Psychosocial Adaptation in Parents of Children Diagnosed with Autism Spectrum Disorder / Adaptación Psicosocial en Padres de Hijos Diagnosticados con Trastorno del Espectro Autista

ABSTRACT The objective of this study was to describe the experiences of psychosocial adaptation in parents of children diagnosed with autism spectrum disorder. A qualitative study of the phenomenological design was conducted using in-depth semi-structured interviews with 12 participants. The results illustrate that psychosocial adaptation can be explained through categories such as stressors, support received, perception of the situation, expectations developed, and strategies used to handle the situation. In conclusion, adaptation involves experiencing feelings of guilt, sadness, frustration, and anger, among others; however, this is followed by acceptance, seeking to provide the child with skills, thereby improving their social adjustment. Perceived support from family and spouses is identified as substantial.

RESUMEN El objetivo de este estudio fue describir la experiencia de adaptación psicosocial en padres de hijos diagnosticados con trastorno del espectro autista. Se realizó una investigación cualitativa de diseño fenomenológico, haciendo uso de la entrevista semiestructurada en profundidad a 12 participantes. Los resultados ilustran que la adaptación psicosocial se explica a través de categorías tales como, factor estresante, apoyo recibido, la percepción de la situación, las expectativas desarrolladas y las estrategias utilizadas para manejar la situación. Se concluye que la adaptación implica experimentar sentimientos de culpa, tristeza, frustración, enojo, entre otros, sin embargo, posteriormente se logra la aceptación, buscando dotar de habilidades al hijo, mejorando su ajuste social. Se identifica al apoyo percibido de la familia y cónyuge como sustancial.

Estratégias de mulheres e familiares no enfrentamento da síndrome congênita do zika vírus / Estrategias de las mujeres y los miembros de la familia para hacer frente al síndrome congénito del virus del zika / Strategies of women and family members in coping with congenital zika virus syndrome

Objetivo: conhecer os recursos familiares e as estratégias de enfrentamento utilizadas na situação de cuidar de uma criança com Síndrome Congênita do Zika vírus. Método: pesquisa qualitativa e interpretativa realizada com mulheres acometidas pelo Zika vírus na gestação e filhos com diagnóstico da Síndrome Congênita do Zika vírus, mediante análise temática de conteúdo embasada no modelo de resiliência, estresse, ajustamento e adaptação familiar. Coleta de dados realizada por meio de entrevistas semiestruturadas e construção de genogramas e ecomapas das famílias como suporte. Resultados: contribuíram como recursos para o enfrentamento das mulheres e famílias a própria família, amigos, vizinhos, grupos, pessoas da comunidade, profissionais de saúde, fontes de informação e a fé em Deus. Considerações finais: as estratégias utilizadas pelas mulheres e seus familiares para cuidar de criança com Síndrome Congênita do Zika vírus procuraram encontrar um caminho singular, em busca do equilíbrio no processo de adaptação, conforme cada realidade e necessidade.

Objetivo: conocer los recursos familiares y las estrategias de afrontamiento utilizadas en la situación de cuidado de un niño con Síndrome Congénito del virus del Zika. Método: investigación cualitativa e interpretativa realizada con mujeres afectadas por el virus Zika durante el embarazo y niños diagnosticados con Síndrome Congénito del virus Zika, a través del análisis temático de contenido basado en el modelo de resiliencia, estrés, adaptación y adaptación familiar. La recolección de datos se realizó a través de entrevistas semiestructuradas y la construcción de genogramas y ecomapas de familias como soporte. Resultados: las familias, sus familias, sus propios amigos, vecinos, grupos, personas de la comunidad, profesionales de la salud, fuentes de información y fe en Dios, contribuyeron como recursos a las mujeres y las familias. Consideraciones finales: las estrategias utilizadas por las mujeres y sus familias para cuidar a los niños con Síndrome Congénito del virus del Zika buscaron encontrar un camino singular, buscando el equilibrio en el proceso de adaptación, de acuerdo a cada realidad y necesidad.

