Journal of Family Nursing

Substance use disorders (SUDs) are a pervasive public health problem facing families in the United States. Although families are frequently urged to support loved ones who have SUDs and cautioned against enabling them, there is a dearth of literature that distinguishes between supporting and enabling. This phenomenological study examined the experiences of parents (n = 8) with adult children with SUD who were currently in recovery. The primary research question in this study centers on how parents navigate their loved one’s SUD, attempting to support recovery without enabling addiction. Three themes emerged from the data, including (a) addiction and recovery knowledge, (b) support group philosophy, and (c) differentiation. The results of this study add to the literature by demonstrating the importance of respective family support group affiliation on family’s perception of enabling versus supporting. More research is needed to compare and contrast family support groups and their respective philosophies.

To assess the moderating effect of family resilience on the relationship between adverse family living conditions and anxiety and depression among adolescents with special health care needs (ASHCN). We conducted a secondary analysis of data of 13,097 ASHCN (aged 10–17 years old) from the combined 2022 and 2023 National Survey of Children’s Health (NSCH), representing a total population of 8,069,879 ASHCN. Measures included demographics, parent-proxy-reported diagnosed anxiety and depression, functional difficulties, family structure, family resilience, and family living conditions. The data were analyzed using survey-weighted descriptive statistics and logistic regression models combined with marginal effects analysis. Family resilience mitigated the negative influence of a maximum of two cumulative adverse family living conditions on the likelihood of having parent-proxy-reported diagnosed depression among ASHCN. When looking at the effects of each separate family living condition, family resilience moderated the effect of household dysfunction and adverse childhood experiences on the likelihood of having parent-proxy-reported diagnosed depression. The study found no moderating effects of family resilience on the relationship between living conditions and the likelihood of having parent-proxy-reported diagnosed anxiety. Consideration of family resilience and living conditions among ASHCN intervenes to reduce the incidence of negative health outcomes like anxiety or depression among these vulnerable youth.

An urgent need exists to elevate the agenda of family ethics, rooted in family nursing’s moral commitment to the well-being of families and society. This paper highlights the practice, research, and educational implications for this agenda. Grounded in relational ethics, this vision calls for a curriculum and practice landscape that reflects the lived realities of diverse families and communities. Clinically, it recommends the creation of interdisciplinary care protocols that embed structured family ethics conversations, drawing on an understanding of family systems. In research, it advocates for expanding studies that examine how familial and cultural values shape moral distress and care outcomes, and for broadening traditional bioethical inquiries to include family-centered perspectives. Educationally, it urges the integration of real-world scenarios, cultural analysis, and emotional intelligence training into classrooms and skills labs. Together, these strategies aim to cultivate ethically grounded, socially responsive nurses equipped to lead transformative changes in family health care.

This paper explores ethical complexities in qualitative research involving families/interrelated persons. Such research requires consideration of relational dynamics, informed consent, and methodological choices to avoid unintended harm to relationships. Drawing on research experiences across diverse clinical contexts, the authors reflect on ethical challenges encountered in family interviews, integrating established ethical frameworks with practical insights from joint and family interviews. Key considerations include: clarifying research objectives, distinguishing research interviews from therapeutic encounters; informed consent as an ongoing process, particularly with vulnerable populations; managing confidentiality and withdrawal in relational settings; attending to verbal and nonverbal cues to balance participant voices; maintaining professional boundaries while recognizing unintended therapeutic effects; sensitivity to interview location and group composition; and relational hierarchies. Ethical dilemmas in family-centered qualitative research are context-dependent and require reflexivity, empathy, and deliberate planning. By anticipating challenges and adopting flexible, participant-centered strategies, researchers can generate meaningful data while safeguarding respect for persons.

We applied Andersen’s Behavioral Model of Health Services Use to investigate the health needs and use of digital health resources among sexual and/or gender minority (SGM) caregivers. Data were from the Caregiving in the U.S. 2020 survey. Regression analyses were used to describe associations between predisposing, enabling, and need factors and usage of digital health resources. SGM caregivers provided more hours of care per week, reported higher levels of care intensity, and reported higher physical, emotional, and financial strain compared with non-SGM caregivers. Regression analyses indicated SGM status was a significant predictor of overall use of digital health resources. Younger caregivers, racial minority caregivers, those providing higher levels of care, and those reporting a poorer health status were more likely to use digital health resources. Digital health resources may be useful tools for SGM caregivers of older adults. More research is needed to investigate the reasons SGM caregivers use these resources.

