Designing a resilience-based intervention program for children with cancer and their families: a study protocol.

Background: Advances in pediatric oncology have significantly increased survival rates, yet have introduced challenges in managing long-term treatment side effects. This study process introduces an interdisciplinary clinical intervention program rooted in the family resilience framework, aimed at improving well-being across the cancer trajectory for children and their families, especially those in Canadian communities far from specialized oncology centers with limited access to resources. Methods: Employing an intervention mapping approach, this program collaboratively involves patients, families, professionals, and researchers. It aims to identify vulnerability factors, establish a logic model of change, and devise comprehensive strategies that include professional interventions alongside self-management tools. These strategies, tailored to address biopsychosocial and spiritual challenges, are adapted to the unique contexts of communities distant from specialized cancer treatment centers. A mixed-methods approach will evaluate program effectiveness. Expected results: Anticipated outcomes include the empowerment of families with self-management tools and professional support, designed to mitigate biopsychosocial and spiritual complications. By addressing the specific needs and limitations of these communities, the program strives to improve the overall health and well-being of both undergoing treatment and survivorship phases. Discussion: By focusing on comprehensive care that includes both professional interventions and self-management, this initiative marks a significant shift toward a holistic, family-centered approach in pediatric oncology care for remote communities. It underlines the necessity of accessible interventions that confront immediate and long-term challenges, aiming to elevate the standard of care by emphasizing resilience, professional support, and family empowerment in underserved areas.

Relationship between Perceived Family Resilience, Emotional Flexibility, and Anxiety Symptoms: a Parent-Adolescent Dyadic Perspective.

Family resilience is crucial for individual's psychological health. Previous studies explored the protective factors of anxiety at the individual level, with less attention paid to the impact of family interaction from a dyadic perspective. This study utilized the Actor-Partner Interdependence Mediation Model to investigate the relationship between family resilience, emotional flexibility, and anxiety symptoms. A sample of 2144 Chinese parent-adolescent dyads (36% upper grades of primary school, 64% secondary school, 49.39% girls; 70.38% mothers) was recruited. Perceived family resilience was inversely related to anxiety symptoms, directly or indirectly, through the mediation of emotional flexibility at the individual level. At the dyadic level, adolescents' perceived family resilience was significantly associated with parents' anxiety symptoms through their own or parents' emotional flexibility. Parents' perceived family resilience was inversely link to adolescents' anxiety symptoms through parents' emotional flexibility. Parents emotional flexibility also mediated the association between adolescents' perceived family resilience and their anxiety symptoms. These findings contribute to understanding the intricate dynamics of family resilience and psychological outcomes in parent-child relationships under adversity, emphasizing the need for child-centered interventions to improve family members' mental health.

Implications of Cash Transfer Programs for Mental Health Promotion among Families Facing Significant Stressors: Using Ecological Systems Theory to Explain Successes of Conditional and Unconditional Programs.

The purpose of this paper is to apply Bronfenbrenner's ecological systems theory to explore the literature on how Conditional Cash Transfer (CCT) and Unconditional Cash Transfer (UCT) programs might support positive mental health outcomes. The paper begins with transnational considerations of stress, such as poverty and COVID-19, and their impact on mental health. Bronfenbrenner's theory is applied to better understand the mechanisms by which CCT and UCT programs can potentially lead to positive outcomes for children and families who face such stressors. The implications of cash transfer programs are subsequently discussed in terms of how they might promote positive mental health outcomes among families globally. This theoretical application paper concludes with a call for transnational research to explore connections between cash transfer programs and mental health outcomes for children/adolescents and their parents/caregivers.

The mediating role of perceived stress in the association between family resilience and psychological distress among gynecological cancer patients: a cross-sectional study.

