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PubMedDate not supplied

Adopted children: core issues and unique challenges.

TOPIC: Psychological impact of adoption and resulting core issues for adopted children. PURPOSE: To raise awareness of the psychological impact of adoption. SOURCES: Published literature and personal observations. CONCLUSIONS: Adoption raises unique issues and challenges for the child and adoptive parents. Resolving the issues of adoption is a lifelong process. Through an awareness of the issues inherent in adoption, nurses and parents can use strategies that will enhance children's self-esteem and decrease their emotional vulnerability. Search terms: Adoption, intervention, loss, self-esteem, strategies

Acculturation↗

PubMedDate not supplied

A fairy tale with a twist: pastoral counseling with adoptive families.

Adoption counseling often focuses primarily on the enigmatic issues faced by adoptees. Very little attention, however, is pointed in the direction of the adoptive parents and their unique struggles. This article begins by providing some current information on adoption in the United States and ensuing implications for pastoral caregiving. Some of the unique challenges associated with the adoption experience are delineated, primarily focusing on systemic and personal issues faced by many adoptive families. Several practical interventions are suggested for pastoral caregivers working with adoptive families. Finally, the entire adoption experience is framed within a theological perspective offering hope to adoptive parents and adoptees.

Adaptation, Psychological↗

PubMed2003

Experiencing infertility--social work dilemmas in child adoption procedures.

The research deals with experiencing infertility and its consequences in the adoption of a child and focuses on infertile couples that have wished to adopt a child and joined a program preparing them to be foster parents. The results show that most of the infertile couples experience infertility very much as being different from couples with children as well as having to cope with the feelings of deep emotional loss resulting from the inability to reproduce biologically. There is therefore the question whether these facts should be taken into account by the profession (i.e. social workers) when dealing with child adoption as, according to most of the respondents of our survey, the process of coming to terms with infertility and its consequences is an important factor in establishing healthy family relationships and the child's identity within the adoptive family. We concluded from the results of the research that the infertile couples preparation program for adopting a child carried out by the Society of Adoptive Families "Deteljica", is a comprehensive autopoietic social workers' answer to the needs of participants for a successful adoption of a child, as it makes it possible to supply these future adoptive parents with the requisite information and experience and provides support to the entire family upon accepting a child in its midst, while its fundamental attribute is offering help to couples in overcoming the traumas resulting from their infertility.

Adaptation, Psychological↗

PubMed2006

Childlessness and adoption: the experience of loss as a source of suffering.

The present work deals with the issue of child's adoption. Adoption is presented as a difficult (stressful) situation for the adopted child, but also for the childless married couple, who has decided to take in the orphaned child. Adoption as a difficult situation is connected with the experience of loss. The childless spouses experience the loss of their biological parenthood, the loss of their biological child, who died during the prenatal period or just after being born, but also the loss of the status of a "normal" family created in accordance with the normative model of a family. The adopted child, on the other hand, experiences the loss of biological parents and biological siblings, the loss of genealogical continuity and of "the bonds of blood". The child must be confronted with the fact that "one, to be adopted, must be first abandoned". The problem with the studies on adoption lies in their theoretical character. Because of that, the psychological understanding of adoption reality is limited.

Adoption↗

PubMedDate not supplied

Adoption versus parenting among young pregnant women.

Three groups of young pregnant women living in maternity residences--those who intended to place their babies for adoption, those who considered adoption but planned to parent and those who never considered adoption--were compared regarding their socioeconomic characteristics, attitudes toward adoption and the personal influences on their decisions. Of the 430 young women, those who intended to place their babies for adoption tended to be at one extreme on most profile variables, those who had considered placing were in an intermediate position, and those who never considered placing their babies were at the other extreme. Placers were both the most advantaged socioeconomically and held the most positive attitudes toward adoption, while young women who never considered adoption were the least advantaged and held the least favorable attitudes. Placers consistently reported that their choice to place their babies rather than parent would increase the likelihood of outcomes such as continuing with school, having enough money to live comfortably and benefiting the baby's emotional development, while those young women who did not consider adoption tended to feel that these outcomes would be more likely if they parented, or that the likelihood of the outcomes would not be affected by their choice. Young women who intended to place their babies were encouraged in that direction by their mothers, fathers and boyfriends, while the two groups of women who chose parenting were encouraged to do so by those in their social networks.

