Background and Purpose: In recent years, individual spirituality has been attracting attention, but little research has been conducted as it relates to family spirituality that applies this concept to the family and r...Background and Purpose: In recent years, individual spirituality has been attracting attention, but little research has been conducted as it relates to family spirituality that applies this concept to the family and relates to the meaning of the family’s existence in terms of the entire family. The purpose of this study was to clarify the attributes of family spirituality and the influencing factors of its decline. Methods: Regarding family spirituality, 1) a literature search was conducted using PubMed and reviews of 20 English-language articles;and 2) semi-structured interviews were conducted with 12 Japanese families having elderly members in the household. Data triangulation was performed for both, and a directed content analysis was conducted using Hohashi’s Concentric Sphere Family Environment Theory as the framework. Results: Attributes of family spirituality included 21 categories, such as “I think that my family exists for my children and grandchildren.” Factors influencing the decline in family spirituality included 20 categories in total, including 6 categories of risk/causal/promoting factors such as “lack of caring for family members”;11 categories of preventive/inhibitory/suppression factors such as “healthcare professionals not being close to the family”;and three categories of context-sensitive factors such as “death of a family member.” Conclusions/Implications for Practice: Family intervention requires nurses to understand the attributes of family spirituality and to control the influencing factors of a decline in family spirituality. Through such efforts, families will be able to discover the meaning of the existence of the family and maintain and improve their well-being.展开更多
Background and Purpose: Therapeutic communication is a new term in family health care nursing, defined by Hohashi (2019) as a method of family intervention, and characterized by inclusion of not only verbal conversati...Background and Purpose: Therapeutic communication is a new term in family health care nursing, defined by Hohashi (2019) as a method of family intervention, and characterized by inclusion of not only verbal conversation but also nonverbal interaction. However, specific therapeutic communication methods have not been systematized. The purpose of this study was to clarify therapeutic communication methods for families/family members from the perspectives of verbal communication and non-verbal communication through a review of existing literature. Methods: We conducted a search using the medical literature databases PubMed and Ichushi-Web using the keywords “therapeutic communication”. Analysis was performed on seven articles from PubMed and 14 articles from Ichushi-Web that described therapeutic communication methods performed by healthcare professionals for families/family members. Through directed content analysis, therapeutic communication methods were subcategorized, and classified into three categories: verbal communication, non-verbal communication, and verbal/non-verbal communication. Results: A total of 23 subcategories were extracted. Verbal communication included 11 subcategories, such as “asking questions using the communicatee’s words as they are”. Non-verbal communication included five subcategories, such as “noticing changes in the content of the communicatee’s story”. And verbal/non-verbal communication featured seven subcategories, such as “making the communicatee aware of one’s own beliefs”. Conclusion: Therapeutic communication methods included basic care/caring in family interviews/meetings, as well as verbal communication and non-verbal communication that act on family/family members’ beliefs. It is believed that changes in family/family members’ beliefs can be used to eliminate, reduce, or improve problematic conditions in the family. .展开更多
This study, in which 519 child-rearing families in Hong Kong participated, examined the reliability and validity of Chinese-language version of the Survey of Family Environment (SFE-C). The SFE-C is a self-administere...This study, in which 519 child-rearing families in Hong Kong participated, examined the reliability and validity of Chinese-language version of the Survey of Family Environment (SFE-C). The SFE-C is a self-administered questionnaire containing 30 items that examines family functioning and family support needs. It is designed to yield an instrument satisfaction score (SS score: family functioning score). Internal consistency was estimated at 0.92 (Cronbach’s alpha for SS scores). In a test-retest study of 33 families, the correlation coefficient for families’ mean SS score over a two-week period was 0.93, indicating high test-retest reliability. Confirmatory and exploratory factor analysis using the Concentric Sphere Family Environment Theory indicated that the SFE-C’s structure included seven factors, thereby supporting the SFE-C’s construct validity. The SFE-C demonstrates good reliability and validity and may be used to evaluate Chinese families’ functioning.展开更多
Background:Jay Haley’s contributions to bioethics introduced a systemic and interventionist perspective on clinical responsibility,autonomy,and ethical governance.His directive therapeutic methods redefined clinical ...Background:Jay Haley’s contributions to bioethics introduced a systemic and interventionist perspective on clinical responsibility,autonomy,and ethical governance.His directive therapeutic methods redefined clinical practice as a domain of ethical action,emphasizing relational accountability and structured decision-making at the core of medical and psychotherapeutic ethics.Haley challenged dominant models of patient autonomy and informed consent by highlighting the clinician’s active role in guiding ethical outcomes within complex relational systems.He positioned therapeutic influence within broader debates on medical authority and ethical boundaries.By integrating medical hypnosis and family systems therapy,Haley’s work bridges clinical practice and bioethical principles,reshaping the ethics principles of psychotherapy.Methods:This medical history study employs a historiographical approach,analyzing over one hundred primary and secondary sources including Haley’s published works,archival audiovisual materials,and contemporaneous policy documents.Systematic source classification,triangulation with independent evaluations,and explicit disclosure of author positionality ensure methodological rigor.Interpretive source analysis and intellectual history frameworks enable a thorough reconstruction of Haley’s bioethical contributions within broader historical and philosophical contexts,with particular attention to the philosophical assumptions underlying his strategic interventions.Results:New findings identifies six interrelated domains in Haley’s ethical approach that emphasize core bioethical principles:autonomy,beneficence,nonmaleficence,justice,and accountability.Haley’s methods demonstrate brief,goal-directed,and ethically accountable interventions aligned with principlism,virtue ethics,and communitarian ethics.Key findings include critiques of psychoanalytic neutrality,the use of metaphor and hypnosis to support informed client engagement without coercion,and integration of systemic factors into ethical decision-making.These insights extend knowledge by showing how Haley’s work advanced ethical standards influencing contemporary clinical governance frameworks such as the AAMFT Code of Ethics.Conclusion:By cataloguing Haley’s corpus and mapping his bioethical emphases across domains,this study extends existing knowledge,positioning Haley as a foundational bioethical theorist in systemic therapy.His work reframes therapy as a relational and ethically governed intervention,offering enduring insights for clinical governance,professional ethics,and therapeutic practice.These findings enrich the historiography of medical ethics by positioning Haley as a foundational bioethical theorist whose work continues to inform therapeutic practice and ethical deliberation.展开更多
