Factors Influencing Posttraumatic Growth in Fathers of Chronically ill Children

Mi Young Kim

doi:10.4040/jkan.2015.45.6.890

Journal List > J Korean Acad Nurs > v.45(6) > 1003130

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kim: Factors Influencing Posttraumatic Growth in Fathers of Chronically ill Children

Original Article

J Korean Acad Nurs 2015;45(6):890-899.

Published online: 15 December 2015

DOI: https://doi.org/10.4040/jkan.2015.45.6.890

Factors Influencing Posttraumatic Growth in Fathers of Chronically ill Children

Mi Young Kim

College of Nursing, Eulji University, Seongnam, Korea

Address reprint requests to : Kim, Mi Young College of Nursing, Eulji University, 553 Sanseong-daero, Sujeong-gu, Seongnam 13135, Korea Tel: +82-31-740-7398 Fax: +82-31-740-7359 E-mail: kimmy@eulji.ac.kr

Received 4 June 2015 Revised 17 June 2015 Accepted 15 September 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose

The purpose of this study was to identify the level of distress and posttraumatic growth in fathers of chronically ill children and also, to identify the relation between characteristics of the fathers and children and their posttraumatic growth and to investigate factors that influence posttraumatic growth.

Methods

In this study, 48 fathers who visited a university hospital in Seoul, Korea and who gave written consent completed the questionnaire between September 23 and November 19, 2013. Data were analyzed using Mann-Whitney U test, Kruskal-Wallis test, Pearson correlation coefficient and stepwise multiple regression.

Results

The level of distress in fathers of chronically ill children was relatively high and the majority of them were experiencing posttraumatic growth. Models including the variable (deliberate rumination, religiousness, optimism) explained 64.3% (F=26.38, p< .001) of the variance for posttraumatic growth. Deliberate rumination (β=.59, p< .001) was the most influential factor.

Conclusion

The findings demonstrate that it is essential for nurses to intervene and facilitate continuously so as to promote posttraumatic growth and relieve distress in fathers of chronically ill children. Furthermore, it is also necessary for nurses to find ways to develop ideal interventions to activate deliberate rumination and offer spiritual care and help maintain optimism in these individuals.

Keywords: Chronic disease, Fathers, Growth, Rumination, Religion

References

1. Han KJ, Kwon MK, Bang KS. Parent-child health and nursing. Seoul: Hyunmoon;2010.

2. Calhoun LG, Tedeschi RG. The foundation of posttraumatic growth: An expanded framework. Calhoun LG, Tedeschi RG, editors. Handbook of posttraumatic growth: Research and practice. Mahwah, NJ: Erlbaum;2006. p. 3–23.

3. Kim Y, Schulz R, Carver CS. Benefit-finding in the cancer caregiving experience. Psychosomatic Medicine. 2007; 69(3):283–291. http://dx.doi.org/10.1097/PSY.0b013e3180417cf4.

4. Cho YK. The change of social structure and fathering in South Korea. Korean Journal of Converging Humanities. 2014; 2(1):83–112. http://dx.doi.org/10.14729/converging.k.2014.2.1.83.

5. Dashiff C, Morrison S, Rowe J. Fathers of children and adolescents with diabetes: What do we know? Journal of Pediatric Nursing. 2008; 23(2):101–119. http://dx.doi.org/10.1016/j.pedn.2007.08.007.

6. Kim J, Yun HJ. A study on the parenting experiences of fathers of children with disabilities. Special Education Research. 2013; 12(3):333–356.

7. Hwang EJ. Experience of fathers raising children with disabilities: Conflicts, difficulties and positive changes [master’s thesis]. Seoul: Chung Ang University;2014.

8. Tedeschi RG, Calhoun LG. The posttraumatic growth inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress. 1996; 9(3):455–471. http://dx.doi.org/10.1002/jts.2490090305.

9. Linley PA, Joseph S. Positive change following trauma and adversity: A review. Journal of Traumatic Stress. 2004; 17(1):11–21. http://dx.doi.org/10.1023/B:JOTS.0000014671.27856.7e.

