Application of the Calgary Family Assessment and Intervention Models: Reflections on the Reciprocity Between the Personal and the Professional

[Healthcare difficulties among people who have a drug use problem: an integrative review]

The scope of this study was to understand the difficulties involving healthcare for people with a drug use problem within the context of specialized mental health services, both nationally and internationally. It involves an integrative review conducted in the PubMed, LILACS, Web of Science, SCOPUS, and EMBASE databases, with the following key words: Drug Users; Mental Health Services; Health Care. Eighteen studies were selected, the inclusion criteria being primary studies, available in full, published in English, Spanish and Portuguese, between January 2016 and January 2021. The inclusion criteria were primary studies, available in full, published in English, Spanish and Portuguese, during the period from January 2016 through January 2021. The analysis identified that the difficulties in healthcare for people with a drug use problem are linked to the dimensions of public health policies, models of care adopted, and the stakeholders involved, and that these aspects are interrelated. It also emphasizes the need for specialized training, as well as further in-depth research that addresses the therapeutics of the drug use problem, and the development of new healthcare technologies for this population group.

Applicability and Validity of Second Victim Assessment Instruments among General Practitioners and Healthcare Assistants (SEVID-IX Study)

BACKGROUND

The second victim phenomenon and moral injury are acknowledged entities of psychological harm for healthcare providers. Both pose risks to patients, healthcare workers, and medical institutions, leading to further adverse events, economic burden, and dysfunctionality. Preceding studies in Germany and Austria showed a prevalence of second victim phenomena exceeding 53 percent among physicians, nurses, emergency physicians, and pediatricians. Using two German instruments for assessing moral injury and second victim phenomena, this study aimed to evaluate their feasibility for general practitioners and healthcare assistants.

METHODS

We conducted a nationwide anonymous online survey in Germany among general practitioners and healthcare assistants utilizing the SeViD (Second Victims in Deutschland) questionnaire, the German version of the Second Victim Experience and Support Tool Revised Version (G-SVESTR), and the German version of the Moral Injury Symptom and Support Scale for Health Professionals (G-MISS-HP).

RESULTS

Out of 108 participants, 67 completed the survey. In G-SVESTR, the collegial support items exhibited lower internal consistency than in prior studies, while all other scales showed good-quality properties. Personality traits, especially neuroticism, negatively correlated to age, seem to play a significant role in symptom count and warrant further evaluation. Multiple linear regression indicated that neuroticism, agreeableness, G-SVESTR, and G-MISS-HP were significant predictors of symptom count. Furthermore, moral injury partially mediated the relationship between second victim experience and symptom count.

DISCUSSION

The results demonstrate the feasible use of the questionnaires, except for collegial support. With respect to selection bias and the cross-sectional design of the study, moral injury may be subsequent to the second victim phenomenon, strongly influencing symptom count in retrospect. This aspect should be thoroughly evaluated in future studies.

Patients' and Family Members' Experiences of a Novel Nurse-Led Intervention Using Family Conversations Targeting Families Afflicted by Chronic Non-Cancer Pain

Purpose

To explore patients' and family members' experiences of participating in an intervention using nurse-led family nursing conversations (NLFCs) targeting families affected by chronic non-cancer pain (CNCP), including the perceived impact of the intervention on the individual and the family. CNCP substantially impacts patients and families. Due to a lack of simple treatment solutions, the condition needs to be managed rather than cured. Family involvement seems a promising tool, but research evaluating specific approaches is limited. Interventions based on the family systems nursing framework by Wright and Leahey have been helpful in other populations. Nonetheless, the approach warrants further investigation and evaluation in patients with CNCP.

Patients and Methods

A phenomenological hermeneutical design was applied, and individual interviews were conducted with ten patients and ten family members who received the intervention. The analysis was inspired by Ricoeur's philosophy of text interpretation.

Findings

Three themes emerged during the analysis. "Taking part in the intervention while being affected by previous experiences" showed that patients and family members were affected by different experiences and burdens and therefore entered the intervention with varied starting points. "Being empowered through validation and understanding" showed that participants mainly viewed the intervention as beneficial, increasing patients' and family members' mutual understanding and underpinning acceptance of the chronic pain condition. "Being receptive to the intervention - mechanisms contributing to achieving benefit" identified contributing mechanisms influencing patients' and family members' experiences of the intervention. These mechanisms included confidence in the nurses' facilitation of the intervention, the timing of the intervention, the participant's level of acceptance, and readiness to engage in the intervention.

