CHILDREN AND THEIR PARENTS

Parental experience of family resources in single-parent families having

a child with cancer
I-Chen Huang, Pei-Fan Mu and Tzeon-Jye Chiou

Aim. The purpose of this study was to explore the essence of family experiences in terms of family resources and how these assist
a single-parent caring for a child with cancer.
Background. When families face stresses caused by cancer, they need to readjust their roles, interactive patterns and relationships, both inside and outside the family. During the adaptation process, family resources may assist recovery from stress
and a return to equilibrium. Most research has emphasised the support resources available to two-parent families during the
treatment process. There is a lack of information on the experiences of single-parent families and their available resources
together with the functions and roles played by family resources during the adjustment process.
Design. Qualitative.
Results. Five major themes were identified: (i) facing the disease with courage; (ii) hope kindled by professionals; (iii) constructing parental role ability; (iv) assisting the children to live with the illness; and (v) family flexibility.
Conclusion. The results of the current study demonstrate that single-parent families with a child suffering from cancer employ
family resources to assist family adjustment and to maintain family function/equilibrium. These results explain the dynamic
interactions between the multiple levels of resources available to the family.
Relevance to clinical practice. The study results provide evidence-based information that identifies the nature of family resources
in single-parent families and describes how these resources can be applied to assist the families.
Key words: cancer, child nursing, family health, family nursing, nurses, phenomenology
Accepted for publication: 14 January 2008

Over the past 40 years, Taiwans economy has grown rapidly.

With the spread of urbanisation and individualism, traditional
family roles and their functions in marriage have become
fuzzy; as a result, family structure is changing swiftly.
Stressful events in a family may result in divorce or separation
and this has led to an increase in single-parent families. In
Taiwan, the percentage of single-parent families has increased
from 5877% from 19902001(Accounting and Statistics,
Executive Yuan 2003). Single-parent families usually suffer

from a financial burden, deviation from the norms of child

nurturing, role-burden, work-related problems and psychosocial pressures (Whiteside-Mansell et al. 2001, Kuo & Wu
2003). When children in a single-parent family suffer
from cancer, a significant further burden is created, and
results in an increase in the stress on both the children and
their families.
At present, studies on children with cancer in relation to
family stress and adjustment have focused on the childrens
physical and mental stress and adjustment (Chao et al. 2003),
symptom management (Rheingans 2007) and parents stress

Authors: I-Chen Huang, RN, MS, Institute of Clinical Nursing,

National Yang-Ming University, Taipei, Taiwan; Pei-Fan Mu, RN,
PhD, Institute of Clinical Nursing, National Yang-Ming University,
Taipei, Taiwan; Tzeon-Jye Chiou, MD, Associate Professor,
Taipei Veteran General Hospital, National Yang-Ming Unviersity,

Taipei, Taiwan
Correspondence: Pei-Fan Mu, Institute of Clinical Nursing,
National Yang-Ming University, Taipei, Taiwan. Telephone: +886
2 28267163.
E-mail: [email protected]; [email protected]

Introduction

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doi: 10.1111/j.1365-2702.2008.02447.x

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I-C Huang et al.

adjustment (Mu et al. 2002, Fuemmeler et al. 2003). With

regard to single-parent families, most research has concentrated on the demands on and the coping strategies of the
single-parent families (Cairney et al. 2003, Wang et al. 2003),
on social support, on the mental health of the single-parent
(Cairney et al. 2003, Keating-Lefler et al. 2004) and on the
factors that impact on the childs outcome (Biblzrs &
Gottainer 2000, Bjorklund et al. 2007). Limited studies have
focused on family resources and assisting life adjustment
among children with cancer in a single-parent family. It is still
not clear what the nature of family resources available during
the adjustment process is when assisting single-parent families to cope with a child with cancer. Using a phenomenological approach, this study explores the essence of the
families experiences and how family resources assist the
single-parent to care for their child with cancer. The study
results provide evidence-based information identifying the
nature of family resources available to single-parent families
and this will facilitate the application of these resources when
assisting a family to cope with this type of stress.

