Family Management Style Framework Research Articles

The Importance of Social Support in the Management of Hypertension in Brazil.

The prevalence of hypertension (HTN) is high in Brazil, and control rates are low. Little is known about the factors that contribute to HTN control from a family-based perspective. Guided by the family management style framework, specific aims were to (1) describe the prevalence of adequate blood pressure (BP) control in individuals cared for the Family Health Strategy, (2) identify facilitators and barriers to HTN management, and (3) identify individual contextual sociocultural influences (sociocultural context and social and Family Health Strategy support), definition of the situation, and management behaviors that help or interfere with individual functioning (BP control in the individual with HTN). This descriptive, cross-sectional study included 213 individuals with HTN randomly selected from 3 Family Health Strategy units from July 2016 until July 2017. Most of the individuals were female (n = 139, 65.3%), retired (n = 129, 60.5%), and White (n = 129, 60.2%) and had less than a high school education (n = 123, 57.6%). Family income (n = 166, 77.8%) was less than 5500 reals (US $1117/month). Mean (SD) systolic BP was 137.1 (±24.1) mm Hg, and mean (SD) diastolic BP was 83.8 (±18.6) mm Hg, with 47.9% (n = 102) having uncontrolled BP. In the multivariate logistic model, only high levels of perceived social support were significantly associated (odds ratio, 3.29; 95% confidence interval, 1.44-7.5; P = .005) with controlled BP. Social support is strongly associated with BP control. Optimizing support may play an important role in BP control and preventing HTN-related complications.

Families' situation of caring for a child with a chronic condition: a mixed methods study.

To analyze the meanings attributed by family members to the situation of caring for a child with a chronic condition (CCC), in the light of the Family Management Style Framework (FMSF). A mixed-methods, parallel-convergent study, guided by the FMSF theoretical framework, using the conceptual component "Definition of the Situation". Fifty-three CCC families took part. Data was collected using a semi-structured interview, a questionnaire to characterize the participants and a Family Management Measure scale. Descriptive and inferential statistical analysis was carried out on the quantitative data and the qualitative data was subjected to deductive thematic analysis. Family members reported a view of normality in relation to CCC, also verified by the Child's Daily Life scale. However, they indicate the repercussions of the chronic condition on the family, and that they devote more attention and time to meeting the child's care needs, which was also verified in the View of the Impact of the Condition and Management Effort scales. Families have a positive view of the situation of caring for CCC at home, but point out some negative effects, such as the greater time spent caring for the child.

Factors Affecting Family Management Among Chinese Parents of Children With Leukemia: A Multisite Study.

Effective family management can improve the ability of children's families to cope with the disease. However, the family management styles of children with leukemia are unknown. This study used a family management style framework and structural equation model to determine the direct and indirect predictors of family management of children with leukemia. A total of 496 parents of children with leukemia completed the Family Management Measure, the Feetham Family Functioning Survey, the Social Support Rating Scale, and a demographic family information form. We used structural equation modeling to explore the direct and indirect effects of the study variables on family management styles. Family functioning, family income, parental education level, and geographic location affect family management directly, among which family functioning has the most significant coefficient in the model (0.53). Siblings and social support can affect family management through the mediating effect of family functioning. Employment change can directly affect family management (-0.27) and indirectly affect family functioning (-0.08). Our results support the family management style framework. Individual and family factors such as family income, parental education level, geographic location, employment change, siblings, and social support contribute to the ease or difficulty of family management. In addition, family functioning can also mediate between contextual influences and family management styles. Family functioning plays a vital role in relationships between contextual influences and family management. We can construct family management interventions according to family management influencing factors.

