International Journal of Behavioral Medicine

, Volume 21, Issue 2, pp 211–220 | Cite as

Caregiver Coping, Mental Health and Child Problem Behaviours in Cystic Fibrosis: A Cross-Sectional Study

  • Jane SheehanEmail author
  • Harriet Hiscock
  • John Massie
  • Adam Jaffe
  • Margaret Hay



In children with cystic fibrosis (CF) sleep, eating/mealtime, physiotherapy adherence and internalising problems are common. Caregivers also often report elevated depression, anxiety and stress symptoms.


To identify, through principal components analysis (PCA), coping strategies used by Australian caregivers of children with CF and to assess the relationship between the derived coping components, caregiver mental health symptoms and child treatment related and non-treatment related problem behaviours.


One hundred and two caregivers of children aged 3 to 8 years from three CF clinic sites in Australia, completed self-report questionnaires about their coping and mental health and reported on their child’s sleep, eating/mealtime, treatment adherence and internalising and externalising behaviours.


Two caregiver coping components were derived from the PCA: labelled ‘proactive’ and ‘avoidant’ coping. ‘Avoidant’ coping correlated moderately with caregiver depression (0.52), anxiety (0.57) and stress (0.55). For each unit increase in caregiver use of avoidant coping strategies, the odds of frequent child eating/mealtime behaviour problems increased by 1.3 (adjusted 95 % CI 1.0 to 1.6, p = .03) as did the odds of children experiencing borderline/clinical internalising behaviour problems (adjusted 95 % CI 1.1 to 1.7, p = .01). Proactive coping strategies were not associated with reduced odds of any child problem behaviours.


Avoidant coping strategies correlated with caregiver mental health and child problem behaviours. Intervening with caregiver coping may be a way to improve both caregiver mental health and child problem behaviours in pre-school and early school age children with CF.


Cystic fibrosis Child behaviour Caregiver coping Mental health Principal components analysis 



We wish to thank the families who took the time to be involved in this research. Jane Sheehan, Harriet Hiscock, and John Massie, were supported by the Victorian Government’s Operational Infrastructure Support Program.


This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors, and was jointly supported by the Centre for Community Child Health, Royal Children’s Hospital, Parkville, Victoria, Australia and the School of Psychology and Psychiatry, Monash University, Clayton, Australia. Harriet Hiscock’s postdoctoral position is funded by NHMRC Population Health Capacity Building Grant 436914 and Career Development Award 607351.

Conflict of interest

The authors declare they have no competing interests in this research or its outcomes, or any relevant affiliations.

Author contributions

The project was conceived, initiated and supervised by JS, MH and HH. JS led the project and the paper, supervised by MH and HH, with all authors providing critical contributions to reviewing, editing and approving its final version. JS conducted the analyses with the supervision of MH and HH. JS is the guarantor and accepts full responsibility for the conduct of the study, had access to the data, and controlled the decision to publish.


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Copyright information

© International Society of Behavioral Medicine 2013

Authors and Affiliations

  • Jane Sheehan
    • 3
    • 2
    • 1
    Email author
  • Harriet Hiscock
    • 1
    • 2
    • 4
  • John Massie
    • 2
    • 4
    • 5
  • Adam Jaffe
    • 6
    • 7
  • Margaret Hay
    • 3
  1. 1.Centre for Community Child HealthMurdoch Childrens Research Insitute, Royal Children’s HospitalParkville VictoriaAustralia
  2. 2.Murdoch Childrens Research Institute, Royal Children’s HospitalParkville, VictoriaAustralia
  3. 3.Health Professions Education & Educational Research (HealthPEER), Behavioural Medicine UnitMonash UniversityClayton, VictoriaAustralia
  4. 4.Department of PaediatricsThe University of MelbourneParkville, VictoriaAustralia
  5. 5.Department of Respiratory MedicineRoyal Children’s HospitalParkville, VictoriaAustralia
  6. 6.Department of Respiratory MedicineSydney Children’s HospitalRandwick, New South WalesAustralia
  7. 7.School of Womens’ and Children’s HealthUniversity of New South WalesNew South WalesAustralia

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