Literature review
McCubbin and McCubbin (1993) defined family resources as
the resources applied in dealing with stress during the
adaptation stages when families undergo stressful events.
When families face stresses such as those caused by cancer,
including prolonged treatment and life-threatening developments, they need to readjust their roles, the pattern of
interactions in the family and the relationships inside and
outside the family. During the adaptation process, family
resources may assist families to recover from stress and return
to equilibrium.
Children with malignancy undergo an extremely unpleasant series of experiences that affect both the child and the
family. The most common findings with respect to these
impacts are physical-psychosocial in nature (Hedstrom et al.
2003) and involve parental and family psychological reactions (McGrath 2001a), parental role stress, changes in the
family relationships and adjustments in family functioning
(Mu et al. 2002). Whether or not parents can successfully
adapt to the process depends greatly on the support provided
by individuals, the family and the social system (McCubbin
& McCubbin 1993).
Only a few studies have used the phenomenological
approach to investigate parental experiences when caring
for a child with cancer. McGrath (2001b) used the phenomenological method to investigate support issues among
parents when a child had leukaemia. The findings indicated
that the need for support was intense and that offers of
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support tended to lessen over time. To understand how social

support has an impact on single mothers, Cairney et al.
(2003) collected and compared data from 725 single mothers
and 2231 married mothers. The study results showed that
single mothers feel they receive less social support, have less
time for friends and family members and participate less in
social activities than married mothers.
The literature outlined above shows that families facing
stress have to use their resources to re-establish the family
structure and its functionality. Most research has emphasised
the support resources available during their treatment process
to two-parent families of a child with cancer. There is a lack
of information on single-parent experiences with respect to
resources and the functions and roles of the family resources.
To understand the nature of useful and the meaningful family
resources available is an important intervention factor for
nurses when caring for sick children and their families. The
purpose of this study is to investigate the essence of family
resources available to assist family adjustment among singleparent families with a child suffering from cancer. Through
an understanding of the real-life experiences of single-parent
families, this studys findings will provide a nursing knowledge base that should assist single-parent families to more
appropriately use both inside and outside family resources
when caring for children with cancer. This, in turn, should
result in better family adjustment.

Methods
Based on Colaizzi (1978), a phenomenological approach was
used. The purpose of the phenomenological philosophy is to
understand the essential structure of an individuals experiences from their own viewpoint. The goal of the phenomenological approach is to describe the experiences of the
participants to discover any common meanings or characteristics together with any underlying empirical variations of a
given phenomenon (Girogi 1997).

Participants
The current study used purposive sampling. Participants were
invited to join the study while they attended one of three
medical centres in Taiwan. The medical centres were standardised in terms of physical and personnel quality control as
stipulated by the government. The services provided primary
care nursing in a paediatric oncology setting and has done so
for many years. The criteria for inclusion were: (i) a singleparent family having a child of <18 years who was suffering
from cancer and was receiving either chemotherapy or
radiotherapy treatment and (ii) a single-mother or a

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Children and their parents

single-father who was capable of using Mandarin or Taiwanese to express their experiences.
Nine single fathers/mothers participated in this study. Five
were single mothers and four were single fathers. The age
range of the single parents was 3042 years old. One of the
nine was unmarried, seven were divorced single parents and
one was separated. In terms of educational level, three had
completed junior high school, five had completed high school
and one had attended college. Six were working full-time.
Their religious beliefs were Taoism for three parents,
Buddhism for another three and the remaining three were
atheist. The nine children consisted of five girls and four boys
and at the time of study, the children ranged in age from
615 years. The age at diagnosis of the cancer ranged from
34133 years. The cancers consisted of one case of acute
promelocytic leukaemia, four cases of acute lymphoblastic
leukaemia, two cases of osteosarcoma, one brain tumour and
one neuroblastoma.

Ethical considerations
The study was approved by the Hospital Human Investigation Committee at each of the three medical centres. The
participants rights of anonymity, confidentiality and withdrawal from the study were explained at the time of
interview.

Data collection
Data were collected through open question interviews. Two
open questions were used to initiate the interview and these
focused on the everyday experiences of the single parents and
their use of family resources to care for their children. Each
interview started with these questions: What have been your
experiences while caring for your child since the cancer
diagnosis? How have you survived this? and Throughout
the process, what kind of assistance or support has been
helpful? The first author conducted all the interviews, which
lasted between 6090 min, were taped and then transcribed
verbatim. Facilitative techniques such as Could you describe
it more? and Could you give an example? were used to
obtain descriptions that were as complete as possible.

Data analysis
An open attitude and imaginative variation techniques were
used to investigate the meaning of single-parents experience.
The Colaizzis (1978) method involves using both destructured and restructured analysis as well as integration using
the principles of phenomenology. Methodological rigour was

Family resources in single-parent families

confirmed using the principles suggested by Lincoln and

Guba (1985) to establish trustworthiness, the criteria of
which included credibility, transferability, dependability and
conformability.