Caring for a patient with terminal cancer poses difficulties for family caregivers. Although families of patients with cancer have been classified by type, little is known about the relation between family functioning...Caring for a patient with terminal cancer poses difficulties for family caregivers. Although families of patients with cancer have been classified by type, little is known about the relation between family functioning and quality of life (QOL) in family caregivers. This study aimed to develop a typology of family functioning in family caregivers of patients with terminal cancer and then examine the relation between the family functioning and QOL of family caregivers. From December 2013 to August 2014, fifty-one family caregivers of patients with terminal cancer were recruited at three hospitals in Tokyo, Japan. Perceptions of family functioning were assessed with the Family Relationship Index, and its three subscores were classified into three groups by cluster analysis. Caregivers’ QOL was measured with the Caregiver Quality of Life Index-Cancer. The average total FRI score among 51 caregivers was 8.5 (SD = 2.8). Family functioning was categorized into three clusters: supportive (n = 12), communicative (n = 30), or conflictive (n = 8). Their QOL was categorized into two groups: the communicative group, with relatively high confliction, showed high QOL comparable to the supportive group. Family functioning in the families of patients with terminal cancer hospitalized in general wards was not good. For improving the QOL of family caregivers, it may be important for the family members to express their feelings and distress if they have conflicts.展开更多
The coronavirus disease of 2019 (COVID-19) has had a serious impact not only on the society, economy, and medical system, but also on the families and family members affected by it. This scoping review aimed to descri...The coronavirus disease of 2019 (COVID-19) has had a serious impact not only on the society, economy, and medical system, but also on the families and family members affected by it. This scoping review aimed to describe the effects of the COVID-19 pandemic on family well-being. Original articles in English published between January 2020 and August 2021 that examined the association between COVID-19 and family well-being, were searched on MEDLINE and CINAHL. The literature search was conducted using Mesh or CINAHL Subject Headings on COVID-19 and families. Of the 923 references extracted from MEDLINE and CINAHL, this review included 25 references based on exclusion criteria. The largest number of articles examined the impact of COVID-19 on family caregivers’ mental health, followed by its impact on family relationships. The pandemic reportedly worsened family relationships and functioning, increasing domestic violence. The increased burden of caregiving for children and older adults due to COVID-19 was a risk factor for poor physical, psychological, and social health among family caregivers. The workplace environments and health conditions of workers involved with COVID-19 patients affected their family members’ physical, psychological, and social health. The social and economic impact of the pandemic could change the internal family system and the permeability of its boundaries, necessitating strategies to maintain an open family system. Additionally, family caregivers are at high risk for poor mental health and need a provision of psychosocial support. Moreover, devising strategies to improve workplace environments and alleviate health issues of workers involved with COVID-19 patients would be crucial for better mental health among their family members.展开更多
Male patients with lower urinary tract symptoms(LUTS)and benign prostatic hyperplasia(BPH)are increasingly seen by family physicians worldwide due to ageing demographics.A systematic way to stratify patients who can b...Male patients with lower urinary tract symptoms(LUTS)and benign prostatic hyperplasia(BPH)are increasingly seen by family physicians worldwide due to ageing demographics.A systematic way to stratify patients who can be managed in the community and those who need to be referred to the urologist is thus very useful.Good history taking,physical examination,targeted blood or urine tests,and knowing the red flags for referral are the mainstay of stratifying these patients.Case selection is always key in clinical practice and in the setting of the family physician.The best patient to manage is one above 40 years of age,symptomatic with nocturia,slower stream and sensation of incomplete voiding,has a normal prostatespecific antigen level,no palpable bladder,and no haematuria or pyuria on the labstix.The roles of α blockers,5-α reductase inhibitors,and antibiotics in a primary care setting to manage this condition are also discussed.展开更多
BACKGROUND Positive family history is a risk factor for development of colorectal cancer.Despite numerous studies on the topic,the absolute risk in patients with a positive family history remains unclear and therefore...BACKGROUND Positive family history is a risk factor for development of colorectal cancer.Despite numerous studies on the topic,the absolute risk in patients with a positive family history remains unclear and therefore studies are lacking to validate non-invasive screening methods in individuals with positive family history.AIM To quantify the risk of colorectal cancer in individuals with a positive family history.METHODS A comprehensive electronic literature search was performed using PubMed from January 1955 until November 2017,EMBASE from 1947 until 2018,and Cochrane Library without date restrictions.Two independent reviewers conducted study selection,data extraction and quality assessment.A meta-analysis of Mantel-Haenzel relative risks was performed using the random effects model.Newcastle-Ottawa scale was used to score the quality of selected papers.Funnel plot and Egger’s regression test was performed to detect publication bias.Subgroup analysis was performed comparing Asian and non-Asian studies.Sensitivity analyses were performed to rule out the effect of the timing of the study,overall quality,the main outcome and the effect of each individual study in overall result.RESULTS Forty-six out of 3390 studies,including 906981 patients were included in the final analysis.41 of the included studies were case-control and 5 were cohort.A positive family history of colorectal cancer in first-degree relatives was associated with significantly increased risk of colorectal cancer with a relative risk of 1.87(95%CI:1.68-2.09;P<0.00001).Cochrane Q test was significant(P<0.00001,I2=90%).Egger’s regression test showed asymmetry in the funnel plot and therefore the Trim and Fill method was used which confirmed the validity of the results.There was no difference between Asian versus non-Asian studies.Results remained robust in sensitivity analyses.CONCLUSION Individuals with a positive family history of colorectal cancer are 1.87 times more likely to develop colorectal cancer.Screening guidelines should pay specific attention to individuals with positive family history and further studies need to be done on validating current screening methods or developing new modalities in this high-risk population.展开更多
HSP110 functions to protect cells, tissues, and organs from noxious conditions. Vasectomy induces apoptosis in the testis; however, little is known about the reason leading to this outcome. The aim of the present stud...HSP110 functions to protect cells, tissues, and organs from noxious conditions. Vasectomy induces apoptosis in the testis; however, little is known about the reason leading to this outcome. The aim of the present study was to evaluate the expression and function of HSP110 in mouse testis after vasectomy. Following bilateral vasectomy, we used fluorescent Terminal deoxynucleotidyl transferase dUTP nick end labeling （TUNEL） to detect apoptosis, Western blotting and immunohistochemistry to examine HSP110 expression and localization. Serum antisperm antibody （AsAb） and testosterone were measured by Enzyme-linked immunosorbent assay （ELISA） and radioimmunoassay, respectively. Expression of endoplasmic reticulum stress （ERS） sensors and downstream signaling components was measured by Reverse Transcription-Polymerase Chain Reaction （RT-PCR）, and the phosphorylation of elF2a and JNK was detected by Western blotting. Vasectomy induced morphologic changes, increased apoptosis in the testis, increased serum AsAb, and decreased testosterone levels. After vasectomy, ORP150 mRNA level was increased first and then decreased, Bcl-2 was decreased, and the expression of HSPA41, GRP78, GADD153, PERK, ATF6, IRE-l, XBP-ls, Bax, Bak, and caspases and the phosphorylation of elF2a and JNK were increased. We present that an ER stress-mediated pathway is activated and involved in apoptosis in the testis after vasectomy. HSPA41 and ORP150 may play important roles in maintaining the normal structure and function of testis.展开更多