Conclusion and Relevance to Clinical Practice

The intervention was mainly experienced as helpful. Thus, healthcare settings treating CNCP should consider implementing NLFC in clinical practice with adjustments to meet the vulnerability of the CNCP population.

Developing a Card Game for Assessment and Intervention in the Person and the Family in Palliative Care: "Pallium Game"

Communication between the multidisciplinary team, the person, and the family in palliative and end-of-life situations implies, in most situations, a high negative emotional burden. Therefore, innovative strategies are needed to reduce it. The goal of this study is to describe the various stages of development and validation of a collaborative card game for people in palliative care and their families. Phase one is an exploratory study, Phase two is a Delphi study, and Phase three is a multiple case study. Participants for phases 2 and 3 were recruited using a convenience sampling method. The results demonstrate in an organized and structured way the different phases required to build a collaborative card game. The use of the game was found to be useful and effective. Four categories emerged from the content analysis of the open-ended responses: usability, evaluation tool, communication and therapeutic relationship, and meaning when using the game. A collaborative game in palliative care helps to create a space for individuals and families to express feelings and experiences, meeting the myriad of physical, psychosocial, and spiritual needs. The "Pallium game" is a useful and impactful approach to discussing sensitive topics in palliative care.

Reflexivity and Relational Spaces: Experiences of Conducting a Narrative Inquiry Study With Emerging Adult Women Living With Chronic Pain

Clandinin and Connelly's narrative inquiry methodology was used to understand the lived and told stories of two emerging adult women (aged 18-29) living with chronic pain. The aim of this paper is to share the experiences of the first author-a graduate student and novice researcher-of creating relational spaces with emerging adult women living with chronic pain, and the experience of co-creating knowledge through the methodological lens of narrative inquiry. There are 12 qualitative touchstones that narrative inquirers attend to when using narrative inquiry, and we present the experiences of a novice narrative inquirer in relation to selected touchstones. Narrative inquiry can greatly contribute to nursing knowledge, and implications for nursing practice and research are discussed.

Effects of the family support and psychoeducation program based on the Calgary Family Intervention Model on the coping, psychological distress and psychological resilience levels of the family caregivers of chronic psychiatric patients

AIMS

This study was aimed at investigating the effects of family support and psychoeducation program based on Calgary Family Intervention Model on coping, psychological distress and psychological resilience levels of families of chronic psychiatric patients.

METHODS

The sample of this quasi-experimental study consisted of the caregivers of chronic psychiatric patients who were admitted to the adult psychiatry inpatient and outpatient unit of a university hospital and the caregivers of chronic psychiatric patients registered with the Schizophrenia Solidarity Association. Nonparametric analysis was used in the analysis of the data.

RESULTS

It was found that there was a significant decrease between the mean distress scores the caregivers participating in the Calgary Family Intervention-Based Family Support and Psychoeducation Program obtained from the measurements before, right after, and 3 and 6 months after the intervention (p < 0.05). There was no statistically significant difference between the coping scores and psychological resilience scores the caregivers obtained from the measurements before, right after, and 3 and 6 months after the intervention (p > 0.05).

CONCLUSION

It was concluded that the family support and psychoeducation program based on the Calgary Family Intervention Model applied to family members giving care to individuals with chronic mental illnesses had positive effects on the general health status of the caregivers.

Experiences of families of adolescents with gender incongruence in the light of the Calgary Models for Families

OBJECTIVE

to know the experiences of family members of adolescents with gender incongruence.

METHOD

this is a qualitative case study, supported by the Calgary Family Assessment and Intervention Models theoretical-methodological framework. Data collection took place through semi-structured interviews, participant observation in family groups and document analysis, with eight family members. Data analysis was performed following the precepts of content analysis.

RESULTS

with family assessment, two categories emerged: "Challenges in the face of gender transition", which highlighted the problems related to the expectations created at birth, new names, pronouns and gender fluidity and the fear of prejudice, and "Supporting aspects in the face of the possibility of gender transition", which revealed family support as a strong point.

