Ugandan Jajjas: Antecedents and rewards of caring for grandchildren in the context of HIV.

AIMS AND OBJECTIVES: The findings presented in this manuscript address two key research questions: (a) What factors contribute to the initiation and maintenance of the caregiving role as performed by the grandparent-caregivers; and (b) What are the perceived benefits of caregiving as reported by grandparent-caregivers? BACKGROUND: Grandparents in sub-Saharan Africa have cared for their grandchildren for generations, yet little is known about this role in the context of the HIV epidemic. Although the impact of the epidemic is overwhelmingly negative, specifically in Uganda, knowledge of familial context and underlying motivations and rewards that incentivise grandparent-caregivers remains limited in the literature. METHODS: Using a constructivist grounded theory approach, we explored the experiences of 32 Ugandan grandparents of grandchildren affected by HIV. Data were collected using a semi-structured and open-ended interview guide, participant observation and fieldnotes. Data analysis included open, focused and axial coding. FINDINGS: The data revealed the influences of extended familial structures and of cultural and gender expectations on the decision-making processes and rewards of caregiving as perceived by the grandparent-caregivers. DISCUSSION AND RECOMMENDATION: These findings provide a broad foundation for policy, practice, research and education interventions needed to support grandparents so they can enjoy the benefits of raising their grandchildren. IMPLICATIONS FOR PRACTICE: Our findings can guide education programs and clinical practice for nurses, nursing students, and other health providers on cultural considerations for holistic care provided for older adults-especially older caregivers.

Food cultures and aging: a qualitative study of grandparents' food perceptions and influence of food choice on younger generations.

OBJECTIVE: To explore food perceptions among grandparents and understand the influence of these perceptions on food choice for the younger generations in their family. DESIGN: Qualitative methodology, thematic analysis of the transcripts from fourteen focus groups. SETTING: Grandparents in the southern region of the United States. SUBJECTS: Participants were fifty-eight Black, Hispanic, and White grandparents, predominantly women (72%), ranging in age from 44-86 years (mean age = 65·4 (sd 9·97) years). RESULTS: Grandparents' perceptions related to personal food choice were related to health issues and the media. Grandparents' perceived influence on their children's and grandchildren's food choices was described through the themes of proximity and power (level of influence based on an interaction of geographic proximity to grandchildren and the power given to them by their children and grandchildren to make food decisions), healthy v. unhealthy spoiling, cultural food tradition, and reciprocal exchange of knowledge. CONCLUSION: Our results highlight areas for future research including nutrition interventions for older adults as well as factors that may be helpful to consider when engaging grandparents concerning food decisions for younger generations to promote health. Specifically, power should be assessed as part of a holistic approach to addressing dietary influence, the term 'healthy spoiling' can be used to reframe notions of traditional spoiling, and the role of cultural food tradition should be adapted differently by race.

Family influences on child nutritional outcomes in Nairobi's informal settlements.

BACKGROUND: Improving child nutritional status is an important step towards achieving the Sustainable Development Goals 2 and 3 in developing countries. Most child nutrition interventions in these countries remain variably effective because the strategies often target the child's mother/caregiver and give limited attention to other household members. Quantitative studies have identified individual level factors, such as mother and child attributes, influencing child nutritional outcomes. METHODS: We used a qualitative approach to explore the influence of household members on child feeding, in particular, the roles of grandmothers and fathers, in two Nairobi informal settlements. Using in-depth interviews, we collected data from mothers of under-five children, grandmothers, and fathers from the same households. RESULTS: Our findings illustrate that poverty is a root cause of poor nutrition. We found that mothers are not the sole decision makers within the household regarding the feeding of their children, as grandmothers appear to play key roles. Even in urban informal settlements, three-generation households exist and must be taken into account. Fathers, however, are described as providers of food and are rarely involved in decision making around child feeding. Lastly, we illustrate that promotion of exclusive breastfeeding for 6 months, as recommended by the World Health Organization, is hard to achieve in this community. CONCLUSIONS: These findings call for a more holistic and inclusive approach for tackling suboptimal feeding in these communities by addressing poverty, targeting both mothers and grandmothers in child nutrition strategies, and promoting environments that support improved feeding practices such as home-based support for breastfeeding and other baby-friendly initiatives.

