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1. What is the relationship between a bipolar parent to the psychological and emotional aspect of the child?

TOPIC: Lived experiences of a young adult with a Bipolar mother Review of Related Literatures: 1. Being a Child of a Bipolar Parent Psychopathology, Social Functioning and Family Functioning Bipolar disorder does not only affect individuals who have the disorder but also their environment, including family members. With bipolar disorder, there is a mutual influence between the affected individuals functioning and the family. Family attitudes can affect the illness course while the illness has a great impact on family distress and functioning (Reinares et al., 2004). There is no information on the perception of offspring themselves about their upbringing in a family with a parent with bipolar disorder. We studied how offspring living in a family with a bipolar parent perceived their families compared to adolescents and young adults from the general population, and we determined the impact of parental psychopathology versus offspring psychopathology on parental rearing practices (chapter 7) The focus of this thesis is on the functioning and development of children of bipolar parents for two main reasons. First, children of bipolar parents are at genetic risk for developing psychopathology, including bipolar disorder themselves (Alda, 1997; Gershon et al., 1987; McGuffin & Katz, 1989). Second, children of bipolar parents are subject to environmental stressors partially associated with parental psychopathology and its consequences. These multiple risks may contribute to multiple types of psychopathology that, in addition, are subject to developmental changes over time. For example, it is possible that the first signs of bipolar disorder are non-specific problems, such as anxiety problems, later followed by the development of a depression that subsequently evolves into a bipolar disorder with also manic episodes. In addition, little is known about the functioning of children of bipolar parents. http://repub.eur.nl/res/pub/6892/050629_Reichart-CG.pdf 2. Children of Bipolar Parents Prevalence of psychopathology and antecedents of mood disorders By the end of 1997 the KBO-project (Dutch for Children of Bipolar Parents) was launched. The major aim of the KBO-project was to study the early development of bipolar disorder and factors influencing this development. Children of bipolar parents are at increased risk of developing psychopathology, including bipolar disorder, compared to children from the general population The lifetime risk for bipolar disorder in relatives of a bipolar proband was found to be 5-10% for first-

degree relatives compared with 0.5-1.5% for unrelated individuals (Craddock and Jones, 1999). This thesis concerns children of bipolar parents for two main reasons. First, children of bipolar parents are at genetic risk for developing psychopathology, including mood disorders (Alda, 1997; Gershon et al., 1987; McGuffin and Katz, 1989). Second, children of bipolar parents are subject to (mostly negative) environmental stressors associated with parental psychopathology. These multiple risks may be responsible for the emergence of multiple types of psychopathology that subsequently are subject to developmental change. In addition, disorders other than a mood disorder can be precursors of bipolar disorder. For instance, an oppositional defiant disorder in childhood can be followed by the development of a unipolar disorder in adolescence which subsequently evolves via a (hypo)manic episode into a bipolar disorder in adulthood. Little is known about the effects of environmental influences on the functioning of children of bipolar parents. Therefore, the global aim of this thesis is twofold; on the one hand we wished to determine the lifetime and current prevalence of psychopathology including mood disorders among offspring of bipolar parents and on the other hand we sought to test the effects of factors influencing the presence and onset of psychopathology, including mood disorders, among offspring of bipolar parents. To achieve these aims we studied a sample of 140 children of 86 bipolar parents aged 12 to 21 years. This thesis is based on two measurements with an interval of 14 months. dissertations.ub.rug.nl/.../medicine/2004/m.wals/14_thesis.pdf 3. Experiences of Adult offspring of parents with a mental illness: Putting together the pieces and making meaning of experiences ABSTRACT According to a 2009 Canadian national health survey approximately 12% of children under the age of 12 live in a household were the survey respondent reported one or more mood, anxiety or substance use disorder (Bassani, Padoin, Philipp & Veldhiuzen, 2009). In fact, one out of every five individuals will experience a mental illness during their lifetime. It is widely accepted that the birth rate of people who experience mental illness is the same or higher than the general population. Numerous studies have explored the topic of children of parents with a mental illness. Early research focused on understanding the adverse effects on children and specifically on identifying risk for childhood psychopathy. More recently researchers have begun to explore the positive aspects of growing up with parental mental illness in light of children who are seen as demonstrating considerable resiliency. Strength-based aspects to the experiences of growing up as a child of parental mental illness have been included in some studies. The goal of this exploratory qualitative study was to explore the experiences of adults, who as children, grew up with a mentally ill mother and/or father. The method used included recruiting study participants using purposive sampling. The data collection and