Adolescent↗

PubMed1985

Mother-infant attachment in adoptive families.

Data from 2 separate samples using the Strange Situation paradigm were combined to assess the quality of attachment relationships in adoptive and nonadoptive mother-infant pairs. Infants were between 13 and 18 months at the time of observation. Results indicated no differences in mother-infant attachment between nonadopted and intraracial adopted subjects or between intraracial and interracial adopted subjects. Interracial adoptive mother-infant pairs did show a higher incidence of insecure attachment in comparison to nonadoptive pairs. Mothers of interracial adopted infants also were less comfortable having others care for their babies and perceived less emotional support from extended family and friends for their decision to adopt a child prior to the actual adoption than did other mothers. No relation was found, however, between quality of mother-infant attachment and either perceived social support, infant developmental quotient, infant temperament, number of foster homes experienced by the infant, or infant's age at the time of adoption placement. It was suggested that the higher incidence of psychological problems found among adoptees in middle childhood and adolescence cannot be explained in terms of insecure attachment relationships during the infancy years.

Adaptation, Psychological↗

PubMedDate not supplied

Adoption research: building blocks for the next decade.

Basic national and state adoption indicators are now unavailable and must await future data collection efforts. The focus of future efforts on the adoption of children in foster care is appropriate. Case-level adoption data with unique child indicators must be developed to advance the field and further clarify the odds of adoption and disruption. Available psychosocial research clearly indicates that adoption generally results in successful outcomes. Yet, more comparative research on differences between long-term outcomes for children who are adopted and those remaining in foster care would better estimate the value of adoption to children and the public. Rigorous research on strategies to successfully place children for adoption is essential.

Adoption↗

PubMed1996

Openness in adoption and the level of child participation.

There is great controversy regarding the impact of openness in adoption, especially the impact of such an arrangement on adopted children. Three indicators of the level of child participation in the openness arrangement were examined: (a) level of openness reported by adoptive parents, (b) level of information adopted children reported having about their birthparents, and (c) whether adoptive parents have withheld any pertinent information gained through communication with the birthmother from the adopted child. 171 children (90 males, 81 females; mean age = 7.99) wee studied to assess how that participation influenced their conceptual understanding of what adoption means, general self-worth, satisfaction with level of openness, and curiosity about birthparents. Overall it does not appear that providing information about a child's birthparents will confuse the child about the meaning of adoption or lower the child's self-esteem, but neither will it move them to levels of understanding that are beyond their cognitive capabilities to reach.

Adaptation, Psychological↗

PubMed1998

An adoption study of depressive symptoms in middle childhood.

Several twin studies of children and adolescents have found significant heritability of depressive symptoms. In contrast, the sole adoption study of biologically related and biologically unrelated adopted siblings found no evidence for genetic influence. The present study attempts to confirm these results in middle childhood using two adoption designs. The sample, from the Colorado Adoption Project, included 180 adopted children (77 with adoptive siblings) and their biological and adoptive mothers, and 227 nonadopted children (93 with biological siblings) and their mothers. Mothers reported their own neuroticism, and children's depressive symptoms were reported by the parents and by the children themselves. For both the sibling adoption and the parent-offspring designs heritability was negligible, shared environment modest, and non-shared environment substantial, irrespective of child gender. Although the power of the sibling data is low, the combined findings from the two designs suggest that genetic effects on depressive symptoms in childhood may be somewhat smaller than previously estimated in twin studies.

Adoption↗

PubMed2002

Exploring hospitals' adoption of information technology.

