Biopsychosocial (BPS) approach to care is essential in family practice. Teaching this approach in family medicine is usually highlighted in family case presentations and counseling sessions. Little is done in showing how the biopsychosocial approach can be used in the day to day family practice. This article discusses the development of a learning tool called the PFC matrix which is a patient-centered, family-focused and community-oriented approach to care for individual patients and their families. The patient-centered care utilizes understanding of the interplay of biomedical psychosocial factors disease in order to implement management that is tailor-fitted to the needs and values of the patient. The family-focused component of the matrix utilizes family assessment to generate assumptions on how the family dynamics affect or facilitate the prescribed management of the patient’s disease. Lastly, the community-oriented component enables the family physician to use social determinants of health and health systems as a lens to understand how larger systems support or hinder the provision of care. Through the use of this matrix, the family physician is able to manage the patient in a holistic manner by recognizing patient needs, creating an enabling family support environment and helping the patient and family navigate various community resources. This results not only in optimal health for the patient but impacts to create a more responsive health system. In the future, further documentation of the use of the PFC matrix particularly in primary care in the light of universal health care and how it impacts on outcomes and how it connects patients and families at the correct tiers of the health system.
Patient-Centered Care ; Humans ; Physicians, Family ; Family Practice ; Family Support ; Counseling

Objective: To explore the relationship of social support to patients with schizophrenia, family burden with patients' quality of life and family life satisfaction. Methods: Multi-stage stratified cluster random sampling was used to select 358 patients with schizophrenia and 358 patients' family members in Gansu Province who met the inclusion criteria were included. The Social Support Rating Scale, Family Burden Scale, Satisfaction with Life Scale and Quality of Life Scale were used in the survey. AMOS 24.0 was used to explore the pathway of influence of family burden on social support to patients with schizophrenia, patients' quality of life and patients' family life satisfaction. Results: There was a two-by-two significant correlation between patients' access to social support, family burden, patients' life quality and family life satisfaction (P<0.05), and the total score of the social support scale negatively predicted the total score of the life quality scale (β=-0.28, P<0.05) and positively predicted the total score of the life satisfaction scale (β=0.52, P<0.05). Family burden was a full mediator between the social support to the patient and the patient's quality of life, and as a partial mediator between the social support to the patient and the family's life satisfaction. Conclusions: Social support to people with schizophrenia is a significant predictor of their quality of life and family life satisfaction. Family burden mediates the relationship of social support to patients with their quality of life and family life satisfaction. Interventions can focus on increasing social support for the patient and reducing the burden on the patient's family to improve the patient's quality of life and increase the satisfaction of the patient's family.
Humans ; Patient Satisfaction ; Quality of Life ; Schizophrenia ; Family Relations ; Social Support

PURPOSE: The purpose of this study was to identify the effect of predictive factors related to family strength and develop a structural equation model that explains family strength among married working women. METHODS: A hypothesized model was developed based on literature reviews and predictors of family strength by Yoo. This constructed model was built of an eight pathway form. Two exogenous variables included in this model were ego-resilience and family support. Three endogenous variables included in this model were functional couple communication, family stress and family strength. Data were collected using a self-report questionnaire from 319 married working women who were 30~40 of age and lived in cities of Chungnam province in Korea. Data were analyzed with PASW/WIN 18.0 and AMOS 18.0 programs. RESULTS: Family support had a positive direct, indirect and total effect on family strength. Family stress had a negative direct, indirect and total effect on family strength. Functional couple communication had a positive direct and total effect on family strength. These predictive variables of family strength explained 61.8% of model. CONCLUSION: The results of the study show a structural equation model for family strength of married working women and that predicting factors for family strength are family support, family stress, and functional couple communication. To improve family strength of married working women, the results of this study suggest nursing access and mediative programs to improve family support and functional couple communication, and reduce family stress.
Adult ; Family Characteristics ; Family Relations ; Female ; Humans ; Marriage ; *Models, Theoretical ; Social Support ; Stress, Psychological ; Surveys and Questionnaires ; Women, Working/*psychology

