1
|
Ismayilova L, Claypool E, Heidorn E. Trauma of separation: the social and emotional impact of institutionalization on children in a post-soviet country. BMC Public Health 2023; 23:366. [PMID: 36803447 PMCID: PMC9942302 DOI: 10.1186/s12889-023-15275-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 02/14/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND In the former Soviet Union (fSU) region, which has the highest rate of institutional care worldwide, 'social orphans' -indigent children who have one or both parents living-are placed in publicly run residential institutions to receive education, food, and shelter. Few studies have focused on understanding the emotional effects of separation and life in an institutional environment on children who grow up with their families. METHODS Semi-structured qualitative interviews (N = 47) were conducted with 8- to 16-year-old children with a history of institutional care placement and their parents in Azerbaijan. Semi-structured qualitative interviews were conducted with 8- to 16-year-old children (n = 21) involved in the institutional care system in Azerbaijan and their caregivers (n = 26). Trained interviewers collected narratives about children's experiences prior to being separated from their families while living in an institution, as well as the impact of institutional placement on their emotional well-being. We applied thematic analysis with inductive coding. RESULTS Most of the children entered institutions around the school entry age. Prior to entering institutions, children had already experienced disruptions within their family environments and multiple traumatic events, including witnessing domestic violence, parental divorce, and parental substance abuse. Once institutionalized, these children may have had their mental health further impaired by a sense of abandonment, a strictly regimented life, and insufficiencies of freedom, privacy, developmentally stimulating experiences, and, at times, safety. CONCLUSION This study illustrates the emotional and behavioral consequences of institutional placement and the need to address accumulated chronic and complex traumatic experiences that occurred before and during institutional placement, which may affect emotion regulation and the familial and social relationships of children who lived in institutions in a post-Soviet country. The study identified mental health issues that could be addressed during the deinstitutionalization and family reintegration process to improve emotional well-being and restore family relationships.
Collapse
Affiliation(s)
- Leyla Ismayilova
- The University of Chicago, Crown Family School of Social Work, Policy, and Practice, Chicago, IL, USA.
| | - Emily Claypool
- grid.170205.10000 0004 1936 7822The University of Chicago, Crown Family School of Social Work, Policy, and Practice, Chicago, IL USA
| | - Emma Heidorn
- grid.170205.10000 0004 1936 7822The University of Chicago, Crown Family School of Social Work, Policy, and Practice, Chicago, IL USA
| |
Collapse
|
2
|
Roach A, Sherburne E, Snethen J. Intercountry adoption of children with complex health conditions and disabilities: A systematic review. J SPEC PEDIATR NURS 2023; 28:e12398. [PMID: 36285418 DOI: 10.1111/jspn.12398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 10/20/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE The rate of children with complex health conditions or disabilities who are intercountry adopted (ICA) is increasing. These children have unique physical, developmental, and psychological needs that must be addressed as they integrate into adoptive families. The purpose of this systematic review is to identify considerations nurses must recognize when caring for children with complex health conditions or disabilities who are ICA and their families. DESIGN AND METHODS A systematic literature review in accordance with the PRISMA guidelines was conducted. Four databases (PubMed, PsycINFO, Web of Science, and ERIC) located 365 articles about intercountry adoption and complex health conditions or disability. Articles that were non-English language, focused on attachment disorder or infectious disease, book chapters, dissertations, or case studies were excluded. Sixteen articles met inclusion criteria and informed this review. RESULTS The systematic review identified eight themes: primary care resources, interdisciplinary care teams, cost, developmental difficulties, nutritional challenges, mental health issues, parental need for knowledge, and parental need for support. These themes correspond to nursing assessments that should be conducted during clinic visits for children with complex health conditions or disabilities who are ICA. PRACTICE IMPLICATIONS This systematic review demonstrates that a multidisciplinary approach is necessary to address the needs of the child diagnosed with a complex health condition or disability and their family in the context of intercountry adoption. Children with a complex health condition or disability who are ICA have unique needs and require individualized care planning to maximize growth and developmental potential. Adoption is a life-long process and adjustment is complicated by the medical needs that children with complex health conditions or disabilities experience. Parents will benefit from additional support and education as they integrate a new family member while also learning about the medical care needs of a child with a complex health condition or disability.