BACKGROUND: Gynecological cancer patients face various stressors and suffer from severe psychological distress. The activation of family resilience supports patients to overcome daily stressors, yet the relationship between family resilience and psychological distress is poorly understood. The purpose of this study is to investigate the degree of psychological distress in patients diagnosed with gynecological cancer, and whether perceived stress mediate the relationship between family resilience and psychological distress. METHODS: A cross-sectional study was undertaken on 358 gynecological cancer patients in China from September 2021 to November 2022. The participants completed surveys that included the Chinese Version of the Family Resilience Assessment Scale, the Perceived Stress Scale, the Hospital Anxiety and Depression Scale, the Distress Management Screening Measure, and socio-demographic questions. Using Pearson's correlation analysis to investigate the association between variables, and the bias corrected bootstrapping method was utilized to establish perceived stress as a mediator. RESULTS: Chinese patients with gynecological cancer experienced a moderate psychological distress. In addition, psychological distress exhibited a negative correlation with family resilience and a positive correlation with perceived stress in gynecological cancer patients (both P < 0.01). Perceived stress partially mediated the correlation between family resilience and psychological distress (ß=-0.182; 95% CI: -0.224 to -0.140; P < 0.001). The total indirect effect value was - 0.182, and the total effect value was - 3.060. CONCLUSIONS: The findings indicate that higher family resilience and lower perceived stress can reduce psychological distress in gynecological cancer patients, and family resilience also tends to reduce perceived stress in cancer patients. Clinical staff and psychologist should consciously cultivate patients' family resilience to reduce psychological distress. Meanwhile, identifying potential mediators between family resilience and psychological distress are able to promote the development and assessment of interventions in the future.

Parent-adolescent family resilience and psychological adjustment in chronically ill adolescents: An actor-partner interdependence mediation model.

AIMS: This study explored the relationships between family resilience, dyadic coping and psychological adjustment among adolescents with chronic illnesses and their parents. The actor-partner interdependence mediation model was used to validate the mediating role of dyadic coping in the relationship between family resilience and psychological adjustment. DESIGN: This is a cross-sectional study. METHODS: A total of 318 parent-adolescents dyads were recruited from three paediatric hospitals in Wenzhou, Hangzhou, Shanghai city, China, between June 2022 and August 2023. The parents had a mean age of 41.62 years, and the adolescents had a mean age of 12.66 years. Participants independently completed a self-report questionnaire assessed family resilience, dyadic coping and psychological adjustment. Data analysis was conducted using the actor-partner interdependence mediation model. RESULTS: The findings suggest that in the actor effects, family resilience directly influenced psychological adjustment, and family resilience is related to psychological adjustment through positive dyadic coping. In the partner effect, parents' family resilience influenced adolescents' psychological adjustment through the parents' positive dyadic coping. Similarly, adolescents' family resilience influenced parents' psychological adjustment through both parents' positive dyadic coping and adolescents' negative dyadic coping. Additionally, there was a partner effect between parents' family resilience and adolescents' psychological adjustment. CONCLUSION: This study demonstrated the importance of developing effective dyadic interventions based on family resilience or positive dyadic coping strategies to improve the mental health of adolescents with chronic illnesses and their parents. IMPACT: The mediating role of dyadic coping in the relationship between family resilience and psychological adjustment among adolescents with chronic illnesses and their parents was demonstrated. Future psychosocial interventions should focus on increasing parents' positive dyadic coping strategies and improving adolescents' negative dyadic coping strategies. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Family resilience experiences of individuals with schizophrenia-family caregivers dyads: Qualitative study.

