The interplay of concepts, data, and methods in the development of the Family Management Style Framework

Empowering caregivers of children with bronchiolitis obliterans: The effectiveness of an internet-based follow-up platform

OBJECTIVE

Limited evidence on home care and need for long-term individualized follow-up highlight the importance of developing an Internet-based follow-up platform to support caregivers of children with Bronchiolitis Obliterans (BO). This Study aims to explore and test the potential benefits of this platform by comparing family management, medication compliance and clinical systems.

STUDY DESIGN AND METHODS

A two-arm, single-blind randomized controlled trial was conducted on 168 children with BO and their families from January 2022 to October 2022. Families were randomly divided into Internet-based follow-up group and conventional follow-up group with a ratio of 1:1. Scores of family management measures (FaMM), 8-item of Morisky Medication Adherence (8-MMAS) and BO clinical symptoms of both groups were collected at three points of time: the day of discharge (T1), 3 months after discharge (T2), and 6 months after discharge (T3). The changes of each group due to intervention were compared by repeated-measures ANOVA.

RESULTS

90 families completed the trial, including 48 in the Internet-based follow-up group and 42 in the conventional follow-up group. The results showed a significant difference in the group-by-time interaction on the scores of Child's Daily Life, Condition Management Ability and Parental Mutuality (p < 0.05). No group-by-time effect was found on the scores of View of Condition Impact and Family Life Difficulty. Scores of BO clinical symptoms and MMAS-8 showed intra-group, inter-group, and group-by-time effects.

CONCLUSIONS

The Internet-based follow-up platform can empower caregivers in enhancing effective family management, improving medication compliance in children with BO, and relieving patients' clinical symptoms.

TRIAL REGISTRATION

Chinese Clinical Trials Registry of ChiCTR2200065121 (04/28/2022).

Caregiver condition management and family functioning after pediatric cancer treatment: Moderation by race and ethnicity

OBJECTIVE

End of pediatric cancer treatment requires family adjustment. Caregivers who struggle to incorporate the child's condition into family life have poorer family outcomes. To better understand factors that contribute to successful transition off active childhood cancer treatment, we sought to examine caregiver perceived management ability of the youth's condition and family functioning as predictors of caregiver distress, evaluate family functioning as a mediator between perceived ability and distress, and explore race and ethnicity as a moderator between perceived ability and family functioning.

METHODS

Caregivers (N = 141) completed measures assessing family management (condition management ability; CMA), family functioning, and distress as part of a clinical education and screening program within 1 year of the end of treatment. Bias-corrected bootstrap regression analyses examined mediation and moderated mediation models with patient race and ethnicity as the moderator.

RESULTS

The overall mediation model was statistically significant for CMA→family functioning→distress. Race and ethnicity moderated the relationship between CMA and family functioning, but the full model was not significant. CMA was related to family functioning for caregivers of non-Hispanic white youth, but not caregivers of Hispanic youth. Family functioning was related to distress for all caregivers.

CONCLUSIONS

Family functioning serves as an initial intervention target to reduce caregiver distress. Caregiver perceived management ability of their child's condition is a meaningful predictor of family functioning and distress for caregivers of non-Hispanic white youth, yet CMA may be limited as a screener of family management patterns for diverse populations, and other family management dimension may be more applicable.

Advancing family science and health equity through the 2022-2026 National Institute of Nursing Research strategic plan

BACKGROUND

Consistent with the National Institute of Nursing Research's mission of leading nursing research to address current health challenges, the new Strategic Plan identifies five research lenses: health equity, social determinants of health, population and community health, prevention and health promotion, and systems and models of care. Family research, central to nursing research and practice, is the cornerstone of social ecology and represents a critical intersection of social and structural determinants of health.

PURPOSE

We argue why family health is essential to the 2022-2026 Strategic Plan and how the lenses can strengthen family research.

METHODS

Drawing from collective expertise and existing literature in family research, sociology, psychology, and nursing science, the authors present a new conceptual model that integrates structural racism and heteropatriarchy to examine the salience of family structure statuses for family outcomes and discuss approaches to research design, empirical measurement, and interpretation in order to bring this new model into practice.

