Journal of Family Nursing

Psychosocial services have been recommended for families of children with chronic illnesses to assist them in adjusting to the illness experience. However, little is known about the benefit of psychosocial interventions in clinical practice. This study aimed at evaluating the benefits of a two-session family therapeutic conversation intervention (FAM-TCIs) for families of children diagnosed with asthma, cancer, or diabetes. A secondary data analysis was conducted on intervention data from 37 families of children with chronic illnesses. Mothers of the children/teenagers perceived significantly higher family support after the FAM-TCI compared with before; mothers reported significantly higher collaboration and problem-solving abilities on the expressive family functioning scale after the FAM-TCI. However, no significant differences were found on the fathers’ perceived family support nor on their expressive family functioning after the FAM-TCI compared with that before the intervention. It is promising that mothers of children with chronic illness perceived the two-session FAM-TCI to be beneficial to them. More attention should be paid to psychosocial interventions for families of children with chronic illnesses.

In the United States, the most significant health disparities occur among members of the American Indian and Alaskan Native populations. Because their health beliefs, values, and cultural practices are learned within a family system, this study used a focused ethnography to explore American Indians’ perceptions of a healthy family. Seventeen interviews were performed with 21 adults residing on a reservation on the Northern Plains of the United States. Participant observation was conducted during 100 hr of fieldwork. All informants identified a healthy family as being “close-knit,” indicating that the major defining feature of these families is the degree of connectedness among members, immediate and extended. In this paper, we present adult tribal members’ descriptions of a healthy family. It is evident that culturally appropriate programs, which consider American Indians’ values/beliefs and build on community assets, are urgently needed to reduce health disparities.

Care work by family and friends is recognized as a cornerstone of community-based care for older adults; however, the role of families in institutional-based care work has been less well understood and researched. Drawing on findings from a critical ethnographic study, this article aims to examine the unique role of highly involved family members within long-term residential care. The study took place between October 2006 and April 2008 in two facilities in British Columbia, Canada. A purposive sample of 11 highly involved family members participated in in-depth interviews and participant observations. The main themes were “Hands-On,” “Hands-Off,” “Surveillance,” and “Interlopers.” These themes illuminate the ways in which highly involved family members engaged in care work, including how they positioned themselves and were positioned by staff and administrators. Implications of the study focus on the need to include families in philosophies of care and policies that shape care work in long-term residential care.

Few studies have explored how African American parents navigate breast cancer while parenting their school-age children. This focus-group study examined how African American parents cope with the diagnosis and treatment of breast cancer. Three focus groups were conducted with nine African American parents coping with breast cancer. Interviews were analyzed using content analysis. Participants described a variety of coping strategies. Five primary themes emerged: involvement in community of support, relationship with cancer, being the family emotional regulator, highlighting positives, and spirituality. Findings suggest that providers can improve the care of African American breast cancer patients and their families by facilitating patient advocacy, encouraging patients to reach out to various support systems, discussing with patients their children’s functioning, and integrating spirituality into available support programs. Developing more culturally sensitive support groups that promote shared family understanding and open communication among African American parents and their children can facilitate better coping.

Emotions are contagious in couples. The purpose of this study was to analyze the manner in which adults with chronic heart failure (HF) and their informal caregivers influence each other’s self-care behavior and quality of life (QOL). A sample of 138 HF patients and spouses was enrolled from ambulatory centers across Italy. The Actor–Partner Interdependence Model (APIM) was used to analyze dyadic data obtained with the Self-Care of Heart Failure Index (SCHFI), the Caregivers Contribution to the SCHFI, and the Short Form 12. Both actor and partner effects were found. Higher self-care was related to lower physical QOL in patients and caregivers. Higher self-care maintenance in patients was associated with better mental QOL in caregivers. In caregivers, confidence in the ability to support patients in self-care was associated with improved caregivers’ mental QOL, but worsened physical QOL in patients. Interventions that build the caregivers’ confidence are needed.