Maintaining love and hope: caregiving for Thai children with HIV infection

Keeping hope possible: a grounded theory study of the hope experience of parental caregivers who have children in treatment for cancer

BACKGROUND

Hope has been found to support parents as they care for their child with a life-limiting or life-threatening illness. However, very little research focuses on the nursing care of parents of pediatric oncology patients, and therefore, nurses may have difficulty in understanding and supporting parental well-being.

OBJECTIVE

The purpose of this qualitative study was to gain an understanding of the experience of hope for parents who care for their child in treatment for cancer.

METHODS

Using purposive theoretical sampling, 16 parents participated in this study. Thirty-three open-ended, face-to-face interviews were conducted, and 14 parent journals were collected. Analysis of the data was conducted using Charmaz's constructivist grounded theory approach.

RESULTS

A developing, substantive grounded theory was constructed. Parental hope was described as an essential, powerful, deliberate, life-sustaining, dynamic, cyclical process that was anchored in time; was calming and strengthening; and provided inner guidance through the challenging experience of preparing for the worst and hoping for the best. Parents' main concern was "fearing the loss of hope," which was ameliorated by the basic social process of "keeping hope possible" through accepting reality, establishing control, restructuring hope, and purposive positive thinking.

CONCLUSIONS

Parents journeyed through numerous transitions related to the treatment of cancer that caused feelings of uncertainty, anxiety, stress, and loss of control. Hope was identified as vital to parents.

IMPLICATIONS FOR PRACTICE

To minimize these adverse experiences, nurses can support parents' ability to keep hope possible and thus to optimize their well-being by understanding, assessing, and supporting parental hope.

Viewing the art and the science of pediatric nursing through the lens of paradigms: the impact on hope for the future

PURPOSE

The purpose of this study was to examine the strengths and limitations of common research paradigms used in the study of the hope of parents who have children with a variety of illnesses.

CONCLUSIONS

Research findings on parental hope extracted from only one paradigm present limitations to related knowledge development. To take into account the contributions from each paradigm and to allow for a multidimensional understanding of parental hope, a multiparadigmatic approach is needed.

PRACTICE IMPLICATIONS

The complementary findings from multiple research paradigms can lead to a comprehensive base of knowledge that can guide future research and develop effective, family-centered pediatric nursing care.

Depression symptoms among caregivers of children in HIV-affected families in rural China

The objectives of this study were to examine symptoms of depression among caregivers of rural AIDS orphans (i.e., children who had lost one or both of their parents to HIV/AIDS) and vulnerable children (i.e., children who were living with HIV-infected alive parents), and to explore factors associated with the presence of symptoms of depression among caregivers. Cross-sectional data were collected from 160 adult caregivers (parents, relatives, or other adults) from a rural area in China where many residents were infected with HIV through unhygienic blood collection. The sample included 120 caregivers from households caring for AIDS orphans and vulnerable children (OVC) and 40 from households without OVC. The Center for Epidemiological Studies Depression Scale (CES-D) was used to assess the symptoms of depression among the caregivers. Multiple regression analysis was performed to assess the associations of depressive symptoms with various individual and family factors among caregivers. The mean score of CES-D for the entire sample was 19.18 (17.84 for men and 20.44 for women). The univariate analysis indicated that the score of CES-D was significantly higher among caregivers with lower education, fewer household items/assets, from families with adult or pediatric HIV infection. Controlling for age, gender, and caregivers' education, multiple regression analysis revealed significant associations between symptoms of depression and reduced family socioeconomic status (SES), adult or pediatric HIV infection in family. Our results indicated an elevated level of depression symptoms among caregivers of OVC and underscored the needs for psychological support and intervention for their caregivers, especially for those with lower family SES, from families with an adult or pediatric HIV infection.