Abstract
The National foster
coalition states at this time there are 700,000 children needing permanent
homes in foster care throughout the United States (National foster care
coalition, 2014). Adoption is a worldwide practice that crosses cultures,
nations, and races (Foli, 2012). This very specialized vulnerable population
use clinical medical services triple the rate identified by birth families
(Foli, 2012). One of the greatest needs identified by adopted parents is the
need for health care professionals to understand the differences of parenting
adopted children verses birth children (Groze, 1996). An area identified by
research literature of great magnitude is the need to promote parent child
attachment in older foster children. Attachment defined as a strong desire to
seek closeness with a few adult figures especially in times of fear, tiredness,
illness and stress (Van den Dries, Juffer, Ijzendoorn, & Bakermans
–Kranenburg, 2008). This attachment usually takes place in infanthood, but is
interrupted in many foster children lives because of abuse and neglect that
occurs during this stage of development (Van den Dries, etal., 2008). The
bonding relationship is also further harmed by the social system that tries to
save them, by frequent change in caregiver, institutionalization and failure to
find adoptive parents quickly (Van den Dries, etal., 2008). Attachment with a
few primary individuals is necessary because it effects emotional regulation
and mental health later in life (Van den Dries, etal., 2008). Individuals with
a secure attachment to others develop emotional resilience to handle life tough
problems and learn that they have the ability to influence the world around
them (Van den Dries, etal., 2008). This basic trust allows children to function
autonomously from the parent in a healthful manner (Van den Dries, etal.,
2008). It is necessary of adopted children to develop this attachment sometime
during childhood or adolescence or they are at risk for physical,
psychological, emotional and behavioral problems throughout life (Foli, 2012).
Further research is needed to provide evidence based health care to this
population, and at this time it is lacking.
Statement and Significance of the
problem
The
purpose of this purposed study is to understand variables that promote
attachment of older adopted foster children. This topic is significant to the
nursing profession because, older adopted children use health services at
triple the rate of biological children (Foli, 2012). The number one greatest
health care service used by older adopted foster children is mental health care
services (Bertram, Narendorf, & Mc Millen, 2013). Older children come to
foster care through physical abuse, neglect and abandonment (Bertram, etal.
2013). Due to these negative life experiences, many of the children fail to
grown emotionally and developmentally (Leve, Harold, Chamberlain, Landsverk,
Fisher, & Vostania, 2012). If the initial bond between mother and child is
impaired because of abuse, the fundamental component of all future relationships
and the foundation of advantageous mental health in jeopardy (Tucker&
Mackenzie, 2012). Children that have been in foster care have an increased rate
of homelessness, crime, poverty, and poor health, which has significant impacts
on society (Dries, Juffer, IJzendoorn, & Bakermans – Kranenburg, 2009).
This
very vulnerable population often receives mental health services that are
inadequate and fractured (Bertram, etal., 2013). Treatment that is provided to
adoptive foster children often times are lacking in empirical evidence and
inappropriate for the symptoms presented (Bertram, etal., 2013). The treatment
for this unique population should be approached in a different manner because
the essential cause of many of the symptoms that are presented as mental
disorders are due to underlining attachment issues and should be treated
differently ( Bertram,etal.,2013). Advanced practice nurses are primed to play
a much greater role in the lives of these children (Bertram, etal., 2013). Many
advanced practice nurses are taking on the health care role for this
population, because of lack of childhood physiatrist, collaboration between
disciplines, decreased funded, overload caseworkers and growing professional
role (Bertram, etal., 2013). Understanding how to promote attachment in later
adoptive children upholds one of the cornerstone institutions of society, the
family.
Literature
Review
The purpose of this literary review is to
discover knowledge on how nurses can serve this specialized population, with
the emphasis on attachment and bonding, in older adopted child. The key words
used during the search were, adoption, attachment, bonding, resilience,
adoption disruption, nurses role in adoption, foster care and adoption
disruption. The literary review conducted revealed a lack of knowledge of this
subject in the nursing literature. The literature reviewed demonstrated that it
is possible to heal poor attachment in infanthood, later in a child life and
improve both the physical as well as mental health of the child. The following
is a review of fifteen peer reviewed research articles to demonstrate the need
for research in this area to further the body of knowledge in nursing practice.
