Adaptation and Resilience in Families of Children With Spina Bifida in South Korea

Translation and validation of the Korean version of the QUAlity of Life Assessment in Spina bifida for Teenagers (QUALAS-T-K)

PURPOSE

The Quality of Life Assessment in Spina bifida for Teenagers (QUALAS-T) is a tool used to evaluate health-related quality of life (HRQOL) in adolescents with spina bifida (SB). The purpose of this study was to translate the QUALAS-T into Korean and validate its Korean version (QUALAS-T-K).

METHODS

Translation and validation processes were carried out in accordance with a specified protocol, including forward and back translation, a content validity study, and a main study. The tool's reliability was evaluated based on its internal consistency and stability. Factor analysis was conducted, and convergent validity was confirmed using the KIDSCREEN-27.

RESULTS

Of the 59 participants, 35 had lipomyelomeningoceles. Confirmatory factor analysis confirmed that QUALAS-T-K had the same structure as QUALAS-T. The QUALAS-T-K showed excellent internal consistency (α: 0.872-0.893, ω: 0.875-0.885), test-retest reliability (ICC:0.84-0.92), and weak to strong correlations with the KIDSCREEN-27.

CONCLUSIONS

The QUALAS-T-K, developed by reflecting on the characteristics of SB and considering the applicability of Korean cultural characteristics and clinical practice, is a convenient and reliable tool with excellent internal consistency and stability. This could be a useful tool in clinical and research settings for HRQOL evaluation of adolescents with SB.

Investigating family resilience factors for enhancing family adaptation in children with epilepsy

PURPOSE

To identify and understand the key family resilience factors that contribute to the improved family adaptation of children with epilepsy.

METHODS

Parent of children with epilepsy treated in the outpatient unit and general ward at Severance Children's Hospital in Seoul, Korea, completed a structured online questionnaire between April and May 2023. This study examined risk (epilepsy severity, time since diagnosis, parental depression, and perceived stigma) and protective factors (child temperament, epilepsy knowledge, family communication skills, parent's educational level, monthly household income, and social support) of family adaptation based on Patterson's Family Resilience Model. Furthermore, general characteristics such as daily caregiving time, perceived parental health, family type, and primary caregiver role were analyzed.

RESULTS

This study included 131 participants with a mean age of 41.79 ± 5.77 years, with children having an average age of 9.19 ± 4.94 years. The regression model was significant, and revealed the impact of communication skills, social support, and primary caregivers other than parents. Moreover, a shorter time since diagnosis has a more positive impact on family adaptation.

CONCLUSIONS

To improve family adaptation in children with epilepsy, the focus should be placed on improving communication skills, increasing social support, and providing access to external support services. Furthermore, families expecting longer illness duration require proactive measures to support them. These findings could guide future strategies to enhance adaptation in families with children with epilepsy.

Current status and influencing factors of family resilience in families of children with epilepsy: a cross-sectional study

Purpose

The study was designed to describe the level of family resilience and identify the protective factors and vulnerability factors of family resilience in families of children with epilepsy. So as to provide theoretical guidance for implementing intervention programs to promote family resilience.

Methods

From November 2020 to July 2021, 258 parents of children with epilepsy were investigated using a convenience sampling method. The questionnaire included demographic data, Chinese-Family Resilience Assessment Scale, Social Support Rating Scale, and the Beck Depression Inventory. SPSS25.0 was used for descriptive statistical analysis, univariate analysis, and multivariate linear regression analysis.

Results

In this study, two hundred and fifty-eight primary caregivers completed the paper questionnaires. The total score of family resilience was (134.97 ± 16.57), which was above the medium level. Multiple linear regression analysis revealed that subjective support (β=0.327, P<0.001), comorbidity (β=0.181, P<0.05), objective support (β=0.117, P<0.05), and parental depression (β=-0.158, P<0.05) were significantly related to family resilience. These variables contribute 31.7% of the variance in family resilience (F=18.07, P< 0.001).

Conclusion

The families of children with epilepsy presented appropriate resilience after the children were diagnosed with epilepsy. Family resilience was correlated with multiple factors, subjective and objective support could be protective factors, comorbidity and parental depression could be vulnerability factors of family resilience. Therefore, future psychosocial interventions could focus on enhancing subjective support and objective support, reducing parental depression, and screening for epilepsy comorbidity to promote the family resilience of children with epilepsy.

Family Resilience as an Emerging Concept in Neonatology: Evidence From a Metasummary Review

BACKGROUND

Family resilience can be observed through specific resilience-promoting processes, namely, shared belief systems, communication, and organizational processes, but the concept remains mostly unstudied in neonatology. This metasummary aims to evaluate the frequency of family resilience processes in qualitative scientific literature to illustrate how family resilience is exhibited in the neonatal intensive care unit (NICU) setting.

