Family Relations
Sending parents outpatient letters about their children: parents' and general practitioners' views. (1/640)
Parents' cooperation is essential to ensuring implementation of effective healthcare management of children, and complete openness should exist between paediatricians and parents. One method of achieving this is to send parents a copy of the outpatient letter to the general practitioner (GP) after the child's outpatient consultation. To determine the views of parents and GPs a pilot survey was conducted in two general children's outpatient clinics in hospitals in Newcastle upon Tyne. In March and April 1991 a postal questionnaire was sent to 57 parents of children attending the clinics, and a similar questionnaire to their GPs to elicit, respectively, parents' understanding of the letter and perception of its helpfulness, and GPs' views on the value of sending the letters to parents. Completed questionnaires were received from 34(60%) parents and 47(82%) GPs; 26(45%) respondents were matched pairs. 27(79%) parents said they understood all of the letter, 19(56%) that it helped their understanding, 32(94%) felt it was a good idea, and 31(91%) made positive comments. In all, 29(61%) GPs favoured the idea and six (13%) did not. Eleven (23%) said they would be concerned if this became routine practice, and 20(74%) of the 27 providing comments were doubtful or negative; several considered that they should communicate information to parents. The views in the matched pairs were dissimilar: parents were universally in favour whereas many GPs had reservations. The authors concluded that sending the letters improved parents' satisfaction with communication, and they recommend that paediatricians consider adopting this practice. (+info)Beyond the disorder: one parent's reflection on genetic counselling. (2/640)
As a mother of two sons with adrenoleukodystrophy the author of this paper writes about her experiences of genetic counselling following the diagnosis. She discusses the dilemmas, emotions and aftermath this knowledge has brought to her family and the roles she played. Personal concerns are raised about the values guiding genetic counselling which, she found, focused on the technical details without considering the ethical implications arising from the new knowledge or the emotional dilemmas of prenatal testing. Some consequences of choice and the value of hope are discussed. She concludes by challenging genetic counsellors to deliver a service which not only provides technical information but is cognisant of the ethical considerations this information may foist upon a family. (+info)Treatment alliance and its association with family functioning, adherence, and medical outcome in adolescents with severe, chronic asthma. (3/640)
OBJECTIVE: To examine the concept of treatment alliance in the care of adolescents with asthma. METHODS: Measures of treatment alliance were obtained from 60 adolescents with severe, chronic asthma admitted to a tertiary care facility, their parents, and their asthma specialists at the referral center. Associations were examined between the alliance measures and multimeasure, multiagent data concerning family functioning and asthma treatment adherence and outcome. RESULTS: Physicians' reports of treatment alliance were associated with concurrent family functioning and asthma medication adherence, as well as with asthma treatment adherence and outcome in the year after the stay at the asthma center. CONCLUSIONS: As emphasized in the recently revised Expert Panel Report: Guidelines for the Diagnosis and Management of Asthma (NHLBI, 1997), the ability of children with asthma, their parents, and their physician to create a positive partnership, or treatment alliance, appears to have an important role in optimal asthma management. (+info)Parental visiting, communication, and participation in ethical decisions: a comparison of neonatal unit policies in Europe. (4/640)
AIM: To compare neonatal intensive care unit policies towards parents' visiting, information, and participation in ethical decisions across eight European countries. METHODS: One hundred and twenty three units, selected by random or exhaustive sampling, were recruited, with an overall response rate of 87%. RESULTS: Proportions of units allowing unrestricted parental visiting ranged from 11% in Spain to 100% in Great Britain, Luxembourg and Sweden, and those explicitly involving parents in decisions from 19% in Italy to 89% in Great Britain. Policies concerning information also varied. CONCLUSIONS: These variations cannot be explained by differences in unit characteristics, such as level, size, and availability of resources. As the importance of parental participation in the care of their babies is increasingly being recognised, these findings have implications for neonatal intensive care organisation and policy. (+info)Family consent, communication, and advance directives for cancer disclosure: a Japanese case and discussion. (5/640)
The dilemma of whether and how to disclose a diagnosis of cancer or of any other terminal illness continues to be a subject of worldwide interest. We present the case of a 62-year-old Japanese woman afflicted with advanced gall bladder cancer who had previously expressed a preference not to be told a diagnosis of cancer. The treating physician revealed the diagnosis to the family first, and then told the patient: "You don't have any cancer yet, but if we don't treat you, it will progress to a cancer". In our analysis, we examine the role of family consent, communication patterns (including ambiguous disclosure), and advance directives for cancer disclosure in Japan. Finally, we explore the implications for Edmund Pellegrino's proposal of "something close to autonomy" as a universal good. (+info)Chinese and U.S. internists adhere to different ethical standards. (6/640)
