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The main aim of the current study was examining parental experiences and the changes in the family system after young people who define themselves as gay explaining their sexual orientation to their parents in depth. A qualitative study was conducted to achieve this goal. The study sample consists of the mothers of six young people who define their sexual orientation as gay. Semi-structured interviews were conducted with the mothers and the obtained data were analyzed with Grounded Theory. As a result of the analyses, the experiences of the mothers were gathered under three main themes. These are (1) pre-coming out experiences, (2) experiences during coming out, and (3) post-coming out experiences, respectively. These themes and the sub-themes they cover were compared with the findings in the literature and discussed from a system perspective.

BackgroundDiagnosis of chronic illness, which constitutes a life-threatening situation such as in Marfan syndrome or dis-ease with periods of remission and severity such as in juvenile idiopathic arthritis (JIA), leads to problems with the functioning of the adolescent and the whole family system. Therefore the aim of the study was to determine the differences in severity of internalizing and externalizing problems and in the perception of the family sys-tem between adolescents with Marfan syndrome, with JIA, and without chronic disease, as well as to determine whether characteristics of the family system are associated with externalizing and internalizing behaviors in those groups.Participants and procedureThe study involved three groups of adolescents: 1) with Marfan syndrome (n = 25), 2) with JIA (n = 29), and 3) without chronic illness (n = 20). We used the adolescent version of the Child Behavior Checklist (CBCL) Youth Self-Report (YSR) and the Family Assessment Scale.ResultsOur results indicated that adolescents with Marfan syndrome have similar scores compared to adolescents without illness on all subscales concerning both internalizing and externalizing behaviors, as well as the family system’s characteristics. Compared to adolescents with JIA, adolescents with Marfan syndrome had lower scores on externalization symptoms and Attention Problems and they also perceive their families as less bal-anced. Additionally, in the perception of adolescents with Marfan syndrome and with JIA the weaker the family bond, the stronger the intensity of externalizing behaviors.ConclusionsAlthough in the light of our novel research, adolescents with Marfan syndrome do not present behavioral prob-lems different from healthy peers, it is worth continuing such research in order to verify the results. Adolescents with JIA present more externalizing behaviors than peers without chronic illness, which is consistent with some previous research. Research on families of an adolescent child with Marfan and JIA are quite novel and they should be continued.

Using a clinical case of three brothers, we discuss a spontaneous, self-organizing family system framework that prevents withdrawal from therapy and acting-out of the borderline clients diagnosed with alcohol dependence. This multi-family framework includes several family members and rests on the symbiotic and co-dependent relational patterns between the clients and their mothers. We discuss the positive and negative aspects of this framework and options for changing it.

Researchers of both contemporary family problems and statistical data point many important changes in family life. Among these, a significant place is occupied by the emergence of alternative forms of family life and transformation in the area of parenting (Dolińska, 2014; Golombok, 2015; Kemkes-Grottenthaler, 2003; Kwak, 2014; Mynarska 2009). Over the past years, the number of postponements or resignations from parental tasks has been increasing (CBOS, 2013b; GUS, 2016). The purpose of this research was to explore the functioning of family of origin of spouses who did not undertake parental tasks. The study involved 210 people (105 women and 105 men) in early adulthood in legalized relationships, and the final analysis included results obtained from 170 people. The criterion group consisted of spouses who did not undertake parental tasks (76 persons) with minimum marital status of three years. The control group (94 persons) consisted of spouses of at least one child with a minimum marriage of three years. The following research tools were used: Survey Questionnaire (own elaboration), Family Adaptability and Cohesion Scale Faces IV in Polish adaptation by Margasiński (2013). Studies have shown that spouses who do not take parental tasks assess their family of origin in a different way than spouses having children. These differences concerned the assessment of flexibility. However, the difference in the assessment of cohesion of families of origin occurred between women and men from the criterion group. The analyzes carried out showed that one and the other study group assesses their current family better than the family of origin.