analysis was informed by grounded theory including a constant comparison of interview data and data analysis. Findings in this study supported previous research related to growing up with parental mental illness. Experiences of study participants were also similar to findings in existing research. Unique findings that would be worthy of further exploration included experiences of growing up in a two parent family with a father with a mental illness. Significant challenges with transitioning from adolescence to young adulthood were found across many of the interviews. The process of making meaning of experiences growing up in a family with parental mental illness as study participants experience their own significant life events was also found. These findings can inform policy and practice working with individuals and families who experience parental mental illness. http://www.parentalmentalillness.org/Andrea%20Harstone_FINAL%20thesis%20Septe mber%2012_2010.pdf

4. Living with Bipolar Disorder: The experiences of the persons affected and their family members, and the outcomes of educational interventions ABSTRACT Bipolar disorder has considerable consequences for the daily life and functioning of the person affected and their family. The aim of this study was to describe the experience of living with bipolar disorder from the view of the person affected and their family. A further aim was to analyze the outcomes of educational interventions for persons with the illness and their family members in outpatient mental health care. In Papers I and II, qualitative interviews were conducted with persons diagnosed with bipolar disorder (n=18) and family members (n=17) focusing on their experiences of life with the illness. In Papers III and IV the outcomes of educational interventions for those affected (n=32) and the families (n=34) were followed-up and analyzed. Paper III included a comparative group (n=15) of persons with the illness only receiving standard treatment. Data were collected using a semi-structured interview (III) and selfassessment instruments (III-IV) on fi ve occasions, starting before the intervention and ending at the two-year follow-up. Content analysis was applied to the qualitative studies, whereas descriptive and non-parametric statistical methods were used for the quantitative studies. The educational intervention was an existing health care intervention in a unit in outpatient mental health care services consisting of ten groupsessions with different topics related to living with bipolar disorder which the group discussed and refl ected on. It is based on the assumption that communication, collaboration and discussion in these groups create interaction that facilitate development of knowledge about and capacity to manage living with the illness. The results of this thesis showed that the whole lives of the family and the member affected were infl uenced. The process of integrating the illness challenged their pre-

understanding, requiring reconsideration of self among the persons affected and confi rmation of the correctness of the families experiences. Uncertainty among persons with the illness concerning their own capacity and the limited life associated with the illness infl uenced their view of the future. The younger adults avoided planning or hoping for the future, and without hope of improvement it sometimes felt hard to continue. The families were strongly committed to the care for the member with the illness, but felt engaged in a lonely and burdensome struggle that diminished their chances of a normal life of their own. Hope for the future, suffi cient social functioning and feeling part of society was prerequisites for a manageable life for these people. The educational interventions gave them opportunity to interact and learn together with mental healthcare professional and other people within a constructive environment. The outcomes of the interventions showed that both persons with bipolar disorder and the family members increased their self-management ability as a result of their developed knowledge and their ability to meet the daily social concerns and stresses related to living with bipolar disorder improved. This thesis contributes increased knowledge concerning what it means to live with bipolardisorder in the long-term and emphasis the importance of educational interventions with a person- centred view for person affected and family members developing their capacity to manage life. The overall support from mental health care has to be further developed and designed to meet all the specifi c and different needs of those persons and their families. To supplement the promising outcomes of the educational interventions more research is needed concerning increased selfmanagement under different stages of the illness and life. https://gupea.ub.gu.se/bitstream/2077/22944/1/gupea_2077_22944_1.pdf

