Two sides to the caregiving story.

PURPOSE: This descriptive study examined problems and successes that a sample of 73 adult caregivers new to the role expressed in the first year of caring for stroke survivors. Data were collected from May 2002 to December 2005. METHOD: Bimonthly, trained telephone interviewers asked the participants open-ended questions to elicit their experience in caregiving. Guided by Friedemann's framework of systemic organization, we analyzed the data using Colaizzi's method of content analysis. RESULTS: There were 2,455 problems and 2,687 successes reported. Three themes emerged from the problems: being frustrated in day-to-day situations (system maintenance in Friedemann's terms), feeling inadequate and turning to others for help (coherence), and struggling and looking for "normal" in caring (system maintenance vs. change). Three themes were attributed to the successes: making it through and striving for independence (system maintenance), doing things together and seeing accomplishments in the other (coherence), and reaching a new sense of normal and finding balance in life (individuation and system maintenance). CONCLUSION: These findings provided an in-depth, theorybased description of the experience of being a new caregiver and can help explain how caring can be a difficult yet rewarding experience. Knowledge of the changes over time allows health care professionals to tailor their interventions, understanding, and support.

Positive attitude. An essential element for effective care of people with mental illnesses.

It is well known that attitudes influence behavior, and attitudes toward people with mental illnesses have been described as negative, stigmatizing, uninformed, and fearful. The general public view people with mental illnesses as dangerous, prone to violence, unpredictable, and in some measure responsible for their illnesses. Health care professionals share these attitudes to a surprising extent, which compromises their ability to deliver competent, compassionate care. Nursing students' perceptions of people with mental illnesses are reflective of those held by the general public. The purpose of this descriptive study was to determine whether a curriculum that embeds psychiatric nursing principles in a course focused on care of people with chronic illnesses and uses specific fear-reduction teaching strategies, would have a positive effect on students' attitudes toward people with mental illnesses. Using an adaptation of Yucker's attitude scale, a test of nursing students' (n = 38) attitudes before and after completion of the course was conducted. Students' attitudes were significantly more positive at the completion of the course. The findings suggest that exposure to factual information about mental illnesses, the opportunity to interact with people with mental illnesses, emphasis on treatment options, and use of fear-reduction strategies positively affected students' attitudes toward people with mental illnesses.