Results
The results of this study demonstrate the essence of the family
resources used to assist family adjustment among singleparent families who have a child who suffers from cancer.
These consist of five major themes: (i) facing the disease with
courage; (ii) hope kindled by professionals; (iii) constructing
parental role ability; (iv) assisting the child to live with the
illness; and (v) family flexibility.

Facing the disease with courage

Both the impacts on the single-parent brought by about by
the childs illness and companionship during their cancer
treatment are unspoken experiences. Single parents gain
strength and face the disease with courage in four ways: (i)
persistent faith; (ii) blessing from holy spirits and rituals; (iii)
appreciating the childs courage for survival; and (iv) receiving encouragement from relatives and friends.
Persistent faith
Cancer treatment is a long and difficult process for children
and two-parent families. It is even more exhausting and
tiring for a single-parent who then cares for the child
alone, arranges all travel between the hospital and the
home with the child and undertakes all the economic
burdens. They accompany their child throughout the
treatment processes with the aim of saving their childs life
and never think of abandoning hope because the child is
precious to them:
Father B: Im okay with the tiredness because its my own child. You
will carry on no matter how tired you are. You cant give up. But,
honestly, the pressure is really heavy.

Blessing from holy spirits and rituals

During the process of the childrens recurrent hospitalisation, the single-parent seeks protection for their child from
spiritual power or from rituals, in hope of obtaining a
blessing for their child. The parent prays that their child will
have an uncomplicated treatment and survive. For example,
to gain spiritual power, they chant Holy Scriptures, dedicate
themselves to charity to obtain a spiritual reward for their
child and throw divination blocks to obtain a divine message:

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Father C: The Gods gave us three favorable messages, which meant
yes (God agrees their wishes). The Gods would lead our child
through the difficulties.

Appreciating the childs courage for survival

During treatment process, single parents understand their
childs courage when facing the illness. They are proud of
their child and this reflects on their parental role responsibilities. They realise that, as the main support of their children, they need to be strong. Therefore, they force themselves
to face the illness with determination:
Mother C: My daughter is very brave. I really think so. I have to hang
in there. I have been tortured a lot by these two years treatment, such
as (my daughter has) low blood count (WBC), but I feel she suffered
more. Nevertheless, I think it has been worth the pain.

Receiving encouragement from relatives and friends

The impact of a childs illness is very strong on a single-parent
and their family. Single parents have the support and concern
of their relatives and friends, so they know they are not alone.
Through chatting, phone calls, visiting similar children and
learning from other parents experiences, they obtain psychological support. By doing these things, they gain the
strength to take their child to the hospital for treatment and
have the courage to carry on:
Father F: Bearing such stress alone, I sometimes need to talk to some
good friends. After talking or complaining to them, I then find a way to
face reality and take my next step, instead of just being helpless person.

Constructing parental role ability

While fighting the illness together with their child, single
parents construct a caring ability. By doing so, they gain
the strength to fight against the illness, to improve the
childs physical, mental and spiritual health and to face the
unknown future. Three sub-themes emerged in this area: (i)
learning to withstand hardship; (ii) building up a protective
environment; and (iii) fulfiling their childs wishes to avoid
later regrets.
Learning to withstand hardship
Single parents have to undertake everything alone including
all kinds of pressures that come from the childs illness and
unexpected events. They learn to withstand hardship by (i)
psychological adjustment; (ii) solving problems alone; and
(iii) strengthening their caring ability.

Psychological adjustment
When facing their child with cancer, single parents feel
anxious, so to face their childs illness with strength, they
relieve their stress using psychological coping strategies, such
as crying, talking to people and transferring their attention.
Furthermore, they look at the childs illness and their future
with an optimistic attitude. Through this, parents hope that
they can be brave and continue the journey with their child
towards health:
Mother I: I am more independent and optimistic. Cross each bridge
when you come to it. We will see. I intend to be this way. I am happy-

Hope kindled by professionals

Because of a lack of understanding of the illness, single parents
do not know what to do and worry about their childs future.
When parents perceive that medical professionals who care for
their children wholeheartedly provide appropriate help, parents feel there is hope for their childrens recovery. Professional
credible treatment increases the single-parents hope for their
childrens recovery. After the doctor explains the illness, single
parents can have a clearer understanding of childrens illness
procedures and they gain strength from this information to face
and accept any sudden changes. When children are hospitalised
for treatment, single parents are especially grateful for the
nurses dedication. Nurses explain the illness to the parents and
assist the parent in caring for the child, showing sympathy with
them for the hardship they undergo:
Mother D: What really boosts my confidence is the medical team
because every nurse here knows every medicine very well and how

go-lucky. You have to look at the childs illness from different angles.

