Resilience characteristics of families with a child with type 1 diabetes

Koegelenberg, Guzelle Joanita (2013-12)

Thesis (MA)-- Stellenbosch University, 2013.

Thesis

ENGLISH ABSTRACT: A chronic illness such as type 1 diabetes does not only have an impact on the individual’s physical and psychological well-being, but ultimately on the well-being of the family as a whole. The family typically fulfils the role of primary support structure for the diabetic child. Regardless of the physical and psychological challenges that form part of the illness, a large number of families are resilient. Families are able to adjust, adapt and cope adequately with a variety of life stressors. Consequently, this study aimed to identify and explore family resilience characteristics that are associated with family adaptation after the diagnosis of a chronic illness in a child. The Resiliency Model of Family Stress, Adjustment and Adaptation (McCubbin & McCubbin, 2001) served as theoretical framework for this study. Fifty-one primary caregivers represented families with a child with type 1 diabetes who was a patient at a big state hospital in the Western Cape, South Africa. The study used a mixed methods approach and it was expected from the participants to answer an open-ended question and complete four self-complete questionnaires. The dependent variable in the study is family adaptation, measured with the Family Attachment and Changeability Index 8 (FACI8) (McCubbin & McCubbin, 2001). Based on the theory and previous studies, the following independent variables were used as measures: family hardiness (The Family Hardiness Index (FHI)), family patterns of communication (Family Problem Solving and Communication Scale (FPSC)) and family time spent together, as well as routines followed together (Family Time and Routine Index (FTRI)). The results show that family resilience characteristics that are significantly correlated with family adaptation are affirming communication in the family; the family’s willingness to accept change as positive; and family time spent together and routines followed in the family. The most important resilience characteristic according to the qualitative data is the support and information received from the paediatric diabetes specialist at the hospital. The family’s religious beliefs, and support received from their church, also play a significant role in their adaptation. This study contributes to the increasing need for and value of positive psychology. The study also creates an opportunity to educate families and medical personnel on the importance of implementing resilience characteristics in families to ensure better adaptation. Recommendations for future studies on resilience in families with a child with type 1 diabetes are made.

AFRIKAANSE OPSOMMING: ’n Chroniese siekte soos tipe 1 diabetes het nie ’n enkelvoudige impak op die individu se fisiese en sielkundige welstand nie, maar uiteindelik ook op die gesin se welstand. Die gesin vervul tipies die rol van primêre ondersteuningsnetwerk vir die kind met diabetes. Ongeag die fisiese en sielkundige struikelblokke wat deel is van die siekte, bly ’n groot aantal gesinne steeds veerkragtig. Gesinne beskik oor die vermoë om verstellings te maak en aan te pas by ’n verskeidenheid van lewensstressors. Gevolglik het hierdie studie gepoog om gesinsveerkragtigheidskenmerke te identifiseer en te verken, nadat ’n kind met ’n chroniese siekte gediagnoseer is. Die Resiliency Model of Family Stress, Adjustment and Adaptation (McCubbin & McCubbin, 2001) het gedien as die teoretiese raamwerk vir hierdie studie. Eenen- vyftig primêre versorgers het hul gesinne in die studie verteenwoordig. In elk van die gesinne was daar ’n kind met tipe 1 diabetes wat ’n pasiënt was by ’n groot staatshospitaal in die Wes-Kaap, Suid-Afrika. Die studie het gebruik gemaak van ’n gemengde-metode benadering en het van die deelnemers verwag om ’n oopeinde-vraag te beantwoord, sowel as vier kwantitatiewe vraelyste te voltooi. Die afhanklike veranderlike in die studie was gesinsaanpassing, gemeet met die Family Attachment and Changeability Index 8 (FACI8) (McCubbin & McCubbin, 2001). Gebasseer op die teorie en die bevindinge van vorige studies is die volgende meetinstrumente gebruik om die onafhanklike veranderlikes mee te meet: die Family Hardiness Index, Family Problem Solving and Communication Scale, en die Family Time and Routine Index. Die kwantitatiewe resultate toon die volgende gesinsveerkragtigheidskenmerke: positiewe kommunikasie wat in die gesin beoefen word; die gesin se bereidwilligheid om verandering te aanvaar en dit as positief te beskou; en gesinstyd saam en gesinsroetines wat beoefen word. Die belangrikste gesinsveerkragtigheidskenmerke volgens die kwalitatiewe data is die ondersteuning en inligting verkry vanaf die pediatriese diabetes-spesialis, die gesin se geloof en die ondersteuning wat hulle van hulle kerk verkry het. Hierdie studie dra by tot die toenemende behoefte aan en waarde van positiewe sielkunde. Die studie skep ook die geleentheid om gesinne en hospitaalpersoneel in te lig oor die noodsaaklikheid van die implementering en ontwikkeling van gesinsveerkragtigheidskenmerke vir die beter aanpassing van gesinne. Ten slotte word aanbevelings vir toekomstige veerkragtigheidstudies in gesinne met ’n kind met tipe 1 diabetes gemaak.

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