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Current Treatment Options in Oncology May 2022Specialists in palliative care view the family meeting as a means to engage patients and their families in a serious illness discussion that may clarify the values of... (Review)
Review
Specialists in palliative care view the family meeting as a means to engage patients and their families in a serious illness discussion that may clarify the values of patients and caregivers, provide information, determine care preferences, and identify sources of illness-related distress and burden. The family meeting is considered the best practice for achieving patient- and family-centered care in palliative care. Although studies of the family meeting are limited, those extant suggest that these interventions may reduce caregiver distress, mitigate the perception of unmet needs, prepare family members for caregiving, and improve bereavement outcomes. The experience of palliative care specialists further suggests that the family meeting may reinforce the therapeutic alliance with families, promote consensus, and reduce the need for ad hoc meetings. Physician satisfaction may be enhanced when the treatment plan includes the opportunity to show empathy and see the family's perspective-core elements of the clinical approach to the family meeting. In the oncology setting, the potential to achieve these positive outcomes supports the integration of the family meeting into practice. Clinical skills for the planning and running of family meetings should be promoted with consideration of a standardized protocol for routine family meetings at critical points during the illness and its treatment using an interdisciplinary team. Further research is needed to refine understanding of the indications for the family meeting and determine the optimal timing, structure, and staffing models. Outcome studies employing validated measures are needed to better characterize the impact of family meetings on patient and family distress and on treatment outcomes. Although better evidence is needed to guide the future integration of the family meeting into oncology practice, current best practices can be recommended based on available data and the extensive observations of palliative care specialists.
Topics: Caregivers; Family; Humans; Palliative Care; Patient Care Planning
PubMed: 35316479
DOI: 10.1007/s11864-022-00957-1 -
BMC Oral Health Jun 2018Dental fear and anxiety (DFA) is a major issue affecting children's oral health and clinical management. This study investigates the association between children's DFA...
BACKGROUND
Dental fear and anxiety (DFA) is a major issue affecting children's oral health and clinical management. This study investigates the association between children's DFA and family related factors, including parents' DFA, parenting styles, family structure (nuclear or single-parent family), and presence of siblings.
METHODS
A total of 405 children (9-13 years old) and their parents were recruited from 3 elementary schools in Hong Kong. Child's demographic and family-related information was collected through a questionnaire. Parents' and child's DFA were measured by using the Corah Dental Anxiety Scale (CDAS) and Children Fear Survey Schedule-Dental Subscale (CFSS-DS), respectively. Parenting styles were gauged by using the Parent Authority Questionnaire (PAQ).
RESULTS
DFA was reported by 33.1% of children. The mean (SD) CFSS-DS score was 29.1 (11.0). Children with siblings tended to report DFA (37.0% vs. 24.1%; p = 0.034) and had a higher CFSS-DS score (29.9 vs. 27.4; p = 0.025) as compared with their counterpart. Children from single-parent families had lower CFSS-DS score as compared with children from nuclear families (β = - 9.177; p = 0.029). Subgroup analysis showed a higher CFSS-DS score among boys with siblings (β = 7.130; p = 0.010) as compared with their counterpart; girls' from single-parent families had a lower CFSS-DS score (β = - 13.933; p = 0.015) as compared with girls from nuclear families. Children's DFA was not associated with parents' DFA or parenting styles (p > 0.05).
CONCLUSIONS
Family structure (nuclear or single-parent family) and presence of siblings are significant determinants for children's DFA. Parental DFA and parenting style do not affect children's DFA significantly.
Topics: Adolescent; Child; Dental Anxiety; Family Characteristics; Female; Humans; Male; Only Child; Parent-Child Relations; Parenting; Siblings; Single-Parent Family; Socioeconomic Factors
PubMed: 29866080
DOI: 10.1186/s12903-018-0553-z -
Nursing Ethics Sep 2022Family involvement in nursing homes is generally recognized as highly valuable for residents, staff and family members. However, family involvement continues to be... (Review)
Review
BACKGROUND
Family involvement in nursing homes is generally recognized as highly valuable for residents, staff and family members. However, family involvement continues to be challenging in practice.
