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 Role of Family Structure, Functioning, and Pain Modeling in Headache

In an initial attempt to examine relationships between family functioning and chronic headache disorders, the present study examined: a) family structure characteristics, b) family functioning, and c) family pain modeling. Subjects completed an assessment battery consisting of several measures of family functioning. Analyses showed that migraine sufferers (N = 42) as compared to headache-free controls (N = 59) were more likely to describe their families as emphasizing clear organization, structure, rules, and overall control, but less likely to encourage emotional expression. No differences were found between tension headache subjects (N = 43) and headache-free controls. While only an initial exploration of the importance of family characteristics in chronic headache, these results suggest that there are important differences in headache subjects' (particularly migraine) reports of family environment and functioning.     

A family empowerment program for families having children with thalassemia,Thailand

The purpose of this quasi‐experimental design study was to examine the effectiveness of a family empowerment program (FEP) on family functioning and empowerment among 56 families having children with thalassemia. The 26 families in the experimental group received the FEP and usual care, while 30 families in the control group received usual care. Data collection occurred through family functioning and empowerment questionnaires. Between‐group differences were tested with t‐tests and analysis of variance. The result revealed that family caregivers who participated in the FEP had significantly increased family functioning and empowerment scores over time. The FEP can be used as a powerful intervention for assisting families and children with thalassemia and the education of health professionals.     

A cross‐sectional descriptive study of the family functioning,health and social support of hospital patients with family violence backgrounds

Family violence (FV ) has serious effects on the health and well‐being of the family. The health sector plays a vital role in FV prevention by helping to identify abuse early, providing victims with the necessary treatment and referring patients to appropriate care. The aim of the present cross‐sectional study was to describe the prevalence of FV among hospital patients, as well as to assess the association between family functioning, health and social support, considering patients as the perpetrators or victims of violence. The data were collected using a Family Functioning, Health and Social Support (FAFHES ) questionnaire that was given to patients who visited a Finnish central hospital between October 2012 and April 2013. As a result, the data (N = 188) were contributed by the patients who returned the questionnaire and gave permission for a follow‐up survey. The participation rate was 47%, of which 73% were women and 27% were men. Their ages ranged from 18 to 89 years. The data were analysed with quantitative methods using the unadjusted analyses and linear regression model. In total, 24% of both the male and female participants had experienced or used violence at home or in the family. Of these, 22 had been the perpetrators, and 23 had been the victims. Participants in relationships and who were living together had less violence than singles and those who were not living together. The family functioning and health of the participants who had experienced or used FV were worse than those of the participants who had not. Various patients can have an FV background, and nursing professionals are on the front line to identify and intervene in FV situations. The results of this study can be utilised in the treatment of FV victims and perpetrators by training healthcare workers to identify and intervene in violence.     

Screening for Hematuria,Glucosuria and Proteinuria in People Aged 55-64 Technical,Clinical and Cost-benefit Experience from a Pilot Study

Objective. To identify the attitudes and perspectives of the family physician towards the caregivers of demented relatives and to describe the caregivers’ satisfaction. Design. Systematic review. Subjects. The studied population consisted of dementia family and their general practitioners. Main outcome measures. Outcome measures were the generic tasks and skills of the general practitioner to improve home care from the perspective of the family caregiver. Caregivers were assessed on satisfaction regarding the care provided by their general practitioner. Results. The general practitioner is aware of his/her skills and limits in all aspects of dementia care and his/her role towards the family caregiver. They also acknowledged the importance of an adequate diagnostic process, but they felt uncomfortable disclosing the diagnosis to both the patient and the caregiver. They reported having more confidence in treatment matters than in diagnostic stages. Caregivers’ reports on the attitude of their general practitioner in the diagnostic process were rated from helpful to poorly empathized. General practitioners found themselves to be highly involved in dementia home care, but caregivers rated their involvement to be insufficient. The lack of appropriate communication skills of general practitioners was also not appreciated by the caregivers. A lack of time and reward was considered by the general practitioner to be a major obstacle in dementia care. Conclusion. The key role of general practitioners as care providers and care planners is consolidated by the family caregivers’ confidence in their skills. Clear guidelines from early diagnosis to adequate referrals should improve the ability of the general practitioner to support these time and energy-consuming home-care situations. Intervention studies addressing the gaps in the skills of the general practitioners in dementia home care management could be helpful in supporting the family caregiver.     

