Family adaptation to the child with cystic fibrosis

McCollum, Audrey T.; Gibson, Lewis E.

doi:10.1016/s0022-3476(70)80196-2

Cited by 96 publications

(25 citation statements)

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“…Behavioral eating problems during childhood and adolescents have been reported. [23][24][25][26] One recent study indicated the potentially important contribution of body image concerns to inadequate nutritional status in girls. 27 This study compared body esteem, eating attitudes, and daily caloric intake of 15 females with CF (8 -15 years of age) and 15 age-matched healthy controls.…”

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confidence: 99%

Body Image and Dieting Behavior in Cystic Fibrosis

Truby

Paxton

2001

Pediatrics

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ABSTRACT. Objective. To examine the relationship between pulmonary function, nutritional status, body image, and eating attitudes in children with cystic fibrosis (CF) compared with healthy controls.Method. Seventy-six children with CF (39 girls) and 153 healthy control children (82 girls) were recruited. All children were between 7 and 12 years of age. After being weighed and measured, participants undertook a structured 1-to-1 interview. Four measures were used to assess body image: body size (perception and satisfaction) were ascertained using the Children's Body Image Scale (CBIS), which uses photographs of children of various body mass index (BMI) representative of the range of BMI percentiles for children 7 to 12 years of age. Body size satisfaction was measured by the response to the questions, "Do you think your body is 1) much too thin, 2) too thin, 3) just right, 4) too fat, and 5) much too fat?" Body weight satisfaction was measured by the question, "Would you like your body to be 1) much thinner, 2) a little bit thinner, 3) stay the same, 4) a little bit fatter, and 5) much fatter?" Global self-esteem was measured using the children's version of the Rosenberg Self-Esteem Scale and Body Esteem Scale using a 24-item scale. Dieting behavior was measured by asking directly about previous weight control behaviors, use of the Dutch Eating Behavior-Restraint Scale (DEBQ-R), and, in children who acknowledged previous dieting behavior, the Children's Eating Attitude Test (ChEAT) was additionally administered.Results. Both girls and boys with CF had significantly reduced BMI percentiles compared with control children. Boys with CF did not have a significantly different BMI compared with girls with CF. There were significant positive correlations between forced expiratory volume in 1 second (FEV 1 ) (% of predicted) and BMI percentile in girls (r ‫؍‬ .35) and boys (r ‫؍‬ .50) with CF. Body image perceptions in boys and girls with CF were examined in relation to the healthy control group using 2 (CF and control groups) by 2 (male and female) analysis of variance. The interaction effect was examined to explore the prediction that girls compared with boys with CF would have greater acceptance of their body shape and less desire to become larger. There were no differences between groups or sex in body esteem. On the CBIS body dissatisfaction score, children with CF were significantly more likely to perceive their ideal body size as a little larger than their current size while control children desired a smaller body size than their current size. CF children had a significantly lower mean score for body size satisfaction (an item assessing perception being too thin) and a significantly higher mean score on body weight satisfaction. There was a significant main effect of gender for only 1 measure, difference between the CBIS body dissatisfaction score, with girls being more likely to nominate a smaller ideal than their current figure. There were no significant interaction effects.Of children with CF and a low BMI (<1...

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confidence: 99%

Body Image and Dieting Behavior in Cystic Fibrosis

Truby

Paxton

2001

Pediatrics

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“…Lask and Fosson ( 1989) asserted that adverse psychological consequences of an illness can play a key role in perpetuation or aggravation of the illness while, in contrast, optimal coping is likely to lead to better health care and outcome. A number of studies suggest that psychological and social processes within the family are important for understanding clinical outcomes in cystic fibrosis (Cowen et al, 1984;Kellerman et al, 1980;Mador and Smith, 1988;McCollum and Gibson, 1970;Patterson et al, 1990;Patterson et al, 1993;Pumariega et al, 1990;Steinhausen and Schindler, 1981;Tavormina et al, 1978). Hofer (1982) demonstrated that psychological, social and biological processes do not necessarily follow parallel courses.…”

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confidence: 99%

Homeostatic interactions: a longitudinal study of biological, psychosocial and family variables in children with cystic fibrosis

Wilson

Fosson

Kanga

et al. 1996

Journal of Family Therapy

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A two-year longitudinal study of thirty-five children used data gathered from pulmonary function tests, clinical measurements and standardized tests of depression, self-esteem and family environment to illustrate homeostatic interactions among biological and psychosocial adaptation to cystic fibrosis. Despite physical deterioration over the course of the study, children with cystic fibrosis reported lower depression and higher self-esteem than population norms, and improvements in psychological functioning. Declinr in biological indicators of health was associated with increases on an index based on Family Environmental Scales (FES), subscales of cohesion, expressiveness and organization, and maintenance of high self-esteem and low depression. Presence of additional major life stressors was associated with deterioration in pulmonary function, higher levels of depression and poorer scores on the FES. 'These findings suggest that homeostatic interactions between children's health status and family functioning may moderate the physical and psychological sequelae of cystic fibrosis.

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“…Reality stressors include the burdens of an intense daily management regimen of chest physiotherapy, diet, and medications; inability to obtain even routine child care (much less respite care); financial burdens from the cost of treatment; lack of mobility in parental occupations and careers due to their child's uninsurability; and social ostracism as a response from family and friends (Allan, Townley, & Phelan, 1974;Anderson, 1960;McCollum & Gibson, 1970). Psychological stressors include a process of anticipatory grief associated with a chronic but eventually fatal illness; guilt, fear, and displaced anger associated with the genetic nature of the illness; and the often unacceptable resentment of the physical and psychological burdens inherent in caring for the child.…”

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confidence: 99%

“…These stressors often result in decreased marital communication and increased conflict. Siblings also struggle with issues such as survivor guilt and resentment of the attention and resources allocated to the CF child (Allan et al, 1974;McCollum & Gibson, 1970;McCrae, Cull, Burton, & Dodge, 1973).…”

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confidence: 99%