FAMILY INFLUENCES ON CHRONIC ILLNESS SURVIVAL

本研究探讨了家庭过程和家庭结构的影响 严重的、致残的和缩短寿命的临床过程 慢性病。 它的中心是家庭在生存中的作用 患者的家属。 更具体地说，该研究探讨：1） 使一个家庭容易遭受高度痛苦的因素 面对慢性病; 2）应对策略， 这些脆弱的家庭雇用; 3）这些应对的效果 患者生存策略。 该研究将观察75名患者 终末期肾病（ESRD）患者及其家属，以及 a比较组75例无并发症的原发性 高血压及其家庭。 ESRD患者及其家属 将作为家庭因素影响的范例进行研究， 严重残疾人的医疗过程和生存 慢性病 每个家庭每年都要接受评估 间隔至少三年或直至死亡的 患者发生。 研究设计是由一个 家庭对慢性病反应的发展模式 它关注的是 家庭随着时间 它是基于一项初步研究（附录A） 家庭变量、测量过程、 和结构来预测病人的生存时间 该研究采用 家庭进程和结构的现行评估方法， 患者对医疗方案的依从性以及患者之间的联系 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.