Having a child diagnosed with cancer is a stressful event for the family. This exploratory multimethod study utilized both quantitative and qualitative multiinformant methodologies to investigate the relationships between parental family functioning and siblings' health-related quality of life (HRQOL) and to describe interrelations between the experiences of parents and siblings of children with childhood cancer. A total of 14 Japanese families participated in the quantitative study, and 4 families of the 14 participated in the qualitative study. In-depth, semistructured interviews revealed three family-unit stages during the time course of the ill child's treatment that included particular parent-sibling interrelations. We also found strong correlation between parental family functioning and siblings' HRQOL in the quantitative study. The results suggest the importance of family nursing interventions directed to individual family members and the family unit that focus on strengthening the parent-sibling relationship and supporting families who are experiencing childhood cancer.
The Japanese-language version of the PedsQL™ Multidimensional Fatigue Scale demonstrated good reliability and validity and could be useful in evaluating Japanese children in school and health care settings.
It is generally agreed that healthcare workers are ideally positioned to recognize and diagnose cases of elder abuse. However, little is known about their knowledge and understanding of this issue. The objective of this study was to assess and compare the perceptions of different groups of healthcare workers toward elder abuse in Japan, using the Knowledge-Attitude-Behavior (KAB) model. Home-visit nurses, medical doctors, care managers, care workers, public health nurses, and social workers, with experience of dealing with elder abuse received self-administered questionnaire surveys that inquired regarding demographics, knowledge, attitudes, and behaviors regarding elder abuse. A total of 311 healthcare workers participated in this survey. To compare the differences among the groups, a one-way analysis of variance with a post-hoc Tukey’s test, and a Kruskal-Wallis with post-hoc Steel-Dwass tests were used in accordance with data normality. Multiple linear regression analysis was conducted to explore variables that predicted the healthcare workers’ perceptions, and covariance structure analysis was used to examine whether the KAB model can accurately predict healthcare workers’ perceptions. Multiple comparisons showed significant differences in knowledge, attitudes, and behaviors regarding elder abuse among the abovementioned six groups. Age, sex, and years of work related to the care of elderly were extracted as significant determinants of healthcare workers’ perceptions of elder abuse. The examination of the KAB model with covariance structure analysis yielded a model with strong goodness-of-fit. These findings emphasize the need to take effective measures to improve their perceptions as well as review the role of each healthcare worker so that they can be more concerned with and involved in the safeguarding of the elderly. Given the strong goodness-of-fit demonstrated by the KAB model, education of healthcare workers on both the knowledge of, and attitudes toward, elder abuse may help in improving healthcare workers’ behavior in dealing with elder abuse.
The SFE-J is a reliable and valid instrument to assess not only intrafamily functioning but also interfamily functioning and, by identifying items/domains with high requirements for family support, serves to facilitate the providing of appropriate support to families.
The article presents development of a nursing model for holistically understanding the family environment that acts on family well-being as well as of tools based on this model to assess family well-being. These were constructed by using qualitative, quantitative, and literary approaches, such as the Delphi technique, a literature review, semistructured interviews with families, and ethnographic studies in Japan, Hong Kong, and the United States. In the "Concentric Sphere Family Environment Model," a three-dimensional logical space is formed by the three assessment axes of relationships (structural distance, functional distance, and temporal distance) and five systems (supra system, macro system, micro system, family internal environment system, and chrono system) located therein. The "Family Environment Assessment Index" comprises 37 items for assessing the family well-being, and for each of their specifications useful sample questions are provided to conduct the culturally congruent family assessment.
A Chinese version of the Feetham Family Functioning Survey (Chinese FFFS) was developed and psychometrically tested using a sample of 317 child-rearing mothers in Hong Kong. The Chinese FFFS is a self-administered questionnaire consisting of 25 items from which an instrument discrepant score (d score) can be extracted. The results from the confirmatory factor analysis and exploratory factor analysis confirm that the Chinese FFFS has a five-factor structure based on the family ecological model, thereby affirming its construct validity. Cronbach's alpha for d scores was .91, indicating a high internal consistency. In the test-retest study of 39 mothers, the correlation coefficient for "total d score" over a 2-week period was .82, which showed high test-retest reliability. The highest discrepant scores in family functioning were at the level of the marital relationship, which requires family nurses to be skilled at assessing and intervening at this family subsystem.
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