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PubMed2006

A family beliefs framework for socially and culturally specific preventive interventions with refugee youths and families.

To assist in designing socially and culturally specific preventive interventions for refugee youths and families, this study identified the processes by which refugee families adapt and apply family beliefs concerning youths. A grounded-theory model constructed with ATLAS/ti for Windows and named the family beliefs framework describes (a) family beliefs concerning refugee youths, (b) contextual factors interacting with these family beliefs, (c) adaptation of family beliefs concerning refugee youths, and (d) the interplay of adapting family beliefs and behaviors concerning refugee youths. Preventive interventions for refugee youths and families would be more socially and culturally specific if they addressed the specific processes of adapting family beliefs experienced by refugee youths and their families amid transitions and traumas.

Acculturation↗

PubMed2006

Relations among family discord, caregiver communication, and children's family representations.

This study examined associations among family discord, caregiver communication quality about emotionally stressful family events, and child internal representations of family security in 50 preschool children and their primary caregivers. Consistent with risk and protective models, findings indicate that children's representations were predicted by the interaction between family discord and caregiver communication quality. Children exhibiting the highest level of secure representations of the family experienced a consistency between low levels of family discord and communications emphasizing family security. Conversely, incongruency between family experiences and communication, reflected in high levels of family discord and communications underscoring family security, was associated with the lowest level of child secure representations. Results suggest that child representations hinge on the fit between caregiver communication quality and family experience.

Caregivers↗

PubMed1998

Relationships between infant temperament, demographic variables, and family dynamics of childrearing families.

Relationships between infant temperament, demographic variables, and family dynamics of child-rearing families were investigated in this study. The revised Infant Temperament Questionnaire (RITQ), the Family Dynamics Questionnaire (FDQ) and the Family Dynamics Measure (FDM) were sent to 118 families who had participated in the first stage of the study as child-bearing families. About 8 months after childbirth 96 mothers and 95 fathers completed the questionnaires. The characteristics of infant temperament and demographic variables related to the variance of dimensions of family dynamics. Characteristics of the temperamentally easy baby related to more positive family dynamics perceived by child-rearing parents. Fathers rearing their first child reported that their families functioned better than fathers with their second infant. In child health clinics families rearing their second child should also be supported, especially families with arrhythmic and negative mood infants.

Adolescent↗

PubMed2002

Family relations, family climate and sexual abuse.

In Europe, 10-20% of all women and 3-10% of all men have experienced sexual abuse before the age of 18, according to surveys. Psychosocial problems are often seen as both short- and long-term consequences of such abuse. Family dysfunction may be seen as both a risk factor for abuse and a result of the disclosure of abuse. The aim of this research was to study how adolescents and adults, sexually abused during their childhood, experienced their family life and family climate in their family of origin. A clinical sample of 18 adolescent girls and 20 adult women comprised the study group. The methods used were a semi-structured interview and the questionnaire Family Climate Test. The majority of the participants kept quiet about the abuse during their childhood. The abuse took place for an average of 2.5 years among the adolescents and 6 years in the adult group. Secrecy, isolation and family problems were typical attributes in the interviews. The majority of both adolescents and women described their relationships in the family of origin as deviant or interrupted, with a reversed (negative) pattern on the Family Climate Test. This meant a low level of closeness and a high level of distance in the families combined with a low level of spontaneity and a high level of chaos. The study, even if relatively small and based on clinical cases, gives support to earlier research, which shows that sexual abuse in general, but especially intra-familial sexual abuse, is associated with family dysfunction.

Adolescent↗

PubMed1997

Family context in pediatric psychology from a transactional perspective: family rituals and stories as examples.

Reviewed the transactional model as applied to the family context of pediatric psychology. A three-part sequence of child behavior, parent behavior, and family interpretation was used to describe developmental adaptation and transitions. It was proposed that families are regulated by practices that are proximal to the child's experience and representations that are more distal to the child's experience. Family practices are examined through family routines and rituals. Family representations are examined through family stories. Case examples of low birth weight premature infants and an adolescent referred for repeated hospitalizations due to diabetic ketoacidosis were presented to illustrate the model. Guidelines for the practicing pediatric psychologist are presented to assess family organization through family rituals and family meaning-making in the telling of family stories.

Adolescent↗

PubMed1988

Family risk index as a measure of familial heterogeneity of cancer risk. A population-based study in metropolitan Detroit.

