DNP Scholarly Projects


Background: Children with medical complexity (CMC) are considered most medically fragile and require the most health care needs. Medical care for CMC is described as fragmented, uncoordinated, and crisis-driven with a tendency to over-medicalize the child and under-support the family. The intimate link between caregiver and child health supports further exploration of factors that may influence family health-related quality of life (FHRQOL) in families of CMC. Purpose: The purpose was description of the population of CMC receiving rehabilitation services in the community setting and exploration of the impact of a comprehensive outpatient rehabilitation facility (CORF) on FHRQOL. Review of Evidence: Few studies have examined FHRQOL as a health outcome measure for CMC despite its identified importance as a meaningful outcome measure by families and researchers, and no study has explored the population of CMC in the context of receiving care services through a CORF. Design: A cross-sectional, web-based survey measured FHRQOL in a convenience sample of primary caregivers with children attending a CORF (N = 139) in fall 2020. Results: Eighteen percent (n = 25, N = 139) of children receiving services at the CORF matched criteria as CMC. Child stability (n = 25, rs = -.310, p = .132) and length of service utilization (n = 25, rs = -.211, p = .312) were not significantly associated with FHRQOL. Parent HRQOL (n = 25, rs = .916, p < .001) and family functioning (n = 25, rs = .919, p < .001) summary scores held positive associations with FHRQOL. Conclusion: Measuring FHRQOL and its influencing factors ought to be a standard part of the evaluation of CMC, as parents, siblings and family units may experience adverse effects caring for the vulnerable population of children.


Spring 4-22-2021

First Advisor

Linda Wofford, DNP, RN, CPNP

Scholarly Project Team Member

Laura Gray PhD, RN

Scholarly Project Team Member

David Phillippi, PhD


Nursing, School of


Health Sciences & Nursing, Gordon E. Inman College of

Document Type

Scholarly Project


Doctorate of Nursing Practice (DNP)

Degree Level


Degree Grantor

Belmont University


children with medical complexity; comprehensive outpatient rehabilitation facility; family health-related quality of life; PedsQL FIM

Included in

Nursing Commons