Search results for: international family law
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6813

Search results for: international family law

6033 Gender Discrimination and Wellbeing in Family Sphere Due to Male Migration and Remittances: A Study of Doaba Region of Punjab

Authors: Atinder Pal Kaur

Abstract:

A central characteristic of people is their apparent movement from one station to other for their sustenance. Human migration has become one of the most challenging issues faced by the world today. Migration represents an important dimension in world-wide setting; and remittances received by families constitute a major agent in integrating societies in the all over the world, both economically and socially. This paper is an attempt to explore the impact of male migration and remittances upon the family system. This paper brings out how the women play the role of head of the household and take all the economic decisions, but still faces discrimination in the family, that bring loneliness and emotional breakdown on their personal front. For the purpose of this study, data was collected using 30 interviews and 10 case studies in the Doaba region of Punjab. The respondents were classified into two age groups 20-35 years and above 40 years aged women whose husbands migrated abroad. The findings of this study revealed that even though the women were taking some of the economic decisions, but in majority of the cases the patriarchal structure still existed and power remained in the hands of their husbands or in-laws. It was found that women of different age groups reported differently in terms of authority that they have regarding remittances and its consequences in their emotional well-being. The distinction related to their participation in public and private spheres still exists and public spheres are mostly dominated by male members of the family. It can be concluded that freedom of women to take decision on their own is still restricted and they are subjugated to follow their husband or in-law’s opinion in matters related to both public and private spheres. However, old age group women enjoyed more independence and freedom to take decision in comparison to young age women. Loneliness and depression were more common in the young age respondent’s group than in old age women.

Keywords: gender discrimination, migration, patriarchal structure, remittances

Procedia PDF Downloads 263
6032 Climate Refugees In International Law – Analyzing The Legal Framework

Authors: Kristof Lukas Heidemann

Abstract:

The adverse effects of climate change, such as rising sea levels, increased temperatures, and extreme weather events, are already posing a significant threat to the lives of people living in extreme weather zones all around the globe and could displace more than a billion people worldwide in the upcoming decades, causing a wave of climate-induced migration. Notwithstanding the urgency of the situation, this situation has so far not been addressed in a specific international treaty. Therefore, this paper analyses whether solutions might be found through existing legal frameworks. To that end, the investigation scrutinizes the possibilities of overcoming the conceptual challenge of combining climate law, refugee law, and human rights law. The paper concludes that the differences in objective, scope, and enforcement of the three fields are too fundamental to be surmounted by overlapping concepts, e.g., state responsibility or the non-refoulement principle. Consequently, states are urged to tackle the problem with a separate international treaty in which the advantages of the different traditions are incorporated into a new protection mechanism.

Keywords: climate change, climate treaties, forcibly displaced persons, human rights, improving and creating advanced knowledge of concepts, non-refoulement, state responsibility, refugee law, refugee status

Procedia PDF Downloads 3
6031 Investigation of International Graduates’ Readiness for Employability Demands in the 21st Century

Authors: Thi Phuong Lan Nguyen

Abstract:

Alongside technical skills, the employability is crucial for any graduates in the fast-evolving 21st century. It is reported that 78% of Australian students believe soft skills give advantages in the changing workforce due to technological automation (Oxford, 2020), which motivated to investigate how students whose English as a foreign or second language (EFL/ESL) are ready for the employability requirements in the new normal. Literature review, document analysis, and Interviews with EFL teachers are used in this research. The results of this research are helpful in preparing international EFL/ESL students to achieve the best preparation for currently increasing demanding employment markets, which are also meaningful for students themselves to be ready of being global citizens in the new normal.

Keywords: readiness, employability, EFL, ESL

Procedia PDF Downloads 32
6030 Intensive Care Nursing Experience of a Lung Cancer Patient Receiving Palliative

Authors: Huang Wei-Yi

Abstract:

Objective: This article explores the intensive care nursing experience of a terminal lung cancer patient who received palliative care after tracheal intubation. The patient was nearing death, and the family experienced sadness and grief as they faced the patient’s deteriorating condition and impending death. Methods: The patient was diagnosed with lung cancer in 2018 and received chemotherapy and radiation therapy with regular outpatient follow-ups. Due to brain metastasis and recent poor pain control and treatment outcomes, the patient was admitted to the intensive care unit (ICU), where the tracheal tube was removed, and palliative care was initiated. During the care period, a holistic assessment was conducted, addressing the physical, psychological, social, and spiritual aspects of care. Medical records were reviewed, interviews and family meetings were held, and a comprehensive assessment was carried out by the critical care team in collaboration with the palliative care team. The primary nursing issues identified included pain, ineffective breathing patterns, fear of death, and altered tissue perfusion. Results: Throughout the care process, the palliative care nurse, along with the family, utilized listening, caring, companionship, pain management, essential oil massage, distraction, and comfortable positioning to alleviate the patient’s pain and breathing difficulties. The use of Morphine 6mg in 0.9% N/S 50ml IV drip q6h reduced the FLACC pain score from 6 to 3. The patient’s respiratory rate improved from 28 breaths/min to 18-22 breaths/min, and sleep duration increased from 4 to 7 uninterrupted hours. The holistic palliative care approach, coupled with the involvement of the palliative care team, facilitated expressions of gratitude, apologies, and love between the patient and family. Visiting hours were extended, and with the nurse’s assistance, these moments were recorded and shared with the patient’s consent, providing cherished memories for the family. The patient’s end-of-life experience was thus improved, and the family was able to find peace. This case also served to promote the concept of palliative care, ensuring that more patients and families receive high-quality nursing care. Conclusion: When caring for terminal patients, collaboration with the palliative care team, including social workers, clergy, psychologists, and nutritionists, is essential. Involving the family in decision-making and providing opportunities for closeness and expressions of gratitude improve personalized care and enhance the patient's quality of life. Upon transferring to the ward, the patient’s hemodynamic stability was maintained, including SBP 110-130 mmHg, respiratory rate 20-22 breaths/min, and pain score <3. The patient was later discharged and transitioned to home hospice care for ongoing support.