Mothers with disabled children: needs,stress levels and family functionality in rehabilitation

This study was planned to investigate the relationship between the needs, stress levels of mothers with disabled children and family functioning in rehabilitation. The study was conducted with 181 mothers in a private rehabilitation centre in eastern Turkey. The personal information form, ‘Family Needs Assessment Tool (FNAT)’, ‘Perceived Stress Scale (PSS)’ and ‘Family Functioning Scale in Rehabilitation (FFSIR)’ were used in the data collection. In the analysis of data number, percentage, mean score, standard deviations, Mann–Whitney U, Kruskal–Wallis tests and Spearman correlation were used. The mean score of the mothers on the whole FNAT was 67.49 ± 1.85; the mean score of them on the PSS was 24.99 ± 4.32; the mean score of them on the FFSIR was 153.98 ± 20.61. It was found that there was a positive correlation between the mean scores of the mothers on the FNAT and PSS while there was a negative correlation between the mean scores of them on the PSS and FFSIR (p < 0.05). There was a significant relationship between the socio-demographic characteristics of the mothers and the PSS and FFSIR (p < 0.05). It was determined that the mothers' information needs were high, they had moderate stress levels, and the family functionality was moderate in rehabilitation. It was concluded that the mothers' stress levels increased as the needs of them increased while their stress levels decreased as the functionality of them increased in rehabilitation.     

Randomized,controlled trial of a brief family‐centred care programme for hospitalized patients with bipolar disorder and their family caregivers

Family interventions have been emphasized in the treatment of bipolar disorder (BPD) due to the bidirectional and entangled relationships between patients and the family system, and have benefits for patients’ symptoms and health; however, the effects of family interventions on family function and caregivers’ health‐related outcomes have not been well investigated. This randomized, controlled trial with 47 hospitalized patients with BPD/family caregiver dyads at a medical centre in northern Taiwan compared the effects of a brief family‐centred care (BFCC) programme with treatment as usual (TAU). All of the family caregivers in two groups were invited to attend a routine 60‐min family discussion group about violence and suicide prevention. The TAU group without specific family interview for patient and family caregiver dyad. In the BFCC group, four 90‐min BFCC programme sessions were additionally provided twice a week for each hospitalized family dyad. We hypothesized that, first, family caregivers in the BFCC group could increase their family function, and second, improve perceived health status and reduce caregiver's burdens compared to the TAU. The results showed that family caregivers in the BFCC group significant interaction effects in overall family function (P = 0.03) and subscale conflict (P = 0.04), communication (P = 0.01), and problem‐solving (P = 0.04), but there were no significant interaction effects on the caregivers’ perceived health status and caregivers’ burdens. Our findings support both the feasibility of using the BFCC programme for inpatients and its specific benefits for family function. An intensive family intervention during hospitalization has been suggested in psychiatric practice to support patients with BPD and family caregivers.     

精神病患者家属心理应激与家庭负担和心理健康状况的相关性研究

目的探讨精神病患者家属的心理应激与家庭负担和心理健康状况的相关性。方法采用焦虑自评量表、抑郁自评量表、简易应对方式问卷、亲属应激量表、疾病家庭负担量表等对128名精神病患者家属进行测评和分析。结果患者家属焦虑和抑郁评分明显高于国内常模,积极应对与消极应对明显低于全国常模,均有统计学意义;患者家属亲属应激量表、疾病家庭负担量表分值均较高,尤其是40岁及以上者,亲属应激量表总分及维度分、焦虑和抑郁评分与疾病家庭负担、家属年龄、住院次数等呈正相关,有统计学意义。结论精神病患者家属存在不同程度的心理应激与心理健康问题,疾病家庭负担较重,心理应激与疾病家庭负担、家属年龄、住院次数等密切相关,需及时进行针对性的健康教育,以提高患者家属的心理健康水平。     

Presenting the model of risk,disability and hard-to-reach families to inform early intervention services

Introduction: Several concepts – risk, resilience, disability and hard-to-reach families in early intervention services – are talked and written about in many ways. Family Stress Theory can be usefully applied to explore these issues systematically.

