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PubMed1997

Relationship of family schema to family adaptation to brain injury.

The relationship between family schema and family adaptation to brain injury was investigated. Participants were 87 primary caregivers of persons with brain injuries in Wisconsin who are part of a comprehensive, longitudinal study of family adaptation to having a member with a brain injury. Stepwise multiple regression of variables measuring family schema on family adaptation indicated that manageability and meaningfulness were predictive of family adaptation. Thus the hypothesis that family adaptation can be predicted from variables measuring family schema was supported. Family intervention and research implications are discussed.

Adaptation, Psychological↗
PubMed1985

Serious illness and family dynamics. 1. Changes in consulting patterns of the unafflicted family members.

This article examines the effect of an acute serious illness in one member of a family on the health behaviour of other members. The number of consultations made by 92 family members before and after an acute serious illness was measured and compared with a control group of 102 people who had experienced no serious illness in their family. The coping resources of the family--defined in terms of flexibility of parental relationships, conflict avoidance and family strain - were assessed and related to the changes in consultation pattern. It was shown that an acute serious illness affecting one member of a family which lacks adequate coping resources can lead to an increase in reporting of serious complaints in other family members. In families which have adequate coping resources, however, the health of the remaining family members can apparently improve. This refutes the view that a serious life event necessarily has only a harmful influence on health.

Acute Disease↗
PubMed1999

Changes in family functioning for stroke rehabilitation patients and their families.

This study charted changes over time in the family functioning of a group of stroke rehabilitation patients and their families. Participants were 60 12-month stroke survivors who had undergone an inpatient rehabilitation programme, 46 spouses, and 25 other family members. Participants were assessed at the time of admission to and discharge from rehabilitation, and 6 and 12 months after discharge. The study was undertaken in the rehabilitation unit at Repatriation General Hospital, in Adelaide, South Australia. Family functioning was assessed using the McMaster Family Assessment Device, and functional outcome was monitored with the competence scale of the Australian ADL Index. Longitudinal change in family functioning was observed in problem solving, family communication, role definition, behaviour control, and affective involvement. There were no significant differences between the family functioning ratings provided by patients and their spouses. It is important that consideration be given to means by which the increase in family dysfunction following stroke can be addressed.

Activities of Daily Living↗
PubMedDate not supplied

Incestuous experience among Korean adolescents: prevalence, family problems, perceived family dynamics, and psychological characteristics.

OBJECTIVES: The present study aimed to identify the prevalence of incest among Korean adolescents and to determine the family problems, perceived family dynamics, and psychological consequences associated with incest in South Korea. DESIGN: A cross-sectional study was performed, using an anonymous, self-reporting questionnaire. Data were analyzed by percentages, Chi-square, and t-test statistical analyses, using SAS software program. SAMPLE: A total of 1,672 adolescents (1,053 student adolescents and 619 delinquent adolescents) were selected using proportional stratified random sampling method in this study. RESULTS: The results showed a 3.7% prevalence of incest in the tested Korean population. Families in which incest occurred were characterized by higher levels of problems, such as psychotic disorders, depression, criminal acts, and alcoholism among family members. Adolescent incest victims showed significantly more dysfunctional and unhealthy in terms of family dynamics and expressed significantly higher maladaptive and problematic psychological patterns than nonvictimized adolescents. CONCLUSIONS: The present findings identified some of the family problems and dysfunctional family dynamics may associate with intrafamilial child sexual abuse in Korea. Therefore, when an allegation of intrafamilial sexual abuse is made, health professionals should carry out a comprehensive assessment of their family dynamics and an evaluation of the impact of the abuse on the child and family.

Adolescent↗
PubMed1989

Observations about family interaction and the effect of therapy: interviews with families eight years after the onset of schizophrenia.

This study focused on the development of and changes in the interaction within a family after the onset of schizophrenia in a family member. Special attention is given to the possible effects of various treatments on the interaction. Our method was a circular interview of all family members in a joint session 8 years after the onset of schizophrenia. We observed that changes in family interaction usually had taken place during the first year of the illness. Thereafter, family conditions and interactions seem to have remained relatively unchanged. On the other hand, in addition to actual family-centered therapy, all other treatment modes--individual therapy, medication, hospitalization--seemed to have acted as systemic interventions on the family level. Our observation that family interactions and models of therapy often had a surprisingly strong resemblance led us to consider the idea of their coevolution over the years and the possible significance of this. This article aims at calling the reader's attention to the manifold influences that the onset of schizophrenia and its various treatments seem to have had on family system.

