Effects of Separation on Families During Hospitalization

Regionalization is becoming the most economical means of offering comprehensive health services, requiring families to travel to regional medical centers for specialized testing, diagnosis, and treatment. These circumstances can separate families and have a detrimental impact on the family and its functioning. The purpose of this study was to identify the stressors associated with family separations in such circumstances, the coping mechanisms and resources they use, and the effects of separation. This study was a prospective, two-group comparison, guided by the Resiliency Model of Family Stress, Adjustment, and Adaptation (McCubbin & McCubbin, 1991), and used methodological triangulation and testing of a hypothesized model. The sample included 188 families from outside the local area (over 50 miles) with a hospitalized child and a comparison group of 215 local families. A subset of 28 families participated in a focused series of interviews. Instruments included a demographic data sheet, the Family Inventory of Life Events (FILE), a visual analogue severity scale, the Family Crisis Oriented Personal Scales (F-COPES), the Family Inventory of Resources for Management (FIRM), the Parental Stress Scale, and the Feetham Family Functioning Survey (FFFS). Descriptive statistics were used on the sample. Relationships between variables and differences between groups were tested by independent t tests, MANOVA, and stepwise regression. Content analysis was used on qualitative data. This study demonstrated differences between the hospitalization experiences of local families and those that traveled. Predictors of positive coping mechanisms for medevac families included communication resources and the perceived severity of the child's condition. Family functioning was predicted by higher quality family relationships and communication and less concern about family finances and illness. The families described their experiences and identified stressors, resources, and suggested policy changes. Caregivers could use these suggestions to relieve stress and promote positive outcomes for parents, children, and families.

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