Objective: to know the family resources and coping strategies used in the situation of caring for a child with Congenital Zika virus Syndrome. Method: qualitative and interpretative research conducted with women affected by Zika virus during pregnancy and children diagnosed with Congenital Zika virus Syndrome, through thematic analysis of content based on the model of resilience, stress, adjustment and family adaptation. Data collection was performed through semi-structured interviews and the construction of genograms and ecomaps of families as support. Results: the families, their families, their own friends, neighbors, groups, community people, health professionals, sources of information and faith in God, contributed as resources to the women and families. Final considerations: the strategies used by women and their families to care for children with Congenital Zika virus syndrome sought to find a singular path, seeking balance in the adaptation process, according to each reality and need.

Adaptação familiar à prematuridade durante a internação na unidade de terapia intensiva neonatal e ao longo do primeiro ano após a alta hospitalar / Family adaptation to prematurity during admission to the neonatal intensive care unit to the first year after hospital discharge

Introdução: a ocorrência do nascimento prematuro e a evolução da criança é influenciada por aspectos biológicos, econômicos, comportamentais, tecnológicos e de condição de saúde da população. Diante desta situação e hospitalização de um filho, a família passa a ter a sua autonomia para o cuidado ameaçada e a sua organização familiar se modifica para atender às necessidades da criança. Este contexto repercute no funcionamento da família e sua consequente adaptação à condição de ter um filho nascido prematuro, podendo ser comprometido em situações de vulnerabilidade familiar. Objetivo: analisar a associação entre aspectos da vulnerabilidade familiar e o processo de adaptação familiar à situação de cuidar de uma criança nascida prematura, desde a internação na Unidade de Terapia Intensiva Neonatal (UTIN) até o primeiro ano após a alta hospitalar. Métodos: trata-se de um estudo do tipo longitudinal, de abordagem quantitativa, realizado no município de Belo Horizonte, Minas Gerais, e guiado pelo referencial teórico do Modelo de Resiliência, estresse, ajustamento e adaptação familiar de McCubbin & McCubbin (1993). A coleta de dados foi organizada em três etapas. O primeiro momento da pesquisa (T0) correspondeu ao período de internação do prematuro na UTIN e foi realizado em Unidades de Terapia Intensiva Neonatal de um hospital público, não governamental. As mães foram acompanhadas após a alta hospitalar em dois momentos diferentes, do 1º ao 6º mês (T1), e do 6º ao 12º mês (T2). Neste período, a coleta de dados aconteceu em cenários diferentes, de acordo com as possibilidades de localização e contato com a família. No T0, participaram do estudo 72 mães de recém-nascidos prematuros internados na UTIN com idade gestacional menor do que 32 semanas. No T1 e no T2 foram acompanhadas 25 e 34 mães, respectivamente. Treze mães foram acompanhadas nos três momentos. Utilizou-se um questionário para caracterização da população, com a utilização das Escalas de Depressão Pós-Parto de Edimburgo, Apoio Social (MOS-SSS) e Funcionamento familiar (B-FAM). Para a análise de dados foram utilizados testes específicos de acordo com as variáveis correspondentes. Os dados foram apresentados em tabelas e gráficos. O nível de significância adotado em toda a análise foi de 5%. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de Minas Gerais sob o parecer de n° CAAE: 37059020300005149. Resultados: no T0, as principais características da vulnerabilidade familiar que tiveram associação com um pior processo de adaptação familiar foram: não residir em Belo Horizonte; ter um menor grau de escolaridade; ter filhos anteriores de risco; ter um maior número de pessoas residindo no mesmo domicílio; e prematuridade extrema. No período após a alta hospitalar, as principais características da vulnerabilidade familiar que tiveram associação com um pior processo de adaptação familiar foram: a necessidade de reinternação hospitalar da criança e a presença de sintomatologia depressiva, ambas especificamente no T2. O apoio social teve associação positiva com o processo de adaptação familiar em todos os períodos. Conclusão: é possível inferir que o processo de adaptação familiar é contínuo e dinâmico e pode estar diretamente associado a características que compõem o constructo da vulnerabilidade familiar. Além disso, cada família possui características, contextos e realidades singulares, por isso, destaca-se a importância dos enfermeiros e outros profissionais de saúde neste processo, podendo contribuir com estratégias de inclusão da família nos cuidados com o prematuro e com a manutenção de uma relação de apoio e confiança, para que dessa forma seja possível identificar aspectos da vulnerabilidade familiar que possam impactar no processo de adaptação familiar ante ao nascimento de um filho prematuro.