Family↗
PubMed1992

A computerized scoring procedure for the Kvebaek Family Sculpture Technique applied to families of children with rheumatic diseases.

A new computer-based quantification procedure was applied to data obtained from administering the Kvebaek Family Sculpture Technique (KFST) to 92 mothers of children with recent onset of rheumatic symptoms (median = 7 months). Four family configuration types (close, hierarchical, unspecified, and skewed) were defined on the basis of distance and structural parameters of the configuration. The types differed with regard to the childhood environment of the mother, chronic family difficulties, and the psychosocial functioning of the primary patient. Comparisons of the families of the mothers that did (n = 23) and did not (n = 69) wish a change of family configuration showed that the families of the mothers who wished change differed with regard to configuration types, distance variables, and psychosocial characteristics. The results are discussed in the context of structural family-systems theory. The computerized scoring procedure opens new possibilities for research about various family members' perspectives and assessment of changes in family configurations during therapy or over time.

Arthritis, Juvenile↗
PubMed1995

The structure of family perceptions among adolescents and their parents: individual satisfaction factors and family system factors.

This study examined the underlying structure of self-reports of family functioning by adolescents, mothers, and fathers (N of individuals = 360) from intact families. Participants completed a multidimensional self-report measure of family functioning, and their responses were entered into a factor analysis with the family as the unit of analysis (N of cases = 120). The results indicate two types of factors: individual satisfaction factors and family system factors. The findings are consistent with the view that different types of characteristics assessed in self-report measures of the family may be stored as different kinds of memories. The findings also provide preliminary data toward understanding the linkages between family system factors and satisfaction with the family based on family roles as adolescents, mothers, and fathers.

Adolescent↗
PubMed1996

Coping with stress in families of servicemen: searching for "win-win" solutions to a conflict between the family and the military organization.

The objective of this research was to explore the coping patterns of servicemen's families with the competing demands of two institutions: the military organization and the family. The sample comprised one hundred career soldiers along with their families. The research instruments included individual interviews, a battery of questionnaires, and a role-playing task. Examination of the couple's joint coping modes yielded two major categories of families-families that were successful in their efforts to resolve the military vs. family conflict, and families that did not manage to reconcile the competing demands of these two domains. Within each of these two categories there were a variety of distinct profiles. To compare the dynamics of successful coping with less successful coping regarding the military vs. family conflict, a conceptual model was suggested. This model subsumes the antecedent variables (job issues, support network, and couple relationships); mediating variables (cognitive appraisal of conflict severity and coping potential, as well as actual coping strategies); and outcome variables reflecting the degree of adjustment to the military vs. family conflict.

Adaptation, Psychological↗
PubMed1996

Measuring family therapy outcome in a clinical setting: families that do better or do worse in therapy.

This study examined several important family and therapist characteristics as they related to treatment success. A total of 434 families entering family therapy at a sliding-fee clinic in Dallas, Texas were rated (on the Beavers Interactional Competence and Style Scales), and completed several self-report family assessment instruments (Self-Report Family Inventory, FACES III) prior to beginning therapy. The therapists, trainees from various disciplines, had been trained in the Beavers Systems Model. Overall, 75% of the families showed at least some improvement. Those that fared best in therapy were more competent at the outset. While number of therapy sessions was associated with greater gains, there were some families that made great gains in fewer than six sessions. There were important demographic qualities that did not discriminate between greater- vs. lesser-gain families, including income level, ethnicity, therapist gender, and family size. A regression analysis indicated that functional rather than demographic variables were more important in predicting therapy outcome.

Adolescent↗
PubMed2007

Familial effects of BRCA1 genetic mutation testing: changes in perceived family functioning.

