Family Hardiness in Patients with Heart Failure: Exploring Protective Factors and Identifying the Mediator

Dyadic communication quality and family resilience in gynecologic cancer survivors: a study on the mediating role of perceived spousal support

PURPOSE

To analyze the level of family resilience in Chinese gynecological cancer survivors and determine whether perceived spousal support plays a mediating role in the relationship between dyadic communication quality and family resilience, enhance the confidence of families in coping with the disease together, and thus promote psychosocial adaptation to cancer.

METHODS

A total of 348 gynecologic cancer survivors were selected from a gynecologic ward in a public hospital in Shandong Province, China. All participants completed the Sociodemographic and Clinical Characteristics Questionnaire, Couples' Communication Quality Scale (CCQS), Perceived Social Support Scale (PSSS), and Family Hardiness Index (FHI). The mediating effect of perceived spousal support was estimated using the bootstrap method via IBM SPSS AMOS 21.0.

RESULTS

The mean FHI score was 53.03 ± 9.34 points, showing moderate levels of family resilience. Family resilience was shown to be significantly positively associated with both perceived spousal support and dyadic communication quality (both p < 0.01). Furthermore, perceived spousal support was shown to partially mediate the relationship between communication quality and family resilience (β = 0.141; 95% confidence interval: 0.063-0.243).

CONCLUSION

The level of family resilience in survivors of gynecologic cancer needs to be further improved, and perceived spousal support partially mediates the relationship between dyadic communication quality and family resilience within this population. Therefore, dyadic communication quality and subjective perceived spousal support should be enhanced for gynecologic cancer survivors to increase their family resilience.

A Study on the Relationship between Sense of Disease Uncertainty and Family Strength and Mental Resilience in Guardians of Children with Inflammatory Bowel Disease

Background

Inflammatory bowel disease is difficult to cure, which seriously affects the physical and mental health of children and brings negative psychological stress to guardians. Uncertainty in illness of guardians reduces the ability of care and is not conducive to the treatment and recovery of children. Therefore, it is of great significance to explore the related factors of uncertainty in illness.

Objective

The aim of this study is to explore the relationship between sense of disease uncertainty and family strength and mental resilience in guardians of children with inflammatory bowel disease (IBD).

Method

A total of 146 guardians of 88 children with inflammatory bowel disease were investigated. The guardians' sense of disease uncertainty, family strength, and mental resilience were evaluated by Mishel uncertainty in illness scale-family member (MUIS-FM), family hardiness index (FHI), and Connor-Davidson resilience sca1e (CD-RISC), respectively. Spearman correlation was used for analyzing the correlation between the guardian's sense of disease uncertainty and family resilience.

Results

The guardian's MUIS-FM score from lowest to highest was complexity, unpredictability, lack of information, and uncertainty. The average scores of FHI and CD-RISC were lower than the average score of CD-RISC of the general community in China 65.4 (t = -4.36, P < 0.05). The score of MUIS-FM was significantly correlated with the scores of FHI and CD-RISC (P < 0.05). Multiple linear regression analysis showed that the challenge score in the FHI scale and the fortitude score and the strength score in the CD-RISC scale were the main influencing factors of guardians' sense of disease uncertainty in children with IBD (P < 0.05).

Conclusion

The guardians of children with IBD had a more serious sense of disease uncertainty, which was related to family strength and mental resilience.

Factors influencing family function in spousal caregivers of head and neck cancer patients within 6 months posttreatment

PURPOSE

Spousal caregiving of head and neck cancer (HNC) patients challenges relationship quality and may negatively impact family function. Our purpose was to identify factors associated with family dysfunction in spousal caregivers (SCs) of HNC patients within the first 6 months after treatment. We explored whether patient or SC characteristics differ by level of family dysfunction.

METHODS

We conducted a cross-sectional study of HNC patient-SC dyads in Taiwan from July 2020 to January 2022 using patient-reported outcomes. Patients were assessed using a set of structured questionnaires to measure performance status, demographic and clinical characteristics, physical function, and social-emotional function. SCs were measured on their hardiness, coping styles, spousal relationship, quality of life, and family function.

RESULTS

Of the 132 dyads surveyed, 62.1% of SCs reported a functional family, 34.8% reported a moderately dysfunctional family, and 3.0% reported a highly dysfunctional family. Patient factors associated with family dysfunction (highly dysfunctional or moderately dysfunctional) included lower family annual income and worse social-emotional function. Associated SC factors were lower hardiness, less use of active coping, and worse spousal relationships.

CONCLUSIONS

Lower family annual income, less patient social-emotional function, less SC hardiness, less SC active coping, and worse SC perceived spousal relationship were associated with perceived family dysfunction. Providing patient-SC dyads with sufficient social resources and problem-solving training may help them positively cope with cancer and enhance family function.