Family Coping Strategies Research Articles

Communal proactive coping strategies among Tamil refugees in Norway: A case study in a naturalistic setting

BackgroundAn exclusive focus on individual or family coping strategies may be inadequate for people whose major point of concern may be collective healing on a more communal level.MethodsTo our knowledge, the current study is the first to make use of ethnographic fieldwork methods to investigate this type of coping as a process in a natural setting over time. Participant observation was employed within a Tamil NGO in Norway between August 2006 and December 2008.ResultsTamil refugees in Norway co-operated to appraise their shared life situation and accumulate resources communally to improve it in culturally meaningful ways. Long term aspirations were related to both the situation in the homeland and in exile. However, unforeseen social events created considerable challenges and forced them to modify and adapt their coping strategies.ConclusionsWe describe a form of coping previously not described in the scientific literature: Communal proactive coping strategies, defined as the process by which group members feel collectively responsible for their future well-being and co-operate to promote desired outcomes and prevent undesired changes. The study shows that proactive coping efforts occur in a dynamic social setting which may force people to use their accumulated proactive coping resources in reactive coping efforts. Theoretical and clinical implications are explored.

Prevalance and Associations of Food Insecurity in Children with Diabetes Mellitus

To examine the prevalence of food insecurity in households with a child with insulin-requiring diabetes mellitus (DM), investigate whether food insecurity is associated with poorer DM control, and describe the household characteristics and coping strategies of food-insecure families with a child with DM. Telephone interviews were conducted with consecutive consenting families over a 16-month period. Food insecurity was assessed through a validated questionnaire; additional questions elicited demographic information and DM management strategies. Charts were reviewed for hemoglobin A1c (HbA1c). Univariate and logistic regression analyses were performed. A total of 183 families were interviewed. Food insecurity was present in 21.9% (95% confidence interval, 15.87%-27.85%), significantly higher than the overall prevalences in Nova Scotia (14.6%) and Canada (9.2%). Food insecurity was associated with higher HbA1c level; however, in multivariate analysis, only child's age and parents' education were independent predictors of HbA1c. Children from food-insecure families had higher rates of hospitalization, for which food security status was the only independent predictor. Common characteristics and coping strategies of food-insecure families were identified. Food insecurity was more common in families with a child with DM, and the presence of food insecurity was predictive of the child's hospitalization. Risk factors identified in this study should be used to screen for this problem in families with a child with DM.

Stresses and Coping Strategies of Chinese Families with Children with Autism and Other Developmental Disabilities

Data from 368 families of children with autism and other developmental disabilities in the People's Republic of China were gathered to understand the stresses that families experience and the coping strategies they employ. Chinese families of children with developmental disabilities perceived high levels of stress related to pessimism, child characteristics, and parent and family problems. Regarding coping strategies, acceptance, active coping, positive reinterpretation and growth, suppression of competing activities, and planning were the most frequently employed coping strategies. Parents of children with autism experienced more stress and used planning as a coping strategy to a greater degree than parents of children with other developmental disabilities. The implications and limitations of these findings are discussed.

Personal stigma and coping strategies in families of patients with schizophrenia: Comparison between Japan and Korea

AbstractIntroduction: It has been extensively documented that caregivers of persons who have serious and persistent mental disorders must successfully cope with many challenging problems in order to provide good care. However, little is known about the relationship between family stigma and strategies for coping with patients with schizophrenia. Therefore, the present study compared the personal stigma and coping strategies of families of patients with schizophrenia by examining the socio‐cultural factors that affect the care experience of families in Northeast Asian countries.Methods: Two self‐rating scales were used to compare personal stigma and coping strategies regarding family members of patients with schizophrenia in 47 Japanese and 92 Korean families. Respondents reported their personal attitudes (personal stigma) with respect to a case vignette that described a person with chronic schizophrenia.Results: Analysis revealed the following: 1) although no differences in coping strategies were observed between the countries, the personal stigma of families was significantly higher in Korea than in Japan; 2) coping strategies, such as positive communication, coercion, and avoidance, were significantly associated with personal stigma in Korean families; however, in Japanese families, resignation was significantly associated with personal stigma.Discussion: The present findings suggest that personal family stigma was higher in Korea than Japan, and the features associated with coping strategies differ between countries. It is important to determine the features of personal stigma that are associated with schizophrenia. Furthermore, education and support programs for families with schizophrenia based on trans‐cultural considerations must be emphasized in both countries.