An unbelievable ordeal: The experiences of adult survivors treated with extracorporeal membrane oxygenation

BackgroundExtracorporeal membrane oxygenation (ECMO) is a rescue treatment option for adult patients with severe cardiac dysfunction or respiratory failure. While short-term patient outcomes, such as in-hospital mortality and complications, have been widely described, little is known about the illness or recovery experience from the perspectives of survivors. Subjective reports of health are important indicators of the full, long-term impact of critical illness and treatment with ECMO on survivors’ lives. ObjectiveThe objective of this study was to describe the experiences and needs of adults treated with ECMO, from onset of illness symptoms through the process of survivorship. MethodsThis study was guided by the qualitative method of interpretive description. We conducted in-depth, semistructured interviews with 16 adult survivors of ECMO who were treated at two participating regional ECMO centres in the northeast United States. Additional data were collected from demographic questionnaires, field notes, memos, and medical record review. Development of interview guides and data analysis were informed by the Family Management Style Framework. Qualitative data were analysed using thematic analysis techniques. ResultsThe sample (n = 16) included 75% male participants; ages ranged from 23 to 65 years. Duration from hospital discharge to interviews ranged from 11 to 90 (M = 54; standard deviation = 28) months. Survivors progressed through three stages: Trauma and Vulnerability, Resiliency and Recovery, and Survivorship. Participants described short- and long-term impacts of the ECMO experience: all experienced physical challenges, two-thirds had at least one psychological or cognitive difficulty, and 25% were unable to return to work. All were deeply influenced by their own specific contexts, family support, and interactions with healthcare providers. ConclusionsThe ECMO experience is traumatic and complex. Recovery requires considerable time, perseverance, and support. Long-term sequelae include impairments in cognitive, mental, emotional, physical, and social health. Survivors could likely benefit from specialised posthospital health services that include integrated, comprehensive follow-up care.

Testing the Feasibility of a Nursing Intervention Focusing on Family Management for Caregivers of Children with Autism

Objective: This pilot study aimed to investigate the feasibility and effects of a nursing intervention focusing on family management for caregivers of children with autism.Material and Methods: Five primary caregivers of children with autism, who visited a hospital in Vietnam were recruited by convenience sampling. All participants were parents, with mean age of 33.40 (+5.46) years, who attended weekly family-management intervention for four consecutive weeks. The intervention was adapted from the Building on Family Strengths program and guided by the Family Management Style Framework. The Beach Center Family Quality of Life Scale and the Caregiver's Strain Questionnaire were used to measure outcomes at three-point times, namely, baseline (week 0), post-intervention (week 4), and follow-up (week 8). Descriptive statistics and Friedman test were used in data analysis .Results: The age of children with autism was from 4-8 years old (M=5.60). The findings revealed that the participants attended all implementation sessions without dropping out. Significant positive changes in the quality of family life and the burden of the caregivers were found among the participants after receiving the intervention.Conclusion: The family-management intervention was feasible and beneficial to family caregivers of children with autism in Vietnam. Future studies should explore the effectiveness of this intervention in randomized controlled trials with a larger sample size. This intervention would be more appropriate as integral component in the services for family and children with autism.

Family Management of Severe Obesity in Adolescents

PurposeSevere obesity, defined as a body mass index (BMI) ≥120th percent of the 95th BMI percentile for age and sex, is the fastest growing subcategory of obesity among youth, yet little is known about how this group understands and incorporates weight management strategies. The aims of this study were to explore how parents and adolescents understand severe obesity and incorporate management into their daily lives and evaluate the applicability of the Family Management Styles Framework (FMSF) to better understand the impact of severe obesity for adolescents. Design and methodsDirected content analysis grounded in a modified version of the FMSF was used to analyze one-time in-home face-to-face interviews with adolescents aged 12–17 years (N = 14) who received pediatric weight management care and a parent (N = 17). ResultsBoth adolescents and parents described the day-to-day management as challenging and impactful to parent-child and sibling relationships. They described the need for sustained support and coaching in meeting daily physical activity requirements and related stories of weight stigma experienced. Further, parents' and adolescents' views were mostly congruent, except in their view of effectiveness of daily routines and how family attitudes and actions did or did not support the adolescent. ConclusionsThe FMSF was successfully applied to understand family management of adolescents with severe obesity. These adolescents have complex physical and psychological needs impacting effective weight management and family life. Practice implicationsTechnology interventions should be considered to improve physiological and psychological outcomes for youth with severe obesity.

