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Alfaro-Diaz C, Esandi N, Clausen AM, Canga-Armayor N, Pueyo-Garrigues M, Dieperink KB. Instruments for Assessing Family Functioning in Adults Patients with Cancer: A Systematic Review of Measurement Properties. Semin Oncol Nurs 2024:151729. [PMID: 39277506 DOI: 10.1016/j.soncn.2024.151729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 08/09/2024] [Accepted: 08/16/2024] [Indexed: 09/17/2024]
Abstract
OBJECTIVES To identify instruments for assessing family functioning in adults patients with cancer and summarize their psychometric properties. METHODS Psychometric systematic literature review was conducted to June 2023 using four databases: PubMed, CINAHL, Psych INFO, and Web of Science. The psychometric properties of the instruments and the methodological quality of the studies were evaluated using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used to rate the best available evidence. RESULTS Forty-four studies reporting 13 instruments were included. The instruments measured varied attributes of family functioning and the dimensions were heterogeneous. The Cancer Communication Assessment Tool for Patients and Families (CCAT-PF) was rated the highest in terms of both methodological rigor and instrument quality. However, the Family Adaptability and Cohesion Evaluation Scale (FACES) and the Ice-Expressive Family Functioning Questionnaire (ICE-EFFQ) offer a more comprehensive measure of family functioning, since they assess multiple dimensions of family functioning and demonstrate high-quality measurement properties. CONCLUSIONS Instruments to assess family functioning were heterogeneous and exhibited limited reliability and validity. The FACES and the ICE-EFFQ seem to be the most suitable measures for adult cancer patients and their families. Future research should aim to refine the content of existing instruments and rigorously assess their psychometric properties. IMPLICATIONS FOR NURSING PRACTICE Given the profound impact of cancer on family functioning, the initial step in crafting effective interventions is providing valid and reliable instruments to measure the impact of these interventions. This paper could assist nursing professionals in making informed decisions regarding the most suitable instrument for assessing family functioning in adults patients living with life-threatening illness as is the case with cancer.
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Affiliation(s)
- Cristina Alfaro-Diaz
- Department of Nursing Care for Adult Patients, School of Nursing, Universidad de Navarra, Navarra, Spain; IdiSNa, Navarra Institute for Health Research, Universidad de Navarra, Navarra, Spain
| | - Nuria Esandi
- Department of Nursing Care for Adult Patients, School of Nursing, Universidad de Navarra, Navarra, Spain; IdiSNa, Navarra Institute for Health Research, Universidad de Navarra, Navarra, Spain.
| | - Anne Møller Clausen
- Department of Haematology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Family focused healthcare research Center, University of Southern Denmark, Odense, Denmark
| | - Navidad Canga-Armayor
- IdiSNa, Navarra Institute for Health Research, Universidad de Navarra, Navarra, Spain; Department of Community, Maternity and Pediatric Nursing, School of Nursing, Universidad de Navarra, Navarra, Spain
| | - María Pueyo-Garrigues
- IdiSNa, Navarra Institute for Health Research, Universidad de Navarra, Navarra, Spain; Department of Community, Maternity and Pediatric Nursing, School of Nursing, Universidad de Navarra, Navarra, Spain
| | - Karin B Dieperink
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Family focused healthcare research Center, University of Southern Denmark, Odense, Denmark; Department of Oncology, Odense University Hospital, Odense, Denmark
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Wang R, Tang H, Cui P, Du R, Wang P, Sun Q, Fu H, Lu H, Li X, Zhang T, Chen C. The influence of resourcefulness on the family functioning of young- and middle-aged lymphoma patients in China: a cross-sectional study. Fam Pract 2024; 41:360-368. [PMID: 38217367 DOI: 10.1093/fampra/cmad093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Lymphoma has become 1 of the 10 most common cancers with increased prevalence in young- and middle-aged adults in China. This poses a tremendous burden on patients and their families and brings great challenges to maintaining the balance of family functioning in young- and middle-aged patients. OBJECTIVE This cross-sectional study aimed to analyse the influence of resourcefulness on the family functioning of Chinese young- and middle-aged lymphoma patients. METHODS A total of 172 Chinese young- and middle-aged patients with lymphoma were recruited from the oncology departments of two tertiary hospitals in Zhengzhou, Henan, China. They were invited to complete a survey that included a demographic questionnaire, the Resourcefulness Scale and the Chinese Version Family Adaptability and Cohesion Scale II. Multiple linear regression was used to analyse the related factors for family functioning. RESULTS The multiple regression analysis revealed that the main influencing factors of family cohesion were resourcefulness (β = 0.338, 95% CI (0.072, 0.173)), spouse caregiver (β = 0.376, 95% CI (1.938, 10.395)), and cancer stage (β = -0.274, 95% CI (-3.219, -1.047)). Resourcefulness (β = 0.438, 95% CI (0.096, 0.181)), spouse caregiver (β = 0.340, 95% CI (1.348, 8.363)), and family per capita monthly income (β = 0.157, 95% CI (0.066, 2.243)) were the influencing factors of family adaptability. CONCLUSIONS Healthcare professionals and family scholars should value young- and middle-aged lymphoma patients' family functioning throughout the cancer treatment process, and family interventions should be designed by healthcare providers based on patients' resourcefulness. Moreover, healthcare providers need to pay attention to the risk factors of patients' family cohesion and adaptability, such as low family per capita monthly income, and consider employing corresponding measures to help them.