10. Antoni MH, Lehman JM, Kilbourn KM, Boyers AE, Culver JL, Alferi SM, et al. Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer. Health Psychology. 2001; 20(1):20–32. http://dx.doi.org/10.1037/0278-6133.20.1.20.

11. Cann A, Calhoun LG, Tedeschi RG, Kilmer RP, Gil-Rivas V, Vish-nevsky T, et al. The core beliefs inventory: A brief measure of disruption in the assumptive world. Anxiety Stress and Coping. 2010; 23(1):19–34. http://dx.doi.org/10.1080/10615800802573013.

12. Thornton AA, Perez MA. Posttraumatic growth in prostate cancer survivors and their partners. Psycho-Oncology. 2006; 15(4):285–296. http://dx.doi.org/10.1002/pon.953.

13. Hungerbuehler I, Vollrath ME, Landolt MA. Posttraumatic growth in mothers and fathers of children with severe illnesses. Journal of Health Psychology. 2011; 16(8):1259–1267. http://dx.doi.org/10.1177/1359105311405872.

14. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G_*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods. 2009; 41(4):1149–1160. http://dx.doi.org/10.3758/brm.41.4.1149.

15. Song SH, Lee HS, Park JH, Kim KH. Validity and reliability of the Korean version of the posttraumatic growth inventory. The Korean Journal of Health Psychology. 2009; 14(1):193–214.

16. Scheier MF, Carver CS, Bridges MW. Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): A reevaluation of the life orientation test. Journal of Personality and Social Psychology. 1994; 67(6):1063–1078. http://dx.doi.org/10.1037/0022-3514.67.6.1063.

17. Shin H. Testing the mediating effect of coping in the relation of optimism and pessimism to psychological adjustment in adolescents. Korean Journal of Youth Studies. 2005; 12(3):165–192.

18. Jo SM. The causal relationship of cognitive factors, social support and resilience on youth’s posttraumatic growth [master’s thesis]. Busan: Pusan National University;2012.

19. Cann A, Calhoun LG, Tedeschi RG, Triplett KN, Vishnevsky T, Lindstrom CM. Assessing posttraumatic cognitive processes: The event related rumination inventory. Anxiety Stress and Coping. 2011; 24(2):137–156. http://dx.doi.org/10.1080/10615806.2010.529901.

20. Ahn HN, Joo HS, Min JW, Sim KS. Validation of the event related rumination inventory in a Korean population. Cognitive Behavior Therapy in Korea. 2013; 13(1):149–172.

21. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. Journal of Personality Assessment. 1988; 52(1):30–41. http://dx.doi.org/10.1207/s15327752jpa5201_2.

22. Shin JS, Lee YB. The effects of social supports on psychosocial well-being of the unemployed. Korean Journal of Social Welfare. 1999; 37:241–269.

23. Polatinsky S, Esprey Y. An assessment of gender differences in the perception of benefit resulting from the loss of a child. Journal of Traumatic Stress. 2000; 13(4):709–718. http://dx.doi.org/10.1023/a:1007870419116.

24. Vishnevsky T, Cann A, Calhoun LG, Tedeschi RG, Demakis GJ. Gender differences in self-reported posttraumatic growth: A meta-analysis. Psychology of Women Quarterly. 2010; 34(1):110–120. http://dx.doi.org/10.1111/j.1471-6402.2009.01546.x.

25. Yi GO, Han SH, Park HJ. Changes and growth among families of children with disabilities: Based on child-rearing experiences of mothers and fathers. Journal of Emotional & Behavioral Disorders. 2010; 26(4):137–163.

26. Bonner MJ, Hardy KK, Willard VW, Hutchinson KC. Brief report: Psychosocial functioning of fathers as primary caregivers of pediatric oncology patients. Journal of Pediatric Psychology. 2007; 32(7):851–856. http://dx.doi.org/10.1093/jpepsy/jsm011.

