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PubMed1992

Lives in a balance: perceived family functioning and the psychosocial adjustment of adolescent cancer survivors.

Childhood cancer patients have a greater likelihood of long-term survival than ever before. This study examined both the perceived family functioning of adolescents who had successfully completed treatment for pediatric cancer and the relationship between family functioning and post-treatment adjustment. Eighty-eight adolescent survivors of hematologic malignancies were assessed regarding their family functioning, mental health, self-esteem, global competence, and problem behaviors. Contrary to expectations about the influence of cancer on these families, adolescent cancer survivors reported lower levels of family cohesion than the normative sample of healthy adolescents and their families. While current age, gender, age at diagnosis, and time since treatment completion were generally not associated with adolescents' adjustment, perceived family cohesion and adaptability were strongly related to post-treatment psychological adjustment.

Adaptation, Psychological↗
PubMed2003

Linking changes in whole family functioning and children's externalizing behavior across the elementary school years.

This study used observational assessments of 57 2-parent families working and playing together when their eldest child was in kindergarten and again in Grade 4 to identify distinct patterns of family functioning derived from structural family systems theory for (a) cohesive, (b) separate, and (c) triangulated families. Little consistency in family type from early to middle childhood was indicated. No significant mean differences were found in teacher reports of children's externalizing behavior in their Grade 1 classrooms for children in cohesive or triangulated families. Fourth graders in triangulated families were seen as more aggressive at school than were their peers in cohesive or separate families. Changes in observed family functioning across a 4-year period (kindergarten to Grade 4) were also systematically linked to changes in teachers' ratings of children's externalizing behavior from Grades 1 to 4.

Adult↗
PubMed1993

Family functioning following adolescent substance abuse treatment.

Reciprocal influences of substance abuse and family functioning have been hypothesized from diverse theoretical perspectives. The longitudinal study presented here investigated the relationship between adolescent alcohol and drug use outcome and family functioning following adolescent substance abuse treatment. Consistent with predictions, long-term improving teens (n = 17) experienced better family relations, and less conflict-related behavior within the family, than did teens who returned to an abuse pattern of drug use (n = 37). Two years following treatment, families of improvers demonstrated greater cohesion and expressiveness, and less conflict, than did families of relapsers. Findings highlight a gradual process of adaptation in relations among families of teens treated for alcohol and drug abuse.

Adolescent↗
PubMed2006

A comparison of family functioning, life and marital satisfaction, and mental health of women in polygamous and monogamous marriages.

BACKGROUND: A considerable body of research concludes that the polygamous family structure has an impact on children's and wives' psychological, social and family functioning. AIMS: The present study is among the first to consider within the same ethno-racial community such essential factors as family functioning, life satisfaction, marital satisfaction and mental health functioning among women who are in polygamous marriages and women who are in monogamous marriages. METHOD: A sample of 352 Bedouin-Arab women participated in this study: 235 (67%) were in a monogamous marriage and 117 (33%) were in a polygamous marriage. RESULTS: Findings reveal differences between women in polygamous and monogamous marriages. Women in polygamous marriages showed significantly higher psychological distress, and higher levels of somatisation, phobia and other psychological problems. They also had significantly more problems in family functioning, marital relationships and life satisfaction. CONCLUSION: The article calls on public policy and social service personnel to increase public awareness of the significance of polygamous family structures for women's wellbeing.

Adult↗
PubMed1990

Family functioning, social adjustment, and recurrence of suicidality.

We examined suicidal and nonsuicidal patients with major depression during and subsequent to their hospitalization. Factors associated with suicidality at the index episode included psychosocial variables as well as measures of family functioning. Previous suicidality, inter-episodic adjustment, changes in family constellation, and perception of family functioning were instrumental in separating nonsuicidal patients at follow-up from patients exhibiting recurrent suicidal behavior. These results indicate that when assessing patients with major depression for suicidality, particular attention should be paid both to the social environment and to family functioning as perceived by the patient.

