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This is to certify that the

thesis entitled

Women's Perception Of Major Life Changes and

Family Closeness During The Pregnancy Of A Sub—
sequent Child In First Married And_Remarried
Families

presented by

Jennifer Boucher

has been accepted towards fulfillment
of the requirements for

Ma 5 te r .gLficienoLdegree in Alumna—

§<2¢Ap€ JCA/fifiAfing

Major professor

Date 3- /5; €19

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W

 

WOMEN'S PERCEPTION OF MAJOR LIFE CHANGES AND FAMILY
CLOSENESS DURING THE PREGNANCY OF A SUBSEQUENT CHILD IN
FIRST MARRIED AND REMARRIED FAMILIES
By

Jennifer Susan Boucher

A THESIS

Submitted to
Michigan State University
in partial fulfilment of the requirements
for the degree of

MASTER OF SCIENCE IN NURSING
College of Nursing

1996

ABSTRACT

WOMEN'S PERCEPTION OF MAJOR LIFE CHANGES AND FAMILY
CLOSENESS DURING THE PREGNANCY OF A SUBSEQUENT CHILD IN
FIRST MARRIED AND REMARRIED FAMILIES

By
Jennifer Boucher

The Roy Adaptation Model was used as a theoretical framework for this
exploratory secondary data analysis which examined the perceptions of women
from 29 first married families and 35 remarried families about recent major life
changes and the impact of the pregnancy of a mutual child on family closeness.
Differences in the developmental stages of the two family types appear to have
contributed to the major differences in the type of major life changes experienced
and the factors perceived as important to family closeness by the women from the
two family types. Despite the more complex family structure and experiencing
more major life changes, remarried families were not more at risk for dysfunctional
adaptation in the interdependence mode and were found to be as close or closer

than first married families.

DEDICATION

The number and types of alternative family types has increased to the point that
alternative family structures have become the norm rather than the exception in
today's society. The myth of the ideal traditional family has been a source of
tension and stress to families with variant Structures for decades. It is hoped that
one day their will be no longer be any societal biases towards alternative family
types and each family can be judged by how well it meets the needs of its
individual members. This study is dedicated to all families because every family

structure is unique.

ACKNOWLEDGEMENTS

I would like to thank Rachel Schiffman for her guidance, patience,
understanding and support above and beyond the hours of MSU operation.
Sincere gratitude is extended to the families who participated in the original study
and to the other members of my thesis committee, Mildred Omar, and Jacqueline
Wright. Lastly, I would like to express my warmest appreciation to my husband for

his continual support and encouragement

iv

TABLE OF CONTENTS
LIST OF TABLES
LIST OF FIGURES

INTRODUCTION

REVIEW OF THE LITERATURE
Conceptual Definitions
Theoretical Framework
Review and Synthesis of Existing Empirical Literature

METHODS
Research Design
Sample
Operational Definitions
Procedure for Data Analysis
Reliability and Validity
Protection of Human Subjects
Assumptions
Limitations

FINDINGS
Findings Related to Demographics
Findings Related to Major Life Changes
Findings Related to Family Closeness

DISCUSSION
Implications of the Findings for the Existing Literature
Implications for RAM
Implications of the Findings for Advanced Nursing Practice
Limitations and Recommendations for Future Studies
Summary

APPENDICES
Appendix A: Original Study Sample Collection Criteria and
Procedure for Recruiting Subjects
Appendix B: Original Interview Process and Interview Questions
Appendix C: Original Data Collection Procedures
Appendix D: UCRIHS Approval for the Current Study
Appendix E: Tables

LIST OF REFERENCES

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81

LIST OF TABLES

Table 1. Developmental Stages of First and Remarried Families

Table 2. Percents of Women Who Perceived No Major
Life Changes by Family Types

Table 3. Percents of Perceived Work Transitions & Strains
By Family Types

Table 4. Percents of Perceived Financial Changes by Family Types
Table 5. Percents of Perceived Legal Changes by Family Types
Table 6. Percents of Perceived Transitions In & Out by Family Types

Table 7. Percents of Perceived Illness/Dependency Changes
by Family Types

Table 8. Percents of Perceived Marital Changes by Family Types
Table 9. Percents of Perceived Childbearing Changes by Family Types

Table 10. Percents of Perceived Intra-Family Relationship Changes
by Family Types

Table 11. Percents of Perceived Differences in Family Closeness Since
the Pregnancy by Family Types

Table 12. Percents of Positive Factors Perceived as Important for
Developing and/or Maintaining Family Closeness

Table 13. Percents of Negative Factors/Areas of Adjustment
Perceived as Important for Developing and/or Maintaining
Family Closeness

Table 14. Percents of Perceived Adjustment Areas Unique
Remarried Families

72

72

73

76

77

78

79

80

LIST OF FIGURES

Figure l. The Roy Adaptation Model as it applies to the family system 17
Figure 2. The Roy Adaptation Model as it applies to the present study 20

Figure 3. Frequencies of first manied families who experienced
the various quantities of major life changes 40

Figure 4. Frequencies of remarried families who experienced the various
quantities of major life changes 40

INTRODUCTION

"There is no way to have a baby and not have lives dramatically change"
(Aranoff & Lewis, 1979, p. 52). Whether these changes are considered to be
positive or negative depends on the family's perception of the pregnancy and
surrounding events. If the changes are of significant magnitude to require some
adjustment in the regular pattern of family interaction, it can result in maladaptive
family functioning where the affectional and emotional needs of individual
members are not adequately met. The purpose of this study was to explore
women's perceptions of major life changes during pregnancy and to describe their
impact on family closeness in two different family types.

Historically, family theorists and clinicians have speculated that remanied
families expecting their first child together experience more major life changes in a
shorter span of time than do first manied families expecting a subsequent child.
The average time remanied families are married before procreating together is
similar to that of first married couples--approximately one to four years (Albrecht,
1979; Dietz-Omar, 1991; Ganong & Coleman, 1988). Therefore, recently formed
remarried families can be expected to experience major life changes similar in
number and magnitude to those of traditional families when expecting their first
mutual child. Recently remarried families will most likely have a higher complexity
of relationships and diffuse or undetermined boundaries which will create even
more expected life changes in a shorter period of time. This proposed greater
number of cumulative life changes has lead researchers to hypothesize that

1

 

remarried families will have lower levels of family closeness during the pregnancy
of a subsequent, or mutual, child (Albrecht, 1979; Peek, Bell, Waldren, & Sorrell,
1988; Pink & Wampler, 1985). Other clinicians and researchers have hypothesized
that having a mutual child would "cement" bonds between remarried family
members and create even greater perceived family closeness (Beer, 1989;
Duberrnan, 1973; Ganong & Coleman, 1988). Although the prevalence of
remanied families is rapidly increasing in our society, relatively little data has been
collected on their functioning. The research that has been done, has provided
contradictory results which support both lines of thought.

"All pregnant families experience a degree of stress, anticipation, and change
involving intrapersonal, interpersonal, and intrafamily boundaries and
relationships" (Mercer, Ferketich, DeJoseph, & Sollie, 1988, p. 268), but more
attention needs to be placed on what these changes may be so that appropriate
anticipatory guidance can be provided for families expecting a subsequent child
and for families with different family structures. Appropriate anticipatory guidance
and knowledge of normative patterns of adjustment can help identify those families
who may need additional interventions to prevent maladaptive levels of family
closeness.

Assessment of a family's perception of major life changes associated with, or
occurring concurrent with pregnancy should begin with the mother at the time the
pregnancy is diagnosed so that early intervention and anticipatory guidance can
occur to promote optimal family closeness and, therefore, promote optimal
individual member functioning. Mercer et al. (1988) found that negative life stress
during pregnancy negatively affected family functioning eight months after the
birth of the infant. High levels of perceived life change during pregnancy have
been linked to child abuse (Conger, Burgess, & Barret, 1979; Dzurec, 1995).

These are just a few examples of how major life changes during pregnancy can not

only have a detrimental impact on family closeness at that time, but also contribute
to dysfunctional patterns of family interactions resulting from unmet needs for
love, nurturing, trust, and mutual respect which endure throughout the stages of
family and individual member development

Family nurse practitioners (FNP's) see families, or family members, on a
regular basis and often have established therapeutic relationships with entire
families, so they are in an unique position to assist families heighten their
awareness about their patterns of interaction and each others' emotional and
affective needs to promote optimal family health and closeness throughout
normative and unexpected transitions in each phase of family development. The
importance of promoting family closeness during pregnancy and other major life
change is essential to family well-being. Family closeness is integral to successful
adaptive responses so that family members' needs of nurturing, affection, love and
belonging can be met. How family closeness is affected during the pregnancy of a
subsequent child in different family types has not yet been explored to a sufficient
extent for FNP's to perform adequate assessment, planning, intervention and
evaluation of families' perceptions the pregnancy and concurrent life changes.

Because the woman is typically the family member with whom the initial and
most frequent ongoing contact with the health care system is made during the
prenatal period, this study focused on women's perception of major life changes
and the impact of pregnancy on family closeness in both first married and
remarried families. Minimal data is available on these concepts, so descriptive data
is necessary before possible relationships between the concepts of family closeness
and their perception of life change can be determined. The specific research
questions of interest in this study were:

1.) What are women's perception of the type and number of major life

changes families experience during the pregnancy of a subsequent child?

 

 

2.) What are any similarities and/or differences in the women's perception
of major life changes in first married and remarried family types?
3.) What are women's perception of the impact of the pregnancy of a
subsequent child on their family's closeness?
4.) What are the similarities and/or differences in the women's
perceptions of family closeness in remarried families and in first married
families?

REVIEW OF LITERATURE

Canceptualflefinitians

W. The evolution of the purpose/function of families in today's
society is closely related to the evolution of alternative family types, such as the
remarried family, and must be understood in order to clearly define different types
of families. Families are and have always been the basic unit of society,
functioning to perpetuate the human race and cultural traditions through
socialization of the young. These functions of the family have not changed. The
changes that have occurred in the priority of the functions of families reflect the
changes in our society. When our society changed from a primarily agricultural
society to an industrial society at the turn of the century, families were no longer
bound by economic necessity because both men and women were working outside
the home (Bahr, 1988).

"Such challenges are met by families by varying their structure to maintain
function” (Boss, 1980, p. 449). The industrial revolution was the catalyst which
changed the primary function of families to switch from economic survival to
meeting the affectional needs of its members. A direct consequence of this change
in family function is an increase in the number of people marrying later in life,
deciding not to marry, simply living together and having children, deciding not to

have children at all, separating and divorcing if the marriage is not meeting their

 

 

emotional needs, raising children in single parent households, and reng for
companionship and love (Gilliss, Highley, Roberts & Martinson, 1989). J

"Almost every one out two recent marriages will end in divorce" (Norton &
Miller, 1992, p. 2). From 1921 to 1989 the rate of divorce in women ages 15 to 44
years increased from 10 per 1,000 to 37 per 1,000 (Norton & Miller, 1992). The
rate of remarriage for women in the same age group and during the same time [
period increased from 98 per 1,000 widowed and divorced women to 109 (Norton
& Miller, 1992). This translates into 16 percent of all children living with a

 

stepparent or, "about one in every six children living with two parents is living with L
a stepparent" (Lugalia, 1992, p. 38). If there are children, they usually live with
the mother in single-parent families. About three quarters of these custodial
parents will remarry and these children will live with a step-parent (Lugalia, 1992).
Two thirds of remarried mothers have a child with their new husbands(Lugalia,
1992). Of children living with two parents in 1990, sixteen percent lived with a
step-parent and one in five of these children have a half-Sibling living in their home
(Norton & Miller, 1992). These societal trends resulted in the a large variety of
structures and types of families in today's society.

Traditionally, families have been thought of as a heterosexual adult couple,
joined in marriage for the first and only time to one another, and their children.
For the purposes of this project, the term "fist-married family" was employed to
refer to this traditional concept of "family". Over the years society has created a
mythical ideal with the implication that if a group of people did not fit this first-
married family mold, they were not really a family. Therefore, the prefixes "step"
and "half' carry many negative connotations. These prefixes infer that the
relationships between family members should be like that of a biological parent-
child, or intrasibling relationship, but that these relationships are not quite the

equivalent, not quite as good; that they are "step" or "half" relationships.

An example of how step and biologically related families have traditionally
been differentiated conceptually is found in Beer's Strangetsjntheflnuse (1989).
From his anecdotal clinical experiences, Beer concludes "when remarried parents
have a child in common, they have transformed a couple with legally related
dependent children into a biologically related family" (Beer, 1989, p. 105). The
birth of a mutual child has consequences for the quality of relationships between
spouses and the children. Before the birth of a half-sibling, who creates a
biological link to the step-parent, the biological parent assumes responsibility for
the children. After the birth, new patterns of interactions are established because
both parents feel responsible for the mutual child, which eventually results in
mutual authority over all the children. In this way, Beer believes remarried families
are converted into biological families, and are "fused in a way that stepfamilies
without one [mutual child] are not" (p.105).

Beer's traditional way of thinking about family types does not reflect the
attitudes and perceptions expressed by remarried families in the few descriptive
studies which have been done and suggests that societal bias and not empirical
research has predominated the remarried literature for several decades. Much of
the descriptive research reflects how families attempt to overcome these negative
societal biases of "step" relationships by avoiding the use of these prefixes. They

employ terms such as "my wife's children, my father's wife," to indicate
acceptance of the exact nature of their relationships rather than a pseudo, "half as
good," or "step" relationship (Ambert, 1986). Ganong and Coleman (1988)
found that when distinctions as "half" were not made by the children, that they
often objected to the interviewer's use of the prefix. In fact, "eighty-two percent of
the adults indicated that the older children did not distinguish between siblings and
half siblings" (p. 696). The terms biological, traditional, nuclear are seen

frequently in the less recent literature to refer to families where both husband and

 

 

wife have only been married once; the terms step, reconstituted, and blended are
used to refer to families where one or both of the spouses have been previously
married.