The
first research article reviewed for the forthcoming research proposal was, “Nursing
care of the adoptive triad” (Foli, 2012).This research was completed using a
cross sectional survey of ninety-seven nurses from three different specialties,
pediatrics, postpartum, and labor and delivery (Foli, 2012). The article states
that adoption is a topic in nursing that has limited research but, is necessary
to improve the body of nursing knowledge, due to the fact that in 2010 alone,
178,200 children were adopted in the Unites States and the numbers have been
increasing every year ( Foil, 2012). Nurses are in a unique place to provide
therapeutic support, physically, mentally and socially to adoptive families
(Foil, 2012). Nurses are often the first health care professional to interact
with the adoptive parents and child (Foil, 2012). Specialized needs exist for
this family dynamic of birth parent, adoptive parent and child (Foil, 2012).
The nurse can assist in improving the overall dynamic of this triad by
understanding needs that are unique to this population (Foil, 2012). Increase
nursing knowledge and intervention in this area promotes family health and
increases the chances of successful adoption outcomes of older children (Foil,
2012).
Areas
of interest in prompting attachment in older children in the article,” Nursing
care of the adoptive triad”, included realistic expectations of adoptive
parents, postpartum depression of adoptive parents, need for increased
sensitivity and culture awareness by health care professionals in the area of
adoption and unique developmental needs of the adoptive child (Foli, 2012). The
article also discusses the myth that all adopted children have attachment
problems. Rather bonding occurs differently in adoptive children (Foli, 2012).
Studies of the developmental stages of adoptive families have implications for improving
clinical practice for the nursing profession (Foli, 2012).
The
second article reviewed is “Inter county adoption and nursing care” (Rykkje,
2007). This research was conducted, in Scandinavia using qualitative research
interview method. The interviews included nurses, adopted adults and adoptive
parents (Rykkje, 2007). The research had several reoccurring themes the need
for attachment, heritage, family identity formation, and grief processing
(Rykkje, 2007). The research concluded the parenting role of adoptive parents
and family is different from biological parenting and requires specialized
knowledge by nurses to support and educate families in this role (Rykkje,
2007). The research demonstrated the need for longer post adoption follow –ups,
to educate the families on specialized parenting skills, needed to parent older
adopted children. Public health nurses trained in the dynamics of this unique
population best accomplish this ( Rykkje,2007). This can only be accomplished
if nurses continue to research and gain knowledge about the unique struggles of
this population (Rykkje, 2007).
The
third article being reviewed is “The personal and professional: Nurses’ Lived
Experience of Adoption” (Foli, Schweitzer & Wells, 2013). This was a
descriptive phenomenological research approach where nurses were ask to write
narrative of their experience’s caring for members of the adoptive triad(
Foli,etal.,2013). The adoption triad includes the biological parents, the child
and the adoptive parents (Foli,etal.,2013). The research demonstrates that
there is a need for nurses to have further education in adoptive friendly
language, unique needs of this family dynamic, ways to advocate for adoptive
families, and services available that can promote healthy outcomes for all the
members of the adoptive triad (Foli,etal., 2013). Early intervention through
advocacy by nurses helps families in developing attached and resilient adoptive
children (Foli,etal., 2013). Research demonstrates the further need for nurses
to grow in knowledge about assisting this unique population that is part of the
health care population (Foli,etal., 2013).
The
fourth article reviewed is “Clinical Interventions for children with Attachment
Problems” (Cornell & Hamrin, 2008). Advanced practice psychiatric nurses
are educationally equipped to provide interventions to older foster children
that are adoptive with attachment difficulties (Cornell & Hamrin, 2008).