Problem: The relationship between risk and disability is complex, and the role of resilience is not fully understood. The idea of “hard-to-reach families” is not well defined, thus presenting challenges to service providers and policy makers.

Reflection: This paper presents the Model of Risk, Disability and Hard-to-Reach Families and uses the model to: (1) define the groups of high risk families and families of children with disabilities and explore the concept of resilience within these groups; (2) describe services offered to these groups; and (3) reflect on service use and so-called “hard-to-reach families”. Each section includes suggested applications for service providers that may inform the work done with young children and their families who experience risk or disability.

Conclusion: Service providers can apply the Model of Risk, Disability and Hard-to-Reach Families to consider each family’s unique strengths and challenges, and use those individual elements to influence service recommendations and anticipate service use.

• Implications for rehabilitation

• The concepts of risk, resilience, and hard-to-reach families are poorly defined in the literatures, but have important implications with respect to early childhood intervention services.

• Family Stress Theory can help to identify high-risk families and account for family resilience

• It is important for clinicians, researchers and policy makers to consider the relationship between disability and risk with respect to services offered to families and the potential barriers to service use.

• Clinicians and policy makers have a role in promoting accessible early childhood services

     

Nursing Care of Families With Parents Who Are Lesbian, Gay, Bisexual, or Transgender

TOPIC:  Families in which parents are lesbian, gay, bisexual, or transgender are more diverse than they are similar. The numbers of parents and children in these families appear to be increasing with implications for nurses and other clinicians.
PURPOSE:  This paper reviews the current literature to determine the fundamental issues facing alternate families that include sexual minority parents and their children. It also explores the unique nursing needs of families with gay, lesbian, transgender, or bisexual parents in the field, which are critically examined for direct relevance to psychiatric nursing practice.
SOURCES USED:  Current theoretical and research literature in nursing, child development, family law, and healthcare professional journals.
CONCLUSIONS:  Despite a relative lack of pathology noted in the literature related to families with sexual minority parents, nurses, and other healthcare professionals can incorporate current knowledge of unique child developmental, parenting, and legal issues into their work with these families. Assessments and interventions that address the unique needs of these families may help parents and children to deal with social stress from being perceived as "different" by other children, or as "problematic and threatening" by other parents.     

系统性训练在精神发育迟滞患儿良性行为建立中的应用效果

目的：探讨实施系统性训练对精神发育迟滞患儿良性行为建立的效果。方法：以便利抽样法选取住院中度精神发育迟滞患儿(以下简称患儿)30例为研究对象。根据其性别及年龄的不同将其分为男生 (6-11岁)、女生 (6-11岁)、男生 (12-17岁)、女生 (12-17岁)组,每组均给予良性行为训练和负性情绪疏导及亲情角色互动的系统性干预,为期6个月。采用儿童行为量表(CBCL)进行基线、第2、4、6个月效果评定。结果：各年龄组患儿CBCL自身前后总分比较具有统计学意义,其中各因子分发生率明显下降(P<0.05)。结论：通过系统性行为训练同时增加亲情角色互动,能有效纠正患儿的不良行为和提高其生存质量。     

The experience of becoming a grandmother to a premature infant – a balancing act,influenced by ambivalent feelings

