Providing Family Support Research Articles

Family Health Conversations Conducted by Telephone in Heart Failure Nursing Care: A Feasibility Study.

Registered nurses (RNs) in heart failure (HF) nursing care have a key role in providing family support, which positively affects the outcome for the patient. Telephone interventions conducted by RNs have been reported to be successful in HF nursing care, but Family Health Conversations (FamHCs) involving the patient and the family, have not previously been tested. The purpose of the current study was to explore the experiences and feasibility of nurse-led FamHCs conducted by telephone with patients and their family caregivers. A single-group intervention study with a pretest–posttest design was conducted in three regional hospitals that had a nurse-led HF clinic. Five RNs, eight patients, and eight family caregivers participated. Three FamHCs were conducted by telephone with each family every 2 weeks. Qualitative and quantitative data were collected through semistructured interviews and questionnaires. FamHCs improved the nurse–family relationships and relationships within the families and provided RNs with new knowledge about the families. FamHCs conducted by telephone were considered to be feasible for both families and RNs, although RNs preferred fewer and shorter FamHCs. The RNs preferred meeting face-to-face with the families as nonverbal communication between the family members could be missed because of lack of visual input. On the other hand, RNs appreciated to focus entirely on the conversation without the need to perform illness-related routine checks. In conclusion, the advantages of FamHCs conducted by telephone outweighed the disadvantages. Visual contact, provided by video telephony, and a shorter version of the tested FamHC would facilitate the use in HF nursing care.

Family Support During Resuscitation: A Quality Improvement Initiative.

Despite increasing support for family presence during cardiopulmonary resuscitation, a review of the literature revealed no published protocols or training curricula to guide hospitals in implementing a family support provider role. To develop a curriculum and train dedicated resuscitation team members whose role is to provide family support during in-hospital resuscitation events. An interdisciplinary team developed a 4-hour training session for the family support staff. The session included an introduction to the evidence for family presence during resuscitation and local data on resuscitations. The training was composed of 4 sections: (1) clinical aspects of resuscitation, (2) integration into the resuscitation team and steps for providing family support during resuscitation, (3) responding to families in distress, and (4) self-care practices. Before and after the training session, the participants completed surveys of self-rated knowledge and attitudes toward family presence during resuscitation. Fifty-nine social workers and 8 spiritual care providers were trained in 2015. There was a significant increase in all rated aspects of knowledge of the family support role and self-care strategies. Through the creation of an interdisciplinary curriculum, an institution can effectively train health care providers in a new resuscitation team role: the family support provider.

Characterization of the communication resources used by patients in palliative care - an integrative review

ABSTRACT The aim of this study was to integrative review of publications concerning the role of speech and language therapists in regards to communication strategies in palliative care, as well as the characterization of the types of communication used in these cases. The search was conducted in the databases SciELO, LILACS and PubMed from 2001 to 2016. The studies selected included abstracts or full articles addressing aspects of communication in palliative care, especially those related to speech and language therapy, with an emphasis on communication. Ten articles focused on communication, and published after 2004, were selected, half being literature reviews, two, case reports, two others, quantitative exploratory studies, and one, a qualitative exploratory study, with only 3 specifically describing the communication strategies used by speech and language therapists in patients in palliative care. The descriptors found were: palliative care, communication, speech and language therapy, quality of life, dysphagia, swallowing and elderly. Four of the ten articles showed the importance of patients communication in palliative care. When described, it is up to the speech and language therapist to provide family support, evaluate the patient, favore patient-family and patient-team intervention, manage and intervene in communication and swallowing. Finally, the most used communication strategies were non-verbal communication, communication board, electronic equipment, verbal communication and speech valve. The analysis of the characterization of the communication in palliative care over the past 15 years allowed concluding that the attention to communication is recent and is only described in a few reports, includes non-verbal communication in different ways as the most frequent resource, but provides oral communication as an important factor for maintaining dignity and comfort in this scenario. Speech and language therapist are the main interlocutors for the maintenance, mediation and adaptation of communication, within the multidisciplinary team as well as among patients, their family and the care team.