This study expands recent research that examines how the receipt of BRCA1 genetic test results affects family adaptability and cohesion 1 year after genetic risk notification. Study participants were members of a large Utah-based kindred with an identified mutation at the BRCA1 locus. The final sample, 90 men and 132 women, contributed information before genetic testing (baseline) and 4 months and/or 1 year after receipt of genetic test results. After controlling for other factors such as family coping resources (Family Crises-Oriented Personal Evaluation Scale) and strains (Family Strains Index) and the tested individual's anxiety levels before genetic testing (state anxiety subscale), men and women reported significant declines in family cohesion 1 year after genetic risk notification (P < 0.01). There is suggestive evidence that carrier men reported increasing adaptability 1 year after risk notification (+0.21 points per month; P < 0.10). Having a carrier sister had a positive influence on women's perceived family cohesion and adaptability levels, whereas a personal history of cancer, having a great deal of caregiving involvement for a female relative with cancer, anxiety, and some types of coping resources had a negative effect on men's perceived family cohesion and adaptability levels. Although results showed that tested parents are perceiving a decline in family functioning after genetic risk notification, there is no evidence to suggest that the decline is due to carrier status. In fact, it is other life circumstances that exist at the time of the genetic testing process that seem to influence the degree to which families adjust to the experience and test results.

Adaptation, Psychological↗
PubMed2001

Familiality of the puerperal trigger in bipolar disorder: results of a family study.

OBJECTIVE: Puerperal psychosis, an episode of mania or psychosis precipitated by childbirth, follows approximately one in 1,000 deliveries. The evidence of clinical, outcome, and genetic studies supports the hypothesis that the majority of puerperal psychotic episodes are manifestations of an affective disorder diathesis with a puerperal trigger. Family studies of puerperal psychosis consistently demonstrate familial aggregation of psychiatric (particularly affective) disorder and suggest a major overlap in the familial factors predisposing to puerperal psychosis and bipolar disorder. The single large study that used direct interview of relatives suggested that familial factors play a role in vulnerability to puerperal triggering itself. The authors' goal was to test this hypothesis further. METHOD: They conducted a study of the occurrence of episodes of puerperal psychosis in families multiply affected with bipolar disorder participating in an ongoing molecular genetic study of bipolar disorder in sibling pairs. RESULTS: Episodes of puerperal psychosis followed 81 (26%) of 313 deliveries to 152 parous women with bipolar disorder, 58 (38%) of whom had at least one puerperal psychotic episode. Puerperal episodes clustered in families. Episodes of puerperal psychosis occurred in 74% (N=20) of the 27 parous women with bipolar disorder who had a family history of puerperal psychosis in a first-degree relative but in only 30% (N=38) of the 125 women with bipolar disorder with no such family history. CONCLUSIONS: These results conclusively demonstrate that familial (probably genetic) factors are implicated in susceptibility to triggering of puerperal episodes in women with bipolar disorder. These findings have implications for future research and will be of use clinically in the management of women with bipolar disorder who are considering pregnancy.

Adult↗
PubMed2005

Development of professional practice based on a family systems nursing framework: nurses' and families' experiences.

The purpose of this evaluation project was to elicit nurses'and families' experiences about differences and changes for nurses and families and the family-nurse relationship when a family systems nursing approach was used to guide practice. Following nurses' involvement in an educational workshop, the evaluation examined changes in nurses'and families' experiences over an 8-week period of a child's hospitalization in a pediatric rehabilitation center. A total of 17 nurses and 13 parents participated in the project. Nurses and parents completed questionnaires and participated in semi-structured interviews and focus groups. Nurses completed journals reflecting on their interactions with families. Data were analyzed using descriptive statistics and content analysis. Findings indicate that a family systems nursing approach had a positive impact on how nurses viewed their nursing practice and their work with families, thereby enhancing family-nurse relationships. Such findings have relevance to clinical nursing practice, professional development, and evaluation research design.

Adolescent↗
PubMed1999

[Children suffering from atopic eczema and their families. A qualitative investigation of the effects on family and their coping styles].

UNLABELLED: Research in the field of the impact of chronic illness is nowadays often based on concepts such as coping and stress adaptation. From the point of view of the family chronic illness influences family functioning, while coping behavior is influenced by the families resources. There is little research done on this interaction. This article focuses on atopic eczema. METHODS: Qualitative free interviews of more than two hours duration each, had been done with all family members of families with a child suffering from severe chronic atopic eczema until the age of (pre-) puberty. A family interview with all members of the family has also been transcribed. The interpretation of the data is based on the qualitative content analysis and the grounded theory. The results from 5 families (24 interviews) lead to a typology of familial coping. The implications of this typology are discussed.

