Translation, Cultural Adaptation, and Psychometric Validation of the European Portuguese Version of the Iceland-Expressive Family Functioning Questionnaire (ICE-EFFQ).

A family's experience of mental illness can change the family's functioning. In clinical contexts, valid and reliable instruments that assess family functioning, therapeutic changes, and the effects of family nursing interventions are needed. This study focuses on the linguistic and cultural adaptation of the Iceland-Expressive Family Functioning Questionnaire (ICE-EFFQ) to European Portuguese and examines the psychometric properties of this instrument. A non-random sample of 121 Portuguese depressed patients and their relatives completed the questionnaire. Principal components analysis extracted 4 factors, explaining 55.58% of the total variance. Confirmatory factor analysis revealed acceptable adjustment quality indices. Cronbach's alpha coefficient was adequate for the global scale α = .86 and for the 4 subscales: communication α = .79, expression of emotions α = .68, problem-solving α = .71, and cooperation α = .61. The Portuguese version of ICE-EFFQ is a sensitive, valid, and reliable instrument for use with Portuguese families with adult members with depression and can be valuable in assessing these families' expressive functioning, before and after intervention.

Maintaining or letting go of couplehood: Perspectives of older male spousal dementia caregivers.

Despite the negative implications for their own health, spouses continue to support each other and maintain their couplehood for as long as possible, including when one of them develops a severe illness. However, with some exceptions, the experiences of older male spousal caregivers have been largely overlooked, and our knowledge of the relational aspects of spousal dementia care is scarce. To respond to this knowledge gap, this article explores the following research questions: How do older male spousal caregivers of wives with dementia talk about changes in their couplehood? What transitions or phases in the relationship can be identified as the caring process evolves and the wife's health continues to deteriorate? To answer these questions, we analyse in-depth interviews with eight purposefully selected men aged 67-92 years old from Iceland and Norway. Our findings reveal that the participants felt that they were gradually losing their couplehood in the sense that they lost their shared everyday life routines, intimacy, joint activities, meaningful communication, and dreams and hopes for the future. Four phases of the dementia caring process were identified: the denial phase, the battle phase, the new reality phase and the redefinition phase. We hope that our findings spur more research on relational challenges as experienced by spouses caring for partners with cognitive decline. In conclusion, we argue that interdisciplinary clinical guidelines for a couple-centred approach in elder care should be developed to urge professional care providers to pay attention to the various changes and challenges that dementia couples undergo to meet not only the health and care needs of dementia patients but also those of their spouses.

Recovery of patients with severe depression in inpatient rural psychiatry: a descriptive clinical study.

Objectives: The aim of this study was to investigate the level of and the relationship between symptoms and health-related quality of life (HRQoL) at admittance and recovery at discharge in patients with severe depression, in a rural inpatient psychiatric setting. Furthermore, whether the anxiety level at admission and/or, if the extent of patients' perception of family support from professionals were related to recovery.Method: Patients admitted with depression were consecutively invited to participate during a 12-month period. Depression, anxiety and stress were measured with DASS (The Depression Anxiety Stress Scale) and HRQoL with The Icelandic Quality of Life scale at admission and discharge. Family support was measured with Icelandic Family Perceived Support Questionnaire at discharge.Results: Majority of the participants had severe depression and anxiety scores (93.8% and 76.9%, respectively) at admission and HRQoL was impaired, especially in men. At discharge, almost three quarters of the participants had recovered into the outpatient or functional symptoms level and HRQoL had increased significantly. Morbid anxiety delayed recovery significantly, but perceived cognitive family support was positively related to depression recovery.Conclusion: Hospitalisation is an effective intervention for severe depression in rural Iceland. Positive benefits in both depression and HRQoL occur, where most of the participants reach outpatient or normal level of depression.

Drawing forward family strengths in short therapeutic conversations from a psychiatric nursing perspective.