To avoid societal bias, for the purposes of this study, the term, 'first-married
families,‘ was used to refer to families where both spouses have only been married
once. The term, 'remarried families,‘ was used to refer to families where one or JR
both of the spouses have been married and divorced prior to entering into the
current marital relationship.

Eamilyclnsencss. Whether it is a first, second, or any subsequent marriage, E

 

individuals create a family system for the same purpose-to meet each others'
interpersonal needs for affection and nurturance to promote individual members'
growth and development into effective members of society (Aranoff & Lewis,
1990). Some families function to achieve this purpose better than others. Many
theorists have attempted to define healthy family functioning. Although definitions
may differ in terminology, the major conceptual components are similar--all include
some aspect of family closeness related to meeting members interpersonal and
affectional needs.

Pill (1990) and Boss (1980) discuss family closeness in terms of boundaries
within the theoretical framework of family systems. Pill (1990) acknowledges that
family form and cultural background influence what amounts of closeness or
degree of boundary regulation are optimal for different families. Pill uses the term,
cohesion, stating that, "The concept of family cohesion concerns the emotional
connectedness within a family with particular emphasis upon alignment and
boundary arrangements between family members and subsystems" (p. 187).
Extremes in family closeness, which are characterized by low bonding or high

fusion, compromise family functioning.

Cowan et al. (1985) defines affective structure (the terminology used for the
concept of family closeness) as, "a sociogramtic concept referring to the family's
pattern of positive and negative feelings about one another...It is similar to the
amount of emotional bonding occurring between individuals" (1980, p. 130).
According to Cowan et al. (1985), the affective dimension is consistent with other
family system approaches and reflects the level of other family processes.

Smilkstein (1978) compares healthy family functioning to that of a body's
organ system, "each component has a unique function, yet is interrelated to the
whole" (p. 1233). Smilkstein applies the acronym "APGAR" to the five
components of family functioning: Adaptation, Partnership, Growth, Affection,
and Resolve. A family with healthy functioning and optimal closeness is one that is
a nurturing unit and that demonstrates integrity of the five components. Of these
five components, all but one, adaptation, relate to the affectional aspect of family
function including sharing of decision making, mutual support, caring, loving, and
commitmentto devote time to other members of the family for emotional
nurturing.

Dzurec (1995) refers to "the notion of 'fit' as a general sense of connectedness
and supportiveness that families generate. It is a tuning-in between and among
family members, an emotional context that allows for growth and development of
each family member as an individual" (1995, pp. 277-278). Within this context, a
family with healthy levels of family closeness, is one with a comfortable fit where
the family is supportive, gives and receives love from one another but encourages
individual members to think independently even if their views differ from those of
other family members. Similarly, Griffith (1976) defines interpersonal
compatibility as "the relationship(s) between two or more people that leads to
mutual satisfaction of the interpersonal needs of enclusion (interaction with

others), control, and affection" (p. 35). Families with interpersonal compatibility

 

live in harmonious coexistence and have the ability to work together and,
therefore, have optimal levels of closeness.

Olson, Sprenkle, and Russell (1979), the authors of the Circumplex Model,
noticed the conceptual similarities among so many different authors' multiple
terms, clustered concepts from the social sciences literature into two main
dimensions of family behavior, cohesion and adaptability. Cohesion is the term
applied to the concept of family closeness and is defined as the "emotional bonding
members have with one another and the degree of individual autonomy a person
experiences in the family system" (Olson, et al.1979, p. 263).

Beavers and Voeller (1983) also synthesized concepts in the existing family
function literature into two similar conceptual dimensions of family functioning
when creating the Beavers Systems Model of family functioning. Beavers and
Voeller postulate that families have either centripetal or centrifugal relationships
and perception of interpersonal satisfactions which reflect varying degrees of
family closeness. "Centripetal family members view most relationship satisfactions
as coming from within the family rather than from the outside world. Conversely,
centrifugal family members see the outside world as holding the most promise of
satisfaction and the family as holding the least" (Beavers & Voeller, p.89 & 91).
Families who are the most functional are neither totally centripital or centrifugal--
they are a well structured group of integrated individuals who share intimacy and
closeness as well as respect for separateness of individual members.

The Circumplex Model and Beavers Model also share the characteristic of
being dynamic. Both models postulate that different levels of family closeness are
more advantageous at different stages of family growth and development. For
example higher levels of family closeness are necessary in the premarital stage and

when the first child is born. Less family closeness is more functional during the

10

stage of early marriage and, again, when there are adolescents in the family
(Beavers & Voeller, 1983; Olson, Russell, & Sprenkle, 1983).

For the purpose of this study, the term family closeness was defined as the
degree of emotional bonding between family system members, such that they are
committed to the family as a whole, working together to solve problems, and to
nurturing one another to meet each individual's affectional needs of unconditional
mutual acceptance, support, and respect Family closeness is dynamic such that
degrees of closeness will adjust to normative and unexpected events throughout
the family's growth and development Families with extreme degrees of closeness
and ones who are not close at all are both at risk during periods of great life
change for unhealthy family functioning where affectional needs of the members
may not be met

Marmlrferhanges. The impact of life changes, normative and unexpected,
has been studied by many researchers. Holmes and Rahe (1967) are the
forefathers of the psychobiological research. They were followed by Sarason,
Johnson and Seigal (1978). These early researchers determined that life changes
stress organisms' steady states and require both physiological and psychosocial
readjustment to maintain homeostasis. If there is a perceived imbalance between
the cumulative environmental demands (life changes) and the individual's capacity
to meet these demands, the individual is more prone to illness or unhealthy
functioning.

Similarly, Hill (1958) describes a family system's response to life change in the
ABCX family crisis model: "A (the stressor event)--interacting with B (the
family's crisis meeting resources)--interacting with C (the definition the family
makes of the event)--produce X (the crisis)..."(p. 141). Changes stress the family

system's ability to carry out its homeostatic functions, just as in the individual, and

11

can precipitate a crisis period of dysfunctional family functioning. Hill (1958)
defines such crisis precipitating stressor events as:

...a situation for which the family has had little or no prior
preparation and must therefore be viewed as problematic...no crisis
precipitating event is the same for any given family; its impact
ranges according to several hardships that may accompany it (p.
140).

Hardships may be thought of as the changes or complications associated with the
crisis event Major life changes are categorized into five classifications: 1) the
source of trouble as intra or extra-family events, 2) the loss of a family member
(dismemberment) or addition of an unprepared-for member (accession), 3) loss of
moral and family unity (demoralization), 4) sudden change in family status (i.e.,
floods, wars, sudden impoverishment or fame and fortune) and, 5) conflict among
family members in the conception of their roles (Hill, 1958). Hill's focus of major
life changes all involve drastic negative changes in families' lives.

Reiss and Oliveri (1980) focus on uncomplicated aspects of major life change
and consider only, "those events and circumstances that are relatively brief and
circumscribed, lasting weeks or at most months, but not years" (p. 437). They also
only look at extrafamilial events that are "beyond the control of the family" (p.
437).

Boss (1980) recognizes some gaps in the previous definitions of major life
changes and, therefore, looks exclusively at normative life-Span stress and related
family boundary changes. "Normative stress in families results whenever
components are added or subtracted from a family system. From birth to death,
family boundaries change and remain ambiguous during the process of
reorganization after acquisition or loss of a member" (p. 445). Like Hill, Boss

includes associated changes, but in this case, the changes are internal rather than

12

external and relate to changes in family structure to facilitate the accomplishment
of family functions.

McCubbin and Patterson (1987) are credited as the first researchers to
empirically apply the concept of cumulative major life changes to the study of
family behavior in response to stress. They define "pile-up" or cumulative life
changes as "...the sum of normative and non-normative stressors and intra-family
strains" (p. 82). Thus, they incorporate all the definitions from the previous family
literature by including internal and extemal family life changes as well as the
changes associated with these major life events. They conceptually group life
changes into eight categories: family development, work, management, health,
friends, social activities, law, and extended family relationships

The major life changes of interest in this study are those experienced by first
married and remarried families who are expecting a baby. Examples of major life
changes associated with expecting a baby may include a change in number of
arguments as a result of fluctuating hormone levels and moods of the expectant
mother, revision of personal habits (i.e., diet, sleep, tobacco use, sexual relations,
etc.) change in employment and financial status, and change in living conditions or
residence to accommodate increasing family size. Remarried families who are
expecting a baby may experience additional major life changes associated with this
early stage of family formation and related to their family form. Such changes may
include the death of a spouse or divorce or both, marital separation, remarriage,
gaining of new family members (i.e. step-siblings, stepchildren, etc.), negotiation
of disciplinary and boundary issues related to the merging of families. Although,
not by any means do all these stressors occur with every pregnancy in every
remanied family, it is easy to see the enormous potential for the cumulative effect
of possible stressors to tear apart any form of family with dysfunctional patterns of

interaction.

 

13

For the purposes of the present study, major life changes included both
internal and external changes resulting from either normative or unexpected
situational events. Major life changes in a year's time span was the focus because
the stress producing effects of family life changes are cumulative and it has been
shown that the more changes that occur in a short time, the more the family system
will be taxed.

Bemepfionnfmajntlifcmangcs. If a life change is considered major or not
can only be determined by each family's perception of the event Referring back
to the early family life change work of Hill, factor C in the ABCX Model is the
primary influence on the family's degree of resilience to crisis proneness. Hill
explains,

A family's definition of the event reflect partly the value system held
by the family, partly its previous experience in meeting crises and
partly the mechanisms employed in previous definitions of events.
This is the meaning aspect of the crisis. The interpretation made of
it (1958, p. 145).
Families who are prone to crises have negative outlooks and see events as crisis-
provoking rather than challenging-

Like Hill, McCubbin (1993) proposes that "In family crisis situations, the
family's positive appraisal of the situation is related to family adaptation and this is
a positive relationship" (p. 54). McCubbin further develops family perception and
applies it to three levels of appraisal in the family's overall response to major life
change. The first level is that of stressor appraisal and is equivalent to Hill's
definition of the family's subjective definition of the specific stressor event. The
second level of appraisal is that of the situation or the family's subjective definition
of the total demands they are experiencing in relation to their resources and

capabilities. The third level refers to a global level of appraisal based on the
family's basic beliefs, values, shared identity and goals. McCubbin has found that

14

"the family's ability to perceive the overall situation as coherent, one that 'makes
sense' and is a 'fit' between the family the family and their circumstances, was of
value to the family in facilitating adaptation" (p.55).

Reiss and Oliveri's "family paradigm" is equivalent to McCubbin's global level
of family appraisal. Reiss and Oliveri postulate that families develop a set of
shared beliefs or constructs about social phenomena and its position in the world.
When faced with a major change, families are forced to revise their system of
framing assumptions. Reiss and Oliveri (1980) refer to the new approach or
perspective of problem solving in daily life as the "family paradigm...[which] serves
as a stable disposition or orientation whenever the family must actively construe a
new situation" (p. 435). Each family's unique paradigm is what determines the
magnitude of stress inherent in the event and how the family will respond to the
change. It is the paradigm that determines whether a family life change is
perceived as a major stressor or a minor challenge.

The importance of family perception is not only emphasized in relation to life
change events as stressors; its significance is also stressed in the relation to family
closeness. Boss (1988) states, "The family's perception of who is inside or outside
the family system is significantly related to the interaction within the system as well
as between that system and the outside world" (p.445). Olson et al. (1983) also
emphasize the importance of assessing the family's perception of closeness. These
authors also hypothesize that "Couples and families will function most adequately
if there is a high level of congruence between the perceived and ideal descriptions
[of cohesion and adaptability] for all family members" (p.74). Kanoy,
Cunningham, White, and Adams (1984) completed a study which examined the
interrelationships between patterns of family interaction and individual well-being
and found that "In general, mothers' perceptions of self and family relationships

were predictive of children's self-concept, perception of parents' behaviors, and

15

perceptions of family relationships" (p. 97). They emphasize the importance of
understanding family life change (especially boundary changes associated with the
addition or loss of a member) as a time of redefinition and focusing on the process
of family interaction rather than on family Structure. Kanoy et al.'s (1984) findings
synthesize the multiple aspects of family perception when a family system is
experiencing a major life change. It is the perception, not only of the change that
matters but, of how the major life change affects their family's interactions.

The main focus of perception in this study was to determine the pregnant
woman's perception of family closeness. The family's perception influences and is
incorporated into what was reported as "major" life changes. The pregnant
women's perspective of family closeness and major life changes was examined
since it is typically representative of the family system's perceptions of these
concepts (Kanoy et al., 1984). In addition, most of the contact with the health
care provider is with the pregnant women for prenatal care during the
developmental transition of a pregnancy of a subsequent child into the existing
family system.

I] . l E 1

WWW. Roy's Adaptation Model (RAM) (see Figure 1)
focuses on environmental stimuli that influence the adaptive system's responses in
four modes: physiological, self concept, role formation, and interdependence (the
four interlocking rings in the center of Figure l). The adaptive system may be an
individual, a family, or other group. The circle outlined in bold print represents the .
boundary of the adaptive family system. All types of adaptive systems have internal
control and feedback processes to regulate input and output (illustrated by the
arrows entering and exiting the adaptive system in Figure 1). The first two steps
of the nursing process are assessment of these inputs and outputs. "The inputs for

the family as an adaptive system include the entire complex of stimuli that affect

 

16

the family as a group, both internal to each person and those coming from the
external environment" (Whall & Fawcett, 1991, p. 22). Alteration in one mode of
adaptation can act as an input to the other modes of adaptation (i.e.,
developmental tasks of the members of the family system). For family adaptive
systems, the output behavior of survival is equated with the physiologic mode, the
output of continuity with the role function mode, the output of growth with the
self-concept mode, and the output of transaction patterns (behaviors which
directed at mutually determined goal attainment) in the interdependence mode

(W hall & Fawcett, 1991).

