Is pre-bereavement collaboration between family caregivers and healthcare professionals associated with post-bereavement emotional well-being? A population-based survey

Family Self-Care Pattern in Families with Children with Intellectual Disabilities: A Pilot Study

Family self-care emphasizes a family's role in health promotion and protection, reflecting society's views on health, illness, and human relationships. In families with children with an intellectual disability, where the child may lack self-care abilities, family self-care becomes crucial, highlighting that self-care needs exceed individual capacity and require family cooperation. Background/Objectives: This pilot study aims to explore the factors influencing family self-care and define attributes of its cognitive, psychosocial, physical, and behavioral domains in families with children with intellectual disabilities. Methods: A descriptive and correlational study with forty-four families was conducted. Exploratory analysis and linear regression analysis were estimated through the assumptions of the Gauss-Markov theorem (specifically homoscedasticity, normality, and model specification adequacy). Multicollinearity was also evaluated. Results: The significant family conditioning factors identified were family income, education level, degree of physical and functional dependence of the child, family household size, and social support. Socioeconomic, demographic, and health-related factors shaped self-care experiences. Conclusions: Family empowerment and the impact of disability are key elements in enabling self-care. Families reporting a greater impact of their child's condition tended to feel less empowered, directly affecting their ability to perform daily self-care activities. The evidence suggests a pattern in which self-care activities might be reactive rather than proactive and focused on managing immediate challenges rather than long-term well-being. These insights can guide healthcare professionals, especially family nurses, toward a holistic, family-centered approach to supporting families with children with intellectual disabilities.

Advance care planning in patients with respiratory failure

Advance care planning (ACP) is a complex and iterative communication process between patients, surrogates and clinicians that defines goals of care that may include, but is not limited to, documentation of advance directives. The aim of ACP is to promote patient-centred care tailored to the patient's clinical situation through informed preparation for the future and improved communication between patient, clinicians and surrogates, if the latter need to make decisions on patient's behalf.The aim of this article is to review research related to ACP in acute and chronic respiratory failure, regarding the process, communication, shared decision-making, implementation and outcomes.Research has produced controversial results on ACP interventions due to the heterogeneity of measures and outcomes, but positive outcomes have been described regarding the quality of patient-physician communication, preference for comfort care, decisional conflict and patient-caregiver congruence of preferences and improved documentation of ACP or advance directives.The main barriers to ACP in chronic respiratory failure are the uncertainty of prognosis (particularly in the organ failure trajectory), the choice of the best timing for initiation and the lack of training of healthcare workers. In acute respiratory failure, the ACP process can be very short, should include the patient whenever possible, and is based on a discussion of treatments appropriate to the patient's functional status prior to the event (e.g. assessment of frailty) and clear communication of the likely consequences of possible options.All healthcare worker dealing with patients with serious illnesses should have training in communication skills to promote engagement in ACP discussions.

"You're the only thing he comes out [of his room] for": A qualitative study of engagement between Laughter Care Specialists and families of people with dementia in long-term care

OBJECTIVES

Family involvement in the lives of people who have dementia and live in long-term care is important, but family members may face challenges communicating and connecting with their loved one as dementia progresses. A type of therapeutic humor (Laughter Care) delivered by trained specialists aims to engage people with dementia who reside in long-term care through creative play and laughter. This study aimed to explore the perceptions of Laughter Care Specialists (LCSs) regarding families' engagement with the program.

METHODS

Semi-structured interviews were conducted with LCSs (n = 8) and analyzed inductively using thematic analysis.

RESULTS

Family members were reported to initially have varied degrees of openness toward Laughter Care, but often become more accepting after observing positive engagement with the person with dementia. Family members were perceived to benefit from the program through witnessing the person with dementia enjoy joyous and light interactions, learn new ways of communicating and connecting with the person with dementia, and engage in positive interactions at end of life.

SIGNIFICANCE OF RESULTS

Laughter Care may provide family members with novel ways of communicating and connecting with people who have dementia at end of life as well as comfort into bereavement.

Family Self-Care in Chronic Disease Management: An Evolving Care Pattern?

INTRODUCTION

Self-care emerges in the family context, despite being seen as an individual determinant of health. The family, understood as a system and social unit, converges to a pattern of self-care and not to a sum of it, assuming relevance at certain moments of the life cycle, particularly in the management of chronic disease.

PURPOSE

To perform the transposition of individual self-care to the family self-care, considering the current family's needs and characteristics, by adopting family self-care as the core concept of a care pattern as a determinant of family health.

CONCLUSION

The family unit is the most influential factor in the health status of individuals, and it will be through family self-care behaviors that families can be healthier by managing their diseases more effectively. They seek to achieve family health, maintaining health through health promotion and disease management practices, always mediated by family self-care behaviors.