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Adaptation in Families of Children with Down Syndrome: A Mixed-methods Design
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Hyunkyung Choi
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J Korean Acad Nurs 2015;45(4):501-512. Published online August 31, 2015
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DOI: https://doi.org/10.4040/jkan.2015.45.4.501
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 Abstract
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Purpose
The purpose of this study, which was guided by the Resiliency Model of Family Stress, Adjustment, and Adaptation, was twofold: (a) to explore family and parental adaptation and factors influencing family adaptation in Korean families of children with Down syndrome (DS) through a quantitative methodology and (b) to understand the life with a Korean child with DS through a qualitative method.
Methods
A mixed-methods design was adopted. A total of 147 parents of children with DS completed a package of questionnaires, and 19 parents participated in the in-depth interviews. Quantitative and qualitative data were analyzed using stepwise multiple regression and content analysis respectively.
Results
According to the quantitative data, the overall family adaptation scores indicated average family functioning. Financial status was an important variable in understanding both family and parental adaptation. Family adaptation was best explained by family problem solving and coping communication, condition management ability, and family hardiness. Family strains and family hardiness were the family factors with the most influence on parental adaption. Qualitative data analysis showed that family life with a child with DS encompassed both positive and negative aspects and was expressed with 5 themes, 10 categories, and 16 sub-categories.
Conclusion
Results of this study expand our limited knowledge and understanding concerning families of children with DS in Korea and can be used to develop effective interventions to improve the adaptation of family as a unit as well as parental adaptation.
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Citations
Citations to this article as recorded by  - Perceived stress and family adaptability in head and neck cancer patients receiving radiotherapy: the chain-mediated effect of social support and family resilience
Xiaoru Li, Yu Zhu, Hongwei Wan
Frontiers in Psychiatry.2025;[Epub] CrossRef - Family adaptation in families of individuals with Down syndrome from 12 countries
Marcia Van Riper, George J. Knafl, Kathleen A. Knafl, Maria do Céu Barbieri‐Figueiredo, Sivia Barnoy, Maria Caples, Hyunkyung Choi, Beth Cosgrove, Elysângela Dittz Duarte, Junko Honda, Elena Marta, Supapak Phetrasuwan, Sara Alfieri, Margareth Angelo, Wann
American Journal of Medical Genetics Part C: Seminars in Medical Genetics.2024;[Epub] CrossRef - ADAPTATION OF THE FAMILY HARDINESS INDEX (FHI) INSTRUMENT FOR INDONESIAN ADOLESCENTS
Luisa Erica, Sri Redatin Retno Pudjiati
Jurnal Ilmu Keluarga dan Konsumen.2024; 17(2): 120. CrossRef - Adaptation at the Family Level in Families of Individuals With Down Syndrome: A Scoping Review
Marcia Van Riper, Bethany Cosgrove, Louise Fleming
Journal of Family Nursing.2023; 29(4): 324. CrossRef - Perceptions of families with adolescents utilizing augmentative and alternative communication technology: A qualitative approach
Patricia West, Emily J. Jensen, Sarah N. Douglas, Gwen Wyatt, Lorraine Robbins, Charles Given
Journal of Pediatric Nursing.2023; 71: e46. CrossRef - Factors influencing quality of life in caregivers of adolescents with developmental disabilities
Joung Woo Joung
Osong Public Health and Research Perspectives.2022; 13(4): 298. CrossRef - Perceived Experiences of Korean Immigrant Mothers Raising Children With Disabilities in the United States
Anna Lee, Vicky J.-H. Yeh, Kathleen A. Knafl, Marcia Van Riper
Journal of Transcultural Nursing.2022; 33(2): 219. CrossRef - A Predictive Model of Resilience in Mothers of Children with Developmental Disabilities
Youyoung Cho, Hyeonok Kim
Journal of Korean Academy of Nursing.2022; 52(4): 407. CrossRef - Tracing the Use of the Family Management Framework and Measure: A Scoping Review
Kathleen A. Knafl, Janet A. Deatrick, Agatha M. Gallo, Beth Skelton
Journal of Family Nursing.2021; 27(2): 87. CrossRef - Measurement of Family Management in Families of Individuals With Down Syndrome: A Cross-Cultural Investigation
Marcia Van Riper, George J. Knafl, Maria do Céu Barbieri-Figueiredo, Maria Caples, Hyunkyung Choi, Gert de Graaf, Elysângela Dittz Duarte, Junko Honda, Elena Marta, Supapak Phetrasuwan, Sara Alfieri, Margareth Angelo, Wannee Deoisres, Louise Fleming, Alin
Journal of Family Nursing.2021; 27(1): 8. CrossRef - Down Syndrome, Obstetricians Should Know
Ji-Hee Sung, Soo Hyun Kim, Sir-yeon Hong, Chi-Son Chang, Yejin Kim, Jungeun Jeon, Hyea Park, Soo-young Oh
Perinatology.2021; 32(1): 1. CrossRef - mHealth Family Adaptation Intervention for Families of Young Children with Down Syndrome: A Feasibility Study
Hyunkyung Choi, Marcia Van Riper
Journal of Pediatric Nursing.2020; 50: e69. CrossRef - Adaptation and Resilience in Families of Children With Spina Bifida in South Korea
Eun Kyoung Choi, Marcia Van Riper, Mina Jang, Sang Won Han
Rehabilitation Nursing.2018; 43(6): 343. CrossRef - Raising a Child with Down Syndrome: Do Preferred Coping Strategies Explain Differences in Parental Health?
Tatjana Alexander, Julia Walendzik
Psychology.2016; 07(01): 28. CrossRef
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Job stress levels and coping among hospital nurses: a latent profile analysis
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Myungji Kim, Hyunkyung Choi
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Received April 23, 2025 Accepted August 5, 2025 Published online August 22, 2025
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DOI: https://doi.org/10.4040/jkan.25061
[Epub ahead of print]
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Abstract
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 ePub
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This study aimed to identify job stress levels and coping profiles among hospital nurses, explore the factors influencing profile classification, and determine whether levels of job embeddedness and happiness varied among the profiles.
Methods
Data were collected through an online survey of 325 hospital nurses, and latent profiles were identified via latent profile analysis. The R3STEP (three-step auxiliary variable approach) method was used to examine the factors influencing the latent profiles, and one-way analysis of variance was conducted to analyze differences in levels of job embeddedness and happiness.
Results
Three job stress and coping profiles were identified: (1) the “moderate stress-balanced coping group”, characterized by moderate levels of job stress and moderate use of all coping strategies; (2) the “high stress-emotional coping group”, with high job stress and primary use of emotional display strategies; and (3) the “low stress-adaptive coping group, with low job stress and the utilization of a variety of coping strategies. Workplace location and monthly income influenced the classification of latent profiles. Nurses working in metropolitan areas and those with lower monthly incomes were more likely to be classified into the high stress-emotional coping group than other groups. The levels of job embeddedness and happiness were highest in the low stress-adaptive coping group and lowest in the high stress-emotional coping group.
Conclusion
The results of this study indicate the need to develop strategies that offer diverse stress-coping programs and support nurses in effectively utilizing coping methods that best suit their individual needs.
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