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Quality of Life Research
Published in: Quality of Life Research 5/2021

26-01-2021

Influences of health and environmental deprivation on family relationships among children with chronic disease

Authors: Elizabeth D. Cox, Mari Palta, Michael Lasarev, Alex T. Binder, Jenny R. Connolly, Kathryn E. Flynn

Published in: Quality of Life Research | Issue 5/2021

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Abstract

Purpose

Families play a key role in managing chronic illness. Among chronically ill children, we describe the Patient-Reported Outcomes Measurement Information System (PROMIS) Family Relationships measure over time and its associations with sociodemographics, environmental deprivation, and health.

Methods

Parents of children aged 8–18 years with asthma (n = 171), type 1 diabetes (n = 199), or sickle cell disease (n = 135), recruited in pediatric clinics and emergency departments (ED), completed demographic surveys. Every six months for up to three years, children completed PROMIS Family Relationships, Anxiety, and Depressive Symptoms short forms (T-scores; mean 50, SD = 10), and a 5-level health status item. Linear mixed models were fit to estimate associations.

Results

Older baseline age was associated with weaker family relationships. For example, for each 3-year higher baseline age, relationships were 3 points weaker for males (− 3.0; 95%CI − 5.7 to − .0.2) and females (− 3.1; 95%CI − 6.0 to − 0.3) with asthma recruited in the ED. For each 1-unit higher mean overall health, relationships were 4.6 points (95%CI 3.2–6.1) stronger for children with diabetes and about 2 points stronger for children with asthma (2.3; 0.7–3.9) and sickle cell disease (2.1; 0.3–3.9). Family relationships were 0.3–0.5 points weaker for each 1-unit increment in mean anxiety or depressive symptoms across all three diseases. Relationships were not significantly associated with environmental deprivation and generally stable over time.

Conclusions

Family relationships were weaker among older children and generally stable over time, yet fluctuated with physical and mental health. Monitoring PROMIS Family Relationships scores may facilitate referrals for chronically ill children who need support.
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Appendix
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Metadata
Title
Influences of health and environmental deprivation on family relationships among children with chronic disease
Authors
Elizabeth D. Cox
Mari Palta
Michael Lasarev
Alex T. Binder
Jenny R. Connolly
Kathryn E. Flynn
Publication date
26-01-2021
Publisher
Springer International Publishing
Published in
Quality of Life Research / Issue 5/2021
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-020-02737-6

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