Journal of Family Nursing recent issues

Highlights From the 9th International Family Nursing Conference

Bell, J. M. — Mon, 26 Oct 2009 08:40:15 PDT

Distinguished Contribution to Family Nursing Award 2009: Marcia Van Riper, RN, PhD

Knafl, K. A. — Mon, 26 Oct 2009 08:40:15 PDT

Family Cancer Caregiving and Negative Outcomes: The Direct and Mediational Effects of Psychosocial Resources

Gaugler, J. E., Linder, J., Given, C. W., Kataria, R., Tucker, G., Regine, W. F. — Mon, 26 Oct 2009 08:40:15 PDT

This study tested the hypothesis that various components of the stress process model were related to negative outcomes (depression, guilt, negative health) in cancer caregivers. This study also tested the hypothesis that psychosocial resources (mastery, socioemotional support) mediated the relationship between the various domains of the stress process model and negative outcomes. A total of 238 cancer caregivers were recruited from radiation medicine clinics at the University of Maryland Greenebaum Cancer Center (n = 186) and the University of Minnesota Cancer Center (n = 52). A comprehensive interview battery was administered. A multivariate regression found that primary subjective stressors were the strongest predictors of depression and negative health impact. A path analysis indicated that mastery mediated the relationship between role captivity and negative health impact. These results emphasize the importance of multidimensional assessment in cancer caregiving. The findings also suggest refinements to the stress process model when examining family cancer care.

Implementing Family Nursing: How Do We Translate Knowledge Into Clinical Practice?

Leahey, M., Svavarsdottir, E. K. — Mon, 26 Oct 2009 08:40:15 PDT

Health care systems worldwide are faced with the challenge of improving the quality of care, closing the knowledge-to-practice gap, and identifying the facilitators in these processes. Knowledge translation that promotes circularity between knowledge and practice is often overlooked. Knowledge transfer and translation are defined and briefly discussed in this article. Examples of knowledge translation in family nursing are provided, including knowledge creation research in pediatrics and adult pulmonary health at a University Hospital in Iceland. A second example focuses on the application of knowledge in mental health urgent care in a community health center in Calgary, Canada. Improving and speeding the circularity between knowledge translation and clinical practice reaps benefits for patients, families, health care providers, and the health care system. Conclusions about facilitating the implementation of family nursing knowledge into clinical practice are offered. The circularity between knowledge translation and practice is emphasized.

Families' and Nurses' Responses to the "One Question Question": Reflections for Clinical Practice, Education, and Research in Family Nursing

Duhamel, F., Dupuis, F., Wright, L. — Mon, 26 Oct 2009 08:40:15 PDT

The "One Question Question," first coined by Dr. Lorraine M. Wright in 1989, is an interventive question designed to elicit family members’ most pressing needs or concerns within the context of a therapeutic conversation. In this article, two clinical projects analyzed the responses to this unique interventive question. The first project analyzed the responses of 192 family members experiencing illness who were asked the question in the context of a therapeutic conversation; families focused on their need to deal with the impact of the illness on the family. The second project examined responses of 297 nurses who were asked the question prior to a 1-week Family Systems Nursing training program; nurses wanted to know how to deal with conflictual relationships between families and health care professionals and how to offer families time-efficient interventions. The responses from both groups, which were markedly different, triggered reflections about teaching, research, and practice in family nursing.

Outcomes Following an Early Parenting Center Residential Parenting Program

Treyvaud, K., Rogers, S., Matthews, J., Allen, B. — Mon, 26 Oct 2009 08:40:15 PDT

Outcomes for maternal well-being and behavior as well as difficult child behavior following participation in a 5-day early parenting center residential parenting program were explored. Participants were 44 mothers and their children, the majority presenting with child sleeping difficulties. Data were collected at four stages: intake (2-4 weeks prior to the program), the first day of the program, the last day of the program, and 4 weeks after the program. Measures included questionnaires, monitoring sheets, and videotaped observations of parent— child interactions. Improvements were seen in mothers’ behavior during parent—child interaction over the week they attended the program. Maternal symptoms of depression, anxiety, and stress were lower after the program. The perceived frequency and seriousness of maternal reported difficult child behavior decreased over the measurement period, and 52% of parents had achieved 80% or more of their behavioral goal for their children. Implications for future research in early parenting centers are discussed.

