Chronic maternal illness: The adjustment of young adult offspring
Strauss, Phyllis Koling
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Advances in the treatment of cancer have created a situation of chronic illness which is stressful for patient and family members. The purpose of this study was to investigate the relationship between illness-related variables and the emotional and social adjustment of young adults to chronic life threatening maternal illness. The subjects were 30 sons and daughters, between the ages of 18 and 35, of women attending an out-patient oncology clinic of an inner-city hospital. Adjustment was measured by self-report questionnaires administered in the context of a semi-structured interview. Emotional adjustment was measured by subscales of the Profile of Adaptation to Life--Clinical Form and the Impact of Event Scale. Social adjustment was measured by subscales of the Social Adjustment Scale--Self-Report. Measures of severity of maternal illness were obtained from the medical records. Judgements about the mother's functioning were made by the mother's physician and clinic nurse using the Karnofsky Patient Performance Rating Scale and the Rating of Psychosocial Function Scale.;It was hypothesized that increased severity of maternal illness and impaired physical and psychosocial functioning of the ill mother would be associated with lower levels of offspring emotional and social adjustment. The hypotheses were partially confirmed. Increased severity of illness was associated with frequent reporting of negative emotions, recurrent intrusions and conscious avoidance of thoughts and feelings about maternal illness, inhibitions of social activities and peer relations, and tension in close personal relationships. The response pattern associated with severe illness was compared with the stress response syndrome described by Horowitz (1982, 1986) and implications for treatment were discussed. Physical functioning was paradoxically related to measures of emotional adjustment. This finding was interpreted with reference to Lazarus and Folkman's (1984) understanding of the influence of situational variables on the coping process. The adaptive use of denial in coping with the stress of severe illness was discussed. There was no relationship between the psychosocial functioning of the ill mother and any aspect of her offspring's adjustment. Clinical applications and implications for future research were presented.