The Beyond the Surface: A Screening-Based Analysis of Family Health, Psychological Well-Being, and Social Support in Student Mental Health

Parents’ experiences of family functioning, health and social support provided by nurses – A pilot study in paediatric intensive care

Background and Purpose: Family functioning, family health, and social support have significant roles in the management of heart failure (HF). This study aimed to translate, adapt, and assess the validity and reliability of the Persian version of the Family Functioning, Family Health, and Social Support (FAFHES) questionnaire. Methods: FAFHES questionnaire was translated into Persian, and an expert panel assessed the cross-cultural adaptation. We examined the construct validity by confirmatory factor analysis and internal consistency by Cronbach's alpha coefficients among 576 participants. Results: The Persian FAFHES confirmed the three-factor structure in the social support and the five-factor structure in the family health scales. However, the family functioning scale yielded the three-factor structure versus the four-factor structure in the original scales. The Cronbach's alpha for the three scales varied from 0.85 to 0.94. Conclusions: The adapted FAFHES seems to be valid and reliable to measure family functioning, family health, and social support in families with HF.

Valid and reliable instruments to assess family functioning, health and social support in families with heart failure constitute a cornerstone in the detection of the families' needs, in improving their functioning and in evaluating the effects of nursing interventions. To translate the three scales of the Family Functioning, Family Health and Social Support (FAFHES) questionnaire from Finnish into Danish, to test validity and reliability of the Danish version among outpatients with heart failure and to add to previous studies by reconstructing scales using confirmatory factor analysis. A cross-sectional design was used to study a sample of 330 patients with heart failure who completed the FAFHES. The validity (dimensionality) and reliability (internal consistency and test-retest) were assessed for each of the three scales. The scales were constructed using confirmatory factor analysis. Patients were primarily men (76%) with a mean age of 66.5 (SD 12.5), categorised as New York Heart Association (NYHA) classification II (80%) and NYHA III (20%) for clinical severity of symptoms. In all three modified scales, construct validity was supported by the analysis. There were strong correlations within the factors, with Cronbach's alpha ranging from 0.73 to 0.95 across the three scales, and significant, though weak, correlations between most of the factors. None of the revised scales showed good model fit according to the goodness-of-fit indices used. The test-retest showed interclass correlation coefficients ranging between 0.69 and 0.86, indicating acceptable test-retest reliability. The Danish version of the FAFHES is an instrument that can be used to measure family functioning, family health and social support from the perspective of the patient with heart failure. Further testing is recommended.

A Survey on the Relation Between Social Support and Mental Health in Students Shahid Rajaee University

Introduction: Several studies have reported that having a child with a neurodevelopmental disorder (NDD) increases parental stress and that parental psychosocial functioning influences child`s development and behavior. It is unclear how parents of children with NDD experience family functionality, family health and receive support and if there are differences between experiences of mothers and fathers.Methods: Families with children referred to a neurocognitive unit were invited to the study. A modified version of the FAmily Functionality, HEalth, and Social support (FAFHES) questionnaire was used. Open-ended questions were also included.Results: Parents rated their social support lower than their family functionality and family health. Family functionality correlated positively with family health. No significant differences were found between mothers’ and fathers’ experiences. A three-months test-retest using the FAFHES showed no significant change in ratings of family functionality, family health, and social support.Conclusions: Family functionality was connected to family health in families with a child with NDD. Mothers and fathers experienced their family health, family functionality, and received social support in similar ways.

The aim of this study was to describe aged home care clients' and their family members' experiences of their family functioning, family health and social support received. An additional purpose was to determine which factors are connected with social support. Increasing life expectancy and ageing of the population require consideration of the adequacy of home care services and the role of family members as care providers. The older population is a very heterogeneous group because of their variable needs and several disabilities. To ensure the quality of home care, experimental information is needed from clients and their family members. A survey design with convenience sampling. The home care client and a family member of his/her answered a questionnaire together, including background questions, the Family Functioning, Health and Social Support instrument and an open question about support received from home care. Statistical methods were used to describe quantitative data, and content analysis was used in analysing the replies to the open question. Family health was noted as good, and family functioning and overall social support fairly good. An older person's higher basic education, higher age of the family member, better family health and male gender were connected with better social support received. The relationship of the older person and the family member as well as the duration of home care service use had an effect on social support received. The content analysis raised expectations related to time, planning of service, organisational factors and caring practise. Home care clients' and families' needs for support vary, and therefore, the assessment of needs, care planning and updating are important. The variable support needs of older people and their family members require flexible and adaptable home services. Cooperation between all participants involved in care would promote the well-being of the older person and the entire family.