Adult↗
PubMed2001

Child and family functioning 6 and 12 months after a serious pediatric fracture.

BACKGROUND: Previous findings indicate that pediatric fractures can have adverse consequences for child adjustment and family functioning immediately after injury. However, longer term effects of the fractures are unknown. The purposes of the present prospective study were to examine the child and family outcomes of pediatric traumatic fractures at 6 months and 1 year after injury, and to identify injury and treatment factors associated with these outcomes. METHODS: We evaluated 57 children 6 to 12 years of age with traumatic fractures requiring hospitalization. Using standardized measures and parent interview, we obtained measures of pre- and postinjury child and family functioning. RESULTS: Although outcomes were primarily positive at 1 year after injury, child functional limitations and family stress were observed up to 6 months after injury. Lower extremity fractures had a more negative impact on families across all three assessment points. Children with fracture interventions that involved prolonged immobilization had more functional limitations at 6 months than children who were ambulatory. Family burden was higher at 1 month for the immobilized children, but not at later follow-up. CONCLUSION: Some children and families experience adverse effects during the year after a serious pediatric fracture, especially if sustained in a lower extremity. Fracture stabilization that allows for greater ambulation may offer some benefits related to functional outcomes and family impact.

Activities of Daily Living↗
PubMed2003

Use of healthcare resources, family function, and socioeconomic support during the first four years after preterm birth.

OBJECTIVES: To assess the use of healthcare resources for preterm infants and to evaluate family function and socioeconomic support in a defined population from birth to 4 years of age. METHODS: In a prospective case-control study, 39 singleton preterm infants without prenatal abnormalities born during an 18 month period were studied together with their families. The population consisted of 19 very preterm infants (less than 32 weeks) and 20 randomised moderate preterm infants (32-35 weeks), and the control group comprised 39 full term infants. Contacts with medical services, child health services, and the social welfare system were registered, and family function and life events were studied. RESULTS: The preterm children were more often readmitted to hospital (odds ratio (OR) 6.6, 95% confidence interval (CI) 2.0 to 22.1) and had more outpatient attendances (OR 5.6, 95% CI 2.1 to 15.0) during their first year of life. Mothers in the preterm group more often used temporary parental allowance than the control mothers (p < 0.001). The number of contacts with the child health services and the social welfare system did not differ significantly from the controls. Neither was there any significant difference with regard to family function or life events at 4 years of age. CONCLUSIONS: A large proportion of the premature children used specialist care during the first years of life. However, the families of the preterm infants were socially well adapted up to four years after birth compared with the control families.

Adult↗
PubMed2003

Factors related to patient's mental adjustment to breast cancer: patient characteristics and family functioning.

Previous studies have suggested that patients who adopted a coping response characterized as helplessness or hopelessness reported higher levels of psychological distress than patients who adopted a response characterized as fighting spirit. There are also studies suggesting a relationship between family functioning and psychological well-being of cancer patients and their family members. The aim of this cross-sectional study was to investigate the relationship between breast cancer patients' coping response to the diagnosis of cancer and family functioning. A total of 46 postoperative ambulatory female breast cancer patients and their husbands participated in this study. Patients and husbands completed the Family Assessment Device (FAD), and patients also completed the Mental Adjustment to Cancer (MAC) scale. They filled in these self-report questionnaires at home. The results of multiple regression analysis showed that patients' perception of poor family functioning in the area of Communication measured by the FAD correlated with high Helplessness/Hopelessness score of the MAC, whereas high education in the patients was correlated with low Fighting Spirit score on the MAC. The results suggested a link between a patient's attitude of helplessness or hopelessness in the face of cancer and inappropriate communication among family members. Consequently, health care professionals should devote attention not only to the patient but also to other family members and intervene to promote appropriate communication patterns among the family members.

Adaptation, Psychological↗
PubMedDate not supplied

[The perception of family function and psychosexual development in obese adolescents].

