Journal of Pediatric Psychology 29(5) pp. 343-353, 2004
Journal of Pediatric Psychology vol. 29 no. 5 © Society of Pediatric Psychology 2004; all rights reserved
Association of Observed Family Relationship Quality and Problem-Solving Skills with Treatment Adherence in Older Children and Adolescents with Cystic Fibrosis
1 Pacific Graduate School of Psychology, 2 Department of Pediatrics, Rainbow Babies and Children's Hospital and Case Western Reserve University School of Medicine, and 3 Department of Clinical and Health Psychology, University of Florida
All correspondence should be sent to Carolyn E. Ievers-Landis, Ph.D., Division of Behavioral Pediatrics and Psychology, Rainbow Babies and Children's Hospital, 11100 Euclid Avenue, Cleveland, Ohio 44106-6038. E-mail: cievers{at}aol.com
Objective To examine associations between observations of the quality of family relationships and problem-solving skills and reported adherence to medical treatments for older children and adolescents with cystic fibrosis (CF). Methods Reports of adherence were obtained from 96 youth with CF and their parents recruited from six CF centers in the Midwest and southeastern United States. Videotaped observations of family discussions of high conflict issues were used to assess quality of relationships and problem-solving skills. Results Hierarchical regression analyses indicated that observed family relationship quality (RQ) was related to parent and child reports of adherence to airway clearance and aerosolized medications after controlling for demographic variables and illness severity. Observed family problem solving was not a significant predictor after controlling for RQ. Conclusions Older children and adolescents who come from families experiencing unhappy and conflicted relationships may be at greater risk for poor adherence to treatments; thus, family relationships are appropriate targets for interventions aimed at improving adherence.
Key words: cystic fibrosis; treatment adherence; family relationship quality; problem-solving skills.
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