CONCLUSION

knowing the experiences allowed us to understand the challenges that family members face when facing physical and emotional aspects of their children's gender transition. It was noticed that the act of seeking help and offering support is important for a healthy transition. The findings provided a better understanding of family issues and provided suggestions on how nursing can develop care for this population.

Efficacy of the Use of the Calgary Family Intervention Model in Bedside Nursing Education: A Systematic Review

Objective

To objectively analyze the research for empirical evidence of the efficacy of the use of the Calgary Family Intervention Model (CFIM) in assisting bedside education by nurses and to identify facilitators and barriers to the use of the Model.

Methods

Four research databases (PubMed [MEDLINE], CINAHL, Web of Science, and Science Direct) were queried for studies commensurate with the objective statement from 1990 to 2021. In total, 169 articles were initially identified in the search, 135 were screened after duplicates and ineligible articles were removed, ultimately leaving the sample of 24 articles for the review.

Results

There is significant evidence to conclude that the CFIM is a very useful model to be used by nurses for bedside education and to improve overall patient and family outcomes. It enables communication, collaboration, and therapeutic conversations. The use of CFIM by nurses serves as a resource for both them and families and patients involved. There are some concerns to the use of CFIM as there are family dynamic issues, which result in problems providing care to patients. A lack of family sharing can result in inadequate care to the patient as well as unrealistic expectations from family members involved.

Conclusion

The CFIM is an excellent tool to enable nurses to provide education at the bedside and to enable improved patient and family outcomes. The use of the tool is suggested in situations where it would improve the level of care provided to patients and families.

District nursing and family/whanau assessment practices: A New Zealand study

Aim

District Nurses apply specialized nursing knowledge and assessment skills to provide care in New Zealand communities. This study aimed to identify whether District Nurse's (both Registered and supervised Enrolled Nurse's) had knowledge of, and used the 15‐Minute Interview tool, including Ecomaps/Genograms, and if not, what they saw as enablers or barriers to doing so.

Design

Participatory action research was used, following the phases of look, think and act.

Methods

Two pre‐intervention focus groups occurred, two education sessions which introduced the 15‐Minute Interview and four postintervention interviews which explored the use of the tools and their potential use in the future.

Results

District Nurses demonstrated working with families, and the selection of when and where to apply the 15‐Minute Interview.

Health Service Needs from a Household Perspective: An Empirical Study in Rural Empty Nest Families in Sinan and Dangyang, China

This study aimed to explore the health service needs of empty nest families from a household perspective. A multistage random sampling strategy was conducted to select 1606 individuals in 803 empty nest households in this study. A questionnaire was used to ask each individual about their health service needs in each household. The consistency rate was calculated based on their consistent answers to the questionnaire. We used a collective household model to analyze individuals’ public health service needs on the family level. According to the results, individuals’ consistency rates of health service needs in empty nest households, such as diagnosis and treatment service (H1), chronic disease management service (H2), telemedicine care (H3), physical examination service (H4), health education service (H5), mental healthcare (H6), and traditional Chinese medicine service (H7) were 40.30%, 89.13%, 98.85%, 58.93%, 57.95%, 72.84%, and 63.40%, respectively. Therefore, family-level health service needs could be studied from a family level. Health service needs of H1, H3, H4, H5, and H7 for individuals in empty nest households have significant correlations with each other (r = 0.404, 0.177, 0.286, 0.265, 0.220, p < 0.001). This will be helpful for health management in primary care in rural China; the concordance will alleviate the pressure of primary care and increase the effectiveness of doctor–patient communication. Health service needs in empty nest households who took individuals’ public needs as household needs (n = 746) included the H4 (43.3%) and H5 (24.9%) and were always with a male householder (94.0%) or at least one had chronic diseases (82.4%). Health service needs in empty nest households that considered one member’s needs as household needs (n = 46) included the H1 (56.5%), H4 (65.2%), H5 (63.0%), and H7 (45.7%), and the member would be the householder of the family (90.5%) or had a disease within two weeks (100.0%). In conclusion, family members’ roles and health status play an important role in health service needs in empty nest households. Additionally, physical examination and health education services are the two health services that are most needed by empty nest households, and are suitable for delivering within a household unit.

