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Autores: Alfaro, Cristina; Esandi, Nuria, (Autor de correspondencia); Gutiérrez-Alemán, T; et al.
ISSN 0309-2402  Vol. 75  Nº 11  2019  págs. 2299 - 2312
Aims To identify, appraise and describe the characteristics and measurement properties of instruments assessing nurses' attitudes towards the importance of involving families in their clinical practice. Design Psychometric systematic review. Data Sources The PubMed, CINAHL, PsycINFO, Web of Science, and Cochrane Library databases were searched from their time of inception to June 2018. Review Methods Two reviewers independently assessed the eligibility of studies, extracted data, and appraised the methodological quality of the studies using the COSMIN checklist. Results A total of 19 studies representing 5 instruments were included. Two instruments-a revised version of the Families' Importance in Nursing Care: Nurses' Attitudes scale (FINC-NA-R) and the Family Nurse Practice Scale (FNPS)-obtained higher scores for most of their properties. The instruments used in the remaining eight studies require further assessment of their psychometric properties. Conclusion This psychometric review offers a synthesis of the quality of the available instruments and gives a better understanding of nursing theory-based tools. The FNPS and FINC-NA-R instruments seem to be the most suitable measures of nurses' attitudes towards the importance of involving families in their clinical practice. Impact The growing emphasis on improving nurse-family relationships and the quality of care provided makes it necessary to have valid and reliable instruments for assessing nurses' attitudes towards the importance of involving families in their clinical practice. This paper provides evidence that will help clinicians and researchers make decisions about the most suitable instrument based on a critical appraisal and comparison of the measurement properties according to a rigorous methodology.
Autores: Esandi, Nuria; Nolan, M.; Alfaro, Cristina; et al.
ISSN 0016-9013  Vol. 58  Nº 2  2018  págs. E56 - E67
Background and Objectives: Historically, research, practice, and policy on Alzheimer's family care has been largely focused on dyadic relationships and the experience of burden and stress, often failing to capture the complex caring dynamics as they unfold over time. This study sought to develop a more nuanced understanding of how people with Alzheimer's disease (AD) and their families are affected by the disease and how they respond to the challenges AD poses. Research Design and Methods: Using constructivist grounded theory, the study explored the experiences of living with AD for native Spanish families residing in Navarra. Data were collected from a series of 26 interviews with seven family units living with early stage AD and further validated with three focus groups with 14 caregivers of people with mid/advanced AD. Data were analyzed to capture the main processes involved and charted how these evolved over time. Results: Keeping things in balance describes the way family works to preserve a balance between caring and their lives before the onset of AD. Three main temporal stages to the experience of early AD, along with their associated processes, were identified: (a) what's going on here and the processes of noticing, suspecting, and confirming; (b) our life is changing underpinned by the processes of watching and redefining; and (c) keeping things together and its associated balancing process. These reinforced the dynamic nature of living with AD over time. Discussion and Implications: This study was novel in its design as it included the person with AD as part of the functioning family unit. The temporal stages and the key social processes identified have the potential to inform the development of "stage-specific" interventions for the support of the whole family at various points in time.