Although studies have demonstrated that family dysfunction is common in families with attention deficit hyperactivity disorder (ADHD) children and that family members often suffer serious psychological effects, knowledge is lacking as to how to intervene to help these families manage the negative sequelae common to this disorder. This grounded theory study explored the effects of ADHD on family life and describes four family management styles exhibited in 15 families with children and adolescents with ADHD: the chaotic family, ADHD-controlled family, the surviving family, and the reinvested family. Descriptions and clinical recommendations are provided that addresses each family management type. By describing an initial typology of family management styles in this population, specific health-related issues and family assessment and intervention strategies can be more specifically directed.
This article examines a community engagement process developed as part of leadership training for clinical trainees in the Oregon Leadership Education for Neurodevelopmental and Related Disabilities (LEND) Program in a complex community with diverse families who have children with disabilities. The goal is to examine the process and lessons learned for clinical trainees and their mentors from such a process. This is a case study conducted as community-engaged action research by participant-observers involved in the Cornelius community for the past 4 years. The authors include faculty members and clinical trainees of the Oregon LEND Program at the Oregon Health & Science University, families with children with disabilities in the community, and city officials. It is a critical case study in that it studied a community engagement process in one of the poorest communities in the region, with an unusually high population of children with disabilities, and in a community that is over half Latino residents. Lessons learned here can be helpful in a variety of settings. Community engagement forum, community engagement processes, a debriefing using a seven-element feasibility framework, and trainee evaluations are key elements. A community engagement forum is a meeting to which community members and stakeholders from pertinent agencies are invited. Community engagement processes used include a steering committee made up of, and guided by community members which meets on a regular basis to prioritize and carry out responses to problems. Trainee evaluations are based on a set of questions to trigger open-ended responses. Lessons learned are based on assessments of initial and long-term outcomes of the community engagement processes in which families, community members, local officials and LEND trainees and faculty participate as well as by trainee participant-observations, end of year evaluations and trainee debriefings at the time of the initial community assessment forum. The thesis that emerges is that community engagement processes can afford significant opportunities for clinicians in training to develop their leadership skills toward improving maternal and child health for minority families with children with disabilities while building capacity in families for advocacy and facilitating change in the community.
Caregiver role strain is a new diagnosis accepted by NANDA in 1992. The diagnosis is a well‐described family phenomenon that can be measured and predicted. Sources of variance for the various defining characteristics have been identified. The diagnosis is also important to society. Nurses can play a significant part in reducing the role strain caregivers feel or preventing its occurrence. Summary Caregiver role strain is an important diagnosis to add to the nursing taxonomy. It is a phenomenon that has been well‐described and studied from many perspectives. It can be measured and identified by nurses. It can be predicted, and interventions can be instituted to diminish its effects or decrease the likelihood of its onset. It is a diagnosis that has boundaries and can be distinguished from other kinds of family problems related to health and illness of family members. It is also a significant issue in society that needs to be addressed by nurses working in many settings and roles.
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