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Original Article
- Factors Influencing Posttraumatic Growth in Fathers of Chronically ill Children
- Mi Young Kim
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Journal of Korean Academy of Nursing 2015;45(6):890-899.
DOI: https://doi.org/10.4040/jkan.2015.45.6.890
Published online: December 15, 2015
College of Nursing, Eulji University, Seongnam, Korea
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: June 4, 2015 • Revised: June 17, 2015 • Accepted: September 15, 2015
Copyright © 2015 Korean Society of Nursing Science
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.
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Abstract
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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.
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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.
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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.
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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.
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 |
||
|---|---|---|---|---|---|
| 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] | ||
Table 2.Posttraumatic Growth according to Fathers’ Distress and Perception of Psychological Growth (N=48)
| Variables | Categories | n (%) or M±SD |
Posttraumatic growth |
||
|---|---|---|---|---|---|
| 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 | |||||
Table 3.Mean Scores and Correlations for Posttraumatic Growth, Optimism, Disruption of Core Beliefs, Deliberate Rumination, Social Support(N=48)
Table 4.Multiple Regression Analysis of Father’s Posttraumatic Growth (N=48)
| Variables | B | SE | β t (p) |
Collinearity statistics |
|
|---|---|---|---|---|---|
| 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 | |||||
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Figure 1. A Theoretical Model of Posttraumatic Growth Model by Calhoun & Tedeschi (2006).
Figure 1.
Factors Influencing Posttraumatic Growth in Fathers of Chronically ill Children
| Variables | Categories | n (%) or M±SD | Posttraumatic growth |
||
|---|---|---|---|---|---|
| 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] | ||
| Variables | Categories | n (%) or M±SD | Posttraumatic growth |
||
|---|---|---|---|---|---|
| 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 | |||||
| Variables | M±SD | Posttraumatic growth |
Optimism |
Disruption of core beliefs |
Deliberate rumination |
Social support |
|---|---|---|---|---|---|---|
| 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 |
| Variables | B | SE | β t (p) | Collinearity statistics | |
|---|---|---|---|---|---|
| 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 | |||||
Table 1. Posttraumatic Growth according to the General Characteristics of Father and Child and Characteristics related Child’s Disease(N=48)
Kruskal-Wallis test; Mann-Whitney U test.
Table 2. Posttraumatic Growth according to Fathers’ Distress and Perception of Psychological Growth (N=48)
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)
Table 4. Multiple Regression Analysis of Father’s Posttraumatic Growth (N=48)
Dummy variable; Religion: Yes=1, No=0; VIF=Variation inflation factor.
