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

Purpose

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

Methods

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

Results

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

Conclusion

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

Mothers' Perceived Co-Parenting and Preschooler's Problem Behaviors: The Mediating Role of Maternal Parenting Stress and the Moderating Role of Family Resilience

Introduction

Problem behaviors in preschoolers signals social adjustment challenges. This study investigates the mediating role of parenting stress in the relationship between co-parenting and these behaviors, and examines how family resilience impacts this dynamic.

Methods

A detailed survey was conducted with 1279 mothers of 3-6-year-olds in Shanghai, China, focusing on co-parenting, family resilience, parenting stress, and children's behaviors. We employed SPSS 26 for initial tests and the Hayes PROCESS macro in SPSS 23.0 for advanced analysis, using bootstrap methods to assess mediation and moderation effects.

Results

The analysis revealed that maternal parenting stress mediates the relationship between co-parenting and children's problem behaviors. Specifically, unsupportive co-parenting or low levels of supportive co-parenting heightened maternal stress, which in turn increased children's problem behaviors. Family resilience was found to moderate this relationship, buffering the impact of unsupportive co-parenting on maternal stress. High family resilience levels were associated with lower parenting stress, regardless of co-parenting quality.

Conclusion

These findings highlight the importance of enhancing family resilience and supportive co-parenting to mitigate parenting stress and reduce problem behaviors in children. It has practical implications for developing family-centred interventions and policies to strengthen family resilience and co-parenting skills.

A systematic review of the use of the concept family resilience in interventions with families with children and young people

OBJECTIVE

To review the evidence on using family resilience as a concept in interventions by public health nurses/health visitors with families with children and young people as part of an evaluation of the evidence base for the Family Resilience Assessment Instrument and Tool (FRAIT). FRAIT was developed by University faculty with Health Visitors and a Community of Practice in Wales, and is used by Health Visitors in Wales with families with children under 5 years to assess family resilience.

METHOD

A standard Cochrane Systematic Review methodology was used to review published literature. A protocol (crd.york.ac.uk/PROSPERO/display_record.php?RecordID = 230845) was submitted to Prospero in September 2021, and reviewing began in January 2022. Title and abstract searching were undertaken 12 databases and results were captured using PRISMA and Excel spreadsheet. Second reviewers reviewed title and abstract screening, and full-text extraction.

RESULTS

Initial title screening brought back 1350 papers across 12 databases. Titles and abstract screening reduced these to 106, 44 papers were considered for full-text extraction, with 25 papers included for review.

DISCUSSION

Results demonstrated a focus on specific demographics, and use of family resilience with families living with specific health problems. Existing family resilience scales showed improved results in selected specific demographic groups, albeit in a reactive way. FRAIT has originality within the literature as it is used in a universal, preventative way with all families regardless of demographic or health issues. There is evidence to show that using a family resilience program in this way has originality and implications for the physical and mental health of children and young people.

NO PATIENT OR PUBLIC CONTRIBUTION

This was a systematic review of existing literature so public or patient contribution would not have been appropriate.

An examination of the effects of family, school, and community resilience on high school students' resilience in China

Introduction

Resilience plays a pivotal role in shaping the academic accomplishments, psychological well-being, and future prospects of high school students. Despite its significance, there is a notable dearth of studies examining the current state and determinants of resilience among high school students in China.

Methods

This research addresses this gap by assessing and exploring levels of resilience and their interconnections across four key domains-individual, family, school, and community-among Chinese high school students. The study also investigates variations in resilience based on factors such as gender, geographical location, and grade levels. A total of 667 high school students participated in the study, responding to four resilience scales.

Results

Chinese high school students exhibited generally low levels of resilience, with family resilience ranking the highest and community resilience the lowest. The study revealed that resilience is positively influenced by resilience levels in school, family, and community settings. Consequently, strategies aimed at fortifying resilience should prioritize interventions in familial, educational, and communal environments.

Discussion

Moreover, the research findings indicate noteworthy disparities in resilience among high school students based on gender, urban-rural divide, and grade levels. Female, urban, and lower-grade students displayed higher resilience compared to their male, rural, and higher-grade counterparts. This highlights the importance of focusing on resilience-building measures tailored to male, rural, and higher-grade high school students, given their increased likelihood of facing significant challenges and stressors in both academic and personal spheres.

Conclusion

This study contributes to the broader understanding of resilience by investigating the correlations between individual, family, school, and community resilience among Chinese high school students. The findings underscore the need for targeted interventions to enhance resilience, particularly in specific demographic groups, thereby advancing the efficacy of resilience-building techniques in high school settings.

Fatalism as a Mediator of the Association Between Family Resilience and Self-Management Among Patients with Chronic Wounds in China

Purpose

The purpose of this study was to examine how fatalism acts as a mediator in the correlation between family resilience and self-management among patients with chronic wounds in China.

Participants and Methods

This study used a cross-sectional research design. A total of 269 adult patients (18-94 years old) with chronic wounds residing in Wuxi, China participated in this study. Participants completed the Chinese version of the Walsh Family Resilience Questionnaire, 16-item Chinese version of the Fatalism Scale, and Self-Management Scale of Chronic Wound Patients. We conducted correlation and mediation analyses using SPSS 27.0 and PROCESS 4.0.

Results

The results indicated family resilience was a significant positive predictor of self-management (β = 0.7101, p < 0.0001), and the pathway between family resilience and self-management was partially mediated by fatalism (Effect = 0.1432, 95% confidence interval [0.0625, 0.2341]).

Conclusion

The results indicated that incorporating spiritual interventions into future person-centered self-management programs could align with the motivation of patients with chronic wounds and their families, and reduce the negative impact of fatalism on health outcomes.

households with young children: an investigation of family resilience processes

Introduction

The COVID-19 pandemic may constitute a traumatic event for families with young children due to its acute onset, the unpredictable and ubiquitous nature, and the highly distressing disruptions it caused in family lives. Despite the prevalent challenges such as material hardships, child care disruptions, and social isolation, some families evinced remarkable resilience in the face of this potentially traumatic event. This study examined domains of changes perceived by parents of young children that were consistent with the post-traumatic growth (PTG) model as factors that facilitate family resilience processes.

Methods

This study drew data from the RAPID project, a large ongoing national study that used frequent online surveys to examine the pandemic impact on U.S. households with young children. A subsample of 669 families was leveraged for the current investigation, including 8.07% Black, 9.57% Latino(a), 74.44% non-Latino(a) White families, and 7.92% households of other racial/ethnic backgrounds. In this subsample, 26.36% were below 200% federal poverty level.

Results

Approximately half of the parents reported moderate-to-large degrees of changes during the pandemic, and the most prevalent domain of change was appreciation of life, followed by personal strengths, new possibilities, improved relationships, and spiritual growth. Black and Latino(a) parents reported more changes in all five domains than White parents and more spiritual growth than parents of the other racial/ethnic groups. Moreover, parent-reported improved relationships were found to indirectly reduce young children's overall fussiness/defiance and fear/anxiety symptoms through reducing parents' emotional distress. Perceived changes in the new possibilities, personal strengths, and appreciation of life domains were found to serve as protective factors that buffered the indirect impacts of material hardship mean levels on child behavioral symptoms via mitigating parents' emotional distress.

Discussion

These findings shed light on resilience processes of a family system in a large-scale, disruptive, and stressful socio-historical event such as the COVID-19 pandemic. The five PTG domains could inform therapeutic and intervention practices in the face of future similar events. Importantly, these findings and the evinced family resilience should not negate the urgent needs of policy and program efforts to address material hardships, financial instabilities, and race/ethnicity-based structural inequalities for families of young children.