Keywords: intensive care, lung cancer, palliative care, ICU

Procedia PDF Downloads 22
6029 Intervening between Family Functioning and Depressive Symptoms: Effect of Deprivation of Liberty, Self-Efficacy and Differentiation of Self

Authors: Jasna Hrncic

Abstract:

Poor family relations predict depression, but also to other mental health issues. Mediating effect of self-efficacy and differentiation of self and moderating effect of decreased accessibility and/or success of other adaptive and defensive mechanisms for overcoming social disadvantages could explain depression as a specific outcome of dysfunctional family relations. The present study analyzes the mediation effect of self-efficacy and differentiation of self from poor family functioning to depressive symptoms and the moderation effect of deprivation of liberty on the listed mediation effect. Deprivation of liberty has, as a general consequence, a decreased accessibility and/or success of many adaptive and defensive mechanisms. It is hypothesized that: 1) self-efficacy and differentiation of self will mediate between family functioning and depressiveness in the total sample, and 2) deprivation of liberty will moderate the stated relations. Cross-sectional study was conducted among 323 male juveniles in Serbia divided in three groups: 98 adolescents deprived of their liberty due to antisocial behavior (incarcerated antisocial group - IAG), 121 adolescents with antisocial behavior in their natural setting (antisocial control group - CAG) and 105 adolescents in general population (general control group - CGG). The CAG was included along with GCG to control the possible influence that comorbidity of antisocial behavior and depressiveness could have on results. Instruments for family relations assessment were: for a whole family of origin the emotional exchange scale and individuation scale from GRADIR by Knezevic, and for a relationship with mother PCS-YSR and CRPBI by barber, and intimacy, rejection, sacrifice, punishment, demands, control and internal control by Opacic and Kos. Differentiation of self (DOS) is measured by emotional self scale (Opacic), self-efficacy (SE) by general incompetence scale by Bezinovic, and depression by BDI (Back), CES-D (Radloff) and D6R (Momirovic). Two-path structural equation modeling based on most commonly reported fit indices, showed that the mediation model had unfavorable fit to our data for total sample [(χ2 (1, N = 324) = 13.73); RMSEA= .20 (90% CI= [.12, .30]); CFI= .98; NFI= .97; AIC=31.73]. Path model provided an adequate fit to the data only for AIG - and not to the data from ACG and GCG. SE and DOS mediated the relationship between PFF and depressiveness. Test of the indirect effects revealed that 23.85% of PFF influences on depressiveness is mediated by these two mediators (the quotient of mediated effect = .24). Test of specific indirect effects showed that SE mediates 22.17%, while DOS mediates 1.67% of PFF influence on depressiveness. Lack of expected mediation effect could be explained by missing other potential mediators (i.e., relationship with that father, social skills, self-esteem) and lower variability of both predictor and criterion variable due to their low levels on the whole sample and on control subsamples. Results suggested that inaccessibility and/or successfulness of other adaptive and defensive mechanisms for overcoming social disadvantages has a strong impact on the mediation effect of self/efficacy and differentiation of self from poor family functioning to depressive symptoms. Further researches could include other potential mediators and a sample of clinically depressed people.

Keywords: antisocial behavior, mediating effect, moderating effect, natural setting, incarceration

Procedia PDF Downloads 116
6028 Isotopes Used in Comparing Indigenous and International Walnut (Juglans regia L.) Varieties

Authors: Raluca Popescu, Diana Costinel, Elisabeta-Irina Geana, Oana-Romina Botoran, Roxana-Elena Ionete, Yazan Falah Jadee 'Alabedallat, Mihai Botu

Abstract:

Walnut production is high in Romania, different varieties being cultivated dependent on high yield, disease resistance or quality of produce. Walnuts have a highly nutritional composition, the kernels containing essential fatty acids, where the unsaturated fraction is higher than in other types of nuts, quinones, tannins, minerals. Walnut consumption can lower the cholesterol, improve the arterial function and reduce inflammation. The purpose of this study is to determine and compare the composition of walnuts of indigenous and international varieties all grown in Romania, in order to identify high-quality indigenous varieties. Oil has been extracted from the nuts of 34 varieties, the fatty acids composition and IV (iodine value) being afterwards measured by NMR. Furthermore, δ13C of the extracted oil had been measured by IRMS to find specific isotopic fingerprints that can be used in authenticating the varieties. Chemometrics had been applied to the data in order to identify similarities and differences between the varieties. The total saturated fatty acids content (SFA) varied between n.d. and 23% molar, oleic acid between 17 and 35%, linoleic acid between 38 and 59%, linolenic acid between 8 and 14%, corresponding to iodine values (IV - total amount of unsaturation) ranging from 100 to 135. The varieties separated in four groups according to the fatty acids composition, each group containing an international variety, making possible the classification of the indigenous ones. At both ends of the unsaturation spectrum, international varieties had been found.

Keywords: δ13C-IRMS, fatty acids composition, 1H-NMR, walnut varieties

Procedia PDF Downloads 313
6027 Asylum Seekers' Legal Limbo under the Migrant Protection Protocols: Implications from a US-Mexico Border Project

Authors: Tania M. Guerrero, Ileana Cortes Santiago

Abstract:

Estamos Unidos Asylum Project has served more than 2,000 asylum seekers and migrants who are under the Migrant Protection Protocols (MPP) policy in Ciudad Juarez, Mexico. The U.S. policy, implemented in January 2019, has stripped asylum seekers of their rights—forcing people fleeing violence and discrimination to wait in similar or worse conditions from which they fled and navigate their entire asylum process in a different country. Several civil rights groups, including the American Civil Liberties Union (ACLU), challenged MPP in U.S. federal courts in February 2019, arguing a violation of international U.S. obligations towards refugees and asylum-seekers under the 1951 Refugee Convention and the Refugee Act of 1980 in regards to the non-refoulement principle. MPP has influenced Mexico's policies, enforcement, and prioritization of the presence of asylum seekers and migrants; it has also altered the way international non-governmental organizations work at the Mexican Northern border. Estamos Unidos is a project situated in a logistical conundrum, as it provides needed legal services to a population in a legal and humanitarian void, i.e., a liminal space. The liminal space occupied by asylum seekers living under MPP is one that, in today's world, should not be overlooked; it dilutes asylum law and U.S. commitments to international protections. This paper provides analysis of and broader implications from a project whose main goal is to uphold the protections of asylum seekers and international refugee law. The authors identified and analyzed four critical points based on field work conducted since August 2019: (1) strategic coalition building with international, local, and national organizations; (2) brokering between domestic and international contexts and critical legal constraints; (3) flexibility to sudden policy changes and the diverse needs of the multiethnic groups of migrants and asylum seekers served by the project; and (4) the complexity of providing legal assistance to asylum seekers who are survivors of trauma. The authors concur with scholarship when highlighting the erosion of protections of asylum seekers and migrants as a dangerous and unjust global phenomenon.

