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.     

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。     

Decision Points in Choosing Family Self-Report Scales in Research

Literature that systematically highlights critical decision-making points in conducting family research is sparse. The wide-spread use of self-report instruments in family research suggests that explication of decision-making points involved in the use of self-report instruments is needed. A specific instrument, the Family Environment Scale (Moos & Moos, 1986), is used to illustrate relevant decision-making. Conceptualization of a study, instrumentation, and data analysis are addressed.     

All in the family: resources and referrals for alcoholism

PURPOSE: To emphasize the family as the unit of treatment when one member has alcoholism, discuss the impact of alcoholism on families, and identify resources and referrals available for primary care nurse practitioners (NPs) to assist the patient and family in improving recovery outcomes and family function. DATA SOURCES: Extensive review of current research, literature, and Internet-based resources, supplemented and illustrated with a case study. CONCLUSIONS: Alcohol dependency flourishes within the social context of the family system and is one of the leading causes of family dysfunction. Understanding the impact that alcoholism has on the family system and being familiar with resources and referrals are critical facets of the overall management of treatment for the patient and family. IMPLICATIONS FOR PRACTICE: Patients often seek health care in a primary care clinic for treatment of medical problems related to alcohol use or abuse, and the primary care NP is frequently the initial point of contact. It is imperative that the family be recognized as the unit of treatment and be included in the treatment plan. As the first line of defense, primary care NPs play a critical role in making appropriate referrals for management of family alcoholism. Helping families make changes leads to improved functioning and recovery outcomes for patients with alcoholism as well as to improved family function.     

Frequency of Headaches in Children is Influenced by Headache Status in the Mother

(Headache 2010;50:973‐980) Background.— Migraine aggregates within families. Nonetheless the familial aggregation of chronic daily headaches (CDH) and of episodic headaches of different frequencies has been very poorly studied. Accordingly herein we test the hypothesis that frequency of primary headaches aggregates in the family. Methods.— Sample consisted of 1994 children (5‐12 years) identified in the population. Validated questionnaires were used to interview the parents. Crude and adjusted prevalences of low‐frequency (1‐4 headache days/month), intermediate‐frequency (5‐9 days/month), high‐frequency (10‐14 headache days/month), and CDH (15 or more headache days/month) in children were calculated as a function of headaches in the mother. Results.— Frequency of headaches in the mother predicted frequency of headaches in the children; when the mother had low frequency headaches, the children had an increased chance to have low or intermediate headache frequency (relative risk = 1.4, 1.2‐1.6) but not CDH. When the mother had CDH, risk of CDH in the children was increased by almost 13‐fold, but the risk of infrequent headaches was not increased. In multivariate models, headaches in the children were independently predicted by headaches in the mother (P < .001); headache frequency in the children was also predicted by frequency in the mother (P < .001). Conclusions.— Frequency of headaches in children is influenced by frequency of headaches in the mother and seems to aggregate in families. Future studies should focus on the determinants of headache aggregation, including genetic and non‐genetic factors.     

家庭亲密度和适应性与脑梗死后抑郁的相关性分析

目的探讨家庭亲密度和适应性与脑梗死后抑郁的关系。方法采用汉密尔顿抑郁量表、家庭亲密度和适应性量表对108例首次发病脑梗死患者进行调查,根据是否存在抑郁,分为抑郁组（63例）和非抑郁组（45例）。比较两组患者家庭亲密度和适应性的差别,并进行家庭亲密度和适应性评分与抑郁的相关性分析。结果抑郁组实际亲密度和实际适应性评分均低于非抑郁组患者（P〈0．01）,亲密度不满意程度和适应性不满意程度评分均高于非抑郁组患者（P〈0．01）。抑郁与实际亲密度和实际适应性均呈负相关（P〈0．05）,与亲密度不满意程度和适应性不满意程度均呈正相关（P〈0．05）。结论家庭亲密度和适应性差是脑梗死后抑郁的重要原因。     

Multiple family group interventions in first episode psychosis: Enhancing knowledge and understanding

Families play a major role in promoting recovery and preventing relapse following the first psychotic episode. This paper presents a multiple family group education programme for the families of clients with first episode psychosis. The educational needs of the families are also discussed. The results of this evaluation show that the programme improved the families' perceptions of their overall knowledge and understanding of mental illness and its treatment. This evaluation demonstrates the efficacy of such groups and the key role of community mental health nurses in providing family interventions.     