Family Resilience With Stunted Children Aged Below 5 Years: A Qualitative Study in Depok City, Indonesia

Stunting is influenced by family and household factors that affect toddler nutrition. As the primary provider of both physical and psychological resources to prevent health problems, the family has a significant role in preventing stunting. Family resilience in supporting child health is mediated by family functioning. A qualitative descriptive study explored the influence of family resilience in fulfilling the nutritional needs of stunted children. This study involved in-depth interviews with 23 mothers of stunted children aged 24 to 59 months. Through content analysis, we identified three main themes: (1) family belief that stunting is hereditary, (2) family belief that stunted children will "grow up," and (3) lack of communication between family members in discussing stunting. Future studies should explore intervention models to increase family resilience and prevent stunting in children under five.

The bereavement experiences of families of potential organ donors: a qualitative longitudinal case study illuminating opportunities for family care

OBJECTIVES

To illuminate opportunities for care in the context of deceased organ donation by exploring pre-existing family and healthcare professional characteristics, in-hospital experiences, and ongoing adjustment through the lenses of grief theory, systems theory, meaning-making, narrative, and organ donation literature.

METHOD

Qualitative longitudinal case studies explored individual and family change in five Australian families who had consented to Donation after Circulatory Determination of Death at a single centre. Participants attended semi-structured interviews at four, eight, and twelve months after the death.

FINDINGS

Family values, pre-existing relationships, and in-hospital experiences influenced first responses to their changed lives, understanding of the patient's death, and ongoing family adjustment. Novel behaviour that was conguent with family values was required at the hospital, especially if the patient had previously played a key role in family decision-making. This behaviour and emerging interactional patterns were drawn into family life over the first year of their bereavement.

RECOMMENDATIONS

Training that includes lenses introduced in this study will enable healthcare professionals to confidently respond to individual and family psychosocial needs.

CONCLUSION

The lenses of grief theory and systems thinking highlight opportunities for care tailored to the unique in-hospital context and needs that emerge in the months that follow.

"Take care of your families, take care of one another": Indigenist families and foodways

Objective

The purpose of this research was to examine how families and foodways have evolved over time and how they may present promising promotive factors for resilience, health, and wellness.

Background

Because food is central to family, social relationships, and healthy living, Indigenist foodways may promote family resilience and offset inequities.

Method

Pragmatic horizon analysis of data drawn from 31 critical ethnographic interviews on food and family in the Southeast and Northwest, including both urban and rural reservation tribal contexts, resulted in emergent themes related to food and families.

Results

Themes included (a) foodways fostering family connectedness: "The fresh vegetable is how I remember my grandpa"; (b) tight-knit extended families and communities: "The community where I grew up … everybody knew each other, so everybody … pitched in"; (c) family and community celebrations nurturing cohesion: "The family I have, I can always count on. I can trust each one of them"; and (d) families fostering healing: "Sit down and talk to somebody … that you can trust."

Conclusion

Participants explained how foodways promoted family resilience by bringing families and communities together. Indigenist foodways fostered continuity and healing through food preparation and processing and through feasts and gatherings.

Implications

Foodways were described as fundamental to family resilience and community connectedness. Subsistence fostered exercise, eating locally sourced foods, and family resilience. Interventions are needed to promote Indigenist foodway sovereignty while first understanding how culture, history, and food inform wellness and community well-being.

Effects of Social Support, Family Resilience, and Individual Resilience on Fear of Cancer Recurrence Among Persons With Breast Cancer: A Cross-Sectional Study

BACKGROUND

There is limited research exploring the psychological and social predictors of fear of cancer recurrence (FCR).

OBJECTIVE

This study tested the effects of social support, family resilience, and individual resilience on FCR among persons with breast cancer.

METHODS

A convenience sampling method was used to select 214 participants from March to August 2021 in 1 tertiary hospital in Jinan, China. Data were collected using self-administered questionnaires. Path analysis was adopted to explore the effects of social support, family resilience, and individual resilience on FCR.

RESULTS

Findings showed that 94.6% of the participants reached a clinical level of FCR. Social support (β = -.75, p < .01) and individual resilience (β = -.32, p < .01) negatively and directly impacted FCR. Family resilience indirectly impacted FCR through individual resilience (β = -.22, 95% confidence interval (CI): -.34 to -.08). Social support indirectly impacted FCR through family resilience and individual resilience (β = -.15, 95% CI: -.23 to -.06).

CONCLUSIONS

Persons with breast cancer experienced a high level of FCR. Individual resilience was a mediator between family resilience and FCR. Resilience (individual resilience and family resilience) partially mediated the effects of social support on FCR. The findings indicate that measures focused on improving individual resilience, family resilience, and social support should be considered by nurses, which are helpful for easing FCR.

Family Communication as a Mediator between Family Resilience and Family Functioning under the Quarantine and COVID-19 Pandemic in Arabic Countries

The coronavirus pandemic has become an unprecedented world crisis in which we have struggled against the most potent threat of the twenty-first century. This pandemic has had a profound impact on individuals and families. Therefore, the study aimed to examine family communication as a mediator of the relationship between family resilience and family functioning under the quarantine and coronavirus pandemic in Algeria and Iraq. This study was conducted among individuals in Iraq and Algeria (N = 361). The respondents completed the Family Communication Scale (FCS), Walsh Family Resilience Questionnaire (WFRQ), and Family Functioning Scale (FFS). Structural equation modeling (SEM) with the bootstrapping method was used to conduct the mediated effects of family communication. Using the bootstrapping method in SEM, family resilience and communication significantly affected family functioning (coefficient = 0.808). Moreover, the direct effect and indirect effect (via family functioning) of family resilience on family functioning were both significant, with coefficients of 0.682 and 0.126. In addition, numerous groups from Iraq and Algeria have been analyzed as a sample and have shown no differences in the relationships between family resilience, family communication, and family functioning. In conclusion, the results showed that family communication mediated the relationship between family resilience and family functioning. Moreover, the type of this mediation seemed to be partial because of the significant direct relationship between family resilience and family functioning. According to the findings, healthcare providers should consider improving family resilience and communication to achieve good family functioning.

Factors Associated with Parenting Adaptability in Facing the First COVID-19 Lockdown: A Study on Portuguese Parents

Parenting was drastically challenged during the COVID-19 pandemic as families complied with the consequent containment for sanitary and social reasons. The purpose of this study is to explore the relationships among self-report measures (co-parenting, emotional experience and parental support network) and the employment condition (teleworking parents and at-home parents with governmental leave aid) that might be associated with the everyday life change, and their contribution towards family's daily routines during the first COVID-19 lockdown. A sample of 878 parents (90.2% mothers), aged from 21 to 61 years (39.58 ± 6.08), and mainly of Portuguese nationality (97.2%), was gathered through an online survey. Participants completed sociodemographic data and answered questions related to four positive parenting dimensions (Daily routines, Co-parenting, Emotional experience, and Support network) rating on a five-point Likert scale how much their behavior changed during the lockdown. Descriptive statistics and multilinear regression models were tested as well as a mediation model. The results showed that Emotional experience, Co-parenting, and Support network played an important role in family Daily routines, reinforcing that the first COVID-19 lockdown was lived differently by parents according to their employment conditions. Furthermore, the pathways model of factors associated with parental adaptability is suggestive that the direct effect of Emotional experience on Daily routines is partially mediated by Co-parenting and Support network. In line with previous studies on the complexity and dynamic ecology of parenting, the reported indicators showcase the interrelated facets of parenting and its corresponding support needs. Further, clear indicators for the design of family support interventions and family resilience enhancement to stressor events are discussed.

Family and Neighborhood Resilience Are Associated with Children's Healthcare Utilization

OBJECTIVE

To evaluate the association of external factors of resilience, neighborhood, and family resilience with healthcare use.

