Stronger Together: Actor–Partner Interdependence Model of Family Resilience and Quality of Life in Parents and Siblings of Children With Epilepsy (SCWE)
DOI:
https://doi.org/10.24156/jikk.2026.19.2.68Keywords:
Actor partner interdependence model (APIM), family resilience, interdependence, quality of life, siblings of children with epilepsyAbstract
Raising a child with epilepsy presents emotional, financial, structural, and time management challenges within the family that affect the quality of life (QoL) of both parents and siblings of children with epilepsy (SCWE). To examine the interconnectedness between them, this study aimed to investigate the relationship between family resilience and the QoL of parents and SCWE using the Actor–Partner Interdependence Model (APIM) and structural equation modeling (SEM). This model highlights family systems theory, in which family members share interdependent relationships and influence one another. The model focuses on the dyadic relationship between parents and SCWE rather than on a single individual. The study involved 197 parent–SCWE dyads recruited through purposive sampling from an epilepsy community in Indonesia. The mean age was 42.84 years for parents and 14.54 years for SCWE. The findings indicated a significant interdependent relationship between family resilience and the QoL of both parents and SCWE (p < 0.05). These results suggest that parents’ family resilience influences the QoL of SCWE and vice versa. Therefore, interventions aimed at strengthening family resilience should be considered to enhance the QoL of both parents and SCWE at the family level.
References
Ao, L., Cheng, X., An, D., An, Y., & Yuan, G. (2025). Relationship between perceived family resilience, emotional flexibility, and anxiety symptoms: A parent–adolescent dyadic perspective. Journal of Youth and Adolescence, 54(2), 510–521. https://doi.org/10.1007/s10964-024-02083-7
Chen, J. J., Wang, Q. L., Li, H. P., Zhang, T., Zhang, S. S., & Zhou, M. K. (2021). Family resilience, perceived social support, and individual resilience in cancer couples: Analysis using the actor–partner interdependence mediation model. European Journal of Oncology Nursing, 52, 101932. https://doi.org/10.1016/j.ejon.2021.101932
Chew, J., Carpenter, J., & Haase, A. M. (2018). Young people’s experiences of living with epilepsy: The significance of family resilience. Social Work in Health Care, 57(5), 332–354. https://doi.org/10.1080/00981389.2018.1443195
Cook, W. L., & Kenny, D. A. (2005). The actor–partner interdependence model: A model of bidirectional effects in developmental studies. International Journal of Behavioral Development, 29(2), 101–109. https://doi.org/10.1080/01650250444000405
Davies, P. T., & Sturge-Apple, M. L. (2014). Family context in the development of psychopathology. In M. Lewis & K. D. Rudolph (Eds.), Handbook of developmental psychopathology (3rd ed., pp. 143–161). Springer. https://doi.org/10.1007/978-1-4614-9608-3_8
Deggelman, E. L. (2011). Coping and quality of life for siblings of children with chronic illness [Doctoral dissertation, Kent State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=kent1309541030
Deng, X., Liu, Q., Geng, L., Li, J., Wang, M., & Wan, Y. (2024). Dyadic coping, resilience, and quality of life in young and middle-aged couples after gynecologic cancer: An actor–partner interdependence mediation model. European Journal of Oncology Nursing, 70, 102601. https://doi.org/10.1016/j.ejon.2024.102601