The interaction of psychological and social factors with family functioning and psychosexual development was studied in obese adolescents. Family functioning was evaluated using the triaxial classification of Tseng and McDermott. A total of 246 adolescents 8 to 18 years old (124 males and 122 females) were grouped in two: obese (n = 109) and non obese (n = 137). With the use of multivariate analysis it was found that the group of obese youngsters had higher rates of triangular parents-child dysfunction (p < 0.001) and more disapproval for their feeding behavior (p = 0.002); on the other hand, they considered they were more accepted in the family (p = 0.029) and felt greater concern from their parents (p = 0.004). It was concluded that the feeding behavior is interrelated with several aspects of the family psychodynamics which has an effect on the adolescents homeostasis and on his own body image perception. Those factors should be taken into consideration when the obese youngster is studied in clinical practice.

Adolescent↗
PubMed2005

Cultural variations in children's coping behaviour, TV viewing time, and family functioning.

AIM: To examine children's coping behaviour, TV viewing hours and family functioning in four ethnic groups and factors related to children's coping behaviour. METHODS: This study was part of two larger research projects investigating children's health behaviours in the United States and Taiwan. Fifty-six White American children of European ancestry, 66 Mexican American children, 68 Chinese American children and 95 native Taiwanese children were included in the analysis. Standardized instruments were used to measure coping strategies, children's TV viewing hours and family functioning. RESULTS: There were significant differences in the types of stressor that children of different ethnicity reported. Similarities and differences were found in the four ethnic groups regarding the top five most frequently used and most effective coping strategies. Multiple regressions identified two variables that contributed significantly to the variance in the frequency of children's coping strategies--ethnicity and poorer behaviour control in the family. Ethnicity was the only variable found to contribute to the variance in coping effectiveness. Significant differences were found in the number of hours children spent watching TV. CONCLUSIONS: Findings suggest that children of different ethnicity utilized different types of coping strategies and ethnicity is one of the important factors related to children's coping behaviour. These findings provide evidence for nurses to assess children's coping behaviour and TV viewing and provide children with healthier alternatives.

Adaptation, Psychological↗
PubMed1997

Primary juvenile fibromyalgia: psychological adjustment, family functioning, coping, and functional disability.

OBJECTIVES: 1) To determine the importance of psychological adjustment and family functioning in primary juvenile fibromyalgia by assessing these factors in children with fibromyalgia and in their parents, compared with children with juvenile rheumatoid arthritis (JRA) and with pain-free control children and their parents. 2) To examine which of these factors predict functional disability. METHODS: Fifteen children in each of the 3 study groups, and their parents, completed self-report questionnaires and pain diaries. A medical evaluation of each child was performed, including assessment of tender points by palpation and by dolorimetry. RESULTS: All children in the fibromyalgia group met the Yunus and Masi criteria for fibromyalgia, and 11 met the American College of Rheumatology criteria. There were almost no significant group differences in the children's or parents' psychological adjustment, ratings of family functioning, or coping strategies. Significant group differences in functional disability, pain, fatigue, tender point threshold, and control point tolerance were found. A number of the psychological adjustment, pain, fatigue, and coping variables were significantly associated with functional disability. CONCLUSION: The notion that fibromyalgia is a psychogenic condition is not supported by these results. Fibromyalgia is associated with disability of a magnitude comparable to that of other chronic pain conditions. Disability among children with fibromyalgia or JRA is a function of the children's psychological adjustment and physical state, and of the parents' physical state and method of coping with pain.

Adaptation, Psychological↗
PubMed2000

Social and emotional adjustment in children affected with Gilles de la Tourette's syndrome: associations with ADHD and family functioning. Attention Deficit Hyperactivity Disorder.