Can Women Facilitate Men’s Prostate Cancer Screening Informed Decision-Making? The M-PACT Trial

The M-PACT study compared an all-male with a mixed-sex intervention to increase informed decision-making for prostate cancer screening among African-American men in church settings. We recruited 262 men in 18 churches randomized to the two intervention approaches. Trained and certified lay peer community health advisors in each church led a series of four men’s health workshops on informed decision-making for prostate cancer screening. African-American male workshop participants completed baseline, post-workshop, and 12-month follow-up surveys. Contrary to our expectations, including women in the workshops did not result in increased intervention efficacy for the informed decision-making outcomes as both groups showed significant improvement over time in several study outcomes including stage of decision-making for prostate cancer screening, preference for role in decision-making, prostate cancer knowledge, and self-reports of prostate specific antigen testing. Finally, men who attended multiple workshops had better informed decision-making outcomes on several indicators. The current findings suggest mixed results from including women in this men’s health educational intervention. Future work should consider optimal ways of providing family support for African-American men’s health promotion.

A Descriptive Analysis of End-of-Life Conversations With Long-Term Glioblastoma Survivors.

Early, high-quality serious illness (SI) conversations are critical for patients with glioblastoma (GBM) but are often mistimed or mishandled. To describe the prevalence, timing, and quality of documented SI conversations and evaluate their focus on patient goals/priorities. Thirty-three patients with GBM enrolled in the control group of a randomized controlled trial of a communication intervention and were followed for 2 years or until death. At baseline, all patients answered a validated question about preferences for life-extending versus comfort-focused care and completed a Life Priorities Survey about their goals/priorities. In this secondary analysis, retrospective chart review was performed for 18 patients with GBM who died. Documented SI conversations were systematically identified and evaluated using a codebook reflecting 4 domains: prognosis, goals/priorities, end-of-life planning, and life-sustaining treatments. Patient goals/priorities were compared to documentation. At baseline, 16 of 24 patients preferred life-extending care. In the Life Priorities Survey, goals/priorities most frequently ranked among the top 3 were "Live as long as possible," "Be mentally aware," "Provide support for family," "Be independent," and "Be at peace." Fifteen of 18 patients had at least 1 documented SI conversation (range: 1-4). Median timing of the first documented SI conversation was 84 days before death (range: 29-231; interquartile range: 46-119). Fifteen patients had documentation about end-of-life planning, with "hospice" and "palliative care" most frequently documented. Five of 18 patients had documentation about their goals. Patients with GBM had multiple goals/priorities with potential treatment implications, but documentation showed SI conversations occurred relatively late and infrequently reflected patient goals/priorities.

Trying to bridge the worlds of home visitation and child welfare: Lessons learned from a formative evaluation

Young children in families contacting the child welfare system are at high risk of recurrent maltreatment and poor developmental outcomes. Home visitation programs to support parenting may offer hope as a preventive resource but these programs are rarely linked with child welfare. This article describes findings from a formative evaluation of a program designed to connect child welfare-involved families to an existing evidence-supported home visitation program. The program, Early Childhood Connections (ECC), was developed by a field-university partnership including leaders from a public state child welfare system, regional early childhood education systems, and several local agencies providing family support services. Despite extensive and rigorous planning by the workgroup and collaborative refining of the intervention approach as agency needs changed, the continued structural and policy changes within both the home visitation agency and the child welfare agencies created significant ongoing barriers to implementation. On the other hand, child welfare-involved families were receptive to engaging with home visitation. Implications of lessons learned for ongoing program development in this area are discussed.

