IMPACT OF A CHILD'S CHRONIC CONDITION ON THE FAMILY SYSTEM.
Contributors: University of California, San Francisco.
Published: 1992
Number of pages: 305
Subjects: Health Sciences, Nursing.; Sociology, Individual and Family Studies.
Description: There is little systematic research about the family-system impact of a child's long-term health problem, and what has been reported cannot be bound into coherent theoretical understanding of the family unit. In recent years there has been steady, consistent publication of family-related research, but day-to-day life and the system-wide effects of families grappling with a child-member's chronic condition have not been studied.

This study used grounded theory to generate understanding of daily family life in the presence of pediatric chronicity. Using a non-categorical approach to the children's medical diagnoses, ten families were drawn from a large metropolitan area using the principles of theoretical sampling. Participant and non-participant observation and unstructured interviewing were the primary methods used to study families' day-to-day lives. A wide variety of family events was sampled and data was systematically collected from individuals, dyads, and families together. Families were visited in various settings and times of day, so a wide range of family activities and interactions constitutes the data-base.

Although the chronic conditions of the 11 affected children in this study were not complex or technologically demanding, and the families could all be described as "doing well", this is a story of hard family work. The logistics of day-to-day life require that things be constantly worked out. This was perceived by the families to be more demanding of their energy and resources than typical family life. Five basic processes were found to be associated with working things out: balancing, managing, adapting, tolerating, and maintaining the family image. In addition to these family-level processes, several individual-level concepts were described in this research, all related to keeping perspective within the family unit; for example, parental monitoring and managing, which includes the special skills needed to interact with the health care system. Affected and well children also have unique, additional work to do.

This research is broadly applicable to the understanding of families in health care, particularly when a child has a chronic condition. Nursing and other health care interventions, programs, and policy could be designed that better address family care. The research also gives direction for further basic research as well as intervention/outcome studies.
Notes: Source: Dissertation Abstracts International, Volume: 54-02, Section: B, page: 0742.

Thesis (PH.D.)--UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, 1992.

School code: 0034.