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

Adaptation Process in Husbands of Iranian Women Undergoing Mastectomy From Diagnosis to Terminal Stages of the Disease: A Grounded Theory Study

INTRODUCTION

Breast cancer is the most common cancer in women and the second cause of cancer-related death. This research was performed to interpret the adaptation process among husbands of Iranian women undergoing mastectomy.

MATERIALS AND METHODS

In this grounded theory study, 23 participants were chosen purposefully and via convenient sampling. After interview with them about adaptation and ways of achieving it, note taking was done, which was analyzed via Strauss and Corbin approach.

RESULTS

Six themes were extracted: Confrontation with crisis, Challenges and opportunities, husband transformation, supportive systems, attempts for life management, accepting an uninvited guest, with each having subclasses.

CONCLUSION

According to the results of the present study the healthcare team and psychologists should identify this issue properly so that they could apply measures for facilitating the coping and acceptance of the issue in husbands of these patients.

Problem-Solving Skills Training for Parents of Children With Chronic Health Conditions: A Systematic Review and Meta-Analysis

Importance

Problem-solving skills training (PSST) has a demonstrated potential to improve psychosocial well-being for parents of children with chronic health conditions (CHCs), but such evidence has not been fully systematically synthesized.

Objective

To evaluate the associations of PSST with parental, pediatric, and family psychosocial outcomes.

Data Sources

Six English-language databases (PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Cochrane Library), 3 Chinese-language databases (China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang), gray literature, and references were searched from inception to April 30, 2023.

Study Selection

Randomized clinical trials (RCTs) that performed PSST for parents of children with CHCs and reported at least 1 parental, pediatric, or family psychosocial outcome were included.

Data Extraction and Synthesis

Study selection, data extraction, and quality assessment were conducted independently by 2 reviewers. Data were pooled for meta-analysis using the standardized mean difference (SMD) by the inverse variance method or a random-effects model. Subgroup analyses of children- and intervention-level characteristics were conducted.

Main Outcomes and Measures

The psychosocial outcomes of the parents, their children, and their families, such as problem-solving skills, negative affectivity, quality of life (QOL), and family adaptation.

Results

The systematic review included 23 RCTs involving 3141 parents, and 21 of these trials were eligible for meta-analysis. There was a significant association between PSST and improvements in parental outcomes, including problem-solving skills (SMD, 0.43; 95% CI, 0.27-0.58), depression (SMD, -0.45; 95% CI, -0.66 to -0.23), distress (SMD, -0.61; 95% CI, -0.81 to -0.40), posttraumatic stress (SMD -0.39; 95% CI, -0.48 to -0.31), parenting stress (SMD, -0.62; 95% CI, -1.05 to -0.19), and QOL (SMD, 0.45; 95% CI, 0.15-0.74). For children, PSST was associated with better QOL (SMD, 0.76; 95% CI, 0.04-1.47) and fewer mental problems (SMD, -0.51; 95% CI, -0.68 to -0.34), as well as with less parent-child conflict (SMD, -0.38; 95% CI, -0.60 to -0.16). Subgroup analysis showed that PSST was more efficient for parents of children aged 10 years or younger or who were newly diagnosed with a CHC. Significant improvements in most outcomes were associated with PSST delivered online.

Conclusions and Relevance

These findings suggest that PSST for parents of children with CHCs may improve the psychosocial well-being of the parents, their children, and their families. Further high-quality RCTs with longer follow-up times and that explore physical and clinical outcomes are encouraged to generate adequate evidence.

Investigating fear of cancer recurrence among female breast cancer survivors and their spouses in southwest China: a cross-sectional study

OBJECTIVES

Examining fear of cancer recurrence (FCR) among breast cancer survivors and their spouses, and the protective effect of family resilience on FCR among couples affected by breast cancer.

DESIGN

Cross-sectional survey design.

SETTING

Ten general grade IIIa (>500 beds) hospitals in southwest China.

PARTICIPANTS

Overall, 392 early breast cancer survivors and their spousal caregivers (N=392) were recruited from cancer centres in hospitals.

PRIMARY AND SECONDARY OUTCOME MEASURES

Spouses' and survivors' FCR were the primary outcome measures. Family resilience and perceived stress were the secondary outcome measures. Using a convenience sampling method, we collected data on-site using paper questionnaires. The Chinese version of the Family Resilience Assessment Scale, Perceived Stress Scale, Fear of Progression Questionnaire Short Form and Fear of Progression Questionnaire-Short Form for spouses were used to evaluate the outcomes.

