-. . . . -u.-. >‘q‘- ‘1wxxnvxwu-v.g RELATIVE POWER DISTRIBUTION. AS RELATED. TO NEED. SATISFACTION IN. FAMILIES WITH A WIFE-MOTHER WHO HAS A 'RHEUMATIC DISEASE ‘ Thesis for the. Degree of Ph. D; MICHIGAN STATE UflIVERSITY NANCY CAROL HOOK 1:972 LIBRARY Michigan State University This is to certify that the thesis entitled RELATIVE POWER DISTRIBUTION AS RELATED TO/ NEED SATISFACTION IN FAMILIES WITH -’ A WIFE-MOTHER WHO HAS A RHEIMATIC DISEfSE I I presented by Nancy Carol Hook has been accepted towards fulfillment of the requirements for Ph .D . degree in of Family Ecology Major professor Department Date July 27, 1972 0-7839 RARY BINDERS 1!,ng! autumn-I. IIlLe- ___. . ' """""." II‘ a ‘In‘ NE A WIFE Although 50' the Premise that Of the respOnSib; 8m. to QCEStiOn iECiSiOn. Becaus meaty t0 Perfo :elatio: ships at e “cclslon‘making a: u the famuy. B} 55:11 Les in which :0 Per 4: «0m heCaus ‘ ABSTRACT RELATIVE POWER DISTRIBUTION AS RELATED TO NEED SATISFACTION IN FAMILIES WITH A WIFEeMOTHER WHO HAS A RHEUMATIC DISEASE BY Nancy Carol Hook Although some family management educators have accepted the premise that the manager is a person who delegates some of the responsibility of carrying out work to others, it is cpen to question whether or not within the family, who makes the decision can be separated from who carries out the decision. Because decision-implementation is dependent upon capacity to perform and within the family, close interpersonal relationships are intermingled with the accomplishment of work, decisionrmaking and decision—implementing may not be separable in the family. By studying power in decision—making in families in which the wife-mother has a limitation in capacity to perform because of her disability, there is an Opportunity to examine the hierarchial power structure in the family and the relation of needs to power in decisionamaking. Satisfied needs may be potential resources for social exchange within the family. Simultaneous field interviews were conducted with three members of 35 families—-the husband-father, wife-mother, and Lumen-7w 4‘ A her-$819653 tee? : .h . ruf 0:5: “no has a azthe Mc‘iaster Rhe; 32:.sia. Fewer, defined 2: influence or con: :sas'xfi by the nail: :zticipated in maki 1e pacer scores deg: 1:: whose behavior w azivities adapted f 2:: Gzorato and modi rare four times more titers and almost f ‘itiese families, t] “Vines to other "35:01: d6pendent up c . vatlsfaction of :5 SHE.“ wort needs as :ESPOZder ‘ was rela: “firs . ' mwer WAS :51?! ificant level \Pf‘s Nancy Carol Hook teen-ager--selected from the medical records of the wife- mother who has a rheumatic disease and has been hospitalized at the.McMaster Rheumatic Diseases Unit, Hamilton, Ontario, Canada. Power, defined as an ability within a social relationship to influence or control another person's behavior, was measured by the number of decisions a family member made or participated in making which affected another person's behavior. The power scores depended not only on who made the decisions, but whose behavior was being decided upon for a series of activities adapted from previous work of Herbst, Johannis, and Onorato and modified for a division of tasks applicable to these families. The average power scores of the wifeemothers were four times more than the average scores of the husband- fathers and almost five times more than that of the teen-agers. In these families, the wife—mothers were able to delegate activities to other family members and decision-implementation was not dependent upon decisiondmaking. Satisfaction of physiological, safety, and companionship and support needs as measured by the perception of the respondent was related to the power scores. For the wife- mothers, power was positively related to need satisfaction at a significant level (.05) for overall need satisfaction and companionship and support needs. 30111 Power a :3: to the exter‘. :zarilY have rh‘ I 1.5 zeasured by 4" 1:5;italized, acti ease, and A.R.A. f :aimal records tv aessessed in the scrateutati .-.. SOC] :terviews. A sig" 'ILSZed between tot e and power f ism ¢ed the Wife-4". .Liiy. With few e: :eLatil- - D“Sh1PS for av 33 Elite-w ..L of (315an Q a high pos i LaCtio n a 3m wt ' Ee of COF'zr‘ Cg tk Nancy Carol Hook Both power and need satisfaction were examined in rela- tion to the extent of disability of the wife-mothers who primarily have rheumatoid arthritis. Extent of disability was measured by number of hospitalizations, total days hospitalized, activity of condition, A.R.A. severity of dis- ease, and A.R.A. functional capacity as determined from the medical records by a resident physician in rheumatology and as assessed in the patients' homes by the Canadian Arthritis and Rheumatism Society physiotherapists following the family interviews. A significant positive linear relationship existed between total days hospitalized and severity of disease and power for the wifedmothers; that is, the more disabled the wifedmother, the more power she had within the family. With few exceptions, there were no significant linear relationships for any family member between need satisfaction and extent of disability of the wifedmothers. For wife— mothers, a high positive linear relationship existed between need satisfaction and "acceptance of illness". Degree of congruence measured by the extent of agreement among the three family members on who does and who decides for the everyday activities varied significantly with the overall need satisfaction and companionship and support needs for the husband-fathers. Out of a possible total score of 102 points for complete agreement, the degree of congruence scores averaged 84 for the family, 78 for the spouses, 73 for iehusband-father a ;5 :he teen-ager ° Inere were no 5 me: in decision—ma :easzred by the H011 ‘, the Elishen Ir :cz-eanual dichotovshJ The study raise EPPOI‘L to the impo; 35513 INith interre; is Perceptions of . 79-“! Similar, the s 53: EEC. :- . h fi‘lly men] '~~e<1 for each new. Nancy Carol Hook the husband-father and the teen-ager and for the wife—mother and the teen-ager. There were no significant linear relationships between power in decisiondmaking and socio-economic status as measured by the Hollingshead Two Factor Index of Social Posi- tign, the Blishen Index of Occupations in Canada, and a manual- nondmanual dichotomy of occupations. The study raised questions for future research and gave support to the importance of recognizing the family as a system with interrelated and interdependent parts. Although the perceptions of the situation (degree of congruence) were very similar, the situations may have quite different meanings for each family member as relationships among variables varied for each member of the family. RELATIVE POWER DISTRIBUTION AS RELATED TO NEED SATISFACTION IN FAMILIES WITH A WIFE-MOTHER WHO HAS A RHEUMATIC DISEASE BY Nancy Carol Hook A THESIS Submitted to Michigan State University in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY Department of Family Ecology 1972 Copyright by NANCY CAROL HOOK 1972 ii “‘QW'Vw' A F .rp‘j’ Appreciation i! :IPlete this 53351": Dr. Beatrice PE Ezily Ecology. for testuéy: the other membe teir special way: tiChaiman of Fami Sacahson, Professor 2:3? .essor of Family Gary Ingvaldson iisearch, ACKNOWLEDGMENTS Appreciation is expressed to those who have helped me complete this study: Dr. Beatrice Paolucci, Professor and Acting Chairman of Family Ecology, for her encouragement and advice throughout the study; the other members of my committee who contributed in their special way: Dr. Margaret Jacdbson Bubolz, Professor and Chairman of Family and Child Sciences; Dr. Eugene Jacobson, Professor of Psychology; and Dr. Jean Schlater, Professor of Family Ecology; Gary Ingvaldson, Computer Institute for Social Science Research, for completing the computer programming and particularly for his good—naturedness despite any problem; the family members who responded to our inquiry without whose complete cooperation there would not have been a study; Dr. John Frid M.D., Clinical Director of the McMaster Rheumatic Diseases Unit at the time of the study. for his stimulating guidance and wholehearted support throughout the project; Dr. William Caughey M.D., resident at the Unit who completed the medical assessments; Miss Marion MacEachern, Medical Records, and her staff for their assistance in the seemingly endless task of selecting the sample; and the many iii .4 ‘k—" my staff members < ”wed by answerin: :forzation; the Canadian Ar accxacenent and as ::-ject and collect i u‘..-: a an“ _.-...n...erapists who it:le:er.t weather co 9.: . Pat Lawson teas and both of :2". aco'iragazent; aid to the many 53:11 The- are: Able wavs . ‘r‘ additicn. t‘: “TOA‘KEhab il itat 10' P; . a ...- «uuous graduate is“. other staff members of The Chedoke McMaster Centre who con— tributed by answering questions and locating needed information; The Canadian Arthritis and Rheumatism Society for its encouragement and assistance in both the formulation of the project and collection of the data, especially to those physiotherapists who completed the home assessments under inclement weather conditions; Mrs. Pat Lawson and my mother who coded the taped inter- views and both of my parents for their continued support and encouraganent ; and to the many others including the interviewers, faculty, fellow students, and friends who have assisted in innumerable ways. In addition, the financial assistance of the General Foods Corporation and the American Home Economics Associ- ation-Rehabilitation Services Traineeship provided for continuous graduate study. Their contributions to the pro— gram are recognized and greatly appreciated. iv I. INTRODUCTION Identific. Concep‘ PurpOSc Assam; Fomulat '1: Selection Power Need S. Extent "Acce; Socio- Degree Fa'fl 1y 3' REID? OF L: TABLE OF CONTENTS CHAPTER Page I. INTRODUCTION. . . . . . . . . . . . . . . . . 1 Identification of the Problem. . . . . . . 6 Conceptual Orientation. . . . . . . . . 6 Purposes. . . . . . . . . . . .'. . . . 9 Assumptions . . . . . . . . . . . . . . lO Formulation of Hypotheses. . . . . . . . . ll Selection and DevelOpment of Definitions . '12 Power . . . . . . . . . . . . . . . . . 12 Need Satisfaction . . . . . . . . . . . 13 Extent of Disability. . . . . . . . . . 13 "Acceptance of Illness" . . . . . . . . l4 Socio-economic Status . . . . . . . . . 14 Degree of Congruence. . . . . . . . . . 15 Family. . . . . . . . . . . .. . . . . . 15 II. REVIEW OF LITERATURE. . . . . . . . . . . . . 1? Theoretical Formulations of Power and Authority . . . . . . . . . . . . . . . 17 Previous Studies of Power Within the Family. . . . . . . . . . . . . . . . . 26 Survey.Methods. . . . . . . . . . . . . 26 Small Group Research. . . . . . . . . . 33 .Methods Used to.Measure Family Power and Authority . . . . . . . . . . . . . . . 36 Physical Disability Within the Family. . . 44 Psychosocial Variables in Rheumatic Diseases. . . . . . . . . . . . . . . . 48 Summary, . . . . . . . . . . . . . . . . . 52 III. THE PROCEDURE . . . . . . . . . . . . . . . . 53 Selection of Sample. . . . . . . . . . . . 53 Criteria. . . . . . . . . . . . . . . . 53 Procedure . . . . . . . . . . . . . . . 54 Description of Sample. . . . . . . . . . . 59 Demographic Information . . . . . . . . 59 Size of family . . . . . . . . . . . 59 3.1.52.2 CF CCNTECS - —‘ WAR“ ,I-y. h ”a...“ TABLE OF CONTENTS—-Continued CHAPTER Composition of family . . . . . . . . Length of marriage. . . . . . . . . . Residency characteristics . . . . Socio—economic status . . . . . . Employment--husband-father. . . . . . Employment--wifeamother . . . . . Employment--teen—ager . . . . . . . . Education . . . . . . . . . . . . . . Ethnic Origin . . . . . . . . . . . . Medical Information. . . . . . . . . . . Major diagnoses . . . . . . . . . . . Hospitalizations. . . . . . . . . . . Duration of disease . . . . . . Rapidity of Onset of disease. . . . . Severity of disease . . . . . . . . . Activity of condition . . . . . . . . Functional capacity ... . . . . . . Medical status of husband- father. . . .Medical status of teen-ager . . . . . Selection and Development of Instruments.'. Description of Instruments. . . . . . . . . Husband-father, Wifedmother, and Teen- ager Interview Schedules. . . . . . . Perception of power in deciSion-making Perception of need satisfaction . . . Husband—Wife Interview Schedule. . . Medical Data for Wifeemother . . . Log for Interview Data . . . . . . Collection of Data. . . . . . . . . Analyses of Data. . . . . . . . . . O 0 O 0 0 IV. THE FINDINGS . . . . . . . . . . . . . . . . . Measurement of Variables. . . . . . . . . Perceived Power in Decision-making . . . PerCeived Need Satisfaction. . . . . . . Degree of Congruence . . . . . . . . . . Extent of Disability . . . . . . . . . . "Acceptance of Illness“. . . . . . . . . Description of the Situation. . . . . . . . Income . . . . . . . . . . . . . . . . . Housing. . . . . . . . . . . . . Perceptions of Health and Functional Level . . . . . . . . . . . . . . . . Tests of Hypotheses . . . . . . . . . . . . Hypothesis 1 . . . . . . . . . . . . . . Hypothesis 1A. . . . . . . . . . . . . . vi Page 60 67 67 67 71 71 71 72 72 74 74 75 77 , 78 79 79 82 83 85 85 88 88 89 98 102 102 103 103 112 117 117 117 118 121 123 123 125 127 129 130 133 133 134 TABLE OF CONTENTS--Continued CHAPTER Page Hypothesis lB. . . . . . . . . . . . . . 135 Hypothesis 2 . . . . . . . . . . . . . . 137 Hypothesis 2A. . . . . . . . . . . . . . 137 Hypothesis 2B. . . . . . . . . . . . . . 139 Hypothesis 2C. . . . . . . . . . . . . . 140 Hypothesis 3 . . . . . . . . . . . . . . 140 Hypothesis 3A. . . . . . . . . . . . . . 143 Hypothesis 3B. . . . . . . . . . . . . . 146 Hypothesis 3C. . . . . . . . . . . . . . 147 Hypothesis 4 . . . . . . . . . . . . . . 149 Hypothesis 5 . . . . . . . . . . . . . . 150 Hypothesis 6 . . . . . . . . . . . . . . 151 V. DISCUSSION, CONCLUSIONS,_AND DMPLICATIONS. . . 153 Discussion of Findings. . . . . . . . . . 153 Perceived Power in Decisiondmaking . . , 153 PerCeived Need Satisfaction , , . . . . 155 Degree of Congruence . . . . . . . . . . 155 Extent of Disability . . . . . . . . . . 157 "Acceptance of Illness". . . . . . . . . 158 Socio-economic Status. . . . . . . . . . 159 Description of the Situation . . . . . . 159 Conclusions . . . . . . . . . . . . . . . . 160 Limitations . . . . . . . . . . . . . . . . l6l Implications for Future Research. . . . . 162 Implications for the Family Educator. . . . 165 SELECTED BIBLIOGRAPHY . . . . . . . . . . . . . . . . 167 APPENDICES A. SAMPLE SELECTION . . . . . . . . . . . . . . . 179 B. INSTRUMENTS. . . . . . . . . . . . . . . . . . 182 c. NEED SATISFACTION MEASUREMENT. . . . . . . . . 215 vii Iqofl ‘ i 1. Reasons for re_ 2. Size of family 3.}erer, age, a: at home . 4. Age patterns 01 mothers ll" . Sex patterns 5: 51’ f year child .- « 1\lhg '5 9e and sex of 14, v LIST OF TABLES TABLE 1. 5. 6. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. Reasons for rejecting women patients. . . . . Size of family at home. . . . . . . . . . . . Number, age, and sex of family members living at home . . . . . . . . . . . . . . . . . . . Age patterns of husband-fathers and wife— mothers . . . . . . . . . . . . . . . . . . . Sex patterns within the family. . . . . . . . Composition of the family living at home. . . Number of years between oldest and youngest child living at home. . . . . . . . . . . . . Age and sex of teen-agers interviewed . . . . Birth order of teen-ager or child interviewed Length of marriage for both spouses . . . . Residency characteristics of sample families. Socio-economic status of families . . . . . . 0 Highest grade of elementary or secondary school attended by family members interviewed. . . . Major diagnoses of wifeamother from last admis— sion to Rheumatic Diseases Unit . . . . . . . HOspital days and hospitalizations for wife- mother. . . . . . . . . . . . . . . . . . . . Duration of disease of wifedmother. . . . . . Rapidity of onset of disease of wifedmother . Severity of disease of wifedmother at last ad- mission to Rheumatic Diseases Unit. . . . . . viii Page 57 6O 61 62 63 63 64 65 66 67 69 7O 73 75 76 78 79 80 I 19. Activity of cor. hospitalizatio r. can LI 21. Functional cap . fro:- each 1205'“ Unit. . . . a. Functional car home asses snen Paerat i sm phv 23. Method of '1 J J'- l’ . ‘: ERIN 0f iter ? . “king for tea ‘3 Method of rte“ family IRE—"fibers 1‘ L 23 . 3.5..gel mea'1 : Ce ‘ I n Wed Power 1 « her 3: p n mange CeiVed an, ~ Feed 31 D 86 ' “Arlee . 1 me‘ Of _ “’1. 14 I e I! 13' Pd}; Activity of co." hose assessment Kte'natisn phys Q 0 \ C s ‘ . item taxing for hts‘: .Method of item taking for Wlfl LIST OF TABLES--Continued- TABLE 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. Activity of condition of wifeemother for each hospitalization at Rheumatic Diseases Unit. . . Activity of condition of wifedmother based on home assessment by the Canadian Arthritis and Rheumatism physiotherapist. .’. . . . . . . . . Functional capacity of wife—mother at discharge from each hospitalization at Rheumatic Diseases unit 0 O O 0 O O O 0 o o 0 O 9 O O O O 0 O O O 9 Functional capacity of wifeamother based on home assessment by the Canadian Arthritis and Rheumatism physiotherapist. . . . . . . . . . . Method of item scoring of power in decision— making for husband-father . . . . . . . . . . . Method of item scoring of power in decision- making for wifeemother. . . . . . . . . . . . . Method of item scoring of power in decision— making for teen-ager. . . . . . . . . . . . . . Method of item scoring of need satisfaction of family members. . . . . . . . . . . . . . . . . Methods used in analysis of data. . . . . . . . Range, mean, and standard deviation of per- ceived power in decisionamaking scores. . . . . Relations of measures of power as perceived by family members. . . . . . . . . . . . . . . . . Range, mean, and standard deviation of per- ceived need satisfaction scores . . . . . . . . Range, mean, and standard deviation of degree of congruence scores. . . . . . . . . . . . . . Intercorrelation matrix.of disability variables Range, mean, and standard deviation of extent of disability variables . . . . . . . . . . . . ix Page 81 82 85 92 94 96 100 114 118 119 "'3' all i vyna .351 I“? r “.1: c“. ‘1 Jan I - ul‘ 0 olu LIV I- C 7" . Satisfaction OF TABLES--CCY ,, . . . coronation of illness" . Husband-fathe; and after 035. Husband- fathe status before :other n~ wily moved Changes in e3. PerceptiOn Of Self- 1 perCECti 4.91.761 ‘ $ Eil‘T‘arCezztj ionai leVel ECrre atier ..a‘-' N K1 3 and P C- T‘Fg-Elatlofic :Qfilng andi‘\ aCC h I Ptance‘ COI- re . LIST OF TABLES-~Continued TABLE 34. 35. 36. 37. 38. 39. 4o. 41. 42. 43. 44. 45. 46. 47. 48. Combinations forming categories of "acceptance Of illness". . . . . . . . . . . . . . . O . . Satisfaction of husband-father with income . . . Husband-fathers' comparison of expenses before and after onset of disease of wife-mother. . . . Husband-fathers' comparison of family financial status before and after onset of disease of wife- mother . . . . . . . . . . . . . . . . . . . . . Family moved because of wife-mother's illness. . Changes in housing because of illness. . . . . . Perception of health as a worry. . . . . . . . . Self-perception of wife-mother of her functional level . O I O O O O I O O O O O O I O O 0 O O I I Self-perception of husband-father of his func- tional level . . . . . . . . . . . . . . . . . . Self-perception of teen-ager of his functional level. . . . . . . . . . O . . . . . . . . . . . Correlations between perceived power in decision- making and perceived need satisfaction . . . . Correlations between perceived power in decision- making and perceived need satisfaction with "acceptance of illness" partialed out. . . . . . Correlations between perceived power in decision- making of wife-mother and her perceived need satisfaction with extent of disability partialed out 0 . . . . . . . . . . . . . . . O . . . . . . Correlations between perceived power in decision- making and extent of disability. . . . . . . . . Correlations between perceived power in decision- making and "acceptance of illness" . . . . . . . Page 126 127 128 128 129 129 130 131 132 133 134 135 136 138 138 125? OF TASLES--Cor.: 4?. Correlations he '- ‘u 4,, c r- (I) . Correlations t . Correlations h. ' COHElatiorS ‘5. . torrent-mas t . raking and ext. of illness" p2; wring and extu1 overall need 3 Out. . satisfactio: - (1 Correlations 1. ‘1 598d sat-18faco- L C . CorrelatiOnS t ..69d Satisfact m 'I— —— LIST OF TABLES-—Continued TABLE 49. 50. 51. 52. 53. 54. 55. 56. 57. 58. 59. 60. 61. Correlations between perceived power in decision— making and extent of disability with "acceptance of illness" partialed out. . . . . . . . . . . . Correlations between perceived power in decision- making and extent of disability with perceived overall need satisfaction partialed out. . . . . Correlations between perceived power in decision- making and extent of disability of wifeamother with her perceived need satisfaction partialed out . . . . O O 0 O O O . . O O O . . O 0 O O 0 0 Correlations between perceived overall need satisfaction and extent of disability. . . . . . Correlations between perceived physiological need satisfaction and extent of disability . . Correlations between perceived safety need sat- isfaction and extent of disability . . . . . . Correlations between perceived companionship need satisfaction and extent of disability . . . Correlations between perceived need satisfaction and "acceptance of illness". . . . . . . . . . . Correlations between perceived overall need satisfaction and extent of disability with "acceptance of illness" partialed out. . . . . . Correlations between perceived need satisfaction and extent of disability of wifeemother with her "acceptance of illness" partialed out. . . . . . Correlations between perceived overall need satisfaction and extent of disability with per- ceived power in decision—making partialed out. . Correlations between perceived need satisfaction and extent of disability of wifeamother with her perceived power in decision-making partialed out Correlations between degree of congruence among family members and extent of disability of wife- mother . . . . . . . . . . . . . . . . . . . . . xi Page 139 141 142 143 144 144 145 145 146 147 148 149 150 ' " 3F TABLES--CO:‘.‘ I“ to». ngh' In Oh (7" rx «4" J" c ': UJ ‘ Correlations b ~ Frequency dist ‘ Prague. fatily matters . Correlations ‘:4 raking and soc Correlations 1: status . C(“Etion of nee F:eqmrcy dist tion of need 5 . Frequency dis: ' ”messy dist satisfaction 5 ”fluency d 1 st ' Alcy disa Pr ‘ f “CY dis Ct' LIST OF TABLES--Continued TABLE Page 62. Correlations between degree of congruence among family members and perceived need satisfaction . 151 63. Correlations between perceived power in decision- making and socio—economiC'status . . . . . . . . 152 64. Correlations between measures of socio-economic Status 0 . . O . . O O O 0 O . O O O O O O O O O 152 65. Frequency distribution of husband-fathers' per- ception of need satisfaction . . . . . . . . . . 217 66. Frequency distribution of wifedmothers' percep- tion of need satisfaction. . . . . . . . . . . . 218 67. Frequency distribution of teen-agers' perception of need satisfaction . . . . . . . . . . . . . . 219 68. Frequency distribution of husband-fathers' need satisfaction as determined by rater number one . 220 69. Frequency distribution of husband-fathers' need satisfaction as determined by rater number two . 221 70. Frequency distribution of wife-mothers' need satisfaction as determined by rater number one . 222 71. Frequency distribution of wife—mothers' need satisfaction as determined by rater number two . 223 72. Frequency distribution of teen-agers' need sat— isfaction as determined by rater number one. . . 224 73. Frequency distribution of teen-agers' need sat- isfaction as determined by rater number two. . . 225 74. Inter-rater reliability by need satisfaction items for all respondents. . . . . . . . . . . . 226 75. Correlations between raters and family members by need satisfaction items . . . . . . . . . . . 227 xii “autism. 'd uoqvq a o oJU-Hfl H . Conceptualiza tive power di disability of tion of fanil 2' Malt-Location Ontario LIST OF FIGURES FIGURE 1. Conceptualization of relationships among rela- tive power distribution in the family, disability of wife-mother, and need satisfac- tion of family members. . . . . . . . . . . . 2. Map--Location of families interviewed in ontar io . . O O O I O O . O . O . O O O O 0 O xiii Page 1'5.“ iii-Ala '- " Because much CE the natural world, “ to gain insight in: flecision-making. ". facily, one realize retain. Studies 0‘ llPetus during the Category Which exan Structure of the f; The crux of m; .‘,. 8811 an S t; . 1.4g. 19; 1e Pa” CHAPTER I INTRODU TION Because much of decision—making remains a mystery of the natural world,1 researchers continue probing the process to gain insight into the who, when, how, and what of man's decisionrmaking. Turning to decisionamaking within the family, one realizes that a number of unanswered questions remain. Studies of decisiondmaking in the family gained impetus during the late 50's and 60's and included a broad category which examined the authority pattern or the power structure of the family.2 The crux of management is decisiondmaking. Management researchers have examined the decision event;3 that is, the the decision context or areas in which decisions are made, 1C. West Churchman, Challenge to Reason (New York: McGraw-Hill, 1968). P- 20. 2For an extensive review of the literature from 1930— 1961 see James.M. Rollins, "Two Empirical Tests of a Parsonian Theory of Family Authority Patterns," The Family Life Coordi- nator,‘12: 1-2 (January—April 1963), 3-79 and Constantina safilios-Rothschild, "The Study of Family Power Structure: A Review 1960-1969," Journal of Marriage and the Family, 32:4 (November, 1970), 539-552. 3Jean R. Halliday, "Relationships Among Certain Character- istics of a Decision Event: Decision Procedure, Decision Context, and Decisionamaker" (unpublished Doctoral disserta- tion, Michigan State University, 1964), pp. 9-12. Seminar HMCD 832, "Theories of Management and Decision— making in the Family," Michigan State University, Winter- Spring, 1969. :e decision- :rocedure or the family is 32:: who imple txe in the 1 ;ientified a: framework} also: " "r‘ b “Awe 0: 1‘: deCiSiOn-f m m r the decisionemaker or who makes decisions, and the decision procedure or how decisions arermade. A critical factor in the family is the linkage between who makes the decisions and who implements the decisions. Along with other behavioral scientists, family management researchers have associated aspects of decision—making‘in the family with the power struc- ture in the family. The hierarchical power structure has been identified and adapted into the traditional family management framework.4 A current question relative to this is the importance of the relationship of personal resources to power in decisiondmaking in the contemporary family. Two factors related to the question may be: 1) recognition of participa- tive management which has been a part of the family and increasingly employed by productive managers in business and industry,5 and 2) reported changes in the family power struc- ture by sociologists.6 Stress has been placed on equalitar— ianism as the norm for families in North American society7 4Irma Gross and Elizabeth W. Crandall, Management for .Modern Families ((2d ed.; New York: AppletonuCentury Crofts, ,1963). 5Rensis Likert, New Patterns of Management (New York: .McGraw-Hill, 1961). Rensis Likert, The Human Organization (New York: .McGraw-Hill, 1967). 6Ernest W. Burgess and Harvey J. Locke, The Family (2d ed.; New York: American Book Co., 1960). 7William G. Dyer and Dick Urban, "The Institutionaliza- tion of Family Norms," Marriage and Family Living, 20: (1958). 53-58. Frederick Elkin, The Family in Canada (Ottawa, Canada: The Vanier Institute of the Family, 1964), p. 97. .25 on the Predictl before the end Of 1 uiicated that a fa :ional well-being c Cartwright10 x. is social psycholo: The important tion raise que systeratic kn: attack on the advance in the :18 recommendations as :enaganent tea C" ‘4: ‘ 1' ' ..amly decrsior. I n the process. 52:2“ ' rt or disjuncti 5"» Nyb ’ S or disequili lc‘ges may be seri Arsua ' at on perso 113: SW. [53:19» llllam A I I ”be me .5. “ mi N” n C Ii~'.- * ' at 1959) 5' "P and on the prediction that equalitarianism will increase before the end of the century.8 However, a recent study indicated that a father-led pattern of authority within the family in addition to other factors contributed to the emo- tional well-being of the children.9 Cartwright10 wrote that power is a neglected variable in social psychology and concluded, The important social problems which demand our atten— tion raise questions about power--questions which our systematic knowledge cannot answer . . . a concerted attack on the problem of power should produce a major advance in the field of social psychology. His recommendations are still pertinent today. Consequently, as management teachers and researchers attempt to explain managerial behavior in the home, they need to continue prob- ing family decisionrmaking patterns and power relationships. In the process of managing, families sometimes face abrupt or disjunctive changes which may or may not produce stress or disequilibrium for the family system. One of these changes may be serious illness or disability which places a constraint on personal resources and may disrupt power rela— tionships in the family. 8Richard E. Farson, Phillip.M.-Hauser, Herbert Stroup, and Anthony J. Wiener, The Future of the Family (New York: Family Service Association, 1969), p. 35. . 9William A. westley and Nathan B. Epstein, The Silent Majority (San Francisco: Jossey-Bass, 1969), p. 166. . 1°Dorwin Cartwright, Studies in Social Power (Ann Arbor, Mich.: Institute for Social Research, The University of Michigan, 1959), pp. 12—13. Within North 31’ 2;;roxirzately 27 mi; 12 and at lea: Cazaia r. the United State. are» ttanpting to ho:se'FUuw~sb~K um-HNJMVA‘HVNA‘t) .muonawe hamfimm mo soapommmapmm too: was .Hmnuoaioma3 mo MDHHHAMmHU .hawamm osu cw cowusnwnumwp Hmsom m>flumaou macaw mmflnmcoaumaou mo cowumuwdmsummocoo .H shaman Muflommmo Hmcowuocdm.mm¢u cowufipnoo mo mufl>wuom mMflO hudommmo HMGOfluocsm ommomwp mo hufluo>om coauaeeoo no sua>aeoe monoon soap . . Iommmflumm 60¢: pwuwdmuwmmog,mmmp Hmuoa mo coauaouuom meowumsflamuamnon mo Honenz Cr momma HHOQQSm pom manmcowcmmeoo monoun mcflxMEICOmeoop cw Hozom mo cowumoouom t1 ommomap awareness momma amoflmoaowmmnm m mo nuoommm momma hummmm Houcmemdmealcowmwoon HoxMEIGOflmwoon mMMDm4HZ. msg#081oma3 mo coeuommmeeme coma mundanmmee me unouxu n coausnflupndp Hmzom 0>Humaom. mZOHBHZHme mmfldeM¢> ''''' rces for soc ial out!“ :eeis of family merit The purposes of :zzceptualize and IT‘E £111.". the family a:‘ of fully netbers: ‘— :‘ ”by; ~" ‘ )-v.. ‘1‘ Jence $1an 251'" u ' “3 and L‘plere" . 