Mental health problems in university students were highlighted during the Covid-19 pandemic, showing the need to pay greater attention to psychological, emotional and social conditions. Since confinement and isolation, diseases and disorders have increased in school environments. Therefore, the objective of the paper is to analyze empirical evidence on mental health in students of higher education through a systematic review of scientific literature, which allows recognizing effects on training and academic performance. The methodology adapted to the study is qualitative cut, based on the systematic review of scientific literature, which consists of three phases, the first consisted of the exploration of 17,649 materials including scientific articles and degree theses; the second phase consisted of a more detailed exploration based on the implementation of filters such as keywords, reading abstracts and reading the full text; The third phase was the processing of materials that met with methodological quality and contribute to knowledge about mental health in university students, in an analysis matrix that allowed identifying categories of analysis, concepts, debates, among others. The systematic literature review identified lines of analysis, the first contributing to the debate on mental health in university students; the next consisted in identifying the most common sufferings in students that compromise their mental health; and third, the effects of mental health on training and academic performance of university students are presented. As a conclusion, it is identified that mental health in university students is an issue that became relevant in the pandemic by Covid-19 and that prevails as a problem that affects training and academic performance.

Background Family caregivers of patients with chronic mental illness experience psychological stresses. Such stresses affect the psychological well-being of relatives, who have moderately high levels of burden and frequently get inadequate support from mental health professionals. Aim The aim of this study is to examine the relationship between burden, psychological well-being, and social support among caregivers of mentally ill patients. Research design A descriptive correlational design was used in this study. Setting This study was conducted at the psychiatric outpatient clinic in Azzazi Psychiatric Mental Health Hospital at Abu Hammad in Sharkia Governorate. Patients A purposive sample of 150 mentally ill patients’ caregivers, who accompany their patients to the psychiatric outpatient clinics, was recruited. Tools of data collection Four tools were utilized for data collection: sociodemographic data sheets, family burden scale, psychological well-being scale, and multidimensional scale of perceived social support. Results More than half of the caregivers aged from 40 to 60 years. Most of the patients were diagnosed as having schizophrenia. More than two-fifths of the caregivers were parents and had high level of burden. Nearly two-thirds had moderate level of psychological well-being, and approximately half of the caregivers had moderate level of social support. Conclusion There were negative statistically significant correlations among family burden, psychological well-being, and social support. However, a positive statistically significant correlation was detected between social support and psychological well-being. Recommendations It is recommended that training programs should be designed for caregivers to enhance psychological well-being and social support and decrease the level of burden among caregivers of mentally ill patients.

A methodological study was conducted to test the psychometric properties of the Family Functioning, Health, and Social Support (FAFHES) Instrument to be used with families of heart patients. A total of 109 initial items were developed based on knowledge generated by three Finnish academic dissertations concerning family functioning, health, and social support provided by nurses. Data were collected from family members of 161 heart patients. Principal component analysis was performed in each of three total scales: family functioning, family health, and social support. The scales had acceptable reliability (alpha coefficients ranged from .73 to .95). Internal consistency reliability and content validity of the FAFHES have initial support. Results obtained from this study support that this instrument is ready for use in research in which the investigator wishes to measure social support associated with family functioning and the health of families of heart patients.