Introduction: the occurrence of premature birth and child development are influenced by biological, economic, behavioral, technological and health aspects of the population. A child's premature birth and hospitalization threaten the autonomy of the family in providing childcare and it modifies family organization to meet the demands of the child. This affects family functioning and adaptation to having a prematurely born child, which may be aggravated in situations of family vulnerability. Objective: to analyze the relationship between aspects of family vulnerability and the process of adapting to the care for a prematurely born child from admission to the Neonatal Intensive Care Unit (NICU) to the first year after hospital discharge. Methods: this is a longitudinal, quantitative study, performed in the city of Belo Horizonte, Minas Gerais. It followed the theoretical framework of the Resiliency Model of Family Stress, Adjustment and Adaptation by McCubbin & McCubbin (1993). Data collection was organized in three stages. The first stage of the research (T0) corresponds to the period of NICU hospitalization, and it was performed in Neonatal Intensive Care Units of a public, nongovernmental hospital. After hospital discharge, the mothers were monitored during two different time periods, from the 1st to the 6th month (T1), and from the 6th to the 12th month (T2). During these stages, data collection occurred in different scenarios, according to the possibilities of location and contact with the families. During T0, the study included 72 mothers of premature newborns of gestational age of less than 32 weeks, hospitalized in the NICU. During T1 and T2, 25 and 34 mothers were monitored, respectively. Thirteen mothers were monitored at all three stages. A questionnaire was used to characterize the population, Edinburgh postnatal depression scale, social support scale (MOS-SSS), and the family functioning scale (B-FAM). Specific tests were used to analyze the data, according to the corresponding variables. Tables and graphs present these data. The entire analysis adopted a 5% level of significance. The study was approved by the Research Ethics Committee of the Federal University of Minas Gerais (CAAE: 37059020300005149). Results: at T0, the main characteristics of family vulnerability associated with a worse family adaptation were residing outside of Belo Horizonte; having a lower level of education; previous at-risk children; having a larger number of people living in the same residence; and extreme prematurity. After hospital discharge, the main characteristics of family vulnerability associated with a worse family adaptation were the need for child rehospitalization, and depressive symptomatology, both specifically during T2. Social support showed a positive association with the process of family adaptation at all moments. Conclusion: the process of family adaptation is continuous and dynamic, and it may directly associate with characteristics of the construct of family vulnerability. Moreover, each family has singular characteristics, contexts, and realities; thus, nurses and other health professionals are important in this process. They may contribute with strategies to include the family in the childcare and to maintain support and trust, making it possible to identify aspects of family vulnerability which may impact on the process of family adaptation to the birth of a premature child.

The influence of social comparison orientation and family function on relocation stress in families of patients transferred from ICU / 中国实用护理杂志

Objective To explore the relocation stress in families of patients transferred from ICU, and the influence of social comparison orientation and family function on it. Methods There were 168 participants recruited from Critical Medical Department of the First Affiliated Hospital of Xi′an Jiaotong University by convenience sampling method between June 2017 and February 2018. The ICU patients′Family Relocation Stress Scale, Chinese version of the Iowa-Netherland Social Comparison Orientation Measure and Family Adaptation and Cohesion Evaluation Scale Ⅱ were used. Results The score of relocation stress and social comparison orientation were 58.47±7.66 and 37.83±9.11. The score of family real cohesion was 65.85 ± 7.83, which was higher than norms (t=-2.067, P<0.05). The score of dissatisfaction of adaptation was 9.22±4.41, which was higher than norms (t=-3.093, P<0.05). The results of regression analysis showed that the time of patient staying in ICU, education level, religion, social comparison orientation, family real cohesion and dissatisfaction of adaptation could influence relocation stress. Conclusion Health professionals should pay attention to the relocation stress in families, provide emotional support and effective information support, guide family members to correctly understand the patients′ condition and prognosis, respect their religious beliefs, give full play to their family functions, help them adapt to the role changes quickly and reduce the level of relocation stress.