STUDY DESIGN

A cross-sectional, observational study was conducted using data from the 2016-2017 National Survey of Children's Health. Children aged 4-17 years were included. Multiple logistic regression was used to determine aOR and 95% CIs for association between levels of family resilience, neighborhood resilience and outcome measures: presence of medical home, and ≥2 emergency department (ED) visits per year while adjusting for adverse childhood experiences (ACEs), chronic conditions, and sociodemographic factors.

RESULTS

We included 58 336 children aged 4-17 years, representing a population of 57 688 434. Overall, 8.0%, 13.1%, and 78.9% lived in families with low, moderate, and high resilience, respectively; 56.1% identified their neighborhood as resilient. Of these children, 47.5% had a medical home and 4.2% reported ≥2 ED visits in the past year. A child with high family resilience had 60% increased odds of having a medical home (OR, 1.60; 95% CI, 1.37-1.87), and a child with moderate family resilience or resilient neighborhood had a 30% increase (OR, 1.32 [95% CI, 1.10-1.59] and OR, 1.31 [95% CI, 1.20-1.43], respectively). There was no association between resilience factors and ED use, although children with increased ACEs had increased ED use.

CONCLUSIONS

Children from resilient families and neighborhoods have an increased odds of receiving care in a medical home after adjusting for the effects of ACEs, chronic conditions, and sociodemographic factors, but no association was seen with ED use.

Family Resilience and Dyadic Coping during the Outbreak of the COVID-19 Pandemic in Italy: Their Protective Role in Hedonic and Eudaimonic Well-Being

The COVID-19 pandemic outbreak has dramatically worsened people's psychological well-being. Our aim was to examine for the first time the concurrent and longitudinal relations of family resilience with hedonic and eudaimonic well-being, and the moderating role of socio-demographics. For people having a romantic partner, we also explored whether family resilience and dyadic coping were uniquely related to well-being. One cross-sectional study (N = 325) and one 10-week follow-up study (N = 112) were carried out during the outbreak of the COVID-19 pandemic (April-May 2020) in Northern Italy. Adult participants completed an online questionnaire in both studies. Correlation, multivariate regression, and moderation analyses were carried out with IBM SPSS version 28 and its PROCESS macro. Significance of differences in correlation and regression coefficients was tested through Steiger's procedure, Wald test, and SUEST method. Family resilience was found to relate more strongly to eudaimonic (versus hedonic) well-being concurrently and to hedonic (versus eudaimonic) well-being longitudinally. The concurrent or longitudinal relations with hedonic well-being were generally stronger for females, part-time workers, and people undergoing multiple stressors. For people having a romantic partner, family resilience was concurrently associated with well-being independently of dyadic coping, whereas dyadic coping was longitudinally related to well-being independently of family resilience. Family resilience was found to protect, in the short term, the psychological well-being of people facing the pandemic outbreak. Its protective role mainly concerned hedonic well-being and was more pronounced for more vulnerable people. For persons having a romantic partner, however, dyadic coping seemed to have equal, if not greater, positive short-term effects.

Mediation effect of self-neglect in family resilience and medication adherence in older patients undergoing maintenance hemodialysis

OBJECTIVES

Chronic kidney disease (CKD) patients with regular dialysis treatment for more than 3 months are called maintenance hemodialysis (MHD). The degree of patients' adherence with the doctor's advice to take medicine on time is called medication adherence, which is very important for the control of the disease and the improvement of the quality of life for MHD patients. Living alone, lack of communication with children and self-neglect are risk factors for medication adherence in the older adults. Inappropriate substance use behaviors are common among older adults with self-neglect. Family resilience denotes the ability of a family to retain the stability of its structure by relying on its internal and external resources when facing a difficult situation. Family resilience entails the combination of family beliefs, interaction styles, problem-solving skills, and emotional communication which reflect supportive and positive psychological adjustment effects to benefit older persons. This study aims to provide a theoretical basis for clinical intervention level to improve medication adherence of older patients on MHD through examineing the correlation among family resilience, self-neglect, and medication adherence based on the self-reports.

METHODS

A random sampling method was used to gather information from 632 older patients receiving MHD treatment in Hemodialysis Center of Hunan Province between July to December 2021. For this purpose, a self-designed demographic questionnaire, the Family Resilience Questionnaire (FRQ), the Scale of the Elderly Self-Neglect (SESN), and the Morisky Medication Adherence Scale-4 (MMAS-4) were used to investigate the questionnaire data of the participants. Pearson correlation was used to examine the relationship between family resilience, self-neglect, and medication adherence in older patients and gain insight into their current status. AMOS 24.0 was used for mediation modeling. Bootstrap mediation effect test was used to evaluate the mediation effect among the 3 variables.

RESULTS

The questionnaires survey showed that the scores of FRQ, SESN, and MMAS-4 were 78.60±12.49, 7.99±5.60, and 5.93±1.40, respectively; and the medication adherence rate was 18.8%. Pearson correlation analysis showed that family resilience was negatively correlated with self-neglect (r=-0.432, P<0.001), and was positively correlated with medication adherence (r=0.169, P<0.001). Self-neglect was negatively correlated with medication adherence (r=-0.217, P<0.001). Mediating effect analysis showed that the total effect of family resilience on medication adherence was significant (β=0.214, 95% CI 0.121 to 0.313, P<0.001), and the direct effect was not significant (β=0.058, 95% CI -0.073 to 0.187, P>0.05). Self-neglect played a major mediating effect between family resilience and medication adherence (β=0.156, 95% CI 0.088 to 0.240, P<0.001).

CONCLUSIONS

Family resilience, self-neglect, and medication adherence among older patients on MHD are significantly related, with family resilience primarily influencing medication adherence indirectly through self-neglect.

The influence of social alienation on maintenance hemodialysis patients' coping styles: chain mediating effects of family resilience and caregiver burden

Objective

Research on the possible impact of social alienation, family resilience, and caregiver burden on the coping styles of Chinese patients on maintenance hemodialysis (MHD) is scarce. We explore the influence of social alienation, family resilience, and caregiver burden on the coping styles of MHD patients, both directly and indirectly.

Methods

We invited 173 MHD patients and their primary caregivers for a cross-sectional study; the study using convenience sampling method at the hemodialysis center of the First People's Hospital of Foshan. The Chinese version of the generalized social of alienation scale, the Chinese version of the simplified coping style questionnaire, and a sociodemographic questionnaire were completed by the MHD patients, while their primary caregivers had filled out the Chinese family resilience assessment scale, the Chinese version of the Zarit caregiver burden interview, and provided socio-demographic information. SPSS macro program PROCESS v3.3 Model 6 were used for analyses of chain-mediated effects.

Results

In the mediating effects model, the direct influence of social alienation upon coping styles was significant (95% CI -0.050, -0.014), and social alienation indirectly impacted coping style by family resilience in a significant way (95% CI -0.012, -0.001) or caregiver burden (95% CI -0.013, -0.001). In addition, social alienation significantly impacted coping style by both family resilience and caregiver burden (95% CI -0.008, -0.001).

Conclusion

Social alienation can exert both a direct and indirect influence on coping styles through the mediating factors of family resilience and caregiver burden. Clinicians can take interventions to strengthen family resilience and reduce caregiver burden, which may be useful in improving socially isolated behaviors and coping skills in MHD patients.

Corrigendum: A randomized controlled trial of a coping-focused family resilience intervention program for breast cancer patients: study protocol

[This corrects the article DOI: 10.3389/fpsyg.2022.968154.].

Family resilience processes among guardians caring for children and youths with leukemia

Based on Walsh's concept of family resilience, this study aims to explain the processes and factors related to family resilience of guardians caring for children and youths with leukemia (GCYL) at a university-affiliated hospital in central Thailand. An explanatory case study is conducted. Semi-structured in-depth interviews were conducted with 21 guardians from 15 families caring for children and youths with leukemia (CYL). The interviews were recorded and transcribed for content analysis. The researcher categorized and coded the data to summarize, interpret, and validate the key study results of family resilience. This study found that families undergo three phases when facing the situation: pre-family resilience, family resilience, and post-family resilience. In each phase, these families face changes in emotions, perspectives, and behaviors related to the factors promoting family resilience. The results of this study will benefit multidisciplinary teams providing care for families with CYL by applying the information about family resilience processes to provide services that cultivate behavioral, physical, psychological, and social growth for the families and enable them to maintain peace in family life.

