Jeffrey A. Hall

Michael Cody, Chair
Sheila Murphy, Michael Messner

Communication and Social Support of Parents of Children Treated at Childrens Hospital Los Angeles

Communication theories guided research on how mothers and fathers coped with increases in anxiety and challenges in family life caused by childhood cancer. Data was gathered using a survey instrument at an annual Childrens Hospital Los Angeles survivorship event. Fifty-four parents completed the survey, and 40 of these were matching mother-father pairs. Using systems theory, a model of family functioning was developed with the communication playing a central role. Results confirmed that competent communication by one’s spouse enables emotional and instrumental social support within the relationship. There was also a weak relationship between communication competence and quality of received social support, but there was no relationship between the quality of social support within the relationship and outside of it. In addition, although fathers were somewhat over-benefited in emotional and instrumental support, results demonstrate that there were no sex differences in perceptions of social support and communicator competence. Results suggest that communicator competence enables both the perception and reception of social support.

Support was also obtained for the theory of optimal matching (Cutrona & Russell, 1990). The theory of optimal matching suggests that social support is most beneficial when it the type of social support matches the needs and characteristics of stressful life events (Cutrona & Russell, 1990). Multi-level modeling was used to determine what types of social support were judged by parents to be most valuable. Results demonstrate that the amount of instrumental support and emotional support both uniquely predicted overall quality of social support. Social support was also of higher quality when given by a family member, but the sex of the family member was not a relevant predictor.

The use of network methodology offered new insights into the sources of social support. By collecting data from mother-father pairs, the sources of social support were able to be identified as either shared or unique. While mothers and fathers received the same quality and types of social support from shared social support sources, mothers received higher quality instrumental support from their unique sources of support.

This dissertation also sought to offer exploratory and descriptive research on fathers that will help CHLA better serve parents of children. Past research has documented sex differences in the risk factors of anxiety and malaise, the relationship between coping and well-being, and the quality and quantity of social support. This project explores the psychological factors within fathers may help to explain why gender differences exist. Guided by past research on masculinity, gender roles, and health, two indicators of gender role conflict, emotional expression and career achievement, were expected to influence fathers’ outcomes. Results demonstrated that fathers’ career achievement conflict reduced the amount of instrumental and emotional support that mothers perceived, but did not affect their own support or anxiety. The other measure of masculinity, restricted emotional expression, was not related to either mothers’ or fathers’ outcomes. Results suggest that fathers who internalize the role of supporter of the family are more likely to have wives who are less supported in their relationship.

Using structural equation modeling, communication, social support, and gender role conflict measures were combined to test a complete dyadic model of family communication. The results of prior analyses were supported in the final model, and the dyadic model demonstrated that support was related to parents’ trait anxiety. The quality of received social support from fathers’ and mothers’ networks reduced father’s anxiety, but received support did not affect mother’s anxiety. When fathers predicted greater social support from their spouses, mothers also reported less anxiety.

The role of ethnicity and acculturation in family function was explored. Acculturation was not related to any of the variables explored in this study, and differences between Latino and white families were not significant.

This project has both limitations and strengths. The small sample size and cross-sectional nature of these data reduce this investigation’s ability to make claims about causality and generalizability. However, this project used innovative statistical techniques and network methods that helped to describe the interdependent nature of parents’ relationships during times of stress. This project points to future interventions into family health. Communication interventions may be used to improve family functioning and the navigation of support roles during a child’s illness. These interventions need to be sensitive to men’s concerns regarding emotional disclosure and support seeking. Future research should replicate the findings of this project, and increase the sample size. A greater amount and diversity of participants might be able to better account for the effects of acculturation and ethnicity. Future research might also explore how extended families might best coordinate the instrumental and emotional support they provide.