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Samuel PS, Marsack-Topolewski CN, Janks E, Raoufi G, Milberger S. Family Support of Older Caregivers: Factors Influencing Change in Quality of Life. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2024; 129:308-325. [PMID: 38917996 DOI: 10.1352/1944-7558-129.4.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 01/30/2024] [Indexed: 06/27/2024]
Abstract
Understanding factors that can improve the quality of life (QOL) of older caregivers of people with intellectual and developmental disabilities (IDD) is important in broadening participation in family empowerment interventions. The purpose of this study was to identify the factors influencing the QOL of older caregivers (50+) of adults with IDD who participated in a peer-mediated state-wide family support project. The research study used a quasi-experimental research design grounded in the family quality of life (FQOL) framework, with pretest and posttest data gathered from 82 caregivers. Correlation and regression analyses were conducted to identify factors influencing changes in the QOL of study participants. Findings indicated that improvements in caregiver QOL after participating in the project could be explained by caregiver's employment status, increased global FQOL, and decreased caregiver stress and depression.
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Affiliation(s)
| | | | - Elizabeth Janks
- Elizabeth Janks, Gelareh Raoufi, and Sharon Milberger, Wayne State University
| | - Gelareh Raoufi
- Elizabeth Janks, Gelareh Raoufi, and Sharon Milberger, Wayne State University
| | - Sharon Milberger
- Elizabeth Janks, Gelareh Raoufi, and Sharon Milberger, Wayne State University
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2
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Brekke I, Alecu A, Ohrazda C, Lee J. Implications of Childhood Autism Spectrum Disorder for Maternal Employment: United States vs. Norway. Matern Child Health J 2024:10.1007/s10995-024-03961-z. [PMID: 38864988 DOI: 10.1007/s10995-024-03961-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2024] [Indexed: 06/13/2024]
Abstract
OBJECTIVES A country's social welfare system may play an important role in maternal employment. This study compared the labor market participation of mothers of children within the United States (U.S.) and Norway to examine whether the child's age and severity of the ASD affected mothers' employment differently between the two countries. METHODS The 2019 National Survey of Children's Health was used for the U.S. analysis, and the 2019 administrative register data were used for the Norwegian analysis. A logit model was used to analyze the impact of a child's age and ASD severity on maternal employment in the U.S. and Norway. We presented the results as average marginal effects obtained from the logistic regression analyses. RESULTS After adjusting for mothers' sociodemographic variables and the child's age, U.S. mothers of children with mild ASD and moderate/severe ASD had respectively 12 and 25% points lower probability of being employed than U.S. mothers of children without special health care needs. In Norway, mothers of children with moderate/severe ASD had a 13% points lower probability of employment than mothers without special health care needs. The probability of being employed for mothers caring for a child with ASD was significantly greater as the child got older in both countries. CONCLUSIONS FOR PRACTICE The employment gap was more substantial in the U.S. than in Norway. A general high employment participation rate among women and an elaborated welfare state and policy package seem to benefit employment among mothers of children with ASD in Norway.
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Affiliation(s)
- Idunn Brekke
- Department of childhood and families, Division of Mental and Physical Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, Oslo, N-0213, Norway.
