Family Functioning as a Constituent Aspect of a Child's Chronic Illness

•Improved medical care has expanded the lifespan of chronically ill children.•This condition implies an enormous engagement of families and healthcare system.•Family functioning is a constituent aspect of a child's chronic illness.•Changes in family functioning may impact on the child's illness trajectory.

This study explored how family functioning may contribute to trace a child's illness trajectory. We conducted semi-structured interviews with 33 parents of children in care at a hospice in northern Italy. We also examined the medical records of the children, and interviewed the physician who cared for them. Data analysis was based on the grounded theory approach. Different illness progressions corresponded to the different ways with which families experienced the illness: possibility, focus on illness, denial, and anger. Clinical interventions should involve the whole family and take into account their role in the construction of illness trajectories.