Resolution of the diagnosis, parents-children dialogues and management strategies of the disease

A diagnosis of chronic illness of a child has a pervasive impact on the life of the family. Parents play a crucial role in their child’s illness experience in that they build the context for the meaning-making and the strategies to face the illness (Freda et al. 2016). In this mixed-method study we intend to explore: 1) the relation between parents’ elaboration of the diagnosis, parents-children dialogues about the illness and the management strategies in daily life;2) the influences of the the specificity of the diseases on these processes. To date, we administered the Reaction to Diagnosis Interview (RDI)(Marvin & Pianta,1996), and another ad-hoc structured interview on symptoms interpretations, parent-children dialogues and on the management strategies(Savarese et al, in press) to 40 parents of children affected form 3 different chronic diseases: Hereditary Angioedema(group1), Rheumatoid Arthritis(group2) and Diabetes(group3). Results from the analysis of the interviews show that in group 1, 82% are “resolved”; in group 2, 43% are resolved, and in group 3, 50% are resolved. In all the groups, dialogues in families with unresolved classifications are characterized from the lack or the confusion of the explanations about the the disease. These classifications will be discussed with reference to the critical areas of each disease. Moreover, the unresolved classifications are linked to strategies of avoidance that convey in heavy limitations in the physical as well as the emotional expression of the children. On the other hand, resolved classifications are linked to strategies for the promotion of resilient skills in children. In the light of the intention to develop a model of intervention for the support of the health-care relation, these results show the crucial role of parents’ elaboration of their child’s diagnosis for the construction of resilient strategies for the management of the diseases.