Family Environment and Coping Strategies for Families Dealing with Children that are Blind or Visually Impaired
Mª Emma Mayo Pais1*, Eva Mª Taboda Ares1, Patricia Mª Iglesias Souto1, José Eulogio Real Deus2, Agustín Dosil Maceira1
1Department of
Evolutionary Psychology and of the Education (Faculty of Psychology), University of Santiago de
Compostela (USC), Spain
2Department of
Methods of Investigation and Diagnosis in Education (Faculty of Psychology),
University of Santiago de Compostela (USC), Spain
*Corresponding author: Mª Emma Mayo Pais, Department of Evolutionary Psychology and Education, Faculty of Psychology, Campus Universitario Sur, s / n, 15782. Santiago de Compostela , Spain . Tel: +34981563100; Email: emma.mayo@usc.es
Received Date: 07 September, 2018; Accepted Date: 21 September, 2018; Published Date: 01 October, 2018
Citation: Mayo, M.E.; Taboada, E.M.; Iglesias, P.M.; Real, J.E.; Dosil, A. (2018) Family Environment and Coping Strategies for Families Dealing with Children that are Blind or Visually Impaired. Curr Perspect Depress Anxiety: CPDA-101. DOI: 10.29011/CPDA-101. 100001
1. Abstract
The birth of a child with visual impairment creates a burden and stress on the family unit. This study analyzes the coping strategies used by parents with children that have a visual impairment and the correlation this has with the family environment that is perceived. Participated in this investigation a total of one hundred and twelve (112) subjects with at least a son with visual impairment in the Autonomous Community of Galicia (Spain ). All of the subjects responded to the Coping Strategies Questionnaire-Spanish version- (C.S.Q.), the Family Environment Scale (F.E.S) and a questionnaire built ad hoc to explore aspects related to the impact of the diagnosis. The results indicate that the preferred coping factors are counting your blessings, wishful thinking and positive thinking. At the same time, a conflictive family environment implies limited strategies in the search for solutions.
2. Keywords: Blindness; Coping Strategies; Disability; Family; Family Environment; Visual Impairment.
3. Introduction
The studies on
vital family cycles were initiated with the study of sociology of the family. The
main concept is that the family changes its ways and its functions during the
course of time following a sequence that is more or less structured and that
can be classified in stages [1]. During each
stage there is a learning period and a fulfillment of certain tasks. Between
each stage there is a moment of transition that is usually inaugurated by a
certain event or ritual that represents the change towards a new stage:
marriage, pregnancy, the birth of the first child and the children to come,
schooling, the children’s adolescence and their future independence,
retirement, etc. These vital family cycles can be modified by specific acts or
circumstances, such as, amongst others, the birth of a child with a disability
that can create a great challenge for the parents who must take on the
responsibility of this diagnosis [2].
Coping is a
process that begins when the threat is perceived, intervening between this and
the results observed and whose main objective is to regulate the emotional conflict
and to eliminate the threat [3]. In the
Transactional Model of Stress and Coping, coping is defined as “the constantly
changing efforts of cognitive and behavioral attitudes that develop in order to
manage the specific external and internal demands that can be evaluated as
excessive or abundant of the resources that an individual may have” [4]. For these authors there exists two types of
coping strategies, one is the resolution of the problems and the other an
emotional regulation. The first one is directed towards the manipulation or
altering of the problem that is causing the uneasiness or an increase of
resources in order to confront the problem. For example, the designing of a new
method for solving the problems or finding professional assistance that can
serve as a guide. The second one is a strategy for emotional regulation that is
centered on emotions and the reduction of stress associated with the situation [5,4]. Consider that people will use this second
strategy when they experiment that the stress is lasting and un-modifiable such
as, for example, the death of a loved one. Examples of these types of
strategies are crying, distraction, sleeping, drinking, etc. Coping strategies
operate so as to diminish the perturbing feeling associated with the threat, in
such a way that the less negative effects there are, we can state that the coping
process is more effective.
