Browsing by Subject "family"
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Item Aging and Post-Intensive Care Syndrome–Family (PICS-F): A Critical Need for Geriatric Psychiatry(Elsevier, 2019) Serrano, Patricia; Kheir, You Na P.; Wang, Sophia; Khan, Sikandar; Scheunemann, Leslie; Khan, Babar; Psychiatry, School of MedicinePostintensive care syndrome–family (PICS-F) describes the psychological symptoms that affect the family members of patients hospitalized in the intensive care unit (ICU) or recently discharged from the ICU. Geriatric psychiatrists should be concerned about PICS-F for several reasons. First, ICU hospitalization in older adults is associated with higher rates of cognitive and physical impairment compared with older adults hospitalized in non-ICU settings or dwelling in the community. This confers a special burden on the caregivers of these older ICU survivors compared with other geriatric populations. Second, as caregivers themselves age, caring for this unique burden can be more challenging compared with other geriatric populations. Third, evidence for models of care centered on patients with multimorbidity and their caregivers is limited. A deeper understanding of how to care for PICS and PICS-F may inform clinical practice for other geriatric populations with multimorbidity and their caregivers. Geriatric psychiatrists may play a key role in delivering coordinated care for PICS-F by facilitating timely diagnosis and interdisciplinary collaboration, advocating for the healthcare needs of family members suffering from PICS-F, and leading efforts within healthcare systems to increase awareness and treatment of PICS-F. This clinical review will appraise the current literature about the impact of critical illness on the family members of ICU survivors and identify crucial gaps in our knowledge about PICS-F among aging patients and caregivers.Item Assessment of First and Second Degree Relatives of Individuals With Bipolar Disorder Shows Increased Genetic Risk Scores in Both Affected Relatives and Young At-Risk Individuals(Wiley, 2015-10) Fullerton, Janice M.; Koller, Daniel L.; Edenberg, Howard J.; Foroud, Tatiana; Liu, Hai; Glowinski, Anne L.; McInnis, Melvin G.; Wilcox, Holly C.; Frankland, Andrew; Roberts, Gloria; Schofield, Peter R.; Mitchell, Philip B.; Nurnberger, John I.; Department of Biochemistry and Molecular Biology, IU School of MedicineRecent studies have revealed the polygenic nature of bipolar disorder (BP), and identified common risk variants associated with illness. However, the role of common polygenic risk in multiplex families has not previously been examined. The present study examined 249 European-ancestry families from the NIMH Genetics Initiative sample, comparing subjects with narrowly defined BP (excluding bipolar II and recurrent unipolar depression; n = 601) and their adult relatives without BP (n = 695). Unrelated adult controls (n = 266) were from the NIMH TGEN control dataset. We also examined a prospective cohort of young (12–30 years) offspring and siblings of individuals with BPI and BPII disorder (at risk; n = 367) and psychiatrically screened controls (n = 229), ascertained from five sites in the US and Australia and assessed with standardized clinical protocols. Thirty-two disease-associated SNPs from the PGC-BP Working Group report (2011) were genotyped and additive polygenic risk scores (PRS) derived. We show increased PRS in adult cases compared to unrelated controls (P = 3.4 × 10−5, AUC = 0.60). In families with a high-polygenic load (PRS score ≥32 in two or more subjects), PRS distinguished cases with BPI/SAB from other relatives (P = 0.014, RR = 1.32). Secondly, a higher PRS was observed in at-risk youth, regardless of affected status, compared to unrelated controls (GEE-χ2 = 5.15, P = 0.012). This report is the first to explore common polygenic risk in multiplex families, albeit using only a small number of robustly associated risk variants. We show that individuals with BP have a higher load of common disease-associated variants than unrelated controls and first-degree relatives, and illustrate the potential utility of PRS assessment in a family context.Item Communication Between Registered Nurses and Family Members of Intensive Care Unit Patients(AACN, 2022-12-01) Dees, Mandy L.; Carpenter, Janet S.; Hoffman-Longtin, Krista; School of NursingBackground Effective communication between intensive care unit patients and their families and nurses promotes relationship-centered care and improves nurses’ ability to meet patient and family needs. However, communication with these patients is challenging because of their critical illness. Families often become surrogate decision makers for adult intensive care unit patients. Objective To systematically assess available evidence on communication between adult intensive care unit patients and their families and nurses as the initial step in developing nursing strategies to strengthen communication skills. Methods In this integrative review, the method of Whittemore and Knafl was used to synthesize findings from qualitative and quantitative (descriptive and experimental) research. Results The review revealed a variety of research designs, measurement tools, and types of interventions. The qualitative findings suggest that