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Objectives: Family members of Intensive Care Unit (ICU) patients can experience mental health difficulties. These are collectively described as Post Intensive Care Syndrome-Family (PICS-F). There are no standardised outcome measures to benchmark the impact of PICS-F. This scoping review aimed to map and characterise interventions, outcomes, and outcome instruments related to PICS-F., Methods: Eight databases were searched in June 2023: Pubmed, CINAHL, Ovid Medline, EMBASE, PsycInfo, AMED, Emcare and Cochrane. The grey literature was also searched. Studies published after 2012 related to PICS-F were included. Search strategy included: (Population) family members of adult ICU patients, (Concept) PICS-F, (Context) ICU settings. Frequency analysis of outcomes was performed, and instruments were mapped to describe the characteristics., Results: Of the identified 4848 records, 46 papers representing 44 unique studies met the inclusion criteria and were retained for analysis. In total, 8008 family members were represented across 15 countries in four continents worldwide. The number of studies reporting PICS-F interventions increased rapidly over the past 12 years and were performed in ICUs treating mixed conditions. Studies were randomised control trials (n = 33), before-and-after design (n = 6) and non-randomised trials (n = 5). A total of 18 outcome instruments were used measuring predominantly anxiety, with complicated grief measured only once. The identified instruments were mostly validated for clinical and disease specific populations but not validated among relatives of ICU patients., Conclusion: There is a plethora of instruments measuring PICS-F outcomes. No core outcome set is currently available for PICS-F. To reduce heterogeneity of how PICS-F is measured, a core outcome set with validated measurements is recommended to allow benchmarking and to document the impact of PICS-F interventions., Implications for Clinical Practice: Recognising PICS-F symptoms and understanding how to assess them could help clinicians to develop interventions to improve family outcomes. Validated instruments are needed to evaluate these interventions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Crown Copyright © 2024. Published by Elsevier Ltd. All rights reserved.)

Rationale: Family members of patients who die in an intensive care unit (ICU) are at heightened risk of post-traumatic stress disorder (PTSD) symptoms. Not all surrogates develop these symptoms and heterogeneity exists in PTSD symptom clusters. Objectives: The study tested a personality model of PTSD symptoms in bereaved family caregivers of ICU patients. It was hypothesized that family members endorsing higher levels of neurotic personality traits would report higher levels of PTSD symptom clusters and that these associations would be explained by tendencies to view the patient's death as unexpected and to cope by suppressing their emotions. Methods: Participants were family members of ICU patients at an urban, academic medical center who either died or were discharged to an inpatient hospice unit. Participants were contacted for participation at least six months after the patient's death. Participants completed measures of personality, emotion regulation, and PTSD symptoms. Data were analyzed using path analysis. Results: Approximately one-third (35%) of the sample of 162 caregivers endorsed at-risk levels of PTSD. Individuals reporting higher levels of neurotic personality traits reported more PTSD symptoms ( r = 0.53, p < 0.001). Perceptions that the patient death was unexpected partially explained the association of neuroticism with the intrusive re-experiencing PTSD symptoms (B = 0.45, p = 0.031). In contrast, emotional suppression partially explained the association of neuroticism with avoidance (B = 0.70, p = 0.010) and hyperarousal symptom clusters (B = 0.37, p = 0.041). Conclusions: Family vulnerability to PTSD after an ICU death can be conceptualized based on neurotic personality traits. Tendencies to view the patient's death as unexpected may contribute to intrusive thoughts and memories of the ICU experience. Individuals may avoid reminders and remain at heightened levels of arousal when they suppress their emotional experiences. Key Message: Family members who experience the death of a loved one following ICU treatment are vulnerable to PTSD symptoms. These reactions to ICU-related losses may be shaped by family members' personalities, expectations, and emotion regulation styles. Understanding these characteristics could inform family screening and intervention efforts in the ICU.

Purpose: To access the attitudes of service users about the sharing of health records for research and to foster collaboration between municipal health services and the specialist health services in Norway., Methods: Members ( n  ≈ 2000) of the Norwegian mental health service users' organizations (SUO's), ADHD Norway, the Autism Association and the Tourette Association, representing Central Norway, participated in the study, ( N  = 108, 5.4% response rate). Descriptive statistics were used to evaluate distributions of responses to the questionnaire., Results: Service users reported being aware that municipal health services collaborate with the specialist health service (62%), with mental health care in the specialist health service (57%), and child and adolescent psychiatric services (61%). A large proportion of individuals were aware of the benefits of sharing their health records (93%), have trust in the use of data by health authorities (81%), and were willing to share records to benefit fellow patients (84%). Personal experience (69%) and impressions from mainstream media (55%) had the most influential impact on users' views of the Health Platform, an electronic health communication system. A majority of users had a negative perception of the Health Platform, even though some expect it to become a valuable tool in the future (50%)., Conclusions: Service users are aware of and positive about benefiting others by sharing health records. They trust the health authorities, however, have negative attitudes about the Health Platform, apparently based on personal experiences and media influence. However, service users can see the potential usefulness of the Health Platform in the future.

Objectives: We tested an extended family stress model of economic hardship (FSM; Conger et al., 2010) incorporating structural risks (discrimination, immigration, and COVID-19 experiences) and qualitative data, to better understand the impact of culturally relevant experiences on family stress processes in rural, immigrant Latine families in the U.S. Midwest., Method: Participants were Latine families (N = 307) with a child aged 10-15 ( M age = 12.21 years, 51.0% boys; 71.5% two parent; 93.1% of caregivers and 29% of youth born outside the United States) Mean household income was 25-30K and 65% of caregivers had less than a high school education. We tested a cross-sectional structural equation model in Mplus and analyzed qualitative interviews with a subsample of mother-youth dyads ( n = 19)., Results: COVID-19 experiences predicted economic pressure, and both COVID-19 and discrimination experiences were linked to caregiver psychological distress. Consistent with the FSM, economic pressure predicted psychological distress, which was associated with interparental relationship problems and parenting. Parenting was associated with youth global health. Unexpectedly, interparental relationship problems to parenting were not significant. The indirect association linking COVID-19 experiences to youth global health via psychological distress and parenting was significant. Qualitative data revealed five themes demonstrating how structural and economic risks contributed to distress, conflict, and maladjustment within the family system., Conclusions: Culturally relevant structural risks exert a negative influence on family processes in rural Latine immigrant families through contributing to economic pressures and parental distress. The additional impact of these experiences should be considered when addressing the FSM in Latine populations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objectives: This qualitative investigation examined how Latinx/Hispanic youth experience cultural stressors, emotionally react to, and cope with these stressors within the family context., Method: Forty-five youth participated in six focus groups (51% female; 49% male; 0% nonbinary; M age = 15.26; SD = 0.79)., Results: Using reflexive thematic analysis, we constructed two themes with four accompanying subthemes centering on (a) observing family members experience cultural stressors and (b) experiencing cultural stressors together with family members., Conclusions: Findings highlight the need for cultural stress theory to focus on the family context in Latinx/Hispanic youths' experiences of cultural stressors, their emotional reactions and coping responses to these stressors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: To evaluate how family functioning, family contributions to college expenses, and access to mentors are associated with college student's self-reported health and flourishing, and to test for moderation by family structure. Participants: Undergraduate college students (N = 238) recruited through an email list-serve at a large midwestern state university. Methods: Participants completed an online survey (distributed through Qualtrics) in February 2020. Data were analyzed using linear regression (in SPSS 28) and simple slope analyses. Results: College students' access to mentors is associated with their self-reported health, and family structure moderates the association between family strengths and self-reported health. Family functioning and access to mentors are both associated with college students' flourishing. Conclusions: College students' health and flourishing may benefit from access to mentors and functional family dynamics. Though students from post-divorce families see fewer benefits from family strengths compared to peers in nuclear biological families.