Solving problems alone

Facing the problems caused by the childs illness, single
parents find their own way to handle them to preserve their
dignity and independence. They do not want concern or help
from relatives or friends based on sympathy. No matter how
hard things are, they believe they need to rely on nobody but
themselves, because this is more realistic:
Father G: After all, I dont like to bother the others. I try my best to
do it myself. If I cannot, then, Ill find another way.

Strengthening the caring ability

To provide better care for their children, single parents
strengthen their caring ability. Some parents share their
caring experiences with other relatives, ask information from

people would react to it. Their explanation restores my confidence.

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Children and their parents

medical professionals or search for information on the

Internet:
Father G: When he was hospitalised, like other single parents, I knew
nothing. If I really needed help, I asked the nurses. Nurses said I could
ask the parents of other sick children because they are more
experienced and they would teach me what to do.

Building up a protective environment

To protect their children, parents are extremely discrete
about everything close to and surrounding them. Parents
build up a protective environment for their children through:
(i) choosing a good medical environment; (ii) building up a
safe school environment; and (iii) nurturing the childs constitution.

Choosing a good medical environment

That the child is able to receive the best treatment and care,
single parents choose hospitals equipped with the most up-todate medical resources so that the childs security is increased
and their childs life is safeguarded:
Father F: I believe every parent wants to provide the best treatment
for their child once they learn about the illness. Besides, (they want)
the most reliable team. Because the team will have better understanding among them and wont insist on personal opinions. This is
best for the child.

Building up a safe school environment

If a child is allowed to go to school, the single-parent
communicates with teachers, other parents and classmates
about the illness and the childs health. By improving the
schools caring and protective abilities towards the child and
offering appropriate help, single parents try to build up a safe
school environment so that their childs life is protected:
Mother I: I talked to the teacher, asking that the child is not to assign
jobs such as cleaning toilets. Id ask the teacher to remind her to take
medicine if she actually catches a cold.

Family resources in single-parent families

organic or vegetarian food to help to change her body to towards an
alkaline pH.

Fulfiling the childrens wishes to avoid regrets

Single parents realise that life is transient once their childs
has cancer. They endeavour to keep their promises to their
children and fulfil their wishes as much as possible. This is so
that, one day, neither the parent nor the child feels any regret
or guilt:
Mother C: I will buy anything as long as she wants to take a bite. I dont
want to regret. I feel that I might not have the day again to do it. Today,
as long my child opens her mouth and asks, I will try my best.

Assisting the children to live with the illness

Cancer treatment is a hard and a prolonged process consisting of travelling back and forth to the hospital. Single parents
try to build up a life for their children so that they can live
with the illness and be brave when facing the treatment. The
experiences of parents as they try to strengthen their child
are: (i) enhancing the childs self-care ability and (ii) building
a normal life pattern.
Enhancing the childs self-care ability
Cancer treatment is visible and it cannot be hidden. Single
parents need to help children have a sense of safety to be able
to face the illness, to accept the pain caused by treatment and
the funny looks from others. When seeing the childs fear of
intrusive treatment or the side effects of chemotherapy, single
parents understand the importance of being there for their
child. The childrens sense of safety is ensured by the presence
of the parent. They are able to bravely accept and cope with
the treatment. Furthermore, single parents hope that, through
increasing the childs understanding of the disease, they will
enhance the childs self-caring ability. Thus, the child learns
to appreciate their bodies, becoming aware and watching for
any tiny uncomfortable changes to alleviate any threat to
their life:
Mother C: She will know it no matter what, because she has received
so many injections while undergoing chemotherapy. I think it is good

Nurturing the childs constitution

Parents are concerned that their child will be unable to
withstand the damage brought about by chemotherapy. Thus,
single parents not only provide appropriate nurturing food,
but also seek alternative therapies to improve the childs
constitution including Chinese medicine and organic food:
Mother F: Information on the Internet said that the pH of the human
body affects the spread of cancer cells. So I often provide her with

for her to take care of herself if she can understand more about her
illness.

