Multiple in-depth interviews with fifteen Chinese families in Singapore were conducted to study family adaptation arising from the diagnosis of chronic childhood illnesses. Disclosure of distressful information was found to be selective. Keeping secrets within the immediate family (i.e., between parents and children, between husband and wife, and between the family and the wider community) were governed by factors related to the support and protection of the family unit. Motivations for keeping family secrets appeared to be in keeping with the behavioral rules of a collectivist culture, emphasizing saving "face," maintaining group harmony and hierarchical roles, and taking responsibility for mutual protection. Implications for practice in the health settings, policy issues (e.g., the right of the patient to knowledge about the illness), and intervention (e.g., the role of the social worker in facilitating open disclosure among family members to enhance family adjustments) are discussed.

Caregiving stress endures after transplantation. Professional intervention is needed to improve caregivers' quality of life and, consequently, that of transplant recipients as well.

Caregiving stress endures after transplantation. Professional intervention is needed to improve caregivers' quality of life and, consequently, that of transplant recipients as well.