Family oriented intervention for families of adolescents with attention deficit hyperactivity disorder: A feasibility study.

PURPOSE: Based on eight research criteria, this study examines the feasibility of a 5-week Family Strength-Oriented Therapeutic Conversation (FAM-SOTC) for caregivers of adolescents diagnosed with attention deficit hyperactivity disorder (ADHD); this intervention aims to improve outcomes of both caregivers and adolescents. DESIGN AND METHODS: The FAM-SOTC intervention was implemented at an adolescent psychiatric outpatient unit with 10 caregivers of 10 adolescents diagnosed with ADHD. The feasibility criteria were addressed through survey responses, diary reports, and a one-group pre- and posttest quasi-experimental design. FINDINGS: The assessment of eight feasibility criteria showed promising results for the further evaluation of the intervention. PRACTICAL IMPLICATIONS: This feasibility study has produced promising results, which represent a step toward a more extensive study, designed to evaluate a protocol that may offer educational and supportive programs for families of adolescents with ADHD, enhancing their self-management behavior. Further studies are warranted to test the FAM-SOTC intervention using a larger sample.

Long-Term Effect of Receiving a Family Strengths-Oriented Intervention on Family Cancer Caregiver Stress, Anxiety, and Depression Symptoms: A Longitudinal Quasi-Experimental Study.

The aim of this longitudinal study was to evaluate the long-term effects of providing a therapeutic conversation intervention, based on Family Systems Nursing, to family caregivers of a close relative with advanced cancer over the period before and during bereavement. To prevent adverse outcomes, caregivers need ongoing support that begins pre-loss and extends into the post-loss period. This study employed a one-group pre-test, post-test quasi-experimental design. Twenty-four caregivers participated in two intervention trials conducted over a 42-month period, receiving two intervention sessions pre-loss (Trial 1) and one intervention session post-loss (Trial 2). Significant decreases in anxiety and stress were noted over the three post-loss assessments. The final post-loss stress outcome was significantly lower than the first pre-loss score. For the depression score, there was not a significant change over time within the pre- or post-loss period. The findings provide evidence of decreasing anxiety and stress following the implementation of an extended family nursing intervention for bereaved family caregivers.

The Impact of Receiving a Family-Oriented Therapeutic Conversation Intervention Before and During Bereavement Among Family Cancer Caregivers: A Nonrandomized Trial.

Effective communication is the foundation of quality care in palliative nursing. As frontline palliative home care providers, nurses could foster more effective bereavement coping skills through therapeutic conversations. The purpose of this study was to evaluate the impact of a nursing intervention offered to bereaved family cancer caregivers. This was a quasi-experimental design, with a posttest-only comparison of the intervention and control groups receiving usual care. Bereaved caregivers (n = 51) receiving services from a specialized palliative home care unit participated and completed measures of depression, anxiety, stress, and grief reactions 3, 5, and 6 months after their close relative had died.There was a significant decrease in anxiety symptoms in the intervention group compared with the control group across all 3 time points. Anxiety and stress symptoms also decreased over time in the 2 groups combined, but this decrease was not observed for depression. When evaluating grief reactions, the intervention group had a lower mean of controlled grief responses, across the posttest period, than the control group.Results demonstrate that providing bereaved family caregivers the opportunity to participate in a therapeutic conversation intervention might reduce distressing symptoms in early bereavement.

The effectivness of a strengths-oriented therapeutic conversation intervention on perceived support, well-being and burden among family caregivers in palliative home-care.

AIMS: To evaluate the effectiveness of a two-session multicomponent family strengths- oriented therapeutic conversation intervention among family caregivers of an individual with advanced/final stage cancer during ongoing palliative home-care. BACKGROUND: Family caregivers of patients in the advanced/final phases of cancer, experience multifaceted psychological distress and morbidity. Psychosocial interventions improve the well-being of family members who are caring for their close relative. DESIGN: A pre-experimental design with a one-group pre-test/posttests measurements. METHODS: Forty-eight family caregivers were assigned to receive two 60-90 min sessions of the intervention. The primary outcome was perceived emotional and cognitive support and psychological well-being, measured at baseline (T1). Then the participants were offered the first session of the intervention. About 1 week later, the second session was administered. The participants answered the same questionnaires again (T2) and then 2-4 weeks later (T3). The guideline; Criteria for Reporting Development and Evaluation of Complex Interventions 2, guided the reporting of the study. RESULTS: Family caregivers reported significantly higher emotional and cognitive support post-intervention (T2) and at (T3). They also reported significantly reduced stress symptoms at (T3) and reduced caregiver burden post-intervention (T2) and at (T3). CONCLUSION: The provision of the intervention contributed to extending knowledge about the usefulness of family conversations in the context of advanced/final stage cancer care. IMPACT: There is a lack of knowledge about the benefit of therapeutic conversation interventions for family caregivers. The therapeutic conversation intervention offered, resulted in perceived support, decreased stress, and decreased caregiving demands among caregivers in palliative home-care. TRIAL REGISTRATION NUMBER: ISRCTN 21786830.

The impact of implementing an educational intervention to enhance a family-oriented approach in specialised palliative home care: A quasi-experimental study.

RATIONALE: Healthcare providers' beliefs, attitudes, experiences and knowledge, which guide the care they deliver, are the key factors influencing the quality of palliative care. Education and coaching innovation are needed to translate research outcomes and adopt evidence-based nursing care into practice. OBJECTIVES: To evaluate the impact of an advanced educational and coaching programme in a family systems' nursing approach for palliative care nurses in a home-care setting. METHODS: A quasi-experimental study using qualitative data from open-ended questions to augment the quantitative outcome study that included a single-group, pre- and post-test design. A total population sample of nurses was recruited from a specialised palliative home care unit at a university hospital. The study utilised two self-reported questionnaires. RESULTS: There was a statistically significant increase in the nurses' critical appraisal of clinical nursing practice related to family nursing after participation in the educational programme than before. No statistical difference was found in items related to nurses' experience of the interaction and reciprocity in the nurse-family relationship after participation in the programme than compared to before or in nurses' cancer-related beliefs. However, there was an overall significant positive change found in attitudes towards families in the total score of the Family Practice Scale. Nurses were also more positive about the further development of their knowledge and skills in advanced family nursing evident in the qualitative data. CONCLUSION: An advanced educational intervention programme was successful in improving the nurses' knowledge, skills, satisfaction and confidence in relation to applied family nursing approach within the context of caring for families affected by advanced/final stage cancer. However, further refinement of the implementation process is needed to enhance family care improvement and the nurses' professional development in advanced family nursing in specialised palliative care.