Caring is directed toward a variety of things. One of them is thought to be the concept of “family caring” aimed at families. This study attempts to clarify family caring and develop Family Care/ Caring Theory (FCCT...Caring is directed toward a variety of things. One of them is thought to be the concept of “family caring” aimed at families. This study attempts to clarify family caring and develop Family Care/ Caring Theory (FCCT), with the aim of implementing it in conjunction with an existing family nursing theory, the Concentric Sphere Family Environment Theory (CSFET). In Japan and in Hong Kong, family ethnography (including formal interviews) was conducted. As a result, the item “family health care nurses and their colleagues” was added to the family external environment of the CSFET. In the family environment, evidence was obtained to the effect that the family system unit is cared for by the nursing professional, and conversely the family system unit cares for the nursing professional, in a circular transaction. Observing the two-dimensional plane formed by the structural distance and functional distance, family caring assumes a structure of concentric circles, and according to transactions, the structural distance and functional distance between the nursing professional and family system unit are gradually approached, and through deepening of mutual trust maintain an appropriate distance. Moreover observing the three-dimensional space-time continuum which is created through addition of the temporal distance, family caring forms a helical structure. As transactions are repeated along the temporal axis, the family system unit’s self-actualization of other individuals and the self-actualization of the nursing professional are realized. Through these processes, a family care/caring relationship is reinforced and established. This is the concept of FCCT. Through future utilization in clinical settings this will be empirically substantiated, and it will be necessary to continue making creative corrections and revisions.展开更多
The four cornerstones of guidance in technique service of family planning are established by WHO based on high quality evidences. They have been updated according to the appearing new evidences, and the consensuses we...The four cornerstones of guidance in technique service of family planning are established by WHO based on high quality evidences. They have been updated according to the appearing new evidences, and the consensuses were reached by the international experts in this field. The four documents include Medical Eligibility Criteria for Contraceptive Use, Selected Practice Recommendations for Contraceptive Use, Decision-making Tool for Family Planning Clients and Providers and The Global Handbook for Family Planning Providers. The first two documents mainly face to the policymakers and programme managers and were treated as the important references for creating the local guideline. The other two documents were developed for the front-line health-care and family planning providers at different levels, which include plenty of essential technical information to help providers improve their ability in service delivery and counselling. China paid great attention to the introduction and application of WHO guidelines. As soon as the newer editions of these documents were available, the Chinese version would be followed. WHO guidelines have been primarily adapted with the newly issued national guideline, The Clinical Practical Skill Guidelines-Family Planning Part, which was established by China Medical Association. At the same time, the WHO guidelines have been introduced to some of the clinicians and family planning providers at different levels. In the future, more special training courses will be introduced to the township level based on the needs of grass-root providers.展开更多
This is a review of current situation of induced abortion and post abortion family planning service in China. Induced abortion is an important issue in reproductive health. This article reviewed the distribution of in...This is a review of current situation of induced abortion and post abortion family planning service in China. Induced abortion is an important issue in reproductive health. This article reviewed the distribution of induced abortion in various time, areas, and population in China, and explored the character, reason, and harm to reproductive health of induced abortion.Furthermore, this article introduces the concept of Quality of Care Program in Family Planning,and discusses how important and necessary it is to introduce Quality of Care Program in Family Planning to China.展开更多
In 2014,in accordance with the decisions and plans of the Party Central Committee and the State Council,health and family planning departments at various levels extensively deepened medical reform;achieved positive ac...In 2014,in accordance with the decisions and plans of the Party Central Committee and the State Council,health and family planning departments at various levels extensively deepened medical reform;achieved positive achievements in major areas;made new progress in public health and major disease prevention and treatment.展开更多
In family healthcare nursing, the family system unit (i.e., a group in which the members, seen as a whole, mutually interact) is the target of care. As nurses tend to obtain family-related information from particular ...In family healthcare nursing, the family system unit (i.e., a group in which the members, seen as a whole, mutually interact) is the target of care. As nurses tend to obtain family-related information from particular family members in the clinical setting, when assessing families, they often confront the issue of the differences between the theoretical level and methodological level. Although this issue needs resolving for evidence-based family nursing practice, sufficient research is lacking on the methodology related to family assessment. The present study aimed to clarify the factors that affected evaluation of family functioning among couples. Semi-structured interviews were conducted with 10 child-rearing families (couples) using the Survey of Family Environment (SFE) as a family functioning scale. Content analysis identified 12 factors that affected discrepancies in the couples’ evaluations and eight factors that affected agreement in those evaluations. These factors were classified into three categories: factors concerning family or family members;factors concerning questions related to the SFE;and factors concerning the view of the family as a whole. The results of this study should contribute to the development of family assessment tools and effective methods for evaluation of family care.展开更多
Introduction: Schizophrenia and bipolar I disorder are very common disorders in hospitalized patients. Considering that family problems are one of the factors in the appearance and persistence of schizophrenia and bip...Introduction: Schizophrenia and bipolar I disorder are very common disorders in hospitalized patients. Considering that family problems are one of the factors in the appearance and persistence of schizophrenia and bipolar I disorder, in this study, we decided to investigate and compare the family functioning between these two groups of patients. Methods: The sample consisted of 50 patients with schizophrenia and 50 patients with bipolar I disorder. The third group was the control group which consisted of 50 normal different professions such as teachers, workers, housekeepers and others. Then the Family Functioning Scale (FAD-I) was used and the final results of the three groups were compared by SPSS V21 software. Results: In the schizophrenia group, 88.9% percent of patients had family functioning scores less than 109.81 which showed that they had severe family dysfunction but in the bipolar I disorder group, 11.1% and all participants in the control group, had scores higher than 109.81.Conclusion: Family dysfunction was seen in schizophrenic patients rather than in the other two groups.展开更多