The attachment that a child has to a primary caregiver is the foundation to all
the relationships the child will have in the future (Cornell &
Hamrin,2008). This connection teaches children social norms, offers protection,
security as well as an emotional foundation of inner sense that they are loved
and of worth ( Cornell &
Hamrin,2008). Without this inner sense of love, it is difficult for the child
to create loving relationships with others (Cornell & Hamrin, 2008). It is
a mistaken philosophy by many nurses that, all a child need is love and
belonging to create this attachment (Cornell & Hamrin, 2008). In vulnerable
children that bond has been damaged or has failed to develop, this is a faulty
belief (Cornell & Hamrin, 2008).
Cornell
and Hamrin did an extensive literary review to determine evidence based
interventions for treating children with attachment disorders (Cornell &
Hamrin, 2008). In this review, it was discovered that foster adoptive children
need different interventions than biological children to promote attachment
(Cornell & Hamrin, 2008). That foster adoptive parents need health care
professionals to work with them in repairing their child’s internal
representation that is individualized for each child (Cornell & Hamrin,
2008). The review of literature demonstrated a large gap in knowledge in the
treatment of adoptive children with attachment disorders and the need for
further research (Cornell & Harmin, 2008). At this time, there is no
standard treatment for this very serious disorder (Cornell & Harmin, 2008).
Nurses
are in a unique position to identify attachment problems in child well visits
(Cornell & Harmin, 2008). The current treatment for improving attachment
disorders in older adoptive children is through teaching the parents,
relationship-building skills, learning to read their child’s non-verbal cues
and helping their child change their internal representation (Cornell &
Hamrin, 2008). These are all areas that nurses who are educated in attachment
problems, could assist in therapeutically intervention and advocacy for this
vulnerable population (Cornell & Harmin, 2008).
The
fifth article being reviewed is “Promoting a secure attachment, maternal mood
& child health in a vulnerable population: a randomized controlled trail”
(Armstrong, Fraser, Dadds & Morris, 2000). In this, trial 181 couple was
interviewed in their postnatal period (Armstrong, etal., 2000). The researchers
set up a randomized control group of 91 mothers and gave 90 mothers a series of
home visits over four months, by a home health nurse and a social worker. The
home health nurse and social worker taught ways to improve family dynamic and
improve health of the family (Armstrong, etal., 2000). Both groups’ home
environments were then reevaluated at the end of the four-month period using
home environment tool created by the researches (Armstrong, etal., 2000).
The
group that received intervention had improved family functioning in all aspects
of family functioning (Armstrong,etal.,2000). The areas that seen the greatest
striders were attachment of the mother and child, improved child relationships,
increase sense of competence by parents and greater use of positive parenting (
Armstrong,etal.,2000). By using this early home based intervention the mental
and physical health of adopted children could be affected for a lifetime
(Armstrong, etal., 2000).
The
sixth article reviewed “Understanding & Promoting attachment” (Wilson,
2009). It has been proven empirically that coaching parents in positive parent
child relationship helps to promote healthy attachment in children who have
bonding problems (Wilson, 2009). Many other therapies promoted are
controversial and even harmful to children (Wilson, 2009). It is important for
nurses to understand evidence based measures that are affective in helping
adoptive children form attachments (Wilson,2009). Without having a thorough understanding
of this problem, a nurse cannot successfully advocate for this population
(Wilson, 2009).
The
seventh article reviewed discusses the need to change the internal model of how
a child thinks in order to promote attachment (Mackenzie & Tucker, 2012).
When a child is an infant, they learn what to expect from the world from the
first relationship of their life the bonding of the mother and infant
(Mackenzie & Tucker, 2012). If this initial relationship is in some way
harmed, the child will exhibit abnormal behaviors, mental health issues and
physical health issues throughout life (Mackenzie & Tucker, 2012). The
research done is “Attachment theory and change processes in foster care” makes
evidence that this initial bonding experience if damage can be repaired
(Mackenzie & Tucker, 2012).