A family risk index was developed that compares the distribution of an endpoint in all families (regardless of disease status) with multiple, random, internal comparison groups. This index incorporates the person-time approach to adjust for risk due to age, birth cohort, sex, and race. It was validated and applied to a population-based sample of 51,714 individuals in 3,277 families from metropolitan Detroit to evaluate the role of familial risk factors in the development of cancer. Interviews took place between June 1973 and July 1977. A measure of familial heterogeneity of risk was used to determine whether cancer risk in families differed from cancer risk in randomly generated comparison groups of the same age, sex, race, birth cohort, and size distributions. For cancers of all sites combined, familial heterogeneity of risk was expressed in the study sample both as lower risk than expected among some families and as higher risk than expected among some families. It is estimated that 27% of the variability in cancer occurrence in the families is due to familial factors.

Adolescent↗

PubMed2006

Use of the measure of process of care for families (MPOC-56) and service providers (MPOC-SP) to evaluate family-centred services in a paediatric disability setting.

BACKGROUND: The value of family-centred principles in paediatric professional caregiving services is widely acknowledged. However, the degree to which such services adhere to these principles is not well documented. AIM: To examine the perceptions of both families and service providers of the extent to which family-centred services were being implemented by a paediatric disability service provider and to pinpoint areas for improvement. METHOD: A sample of 158 families receiving services from the Cerebral Palsy Association of Western Australia completed the Measure of Processes of Care for families (MPOC-56) and 43 clinicians (most of them physiotherapists, speech pathologists and occupational therapists) completed the Measure of Processes of Care for service providers (MPOC-SP). RESULTS: As in previous studies, the families rated 'respectful and supportive care' highest and 'providing general information' lowest. Clinicians rated 'showing interpersonal sensitivity' highest and 'providing general information' lowest. Analysis of individual items revealed that the following areas of family-centred services were in need of improvement: provision of general written information to families on a range of issues, continuity of care, greater involvement of the family in therapy and provision of more detailed information about therapy issues and provision of more general support to whole families. CONCLUSIONS: The MPOC tools have been found useful in enabling disability service providers to identify areas for improvement and move towards providing services that are more family centred.

Attitude of Health Personnel↗

PubMed1998

The impact of pituitary disease on the family caregiver and overall family functioning.

Chronic medical illness not only affects the patient but the entire family. The family system undergoes a tremendous change in focus during the acute illness, with members marshaling their resources to help the ill member. This inward focus is costly, producing profound stress. Often, family communication styles change to protect the family system and prior functioning. When the stress of caring for an ill member becomes chronic, as is seen in pituitary disease, the initially adaptive changes in family functioning may become problematic even in those families with previously healthy coping. Those families with previously less healthy functioning become even more dysfunctional. Each family identifies a caregiver for their ill member. This caregiver also experiences significant stress related to caregiving demands. Caregiver adaptation to the stress depends on how the stress is perceived, as well as the caregiver's coping patterns and availability of and satisfaction with social support. These elements comprise a stress process model of caregiving, which has been well-validated in dementia caregiving research. Although the majority of research has focused on dementia and cancer caregiving, identified issues have applicability to caregiving and family issues related to pituitary disease. This report will review: (1) the field of caregiving research, focusing on a stress process model; (2) those issues identified in prior caregiving research which have applicability in caregiving for patients with pituitary disease; (3) stresses on the family system; (4) assessment of family functioning, and (5) interventions for caregivers and areas for future research.

Caregivers↗

PubMed2006

Family identity: black-white interracial family health experience.

The purpose of this interpretive descriptive study was to describe how eight Black-White couples with school-aged children constructed their interracial family identity through developmental transitions and interpreted race to their children. Within and across-case data analytic strategies were used to identify commonalities and variations in how Black men and White women in couple relationships formed their family identities over time. Coming together was the core theme described by the Black-White couples as they negotiated the process of forming a family identity. Four major tasks in the construction of interracial family identity emerged: (a) understanding and resolving family of origin chaos and turmoil, (b) transcending Black-White racial history, (c) articulating the interracial family's racial standpoint, and (d) explaining race to biracial children across the developmental stages. The findings guide family nurses in promoting family identity formation as a component of family health within the nurse-family partnership with Black-White mixed-race families.

Adaptation, Psychological↗

PubMed2005

Familial aggregation of both aortic and cerebral aneurysms: evidence for a common genetic basis in a subset of families.

