title: Family adjustment and parenting stress when an infant has serious liver disease: the Australian experience.
abstract: OBJECTIVE
  Parenting stress, problems in family functioning, and lack of fathers' engagement in treatment are associated with poor quality of life in children with chronic illnesses. The aim of the present study was to examine these characteristics in families of infants with serious liver disease in Australia, to inform the provision of mental health care for these families.
  
  
  METHODS
  From September 2009 to May 2013, 42 parents of infants recently diagnosed as having serious liver disease (defined as liver disease that may require transplantation in the future) completed questionnaires about family function, impact of the infant's illness on the family, parent stress symptoms, and fathers' engagement in the care of the child. Participants were recruited from 4 metropolitan children's hospitals in Australia.
  
  
  RESULTS
  Parents reported psychological symptoms at similar rates to normative populations. Their reports of family functioning were significantly below mean scores in previously published populations with a medically ill family member (population mean 1.89; mothers mean 1.59; fathers mean 1.61, P < 0.001). Disruption to family roles was significantly correlated with psychological symptoms for mothers (r = 0.48, P < 0.01) and fathers (r = 0.31, P < 0.05). Greater helpfulness of fathers was correlated with lower depression in mothers (r = -0.35, P < 0.05), and fathers' anxiety was correlated with their increased engagement (r = 0.40, P < 0.01).
  
  
  CONCLUSIONS
  When parents report the presence of psychological symptoms, symptoms are likely to be present in both parents and are associated with difficulties adjusting to disrupted family roles. Father engagement may be protective of mothers' mental health.
authors: *Departments of Psychological Medicine †Gastroenterology ‡Department of Gastroenterology and Clinical Nutrition §Queensland Paediatric Gastroenterology, Hepatology, and Nutrition Service, Royal Children's Hospital, Melbourne ¶Social Work, Children's Hospital, Westmead, Sydney ||Department of Gastroenterology, Sydney Children's Hospital, Randwick, Australia #Department of Paediatrics, University of Otago, Christchurch, New Zealand **Department of Psychiatry, University of Melbourne, Melbourne ††Discipline of Psychiatry, Sydney Medical School, Sydney, Australia.
authors: Michael R
authors: MR
authors: Bowden
authors: Michael
authors: M
authors: Stormon
authors: Winita
authors: W
authors: Hardikar
authors: Looi C
authors: LC
authors: Ee
authors: Usha
authors: U
authors: Krishnan
authors: Diana
authors: D
authors: Carmody
authors: Vicki
authors: V
authors: Jermyn
authors: Mee-Mee
authors: MM
authors: Lee
authors: Edward V
authors: EV
authors: O'Loughlin
authors: Janine
authors: J
authors: Sawyer
authors: Kathe
authors: K
authors: Beyerle
authors: Daniel A
authors: DA
authors: Lemberg
authors: Andrew S
authors: AS
authors: Day
authors: Campbell
authors: C
authors: Paul
authors: Philip
authors: P
authors: Hazell
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology; D001315:Australia / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005195:Family Relations / Q000523:psychology*; D005220:Fathers / Q000523:psychology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008107:Liver Diseases / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D009035:Mothers / Q000523:psychology; D016487:Parenting / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires