Assessment of family functioning with family apgar among individuals over 65 years of age with chronic disease

Introduction and Aim: The family is the first source of health-related beliefs, behaviors, stress, and emotional support. In family medicine, individuals are evaluated together with their families. Over sixty-five-years-old individuals account for 8% of our society. Usually chronic diseases are common in this age group. We know that there are many health-related effects of family, ranging from compliance with medicines to management of chronic diseases, to morbidity and mortality. It can be predicted that increasing the positive effect of the family by increase of family functioning. In this study, it was aimed to compare the socio-demographic characteristics and clinical profiles of 65 years old individiuals with chronic disease with family functioning by using family APGAR scale. Method: The study was carried out between March-September 2017, among the people over 65 years (n=350) registered in five Educational Type Family Health Centers which are affiliated to Atatürk University Medical Faculty Family Medicine Department. 200 persons were included in the study who met the inclusion criteria, such as having at least one chronic illness, volunteering to participate into the study. First, a 17-questions data collection form was used to obtain descriptive information about the sociodemographic and clinical characteristics of these people. Then, family APGAR scale consisting of five questions was applied to measure family functioning. The data were transferred to the SPSS.20 package program and analyzed. Number and percentage for categorical data; mean and standard deviation for numerical data are presented in descriptive statistics. Student t test, one way ANOVA, Chi square, correlation analysis tests were used as hypothesis tests. Statistically, the significance limit was accepted as p <0.05. Findings: A total of 200 people participated in the study. The mean age of the participants was 72.8±6.6 years. The mean family APGAR scale score of the participants was 7.5±2.5. According to the family APGAR scale, %56 (n=112) of the participants were functional and %44 (n=88) were dysfunctional. According to the results of our study; family functioning decreases by increasing of the age, men according to women; to be married according to be single or widow; retirees according to unemployed; defining relationships with family members as good according to as bad, living with the wife or children according to living single or in a nursing home, who have been hospitalized in the past year, and whose companion is a relative according to nursing home personnel; it is found to be more functional in terms of family functioning (p<0.05). It has also been observed that family functioning is increasing with the increase of education level and income level (p<0.05). It was determined that the presence of chronic illness, hospitalization in the last one year and the presence of comorbidity had no effect on family functioning (p>0.05). Conclusion: In our study, variables such as gender, age, occupation, education level have been shown to affect family functioning of elderly and chronic patients. In the context of the WHO's concept of an elderly friendly primary care center, patients 65 years of age and older in primary health care services need to be assessed in many aspects, especially quickly and effectively, to make further evaluation of the illness necessary. Family physicians, who are particularly exposed to the geriatric age group and who are able to recognize patients more closely and keep them under constant supervision, can be given more control over these problems. These people need more attention in the primary care. It is necessary not only to evaluate diseases but also to evaluate their diseases with family functions. In terms of the variables affecting family functioning that was found in our study, it would be beneficial to evaluate elderly individuals in a more comprehensive and biopsychosocial perspective. Key Words: elderly patient, chronic diseases, family functioning, family APGAR scale