1Department Nursing, the College of Medicine, Chung-Nam National University, Korea. 2Department Nursing, the College of Medicine, Hanyang Universit, Korea.
Abstract
As a family respond to any stressful situation as a whole system, cancer diagnosis of a child, as a serious life event, could be emotional shock to destroy homeostasis of the family system. A family has a resilient capacity to adjust and adapt to stressful events. Previous studies have been focused on family stress and adaptation, but little attention has been given to family value as one of resilient factors. The data for model testing were collected from July 18, 2000 to August 30, 2000 and the analysis included 309 parents of children who are diagnosed as cancer, 18 or less years of age, and treated either hospitalized or at the outpatient clinics. The data analysis utilized SAS 6.12 and LISREL 8 for descriptive statistics, correlation, cluster analysis, factor analysis, and LISREL. The study findings are as follows. 1) Monthly income ( gamma =-0.28, t=-5.81) was the most important factor to explain family strain along with family support ( gamma =-0.11, t=-2.43), severity of children's illness ( gamma =0.26, t=5.22), and family stressor ( gamma =0.22, t=4.62). All of these factors together explained 40% of variance in family strain. 2) Among general family value, the relationship with the parents ( gamma =0.28, t=4.89) and relationship with the children ( gamma =0.20, t=3.60) showed positive effects to family value for cancer children, while relationship with the spouse ( gamma =-0.19, t=-3.22) and the age of the cancer children ( gamma =-0.11, t=-2.21) showed negative effects. These predictors together explained 22% of variance in family value for cancer children. 3)Family hardiness was explained mostly by family strain ( gamma =-0.53, t=-8.65) along with direct negative effects of family persistency and indirect negative effects of severity of children's illness, family stressor, relationship with the spouse, and the children's age. Family value for cancer children was the most important predictor with positive effect ( gamma =0.44, t=6.76) along with indirect effects of monthly income, relationship with the parents, relationship with the children, support from family and significant others, and confidence with the health professionals. 51% of variance in family hardiness was explained by all of these predictors.
4)The most important predictor for family adaptation was family stressor ( gamma =-0.50, t=-6.85) with direct and indirect negative effects along with the severity of children's illness ( gamma =-0.27, t=-5.21). However, family value for cancer children showed compromised total effect ( gamma =-0.13, t=-1.99) with negative direct effects ( gamma =-0.28, t=-3.43) and positive indirect effects ( gamma =0.14, t=3.01). Similarly, confidence with the health professionals also showed compromised total effect ( gamma =0.09, t=1.99) with positive direct effects and negative indirect effects. Family hardiness showed the biggest positive direct effects while other factors such as monthly income, family stressor, family persistence, support of family and significant others, relationship with the parents, relationship with the children, and relationship with the spouse, and children's age showed indirect effects only. 39% of variance in family adaptation was explained by all of these predictors.
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