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Journal of Pediatric Psychology Advance Access published online on June 25, 2009
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsp054
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© The Author 2009. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Medical Adherence in Young Adolescents with Spina Bifida: Longitudinal Associations with Family Functioning

Mona A. Stepansky, PhD, Caitlin R. Roache, MA, Grayson N. Holmbeck, PhD and Karen Schultz, BS

Loyola University

All correspondence should be addressed to Grayson N. Holmbeck, Loyola University Chicago, Department of Psychology, 6525 N. Sheridan Road, Chicago, IL 60626, USA. E-mail: gholmbe{at}luc.edu


  Abstract

Objective The purpose of this study was 2-fold: (1) to explore the transfer of responsibility of medical tasks from parent to child during the transition to adolescence, and (2) to examine the associations between family functioning and medical adherence in youth with spina bifida. Methods Seventy families of children with spina bifida participated in this study. Data were collected during family interaction sessions by using questionnaires completed by mothers, fathers, youth, teachers and health professionals. Results Findings suggest that responsibility for medical regimens transfers gradually from parent to child over time. Additionally, family conflict and cohesion were correlated with medical adherence. Finally, family conflict over medical issues was related to a decrease in medical adherence over time. Conclusions Results suggest that as youth take more responsibility over their medical regimens, family conflict regarding medical issues becomes a contributor to their adherence behaviors. Interventions that target family conflict may facilitate adherence behaviors.

Key words: spina bifida; adherence; adolescence; family conflict..

Received October 16, 2008; revision received May 20, 2009; accepted May 31, 2009


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