Family resiliency during childhood cancer: the father's perspective.

Most studies of childhood cancer have focused on mothers, but few studies have examined the views of fathers on the effects of their child's cancer diagnosis and treatment on the family. The purpose of this study was to explore the resources that help fathers adapt to life after their child's diagnosis using the resiliency model of family stress, adjustment, and adaptation as a framework. Eight fathers whose children had received treatment in a university pediatric oncology clinic in the prior 12 months were interviewed in depth. Data were coded thematically using NVivo. Results indicated that support from extended family, the church, and health care professionals was necessary for fathers to remain positive during their child's illness; spousal and parent-child relationships strengthened; and changes in family life varied based on the composition of the household. Further studies are warranted to better understand how fathers cope, so that pediatric oncology nurses and other health care professionals can provide holistic care that addresses the unique needs of all family members.     

Coping, satisfaction, and the life cycle in families with mentally retarded persons.

The study focused on the variables influencing the functioning of 62 families with MR (mentally retarded) persons, living at home, in various stages of the life cycle. Results demonstrated the importance of some father characteristics to maternal coping skills in two-parent households. Although mean maternal coping scores were not statistically different between two-parent and single-parent households, single mothers' coping skills showed strong negative associations with both the number of children in the household and the age of the mother. This was not true of mothers in two-parent households. Single-parent mothers also appeared to be considerably more dissatisfied with family functioning than mothers in two-parent households. The supportive role of older fathers in mothers' coping in two-parent households also was apparent. Clinical implications of the study point to the need for greater support for mothers of young children with MR, mothers who are sole caregivers, and parents with many children. Differential support to mothers and fathers of an MR person may be required over the life cycle.     

Mothers in postdivorce families caring for a child with cystic fibrosis

This study explored the experiences of mothers of children with cystic fibrosis (CF) in postdivorce family structures. In-depth interviews of mothers were conducted by registered nurses with expertise in CF. Interviews focused on responsibility for care of the CF child within the context of postdivorce families (e.g., extent of nonresidential fathers' involvement in children's care, communication between households). Interviews were audiotaped and transcribed verbatim. The constant comparison method was used for analyzing interview data. Marital transitions contributed to the closeness between mothers and children with CF, but they also added to the mothers' sense of being overwhelmed with responsibilities. It is likely that children and mothers are more at risk for stress-related problems when mothers are overburdened by the demands of caregiving, earning a living, and other responsibilities.     

Psychosocial impact of cystic fibrosis in adolescence

Over 8,000 children, young people and adults in the UK are affected by cystic fibrosis and although no cure exists, comprehensive therapy started early and administered consistently delays disease progression. This article explores three aspects of the psychosocial effects of cystic fibrosis on the adolescent/young adult: the effect on the family, the effect on relationships and adherence to treatment. Much of the early research on the psychosocial impact of cystic fibrosis on the adolescent and the family presented a dismal picture of dysfunction. More recent studies indicate that cystic fibrosis patients generally lead active, age-appropriate social lives, that good information and support can reduce negative effects on families and that treatment regimes continue to cause difficulties for young people. Further research is needed into the psychosocial impact of cystic fibrosis on the increasing numbers of young people and adults with the disease.     

Contemporary psychosocial issues in cystic fibrosis: treatment adherence and quality of life

Summary

This review focuses on the two major psychosocial areas currently topical in cystic fibrosis research: treatment adherence and quality of life. First, the paper discusses the importance of evaluating adherence to treatments and medical advice, its measurement, predictors of adherence and non-adherence and whether the data should be used to inform clinical practice and policy decisions. Second, the purpose of evaluating quality of life in cystic fibrosis and an overview of the data are discussed. Both areas have suffered from problems with terminology and definition, inappropriate methodologies and hence difficulties with data interpretation. Future directions for research are advocated.     

Help for Mothers with Infant Care and Household Tasks: Perceptions of Support and Stress

Abstract This study explored help with infant care and with household tasks from the infant's father and grandparents that mothers reported throughout their infant's first quarter-year, the extent to which help was perceived as a support and its lack as a stressor, and the difference that maternal experience made in holding this view. Participating mothers were interviewed biweekly concerning sources of help with infant care and household tasks (received help), and kept a daily log for the first 90 days after their healthy infant's birth that included supportive (e.g., help with infant care) and stressor (e.g., lack of help with household tasks) events. Received help varied by type (infant care or household help) and by source (father or grandparent). Help with infant care was more frequent than help with household tasks, and help from fathers was more frequent than help from grandparents for all six 15-day study periods. Lack of help was infrequently reported as a stressor, and only in the first 30 days. The discrepancy in number of mothers receiving help from fathers with infant care and household tasks and mothers perceiving help from them as supportive was significant in the last three study periods. Parity did not significantly affect either received or supportive help from fathers; however, with time fathers' supportive help with household tasks decreased. Study of mothers' expectations for help with infant care and household tasks from fathers and grandparents is needed to clarify these findings.     

