Assessing Parental Coping in the Context of Having a Child With a ...

Assessing Parental Coping
in the Context of Having
a Child With a Chronic or
Severe Illness
Katharine Wickel, MS, LAMFT

Objective
• Understand current methodologies as it relates to
assessing parental coping in this context
• Theoretical Underpinnings
• Assessment instruments
• Settings and Samples
• Strengths
• Limitations and Future Research

Definitions
• Chronic or severe illnesses
• Children who have been diagnosed with a physical illness
that requires special health care needs that are beyond the
experience of a child without such diagnosis
• Coping
• Actions an individual may take to avoid the harmful effects
of an event or any effort to control emotional distress
(Pearlin & Schooler, 1978)
• Stress
• Any “upset in the steady state of the family” (Boss, 1987, pg.
695)

Introduction
• 17-18% of US children (Bethell, Read, Blumberg, 2008)
• The number of children with chronic illnesses will
continue to rise (Katz, 2002)
• Many parents will have either direct or indirect effects
• Medical systems
• Ability to be flexible and adapt
• Additional challenges (Given, Stommel, Given, Osuch, Kurtz, &
Kurtz, 1993; Silver, Westbrook, & Stein, 1998)
• Low self-esteem, low parental efficacy, depression and anxiety

Theoretical Underpinings
• Themes of perception and resources
• Problem-focused versus emotion-focused coping
• ABC-X model (Hill 1949)
• Family Stress Theory (Boss, 1987)

Assessment Instruments
• Coping Health Inventory for Parents (CHIPS) (McCubbin, et
al., 1983; McCubbin, et al., 1996)
• The Parental Coping Strategy Inventory (PCSI) (Yeh, 2001)
• Ways of Coping Questionnaire (Lazarus & Folkman, 1988; Kupst, et
al., 1995)
• Modified COPE Scale (Sales, et al., 2008; Carver, Scheier, &
Weintraub, 1989)
• Qualitative Methods

Settings and Samples
• Medical or Clinical Setting
• Local clinics
• Child’s diagnosis
• Childhood cancer, cystic fibrosis, HIV, asthma, epilepsy
• Lack of diversity
• Race/ethnicity
• Income

Strengths
• Strong theory
• Starting to take culture into account
• International culture

Limitations and Future Research
• Many samples lacked ethnic, cultural, and economic
diversity that are represented in the United States
• Explorations of the development of gender specific
assessments
• Some studies have found that the gender of the parent
impacts coping styles and methods (Chesler & Parry, 2001; Goble,
2004)
• Are all illnesses created equal?
• Is it valid and reliable to use a measure that was normed
on one childhood illness with populations that have
children with different illnesses

References
Bethell, C. D., Read, D., & Blumberg, S. J. (2008). What is the prevalence of children
with special health care needs? Toward an understanding of variations in fin
Boss, P. G. (1987). Family stress. In M. B. Sussman, & S. K. Steinmetz
(Eds.), Handbook of marriage and the family (pp. 695-723). New York: Plenum
Press.
Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies: A
theoretically based approach. Journal of Personality and Social Psychology, 56(2),
267-283.
Chesler, M. A., & Parry, C. (2001). Gender roles and/or styles in crisis: An integrative
analysis of the experiences of fathers of children with cancer. Qualitative Health
Research, 11, 363-384.
Given, C. W., Stommel, M., Given, B., Osuch, J., Kurtz, M. E., & Kurtz, J. C. (1993).
The influence of cancer patients' symptoms and functional states on patients'
depression and family caregivers' reaction and depression. Health
Psychology, 12(3), 277-285.

References (Continued)
Goble, L. A. (2004). The impact of a child's chronic illness on fathers. Issues in
Comprehensive Pediatric Nursing, 27, 153-262.
Hill, R. (1949). Families under stress (1st ed.). New York: Harper & Row.
Katz, S. (2002). Gender differences in adapting to a child's chronic illness: A causal
model. Journal of Pediatric Nursing, 17, 257-269.
Kupst, M. J., Natta, M. B., Richardson, C. C., Schulman, J. L., Lavigne, J. V., & Das,
L. (1995). Family coping with pediatric leukemia: Ten years after
treatment. Journal of Pediatric Psychology, 20(5), 601-617.
Lazarus, R. S., & Folkman, S. (1984). Coping and adaptation. In W. D. Gentry
(Ed.), The Handbook of Behavioral Medicine (pp. 282-325).
McCubbin, H. I., McCubbin, M. A., Patterson, J. M., Cauble, A. E., Wilson, L. R., &
Warwick, W. (1983). CHIP. Coping health inventory for parents: An assessment of
parental coping patterns in the care of the chronically ill child. Journal of
Marriage and Family, 45(2), 359-370.

References (Continued)
McCubbin, H. I., Thompson, A. I., & McCubbin, M. A. (1996). Family
assessment: Resiliency, coping and adaptation: Inventories for research
and practice. Madison, WI: University of Wisconsin Publishers.
Pearlin, L. I., & Schooler, C. (1978). The structure of coping. Journal of
Health and Social Behavior, 19(1), 2-21.
Sales, J., Fivush, R., & Teague, G. W. (2008). The role of parental coping in
children with Asthma’s psychological well-being and asthma-related
quality of life. Journal of Pediatric Psychology, 33(2), 208-219.
Silver, E. J., Westbrook, L. E., & Stein, R. E. K. (1998). Relationship of
parental psychological distress to consequences of chronic health
conditions in children. Journal of Pediatric Psychology, 23(1), 5-15.
Yeh, C. (2001). Development and testing of the parental coping strategy
inventory (PCSI) with children with cancer in Taiwan. Journal of
Advanced Nursing, 36(1), 78-88.