The studies on
coping strategies for families in cases of disability generally indicate that
the stress and the burden of the diagnosis can harm the family [6]. Also, it has been found that all of the family
members of the child with multiple disabilities, including visual impairment,
experiment a variety of forms of stress that were considered clinically
significant and that required a clinical intervention [7,8].
Studied how mothers reacted when faced with the diagnosis of their child’s
visual impairment and [9] focused on coping
strategies, emotions, and problems and preoccupations of the mothers of
children with a visual impairment, without taking into account the parental
perspective.
There is a
substantial amount of empirical evidence regarding the impact that a disability
can have on a family and its consequential adaptation. Its influence is such
that for many years researchers have classified the families in that a member
suffers a disability, as poorly integrated and pathological. Perhaps as a
consequence of this, there exists an ample and generalized negative evaluation
on the adaptation of a family in which one of its members has a disability [10,11]. This occurs without taking into account that
the condition of the disability is specific to each person in relation to the
variables of its context and that each family gathers a series of
characteristics that make them one and only and different in comparison to the
rest. For this reason, it is impossible to address the family’s adaptation in a
broad and unlimited way.
In regards to the
family environment, the relationship between the mother and the father is very
important and a child with a chronic condition or a disability can cause
tension in this relationship. For example, it has been observed that the mother
tends to displace or reduce the importance of her fulfillment to her
responsibility and role as a spouse, due to the fact that she dedicates a large
part of her efforts to taking care of the child with the disability [12,13].Although in other cases, the child with a
chronic illness or with a disability can improve this relationship [14].
If we focus on
visual impairment, several investigators indicate that the experience of taking
care of a child with a visual disability is oftentimes stressful and
challenging and can become a threat to the members of the family [9,15,16]. Having a child with a visual disability in
the family can cause preoccupation regarding the constant implication and time
the child requires, the attitudes of others, and the localization of the
appropriate educative programs, etc. It can also cause uncertainty regarding
the future, it unfavorably affects the siblings and it creates symptoms of
psychological maladjustments and marital problems [9,16].
However, if the proper coping strategies and resources to face the
circumstances in an effective manner are used (finding networks of assistance
inside and outside of the family) many of these families can pose a good
balance and consequently, a good family atmosphere.
Scientific
literature collects references related with the coping strategies of child
cancer on behalf of the parents. This is how [17]
distinguish methods of coping strategies such as isolation, denial, the search
for spiritual guidance through the help of religion, or anticipated mourning
among others. We have not found similar studies that analyze the utilization of
coping strategies and the family atmosphere perceived by the parents of
children with a visual disability.
The objective of
this investigation is dual. On one hand, to determine if the coping strategies
of the parents of the children with the visual impairment follow the same pattern
as those in the cases of child cancer, and on the other hand to analyze the
existing correlation between the strategies of confrontation utilized and the
family atmosphere perceived.
4. Method
4.1 Participants
A total of
fifty-six (56) families participated in this investigation and at least one
child that is affiliated with the ONCE (in English, The National Association of
Blind Spaniards) located in the autonomous region of Galicia, Spain. There was
a total of one hundred and twelve (112) subjects (50% fathers and 50 %
mothers).
The median age of
the fathers was 41-year-old (SD 6.92) within a range of 20 to 61 years old and
the median age of the mothers was 38 years old (SD 6.59), within a range of 20
to 57 years old.
A 94.6% of the
parents were married and lived primarily in a semi-urban (46.4%) or urban
(37.5%) environment. The educational and economic levels are low or semi-low
and it is primarily the majority of the fathers who are actively employed. High
percentages (60.7%) of the subjects have not had any more children since the
birth of the child with the visual disability Table 1.
Only 28.6% of the
children with the disability are completely blind. In the majority of the cases
the visual impairment is not associated to another pathology (57.1%), is
congenital (82.1%) or there are no other existing cases within the family
(78.6%).