Keywords: asylum, human rights, migrant protection protocols, refugees law

Procedia PDF Downloads 133
6026 OER on Academic English, Educational Research and ICT Literacy, Promoting International Graduate Programs in Thailand

Authors: Maturos Chongchaikit, Sitthikorn Sumalee, Nopphawan Chimroylarp, Nongluck Manowaluilou, Thapanee Thammetha

Abstract:

The 2015 Kasetsart University Research Plan, which was funded by the National Research Institutes: TRF – NRCT, comprises four sub-research projects on the development of three OER websites and on their usage study by students in international programs. The goals were to develop the open educational resources (OER) in the form of websites that will promote three key skills of quality learning and achievement: Academic English, Educational Research, and ICT Literacy, to graduate students in international programs of Thailand. The statistics from the Office of Higher Education showed that the number of foreign students who come to study in international higher education of Thailand has increased respectively by 25 percent per year, proving that the international education system and institutes of Thailand have been already recognized regionally and globally as meeting the standards. The output of the plan: the OER websites and their materials, and the outcome: students’ learning improvement due to lecturers’ readiness for open educational media, will ultimately lead the country to higher business capabilities for international education services in ASEAN Community in the future. The OER innovation is aimed at sharing quality knowledge to the world, with the adoption of Creative Commons Licenses that makes sharing be able to do freely (5Rs openness), without charge and leading to self and life-long learning. The research has brought the problems on the low usage of existing OER in the English language to develop the OER on three specific skills and try them out with the sample of 100 students randomly selected from the international graduate programs of top 10 Thai universities, according to QS Asia University Rankings 2014. The R&D process was used for product evaluation in 2 stages: the development stage and the usage study stage. The research tools were the questionnaires for content and OER experts, the questionnaires for the sample group and the open-ended interviews for the focus group discussions. The data were analyzed using frequency, percentage, mean and SD. The findings revealed that the developed websites were fully qualified as OERs by the experts. The students’ opinions and satisfaction were at the highest levels for both the content and the technology used for presentation. The usage manual and self-assessment guide were finalized during the focus group discussions. The direct participation according to the concept of 5Rs Openness Activities through the provided tools of OER models like MERLOT and OER COMMONS, as well as the development of usage manual and self-assessment guide, were revealed as a key approach to further extend the output widely and sustainably to the network of users in various higher education institutions.

Keywords: open educational resources, international education services business, academic English, educational research, ICT literacy, international graduate program, OER

Procedia PDF Downloads 221
6025 The Recognition of Exclusive Choice of Court Agreements: United Arab Emirates Perspective and the 2005 Hague Convention on Choice of Court Agreements

Authors: Hasan Alrashid

Abstract:

The 2005 Hague Convention seeks to ensure legal certainty and predictability between parties in international business transactions. It harmonies exclusive choice of court agreements at the international level between parties to commercial transactions and to govern the recognition and enforcement of judgments resulting from proceedings based on such agreements to promote international trade and investment. Although the choice of court agreements is significant in international business transactions, the United Arab Emirates refuse to recognise it by Article 24 of the Federal Law No. 11 of 1992 of the Civil Procedure Code. A review of judicial judgments in United Arab Emirates up to the present day has revealed that several cases appeared before the Court in different states of United Arab Emirates regarding the recognition of exclusive choice of court agreements. In all the cases, the courts regarded the exclusive choice of court agreements as a direct assault on state authority and sovereignty and refused categorically to recognize choice of court agreements by refusing to stay proceedings in favor of the foreign chosen court. This has created uncertainty and unpredictability in international business transaction in the United Arab Emirates. In June 2011, the first Gulf Judicial Seminar on Cross-Frontier Legal Cooperation in Civil and Commercial Matters was held in Doha, Qatar. The Permanent Bureau of the Hague Conference attended the conference and invited the states of the Gulf Cooperation Council (GCC) namely, The United Arab Emirates, Bahrain, Saudi Arabia, Oman, Qatar and Kuwait to adopt some of the Hague Conventions, one of which was the Hague Convention on Choice of Court Agreements. One of the recommendations of the conference was that the GCC states should research ‘the benefits of predictability and legal certainty provided by the 2005 Convention on Choice of Court Agreements and its resulting advantages for cross-border trade and investment’ for possible adoption of the Hague Convention. Up to today, no further step has been taken by the any of the GCC states to adapt the Hague Convention nor did they conduct research on the benefits of predictability and legal certainty in international business transactions. This paper will argue that the approach regarding the recognition of choice of court agreements in United Arab Emirates states can be improved in order to help the parties in international business transactions avoid parallel litigation and ensure legal certainty and predictability. The focus will be the uncertainty and gaps regarding the choice of court agreements in the United Arab Emirates states. The Hague Convention on choice of court agreements and the importance of harmonisation of the rules of choice of court agreements at international level will also be discussed. Finally, The feasibility and desirability of recognizing choice of court agreements in United Arab Emirates legal system by becoming a party to the Hague Convention will be evaluated.

Keywords: choice of court agreements, party autonomy, public authority, sovereignty

Procedia PDF Downloads 246
6024 The Lasting Impact of Parental Conflict on Self-Differentiation of Young Adult OffspringThe Lasting Impact of Parental Conflict on Self-Differentiation of Young Adult Offspring

Authors: A. Benedetto, P. Wong, N. Papouchis, L. W. Samstag

Abstract:

Bowen’s concept of self-differentiation describes a healthy balance of autonomy and intimacy in close relationships, and it has been widely researched in the context of family dynamics. The current study aimed to clarify the impact of family dysfunction on self-differentiation by specifically examining conflict between parents, and by including young adults, an underexamined age group in this domain (N = 300; ages 18 to 30). It also identified a protective factor for offspring from conflictual homes. The 300 young adults (recruited online through Mechanical Turk) completed the Differentiation of Self Inventory (DSI), the Children’s Perception of Interparental Conflict Scale (CPIC), the Parental Bonding Instrument (PBI), and the Symptom Checklist-90-Revised (SCL-90-R). Analyses revealed that interparental conflict significantly impairs self-differentiation among young adult offspring. Specifically, exposure to parental conflict showed a negative impact on young adults’ sense of self, emotional reactivity, and interpersonal cutoff in the context of close relationships. Parental conflict was also related to increased psychological distress among offspring. Surprisingly, the study found that parental divorce does not impair self-differentiation in offspring, demonstrating the distinctly harmful impact of conflict. These results clarify a unique type of family dysfunction that impairs self-differentiation, specifically in distinguishing it from parental divorce; it examines young adults, a critical age group not previously examined in this domain; and it identifies a moderating protective factor (a strong parent-child bond) for offspring exposed to conflict. Overall, results suggest the need for modifications in parental behavior in order to protect offspring at risk of lasting emotional and interpersonal damage.

