Published: 07-05-2021 10:27 | Updated: 17-05-2021 08:45

New thesis about how children and family communication are affected by parental illness

Charlotte Oja, PhD student at the Division of Family Medicine and Primary Care, will defend her thesis “Upholding family relationships in a context of increasing awareness of parental illness” on June 4.

Charlotte Oja, PhD student at the Division of Family Medicine and Primary Care. Photo: Clement Morin.

What is the main focus of your thesis? 

Children are affected when their parent is ill and parental illness can therefore be risk factor for the health of the child. There are laws charging health care professional to consider the needs of children to receive information, advise and support about their parent’s illness when the parent is seriously physically or mentally ill, or dies. Interventions using psychological and pedagogical methods have been created in the fields of psychiatry including parental alcohol and substance abuse, cancer- and HIV care. However, a vast majority of patients in Sweden are treated in primary health care where these methods are not applied. It is therefore unknown if parental illness within primary health care create a challenge and risk for the children. It is also unknown how the children and parents deal with the situation and what strategies they use or should apply.

In order to explore the understanding and interaction of parents and children interviews were conducted with 32 parents and 23 of their children in three primary health care clinics. The parents had on the average been on sick leave for a year

Which are the most important results? 

This thesis therefore explores this new theme through analysis of interviews with children and their parents, as well as analysis of literature. Literature show that interventions have effect on the emotional state of the child. Furthermore, children and parents have a shared and joined need not only to understand the illness and talk about it but also to find tools and strategies to handle the situation and the emotions that come with it. Parents, when subjected to interventions, appreciate their increased understanding of their own child, the positive changes they observed in their own children’s behaviour, and to experience their child at ease.

Analysis of the interviews, using grounded theory method, revealed that both parents and children, by upholding family relationships, at the same time sustain family equilibrium. The child feels burdened and lonely when the parent is ill and wants the parent to talk about the illness and the effects it has. The parent is aware of that the child knows that the parent is ill and that the child wishes the parent to talk. But the parent often feels incapable to do so.

From these findings a Grounded Theory is developed, conceptualizing what it takes to uphold family relationships in a context of increasing awareness of parental illness. To be able to speak about the illness the parent needs to be able to handle the common awareness context about the illness he or she has with the child. And to handle their common awareness context the parent must comprehend both the illness and the child’s needs. Six different awareness contexts are proposed - closed, concealed, suspicious, conflicted, mutual pretence and open. Added to this is an understanding of how parents manage, or often fail to manage, to move between the concepts of the common awareness towards open awareness.

How can this new knowledge contribute to the improvement of people’s health? 

Parents and children wish for the support from primary health in the often-needed learning process. By using this theory professionals can find out in which awareness context regarding the illness their patient stands together with their child. From there the appropriate steps can be taken to give the parent the much-needed support. With better understanding of the illness and the child’s needs the parent gains a better capacity to communicate. This in turn reduces family tension and provides the child with better situation in which to grow and develop.

What's in the future for you? Will you keep on conducting research? 

I will spread knowledge on the theme children as next of kin to health care professionals by writing and lecturing. I also wish to continue important research on the topic.


Charlotte Louise Oja Affiliated to Teaching/Tutoring