Abstract
To examine how often specialists caring for chronically ill children detect serious psychosocial problems in the family, parents of 23 children (ages 5-11 yrs.) with diabetes mellitus who regularly attended the diabetes clinic were interviewed at home by psychological researchers previously unknown to the family. Questions were designed to detect serious marital problems (e.g., considering divorce) and serious problems in the parent-child relationship (PCR) (e.g., excessive underinvolvement by a parent). Problems were rated as: definite, possible, or absent. Parental responses were compared with the clinic staff's (physician, nurse practitioner, and social worker) knowledge of marital and PCR problems. Knowledge was assessed by an interviewer unaware of the parental responses.
Clinicians and researchers agreed in 61% of the assessments of the marriages; clinicians noted that 9% of families had a definite marital problem vs. 26% reported to the researchers. Of the 6 families reporting a definite problem, 2 were also noted by the clinicians. Agreement in the assessments of the PCR occurred in only 30% of cases. A definite problem was noted in 9% of families by clinicians and 17% by researchers.
Clinicians appear to underestimate the extent of psychosocial problems in these families. This may be due to the family's need to present itself as normal in the medical setting, as well as the clinician's style of offering services.
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Leventhal, J., Sabbeth, B., Emmons, E. et al. CLINICIANS' ASSESSMENTS OF FAMILIES WITH A CHRONICALLY ILL CHILD. Pediatr Res 18 (Suppl 4), 108 (1984). https://doi.org/10.1203/00006450-198404001-00090
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DOI: https://doi.org/10.1203/00006450-198404001-00090