Resilience in families with a member with chronic pain: a mixed methods study

Aims and objective. To measure and explore between 2007–2010 measure and explore the nature of family resilience in the context of families with a member with chronic pain. Background. Chronic pain impacts on the entire family. The literature suggests that it is possible to strengthen resilience in individuals with chronic conditions, but little is known about the impact of chronic pain on family resilience. Design. A explanatory sequential mixed method study was undertaken. Methods. In the initial quantitative phase, assessment measures were administered using the Connor‐Davidson Resilience Scale, Family Impact of Pain Scale, Medical Outcomes Study Short Form 36 and Medical Outcomes Study Social Support Survey. Data were collected and analysed from 31 family cases (n = 67 participants). In the second, qualitative phase, follow‐up semi‐structured interviews were undertaken with 10 families to help explain the quantitative results. Results. The impact of pain on the family was high overall, but the perceived impact was greater for the person with pain. Resilience scores were above average for both the person with pain and other family members. However, the person with pain scored lower on the resilience scale than other members of the family. The families scored high for social support overall, while the person with pain perceived they had greater support than their family members. Conclusions. Identifying the strengths or resilient properties inherent in families and using those strengths in the planning and implementation of care, especially of chronic conditions such as chronic pain, is pivotal to quality health outcomes. Relevance to clinical practice.  It is important that nurses and healthcare professionals include family members when planning and delivering care for persons with chronic pain. Identification of strengths within families can help tailor nursing interventions to meet family needs.     

Critical times for families with a chronically ill child

Parents identified difficult times in caring for their chronically ill children. A model describing these critical times was developed through an analysis of parent interviews. Predicting these critical times enables the health care team to optimize and maximize the effectiveness of their interventions.     

基于家庭照顾者视角下结直肠癌家庭的家庭弹性现状及影响因素分析

目的：以家庭照顾者为视角探讨结直肠癌家庭的家庭韧性现状及影响因素。方法：便利抽取云南省某三甲肿瘤专科医院结直肠外科的327名结直肠癌患者的家庭照顾者作为研究对象,使用一般人口信息学问卷、家庭韧性评估量表（FRAS）进行调查。结果：家庭照顾者视角下的结直肠癌家庭的FRAS得分为（147.08±13.91）分;多元线性回归分析显示,照顾者的文化程度、是否为家庭主要经济支柱、照顾技能的掌握程度、社会支持、照顾负担以及患者有无其它治疗（如靶向治疗、中医治疗、免疫治疗等）是其家庭韧性的主要影响因素（P<0.05）。结论：基于家庭照顾者视角下结直肠癌家庭的家庭韧性处于中等偏上水平,医护人员在关注结直肠癌患者的同时,需及时对其家庭照顾者进行家庭韧性评估和针对性干预,以促进家庭的适应和恢复。     

意识障碍病人家庭照顾者家庭抗逆力研究进展

综述家庭抗逆力的概念、测量工具,解释家庭照顾者家庭抗逆力研究的生物-心理-社会意义,分析意识障碍病人家庭照顾者的压力源、家庭抗逆力的风险因素与保护因素、干预措施,以期为开展意识障碍病人家庭照顾者家庭抗逆力干预研究提供参考。     

I am not alone: spirituality of chronically ill rural dwellers.

Spirituality plays a vital role in adjusting to chronic illness and rehabilitation nurses strive to gain understanding of their patients' spirituality in order to improve patient care and outcomes. The purpose of this qualitative study was to explore the nature of spirituality in chronically ill rural dwellers and how it relates to their illness. As a part of this pilot project, 10 women with chronic illness volunteered to participate in a phone interview to discuss their spirituality. Content analysis was used to analyze the data. The theme Means the World to Me described what spirituality meant to participants. The following themes described how spirituality related to chronic illness: I Am Not Alone, Putting on a Happy Face, Others Are Worse Off, Transcending Despair and Letting Go. Participants were able to use spiritual coping measures to transcend despair. Results from this study provide rehabilitation nurses with insight into the spirituality needs of chronically ill rural-dwelling women.     

癌症患者家庭适应性与家庭坚韧力、社会支持的相关研究

目的调查癌症患者家庭的适应性现状,结合家庭韧性理论探讨癌症患者家庭适应性与家庭坚韧力、社会支持的相关性。方法采用一般资料调查表、家庭适应性量表、家庭坚韧力量表和社会支持评定量表对130例癌症患者家庭进行问卷调查。结果癌症患者家庭适应性得分为(49.55±5.93)分,低于国内常模(P0.05)。癌症患者家庭适应性与家庭坚韧力总分及各维度、社会支持总分及各维度均呈正相关。结论癌症患者家庭的适应水平较低,应加强对癌症患者家庭适应性的关注;提高其家庭坚韧力和社会支持水平,可促进家庭的积极适应。     

