SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
The universal appeal of nostalgia and reminiscence makes photographs a natural instrument for studying the impact of the past upon the present. This paper explores photography as a medium for facilitating reminiscence to discover individual roles, interpersonal relationships, and family dynamics. A method is described for using family photographs in treatment and training of clinicians at a Family Therapy Clinic.
BACKGROUND AND OBJECTIVES: In Venezuela, family medicine is taught and practiced almost exclusively in ambulatory care settings. This article describes the evolution of the educational strategies that emphasize family and community aspects of clinical practice within one residency program in the country of Venezuela. METHODS: Three distinct phases of development are depicted, beginning with a biomedical and individual-centered approach. Subsequent efforts to involve residents in the community provoked criticism. Resident-faculty dialogue led to modifications and to the success of the current program. Some of the specific educational strategies are: a structured weekly five-hour community afternoon, a 40-hour course titled "Family Dynamics and Counseling," use of the family-oriented home visit to introduce residents to the community aspects of health care, and completion of a community-based and health-related project. RESULTS: A sample of residents and graduates noted an improved doctor-patient relationship, improved ability to work with groups, and improved skills for incorporating preventive medicine with a community focus into their clinical practice. CONCLUSIONS: The community involvement is enthusiastically supported by the residents, as it is perceived as useful for clinical practice. The program prepares family physicians to become more responsive to the health needs and the reality of Venezuelan society.
This paper is concerned with the cultural construction of reproduction and gender in Turkey as it relates to the remarkable decline from high levels of fertility to near-replacement levels. It critiques demographic transition theory and family systems theory as found in the Turkish demographic discourse. A combination of ethnographic and demographic methodologies are used. The ethnographies are from working-class communities in Istanbul. A concept of negotiated conduct is used to interpret family dynamics in matters of reproductive control replacing the family systems models that are based on the assumption of male domination or patriarchy. It is found that the physical characteristics (male or female) of methods of contraception do not directly reveal whose power dominates negotiations. The variety of experience shows that not only women, but also men, negotiate in favor of birth control or, in some instances, to birth more children. The changes in structural conditions that brought fertility from high levels to near-replacement levels in Turkey were effective without very much "empowerment" of women. The proposition that women's status, in terms of education and economic activity, must improve to bring about a fertility decline is questioned by the Turkish experience.
This report portrays the distinctive clinical features of four groups of families with psychiatrically hospitalized adolescents. The classification of families into the four groups was made by objective measures of their performance in a standard problem-solving task. Clinicians, blind to this classification, synthesized and described their clinical impressions of these families. There were clear differences among the four groups in family dynamics and in the adolescents' ward behavior. Furthermore, families who experienced themselves as an integrated group became more effectively engaged in a family-oriented inpatient treatment program. Families with noticeable alienation between members did not become effectively engaged in the family-oriented program and may be better candidates for other approaches to inpatient care.
A group of 24 normal weight bulimics and 13 bulimic anorexics were compared with each other and a normal control group (n = 41) on two self-report measures of family functioning (Family Environment Scale and Family Dynamics Survey). The two bulimic groups perceived their families as more dysfunctional than did the normal control group on the dimensions of cohesion, expressiveness, conflict, recreational orientation, emotional support, communication, and need for counseling. There were few significant differences in the family perceptions of the two bulimic groups.
This paper describes a particular family dynamics involved in suicidal behaviors of adolescents. Certain family situiations create a split between some family members and the suicidal adolescent to the point of total estrangement. The adolescent copes with this split by forming intrapsychic splits, including a suicidal self and nonsuicidal self, through dissociation. This process peaks in the suicidal behavior itself. The therapeutic principles implied by this model are presented.
When a family member is hospitalized, family dynamics change. One hospital seeks to help a family better cope with one member's illness through educational programs and hospital policies that seek to strengthen the family unit and to involve the family in patient care.