Background: Purposeless physiological monitoring at the end-of-life is not recommended. However, studies on how families feel regarding the death of patients with terminal cancer without continuous electrocardiographic monitoring (CEM) are lacking., Objectives: To explore the impact on the quality of care and the feelings and psychological distress experienced by families when CEM is not used during the 24 hours preceding a patient's death., Methods: In this multicenter cross-sectional, self-report questionnaires were distributed to 1087 bereaved families at Japanese specialized palliative care units in 2018., Results: Out of 671 responses, 394 valid responses were analyzed. Families of nonmonitored patients (NM-group) accounted for 79.2%, while those with bedside electrocardiogram monitoring (MB-group) and remote nurse station monitoring (MC-group) comprised 11.9% and 8.9%, respectively. In the NM-group, 85.5% expressed satisfaction without CEM, which was more than 10% lower than other groups. While 14% in the NM-group desired patient monitoring, families who received adequate explanations about CEM had lower proportions compared to the MB-group ( P = .021). Univariate analyses showed no significant differences in evaluations of the quality of care and families' psychological distress (mean scores of Overall Care Satisfaction, Care Evaluation Scale, Good Death Inventory, Brief Grief Questionnaires) across all groups., Conclusion: While the majority of NM-group were satisfied with their patient's care without CEM, the proportion of dissatisfied families was higher than in other groups. Although not using CEM is not a major hindrance to end-of-life care for patients with terminal cancer, providing sufficient explanations may be important for satisfactory care., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Aim: To explore patient and family narratives about their recognition and response to clinical deterioration and their interactions with clinicians prior to and during Medical Emergency Team (MET) activations in hospital., Background: Research on clinical deterioration has mostly focused on clinicians' roles. Although patients and families can identify subtle cues of early deterioration, little research has focused on their experience of recognising, speaking up and communicating with clinicians during this period of instability., Design: A narrative inquiry., Methods: Using narrative interviewing techniques, 33 adult patients and 14 family members of patients, who had received a MET call, in one private and one public academic teaching hospital in Melbourne, Australia were interviewed. Narrative analysis was conducted on the data., Results: The core story of help seeking for recognition and response by clinicians to patient deterioration yielded four subplots: (1) identifying deterioration, recognition that something was not right and different from earlier; (2) voicing concerns to their nurse or by family members on their behalf; (3) being heard, desiring a response acknowledging the legitimacy of their concerns; and (4) once concerns were expressed, there was an expectation of and trust in clinicians to act on the concerns and manage the situation., Conclusion: Clinical deterioration results in an additional burden for hospitalised patients and families to speak up, seek help and resolve their concerns. Educating patients and families on what to be concerned about and when to notify staff requires a close partnership with clinicians., Implications for the Profession And/or Patient Care: Clinicians must create an environment that enables patients and families to speak up. They must be alert to both subjective and objective information, to acknowledge and to act on the information accordingly., Reporting Method: The consolidated criteria for reporting qualitative research (COREQ) guidelines were used for reporting., Patient or Public Contribution: The consumer researcher was involved in design, data analysis and publication preparation., (© 2024 The Author(s). Journal of Clinical Nursing published by John Wiley & Sons Ltd.)

Background: Regarding the prevalence and pervasiveness of psychiatric disorders, which significantly affect not only the patients themselves, but also their families, family therapy has emerged as a promising intervention. This research examined the effects of Acceptance and Commitment Therapy (ACT) on stigma and family functioning in family members of patients with psychiatric illnesses, demonstrating effectiveness in improving family functioning and coping strategies in the face of mental illness., Methods: This randomized controlled clinical trial without blinding. Forty family members of patients with psychiatric disorders were randomly assigned to an intervention group (N = 20) or a control group (N = 20). The intervention group received ACT in eight weekly sessions, each lasting 90 min, while control group remained on a waiting list. Both groups were assessed at three time points: pre-intervention, post-intervention, and at a one-month follow-up. Data collection instruments included a demographic information questionnaire, a stigma assessment, and a family functioning measure. Data were analyzed using SPSS software version 23., Results: A statistically significant difference was observed between the mean post-test and follow-up stigma scores of the intervention and control groups (P < 0.05). The intervention group's mean scores showed a rising trend, whereas the control group's mean scores showed a declining trend. This was evident from within-group comparisons of the mean post-test and follow-up stigma scores. Repeated measures ANOVA indicated that the pattern of change in stigma for the intervention group was significant, in contrast to control group, suggesting a reduction in stigma (P < 0.001)., Conclusion: In light of the findings presented in this study, ACT emerges as a promising intervention for mitigating stigma, and enhancing the family functioning of individuals afflicted with mental disorders. To improve the generalizability of the study results, comparable studies using this therapy method should be undertaken on family caregivers of patients with mental illnesses., Iranian Registry of Clinical Trials: IRCT registration number: IRCT20190917044802N10., Registration Date: 14/9/2023., (© 2024. The Author(s).)

Background: This study explores how family members of individuals with mental illnesses address potential familial mental illness stigma. Previous studies have concentrated on self, social, and associative stigma and its impacts on families and persons with mental illnesses. Far less work has considered family members as perpetrators of mental illness stigma towards their loved ones with mental illnesses., Methodology/principal Findings: We conducted this study with 15 participants who were family members of persons with mental illnesses using semi-structured qualitative interviews. The in-depth interviews were followed by inductive analysis using Braun and Clarke's technique for thematic analysis. Participants' views on familial mental illness stigma and ways to reduce this were reported in five key themes. The themes included: (1) layered perspectives of social and family stigma; (2) family-related stigma; (3) complex interplay of family relationships and mental illness; (4) confronting stigma personally; and (5) envisioning a better future. The uncertainties connected with mental illnesses and the increased social stigma were conceptualized as contributors to familial mental illness stigma as ways to prevent potential associative stigma., Conclusion/significance: Participants suggested the need for more social contact-based education and positive media reporting to correct the ongoing fallacies around mental illnesses. This study highlights how higher-order reforms to social systems and services would support both families and those living with mental illnesses to have more positive experiences., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Adu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Competing Interests: Co-first authors: Zhanshuo Xiao and Yilin Jiang. The authors report no conflicts of interest in this communication.

Aim: To provide an overview of the various influencing factors related to the positive aspects of caring for dementia patients by family caregivers., Design: A systematic mixed studies review., Methods: The Preferred Reporting Items for Systematic Reviews guided this protocol as reported. Peer-reviewed studies published in English from 1997 to the present will be searched via information sources, gray literature, and the following databases: Web of Science, PsycINFO, PubMed, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials. Eligible trials will also be retrieved from ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform. This will be a mixed studies review. The Mixed Method Appraisal Tool will be used for the mixed-method studies. The Newcastle-Ottawa Scale for case-control and cohort studies and the JBI quality scale for cross-sectional and interventional (i.e., randomized or quasi-experimental) studies will be consulted. The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research will be used for the qualitative studies. All the data will be extricated with JBI data extraction tools. The convergent synthesis method will be used in the review., Discussion: This systematic review will synthesize and analyze the factors that influence the positive aspects of caring for dementia patients by family caregivers., Conclusion: The findings will help decision-makers to adopt more appropriate and effective interventions for caregivers of people with dementia., Patient or Public Contributions: This review protocol will ascertain the factors affecting the mediation of and path to improved caregiving, explore the factors' action mechanisms, and examine the controlling factors to design a more targeted intervention program to improve caregiving, thus improving dementia patients' outcomes and care. Contributions of the findings will include evidence of strategies that address ongoing dementia caregiving issues and the identification of areas for future research., (© 2024. The Author(s).)