Tracing the Use of the Family Management Framework and Measure: A Scoping Review.

This article reports the results of a scoping review of research applications of the Family Management Style Framework (FMSF) and the Family Management Measure (FaMM). We identified 32 studies based on the FMSF and 41 studies in which the FaMM was used, 17 of which were based on the FMSF. Both the framework and measure have been used by investigators in multiple countries, with most applications of the FaMM outside the United States. Although the FMSF and FaMM were originally developed for use with families in which there was a child with a chronic physical condition, both have been applied to a broader range of health conditions and to studies focusing on families with an adult member facing a health challenge. Based on our findings, we make recommendations for how researchers can more fully address all aspects of the FMSF.

Family experience living with advanced neoplasm: a glance at the rural population.

to understand the experience of rural families living with advanced cancer, from Family Management Style Framework's perspective. a qualitative research conducted in seven cities of the northern of state of Rio Grande do Sul in homes of 11 families (27 people). Data collection took place in 2014, using the genogram and narrative interview. Analysis followed Family Management Style Framework's theoretical model. the results were organized into three categories based on conceptual components of the referred model: no more normal life: situation definition; attempt to reconcile care and work: management behavior; imminence of the finitude of life: perception of consequences. living in rural context gives families specific ways of dealing with advanced cancer. Understanding the movements undertaken by rural families throughout the experience can guide nursing professionals in planning interventions collaborating with this population's health.

Family management ofchildren who experience sickle cell disease: a qualitative study.

to know the family management experience of children with sickle cell disease in the light of the Family Management Style Framework. a qualitative case study carried out between September/2015 and July/2016 with 12 members of eight families registered in a blood center in Minas Gerais. The semi-structured interviews were recorded, and the data were analyzed and interpreted by the hybrid model thematic analysis. three management styles were identified: five families in the accommodating style; two families in the struggling style; and only one family in the enduring style.It was noted that empowerment was paramount in the acquisition of skills and abilities to care for these children. family management knowledge of children with sickle cell disease provided a reflection on nurses' role in supporting, orienting and encouraging the empowerment of these families aiming at the search for comprehensive care.

Chinese family care patterns of childhood rheumatic diseases: A cluster analysis

ObjectivesThe purpose is to distinguish family care (FC) patterns of childhood rheumatic diseases in Chinese families and to determine the predictors of FC patterns. MethodsThis secondary analysis contained two cross-section surveys with a convenient sample of totally 398 caregivers who have a child with rheumatic diseases from four pediatric hospitals. Caregivers were required to completed Family Management Measure questionnaire. Cluster analysis was used to distinguish patterns and multinomial logistic regression analysis was used to find predictors. ResultsFour patterns were identified: the normal-perspective and collaborative (28.4%), the effortless and contradictory (24.6%), the chaotic and strenuous (18.3%), and the confident and concerning (28.7%). Disease category (χ2 = 21.23, P = 0.002), geographic location (χ2 = 8.41, P = 0.038), maternal educational level (χ2 = 12.69, P = 0.048) and family monthly income (χ2 = 33.21, P < 0.001) predicted different patterns. ConclusionsFC patterns were different among families. Disease-related and family-related factors were vital predictors to distinguish patterns consistent with the Family Management Style Framework. The result assisted that clinicians recognize FC patterns and predictors effectively to provide tailored advice in time.