Correlation between family cohesion and adaptation and work adaptation in postpartum nurses with second child / 中国实用护理杂志

Objective To explore the correlation between family cohesion and adaptation and work adaptation in postpartum nurses with second child. Methods There were 155 postpartum nurses with second child collected from 4 hospitals in Chengdu of Sichuan Province between October and December 2017, by convenience sampling. Family Adaptation and Cohesion Evaluation Scale Ⅱ and Questionnaire of Return Adaptation for Postpartum Nurse were used in the investigation. Results The family real cohesion, ideal cohesion and dissatisfaction of coherence were (66.95 ± 8.37), (71.68 ± 6.45), (7.87 ± 5.13) points in this study, which were higher than norms: (63.90 ± 8.00), (68.80 ± 5.30), (6.40 ± 5.00) points, and there were significant differences (t=-3.086,-4.079,-2.403, all P<0.05) . The family real adaptation was (48.86 ± 7.33) points, which was less than norms: (50.90 ± 6.20) points, and there was significant difference (t=2.514, P<0.05). The ideal adaptation had no significant difference with norms (P>0.05). The dissatisfaction of adaptation was (9.36±5.22) points, which was higher than norms: (7.40 ± 5.30) points, and there was significant difference (t=-3.076, P<0.05). There were 24 (15.5%) nurses in extreme type family, 54 (34.8%) in intermediate type and 77 (49.7%) in balance type. The average score of work adaptation was (2.41 ± 0.76) points. The scores of work adaptation in nurses of extreme type family were lowest. Time since working, dissatisfaction of adaptation, dissatisfaction of coherence and hospital level were the influencing factors of work adaptation. Conclusions Nursing managers should face up to the situation of work adaptation in postpartum nurses, humanize their management, pay attention to the emotional state, promptly dispel their bad negative emotions, take measurements to improve the understanding of nurses'families and help them pass the adaptation period of returning to work.

Relações familiares de cuidadores de pessoas com deficiência intelectual profunda / Family relations of carers of profound intellectually disabled people

O objetivo desta pesquisa foi estudar as relações familiares no cuidado a pessoas com transtornos crônicos. Participaram desta pesquisa cinco famílias, responsáveis pelo cuidado de pessoas dependentes, com deficiência intelectual profunda, que responderam à escala de Crichton e a uma adaptação do APGAR Familiar (Smilkstein). Os resultados mostraram que as famílias encontram-se integradas na relação de ajuda, participação de seus membros na tomada de decisões, liberdade dos seus membros nas questões financeiras, relação afetiva positiva e tempo que dedicam ao paciente crônico. Nestes casos estudados, a interação familiar não sofreu prejuízo devido à dependência crônica de alguns de seus membros.(AU)

The aim of this research was to study changes in family relations dues to caring of chronic disabled people. Five families responsible for caring of dependent profound intellectually disabled people participated in this research, answering to the Crichton Scale and to the adapted version of the Family APGAR (Smilkstein). Results showed that families are integrated regarding support, family members’ participation in decision making, freedom in financial issues, positive affective relations and time dedicated to the chronic patient. In the cases studied family interaction has not been disturbed by the chronic dependence of some of its members.(AU)

Family Adaptation to Stroke: A Metasynthesis of Qualitative Research based on Double ABCX Model

PURPOSE: There is growing interest in synthesizing qualitative research. Stroke is a very common cause of disability often leaving stroke survivors dependent on their family. This study reports an interpretive review of research into subjective experience of families with stroke survivors based on the components of the Double ABCX Model including stressors, resources, perception, coping strategies, and adaptation of these families. METHODS: Metasynthesis was applied to review qualitative research looking at stroke family members' experiences and responses to having a stroke survivor as a family member. Electronic database from 1990 to 2013 were searched and 18 separate studies were identified. Each study was evaluated using methodological criteria to provide a context for interpretation of substantive findings. Principal findings were extracted and synthesized under the Double ABCX Model elements. RESULTS: Loss of independence and uncertainty (as stressors), struggling with new phase of life (as perception), refocusing time and energy on elements of recovery process (as coping strategy), combined resources including personal, internal and external family support (as resources), and striking a balance (as adaptation) were identified as main categories. Family members of stroke survivor respond cognitively and practically and attempt to keep a balance between survivor's and their own everyday lives. CONCLUSIONS: The results of the study are in conformity with the tenets of the Double ABCX Model. Family adaptation is a dynamic process and the present study findings provide rich information on proper assessment and intervention to the practitioners working with families of stroke survivors.