2C1} 0f theSe COFCe‘ 1:: t' .S..lP 0f the ext. I: ‘ J. {A 'o ..e “lfe‘mother ESE: .rch for answeri .:s;s for the St“dyJ 3)h resources for social exchange may be to identify satisfied needs of family members. Purposes The purposes of this exploratory study were: 1) to conceptualize and measure the relative power distribution within the family and the extent of satisfaction of needs of family members; 2) to conceptualize and measure the degree of congruence among family members of perceptions of decision- making and implementing; 3) to examine relationships between each of these conceptualizations; and 4) to explore the rela- tionship of the extent of disability from a rheumatic disease of the wifedmother with each conceptualization. Specifically a search for answers to the following questions formed the basis for the study: 1) How may the variables of relative power distribution, need satisfaction, and degree of congruence among family members be operationalized and measured? A. To what extent do family members concur on the decision—making and implementing within the family? 2) What relationships exist between relative power distribution and need satisfaction? 3) Do the variables of relative power distribution, need satisfaction, and degree of congruence among family members vary significantly with the extent of dis- ability of the wifedmother? 4) Is "acceptance of illness" an intervening variable in these relationships? A. Are the ' and need illness” 5) What interr relative po the extent 6) Does the re ence among the need 55 7) Does relati with the so In addition tc ”530' game theory :0: which the sear“ werests within T“ Staff ., ‘ ‘as provided ’\ cg. or der not to aff 3“ n55e:i ed to in this 10 A. Are the variables of relative power distribution and need satisfaction related to "acceptance of illness"? ' 5) What interrelationships exist among the variables of relative power distribution, need satisfaction, and the extent of disability of the wifedmother? 6) Does the relationship between the degree of congru- ence among family members vary significantly with the need satisfaction of family members? 7) Does relative power distribution vary significantly with the socio-economic status of the family? In addition to these questions, another phase which em- ployed game theory was outlined in cooperation with The Centre from which the sample was obtained. Based on current research interests within The Centre, consultation with one of their staff was provided to field test a series of one trial games. In order not to affect the answers to the research questions attended to in this study, data fulfilling the researcher's obligation to The Centre were collected from a selected number of families following the interviews with each family member. These findings will be analyzed later. Assumptions 1. Families have a flexible pattern of internal differ— entiation based on power and status but attempt to maintain a practical equilibrium25 (equifinality).26 2. In North American society although wives may be em- ployed outside the home, their major responsibility within 25George C. Homans, Social Behavior: Its Elementary Forms (New York: Harcourt, Brace and WOrld, 1961). PP. 112-114. 26Walter Buckley, Sociology and.Modern Systems Theory (Englewood Cliffs, New Jersey: Prentice-Hall, 1967), p. 60. “stone is a comb1.. 3. A wife-mothe “font upon other 4. Methodolog it aims cat egor ies o F: Recognizing 1h Gotheses were for Wieses were ge: 1- The power member is Positix he: "ac 8‘ The 130 Positi .9: ex . rhe PO‘w'e A. The B. The wheh C. The IQVE “he: 3. m‘e n94 l‘elat A, T‘ E tix a, TR 11 the home is a combination of household tasks and family care. 3. A wife-mother with a disability is apt to be more dependent upon others than a wife—mother without a disability. 4. Methodological considerations remain the same across various categories of families. Formulation of Hypotheses Recognizing the exploratory purpose of this study, the major hypotheses were formulated prior to the field work and the sub- hypotheses were generated as part of the research process. 1. The power in decision—making of an individual family member is positively related to his need satisfaction. A. The power in decision-making of the wife—mother is positively related to her need satisfaction when her "acceptance of illness" is partialed out. B. The power in decision—making of the wife-mother is positively related to her need satisfaction when her extent of disability is partialed out. ‘2. The power in decision-making of the wife-mother is inversely related to the extent of her disability. A. The power in decision-making of the wife-mother is inversely related to her "acceptance of illness". B. The power in decision-making of the wife—mother is inversely related to the extent of her disability when her "acceptance of illness" is partialed out. C. The power in decision-making of the wife-mother is inversely related to the extent of her disability when her need satisfaction is partialed out. 3. The need satisfaction of the wife-mother is inversely related to the extent of her disability. A. The need satisfaction of the wife—mother is posi- tively related to her "acceptance of illness". B. The need satisfaction of the wife-mother is in- versely related to the extent of her disability when her "acceptance of illness" is partialed out. C. The need versely when her out. 4. The degree members as activities disability 0 The degree members as activities faCtiOn of ' The POWer , mat‘ibex Var Status Of Q i m The task Of 13‘. . . es reCOgnlzlnc \. z. u. e theoretic; 7:. L . a t‘leoretical x .,"‘ I‘Lh the °ther c 12 C. The need satisfaction of the wifedmother is in- versely related to the extent of her disability when her power in decision-making is partialed out. 4. The degree of congruence among responses of family members as to who does and who decides on various activities varies significantly with the extent of disability of the wifedmother. 5. The degree of congruence among responses of family members as to who does and who decides on various activities varies significantly with the need satis- faction of family members. 6. The power in decisiondmaking of an individual family member varies significantly with the social—economic status of the family. Selection and Development of Definitions The task of selecting and developing definitions necessi— tates recognizing that for any concept there are two meanings: l) the theoretical meaning and 2) the empirical meaning.27 The-theoretical meaning is determined by its interrelations with the other constructs in its theoretical system. The em- pirical meaning is determined by the rules of correspondence or the operational definitions that link the construct to observ- able events. An attempt to include both definitions for key concepts follows. Other definitions pertinent to the study appear when the term is first used. Power From the various uses of the term in~the literature, power was defined as an ability within a social relationship to 27Morton Deutsch and Rdbert M. Kraus, Theories in Social Psychology (New York: Basic Books, 1965), p. 8. rilxence or contro power in decision-tr siors a family meat affected another pe Seed Satisfaction This term has ages-on wants with becme part of his to hear: behavior . Satisfaction was me SEdefied with . rfiPOnses: "mOSt O. 51:111." . QUEStlons, 5:1: I, ‘ i‘d Support re 13 influence or control another person's behavior. Operationally power in decisiondmaking was measured by the number of deci— sions a family member made or participated in making that affected another person's behavior. Need Satisfaction This tenm has been defined as the fulfillment of anything a person wants with sufficient consistency over time to have become part of his personality, that is, a motivation basic to human behavior. These needs may be considered as sub-goals. Satisfaction was measured by asking the respondent "Are you satisfied with . . . " and by his selecting one of these responses: "most of the time, sometimes, usually not, or not at all." Questions were included which asked about activities in three areas of needs: physioIOgical, safety, and companion- ship and support needs. Extent ofyDisability This concept has been defined as levels of a physical, ‘mental, or emotional condition which limit the potential or create serious problems in working, going to school, keeping house, or other activities nonmal for the age group. For this study, disability primarily stems from the effects of a rheu— 'matic disease. Fully recognizing the lack of an Objective ‘measure of disability for these effects, five indicators were used to Operationally measure extent of disability of the wife- mothers. These included number of hospitalizations, total days hospitalized, activity of condition, severity of disease, . a' 1:5. functional c . section of Chapte I ‘5 ‘Accectance Of I This concept Era: the acceptan ariettations of a :zestions did not :29 Primary fOCus rejection . Op er a “mine two que ‘5"'615 0f the var filth a worry tc ire' able to do fc l4 and functional capacity. Each indicator is defined in the section of Chapter Three entitleanedical Information, page 74. "Acceptance of Illness" This concept was derived specifically for the study from the acceptance-rejection continuum of attitudes and orientations of a person towardhimself.28 Although the questions did not specify the arthritis of the wifedmother, the primary focus was on her health and her acceptance- rejection. Operationally combinations of answers to the following two questions asked of the wifeemother formed the levels of the variable "acceptance of illness": "Is your health a worry to you?" and "Are you satisfied with what you are able to do for your family?" Responses for both questions were "most of the time, sometimes, usually not, or not at all." Socio-economic Status Social class, status, stratification, role, and life style are frequently encountered concepts. From this assort- ment, socio—economic status was selected as a concept implying the differentiation among families based upon social and eco- nomic factors in society. The concept was measured by the 38Julius Gould and William L. Kolb (eds), A Dictionary of the Social Sciences (New York: The Free Press, 1964), pp. 4-5. 2.: , 439'" Sailingshead ME 22521 of Occupation ..::-.- tony 0f ”cu” flof Congrtfl Agreement amo: various ways. Deg: :f coinciding or ac tong responses of to decides for thc :easure degree of 1 f1: .1 respondents h . klk‘lz We define fa 15 Hollingshead Two Factor Index of Social Position,29 the Blishen 0 Index of Occupations in Canada,3 and a manual-nondmanual dichotomy of occupations.31 Degree o§_Congruence Agreement among any number of persons may be evaluated in various ways. Degree of congruence is the amount or intensity of coinciding or agreeing. Scores indicating the agreement among responses of family members to the items of who does and who decides for the various activities were calculated to ‘measure degree of congruence. Complete agreement was indicated when respondents had given the same response to an item. Family “we define family as'a corporate unit of interacting and interdependent personalities who have a common theme and goals, have a commitment over time, and share resources and living space."32 Although the definition encompasses a number of 29August B. Hollingshead,~ Two Factor Indexgof Social Posi— tion (New Haven, Connecticut,1965 Yale Station, 1957), pp. 1-11. 3°Bernard R. Blishen, "A Socio-Economic Index for Occupa- tions in Canada," The Canadian Review of Sociology and Anthro- pglggy, 4:1 (February, 1967), 41-53. -"Social Class and Opportunity in Canada," The Canadian Review of Sociology and Anthropology, 7:2 (May, 1970), 110-112. nRonaldM. Pavalko and David R; Bishop, 3'Socioeconomic Status and College Plans: A Study of Canadian High School Students,” Sociology onyducation, 39 (Summer, 1966), 292—293. 32Nancy C. Hook and Beatrice Paolucci, "The Family As An Ecosystem," Journal o§,Home Economics, 62:5 (May, 1970), 316. possible canbinati. for selection of f. lation include a h child. Families 0 :edical records li far the study. No End benefited fror tabers. 16 possible combinations, in this study the criteria chosen for selection of families specified that the minimum constel— lation include a husband-father, wifeemother, and teen-age child. Families of all women whose admittance form in the medical records listed a husband became potential candidates for the study. Nonrelated persons who lived in the household and benefited from the homemaking tasks were considered family menbers . ‘4 a! 'f‘ i; __...V.i't.-." ' This review firm five areas w lations of power within the family authority; physio social variables CHAPTER II REVIEW OF LITERATURE This review of literature is a selected compilation from five areas within the major tOpic: theoretical formu- lations of power and authority: previous studies of power within the family; methods used to measure family power and authority; physical disability within the family: and psycho- social variables in rheumatic diseases. Theoretical Formulations q; Power and Authority A cursory review of the literature reveals a number of words and phrases such as power, power structure, authority, authority patterns, influence, dominance, submission, equali- tarianism, and status. Frequently terms have been used interchangeably by various authors, thus indicating that one of the major problems is a lack of consistent use of termin- ology. In dealing with this problem, it is possible to re- view conceptualizations of power and authority remembering both the theoretical and the empirical meanings for concepts.1 1Morton Deutsch and Robert M. Kraus, Theories in Social Psychology (New York: Basic Books, 1965), p. 8. l7 ‘.-._._-_u_'v~!5 EC. The concept l 1) power viewed a. and 2) power view Schopler limited ‘ atich power was c relationship, in: tent of power ‘1 relationship." '1‘ Study. REYlE'w'lng 0; 035 research Stud F L. e W to affect the n ‘ MC: I’I' lens \leWed inte and WC>lfe6 define farther to infl-x e 18 The concept of power has been differentiated into: 1) power viewed as a characteristic of a social relationship and 2) power viewed as a personality trait of an individual.2'3 Sch0pler limited his review to theories and experiments in which power was considered "a characteristic of a social relationship, involving at least two persons, where the amount of power is defined by the events occurring in the relationship." This limitation has been accepted for the study. Reviewing Operational definitions of power used in vari— ous research studies denoted the interchangeable usage of the concepts of power and authority. Within an interaction framework, Thibaut and Kelley“ defined power as the ability to affect the quality of the partner's outcomes. Homans and Blaus viewed interaction as an 'exchange' process. Blood and Wolfe6 defined power as the potential ability of one partner to influence the other's behavior and stated that it 2RichardM. Emerson, "Power-dependence Relations," American Sociological Review, 27: (1962), 32. 3John Schopler, "Social Power," Advances in Experimental Social Psychology, ed. L. Berkowitz (New York: Academic Press, 1965), p. 178. 4John w. Thibaut and Harold H. Kelley, The Social Psy- chology of Groups (New York: John Wiley, 1959), p. 101. 5George C. Homans, The Human Group, 1950 and Social Behavior: Its Elementary Forms, 1961 (New York: Harcourt, Brace and World). Peter M. Blau, Exchange and Power in Social Life (New York: John Wiley, 1964). 6RObert 0. Blood Jr., and Donald M. Wolfe, Husbands and Wives (New York: The Free Press, 1960). is manifested in 1 life of the famil; defined authority zetbers to make (3 :oremenbers in a sidered power th other's behavior. ailiity to 1381‘?ch sion that is cont 3% defined author lives the other t 53:11}! decision. with few exC lfiiti‘ate POWer. °fa9r°up and is and the SOCial no ‘ieproblem is 33::- h . .sthild'io fa~ 19 is manifested in the ability to make decisions affecting the life of the family. Authority is legitimate power. Rollins7 defined authority as the ability of one or more family manbers to make decisions which guide the conduct of one or 'more members in a given home activity area. Hoffman8 con— sidered power the extent to which one person decides over the other's behavior. Olson9 defined power as an individual's ability to persuade the spouse to accept a particular deci- sion that is contrary to the spouse's personal preference. He defined authority as the legitimate right that a spouse gives the other to exercise power in regard to a particular family decision. With few exceptions, authority is usually defined as legitimate power. Authority is part of the formal structure of a group and is based on role position, role expectations, and the social norms of the group or society. The crux of the prdblen is in defining power. According to Safilios- Rothschild.1° family power 7James M. Rollins, "EWO Empirical Tests of Parsonian Theory of Family Authority Patterns," The Family Life Coordi- nator, 12: 1-2 (January-April, 1963), 10. 8Lois W. Hoffman, "Effects of the Employment of Mothers on Parental Power Relations and the Division of Household Tasks," Marriage and Family Living, 22: (1960), 27—35. 9David H. Olson, "Decisiondmaking in Couples: A Com- parison of a Self-report and Behavioral Measure of Power" (Doctoral dissertation, Pennsylvania State University, Ann Arbor, Mich.: University Microfilms, 1967), No. 68-8729. 1°Constantina Safilios-Rothschild, "The Study of Family Power Structure: A Review 1960-1969," Journal of Marriage gnd the Family, 32: (1970), 540. 15 a mult1d1 11; through b power is put measured thr patterns 05 of prevailir None Of thee identified E configuret 1‘ model Of PC" Cor.se"ueI‘-t1 onsiders the ‘3‘ glaity of the ; oparationalizim Despite t‘r. Emu, there a; 13y be defined influence or c Edwards“ “this? the it it 1 ‘ -.. to r eLat it arc-d “36313 J. L Sc} ‘ 12 f?§’er : Da‘ 0 ‘4 3: 20 is a multidimensional concept that is measured indirect- ly through behavioral acts in which the degree of one's power is put to the test. Thus, familial power can be measured through the outcome of decisiondmaking, the patterns of tension and conflict management, or the type of prevailing division of labor. . . . None of these particular behavioral patterns can be identified alone with familial power; it is their total configuration that tends to reflect the prevailing model of power. Consequently, as one reviews Schopler's11 summary and 12 the com- considers the 'multidimensional' nature of power, plexity of the problem of theoretically defining and then operationalizing the concept becomes more than apparent. Despite this complexity and the numerous definitions of power, there appear to be recurring elements such that power may be defined as an ability within a social relationship to influence or control another person's behavior. Edwards13 proposed that familial behavior be examined within the framework of social exchange.14 Briefly the framework relies on the prenise that individuals will enter into relationships with others to accomplish socially medi- ated goals and to fulfill the role expectations of their 11Schopler. 12DavidM. Herr, "The.Measurement and Bases of Family Power: an Overview," Marriage and Family Living, 25: (May, 1963), 135. Safilios-Rothschild, 1970. 13John Edwards, "Familial Behavior as Social Exchange," Journal of.Marriage and the Family, 31: (1969), 518-526. 1‘Homans, 1961. Peter M. Blau, 1964. ,. ”‘w. 'L'v " positions. This . one person's 9031‘ site: person. 71'“ my not be of the he: resources of } isssert for her f. ureturn. The rl within the family this social excha: is “that which an 1: social exchang s3§9e5ted that moi 1: the study of e: i119-means to 91‘ :ceives in exchai 10th: - “*t “11 Ch he 1 13196 1. Concepts and ‘ie‘ ~ ”518 of stud ’ieory" Of family \ 15., Zdw ards, 21 positions. This entails an exchange, that is, to attain one person's goals involves an investment and cost by the other person. The resources exchanged in a social situation ‘may not be of the same kind, for example, a mother may use her resources of time and skills to prepare a favorite dessert for her family and then receive affection and praise in return. The resources necessary for transactional behavior within the family are not always clear or easily defined. In this social exchange framework, Edwards15 defined a resource as "that which an exchanger has to give in a relationship." In social exchange as contrasted with economic exchange, he suggested that most resources are inseparable from the giver. In the study of exchange in archaic societies,15 to give some- thing means to give a part of oneself. Each person supposedly receives in exchange something which he perceives as equivalent 7 unrecipro- to that which he has given. According to Blau,l cated exchange leads to the differentiation of power. Concepts and hypotheses from exchange theory have formed the basis of studies of family power structure.18 The "resource theory" of family power was develoPed by Blood and Wolfe from 15Edwards, p. 519. 15MarcelMauss, The Gift: Forms and Functions of Exchange in Archaic Societies (New York: W. W. Norton, 1967), p. 10. 17Blau, p. 7. ”Blood and Wolfe. Herr, 1963, pp. 133-139. their study in De1 of marital power 4 :ion of the husba- participation in < azd social activi Tie balance of po' coztributes the g the most competen Herr critici 5.35611;th whiCh thi inWolves the hUSband and e§e resom p031tin dij e resouIC‘ to er of ti ”Changing ] V'al’sa. ilq to Hertz 0 son existing da‘ 'J . eternal SOCi 22 their study in Detroit. This theory holds that the balance of marital power is determined by the comparative participa- tion of the husband and wife in the external system. This participation in occupational, educational, organizational, and social activities provides the bases for marital power.19 The balance of power will be on the side of the partner who contributes the greater resources to the marriage and who is the most competent. -Herr criticized Blood and Wolfe's theory proposing a substitute which he labeled "exchange value theory." Accord- ing to Herr2° this theory involves the terms of the exchange of resources between ,husband and wife with the focus on the value placed on these resources outside the marriage. The greater the positive difference between the value to the wife of the resources contributed by her hquand and the value to her of the resources which she might obtain through exchanging her own resources outside the existing marriage, the greater the power of the husband and vice- versa. From existing data, Herr suggested five bases of power: 1) external social control, 2) the prior internalization of norms, 3) discrepancy between actual return and return expected under an alternative to the existing marriage or family, 4) relative competence, and 5) relative involvement. Safilios- Rothschild also criticized the "resource theory" citing studies which have refuted.its basic premises. She considered the 19Robert 0. Blood Jr., "The.Measurement and Bases of Family Power,".Marriage and Family Living, 25: (1963), 475- 478. 2°Herr, 1963, p. 477. relevancy of Her: tive love and nee power structure. :‘egree to which "21 Wilkening . 2 :zeory," listed responsiveness < H . . , , .ecxsmn-maxinc esteem in a 9:0 es:een by provj The resouJ lllher of waYS resources _ Q.- "HQ‘~\‘ -Q “ring hum; C: ' . ‘311‘! ldenti 2 ‘§_ \., . 4‘53 ;\ . 1 ‘ 23 Bob ‘12,»- ZQ G t" ER? &< ‘;_-., R ‘ ‘ .fi‘c. QE Irt? at‘ o 7~ 23 relevancy of Herr's "exchange theory" and prOposed a "rela- tive love and need" theory as a possibility for explaining power structure. The crucial variable may be "the relative degree to which the one spouse loves and needs the other. . "21 2 in an attempt to refine the "resource Wilkening,2 theory," listed resources of companionship, love and sexual responsiveness of the spouses as unknown influences in decisiondmaking. Homans23 proposed that the higher a man's esteem in a group, the higher his authority and that men earn esteem by providing rare and valuable service to others. The resources of the family have been categorized in a number of ways with research focusing on material or non-human resources. Only recently effort has been directed toward measuring human resources in the family.24 They are not easily identified or quantified in measurable terms. Non- human resources are tangibles that in the majority of instances may be identified, counted, measured, and readily observed in exchange transactions. ZISalifios-Rothschild, 1970, p. 548. 22E. A. Wilkening, "Toward Further Refinement of the Resource Theory of Family Power," Sociological Focus, 2: (1968) : 1’19 0 23Homans, 1961. pp° 286-290. 24Georgianne R. Baker, "Patterning of Family Resources for Educability: Conceptualization and Measurement in Costa Rican Families" (Doctoral dissertation, Michigan State Univer- sity, Ann Arbor, Michigan: University.Microfilms, 1970.) No. 71-11, 779. Uriel G. Foa, "Interpersonal and Economic Resources," Science, 171 No. 3969 (1971), 345-351. Lush” é From an eco. utility or the w services. Fitzs uportant produc' her, they are satisfactio: another . . the telepho meaning of but sometim POtential 1'? family members 3 need has been d! 0f ma “'3 baSic 24 From an economic stance, production is the creation of utility or the want-satisfying power possessed by wealth and services. Fitzsimmons25 stressed service utilities as an important production activity within the home. According to her, they are satisfactions which one individual makes possible for another . . . such things as answering the doorbell and the telephone, care of the sick, and interpreting the meaning of experience——most often, perhaps to children—- but sometimes for adults also. Potential human resources available for exchange by family members may stem from satisfied needs. The concept of need has been defined in a number of ways and various listings of man's basic needs postulated. One theoretical framework that has been commonly used to conceptualize the full range of man's needs was deve10ped by Maslow.26 He listed five basic needs: physiological, safety, love, esteem, and self- actualization. From a managerial stance, meeting human needs is one goal in family development.27 The needs as delineated by Maslow 25Cleo Fitzsimmons, The Management of Family Resources (San Francisco: W. H. Freeman, 1951), p. 165. 26A. H. Maslow, Motivation and Personality (2d ed. New York: Harper and Bros., 1970), pp. 35-58. 27Margaret I. Liston, "Management in the Family as Social Process." In Conceptual Frameworks: Process of Home Manage- ment. Proceedings of a Home Management Conference, East Lansing, Michigan, June l7-20, 1964 (Washington, D. C.: American Home Economics Association). Beatrice Paolucci, "Contributions of a Framework of HOme.Management to the Teaching of Family Relationships," gzgrnal of Marriage and the Family, 28:3 (August, 1966), 339- 7 1 '1'; ."-_‘.!'.LJ Lia—“46— LL" gay be looked at degree to which :‘etemine the c': family may capit ize human resou: identify the sat from these sati: exchange. Th is conceptualiz at i. R u s art of Maslow' a}!!! ' .-._.51cally disa fied satisfacti and related it s :IOns . 3 0 25 may be looked at as sub—goals. According to Liston,28 "the degree to which the needs of family members are met will determine the character of the human resources on which the family may capitalize. . . ." In attempting to conceptual- ize human resources for social exchange, one step may be to identify the satisfied needs of family members. Stemming from these satisfied needs then are potential resources for exchange. This essentially became the foundation for the conceptualization and measurement of needs in this study. Part of Maslow's hierarchy of needs as used in a study of physically disabled women29 formed the basis for measuring need satisfaction. A review of various marital satisfaction and related instruments guided the formulation of the ques- tions.3° 28Liston, p. 26. 29Phyllis N. Hallenbeck, James K. Skipper Jr., and Stephen L. Fink, How the Severely Disabled Client Perceives the Prdblems of Daily Living, (VRA Project #1584. Final report. Cleveland, Ohio: Vocational Guidance and Rehabili- tation Services, July, 1966). 3°Luther T. Jansen, "Measuring Family Solidarity," American Sociological Review, 17: (1952), 727-733. Charles E. Bowerman, "Adjustment in Marriage: Over- all and in Specific Areas,” Sociology and Social Research, 41: (1957), 257-263. Harvey J. Locke and Robert C. Williamson, "Marital Adjustment: A Factor Analysis Study," American Sociological Review, 23: (1958), 562-569. Harvey J. Locke and Karl M. Wallace, "Short Marital- Adjustment and Predication Tests: Their Reliability and Validity," Marriage and Family Living, 21: (August, 1959), 251-255. Elizabeth Most, "Measuring Change in Marital Satis— faction," Social Work (July, 1964), 64-70. Cont'd next page. m Previotf In this sec‘. stuéies divided or small 91011? r’ 53?? Methods As part of ‘ Herbst3 1 was res1 within the Email necessary in add Lain area of act 1PM. His 5 tudy asrnmation of f the autono': activi activi 26 Previous Studies of Power Within the Family In this section there is an overall review of previous studies divided according to the methods used: either survey or small group research methods. Survey.Methods As part of the UNESCO studies of the Australian culture, Herbst31 was responsible for a study of the relationships within the family between husband and wife. He considered it necessary in addition to who makes the decision within a cer— tain area of activity to know whose behavior is being decided upon. His study with Australian school children resulted in a summation of four basic types of power relationships: the autonomic pattern--the husband decides and does the activity by himself: the wife decides and does the activity by herself. the husband—dominance pattern--the husband decides and they both do it; the husband decides and the wife does the activity. the wife—dominance pattern--the wife decides and they both do it; the wife decides and the husband does the activity. the syncratic pattern—-they decide and do the activity together; after both decide, either does the task. Myer Katz, "Agreement on Connotative Meaning in Marriage," Eamily_2;oge§§J 4: (1964), 64-74. Malcolm Kahn, “Non-Verbal Communication and Marital Satisfaction," Family Process, 9:4 (December, 1970), 449- 455. 31P. G. Herbst, "The.Measurement of Family Relation— ships,” Human Relations, 5: (1952), 3-30. 1H i7 ’- This frames. the basis for 15 Another 9:0 . 