Understanding familial response to parental advanced cancer using the family management style framework

Purpose: A parental advanced cancer diagnosis can have profound and lasting impact on family functioning. We used an adapted version of the Family Management Style Framework (FMSF) to identify and describe patterns of family management in parental advanced cancer.Design: This is a secondary analysis of data from a cross-sectional, mixed-methods study. Forty-two adults participated in semi-structured, in-depth interviews about their experiences as a parent with advanced cancer and completed measures of psychosocial functioning. We analyzed interviews using codes derived from the FMSF and used directed content analysis to identify themes reflected in the coded data.Findings: We identified five distinct patterns of family management in parental advanced cancer: (1) Equipped and Optimistic; (2) Equipped and Pragmatic; (3) Discouraged and Struggling; (4) Apprehensive and Passive; and (5) Discouraged and Conflicted.Conclusions: The FMSF was a useful framework for differentiating and understanding underlying patterns of family response to parental advanced cancer.

Challenges to Family Management for Caregivers of Adolescent and Young Adult Survivors of Childhood Brain Tumors [Formula: see text

Due to the complexity of cancer late effects, the education required to provide anticipatory guidance and support to the caregivers of adolescent and young adult (AYA) survivors of childhood brain tumors can be difficult. Therefore, identifying challenges to family management (FM) could be helpful in anticipating complications with the integration of tumor and treatment late effects into family life. Building on previous research that described FM for children with chronic conditions, children who survived cancer, and the Family Management Styles Framework, the purpose of this study was to identify FM challenges for caregivers of AYA survivors of childhood brain tumors to guide clinical practice and research. Directed content analysis was used to identify FM challenges in data from semistructured interviews with 45 maternal caregivers for AYA survivors of childhood brain tumors living with them. Caregivers were largely White (89%) with an average age of 52 years, educated beyond the high school level (67%), and were partnered or married (53%). On average, caregivers had been caring for the AYA for 21 years since diagnosis, and 56% of their survivors had moderate functional restrictions. A primary and a secondary analyst were assigned to the data for each interview and completed a single summary matrix. A list of challenges was created by the research team based on Family Management Styles Framework, the literature, and clinical expertise. Seven core challenges to FM were identified: ensuring survivor well-being, supporting survivor independence, encouraging sibling well-being, planning family activities, sustaining parents as caregivers, attending to survivor late effects, and providing support and advocacy.

Development and validation of the family management scale for children with asthma (FMSCA)

Objective: This study aims to develop and validate the Family Management Scale for Children with Asthma (FMSCA) in China context. Methods: Based on the Family Management Style Framework (FMSF) model, an original 89 items were generated from literature review and interviews with 15 caregivers of children with asthma. The preliminary scale was refined to 82 items through two rounds of experts’ evaluation and a pilot study, then administered to 329 caregivers of children with asthma for testing between April and July 2013. Item analysis and exploratory factor analysis were performed to screen the items, reliability and validity analysis were tested using psychometric techniques (internal consistency, split-half reliability, test-retest reliability, content validity, and construct validity). Confirmatory factor analysis was adopted to further evaluate the construct validity of the scale in an additional 600 children with asthma and their parents from August 2014 to December 2015. Results: A final 57-item FMSCA from 8 subscales (children identity, view of condition, management mindset, parental mutuality, parenting philosophy, management approach, family focus, and future expectation) were generated. The excellent internal consistency (Cronbach’s α = 0.918), very good split-half reliability (r = 0.802, p < 0.01) and test-retest reliability (r = 0.857, p < 0.01) indicate a satisfactory reliability of the FMSCA. The Item Content Validity Index (I-CVI) of the scale ranged 0.8 3 ～1.00, Scale Content Validity Index (S-CVI) was 0.807, indicating a good content validity. Construct validity was established by accepted correlation coefficient of item-to-subscale (r range = 0.513–0.865, P < 0.01), intersubscale (r range = 0.195–0.604, p < 0.01), and subscale-to-total (r range = 0.408–0.876, p < 0.01), respectively. Additionally, the factors accounted for 51.586%∼74.063% of the variance in each subscale, confirmatory factor analysis indicated the confirmatory model fitted data well and the scale had adequate construct validity. Conclusions: The study demonstrates FMSCA can serve as a valid and reliable measure of family management level for Chinese children with asthma.