PURPOSE: The aim of the narrative is to describe the therapeutic process and experience from a psychiatric nursing perspective, in therapeutic communication, with a father and his son in acute psychiatry. METHODS: In this case scenario, the Family Strength-Oriented Therapeutic Conversation Intervention (FAM-SOTC Intervention) was used. FINDINGS: The FAM-SOTC Intervention was found to be beneficial for the father-son relationship. PRACTICE IMPLICATION: It is encouraging for nurses in acute psychiatry to know that three short therapeutic conversations can make a difference within the family system. FAM-SOTC seemed to offer cognitive and emotional support to the father-and-son dyad.

The process of translating family nursing knowledge into clinical practice.

PURPOSE: To report on approaches that were used to assist with implementation of family systems nursing (FSN) at a university hospital level in Northern Europe. DESIGN AND METHODS: A quasi-experimental research design was used for the first phase of the study. For the second phase, a cross-sectional research design was used. Data were collected in the first phase of the study from 457 nurses in all except one of the divisions of the hospital regarding their attitudes towards involving families into their care before and after having participated in the education and training intervention (ETI) program in FSN. Furthermore, in the second phase, data were collected from 812 nurses, after FSN had been implemented in all divisions at Landspitali University Hospital, regarding the nurses' knowledge of FSN and their evaluation of the quality of the ETI program (i.e., theoretical lectures on FSN as well as the benefit of the skill lab training regarding applying FSN into their clinical practices). Graham and colleagues' Knowledge to Action framework was used as the conceptual framework for the research. RESULTS: Nurses who had taken a course in FSN reported a significantly more positive attitude towards involving families in their care after the ETI program compared to those who had not taken such a course. Furthermore, a majority of the nurses who participated in the ETI program reported that the program was a favorable experience and indicated readiness for applying FSN in clinical practice. CONCLUSIONS: Further research is needed regarding the benefits of offering FSN at an institutional level, but focusing international attention on effective strategies to implement FSN into nursing practice may result in better health care for individuals and families around the globe. CLINICAL RELEVANCE: Providing clinically meaningful education and training in family nursing through programs such as the ETI program for practicing nurses at a university hospital is essential in supporting nurses applying new knowledge, when providing evidence-based health care services, to individuals and their family members. Such training can facilitate integration of new and needed information in clinical practice.

What are the benefits of a short therapeutic conversation intervention with acute psychiatric patients and their families? A controlled before and after study.

BACKGROUND: Psychiatric illness of a family member can have a serious impact on the entire family. In addition, these families are faced with psychological burdens and stigmas. Little is known about the effectiveness of family nursing interventions on patients and their families when a family member is admitted for psychiatric treatment. Few studies have been published where family nursing interventions are integrated into routine inpatient services. PURPOSE: To evaluate the effectiveness of implementing a therapeutic conversation intervention in acute inpatient psychiatry with families, by evaluating family perceived support, expressive family function and general well-being. DESIGN AND METHODS: A controlled before and after study design was used. Patients and family members at four acute psychiatric units at a university hospital were selected for the implementation of family systems nursing (FSN). The nurses on one acute psychiatric unit were educated, trained, and supervised in a therapeutic conversation intervention built on the Calgary Family Assessment and Interventions models (Wright and Leahey, 2009). In the intervention group, 68 patients and 68 family members (N=136), received two-to-five therapeutic conversations with a nurse. The control groups were from three other acute units at the hospital, where 74 patients and 74 family members (N=148) received family nursing care as usual. RESULTS: The main findings indicated that family members who received the short therapeutic conversation intervention were found to perceive significant higher cognitive and emotional support from the nurses than family members who received standard care. CONCLUSION: The benefits of a specific short-term therapeutic conversation intervention are evident and valuable for nurses working in acute psychiatry. These positive results for families of psychiatric patients should not only encourage and propel clinical educators, clinical nurses and nurse researchers and other health professionals to develop and implement the therapeutic conversation intervention in acute psychiatric services but also be part of ritualized protocols of practice.