THE EFFECTS OF CHILDREN WITH CHRONIC ILLNESS

The Effects Of Children With Chronic Illness And Hospitalisation On Families With Children And Family Centred Care

The Effects Of Children With Chronic Illness And Hospitalisation On Families With Children And Family Centred Care

Advances in medical care and technology have increased the lifespan and decreased the disease-related suffering of children with chronic illnesses. In addition to physical health outcomes, health care professionals are increasingly evaluating other parameters, such as child and family adjustment. Among these psychosocial factors, family functioning is a key variable that has been shown to play an essential role in children's adjustment to chronic illness.

Family functioning is a broad concept and is often used as an umbrella term encompassing numerous constructs, including parents' satisfaction with their parenting role, positive parent-child interactions, family communication, family adaptability, and family cohesion. Research has shown that families of a child with a chronic illness may have deficits in family cohesion, family adaptability, parent-child interactions, family conflict, and family problem-solving skills.[3] and [4] Understanding the nature and development of these problems in family functioning is critical to formulating effective interventions.

Although we know that family functioning is related to the well-being of children with chronic illness, we lack a clear understanding of whether families of chronically ill children are significantly more likely to have difficulties in functioning compared with families of healthy children. In this article we review the research into the functioning of families with children with a range of chronic illnesses compared with healthy controls, critique these studies, highlight parallels across the literature, and provide directions for future study.

Cystic Fibrosis

The literature on families with a child with CF reports varying findings regarding the impact of chronic illness on family functioning. Research shows that parents of children with CF report higher parenting stress compared with parents of healthy children. In addition, mothers of children with CF report decreased time available to spend with their spouses. Spieth et al8 found similar results and concluded that families of a child with CF score significantly lower than healthy control families in domains of communication, interpersonal involvement, affect management, behavior control, and role allocation.

Some research indicates that having a child with CF might not impair family functioning, however. For example, 2 studies have shown no differences in family functioning between families with children with CF and families of physically healthy children.[9] and [10] Further, on an in vivo problem-solving task, families of adolescents with CF were more likely to be categorized as good problem solvers than were families of healthy adolescents. Cowen et al11 found that fathers of young children with CF are more likely to report positive family functioning than are fathers of healthy children.

Type 1 Diabetes Mellitus

For the most part, the research has found few differences in family functioning comparing families of children with type 1 diabetes mellitus with families with healthy children.[12], [13] and [14] However, mothers of children with diabetes report having less time to engage in activities with their children compared with mothers of healthy ...