| | - Andreea Alecu
- Consumption Research Norway, Oslo Metropolitan University, Oslo, Norway
| | | | - Jiwon Lee
- School of Nursing, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, Georgia, U.S.A
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Vatsolaki E, Agouropoulos A, Papagiannoulis E, Gizani S. Two years outcome of an individualized oral health preventive program for preschool children with neurodevelopmental disorders. SPECIAL CARE IN DENTISTRY 2024. [PMID: 38831338 DOI: 10.1111/scd.13029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 05/19/2024] [Accepted: 05/22/2024] [Indexed: 06/05/2024]
Abstract
AIMS Limited data exist on the effectiveness of oral health preventive programs in children with Neurodevelopmental Disorders (NDD). The aim of this study was to evaluate the effectiveness of an individualized preventive oral health program for preschool children with NDD at a rehabilitation center, over a two years period. METHODS AND RESULTS In this study, 102 preschool children with NDD were assessed for caries (dmft), oral hygiene status (Green & Vermillion Index) and presence of developmental dental defects. An individualized preventive program was applied based on caries risk and children were followed for two years. Effectiveness of the program was assessed for caries and dental plaque change and explanatory individual factors were used in multivariate models. After two years prospective, dmft increased significantly from 1.1 (SD = 2.7) to 2.04 (SD = 3.6), while GVPI was reduced significantly from 1.8 (SD = 0.9) to 1.4 (SD = 0.9). Children in the moderate and high-risk groups missed significantly more follow-ups compared to the low caries risk group (p < .001) while older maternal age (OR = 1.38, 95%CI = 1.057-1.808) and consumption of more than three sugary snacks/day (OR = 0.005, 95%CI = 0-0.0794) were significantly correlated with dental caries. CONCLUSION The individualized preventive program for preschool children with NDD was effective in improving oral hygiene but not dental caries status.
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Affiliation(s)
- Eleni Vatsolaki
- Department of Paediatric Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Andreas Agouropoulos
- Department of Paediatric Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Papagiannoulis
- Department of Paediatric Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Sotiria Gizani
- Department of Paediatric Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
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Rutter TL, Hastings RP, Murray CA, Enoch N, Johnson S, Stinton C. Psychological wellbeing in parents of children with Down syndrome: A systematic review and meta-analysis. Clin Psychol Rev 2024; 110:102426. [PMID: 38652972 DOI: 10.1016/j.cpr.2024.102426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/06/2024] [Accepted: 04/04/2024] [Indexed: 04/25/2024]
Abstract
We report a review examining the psychological wellbeing of parents of children with Down syndrome (DS) relative to that of parents of typically developing (TD) children. A systematic search identified 57 relevant studies, which were synthesised meta-analytically. Relative to their counterparts with TD children, mothers and fathers of children with DS reported higher levels of parenting stress (mothers: g = 0.57, 95% CI [0.33, 0.81]; fathers: g = 0.40, [0.24, 0.56]), depressive symptoms (mothers: g = 0.42, [0.23, 0.61]; fathers: g = 0.25, [0.02, 0.48]) and psychological distress (mothers: g = 0.45, [0.30, 0.60]; fathers: g = 0.63, [0.26, 0.99]). Small effects were found for anxiety for mothers (g = 0.16, [0.03, 0.29]), with no differences for fathers (g = 0.03, [-0.25, 0.32]). No group differences were found for positive impact of parenting (mothers: g = -0.09, [-0.25, 0.07]; fathers: g = -0.04, [-0.30, 0.22]), while evidence concerning other positive wellbeing outcomes was limited. No significant moderating effects of child age range, country income level, or group differences in parental education level were identified, but limited subgroup analyses were possible. Raising a child with DS may be associated with elevated stress, depressive symptoms, and psychological distress for mothers and fathers. However, levels of parenting reward appear equivalent to those experienced by parents raising TD children.
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Affiliation(s)
- T L Rutter
- Centre for Research in Intellectual and Developmental Disabilities, University of Warwick, Coventry, UK.
