Case-study research to investigate how family-systems-centered therapeutic conversations support families of a child with intellectual disability
Bibliographic record
Abstract
Background and Objectives: Parents of children with intellectual disability are at risk of physical and mental symptoms and chronic sorrow. Family-systems-centered therapeutic conversations improve family functioning and quality of life. The Family Systems Care Unit (FSCU) is a university-run real-ife lab offering nurse-led therapeutic conversations to families with health-related burdens. The conversations are based on the Calgary Family Assessment and Intervention Models and the Illness Beliefs Model. The objective of this study was to understand how the therapeutic conversations were supportive of two exemplary families raising a child with intellectual disability. Design and Methods: Two qualitative longitudinal embedded single-case studies were applied. Advanced practice nurses specialized in family systems care provided three therapeutic conversations to each family at the FSCU. We asked for consent for audio or video recording and observing the therapeutic conversations through a one-way window for research. The conversations were transcribed verbatim and analyzed with inductive-deductive qualitative coding methods. Results: These single-case studies provided a nuanced understanding of the families’ needs and how they found support in the therapeutic conversations. The common needs of the two families were finding peace and a feeling of belonging as a family as well as coping with feelings of guilt and blame. The first family consisted of a single mother of two children who experienced deep suffering due to various severe challenges burdening her physical and mental health. The burdens and suffering were modeled through the conversations, and the woman gained more ease regarding her situation and suffering. The second family consisted of a couple and an adolescent son. Although exhausted, they were creative in dealing with their challenging everyday life. Through the conversations, they found confidence in continuing to cope with their situation by being given time and space in the conversations to be listened to and to listen to each other. Conclusions: Case-study research is a suitable method for gaining in-depth, multifaceted insights into the complex needs and strengths of families raising a child with intellectual disability and the process and effects of therapeutic conversations. The FSCU real-life lab setting provides support for burdened families while collecting valuable data for research. This makes the real-life lab a design and setting for ethically sensitive and justifiable nursing research.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.023 | 0.033 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.010 | 0.006 |
| Scholarly communication | 0.004 | 0.005 |
| Open science | 0.003 | 0.005 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".