nurses can strengthen relationship-centered care by regularly updating patients’ families and providing information that can assist with decision-making. The quantitative findings suggest that nurses should be mindful of family members’ needs for assurance, comfort, and support. Providing information on patient status can help alleviate family concerns. Conclusions Improved communication between patients and families and intensive care unit nurses is essential to strengthen relationship-centered care. Additional research is needed to better understand the communication needs of adult patients and their families in the intensive care unit.Item Conflicted Duty on the Indiana Home Front: A Family’s Civil War Story(2020-01) Tanzer, Anastasia; Morgan, Anita; Cramer, Kevin; Robertson, Nancy MarieThis project looks at the Ketcham family of Indianapolis and analyzes how each member had a different sense of duty that led them to take on different activities during the Civil War. It includes both a typical thesis portion and a public history supplement that takes the form of an exhibit brief. The supplement provides an alternate means of presenting the family to the public. The Ketchams were a white, upper-class family, so although many of their ideas and activities aligned with those of others across the northern United States, in this thesis I argue that they also had a unique experience. For example, the matriarch, Jane Merrill Ketcham, chose to serve as a nurse, as did many other women, but her decision took precedence over her husband’s preference. This assertion was noteworthy because, during this time period, women were still typically expected to defer to their fathers or husbands. This conclusion, and others throughout the project, are based on an analysis of both primary and secondary sources. The main primary sources used were the letters included in the Ketcham collection at the Indiana Historical Society, which provided insight to the thoughts, opinions, and activities of most family members – some members had fewer surviving letters than others. Scholarship regarding the Civil War from national, regional, and local perspectives allowed for a fuller picture of what the prevailing views and activities were and understand how the Ketchams were either emblematic of the common experience or different from it.Item Effects of Language on Children’s Understanding of Mathematics(ICRSME, 2022) Wilkerson, Trena L.; Mistretta, Regina M.; Adcock, Justin; Borgioli Yoder, Gina; Johnston, Elisabeth; Bu, Lingguo; Nugent, Patricia M.; Booher, Loi; School of EducationTeacher educators have a moral and civic obligation to examine ways in which language and mathematics are connected and supported in teaching and learning mathematics. It is essential to examine the roles and influence of family, parents, community, teachers, administration, and teacher educators as they collaborate to support learners. Their role should be considered in preparing and supporting teachers to develop curriculum, plan instruction, and implement strategies that support students’ development of language in the mathematics classroom. An examination of the literature regarding the effects of language on children’s understanding of mathematics was conducted around six areas: 1) impact of language on understanding and meaning making; 2) symbols, expressions and language connections; 3) effects of teachers’ listening orientation; 4) language development, play and family influences; 5) implications for multilingual learners; and 6) technology and digital media. Implications for teacher education and future research are presented. We offer readers a potential framework to consider for guiding teacher educators’ practices and future research efforts. In so doing, we display various connections and interplays between language and children’s mathematical meaning making and understanding.Item The Family Navigator: A pilot intervention to support intensive care unit family surrogates(American Association of Critical Care Nurses, 2016-11) Torke, Alexia M.; Wocial, Lucia D.; Johns, Shelley A.; Sachs, Greg A.; Callahan, Christopher M.; Bosslet, Gabriel T.; Slaven, James E.; Perkins, Susan M.; Hickman, Susan E.; Montz, Kianna; Burke, Emily; Medicine, School of MedicineBackground Although communication problems between family surrogates and intensive care unit (ICU) clinicians have been documented, there are few effective interventions. Nurses have the potential to play an expanded role in ICU communication and decision making. Objectives To conduct a pilot randomized controlled trial of the Family Navigator (FN), a distinct nursing role to address family members’ unmet communication needs early in an ICU stay. Methods An inter-disciplinary team developed the FN protocol. A randomized controlled pilot intervention trial of the FN was performed in a tertiary referral hospital ICU to test the feasibility and acceptability of the intervention. The intervention addressed informational and emotional communication needs through daily contact using structured clinical updates, emotional and informational support modules, family meeting support and follow-up phone calls. Results Twenty-six surrogate/patient pairs (13 per study arm) were enrolled. Surrogates randomized to the intervention had