Incorporating family members in the care of patients with dementia provided pertinent psychosocial data, led to mutual decision-making regarding care, and produced changes in the responses of the residents with dementia, as well as in the family and nursing staff. The experimental group experienced increases in psychosocial nursing diagnoses with planning and interventions to meet the problems, more extensive problem description, and an active focus on interaction and change in the nurse's notes. As a result of collaborative nursing and family involvement, personal articles were brought from home; family collateral visits and interaction increased; families were more involved in the unit, medical center, and support groups; and p.r.n. medication use was decreased. As health-care technology prolongs the life of patients with chronic illness and sequelae such as dementia, nurses will need to continue to include families as collaborators in providing quality care.

Poor adherence limits the effectiveness of antipsychotic treatment in people with psychosis. The aim of the pragmatic, exploratory, single-masked trial conducted in the USA was to explore the efficacy, acceptability, and satisfaction with adherence therapy (AT) in a sample of people with schizophrenia. Twenty-six patients (12 experimental and 14 controls) were randomly allocated to receive eight weekly sessions of AT or continue with their treatment as usual (TAU). Patients were assessed at baseline and follow up (after therapy completion). The primary outcome was psychiatric symptoms, assessed using the Positive and Negative Syndrome Scale (PANSS). The secondary outcome, medication adherence, was measured by The Personal Evaluation of Transitions in Treatment. Patients receiving AT did not significantly improve in overall psychiatric symptomatology (change in PANSS total scores: AT: -10.2, TAU: -8.6; mean difference, -1.6; P = ns) or with medication adherence (AT: -2.8, TAU 1.5; P = ns) compared with the TAU group at follow up. Using the Adherence Therapy Patient Satisfaction Questionnaire, a high degree of satisfaction with AT was reported. Although AT did not result in a statistically-significant improvement in symptoms or medication adherence, evidence of active clinical engagement in treatment occurred.

This paper explores the phenomena of family health from a nursing perspective by examining the view of health in the discipline of nursing, and the view of family health in multiple disciplines. A holistic definition of family health for nursing is proposed which includes five realms of family experience which make up the family health system. The proposed classification is offered as a beginning heuristic model to organize knowledge generation for use in the practice of family nursing.

No abstract