Wayne County Medical Examiner’s Office Homicide in Wayne County: An Epidemic in the Black Community

The mission of the Wayne County Medical Examiner’s Office is to determine the cause and manner of death of those who die in Wayne County under the conditions of Act No.92 of the Michigan Public Acts of 1969 (Medical Examiner’s Office). In Wayne County, five manners of death are recognized: Accident, Homicide, Indeterminate, Natural and Suicide (Medical Examiner’s Office). This article will specifically discuss prevalence of homicide cases at WCMEO and the implications of these deaths for Wayne County and the African-American community. As a social work intern, one of the main objectives of the pilot program was to provide support for the families of the decedents. A large majority of the families supported were African-Americans who had lost their loved one due to a homicide. There are a disproportionate number of black males that are victims of homicide in Wayne County. This is a systemic problem and a social justice issue. There is limited research or data available around recent statistics of homicide in the black community, the effect of homicide in the black community, the implications of homicide for the surviving family members, support for surviving homicide family members and a national model for treatment or trauma associated with these losses.

KEADILAN PEMBAGIAN HARTA WARISAN PERSPEKTIF HUKUM ISLAM DAN BURGERLIJK WETBOEK

The question of the distribution of heritage property from parents to their children, or from people who have died to the parties entitled to them is a complicated problem and often cause problems for many family members. Generally, the problems arising from the practice of inheritance share are because each party feels it does not get the inheritance as it should be (unfair). This paper examines the concept of justice in the distribution of inheritance under Islamic law and Burgerlijk Wetboek (BW). This paper has provided valuable information on the understanding and concept of justice existing in Islamic law and also in BW, in which the different concept of justice has given rise to different provisions in terms of inheritance division. In the Islamic heirs law, the concept of justice is based on the principle of equitable justice, while the concept of justice contained in Burgerlijk Wetboek is built on Western philosophies and ideas, especially the justice Aristotle made about the equality of rights between individuals. Therefore, the rights of the heirs are equal to the rights of the daughter's heirs. The difference in fairness in the distribution of inheritance is due to differences in the perspectives of justice and the legal basis of the two heirs. Islam considers that the obligation to provide family support is the responsibility of men so that it is appropriate if men doubled the share of women's heritage. Meanwhile, in the Western thinking that forms the BW heir system does not determine and imposes obligations to provide a family income only to men or women, so BW's heirs provide a share of inheritance equally between men and women.

A Study of Psychological Well-Being of Senior Citizens from Community and Non Community Living

Rise in the share of elderly in total population of India posses multiple challenges viz., improving their wellbeing through providing family support, medical assistance and social support, reducing their negative aspect of life. There is an increasing interest worldwide in the study of well-being as a means to assess and need to evaluate positive dimensions of health aspects of senior citizens. In a study on the psychological well being of senior citizens residing in community and non community living, the objective was to see the difference in their psychological well being of senior citizens from community and non community living. A sample of 100 senior citizens was taken randomly from different areas in the city of Jaipur, for non community living and the sample for community living was taken from Ashiana Utsav (senior citizen homes).Out of the entire sample 50 were from community living and 50 from non community living and out of them, 25 were males and 25 were females respectively for both the groups. Standardized tool used for the study was Psychological well being scale by Dr. D.S.Sisodia and Pooja Singh. Statistical analysis used was mean, SD and‘t’ test. The results revealed that there was a significant difference in the psychological well being of senior citizens living in community living and non community living. There was also a significant difference between males and females in the different types of housing.

Barriers and facilitators to implementing family support and education in Early Psychosis Intervention programmes: A systematic review.