PURPOSE: This cross-sectional study was done to compare factors influencing young adolescents' aggression according to family structure. METHODS: Participants were 680 young adolescents aged 11 to 15 years (113 in single father families, 136 in single mother families, 49 in grandparent families, and 382 in both-parent families). All measures were self-administered. Data were analyzed using SPSS 18.0 program and factors affecting young adolescents' aggression were analyzed by stepwise multiple regression. RESULTS: Levels of young adolescents' aggression and all variables were significantly different among the four family structure groups. Factors influencing young adolescents' aggression were also different according to these 4 groups. For single father families, depression-anxiety and family hardiness significantly predicted the level of young adolescents' aggression (adjusted R square=.37, p<.001). For single mother families, depression-anxiety, gender, and friends' support significantly predicted the level of young adolescents' aggression (adjusted R square=.58, p<.001). For grandparent families, depression-anxiety and family support significantly predicted the level of young adolescents' aggression (adjusted R square=.58, p<.001). For both-parent families, depression-anxiety, family hardiness, and friends' support significantly predicted the level of young adolescents' aggression (adjusted R square=.48, p<.001). CONCLUSION: Nurses working with young adolescents should consider family structure-specific factors influencing aggression in this population.
Adolescent ; *Adolescent Psychology ; *Aggression ; Anxiety ; Child ; Cross-Sectional Studies ; Depression ; Family ; Family Relations ; Female ; Humans ; Male ; Questionnaires ; Sex Factors ; Single-Parent Family ; Social Support

PURPOSE: The purpose of this study was to explore the relationships of family strain, perceived social support, family hardiness, and family adaptation and identify the family resiliency factors for the adaptation of families who have a child with congenital heart disease. METHOD: The sample consisted of 90 families who had a child diagnosed with congenital heart disease and completed surgical treatment. Data was collected from parents using a questionnaire. RESULTS: Results from path analyses revealed that family strain had a direct effect on both perceived social support and family hardiness, and an indirect effect on family adaptation. Also, the findings revealed that perceived social support had a direct effect on both family hardiness and family adaptation, and family hardiness had a direct effect on family adaptation. Thus, these results indicated that perceived social support and family hardiness had a mediating effect on family strain. CONCLUSION: Findings provide the evidence for the theoretical and empirical significance of perceived social support and family hardiness as family resiliency factors for family adaptation. Clinical implications of these findings might be discussed in terms of family-centered nursing interventions for the families who have a child with congenital heart disease based on an understanding of family resiliency for adaptation.
*Adaptation, Psychological ; Child ; Family/*psychology ; Female ; Heart Defects, Congenital/*psychology/surgery ; Humans ; Male ; Questionnaires ; Social Support

PURPOSE: This study was designed to examine the effects of a solution-focused group counseling program on the family burden, active coping, expressed emotion, and family support in schizophrenic patients and their families. METHOD: The subjects consisted of 48 schizophrenic patients and 56 families. Twenty-four schizophrenic patients and 28 families were assigned to both the experimental and control groups. The solution-focused group counseling program was conducted for the families of the experimental group, but not for the control group or the patients of the experimental group. RESULT: There was a significant greater decrease in scores of family burden and expressed emotion in the experimental groups than the control groups. There was a larger increase in active coping scores in the experimental groups than the control groups, but it was not significant. There was no significant difference between the two groups in family support scores. CONCLUSION: This program may be an effective nursing intervention program for families with schizophrenic members.
Adaptation, Psychological ; Adult ; Aged ; *Counseling ; Expressed Emotion ; Family/*psychology ; Female ; Humans ; Middle Aged ; *Schizophrenia ; Social Support

PURPOSE: The purpose of this study was to compare the degree of cognitive level, nutritional status and depression in elderly according to living situations. METHOD: The subjects consisted of 173 elderly classifying three groups(living alone, living with spouse, living with children). Data was collected from March to June, 2003 by a structured questionnaire that included general characteristics, MMSE-K, nutritional status and depression scale. The collected data was analyzed by the SPSS program including descriptive statistics, x2-test, ANCOVA, Scheffe test and Pearson Correlation Coefficient. RESULT: In MMSE-K, the living alone group showed suspicious dementia while the other groups were normal. The living alone group showed a high nutritional risk and all three groups showed depression. In MMSE-K, the nutritional status and depression were statistically significant by the living situation. In each group except living with spouse, MMSE-K indicated a significantly negative correlation to depression and nutritional status, while nutritional status showed a significantly positive correlation to depression. CONCLUSION: It is necessary to develop supportive programs for decreasing the risk of bad health in the elderly and an individual approach according to their living situation. Especially, more concern and intervention is necessary for the solitary elderly.
Aged ; *Cognition ; Depression/*diagnosis ; *Family ; Female ; Humans ; Male ; Middle Aged ; *Nutritional Status ; Social Support

