No abstract

In family healthcare nursing, the family system unit (i.e., a group in which the members, seen as a whole, mutually interact) is the target of care. As nurses tend to obtain family-related information from particular family members in the clinical setting, when assessing families, they often confront the issue of the differences between the theoretical level and methodological level. Although this issue needs resolving for evidence-based family nursing practice, sufficient research is lacking on the methodology related to family assessment. The present study aimed to clarify the factors that affected evaluation of family functioning among couples. Semi-structured interviews were conducted with 10 child-rearing families (couples) using the Survey of Family Environment (SFE) as a family functioning scale. Content analysis identified 12 factors that affected discrepancies in the couples' evaluations and eight factors that affected agreement in those evaluations. These factors were classified into three categories: factors concerning family or family members; factors concerning questions related to the SFE; and factors concerning the view of the family as a whole. The results of this study should contribute to the development of family assessment tools and effective methods for evaluation of family care.

There exists an international consensus on the importance of family-centered care (FCC) in intensive care settings and the evaluation of collaboration between nurses and families; however, FCC is currently practiced blindly in Japan. In this study, we developed a Japanese version of the questionnaire, Factors that Influence Family Engagement (QFIFE-J) and examined its reliability and validity. A web-based survey was conducted with 250 nurses working in the intensive care unit (ICU). Exploratory and validatory factor analyses were used to ascertain factor validity. Criterion-related validity was tested using correlation analysis with the ICU Nurses’ Family Assistance Practice Scale. Internal consistency and reproducibility were verified for reliability. Following exploratory and confirmatory factor analyses, a 15-item measure emerged comprising four factors: “ICU environment”, “nurses’ attitudes”, “nurses’ workflow”, and “patient acuity”. Confirmatory factor analyses showed a generally good fit. Cronbach’s α for the overall scale was 0.78, indicating acceptable internal consistency. The intraclass coefficient for test–retest reliability was 0.80. It was found that the QFIFE-J was reliable and valid and may help determine the factors that promote or inhibit FCC. Additionally, this study has also clarified the current status and family support related issues in ICUs in Japan.