Background: This study aimed to enhance knowledge on which aspects of the family context are most important in relation to adolescents’ at-risk/problematic social media use (SMU). Therefore, we examined the relative contribution to adolescents’ at-risk/problematic SMU of general and Internet-specific family factors related to three different family (sub)systems: parent-child (Internet-specific rule-setting, reactive restrictions towards Internet use, co-use, adolescents’ involvement in rule-setting and positive parenting), parent (parental screen time, phubbing, stress, anxiety and depression) and family (family functioning, family intactness and SES) (sub)system. Method: Questionnaire data came from 403 adolescents (M = 13.51, SD = 2.15) and 396 parents (M = 46.59, SD = 5.29) who participated in wave 1 of the Dutch ‘Digital Family project’. Results: Logistic regression analyses showed that only factors related to the parent-child subsystem remained significant in predicting at risk/problematic SMU when examining predictors related to the parent-child, parent and family (sub)system simultaneously. Specifically, general and Internet-specific parenting practices contributed to the prediction of adolescents’ at-risk/problematic SMU above and beyond each other. Positive parenting and Internet-specific rule-setting seem protective, while parental reactive restrictions towards Internet use could be a risk factor. Conclusion: The results suggest that parental behaviors directed towards the child should be a focus of attention in research on prevention of adolescents’ problematic SMU. In addition, our findings highlight the importance of untangling restrictive mediation (impulsive, in the moment, attempts to limit SMU versus communicating clear rules in advance) when examining its effects.

Relatório de Estágio para o Mestrado em Política Social Os conflitos no seio da família têm resultado em diversas consequências, tanto para seus membros como para a comunidade geral, como por exemplo, as implicações no desenvolvimento das relações familiares que, consequentemente, aumentam os desafios bloqueando os membros de enfrentar situações externas ao sistema e limitam suas capacidades. Quando o conflito resulta em rutura conjugal coloca todo o sistema em situação de vulnerabilidade, em casos extremos, leva a violência. Dado a urgência em criar respostas direcionada a minimizar a vulnerabilidade familiar e social, apoiamos na premissa da família como pilar da sociedade e nas suas relações sustentáveis como um contributo a produtividade e sucesso da nação, desenvolvemos esse projeto ancorado na vertente preventiva da política social, com o intuito de prevenir tensões e conflitos familiares e reduzir suas vulnerabilidades. Nesse sentido, elaboramos o projeto a partir do estágio realizado na Divisão de Ação Social da Câmara Municipal de Albufeira (DAS-CMA), onde implementamos uma intervenção através da mediação transformativa dirigidas aos moradores da habitação social do concelho, com o objetivo de prevenir conflitos, mudar os hábitos de vida e reduzir as situações de vulnerabilidade. Foram dinamizadas sessões de sensibilização para empoderar, dar formas sustentáveis de relação e informações de qualidade sobre as funções do sistema familiar. Igualmente transmitimos a estratégia num workshop com os técnicos como medida de qualificação dos serviços. Conflicts within the family have resulted in several consequences, both for its members and for the general community, for example, the implications for the development of family relationships which, consequently, increase the challenges blocking members from facing situations external to the system and limit their capacities. When conflicts result in marital disruption, it puts the whole system in a situation of vulnerability, in extreme cases, leads in violence. Given the urgency to create responses aimed at family and social vulnerability, based on the premise of the family as a pillar of society and its sustainable relationships as a contribution to the nation's productivity and success. We built this project based on the preventive aspect of social policy, which aims to prevent family tensions and conflicts, to reduce vulnerability. The project presented was carried out from the internship in the Social Action Division of the he Municipal Council of Albufeira (DAS-CMA). It consisted of an intervention through transformative mediation, aimed at residents of social housing in the municipality, with the aim of preventing conflicts, changing life habits and reducing situations of vulnerability. Awareness-raising sessions were held to empower, to give sustainable forms of relationships, and quality information about functions of family system. We also transmitted the strategy in a workshop with the technicians as a measure of service qualification. N/A