The purpose of this descriptive study was to identify th homecare needs of the discharged patient with cancer as perceived by nurses caring hospitalized cancer patients. At two hospitals in Gyeognam, 74 nurse responded to an open-ended questionnaire consisting of four need categories; 1) educational and information need, 2) physical need, 3) emotional need, 4) social need. Respondents were asked to list above ten needs of cancer patient in each category. Two researchers analyzed the data by content analysis method. The finds are summarized as follows; 1) A total of 1,417 need items were generated by nurses. The largest number of needs were in the educational and information need category(475 items, 36.3%). Physical (414 items, 31.6%), emotional (237 items ,18.1%) need were the second, third largest, and social(184 items, 14.0%) need made up the smallest category. 2) In the educational and informational need category, there were seven subcategories of prognosis, diet and exercise, medication and pain, wound care, folk remedy, personal hygiene, comfort. The need items related to prognosis of cancer accounted for almost a half(48.2%) of the total. 3) In the physical need category, there were ten subcategories of personal hygiene, skin and tissue, nutrition, side effect on treatment, exercise, pain, elimination, equipment, comfort and safety, others. The largest number of needs were in subcategory of the personal hygiene982 items, 19.8%). 4) In the emotional need category, there were four subcategories of emotional support related to disease, emotional support related to routine life, spiritual support, maintenance of relationship with nurse and doctor. The largest number of need were in subcategory of the emotional support related to disease(96 item, 40.5%). 5) In the social need category, there were five subcategories of support for social life, household management, legal support, the use of volunteer service, financial support. The largest number of needs were in support for social life subcategory(58 item, 31.5%).
Surveys and Questionnaires ; Diet ; Family Characteristics ; Financial Support ; Humans ; Hygiene ; Medicine, Traditional ; Prognosis ; Skin ; Volunteers ; Wounds and Injuries

PURPOSE: This study was done to identify the relationship between social support and morale in the elderly. METHOD: A structured questionnaire was carried out from April, 2003 to June, 2003 on 203 elderly. The data was analyzed with a SPSS program for descriptive statistics, Pearson's correlation coefficients, t-test, ANOVA, and stepwise multiple regression was done RESULT: The level of social support was moderate, and family support was the highest score. In types of support, appraisal support was the highest score. The level of morale was slightly lower than moderate, and the score of social support showed significantly positive correlation with morale. In general characteristics, several variables were significantly related to social support and morale. The most powerful predictor of morale was material support by family and the variance was 19.6%. A combination of material support by family, emotional support by relatives, level of satisfaction with pocket money, perceived health, level of intimacy with one's children, and material support by friends account for 43.3% of the variance in morale of the elderly. CONCLUSION: To increase the morale of the elderly, it is necessary to consolidate material support by family and relatives.
Aged/*psychology ; Family ; Female ; Humans ; Male ; *Morale ; *Residence Characteristics ; *Social Support

OBJECTIVETo study the major social-psychological factors contributing to male juvenile delinquency.

METHODSOne hundred and thirty-seven cases of male juvenile delinquents (delinquent group) and 145 aged-matched male students (control group) were enrolled in this case-control study. A questionnaire survey was conducted using the Adolescent Self-Rating Life Events Check List, the Coping Style Questionnaire, the Family Environment Scale-Chinese version, and the Social Support Rating Scale.

RESULTSThe monovariate analysis showed that the total score and the scores of some factors of negative life events, the scores of immature coping styles and family conflicts, and the proportion of broken families in the delinquent group were significantly higher than those in the control group. In contrast, the scores of educational levels, study stress factor in the negative life events, mature coping styles, family environments and social supports were significantly lower in the delinquent group than those in the control group. The multivariate factors analysis showed that 7 variables were enrolled into the discriminatory equations, including negative life events (interpersonal relationship and healthy adaptation), self-condemn styles, family conflicts, subjective supports, objective supports, and utilization of social supports. The total accuracy of this equation was 92.2%.

CONCLUSIONSNegative life events in the interpersonal relationship and healthy adaptation, self-condemn styles, family conflicts, and weak social support system may be major social-psychological factors contributing to male juvenile delinquency.

Adolescent ; Adult ; Case-Control Studies ; Family ; Humans ; Juvenile Delinquency ; Male ; Multivariate Analysis ; Risk Factors ; Social Support