It
theorized that if this initial attachment was damaged it was unable to be
mended (Mackenzie & Tucker, 2012). The article states that at this time
there is limited research regarding this very important topic (Mackenzie &
Tucker, 2012). The method of research was to analyze the placement records and
exit records of 3,448 children taken in to protective custody in Canada
(Mackenzie & Tucker, 2012). The researchers removed variables that could
affect the change seen in the children besides time to include gender, parents
in the labor force, economic incentives, age, number of placements prior to
adoption, and unemployment of adoptive parents. The researchers attempted
understand reasons why children may have placement changes and adoption
disruption (Mackenzie & Tucker, 2012).
This
article shows through research that the longer a child been with a family, that
is without abuse or neglect, the less mental health problems are exhibited
(Mackenzie & Tucker, 2012). This research not only provides evidence of the
significance mental health benefits, that adoption provides to the child but,
hope to adoptive families that are experiencing behavior problems with adoptive
children (Mackenzi & Tucker,2012). Behavior problems are the number on
reason given for children being moved in foster care and adoption disruption
(Mackenzie & Tucker, 2012). This research gives support to the fact that
with nurturing supportive parenting that adoption makes positive changes in the
life of a child (Mackenzie & Tucker, 2012). This research in valuable to
the nursing profession because it establishes the need for nurses to promote
nursing interventions in families to maintain the parent child relationship in
the home
(Mackenzie &
Tucker, 2012).
This
is indispensable research to demonstrate further support for laws in health
care to support adoption of foster children and to help families to maintain
adoptions. In recent years, there has been decreased support of incentive to
adopt foster children in government policy. This one act of permancy not only
has great impact on the child’s overall health but on society as a whole. This
study demonstrated children regardless of their past mental issues with the
protective support of a family have decrease behavior problems, that can lead
to incarceration, long term mental healthcare, improved physical care, better
education outcomes ( Mackenzie,& Tucker, 2012).
The
research done article “Fostering security? A meta-analysis of attachment in
adopted children”, provides valuable understanding into intercessions that
nurses could use to plan and implement in families experiencing problems in
adoptive children behavior related to attachment issues (Dries, Juffer,
Ijendoorn, & Bakermans- Kranenburg, 2009). The research also provides
understanding into the different dynamic of growth and development process of
families of adoptive children and the children themselves. The growth and
development of adoptive families and children progresses differently than that
of birth families and it is important that nursing literature reflect this
distinction in to provide therapeutic health interventions.
This
inquiry provides the reader with an exceptional understanding of what
characteristics are demonstrative of normal attachment. The study then goes on
to not only identify risk factors that
may compromise optimal child development but, also protective factors
that can negate the risk experience by foster adopted foster children who have
been subject to abuse and neglect ( Dries,etal.,2009). The researchers used
observational assessment and parent reporting measures to examine the
attachment relationship of adoptees in a longitudinal study (Dries, etal.,
2009). The investigation concluded that very nurturing homes provided the
ability for children that were behind in growth and development related to
broken attachment were able to catch up to their peers of biological children
if given the right home environment ( Dries,etal.,2009).
Traits
that were revealed in the exploration included, encouraging, supportive
parenting, positive reinforcement, sensitivity that biological age does not
always reflect emotional age, providing a home environment that promotes
experiences for the child to attach to the adoptive parents (
Dries,etal.,2009). This research would be of great significance as a foundation
to acquire knowledge about future nursing research to discover parental
behaviors that support attachment in later adoptive children (Dries, etal.,
2009).
The
ninth article appraised was “Practitioner
Review: Children in foster care- vulnerabilities and evidence-based
interventions that promote resilience processes ( Leve, Harold, Chamberlain,
Landsverk, Fisher, & Vostanis, 2012).The researchers in this journal
article point out the fact that there is little evidence based science on
promoting bonding of older adopted foster children ( Leve,etal.,2012). There is much
needed effort by society to understand this phenomenon because there is
established documented proof of the poor outcomes of foster children
(Leve,etal.,2012). By understanding the unique vulnerabilities of this
population interventions can be implemented across childhood and adolescence to
improve the child’s mental and physical health (Leve,etal.,2012).
