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. Author manuscript; available in PMC: 2011 Mar 3.
Published in final edited form as: J Spec Pediatr Nurs. 2010 Apr;15(2):111–134. doi: 10.1111/j.1744-6155.2009.00223.x

Table 2.

Assessment Model: Nursing Research Studies on At-Risk Parent-Child Relationships: 1980-April, 2008

Source Design/Theory Focus/Measures Sample Results
Barabach, Glazer, & Norris (1992) Descriptive, two-group observational pilot/Attachment Theory Observations of parent-infant interaction between women with positive cocaine drug screens and negative urine drug screens/Nursing Child Assessment Feeding Scale (NCAFS; Barnard, 1980), Neonatal Perception Inventory 1 (Broussard, 1978) n = 30 mothers, 15 with positive drug screens and 15 with negative drug screens; Infants: ages 18 to 36 hours old, mothers: African-American, USA No significant differences between the groups on maternal perception of the infant or parent-infant interaction, mothers with positive urine screens were less sensitive to the cues of the infants than the mothers with negative screens, three subscales trended toward significance: response to distress, clarity of cues, and responsiveness to parent
Becker, Engelhardt, Steinmann, & Kane (1997) Descriptive, correlational/Family and Social Systems Theory, Ecological Theory Examine relationship between child’s development, context, family and social system characteristics and interactive behavior of mothers, infants with and without mental delay/NCAST scales (Barnard, 1980), Family Inventory of Life Events and Family Crisis Oriented Personal Scales (McCubbin & Thompson, 1987) n = 60 mothers, children ages 8–24 months, mothers: 59 Caucasian, 1 Native American, USA Interactive behavior of infants with special needs was rated as less clear in communicative signals and less responsive than that of typically developing infants of similar mental age, behavior of mothers was rated less optimal in support for social-emotional and cognitive development – differences appeared in the demanding teaching but not in the more casual feeding situations
Board & Ryan-Wenger (2003) Three-group, prospective comparison/Resiliency Model of Family Stress, Adjustment, and Adaptation (McCubbin & McCubbin, 1993) Prospective study of family functioning and stress of parents with children who were critically ill or who were hospitalized compared to parents of ill children hospitalized in a GCU, and parents with ill children in a clinic or urgent care setting/Parental Stressor Scale: PICU, Symptom Checklist-90, Family Assessment Measure III, Family Inventory of Life Events and Changes n = 31 PICU (mean child age = 13.8 mo, n = 25 Caucasian), n = 32 GCU (mean child age = 5.4 mo, n = 28 Caucasian), n = 32 nonhospitalized (mean child age – 24.7 mo, n = 22 Caucasian), all mothers, USA Mothers in all groups had higher stress levels than the normative sample, families perceived as dysfunctional after discharge, possibly indicating family is establishing new patterns of functioning after a stressful event like serious illness.
Connelly (2005) Descriptive, correlational/No explicit theory Examination of relationships among family functioning, hope, quality of life in children with juvenile rheumatoid arthritis/Parents: Feetham Family Functioning Survey, Parent Report for Children Pediatric Quality of Life (Peds QL) Inventory, Parent Report for Children Peds QL Rheumatology Module; Children: Children’s Hope Scale, Child Report Peds QL, Child Report for Children Peds QL Rheumatology n = 68, child ages 8–12 years, mothers and fathers, 94% Caucasian, 6% Hispanic, USA Family functioning and children’s hope showed a negative correlation, indicating children’s hope was lower when parents reported greater dissatisfaction with family functioning. Hope not related to parent/child ratings of the child’s quality of life.
Copeland & Harbaugh (2005) Quantitative, Descriptive/Belsky’s Model of the Determinants of Parenting (1984) Differences in parenting stress among single & married mothers/Parenting Stress Index/Short Form (PSI/SF; Abidin, 1995) n = 80 mothers, infant ages 2 days-8 weeks, 81% Caucasian, 15% African American, 2.5% Hispanic, USA Single mothers scored higher than married mothers on Parenting Stress Index Total Score, Difficult Child, Defensive Responding subscales, no significant difference between single and married mothers on the dysfunctional interaction subscale.
Dashiff, Bartolucci, Wallander, & Abdullatif, (2005) Descriptive, longitudinal/No explicit theory Investigation of the relationship of family structure and maternal employment with family conflict and the relationship of family conflict with self-care adherence/Issues Checklist, Diabetes Family Conflict Scale, Self-Care Adherence Inventory n = 161 adolescents ages 11–15 years with Type 1 diabetes, about 20% Black, 80% Caucasian, USA No relationship was found between general conflict/diabetes-specific conflict and diabetes self-care adherence.
