The death of a parent is one of the most traumatic events a child can experience and is accompanied by a profound and potentially lasting impact on a child's psychosocial well-being. The natural grieving process involves a requisite set of skills, which present specific challenges for children due to their developmental vulnerability (e.g., emotional and intellectual immaturity). In addition to the obstacles to a successful resolution of grief normally faced by children who have lost their parents to any other causes, children orphaned by AIDS may face additional psychological and social challenges including stigmatization, the impending or actual death of the surviving parent, and financial hardship; these challenges may further impede the grieving process, placing these children at heightened risk of prolonged mental and behavioral problems. This proposed investigation brings together an assessment model that integrates research findings from the literatures on bereavement, attachment, as well as risk and resilience to delineate the psychosocial needs of children orphaned by AIDS in China.
The specific aims of the current application include (1) conducting a qualitative assessment (in-depth semi-structured individual interviews) among AIDS orphans, caregivers (surviving parent, orphanage workers, extended family members), community members (neighbors, community leaders, village doctors, local school teachers), and local leaders (at the county, township, and village levels) to explore issues related to the social and cultural context of bereavement and grief among children orphaned by AIDS and the community and caregivers' reaction to these children's psychosocial needs; (2) conducting a quantitative longitudinal psychosocial assessment of both children and their caregivers to determine the extent to which the psychosocial needs of children orphaned by AIDS are different from those of demographically matched comparison children from the same community; and to examine whether these problems are transitory or persistent and how they affect children in later life; and (3) identifying individual and contextual factors that are associated with prolonged episodes of emotional and behavioral problems among children orphaned in China. By identifying risk and resilience factors, both individual and contextual, affecting short-term and long-term psychosocial functioning of children orphaned by AIDS, this study will inform not only future intervention efforts among AIDS bereaved children, but also public policy regarding the care of AIDS orphans globally.
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