There is a significant gap in understanding the sexual health of Arab Americans. The purpose of this study is to explore family sex communication among Arab American young adults and its association with gender and sexual attitudes. We used a parallel mixed methods design and administered an electronic survey (N = 100); a subsample of 24 participants participated in five focus groups. We observed convergence in the findings. Participants reported rare occurrences of family sex communication, with women reporting less comfort than men. Family sex communication was often “unspoken,” and reinforced prevailing social norms. Gender differences were reported based on sex communication topics. The most common source of sex information was peers/friends. Focus group participants perceived their parents to be more conservative and less knowledgeable about sex than they were. Future research on strategies to bridge generational differences is needed to promote family-based sex communication, given the multiple teachable moments at home.

The aim of this study was to investigate current nursing practice related to end-of-life discussions with incurable lung cancer patients and their family caregivers from the perspectives of patients, family caregivers, and nurses in an oncology outpatient clinic. This phenomenological hermeneutic study included nine patients, eight family caregivers, and 11 nurses. Data were collected using participant observation, informal and semi-structured individual or joint interviews with patients and family caregivers, and focus group interviews with nurses. A Ricoeur-inspired approach was used to analyze the data. Three themes were identified: (a) content of end-of-life discussions, (b) timing of end-of-life discussions, and (c) challenges in end-of-life discussions. End-of-life discussions were seldom initiated; when they were, it was often too late. Discussions addressed treatment, place of care, practical/economic concerns, and existential matters. The physical environment at the outpatient clinic, lack of continuity, and nurses’ instrumental task workloads and time pressure posed challenges to initiating end-of-life discussions.

Gottlieb, L. N. & Gottlieb, B. (2017). Strengths-Based Nursing: A Process for Implementing a Philosophy Into Practice. Journal of Family Nursing, 23, 319-340. Doi: 10.1177/1074840717717731

The authors have identified changes to certain sentences, which they believe are important for their article. These edits are outlined below.

Page 328, 8^th line from bottom

Incorrect sentence: To illustrate, a point-of-care nurse, Jenette Schoon, who works in a long-term children’s rehabilitation hospital had been unhappy with the way family discharge planning meetings has been conducted.

Correct sentence: To illustrate, a point-of-care nurse, Jenette Schoon, who works in a long-term children’s rehabilitation hospital wanted to improve how family team goal planning meetings were conducted.

Page 330, 12^th line from bottom

Incorrect sentence: We chose Hospital for Sick Kids (HSK), a quaternary care hospital, and Holland Bloorview Children’s Rehabilitation Hospital (HB), Toronto, Canada, because they were early adopters of SBN and their institutional values aligned with SBN.

Correct sentence: SickKids, a quaternary care hospital, and Holland Bloorview Kid’s Rehabilitation Hospital (HB), Toronto, Canada, because they were early adopters of SBN and their institutional values aligned with SBN.

Page 330, 4^th line from bottom

Incorrect sentence: In addition, a survey of clinical leaders from HSK and HB was undertaken to assess their learning needs and interest in understanding SBN, as well as the management/leadership concepts and skills that could be offered in a formal SBN management and leadership training program.

Correct sentence: In addition, a survey of clinical leaders from SickKids and HB was undertaken to assess their learning needs and interest in understanding SBN, as well as the management/leadership concepts and skills that could be offered in a formal SBN management and leadership training program.

Page 334, 15^th line from bottom

Incorrect sentence: For example, at HB Nursing Department adopted SBN as their nursing philosophy.

Correct sentence: For example, at HB Nursing Profession adopted SBN as their nursing philosophy.

Page 334, 12^th line from bottom

Incorrect sentence: Dr. Marilyn Ballantyne, HB’s Chief Nursing Executive/Clinical Investigator finds that Strengths-Based Care can help her nursing department achieve the hospital’s vision

Correct sentence: HB’s Chief Nursing Executive/Clinician Investigator finds that Strengths-Based Care can help her achieve the hospital vision