Mi Young Kim

doi:10.4040/jkan.2015.45.6.890

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Original Article
Factors Influencing Posttraumatic Growth in Fathers of Chronically ill Children: Mi Young Kim; Journal of Korean Academy of Nursing 2015;45(6):890-899.
DOI: https://doi.org/10.4040/jkan.2015.45.6.890
Published online: December 15, 2015

College of Nursing, Eulji University, Seongnam, Korea

Address reprint requests to : Kim, Mi Young College of Nursing, Eulji University, 553 Sanseong-daero, Sujeong-gu, Seongnam 13135, Korea Tel: +82-31-740-7398 Fax: +82-31-740-7359 E-mail: kimmy@eulji.ac.kr

• Received: June 4, 2015 • Revised: June 17, 2015 • Accepted: September 15, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

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Abstract
REFERENCES

Abstract

Purpose
The purpose of this study was to identify the level of distress and posttraumatic growth in fathers of chronically ill children and also, to identify the relation between characteristics of the fathers and children and their posttraumatic growth and to investigate factors that influence posttraumatic growth.
Methods
In this study, 48 fathers who visited a university hospital in Seoul, Korea and who gave written consent completed the questionnaire between September 23 and November 19, 2013. Data were analyzed using Mann-Whitney U test, Kruskal-Wallis test, Pearson correlation coefficient and stepwise multiple regression.
Results
The level of distress in fathers of chronically ill children was relatively high and the majority of them were experiencing posttraumatic growth. Models including the variable (deliberate rumination, religiousness, optimism) explained 64.3% (F=26.38, p< .001) of the variance for posttraumatic growth. Deliberate rumination (β=.59, p< .001) was the most influential factor.
Conclusion
The findings demonstrate that it is essential for nurses to intervene and facilitate continuously so as to promote posttraumatic growth and relieve distress in fathers of chronically ill children. Furthermore, it is also necessary for nurses to find ways to develop ideal interventions to activate deliberate rumination and offer spiritual care and help maintain optimism in these individuals.
Keywords: Chronic disease; Fathers; Growth; Rumination; Religion

Figure 1.

A Theoretical Model of Posttraumatic Growth Model by Calhoun & Tedeschi (2006).

Table 1.

Posttraumatic Growth according to the General Characteristics of Father and Child and Characteristics related Child’s Disease(N=48)

Variables	Categories	n (%) or M±SD	Posttraumatic growth
Variables	Categories	n (%) or M±SD	M±SD	Median [Min, Max]	p
Fathers’ age (yr)	25~34	9 (18.8)	48.33± 17.68	53.0 [11, 69]	.248^*
	35~44	29 (60.4)	46.69± 18.02	43.0 [17, 79]
	45~54	10 (20.8)	57.90± 9.48	60.0 [42, 74]
		40.73± 5.77
Level of education	≤High school	13 (27.1)	51.00± 13.98	53.0 [11, 79]	.871^†
	≥College	35 (72.9)	48.71± 17.95	51.0 [29, 72]
Employment (at diagnosis)	Employed	47 (97.9)	49.98±16.42	52.0 [11, 79]	.125^*
	Not employed	1 (2.1)	19.00	19.0
Employment (current)	Employed	34 (70.8)	50.03±16.93	53.5 [17, 79]	.610^†
	Not employed	14 (29.2)	47.64±17.17	50.0 [11, 74]
Burden of medical care costs	None at all or hardly any	7 (14.6)	40.57±19.72	41.0 [11, 62]	.226^*
	Moderately	12 (25.0)	46.67±17.81	46.0 [19, 79]
	Very high	16 (33.3)	50.13±13.31	51.0 [29, 70]
	Extremely high	13 (27.1)	55.54±17.63	58.0 [17, 74]
Religion	Yes	30 (62.5)	55.67±15.09	59.0 [17, 79]	.001^†
	No	18 (37.5)	38.78±14.70	41.0 [11, 66]
Child’s age (yr)	0~2	11 (22.9)	52.00±13.60	53.0 [29, 70]	.239^*
	3~6	8 (16.7)	35.25±21.26	27.5 [11, 70]
	7~12	15 (31.3)	52.47±15.87	52.0 [27, 79]
	≥13	14 (29.1)	51.93±14.93	54.0 [17, 74]
		8.67±5.81
Child’s gender	M	31 (64.6)	48.90±16.00	51.0 [11, 74]	.746^†
	F	17 (35.4)	50.12±18.80	52.0 [17, 79]
Child’s birth order	1st or only child	33 (68.8)	49.03±16.52	51.0 [11, 79]	.772^†
	≥2nd	15 (31.2)	50.00±18.14	52.0 [19, 74]
Child’s age at diagnosis (yr)	0~2	18 (37.5)	49.39±17.27	51.5 [11, 70]	.829^*
	3~6	11 (22.9)	45.55±17.21	50.0 [19, 72]
	7~15	19 (39.6)	51.47±16.78	56.0 [17, 79]
		5.60±4.59
Duration of illness	3 months -1yr	20 (41.7)	46.35±15.31	46.0 [19, 69]	.668^*
	1~3 yr	12 (25.0)	50.50±24.05	57.5 [11, 79]
	3~5 yr	7 (14.6)	50.43±11.84	51.0 [35, 70]
	> 5 yr	9 (18.7)	53.56±12.88	52.0 [29, 69]
		3.16±4.10
Child’s diagnosis	Leukemia	15 (31.3)	50.93±15.45	52.0 [19, 74]	.621^*
	Brain tumor	6 (12.5)	46.83±19.90	50.5 [17, 69]
	Neuroblastoma	6 (12.5)	40.83±19.93	43.5 [11, 66]
	Others	21 (43.7)	51.33±16.50	53.0 [20, 79]