Adaptation, Psychological↗
PubMed2002

Family routines and rituals--the importance of family functioning: comment on the special section.

This diverse collection of papers highlights routines and rituals in family life. Just as individual family members bring unique styles and perspectives to the family table, to be incorporated into a family framework, so do each of these papers present rich and varied research questions, designs, and measurement strategies that enrich our understanding of family routine behavior patterns and ritual meanings. This series adds to our conceptualization of family routines and rituals within a systems perspective highlighting: 1) families are comprised of multiple levels that operate individually; interact with each other; and as a whole, reveal properties distinct from separate parts; 2) families tend toward stability in meaningful patterns of functioning; and 3) family functioning has meaning for individual outcomes.

Ceremonial Behavior↗
PubMed2005

[Finding the way in a new family--ressources and conflicts in patchwork and successive families].

A new family follows the separation of a former nuclear family. At least one of the new partners and its children had to do mourning work to overcome the former separation. Children and adolescents need a reliable network of familiar relations. The following article discusses the communalities and differences and the chances and difficulties in new families (patchwork families, successive families and step families). The resources of all the members, adults and children, are a key issue. Flexibility and dynamics are special resources of new families which can be learned in a therapeutic process. A special focus lies on the strengths of the sibling relations. A high capacity to communicate and to handle the actual problems is needed to succeed as a new family. A new family means the ongoing bargaining of the former and actual relationships as parents and as children.

Adaptation, Psychological↗
PubMedDate not supplied

The family therapist and the family physician: a cooperative model.

This study discusses the current lack of cooperation between family physicians and family therapists and its roots in the different belief systems that influence each profession. Family medicine and family therapy have each, in different ways, espoused a reductionistic view of the systems model they each formally espouse. A model is proposed that enables each profession to work cooperatively with the other by recognizing the particular dysfunction present within the family. This model is explained and clarified in terms of the interaction of biomedical and developmental crises in the course of the normal family life cycle. The purpose of this model is to provide a framework through which the two professions of family medicine and family therapy can cooperate to treat the various kinds of levels of dysfunction that occur within families.

Family Practice↗
PubMed1985

The family and hypertension in family practice.

The influence of the family in the care of family practice patients has not been studied extensively. This study uses hypertension as an index condition to characterize the extent of involvement of family around family practice center (FPC) patients and to examine whether the presence of family members influences patient outcomes. Records of 366 hypertensive patients were reviewed for information about blood pressures, demographic characteristics, associated medical conditions, and treatment. Three hundred forty-three of these patients responded to questions about family members, including their use of the FPC and whether they also had hypertension. Twenty percent of patients lived alone. Of the rest, two thirds had some, and one half had all family members enrolled in the FPC. Seventy-three listed family with hypertension, and 42 said these relatives were treated at the FPC. At the time of the first visit to the FPC for hypertension, the mean diastolic blood pressure was 93 mmHg. At their most recent visit, the mean was 83 mmHg, and 69 percent were below 90 mmHg. There was no association between blood pressure control and family enrollment in the FPC.

Adult↗
PubMed1984

Alcoholism in the families of family practice outpatients.

As part of a screening process for alcoholism, 147 patients at a university-based family practice center were each asked to complete two tests: the Michigan Alcohol Screening Test (MAST) concerning themselves and a modified MAST concerning their families. Charts of patients with positive results for family alcoholism were reviewed for presenting complaints, ongoing medical problems, and recognition or mention of family alcoholism by the physician. Over 34 percent (50) of patients had definite alcoholism problems in their families. Women were more likely than men to have a positive family MAST (37.7 percent women vs 24.4 percent men, P less than .001), whereas men were more likely to be alcoholic (34.1 percent men vs 10.4 percent women, P less than .001). Nearly 40 percent of patients with a positive family MAST had complaints that could be attributed to the family disruption of alcoholism, and another 20.8 percent had medical problems that might be exacerbated by stress, but use of alcohol by a family member was mentioned in only 12.5 percent (5/40) of charts reviewed.

Adult↗