Families, systems & health : the journal of collaborative family healthcare
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Comparative Study
Social support mediates the relations between role strains and marital satisfaction in husbands of patients with fibromyalgia syndrome.
Husbands of patients with fibromyalgia syndrome (HFMS) report poorer physical and mental health than husbands of women without illness, as well as role strains because of their wives' condition. There are no published reports regarding the impact of fibromyalgia on their marital relationship. In the present study, we used Lazarus and Folkman's (1984) model of stress and coping as a framework to examine marital satisfaction among HFMS. ⋯ Among HFMS, sexual and domestic roles strains and social support were related to marital satisfaction. Social support alone mediated the relationship between role strain and marital satisfaction, and no variable moderated the relationship. These findings support prior research that shows that these husbands are significantly impacted by their wives' condition, and suggest the need to focus more attention on this population, possibly targeting social support for interventions.
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In the past two decades a great deal of research has demonstrated improved quality of care when mental health care is integrated into primary care. To date, most of the literature has addressed care management for specific mental illnesses. Such programs can be difficult to implement and sustain. ⋯ It makes use of technology to streamline assessment and track outcomes. The clinic provides a mix of care management, specialty expertise and chronic disease management. Originally developed in a capitated health care system, adherence to general principles that guided its development may be useful in any system of care.
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This pilot study explored the associations between parent and adolescent reports of adolescent attachment and glycemic control in adolescents with Type 1 diabetes. We hypothesized that more secure attachment would correlate with more optimal diabetes control. Thirty-one families completed written self-report questionnaires about adolescent attachment, demographic data, and diabetes control. ⋯ Attachment appears to be associated with glycemic control in this population though the mechanisms are unclear. Mothers' perceptions of attachment had the strongest associations with control, not adolescent reports. Further research is needed to understand the mechanisms through which parent reports of adolescent attachment are associated with glycemic control.
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Munchausen Syndrome by Proxy (MSP) is a disturbing diagnosis that should be considered when persistent signs and symptoms defy adequate explanation despite extensive testing. Insistence by a parent (often mother) that more, and particularly invasive investigations be pursued, should serve as a warning sign that MSP might be present. ⋯ This easily occurs in cases of MSP both because frequent hospitalizations offer ample opportunity for the articulate and inquisitive parent to pick up the ways of "medical-speak," and because the World Wide Web provides countless and effortlessly accessible sources of disease related information (albeit not always accurate or relevant to the diagnostic dilemma in question). An additional complicating factor in posing a risk for MSP is the child with a chronic illness, or one whose neonatal course has served to label the child as vulnerable.
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Families navigate loss of loved ones in a number of ways, including the creation of narratives of family experiences during the patient's illness and death. Robinson (2004) suggests that grieving family members create poetry together. Using a version of this method, the author processes losses by responding to the poems her husband wrote about the illnesses and deaths of a friend and several family members. Each poem is followed by a letter in which the author addresses the main character of the poem in order to provide new perspectives on her identity and her memories.