670I HOMEOSTATIC PATTERNS OF FAMILY BEHAVIOR IN THE PEDIATRIC CLINIC

Abstract

Clinic staff (CS) working with pediatric patients (pts) benefit from knowing the relationship between pt and parent (par) behaviors in the clinic. Also, CS need to know if they share similar perceptions of family behaviors, and if their perceptions are affected by age of pt. In our study of adolescents with cancer, a pt/par questionnaire was given to CS and research team (RT) to assess patterns of pt/par behaviors seen in clinic. The data were analyzed to assess inter-rater reliability (IRR) and influence of pt's age on IRR. Par and pt anxieties were unrelated, but pt anxieties were related to overprotective and controlling par behavior (factor analysis). Pt maturity was related to perceptions of pars as anxious and overwhelmed by pt's illness. IRR was .78 for CS and .84 for RT (p<.0001). For CS, IRR was .71 for 10-13 yr. olds and .82 for 14-18 yr. olds (p<.0001); these IRR's differed at p<.02 (Z=2.25). RT's IRR was .81 for younger and .86 for older pts (p<.001); these IRR's did not differ significantly. The difference between CS and RT IRR's of younger pts approached significance (p≃.06; Z=1.92). The data show 2 homeostatic patterns of pt/par behavior: (1) Pt and par anxieties are unrelated; rather, pars of anxious pts maintain control and are seen by staff as overprotective. (2) Pars of pts seen as mature show more anxiety and appear overwhelmed. It seems as if pts and pars alternately “hold the fort.” Although clinic staff found some difficulty in assessing younger pts, such strong agreement among inexperienced raters is striking.

Log in or create a free account to read this content

Gain free access to this article, as well as selected content from this journal and more on nature.com

Access through your institution

or

Sign in or create an account

Continue with Google

Continue with ORCiD