Journal of Family Nursing

Evidence suggests that intergenerational caregiving between mothers and daughters will become increasingly common, and yet, we know very little about the specific relationships between adult daughters and their mothers with dementia. Guided by socialist-feminist theory and a life-course perspective, 15 mother-adult daughter dyads participated in two individual, semistructured interviews. Data analysis revealed four dynamic types of mother-daughter relationships: custodial, combative, cooperative, and cohesive. Custodial and cooperative relationships mainly focused on the provision of and receipt of tasks, whereas combative and cohesive are emotion focused. At the same time, custodial and combative relationships are based on deficits compared with strength based cohesive and cooperative relationships. In addition, certain contextual factors, such as expectations of care and levels of support, shaped the development of these relationships. Moreover, study findings highlight a number of implications for practice, policy, and research necessary to support individuals with dementia and their families.

The purpose of this critical feminist study was to examine employed mothers' meanings of family and personal health as they frame the context of daily experience in caring for their families' and their own health. Twenty mothers employed in support staff positions with a large institution in Western Canada participated in repeat interviews over 2 years. Women considered individual family members and the family group as they emphasized everyday function and satisfaction, and the presence or absence of various attributes of health as a multifaceted and dynamic experience. Women's health work included keeping track, constructing routines, facing challenges, setting priorities, being there for each other, finding joy and fulfillment, and fostering personal development. A preliminary typology of four orientations to family health work is suggested. Common themes between women's and family health and congruence between women's health meanings and actions provide guidance to nurses in family health promotion practice.

This study investigated how English and Canadian families with preschool children used strategies to impose varying levels of order to manage day-to-day activities. This grounded theory study is a secondary analysis of 55 hours of participant observation and interviews with 58 individuals and 29 couples. Constant comparative analysis and theoretical sampling were used to construct categories. To attempt to impose order, strategies used by families included organizing and planning, establishing routines, setting limits, setting standards, purchasing services and technology, and delegating tasks. Most families used these strategies successfully; costs outweighed benefits where families concentrated inflexibly on a few strategies in particular spheres of activity or had difficulty using strategies. Families using a variety of strategies flexibly were better at balancing personal and family goals, promoting fulfillment, health, and happiness for each family member, and fostering family development and commitment. Imposing order links everyday family dynamics and concerns to long-term goals.

Improved disease management in children has resulted in an increased interest in the quality of life in children. Quality of life research in children may enlist either the substitute or complementary perspective. Much of the quality of life literature has been guided by the substitute perspective, which infers that parents may best report their child's quality of life. However, the complementary perspective values both parent and child perspectives equally. The purpose of this article was to critically review the quality of life literature with respect to children with diabetes. Limitations in the literature were addressed as conceptual and methodological, demographic, and underlying proxy perspectives. Benefits and limitations of quality of life measurements and perspectives were also discussed. Recommendations and future implications for quality of life research in children extend current understanding from both substitute and complementary perspectives.

Family caregivers of stroke survivors who are just beginning their role must learn new skills and incorporate new knowledge into their daily activities. This can be a time of increased anxiety and stress for them. Nurses and other health professionals need more knowledge about this transition from the perspective of the caregivers. The purpose of this grounded theory study was to describe the process associated with preparing for and beginning a new caregiving role following a family member's stroke. Caregivers who were new to the role were interviewed prior to the stroke survivor's discharge and 4 weeks after discharge. The grounded theory, Restructuring Life for Caregiving, was associated with five dimensions of participants' lives: daily life, managing multiple roles, relationship with the stroke survivor, future hopes and plans, and time for self. The process of waiting, rearranging, and stabilizing further explained the timing and elements of restructuring activities.

The courage and willingness to walk alongside families in grief calls forth particular beliefs and practices in nurses and other health care professionals. In this second phase of a study on grief and grief interventions, the researchers examine experiences of bereaved family members who received care in a grief support program and explore program clinicians'explanations of the work that they do with the bereaved. Findings of this interpretive study suggest that it is not so much models of grief intervention but maps that most guide the clinicians—maps that are drawn out of experience and with awareness of their limitations. The family members and the clinicians bring us to an understanding that, often, it is the willingness to step off of the map that makes for the best traveling companion in the spiritual walk of grief.