Family Functioning in School-Age Children With Cystic Fibrosis: An Observational Assessment of Family Interactions in the Mealtime Environment
1 Department of Clinical and Health Psychology, College of Public Health & Health Professions, University of Florida and 2 Division of Psychology, Cincinnati Children’s Hospital Medical Center/University of Cincinnati College of Medicine
All correspondence should be sent to David M. Janicke, PhD, Department of Clinical Health Psychology, University of Florida, PO Box 100165, Gainesville, FL 32610-0165; Lori J. Stark, PhD, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Division of Psychology MLC 3015, Cincinnati, OH 45229.
Objective To examine, using direct observation methodology, differences in family functioning at mealtime between families of school-age children with cystic fibrosis (CF) and families of school-age children without a chronic illness. Method Family functioning was rated using the McMaster Mealtime Interaction Coding System (MICS) during a videotaped dinner among 28 families of children with CF and 27 families of non-ill, age-matched peers. Families were rated on overall family functioning and on six dimensions of the MICS: task accomplishment, communication, affect management, interpersonal involvement, behavior control, and role allocation. Results Ratings for families of a child with CF were significantly lower than they were for comparison families on overall family functioning and on four of the six MICS dimensions: communication, affect management, interpersonal involvement, and behavioral control. Moreover, a significantly greater percentage of families of children with CF were rated in the unhealthy range on overall family functioning and on five of six MICS dimensions. There was no relationship between family functioning and child weight status for children with CF. Conclusions The current study suggests that for families of school-age children with CF, the family system is negatively affected during mealtime. Dietary interventions need to address family-centered, as well as child-centered, interventions to help families manage challenges presented during the family meal.
Key words: cystic fibrosis; family functioning; mealtime; children; behavior.
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