P02-113 - Mental health and coping strategies in families caring for patient with epilepsy in Iran

IntroductionA research base should be of mental health and coping strategies in families of having patient with epilepsy, in Iran.Objective and aimThese families are at increased risk of stress and weakened family relationship, and to identify the variables that have a negative impact on a families and possible moderating influences on them.MethodThis research was a descriptive study on 150 families of epileptics referring to the Iranian Association of Epilepsy Selected Using a Systematic sampling. All subjects were living with the epileptic person, were at least 16, all Iranian and it was at least six month after the beginning of the family’ epileptic members’ illness. For obtaining further information, a questionnaire consisting of three parts was used. The first part indicated the demographic specifications of the patient's family, the second part showed the General Health Questionnaires (GHQ), and the third part indicated stress coping strategies carversheier- weinrub questionnaires.ResultsAccording to the acquired screen in the total mental health score, the majority of the epileptic patients’ family (56/7%) were not in an appropriate mental health condition. In this report contains depression (56/7%), social functional disorder (52%) somatic signs (61/3%) and anxiety and sleep disorder (6/7%). The majority of under research units based on acquired scores of general stress coping strategies, used this strategies in a medium level.ConclusionThe result is that if there is more mental health in the family of the epileptic patient, they will use stress coping strategies in more suitable level.

Dual-earner couples in the sandwiched generation: Effects of coping strategies over time.

The purpose of this study was to examine the effects of work and family coping strategies used by dual-earner couples caring both for children and for aging parents on well-being over time among a national sample of 234 couples (468 individuals). Specifically, the effects of three types of coping strategies—those that decrease social involvement (behavioral), those that increase emotional resources (emotional), and those that involve increased prioritizing (cognitive)—were examined over a two-year period on sandwiched-generation husbands' and wives' life satisfaction, depression, affect balance, work-family conflict, and positive work-family spillover. These coping strategies were based on a model that was theoretically and empirically derived by Neal and Hammer (2007). In terms of “what works and what doesn't work” for sandwiched-generation couples over time, in general, coping strategies that increase emotional resources and coping strategies that involve prioritization have beneficial effects on well-b...

The Effect of BRCA Gene Testing on Family Relationships: A Thematic Analysis of Qualitative Interviews

Discovery of mutations in the breast and ovarian cancer susceptibility genes BRCA1 and BRCA2 can have emotional consequences for both the tested individual and his or her relatives. This secondary analysis study investigated how BRCA testing impacts family dynamics and relationships. For the original study, a grounded theory inquiry, participants were recruited from a hereditary breast/ovarian cancer syndrome support website and open-ended interviews were performed asking about individual and family experiences after BRCA testing. All 12 participants whose interviews were included in the secondary analysis had a BRCA mutation. For the secondary analysis, thematic analysis was conducted and revealed three main themes characterizing the effect of BRCA testing on family relationships: 1. That the first in the family to have testing or seek genetic counseling takes on a special family role that can be difficult for them; 2. That discussions in the family often change; and 3. That individuals may feel more or less connected to certain family members. These changes seemed to relate to family cancer history, relationships, coping strategies, communication patterns, and mutation status. Genetic counselors might find it useful to explore these issues in order to prepare clients before BRCA testing and to support them through shifts in family dynamics after disclosure of results.

Étude qualitative de l’évolution des stratégies de faire face chez les parents d’adolescents atteints de troubles autistiques

Since their child has been diagnosed as having an autistic spectrum disorder (ASD), parents are confronted with important and chronic stress in their everyday life. To face it, they use coping strategies. Using qualitative analyse, this article exposes preliminary results on changes in coping strategies of ASD families and presents how parents manage to adjust their coping.

