Family has emerged as a key concept in nursing. Family has been identified as a the most important primary environment having a direct effect on human development. Nursing views the client as unitary whole being. This research problem was to compare the degree of family functioning in families with an acutely ill older member (acute patient family group) with that of families with a chronically ill older meinber (chronic patient family group) in order to provide theoretical understanding to contribute to effective family--focused nursing interventions in the clinical setting.
Subjects were 42 families with a acutely ill older member who had an acute illness (myocardiac infarction, gastritis, pneumonia, cystitis, appendicitis, pancreatitis, cholecystitis, gall bladder obstruction, panperitonitis, pyelonephritis, etc.), but was expected to be restored to the previous state of health. The patients were hospitalized at two university hospitals in Seoul. As a comparative group, 44 families with a chronically ill older member who had a chronic illness(hypertension, diabetes mellitus, arthritis, COPD, chronic nephrotic syndromes, etc.) not expected to be restored to the previous state of health but controlled throughout the rest of their life. The chronic older patients were hospitalized or were being treated through the out patient clinics at the same University hospitals.
Date collection was done from April to August, 1989. The instrument used was the Family Adaptability and Cohesion Evaluation scale, developed by Olson, Russell and Sprenkle and modified by the investigator.
Data analysis included frequency, x2-test, t-test and. ANOVA.
The results of the analysis follows.
1. The mean score of the family functioning in the acute patient group was 3,6220, and in the chronic patient group 3,4219 in a range of 0 to 5 where a higher score suggests a higher level of family functioning.
2. Test of hypothesis.
The main hypothesis, That the degree of family functioning families with an acutely ill older person (acute patient family group) would be different from that of families with a chronically ill older person (chronic patient family group), was not supported(t=1.51, p=0.135). Only in the category, spending time together was the degree of family functioning in. acute patient family group different from that of the chronic patient family group (t=3.70, p=0.00 0). More time together as a family was spentin the acute patient family group.
3. There was no significant relationship between family structure and the degree rf family functioning.
4. Relationship between general characteristic variables and the degree of family functioning. The only variable related to the degree of family functioning in acute patient family group was the presence or absence of the patients spouse (t=r 2.51, p=0.016). Family functioning was higher where the spouse was absent. The variables related to the degree of family functioning in the chronic patient family group was the older persons role in the family group and the family´s attitude toward the medical treatment (p=0.0048: P=0.0041). Family functioning was higher when the patients role were many and when the attitude toward treatment was positive.
The degree of family functioning was relatively high in both the acute and chronic patient family groups. But whether the illness is acute or chronic, may have an effect on the perceptions of the family towards the patient´s roles and towards the treatment. When nurses care for chronic patients, they should assess the degree of family functioning and plan interventions to strengthen family focused nursing care.
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