Transcendent Sacrifice and Spirituality: Cambodian Grandparents raising Orphaned Grandchildren

Stepping Up and Stepping In: Exploring the Role of Nurses in Supporting Grandparents Raising Grandchildren

This study focused on the experiences of grandparents raising grandchildren in rural, Prince Edward Island, Canada. Termed grand-families, there are numerous reasons why grandparents must step up and step in to care for their grandchildren. Often these reasons are related to their adult children's struggles with mental illness and substance use disorders. Adopting Clandinin and Connelly's approach to narrative inquiry, we present findings from the conversational interviews conducted with 12 grandparents raising their grandchildren. Interview data were analyzed through the narrative dimensions of time, place, and relationship. Findings are presented as rich narratives which illuminate the evolution and storied experiences of grand-families. Particularly revealing are the challenges grandparents face as they navigate various systems, including health care, that do not acknowledge the uniqueness of their family form. Nurses work with grand-families across varied clinical settings. Grounded within the philosophy of Patient and Family Centered Care and family nursing theory, this article offers recommendations for supportive interventions that nurses can implement when caring for grand-families across clinical settings. This study has the potential to facilitate the development of evidence-based supports and services, which are responsive to the needs, realities, and complexities of grand-families.

A responsive evaluation of mental health treatment in Cambodia: Intentionally addressing poverty to increase cultural responsiveness in therapy

Mental health issues are significant contributors to the global burden of disease with the highest incidence in resource poor countries; 90% of those in need of mental health treatment reside in low resource countries but receive only 10% of the world's resources. Cambodia, the eighth least developed country in the world, serves as one example of the need to address mental health concerns in low-income, resource poor countries. The current study utilises responsive evaluation methodology to explore how poverty-stricken Cambodian clients, therapists and supervisors experience Western models of therapy as culturally responsive to their unique needs. Quantitative and qualitative data were triangulated across multiple stakeholders using numerous methods including a focus group, interviews, surveys, case illustrations and live supervision observation and analysed using constant comparative analysis. Emerging findings suggest that poverty, material needs, therapy location and financial situations greatly impact the daily lives and mental health conditions of Cambodians and hinder clients' therapeutic progress. The local community needs and context of poverty greatly hinder clients' therapeutic progress in therapy treatment and when therapy does not directly address the culture of poverty, clients did not experience therapy as valuable despite some temporary decreases in mental health symptoms.

Self-perception of when old age begins for Cambodian elders living in the United States

OBJECTIVE

To deepen the understanding of the life course of refugees this study explores the question: when do Cambodian elders perceive the beginning of old age?

METHODS

In-depth interviews were conducted with 32 Cambodians, age range 53-82, who attended an elder day center in an urban setting in Massachusetts. Interviews were transcribed and analyzed using the modified grounded theory approach.

RESULTS

The analysis revealed that the participants primarily reported two determinants to defining when old age begins: 1) the body "has too many illnesses" due to harsh working conditions; and 2) social role transition into grandparent.

DISCUSSION

This study extends research on cultural differences in aging, specifically identifying the cultural difference in the definition of when "old age" begins. Age is culturally derived and creates expectations for social roles, health, self-identity, and behavior. Understanding how refugees experience the cultural discrepancies in their expectations of aging can inform providers who serve this population.