This paper explores the impact of complicated grief on the family system following the drug-related death of a family member. Drug-related deaths are rife with moral stigmas, and those left behind often carry an emotional burden laden with shame and guilt. 17 bereaved family members were interviewed using semi-structured interviews and transcripts were analyzed using reflexive thematic analysis. Three core themes were generated: Renegotiation of Relationships; Experiencing Complex Emotions; and Adjusting to a New Reality. The findings demonstrate that this population experience great difficulty in processing their grief as they struggle with family breakdown, navigating supports and stigma.

BackgroundAdvantages and disadvantages associated with joint and nuclear family systems can affect quality of life (QOL). However, there is scarcity of literature about QOL among joint and nuclear family systems. This study aimed to assess the factors associated with QOL in joint and nuclear family systems.MethodsWe conducted a population based cross sectional study in all 52 Union Councils (UCs) of District Abbottabad, Khyber Pakhtunkhwa province, Pakistan from March 2015 to August 2015. Multistage cluster sampling technique was used to select participants from both nuclear and joint family houses. The validated Urdu version of World Health Organization Quality of Life Questionnaire-Brief Version (WHOQOL-BREF) was used to assess quality of life among participants. Univariate and multivariate analyses were performed to explore the associations of different socio demographic variables with QOL among both family systems. Also a multilevel linear regression using backward analysis to obtain final model for each domain was performed to find out the variables that are associated with QOL score in each of family systems.ResultsA total of 2063 participants were included in this study (51.0% joint family, 49.0% nuclear family) with the response rate of 97.4%. In multiple linear regression analysis of each domain for joint and nuclear family systems, rural residence compared to urban (p p p p p p ConclusionThis study was the first of its kind which determined the factors of QOL in joint and nuclear families using the validated Urdu version of WHOQOL-BREF in Pakistan. Male gender, urban residence, younger age, higher socioeconomic status and social capital were positive predictors of QOL score while older age and presence of illness were associated with lower QOL scores among both family systems.

Ο στόχος της παρούσας μελέτης είναι η καταγραφή των μεταβολών που συνέβησαν εντός του οικογενειακού πλαισίου στην Ελλάδα κατά την πρώτη περίοδο της καραντίνας λόγω SARS-CoV-2. Με βάση την ανασκόπηση της βιβλιογραφίας κρίθηκε αναγκαία η διατύπωση δεδομένων σχετικά με την πανδημία και τις συνέπειες της στην οικογένεια, καθότι πρόκειται για ένα ιδιαίτερα πρόσφατο γεγονός για το οποίο έχει διεξαχθεί ελάχιστος αριθμός ερευνών στην Ελλάδα. Παρατίθενται στοιχεία άλλων χωρών, τα οποία σχετίζονται με τις κοινωνικές και οικονομικές αλλαγές που έχει επιφέρει η πανδημία. Μεθοδολογία : Το δείγμα της μελέτης περιελάμβανε 3.399 ενήλικες που κατοικούσαν στην Ελλάδα κατά την περίοδο επιβολής του μέτρου του εγκλεισμού για την προστασία κατά SARS-CoV-2. Χρησιμοποιήθηκε ένα αυτοσυμπληρούμενο ερωτηματολόγιο διαβαθμισμένης κλίμακας Likert τεσσάρων επιπέδων. Αποτελέσματα : Τα αποτελέσματα έδειξαν αύξηση των αναγκών συναισθηματικής υποστήριξης και επικοινωνίας με τα υπόλοιπα μέλη, ενώ οι συγκρούσεις εντός του οικογενειακού συστήματος παρέμειναν ως είχαν πριν την πανδημία. Τα ευρήματα συζητούνται σε σχέση με τη γενική θεωρία συστημάτων και την ιδιότητα της ανθεκτικότητας του συστήματος, καθώς και σε σχέση με τα ευρήματα που παρουσιάζονται από έρευνες άλλων χωρών σχετικά με τις μεταβολές στην οικογένεια λόγω της καραντίνας. Συμπέρασμα : Η ανάγκη για επικοινωνία και συναισθηματική υποστήριξη στο οικογενειακό πλαίσιο φάνηκε να αυξάνεται κατά την πρώτη περίοδο του εγκλεισμού, The aim of this study is to record the family changes in Greece during the first period of quarantine due to SARS-CoV-2. Review of the literature, that was necessary in order to formulate data about the pandemic and its consequences in the family, as there is a small amount of research have been conducted in Greece. There are data from other countries, which are related to the social and economic during the pandemic. Methodology : The sample of the study included 3,399 adults residing in Greece during the period of imposition of the SARS-CoV-2 protection measure. A self-administered four-level Likert graded questionnaire was used. Results: The results showed an increase in the need for emotional support and communication with others, while conflicts within the family system remained. The findings are related to general theory of systems and the resilience of the system, as well as in relation to the research findings from other countries due to quarantine. Conclusion : The need for communication and emotional support in the family context seemed to increase during the first quarantine