DISCUSSION

The NINR Strategic Plan has the potential to dismantle structures that perpetuate racism and health inequity within and across family structures. An underaddressed research area under the new Strategic Plan relates to how social determinants of health influence and are influenced by families.

CONCLUSION

We challenge all investigators, not just family scientists, to expand the scope of their research to conceptualize the role of family on health inequities.

Determinants of Burden in Family Caregivers of Individuals With Schizophrenia: A Systematic Review

The current systematic review was performed to determine the specific burdens placed on families of individuals with schizophrenia. Scopus, PubMed, and CINAHL databases were searched, resulting in 21 articles that met inclusion criteria. Results showed that treatment of individuals with schizophrenia poses a burden on families. Most caregivers experienced emotional and financial problems that affected their quality of life. Influencing factors in caregivers were age, sex, educational level, family status, income, time spent with the individual per day, knowledge regarding schizophrenia, attitude, and psychological stress. Influencing factors in individuals with schizophrenia were age, sex, severity of illness, social function, and treatment adherence. Environmental factors were stigma, social support, and professional support from health care providers. Family caregivers of individuals with schizophrenia need to be empowered to improve resilience and acceptance in caring for these individuals. [Journal of Psychosocial Nursing and Mental Health Services, 61(2), 38-43.].

The Relationship of Family Factors to Psychosocial Outcomes in Children with Hypoplastic Left Heart Syndrome at 6 Years of Age

OBJECTIVE

The objective of this study was to describe the relationships between family factors and outcomes for children with hypoplastic left heart syndrome (HLHS).

STUDY DESIGN

This cross-sectional study was ancillary to the Pediatric Heart Network Single Ventricle Reconstruction Extension Study to examine family factors including parental mental health, quality of life (QOL), family resources, function and management, and their relationships to child psychosocial outcomes (adaptive behavior, internalizing and externalizing behaviors and health-related quality of life [HRQOL]) at 6 years of age.

RESULTS

Participants were parents (115 mothers, 71 fathers) of children with HLHS. Parents reported anxiety, QOL and family resources that were worse than the general population; 33% reported family dysfunction. There were no meaningful differences between reports from mothers and fathers. Parental perception of better child health was associated with better family management of the condition (P < .05). Several family management factors explained a moderate amount of variance in adaptive behavior (ΔR² = 0.08-0.14), adaptive skills (ΔR² = 0.19-0.21), and HRQOL scores (ΔR² = 0.04-0.18); little variance was explained in internalizing problems (ΔR² = 0.02-0.03) (all P < .05) above and beyond demographic and clinical variables.

CONCLUSIONS

HLHS has a significant impact on both children and families. Relationships between child and family characteristics may impose risk or protection. Improved understanding of these associations should guide counseling and tailored interventions.

The Relationship between Diabetes Family Conflict and Parental Conflict on Problem Recognition in Illness Self-Management among Individuals with Type 1 Diabetes Mellitus

We investigated the relationship between diabetes family conflict and parental conflict on problem recognition in illness self-management (PRISM) among individuals with type 1 diabetes mellitus (T1DM). We employed a descriptive research design. Participants were 243 individuals with T1DM who completed online questionnaires. Data were analyzed with descriptive statistics, correlations, and multiple regression analyses. Results revealed that barriers were felt in all areas (understanding and organizing care, regimen pain and bother, healthcare team interaction, family interaction, and peer interaction), especially peer interaction. The significant influencing factors in the regression model for the total PRISM score of individuals with T1DM were conflict behavior toward mothers (t = 4.44, p < 0.001), diabetes family conflict (t = 5.77, p < 0.001), conflict behavior toward fathers (t = 2.58, p = 0.011), women (t = 2.67, p = 0.008), non-religious (t = -2.33, p = 0.020), and diabetic complications (t = 2.17, p = 0.031). The explanatory power of the constructed regression model for PRISM was 42.0% (F = 30.12, p < 0.001). To promote self-management among individuals with T1DM, the development of interventions that promote improved peer interactions, a family-centered approach, and a program that can minimize conflicts between families and parents are required.