WHAT IS KNOWN ON THE SUBJECT?: Family resilience is an important determinant of family caregivers' coping with difficulties of life and stress effectively. Family resilience factors contribute to the family's adaptation to difficulties. From the perspective of the individual living with schizophrenia and family, family resilience focuses not on the losses experienced but on the strengths. WHAT DOES THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Many factors such as routines, positive cognitions, intra-family communication, family support and love as a healing force that contribute to family resilience were identified from the common perspective of the individual diagnosed with schizophrenia-family caregiver dyads. The climate of love within the family is an important strength both for the patient diagnosed with schizophrenia and for the family caregivers. Mutual support between family members, their listening to each other and sharing experiences with each other during this disease process are therapeutic for both parties and make them resilient. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Family resilience factors should be considered in planning psychosocial interventions to be applied to individuals diagnosed with schizophrenia and family caregivers. The clinical use of psychosocial support interventions in family resilience which help both the individual diagnosed with schizophrenia and the family caregivers to gain a positive perspective, to improve their problem-solving skills, and to support each other within the family should be expanded. Displaying approaches aimed at increasing the climate of love and strengthening correct communication techniques within the family towards both the individual diagnosed with schizophrenia and the family caregiver should be supported. Psychiatric nurses' focusing on family resilience from a systemic perspective in chronic mental illnesses such as schizophrenia strengthens the patient and the family. This perspective focuses on functional dimensions and protects mental health despite existing problems. ABSTRACT: INTRODUCTION: Family resilience is one of the important concepts that should be addressed in chronic mental illnesses. AIM: This study was aimed at investigating family resilience experiences from the perspective of individuals diagnosed with schizophrenia-family caregiver dyads. METHOD: The study was conducted in the Adult Psychiatry inpatient and outpatient unit of a university hospital in a province in western Turkey using the phenomenological method. By using the purposeful sampling method, 20 participants were selected in the study. Of them, 10 were family caregivers and 10 were patients diagnosed with schizophrenia. The results of the study were analysed with a dyadic approach within the framework of key processes of Walsh family resilience model. The directed content analysis method was used to analyse the data obtained from the study. COREQ checklist was used to report the research. RESULTS: After the analysis, the following five main themes emerged: positive cognitions, routines, family support, intra-family communication and love as a healing force. DISCUSSION: Family resilience is a structure shaped by the relationship between family members. The factors that contribute to the individual diagnosed with schizophrenia-caregiver dyads' ability to overcome difficulties in family resilience are discussed in line with the relevant literature. IMPLICATIONS FOR PRACTICE: Intervention programs should be implemented to create an environment of love by improving relationships and communication in the family, improving problem solving and increasing support resources.

Illness perception and family resilience in gynaecologic cancer patients: A study on the mediating role of hope.

OBJECTIVE: To investigate the level of family resilience among patients with gynaecologic cancer and explore hope as a mediator between perceptions of illness and family resilience. DESIGN: A cross-sectional study. METHOD: From May to October 2022, researchers used convenience sampling to survey 320 patients with gynaecological cancer at a level 3A hospital in Jinan City. The study instruments included the General Information Questionnaire, Family Hardiness Index, Brief Illness Perception Questionnaire, and Herth Hope Index. SPSS 26.0 was used to analyse the mediation effect of hope. RESULTS: The mean score for family resilience was 55.86 ± 8.62. Illness perception was negatively associated with family resilience, while hope was positively associated with it. Additionally, hope mediated the relationship between illness perception and family resilience. CONCLUSION: There is considerable room for improvement in family resilience among patients with gynaecologic cancer. Interventions aimed at increasing hope can enhance family resilience. IMPACT: Healthcare providers can boost family resilience by fostering hope in patients, thereby promoting effective coping and adaptation to cancer. PATIENT OR PUBLIC CONTRIBUTION: Patients primarily completed the questionnaires, providing insights into the factors that hindered and facilitated the development of family resilience. These findings were communicated to caregivers for further understanding and action.

The mediating roles of caregiver needs and caregiver readiness in the relation between family resilience and benefit finding in family caregivers of patients with stroke in China.

