Family Functioning and the Well‐Being of Children With Chronic Conditions: A Meta‐Analysis

Abstract

For children with chronic conditions, well-being is closely related to how well their families function. Most prior research syntheses on family functioning and child well-being have focused on children with a single condition, thereby limiting the potential to aggregate and build on what is known across conditions. To address this challenge, research reports were reviewed and meta-analyses conducted of findings on the relationship between family functioning and child well-being across a range of chronic physical conditions. The sample was derived from a larger systematic review study that included 1,028 reports published between January 1, 2000 and March 31, 2014. The current review includes 53 studies in which a relationship between family functioning and child well-being was analyzed using one of four family measures: Family Adaptability and Cohesion Evaluation Scales, Family Environment Scale, Family Relationship Index, or Family Assessment Device. Most studies were cross-sectional and observational (n = 43, 81%). The most frequently studied conditions were diabetes, cancer, sickle cell disease, and asthma. In 37 studies, findings were sufficiently comparable to conduct meta-analyses. Significant correlations were identified between children's psychological health and seven of nine dimensions of family functioning. Significant correlations also were found between dimensions of family functioning and children's problem behaviors, social competence, quality of life, and, to a lesser extent, adherence and physical health. Of the family dimensions, cohesion and conflict were associated most strongly with child outcomes. Understanding the specific family variables, such as conflict, linked to varied child outcomes is key for intervention development. © 2016 Wiley Periodicals, Inc.

Parents of children referred to a sleep laboratory for disordered breathing reported anxiety, daytime sleepiness and poor sleep quality

“…These results depended on the type of disorder the child had. Indeed, in the above meta-analysis, the most common diseases were different to those in the present study and were mainly diabetes, cancer, sickle cell disease and asthma (26). This may explain why only 6% of the parents in the present study showed complex familial cohesion, suggesting that most of them were able to adapt to, and cope with, the disease that their child had.…”

“…For children with chronic conditions, well‐being is closely related to how well their families function. A meta‐analysis of 53 studies published between 2000 and 2014 revealed significant correlations between dimensions of family functioning and children's problem behaviours, social competence, quality of life, and, to a lesser extent, adherence and physical health . These results depended on the type of disorder the child had.…”

“I'm not what I used to be”: A qualitative study exploring how young people experience being diagnosed with a chronic illness

“…Over recent decades, the number of children living with a chronic illness has increased significantly with an estimated 12% of young people aged 10–19 years having a long‐term health condition (DH, ; Leeman et al, ). However, they may experience poorer psychosocial and educational outcomes when compared with their healthy peers (Champaloux & Young, ; Lum et al, ; Nylander, Seidel, & Tindberg, ).…”

Sleep problems in Korean children with Down syndrome and parental quality of life

“…This is surprising given the research demonstrating the critical role families play in the lives of children, especially children with chronic health conditions and developmental disabilities (Leeman et al . ). Meltzer and Montgomery‐Downs () have argued that sleep problems in children cannot be understood in isolation; rather, they need to be viewed within a broader family context, as family systems are dynamic.…”