Patient and Family-Centered Care for Pediatric Intraluminal Pulmonary Vein Stenosis: Case of a 3 Year Old Patient with Focus on Nurse Practitioner Role

A nurse practitioner’s experience in managing children with intraluminal pulmonary vein stenosis. A case study of a 3-year-old patient with multi–vessel intraluminal pulmonary vein stenosis.

Use of the self- and family management framework and implications for further development

BACKGROUND

The Self- and Family Management Framework (SFMF) was created in 2006 and revised in 2015 to guide research on self- and family management of chronic conditions. There has been no review of use of the SFMF.

PURPOSE

We reviewed articles citing the SFMF to identify the frequency and nature of use.

METHOD

We conducted a citation analysis, searching Web of Science, Scopus, and Google Scholar databases and extracted key data from identified articles.

FINDINGS

Of 126 articles, 84(66%) cited the 2006 SFMF, 37(29%) cited the 2015 SFMF, and 6(5%) cited both. The SFMF was used most to inform study design. Users noted strengths (e.g., considers family context) and limitations (e.g., non-specification of patient- family caregiver synergies) of the framework.

DISCUSSION

The SFMF has been used broadly to guide research on self- and family management of chronic conditions. Findings will inform development of a third version of the SFMF.

Family functioning according to clusters of family management styles in Korean families of children with chronic atopic disease: A cross-sectional study

BACKGROUND

Chronic allergic diseases in children are often linked with behavioral problems, poor daily living, negative perceptions of health, and low life satisfaction.

OBJECTIVES

This study aimed to propose clusters of family management styles in the Korean families of children with chronic atopic disease, including allergic asthma, atopic dermatitis, and/or allergic rhinitis and examine the level of family functioning according to these clusters.

DESIGN

Cross-sectional study.

SETTINGS

A university-level hospital in metropolitan Seoul, South Korea.

PARTICIPANTS

Parents of children with chronic atopic disease.

METHODS

This study included 146 participants. The Korean version of the Family Management Measure and the Korean Family Functioning Scale were used to assess family management styles and family functioning, respectively. Data were analyzed using SPSS 24.0 using descriptive statistics, agglomerative hierarchical clustering with Ward's method prior to k-means clustering, k-means clustering analysis, analysis of variance, and chi-squared test.

RESULTS

Four clusters of family management styles were identified as follows: stable-resilient, less committed, parents' mission, and challenging. Among all participants, 19.9%, 30%, 20.6%, and 29.5% belonged to each of these clusters, respectively. The level of family functioning significantly differed between the four clusters, with the stable-resilient cluster having the highest mean level and the challenging cluster having the lowest mean level. Parents' perceived the complexity of self-managing their child's condition as one of the factors differentiating the level of family functioning of each cluster.

CONCLUSIONS

This study identified four clusters of family management styles and showed that each cluster was associated with a different level of family functioning. The unique characteristics of the four clusters may be helpful in providing individualized care and promoting positive family functioning in families with children having chronic atopic disease.

"I Just Kept It to Myself": The Shaping of Latina Suicidality Through Gendered Oppression, Silence, and Violence

Suicide is a critical issue among Latina youth. In this study, we use family case analysis to explore how gendered oppression, silencing, and violence shape suicidal behaviors among a sample of Latina daughters (n = 10), and their parents. For comparison, we include family narratives from Latina adolescents with no histories of suicide attempts (n = 10). Results suggest how secrets and silence, as indicative of gendered oppression, may catalyze a suicide attempt. The risks are particularly salient when daughter and mother both have experienced violence that conflicts with gendered cultural scripts. Findings highlight the importance of parental engagement and exploration of histories of violence in the treatment of Latina suicide attempters. Future research should incorporate the risk factors of gendered oppression and violence to better understand the development of suicidality among Latina women.