OBJECTIVES: The purpose of this study was to assess the effects of family resilience, caregiver needs, and caregiver readiness on benefit finding for family caregivers of patients with stroke and to examine the mediating role of caregiver needs and caregiver readiness between family resilience and benefit finding. METHODS: In this cross-sectional study, convenience sampling was designed and used to recruit participants from three general hospitals in Jinan, Shandong Province, China, from February to September 2022, in which 340 participants completed the General Information Questionnaire, Chinese version of the Family Resilience Assessment Scale (C-FRAS), Caregiver Needs Assessment Scale (CNAS) Chinese version of the Caregiver Preparedness Scale (C-CPS), and Caregiver Benefit Finding Scale (CBFS). Model 6 in process version 4.0 was used to test the chain mediation model between family resilience and benefit finding for caregiver needs and caregiver readiness. RESULTS: Correlation analysis showed that benefit finding in family caregivers was positively associated with family resilience and caregiver readiness and negatively associated with caregiver needs; mediation model tests showed that the total indirect effect of family resilience on benefit finding was 0.163, with the specific mediating effects of caregiver needs and caregiver readiness accounting for 33.74% and 59.51%, and the chain mediating effect of both accounting for 6.75%. CONCLUSIONS: Family resilience not only directly influences benefit finding for family caregivers but also indirectly affects benefit finding through caregiver needs and caregiver readiness. Caregiver needs and caregiver readiness have a mediating role between family resilience and benefit finding in family caregivers.

Family resilience in a social-ecological context - emotional difficulties and coping strategies.

Introduction: This research explored how crises such as the pandemic influence the family dynamic and the way that the parents and the children face new difficulties and challenges. The present study investigates children's and young people's emotional states, the dimensions of family resilience, and the types of coping strategies and parents' emotional states during the coronavirus pandemic. The final sample for the research was represented by 1,010 parents from Romania. Methods: The present scientific research is a transversal study with the scope to understand the emotional difficulties that parents and children/ young people face and the coping strategies that they adopt in a crisis, such as the time of the coronavirus pandemic. Results: Parents with maladaptive coping strategies are more affected by the pandemic. Also, the results indicate that there is a significant correlation between parental coping strategies and the children's emotional states, and the adaptability level. Therefore, the high scores on the subscales which measure maladaptive coping indicate high scores of the levels of depression, anxiety, and stress of the parents. Family resilience, through the dimension of 'communication and problem-solving in the family' has a moderation role in the relationship between parental depression and the maladaptive coping strategy of rumination. Family resilience through 'maintaining a positive attitude' has a moderation role in the relationship between catastrophizing and the teenagers' level of adaptability. Discussion: The results of the study pointed out the role and place of family resilience within the family system and how a period of crisis can affect this system.

Family resilience mediates exposure to adverse childhood experiences on insufficient sleep among children: findings from a population-based study.

Background: Sleep plays a vital role in the well-being of children and adolescents. Researchers have identified adverse childhood experiences (ACEs) as an important factor associated with poor sleep among adolescents. The objective of this study was to examine the mediating role of family resilience on the association between ACEs and insufficient sleep among adolescents in the United States. Methods: Data for this study came from the 2018-2019 National Survey of Children's Health (N = 28,097). The outcome variable in this study was insufficient sleep, and the main explanatory variable was exposure to ACEs. The mediating variable was family resilience. Data were analyzed using binary logistic regression. Results: Based on parent reports, one in five (22.4%) adolescents did not meet the recommended sleep hours on an average night. About half of the adolescents had no ACEs, 24.2% had one ACE, and 14.6% had three or more ACEs. Controlling for the effect of other factors and family resilience, the odds of having insufficient sleep were 1.63 times higher for children exposed to three or more ACEs (AOR = 1.63, 95% CI = 1.30-2.05). Family resilience partially mediates the association between exposure to ACEs and insufficient sleep. Each additional increase in family resilience decreased the odds of having insufficient sleep by a factor of 12% (AOR = 0.88, 95% CI = 0.86-0.91). Conclusions: Family resilience partially mediated exposure to ACEs on insufficient sleep. There are modifiable factors that may improve sleep outcomes among adolescents who have been exposed to adversity. Future research can help elucidate findings and establish the directionality of this association.