OBJECTIVE: Although previous reports have described patients with both cerebral and aortic aneurysms, any association was believed to be coincidental. In this study, we provide evidence that aortic and cerebral aneurysm formation may share a common genetic predisposition in some families. METHODS: A prospective enrollment of consecutive patients treated for saccular cerebral aneurysm by a single surgeon was constructed. Medical and family histories were obtained. Familial syndromes were identified when two or more first-degree relatives had diagnoses of cerebral or aortic aneurysm. Pedigrees were constructed, and asymptomatic relatives were screened. RESULTS: In 2.5 years, 274 patients were enrolled from 322 eligible patients (85%). A family history of aortic aneurysm was noted in 29 patients (10.5%). These patients were older, included more males, and were overwhelmingly Caucasian. Statistically significant demographic differences were noted when these families were compared with families affected by cerebral aneurysm only. A total of 110 affected family members were identified (average, 3.8 per family; range, 2-12); 59 had cerebral aneurysms, and 51 had aortic aneurysms. In some families, the association may have been coincidental. But in several families, pedigree analyses showed an inheritance pattern likely to represent autosomal dominance with variable penetrance. In addition, both cerebral and aortic phenotypes could be inherited from a parent with an aortic aneurysm, further evidence for a common genetic basis. CONCLUSION: This study, which represents the largest and most complete characterization of families affected by both cerebral and aortic aneurysms, provides evidence that a single gene defect may lead to the development of either lesion.

Aortic Aneurysm↗

PubMed2005

The status of low-income families in the post-welfare reform environment: mapping the relationships between poverty and family.

Low-income families face an enormous burden to achieve economic security since the deterioration of a guaranteed safety net. Health insurance coverage is uneven, affordable childcare falls short of demand, and wage earnings insufficiently support family needs. This analysis focuses on recent trends in family formation, the impact of policy changes on families of color and of immigrant status, and explores the daily challenges and coping strategies low-income families use to survive despite insufficient resources. Four key findings emerge from this body of knowledge: (1) Low-income families experience severe hardships when relying on cash assistance, work, or a combination of both; (2) Low-income families are resilient and resourceful; (3) Low-income families face significant barriers to using public and private services along with increasing earnings from work; and (4) The quality of life for families of color and immigrant families is directly affected by employment and service sector practices. Future research needs to focus on identifying the critical unmet needs of low-income families.

Adaptation, Psychological↗

PubMed1991

[A study of family communication space (Part I)--A preliminary study on how family communication is actually practiced].

Housing science needs to concern itself with how to improve space for family communication because it plays an important role in human dwelling life. The purpose of this report (Parts I, II & III) is, hence, to elucidate various factors conditioning family communication, and spatial traits of the rooms where it is conducted, based on the survey of the households of students at women's junior colleges. Part I delves into what is specifically communicated within a family and how it is related with other living activities, by grasping how communication is practiced in everyday family life. A basic analysis is made as to how conscious a family members are of their mutual communication, and how rooms are used for it. It has become clear that family communication is closely related with meal-taking both behaviorally and spatially, and that different attitudes among a family members toward family communication cause different modes, and evaluations of it. It has proved to be necessary, for the further studies of family communication, to give an analytical perspective to an in-depth examination of how rooms in the target families are used and how every member views and evaluates their family communication.

Communication↗

PubMed2004

[Influencing factors on file-up stress of family caregivers with a family member having a chronic mental illness].

PURPOSE: The purpose of this study was to identify the factors influencing file-up family stress in the family with a family member having a chronic mental illness. METHOD: Data was collected by questionnaires from 365 families with a member having a chronic mental illness, in an outpatient clinic of a General Hospital and Government Psychiatric Hospital in Seoul. The data was analyzed using descriptive statistics, pearson correlation coefficients, and stepwise multiple regression. RESULT: The score of file-up stress showed a significantly negative correlation with the score of level of hardiness (r=-.31, p=.00), family support (r=-.13, p=.00), family cohesion (r=-.25, p=.00), and sense of coherence (r=-.26, p=.00). The most powerful predictor of file-up stress was family hardiness and the variance was 11.1%. A combination of hardiness, family support, and sense of coherence account for 14.8 % of the variance in file-up stress of the family with a member having a chronic mental illness. CONCLUSION: This study suggests that family support, hardiness, cohesion, and sense of coherence are significant influencing factors on file-up stress in the family with a member having a chronic mental illness.

Adolescent↗

PubMed2001

Quality of a family medicine preceptorship is significantly associated with matching into family practice.

