Date of Award

August 2014

Degree Type


Degree Name

Doctor of Philosophy



First Advisor

Kathleen J. Sawin

Committee Members

Rachel Schiffman, Bonnie Klein-Tasman, Joshua Mersky, Michele Polfuss


Adolescents, Chronic Health Condition, Depressive Symptoms, Family Quality of Life, Parents, Spina Bifida


The purpose of this study was to explore which context and process factors contribute to parent depressive symptoms (PDS) and family quality of life (FQOL) in families with adolescents/young adults (AYA) with and without spina bifida (SB). Secondary analysis was conducted on data (N = 209) from a multi-site cross-sectional study of adaptation in AYA with SB. Measures included: Behavior Rating Inventory of Executive Function (Behavioral Regulation Index and Metacognition Index), FACES III (Cohesion subscale), Family APGAR, Family Inventory of Resources for Management (Family Mastery and Health subscale), a single-item measure of stress, Beck Depression Inventory (BDI-II) and The FQOL Scale. Descriptive statistics, hierarchical multiple regression and Sobel test for mediation were used for the analysis. Cronbach's alphas ranged from 0.80 - 0.97. Fifty-four percent of the parents had an AYA with SB, 86% parents were Caucasian, 19% experienced depressive symptoms and the average age of the AYA was 15.2 years. Income, family resources and parent stress but not presence of SB explained 38% of the variance of PDS. Presence of SB, family satisfaction, parent stress and PDS explained 49% of the variance of FQOL. PDS partially mediated the relationship of family resources and FQOL. Further exploratory analysis indicated that in parents of AYA with SB, family satisfaction and PDS explained 47% of the variance of FQOL. In the comparison group, family resources and parent stress explained 49% of the variance of FQOL. It is important for health care providers to screen parents for PDS, address effective use of family resources, and implement strategies to reduce stress. Attention to FQOL in families who have an AYA with SB is particularly important. Further research is needed to identify other factors that contribute to PDS and FQOL.

Included in

Nursing Commons