ABSTRACT
Inflammatory Bowel Disease (IBD) is a chronic illness. It often requires aggressive treatment and is met with a variety of family management responses regarding health behaviors and use of resources. Like most chronic illnesses, IBD has major social and psychological implications, in addition to the phsiological manifestations that can affect a person's quality of life. It is important for nurses to understand the challenges to family functioning that chronic illness can present. Assisting families to engage in health promotion activities will promote health outcomes such as improved health status and quality of life.
The purpose of this correlation study was to examine the relationships between family hardiness, health work and quality of life in persons with inflammatory bowel disease by testing hypotheses derived from the Developmental Health Model. In this model, families who are actively involved in health promotion pay attention to health issues, work toward health goals and use problem solving in collaboration with experts to deal with problems. Allen (1986) has described this as health work. Health potential - the strengths, motivation and resources of the family and its members, influences participation in health work and, subsequently, health promoting outcomes such as competence in health behaviors and health status (Allen, 1986; Gottlieb & Rowat, 1987). Family hardiness is a family strength and an aspect of health potential. Hardiness is a key factor in a family's adaptation to stress and illness, yet, hardiness has not been studied in families coping with IBD. In the DHM, quality of life is considered an outcome of health work, although the relationship between health work and quality of life has not been examined in previous studies.
A convenience sample of 61 families was obtained from three acute care gastroenterology outpatient clinics. The family member with IBD was asked to complete a survey containing three measures: the Family Hardiness Index, which measures hardiness - a stress resistance resource in families (McCubbin, McCubbin & Thompson, 1987); the Health Options Scale, which measures the degree of family participation in health work (Ford-Gilboe, 1994b); and Ferrans and Powers' (1985) Quality of Life Index, which measures quality of life - the subjective evaluation of satisfaction with and importance of life domains. Information about sample characteristics was obtained using a demographic questionnaire.
The results of this study provided support for the hypothesised relationships between family hardiness and health work (r = .51, p < .001), family hardiness and quality of life (r = .63, p < .001), and between health work and quality of life (r = .24, p = .03). Demographic variables related to one or more main study variables (family hardiness, health work and quality of life) included: age, marital status, family income, and diagnosis of participants.
The study findings enhance nursing knowledge of how family hardiness and health work affect quality of life in persons living with IBD. This information can assist nurses in the practice setting with assessments of family coping. Results also contribute to the Family Health Promotion Resesarch Program at the University of Western Ontario through further testing of the DHM.