CONVIVENDO COM O CÂNCER GESTACIONAL: UMA TEORIA FUNDAMENTADA NOS DADOS A PARTIR DE EXPERIÊNCIAS DE FAMÍLIAS

RESUMO Objetivo: compreender a experiência de famílias diante do adoecimento de familiar por câncer gestacional. Método: trata-se de uma teoria fundamentada nos dados que teve como referencial teórico o interacionismo simbólico. Participaram do estudo doze famílias que tiveram entre seus membros uma mulher com diagnóstico de câncer gestacional. A coleta dos dados deu-se por formulário de identificação, genograma e entrevista, entre março de 2018 e março de 2019, e a análise seguiu as etapas da codificação substantiva e teórica. Resultados: a análise comparativa constante dos dados permitiu a elaboração de uma teoria substantiva “Convivendo entre fragilidades e motivações: experiências de famílias com o câncer gestacional” explicativa da experiência que teve como conceito central “Vivendo entre perdas que fragilizam e a chegada da criança que fortalece”, que representa as ações e estratégias simbólicas da família que se percebe em uma condição de dualidade. Conclusão: ao longo da experiência, a família movimenta-se de uma condição em que o adoecimento é identificado como um dificultador para a vivência da gestação e nascimento para outra em que a gestação e o nascimento são significados como motivadores para o tratamento oncológico.

Experiências de famílias de adolescentes com incongruência de gênero à luz dos Modelos Calgary para famílias

RESUMO Objetivo: conhecer as experiências de familiares de adolescentes com incongruência de gênero. Método: estudo de caso qualitativo, apoiado pelo referencial teórico-metodológico dos Modelos Calgary de Avaliação e Intervenção Familiar. A coleta dos dados ocorreu por meio de entrevistas semiestruturadas, observação participante em grupos de familiares e análise documental, com oito familiares. A análise dos dados foi realizada seguindo os preceitos da análise de conteúdo. Resultados: com a avaliação familiar, emergiram duas categorias: “Desafios em face à transição de gênero”, que evidenciou os problemas relacionados às expectativas criadas ao nascimento, novos nomes, pronomes e fluidez de gênero e o medo do preconceito, e “Aspectos apoiadores diante da possibilidade de transição de gênero”, que revelou o apoio familiar como ponto forte. Conclusão: conhecer as experiências permitiu compreender os desafios que os familiares enfrentam ao se deparar com aspectos físicos e emocionais da transição de gênero de seus filhos. Percebeu-se que o ato de procurar ajuda e de oferecer apoio é importante para uma transição saudável. Os achados proporcionaram melhor compreensão das questões familiares e forneceram sugestões de como a enfermagem pode elaborar o cuidado a essa população.

How Family Members Experienced a Family-Focused Atrial Fibrillation Intervention in an Outpatient Setting—A Qualitative Study

Introduction

Family-focused nursing has gained ground worldwide, and a range of healthcare systems are now practicing family-focused nursing, which has been shown to increase the quality of care. Even so, a lack of research remains into family-focused nursing for various groups of patients in clinical practice.

Objectives

The purpose of this study was to explore how family members (FMs) of patients with atrial fibrillation (AF) experienced a family-focused nursing intervention in a clinical outpatient setting.

Methods

This was a qualitative phenomenological interview study employing Reflective Lifeworld Research (RLR) to explore humans’ lived experiences. The data reported herein were derived from semi-structured interviews with seven FMs of patients with AF who participated in a clinical trial which tested a family-focused intervention in a Cardiology outpatient clinic treating patients with AF. The transcribed interviews were analyzed in four phases which is an iterative process as proposed by Dahlberg and Dahlberg.

Findings

The essence of the phenomenon was experiencing less panic and finding peace, which emerged from the following four patterns. (1) The FMs’ post-AF experience, (2) Enhanced understanding and knowledge of AF, (3) Personal interaction with a nurse specialist and (4) AF becomes manageable. A space facilitating reflection upon the disease and daily life with the disease was established through group sessions and family conversations.

Conclusion

A family-focused nursing intervention facilitated by specialized nurses with extensive communication skills filled a knowledge gap related to AF thereby reducing panic and increasing peace among FMs. Furthermore, the intervention facilitated family awareness of their resources to bring about change, regain balance, and enhance well-being in their everyday lives and initiated a healing process in the families. Future interventions for patients with AF should consider FMs as well as patients as an entity of care.

