Parent-Child Dyadic Coping and Quality of Life in Chronically Diseased Children

Parent-adolescent family resilience and psychological adjustment in chronically ill adolescents: An actor-partner interdependence mediation model

AIMS

This study explored the relationships between family resilience, dyadic coping and psychological adjustment among adolescents with chronic illnesses and their parents. The actor-partner interdependence mediation model was used to validate the mediating role of dyadic coping in the relationship between family resilience and psychological adjustment.

DESIGN

This is a cross-sectional study.

METHODS

A total of 318 parent-adolescents dyads were recruited from three paediatric hospitals in Wenzhou, Hangzhou, Shanghai city, China, between June 2022 and August 2023. The parents had a mean age of 41.62 years, and the adolescents had a mean age of 12.66 years. Participants independently completed a self-report questionnaire assessed family resilience, dyadic coping and psychological adjustment. Data analysis was conducted using the actor-partner interdependence mediation model.

RESULTS

The findings suggest that in the actor effects, family resilience directly influenced psychological adjustment, and family resilience is related to psychological adjustment through positive dyadic coping. In the partner effect, parents' family resilience influenced adolescents' psychological adjustment through the parents' positive dyadic coping. Similarly, adolescents' family resilience influenced parents' psychological adjustment through both parents' positive dyadic coping and adolescents' negative dyadic coping. Additionally, there was a partner effect between parents' family resilience and adolescents' psychological adjustment.

CONCLUSION

This study demonstrated the importance of developing effective dyadic interventions based on family resilience or positive dyadic coping strategies to improve the mental health of adolescents with chronic illnesses and their parents.

IMPACT

The mediating role of dyadic coping in the relationship between family resilience and psychological adjustment among adolescents with chronic illnesses and their parents was demonstrated. Future psychosocial interventions should focus on increasing parents' positive dyadic coping strategies and improving adolescents' negative dyadic coping strategies.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Interactions among dyadic coping, self-efficacy, and negative emotions in Chinese parents of children with leukemia

BACKGROUND AND AIM

The prevalence of childhood leukemia in China has been on the rise, imposing significant psychological burden on parents. Currently, few studies have explored the dyadic coping status of parents of children with leukemia and its influencing factors. This study aimed to investigate the associations among dyadic coping, self-efficacy, anxiety and depression in parents of children with leukemia.

METHODS

A cross-sectional design was performed to conveniently sample 342 parents from the pediatric hematology ward of Peking University People's Hospital. The general demographic information, dyadic coping inventory, general self-efficacy scale, and hospital anxiety and depression scale were collected and analyzed using SPSS.22.0 software.

RESULTS

The average age of the parents was (37.29 ± 5.73) years, while the total score of dyadic coping was 122.95 ± 16.68, the self-efficacy score was 25.03 ± 3.93, anxiety score was 15.58 ± 3.59, and depression score was 16.27 ± 3.86. Dyadic coping was significantly positively correlated with self-efficacy (r = 0.386, P < 0.01), and negatively correlated with parental anxiety and depression scores (r=-0.372; r=-0.264; P < 0.01). Multiple linear regression revealed that self-efficacy(β = 0.262), anxiety(β=-0.242), income per month (RMB,β = 0.182), knowledge of the child's illness(β = 0.138), number of relapses(β=-0.135), current treatment programs(β=-0.149), education level(β = 0.101) and the duration of diagnosis(β = 0.092) were significant factors influencing the parents' dyadic coping level (R2 = 0.378, P < 0.01).

CONCLUSION

The dyadic coping level of parents of children with leukemia is generally moderate, is positively correlation with self-efficacy and negatively correlated with anxiety. Therefore, interventions targeting dyadic interactions between parents should be established to improve parental communication, foster coping mechanisms under stress, and alleviate the negative emotional responses.

Parent strategies to help emerging adults manage stress are associated with their mental health: A dyadic coping perspective

Emerging adults (EAs) are at high risk for mental health challenges and frequently reach out to their parents for support. Yet little is known about how parents help emerging adults manage and cope with daily stressors and which strategies help and which hinder EA mental health. In this cross-sectional pilot study of students at a 2- and 4-year college (ages 18-25, N = 680, mean age = 19.0), we extend models of dyadic coping from intimate relationships to the parent-emerging adult relationship and test whether six specific parent strategies to help emerging adults manage stress are associated with EA mental health. Emerging adults with parents who provided problem and emotion-focused supportive dyadic coping, delegated dyadic coping, and common/joint dyadic coping reported fewer symptoms of anxiety and depression, as well as higher levels of psychological well-being. In contrast, college-attending emerging adults who reported higher levels of parent-provided negative dyadic coping reported higher levels of depressive and anxiety symptoms and lower psychological well-being. Parent-emerging adult dyadic coping is a fruitful area for future research and intervention development.

Bereavement dyadic coping questionnaire: Development and validation

Most theories and empirical studies of bereavement coping focus on the individual, although researchers have highlighted the importance of family-level coping and proposed the concept of bereavement dyadic coping (BDC). We developed and validated a 25-item Bereavement Dyadic Coping Questionnaire (BDCQ). The procedure includes item generation, expert review, and examination of the psychometric properties in 241 bereaved persons in bereaved families from China. Factor analysis revealed four factors: direct loss-oriented, indirect loss-oriented, restoration-oriented, and collaborative. The questionnaire had satisfactory internal consistency, test-retest reliability, and convergent and divergent validity. The BDCQ is the first of its kind to measure dyadic coping in the context of bereavement, permitting future quantitative explorations of bereavement dyadic coping and its influence on bereaved individuals and families.

