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PubMedDate not supplied

Managing the multigenerational nursing team.

Today's workforce is more diverse in age than ever before. This study examined the generational profiles of two groups (the Silent Generation, and Baby Boomers vs. Generation X and Generation Y) in terms of the following variables: characteristics, communication styles, and significance of tasks. The purpose was to assist nurse managers to maximize departmental effectiveness by capitalizing on the unique characteristics of the multigenerational nursing team. A descriptive design was used to examine nursing staff perceptions of their generational profiles, communication styles, and significance of tasks. The convenience sample included registered nurses, nurse technicians and nursing secretaries from two departments, a medical-surgical and a critical care department (N = 62). The study provided participants with the opportunity to give their interpretations of their generational types. Similarities and differences of generational profiles were found between the two groups. There were no significant differences in communication style and significance of tasks between the two groups (P > .05). However, there were differences in expectations regarding commitment to the manager versus the organization and the type and timing of rewards for performance. All four generational groups had vastly different employment demands and different needs for orientation, training, advancement, benefits, perks, and retirement options.

Chi-Square Distribution↗
PubMed2001

"These young chaps think they are just men, too": redistributing masculinity in Kgatleng bars.

In the 19th century the BaKgatla polity was a chiefdom with a redistributional economy based on mixed agriculture. Sorghum beer was symbolic not only of the patrilineal core of their descent system and of the ideologies of reciprocity and redistribution, but also of masculinity and patriarchal control. With the establishment of a market economy, an industrial brewery and individual access to income, both beer and the act of drinking have been symbolically reconstructed. The ideology of redistribution was well suited to the support of the BaKgatla gerontocracy via alcohol production and consumption. The limits on production and consumption of beer inherent in the agricultural cycle and the control of young men's access by elders made alcohol an effective symbol of managerial competence from the limited context of household authority to that of the chiefdom as a whole. Today, young men's greater control of cash income has given them access to beer beyond the control of elders. As a result, the contrasting ideology of market exchange and competitive distribution of beer has contributed to the degradation of the power of seniors. After reviewing the historical background, this paper explores those changes. It argues that while the observed infrastructural changes have had a predictable impact on drinking behaviors and the symbolic structure of "seniority/masculinity", constructions of the "masculine community" in BaKgatla bars demonstrate continuity in key areas of mens' identities. If as anthropologists we see obvious discontinuities in behavior and ideology, the BaKgatla build selective bridges to "tradition" which seemingly ground the experience of change in relatively seamless continuity.

Adult↗
PubMed2006

Grandmothers, caregiving, and family functioning.

OBJECTIVES: We used McCubbin's Resiliency Model of Family Stress, Adjustment and Adaptation ( McCubbin, Thompson, & McCubbin, 2001) to examine how demographic factors, family stress, grandmother resourcefulness, support, and role reward affect perceptions of family functioning for grandmothers raising grandchildren, grandmothers living in multigenerational households, and grandmothers not caregiving for grandchildren. METHODS: A sample of 486 grandmothers completed a mailed questionnaire. We used structural equation modeling to (a) test the effects of demographic factors (i.e., grandmother's age, race, marital status, and employment), family stressful life events and strain, grandmother's resourcefulness, subjective and instrumental support, and role reward on perceptions of family functioning for each grandmother group; (b) evaluate differences in the measurement and structural models between the grandmother groups using multisample analysis; and (c) test the model on the full sample, coding for caregiver status. RESULTS: The models did not differ significantly by grandmother group; therefore we assessed the composite model using a multisample analysis. We found general support for the resiliency model and equivalence of the models across grandmother groups. Less support, resourcefulness, and reward, and more intrafamily strain and stressful family life events contributed to perceptions of worse family functioning. DISCUSSION: Findings demonstrate the importance of the quality of family functioning for grandmothers in all types of families.

Adult↗
PubMed1992

Children's relationships with maternal grandparents: a longitudinal study of family structure and pubertal status effects.