Family risk and related education and counseling needs: Perceptions of adults with bipolar disorder and siblings of adults with bipolar disorder

Genetics and mental health professionals increasingly provide education and counseling related to risk for psychiatric illness, but there is insufficient evidence about patient perceptions and needs to guide such interventions. Affected individuals and relatives may perceive increased family risk and have interest in genetic education and counseling. Our objectives were to explore perceptions of family vulnerability, perceived control, and coping strategies related to familial risk and needs from genetic counseling. Our methods included conducting semi-structured interviews (n = 48) with individuals with bipolar disorder (BPD) and unaffected siblings. Content analysis generated descriptive data that provide guidance for clinical interventions and themes to evaluate in future studies. The results showed that participants perceived increased personal and family risk, attributing BPD to genes and family environment. Causal attributions were often uncertain and at times inconsistent. Participants wished to modify psychiatric risk to relatives, but were uncertain how to do so; despite the uncertainty, most parents reported risk-modification efforts. Efforts to cope with family vulnerability included monitoring and cognitive distancing. Participants endorsed the usefulness of education and psychological support, but described more ambivalence about receiving risk assessment. Educational and supportive interventions around family risk for BPD should focus on perceptions of cause and vulnerability, reproductive decision-making, and early intervention and risk modification in young relatives. Psychological support is an important component. Providers should evaluate patient coping strategies, which could facilitate or hinder genetic counseling interventions, and should not assume interest in quantitative risk assessment.

Identifying and Building on Family Strength

In family-centered intervention, one important issue is to support families' different ways to manage stress. The purpose of this study was to investigate whether professionals encourage positive coping strategies in families of children with disabilities. Data (videotaped planning meetings and interviews) from 5 families enrolled in intervention programs were used. The data were analyzed deductively by applying theoretical concepts of 4 types of positive coping. Goal-directed problem-focused coping was the most frequently used type of coping, together with spiritual beliefs and practices. Professional encouragement of families' own strategy to solve problems occurring in everyday life must focus not only on explicit problem solving but also on the use of supplemental coping types.

High Thresholds and Prevention in Children's Services: The Impact of Mothers' Coping Strategies on Outcome of Child and Parenting Problems--Six Month Follow-Up

High thresholds characterizing the provision of Children’s Services have become increasingly apparent in recent years, and concerns that these thresholds mean that high need families do not receive a service have been expressed in key policy documents. This is despite a commitment, in policy and practice, to Prevention as an underlying theme for services. When referral is followed by a failure to access services, the coping strategies of the parents, in particular the mother, who is generally the primary caregiver, become of particular practical importance. These coping strategies are also of theoretical interest, being a key element of the newly developed concept of Proto Prevention, which extends our previous understanding of this area. This paper focuses on the coping strategies of families who were unsuccessful applicants for Children’s Services, and asks: Which coping strategies were most effective in securing positive outcomes? It was found that the direct actions of the mother, and avoidance strategies such as denial or acceptance had little effect. However, seeking social support was associated with more positive outcomes in child development and parenting, and denial and disengagement with an increase in depression symptoms. The implications of these findings, for policy and practice, are discussed.

Experiences and coping strategies of host families in international youth exchange

Twenty narrative interviews were conducted with German host parents between 2006 and 2007 about their experiences with a one‐year stay of a guest student in their family. The study took place within the context of a student research project as part of the research‐oriented MA course ‘Intercultural Communication – Intercultural Competence’ at Chemnitz University of Technology. The interviews were analyzed by means of Grounded Theory, which revealed that the guest families’ experiences are determined not only by the personality/character and sociocultural background of the guest student, but to a higher degree by the specific motives, wishes and expectations of the host parents. Both socially shared and individual norms, attitudes and values proved to guide the host parents’ interaction with their guest, to some extent explicitly, but mainly in an unconscious and implicit way. The action chains as explicated by the interviewees can be understood as individual coping strategies for cultural differences, which in themselves can turn out to be problematic (i.e. when they mainly serve the regulation of self‐esteem, or when experienced difference is wrongly attributed to culture instead of, for example, developmental processes of adolescence). Hence, in comparative analysis, both challenges and potentials of intercultural learning (as defined in the CfP) from hosting a guest student could be identified, and recommendations for better practice could be derived. In particular, the latter should be discussed in a practitioner–scientist dialogue.

Family Perceptions and Coping Strategies in Cases of Intersexuality: Understanding their Significance

Considering that the intersexual condition has a negative impact on the individual, their family, and society, health professionals and researchers have dedicated themselves to studying and assisting families faced with such an experience. The purpose of this study is to describe and understand the perceptions of primary caregivers regarding intersexuality and its developmental aspects. Six mothers and one grandmother of school age children were interviewed. The data indicated that living with the stigma of intersexuality can mean a permanent state of crisis within the family system. Issues such as guilt about the child's suffering and questions related to the choice of gender follow the family from the moment of diagnosis. It is suggested that the therapeutic follow-up should foster the necessary conditions for the family group to be organized as a model of competence, replacing the model of guilt.

