A multimodal intervention for grandparents raising grandchildren: results of an exploratory study.

This article describes the results of an exploratory study of a multimodal, home-based intervention designed to reduce psychological stress, improve physical and mental health, and strengthen the social support and resources of grandparents raising grandchildren. The six-month intervention included home visits by registered nurses, social workers, and legal assistants; the services of an attorney; and monthly support group meetings. The intervention resulted in improved mental health scores, decreased psychological distress scores, and increased social support scores. Participants also experienced improvement in the level of public benefits received and in their legal relationships with their grandchildren. Implications of these findings for practice are highlighted.

Psychological distress in grandmother kinship care providers: the role of resources, social support, and physical health.

OBJECTIVE: The purpose of the present study was to investigate predictors of psychological distress in grandmother kinship care providers. More specifically, it was hypothesized that social support, family resources, and physical health would predict psychological distress in grandmothers raising grandchildren. METHOD: One hundred and two grandmothers raising grandchildren in parent-absent homes completed the Brief Symptom Inventory, Short Health Form-36, Family Resource Scale, Family Support Scale, and a questionnaire requesting background and demographic data. RESULTS: Results indicated that psychological distress was predicted by family resources, participants' physical health, and to a lesser extent, social support. CONCLUSION: The findings indicate that family resources, social support, and physical health affected psychological distress in grandmothers raising grandchildren. Grandmothers who reported fewer resources, less social support, and poorer physical health tended to experience higher levels of psychological distress. This study suggests that greater attention be given to interventions aimed to decrease psychological distress and improve the financial resources and physical health of grandmothers raising grandchildren.

To grandmother's house we go ... and stay. Children raised in intergenerational families.

An increased incidence in child abuse and neglect has resulted in a dramatic rise in the number of grandparents raising grandchildren and great-grandchildren. Grandchildren raised by grandparents often suffer from emotional and behavioral problems due to prior abuse, neglect, and abandonment. Grandparent caregivers experience increased health problems, psychological distress, and social isolation related to their roles as primary caregivers of children. Grandparents who become caregivers of grandchildren face increased financial responsibilities at a time in their lives, close to or at retirement, when income is dramatically decreased.

Fears of medical events among school-age children with emotional disorders, parents, and health care providers.

The purpose of this comparative study was to describe the reports of fears of medical events among school-age children with emotional disorders and compare their reports with those of parents and health care providers. A secondary purpose was to determine the reliability of the Child Medical Fear Scale (CMFS) with this population. Thirty children, parents, and health care providers (N = 90) completed the CMFS; the parents and health care providers also completed demographic instruments. The internal consistency reliability was acceptable (alpha = .75) for the CMFS with this population. Overall, the children reported lower fear scores of medical events than in previous research studies. Boys reported lower fear scores (p = .03) than girls. There was a statistical difference (p = .006) between the mean scores of the children and those of the parents and health care providers, with the children reporting less fear. The CMFS is useful among children with emotional disorders both in the clinical setting and in research.

Case studies of children presenting with a history of ritualistic abuse.

TOPIC: Ritualistic child abuse is an alarming and controversial problem. Child psychiatric nurses need to increase their awareness of the clinical picture associated with this specific form of abuse. PURPOSE: This article reviews the literature to date on ritualistic child abuse and addresses the controversy surrounding the phenomena. SOURCES: A small research project using historical data collection methods reviewed hospital records of children with a documented history of ritualistic abuse. Results are organized into clusters of linked interrelated characteristics. CONCLUSION: The symptom characteristics of these children revealed medical/somatic symptoms, distortion of self-oncept and world view, and a variety of emotional disturbances. The findings of this study are presented with implications for nurses who care for clients with a history of ritualistic abuse.

Workers' compensation law: an overview.

1. The workers' compensation system provides benefits to workers who are injured or made ill in the course of employment or their dependents regardless of fault. 2. The current workers' compensation laws benefit both the employer and the employee; however, workers' compensation is an exclusive remedy which bars recovery through a negligence lawsuit. 3. Workers' compensation regulations interact with other federal statutes such as the Americans With Disabilities Act and the Family Medical Leave Act. 4. Workers' compensation covers occupational injuries and occupational diseases, which may include cumulative trauma and mental stress claims. Nurses may be instrumental in evaluating and planning for an injured employee's return to work and occasionally in detecting fraudulent claims.

Case studies of bibliotherapy with homeless children.

Children who experience homelessness constitute a growing population at-risk for developing mental health problems. The purpose of this study was to explore and describe the use of bibliotherapy with homeless children. A case study method of inquiry was used with drawings, audiotapes and clinical records from a convenience sample of three children living in a transitional homeless shelter. Four themes of homelessness emerged from the case studies. These were labelled "Longing for Affluence," "Escaping Violence," "Shame and Stigma," and "Making Transitions." Therapeutic stories were selected in response to the emergence of each child's own issues and the theme issues. Implications for psychiatric mental health nurses are discussed.

Münchausen's syndrome by proxy as a form of child abuse.

Munchausen's syndrome by proxy (MSBP) is an emotional disorder in which the parent, almost always the mother, induces or fabricates illness in her child in order to gain medical attention. Although numerous case studies exist in pediatric and medical literature, most nurses are unaware of the warning signs of this disorder. Psychiatric consultation liaison nurses are in an ideal position to identify and intervene in MSBP situations and can also support the pediatric nursing staff through feelings of denial, shock, and guilt as they recognize the syndrome and its danger to the child.