# Unravelling typology of family life when a parent has heart disease: A qualitative study of families with adolescents

## TL;DR

This study explores how families with adolescents cope when a parent has heart disease, identifying four distinct family response types.

## Contribution

The paper introduces a novel typology of family responses to heart disease: resilient, fragile, overwhelmed, and resigned.

## Key findings

- Family cohesion and external support networks are crucial for coping with heart disease.
- Four distinct family response types were identified based on how families manage heart disease challenges.
- The typology provides a framework to understand family dynamics affected by chronic illness.

## Abstract

When a parent is living with heart disease, it impacts the entire family. To fully understand the effect, the perspectives of all family members need be analysed together as a unit.

To identify what characterises family life and relationships in families with adolescents, with a parent living with heart disease.

Qualitative study with an inductive approach.

In three Scandinavian countries between 2019 and 2022.

A total of 28 families with 83 family members, from three university hospitals were included. Inclusion criteria were families with a parent living with any type of heart disease, within six months and up to five years since diagnosis and having one or more adolescents living at home.

Data was collected through semi-structured individual interviews. Reflexive thematic analysis was used to identify patterns within families. This was followed by an ideal-type analysis, which resulted in a typology defining aspects of family experiences and responses of living with heart disease.

A typology was developed describing four different family responses to heart disease: resilient, fragile, overwhelmed, and resigned. A family with a resilient response exhibits a collective approach, fostering solidarity and adaptability as they manage heart disease. A family with a fragile response shares a sense of belonging among family members, but struggles with concurrent stressors, navigating challenges individually without external support. A family with an overwhelmed response experience breakdowns in communication and helplessness in managing heart disease alongside various demands. A family with a resigned response relies on individual strategies leading to challenges for them to interact and understand each other.

Families affected by heart disease handle their new life circumstances in various ways. Strong family cohesion and supporting networks emerged as crucial elements in helping families cope with the multifaceted challenges associated with living with heart disease.

•Chronic diseases significantly impact family dynamics, often altering structure, routines, and redistributing responsibilities to meet the care needs of the person being ill.•Managing chronic illnesses within a family is complex; the disease can strain relationships due to its challenges, but it also offers an opportunity to strengthen bonds through support and resilience.•This study identified four family responses: Resilient, fragile, overwhelmed, and resigned, illustrating how family life and relationships can be described using a typology.•The typology illustrates how family cohesion and external supporting networks influence experiences of coping with heart disease, with the family responses placed along a continuum on these two factors.•Identifying different family responses may offer a heuristic tool to understand dynamics in families with a parent living with heart disease.

Chronic diseases significantly impact family dynamics, often altering structure, routines, and redistributing responsibilities to meet the care needs of the person being ill.

Managing chronic illnesses within a family is complex; the disease can strain relationships due to its challenges, but it also offers an opportunity to strengthen bonds through support and resilience.

This study identified four family responses: Resilient, fragile, overwhelmed, and resigned, illustrating how family life and relationships can be described using a typology.

The typology illustrates how family cohesion and external supporting networks influence experiences of coping with heart disease, with the family responses placed along a continuum on these two factors.

Identifying different family responses may offer a heuristic tool to understand dynamics in families with a parent living with heart disease.