Analysis of the related factors on family adaptation of hospitalized children / 中国实用护理杂志

Objective The purpose of this study was to identify the effect factors on family adaptation of hospitalized children.Methods A survey was conducted in 330 hospitalized children's parents using questionnaires such as FSI,FVI,FHI,FWBI.Results Multiple factor analysis showed that the strongest resilience factor was family hardiness,the second one was general family value on family adaptation of hospitalized children.Conclusions Family hardiness and family value have the adjusting role on family adaptation of hospitalized children.Therefore,the significance of this study can be used to develop family nursing intervention program based on family resilience to strengthen family adaptation of hospitalized children.

Estresse e adaptação psicossocial em mães de crianças com transtorno de déficit de atenção/hiperatividade / Stress and psychosocial adaptation in mothers of children with attention deficit hyperactivity disorder

O presente estudo investigou o estresse parental em mães de crianças com Transtorno de Déficit de Atenção/Hiperatividade (TDAH) (n=30), de crianças com TDAH e comorbidade com o Transtorno Opositor Desafiador (TOD) (n=30), e com desenvolvimento típico (n=30). Além disso, foram investigadas possíveis correlações do estresse parental, com as estratégias de coping, apoio social e severidade do TDAH. As mães foram avaliadas a partir dos seguintes instrumentos: Questionário de Suporte Social (SSQ); Inventário de Coping Parental - Área da Saúde - CHIP; Questionário de Estresse Parental para Pais de Criança com Transtorno de Desenvolvimento; MTA SNAP-IV Escala de pontuação para pais e professores. Dentre outros fatores, os resultados indicaram que as mães das crianças com TDAH combinado e TDAH + TOD apresentaram mais estresse parental do que mães de crianças com desenvolvimento típico e que o apoio social, o coping auto-estima e médico atuaram como moderadores do estresse parental.

The present study has investigated the parental stress in mothers of children with Attention Deficit Hyperactivity Disorder (ADHD) (n=30), in mothers of children with co-morbidity with the Oppositional Defiant Disorder (ODD) (n=30), and in mothers of children with typical development (n=30). In addition, possible correlations of parental stress with coping strategies, social support and ADHD severity have been investigated. The mothers have been evaluated using the following instruments: (a) Social Support Questionnaire (SSQ); (b) Parental Coping Inventory - Health Area - CHIP; (c) Questionnaire of Parental Stress for Parents of Children with Development Disorder; (d) MTA SNAP-IV Teachers and Parents Rating Scale. The results indicated that mothers of children with ADHD and ADHD + ODD presented more parental stress than mothers of children with typical development. In addition, social support, self-esteem coping and medical coping moderated the parental stress effect.

Aspectos biopsicossociais na surdocegueira / Bio psycho social aspects in deaf blindness

O presente artigo tem por objetivo discutir aspectos biopssicossociais referentes a pessoas com surdocegueira e suas famílias com o objetivo trazer a tona estas questões que se tem mostrado importantes para o desenvolvimento dos atendimentos aos surdocegos. Está baseado em dados bibliográficos de pesquisas com pais e outras divulgações abordando as causas que são, principalmente, Rubéola Congênita, prematuridade, infecções, acidentes, síndromes genéticas ou não. Coloca as conseqüências das mesmas, o desenvolvimento educacional alcançado e as necessidades das famílias em aspectos ligadas às áreas da saúde, educação, lazer, segurança e inclusão social. Também trata da adaptação das famílias ao impacto produzido pela surdocegueira tendo em conta aspectos orgânicos, afetivo-relacional, sócio-culturais e de produtividade. Reflete sobre a necessidade da divulgação dos conhecimentos e da ação conjunta de todas as partes envolvidas nos mais diversos aspectos da vida dos surdocegos para conseguir o desenvolvimento dos atendimentos para os surdocegos.