Examining the relationship between birth weight and attention-deficit hyperactivity disorder diagnosis

Background

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition that is prevalent in children worldwide. We evaluated the potential relationship between birth weight and ADHD using newly released data from the National Survey of Children's Health 2019-2020.

Methods

This population-based survey study used parent recollection data that were collected and submitted by 50 states and the District of Columbia to the National Survey of Children's Health database from the National Survey of Children's Health database. Those aged < 3 years and without birth weight or ADHD records were excluded. Children were stratified according to ADHD diagnosis and birth weight: very low birth weight (VLBW, < 1,500 g), low birth weight (LBW, 1,500-2,500 g), and normal birth weight (NBW, ≥ 2,500 g). Multivariable logistic regression was applied to examine the causal association between birth weight and ADHD while controlling for child and household characteristics.

Results

The final sample consisted of 60,358 children, of whom 6,314 (9.0%) were reported to have an ADHD diagnosis. The prevalence of ADHD was 8.7% in NBW children, 11.5% in LBW, and 14.4% in VLBW. Compared with NBW children, LBW children [adjusted odds ratio (aOR), 1.32 (95% CI, 1.03-1.68)], and VLBW children [aOR, 1.51 (95% CI, 1.06-2.15)] had a significantly higher risk of ADHD after adjusting all variables. These associations persisted in the male subgroups.

Conclusion and relevance

This study found that LBW and VLBW children were at a higher risk of ADHD.

The dyadic effects of social support on anxiety among family members during COVID-19: The mediating role of perceived family resilience

Families have been suffering from huge financial loss and psychological distress due to the COVID-19 pandemic. Most existing studies investigated the protective factors for anxiety at the individual level, while understandings from the perspective of family dyadic level were left unknown. Considering that social support could serve as a protective factor to reduce anxiety both at individual level and at dyadic level, the present study adopted dyadic data analysis approach to tackle this puzzle. In total, 2512 Chinese parent-adolescent dyads completed a survey with scales of anxiety, social support, and perceived family resilience on July 31 and August 1 of 2021. Results showed that: (1) adolescents' perceived social support had significant actor and partner effects on their own and parents' anxiety, whereas parents' perceived social support only had a significant actor effect on their own anxiety and (2) the actor mediating effects of social support on anxiety via one's own perceived family resilience were found in both adolescents and parents, and a partner mediating effect of adolescents' social support was significantly associated with parents' anxiety through parents' perceived family resilience. Findings emphasize that interventions aiming at increasing adolescents' support resources could generate a significant effect on reducing anxiety.

Long-Term Effects of Family Resilience on the Subjective Well-Being of Offspring in the National Longitudinal Lesbian Family Study

The current study used a family resilience approach to investigate why some offspring of sexual minority parents thrive despite homophobic stigmatization while others do not. Specifically, the study explored the role of two specific family functioning mechanisms (i.e., during adolescence, disclosure of offspring's personal life to their parents, and family compatibility) in the association between experienced homophobic stigmatization at age 17 and subjective well-being at age 25, among 71 offspring (37 females and 34 males, all cisgender) of the National Longitudinal Lesbian Family Study (NLLFS). The results showed that, overall, the offspring reported healthy subjective well-being as emerging adults. However, among NLLFS offspring with less family compatibility as adolescents, homophobic stigmatization was related to higher scores on negative affect when they were emerging adults. Psychological counseling that supports adolescent-parent communication may help prevent the negative effect of homophobic stigmatization on the subjective well-being of offspring with sexual minority parents.

Validation of the Chinese version of the Walsh Family Resilience Questionnaire

The Walsh Family Resilience Questionnaire (WFRQ) is one of the most widely used and strong theory-based measurement tools of family resilience. This study aimed to develop and psychometrically test the Chinese version of the WFRQ (WFRQ-C). The WFRQ was translated following Brislin's translation model. Psychometric testing, combining classical theory test and item response theory, was conducted with a sample of 800 community adult residents. The Connor-Davidson resilience scale-10 (CD-RISC-10), Self-reported Family Happiness Scale (SFHS-1), and Family APGAR (Adaption, Partnership, Growth, Affection, Resolve) Scale (Family APGAR-5) were applied for convergent validity. Six items were deleted at the item analysis level. The minimum average partial test and a parallel analysis supported a three-factor structure, which was validated by confirmatory factor analysis. The three factors were named "Family belief system," "Organization, communication and problem solving," and "Utilization of external resources." The WFRQ-C was significantly correlated with CD-RISC-10, SFHS-1, and Family APGAR-5, with r values ranged from 0.51 to 0.56. The Cronbach's α was 0.97 for the scale and 0.93, 0.95, and 0.72 for the three factors, respectively. The ICCs of 0.96 for the whole scale, and 0.95, 0.75, and 0.95 for the three factors, respectively. The mean score for the WFRQ-C was 97.00 ± 17.94, of which per capita monthly income and education level were predictors. The 26-item WFRQ-C is a stable, concise, and validated tool to measure family resilience. It is applicable for Chinese community adults in nonspecific stressful settings and has potential utility in the health care domain.

The Role of Family Resilience and Pandemic Burnout on Mental Health: A Two-Wave Study in China

Family resilience refers to the processes through which a family adapts to and bounces back from adversities. Pandemic burnout refers to feeling emotionally exhausted, cynical, and lack of accomplishment during the pandemic and/or toward various preventive polices and measures. This two-wave, region-wide, longitudinal study included 796 adult participants residing in mainland China. Participants completed online surveys at two time points during the COVID-19 pandemic. Time 1 (T1) survey was conducted when the number of new infected cases in China stabilized, while Time 2 (T2) was conducted 5 months later when there was a sudden surge of new infected cases. Results of a hierarchical regression analysis revealed that the interaction and main effects of pandemic burnout and family resilience at T2 showed significant incremental prediction of depression and anxiety at T2, after controlling for demographic as well as individual and family resilience at T1. These results supported the hypotheses that current family resilience functions as a protective factor, whereas pandemic burnout functions as a risk factor of mental health during successive waves of pandemic outbreaks. In particular, family resilience at T2 mitigated the negative impact of high pandemic burnout on anxiety and depression at T2.

The Moderating Role of Family Resilience on the Relationship between COVID-19-Related Psychological Distress and Mental Health among Caregivers of Individuals with Eating Disorders in Post-Pandemic China

COVID-19 has amplified long-standing emotional distress for vulnerable families. While abundant research highlights the importance of resilience under adverse circumstances, little has been undertaken to understand its effectiveness in helping caregivers of individuals with eating disorders (ED) navigate pandemic-related challenges. This paper presents findings of a cross-sectional study investigating the effects of COVID-19-related life disruptions (COLD) and COVID-19-related psychological distress (CORPD) on caregivers' depression, anxiety and stress, as well as the moderation role of individual resilience (IR) and family resilience (FR) during the post-pandemic period in China. A total of 201 caregivers of individuals experiencing ED participated in our online survey from May 2022 to June 2022. The association between pandemic-related stressors (i.e., COLD and CORPD) and mental health conditions were confirmed. FR moderated the relationship between CORPD and mental health outcomes, while IR independently contributed to low emotional distress. We call for intervention programs strengthening caregivers' FR and IR, which might benefit both patients and caregivers' well-being in the post-pandemic period.