Adapting the Family Management Styles Framework to Include Children

Empirical study purposePropose an adapted Family Management Style Framework that includes the perspectives of children with chronic health conditions. Design and methodsBuilding on the current Family Management Style Framework, the authors used recent empirical studies with children to further develop the framework. Definitions of each dimension and component of the framework were reviewed and revised to reflect the perspectives of the child, based on the child data and prior work. ResultsThe Family Management Style Framework was adapted to reflect children's perspectives of themselves and their family. Based upon our understanding of the components of the framework, we expanded the components and revised the definitions of the dimensions to reflect the child perspectives. ConclusionsIncorporating the perspectives of children allows us to consider the transactions that occur during condition management between parents, children and families. Additional research is needed to explore this interaction and the implications it has on the outcomes. Practice implicationsChildren experience the way their family manages their chronic health condition and incorporate those experiences as part of their developing understanding of themselves and their condition. Practitioners should encourage children to express their understanding of their condition and its management to model and encourage them to dialogue about management with their families.

Making a Connection: Family Experiences With Bedside Rounds in the Intensive Care Unit.

The hospitalization of a family member in an intensive care unit can be stressful for the family. Family bedside rounds is a way for the care team to inform family members, answer questions, and involve them in care decisions. The experiences of family members with intensive care unit bedside rounds have been examined in few studies. To describe (1) the experiences of family members of patients in the intensive care unit who participated in family bedside rounds (ie, view of the illness, role in future management, and long-term consequences on individual and family functioning) and (2) the experiences of families who chose not to participate in family bedside rounds and their perspectives regarding its value, their illness view, and future involvement in care. A qualitative descriptive study was done, undergirded by the Family Management Style Framework, examining families that participated and those that did not. Most families that participated (80%) found the process helpful. One overarching theme, Making a Connection: Comfort and Confidence, emerged from participating families. Two major factors influenced how that connection was made: consistency and preparing families for the future. Three types of consistency were identified: consistency in information being shared, in when rounds were being held, and in informing families of rounding delays. In terms of preparing families for the future, families appeared to feel comfortable with the situation when a connection was present. When any of the factors were missing, families described feelings of anger, frustration, and fear. Family members who did not participate described similar feelings and fear of the unknown because of not having participated. What health care providers say to patients' families matters. Families may need to be included in decision-making with honest, consistent, easy-to-understand information.

Patterns of family management for adolescent and young adult brain tumor survivors.

Little is known about how families systemically incorporate the work of caring for adolescent and young adult (AYA) survivors of childhood brain tumors who often remain dependent on their families well into adulthood. The primary aim of this study was to develop a typology of family management (FM) patterns for AYA survivors. The secondary aims were to compare them with FM patterns previously described for children with chronic health conditions and to validate the patterns using quantitative and qualitative data. Guided by the Family Management Styles Framework, a sequential, mixed-methods design was used to gather quantitative data from 186 mothers (primary caregivers) and 134 AYA survivors. FM patterns (family focused; somewhat family focused; somewhat condition focused; and condition focused) were identified using cluster analysis of data from the Family Management Measure. FM patterns were found to be similar to those for children with chronic health physical conditions and were significantly related to maternal quality of life, survivor quality of life (health-related quality of life [self- and mother proxy report]), cancer-related variables (treatment intensity, medical late effects), and family functioning in theoretically meaningfully ways. Significant demographic characteristics included private insurance and AYA survivors' engagement in school or employment. Qualitative analysis of data from 45 interviews with mothers from the larger sample provided additional support for and elaborated descriptions of FM patterns. Identification of FM patterns moves the science of family caregiving forward by aggregating data into a conceptually based typology, thereby taking into account the complex intersection of the condition, the family, and condition management. (PsycINFO Database Record

“It's a Long-Term Process”: Description of Daily Family Life When a Child Has a Feeding Disorder

Pediatric feeding problems occur in 25% of the general pediatric population and up to 80% of those who have developmental delays. When feeding problems place the child at nutritional risk, families are typically encouraged to increase their child's intake. Family mealtime can become a battle, which further reinforces problematic feeding behaviors from the child and intensifies well-intentioned but unguided parental mealtime efforts. Family has an essential influence on feeding; however, studies to date neglect to address the family context of feeding difficulty. In this study we describe, in the context of everyday life, family management of feeding when a child had a significant feeding problem. Parents of children with feeding problems were interviewed with the Family Management Style Framework components as a guide. Twelve parents participated, representing nine families of children with feeding disorder. Description of family management of feeding provides a foundation for development of family feeding interventions.

