Adaptation of Caregivers of Children With Sickle Cell Syndromes

Objective: To examine moderating effects of family functioning and social support on the relationship of child-related stressors to caregivers ' psychological adaptation in a sample of caregivers of children with a chronic illness. Method: Participants were 67 caregivers of children and adolescents with sickle cell syndromes. We con-ducted MANOVAs and subsequent effect size calculations to determine if family functioning would buffer the effects of caring for difficult-to-manage children with this illness. Results: Findings supported a moderator effect of family functioning on the association of children's exter-nalizing behavioral problems to caregivers ' symptoms of hostility. Greater levels of cohesive and adaptive family functioning buffered the potential detrimental effects of caring for children perceived as hard to manage. No significant associations were obtained between measures of caregivers ' psychological adapta-tion and the severity of their children's disease. Conclusions: We make recommendations for family systems interventions, particularly for caregivers of chil-dren with behavior problems. Key words: sickle cell syndrome; family functioning. Childhood chronic illness represents one extreme source of parental strain for which a caregiver must manage the traditional tasks of parenting in ad-dition to the physical and emotional burdens of caring for a child with a physical malady (Drotar, This research was supported in full by the National Institutes of Health (NIH) Grant 1-P60HL48-482. We would like to acknowledge the contri-bution of Thomas Adamkiewicz, MD, for his assistance in the recruit-ment of subjects for this investigation and of Robert). Thompson, Jr., PhD, for his comments on an earlier draft of the manuscript. All corre-spondence should be sent to: Ronald T. Brown, Department of Pediatrics