FAMILY INFLUENCES ON CHRONIC ILLNESS SURVIVAL

本研究考察了家庭过程和家庭结构的影响。 论重残短寿的临床病程 慢性病。它以家庭在生存中的作用为中心 它的病人的成员。更具体地说，这项研究探索了：1) 使一个家庭易受高度痛苦影响的因素 面对慢性病；2)应对策略 这些脆弱的家庭雇用；3)这些应对措施的效果 关于病人生存的策略。这项研究将观察75名患者 患有终末期肾病(ESRD)及其家人以及 无并发症高血压病患者75例对照研究 高血压和他们的家人。终末期肾病患者及其家属 将作为家庭因素影响的范例进行研究 严重残废者的医疗过程和生存 慢性病。每个家庭将每年进行一次评估 间隔至少三年或直至死亡 出现患者成员。研究设计是由一个 家庭应对慢性病的发展模式 它关注的是联盟中的情感变化 随着时间的推移，我们是一家人。该报告基于初步研究(附录A)。 它显示了家庭变量的冲击力，测量过程 和结构，以预测患者的生存时间。这项研究采用了 目前评估家庭进程和结构的方法， 患者对医疗方案的依从性和患者依从性 给透析治疗小组。

This study investigates the effect of family process and structure on the clinical course of severe, disabling and life-shortening chronic illness. It centers on the family's role in the survival of its patient member. More specifically, the study explores: 1) factors which render a family vulnerable to high levels of distress in the face of chronic illness; 2) the coping strategies which these vulnerable families employ; 3) the effect of these coping strategies on patient survival. The study will observe 75 patients with end-stage renal disease (ESRD) and their families, as well as a Comparison Group of 75 patients with uncomplicated essential hypertension and their families. ESRD patients and their families are to be studied as exemplars of the impact of family factors on the medical course and survival of persons with severe disabling chronic illnesses. Each family will be assessed at yearly intervals for a minimum of three years or until death of the patient member occurs. The research design is shaped by a developmental model of the family's response to chronic illness which focuses on affective shifts in the alliances within the family over time. It is based on a preliminary study (Appendix A) which showed striking power of family variables, measuring process and structure, to predict patient survival time. The study employs current methods of assessment of family process and structure, of patient compliance with the medical regimen and of patient bonding to the dialysis treatment team.