This longitudinal study assessed the effects of parents' marital transitions and pubertal development on grandparent-grandchild relationships. 9- to 13-year-old children, their mothers, and maternal grandparents from 186 Caucasian, middle-class families including 73 intact families, 64 mother-custody, single-parent families and 49 stepfamilies completed questionnaires focusing on the degree of children's "relationship involvement" (perceived closeness and frequency of contact) with maternal grandparents at 2 time periods 13 months apart. Children also completed questionnaires 9 months later during a third interview. Grandparents, and especially grandfathers, were more involved with grandchildren from single-parent families (supporting the "latent function" hypothesis). The pubertal status results supported the "emotional distancing" hypothesis for grandfather-granddaughter relationships (higher pubertal status, less involvement) and the "stress buffer" hypothesis for grandsons' relationships with both grandparents (greater change in physical development, more involvement and greater perceived closeness).

Aged↗
PubMed2002

Childhood adversity, parental vulnerability and disorder: examining inter-generational transmission of risk.

BACKGROUND: An investigation of intergenerational factors associated with psychiatric disorder in late adolescence/early adulthood was undertaken to differentiate influences from maternal disorder, maternal poor psychosocial functioning and poor parenting, on offspring. METHOD: The sample comprised an intensively studied series of 276 mother-offspring pairs in a relatively deprived inner-city London area with high rates of lone parenthood and socio-economic disadvantage. The paired sample was collected over two time periods: first a consecutively screened series of mothers and offspring in 1985-90 (n = 172 pairs) and second a 'vulnerable' series of mothers and offspring in 1995-99 (n = 104 pairs). The vulnerable mothers were selected for poor interpersonal functioning and/or low self-esteem and the consecutive series were used for comparison. Rates of childhood adversity and disorder in the offspring were examined in the two groups. Maternal characteristics including psychosocial vulnerability and depression were then examined in relation to risk transmission. RESULTS: Offspring of vulnerable mothers had a fourfold higher rate of yearly disorder than those in the comparison series (43% vs. 11%, p < .001). They were twice as likely as those in the comparison series to have experienced childhood adversity comprising either severe neglect, physical or sexual abuse before age 17. Physical abuse, in particular, perpetrated either by mother or father/surrogate father was significantly raised in the vulnerable group. Analysis of the combined series showed that maternal vulnerability and neglect/abuse of offspring provided the best model for offspring disorder. Maternal history of depression had no direct effect on offspring disorder; its effects were entirely mediated by offspring neglect/abuse. Maternal childhood adversity also had no direct effect. CONCLUSIONS: Results are discussed in relation to psychosocial models of risk transmission for disorder. Maternal poor psychosocial functioning needs to be identified as a factor requiring intervention in order to stem escalation of risk across generations.

Adolescent↗
PubMed2005

The psychotherapy of genetics.

The evolution of genomic science and its effect on medicine and health care offer opportunities for family therapists to participate in the comprehensive care of patients and families with genetic disorders. This article provides an overview of what we now know about the psychological and interpersonal experience of patients and families facing some of these illnesses. Case examples illustrate the process of decision-making about testing and treatment, and the importance of understanding developmental issues and transgenerational family dynamics in any related psychotherapy. Challenging emotional issues include managing anger, ambivalence, and guilt; challenging interpersonal issues include dealing with differing coping and communication styles, decisions about disclosure and secrets, and conflict resolution. Family-oriented interventions include individual, couple, and family therapy, and psychoeducational groups. Recommendations are made for family therapists to participate as part of the genetic healthcare team.

Adolescent↗
PubMed2004

Yu Duan practices as embodying tradition, modernity and social change in Chiang Mai, Northern Thailand.

