Families with special needs children: family health, functioning, and care burden

J Am Psychiatr Nurses Assoc. 2014 Nov-Dec;20(6):398-407. doi: 10.1177/1078390314561326. Epub 2014 Nov 26.


There are 11.2 million children with special health care needs in the United States or one in five households caring for a special needs child. A small group of children who need continuous medical, nursing, therapeutic services that enable them to survive is growing in numbers. This study examined physical health (physical functioning), mental health (emotional, social, and cognitive functioning; communication; and worry), family functioning (daily activities, family relationships), and care burden (caregiver employment, caregiving time, travel time, health-related out-of-pocket expenditures) of parent caregivers for medically complex, medical technology-dependent children. Data were collected once a month for 5 months on 84 parents recruited in South Florida using the Pediatric Quality of Life Family Impact Module. Physically, parents were tired when they woke up: too tired to do the things they liked to do and with little energy for chores or social activities. Mentally, they were frustrated, anxious, and angry; felt helpless and hopeless; had cognitive problems remembering and focusing on tasks; were worried about the child's medications, treatments, side effects; and were anxious about child's future and effect of the child's condition on other family members. Socially, they felt isolated and that people did not understand their family situation; they found it hard to talk with others including physicians and nurses. Average weekly hours of direct care was 33.0 (SD = 30.4 hours); average monthly out-of-pocket expenditures was $348.78 (SD = $623.34). It is essential to assess parents' physical and mental health and functioning and to provide interventions to improve health and functioning for both the parents and the children for whom they are caring.

Keywords: family process; health services; medical technology-dependence; primary health care; stress.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Caregivers / psychology*
  • Caregivers / statistics & numerical data
  • Child
  • Child, Preschool
  • Chronic Disease
  • Cost of Illness*
  • Disabled Children / psychology*
  • Disabled Children / statistics & numerical data*
  • Family / psychology*
  • Family Health / statistics & numerical data*
  • Female
  • Florida
  • Health Expenditures / statistics & numerical data
  • Health Services Needs and Demand / economics
  • Health Services Needs and Demand / statistics & numerical data
  • Health Status
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Parents / psychology
  • Socioeconomic Factors
  • Young Adult