Date of Award

December 2017

Degree Type


Degree Name

Doctor of Philosophy



First Advisor

Rachel F. Schiffman

Committee Members

Jennifer J. Doering, Julie L. Ellis, Emmanuel M. Ngui


Black/African American, Family Functioning, Family Resiliency, Parent, Premature Infant, White/euroamerican


The impact of a premature birth on a family is a crisis requiring a process of adjustment and adaptation. The Resiliency Model of Family Stress, Adjustment and Adaptation (RMFAA) describe this process for families and was the conceptual framework for the current study. A modified model of the RMFAA was used to explore family resiliency for Non-Hispanic Black (NHB) and Non-Hispanic White (NHW) families of premature infants through the identification of protective and recovery factors. The aims of the current study explored the association between protective and recovery factors and family functioning.

Biological mothers of premature infants (< 37 weeks gestational age) and one other family member, who identified as either NHB or NHW were recruited in five separate Level III or IV neonatal intensive care units. Fifty-five NHW (N = 110) and 24 NHB (N = 48) families completed five scales that assessed their use of protective and recovery factors and their perception of family functioning. Mean scores for family functioning indicated that most family members viewed themselves as functioning effectively at that point in time.

Specific demographic variables (age, education and income) were not significantly correlated with any of the protective and recovery variables from the scales and subscales. The subscale for the Family Inventory of Resources for Management (FIRM), Financial Well-Being, was moderately correlated with income for NHW.

. Six subscales with the strongest correlations to family functioning from the four instruments as well as the covariates of income, education, and race were entered in a hierarchical regression analysis to predict family functioning. The prediction model was statistically significant F (9, 145) = 26.26, p = .00, and accounted for approximately 60% of the variance of family functioning. The subscales Strengths I (β = -.44, t (5.24), p = .00), a measure of family esteem, respect, communication, mutual assistance, problem-solving and autonomy, and Commitment (β = -.32, t (5.24), p = .00), which measured dependability and the ability to work together were the strongest predictors of family functioning. In the final model, race was not a statistically significant predictor.

The assessment of protective and recovery factors appear relevant to the support and development of resiliency in families of premature infants. The optimal development of the premature infant is dependent on effective family functioning. Nursing assessment of resiliency factors to influence nursing interventions support family development and may affect family functioning.

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