The FAM-SOTC Intervention: Families of Children With Chronic Illnesses

Sample Data were collected at the Children's Hospital (CH) at the National University Hospital of Iceland (NUHI) in Reykjavik, Iceland. The population of Iceland is about 340,000 people. The incidence of diabetes among children in Iceland is 18 per year, and similar frequency among children and adolescents is reported regarding arthritis, epilepsy and sleeping disorder with ADHD. Participants in this study were 31 primary caregivers who all were the mothers of the children/adolescents with diabetes, arthritis, epilepsy or sleeping disorder with ADHD (see Table 1). A research assistant offered all the primary caregivers (N = 39; n=38 mothers and n=1 father) of children with one of the above-mentioned illnesses/disorders at the time of the data collection, to participate in the study. The 31 primary caregivers, who signed the consent form, participated in the study and represented 80% response rate. Parents completed online the questionaires at the clinic, before they started the first session and then again after the second session. Three APN ,specialists in the child illness diagnosis and who had special graduate educational training in family system nursing or had a doctorate degree in family nursing, offered the families the FAM-SOTC intervention. The parents meet with the APN at the Children´s Hospital without the child in both sessions, but each session lasted for 45 to 90 minutes. The sessions were offered with 4-8 weeks interval.

Description of the FAM-SOTC intervention The description of the development of the FAM-SOTC as well as a figure of the FAM-SOTC intervention, has been published elsewhere.

The first FAM-SOTC session:

When the APN had greeted the parents and made them comfortable, a family assessment was conducted by drawing a family tree and the quality of the family relations indicated, as well as asking them who belonged to their family. Therapeutic questions were used and parents asked questions like where they got support from? The parents were encouraged to talk about their child's illness experience and to reflect on how they perceived the diagnose of the child/adolescent. Further, the main concerns of each of the parent where explored by using therapeutic questions such as: (a) What is your greatest challenge now? and (b) If something could be different, what would that be? Throughout the therapeutic conversaton's the nurse acknowledge the suffering of each family member and normalized their emotional responses. The nurse than drew attention to the family strengths that had been observed. Potential resources were then discussed and the nurse offered advice and education. At the end of the therapeutic conversations the nurse again mentioned the parents strengths and resources and a time was set for the next appointment.

The second FAM-SOTC session: