Parenting styles and family power dynamics in pediatric liver transplant families: a qualitative study

Pediatric liver transplantation (PLT) is a vital treatment for children with end-stage liver disease. While most studies on quality of life focus on medical complications and medication effects, limited attention has been paid to how family dynamics and parenting styles shape children's recovery. Parenting styles are crucial for children's adjustment, yet how parents experience and enact them in PLT families remains unclear. This study uses qualitative interviews with caregivers to explore parents' lived experience of parenting after transplantation and how it relates to children's quality of life, providing insights for family-centered care.

This qualitative phenomenological study initially recruited thirty-two parents of children who underwent liver transplants at a tertiary hospital in Guangzhou, China. A separate group of eighteen parents participated in preliminary interviews to refine the interview guide, and a different, non-overlapping group of fourteen parents participated in formal semi-structured interviews, whose data were included in the final analysis.

Three main themes were identified: (a) Reconfiguring Parental Authority: Toward Gendered Specialization; (b) Living with Constrained Maternal Agency: Between Intensive Mothering and a Diminished Voice; (c) Stepping into Paternal Pragmatic Authority: Leading Through Problem-Solving. These shifts not only reflected spousal interactions but also directly shaped parenting styles toward the child, influencing the child's daily routines and post-transplant adaptation.

The study describes how parental psychology and spousal power are reconfigured in a high-risk medical context. These shifts help explain why families tend to adopt more controlling, protective practices after transplantation to manage uncertainty and safeguard adherence.