Relationship Between Social Problem-Solving Skills, Quality of Life, and Family Adjustment in

188 Pages·2015·5.17 MB·English

Philadelphia College of Osteopathic Medicine
DigitalCommons@PCOM
PCOM Psychology Dissertations Student Dissertations, Theses and Papers
2009
Relationship Between Social Problem-Solving
Skills, Quality of Life, and Family Adjustment in
Caregivers of Children with Developmental
Disability
Bonita Ellen Fisher
Philadelphia College of Osteopathic Medicine, [email protected]
Follow this and additional works at:http://digitalcommons.pcom.edu/psychology_dissertations
Part of theClinical Psychology Commons
Recommended Citation
Fisher, Bonita Ellen, "Relationship Between Social Problem-Solving Skills, Quality of Life, and Family Adjustment in Caregivers of
Children with Developmental Disability" (2009).PCOM Psychology Dissertations.Paper 47.
This Dissertation is brought to you for free and open access by the Student Dissertations, Theses and Papers at DigitalCommons@PCOM. It has been
accepted for inclusion in PCOM Psychology Dissertations by an authorized administrator of DigitalCommons@PCOM. For more information, please
[email protected].
Philadelphia College of Osteopathic Medicine
Depmtment of Psychology
THE RELATIONSHIP BETWEEN SOCIAL PROBLEM-SOLVING SKILLS,
QUALITY OF LIFE, AND FA MIL Y ADJUSTMENT IN CAREGIVERS OF
CHILDREN WITH DEVELOPMENTAL DISABILITY
By Bonita Ellen Fisher
Submitted in Partial Fulfillment of the Requirements of the Degree of
Doctor of Psychology
May 2009
COLLEGE OF OSTEOPATIDC MEDICINE
DEPARTMENT OF PSYCHOLOGY
Dissertation Approval
This is to certify that the thesis presented to us by Bonita Fisher on the 28th day of April
2009, in partial fulfillment ofthe requirements for the degree of Doctor of Psychology,
has been examined and is acceptable in both scholarship and literary quality.
Committee Members' Signatures:

Stuart Badner, Psy.D., Chairperson

Steven Godin, Ph.D.

Adnan Zawawi, M.D.

