Suzanne Feetham

Evaluating A Multiple‐Family Group Access Intervention for Refugees with PTSD

The purpose of this study was to analyze the effects of a multiple-family group in increasing access to mental health services for refugees with posttraumatic stress disorder (PTSD). This study investigated a nine-session multiple-family group called Coffee and Families Education and Support with refugee families from Bosnia-Herzegovina in Chicago. Adults with PTSD (n = 197) and their families were randomly assigned to receive either the intervention or a control condition. The results indicated that a multiple-family group was effective in increasing access to mental health services and that depression and family comfort with discussing trauma mediated the intervention effect. Further well-designed studies of family interventions are needed for developing evidence-based interventions for refugee families.

The TAFES multi-family group intervention for Kosovar refugees: A feasibility study

The object of this study was to describe a feasibility study of the Tea and Families Education and Support (TAFES) intervention used in a group of newly resettled adult refugees from Kosova. The subjects were 86 newly resettled Kosovar refugees in Chicago who gave informed consent to participate in an investigation of the TAFES intervention. All subjects received family home visits, and most participated in the TAFES multi-family groups. The instruments were administered to adult participants before and 3 months after the intervention. The TAFES program had contact with 61 Kosovar refugee families, of which 42 families (69%) engaged in TAFES groups, including families with educated and working members. Several characteristics were associated with engaging in TAFES groups and included lower monthly family income and higher age of the first child. The uncontrolled postintervention assessments demonstrated increases in social support and psychiatric service use associated with engagement in the TAFES group. Participants also showed time changes in scale scores assessing trauma mental health knowledge, trauma mental health attitudes, and family hardiness. This study provides preliminary evidence that multi-family support and education groups are a feasible and possibly beneficial intervention for newly resettled refugees and indicates the need for further studies.

Issues to consider when choosing and using large national databases for research of families

Secondary analysis of large national databases offers promise for research of families. In this article, issues that the secondary analyst must consider when choosing a database for research of families are described. Potential advantages and limitations of databases are discussed. Strategies to minimize potential limitations are highlighted.

A Family Beliefs Framework for Socially and Culturally Specific Preventive Interventions With Refugee Youths and Families

To assist in designing socially and culturally specific preventive interventions for refugee youths and families, this study identified the processes by which refugee families adapt and apply family beliefs concerning youths. A grounded-theory model constructed with ATLAS/ti for Windows and named the family beliefs framework describes (a) family beliefs concerning refugee youths, (b) contextual factors interacting with these family beliefs, (c) adaptation of family beliefs concerning refugee youths, and (d) the interplay of adapting family beliefs and behaviors concerning refugee youths. Preventive interventions for refugee youths and families would be more socially and culturally specific if they addressed the specific processes of adapting family beliefs experienced by refugee youths and their families amid transitions and traumas.

Conceptual and pragmatic considerations in conducting a secondary analysis. An example from research of families.

In this article, the authors discuss conceptual and pragmatic considerations for conducting research of families using large secondary data sets. Conceptual considerations include establishing consistency among the theory, variables, and available data, and determining reliability and validity of the data in the context of the theory. Pragmatic considerations include the use of resources such as management of the data among several authors, criteria and methods for selection of a subsample, and, recoding of the data to examine dyadic difference scores. The Family Special Interest Group of the Eastern Nursing Research Society initiated this research as part of a project to analyze families using large national data sets. The purpose of the secondary analysis was to identify family beliefs about healt-promoting behaviors. Combining parent and teen data to create relational level data resulted in new information that had not been identified in the original survey.

Parent-teen worry about the teen contracting AIDS.

A secondary data analysis of the National Commission on Children: 1990 Survey of Parents and Children was conducted with a subsample of 457 parent-teen pairs who responded to the “worry about AIDS” question. The teen’s worry about contracting AIDS was associated with race, parent’s education, the amount of discipline from the parent for engaging in sex, the teen’s desire to talk to the parent about the problem of sex, the teen’s rating of the neighborhood as a safe place to grow up, whether the parent listened to the teen’s telephone interview, and the parent’s response to whether his or her teen had a history of sexually transmitted disease. Of the parent-teen pairs in the subsample, 46% (N = 210) agreed in their responses about worry. Agreement was more frequent among the parent-teen pairs when compared to randomly constructed surrogate pairs. Dyadic analysis supported a family system view of perceived susceptibility.

The family factor knowledge needed in oncology research.