Background: The family is one of the most important pillars of society. They provide strong feelings of security, emotional support, and belonging. Family health has a significant impact on the welfare of people and society as a whole., Objectives: This study aimed to create the Satisfaction with Family Life Scale (SWFLS) for Türkiye by modifying the well-known Satisfaction with Life Scale (SWLS) first developed by Diener et al. (1985) and to evaluate its psychometric properties., Method: The present study examined the factor structure, measurement invariance, convergent validity, and internal consistency of the SWFLS. Confirmatory factor analyses (CFA) were performed on data from a research group of 646 participants aged 18-71 years (M = 31.71, SD = 11.79) in Study 1. As part of the validity assessment, CFA confirmed the unidimensional structure of the SWFLS. The reliability of the scale was assessed using Cronbach's alpha (α), composite reliability, and the McDonald 0mega (ω). In Study 2, the scale was administered to a new group of 555 participants aged 18 to 67 years (M = 36.4, SD = 9.73) to assess its criterion validity. Test-retest reliability was assessed using a sample of 48 undergraduate students via the intraclass correlation coefficient model 2.1 (ICC 2,1 )., Results: The CFA's results verified the SWFLS's single-factor model. The internal consistency coefficients of Cronbach's α and McDonald's ω were both 0.93. The composite reliability value was 0.94. The result of test-retest reliability (ICC2,1) was 0.96 and ranged from the ICC2,1 value of 0.85 to 0.90 for items of the SWFLS. Multigroup analysis supported full measurement invariance across genders for the SWFLS. Corrected item correlations ranged from 0.75 0.85. The Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) and SWFLS were shown to have a positive correlation (r = .483, p 0.001), which supports the idea that the two scales have similar convergent validity., Conclusions: Based on these results, the Turkish SWFLS version can be utilized to measure family life satisfaction in the Turkish sample and has appropriate psychometric validity and reliability., (© 2024. The Author(s).)

The family plays an immensely crucial role in the development of adolescents, significantly influencing their behavioral patterns. To explore the impact mechanism of the family physical activity environment on adolescents' exercise adherence, and analyze the chain-mediating role of exercise self-efficacy and exercise satisfaction. A questionnaire was administered to 500 adolescents and their parents using the Family Physical Activity Environment Scale, Exercise Adherence Scale, Exercise Self-Efficacy Scale and Satisfaction Scale. The direct impact value of the family physical activity environment on adolescents' exercise adherence is 0.148, with an effect size of 32.81%. The impact values of exercise self-efficacy and satisfaction between the family physical activity environment and adolescents' exercise adherence are 0.113 and 0.092 respectively, with effect sizes of 25.05% and 20.39%. The chain-mediating effect of exercise self-efficacy and satisfaction is significant, with an effect value of 0.097 and an effect size of 21.50%. Family physical activity environment can directly and positively predict adolescents' exercise adherence, positively predict adolescents' exercise adherence through the independent mediating role of exercise self-efficacy and satisfaction, and also positively predict adolescents' exercise adherence through the chain mediating role of exercise self-efficacy and satisfaction. This provides a theoretical reference for enhancing adolescents' exercise adherence and improving their levels of physical health., (© 2024. The Author(s).)

Support for children and young people who provide unpaid care is important to help prevent negative impacts of caregiving on their education, employment, mental health, and social relationships. We aimed to address an evidence gap about what services and support are needed from young carers' perspectives. We carried out focus groups or in-depth interviews with 133 carers aged 9-25 in England. Expressed unmet need for services and support could be grouped in three categories: support that would reduce or remove young people's need to provide care, help improve the lives of the people they care for, mitigate against impacts of providing care on their mental health, wellbeing, education, social participation and leisure activities, and, whilst they are still providing care, assist them in their caring role. Action is needed to address these currently unmet needs and implement young carers' and their families' rights to support., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Brimblecombe et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: In recent years, it has become increasingly evident that the population in many countries has been declining. China, which was previously the world's most populous nation and is often categorized as an emerging economy, officially entered an era of population decline in 2022. The advent of this era has make China's economic development more uncertain and aging of population more pronounced. To address the population decline, the Chinese government implemented the "Three-Child Policy" to encourage childbirth, aiming to reverse the negative population growth. However, this policy has not achieved the expected goals. Instead, it has increased the pressure on women to bear children, particularly for career women, where such pressure may conflict with their existing work and family environments, subsequently affecting their mental wellbeing., Methods: A survey was conducted to investigate the mental wellbeing status of career women in Changchun City, Jilin Province, Northeast China. It analyzes the impact of working and family environments on the mental wellbeing of these women., Results: Based on the survey, this study draws five conclusions: A . The mental wellbeing status of career women varies across different ages, industries, and childbirth statuses. B . The perceived adverse impact of childbirth on the working environment may negatively affect the mental wellbeing of career women. C . The perceived adverse impact of childbirth on the family environment may negatively affect the mental wellbeing of career women. D . Career women are not satisfied with the effectiveness of current policies in protecting women's rights. E . Compared to working environments, there is a greater demand for career women in the family environments, particularly in reducing various family burdens., Discussion: The pro-natalist policies introduced in response to negative population growth can worsen the mental wellbeing of career women, while the deterioration of their mental wellbeing could further accelerate population decline. Given the current challenges, this study suggests that effectively improving the mental wellbeing of career women requires building psychological resilience among childless career women, reducing the burden of family on career women, and continuously improving policies and regulations that protect the rights of career women., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zhou, Wu, Ge and Zhuo.)

Objective: to conduct the cross-cultural adaptation and psychometric validation of the Family Integration Experience Scale: Chronic Illness in Brazilian Portuguese., Method: a methodological study divided into two stages. In the first stage, the Family Integration Experience Scale: Chronic Illness was cross-culturally adapted for Brazilian culture, when the scale was subjected to translations, back-translations, and a committee of judges - to verify the semantic, linguistic, and contextual equivalence between the original and translated items. The second step was to validate the scale in a sample of families of children and adolescents with chronic illnesses. The participants were 230 families of children with chronic illnesses attending the outpatient clinic of a tertiary public hospital with teaching and research characteristics., Results: internal consistency was tested using Cronbach's alpha (0.81) and McDonald's omega (0.81). Confirmatory factor analysis was also tested, and the model's fit was acceptable for validation standards., Conclusion: the version of the Family Integration Experience Scale: Chronic Illness showed evidence of validation and can be considered a valid and reliable instrument in Brazilian culture. The Brazilian Portuguese version of the Family Integration Experience Scale: Chronic Illness can be used to measure the experience of family integration in chronic illness.