Dinleyici, M., & Dağlı, F. Ş. (2018). Evaluation of quality of life of healthy siblings of children with chronic disease. Turkish Archives of Pediatrics, 53(4), 205–213. https://doi.org/10.5152/TurkPediatriArs.2018.6778
Dinleyici, M., Çarman, K. B., Özdemir, C., Harmancı, K., Eren, M., Kirel, B., Şimşek, E., Yarar, C., Duyan Çamurdan, A., & Şahin Dağlı, F. (2020). Quality-of-life evaluation of healthy siblings of children with chronic illness. Balkan Medical Journal, 37(1), 34–42. https://doi.org/10.4274/balkanmedj.galenos.2019.2019.7.142
Dray, J., Bowman, J., Campbell, E., Freund, M., Wolfenden, L., Hodder, R. K., McElwaine, K., Tremain, D., Bartlem, K., Bailey, J., Small, T., Palazzi, K., Oldmeadow, C., & Wiggers, J. (2017). Systematic review of universal resilience-focused interventions targeting child and adolescent mental health in the school setting. Journal of the American Academy of Child & Adolescent Psychiatry, 56(10), 813–824. https://doi.org/10.1016/j.jaac.2017.07.780
Erica, L., & Pudjiati, S. R. R. (2024). Adaptation of the Family Hardiness Index (FHI) instrument for Indonesian adolescents: Alat ukur Family Hardiness Index (FHI) untuk remaja Indonesia. Jurnal Ilmu Keluarga dan Konsumen, 17(2), 120–131. https://doi.org/10.24156/jikk.2024.17.2.120
Felce, D., & Perry, J. (1995). Quality of life: Its definition and measurement. Research in Developmental Disabilities, 16(1), 51–74. https://doi.org/10.1016/0891-4222(94)00028-8
Ha, J. Y., & Ban, S. H. (2020). Effect of resilience on infertile couples’ quality of life: An actor–partner interdependence model approach. Health and Quality of Life Outcomes, 18(1), 295. https://doi.org/10.1186/s12955-020-01550-6
Hamidou, Z., Auquier, P., Leroy, T., Barlesi, F., Salas, S., Chinot, O., & Baumstarck, K. (2018). Dyadic effects of coping strategies, time perspectives, and personality on the quality of life of cancer patients and their caregivers. Psycho-Oncology, 27(2), 590–599. https://doi.org/10.1002/pon.4553
Heng, P. H., Soetikno, N., & Fahditia, A. (2020). Peranan pola asuh orang tua terhadap kualitas hidup remaja perkotaan. Jurnal Muara Ilmu Sosial, Humaniora, dan Seni, 4(2), 550–561. https://doi.org/10.24912/jmishumsen.v4i2.6599.2020
Hoang, M. T., Do, H. N., Dang, T. Q., Do, H. T., Nguyen, T. T., Nguyen, L. H., Nguyen, C. T., Doan, L. P., Vu, G. T., Ngo, T. V., Latkin, C. A., Ho, R. C. M., & Ho, C. S. H. (2021). Cross-cultural adaptation and measurement properties of Youth Quality of Life Instrument-Short Form (YQOL-SF) in a developing South-East Asian country. PLOS ONE, 16(6), e0253075. https://doi.org/10.1371/journal.pone.0253075
Ke, J., Lin, J., Lin, X., Chen, W., & Huang, F. (2023). Dyadic effects of family resilience on quality of life in patients with lung cancer and spousal caregivers: The mediating role of dyadic coping. European Journal of Oncology Nursing, 66, 102400. https://doi.org/10.1016/j.ejon.2023.102400
Kennedy, H. M., Cole, A., Berbert, L., Schenkel, S. R., & DeGrazia, M. (2024). An examination of characteristics, social supports, caregiver resilience and hospital readmissions of children with medical complexity. Child: Care, Health and Development, 50(1), e13206. https://doi.org/10.1111/cch.13206
Keniş-Coşkun, Ö., Atabay, C. E., Şekeroğlu, A., Akdeniz, E., Kasil, B., Bozkurt, G., & Karadağ-Saygı, E. (2020). The relationship between caregiver burden and resilience and quality of life in a Turkish pediatric rehabilitation facility. Journal of Pediatric Nursing, 52, e108–e113. https://doi.org/10.1016/j.pedn.2019.10.014
Khullar, V., Singh, H. P., & Bala, M. (2021). Meltdown/tantrum detection system for individuals with autism spectrum disorder. Applied Artificial Intelligence, 35(15), 1708–1732. https://doi.org/10.1080/08839514.2021.1991115