Background: About 70% of Japanese children with severe motor and intellectual disabilities (SMID) live at home, and the number is increasing. Family members have an enormous burden of daily physical care for these chi...Background: About 70% of Japanese children with severe motor and intellectual disabilities (SMID) live at home, and the number is increasing. Family members have an enormous burden of daily physical care for these children. A top priority is to understand quality of life (QoL), family function, and family empowerment to effectively support these families. We aimed to assess current living situations of families with a SMID child, and to reveal the relationships between QoL, family function, and family empowerment. Methods: Sixty-five family members from 34 families with a SMID child participated in this study. We assessed 5 parameters using the Japanese versions of the following instruments: World Health Organization Quality of Life 26 (WHOQOL26), Kinder Lebensqualitats Fragebogen (KINDL), Family Assessment Device (FAD), Family Adaptability and Cohesion Evaluation Scale KG-4 (FACESKG-4), and Family Empowerment Scale (FES). Correlation and multiple regression analyses were conducted;QoL score was the objective variable. Results: Participants included 54 parents (34 mothers, 20 fathers) and 11 siblings. The mean age of SMID children was 10.4 ± 5.03 years. Twenty-two children needed multiple types of medical care. The mean age of parents and siblings was 41.5 ± 6.16 years and 15.5 ± 2.35 years, respectively. The mean QoL score (3.28 ± 0.5) was similar to the Japanese average. The mean KINDL score (77.2 ± 12.1) was higher than those of previous studies. The mean FAD score was 1.97 ± 0.32. For FACEKG-4, the score of adaptability was correlated with WHOQOL score (r = 0.459, p < 0.05). The mean score of FES was 113.6 ± 14. As the result of multiple regression analysis, lower family FAD scores ([sb] = ?0.61, p < 0.01) indicated higher family function and greater age of participants (sb = 0.495, p < 0.01) was correlated with higher WHOQOL scores (F = 15.208, p < 0.01). Conclusions: Our results indicated that the individual QoL depended on the age of participants (equals the years of experience caring for a SMID child) and the recognition of family function as a whole. Thus, to improve family members’ QoL, we should focus on individuals and also approach the family as a whole.展开更多
Background: Acquisition of family medical history (FMH) is emphasized as a part of obtaining a complete medical history, but whether FMH is consistently documented and utilized in primary care, as well as how it can a...Background: Acquisition of family medical history (FMH) is emphasized as a part of obtaining a complete medical history, but whether FMH is consistently documented and utilized in primary care, as well as how it can affect patient care in this context, remains unclear. Thus, the objectives of this study were to determine: 1) if FMH is regularly acquired in a representative primary care practice (the Queen’s Family Health Team, QFHT);2) what is included in the FMH obtained;3) what the utility of FMH is with regards to patient management in primary care;and 4) to utilize healthcare practitioners’ perspectives in order to elucidate any findings regarding the acquisition and utility of FMH at the QFHT. Methods: Patients were interviewed in order to obtain their FMH. For each patient, the FMH obtained was compared to the FMH documented in the patient’s record to determine the record’s completeness. Each patient’s FMH was analyzed for significant history of coronary artery disease (CAD), diabetes mellitus type II (DMII), substance abuse (SA) and colorectal cancer (CRC). Participants were patients scheduled for appointments at the QFHT between May and July 2011. Any patient of the QFHT older than 25 years was eligible to participate. Clinical staff of the QFHT completed an online questionnaire to determine healthcare practitioners’ perspectives regarding the acquisition and utility of FMH. Results: 83 patients participated in the study. Participants ranged in age from 25 - 86 years (median: 63 years);69% were female. FMH present in patients’ records was often either incomplete (42% of charts reviewed) or not documented at all (51% of charts reviewed). Knowledge of FMH can affect patient management in primary care for the diseases assessed (CAD, DMII, SA and CRC). HCP do consider FMH to be important in clinical practice and 86% of respondents stated that they regularly inquired about patients’ FMH. Interpretation: Despite the belief by HCP that FMH is important, there is a disparity between this belief and their practices regarding its documentation and utilization. Finally, analysis of the FMH of the representative population studied shows that information commonly missing in patients’ FMH can affect patient management at a primary care level.展开更多
Objective:To assess the effectiveness of a community-based educational intervention on necklace method as a natural family planning amongst reproductive age group women.This approach helps women decide on their reprod...Objective:To assess the effectiveness of a community-based educational intervention on necklace method as a natural family planning amongst reproductive age group women.This approach helps women decide on their reproductive health choices and avoid ill health,impact and long-term consequences of unwanted pregnancy that lead to unsafe abortion.Methods:A total of 120 women were selected using non-probability purposive sampling technique.The knowledge and practice of participants were assessed using the structured knowledge questionnaire and practice checklist followed by a community-based educational intervention to participants,which covered aspects such as meaning,purposes and criteria;steps of the procedure;and advantages and disadvantages of the necklace method.The methods of teaching were lecture cum discussion and demonstration.The collected data were analysed using SPSS version 21.Results:The levels of knowledge (t-14.571,P=0.023) and practice (t =14.571,P=0.026) significantly improved after administering the community-based educational intervention.Knowledge and practice positively correlated with each other (P < 0.05).Conclusions:Nurses play a vital role in educating women and creating awareness regarding modern and safe family planning methods.These methods are effective and essential to avoid unwanted pregnancy and thus greatly impact the health of women.展开更多
Purpose: The objective of this study was to examine the correlation between the sexuality of patients with Inflammatory Bowel Disease and family functioning. Methods: The study took the form of a self-administered que...Purpose: The objective of this study was to examine the correlation between the sexuality of patients with Inflammatory Bowel Disease and family functioning. Methods: The study took the form of a self-administered questionnaire survey, utilizing the Sexuality Satisfaction Index for IBD (SEXSI-IBD) for measuring sexuality and the Survey of Family Environment Survey of Family Environment (SFE) for measuring family functioning. SEXSI-IBD consists of 28 items and five domains, and SFE consists of 30 items and five domains. The participants were recruited at 15 self-help groups and 14 hospitals. Results: Of 146 participants, 48.6% were male and 52.4% female, with an average age of 41.1 years. A significant correlation was observed between the item average score of SEXSI-IBD and Overall Satisfaction Score (OSS) of SFE. Significant correlations were observed in two domains of the SEXSI-IBD, “Daily interaction” and “Sexual communication,” and in all five domains of the SFE. In particular, for “Daily interaction,” the strongest correlation was observed in the SFE’s “Macro system” and “Family internal environment system.” A correlation was observed between the “Physical contact importance” in SEXSI-IBD and the “Macro system” in the OSS of the SFE. Conclusions: Sexuality correlates with family functioning not only in the family internal environment system but also in the family external environment system. Through an approach aimed at elevating the degree of satisfaction for sexuality, it becomes possible to improve family functioning and realize a sense of family well-being.展开更多
