowledge of literacy instruction, a perception that appeared untenable once they were immersed in a regular instructional setting. This disparity provoked some of the teacher candidates to denounce their teacher mentors for not consistently employing literacy strategies and individualized instruction. This critical perspective could have been a demonstration of cognitive dissonance. In the end, when the teacher candidates began to look toward the future and how they would manage the demands of an inclusive classroom, they recognized the differences in the contexts. With an appreciation for the need for balance between prior and present knowledge, the teacher candidates remained committed to implementing their tutoring strategies in future teaching positions. This document highlights the need for teacher candidates with instructional experience prior to teacher education, to engage in cognitive negotiations to assimilate newly acquired pedagogies into existing pedagogies.

Reality status evaluations in mediated experiences /

This paper explores the cognitive functions of the Reality Status Evaluation (RSE) system in our experiences of narrative mediated messages (NMM) (fictional, narrative, audio-visual one-way input and moving picture messages), such as fictional TV programs and films. We regard reality in mediated experiences as a special mental and emotional construction and a multi-dimensional concept. We argue that viewers' reality sense in NMM is influenced by many factors with "real - on" as the default value. Some of these factors function as primary mental processes, including the content realism factors of those messages such as Factuality (F), Social Realism (SR), Life Relevance (LR), and Perceptual Realism - involvement (PR), which would have direct impacts on reality evaluations. Other factors, such as Narrative Meaning (NM), Emotional Responses, and personality trait Absorption (AB), will influence the reality evaluations directly or through the mediations of these main dimensions. I designed a questionnaire to study this theoretical construction. I developed items to form scales and sub-scales measuring viewers' subjective experiences of reality evaluations and these factors. Pertinent statistical techniques, such as internal consistency and factorial analysis, were employed to make revisions and improve the quality of the questionnaire. In the formal experiment, after viewing two short films, which were selected as high or low narrative structure messages from previous experiments, participants were required to answer the questionnaire, Absorption questionnaire, and SAM (Self-Assessment Manikin, measuring immediate emotional responses). Results were analyzed using the EQS, structural equation modeling (SEM), and discussed in terms oflatent relations among these subjective factors in mediated experience. The present results supported most of my theoretical hypotheses. In NMM, three main jactors, or dimensions, could be extracted in viewers' subjective reality evaluations: Social Realism (combining with Factuality), Life Relevance and Perceptual Realism. I designed two ways to assess viewers' understanding of na"ative meanings in mediated messages, questionnaire (NM-Q) and rating (NM-R) measurement, and its significant influences on reality evaluations was supported in the final EQS models. Particularly in high story stnlcture messages, the effect of Narrative Meaning (NM) can rarely be explained by only these dimensions of reality evaluations. Also, Empathy seems to playa more important role in RSE of low story structure messages. Also, I focused on two other factors that were pertinent to RSE in NMM, the personality trait Absorption, and Emotional Responses (including two dimensions: Valence and Intensity). Final model results partly supported my theoretical hypotheses about the relationships among Absorption (AB), Social Realism (SR) and Life Relevance (LR); and the immediate impact of Emotional Responses on Perceptual Realism cPR).

Examining the inclusion experiences of students with intellectual disabilities : a study focusing on the transition from elementary to secondary school

Transitioning from elementary to secondary school is a major event in adolescents' lives and can be associated with academic, social, and emotional challenges (Shaffer, 2005; Sirsch, 2003). Considerably less research has focused on the transitional experiences of students with intellectual disabilities (lD) as they enter secondary school and the role of educational inclusion in this process (Noland, Cason, & Lincoln, 2007). Conceivably, students with ID who leave inclusive elementary schools, where they have been educated alongside their peers without ID, and who enter segregated secondary educational placements may experience unique social and emotional challenges (Farmer, Pearl, & Van Acker, 1996; Fryxell & Kennedy, 1995; Shaffer, 2005). This study examined the transitional experiences of 6 students with ID and the role of educational inclusion, with a focus on elementary to secondary school transitions from inclusive to segregated settings and vice versa. This study included the collection of multiple sources of data. Semi-structured interviews with 6 caregivers and students with ID were conducted. Students' Individual Education Transitional Plans were discussed in caregivers' interviews to determine how they shaped students' educational inclusion experiences (Ontario Ministry of Education & Training, 1999/2000/2004). Parts ofthe following questionnaires were "qualitized" (Tashakkori & Teddlie, 1998) and administered orally: "Youth Self-Report" (YSR; Achenbach, 2001 c) and "Child Behaviour Checklist Caregivers Form" (CBLC/6-18; Achenbach, 200la). The findings of this study contribute to the literature on educational inclusion by highlighting the positive/negative social and emotional impact of congruent and incongruent transitional experiences of students with ID and the role of educational inclusion.