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IntroductionFamily engagement in care has been advocated to promote recovery for patients with mental health conditions. Attitudes of mental health nurses toward the importance of families influence the way they partner with families in mental healthcare. However, little is known about how mental health nurses engage with families and quality of family‐centered care (FCC) perceived by patients and caregivers. The study aimed to examine the mediating effect of family nursing practice on the association between mental health nurses' attitudes toward integrating families into care and quality of FCC perceived by patients with schizophrenia and caregivers.DesignA cross‐sectional study was conducted.MethodsA convenience sample of 143 dyads of patients with schizophrenia and their caregivers and 109 mental health nurses were recruited from inpatient wards at two psychiatric hospitals in Taiwan. Demographic and clinical questionnaires, Families' Importance in Nursing Care‐Nurses' Attitudes scale, Family Nursing Practice Scale, and Measure of Process of Care for Adults were used to collect data. Data were analyzed using descriptive statistics, independent‐sample t‐tests, one‐way analysis of variance, Pearson correlation coefficients, paired‐sample t‐tests, and intraclass correlation coefficient (ICC). Mediation analyses were performed using Hayes' PROCESS macro in SPSS (Model 4) with bootstrapping.ResultsMental health nurses exhibited supportive attitudes toward integrating families into care (Mean = 98.96) and greater perceptions of family nursing practice (Mean = 2.44). The concordances between patients and caregivers on perceived quality of family‐centered care were significant (ICC = 0.63–0.77). Attitudes of mental health nurses toward integrating families into care had both the total and direct effects on all domains of quality of FCC perceived by patients and caregivers, respectively. The indirect effects of mental health nurses' attitudes toward integrating families into care on aspects of quality of FCC through family nursing practice were significant for patients (95% bias‐corrected bootstrap CI of 0.015–0.053) and caregivers (95% bias‐corrected bootstrap CI of 0.004–0.041). The magnitude of the indirect effects was medium to large for patients (ES = 0.209–0.257) and caregivers (ES = 0.148–0.221).ConclusionFamily nursing practice partially mediated the association between mental health nurses' attitudes toward integrating families into care and aspects of quality of FCC from perspectives of patients and caregivers.Clinical RelevanceInterventions tailoring mental health nurses' practice skills and reciprocity with families have the potential to enhance supportive attitudes of mental health nurses toward working with families and further improve perceived quality of FCC in patient‐caregiver dyads in mental healthcare practice.
IntroductionFamily engagement in care has been advocated to promote recovery for patients with mental health conditions. Attitudes of mental health nurses toward the importance of families influence the way they partner with families in mental healthcare. However, little is known about how mental health nurses engage with families and quality of family‐centered care (FCC) perceived by patients and caregivers. The study aimed to examine the mediating effect of family nursing practice on the association between mental health nurses' attitudes toward integrating families into care and quality of FCC perceived by patients with schizophrenia and caregivers.DesignA cross‐sectional study was conducted.MethodsA convenience sample of 143 dyads of patients with schizophrenia and their caregivers and 109 mental health nurses were recruited from inpatient wards at two psychiatric hospitals in Taiwan. Demographic and clinical questionnaires, Families' Importance in Nursing Care‐Nurses' Attitudes scale, Family Nursing Practice Scale, and Measure of Process of Care for Adults were used to collect data. Data were analyzed using descriptive statistics, independent‐sample t‐tests, one‐way analysis of variance, Pearson correlation coefficients, paired‐sample t‐tests, and intraclass correlation coefficient (ICC). Mediation analyses were performed using Hayes' PROCESS macro in SPSS (Model 4) with bootstrapping.ResultsMental health nurses exhibited supportive attitudes toward integrating families into care (Mean = 98.96) and greater perceptions of family nursing practice (Mean = 2.44). The concordances between patients and caregivers on perceived quality of family‐centered care were significant (ICC = 0.63–0.77). Attitudes of mental health nurses toward integrating families into care had both the total and direct effects on all domains of quality of FCC perceived by patients and caregivers, respectively. The indirect effects of mental health nurses' attitudes toward integrating families into care on aspects of quality of FCC through family nursing practice were significant for patients (95% bias‐corrected bootstrap CI of 0.015–0.053) and caregivers (95% bias‐corrected bootstrap CI of 0.004–0.041). The magnitude of the indirect effects was medium to large for patients (ES = 0.209–0.257) and caregivers (ES = 0.148–0.221).ConclusionFamily nursing practice partially mediated the association between mental health nurses' attitudes toward integrating families into care and aspects of quality of FCC from perspectives of patients and caregivers.Clinical RelevanceInterventions tailoring mental health nurses' practice skills and reciprocity with families have the potential to enhance supportive attitudes of mental health nurses toward working with families and further improve perceived quality of FCC in patient‐caregiver dyads in mental healthcare practice.
