FAMILY RESOURCES AND RECOVERY.
Contributors: University of California, San Francisco.
Published: 1988
Number of pages: 279
Subjects: Health Sciences, Nursing.
Description: Twenty-one families were followed from admission of a family member for vascular surgery to three months after discharge. Families were observed and interviewed during the hospitalization, again after returning home, and by telephone. Family instrumentation--the Family APGAR (APGAR), the Family Coping Index (FCOPES), and the Family Inventory of Resources for Management (FIRM)--was combined with grounded theory methodology to study family responses over time and to determine the relevance of the family assessment tools to this clinical population.

Family integration of the illness and surgery over time, moderated by strategies of containment, emerged as the grounded theory. Containment strategies served to limit the disruption of the crisis of surgery and its associated meanings in the pre-existing family life patterns of functioning. Three phases of the process of integration were identified: accommodation, confrontation, and acknowledgement.

Conclusions of the grounded theory analysis were that containment controlled family disruption but preempted the opportunity for the family to accept and understand peripheral vascular disease or manage its risk factors. A pivotal dimension of containment was the sustained ambiguity of the meaning of the physical symptoms and the purpose of the surgery, which appeared to be poorly understood by the family. The hospital was not a resource for families: families were not mobilized by health care providers for a health care role after discharge.

Recovery morbidities were unexpected, poorly understood and more distressing to families than to clinicians. This was particularly so for psychological morbidity (depression, emotional liability and family conflict). Family relationships acted as the primary mediator of information management. Families tended to be isolated in their coping patterns with the exception of the Black American and Hispanic families who drew on extensive social networks for support.

Significant findings of the family measures analyses were compared with the grounded theory analyses. Assessment of families at risk can be made on the basis of low and discrepant family and patient scores on the APGAR. The FCOPES and the FIRM were less discriminating or valid.

The family measures results corresponded to and corroborated the grounded theory. The theory, in turn provided substantive explanation for the measures' results. The convergent validity of the combined methods supports the utility of this design for family study.
Notes: Source: Dissertation Abstracts International, Volume: 49-10, Section: B, page: 4232.

Thesis (D.N.SC.)--UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, 1988.

School code: 0034.