Introduction: Alaska Native and American Indian (ANAI) peoples in Alaska currently experience a disproportionate burden of morbidity and mortality from tobacco cigarette use. Financial incentives for smoking cessation are evidence-based, but a family-level incentive structure has not been evaluated. We used a community-based participatory research and qualitative approach to culturally adapt a smoking cessation intervention with ANAI families., Aims and Methods: We conducted individual, semistructured telephone interviews with 12 ANAI adults who smoke, 12 adult family members, and 13 Alaska Tribal Health System stakeholders statewide between November 2022 and March 2023. Through content analysis, we explored intervention receptivity, incentive preferences, culturally aligned recruitment and intervention messaging, and future implementation needs., Results: Participants were receptive to the intervention. Involving a family member was viewed as novel and aligned with ANAI cultural values of commitment to community and familial interdependence. Major themes included choosing a family member who is supportive and understanding, keeping materials positive and encouraging, and offering cash and noncash incentives for family members to choose (eg, fuel, groceries, activities). Participants indicated that messaging should emphasize family collaboration and that cessation resources and support tips should be provided. Stakeholders also reinforced that program materials should encourage the use of other existing evidence-based cessation therapies (eg, nicotine replacement, counseling)., Conclusions: Adaptations, grounded in ANAI cultural strengths, were made to the intervention and recruitment materials based on participant feedback. Next steps include a beta-test for feasibility and a randomized controlled trial for efficacy., Implications: This is the first study to design and adapt a financial incentives intervention promoting smoking cessation among ANAI peoples and the first to involve the family system. Feedback from this formative work was used to develop a meaningful family-level incentive structure with ANAI people who smoke and family members and ensure intervention messaging is supportive and culturally aligned. The results provide qualitative knowledge that can inform future family-based interventions with ANAI communities, including our planned randomized controlled trial of the intervention., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Objectives: to describe researchers' experience in collecting data from families of femicide victims., Methods: this descriptive, qualitative study took the form of an experience report and was conducted in Manaus, Amazonas, Brazil. It involved documentary consultation, training researchers, scheduling and conducting interviews, and using a field diary to record the researchers' perceptions and experiences., Results: the descriptions and photographs of the crime scene were both distressing and impactful for the researchers. The mementos of the victims (including clothing, objects, and childhood photos) shown by their families were deeply moving. Identifying with these experiences facilitated listening to the stories told by the relatives. It was essential to maintain a non-judgmental attitude, acknowledge the loss, provide support for the suffering, and demonstrate a willingness to help., Final Considerations: the experience encompassed both theoretical and methodological aspects that were planned and executed in data collection, fostering the development of skills and sensitivity towards the cases. Beyond knowledge and preparation, researchers are expected to exhibit ethical conduct and empathetic capacity.

Competing Interests: Competing interests: None declared.

Competing Interests: Competing interests: None declared.

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 (β=-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., (© 2024. The Author(s).)

Background: Frail people receiving home care services face an increased risk of developing crisis, which can result in adverse events, coercive measures, and acute institutionalisation. The prevalence of frailty is expected to increase due to the ageing population in most countries. However, our knowledge of the process leading to crises among frail community-dwelling patients remains limited. The aim of our study was to explore how users of home care services and their next of kin experienced crises and how these crises were approached by home care services., Methods: A qualitative explorative design with 21 interviews was conducted. We explored crises within the last year that had led to an acute institutionalisation (hospital or nursing home) or to an unstable situation with high risk of institutionalisation. Systematic text condensation (STC) was used to analyse the data., Results: Our findings are summarised into one overarching theme; an organisation working mainly reactively instead of proactively, which is supported by four subthemes: (1) insufficient communication-a determinant of crises, (2) the lack of a holistic approach, (3) a sense of being a burden, and (4) the complexity of crises. The reactive approach is demonstrated in the participant's experience of insufficient communication and the lack of a holistic approach from the service, but also in the user's sense of being a burden, which seems to be reinforced by the experienced busyness from the staff in the home care services. This reactive approach to crises seems to have contributed to difficulties in detecting the various stressors involved in the complex process leading to crisis., Conclusions: Our findings suggest that home care services tend to be characterised by a reactive approach to rising instability and the development of crises for users. This can be interpreted as an emergent property of the organisation and the adaptation towards exceeding demands due to insufficient capacity in health care services. We recommend the use of multicomponent care programmes comprising interdisciplinary case conferences in home care services to implement a cultural change that can shift the service from a reactive, fragmented, and task-oriented approach to a more proactive approach., (© 2024. The Author(s).)

We aimed to explore the experiences, needs, and mental health impact of family members of healthcare workers (HCWs) before and during the COVID-19 pandemic. Eleven quantitative and nine qualitative studies were included in this review. Based on the narrative synthesis, we identified five outcomes: 'Mental health outcomes', 'Family relationships, 'Coping skills and resilience', 'Quality of life and social life', and 'Practical outcomes'. Our findings indicated that there was a high risk to the mental health and well-being of families of healthcare workers both before and during the pandemic. However, with the COVID-19 pandemic, some experiences and mental health issues of families were worsened. There was also a negative association between working long hours/shift work and family relationships/communication, family social life, and joint activities, and family members taking on more domestic responsibilities. Families tended to use both positive and negative coping strategies to deal with their loved one's job stress. Organisations and support services working with people in health care work should consider widening support to families where possible. With this understanding, HCWs and their families could be supported more effectively in clinical and organisational settings. Trial registration: Systematic Review Registration Number: CRD42022310729. https://www.crd.york.ac.uk/prospero/display&#95;record.php?ID=CRD42022310729., Competing Interests: NO authors have competing interests., (Copyright: © 2024 Tekin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: The enabling behaviors of family members of psychoactive substance users can be crucial in maintaining addiction. There are no psychometrically evaluated instruments to measure the frequency of the enabling behaviors of family members of psychoactive substance users. Therefore, this study aimed to assess the internal consistency and factor structure of the Behavioral Enabling Scale., Design: A cross-sectional study was carried out, with a secondary analysis of data collected from 400 family members of psychoactive substance users that used a hotline service in Brazil. Exploratory factor analysis was conducted with an initial sample of 200 protocols, and with the remaining 200 protocols, a confirmatory factor analysis was conducted., Results: The internal consistency estimate proved entirely satisfactory in both samples, where the first presented a Cronbach's alpha of 0.76 and the second had a consistency estimate of 0.79. Factor analysis was conducted using a shortened version of the instrument, with 15 items, during which six factors that cover 65% of the scale's explained variance were extracted. KMO = 0.68 and Bartlett's test of sphericity = X 2 (gl = 153) 497.201, p < 0.0001, were significant., Conclusion: The Brazilian version of the Behavioral Enabling Scale is a valid tool that measures the frequency of the enabling behaviors of family members of psychoactive substance users. The measurement instrument enables further investigations into the behavior of family members regarding the use of psychoactive substances by their relatives.

Background: Children utilizing invasive home mechanical ventilation (administered via tracheostomy tube) receive intensive care at home without the support of trained staff typically present in an intensive care unit; within the context of worsening home nursing shortages, much of the 24/7 care burden falls to families which are likely under supported. Prior reviews have explored the quality of life of children receiving various forms of mechanical ventilation, without addressing the impact on the family. Additionally, the literature inconsistently differentiates the unique experience of families with children using invasive home mechanical ventilation from non-invasive, which has lower morbidity and mortality and requires less nursing care in the home. Therefore, our study aims to explore and map the existing literature regarding the impact of invasive home mechanical ventilation on the child and family's quality of life. Identified gaps will inform future research focused on improving the family quality of life of children with invasive home mechanical ventilation., Methods: Five databases will be searched using keywords and controlled vocabulary to identify relevant studies: Ovid Medline, Embase, Scopus, and Cochrane Library. English language studies will meet inclusion criteria if they include primary research studies of children or families of children utilizing invasive home mechanical ventilation at home and assess quality of life. Children and young adults aged 0-25 years will be included. We exclude studies of hospitalized children, studies focused solely on healthcare professional experiences or clinical outcomes, and those focused on the period surrounding discharge from admission for tracheostomy placement. Two independent reviewers will screen studies at the title/abstract and full-text levels. Two independent reviewers will extract data from relevant studies. Disagreements will be resolved by an independent third reviewer. A targeted grey literature search will be performed utilizing ProQuest, clinicaltrials.gov, WHO trial registry, Google Scholar, and professional societies. Findings will be presented in tables and figures along with a narrative summary., Discussion: This scoping review seeks to map the literature and provide a descriptive report of the health-related quality of life of children using invasive home mechanical ventilation and their families., Registration: Open Science Framework https://doi.org/10.17605/OSF.IO/6GB84 Date of Registration: November 29, 2023., (© 2024. The Author(s).)