| | - R P Hastings
- Centre for Research in Intellectual and Developmental Disabilities, University of Warwick, Coventry, UK
| | - C A Murray
- Centre for Research in Intellectual and Developmental Disabilities, University of Warwick, Coventry, UK
| | - N Enoch
- Down Syndrome UK, Leamington Spa, Warwickshire, UK
| | - S Johnson
- University of Warwick Library, University of Warwick, Coventry, UK
| | - C Stinton
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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McGlinchey C, Harniess P, Borek AJ, Garrood A, McDonald A, Boyle F, Logan S, Morris C. What aspects of health and wellbeing are most important to parent carers of children with disabilities? Health Expect 2024; 27:e14085. [PMID: 38845158 PMCID: PMC11156688 DOI: 10.1111/hex.14085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 05/02/2024] [Accepted: 05/06/2024] [Indexed: 06/10/2024] Open
Abstract
INTRODUCTION Parent carers of children with special educational needs or disabilities are at risk of poorer health and wellbeing outcomes because of the distinct and challenging circumstances they face. Evaluations of interventions promoting the health of parent carers should focus on measuring the aspects of health and wellbeing which are most relevant to this group. As part of a programme of research on parent carer-focused interventions, this study aimed to understand which aspects of health and wellbeing are perceived by parent carers as most meaningful and important. METHODS A qualitative study using semistructured online interviews was conducted. A purposive sample of parent carers was interviewed about relevant health and wellbeing outcomes. Transcripts were analysed thematically. RESULTS Thirty parent carers were interviewed, 19 of whom had experienced a health-promoting intervention, either as participants (n = 14) or facilitators (n = 5). Three main themes were identified: 'self, identity and beliefs'; 'social connections and support' and 'health-promoting practices and outcomes.' Each theme encompassed the challenges participants faced, and the changes that helped them overcome these challenges. 'Self-identity' challenges focused on the overwhelming nature of the parental care role and the emotional impact of this. Changes were brought about by developing a positive mindset, increasing confidence, and reconnecting with aspects of their identity which were important to them before they became parent carers. Challenges related to 'social connections' reflected parent carers' isolation. Change was brought about through increased peer support and peer interactions. Parent carers experienced challenges in terms of 'health-promoting activities' because they lacked free time and experienced poor physical health. Changes were brought about by engagement in health-promoting activities of various kinds. CONCLUSION Parent carers view health and wellbeing in terms of overcoming the common challenges they face as a group. These challenges reflect the ways in which their physiological and psychological needs are often unmet. Researchers interested in measuring parent carer health and wellbeing should consider the specific challenges this group face, as well as theoretical frameworks which can make sense of these challenges, such as self-determination theory. PATIENT OR PUBLIC CONTRIBUTION Our team carries out patient and public involvement (PPI) through a Family Faculty group facilitated by a Family Involvement Co-ordinator (A. McD.) who is herself a parent carer. A study-specific PPI working group was established which included members of the Family Faculty. The PPI group advised on various aspects of the research as reported in the paper. The manuscript was co-authored by the team's Family Involvement Co-ordinator (A. McD.).
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Affiliation(s)
- Caomhan McGlinchey
- Peninsula Childhood Disability Research Unit (PenCRU) and NIHR Applied Research Collaboration South West Peninsula (PenARC)University of Exeter Medical School, University of ExeterExeterUK
| | - Phillip Harniess
- Peninsula Childhood Disability Research Unit (PenCRU) and NIHR Applied Research Collaboration South West Peninsula (PenARC)University of Exeter Medical School, University of ExeterExeterUK
| | - Aleksandra J. Borek
- Nuffield Department of Primary Care Health Sciences, Medical Sciences DivisionRadcliffe Observatory Quarter, University of OxfordOxfordUK
| | - Alice Garrood
- Peninsula Childhood Disability Research Unit (PenCRU) and NIHR Applied Research Collaboration South West Peninsula (PenARC)University of Exeter Medical School, University of ExeterExeterUK
| | - Annabel McDonald
- Peninsula Childhood Disability Research Unit (PenCRU) and NIHR Applied Research Collaboration South West Peninsula (PenARC)University of Exeter Medical School, University of ExeterExeterUK
| | - Fleur Boyle
- Peninsula Childhood Disability Research Unit (PenCRU) and NIHR Applied Research Collaboration South West Peninsula (PenARC)University of Exeter Medical School, University of ExeterExeterUK