3:- :ole frameworfi filling the expr :ental role. R0 aialysis of dat 3 decision-making - 1,217 tenth grad the predictions when the respon: ported when th e a me results fro -ES weak over a] as the leading 35,, ‘u CORSi dered 27 This framework and various adaptations have served as the basis for later studies.32 Another group of studies focused on the Parson—Bales role framework33 which designates the wifeemother as ful- filling the expressive role and the husband-father the instru- mental role. Rollins34 used this framework in secondary analysis of data collected by Johannis in a study of family decisiondmaking. These data consist of the responses of 1,217 tenth grade adolescents. Rollins' analysis supported the predictions derived from the Parsonian frame of reference when the responses of female subjects were used and not sup- ported when the responses of male subjects were used. When the results from the two separate tests were combined, there was weak overall support for the theory. The wife emerged as the leading authority figure in all areas of home activ~ ity considered in the study-~household tasks, child care and 32Theodore B. Johannis Jr., and James M. Rollins, "Teenager Perception of Family Decision Making," The Coordi- nator, 7: (1959), 70—74. Verda.M. Dale, "An Exploration of the Relationship of Home.Managers' Self-actualization to Participation by Family Members in Home Activities" (unpublished Doctoral disserta- tion, Michigan State University, 1968). Loretta Ann Onorato, "Structures of Family Management in Two Socio-economic Classes" (unpublished Master's thesis, Michigan State University, 1968)° 33Talcott Parsons and Robert F. Bales, Family, Sociali— zation and Interaction Process (New York: Free Press, 1955), p. 46. 34Rollins, 3-79. Quote p. 12. :‘i‘ j 1);- _ 1; control, family Rollins conclude the evident lower strat with either slightly i: tend towarc strata tenc the male t; In a cross the necessary i that 46 societi is, there is a «Dies With the wife—mother r0. * I -0 deScrlbe r0 :lOnfiG Basins v VA - 2c;- . Y by 28 control, family economic behavior, and family social conduct. Rollins concluded that: the evidence appears to support the notion that the lower strata tend toward non—joint authority patterns, with either spouse taking the lead, the odds being slightly in favor of the female. The middle strata tend toward joint authority patterns, and the higher strata tend toward a non—joint authority pattern with the male taking the lead. In a cross—cultural survey of 56 societies for which the necessary information was available, Zelditch35 found that 46 societies had a Parsons-Bales role structure. That is, there is a differentiation of instrumental and expressive roles with the husband-father role more instrumental and the wifedmother role more expressive. This structure is intended to describe roles in decisionemaking rather than task execu— tion.36 Basing their framework on the Parsons-Bales proposition, McKinley37 reported that whoever exercises power is determined not solely by the sex of the parent but by the area of decision-making . 35Morris Zelditch Jr., "Role Differentiation in the Nuclear Family: a Comparative Study," Family Socialization and Interaction Process, eds. Talcott Parsons and Robert F. Bales (New York: Free Press, 1955), p. 320. 3sMorris Zelditch Jr., "Cross-cultural Analysis of Family Structure," Handbook ofyMarriage and the Family, ed. Harold T. Christensen (Chicago: Rand McNally, 1964), p. 479. 37Donald G. McKinley, Social Class and Family Life (New York: Free Press, 1964), pp. 107-108. Some studi be that of loca tinuum from mat: archal family 0. fazily and desi- the family powe seem-economic have been exami. statements abou ”nu-mum are i anL‘ITber 0f var This may teen no COHSist BOWeman a for three relat .Or the percei." 4} parental 1‘01 EO‘L Isa:- 1?. 9’ Est:I:\l(:t:1; 29 Some studies38 have considered the crucial problem to be that of locating the family at any given time on a con- tinuum from matriarchal through equalitarian, to the patri— archal family or from the authoritarian to the democratic family and designating these categories as descriptive of the family power structure. Background variables such as socio-economic class, race, employment status, occupation have been examined in relation to each group. Unless specific statements about the relationships being described for each continuum are included, these overall categories may include a number of variations in describing the family power struc- ture. This may partially explain why, in general, there have been no consistent findings. Bowerman.and Elder39 formulated family structural patterns for three relationships: 1) conjugal or marital role pattern for the perceived structure of husband-wife relations; 2) parental role or authority pattern for the structure of mother and father relations in child rearing; and 3) child rearing structure for that of parent—child relations. Measures of family structure and related data were obtained from 38Karl King, "A Comparison of the Negro and White Family Power Structure in Low-income Families," Child and Family, (Spring, 1967), 65-75. Carol L. Stone and Paul H. Landis, "An Approach to Authority Pattern in Parent-Tben—age Relationships," Rural Sociology, 18:3 (1953), 233-242. . 39Charles E. Bowerman and Glen H. Elder Jr., "Variations in Adolescent Perception of Family Power Structure," American Sociological Review, 29: (1964), 551-567. structured quest large sample of Using a crude t; they attempt ed t were seen as mos :"ital and pare equalitarian or The 1 r “ aeges’t pro: Parents had equ minance and w ("-3. n LulnSS also 5.- Vary dependipg SQ‘QCture is EX“ ii 028 cons iderer: Atmi- I “‘H.S ere not baSed o 3O structured questionnaires administered in classrooms to a large sample of adolescents in Ohio and North Carolina. Using a crude typology for parental power in decisionemaking, they attempted to determine whether mother, father or both were seen as most frequently making final decisions in both marital and parental relations: wife or mother-dominance, equalitarian or shared, and husband or father—dominance. The largest proportion of adolescents reported that their parents had equal power in family decisiondmaking with husband— dominance and wife—dominance next in order of prevalence. The findings also suggested that the effects of family structure vary depending on the relationships involved and that family structure is extremely complex. Stone and Landis40 in a study of parent—adolescent rela— tions considered family authority patterns based on the stu- dents'conception of their family patterns. These perception were not based on who made decisions or how decisions were made but on the content of the decisions. From six questions which formed a Guttman—type scale, the families of the teen- agers were classified as to authoritarian, intermediate, or _democratic. The researchers then related these family author— ity patterns to the adjustment problems of teen-agers and found that young peOple from democratic families more often gave responses indicating harmonious relationships with par- ents than did youth from authoritarian families. Later work 40Stone and Landis, 233-242. TE W‘vllVL' ”:Y may“ adde‘d study. A survey 0f 2 simila Pugeles‘ that husband and such the same in g-articularly Vhe to reflect power six additional 1 33.5. an equal £30.“. M “‘9 Personali ty for t form 0f t‘n 31 by Empey41 added intensity analysis to the scale used in this study. A survey of 776 married persons in Metropolitan Los Angeles42 similar to the Blood and Wolfe43 study, indicated that husband and wives in Los Angeles and Detroit are very much the same in their allocations of who makes decisions particularly when analyzing the original eight items selected to reflect power. By broadening the sample of decisions with six additional items, the mean power of the husband drOpped and an equal power position for the husband and wife resulted. The personality variable of authoritarianism measured by a short form of the F-scale was positively and significantly related to the exercise of power in marriage. The study also considered the relationship of need to conjugal power. A significant interaction effect indicated that needs of the husbands have different effects on the power relationship than the comparable needs of the wives. In this study the effects of prior marriage significantly reduced the husband's power in the family. 41LaMar (P. Empey, "An Instrument for the.Measurement of Family Authority Patterns," Rural Sociology, 22: (1957), 73-77. 42Richard Centers, Bertram H. Raven, and Aroldo D. Rodrigues, "Conjugal Power Structure: A Re-examination" (University of California, Los Angeles, 1969, Technical Report No. 23. Contract Nonr. 233 (54)). 43Blood and Wolfe. {I} .l‘ W L“? . A In a study ' satisfaction to hzsband and wive. Eild rearing de ated with marita decision area it: each area contri; couples. French and . | 3‘r’WEl‘ 1n Sinai; 5056 research 1; filology for anai :‘r. -ese bases of PC a .‘ LL we perSOn pOC :19 in 1' . I legitimate | fluenced; Ill | 32 In a study with farm families, Smith44 related marital satisfaction to syncratic decision-making patterns, that is, husband and wives sharing in making decisions. For selected child rearing decisions, syncratic decision—making was associ— ated with marital satisfaction. Although this was the only decision area in which there was a significant relationship, each area contributed to the overall satisfaction of the couples. 45 French and Raven's classical delineation of five bases of power in small group theory has formed a framework for 46 Hallenbeck47 proposed a some research in decisionamaking. typology for analyzing power dynamics in marriage relying on these bases of power: 1) reward power, based on the ability of the person possessing power to provide rewards for the one influenced; 2) coercive power, based on the powerful one's ability to mediate punishments for the one influenced; 3) legitimate power, based on the influenced one's belief that 44Herbert L. Smith, "Intra—familial Decision Making and Marital Satisfaction" (paper presented at the Annual Meetings of the National Council on Family Relations, August 16-19, 1967, San Francisco, California), p. 13. 45John R. French and Bertram H. Raven, "The Bases of Social Power," Studies in Social Power, ed. D. Cartwright (Ann Arbor, Mich.: Institute for Social Research, The University of Michigan, 1959). PP. 155—156. 46Paul A. Dawson, "The Effects of Expert Power and Dogma- tism on a Process of Individual Decision-making" (unpublished Doctoral dissertation, Michigan State University, 1969). 47Phyllis N. Hallenbeck, "An Analysis of Power Dynamics in Marriage," Journal of Marriage and the Family, 28: (May, 1966), 200-203. :1 ”.1- A ._V i the powerfUI 0 opinions: 4) r identification based on the if edge or expert: 3f this typolog Centers, and R0 rang the variO‘ spouses, would base for influer 55 percent consi likely and 47 pe Tery likely basi :luded that the ] :16? 7 . ‘aIy accord: *\ “Vst I“ to other d8“ 33 the powerful one has the right to control his behavior or opinions; 4) referent power, based on the influenced one's identification with the powerful one; and 5) expert power, based on the influenced one's perception of superior knowl- edge or expertness in the powerful one. An empirical test of this typology was conducted in a field study by Raven, Centers, and Rodrigues.48 Husbands and wives differentiated among the various power bases which, when exercised by their spouses, would influence them. Coercion is the least likely base for influence followed by reward power. Approximately 55 percent considered expert and referent power as very likely and 47 percent selected the legitimacy response as a very likely basis for compliance. Raven and associates con- cluded that the bases of power Operate independently because they vary according to domain or area of decision and in rela- tion to other demographic variables. Small Group Research Kenkel49 published a series of articles as a result of a long-term empirical study of family decisiondmaking in which 48Bertram H. Raven, Richard Centers, and Aroldo D. Rodrigues, "Social Influence in the Dyad: The Bases of Con— jugal Power" (University of California, Los Angeles, 1969, Technical Report No. 25. Contract Nonr. 233 (54)). 49William F. Kenkel, "Influence Differentiation in Family Decisiondmakingf'Sociélogygand Social Research, 425 (1957), 18-25: "Traditional Family Ideology and Spousal Roles in Decisiondmaking," Marriage and Family Living, 21: (1959), 334-339; "Family Interaction in Decisionemaking on Spending," Household_DecisioneMaking, ed. Nelson Foote (New York: New York University Press, 1961), pp. 140-164. “I .E 1 A. . a”; he focused on r process, relati process over ti' teach rational tions of couple gift of money, 3° Great abilit‘ would play in a y‘aCkso foc EC married Coup aPQrimEIltal gr‘ :IECk erking-c, Sev eral Infiasure 34 he focused on roles of family members in the decisiondmaking process, relative influence of family members, changes in the process over time, and an assessment of their ability to teach rational decisionamaking. From experimental observa— tions of couples as they decided how to spend a hypothetical gift of money, he concluded that husbands and wives showed no great ability to judge several aspects of the roles they would play in a decisionamaking session. ,Mackso focused on the husband—wife power relationship in 80 married couples selected to measure differences among four experimental groups: Black middle—class, white middle—class, Black working-class, and white working—class. In employing several measures of power, Mack found that results Obtained from the questionnaire were quite different from those ob- tained either in the discussion situation or in the bargaining situation. Class differences were more predominant than racial differences in this stud". University Press, 1961), pp. 140—164; "Dominance, Persistence, Self-confidence, and Spousal Roles in Decisiondmaking," The Journal of_§ocial Psychology, 54: (1961), 349—359: "Observa- tional Studies of Husband-wife Interaction in Family Decision- making," Sourcebook in.Marriage and thegamily, ed. Marvin B. Sussman (Boston: Houghton Mifflin Co., 1963), pp. 144-156. 50Delores E. Mack, "The Hquand-wife Power Relationship in Black Families and White Families" (Doctoral dissertation, Stanford University, Ann Arbor, Michigan: University Micro- fihns,l970), No. 70-18, 438. J; -I'«‘I'_~‘:" - -:- J‘ Middleton fornd there was fessors and ski mates in the ma on observation They suggested PEG-pie saying 0 Straus and behavior of fans. called SIMFA! :easuxe the var tation, PIOblegg . L . 73.36 in the 120719 1 and presSiv 9's (D I: H H n! _ ; u (.-' [I] I " I O‘ 4‘ (Lu I ’- ’ o 35 Middleton and Putney,51 contrary to their expectations, found there was no evidence that whites and Negroes, pro- fessors and skilled workers, differ as to which spouse domi- nates in the making of daily decisions. Their study is based on observation of behavior rather than on subjects' statements. They suggested that these differences may be an example of peOple saying one thing and doing another. Straus and Tallman52 have been studying problem solving behavior of families. They develOped a laboratory technique called SIMFAM (Simulated Family Activity.Measurement) to measure the variables of relative power of family meMbers, interpersonal support patterns, volume and quality of communi— cation, problem solving ability, and creativity. A modified technique known as the bean bag task has been deve10ped for use in the home. In a study which used SIMFAM to examine the effects of sex of a child and social class on instrumental and expressive roles, the working class wives exercised more power relative to their husbands than did the middle class wives on instrumental roles. Husbands tended to be predomi- nant in both instrumental and expressive roles among middle 51Russell Middleton and Snell Putney, "Dominance in Decisions in the Family: Race and Class Differences," The American Journal of Sociology, 65: (1960), 605-609. 52Murray A. Straus and Irving Tallman, “SIMFAM: A Tedh— nique for Observational Measurement and Experimental Study of Families," Family Problem Solving, eds. Joan Aldous et al. 15insdale, Illinois: The Dryden Press Inc., 1971), pp. 381— 8. Kr? class families . 53 girls. Straus ing relative p0' tudies. Bahr and R: EXPEIimentally PM! concluded WEI Structure. IESISt POWer Che tire that Pemh 36 class families. Boys had a higher mean power score than girls.53 Straus54 has used the SIMFAM technique for measur- ing relative power Of the husband and wife in cross—cultural studies. Bahr and Rollins55 in their use Of the technique to experimentally investigate the effects Of crisis on conjugal power concluded that the effect depends on the precrisis power structure. Couples with a very dominant mate tended to resist power changes during stress while couples without an especially dominant mate tended to have a flexible power struc— ture that permitted change tO occur during the crisis. Methods Used tO Measure Family Power and Authority Problems in methodology in various studies Of family power structure have been discussed in the literature.56 53Murray A. Straus, "The Influence Of Sex Of Child and Social Class on Instrumental and Expressive Family Roles in a Laboratory Setting," Sociology and Social Research, 52:1 (1967), 7-21. 54Murray A. Straus, "Husband-wife Interaction in Middle and Working Class Nuclear and Joint Households in Bombay," Preliminary working paper for Studies in Honor Of K. M. Kapadia, University Of Bombay, in press. 55StephenJ. Bahr and Boyd C. Rollins, "Crisis and Conjugal Power," Journal of Marriage and the Family, 33:2 (1971), 360-367. 56Rollins. vHerr, 1963. Olson, 1967. Constantino Safilios-Rothschild, "Family Sociology or Wives' Family Sociology? A Cross-cultural Examination Of Two recent stud another re-emph upon the method Dimensions tional and expe aP.31'oach, infli; {EPOIt Of a per 51mm“! throu exPerinental 0b exP‘eril'dentally , 33*? situation 6 o 37 57 focused on methodological prOblems and Two recent studies another re-emphasized the discrepancies in responses depending upon the methods used.58 Dimensions Of measurement have included both reputa— tional and experimental Observation. (In the reputational approach, influence has been measured by self report or by report Of a person closely acquainted with the family power structure through use Of an interview or questionnaire. The experimental Observation approach frequently has involved an experimentally contrived decision making process, e.g., a $300 allocation by the husband and wife,59 a boutique bargain— ing situation60.0r some version Of Strodtbeck's method Of revealed differences.61 Strodtbeck62_is well known for his experimental Observa- tion approach--the method Of revealed differences. .In his Decisiondmaking," Journal Of Marriage and the Family, 31: (1969), 290-301. Safilios-Rothschild (1970). James L. Turk and Norman W. Bell, "Measuring Power in gamilies," Journal of Marriage and the Family, 34: 2 (1972), 15-222 David H. Olson and Carolyn Rabunsky, "Validity Of Four Measures Of Family Power,“ Journal Of Marriage and the Family, 34:2 (1972), 224-234. 57Olson, 1967. Olson and Rabunsky. Turk and Bell. 5eMack. 59Kenkel, 1963. 59Mack. 61Fred L, Strodtbeck, "HusbandAWife Interaction Over Revealed Differences," American Sociological Review, 16: (1951), 4687473. . 62Strodtbeck, 1951. , Fred L. Strodtbeck, "The Family as a Three-person Group,I American Sociological Review, 19: (1954), 23 -29. v-I early work, this experiences to U asking the subj‘ tations. In a determine the pt thetical questil of value reveal of the family d 3 .Zz-er); and th ierence is resc D'Jt Whose opinj a revealed difj on all discuss The rex.ea 38 early work, this consisted Of asking subjects who have shared experiences to make individual evaluation Of them and then asking the subjects to reconcile any differences in interpre- tations. In a later deveIOpment, the first step has been to determine the position Of each family member on certain hypo— thetical questions Of value: second tO find out differences Of value revealed by the questionnaire (at least one member of the family disagrees with the value position Of another member): and the last step tO find out how the revealed dif- ference is resolved. Family power is then measured by finding out whose Opinion prevails in each Of several discussions over a revealed difference and adding up scores Of each participant On all discussions. The revealed difference technique was used in an exten— sive study63 comparing families with normal children and families with schiZOphrenic children. They focused on the control strategies, either attention control or person-control, which group members use tO influence other members. In famil— ies with normal children there was a clear power structure and a norm which allows all members tO participate in the decision— making process. Middleton and Putney64 used a modified version Of the revealed differences technique. Their questions concerned 63Elliot G. Mishler and Nancy E. Waxler, Interaction in Families (New York: John Wiley, 1968). 64Middleton and Putney. ‘i u, 1'1} V'l‘ “cur—H g judgments of value to eliminate the l nation. In the analy: scoring has been 7 or a modified ver Much of the mese categories out a history. 1‘ of a relatively 1 Laboratory studie 3P0wer SUUCture established power L ‘ 67 eik COmp: groups ComPosed 39 judgments Of value or preference rather than matters Of fact to eliminate the possibility Of one partner having more infor- mation. In the analysis Of interaction between family members, scoring has been based on Bales Interaction Process Analysis65 or a modified version Of his categories.66 Much of the laboratory small group research in which these categories have been employed has been with groups with— out a history. Yet the relationships within the family are of a relatively long duration--there is a past and a future. Laboratory studies Of small groups examine the emergence Of a power structure while studies Of families begin with an established power structure. Leik67 compared initiation Of acts in the experimental groups composed Of triads from nine families-- 1) the families meeting as families, 2) three groups composed Of either all mothers, all fathers, or all daughters, and 3) nine groups composed Of a father, a mother, and a daughter but not from the same family. He concluded that predictions from inter— action with strangers will not hold for interaction with family members. 65Robert F. Bales, Interaction Process Analysis (Cam- bridge, Mass.: Addison-Wesley Press, 1950). 66John O'Rourke, "Field and Laboratory: The Decision— making Behavior Of Family Groups in Two Experimental Condi— tions," Sociometry, 26: (1963), 422-435. _Kenke1, 1957. RObert K. Leik, ”Type Of Group and the Probability Of Initiating Acts," Sociometry, 28: (1965), 57-65. 67Leik. E? d?! 'r,(-_‘-:;3!'.'." 3‘ Although O'RO strictly limited I‘ the quantity and changed as the gro There was a genera social-enotional t to the laboratory Person family gro: Of a group proj EC‘ 1fits, and a ranki; In using the 40 Although O'Rouke68 cautioned the reader regarding the strictly limited nature Of his results, he found that both the quantity and quality Of the groups' interactive behavior changed as the groups moved from the home tO the laboratory. There was a general increase in instrumental and negative social—emotional behaviors as the groups moved from the home to the laboratory situation. In his experiment with 24 three— person family groups, the procedure included the completion of a group projective task, discussion Of twO decision prOb— lems, and a ranking task. In using the reputational approach, most studies have Obtained a report from only one respondent and then frequently this has been interpreted tO represent the family power struc— ture. Blood and Wolfe69 had only the wife respond. In other studies a child has been asked to report the balance Of power 0 There are a few exceptions when both between his parents.7 husband and wife have been asked about the conjugal power structure,71 and when husband, wife and one child have been 68O'Rourke, pp. 426—427, 434. 69Blood and Wolfe, p. 6. 70Herbst. Stone and Landis. Hoffman. Bowerman and Elder. 71DavidM..Herr, "Husband and Wife Perceptionsiof Family Power Structure," Marriage and Family Living, 24: (1962), 65-67. Ella Jane Oyer, "Relationship Of Homemakers' Hearing Losses to Family Integration" (unpublished Doctoral disserta— tion, Michigan State University, 1969). Mack. fl 1 1..’t_—‘ "—-—+—Ju re asked about famil A group of 1: who in their fami lens. The resear and wives reflect This may be true filllieS? Woulc ““93 in the san: Disagreemen. exists according Rothschild . 7 4 T‘ CN‘ 5‘ . tines sometimes family members . p- a ‘J‘ E . Ikc‘has . ll 41 asked about family power.72 A group Of husbands and a group Of wives responded to who in their families decides about certain economic prob- lems. The researcher,73 suggested that, in general, husbands and wives reflect one another's judgment almost perfectly. This may be true in the aggregate, but does it happen within families? Would this have been the finding if husbands and wives in the same family had been interviewed? Disagreement between responses Of husbands and wives exists according to a summary of various studies by Safilios- Rothschild.74 The degree Of disagreement varies depending upon the variable under consideration. -But practical diffi- culties sometimes complicate simultaneous interviewing Of family members. Although the concurrence Of perception has been analyzed in some studies, much more knowledge is needed tO determine the part Of all family members in the family power structure. Kenkel75 studied the sex Of the Observer in his Observa- tions and found that the effects Of the sex Of an Observer were in the hypothesized direction—-that is, wives in the presence Of a female researcher talked more, contributed.more 7ZStrOdtbeck, 1954. - Onorato. 73Elizabeth H. WOlgast, ”DO Husbands or Wives Make the Purchasing Decisions?" The Journal Of.Marketing, 23: (1959), 151-158. . 74Safilios-Rothschild, 1969, 1970. 75Kenke1, 1961, 42 Of the prOblem solving attempts, and had more influence on the decision outcome than the wives who interacted with their husbands in the presence Of a male worker. The reasons for the differences could be debated as tO whether they were due tO the sex of the Observer, their personalities, or the tech- niques. However, it raises the question Of the effect any observer may have on family interaction. In one study in which conversations between husband and wives were recorded, there were no striking differences be- tween conversations when the recording devices were concealed or when the recorder was in full view.76 Vidich77 concluded that the tape recorder made a difference in the interaction situation between husbands and wives. From these contradictory findings, the question could be asked to what extent does the acceptability of the recorder depend on the attitude and approach Of the researcher? A study comparing the two methodological approaches was completed by Olson78 who had as his primary purpose tO investigate the relationship between the self-report measure of predicted_power and the behavioral measure Of actual power 76Fred L. Strodtbeck, "Family Interaction, Values, and Achievement," Talent and Society, eds. R. C. McClelland, A. L. Baldwin, U. Bronfenbrenner, F. L. Strodtbeck (Princeton, N. J.: Van Nostrand, 1958), 135—194. 77A. J. Vidich, "Methodological Problems in the Observa- tion of Hquand-Wife Interaction," Marriage and Family_Living, 18: (1956), 234-239.. 78Olson. 1969. ,V .1... 4.1. 'Ju'W‘ :R. in family deCiSiC relationship bet“ the decisions. 3 measure of power, tended to overest taking process. authority and act the authority var actually exert: ise Later Olson and R. sroj act to det err. Power with a crit Jet none of the War, retrospec t BY COmParing l:42 in call: 1? diVidua l S ) n9 fer reara r. . Epllcation 43 in family decision-making by couples. He found there is nO relationship between these measures based on an analysis Of the decisions. When there is incongruence between these measure Of power, husbands' responses on the questionnaire tended to overestimate their actual influence in the decision- making process. There was a strong relationship between authority and actual power. When using the questionnaire, the authority variable may be a better estimate Of who will actually exercise power than the variable Of predicted power. Later Olson and Rabunsky79 completed a third phase Of the project tO determine the validity Of four measures Of family power with a criterion measure Of outcome power and concluded that none Of the four variables--predicted power, process power, retrospective power, and authority--were valid. By comparing nine measures Of power in 211 families (842 individuals), Turk and Bell80 raised the basic issue calling for reanalysis Of the concept Of power because general- 1y the measures were not equivalent. Those selected for replication included questionnaire, task outcome, and inter- actional measures. In the Observational measures, children had power which had not happened in the questionnaire measures. With both approaches tO measuring family power——the experimental observation and the reputational--little is known 790130n and Rabunsky, 1972} 8°Turk and Bell, 1972. ,— . 53L .4...“ m”... ”a of their respect1 would be desirabi of each method fc sions of power w} tion. The disable: all SOrts 0f COIN as disabled. 8 1 of a Particu1ar ‘ 44 Of their respective contributions. In future studies it would be desirable to use both capitalizing on the strengths of each method for Obtaining the desired data Of the dimen— sions Of power which Of necessity need conceptual clarifica- tion. Physical Disability Within the Family The disabled are a motley assortment Of individuals with all sorts Of conditions--psychological, sociological, and economic--and diverse impairments that medically define them as disabled.81 Some studies have concentrated on the effects Of a particular disability on the family.82 In others, the 81Disability may be defined as ". . . a condition Of im- pairment, physical or mental, having an.Objective aspect that can usually be described by a physician . . . ," in contrast, a handicap ". . . is the cumulative result Of the obstacles which disability interposes between the individual and his maximum functional level." See K. W. Hamilton, Counseling the .Handicapped in the Rehabilitation Process (New York: Ronald Press, 1950), p. 17, quoted in Beatrice A. Wright, Physical Disability--A Psychological Approach (New York: Harper and Row, 1960), p. 9. 82Gretchen H. Bonnewell, "Effects of Cystic Fibrosis on Families?(unpublished.Master's thesis, Kansas State Univer- sity, 1965). Bernard Farber, "Some Effects Of a Retarded Child on the Mother,“ yourcgbggk in.Marriage and the Family, ed..Marvin B. Sussman (2d. ed.; Boston: Houghton Mifflin,l963), 324-333. .Margaret M. Jacobson, "COping with Heart Disease: A Study Of Farm Families? (Doctoral dissertation, Purdue University, Ann Arbor, Mich.: University Microfilms, 1963) No.163-6507. Oyer. subjects have va: King“ in d1 illness suggestec and emotional sag tion and meaning illness. " The '1; the support-gin family. Harzmann ES liking in fan-ill \ s _ . . 