AIM
To contribute to the dialogue about family involvement and develop strategies to improve family involvement in the nursing home.
METHODS
This interpretative synthesis consists of a thematic analysis and care ethical interpretation of issues regarding family involvement from the perspective of families in nursing homes reported in literature.
FINDINGS
This study reveals the complexities of family involvement in the nursing home by drawing attention to the moral dimension of the issues experienced by families, as seen through the theoretical lens of Baier's care ethical concept of trust as a theoretical lens. The synthesis of literature resulted in a thematic categorization of issues reported by families, namely, family-staff relationship, psychosocial factors and organizational circumstances. The care ethical interpretation of the synthesis of literature showed that the concept of trust resonates with all reported issues. Trust evolves over time. Early issues are mostly related to getting to know each other. Secondly, families want to experience that staff are competent and of good will. Difficult feelings families may have, such as guilt or loneliness, and dealing with the deterioration of the loved one puts families in a vulnerable position. This power imbalance between family and staff impedes a trusting relationship. Issues related to organizational circumstances, such as understaffing, also undermine families' trust in staff and the nursing home.
DISCUSSION AND CONCLUSION
Baier's theoretical concept of trust provides a deeper insight into the moral dimension of family involvement from the perspective of families in the nursing home. To improve family involvement in practice, we propose to aim future interventions at reinforcing trust in the relationship between family and staff as well as in the organizational context in which these care relationships occur.
Topics: Family; Guilt; Humans; Nursing Homes; Professional-Family Relations; Trust
PubMed: 35732193
DOI: 10.1177/09697330221085774 -
International Journal of Environmental... Dec 2022The literature indicates a variety of factors that contribute to adolescent well-being: among these, the parent-adolescent relationship has a key role. The present... (Review)
Review
The literature indicates a variety of factors that contribute to adolescent well-being: among these, the parent-adolescent relationship has a key role. The present article offered an overview of studies on parent-adolescent relationships across diverse family forms, not limited to the traditional family but also including "non-traditional" and "modern" families. To do so, this article described the evolution of the concept of family over the last fifty years and traced the significant family variables that guarantee adolescent well-being. Additionally, this article discussed the changes that occurred in family research, shifting from studies that considered only the family structure to more recent studies that investigated family processes and contextual factors. Overall, the reviewed studies indicated that the quality of parent-adolescent relationship, the interparental conflict and the consequent spillover effect on the child subsystem, and the changes in the economic situation following parental separation/divorce override the effect of the family structure. Finally, this article pointed out the need to examine, in the future research, adolescent well-being across diverse families by adopting more fine-grained methodologies, collecting data from the entire family system, and using a multi-method assessment to obtain a more ecological view of family complexity.
Topics: Child; Humans; Adolescent; Family Conflict; Divorce; Adolescent Health; Family Structure; Parent-Child Relations; Parenting
PubMed: 36612705
DOI: 10.3390/ijerph20010383 -
International Journal of Environmental... Jan 2022Hereditary cancer syndromes are inherited pathogenic genetic variants that significantly increase the risk of developing cancer. When individuals become aware of their... (Review)
Review
Hereditary cancer syndromes are inherited pathogenic genetic variants that significantly increase the risk of developing cancer. When individuals become aware of their increased probability of having cancer, the whole family is affected by this new reality and needs to adjust. However, adjustment to hereditary cancer syndromes has been mainly studied at an individual level, and research about familial adjustment remains dispersed and disorganized. To overcome this gap, this review aims to understand how families adjust to genetic testing and risk management, and to what extent the family's adjustment influences the psychological response and risk management behaviors of mutation carriers. We conducted searches on the PubMed/Med Line, PsycInfo, SCOPUS, and Google Scholar databases and used the Mixed Methods Appraisal Tool (MMAT-v2018) to assess the methodological quality of each selected study. Thirty studies met the inclusion criteria. Most results highlighted the interdependent nature of adjustment of pathogenic variant carriers and their families. The way carriers adjust to the syndrome is highly dependent on family functioning and related to how family members react to the new genetic information, particularly partners and siblings. Couples who share their worries and communicate openly about cancer risk present a better long-term adjustment than couples who use protective buffering (not talking about it to avoid disturbing the partner) or emotional distancing. Parents need help dealing with disclosing genetic information to their children. These findings reinforce the importance of adopting a family-centered approach in the context of genetic counseling and the necessity of involving family members in research.