Einleitung Diese Bachelorarbeit beschäftigt sich mit den Herausforderungen in der Palliative Betreuung eines Kindes oder eines/einer Jugendlichen mit einer lebenslimitierenden Erkrankung. Ziel der Arbeit ist, die Herausforderungen und Belastungen von der Familie des/ der Patient*in, sowie die der Pflege-personen zu beleuchten. Methodik Es wurde eine Literaturrecherche in den Datenbanken Cinahl, Cochrane Library, SpringerLink und Medline durchgeführt. Insgesamt wurden acht Studien selektiert. Davon sind sechs qualitative, eine quantitative Studie und eine Grounded Theory. Diese Studien wurden mithilfe eines Bewertungsbo-gen analysiert. Ergebnisse Pflegepersonen stehen, wie Familienangehörige vor mehreren Belastungen und Herausforderun-gen. Familienangehörige haben mit Gefühlen wie Angst, Unsicherheit, Trauer und Verlust zu kämp-fen. Solche Belastungen erleben auch Pfleger*innen, wobei bei Pflegepersonen Gefühle von Hilflo-sigkeit, Frustration und Schuld ebenfalls beschrieben werden. Viele Herausforderungen ergeben sich durch minderwertige Kommunikation zwischen dem Behandlungsteam und den Familien. Dadurch werden die zuvor erwähnten psychischen Probleme verstärkt. Pfleger*innen stehen vor der Herausforderung den bevorstehenden Tod anzusprechen und mit Geschwistern, sowie den Eltern über dieses sensible Thema zu sprechen. Jedoch fühlen sich Pflegepersonen unerfahren in der Kommunikation. Eltern hingegen verstecken oftmals die Wahrheit vor dem Kind. Während der Be-handlung ist ein effizientes Schmerz- und Symptommanagement wichtig, um Belastungen zu mini-mieren. Jedoch fühlen sich viele Pflegepersonen unerfahren im Symptom- und Schmerzmanage-ment. Das betroffene Kind durch Schmerzen leiden zu sehen ist für Familien und Pfleger*innen sehr belastend. Diskussion Eine lebenslimitierende Erkrankung eines Kindes oder eines/einer Jugendlichen stört die Stabilität einer Familie. Dadurch, dass die Angehörigen vor diversen Herausforderungen stehen, kann die Kongruenz der Familie und die Familiengesundheit maßgeblich verändert werden. Die Belastungen und Herausforderungen für das Pflegepersonal kann ebenfalls das System Familie beeinflussen. Aus diesem Grund ist es für Pfleger*innen wichtig reflektiert arbeiten zu können und sich den bevor-stehenden Herausforderungen in der pädiatrischen Palliative Care bewusst zu sein. Introduction This bachelor thesis deals with the challenges and burdens of palliative care of a child or adolescent with a life-limiting disease. The aim of this paper is to reflect on the challenges and burdens that families and nurses experience in paediatric palliative care. Methods A literature search was conducted in the databases Cinahl, Cochrane Library, SpringerLink and Medline. A total of eight studies were selected and anlysed using an evalutaion form. Six of them are qualitative, one is a quantitative study and one is grounded theory. Results Nurses, like family members, face several burdens and challenges. Family members have to deal with feelings of fear, insecurity, grief and loss. Nurses also experience such burdens, furthermore are feelings of helplessness, frustration and guilt described. Many challenges arise from poor com-munication between the treatment team and families. This increases the emotional problems men-tioned above. Caregivers face the challenge of addressing impending death and talking to siblings and parents about this sensitive issue. However, many nurses feel too inexperienced. Parents on the other hand often hide the truth from the child. During treatment, efficient pain and symptom ma-nagement is important to minimize stress. However, many caregivers feel inexperienced in symptom and pain management. Watching the child suffer through pain is very stressful for families and nur-ses. Discussion A life-limiting illness of a child or adolescent disrupts the stability of a family. The fact that the relatives are faced with various challenges can significantly change the congruence of the family and the family health. The burdens and challenges for the nursing staff can also influence the family system. For this reason, it is important for nurses to be able to work in a reflective manner and to be aware of the upcoming challenges in pediatric palliative care.