UNLABELLED: Objective of the study is an attempt to determine main psychological features and family functioning properties of sentenced women, as well as possible differences in these characteristics compared to the normal population. METHODOLOGY: The study included 108 women classified into two exclusive groups. The group of tested convicts (N= 62) included women serving their sentences in the Women prison in Pozarevac, and within this group we distinguished 4 subgroups according to the type of the crime commited. A control group (N= 46) consisted of women employed in Belgrade industrial complex "Sport". The tests were carried out by applying the self-estimation questionnaire on certain aspects of family functioning, FACES version III of the Olson's circumplex model and a standardised version of MMPI 201. RESULTS: The results indicate that there is a difference between the control and the convict grous, both in family dynamics and in psychological characteristics. By studying the family functioning, we established the existence of statistically significant differences in the following aspects: more frequent presence of violenc and socio-pathological behaviours, with a lower level of cohesion in the families of the female convicts. In comparison with the control group, which founds itself within the average limits, the female convicts are characterized by certain personality features, which may serve as a basis for their classifying into certain psychological profiles. CONCLUSION: The results of our study reveal the necessity, both in studying the etiology of female criminality, and in prevention, diagnostics, planning and completion of rehabilitation treatment, of paying a special attention to the determination of the influence of family circumstances as well as psychological characteristics of this population.
Mental health depends on establishing an equilibrium between bodily needs, drives, and demands from the environment. A balance must be maintained between the basic human urges, self-centered wishes, and the demands of both conscience and society at every stage of human development. Eating and feeding behaviors are bound up with family dynamics and are often a barometer of the family's emotional climate and parent-child interactions. A positive feeding relationship is a concrete measure parents can be taught to provide for the child's healthy psychosocial development. Although the development of eating disorders is complex and caused by a multiplicity of factors, community-wide education by nurses about nutrition and feeding at successive developmental levels from infancy to old age can decrease the incidence of eating disorders in the community. Evaluation of prevention programs is essential to guarantee the refinement of preventive efforts over time.
The qualities of the multi-disciplinary social, psychological, medical and nursing contributions for children diagnosed consecutively as having acute lymphoblastic leukaemia and their families were investigated. The parents of a total of 39 children, 31 fathers and 36 mothers, participated in a semi-structured interview with the psychologist attached to the department concerning the extent to which the psycho-social requirements of the family had been met by offers from the hospital. The interview concerning the diagnosis took place equally frequently in local hospitals and in Rigshospitalet. In both of these locations only half of the parent couples were satisfied with the course of the conversation. In the course of the disease, the mothers and the fathers experienced three situations differently: the situation at work, the parents' married life and the responsibility for treatment of the child. The family dynamic situation was altered in all of the families. Parents developed a closer relationship to the sick child while the relationship to the siblings equally frequently improved or deteriorated. At the conclusion of treatment, 2/3 felt that a form of security disappeared even though they were pleased to have got so far. In cases with relapse, another crisis developed and was just as difficult as the first, regardless of whether attempts had been made to prepare the families for this possibility. This investigation has pointed out a series of circumstances which the therapeutic system should be familiar with and which they can be prepared for.
We have described the different sources of stress and burden that are imposed by caring for a family member with AD. We have provided an approach to assessing each of these possible sources of stress and burden and have indicated how such assessments must take a family-based approach and consider the broader social roles and family dynamics that may color the way in which family members view and carry out their caregiving roles.
In 1980 the Psychotherapeutic Department of the University Clinic for Pediatrics carried out a follow-up study on all children and adolescents with behavioral and psychosomatic disturbances who had come in as in-patient treatment between 1974 and 1979. 153 out of 150 questionnaires were returned and the statistical results may be considered representative of the entire patient group treated at the hospital. The minimal duration of the catamnesis is one year, the average duration is about three years. There is significant agreement between therapists and parents in their evaluation of the success of the therapy. Our article describes the therapeutic change in the children's symptoms in general and in comparison to the various diagnosis and also the change in different aspects of behavior. According to the parents, the therapy resulted in a significant and lasting improvement for 50% of the children; if we include the category "decrease in symptoms", the success rate goes up to 80%. Also described is the parents' point of view on the impact of the individual family's problems on the children' disturbances and on the development of family dynamics. As our Department lays special emphasis on family therapy the parents' attitude toward this aspect is interesting: according to the follow-up study, 50% of the parents consider family therapy to be one of the main reason for therapeutic success.