The Family Management Styles Framework as A Tool for Tailoring Interventions for Pediatric Transplant Recipients and Their Families: A Case Study

ABSTRACTThe aim of this research study was to explore family management in pediatric liver transplantation. This qualitative case study research project used a hybrid model of thematic analysis methodology and employed the Family Management Style Framework (FMSF) as the theoretical framework. Four families of transplanted children who were outpatients in a public hospital in Brazil were analyzed in depth through interviews and analysis of medical records in the parent study. In this article, the case of 1 of those families is presented. The results show that the family defines the condition as threatening, and has dichotomous feelings about the child’s identity, sometimes seen as “special” and other times as “like any other child.” The family’s perceived consequences, one of the FMSF dimensions, bring uncertainty about the future as an important issue that deserves nursing attention. A deeper understanding of family management can promote informed discussions about the best interventions for this and other similarly affected families. The use of the FMSF in evaluating family management in pediatric transplantation and other chronic pediatric conditions can aid pediatric nurses and other nursing professionals in planning tailored interventions that maximize patient and family outcomes.

Family Caregivers Define and Manage the Nursing Home Placement Process.

The nursing home placement process is complex and difficult for family caregivers. This qualitative descriptive study examines the experiences of caregivers involved in the management of care and placement of an older family member using the Family Management Style Framework. Ten caregivers were recruited from four nursing homes in the Midwest. The caregivers were interviewed shortly after placement and again 3 months post-placement. Results provide a unique understanding of care management and the nursing home placement process from the perspective of the primary family caregiver. Overall, there were similarities across the same types of caregiving dyads, for example, spousal and adult-children caregivers. Caregivers expressed the need to maintain the identity of their older family member, a familial responsibility for caregiving, and change in their family relationship over time. Appreciating caregivers' challenges and needs gives health care professionals a better understanding for how to provide assistance for a smoother nursing home transition.

Therapeutic Camps and Their Impact on the Family of Children with Special Health Care Needs: A Mixed Method Study

Respite care through therapeutic summer day camps is a service used to relieve the physical and mental strains placed on caregivers of children with special health care needs while also creating unique opportunities to benefit the child. The purpose of this study is to determine how respite care in the form of a therapeutic summer day camp for children with special needs impacts a family’s ability to manage their child’s special health care needs within their family. This research study used mixed methodology combining quantitative data collection through pre- and post-survey and qualitative data collection through interviews that worked to answer questions relating to the effects of a therapeutic summer day camp on parents’ perspective and management of their child’s condition. The theoretical framework used to guide the study is the Family Management Style Framework. Twenty-two parents completed The Family Management Measure that was administered prior to and at the conclusion of an 8-week therapeutic summer day camp program. Qualitative interviews with 11 parents helped to better understand specific interventions and experiences of the therapeutic camp that benefitted their child and family. Although the quantitative analysis did not yield statistically significant changes in the family’s ability to manage their child’s condition as a result of attendance at the camp, the qualitative interviews demonstrated robust evidence that the camp provided meaningful experiences for the campers and parents while alleviating stress within the family. Themes include: 1) Family-Child themes of loss of normalcy, relationships affected, increased stress, family adaptations, and love for the child; 2) Camp-Child themes of meeting individual needs, creating happiness, and behavior changes; and (3) Camp-Parent themes of improved perception of the child, decreased stress, parent involvement with staff, and need for specific environment at camp. Implications of the results are discussed, along with recommendations for future research.