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.

The Family Management of Childhood Chronic Conditions: Measurement in a Turkish Sample

PURPOSE

The principal aim of this study was to adapt the FaMM into the Turkish language and test its validity and reliability.

DESIGN AND METHODS

Data were collected from a total of 395 parents of children with chronic disease. The FaMM was translated using the translation and back-translation method. The reliability analysis of the FaMM was performed using Cronbach alpha coefficients, item-total correlations and test-retest correlations. Construct validity for the scale was assessed with confirmatory factor analysis (CFA) and exploratory factor analysis (EFA).

RESULTS

The overall content validity index was 95%, signifying that the FaMM has good content validity. The CFA of the Turkish version of the FaMM did not confirm the original factorial structure. The model of three subscales for the Turkish FaMM was validated using EFA. The values of ≥0.70 for the Cronbach alpha coefficient, >0.25 for the item-total correlations and >0.40 for the test-retest application correlations for 2 weeks were found to be acceptable levels for the instruments and its subscales.

CONCLUSIONS

The FaMM was found to be valid, reliable and appropriate for Turkish culture and psychometric characteristics were satisfactory.

PRACTICE IMPLICATIONS

The FaMM can be used in evaluating the management of illness in families with children with chronic disease.

Family Management Style as a Mediator between Parenting Stress and Quality of Life of Children with Epilepsy

PURPOSE

To examine the possible relationship between parenting stress and quality of life of children with epilepsy together with the mediating effects of family management styles on this relationship.

DESIGN AND METHODS

We conducted a descriptive and exploratory study using data of participants were 93 parents with an epileptic child. Instruments were self-reported questionnaires including the Korean version of the Quality of Life (QOL) in Childhood Epilepsy Questionnaire (K-QOLCE), the Korean version of the Parenting Stress Index (PSI), and the Korean version of the Family Management Measure (FaMM). Six domains of FaMM were clustered into two domains: easy or difficult family management styles. Descriptive and Pearson correlation path analyses were used to analyze the data.

RESULTS

The direct effects of PSI on QOL were not significant (b = -0.21, t = -0.94, p = .349). Indirect effects of PSI through easy family management styles on QOL were significant (b = -0.33, 95% CI = [-0.77, -0.05]). Additionally, two other effects (i.e., indirect effects through difficult family management styles and direct effects) were non-significant. All effects of PSI on QOL were fully mediated through easy family management styles.

CONCLUSION

Easy family management styles are the most important factor in predicting QOL in childhood epilepsy patients.

PRACTICE IMPLICATIONS

Comprehensive intervention programs are recommended for parents and families of epileptic children to promote positive perceptions of the child's life and to increase parental management ability of the child's condition and parental mutuality.

The Diagnosis of Hereditary Angioedema: Family Caregivers' Experiences

The aim of this study was to understand the experiences of family caregivers in the process of diagnosing hereditary angioedema. An interpretive and qualitative research methodology based on Gadamer's philosophical hermeneutics was carried out. Data collection took place between May 2015 and August 2016 and included a focus group and in-depth interviews with 16 family caregivers. Two themes define the experiences of family caregivers: "Family life focuses on identifying the problem" and "Discovering and coping with a complex diagnosis." The process of diagnosis generates fear, anxiety, uncertainty, and incomprehension. Family caregivers are the main support for patients diagnosed with hereditary angioedema. As they share in the patients' suffering, they need a diagnosis to be established to be able to cope with the disease and offer support. Family health nurses can contribute to improving the coping process in this phase of the disease.

The Theory of Dyadic Illness Management

Despite the importance of both members of the adult patient-care partner dyad, a majority of research on illness management is focused on the patient or the care partner. The basic principle of the Theory of Dyadic Illness Management is that illness management is a dyadic phenomenon; the theory focuses extensively on the dyad as an interdependent team. The way dyads appraise illness as a unit influences the ways in which they engage in behaviors to manage illness together in a recursive fashion that influences dyadic health. Optimizing the health of both members of the dyad is a goal of the theory. In turn, the health of the dyad can feedback to influence how they appraise and manage illness together. Finally, dyadic illness management is an inherently variable process that is influenced by several contextual factors. Supportive evidence and implications for practice and future research are presented.