The
inquiry of literature done by the investigators revealed several areas in the
development of foster adopted children that needed to be understood as unique
to their growth and development (Leve,etal.,2012). Many foster adoptive
children have delayed emotional and behavioral development because of the
breakdown of attachment of mother and child due to abuse, neglect and mental
illness (Leve, etal.,2012). A national sample was collected of over 6,200
foster children over half had signs of emotional and behavioral dysregulation.
(Leve,etal., 2012). The rates of childhood mental health problem were three
times higher in this population than in biological children (Leve,etal.,2012).
Similar trends have also been established in other countries (Leve,etal.,
2012). This study also revealed that foster adoptive children were at risk of
brain and neurobiological that was behind their peers, due to abuse and neglect
(Leve,etal.,2012). The third area of vulnerability identified was the
relationship with parents and peers (Leve,etal.,2012).
The
scholars identified several areas that revealed standard parenting intervention
programs may not be helpful to this type of family ( Leve,etal.,2012). The
reasons identified were prenatal drug and alcohol abuse, multiple caregivers in
a child’s life and working from a model of parenting that is not appropriate
for this population of children (Leve, etal, .2012).
The
methodology used by the researchers in this investigation was a literary search
of Psych Info to identify interventions
that had been tested with this population and has been proven effective (
Leve,etal,.2012). The review of literature revealed that there are many proven
effective interventions for both children and adolescence (Leve, etal,.2012).
This study is valuable to the knowledge of nursing practice for many reasons.
Areas that should be considered are education by public health nurses of what
occurs when using drugs and alcohol during pregnancy. Public health nurses need
to become astute in helping at risk women find help before these problems occur
or give education on birth control and were it can be obtained . Also the
interventions discussed in the literature could be the bases for care and
intervention by psychiatric advanced practice nurses, which are growingly
responsible for serving this population (Leve, etal., 2012).
The
tenth article “Disruptions in foster care: A review and meta- analysis”
discusses protective factors of certain types of foster families, that prevent
breakdown of the parent child relationship between foster child and parent
(Scheuengel, Slot, Bullens & Doreleijers, 2007). The study determined
factors that influence good outcome in placement of foster children (
Scheuengel, etal.,2007). A meta-analytic approach employed by the researchers
to determine what factors create resilient children and families
(Scheuengal,etal., 2007). Factors that
had been determined as indicators for potential breakdown in adoption include:
children being exposed to drugs and alchole in utero, advanced age of children,
low income of adopting parents, behavior problems of children, previous
placement in foster care and physical disabilities ( Scheuengal,etal.,2007). By
being aware of possible indicators in adoption disruption, health care personal
can provide support and intervention prior to the breakdown of the relationship
between the child and family (Scheuengal,etal,.2007).
The
enquiry also identified areas that served as protective factors for the
children. Areas that were demonstrated in the research were children that
exhibited empathy, sensitivity, humor, loving nature, attractiveness and
maturity characteristic were more likely to maintain placement (Scheuengal,
etal, .2007). Further research in ways to teach children these characteristics
would help children maintain adoptions. The study also found that the more
involved the child caseworker was in the child’s care the more likely the adoption
would be successful. In addition, children placed with other foster children or
sibling had more successful outcomes (Scheuengal,etal.,2007). Adoptive families
that were afforded more support through community, family, and health care
personal also reported being more satisfied with adoption (
Scheuegal,etal.,2007). This article gave
support to further research by advanced practice nurses, in many areas to
support families through the developmental stages of adoption.
