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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Nothing can defeat combined hands (Abashize hamwe ntakibananira): Protective Processes and Resilience in Rwandan Children and Families Affected by HIV/AIDS</title><author><name sortKey="Betancourt, Theresa Stichick" sort="Betancourt, Theresa Stichick" uniqKey="Betancourt T" first="Theresa Stichick" last="Betancourt">Theresa Stichick Betancourt</name><affiliation><nlm:aff id="A1">Department of Global Health and Population/François-Xavier Bagnoud Center for Health and Human Rights at the Harvard School of Public Health, Boston, MA, USA</nlm:aff></affiliation></author><author><name sortKey="Meyers Ohki, Sarah" sort="Meyers Ohki, Sarah" uniqKey="Meyers Ohki S" first="Sarah" last="Meyers-Ohki">Sarah Meyers-Ohki</name><affiliation><nlm:aff id="A2">François-Xavier Bagnoud Center for Health and Human Rights at the Harvard School of Public Health, Boston, MA, USA</nlm:aff></affiliation></author><author><name sortKey="Stulac, Sara N" sort="Stulac, Sara N" uniqKey="Stulac S" first="Sara N." last="Stulac">Sara N. Stulac</name><affiliation><nlm:aff id="A3">Partners In Health, Rwinkwavu, Rwanda</nlm:aff></affiliation></author><author><name sortKey="Barrera, Elizabeth" sort="Barrera, Elizabeth" uniqKey="Barrera E" first="Elizabeth" last="Barrera">Elizabeth Barrera</name><affiliation><nlm:aff id="A4">Independent consultant</nlm:aff></affiliation></author><author><name sortKey="Mushashi, Christina" sort="Mushashi, Christina" uniqKey="Mushashi C" first="Christina" last="Mushashi">Christina Mushashi</name><affiliation><nlm:aff id="A5">Partners In Health, Rwinkwavu, Rwanda</nlm:aff></affiliation></author><author><name sortKey="Beardslee, William R" sort="Beardslee, William R" uniqKey="Beardslee W" first="William R." last="Beardslee">William R. Beardslee</name><affiliation><nlm:aff id="A6">Children's Hospital, Boston, MA, USA</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21840634</idno><idno type="pmc">3162991</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3162991</idno><idno type="RBID">PMC:3162991</idno><idno type="doi">10.1016/j.socscimed.2011.06.053</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">001194</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001194</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Nothing can defeat combined hands (Abashize hamwe ntakibananira): Protective Processes and Resilience in Rwandan Children and Families Affected by HIV/AIDS</title><author><name sortKey="Betancourt, Theresa Stichick" sort="Betancourt, Theresa Stichick" uniqKey="Betancourt T" first="Theresa Stichick" last="Betancourt">Theresa Stichick Betancourt</name><affiliation><nlm:aff id="A1">Department of Global Health and Population/François-Xavier Bagnoud Center for Health and Human Rights at the Harvard School of Public Health, Boston, MA, USA</nlm:aff></affiliation></author><author><name sortKey="Meyers Ohki, Sarah" sort="Meyers Ohki, Sarah" uniqKey="Meyers Ohki S" first="Sarah" last="Meyers-Ohki">Sarah Meyers-Ohki</name><affiliation><nlm:aff id="A2">François-Xavier Bagnoud Center for Health and Human Rights at the Harvard School of Public Health, Boston, MA, USA</nlm:aff></affiliation></author><author><name sortKey="Stulac, Sara N" sort="Stulac, Sara N" uniqKey="Stulac S" first="Sara N." last="Stulac">Sara N. Stulac</name><affiliation><nlm:aff id="A3">Partners In Health, Rwinkwavu, Rwanda</nlm:aff></affiliation></author><author><name sortKey="Barrera, Elizabeth" sort="Barrera, Elizabeth" uniqKey="Barrera E" first="Elizabeth" last="Barrera">Elizabeth Barrera</name><affiliation><nlm:aff id="A4">Independent consultant</nlm:aff></affiliation></author><author><name sortKey="Mushashi, Christina" sort="Mushashi, Christina" uniqKey="Mushashi C" first="Christina" last="Mushashi">Christina Mushashi</name><affiliation><nlm:aff id="A5">Partners In Health, Rwinkwavu, Rwanda</nlm:aff></affiliation></author><author><name sortKey="Beardslee, William R" sort="Beardslee, William R" uniqKey="Beardslee W" first="William