Keywords: divorce, family dysfunction, parental conflict, parent-child bond, relationships, self-differentiation, young adults

Procedia PDF Downloads 154
6023 Global Differences in Job Satisfaction of Healthcare Professionals

Authors: Jonathan H. Westover, Ruthann Cunningham, Jaron Harvey

Abstract:

Purpose: Job satisfaction is one of the most critical attitudes among employees. Understanding whether employees are satisfied with their jobs and what is driving that satisfaction is important for any employer, but particularly for healthcare organizations. This study looks at the question of job satisfaction and drivers of job satisfaction among healthcare professionals at a global scale, looking for trends that generalize across 37 countries. Study: This study analyzed job satisfaction responses to the 2015 Work Orientations IV wave of the International Social Survey Programme (ISSP) to understand differences in antecedents for and levels of job satisfaction among healthcare professionals. A total of 18,716 respondents from 37 countries participated in the annual survey. Findings: Respondents self-identified their occupational category based on corresponding International Standard Classification of Occupations (ISCO-08) codes. Results suggest that mean overall job satisfaction was highest among health service managers and generalist medical practitioners and lowest among environmental hygiene professionals and nursing professionals. Originality: Many studies have addressed the issue of job satisfaction in healthcare, examining small samples of specific healthcare workers. In this study, using a large international dataset, we are able to examine questions of job satisfaction across large groups of healthcare workers in different occupations within the healthcare field.

Keywords: job satisfaction, healthcare industry, global comparisons, workplace

Procedia PDF Downloads 143
6022 Psychological and Ethical Factors in African American Custody Litigation

Authors: Brian Carey Sims

Abstract:

The current study examines psychological factors relevant to child custody litigation among African American fathers. Thirty-seven fathers engaged in various stages of custody litigation involving their children were surveyed about their perceptions of racial stereotypes, parental motivations, and racialized dynamics of the court/ legal process. Data were analyzed using a Critical Race Theory model designed to statistically isolate fathers’ perceptions of the existence and maintenance of structural racism through the legal process. Results indicate significant correlations between fathers’ psychological measures and structural outcomes of their cases. Findings are discussed in terms of ethical implications for family court judicial systems and attorney practice.

Keywords: ethics, family, legal psychology, policy, race

Procedia PDF Downloads 351
6021 Parent’s Expectations and School Achievement: Longitudinal Perspective among Chilean Pupils

Authors: Marine Hascoet, Valentina Giaconi, Ludivine Jamain

Abstract:

The aim of our study is to examine if the family socio-economic status (SES) has an influence on students’ academic achievement. We first make the hypothesis that the more their families have financial and social resources, the more students succeed at school. We second make the hypothesis that this family SES has also an impact on parents’ expectations about their children educational outcomes. Moreover, we want to study if that parents’ expectations play the role of mediator between parents’ socio-economic status and the student’ self-concept and academic outcome. We test this model with a longitudinal design thanks to the census-based assessment from the System of Measurement of the Quality of Education (SIMCE). The SIMCE tests aim to assess all the students attending to regular education in a defined level. The sample used in this study came from the SIMCE assessments done three times: in 4th, 8th and 11th grade during the years 2007, 2011 and 2014 respectively. It includes 156.619 students (75.084 boys and 81.535 girls) that had valid responses for the three years. The family socio-economic status was measured at the first assessment (in 4th grade). The parents’ educational expectations and the students’ self-concept were measured at the second assessment (in 8th grade). The achievement score was measured twice; once when children were in 4th grade and a second time when they were in 11th grade. To test our hypothesis, we have defined a structural equation model. We found that our model fit well the data (CFI = 0.96, TLI = 0.95, RMSEA = 0.05, SRMR = 0.05). Both family SES and prior achievements predict parents’ educational expectations and effect of SES is important in comparison to the other coefficients. These expectations predict students’ achievement three years later (with prior achievement controlled) but not their self-concept. Our model explains 51.9% of the achievement in the 11th grade. Our results confirm the importance of the parents’ expectations and the significant role of socio-economic status in students’ academic achievement in Chile.

Keywords: Chilean context, parent’s expectations, school achievement, self-concept, socio-economic status

Procedia PDF Downloads 140
6020 Sustainability Study of Government Procurement of Public Services in Guangzhou: a Perspective Based on the Resources Dependence of Social Work

Authors: Li Pan

Abstract:

The recently prevalent government procurement of public services in China boasts a new form of government’s provision of public service through the purchasing of social work from social organizations, a new measure of the transformation in governmental functions as well as an unprecedented opportunity for the development of social organizations. For the past few years, the phenomenon of a surge in the number of social work organizations and social work staff emerged right with the initiatives of energetically carrying out the purchase of public services by the government. Such efforts have presented the strong determination of the Chinese government in building a small government by streamlining administration and delegating part of the governmental power to social organizations. This paper is based on the 2012-2014 performance appraisal project of the Guangzhou municipal government’s purchasing of public services and the project was carried out in the summer of 2015. During the process of the appraisal, several general problems hindering the sustainable development of government purchasing of public service have been observed. As Guangzhou is among the rank of pioneer cities in the conduct of the reform, it is representative and imperative to study the sustainability of government purchasing of public service. In 2012, Guangzhou local government started contracting out public service to the community social organizations to provide general family services and special services to community residents, since when integrated family service centers and special service centers were established as platforms to provide public social service in a city-wide range. Consequently, taking an example of the current rapid development of government purchase of the integrated family services and special services in Guangzhou, this paper puts up several proposals for the sustainable development of Guangzhou municipal government’s procurement of public services on the perspective of social work’s resource dependence.

Keywords: government procurement of public services, Guangzhou, integrated family service center, social work, sustainability.

Procedia PDF Downloads 267
6019 An Investigation into the Decision-Making Process of Choosing Long-Term Care Services in Taiwan

Authors: Yu-Ching Liu

Abstract:

Background: Family numbers usually take responsibility for taking care of their elderly relatives, especially parents. Caring for a patient with chronic diseases is a stressful experience, which makes carers suffer physical and mental health stress, difficulties maintaining family relationships and issues in participating in the labor market, which may lower their quality of life (QoL). The issue of providing care to relatives with chronic illness has been widely explored in Taiwan, but most studies focus on the need for full-time caregivers. Objective: The main goal of this study was to examine the topic of working carers involved in the decision-making process of LTC services and to explore what affects working carers considering when they choose the care services for their disabled, elderly relatives. Method: A total of 7 working caregivers were enrolled in this study. A face-to-face and semi-structured in-depth qualitative interview study were conducted to explore the caregivers' perspectives. Results: Working carers have a positive experience of using LTC service because it allows them to kill two birds with one stone, continue employment, and care for an elderly disabled relative. However, working carers have still been struggling to find friendly community-based LTC services. There were no longer available community services that could be used with the illness condition of patients getting worse. As such, patients have to be cared for at home, which might increase the caregiver burden of carers. Conclusion: Working family caregivers suffer from heavy physical and psychological burdens as they not only have to maintain their employment but care for elderly disabled relatives; however, the current support provided is insufficient. The design of services should consider working carers' employment situation and need rather than the only caring situation of patients at home.

