Securing permanence for children in care: A cross-country analysis of citizen's view on adoption versus foster care

If children in child protection cannot be cared for by their natural parents, should they be adopted or live in foster home? Results from a study of representative samples of populations (n = 12 330), in eight European countries—Austria, England, Estonia, Finland, Germany, Ireland, Norway and Spain—and California, USA, reveal that people would recommend adoption over foster care, if a child in public care cannot grow up with their natural parent(s). There are cross-country differences between populations, and examining if institutional context such as type of child protection system explains differences, we find that child maltreatment-oriented systems are more supportive of adoption than other types of systems. Citizens having little confidence in the child protection system were only weakly correlated with preference for adoption. In conclusion, people prefer adoption as placement options for children in care are more than foster homes, and possible this finding reflects a sort of refamalialization of children into the private sphere.publishedVersio

On the verge of leaving the care system: assessment of life skills and needs of adolescents in care

"The present study examines professional workers' perceptions about life skills and the needs of adolescents in (educational) youth villages, (welfare) residential treatment and family foster care in the final two years of their stay in care. The study further examines the extent to which they can expect family support when they leave care. The sample in the study included 178 adolescents in foster care, 291 in residential care and 1257 in youth villages. Structured questionnaires were completed by staff members working with the adolescents in care. The findings indicate that adolescents in youth villages may expect more familial support when they leave the system compared with youths in other types of placements, whereas the families of adolescents in residential care exert on them many more negative pressures. Workers identified several areas in which adolescents lacked life skills, among them education and the ability to complete meaningful (compulsory) military service. Many needs were identified and were especially evident in the areas of future education and employment. The findings imply a clear need to engage in individual assessment and plan for youths while they are still in care. Furthermore, the importance of developing programs to prepare youths while in care is discussed, as well as services for care leavers in the transition period." (author's abstract)"Die vorliegende Studie beschäftigt sich mit der Wahrnehmung der Lebenskompetenzen und der Bedarfe von Jugendlichen während ihrer letzten zwei Jahre in (pädagogisch betreuten) Jugenddörfern, Einrichtungen der stationären Jugendhilfe sowie Pflegefamilien durch Fachkräfte. Es wird zudem danach gefragt, in welchem Ausmaß die Jugendlichen Unterstützung durch ihre Familien erwarten können, wenn sie die Betreuungsmaßnahmen verlassen. Insgesamt wurden 178 Jugendliche in Pflegefamilien, 291 in der stationären Jugendhilfe und 1257 in Jugenddörfern untersucht. Die strukturierten Fragebögen wurden von Fachkräften ausgefüllt, die mit den Jugendlichen zusammenarbeiten. Die Ergebnisse zeigen, dass Jugendliche, die in Jugenddörfern betreut werden, nach dem Ende der Betreuung mehr familiäre Unterstützung erwarten können als Jugendliche in anderen Betreuungsformen. Familien von Jugendlichen in der stationären Jugendhilfe üben erheblich mehr negativen Druck aus. Die Fachkräfte identifizieren zahlreiche Bedarfe, vor allem in Bezug auf Bildung und Beschäftigung sowie die Fähigkeit, angemessen den Wehrdienst zu verrichten. Die Ergebnisse verweisen auf die Notwendigkeit einer individuellen Einschätzung und Zukunftsplanung für die Jugendlichen noch während ihrer Betreuung. Weiterhin werden die Bedeutung der Entwicklung von Programmen und der Einrichtung sozialer Dienste diskutiert, die Jugendliche auf die Übergangsphase vorbereiten und sie dabei begleiten." (Autorenreferat

LIFE AND DEATH IN ICU: NURSING CARE TO SMOOTH TRANSITIONS FOR PATIENTS AND FAMILY

The full version of this thesis cannot be open access because it contains 16 published articles which are copyrighted by 16 different publishers. Therefore an edited version of the thesis is uploaded and can be open access.Background Nurses are the clinicians closest to the patients in daily monitoring of processes and adaptations: assessing, intervening with treatments and evaluating the outcomes. Nurses evaluate all physiological abnormalities, emotional instabilities as well as spiritual requirements regarding religious beliefs, cultural rituals and family relationships. Aim This thesis examines the context, purpose, significance of life threatening and end-of- life situations in critical care and demonstrates the integral work of nurses in calming, organizing and making sense of intensive care unit life and death conditions. Program of work The body of work reported in this thesis comprises a collection of work resulting in the creation of an end of life care bundle. Each segment of the bundle is organized into evidenced-based critical junctures. The first critical juncture is an appraisal of responsiveness of patient’s disease process to curative interventions applied in the ICU. The second critical juncture looks at shared decision making, coping with conflicts, and using verbal and non-verbal communication. The third critical juncture analyses consensus, how to accomplish this task addressing moral, cultural and religious issues. Critical juncture number four discusses comfort care including spiritual practices and therapeutic relationships. The fifth critical juncture involves family care and nurses’ role in providing cultural competencies and examples of family focused interventions to assist this population with the grieving process. The sixth critical juncture looks at various aspects of end of life care and assuring a good death. The final critical juncture proposes post intensive care follow up and using family support groups as a tool for coping. Conclusions This work incorporates scientific rational into critical junctures to create an end of life care bundle

Advancing the field of decision making and judgement in child welfare and protection:A look back and forward

Our knowledge of decision making in child welfare has evolved concurrent with the recognition that there is variability in the rates at which children and families experience no involvement to deeper involvement in the system from jurisdiction to jurisdiction and person to person. In this synthesis of concepts and studies we recap the reasons it is important and challenging to identify systematic causes for variability in decisions and what can be learned about them. Child protection systems have a history of relying on both formal and informal assessments of children and families. While research indicates that emphasis on assessment is warranted, errors and mistakes can happen in all the stages of the assessment and decision processes due to a range of system and human factors. We present some examples here

Examining the Relationship between School Climate and Peer Victimization among Students in Military-Connected Public Schools

In the Iraq and Afghanistan war context, studies have found that military-connected youth—youth with parents and/or siblings serving in the military—have higher rates of school victimization than their nonmilitary-connected peers. A positive school climate—where students perceive high levels of school connectedness, caring relationships and high expectations from adults, and meaningful participation—is associated with lower rates of victimization in secondary public schools. Based on a survey of 7th, 9th, and 11th grade students (n=14,493) enrolled in six military-connected school districts (districts that have a significant proportion of military-connected students), this study explores victimization rates and the role of school climate, deployment, and school transitions in the victimization of military-connected students and their civilian peers. The findings indicate that deployment and school transitions were significant predictors of physical violence and nonphysical victimization. In addition, multiple school climate factors were significantly associated with physical violence and non-physical victimization. The authors conclude with a discussion of future directions for research on school climate, victimization, and military-connected youth