노년층에서 가족 간 의사소통 개선: 파일럿 무작위 대조 시험 (ReFrame-P)

실험적: ReFrame-R 트레이닝

ReFrame-R은 주 1회 90분씩 총 4회(총 6시간) 진행되는 그룹 세션으로 구성되며, 장애물 해결 및 가정 연습 강화를 위한 간단한 주간 개별 상담이 보완됩니다. 일반인을 위한 기존 MI 프로토콜(Kline et al., 2022)을 수정한 이 프로그램은 가족 체계 이론에 기반하여 노인 부모-성인 자녀 관계의 과도한/부족한 기능 역학을 다루면서, 공감적 경청과 자율성 지원적 의사소통을 강조합니다. 가정 연습을 지원하고 기록하기 위해 MI 기술 소책자가 배포될 예정입니다.

행동: ReFrame-R

ReFrame-R 프로그램은 비전문가를 위한 확립된 동기 부여 면담(MI) 프로토콜(Kline et al., 2022)을 적용한 것입니다. 가족 체계 이론에 기반한 이 커리큘럼은 특히 노년 부모-성인 자녀 간 관계에서 흔히 발견되는 과기능 및 저기능 역동과 홍콩의 문화적 특수 상황을 다룹니다. 일반적인 커뮤니케이션 워크숍과 달리, 이 프로그램은 부모-성인 자녀 관계 내 역할 경계를 강조합니다.

간섭 없음: 대조군

대조군 참가자는 연구 기간 동안 능동적인 훈련을 받지 않습니다. 참고 및 자율적인 연습을 위해 동일한 MI 기술 소책자가 제공됩니다.

Perceived communication competence

Participants' self-perceived communication competence is assessed using an 11-item scale adapted from the Family Communication Scale (FCS). The scale consists of 10 items adapted from the original FCS to measure perceived ability to engage in positive communication with adult children, plus an additional item regarding overall communicagtion competence. Each item is rated on a 5-point scale (1-5), with a total score ranging from 11 to 55. Higher scores indicate a higher level of perceived communication competence.

Meaning in life

The 10-item Meaning in Life Questionnaire (MLQ; Steger et al., 2006) is used. It consists of two subscales: presence of meaning (5 items) and search of meaning (5 items). Each subscale is rated on a 7-point scale, with summed scores are calculated (ranged 5-35 for each). Higher scores indicate stronger sense of purpose and motivation to find meaning, respectively.

Self-efficacy

Participants' self-efficacy will be assessed using the 6-item General Self-Efficacy Scale (GSE-6; Romppel et al., 2013). It is typically rated on a 4-point scale from 1 to 4. Total scores range from 6 to 24, with higher scores reflecting greater perceived self-efficacy.

Well-being

The 5-item WHO Well-Being Index will be adopted for measuring participants' subjective well-being (Bech, 1998; Kong et al., 2016), rated on a 7-point scale. The WHO-5 score ranges from 0 to 25, zero representing worst possible mental well-being and 25 representing best possible mental well-being.

Role boundaries

We used a 5-item scale adapted from the Control subscale of the Parent-Adult Child Relationship Questionnaire's Relationship with Father component (PACQF; Peisah et al., 1999). While the original scale assess children's perceptions of parental conrtol, this adapted version is a self-report measure for parent to assess their attempt to maintain power, influence, or dominance over their adult children. Each item is rated on a 5-point scale, with a total score ranging 5-25. Higher scores indicater higher levels of parent control, reflecting weaker awareness of role boundaries in parent-adult children relationship.

Family functioning

The 5-item Family Adaption, Partnership, Growth, Affection, Resolve questionnaire (Family APGAR; Chan et al., 1988; Smilkstein, 1978) is used. This scale assesses participants' satisfaction with five aspects of family function. Each item is rated on a 3-point scale (0-2), with a total score ranged from 0 to 10. Higher scores indicate better family functioning.

Training appropriateness

We used the 4-item Intervention Appropriateness Measure (IAM) from Weiner et al (2017) to access training appropriateness. All items are rated on a 5-point scale (1-5), with an average score being calculated. Higher scores indicate greater perceived appropriateness of training.

Training acceptability

The 4-item Acceptability of Intervention Measure (AIM) from Weiner et al (2017) is adopted to access training appropriateness. All items are rated on a 5-point scale (1-5), with an average score being calculated. Higher scores indicate greater perceived acceptability of training.

Training feasibility

This study used the 4-item Intervention Appropriateness Measure (IAM) from Weiner et al (2017) to access training feasibility. All items are rated on a 5-point scale (1-5), with an average score being calculated. Higher scores indicate greater perceived feasibility of training.