Advertisement

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
Article

Abstract

Background

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.

Purpose

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.

Method

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.

Results

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.

Conclusions

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.

Keywords

Cystic fibrosis Child behaviour Caregiver coping Mental health Principal components analysis 

Notes

Acknowledgements

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.

Funding

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.

References

  1. 1.
    Massie RJ, Olsen M, Glazner J, Robertson CF, Francis I. Newborn screening for cystic fibrosis in Victoria: 10 years’ experience (1989–1998). Med J Aust. 2000;172(12):584–7.PubMedGoogle Scholar
  2. 2.
    O’Sullivan BP, Freedman SD. Cystic fibrosis. Lancet. 2009;373(9678):1891–904.PubMedCrossRefGoogle Scholar
  3. 3.
    Hodgkinson R, Lester H. Stresses and coping strategies of mothers living with a child with cystic fibrosis: implications for nursing professionals. J Adv Nurs. 2002;39(4):377–83.PubMedCrossRefGoogle Scholar
  4. 4.
    Patterson JM, Budd J, Goetz D, Warwick WJ. Family correlates of a 10-year pulmonary health trend in cystic fibrosis. Pediatrics. 1993;91(2):383–9.PubMedGoogle Scholar
  5. 5.
    Sheehan J, Massie J, Hay M, Jaffe A, Glazner J, Armstrong D, et al. The natural history and predictors of persistent problem behaviours in cystic fibrosis: A multicentre, prospective study. Archives of Disease in Childhood. 2012; doi: 10.1136/archdischild-2011-301527.
  6. 6.
    Ward C, Massie J, Glazner J, Sheehan J, Canterford L, Armstrong D, et al. Problem behaviours and parenting in preschool children with cystic fibrosis. Arch Dis Child. 2009;94(5):341–7.PubMedCrossRefGoogle Scholar
  7. 7.
    Abbott J. Coping with cystic fibrosis. J R Soc Med. 2003;96 Suppl 43:42–50.PubMedCentralPubMedGoogle Scholar
  8. 8.
    Lazarus RS, Folkman S. Stress, appraisal and coping. New York, USA: Springer; 1984.Google Scholar
  9. 9.
    Staab D, Wenninger K, Gebert N, Rupprath K, Bisson S, Trettin M, et al. Quality of life in patients with cystic fibrosis and their parents: what is important besides disease severity? Thorax. 1998;53(9):727–31.PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Compas BE, Jaser SS, Dunn MJ, Rodriguez EM. Coping with chronic illness in childhood and adolescence. Annu Rev Clin Psychol. 2012;8:455–80.PubMedCentralPubMedCrossRefGoogle Scholar
  11. 11.
    Wong MG, Heriot SA. Parents of children with cystic fibrosis: how they hope, cope and despair. Child Care Health Dev. 2008;34(3):344–54.PubMedCrossRefGoogle Scholar
  12. 12.
    Carver CS. You want to measure coping but your protocol’s too long: consider the brief COPE. Int J Behav Med. 1997;4:92–100.PubMedCrossRefGoogle Scholar
  13. 13.
    Patterson JM, McCubbin HI, Warwick WJ. The impact of family functioning on health changes in children with cystic fibrosis. Soc Sci Med. 1990;31(2):159–64.PubMedCrossRefGoogle Scholar
  14. 14.
    McCubbin HI. CHIP–coping health inventory for parents: an assessment of parental coping patterns in the care of the chronically ill child. J Marriage Fam. 1983;45(2):359–70.CrossRefGoogle Scholar
  15. 15.
    Anthony H, Paxton S, Bines J, Phelan P. Psychosocial predictors of adherence to nutritional recommendations and growth outcomes in children with cystic fibrosis. J Psychosom Res. 1999;47(6):623–34.PubMedCrossRefGoogle Scholar
  16. 16.
    Thompson RJJ, Gustafson KE, Gil KM, Kinney TR, Spock A. Change in the psychological adjustment of children with cystic fibrosis or sickle cell disease and their mothers. J Clin Psychol Med S. 1999;6(4):373–92.CrossRefGoogle Scholar
  17. 17.
    Lovibond SH, Lovibond PF. Manual for the depression anxiety stress scales. 2nd ed. Sydney: Psychology Foundation; 1995.Google Scholar
  18. 18.
    Martin J, Hiscock H, Hardy P, Davey B, Wake M. Adverse associations of infant and child sleep problems and parent health: an australian population study. Pediatrics. 2007;119(5):947–55.PubMedCrossRefGoogle Scholar
  19. 19.
    Crist W, McDonnell P, Beck M, Gillespie CT. Behavior at mealtimes and the young child with cystic fibrosis. J Dev Behavl Pediatr. 1994;15(3):157–61.Google Scholar
  20. 20.
    Achenbach TM, Rescorla LA. Manual for the ASEBA preschool forms & profiles. Burlington VT: University of Vermont, Research Center for Children, Youth & Families; 2000.Google Scholar
  21. 21.
    Achenbach TM, Rescorla LA. Manual for the ASEBA school-age forms & profiles. Burlington, VT: University of Vermont Research Center for Children, Youth, & Families; 2001.Google Scholar
  22. 22.
    StataCorp. Stata statistical software: Release 11. College Station, TX: StataCorp LP. 2009.Google Scholar
  23. 23.
    Tabachnick BG, Fidell LS. Using multivariate statistics (Fifth Edition). United States of America: Pearson Education; 2007.Google Scholar
  24. 24.
    Benson PR. Coping, distress, and well-being in mothers of children with autism. Res Autism Spect Dis. 2010;4(2):217–28.CrossRefGoogle Scholar
  25. 25.
    Goldbeck L, Babka C. Development and evaluation of a multi-family psychoeducational program for cystic fibrosis. Patient Educ Couns. 2001;44(2):187–92.PubMedCrossRefGoogle Scholar
  26. 26.
    Klebanov PK, BrooksGunn J, McCormick MC. Maternal coping strategies and emotional distress: results of an early intervention program for low birth weight young children. Dev Psychol. 2001;37(5):654–67.PubMedCrossRefGoogle Scholar
  27. 27.
    Hiscock H, Bayer J, Gold L, Hampton A, Ukoumunne OC, Wake M. Improving infant sleep and maternal mental health: a cluster randomised trial. Arch Dis Child. 2007;92(11):952–8.PubMedCentralPubMedCrossRefGoogle Scholar

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

Personalised recommendations