What roles do male partners play in the mothering experiences of women living with mental illness? A qualitative secondary analysis.

BACKGROUND: Mothers who live with mental illness face diverse challenges. Research suggests that partner support or otherwise is likely to have a crucial influence on mothers' abilities to manage these challenges, yet little is known about how this plays out. In this study, we aimed to explore the roles played by male partners in the mothering experiences of women living with mental illness. METHODS: We conducted a qualitative secondary analysis using interview data collected from 18 participants in two previous qualitative studies. Both studies focused on the mothering experiences of women who lived with mental illness. In both studies, the importance of male partners was striking. The data were analyzed using constant comparative analysis. RESULTS: The roles of partners in women's experiences of mothering were multiple and dynamic, with each male partner playing a unique combination of roles. These included: facilitator; teammate; unfulfilled potential; distraction; dismantler, and threat to child. Roles were influenced by: mothers' interpretations; partners' behaviors, characteristics and circumstances; the family's living and custody arrangements; mothers' active management strategies; and a range of external controls and supports. CONCLUSIONS: Health professionals need to consider the complex roles partners play. This crucial aspect of mothers' social environments can be optimized by directly supporting and enabling partners themselves, and by supporting mothers to actively shape their partners' roles.

Mothering differently: narratives of mothers with intellectual disability whose children have been compulsorily removed.

BACKGROUND: Despite the frequency with which mothers with intellectual disability have their children removed, little theoretical or empirical work has understood the mothers' perspectives on this. A few studies have reported mothers' feelings of grief and loss and their sense of powerlessness in the child protection system. METHOD: This qualitative study explores the daily life narratives of 7 mothers with intellectual disability following the involuntarily removal of their children. RESULTS: For most mothers, having a child removed was not a one-off experience. The serial nature of the experience yielded 3 different narratives, lived out in different ways. In some cases, women told a different narrative for each of their removed children. All women remained focused on their children in care. CONCLUSIONS: The multiple and varied narratives of mothers with intellectual disability who have children in care suggest that their support needs may differ from each other and over time. How their support needs might best be met remains an unanswered question. Further research is also needed to identify any adverse health and social consequences for mothers with children in care as well as the effects on their children.

The balancing act: meeting the needs of all children including an adolescent with disabilities.

BACKGROUND: The aim of this study was to explore parents' experiences and strategies used when meeting the needs of all their children, including an adolescent with disabilities. MATERIALS AND METHODS: A qualitative study design was employed. The study was conducted in two phases. (i) Secondary analysis of ecocultural interviews with 12 parent-carers of more than one child, including an adolescent (10-21 years) with intellectual disabilities. (ii) In-depth, semi-structured interviews with a sub-sample (n = 4) of parent-carers. Data was analysed using Strauss & Corbin's (1998) constant comparative method. RESULTS: Parents balanced their children's needs through a combination of strategies driven by their goals, beliefs and values. Parents found this very challenging. They were always conscious of the needs of all of their children, although they could not necessarily meet all their children's needs equally. Strategies that attended to all children simultaneously were preferred by most parents, but could not always be used. Parents, at times, used strategies that prioritized the needs of the adolescent with disabilities or siblings. CONCLUSIONS: Findings add to knowledge on what families of adolescents with disabilities do day to day and specifically reveal how these parents meet the needs of their children. Practitioners, together with disability and mainstream services and systems, need to recognize parents' goals, beliefs and values and the needs of the adolescent with disabilities. This will effectively aid the adolescent with disabilities, their siblings, parents and the whole of family life.

Transition to independent accommodation for adults with schizophrenia.

OBJECTIVE: The aim of this exploratory study was to investigate the process of transition to independent accommodation for people with schizophrenia. METHOD: The study employed a grounded theory approach. Multiple semi-structured and responsive e-mails and interviews were conducted with a total of seven participants currently living in independent accommodation. Through constant-comparative analysis of interview and e-mail data, three central processes were identified. RESULTS: The three processes are developing a sense of control; establishing a relationship between illness and place; and attaining a sense of belonging. CONCLUSION: By attending to each of these three processes, mental health professionals may better assist people with schizophrenia to make a successful transition to independent accommodation, and in turn, to living well in the community.

The Log Handwriting Program improved children's writing legibility: a pretest-posttest study.

OBJECTIVE: We determined the feasibility and outcomes of the Log Handwriting Program (Raynal, 1990), an 8-week training program based on task-specific practice of handwriting. METHOD: We used a pretest-posttest design involving 16 first- and second-grade Australian students. Handwriting training sessions occurred in schools for 45 min per week over 8 weeks, in groups of 2 or 3. Weekly homework was provided. The primary outcome measure was the Minnesota Handwriting Assessment (range = 0 to 34; Reisman, 1999). Legibility, form, alignment, size, spacing, and speed were measured. RESULTS: All six assessment subscales showed statistically significant differences. Legibility improved by a mean of 4.1 points (95% confidence interval = 2.5 to 5.7); form, 5.3 points; alignment, 7.8 points; size, 7.9 points; and space, 5.3 points. Speed decreased by 3.9 points. CONCLUSION: Preliminary evidence indicates that an 8-week Log Handwriting Program is feasible and improved handwriting in primary school children.

