The impact of fluctuating relationships with the Canadian health care system on family management of otitis media with effusion.

The analysis of data from a grounded theory study of family interaction when a child has otitis media with effusion (OME) shows that these families are engaged in the process of learning to manage. Their relationship with the health care system, coupled with the effects of the disease on the child and the family lifestyle, has a powerful influence on how this process proceeds. In this paper, the authors discuss the impact of the family's relationship with the Canadian health care system on the development of management skills. Relationships with the health care system fluctuate forward and backward through entrusting, becoming disillusioned, learning the rules and negotiating, as families learn to manage the effects of the disease process on the child and the family. The family perspective of the quality and availability of health care at a time when health care systems throughout the world are under close scrutiny, adds to our understanding of consumer expectations. Some recommendations for improving current relationships between families and the health care system are made.