While the occupational and health-related consequences of workplace bullying have received extensive research attention, the effects of workplace bullying on the family domain have been largely ignored. Based on the PRISMA framework, the Scopus, Web of Science, PsycINFO, and PubMed databases were searched up to May 12, 2024, for articles on associations between workplace bullying and family functioning. A total of 1347 articles were identified, of which 37 were found after review to meet the criteria for inclusion. All the included studies found a direct or indirect association between workplace bullying and family functioning. Most studies are grounded in the conservation of resources (COR) theory, spillover theory, crossover theory, and work-family interface model. Negative affect (emotions), work-family conflict (WFC), and burnout were considered essential mechanisms explaining the links between workplace bullying and family functioning, with personal resources (demands) as the main moderators. Most studies focus on the one-way impact of workplace bullying on family functioning, mainly using cross-sectional, non-randomized self-report designs. Future research will benefit from using a longitudinal design, continued characterization of the workplace bullying-family functioning relationship, including its nature, direction, processes, and boundary conditions in various industrial and cultural contexts, together with the use of models for the integration of research findings., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Jie et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Effective communication between patients and healthcare providers in the emergency department (ED) is challenging due to the dynamic nature of the ED environment. This study aimed to trial a chat service enabling patients in the ED and their family members to ask questions freely, exploring the service's feasibility and user experience., Objectives: To identify the types of needs and inquiries from patients and family members in the ED that could be addressed through the chat service and to assess the user experience of the service., Methods: We enrolled patients and family members aged over 19 years in the ED, providing the chat service for up to 4 h per ED visit. Trained research nurses followed specific guidelines to respond to messages from the participants. After participation, participants were required to complete a survey. Those who agreed also participated in interviews to provide insights on their experiences with the ED chat service., Results: A total of 40 participants (20 patients and 20 family members) sent 305 messages (72 by patients and 233 by family members), with patients sending an average of 3.6 messages and family members 11.7. Research nurses resolved 41.4% of patient inquiries and 70.9% of family member inquiries without further healthcare provider involvement. High usability was reported, with positive feedback on communication with healthcare workers, information accessibility, and emotional support., Conclusions: The ED chat service was found to be feasible and led to positive user experiences for both patients and their family members., (© 2024. The Author(s).)

Background: Delivering serious news is usually challenging for healthcare professionals and the pandemic of COVID-19 and related restrictions brought additional challenges in this process., Aims: To explore the experience of bereaved relatives with receiving serious news from healthcare professionals during the pandemic COVID-19., Design: A qualitative study using thematic analysis and a codebook approach of data collected in semi-structured interviews with bereaved relatives., Setting/participants: Data were collected from July to August 2022 in person/via phone with bereaved relatives who lost their relatives during the pandemic (from March 2020 to March 2022). Participants were recruited using a convenience sample and snowball method through social media and through one university hospital palliative care unit that invited bereaved relatives of deceased patients treated at the unit to participate in this study., Results: A total of 22 participants, consisting of 4 men and 18 women, were interviewed for this study. Most of the participants were sons or daughters of individuals who had died (5 grandchildren, 14 sons/daughters, 2 spouses, 1 great-niece). Six themes were identified: Burden caused by visit ban, Fear of COVID-19, Inappropriate behaviour and communication of healthcare professionals, High need for emotional support, Need for detailed and honest communication, Tendency to make excuses for mistakes and lapses by healthcare professionals., Conclusions: Delivering serious news during a pandemic was negatively influenced by a lack of contact with patients and a lack of support and empathetic communication with staff. Overcoming these circumstances can be achieved by frequent communication using various communication tools (such as videoconferences or phone calls), and maintaining empathy and honesty in the communication process., (© 2024. The Author(s).)

When individuals face life pressure or significant family changes, individuals with better family adaptation can better survive the crisis. Although the influencing factors of family adaptation have been investigated, the application of potential profile analysis has yet to be found. This analytical approach can reveal different potential categories of family adaptation, providing new perspectives for theoretical development and interventions. This study used latent profile analysis to explore family adaptation levels in breast cancer patients and identify different latent categories, examining their characteristic differences. A cross-sectional study was conducted in Jinzhou, China, from July 2023 to March 2024. The questionnaire included Sociodemographic and clinical characteristics, Benefit Finding Scale (BFS), Dyadic Coping Scale (DCI), Chinese Perceived Stress Scales (PSS), and Family adaptability and cohesion evaluation scales (FACES). Mplus8.3 and SPSS26.0 software were used for data analysis. The latent profile analysis (LPA) method was used to fit the family adaptations of breast cancer patients. Three latent categories of family adaptation were identified: low-level family adaptation (21.5%), medium level family adaptation (47.8%), and high-level family adaptation (30.6%). All 14 items with high levels of family adaptation scored higher than the other two groups. In particular, out of all the categories, item 9, "The idea of educating children is sound," scored highest. Compared with the low-level group, the influential factors of family adaptation in the high-level group were BFS, DCI, PSS, relapse and personal monthly income; The factors influencing family adaptation at the middle level are DCI, BFS, breast cancer type, family history of breast cancer, and personal monthly income. Compared with the medium level group, PSS and DCI were the influential factors of family adaptation in the high-level group. Family adaptation in breast cancer patients can be divided into three categories: low-level, medium-level, and high-level. There were significant differences among different categories of family adaptation levels in "personal monthly income", "family history of breast cancer", "type of breast cancer", "recurrence", "dyadic coping", "benefit finding", and "perception stress"., (© 2024. The Author(s).)

Understanding what matters to people with Parkinson's and their family is essential to derive relevant clinical outcome measures and guide clinical care. The purpose of this study was to explore what is important to people with Parkinson's disease vs. family over time. A qualitative content-analysis of online survey data collected by Parkinson's UK was conducted to identify types and frequencies of important symptoms and impacts of Parkinson's for people with the disease vs. family of people with Parkinson's. Independent T-tests were used to identify significance of between group differences for patients vs. family at < 2, 2-5, 6-10, 11-20, > 20-year durations. ANOVA was used to assess for within group differences by disease duration. We found that symptom priority changed significantly over time with longer disease duration. Tremor was reported less often later on, whereas mobility, dyskinesias, gait and speech/communication symptoms gained priority. In general, patients identified movement-related symptoms (e.g., walking, bradykinesia) as the most bothersome at all durations while family more strongly prioritized the physical and psychosocial impacts of disease (e.g., mobility, safety, interpersonal interactions, independence, and family impact). We conclude that important differences exist between family and patient perspectives of what matters and change over time with longer duration of disease., (© 2024. The Author(s).)