Finding a balance point: A process central to understanding family caregiving in Taiwanese families

The grounded theory method was used to explore the psychosocial process of family caregiving to frail elders in Taiwan. Interview and observation data from 15 family caregivers were analyzed using constant comparative analysis. Caregivers used the process of finding a balance point to achieve or preserve equilibrium between and within caregiving and family life. Caregivers who did better in finding a balance point provided better quality care to frail elders. Caregivers who were good at finding a balance point anticipated competing needs, conceptualized multiple strategies to meet the needs, and predicted accurately the consequences of the strategies. They described a wide variety of balancing strategies. © 1998 John Wiley & Sons, Inc. Res Nurs Health 21:261–270, 1998     

上海市常住居民家庭功能的自我知觉

目的探索上海市常住居民对家庭功能的整体知觉情况以及不同家庭人口数、不同家庭结构、不同收入水平对家庭功能的影响。方法采用家庭功能评定量表（中文版）对分布于上海市11个行政区的176个家庭的460名12岁以上成员进行问卷调查。结果家庭功能各维度得分由低到高依次为：问题解决（2．06±0．33）分、总体功能（2．094±0．36）分、沟通（2．21±0．33）分、情感卷入（2．30±0．37）分、行为控制（2．34±0.28）分、情感反应（2．36±0．38）分、角色分工（2．40±0．24）分。不同人口数的家庭,在角色分工、行为控制两个功能维度上差异有统计学意义（P〈0．05）;核心家庭中,独生子女家庭在家庭总体功能上与多子女家庭存在差异;有子女家庭中,二代户家庭（核心家庭和单亲家庭）在沟通维度上与三代同堂大家庭的差异有统计学意义（P〈0．05）;人均月收入3000元及以上的家庭在问题解决维度上得分低于其他各组（P〈0．01）,2000～2999元的家庭在沟通维度上得分明显高于1000～1999元、3000元及以上组（P〈0．01）,而人均月收入在1000元以下的家庭除了问题解决维度外的其他各维度得分与中、高收入组差异无统计学意义。结论上海市常住居民家庭在问题解决、家庭总体功能方面表现较佳,而在家庭角色分工、情感反应方面表现相对较差;三代同堂、人口数较多的大家庭更能有效发挥理想的家庭功能,不同收入水平对家庭功能各维度的影响不尽相同。     

家庭干预对乳腺癌患者家庭亲密度及适应性的影响

目的探讨家庭干预对乳腺癌患者家庭关系的影响。方法将128例术后乳腺癌患者随机分为对照组和干预组,每组各64例,对照组给予常规护理措施,干预组在此基础上针对患者家庭及主要照顾者实施干预,包括针对患者主要照顾者进行的护理指导;与患者及家属进行座谈,进行心理疏导;出院后定期电话回访,给予生活和康复指导等。干预前后用家庭亲密度和适应性量表中文版(family adaptability and cohesion scale,FACESII-CV)分别对干预组和对照组进行测评。结果干预后,干预组在家庭实际亲密度及家庭实际适应性得分均高于干预前和对照组;家庭亲密度和适应性不满意程度得分均低于干预前和对照组(均P0.05)。结论家庭干预能有效地提高乳腺癌患者的家庭亲密度和适应性。     

Resilience in families of children with Down syndrome in Korea

This study aims to identify the factors related to resilience of the families of children with Down syndrome (DS). Data were collected from 126 parents of children with DS in Korea, using a self‐administered questionnaire. The age of the child, developmental level of the child, parental depression, and stress and strain were negatively related with family adaptation, whereas health of parents, family cohesiveness, flexibility, communication skills, supportive family/relatives, and quality of community service were positively related. Parental depression, family cohesiveness and communication skills were the factors that were strongly related to family resilience and adaptation. It is suggested that nursing interventions to decrease parental depression and increase family cohesiveness and communication skills should be included to increase resilience of the families of children with DS.     

Child in hospital: family experiences and expectations of how nurses can promote family health

Aims and objectives. This study set out to explore, from the family's point of view, ways in which nursing staff can promote family health during the child's hospital stay. Background. Having a child in hospital is a major source of stress and anxiety for the whole family. Earlier studies have described parental coping strategies, ways to strengthen those strategies and to support parental participation in child care, but no one has studied the promotion of family health during the child's hospitalization from the family's point of view. Design. Interviews were conducted in 2002 with 29 families who had a child with a chronic illness which were receiving or had received treatment on the paediatric wards of two Finnish hospitals. Methods. Data analysis was based on the grounded theory method, proceeding to the stage of axial coding. Data collection and analysis phases proceeded simultaneously. Results. Five domains were distinguished in the promotion of family health: (1) reinforcing parenthood, (2) looking after the child's welfare, (3) sharing the emotional burden, (4) supporting everyday coping and (5) creating a confidential care relationship. Conclusions. The results strengthen the knowledge base of family nursing by showing how nursing staff can promote family health during the child's hospital stay. Relevance to clinical practice. The results have a number of practical applications for nursing, both for clinical practice and research. The results can be used in paediatric hospital wards caring for chronically ill children and their families. The five domains of family health promotion described here should be tested in other paediatric wards and in other geographical locations.