Why is family support so important in managing Heart Failure?

Family support plays a vital role because Heart Failure presents both physical and emotional challenges. Studies show strong social support networks can decrease hospital readmissions and improve mortality rates. Emotional support, especially from partners, significantly impacts patient well-being. However, it's crucial to recognize that caregiving can also stress families, affecting their overall functioning. Understanding and strengthening family support is therefore essential for comprehensive Heart Failure management.

What is the FAFHES questionnaire, and what does it measure?

The Family Functioning, Family Health and Social Support (FAFHES) questionnaire is a tool designed to evaluate family dynamics in the context of Heart Failure. It assesses the interconnections among family health, family functioning, and available social support. The questionnaire delves into aspects like family relationships, connections outside the family, structural factors, and family strengths to provide a comprehensive understanding of the family's support system.

What were the main findings of the study that tested the Danish version of the FAFHES questionnaire?

The study, involving 330 Heart Failure patients, found that the Danish version of the Family Functioning, Family Health and Social Support (FAFHES) questionnaire is a valuable tool for healthcare professionals. It can effectively assess family functioning, health, and social support in this population. While further testing is encouraged, the instrument helps identify families who may need additional support, paving the way for family-centered interventions to enhance patient well-being and Heart Failure management.

How does Confirmatory Factor Analysis (CFA) relate to the validation of the FAFHES questionnaire?

Confirmatory Factor Analysis (CFA) is a statistical method used to validate the theoretical structure of the Family Functioning, Family Health and Social Support (FAFHES) questionnaire. In the context of validating the Danish version, CFA was employed to reconstruct the scales and confirm the underlying dimensions that the questionnaire is designed to measure. This process ensures that the questionnaire accurately reflects the concepts of family functioning, family health, and social support as intended by its original design, thus confirming its validity for use in the Danish population.

Supportive family surrounding a heart

Heart Health Harmony: Strengthening Family Support in Heart Failure Recovery

Q: How was the FAFHES questionnaire adapted for use in Denmark?

To ensure the Family Functioning, Family Health and Social Support (FAFHES) questionnaire was suitable for a Danish population, researchers followed a rigorous process. This included translating the questionnaire from Finnish to Danish, back-translating it to Finnish, and comparing the back-translation to the original to ensure accuracy. Cognitive debriefing interviews were also conducted with Heart Failure outpatients to check the questionnaire's clarity and acceptability within the Danish cultural context.

Lena Kashyap in Health & Wellness November 2025 • 4 min read.

"Discover how family dynamics significantly impact heart failure recovery and explore practical steps to enhance support networks for better patient outcomes."

Heart failure (HF) affects millions globally, creating significant physical and emotional challenges for patients and their families. Managing this chronic condition requires comprehensive care that extends beyond medical treatments, emphasizing the critical role of family support.

Studies reveal that robust social support networks are key predictors of reduced hospital readmissions and improved mortality rates among HF patients. Emotional support from partners and spouses, in particular, has a profound impact on patient well-being. However, providing care for a loved one with HF can also place considerable stress on family members, potentially jeopardizing overall family functioning.

Recognizing the importance of family dynamics, researchers have developed tools to assess and enhance family support systems in HF care. One such tool is the Family Functioning, Family Health and Social Support (FAFHES) questionnaire, designed to evaluate the interplay between family health, functioning, and available support. This article delves into the translation and field testing of the FAFHES questionnaire in a Danish outpatient setting, examining its validity and reliability in assessing family needs and improving patient outcomes.

The FAFHES Questionnaire: A Tool for Assessing Family Dynamics in Heart Failure

The FAFHES questionnaire was originally developed in Finland to assess the connections among family health, functioning, and professional nursing support. The initial version consisted of 109 items, which were later reduced to 63 items covering three main scales: family functioning, family health, and social support. The family functioning scale includes subscales that measure family relationships, connections outside the family, structural factors, and family strengths.

To adapt the FAFHES questionnaire for use in a Danish population, researchers followed a rigorous translation and validation process. This involved translating the questionnaire from Finnish to Danish, back-translating it to Finnish, and comparing the back-translation to the original Finnish version to ensure semantic equivalence. Cognitive debriefing interviews were also conducted with HF outpatients to assess the questionnaire's comprehensibility and acceptability.

Translation and Adaptation: The FAFHES questionnaire was meticulously translated and adapted to ensure it resonated with the cultural and linguistic nuances of the Danish population.
Validity and Reliability Testing: The Danish version of the FAFHES questionnaire underwent thorough testing to confirm its validity and reliability in measuring family functioning, health, and social support among HF patients.
Confirmatory Factor Analysis (CFA): CFA was used to reconstruct the scales and validate the theoretical dimensions of the questionnaire.

A cross-sectional study was conducted with 330 patients diagnosed with heart failure. Participants completed the Danish version of the FAFHES questionnaire, and their responses were analyzed to assess the tool's validity and reliability. The study also included a test-retest component, where a subset of patients completed the questionnaire again after 15 days to evaluate its stability over time.

Conclusion: Empowering Families for Better Heart Failure Management

The Danish version of the FAFHES questionnaire provides a valuable tool for healthcare professionals to assess family functioning, health, and social support among heart failure patients. While further testing is recommended, this instrument can help identify families in need of additional support and inform the development of family-centered interventions. By empowering families, healthcare providers can enhance patient well-being and improve outcomes in heart failure management.