The objective of the present article is to discuss bio-psycho-social aspects related to people with deaf blindness and their families so as to highlight those issues that have become important for the development of working methods in deaf blindness. It is based on bibliographic data found in research with parents of deaf blind children and other publications that deal with the causes of the condition. The main causes are congenital German measles, prematurity, infection, genetic or non genetic syndromes. The authors discuss the results of the various presentations, the expected educational development and the needs of the families in aspects related to health, education, leisure, safety and social inclusion. They also discusses issues of family adaptation to the impact produced by deaf blindness, taking into account organic, social-cultural, affect and inter-relational aspects, as well as productivity. The article reflects on the importance of divulging information and of common actions by all involved in the various aspects of the life of the deaf blind in order to achieve working methods in the field of deaf blindness.

Influencing Factors on Family Stress, Family Meaning and Family Adaptation in Families with High Risk Neonates / 간호학회지

PURPOSE: The purpose of this study was to identify the relationship among family stress, family meaning and family adaptation of families with high risk neonates. METHOD: The date was collected on the basis of self- report questionnaires (August 2004 to March 2005); Tow-hundred twelve parents, who had high risk neonates in C hospital's neonatal intensive care unit, participated on request. RESULTS: Family sense of coherence, family meaning, social support, family stress, marital communication and patient condition had a significant, direct effect on family adaptation. Family cohesion, religion, confidence in the health professional, and length of stay had a significant, direct effect on family meaning. CONCLUSION: The results of this study suggest the consequences associated with high risk neonates may be alleviated by a family support intervention designed to improve parental communication skills as well as to maintain family cohesiveness. Medical care could also encourage more emotional support of parents towards their neonate.

Family Resiliency Facto for the Adaptation of Family who have a Congenital Heart Disease / 간호학회지

PURPOSE: The purpose of this study was to explore the relationships of family strain, perceived social support, family hardiness, and family adaptation and identify the family resiliency factors for the adaptation of families who have a child with congenital heart disease. METHOD: The sample consisted of 90 families who had a child diagnosed with congenital heart disease and completed surgical treatment. Data was collected from parents using a questionnaire. RESULTS: Results from path analyses revealed that family strain had a direct effect on both perceived social support and family hardiness, and an indirect effect on family adaptation. Also, the findings revealed that perceived social support had a direct effect on both family hardiness and family adaptation, and family hardiness had a direct effect on family adaptation. Thus, these results indicated that perceived social support and family hardiness had a mediating effect on family strain. CONCLUSION: Findings provide the evidence for the theoretical and empirical significance of perceived social support and family hardiness as family resiliency factors for family adaptation. Clinical implications of these findings might be discussed in terms of family-centered nursing interventions for the families who have a child with congenital heart disease based on an understanding of family resiliency for adaptation.

Relationships of Family Value, Vamily Hardiness and Hamily Adaptation in Family who has a Child with Cancer / 아동간호학회지

