Table 2.

Summary of Nursing Research on Parent–Adolescent Relationships: The Assessment Approach

Source	Design	Focus/Dependent Variable	Sample Description	Results
Aronowitz et al. (2005)	Descriptive correlational survey	Female risky sexual behavior Measures: Information HIV knowledge, 18-item scale; motivation—behavioral intention scenario with an 8-item scale; social norms two 8-item scales; future time perspective with a 13-item subscale of Zimbardo Time Perspective Inventory; closeness to mother with 11-item scale; sexual communication 16-item scale; behavioral skills—confidence to talk with mother, 5-item scale; and heterosocial behaviors with structured interview.	39 African American middle-school-age daughters and their mothers from community centers in central New York. 53% lived with one parent; 54% were impoverished; adolescent age minimum was 11 years and maximum was 14 years (M = 12.4). SD not reported; Mothers’ (or primary care providers’) minimum age was 32 years and maximum age was 78 years (M = 35). SD not reported. United States	HIV knowledge was limited among the daughters, with 61% answering the 18 items correctly. Mothers’ knowledge was 77%. The more the mothers knew about HIV, the more the daughters knew. All adolescents intended to avoid risky situations. Social norms with friends correlated positively but moderately with mothers’ social norms. Closeness to the mother was negatively correlated to HIV knowledge and positively correlated with daughters’ confidence that they would speak with mothers about boys and sex. Most girls had not been in risky heterosocial situations, but the older they were, the higher their scores on the interview. Impoverished mothers and adolescents tended to have less HIV knowledge, and the adolescents had more social norms that advocated risky behaviors than non-impoverished ones. Daughters of mothers with high future time perspectives were less likely to have risky heterosocial experiences. Closeness to mother likely facilitated the adolescents’ perceptions of mothers’ values related to heterosocial behaviors and created environments where daughters felt more confident in discussing sensitive issues. It is important to enhance and maintain sense of closeness between mother and daughter.
Cha, Doswell, et al. (2007)	Cross-sectional correlational design using an exploratory survey method	Intention of engaging in premarital sex. Measures: attitudes—modified Treboux Premarital Sexual Attitude Scale; subjective norms—modified Parental and Friends Approval of Sexual Behavior Scale; perceived behavioral control—Sexual Abstinence Efficacy Scale; intention—modified Doswell Intention of Sexual Behavior Scale. Perceived risk of sexual behavior—3 items, quality of family communication—Parent–Adolescent Communication Scale	298 unmarried students attending a college or university in Seoul, Korea. 165 were males, age 22 years (SD = 2.12), and 133 were females, age 21 years (SD = 1.67). 69% of females and 52% of males lived with parents, with 88% dependent on parents financially. South Korea	Female students reported they had higher quality mother–adolescent communication than male students. There was no significant gender difference in terms of the quality of father–adolescent communication. Good quality of parent–adolescent communication significantly predicted a higher abstinence efficacy and perceived disapprovals of premarital sex for males. Parent–adolescent communication did not predict abstinence efficacy and subjective norms of premarital sex for females.
Cha, Kim, et al. (2007)	Cross-sectional descriptive survey	Condom use at first sexual experience. Measures: sample characteristics—Background and Sexual Behavior Questionnaire in Korean; parent–adolescent relationship—20-item Parent Adolescent Communication Scale; Condom Efficacy Scale—14-item modified Condom Self Efficacy Scale; Intention of condom use—modified Doswell’s Intention of Sexual Behavior Scale	82 male South Korean university students, with a mean age of 23 years (SD = 2.6), 50% lived with, and 88% financially dependent on, parents. 85% had no girlfriend, 67% perceived most of their friends had had sex, less than half reported sexual experience. South Korea	A better quality of mother–son communication predicted a higher intention to use condoms and a higher condom self-efficacy. The quality of mother–son communication did not predict the intention to use condoms after adjusting for condom self-efficacy. The quality of the father–son relationship did not significantly predict the intention to use condoms. A better quality relationship predicted higher condom self-efficacy, which predicted a higher intention to use condoms. Consistent with prior literature, when adolescents have a good relationship with their parents, they are more likely to intend to and actually use condoms. Authors intend to take findings and develop culturally specific, theory-based, and family-based interventions to reduce risky sexual behavior among South Korean adolescents.
Chen and Thompson (2007)	Secondary analyses of the National Longitudinal Study of Adolescent Health data	Adolescent risky sexual behavior Measures: not explicit, but a measure of parental approval of premarital sex, socioeconomic status, association with deviant peers, and risky sexual behavior	A sample of 6,342 adolescents (3,217 females and 3,125 males) were living with both parents. Mean age was 16.5 years. United States	Adolescents from socioeconomically disadvantaged families and those who were associated with deviant peers engaged in more risky sexual behaviors. A satisfying parent–child relationship did not directly influence adolescents’ risky sexual behaviors. Adolescents who were more satisfied with their relationships with parents, however, were less likely to be associated with deviant peers and, in turn, reduced their engagement in risky sexual behaviors. Adolescents with parents who reported communicating about sexual issues actually engaged in more risky sexual behaviors. The satisfying relationship was protective to the adolescent.