83ViCtor _ Tauclcapped 80m E 45 subjects have various disabilities.83 King84 in discussing social psychological factors in illness suggested that "work, authority or decision-making, and emotional support or affection are areas where alloca— tion and meaning of roles will have the greatest impact on illness." The illness of the mother may produce strain on the support-giving activities or affection patterns of the family. Harzmann85 conducted an exploratory study of decision- making in families with physically disabled homemakers. 83Victor A. ChristOpherson, "Role.Modifications of the Handicapped Homemakers," Rehabilitation Literature, 21: (1960), 110-117. Ruth Deason, Francille.Maloch, and Ann Bardwell, RelatiOnships reviewed her records to check on possible families for the study. Her list was compared with the sample already ac- quired; additional families were those in which the patient was still hospitalized. Reasons for rejecting women patients are given in Table 1. Although any one patient could have been rejected for several reasons, only the major reason is indicated. Patients with either osteoarthritis or lumbar and lumbrosacral dis- placement of an intervertebral disc were rejected because the probability of these women having dependent children was far less than those with other diagnoses. The average age of the -39 women with osteoarthritis who were rejected was 66.3 years. For the-five women with disc displacement, the average age was 58.8 years. The averages are based on age at admis- sion to the Unit. Following identification of intact families with de- pendent children, intact families in which the ages of the children were not known, and families in which the present marital status was not known, letters were sent to each of the referring physicians by Dr. John I. Frid, Clinical Director of the McMaster Rheumatic Diseases Unit. A copy of the letter is in Appendix A, page 180. Since patients are I L I. -‘ LLL‘I i"; . "- referred to the contact each fa physicians. Du responses from of the Canadian rested for info, which there had :edical records Table 1. ReaSOf \ REason \\ Pertaining No depen Children Pertaining ‘ WidOWed Single separate, pertaining DiagnOSe Dead English Pertaining Out 0f 0 Total Incl Uded m , mltdr 104}? 2:31 31 er; OI 57 referred to the Unit by the-family physician, permission to contact each family was obtained by writing to each of the physicians. During the period of two weeks while waiting for responses from the family physicians, the physiotherapists of the Canadian Arthritis and Rheumatism Society were con- tacted for information on the composition of the families in which there had been questions following the review of the medical records. Table 1. Reasons for rejecting women patients. Reasons Number Pertaining to children: No dependent children 92 Children under age 13 Pertaining to marital status: Widowed 33 Single 28 Separated or divorced l7 Pertaining to the individual: Diagnoses 44 Dead 4 English not spoken l Pertaining to the location: Out of areaa 4 Admitted to nursing home 1 Total 237 aIncluded patients in British Columbia and outlying areas of Ontario-Windsor, White River and Little Current. " W «pv- u_ {w Letters we: Patients r 991195: her family in t}- nated based on i therapists indiC or the children note to each 01' letter is in AP} in intervals jL‘S the families by who were contact because there we family had recei-| mothers were hos. Out of the totall C .or the followir. Lm‘rs‘équer‘ily, 3 9 eligible after 58 Letters were sent to family physicians of 55 women patients requesting permission to include the patient and her family in the study. Of this number, seven were elimi— nated based on information from the physicians or physio- therapists indicating that the family had moved, separated, or the children were no longer dependent. Dr. John I. Frid wrote to each of the remaining families. A capy of the letter is in Appendix‘A, page 181. The letters were mailed in intervals just prior to the time of contacting each of the families by telephone or in person. Of the families who were contacted directly, six families were eliminated because there were no dependent children in the family; one family had recently separated; and in two families the wife- mothers were hospitalized for an indefinite period of time. Out of the total of 55 families, 16 families were omitted for the following reasons: No dependent children 9 Husband and wife separated 4 Hospitalized 2 Moved to United States 1 Consequently, 39 families or 71 per cent were verified as eligible after contacts with the family physicians, the Canadian Arthritis and Rheumatism Society physiotherapists, and the wifedmother or another family member in each family. In the family with the twelve year old who precipitated the revision of the criterion for sample selection, only the hquand-father and wifedmother were interviewed. Therefore, this family has been eliminated from the analysis of the data° 'n" nevi" 5“" :9 There were th] of interviews cent of those views - Various c identified fr< home assessme: graphic and m E exocra hit: I: The size of marriage, J are ~ ley’ment, ec fro- .. the inter Si % selectim1 o f 59 There were three additional refusals-resulting in completion of interviews with three members of 35 families or 90 per cent of those eligible for a total of 105 individual inter- views. Description of Sample Various descriptive characteristics of the sample were identified from the medical records, the interviews, and the home assessments. These have been categorized as to demo- graphic and.medical information. Demographic Information The size of family, composition of the family, length of marriage, residency characteristics, socio-economic status, employment, education, and ethnic origin were determined from the interviews and the hospital admission forms. Size of family. Since a major criterion used in the selection of subjects was that the families include a husband- father, a wifesmother, and a teen-ager living at home and attending school, the minimum size of family at home was three. Table 2 shows the distribution of the size of family at home. The families ranged from three to seven members at home averaging 4.26 members. In seven families there was an only child and in two families one child still remained at home. Family members at home included parents and their children except in one family which employed a full—time '"F \wt’vuvwml no housekeeper whc amber of the i used in the st: Table 2. Size Size of fa Three FOur FiVe Six Seven TOtal \ In 27 fami 60 housekeeper who lived with the family and was considered a member of the family according to the definition of family used in the study. Table 2. Size of family at home. Distribution Size of family Frequency Percentage Three 9 25.71 Four 15 42.85 Five 5 14.29 Six 5 14.29 Seven 1 2.86 Total 35 100.00 In 27 families there were no members of the family liv- ing away from home. Among eight families there were eleven children living away from home. Except for one seventeen year old boy, these family members were married. Composition of family. The number, age, and sex of family members living at home is shown in Table 3. The ~husband-fathers ranged from 35 to 63 years of age while the wifeamothers ranged from 33 to 58 years of age. However, the mean and.median differences indicate the closeness in age of the spouses in the total sample. In Table 4, the age patterns of the spouses show that the husband is older than the wife in 21 families and the wife is older than the husband in ten families. .: e-u ruirv '5'! Table 3. Numbe home. Age of par (Yearsi \ 30-34 35-39 40~44 45-49 50-54 55-59 60~64 Range Mean Median \ Age Of ch11 (Years: \‘ 12 and nod 13-17 18~19b Adult ch11 61 Table 3. Number, age, and sex of family members living at home.a Age of parents Number of parents (Years) Husband-fathers Wife-mothers 30-34 0 2 35—39 3 4 40-44 14 10 45—49 11 12 50-54 3 6 55—59 3 1 60-64 1 0 Years Years Range 35-63 33-58 Mean 45.9 44.6 Median 44.7 45.6 Age of children Number of teenagers and children (Years) Boys Girls 12 and under 9 17 13-17 20 24 18-19b :2 3 Adult children 1 2 Total 32 46 aOne family had a female housekeeper living in the family who was 20 years of age. bAttending high school. "'w «Ii! ‘1 ‘,. -- l—‘I :1- '. Table 4. Age r Age patter H-F older the I My Older the. 5 or more H‘F EQual to TOtal \ sa‘aple families 5C ' . th . ..e family repo oIt:::‘ml:’(il‘ the c m lable 6 S}? :02. fOHOWs from th 62 Table 4. Age patterns of husband-fathers and wife-mothers. Distribution Age patterns Frequency Percentage H-F older than WeM by 1 to 4 years 15 42.86 H-F older than WeM by 5 or more years 6 17.14 H-F equal to WeM 4 11.43 WAM older than H-F 10 28.57 Total 35 100.00 ‘There are predominantly more girls than boys in the sample families and more family members 13-17 years of age according to information in Table 3. The sex patterns within the family reported in Table 5, emphasize that the females outnumber the males in 16 families. Table 6 shows that almost half of the-families were composed of parents and a teen—ager or teen-agers which follows from the established criteria for the study. Four families had adult members in addition to the parents. In the 26 families with more than one child or teen- ager, the youngest member at home ranged in age from 2 to 17 years of age and the oldest ranged from 11 to 20 years of age. The age spread between the youngest and oldest child or teen-ager in each family ranged from one to eleven years averaging 4.96 years (Table 7). l"' 'l ‘7'?"me 1': Table 5. Sex ; Sex patter Males less t? Males equal : Males greater Total \ Parents, tee:- child fen) ‘arEI‘ts . a. :2 Parent . a dlll Total 63 Table 5. Sex patterns within the family. Distribution Sex patterns Frequency Percentage Males less than females 16 45.71 Males equal to females 11 31.43 Males greater than females 8 22.86 Total 35 100.00 Table 6. Composition of the family living at home. Distribution Composition of family Frequency Percentage Parents and teen-agerxs) 16 45.71 Parents and child(ren) 3 8.57 Parents, teen-ager(s) and child(ren) 12 34.28 Parents, adult, and teen— ager 2 5.72 Parents, adult, teenager(s) and children 2 5.72 Total 35 100.00 TAble 7. Numb livi: Years 64 Table 7. Number of years between oldest and youngest childa living at home. Distribution Years Frequency Percentage 1—3 12 46.15 4—6 6 23.08 7-9 6 23.08 10-11 2 7.69 Total 26b 100.00 aIncludes adult children living at home. In nine families, only one child is living at home. The sixteen boys interviewed (Table 8) ranged from 10 to 18 years of age averaging 15.0 years. The nineteen girls ranged from 11 to 18 years of age averaging 14.6 years. The four children, 10 and 11 years of age, who were interviewed will be designated as teen-agers in the following discussion.1 1During the process of collecting data, an interview was scheduled with a family whose only child at home was twelve years of age. When the interview was arranged, it was thought that an older teen-ager still lived with the family. Through a communication problem with the wifedmother who does not speak fluent English and because of her hospitalization in the interim, the interview was not cancelled. Instead, the forms of the total number of families with children twelve ‘years of age and under were reviewed. There were four fami- ‘lies with children eleven and twelve years of age and three‘of these were then included. The fourth family was omitted be— cause the wifedmother helped in deve10pment of the interview schedules when the focus was on families with teen-agers. .Another family was inadvertently omitted in the review. Although the intent of‘the adjustment was only to lower - I- .‘I w-Ir U ‘K ml 7: _ 1- Table 8. Age .1 Age -——__________ Ten Eleven Thirteen Fourteen Fifteen Sixteen Seventeen Eighteen Total \\ Range 65 Table 8. Age and sex of teen-agers interviewed. Number of teen-agers Age Boys Girls Total Ten 2 0 2 Eleven 1 1 2 Thirteen 1 4 5 Fourteen 2 5 7 Fifteen O 3 3 Sixteen 3 3 6 Seventeen 6 2 8 Eighteen 1 l 2 Total 16 19 35 Years Years Years Range 10-18 11-18 10-18 Mean 15.0 14.6 14.4 An attempt was made to interview an equal number of boys and girls. In sixteen families the only teenuager elig— ible for the study was a girl and in ten families, it was a boy. Consequently, whenever there was a choice between boys and girls, the boy was interviewed. If there were more than the age to eleven year olds, two ten year olds were inter— viewed as noted in'Table 8. The records had shown one boy to be eleven years of age in 1970 and the second was the younger brother of a teen-ager who, after receiving a gun for his birthday, did not remain at home for the interview scheduled late Saturday afternoon. Since this family lived 91 miles from Guelph, Ontario and the interviewers expected everyone to be present from the telephone conversation with the wifedmother enroute to their home, the ten year old boy was interviewed as a replacement for the teen-ager. c "it 1! v' .‘I one eligible t arandom proce pretests, it w selected by th for the other often selected position. For because the ir. withas little birth order of Table 9. the: Children or th \ Birth 0rd. First Second Third Fifth only Chilc Total 1 D an were 66 one eligible teen-ager of the same.sex, plans were to initiate a random procedure for selection of the respondent. In the pretests, it was evident that the oldest child would be selected by the family. The families needed justification for the other children in the family and the oldest child is often selected for special consideration by virtue of his position. For practical reasons, this procedure was followed because the interviewer attempted to leave the family scene with as little disruption of relationships as possible. The birth order of the teen—ager interviewed is recorded in Table 9. Twenty-three of the respondents were either only children or the oldest child in the family. Table 9. Birth order of teen-ager or child interviewed.a Distribution Birth order Frequency Percentage First 16 45.71 Second 7 20.00 Third 4 11.43 Fifth 1 2.86 Only child 7 20.00 Total 35 100.00 aBased on children alive at time of interview. AdOpted children were not differentiated. [-v— w ‘3 wt" v v“. a. 1': Length of was the only In marriages for ' for the wife i approximately Table 10. Lem \\ \ \ Total length 0 67 Length of marriage. For 32 families the present marriage was the only marriage for either spouse. There were previous marriages for both the husband and wife in two families and for the wife in one family. The length of marriage averaged approximately twenty years (Table 10). Table 10. Length of marriage for both spouses. Years married Range Mean .Median SD Length of present marriage 6-32 19.97 20.00 5.4 Total length of marriage: Husband 7-32 20.28 20.00 5.6 Wife 11-32 20.28 20.00 5.2 Residency characteristics. The majority of the families (27) lived in one of the following census metrOpolitan areas: Kitchener, Hamilton, Niagara-St. Catherines, or Toronto. Table 11 shows that the sample families are a relatively stable group averaging either 10.5 years or 10.6 years in their present homes which are owned by 31 of the families (88.57 per cent). Length of present residence ranged from one to twenty-eight years. Socig:eggnomig_§tatu§. The socio-economic status of each family was determined by the Hollingshead . III. 1.x. .. 45—“" "5 NO Factor Inde Occupations in tions into 003': high and low 50C The Bolling the husband aS d in the United St ranking of occup and income chara in Canada and fr scale scores. 'I‘ skilled manual 6 sployees, and 1. from the Holling nurseryman as ma- d‘de PIOfessior. Clerical and sail Table 12 shl L ““9 measures 0 far“ ' .1 lies are in I " 2Ahm S Q( ‘jJSt R EV eHaVen 4' 68 Two Factor Index of Social Position,2 the Blishen Index of Occupations in Canada,3 and a dichotomization of the occupa— tions into non—manual and manual categories to represent high and low socio—economic status.4 The Hollingshead Index uses occupation and education of the husband as determinants of social status and was developed in the United States. The Blishen Index for 1961 uses a ranking of occupations which has been derived from education and income characteristics of incumbents of these occupations in Canada and from approximations of the Pineo—Porter prestige scale scores. The dichotomization of occupations includes skilled manual employees, machine Operators and semi-skilled employees, and unskilled employees (groups five through seven from the Hollingshead Occupational Scale), farmers, and a nurseryman as manual occupations. Nonmanual occupations in— clude professionals, proprietors, managers, technicians, and clerical and sales workers. Table 12 shows the distribution of the families on the three measures of socio-economic status. The majority of the families are in the lower socio-economic classes. 2August B. Hollingshead, Two Factor Index of Social Posi— ‘tion.(New Haven, Connecticut,l965 Yale Station, 1957), pp. 1-11. 3Bernard R. Blishen, "A Socio-Economic Index for Occupa- 'tions in Canada,“ The Canadian Revigwgf:Sociology and Anthro- pology, 4:1 (February, 1967), 41—53. "Social Class and Opportunity in Canada," The Canadian Review QQSociology and Anthr0pology, 7:2 (May, 1970), 110-112. 4RonaldM. Pavalko and David R. Bishop, "Socioeconomic Status and College Plans: A Study of Canadian High School Stnnients," Sociology of Education, 39 (Summer, 1966), 292-293. Table 11. Res Location of re Census metrOpol Census agglomer Rural farm Rural non-farm Total \ Length Of prese (Year 69 Table 11. Residency characteristics of sample families. Location of residencea Number of families Percentage Census metrOpolitan area 27 77.14 Census agglomeration 1 2.86 Rural farm 5 14.29 Rural non—farm 2 5.71 Total ‘ 35 100.00 Length of present residence Perception of (Years) Husband Wife 1-5 11 11 6-10 6 7 11-15 10 8 16—20 5 7 21-25 2 1 26-30 1 1 Years Years Range 1-28 1—28 Mean 10.6 10.5 Median 11 10.25 Home ownership Number of Families Percentage Own 31 88.57 Rent 4 11.43 Total 35 .100.00 aBased on area divisions established for the 1971 Census, Statistics Canada, Ottawa, Canada. Obtained through ‘ correspondence with Dr. F. Ricour-Singh, Geography Section, Census Division, Statistics Canada. "Census metr0politan area is the main labour market area of a continuous built—up area having 100,000 or more papulation." "Census agglomeration is a statistical area having an urban centre with a papulation over 1,000 and adjacent built-up area of at least 1,000 population and a minimum density of 1,000 persons per square mile...." wee—.wJ-l Table 12 . Soc Hollingshe Class *4 :4 70 Table 12. Socio—economic status of families. Distribution Hollingshead Index Frequency Percentage Class I (high) 1 2.86 II 1 2.86 III 9 25.71 IV g 11 31.43 V (low) 13 37.14 Total . 35 100.00 Blishen Index Class I (high) 2 5.71 II 2 5.71 III 1 2.86 IV 7 20.00 V 18 51.43 VI (low) 5 14.29 Total 35 100.00 Occupations Nonmanual (high) 13 37.14 Manual (low) 22 62.86 Total 35 100.00 31‘, _;;a.'.£l;-‘ were full-time man had been la went on strike. interview Nova?" at home on com; for these two In tine at the ti'v worked per week hours per week farmer refused Worked each wee; HT; 10 {dents were employea. side the home woman worked th: The remaining u 71 Employment-—hg§band—father. All of the husband—fathers were full-time employees at the time of the interview. One man had been laid off in May, 1971 and later the workers went on strike. He was still on strike at the time of the interview Nevember 3, 1971. Another worker was temporarily at home on compensation from an industrial accident. Except for these two men, the husband-fathers were working full- time at the time of the interviews. The number of hours worked per week ranged from 32 to 100 hours averaging 46.6 hours per week (based on responses from 34 men). One dairy farmer refused to estimate the number of hours that he worked each week. Employment--wifeamother. Only seven women (20 per cent) were employed. Of these, four were employed full-time oute side the home, that is, 35 hours or more per week. One woman worked three to four hours each week away from home. The remaining two women worked at home for pay. One averaged 16 hours per week at dressmaking and the other did full—time farm work during the harvest of apples. Except for the farm work, the work was primarily sedentary. Employment-—teen-ager. Thirteen of the 35 teen-agers were employed at the time of the interview. For those employed, the hours ranged from one half hour per month to 23 hours per week with an average of 10.1 hours per week. The computation does not include two respondents who work on their family farms and the boy who works only one-half hour "r r w.“ «'49 (W! Per month' T: ofselling Pro regular par t-t service: and j the husband- fat had more educat have already 3"" secondary schOO orchild: 9.51 3 father. The fa‘ children to get Wenty-two additional scho; night school co i completed their en and three The child eit ' h&1npfil I cated I' as clo ~ frag SE {2' tI‘Eir borne 72 per month. The kinds of jobs ranged from intermittent tasks of selling programs, shoveling snow, and baby-sitting to regular part—time jobs, such as, a paper route, clerking, food service, and janitorial work. Education. From Table 13 it can be seen why several of the husband-fathers remarked that their son or daughter already had more education than they had completed. The teen—agers have already averaged slightly more grades of elementary or secondary schooling than either parent-—9.97 for the teen-ager or child; 9.51 for the wifedmother: and 9.43 for the husband- father. The fathers frequently stressed the desire for their children to get more schooling. Twenty-two husband-fathers and fourteen wife-mothers had additional schooling. The husband—fathers primarily had taken night school courses. Two husband—fathers and one wifeamother completed their bachelor's degree. Two husband-fathers and one ‘wifedmother received diplomas from university diploma courses. There were two registered nurses and two registered nursing assistants among the women who had additional schooling. Four women and three men had taken business college courses. The children interviewed were in grades 5 through 13 «either in public or separate schools. The schools were lo— «cated as close as one-half block and as far away as 24 miles from theirhomes. Ethnic origin. The birthplace of the wifeamother was used to determine the ethnic origin of the family. .21] 1:— 4... J.:. Table 13. Hig‘ atti Grade Hush. \ socowoam 10 ll 12 13 Wleinother Teenager or Child 73 Table 13. Highest grade of elementary or secondary school attended by family members interviewed. Frequency Distribution Grade Husband-father Wifeamother 'Teen—ager or child 5 3 3 l 6 0 l l 7 3 l 2 8 8 6 6 9 3 3 6 10 7 7 3 ll 4 8 3 12 2 6 10 13 5 0 3 .4 Highest grade of schooling _fi Family Member Range Mean Median Husband-father 5-13 9.43 9.57 ‘Wifedmother 5-12 9.51 10.00 Teen-ager or 5-l3 9.97 10.00 child Twenty-three of the women were born in Canada and most of these were born in Ontario. One family was Canadian Indian and lived on the Six Nations Reserve at Ohsweken, Ontario. Another woman indicated that her husband was French Canadian, 'but she was not. Otherwise there were no French Canadians in the sample. Four women were born in the United Kingdom. One woman was born in Buffalo, New York--very close to the community where she now lived. There was one family from . J! . J.:! _‘.‘—.—— 1 Hungary, P013. the Netherlan Eur0pean cour. migration us Medical Infor The majorl fied that the affects. their methers was evc views, and the Woman is report 30598. hospital onset of disead and functional 531% 88.57 pe mmitis (PA) EBiseaies Unit ( or other milScul eh. Ong the Secon 74 Hungary, Poland, and Yugoslavia and two each from Italy and the Netherlands. For the women who were born in these European countries, their husbands were born there, too. Emigration usually took place following World War II. Medical Information The major criterion for selection of the sample speci- fied that the wifedmothers have a rheumatic disease which affects their activities. The medical status of the wife— mothers was evaluated from the medical records, the inter— views, and the home assessments. The data describing the women is reported under the following headings: major diag— noses, hospitalizations, duration of disease, rapidity of onset of disease, severity of disease, activity of condition, and functional capacity. Major diagnoses. The majority of the women in the study (31 or 88.57 per cent) were diagnosed as having rheumatoid arthritis (RA) at their last admission to the Rheumatic Diseases Unit (Table 14). Three women had systemic lupus erythematosus (SLE) and another was diagnosed as non—articular or other muscular rheumatism, fibrositis andmyalgia.5 Among the secondary diagnoses were obesity, Cushing's syndrome, anemias, and ulcerations of the skin which are frequently 5U. S. Department of Health, Education,and.Welfare, Eighth Revision International Classification of Diseases .Adapted fgr Use in the United States, Public Health Service Pubn. No. 1693 Vol. 1 (Washington: Government Printing Office. 1967), p. 325. r N:- 'r4~ Viva.“ '7'! I 0' Table 14. Maj. t0 Diagnosis \ Rheumatoid ar Systemic lapu Arthritis, no Total \ seen in Patiern diabetes meliiJ determined by (i ratio Diseases when the Patie; a . hospital recorc readmitted Wit} missims alsr who was asked t at Holbrook 0r Shoe at the Uni ho - spltalized ell 75 Table 14. Major diagnoses of wife-mother from last admission to Rheumatic Diseases Unit. Distribution Diagnosis Frequency Percentage Rheumatoid arthritis 31 88.57 Systemic lupus erythematosus 3 8.57 Arthritis, non—articular 1 2.86 Total 35 100.00 seen in patients with rheumatoid arthritis. One patient had diabetes mellitus and another goiter. Hospitalizations. The number of hospitalizations was determined by grouping the admissions to the.McMaster Rheu- matic Diseases Unit to cover each extended period of time When the patient was away from the family. According to hospital records, the patients may have been discharged and readmitted within short periods of time. The grouping of admissions also reflected the perception of the wifedmother who was asked the number of times she had been hospitalized at Holbrook or Evel. Nineteen women were hospitalized only once at the Unit as shown in Table 15. Sixteen women were hospitalized either two or three times. The number of days that the women were hospitalized at the Unit ranged from 15 to 532 days averaging 108.6 days with a median of 65 days. The Chedoke General hospitalizations I.“ ‘LFt-A'u' tutu-*uja Table 15. H Hospital \— Rheumatic Dis: Chedoke Genera Table 15. Hospital days and hospitalizations for wife- mother. Hospital days Hospitals Range Mean .Median Rheumatic Diseases Unit N=35 15-532 108.6 65 Chedoke General Hospital N=15 1—99 28.6 15 Number of Frequency Hospitals Hospitalizations Distribution Rheumatic Diseases Unit one 19 two 9 three 7 Chedoke General Hospital none 20 one 9 two 3 three 1 four 2 Other hospitals none 20 one 9 two 4 four 1 six 1 wv-A— ‘ “fig“ were mainly transferred The oth throughout t3 in reporting tions, only t Department at {thematic Dis: m clude women f: of one year at restrictions 0 Phase of the p less than one j jusfinents to tj families. The effects from t. greatly from t‘ "No Women Iar ' “age and h ~13 \J were mainly for surgical procedures and the patients were transferred to Chedoke from the Unit across the street. The other hospitalizations were in hospitals scattered throughout the area. Since the women were quite inaccurate in reporting the number of days and dates of hospitaliza- tions, only the data which came from the.Medica1 Records Department at Chedoke General Hospital and the.McMaster Rheumatic Diseases Unit have been reported. Duration of disease. Originally it was planned to in- clude women for whom the disease had been diagnosed a minimum of one year after their marriage. Some of these stringent restrictions on the sample were relaxed during the field work phase of the project. Only one wifedmother had the disease less than one year. That family had made more structural ad- justments to their house than the majority of the other families. The family is attempting to prevent any adverse effects from the disease and seemed to have benefitted greatly from the rehabilitation efforts at the RDU. Two women entered marriage with the disease. For one family both spouses were on crutches at the time of their 'marriage and have adapted to their disabilities together. For the other wifedmother, there is a discrepancy of 22 years in duration of disease between the perception of the physician from the clinical record and the perception of the patient .reported in the interview. This wifedmother also had been tnarried for only six years. According to her report, the diagnosis of the disease followed marriage. ,._'. .ilvl fill Table 16 . Dura “line since on (Years) Less than one y 1-5 6-10 11-15 16-20 More than 20 ye Total \ Mean Median Range \ a NO data aVaila W event. Tilthouq fumes of rhe M cases is ins I I l I ”able 1?) and \ 6 be "I p. 1169 :3 dis e1 eTtabl‘ “ease... .1" 78 Table 16. Duration of disease of wifedmother. Tine since onset Frequency Distribution (Years) From Clinical Record From interview Less than one year 1 1 1—5 12 15 6-10 7 9 11—15 7 16-20 4 5 More than 20 years 2 1 Total 33a 35 Years Mean 9.1 8.0 Median 6.1 6.0 Range 1 year-27 years 10 months-26 years aNo data available for two patients. Rapidity of onset of disease. The adjustment of the family to any crisis may be affected by the-onset of the event. Although there is a great variation in the clinical features of rheumatoid arthritis, the onset in the majority of cases is insidious.6 The onset was insidious for 22 women (Table 17) and acute for 11 women. 6According to Wébster's Third New International Dictionary, 1961, p. 1169, insidious means "developing so gradually as to be well established before becoming apparent as an insidious disease.” Committee of A.R.A., Primer on the Rheumatic Diseases (New York: The Arthritis Foundation, 1964), p. 7. ”,3 1 “ufi ty‘urwvltv _lf Table 17 . R; Onset a Acute Insidious Tota \ a. 5:0 data avail % last admissior Approximately Stage III“Sev 30int deformit Stages, Append instage I‘~Ea gen°1°9ically 79 Table 17. Rapidity of onset of disease of wifedmother. Distribution Onset Frequency Percentage (N=35) Acute 11 31.43 Insidious 22‘ 62.86 Total 33a 93.29 3No data available for two patients. Severitvggf digeagg. The severity of disease at the last admission of the wife-mother was recorded in Table 18. Approximately 40 per cent Of the women were classified as Stage III--Severe or Stage IV—-Terminal which indicates joint deformity and various other criteria (A.R.A. Anatomical Stages, Appendix B, page 212).7 Only six women were placed in Stage I—-Early, indicating no destructive changes roent- genologically. Activity of condition. Rheumatoid arthritis is charac- terized by exacerbations and remissions. Consequently, one cannot expect an increasing degree of severity of the activ- ity of condition or decreasing functional capacity with an 7Otto Steinbrocker, Cornelius H. Traeger, and RObert C.