The purposes of the study were to develop an instrument for family value and to identify the relationships of family value, family hardiness, and family adaptation by appling the family value scale to family with cancer children. The study was conducted in three phases. 1) A survey was conducted from July 20 to August 20, 1999 and 18 items of general family value scale was modified from the data of 153 fathers and 164 mothers. 2) In-depth interviews were made with 29 parents of cancer children from April 20, 1998 to May 20, 1999 to develop family value scale with cancer children, and 12 statements were developed. 3) The final survey was conducted from July 18, 2000 to August 30, 2000 and the data from 309 parents of children who are diagnosed as cancer, 18 or less years of age, and treated either hospitalized or at the outpatient clinics were analyzed to identify the relationships of the concepts. The data analysis utilized SAS 6.12 and LISREL 8 for descriptive statistics, correlation, and Regression for path analysis. The study findings are as follows. The psychometric testing of general family value scale was Cronbach's alpha = 0.78. The reliability of the family value scale with cancer children showed the reliability as Cronbach's alpha = 0.73. Demographic characteristics showing significant correlations were cancer children's age, period of illness, period after completing treatment, mother's age, mother's education level, monthly income, payment type, confidence with health professional, and severity of children's illness. The correlation coefficients among major variables showed that family stressor was positively related with family strains(r=0.33, p < .001), and negatively related with family hardiness(r=-0.21, p < .001). Family strains was negatively related with family hardiness(r= -0.41, p < .001) and family adaptation(r=-0.46, p < .001). Correlations of family hardiness was positive with family value with cancer children(r=-0.31, p < .001), and negative with general family value(r=-0.16, p < .01). Family hardiness was positively related with family adaptation(r=0.35, p < .001). The causal relationship between study variables showed that family strains predicts general family value( gamma =0.12, t=2.02), family value with cancer children predicts family hardiness( gamma =0.31, t=6.30), family strains predicts family hardiness( gamma =-0.40, t=-7.70), family value with cancer children predicts family adaptation( gamma =-0.23, t=-4.11), and family hardiness predicts family adaptation( gamma =0.43, t=7.78).

Effects of Family Value on Family Adaptation in Family Who has a Child with Cancer / 아동간호학회지

As a family respond to any stressful situation as a whole system, cancer diagnosis of a child, as a serious life event, could be emotional shock to destroy homeostasis of the family system. A family has a resilient capacity to adjust and adapt to stressful events. Previous studies have been focused on family stress and adaptation, but little attention has been given to family value as one of resilient factors. The data for model testing were collected from July 18, 2000 to August 30, 2000 and the analysis included 309 parents of children who are diagnosed as cancer, 18 or less years of age, and treated either hospitalized or at the outpatient clinics. The data analysis utilized SAS 6.12 and LISREL 8 for descriptive statistics, correlation, cluster analysis, factor analysis, and LISREL. The study findings are as follows. 1) Monthly income ( gamma =-0.28, t=-5.81) was the most important factor to explain family strain along with family support ( gamma =-0.11, t=-2.43), severity of children's illness ( gamma =0.26, t=5.22), and family stressor ( gamma =0.22, t=4.62). All of these factors together explained 40% of variance in family strain. 2) Among general family value, the relationship with the parents ( gamma =0.28, t=4.89) and relationship with the children ( gamma =0.20, t=3.60) showed positive effects to family value for cancer children, while relationship with the spouse ( gamma =-0.19, t=-3.22) and the age of the cancer children ( gamma =-0.11, t=-2.21) showed negative effects. These predictors together explained 22% of variance in family value for cancer children. 3)Family hardiness was explained mostly by family strain ( gamma =-0.53, t=-8.65) along with direct negative effects of family persistency and indirect negative effects of severity of children's illness, family stressor, relationship with the spouse, and the children's age. Family value for cancer children was the most important predictor with positive effect ( gamma =0.44, t=6.76) along with indirect effects of monthly income, relationship with the parents, relationship with the children, support from family and significant others, and confidence with the health professionals. 51% of variance in family hardiness was explained by all of these predictors. 4)The most important predictor for family adaptation was family stressor ( gamma =-0.50, t=-6.85) with direct and indirect negative effects along with the severity of children's illness ( gamma =-0.27, t=-5.21). However, family value for cancer children showed compromised total effect ( gamma =-0.13, t=-1.99) with negative direct effects ( gamma =-0.28, t=-3.43) and positive indirect effects ( gamma =0.14, t=3.01). Similarly, confidence with the health professionals also showed compromised total effect ( gamma =0.09, t=1.99) with positive direct effects and negative indirect effects. Family hardiness showed the biggest positive direct effects while other factors such as monthly income, family stressor, family persistence, support of family and significant others, relationship with the parents, relationship with the children, and relationship with the spouse, and children's age showed indirect effects only. 39% of variance in family adaptation was explained by all of these predictors.