Cox (2006)	Secondary analysis of Ad Health data for Waves I and II	Youth condom use at sexual debut	For teens, M age = 17.6 years; 56% females; 11% African American; 75% two-parent households; M = $51,000 household income. 153 mother–adolescent dyads United States	Logistic regression analysis to demonstrate that maternal demandingness reliably predicted adolescent condom use, and race was a significant predictor. For African American youth, as maternal demandingness increased, so did condom use, but for Whites, increasing maternal demandingness predicted lower condom use.
Grey et al. (2004)	Descriptive	Quality of life of adolescent with diabetes. Measures: self-perceptions to manage diabetes—35-item Self Efficacy for Diabetes scale; self-reported depressive behavior—27-item Children’s Depression Inventory; issues in handling IDDM—28-item Issues in Coping with IDDM scale; behaviors to manage problems or situations—54-item Adolescent Coping Orientation for Problem Experiences; Diabetes Family Behavior; Family Adaptability and Cohesion Evaluation Scale; Diabetes Quality of Life: Youth; and HbA1c	52 families of children with insulin-dependent diabetes mellitus. Income was >$40,000 in 58% of families; most were White; child’s mean age was 16.1 years (SD = 1.9); diagnosed with diabetes for 8 years (SD = 0.8), 49% female, 55% had injections >3 times/day, with an HbA1c of 9.8 (SD = 1.7) United States	The coping strategy of rebellion and ventilating were used to cope with problems in their lives. Families were relatively warm and caring but provided less guidance and control than average adolescents. Families were reported to be relatively flexible and connected. The challenge will be to find the degree of parental involvement that is comfortable for all involved, without risking poorer control from over-involvement or under-involvement. Because family warmth and caring, and adaptability and cohesion were not associated strongly with quality of life, the adolescents in this study may have negotiated a comfortable degree of involvement, whereas those who did not consent to the study may not have.
Hanna et al. (2003)	Descriptive survey	Parental involvement in diabetes management responsibility and metabolic control from the adolescent perspective Measures: Independent Functioning in Diabetes Management Checklist, Independent Decision Making in Diabetes Management Checklist, Communication of Diabetes Management, Parental Support for Diabetes Management; All adapted for this study.	27 adolescents, mean age = 15 years, SD = 1.9, minimum age = 11 years, maximum age = 18 years; 52% female; 89% Caucasian; duration of diabetes—M = 7 years, SD = 1.3; HbA1c—M = 8.5, SD = 1.3; 63% living with both biological parents. United States	High level of communication amounts and agreement, low level of seeking parental support, high level of receiving parental support. Seeking and receiving support increased from early to middle adolescence but then decreased in late adolescence. Communication agreement was related to worse metabolic control; in other words, metabolic control was worse when the adolescent reported less agreement with parents about diabetes management responsibility.
Kendall et al. (2005)	Descriptive correlational	Explain family living with children with ADHD. Measures: social characteristics; child behavior problems—118-item Child Behavior Checklist; mother’s distress—53-item Brief Symptom Inventory; family conflict—90-item Family Environment Scale	157 families from California and Oregon; 31% African American, 36% Hispanic American, 33% Euro-American; mothers had a minimum age of 21 years and a maximum age of 79 years, M = 38.3, SD = 8.7; Children’s ages had a minimum of 6 years and a maximum of 18 years, M = 10.8, SD = 3; 51% single-parent families; well-distributed family incomes United States	Children with more comorbidities had more behavior problems; increases in behavior problems were associated with distress in the mothers; mothers reporting distress had higher family conflict; families with older children had more conflict. No associations between ethnicity and income were found for family conflict. Ethnic differences in what constitutes problem behavior in children need further examination. Behavioral interventions that do not take maternal distress into account may not be effective.