The effect of social activities on the alienation and family resilience of Chinese caregivers for children with autism: a latent class analysis.

Introduction: Caregivers of children with autism spectrum disorder (ASD) in China often experience alienation due to societal stigma. While this alienation detrimentally impacts their mental well-being, family resilience serves as a protective factor. Previous research has predominantly examined the social support derived from social activities but has neglected to delve into the specific patterns of these activities. The primary objective of this study was twofold: firstly, to gain insights into the various social activities engaged in by caregivers of children with autism in China, and secondly, to ascertain the influence of these social activities on alienation and family resilience. Methods: Between June and August 2023, a cross-sectional survey was carried out across multiple cities in Jilin Province, aiming to gather data from a total of 205 Chinese caregivers of children with autism. Data collection was conducted through the utilization of a structured questionnaire. The assessment of social activity involved the completion of 12 questionnaires, while alienation was evaluated using the Generalized Alienation Scale (GSAS), and family resilience was gauged through the Chinese version of the Family Resilience Scale (FaRE). The classification of social activities was conducted through latent class analysis (LCA), while the impact of these social activities on alienation and family resilience was examined using linear regression analysis. Results: The findings revealed that social activities can be categorized into five types (Low, Self-Recreation, Communication, Web Surfing, High). Communication social activities were found to reduce family resilience(ß=.332, p<0.01), while high social activities were associated with reduced alienation(ß=-.349, p<0.05) and increased family resilience(ß=.417, p<0.01). Conclusion: Supporting these particular types of social activities has the potential to reduce alienation and bolster family resilience among caregivers for children with autism in China.

Social support and family resilience among Chinese people receiving maintenance hemodialysis: A polynomial regression and response surface analysis explaining psychological resilience.

Psychological resilience plays an important role in overcoming emotional distress among people receiving maintenance hemodialysis (MHD). This study aimed to investigate how social support and family resilience interact to influence psychological resilience among Chinese people receiving MHD. This was a prospective longitudinal study with three time points: baseline (T1), 3 months (T2), and 6 months (T3) later. A convenience sample of 252 participants (67.1% male; 57.6 ± 13.8 years of age) from Zhejiang Province, China, who completed baseline measures of social support, family resilience, and psychological resilience, were further assessed for psychological resilience at T2 and T3. Polynomial regression (PR) and response surface analysis (RSA) were used to analyze the data. At all time points, and in the case of agreement between social support and family resilience, the combined effect of both variables manifested as a positive linear association with psychological resilience. Instead, at baseline, and in case of disagreement, the same combined effect manifested as a negative linear relationship related to psychological resilience. The findings highlighted the importance of considering the conjoint influence of social support and family resilience when developing interventions to improve the psychological resilience of people receiving MHD.

The association between self-efficacy, perceived social support, and family resilience in patients undergoing hemodialysis: a cross-sectional study.

BACKGROUND: Self-efficacy of patients on hemodialysis is considered a main component of the successful management of chronic kidney diseases. The self-efficacy of these patients may be influenced by many individual and social factors. This study aimed to assess the association between perceived self-efficacy and social support by patients on hemodialysis treatment and the resilience of their families. METHODS: This cross-sectional study was conducted on 183 patients and 183 families of hemodialysis patients in the largest hemodialysis center in northwest of Iran. Data was collected from July to December 2021 using chronic kidney disease self-efficacy, multidimensional perceived social support (MSPSS), and the Walsh family resilience questionnaire (WFRQ). The collected data were analyzed by SPSS software using descriptive and inferential statistical tests. RESULTS: The findings showed that the mean score of patients' self-efficacy was 171.63 ± 38.19 in a possible range of 25 to 250. Moreover, the mean score of perceived social support was 62.12 ± 16.12 in a possible range of 7 to 84. The mean total score of family resilience was 119.08 ± 26.20 in a possible range of 32 to 84. Also, the results of the study showed a positive and significant relationship between the self-efficacy of patients with their perceived social support and the resilience of their families (p < 0.01). CONCLUSION: The results of the study showed that there is a significant relationship between patient self-efficacy and family resilience and social support received in chronic kidney patients undergoing hemodialysis. Therefore, it is suggested to consider practical strategies in the field of family resilience and social support to improve patients' self-efficacy.