Although the concept of family functioning has gained recent popularity, the terms ＂family functioning＂ and ＂family resilience＂ are sometimes confused and used interchangeably. The aim of this concept analysis was...Although the concept of family functioning has gained recent popularity, the terms ＂family functioning＂ and ＂family resilience＂ are sometimes confused and used interchangeably. The aim of this concept analysis was to clarify what is meant by family functioning in the context of diabetes self-management by assessing specific attributes, antecedents, and consequences. A concept analysis model by Walker and Avant was applied. The identified attributes of family functioning in a diabetes self-management context included problem-solving, communication, roles, affective responsiveness, affective involvement, and behavioral control. Antecedents included family structure, socioeconomic status, family functioning relationships, family stage, and life events. Consequences included family satisfaction, family cohesion, and family relationships. This analysis provided a deeper understanding of a family functioning concept within a diabetes self-management context. It is recommended that health care providers should be aware of antecedent factors that could inhibit outcome improvement. Further research is needed to explain family functioning attributes in relation to antecedents and potential consequences.展开更多
文摘Background and Purpose: In recent years, individual spirituality has been attracting attention, but little research has been conducted as it relates to family spirituality that applies this concept to the family and relates to the meaning of the family’s existence in terms of the entire family. The purpose of this study was to clarify the attributes of family spirituality and the influencing factors of its decline. Methods: Regarding family spirituality, 1) a literature search was conducted using PubMed and reviews of 20 English-language articles;and 2) semi-structured interviews were conducted with 12 Japanese families having elderly members in the household. Data triangulation was performed for both, and a directed content analysis was conducted using Hohashi’s Concentric Sphere Family Environment Theory as the framework. Results: Attributes of family spirituality included 21 categories, such as “I think that my family exists for my children and grandchildren.” Factors influencing the decline in family spirituality included 20 categories in total, including 6 categories of risk/causal/promoting factors such as “lack of caring for family members”;11 categories of preventive/inhibitory/suppression factors such as “healthcare professionals not being close to the family”;and three categories of context-sensitive factors such as “death of a family member.” Conclusions/Implications for Practice: Family intervention requires nurses to understand the attributes of family spirituality and to control the influencing factors of a decline in family spirituality. Through such efforts, families will be able to discover the meaning of the existence of the family and maintain and improve their well-being.
文摘Background and Purpose: Therapeutic communication is a new term in family health care nursing, defined by Hohashi (2019) as a method of family intervention, and characterized by inclusion of not only verbal conversation but also nonverbal interaction. However, specific therapeutic communication methods have not been systematized. The purpose of this study was to clarify therapeutic communication methods for families/family members from the perspectives of verbal communication and non-verbal communication through a review of existing literature. Methods: We conducted a search using the medical literature databases PubMed and Ichushi-Web using the keywords “therapeutic communication”. Analysis was performed on seven articles from PubMed and 14 articles from Ichushi-Web that described therapeutic communication methods performed by healthcare professionals for families/family members. Through directed content analysis, therapeutic communication methods were subcategorized, and classified into three categories: verbal communication, non-verbal communication, and verbal/non-verbal communication. Results: A total of 23 subcategories were extracted. Verbal communication included 11 subcategories, such as “asking questions using the communicatee’s words as they are”. Non-verbal communication included five subcategories, such as “noticing changes in the content of the communicatee’s story”. And verbal/non-verbal communication featured seven subcategories, such as “making the communicatee aware of one’s own beliefs”. Conclusion: Therapeutic communication methods included basic care/caring in family interviews/meetings, as well as verbal communication and non-verbal communication that act on family/family members’ beliefs. It is believed that changes in family/family members’ beliefs can be used to eliminate, reduce, or improve problematic conditions in the family. .
文摘This study, in which 519 child-rearing families in Hong Kong participated, examined the reliability and validity of Chinese-language version of the Survey of Family Environment (SFE-C). The SFE-C is a self-administered questionnaire containing 30 items that examines family functioning and family support needs. It is designed to yield an instrument satisfaction score (SS score: family functioning score). Internal consistency was estimated at 0.92 (Cronbach’s alpha for SS scores). In a test-retest study of 33 families, the correlation coefficient for families’ mean SS score over a two-week period was 0.93, indicating high test-retest reliability. Confirmatory and exploratory factor analysis using the Concentric Sphere Family Environment Theory indicated that the SFE-C’s structure included seven factors, thereby supporting the SFE-C’s construct validity. The SFE-C demonstrates good reliability and validity and may be used to evaluate Chinese families’ functioning.
文摘Background:Jay Haley’s contributions to bioethics introduced a systemic and interventionist perspective on clinical responsibility,autonomy,and ethical governance.His directive therapeutic methods redefined clinical practice as a domain of ethical action,emphasizing relational accountability and structured decision-making at the core of medical and psychotherapeutic ethics.Haley challenged dominant models of patient autonomy and informed consent by highlighting the clinician’s active role in guiding ethical outcomes within complex relational systems.He positioned therapeutic influence within broader debates on medical authority and ethical boundaries.By integrating medical hypnosis and family systems therapy,Haley’s work bridges clinical practice and bioethical principles,reshaping the ethics principles of psychotherapy.Methods:This medical history study employs a historiographical approach,analyzing over one hundred primary and secondary sources including Haley’s published works,archival audiovisual materials,and contemporaneous policy documents.Systematic source classification,triangulation with independent evaluations,and explicit disclosure of author positionality ensure methodological rigor.Interpretive source analysis and intellectual history frameworks enable a thorough reconstruction of Haley’s bioethical contributions within broader historical and philosophical contexts,with particular attention to the philosophical assumptions underlying his strategic interventions.Results:New findings identifies six interrelated domains in Haley’s ethical approach that emphasize core bioethical principles:autonomy,beneficence,nonmaleficence,justice,and accountability.Haley’s methods demonstrate brief,goal-directed,and ethically accountable interventions aligned with principlism,virtue ethics,and communitarian ethics.Key findings include critiques of psychoanalytic neutrality,the use of metaphor and hypnosis to support informed client engagement without coercion,and integration of systemic factors into ethical decision-making.These insights extend knowledge by showing how Haley’s work advanced ethical standards influencing contemporary clinical governance frameworks such as the AAMFT Code of Ethics.Conclusion:By cataloguing Haley’s corpus and mapping his bioethical emphases across domains,this study extends existing knowledge,positioning Haley as a foundational bioethical theorist in systemic therapy.His work reframes therapy as a relational and ethically governed intervention,offering enduring insights for clinical governance,professional ethics,and therapeutic practice.These findings enrich the historiography of medical ethics by positioning Haley as a foundational bioethical theorist whose work continues to inform therapeutic practice and ethical deliberation.