Parents Caring For Adult Children With Serious Mental Illness

BACKGROUND

Parents often become the caregivers for their adult children with serious mental illness (SMI) due to the chronic and debilitating course of the illness and shortages in funding for community mental health services and residential placements.

OBJECTIVE

To examine parents' management styles when caring for adult children with SMI and parents' perspectives on what type of community-based mental health interventions would support and/or enhance overall family functioning.

DESIGN

A qualitative descriptive study using semistructured interviews with parents caring for adult children with SMI. The study was undergirded by Knafl and Deatrick's Family Management Style Framework.

RESULTS

Four major themes emerged from the data describing prolonged and difficult phases that parents and the family undergo in caring for an adult child with SMI.

CONCLUSIONS

Successful management of these phases must include increasing access to mental health information, mental health screening, early interventions, and violence prevention for adult children and their families.

[Needs of psychopedagogical training for the care of children with chronic disease: perceptions of hospital nursing]

OBJECTIVE

To identify the psychopedagogical training needs of the pediatric nurses in the largest public hospital of the Balearic Islands, Spain.

METHOD

This study was developed with a quantitative and qualitative design, where 78 nurses (97.5% of the service) answered a questionnaire, and 15 participated in interviews that were analyzed via content analysis.

RESULTS

The quantitative results show gaps in the knowledge and psychopedagogical skills of the staff. These aspects could facilitate the development of tasks tailored to the personality and the psychoevolutional time of children with chronic diseases, as well as to the emotional state of families. The qualitative data was organized into four categories: family support; hospital and education; psychopedagogical training and difficulties in practice. The little communication between nurses and teachers is evident.

CONCLUSION

The data reinforces the need to implement training strategies and interdisciplinary work among health professionals, educators and families.

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.

A Case Study Approach to Nursing Home Placement: Smooth and Difficult Cases and Implications for Nursing

Nursing home placement is one of the most challenging aspects of the caregiving journey. A case study approach was used to understand the experiences of caregivers during the first few months following nursing home placement. Two caregivers were selected from a larger qualitative descriptive study because their experiences exemplified smooth and difficult transitions for both themselves and their older family member. The caregivers were interviewed shortly after placement and 3 months post-placement. Four major contextual issues were identified that indicated the similarities and differences between the two cases, including (a) the caregiver's relationship with the older adult during the home caregiving time and post nursing home placement, (b) the circumstances surrounding placement, (c) support systems, and (d) continued involvement in care post-placement. Nursing home staff who understand these issues and address concerns through family-centered care can ease the transition and promote successful collaborations between staff and families.

Cultural adaptation of the Family Management Measure among families of children and adolescents with chronic diseases

OBJECTIVES

to perform the cultural adaptation of the Family Management Measure into the Brazilian Portuguese language.

METHOD

the method complied with international recommendations for this type of study and was composed of the following steps: translation of the instrument into the Portuguese language; reaching consensus over the translated versions; assessment by an expert committee; back translation; and pretest.

RESULTS

these stages enabled us to obtain conceptual, by-item, semantic, idiomatic, and operational equivalences, in addition to content validation.

CONCLUSION

the Family Management Measure is adapted to the Brazilian Portuguese language and that version is named Instrumento de Medida de Manejo Familiar.

The relationships among family management behaviors and asthma morbidity in maternal caregivers of children with asthma

Numerous studies have identified the relationship of the family caregiver's perception regarding asthma management and the child's asthma outcomes, although few have examined family caregiver asthma management behaviors. The primary aim of this study was to examine the relationship among family management behaviors and asthma morbidity as perceived by maternal caregivers. The Family Management Style Framework was used to guide the research. Maternal caregivers (N = 101) with school-aged children diagnosed with persistent asthma and living in the United States were recruited from a specialty asthma clinic. When caregivers perceived they were expending much effort on their child's asthma management and were not confident in their ability to perform management activities, the child's asthma outcomes were worse. This is the first study to examine family management behaviors with maternal caregivers of school-aged children with asthma. Findings from this study encourage health care providers to tailor each educational opportunity with families to improve child asthma outcomes. An ongoing effort must be made to include families in asthma management. Health care partnerships between provider and family can lead to improved asthma management.