Post-stroke family resilience is correlated with family functioning among stroke survivors: The mediating role of patient's coping and self-efficacy.

AIM: Family resilience and healthy family functioning are crucial for stroke survivors' rehabilitation. This study aimed to determine the mediating effects of self-efficacy and confrontation coping on the relationship between family resilience and functioning among patients with first-episode stroke. DESIGN: A cross-sectional design was applied. METHODS: 288 patients with first-episode stroke were recruited from 7 hospitals in Shangqiu and Shanghai, China, from July 2020 to October 2020. A shortened Chinese version of the Family Resilience Assessment Scale, family adaptation, partnership, growth, affection and resolve questionnaire, Medical Coping Modes Questionnaire, and Self-efficacy for Chronic Disease 6-item Scale were used to collect the self-reported data. The relationships among the studied variables were studied using spearman correlation and structural equation model. RESULTS: The average level of family functioning among stroke patients was 7.87 (SD = 2.32). About 26.8% (n = 76) of patients reported family dysfunction. The structural equation model showed that family resilience directly affected patients' satisfaction with family functioning (r = 0.406, p < 0.001) and indirectly affected the mediating role of patients' self-efficacy and confrontation coping style (r = 0.119, p < 0.001). The model was with good fit (χ2/df = 2.128, RMSEA = 0.065, GFI = 0.956, AGFI = 0.919, NFI = 0.949, and TLI = 0.956). CONCLUSION: Family resilience and functioning among patients with first-episode stroke are positively associated with the mediating effects of the patients' confrontation coping style and self-efficacy between family resilience and functioning. The findings indicate that the professionals should pay special attention to families exhibiting poor family resilience or with patients who rarely use confrontation coping styles or with poor self-efficacy since they are more likely to suffer from low functioning.

Family adjustment and resilience after a parental cancer diagnosis.

PURPOSE: To explore the resources, parents with cancer and their partners draw upon to sustain their family resilience through the cancer experience. METHODS: Fifteen participants who were parents of children aged 8 to 25 years completed phone, audio-recorded, and semi-structured interviews. Of these participants, 11 were parents diagnosed with cancer, and four were partners of a parent diagnosed with cancer. Interview questions aimed to increase understanding about how families communicate, connect, and face challenges from the cancer experience. Interview data was analysed using inductive thematic analysis to provide scope to generate themes from parent's experiences rather than to test pre-existing frameworks. RESULTS: The thematic analysis of interview transcripts generated three key themes related to family resilience: (1) adaptability to changes in roles and routines, (2) open communication within the family, and (3) accepting support from others. CONCLUSION: This study found that parents' ability to use personal resources when faced with significant challenges helped to improve the resilience of parents' family system. Further research is needed to understand the factors that influence family resilience when a parent is diagnosed with cancer. Implications for the development of targeted interventions that provide support to not only the patient, but their whole family system will be discussed.

The mediating effect of perceived social support between family resilience and meaning in life in breast cancer patients.