Family support is a core component of the Early Psychosis Intervention (EPI) model, yet it continues to have relatively low rates of implementation in practice. This paper reports results of a literature review on facilitators and barriers to delivering family interventions in EPI programmes. A search was conducted of 4 electronic databases, Medline, EMBASE, PsycINFO and Joanna Briggs, from 2000 to 2015 using terms related to early onset psychosis, family work and implementation. Four thousand four hundred and two unique studies were identified, 7 of which met inclusion criteria. Barriers and facilitators were coded and aggregated to higher-level themes using a consensus approach. Five of 7 studies examined structured multifamily psychoeducation. Uptake by families was affected by: family/client interest and readiness to participate; ability to access supports; and support needs/preferences. Implementation by programmes was affected by staff access to training and resources to provide family support. A key finding across the identified studies was that families have different needs and preferences regarding the timing, length, intensity and content of the intervention. One size does not fit all and many families do not require the intensive psychoeducational programmes typically provided. The reviewed literature suggests that flexible, tiered approaches to care may better meet family needs and increase rates of uptake of family support. However, more research is needed on the effectiveness of different models of family support in early psychosis and how they can be successfully implemented.

IIIT-FCNA Fiqh Forum on Adoption and Orphan Care

On April 13, 2017, the International Institute of Islamic Thought (IIIT) andthe Fiqh Council of North America (FCNA) brought jurists, scholars, and professionalsin the field to share their latest research on the topic of adoptionand orphan care. The day-long forum, held at the IIIT headquarters in Herndon,VA, featured one concept paper and five panels.The opening session featured Zainab Alwani (vice chair, FCNA; programdirector, Fiqh Forum on Adoption and Orphan Care; founding director, Islamicstudies, Howard University School of Divinity), who spoke on “Orphan Carein the Qur’an and Sunnah: Critical Reading on Adoption and Kafala.” Statingthat she is providing a framework – not a solution – grounded in the Qur’anand Sunnah, she discussed why the number of orphans and abandoned childrenhas reached an all-time high; why Muslim Americans are reluctant toadopt them; and such concerns as the un-Islamic nature of the American legalsystem and the ensuring legal, cultural, and linguistic problems. She stressedthat taking care of these children is an ethical/moral issue and reminded theaudience of the biographies of Musa, Yusuf, Muhammad, and Maryam, all ofwhom were raised by people who were not their biological parents, and theimportance of the family structure. In closing, she recommended that Muslimsrevive the collective spirit of caring for orphans, work with lawyers to deriveSharia-compliant solutions, integrate these children into our communities, andreconsider some traditional fiqhī concepts (e.g., brother and mawlā). AbubakerAl-Shingieti (executive director, IIIT) chaired.Panel 1, “Voices from the Field,” opened with Ranya Shbeib (co-founder,Muslim Foster Care Association; https://www.muslimfostercare.org), who focusedon meeting orphans’ immediate needs and provide family support. Herorganization works hard to achieve these twin goals and to raise local communityawareness by a four-step process: making a presentation, providingthe relevant orientation, giving practical training, and actually receiving thechild. After each step, unfortunately, the number of interested people declines ...

여성 베이비부머의 부양지원 제공과 우울

여성 베이비부머의 부양지원 제공과 우울

Twice as many helpers: Unpacking the connection between marriage migration and older labour immigrants’ access to family support

In research on ethnic minority families, the topics of marriage migration and filial support to the elderly have generally been studied separately. This article argues that the two phenomena are linked, as older immigrants are better able to receive family support when children-in-law arrive as marriage migrants, leaving behind their own parents in their country of origin. On the basis of interviews with 39 first-generation immigrants from Turkey who are aging in Denmark, the study argues that the substantial family support which these older immigrants receive depends on the ability of their children and children-in-law to divide such support between them. In the host country context in which women generally work, however, the failing health of older immigrants may lead to considerable family strain. To honour filial obligations, some families make use of an option to seek to have daughters or daughters-in-law employed by the authorities to provide family support.

The Impact of Family Engagement on Anxiety Levels in a Cardiothoracic Intensive Care Unit.

The Impact of Family Engagement on Anxiety Levels in a Cardiothoracic Intensive Care Unit.

Aggression among adolescent victims of school bullying: Protective roles of family and school connectedness.