Factors Associated With College Students' Mental Health During the COVID-19 Pandemic Krista M. Soria (bio) and Bonnie Horgos (bio) In December 2019, an outbreak of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), the virus that causes coronavirus disease (COVID-19), was first reported in China. By March 11, 2020, the World Health Organization declared COVID-19 a global pandemic, forcing many higher education institutions to take measures to promote students' safety. The COVID-19 pandemic continues to upend the lives of students in higher education institutions. In particular, the pandemic has had deleterious effects on students' mental health, leading to increased prevalence of major depressive disorder (MDD) and generalized anxiety disorder (GAD; Healthy Minds Network & American College Health Association [HMN], 2020). Students' mental health has become a paramount concern to institutional leaders: over 90% of college presidents expressed concern about students' mental health during the pandemic (Lederman, 2020). As faculty, student affairs practitioners, administrators, and mental health providers brace for the impact of increasing numbers of students who experience mental health disorders in upcoming semesters, they may benefit from an enhanced understanding of the students who are likely to experience mental health disorders and of the roles that other stressors or supports can play in students' mental health. The unique context surrounding the pandemic may create conditions that alter previous research findings related to students' mental health; therefore, we designed this study to examine the associations between individual, interpersonal, institutional, health, and stress-related factors and undergraduates' risks for clinically significant MDD and GAD. MENTAL HEALTH DISORDERS AMONG COLLEGE STUDENTS Even before the pandemic, the frequency of college students' mental health disorders was increasing at an alarming rate. Recent estimates indicate that 31% of students experienced GAD and 41% experienced MDD during the pandemic (HMN, 2020). College students are a particularly vulnerable group when it comes to their risk for mental health disorders, many of which first present themselves in late adolescence and early adulthood (Liu et al., 2020). Some of the variables associated with college students' mental health can be grouped into five broad categories: (a) individual characteristics (e.g., gender and sexual orientation), (b) interpersonal factors (e.g., sense of belonging), (c) institutional factors (e.g., perceptions of a supportive environment), (d) health and safety factors (e.g., nutrition and sleep), and, (e) stressors (e.g., financial and academic; Fink, 2014; [End Page 236] Oswalt & Wyatt, 2011). The unique conditions surrounding the COVID-19 pandemic might exacerbate the effects of some of the aforementioned factors on students' MDD and GAD. While emerging studies on college students' mental health during the COVID-19 pandemic present useful information to practitioners, the majority of those studies are limited because of small sample sizes, single-institution samples, or a limited number of independent variables (Huckins et al., 2020; Liu et al., 2020). We examined a wide variety of factors associated with college students' rates of MDD and GAD with variables specific to students' experiences during the pandemic; our sample was drawn from 8 large, public research universities; and, our sample size allowed us to examine the effects among demographic groups typically excluded in studies because of their small numbers. CONCEPTUAL FRAMEWORK We drew from Fink's (2014) integrated model of college students' mental health, which combines Astin's (1993) input–environment–outcome model, the VicHealth framework (Keheler & Armstrong, 2005), and Keyes's (2002) mental health continuum. Fink examined the effects of students' individual characteristics, interpersonal factors, and institutional factors on students' mental health. We extended Fink's framework by adding stressors that we theorized would impact students' mental health, including health and safety factors and financial and academic stressors. METHOD Instrument and Sample We used the Student Experience in the Research University (SERU) COVID-19 survey, developed by members of the SERU Consortium. Eight large, public research universities located in different regions of the US administered the census survey in June and July 2020. The response rates ranged from 13% to 30%, 90% of students answered all items in the survey; we excluded responses with missing data, and the final sample was N = 27,118. Detailed information about the sample is available in Table 1. Measures Our individual measures include...

Background: Empirical studies show social and psychological supports are pivotal for maintaining physical, psychological, and social health in patients living with HIV/AIDS. Objectives: The present study aimed at evaluating social and psychological support and the relationship between these two factors among HIV/AIDS patients receiving services form health centers of Zahedan province, south eastern Iran. Methods: A cross sectional study was conducted. HIV/AIDS patients, who received services from health care facilities of Zahedan University of Medical Sciences were recruited in the study. Psychological well-being and social support were assessed using the Ryff Scales of Psychological Well-Being and medical outcomes study Social Support Scale (MOS-SSS) questionnaires, respectively. Multivariable linear regression analysis using backward stepwise method was conducted to determine factors related to psychological health and social support. Results: A total 110 patients aged over 16 years old (83 males) were included in the study. Unsafe injecting drug use was the major HIV transmission route (59.1%). Mean psychological health score was significantly higher in males compared to females (P = 0.048). Also, a gender difference was observed for mean social support score, although it was non-significant. The regression analysis showed that females versus males and AIDS patients versus HIV infected patients had lower score of psychological well-being, moreover, social support positively and independently related to the score of psychological well-being (β = -0.505; 95% confidence interval: 0.360 to 0.649). Conclusions: The findings suggest that female patients, those living in the AIDS stage, and those with poor social support are more vulnerable to having lower level of psychological well-being. Harm reduction programs should be reinforced in such groups.

Background The COVID-19 pandemic continues to impact mental health by exacerbating anxiety, fear, and substance use worldwide. Several studies have demonstrated increased substance use and declining mental health in students abroad, but no investigation has assessed the COVID-19 pandemic’s effects on mental health and substance use in graduate and healthcare students in the United States. Objective Researchers sought to quantify and qualify the ongoing COVID-19 pandemic’s impacts on Colorado graduate and healthcare students’ mental health and substance use, hypothesizing that greater COVID-19-related fear would correlate with higher substance use rates across metrics. Methods Investigators utilized an online, institutionally-distributed, mixed-methods survey to assess quantitative and qualitative changes in various mental health metrics and substance use in Colorado healthcare and graduate students during the COVID-19 pandemic from June 2020 to February 2021. An augmented Fear of COVID-19 Scale (FCV-19S) academic survey served as the primary data collection vessel. Results Students who reported higher levels of depression, exhaustion, loneliness, nervousness, and anger had significantly higher FCV-19S scores. Higher FCV-S19 scores were also significantly associated with increased levels of alcohol consumption, binge drinking, and cannabis use. Qualitative analysis elucidated recurring themes regarding use frequency, substances used, and the reasons underlying use. Further qualitative analysis revealed three common student concerns: worries regarding the length of the pandemic, its social impact, and educational/financial impact. Conclusions The COVID-19 pandemic has negatively affected the well-being of Colorado healthcare and graduate students, directly increasing substance use while simultaneously exacerbating feelings of fear, anxiety, and helplessness.