Family Resilience Progress from the Perspective of Parents of Adolescents with Depression: An Interpretative Phenomenological Analysis

Family resilience plays an important role in the healthy family development of adolescents with depression, but few studies have explored the specific process of family resilience. This study aims to explore the dynamic processes of family resilience from parents of adolescents with depression. Data were collected from 14 Chinese parents of adolescents with depression by interpretative phenomenological analysis method. Four themes and 12 sub-themes emerged: (1) decompensation phase: (i) misinterpretations of illness, (ii) heavy psychological burden, (iii) chaotic rhythms in family; (2) launch phase: (i) potential influences of labeling, (ii) we must cure my child anyway, (iii) begin adjusting to family roles; (3) recovery phase: (i) family reflection, (ii) subsequent reorganization of family resources, (iii) ultimately establishing a new balance; (4) normality phase: (i) adaption for medical seeking process, (ii) actively lower expectations, (iii) concerns of future needs. Mental health professionals could provide targeted suggestions to help the parents achieve family resilience by assessing its different phases.

Development and Validation of the Chinese Family Resilience Scale in Families in Hong Kong

Family resilience is an important protective factor mitigating the negative impact of adversities on individuals and families. As there are very few validated measures of family resilience in the Chinese context, we have developed the Chinese Family Resilience Scale (C-FRS) based on the family resilience framework of Froma Walsh. In this paper, we outline the development and the validation of the C-FRS with reference to the socio-cultural context of Hong Kong. Based on content validation involving family experts, the initial 51 items were assessed in terms of their relevance, clarity, and representativeness. The results showed that these items possessed adequate content validity. In order to validate the 51-item measure, we examined its convergent validity, its factorial validity, and its internal consistency based on the responses of 1020 Chinese families (N = 2858 participants). After removing the items with unsatisfactory psychometric properties, we retained 35 items in the final scale. The results showed that the C-FRS scores were significantly related to family functioning, thus providing support for its convergent validity. This study also provided support for the conceptual model of Walsh (i.e., three high-order domains involving nine primary indicators). Most importantly, the measurement invariance tests showed that the dimensions of the C-FRS were invariant among fathers, mothers, and adolescent children. As the findings support the reliability and the validity of the 35-item C-FRS, we suggest that this measure can be objectively used to assess family resilience in Chinese communities.

Reliability and validity of the Chinese version of the Walsh Family Resilience Questionnaire among community-dwelling disabled elderly individuals (WFRQ-CE)

Objective

To test the reliability and validity of the Chinese version of the Walsh Family Resilience Questionnaire among community-dwelling disabled elderly individuals (WFRQ-CE).

Methods

Convenience sampling was used to select 566 dyads of disabled elderly individuals and their caregivers. The Walsh Family Resilience Questionnaire Chinese Version (WFRQ-C) was tested among elderly individuals. The Family Care Capacity Scale for Elderly Patients (FCCSE) was used as a concurrent validation tool for the caregivers, and the Psychological Resilience Scale (CD-RISC-10), and the Social Support Assessment (SSRS-10) were used as concurrent validation tools for both the elderly individuals and the caregivers.

Results

Exploratory factor analysis (EFA) revealed four common factors-"Family belief," "Organization and problem solving," "Family communication," and "Utilization of external resources"-with a cumulative variance contribution rate of 56.94%. Confirmatory factor analysis (CFA) yielded the following fit indices: chi-square/freedom degree (χ2/df) = 2.007, Tucker Lewis index (TLI) = 0.900, incremental fit index (IFI) = 0.917, comparative fit index (CFI) = 0.916, parsimony goodness-of-fit index (PGFI) = 0.681, and root-mean-square error of approximation (RMSEA) = 0.060. The concurrent scales were significantly correlated with the WFRQ-C total score and the scores for each factor (r values between 0.23 and 0.60, P < 0.01). The Cronbach's alpha coefficient was 0.93 for the WFRQ-CE and 0.87, 0.83, 0.89, and 0.65 for the four factors; the retest reliability was 0.96 for the total scale and 0.95, 0.92, 0.92, and 0.95 for the four factors; the split-half reliability was 0.85 for the total scale, and 0.81, 0.78, 0.79, and 0.68 for the four factors.

Conclusion

The WFRQ-CE has good reliability and validity among community-dwelling disabled elderly individuals and can be used to evaluate the level of family resilience.

Cross-cultural adaptation and psychometric evaluation of the Portuguese version of the family resilience questionnaire - short form (FaRE-SF-P) in women with breast cancer

Background

A diagnosis of cancer, and the resulting treatment process, can be perceived as a life-threatening event, affecting not only patients but also their social network and, more specifically, their relatives. While the ability to cope and adjust to difficult health situations may be challenging, family resilience may optimize a positive adaptation to adversity and contribute to enhance the patient's quality of life. The Family Resilience Questionnaire (FaRE) is a self-report measure of family resilience that assesses this construct systematically. We aimed to validate the Portuguese version of a short form of the FaRE (FaRE-SF-P) in a sample of women with breast cancer.

Methods

147 women recently diagnosed with early breast cancer were recruited at the Champalimaud Clinical Centre in Lisbon. Participants completed psychometric assessment including the Portuguese version of the FaRE-SF-P, composed by two subscales of the original version - the FaRE Perceived Family Coping (FaRE-PFC) and the FaRE Communication and Cohesion (FaRE-CC). Confirmatory factor analysis (CFA) was performed to assess the factor structure of the FaRE-SF-P. Construct validity was assessed using the Hospital Anxiety and Depression Scale (HADS) for divergent validity, and the Modified Medical Outcomes Study Social Support Survey (mMOS-SS) as well as the social functioning subscale from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) for convergent validity.

Results

The CFA results confirmed a correlated two-factor structure model consistent with the Perceived Family Coping and the Communication and Cohesion subscales. Internal consistency reliability indicated good values both for Perceived Family Coping and Communication and Cohesion subscales. The results for construct validity showed acceptable convergent and divergent validity.

Discussion

The FaRE-SF-P showed good psychometric properties demonstrating to be a valid and reliable family resilience measure to use in Portuguese women diagnosed with breast cancer. Since FaRE-SF-P is a short instrument it may be a useful screening tool in an oncological clinical practice routine.

Family resilience and its predictors among patients with a first-ever stroke one month after stroke: a cross-sectional study

BACKGROUND

Understanding post-stroke family resilience would be helpful for healthcare professionals in planning interventions to facilitate family adaptation following stroke onset.

OBJECTIVE

To investigate the level of family resilience and its predictors among patients with the first stroke.

DESIGN

An explorative cross-sectional study.

METHODS

The study was conducted on 288 first stroke patients recruited from 7 tertiary hospitals in China between July 2020 and October 2020, and they were followed up one month after stroke. Data were collected using the Medical Coping Modes Questionnaire, Self-efficacy for Managing Chronic Disease 6-item Scale, shortened Chinese version of Family Resilience Assessment Scale, and the Social Support Rating Scale. The predictive variables of family resilience were investigated using hierarchical regression analyses.

RESULTS

A total of 255 patients finished the survey with a response rate of 88.5%. The mean score of family resilience was 96.19 (SD = 9.87), highest in the dimension of maintaining a positive outlook and lowest in utilizing social resources. Patient subjective support (β = 0.22, P = 0.004), social support utilization (β = 0.13, P = 0.027), self-efficacy for managing disease (β = 0.27, P < 0.001), marriage status (divorced vs married)(β=-0.18, P = 0.002), and caregivers' relationship with patients (siblings vs spouse)(β=-0.18, P = 0.002) were predictors of family resilience.

CONCLUSION

Family resilience was low among stroke patients one month after the onset. Special attention should be paid to families of patients who were divorced, cared for by siblings, or have low social support or self-efficacy in managing stroke. Further research on family-based interventions may focus on increasing patient social support and promoting their self-efficacy in managing stroke.