| | - Stuart Logan
- Peninsula Childhood Disability Research Unit (PenCRU) and NIHR Applied Research Collaboration South West Peninsula (PenARC)University of Exeter Medical School, University of ExeterExeterUK
| | - Christopher Morris
- Peninsula Childhood Disability Research Unit (PenCRU) and NIHR Applied Research Collaboration South West Peninsula (PenARC)University of Exeter Medical School, University of ExeterExeterUK
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Täljedal T, Granlund M, Osman F, Norén Selinus E, Fängström K. Parenting children with disabilities in Sweden: a cluster-analysis of parenting stress and sufficiency of informal and formal support. Front Psychol 2024; 15:1389995. [PMID: 38882520 PMCID: PMC11177875 DOI: 10.3389/fpsyg.2024.1389995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 05/15/2024] [Indexed: 06/18/2024] Open
Abstract
Objective To investigate patterns of parenting stress and access to sufficient informal and formal support among parents of children with disabilities. To explore whether child cognitive level, conduct problems and the need of language interpretation in contacts between parents and professionals are associated with patterns of parenting stress and support. Method Parents (N = 140) of children with disabilities in Sweden completed a questionnaire about parenting stress and support. Patterns of three variables-parenting stress and access to sufficient informal and formal support-were investigated using cluster analysis. The relationship of child cognitive level, level of conduct problems and of language interpretation needs between parents and professionals to cluster membership was explored using multinomial logistic regression. Results Five different clusters of parenting stress and support emerged. Parents in cluster 1 had lower than sample mean ratings on all three variables. Cluster 2 had elevated parenting stress, cluster 3 had elevated insufficient informal support and cluster 4 had elevated insufficient formal support. Cluster 5 had elevated ratings on all three variables. Greater child cognitive difficulties increased the likelihood of parent membership in cluster 2 (elevated stress), cluster 3 (elevated insufficient informal support), or cluster 5 (elevated ratings on all variables). Child conduct problems increased the likelihood of membership in cluster 2 (elevated stress) or cluster 5 (elevated ratings on all variables). No relationship between language interpretation needs and cluster membership was found. Conclusions Patterns of parenting stress and sufficiency of support, and their associations with child characteristics, vary substantially. However, families of children with conduct problems experiencing elevated parenting stress in combination with insufficient informal and formal support, may be particularly vulnerable. The results of the current study highlight the clinical importance of exploring and identifying individual parenting stressors and perceived levels of support, to be able to adapt services to better suit a variety of needs, and thus promote equitable care.
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Affiliation(s)
- Torun Täljedal
- Region Västmanland-Uppsala University, Centre for Clinical Research, Västmanland Hospital Västerås, Västerås, Sweden
- CHAP, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Mats Granlund
- CHILD Research Environment, Jönköping University, Jönköping, Sweden
- Department of Mental Health, Norway Technical and Natural Sciences University, Trondheim, Norway
| | - Fatumo Osman
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Eva Norén Selinus
- Region Västmanland-Uppsala University, Centre for Clinical Research, Västmanland Hospital Västerås, Västerås, Sweden
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Karin Fängström
- CHAP, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Shpigelman CN, Araten-Bergman T. Adults With IDD in Supported Accommodation During COVID-19 Lockdown: The Families' Perspective. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2024; 129:215-230. [PMID: 38657961 DOI: 10.1352/1944-7558-129.3.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/21/2023] [Indexed: 04/26/2024]
Abstract
The present study aims to understand and describe family caregivers' perceptions and experiences regarding contact and relationships with their adult relatives with intellectual and developmental disabilities (IDD) living in supported accommodation during the COVID-19 lockdown. A qualitative phenomenological approach was applied in which 19 Israeli family caregivers (parents and siblings) were interviewed. Inductive thematic analysis revealed themes at the microsystem level (the resident, the caregiver, and their relationship), and at the mesosystem level (the caregivers' interactions with service providers and other residents' families). The findings highlight the pivotal role of family caregivers in times of uncertainty and the need to develop explicit policies and mechanisms to facilitate family engagement in the residents' lives.