Avosidade nos desenhos animados ocidentais: estilos de avós com netos adolescentes / Grandparenthood in western cartoons: grandparent styles with teen grandchildren

O presente artigo objetivou analisar os tipos de relações entre avós idosos e netos adolescentes exibidos em desenhos animados de longa metragem da filmografia ocidental. Foi realizada a busca dos desenhos nos sites de companhias cinematográficas, lançados no período de 1950 a 2015, que mostrassem essa relação de avosidade. Os filmes foram selecionados através da leitura das sinopses, visualização dos respectivos trailers e, posteriormente, dos filmes escolhidos. Os avós mostrados nos filmes foram analisados através de adaptação da escala de Responsividade e Exigência. Os estilos de avós encontrados foram classificados em quatro tipos: autoritativo, autoritário, indulgente ou negligente. Preencheram os critérios de inclusão 17 desenhos animados. Observou-se predomínio de desenhos animados mostrando estilos de avós indulgentes, seguidos de autoritativo. Não foram encontradas relações autoritárias. (AU)

The present article aimed to analyze the types of relationships between older grandparents and teen grandchildren exhibited in feature film cartoons of the western filmography. The cartoons were searched on film companies' sites, in the period from 1950 to 2015, looking for those who showed grandparenthood relations. The films were selected through the reading of the synopsis, visualization of the respective trailers and, later, of the selected films. The grandparenthoods shown in the films were analyzed by adaptation of the scale of Responsiveness and Requirement, being classified into four types: authoritative, authoritarian, indulgent or negligent. There were 17 cartoons that met the criteria for inclusion. What can be observed is a predominance of cartoons showing indulgent grandparenthood relations, followed by authoritative. No authoritarian relationships were found. (AU)

Biofeedback in Grandmothers Raising Grandchildren: Evaluating Intervention Parameters.

This study examined the six critical parameters for evaluating interventions, including necessity, acceptability, feasibility, safety, fidelity, and effectiveness, of a heart rate variability (HRV) biofeedback training intervention in a sample of 20 grandmothers who were the primary caregivers of their grandchildren. After the grandmothers completed the HRV biofeedback training, they answered open-ended questions to provide data on the six parameters during face-to-face interviews. The findings of the study provided evidence for the necessity, acceptability, feasibility, safety, fidelity, and effectiveness of the HRV biofeedback intervention for reducing the stress experienced by grandmothers in raising their grandchildren.

Support for and From Aging Mothers Whose Adult Daughters are Seriously Mentally Ill.

This article discusses, from the grandmother's perspective, the ways in which support is exchanged in families coping with serious mental illness. A strengths perspective was utilized to identify ways in which family members help each other. Employing a qualitative approach, this study focuses on interviews obtained from a sample of 22 aging mothers, aged 52-90, who are in contact with their daughters who have a mental illness. Grandmothers provided several kinds of support to their mentally ill adult daughters and to their grandchildren, who also supported the aging mother in numerous ways. As social workers seek to assist individuals with mental illness, it is important to assess the existing strengths of their intergenerational family context.

Grandmothers as gatekeepers? The role of grandmothers in influencing health-seeking for mothers and newborns in rural northern Ghana.

Previous research suggests that care-seeking in rural northern Ghana is often governed by a woman's husband or compound head. This study was designed to explore the role grandmothers (typically a woman's mother-in-law) play in influencing maternal and newborn healthcare decisions. In-depth interviews were conducted with 35 mothers of newborns, 8 traditional birth attendants and local healers, 16 community leaders and 13 healthcare practitioners. An additional 18 focus groups were conducted with stakeholders such as household heads, compound leaders and grandmothers. In this region, grandmothers play many roles. They may act as primary support providers to pregnant mothers, care for newborns following delivery, preserve cultural traditions and serve as repositories of knowledge on local medicine. Grandmothers may also serve as gatekeepers for health-seeking behaviour, especially with regard to their daughters and daughters-in-law. This research also sheds light on the potential gap between health education campaigns that target mothers as autonomous decision-makers, and the reality of a more collectivist community structure in which mothers rarely make such decisions without the support of other community members.