Another word for inputs into the adaptive system, or family, is stimuli (step 2
of the nursing process illustrated in Figure 1). Roy (1991) defines stimuli as that
which provokes a response. Roy elaborates, "Stimuli can be internal or external
and influences surrounding and/or affecting the development and behavior of the
person [or family]. A collective term for all internal and external stimuli is
environment" (p. 33). Stimuli are delineated into three categories. "The focal
stimulus has been defined as the internal or external stimulus most immediately
confronting the person [or family]" (p. 34). The second category of stimuli is that
of contextual stimuli or "all other internal or external stimuli evident in the
situation" (p. 34). Roy also mentions the importance of consideration of factors
related to the developmental stage of the family when assessing possible contextual
stimuli affecting adaptation. The third category of stimuli described by Roy is that
of residual stimuli, which are "those stimuli having an undetermined effect on the
person's behavior" (Roy, 1991, p. 29). Nursing diagnoses are determined from
assessment of behavior related to stimuli (step 3 of the nursing process illustrated
in Figure 1).

Control processes of input and output within a system are described by Roy

(1991) as coping mechanisms (the solid center ring which intersects and unites the

 

l7

 

Figure l. The Roy Ada ration Model as it applies
to the family system ( oy. 1991. p.30).

18

four rings which represent the four adaptive modes in Figure l) which are "innate
or acquired ways or responding to the changing environment" (p.13). Inputs are
channelled into the regulator subsystem of the COping mechanisms which have a
role in the forming of perceptions. The other major subsystem of the coping
mechanisms is the cognator subsystem. "This subsystem responds through four
cognitive-emotive channels: perceptual/infonnation processing, learning,
judgement, and emotion. Perceptual/information processing includes the attitudes
of selective attention, coding and memory...through the person's [or family's]
emotions, defenses are used to seek relief from anxiety and to make affective
appraisal and attachments" (Roy, 1991, p. 14). According to Roy, the perceptions
the family members have about stimuli are a result of coping mechanisms and have
impact on adaptation in each of the four modes. The goal of nursing is to promote
adaptation by enhancing interaction of the family with their environment, thereby,
producing health. The goals for nursing interventions (steps 4 and 5 in of the
nursing process illustrated in Figure l) are mutually set with the family and are
focused at managing the stimuli to allow the family to maintain or make an
adaptive response (refer to the small arrow in the assessment step 1, which, after
evaluation, completes and re-initiates the feedback loop illustrated in Figure l).
IheRoxAdaptatmnMndeLasapplredrmhementsmdy. Within the
context of RAM, the goal of this study was to describe how each woman
cognitively copes or perceives the focal stimuli of the pregnancy of a subsequent
child (represented by the small arrow in Figure 2) into her family system (the dark
circle in Figure 2), any contextual stimuli or major life changes such as family
developmental tasks (the larger arrow in Figure 2), and her perception of any
differences in her family's closeness or adaptation in the interdependence mode (the
dark slashed inner circle in Figure 2) since pregnancy. The circle outlined in bold

print represents the family system, whether it be a remarried or a first married

19

family system. As mentioned previously, family systems are dynamic and regulate
their boundaries to allow for the transition of members in and out of their open
system.

For this reason the model applies all types of families with all types of various
stuctures. The interdependence mode is the adaptive mode of primary interest in
this study for several reasons (refer to the dark slashed inner circle in Figure 2).
First, the interdependence mode can be equated to family closeness when the
adaptive system of interest is a family. "Interdependence is defined as the close
relationships of people" (Roy, 1991, p. 386). The purpose of these relationships
is to achieve affectional adequacy through in depth interactions with other persons
in mutually satisfying relationships, thus the formation of families. "Affectional
adequacy is the feeling of security in nurturing relationships...These relationships
involve the willingness and ability to love, respect, and value others and to accept
and respond to love respect, and value given by others" (Roy, 1991, p. 386-387).
The first nurturing relationship an individual develops during infancy is with the
people in his/her family, usually their parents and siblings.

"The quest for affectional adequacy is part of today's culture. Intact families
try to Spend time together, divorced people remarry, social groups for young and
old proliferate" (Roy, 1991, p. 390). This quest for affectional adequacy may
partially explain why people in today's society are less willing to stay in a
relationship where their affectional needs are not being met, even at great costs,
and explain the rising rates of divorce and remarriage; this is the second reason for
focusing on the interdependence mode. Another rationale for focusing on the
interdependence mode is that "People who are ill or in a state of change usually
experience an increased need for love, respect, and affirmation" (Roy, 1991, p.

392). The subjects in this study all share the common experience of the pregnancy

 

20

   

murmur 511.1111:
“.10! UP! (11111655
-IIIEXPECI'ED EVENTS
~0MLOPIENTA1. TASKS

Figure 2. The Roy Adaptation Model as it applies
to the present study (Roy, 1991. p.30).

 

21

of a subsequent child and, therefore, according to RAM the subjects are all
inherently in a state of change which augments their affectional needs.

Roy emphasizes the importance of assessing an adaptive system's perception
because the cognator subsytem gives meaning to events and influences adaptation,
and therefore, has more importance than an external view of a family's closeness.
What may appear as weak and problematic interdependence for one family may
actually be beneficial and adaptive for their perception of their circumstances. For
this reason, this study focused on how the women cognitively coped or perceived
the stimuli in their family's environment and how they perceived their family's
interdependence, or closeness.

Roy delineates seven stimuli that are most important when assessing in the

interdependence mode:

(1) expectations of the relationship and awareness of needs, (2)
nurturing ability of both persons, (3) level of self-esteem, (4) level
and kinds of interactional skills, (5) presence of the other in the
physical environment, (6) knowledge about friendships and
relationships, and (7) developmental age and tasks (Roy, 1991, p.
395).

These stimuli can be grouped into three categories-stimuli inherent in the
environment, stimuli inherent in the people in the relationships based on past
experiences, and lastly, Stimuli which the people determine throughout their
interactions.

Stimuli in the environment include the fifth and seventh stimuli identified by
Roy. The fifth stimuli, "presence of the other person in the physical environment"
(Roy, 1991, p. 395) includes the amount of contact and physical proximity of the
persons in the relationship. Frequent contact facilitates the development of
attachment and maintenance of any relationship. For example, custody and

visitation arrangements may have significant impact on remarried family affectional

 

22

adequacy. The other stimuli inherent in the environment is that of
"developmental age or developmental tasks or crisis" (Roy, 1991, p. 397).
Theories of human and family development (i.e., Erickson, 1963; and Duvall,l977)
are particularly relevant to understanding how interdependence behavior develops
and what tasks or changes a family may be facing.

Three of the stimuli identified by Roy are ones that the people bring with them
to the relationship based on their past experiences. The first is "nurturing ability of
other persons" (Roy, 1991, p. 395). Past experiences and quality of past A
relationships and amount of physical energy influence a person's present ability to
provide growth-producing care and attention. The second stimuli inherent in the
individuals is level of self-esteem " is a basic contextual factor for the person to
handle the circumstances in life in which the opportunities for receiving love,
value, and respect change" (Roy, 1991, p. 396) for example, in divorce. The last
stimuli inherent in the individuals is the stimuli of "knowledge about friendship and
how to build or maintain a relationship" (Roy, 1991, p. 397). Activities of
significance here include priority of the relationships, expression of affection,
communication, space for autonomy, affinnation, and acceptance of each other's
episodes of anger and short comings.

The third and final category includes the other two stimuli which are
determined by the individuals' current interactions and can be modified. The first in
this category is "expectations of the relationship and awareness of needs" (Roy,
1991, p. 395). This encompasses how the people in the relationship expect each
other to express affection (i.e., physical proximity, spending time together, physical
contact), how much self awareness they have of their own needs, and how well
they communicate these expectations to one another. The other stimuli in this

grouping is "the level and type of interactional skills" (Roy, 1991, p. 396), such as

23

open communication and sensitivity to other's verbal and nonverbal behavior. Roy
believes interactional skills can be learned.

Because all the women were in the third trimester of the pregnancy of a
subsequent child and this was the stimuli of interest, it was considered to be the
focal stimulus. How the women were cognitively coping or perceiving any
contextual stimuli was also assessed because there may be other changes occurring
which may also have increased their affectional needs. Contextual stimuli of any
major life change, such as family developmental tasks, in the year prior was
explored and described. Since the effect of the third and final category of stimuli,
residual stimuli, cannot be validated, it was not described in this study.

Clearer understanding of women's perceptions of the focal and contextual
stimuli they were facing, as well as a clearer understanding of their perception of
family closeness or interdepence mode functioning will enable family nurse
practitioners to assist families as clients to learn to elicit the nurturing each
individual member needs and to reciprocate love and caring for improved quality
of life. Better understanding of the Roy Adaptation Model as it applies to families
as adaptive systems will also enhance the discipline's body of knowledge for future
research and clinical practice.

The majority of the literature on the women's perception of the impact of
pregnancy and other major life changes on their family's closeness is fragmented,
with most researchers looking at one of these concepts at a time rather that the
whole picture. For this reason, this section was subdivided into three sections
according to concept clusters in the existing literature: the impact of pregnancy on
family closeness, the affectional functioning of different family forrrrs, and the

impact of a subsequent or mutual child on family is closeness.

 

24

W. The majority of
research looking at the impact of pregnancy on family closeness has focused on the
pregnancy and birth of a first child in first-married families. Mercer et al. (1988)
found that stressors during pregnancy, such as obstetric risks and unexpected
events, have a negative effect on interpersonal and family relationships. However,
when uncomplicated (low risk) pregnancy of a first child was the only variable

studied, Shereshefsky and Yarrow (1973) found that pregnancy of a first child

 

enriched the interpersonal relationship between the family members (the husband

 

and wife). The majority of the studies focus on the transition to parenthood and

indicate a negative relationship between spousal perceptions of family closeness E
and the birth of the first child (Belsky, Lang, & Rovine, 1985; Belsky, Spanier &

Rovine, 1983; Cowan et al., 1985; Harriman, 1983; Miller & Sollie, 1980).

Although a significant decline in quality of family interactions has been

documented by most researchers, it is important to note that the change is of a

relatively small magnitude (Cowan & Cowan, 1988).

The majority of these studies which report a negative impact on family
closeness with the birth of the first child were all short term studies (at maximum,
looking at periods of several months). A longitudinal study by Grossman, Eichler,
and Wienickoff (1980) found that although perceptions of family closeness did
decline initially, by one year after birth, parents' perceptions returned to previous
levels of satisfaction. A study which spanned many stages of family development
found that on average, perceptions of family closeness are higher early in the
marriage, they decline when the first child is born, and they improve again later
when the children mature into young adults and begin to leave the home
(Anderson, Russell, & Schumm, 1988).

There are only a few studies which actually focus on the pregnancy of a

subsequent child. Tomlinson, White and Wilson (1990) concluded that positive

25

family interactions may better be explained by availability of resources, previous
coping experiences, and societal approval of their family form than by whether it
was a first or subsequent pregnancy. Hall, Wulff, and Wilson ( 1994) determined
from their research that second-time parents do not require less support than first-
time parents, but a different type of support. Both studies suggest that the
pregnancy of a subsequent child may be equally as great a stressor as the
pregnancy of a first child on a family system because it necessitates equal amounts
but different types of changes in family boundaries and interactions and, therefore,
family closeness.

An overall analysis of the childbearing literature reviewed which looked at
family closeness suggests a curvilinear relationship between perceptions of family
closeness and developmental transitions. As suggested by Beavers and Voeller
(1983) and Olson et al. (1983), different degrees of family closeness are more
suitable for different developmental tasks. In accordance with RAM, each of these
major developmental events require the family system to reorganize and
accommodate change in the interdependence model by renegotiating system and
subsystem boundaries, the interpersonal hierarchies of power, and the degree of
emotional closeness in the interpersonal relationships. The childbearing literature
reviewed suggests that in the earliest stage of family development, the couple is
very close. When the first child is bom the couple must loosen their boundaries to
make room for the addition of a new member and are less close. After a year the
family has adapted and regained its initial degree of family closeness.

Eamrlxclosmcssmmmamediamrhcs. The predominant attitude in the
remarried family literature has been that remanied families by the nature of their
more complex network of extended family member relationships are inherently
different from first married families. Because remarried families are presumed to be

so different, it is also presumed that a different theoretical model for research and

26

clinical practice may be required for use with remarried families. The majority of
the research which compares the degree of remarried family closeness to that of
fust married families does show that remanied families are significantly less close
than fust married families (Pill, 1990; Pink & Wampler, 1985 ; Waldren, Bell, Peek
& Sorell,1990). What is mentioned in only one of these studies is that the
magnitude of the differences in family closeness is very small (W aldren et al.,
1990). In the past, many clinicians speculated that emotional closeness was less
important to remarried family happiness. Pill's (1990) research disputes this and
shows that remarried families desire similar levels of cohesion to that of first
married families. Remarried families made continuous and deliberate effort to
spend time as a family (similar to first married families in the early stage of family
formation) and when unable to achieve greater closeness, they changed their
perceptions and derived pleasure from looser family boundaries (Pill, 1990).

Few studies have to this point attempted to determine what causes the lower
levels of family closeness in remarried families. Crosbie-Bumett (1984) attributes
the difference to unwanted nurturant behaviors on the part of the step-parent and
concludes that the cornerstone to achieving adaptive levels of family closeness is
the Step-relationship. Kurdeck (1989) found that the presence of Step children had
a weak, but positive, effect on marital satisfaction when other factors were
controlled. Therefore, the step-relationship was shown not to be the most
significant cause for varying degrees of family closeness. Waldren et al. (1990)
added the variable of major life changes, or family stress, to the analysis of
differences between the degree of family closeness in the two family forms. They
determined that the patterns of relationships between family stress and family
closeness were similar for the two family types. Pill's (1990) research showed that
major life events, both positive and negative, contributed to the development of

family closeness in remarried families. Waldren et al.'s (1990) overall conclusion

27

(which was the opposite of other literature which did not look at stress and its
relationship with family closeness) was that in spite of stepfamily member needs to
maintain ties with noncustodial parents and others, higher rather than lower
cohesion may be more important to stepfamilies than to intact [first married]
families.