Finding family resilience in adversity: A grounded theory of families with children diagnosed with leukaemia

AIMS AND OBJECTIVES

To develop a conceptual framework that explores the process of building family resilience among Chinese families with children diagnosed with leukaemia.

BACKGROUND

The diagnosis of childhood leukaemia has a devastating effect on the family. Nonetheless, some families were able to positively respond to the crisis. The process through which Chinese families bounce back has received little attention.

DESIGN

Grounded theory.

METHODS

This study used purposive and theoretical sampling to select 16 parents who agreed to participate in semistructured interviews after children were diagnosed with leukaemia. Data collection and analysis occurred simultaneously. Data were analysed through a process of open, axial and selective coding. The COREQ checklist was followed for reporting.

RESULTS

A core category of 'finding family resilience in adversity' was generated. The core category was underpinned by a transition process between two fluid stages: (a) Disrupting the family system, informed by subcategories of negative emotional disturbances and challenges of the diagnosis and treatment journey; (b) Cultivating resilience in families, informed by subcategories of increasing positive attitudes; establishing new family routines; activating good support systems; and practising open family communication.

CONCLUSIONS

The transition process from the disruption of the family system to the cultivation of family resilience is perceived as a complex family dynamic in response to childhood leukaemia. Our findings can form the basis for further research about resilience-based family interventions that promote family well-being during the early stages of a childhood leukaemia diagnosis.

RELEVANCE TO CLINICAL PRACTICE

It is necessary for healthcare professionals to provide essential support for families to face the challenges of diagnosis and treatment to facilitate the successful transition to family resilience. By understanding the dynamic process of developing family resilience, healthcare professionals are able to focus on these families to provide holistic care that satisfies the specific demands of family members.

Community support, family resilience and mental health among caregivers of youth with autism spectrum disorder

BACKGROUND

Caregivers of children with autism spectrum disorder (ASD) have been shown to have unique mental health vulnerabilities that community support may buffer. Positive caregiver mental health can stimulate family resilience behaviours, such as strong communication and problem-solving. Further, community support has been found to be related to caregiver mental health, as well as improved child functioning. The current study aims to investigate caregiver mental health as a mediator between community support and family resilience in families of a child with an autism spectrum disorder.

METHODS

Data obtained from caregivers of 654 children with a reported diagnosis of ASD were utilized from the 2016 National Survey of Children's Health (NSCH) public database.

RESULTS

Community support was positively correlated with family resilience and caregiver mental health. Bivariate correlations indicated significant positive associations between community support and family resilience. Caregiver mental health, significantly, partially mediated the relationship between community support and family resilience.

CONCLUSIONS

The present study provides important insight into fostering caregiver health as a strategy to promote family resilience behaviours. Interventions designed to address family resilience behaviours among families of children with ASD should focus on ways that positively impact caregiver mental health.

Influence of home chaos on preschool migrant children's resilience: A moderated mediation model

Increasing attention has been drawn to the development of preschool migrant children's resilience recently. Resilience refers to the positive internal strengths and qualities of individuals in adverse situations, and is an essential psychological quality for preschool migrant children to cope with adversity. Home chaos as a risk factor, has an important impact on the development of individual's resilience, but the specific mechanisms under which home chaos works have yet to be explored, especially for preschool migrant children. Based on resilience model theory, 3,135 preschool migrant children and their families were surveyed and a moderated mediating effect mode was constructed to test the effect of home chaos on preschool migrant children's resilience. The results showed that after controlling for gender and age, home chaos significantly and negatively predicted preschool migrant children's resilience. Family resilience played a mediating role in the relationship between home chaos and preschool migrant children's resilience. Meanwhile, social support positively moderated the mediating effects of family resilience. The findings of this study suggested that low home chaos was conducive to promoting family resilience, which in turn fostered children's resilience, and that social support could play its protective role in weakening the negative effects of home chaos and this had certain guiding implications for the development of resilience in preschool migrant children.

Parent-Child Relationships, Digital Media Use and Parents' Well-Being during COVID-19 Home Confinement: The Role of Family Resilience

Research has provided substantial evidence on the role of parents' well-being in the quality of parent-child relationships and children's adjustment. Parents' stress and parental couple conflict have been linked to children's adverse developmental outcomes. However, little is known about the factors that affect parents' well-being when coping with multiple stressors such as those brought by the recent COVID-19 global pandemic. Our study intended to examine the predictors of parental well-being by looking at the contextual factors of COVID-19 home confinement, i.e., the use of digital media and parents' domestic workload, and family resilience in two countries: Ireland and Italy. Additionally, the age and number of children were controlled as potential variables impacting parents' well-being. A three-step hierarchical regression analysis was applied. The results showed that family resilience was a very strong predictor of parents' well-being after controlling for any other variable. Parental couples' conflict over the use of technology predicted lower levels of parents' well-being, while, notably, parent child-conflict and domestic workload were not associated with parents' well-being. Additionally, the age of children did play a role: the higher the mean age of children in the family the better the parents' well-being. The findings are discussed in the light of cross-country differences and their implications for research and practice.

The conditional effect of family resilience on family quality of life during the Covid-19 pandemic

Introduction: The Covid-19 pandemic has brought unprecedented challenges, both economically and psychologically, to most families across the world. Yet, little study has been done on this topic in Indonesia, even after the second year of the pandemic. This study examines how the Covid-19 economic impact and parental stress are related to the family quality of life (FQOL) and how the relation is moderated by family resilience. Methods: To this end, we employed previously tested measures to assess the level of parental stress, family resilience and FQOL. Especially for the latter, we modified the measure, developed by Beach Center on Disability, by including only four domains (i.e., family interaction, parenting, emotional well-being, and material well-being) to adjust to our research context. Results: Based on 169 participants, our confirmatory factor analysis (CFA) displays that all employed measures in the study are valid and reliable. Our regression analysis shows that there are significant direct relations of parental stress & family resilience with FQOL. However, we find that family resilience only positively moderates the relation between the Covid-19 economic impact and FQOL but not the relation between parental stress and FOQL; indicating that high family resilience can only buffer the effect of economic impact on FQOL. Discussion: This study presents a view on how the Covid-19 pandemic affects the way families live and hence, their quality of life. In addition, the findings suggest the importance of family relationship and support in times of crisis, not limited to the Covid-19 pandemic.

The conditional effect of family resilience on family quality of life during the Covid-19 pandemic

Introduction This study examines how the Covid-19 economic impact and parental stress are moderated by family resilience to relate to the family quality of life (FQOL). Methods We modify the measure of FQOL, developed by Beach Center on Disability, by including only four domains (i.e., family interaction, parenting, emotional well-being, and material well-being) to adjust to our research context. Results Based on 169 participants, our CFA displays that all employed measures in the study are valid and reliable. Our regression analysis shows that there are significant direct relations of parental stress & family resilience with family quality of life. However, we find that family resilience only positively moderates the relation between the Covid-19 economic impact and family quality of life. Discussion This study presents a view on how the Covid-19 pandemic affects the way families live and hence, their quality of life.

The conditional effect of family resilience on family quality of life during the Covid-19 pandemic

Introduction: The Covid-19 pandemic has brought unprecedented challenges, both economically and psychologically, to most families across the world. Yet, little study has been done on this topic in Indonesia, even after the second year of the pandemic. This study examines how the Covid-19 economic impact and parental stress are related to the family quality of life (FQOL) and how the relation is moderated by family resilience. Methods: To this end, we employed previously tested measures to assess the level of parental stress, family resilience and FQOL. Especially for the latter, we modified the measure, developed by Beach Center on Disability, by including only four domains (i.e., family interaction, parenting, emotional well-being, and material well-being) to adjust to our research context. Results: Based on 169 participants, our CFA displays that all employed measures in the study are valid and reliable. Our regression analysis shows that there are significant direct relations of parental stress & family resilience with family quality of life. However, we find that family resilience only positively moderates the relation between the Covid-19 economic impact and family quality of life. Discussion: This study presents a view on how the Covid-19 pandemic affects the way families live and hence, their quality of life. In addition, the findings suggest the importance of family relationship and support in times of crisis, not limited to the Covid-19 pandemic.