27. Davies B, Gudmundsdottir M, Worden B, Orloff S, Sumner L, Brenner P. “Living in the dragon’s shadow” fathers’ experiences of a child's life-limiting illness. Death Studies. 2004; 28(2):111–135. http://dx.doi.org/10.1080/07481180490254501.

28. Shin SY, Chung NW. The effect of meaning in life and social support on posttraumatic growth: Rumination as a mediating variable. Journal of Human Understanding and Counseling. 2012; 33(2):217–235.

29. Park H, Ahn H. The effects of posttraumatic stress symptoms, spirituality, and rumination on posttraumatic growth. The Korea Journal of Counseling. 2006; 7(1):201–214.

30. Yoo YS, Cho OH, Cha KS, Boo YJ. Factors influencing post-traumatic stress in Korean forensic science investigators. Asian Nursing Research. 2013; 7(3):136–141. http://dx.doi.org/10.1016/j.anr.2013.07.002.

Figure 1.

A Theoretical Model of Posttraumatic Growth Model by Calhoun & Tedeschi (2006).

Table 1.

Posttraumatic Growth according to the General Characteristics of Father and Child and Characteristics related Child’s Disease(N=48)

Variables	Categories	n (%) or M±SD	Posttraumatic growth
Variables	Categories	n (%) or M±SD	M±SD	Median [Min, Max]	p
Fathers’ age (yr)	25~34	9 (18.8)	48.33± 17.68	53.0 [11, 69]	.248^*
	35~44	29 (60.4)	46.69± 18.02	43.0 [17, 79]
	45~54	10 (20.8)	57.90± 9.48	60.0 [42, 74]
		40.73± 5.77
Level of education	≤High school	13 (27.1)	51.00± 13.98	53.0 [11, 79]	.871^†
	≥College	35 (72.9)	48.71± 17.95	51.0 [29, 72]
Employment (at diagnosis)	Employed	47 (97.9)	49.98±16.42	52.0 [11, 79]	.125^*
	Not employed	1 (2.1)	19.00	19.0
Employment (current)	Employed	34 (70.8)	50.03±16.93	53.5 [17, 79]	.610^†
	Not employed	14 (29.2)	47.64±17.17	50.0 [11, 74]
Burden of medical care costs	None at all or hardly any	7 (14.6)	40.57±19.72	41.0 [11, 62]	.226^*
	Moderately	12 (25.0)	46.67±17.81	46.0 [19, 79]
	Very high	16 (33.3)	50.13±13.31	51.0 [29, 70]
	Extremely high	13 (27.1)	55.54±17.63	58.0 [17, 74]
Religion	Yes	30 (62.5)	55.67±15.09	59.0 [17, 79]	.001^†
	No	18 (37.5)	38.78±14.70	41.0 [11, 66]
Child’s age (yr)	0~2	11 (22.9)	52.00±13.60	53.0 [29, 70]	.239^*
	3~6	8 (16.7)	35.25±21.26	27.5 [11, 70]
	7~12	15 (31.3)	52.47±15.87	52.0 [27, 79]
	≥13	14 (29.1)	51.93±14.93	54.0 [17, 74]
		8.67±5.81
Child’s gender	M	31 (64.6)	48.90±16.00	51.0 [11, 74]	.746^†
	F	17 (35.4)	50.12±18.80	52.0 [17, 79]
Child’s birth order	1st or only child	33 (68.8)	49.03±16.52	51.0 [11, 79]	.772^†
	≥2nd	15 (31.2)	50.00±18.14	52.0 [19, 74]
Child’s age at diagnosis (yr)	0~2	18 (37.5)	49.39±17.27	51.5 [11, 70]	.829^*
	3~6	11 (22.9)	45.55±17.21	50.0 [19, 72]
	7~15	19 (39.6)	51.47±16.78	56.0 [17, 79]
		5.60±4.59
Duration of illness	3 months -1yr	20 (41.7)	46.35±15.31	46.0 [19, 69]	.668^*
	1~3 yr	12 (25.0)	50.50±24.05	57.5 [11, 79]
	3~5 yr	7 (14.6)	50.43±11.84	51.0 [35, 70]
	> 5 yr	9 (18.7)	53.56±12.88	52.0 [29, 69]
		3.16±4.10
Child’s diagnosis	Leukemia	15 (31.3)	50.93±15.45	52.0 [19, 74]	.621^*
	Brain tumor	6 (12.5)	46.83±19.90	50.5 [17, 69]
	Neuroblastoma	6 (12.5)	40.83±19.93	43.5 [11, 66]
	Others	21 (43.7)	51.33±16.50	53.0 [20, 79]

^* Kruskal-Wallis test;

^† Mann-Whitney U test.