文摘Caring for a patient with terminal cancer poses difficulties for family caregivers. Although families of patients with cancer have been classified by type, little is known about the relation between family functioning and quality of life (QOL) in family caregivers. This study aimed to develop a typology of family functioning in family caregivers of patients with terminal cancer and then examine the relation between the family functioning and QOL of family caregivers. From December 2013 to August 2014, fifty-one family caregivers of patients with terminal cancer were recruited at three hospitals in Tokyo, Japan. Perceptions of family functioning were assessed with the Family Relationship Index, and its three subscores were classified into three groups by cluster analysis. Caregivers’ QOL was measured with the Caregiver Quality of Life Index-Cancer. The average total FRI score among 51 caregivers was 8.5 (SD = 2.8). Family functioning was categorized into three clusters: supportive (n = 12), communicative (n = 30), or conflictive (n = 8). Their QOL was categorized into two groups: the communicative group, with relatively high confliction, showed high QOL comparable to the supportive group. Family functioning in the families of patients with terminal cancer hospitalized in general wards was not good. For improving the QOL of family caregivers, it may be important for the family members to express their feelings and distress if they have conflicts.
文摘The coronavirus disease of 2019 (COVID-19) has had a serious impact not only on the society, economy, and medical system, but also on the families and family members affected by it. This scoping review aimed to describe the effects of the COVID-19 pandemic on family well-being. Original articles in English published between January 2020 and August 2021 that examined the association between COVID-19 and family well-being, were searched on MEDLINE and CINAHL. The literature search was conducted using Mesh or CINAHL Subject Headings on COVID-19 and families. Of the 923 references extracted from MEDLINE and CINAHL, this review included 25 references based on exclusion criteria. The largest number of articles examined the impact of COVID-19 on family caregivers’ mental health, followed by its impact on family relationships. The pandemic reportedly worsened family relationships and functioning, increasing domestic violence. The increased burden of caregiving for children and older adults due to COVID-19 was a risk factor for poor physical, psychological, and social health among family caregivers. The workplace environments and health conditions of workers involved with COVID-19 patients affected their family members’ physical, psychological, and social health. The social and economic impact of the pandemic could change the internal family system and the permeability of its boundaries, necessitating strategies to maintain an open family system. Additionally, family caregivers are at high risk for poor mental health and need a provision of psychosocial support. Moreover, devising strategies to improve workplace environments and alleviate health issues of workers involved with COVID-19 patients would be crucial for better mental health among their family members.
文摘Male patients with lower urinary tract symptoms(LUTS)and benign prostatic hyperplasia(BPH)are increasingly seen by family physicians worldwide due to ageing demographics.A systematic way to stratify patients who can be managed in the community and those who need to be referred to the urologist is thus very useful.Good history taking,physical examination,targeted blood or urine tests,and knowing the red flags for referral are the mainstay of stratifying these patients.Case selection is always key in clinical practice and in the setting of the family physician.The best patient to manage is one above 40 years of age,symptomatic with nocturia,slower stream and sensation of incomplete voiding,has a normal prostatespecific antigen level,no palpable bladder,and no haematuria or pyuria on the labstix.The roles of α blockers,5-α reductase inhibitors,and antibiotics in a primary care setting to manage this condition are also discussed.
文摘BACKGROUND Positive family history is a risk factor for development of colorectal cancer.Despite numerous studies on the topic,the absolute risk in patients with a positive family history remains unclear and therefore studies are lacking to validate non-invasive screening methods in individuals with positive family history.AIM To quantify the risk of colorectal cancer in individuals with a positive family history.METHODS A comprehensive electronic literature search was performed using PubMed from January 1955 until November 2017,EMBASE from 1947 until 2018,and Cochrane Library without date restrictions.Two independent reviewers conducted study selection,data extraction and quality assessment.A meta-analysis of Mantel-Haenzel relative risks was performed using the random effects model.Newcastle-Ottawa scale was used to score the quality of selected papers.Funnel plot and Egger’s regression test was performed to detect publication bias.Subgroup analysis was performed comparing Asian and non-Asian studies.Sensitivity analyses were performed to rule out the effect of the timing of the study,overall quality,the main outcome and the effect of each individual study in overall result.RESULTS Forty-six out of 3390 studies,including 906981 patients were included in the final analysis.41 of the included studies were case-control and 5 were cohort.A positive family history of colorectal cancer in first-degree relatives was associated with significantly increased risk of colorectal cancer with a relative risk of 1.87(95%CI:1.68-2.09;P<0.00001).Cochrane Q test was significant(P<0.00001,I2=90%).Egger’s regression test showed asymmetry in the funnel plot and therefore the Trim and Fill method was used which confirmed the validity of the results.There was no difference between Asian versus non-Asian studies.Results remained robust in sensitivity analyses.CONCLUSION Individuals with a positive family history of colorectal cancer are 1.87 times more likely to develop colorectal cancer.Screening guidelines should pay specific attention to individuals with positive family history and further studies need to be done on validating current screening methods or developing new modalities in this high-risk population.