Special Characteristics of the Resilience of Russian Families in the Face of Modern Challenges (A Preliminary Study)

Background

A challenge is considered a "wake-up call" for family resilience, requiring a proper response (willingness to evaluate, understand an event and its signals, and also give an adequate response). Family resilience is defined as an adequate response to challenges, that is, the ability to cope with them based on the cultural-historical context and family resources, such as clear and open family communication and connectedness, the use of social resources, a broad system of values and senses, the ability to derive meaning from adversity, acceptance, and flexibility.

Objective

This article reports on a study which aimed to analyze components of the resilience of Russian families in response to life circumstances that have become challenges for them.

Design

The study was conducted from March 20 to May 7, 2022. Participants took an online survey on Yandex-forms; the link to the survey was distributed through social networks on public pages and in private messages. Two hundred seventy-four (274) representatives of Russian families responded, including 234 women and 40 men (14.6%) ranging from age 17 to 65 (cf. 34.1+12.5). After removing the data of 15 participants who did not report a negative event in their families, the final sample consisted of 259 people.

Results

Challenges for modern Russian families can be categorized as loss challenges, relationship challenges, global challenges, challenges of illness, and challenges of financial well-being. The challenges of loss stimulate flexibility of response, acceptance, and overcoming suffering through mutual understanding. Global challenges and the challenges of illness awaken family spirituality. The ability to discuss problems together and share decision making becomes a resource to meet the challenge of families' financial well-being. Confidence in solving problems and a positive outlook become resources to face relationship challenges. The intensity of events is a signal for a family to evoke communication and connectedness, acceptance, and flexibility, as well as family resilience as a whole.

Conclusion

There is a connection between the difficulties that respondents regard as challenges and the characteristics of their family resilience; the most adequate response to challenges is to increase family resilience.

Managing Children's Fears during the COVID-19 Pandemic: Strategies Adopted by Italian Caregivers

BACKGROUND

Life-threatening events, such as the COVID-19 pandemic, may generate feelings of insecurity and fear in the affected population, particularly children. Parents' ability to help children cope with negative emotions is essential during challenging periods. The current study aims to analyse the coping strategies adopted by Italian caregivers concerning their children's fears about COVID-19.

METHOD

An online survey was administered during the Italian lockdown to 649 parents of at least one child aged 5 to 17 years old. Respondents completed the survey for themselves and their children. In addition, a qualitative content analysis of the data from the open-ended question was conducted (N = 569; 87.9% women; M_Age = 45 years).

RESULTS

Several themes were identified. Firstly, families' primary approach was 'communication and meaning-making'. Secondly, another essential strategy was 'the importance of safe space', enabled by keeping routine in place and creating a loving and caring environment. Thirdly, other factors relevant to managing children's fears were 'adaptation', 'religion', 'a positive attitude', and 'humour and hope'. Finally, the last two strategies significant and valuable for Italian families were 'flexibility' and 'maintaining virtual contacts.

CONCLUSION

During the pandemic COVID-19, parents may have used various strategies to protect their children from stress. Future research could investigate single parents' coping strategies explicitly developed during the COVID-19 lockdown.

Effect of disability severity on home-based care quality among families with Uygur and Kazakh disabled older adults in far western rural China: A cross-sectional study

AIMS

To explore how family functioning and family resilience mediate the relationship between disability severity and quality of home-based care among families with disabled older adults.

METHODS

A cross-sectional survey was conducted with 431 families with Uygur and Kazakh disabled older adults in Xinjiang, China, in 2020. The data were collected using the Katz Activity of Daily Living Scale; Mini-Mental State Examination; Family Adaptation, Partnership, Growth, Affection and Resolve Index Scale; Family Resilience Assessment Scale; and Family Caregiving Consequences Inventory Scale. All mediation effects were estimated in SPSS26.0.

RESULTS

Disability severity, family functioning and family resilience were all significantly correlated with home-based care quality. Disability severity had a 46.16% direct effect on home-based care quality and a 53.84% indirect effect on home-based care quality independently and in series through family functioning and family resilience.

CONCLUSIONS

Disability severity directly affected home-based care quality and had an indirect influence via family functioning and family resilience. Multidisciplinary care teams should focus on families with disabled older adults and help them improve family functioning and family resilience by implementing targeted interventions, so as to improve home-based care quality.

"When You Come Together and Do Everything, It'll be Better for Everybody": Exploring Gender Relations Among Two Southeastern Native American Tribes

Prior to the imposition of patriarchal colonial norms, Native American (NA) gender relations were characterized as complementary and egalitarian; however, little research has explored gender relations within NA communities today. This study used a community-based critical ethnography to explore contemporary NA gender relations with a purposive sample of 208 individuals from the "Coastal Tribe" and 228 participants from the "Inland Tribe." After participant observation, interviews, and focus groups were conducted, a collaborative approach to reconstructive analysis was used to identify themes in the data. Within these communities, gender relations tended to reflect egalitarian and cooperative but gendered norms, and participants provided examples of how tribal members are transcending patriarchal colonialism. Through the lens of the Framework of Historical Oppression, Resilience, and Transcendence, we theorize how these gender norms may protect families from risks associated with historical oppression and promote family resilience with implications for research, practice, and policy.

Dyadic profiles of family resilience among patients with first-episode stroke: A longitudinal study of the first 6 months after stroke

BACKGROUND

The importance of family resilience in the recovery of stroke patients has been demonstrated in numerous studies. However, little is known about post-stroke family resilience.

AIMS

To investigate the family resilience of stroke patients from a patient-caregiver dyadic perspective during the first 6 months after stroke.

METHODS

A total of 288 dyads of patients diagnosed with a first-episode stroke and their principal caregivers were recruited from neurology departments of 7 tertiary hospitals in Shanghai and Shangqiu, China. Family resilience and family function were assessed during hospitalisation and at 1, 3 and 6 months after stroke. K-means cluster analysis was used to identify different clusters of family resilience based on family resilience of patients and caregivers during hospitalisation. The STROBE guidelines for observational studies were followed.

RESULTS

Three clusters of family resilience were identified with distinct trajectories: cluster of high resilience (HR), cluster of low resilience (LR) and cluster of discrepant resilience (DR). The level of family function was consistently highest in cluster HR and lowest in cluster with LR at four time points. Most (69.8%) families fell into the cluster with low resilience and low family function. Characteristics such as the Rankin scores and education level of patients, education level of caregivers, family monthly income and living district were different among the three clusters.

CONCLUSIONS

We concluded that family resilience was linked to the family functioning of patients with a first-episode stroke, however, the levels of resilience in most families were low. Factors, including the education level, family income and stroke severity of patients were revealed to influence the family resilience and its development.

RELEVANCE TO CLINICAL PRACTICE

A resilience-focused approach to family-related treatment is beneficial for families. Therefore, understanding family resilience among stroke survivors is needed to inform the development of interventions for enhancing the recovery of stroke families.

Resilience and Risk Factors Predict Family Stress Among Married Palestinians in Israel During the COVID-19 Pandemic

The present study examined effects of sociodemographic, risk, and resilience factors on marital, parental, and financial stress early in the COVID-19 pandemic. A cross-sectional online survey was conducted among 480 married Palestinians living in Israel, using self-report questionnaires. Descriptive statistics and bivariate correlations were computed. Then, hierarchical multiple regression analyses were conducted to predict each of the three stress measures. Finally, dominance analyses were conducted to compare the contributions of sociodemographic, risk, and resilience factors. The results showed considerable differences between predictors of marital and parental stress and predictors of financial stress. For marital and parental stress, resilience factors mainly family resilience were the strongest predictors, followed by risk factors and then sociodemographic characteristics. For financial stress, risk factors (mainly financial damage and prior stressful life events) were the strongest predictors, followed by sociodemographic characteristics and resilience factors (mainly individual resilience). These results suggest that family and individual resilience reduce marital and parental stress under difficult conditions, including the COVID-19 pandemic. Though resilience has been found to ameliorate financial stress to some extent, it appears that other measures are required to manage stress related to financial difficulties.

