Family functioning in the context of chronic illness in women: a Korean study

The aims of this study were to clarify the concept of family functioning in the context of a female family member’s chronic illness, and to describe the processes by which the housewife copes with the situation. The study applied the hybrid model of concept development, which consists of three phases: theoretical, empirical, and analytic. In the theoretical phase, a working definition of family functioning was established and the dimensions of family functioning and subconcepts were identified through an extensive review of the literature. In the empirical phase, in-depth interviews with members of six normal families and seven families in which the housewife had a long-term diagnosis of rheumatoid arthritis were carried out in order to gain descriptions of family functioning in both contexts, and to assess how the housewife coped with her illness in relation to family functioning. The final analytic phase identified the differences and similarities in family functioning between the normal family and family with a chronically ill housewife. A refined definition of family functioning emerged that identified the concept in terms of a complex set of functional dimensions comprising affective, structural, control, cognitive, and external relationships. The data revealed that family functioning is dynamically changed when the housewife becomes ill with a chronic disease. Three types of adaptation process were identified by which the housewives adapted to family functioning in the context of their chronic illnesses: negotiated, self-accommodating, and separated-enduring. The implications of these findings for research and nursing practice are discussed.