Climate change and urban children: impacts and implications for adaptation in low- and middle-income countries

This paper discusses the particular and disproportionate risks to urban children in poverty from various aspects of climate change, both extreme events and changing means. It explores the potential impacts on children's health, learning and psychosocial well-being, and considers the implications of family coping strategies for children. The paper goes on to discuss the implications for adaptation, making recommendations for an adaptation agenda that focuses on the realities for children. Preparatory measures are considered, as well as responses to extreme events and to changes in weather patterns.

Stress Appraisal and Coping in Siblings of Childrenwith Special Needs

Self-reports from siblings of children with special needs regarding their appraisal of family stress and coping are important additions to the disability literature. Twelve school-age siblings of children with special needs were interviewed about their daily hassles, uplifts, and coping strategies related to living in a family with a child with a disability. Parents also reported on family coping strategies. Children reported that the most frequent daily hassle was when their sibling with special needs cried, screamed, or yelled when he/she did not want to do some-thing. The most frequent daily uplift was when their sibling gave hugs or kisses. Children reported feeling most stressed when embarrassed by their sibling with special needs in front of friends and happiest when playing with their sibling. Wishful thinking was a common child coping strategy during stressful times. Im-plications for working with families with special needs are discussed.

Coping strategies of families in HIV/AIDS care: some exploratory data from two developmental contexts

Caring for a family member with HIV/AIDS presents multiple challenges that strain a family's physical, economic and emotional resources. Family carers provide physical care and financial support and deal with changes in family relationships and roles, often with little support from outside of the family. Carers in developing countries face even greater challenges, due to lack of medical and support services, poverty and widespread discrimination against those with HIV/AIDS. Little is known about how family carers cope with these challenges or about the ways that development impacts on the process of coping. The current study explored coping strategies used by family carers in two contexts, Kerala, India and Scotland, UK. As part of a larger study, 28 family carers of persons living with HIV/AIDS were interviewed −23 in Kerala and 5 in Scotland. A modified version of the Ways of Coping scale was used to assess coping strategies. Responses were compared on the total number of coping responses used as well as on selected subscales of the WOC. Differences were assessed using the Mann-Whitney U-test. The two cohorts differed significantly in terms of the coping strategies used. The carers from Scotland used a larger number of different coping strategies and scored higher on measures of problem focused coping, positive reappraisal, seeking social support, self-controlling and distancing/detachment. Respondents from Kerala scored higher on a measure of self-blame. Results are discussed in terms of the impact of community resources on coping strategies.

A preliminary investigation of family coping styles and psychological well-being among adolescent survivors of Hurricane Katrina.

The relation between family coping styles and psychological well-being was compared for adolescents (12-17 years) displaced by Hurricane Katrina and currently living in a relocation camp (n = 50) and nonaffected adolescents (n = 31) matched on age, race, and socioeconomic status. Adolescents in the Katrina sample reported a family mobilizing strategy that reflected an increased reliance and seeking of extra-familial, community-based support but lower self-esteem and more symptoms of distress and depression. Follow-up analyses suggested that the relations between group differences in participants' hurricane-related trauma experiences and greater psychological distress may be mediated in part by the family coping strategy; exposure to increased levels of community-provided support may have unintended consequences on adolescents' psychological health. These results highlight the importance of future research on both potential benefits and costs of family coping styles in adolescents affected by a large-scale disaster.

Revealing and Concealing Personal and Social Problems: Family Coping Strategies and a New Engagement with Officials and Welfare Agencies c. 1900–12

Researchers from many disciplines have identified new forms of health and welfare services emerging in the late 19th and early 20th centuries. Attention has focused on the growth of direct provision by the local and national state, and new relationships between the statutory and voluntary sectors. The literature describes an important transition from the general workhouse to more specialist institutions, and the rise of community care. It also suggests that the increasing number of women employed by statutory and voluntary sector organizations forged new relationships with clients, but to date this research has been limited by a lack of sources and an emphasis on controlling practices. This new research on the work of female sanitary inspectors parallels this interpretation in the sense it was often intrusive, and certainly created new routes into institutional care. However, it also supports the idea that the inspectors were welcomed by some sections of the community and thereby made a distinctive contribution to the evolution of health and welfare services.