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Affiliation(s)
- Ruibo Wang
- The School of Nursing and Health, Zhengzhou University, Zhengzhou, China
- Department of Quality Control, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Academy of Medical Sciences of Zhengzhou University, Zhengzhou, China
| | - Han Tang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi' an, China
- Department of Clinical Nursing, School of Nursing, The Fourth Military Medical University, Xi' an, China
| | - Panpan Cui
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Ruofei Du
- The School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Panpan Wang
- The School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Qiaozhi Sun
- Pediatric Outpatient Department, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hang Fu
- Hospital Office Room, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Institute for Hospital Management of Henan Province, Zhengzhou, China
| | - Hongmei Lu
- Medical Department, Henan Cancer Hospital, Zhengzhou, China
| | - Xuekun Li
- Interventional Operating Room, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Tiange Zhang
- Department of Neurology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Changying Chen
- The School of Nursing and Health, Zhengzhou University, Zhengzhou, China
- Department of Quality Control, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Institute for Hospital Management of Henan Province, Zhengzhou, China
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Abstract
OBJECTIVES To synthesise empirical findings on the role of family in end-of-life (EOL) communication and to identify the communicative practices that are essential for EOL decision-making in family-oriented cultures. SETTING The EOL communication settings. PARTICIPANTS This integrative review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. Relevant studies published between 1 January 1991 and 31 December 2021 were retrieved from four databases, including the PsycINFO, Embase, MEDLINE and Ovid nursing databases, using keywords with meanings of 'end-of-life', 'communication' and 'family'. Data were then extracted and coded into themes for analysis. The search strategy yielded 53 eligible studies; all 53 included studies underwent quality assessment. Quantitative studies were evaluated using the Quality Assessment Tool, and Joanna Briggs Institute Critical Appraisal Checklist was used for qualitative research. PRIMARY AND SECONDARY OUTCOME MEASURES Research evidence on EOL communication with a focus on family. RESULTS Four themes emerged from these studies: (1) conflicts in family decision-making in EOL communication, (2) the significance of timing of EOL communication, (3) difficulty in identification of a 'key person' who is responsible for decisions regarding EOL care and (4) different cultural perspectives on EOL communication. CONCLUSIONS The current review pointed towards the importance of family in EOL communication and illustrated that family participation likely leads to improved quality of life and death in patients. Future research should develop a family-oriented communication framework which is designed for the Chinese and Eastern contexts that targets on managing family expectations during prognosis disclosure and facilitating patients' fulfilment of familial roles while making EOL decision-making. Clinicians should also be aware of the significance of the role of family in EOL care and manage family members' expectations according to cultural contexts.
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Affiliation(s)
- Jack Pun
- Department of English, City University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - James C H Chow
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong SAR, People's Republic of China
| | - Leslie Fok
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong SAR, People's Republic of China
| | - Ka Man Cheung
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong SAR, People's Republic of China
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Jung M, Jeong Y, Park BJ. Adaptation of families of adult patients with brain tumor: Partial least squares structural equation modeling. PLoS One 2023; 18:e0285677. [PMID: 37167209 PMCID: PMC10174583 DOI: 10.1371/journal.pone.0285677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 04/23/2023] [Indexed: 05/13/2023] Open
Abstract
Brain tumor patients experience physical, psychological, social, and cognitive changes. These changes are challenging for both the patients and their families. These patients and their families need to adapt together on the cancer treatment path. This study aimed to identify the factors affecting adaptation in families of adult patients with brain tumors. A quantitative, cross-sectional study of 165 families of adult patients with primary brain tumors was conducted using a self-administered questionnaire. Partial least squares structural equation modeling was used to test a hypothetical model. The results showed that family stress, family functioning, and family resources influenced on family adaptation in families of adult patients with primary brain tumors. Among these factors, family resources were identified to be the strongest factor associated with family adaptation. The results of this study may be utilized as a theoretical basis in nursing to improve the family adaptation of patients with brain tumors. Regarding nursing practices, the results suggest that nurses should provide family-centered nursing interventions and promote family resources to help brain tumor patients and their families to adapt.
