Measuring Parent-Child Shared
Management of Chronic Illness
Gail M. Kieckhefer
Cristine M. Trahms
Shervin S. Churchill
Jessica N. Simpson
Over time, most children with special health needs must become partners in their disorder management.
Because most care of chronic conditions takes place in the home, parents assume significant responsibility in
starting and supporting the child’s role in parent-child shared management over time. This article describes
findings from analysis of one attempt to measure this important construct.
Methods: Cross-sectional descriptive study with 129 parents of children with chronic conditions.
Results: Internal consistency of the shared management scale was adequate (Cronbach’s Alpha: overall scale,
0.91; and subscales: desire, 0.79; knowledge, 0.76; and current actions, 0.86). Observed relationships were
in theoretically expected directions. In unadjusted univariate analyses, there were statistically significant associations
between parent-child shared management and each of the following variables: (a) condition grouping
and severity, (b) parent self-efficacy and coping, (c) amount and frequency of child’s limitation to do things,
and (d) emergency visits in the past 6 months (all at p < 0.01 levels). Adjusted multivariable analysis retained
condition severity, parent self-efficacy, and coping as significant factors.
Conclusions: The parent-child shared management tool can be used in research to broaden understanding of
this important construct and identify precursors and outcomes of high or low shared management in a family.
Nurses might use the tool in clinical practice to more accurately gauge parent desire for, knowledge of, and
current actions in support of parent-child shared management so interventions can be individualized to the
family’s unique wishes.