Kobayashi, K., Hayakawa, A., & Hohashi, N. (2015). Interrelations between siblings and parents in families living with children with cancer. Journal of Family Nursing, 21(1), 119–148. https://doi.org/10.1177/1074840714564061
Kuru, N., & Piyal, B. (2018). Perceived social support and quality of life of parents of children with autism. Nigerian Journal of Clinical Practice, 21(9), 1182–1189. https://doi.org/10.4103/njcp.njcp_13_18
Lamsal, R., & Ungar, W. J. (2021). Impact of growing up with a sibling with a neurodevelopmental disorder on the quality of life of an unaffected sibling: A scoping review. Disability and Rehabilitation, 43(4), 586–594. https://doi.org/10.1080/09638288.2019.1615563
Li, Y., Qiao, Y., Luan, X., Li, S., & Wang, K. (2019). Family resilience and psychological well-being among Chinese breast cancer survivors and their caregivers. European Journal of Cancer Care, 28(2), e12984. https://doi.org/10.1111/ecc.12984
Lu, Z. H., Lam, F. M. H., Leung, J. C. S., & Kwok, T. C. Y. (2022). The resilience and the subsequent hospitalization of older people with different frailty status: A prospective cohort study. Journal of the American Medical Directors Association, 23(10), 1718.e1–1718.e6. https://doi.org/10.1016/j.jamda.2022.07.021
Mangunatmadja, I., Mulyani, D. I., Pardede, S. O., Tridjadja, B., & Wulandari, H. F. (2019). Faktor risiko epilepsi intraktabel pada anak dengan epilepsi umum. Journal of the Indonesian Medical Association, 69(2), 59–65. https://doi.org/10.47830/jinma-vol.69.2-2019-72
Mayangsari, A., Rustyawati, R., Kusumawardhani, S. J., & Ariantika, V. (2026). Beyond family ties: Intergenerational trauma as a predictor of mental well-being among Indonesian youth. Nusantara Journal of Behavioral and Social Science, 5(1), 9–16. https://doi.org/10.47679/njbss.202615051
McCubbin, H. I., & McCubbin, M. A. (1988). Typologies of resilient families: Emerging roles of social class and ethnicity. Family Relations, 37(3), 247–254. https://doi.org/10.2307/584557
McCubbin, M. A., McCubbin, H. I., & Thompson, A. I. (1987). Family Hardiness Index (FHI). In H. I. McCubbin & A. I. Thompson (Eds.), Family assessment inventories for research and practice (pp. 125–130). University of Wisconsin–Madison.
Mendes, T. P., Crespo, C. A., & Austin, J. K. (2017). Family cohesion, stigma, and quality of life in dyads of children with epilepsy and their parents. Journal of Pediatric Psychology, 42(6), 689–699. https://doi.org/10.1093/jpepsy/jsw105
Neo, A. H. C., Chang, W. C., & Fung, D. S. S. (2016). An actor–partner interdependence model on family resilience and subjective wellbeing. Psychology, 7(6), 889–900. https://doi.org/10.4236/psych.2016.76091
Olsavsky, A. L., Ralph, J., Benhayoun, A., Hill, K. N., Guttoo, P., Akard, T. F., Gerhardt, C., & Skeens, M. A. (2024). COVID-19 impact, resilience, and child quality of life: A dyadic analysis. Journal of Family Psychology, 38(4), 523–535. https://doi.org/10.1037/fam0001218
Pagorek-Eshel, S., & Finklestein, M. (2019). Family resilience among parent–adolescent dyads exposed to ongoing rocket fire. Psychological Trauma: Theory, Research, Practice, and Policy, 11(3), 283–291. https://doi.org/10.1037/tra0000397
Puka, K., Tavares, T. P., Anderson, K. K., Ferro, M. A., & Speechley, K. N. (2018). A systematic review of quality of life in parents of children with epilepsy. Epilepsy & Behavior, 82, 38–45. https://doi.org/10.1016/j.yebeh.2018.03.008