\M Betterman, "Therapeutic Criteria in Rheumatoid Arthritis," Ihg Journallgfgthe Americaanedical Association, 140:8 (June 25, 1949). p. 661. 80 Table 18. Severity of disease of wifedmother at last admis- sion to Rheumatic Diseases Unit. a Distribution Stage Frequency Percentage 1. Early 6 17.14 II. Moderate 14 40.00 2.5 ‘ l 2.86 III. Severe 9 25.71 IV. Terminal 5 14.29 Total 35 100.00 aBased on A.R.A. Anatomical Stages. additional number of hospitalizations at the Unit. The activity of condition rated as mild, moderate, and severe is shown in Table 19 for each admission of the wifeamother. Nineteen women were admitted once to the Unit and the activ- ity of condition was rated as mild for eight, mild to moderate for one, moderate for nine, and severe for one. The nine women with two admissions and the seven women with three admissions were rated as prOportionatelymore severe at their first and later hospitalizations. The activity of condition assessed by the C.A.R.S. physiotherapists reported in Table 20 shows that over 50 percent of the women were at a moderate level. 81 n m n m m ma mum£u081mMH3 Hmuoa N m H w m H ouo>mm o o o o o o m.N m H e o w m mDMHMUOE o o o o o H m.H Aoumuopoz 0» UHMEV o H N H H m odes cosmmflEpd GOflMmHEod coflmmfl864 scammaaod cofimmflsfifi scammaeod cofiuflocou mo hue>fluum cause scoomm umunm vacuum umuam pmuum m N a mGOHpmenm+fiQmOmH HO HMQEDZ .uch.mmmmomdn chumsflonm um newumnwamuwmuon gums How H0£UOEiomw3 mo cowuwocou mo huw>fluod .mH manna 82 Table 20. Activity of condition of wifedmother based on home assessment by the Canadian Arthritis and Rheu- matism physiotherapist. Distribution Level of condition Frequency Percentage Mild 13 37.14 Moderate 19 54.29 Severe 3 8.57 Total 35 100.00 Functional capacity. Functional capacity may vary con- siderably regardless of the degree of activity of condition or the extent of structural damage as measured by the stages of the severity of the disease. From the perspective of the wifeamother who is attempting to fulfill her roles as wife, mother, and housekeeper, her degree of functional impairment is of utmost importance. However, the categories of func- tional capacity are gross measures and the extent of subjec— tiveness inherent in the evaluation may not indicate the real differences among the wifeamothers in their ability to per- form within the home. Various rating scales have been developed to evaluate the extent of disability on functional performance. The complexities involved in using some scales frequently override the practicalities of evaluation. Fully recognizing the shortcomings of the schema selected 83 (the A.R.A. Functional Class),8 the functional capacity of each wifedmother at each admission and discharge from the Unit was evaluated by the physician from the medical records. Table 21 shows the functional capacity at discharge from each hospitalization. The majority of the women were con- sidered Class II-—Adequate for normal activities despite handicap of discomfort or limited motion at one or more joints. At the home assessment by the C1A.R.S. physiotherapist, 14 -women were placed in Class 1--Unimpaired or slightly impaired and 15 women were placed in Class 2--Complete self-care (Table 22). From the time of the interview until the home assessment, one wifedmother had been hospitalized; therefore, she was rated as severely impaired. Although the woman was in her own home at the time of the interview, she was dependent upon auxillary services such as a visiting nurse, a homemaker, and the C.A.R.S. physiotherapist. The'additional services had been employed to avoid further hospitalization; however, another medical problem necessitated hospitalization for an extended period of time. Medical status of husband-father. Thirty of the men reported that there was no condition for which they were presently receiving medical care. Of the five men who were receiving care, two had heart conditions which affected their activities. One each reported being treated for allergies, back, and gout and high blood pressure. 8Steinbrocker et al., p. 661. 84 .mmMHU HMGOHuucom .<.m.4 so oommmm u w n m m mH muo£u081oMH3 Hence 0 o o o o o emumuHommmucH >H H o o o o o m.m m e m c m N oouHeHH HHH o o o H o H m.N m m a e o mH meanness HH 0 o o o o o m.H o o o o o m mumHmeoo H mmmHo GOHonHEG< coHan56¢ coHnnHeoé GOHmMHEQm GOHmnHeoa- :OHmmH664 mhuHommmu HMGOHuocom oHHna ocouom umHHm odouom umHHm umHHm m N H nGOHumuwflmuH now no quEDz .uHcD monmwuHQ UHHMESoam um COHumuHHmuHmmon some scum omumnomHo um HuguOETmMH3 mo huwommmu HMGOHuocom .HN oHQMB 85 Table 22. Functional capacity of wifedmother based on home assessment by the Canadian Arthritis and Rheu— matism physiotherapist. a Distribution Functional capacity Frequency Percentage l. Unimpaired or slightly impaired 14 40.00 2. Complete self-care 15 42.85 3. Partial self-care 5 14.29 4. Severely impaired 1 2.86 Total 35 100.00 aFrom Part II, Appendix C Functional Capacity Code, C.A.R.S. Medical and Scientific Committee, 1954. Medical status of teen—ager. Only four teen-agers re- ported that they were receiving medical care at the time of the interview. Three teeneagers were receiving treatment for asthma or allergies and one boy was still confined to his home with infectious mononucleosis. Selection and Development of Instruments During the formulation of the interview schedules, a wife- mother who had been a patient at the Rheumatic Diseases Unit willingly discussed problems that developed for her family and for families she knew in which the wifedmother had one of the rheumatic diseases such as rheumatoid arthritis, ankylosing 86 spondylitis, or systematis lupus erythematosus. She had graduated from college in home economics and periodically discusses her disability and family with university students in home management. Originally the family was not eligible for the study, because the children were 9 and 11 years of age. When the age of the children was changed, the family became eligible. But the family was rejected because of the assistance given by the wifedmother in the development phase of the project. The initial visit to her home and subsequent visits indicated that the roles of wife, mother, and house— keeper and the family dynamics probably have been affected by the disease. While reading the medical records of the patients to determine the sample, it was usually necessary to read reports by both the physiotherapists and occupational therapists to determine family composition. Their reports were helpful in the development of the measure of power in decisionmmaking by providing information for the division of tasks into segments to reflect the capabilities of the wifeamother and the general pattern of the family situation. In addition to the litera- ture review of rheumatic diseases, an educational conference sponsored by C.A.R.S° for physiotherapists and occupational therapists on "The Total Management of Rheumatoid Arthritis," June 25, 1971 provided background infonmation regarding the medical aspects of the majority of the women in the sample. 87 A psychiatrist in Tbronto, Ontario who serves as a ‘member of the Medical Advisory Committee to The Canadian Arthritis and Rheumatism Society in Ontario reviewed the pr0posed interview schedules prior to pretesting. He stressed the fatigue aspects of the disease and the resulting need to limit the length of the interviews. The Director of Prefessional Services, Ontario Division of The Canadian Arthritis and Rheumatism Society, reviewed the project prOposal and offered his support. The C.A.R.S. librarian initially helped with the review of literature on psychosocial factors in rheumatoid arthritis. Pretests were arranged through the cooperation of the C.A.R.S. senior physiotherapist in the Toronto region. The therapists in that region determined the families from their case loads who met the established criteria and secured per— mission from the family for their participation. The investi- gator contacted each family and arranged interviews with the husband-father, wife-mother, and teen-ager in four families. The pretests were conducted in July, 1971 by the investigator and a male interviewer hired to conduct the interviews of the husband-fathers. For the pretests, one of the two interviewers interviewed the teen—ager depending upon the sex of the teen- ager. Following the pretests, the decision was made to hire a third person to interview the teen-ager, therefore enabling the three members of the family to be interviewed simul- taneously in separate parts of the home. 88 Based on comments from the pretests and the knowledge gained from reading the medical charts, the interview schedules were revised. Length of interview was one of the major con— siderations. It was felt that the interview schedule should be less than 90 minutes in length, preferably no more than 60 minutes. A review of the conceptualization of the major varia- bles resulted in eliminating parts of both the power in decisiondmaking and the perception of needs components of the interview schedules. After revisions of the interview sched- ules, a pretest was conducted with a wifedmother who had been a patient at the McMaster RDU but no longer had dependent children; consequently, she was not eligible for the sample. The format appeared acceptable, but questions still needed to be eliminated because of the length of the interview. The questions pertaining to family activities were condensed and certain information eliminated prior to the final type setting and printing of the interview schedules. Description of Instruments Instruments which have been utilized in this study may be found in Appendix B, pages 182 to 214. Husband-father, Wife-mother, and Teen- ager Interview Schedules The interview schedules for the husband—father, wife- mother, and teen-ager are identical except for questions per- taining to employment, income, the wifedmother's illness, 89 sexual satisfaction: for references to the person interviewed in relation to other family members: and for color. To facilitate use of the interview schedules, a different color was chosen for each family member. The husband-father sched- ules were yellow; the wifeamother schedules were green: and the teen-ager schedules were salmon. The interview schedules were developed for use with the respondent reading along with the interviewer if the respond- ent so desired. Any extraneous information for coding that could lead to apprehension on the part of the respondent was not included in the schedule. For this reason the questions were not numbered. 1 Two major variables—-power in decisiondmaking and per- ception of need satisfaction--were measured by components of the interview schedule. Each component is discussed in the following sections. There were additional questions to measure descriptive variables. Perception ofrpower in degisionamaking. Onorato9 devel- 0ped an instrument to measure the involvement of family mem- bers in decisiondmaking'and decision-implementing. She built her instrument upon previous work of Herbst, Johannis, and 9Loretta Ann Onorato, "Structures of Family Management in Two Socio-Economic Classes" (unpublished Master's thesis, Michigan State University, 1968), pp. 77-89. 90 0 Dale11 used part of this instrument to identify Harzmann.1 family member participation in family activities. Oyer12 used a measure of-task performance and power of the home- maker in decision-making comprised of selected items from the Onorato instrument. A preliminary listing of tasks for this study was se- lected from results obtained in each study named. Revisions in the first form were made from the comments of the family members in the pretesting and the information gained in the review of the medical charts. The areas of control derived from Heribst13 that were part of the previous studies were not delineated as part of this study. However, the tasks were partially grouped according to the classification of the needs in the perception of needs measure. 1OP. G. Herbst, "The Measurement of Family Relation- ships," Human Relations, 5 (1952), pp. 32-33. T. B. Johannis, Jr., "The Adolescent's View of Father Roles in Relation to Socio-economic Class" (unpublished Doctoral dissertation, The Florida State University, Talla- hassee, 1955). Rosemary M. Harzmann, "Decisiondmaking in Homes of Disabled Homemakers" (unpublished Master's problem, Depart- ment of Home Management and Child DeveloPment, Michigan State University, 1964), pp. 70—75. 11Verda M. Dale, "An Exploration of the Relationship of Home Managers' Self-actualization to Participation by Family Members in Home Activities" (unpublished Doctoral disserta- tion, Michigan State University, 1968), pp. 88-92. 12Ella Jane Oyer, "Relationship of Homemakers' Hearing Losses to Family Integration" (unpublished Doctoral disser- tation, Michigan State University, 1969), pp. 104-107. 13Herbst, 1952. 91 The first component of the power in decisionamaking measure consisted of fifty-one activities for which each respondent was asked to identify from his perception who completed the task (pages 1, 2, and 7 in schedule, Appendix B, pages 182, 183, 188; 191,;192, 197: 200, 201, 206). The second component consisted of who was perceived to make the decision regarding who com- pleted the task for the same fifty-one activities (pages 7-8 in schedule, Appendix B, pages 188-189; 197-198: 206—207). By com- bining these two components of the measure, a perceived power in decisiondmaking score was computed for each respondent according to the method outlined in Tables 23-25. Previous studies14 based the scoring procedures on a dichotomy--homemaker and others or mother and father--although the responses permitted more refinements in the scoring pro- cedures. In this study, the response categories for who does and who decides were: husband, wife, teen-age boy, teen-age girl, child boy, child girl, other family adult, other than family, each does himself, and no one or does not apply. For scoring, the categories of husband, wife, teen-age boy, teen-age girl, child boy, child girl, other family adult, and other than family were reduced to hquand-father, wife- mother, teen—ager and others. There are a multiplicity of possible combinations when four response categories are used 14LoisW. Hoffman, "Some Effects of the Employment of Mothers on Family Structure" (Doctoral dissertation, Univer- sity of Michigan, 1958), p. 60. Harzmann, p. 21. Oyer, p. 60. 92 Table 23. Method of item scoring of power in decisionrmaking for husband—father. Response of husband-father Weight HF decides: any one, two, or all three-- WM, T, or O(s)--does or do. + 7 HF decides: HF and any one, two. or all three-- WM, T, O(s)-4do. + 6 HF and any one-—WM or T or O(s)--decide: any one, two, or all three——WM, T, O(s)——does or do. + 5 HF and any one--WM or T or O(s)--decide; HF and any two or all three——WM, T, O(s)--do. + 4 HF and any two-—WM, T, O(s)--decide: any one, two, or all three——WM, T, O(s)—-does or do + 3 HF and any two--WM, T, O(s)-—decide: HF and WM and T and 0(3) do + 2 HF and WM and T and 0(3) decide: any one, two, of all three--WM, T, O(s)--does or do + 1 HF decides; HF does 0 HF and WM or T or O(s) decide; HF and WM or T, or O(s) do 0 HF and any two-—WM, T, O(s)--decide: HF and any two-~WM, T, O(s)--do 0 HF and WM and T and 0(3) decide; HF and WM and T and O(s) do 0 Any one, two, or all three—-WM, T, O(s) decide: HF and WM and T and 0(3) do - 1 HF and WM and T and 0(3) decide; HF and any two-- WM, T, O(s)--do - 2 Any one, two,or all three--WM, T, O(s)--decide: HF and any two--WM, T, O(s)--do - 3 HF and any two or all three—-WM, T, O(s)--decide: HF and any one—-WM or T or O(s)--do - 4 continued 93 Table 23——Continued Response of husband-father Weight Any one, two, or all three——WM, T, O(s) decide: HF and any one-—WM, T, O(s)--do — 5 HF and any one, two, or all three--WM, T, O(s) decide; HF does - 6 Any one, two, or all three--WM, T, O(s)--decide: HF does - 7 94 Table 24. .Method of item scoring of power in decisiondmaking for wifedmother. .7 Response for wifedmother Weight WM decides: any one, two, or all three--HF, T, O(s)--does or do + 7 WM decides; WM and any one, two, or all three-- HF. T, O(S)--do + 6 WM and any one--HF, T, O(s)-—decide: any one, two, of all three—-HF, T, O(s)--does or do + 5 WM and any one-HF, T, O(s)--decide: WM and any two or all three--HF, T, O(s)-~do + 4 WM and any two--HF, T, O(s)--decide: any one, two, or all three--HF, T, O(s)--does or do + 3 WM an any two—-HF, T, O(s)-—decide; WM and HF and T and 0(8) do + 2 WM and HF and T and O(s) decide: any one, two, or all three--HF, T, O(s)--does or do + 1 WM decides: WM does 0 WM and HF or T or O(s) decide; WM and HF or T or O(s) do ' 0 WM and any two-éHF, T, O(s)—-decide: WM and any two--HF, T, O(s)--do 0 WM and HF and T and 0(8) decide: WM and HF and T and O(s) do 0 Any one, two, or all three--HF, T, O(s)--decide: WM and HF and T and O(s)--do - 1 WM and HF and T and O(s) decide: WM and any two-- HF, T, O(‘s)--do _ 2 Any one, two, or all three--HF, T, O(s)--decide: WM and any two--HF, T, O(s)--do - 3 WM and any two or all three-—HF, T, O(s)--decide; WM and any one--HF, T, O(s)-—do - 4 continued 95 Table 24--Continued Response for wifedmother Weight Any one, two, or all three—-HF, T, O(s)--decide: WM and any one-—HF or T Or O(s)--do - 5 WM and any one, two, or all three—-HF, T, O(s)-— decide: WM does — 6 Any one, two, or all three-*HF, T, O(s)--decide: WM does - 7 rlhu‘}. a.» 0! 0.0.5... I. 3 w- 96 Table 25. .Method of item scoring of power in decision-making for teen—ager. Response of teen—ager Weight T decides; any one, two, or all three--HF, WM, O(s)--does or do + 7 T decides: T and any one, two, or all three-— HT. WM, O(s)--do + 5 T and any one--HF or WM or O(s)--decide: any one, two, or all three-—HF, WM, O(s)--does or do + 5 T and any one--HF, WM, O(s)--decide; T and any two or all three—-HF, WM, O(s)-—do + 4 T and any two-—HF, WM, O(s)--decide; any one, two, or all three--HF, WM, O(s)--does or do + 3 T Lnd any two--HF, WM, O(s)--decide; T Lnd HF Lnd WM Lnd O(s) do + 2 T Lnd HF Lnd WM Lnd O(s) decide: any one, two, or all three--HF_ WM, O(s)——does or do + l T decides: T does 0 T and HF or WM or O(s) decide: T and HF or WM or O(s) do 0 T and any two--HF, WM, O(s)--decide: T and any two—-HF, WM, O(s)--do 0 T Lnd HF Lnd WM Lnd O(s) decide; T Lnd HF Lnd WM Lnd O(s) do 0 Any one, two, or all three-—HF, WM, O(s)-~decide: T and HF and WM and 0(3) do - l T Lnd HF Lnd WM and 0(3) decide; T Lnd any two-— HF, WM, O(s)--dom - 2 Any one, two, or all three--HF, WM, 0(s)--decide; and any two--HF, WM, O(s)-—do -,3 and any two or all three—-HF, WM, O(s)--decide: and any one--HF, WM, O(s)--do - 4 Ell-30% continued 97 Table 25--Continued Response of teen-ager Weight Any one, two, or all three--HF, WM, O(s)--decide: T and any one-—HF, WM, O(s)--do - 5 T and any one, two, or all three——HF, WM, O(s)—- decide; T does - 6 Any one, two, or three-~HF, WM, O(s)—-decide; T does — 7 98 in determining scores of power in decisiondmaking. These have been combined in Tables 23-25. .The weighting is based on the assumption that the persons named above have equal access to power. The response category 'each does himself' adapted from Oyer15 was found not to be mutually exclusive in the coding process. One member of the family may have responded with 'each does himself' while another may have named all members of the family which is essentially the same response. By using these response categories, there is no way to determine for any activity whether the task is perceived as done individually or collectively. The concern in this measure is with the percep- tion of who does the task and not the manner in which it is accomplished. Peggeption of need satisfactigg, An interview schedule to measure need satisfaction developed by Hallenbeck, Skipper and Fink16 was modified for this study. Maslow's17 hierarchy of needs formed the basis of the Hallenbeck schedule. Only those questions reportedly measuring physiological, safety, and love and belongingness needs were adapted. Maslow's schema was accepted for-categorization only and no assumption was made that needs are ordered in a hierarchy. 15Oyer, p. 104. 16Phyllis N. Hallenbeck, James K. Skipper, and Stephen L. Fink, How the Severely Disabled Client Perceiveg the Problems gfyDaily Living (VRA Project No. 1584, Cleveland, Ohio: Vocational Guidance and Rehabilitation Services, Final Report, July, 1966). PP. 95-99. 17A. H. Maslow, Motivation and Personality (2d ed. New York: Harper and Bros., 1970), pp. 35-58. 99 18 was a The second measure employed by Hallenbeck et a1. marital satisfaction interview schedule. Some of these items were included in the love and belongingness category which was expanded and designated companionship and support needs. Hallenbeck gt_§1.19 depended upon trained coders to evaluate the responses of the interviewees to determine the extent of satisfaction of the needs. They used a seven—point Likert-type scale ranging from “very dissatisfied" to "very satisfied". This procedure was modified for the present study. The extent of need satisfaction was evaluated by the respondent on a scale of four responses: most of the time, sometimes, usually not, or not at all. The component of the interview schedule measuring perception of need satisfaction is found on page nine of the husband-father, wife—mother, and teen-ager interview schedules (Appendix B, pages 190, 199, 208) . Table 26 shows the method of item scoring for the perceived need satisfaction scores. 18Halienbeck et al., pp. 100-104. 19Hallenbeck et al., pp. 114-116. 100 Table 26. :Method of item scoring of need satisfaction of family menbers . Needs Poggible Scores '2 u u n 8 S '44 Q) >1 (U o .5 H u u .H m t;g o m o H 8 a ‘6 z.u m :3 2 Physiological needs: Satisfaction with meals 4 3 2 1 Satisfaction with rest and sleep 4 3 2 l Concern about pain Not concerned 3.5 Concerned 1.5 Safety needs: Satisfaction with clothing 4 3 2 1 Satisfaction with housing 4 3 2 1 Satisfaction with family's safety and security 4 3 2 1 Companionship and support needs: Satisfaction with empathy (understanding of feelings) 4 3 2 1 Satisfaction with expression of affection spouse 2 1.5 l .5 parent-teen-ager 2 1.5 1 .5 Satisfaction with thoughtfulness spouse 2 1.5 1 .5 parent-teen-ager 2 1.5 1 .5 Satisfaction with sharing of information spouse 2 1.5 l .5 parent-teen-ager 2 1.5 l .5 Satisfaction with sharing of confidences spouse 2 1.5 l .5 parent-teen-ager 2 1.5 1 .5 continued E'llfl'fl lull 101 Table 26--Continued Needs Posgible Scores 0’ .u '5 m 8 S o m m a >, o - H .u u r4 m as w s . o... 8 m 0 SH m D Z Sexual satisfaction and satis- faction with self as sex partner 4 3 2 1 Satisfaction with activity shar- ing spouse .8 .6 .4 .2 parent-teen—ager .8 .6 .4 .2 family .8 6 .4 .2 friends .8 .6 .4 .2 relatives .8 .6 .4 .2 102 Responses to open—ended questions relative to each need were taped. Coders were trained to evaluate these responses to determine the need satisfactiOn of the respondents. The coding form is found in Appendix C, pages 215—216. The results of inter—rater reliability and respondent-rater congruence relative to need satisfaction are found in Appendix C, pages 220-227. Hquand4Wife Interview Schedule The husband-wife interview schedule consists of a single sheet and includes basic demographic data obtained from the husband and wife jointly (Appendix B, page 209). The 1971 Canadian Census was conducted in June, 1971. Because families were quite familiar with that format, some questions were patterned after the Census. Other questions were similar to these used in previous studies. Medical Data for Wifermother The medical data forms were developed in consultation with Dr. John I. Frid, Clinical Director, McMaster Rheumatic Diseases Unit, Hamilton, Ontario. They included two sheets- for medical data from the patient's hospital chart and a home- assessment form used by the C.A.R.S. physiotherapist (Appendix B, pages 210—213). When feasible, established criteria for patient assessment were incorporated into the forms. These are the A.R.A. criteria for functional capacity and the A.R.A. 0 anatomical stages.2 An estimate of the degree of disease 2°Steinbrocker et a1., p. 661. 103 activity as to mild, moderate, and severe was included in preference to the more detailed A.R.A. criteria for estimat- ing degrees of disease activity. On the home assessment form, the wording for the func- tional capacity categories came from the Functional Capacity Code, C.A.R.S. Medical Scientific Committee, 1954 and is the terminology which the C.A.R.S. therapists regularly employ in patient assessment. Although the wording is not identical with that on the medical data form, the categories are con- sidered to represent comparable functional levels. Log for Interview Data A form was used (Appendix B, page 214) as a log during the field work phase of the study. The form included family code information, the address, telephone number, directions to the home, a listing of all contacts with the family, and comments from the interview that assisted in further contacts with the family. Collection of Data Three persons were involved in the initial collection of data in the field. The investigator interviewed the wife- mothers in each family. In selecting a person to interview the husband-fathers, three males were considered. Through Canada Manpower, a fonmer fanmer, who is now selling to farmers, was recruited and trained in the pretesting phase. 104 His previous experience in tax assessment and collection and in sales helped him easily gain rapport with the husband- fathers and his educational level approximated that of the majority of the men in the sample. A recent college graduate was hired to interview the teen-agers. Following the first 20 interviews she was replaced due to the difficulty of arranging transportation for her from her home in Kitchener to Guelph, Ontario. The second person hired to interview the teen-agers was a college student from Ohio who was working as a volunteer at the EMCA—YWCA in Guelph. She had excellent rapport with the children and was well accepted by the families (as reported by the physiotherapists after their family visits). The field work began after letters were mailed to each wifedmother. Since the families were spread over a wide geo- graphic area (Figure 2, page 106), there was a need to coordi- nate interviews with families who lived close to each other or enroute to another family. Consequently, the location of each family was plotted on a provincial road map according to the postal address or on a city street map for Hamilton, Burlington, Kitchener-Waterloo, and Galt. Clusters of families were de- termined from a visual inspection of the maps. Families were contacted by telephone to elicit coOpera- tion for the interview and to arrange a time when the husband- father, wife-mother, and teen—ager would be home. Usually the wifedmother made these arrangements. Occasionally she wanted 105 sedan puowucmnm "mGOHpmHoEOHmmm moncmo oucouoe mocHHmnumo .umlmummMHz COUGOH MononuuHM couHHEmm "mmmum emuHHomoupoE momsmu _U .+ .OHHmuco CH uoBmH>HmDCH moHHHemw mo coHumUOH .umoumum CH ©o3mH>HmHCH mmHHHemm .mHmEMm CH pmon>HoucH moHHHemm in-’h.h..'|) .. r. .. hu- L- °N whomHm 106 \ \ “EN MI: q 93:03 + 03¢on ”85 I I / I I Sr .fivovs. » 69 a on” \ \ also 3&9 \ \ .0" \ \ \ otto o OPZOCOP D ++ 9:520 + .1 20:83. 8.85:! 0020a03 + :38... ooZI .0 zoom igfin Er N: 107 to check with the family and asked that the telephone call be returned after she had consulted with other family members. Two families without telephones were contacted directly in person. One of the women reported that there was a telephone both at her home and at her place of employ- ment where she could be contacted. The family without a telephone eventually refused to cooperate in the study. Although it was emphasized that the interviewers would adjust to the families's schedules, most wifedmothers sug- gested that the interviewers set the time. Families offered to forego activities for the interview: the appointments were arranged to make this unnecessary. By being able to occasion— ally set the time of the interview at the convenience of the interviewers, it facilitated two family visits per evening-- usually one at 6:30 P. M. and another at 8:30 P. M. It was necessary to interview in the evenings and on Saturdays, because children were not home during the day even though the husband-fathers on shift work were frequently home. .Many of the men who worked in industry were on a swing shift, that is, every week the men worked a different shift rotating through the cycle of three shifts--days, evenings, and nights. 0n Saturdays, arrangements were made to interview those families who lived near one another the farthest distance from Guelph. Ontario. . Families were usually waiting for the interviewers. A reminder note was sent to the family only if the appointment 108 had been scheduled a week or two in advance. In two families the husband-fathers were late returning from work and in another family the husband—father had unexpectedly acted as chauffeur for children in several families. The usual format during the interview began with the investigator introducing her assistants to the family members soon after entering their home. The general procedure was explained to the husband—father or wifeamother or both depend- ing upon who was present and who functioned as host or hostess. The teen—ager was interviewed by the younger female interviewer while the husband-father and wifedmother answered some questions together and were then interviewed separately. The male investigator interviewed the husband—father while the female investigator interviewed the wifedmother. If there were any questions about the research project, these were deferred until the interviews were completed. The parents usually suggested which rooms could be used for the interviews. The husband—father and wifedmother sat with the interviewers in the living room or around the table in the dining room for the combined husband-wife interview. The location of the individual interviews of the husband-father and wifeemother was determined mainly by the mobility of the wifedmother. She picked a comfortable location for herself; and everyone else arranged themselves accordingly. Frequently her choice was a particular chair which had been raised to accommodate her. Several of the women never moved from the location where they were seated when the interviewers arrived. 