Keywords: family caregiver, Long-term care, work-life balance, decision-making

Procedia PDF Downloads 179
6018 Structural and Functional Characterization of the Transcriptional Regulator Rv1176 of Mycobacterium tuberculosis H37Rv

Authors: Vikash Yadav, Ashish Arora

Abstract:

Microorganisms have self-defense mechanisms to protect themselves from toxic environments. Phenolic acid decarboxylase(pad) is responsible for the defense against toxicity caused by phenolic acids, converting them into less toxic vinyl derivatives. The transcription of the pad gene is regulated by a negative transcription factor, phenolic acid decarboxylase regulators (PadR), in a substrate-inducible manner. The PadR family members share the conserved DNA-binding features and interact with the operator DNA using a winged helix-turn-helix (wHTH) motif, which contains a three-helix motif and a β-stranded wing. The members of this family function as transcriptional regulators that are involved in various cellular survival processes, such as toxin production, detoxification, multidrug resistance, antibiotic biosynthesis, and carbon catabolism. Rv1176 of Mycobacterium tuberculosis H37Rv has been assigned to the PadR family protein that remains to be structurally and functionally uncharacterized. To reveal the structural mechanism by which Rv1176 could regulates effector-responsive transcription, several experiments were performed, including Electrophoretic Mobility Shift Assay (EMSA) for DNA protein interaction, differential scanning calorimetry (DSC) and Differential Scanning Fluorimetry (DSF) for temperature and ligand-dependent protein stability, Circular Dichroism (CD) spectroscopy for secondary structure analysis. Further, to evaluate the functional role of Rv1176, the intracellular survival of recombinant M. smegmatis was examined in murine macrophage cell line J774A.1 and different stressed conditions like oxidative, pH, and nutritive stress. All these studies demonstrated that Rv1176 could behave as a transcription regulator and its expression in recombinant M. smegmatis increases intracellular survival.

Keywords: EMSA, Mycobacterium tuberculosis, PadR family protein, transcriptional regulator

Procedia PDF Downloads 76
6017 Communication Barriers in Midwifery Students in the Field of Perinatal Palliative Care

Authors: Magdalena Hasplova, Katerina Ivanova

Abstract:

Perinatal palliative care is a relatively young and developing field that includes the care of a fetus or newborn with a life-threatening or limiting defect and his family. However, the training of midwives in perinatal palliative care is insufficient and midwives do not feel prepared for this aspect of their work. This fact can affect the barriers to communication with the mother or family of the endangered child. The main aim was to analyze the awareness of midwifery students on the issue of perinatal palliative care in the Czech Republic. Based on the analysis, draw attention to possible communication barriers that may be caused by insufficient information. The research was carried out using a qualitative method, the method of data collection was a semi-structured interview. Eleven female students took part in the research, and the respondents were selected using the Snowballing method. Some methods of grounded theory (open coding and category creation) were used to analyze the data. Based on the results of the research, questions were set in a questionnaire focused on communication barriers between mothers (family) and health care professionals in the care of newborns with life-threatening or limiting disabilities. Based on the analysis of data, categories 1 were determined. Knowledge of perinatal palliative care 2. Education 3. Practical experience 4. Readiness and concerns in the provision of perinatal palliative care 6. Supervision. The questions in the questionnaire were then derived taking into account the data obtained, and the operationalization of health literacy in the field of perinatal palliative care was performed. The analysis of the interviews revealed that the education of midwives in the Czech Republic in the issue of perinatal palliative care is not uniform. The research confirmed the insufficient knowledge and skills of midwifery students preparing to provide perinatal palliative care. Respondents reported feelings of unpreparedness in the areas of communication with a woman after perinatal loss, psychological support for a woman and her family, the care of a stillborn or dying child, or self-coping with death. The questions in the questionnaire then develop these areas. We assumed that by analyzing and interpreting the data obtained from our research, we will help to better understand the concerns and motivations of students in providing holistic perinatal palliative care. We came to the conclusion that it would be appropriate to set up a unified and comprehensive education on this issue in the Czech Republic. Healthcare professionals are in a unique position that can positively or negatively affect the intensity of perinatal loss. Already properly set up education of health professionals leads to overcoming barriers in communication between health professionals and the family, experiencing perinatal loss.

Keywords: midwife, perinatal loss, perinatal palliative care, communication, barriers, mothers, family

Procedia PDF Downloads 116
6016 Contribution of Urban Agriculture to the Livelihood of Urban Dwellers in Ilorin West Local Government Area of Kwara State, Nigeria

Authors: Okunola Solomon Olufemi

Abstract:

The study focused on the contribution of urban agriculture to the livelihood of 107 respondents in Kwara State of Nigeria. The study employed structured questionnaire to collect relevant data for the study while descriptive statistics such as frequency distribution and percentage were employed to analyses the objectives. Most respondents (82.9%), were one time or the other in a married state and they had formal education (80.4%) while many of the lot (58.9%) had superior education ranging from OND to Ph.D level. These farmers were either retired government workers or those trying to argument their family income or trying to be food sufficient. Most of the respondents (77.4%) had a farm size of less than or equal to 3 hectares showing that most the urban farmers were smallholders which might be as a result of stiff completion for land resource. Most of the respondents had a relatively large family size of 6 and above members. Most respondents used family labor (59.8%). Respondents in the study area also made use of the cooperatives and daily contributions for loanable funds, while few respondents utilized the formal sector. .Urban agriculture accounted for 84.4% of the Livelihood outcomes of the respondents. While non-farming activities contributed 17.6%.Most of the respondents (31.8%) participated in non-farming activities to generate extra income while their major constraints were shortage of land both in term of access and tenure (34.1%), limited access to resource and agricultural inputs (29.3%), and prohibitive urban policies and regulation (23.2%).

