Abstract
Objectives: To evaluate the level of parent-reported family resilience, parenting styles and psychosocial adjustment of children with chronic illness and to identify the relationships between family resilience, parenting styles and psychosocial adjustment in families with children with chronic illness.Methods: A cross-sectional study was conducted between June 2019 and August 2019. A total of 236 parents of children with chronic illness and 98 parents with healthy children were recruited from general hospitals by convenience sampling. A parent completed the Chinese Family Resilience Assessment Scale, the Parenting Rearing Patterns Questionnaire and the Strengths and Difficulties Questionnaire. Family resilience, parenting styles, and psychosocial adjustment of children with chronic illness were compared with those of healthy children. Structural Equation Modeling (SEM) was performed to explore the mediation effect of parenting styles between family resilience and psychosocial adjustment among children with chronic illness.Results: Parents of children with chronic illness reported lower level of family resilience and authoritative parenting, but more peer relationship problems compared to parents of healthy children. SEM showed that authoritative parenting fully mediated the relationship between family resilience and psychosocial adjustment of children with chronic illness.Conclusion: Childhood chronic illness reduces family resilience, authoritative parenting and children's psychosocial adjustment, but authoritative parenting mediated these effects, so authoritative parenting may be important for family resilience in families of children with chronic illness. Pediatric clinicians and nurses should provide family-centered interventions, as well as parenting training, to improve children's psychosocial outcomes.
Highlights
It has been reported that 10–20% of children in China suffered from chronic illness, and the prevalence of childhood chronic illness will reach to 29.4‰ by 2020 [1]
The present study found that parents of children with chronic illness reported lower level of family resilience compared to parents of healthy children
Parents of children with chronic illness reported lower scores on the authoritative parenting compared to their counterparts in present study, which partially support the result of previous study that parents of children with chronic illness tended to be over-involved in children’s lives, and their children were more likely to depend on their parents without autonomy [49]
Summary
It has been reported that 10–20% of children in China suffered from chronic illness, and the prevalence of childhood chronic illness will reach to 29.4‰ by 2020 [1]. Chronic illness is a physical or mental condition, which is defined as a process of ‘long duration and generally slow progression that requires ongoing management over a period of years or decades’ [2].Such conditions include diabetes, chronic kidney disease, congenital heart disease, bone/joint disorders, genetic disorders and et al, which are rarely cured completely [2, 3], and are severe challenges to the children and their families [4]. Despite the above mentioned negative impacts of childhood chronic illness, there is evidence that some families with children with chronic illness, including mental, emotional, and behavioral disorders [11], pediatric asthma [12], type 1 diabetes [13] and pediatric cancer [14] demonstrate family strength to positively cope with the challenge of chronic illness [15, 16], and take advantage of their stressful experiences to develop stronger relationships, better family cohesion, and positive family belief systems [17, 18]
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