5. The effects of Parental Mental Illness on children: Pathways to Risk to resilience from Infancy to Adulthood The research that has been conducted has shown that children who have a parent with a mental illness are at significantly greater risk for multiple psychosocial problems (Beardslee et al., 1996). Studies have noted that offspring of mentally ill parents have higher rates of psychiatric diagnoses in childhood (Friedman et al., 1996), and are more likely to show developmental delays, lower academic competence, and difficulty with social relationships (Sameroff & Seifer, 1983; Oyserman et al., 2000). In addition, these offspring are more likely to have mental health problems in adolescence and adulthood (Beardslee et al, 1998; Weissman et al., 1997). What is missing from this body of work is a focus not only on the outcomes of offspring of mentally ill parents, but also the processes through which parental psychopathology influences children. The primary aim of this dissertation was to examine the effects of early maternal\ mental illness on children across development. A sample of parents and offspring were followed over the course of 40 years, and pathways from maternal psychopathology

during the first three years to offspring adaptive functioning in adulthood were examined. The three studies of this dissertation attempt to address several gaps in the current research literature, and also build off each other in order to add to our current understanding of how parental psychopathology affects offspring adaptive functioning. http://deepblue.lib.umich.edu/bitstream/handle/2027.42/77750/lslomins_1.pdf?sequence =1 6. Connection, Caretaking and Conflict: The recalled Lived Experience of Adult Daughter of Bipolar Mothers ABSTRACT At present in the United States approximately four million people (one and six tenths percent) suffer from Bipolar I and Bipolar II disorders. Twenty percent of bipolar persons are not helped by medication. Each bipolar person has two parents, and may have siblings, friends, spouses, and children. All of these people are affected by the feelings and behavior of the bipolar person. The children are particularly vulnerable to behavior disorders, depression and anxiety, even if protective factors mitigate the family situation. This qualitative research addresses the events recalled by adult daughters whose mothers are bipolar: what they recalled of what they thought, felt, and did in response. Events from early childhood to the time of the interview were explored. Seidmans phenomenological interview series was the model for the interview, both in the pilot study and later when it was modified into one long interview as suggested by McCracken. This study was not retrospective. It focused on the daughters recollections and how these affected their development, their relationships, and their work or careers. The transcripts from the two pilot study participants interviewed in two-thousandtwo were included as archival material and analyzed with the transcripts from the two thousand-five interviews with the dissertation participants. The pilot study participants were recruited from a clinical setting. One dissertation participant heard about the study by word of mouth. The others responded to a newspaper advertisement. Two were twenty five, two were in their early fifties, and the rest were between thirty four and thirty nine. Two were African American, one was biracial. The remaining seven came from a wide variety of ethnic backgrounds.The data was analyzed using NVivo. It enabled comparison of themes from each life stage addressed in the interviews. These themes were recorded in forty-one tables. The most populated and enduring were role reversal, beginning in early childhood, and conflict, beginning in the high school years. Each theme persisted in the presence of the other until the time of the interviews, profoundly interfering with development, trust, intimacy, and work. These conclusions suggested both needed services and further research.

http://ecommons.luc.edu/luc_diss/260/ 7. Young carers of parents with mental health issues ABSTRACT It is estimated that twenty percent of the Canadian population experiences a serious mental illness at some point in their lifetime. A portion of those that do so will be parents. Research indicates that in some circumstances, when a parent with a serious mental Illness needs support that they are not getting from other adults or the formal mental health care system, the caregiving responsibilities can fall to their children. Sometimes called young mncarers in literature developed in the U.K. and elsewhere, there has been little attention in Canada to this population or the implications of the term young carers. Through a critical feminist lens, a small qualitative study was undertaken to explore the lived experiences of adults looking back on having been young carers, a perspective seldom taken in the literature. The four study participants had all cared for their mothers in households with extended social networks that included fathers and siblings- an interesting counterpoint to the young carer literature, which has centered on isolated single parents with children. Participants described how they found themselves in caring roles, what their caring consisted of, and why they continued to care despite other options being available. The study reveals the intricate social pressures that the participants faced, and suggests that becoming a carer may be more complex than past studies have indicated. I examined participants stories with an eye to the structural forces that shaped their pathways as carers and their reflections on those pathways. The discussion focuses on what the participants experiences can tell us about the contemporary neoliberal political climate: how its emphases on individualism, independence and smaller government, contribute to the depletion of public mental health services and a troubling focus on sustaining young carers rather than questioning their positioning http://digitalcommons.mcmaster.ca/opendissertations/6205/

