Introduction
The family goes through events that require change and readjustment during its developmental stages (formation, middle, and final stages). An unexpected event can do a lot of damage to the family and disrupts the family growth sequence (Goldenberg & Goldenberg, 2012, p.29-40) Meanwhile, illness is a phenomenon which affects the family’s health by making structural, procedural, and emotional changes, and members try to adapt to it (K. A. Knafl & Gilliss, 2002). The members’ relationships impact the patient behavior, health, and well-being. Further, marital relationships and family stress affect the patient’s self-care behavior (Fisher et al., 2000). In this regard, the concept of disease management is related to the efforts for developing the standard of patient care (Faxon et al., 2004). Further, it refers to the cooperation of members in managing and adapting the daily routines to the disease (Zhang, Wei, Shen, & Zhang, 2015). Family as a system reacts to the condition positively and negatively. Emphasis on behaviors like autonomy and personal success, family integrity, careful reactions to symptoms, and expressiveness of emotions were related to the positive outcomes. On the other hand, judging and excessively protected actions were related to negative consequences for patients(Rosland, Heisler, & Piette, 2012). In recent years, covid-19 as a pandemic illness affects the family. It limited communication with relatives. Therefore, people spend more times in their family. Advantages and disadvantages of being together in including members can benefit from each other’s support, they can share their concerns, and help each other solve the problems and endure hardships. After all, tensions may increase. The lack of entertainment and financial problems in this period causes people to be in a bad mood (Shahyad & Mohammadi, 2020). Summarily, some studies indicated that families experience higher mental distress and pressure during disease (Ones, 2020; Tanoue et al., 2020) can help the patient to improve self-care (Fisher et al., 2000; Tramonti, 2021; Zhang et al., 2015). Thus, the study of family disease management is essential. Researchers have developed different instruments which examine family health focused on family managing strategies and functioning (Lima-Rodríguez, Lima-Serrano, & Domínguez-Sánchez, 2015). Knafl et al. (2011) studied the psychometric properties of family management tools, addressed families with diabetic children. Knafl and Deatrick (2003) focused on family response styles to illness, which helps understand family life in the context of disease. Previous tools have examined family disease management for chronic illness. A general means is needed to compare family management in different contexts can give a good perception of the difficulties faced by the family. In this regard, Rodriguez et al. (2013) created a self-perceptions of family health scale. Based on the previous research, Rodriguez et al. (2015) developed the Family Disease Management (FDM) Scale for assessing disease management in family members. A three-dimensional scale consisted of family support, normalization, and participation. Family support includes the activities related to care, disease monitoring, decision-making, and proper actions. Normalization is the awareness of the new condition and potential changes to manage this situation. Involvement is the decision of whom to consult, when, and where to seek treatment. For the overall scale, Cronbach’s alpha coefficient was 0.93, and 0.80 for the three subscales (Lima-Rodríguez et al., 2015).