Family functioning and associated factors in families of children and adolescents with chronic illness at King Chulalongkorn Memorial Hospital

Abstract

Background: Chronic illnesses have a serious effect on the physical and mental health of the children and their families. Previous studies showed that families of children with chronic illnesses have a lower family functioning score. Their parents suffer more stress than those of healthy children. Diabetes and obesity are mainstay chronic illnesses with high prevalence and is a threat to the healthcare system of Thailand.

Objective: To study family functions and its associated factors in families of children or adolescents with chronic illnesses.

Methods: This is a cross-sectional descriptive study performed on parents of children and adolescences with Type I and II diabetes and obesity with aged 20 - 60 years and with 6 months of care or more that had been receiving services at diabetes and obesity clinic of King Chulalongkorn Memorial Hospital between February 1 to September 31, 2018. The questionnaire consisted of 3 part: 1) Personal information and factors that are associated with patient care; 2) Chulalongkorn Family Inventory (CFI); and 3) Thai hospital anxiety and depression scale (Thai HADS). Descriptive analysis including frequencies, percentage, mean, standard deviation of family function was analyzed using an independent t - test, one-way ANOVA and Pearson correlation.

Results: There were 108 parents of children and adolescences with Type I or II diabetes or obesity; 79.6% of them are mothers. The duration of patient care ranges from 6 months to 5 years. CFI is at a mean of 1.8  0.4 which is a slightly good score. There was no depression or anxiety found in 75.9% of these parents. The duration of patient care had a significant association with the roles (P = 0.017), affective responsiveness (P = 0.036). Depression also had a positive association with problem solving (r = 0.359), communication (r = 0.295), affective involvement (r = 0.212), role (r = 0.297), general family function (r = 0.310) and overall family functions (r = 0.331). Anxiety has a positive association with problem solving (r = 0.372), communication (r = 0.377), affective responsiveness (r = 0.288), affective involvement (r = 0.264), role (r = 0.295), general family function (r = 0.392) and overall family function (r = 0.410).

Conclusion: Family functioning in families of children and adolescents with chronic illnesses is generally slightly good. Associated factors are the duration of patient care and types of chronic illnesses, both of which are associated with family functioning. Emotional factors including depression and anxiety also have a correlation with family functioning. Awareness of the parent’s family functioning and emotional conditions is important.