OBJECTIVES: To examine cross-sectional and 2-year longitudinal associations between school victimization and aggression among middle and high school students. Drawing on resilience theory, family and school connectedness were examined as compensatory or protective factors. METHOD: We sampled 373 students (Grades 7-10, 54% girls, 53% White/Caucasian, 26% Hispanic/Latino, and 56% economically disadvantaged), who completed up to 3 annual surveys. RESULTS: Aggression declined over the 3 waves. Victimization predicted higher initial levels of and steeper decline in aggression. Family connectedness was protective; baseline aggression was lower and declined more steeply for youth who reported more family connectedness. School connectedness played a complex role, potentially contributing to students' vulnerability over time. CONCLUSIONS: The steeper declines in aggression among victimized youth suggest a resilience process. High family connectedness and school belonging were linked to lower level of aggression regardless of victimization. Efforts to provide family support may be effective in reducing risk for aggression among victimized youth. Promoting students' sense of school belonging may compensate for negative effects of victimization on aggression in the short term; however, broader efforts directed at establishing a safe and supportive school climate and setting social norms that discourage school violence may be necessary to reduce the incidence of victimization and subsequent aggressive behavior. ©2016 American Psychological Association Language: en

The Process of Support by Nursing Professionals for Families Having a Member with Borderline Personality Disorder

The purpose of this study was to explore the process of family support provided by nurses to families with a borderline personality disorder (BPD) patient. Semi-structured interviews were conducted with 16 nurses who had provided care to BPD patients. Data obtained from the interviews were qualitatively analyzed using a modified grounded theory approach. As an overall core category of family support processes practiced by nurses for families with BPD patients, family support practiced without awareness that the nurses were supporting families was extracted. Through this process, nurses held perceptions that were premises for family support, which were formed through their individual nursing experiences and perspectives. Nurses also had diverse perceptions concerning the image of families. Through the integration of perceptions that were premises for family support and perceptions of an image of the family, nurses underwent a process of “determination and ambivalence about the need for family support.” Then, nurses provided “family support practice” when they acknowledged the need for family support. During the “family support practice,” nurses had difficulties in providing family support. When family support was not successfully provided, nurses provided “family support practice with seeking more effective ways through trial and error.” For cases in which nurses did not acknowledge the need for intervention, they intentionally chose “not to provide family support.” Furthermore, during the “family support practice,” nurses had contradictory perspectives of family support. Such family support processes ultimately led to an awareness of the same family support required for the future. Family support was provided with “family support practice” and “family support practice with seeking more effective ways through trial and error.” In some cases, however, the process ended in “not to provide family support intentionally.” Experiences and perspectives in providing family support are important factors in carrying out future family support. Developing the positive implications of these factors and reducing psychological strain on nurses may ensure smooth implementation of family support. Thus, nurses need to recognize that they are supporting the family, which is identified as a core category.

The Effect of Reciprocal Providing Family Support and Non-Family Support on Subjective Happiness of Retired Elderly

The Effect of Reciprocal Providing Family Support and Non-Family Support on Subjective Happiness of Retired Elderly

Functional independence of Taiwanese children with Down syndrome.

Information regarding the functional strengths and weaknesses of children with Down syndrome is important for early intervention programmes and for agencies providing family support and educational services. This study used the Functional Independence Measure for Children (WeeFIM) questionnaire for the parents or caregivers of 166 Taiwanese children (101 males and 65 females; median age 12y 7mo; range 3y 2mo-19y 1mo) with Down syndrome to assess their functional skills. Out of a potential score of 126, the mean total WeeFIM score was 101.2. There was no statistically significant difference between the scores from the male and female participants (100.4 [SD 21.4] vs 102.4 [SD 24.7]; p>0.05). The mean scores for three domains (self-care, mobility, and cognition) were 45, 33, and 23 respectively (maximum of 56, 35, and 35 respectively). Performance was strongest in the mobility domain and weakest in the cognition domain. The total WeeFIM scores and 18 subscores for the three domains all positively correlated with age (p<0.05). For children with Down syndrome, some support and supervision is required for cognition and self-care tasks. The WeeFIM questionnaire may be useful for identifying the strengths and limitations of children with developmental disabilities and their families.