R." last="Beardslee">William R. Beardslee</name><affiliation><nlm:aff id="A6">Children's Hospital, Boston, MA, USA</nlm:aff></affiliation></author></analytic><series><title level="j">Social science & medicine (1982)</title><idno type="ISSN">0277-9536</idno><idno type="eISSN">1873-5347</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p id="P1">In Rwanda, the dual vectors of HIV and legacy of the 1994 genocide have had devastating consequences for children and families. In this and other low-resource settings, extreme poverty, poor access to services, family conflict, and other adversities put children and families affected by HIV/AIDS at increased risk of mental health problems. However, even in the face of tremendous hardship, many children and families demonstrate better than expected outcomes. To design interventions that harness these natural sources of resilience, greater knowledge of local protective processes is needed. This study used free listing exercises (N=68) and key informant interviews (N=58) with adults and children (ages 10-17) to investigate strengths and sources of resilience in Rwandan children and families at risk for psychosocial difficulties due to HIV/AIDS. Clinician key informants (N=10) were also interviewed. Five forms of protective resources emerged through this research: perseverance (<italic>kwihangana</italic>); self-esteem/self-confidence (<italic>kwigirira ikizere</italic>); family unity/trust (<italic>kwizerana</italic>); good parenting (<italic>kurera neza</italic>) and collective/communal support (<italic>ubufasha abaturage batanga</italic>). Operating within individual, family, and collective/community systems, these resources support children at multiple ecological levels. Study evidence suggests that these protective processes provide “leverage points” for strengths-based interventions designed to increase resilient outcomes and prevent mental health problems. This information on culturally-appropriate practices for building resilience, along with input from local community advisory boards and the government, has informed the development of a Family Strengthening Intervention, which has broad applications to many forms of adversity and trauma.</p></div></front></TEI><pmc article-type="research-article" xml:lang="en"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8303205</journal-id><journal-id journal-id-type="pubmed-jr-id">7517</journal-id><journal-id journal-id-type="nlm-ta">Soc Sci Med</journal-id><journal-title-group><journal-title>Social science & medicine (1982)</journal-title></journal-title-group><issn pub-type="ppub">0277-9536</issn><issn pub-type="epub">1873-5347</issn></journal-meta><article-meta><article-id pub-id-type="pmid">21840634</article-id><article-id pub-id-type="pmc">3162991</article-id><article-id pub-id-type="doi">10.1016/j.socscimed.2011.06.053</article-id><article-id pub-id-type="manuscript">NIHMS313992</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Nothing can defeat combined hands (Abashize hamwe ntakibananira): Protective Processes and Resilience in Rwandan Children and Families Affected by HIV/AIDS</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Betancourt</surname><given-names>Theresa Stichick</given-names></name><email>Theresa_Betancourt@harvard.edu</email><xref rid="A1" ref-type="aff">1</xref></contrib><contrib contrib-type="author"><name><surname>Meyers-Ohki</surname><given-names>Sarah</given-names></name><email>smeyers@hsph.harvard.edu</email><xref rid="A2" ref-type="aff">2</xref></contrib><contrib contrib-type="author"><name><surname>Stulac</surname><given-names>Sara N.</given-names></name><email>sstulac@pih.org</email><xref rid="A3" ref-type="aff">3</xref></contrib><contrib contrib-type="author"><name><surname>Barrera</surname><given-names>Elizabeth</given-names></name><email>amyebarrera@gmail.com</email><xref rid="A4" ref-type="aff">4</xref></contrib><contrib contrib-type="author"><name><surname>Mushashi</surname><given-names>Christina</given-names></name><email>mchrisy3@gmail.com</email><xref rid="A5" ref-type="aff">5</xref></contrib><contrib contrib-type="author"><name><surname>Beardslee</surname><given-names>William R.