Topics: Child; Family; Genetic Counseling; Genetic Testing; Humans; Neoplastic Syndromes, Hereditary; Risk
PubMed: 35162625
DOI: 10.3390/ijerph19031603 -
International Journal of Environmental... Dec 2022The violation of children's right to a safe home environment is a major public health problem in need of serious attention. Evidence has been limited about the family...
The violation of children's right to a safe home environment is a major public health problem in need of serious attention. Evidence has been limited about the family characteristics that go with the co-occurrence of harsh parenting and family conflict. By using a representative community sample of Hong Kong families, this study aims to examine the prevalence and risk factors of harsh parenting and family conflict. This study was conducted using a secondary analysis obtained from the 2017 Hong Kong Family Survey with a sample size of 1926 respondents who have children. Results showed that participants' ages are negatively related to the occurrence and co-occurrence of harsh parenting and/or family conflict. Married mothers reported less family conflict. Fathers with lower education levels reported more experiences of family violence. Mothers reporting a higher level of family satisfaction were less associated with harsh parenting. This study provides insights into the unique and shared familial elements that prevent harsh parenting and family conflict and help facilitate the development of effective intervention strategies for family violence co-occurrence. Family-based prevention for family violence may screen for the presence of harsh parenting and family conflict and take into consideration these signals to better support families in need.
Topics: Child; Female; Humans; Family Conflict; Parenting; Mothers; Domestic Violence; Hong Kong
PubMed: 36498275
DOI: 10.3390/ijerph192316199 -
Journal of Affective Disorders May 2020Our objective was to systematically review non-experimental studies of parental bipolar disorder (BD), current family environment, and offspring psychiatric disorders to... (Review)
Review
BACKGROUND
Our objective was to systematically review non-experimental studies of parental bipolar disorder (BD), current family environment, and offspring psychiatric disorders to identify characteristics of family environment associated with parental BD and risk for offspring psychiatric disorders.
METHODS
CINAHL, Embase, PsycINFO, and PubMed were searched using MeSH terms to identify studies on offspring of BD parents published through September 2017. We followed PRISMA guidelines and used the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS). We calculated prevalence ratios and 95% confidence intervals to compare offspring psychiatric disorders within and across studies.
RESULTS
Of 10,454 unique documents retrieved, we included 13 studies. The most consistent finding was lower parent-reported cohesion in families with a BD parent versus no parental psychiatric disorders. Family environment did not differ between BD parents and parents with other disorders. Offspring of BD parents had higher prevalence of psychiatric disorders than offspring of parents without psychiatric disorders but did not differ from offspring of parents with other disorders. Families with a BD child had higher conflict than families without a BD child.
LIMITATIONS
Comparisons between studies were qualitative. A single reviewer conducted screening, data extraction, and bias assessment.
CONCLUSIONS
Family environment in families with a BD parent is heterogeneous. The pattern of findings across studies also suggests that family problems may be associated with parental psychiatric illness generally rather than parental BD in particular. Few studies included offspring-reported measures. Given the association of family conflict with offspring mood disorders, further study is merited on children's perceptions of the family environment in the BD high-risk context.
Topics: Bipolar Disorder; Child; Child of Impaired Parents; Family Conflict; Humans; Mood Disorders; Parents
PubMed: 32158009
DOI: 10.1016/j.jad.2020.03.005 -
Journal of Pediatric Nursing 2021Interventions for children with obesity lead to only modest improvements in BMI and long-term outcomes, and data are limited on the perspectives of families of children... (Review)
Review
PROBLEM
Interventions for children with obesity lead to only modest improvements in BMI and long-term outcomes, and data are limited on the perspectives of families of children with obesity in clinic-based treatment. This scoping review seeks to answer the question: What is known about the perspectives of families and children who receive care in clinic-based child obesity treatment?