New Appointments to the Editorial Board of the Journal of Family Nursing

Mon, 26 Oct 2009 08:40:15 PDT

Calendar

Mon, 26 Oct 2009 08:40:15 PDT

Acknowledgement of Reviewers

Mon, 26 Oct 2009 08:40:15 PDT

Distinguished Contribution to Family Nursing Award (2009): Paivi Astedt-Kurki, PhD, RN

Saveman, B.-I. — Tue, 21 Jul 2009 18:01:41 PDT

Caregiving by Teens for Family Members With Huntington Disease

Williams, J. K., Ayres, L., Specht, J., Sparbel, K., Klimek, M. L. — Tue, 21 Jul 2009 18:01:41 PDT

The purpose of this report is to describe caregiving by teens for family members with Huntington disease (HD). Thirty-two teens in HD families in the United States and Canada participated in focus groups from 2002 to 2005 in a study to identify concerns and strategies to manage concerns. An unexpected finding was 24 (77%) described caregiving activities. Descriptive analysis of caregiving statements identified themes of Tasks and Responsibilities, Subjective Burden, Caregiving in Context of Personal Risk for HD, and Decisional Responsibility. Teens took an active part in nearly all aspects of care with the exception of contacting health care providers and attending doctors' appointments. Some described emotional distress, and many provided care knowing they had the potential to develop HD. Teens recognized the need for decisions but lacked the authority to make these decisions. Findings may be relevant for other teens who strive to meet caregiver and student roles and developmental tasks.

"You Don't Want to Burden Them": Older Adults' Views on Family Involvement in Care

Cahill, E., Lewis, L. M., Barg, F. K., Bogner, H. R. — Tue, 21 Jul 2009 18:01:41 PDT

Burden emerged as an important concept among older adults in a study of how older adults interact with their families around care. The authors conducted 50 semistructured interviews with adults older than the age of 65 years and a spouse or adult child. The sample was stratified by ethnicity thus giving the opportunity to explore both ethnic similarities and differences. Older adults who expressed the concept of burden were more likely to be White compared with older adults who did not express burden. Older respondents discussed burden in relation to not wanting to complicate the busy lives of adult children, guilt about health problems, and concern that children were overly worried about the care of their older family member. The expression and meaning of burden differed according to ethnicity. This study has implications for practice and policies to meet the needs of families and promote the independence of older persons.

Patterns of Parenting in Korean Mothers of Children With ADHD: A Q-Methodology Study

Oh, W.-O., Kendall, J. — Tue, 21 Jul 2009 18:01:41 PDT

The purpose of this study was to investigate patterns of parenting in Korean mothers of children with attention-deficit/hyperactivity disorder (ADHD) and identify major threads that structured various patterns of parenting. Q-methodology, a technique for extracting subjective attitudes, was used for data collection and analysis. Participants were asked to sort statements on issues associated with parenting. Factor analysis was applied to identify patterns in the ranking of statements. Participants were 45 Korean mothers of children with ADHD. As a result, three patterns of parenting emerged: Praise—Fairness, Strict—Control, and Sensitive Response—Balanced. These patterns differed on two axes: external and internal control and positive and negative reinforcement. This study provides an opportunity to enhance our understanding of the parenting patterns of mothers of children with ADHD in Korea. The findings can function as a cornerstone for developing future models of parenting children with ADHD and parent—child interactions.

Measuring Parents' Perceptions of Care: Psychometric Development of a Research Instrument

Maijala, H., Luukkaala, T., Astedt-Kurki, P. — Tue, 21 Jul 2009 18:01:41 PDT

This article describes the development and testing of a research instrument called Parents' Perceptions of Care (PPC). It is designed to measure the interaction between health care professionals and family members in situations where a child aged 1 to 3 years is in need of acute hospital care. Administered to the child's parents or other persons responsible for the child's care, PPC was developed using four concept categories drawn from Maijala's substantive theory of interaction. The instrument was piloted with 91 parents recruited from four hospitals in southern Finland. The construct validity of the scale was assessed by item analysis, and internal consistency was assessed by Cronbach's alpha values. The results of the statistical analysis are sufficient to encourage further psychometric development.