Aims and objectives. To explore and describe the experience of becoming a grandmother to a premature infant. Background. Becoming a grandmother involves a new perspective of life. Grandmothers of sick infants find themselves in a new situation with an adult child undergoing serious stress. Few studies have approached the grandmothers’ own experience of becoming a grandmother to a premature infant. Design. A qualitative content analysis was used. Methods. Eleven women, 52–66 years of age, who were grandmothers to premature infants born at a gestational age of 25–34 weeks, were interviewed during 2010. The infants were less than three years old at the time of the interview. The interviews were analysed with qualitative content analysis. Results. The overall theme was a balancing act. Two categories of experience were identified: emotional experiences and a new role. ‘Emotional experiences’ was related to the first meeting, ambivalent feelings and confidence in care. ‘A new role’ was related to the subcategories supportive, a balance of involvement and limitations. Conclusions. To become a grandmother to a premature infant was experienced as a balancing act influenced by ambivalent feelings of joy, fear and worry. The grandmothers sensed the seriousness of the situation at the same time as they wanted to be happy about the newborn infant. They worried about their adult child’s as well as the premature infant’s health but put their own needs aside. The grandmothers’ new role was a balance between being involved and supportive without disturbing. Relevance to clinical practice. Neonatal intensive care unit staff should be open to grandmothers’ needs and acknowledge them as an obvious support for the immediate family of a premature infant. The grandmothers need guidance and information about what to expect concerning the infants health, the parents situation and their own role.     

Transition to early parenthood,and family functioning relationships in Japan: a longitudinal study

Greater knowledge of the process by which postpartum parents acquire further awareness of their child and fulfill parental roles will likely lead to an understanding that creates a new approach to nursing. This study explored the transition to parenthood and the relationship between parenthood and family functioning in first‐time mothers and fathers. Seventy‐eight parents (41 mothers, 37 fathers) participated in the study and completed the Scale of Early Childrearing Parenthood and Family Assessment Inventory at birth and at 1, 3, 6, and 12 months postpartum. The levels of parental role attainment and awareness of the child rose dramatically between birth and 3 months postpartum, thereafter stabilizing up to 12 months postpartum. Parenthood and family functioning showed a moderately positive correlation, which gradually became more positive over time. Appropriate nursing interventions might be necessary for parents who show difficulty in accepting their parental roles and have low levels of awareness of their child after 3 months postpartum. Such intervention might be necessary for not only the parents, but also the family unit.     

Family dynamics of families with mental health problems in Finland

This study forms part of the International Family Dynamics Project. Its purpose was describe the family functioning of families with mental health problems on the basis of Barnhill's framework for healthy family systems. The sample consisted of 160 families in which one family member had mental health problems. Both the patients and their relatives took part. The data were collected by questionnaires, i.e. The Family Dynamics Measure and The Family Dynamics Questionnaire. According to the results, mental health patients described family functioning as fairly poor, while relatives described it as fairly good. However, patients' and relatives' perceptions of family functioning did not differ significantly. There were some statistically significant differences between patients' and relatives' perceptions of different family dynamics dimensions. Relatives reported more mutuality (P= 0.006) and clearer communication (P= 0.009) than patients. Older mental health patients reported more isolation than patients under 30. Relatives who mentioned some serious illness in the family reported more role conflict than those who didnt. No differences were found by gender, family structure or education. The results indicated that the mental health problems of a single family member did not impair family dynamics. The study showed that the resources and functioning of families are fairly good in spite of the illness in the family.     

The perceived needs of Jordanian families of hospitalized, critically ill patients

The purpose of this study was to identify needs of Jordanian families of hospitalized, critically ill patients. The Critical Care Family Needs Inventory was introduced to 158 family members who were visiting their hospitalized, critically ill relatives. The findings revealed that > or = 80% of the family members perceived 16 need statements as important or very important. The participants ranked order needs for assurance, information and proximity the highest and needs for support and comfort the lowest. Specifically, the most important needs of the families were to receive information about the patients, to feel that the hospital personnel care about the patients and to have the information given in understandable terms. Results of this study indicated that Jordanian families had specific and identifiable needs. Providing families of critically ill patients clear, simple and updated information about the patients, and assuring them about the quality of care the patients receive, should be essential components of the critical care nursing delivery system.     

Social Networking,Social Support,and Well-being for the Military Spouse

Military spouses experience unique stressors due to service member deployments and frequent relocations. Our purpose is to examine how military spouses use social networking groups, such as Facebook, and determine how this use was related to perceived social support and well-being. We found more frequent Facebook use was associated with decreased well-being compared with those who reported using Facebook less frequently. Practitioners may enhance the care provided to military spouses by inquiring about their circumstances, social media use, and helping them to identify social support services that may mitigate stress and improve well-being.