Abstract
BackgroundSevere illness can disrupt family life, cause family dysfunction, strain resources, and cause caregiver burden. The family's ability to cope with crises depends on their resources. This study sought to assess families of children with cancer in terms of family function-dysfunction, family caregiver strain and the adequacy of family resources using a new family resources assessment instrument.MethodsThis is a cross-sectional study involving 90 Filipino family caregivers of children undergoing cancer treatment. This used a self-administered questionnaire composed of a new 12-item family resources questionnaire (SCREEM-RES) based on the SCREEM method of analysis, Family APGAR to assess family function-dysfunction; and Modified Caregiver Strain Index to assess strain in caring for the patient.ResultsMore than half of families were either moderately or severely dysfunctional. Close to half of caregivers were either predisposed to strain or experienced severe strain, majority disclosed that their families have inadequate economic resources; many also report inaccessibility to medical help in the community and insufficient educational resources to understand and care for their patients. Resources most often reported as adequate were: family's faith and religion; help from within the family and from health providers. SCREEM-RES showed to be reliable with Cronbach's alpha of 0.80. There is good inter-item correlation between items in each domain: 0.24-0.70. Internal consistency reliability for each domain was also good: 0.40-0.92. Using 2-point scoring system, Cronbach's alpha were slightly lower: full scale (0.70) and for each domain 0.26-.82. Results showed evidence of association between family resources and family function based on the family APGAR but none between family resources and caregiver strain and between family function and caregiver strain.ConclusionMany Filipino families of children with cancer have inadequate resources, especially economic; and are moderately or severely dysfunctional. Many caregivers are predisposed to caregiver strain or are already experiencing severe strain. To provide appropriate care for these families, physicians should regularly assess family function, resources and strain experienced by caregivers. The SCREEM-RES questionnaire used in this study is a helpful and reliable instrument to assess adequacy of family resources.
Highlights
Severe illness can disrupt family life, cause family dysfunction, strain resources, and cause caregiver burden
The specific objectives of the study were: 1) to determine family function using the Filipino Family APGAR; 2) to measure the family caregiver strain utilizing the Modified Caregiver Strain Index; 3) to evaluate family resources using a new questionnaire based on the six domains of the SCREEM method of analysis- social, cultural, religious, economic, education and medical; 3) to determine the relationship between family resources, family function and caregiver strain; and 4) to determine the reliability of the new family resources questionnaire in terms of internal consistency among pediatric cancer patients
According to Smilkstein’s cycle of family function [13], families faced with stressful life events may experience disequilibrium and their ability to recover from this is determined by the availability of family resources; inadequate resources would lead to terminal disequilibrium and adequate resources would direct them into functional equilibrium
Summary
Severe illness can disrupt family life, cause family dysfunction, strain resources, and cause caregiver burden. The family’s ability to cope with crises depends on their resources. This study sought to assess families of children with cancer in terms of family function-dysfunction, family caregiver strain and the adequacy of family resources using a new family resources assessment instrument. The diagnosis of cancer in a child can send a family into crisis. It disrupts the child’s life but the family’s life as well - as family members try to adjust their roles, interactive patterns and relationships inside and outside of the family. The family’s ability to cope with a medical crisis such as cancer in a child depends on their resources. In the Philippines, many families may lack financial and other resources to deal with childhood cancer
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