Collapse
Affiliation(s)
- Audrey Roach
- Children's Hospital of Wisconsin, Spina Bifida Clinic, Milwaukee, Wisconsin, USA.,University of Wisconsin-Milwaukee, College of Nursing, Milwaukee, Wisconsin, USA
| | - Eileen Sherburne
- Children's Hospital of Wisconsin, Spina Bifida Clinic, Milwaukee, Wisconsin, USA
| | - Julia Snethen
- University of Wisconsin-Milwaukee, College of Nursing, Milwaukee, Wisconsin, USA
| |
Collapse
|
3
|
Glass DJ, Geerkens JT, Martin MA. Psychosocial and energetic factors on human female pubertal timing: a systematized review. EVOLUTIONARY HUMAN SCIENCES 2022; 4:e28. [PMID: 37588922 PMCID: PMC10426011 DOI: 10.1017/ehs.2022.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Childhood psychosocial stressors have been proposed to favour fast life history strategies promoting earlier puberty in females. However, studies demonstrating this association often do not elucidate causal mechanisms, nor account for greater childhood energetic availability - also known to promote rapid growth and earlier puberty. To assess the extent to which such confounding has been considered, we conducted a systematized review to identify studies examining measures of both prepubertal growth (e.g. weight, height) and psychosocial stressors (e.g. adversity, father absence) in relation to female pubertal timing. A total of 1069 non-duplicated studies were identified across five databases. Twenty studies met selection criteria for critical review following independent screening of titles, abstracts and manuscripts. Within these studies, measures indicative of rapid childhood growth were more consistently associated with earlier pubertal timing than were measures of psychosocial stress. We discuss future research directions to investigate the impact of psychosocial stress on pubertal timing more robustly, including methodological and mechanistic considerations, and contextualization of findings by socioecological environments.
Collapse
Affiliation(s)
- Delaney J. Glass
- University of Washington, Department of Anthropology, Seattle, Washington, USA
| | | | - Melanie A. Martin
- University of Washington, Department of Anthropology, Seattle, Washington, USA
| |
Collapse
|
4
|
Ducreux E, Puentes-Neuman G. Adaptation of babies in three types of placement: An ethological approach. Infant Ment Health J 2020; 42:279-291. [PMID: 33340137 DOI: 10.1002/imhj.21903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The present pilot study focuses on the adaptive processes of babies who are placed during their first months of life. It used an ethological approach to explore the behavioural adjustment of 19 infants from their arrival in placement through their first 6 weeks in Residential Care (RC; France), a Foster Family (FF; Québec) or an Infant-Mother Centre (IMC; Québec). Direct observations were conducted once a week during feeding sessions. Observed behaviours were as follows: sleep-wake state, self-soothing, burp, visual exploration, motor activity, facial and vocal expressions. Then, a Kruskal-Wallis test was conducted to examine differences in babies' adaption as a function of placement setting. Results showed that, in RC, the duration of the post-feeding phase is the shortest. Moreover, these institutionalized babies showed the most modes of self-protection and the fewest vocalizations. By contrast, babies placed in the IMC spent the least time in withdrawal, expressed motor activity more regularly and were never placed back in their recliner before burping. Larger differences appear comparing placement in RC and that in the IMC, the placement in FF showing intermediate results.