2. What factors have promoted the high level of wellness and longevity among people over to be 70 years of age? TOPIC: Lived Experiences of Physically Active Geriatric Clients Significance of the Study: Geriatric Nurses. The proposed study will help the geriatric nurses give nurses give and quality nursing interventions such as plans of care and its continuity on geriatric clients based on the outcomes of the study. Geriatricians. The proposed study will help geriatricians in evaluating the benefits of physically active clients than those who are not based on actual experiences. Also, it will serve basis on improving or changing their medical interventions primarily on rehabilitation of geriatric clients. Geriatric Clients. The proposed study will help the less active elderly clients promote their health status through adapting the behaviour and/or routines of the physically active clients. Future Researchers. The proposed study will help future researchers as means of being a framework or basis in generating or improving health programs, health activities and rehabilitation of geriatric clients. Purpose of the Study: The purpose of this study is to identify the subjective benefits and factors brought about by the geriatric clients physical activities and to contribute to the knowledge of specific groups of people. Review of Related Literatures: 1. Scientific Basis of Exercise on Aging People Exercise is not a single entity but a variety of leisure time, occupational, and self-care activities which, if performed routinely, result in biochemical and physiologic adaptations that improve the body's functional capacity, efficiency, muscular endurance, and range of motion. This can occur regardless of the initial fitness level and age of an individual. Aerobic exercise usually involves sustained, dynamic contractions of large muscle groups. Repeated episodes of aerobic exercises improve muscular endurance and strength while simultaneously improving the functioning of the cardiovascular system. In contrast, resistance exercise, such as lifting heavy weights, increases muscular strength and endurance but has little effect on improving cardio-respiratory efficiency. Source: http://www.mdch.state.mi.us/pha/vipf/eldtext.htm#History

2. Mobility and Quality of Life in Elderly and Geriatric Patients Quality of life in older people is significantly influenced by their mobilization. Using the statistical comparison of observed groups we found out that the mobilization of elderly and geriatric patients improves their quality of life. We used nonparametric Mann Whitney test as an evaluation method. Codetermine relations between variables we used the Spearman correlation coefficient. Geriatric patients have shown rates of mobility in the BREF questionnaire (item 15) and ADL test at the same level. Physical activity represents a significant attribute of mobility in seniors, which confirmed the results of foreign studies. Reduced mobility is a maximum barrier in hospitalized geriatric patients. The positive overall impact of physical activity was reflected in increased confidence of seniors in their own abilities. In nursing there must be a continuous mobilization of geriatric patients according to their degree of dependence. Source: International Journal of Nursing and Midwifery Vol. 3(7), pp. 81-85, July 2011 Available online http://www.academicjournals.org/ijnm

3. Effects of Physical Exercise Therapy on Mobility, Physical Functioning, Physical Activity and Quality of Life in Community-Dwelling Older Adults with Impaired Mobility, Physical Disability and/or Multi-Morbidity: A Meta-Analysis CRD summary This review found that mobility- or disability-limited older adults with or without multimorbidity benefited from physical exercise therapy. Methodological and reporting limitations mean that the results should be interpreted with some caution and make the reliability of the authors' conclusions unclear. Authors' objectives To evaluate the effect of physical exercise therapy on mobility, physical functioning, physical activity and quality of life in elderly patients with mobility problems, physical disability and/or multi-morbidity. Study selection Randomised controlled trials (RCT) of physical exercise therapy interventions in community-dwelling adults aged at least 60 years were eligible for inclusion. Patients had to be physically frail as defined by the study authors using specific criteria on the presentation of mobility problems and/or physical disability and/or multi-morbidity. Studies needed to report data on at least one of the outcomes of mobility, physical functioning, physical activity levels and quality of life. Studies of particular patient populations, institutionalised older adults, combined interventions of exercise and other

