Predicting the impact of severe illness in families.

The goals of this survey of families with a leukemic child were (1) to develop simple, objective methods of describing the overwhelming impact of this serious illness on families, and (2) to test the value of family coping responses that manifested themselves immediately after the diagnosis in predicting stress outcome as measured a few months after the death of the child. The findings indicate that most of the families with a seriously ill child were still overwhelmed by this crisis three months postmortem. The effectiveness of these families appeared, at that time, to have been substantially reduced in that their members suffered from multiple problems affecting their health and normal functioning. The evidence indicates substantial differences in the impact of the illness on the survey families, in accord with the effectiveness of their initial coping response to the diagnosis. Adaptive coping families were far superior in outcome than were maladaptive coping families in the follow-up survey. The study findings support the view that the optimal period for intervention is during the early, acute stage of the crisis, immediately following the confirmation of the diagnosis, when the family is making those decisions associated with maladaptive coping and poor stress outcome.