COPING STRATEGIES AND FAMILY FUNCTIONING OF CHILDREN WITH INFLAMMATORY BOWEL DISEASE AND THEIR FAMILIES

Abstract

Introduction: Inflammatory Bowel Disease (IBD) can have an enormous effect on the quality of life (QOL) of affected individuals and their families. Little is known about the effect of IBD on family functioning, the coping strategies employed and the effect on QOL. Aims: To evaluate the ways in which children with IBD and their parents cope with their disease and to assess their family functioning. Methods: 90 children (51 boys) with IBD (58 Crohns disease, 12 ulcerative colitis, 20 indeterminate colitis) aged 8-17 yrs completed the Kidcope questionnaire. 87 parents completed the Ways of Coping scale and 84 completed the McMaster Family Assessment Device. Results: Children with IBD used cognitive restructuring as the principle way of coping (boys(b) 86%, girls(g) 85%). Other popular coping strategies included wishful thinking (b 84%, g 82%), distraction (b 73%, g 81%) and seeking social support (b 71%, g 77%). When evaluated by age (young (y) 8-12 yrs, old (o) 13+ yrs) cognitive restructuring (positive reinterpretation of events) was used by 88% (o) and 83% (y), wishful thinking was used by 78% (o) and 90% (y) and distraction techniques were used by 72% (o) and 83% (y). Adolescents were more likely to accept their disease with 88% adopting resignation compared to only 23% of the young group (z = −6.7, p = 0.001). Parents engaged in problem solving strategies (78%), seeking social support (77%) and self control (49%) as principle ways of dealing with their childs IBD. Mean scores for domains of family functioning were generally “healthy” and similar to previous studies of “normal” families. Summary: Children with IBD and their parents use many different coping strategies. These are similar in boys and girls and at different ages except that older children were more likely to be resigned to their illness than younger children. Family functioning appears to be healthy and similar to that in families who do not have a chronically ill child. Conclusion: More research is needed to determine whether the QOL of children with IBD can be improved by teaching positive coping strategies.