therapies and non-specified movement interventions and studies with a PEDro quality score of less than 6 out of a maximum 11 were excluded from the review. The age of the study population ranged between 60 and 85 years. The intervention goals included fall reduction, improved physiological, psychological and functional risk factors for disability and improved health-related quality of life, strength, physical performance, gait, balance and endurance. Half of the included studies used multicomponent training programmes that comprised strength, balance and endurance training. Some studies evaluated specific strength or balance training and other studies used functional training programmes. Supervision of the exercise programmes were by physical therapists or exercise leaders. Intervention duration ranged from five weeks to 18 months. Initial screening of titles was performed by one author. Two reviewers selected the studies by evaluation of abstracts and full texts of each article. Any discrepancies between the reviewers were resolved by discussion. Assessment of study quality Two independent reviewers assessed methodological quality using the PEDro 11-item scale of randomisation, allocation concealment, baseline similarities, blinding of patients, therapists and assessors, proportion of drop-outs, use of intention-to-treat analyses, use of between-intervention statistical comparisons and presentation of point measures and measures of variability. Any disagreements between the reviewers were resolved by discussion and a third reviewer. Data extraction Data were extracted to calculate standardised mean differences (SMD) and 95% confidence intervals for the outcomes. Where more than one instrument was used to measure outcomes in any study, the reviewers selected the results from one instrument for use in the analysis. Study authors were contacted for missing data. Methods of synthesis Pooled standardised mean differences and 95% CIs were calculated using a fixed-effect model. Statistical heterogeneity between the trials was evaluated with . Where statistical heterogeneity was present, the results were combined using a random-effects model. Subgroup analyses compared low intensity exercise therapy with higher intensity exercise therapy and long interventions (more than three months) with short interventions (less than three months). The reviewers assessed potential for publication bias by visual appraisal of funnel plots. Implications of the review for practice and research Practice: The authors stated that adults with mobility problems and/or disability with or without multi-morbidity should be encouraged to engage in high-intensity exercise and perform strength training. Revisions and updated specifications (published in 2007) of the American College of Sports Medicine guidelines for physical activity might apply to these particular patient groups.

Research: The authors stated a need for more high quality research aimed specifically at improving physical activity levels and using specific intervention and evaluation techniques. In particular the authors advocated development of a generic core set of measurement instruments in physical exercise research and presentation of data in such a way that comparisons using meta-analyses would be feasible. Source: de Vries NM, van Ravensberg CD, Hobbelen JS, Olde Rikkert MG, Staal JB, Nijhuis-van der Sanden MW. Effects of physical exercise therapy on mobility, physical functioning, physical activity and quality of life in community-dwelling older adults with impaired mobility, physical disability and/or multi-morbidity: a meta-analysis. Ageing Research Reviews 2012; 11(1): 136-149 Available Online: http://www.crd.york.ac.uk/crdweb/ShowRecord.asp?LinkFrom=OAI&ID=12012000277#. Udc_DztHKSo 4. Improvements in Balance in Older Adults Engaged in a Specialized Home Care Falls Prevention Program Abstract Background and Purpose: To determine if persons older than 65 years receiving a combination of physical therapy, occupational therapy, speech or nursing interventions in their home demonstrated changes in gait/balance function after an episode of home care services. Methods: Charts from 11, 667 persons who were at risk for falling and who were participating in exercise program in the home included. Study Design: Data were retrieved from the Outcome and Assessment Information Set, Version B, and the computerized database of physical therapist-collected outcome data. Recorded physical therapist-data may have included a neuropathic pain rating, the Berg Balance Scale (BBS), the Performance Oriented Measurement Assessment (POMA), the Dynamic Gait Index (DGI), and the modified Clinical Test of Sensory Integration and Balance (mCTSIB). Source: Journal of Geriatric Physical Therapy 2013;36:3-12

REVIEW OF RELATED LITERATURES AND STUDIES

1. Spiritual realm may be the source of strength, support, security and well-being in a clients life. The nurses role is not limited to alleviating spiritual distress, but also can include viewing spirituality as an integral aspect of the client and integrating the clients spirituality into his/her overall plan of care (Thomson, 2002) Source: Lippincotts Manual of Psychiatric Nursing Care Plan, 7th Edition Judith M. Schultz and Sheila L. Videbeck

2. Spiritual needs focus on giving and receiving love; a need for closeness and acceptance; experiencing hope; feeling of self-esteem and confidence; finding meaning and purpose in life events, including sickness and death; resolving guilt and experiencing forgiveness.

Source: Mental Health Nursing Giving Emotional Care by Murray, R.B

3. Spiritual concerns and needs of clients are often overlooked in practice, yet play an important role in the lives of many individual. It provides a sense of well-being and assist in forming positive interpersonal relationship. Source: Psychiatric Mental Health Nursing by: Birckhed, Loretta M.