Patterns of family management of childhood chronic conditions and their relationship to child and family functioning

Understanding patterns of family response to childhood chronic conditions provides a more comprehensive understanding of their influence on family and child functioning. In this paper, we report the results of a cluster analysis based on the six scales comprising the Family Management Measure (FaMM) and the resulting typology of family management. The sample of 575 parents (414 families) of children with diverse chronic conditions fell into four patterns of response (Family Focused, Somewhat Family Focused, Somewhat Condition Focused, Condition Focused) that differed in the extent family life was focused on usual family routines or the demands of condition management. Most (57%) families were in either the Family Focused or Somewhat Family Focused pattern. Patterns of family management were related significantly to family and child functioning, with families in the Family Focused and Somewhat Family Focused patterns demonstrating significantly better family and child functioning than families in the other two patterns.

The family experience following bone marrow or blood cell transplantation

AIM

To explore how families with children at home managed 4-12 months after an adult family member was discharged from the hospital to home following bone marrow or blood cell transplantation.

BACKGROUND

Studies of these families have been limited in number. The Family Management Style Framework offers a conceptual framework relevant to families with children who have an adult member who has undergone a bone marrow or blood cell transplant.

DESIGN

This was a descriptive, qualitative, one-point-in-time study.

METHOD

Content analysis in relation to the three conceptual components of the Family Management Style Framework was employed; inductive thematic analysis determined the emergent conceptual dimensions present in the data. The sample was composed of 29 participants: 15 transplant recipients and 14 significant others who met the study criteria in 2008 and 2009. Each patient and his or her significant other were interviewed; the audio-recorded interviews were analysed after transcription.

FINDINGS

The three conceptual components of the Family Management Style Framework: (1) definition of the situation; (2) management behaviours; and (3) perceived consequences, were validated as relevant for this sample across all participants. New conceptual dimensions were also present, inclusive of recovery view, support base, financial picture, management domains, perceived consequences to the whole family, and perceived consequences to the dyad relationships.

CONCLUSION

There are several overarching findings in this study, notably that recovery at home is a family experience. Implications for nursing practice include the need for effective transitional care for the patient and family.

Adapting the family management style framework for families caring for older adults with dementia

This article presents an adaptation of the Family Management Style Framework (FMSF)-a well-established framework of family response to chronic condition care of children-to families caring for older adults with dementia. Using the FMSF to better understand how families manage dementia care can provide clinicians with insights on how to work effectively with families. Using data from interviews with eight female caregivers of older adults with dementia, this secondary analysis adapts the FMSF, and identifies new dimensions that apply specifically to families caring for older adults with dementia. The discussion draws comparisons between the family management of a child with chronic condition to management of an older adult with dementia. The article concludes with a discussion of how understanding how families manage care of an older adult with dementia informs assessment for management styles and the tailoring of interventions specific to family, caregiver, and older adult needs.

The process of family management when a baby is diagnosed with a lethal congenital condition

The Family Management Style Framework (FMSF) was used as a conceptual basis for secondary data analysis of 55 previously conducted interviews with mothers and fathers of children with a lethal congenital condition from two surgical treatment eras. The directed content analysis was guided by a coding structure developed from family management dimensions identified in prior research of family response to childhood chronic conditions. Results indicated that application of the FMSF was helpful in differentiating families and their processes of family management at the onset of their infant's illness through to surviving the first surgery and going home. The dimensions of Illness View and Child Identity were central to the parents' capacity to manage their baby's illness demands within their family context. Applying a robust family framework to a complex neonatal condition at illness onset provides compelling direction for clinical interventions and their rigorous evaluation.