First‐time fathers’ experiences of professional support from child health nurses

Nowadays, in Sweden, fathers are expected to be active in their father role and to share caring responsibilities for their children equally with mothers. This active role of a father in a family can be challenging, especially for the first‐time fathers. Child health nurses’ support is an important factor for fathers to become confident caregivers. The Father Perceived Professional Support scale (FaPPS scale) can be used in nursing practice for better understanding father's needs of professional support. The aim of this study was to describe first‐time fathers’ experiences of the professional support received from child health nurses and to validate the instrument: ‘FaPPS scale’. A qualitative design, with inductive and deductive approaches, was used in this study. Twelve first‐time fathers participated in the semi‐structured interviews, thereafter grading the FaPPS scale items and commenting on them. The fathers experienced nurses’ support positively when nurses provided practical information and stimulated them to be involved in care of their children. In contrast, the support was experienced negatively because of nurses’ lack of commitment, availability and adaptation to the fathers’ individual needs. The fathers also felt inequality between the support received by fathers and by mothers. Although some fathers perceived it as negative, others considered it fair, believing that mothers needed more support. In addition, fathers expect nurses to actively offer support to them and supervise them in childcare. The fathers also needed meeting other parents, for example in parental groups. This study also indicates that FaPPS scale can be used both in research and clinical practice, though still needing further development.     

Differences in stress and coping for mothers and fathers of children with Asperger's syndrome and nonverbal learning disorders

Research conducted on families of children with disabilities shows that family cohesion and positive family outcomes are influenced by how mothers and fathers cope with raising their child with disabilities. This study was designed to examine stress and coping differences between mothers and fathers (n = 103) of children with Asperger's syndrome (AS) and nonverbal learning disorders (NLD). A repeated measure design was used to compare how mothers and fathers cope with caring for a particular child to control for differences in the severity and nature of the disability across children. Few studies that compare mothers and fathers do so at the couple level. Responses indicated that mothers had higher rates of stress related to family problems and pessimism about their child's future, higher rates of antidepressant use, and higher rates of therapy use than did fathers. Mothers found some coping strategies more helpful than fathers did. Maternal education and child's age also were related to some stress and coping variables. Implications for nurses and future research are discussed.     

Family functioning when children have cystic fibrosis.

The purpose of this study was to compare family functioning between 32 mothers with a child who had been diagnosed with cystic fibrosis (Group 1) and 32 mothers with a child who did not have cystic fibrosis (Group 2). The children's ages ranged from 4 months to 3 years. The mothers' perceptions of their family's functioning was measured by the Feetham Family Functioning Survey. There were no significant differences found between the groups on the total score of the Feetham Family Functioning Survey. Both groups of mothers reported that they were quite satisfied with their family functioning.     

Family training: supporting mothers and fathers in the transition to parenthood

This study discusses the views of mothers and fathers on family training and on how family training supports them in the transition to parenthood The data were collected in 1993, using a questionnaire submitted about 9 weeks after the birth of a child The same questions were asked of the 189 mothers and the 127 fathers who replied According to the results both mothers and fathers consider it essential that their views and expectations are given due attention in the planning of family training Specific issues that were thought to require priority attention in family training were the actual process of childbirth, themes related to parenthood, pain alleviation during labour, and abnormal childbirth Less importance was attached to the themes of sex, contraception and certain aspects of health education Both mothers and fathers agreed that they had had ample opportunity to talk with their group leaders and that there had been enough lectures By contrast, it was widely felt that there was not sufficient opportunity to talk with other group members It is suggested that efforts be continued to further develop family training schemes so that they offer not only more support to families but also better opportunities for open discussion     

Caring for children with cystic fibrosis: a collaborative clinical and school approach.

Earlier diagnosis and more effective treatments have improved both morbidity and mortality associated with cystic fibrosis, making regular school attendance a reality. School nurses have a unique opportunity to assist students with cystic fibrosis successfully manage their disease. Medical treatment for cystic fibrosis can be complex, leaving students and families in need of health consultation and support. The clinic and school nurse each brings a unique perspective to cystic fibrosis care management. Working to understanding perspectives across settings and looking for ways to collaborate through mutual planning and goal setting is an ideal way to support families and promote achievement of optimal health status for students.     