109 Each interview was tape recorded. No family refused per— mission, because they willingly accepted the reason that it saved time for the interviewers and the information was strictly confidential. Only short answers or columns were checked by the interviewers during the interviews. The three tape recorders were used throughout the sessions mainly for recording answers to openuended questions. Technical diffi- culties resulted in the loss of eight taped interviews out of the total of 105 interviews. Although any artifact of the interviewing situation may potentially affect the responses, the tape recorder did not elicit behavior similar to that reported by Vidich21 who indicated that respondents were aware of the recorder and their attitude changed when the machine was turned off. In this study, families reported that they had tape recorders and often explained how they used them. The teen-agers frequently used a recorder in their school work. Several of the children wanted recorders for Christmas presents and were extremely interested in those used in the study. Between the time Vidich conducted his study (prior to 1956) and this study in 1971, tape recorders are morecommonly used by the general public. After completion of each interview, the schedules were numbered.with a stamp: the tapes were labeled: and the 21Arthur J. Vidich, "Methodological Problems in the Ob- servation of Husband—Wife Interaction," Marriage and Family Living (August, 1956), 236. 110 Rheumatic Diseases Unit chart number and census geographic location recorded on the~husbandrwife interview schedule. A personal thank you note was sent to the three members of each family who participated. If any requests had been made, these were met or referred to the apprOpriate person. In a four week period of time from Octdber 20, 1971 to NOvember 17, 1971, thirty—two families were interviewed. The remaining three family interviews were completed by December 7, 1971. There were an average of five contacts with each family including the initial letter, the telephone call or visit, the interview, and the personal thank you note following the interview. Additional contacts were either a reminder note of the interview or telephone calls to re- schedule or confirm appointments. Several families cancelled appointments because of unexpected family situations. The time spent with each family ranged from one hour to three hours averaging one hour and forty-five minutes. In eleven families follbwing the completion of the inter— view schedules, the family members independently completed four games. The family visits which included the games ranged from one hour fifteen minutes to two hours thirty minutes averaging one hour and fifty minutes. By subtracting the eleven interviews from the total, the time spent with each family in which the games were not played averaged three minutes less. The differences in timespent with the families does not reflect the length of time necessary for the games. 111 In the families in which the games were not played, the extra time may have been used in waiting for a family member or in sociability. Family researchers have sometimes reported difficulty in contacting and including several members of one family. Surprisingly this was not the response among the sample. One can only speculate as to whether this reflects particular characteristics of the sample, their eagerness to help provide a better life for arthritics. their expectations from meeting appointments scheduled by the hospital, or a combination of these factors. The medical data form for each wifedmother was completed by Dr. William Caughey, M.D., resident physician at the Unit during this phase of the study, and by the investigator. Prior to submitting the forms to Dr. Caughey, the admissions were numbered and recorded indicating the inclusive dates for each admission; the diagnoses, surgical procedures, length of illness and laboratory data were recorded in pencil. The resident physician revised any data that was incorrectly recorded. These forms were completed by February 8, 1972. The home assessment forms were presented to the C.A.R.S. physiotherapists at a regional meeting in Hamilton on January 20, 1972. The Patient Care Program of The Canadian Arthritis and Rheumatism Society consists basically of a home physiotherapy program for patients who are referred by their physicians. They also provide follow-up on each patient who 112 has been hospitalized at the Rheumatic Diseases Units. To facilitate the work of the Society, the province is divided into regions each with a.regional office and various branch offices. The families in this sample lived in Regions 4 and 5. Contacts were initially made with the senior therapists at London and Hamilton who are in charge of services in these regions and who, with their staff have provided or are presently providing a patient care program.for the wifedmothers in the sample. In Region 4 (Kitchener), there are branch offices in Hamilton, Oakville, and St. Catharines. There were eight therapists from the five offices who completed the forms for the patients in the sample. The assessments were made between January 20, 1972 and.March 7, 1972 for 30 women. Four other assessments were based on earlier visits to the patients in January and one assessment was based on a visit to the wifedmother two days before the family interview in November, 1971. Analyses o§_Data Data from the various instruments were coded on forms prior to keypunching data processing cards. An acetate over- .lay was used for coding the-husband-father, wifeemother, and teen-ager interview schedules. These sheets included the column numbers and code responses for the questions. The CDC 6500 computer was used to perform the computa- tions. Table 27 shows the methods used in each analysis of 113 the data. The revision of response-categories for power scores was necessitated to eliminate the non-mutually exclusive categories in the power in decisiondmaking measure (see page 98). The statistical tests performed included: tests of significance of the Pearson product moment correlation co- efficients, the biserial correlation coefficients, the partial correlation coefficients, and the Phi coefficients; and the Ebel test for reliability by the intraclass correlation.22 The selection was based on two purposes of the study which were to measure relationships between specific variables. Therefore, correlational techniques are an apprOpriate statis- tical model. The Pearson product moment correlation coeffi- cient was selected to measure relationships between continuous variables. Unless otherwise specified, this is the coeffi- cient represented by r in the findings for the zero order correlations. The biserial correlation coefficient was se- lected to measure relationships between the nondmanual and manual dichotomy of occupations (a continuous variable forced into a dichotomy) and the continuous variables in the study. Partial correlation coefficients of the first order were used to measure the relationship between two variables while 22N. M. Downie and R. W.1Heath, page Statistgal Methods (3d ed. New York: Harper and'Row, l970), pp. 86-91, 112-114, 232, 236—237, 311, 318. H. M. Blalock, Social Statistics (New York: .McGraw- ,Hill, 1960). pp. 329-336. J. P. Guilford, Psychometric Methods (2d ed. New York: McGraw-Hill, 1954), pp. 395-397. oemumoum Hmcqmwuo “GOHDMH umuuoo ummaomuucfl an hpfiaan Images How massuou m.amnm moans» mocomcwucoo v oxHHumE.c0flumamuuoououcH .cowumw>mc unoccmum.vcm . mmmucmuumm .ucoou Hamu .omcmu .cmmE .GOfiuanHumflc hocmsomum 114 mamumoum coflvmfinowmcmue meumOHm coaumeuowmcmue mamumoum cowumsuommcmue 3ww>umpcfl scum cowuomw .moasomnom 3oa>umucfl scum «sous mooaoop 033 can meow 0:3 .mquEmE kHaEwm moose oucmsumcoo mo mwummp mo cowumcfieumumn .5 .mocmuommwo 0mm .:mmmcaaw mo oocmummoom: .mump 3mfl>noucH ”mmHQMMHm> mo cowum>wuwa .m mmflnmaum> suaaanmmav m>onm ma .mump ucmEmmmmnm mean can .Hmuwvoe .3mw>umucH .masomnom Imwuwm Ummc mo coda Immoumm m.ucm©qommmm .m>opm ma .mmaspmnom 3mw>nmucfl Eoum named mmowomp 0£3 bum mmop 033 mo ucmuxm mo cofiuomaom .m .mamEmm mo coaumwuumma .¢ .mmnoom Hamum>o tam noncomlnsm Goduomwmwumm poms mo coaumcfiEHmuwQ .m . MMHOUW Hmzom mo GOADMGAEHmqu .m .mmuoom Hm3om Ham mmauom Imumo uncommon mo scamw>mm .H Emumonm Housmeou cam oaumwumum .Gmhoamem mumn mwm%amc¢ mo ucmucH mu ..III41I|- It.» .mumo mo mflmhamcm aw wwmn moonumz .hm mHQMB 115 . .Amoma .ma Honemvmom .huflmuw>wca oumum cmmfigowz .nuummmmm mucmfium anduom How muduwpmcH Housmeoo "mcwmcmq ummmv ulna .oz uuomom Hmowcaome :.cowumamuuoo Hodummfluasz mo ucmwoflwmmouz .mflnusu .m can omcwnvaom .dm .Amema .ka ma:..»namum>aco oumum Comanowz snuummmmm mocmwum Hafioom How musudumcH HousmEOU "mcwmcmn ummmv «Hum» .02 uuommm amoacsooe =.mao«umamuuoo Hmauumm= .mumm.o .3 can manna .qm .Nnmd gmcflumm . .huwmumafico mumum cmmflsuaz .comUHMsrmcH mummv an cuppa; Emumoumm .Amsma .sa mmz_.muamum>aca oumum cmmwSOMZ .noummmmm mocmwom Hmwoom How ousuflumcH Housmeou umcwmcmq ummmv mums .oz uuommm Handcnome =.moHQMB accomqwucoo mo mammamcm= .mnmm.o .3 can ouwum .AU . 3an .2 was $33932: mumum Gmmflsoflz .suummmmm mocmwom Hmwuom How mflbuwumcH Housmsoo ”madmcnn ummmv oaumn .oz phenom Hmoquuma =.xfiuumz.coaumaouuooumucH= .com©Hm>mcH .0 was ouwum .Au .Amsma .ea mm: .munmum>aco mumnm cmmwnuwz..£oummmmm mosmflum amauom How wusuflumcH Housmeoo ”mcfimcmq ummmv mums .oz uuommm HMOflcnumB =.c0Hu5QHHumHQ hocmsomum cam mmmucmouwm: .oumm.o .3_Ucm madam .AQ .Nnma .huwmum>wcb mumum cmmwnuwz .noummmmm mocmwom HMMUOW How musuwumcH HopsmEou .GOmon>mcH whom an sounds—3 mamumoumm m.mucofluwmmmoo coaumamuuoo Hafiuomwunoe mo cowumusmeou . .moumum oweocooo|o«00m com muqmoum m.mGOMMMHounoo unfluumm Icoo mo moummo =.mmmcadw Moose and mo cowumusmeou mo moqmummoomg .huwawnmmwp mo ucmuxo .mmuoum cofluomm o.mucmqu«mmmou .mumo Imwumm new: .mmnoum nozom coaumamuuoo unmsOE1uosuoum unmemmommm use: pom coo3umn coaumwoommm mo somummm mo coflumuomeou .Hmowvmfi .Bwfl>umch mmummc mo coaumcfieuoumo .m I I! I II 1 I O... I a. .r- I I s I [I n (I ll: 1.... lnIOl.l llllll Illnlllal- In. It!) .11 I Quill-r: I. I... '1. . I 6 II?‘ I I?! Dali ‘I . I 1.5.14 lid IlU .U .i A 43 F6 c.441- .l . . I 59%.",3 fi“ A“ PU flavrvtfllv ’H’fl.'flUH.V 17¢ a it A: 4.! >.v\Vn .. J , I , . to .. . : 2. “V I: A .A J HIV" r-IflJF-CU ‘UJd-‘nU gdkluflUJC‘ "*qudv‘fiifiW‘ “‘17 (“a Alllflllflvmll‘. .Vlnfr‘nl I) 53:.l‘y10. , IVE. 116 controlling for one other variable. The Ebel test for relia— bility bythe intraclass correlation was used to compute degree of congruence scores. For inter—rater reliability and for relationshipsbetween the raters' perception of need satisfaction and the family members' perceived need satisfac- tion dichotomized as satisfied or dissatisfied, the Phi coefficient was selected. The choice of tests was made fully recognizing that in- herent in the use of the statistical procedures was the assump- tion of linearity. Consequently no significance in a coefficient indicates that there are no linear relationships, but it does not follow that there are no relationships among the variables. A non—linear relationship may be masked by the statistical test chosen. The assumption of homoscedasticity was assumed to have been'met. CHAPTER IV THE FINDINGS The chapter presents the results under three headings: measurement of variables, description of the situation, and tests of hypotheses. Measurement of Variables Perceived Power in Decision-akigg Scores for perceived power in decisionamaking in the family were computed for each respondent by looking at who does and who decides for each of 51 items and assigning points for each item according to the weighting listed in Tables 23—25 (pages 92-97). The range, mean, and standard deviation of the scores are given in Table 28. A higher score indicates more power in decisiondmakingn The wifedmothers in these families perceive themselves as having the most power: their scores ranged from minus 2 to 156 and averaged 83. The husband-fathers and teen-agers have simi- lar lower limits to their range of.scores, a minus 81 for the hquand-fathers and a minus 88 for the teen-agers. The husband-fathers have a higher upper limit and averaged.minus 24.7 compared to the teen-agers who averaged only minus 43.6 points . 117 118 Table 28. Range, mean, and standard deviation of perceived power in decisionamaking scores. Power in decisiondmaking N Range .Mean S.D. Hquand-father 34 -81 to 43 -24.7 28.5 Wifedmother 35 — 2 to 156 83.0 38.0 Teen-ager 35 -88 to 24 -43.6 29.8 For the power scores, the score for one husband-father was eliminated because of missing data for the part on who does the task. Whenever power scores or degree of congruence scores are used in analyses of data, the total number of husband-fathers and the total number of families for degree of congruence and for those combinations involving the husband-father is 34. Table 29 shows the various perceptions of who is boss and who makes the final decision for each family member. With the exception of seven or less families, wifedmothers were not perceived as boss or as making the final decision when there is a disagreement. Perceived Need Satisfaction The perceived need satisfaction scores were determined ac- cording to the method reported in Table 26, page 100. The total possible overall scores of the husband-fathers and wifedmothers 119 .HmfiO—GIQMH3 0G0 HO mmcammufillmfio OZU .Homolsoou one no oncommonllhoonwuo>mn .muosuoelowflS 03» mo oncommouuloso ozm m as w OH ummmacmms In «a m ma oumnuosummwz I: as s 0H umsummuoqmnmsm mcoflmflomp Hocwm osu mmxmfi 0:3 .mcflnuoEOm no woman p.c0p DON sonz II m 0 ma Dummolsooe II 0H v ma mnmnuofiloMHB I: ma m ma monoculpconmsm Honuofilowwz Hummusooe poo Hosummnpconmsm Hoauoelomwz Hoswmwlbsmnmsm wwwwfiom “50% ca moon was mH.Nom somloaso3 0:3 "mo coaummouom .mHmDEoE haflfimm an om>wwoumm mo Ho3om mo mousmmme mo mCOHumHom .mm magma 120 is~51.5 with a minimum of 13.5. The teen-agers total possible overall score is 47.5 with a minimum of 12.5, because the sexual satisfaction and satisfaction with self as sex partner were omitted from their interview schedule. A higher score indicates more need satisfaction. The range, mean, and standard deviation of perceived need satisfaction.scores'are' reported in Table 30. Table 30. Range, mean, need satisfaction scores. and standard deviation of perceived Need satisfaction Range Mean S.D. Overall need satisfactigg: Husband-father 43.6 to 51.5 49.23 2.05 Wifedmother , 40.4 to 51.5 46.74 3.22 Teen-ager 28.2 to 47.5 43.18 3.73 Subscgres: Physiological needs Husband-father 7.5 to 11.5 10.43 1.18 Wifeemother 7.5 to 11.5 9.79 1.23 Teen-ager 6.5 to 11.5 9.42 1.18 Safety needs Husband-father 10.0 to 12.0 11.89 .40 Wifedmother 9.0 to 12.0 11.63 .88 Teen-ager 8.0 to 12.0 11.63 1.00 Companionship needs Husband-father 22.8 to 28.0 26.92 1.43 Wifeemother 20.4 to 28.0 25.32 2.27 Teen-ager 11.6 to 24.0 22.13 2.34 121 Degree of Congruence A method of estimating reliability for ratings described by Ebell was used to compute scores which indicate the degree of congruence among responses of family members to the 51 items of who does and the 51 items of who decides. For each of these items, there were eight possible responses. The family member could give any number of responses for each item. From a formula2 which gives the reliability for mean ratings from k raters, the coefficient for each of the 102 items for the three family members was determined and then the coeffi- cients for each item were added for a total score for each family designated in this study as degree of congruence among family members. The formula also was used to give a degree of congruence score between pairs within each family: husband- father and wife-mother, husband-father and teen-ager, and wifedmother and teen-ager. The range, mean, and standard devi- ation of the degree of congruence scores are given in Table 31.. A higher score indicates more congruence among family members.- 1R. L. Ebel, "Estimation of the Reliability of Ratings," .Psychometrika, 16 (1951), 407-424, cited by J. P. Guilford,‘ Psychometric Methods (New York: McGraw-Hill, 1954), pp. 395-397. zGuilford, p. 395. 122 Table 31. Range, mean, and standard deviation of degree of congruence scores. Degree of congruence score N Range Mean S.D. Family score 34 73.1-92.5 84.0 4.3 Husband-father and wife- mother 34 66.0-92.6 78.2 7.0 Husband-father and teen- ager 34 52.9-85.5 72.5 7.8 Wife-mother and teen-ager 35 54.6-85.0 73.3 7.8 123 Extent of Disability From an intercorrelation matrix of the disability vari- ables (Table 32), seven variables were selected for the analy- sis: number of hospitalizations, total days hospitalized, activity of condition at last admission, severity of disease at last discharge, functional capacity at last discharge, activity of condition following the interview, and functional capacity following the interview. An increasing value of each of these variables indicates a greater extent of disability. Table 33 shows the range, mean, and standard deviation of extent of disability variables. Rapidity of onset is a disability variable that does not indicate extent of disability. As a component of disability, the onset.may affect the relationships within the family. The measure is available for further analyses of the data. "Acceptance of Illness" Using a four-dimensional contingency table, three cate— gories of a variable designated “acceptance of illness" were derived from responses by the wifeemother to two questions: "Is your health a worry to you?" and "Are you satisfied with what you are able to do for your family?” The response choices were "most of the time, sometimes, usually not, and not at all”. Table 34 reports the combination of responses for each cate— gory. There were fourteen women who have accepted their ill- ness, thirteen who have partially accepted their illness, and eight who have not accepted their illness. :As measured in this 124 00.H 00. ,0H.- «0.- NH. N0. 00.- sa.u «0.- 50.- uaoaummuummmcaaa mo nonhuman .0H 00.3,00.u H0.u ms. 00. 00.: 0H.u H0.- 00.- 0§Tnmmwcaaa mo coaumuso..0 00.H ma. Hm. H0. mm. 00.- ms. H0.: #0000 m0 muaommmm .0 00.H an. on. he. as. an. 0a. mm40.muwomamo Hmcoauocam .e 00.H 0m. mm. mm. 0H. 00. mmau coaumoaoo mo mua>auu< .0 00.d 05. 00. mm. 00. suhommmo amcoauucsm .m 00.H.~m. om. a0. mummmao «0 muauu>mm .0 00.H 00. 00. coauaocoo mo sua>nuoc .m 00.3 00. 0mnoamuammon memo Haves .m 00.H mcoaumuaamuammon «0 Huneuz .H 0H. 0 0 .M 0 m 0 an m H madnmaum> muaasnmman .moHAMfluotr huflawnmmac mo wanna-.8 cowumaflmuooumucun .mm wanna _125 Table 33. .Range, mean, and standard deviation of extent of disability variables. Extent of disability Range .Mean S.D. Number of hospitalizations -l-3 1.66 .80 Total days hospitalized 15-532 108.60 108.30 Activity of conditiona 1-3 1.93 .69 Severity of diseaseb 1-4 2.39 .94 Functional capacityb :1-3.5 2.24 .61 Activity of conditionC 1-3 1.71 .62 Functional capacityc 1-4 1.82 .78 aAt last admission. bAt last discharge. cFollowing interview. study, a low score indicates "acceptance of illness" and a high score indicates the wife—mother has not accepted her illness. Description ofthe Situation From the data collected, there are a number of possibil- ities for describing the families and their environment. This section is limited to three areas: perceptions of health and functional level. .income, housing, and 126 whaflEmm H50» How 0U on mans one so» umn3 suaz cofimowumm so» one meow o» huuo3 m nausea H30» mHm m Has no 002 0 pa: seamen: coauommmnumm m o moEHuoeom m was» on» no umoz huuo3 m seamen :oocoumooom: oz .m m mosauoEOm n oEau on» no umoz cowuummowumm b mosauoeom m 08.3 on» no uooz EH03 m fiamom MA A Ham um #02 N poo MHHmst coauommmfiumm H Ham um #02 N no: hHHMSmD wuuo3 m zuaoom :oocmnmooom: Hmwuumm .N o moeauoeom m was» on“ mo umoz coauommowumm «a m Ham um #02 0 Doc madman: muuo3 o nuamom moocaaw gooumoood: .H dance 2 oncomomm ocowuooso whomouoo .:mm0GHHfl mo ‘ ‘1 oucmumouom: mo oowuomoumo moweuom mcowumcflneoo .om magma 127 Income A comparison of gross family income may be meaningless unless the demands upon the income are known. Consequently in this study, the husband-father evaluated his satisfaction with income and reported his perceptions of changes in financial status and expenses since the onset of the disease (Tables 35-37). The majority of the husband-fathers were satisfied with their income (Table 35). Table 35. Satisfaction of husband-father with income. Distribution Degree of satisfaction Frequency Percentage Most of the time 30 85.71 Sometimes 2 5.71 Usually not 1 2.86 Not at all 2 5.71 Total 35 100.00 Even though 21 husband—fathers indicated that there were more expenses since the onset of the disease of the wife- mother (Table 36), only four husband-fathers reported that their financial status was worse since the onset (Table 37). Twenty-four husband-fathers thought their family financial status had remained the same. 128 Table-36. Husband—fathers' comparison of expenses before and after onset of disease of wifedmother. Distribution Expenses Frequency Percentage More 21 60.00 No more 14 40.00 Total 35 100.00 Table 37. .Husband-fathers' comparison of family financial status before and after onset of disease of wife- mother. v Distribution Financial status Frequency Percentage Better 7 20.00 Same 24 68.57 Worse 4 ‘1l.43 Total 35 100.00 129 Housing The effects of the rheumatic disease may limit the mobility of the wifedmother which in turn affects the deci- sions of the family in the area of housing. Families may move or make changes in their present housing to accommodate her limitations (Tables 38—39). According to the wife- mother, six families moved because of her illness and 13 families made changes in their present housing. Teen-agers perceive changes in present housing in more families than either the~husband-fathers or wifeamothers (Table 39). Table 38. Family moved because of wifedmothem's illness. Perception of: Moved No move Husband-father 6 29 Wifedmother 6 29 Teen-ager 4 31 Table 39. Changes in housing because of illness. Perception of: Changes No changes Husband-father .14 21 ‘Wifeemother 13 22 Teen-ager 19 16 130 Perceptions of_Health and Functional Level Health is a personal resource which is limited at least for the wifedmothers in the sample. The self-perceptions of health and of functional level of each family member are reported in Tables 40—43. Health was perceived as a worry most of the time or sometimes by 13 husband—fathers, 18 wife- mothers, and 15 teen-agers (Table 40). Table 40. Perception of health as a worry. Extent of worry Husband—father Wifeemother Tebn—ager Most of the time 1 11 4 Sometimes 12 7 11 Usually not 7 12 14 Not at all 15 5 6 As shown in Table 41, all except four of the wifedmothers saw themselves as limited in both amount and.kind of housework and all except one saw themselves limited in other activities. Yet only 24 wifeemothers thought they were not able to work outside the home. One woman felt she didn't know if she could work outside the home, two felt there were no limitations, and eight said they would be limited in both amount and kind of work outside the home. One woman consistently reported no limitations, but during the interview she contradicted her 131 00.00H mm 00.00H mm 00.00H mm 00.m H. - - - - em.00 0m - - - - 00.- 0 wa.sm 0m sm.00 Hm - - - - 45.0 m - - - - 00.~ a as.m m 00.~ a 00.~ H #0000 30c: u.aoooa mean on» mowmuso sue; on manm uoz coax can undoam such as voyages mass as voyages #00020 as omussaq acoeumuneaa oz ommucoouom hucooooum omouqoouom hocozoowm mmmucoouvm hocosvmmm ao>0d HMGOfiuoqom mean on» opwmuso xnoz cw oqoaumuHEHq mowufl>wuum Honuo as acosumuasaq xuosowoon as mcosumusan .ao>oa Hoaowuosom no: mo Ho£HOE1omw3 mo newumounomlmaom .Ho magma 132 self-perception by reporting limitations in her housework, social activities, and in loss of employment. More than two-thirds (24) of the families received help while the wifeemother was hospitalized at the Rheumatic Diseases Unit. At the time of the interview, onlyl3 of the women anticipated that their family would have help if they were hospitalized again. Of the 35 husband—fathers, eight reported limitations in their work and nine reported limitations in other activi- ties (Table 42). Four teen-agers reported limitations in work and three reported limitations in other activities (Table 43). One teen-ager with infectious mononucleosis at the time of the interview indicated that his health was keeping him away from school. Table 42. Self-perception of husband-father of his functional level. Limitations in Limitations in work other activities Functional level Frequency Percentage Frequency Percentage No limitations 27 77.14 26 74.29 limited in amount 3 8.57 3 8.57 Limited in kind 3 8.57 3 8.57 limited in both amount and.kind 2 5.72 3 8.57 Total 35 100.00 «35 100.00 133 Table 43. Self-perception of teen-ager of his functional level. - Limitations in Limitations in work other activities Functional level Frequency Percentage Frequency Percentage No limitations ‘ 31 88.57 32 91.42 Limited in amount 1 2.86 l . 2.86 Limited in kind ‘1 2.86 l . 2.86 Limited in both amount and kind 2 5.71 . l 2.86 Total 35 100.00 35 100.00 Tests oinypotheses Hypgthesis'l.’ The power in decision—making of an individual family member is positively related to his need satisfaction. For the wifeamother, the hypothesis was supported. There was a significant positive linear relationship (r = .36) be- tween her power in decisionemaking and overall need satisfac- tion (Table 44). The subscore of companionship and support needs was also significantly related to power in decision- making (r = .35). This is a positive linear relationship, that is, the more power infdecisiondmaking, the more satisfied needs of the wifedmother. 134 Table 44. Correlations between perceived power in decision- making and perceived need satisfaction. v’ 7 Need satisfaction Husband-father Wifedmother Teen-ager Overall need satis- faction .05 .36* -.07 Physiological needs ' .22 .ll —.13 Safety needs .01 .27 .28 Companionship needs -.13 .35* —.16 df = 33:*r: .33: p = .05 df ; 32: r:t.34: p = .05 There were no significant relationships between the variables for the husband-father or for the teen-ager. The weak association that did appear for the teen-ager was in the negative direction. There was a slight positive rela- tionship between the power in decisiondmaking of the husband— fathers and their perceived satisfaction of physiological needs. Hypothesis 1A. The power in decisiondmaking of the wife- mother is positively related to her need satisfaction when her "acceptance of ill— ness" is partialed out. When "acceptance of illness" is partialed out, the sig- nificant linear relationships between power in decision- making and need satisfaction in hypothesis 1 increase (Table 45). Thus, hypothesis 1A is supported. 135 Table 45. Correlations between perceived power in decision- making and perceived need satisfaction with "acceptance of illness" partialed out. Need satisfaction Husband—father ‘Wifedmother Teen-ager Overall need satis- faction .05 .45** -.04 Physiological needs .25 .14 -.10 Safety needs .00 .27 .25 Companionship needs -.14 .42* -.12 df = 31 or 32; r i .34: p = .05 *r t .40: p = .02 **r t .44: p = .01 Hypothesis 18. The power in decisionemaking of the wife- mother is positively related to her need satisfaction when her extent of disability is partialed out. Table 46 shows that the significant positive linear rela- tionships of the wife-mother between her power in decision- making and her need satisfaction as noted in Tables 44 and 45 continue when the extent of disability variables are par- tialed out except for functional capacity at last discharge. For that particular extent of disability variable, the degree of the relationships does not quite reach the .05 level of significance. The direction of the relationship and the pat— tern among the need satisfaction subscores is similar to that of the other extent of disability variables. With the one exception, hypothesis 18 is supported. ' . on)!» in» 136 H0. u m "00. n “0.. me. u Q "ow. H use 00. u o "00. H u. num.n mo .00. 0mm. 0m. .00. 400. 00.00. .00. momma monocooomoeoo mm. 00. 0H. 0H. mm. 40. mm. momma spouse 00. ms. as. .-N~. .00. as. .03. momma Hmoamoaosmmgm 000. «em. on. 4:00. .00. «:H0. «em. aoaoommmaumm_oooo Hamoo>o m m m. 0 w 0,... w... GOA. UM ma mm mm s 0. m m a hwm_ hum. .u m .u o z I. E m 0. M... m. 0 . MU 0 10c 0 0D.- ..“ ” 1 .uoo poamwuumm hueawnmowc mo uqouxo £ua3 cosuummowumm poo: wo>woouom you. was Ho£u061oMfl3 mo mcaxMEIGOHoHooU cw Hosea po>wouuom coo3uon ocowuoaouuoo .h¢ manna 'D lihu‘u- E- .137 Hypgthesis 2. The power in decisiondmaking of the wife- mother isinversely related to the extent of her disability. Table 47 shows that the hypothesized direction of the relationship in hypothesis number two was not supported for the wifedmother. Instead, there were significant positive linear relationships between power in decisionemaking and two of the extent of disability variables: total days hos— pitalized and severity of diSease at last discharge. A positive relationship existed between power in decision— making and the other extent of disability variables. Although no hypothesized relationship was stated for the other family members, the distribution of power in decision- making is relative to that of the wifedmother. The trend in the relationship between power in decisionemaking of the husband-father and the extent of disability of the wifeemother is a negative one, that is, the husband-fathers may have less power when the wifeemothers are more disabled or the husband- fathers may have more power when the wifedmothers are less disabled. Hypothesis 2A. The power in decisionamaking of the wifedmother is inversely related to her ”acceptance of illness". As indicated in Table 48, hypothesis 2A was not sup- ported. There was an indication that in families in which the wifedmother has not accepted her illness, the teen-ager may have more power in decisionamaking or conversely in families in which the wifedmother has accepted her illness, the teen-ager may have less power in decisionemaking. m? .4?! cu. Pal .0. . l' -'r ~'u 138 Table 47. Correlations between perceived power in decision- making and extent Of disability. Extent of disability Husband-father Wifedmother Teen-ager Number of hospitali- zations -.00 .14 .14 Total days hospital- ized -.15 .41** -.17 Activity of conditiona -.18 .20 .04 Severity of diseaseb -.07 .45*** -.14 Functional capacityb -.04 .30 -.06 Activity of conditionc -.26 .18 —.14 Functional capacityc -.35* .24 —.13 b aAt last admission. At last discharge. cFollowing inter- view. df = 32; *r i .34: p = .05 df = 33; r t .33: p = .05 **r t .40: p.