Table 2.

Posttraumatic Growth according to Fathers’ Distress and Perception of Psychological Growth (N=48)

Variables	Categories	n (%) or M±SD	Posttraumatic growth
Variables	Categories	n (%) or M±SD	M±SD	Median [Min, Max]	p
Fathers’distress	Less than usual distress (≤3)	1 (2.1)	50.00	50.0	.800^†
(at diagnosis)	More than usual distress (≥4)	47 (97.9)	49.32±17.03	52.0 [11, 79]
(range 0~7)		6.71±0.71
Fathers’ distress	Less than usual distress (≤3)	6 (12.5)	57.83±7.60	57.5 [50, 70]	.249^†
(current)	More than usual distress (≥4)	42 (87.5)	48.12±17.50	51.5 [11, 79]
(range 0~7)		4.81±1.39
Fathers’ alleviation	Not alleviated	11 (22.9)	55.09±15.68	56.0 [17, 74]	.155^†
of distress	Alleviated	37 (77.1)	47.62±17.01	50.0 [11, 79]
Acceptable	Yes	45 (93.7)	61.67±7.51	51.0 [11, 79]	.147^†
	No	3 (6.3)	48.51±17.02	62.0 [54, 69]
Positive changes due	Yes	43 (89.6)	50.86±16.75	53.0 [11, 79]	.041^†
to child’s illness	No	5 (10.4)	36.20±12.19	41.0 [19, 50]
Experienced	Yes	47 (97.9)	49.77±16.76	52.0 [11, 79]	.220^†
psychological growth	No	1 (2.1)	29.00	29.0
The point at which	≤1	42 (87.5)	48.62±16.82	51.5 [11, 79]	.188^*
psychological growth	≤2	2 (4.2)	52.00±24.04	52.0 [35, 69]
began (yr)	Don’t know	3 (6.3)	64.33±4.93	62.0 [61, 70]
	Not yet	1 (2.0)	29.00	29.0
		6.00±5.74 months

^* Kruskal-Wallis test;

^† Mann-Whitney U test.

Table 3.

Mean Scores and Correlations for Posttraumatic Growth, Optimism, Disruption of Core Beliefs, Deliberate Rumination, Social Support(N=48)

Variables	M±SD	Posttraumatic growth	Optimism	Disruption of core beliefs	Deliberate rumination	Social support
Variables	M±SD	r (p)	r (p)	r (p)	r (p)	r (p)
Posttraumatic growth	49.33±16.85	1.00	.41 (.002)	.49 (<.001)	.69 (<.001)	.48 (<.001)
Optimism	16.58±2.98		1.00	.21 (.074)	.19 (.090)	.35 (.008)
Disruption of core beliefs	s 27.10±8.16			1.00	.48 (<.001)	.43 (.001)
Deliberate rumination	20.33±4.67				1.00	.41 (.002)
Social support	63.06±11.91					1.00

Table 4.

Multiple Regression Analysis of Father’s Posttraumatic Growth (N=48)

Variables	B	SE	β t (p)	Collinearity statistics
Variables	B	SE	β t (p)	Tolerance	VIF
Deliberate rumination	2.11	0.34	.59 6.25 (<.001)	.92	1.07
Religion^*	10.51	3.27	.31 3.22 (.002)	.90	1.10
Optimism	1.21	0.53	.21 2.27 (.028)	.91	1.09
R²=.64, F=26.38, p<.001

^* Dummy variable; Religion: Yes=1, No=0; VIF=Variation inflation factor.

TOOLS

Similar articles