^*Kruskal-Wallis test;

^†Mann-Whitney U test.

Table 2.

Posttraumatic Growth according to Fathers’ Distress and Perception of Psychological Growth (N=48)

Variables	Categories	n (%) or M±SD	Posttraumatic growth
Variables	Categories	n (%) or M±SD	M±SD	Median [Min, Max]	p
Fathers’distress	Less than usual distress (≤3)	1 (2.1)	50.00	50.0	.800^†
(at diagnosis)	More than usual distress (≥4)	47 (97.9)	49.32±17.03	52.0 [11, 79]
(range 0~7)		6.71±0.71
Fathers’ distress	Less than usual distress (≤3)	6 (12.5)	57.83±7.60	57.5 [50, 70]	.249^†
(current)	More than usual distress (≥4)	42 (87.5)	48.12±17.50	51.5 [11, 79]
(range 0~7)		4.81±1.39
Fathers’ alleviation	Not alleviated	11 (22.9)	55.09±15.68	56.0 [17, 74]	.155^†
of distress	Alleviated	37 (77.1)	47.62±17.01	50.0 [11, 79]
Acceptable	Yes	45 (93.7)	61.67±7.51	51.0 [11, 79]	.147^†
	No	3 (6.3)	48.51±17.02	62.0 [54, 69]
Positive changes due	Yes	43 (89.6)	50.86±16.75	53.0 [11, 79]	.041^†
to child’s illness	No	5 (10.4)	36.20±12.19	41.0 [19, 50]
Experienced	Yes	47 (97.9)	49.77±16.76	52.0 [11, 79]	.220^†
psychological growth	No	1 (2.1)	29.00	29.0
The point at which	≤1	42 (87.5)	48.62±16.82	51.5 [11, 79]	.188^*
psychological growth	≤2	2 (4.2)	52.00±24.04	52.0 [35, 69]
began (yr)	Don’t know	3 (6.3)	64.33±4.93	62.0 [61, 70]
	Not yet	1 (2.0)	29.00	29.0
		6.00±5.74 months

^*Kruskal-Wallis test;

^†Mann-Whitney U test.

Table 3.

Mean Scores and Correlations for Posttraumatic Growth, Optimism, Disruption of Core Beliefs, Deliberate Rumination, Social Support(N=48)

Variables	M±SD	Posttraumatic growth	Optimism	Disruption of core beliefs	Deliberate rumination	Social support
Variables	M±SD	r (p)	r (p)	r (p)	r (p)	r (p)
Posttraumatic growth	49.33±16.85	1.00	.41 (.002)	.49 (<.001)	.69 (<.001)	.48 (<.001)
Optimism	16.58±2.98		1.00	.21 (.074)	.19 (.090)	.35 (.008)
Disruption of core beliefs	s 27.10±8.16			1.00	.48 (<.001)	.43 (.001)
Deliberate rumination	20.33±4.67				1.00	.41 (.002)
Social support	63.06±11.91					1.00

Table 4.

