Caring and thriving: An international qualitative study of caregivers of orphaned and vulnerable children and strategies to sustain positive mental health
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© 2018 Background: Child well-being is associated with caregiver mental health. Research has focused on the absence or presence of mental health problems, such as depression, in caregivers. However, positive mental health – defined as the presence of positive emotions, psychological functioning, and social functioning – likely prevents depression and in caregivers may benefit children more than the mere absence of mental health problems. Little attention has been given to how caregivers sustain positive mental health, particularly when doing challenging work in impoverished settings. Objective: The study's objective was to determine what successful caregivers of orphaned and vulnerable children (OVC) in diverse countries do to sustain their positive mental health. Methods: Using a mixed-methods, cross-sectional study design, trained local interviewers recruited a convenience sample of OVC caregivers through residential care institutions from five geographic regions (Kenya; Ethiopia; Cambodia; Hyderabad, India; and Nagaland, India). Participants completed surveys and in-depth interviews about strategies used to sustain their mental health over time or improve it during challenging times. Results: Sixty-nine OVC caregivers from 28 residential care institutions participated. Positive mental health survey scores were high. We organized the strategies named into six categories ordered from most to least frequently named: Religious Practices; Engaging in Caregiving; Social Support; Pleasurable Activities; Emotion Regulation; and Removing Oneself from Work. Prayer and reading religious texts arose as common strategies. Participants reported promoting positive emotions by focusing on their work's meaning and playing with children. The similar findings across diverse regions were striking. Some differences included more emphasis on emotion control in Ethiopia; listening to music/singing in Kenya and Hyderabad; and involving children in the tasks the participants enjoyed less (e.g., cleaning) in Cambodia. Conclusions: Under real-world conditions, small daily activities appeared to help sustain positive mental health. In addition, fostering structures that allow caregivers to engage regularly in rewarding caregiving tasks may be an affordable and scalable idea which could potentially benefit caregivers, children, and employers.
Orphaned and vulnerable children (OVC)
Published Version (Please cite this version)10.1016/j.childyouth.2018.12.024
Publication InfoProeschold-Bell, Rae; Eagle, David; Kinghorn, Warren; Whetten, Kathryn; Molokwu, NJ; Keyes, CLM; ... Dubie, ME (2019). Caring and thriving: An international qualitative study of caregivers of orphaned and vulnerable children and strategies to sustain positive mental health. Children and Youth Services Review, 98. pp. 143-153. 10.1016/j.childyouth.2018.12.024. Retrieved from https://hdl.handle.net/10161/18180.
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Assistant Research Professor of Global Health
I am an Assistant Research Professor the Center for Health Policy and Inequalities Research and the Duke Global Health Institute. I am an expert on the health of religious clergy, the changing shape of churches in North American society, and the implications of these trends for the professional training of ministers.More recently, my research ha
Associate Professor of Psychiatry and Behavioral Sciences
Medical Professionalism Religion, Spirituality, and Psychiatry Philosophy of Psychiatry
Associate Research Professor of Global Health
Rae Jean Proeschold-Bell is interested in the interplay between mental and physical well-being and has designed and tested interventions that integrate care for people with obesity and depression; HIV/AIDS and substance use; and hepatitis C and alcohol use. Most recently, Rae Jean has been studying positive mental health as a way to prevent depression and promote caring for one's physical health. Her work currently focuses on caregivers, including clergy in North Carolina and ca
Professor in the Sanford School of Public Policy
Director, Center for Health Policy and Inequalities ResearchResearch Director, Hart Fellows Program,Professor, Public Policy and Global Health Professor, Nursing and Community & Family Medicine Kathryn Whetten (PhD) is Chair of the Maternal, Adolescent and Child Health working group, and she is the Co-Chair of the University Diversity Task Force and the Sanford Diversity Committee. Kathryn Whetten is the Principal Investigator on
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