LIVING WITH PREGNANCY-ASSOCIATED CANCER: GROUNDED THEORY BASED ON FAMILY EXPERIENCES

ABSTRACT Objective: to understand the experience of families living with pregnancy-associated cancer. Method: grounded theory with symbolic interactionism as a theoretical reference. Twelve families with a woman diagnosed with pregnancy-associated cancer participated in the study. Data were collected by identification form, genogram and interview, between March 2018 and March 2019, and the analysis followed the stages of substantive and theoretical coding. Results: the constant comparative analysis of the data developed the substantive theory "Living between weaknesses and motivations: experiences of families with pregnancy-associated cancer" explaining the experience with the central concept "Living between losses that weaken and the arrival of the child who strengthens", which represents the symbolic actions and strategies of the family that perceives itself in a condition of duality. Conclusion: throughout the experience, the family moves from a condition in which illness is identified as a difficulty for the experience of pregnancy and birth to another in which pregnancy and birth are seen as motivators for cancer treatment.

Information provision to older patients receiving palliative chemotherapy: a quality study

OBJECTIVES

Cancer treatment has become increasingly successful. However, prolonging and preserving life has become an important goal of therapy since many patients generally receive palliative chemotherapy. The perception of life changes when patients are informed, that no curative treatment is possible. This raises new dilemmas for patients with incurable cancer, but only sparse information is available about the thoughts of these patients.The aim of this study was to explore how older patients experience the information on absence of curative treatment options.

METHODS

Qualitative interviews were performed in eleven older patients with incurable upper gastrointestinal cancer receiving first-line palliative chemotherapy. Median age was 74 (65-76) years. We used a qualitative approach to collect data through semistructured individual interviews conducted at the hospital or by telephone interviews by an experienced researcher. The thematic analysis was conveyed by Braun and Clarke.

RESULTS

The interview findings were grouped around three main themes: hope of being cured, hearing but not comprehending, and desired milestones to reach. Further, it was determined that patients hid their feelings and avoided talking about the disease with the health professionals due to fear of being told the truth.

CONCLUSIONS

Receiving information about their incurable cancer was an ongoing dilemma for the patients. Following the message, patients shared thoughts about reaching important milestones in life, spending time with their family or hope for a cure to be found.

Emotional and Psychological Effects of Dysphagia: Validation of the Jugendwerk Dysphagia Emotion and Family Assessment (JDEFA)

Introduction

Patients suffering from swallowing disorders are experiencing emotional effects like anger, anxiety, and sadness. This may be affecting patient–therapist relation and family functioning. To assess emotional reaction and their influence on family systems, we developed a 55-item questionnaire based on the Atlas of Emotion and the Calgary Family Intervention Model.

Methods

We recruited more than 160 participants to validate an online survey, namely the Jugendwerk Dysphagia Emotion and Family Assessment Score (JDEFA). Forty-Nine health care workers, patients, and family members completed the survey and provided additional comments regarding interactions of emotions and dysphagia. Analysis was accomplished by non-parametric tests and principal component analyses with Varimax rotation. Additionally, we accomplished a qualitative content analysis taking a phenomenological single-coder approach.

Results

Analysis revealed a Cronbach’s Alpha of 0.93. Using primary component analyses, justified by a Kaiser–Meyer–Olkin value of 0.81, we identified two main factors (emotion and family). Patients experienced sadness and anger more often than health care providers, whereas family members felt anxiety even more often. Our qualitative analysis revealed 20 themes (7 for anger, 2 enjoyment, 4 sadness, 3 anxiety, 2 disgust, 1 shame, and 1 punishment). Predominantly, the fear of choking was mentioned by patients, whereas professionals reported about the fear of making mistakes.

Conclusion

The JDEFA is a valid and reliable testing tool for the assessment of swallowing disorders concerning emotional aspects and family functioning. Both factors have a significant role in dysphagia and evaluations should go along with functional assessments and psychological scores for a holistic understanding of swallowing disorders.

Interprofessional perceptions of emotional, social, and ethical effects of multidrug-resistant organisms: A qualitative study

INTRODUCTION

Multi-drug-resistant organisms (MDRO) are usually managed by separating the infected patients to protect others from colonization and infection. Isolation precautions are associated with negative experiences by patients and their relatives, while hospital staff experience a heavier workload and their own emotional reactions.