Multiple Regression Analysis of Father’s Posttraumatic Growth (N=48)

Variables	B	SE	β t (p)	Collinearity statistics
Variables	B	SE	β t (p)	Tolerance	VIF
Deliberate rumination	2.11	0.34	.59 6.25 (<.001)	.92	1.07
Religion^*	10.51	3.27	.31 3.22 (.002)	.90	1.10
Optimism	1.21	0.53	.21 2.27 (.028)	.91	1.09
R²=.64, F=26.38, p<.001

^*Dummy variable; Religion: Yes=1, No=0; VIF=Variation inflation factor.

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Figure & Data

REFERENCES

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Factors Influencing Posttraumatic Growth in Fathers of Chronically ill Children

J Korean Acad Nurs. 2015;45(6):890-899. Published online December 15, 2015

DOI: https://doi.org/10.4040/jkan.2015.45.6.890

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Factors Influencing Posttraumatic Growth in Fathers of Chronically ill Children

Figure 1. A Theoretical Model of Posttraumatic Growth Model by Calhoun & Tedeschi (2006).

Figure 1.

Factors Influencing Posttraumatic Growth in Fathers of Chronically ill Children

Variables	Categories	n (%) or M±SD	Posttraumatic growth
Variables	Categories	n (%) or M±SD	M±SD	Median [Min, Max]	p
Fathers’ age (yr)	25~34	9 (18.8)	48.33± 17.68	53.0 [11, 69]	.248^*
	35~44	29 (60.4)	46.69± 18.02	43.0 [17, 79]
	45~54	10 (20.8)	57.90± 9.48	60.0 [42, 74]
		40.73± 5.77
Level of education	≤High school	13 (27.1)	51.00± 13.98	53.0 [11, 79]	.871^†
	≥College	35 (72.9)	48.71± 17.95	51.0 [29, 72]
Employment (at diagnosis)	Employed	47 (97.9)	49.98±16.42	52.0 [11, 79]	.125^*
	Not employed	1 (2.1)	19.00	19.0
Employment (current)	Employed	34 (70.8)	50.03±16.93	53.5 [17, 79]	.610^†
	Not employed	14 (29.2)	47.64±17.17	50.0 [11, 74]
Burden of medical care costs	None at all or hardly any	7 (14.6)	40.57±19.72	41.0 [11, 62]	.226^*
	Moderately	12 (25.0)	46.67±17.81	46.0 [19, 79]
	Very high	16 (33.3)	50.13±13.31	51.0 [29, 70]
	Extremely high	13 (27.1)	55.54±17.63	58.0 [17, 74]
Religion	Yes	30 (62.5)	55.67±15.09	59.0 [17, 79]	.001^†
	No	18 (37.5)	38.78±14.70	41.0 [11, 66]
Child’s age (yr)	0~2	11 (22.9)	52.00±13.60	53.0 [29, 70]	.239^*
	3~6	8 (16.7)	35.25±21.26	27.5 [11, 70]
	7~12	15 (31.3)	52.47±15.87	52.0 [27, 79]
	≥13	14 (29.1)	51.93±14.93	54.0 [17, 74]
		8.67±5.81
Child’s gender	M	31 (64.6)	48.90±16.00	51.0 [11, 74]	.746^†
	F	17 (35.4)	50.12±18.80	52.0 [17, 79]
Child’s birth order	1st or only child	33 (68.8)	49.03±16.52	51.0 [11, 79]	.772^†
	≥2nd	15 (31.2)	50.00±18.14	52.0 [19, 74]
Child’s age at diagnosis (yr)	0~2	18 (37.5)	49.39±17.27	51.5 [11, 70]	.829^*
	3~6	11 (22.9)	45.55±17.21	50.0 [19, 72]
	7~15	19 (39.6)	51.47±16.78	56.0 [17, 79]
		5.60±4.59
Duration of illness	3 months -1yr	20 (41.7)	46.35±15.31	46.0 [19, 69]	.668^*
	1~3 yr	12 (25.0)	50.50±24.05	57.5 [11, 79]
	3~5 yr	7 (14.6)	50.43±11.84	51.0 [35, 70]
	> 5 yr	9 (18.7)	53.56±12.88	52.0 [29, 69]
		3.16±4.10
Child’s diagnosis	Leukemia	15 (31.3)	50.93±15.45	52.0 [19, 74]	.621^*
	Brain tumor	6 (12.5)	46.83±19.90	50.5 [17, 69]
	Neuroblastoma	6 (12.5)	40.83±19.93	43.5 [11, 66]
	Others	21 (43.7)	51.33±16.50	53.0 [20, 79]