O ur literature in oncology is replete with valid findings about the cancer experiences of individuals, from prevention, to diagnosis, to cure, to end of life. These findings have been translated into clinical practice guidelines or have been independently applied by clinicians. Importantly, these findings are applicable to adults and children who seek to adopt healthy lifestyles to diminish their likelihood of developing cancer, to caregivers of individuals being treated for cancer, and to patients in treatment themselves, in survivorship or at end of life. These findings improve the care of individuals affected by cancer around the world in invaluable ways. How could we add to these contributions? How could we extract knowledge that goes beyond these findings and increase their applicability to clinical care? We believe that the way to do this is to conduct more studies that address the ‘‘family factor.’’ From the time of Nightingale forward, the family has been recognized by many as the most important social context in which health and illness occur, with the family being responsible for providing an environment to support the health and well-being of its members. Likewise, the health of an individual affects the health and development of individual family members and of the family as a whole. Although the cancer literature is heavily dominated by reports of individual cancer experiences, there are exemplary reports of how families experience cancer, for example, from the patient-caregiver dyad perspective and from couples regarding treatment decision making for their child with cancer. The family factor, so named by Schumm and colleagues, has the potential to guide our research, from the kind of questions we pose, to the methods we use, to the sampling plan we establish, and indeed to the interpretation of our data. Originally coined to consider how data from multiple family members could be analyzed together to describe family experiences, the family factor perspectiveVif used in today’s researchV could lead us to understand the interdependence of individual family members’ perspectives (ie, not only the caregiver but also the caregiver and the ill person; the ill child and the parent; the ill patient and the spouse; the ill child and his/her siblings; the transplant patient, donor, and other family members who are not the donors). Our commitment to studying and understanding this interdependence will yield a new class of interventions designed to assist entire families affected by cancer. We believe that the interdependence accounts for variances in the impact of interventions on individual cancer patients, family members, and on the family as a whole. Intervention studies and systematic reviews that seek to evaluate family interventions must begin with a clear definition of the type of intervention being examined and its target sample. Interventions based only on the well-documented perspective of 1 family member can limit the applicability to other family members and, at their worst, risk creating additional challenges for the family. For example, some parents making treatment decisions for their ill child with cancer exclude the child and other children in the family to protect them from distressing information, but the outcomes of this exclusion for the ill child, siblings, parents, and family are unknown. An intervention would be well supported by a unilateral approach if its focus is independent of the perspectives of other family members and directed only to the individual whose perspective did inform the intervention. An intervention developed based on one member’s perspective but which is intended to influence multiple family members could chance being incompletely informed and thereby contributing to unanticipated or negative experiences for family members or for the entire family. In contrast, those interventions that reflect the perspectives of multiple family members are more likely to be sensitive to the overall family style or ‘‘shared variance.’’ True family-level research must be informed by data obtained from family members whose perspectives are relevant to what is being studied. Family factor knowledge may already be available to us in our existing databases that include 2 or more perspectives from members of the same family if analyzed at the level of the family in addition to the level of parent or child, caregiver and ill patient, and so forth. Insight into the routine and the illness-specific interactions of the family could be the basis of family-level interventions for care. Although there are stunning challenges to interpreting data at the level of the family, innovations in both quantitative and qualitative methods now allow for this level of analysis. Cancer Nursing seeks family-focused research submissions where the perspectives of 2 or more family members are included and are analyzed at both the individual family member level and the family level with a careful consideration of how the two are similar and different. In this way, we will learn the sources of variance within the family and their contributions to the overall family perspective. As a result, we will have a more comprehensive examination of the underlying family factor. Our very best to you.

Measuring Transition Readiness: A Correlational Study of Perceptions of Parent and Adolescents and Young Adults with Sickle Cell Disease

Adolescents and young adults (AYAs) often transfer from pediatric to adult care without adequate preparation, resulting in increased morbidity and mortality. The purpose of this descriptive research study of parent/AYA dyads was to measure perceptions of transition readiness. Factors that were found to be associated with perceptions of increased readiness to transition included AYA age, the amount of responsibility AYAs assume for their healthcare and the degree of parent involvement. More attention should be focused on these aspects of care to improve transition from pediatric to adult care for AYAs with sickle cell disease.

Expanding Science Policy Regarding Research with Vulnerable Families

Research with families described as vulnerable is a rapidly evolving area. This study provides a brief commentary on articles from the Eastern Nursing Research Society (ENRS) symposium on research of vulnerable families using standards for research of families. These standards constitute science policy that is intended to advance nursing or family science through setting broad-based standards and providing guidelines for research. This commentary also discusses the usefulness of these standards for research with vulnerable families and provides recommendations for positioning this research to inform social and health policy to improve the outcomes for these families.

Family Presence During Resuscitation After Trauma.

The purpose of this study was to examine the effects of family presence during resuscitation (FPDR) in patients who survived trauma from motor vehicle crashes (MVC) and gunshot wounds (GSW). A convenience sample of family members participated within three days of admission to critical care. Family members of 140 trauma patients (MVC n = 110, 79%; GSW n = 30, 21%) participated. Family members ranged in age from 20-84 years (M = 46, SD = 15, Mdn = 47). The majority were female (n = 112, 80%) and related to the patient as spouse (n = 46, 33%). Participating in the FPDR option reduced anxiety (t = −2.43, p =.04), reduced stress (t = −2.86, p = .005), and fostered well-being (t = 3.46, p = .001). Results demonstrate the positive initial effects of FPDR on family members of patients surviving trauma injury.