Postpartum depression is a family affair: addressing the impact on mothers, fathers, and children

The purpose of this paper is to present research on the effects of postpartum depression (PPD) on mothers, fathers, and children that point to a re-conceptualization of PPD as a mental health condition that affects the whole family. As such, the objectives of this paper are to discuss: (1) the incidence and effects of PPD on mothers and fathers; (2) common predictors of PPD in mothers and fathers, and (3) the effects of PPD on parenting and parent-child relationships, and (4) the effects of PPD on children's health, and their cognitive and social-emotional development. Finally, the implications for screening and intervention if depression is re-conceptualized as a condition of the family are discussed.     

The needs, concerns and coping of mothers of children with cystic fibrosis

The questionnaire CICI:PQ for measuring needs, concerns and coping of parents of chronically ill children was mailed to 85 families with children with cystic fibrosis (CF). Some questions about the parents' experiences of the health care system were also included. Fifty-four per cent responded--in all cases but two the mothers. More than half of the mothers wanted help with or opportunities to discuss the state of health and the emotional development of the child and dietary issues. Many of them were concerned about the child's future. Shortage of time was another problem. The coping strategies used when having problems with the child were partly different from those used when problems arose with the partly different from those used when problems arose with the spouse. Most mothers were satisfied with the hospital care and the CF paediatrician. They wanted further support from the physiotherapist and many of them missed a CF nurse. The project illuminated many areas for further investigation.     

Postpartum Depression is a Family Affair: Addressing the Impact on Mothers,Fathers, and Children

The purpose of this paper is to present research on the effects of postpartum depression (PPD) on mothers, fathers, and children that point to a re-conceptualization of PPD as a mental health condition that affects the whole family. As such, the objectives of this paper are to discuss: (1) the incidence and effects of PPD on mothers and fathers; (2) common predictors of PPD in mothers and fathers, and (3) the effects of PPD on parenting and parent-child relationships, and (4) the effects of PPD on children's health, and their cognitive and social-emotional development. Finally, the implications for screening and intervention if depression is re-conceptualized as a condition of the family are discussed.     

Understanding treatment adherence in affective disorders: a qualitative study

The objective of this study was to explore the perspective of depressed patients, their family and mental health professionals from their community mental health centre (CMHC) on factors related to treatment adherence. We conducted eight separate focus groups involving patients, their families and their therapists from three CMHCs. A total of 52 persons were involved. The groups explored patients' and family's explanatory model of depression, perceptions about the course of the disease, the role of medication and other treatments, the main causes of non-adherence, and interventions which would help increase it. Patients and families had a complex cognitive model of depression, which combined intrinsic vulnerability, psychological suffering during childhood and adolescence, and adverse life events. Drugs as well as other treatments were considered helpful, more so by patients than by family members. Denial of the disease and need to test its continuing presence were the main causes of non-adherence for patients, while adverse reactions did not play a relevant role. Mental health professionals tended to underestimate non-adherence in depressed patients, and did not question their patients about medication adherence. Family members needed more information on depression, on how to manage their relatives, as well as psychological and social support for themselves. The study allowed for the identification of a number of specific interventions aimed at facilitating treatment adherence, such as providing more information to patients and families, and training doctors and nurses in effective prevention and management of non-adherence.     

One breath at a time: living with cystic fibrosis

The purpose of this qualitative investigation was to describe the lived experiences of families caring for a child with cystic fibrosis at the time of initial diagnosis. Phenomenological research methodology as described by Colaizzi (1978) was used to guide the investigation. A purposive sample of 9 family members voluntarily participated in the study. Data were gathered through focus groups and written narratives. Data analysis yielded 3 essential theme clusters with subthemes: Falling Apart, Pulling Together, and Moving Beyond. Within the theme of Falling Apart, the subthemes of Devastation of Diagnosis, An All-Encompassing Sense of Fear and Isolation, and An Overwhelming Sense of Guilt and Powerlessness are described. The theme of Pulling Together included the subthemes of Perpetual Vigilance and Returning to Normalcy, and the third theme of Moving Beyond included the subtheme of An Optimal Unfolding of a New Kind of Consciousness. This article describes in detail the themes and subthemes identified during data analysis and the fluid nature of the relationship that exists within the essential structure of caring for a family member with cystic fibrosis. The diagnosis of cystic fibrosis most often comes as a life-shattering experience to families. Lifestyle readjustments are made in an attempt to return to some sense of family normalcy. In order to achieve stability in their daily lives, families are vigilant in the care and monitoring of the health of a child with cystic fibrosis. Ongoing support from health care professionals that is grounded in the realities of living with cystic fibrosis is critical. This study describes how families develop their own unique way of controlling the experience of living with cystic fibrosis, one day and one breath at a time.