4. Nursing care should be focused on physical and psychological needs as well as spiritual. Nurses must also assess patients' strengths and coping styles, as it helps with assessing spirituality. Listening, silence and touch are important aspects of spirituality. Touch can demonstrate caring, sense of worth and relieves stress. Being present at a religious ritual such as anointing of the sick can be important to the dying patient. Other ways of introducing spirituality and health can be undertaken through encouragement of journaling, meditation, scripture reading, prayer, music, art therapy, guided imagery and aromatherapy. I have the opportunity to work with both psychiatric and hospice patients. Both can be very challenging especially when the patients are in spiritual distress or religiously delusional. I have worked in psychiatry for the past ten years and found that spirituality can be easily ignored. Spiritual assessment is part of patient assessment because it can affect the care and treatment of the patient. Asking the patient what their religious affiliation is no longer tabooed. It is encouraged that spirituality be part of their treatment , especially if they are in spiritual distress. Working as a hospice nurse has its great reward which is providing comfort and hope to patients who are dying. Being able to sit with the patient, holding their hands, saying a prayer or rosary is an important aspect of spiritual care. Being a source of strength and hope for the patient and family is rewarding. Spiritual support provides meaning of hope, love and satisfaction in their final days. Reconciliation is also part of spiritual care. Being able to help with these unfulfilled expectations or omissions can be fulfilling. Assuring the patient that they will not die alone and guiding them to the light.

Spirituality provides a means for service providers to empower and encourage patients to engage in their healing process. Spirituality is incorporated with holistic care and is essential to the holistic care of any patient. We as nurses become a source of spiritual hope for all our patients. Article Source: http://EzineArticles.com/2863101, http://maryanngabriel.blogspot.com Article Source: http://EzineArticles.com/?expert=Mary_Ojnik

5. The Lived Experience of Spirituality and Dementia in Older People Padmaprabha Dalby Sussex Partnership NHS Trust, UK David J. Sperlinger Canterbury Christ Church University, UK Stephen Boddington South London & Maudsley NHS Foundation Trust, UK

Abstract A literature review highlighted the importance of understanding the subjective experience of spirituality and dementia. Two research aims were identified: to build an understanding of how older peoples experience of spirituality, religion or faith is affected by having dementia and to understand how the spiritual aspects of their lives affect the experience of dementia. Six older people with mild to moderate dementia were interviewed about their experience of spirituality and dementia. Interview transcripts were analysed using Interpretive Phenomenological Analysis. Five superordinate themes were identified: experience of faith; searching for meaning in dementia; Im not as I was changes and losses in experience of the self; staying intact; and current pathways to spiritual connection and expression. The results offered a unique perspective on the experience of spirituality and dementia, uniting themes from both research and theory concerning the experience of the self and the experience of spirituality in dementia. Reference:

Padmaprabha Dalby, David J. Sperlinger and Stephen Boddington Dementia 2012 11: 75 originally published online 7 November 2011 DOI: 10.1177/1471301211416608 The online version of this article can be found at: http://dem.sagepub.com/content/11/1/75

6. A Pilot Study of Nurses' Experience of Giving Spiritual Care Belinda Deal The University of Texas at Tyler, USA Abstract Using spiritual and religious resources gives patients and families strength to cope during a crisis, but nurses often do not offer spiritual care (Kloosterhouse & Ames, 2002). The purpose of this phenomenological study was to explore nurses" lived experience of giving spiritual care. A descriptive phenomenological approach was used to interview 4 nurses. Data were analyzed using Colaizzis (1978) phenomenological method. Five themes were identified: spiritual care is patient-centered, spiritual care is an important part of nursing, spiritual care can be simple to give, spiritual care is not expected but is welcomed by patients, and spiritual care is given by diverse caregivers. Spiritual care is an integral part of nursing and nurses can support patients with spiritual interventions.

