Family-level coping in juvenile rheumatoid arthritis: Assessing the utility of a quantitative family interview

Objective. To explore the viability of a quantitative family interview to d escribe family-level coping strategies used to deal with juvenile rheumatoi d arthritis (JRA)-related stressors for early and late adolescents. Method. A structured interview protocol with 30 adolescents with JRA and fa mily members assessed ways JRA disrupts or changes family functioning. Emot ional reactions, sequential phases of family response, and treatment adhere nce were discussed. Interviews were coded for family-level coping. To asses s adjustment, family members completed the Youth Self Report and the Family Environment Scale. The pediatric rheumatologist provided medical informati on. Results. The family interview produced both quantitative and qualitative da ta. Families reported multiple JRA-related stressors (mean 6.6), For many a dolescents, treatment adherence was problematic. Families used all 3 types of coping strategies (appraisal-, problem-, and emotion-focused) to varying degrees. Problem-focused approaches were most commonly used and included s eeking support (used by 73% of families), self-reliance (70%), and family c oordination (70%) for dealing with specific problems, and seeking informati on about JRA (67%). Emotion-focused approaches, such as impulsive outbursts and diminished awareness of others' feelings, were associated with problem atic adjustment. Few differences rr ere found between the families of early and late adolescents. Conclusion. The quantitative family interview has the potential to be a use ful tool in documenting JRA-related stressors, family-level coping processe s, and how family-level coping is associated with treatment adherence and p sychosocial adjustment.