OBJECTIVES: This study tested whether clinical experiences in family practice are associated with matching into family practice. METHODS: We conducted a prospective cohort study of 913 medical students who completed the Family Practice Preceptorship (FPP) at the University of Iowa from 1990-1996. Using univariate techniques and logistic regression, we compared the background and experiences of those who matched into family practice with those who chose other specialties. RESULTS: Twenty-nine percent (n=267) matched into family practice. Positive independent predictors of family practice match were hometown size less than 10,000 (odds ratio [OR] 1.8), anticipating choosing family practice at matriculation (OR 4.2), and liking to help others (OR 4.1). Negative independent predictors included parental income of at least $120,000 (OR .61), desiring to perform technical procedures (OR .51), and liking the scientific method and research (OR .54). The effect of an early summer clinical experience at a community hospital varied depending on the level of student interest in family practice at matriculation. Students who rated the educational value of the FPP as high or very high were significantly more likely to go into family practice (OR 2.9), even after adjusting for all other student characteristics. CONCLUSIONS: A number of student characteristics and preferences, early clinical experiences, and the perceived quality of a required family medicine preceptorship were significantly and independently associated with students matching into family practice.

Adult↗

PubMed1992

Teaching family-centered perinatal care in family medicine, Part 2.

Pregnancy, childbirth, postpartum, and infant care are a continuum in the family life cycle for which the family physician is especially qualified to provide primary, comprehensive care. The purpose of this paper is to document and share the controversies, wisdom, and knowledge about caring for women and their families before, during, and after pregnancy. Family physicians can be leaders in developing an appropriate perinatal care system for the community. The level of care the family physician chooses to provide is discretionary. However, the family physician should be invested in ensuring that all families receive the greatest benefit from pregnancy, birth, and the newborn experience. Interest in perinatal care in family medicine is increasing, as reflected by the growing numbers participating in the Society of Teachers of Family Medicine Working Group on Family-Centered Perinatal Care. The authors of this article, who are active in this working group, hope that this information is useful in designing a balanced curriculum and delivery system for perinatal care in family medicine training programs.

Anesthesia, Obstetrical↗

PubMed1992

Behavioral science education in family medicine: a survey of behavioral science educators and family physicians.

A mailed questionnaire was used to provide a profile of behavioral science educators in family practice residency programs, to examine some aspects of behavioral science curriculum development, and to compare the attitudes of behavioral science educators and family physicians regarding the proper level of involvement of family physicians in a variety of psychosocial problems. The study populations consisted of all 383 behavioral science coordinators of US family practice programs and a national sample of 400 residency-trained family physicians. Eighty percent of the behavioral science educators were familiar with the Core Competency Objectives in Behavioral Science Education, published by the Society of Teachers of Family Medicine, and 61% had used this document to aid in curriculum development. Both behavioral science educators and family physicians perceived that the training provided in the areas of physician-patient relationships, family awareness, and personal and professional relationships was quite effective. The physicians felt significantly less effectively trained in the areas of biopsychosocial assessment and management. A high level of concordance was found between the responses of physicians and educators regarding the appropriate level of involvement of family physicians in various psychosocial problems. One exception between the two groups involved the problems of family and social functioning, for which family physicians advocated a more active level of involvement than did behavioral science educators.

Adult↗

PubMedDate not supplied

Teaching family-centered perinatal care in family medicine, Part I.

Curriculum↗

PubMed2005

Families' perception of the value of timed daily "family rounds" in a trauma ICU.

Daily communications between the ICU trauma patients' families and the trauma team are often limited due to the unpredictable nature of subsequent patient admissions and operative procedures. In order to improve the lines of family-physician communication and educate residents regarding family communication, our level I trauma center instituted daily "Family Rounds" (FR). FR occur at the same time every day, in the patient's ICU room. The purpose of this study was to determine whether families valued the scheduled daily FR, to establish whether FR improved the family-physician relationship, and to delineate strengths and weaknesses of the present structure of our FR. We mailed surveys to family members of trauma patients hospitalized in the trauma ICU for > or = 3 days. A total of 55 (22%) families responded. Combining "excellent" and "good" responses, 86.5 per cent of families looked forward to having a specific time of day to meet with the trauma team, and 90 per cent liked having rounds in the ICU room with the patient. However, 36 per cent did not like having only scheduled time for FR. The majority, 75 per cent, believed that all concerns were addressed during FR, and 84.9 per cent rated their overall experience as either excellent or good. Scheduled FR appear to improve communication between trauma surgeons and patients' families, enhance the family-physician relationship, and strengthen our surgical residency teaching program.

Adolescent↗