In
the journal of psychiatric nursing investigation has been conducted to
understand “Problem –solving interventions for caregivers of children with
mental health problems” (Gerkensmeyer, Johnson, Scott, Oruche, Lindsey, Austin,
& Perkins,2013). This study is important to this investigation because many
older children adopted out of foster care have mental health problems. This
study focus on ways to enrich problem- solving skills of caregivers of children
with mental illness (Gerkensmeyer,etal,.2013). The investigation was conducted
using an experimental random design (Gerkensmeyer,etal,.2013). The purpose of
the study was to determine if using the building solutions and connections
intervention had a positive effect on the coping and stress of families, caring
for children with mental illness. The investigation proved that this
intervention had moderate to high positive effects on families (
Gerkensmeyer,etal,.2013). This research is important because it could provide a
method to help adoptive families of older foster children.
The
twelfth article reviewed in this review of literature is an inquiry into
evidence on changing abnormal attachment in later adopted children (Steele,
Steele, Hodges, & Kaniuk, 2010). This was a longitudinal, intergenerational
study of previously abuse children (Steele,etal., 2010). This study in valuable
in understanding the mental representation of adults and children (Steel,
etal.,2010). By understanding the internal working of abused children minds, it
is possible to provide positive changes in faulty thinking to improve
attachment (Steel,etal., 2010).
The
thirteenth research paper reviewed the researcher assessed the foster adoptive
family’s attachment at the onset of adoption and then a year later using adult
attachment interview for adults and children used the Manchester children’s
story assessment ( Barone & Lionetti, 2011). The research established that
adoption is a protective measure for children ( Barone & Lionetti, 2011).
Those children that are placed in secure homes are able to emotionally catch up
developmentally (Barone & Lionetti, 2011).
The
fourteenth research article reviewed is “Strengthening adoption practice,
listening to adoptive families (Atkinson & Gonet, 2007). A enquiry of 500 adoptive families was
conducted to understand challenges faced and what they need to sustain the
adoption (Atkinson & Gonet,2007). The research concluded very important
facts that will influence future research. The family dynamics of adopted
families is different from birth families ( Atkinson & Gonet, 2007).
Adoption has a life- long impact on society as well as the individual family (
Atkinson & Gonet, 2007). Adoption is advantageous to civilization, the
child and family ( Atkinson & Gonet, 2007). It is the responsibility of
everyone to aid families in maintaining this institution (Atkinson & Gonet,
2007).
The last study in this review is about
understanding how attachment pattern of mother affect their adoptive children
(Pace & Zavattini, 2010). This investigation was of significance, because
it showed that mothers that had more secure attachment models, had adoptive
children with better attachment at the end of the study, despite where the
child started on the attachment scale ( Pace & Zavattini,2010). The study
reveals that children that have traumatic past can catch up emotionally through
supportive, nurturing parenting (Pace & Zavattini, 2010). The study suggests that improvement is slow
and more possible to occur the mother has a greater attachment and bonding herself
(Pace & Zavattini, 2010). The enquiry also promoted future investigation as
to ways to improve mothers own internal representation to improve attachment in
order to promote bonding between adoptive child and mother.
This
literary review establishes the need to conduct further research on the topic
of how nurses can understand and promote attachment in adoption. There is a
great many empirical studies covering growth in development in birth children.
Nursing literature is lacking in the areas of adoptive parenting and attachment
promotion of older adoptive children (Foli, 2012). Other disciplines have
created unique knowledge in understanding families, that have created
successful bonds with older foster children; this would be valuable to
translate into knowledge applicable to nursing. Nurses are in a unique position
to assisting adoptive families with healthy attachment to adoptive children.
Adoptive families often seek medical care for issue that our related to
problems with early attachment (Foli, 2012). The nurse is often the most
frequent health care professional adoptive families are in contact with,
initiating nursing interventions to promote attachment between the child and
adoptive family would promote health within the family and the child (Foli,
2012).