Continued development of the family management style framework

Based on a review of 64 published reports, this article addresses the implications of current research for the further development of the Family Management Style Framework (FMSF). Articles are published in 46 different journals, including 13 in nursing and 12 in interdisciplinary outlets. Most studies are based on samples of less than 50 individuals. The review provides continuing support for the 8 dimensions of the framework, with between 8 and 16 reports supporting the relevance of each. Changes to the sociocultural component of the framework are proposed as well as wording changes to reflect the broader applicability of the framework. The family's social network, health care and education professionals, and resources predominate as key influences on family management.

Family management style framework and its use with families who have a child undergoing palliative care at home

Palliative care settings in many countries acknowledge families as their prime focus of care, but in Brazil, to date, researchers have devoted scant attention to that practice setting. In this article, we report the findings of a study that explored how families define and manage their lives when they have a child or adolescent undergoing palliative care at home. Data included individual semistructured interviews with 14 family members of 11 different families. Interviews were transcribed and the coding procedure featured qualitative content analysis methods. The deductive coding was based on the major components of the Family Management Style Framework and the eight dimensions comprising these components. The analysis provides insight into families' daily practices and problems inherent in managing their everyday lives that are encountered when they have a child in palliative care. The article features discussion of implications for the palliative care related development of family nursing practice.

Parents of Children Newly Diagnosed With Type 1 Diabetes: Experiences With Social Support and Family Management

Purpose

The purpose of this mixed-methods descriptive study with parents of children newly diagnosed with type 1 diabetes was to explore their experiences with peer social support following the Social Support to Empower Parents (STEP) intervention and the usefulness of the Family Management Measure (FaMM) in this population.

Methods

Parents who were in the experimental arm of STEP were recruited. Qualitative interviews were conducted (n = 21), and 11 parents completed the FaMM, a quantitative family-functioning measure. Qualitative content data analysis was conducted and compared to the descriptive measure analysis.

Findings

Three themes were identified: availability, practical tips, and common ground. Five FaMM subscales were reliable (α > .80) in this small sample.

Conclusions

The findings illustrate that the STEP intervention is helpful, providing the participants with emotional, affirmational, and informational social support. The use of the FaMM is a first step in assessing family management in families with children with type 1 diabetes.

Test of a conceptual model of uncertainty in children and adolescents with cancer

Despite recognition as a significant stressor in childhood cancer, illness-related uncertainty from the perspective of children remains under-studied. We tested a conceptual model of uncertainty, derived from Mishel's uncertainty in illness theory, in 68 school-aged children and adolescents with cancer. As hypothesized, uncertainty was significantly related to psychological distress, but only one hypothesized antecedent (parental uncertainty) significantly predicted children's uncertainty. An alternative model incorporating antecedent developmental factors (age and illness-specific expertise) explained 21% of the variance in child uncertainty; controlling for stage of treatment, uncertainty was higher in children with shorter time since diagnosis, older age, lower cancer knowledge, and higher parental uncertainty. These findings provide the foundation for further studies to understand children's management of uncertainty and its contribution to psychological adjustment to illness.

Exploring family management of childhood brain tumor survivors

Family management of childhood chronic conditions consists of 6 family factors: (1) the family's view of the child's daily life, (2) the impact of the condition on family life, (3) the difficulty of family life, (4) the family's effort managing the child's condition, (5) the family's ability managing the child's condition, and (6) parental mutuality. Recently, the Family Management Measure (FaMM), which measures family management of children with chronic conditions (excluding cancer), was validated. The purpose of this descriptive study was to examine the comparability of these 6 factors in families with childhood brain tumor survivors. First, 14 advanced practice nurses who are experts in neuro-oncology and survivorship rated items on the FaMM as relevant and clear to families of brain tumor survivors. Second, 22 cognitive interviews with parents of brain tumor survivors described family management as comparable with families of children with other chronic illness. In this report, 2 hypothetical, contrasting case studies of family management are used to illustrate family management within the context of brain tumor survivors.