METHODS

In 2018, 35 participants (nurses, physicians, pharmacists) in an antimicrobial-stewardship program participated in facilitated discussion groups working on the emotional impact of MDRO. Deductive codings were done by four coders focusing on the five basic emotions described by Paul Ekmans.

RESULTS

All five emotions revealed four to 11 codes forming several subthemes: Anger is expressed because of incompetence, workflow-impairment and lack of knowledge. Anxiety is provoked by inadequate knowledge, guilt, isolation, bad prognoses, and media-related effects. Enjoyment is seldom. Sadness is experienced in terms of helplessness and second-victim effects. Disgust is attributed to shame and bad associations, but on the other hand MDROs seem to be part of everyday life. Deductive coding yielded additional codes for bioethics and the Calgary Family Assessment Method.

CONCLUSION

MDRO are perceived to have severe impact on emotions and may affect bioethical and family psychological issues. Thus, further work should concentrate on these findings to generate a holistic view of MDRO on human life and social systems.

Implementation of the Family HELP Protocol: A Feasibility Project for a West Texas ICU

The purpose of this project was to determine if bedside intensive care unit (ICU) nurse buy-in to the Family Hospital Elder Life Program (HELP) protocol was sufficient to make implementation feasible at one county hospital in West Texas. Surveys were anonymous with ballot box collection being available to the bedside ICU nurses for one week each. Questions were based on literature findings of expected outcomes, identified barriers and facilitators, Calgary Family Intervention Method framework domains, and the Centers for Disease Control and Prevention Framework for program evaluation. Outcome measures were taken from the stated aims of the project and evaluated from paired baseline and summative survey questions. Survey participation was approximately half of nurses employed in the studied ICU. Analysis of the surveys showed a positive perception of family presence decreasing patient delirium symptoms, and a positive perception of the Family HELP protocol. The results described a high perception of family members as partners in care and high intention to implement the Family HELP protocol, indicating strong support of a full implementation of the protocol. The high level of bedside nurse buy-in present in this study has large implications for successful implementation of the Family HELP protocol in the near future, with sustainability and continued use supported by potential inclusion of the task in the electronic health record charting.

Effects of Implementing a Brief Family Nursing Intervention With Hospitalized Oncology Patients and Their Families in Germany: A Quasi-Experimental Study

Family nursing, based on the Calgary Family and Intervention Models, was implemented in a German oncological inpatient unit to promote effective family functioning in the context of cancer care. The objective of this study was to investigate the effects of implementing family nursing care on several psychological and physical outcomes of patients and their family members. A quasi-experimental study with 214 patients with a cancer diagnosis and 122 family members was conducted. Findings indicate that the superiority of family nursing, when compared to traditional care, could not be confirmed with respect to patients' outcomes (psychological burden, social support, satisfaction with care) and family members' outcomes (psychological burden, physical complaints, satisfaction with care). Various factors, such as country-specific structures and challenges in implementing family nursing care on an inpatient unit, may have contributed to these findings. Further replication attempts in similar settings in other countries are needed to shed light on the factors impairing or promoting the implementation of family nursing in practice settings.

Creating a space to talk about one's experience of suffering: families' experience of a family nursing intervention

STUDY RATIONALE

The impacts of health problems on individual and family functioning, as well as the influence of family on health, are well documented. However, health care and services in the West are mostly oriented towards individuals, and the needs of families often receive little consideration. The Family Support Service (FSS) was developed to address this situation. Its aim is to improve the education of nursing students and contribute to the health of the community by offering family conversations to families whose members have a health problem or who have difficulty adjusting to certain transitions.

AIMS AND OBJECTIVES

The objective of this study was to explore families' experience of the family conversations in which they participated and their satisfaction with the FSS.

METHODOLOGICAL DESIGN AND JUSTIFICATION

This study used a descriptive qualitative design based on semi-structured interviews and thematic analysis. The study followed ethical codes of conduct and conformed to the Canadian Tri-Council Policy Statement (TCPS).

RESEARCH METHODS

Qualitative interviews were conducted with 22 participants who had participated in family conversations as interventions, to evaluate their experience of those family conversations and their satisfaction with the FSS.