G233(P) Family support provision by the nursing team in neurorehabilitation following acquired brain injury (abi) in children and young people

<h3>Aims</h3> To examine how family support is provided by the nursing team following acquired brain injury (ABI) in a neurorehabilitation setting within the context of the multidisciplinary team. <h3>Methods</h3> One specialist paediatric rehabilitation centre n = 23 7 week period Children and young people aged 2 to 18 years Acquired brain injury Retrospective data analysis using the Northwick Park Therapy Dependency Assessment (NPTDA) and the Northwick Park Nursing Dependency Scale (NPDS). The NPTDA provides an assessment of a patient’s therapy dependency, including family support, and is designed for use in neurorehabilitation settings where rehabilitation is provided by a multi-disciplinary team. The NPDS provides a measure of care including patient/family psychological support provided by the nursing team. Examined family support processes and relevant training opportunities. <h3>Results</h3> Time spent supporting families The nursing team provide an average of 5.1 h (range 0.1–22.5) family support per week to families of children with ABI. The total time other team members combined (including psychologists and social workers) spent in family support was an average of 2.2 h per week. Processes/systems in place The nursing team work collaboratively with psychology and social work team to ensure a team approach in providing family support Training provided The psychology and nursing teams prepare a case study prior to each child’s admission to ensure the nursing team have a good insight and understanding into the child’s brain injury and family dynamics. The nursing team need to have a good knowledge and understanding of ABI to effectively support parents and receive training to support this. The nursing team receive training in communication, managing grief and loss and the importance of giving information whilst maintaining realistic hope. <h3>Conclusions</h3> The nursing team have a higher number of direct contact hours with families in neurorehabilitation compared to other members of the multidisciplinary team. Nurses need training to be able to give the level of family support and information that is required. Nurses in the acute setting can begin to support families and prepare them for the rehabilitation journey.

Abstract NS19: A Bird’s Eye View: A System-Wide Approach to Reducing Stroke Readmissions

Background: In January of 2013, Aultman Hospital was selected among 500 hospitals nationwide to participate in the Centers for Medicare and Medicaid Services (CMS) Bundled Payments for Care Improvement (BPCI) Initiative. The hospital chose to participate using the stroke patient population during the acute hospital stay and services up to 90 days after hospital discharge. During the discovery phase, data was analyzed that helped to identify opportunities for stroke patients across the continuum of care. Purpose: To identify areas of opportunity to reduce all-cause readmissions and to improve transitions of care across the continuum for stroke patients. Methods: A multi-disciplinary steering committee came together to review the analyzed data and identify care coordination opportunities. Reviewed data included stroke patients from 2008 to current, with a strong focus on readmissions and complications of care. A care coordinator position was created to follow all Medicare stroke patients for 90 days following discharge. The position provides a consistent person that would ensure that individual needs are met across the continuum and possibly prevent readmissions. Several interventions have been initiated that have helped to prevent readmission to the hospital system such as: facilitation of visiting physician for home bound patients, obtaining therapy orders for patients post-discharge, medication counseling, referrals to physicians when appropriate, and providing family support. Results: In 2012, the all-cause readmission rate for stroke patients was 8.8%. In 2013, the readmission rate for stroke patients was 9.4%. From January of 2014 to April of 2014, the readmission rate decreased to 9.0%. After implementation of the high risk care coordinator position in May of 2014, the readmission rate has decreased to 5.8%. Conclusions: Throughout Aultman’s journey with the BPCI, common themes remain: the need for collaboration of services for stroke patients to ensure continuity of care and to streamline the encounter for the patient. Aultman’s BPCI for Stroke team was able to identify ways to reduce stroke readmissions, prevent complications of care for stroke patients, and reduce the overall financial impact to an overburdened public health system.