文摘HSP110 functions to protect cells, tissues, and organs from noxious conditions. Vasectomy induces apoptosis in the testis; however, little is known about the reason leading to this outcome. The aim of the present study was to evaluate the expression and function of HSP110 in mouse testis after vasectomy. Following bilateral vasectomy, we used fluorescent Terminal deoxynucleotidyl transferase dUTP nick end labeling （TUNEL） to detect apoptosis, Western blotting and immunohistochemistry to examine HSP110 expression and localization. Serum antisperm antibody （AsAb） and testosterone were measured by Enzyme-linked immunosorbent assay （ELISA） and radioimmunoassay, respectively. Expression of endoplasmic reticulum stress （ERS） sensors and downstream signaling components was measured by Reverse Transcription-Polymerase Chain Reaction （RT-PCR）, and the phosphorylation of elF2a and JNK was detected by Western blotting. Vasectomy induced morphologic changes, increased apoptosis in the testis, increased serum AsAb, and decreased testosterone levels. After vasectomy, ORP150 mRNA level was increased first and then decreased, Bcl-2 was decreased, and the expression of HSPA41, GRP78, GADD153, PERK, ATF6, IRE-l, XBP-ls, Bax, Bak, and caspases and the phosphorylation of elF2a and JNK were increased. We present that an ER stress-mediated pathway is activated and involved in apoptosis in the testis after vasectomy. HSPA41 and ORP150 may play important roles in maintaining the normal structure and function of testis.
文摘Caring is directed toward a variety of things. One of them is thought to be the concept of “family caring” aimed at families. This study attempts to clarify family caring and develop Family Care/ Caring Theory (FCCT), with the aim of implementing it in conjunction with an existing family nursing theory, the Concentric Sphere Family Environment Theory (CSFET). In Japan and in Hong Kong, family ethnography (including formal interviews) was conducted. As a result, the item “family health care nurses and their colleagues” was added to the family external environment of the CSFET. In the family environment, evidence was obtained to the effect that the family system unit is cared for by the nursing professional, and conversely the family system unit cares for the nursing professional, in a circular transaction. Observing the two-dimensional plane formed by the structural distance and functional distance, family caring assumes a structure of concentric circles, and according to transactions, the structural distance and functional distance between the nursing professional and family system unit are gradually approached, and through deepening of mutual trust maintain an appropriate distance. Moreover observing the three-dimensional space-time continuum which is created through addition of the temporal distance, family caring forms a helical structure. As transactions are repeated along the temporal axis, the family system unit’s self-actualization of other individuals and the self-actualization of the nursing professional are realized. Through these processes, a family care/caring relationship is reinforced and established. This is the concept of FCCT. Through future utilization in clinical settings this will be empirically substantiated, and it will be necessary to continue making creative corrections and revisions.
文摘The four cornerstones of guidance in technique service of family planning are established by WHO based on high quality evidences. They have been updated according to the appearing new evidences, and the consensuses were reached by the international experts in this field. The four documents include Medical Eligibility Criteria for Contraceptive Use, Selected Practice Recommendations for Contraceptive Use, Decision-making Tool for Family Planning Clients and Providers and The Global Handbook for Family Planning Providers. The first two documents mainly face to the policymakers and programme managers and were treated as the important references for creating the local guideline. The other two documents were developed for the front-line health-care and family planning providers at different levels, which include plenty of essential technical information to help providers improve their ability in service delivery and counselling. China paid great attention to the introduction and application of WHO guidelines. As soon as the newer editions of these documents were available, the Chinese version would be followed. WHO guidelines have been primarily adapted with the newly issued national guideline, The Clinical Practical Skill Guidelines-Family Planning Part, which was established by China Medical Association. At the same time, the WHO guidelines have been introduced to some of the clinicians and family planning providers at different levels. In the future, more special training courses will be introduced to the township level based on the needs of grass-root providers.
文摘This is a review of current situation of induced abortion and post abortion family planning service in China. Induced abortion is an important issue in reproductive health. This article reviewed the distribution of induced abortion in various time, areas, and population in China, and explored the character, reason, and harm to reproductive health of induced abortion.Furthermore, this article introduces the concept of Quality of Care Program in Family Planning,and discusses how important and necessary it is to introduce Quality of Care Program in Family Planning to China.
文摘In 2014,in accordance with the decisions and plans of the Party Central Committee and the State Council,health and family planning departments at various levels extensively deepened medical reform;achieved positive achievements in major areas;made new progress in public health and major disease prevention and treatment.
文摘In family healthcare nursing, the family system unit (i.e., a group in which the members, seen as a whole, mutually interact) is the target of care. As nurses tend to obtain family-related information from particular family members in the clinical setting, when assessing families, they often confront the issue of the differences between the theoretical level and methodological level. Although this issue needs resolving for evidence-based family nursing practice, sufficient research is lacking on the methodology related to family assessment. The present study aimed to clarify the factors that affected evaluation of family functioning among couples. Semi-structured interviews were conducted with 10 child-rearing families (couples) using the Survey of Family Environment (SFE) as a family functioning scale. Content analysis identified 12 factors that affected discrepancies in the couples’ evaluations and eight factors that affected agreement in those evaluations. These factors were classified into three categories: factors concerning family or family members;factors concerning questions related to the SFE;and factors concerning the view of the family as a whole. The results of this study should contribute to the development of family assessment tools and effective methods for evaluation of family care.
文摘Introduction: Schizophrenia and bipolar I disorder are very common disorders in hospitalized patients. Considering that family problems are one of the factors in the appearance and persistence of schizophrenia and bipolar I disorder, in this study, we decided to investigate and compare the family functioning between these two groups of patients. Methods: The sample consisted of 50 patients with schizophrenia and 50 patients with bipolar I disorder. The third group was the control group which consisted of 50 normal different professions such as teachers, workers, housekeepers and others. Then the Family Functioning Scale (FAD-I) was used and the final results of the three groups were compared by SPSS V21 software. Results: In the schizophrenia group, 88.9% percent of patients had family functioning scores less than 109.81 which showed that they had severe family dysfunction but in the bipolar I disorder group, 11.1% and all participants in the control group, had scores higher than 109.81.Conclusion: Family dysfunction was seen in schizophrenic patients rather than in the other two groups.