Building a normal life pattern

As a result of cancer, single parents are discrete about
everything that concerns their child and fear that their child
might develop inappropriate behaviour. Therefore, parents
try to create a healthy lifestyle to maintain the childs
normal development and growth. Children might not be

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I-C Huang et al.

able to go back to school because of frequent re-admission

to hospital or poor health. Single parents worry that their
child might become eccentric as a result of being isolated
or might lose interest in schoolwork. Therefore, they
organise bedside teachers to help to continue their childs
education:
Father B: I arranged to apply for home-education for David. He had
not studied for a half year. The teacher was quite worried. Now he is
much better and as a result his teacher applied for home education
for him. A teacher comes a few times a week to regularly teach him.
When he is recovered, he wont be lagging behind too much in
schoolwork.

Family flexibility
Single parents with children who have cancer already face the
need to take care of the child, to continue to work at a job
and to look after their family, which is already a heavy
responsibility. To function as a normal family, single parents
need to adjust to the family relationships in a flexible manner
and must modify the family roles or interaction patterns.
During this period, the resources that parents use are: (i)
overcoming economic difficulties and (ii) role replacement.
Overcoming economic difficulties
Single parents must carry alone the huge medical expenses for
the cancer treatment and they realise the importance of
financial resources. Single parents usually look for appropriate
information about social benefits. They also receive help from
ex-husband/ex-wives, the medical team and certain institutions, all of which helps to relieve their financial burden:
Mother D: It is my brother who finances me; and there is my parents
and my sister too. Anyway, I borrow some from them if I am short of
money. So far, Ive returned what I have borrowed.

Role replacement
As a result of childs illness, parents feel a need for more
family cohesion. Family members and relatives reach out to
help, dividing the jobs that need to be performed to provide
financial and care assistance. This allows the parent to leave
their child temporarily and to keep their job. Furthermore,
siblings know they are in single-parent families and their
parents have to bear the burden alone. To lessen the parents
burden, siblings share the work. On the other hand, parents
feel their hardship is worthwhile as their children are so
understanding and considerate:
Mother C: Mary is studying in Taipei. They (the relatives) will pick
her up for me, make her dinner and help her bath. I then can similar

2746

to do what I need to do knowing that they know what medicine to

give her or similar.

Discussion
The results of the current study demonstrate that single
parents who have a child with cancer employ family resources
to assist with family adjustment, to maintain family functions
and to keep equilibrium. There are five themes that are
involved in this deployment of family resources: acquiring
courage, kindling hope, constructing parental roles, assisting
the childs adjustment and family flexibility. These results
support McCubbin and McCubbins (1996) idea of family
resiliency, which explains the dynamic interaction between
multiple levels of resources that are available to assist a
family to manage their stress.
While caring for children with cancers, the courage of
the single parents arises from their persistent faith in the
hope of recovery. Single parents look for strength from
religion to gain psychological strength and thus be able to
help their children. Through psychological support from
family members and friends, parents realise they are not
alone and so have the courage to continue the journey with
their children. This result is similar to findings by Judge
(1998) and Martinsen et al. (1997). Furthermore,
parents rely a great deal on the medical team to save
their children. The promises, messages and assistance
provided by the medical team help to kindle each parents
hope.
When with their children, the single parents ability to
adjust is an important family resource. Single parents use
emotional-coping strategies to release their stress. These
results resemble other studies that have explored the coping
strategies of parents whose children have cancer (James et al.
2002, Yeh 2003). The current study also identifies that
parents treat the future with optimism to preserve personal
psychological health and to face their childrens illness with
bravery. Walsh (2003) indicated that a positive attitude is the
major factor when overcoming stress in a family. Furthermore, the parents have strong self-esteem and a sense of
responsibility. When parents encounter difficulties or stress,
they rely on themselves to solve problems.
The study further demonstrates that, with regard to their
childrens illness, single parents actively seek multiple sources
of information to strengthen their caring ability. They make
every effort to safeguard their childrens lives and single
parents are careful to establish a safe environment. Furthermore, during their childs illness, single parents use alternative treatment approaches to increase their childs chances of

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Children and their parents

recovery. This result is similar to several relevant studies

(Leavitt et al. 1999, Martinsen et al. 1999).
Single parents apply resources to help their children
establish a pattern that allows them to coexist with the
illness. The parent increases the childs understanding of the
illness to establish the childs sense of security and self-caring
ability. During the childs treatment, single parents try to
maintain a normal lifestyle through appropriate nurturing
and a healthy living environment; this lowers the influence
that the illness has on their child.
One of the significant findings of this study is that family
flexibility is a major family resource that assists single parents
to manage the stress. Family members face the difficulties
together and share the family roles and burdens in a flexible
manner. Furthermore, following the childs treatment, single
parents face a huge number of medical expenses and this
produces a large financial burden on the parent. Our research
demonstrates that single parents families, to solve the
financial problems, will apply family resources from both
inside and outside family and arrange their own financial
plans in a practical way.

