Relationships Influence Health: Family Theory in Health-Care ResearchThis article reviews the presence of family theory in health-care research. First, we demonstrate some disconnect between models of the patient, which tend to focus on the individual, and a large body of research that finds that relationships influence health. We summarize the contributions of family science and medical family therapy and conclude that family science models and measures are generally underutilized. As a result, practitioners do not have access to the rich tool kit of lenses and interventions offered by systems thinking. We propose several possible ways that family scientists can contribute to health-care research, such as using the family as the unit of analysis, exploring theories of the family as they relate to health, and suggesting greater involvement of family scientists in health research.Health-care literature has several different models that explain patient behavior, typically using the individual as the unit of analysis. Family researchers, however, have noted that social situations, families, relationships, and external factors strongly influence both health and health decision making. Research-often conducted by cardiologists, nurses, and others from outside family science-has shown strong empirical support for the interrelationship of
This research explored health decision-making processes among people recently diagnosed with type 2 diabetes. Our analysis suggested that diagnosis with type 2 was followed by a period of intense emotional and cognitive disequilibrium. Subsequently, the informants were observed to proceed to health decision-making which was affected by three separate and interrelated factors: knowledge, self-efficacy, and purpose. Knowledge included cognitive or factual components and emotional elements. Knowledge influenced the degree of upset or disequilibrium the patient experienced, and affected a second category, agency: the informants’ confidence in their ability to enact lifestyle changes. The third factor, purpose, summarized the personal and deeply held reasons people gave as they made decisions concerning their health, eating and exercising. We propose this model, grounded in informant stories, as a heuristic, to guide further inquiry. From these stories, the patient is seen as more active and the interrelated influences of knowledge, agency, and purpose, synergistically interact to explain changes in health behaviors.
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