Collapse
Affiliation(s)
- Edwige Ducreux
- Lecturer, Institut National Supérieur du Professorat et de l'Éducation (INSPE), Lille Hauts de France, France.,PSITEC Lab, Université de Lille, Lille, France.,Department of Psychology, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | | |
Collapse
|
5
|
Improving social-emotional competence in internationally adopted children with the Attachment and Biobehavioral Catch-up intervention. Dev Psychopathol 2020; 33:957-969. [PMID: 32672145 DOI: 10.1017/s0954579420000255] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Children adopted internationally experience adverse conditions prior to adoption, placing them at risk for problematic social-emotional development. The Attachment and Biobehavioral Catch-up (ABC) intervention was designed to help internationally adoptive parents behave in ways that promote young children's social-emotional competence. Participants included 131 parent-child dyads randomly assigned to receive either ABC (n = 65) or a control intervention (n = 66). In addition, 48 low-risk biologically related parent-child dyads were included as a comparison group. At follow-up assessments conducted when children were 24 to 36 months old, internationally adopted children who received the ABC intervention had higher levels of parent-reported social-emotional competence than children who received a control intervention. In addition, observational assessments conducted when children were 48 and 60 months of age showed that internationally adopted children who received ABC demonstrated higher social-emotional competence than children who received a control intervention. Adopted children who received the control intervention, but not the ABC intervention, displayed more difficulties with social-emotional competence than low-risk children. Finally, postintervention parent sensitivity mediated the effect of ABC on observed child social-emotional competence in parent interactions, controlling for preintervention parent sensitivity. These results demonstrate the efficacy of a parenting-focused intervention in enhancing social-emotional competence among children adopted internationally.
Collapse
|
6
|
DeLacey E, Tann C, Groce N, Kett M, Quiring M, Bergman E, Garcia C, Kerac M. The nutritional status of children living within institutionalized care: a systematic review. PeerJ 2020; 8:e8484. [PMID: 32071812 PMCID: PMC7007983 DOI: 10.7717/peerj.8484] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 12/29/2019] [Indexed: 12/19/2022] Open
Abstract
Background There are an estimated 2.7 million children living within institutionalized care worldwide. This review aimed to evaluate currently available data on the nutrition status of children living within institutionalized care. Methods We searched four databases (Pubmed/Medline, CINHAL Plus, Embase and Global Health Database) for relevant articles published from January 1990 to January 2019. Studies that included information on anthropometry or micronutrient status of children living within institutionalized care were eligible for inclusion. The review is registered on PROSPERO: CRD42019117103. Results From 3,602 titles screened, we reviewed 98 full texts, of which 25 papers were eligible. Two (8%) studies reported data from multiple countries, nine (36%) were from Asia, four (16%) from Africa, three (12%) from Eastern Europe, four (16%) from the European Union and one (4%) from each of the remaining regions (Middle East, South America and the Caribbean). Twenty-two (88%) were cross sectional. Ten (40%) of the studies focused on children >5 years, seven (28%) on children <5 years, seven (28%) covered a wide age range and one did not include ages. Low birth weight prevalence ranged from 25–39%. Only five (20%) included information on children with disabilities and reported prevalence from 8–75%. Prevalence of undernutrition varied between ages, sites and countries: stunting ranged from 9–72%; wasting from 0–27%; underweight from 7–79%; low BMI from 5–27%. Overweight/obesity ranged from 10–32% and small head circumference from 17–41%. The prevalence of HIV was from 2–23% and anemia from 3–90%. Skin conditions or infections ranged from 10–31% and parasites from 6–76%. Half the studies with dietary information found inadequate intake or diet diversity. Younger children were typically more malnourished than older children, with a few exceptions. Children living within institutions were more malnourished than community peers, although children living in communities were also often below growth standards. High risk of bias was found. Conclusions This study highlights the limited amount of evidence-based data available on the nutritional status of children in institutions. Of the studies reviewed, children living within institutionalized care were commonly malnourished, with undernutrition affecting young children particularly. Micronutrient deficiencies and obesity were also prevalent. Data quality was often poor: as well as suboptimal reporting of anthropometry, few looked for or described disabilities, despite disability being common in this population and having a large potential impact on nutrition status. Taken together, these findings suggest a need for greater focus on improving nutrition for younger children in institutions, especially those with disabilities. More information is needed about the nutritional status of the millions of children living within institutionalized care to fully address their right and need for healthy development.
