Parents of children diagnosed with complex chronic conditions (CCCs) face many challenges with managing their child's health. As parents are tasked with competing demands and the constant changes required to provide the best care possible for their child, talk about contradictions regarding their dual, and oftentimes competing, roles and responsibilities as both parent and caregiver is likely to occur. Using relational dialectics theory (Baxter, 2011) as a framework, we conducted a contrapuntal analysis to analyze 35 White, mostly Christian parents’ narratives about their experiences managing their child’s healthcare. Two primary discourses emerged: the centripetal discourse of normal health and the centrifugal discourse of difference. The interplay between these two primary discourses led to a hybrid discourse: difference is our new normal. Within this discourse, parents discussed previous speech encounters where they relied upon the co-construction of a new normal with others who were living or willing to live in their new reality. Our findings emphasize how an assessment of parents’ talk conveys their discourse-dependence with navigating the inevitable uncertainties associated with managing their child’s CCC. In addition, we discuss how parents co-construct their new normal in the face of unique family functioning that is structurally different from societal expectations and social norms about parenting and pediatric health care management.


Relational Dialectics Theory, Contrapuntal Analysis, Pediatric Chronic Illness, Parental Caregivers, Health Communication, Family Communication, Complex Chronic Conditions

Author Bio(s)

Katherine Rafferty (PhD, University of Wisconsin-Milwaukee, 2015) is an assistant teaching professor at Iowa State University where she teaches undergraduate courses in health communication, communication theory, interpersonal communication and conflict management. She also manages a team of undergraduate students in the Family Health Communication research lab. Katherine's research lies at the intersection of interpersonal and health communication, with a focus on how patients and families manage and cope with chronic illness and end-of-life care. She previously worked as a Health Communication Specialist for the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia. Correspondence regarding this article can be addressed directly to: rafferty@iastate.edu.

Kara Hutton (B.A., Iowa State University, 2018) graduated from Iowa State University with a double major in English and Communication Studies. As an undergraduate student, she worked as a research assistant in the Family Health Communication Research Lab.


We would like to thank the families who shared their stories with us. We would also like to thank The Ronald McDonald House Charities for their help and support with recruitment and data collection. Last, we want to thank Sarah Heller, Nicole Miller, and Madison Schwenneker for their assistance with data analysis.

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Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 International License.





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