Posttraumatic growth in parents caring for a child with a life-limiting illness: A structural equation model.

Abstract

When parents first meet their child, they take on the entwined joys and burdens of caring for another person. Providing care for their child becomes the basic expectation, during health and illness, through the developmental milestones, into adulthood and beyond. For those parents who have a child who is born with or is later diagnosed with a life-limiting illness, parents also become caregivers in ways that parents of predominantly well children do not. While the circumstances are undisputedly stressful, for some parents benefits can co-occur along with the negative outcomes. This article tests two structural equation models of possible factors that allow these parent caregivers to experience growth in the circumstances. The diagnosis and illness of a child in the context of pediatric palliative care is a very complex experience for parents. The stresses are numerous and life-changing and yet the parents in this research demonstrated growth as measured by the Post Traumatic Growth Inventory. It appears that particular personal resources reflected in personal well-being are a precursor to the process of positive meaning making, which then, in turn, contributes to growth. The path to posttraumatic growth is not a simple one, but this research contributes to further elucidating it.

Examining the Experiences of Fathers of Children with a Life-Limiting Illness

“…Parental outcomes across emotional, spiritual, physical, and financial domains are reported, with guilt and fatigue identified as components of parental experience . Beyond challenges and struggles, some parents are reported to also experience posttraumatic growth (Cadell et al, 2014). To examine these outcomes specifically for fathers, this study examined paternal experiences associated with childhood LLI.…”

Parameter uncertainty in structural equation models: Confidence sets and fungible estimates.

“…MCG and Spirituality are single indicators and the square root of their reliability values (0.82 and 0.93 as reported in Cadell et al, 2014) were used as fixed (standardized) loadings. All variables are standardized, with 11 manifest variable standard deviations included separately as nuisance parameters.…”

“…In this situation, parameter estimates are not as sensitive to perturbations to model fit as they CONFIDENCE SETS AND FUNGIBLE ESTIMATES 19 are to sampling error, and conclusions based entirely on the analysis of sampling variability is valid. Cadell et al (2014) investigated factors which contribute to post-traumatic growth (PTG) of caregivers to children with a life-limiting illness. In this context of caregiving, PTG refers to the positive changes that people experience as a result of adverse circumstances due to a traumatic event (Tedeschi, Park, Calhoun, et al, 1998) and is measured by five subscales of the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996): Relating to Others (y 1 ), New Possibilities (y 2 ), Personal Strength (y 3 ), Appreciation of Life (y 4 ) and Spiritual Change (y 5 ).…”

“…Five additional variables were also included in their study: Selfesteem, Optimism, Spirituality, Depression and Caregiver burden. The correlation matrix and standard deviations of the five subscales of PTGI and the six other variables are presented in Table 2 of Cadell et al (2014), and the total sample size is N = 273. …”

Supplemental Material for Parameter Uncertainty in Structural Equation Models: Confidence Sets and Fungible Estimates

“…In this example, we fit a latent variable multiple regression model to the data from Cadell et al (2014). In this model, the latent variable Posttraumatic Growth (PTG) of caregivers is predicted by Meaning in Caregiving (MCG), Spirituality and Psychological…”