PhD in Nursing Science Program

Mothers And Adolescents: A Dyadic Perspective on Family Functioning with Maternal Chronic Illness

Dissertation under the direction of Professor Kenneth Wallston

There is considerable research exploring the impact of a child's chronic illness on the family and its functioning. However, a gap in the literature exists in the area of family functioning when a parent is chronically ill, especially from the adolescent's perspective. This research was undertaken to: 1) examine family functioning with mother's chronic illness as compared with a no-illness group from the perspective of mothers and their adolescents; and 2) determine mothers' and adolescents' perceptions of family functioning when reporting by themselves as compared to reporting together as a single unit.

There were 212 participants: 106 adolescents and their mothers who have either a rheumatic disease (50 pairs) or no illness (56 pairs). A framework based on family development, systems, and communication theories provided the conceptual basis for this study. Data were collected using self-report instruments measuring the constructs of global family functioning and its dimensions: relationships, communication, flexibility, and social support. Mothers and adolescents completed the measures independently and together as a dyadic unit, then evaluated the process of reporting together.

Data were analyzed using independent and paired t-tests and multifactorial ANOVA. When controlling for SES differences between groups, there appeared to be no detrimental effect on family functioning when the mother has a chronic rheumatic disease. Overall, these dyads perceived their family functioning more similarly than mothers and adolescents in the no-illness control group. Adolescents and their mothers with a chronic illness may have developed a sense of coherence, and thus, are tuned in to each others' feelings and share similar perspectives.

A serendipitous occurrence was the positive effect that was achieved when mothers and their adolescents filled out the questionnaire together. This together-method served as an intervention which facilitated communication and allowed dyads to gain insight into each other's thoughts and feelings. It encouraged discussions about family issues, especially how they perceive their family functioning.

This study has furthered our understanding of mothers' and adolescents' perceptions of family functioning with chronic illness in the mother as compared to no illness in the family. In addition, it has advanced our knowledge of methodological issues facing researchers who study chronic illness within the context of the family with adolescents.