Collapse
Affiliation(s)
- Emily DeLacey
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, University of London, London, United Kingdom.,Holt International, Eugene, OR, United States of America.,Centre for Maternal, Adolescent, Reproductive, & Child Health (MARCH), London School of Hygiene & Tropical Medicine, University of London, London, United Kingdom
| | - Cally Tann
- Centre for Maternal, Adolescent, Reproductive, & Child Health (MARCH), London School of Hygiene & Tropical Medicine, University of London, London, United Kingdom.,Department of Infectious Disease Epidemiology, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, University of London, London, United Kingdom.,MRC/UVRI & LSHTM Uganda Research Unit, London School of Hygiene & Tropical Medicine, University of London, Entebbe, Uganda.,Neonatal Medicine, University College London Hospitals NHS Trust, London, United Kingdom
| | - Nora Groce
- UCL International Disability Research Centre, Department of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Maria Kett
- UCL International Disability Research Centre, Department of Epidemiology and Health Care, University College London, London, United Kingdom
| | | | - Ethan Bergman
- Department of Health Sciences, College of Education and Professional Studies, Central Washington University, Ellensburg, WA, United States of America
| | - Caryl Garcia
- Holt International, Eugene, OR, United States of America
| | - Marko Kerac
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, University of London, London, United Kingdom.,Centre for Maternal, Adolescent, Reproductive, & Child Health (MARCH), London School of Hygiene & Tropical Medicine, University of London, London, United Kingdom
| |
Collapse
|
7
|
Birth Size, Stunting and Recovery from Stunting in Andhra Pradesh, India: Evidence from the Young Lives Study. Matern Child Health J 2018; 21:492-508. [PMID: 27456305 DOI: 10.1007/s10995-016-2132-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives Few Indian studies have examined the relationship between birth size and stunting in children. Studies on recovery from stunting in India are even fewer. This study, thus, investigates the relationship between birth size and stunting in Andhra Pradesh, India. This study further examines the factors associated with recovery from stunting using a longitudinal data. Methods We used data from the three waves of Young Lives Study (YLS) conducted in Andhra Pradesh in the years 2002, 2006-2007, and 2009 respectively. We used data from 1965 children in wave 1 to examine the association between birth size and stunting. For examining the factors associated with recovery from stunting between 1 and 5 years of age, and between 5 and 8 years, we use data from 582 and 670 children who were stunted at age 1 and age 5 respectively. We use multivariable logistic regression models to fulfil the objectives of the paper. Results The children who were of average- or large- size at birth were significantly less likely to be stunted than children who were of small size at birth (OR 0.61 and 0.47 respectively). Children of average/tall mothers were 0.41 times less likely to be stunted than children of shorter mothers. Severely stunted children were less likely than other stunted children to recover from stunting between 1 and 5 years of age, and between 5 and 8 years. Mother's height was statistically associated with recovery. Change in wealth status of the household was statistically associated with recovery between 1 and 5 years of age. In comparison, child immunization was associated with recovery between 5 and 8 years. Conclusions for Practice This study contributes to the understanding of the impact of birth size on childhood stunting, and to the extent of recovery from stunting in India. Further follow-up is necessary to demonstrate the impact during adolescence and adulthood.
Collapse
|
8
|
Rabaey P. A review of feeding interventions for children with disabilities: Implications for institutionalised settings. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2017. [DOI: 10.12968/ijtr.2017.24.4.174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Paula Rabaey
- PhD Candidate Nova Southeastern University, Fort Lauderdale, FL; Assistant professor, Occupational Therapy Department, St Catherine University, St Paul, MN, USA
| |
Collapse
|