Effects of Family Value on Family Adaptation in Family Who has a Child with Cancer / 아동간호학회지

As a family respond to any stressful situation as a whole system, cancer diagnosis of a child, as a serious life event, could be emotional shock to destroy homeostasis of the family system. A family has a resilient capacity to adjust and adapt to stressful events. Previous studies have been focused on family stress and adaptation, but little attention has been given to family value as one of resilient factors. The data for model testing were collected from July 18, 2000 to August 30, 2000 and the analysis included 309 parents of children who are diagnosed as cancer, 18 or less years of age, and treated either hospitalized or at the outpatient clinics. The data analysis utilized SAS 6.12 and LISREL 8 for descriptive statistics, correlation, cluster analysis, factor analysis, and LISREL. The study findings are as follows. 1) Monthly income ( gamma =-0.28, t=-5.81) was the most important factor to explain family strain along with family support ( gamma =-0.11, t=-2.43), severity of children's illness ( gamma =0.26, t=5.22), and family stressor ( gamma =0.22, t=4.62). All of these factors together explained 40% of variance in family strain. 2) Among general family value, the relationship with the parents ( gamma =0.28, t=4.89) and relationship with the children ( gamma =0.20, t=3.60) showed positive effects to family value for cancer children, while relationship with the spouse ( gamma =-0.19, t=-3.22) and the age of the cancer children ( gamma =-0.11, t=-2.21) showed negative effects. These predictors together explained 22% of variance in family value for cancer children. 3)Family hardiness was explained mostly by family strain ( gamma =-0.53, t=-8.65) along with direct negative effects of family persistency and indirect negative effects of severity of children's illness, family stressor, relationship with the spouse, and the children's age. Family value for cancer children was the most important predictor with positive effect ( gamma =0.44, t=6.76) along with indirect effects of monthly income, relationship with the parents, relationship with the children, support from family and significant others, and confidence with the health professionals. 51% of variance in family hardiness was explained by all of these predictors. 4)The most important predictor for family adaptation was family stressor ( gamma =-0.50, t=-6.85) with direct and indirect negative effects along with the severity of children's illness ( gamma =-0.27, t=-5.21). However, family value for cancer children showed compromised total effect ( gamma =-0.13, t=-1.99) with negative direct effects ( gamma =-0.28, t=-3.43) and positive indirect effects ( gamma =0.14, t=3.01). Similarly, confidence with the health professionals also showed compromised total effect ( gamma =0.09, t=1.99) with positive direct effects and negative indirect effects. Family hardiness showed the biggest positive direct effects while other factors such as monthly income, family stressor, family persistence, support of family and significant others, relationship with the parents, relationship with the children, and relationship with the spouse, and children's age showed indirect effects only. 39% of variance in family adaptation was explained by all of these predictors.

Stress and Adaptation in Family with Physical Disabled Children / 간호학회지

The purpose of this study was to describe the relationship between family stress and adaptation in families with a disabled child through literature review using McCubbin's Double ABCX family crisis framework. The literature review focused on (1) family stress and factors affecting family stress, (2) the critical individual, familial and social resources which families acquire and employ over time in managing crisis situation, (3) the changes in definition and meaning families develop in an effort to make sense out of their predicament, (4) the coping strategies families employ, and (5) the range of outcomes of these family efforts The results showed that families reported financial difficulties and the burden of care-giving demands as major family stressors. Siblings of disabled children manifested depressive symptoms and social isolation, but was not consistent study results. The parents' views of the cause of the disabling condition fundamentally affected their behavior toward their disabled child. Especially, the fathers' views of the child's characteristics made the greatest contribution to positive changes in the mothers' perceptions. The term perceived social support refers to the cognitive appraisal by individuals that they are cared for and valued, that significant others are available to them if needed, and that they are satisfied with their interpersonal relationships. The perceived social support was more protective than social support source, network size and network density. Parental adaptation was found to be related to the child's communication competence rather than family coping strategies proposed by Lazarus and Folkman. One study results showed that there was no difference in depressive symptoms and physical health between mothers with a disabled child and those without all though mothers with a disabled child had negative attitudes and perceived themselves as having significantly less social support and lower family functioning. But a longitudinal study revealed decreases in the negative impact of the child and increases in sibling and overall family adaptation.