This study explores the adoption of information technology (IT) and the association between organizational and market factors, and IT adoption in hospitals. Results suggest that a wide range of amounts and types of IT are adopted. Hospitals with higher overall IT adoption adopt strategic IT most often. Hospitals with lower IT adoption adopt administrative IT most often. Results also show hospital IT adoption to be positively associated with hospital size, location, system membership, ownership, and market competition.

Diffusion of Innovation↗

PubMed1990

Adoption of guidelines for Universal Precautions and Body Substance Isolation in Canadian acute-care hospitals.

The impact of recently recommended hospital infection control guidelines on Canadian acute-care hospitals is unknown. A confidential cross-sectional mailed survey of all acute-care Canadian hospitals was conducted to determine rates of receipt and adoption of published guidelines for Universal Precautions (UP) or Body Substance Isolation (BSI), rationale for adoption and knowledge of costs and benefits. Five hundred and seventy-nine of 943 sites (61%) responded (exceeding 80% in urban centers); 94% among hospitals with at least 300 beds and 57% among those under 300 beds. Seventy-four percent of responders claimed adoption of UP (65%) or BSI (9%), staff protection being their primary motivation. Adoption of either UP or BSI was associated with size (p less than .001), increasing progressively from 45% in the smallest group (less than 25 beds) to 84% in the largest (greater than or equal to 500 beds). Many hospitals introduced modifications and some substituted names other than UP or BSI in adopting a new strategy. In practice, UP and BSI now mean different things in different hospitals, and the distinction between them has become blurred. Furthermore, only 5% claiming adoption of a new strategy adopted all of the fundamental policies expected under UP or BSI. Receipt of guidelines was also correlated with size: one-third of hospitals under 200 beds had not received key publications defining UP and BSI. Only 19% claiming adoption of a new strategy indicated knowledge of cost implications. These results suggest a need for closer collaboration among hospitals and government agencies in developing uniform infection control policies, and for systematic evaluation of the cost and effectiveness of new strategies.

Body Fluids↗

PubMedDate not supplied

Prevalence of safer needle devices and factors associated with their adoption: results of a national hospital survey.

OBJECTIVES: In this study, we collected and analyzed the first data available on the extent of the adoption of safer needle devices (engineered sharps injury protections [ESIPs]) by U.S. hospitals and on the degree to which selected factors influence the use of this technology. METHODS: We gathered data via a telephone survey of a random sample of 494 U.S. hospitals from November 1999 through February 2000. RESULTS: Although 83% of the sample reported some ESIP adoption, adoption was inconsistent across types of devices. All of the appropriate units in 52% of the facilities had adopted needleless intravenous delivery systems, but the hospitals used other types of ESIPs less often. A respondent's perception that the cost of ESIPs would not be a problem for the hospital was the best predictor of adoption of ESIPs in the facility, explaining 8% of the variance. Other predictors of adoption included the size of the hospital and the presence or absence of state legislative activity on the needlestick issue. CONCLUSIONS: Smaller hospitals may require special encouragement and assistance from outside sources to adopt expensive risk-reduction innovations such as ESIPs. Although use of ESIPs is the mandated and preferred way to protect workers from needlesticks, complete adoption of this technology will depend on the support of the social systems in which it is used and the people who use it.

Attitude of Health Personnel↗

PubMed1991

Time to adoption of an innovation by dentists in private practice: sealant utilization.

Dentists can be divided into five adoption categories based upon their time of adoption of pit and fissure sealants: innovators, early adopters, early majority, late majority, and laggards. The differences among dentists in the five adoption categories were examined for four classes of variables: practice characteristics, dentist characteristics, communication of information, and practice environment. Questionnaires were mailed in September 1984 to a random sample (N = 521) of Washington State dentists in general practices. A total of 376 completed questionnaires were returned, for a response rate of 72 percent. Adoption of sealants proceeded as follows: 5 percent of dentists through 1973, 24 percent through 1979, 50 percent through 1982, and 75 percent through 1984. Adoption category was related to percent of assistants who were certified, delegation to assistants and hygienists, magnitude of the fees charged by the practice, number of staff meetings per month, the dentist having been an officer in a dental organization, year the dentist adopted other new technologies, dentist's self-rating of willingness to try new things, percent of patients who are children, and percent of the dentist's colleagues who used sealants. These data lend some support to the two-stage or opinion-leader model of diffusion and suggest that new technologies can be promoted by first influencing dentists who consistently adopt early.