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Affiliation(s)
- Mijung Jung
- Department of Nursing, Kwangju Women's University, Gwangju, Korea
| | - Younhee Jeong
- College of Nursing Science, Kyung Hee University, Seoul, Korea
- East-West Nursing Research Institute, Kyung Hee University, Seoul, Korea
| | - Bong Jin Park
- College of Medicine, Kyung Hee University, Seoul, Korea
- Department of Neurosurgery, Kyung Hee Medical Center, Seoul, Korea
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Perceptions of the meaning of life among Korean patients with advanced cancer: A mixed-methods study. Palliat Support Care 2022:1-12. [PMID: 36017653 DOI: 10.1017/s1478951522000979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study aimed to explore perceptions of the meaning of life among Korean patients living with advanced cancer. METHOD The study employed a mixed-methods design, and 16 participants were included in the analysis. Qualitative data gathered from in-depth interviews were analyzed using Colaizzi's phenomenological method. Quantitative survey data were analyzed using descriptive statistics, the Mann-Whitney U test, the Kruskal-Wallis test, and Spearman's ρ correlation. RESULTS Participants experienced both the existence of meaning and the will to find meaning in terms of four categories: "interpersonal relationships based on attachment and cohesion" (three themes - family as the core meaning of one's life, supportive and dependent interconnectedness with significant others, and existential responsibility embedded in familism), "therapeutic relationships based on trust" (one theme - communication and trust between the patient and medical staff), "optimism" (two themes - positivity embodied through past experiences and a positive attitude toward the current situation), and "a sense of purpose with advanced cancer" (two themes - the will to survive and expectations for the near future). The meaning in life questionnaire (MLQ) and the purpose in life scale (PIL) showed a significant positive correlation tendency with the functional assessment of chronic illness therapy-spiritual well-being scale (FACIT-Sp). The patient health questionnaire (PHQ-9) showed significant negative correlation tendency with both the MLQ-presence of meaning (MLQ-PM) and PIL-Initiative (PIL-I) questionnaires. SIGNIFICANCE OF RESULTS Finding meaning in life helps advanced cancer patients realize their will to live. It also acts as a coping mechanism that palliates negative experiences in the fight against the disease. In particular, among advanced cancer patients in the Korean culture, the dynamics of relationships with family and medical staff was a key axis that instilled optimism and will to live. These results suggest that considering the meaning of life in advanced cancer patients by reflecting Korean culture in the treatment process improves the quality of care.
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Martín-Martín J, Pérez-Díez-Del-Corral M, Olano-Lizarraga M, Valencia-Gil S, Saracíbar-Razquin MI. Family Narratives About Providing End-of-Life Care at Home. JOURNAL OF FAMILY NURSING 2022; 28:17-30. [PMID: 34165346 DOI: 10.1177/10748407211025579] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Currently, the dying process in Spain is moving to the home environment where responsibility for care falls largely on the family, thereby challenging and testing the stability of the family. Previous research has focused on the impact of illness on the primary caregiver; therefore, a knowledge gap exists. This study aimed to understand families' unitary experiences of providing home care to terminally ill family member. Using the "Model of Interpersonal Relationship Between the Nurse and the Person/Family Cared For," narrative research included family and individual interviews with nine families (9 groups/23 individuals). Thematic narrative analysis was used to interpret the interviews. The results highlight the impact of illness on family well-being as a whole. Family members often felt abandoned while caring for an ill family member and wished to be cared for themselves. However, their immediate community and the nurses caring for their ill family member neglected them. A paradigm shift is required by society and in home care at the end of life to better support the family.
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Affiliation(s)
- Jesús Martín-Martín
- University of Navarra, Pamplona, Spain
- Navarra's Health Research Institute, Pamplona, Spain
| | | | - Maddi Olano-Lizarraga
- University of Navarra, Pamplona, Spain
- Navarra's Health Research Institute, Pamplona, Spain
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