Although there has been increasing awareness of the psychologic effects of illness and hospitalization in children and early adolescents, those who have sustained spinal cord injury (SCI) have received scant notice in the literature. A developmental approach in work with hospitalized children having SCI has been found helpful in trying to meet the psychologic needs of these children, and in guiding staff to better understand their behavior and to implement care more appropriately. In this approach to children and early adolescents with SCI, developmental status is evaluated and each child's response to SCI in relation to the prominent issues of developmental stage is assessed. A productive byproduct of this approach is that family dynamics become more obvious and both patient and family behavior are better understood by those providing medical care.
Detailed analysis of family dynamics of 63 adolescent psychiatric in-patients' families was carried out. The results of this project show indicate relatively more dysfunctional relations of the patient with other family members, especially with both parents. Also the study showed undifferentiated needs of family members' for co-operation and support from the psychiatric institution. Attitudes of resistance and anxiety in relation to psychiatry, which are still typical for Polish families at the end of eighties, were indicated.
A dynamic systems (DS) approach was used to study changes in the structure of family interactions during the early adolescent transition period. Longitudinal observational data were collected in 5 waves prior to, during, and after the transition. Boys (n = 149 families) were videotaped problem solving with their parents at 9-10 years old and every 2 years thereafter until they were 18 years old State space grids (a new DS method) were constructed for all families across all waves. Two variables indexing the variability of the family interactions were derived from the grids. As hypothesized, the DS variables revealed a significant quadratic effect related to a peak in variability at 13-14 years of age.
OBJECTIVE: To extend the knowledge on long-term effects of childhood abuse in psychiatric patients to a large sample, the authors explored childhood sexual and physical abuse in adult inpatients over 1,040 consecutive admissions. METHOD: The 947 patients were admitted to a tertiary-care military medical center. Each patient was interviewed, and abuse history, DSM-III-R diagnosis, and other characteristics were recorded. RESULTS: The prevalence of reported childhood abuse was 18% overall: 9% for sexual abuse (with or without physical abuse), 10% for physical abuse (with or without sexual abuse), and 3% for combined abuse. More female than male patients reported abuse. Alcohol use disorders were more common in victims of physical or combined abuse than in sexually abused or nonabused patients. Axis II diagnoses, particularly borderline personality disorder, were more frequent in abuse victims than in nonabused patients. Histories of drug and alcohol abuse were more common in patients reporting physical or combined abuse than in nonabused patients. Suicidality was also more frequent in abused than nonabused inpatients and was noted in 79% of the patients with histories of combined abuse. Combined abuse in women and physical abuse in men were associated with a family history of psychiatric illness, most commonly alcoholism in male relatives. CONCLUSIONS: These findings emphasize the need for greater attention to family dynamics, aggressive diagnosis and treatment of alcoholism within the family, and, especially, determination of patients' abuse histories, even if repeated questioning is necessary.
Caring for an individual in the home is inherently complex. The physical environment, family dynamics and the cognitive abilities of the client and family members are only a few of the factors to be considered in delivering services. Although targeted initiatives have been established to reduce preventable injuries and deaths in the hospital sector, there has not been a corresponding level of research or patient safety initiatives in other healthcare delivery sectors. A coordinated and collaborative approach to generate new knowledge pertaining to safety in home care in Canada has therefore been undertaken by the Canadian Patient Safety Institute (CPSI), VON Canada, and Capital Health (Edmonton). Actions included the development of a background paper (Lang and Edwards 2006) that informed an invitational roundtable discussion, where key safety issues in home care were identified and priority actions discussed. Over 40 individuals from across Canada participated, reflecting various disciplinary and organizational affiliations in the delivery of home care services. This paper describes key findings from the background paper, outcomes from the ensuing roundtable discussions and implications for practice, research and policy.
Sibling incest has seldom been researched and thus remains poorly understood. The authors review a case and discuss it in the context of the recent literature on incest. The case report they present demonstrates the complexity of individual and family dynamics leading to incest and illustrates the need for caution in making generalizations about incestuous families. The authors recommend that evaluators and treaters of incestuous families pay close attention to the specific dynamics of any given case and avoid assuming that common scenarios or traits of participants alone can adequately explain the incest.