ELIGIBILITY CRITERIA
Studies were eligible for inclusion in this review that 1) reported parent, family or child perspectives of obesity treatment; 2) addressed concepts identified in the obesity literature as barriers or facilitators to success in obesity treatment from the perspective of the parent/family/child, including reasons for failure to return to clinic and satisfaction with care.
SAMPLE
Twelve studies qualified for final inclusion in this scoping review RESULTS: Families report a lack of interventions tailored to their unique needs and resources. Barriers and facilitators encompass 1) structural issues (e.g., clinic location and scheduling); 2) financial issues; 3) patient and family issues; and 4) personal behaviors, motivation, and expectations.
CONCLUSION
Data are lacking on the clinic-based treatment of children with severe obesity, and few studies report on non-maternal perspectives.
IMPLICATIONS
Clinical practice must be tailored to individual family needs. Future research should concentrate on identifying missing variables which impact successful treatment outcomes through more rigorous qualitative studies, standardized outcome measures, focus on children with severe obesity, and fathers' and siblings' perspectives.
Topics: Child; Family; Fathers; Humans; Male; Parents; Pediatric Obesity; Qualitative Research
PubMed: 33271477
DOI: 10.1016/j.pedn.2020.10.025 -
Nursing Open Jun 2023To identify the challenges facing burn care nurses and burn patients' family members and to explore the relationship between the above challenges. (Review)
Review
AIMS
To identify the challenges facing burn care nurses and burn patients' family members and to explore the relationship between the above challenges.
DESIGN
Whittemore and Knafl's integrative review.
METHODS
Databases used for this review included Cochrane Library, Web of Science, PubMed and Embase. The original research published from January 2010 to November 2021 was selected. Studies reporting the challenges of family members or nurses of burn patients identified through extensive database search were considered for inclusion. The Mixed-Method Appraisal-Tool was applied for the evaluation of the quality of the literature. The analysis approach used was content analysis.
RESULTS
Of the 2746 identified studies, 17 studies were included. Key findings related to the challenges facing nurses and family members of burn patients were extracted. The themes relating to burn care nurses included ethical and religious issues, clinical issues, work-life imbalance and limited support. The themes relating to family members included family's different views on prognosis and treatment, work-life imbalance, psychological issues and lack of multifaceted support. The challenges for the formal and informal caregivers are similar and there is existence of some shared concerns. If the above challenges are not resolved, support for the burn patients may be adversely affected. Corresponding measures should be taken to overcome such challenges.
Topics: Humans; Family; Burns; Caregivers
PubMed: 36840702
DOI: 10.1002/nop2.1651 -
Current Opinion in Psychiatry Mar 2015Developmental disabilities are increasingly recognized, and remarkable progress is being made on the genetic and neurobiological underpinnings of many disorders. Yet,... (Review)
Review
PURPOSE OF REVIEW
Developmental disabilities are increasingly recognized, and remarkable progress is being made on the genetic and neurobiological underpinnings of many disorders. Yet, only a tiny percentage of the disability literature addresses families of children with disabilities. A review of recently published family studies reveals salient trends and gaps.
RECENT FINDINGS
Consistent with previous work, high levels of parent stress, illness, anxiety, and depression are apparent. Studies in the USA focused on parents of children with autism; in contrast, studies on parents of children with intellectual disabilities were almost always conduced abroad. Compared to other disabilities, families of children with psychiatric disorders and genetic syndromes are understudied. The majority of family studies are descriptive, with very few trials or interventions aimed at reducing parental stress. Of these, mindfulness practices and a peer-mentor model of treatment delivery hold much promise for effective stress reduction. Psychoeducational programs and respite care are differentially beneficial.
SUMMARY
A new era of family intervention research is in order. This work can take advantage of many advances in telemedicine, peer-mentor models, smart technology, and biomarkers as indices of change. Benefit could also stem from group interventions with parents who share similar concerns, regardless of their child's diagnostic label.
Topics: Child; Developmental Disabilities; Disabled Children; Family; Humans; Nervous System Diseases; Parents; Siblings
PubMed: 25594421
DOI: 10.1097/YCO.0000000000000129