Impactnfamumalfihrldmmmamedfamrlxdoseness. There are many
clinicians who have made assertions about the impact of a mutual child on
remarried family functioning, but there are only six research studies which
incorporate the impact of a mutual child on remarried family closeness as part of
their focus (Duberrnan, 1973; Albrecht, 1979; White & Booth, 1985; Ambert,
1986; Ganong & Coleman,1988; Omar, 1989; Kelley, 1992). There is only one
study which looks at the impact of the pregnancy of a subsequent child as the
main purpose of the study (Omar, 1989). Like the literature on remanied family
closeness, the findings from these studies have conflicting findings. Some report a
positive effect (Dubennan, 1973; Kelley, 1992), one a negative effect (White &
Booth, 1985), one no effect (Ganong & Coleman, 1988), and others which show a
positive and negative effect based on gender perception (Albrecht, 1979; Ambert,
1986; Omar 1989).

Two studies report a wholly favorable and statistically significant impact of a
mutual child on remarried family closeness. The first was completed by Duberrnan
(1973). The purpose of that research was to study step-kin relationships,
especially between sibling and stepparent/stepchildren. Dubennan found that of
those remarried families who had a child together, the percentage of couples who
reported on excellent relationship between step-kin was 78 percent compared with
53 percent of those who did not have children together. Kelley (1992) obtained
similar results in terms of better family functioning in those families with mutual

children. Kelley further analyzed the differences between remarried families with

28

mutual children, those without mutual children, and those seeking counselling for
problems with family interactions and discovered that the families with mutual
children and those not currently in treatment had been married for longer periods
of time.

The opposite impact of a mutual child was determined by White and Booth
(1985). Although they did find that mutual children did help lessen these positive
attitudes to divorce in first married families, they found this was not the case in
single or double remarriages. Mutual children in remanied families with
stepchildren residing with them were actually associated with decreased
satisfaction with family closeness and with increased positive attitudes towards
divorce. Although attitudes toward divorce is not an exact measure of family
closeness, it can be inferred that if all the family members' needs for emotional
bonding were being met, that they would not desire a divorce.

The findings of Albrecht (1979) and Ambert (1986) both indicate that there is
a gender effect relative to the perceived impact of having a child together. In both
studies a mutual child was perceived as having a positive impact on the degree of
family emotional closeness by the men while the women perceived a decreased
quality of family interactions and family closeness.

Ganong and Coleman (1988) collected qualitative data as well as quantitative
data on the effect of the presence of a mutual child on marital adjustment, step-
and parent—child relations, and stepfamily closeness. The descriptive data collected
from the parents and stepparents indicate that approximately a fifth of both the
stepparents and the parents felt that the birth of a mutual child made them feel
closer to the older children in the family. The quantitative data did not support this
finding. From analysis of control variables, Ganong and Coleman (1988) suggest
that any effects of a mutual child are likely to be related to motivations and

influences prior to the pregnancy such as the number of children in the home,

29

income, age, feelings of obligation to their spouse, and wanting to have a child
together with their partner.

Only one study focused on the impact of the a pregnancy of a subsequent or
mutual child. This study by Omar (1989) was based on the quantitative data
collected concumently with the qualitative data for analysis in the present study.
The gender effect found by Omar during pregnancy is the opposite of that found in
the studies conducted after the birth of a mutual child: first married and remarried
family wives both viewed their families as more cohesive and together than did
their husbands (Dietz-Omar, 1991). Family closeness was slightly greater in first
married families for both spouses when compared to remarried spouses, but these
differences by family type were not significant The only significant difference
between the two family types was in the type of coping strategies they preferred.
Omar (1989) found stepfamilies were more satisfied with more internal family
coping strategies (verses external support) than their first married family
counterparts. This could in part be due to their attempts to establish themselves as
a family through developing greater emotional closeness between members. Thus,
like Pill (1990), Dietz-Omar (1991) concludes that remarried families having a
mutual child are most likely to still be in the early stages of family formation and
desire greater emotional closeness, similar to first married families in the early
stages of development when they are having their first mutual child.

Overall, Omar's (1989, 1991) results indicate that first married families and
remarried families are more alike than different The two types of families perceive
and desire higher levels of emotional closeness in their families. The gender effect
for both family types is the same, with the woman having a more optimistic
outlook The small difference in degree of family closeness may be due to the fact
that first married families had been together longer and achieved a higher level of

development than remarried families rather than to expecting a mutual child. First

30

married families may have already "developed and established satisfactory bonding,
boundaries, roles, and rules from managing prior family life experiences together"
(Omar, 1989, p. 119). Thus, these findings indicate that multiple other factors,
such as major life changes, can influence the perceived impact of the pregnancy of
a subsequent child.

Cnticalevaluationgflheliteramze. To determine if length of time since
family formation, or marriage, and the number of major life changes managed
together by a family, and the pregnancy of a mutual child are significant factors in
the development of family closeness, more research must be done. The studies
reviewed differ in sample size, appropriate control or comparison groups, length of
the study, measurement instruments and whether they controlled for variables
other than family type and having a mutual child. These differences may account
for the conflicting findings and conclusions.

As discussed earlier, Pill (1990) reported that shared life experiences increase
family closeness in remarried families. This is the one weak area in Omar's (1989)
study, other factors (major life changes) which may influence the degree of family
closeness were not included in the quantitative analysis. Omar's (1989) study is
the only one which looks at the impact of expecting a subsequent or mutual child.
This highlights the biggest gap in the literature-the difference of expecting and
actually introducing a mutual child into the home. The literature on pregnancy
strongly indicates that pregnancy (whether it is the first, second, third, or fourth) is
a major family life event and worthy of considerable attention, yet only the one
study exists on the topic in remarried families.

Omar's (1989) study may lack the conceptual piece about the type and number
of major life changes experienced by families, but unlike many of the studies which
lack appropriate comparison groups, sample sizes, and/standardized tools of

measurement, the study is empirically sound. Both qualitative and quantitative

31

data were collected (although only the quantitative data was analyzed at that time)
from 40 first married families and 40 remanied families. Standardized instruments
(F-COPES, FACES TH, and the FLSS) were utilized to measure the concepts of
interest

Ganong and Coleman's (1988) study is one of the studies conceptually
focused on after the birth of the mutual child, but which is also empirically quite
sound. This study did not support any differences in family closeness between
family forms, and was also one of the few studies to control for other variables
which may influence quality of family interactions, in this case the importance of
influences on the emotional relationship between members before the pregnancy.
The study was adequately large (106 remarried families) and an equally large .
comparison group of first married families was utilized. Both qualitative and
quantitative data were collected. A widely accepted standardized instrument for
measuring positive affect in relationships (IFF) was used to collect data on family
closeness.

Albrecht (1979) obtained a significantly large random sample (369 remarried
subjects). The major weakness of this study was that it did not use standardized
measures to obtain the data. Ambert's (1986) study was not actually large enough
for significant quantitative data to be reported on the different types of families--
only 25 couples had remanied, were stepparents, and had at least one child
together. This study also did not use established, standardized, reliable measures.
These studies are of interest conceptually because they contribute to the variance
in perception of the impact of having a mutual child in remarried families which is
dependent on the gender of subjects.

White and Booth's (1985) study also obtained a large random sample of
remarried subjects and a control group of first married subjects. The study was

longitudinal (subjects were interviewed at two points in time three years apart),

32

therefore, it captured a larger picture how mutual children are associated with
decreased satisfaction with family closeness over time. The importance of time
frame is demonstrated by the curvilinear relationship between perception of
satisfaction with family closeness and developmental transitions in the first family
childbearing literature. The weakness of White and Booth's (1985) research is that
no data was collected on the relationship of children in the home, children were
coded as being stepchildren if they were older than the respondent's current
marriage. The researchers also report quantitative statistical results but do not
mention the use of any standarized measurement instruments for questioning the
respondents.

Duberrnan (1973) made an early attempt to determine if mutual children had a
favorable impact on remarried family closeness and analyzed a random sample of
88 subjects obtained from reviewing marriage licenses from 1965 to 1968. This
study reported a statistically significant, positive impact of mutual children, These
results must be questioned due to the lack of a standardized measurement tool for
family affect

Kelley's (1979) exploratory research is insightful about the coexisting
relationship of length of marriage and mutual children to increased remanied
family closeness, but not generalizable to the population because out of the small
sample of six remarried families with a mutual child. Also, there was no "normal"
comparison group. Well functioning remarried families were compared to six
families who were in treatment for family problems.

The problems found in the study designs and methodologies are problems
which are commonly cited when discussing the difficulties in researching remarried
families. It is difficult to obtain samples of sufficient quantity to report significant
quantitative results. Even when large samples are obtained, it seems the studies

are lacking in the areas of reliable, standardized measurement instruments, for

33

appropriate comparison groups, or in the area of possible covariates. A possible
explanation for the conceptual gaps in the remarried family literature is the lack of
descriptive studies and the small sample size of the few studies which have been
done. Without descriptive data to identify possible covariates and influencing
factors of the perceived impact of the pregnancy of a subsequent child in first
married and remanied families, doing large scale quantitative studies may be
causing researchers to leap to erroneous conclusions influenced by societal biases.

Qualitative, exploratory research on substantial numbers of first married and
remarried families must be done to determine not only how expecting a subsequent
or mutual child impacts families perception of their emotional closeness, but to
determine what other concurrent factors may also impact this affective area of
family functioning. To prevent insignificant sample sizes of remanied families
expecting a mutual child and to ensure an appropriate comparison group, quota
sampling rather than random sampling is more appropriate. The only way to
answer the question of whether remarried families are more similar to first married
families expecting their first mutual child is by doing more descriptive research.
Descriptive analysis of multiple remanied families is necessary to determine if
remarried families really are different, or at higher risk for maladaptive family
closeness, than first married families and to determine what factors, if any
contribute to this higher risk. This information is necessary for earlier assessment
and intervention to occur with these families during the prenatal period before the
child is born to promote optimal affective functioning for each family as a whole
and thereby, promoting optimal growth and development of each individual family
member.

This study used quota sampling to ensure adequate representation of both
remarried and first married family types. It will explore and describe women's

perceptions of any major life changes in the last year and attempt to determine any

34

similarities and/or differences between remanied families and first married families,
and any similarities and/or differences in women's perception of family closeness in
first married and remarried families.
METHODS
Win

This study was a secondary data analysis of the qualitative data collected as
part of a larger quantitative study (Omar, 1989). For this part of the study, a
qualitative design using semi-structured interview questionnaire was used to
collect data at one point in time.

Sample

The sample included the women from the 40 remarried and 40 first-married
families originally recruited and interviewed in 1989 as part of the larger study by
Omar (see Appendix A for a copy of the original study's sample selection criteria).
Although the original study did collect qualitative and quantitative from both the
men and the women, the present study used only the interview data from the
women.

I] . l I: E . .

The first variable/concept of interest, "major life changes" was
operationalized by identifying themes in the text from the women's responses to
the original interview question, "Within the last year, have any major changes
occurred in your life?" The other major concept/variable, "family closeness" was
operationalized by looking for themes in the text from the women's responses to
the original interview question, "Have you noticed any difference in your family's
closeness since this pregnancy?"

ProcednteEOLDataAnalysis
This study focused on a small portion of the data collected as part of a larger

study by Omar (1989). A semi-structured questionnaire consisting of eleven broad

35

open-ended questions was the instrument used by the principal investigator of the
original larger study to interview one spouse (see Appendix B for a copy of the
original interview process and interview questions) while the other spouse
completed the self administered quantitative questionnaires. Data collection
occurred in the subjects' homes (see Appendix C for a copy of the original data
collection and management procedures). The responses to the interview
questionnaire were already transcribed into text and prepared for the computer
program, the Ethnograph (Siedel, Friese & Leonard, 1995), for data management.
The present study consisted of a content analysis of the women's responses to two
of open-ended interview questions. Trends in similarities and differences between
and among cases were then described SO that tentative hypotheses could be
formulated for further study.

Based on the literature review, themes related to family emotional bonding,
affectional function, commitment to the family as a whole, working together to
solve problems, and to meeting one another's affectional needs of nurturing, love,
respect, and unconditional acceptance were sought in the text excerpts from the
responses to the first question on family closeness. Answers to the question of
whether women from remarried families use similar language to describe
differences in their families' closeness were sought by comparing the responses of
women from the different family types.

The literature review on major life changes served as a basis for determining
themes from the text of the women's responses to the second interview question,
"Have you experienced any major life changes in the last the last year?"
Responses of the women from the two different family types were compared in
attempt to answer the research question of whether remarried and first married
families believed to be at similar stages of family development experienced similar

types and numbers of major life changes. The women's responses from the two

36

family types were also compared to determine if women from remarried families
perceived major life changes similarly to how women from first-married families
perceived similar events.

E 1.1.]. lllll'

Reliability that each category or theme of the content analysis was mutually
exclusive was established by checking for agreement between two or more of the
researchers involved in the study analyzing this data set. The current researcher
did the initial coding then, a random sample of the data was analyzed by two
members of the current researcher's thesis committee, Rachel Schiffman and
Mildred Omar. Face validity, or the extent to which each category or theme found
in the content analysis looked as if it represented the theme or concept on which it
was based, was established by explaining where these categories came from based
on the literature reviewed. Each category or theme found was explained as to why
it fit the Roy Adaptation Model and was supported by the apparent relevance of
the themes to the research questions. Each theme was coded and frequencies of
the codes were tabulated to provide a better description of the sample
characteristics.

E . EH S l .

