Medical adherence and childhood chronic illness: family daily management skills and emotional climate as emerging contributors

Medical adherence and childhood chronic illness: family daily management skills and emotional climate as emerging contributors

Fiese BH; Everhart RS

Current Opinion In Pediatrics

2006

Child; Humans; Home Nursing; Emotions; Patient Compliance; Family/psychology; Adolescent Transitions; Chronic disease; Cystic Fibrosis/therapy; Asthma/therapy; Diabetes Mellitus/therapy

PURPOSE OF REVIEW: To describe recent research that examines family factors that promote or derail adherence to medical regimens for children with chronic health conditions, primarily asthma, diabetes, and cystic fibrosis. From the past 2 years, eight correlational studies were identified which specifically examined the links between family management strategies, family climate and medical adherence. RECENT FINDINGS: Findings from the studies suggest that team-based management strategies and cohesive family climate promote adherence to medical treatments over time. Family interactions that are characterized by conflict and disengagement tend to disrupt adherence and inevitably cause a decline in child health. Moreover, these findings seem to be moderated by child age in that poorer adherence often occurs when a child reaches adolescence and is searching for greater autonomy. SUMMARY: Future research should consider the challenges in measuring medical adherence in the family context as well as incorporating more naturalistic studies of family interactions. Randomized controlled trials using family-based interventions may consider focusing on medical adherence as an important mediator between family process and child health outcomes.

2006

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