The relative contribution to illness stress and family system variables to family quality of life during early chronic illness.

摘要

This study examined the nature of illness stress in the family subsequent to diagnosis and the contribution of illness stress and family system variables to family quality of life. An illness severity rating was developed to help estimate illness stress.The sample consisted of 78 families recruited in outpatient clinics at the time of the initial diagnosis of a chronic illness in the family. Data collection was by mailed survey. Families were surveyed using standard measures of ongoing family strain, illness demands, family sense of coherence, family system balance, and family quality of life. Using multiple regression, the study determined illness stress, comprised of five factors, had an important influence on family well-being post diagnosis.The study also confirmed a Family Illness Stress Model, modified from Hill's ABCX Model. Family sense of coherence, illness stress, family system balance, employment status, length of relationship, and income accounted for 57.6% of the variance in family quality of life. The family system variables mediated the influence of illness stress on family quality of life. The family shared belief about managing and giving meaning to family life was the single most powerful predictor.Four of the six study hypotheses were confirmed. As predicted, illness stress was negatively related to family quality of life and family sense of coherence, and family system balance and family sense of coherence were positively related to family quality of life. Although, it was predicted there would be less illness stress in families and greater family sense of coherence with a more balanced system, this was not confirmed. The Illness Severity Rating provided a descriptive profile of patient illness and validated psychosocial/physical interplay of illness across differing diagnoses.Recommendations for future studies include exploring the Family Illness Stress Model with different illness conditions and family system factors as family trait and state variables, contributing to family outcomes of illness. Further psychometric testing of the illness severity rating is warranted.Results of this study support inclusion of family factors in estimates of health care outcomes used in the future to determine levels of care for chronic illness.