RESULTS

The model accounted for 66.3% and 53.6% of the variance in spouses' FCR and survivors' FCR, respectively. Family resilience directly negatively affected perceived stress and spouses' and survivors' FCR (β=-0.22; β=-0.13; β=-0.19). Perceived stress was a partial mediator of the association between family resilience and survivors' FCR (β=-0.070; 95% CI :-0.151 to -0.022). Spouses' FCR partially mediated the association between family resilience and survivors' FCR (β=-0.048; 95% CI= -0.092 to -0.015). Perceived stress and spouses' FCR played a significant chain-mediated role between family resilience and survivors' FCR (β=-0.061; 95% CI: -0.119 to -0.022).

CONCLUSIONS

Family-centred approaches to reducing survivors' perceived stress can improve the psychological well-being of couples affected by breast cancer and ultimately reduce FCR. Medical staff should consider the psychological feelings of survivors and their spousal caregivers when devising the intervention plan, which should address the families' potential and mobilise family and community resources for increasing family resilience.

Do spouse burden of care, family resilience, and coping affect family function in gynecologic cancer in Korea?: a cross-sectional study

PURPOSE

This study aimed to investigate family functioning among spouses of gynecologic cancer patients in Korea. McCubbin and McCubbin's Family Resilience Model (1993) guided the study focus on burden of care, family resilience, coping, and family functioning.

METHODS

An online survey collected data from 123 spouses of gynecologic cancer patients through convenience sampling from online communities for gynecologic cancer patients in Korea. Burden of care, family resilience (social support, family hardiness, and family problem-solving communication), coping, and family functioning were measured by self-report.

RESULTS

The patients (44.7%) and their spouses (47.2%) were mostly in the 41 to 50-year age group. Stage 1 cancer was 44.7%, and cervical cancer was the most common (37.4%) followed by ovarian cancer (30.9%) and uterine cancer (27.6%) regarding the cancer characteristics of the wife. Family function, burden of care, family resilience, and coping were all at greater than midpoint levels. Family functioning was positively related with social support (r=.44, p<.001), family hardiness (r=.49, p<.001), problem-solving communication (r=.73, p<.001), and coping (r=.56, p<.001). Multiple regression identified significant factors for family functioning (F=25.58, p<.001), with an overall explanatory power of 61.7%. Problem-solving communication (β=.56, p<.001) had the greatest influence on family function of gynecologic cancer families, followed by coping (β=.24, p<. 001) and total treatment period of the wife (β=.17, p=.006).

CONCLUSION

Nurses need to assess levels of family communication and spousal coping to help improve gynecologic cancer patients' family function, especially for patients in longer treatment.

Effects of Family Participatory Nursing on Clinical Outcomes of Premature Infants in NICU and Families’ Psychological Status

The purpose of this study was to explore the effects of family participatory nursing on the clinical outcomes of premature infants in the neonatal intensive care unit (NICU) and their families’ psychological status. Total of 150 premature infants were admitted to the NICU of our hospital from December 2019 to December 2021, and their families were selected by convenience sampling method and divided into control group (n = 78, from December 2019 to December 2020) and observation group (n = 72, from January 2020 to December 2021) according to the admission time. The infants in the control group were given routine nursing, while those in the observation group received family participatory nursing. In the observation group, the length of stay and duration of oxygen therapy were shorter, the weight gain speed was higher, and the incidence rate of nosocomial infection was lower than those in control groups $\left(P<0.05\right)$ . The time of reaching full gastrointestinal feeding was earlier, the daily milk intake and exclusive breastfeeding rate were higher, and the feeding intolerance rate was lower in observation group than those in control group $\left(P<0.05\right)$ . Observation group exhibited significantly higher body weight, Z-value of body weight, NBNA score at 7 d after hospitalization, 15-month mental development index (MDI), and psychomotor development index (PDI) scores than control group $\left(P<0.05\right)$ . In addition, the families’ somatization, depression and anxiety factor scores, and total score of SCL-90 in the observation group were lower than those in the control group, while each dimension score and total score of MPOC-20 were higher than those in control groups $\left(P<0.05\right)$ . Family participatory nursing is of great significance in ameliorating the clinical outcomes of premature infants in the NICU, which can shorten the length of stay, improve feeding conditions, facilitate infant growth and development, and enhance their families’ psychological status and nursing satisfaction.