Divorce and Childhood Chronic Illness

Abstract

Divorced parents face distinct challenges in providing care for chronically ill children. Children's residence in two households necessitates the development of family-specific strategies to ensure coparents' supervision of regimen adherence and the management of children's health care. Utilizing a risk and resilience perspective, a grounded theory study was conducted with 14 divorced parents of children with chronic illnesses. The importance of trust, gender, and relationships with third-party care providers emerged as key themes related to the development of effective coparenting relationships for maintaining children's health. Divorced parents were best able to support the management of their children's chronic conditions when care providers operated as neutral third parties and intermediaries. Collaborative family care may require health care practitioners to avoid being drawn into contentious inter-parental conflicts.

Family-Centered Care and Positive Developmental Outcomes for Youth With Special Health Care Needs: Variations Across Family Structures

“…As a result, doctors and nurses may lack the resources, willingness, or awareness to provide effective FCC in the context of the specific challenges that can occur in diverse family systems. For example, it may be difficult to implement FCC when families have ongoing conflicts and disagreements, as can be common in postdivorce or nonresidential families (Russell et al, 2016). Stigma regarding diverse family structures may also affect the implementation of FCC.…”

“…Family nurses are well positioned to lead these adjustments by recognizing the need to reach out to the entire family, not just a primary caretaker. Inviting secondary and tertiary caretakers to family conferences, who may live in a child's household only part-time, or even in an entirely separate household, may be critical to ensuring a child is receiving the care and responsiveness he or she needs (Russell et al, 2016). Family nursing tools such as the 15-min family interview (Wright & Leahey, 2013), nurse-family meetings (Nelms & Eggenberger, 2010), or genograms and ecomaps that can be used to build and recognize family capacity and resources could be especially valuable in working with structurally diverse families (Rempel, Neufeld, & Kushner, 2007).…”

Capturing Family Complexity in Family Nursing Research and Practice

“…In this example, if Tina and Jane were the typical attendees at Jane's medical appointments, the construction of a genogram would allow for the identification of a divorced father (Issac), stepparent (Frank), or older half-sibling (Rita) whom may provide care for Jane or have moments in time when they are the only individual available to handle an acute emergency (such as the need for an inhaler or epinephrine injection). Those same family members, however, may be unlikely to voluntarily arrive at the same medical appointment and/or receive important health or condition-related education if they are not actively sought out by health care providers (Russell et al, 2016). Some individuals may still fail to include some aspects of family complexity when constructing a genogram, either due to forgetfulness or presumptions a questioner would not be as interested in such relationships; however, careful questioning and repeated inquiry can help overcome such challenges (Sanner et al, 2020).…”

“…The main drawback of working with individuals while attempting to attend to wider aspects of family is the increased propensity for information received from patients to be biased by their own perceptions or experiences (Rosenman et al, 2011). In addition, information meant to be communicated to family members may be misinterpreted, forgotten, or ignored (Marcussen et al, 2019;Russell et al, 2016). Creatively coordinating and communicating with families may be particularly important when the family caregiver who shows up in the office has a strained or conflictual relationship with other important caregivers for a patient (such as may be common in postdivorce families; Marcussen et al, 2019;Russell et al, 2016).…”

Expand your HEADS, follow the THRxEADS!

“…Parental involvement can have an important impact on the adolescent's physical and psychological well-being. While having to rely on parents for various aspects of care may be perceived as burdensome for some, spending time with parents in the context of a chronic condition can provide an opportunity to strengthen parent-teen relationships (8).…”