Adolescent↗

PubMed1996

Getting started--a review of physical activity adoption studies.

The aim of this paper has been to review methods that have been found to be effective in getting sedentary adults to adopt physical activity, to examine these methods within the multilevel framework conceptualised by Winett et al, and to provide recommendations for future research to test new methods and their effectiveness in leading to the adoption of physical activity in sedentary populations. Searches for relevant studies were conducted on the Medline computerised database. Additional studies were located in reference sections of these studies and other review papers. Surveys that specifically identified determinants of adoption of physical activity in adults were included. Reviewed articles were selected on the basis of quasi-experimental and experimental designs that specifically examined the question of how to get sedentary adults to adopt a programme of physical activity or exercise, had completely described methods, and evaluated the effectiveness of methods of increasing physical activity and/or exercise. While numerous reviews have been written on determinants on physical activity adoption and maintenance, only two prospective surveys have identified specifics of adoption of physical activity. Most of the evidence for techniques that help inactive people to adopt physical activity comes from quasi-experimental and experimental intervention studies examining various cognitive and behavioural strategies at the individual level. Fewer studies have examined techniques at the interpersonal, organisational, community, environmental, and policy level. More prospective observational studies aimed at homogeneous subgroups are needed to identify correlates of physical activity adoption to help tailor interventions. Continued clinical studies are needed to differentiate the necessary and sufficient strategies at the personal and interpersonal levels. Interventions aimed at environmental, institutional, and social levels remain largely unexplored and there is a need for more research that specifically targets inactive subgroups at these levels.

Adult↗

PubMed2006

IT-adoption and the interaction of task, technology and individuals: a fit framework and a case study.

BACKGROUND: Factors of IT adoption have largely been discussed in the literature. However, existing frameworks (such as TAM or TTF) are failing to include one important aspect, the interaction between user and task. METHOD: Based on a literature study and a case study, we developed the FITT framework to help analyse the socio-organisational-technical factors that influence IT adoption in a health care setting. RESULTS: Our FITT framework ("Fit between Individuals, Task and Technology") is based on the idea that IT adoption in a clinical environment depends on the fit between the attributes of the individual users (e.g. computer anxiety, motivation), attributes of the technology (e.g. usability, functionality, performance), and attributes of the clinical tasks and processes (e.g. organisation, task complexity). We used this framework in the retrospective analysis of a three-year case study, describing the adoption of a nursing documentation system in various departments in a German University Hospital. We will show how the FITT framework helped analyzing the process of IT adoption during an IT implementation: we were able to describe every found IT adoption problem with regard to the three fit dimensions, and any intervention on the fit can be described with regard to the three objects of the FITT framework (individual, task, technology). We also derive facilitators and barriers to IT adoption of clinical information systems. CONCLUSION: This work should support a better understanding of the reasons for IT adoption failures and therefore enable better prepared and more successful IT introduction projects. We will discuss, however, that from a more epistemological point of view, it may be difficult or even impossible to analyse the complex and interacting factors that predict success or failure of IT projects in a socio-technical environment.

Anxiety↗

PubMed2005

Predicting the adoption of electronic health records by physicians: when will health care be paperless?

