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Parental risk and resistance factors among children with juvenile rheumatic disease: a four-year predictive study
C Timko1, M Baumgartner, R H Moos
1Department of Veterans Affairs and Stanford University Medical Centers, Palo Alto, California.
Insights
Children's juvenile rheumatic disease outcomes are predicted by baseline functioning and parental factors. Parental strain and mood impact child adjustment, with fathers' factors offering unique insights into long-term disease adaptation.
Area of Science:
- Pediatric Rheumatology
- Child Psychology
- Family Studies
Background:
- Juvenile rheumatic diseases (JRD) present significant challenges to children's physical and psychosocial well-being.
- Longitudinal studies are crucial for understanding the trajectory of JRD and identifying predictive factors for patient outcomes.
- Parental influences, including risk and resistance factors, are increasingly recognized as significant moderators of child health outcomes.
Purpose of the Study:
- To investigate the predictive power of baseline functioning and parental risk/resistance factors on disease-related and psychosocial functioning in children with JRD over a 4-year period.
- To determine the independent contribution of fathers' risk and resistance factors in predicting patient adaptation, beyond maternal factors.
- To identify specific parental factors (e.g., strain, mood, social functioning, drinking problems) associated with children's adjustment in the context of JRD.
Main Methods:
- Longitudinal study design involving 172 children diagnosed with juvenile rheumatic disease.
- Assessment of baseline functioning (disease-related and psychosocial) and parental risk and resistance factors.
- Statistical analysis to predict functioning 4 years later, controlling for patient age and baseline functioning, and examining maternal and paternal contributions.
Main Results:
- Poorer baseline functioning was a significant predictor of poorer functional and psychosocial outcomes at the 4-year follow-up.
- Parental risk factors, including maternal and paternal personal strain, depressed mood, and paternal drinking problems, were associated with poorer patient adjustment.
- Positive parental social functioning (both mothers and fathers) was linked to better patient adjustment.
- Fathers' risk and resistance factors provided independent predictive value for patient outcomes, beyond maternal factors.
Conclusions:
- Baseline functioning is a critical determinant of long-term outcomes in children with juvenile rheumatic disease.
- Parental psychological distress and substance use represent significant risk factors for children's adjustment, while positive social functioning acts as a protective factor.
- Fathers' experiences and characteristics play a distinct and important role in predicting their children's adaptation to juvenile rheumatic disease, necessitating consideration in comprehensive care strategies.
Abstract:
Examined the extent to which baseline functioning and parental risk and resistance factors predicted disease-related (functional disability and pain) and psychosocial functioning (social competence and behavior problems) 4 years later among 172 children with juvenile rheumatic disease. The study also examined the extent to which fathers' risk and resistance factors explained patients' adaptation, above and beyond maternal factors. Poorer baseline functioning was a strong risk factor that predicted poorer functioning 4 years later. In addition, parental risk and resistance factors at baseline predicted patients' adjustment after patients' age and baseline functioning were controlled. Mothers' and fathers' personal strain and depressed mood, and fathers' drinking problems, were associated with poorer patient adjustment; mothers' and fathers' social functioning appeared to aid patients' adjustment. Fathers' risk and resistance factors contributed independently from those of mother, to predict patients' outcome.