Kaplan D M, Grobstein R, Smith A
Health Soc Work. 1976 Aug;1(3):71-82. doi: 10.1093/hsw/1.3.71.
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.
（1）开发简单、客观的方法来描述这种严重疾病对家庭的巨大影响；（2）检验在诊断后立即表现出的家庭应对反应在预测孩子死亡数月后所测量的压力结果方面的价值。研究结果表明，大多数有重病患儿的家庭在孩子死后三个月仍被这场危机压得喘不过气来。那时，这些家庭的效能似乎已大幅降低，因为其成员遭受了多种影响他们健康和正常功能的问题。证据表明，疾病对参与调查家庭的影响存在显著差异，这与他们对诊断的初始应对反应的效能相符。在后续调查中，适应性应对家庭的结果远比适应不良应对家庭要好。研究结果支持这样一种观点，即干预的最佳时期是在危机的早期急性阶段，即在确诊后立即进行，此时家庭正在做出与适应不良应对和不良压力结果相关的决策。