In this paper I examine the traditional postpartum beliefs and practices which still exist in northern Thailand today. The paper is based on qualitative research involving in-depth interviews with 30 women in Chiang Mai province. Beliefs and practices remain an essential part for postpartum care for women and have important consequences for women's health and wellbeing in northern Thailand. Many Thai women see their reproductive health problems as the consequence of inadequate postpartum practices. Thai women also believe that the effects of postpartum taboos would continue for the rest of their lives. Although the traditional postpartum beliefs and practices abound, the level of adherence differs according to the social structure of the women and their families. Poor rural women seem to hold on to their traditions more strongly than their urban counterparts. Urban middle class women in particular embody modernity in their thinking and behaviours concerning postpartum practices. But modernization has brought with it medical dominance. Due to their medical knowledge, doctors retain authority over both knowledge and status. The consequence of this dominance is the attempt to dismiss local traditional knowledge and practices. Although the pattern of traditional postpartum beliefs and practices is changing, it is still observed in northern Thailand. I contend that postpartum care for women incorporates local traditions so that women's health can be optimized at the time when they are in the most vulnerable stage of their lives.

Adult↗
PubMed2005

Mothers living with suicidal adolescents: a phenomenological study of their experience.

Adolescents who exhibit suicidal behaviors have a devastating effect on their mothers, but unfortunately, the mothers' experience is often the hidden dimension in the family. Currently, there is a considerable lack of research into the maternal experience of living with a suicidal adolescent. This phenomenological study describes and enhances the understanding of what life is like for 6 mothers living with suicidal adolescents. The data were collected through unstructured interviews. Thematic analysis using van Manen's methodology identified six themes: failure as a good mother, the ultimate rejection, feeling alone in the struggle, helplessness and powerlessness in the struggle, cautious parenting, and keeping an emotional distance. From these themes, the essence, "multiple loss and unresolved grief," was captured. The findings have implications for nursing education, practice, and research. In the provision of quality family-centered care, nurses can be educated and guided in their interventions by phenomenological research that recognizes the importance of the maternal perspective in the experience of living with suicidal adolescents.

Adaptation, Psychological↗
PubMedDate not supplied

The experience of being a grandmother who is the primary caregiver for her HIV-positive grandchild.

BACKGROUND: The number of grandparents assuming care for their grandchildren is increasing, and this affects grandparents both positively and negatively. The current study builds on an earlier study of the effects of social support, stress, and level of illness on caregiving of children with acquired immune deficiency syndrome (AIDS) that identified both positive and negative effects of caregiving. OBJECTIVES: To identify the lived experience of African American and Latino grandmothers as the primary caregivers for their grandchildren who are human immunodeficiency virus (HIV)-infected or have AIDS and to identify the similarities and differences between the two groups. METHODS: Using Van Manen's method for hermeneutical phenomenological research, the lived experiences of 10 African American and Latino grandmothers who were the primary caregivers for their HIV-positive grandchildren were investigated. Additionally, the similarities and differences between the two groups were studied. RESULTS: Four themes identified were (a) upholding the primacy of the family, (b) living in the child-centered present, (c) being strong as mature women, and (d) living within a constricting environment. Twelve subthemes expanded and clarified the meaning of these themes. CONCLUSIONS: Although there were differences related to family structure and cultural backgrounds, the grandmothers were more alike than different.

Adaptation, Psychological↗
PubMed2005

Effects of acculturation and social exchange on the expectations of filial piety among Hispanic/Latino parents of adult children.

This study explores the effects of acculturation and social exchange variables on the expectations of filial piety (values and beliefs about parents' care) among Hispanic/Latino parents of adult children. A convenience sample of 318 Hispanics/Latinos with adult children was assembled in Texas and North Carolina, USA, for face-to-face interviews in order to collect information about their families and to assess their expectations of filial piety by their adult children. The number of years in the USA, age, gender, the eldest child's age, and living with a person > or = 65 years of age had significant relationships to scores from a new Spanish version of the Expectations of Filial Piety Scale (EFPS). The significant variables explained 46.3% of the variance in the EFPS scores. A conceptual model that includes both acculturation and social exchange variables is a useful approach for understanding the expectations of filial piety by Hispanic/Latino parents of adult children.