Health-illness transition processes in children with complex chronic conditions and their parents: a scoping review

BACKGROUND

The prevalence of complex chronic conditions (CCC), which cause serious limitations and require specialized care, is increasing. The diagnosis of a CCC is a health-illness transition for children and their parents, representing a long-term change leading to greater vulnerability. Knowing the characteristics of these transitional processes is important for promoting safe transitions in this population. This scoping review aimed to map the available evidence on health-illness transition processes in children with complex chronic conditions and their parents in the context of healthcare.

METHODS

Six databases were searched for studies focusing on children aged 0-21 years with CCC and their parents experiencing health-illness transition processes, particularly concerning adaptation to illness and continuity of care, in the context of healthcare. Studies within this scope carried out between 2013 and 2023 and written in Portuguese or English were identified. The articles were selected using the PRISMA methodology. The data were extracted to an instrument and then presented with a synthesizing approach supporting the interpretation of the results.

RESULTS

Ninety-eight methodologically broad but predominantly qualitative articles were included in this review. Children with CCC have specific needs associated with complex and dynamic health-illness transitions with a multiple influence in their daily lives. Several facilitating factors (p.e. positive communication and a supportive therapeutic relationship with parents and professionals, as well as involvement in a collaborative approach to care), inhibiting factors (p.e. the complexity of the disease and therapeutic regime, as well as the inefficient organization and coordination of teams) and both positive (p.e. well-being and better quality of life) and negative response patterns (p.e. negative feelings about the chronic illness) were identified. Some interventions to support the transitional process also emerged from the literature. Pediatric palliative care is seen as a good practice and an integrative approach for these children and families.

CONCLUSION

Health professionals play a fundamental role in supporting the transitional process and promoting positive response patterns. More significant investment is needed at the clinical and academic levels regarding production and dissemination of knowledge in this area to ensure the awareness of children with CCC and that their needs are fully enhanced.

REVIEW REGISTRATION

https://doi.org/10.17605/OSF.IO/QRZC8 .

A dyadic perspective on parent-child dyadic coping in children with a chronic condition

OBJECTIVE

In this study, we examined the extent to which parents and their children with a chronic condition communicate their stress to one another and whether stress communication is associated with different forms of dyadic coping.

METHODS

In a sample of 239 parent-child dyads, self-reported stress communication and different forms of perceived dyadic coping (i.e., emotion-oriented, problem-oriented, and negative dyadic coping) were assessed using a cross-sectional design.

RESULTS

We first found that children's stress communication was positively associated with more positive (r = 0.28, p < .001) and less negative dyadic coping responses by children (r = -0.22, p < .001). Children's stress communication was also associated with more positive (r = 0.52, r = 0.45, p's < 0.001), and less negative dyadic coping responses by parents (r = -0.19, p < .001). Using dyadic data of children with a chronic condition and their parents, we found that more stress communication of children was associated with healthier coping responses of both children (perceived emotion-oriented dyadic coping: β = 0.23, p < .001) and parents (perceived emotion-oriented dyadic coping: β = 0.33, p < .001; perceived problem-oriented dyadic coping: β = 0.22, p < .001).

CONCLUSION

This underscores the importance of communication and adaptive coping strategies of parents and children in the context of a child's chronic condition. These findings may help us find ways to support children and their parents to optimally communicate about and deal with their stress.

Stress and coping strategies of families of pediatric solid organ transplant recipients in times of pandemic

Objective

Pediatric solid organ transplantation (SOT) is a chronic condition that impacts the whole family system. The objective of this study is to evaluate psychopathology, family stress, and coping strategies in families of SOT recipients compared to families of healthy children and adolescents. Moreover, it analyzes if the stress related to the COVID-19 pandemic has had an additional impact on these families.

Methods

The sample was recruited between May and July 2021, during the fourth and fifth wave of the pandemic in Spain. It consisted of 102 families, 51 with a pediatric recipient who had undergone a SOT (liver, kidney, heart, or lung) and 51 healthy controls, matched by child age and gender. A primary caregiver from each family answered an online sociodemographic questionnaire and different tests to evaluate family stress, depression, anxiety, coping strategies, and effects of the pandemic on the family.

Results

Caregivers were mostly mothers (89.2%). Families of SOT recipients showed greater anxiety (U = 863.5, p = 0.003) and more total stress, stress related to childcare (t = -2.043; p = 0.045), and parent-child interaction stress (U = 355.5, p = 0.015). SOT families used more avoidance strategies, specifically denial (U = 889.5; p = 0.010) and abandonment of coping efforts (U = 1,013; p = 0.047), more religious strategies (U = 792.5; p = 0.031), and fewer social support coping strategies (t = 2.098; p = 0.038). No differences were found between groups in terms of exposure, impact, and distress more than 1 year after the start of the pandemic.

Conclusion

SOT families showed clinical levels of anxiety, more parent-child interaction stress, more difficulties in taking care of their child, more avoidance and religious strategies, and less use of social support strategies, even 4 years after transplantation. The pandemic did not have an additional differential effect on SOT families. Caregivers of SOT patients can benefit from psychological interventions focused on parents' mental health, parent-child connectedness, skill building, and social support aid groups, with attention to multiculturalism and promoting a better balance between caregivers. There is a need for family interventions that are maintained over time. Strategies that offer this support to families through digital resources can facilitate adjustment to chronic illness, especially in pandemic times.