Background: Over the last decade attention has grown to give patients and next of kin (P/N) more substantial roles in adverse event investigations. Adverse event investigations occur after adverse events that resulted in death or severe injury. Few studies have focused on patient perspectives on their involvement in such investigations. The present study sets out to investigate how P/N and patient representatives (client councils and the Patient Federation Netherlands) view the involvement of P/N in adverse event investigations, particularly whether and why they want to involved, and how they want to shape their involvement., Methods: The study features qualitative data on three levels: interviews with P/N (personal), focus groups with representatives of client councils (institutional), and an interview with the Patient Federation Netherlands (national). Researchers used inductive, thematic analysis and validated the results through data source triangulation., Results: The initiative taken by the hospitals in this study provided P/N with the space to feel heard and a position as legitimate stakeholder. P/N appreciated the opportunity to choose whether and how they wanted to be involved in the investigation as stakeholders. P/N emphasized the need for hospitals to learn from the investigations, but for them the investigation was also part of a more encompassing relationship. P/N's views showed the inextricable link between the first conversation with the health care professional and the investigation, and the ongoing care after the investigation was finalized. Hence, an adverse event investigation is part of a broader experience when understood from a patient perspective., Conclusions: An adverse event investigation should be considered as part of an existing relationship between P/N and hospital that starts before the investigation and continues during follow up care. It is crucial for hospitals to take the initiative in the investigation and in the involvement of P/N. P/N motivations for involvement can be understood as driven by agency or communion. Agentic motivations include being an active participant by choice, while communion motivations include the need to be heard., (© 2024. The Author(s).)

Background: Family members are often affected by the long-term consequences of traumatic brain injury, but are rarely involved in rehabilitation programs in the chronic phase. We thus do not know what family members´ main concerns are in the chronic phase, what factors are associated with perceived caregiver burden, and whether family members´ health and functioning improves due to rehabilitation efforts received by the patients. This study explored family-members` functioning, predictors of caregiver burden and effect for family members of a goal-oriented intervention in the chronic phase of traumatic brain injury., Methods: Family members self-reported data measuring their caregiver burden, depression, general health, loneliness, and their evaluation of patient competency in everyday life, patient awareness levels, main problem areas (target outcomes) for the patient related to the brain injury, and demographic data were collected. Regression models were used to explore predictors of caregiver burden, and mixed models analysis was used to explore treatment effects., Results: In total, 73 family members were included, 39 in the intervention group and 34 in the control group. Moderate to high caregiver burden was reported by 40% of family members, and 16% experienced clinical levels of depression. Family member loneliness and their evaluation of the patient`s level of functional competency explained 57% of the variability in caregiver burden. There were no treatment-related changes in caregiver burden, family member depression or general health. At T2 there was however a significant reduction in how family members rated severity of target outcomes that the family members had nominated at baseline (-0.38, 95% CI, -0.75 to -0.02, p = 0.04), but not for the target outcomes the patients had nominated., Conclusions: A significant proportion of family members to patients in the chronic phase of TBI continue to experience challenging caregiver burden and emotional symptoms. Both family member-related and patient factors contribute to caregiver burden. Interventions targeting patient complaints do not automatically alleviate family members´ burden. It is important to address social support for family members early after injury, and there is a need for more interventions specifically targeting family members´ needs., Trial Registration: The trial was registered at ClinicalTrials.gov, NCT03545594 on the 4th of June 2018., (© 2024. The Author(s).)

The situation/risk of family homelessness presents multiple interrelated issues. It has considerable negative consequences, namely the deterioration of the family members' health and well-being, and alterations in the family's dynamics, with parents sometimes being separated from their children. The aim of this research was to understand how parenting takes place in families experiencing, or at risk of, homelessness. The conducted study falls within the qualitative paradigm, using Strauss and Corbin's version of the Grounded Theory methodology. Three main categories emerged, supported by all the participating families: "Meaning of Parenthood", "Key Events", and "Transition Circumstances". These categories were translated into facilitating/inhibiting factors, within the following dimensions: "Individual", "Family", and "Society". We were able to conclude that, in the population under study, parenting is restricted, being mostly exerted in a remote manner. Furthermore, it takes on different forms, depending on the specific homelessness situation/risk. In families at risk of homelessness, we identified "Remote Parenting with Maintained Parental Authority", as well as "Restricted Parenting", when the children still lived with their parents. On the other hand, in families experiencing homelessness, we identified "Remote Parenting with Maintained Parental Authority", "Unilateral Remote Parenting", "Interrupted Parenting", and the "Total Disruption of Parenting".

In the post-pandemic context, there has been an increasing demand for technology-based interventions in education and healthcare systems, such as augmented and mixed reality technologies. Despite the promising outcomes of applying mixed reality (MR), there is limited aggregated evidence focusing on child-patient interventions in hospital-based or clinical settings. This literature review aimed to identify and synthesize existing knowledge on MR technologies applied to pediatric patients in healthcare settings. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search of the Scopus and Web of Science databases was conducted to identify articles published in the last 10 years that address the application of augmented and/or MR technologies in pediatric hospital settings or clinical environments to improve patient and family outcomes. A total of 45 articles were identified, and following a rigorous screening and eligibility process, 4 review articles were selected for qualitative synthesis. From these reviews, 10 studies with relevant interventions and measured effects were extracted. The extracted studies were analyzed based on eight key attributes: country of origin, study design, characteristics of the study population, primary clinical setting, type of MR device used, nature of the intervention, variables measured, and significant effects observed in the outcome variables. The analysis revealed diverse approaches across different clinical settings, with a common focus on improving both emotional well-being and learning outcomes in pediatric patients and their families. These findings suggest that MR-based pediatric interventions generally provide children and their parents with positive emotional experiences, enhancing both learning and treatment outcomes. However, the studies reviewed were heterogeneous and varied significantly in terms of clinical settings and MR applications. Future research should focus on developing more controlled study designs that specifically target the pediatric population to strengthen the evidence base for MR interventions in healthcare.

Objectives: The purpose of this study was to describe the experiences and actions of part-time firefighters' family members in rural areas in Sweden., Design: The study had an inductive descriptive design and used the critical incident technique., Setting: Rural areas, primarily served by a part-time fire station, across Sweden., Participants: The study included 25 participants (21 females and 4 males) with experiences of being a family member of a part-time firefighter. Family members who themselves served as firefighters were excluded., Results: Being a part-time firefighter's family member was described into three main areas of experiences: 'affecting everyday life', 'dealing with uncertainty' and 'being in this together'. Actions taken were divided into two main areas: 'pursuing adaptations' and 'alleviating difficulties'., Conclusions: Family members of part-time firefighters faced increased responsibility at home, managing personal inconvenience and frustration. They offered emotional support for the firefighter, however, expressing a need for guidance on handling firefighters' emotions and mental health after call-outs. Despite their crucial role, they often felt unrecognised by the fire and rescue service. Nonetheless, they took pride in their firefighter's contribution to the community and noted positive impacts on the family., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: The decisions of withholding or withdrawing life-sustaining treatments are difficult to make in the context of emergency departments (EDs) because most patients are unable to communicate. Relatives are thus asked to participate in the decision-making process, although they are unprepared to face such situations. We therefore aimed to develop a standardised intervention for announcing decisions of withholding or withdrawing life-sustaining treatments in EDs and assess the efficacy of the intervention on the stress of relatives., Methods and Analysis: The DISCUSS trial is a multicentre stepped-wedge cluster randomised study and will be conducted at nine EDs in France. A standardised intervention based on human simulation will be codesigned with partner families and implemented at three levels: the relatives, the healthcare professionals (HCP) and the EDs. The intervention will be compared with a control based on treatment as usual. A total of 538 families are planned to be included: 269 in the intervention group and 269 in the control group. The primary endpoint will be the symptoms of post-traumatic stress disorder (PTSD) at 90 days. The secondary endpoints will be symptoms of PTSD at 7 and 30 days, diagnosis of PTSD at 90 days and anxiety and depression scores at 7, 30 and 90 days. Satisfaction regarding the training, the assertiveness in communication and real-life stress of HCPs will be measured at 90 days., Ethics and Dissemination: This study was approved by the ethics committee Est III from Nancy and the French national data protection authority. All relatives and HCPs will be informed regarding the study objectives and data confidentiality. Written informed consent will be obtained from participants, as required by French law for this study type. The results from this study will be disseminated at conferences and in a peer-reviewed journal., Trial Registration Number: NCT06071078., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Atopic eczema is common in childhood and can continue into adulthood. Adherence to treatment is a significant factor in its effective management, but the complexity of treatment regimens can make adherence challenging. Additionally, living with the condition can have adverse psychosocial consequences for young people in particular. This article discusses treatment regimens for moderate-to-severe atopic eczema and some of the challenges encountered by children, young people and families in self-managing the condition. The authors discuss strategies that can support families to achieve optimal self-management, namely online support tools, written action plans and nurse-led eczema clinics., Competing Interests: None declared, (© 2024 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.)