The proposal was reviewed by the University Committee on Research
Involving Human Subjects of Michigan State University (see Appendix D for
UCRIHS approval for the current study). Several strategies were utilized to
protect the rights of the women who agreed to participate in this study. First, the
original study was approved by UCRIHS and no physical, psychological, social,
legal, or economic risks were identified for subjects participating in the study.
Second, the interview questions were already asked by another member of the
research team, and were already organized and coded by subject identification

numbers so the current researcher had no contact with the subjects or had access

37

to their names, addresses, or any other information which could inadvertently lead
\to the identification of any of the subjects.
Assnmpfions

It was assumed that the subjects actually met the sample requirements
outlined in the original study. It was assumed that the original investigator asked
each subject the same questions in a non-leading manner. It was assumed that the
subjects answered the interview questions honestly and their responses accurately
depicted their true feelings. It was assumed that the original investigator and
collector of the data took accurate notes during the interview process and that
these notes were accurately transcribed into text.

The present study only looked at the women's perceptions. The men's and
children's perceptions may differ from the women's perceptions. Convenience
sampling includes the risk of self-selection bias. Most families in the sample were
Caucasian, middle-class, and well-educated, therefore, the findings can only be
generalized to this population. The study looked only at women's perceptions at
one point in time. Perceptions may change from day to day, or over a period of
years.

FINDINGS

The group of women from first married families and the group of women from
remanied families shared many similarities, as well as differences. These
differences and similarities are presented in three sections: findings related to
demographics; findings related to perceptions of major life changes experienced in
the last year; and findings related to perceptions of family closeness.

The original investigator did not realize that the topic of major life changes
was going to be an area of interest for this exploratory study until after several

interviews. The cases for which this question was not asked, were excluded from

38

the current study. There were several other cases for which only the demographic
and quantitative data were obtained and the qualitative interview questions were
not asked. This left 29 women from first married families and 35 women from
remarried families who were ultimately included in the present study.

The women from the two family types shared many demographic
similarities. It is known from the original sample and data collection that, "Both
groups were predominantly Caucasian, Protestant, middle class, well-educated,
with one to two children in the household" (Dietz-Omar, 1991, p.7). Although the
average age of the women from both groups was the same (30 years; the range for
remanied women was 19-39 years and 21-36 years for first married women) and
both family types were expecting the birth of a subsequent child into their family
system, there were other major developmental differences between the two family
types. Developmental age and tasks are one of the stimuli Roy identified as
important for assessment of the interdependence mode.

The couples from first married families had been married longer, an average of
6.5 years (range: 2-12 years), while the remarried family couples had been manied
for an average of only 1.4 years (range: 4 months to 3 years). Remanied families
could then be considered to be in the early stages of family formation. The first
married families could be considered to be established as families based on the
average years of marriage.

There were some interesting developmental differences between first married
families and remarried families when family developmental stages were based on
the developmental stages of the children (see Table 1). Almost all of the first
married families were in the preschool developmental stage. The remarried
families were more likely to have older children and be in multiple developmental

stages at the same time. For example, several remarried families had children in

39

school and adolescent developmental stages, were recently married, and would
soon have an infant which would place them in four of the traditional stages of
family development at one time.

On average, remarried families experienced a greater number of major life
changes in the last year than first manied families (see Figures 3 & 4) and, thus,
had more contextual stimuli confronting them during equal periods of time.
Remarried families not only experienced more changes, in some cases they
experienced different types of major life changes (types of changes will be
discussed later). These contextual stressors, or types of major life changes, were
categorized based on the main categories in the Family Inventory of Life Events
(FILE) (McCubbin & Patterson, 1987). Because of the open-ended nature of the
responses, some text had possible implications for multiple categories. To avoid
making any false inferences, codes for major life changes were tabulated based
only on women's perception, or exact responses (for example if a woman said she
had remarried in the last year, but did not mention the addition of a new immediate
family member, the change was tabulated only for getting married),
therefore, some categories may be falsely under-represented. The nine categories
of change identified were: (1) no major life changes, (2) work transitions and
strains, (3) financial strains and changes, (4) legal problems or changes, (5) family
membership transitions, (6) illness/dependency changes, (7) marital changes, (8)
childbearing changes, and (9) intra-family interactional changes (see Tables 2- 10).

There were several areas where the women from the two family types
perceived strikingly different types of major life changes. The first area was that of
no changes. The women from first married families were more likely to have
perceived no major life changes (see Table 2). The second area of interest,

moving, is one where the perceived changes could have implications for other

 

Frequencies of first married families
0 .— N u uh U! or \I on

01234 5 6 7 8 910
Number of Major Life Changes

Figure 3. Frequencies of first married families who experienced the
various quant ties of major life changes in a year's time.

"(HID = 5

 

o—Nubmmqmm

Frequencies of remarried families

0 i 234 5 6 7 8 9101112
Number of Major Life Changes in the Last Year

Figure 4. Frequencies of remarried families who experienced the
various quantities of major life changes in a year's time.

41

areas of the families' lives, or other change categories. Lastly, moving was
perceived as a major change by 37% of the women from remarried families yet,
only approximately 10% perceived buying or selling a house as a major change.
For this reason, the financial change category may be under represented (see
Tables 3 & 4). The women from first married families perceived changes in their
husband's work more frequently than women from remarried families, and
remarried families moved more frequently than first married families, but
otherwise, the pattern of perceived work transitions and strains by family types
was fairly similar (see Table 3).

There were differences in both the number and the type of financial changes
experienced by the women from the different family types (see Table 4). Women
from remarried families perceived more financial changes than women from first
married families in all three categories. Women from remarried families perceived
financial changes related to the merging of the couple's individual financial
responsibilities and in some cases related to child support and the splitting of the
former couples' finances. The financial change category is another category of
change which may be under-represented because women from both family types
mentioned changes in the work category, which most likely impacted family
finances as well, but they did not always mention a financial change.

Legal problems were perceived to be a major life change by 11% of the
women from remarried families and by none from first married families. All of
these legal changes, except the example in Table 5, were related to court battles
with ex-spouses over issues such as child support and custody.

As mentioned earlier, many more women from remanied families mentioned
maniage in the last year than mentioned gaining a new family member, therefore,
although Table 6 does not show this difference between the family types, women

from remanied families experienced more changes in the composition of their

42

immediate families. Women from first married perceived changes in the
composition of their extended family as major life changes more often than
women from remarried families (see Table 6).

Women from first manied families were more likely to perceive changes in the
health of extended family member as a major life change. Women from remarried
families perceived changes in childcare as major life changes slightly more often
than women from first manied families. The rest of the patterns of perceived
illness/dependency changes were similar for the two family types (see Table 7).

All the women who perceived major life changes related to marital status were
from remarried families. This is related to the differences in the time the couples
from the different family types had been manied. All the first married
families had been manied long enough to have one child in the home and be
expecting a subsequent child, therefore, could not have possible experienced any
marital changes in the last year (see Table 8).

Even though all the subjects in the study were expecting a subsequent child, it
appears that the remarried families were also more likely to have more childbearing
changes occurring (see Table 9). For example, a greater percentage of remanied
families were experiencing an unplanned pregnancy. This information was obtained
from the demographic section of the interview text in response to a direct
question. None of the women mentioned whether the pregnancy was planned or
unplanned in response to the major life change question, most likely due to the
sequence of the questioning. Many of the women mentioned " getting pregnant"
knowing that the investigators already knew whether or not the pregnancy was
planned. Also, for almost a quarter of the women from remarried families, the
current pregnancy was their first pregnancy experience.

Although, miscarriages are an additional unexpected major life change and a

cause of great sorrow, it appears that women were able to perceive some beneficial

43

aspects of this change. This is one women's perception, "The miscarriages have
brought us closer this pregnancy. We're nervous, it's really brought us closer as
time passes by ..... going through so much together, a stronger bond helps get us
through the rough spots" (woman from a remarried family). This example also
illustrates an intra-family relationship change, the shared experiences of the
spontaneous abortion brought the couple closer together. Table 10 shows that
remarried families experienced more changes in their intra-family relationships.

As Roy identified in the seven stimuli important for assessment of the
interdependence mode, the importance of assessing the developmental stages of
the family and it's individual members is demonstrated by the fact that many of the
responses which fell into this intra-family relations category frequently included
some aspect of developmental tasks, especially when referring to difficulty
managing children. It appears that the older school age children were often
perceived as having a more difficult time adjusting to a new step-parent or family
situation, or that they objected in a more outwardly way with behavior changes
and vocal outbursts.

An unexpected area of similarity was that while a quarter of the remarried
women were experiencing a first pregnancy they perceived difficulty managing
children as a major life change at a rate similar to that of the women from first
married families. This could be due to the sequence of the interview questions.
Many women had already discussed family interaction issues in response to
previously asked questions in the interview schedule.

Almost all of the women from both groups began their response with some
statement affirming that their family was close whether or not they went on to
discuss problems or adjustment areas related to their family's closeness. From this,

it could be considered that all the women desired family closeness. After affirming

that their family was close, a third of the women from both groups went on to
make a direct reply to the question of whether they had noticed any difference in
their farrrilies' closeness since the pregnancy (i.e., it brought them closer, it was
disruptive, or it did not affect closeness). The remainder of the text responses to
the interview question " Have you noticed any differences in your family's
closeness since this pregnancy?" were extremely varied in what aspects of
closeness women chose to comment The two main themes which emerged were
classified as factors which positively or negatively affected family closeness. The
findings regarding each of these types of responses are presented.
There were some negative areas of family closeness, or areas of adjustment, which
were unique to remarried families; these findings are presented separately.
closeness. There were basically no differences in the number of women from the
different family type groups who perceived increased family closeness, or who
perceived that their family's closeness was unchanged since the pregnancy (see
Table 11). There were differences in how often women from the two family
types perceived a negative impact on family closeness and how often they discuss
areas of family closeness without relating them to the pregnancy (see Table 11).
Women from remarried families discussed other areas of family closeness
unrelated to the pregnancy more often than women from first married families.
The reason for this difference is unclear. It is possible that women from remarried
families are reluctant to mention that the pregnancy may be causing any problems
because they were working so hard to develop a sense of family closeness.
Another possibility is that they were too preoccupied with all the other major life
changes confronting them, to focus on the impact of the pregnancy. The following

is an example of a response which does not ever directly mention

45

any change/difference in family closeness Since the current pregnancy:

We are very close. We are growing up together and spending time
together. My husband and my stepson are very close. My husband
had to decide how much quantitatively he loved everybody; me as
an adult, his wife, and the child his son, and I love him so much and
he loves me. We all work out this love thing so there is no jealousy
on anybody's part. He [the stepson] feels his mom loves him more
than I do (his real mom), but he know his dad loves him...We just
sort of go with the flow and it's very comfortable between the
houses. We can have time with him and still have time alone. We
try organize and share our life. We do normal things. He goes to
sports even ifI am not with him. He goes to the games and we play
games and cards. I'm very close to my [step]son; he is to both of us.
Sometimes not sure where I fit in. Sometimes I felt like I was an
outsider, but not for long. Sometimes he does call me mom and
that's okay. Sometimes he can butter us both up and he knows very
well what buttons to push. We do things as a three family. He
does have two sets of parents and he fights for his rights when he
has to. We're as close as we can be. We share in parents scheduled
time. We sit down in a group and we talk and we work things out.
It does take a lot of effort. So far it has worked out well. His real
mom has just remarried also. As for as changes in the pregnancy,
it's a lot more to think about and a new person to relate to. My
husband is aware of the amount of work involved with having little
babies and he knows how to care and is willing to help and how
special it will be (36 year old woman from a remarried family,
experiencing her first pregnancy, time married is two and a half
years).

From this woman's response, it is obvious that this woman desires family closeness
and that the family has a lot of contextual stimuli to cope with at this time.

. .- ‘_. -.. 'uu... . ‘ .2 ..1 .H "I. 3'”; m. . ...l
The most noted aspect of family closeness by both groups of women was that of
spending time together as a family (see Table 12). This is a component of Roy's
"presence of other in the environment" stimulus important for assessment of the
interdependence mode (1991, p.397). It was mentioned by 58% of women from

first manied families and by 40% of women from remarried families. In general

what they did together was not included. This suggests that what they did

46

was not as important as the fact that they did spend time together as a family.
"Presence of other in the physical environment" (Roy, 1991, p. 397), or time
together as a family, appears to be of special importance when assessing the
interdependence mode of remanied families who may have members living in other
homes, children who have other parents, and visitation issues impacting their
development of family closeness. For example one woman from a remarried family
included this in her response to the family closeness question, "Well we're sort of
close to the three of us in the house-~the other two are not as close, we love them,
but they're not there...proximity certainly helps."

A second theme which women from first married families mentioned more
frequently than women from remarried families was that of spousal support (28%
compared to 3% ). Spousal support is a component of Roy's "expectations of the
relationship and awareness of needs" (1991, p.395) interdependence stimulus.
Comments such as the following, exemplify this Stimulus: "We've been close
always anyway, we know each other's moods," "My husband seems sensitive to my
needs...," and "my husband was always attentive and increased with this
pregnancy" (these comments were all made by women from first married families).
These examples demonstrate awareness of one's one needs, the ability to
communicate these needs to one's significant other so that they can be met

The first theme that repetitively occurred in the women from remarried
families' responses was that of a sense of family unity. The dictionary definition of
unity is "An arrangement of parts that will produce a single, harmonious effect,
...constancy or continuity of purpose, action, etc." (Guralnik,1974, p. 810).
Themes of constancy and stability and a feeling of belonging together as one were
mentioned by 17% of women fonrr remanied families, but by none of the women
from first married families. Affection was another factor mentioned by 17 % of

women from remarried families, but by none from first married families. Roy

47

believes that expression of affection is another activity of significance to the sixth
interdependence stimuli, "knowledge about friendships and relationships." This
example of the importance of affection is also excellent example of this stimulus, "I
was related to a family that wasn't too close...we weren't raised with hugs and
kisses. Wanted to bring that back and have my children know what that's like
(woman from a remanied family)"

A strong marital relationship or strong emotional bond between the spouses
was the third theme which reoccurred more in the remarried responses. This is
also component of Roy's sixth interdepence stimuli, "knowledge about friendships
and relationships" which is demonstrated by this woman's comment, "We
appreciate our togetherness which we didn't have in our previous marriages." The
fourth theme, which a greater proportion of women remarried families discussed,
was the importance of open communication for developing and maintaining family
closeness. Open communication is a major component of Roy's fourth
interdependence stimulus, interactional skills.

r1. ' - . e .r. re an: ..o III‘I e. .- '.re e .... ,.. .u
closeness. The areas of adjustment perceived by women from both farrrily types
were strikingly similar in regards to couple relations, family relations, and
biological parent-child relations (See Table 13). Women from first married
families discussed issues related to extended family relations, negative physical
changes and sibling adjustment more often than the women from remarried
families. Negative physical and emotional changes related to the pregnancy
appear to have a great impact on Roy's second interdepence mode stimulus,
nurturing ability. An example of how these changes can affect nurturing ability
is, "I have been so tired and have more of a temper and I have less tolerance with

the kids" (woman from a first married family).