文摘Background: About 70% of Japanese children with severe motor and intellectual disabilities (SMID) live at home, and the number is increasing. Family members have an enormous burden of daily physical care for these children. A top priority is to understand quality of life (QoL), family function, and family empowerment to effectively support these families. We aimed to assess current living situations of families with a SMID child, and to reveal the relationships between QoL, family function, and family empowerment. Methods: Sixty-five family members from 34 families with a SMID child participated in this study. We assessed 5 parameters using the Japanese versions of the following instruments: World Health Organization Quality of Life 26 (WHOQOL26), Kinder Lebensqualitats Fragebogen (KINDL), Family Assessment Device (FAD), Family Adaptability and Cohesion Evaluation Scale KG-4 (FACESKG-4), and Family Empowerment Scale (FES). Correlation and multiple regression analyses were conducted;QoL score was the objective variable. Results: Participants included 54 parents (34 mothers, 20 fathers) and 11 siblings. The mean age of SMID children was 10.4 ± 5.03 years. Twenty-two children needed multiple types of medical care. The mean age of parents and siblings was 41.5 ± 6.16 years and 15.5 ± 2.35 years, respectively. The mean QoL score (3.28 ± 0.5) was similar to the Japanese average. The mean KINDL score (77.2 ± 12.1) was higher than those of previous studies. The mean FAD score was 1.97 ± 0.32. For FACEKG-4, the score of adaptability was correlated with WHOQOL score (r = 0.459, p < 0.05). The mean score of FES was 113.6 ± 14. As the result of multiple regression analysis, lower family FAD scores ([sb] = ?0.61, p < 0.01) indicated higher family function and greater age of participants (sb = 0.495, p < 0.01) was correlated with higher WHOQOL scores (F = 15.208, p < 0.01). Conclusions: Our results indicated that the individual QoL depended on the age of participants (equals the years of experience caring for a SMID child) and the recognition of family function as a whole. Thus, to improve family members’ QoL, we should focus on individuals and also approach the family as a whole.
文摘Background: Acquisition of family medical history (FMH) is emphasized as a part of obtaining a complete medical history, but whether FMH is consistently documented and utilized in primary care, as well as how it can affect patient care in this context, remains unclear. Thus, the objectives of this study were to determine: 1) if FMH is regularly acquired in a representative primary care practice (the Queen’s Family Health Team, QFHT);2) what is included in the FMH obtained;3) what the utility of FMH is with regards to patient management in primary care;and 4) to utilize healthcare practitioners’ perspectives in order to elucidate any findings regarding the acquisition and utility of FMH at the QFHT. Methods: Patients were interviewed in order to obtain their FMH. For each patient, the FMH obtained was compared to the FMH documented in the patient’s record to determine the record’s completeness. Each patient’s FMH was analyzed for significant history of coronary artery disease (CAD), diabetes mellitus type II (DMII), substance abuse (SA) and colorectal cancer (CRC). Participants were patients scheduled for appointments at the QFHT between May and July 2011. Any patient of the QFHT older than 25 years was eligible to participate. Clinical staff of the QFHT completed an online questionnaire to determine healthcare practitioners’ perspectives regarding the acquisition and utility of FMH. Results: 83 patients participated in the study. Participants ranged in age from 25 - 86 years (median: 63 years);69% were female. FMH present in patients’ records was often either incomplete (42% of charts reviewed) or not documented at all (51% of charts reviewed). Knowledge of FMH can affect patient management in primary care for the diseases assessed (CAD, DMII, SA and CRC). HCP do consider FMH to be important in clinical practice and 86% of respondents stated that they regularly inquired about patients’ FMH. Interpretation: Despite the belief by HCP that FMH is important, there is a disparity between this belief and their practices regarding its documentation and utilization. Finally, analysis of the FMH of the representative population studied shows that information commonly missing in patients’ FMH can affect patient management at a primary care level.
文摘Objective:To assess the effectiveness of a community-based educational intervention on necklace method as a natural family planning amongst reproductive age group women.This approach helps women decide on their reproductive health choices and avoid ill health,impact and long-term consequences of unwanted pregnancy that lead to unsafe abortion.Methods:A total of 120 women were selected using non-probability purposive sampling technique.The knowledge and practice of participants were assessed using the structured knowledge questionnaire and practice checklist followed by a community-based educational intervention to participants,which covered aspects such as meaning,purposes and criteria;steps of the procedure;and advantages and disadvantages of the necklace method.The methods of teaching were lecture cum discussion and demonstration.The collected data were analysed using SPSS version 21.Results:The levels of knowledge (t-14.571,P=0.023) and practice (t =14.571,P=0.026) significantly improved after administering the community-based educational intervention.Knowledge and practice positively correlated with each other (P < 0.05).Conclusions:Nurses play a vital role in educating women and creating awareness regarding modern and safe family planning methods.These methods are effective and essential to avoid unwanted pregnancy and thus greatly impact the health of women.
文摘Purpose: The objective of this study was to examine the correlation between the sexuality of patients with Inflammatory Bowel Disease and family functioning. Methods: The study took the form of a self-administered questionnaire survey, utilizing the Sexuality Satisfaction Index for IBD (SEXSI-IBD) for measuring sexuality and the Survey of Family Environment Survey of Family Environment (SFE) for measuring family functioning. SEXSI-IBD consists of 28 items and five domains, and SFE consists of 30 items and five domains. The participants were recruited at 15 self-help groups and 14 hospitals. Results: Of 146 participants, 48.6% were male and 52.4% female, with an average age of 41.1 years. A significant correlation was observed between the item average score of SEXSI-IBD and Overall Satisfaction Score (OSS) of SFE. Significant correlations were observed in two domains of the SEXSI-IBD, “Daily interaction” and “Sexual communication,” and in all five domains of the SFE. In particular, for “Daily interaction,” the strongest correlation was observed in the SFE’s “Macro system” and “Family internal environment system.” A correlation was observed between the “Physical contact importance” in SEXSI-IBD and the “Macro system” in the OSS of the SFE. Conclusions: Sexuality correlates with family functioning not only in the family internal environment system but also in the family external environment system. Through an approach aimed at elevating the degree of satisfaction for sexuality, it becomes possible to improve family functioning and realize a sense of family well-being.
基金the Indonesia Endowment Fund for Education (Lembaga Pengelolah Dana Pendidikan [LPDP] scholarship)Ministry of Higher Education and Research for grant support
文摘Although the concept of family functioning has gained recent popularity, the terms ＂family functioning＂ and ＂family resilience＂ are sometimes confused and used interchangeably. The aim of this concept analysis was to clarify what is meant by family functioning in the context of diabetes self-management by assessing specific attributes, antecedents, and consequences. A concept analysis model by Walker and Avant was applied. The identified attributes of family functioning in a diabetes self-management context included problem-solving, communication, roles, affective responsiveness, affective involvement, and behavioral control. Antecedents included family structure, socioeconomic status, family functioning relationships, family stage, and life events. Consequences included family satisfaction, family cohesion, and family relationships. This analysis provided a deeper understanding of a family functioning concept within a diabetes self-management context. It is recommended that health care providers should be aware of antecedent factors that could inhibit outcome improvement. Further research is needed to explain family functioning attributes in relation to antecedents and potential consequences.