PURPOSE: The beneficial effects of family resilience and meaning in life on patients are established, but limited is known for the effect of perceived social support. We aim to investigate the impact of family resilience on the meaning of life among Chinese patients with breast cancer (BC) and to further detect whether perceived social support mediated this association. METHODS: From February to June 2022, we conducted this cross-sectional study with 276 women who were diagnosed with BC in a tertial hospital in Guangdong province, China. The Chinese version of Meaning in Life Scale (C-MiLS) was used to measure the meaning in life. The Chinese version of the family resilience assessment scale (C-FRAS) and the perceived social support scale (PSSS) were adopted to obtain the family resilience and perceived social support, respectively. The mediating effect of perceived spousal support was estimated using the bootstrapped confidence interval (CI) via IBM SPSS AMOS 22.0. RESULTS: The mean scores were 60.79 ± 11.63 for meaning in life, 82.08 ± 11.48 for family resilience, and 62.72 ± 12.19 for perceived social support, respectively. Our results indicated the positive correlations of meaning in life with family resilience (ß = 0.822, P < 0.05) and perceived social support (ß = 0.886, P < 0.05). The perceived social support exerted the mediating effect in the relationship between family resilience and meaning in life (ß = 0.368 [95%CI, 0.274, 0.450], P < 0.001), accounting for 54.6% of the variance in meaning in life. CONCLUSIONS: Our findings highlight that family resilience and perceived social support should be enhanced for BC patients to improve their meaning in life. In particular, the association between family resilience and meaning in life was positively mediated by perceived social support. Thus, interventions for improving family resilience and perceived social support might be useful in easing psychological distress and improving meaning in life in individuals with BC.

Family Resilience and Its Influencing Factors in Patients with Stress Urinary Incontinence after Cervical Cancer Surgery: A Retrospective Study.

OBJECTIVE: This study aimed to analyse the family resilience of patients with stress urinary incontinence (SUI) after cervical cancer surgery and its influencing factors. METHODS: Patients with cervical cancer postoperative SUI admitted to our hospital from May 2020, to May 2023, were retrospectively selected. They were divided into low-resilience group and high-resilience group in accordance with the Family Resilience Questionnaire (FaREQ). The general demographic data of the two groups were statistically analysed, and correlation and logistic regression analyses were performed. RESULTS: The FaREQ score of 222 patients was (93.61 ± 8.45). Amongst these patients, 21.62% scored less than 84 points, and 78.38% scored more than 84 points. Significant differences were found in the educational level, indwelling catheter time, family monthly income, religious belief, hope index, psychological resilience, family function and social support between the two groups (p < 0.05). A significant positive correlation was observed between family resilience and the above indicators (p < 0.05). The variance inflation coefficient values of educational level and indwelling catheter time were 15.764 and 43.766, and the tolerance values were 0.063 and 0.023, respectively. After removing them, family monthly income, religious belief, hope index, psychological resilience, family function and social support were the factors affecting the family resilience level of patients with SUI after cervical cancer surgery. CONCLUSIONS: The level of family resilience of patients with SUI after cervical cancer surgery is low. Many factors, such as family monthly income and religious belief, affect the level of resilience. Therefore, corresponding measures could be formulated in advance to improve the level of family resilience of such patients.

Relationship Between Illness Uncertainty and Family Resilience Among Caregivers of Stroke Patients in Chinese Nuclear Families: The Mediating Role of Perceived Stress.

Purpose: Stroke is a major disease endangering the health of Chinese people, and patients need to rely on the care of family members, which brings heavy caregiving burdens and pressures to caregivers and families, thus disrupting the stable family structure. In view of this, this study was to analyse the current status of family resilience among caregivers of stroke patients in Chinese nuclear families, and to explore the correlation and mechanism of action among perceived stress, illness uncertainty and family resilience. Patients and Methods: This study used a cross-sectional research design. A total of 350 carers of stroke patients in nuclear families from four tertiary hospitals in Suzhou City, Jiangsu Province, China were selected by convenience sampling method and assessed by using demographic questionnaires, the Chinese Perceived Stress Scale (CPSS), the Parental Perceptions of Uncertainty Scale-Family (PPUS-FM), and a short Chinese version of the Family Resilience Assessment Scale (FRAS-C). Based on the above data, structural equation model was used to test the mediating role of perceived stress between illness uncertainty and family resilience. Results: Family resilience among caregivers of stroke patients in nuclear families was at the medium lower level, illness uncertainty was at the medium level, and perceived stress was at the relatively high level. Illness uncertainty was positively correlated with perceived stress (P<0.01) and negatively correlated with family resilience (P<0.01). Illness uncertainty directly predicted family resilience (ß = -0.516, p < 0.05). And the pathway between illness uncertainty and family resilience was partially mediated by perceived stress (Effect= -0.091, 95% CI [-0.141, -0.055]). Conclusion: Healthcare professionals should pay adequate attention to the level of illness uncertainty and perceived stress among carers of stroke patients, with the need to take measures to reduce carers' illness uncertainty and perceived stress in order to improve family resilience.

