Keller, Kathryn B.

Second generation Haitian Americans have a unique set of challenges created by the fluid balancing of three cultures. This group has to be able to understand and function appropriately between the American culture, Black American culture, and the Haitian culture. Balancing and living in between multiple cultures while trying to grow in autonomy and adulthood can affect the mental health of emerging adults. Youth transitioning into adulthood struggle with gaining independence while finding their way in their identity. This stress coupled with cultural expectations are increasing stress levels in this population and age group. This study implemented a mixed methods approach to explore if acculturative stress had an effect on the mental health of second generation Haitian Americans. Also, explored in this study is the degree of stress experienced by this population. Resulting themes revealed that Haitian parents and culture were strict, a dual identity, and lack of awareness/ support for mental health in the culture were stressors. Themes of admiration for the Haitian culture and resiliency serve as possibilities as to why many continued to be educated members of society.

The continued development of the American health care system and evolving
technology have led to an increased life expectancy within the general population. In fact, these advancements have also resulted in growing numbers of young people with chronic illnesses living into adulthood. Approximately one third of children ages 10-17 have a chronic disease, and the vast majority of these children will survive beyond their 20th birthday (Blum, 1995; Lotstein, McPherson, Strickland, & Newacheck, 2005; White,
2002). The main objective of this study was to explore the healthcare transition (HCT)
practices of health care providers and the HCT experiences of chronically ill young adults living with sickle cell disease, cystic fibrosis, and/or diabetes. Meleis, Sawyer, Im,
Hifinger Messias, & Schumacher’s (2000) theory on transition and Boykin and
Schoenhofer’s (2001) theory of Nursing as Caring provided the theoretical lenses throughwhich study findings were viewed. This was a descriptive exploratory mixed methods design that consisted of survey data and used conventional content analysis to analyze the qualitative data. The quantitative portion of this study incorporated a 41-question survey that was completed by 33 health care providers working with chronically ill young adults in the southeast Florida region. Additionally, semi-structured interviews were conducted with eight young adults (18-24 years of age) living with a sickle cell disease, cystic fibrosis, and/or diabetes. Five themes emerged from an analysis of the data describing the healthcare transition (HCT) experience: Transition Confusion, Familial Reliance, Lost in Transition, Fiscal Stressors, and Transition Uneasiness. The findings of this study demonstrate that there are, at minimum, three general parts of the HCT process that remain deficient: educational preparation, consistent communication between all parties involved in the HCT process, and guidance for the independent negotiation of the present healthcare system.
Recommendations for healthcare providers that work with chronically ill young
adults include establishing a HCT framework that incorporates consistent communication among team members and patients/families, individualized educational formats, and guidance for navigational skills to negotiate the healthcare system.