The
family is one of the fundamental cornerstones of society. Nursing research is
necessary in the area of promoting attachment in older adoptive children
because, it is one of the primary needs to overall health throughout life for
the adoptive family and child (Foli, 2012). Understanding ways to promote this
bond is beneficial to society by producing the next generation with better
physical and mental health (Foli, 2012). Understanding promotion of healthy
bonding of older adopted children will further nursing knowledge and be
beneficial to include in current literature on growth and development. I
purpose there is a significant need to identify traits that are unique to
families that have successfully bonded and adopted older children through
foster care. With this knowledge, health care providers can work with families
to build these traits to promote healthy adoptions of older children, in foster
care and prevent adoption disruption that could further damage the bonding
process of this very susceptible population.
Research
question or Hypothesis
The research purposed is an inquiry into
understanding of situations or variables, which influence attachment in older
adopted children..
Methodology
Study
setting
The
study population will include all of the foster adoptive parents who have completed
adoption within the agency that is greater than two years old. The inquiry
geographical location will cover the entire county the foster adoption agency
covers, that agrees to participate in this future investigation. The study will
only include adoptions parents who have adopted children greater than five
years of age.
Research
Design
Due to the lack of exploration on this topic in the
nursing literature, the investigation that purposed for future research on the
issue of attachment in older adoptive children is an exploratory quantitative
research design. This design was chosen in order gain insight into the
phenomena of attachment of abuse and neglected children, who are adopted at an
older age, to determine if this has significant meaning to nursing practice
(Grove, Burns, & Gray, 2013). Exploratory research is often conducted when
little is known about a topic to gain better insight and hypothesis regarding a
phenomenon, to generate better hypothesis and research questions (Grove, etal.,
2013). Because of lack of research on this topic in the body of nursing
knowledge, this design was chosen.
Sample and Sampling procedure
The sampling procedure will take
place-using data collected from sending out a random survey of all adoptive
parents in the county of the chosen adoptive foster care agency (Grove, etal.,
2013). The sample will exclude foster parents, parents that have adopted
children five years old or younger and parents must have adopted greater than
two years ago. The subjects will be obtained
using the national adoption database that is used by all foster and adoption
agencies (Foli, 2012).
Ethics/ Institutional board review
Due to the fact, the surveys are random,
each individual chooses participation, consent and infringement on a person’s
rights is not of significance consequence (Grove, etal., 2013). Prior to doing
research, an institutional board has to approve the research proposal, review
for ethical issues and promote cost effectiveness (Grove, etal., 2013). The
benefits that the participates may receive is future understanding of the
unique parenting challenges of adoptive parents and better interventions by
health care providers to support these families.
Data collection
The data will be collected by sending a
random survey via e-mail, to all adoptive families that meet the sample
criteria. The survey will be sent over a period of six-weeks on weekly bases to
all individuals that meet the set criteria to illicit a response. After six
weeks, the data collection will be completed. The survey will developed using
the atlas of qualitative analysis software to create the survey (
Grove,etal.,2013).
The information obtained from the survey will be
analyzed using the atlas qualitative analysis software (Grove,etal,2013). This
software was created to organize and evaluate soft data, in the social sciences
(Grove,etal.,2013).
Strengths and weakness
The strength of this type of research that it is
cost effective (Grove, etal., 2013). Another strength of this design type is
the fact that it generates new knowledge and ideas the researcher may not have
considered (Grove,etal.,2013). This study design is considered weak in nature
due to the fact it is based on phenomena and experience of another but, cannot
be proven (Grove,etal.,2013). This type of research has proven beneficial in
understand a topic that has not been fully research or understood before
(Grove,etal., 2013).This research would help advance practice nurses promote meaningful
bonding and attachment experiences for families of older adoptive children.
This type of investigation selected because the literary review produced a
deficiency of knowledge in relation to nursing. This topic proves to be a
significant importance to the body of nursing knowledge. Adoptive children use
mental health care services and a significantly higher rate than birth children
do. One significant contributors to this as demonstrated by the review of
literature is attachment issues stemming from prior abuse and neglect prior to
adoption. By having, a greater understanding of these phenomena nurses can
serve this health care population in a more meaningful way and prevent future
adoption disruptions. This investigation would create a foundation and
questions for future research on a topic that cannot be overlooked by the
nursing profession.
References
