Sieh Dominik Sebastian, Visser-Meily Johanna Maria Augusta, Meijer Anne Marie
Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Prinsengracht 130, 1018 VZ Amsterdam, The Netherlands.
J Child Fam Stud. 2013 Feb;22(2):209-218. doi: 10.1007/s10826-012-9570-8. Epub 2012 Feb 22.
Approximately 10% of children grow up with a parent who has been diagnosed with a chronic medical condition (CMC) and seem to be at risk for adjustment difficulties. We examined differences in behavioral, psychosocial and academic outcomes between 161 adolescents from 101 families with a chronically ill parent and 112 adolescents from 68 families with healthy parents, accounting for statistical dependence within siblings. Children between 10 and 20 years and their parents were visited at home and filled in questionnaires. Multilevel analyses showed that 20-60% of the variance in most adolescent outcomes was due to the family cluster effect, especially in internalizing problem behavior, caregiving variables and quality of parent attachment. Conversely, the variance in stress and coping variables and grade point average (GPA) was mainly due to individual characteristics. Adolescents with parents affected by CMC displayed more internalizing problems than the comparison group and scored higher on frequency of household chores, caregiving responsibilities, activity restrictions, isolation, daily hassles and stress. In addition, their grade point average was comparatively worse. No group differences in externalizing problems, coping skills and quality of parent attachment were found. In conclusion, the family cluster effect largely explains adolescent outcomes and should be accounted for. Adolescents with parents affected by CMC are subject to an increased risk for internalizing problems, adverse caregiving characteristics, daily hassles, stress and a low GPA. According to a family-centered approach, school counselors and health care practitioners should be alert to adjustment difficulties of children with a chronically ill parent.
大约10%的儿童在成长过程中有一位被诊断患有慢性疾病（CMC）的父母，他们似乎面临适应困难的风险。我们研究了来自101个有慢性病父母家庭的161名青少年与来自68个有健康父母家庭的112名青少年在行为、心理社会和学业成果方面的差异，同时考虑了兄弟姐妹之间的统计相关性。对10至20岁的儿童及其父母进行了家访并填写问卷。多层次分析表明，大多数青少年成果中20%至60%的方差归因于家庭集群效应，尤其是在内化问题行为、照顾变量和亲子依恋质量方面。相反，压力和应对变量以及平均绩点（GPA）的方差主要归因于个体特征。父母受CMC影响的青少年比对照组表现出更多的内化问题，在家务频率、照顾责任、活动限制、孤立、日常烦恼和压力方面得分更高。此外，他们的平均绩点相对较差。在外化问题、应对技能和亲子依恋质量方面未发现组间差异。总之，家庭集群效应在很大程度上解释了青少年的成果，应予以考虑。父母受CMC影响的青少年面临内化问题、不良照顾特征、日常烦恼、压力和低GPA的风险增加。根据以家庭为中心的方法，学校辅导员和医疗保健从业者应警惕有慢性病父母的儿童的适应困难。