£ .02 ***r i .43: p = .01 Table 48. Correlations between perceiVed power in decision; making and "acceptance of illness." ‘Power in decision- Husband—father ‘Wifeemother Teen—ager making Total -.05 .06 .27 df = 32: r i .34: p = .05 df = 33; r i .33: p = .05 139 Hypgthesis 28. The power in decisionrmaking of the wife— mother is inversely related to the extent of her disability when her "acceptance of ill- ness" is partialed out. Since hypothesis 2A was not supported, there was no ex- pectation that the relationships from Table 47 would change when "acceptance of illness" was partialed out of the rela- tionship between power in decisiondmaking of the wifeemother and her extent of disability (Table 49). Therefore, hypothe- sis 28 was not supported. Table 49. Correlations between perceived power in decision- making and extent of disability with "acceptance of illness" partialed out. 1? Extent of disability Husband-father Wifeemother Teen-ager Number of hospitali- zations . .00 .14 .11 Total days hospital- ized -.14 .41** -.24 Activity of conditiona -.17 .20 -.04 Severity of diseaseb -.07 .45*** -.20 Functional capacityb —.04 .30 —.06 Activity of conditionC -.26 .17 —.17 Functional capacityc -.35* .23 -.22 aAt last admission. bAt last discharge. cFollowing interview. df = 32: *r i .34: p': .05 df = 33: r i .33: p = .05 **r i .40: p = .02 ***r i .43: p = .01 :I' .ll’.E-.I|'u- Null 140 As in hypothesis 2, there were significant positive linear relationships between power in decisiondmaking and two of the extent of disability variables (total days hospitalized and severity of disease at last discharge) and positive relationships between power in decisionemaking and the other extent of disability variables. Hypothesis 2C. The power in decisiondmaking of the wife- mother is inversely related to the extent of her disability when her need satisfaction is partialed out. As in the previous hypothesis, the positive linear rela- tionship between power in decisiondmaking of the wifedmother and the extent of her disability continued when her overall need satisfaction was partialed out (Table 50). These linear relationships increased slightly in degree. The same pattern was shown in Table 51 for power in decisionemaking and extent of disability when each of the need satisfaction subscores was partialed out. Hypothesis 3. The need satisfaction of the wifedmother is inversely related to the extent of her dis— ability. Although there was an inverse relationship between over— all need satisfaction of the wifedmother and her extent of disability for all extent of disability variables except functional capacity at last discharge, hypothesis three was not supported (Table 52). The various relationships did not approach significance. Table 50. 141 Correlations between perceiVed power in decision- making and extent of disability with.perceived OVerall need Satisfaction partialed out. Extent of disability Husband-father Wifeemother Teen—ager .+ Number of hospitali- zations -.01 .17 .14 Total days hospital- ized -.16 .45** -.16 Activity of conditiona -.19 .24 .04 Severity of diseaseb -.10 .48** -.14 Functional capacityb -.06 .23 -.04 Activity of conditionc -.26 .21 -.17 Functional capacityc -.35* .28 -.14 aAt last admission. bAt last discharge. cFollowing interview. df = 31 or 32: *r i .34: p = .05 **r i .44: p = .01 142 Table 51. Correlations between perceived power in decision— making and extent of disability of wifeemother with her perceived need satisfaction partialedout. Need satisfaction Extent of disability Physiological Safety Companionship Number of hospitali- zations .14 .10 .21 Total days hospitalized .41** .38* .49*** Activity of conditiona .20 .18 .28 Severity of diseaseb .48*** .41** .48*** Functional capacityb .30 .23 .24 Activity of conditionC .20 .17 .18 Functional capacityc .29 .22 .25 aAt last admission. bAt last discharge. cFollowing interview. df = 32: *r i .34: p = .05 **r i .40: p = .02 ***r i .44: p = .01 143 Table 52. Correlations between perceived overall need satis- faction and extent of disability. Extent of disability Husband-father Wifedmother Teen—ager Number of hospitaliza— tions .13 -.05 .01 Total days hospitalized .14 -.03 .15 Activity of conditiona .21 -.04 .07 Severity of diseaseb .33— -.Ol .04 Functional capacityb .33- .26 .20 Activity of conditionc -.1o -.05 -.25 Functional capacityc .04 -.08 -.12 aAt last admission. bAt last discharge. cFollowing interview. df = 33: r i .33: p = .05 The relationships between the various subscores of per- ceived need satisfaction and extent of disability were examined and reported in Tables 53—55. There were no significant rela- tionships except for that between safety needs of the wife- 'mother and functional capacity at last discharge as reported in Table 54. .Hypothesis 3A. The need satisfaction of the wifeemother is positively related to her "acceptance of illness". For the wifedmother, there is a high positive relation— ship between need satisfaction and "acceptance of illness" (Table 56). That is, if the wifedmother has "accepted" her 144 Table 53. Correlations.between perceived physiological need isatisfaction and extent of disability. Extent of disability Husband—father‘Wifedmother Teen-ager Number of hospitaliza- tions .00 .Ol .01 Total days hospitalized .07 .01 .02 Activity of conditiona .27 .09 .05 Severity of diseaseb .22 -.20 .01 Functional capacityb .30 .00 .11 Activity of conditionC -.Ol -.20 -.28 Functional capacityc .09 -.31 -.24 aAt last admission. bAt last discharge. CFollowing interview. df = 33; r i .33: p = .05 Table 54. Correlations between perceived safety need satis- faction and extent of disability. Extent of disability Husband-father Wifeemother Teen-ager Number of hospitaliza- tions —.22 .19 .20 Total days hospitalized .02 .20 .18 Activity of conditiona -.03 .12 .02 Severity of diseaseb .04 .25 .09 Functional capacityb .12 .34* .15 Activity of conditionC -.13 .07 -.36* Functional capacityc -.06 .12 -.08 aAtlast admission. bAt last discharge. cFollowing interview. df = 33: r t .33: p = .05 145 Table 55. Correlations between perceived companionship need satisfaction and extent of disability. Extent of disability Husband-father Wifeemother Teen-ager Number of hospitaliza- tions .00 —.14 -.07 Total days hospitalized .14 --12 .16 Activity of conditiona .08 -.15 .00 Severity of diseaseb .27 —.00 .02 Functional capacityb .20 .24 .19 Activity of conditionC -.10 .00 —.10 Functional capacityc .01 .01 -.03 aAt last admission. bAt last discharge. cFollowing interview. df 2 33:1? i .33: p = .05 Table 56. Correlations between perceived need satisfaction andr"acCeptance Of illness". Need satisfaction Husband-father Wifeemother Teen-ager Overall need satisfac- tion .15 -.50*** -.10 Physiological needs .38* —.40** -.11 Safety needs -.06 —.10 .14 Companionship needs -.08 -.45*** -.16 df = 33; *r t .33: p = .05 **r i .39: p .02 ***r i .43: p .01 146 illness, she has more satisfied needs. This finding supports hypothesis three A. (The correlation coefficients are nega- tive, because a low score indicates the wifeemother has "accepted" her illness and a high score indicates more needs are satisfied.) Hypothesis 3B. The need satisfaction of the wifedmother is inversely related to the extent of her dis- ability when her "acceptance of illness" is partialed out. As for hypothesis 3, there were no significant linear relationships for the wifeemother between overall need satis— faction and her extent of disability, thus giving no support to hypothesis 3B (Table 57). The inverse relationship which was predicted and found in the relationships for hypothesis 3 disappeared when "acceptance of illness" was partialed out. Table 57. Correlations between perceived overall need satis- faction and extent of disability with "acceptance of illness" partialed out. Extent of disability Husband—father Wifeemother Teen—ager Number of hospitaliza- tions .11 .03 .03 Total days hospitalized .12 .08 .18 Activity of conditiona .18 .12 .10 Severity of diseaseb .31 .10 .06 Functional capacityb .33 .30 .20 Activity of conditionc .03 -.01 -.24 Functional capacityc -.00 .08 -.10 aAt last admission. bAt last discharge. cFollowing interview. df = 32; r i .34: p = .05 147 There was a significant positive relationship between satisfaction of safety needs and functional capacity at last discharge when "acceptance of illness" was partialed out (Table 58). This relationship is Opposite to that hypothe- sized. Table 58. Correlations between perceived need satisfaction and extent of disability of wifeemother with her "acceptance of illness" partialed out. Need satisiaction Extent of disability Physiological Safety Companionship Number of hospitaliza- tions .08 .20 -.09 Total days hospitalized .10 .22 -.04 Activity of conditiona .24 .16 -.03 Severity of diseaseb -.14 .27 .10 Functional capacityb .00 .34* .27 Activity of conditionc -.18 .08 .05 Functional capacityc -.23 .15 .16 aAt last admission. bAt last discharge. cFollowing interview. df = 32; *r i .34: p = .05 Hypothegis 3C. The need satisfaction of the wifeemother is inversely related to the extent of her dis- ability when her power in decisionamaking is partialed out. Most of the relationships for the wifedmothers between overall need satisfaction and extent of disability and between physiological and companionship and support needs and extent 148 of disability when perceived power in decision-making was partialed out were inverse linear relationships which did not approach a level of significance (Table 59). Consequently hypothesis 3C was not supported. The only relationships which reached a level of statistical significance (Table 60) was between functional capacity following the interview and the satisfaction of physiological needs (r = .35). Relationships which approached a significant level were that of total days hospitalized and satisfaction of companionship and support needs and of severity of disease and satisfaction of physio- logical needs (Table 60). Table 59. Correlations between perceived overall need satis- faction and extent of disability with perceived power in decision—making partialed out. Extent of disability Husband-father Wife-mother Teen-ager Number of hospitaliza- tions .07 -.ll .02 Total days hOSpitalized .10 -.21 .14 Activity of conditiona .26 -.12 .08 Severity of diseaseb .34- -.20 .04 Functional capacityb .34“ .17 .19 Activity of conditionC -.O6 -.12 -.26 Functional capacityC .09 -.18 -.13 aAt last admission. bAt last discharge. cFollowing interview. df = 31 or 32; r i .34: p = .05 .149 Table 60. Correlations between perceived need satisfaction and extent of disability of wifeemother with her perceived power in decision-making partialed out. Need satisfaction Extent of disability Physiological Safety Companionship Number of hospitaliza— tions -.00 .16 -.21 Total days hospitalized —.04 .10 —.31 Activity of conditiona .07 .07 -.24 Severity of diseaseb -.28 .15 -.18 Functional capacityb -.03 .28 .15 Activity of conditionC -.22 .02 -.06 Functional capacityc —.35* .06 -.08 aAt last admission. bAt last discharge. cFollowing interview. df = 32; *r i .34: p = .05 gypothesis 4. The degree of congruence among responses of family members as to who does and who decides on various activities varies significantly with the extent of disability of the wife- mother. The hypothesis was not supported by the findings (Table 61). Although the correlations were not significant, the trend was for the relationship to be positive, that is, the more congruence among family“members, the more disabled the wifeemother. 150 Table 61. Correlations between degree of congruence among family members and extent of disability of wife- mother. \Extent of disability Pearson product moment correlation (r) Number of hospitaliza- tions .28 Total days hospitalized .21 Activity of condition3 .10 Severity of diseaseb .24 Functional capacityb “* .31 Activity of conditionC .00 Functional capacityc -.04 aAt last admission. bAt last discharge. cFollowing interview. dfr= 33; r t .33: p = .05 Hypothesigps. The degree of congruence among responses of family members as to who does and who decides on various activities varies significantly with the need satisfaction of family members. For the wifeamother, hypothesis number.five was not supported and there was no trend in the data (Table 62) . There was a significant relationship beyond the .01 level between the degree of congruence among responses of family members and the teen-agers' perception of the satisfaction of his physiological needs. Both overall need satisfaction and companionship and sup— port needs of the husband-father varied significantly with 151 the degree of congruence among family members. The relation- ship with overall need satisfaction was significant beyond the .02 level and with companionship and support needs beyond the .05 level of significance. Table 62. Correlations between degree of congruence among family members and perceived need satisfaction. Need satisfaction Husband-father Wifedmother Teen-ager Overall need satisfac- tion .42** .02 .27 Physiological needs .21 -.18 .48*** Safety needs .09 .02 .21 Companionship needs .39* .12 .10 df = 33; *r .33: p = .05 **r i .39: p = .02 ***r i .43: p = .01 H- Hypothesis 6. The power in decisiondmaking of an individual family member varies signigicantly with the socio-economic status of the family. Table 63 shows that there were no significant linear rela- tionships between perceived power in decision-making and socio- economic status: therefore, hypothesis six wasonot-supported in this study. The correlations (r and rb) among the three socio-economic status measures were significant beyond the .001 probability 152 Table'63. Correlations between perceiVed”power in decision- making and sOcio—economic status. Socio-economic status Husband—father Wifeemother Teen-ager Hollingshead Index .01 -.05 —.11 Blishen Index‘ .08 -.06 .10 Manual-nonmanuala -.22 .07 .00 aBiserial correlation coefficient (rb) level (Table 64). There is a negative relationship between the Blishen and Hollingshead measures and between the Blishen and nonemanual—manual measures, because the raw scores are reversed for the class designations. In both the Hollingshead Index and the nonemanualamanual dichotomy, a low score indi- cates a higher socio-economic status. In the Blishen Index, a high score represents a higher socio-economic status. Table 64. Correlations between measures of socio-economic status. Hollingshead Blishen NOnemanual-manual Hollingshead 1.00 Blishena -.66 1.00 Non-manualb manual .72 -.83 1.00 aPearson product moment correlation (r) ‘bBiserial correlation coefficient (rb) df = 33; r i .53: p = .001 CHAPTER V DISCUSSION, CONCLUSIONS, AND IMPLICATIONS Within this chapter there is a discussion of findings and presentation of limitations, conclusions, and implica— tions of the research. Discussion of Findings Perceived Power in Decisiondmaking The wifedmothers have more perceived power in decision— making in everyday activities within these families averaging 83 points compared to the husband—fathers who averaged minus 24.7 points and the teen-agers who averaged minus 43.6 points. This is in direct contrast to the perceptions of family members as to who is boss or who makes the final decision when there is a disagreanent. Knowing that there are a number of methodological problems in measurement of power and differences between measures reported in other studies, it is still a revealing finding that family members perceive the husband-fathers as boss or as making the final decision especially since the degree of congruence scores (based on the components of the perceived power in decision- making measure) were relatively high. 153 154 Harzmann found that the power scores of the mothers were in general very low. Consequently the question becomes, why is the perceived power of the husband—fathers so low in these families and that of the wifeamother so high? Has the relative power distribution changed over time? Is there a personality factor of the respondents which would explain this finding? Have the husbands and wives separated in those families in which the power needs of the husband-father were not met? Is this an acceptable distribution of power or does the wife- mother have manipulative control over other family members? Why does the discrepancy exist between the perceptions of the wifeemother as having power in decisionemaking (control or in- fluence over the behavior of others) and her perception of the husband—father as the final decisiondmaker and boss? Does the- perception of who is boss or who makes the final decision ful- fill societal and role expectations and while in actuality, other behavioral enactments are taking place? There was no attempt to divide various tasks into areas of control even though one question that appears in studies of the conjugal power structure related to the representative- ness of the sampling Of decision areas. Some preliminary compu- tations with the data in determining perceived power scores on the basis of the extent of involvement were not successful. It ‘was thought that by defining the power score as an average 'measure of those activities in which the person was actually involved would answer the criticism that many of the activities 'may be defined as "women's work". The findings indicated ‘1'- I'I. “ll. w '"4 Hill 155 that the relative perceived power distribution within the family may not be associated with the extent of involvement. Further analyses of the data using several methods for com- puting power scores are a next step. Perceived Need Satisfaction The perceived needs of the majority of the family members were met. Scores averaged 49.23 points for the husband- fathers and 46.74 points for the wife-mothers out of a possible score of 51.5; the teen-agers averaged 43.18 points out of a possible score of 47.5. Even a slight indicator of unmet needs may be a clue to greater dissatisfaction not verbalized and merits further study. This study is still acknowledged as only a beginning attempt to operationalize components of need satisfaction. Recognizing that the questions are quite global, additional findings will help delineate specific aspects of each need and perhaps illuminate those needs which are not easily verbalized. There was some difficulty in operationaliz- ing safety needs. Because of the narrow range of scores and the differing responses, conclusions from relationships with safety needs are extremely tenuous. The components of physio- logical needs and companionship and support needs were more readily identified and the findings related to these needs are more meaningful. Degree of Congruence The degree of congruence among family members was rela- tively high. The finding indicated that family members who gist-i31- 156 were interviewed have similar perceptions of the decision- maker and the decision-implementer in the specific family situations identified. The predicted relationship between degree of congruence among family members and the extent of disability of the wife- mother was not statistically supported. However, the more dis— abled the wife-mother, the more similar the perceptions of who does and who decides within the family. Perhaps families per— ceive the situation clearly when there is a chronic illness of a family member. Could it be that when a resource is restricted within the family, roles are clearly defined and communicated? For the husband-fathers and teen-agers there was quite a different pattern of relationships between degree of con- gruence and perceived need satisfaction than for that of the wife-mothers. The correlation coefficient for the wife-mothers between degree of congruence and their perceived overall need satisfaction was almost zero (r = .02). Their component scores also correlated relatively low. The husband-fathers had significant correlation coefficients for both their over- all need satisfaction (r - .42) and satisfaction of their companionship and support needs (r a .39) as related to degree of congruence. Satisfaction of physiological needs was highly correlated with degree of congruence for the teen-agers (r a .48). The correlation coefficient for their overall need satis- faction and degree of congruence tended to be significant (r = .27). These findings, coupled with the finding of the positive relationships between perceived power in decisiondmaking and jperceived need satisfaction for the wife-mother, make it l'u-Ifiil up lulu..- an 157 apparent that for the three family members an explanation of the relative power distribution may vary for each family member. A question remains unanswered as to whether there are any non—linear relationships among these variables. Extent of Disability Measures to reflect a continuum of disability for a chronic disease which is characterized by exacerbations and remissions are difficult to define objectively. Seven measures were selected ranging in objectivity from total days hospitalized to more subjective evaluations such as present activity of condition by the physiotherapist. Even though some of these extent of disability measures correlated quite highly, there are various patterns in the relationships with other variables. Among the variables measuring extent of disability, functional capacity at last discharge stands alone in many of the relationships: power in decisionemaking and perceived need satisfaction of the wifeemother with extent of disability partialed out; power in decisiondmaking of the husband-father and extent of disability; overall need satis— faction and extent of disability with "acceptance of illness" partialed out; perceived need satisfaction and extent of disability of wifeamother with power in decisiondmaking par- tialed out: and degree of congruence among family members and extent of disability. For this reason, functional capacity Inerits further attention. Do the expectations from the pro- fessional rehabilitation team regarding functional capacity at time of discharge linger and assume an aura of role 158 expectations for the family? There was some indication that the more severely disabled wifeemother has more perceived power in decisionemaking. This relationship was particularly strong for total days hospital- ized and severity of disease at last discharge. One might ask what is the effect of the disability of the wifeemother on the relative power distribution? Although the relationships were not statistically significant, perceived overall need satisfac- tion and extent of disability as measured by severity of dis— ease and functional capacity at last discharge were positively related for the husband—fathers. Why is it that in families with a more severely disabled wifeemother, the husband-fathers tended to have more satisfied needs? Is this apparent because of the project limitation of intact families? Is there need for rehabilitation efforts with the less severely disabled wifedmothers and their families because role expectations of the wife-mother may not be as clearly defined in these families? "Acceptance of Illness" The original question asked whether "acceptance of illness" were an intervening variable in these relationships. As a variable, it had no noticeable effects on the relationships which included power in decision-making. However, it was high— ly correlated with need satisfaction of the wifedmothers, and perhaps it indicated the subjectiveness of the need satisfac- tion ratings. Are the attitudes and/or values of an individual an underlying determinant of his satisfactions? lug-bl . , I 11.0"}! 159 Socio-economicfiStatug Contrary to findings in other studies, there were no re- lationships between perceived power in decision-making and the measures of socio-economic status. .Because there was no censistent use of measures for socio-economic status in the Canadian studies reviewed, three measures were selected: The Hollingshead Two Factor Index oiSocial Position, the Blishen Index of Occupations in Canada, and a dichotomy of occupations classified as nonemanual and manual. These measures correlated quite highly. Description of the Situation For the majority of these families, expenses related to the illness had not decreased their financial status according to the husband-fathers, but for 24 families, they see no increase in their financial status. At least some of these families anticipate future educational expenses for their teen-agers. If the family will be able to meet addi— tional obligations and whether there is any reserve for un- expected events are unanswered questions for the family economist. In housing, the most frequent problem mentioned by family members or the reason usually given for moving or mak- ing changes or contemplating a future move was stairs. .Accomplishment of household tasks was sometimes limited be— cause of then. Since some families did move and make changes in their housing, the economic resource was available and tnay have contributed to need satisfaction. a; . JP!!! . Nu. 160 Since almost fifty per cent of the family members worry about their health, the question is how does this compare with families in which there is no chronic illness? Almost a third of the women thought they could work outside the home. Seven women were gainfully employed with only four employed full time. Does this reflect realistic perceptions or a desire to get out since many have very few activities away from home or both? Conclusions The major findings from this study were: 1. Within the power distribution in the family, the wife-mothers perceived that they had more power relative to either of the other family members who were interviewed. 2. For the wife-mothers, power in decision-making was positively related to need satisfaction. 3. There was a positive relationship between the per- ceived power in decision-making of the wife-mother and the extent of her disability. 4. The need satisfaction of the wife-mother was posi- tively related to her "acceptance of illness". 5. Three members of the family were able to concur on their perceptions of the decision—maker and the decision- implementer in specific family activities. 6. Perceptions of components of need satisfaction of the husband-father and teen-ager were positively related 161 to the degree of congruence among family members. 7. Relationships among variables varied for each member of the family. Limitations l. The size of the sample (35 families) limits the pos- sibilities for sub-dividing the group into potentially useful classifications. For some variables, there is inadequate representation in the categories for desirable analyses. 2. The sample is representative of a particular group of women patients with rheumatic diseases and their families; the sample in no way represents the total population of dis- abled women with rheumatic diseases and their families. Therefore, generalizations may not be applicable beyond the sample in the study and have been limited to the sample. 3. The measurement of variables depends upon the self- report of family members. To what extent the respondent's self report of his behavior and his actual behavior corre- sponds is unknown. 4. Interviewing only one child in each family places restrictions on what is gained relative to the part of children in the relative power distribution especially in families with more than one child at home. 5. By including only intact families in the sample, a particular bias may have been introduced and its effects are unknown. 162 6. In limiting the analysis to linear relationships, any non-linear relationship which may exist is not recognized. Assumptions underlying the statistical techniques were recognized but no claims for rigorous adherence are made. Implications for Future Research Within the data collected for this study, there are possibilities for further analyses. Relationships of two disability variables, namely duration of illness and rapidity of onset of illness, to perceived power in decisionemaking, perceived need satisfaction, and degree of congruence among family members may be examined. Participation of family Inembers in the various activities could be identified. Because the wifedmother had more perceived power indicating that she made more decisions affecting the behavior of other family members, participation of other family members is expected to be high. The degree of congruence among respond- ents could be examined for other questions. The self—perception of power could be compared with each person's perception of other family member's power. Since there was a high degree of congruence among family Inembers, it would be expected that perceptions of the power scores wouldH e highly correlated. Methodological questions have been inherent throughout studies of power. Continued refinement-of alternative Inethods of computing power scores may be pertinent to area IVE F Dr'- El 163 of control and extent of involvement. A factor analysis of the power score measure and a test of its reliability are necessary for improved measurement. Descriptive data from the open-ended questions pertinent to each need could be analyzed. The results may assist in refinement of items comprising the need satisfaction scores. For only the major analyses were findings from the husband-fathers and teen-agers reported. These data may be examined more closely and also that from the selected families in which additional children were interviewed. Tests for non-linear relationships may be appropriate with the data from both the husband-fathers and the teen—agers, and socio-economic status. Replication of this study with similar families in which the wifeemother is not disabled becomes necessary to determine the effect of the disability particularly on the relationships between perceived need satisfaction and both perceived power in decisiondmaking and degree of congruence. Also, a study could examine the same relationships in families in which the wifeemother has a rheumatic disease, but has not been hos- pitalized in a rehabilitation setting. Comparisons between the perceptions of health and functional level may indicate if the chronic illness of one family member affects these per- ceptions. The values of each family member may elucidate these self-perceptions and the extent of satisfaction of needs. 