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The impact of a child with sickle cell disease on family dynamics
1Department of Psychology, University of Cincinnati, Dyer Hall (ML 376), Ohio 45221-0376.
Insights
Caring for a child with sickle cell disease (SCD) strains parents emotionally and affects family dynamics. Increased parental knowledge and social support improve coping for both the child and family.
Area of Science:
- Pediatric Hematology
- Family Psychology
- Chronic Illness Care
Background:
- Children with sickle cell disease (SCD) present unique challenges to family functioning.
- Previous research indicates chronic childhood illnesses impact family dynamics, but SCD-specific impacts require further elucidation.
Purpose of the Study:
- To review existing research on the impact of a child with SCD on the family system.
- To identify key areas of family functioning affected by the child's illness and explore mediating factors.
Main Methods:
- Systematic review of research papers and other scholarly literature.
- Analysis of studies examining parental emotional strain, interpersonal relationships, family environment, and social participation.
- Inclusion of research considering mediating factors like parental knowledge and social support.
Main Results:
- Primary caregivers experience significant emotional strain.
- Adverse effects noted in parent-offspring relationships and family conflict/organization.
- Reduced social participation for primary parents and unmet needs for secondary parents.
- Parental knowledge and social support positively mediate family coping.
- Family psychosocial stressors negatively impact patient coping and treatment compliance.
Conclusions:
- The presence of a child with SCD significantly impacts family emotional well-being, relationships, and environment.
- Parental knowledge, social support, and reduced family stressors are crucial for better adaptation.
- Methodological improvements, including comparison groups and collaborative research, are needed to advance understanding.
Abstract:
This paper has reviewed research and other papers that have furthered our understanding of the impact of the presence of a child with sickle cell disease on the family. The research suggests that the primary parent in such a family experiences additional emotional strain much like primary parents of children with other chronic illnesses have been found to exhibit. The research also suggests that the ill child's presence influences interpersonal relationships within the family. Specifically, there is some evidence that the relationship between the parents and the relationship between the parent and other offspring may be affected adversely. The only evidence for an adverse impact on the relationship between the parent and the chronically ill child was in our research when considering only single-parent families. The research also suggests that the family environment is affected. In particular, the research suggests that the level of conflict and organization within the family was less favorable than within the control families. Moreover, the research suggests that the child's presence reduces the ability of the primary parent to participate in social activities outside of the family. Secondary parents, on the other hand, report less satisfaction with the extent to which their own individual needs are being met within the family. The available research also suggests that other factors mediate the impact of the child's illness on the family. In particular, parents with more knowledge about the illness and more social support available appear to cope more favorably with the illness. Moreover, the available research also suggests that the family also impacts on how the patient responds to the illness. Specifically, the more psychosocial stressors within the family, the less effectively the patient copes with the illness. In addition, the more social support available to the patient from the family and other significant others, the more likely the patient is to comply with the treatment regimen. Finally, two methodological issues have been discussed. First, a tendency is evident for parents to deny any impact on the family when asked directly but to demonstrate the impact when the responses of these parents are compared to the responses of a comparison group. This suggests a need for more studies that involve a comparison group in the design. Second, the small sample sizes in many of the studies reflect the lack of adequate sample in individual geographic locales. This suggests a need for more collaborative research projects such as the CSSCD project to increase sample size.
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