OBJECTIVES: The purpose of this study was threefold. First, we gathered and synthesized the historic literature regarding electronic health record (EHR) adoption rates among physicians in small practices (ten or fewer members). Next, we constructed models to project estimated future EHR adoption trends and timelines. We then determined the likelihood of achieving universal EHR adoption in the near future and articulate how barriers can be overcome in the small and solo practice medical environment. DESIGN: This study used EHR adoption data from six previous surveys of small practices to estimate historic market penetration rates. Applying technology diffusion theory, three future adoption scenarios, optimistic, best estimate, and conservative, are empirically derived. MEASUREMENT: EHR adoption parameters, external and internal coefficients of influence, are estimated using Bass diffusion models. RESULTS: All three EHR scenarios display the characteristic diffusion S curve that is indicative that the technology is likely to achieve significant market penetration, given enough time. Under current conditions, EHR adoption will reach its maximum market share in 2024 in the small practice setting. CONCLUSION: The promise of improved care quality and cost control has prompted a call for universal EHR adoption by 2014. The EHR products now available are unlikely to achieve full diffusion in a critical market segment within the time frame being targeted by policy makers.

Attitude of Health Personnel↗

PubMed2003

Influence of information sources on the adoption of uterine fibroid embolization by interventional radiologists.

OBJECTIVES: The purpose of the research was to (1) understand the influence of information sources on the awareness and adoption of uterine fibroid embolization (UFE) by interventional radiologists in Michigan and (2) to decipher communication relations in the social network of interventional radiologists that were most conducive to the flow of information about UFE. METHODS: Diffusion of innovations theory and constructs in social network analysis formed the basis for the development of an interview guide. Thirty-two interventional radiologists in Michigan were interviewed over the phone. Chi-square statistics were employed to analyze the awareness and adoption of UFE. Factor analysis was applied to decipher important communication relations in the social network of interventional radiologists. RESULTS: Conferences were found to be an initial source of information, creating awareness among early adopters (P < 0.05), but other individuals were found to be influential sources in the adoption of UFE by later adopters (P < 0.05). Radiologists rarely browsed Websites for information. Work relations in everyday clinical practice were the communication relations most conducive to the flow of information about UFE. Preliminary qualitative data indicated that opinion leaders in the diffusion of UFE in Michigan were located in hospitals primarily dedicated to practice rather than in hospitals affiliated with universities. CONCLUSIONS: Journals are important information sources for creating awareness and stimulating adoption of innovation among both early and late adopters of new procedures in interventional radiology. Conferences, however, are significantly more important for creating early awareness, while interactions with colleagues is the most important factor in stimulating use of the innovation among later adopters. Among colleagues, opinion leaders in nonacademic hospitals may be more influential than individuals in the academic community.

Adult↗

PubMed2005

Decisions to adopt new technologies at the hospital level: insights from Israeli medical centers.

OBJECTIVES: New medical technologies have been identified as the leading cause of increasing health-care expenditures. Adoption of a new technology is one of the most important decisions in medical centers. The objectives of this study were to map and describe the function of hospital decision-makers within the area of new technology assessment and adoption, and to examine relevant considerations, sources of information, and decision-making processes in the adoption of a new technology. METHODS: A questionnaire was mailed to hospital executives and referred to (i) the considerations for and against adoption of a new technology, (ii) the decision-making process, (iii) information sources used in the decision-making process. RESULTS: The most frequent criteria favoring adoption included increased cost-effectiveness, increased efficacy, and decrease in complication rates. An increase in complication rates or side effects and decreased efficacy were the top ranked criteria against adoption. The final decision-making responsibility varied among technologies; the medical director frequently made the final decision when a new device was involved, but this responsibility decreased when a new drug or a new procedure was considered, Participation in scientific meetings, opinions of local experts, medical journals, and Food and Drug Administration clearance documents were the most important information sources used in the decision-making process. However, these were not necessarily the optimal sources of information. Significant barriers in adoption decision-making are lack of timely data regarding the safety of the new technology, its cost-effectiveness, and efficacy. CONCLUSION: To improve the adoption decisions, hospitals must develop criteria upon which the decision-making will be based.

Biomedical Technology↗