48

One fifth of the women from remarried families perceived concerns about
sibling adjustment to the expectant child as important to family closeness
compared to only 6% of the women from remarried families. First married women
were also more likely to be concerned with extended family relations.

H. m-‘ .. 'un... . . .2 .': ‘H . "I. ...H: .H. . _._‘
migmlommaflerlfamilies. The first recurrent negative theme, or area requiring
adjustment, found only in the women from remarried families'
responses was that of allowing the children their own space and time to adjust at
their own pace. This is a component of Roy's interdependence stimulus,
"knowledge about friendships and relationships." The first example of this theme
in Table 14 demonstrates knowledge about communication, allowing the children
autonomy and showing acceptance of their feelings by allowing them to make their
own decisions. Women from remarried families frequently mentioned being friends
with step-children and allowing the children to call them by their first names rather
than by "mom". This type of no pressure friendship relationship with a step-child
is illustrated by this excerpt, "My step daughter confides in me, she goes to school,
she tells me who calls, which is unusual. She doesn't really tell anyone, then
explains. She asks for my opinion regarding her clothes and hair, it's really nice"
(woman from a remarried family).

Another area requiring adjustment found only in the women from remarried
families' responses is that of simply requiring time to adjust to one another and live
in harmony, as seen the first example in Table 14. The last theme unique to
remarried families was that of difficulty coping with the fact that biological bonds
between parents and children were formed before the bond between the couple (as

seen in the example of exclusion, the second example in Table 14).

49

DISCUSSION

There were some major differences between the first married and remarried
family types in regards to major life changes and perceptions of family closeness.
Most of these differences in both the type and number of life changes and
perceptions family closeness can be explained in part by differences in the
developmental stages of the two family types. According to RAM, both
developmental tasks and major life changes are classified as contextual stimuli.
Because developmental stages are determined by demographic information such as
time married and ages of the children in the home, findings related to demographic
differences are discussed with major life changes. The implications of the findings
are discussed as they relate to the existing literature on major life changes,
perceptions of family closeness, and the RAM. Lastly, recommendations for future
research and implications for advanced nursing practice and primary care are
discussed.

MajoLlifeLhanges. Couples from first married families had been manied for
longer periods of time, on average, 6.5 years. Couples from remarried families had
only been married, on average, one year. Almost half of the remarried family
couples had been married for less than a year at the time of the study. From this, it
can be concluded that first married families were established families who had
probably progressed through the early stage of couple formation to later stages of
family development. Couples from remanied families were in the early stages of
couple formation.

If developmental stages of the children are used as the basis for determination
of family development, a different picture of developmental differences emerges.

Almost all of the children from first married families were in the preschool

50

developmental Stage. The majority of children from remarried families were school
age. Another quarter of the remarried families had even older children. From this
it could be concluded that remarried families were in a later stages of family
development. Both methods for determining family developmental stages are
correct and must be taken into consideration. The rationale for determining
developmental stages is to predict what developmental tasks a family may be
confronting at a given point in time. If a family has the demographic
characteristics which place them in multiple stages, they will also be facing
developmental tasks associated with multiple stages of family development at one
point in time.

When developing Family Inventory of Life Events (FILE), McCubbin and
Patterson (1987) found that pile-up of stressors was generally highest for families
in the launching and adolescent stages of family development, followed by
preschool, then school age and lastly by the couple stage. Therefore, by
developmental differences alone, the remarried families can be predicted to be
experiencing more major life changes and, therefore, coping with more contextual
stimuli at one time. Tables 2 and 3 Show that this prediction is valid. Remarried
families on average experienced 4.5 major life changes in the last year compared to
an average of two for first married families. These findings are in concurrence
with Waldren et al.'s (1990) findings that remanied compared with first married
families experience higher levels of family stress based on the number of life events
and changes as measured by FILE.

Remarried families experienced different types of major life changes.
Remarried families perceived more financial and legal changes. More women from
remarried families had not planned this pregnancy (28% compared to 10% of first
married families). Obviously remarried families experienced more changes in

marital status. Forty-three percent of remarried couples had been manied less than

51

a year compared to the minimum time married for first married family couples of
two years. Women from remarried families experienced more changes related to
childrearing. Most of these changes can be linked to developmental tasks related
to role negotiating confronted in the early period of couple/family formation.

These major life changes had probably already been addressed and resolved by first
married families who had been together longer. A

Remarried families moved slightly more often, which was expected due the
merging of two families, but first married families were moving frequently as well,
probably to accommodate the increasing size of their families. Because not nearly
the number of women who perceived moving as a major life change mentioned
buying or selling of their house, the financial change category may be under-
represented. This tells us that for most women, financial changes were not
perceived as top priority, instead, other areas which more directly affect their
family interactions appear to be perceived as having greater priority. This
supports Lowman's (1980) conclusion that the affective dimension reflects the
level of other family processes.

Approximately three quarters of the women from remarried families had
custody of their children and, therefore, the step relationship was between their
new husband and their biologically related children. The opposite was true for the
quarter of women from remanied families who were experiencing their first
pregnancy. In these cases the step relationship was between the women and their
husbands' biologically related children. These women had even more changes
confronting them than the rest of the women from other remarried families because
of their limited knowledge of the emotional and physical changes associated with
pregnancy in combination with becoming instant parents of their husbands'
children. According to the finding of Mercer et al. (1988), these families with

high levels of perceived life changes are at greater risk for dysfunctional family

52

functioning after the birth. The women who never mention how the pregnancy
impacts family closeness may not be able to focus on the pregnancy as much as
other women and, therefore, spend less time bonding with the expectant child.
According to Dzurec (1995), this could place them at higher risk for child abuse.

The only major life change experienced more by women from first married
families than from remarried families was that of illness of an extended family
member. This was perceived as a major life change by 13% of women from first
married families perceived and by none of the women from remarried families.
What is not known is whether the remarried families interviewed had no extended
family members who were ill, or if remarried families were too preoccupied with
all the major life changes confronting their immediate family to perceive the illness
of an extended member as a major life change affecting them.

EamiGCloseness. The findings regarding perception of family closeness are
nearly opposite those from the literature reviewed. A third of both groups of
women from the current study perceived an improvement in family closeness.
Another third of the women from first married families perceived pregnancy of a
subsequent child as disruptive to their family closeness. Almost none of the
women from remarried families felt that their family closeness had declined.
Therefore, it can be concluded that more women from first married families
perceived a decline in family closeness than women from remarried families during
this developmental transition.

The majority of the past research showed remarried families to be less close
than their first married family counterparts (Pink & Wampler, 1985; Pill, 1990;
Waldren et al., 1990). The findings of this study also support the quantitative data
collected by Omar ( 1989) from the same sample population which showed no
statistically significant difference between remarried and first married family

closeness.

53

Pill (1990) found that 44% of couples from remarried families who had
developed a sense of family unity reported that the factors which contributed the
most to this were sharing major life events, either positive or negative. This
concept of shared experiences bringing families together and bonding them
emotionally, suggests that it is possible that after a few years time, remarried
families may become closer than their first manied family counterparts because
they will have shared the experiences of so many major life changes together.

Because 42% of women from remanied families made no direct mention of
the impact of the current pregnancy, the possibility that these women were placing
so much effort into establishing a sense of family closeness that they were afraid or
even unaware of the impact of the current pregnancy. This concept of an energy
intensive concentrated effort to establish themselves as a family in the early stages
of family development may be a part of why Waldren et al. (1990) found that high
levels cohesion are equally, if not more important for first married families.

The fact that so many women from first married families found this
subsequent pregnancy to be disruptive support the findings of Hall et al. (1994)
and those of Tomlinson et al. (1990) that the pregnancy of a subsequent child can
be equally as stressful as the pregnancy of a first child. The finding that a third of
the remarried women perceived that the pregnancy of a subsequent child brought
their family closer together supports Dubennans's (1973) findings that mutual
children improve intra-family relations.

There were not only differences between the family types as to the direction of
the impact of the pregnancy, but also in the type of positive and negative factors
mentioned which were perceived as important for developing and maintaining
family closeness. As with major life changes, the differences can be explained by
differences in developmental stages of the two groups. There are more people

involved in the early stages of remarried family formation than in the early stages

54

of first married family formation. Remarried family members must contend with
ex-spouses who are still involved with their family because they are still parents of
the children. The children are present and very strong forces in these family
interactions because they are older. The factors mentioned more frequently by
women from remarried families included a strong marital relationship, family unity,
showing affection, making an effort to be close, and open communication.

The focus of women from first manied families was on spending time together
as a family, family supportiveness of one another, and spousal support The
factors mentioned by women from the first married families are of a higher order
than the factors mentioned by the women from the remanied families. For
example, you cannot provide emotional and role support for another person until
open lines of communication and a strong enough relationship between the people
that a clear understanding of their affectional needs are and how the other can help
meet these needs; one set of factors comes before the others.

The negative factors mentioned more often by the women from first married
families included negative physical changes related to the pregnancy, extended
family relationships, and concern about sibling adjustment to the expectant child.
These findings support Hall et al.'s (1994) premise that second-time parents do not
require less support than first-time parents, but a different type of support The
negative factors mentioned more often by women from remarried families were
areas of adjustment unique to remarried families such as step-parent-child
relations, needing time to adjust and assimilate, and not pressuring children to feel
a false sense of family closeness, and for a few, feelings of exclusion. These
adjustment areas appear to be related to the issues of the greater complexity of the
remarried family structure.

Papemow (1984) concluded that a different model of family development was

needed for remarried families based on the unique characteristics of the remarried

55

family structure. Some of the reasons remanied families are unique are that
parent-child bonds precede rather than follow the formation of the couple
relationship and there are more people involved than just the couple, adults and
children are coming together at very different places in their individual, marital and
family cycles. Lastly, there is a biological parent in another household whom the
children may live with part of the time. These unique structural characteristics
account for the unique areas of remarried family adjustment related to family
closeness found in this study.

The theme of remarried families needing time to adjust supports Papemow's
(1984) finding that it takes four to eight years for remarried families to establish
themselves as a family. Part of the usual sequence of events after a divorce is that
Single parents look to their children to meet their own affectional needs. Because
the children are overly close to their parent(s) it takes time for the children to
relinquish fantasies of parental reconciliation and readjust subsystem boundaries to
make room for a new Step-parent, thus theme related to not pressuring family
closeness and concern about step-parent-child relations. This theme is in
congruence with Crosbie-Burnett's (1984) conclusions that unwanted nurturant
behaviors on the part of the step-parent are the etiology for the lower levels of
family closeness in some remarried families. The few women who felt excluded
from their new families exemplify the fact that the parent-child bond precedes the
couple bond. This is the opposite for what Kurdek (1989) felt to be true for the
majority of remarried families with step-children present in the home.

The findings support the model to the extent it could considering the
secondary nature of the study. The original interview questions were not
developed with the purpose of assessing the RAM and, therefore, did not include

assessment of all of the seven stimuli Roy identified as important for assessing

56

functioning in the interdependence mode. Several of the stimuli did emerge as
extremely relevant stimuli in the present study.

Developmental stages of the families and the individual family members were
crucial factors related to the similarities and differences found in types and
numbers of major life changes experienced and in the types of positive and
negative factors which the two family types perceived as important for developing
and/or maintaining family closeness, or successful functioning in the
interdependence mode. First married families were generally more established as a
family. First married couples were in later stages of development compared to
remarried couples. Remarried families were facing many more concurrent
developmental tasks because of the various deveopmental tasks facing the more
complex remarried families. These differing stages of development impacted other
areas such as interactional skills, physical presence of the other in the environment,
nurturing ability, and knowledge of relationships which were also relevant stimuli.

One area of family closeness which RAM did not address was that of family
unity. This could be due to the fact that the seven stimuli were developed for
assessment of an individual as the adaptive system. It is also possible that family
unity would be more appropriately be categorized as an aspect of family adaptation
in another mode, such as self concept Future application of RAM to families as
adaptive systems may require incorporation of some other family oriented stimuli
for assessment of the interdependence mode.

The findings support Roy's (1991) statement that "People who are ill or in a
state of change usually experience an increased need for love, respect, and
affirmation" (p.392). The women who were experiencing negative physical
changes related to the pregnancy were quick to mention how their spouses were
supporting them and being attentive to their increased emotional needs. The

women from remanied families who experienced more change also readily

57

mentioned their own affectional needs. According to this premise of RAM, the
remarried families experience increased number of major life changes, therefore,
they should experience greater affectional needs. This premise supports the
conclusion that in spite of the greater number of stimuli facing remarried families
and their greater complexity, these families are just as close if not closer than the
first married families.