4.2 Instruments
All of the
subjects responded to the Coping Strategies Questionnaire (C.S.Q.) (Spanish
version) [18], with the goal of analyzing the
following ways of coping: positive thinking, the blaming of others, wishful
thinking, the search for social support, the search for solutions, emotional
repression, the analysis of advantages, religiosity, self-blame, resignation
and escape. This was also the case on the Family Environment Scale (F.E.S) [19], utilized to evaluate and describe the
interpersonal relationships between the members of the family, the aspects of
development that are the most important within the family and its basic
structure. As well as on, a constructed questionnaire created ad hoc for the
purpose of a more thorough investigation whose main objective was to explore
the different aspects related to the impact of the diagnosis of the visual
disability on the family (the parental bond, the parental perception of the
impairment and the effects of the disability). Two versions were created, one
for the father and the other for the mother in order to collect, in the latter
case, specific information regarding the pregnancy and the birth.
4.3 Procedure
One hundred
families (100) that had at least one child between the ages of 0 and 18 years
old and that were affiliated with the ONCE of the Autonomous region of Galicia,
Spain were contacted by telephone. Their collaboration in the investigation and
their consent to be sent the necessary documentation to their homes in order to
complete the questionnaires and mail it back was requested. After one month
from the date of the mailing, the rate of return of the documentation (the
questionnaires from both parents) thoroughly completed was 56%, very superior
to the one usually obtained by this means (approximately 20%).
5. Results
The quantitative
analysis revealed that both parents coincided in highlighting that their
preferred factors of coping were the counting of blessings, wishful thinking
and positive thinking, but that in the mothers’ cases this last strategy is
shared with the seeking of solutions Table 2.
To see if there
were any significant differences between the fathers and the mothers in regards
to the coping strategies used we carried out a Student’s t-test. The mothers
stated that they significantly used the seeking of solutions more frequently
than the fathers (t = 2.72; p ≤.01) and also the seeking of social support (t =
2.46; p ≤.05)
and religiosity (t = 3.01; p≤.05) Table 2.
In regards to the
perception of family environment, there were no significant statistical
differences between the parents; both coincided in stating that they used
active-recreational methods the most, and as a last option the independence and
conflict Table 3.
To calculate if
there exists a relationship between the coping strategies used and the family
atmosphere perceived by the parents we used Pearson’s Correlation Index. In
using this index, we found that there was a significant correlation between the
parents who used positives thinking and who perceived an
achievement-orientation family atmosphere (p ≤.01; r = .26),
intellectual-cultural (p ≤.01; r= .31), active-recreational (p ≤.01; r
= .35), and moral-religious (p ≤.01; r = .27). This correlation was also obtained
between the factor seek solutions and the intellectual-cultural family
environment (p ≤.01;
r = .31) and active -recreational (p ≤ .01; r = .25), and between the factor of
religiosity and the family atmosphere achievement-orientation (p ≤.01; r
= .25) and moral-religious (p ≤.01; r = .48). On the other hand, the use of
inappropriate coping factors such as placing the blame on others, on oneself or
trying to escape from the problem can be related to family atmospheres that
lack cohesion and organization. In the same respect, a conflictive family
environment contains less strategies in the seeking of solutions of the problem
that has presented itself to the family (in this case, the visual impairment of
a child) Table 4.
6. Discussion
We have not found
in the literature any in-depth study about the use of coping strategies by
fathers and mothers of children with disabilities in order to compare our data,
but our results coincide with those of [17] in
which they highlight that in cases of child cancer the conduct of coping most
utilized is religiosity (among others such as denial, the development of
limited hopes and anticipated mourning). In our research we found significant
differences between both parents in the seeking of solutions (p ≤ .01), as well as in the seeking of social support
and religiosity (p ≤ .05), coping factors that
were used more by the mothers than by the fathers. We believe, as indicated in
other research [20], that these differences in
the use of coping strategies could be related to the fact that mothers exercise
the role of primary caregiver, which leads them, mostly, to conduct behaviors
such as looking for information, planning and raising possibilities (seeking of
solutions) or looking for people to solve the problem, ask for instrumental
support, etc. (seeking of social support).
We also found that
religiosity, as a conduct of coping, is related to the morality-religiosity of
the family environment. This relation suggests that practices and values of an
ethical and religious nature are perceived as being important in the family
environment and help parents to deal with the problem of the visual impairment.