Cancer is a deadly disease that affects millions of people worldwide and is a source of great difficulty, stress, and trauma not only for patients but also for their caregivers. The physical and emotional suffering that patients experience by patients can lead their caregivers to cope with constant anxiety, sadness, and uncertainty. Moreover, during the cancer treatment process, caregivers must make a great effort to meet the needs of patients and support them. This situation may negatively affect the quality of life and psychological health of cancer patients' caregivers and may lead them to experience trauma. The aim of this cross-sectional study was to examine posttraumatic growth's relationship with age, the transformative power of suffering, and hope in family caregivers of cancer patients. Participants consisted of 314 Turkish family caregivers of cancer patients (73.2% women; M age  = 39.89 years) selected by using convenience sampling method. Participants answered a data collection tool consisting of a demographic information form, the Posttraumatic Growth Inventory, Trait Hope Scale, and Transformative Power of Suffering Scale. Data were analyzed using descriptive statistics, the Pearson product-moment correlation coefficient analysis, simple mediation analysis, and moderated mediation analysis. The results of this study revealed that hope mediated the association between the transformative power of suffering and posttraumatic growth in family caregivers of cancer patients, whereas age moderated this relationship. Psychosocial support programs for cancer caregivers could benefit from incorporating interventions that explore the transformative potential of suffering and cultivate hope. Tailoring these interventions to address the specific needs of different age groups may enhance their effectiveness. Future researchers should investigate the factors associated with posttraumatic growth in caregivers across diverse cultures, age ranges, and cancer diagnoses., (© 2024. The Author(s).)

Purpose: This study aimed to investigate family resilience-defined as the capacity of a family to harness its collective strengths and resources to recover from and adapt to significant adversities or crises effectively-in primary caregivers of children who are deaf and hard of hearing (cDHH) and its association with quality of life, life satisfaction, perceived social support, and loneliness., Method: The study involved 108 primary caregivers of cDHH and 139 primary caregivers of children with normal hearing. Participants underwent psychometric evaluations including the Family Resilience Scale, World Health Organization Quality of Life Assessment-Brief Form, Satisfaction with Life Scale, UCLA Loneliness Scale, and Multidimensional Scale of Perceived Social Support., Results: Significant differences were found in almost every scale and its subdimension between the two groups ( p < .05). Correlation analysis revealed significant correlations between all scale total scores for both groups ( p < .05, .153 < | r | < .737). Quality of life was found to be a significant predictor of family resilience, F (1, 139) = 41.824, R 2 = .279, B = 0.495, t = 6.467, p < .001., Conclusions: Our study highlights the significant impact of having cDHH on caregivers' family resilience, quality of life, life satisfaction, feelings of loneliness, and perceived social support. The results underscore the importance of enhancing caregivers' quality of life as a potential strategy to improve their family resilience. Further research is needed to understand the complex interplay of factors influencing these outcomes.

Background: Most relatives of women with ovarian cancer are unaware of their increased risk for cancer and their eligibility for genetic counseling. State cancer registries offer a platform to communicate about inherited risk to this population., Methods: We conducted a two-arm randomized trial to test a theory-based communication intervention-Your Family Connects (YFC)-compared to the standard Georgia Cancer Registry (GCR) contact. A total of 1,938 eligible ovarian cancer survivors were randomly assigned to either the YFC arm (n = 969) or the Standard Care arm (n = 969). We assessed the number of ovarian cancer survivors and their close relatives who logged on to the study website by arm., Results: Survivor reach was significantly higher in the Standard Care arm than YFC (20.8% vs. 15.2%, respectively; P < 0.001). However, reach to relatives was limited to listed relatives in the YFC arm (n = 20, 13.2%), with little participation from those in the Standard Care arm (n = 1, 0.4%). Pooling across arms, minority race, longer time since diagnosis, and older age were all significantly associated with a decreased likelihood that the survivor accessed the website., Conclusions: The YFC intervention showed lower effectiveness for engaging survivors but was more effective than Standard Care in engaging at-risk relatives. Other factors (e.g., time since diagnosis) associated with lower reach must be considered in refining future outreach approaches., Impact: Partnering with a state cancer registry to foster family communication about inherited cancer risk is feasible but the possibility for broad population reach warrants further testing., (©2024 The Authors; Published by the American Association for Cancer Research.)

Background: Cervical cancer-related stigma is common but understudied in the Caribbean. This study aims to describe the age difference of cervical cancer stigma and to evaluate the influence on the prevention practices among the Caribbean nonpatient population in Jamaica, Grenada, and Trinidad and Tobago., Methods: A cross-sectional study involving 1209 participants was conducted using a culturally trans-created Cancer Stigma Scale for the Caribbean context and supplemented with questions on cervical cancer and human papillomavirus (HPV) and HPV vaccine knowledge and beliefs. Descriptive analyses and χ2 tests were conducted., Results: The χ2 tests showed age is statistically significantly related to participants' response to stigma items such as "community members believe cervical cancer is viewed as shameful" (P = .0001); "women with cervical cancer are treated with less respect than usual by others" (P < .0001); "women with cervical cancer are rejected by family members" (P = .0007); "women with cervical cancer are rejected by intimate partners" (P < .0001); and "intimate partners blame women for having cervical cancer" (P = .0032). Additionally, age has statistically significant associations with endorsements of negative views of cervical cancer from the community (P < .0001) and family (P < .0001) as key barriers to cervical cancer care (item: "discourage women from seeking and obtaining screening and treatment"). Notably, younger respondents (18-25 years) are more sensitized to the unfair stigma and hold more stigma., Conclusions: Among Caribbeans, age influences cervical cancer stigma. Younger persons acknowledged greater stigma within families and communities. This study can guide age-informed interventions and programs to reduce stigma and improve cervical cancer screening and care seeking to reduce cervical cancer burden and disparities., (© The Author(s) 2024. Published by Oxford University Press.)