'The intruder': spouses' narratives about life with a chronically ill partner

Aim. The aim of this study was to illuminate the meaning of middle‐aged spouse's experiences of living with a chronically ill partner. A purposive sample of four female spouses was selected for interviews using a narrative approach. Background. When someone is diagnosed with a chronic illness, it is easy to understand that a considerable number of devastating consequences follow, both for the afflicted as well as for the family. Families often feel neglected and that their problems and needs are underestimated, if they do not personally draw attention to this fact. Methods. A phenomenological hermeneutic method, inspired by the philosophy of Ricoeur, was used when interpreting the interview text. Results. The experiences of spouses living with a chronically ill partner often brought a feeling of detachment from their partner's lives. The women experienced changes in their relationships because of their partners’ disabilities; they had emotions of loneliness, despite living together as a couple. Through their actions, the women sought reassurance and support in order to maintain a meaningful partnership with their spouses and this is expressed in three themes: feelings of limitation, the struggle of everyday life and a striving for normalization. Conclusions. Middle‐aged women living with a chronically sick partner are still of an active disposition and regard themselves as still being in mid‐life. They wish to be loved as a wife and not as a care provider. Relevance to clinical practice. The findings from this study can help increase the knowledge and understanding of the problems and concerns encountered by middle‐aged spouses living with chronically ill partners and can be useful in the education and supervision of nurses and in relationship with relatives.     

Nurse resilience: A concept analysis

Nurse resilience is attracting increasing attention in research and practice. Possession of a high level of resilience is cited as being crucial for nurses to succeed professionally and manage workplace stressors. There is no agreed definition of nurse resilience. A concept analysis was undertaken to examine nurse resilience using a priori selected analysis framework. This concept analysis aims to systematically analyse resilience as it relates to nurses and establish a working definition of nurse resilience. Sixty‐nine papers met the search criteria for inclusion. Key attributes of nurse resilience were social support, self‐efficacy, work–life balance/self‐care, humour, optimism, and being realistic. Resilience enables nurses to positively adapt to stressors and adversity. It is a complex and dynamic process which varies over time and context and embodies both individual attributes and external resources. Sustaining nurse resilience requires action and engagement from both individuals and organizations.     

Families' needs when a child is long-term ill: a literature review with reference to nursing research

This article reports a literature review which draws together findings targeting families' needs when a child is long-term ill. The databases PubMed and CINHAL were searched from 1999 to 2003 during February 2004. The search terms were child health care, family caregivers, and needs and combinations of these. The search was limited to articles published in English and the Scandinavian languages. The analysis entailed a series of comparisons across articles focusing on major areas of inquiry and patterns of results. Various levels of needs are described, based on individual, family and social needs.     

Technology-dependent children and their families: a review

Background. Advances in medical technology and nursing care have enabled children who rely on long‐term medical and technical support to reunite with their families and community. The impact of discharging these children into the community involves a number of unprecedented social implications that warrant policy consideration. To begin with, an effort must be made to understand the phenomenon of caring for technology‐dependent children living at home. Aim. The aim of this paper is to provide a comprehensive literature review on caring for technology‐dependent children living at home. Methods. The review was conducted via keyword searches using various electronic databases. These included CINAHL, MEDLINE, Social Science Index, Sociological Abstracts, Australian Family and Society Abstracts, and the Australian Bureau of Statistics. The articles and books found were examined for commonality and difference, significant themes were extracted, and the strength of the research methods and subsequent evidence were critiqued. Findings. In this paper, themes relating to home care for technology‐dependent children and their families are elucidated and summarized. These are: chronic illness and children; the impact of paediatric home care on children; the uniqueness of technology‐dependent children and their families; and parents’ experience of paediatric home care. Discussion. Contentious issues, relevant to the social life of these children and their families, are raised and are discussed with the intention of extending awareness and provoking further debate among key stakeholders. These issues include: the changed meaning of home; family dynamics; social isolation; saving costs for whom?; shifts in responsibility; and parent–professional relationships. Conclusion. More research is needed in the arena of paediatric home care, to facilitate relevant policy formation and implementation.     

Chronic illness: the importance of support for families caring for a child with cystic fibrosis

• ? The effect of chronic life-threatening illness on the family is one of the major problems confronting the health-care system today. Increasingly, parents have the major responsibility for the daily management of their child's condition.
• ? There is evidence that many parents lack the pofessional help and support which could ameliorate some of their problems. It is important that nurses have an understanding of how families cope with the burden of caring for a chronically ill child.
• ? Health professionals need clear guidelines on how to support these families in their role as primary care-givers.
• ? This paper examines how families of children with cystic fibrosis adapt to the illness in order to provide indicators for nursing practice and to enhance the care and support provided for these families.
• ? Effective coping strategies include: assigning meaning to the illness, sharing the burden, denial of diagnosis and incorporating therapy in a schedule.