In our research,
no differences were found between fathers and mothers regarding the family environment.
According to several authors, it can be attributed to the high cohesion
expressed to adapt to the new situation that has arisen [20-22].
It has also been
found that there is a significant relationship between the family environment
and disability coping. It has important implications for the intervention, as
it was found that a family environment with cohesion, organization,
intellectual-cultural, active-recreational and moral-religious, is positively
related to the use of adaptive coping strategies. When family members are
interpenetrated, help and support each other, present a clear organization and
structure planning the activities and responsibilities of the family, show
interest in political, social, intellectual and cultural activities,
participate in activities of active-recreational type and give importance to
ethical and religious practices and values, they will face disability in an
adaptive way, which favors support among members of the family and readjustment
of its relationships and functions [20,23].
If these findings
were to be confirmed in further investigations, we could learn which coping
strategies should be promoted to the parents. This could be done in order to
teach them how to better confront and adapt to the traumatic situation that
arises with the diagnosis of a visual impairment of a child and how to develop
guidelines on modifying the family atmosphere. This would permit the families
to receive a specific psychological aide to assist them in coping with the situation,
as well as enable them to modify, as much as possible, certain social factors
that can turn them into problematic families.
|
FATHER’S |
MOTHER’S |
AGE |
|
|
20-30 years old |
3.60% |
10.80% |
31-40 years old |
48.30% |
48.30% |
41-50 years old |
41.10% |
37.50% |
51-61 years old |
7.20% |
3.60% |
MARITAL STATE |
|
|
Single |
1.80% |
1.80% |
Married |
94.60% |
94.60% |
Separated or Divorced |
1.80% |
1.80% |
Living with partner |
1.80% |
1.80% |
EDUCATIONAL LEVEL |
|
|
Without studies |
5.40% |
1.80% |
Elementary school |
50% |
44.60% |
High School Degree |
28.60% |
33.90% |
University Degree |
12.50% |
17.90% |
Technical Degree |
1.80% |
1.80% |
No response |
1.70% |
0% |
SOCIO-ECONOMIC LEVEL |
|
|
Low (< 600€/month) |
8.90% |
8.90% |
Mid-low (600-1000€/month) |
23.20% |
23.20% |
Mid (1000-1500€/month) |
1.80% |
1.80% |
Mid-High (1500-2000€/month) |
2.50% |
2.50% |
High (> than 2000€/month) |
0% |
0% |
PLACE OF RESIDENCY |
|
|
Rural (< 5000 inhabitants) |
14.30% |
14.30% |
Semi-urban (5000-50000 inhabitants) |
46.40% |
46.40% |
Urban (> 50000 inhabitants) |
37.50% |
37.50% |
No response |
1.80% |
1.80% |
EMPLOYMENT |
|
|
Active |
89.30% |
48.20% |
Unemployed |
5.40% |
48.20% |
Incapacitated |
3.60% |
1.80% |
Retired or Leave of absence |
1.80% |
1.80% |
NUMBER OF CHILDREN |
|
60.70% |
One |
60.70% |
37.50% |
More than one |
37.50% |
1.80% |
The child with the visual deficiency is a twin |
1.80% |
1.80% |
Table 1: Socio-demographic characteristics of the sample.
|
FATHER’S (n = 56) |
MOTHER’S (n = 56) |
|||
M |
SD |
M |
SD |
t |
|
Blamed your-self Seek social support |
2.05 |
1.10 |
1.95 |
1.04 |
-0.45 |
Seek social support |
2.78 |
1.06 |
3.28 |
1.07 |
2.46* |
Seek solutions |
3.09 |
1.01 |
3.60 |
0.91 |
2.72** |
Count your blessing |
3.90 |
0.90 |
4.01 |
1.03 |
0.60 |
Blamed others |
1.80 |
0.73 |
1.98 |
0.92 |
1.10 |
Problem avoidance |
1.96 |
0.75 |
1.94 |
0.78 |
-0.11 |
Wishful thinking |
3.50 |
0.99 |
3.66 |
0.91 |
0.89 |
Positives thinking |
3.41 |
0.92 |
3.60 |
0.80 |
1.16 |
Religiosity |
1.82 |
0.98 |
2.50 |
1.34 |
3.01* |
Repressed emotional |
3.10 |
0.65 |
3.09 |
0.56 |
-0.09 |
Resignation |
3.12 |
1.12 |
3.25 |
1.32 |
0.57 |
*p ≤ .05 **p ≤ .01 |
Table 2: Coping behaviors of the father and of the mother.