Einleitung: Durch die Steigerung der Weltbevölkerung nimmt auch die Zahl der Menschen mit einer oder mehrerer onkologischen Erkrankungen zu. Eine diagnostizierte onkologische Erkrankung bei einem Menschen bringt oft Angst, Hoffnungslosigkeit und Hilfslosigkeit mit sich, für ihn selbst aber auch für seine Familie. Durch verschiedene Situationen wie z.B.: schwache Einkommen, Mangel an Fachkräften, ethische Grundeinstellung und anderen persönlichen Motiven, werden die Angehörigen oder Freunde zu pflegenden Angehörigen. Dies bringt zur Folge, dass diese vulnerablen Patienten*innen und deren Angehörigen besondere medizinische Hilfe und Pflege brauchen. Die Pflege, psychische Betreuung, Beratung, Schulung und Unterstützung von Krebserkrankten und ihrer Familien oder pflegenden Angehörigen, bringt viele Herausforderungen mit sich. Im weiteren Verlauf wird die mögliche Unterstützung aber auch die Belastung von Patienten*innen mit einer onkologischen Erkrankung und deren Angehörigen analysiert und beleuchtet. Methodik: Für die Beantwortung der Forschungsfragen wurde ein Literaturreview als Design verwendet. Dabei wurden quantitative und qualitative Studien sowie Artikel inkludiert, welche sich mit dem Thema beschäftigen und auseinandersetzen. Nach der Festlegung von Ein- und Ausschlusskriterien wurde in Datenbanken wie PubMed und CINAHL gesucht. Auch wurden Suchkriterien festgelegt. Alle als passend befundenen Studien und Artikel wurden mittels Bewertungsbögen kritisch analysiert und ausgewertet. Ergebnisse: Die Literaturrecherche zeigte, dass in der Pflege und Beratung onkologische Patienten*Innen und deren Angehörigen noch Handlungsbedarf herrscht. Um eine wertfreie Pflege zu bieten, sollte gleich in der Ausbildung jede Pflegeperson eine individuelle Schulung und Beratung bekommen, welche im Zusammenhang im Umgang mit Krebserkrankten und deren Angehörigen steht. Dies kann zu einer Verhaltensänderung führen bei Krebserkrankten, deren Angehörigen und Medizinischen Personal. Schlussfolgerung: Durch die Literaturrecherche hat sich herauskristallisiert, dass das Gesundheitspersonal nur den/die Patienten*in mit seiner/ihrer Erkrankung sieht und nicht seine/ihren ganzen Familien- und Freundschaftssystem, das mit darunter leidet. Daher ist es notwendig Schulungen anzubieten, um Personen, welche im Gesundheitswesen beschäftig sind, darauf zu sensibilisieren. Abstract: As the population of the world is increasing, so are the numbers of people who suffer from cancer. For the patient the illness often means Fear, loss of hope, but also for their families and friends. There are various situations that lead to an increased level of stress as for example: low income, health specialist, diverse moral systems, and personal motives. These situations not only cause stress for the patient him or herself, but also for their relatives, when their role changes into caretakers. This causes, that also the relatives need help and patience, as well as medical caretaking. The psychological medical and social work that is needed for the patients and their relatives bear a lot of challenges. In this paper the possible ways of support, as well as emotional strains are being described Methodology: To answer the research questions, it had been used a literature review as a design, in fact it had been used quantitative, qualitative studies and articles that deal with this topic. They search in recognized Databases as PubMed and CINAHL after determinations of inclusion and exclusion criteria and fix search criteria. All studies and articles that were compatible were analyzed and evaluated with evaluations sheets. Ergebnisse: The research showed, that caretaking and consultancies for cancer patients and their relatives can and must be improved. To make a care taking possible, that is free of moral judgement, there must be courses for all people working in the health sector during their education. Those will lead to a change in handling these challenging situations for the patients themselves, their families, and friends, but also for the medical specialists. Conclusion: The research has shown that only the oncological patients are being seen by the health system. Whole systems of family and friends suffer from this fact. This makes it necessary to sensibilize workers for this topic.

