家庭癌症告知过程及类型分析

将癌症告知看作一个家庭过程,以患者-家属为分析单位,阐述确诊及病程信息如何在家庭中流动,以及告知过程中患者和家属的角色演变。研究者对12位肺癌患者、7位家庭照护者和2位医生进行半结构访谈,并对访谈数据进行主题分析。家庭癌症告知是一个关乎患癌事实如何在家庭内流动的过程。围绕确诊、治疗和临终安排三个阶段,详细阐述了病患和家人的多种角色的演变,并基于此构建了两种家庭告知的理想类型：病患决策型和家属代理型。患者以往家庭角色、家庭沟通系统和疾病具身性体验是家庭癌症告知过程的重要影响因素。

     

以家庭平衡为目的的辅助生殖技术性别选择问题探讨

对三孩政策下辅助生殖医疗机构患者就诊过程中呼声较高的以家庭平衡为目的的性别选择问题进行探讨,从概念的界定、产生需求的社会背景及可能引发的伦理问题进行论证,从而推动社会层面的深度思考。同时,结合当前辅助生殖技术中存在的社会需求,提出了以家庭平衡为目的的性别选择是曾经实行的“生男即止法”的延伸。但以家庭平衡为目的的性别选择还需要以辅助生殖技术规范应用为前提,应该从法律法规的完善、技术应用的监督及审查体系的加强等方面推动工作,防止相关技术的滥用。

     

家庭及社会支持对城乡老年人心理健康影响的研究——以河北省城乡老年人调查为例

探究家庭及社会支持对老年人心理健康的影响,选取河北省6 173名60岁及以上城乡老年人,采用社会支持和心理健康症状自评量表进行问卷调查。城乡老年人心理健康评测结果显示,有心理症状者占22.9%;社会支持以低中度水平为主,占77.4%;家庭功能以一般及以下为主,占86.3%;经常与子女交流者占53.7%;得到社区帮助者占84.7%;社会支持、家庭功能、与子女交流情况、得到基层社区卫生服务情况均与城乡老年人的心理健康显著相关。统计结果揭示,我国应加大家庭及社会对老年人的支持力度,改善其心理健康状况。     

Preconceptional family health evaluation: A regional education program for family planning clients and health professionals

The Preconceptional Family Health Evaluation Program was a regional project developed and funded for 2 years by the New England Regional Genetics Group (NERGG) to educate family planning health professionals about genetics, and to offer family planning clients preconceptional identification of genetic and environmental exposure risks. To meet these goals, genetic education was provided on a regional basis to 45 family planning professionals. A self-administered family health risk questionnaire adaptable to individual family planning settings was developed. Five hundred and twenty-nine family planning clients voluntarily completed the questionnaire. Cigarette smoking (35%) and alcohol use (57%) were two major categories of risks identified. The Preconceptional Family Health Evaluation Program was well received by all participants and provided an effective means for regional education of family planning health professionals. As a result of the program, state program planners, clinical genetics services, and family planning health professionals developed a strong relationship that will serve future educational and genetic risk screening efforts.     

Family,peer, and neighborhood influences on academic achievement among African-American adolescents: One-year prospective effects

Using a 1-year prospective design, this study examined the influence of family status variables (family income, parental education, family structure), parenting variables (maternal support and restrictive control), peer support, and neighborhood risk on the school performance of 120 African American junior high school students. In addition to main effects of these variables, neighborhood risk was examined as a moderator of the effects of parenting and peer support. Family status variables were not predictive of adolescent school performance as indexed by self-reported grade point average. Maternal support at Time 1 was prospectively related to adolescent grades at Time 2. Neighborhood risk was related to lower grades, while peer support predicted better grades in the prospective analyses. Neighborhood risk also moderated the effects of maternal restrictive control and peer support on adolescent grades in prospective analyses. These findings highlight the importance of an ecological approach to the problem of academic underachievement within the African American community.     

Family characteristics as mediators of the influence of problem drinking and multiple risk status on child mental health

Structural equation modeling was used to test a theoretical model in which family cohesion and family reframing coping were hypothesized as mediators between family drinking problems, multiple risk factors, negative life events, and child mental health (conduct disorder, depression, anxiety) in two-parent families. Family cohesion mediated the relationships of family drinking problems and negative life events to child conduct disorder and depression. Negative life events mediated the relationships of family drinking problems and family multiple risk to child conduct disorder. Family reframing coping did not function as a mediator nor was it related to child mental health when other factors were considered simultaneously. Results indicate that increasing family cohesion and reducing sources of stress within the family (negative life events) represent promising areas for interventions for children with problem-drinking parents. Work on this study was funded in part by the National Institute for Mental Health Grant 2-P50-MH39246-06 to support a Preventive Intervention Research Center. The authors gratefully acknowledge contributions made by Rita Shell, Marcia Michaels, Joanne Gersten, George Knight, and Carolyn Berg.     

Researchers discover what they already knew about validity: The case of the family-of-Origin Scale

This article is concerned with two recnet studies of the Family-of-Origin Scale (FOS), Gavin and Wamboldt (1992) and Ryan, Kawash, Fine, and Powel (1994). The external validity analyses conducted for the FOS in these studies assumed the scale to be a unidemsional measure. The present discussion centers on methodological decisions and interpretive strategies that may have prevented a more complete understanding of the scale's dimensional structure and theoretical meaning. It is concluded that a unidimensional view of the FOS is an oversimplification that is inconsistent with the available data. A case is made for a more comprehensive and technically adequate evaluation of the FOS. Specific suggestions are offered.     

Open live supervision in family therapy

This article reviews changes in models of supervision, resulting from technological developments and reflecting a variety of theoretical approaches. The focus is on open live supervision, conducted in the presence of the family. The supervisor and a therapeutic team join the therapist and the family, creating a complex supra-system that opens up several options for therapeutic intervention. Sessions are videotaped, and therapists use recordings for additional supervision and independent study. Therapists may also show recordings to the family as part of the therapeutic process. The advantages and disadvantages of the model are considered, and examples of some of the therapeutic options are described.This model was developed in the course of the author's work teaching and supervising students at the Counseling Department of the School of Education at the Hebrew University of Jerusalem, and supervising a multi-disciplinary team including physicians, psychologists, and social workers engaged in family therapy at the Municipal Psychological Services for Schools in Jerusalem. A shorter version of this article appeared in Hebrew inSihot 5 1991. Appreciation is expressed to Batya Stein for translating the final version of this article from Hebrew. Reprint requests should be addressed to Katrit Ron, Neve Granot 3-B, Jerusalem 93706, Israel.