Acculturation↗
PubMed2001

The dynamics of elderly support. The transmission of solidarity patterns between generations.

This paper analyses the support given to the handicapped elderly by their children on the basis of a large survey done in France where both the elderly and their middle-aged children were interviewed. These data allow us to address such questions as: "Who helps?", "Who receives help?" and "According to what principles?". Besides the principle of need which is at work, the results show that there is also the principle of equity, which functions through reciprocity. This study highlights two main processes in the dynamics of support for the elderly, its redistributive effects (family support mainly benefits the poorest elderly), and its complementarity with the state health care systems (family support is mainly directed towards those who also receive public help). Can we make the deduction that the more generous the welfare state, the more developed family solidarity is? Nevertheless, some difficulties arise: support is mostly given by women. Furthermore there are a small number of people on whose shoulders it falls to take care of everybody else in the family. One sign of these difficulties is that the carers are more often in less good health than the non-carers of the same age. Comparisons from one generation to the other, including the youngest (the children of the middle generation who were also interviewed) shows that the younger generation will not want to be so completely involved in parental care at the expense of their own private time and life. Most probably family involvement will be maintained in the future, but to a lesser extent.

Adult↗
PubMed2003

Transgenerational persistence of education as a health risk: findings from the Women Physicians' Health Study.

OBJECTIVE: Whereas the effect of socioeconomic status (SES) on morbidity and mortality is well known, little is known about its transgenerational persistence. METHODS: We studied SES and health data from the U.S. Women Physicians' Health Study (WPHS). WPHS studied 4,501 women physicians, a group with relatively homogeneously high income, occupational prestige, and educational attainment. RESULTS: In logistic regression models controlling for age and ethnicity, those with better educated mothers ate more fruits and vegetables and were less likely to have a gun in their home; those with better educated fathers were more likely to have a regular physician. There was no significant difference by parents' educational levels in exercise habits, fat consumption, compliance with prevention recommendations, current health status, or history of smoking, hypertension, or dyslipidemia. CONCLUSIONS: Parents' (especially mothers') educational levels affect their adult children's health habits and outcomes, even if those adult children are physicians. However, at least among physicians, this differential is small after only one generation of improved SES.

Adult↗
PubMed1999

Children of substance abusers: overview of research findings.

A relationship between parental substance abuse and subsequent alcohol problems in their children has been documented extensively. Children of alcoholics (COAs) are considered to be at high risk because there is a greater likelihood that they will develop alcoholism compared with a randomly selected child from the same community. COAs and children of other drug-abusing parents are especially vulnerable to the risk for maladaptive behavior because they have combinations of many risk factors present in their lives. The single most potent risk factor is their parent's substance-abusing behavior. This single risk factor can place children of substance abusers at biologic, psychologic, and environmental risk. Since the turn of the century, many reports have described the deleterious influence of parental alcoholism on their children. A series of studies measured mortality, physiology, and general health in the offspring of alcoholic parents and concluded that when mothers stopped drinking during gestation, their children were healthier. Today, research on COAs can be classified into studies of fetal alcohol syndrome, the transmission of alcoholism, psychobiologic markers of vulnerability, and psychosocial characteristics. Each of these studies hypothesizes that differences between COAs and children of nonalcoholics influence maladaptive behaviors later in life, such as academic failure or alcoholism. This research supports the belief that COAs are at risk for a variety of problems that may include behavioral, psychologic, cognitive, or neuropsychologic deficits. The vast literature on COAs far outweighs the literature on children of other drug abusers. Relatively little is known about children of heroin addicts, cocaine abusers, or polydrug abusers. Nonetheless, many researchers suggest that the children of addicted parents are at greater risk for later dysfunctional behaviors and that they, too, deserve significant attention to prevent intergenerational transmission of drug abuse. Most research on children of other drug abusers examines fetal exposure to maternal drug abuse. The overview of the research on children of substance abusers points toward the need for better, longitudinal research in this area. Most studies on COAs or other drug abusers are not longitudinal; they examine behavior at one point in time. Given the studies reviewed in this article, it is unclear whether we see true deficits or developmental delay. Longitudinal studies will allow us to predict when early disorders and behavioral deviations will be transient or when they will be precursors to more severe types of maladaptive behavior. Longitudinal research also will enable us to explain specific childhood outcomes. Differences in outcome could be studied simultaneously to understand whether antecedents discovered for one are specific to it or are general antecedents leading to a broad variety of outcomes.

