Journal of Family Nursing最新文献

The family context is an important factor for sleep health in early childhood. About 40% of children between 0 and 3 years have problems regarding sleep that can affect their development. The aim of this study was to investigate the contribution of the brief family strength-oriented therapeutic conversation intervention to early-childhood sleep health. Data were collected in 2020-2021 from 57 primary caregivers of young children with moderate or severe sleep difficulties. The intervention was delivered through (a) a one 60-min face-to-face family educational and support session and (b) one to six 20- to 40-min telephone sessions based on the families' needs. After the intervention, primary caregivers reported greater family support, more helpful beliefs about their infant's/child sleep patterns, better family quality of life (QOL), better self-regulation regarding learning to fall and staying asleep among infants, and longer sleep periods at night in infants. These findings may prevent infants sleep difficulties from increasing and becoming more serious.

This study evaluated adaptations to the revised Self- and Family Management Framework aimed at enhancing support for families of young adult survivors of childhood brain tumors (YAS). Baseline data from condition-focused caregivers of YAS (N = 53) examined correlations between the Framework's Facilitators and Barriers (individual/contextual/clinical factors), Processes (caregiver problem-solving), Proximal Outcomes (YAS self-management, caregiver family management), and Distal Outcomes (YAS/caregiver HRQOL). All aspects of family management were associated with YAS HRQOL; only Parent Mutuality was associated with caregiver HRQOL. Problem-solving was partially supported as a process linked to family management and caregiver HRQOL. Individual/contextual/clinical factors were not associated with problem-solving. Self-management was not associated with problem-solving or HRQOL. Interventions grounded in concepts of family management may improve YAS HRQOL and have future potential for family nursing practice. Further research is needed to understand the divergence between HRQOL findings, partial support for problem-solving, and lack of associations with individual/contextual/clinical factors, and self-management.

Family caregivers provide essential care and support for individuals living with dementia, yet their contributions and needs are often unrecognized within formal health care systems. Over time, this marginalization can contribute to long-term trauma. Guided by a trauma-informed care (TIC) framework, we explored the experiences of 15 family caregivers in a longitudinal, qualitative study. Set in British Columbia, Canada, data were collected through semi-structured interviews and reflective diaries. Data were analyzed using inductive-deductive thematic analysis. Deductive analyses demonstrated that participants' experiences aligned with existing TIC principles. Inductive analysis identified "Uncertainty" as a novel principle, reflecting the ongoing challenges caregivers face from diagnosis to the inadequacy of in-home supports. Our study highlights the importance of recognizing trauma induced by interactions with formal health care services and the value of using a TIC approach with family caregivers of people living with dementia.

More than three million people in the United States are treated for diabetic extremity wounds every year, with numerous physical, financial, and psychosocial impacts not only to patients but also their families who care for them. This study examined the experiences of families who care for adult members with a diabetic extremity wound. A qualitative multiple case study was conducted with four family cases recruited from an urban academic medical center in the Southeastern United States, with data collection consisting of individual interviews, demographic survey instruments, and family caregiving genogram construction. Individual- and cross-case synthesis was completed using reflexive thematic analysis. Themes related to impacts on family functioning, the caregiving experience, and formal health care utilization were identified. These findings provide insight into the experiences of families living with diabetic extremity wounds, as well as clinical and research directions for the future.

Benefit finding is a concept that represents finding positive changes or benefits through difficult experiences. To map the currently available studies on benefit finding and growth among family caregivers of individuals with mental illness, we conducted a scoping review based on methodological frameworks. A systematic search for studies published in English was conducted using MEDLINE, PsycINFO, PsycARTICLES, CINAHL, and PTSDpubs from inception to August 2023. After screening, 21 articles were included in the review. Of these, 11 studies were cross-sectional studies, 7 were qualitative studies, 2 were mixed-methods studies, and a randomized controlled trial (RCT). Family caregivers experienced various positive psychological changes, such as becoming compassionate/tolerant and resilient, stronger family bonds, change in perspective on life and hope, acquisition of knowledge and coping strategies, and leveraging their experiences and appreciation by others, following various struggles and negative changes. Some indicators of benefit finding and growth, such as positive personal traits, positive reappraisal, good relationships with patients, and social support, were also revealed. The quality assessment demonstrated an acceptable level of quality in most studies, with a few outliers. Future longitudinal studies would reveal the mechanism of benefit finding and growth among family caregivers of individuals with mental illness.

