Jona Celine M H, Labuschagne Izelle, Mercieca Emily-Clare, Fisher Fiona, Gluyas Cathy, Stout Julie C, Andrews Sophie C
School of Psychological Sciences, Monash Institute of Cognitive and Clinical Neurosciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton Campus, VIC, Australia.
Cognition and Emotion Research Centre, School of Psychology, Australian Catholic University, Fitzroy, Australia.
J Huntingtons Dis. 2017;6(3):169-177. doi: 10.3233/JHD-170250.
Family functioning in Huntington's disease (HD) is known from previous studies to be adversely affected. However, which aspects of family functioning are disrupted is unknown, limiting the empirical basis around which to create supportive interventions.
The aim of the current study was to assess family functioning in HD families.
We assessed family functioning in 61 participants (38 HD gene-expanded participants and 23 family members) using the McMaster Family Assessment Device (FAD; Epstein, Baldwin and Bishop, 1983), which provides scores for seven domains of functioning: Problem Solving; Communication; Affective Involvement; Affective Responsiveness; Behavior Control; Roles; and General Family Functioning.
The most commonly reported disrupted domain for HD participants was Affective Involvement, which was reported by 39.5% of HD participants, followed closely by General Family Functioning (36.8%). For family members, the most commonly reported dysfunctional domains were Affective Involvement and Communication (both 52.2%). Furthermore, symptomatic HD participants reported more disruption to Problem Solving than pre-symptomatic HD participants. In terms of agreement between pre-symptomatic and symptomatic HD participants and their family members, all domains showed moderate to very good agreement. However, on average, family members rated Communication as more disrupted than their HD affected family member.
These findings highlight the need to target areas of emotional engagement, communication skills and problem solving in family interventions in HD.
先前的研究表明,亨廷顿舞蹈症(HD)患者家庭的功能受到不利影响。然而,家庭功能的哪些方面受到了破坏尚不清楚,这限制了制定支持性干预措施的实证依据。
本研究旨在评估HD患者家庭的功能。
我们使用麦克马斯特家庭评估工具(FAD;爱泼斯坦、鲍德温和毕晓普,1983年)对61名参与者(38名HD基因扩增参与者和23名家庭成员)的家庭功能进行了评估,该工具为七个功能领域提供评分:问题解决、沟通、情感卷入、情感反应、行为控制、角色和家庭总体功能。
HD参与者最常报告的功能受损领域是情感卷入,39.5%的HD参与者报告了这一领域,紧随其后的是家庭总体功能(36.8%)。对于家庭成员来说,最常报告的功能失调领域是情感卷入和沟通(均为52.2%)。此外,有症状的HD参与者比无症状的HD参与者报告在问题解决方面受到的干扰更多。就无症状和有症状的HD参与者及其家庭成员之间的一致性而言,所有领域都显示出中度到非常好的一致性。然而,平均而言,家庭成员认为沟通方面比受HD影响的家庭成员受到的干扰更大。
这些发现凸显了在HD家庭干预中针对情感参与、沟通技巧和问题解决领域的必要性。