This study examined social-emotional functioning in children with Gilles de la Tourette's syndrome (TS) alone and children with TS and Attention Deficit Hyperactivity Disorder (ADHD). In addition, the contribution of family functioning to social competence was examined. Children with a clinical diagnosis of TS were recruited from the Yale Child Study Center TS specialty clinic. Unaffected control children were recruited through newspaper advertisements and announcements within the university and at area schools. The final sample consisted of 72 children (45 boys and 27 girls) between the ages of 8 and 14. Sixteen children met DMS-III-R criteria for TS, 33 children met criteria for TS and ADHD, and 23 children had no psychiatric diagnoses. Children with TS and ADHD evidenced more externalizing and internalizing behavior problems and poorer social adaptation than children with TS only or unaffected controls. Children with TS only were not significantly different from unaffected controls on most measures of externalizing behaviors and social adaptation but did exhibit more internalizing symptoms. Tic symptom severity was not associated with social, behavioral, or emotional functioning among children with TS, even after stratifying by medication status. However, ADHD diagnosis, obsessional symptom severity, and family functioning were significantly associated with social and emotional adjustment among TS children. Moreover, family functioning was associated with social and emotional adjustment even after controlling for TS and ADHD diagnostic status. These findings demonstrate that much of the social and behavioral dysfunction in children with TS is ADHD-specific and children with TS alone have a very different social-emotional profile than do those with TS plus ADHD. Finally, social-emotional adjustment in children with TS is best understood within the family context.

Adaptation, Psychological↗
PubMed2000

Parent-child bonding and family functioning in depressed children and children at high risk and low risk for future depression.

OBJECTIVE: To evaluate parent-child bonding and familial functioning in depressed children, children at high risk for depression, and low-risk controls. METHOD: Diagnoses of children and their relatives were obtained via structured interviews with all available informants. Depressed children (n = 54) received a diagnosis of current major depressive disorder (MDD). The high-risk children (n = 21) had no lifetime diagnoses of mood disorders, but at least one first-degree relative with a lifetime history of depression. The low-risk controls (n = 23) had no lifetime psychiatric disorders and no first-degree relative with a lifetime history of mood disorders. Parent-child bonding was evaluated with the child's report on the Parental Bonding Instrument (PBI). Familial functioning was evaluated with each parent answering the Family Assessment Device (FAD). RESULTS: Significant differences were found between the MDD and low-risk children on most parameters of the PBI and FAD. The children with MDD reported significantly elevated maternal overprotection, and their fathers scored significantly lower on the FAD scales of Behavioral Control and General Functioning, compared with the high-risk children. Mothers of high-risk children had significantly lower scores on the Roles and Affective Involvement dimensions of the FAD compared with mothers of low-risk children. Current maternal depression had a deleterious effect on the child's perception of maternal protection and paternal care, mother's report on all FAD scales, and father's report on most FAD scales, whether interacting with the child's depression or existing even if the child was not depressed. CONCLUSION: Maternal depression and its interaction with the child's depression appear to have negative consequences for parent-child bonding and family functioning.

Adolescent↗
PubMed2003

Familial functioning as a support system for adolescents' postdetention success.

Youths transitioning out of detention are particularly in need of support systems that can divert them from recidivism. This article examines the relationship between incarcerated youths' sense of their families' functioning and their perceived likelihood for postdetention success. Despite the control of background variables, results reveal that delinquents who indicated stronger familial functioning also reported a greater likelihood of future success. Although interventions that focus on improving the supportive capacity of families have shown great promise, treatment drop-out rates remain high. To explore incarcerated youths' view of family focused interventions, respondents rated the potential utility of family and nonfamily focused intervention options. A majority of respondents reported that family focused interventions would be helpful. A group of respondents, overrepresented by adolescents with low family functioning, reported that this type of intervention would not be helpful. These results are discussed in terms of their impact on offering family focused interventions for juveniles.

Adolescent↗
PubMedDate not supplied

Hostility, hostile detachment, and conflict engagement in marriages: effects on child and family functioning.