Hale, Holditch-Davis, D’Auria, & Miles (1999) Descriptive, longitudinal/Attachment theory Examination of Attachment During Stress scale (ADS) for measuring the emotional involvement of HIV-positive mothers with their infants during a clinic visit and to explore effects of maternal health status, age, parity, and educational level on mother-infant involvement/Massie-Campbell Attachment During Stress (ADS) scale (Massie, 1983) n = 57 mothers, child ages 3–12 months, 89.5% African American, 7% Caucasian, 3.5% Native American, USA Maternal age, education level, health status, and parity were not related to maternal emotional involvement. However, the emotional involvement of the mother and infant were correlated (r = 0.73, p < .001).
Holditch-Davis, Sandelowski, & Harris (1998) Naturalistic, two-group observational/No explicit theory Early parent-infant interactions in infertile couples who become parents through pregnancy or adoption/Observation of parent-infant interactions using ethnogram developed by Thoman et al. (1979) n = 30 couples, 21 adoptive couples, 19 fertile couples, Child ages = 11–160 days, mothers and fathers, reported to be mostly Caucasian, details of racial/ethnic characteristics not given, USA No differences between fertile and infertile biological parents. Adopted infants showed more alertness, less sleeping, more smiles, and more looking than biological infants. Adoptive mothers spent less time as the sole interactor. Adoptive parents spent more time in playing with infants, held and touched them less than did biological parents. Infertility does not appear to affect early parenting. Amounts of behaviors of infertile biological parents were very close to those of fertile parents.
Holditch-Davis, Sandelowski, & Harris (1999) Naturalistic observational/No explicit theory Influence of infertility on mothers’ and fathers’ interactions with young infants/Observation of parent-infant interactions n = 70 couples, 30 with history of infertility and biological children, 21 adoptive, and 19 fertile, Child ages 11–160 days, reported to be mostly Caucasian, details of racial/ethnic characteristics not given, USA Fathers had less interaction time than mothers and provided less stimulation. Adoptive mothers showed the least feeding, holding, body contact, looking, and touching of all mothers and fertile mothers the most. Adoptive fathers showed most of these behaviors and fertile fathers the least. Fathers with a history of infertility, and especially adoption, appear to be more involved in interacting with their infants.
Leonard, Jang, Savik, & Plumbo (2005) Cross-sectional, descriptive/Conceptual Framework based on Rolland’s Model of Family Adaptation to Illness Examination of the relationship between family functioning and metabolic control in adolescents with Type 1 diabetes/McMaster Family Assessment Device (family functioning), Youth Self-Report Form (adolescent behavior), HbA1c levels n = 226 youth 11 – 18 years old (mean age = 15.5 years) and their parents, 96% Caucasian, USA Increased family dysfunction, older adolescents, males, and adolescents with greater problem behaviors had higher HbA1c levels.
Leonard, Skay, & Rheinberger (1998) Quantitative, descriptive/Bandura’s Social Learning Theory Investigation of maternal self-efficacy and its relationship to maternal perception of the child’s self-management of diabetes/Maternal Self-Efficacy for Diabetes Management, Mother’s perceptions of the child’s level of self-care n = 154 mothers, child ages 8–17 years, race/ethnicity not described, USA 30% of mothers reported interpersonal conflict over amount of responsibility children should assume in managing their own diabetes. Mothers who rated their children’s level of independence as low were three times more likely to report experiencing conflict. The child was most often the primary source of conflict. Hierarchical logistic regression of children’s independence showed conflict with child remained significant predictor, above and beyond background, demographic, and important conceptual variables, including self-efficacy.
Lobo (1992) Two groups observation/Barnard’s Ecological Model Parent-infant interaction during feeding of an infant with congenital heart disease (CHD). Infant heart rate and respiratory rate/NCAFS n = 10 mother-infant dyads with CHD, n = 10 mother-infant dyads without CHD, child ages 16–17 weeks, race/ethnicity not reported, USA Infants with CHD scored significantly lower than controls on subscales of Responsiveness to Caregiver and Clarity of Cues of the NCAFS. Mothers scored significantly lower on the Social Emotional Growth Fostering subscale.
Van Riper (2000) Descriptive, Correlational/Resiliency Model of Family Stress, Adjustment, and Adaptation (McCubbin & McCubbin, 1993) The Resiliency Model used to explore relationships among family demands, family resources, family problem-solving communication, family coping, and sibling well-being/Family Inventory of Life Events, Family Inventory of Resources for Management, Family Problem-solving Communication Index, Family Crisis Oriented Personal Evaluation Scales (McCubbin & Thompson, 1987) n = 41 families of children with Down syndrome, child ages 1 18, M = 8.4, 93% Caucasian, USA There was a significant positive association between family problem-solving communication and family resource, sibling social competence, and self-concept.