Keywords: poverty throes, urban agriculture, rigors of farming, non-farming, married state

Procedia PDF Downloads 66
6015 Of Love and Isolation: Narratives of Siblings of Children with Cerebral Palsy in Sri Lanka

Authors: Shyamani Hettiarachchi

Abstract:

Aim: Siblings of children with cerebral palsy are often in the periphery of discussions; their views not always taken into account. The aim of this study was to uncover the narratives of young siblings of children with cerebral palsy in Sri Lanka. Methods: Semi-structured interviews and artwork were gathered from 10 children who have siblings diagnosed with cerebral palsy. The data was analyzed using the key principles of Framework Analysis to determine the key themes within the narratives. Results: The key themes to emerge were complex and nuanced. These included themes of love and feeling of protectiveness; jealousy and uncertainly; guilt and hope. Conclusions: The results highlight the need to take document the views of siblings who are often on the margins of the family and of family decisions and discussions. It also supports the need to offer safe spaces and opportunities for siblings of children with disabilities to express their feelings and to receive support where required.

Keywords: disability, grandmothers, mothers, narratives, women

Procedia PDF Downloads 283
6014 Judicial Review of Indonesia's Position as the First Archipelagic State to implement the Traffic Separation Scheme to Establish Maritime Safety and Security

Authors: Rosmini Yanti, Safira Aviolita, Marsetio

Abstract:

Indonesia has several straits that are very important as a shipping lane, including the Sunda Strait and the Lombok Strait, which are the part of the Indonesian Archipelagic Sea Lane (IASL). An increase in traffic on the Marine Archipelago makes the task of monitoring sea routes increasingly difficult. Indonesia has proposed the establishment of a Traffic Separation Scheme (TSS) in the Sunda Strait and the Lombok Strait and the country now has the right to be able to conceptualize the TSS as well as the obligation to regulate it. Indonesia has the right to maintain national safety and sovereignty. In setting the TSS, Indonesia needs to issue national regulations that are in accordance with international law and the general provisions of the IMO (International Maritime Organization) can then be used as guidelines for maritime safety and security in the Sunda Strait and the Lombok Strait. The research method used is a qualitative method with the concept of linguistic and visual data collection. The source of the data is the analysis of documents and regulations. The results show that the determination of TSS was justified by International Law, in accordance with article 22, article 41, and article 53 of the United Nations Convention on the Law of the Sea (UNCLOS) 1982. The determination of TSS by the Indonesian government would be in accordance with COLREG (International Convention on Preventing Collisions at Sea) 10, which has been designed to follow IASL. Thus, TSS can provide a function as a safety and monitoring medium to minimize ship accidents or collisions, including the warship and aircraft of other countries that cross the IASL.

Keywords: archipelago state, maritime law, maritime security, traffic separation scheme

Procedia PDF Downloads 127
6013 International Students into the Irish Higher Education System: Supporting the Transition

Authors: Tom Farrelly, Yvonne Kavanagh, Tony Murphy

Abstract:

The sharp rise in international students into Ireland has provided colleges with a number of opportunities but also a number of challenges, both at an institutional and individual lecturer level and of course for the incoming student. Previously, Ireland’s population, particularly its higher education student population was largely homogenous, largely drawn from its own shores and thus reflecting the ethnic, cultural and religious demographics of the day. However, over the twenty years Ireland witnessed considerable economic growth, downturn and subsequent growth all of which has resulted in an Ireland that has changed both culturally and demographically. Propelled by Ireland’s economic success up to the late 2000s, one of the defining features of this change was an unprecedented rise in the number of migrants, both academic and economic. In 2013, Ireland’s National Forum for the Enhancement for Teaching and Learning in Higher Education (hereafter the National Forum) invited proposals for inter-institutional collaborative projects aimed at different student groups’ transitioning in or out of higher education. Clearly, both as a country and a higher education sector we want incoming students to have a productive and enjoyable time in Ireland. One of the ways that will help the sector help the students make a successful transition is by developing strategies and polices that are well informed and student driven. This abstract outlines the research undertaken by the five colleges Institutes of Technology: Carlow; Cork; Tralee & Waterford and University College Cork) in Ireland that constitute the Southern cluster aimed at helping international students transition into the Irish higher education system. The aim of the southern clusters’ project was to develop a series of online learning units that can be accessed by prospective incoming international students prior to coming to Ireland and by Irish based lecturing staff. However, in order to make the units as relevant and informed as possible there was a strong research element to the project. As part of the southern cluster’s research strategy a large-scale online survey using SurveyMonkey was undertaken across the five colleges drawn from their respective international student communities. In total, there were 573 responses from students coming from over twenty different countries. The results from the survey have provided some interesting insights into the way that international students interact with and understand the Irish higher education system. The research and results will act as a model for consistent practice applicable across institutional clusters, thereby allowing institutions to minimise costs and focus on the unique aspects of transitioning international students into their institution.

Keywords: digital, international, support, transitions

Procedia PDF Downloads 281
6012 Global Gender Differences in Job Satisfaction in the Hospitality Industry

Authors: Jonathan Hinton Westover, Maureen S. Andrade, Doug Miller

Abstract:

Research has been inconclusive in determining if men or women experience more job satisfaction. A global comparison examining extrinsic and intrinsic factors, work relations, and work-life balance determinants found few differences; however, work relations and work-life balance factors were more significant for male than female workers across occupations. The current study uses International Social Survey Program data representing 37 countries to explore gender differences in job satisfaction in the hospitality industry. Findings demonstrate that mean job satisfaction scores for females are lower across hospitality occupations except for hotel receptionists, housekeeping supervisors, and hotel cleaners. Regression results revealed additional differences such as the significance of co-worker relations, the negative impact of being discriminated against and harassed at work, working weekends, marital status, and supervisory status for women with autonomy, work stress, education, and employment relationship being more salient for men. Interesting work, work being useful to society, job security, pay, relations with management, and work interfering with family were significant for both males and females.

Keywords: job satisfaction, gender, hospitality, global comparisons

Procedia PDF Downloads 133
6011 Unsafe Abortions in India: Questioning the Propitiousness of MTP Act

Authors: Suresh Sharma, Neeti Goutam

Abstract:

In India abortions are legal and with the exceedingly liberal and broadened law that was passed in 1971, “Medical Termination of Pregnancy Act” had opened a new window to Women’s’ freedom and choice over their fertility. This paper would like to focus on the factors responsible for or leading to unsafe abortion as well as such high incidence of abortion in India which can help in understanding the ways in which we can prevent this apathy. To study the intricacies involved in delivering safety to womanhood in terms of safe abortion practice which includes more trained personnel, detailed explanation and consequences of conducting an abortion, fine reporting, awareness regarding family planning measures and not only pressurizing them to sterilize immediately after an abortion but also prior to that informing them and lastly easy accessibility of Contraceptives with a educated and brief information on that. Data has been drawn from various sources such as National Family Household Survey (1, 2, 3), Health Management Information System and Annual Health Survey. To safeguard the interest of women when it comes to complications resulting from unsafe abortions, Reproductive Health laid its strict adherence to it in its guidelines. The Government could induce more measures in terms of family planning measures and increase in the number of skilled medical health force, chiefly in rural areas to prevent the illegality of abortions. But before that fine reporting on the number of abortions performed will give an insight to this very issue only then policies and programs will work much better in favor of women.