The cognator subsystem which controls perceptual /information processing
was shown to be important for determining which major life changes the women
mentioned. How changes affected family interactions, or family closeness were
mentioned more often than how these changes affected the financial aspect of their
families' functioning. How women cognitively coped, or prioritized determined
which changes were perceived as major life changes which were not How women
cognitively coped determined if they were able to perceive any impact the current
pregnancy might have had on their families' closeness, as was seen in the example
of the woman's response who mentioned many other stimuli confronting her family
and never mentioned any differences in her family's closeness since the pregnancy.
In this case, the pregnancy may not have been perceived as the focal stimuli,
because she was coping with so many other stimuli.

RAM guides the assessment of other changes, or contextual stimuli which
proved to be of great concern to the families in this study. Many of these
contextual stimuli also necessitate changes in the family system's affectional needs
and interdependence functioning. Because RAM does incorporate major life
changes and developmental tasks of families as stimuli important for assessment of
the interdependence mode, it proved to be especially applicable to the assessment

of first married families and remarried families alike.

58

Il"E!i ”1.2.!”3.:

RAM provides an excellent blue print for applying the nursing process to
families expecting a subsequent child. Roy states, "it is the nurse's responsibility to
help persons [or families] adapt to these changes. She [or he] must be able to
identify the person's [or family's] level of adaptation and coping abilities, to identify
difficulties, and to intervene to promote adaptation" (Roy, 1991, p.27). Because
advanced practices nurses in primary care have established relationships with some
or all members of families, they are in a unique position to heighten families'
awareness about their patterns of interaction and to help families identify
interventions which promote optimal levels of family closeness throughout
different each phase of family development

Family stucture and quality of relationships should be assessed from the
' perspective of each individual family member as part of the routine initial
assessment of any client new to the practice. Having the client draw or fill in a
family tree form and complete an established reliable family assessment tool such
as the Family APGAR (Smilkstien, 1978) are two methods for easy and rapid
assessment

This findings from this study illustrated areas of adjustment or potential
problems to family closeness for both first married families and remanied families.
One of the areas of adjustment for first married families included concerns about
sibling adjustment. Family nurse practitioners routinely assess how families are
promoting sibling adjustment to the future member of their family and provide
information and resources for parents to help provide their children anticipatory
guidance about how to incorporate the expectant baby into their family system.

Another area the findings indicate as an important area for assessment with
first married families expecting a subsequent child is that of spousal support

FNP's can assist clients to become more aware of their expectations of significant

59

Others and assist them to improve their communication of these expectations. If a
woman's nurturant ability is temporarily diminished secondary to the physical and
emotional changes of pregnancy, the FNP could help the family to identify ways of
providing the woman with respite childcare and household duties, which would
enable her to meet her increasing demands for rest and, thereby, improve her
emotional capability to nurture other family members. Providing expectant fathers
with material on the physical and emotional changes associated with pregnancy
could be an effective means of making the men more sensitive to the woman's
needs and recruit their support.

Lastly, the findings indicate a fair proportion of women from first married
families had concerns about dependency issues related to illnesses of extended
family members. FNP's need to include this in their assessment. Resources in the
community to help provide respite relief for caregivers, home health aides and
nurses and time management skills may interventions of value to these clients.

The findings of this study also indicate areas of importance for assessment and -
intervention may be necessary for remarried families. Educating clients who are
new step-parents about respecting each other's autonomy will prevent unwanted
nurturant behaviors which may actually drive members away. The findings
indicate that assessment of expectations about remarried family integration and
assimilation are important. Remarried families may need anticipatory guidance
about the usual time frames for members to adjust to living with one another. The
fact that 42% of remanied families did not mention the impact the pregnancy of
the expectant child had on their family's closeness may have implications for
bonding with the child after the birth. Further probing to assess how well the
family is bonding with the unborn child are necessary. Remanied families may also
benefit from counseling related to the integration of the new family member and

assistance with sibling adjustment

60

A brochure about realistic expectations for remarried family integration and
development of family closeness is another way to provide anticipatory guidance
for these families. The brochure should be made available at sites of state required
premarital counselling, in health care provider waiting rooms, schools and
daycares. A blank space on the back which could be filled in to include where to
obtain additional information and counselling and locations of support groups
should be included.

Information which should be covered in the brochure based on the findings of
this study includes five topics. The first is "realistic expectations". Families need to
know that the usual time periods for remarried family integration and for parents to
achieve full co-management status has been proven to be between four to six years
so that they do not set themselves up for frustration and failure when instant family
closeness is not achieved. The second topic, "how to get along with your step-
child" is a concern of most step-parents. Adults need to know how to be a friend
to their spouse's child until a time (if ever) when the child sees the new adult
member of the family as a parent The option for the child to call the new parent
by their first name, or by "mom" or "dad" is crucial for not forcing unwanted
nurturant behaviors, especially with older children. The third topic,"The
importance of consistant disciplinary rules between households" is necessary for
households where visitation is an issue to prevent the child(ren) from "pushing the
right buttons..to fight for their own needs" as one woman from a remarried family
stated. The fourth and fifth topics,"What to call new family members" and "the
myth of the traditional/ideal family" are closely related. Family members need to
understand that every family is unique. There is no ideal family mold to try to fit
into. Family members should be encouraged to assess how they feel about one
another and their roles in the family system and call members by first names or by

the relationship title without prefixes. The last topic which should be included,

61

"spending time as a family" because this was found to be the single biggest factor
identified by both family types as important for developing and maintaining family
closeness. Families need to work plan family time to regularly include members
who are not always present.

Facilitating focus/support groups is one way to reach a greater population of
families than interaction with individuals during office visits. The group format
described by Aranoff and Lewis (1979) to "stimulate couples to become aware of
their communications and support systems as the necessary building blocks for
health family emotional development" (p. 51) could be applied to families
experiencing the birth of a subsequent child to improve parenting skills and
communication and support between partners. Aranoff and Lewis' pilot project
consisted of groups of six couples meeting for eight weeks in a small discussion
group for two hours. A lecture/discussion format focused on a variety of issues
about pregnancy and infancy, such as what couples' expectations were of
themselves and of each other as parents, the changes in the relationship during
pregnancy, and how to best meet the emotional needs of an infant The objectives
of the facilitators were to present new information, facilitate communication
between each couple in areas they had not yet explored and to help establish a
supportive problem-solving system between each couple. These focus groups
were evaluated positively by the participants.

This focus group format could be adapted for any, or many types of family
developmental transition(s). Focus groups specialized to the transition of
remarried family integration needs to include issues unique to remarried families
such as: (l) respecting children's autonomy; (2) discussing what the couples'
expectations are of themselves and of each other as parents and as spouses to
facilitate a strong marital relationship; (3) how to establish a relationship with a

spouse's child by becoming friends first; (4) dealing with the multitude of major life

62

changes, or external stimuli confronting the family system; and (5) the importance
of setting aside couple time and family time. Anticipatory guidance on the stages
and usual time periods for remarried family integration (Papemow, 1984) needs to
be included as well, to help develop realistic expectations, especially related to the
numerous developmental tasks which face newly formed remarried families.
Papemow (1984) found that families with older children require 5-6 years to
achieve integration and co-management status between spouses. This will prevent
tensions from trying to instantly fit into the "ideal" family mold. Focus
groups/sibling preparation classes for older children and supervised play or
childcare needs to be provided concurrently to increase attendance and to target
improved family adjustment from every angle. Participants for the focus groups
could be recruited from the back of the brochures mentioned above and by
advertising in a associated health system's newsletter sent out to residents of the
community it serves.

Health care providers and the general public need to be educated about the
negative connotations remarried families feel towards the terms "step" verses
"natural" or "traditional" needs to occur. These terms and prefixes imply a step or
half relationship that is some how inferior to a real biological relationship. Four of
women from remarried families identified themselves as "natural" families when '
asked to choose their family type from the terms "step-family" or "natural family".
One woman made this statement in her response to the question about family
closeness, "We do struggle for a family relationship here. We're not going to
mention half-brother, we don't question that." Eliminating the use of these terms
and prefixes with such negative connotations is one way to help eliminate the bias
towards remarried families.

Another way to help eliminate societal bias towards alternative family types,

such as remarried families, is to dispel the myth of the traditional/ideal family

63

which does not and never really did exist. This can be done by conducting and
then publishing more remanied family research in professional journals. Articles
published in popular women's magazines would reach large percentages of the
general public. Speaking at conferences of health care providers and educators is
another way to share findings of research. Reaching other professionals and
educators of higher learning through the above means will enable them to educate
future health care providers, counsellors, ministers, and educators that needs for
affectional adequacy can be met through interactions with significant others no
matter who they are or how, if at all, they may be related. By dispelling the myth
of the "ideal/traditional" family, societal bias towards "alternative" family forms
can be eliminated. With so many various family structures emerging in today's
society, knowing that there is no perfect family type to strive for will eliminate a
lot of unnecessary tensions and unrealistic expectations, and help all people
achieve affectional adequacy.

Many of the differences found between the responses of the women from first
manied and remanied families appear to be related to differences in family
developmental stages. This is most likely due to the difficulty obtaining an
appropriate comparison group for remanied family research. It would be of
interest to repeat the study this study with a comparison group of first manied
families who had been married one to two years and who were also expecting their
first mutual child. Unfortunately, there is no was to control for the greater
complexity of remarried family formation due to the presence of children from
previous marriages. It is also not possible to control for patterns of interaction
developed in previous relationships.

Collecting data at multiple points in time would increase the reliability and

validity and generalizability of the findings for two reasons. The first is that

perceptions change from day to day and this study design would verify that how
the subjects responded was what they were really feeling. The second is that this
would help control for developmental differences between the two family types.
Because the remarried families are confronted with developmental tasks from
multiple stages of family development at one time, this would enable the
researchers to compare how both of the family types dealt with the different
developmental tasks.

There were some limitations due to the fact that this was a secondary data
analysis. Both of the interview questions were not asked of all the subjects thus,
the unequal number of subjects in the two different groups. The open-ended semi-
structured interview format allowed the subjects to respond to what they perceived
to be most significant to them and their family situations. The disadvantage of the
format is that subjects may answer about topics irrelevant to the question or may
forget or not realize some information that is relevant The brevity of some
responses raises questions as to whether or not the subjects were completely
honest and complete with their responses. Some of this guess work could be
eliminated by asking a broad open-ended question, such as the questions studied
here, then having several sub-questions to help direct, clarify and ellaborate on the
information desired. For example, after asking and allowing the subjects to
respond to question about family closeness, questions pertaining to the assessment
of the seven stimuli Roy identified as important for assessing in the interdependent
mode could be asked. A second limitation related to the qualitative nature of the
data is that the coding of responses needs to be verified by independent readers.
Some verification of random sections of the text was verified by two members of
the thesis committee, but all the text was not verified which limits the reliability

and validity of the findings.

65

The convenience sampling resulted in a very homogenous sample which limits
the generalizability of the findings to families of other culture, religions, races, and
socioeconomic status's. The other factor which limits the generalizability of the
findings is that only the women's perceptions were studied. To be more
representative of family closeness and major life changes impacting a family,
perceptions of all the members of a family should be examined. The ideal Study
design would be a longitudinal study of all the members of the families from the
two family types. The study should begin in the early stages of family formation
and extend through the entire childbearing period. This would provide a more
accurate description of family closeness and how a new life is incorporated into
and how it impacts the different types of families and their closeness.

Summaoc

The findings of this study may help dispel the myth that because remarried
families are more complex and experience more major life changes that they are
less close and more at risk for dysfunctional adaptation. Although remarried
families did experience more major life changes, they appear to be as close as or
closer than first married families. The two factors which are hypothesized to help
remarried families compensate for the added stress of the increased number of
major life changes in this study were energy intensive effort placed on becoming a
family in the early stages of family formation/development and secondly, that the
increased number of shared life experiences caused by the higher number of major
life changes may contribute to greater emotional bonding.

Developmental stage differences between the two family types appear to have
had a large contribution to the differences in the type and number of perceived
major life changes in the last year and to the differences in the type of factors
important to family closeness discussed by the women from first and remarried

families. Future studies which match families by the number of years of marriage

66

are necessary to determine if the unique differences in the structural formation of
remarried families make them more similar than different from first married
families. Research guided by the RAM helps control for other variables/contextual
stimuli which may also impact family closeness, or functioning in the
interdependence mode. The findings from the current study show that all families,
regardless of their family type, desire family closeness. RAM also can serve as a
guide for FNP's to apply the nursing process to assist families as adaptive systems

improve and maintain optimal functioning in the interdependence mode.

APPENICES

APPENDIX A

67

APPENDIX A

“”1“ . a”. . -. .H . -.‘. .H , .1 _. {a '.. ...

A convenience sample consisting of 40 stepfamily couples and 40
traditional nuclear family couples was used. Obstetricians and others physicians,
nurse midwives and nurses providing prenatal care, and childbirth educators
throughout southern Michigan were contacted by the investigator who explained
the study and elicited permission to identify potential participants for the study.

All couples who met the following criteria were admitted to the sample: (a)
stepfamily and traditional nuclear family couples in which the wife was in the third
trimester of pregnancy; (b) stepfamily couples who were experiencing a joint-birth
for the first time; (c) traditional nuclear family couples who were not experiencing
a first-time birth; (d) couple who were married and living together with at least one
child under the age of 18 who was living in the home; (e) husband and wife
couples' who were able to understand, read, and write English in order to give
consent, participate in the in-home interview discussion, and willing to participate.

Specific exclusion criteria included couples in which the woman was identified as

being medically high risk during her pregnancy.

APPENDIX B

68

APPENDIXB
0.. II . E II . Q .

IntentimProcess

I want to ask you some questions about your relationship with your spouse,

about your children, and your family life. All the information you give me will be

held in Strict confidence. You will be identified only by a code number and that

information will to appear in the study. If you should experience any undue stress

or anxiety after the interview, I will be available for counselling. Please call me at
(517) 339-1921.

1.0.

l.

7.
8.
9.

How do you feel about having this new baby?

2. How do you think your spouse feels about having this new baby?
3.
4

How do you think you children/stepchildren feel about having this new baby?