This study examined the relations between patterns of marital communication, child adjustment, and family functioning. Couples with a 4- or 5-year-old child were divided into three groups (N = 126) based on observed patterns of emotional communication: Hostile couples showed a cumulative increase in negative speaker behaviors over the course of a high-conflict marital discussion; hostile-withdrawn couples showed a cumulative increase in both negative speaker and negative listener behaviors over the course of the interaction; and engaged couples showed a cumulative increase in both positive speaker and listener behaviors over the course of the interaction. The families of these three types of couples were then compared on child outcomes (i.e., peer relations, behavior problems), parenting quality, co-parenting quality, and family-level functioning. Differences in marital violence and marital satisfaction between marital couples were also examined in relation to family risk. Families in which couples were hostile-detached showed the most negative outcomes. Hostile-detached couples were more likely than hostile or conflict-engaging couples to use more power-assertive methods of discipline; to be ineffective in co-parenting their child; to have family units that were less cohesive, less playful, and more conflictual; and to have children that exhibited behavior problems. Results also indicated that marital typology still accounted for significant variance in child outcome after controlling for marital violence and marital satisfaction. Differences in the absolute degree of negative behaviors also did not account for results. Findings are discussed in terms of the detrimental impact of marital conflict on child and family functioning.

Child Behavior Disorders↗
PubMed2001

Family functioning in anorexia nervosa differs by subtype.

OBJECTIVE: This study investigated family functioning in adolescents with the restricting and bulimic type of anorexia nervosa (AN) and in healthy controls. METHOD: Fifty-one parents and their children (17 with AN and 34 healthy adolescents) completed the Family Assessment Measure, a self-report instrument that provides information about the functional strengths and weaknesses of the family and each family member. RESULTS: AN patients with the bulimic subtype and their mothers were significantly more likely to perceive family functioning as impaired than were healthy adolescents or restricting AN patients. Restricting AN patients and their families did not differ from healthy control families. CONCLUSION: The results suggest that the problems faced by bulimic patients color their and their parents' view of each other and the family. Symptomatic and personality differences between the subtypes of AN with better control, fewer symptoms, and denial of conflict characterizing restricting AN families may be reflected in family interaction styles.

Adolescent↗
PubMed2007

Relationships of family functioning, self-esteem, and resourceful coping of Thai adolescents with asthma.

Within the context of Rosenbaum's theory of learned resourcefulness, this correlational study examined the relationships among family functioning, self-esteem, and resourceful coping in Thai adolescents with asthma. A convenience sample of 132 Thai adolescents (aged 12-17 years) with asthma was recruited from the outpatient asthma clinics of four hospitals in Bangkok. Self-administered questionnaires included an assessment of demographic information and asthma status, the revised Family APGAR, the Rosenberg Self-Esteem Scale, and the Children's Self-Control Scale. Hierarchical multiple regression analysis was used to examine the relationships among variables. Effective family functioning had a significant positive effect on self-esteem (beta = .27, p < .01) and resourceful coping (beta = .30, p < .01), controlling for gender and age. However, self-esteem was not significantly correlated with resourceful coping (beta = .15, p = .08). The findings suggest that nursing interventions should take into account the role of family functioning in promoting self-esteem and resourceful coping in Thai adolescents with asthma. Recommendations for future research include replication of the study with a larger sample of adolescents with asthma and with adolescents with other chronic illnesses.

Adaptation, Psychological↗
PubMedDate not supplied

Predicting self-care with patients and family members' affective states and family functioning.

People with cancer manage the side effects of treatment with the assistance of their family members. This study was designed to describe self-care behaviors (SCBs) initiated by patients and their family members and to determine the relationship between patients and family members' affective states and family functioning and SCBs. Using a longitudinal design, 42 patients and 40 family members were followed during 3 cycles of chemotherapy (12-16 weeks). The patients completed measures of affective state (POMS) each cycle; patients and family members completed a family functioning measure (F-COPES) at second cycle only; and the patients reported in an SCB log on an ongoing basis. The overall pattern of SCBs corroborated previous findings. The average number of SCBs initiated was 1.4 per side effect. Depression and vigor significantly predicted SCBs at Cycle 1 only. The severity of side effects consistently predicted SCB over the 3 cycles (r 2 = -0.39 to -0.46). Patients who experienced more severe side effects were at risk of diminished self-care.

Adaptation, Psychological↗