</given-names></name><email>William.Beardslee@childrens.harvard.edu</email><xref rid="A6" ref-type="aff">6</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Global Health and Population/François-Xavier Bagnoud Center for Health and Human Rights at the Harvard School of Public Health, Boston, MA, USA</aff><aff id="A2"><label>2</label>François-Xavier Bagnoud Center for Health and Human Rights at the Harvard School of Public Health, Boston, MA, USA</aff><aff id="A3"><label>3</label>Partners In Health, Rwinkwavu, Rwanda</aff><aff id="A4"><label>4</label>Independent consultant</aff><aff id="A5"><label>5</label>Partners In Health, Rwinkwavu, Rwanda</aff><aff id="A6"><label>6</label>Children's Hospital, Boston, MA, USA</aff><author-notes><corresp id="FN1">Corresponding Author: Theresa Betancourt, Department of Global Health and Population/François-Xavier Bagnoud Center for Health and Human Rights at the Harvard School of Public Health, Boston, MA, USA, 651 Huntington Avenue, Boston, MA 02115, ph (617) 432-5003, fax (617) 432-4310, <email>Theresa_Betancourt@harvard.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>10</day><month>8</month><year>2011</year></pub-date><pub-date pub-type="epub"><day>23</day><month>7</month><year>2011</year></pub-date><pub-date pub-type="ppub"><month>9</month><year>2011</year></pub-date><pub-date pub-type="pmc-release"><day>1</day><month>9</month><year>2012</year></pub-date><volume>73</volume><issue>5</issue><fpage>693</fpage><lpage>701</lpage><permissions><copyright-statement>© 2011 Elsevier Ltd. All rights reserved.</copyright-statement><copyright-year>2011</copyright-year></permissions><abstract><p id="P1">In Rwanda, the dual vectors of HIV and legacy of the 1994 genocide have had devastating consequences for children and families. In this and other low-resource settings, extreme poverty, poor access to services, family conflict, and other adversities put children and families affected by HIV/AIDS at increased risk of mental health problems. However, even in the face of tremendous hardship, many children and families demonstrate better than expected outcomes. To design interventions that harness these natural sources of resilience, greater knowledge of local protective processes is needed. This study used free listing exercises (N=68) and key informant interviews (N=58) with adults and children (ages 10-17) to investigate strengths and sources of resilience in Rwandan children and families at risk for psychosocial difficulties due to HIV/AIDS. Clinician key informants (N=10) were also interviewed. Five forms of protective resources emerged through this research: perseverance (<italic>kwihangana</italic>); self-esteem/self-confidence (<italic>kwigirira ikizere</italic>); family unity/trust (<italic>kwizerana</italic>); good parenting (<italic>kurera neza</italic>) and collective/communal support (<italic>ubufasha abaturage batanga</italic>). Operating within individual, family, and collective/community systems, these resources support children at multiple ecological levels. Study evidence suggests that these protective processes provide “leverage points” for strengths-based interventions designed to increase resilient outcomes and prevent mental health problems. This information on culturally-appropriate practices for building resilience, along with input from local community advisory boards and the government, has informed the development of a Family Strengthening Intervention, which has broad applications to many forms of adversity and trauma.</p></abstract><kwd-group><kwd>Rwanda</kwd><kwd>HIV/AIDS</kwd><kwd>children and adolescents</kwd><kwd>mental health</kwd><kwd>resilience</kwd></kwd-group><funding-group><award-group><funding-source country="United States">National Institute of Mental Health : NIMH</funding-source><award-id>K01 MH077246-01A2 || MH</award-id></award-group></funding-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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