Kristiina Lehti

Development and testing of a family nursing scale.

A methodological study was conducted to test the psychometric properties of the Family Functioning, Health, and Social Support (FAFHES) Instrument to be used with families of heart patients. A total of 109 initial items were developed based on knowledge generated by three Finnish academic dissertations concerning family functioning, health, and social support provided by nurses. Data were collected from family members of 161 heart patients. Principal component analysis was performed in each of three total scales: family functioning, family health, and social support. The scales had acceptable reliability (alpha coefficients ranged from .73 to .95). Internal consistency reliability and content validity of the FAFHES have initial support. Results obtained from this study support that this instrument is ready for use in research in which the investigator wishes to measure social support associated with family functioning and the health of families of heart patients.

Family dynamics of families with cancer in Finland

The purpose of this study was to describe family dynamics of families with cancer on the basis of Barnhills framework for healthy family systems. The sample consisted of families in which one member had cancer. Both the patients (n = 96) and their relatives (n = 96) participated in the study (n = 192). The data for the study were collected using the Family Dynamics Questionnaire and the Family Dynamics Measure. The results indicated that the cancer of a single family member did not impair family functioning, but that family dynamics were considered quite good. There were no statistically significant differences between cancer patients and relatives on any of the family dynamics dimensions. However, an examination of sociodemographic characteristics did reveal some differences. Older relatives reported more enmeshment and rigidity than did younger relatives, whereas the latter reported more role conflict than older relatives. Older patients reported more rigidity than younger patients. Relatives who were men reported more enmeshment than women, whereas women reported more role conflict. Relatives of two-member families reported more rigidity than relatives with a larger family. Patients who reported a serious illness in the family described more mutuality, better flexibility, and clearer communication than patients who did not report such an illness. Also, relatives who mentioned a serious illness reported more mutuality and flexibility.

Further testing of a family nursing instrument (FAFHES)

BACKGROUND Cardiac illness in one family member affects the well-being and health of the whole family. When a family member falls ill, life may change for the whole family in many ways. Family members expect nursing staff to provide more support when their family situation changes. OBJECTIVES To describe further development and testing of a family nursing instrument for assessing the association between social support for the family of an adult cardiac patient and family functioning and perceived family health. SETTINGS The study was conducted in two university hospitals and in two central hospitals in Finland. METHODS AND PARTICIPANTS Questionnaires were given to family members of heart patients. Patients themselves defined who their closest adult relative was. Data were collected from family members of 509 heart patients. RESULTS Good internal reliability in this further testing of a new instrument was demonstrated. Principal component analysis (PCA) with varimax rotation was performed in each of the three total scales: family functioning, family health and social support. PCA supported the previously proposed theoretical framework. A final scale consisted of 62 items. All the total scales and subscales had acceptable validity and reliability, alpha coefficients ranged from .76 to .98. CONCLUSIONS The Family Functioning, Health and Social Support (FAFHES) provides a reliable and valid instrument when the investigator wishes to measure social support associated with family functioning and the health of families of heart patients.

Family Functioning Assessed by Family Members in Finnish Families of Heart Patients

Background: The role of family is central to the wellbeing and health of individuals. Family attitudes, habits and routines affect the way individuals promote their health. Family functioning and family health are threatened when one family member develops heart disease. Aims: The aim of the study was to describe family functioning and to ascertain factors related to family functioning of families with heart patient as assessed by family members. Methods: Data collection was done using a questionnaire (FAFHES) in 2000. The sample consisted of 161 family members of patients receiving treatment on two medical wards. The data were analysed by means and tested by parametric and non-parametric tests. The multivariate method used was stepwise regression analysis. Results: The better the family values were materialized and the greater the familys contribution to family health, the better the familys functioning is. Concrete aid was also related to family health. The more concrete aid the family received from nurses, the better family functioning is. When the background variables were included, values and activities remained in the model, but two new variables explained family functioning: family members age and knowledge of health issues. The older the family member is and the better the knowledge in the family is, the better is family functioning. Conclusion: Family functioning of families with heart patients can be supported and developed by family nursing, e.g. concrete aid from nurses. Other aspects of support, e.g. consideration of family members age and knowledge of health issues also need to be further considered and studied as the basis of care.