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Affiliation(s)
- Carmit-Noa Shpigelman
- Carmit-Noa Shpigelman, Department of Community Mental Health, University of Haifa, Israel
| | - Tal Araten-Bergman
- Tal Araten-Bergman, Social Work and Social Policy, School of Allied Health, Human Services and Sport, and Living with Disability Research Centre, La Trobe University, Melbourne, Australia
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Lee J, Barger B. Factors Predicting Poor Mental and Physical Health in Parents of Children with Autism Spectrum Disorder: Results from 2016 to 2019 National Survey of Children's Health. J Autism Dev Disord 2024; 54:915-930. [PMID: 36562931 DOI: 10.1007/s10803-022-05870-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
Although poor health has been reported in parents of children with autism spectrum disorder (ASD), most studies excluded fathers and focused on mental health. We combined 2016-2019 data from the National Surveys of Children's Health to determine child and parent characteristics that predict poor mental and physical health in fathers (n = 818) and mothers (n = 2111) of children with ASD. For fathers of children with ASD, higher parenting stress was significantly associated with greater odds of poor physical health, whereas racial and ethnic minorities and living at 400% above the federal poverty were significantly associated with lower odds of poor mental health. For mothers of children with ASD, greater child sleep problems were significantly associated with greater odds of poor physical health, and two-parent household living 400% above the poverty line was significantly associated with reported lower odds of poor mental health. Continued efforts to reduce parenting stress and improve child sleep problems, along with expanding existing services and coverages of ASD services, especially for low-income families, may help reduce the burden on these families, preventing adverse future health outcomes in this population.
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Affiliation(s)
- Jiwon Lee
- School of Nursing, Byrdine F. Lewis School of Nursing and Health Professions, Georgia State University, 140 Decatur Street, Urban Life Building Suite 911, Atlanta, GA, 30303, USA.
| | - Brian Barger
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
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Yi J, Kim MA, Sang J, Gonzalez-Pons KM. Caregiving Stress Experienced by Parents of Adult Children with Intellectual Disabilities During COVID-19 in Korea. SOCIAL WORK IN PUBLIC HEALTH 2024; 39:105-117. [PMID: 38373006 DOI: 10.1080/19371918.2024.2319856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Many of community supports and resources were shattered in the COVID-19 pandemic, leaving parents to navigate caring for their adult child with intellectual disabilities with little support. This study explored caregiving stress experienced by parents of adult children with intellectual disabilities during the COVID-19 pandemic in Korea. In-depth interviews were conducted with 19 parents of an adult child with intellectual disabilities. Thematic analysis yielded two themes: caregiving burden and deteriorating health. Parents bore the brunt of the caregiving burden, spending much of their time helping their adult child with daily activities and managing their challenging behaviors, leaving the caregivers struggling physically and mentally. The heightened caregiver burden and associated deteriorating health among these parents raise serious concerns, indicating a need for immediate support to alleviate these issues and help parents navigate caring for their adult child with intellectual disabilities during the COVID-19 pandemic.