7. Essence of Spirituality for Women in Late Life Lydia K. Manning, Ph.D., MGS Duke University, Durham, North Carolina Abstract Against the backdrop of a dramatic increase in the number of individuals living longer, particularly older women, it is vital that researchers explore the intersection of spirituality, gender, and aging. In this qualitative study of six women aged 80 and older, I explore, using, multiple, in-depth interviews, the experiences of spirituality over the life course. A hermeneutic phenomenological analysis of the interviews was performed and provided insights into the nature of their lived experience allowing for the understanding of the essence of their spirituality. The results are presented as an interpretation of the participants perceptions of their spirituality and spiritual experiences. For the women in this study, the essence of their spirituality lies in: being

profoundly grateful; engaging in complete acceptance; and having a strong sense of assuredness, while stressing the linkages and importance of spirituality. Implications for understanding spirituality for older adults are considered.

GOAL The purpose is to introduce a qualitative study of the recalled life experience of young adults of Bipolar mother, their psychosocial development, functioning and identity. These studies identify the ups and downs of childrens mental health at different developmental stages and identify adverse conditions that may be associated with their difficulties.

OBJECTIVES: 1. Identify the family interactions that may affect the child 2. Recognize the childs subjective experience of his or her parents bipolar Illness 3. Understand the adults perception of the meaning of the recalled childhood experience to his or her daily life.

SIGNIFICANCE OF THE STUDY

1. Patient. The client will benefit from a much personalized approach of psychiatric nursing care and may indicate a better relationship with the young adult.

2. Young adult. The study will help this group to be aware of their subjective experience of their parents Bipolar illness and will be able to recognize the positive coping skills. It will help them evaluate and normalize their own experiences. 3. Family. It will address the family identity, its cultural, generational and individual sources of meaning. Sharing individual perceptions of this meaning and identity will assist the family in deepening and changing itself, thereby promoting coping skills. 4. Nurse. It will help the clinician to develop empathy for the young adult of a bipolar mother, and patience in her treatment. It will also assist clinician in his or her efforts to work with the client in managing their relationship with their mother. 5. Nursing Education. This will certainly be of use to the clinical social work practitioner. It may be used as well as to create or endorse community mental health policies, public or private foundation efforts that support optimal development of children in bipolar families. 6. Future Researchers

SPIRITUAL LIVED EXPERIENCES OF GERIATRIC CLIENTS IN MISSIONARIES OF CHARITY

GOAL The aim of this study is to build an in-depth understanding of how spirituality affects the health of geriatrics clients living in a specific home for the aged institution. The study aims to have an in-depth understanding of the lived experiences of the geriatric clients living in a specific home care facility and how spirituality gain an impact in affecting the health of the aged client. OBJECTIVES

1. Make an observation to the situation and the setting of geriatric clients living in a home for the aged institution. 2. Recognized their thoughts and feelings concerning their moving in a home for the aged institution. 3. Distinguish the spiritual beliefs and practices of the geriatric clients prior to their confinement as well as all through their stay in the home for the aged institution. 4. Determine the importance of spiritual beliefs and practices to people who reach the age of 60 years old and above. 5. Discover the ways how geriatric clients living in home for the aged institution meet their spiritual needs.

SIGNIFICANCE OF THE STUDIES 1. Geriatrics. The study will be served as a guide for strengthening the spiritual beliefs of the geriatric client and will help promote proper activities to cope with the situation. 2. Clients in Home for the Aged. The results of this study can directly help the clients to motivate themselves to engage in the spiritual activities to maintain their spirituality for the promotion of their well-being. 3. Family members and significant others of the Client. 4. Home for the Aged Administrators. The administrators could draw insights and knowledge from the results of the study which may make them realize the importance of providing spiritual care to the geriatric clients under their care to promote the geriatric clients well-being in the home for the aged institutes. 5. Nursing Practice and Education. The findings of the study will empower the nurses on taking care of the geriatric clients specifically in their spiritual needs. 6. Other Health Care Professionals. Through this study they would be able to gain better understanding on how to deal with the spiritual needs of the geriatric clients in home for the aged institutions. 7. Future Researchers. This study could serve as a motivation to undergo more researches similar to this study. It can also be a basis for further research endeavours geared towards the improvement of health services to geriatrics. Theme 1: Revisiting the Life of the Geriatric before moving in a Home Care Institution Subtheme: Geriatric clients compared their life in an Institution with that of the past Subtheme: Spiritual beliefs and practices before Theme 2:

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