METHODS

A search among 4 databases yielded 7029 results, which were reviewed for inclusion. Following Sandelowski and Barroso's qualitative metasummary method, findings from each study were independently coded and frequency effect size was calculated.

RESULTS

Forty-six primary qualitative studies published between 2016 and 2022 conducted with parents of preterm infants who discussed their NICU hospitalization experience were included in this metasummary. All 9 of Walsh's family resilience processes were identified in the literature, and their frequency effect size ranged from 4% to 91%. Four additional themes emerged pertaining to specific family resilience behaviors exhibited by NICU families.

CONCLUSION

This analysis sheds new light on the most recent qualitative evidence of parents' experiences in the NICU by analyzing it through the lens of family resilience and posits family resilience as a promising concept in relation to the predominance of the family-centered care philosophy in neonatal units.

Family resilience factors affecting family adaptation of children with cancer: A cross-sectional study

PURPOSE

Pediatric cancer impacts all family members, including parents and siblings, who strive to adjust to a multitude of changes brought about by the illness. Family resilience is an important factor in the successful adaptation of families of children with cancer. Therefore, we aimed to identify risk and protective factors for family resilience at the child, family, and community levels that affect the adaptation of families of children with cancer.

METHOD

This study employed a descriptive survey design, and data were collected from 111 parents of children undergoing treatment for cancer between April and May 2020 at a university hospital in South Korea. Based on Patterson's family resilience model, risk factors-severity of child's condition, parental depression, and stigma and discrimination-and protective factors-the child's temperament, family communication skills, and supportive health services-for family adaptation were analyzed using multiple regression analyses.

RESULTS

Among family resilience factors affecting the adaptation of families of children with cancer, parental depression (ß = -0.290, p = 0.004) and family communication skills (ß = 0.403, p < 0.001) were identified as risk and protective factors, respectively. These variables accounted for 29.3% of the variance in family adaptation (F = 7.503, p < 0.001).

CONCLUSIONS

There is a need to develop strategies such as intervention programs that focus on reducing parental depression and strengthening family communication skills to promote the adaptation of families to pediatric cancer.

Cross-cultural adaptations of the Family Resilience Assessment Scale: a systematic review protocol of measurement properties

OBJECTIVE

The review aims to critically appraise the measurement properties and adaptation processes of all cross-cultural adaptations of the Family Resilience Assessment Scale.

BACKGROUND

A number of family resilience instruments have been developed over the past decade; however, the Family Resilience Assessment Scale reports the best psychometric properties among populations with health issues. Since its publication in 2005, numerous translations and adaptations have been undertaken to use with culturally diverse populations. A systematic review of the properties of the Family Resilience Assessment Scale's cross-cultural adaptations is needed to evaluate the adapted versions' quality (validity, reliability, and responsiveness).

INCLUSION CRITERIA

Studies of interest include validation and cross-cultural adaptation studies of the Family Resilience Assessment Scale as well as research publications reporting psychometric properties of cross-cultural adaptations in specific populations.

METHODS

Nine databases will be consulted: CINAHL, PubMed, Embase, PsycINFO, PubPsych, Health and Psychosocial Instruments database, ProQuest Dissertations and Theses, ScienceDirect, and Web of Science. The search will be limited to publications since 2005 without language restrictions. Articles will be screened by two independent reviewers and will undergo risk of bias assessment. The measurement properties of retrieved instruments will be assessed following COSMIN guidelines. Data extraction will be piloted and completed by two independent reviewers using an adapted extraction form. Psychometric properties will be reported in a narrative synthesis and further supported by a summary table.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO (CRD42020219938).

Seeking tirelessly for better health and life conditions for the child with myelomeningocele

OBJECTIVE

to understand the experience of families in the care of children with myelomeningocele.

METHOD

a qualitative research study, which adopted Symbolic Interactionism and Grounded Theory as its theoretical and methodological framework, and the semi-structured interview as a data collection instrument. Twenty-eight participants from thirteen families living in a municipality in the inland of São Paulo took part in the study.

RESULTS

the family tirelessly seeks better health and life conditions for the child with myelomeningocele; aiming at the child's autonomy, it is mobilized to the necessary treatments, to learn the care, to adapt the routine, as well as to supply for all the child's needs so that it reaches potential development, looking for a less dependent future with inclusion and social ascension.

CONCLUSION

family nursing shows potential support in the face of myelomeningocele, due to its ability to apprehend the family system, evaluate it and enable intervention proposals in the care process. In this study, rehabilitation nursing was also emphasized, since it goes together with the child and the family who experience myelomeningocele.

