Journal of Family Nursing最新文献

Although family-centered care (FCC) has been widely studied in pediatric settings, research focusing on families of children with medical complexity is limited, especially regarding parental perspectives in the Canadian context. This study explored how mothers of children with medical complexity conceptualize FCC. A qualitative approach was employed, using semi-structured interviews for data collection. Purposive sampling was used to recruit 19 mothers of children with medical complexity (aged 0-18 years) residing in British Columbia, Canada. Five key themes emerged: (a) Meeting families where they are; (b) Understanding family roles, responsibilities, and preferences; (c) Recognizing that family needs are dynamic and require ongoing reassessment; (d) Encouraging open communication and feedback; and (e) Acknowledging that the health of the child and parents is inextricably linked. Findings provide insights to guide policy and best practices for this population, who represent some of the highest users of pediatric health care services in Canada.

Parents of pediatric intensive care unit (PICU) children experience significant stress and miscommunication with health care providers. This sequential mixed methods study aimed to (a) describe miscommunication, stress, and trust; (b) describe parent experiences related to miscommunication; and (c) compare stress levels between parents who perceived miscommunication and those who did not. A total of 200 parents completed the survey, with 14 participating in interviews. Key findings indicated that higher miscommunication led to increased distress and decreased trust in health care providers. Parents attributed miscommunication causes to clinician workload, provider availability, and involvement of multiple medical teams. Interestingly, greater distress occurred when miscommunication stemmed from conflicting information rather than clinical acuity concerns. The study highlights the urgent need for psychosocial support in PICU settings, as parental insights offer potential clinical relevance for future research. Parents' experiences underscore the importance of addressing miscommunication to enhance patient care outcomes and improve parental well-being.

Feeding children is part of family caregiving. Children with Down syndrome have increased risks for feeding problems, but there is limited literature on caregiving specific to feeding children with Down syndrome. The purpose of this study is to understand mothers' experiences related to feeding their 3- to 10-year-old children with Down syndrome within family and sociocultural contexts. This was a qualitative study using interviews and photo-elicitation. Twenty-nine mothers of children with Down syndrome in the United States participated. Three themes were identified: (a) Feeding Challenges and Foodwork Related to the Child's Feeding Attributes, (b) Family Dynamics and Routines that Impact Foodwork, and (c) Influence of Family and Sociocultural Norms on Feeding Experiences. Mothers engage in complex family caregiving work to feed their children with Down syndrome. Feeding can be influenced by child and family characteristics and by sociocultural contexts. Findings have implications for clinical practice and research.

To evaluate the family members' psychosocial support during specialist palliative inpatient care. Cross-sectional study. The "Family Involvement Scale-Psychosocial Support in Palliative Inpatient Care" (FIS-PS-InPal) questionnaire was used to collect data from family members from specialized palliative care wards across Finland. Data were analyzed using descriptive statistics. In total, 171 family members from 16 wards across Finland participated in the study. Family members evaluated the support they received as close to ideal, with 19.9% of participants reporting that the support was less than desired. They rated psycho-emotional support and support practices as the strongest and informational support as the weakest. The psychosocial support that family members receive in specialist palliative care is generally adequate. However, efforts should be made to improve how information is communicated. The study underscores the importance of evaluating and addressing the unique support implementation for families in palliative care.

Having an infant requiring care in a neonatal intensive care unit (NICU) is challenging for parents. The aim was to investigate the effects of the Family Health Conversation (FamHC) model on self-reported mental health, family wellbeing, and family functioning in parents of infants requiring mechanical respiratory support during NICU care. This interventional study included 147 parents (72, intervention group; 75, control group). All participants received a study-specific questionnaire at three time points. The intervention trended toward positive effects on mental health, family wellbeing, and family functioning. However, all measurements showed considerable variation, and the estimated effects were not statistically significant at the 0.05 level. Regardless of the intervention, mental health symptoms decreased over time, whereas family wellbeing and functioning remained stable. To conclude, although the intervention trended favorable for all outcomes, no significant differences were observed between groups. Potential effects might be better identified using qualitative methodology or self-reporting measures in a larger sample.

This qualitative review aims to synthesize the evidence on nurses' experience of intervening with fathers when providing care to their young children. Five databases were searched. Inclusion criteria were (a) nurses' experience, (b) intervention with fathers, (c) written in English or French. Data were extracted by two independent reviewers. Qualitative thematic synthesis of 17 peer-reviewed studies was performed by 12 family nurse researchers from six countries. Three analytical themes were identified: "Conceiving of the father's role in terms of his involvement within the family"; "Working with fathers based on the nurse's individual conception of the paternal role"; and "Developing a sense of efficacy in working with fathers." The results highlight the importance of raising family nurses' awareness of fathers' individual realities. Training in this regard makes it possible to modify nurses' perceptions of the paternal role and to promote the adoption of father inclusive practices within the family.

This study aimed to learn how a sequence of family-systemic therapeutic conversations created a context to respond to the challenges and needs of a family raising a child with intellectual disability. The data for this qualitative, exploratory, longitudinal single-case study were collected at a Swiss Family Systems Care Unit. The three therapeutic conversations conducted with a single mother of an adolescent with intellectual disability were analyzed using summarizing and explicative content analysis on the within-data source level and structuring content analysis on the across-and-between data source level. The main category, "gaining more ease by modeling burdens and suffering," refers to a better balance of the woman's challenges cumulating to deep suffering. Six subcategories detail the challenges, needs, interventions, and effects. Therapeutic conversations in families with multiple severe vulnerabilities are supportive. The study was written according to the Standards of Reporting Qualitative Research and the Methodological Framework for Organizational Case Studies.

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.

Children with autism spectrum disorder (ASD) have complex health needs and co-occurring medical and psychiatric diagnoses. Using the Family Management Style Framework, this convergent parallel mixed methods (QUAN + qual) study: (a) examined the intersection of Ability and Effort to define family management patterns and (b) evaluated the influence of child (ASD-related behaviors, feeding difficulties, sleep disturbances, gastrointestinal symptoms, aggression, self-injury), caregiver (anxiety, depression), and family (social support, unmet social needs) factors on family management pattern. Fifty-six primary caregivers of children with ASD completed the quantitative strand of the study. A nested sample of 30 caregivers participated in semi-structured interviews. The four patterns of family management were similar to those previously identified. Data from quantitative measures and interviews converged to identify that specific child characteristics (ASD behaviors, sleep disturbances, aggression, self-injury) and the caregiver's perceived social support influence family management. Descriptions of family management patterns and their correlates are important to guiding family nursing for this population.

Illness beliefs have a role in the adaptation, coping, well-being, healing, and recovery in families of children/adolescents with chronic illness. The assessment of family illness beliefs can support family nursing interventions that address the suffering of family members when illness arises. The purpose of this study was to translate, cross-culturally adapt, and psychometrically test the Portuguese version of the Iceland-Family Illness Beliefs Questionnaire. A sample of 237 parents of children/adolescents who experienced chronic health conditions completed the online questionnaire. The original factor model was tested through confirmatory factorial analysis. The results showed satisfactory model fit indices (χ²/gl = 3.004; comparative fit index [CFI] = 0.90; root mean square error of approximation [RMSEA] = 0.092) and internal consistency (Cronbach's α = 0.74). The instrument showed good psychometric characteristics of validity and reliability, suggesting it may be useful in the assessment of illness beliefs in families experiencing a pediatric chronic illness.