Adaptation, Psychological↗
PubMedDate not supplied

Childhood history of abuse and child abuse screening.

Although a childhood history of abuse is related to parental child abuse, many parents with a history of abuse are not abusive. To determine the effects of a childhood history of abuse on adult child abuse potential, a modified Conflict Tactics Scale (CTS) and the Child Abuse Potential (CAP) Inventory were administered to matched groups of physically abusive mothers with a childhood history of abuse, nonabusive comparison mothers with a childhood history of abuse, and nonabusive comparison mothers without a childhood history of abuse. The modified CTS asked about childhood events and was used to confirm a childhood history of abuse. As expected, the CTS verbal and violence scales were higher for the abusive and nonabusive mothers with a childhood history of abuse. None of the CTS scores were different for the abusive and nonabusive mothers with a childhood history of abuse. In contrast, the CAP abuse scores distinguished between all three study groups. However, on the CAP factor scales, only the rigidity and unhappiness factors discriminated between abusive and nonabusive mothers with a childhood history of abuse. Nonabusive mothers with a childhood history of abuse were less rigid in their child expectations and were happier in their interpersonal relationships than abusive mothers with a childhood history of abuse.

Adult↗
PubMed1997

A dialogue between descendants of Holocaust perpetrators and victims--session two.

The legacy of the Holocaust lingers on, continuing to have a marked and pervasive effect on the survivors-and their second, third and fourth generation descendants. This is now well documented in the professional literature, in novels, on film and in museums. What has been virtually non-existent is activity which brings together the descendants of perpetrators and of victims to interact and move toward some rapprochment in the here and now, and for the future, and a literature documenting and analyzing such activity. This article describes a second dialogue session between German and Israeli mental health professionals, all of whom are descendants of survivors and/or are treating such descendants. This meeting was held during the International Family Therapy Association Congress in Guadalajara, Mexico, in October 1995, and some Mexican colleagues who had inherited the Holocaust legacy also participated, as did several others from Sweden and the United States. The interchanges about their memories and deeply entrenched feelings were heated, emotional and profound. All involved indicated they had experienced great anguish about coming, and in being present, and that during the session they felt some relief and gained some understanding of the "other." They urged continuation of this dialogue process, begun during a conference in Budapest, Hungary, in 1994.

Concentration Camps↗
PubMed2002

Relational theory and cultural enhancement interventions for African American adolescent girls.

OBJECTIVE: This study tested the effectiveness of two culturally appropriate substance abuse prevention intervention programs for African American girls. METHODS: Project Naja recruited 210 girls ages 10-12 from schools in a low-income ward in Washington, D.C., to participate in a 2.5- year, three-phase intervention to develop strong ethnic and gender identity. The Cultural Enhancement Project recruited sixth grade girls in Richmond, Virginia, for a 15-week curriculum. The author collected pre- and post-test data on cultural, drug, and sex measures. RESULTS: Project Naja participants in the intervention group scored significantly higher on Africentric values and racial identity than comparison group participants. They also had more positive concepts of their physical appearance. In the Cultural Enhancement Project, girls in the intervention group scored higher on the global African American identity scale. There was a trend toward significance in increased percentage of androgyny for girls in the intervention group. CONCLUSIONS: Prevention programs should include a component directed at strengthening ethnic identity and other protective factors (self-esteem, positive peer support, and skill-enhancement).