ObjectivesPrevious studies have highlighted the need to offer targeted interventions to strengthen the wellbeing of family members in families with children with neurodevelopmental disorders (NDD). Interventions for this target group require research and development. The purpose of this study was to test a new family intervention: Dialogical Family Guidance (DFG).MethodsFamilies of children with NDD were randomized into an intervention group that was delivered DFG and a comparison group provided with ordinary clinical treatment. The Family Functioning, Family Health and Social Support (FAFHES) and the DFG instrument were used to collect data at baseline and after 3 months. Repeated measure analysis of variance (ANOVA) was used as an analytical strategy.ResultsThere was a significant within-subjects effect of time on family health and social support, indicating that family health and social support increased in both groups over time. There was also a significant between-subjects effect of group and interaction between time and group on social support, indicating that social support increased more in the intervention group than in the control group. Managing in daily life and the relationship between parents were associated with family functioning and family health.ConclusionDFG can strengthen parental experiences of social support. Managing in daily life, relationship between parents, practical guidance, psychoeducation, dialogue, and receiving positive feedback on parenting were strengthening factors during DFG. However, the results of this study must be considered as only preliminary, as they relate only to parental perceptions of the intervention effects.Trial registrationClinicalTrials.gov NCT04892992 (retrospectively registered).

To describe and compare family functioning, family health, and perceived social support from nurses and to identify the variables that are associated with family functioning in patients with heart failure (HF) and their family members in Denmark, Iran, and Iceland. An international multi-centre cross-sectional study. A sample of 1382 participants (692 patients and 690 family members) from Denmark, Iceland, and Iran were included from January 2015 to May 2020. Data were collected using the Family Functioning, Health, and Social Support questionnaire. The significant factors associated with family functioning in patients were country, New York Heart Association classification (NYHA), education level, age, family health, social support, and there was a significant interaction effect between NYHA class and gender. The significant factors associated with family functioning in family members were country, education level, work status, family health, and there was a significant interaction effect between education and work status. This study indicated that the strongest factor associated with higher family functioning was family health for both patients and family members. Women in NYHA class I and younger patients and those with an academic education had a lower level of family functioning. Moreover, unemployed family members with an elementary education and family members with elementary and high school educations who were self-employed or employees had a lower level of family functioning. This is the first international study to investigate family functioning, family health, and social support and adds to the literature on the factors associated with family functioning in patients with HF and their family members. Our findings may help nurses to identify the most vulnerable families living with HF, thereby being able to provide special support to enhance their family functioning to promote self-management strategies.

Family violence (FV) has serious effects on the health and well-being of the family. The health sector plays a vital role in FV prevention by helping to identify abuse early, providing victims with the necessary treatment and referring patients to appropriate care. The aim of the present cross-sectional study was to describe the prevalence of FV among hospital patients, as well as to assess the association between family functioning, health and social support, considering patients as the perpetrators or victims of violence. The data were collected using a Family Functioning, Health and Social Support (FAFHES) questionnaire that was given to patients who visited a Finnish central hospital between October 2012 and April 2013. As a result, the data (N = 188) were contributed by the patients who returned the questionnaire and gave permission for a follow-up survey. The participation rate was 47%, of which 73% were women and 27% were men. Their ages ranged from 18 to 89 years. The data were analysed with quantitative methods using the unadjusted analyses and linear regression model. In total, 24% of both the male and female participants had experienced or used violence at home or in the family. Of these, 22 had been the perpetrators, and 23 had been the victims. Participants in relationships and who were living together had less violence than singles and those who were not living together. The family functioning and health of the participants who had experienced or used FV were worse than those of the participants who had not. Various patients can have an FV background, and nursing professionals are on the front line to identify and intervene in FV situations. The results of this study can be utilised in the treatment of FV victims and perpetrators by training healthcare workers to identify and intervene in violence.