OBJECTIVE: To determine whether internists in the United States and China have different ideas and behaviors regarding informing patients of terminal diagnoses and HIV/AIDS, the role of the family in end-of-life decision making, and assisted suicide. DESIGN: Structured questionnaire of clinical vignettes followed by multiple choice questions. SETTING: University and community hospitals in San Francisco and Beijing, China. SUBJECTS: Forty practicing internists were interviewed, 20 in China and 20 in the United States. MEASUREMENTS AND MAIN RESULTS: Of the internists surveyed, 95% of the U.S. internists and none of the Chinese internists would inform a patient with cancer of her diagnosis. However, 100% of U.S. and 90% of Chinese internists would tell a terminally ill patient who had AIDS, rather than advanced cancer, about his diagnosis. When family members' wishes conflicted with a patient's preferences regarding chemotherapy of advanced cancer, Chinese internists were more likely to follow the family's preferences rather than the patient's preferences (65%) than were the U.S. internists (5%). Thirty percent of U.S. internists and 15% of Chinese internists agreed with a terminally ill patient's request for sufficient narcotics to end her life. CONCLUSIONS: We found significant differences in clinical ethical beliefs between internists in the United States and China, most evident in informing patients of a cancer diagnosis. In general, the Chinese physicians appeared to give far greater weight to family preferences in medical decision making than did the U.S. physicians. (+info)Promoting medical self-care: evaluation of a family intervention implemented in the primary health care by pharmacies. (7/640)
BACKGROUND: Medical self-care is the range of behaviours undertaken by people to promote or restore health when dealing with a medical problem. OBJECTIVES: The aim of the study was to evaluate medical self-care effects of a family intervention implemented in primary health care by pharmacies, in terms of non-professional and professional involvement. METHODS: The intervention was implemented in one of two primary health care areas during a 4-month period and involved consecutive families acting as an intervention (IG, n = 94) or a control (CG, n = 93) group. Eight telephone interviews were conducted with each family. The families were asked about complaints of illness, how long they prevailed and how they were treated. RESULTS: The results showed (P < 0.05-0.0001) that the IG had more medical problems (931 versus 621) compared with the CG, were less hospitalized (4 versus 10), stayed at home more to take care of sick children (84 versus 40), read more medical brochures (121 versus 31), tried more non-medical treatments (228 versus 116), and had fewer visits to the department of paediatrics but more visits to primary health care (69 and 98 versus 90 and 68). CONCLUSIONS: Due to the non-randomization procedure, some caution with regard to generalization of the results must be taken, but they are in concordance with established knowledge of the usefulness of medical self-care. The results indicate that a brief intervention for families can change the use of health authorities. It therefore seems meaningful to implement the intervention in a more comprehensive way in the primary health care setting, while at the same time trying to implement it as a large-scale randomized experimental study, comprising aspects such as the individual's need for care, the use of the right organization level and the assessment of economic costs and savings. (+info)'He is too young to die ... and you too, doctor'. (8/640)
Sometimes caregiving can be a matter of fear rather than of love. (+info)"Family relations" is a broad term that refers to the various interactions, roles, and relationships between members of a family unit. This can include the dynamics between parents and children, siblings, extended family members, and any other individuals considered part of the family.
Family relations can be influenced by a variety of factors, including cultural background, individual personalities, life experiences, and family structure. These relationships can have a significant impact on an individual's emotional, social, and psychological development and well-being.
Positive family relations are characterized by open communication, mutual respect, support, and affection. On the other hand, negative family relations can be marked by conflict, hostility, neglect, and abuse. It is important to note that family relations can be complex and multifaceted, with both positive and negative aspects coexisting within the same family system.
In a medical context, understanding family relations can be crucial for healthcare providers in order to provide effective care and support to their patients. This may involve assessing family dynamics and communication patterns, as well as providing education and resources to help families navigate any challenges or conflicts that may arise.
The term "family" in a medical context often refers to a group of individuals who are related by blood, marriage, or adoption and who consider themselves to be a single household. This can include spouses, parents, children, siblings, grandparents, and other extended family members. In some cases, the term may also be used more broadly to refer to any close-knit group of people who provide emotional and social support for one another, regardless of their biological or legal relationship.
In healthcare settings, understanding a patient's family dynamics can be important for providing effective care. Family members may be involved in decision-making about medical treatments, providing care and support at home, and communicating with healthcare providers. Additionally, cultural beliefs and values within families can influence health behaviors and attitudes towards medical care, making it essential for healthcare professionals to take a culturally sensitive approach when working with patients and their families.
A "Professional Role" in the context of medicine typically refers to the specific duties, responsibilities, and expectations associated with a particular healthcare position. It encompasses the legal, ethical, and clinical aspects of the job, and is shaped by education, training, and professional standards. Examples include roles such as a physician, nurse, pharmacist, or therapist, each with their own distinct set of professional responsibilities and obligations to patients, colleagues, and society.
Professional competence, in the context of medicine, refers to the possession of the necessary skills, knowledge, and behaviors required for the provision of high-quality healthcare services. It involves the ability to apply medical knowledge and clinical skills effectively in practice, make informed and evidence-based decisions, communicate clearly and effectively with patients and colleagues, demonstrate professionalism and ethical behavior, and engage in continuous learning and improvement.
Professional competence is evaluated through various means, including assessments of clinical skills, knowledge tests, patient feedback, and peer reviews. It is an ongoing process that requires healthcare professionals to continually update their knowledge and skills, adapt to changes in medical practice, and strive for excellence in patient care. Maintaining professional competence is essential for ensuring the safety and quality of healthcare services and is a key component of medical regulation and licensure.