Introduction: The current study examines the psychometric characteristics of the Family Climate Questionnaire (FCQ), which was intended to measure the degree of autonomy-support among family members for a respondent with health concerns., Method: The sample included military veterans (N = 350), a portion of whom had congestive heart failure (N = 86) or diabetes (N = 77), and a portion who were referred from primary care for behavioral health concerns (N = 187). Overall, 92.6% of the participants were male, and 56.7% were Black or African American and 40.6% were Caucasian., Results: The findings highly supported the factor structure, internal consistency, and construct validity of the Autonomy Support subscale. In addition, there was high support for factorial invariance across subsamples of veterans with chronic medical problems compared to those referred from primary care. The findings for an additional subscale developed for this study, Coercion, were less supportive, with insufficient convergence in factor structure and relatively poorer internal consistency., Discussion: The FCQ Autonomy Support measure appears to have potential as a useful measure of a family environment that supports autonomy for health among individuals with both medical and mental health conditions, and it is a flexible measure that can be used with a range of family member types. The FCQ Coercion measure received less consistent empirical support and will require additional development and testing. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: Public engagement in long-term care policy making in Canada has primarily focused on "intermediary agents" who speak on behalf of long-term care (LTC) residents and their family caregivers. Yet the legitimacy of these intermediaries, as perceived by those they represent, has gone largely unexplored. This study examines LTC resident and family perspectives on who can legitimately represent them in LTC policy making., Methodology: We used an interpretive description design, drawing on semi-structured interviews with LTC residents and family caregivers in Ontario, Canada. Data were analyzed using inductive thematic analysis., Results: Eighteen interviews were conducted with 19 participants. Three key characteristics of legitimate representatives were identified: (1) willingness to act in the best interests of residents and families, (2) having the necessary skills and capacity to participate in LTC policy making and (3) engaging directly with residents and families., Conclusion: Governments and civil society organizations seeking to establish and maintain legitimacy in the eyes of LTC residents and family members can pursue this goal by supporting intermediaries who mirror the identities or experiences of those they represent, who are dedicated to serving their interests and who routinely and directly engage with them to understand the realities of LTC., (Copyright © 2024 Longwoods Publishing.)

Introduction: Depression and anxiety are common among breast cancer patients, due to the ongoing mental distress during illness. This study examines the impact of family support on depression and anxiety changes in Jordanian women undergoing mastectomy and reconstruction surgery., Methods: We conducted a cross-sectional study to investigate the effect between family support and depression/anxiety levels in women post-mastectomy in Jordan. Participants included breast cancer patients who had undergone mastectomy surgery, meeting specified inclusion criteria. We collected data on socio-demographic variables via a questionnaire between October 2023 and January 2024. Depression and anxiety levels were assessed using the Depression, Anxiety and Stress Scale - 21 Items (DASS-21), while social support was evaluated using the Social Support Survey., Results: A significantly negative correlation was observed between the DASS-21 score and social support, indicating that higher levels of social support were associated with lower levels of depression, anxiety, and stress (p-value: 0.001). Additionally, analyzing the correlation between physical therapy, social support (median scores: 76 vs. 90, p = 0.021), and DASS-21 (median scores: 25 vs. 11, p < 0.001) revealed significant findings. Specifically, individuals who had received physical therapy exhibited significantly lower DASS-21 scores and higher social support scores., Conclusion: Our study underscores the significant role of family support in alleviating depression and anxiety levels among women with breast cancer. Strong family support emerges as a key factor in improving the emotional well-being of these individuals.

Background: Due to rapid increases in the number of Korean people with dementia, dementia has become a priority health issue in South Korea. Likewise, the well-being of family caregivers of people with dementia has also become an issue of concern. However, little is known about the resilience of Korean family caregivers because there is a lack of review studies from a Korean cultural perspective about the resilience of family caregivers of people with dementia., Objectives: The purpose of this scoping review was to investigate quantitative studies related to resilience theories, measurement instruments, correlates and resilience interventions for family caregivers of people with dementia., Method: This review was conducted according to the Joanna Briggs Institute based on Arksey and O'Malley. Nine databases were searched to retrieve evidence published in English or Korean between January 2000 and September 2022. Studies with a quantitative research design reporting the resilience of family caregivers of people with dementia based on a resilience theory framework were included., Results: A total of 13 studies were included in this review. All studies used either a modified McCubbin and McCubbin's family stress, adjustment and adaptation model or Walsh's family resilience model. All resilience instruments were used without cross-cultural adaptation. Family adaptation, social support, life satisfaction, family (di)stress and caregiver burden were associated with resilience among family caregivers. A few family resilience-enhancing programmes showed a positive effect on caregiver resilience., Conclusion: This review noted that all the resilience measures documented in this study need to test for cultural adaptation in a Korean context. Further research is required to develop and implement family-based, culturally tailored interventions to effectively enhance Korean resilience for family caregivers of people with dementia., Implications for Practice: Gerontological nurses should include Korean family caregivers in their nursing care and assess whether family caregivers have depression or suicidal thoughts to promote better health outcomes for caregivers and their family members., (© 2024 John Wiley & Sons Ltd.)

Background: National initiatives such as 'Joining Forces' and the 'Have you ever served in the military?' campaign increased awareness of the needs of the military and veteran population. Yet, empirical evidence suggests that nurses and other healthcare providers continue to report insufficient cultural competency, as well as knowledge and awareness of unique healthcare needs to provide optimal care to this population., Purposes: The study purposes were to explore nurses' and nursing students' knowledge, attitudes, confidence, and comfort levels to care for veterans and their family, identify potential factors associated with these outcome measures, and examine the relationships between knowledge, attitudes, confidence, and comfort., Method: A quantitative, cross-sectional study design guided an online survey of 153 respondents. The military and veteran family cultural competency model provided a theoretical foundation., Findings: Overall, the confidence in skills and abilities, and comfort levels on addressing military culture, providing care, and discussing health issues increases as participants' gain knowledge and awareness of the military. Having an immediate family member(s) who served in the military was a significant factor related to confidence., Implications: Nursing students and nurses in practice need education aimed at addressing the veteran care competencies, specifically military/veteran culture., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Inc. All rights reserved.)

When people talk about kinship systems, they often use co-speech gestures and other representations to elaborate. This paper investigates such polysemiotic (spoken, gestured, and drawn) descriptions of kinship relations, to see if they display recurring patterns of conventionalization that capture specific social structures. We present an exploratory hypothesis-generating study of descriptions produced by a lesser-known ethnolinguistic community to the cognitive sciences: the Paamese people of Vanuatu. Forty Paamese speakers were asked to talk about their family in semi-guided kinship interviews. Analyses of the speech, gesture, and drawings produced during these interviews revealed that lineality (i.e., mother's side vs. father's side) is lateralized in the speaker's gesture space. In other words, kinship members of the speaker's matriline are placed on the left side of the speaker's body and those of the patriline are placed on their right side, when they are mentioned in speech. Moreover, we find that the gesture produced by Paamese participants during verbal descriptions of marital relations are performed significantly more often on two diagonal directions of the sagittal axis. We show that these diagonals are also found in the few diagrams that participants drew on the ground to augment their verbo-gestural descriptions of marriage practices with drawing. We interpret this behavior as evidence of a spatial template, which Paamese speakers activate to think and communicate about family relations. We therefore argue that extending investigations of kinship structures beyond kinship terminologies alone can unveil additional key factors that shape kinship cognition and communication and hereby provide further insights into the diversity of social structures., (© 2024 The Author(s). Cognitive Science published by Wiley Periodicals LLC on behalf of Cognitive Science Society (CSS).)

Motivation is a key factor for child development, but very few studies have examined child and family predictors of both child task and perceived motivation. Thus, the three aims of this 6-month longitudinal study in preschoolers with global developmental delays (GDD) were to explore: 1) differences between task and perceived motivation in cognitive domain; 2) differences among three domains of perceived motivation: cognitive, gross motor, and social; and 3) early child and family predictors of cognitive task motivation and the three domains of perceived motivation 6 months later. Results indicated that preschoolers with GDD showed higher cognitive task motivation than cognitive perceived motivation, and lower perceived cognitive motivation than the other two perceived motivation domains. Different child and family factors predicted cognitive task motivation and the three domains of perceived motivation. Practitioners should educate caregivers on how to observe children's motivation to enhance children's active participation., (©AAIDD.)