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).