Prevention programs often are directed at either parents or children separately, thereby ignoring the intergenerational aspect of health and well-being. Engaging the family is likely to improve... Show morePrevention programs often are directed at either parents or children separately, thereby ignoring the intergenerational aspect of health and well-being. Engaging the family is likely to improve both the uptake and long-term impact of health behavior change. We integrated an intergenerational approach into a frequently used shared assessment tool for children's care needs. The current study's aim was 2-fold: to monitor this family-engagement tool's effects on both children and their parents' health behaviors and well-being, and to examine the different dynamics of health behavioral change within a family.Method: We followed 12 children ages 10-14 years and their parents for 12 weeks using an explanatory mixed-methods design comprising interviews, questionnaires, and an n-of-1 study. During home visits at the beginning and end of the study, we interviewed children and their parents about their expectations and experiences, and measured their height and weight. Furthermore, we collected secondary data, such as notes from phone and email conversations with parents, as well as evaluation forms from professionals. In the n-of-1 study, families were prompted three times a week to describe their day and report on their vegetable intake, minutes of exercise, health behavior goals, and psychosomatic well-being. The interviews, notes, and evaluation forms were analyzed using qualitative content analyses. For the n-of-1 study, we performed multi-level time-series analyses across all families to assess changes in outcomes after consulting the family-engagement tool. Using regression analyses with autocorrelation correction, we examined changes within individual families.Results: Five child-mother dyads and three child-mother-father triads provided sufficient pre- and post-data. The mean minutes of children's physical activity significantly increased, and mothers felt more energetic, but other outcomes did not change. In consultations related to overweight, the family-engagement tool often was used without setting specific or family goals.Conclusions: The family-engagement approach elicited positive effects on some families' health and well-being. For multifaceted health problems, such as obesity, family-engagement approaches should focus on setting specific goals and strategies in different life domains, and for different family members. Show less
Akkermans, A.; Lamerichs, J.; Schultz, M.; Cherpanath, T.; Woensel, J. van; Heerde, M. van; ... ; Vos, M. de 2021
Background: Intensive care doctors have to find the right balance between sharing crucial decisions with families of patients on the one hand and not overburdening them on the other hand. This... Show moreBackground: Intensive care doctors have to find the right balance between sharing crucial decisions with families of patients on the one hand and not overburdening them on the other hand. This requires a tailored approach instead of a model based approach. Aim: To explore how doctors involve families in the decision-making process regarding life-sustaining treatment on the neonatal, pediatric, and adult intensive care. Design: Exploratory inductive thematic analysis of 101 audio-recorded conversations. Setting/participants: One hundred four family members (61% female, 39% male) and 71 doctors (60% female, 40% male) of 36 patients (53% female, 47% male) from the neonatal, pediatric, and adult intensive care of a large university medical center participated. Results: We identified eight relevant and distinct communicative behaviors. Doctors' sequential communicative behaviors either reflected consistent approaches-a shared approach or a physician-driven approach-or reflected vacillating between both approaches. Doctors more often displayed a physician-driven or a vacillating approach than a shared approach, especially in the adult intensive care. Doctors did not verify whether their chosen approach matched the families' decision-making preferences. Conclusions: Even though tailoring doctors' communication to families' preferences is advocated, it does not seem to be integrated into actual practice. To allow for true tailoring, doctors' awareness regarding the impact of their communicative behaviors is key. Educational initiatives should focus especially on improving doctors' skills in tactfully exploring families' decision-making preferences and in mutually sharing knowledge, values, and treatment preferences. Show less
Japan is undergoing a significant demographic upheaval, and the Japanese government is formulating policies for stimulating technological advances based on the assumption that they will solve... Show moreJapan is undergoing a significant demographic upheaval, and the Japanese government is formulating policies for stimulating technological advances based on the assumption that they will solve issues such as labour shortages and elder care. The government argues through policy initiatives that technology will decrease the care burden on Japan’s workers, families, and itself. Although the domestic media show awareness of changing family patterns in Japan, newspapers are following a similar pattern of technological utopianism. However, this article posits that the proposed policy reforms rely on a conservative ideal of the extended family that ignores changing patterns in Japanese households. Moreover, it argues that, rather than facilitating a return to the ideal of an extended family, technology is exacerbating separation among families that have been growing apart for some time. Show less
Shabalala, F.; Lannoy, A. de; Moyer, E.; Reis, R. 2016
This chapter demonstrates how Ghanaian migrants in the Netherlands look to the Pentecostal Church for the deconstruction of Ghanaian traditions in favour of international mobility. The Pentecostal... Show moreThis chapter demonstrates how Ghanaian migrants in the Netherlands look to the Pentecostal Church for the deconstruction of Ghanaian traditions in favour of international mobility. The Pentecostal Church strongly identifies and propagates notions of individualism and the nuclear family. In this way traditional matrilineal social organization is displaced by more Western-style conjugality mediated by Pentecostalist beliefs. The author argues that the appeal of Pentecostalism is based on the opportunities it provides for bringing kinship obligations under the supervision of its individual members. Pentecostalism reformulates the hierarchical and obligatory gift-giving system upon which kinship relations are based. It subjects reciprocity to moral supervision while making it thoroughly multilocal. his is of particular significance in the diaspora where many migrants see themselves faced with the obligation to send money to relatives living n Ghana and elsewhere. Show less
As labour migration to South Africa is a pronounced feature of Swazi society, its impact on Swazi society is substantial. This paper examines what labour migration means to the social security... Show moreAs labour migration to South Africa is a pronounced feature of Swazi society, its impact on Swazi society is substantial. This paper examines what labour migration means to the social security role of the Swazi rural homestead. By discussing the relationship between labour migration and the conditions which determine whether or not a social group can act as a solidarity group (viz. the size of a social group, its composition, its durability, its capacity to raise means, and the existence of a 'normative insurance'), the author estimates the impact of labour migration on the rural homestead in its capacity as a solidarity group. For this purpose he compares a group of homesteads with migrants in South Africa and a group of homesteads without. Data are derived from a 1990 survey among 115 rural homesteads situated on Swazi Nation Land. The author shows that the impact of labour migration differs according to the type of homestead. As a solidarity group, homesteads in the establishment and expansion stage are far more affected by labour migration than homesteads in other stages of the developmental cycle (viz. consolidation, fission, decline). Show less
After an introductory chapter on the assumptions and methods of the study, which was carried out in Sierra Leone in 1971, this report contains chapters on marriage, divorce, property rights of... Show moreAfter an introductory chapter on the assumptions and methods of the study, which was carried out in Sierra Leone in 1971, this report contains chapters on marriage, divorce, property rights of women, maintenance responsibilities, rights over children and adoption under customary law in Sierra Leone. Then the authors attempt to indicate areas where conflicts of law exist or where certain social problems are created or aggravated by the inadequacies of the law. Finally, a number of problems relating to the administration of customary law are considered. Throughout the report the inferior legal position of women in the face of changing social and economic conditions has been stressed. Show less