Family Resilience, Parenting Styles and Psychosocial Adjustment of Children With Chronic Illness: A Cross-Sectional Study

Objectives: To evaluate the level of parent-reported family resilience, parenting styles and psychosocial adjustment of children with chronic illness and to identify the relationships between family resilience, parenting styles and psychosocial adjustment in families with children with chronic illness. Methods: A cross-sectional study was conducted between June 2019 and August 2019. A total of 236 parents of children with chronic illness and 98 parents with healthy children were recruited from general hospitals by convenience sampling. A parent completed the Chinese Family Resilience Assessment Scale, the Parenting Rearing Patterns Questionnaire and the Strengths and Difficulties Questionnaire. Family resilience, parenting styles, and psychosocial adjustment of children with chronic illness were compared with those of healthy children. Structural Equation Modeling (SEM) was performed to explore the mediation effect of parenting styles between family resilience and psychosocial adjustment among children with chronic illness. Results: Parents of children with chronic illness reported lower level of family resilience and authoritative parenting, but more peer relationship problems compared to parents of healthy children. SEM showed that authoritative parenting fully mediated the relationship between family resilience and psychosocial adjustment of children with chronic illness. Conclusion: Childhood chronic illness reduces family resilience, authoritative parenting and children's psychosocial adjustment, but authoritative parenting mediated these effects, so authoritative parenting may be important for family resilience in families of children with chronic illness. Pediatric clinicians and nurses should provide family-centered interventions, as well as parenting training, to improve children's psychosocial outcomes.

Evaluation of Psychosocial Pathways to Family Adaptation of Chinese Patients With Liver Cancer Using the McCubbin's Family Resilience Model

Background and Aim: With the prolonged survival time of patients with liver cancer, these families may face tremendous pressure and development dilemmas that can easily lead to family adaptation crises. Correspondingly, family adaptation crises adversely affect the quality of life of patients and family members. Basing on McCubbin's resilience model of family stress, adjustment, and adaptation, and considering the key factors affecting family resilience based on a review of literature, this study involved a construction of a family adaptation influencing factors model in Chinese liver cancer patients, which was then verified and revised. Methods: This cross-sectional study was conducted between August and December 2020. Using convenience sampling, we selected 265 liver cancer families from the liver tumor center of a teaching hospital affiliated with a university in Shanghai, China. Data from 252 patients with liver cancer and their caregivers were used to identify the factors and pathways associated with family adaptation. The relationships were modeled using structural equations. Results: A total of 265 liver cancer families participated in the survey, and 252 valid questionnaires were returned, with a response rate of 95.09%. The pathway regression coefficients of six factors (family burden, individual resilience, family problem-solving and coping, inner family support, outer family social support, and family function) in the model were found to be statistically significant (P < 0.05), indicating that all of them were significantly associated with family adaptation. Among them, inner family support, outer family social support, and family function were direct influencing factors, while the others were indirect. The path coefficients of the total effect of the determinants on family adaptation were as follows (from largest to smallest): individual resilience (0.562), family function (0.483), outer family social support (0.345), family burden (-0.300), inner family support (0.293), family problem-solving and coping (0.127). Conclusions: Our findings suggest that clinical nurses should not only pay particular attention to direct influencing factors, develop strategies to strengthen the overall family function, encourage patients and caregivers to utilize inner family and outer family social support, but should also consider indirect influence factors, focus on the vital role of the individual, and promote patients' and caregivers' personal and family coping ability.

Parents' Needs Concerning Their Children with Spina Bifida in South Korea: A Mixed Method Study

PURPOSE

This study aimed to determine the needs of children with spina bifida (SB) and their families from their parents' perspective in South Korea.

DESIGN AND METHODS

This was a convergent mixed methods study design. From December 2016 to February 2017, parents of children with SB participated in a quantitative prospective observational study (N = 164), using the Family Needs Assessment Tool. Qualitative focus group interviews were conducted, according to three developmental stages (N = 15) in May 2017. Integrated analyses were conducted jointly by merging the quantitative and qualitative findings.

RESULTS

Quantitative findings revealed very high parental needs in three assessment domains: information, healthcare service/program, and difficulties related to healthcare. Ten qualitative themes were identified in these 3 domains. Quantitative and qualitative methods enabled more extensive findings. Comparison and merging of the data resulted in six confirmed and four expanded findings. In particular, we identified the need for a child-focused self-management program, a bladder/bowel disability awareness program, welfare policies, and partnership with healthcare professionals as the expanded findings.

CONCLUSION

This mixed method study provided empirical evidence to help better understand the complex needs of parents of children with SB.

PRACTICE IMPLICATIONS

When developing and providing healthcare education and service to families of children with SB, especially, in countries where SB educational programs have not been established yet, it is important to develop them based on their own needs, which may vary based on the child's developmental stage and socio-cultural characteristics.