Background Burdening health and illness issues such as physical or mental illnesses, accidents, disabilities, and life events such as birth or death influence the health and functioning of families and contribute to the complexity of care and health care costs. Considerable research has confirmed the benefits of a family systems–centered care approach for patients, family caregivers, families, and health care professionals. However, health care professionals face barriers in working with families, such as feeling unprepared. Family systems–centered therapeutic conversations support families’ day-to-day coping, resilience, and health. A family systems care unit (FSCU) was recently established as a real-life laboratory at one of the Swiss Universities of Applied Sciences. In this unit, health care professionals offer therapeutic conversations to families and individual family members to support daily symptom management and functioning, soften suffering, and increase health and well-being. These conversations are observed in real time through a 1-way window by other health care professionals, students, and trainees and are recorded with video for research and education. Little is known about how therapeutic conversations contribute to meaningful changes in burdened families and the benefits of vicarious learning in a real-life laboratory setting for family systems care. Objective In this research program, we aim to deepen our understanding of how therapeutic conversations support families and individuals experiencing burdening health and illness issues and how the FSCU laboratory setting supports the learning of students, clinical trainees, and health care professionals. Methods Here we apply a transformational action research design, including parallel and subsequent substudies, to advance knowledge and practice in family systems care. Qualitative multiple-case study designs will be used to explore the benefits of therapeutic conversations by analyzing recordings of the therapeutic conversations. The learning processes of students, trainees, and professionals will be investigated with descriptive qualitative study designs based on single and focus group interviews. The data will be analyzed with established coding methods. Results Therapeutic conversations have been investigated in 3 single-case studies, each involving a sequence of 3 therapeutic conversation units. Data collection regarding the second research question is planned. Conclusions Preliminary results confirm the therapeutic conversations to support families’ coping. This renders the FSCU a setting for ethically sensitive research. This program will not only support the health and well-being of families, but also contribute to relieving the financial and workforce burdens in the health and social care system. International Registered Report Identifier (IRRID) DERR1-10.2196/53090
Background: Fears about the future and uncertainty in multiple sclerosis (MS) can affect the patients’ adaptation and well-being. Objectives: This study investigated the effect of collaborative care on the fear of disease progression in MS patients. Methods: In this randomized controlled trial, patients and their main caregivers were assigned into study groups (36 in the intervention and 43 in the control group) by randomized minimization method. For the intervention group, the collaborative care model was implemented in seven sessions over nine weeks. The data were collected using the Fear of Progression Questionnaire-Short Form (FOP Q-SF). Data analysis was done using descriptive statistics, Shapiro-Wilk, chi-square, Fisher Exact, independent, and paired t-tests. Results: A near-significant difference was found between the groups after the intervention (P = 0.051). However, in intragroup comparisons, the FOP score significantly decreased in the intervention group (P = 0.001) and increased in the control group after the intervention (P = 0.001). Conclusions: Collaborative care could potentially be an effective strategy for managing FOP in patients with MS.
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