Purba, F. D., Hunfeld, J. A. M., Iskandarsyah, A., Fitriana, T. S., Sadarjoen, S. S., Passchier, J., & Busschbach, J. J. V. (2018). Quality of life of the Indonesian general population: Test-retest reliability and population norms of the EQ-5D-5L and WHOQOL-BREF. PLOS ONE, 13(5), e0197098. https://doi.org/10.1371/journal.pone.0197098
Qin, F., Wei, T., Zhao, X., Yuan, S., He, Y., Chen, M., Luo, Z., Shi, L., & Li, G. (2024). Relationship between family resilience and dyadic coping in colorectal cancer patients and their spouses, based on the actor–partner interdependence model. European Journal of Oncology Nursing, 70, 102622. https://doi.org/10.1016/j.ejon.2024.102622
Rachman, Y. A., Sunarti, E., & Herawati, T. (2020). Interaksi suami-istri, interaksi orang tua-anak, interaksi teman sebaya, dan resiliensi remaja. Jurnal Ilmu Keluarga dan Konsumen, 13(1), 1–12. https://doi.org/10.24156/jikk.2020.13.1.1
Rafiee, M., Istasy, M., & Valiante, T. A. (2021). Music in epilepsy: Predicting the effects of the unpredictable. Epilepsy & Behavior, 122, 108164. https://doi.org/10.1016/j.yebeh.2021.108164
Rafli, A., Handryastuti, S., Mangunatmadja, I., Mulyadi, R., Kekalih, A., Gayatri, A., Herini, E., Kusuma, W. A., Raditha, C., Tjandrajani, A., Lestari, P. C., & Muchtar, Y. M. (2026). Characteristics and risk factors of drug-resistant epilepsy in children: A retrospective study in Jakarta from 2020–2025. Paediatrica Indonesiana, 66(1), 69–75. https://doi.org/10.14238/pi66.1.2026.69-75
Rana, P., & Mishra, D. (2015). Quality of life of unaffected siblings of children with chronic neurological disorders. The Indian Journal of Pediatrics, 82(6), 545–548. https://doi.org/10.1007/s12098-014-1672-4
Ruiz-Rodríguez, I., Hombrados-Mendieta, I., Melguizo-Garín, A., & Martos-Méndez, M. J. (2022). The importance of social support, optimism and resilience on the quality of life of cancer patients. Frontiers in Psychology, 13, 833176. https://doi.org/10.3389/fpsyg.2022.833176
Setiawan, T., Wardani, R., & Theresia, E. (2022). The conditional effect of family resilience on family quality of life during the COVID-19 pandemic [Version 2]. F1000Research, 11, 1279. https://doi.org/10.12688/f1000research.125852.2
Syakina, L., & Hawari, I. (2020). Pengaruh fungsi kognitif terhadap kualitas hidup orang dengan epilepsi pada Komunitas Peduli Epilepsi Indonesia di Depok periode November 2017–Maret 2018. Tarumanagara Medical Journal, 2(1), 110–116. https://doi.org/10.24912/tmj.v2i2.7846
Wang, H., Yue, H., Ren, M., & Feng, D. (2021). Dyadic effects of family-functioning and resilience on quality of life in advanced lung cancer patients and caregivers: An actor–partner interdependence mediation model. European Journal of Oncology Nursing, 52, 101963. https://doi.org/10.1016/j.ejon.2021.101963
Watson, W. H. (2012). Family systems. In V. S. Ramachandran (Ed.), Encyclopedia of human behavior (2nd ed., pp. 184–193). Academic Press. https://doi.org/10.1016/B978-0-12-375000-6.00169-5
Yan, Z., Zhang, Q., Chang, L., Liu, Y., & Li, Y. (2021). Dyadic effects of family resilience on post-traumatic stress symptoms among breast cancer patients and their primary family caregivers: A cross-sectional study. European Journal of Oncology Nursing, 53, 101998. https://doi.org/10.1016/j.ejon.2021.101998
Zhou, K., Ning, F., Wang, X., Wang, W., Han, D., & Li, X. (2022). Perceived social support and coping style as mediators between resilience and health-related quality of life in women newly diagnosed with breast cancer: A cross-sectional study. BMC Women’s Health, 22(1), 198. https://doi.org/10.1186/s12905-022-01783-1
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