Robert A. DiTomasso, Ph.D., ABPP, Chair, Department of Psychology
iii
Dedication
"The world is round, and the place which may seem like the end
may also be only the beginning."
- Ivy Baker Priest
This dissertation is dedicated to the families who made it possible. They have
allowed me into their hearts and their families for nearly 20 years, sharing joys,
sorrows, successes and frustrations. They embody courage, patience, grace and
optimism, often under the proverbial fire. They rejoice with uncommon successes: a
child beginning to talk at the age of thirteen (no, it is not "too late"), persisting against
the voice of current wisdom; an autistic youngster signing the Apostles' Creed for his
church on an Easter Sunday morning; regaining balance in a family after years of
sleep deprivation and in the face of severe life-threatening disorders. These are life's
true heroes, and I am inspired by them. My love to you all, and many, many thanks.
IV
Aclmowledgements
First and foremost, I must thank my committee chair, Dr. Stuart Badner, for
his truly exceptional patience and encouragement. For his voice over the phone has
soothed more than one crisis in the making. His fami\y has been more than generous
in the sharing of his weekend hours. I thank you, Stuart.
Also contributing as committee members were Dr. Stephanie Felgoise and Dr.
Adnan Zawawi. Dr. Felgoise has assisted me throughout the journey that has been my
years at PCOM, and has provided invaluable insight into the Social Problem Solving
Model as is paramount in this study - indeed, a presentation by Dr. Felgoise initially
piqued my interest in the contribution of problem solving to the management of stress
chronic disease states. Friend and colleague Dr. Adnan Zawawi was instrumental in
the inception and design of this work, with ceaseless encouragement and countless
hours generously shared during my practicum at KidsPeace, and thereafter. My
hemifelt thanks to you both.
I would like to thank Kathleen Kelly, director of Northampton County
MH/MR Division, for graciously permitting my research with these parents, and to
my co-workers for their interest and encouragement.
I would also like to thank Dr. Richard Schall, and the neuropsychology staff at
Good Shepherd Rehabilitation Hospital for permitting me time during my internship
to devote to this project, and for their counsel and inspiration. It was a further
0ppOliunity to witness firsthand, the triumph of the human spirit in severe and
unimaginable trauma and tragedy, as well as the skill and compassion of their staff in
v
leveraging the healing of mind and spirit, which the body had often held captive.
Dr. Barbara Basile and Gene Miller have tirelessly supported my physical
being during these years of 75-hour work weeks, giving of themselves time and
again. I sincerely thank you both.
Drs. Beverly Comoy and Judith Ramirez were true comrades, blazing the path
just ahead of me, and offering voices and em ails of true empathy, humor, and an
uncanny knack for re-focusing on the proverbial forest in lieu of the trees.
Dear friend and colleague, Dr. Bill Van Meter, encouraged me in the taking of
that very first step, and each thereafter. Thank you, Bill.
Many have prayed for and loved me tlu'ough this process, in spite of my
notable absences at times. Words fail for the expression of gratitude to my brothers,
Ken, Dave, and Frank, and their families, who encouraged, humored, and fed me, and
helped to maintain my home during the longjouruey of this doctorate degree. And to
my children, Jeffrey and Stephanie, who have re-ordered their lives to accommodate
my studies, and have provided emiching love and support, often lacking the
reciprocation that was their due. The children to whom I am Nan, Paige and Calvin,
continue to remind me of the importance of play, with their exuberant and
youthful wonder at the world.
Most special words of all are reserved for my parents, Dwane and Mary
Annette Yoder, who have loved, supported and emphatically reiterated, time and
again, that truly, "all things are possible," and who have modeled, their lives long, a
faith I can only strive to emulate.
My heartfelt gratitude to each and everyone.
VI
In memory of Madeleine Anne Yoder
1955 - 2000
You always wanted me to meet a nice doctor
I've become one instead.
vii
Abstract
This study focused on the relationship between a caregiver's problem solving
skills, their perceived quality of life, their family's adjustment to their child's
disability, and the potential for mediation of those relationships by the child's
behavior. A total of 111 parents completed the Social Problem Solving Skills
InventOly-Revised, short fonn (SPSI-R:S), the World Health Organization Quality of
Life Assessment, brief version (WHOQOL-BREF), the Family Impact of Childhood
Disability Scale (FlCD), the Nisonger Child Behavior rating Form (NCBRF) and a
demographics questionnaire.
Analyses of the data by Pearson product-moment con'elation coefficient
identified significant correlations between scores on the problem orientation
components of the SPSI-R:S) and quality oftife (QOL) scores on the WHOQOL
BREF domains. Scores in all four domains (psychological, social, environmental, and
physical) demonstrated positive correlation with Positive Problem Orientation (PPO),
and negative correlation with Negative Problem Orientation (NPO).
Of the problem solving styles, scores on both Rational Problem Solving (RPS)
and Impulsive/Careless Style (ICS) demonstrated small correlations (positive and
negative, respectively) with scores on only one - the psychological -domain of the
WHOQOL-BREF. Scores on Avoidant Style (AS) were negatively conelated with
three of the four WHOQOL-BREF domains: physical, psychological, and
environmental.
viii
There were no significant correlations between problem orientations and
scores on the FICD. Of the problem solving style scores, only Impulsive/Careless
style (ICS) scores were correlated with FICD (positive subscale scores, in the
negative direction). There were no correlations between any problem solving scores
(orientation or style) and negative subscale scores of the FlCD. There was 110
mediation by the child's behavior, as measured by scores on the NCBRF, in any of
the correlations found. Scores 011 the Problem Behavior scale of the NCBRF were
indeed correlated with QOL scores, but were independent of the other correlations.
Problem-solving interventions may contribute to an increase of quality of life
in parents of children with developmental disability.
IX
Table of Contents
Chapter 1 - Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1
Family Adjustnlent .................................................................... 1
Impact of Child Characteristics on Family Adjustment......... .... ............. 4
Research on Family Characteristics... ......... .. ...... .............. ........... ... 8
Coping Resources ..................................................................... 13
Personal Coping Resources ................................' . . . . . . . . . . . .... 13
Socio-Ecological coping resources..................................... 22
Adaptation to Caregiving: The Research. .. . .. .. .. .. .. .. .. .. .. .. . .. .. . .. . .. .. ..... 28
Problem-Solving Ability and Family Functioning............................... 32
The Social Problem Solving Model....... .................................... ..... 36
Well-being: Definition and Correlates............................................. 42
Purpose of the Study ........................ .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ... 46
Rationale ............................................................................... 48
Hypotheses .......................................................................... '" 49
Chapter 2 Method. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . ... 52
PartIclpants ............................................................................. 52
Procedures.............................................................................. 53
Measures ................................................................................ 54
Demographic Information ............................................. ,. 54
Social Problem Solving Inventory-Revised, short form (SPSI-R:S) ..... 54
World Health Organization Quality of Life, brief version
(WHOQOL-BREF).,., .......................... , .................. "... 58
Family Impact of Child Disability scale (FlCD) ........................... 61
Nisonger Child Behavior rating Form (NCBRF) ........................... 62
Research Design .............. , ................. , ..... ... .... ..... . ......... ... ........ 65