Evaluation of Memory Book Interventions with Orphaned Children in India, Kenya and South Africa

Purpose

The purpose of this collaborative multi-site research study was to explore and compare the lived experiences of orphaned children in India, Kenya and South Africa who have utilized the Memory Book intervention.

Background

Circumstances leading to an orphaned state were related to HIV/AIDS or abandonment due to poverty, disease or war. Traditional models for surrogate parenting by extended families have been strained by the frequent loss of one or both parents of affected children resulting in the need for alternative care models such as orphanages. Orphaned children have sustained many threats to their holistic health, including the loss of precious family memories, severed family relationships, and potential significant paralysis in development due to loss and grief. The Memory Book was developed and implemented in 2005 by a nurse leader, with a supportive volunteer base, in a northwestern city in the United States. The books were implemented to facilitate orphaned children in "telling their story" and to foster their sense of well-being and resilience.

Methods

A qualitative phenomenological approach was implemented to evaluate the Memory Book intervention in six children's homes in these three countries. Following university institutional ethics review board approval in the United States, separate focus group interviews with children (n = 65) and their caregivers (n = 6) were conducted. Following data saturation with multiple focus groups at the identified international sites, data were analyzed based on a constant comparison method for narrative themes.

Results

Study findings offer evidence to support the ability of children to work through loss and grief when they are assisted in preserving and telling their story through the use of Memory Books. Common themes offered by orphans between the six sites as a result of the intervention included support for their identity, awareness of family or relationships, and emotional expressions.

Implications

The Memory Book intervention assisted children to chronicle their lives and demonstrated the potential to guide future interventions for orphaned children by care providers, nurses and other healthcare providers in this context.