One of the most important systems in society is the family, and with it the communication that arises between members. For this reason, the psychometric evidence of the Family Communication Scale (FCS) was analyzed. The sample was of 210 Peruvian university students, 46.19% were from public universities and 53.81% were from private universities. The sample was made up of 44.29% men and 55.71% women, with participants from the Costa region(85.25%), Sierra (11.44%) and Selva (3.31%). The reagents indicated appropriate adjustment indexes. In addition, confirmatory factor analysis (CFA) showed the validity of the internal structure and the unidimensionality of the scale, providing the following results: X2= 79,370, gl =35, X2/gl = 2.26, IFC = .945, TLI = .929, RMSEA = .078, SRMR = .046. In turn, the FCS scale has a positive correlation with the family functioning scale and need for social approval; however, it has an inverse relationship with the filio-parental violence scale. On the other hand, the reliability was of α .939 and ω of .94, thus representing the validity of the instrument. Finally, invariance was presented, taking into account gender and university management, resulting in participants understanding and responding similarly to the questionnaire. Uno de los más importantes sistemas en la sociedad, es la familia, y con ella la comunicación que surge entre los miembros. Por tal motivo, se analizó las evidencias psicométricas de la Escala de Comunicación Familiar (FCS). La muestra fue de 210 estudiantes universitarios peruanos, el 46.19% fue de universidad pública y el 53.81% fue de universidad privada, la cual estuvo conformada por 44.29% hombres y 55.71% mujeres, teniendo como participantes en la región Costa 85.25%, Sierra 11.44% y Selva 3.31%. Los reactivos indicaron unos apropiados índices de ajuste, además, el análisis factorial confirmatorio (AFC) evidenció la validez de la estructura interna y la unidimensionalidad de la escala, proporcionando los siguientes resultados: X2= 79.370, gl =35, X2/gl = 2.26, CFI = .945, TLI = .929, RMSEA = .078, SRMR = .046. A su vez, la escala FCS tiene una correlación positiva con la escala de funcionamiento familiar y necesidad de aprobación social; sin embargo, presenta una relación inversa con la escala violencia filio parental. Por otro lado, la confiabilidad fue de α .939 y ω de .94, representando de esta forma la validez del instrumento. Finalmente, se presentó invarianza, tomando en cuenta el sexo y gestión de universidad, dando como resultado que los participantes entendieron y respondieron de forma similar el cuestionario.