|
FATHER’S (n = 56) |
MOTHER’S ( n = 56) |
|||
M |
SD |
M |
SD |
t |
|
Achievement-Orientation |
50.34 |
6.78 |
49.77 |
7.83 |
-0.42 |
Independence |
46.95 |
8.95 |
44.43 |
8.36 |
-1.53 |
Cohesion |
52.56 |
8.5 |
52.91 |
8.66 |
0.21 |
Conflict |
46.13 |
6.87 |
47.16 |
6.93 |
0.79 |
Control |
49.93 |
8.58 |
50.14 |
7.78 |
0.14 |
Expressiveness |
52.34 |
8.61 |
50.57 |
9.35 |
-1.04 |
Intellectual-Cultural |
50.53 |
9.64 |
53.21 |
9.12 |
1.51 |
Moral-Religious |
47.82 |
9.48 |
49.18 |
8.31 |
0.81 |
Organization |
51.35 |
9.25 |
53.38 |
9.04 |
1.17 |
Active-Recreational |
53.62 |
8.43 |
54.52 |
7.92 |
0.58 |
There are no significant differences |
Table 3: The family atmosphere, perceived by the father and the by the mother.
|
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
Positives Thinking |
0.20* |
0.18 |
-0.12 |
0.06 |
0.26** |
0.31** |
0.35** |
0.27** |
0.08 |
0.01 |
Blamed others |
-0.34** |
-0.11 |
0.11 |
0.18 |
0.04 |
-0.02 |
-0.12 |
0.01 |
-0.19 |
-0.04 |
Wishful Thinking |
-0.10 |
-0.24* |
-0.09 |
0.01 |
-0.02 |
0.01 |
-0.1 |
-0.01 |
0.03 |
0.14 |
Seek social support |
0.09 |
-0.06 |
-0.07 |
-0.12 |
0.12 |
0.14 |
0.06 |
0.22* |
-0.03 |
0.06 |
Seek solutions |
0.24* |
0.03 |
-0.26** |
-0.09 |
0.09 |
0.31** |
0.25** |
0.16 |
0.09 |
-0.11 |
Repressed emotional |
0.15 |
0.05 |
-0.19* |
0.02 |
-0.23 |
0.07 |
0.11 |
0.13 |
-0.01 |
-0.08 |
Count your blessing |
0.04 |
0.00 |
-0.18 |
0.09 |
0.18 |
0.17 |
0.19 |
0.09 |
-0.11 |
0.02 |
Religiosity |
0.09 |
-0.12 |
-0.02 |
-0.06 |
0.25** |
0.16 |
0.06 |
0.48** |
0.16 |
0.06 |
Blamed your-self |
-0.27** |
0.00 |
0.02 |
0.24* |
-0.06 |
-0.05 |
-0.06 |
-0.14 |
-.22* |
-0.14 |
Resignation |
0.06 |
0.01 |
0.05 |
-0.02 |
-0.02 |
0.13 |
0.13 |
0.00 |
-0.07 |
-0.03 |
Problem avoidance |
-0.18 |
-0.02 |
0.07 |
0.05 |
-0.12 |
-0.06 |
-0.06 |
-0.12 |
-0.25** |
-0.09 |
1 = Cohesion; 2 = Expressiveness; 3 = Conflict; 4 = Independence; 5 = Achievement-Orientation; 6 = Intellectual-Cultural; 7 = Active-Recreational; 8 = Moral-Religious; 9 = Organization; 10 = Control * The correlation is significant to the level .05 (bilateral). ** The correlation is significant to the level .01 (bilateral). |
Table 4: The correlation between the family environment and coping strategies.