Adversity Meaning in the Lived Experiences of Adolescents Living in Residential Out-of-Home Care Centers: A Qualitative Study

Document Type : Original Article

Authors

1 Associate Professor, Department of Pediatric Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Assistant Professor, Department of Pediatric Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Introduction: The adversities experienced by adolescents in residential care centers greatly affect different aspects of their life. The objective of this study was to shed light on the meaning of adversity by exploring the lived experience of adolescents living in Tehran residential care centers affiliated to the Welfare Organization of Tehran Province.
Methods: This qualitative study was conducted in 2019, using a hermeneutic phenomenological method. The data were collected using in-depth semi-structured interviews and, the data collection process continued until the data saturation point. A total of 10 adolescents living in residential out-of-home care centers of Tehran were selected using purposive sampling with a maximum variety in terms of demographic characteristics. The data collected from the interviews were analyzed using van Manen’s approach.
Results: The themes extracted in this study were “Self-alienation”, “Introspection”, “Constant comparison”, and “A secret life”. Constant comparison was a unique theme that was found in the experience of Iranian adolescents living in residential care centers.
Conclusion: This study identified the life adversity in residential centers from the viewpoint of adolescents. The provision of holistic care, promotion of professional interactions, and application of management practices based on the developmental, psychological, and social needs of this group of high-risk adolescents are recommended