Nursing practices
The study results point out the nature of the family coping
resource experience among children with cancer who are
members of a single-parent family and describe how they
apply family resources. Nursing professionals should evaluate family resources at an early stage and verify the familys
strengths and needs. This will help with the development of
strategies that assist family adaptation. The current study
also indicates that the single-parents persistence and bravery
in dealing with the illness is the major resource involved
in adaptation. Nurses should admire and compliment
the parents persistence and determination, pointing
out the childrens efforts and courage, verifying and
revitalising the family support system network and thus
providing psychological and mental backup for the parents.
Further, spiritual caring is an important family resource,
which can strengthen inner power. Nurses should actively
try to understand the parents religious beliefs and establish a
channel for them to have contact with their religion.
Through their religious faith or a pursuit of religion, single
parents can assist themselves to face the meaning of life and
thus have hope for the future.
Professional medical skill is an essential resource that can
rekindle parents hope. It is vital to establish a constructive
nursepatient relationship and trust. The medical teams
understanding of the sick childrens treatment process, the

Family resources in single-parent families

provision of clear information and the offering of positive

explanations on the possible future progress of treatments are
able to help maintain the hope of the parents.
With their childrens illness, single-parents construction
of their role as a caregiver is also important to the family
resources. Nurses should react by listening to their emotions
and provide psychological counselling or information as to
where to get help. Nurses can provide available medical and
social resources to establish a resource network and help
with the creation of medical information resources to give
the parents a sense of control when dealing with the
problems alone. Nurses should help the single-parent to
communicate with doctors to understand the purpose of
treatment; this will strengthen the childs and parents
motivation and help them to follow the doctors instructions. If sick children return to school, parents should be
encouraged to communicate with the school to help them
understand the childs situation and needs; this should
provide a healthy learning environment. Furthermore,
nurses can assist parents to fulfil any wishes that the child
may have to avoid any regrets by the child or the family in
the future.
Normalisation is another resource involved in family
readjustment. Nurses can encourage single parents to
interact with the outside world by sharing the illness,
gathering information and helping to care for other patients
in the same ward. By doing this, it is hoped that a suitable
and individualistic way of nurturing the child will be
developed that helps coexistence with the illness and helps
to regain a normal life for the child. To safeguard the
childrens lives, it is advisable for the nurses to help children
understand their illnesses at a level appropriate to the childs
development; this builds up the childs sense of security and
enables them to learn self-caring skills. For the childrens
normalisation, nurses can provide relevant illness information to strengthen the teachers caring ability and allow
parents to send their children back to school as soon as
possible.
Furthermore, it is helpful if the family cements family
cohesion, which allows adjustment to the roles in the family
and increases functional flexibility; this includes such things
as encouraging siblings responsibilities by caring and
participating. Financial resources also help with family
readjustment. It is suggested that the childs family financial
situation and needs ought to be examined regularly. This
will allow the appropriate provision of social benefits to
relieve the parents economic burden. This, in turn, helps
to avoid breaks in treatment that might endanger the
childs life.

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Limitations and recommendations

The participants in this study are from three medical centres,
which are not representative of the complete range of
experiences among families living in other areas of Taiwan.
Thus, the study results cannot be extrapolated to deduce the
overall family resources experience of single-parents families
across Taiwan. Unique family resources experiences may
occur at different stages of the illness and these might require
a combination of qualitative and quantitative research
approaches to obtain a well-rounded understanding of the
family resources experience in single-parent families. It is also
recommended that nursing interventions are developed to
help family resource development and that these be used to
test the effectiveness of strengthening family resources in
single-parent families.

Acknowledgement
We are grateful to the participants and nursing staff for their
help.

Contributions
Study design: IH, PM, TC; data collection and analysis: IH,
PM, TC and manuscript preparation: IH, PM.

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