. Have you noticed any difference in you family's closeness since this

pregnancy?

. Have you noticed any difference in how your family handles family

situations since this pregnancy?

What do you think will be the biggest change for your family with the new
baby?

What gives you the most satisfaction with your family now?

What makes you the least satisfied with you family now?

What helps you the most?

10. Within the last year, have any major changes occurred in you life?

11. What advice would you give to other expectant couples?

 

APPENDIX C

69

APPENDIX C
D . . l E C 11 . E 1

Data collection occurred in the families' homes. During the home visit both
spouses were given more information about the study. Interview data was
collected as part of a larger study. Wives and husbands were interviewed
separately. While one spouse completed the quantitative questionnaires used in
the larger study, the other spouse was interviewed by the principal investigator to
obtain additional data. All interviews were conducted by the principal investigator.
The principal investigator took extensive notes during each interview. The
interviews were not taped. The total home visit lasted about one hour, with on-
half hour needed to complete the questionnaire, and the other half-hour for the

interview.

APPENDIX D

 

OFFICE OF
RESEARCH
AND
GRADUATE
STUDIES

   
 
 
  
  
 

MmmanflmUmwmw
232 Administration Building
East Lansmq. Mm
watt

517,355-le
FAX. 517132-1171

The woman Stare .‘nnerwy
06-1 3 nsrmrmi 3mm?
from n khan

MSU 3 an rmmrvexam
W'OOCWFU’] ns'vtcnm

70

APPENDIX D
UCRIHSApptoxaLfouheLnnenLSlndx

MICHIGAN STATE

UNIVERSITY

March 6, 1996

 

To: Jennifer S. Boucher
5317 Harvard Rd.
Detroit, MI 48224

RE: IRBA: 96-122
TITLE: WOMEN'S PERCEPTION OF MAJOR LIFE CHANGES AND
FAMILY CLOSENESS DURING THE PREGNANCY OF A
SUBSEQUENT CHILD IN FIRST MARRIED AND REMARRIED

FAMILIES
REVISION REQUESTED: N/A
CATEGORY: r-E
APPROVAL DATE: 03/04/96

The University Committec on Researzh Involving Human Subjects'iUCRIHS)
review of cnis project is complete._ I am pleased to advrse that the
rights and welfare of the human subjects appear to be adequately
rotected and methods to obtain informed consent are appropriate.
gerefore. the UCRIHS approved this proyect and any reVISions listed
a ove.

RINIWAL: UCRIHS approval is valid for one calendar year, beginning with
the approval date shown above. Investigators planning to
continue a project be ond one year must use the green renewal
form (enclosed with c e original agproval letter or when a
pr03ect is renewed) to seek u date certification. There is a
maxrmum of four such expedite renewals ossible. Investigators
wishing to continue a project beyond tha time need to submit It
again or complete revrew.

RIVISIONS: UCRIHS must review any changes in procedures involving human
subjects, rior to initiation of c e change. If this is done at
the time o renewal, please use the green renewal form. To
revrse an approved protocol at any other time during the year,
send your written request to the. CRIHS Chair, requesting revrsed
approval and referencrng the project's IRE 8 and title.. Include
in your request a description of the change and any revrsed
instruments, consent forms or advertisements that are applicable.

snootsus/ ,

CRANGBS: Should_either of the following arise during the course of the
work, investigators must noti y UCRIHS promptly: (l) roblems
(unexpected srde effects, comp aints. etc.) involving uman
subjects or (2) changes in the research environment or new
information indicating greater risk to the human sub'ects than
existed when the protocol was previously reviewed an approved.

If we can be of any future hel , lease do not hesitate to contact us
at (517)355-2180 or FAX (Sl7l4 2- 171.

Sincerel

  
    
 

David E. Wright,
UCRIHS Chair

DEW:bed

Ph.D

cc: Rachel F. Schiffman

APPENDD( E

71

 

 

 

 

 

APPENDIX B
Table l
E l l 5 [E I B . l E .1.
Developmental Stages %First Married Families %Remarried Families
(n=29) (n=35)
Preschool 90% 14%
Preschool & Early School 20% 20%
School 3% 5 1%
School & Adolescent 0% 9%
Adolescent 0% l 1%
Adolescent & Launching 0% 3%
Table 2
"t‘u 0 iou‘u AI. "(‘mtouoo ° .412 o .u u.‘
First Married Women Remanied Women
Who Perceived Who Perceived
No Change (n=29) No Change (n=35)
24% 6%

Example: "No major changes" (woman from a first married family).

72

APPENDIX E

Table3
E EE 'IIEIII .. SS'IE'II

 

First Married (n=29) Remarried (n=35)

 

Wife's Work 28% 34%
Husband's Work 23% 9%
Quit School 0% 3%
Complete Education 0% 7%
Major Trips 3% 3%
Start School 0% 3%
Move 20% 37%

Example (Husband's Work): "My husband's been off his job since September--
employment is kind of scary. It's uncertain for the past year. No idea of the
turnover. It's a very scary time but we're having a new baby and my husband
having no job" (woman from first manied family).

Example (W ife's Work): "Well as far as job hours have changed. I work now
from 1 to 9, and that is a pain, because I hardly have any time with the kids and
visitation" (woman from a remarried family).

 

 

 

Table 4
E [E . l E' . 1 Cl 1 E 'l I
First Married (n=29) Remarried (n=35)
Sell House 3% l 1%
Buy House 3% 6%
Other 10% 27%

Example (Other): "I stopped working. Finances are a big problem. We've sold
the business" (woman from a first married family).

Example (Other): "We sort of wath support" (woman from a remarried family).
Example (Other): "We moved around Thanksgiving. Finance planning, income

tax, IRA, and investments we pooled our resources, got new vehicles, changed
over titles,'names, it's been a lot" (woman from a remanied family).

 

73

APPENIDIX E

TableS
E [E . II 1C] 1 E .1 I

First Married (n=29) Remanied (n=35)
0% 1 1%

 

Example: "...my ex-husband was on trial for two months and I couldn't stand it. It
was just very difficult" (woman from a first manied family).

Example: "...we were coping with the ex-wife...Initially, she used the courts
effectively" (woman from a remarried family).

Table 6

E EE'!I"ISDIE'II

Remarried (n=29) First Married (n=35)

 

Loose an Immediate Member 3% 6%
Gain an Immediate Member 7% 14%
Child with Visitation 0% 3%
Gain an Extended Family Member 7% 6%
Lose an Extended Family Member 3% 8%
Divorce in the Extended Family 3% 3%

Example (Lose an Extended Member, Gain an Immediate Member): "The death
of my mom. I'm the oldest. I have a younger brother. I have one brother now
living with me. He's 20 years old and a little slow. I have another brother on his
own, but needs watching over. I'm watching my brothers adjusting on their own.
But they come to me with their ups and downs. I incorporate them into my family
here" (woman from a first married family).

74

APPENDIX E

Table7
E E2 . 11]] l: I C] I E 'l I

First Married (n=29) Remarried (n=35)

 

 

Illness of Self 3% 6%
Illness of Immediate Member 3% 3%
Illness of Extended Family Member 14% 0%
Childcare 3% 1 1%

Example (Illness of Extended Family Member): "I quit my job to help take care of
my dad last May..." (woman from a first married family).

Example (Childcare): "I worry about having a baby and having to work. The
grandmother right now watches our stepdaughter" (woman from a remanied
family).

 

Table 8

E [2.111.1[2] [£11
First Married (n=29) Remarried (n=35)

 

Marriage ‘ 0% 43%
Divorce 0% 6%
Problems with Ex-spouses 0% 6%

Example (Marriage): "It has thrown me into some what of a whirlwind. Getting
married, having a child, moving ..... lot of big changes in a short time."(woman from
a remanied family)

Example (Marriage, Divorce): "Got married, got pregnant. The divorce finally
went through." (woman from a remarried family)

Example (Problems with Ex-Spouses): "...we were coping with the ex-wife..."
(woman from a remarried family).

 

75

APPENDIX E

Table9
E [E . lCl’lll . Cl IE '11

 

First Married (n=29) Remarried (n=35)

 

Unplanned Pregnancy 10% 28%
Planned Pregnancy 90% 72%
Spontaneous Abortion 3% 6%
First Pregnancy Experience 0% 23%

Example (Spontaneous Abortion): "...I've had two miscarriages" (woman from a
remarried family).

 

 

Table 10
"r‘t 0 " I Ir- u I In I! t I o u 0

First Married (n=29) Remarried (n=35)
Closeness ' 3% 14%
Communication 3% 0%
Difficulty Managing Child(ren) 3% 14%
Witnessed A Traumatic Event 3% 3%

Example (Change in Closeness and Communication): "My niece lived with us for
five years, I was her guardian. She moved out and went to college. This was a big
change. It's a lot better, because now we communicate more and increase the
sense of closeness" (woman from a first married family).

Example (Difficulty Managing Children): "The 14 year old is sort of a
challenge...They [her two children] were challenging everything with me being
home, very stressful. I try to be sensitive to what's going on, but they don't seem
to know what they're putting me through. They keep testing me" (woman from a
remanied family).

Example (W itnessed a Traumatic Event): "...I witnessed a 17 year old girl getting
shot, I'm worried about the baby, I was 14 weeks at the time, it was a big shock."
(woman from a first manied family).

 

76

 

 

APPENIDD( E
Table 11
"I‘I I"I‘ I II II I I II I I I 'd‘II
Wm
Type of Difference in First Married Remarried
Family Closeness Women (n=29) Women (n=35)
Increased Closeness 31% 34%
Disrupted Closeness 27% 3%
Unchanged Closeness 20% 22%
No Direct Mention of Impact 22% 42%

Example (Closer): "I feel like this pregnancy has brought us closer together. We
share now in the planning of it, of a new baby and the permanency" (woman from

a remarried family).

Example (Disruptive): "Well, actually we seem to be further apart with everything
going on...We used to be close" (woman from a remarried family).

Example (Unaffected): "No major change since the Pregnancy" (woman from a

first married family).

 

77

 

 

APPENDIX B
Table 12
" ‘I I 'I‘ .. II."I.“.I. IIIII-I I a l.‘ I:.III
Il"'E'lCl IE'II
Positive Factors First Married Remarried

(n=29) (n=35)

Shared Experiences 3% 6%
Sharing the Pregnancy Experience 17% 23%
Strong Marital Relationship 10% 20%
Sense of Family Unity 0% 17%
Sense of Commitment to Family 14% 12%
Affection 0% 17%
Open Communication 17% 29%
Spending Time Together as a Family 58% 40%
Having Time to Oneself 3% 3%
Spending Time as a Couple 17% 17%
Making an Effort to be Close 7% 14%
Family Support 10% 3%
Spousal Support 31% 3%

Example (Commitment, Family Time, & Family Support): "Well, we're very close,
we're committed. Not just by word, but by actions. We spend time together,
we're caring and concerned" (woman from a remarried family).

Example (Effort, Spousal Support, Open Communication, Couple Time,
Affection): "Everyone is working toward a family that works. My husband plays
with the kids a lot and pays attention to them. and my husband and I talk a lot and
spend a lot of time together cuddling..." (woman from a remarried family).

Example (Sense of Family Unity): "It has brought us unity and a sense of peace"
(woman from a remarried family).

Example (Sense of commitment to Family, Sharing the Pregnancy Experience):
"The child is giving us some new goals, direction, and focus. It has brought us
close together is Some aspect, through sharing a new life" (woman from a
remarried family).

 

78

APPENDIX B

Table 13

I C C
'l‘l R \‘:.l ‘ . O ;R-.0 0 A. lll’l -..a "DUI-l 0

El" i!11"'E'lCl lE'lI

 

 

Negative Factors/ First Married Remanied
Adjustment Areas (n=29) (n=35)
Couple Relations 10% 17%
Family Relations 14% 9%
Biological Parent/Child Relations 24% 21%
Extended Family Relations 17% 3%
Negative Physical Changes 34% 17%
(Related to the Pregnancy)

Negative Emotional Changes 17% 9%
(Feeling Less Tolerant r/t Preg.)

Decreased Marital Intimacy 7% 0%
Sibling Adjustment 20% 6%

Example (Sibling Adjustment): "I concentrate on my daughter being the older
sister" (woman from a first married family).

Example (Biological Parent/Child Adjustment): "I'm having a little bit of difficulty
letting go. Her father puts her to bed and I'll be putting the baby to bed" (woman
from a first married family).

Example (Negative Physical and Emotional Changes, Less Intimacy, Disruptive):
"Changes regarding the pregnancy, it's put a strain on our closeness. I'm more
grouchy...I've been sick...I'm more uncomfortable, and I have a sore back, and it's
a pain to do things, and I don't want to move and, therefore, it puts a strain on our
closeness" (woman from a first married family).

Example (Extended Family Relations): "My parents are closer, his parents are not
happy about this pregnancy. They said, 'Oh no, not an accident...‘ My parents and
others sort of pull together to get us through" (woman from a first married
family).

 

79

APPENIDIX E

Table 14
E EE .1”. ! 11° R 'IE 'I'

 

 

Adjustment Areas Remanied Women Who
Mentioned These Areas (n=35)

Step Parent/Chfld Relations 60%

Time to Adjust to Each Other 26%

Not Pressuring Family Closeness 20%

Feeling Excluded From the Family 6%

Example (Time to Adjust to One Another, Step Parent/Cth Relations): "Just in
the last year, my son and my stepdaughter seem to be getting along better...My
husband and son share when they have to."

Example (Excluded): "...he [husband] and Eric [stepson] are close, but I'm not in
it. I feel like an outsider. I'm not doing anything to be excluded, it's just between
them."

Example (Not Pressuring Family Closeness): "The boys sort of keep their
distance, they do their own thing and go their own way. We try to allow them
space. We invite them to dinner and trips if they are interested. They make the
decision."

Example (Not Pressuring Family Closeness): "My stepson calls me Jane. There's
no pressure there."

 

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