Supporting Relationships Between Family and Staff in Continuing Care Settings

Tue, 21 Jul 2009 18:01:41 PDT

In this Canadian study, a participatory action research approach was used to examine the relationships between families of residents of traditional continuing care facilities and the health care team. The objectives were to (a) explore the formation and maintenance of family—staff relationships, with attention paid to the relational elements of engagement and mutual respect; (b) explore family and staff perspectives of environmental supports and constraints; and (c) identify practical ways to support and enhance these relationships. Results indicate that the resource-constrained context of continuing care has directly impacted family and staff relationships. The nature of these relationships are discussed using the themes of "Everybody Knows Your Name," "Loss and Laundry," "It's the Little Things That Count," and "The Chasm of Us Versus Them." Families' and staff's ideas of behaviors that support or undermine relationships are identified, as are concrete suggestions for improving family— staff relationships in traditional continuing care settings in Canada.

Policy Aspects and Nursing Care of Families With Parents Who Are Sexual Minorities

Weber, S. — Tue, 21 Jul 2009 18:01:41 PDT

Families in which parents are lesbian, gay, bisexual, or transgender are more diverse than they are similar. This article reviews current literature to identify fundamental issues facing families that include sexual minority parents and their children. The unique nursing needs of families with gay, lesbian, transgender, or bisexual parents are critically examined for direct relevance to family nursing practice. Nurses and other health care professionals can incorporate current knowledge of unique child developmental, parenting, and legal issues into their work with these families. Nursing assessment and policies that consider the unique needs of these families will be addressed.

Diabetes: A Family Matter

Denham, S. A. — Tue, 21 Jul 2009 18:01:41 PDT

Calendar

Tue, 21 Jul 2009 18:01:41 PDT

Family Systems Nursing: Re-examined

Bell, J. M. — Thu, 07 May 2009 10:16:02 PDT

Analysis of Cross-Sectional Univariate Measurements for Family Dyads Using Linear Mixed Modeling

Thu, 07 May 2009 10:16:02 PDT

Outcome measurements from members of the same family are likely correlated. Such intrafamilial correlation (IFC) is an important dimension of the family as a unit but is not always accounted for in analyses of family data. This article demonstrates the use of linear mixed modeling to account for IFC in the important special case of univariate measurements for family dyads collected at a single point in time. Example analyses of data from partnered parents having a child with a chronic condition on their child's adaptation to the condition and on the family's general functioning and management of the condition are provided. Analyses of this kind are reasonably straightforward to generate with popular statistical tools. Thus, it is recommended that IFC be reported as standard practice reflecting the fact that a family dyad is more than just the aggregate of two individuals. Moreover, not accounting for IFC can affect the conclusions.

Mexican Adolescents' Alcohol Use, Family Intimacy, and Parent-Adolescent Communication

Thu, 07 May 2009 10:16:02 PDT

Despite widespread adolescent alcohol use, research on individual and contextual factors among Mexican adolescents is limited. This study describes the relationship between adolescent risk/protective factors, parent-adolescent communication, and their effects on alcohol use of 14- to 17-year-old adolescents living in Mexico (N = 829; 458 girls, 371 boys). In this study, adolescents reported that 55% ever used alcohol, 24% used alcohol in the past 30 days, and 10% reported binge drinking. Adolescents with high family intimacy were less likely to report ever using alcohol and binge drinking. Regression analysis revealed that parent-adolescent communication mediated the effect of family intimacy on overall and binge drinking. Alcohol use prevention with Mexican adolescents should focus on family intimacy and parent-adolescent communication.