Comment: Fertility, mobility, and changing household dynamics in South Africa

Much has changed since the transition to democracy in South Africa more than a decade ago. Racial barriers are breaking down, a small but emerging black middle class has sprung up, and South Africa has become a major migration destination for people from all over Africa. But equally true, as evidenced by the papers in this section, is the persisting legacy of the apartheid era. Patterns of disease, population movement, household structure, and fertility continue to be shaped by severe inequalities in the distribution of wealth and resources. While such factors were well-known features of apartheid-era South Africa, it is perhaps less well known that postapartheid South Africa remains one of the world’s most unequal societies. The country’s severe HIV epidemic is superimposed on this reality. The three papers in this section address the epidemic – and how it impacts on and is impacted by fertility, migration, and household coping strategies. Rural areas in South Africa continue to demonstrate remarkable fluidity, and many places like Agincourt have experienced rapid change in the last decade. Household fluidity, fuelled by migration and HIV mortality, has become even more pronounced with increasing numbers of women entering the migrant labour market. These rapidly changing conditions underscore the central strength in the data brought together in this issue: a health and demographic surveillance system that has been in place since 1992 and has generated quality data on approximately 70,000 people in a rural, former ‘‘homeland’’ area in the northeast of South Africa. All of the papers in this section offer longitudinal analyses of these data, shedding light on the changing dynamics of fertility and rural livelihoods during this critical period of South Africa’s political and social transition. Garenne and colleagues show the consistent decline in fertility over the last 25 years, when the fertility rate decreased from 6.0 in 1979 to 2.3 in 2004, and the net reproduction rate declined to 1. This decline is faster than expected and represents perhaps the first time that fertility below replacement level has been measured in rural Africa. Garenne estimates that HIV is responsible for about 20% of the fall [1]. Concurrent with the measured decline in fertility, Madhavan & Schatz examined household structure and composition in 1992, 1997, and 2003. Their findings – that average household size decreased, that the proportion of female-headed households increased, and that the proportion of households with at least one maternal orphan doubled – point again to the impact of the HIV epidemic [2]. High mortality due to AIDS is already restructuring family coping strategies, decisions on whether or not to migrate and countless other variables that have yet to be examined. Collinson’s paper addresses the complexity of defining ‘‘urbanization’’ in a dynamic environment characterized (at least in part) by the maintenance of family ties to rural areas and the associated largescale circular migration so prevalent throughout southern Africa [3]. He rightly makes the point that, if we define urbanization as simply a massive, permanent movement to town, we end up missing much about the complexity, frequency, and indeed impact of such movement. His comparison between

Stress and coping of Hong Kong Chinese family members during a critical illness

The present study aimed to investigate the stress and coping strategies of Hong Kong Chinese families during a critical illness and to examine the relationships between stress and coping. Admissions to intensive care unit are usually an unanticipated event, which imposes stress on the family. Family's wellness is one of the significant factors affecting patient's well-beings. Much work has been conducted in Western societies. Stress and coping in Chinese families of critically ill patients have rarely been discussed. Structured face-to-face interviews were conducted, using the Impact of Events Scale and the Family Crisis Oriented Personal Evaluation Scales. A convenience sample of 133 participants was recruited from a regional hospital in Hong Kong. Many were patients' children with age between 30 and 49. A total of 39.1% (n = 52) of the participants were males and 60.9% (n = 81) were females. The participants experienced high level of stress (mean = 25.1, SD = 8.3). Higher level of stress were experienced by female (t = -4.6; d.f. = 1, 131; P = 0.00), those with lower educational attainment (F = 3.0; d.f. = 2, 130; P = 0.05) and those whose relatives were admitted to the intensive care unit unexpectedly (t = -2.2; d.f. = 1; P = 0.03). Patients' length of stay in the unit was significantly correlated with levels of stress (r = 0.5, P < 0.00). Level of stress had significant correlation with coping strategies utilization (r = 0.5, P < 0.00). Reframing strategies were frequently used whereas the passive appraisal strategies were least used. Family members used positive-coping strategies, which concurred with the Chinese stress-coping pattern 'fatalistic voluntarism'. This study contributes to the understanding of Hong Kong Chinese families' stress and coping during a critical illness. Comprehensive assessments of family members' psychosocial needs are important to plan appropriate interventions to alleviate their stress and strengthen their coping skills. The findings will serve as guidance for nurses in delivering culturally sensitive and competent interventions.