Parenting a seriously ill child is complex and emotionally intense. To further develop Hinds and colleagues' Good Parent themes: "Keeping a Positive Outlook" and "Keeping a Realistic Outlook," we reviewed grounded theories published in English language journals from January 2006 to April 2021 identifying 18 studies with relevant results. Parents' efforts to keep a positive outlook included cognitive (e.g., remain hopeful, avoid negative thinking) and behavioral (e.g., monitoring child for signs of improvement, information seeking) actions. To keep a realistic outlook, parents acknowledged the serious nature of the condition, negative treatment effects, and limitations to treating the child normally. Parents holding both positive and realistic outlooks recognized the seriousness of their child's illness and remained hopeful while preparing for their child's death. Our analysis extends the understanding of how parents' expectations regarding the course and outcome of their child's illness shape cognitive and behavioral aspects of their parenting.

The ways that families communicate about traumatic experiences is a critical social process. Intrafamily trauma communication encompasses approaches through which family members share and respond to difficult past experiences. We examined the embedded communication processes and actions of war-affected Karen maternal caregivers living post-resettlement in the United States, as they described disclosures of torture and war trauma experiences to their children. Using a modified approach to a constructivist-oriented grounded theory, we analyzed 33 in-depth qualitative interviews. Narrative experiences of mothers and synthesized storylines shaped a psychosocial theory of maternal intrafamily trauma communication, Ushering a Witness. The core category was depicted by the coalescence of three distinct conceptual, temporal phases and corresponding properties: (a) Appraising: Communication decision-making, (b) (Co-)Constructing: Act of communicating, and (c) Amending: Developing awareness and reevaluating purpose, response, and approach to communication. Findings will facilitate further exploration of the relationships between the intergenerational effects of trauma and intergenerational communication.

Nurses caring for hospitalized children with long-term ventilator dependence (LTVD) assess family management capability and teach new skills through communication with family caregivers. This theoretically-based quantitative, descriptive study aimed to determine the communication behaviors associated with family caregiver uncertainty and management of the child with LTVD's care after discharge. One hundred families and 48 nurses enrolled. Family caregiver-nurse conversations were recorded and transcripts coded for communication behaviors. Family management and uncertainty data were gathered during hospitalization and after discharge. Data analysis included correlations and linear mixed models. Family caregivers and nurses used advocating and negotiating roles communication behaviors least frequently; however, these communication behaviors were associated with the most aspects in terms of uncertainty about the child's condition and ease of management of the child's care after discharge to home. Nurses should assess family caregiver ease in managing care, provide support, and engage in collaborative problem-solving through respectful communication.

This qualitative meta-synthesis was conducted with the aim to understand fathers' experiences and involvement when their child has a chronic condition within family context. Family nurse researchers from five countries identified 19 studies through a systematic search. Inclusion criteria were: (a) fathers as primary informant; (b) children (<19 years) with a chronic condition; (c) written in English, Spanish, French, or Portuguese. Data were synthesized using thematic analysis. Four themes reflected fathers' journey: "Juggling multiple roles" included protector, provider, and supporter; "Managing control" included relinquishing and regaining control; "Creating a new normal" addressed recovery; "Maintaining wellbeing" reflected multiple emotional responses and support found through partners, family, spirituality, and health care communities. Fathers desire to be involved in caring for their child with a chronic condition, yet involvement and experience are continually evolving due to various family needs. Health care providers should consider unconscious assumptions regarding fathers' role in child care and encourage fathers' involvement to facilitate family wellbeing.