Men Family Caregivers' Experience of Nonsupportive Interactions: Context and Expectations

Neufeld, A., Kushner, K. E. — Thu, 07 May 2009 10:16:02 PDT

Men's involvement as family caregivers has grown as the prevalence of dementia has increased. Men rely on support from others for caregiving but also experience nonsupportive interactions. The purpose of this ethnographic study of 34 men (24 spouses and 10 sons) caring for a relative with dementia, 5 assisting caregivers, and 15 professionals was to identify primary caregivers' perceptions of nonsupportive and supportive interactions in relationships with kin and friends as well as professionals. Thematic analysis of transcribed data generated from interviews, diaries, and focus group discussions revealed the nature of men's caregiving journeys, the characteristics of their social networks, and their expectations of supportive interactions. The nonsupportive interactions men caregivers experienced included a lack of orientation to the caregiving situation, an unsatisfactory linkage to support sources, insufficient support, and hurtful interactions. Information about nonsupportive interactions can sensitize kin and friends as well as professionals to the complexity of men's experience and potentially avoid unintended negative consequences of support efforts.

Advocating for a Parent with Dementia in a Long-term Care Facility: The Process Experienced by Daughters

Legault, A., Ducharme, F. — Thu, 07 May 2009 10:16:02 PDT

Daughter caregivers of elders with dementia become their parents' advocates over time. This role takes on even greater importance when one or both parents are placed in a long-term care facility. This article presents the results of a qualitative study aimed at explaining how this advocacy role evolves following institutionalization. In-depth interviews were conducted with daughters (N = 14) of an institutionalized parent with dementia and selected using a theoretical sampling procedure. Data analysis using grounded theory revealed three interrelated processes that explain role transformation of the daughters: integration in the care setting, evaluation of quality of care, and development of trust. Implications for involving daughters as care partners in long-term care settings are offered.

New Mothers Network: The Provision of Social Support to Single, Low-Income, African American Mothers Via E-Mail Messages

Campbell-Grossman, C. K., Hudson, D. B., Keating-Lefler, R., Heusinkvelt, S. — Thu, 07 May 2009 10:16:02 PDT

Electronic mail (e-mail) is being investigated as a health care intervention for mothers caring for their infants. The purpose of this study is to describe themes representing the content of e-mail messages written by 12 single, low-income, African American mothers to nurses participating in the New Mothers Network Study. Three themes that emerged were (a) life's logistics: day-to-day concerns; (b) relationships of support; and (c) personal reflections about being a new mother. Reported themes support the social support theory based on works by House and Revenson, Schiaffano, Majerovitz, and Gibofski used to develop the nursing intervention. Nurses are in key positions to offer social support to African American mothers adjusting to single parenting. Nurses can provide social support to single, low-income African American mothers via e-mail messages to assist them with caring for themselves and their infants.

Perception of Marital Quality by Parents with Small Children: A Follow-up Study When the Firstborn Is 4 Years Old

Ahlborg, T., Misvaer, N., Moller, A. — Thu, 07 May 2009 10:16:02 PDT

Swedish couples' perceptions of their marital quality when their firstborn was 6 months old and then 4 years later were studied in 2002 and 2006, respectively. The results show that almost half of the 368 responding parents were satisfied with their marital relationship both in 2002 and 2006 as assessed by a modified Dyadic Adjustment Scale. However, a study of the various dimensions showed a significant decrease in marital quality. Housework and child care were perceived as having a greater strain on the relationship between couples who had had additional children during this period. Dyadic Sexuality and Dyadic Cohesion were the most significant predictors of marital quality. Covariates of marital quality in the group with additional children were "partner relation and parenthood perceived as a strain" and "perceived social support." The results emphasize the need for supportive interventions for parents with children aged 0 to 4 years.

The Legacy of Letter Writing as a Clinical Practice: Introduction to the Special Issue on Therapeutic Letters

Epston, D. — Fri, 13 Mar 2009 11:08:57 PDT

Therapeutic Letters and the Family Nursing Unit: A Legacy of Advanced Nursing Practice

Bell, J. M., Moules, N. J., Wright, L. M. — Fri, 13 Mar 2009 11:08:57 PDT

This article focuses on the history of the use of therapeutic letters in the clinical scholarship of the Family Nursing Unit at the University of Calgary and offers examples of a variety of therapeutic letters written to families experiencing illness suffering. A case study from the research of Moules (2000, 2002) is offered to further illustrate the usefulness of therapeutic letters as a family nursing intervention.