Van Riper (2007) Descriptive, Correlational/Resiliency Model of Family Stress, Adjustment, and Adaptation (McCubbin & McCubbin, 1993) A description of maternal perceptions of parental and family adaptation and an examination of linkages between family demands, family resources, family problem-solving and coping, and adaptation in families raising a child with Down syndrome/Family Inventory of Life Events, Family Inventory of Resources for Management, Family Problem-solving Communication Index, Family Crisis Oriented Personal Evaluation Scales (McCubbin & Thompson, 1987) n = 76 families of children with Down syndrome, child age mean = 7.5, 95% Caucasian, USA Family problem-solving communication was significantly positively related to family adaptation.
Youngblut & Brooten (2008) Prospective survey/Resiliency Model of Family Stress, Adjustment, and Adaptation (McCubbin & McCubbin, 1993) Examination of mother’s mental health, mother-child relationship, and family functioning 3 months after a preschooler’s head injury/2 domains of the Mental Health Inventory, Parenting Stress Index – Short Form, 2 subscales (family adaptability and cohesion) of FACES-II, Multidimensional Scale of Perceived Social Support, Mental Health Inventory, Parental Stressors Scale n = 80 mothers of children ages 3–6 years, 50% Caucasian, 29.5% African American, 19.2% Hispanic, 1.3% Asian, USA The mother-child relationship and family functioning did not differ across mild, moderate, serious, severe/critical head injury severity groups. Psychological distress 24 to 48 hours after hospital admission negatively affected parenting distress and family cohesion and had a continuing impact on parenting distress and family adaptability at 3 months post discharge. Social support positively affected parenting distress, quality of mother-child relationship, and the family’s adaptability. Family cohesion was higher in 2-parent families compared to single-parent families.
Youngblut & Brooten (2006) Descriptive, correlational/No explicit theory Comparison of mothers’ and fathers’ reactions to child’s head injury, perceptions of child’s injury severity, and social support and mental health/FACES II, Parenting Stress Index, Parent Mental Health, Parental Concerns Scale, Parental Stressors Scale, Multidimensional Scale of Perceived Social Support n = 106 families, n = 97 mothers, n = 37 fathers, children preschool age, 46% Caucasian, 34% African American, 19% Hispanic, 1% Asian, USA Mental health after discharge related to social support and baseline mental health, mothers’ parental distress was related to perceived injury severity and social support. Greater family cohesion was related to baseline mental health, social support, and being in a two-parent family for mothers and social support for fathers
Youngblut & Lauzon (1995) Cross-sectional, comparative/No explicit theory A comparison of family functioning between families with children hospitalized in a pediatric intensive care unit (PICU) and families with children hospitalized in a general care unit (GCU)/FACES III, Feetham Family Functioning Survey, Pediatric Risk of Mortality Scale n = 27 PICU families, n = 25 GCU families, 84% Caucasian, 15% African American, 4% Native American, USA Severity of illness in the child was negatively related to family adaptability in mothers and family cohesion in fathers, length of hospital stay was negatively related to fathers’ perceptions of family adaptability and cohesion and mothers’ perceptions of family adaptability
Youngblut & Shiao (1993) Pilot study, correlational, repeated measures design/Family Systems Theory A description of child behaviors and family functioning after a child’s discharge from a PICU and an exploration of the relationship between family reactions and child’s severity of illness and child and family outcomes after discharge, Parental Concern Scale, and Parental Stressor Scale: PICU, Posthospitalization Behavior Questionnaire, Feetham Family Functioning Survey, FACES III, Pediatric Risk of Mortality Scale n = 9 families, average child age = 19.5 months, all Caucasian, USA PICU admission stressful for parent, regardless of severity of child’s illness, mother’s perception of family may be negatively affected
Youngblut, Singer, Madigan, Swegart, & Rodgers (1998) Descriptive, Correlational/Family Systems Theory An exploration of differences in home environments, stress in mother-child relationship, and mothers’ satisfaction with family functioning in employed and nonemployed single mothers of low birth weight (LBW) and full-term preschool children/Parenting Stress Index, Feetham Family Functioning Survey, Home Observation for Measurement of the Environment n = 61 families with full-term preschoolers and n = 60 families with LBW preschoolers, 66.1% African American, USA Employed mothers had more positive perceptions and provided more enriching home environments for their children. But when sociodemographic factors were controlled mothers’ employment was not related to any of the mother-child or family measures.