Variables	Categories	n (%) or M±SD	Posttraumatic growth
Variables	Categories	n (%) or M±SD	M±SD	Median [Min, Max]	p
Fathers’distress	Less than usual distress (≤3)	1 (2.1)	50.00	50.0	.800^†
(at diagnosis)	More than usual distress (≥4)	47 (97.9)	49.32±17.03	52.0 [11, 79]
(range 0~7)		6.71±0.71
Fathers’ distress	Less than usual distress (≤3)	6 (12.5)	57.83±7.60	57.5 [50, 70]	.249^†
(current)	More than usual distress (≥4)	42 (87.5)	48.12±17.50	51.5 [11, 79]
(range 0~7)		4.81±1.39
Fathers’ alleviation	Not alleviated	11 (22.9)	55.09±15.68	56.0 [17, 74]	.155^†
of distress	Alleviated	37 (77.1)	47.62±17.01	50.0 [11, 79]
Acceptable	Yes	45 (93.7)	61.67±7.51	51.0 [11, 79]	.147^†
	No	3 (6.3)	48.51±17.02	62.0 [54, 69]
Positive changes due	Yes	43 (89.6)	50.86±16.75	53.0 [11, 79]	.041^†
to child’s illness	No	5 (10.4)	36.20±12.19	41.0 [19, 50]
Experienced	Yes	47 (97.9)	49.77±16.76	52.0 [11, 79]	.220^†
psychological growth	No	1 (2.1)	29.00	29.0
The point at which	≤1	42 (87.5)	48.62±16.82	51.5 [11, 79]	.188^*
psychological growth	≤2	2 (4.2)	52.00±24.04	52.0 [35, 69]
began (yr)	Don’t know	3 (6.3)	64.33±4.93	62.0 [61, 70]
	Not yet	1 (2.0)	29.00	29.0
		6.00±5.74 months

Variables	M±SD	Posttraumatic growth	Optimism	Disruption of core beliefs	Deliberate rumination	Social support
Variables	M±SD	r (p)	r (p)	r (p)	r (p)	r (p)
Posttraumatic growth	49.33±16.85	1.00	.41 (.002)	.49 (<.001)	.69 (<.001)	.48 (<.001)
Optimism	16.58±2.98		1.00	.21 (.074)	.19 (.090)	.35 (.008)
Disruption of core beliefs	s 27.10±8.16			1.00	.48 (<.001)	.43 (.001)
Deliberate rumination	20.33±4.67				1.00	.41 (.002)
Social support	63.06±11.91					1.00

Variables	B	SE	β t (p)	Collinearity statistics
Variables	B	SE	β t (p)	Tolerance	VIF
Deliberate rumination	2.11	0.34	.59 6.25 (<.001)	.92	1.07
Religion^*	10.51	3.27	.31 3.22 (.002)	.90	1.10
Optimism	1.21	0.53	.21 2.27 (.028)	.91	1.09
R²=.64, F=26.38, p<.001

Table 1. Posttraumatic Growth according to the General Characteristics of Father and Child and Characteristics related Child’s Disease(N=48)

Kruskal-Wallis test;

†

Mann-Whitney U test.

Table 2. Posttraumatic Growth according to Fathers’ Distress and Perception of Psychological Growth (N=48)

Kruskal-Wallis test;

†

Mann-Whitney U test.

Table 3. Mean Scores and Correlations for Posttraumatic Growth, Optimism, Disruption of Core Beliefs, Deliberate Rumination, Social Support(N=48)

Table 4. Multiple Regression Analysis of Father’s Posttraumatic Growth (N=48)