Therapeutic Letters in Nursing: Examining the Character and Influence of the Written Word in Clinical Work With Families Experiencing Illness

Moules, N. J. — Fri, 13 Mar 2009 11:08:57 PDT

This article summarizes the first research to be completed on the Family Systems Nursing intervention of therapeutic letters. In the Family Nursing Unit (FNU) at the University of Calgary, therapeutic letters have been used for more than 22 years in work with families experiencing illness and suffering. Using Gadamerian philosophical hermeneutic inquiry, the research explores 11 therapeutic letters sent and received in the work with three families (four participants) seen in the FNU. Textual interpretation of the 11 letters was complemented by research interviews with the families and nurses who wrote the letters as well as in-session, presession, and postsession transcriptions. Interpretations suggest that letters have an influence related to the tone of the individuals and the relationship created; the balancing of questions, commendations, and artful writing; memory and remembrance; measures and markers of change; and the obligation of meeting people experiencing illness at the point of their suffering.

Therapeutic Letters: A Challenge to Conventional Notions of Boundary

Rodgers, N. — Fri, 13 Mar 2009 11:08:57 PDT

This article explores the impact of letter writing on therapeutic boundaries. Letters challenged and extended the spatial and temporal boundaries of the therapeutic relationship, and especially the boundary between the personal and the professional, resulting in greater relational connectedness and therapeutic intimacy between the author as therapist and his client participants. By crossing boundaries traditionally posited to keep clients safe, letter writing evoked a carefully considered use of boundary that, perhaps paradoxically, brought the author and the participants into a fuller relationship with self and with each other. A revisioning of therapeutic boundary that challenges "professionalism" and patriarchal constructions of boundary is followed by an exploration of how letters contributed to therapeutic intimacy by giving expression to therapist availability, mutuality, and vulnerability. The experiences of five of the author's clients who agreed to be interviewed are used to illustrate and enrich this narrative.

Therapeutic Letters as Relationally Responsive Practice

Pyle, N. R. — Fri, 13 Mar 2009 11:08:57 PDT

Therapeutic letters have become a practice adopted by many clinicians as an adjunct to therapeutic conversations. This article presents selected findings from a larger study that examined both the letter-writing practices of nine clinicians as well as the experiences of seven adult clients who received a therapeutic letter or letters during the course of individual or family therapy. A novel aspect of this study is that data from clients were gathered in the form of letters—eight letters written by the clients to the researcher about their experience of receiving a therapeutic letter or letters from their clinician. Thematic analysis guided the analysis of the data. Findings are placed within the context of relationally responsive (or relationally engaged) practice. An invitation is extended to conceptualize letters not as monologic documents but as a means of dialogically relating to clients and to the "goings-on" of therapeutic conversations.

Undergraduate Nursing Students Writing Therapeutic Letters to Families: An Educational Strategy

Erlingsson, C. — Fri, 13 Mar 2009 11:08:57 PDT

Writing therapeutic letters to families is discussed in this article as an educational strategy encouraging students to think reflectively about family nursing. At the University of Kalmar, Sweden, undergraduate nursing students in a primary care module interviewed families using the Calgary Family Assessment Model and wrote therapeutic letters to these families. This article describes (a) the examination process, which was the context for writing therapeutic letters, (b) results of analyses of the letters, and (c) student's post-examination evaluation comments. Results indicate that most students needed encouragement to focus on the family's strengths and resources instead of focusing on own feelings or problems they perceived the family as having. Students also needed support in relinquishing their hierarchical role of "expert nurse." Students' evaluation comments showed that writing therapeutic letters provided students with opportunities to reflect about the connections between family nursing theory and the family itself.

The Past and Future of Therapeutic Letters: Family Suffering and Healing Words

Moules, N. J. — Fri, 13 Mar 2009 11:08:57 PDT

This article explores the technological implications of the translation of therapeutic letters to therapeutic e-mail communication. The history of letters is juxtaposed with the currency with which the written language locates itself in today's methods and patterns of communication. Implications of such a translation, inherent with gifts and limitations, all deeply embedded in a historical context, are explored. The future of therapeutic letters continues to be located in their utility and ultimately their capacity to offer healing and helpful words to families in suffering.

International Family Nursing Association (IFNA) Call for Nominations

Fri, 13 Mar 2009 11:08:57 PDT

Calendar

Fri, 13 Mar 2009 11:08:57 PDT