RESULTS

The families reported a very positive experience of the family conversations. Three themes emerged from their statements and explained this satisfaction: (i) the nurse's attitudes and skills as the foundation for meaningful encounters; (ii) a family systems intervention where families feel recognised; and (iii) a structure adapted to the needs of families.

CONCLUSIONS

This study adds to the existing body of knowledge on families' experience of family system nursing and invites nurses to develop attitudes that are conducive to meaningful encounters with families.

Jivi indigenous peoples: family functioning and health care, an analysis from Community Health Nursing practices

OBJECTIVE

To explore the meaning of beliefs and practices related to family functioning and health care in a Venezuelan indigenous group.

MATERIALS AND METHODS

A qualitative research study was conducted using a focused-ethnography (FE) method. The techniques implemented during data collection were focus group and observer-as-participant. Twenty-seven people distributed into four groups were included in the study. The qualitative content analysis method was selected for the interpretation stage.

RESULTS

The most significant findings revealed that Jivi people's customs were mixed with modern practices. Cultural practices such as maternity and childbirth are processes in which the formal healthcare system has a secondary role. Moreover, participants showed flexibility in terms of responsibilities without association to sex.

CONCLUSION

Training of human resources with an intercultural approach is a measure that could strengthen the practices of ethnic groups in terms of healthcare.

Family functioning in the context of an adult family member with illness: A concept analysis

AIM

To describe and explain how the concept of family functioning has been used in the targeted sample of health literature on adult family members with illness.

BACKGROUND

Understanding the influence of illness on family functioning is central to the provision of patient- and family-centred care. There is lack of consistency in utilising family functioning which creates confusion about the concept and can interfere with theory development in nursing science. A clear conceptual definition of attributes of family functioning based on concept analysis could act as a guide in the development of instruments to assess family functioning, the design of family-based interventions and their application in clinical practice.

DESIGN

Concept analysis.

DATA SOURCES

Academic Search Premier, ProQuest Research Library, Family & Society Studies Worldwide, PsycINFO, SocINDEX, PubMed and CINAHL databases were searched within the last 20 years (1997-Dec. 2016) using the terms "family function*" and "patient." Studies of paediatric patients and non-English articles were excluded.

METHOD

Rodgers' evolutionary perspective.

RESULTS

The findings suggest that family functioning in the context of illness is defined as family members' ability to maintain cohesive relationships with one another, fulfil family roles, cope with family problems, adjust to new family routines and procedures and effectively communicate with each other.

CONCLUSION

Further research is needed to inform nurses' practice when assessing families or providing patient- and family-centred interventions to support family functioning across different sociocultural and political contexts, and further identification and evaluation of antecedents and consequences regarding family functioning from a nursing perspective.

RELEVANCE TO CLINICAL PRACTICE

Having a comprehensive understanding of the attributes, antecedents and consequences of ineffective family functioning can facilitate healthcare providers' ability to identify strengths and potential targets to improve family functioning among their clients.

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

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

Giving Voice to Caregivers: a game for family caregivers of dependent individuals

OBJECTIVE

To construct and assess a board game created to promote the effective transition of family members into caregivers of dependent individuals.

METHOD

This was a qualitative exploratory and descriptive case study conducted with family caregivers of dependent individuals.

RESULTS

The study resulted in the conceptualization, construction, and assessment of the board game. The game proved to be an important family evaluation tool, enabling open communication and interventions in family dynamics.

CONCLUSION

The results showed that the game can help build new family narratives, providing an opportunity for open communication, expression of problems and sharing, representing an important family evaluation and intervention strategy.

Family Perceptions of Family Nursing in a Magnet Institution During Acute Hospitalizations of Older Adult Patients

Family involvement during hospitalizations of older adults with chronic illnesses may benefit both patients and family. However, there is a limited amount of research focused on families of older adults managing chronic illness. This study describes family member perceptions of the relationship between family and nurses when an older adult with diabetes is hospitalized in a Magnet institution. The Calgary Family Intervention Model guided the study. A family member of 60 older adult patients completed the Family Function, Family Health, and Social Support Instrument. The results revealed positive perceptions from family members regarding their perceptions of family nursing practice. Family health, however, was found to decrease slightly as loved ones are hospitalized more frequently, and is an area where nurses may provide improved social support. Future research might target the implementation of a targeted family-level intervention designed to improve family outcomes as well as family nursing practice.