The research literature indicates that chronic childhood illness in general and cystic fibrosis in particular, can be a significant stressor for the child and his/her family. The resiliency of individuals in the face of stress is impressive and considerable success has been demonstrated in teaching individuals and families how to deal effectively with a wide range of stressful situations to prevent and/or lessen psychosocial maladjustment. The primary aim is to evaluate the effectiveness of a competency based stress management training approach to fostering compliance and psychosocial adjustment to cystic fibrosis by enhancing the coping skills of parents and patients.
The second aim i s to identify the pattern of hypothesized mediational variables associated with successful response to the Stress Management Training Program.
The third aim i s to identify the pattern of hypothesized mediational variables associated with """"""""invulnerability"""""""" and """"""""vulnerability"""""""" for psychosocial maladjustment in response to the stresses associated with cystic fibrosis. The conceptual framework for this project is the transactional model of coping with stress. The hypothesized mediational variables are patients and parents' cognitive process of health locus of control and self efficacy, coping methods, and family functioning. Outcome is assessed multidimensionally including disease status, compliance, patients and parents' psychosocial functioning and patient academic functioning. Two concurrent studies of patients with cystic fibrosis are proposed: Study I with children 7-12 years old and Study II with adolescents 13-18 years old. There are four phases of the project conducted over both studies. Phase I is baseline assessment of control, mediating, and outcome factors from which subjects will be categorized as either poor adjustment or good adjustment. The poor adjustment group will be divided into a subgroup to receive Stress Management Training in Phase II (N=25 in each study) and a control subgroup (N=20 in each study). A good adjustment subgroup will also be formed (N=25 in each study). Phases III & IV involve reassessment of mediational and outcome factors post Phase II and at followup nine months later.