Keywords: abortion, MTP act, India, women

Procedia PDF Downloads 357
6010 Spatial Analysis of the Perception of Family Planning among Teenage Mothers in Nigeria

Authors: Mbuotidem Brendan, Nathanael Afolabi

Abstract:

Teenage pregnancy is a major health concern because of its association with high morbidity and mortality for both mother and child. In 2013, 23% of women in Nigeria, aged 15 - 19 yr have begun childbearing: 17% have had a child and 5% are pregnant with their first child. Reported differences across locations have been attributed to factors such as educational attainment and exposure to mass media. This study therefore seeks to determine the difference in the level of exposure among teenage mothers and older women of reproductive age in Nigeria. Over 12,000 women of reproductive age (18 – 49 yr) were interviewed across 8 states from the Northern and Southern region of Nigeria. The women were further segregated into two groups of 0 (women aged 18 – 20 yr who had children of their own) and 1 (women of reproductive age excluding teenage mothers). Data was collected via structured questionnaires on mobile devices using the open data kit platform. Initial data formatting and recoding was done using STATA 13 package. Initial analysis was also conducted using SPSS version 21 and the data points were mapped on QuantumGIS package. From the results of analyzed data obtained from the studied states, there were various mean ages of first births across the supported states. Though Akwa Ibom had one of the oldest mean ages (21.2 yr) at first birth and the lowest fertility rate of 3.9 births/woman according to the National Demographic Health Survey 2013, Akwa Ibom had the highest rate of teenage pregnancy (18.2%) across the respondents. Based on education, the respondents that had completed secondary school education (56.9%) made up the greatest cohorts of the teenage parents. This is counter indicative of the initial thinking that there is an inverse relationship between level of education and teenage pregnancy. Akwa Ibom, Bauchi and Delta states are states where respondents felt that contraceptive use is dangerous to health and they were the top 4 states that had a large proportion of teenage mothers. Similarly, across the states examined, all the women of reproductive age felt they could convince their spouses to use contraceptives, as using family planning does not cause women to be promiscuous. This study thus reveals that across the states studied, there was no marked variation in the perception of family planning between teenage parents and women of reproductive age. The study also highlights the need for future planning and exposure to family planning messages at secondary school level.

Keywords: adolescent, family planning, mass media, teenage mothers

Procedia PDF Downloads 180
6009 Intensive Care Unit Patient Self-Determination When Facing Cardiovascular Surgery for the First Time

Authors: Hsiao-Lin Fang

Abstract:

The Patient Self-Determination Act is based on the belief that each life is unique. The act regards each patient as an autonomous entity and explicitly protects the patient’s rights to know and make decisions and choices while ensuring that the patient’s wish for a peaceful end is granted. Even when the patient is unconscious and unable to express himself/herself, the patient’s self-determination and its exercise are still protected under the law. The act also ensures that healthcare professionals (HCPs) have a specific set of rules to follow and complete legal protection when their patients are unable to express themselves clearly. This report is about a 55-year-old female patient who weighed 110 kg and was diagnosed with acute type A aortic dissection. The case was that the patient suddenly felt backache and nausea during sleep before daybreak and was therefore transferred to this hospital from the original one. After the doctor explained the patient’s conditions, it was concluded that surgery was necessary. However, the patient’s family was immediately against the surgery after having heard its possible complications. Nevertheless, the patient was still willing to receive the surgery. Being at odds with her family, the patient decided to sign the surgery agreement herself and agreed to receive the two surgical procedures: (1) ascending aorta replacement and (2) innominate artery debranching. After the surgery, the patient did not regain consciousness and therefore received computed tomography scanning of the brain, which revealed false lumen involving proximal left common carotid artery, left subclavian artery and innominate artery, and severe compression of the true lumen with total/subtotal occlusion in the left common carotid artery. On the following day, the doctor discussed two further surgical procedures: (1) endografting for descending aorta and (2) endografting for left common carotid artery and subclavian artery with the family. However, as the patient’s postoperative recovery of consciousness only reached the level of stupor and her family had no intention of subsequent healthcare for the patient, the family made the joint decision three days later to have the endotracheal tube removed from the patient and let her die a natural death. Suggestion: An advance directive (AD) can be created beforehand. Once the patient is in a special clinical state (e.g., terminal illness, permanent vegetative state, etc.), the AD can determine whether to sustain the patient’s life through ‘medical intervention’ or to respect the patient’s rights to choose a peaceful end and receive palliative care. Through the expression of self-determination, it is possible to respect the patient’s medical practice autonomy and protect the patient’s dignity and right to a peaceful end, thereby respecting and supporting the patient’s decision. This also allows the three sides: the patient, the family and the medical team to understand the patient’s true wish in the process of advance care planning (ACP) and thereby promote harmony in the HCP-patient relationship.

Keywords: intensive care unit patient, cardiovascular surgery, self-determination, advance directive

Procedia PDF Downloads 175
6008 British English vs. American English: A Comparative Study

Authors: Halima Benazzouz

Abstract:

It is often believed that British English and American English are the foremost varieties of the English Language serving as reference norms for other varieties;that is the reason why they have obviously been compared and contrasted.Meanwhile,the terms “British English” and “American English” are used differently by different people to refer to: 1) Two national varieties each subsuming regional and other sub-varieties standard and non-standard. 2) Two national standard varieties in which each one is only part of the range of English within its own state, but the most prestigious part. 3) Two international varieties, that is each is more than a national variety of the English Language. 4) Two international standard varieties that may or may not each subsume other standard varieties.Furthermore,each variety serves as a reference norm for users of the language elsewhere. Moreover, without a clear identification, as primarily belonging to one variety or the other, British English(Br.Eng) and American English (Am.Eng) are understood as national or international varieties. British English and American English are both “variants” and “varieties” of the English Language, more similar than different.In brief, the following may justify general categories of difference between Standard American English (S.Am.E) and Standard British English (S.Br.e) each having their own sociolectic value: A difference in pronunciation exists between the two foremost varieties, although it is the same spelling, by contrast, a divergence in spelling may be recognized, eventhough the same pronunciation. In such case, the same term is different but there is a similarity in spelling and pronunciation. Otherwise, grammar, syntax, and punctuation are distinctively used to distinguish the two varieties of the English Language. Beyond these differences, spelling is noted as one of the chief sources of variation.