Keywords


  1. Rebbe R, Nurius PS, Ahrens KR, and. Courtney ME. Adverse childhood experiences among youth aging out of foster care: A latent class analysis. child Youth Serv 2017; 74:108-116. doi: 10.1016/j.childyouth.2017.02.004.
  2. Doyle JJ. Causal effects of foster care: An instrumental variables approach. Child Youth Serv Rev. 2013; 35(7): 1143-1151. do: 10.1016/j.childyouth.2011.03.014.
  3. Kools S, Steven M, Rasheda J, Monasterio E, Norber J. Health profile of adolescents in foster care. J Pediatr 2013; 28(3):213-222. doi: 10.1016/j.pedn.2012.08.010.
  4. Drapeau S, Saint-Jacques MC, Lepine R, Begin G, Bernard M. Processes that contribute to resilience among youth in foster care. J Adolesc. 2007; 30(6): 977-99. doi: 10.1016/j.adolescence.01.005.
  5. Ellis BH, Fisher PA, Zaharie S. Predictors of disruptive behavior, developmental delays, anxiety, and affective symptomatology among institutionally reared romanian J Am Acad Child Adolesc Psychiatry. 2004; 43(10):1283-92. doi: 10.1097/01.chi.0000136562.24085. 160.
  6. Warburton WP, Warburton RN, Sweetman A, Hertzman The impact of placing adolescent males into foster care on education, income assistance, and convictions. Canadian Journal of Economics. 2014; 47(1):35-69. doi.org/10.1111/caje.12064.
  7. Barnsley SE. An examination of factors contributing to resilience among children and youths in out of home care in Ontario. [Doctoral dissertation]. University of Ottawa, Ontario, Canada; 2011.
  8. 8. Nelson CA, Scott RD, Bhutta ZA, Harris NB, Danese A, Samara M. Adversity in childhood is linked to mental and physical health throughout life. BMJ. 2020; 371:3048. doi: 10.1136/bmj.m3048.
  9. 9. Romano E, Moorman J, Bonneville V, Newton C, Flynn R. Adolescent males in out-of-home care: Past adversity and current functioning. Dev Child Welf. 2019; 1(3):199-16. doi: 10.1177/2516103219866198.
  10. Nourian M, Mohammadi Shahbolaghi F, Nourozi Tabrizi K, Rassouli M, Biglarrian A. The lived experiences of resilience in Iranian adolescents living in residential out-of-home care centers: A hermeneutic phenomenological study. Int J Qual Stud Health Well-being. 2016; 11(1):30485. doi: 10.3402/qhw.v11.30485.
  11. Rudd KL, Doan SN, Yates TM. The physical health costs of positive adaptation to childhood adversity. J Health Psychol. 2021; 26(9):1324-1338. doi: 10.1177/1359105319873961.
  12. Ungar M. Researching and theorizing resilience across cultures and contexts. Prev Med. 2012; 55(5):387-9. doi: 10.1016/j.ypmed.2012.07.021.
  13. Finkelhor D. Screening for adverse childhood experiences (ACEs): Cautions and suggestions. Child Abuse Negl. 2018; 85:174-179. doi: 10.1016/j.chiabu.2017.07.016.
  14. Shi Z, Wu C. Early life adversity and health inequality: A dual interaction model. J Chin Sociol. 2020; 7:11. doi: 10.1186/s40711-020-00121-y.
  15. 15. Ghimbulut O, Opre A. Assessing resilience using the mixed method: Youth Resilience Measure. Procedia Soc Behav Sci. 2012; 78: 310-314.
  16. Hunter AJ. A cross-cultural comparison of resilience in adolescents. J Pediatr Nurs. 2001; 16(3):172-9. doi: 10.1053/jpdn.2001.24180.
  17. Shepherd C, Reynolds F, Moran J. They̕ re battle scars, I wear them well: A phenomenological exploration of young women's experiences of building resilience following adversity in adolescence. J Youth Stud. 2010; 13(3):273-290. doi: 10.1080/13676260903520886.
  18. McMillen JC. Better for it: how people benefit from adversity. Soc Work. 1999; 44(5):455-68. doi: 10.1093/sw/44.5.455.
  19. Windle G, Bennett KM, Noyes J. A methodological review of resilience measurement scales. Health Qual Life Outcomes. 2011; 9:8. doi: 10.1186/1477-7525-9-8.
  20. Jackisch J, Brännström L, Almquist YB. Troubled childhoods cast long shadows: Childhood adversity and premature all-cause mortality in a Swedish cohort. SSM Popul Health. 2019; 9:100506. doi: 10.1016/j.ssmph.2019.100506.
  21. Van Manen M. Researching lived experience, human science for an action sensitive pedagogy. 2th ed. Cobourg: Transcontinental Printing Inc; 2001.
  22. 22. Gerrish K, Kathleen J. The research process in nursing. 7th ed. United State: Jhon wiley and Sons. Ltd; 2015.
  23. 23. Lincoln YS, Guba EG. Paradigmatic Controversies, Contradictions, and Emerging Confluences. In Denzin NK, Lincoln YS. (Eds.), Handbook of Qualitative Research. Thousand Oaks, CA: Sage; 2005. pp. 163-188.
  24. 24. Hockenberry MJ, Wilson D. Wong's nursing care of infants and children-e-book. St.louis, Missouri: Elsevier Health Sciences; 2018.
  25. 25. Naderifar M, Goli H, Hosseinzadeh M, Ghaljaei F. Adolescents' experiences of hospitalization in pediatric ward: A phenomenological study. J Qual Res Health Sci. 2017; 6(2):124-33. [In Persian].
  26. Abela A, Abdilla N, Abela Cl, Camilleri J, Mercieca D & Mercieca G. Exploring the long-term outcomes of children in residential out-of-home care. [Doctoral dissertation]. University of York, England; 2012.
  27. 27. Parker CR. The lived experience of transitioning from the foster care system to adulthood. [Doctoral dissertation]. USA: University of Tennessee; 2013.
  28. 28. Geenan S, Powers LE. Tomorrow is another problem The experiences of youth in foster care during their transition into adulthood. Child Youth Serv Rev. 2007; 29(8):1085-1101. doi: 10.1016/j.hildyouth.204.008.
  29. McCullough, M Elizabeth A. A phenomenological study of youth experiences in residential foster care and their recommendations for change. [Doctoral dissertation]. George Fox University; 2017.
  30. Kovarikova J. Exploring youth outcomes after aging-out of care. Toronto, Canada: Provincial Advocate for Children and Youth; 2017.
  31. Dworsky A, Courtney ME. The risk of teenage pregnancy among transitioning foster youth: Implications for extending state care beyond age 18. Child Youth Serv Rev. 2017; 32(10):1351-1356. doi: 10.1016/j.childyouth.2010.06.002.
  32. Steenbakkers A, Ellingsen IT, van der Steen S, Grietens H. Psychosocial Needs of Children in Foster Care and the Impact of Sexual Abuse. J Child Fam Stud. 2018; 27(4):1324-1335. doi: 10.1007/s10826-017-0970-7.
  33. Schofield G, Beek M. Growing up in foster care: Providing a secure base through adolescence. Child & Family Social Work. 2009; 14(3):255-266. doi: 10.1111/j.1365-2206.2008.00592.x.
  34. 34. Murray LK, Singh NS, Surkan PJ, Semrau K, Bass J, and Bolton P.A Qualitative Study of Georgian youth who are on the street or institutionalized. International Journal of Pediatrics. 2012; 3:921604. doi: 10.1155/2012/921604.
  35. Zeanah P, Karen B, and Cartier J. Addressing adverse childhood experiences: It’s all about relationships. Societies. 2018; 8(4):115. doi: 10.3390/soc8040115.
  36. Pienaar A, Swanepoel Z, van Rensburg H, Heunis C. A qualitative exploration of resilience in pre-adolescent AIDS orphans living in a residential care facility. Sahara J. 2011; 8(3):128-37. doi: 10.1080/17290376.2011.9724995.
  37. Rouski C, Knowles SF, Sellwood W, Hodge S. The quest for genuine care: A qualitative study of the experiences of young people who self-harm in residential care. Clin Child Psychol Psychiatry. 2021; 26(2):418-429. doi: 10.1177/1359104520980037.
  38. Hiller RM, Halligan SL, Meiser-Stedman R, Elliott E, Rutter-Eley E, Hutt T. Coping and support-seeking in out-of-home care: A qualitative study of the views of young people in care in England. BMJ Open. 2021; 11(2):e038461. doi: 10.1136/bmjopen-2020-038461.