Family caregivers' perceptions of hospital-based allied health services post-stroke: use of the Measure of Processes of Care to investigate processes of care.

AIM: To investigate family caregiver perceptions of allied health professional processes of care and support in hospital following stroke, and to test an adapted version of the Measure of Processes of Care (MPOC) for its suitability of use in the stroke care setting. METHODS: The first stage involved the adaptation and refinement of the MPOC, designed to measure caregiver perceptions of processes of professional care and support across five care dimensions. The second stage involved mailing out of questionnaires to primary caregivers of stroke survivors. A total of 107 completed questionnaires were included in the analysis. The reliability of the adapted questionnaire was assessed and summary statistics were computed. RESULTS: The reliability of the adapted MPOC was found to be high, with good internal consistency of items within each subscale. Mean scores indicated that caregivers were most likely to report negative perceptions of the way allied health professionals engaged with and supported them, particularly in the area of information provision. CONCLUSION: The number of families being affected by stroke is predicted to rise substantially in the near future. Allied health professionals have a significant role to play in supporting family caregivers. Results highlight caregiver-identified areas of weakness in current clinical practice.

Pre-partum distress in women with intellectual disabilities.

BACKGROUND: This study investigates depression, anxiety and stress in pregnant women with intellectual disabilities and/or self-reported learning difficulties, and examines the association between these negative emotional states and perceived support and conflict in the women's interpersonal relationships. METHOD: Eight-hundred-and-seventy-eight women attending their first antenatal visit in a socioeconomically disadvantaged area of Sydney, Australia during a 5-month period in 2002 completed a brief questionnaire to identify those with intellectual disabilities (ID) and/or self-reported learning difficulties. These 57 women were then invited to participate in a series of three interviews (two pre- and one post-partum). The second interview, which was conducted with 31 women in their third trimester, incorporated standard measures of depression, anxiety and stress, and support and conflict in interpersonal relationships, and is the subject of the research reported here. RESULTS: More than one-third of the women interviewed reported moderate to severe depression, anxiety and stress. A significant association was found between depression and both perceived support and conflict in interpersonal relationships. Stress was associated with conflict but not with either perceived support. Anxiety was not significantly associated with either perceived support or conflict. CONCLUSIONS: Negative emotional states in this population of women may be confounded with their cognitive deficits. Routine antenatal screening for negative emotional states is therefore recommended to ensure that the mental health care needs of women with ID and/or self-reported learning difficulties are not overlooked.

Health of mothers with intellectual limitations.

OBJECTIVE: To investigate the health status of mothers with intellectual limitations. METHOD: The health status of 50 mothers with intellectual limitations in metropolitan Sydney was assessed during the baseline assessment phase of a randomised controlled trial of a parent education program. RESULTS: Self-reported maternal health was significantly worse than women's health in the Australian population. Controlling for socio-economic status, mothers' health remained significantly worse on four of the eight subscales. CONCLUSIONS: The findings suggest that mothers with intellectual limitations are particularly at risk for poor health status. An urgent need exists for policy and service initiatives to address the health status of this group of vulnerable mothers.

Promoting health and home safety for children of parents with intellectual disability: a randomized controlled trial.

The objective of this study was to evaluate the efficacy of a home-based intervention targeted to parents with intellectual disability to promote child health and home safety in the preschool years. A total of 63 parents were recruited for the study with 45 parents (40 mothers and 5 fathers) from 40 families completing the project. The research design permitted comparison between the intervention and three alternative conditions with all parents receiving the intervention in an alternating sequence over the life of the project. The intervention consisted of 10 weekly lessons carried out in the parent's home focusing on child health and home safety. The program was adapted to suit the Australian context from the UCLA Parent--Child Health and Wellness Project (Tymchuk, Groen, & Dolyniuk, 2000). Outcome measures assessed parental health and safety behaviours. Standard measures included parental health, intelligence and literacy. The intervention improved parents' ability to recognize home dangers, to identify precautions to deal with these dangers and resulted in a significant increase in the number of safety precautions parents implemented in their homes with all gains being maintained at 3 months post-intervention. Parents' health behaviours including improved understanding of health and symptoms of illness, knowledge of and skills needed to manage life-threatening emergencies, knowledge about visiting the doctor, knowing when to call, what information to provide and what questions to ask, and how to use medicines safely significantly increased. Again, all gains were maintained 3 months post-intervention. The intervention was effective regardless of parental health, literacy skills, and IQ. This form of home-based intervention promotes a healthy and safe environment which is a prerequisite to continuing parental custody.