Keywords: Greek, Latin, French pronunciation expert, varieties of English language

Procedia PDF Downloads 499
6007 Exploring Family and Preschool Early Interactive Literacy Practices in Jordan

Authors: Rana Alkhamra

Abstract:

Background: Child's earliest experiences with books and stories during the first years of his life are strongly linked with the development of his early language and literacy skills. Interacting in routine learning activities, such as shared book reading, storytelling, and teaching about the letters of the alphabet make a critical foundation for early learning, language growth and emergent literacy. Aim: The current study explores family and preschool early interactive literacy practices in families and preschools (nursery and kindergarten) in Jordan. It highlights the importance of early interactive literacy activities on child language and literacy growth and development. Methods: This is a cross sectional study that surveyed 243 Jordanian families. The survey investigated literacy routine practices, largely shared books reading, at home and at preschool; child speech and language development; and family demographics. Results: Around 92.5% of the families read books and stories to their children, as frequently as 1-2 times weekly or monthly (75%). Only 19.6% read books on daily basis. Many families reported preferring story-telling (97%). Despite that families acknowledged the importance of early literacy activities, on language, reading and writing, cognitive, and academic development, 45% asked for education and training pertaining to specific ways and ideas to help their young children develop language and literacy skills. About 69% of the families reported reading books and stories to their children for 15 minutes a day, while 71.2% indicated having their children watch television for 3 to > 6 hours a day. At preschool, only 52.8% of the teachers were reported to read books and stories. Factors like parent education, monthly income, living inside (33.6%) or outside (66.4%) the capital city of Amman significantly (p < 0.05) affected child early literacy interactive activities whether at home or at preschool. Conclusion: Early language and literacy skills depend largely on the opportunities and experiences provided to children in the home and in preschool environment. Family literacy programs can play an important role in bridging the gap in early literacy experiences for families that need help. Also, speech therapists can work in collaboration with families and educators to ensure that young children have high quality and sufficient opportunities to participate in early literacy activities both at home and in preschool environments.

Keywords: literacy, interactive activities, language, practices, family, preschool, Jordan

Procedia PDF Downloads 447
6006 Informal Governance as Response to Institutional Paralysis

Authors: Stefanie Kasparek

Abstract:

The United Nations Security Council (UNSC) is probably the most recognized international security organization. It is also profoundly misunderstood and undervalued in its effort to promote peace and security. With the rising involvement of non-state actors and the way states fight wars, international governance has become increasingly complex. However, the formal UNSC agenda has long remained static, reflecting states' unwillingness to entertain more conflicts. Nevertheless, resolutions remain the scholarly measure of states' interests and policies, neglecting the significant share of issues the Council entertains informally. This project builds on a rational institutionalism framework. It provides a systematic analysis of how and under what conditions states use informal governance instead of, or in combination with, formal rules at the agenda-setting stage of the policy process. Data for this project comes from elite interviews and a newly created dataset on governance choices. The results show that counter existing arguments, weaker states successfully circumvent formal institutional roadblocks and use informal governance mechanisms to pursue vital interests, thereby countering institutional restrictions and power asymmetries present informal governance settings.

Keywords: agenda-setting, decision-making, international governance, UNSC

Procedia PDF Downloads 198
6005 Explanation and Temporality in International Relations

Authors: Alasdair Stanton

Abstract:

What makes for a good explanation? Twenty years after Wendt’s important treatment of constitution and causation, non-causal explanations (sometimes referred to as ‘understanding’, or ‘descriptive inference’) have become, if not mainstream, at least accepted within International Relations. This article proceeds in two parts: firstly, it examines closely Wendt’s constitutional claims, and while it agrees there is a difference between causal and constitutional, rejects the view that constitutional explanations lack temporality. In fact, this author concludes that a constitutional argument is only possible if it relies upon a more foundational, causal argument. Secondly, through theoretical analysis of the constitutional argument, this research seeks to delineate temporal and non-temporal ways of explaining within International Relations. This article concludes that while the constitutional explanation, like other logical arguments, including comparative, and counter-factual, are not truly non-causal explanations, they are not bound as tightly to the ‘real world’ as temporal arguments such as cause-effect, process tracing, or even interpretivist accounts. However, like mathematical models, non-temporal arguments should aim for empirical testability as well as internal consistency. This work aims to give clear theoretical grounding to those authors using non-temporal arguments, but also to encourage them, and their positivist critics, to engage in thoroughgoing empirical tests.

Keywords: causal explanation, constitutional understanding, empirical, temporality

Procedia PDF Downloads 193
6004 The Spiritual Distress of Women Coping with the End of Life and Death of Their Spouses

Authors: Szu-Mei Hsiao

Abstract:

Many nurses have concerns about the difficulties of providing spiritual care for ethnic-Chinese patients and family members within their cultural context. This is due to a lack of knowledge and training. Most family caregivers are female. There has been little research exploring the potential impact of Chinese cultural values on the spiritual distress of couple dyadic participants in Taiwan. This study explores the spiritual issues of Taiwanese women coping with their husband’s advanced cancer during palliative care to death. Qualitative multiple case studies were used. Data was collected through participant observation and in-depth face-to-face interviews. Transcribed interview data was analyzed by using qualitative content analysis. Three couples were recruited from a community-based rural hospital in Taiwan where the husbands were hospitalized in a medical ward. Four spiritual distress themes emerged from the analysis: (1) A personal conflict in trying to come to terms with love and forgiveness; the inability to forgive their husband’s mistakes; and, lack of their family’s love and support. (2) A feeling of hopelessness due to advanced cancer, such as a feeling of disappointment in their destiny and karma, including expressing doubt on survival. (3) A feeling of uncertainty in facing death peacefully, such as fear of facing the unknown world; and, (4) A feeling of doubt causing them to question the meaning and values in their lives. This research has shown that caregivers needed family support, friends, social welfare, and the help of their religion to meet their spiritual needs in coping within the final stages of life and death. The findings of this study could assist health professionals to detect the spiritual distress of ethnic-Chinese patients and caregivers in the context of their cultural or religious background as early as possible.

Keywords: advanced cancer, Buddhism, Confucianism, Taoism, qualitative research, spiritual distress

Procedia PDF Downloads 175