164 The disparity between who is boss and.who makes the final decision and the perceived power scores suggests further study of role expectations and role enactments and an examination of the area or content of decisions. Does the husband-father make decisions of a consequential nature that establishes his role expectation as boss or as making the final decision? And in the majority of the routine activities does the wife- mother make decisions and direct the behavior of other family members which is accepted as her role, hence not perceived as the boss or as making final decisions? In obtaining the sample for this study, a number of families were contacted in which an adult child was still living at home. These families may be an important part of a study examining role relationships within similar families. Comparisons could be made with similar families living in the United States or with families without a disabled wife— mother. Families which have separated or obtained a divorce following the onset of the illness may have had different patterns of relationships from intact families in which the wifeemother is disabled. To continue identification of needs which become poten- tial resources for exchange and may be the basis of reward power, further elaboration of the measures for the sub-scores of need satisfaction directly follows from this study. The satisfaction of physiological needs, particularly those of the husband-father, would be a fruitful area of research 165 following from the comments to the Open-ended question "How are the meals at your house?" The-concepts of relative involvement and relative competence apparently require elabor— ation, too. Answers to the questions who does the various activities were often qualified with the comments that the person doing the activity varied with the schedule of each. family member and that some activities varied depending on the skills and abilities of the person completing the task. Decisions that families make about housing are critical. And evident from this study, adjustments are made to meet individual needs. These can be costly. What differences exist between those families who move and make changes and those who do not? What consideration is given in architec- tural planning for individuals with physical disabilities? Attention to the financial management of the families becomes part of this research. Implications:ior the Family Educator The major implication from this study for family educa- tion stresses the importance of recognizing the family as a system with interrelated and interdependent parts. Although the perceptions of the situations at times may be very simi— lar, the situations may have different meanings for each family member. It behooves the family educator to work with the family in totality rather than yiewing and assisting the 166 family only through individuals. Perception of one family member and his acceptance of the situation may not adequately reflect the acceptance of the situation by other members of the family. Secondly, some families are able to cope with chronic illness making changes and adjusting to them. This indicates a need for the family educator to be able to recognize and to assist families in anticipating changes and in making the needed adjustments. And lastly, for those educators or the rehabilitation team directly involved with families of disabled members, there is an indication for a need.to recognize that some differences among families with the same disability may be dependent upon the extent of the disability and that greater disability may not indicate more prOblems or less satisfac- tion. Therefore, rehabilitation efforts could be directed at families with less severely disabled wifeemothers. Realization of the situation specific elements of any prdblen are again emphasized. SELECTED BIBLIOGRAPHY Articles irom Journals Bahr, Stephen J. and Rollins, Boyd C. "Crisis and Conjugal Power," Journal of.Marriage and the Family, 33:2,7May, 1971, 360—367. Blishen, Bernard R. 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Paper read at the Annual Meet- ings of the National Council on Family Relations, August 16-19, 1967, San Francisco, California. (Mimeographed) APPENDICES APPENDIX A SAMPLE SELECTION Initial Form for Listing Patients Letter to Referring Physicians Letter to Families 179 M.D. __ RDU No. Family No. Name: Phone: Address: Location of home: No. of children: Boys Girls Dates of hOSpitalization (RDU) Admission: Date of birth: Birthplace: Referring MD: Discharge: Hospital Days: Diagnosis: CARS Therapist: Date of first illness: Public Health Date of diagnosis of arthritis: Nurse: Clinic or outpatient: Date of marriage: Occupation of husband: Date Kind f Conta Insurance group: Comments 180 THE CI-IEDOKE—MCMASTER CENTRE OPERATED BY THE HAMILTON HEALTH ASSOCIATION IN CONJUNCTION WITH THE DIVISION OF HEALTH SCIENCES McMASTER UNIVERSITY MCMASTER RHEUMATIC DISEASES UNIT POST OFFICE BOX 590 HAMILTON. ONTARIO TELEPHONE (416) 388-0240 August l6, 1971. Dear Dr. We are grateful to you for the opportunity to participate in the care of your patient. As part of our continuing interest in the welfare of arthritics, we are cooperating with Miss Nan:V Hook in a research project. The purpose I, \ I. f‘ .3. . ‘. V l‘ v\-. . 0" ‘|‘. I ' D "‘ ql '\ ' " 'I'nf‘. “".'\"‘ f‘..':." ‘. 3‘ "7‘. . ..‘.‘ , an. oven-gyros 910v IAAV view-A. AU “‘4 v.5 utlfid-VA-V' ' h-’-““ -0- A -- lf‘. - -- u , .‘0 vv 51.23.12; -;;: 'J}'Zlbilil.’.’..$ 31' I‘;" Miss Hook presently lives in Guelph where she has been a member of the faculty of the University of Guelph. This research is in support of her Ph.D. Thesis at Michigan State University. Her work involving former McMaster R.D.U. patients has our full endorsement. As you know, we are concerned not only with the treatment of disease but in rehabilitation in its fullest sense and thus our support of this project. We will assume that you approve of Miss Hook interviewing your patient at her home unless we hear otherwise from you within two weeks. Thank you very much, in advance, for your cooperation. Yours sincerely, MW JOI. F id, M.D., JIF:dj Clinical Director. 181 THE CHEDOKE-MCMASTER CENTRE OPERATED BY THE HAMILTON HEALTH ASSOCIATION IN CONJUNCTION WITH THE DIVISION OF HEALTH SCIENCES McMASTER UNIVERSITY MCMASTER RHEUMATIC DISEASES UNIT POST OFFICE BOX 590 HAMILTON, ONTARIO TELEPHONE (416) 388-0240 Dear I am writing to you as a former patient of the McMaster Rheumatic Diseases Unit. Everyone here at the Unit joins me in sending greetings to you. As you well know, we are interested not only in your arthritis but in day-by-day functioning: being able to work, being able to enjoy life, etc. We are continuously trying to learn more about the kinds of problems arthritis creates in the business of living so that we can do a better job to help you. Therefore the staff here are cooperating with Miss Nancy Hook in a study she is carrying out on families in which the homemaker has arthritis. Your doctor has given permission for Miss Hook to contact you to make arrangements to visit with you, your husband and your children who are living at home. We think that you will find the contact with Miss Hook pleasant and interesting. We will assume that you are willing to welcome Miss Hook unless we hear otherwise. She will be contacting you in the near future to arrange a time to visit with you and your family. Kindest regards. Yours sincerely, WIT J.I. rid, M.D., JIdej Clinical Director. APPENDIX B INSTRUMENTS Husband-father, Wifeemother, and Teen—ager Interview Schedules Husband-Wife Interview Schedule Medical Data for Wifedmother Log for Interview Data 182 HUSBAND I N‘I'EBVIE' These are questions about you and your lamlly. Every lamlly is special; strictly conlidential. leala are an everyday activity lor all families. dislikes sometimes make meals a problem. there are no right and wrong answers. We are interested In what happens in your tamlly and some ol your reactions to what happens. Your answers are The recent price wars. special diets. and Individual likes and OTHER Till! Boy CH Boy lLD Girl HU.AND WIFE Girl FAMILY ADULT OTHER THAN FAMILY EACH DOES HIMSELF NO ONE DOES NOT APPLY Who makes breaklast ? Who does the bresklast dishes? sets the table lor the main meal?__._.._ cooks the main meal ? clears the table alter the main meal ? __,___ _.,L-._-i, - does the dishes alter the main meal? ”it. it- takes care at the garbage and trash? “w”. _“*‘,--.-.y buys groceries? makes out a shopping list 7 Who Who Who Who Who Who Who bm—1—fiod ——d> ”firm. , -.— v 4*- ~ .4p——. m-—~.—‘ -JL- y.- H1> .-—-q How are the meals at your house? pm- i~~~——---« r———-——-—J In our society Clothing is another concern at the lamily. Do you have what you need? is there plenty ol warm clothing Ior everybody? OTHER FAMILY ADULT TEENAGE] CHILD Boy Girl Boy Girl MUHAND WIFE omen EACH DOE. HIMCLF AFFLV Who mends or sews the lamily's clothes? FAMI LV Who does the lamliy wash? Who does the family Ironing?___ Who buys father's clothes? Who buys mother's clothes?._ Who buys teenager's clothes ? What do you think about the clothing In your lamily ? Have you had any problems with clot hing the family ? How long have you lived in this house (apartment) ? Have you had to move because of your wlle's arthritis? no [3 yes D Tell meabout the move. Howdo you Ieel about the move? Have any changes been made In the house because ol your wlle'a arthritis? so D vas [3 Tell me about the changes. How do you teal about the changes? What are the advantages of your present housing ? What are the disadvantages ol your present housing ? 183 OTHER OTHER TEEN CHILD FAMILY THAN HUMND WIFE Boy GIrl Boy GIII ADULT FAULT EACH DOES HIMSELF DOES NOT NO ONE AFFLV Who does the dusting? Who does the vacuuming? Who scrubs the floors? - Who makes the beds? - Who cleans the bedrooms ? T' ___uc_ Who cleans the bathtub ?. ---.,_-_.___-_._ Who cleans the bathroom ? ..- "TIT -_--. w- Who washes the walls ? .0- ._4p..---~..0._..._.- - Who washes windows inside the house ? _.__.e_.-.._--+-_. final-“.T- ...- Who washes windows outside the house ? -. a” .- . Who selects furniture and other household appliances ? __ - I-.-._._-. Who arranges furniture inside the house ? --. - «whic- Who puts up curtains and draperies in the house? _u-.____- T Who fixes broken things or makes repairs around the house? a..- Who sees to it that children help with the housework ? Who same money for the family 7 a... Who plans the savings for the family ? ._._-_---_.- .____-_.T__.-+ - -4. .-.-_-.,_ ...- I _sr-fl Who pays the bills Who locks up at night? m--..-.-_..--_.__l-.. _.-..-L -. -4.-- ir-ml” .. ---—l l--._ -... Who cares for family members when they are sick ? .__-.._.- _- . --. «y. -.i- "it...“ —--—-—+ ..... T" __ Who takes family menbers to the doctor's office ? _it__._.._ T-ulw. .--_-t --r. . - _ -.l Who tells the children and teenagers what time to come in at night? -- ”.0 Who cares for the children or teenagers when the parents are not at home ? _.-. ....L-. Who sees that the children and teenagers get to school on time ? _.-__ -_.-__ _.,_ Elfin»... L--- _- ninja-- Who sees that the children and teenagers practice good manners ? .-- ._ .-. -- 4p -_ I- _4- .._li ._--- - .-.- - 0— locks up at night 7 __- .- -.--._---.-._._-._.._.l..--.- up--. cares for family members when they are sick 7 _- ...... p- __. ...... takes family members to the doctor’s office 7 1.... - ----la.- tells the children and teenagers what time to come in at night 7 cares for the children and the teenagers when the parents are not at home? sees that the children and teenagers get to school on time 7 - _-—_—*1p sees that the children and teenagers practice good manners 7 -M- -- _----_--- gives the children and teenagers advice 7 gets the family up in the morning? ..-. ease to it that children get washed and dressed in the morning 7 _.__ -- _-- -.__.- _ .- selects the programs on TV 7 -- - -- -._ -. -. -. - ..- .._- «..--.. p ---.-_-.--_____l-- .-_- -..p.. --.-“...”... goes together on vacations 7 ...-- ---..---_ - - ... -.-- . . goes together on outings. picnics. cookouts 7 4r - ---.-- -. goes together on Sunday drives ordrlves in the country?..- - -.- ..__-- ._ r -_ --.- _ i'mlT’JT'ATW . .- M, _ -.. 1.- .._1p_-__ goes together to visit friends 7 __ _.-.__- -. “up--- -..-.1... ,. ..- l... -- .. ---, --. .. invites guests to your home? .-. . -- . . . . keeps in touch with relatives? -.-_ ----- _.- . . - c. - T- V--. ...-. .- ._-_.__-.--d._-._.._.-- .-----.q._.__ goes together to visit relatives? -.- _- -.--. .. - --qp—o-~.~._—dr—- p ---—» IF‘ -- 4»...— q) —«-.45 ««--4L.———-_—'--.jp-o-—-4>--r-——-— -—---——--+—- _. - ...-...- Who washes windows outside the house 7 __----. .. _---, .11..-. I". H] -. -.--. -. - -.-.. -~«-1-~—----l-——-— Who selects furniture and other household appliances 7 _.._—.»- -.._~._ —- - .1». 7n*«W--—4h——_-.n—d cleans the bathtub? a. ._ -...--_._ ...--. . - ..-. - .-.. .- cleans the bathroom? _. .- --..-- -.-- .- - ... .. .. . --. .4--- -. . -. a. .. _ -. .___ ..--.- __ 2,-.._ washes the walls? M... .. a.-- . . , .... . i. . i- .... washes windows inside the house? ---- .. .i .4 . ... washes windows outside the house 7 ..- .-. - . . _. _ . . _ selects furniture and other household appliances? . . - ..- ._.__ _ --. . . -....p - a ._ i- arranges furniture inside the house 7 -..._-_ .....M __ -. _. -.-... .2.-___..- emperor- _ ..- puts up curtains and draperies in the house 7 ...- -.-- .._ ”use... ._i. fixes broken things or makes repairs around the house 7 secs to it that children help with the housework? .-....,_ ... . ... .....- . ....m... 4--.“--. earns money for the family 7 -__n.-.“.__a__.e.e ._ _ . .-fi ., _,. ... a..- .__--....--M--e_- plans the savings for the family 7. ,. - .--- W -.. _ .- _ __ “up--- -. pays the bills 7 _ _. . . .._ -- ,, .... ,- .. - . i..-“ ...... -_ ._--._.,_----_--ei._.. mum- locks up at night? . .... . . . . _ ... cares for family members when they are sick 7 . 4 . . . . . e, ...- ”.-- fem“... takes family members to the doctor' a office 7 1 . . , p . . tells the children and teenagers what time to J come in at night? ... .---.. . . .. cares for the children and the teenagers when the parents are not at home 7 .--- - ...- . . l sees that the children and teenagers get to school on time 7 . . .- -.L-- -.- -. -.--“ ---.,.___--_._._._. r _ _ .-.. -..“..- _u.__-_... --.,._.__.___ ~-4 _, . ”AT” . ”no. ~. -. y ., 1....— Q. .. a -..—.....wdr‘m .. AJ- 4..-”..- >-— ~-«i—~~---- sees that the children and teenagers practice good manners 7 gives the children and teenagers advice 7 gets the family up in the morning? ease to it that children get washed and dressed in the morning 7 .. -_ selects the programs on TV 7 .-- . goes together on vacations 7 .. . goes together on outings. picnics. cookouts 7 goes together on Sunday drives ordrives in the COUNITY?”-_ -....- -... .--...fl-. . -..--. , 4. 4y I’ o .—Jp.—-——-—-»-»-.4 . ..-.. -.., goes together to visit friends 7 invites guests to your home? keeps in touch with relatives 7 . . goes together to visit relatives 7 . . i 208 This section is about Your reactions to what happens in your family. Are you satisfied with your ideals? most of the time I] sometimes [3 usually not [3 not at all [:1 Are you satisfied with the Clothing in your family 7 most of the time [Z] sometimes E] usually not [:1 not at all C] Are you satisfied with your Housing? most of the time [3 sometimes E] usually not [:1 not at all [Z] Are you satisfied with the arrangements for the Safety and Security of the family 7 most of the time E] sometimes {3 ‘ usually not [3 not at all [3 Are you satisfied with the nest and Sleep you get? ' most of the time [:1 sometimes E] usually not C] not at all [3 Are you satisfied with the Understanding of Feelings among family members 7 most of the time D sometimes [:I usually not [:1 not at all [3 Are you satisfied with the Affection expressed between you and your father? most of the time D sometimes 1:] usually not [:1 not at all L] Are you satisfied with the Affection expressed between you and your mother? most of the time [3 sometimes [I usually not [3 not at all [3 Are you satisfied with the Thoughtfulness of your father? most of the time [:1 sometimes [3 usually not C] not at all [:1 Are you satisfied with the Thoughtfulness of your mother? most of the time [3 sometimes L] usually not C] not at all [:1 Are you satisfied with the Sharing of information between you and your father? most of the time D sometimes [3 usually not B not at all [:I Are you satisfied with the Sharing of information between you and your mother? most of the time D sometimes [3 usually not C] not at all [:1 Are you satisfied with the Sharing of Confidences pertaining to your family between you and your father? most of the time L] sometimes [:I usually not [3 not at all [3 Are you satisfied with the Sharing of Confidencea pertaining to your family between you and your mother? most of the time [3 sometimes E] usually not [:1 not at all C] Are you satisfied with the Sharing of Activities with your father? most of the time L] sometimes E] usually not D not at all Are you satisfied with the Sharing of Activities with your mother? most of the time C] sometimes C] usually not [:1 not at all Are you satisfied with the Sharing of Activities as a family 7 most of the time [3 sometimes 1:] usually not [3 not at all Are you satisfied with the Sharing of Activities with your friends 7 most of the time [I sometimes C] usually not C] not at all Are you satisfied with the Sharing of Activities with your relatives 7 most of the time C] sometimes E] usually not [:I not at all SUEDE] 20‘) HUSBAND - WIFE INTERVIEW These are questions about you and your family. Every family is special; there are no right and wrong answers. We are interested in what happens in your family and some of your reactions to what happens. Your answers are strictly confidential. 1. How many people live in this home and benefit from the homemaking tasks? 2. How old are the children who live in this home? Boys Glfls (Circle ages of those attending school --through high school.) 3. Who else lives in this home? (Note relations to the husband and/or wife; sex and activity) 4. Are there members of this family living away from home? was C] no [1 Who .. .. Age ._______._.-_. .. Where .___—___ - . .___ -___- 5. When were you born? Husband -___. Wife __ .....--..__ -----._._.__._ 6. What is the Highest grade or year of elementary or secondary school you ever attended? No Schooling [3 Kindergarten Ci Elementary or secondary (grade or year) Husband12345678910111213 Wlfe12345678910111213 7. Have either of you had any additional schooling 7 (indicate length of time. nature of the course. and degrees. certificates or diplomas received.) Husband vas r] no [3 Wife vas [:3 no [:1 8. When were you married? 9. Were either of you married previously? Husband "0 D V" C] For how long? Wife no C] vas C] For how long? 211) Medical Data for Hits-Mother Name: Chart No. W mamas}. _n_.9.L_!‘_—_.i.3“ I 1 1’ oc-dum mm. 1. 2. 3. Year of onset of disease: . Onsett acute insidious Labo ator Datat ——Ja "0 3% Admission Discharge Admission Discharge Admission Discharge Hemoglobin Sad. rate RA factor titre 5.3.A. Functions} Clagst Class 1 Complete (Ability to carry on all usual duties without handicaps) ll Adequate for normal activities (Despite handicap of discomfort or limited motion at one or more joints) III Limited (Only to little or none of duties of usual occupation or self care) IV Incapacitated, largely or wholly (bedridden or confined to uheelchair; little or no self care) Functional Class for tech Admission and Discharges 1. Admission 2. Admission 3. Admission Discharge Discharge Discharge Activity of Congigiggt Indicate activity of condition for each admissiont Mild Moderate Severe 2]Ll Medical Data for RifenMother Chart No. R22 Admissions; W l. 2. §2IILE£L_££222£2££!L .EIESL Year of onset of disease: Onset: Labogatogz 235a; . 2. acute insidious 3. Admission Discharge Admission Discharge Admission Discharge Hemoglobin Sad. rate L.l. cells Hhite,count —_ 5.5.A. Pgnggigggl Class: Class I Complete (Ability to carry on all usual duties without handicaps) I Adequate for normal activities (Dsspite handicap of discomfort or limited motion at one or more joints) 1!! Limited (Only to little or none of duties of usual occupation or self care) IV Incapacitated, largely or wholly (Sedridden or confined to wheelchair; little or no self care) Functional Class for Each Admission and Discharge: l. Admission 2. Admission 3. Admission Discharge Discharge Discharge Activity of Condition: Indicate activity of condition for each admission: Mild Moderate Severe 212 Namet Chart No. A.R.A. Anggggigal §§gges§ If change in anatomical stage since first admission, please indicate for each admission. Stage Stage Stage Stage Check these criteria which are applicable. 1, Early *1. Mo destructive changes roentgenologlcally. 2. Roentgenologic evidence of osteoporosis may be present. 1!, Moderate *l. Roentgenologic evidence of osteoporosis, with or without slight bone destruction: slight cartilage destruction may be present. *2. No joint deformities. although limitation of joint mobility may be present. 3. Adjacent muscle atrophy. A. Extra-articular soft tissue lesions, such as nodules and tenovaginitis, may be present. 11!, Severe *l. *2. 3. 6. t"s *1 2. Roentgenologic evidence of cartilage and bone destruction, in addition to osteoporosis. Joint deformity, such as subluxation. ulnar deviation or hypereatension, without fibrous or bony ankylosis. Intensive muscle atrophy. Extra-articular soft tissue lesions, such as nodules and tenovaginitis. may be present. Terminal Fibrous or bony ankylcsia. Criteria of stage III. The criteria prefaced by an asterisk are those which must be present to permit classification of a patient in any particular stage- 2213 CARS Physiotherapist Assessment of Rife-Mother Address: Phone no. Date of interview: Please assess the functional capacity of the above individual from your records as of the data of interview if possible. If you did not see the person at that time or sometime after October 1, 1971, please make your assessment at present. Date of visit to patient on which assessment is based: Person making the assessment: Person completing this form if different from above line: ion a (Check appropriate category) 1. Unimpaired or slightly impaired 2. Complete self-care 3. Partial self-care . C a. Severely impaired *An elaboration of these categories is found in Part II, Appendix c. Please assess the activity of the condition of the above individual following the same guidelines for the date of assessment of functional capacity. Mild Moderate Severe 214 FAMILY NO. NAME: PHONE: ADDRESS: LOCATION or none: RECORD OF CONTACTS DATE RIND 0' CONTACT PEMN MAKING IT COMMENT. cnacn ornam sioa DATE RIND OF CONTACT PERMIN MAIINO IT COMMENTE APPENDIX C NEED SATISFACTION MEASUREMENT 21J5 Family number Respondent Coder M 4m W4 56 Meals 57 Clothing 58 housing 59 Safety and security 60 Rest and sleep bl Understanding of feelings 62 Affection husband-father; wife 63 Affection teenager: mother 66 Thoughtfulness husband-father; wife 65 Thoughtfulness teenager: mother 6‘ Sharing of information husband-father: wife 67 Sharing of information teenager; mother 68 Sharing of confidences husband-father; wife 69 Sharing of confidences teenager: mother 70 Samuel satisfaction 7l Sex partner 2115 Family number Respondent Coder Column numng m sf . Not S ied 72 Sharing of activities husband-father; wife 73 Sharing of activities teenager; mother 76 Sharing of activities family 75 Sharing of activities friends 76 Sharing of activites relatives 217 Table 65. Frequency distribution of husband-fathers' percep- tion of need satisfaction. Needs Frequency Distribution 0) +1 .c o n 3 u m c in c n 2 n ‘° 8. ° ‘3 :i a 3 +io o m n “'8 E s .u out o m o 0 Eu U) D Z Z Physiological needs: Satisfaction with meals 35 Satisfaction with rest and sleep 33 l 1 Concern about pain Not concerned = 18 Concerned = 11 No response = 6 Safety needs: Satisfaction with clothing 35 Satisfaction with housing 33 2 Satisfaction with family's safety and security 33 2 Companionship and support needs: Satisfaction with empathy (understanding of feelings) 31 4 Satisfaction with expression of affection spouse 31 3 1 teen-ager 34 l Satisfaction with thoughtfulness spouse 33 2 teen-ager 29 4 2 Satisfaction with sharing of information spouse 34 l teen-ager 31 2 l l Satisfaction with sharing of confidences spouse 35 teen—ager 31 3 1 Sexual satisfaction 28 5 1 1 Satisfaction with self as sex partner 29 4 2 Satisfaction with activity shar- ing spouse 29 5 l teen-ager 3O 3 2 family 33 l 1 friends 30 2 l 2 relatives 27 3 l 4 218 Table 66. Frequency distribution of wifedmothers' perception of need satisfaction. Needs Frequency Distribution 5 u .G O H u m c .4 n 2 n “‘ O -:-l .-| .p u —i m 32 °’ 3 .. own 8 m 0 2:41 U) D Z Physiological needs: Satisfaction with meals 29 6 Satisfaction with rest and sleep 26 6 3 Concern about pain Not concerned = 14 Concerned a 21 Safety needs: Satisfaction with clothing 30 4 1 Satisfaction with housing 30 4 1 Satisfaction with family's safety and security 34 1 Companionship and support needs: Satisfaction with empathy 22 10 3 (understanding of feelings) Satisfaction with expression of affection spouse 26 7 2 teen-ager 28 7 Satisfaction with thoughtfulness spouse 28 4 2 ,l teen—ager 27 7 l Satisfaction with sharing of information spouse 31 4 teen-ager 28 7 Satisfaction with sharing of confidences spouse 32 2 l teen-ager 30 4 1 Sexual satisfaction 23 10 1 1 Satisfaction with self as sex partner 13 15 5 2 Satisfaction with activity shar- ing spouse 16 15 3 1 teen—ager 14 18 2 1 family 16 15 3 1 friends 18 13 2 2 relatives 20 12 1 2 219 Table 67. Frequency distribution of teen-agers' perception of need satisfaction. Needs Frequency Distribution 0 +1 D o .4 u m a .4 OJ rd “4 E >- o -n .4 u u .4 m :32 2 S u own 0 m 0 2+1 U) D Z Physiological needs: Satisfaction with meals 3O 5 Satisfaction with rest and sleep 25 6 3 l Concern about pain Not concerned = 8 Concerned = 14 No response = 13 Safety needs: Satisfaction with clothing 34 l Satisfaction with housing 30 4 l Satisfaction with family's safety and security 31 3 1 Companionship and support needs: Satisfaction with empathy 23 12 (understanding of feelings) Satisfaction with expression of affection father 25 8 2 mother 30 4 1 Satisfaction with thoughtfulness father 27 7 1 mother 32 2 1 Satisfaction with sharing of information father 25 8 l 1 mother 27 7 1 Satisfaction with sharing of confidences father 23 9 2 1 mother 30 4 1 Satisfaction with activity sharing father 24 6 4 1 mother 23 11 1 family 25 5 4 1 friends 31 2 2 relatives 21 12 2 220 Table 68. Frequency distribution of husband-fathers' need satisfaction as determined by rater number one. Needs ‘ Frequency Distribution Satisfied Dissatis- No response fied Physiological needs: Satisfaction with meals 33 2 Satisfaction with rest and sleep 32 1 2 Safety needs: Satisfaction with clothing 33 2 Satisfaction with housing 32 3 Satisfaction with family's safety and security 30 3 2 Companionship and support needs: Satisfaction with empathy 31 2 2 (understanding of feelings) Satisfaction with expression of affection spouse 29 2 4 ‘ teen-ager 21 1 l3 Satisfaction with thoughtfulness spouse 33 2 teen-ager 30 2 3 Satisfaction with sharing of information spouse 31 2 2 teen-ager 3O 3 2 Satisfaction with sharing of confidences spouse 30 3 2 teen-ager 25 8 Sexual satisfaction 27 6 2 Satisfaction with self as sex partner 30 2 Satisfaction with activity sharing spouse 26 7 2 teen-ager 24 8 3 family 27 6 2 friends 27 6 2 relatives 25 7 3 221 Table 69. Frequency distribution of husband-fathers' need ‘satisfaction as determined by rater number two. Needs Frequency Distribution fied No response Satisfied Dissatis- Physiological needs: Satisfaction with meals 33 2 Satisfaction with rest and sleep 31 2 2 Safety needs: Satisfaction with clothing 32 1 2 Satisfaction with housing 31 l 3 Satisfaction with family's safety and security 32 3 Companionship and support needs: Satisfaction with empathy 31 2 2 (understanding of feelings) Satisfaction with expression of affection spouse 28 3 4 teen-ager 21 14 Satisfaction with thoughtfulness spouse 33 2 teen-ager 32 l 2 Satisfaction with sharing of > infOrmation spouse 32 l 2 teen-ager 29 3 3 Satisfaction with sharing of confidences spouse 31 2 2 teen-ager 32 :1 2 Sexual satisfaction 30 3 2 Satisfaction with self as sex partner 30 2 3 Satisfaction with activity sharing spouse 21 12 2 teen—ager 19 ~12 4 family 18 15 2 friends 16 17 2 relatives 6 26 .3 222 Table 70. Frequency distribution of wifedmothers' need satis- faction as detenmined by rater number one. Needs Frequency Distribution "0 o o -H m 'o w: c .2 .33 S. tH u m .2: a a 13 “.3 c U) 0 Z Physiological needs: Satisfaction with meals 33 2 Satisfaction with rest and sleep 30 3 2 Safety needs: Satisfaction with clothing 33 2 Satisfaction with housing 33 2 Satisfaction with family's safety and security 32 1 2 Companionship and support needs: Satisfaction with empathy 3O 3 2 (understanding of feelings) Satisfaction with expression of affection spouse. 31 2 2 teen-ager ' 32 1 2 Satisfaction with thoughtfulness spouse 27 5 3 teen-ager 31 1 2 Satisfaction with sharing of information spouse 26 7 2 teen-ager 32 1 2 Satisfaction with sharing of confidences spouse 29 4 2 teen—ager 30 3 2 Sexual satisfaction 32 l 2 Satisfaction with self as sex partner 27 6 2 Satisfaction with activity sharing spouse 32 1 2 teen—ager 31 2 2 family 32 l 2 friends 31 2 2 relatives 30 13 2 Table 71. Frequency distribution.of’wifedmothers' need satis- faction as determined by-rater number two. 223 Needs Frequency Distribution ' If m a .1, = ..4 ... 8. ‘H u o m m o -H on: H u «:0 cu -a-a o (I) D ‘M 2 Physiological needs: Satisfaction with meals 33 2 Satisfaction with rest and sleep 24 9 2 Safety needs: Satisfaction with clothing 32 l 2 Satisfaction with housing 30 3 2 Satisfaction with family's safety and security 33 2 Companionship and support needs: Satisfaction with empathy 27 6 2 (understanding of feelings) Satisfaction with expression of affection spouse 30 3 2 teen-ager 3l 2 2 Satisfaction with thoughtfulness spouse 28 5 2 teen-ager 31 2 2 Satisfaction with sharing of information spouse 22 10 3 teen—ager 28 4 3 Satisfaction with sharing of confidences spouse 28 4 3 teen-ager 29 4 2 Sexual satisfaction 32 3 Satisfaction with self as sex partner 27 6 2 Satisfaction with activity sharing spouse 26 7 2 teen-ager 17 ,16 2 family 19 >14 2 friends 15 17 3 relatives 12 21 2 W‘- 224 Table 72. Frequency distribution of teen-agers' need satis- faction as determined by rater number one. Needs Frequency Distribution Satisfied Dissatisfied No response Physiological needs: Satisfaction with meals 31 4 Satisfaction with rest and sleep 28 3 4 Safety needs: Satisfaction with clothing 31 4 Satisfaction with housing 30 1 4 Satisfaction with family's safety and security 31 4 Companionship and support needs: Satisfaction with empathy 30 1 4 (understanding of feelings) Satisfaction with expression of affection father 30 l 4 mother 31 4 Satisfaction with thoughtfulness father 28 2 5 mother 29 1 5 Satisfaction with sharing of information father 21 9 5 mother 26 4 5 Satisfaction with sharing of confidences father 18 12 5 mother 27 3 5 Satisfaction with activity sharing father 28 3 4 mother 27 4 4 family 27 4 4 friends .31 4 relativesv 27 4 4 225 Table 73. Frequency distribution of teen-agers' need satisfac- tion as determined by rater number two. Needs Frequency Distribution Satisfied Dissatis- No response: fied Physiological needs: Satisfaction with meals 31 4 Satisfaction with rest and sleep 26 5 4 Safety needs: Satisfaction with clothing 31 4 Satisfaction with housing 29 2 4 Satisfaction with family's safety and security 31 4 Companionship and support needs: Satisfaction with empathy (understanding of feelings) 29 2 4 Satisfaction with expression of affection father 30 1 4 mother 31 4 Satisfaction with thoughtfulness father 30 1 4 mother 31 4 Satisfaction with sharing of information father 24 5 6 mother 27 3 5 Satisfaction with sharing of confidences father 25 5 5 mother 29 2 4 Satisfaction with activity sharing father 18 13 4 mother 7 24 4 family 20 11 4 friends 34 4 relatives- 21 10 4 Table 74. Inter—rater reliability by need satisfaction items 226 for all respondents. 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