Adolescent↗
PubMedDate not supplied

Psychometric properties of the Grandparent Perceptions of Family Scale (GPFS).

BACKGROUND: For the majority of grandparents, rarely are their perceptions of family assessed, acknowledged, or viewed in the context of potential effect on individual and family health. OBJECTIVE: To develop and test an instrument to measure grandparent perceptions of family. METHOD: An inductively derived semantic differential instrument comprising 112 items, 8 stimuli, and 27 adjective pairs within 2 domains and framed by the Becoming a Grandparent theoretical model was content validated by an expert panel, revised, and evaluated on a convenience sample of 306 community-dwelling grandparents, aged 41-92 years (M = 64, SD = 9.8), 72% female, 93% U.S. born, 62% college educated, 55% economically comfortable, and 71% living with a spouse or partner. Assessment procedures included internal consistency reliability, item and scale correlation coefficients, and principal components factor analysis with varimax rotation to evaluate construct validity, structure, and magnitude of the scale. RESULTS: The final scale consists of 25 items using 3 stimuli (grandparent's view of grandchild, mother of grandchild, father of grandchild) measuring a single domain (overall view of family). The Grandparent Perceptions of Family Scale (GPFS) includes 5 factors for a total explained variance of 60%. Coefficient alpha for the total scale is .90. DISCUSSION: The GPFS should be helpful to clinicians and researchers in their assessment of grandparents within multigenerational families and in planning appropriate interventions to address the roles and relationships of grandparents within families. Further GPFS evaluation is suggested with grandparents of diverse racial or ethnic identification; social economic position; education; and family definition, roles, composition, and structure.

Adult↗
PubMed1996

Apparent anticipation in familial melanoma.

Genetic anticipation refers to progressively earlier age at diagnosis (AAD) and/or increasing severity of a disorder in successive generations. Previous examination of 23 familial melanoma kindreds revealed evidence for a dramatic reduction in AAD in successive generations. To further evaluate evidence for anticipation, we examined the AAD, number of tumours, and tumour thickness in affected parent-offspring (P-O) pairs from these 23 kindreds. Number of tumours and tumour thickness were also evaluated by generation. There were statistically significant intergenerational differences for AAD and number of tumours in the 47 affected P-O pairs. Median AAD decreased from 48 years to 28 years. The median AAD in the offspring (AADo) of a parent with CMM (median 28, mean 29.3 +/- 10.1 years, n = 51) was significantly different from the median AADo of a parent without CMM (42, 42.3 +/- 13.9 years, n = 55) (P < 0.001). In addition, parents with AAD less than the median of 48 years had offspring with a median AAD (26, 25.8 +/- 8.5 years, n = 21) significantly different from those of parents with AAD > or = 48 years (32, 34.5 +/- 10.2 years, n = 26) (P = 0.005). Ninety-four percent (44/47) of the P-O pairs showed positive anticipation, with 62% showing anticipation of > 15 years. There was little difference based on the affected parent's sex. In the 106 CMM cases there were no significant differences in tumour number (P = 0.08) or tumour thickness (P = 0.85) by generation. Number of tumours was however significantly different in cases with AAD < 34 years (n = 52, median 1.5, mean 2.3 +/- 2.4) vs cases with AAD > or = 34 years (n = 54, 1.0, 1.6 +/- 1.7) (P < 0.001). Thus these 23 familial melanoma kindreds showed evidence for anticipation as defined by a decrease in AAD in successive generations. Although increased surveillance may partly explain the results, additional studies should evaluate melanoma risk factors, genetic and/or environmental, across generations to examine the reasons for the apparent anticipation.

Age of Onset↗