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Family Functioning in the Context of Pediatric Chronic Conditions

Herzer, Michele PhD*; Godiwala, Neha BS; Hommel, Kevin A. PhD*; Driscoll, Kimberly PhD; Mitchell, Monica PhD*; Crosby, Lori E. PsyD*; Piazza-Waggoner, Carrie PhD*; Zeller, Meg H. PhD*; Modi, Avani C. PhD*

Journal of Developmental & Behavioral Pediatrics: January 2010 - Volume 31 - Issue 1 - p 26-34
doi: 10.1097/DBP.0b013e3181c7226b
Original Article
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Objective: The aims were to describe and compare generic family functioning in children with five different chronic conditions and healthy comparisons, and to examine the relations between family functioning and sociodemographic variables.

Methods: A secondary data analysis from six independent studies including 301 children (cystic fibrosis: n = 59; obesity: n = 28; sickle cell disease: n = 44; inflammatory bowel disease: n = 43; epilepsy: n = 70; healthy comparison group: n = 57) was conducted. In each study, parents completed the Family Assessment Device.

Results: Across all five chronic conditions, between 13% and 36% of families endorsed levels of functioning in the “unhealthy” range, with the greatest proportions in the following domains: communication, roles, and affective involvement. No significant group (i.e., between all six groups, namely five chronic conditions as well as healthy comparisons) differences were observed on Family Assessment Device scales (model F [35, 1335] = 0.81, p = .79). Older child age, fewer children living in the home, and lower household income were significantly related to poorer family functioning in the areas of communication, roles, affective involvement, and general functioning.

Conclusions: Families of children with and without chronic conditions do not differ significantly from each other on generic family functioning. However, risk factors for poor family functioning include older child age, less children in the home, and lower household income. These risk factors combined with data suggesting that a subset of families exhibit “unhealthy functioning” warrants the need for close monitoring of how families function in the context of a pediatric condition.

From the *Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; †Pain Prevention & Treatment Research Program, Duke University, Durham, NC; and ‡Department of Medical Humanities & Social Sciences, Florida State University College of Medicine, Tallahassee, FL.

Received June 19, 2009; accepted October 7, 2009.

This work was supported by the National Institutes of Health (T32-DK63929 to A.C.M., C.P.W., and K.D.), (K23 DK60031 to M.H.Z.), (K01 MH064078-05 to M.M.); Procter and Gamble Pharmaceuticals and Prometheus Laboratories, Inc. (to K.A.H.); AAMC Herbert Nickens Award (to M.M.).

Address for reprints: Michele Herzer, PhD, Center for the Promotion of Treatment Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, MLC 7039, 3333 Burnet Avenue, Cincinnati OH 45229; e-mail: michele.herzer@cchmc.org.

© 2010 Lippincott Williams & Wilkins, Inc.