Lifestyle Dimensions of Public Safety Personnel Families: There's No Life Like It.

PURPOSE: The nature and cumulative occupational demands imposed on families of public safety personnel (PSP) are substantial, in many cases non-negotiable, and distinct from the general population accentuating risk factors for family well-being. Despite this reality, the contributions of PSP families are not well understood, and a conceptual framework is needed. The aim of this paper is to summarize contextual factors (lifestyle dimensions) that shape the lives of PSP families; factors supported in the existing, albeit limited, body of research. METHODS: Grounded in the interpretive/constructivist paradigm, a synthesis was central to understanding the lived experiences of PSP families. An interdisciplinary research team engaged in an iterative process of framework analysis to capture the variability and complexity of PSP family life and distilled the overarching lifestyle dimensions. RESULTS: Three lifestyle dimensions-logistics, risks, and identities-emerged from contextual factors and represent distinct aspects of PSP family life. PSP families play a crucial role in that their capacity to accommodate the lifestyle dimensions (i.e., logistics, risks, and identities), without which the PSP could not meet the demands of the profession. CONCLUSION: Promoting awareness of these dimensions and their consequent demands underscores the cumulative demands that put PSP families at risk. Responses from governments, public safety organizations, and communities are required to help PSP families manage non-negotiable elements of the public safety occupation that spill over into family life over which they have no control.

Discrepancies in perceived family resilience between adolescents with chronic illness and parents: using response surface analysis to examine the relationship with adolescents' psychological adjustment.

BACKGROUND: This study aimed to explore discrepancies in adolescents with chronic illness and their parents' perceptions of family resilience, as well as the relationship between these differences and the psychological adjustment of adolescents with chronic illness. METHODS: A cross-sectional study was conducted. A total of 264 dyads of parents (77.7% mothers, mean age 41.60 years, SD = 6.17) and adolescents (48.5% girls, mean age 12.68 years, SD = 2.11) with chronic illness were recruited through convenience sampling from three children's hospitals in Wenzhou, Hangzhou, and Shanghai, China between June 2022 and May 2023. The Chinese version of the Family Resilience Scale and the Psychological Adjustment Scale, which are commonly used measures with good reliability and validity, were employed to assess family resilience and psychological adaption, respectively. The data were analyzed using polynomial regression and response surface analysis. RESULTS: Adolescents with chronic illness reported higher family resilience than their parents (t=-2.80, p < 0.05). The correlations between family resilience and adolescents' psychological adjustment reported by the adolescents (r = 0.45-0.48) were higher than parents (r = 0.18-0.23). In the line of congruence, there were positive linear (a1 = 1.09-1.60, p < 0.001) and curvilinear (a2=-1.38∼-0.72, p < 0.05) associations between convergent family resilience and adolescents' psychological adjustment. In the line of incongruence, when adolescents reported lower family resilience than parents, adolescents had a lower level of psychological adjustment (a3=-1.02∼-0.45, p < 0.05). Adolescents' sociability decreased when the perceived family resilience of parent-adolescent dyads converged (a4 = 1.36, p < 0.01). CONCLUSION: The findings highlighted the importance of considering the discrepancies and congruence of family resilience in the parent-child dyads when developing interventions to improve the psychological adjustment of adolescents with chronic illness. Interventions aimed at strengthening family communication to foster the convergence of perceptions of family resilience in parent-adolescent dyads were warranted.