Kim (2005)	Descriptive cross-sectional	Parent Acceptance and Rejection Questionnaire (PARQ)	106 young adolescents, 26 Korean born age—M = 12.7 years, SD = 1.2; U.S. residency—M = 6.3 years, SD = 4.3; 80 U.S.-born age—M = 12.3 years, SD = 1.1; 104 mothers, 26 Korean-born youth age—M = 41.7 years, SD = 4.6; U.S. residency—M = 6.7 years, SD = 5; education—M = 15.9 years, SD = 2.8; work hours/ week—M = 20.6, SD = 24.3; U.S.-born youth age—M = 42.3 years, SD = 4; U.S. residency—M = 17.8 years, SD = 5.2; education—M = 14 years, SD = 3; work hours/week—M = 29, SD = 20. 97 fathers, Korean-born youth age— M = 43 years, SD = 5; U.S. residency—M = 8, SD = 6; education—M = 17 years, SD = 3; Work hours/week—M = 50, SD = 17; U.S.-born youth age—M = 46 years, SD = 4; U.S. residency—M = 20, SD = 5; education—M = 17 years, SD = 3; work hours/week—M = 49, SD = 13. United States	Young adolescents and their parents agreed that parents tended to be loving and warm, and moderate to firm in behavioral control. Korean-born adolescents were more accepting of parental control than American-born Korean adolescents. Mothers and young adolescents viewed behavioral control as less acceptance, while fathers viewed behavioral control as warmth/affection.
Murata (1994)	Descriptive	Stress, social support, and conflict tactics	23 mother–son pairs Sons’ M age = 8.8 years Mothers’ M age = 35.5 years African American United States	Low-income African American mothers reported a mean of 15 recent stressful family events in contrast to 11 for Anglo-Saxon, protestant families. Self-esteem and instrumental aid were the most available forms of social support. Mothers’ use of verbal aggression was high. No serious behavior problems were found. Family stress was found to be significantly related to mothers’ verbally aggressive conflict tactics, and mothers’ verbal aggression was highly correlated with their use of violence, which was associated with sons’ internalizing behavior.
Pai et al. (2004)	Cross-sectional, descriptive	Climacteric and the mother–daughter relationship	70 mother–daughter pairs. Daughters’ M age = 17 years Mothers’ M age = 46.9 years Taiwan	Based on scores on the Parent Child Relationship scale, sense of attachment was ranked first by mothers and daughters. Statistical differences in the perception of the relationship were found between mothers and daughters on all 5 scales: sense of attachment, absence of sense of autonomy, sense of indebtedness, sense of respect, and instrumental valance.*
Riesch et al. (2000)	Descriptive survey	Topics of conflict between parents and young adolescents Measures: Issues Checklist	178 young adolescents—M age = 12.6 years, SD = 1; 55% female, 55% firstborn. 144 mothers—M age = 39 years, SD = 5.4; education—M = 14.6 years, SD = 2.7; 34 fathers—M age = 41 years, SD = 5; education—M = 16 years, SD = 3; 80% White, 15% Black, 3% Hispanic, 2% Asian, 1% Native American United States	Typical issues included chores and getting in sibling fights. Discussions are not typically angry. Mothers had more issues than adolescents or fathers. Topics not chosen were what is typically termed health risk behavior (tobacco, alcohol, language use). The topics endorsed most frequently by mothers, fathers, and young adolescents were chores and sibling relationships, and those endorsed least frequently were timing of meals, potential risk situations, and behaviors such as smoking, drinking, dating, and picking books and movies. The topics discussed most and least frequently followed the same pattern. In terms of intensity of discussion, fighting with siblings, talking back, lying, grades, and chore activities were cited as most intense, while the taking care of things and potential risk situations and behaviors were the least. When compared with other findings from the literature, this sample scored slightly above previous samples of non-distressed families but below distressed families.
Willgerodt and Thompson (2005)	Secondary analyses of the National Longitudinal Study of Adolescent Health data	Family relations among Filipino and Chinese adolescents. Measures: generational status—foreign born, parents foreign born, U.S.-born adolescents and parents; ethnicity—216 Chinese and 387 Filipino adolescents; parent–adolescent relationship—6 items for mother, 5 items for father; parent adolescent activities—10 items per parent; family closeness—4 items; demographics—3 items	216 (57% male) self-identified Chinese adolescents with a minimum age of 13 years and a maximum age of 19 years, M = 15.5, SE = 0.28. Minimum family income: $2,000, and maximum: $600,000, M = $59,000, SE = 6.39; 387 (58% male) self-identified Filipino adolescents with a minimum age of 12 years to a maximum of 20 years, M = 16, SE = 0.47, minimum family income: $0,000; maximum: $450,000, M = $41,000, SE = 4.22 USA	Ethnicity was not associated with relationship satisfaction, activities with either parents, or perceived family closeness. Third-generation youth were more satisfied with their relationship with their parents, engaged in more activities with their mothers, and perceived higher levels of family closeness compared with first- or second-generation youth. Older adolescents were less satisfied with relationships with mothers and fathers; males were more satisfied with their relationship with their mothers, but females engaged in more activities with their mothers. The authors suggested including additional variables such as household composition and size in future studies.

IDDM, insulin-dependent diabetes mellitus.

^*Parent Child Relationship scale (Lo, 1998).