contact with the FN 90% or more of eligible patient days. All surrogates agreed or strongly agreed that they would recommend the FN to other families. Open-ended comments from both surrogates and clinicians were uniformly positive. For both groups, 100% of baseline data collection interviews and 81% of 6–8 week follow-up interviews were completed. Conclusions A fully integrated nurse empowered to facilitate decision making is a feasible intervention in the ICU setting. It is well-received by ICU families and staff. A larger randomized controlled trial is needed to demonstrate an impact on important outcomes, such as surrogate well-being and decision quality.Item "Fitter Families, Better Babies, and Reproductive Control"(2005-10-10) Stern, AlexandraItem Promoting Family Engagement in a Community Setting for Children Impacted by the Substance Use Disorder of a Family Member(2024-05) Greenwell, Conner; Belkiewitz, Johnna; Department of Occupational Therapy, School of Health and Human Sciences; McFadden, RachelIndividuals caring for children impacted by the substance use disorder of a family member are often less able to participate in valued occupations, specifically social participation, and they lack a community in which they feel supported and understood. The capstone student collaborated with Camp Mariposa Aaron’s Place in Indianapolis, IN and Mitchell, IN, with the purpose of promoting family and peer engagement for caregivers of children who attend this program. The student identified a gap in current research on how to best support caregivers of children affected by the substance use disorder of a family member. The main component of this project was evaluation and further development of Camp Village Council, a support program for family members of children who attend Camp Mariposa Aaron’s Place. The student created an intervention binder, educational modules, and educational handouts to promote connectedness between group members and to provide caregivers with an improved ability to carry over what kids are learning at camp into the home. Another component of this project was supplemental programming of family events to promote family engagement. Overall, results suggest that groups facilitated by the student and materials created by the student had a positive impact on the Camp Village Council participants and program as a whole. Results were mixed on the impact of supplemental programming.Item Relationship of Decisional Conflict About Driving Habits Between Older Adult Drivers and Their Family Members and Close Friends(Sage, 2024) Fowler, Nicole R.; Johnson, Rachel L.; Peterson, Ryan; Schroeder, Matthew W.; Omeragic, Faris; DiGuiseppi, Carolyn; Han, S. Duke; Hill, Linda; Betz, Marian E.; Medicine, School of MedicineThis study examines the relationship of decisional conflict about driving habits between older adult drivers (≥70 years old) and their family members and close friends. This secondary analysis utilizes data originating from a multi-site randomized controlled trial assessing the effect of a driving decision aid (DDA) intervention. Decisional conflict about stopping or changing driving habits for drivers was measured with the Decisional Conflict Scale (DCS). Dyadic associations between drivers’ and study partners’ (SPs’) DCS scores were analyzed using an actor-partner interdependence model. Among 228 driver-SP dyads, Dyadic DCS was correlated at baseline (r = .18, p < .01), and pre-intervention DCS was associated with post-intervention DCS (p < .001 for SPs [β = .73] and drivers [β = .73]). Drivers’ baseline DCS and SPs’ post-intervention DCS were slighly correlated (β = .10; p = .036). Higher decisional conflict about driving among older drivers is frequently shared by their SPs. Shared decisional conflict may persist beyond intervening to support decision-making about driving cessation.Item The Straw that Broke the Camel's Back? A Sociological Analysis of Marriage and Law School(2007-06-04T20:26:35Z) McQuillan, Deanna Boyd; Foote-Ardah, Carrie Elizabeth; Haas, Linda; Howard, JayThis Master's thesis is based on a qualitative study which aimed to understand the perspectives of married male and female law students and the ways in which they managed the interaction between law school and family life. The data was gathered from in-depth interviews with 23 married law students at an urban university. The spillover model was used to address both how being married impacts students' school experiences, as well as to look at how the law school experience influences students' families. In an analysis of marriage-to-school spillover, the married law students reported feeling that they were having a non-normative law school experience as a result of their marital and parenthood statuses and they often compared their experiences to that of an "unmarried other" group of more traditional students. In an analysis of school-to-marriage spillover, students reported various types of strains that resulted from missing out on parts of a perceived normal married life as a result of the demands of law school. Several key differences were noted between the ways male and female students handled the often competing demands of marriage, children, and law school. The implications for the families as well as for legal education are discussed.