Discussion
This study aimed to evaluate the reliability and validity of the Family
Disease Management (FDM) Scale in families of patients with Covid-19.
The reliability of the scale was confirmed by Cronbach’s alpha,
composite reliability and cross loadings. Validity was also confirmed
through the AVE index, and the model was tested. In this model, the
items 1-10 assessed family support, 11-20 evaluated family
normalization, and 21-30 focused on family participation. The CFA
results revealed that the 30-items scale provided a good fit, and three
factors were obtained. Family support assists patients in self-care and
decision-making. The family should have compassionate communication with
the patient’s expression of feeling, providing information, material,
and satisfying the patient’s essential needs. Some studies indicated
that patients with fewer levels of family support show higher depression
and anxiety (Reinares et al., 2016). In addition, family support is
associated with adjustment to the disease (Arpin, Fitch, Browne, &
Corey, 1990). Family normalization refers to the strategies which keep
the family normal, which is a process and outcome. Attempts to develop a
normal family life points to the process, and the perception of the
result of this effort reflects the outcome (K. A. Knafl, Darney, Gallo,
& Angst, 2010). The family should be flexible in the performance of
roles, afford resources for the patient’s comfort, and request for help
(Avila-Jimenez, Cerón, Ramos-Hernández, & Velázquez, 2013). Families
who emphasize the normality of the condition take an adaptable approach
to follow the treatment (Bellack, Haas, Schooler, & Flory, 2018; K.
Knafl, Breitmayer, Gallo, & Zoeller, 1996). Family participation refers
to the responsibility of the family for helping in the management of a
patient’s life. Family’s statement of patients with covid-19 revealed
that caregivers had different experiences from their previous caring
experience because of fluctuating symptoms, and unpredictable diseases,
lack of knowledge, health facilities, and economic aid. However, social
supports, offering food and necessities of life and guidance for care,
as well as emotional support were accessible. Caregivers used defense
mechanisms like positive self-talking, distracting, seeking information
from various sources, and praying. Caring for these patients had some
positive outcomes for caregivers such as promoting spirituality,
improving relationships, and growth (Rahimi, Dastyar, & Rafati, 2021).
In conclusion, family is considered as one of the valuable dimensions in
the research and treatment of diseases which have been emphasized in
both the management of mental illness and physical illness (Fisher et
al., 2000; K. A. Knafl & Gilliss, 2002; Reinares et al., 2016), and
play an important role in promoting Patient health and well-being in the
disease condition. In this way, family members can ensure that the
patient’s needs are met, provide staff with information about the
patient, Members can also monitor the patient’s health and report
changes to prevent crisis, and finally, the family can help people with
physical disabilities, and thus reduce personnel pressure(Kemp, 2021).
The result of this study showed the empirical evidence for the
reliability and validity of this scale. Thus, the FDM scale could be a
valid and reliable scale for determining the role of the family in the
management of the Covid-19 for this population.