Weathering the Storm: Longitudinal Evidence on Women’s Changing Family Relationships During COVID-19

The massive socioeconomic changes wrought by COVID-19 have disrupted multiple aspects of family life. However, evidence is still lacking on the sustained long-term impact of the pandemic and how families are adapting to this new normal. This article studies changes in women’s family relationships against the backdrop of evolving COVID-19 public health responses, and investigates the adverse effects of working from home, income loss, and anxiety about the virus. We survey 356 Singaporean mothers over four waves: a baseline in April–July 2018 and follow-ups in May, June, and November 2020. Results suggest that while some family relationships suffered during the early days of the crisis, most families displayed resilience in the long-term. Nevertheless, a substantial minority continued to report worsened relationships. Mother’s work from home status and father’s income loss emerged as significant predictors of change in family relationships, highlighting the gendered nature of adaptation to crisis.

Assessing family resilience for African American college students: Confirmatory factor analysis of the Family Resilience Assessment Scale

ObjectivePsychometric properties of the Family Resilience Assessment Scale and its utility for use with African American college students were examined. Participants: Subjects were 440 university students (M age = 21.65, SD = 6.17) who were enrolled during the 2018-2019 academic year and recruited during the fall and spring semesters. Methods: A single-group confirmatory factor analysis was employed to determine the best model for assessing family resilience in an African American college student population. Results: The model fit was poor and could not be respecified due to numerous item cross-loadings. Conclusions: Further research is needed to validate a measure that adequately assesses family resilience for African American students.

'A learning experience': Disciplinary and parenting practices among Native American families

Research indicates that effective disciplinary practices, such as offering praise and teaching acceptable versus non-acceptable behaviour, can act as protective factors against the social and behavioural health disparities experienced by Native Americans (NA). The purpose of this critical ethnographic study (n = 436 qualitative elder, adult, youth and professional participants) was to use the Framework of Historical Oppression, Resilience, and Transcendence (FHORT) to qualitatively examine participants' reported experiences of disciplinary practices. Thematic analysis of qualitative results indicated several approaches to disciplining children, which included the following themes: (a) Establishing Structure and Boundaries; (b) Taking Away Privileges and Rewarding Good Behavior; and (c) Teaching Right from Wrong. Results indicate that despite experiencing historical oppression, NAs still report many disciplinary and other parenting practices contributing to family resilience that were present prior to colonization. Communal and relational supports contribute to positive parenting practices, indicating an importance to promote holistic and inclusive clinical treatment approaches.

Resilience-Promoting Programs in Families of Children With Cancer: A Systematic Review

Purpose: Pediatric cancer is a difficult experience for children and their families. It is thus necessary to promote family resilience for the effective treatment and quality of life improvement among children with cancer. The aim of this systematic review was to identify the components of a resilience-promoting program for children with cancer and their families and to synthesize the literature findings on the outcomes of the resilience-promoting program. Method: A systematic search of the literature was conducted using five databases (PubMed, CHIAHL, PsycINFO, Web of Science, and Research Information Sharing Service) up to July 22, 2020. The search was limited to studies published in English and Korean, and to grey literature published in Korea. Studies were critically appraised using the Mixed Methods Appraisal Tool and Cochrane Risk of Bias tool. Extracted data were summarized as tables. Results: Eight studies were selected. The main components of the resilience-promoting program were providing information (on strategies, medical and psychoeducation, and community resources) and emotional coping (expressing feeling, reappraising cognition about adversity, and stress management). The main outcomes of these programs were reinforced outcomes (resilience, benefit finding, coping, positive affect, problem-solving skills, family adaptation, and self-concept) and improved outcomes (in depression, posttraumatic stress, anxiety, impact of illness of the family, and mood). Conclusion: As the components and outcomes of family resilience-promoting programs vary, it is necessary to consistently use valid tools to effectively identify interventions. Additionally, various methodological studies are required to further analyze the effect of these programs.

Walsh Family Resilience Questionnaire-Polish Adaptation (WFRQ-PL)

Family resilience is a construct based on interactive processes occurring in the family, enabling the family to effectively overcome everyday stressors, as well as developmental and unpredictable crises. By observing how the family deals with difficulties using family resilience processes, we are able to support both parents and protect children against the harmful effects of unfavourable conditions. The aim of our research was to carry out the procedure of adaptation to the Polish language and culture of the Walsh Family Resilience Questionnaire. In this study, 930 Poles participated (72.5% women), aged from 18 to 63 (M = 26.94, SD = 9.8). They filled in the questionnaire online. Confirmatory factor analysis confirmed the model with three factors: belief system, organisational processes, and communication processes. The model indicators were found to be well suited to the data: χ²/df = 1.12, RMSEA = 0.01, CFI = 0.99, TLI = 0.99, SRMR = 0.04. The reliability (Cronbach’s alpha) of the scales was also satisfactory (0.94 for the belief systems, 0.86 for the organisational processes, and 0.94 for the communication processes). Tool validation with FRAS-PL scales showed convergence. We named the Polish version of the WFRQ Questionnaire Kwestionariusz Prężności Rodzinnej Walsh (WFRQ-PL) and found it to be a good tool for assessing the processes of family resilience in our country.

Combining Family Systems Approaches to Address BIPOC Families' Racial Trauma Amidst the Global Pandemic

The ACE study (Felitti et al., 1998) led to the recognition of the prevalence and impact of trauma. However, since the ACE study sample was mostly white and middle class, the Philadelphia task force implemented their own study to account for trauma of a more diverse sample. A result of the study was a list of evidence-based treatments to be utilized with BIPOC populations. Of the evidence-based treatments was, ecosystemic structural family therapy (ESFT). A similar effective approach is the family resilience framework. When combined, the approaches can be effective with BIPOC families during the global pandemic and racial trauma, something not typically at the forefront of family counseling goals. In this article, I explain the four steps family counselors should follow when combining the approaches to better approach and treat racial trauma while also partaking in effective advocacy to enhance family resilience of BIPOC families. A case study is provided for family counselors to understand how to effectively utilize this combined approach.

Family Resilience and Psychological Responses to COVID-19: A Study of Concordance and Dyadic Effects in Singapore Households

The impacts of COVID-19 may be magnified in a shared environment like the household, especially with people spending extended time at home during the pandemic. Family resilience is the ability of a family to adapt to crisis and can be a protective factor against stress and negative affect. While there have been calls to address family resilience during the pandemic, there is a lack of empirical study on its benefit. In this dyadic observational study, we sought to investigate the concordance of family members’ psychological responses to COVID-19, whether dyad members’ risk factors (COVID-19 exposure and financial impact) mutually affected each other’s psychological responses, and importantly, whether family resilience was a significant factor in these responses. A total of 200 family dyads from the same household completed the Family Resilience Assessment Scale and questionnaires on COVID-19 threat perception, impacts, and exposure. We found concordant dyad responses for COVID-19 threat perception, but not for psychological impact. Using the Actor-Partner-Interdependence Model framework, we found that one’s psychological impact was affected by the financial impact from both dyad members. After controlling for risk factors and demographic covariates, we found that family resilience significantly associated with lower COVID-19 psychological impact, though not with threat perception. The findings suggest that both family and individual factors need to be addressed and there may be benefit in addressing multilevel risk and protective factors using an ecological systems approach, which may help prepare the population for future crises.