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Affiliation(s)
- Jaehee Yi
- School of Social Work, University of Victoria, British Columbia, Canada
| | - Min Ah Kim
- Department of Social Welfare, Sungkyunkwan University, Seoul, Republic of Korea
| | - Jina Sang
- School of Social Work and Family Sciences, The University of Akron, Akron, Ohio, USA
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Larson E, Jeglum N, Shmays C. Mixed-method evaluation of fidelity of motivational interviewing-based coaching in 5Minutes4Myself Wellness Program for caregivers of children with autism. PEC INNOVATION 2023; 2:100149. [PMID: 37214523 PMCID: PMC10194175 DOI: 10.1016/j.pecinn.2023.100149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 02/28/2023] [Accepted: 03/20/2023] [Indexed: 05/24/2023]
Abstract
Objective This mixed method analysis examined fidelity of the motivational interviewing (MI) delivered during the 5Minutes4Myself wellness program for caregivers of children with Autism Spectrum Disorders. Methods Coaches used a manualized MI-approach to collaboratively design participants' individualized wellness programs, and then used it in monthly coaching sessions to support goal pursuit. Audio-recorded consultations and post-participation focus groups were transcribed verbatim. Consultation transcripts were rated for MI adherence using Motivational Interviewing Treatment Integrity Code. Focus group data was coded by the team to identify conceptual categories. Results Eighty-seven percent of consultations achieved a beginning (competent) level expert-derived MI standard. Caregivers noted that coaches' MI approach evoked deep emotions and understandings about their lives related to wellness goals, allowed for a permissive flexibility in goal pursuit, and fostered supportive accountability. Conclusion MI was used with high levels of fidelity. Participants described the MI approach as more productive, precise, and useful in addressing their needs compared to other available interventions.
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Affiliation(s)
- Elizabeth Larson
- Department of Kinesiology, University of Wisconsin, Madison, Wisconsin, USA
| | | | - Chloe Shmays
- Providence Child Development Institute, Portland, OR, USA
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11
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Brekke I, Alecu A. The health of mothers caring for a child with a disability: a longitudinal study. BMC Womens Health 2023; 23:639. [PMID: 38037017 PMCID: PMC10688054 DOI: 10.1186/s12905-023-02798-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/21/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Raising a child with disabilities requires a significant parental investment that is greater than that required by typically developing children. Previous studies have shown that parents caring for a child with a disability experience a range of health problems, particularly the mothers. However, few of these studies have controlled for maternal health prior to birth. METHODS This study used a sample from the Norwegian administrative register that comprised all children born between 2009 and 2015. We followed the mothers and their children for 11 years, between 2009 and 2019. The outcome variable was the mothers' physical and mental health, which was assessed using specific ICD-10 diagnoses recorded in the Norwegian Patient Register (NPR). The data included information on the mothers' health before and after the birth of their first child, enabling us to control for maternal health prior to birth in our analysis, in addition to socio-demographic characteristics. The analyses of maternal health were performed using multiple logistic regression, and the results are presented on both a relative scale (odds ratio [OR]) and an absolute scale (average marginal effect [AME]), both with 95% confidence intervals. RESULTS Mothers caring for a child with a disability have higher odds of having a diagnosis of a musculoskeletal disorder, depression, anxiety, sleeping disorder or migraines than mothers of children without a disability. The differences between the two groups of mothers decrease after adjusting for the characteristics of the children, mothers and families, but remain significant for musculoskeletal disorder, depression, anxiety and sleeping disorder, although the absolute differences are modest. CONCLUSION The findings suggest that mothers caring for a child with a disability are more likely to have health problems than mothers of children without a disability after controlling for maternal health prior to birth. Providing more support for mothers of children with a disability might help to improve their health.
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Affiliation(s)
- Idunn Brekke
- Department of Childhood and Families, Division of Mental and Physical Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, Oslo, N-0213, Norway.
| | - Andreea Alecu
- Consumption Research Norway, Oslo Metropolitan University, Oslo, Norway
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Bentum LS, Ohene LA, Agyare VA, Laari L, Ampomah MO. Fathers' experiences of caring for children living with cerebral palsy: A qualitative study in a low resourced socioeconomic context, Ghana. J Pediatr Nurs 2023; 73:e100-e106. [PMID: 37543505 DOI: 10.1016/j.pedn.2023.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND In Ghana, little is known about fathers' experiences caring for children with cerebral palsy. PURPOSE The purpose of this study is to explore a. the caregiving demand and burden on fathers of children with cerebral palsy and b. describe the caregiving consequences and coping strategies of fathers of children with cerebral palsy. DESIGN AND METHODS The study utilized an exploratory, descriptive qualitative approach with a sample size of fifteen fathers purposively selected. The study used a semi-structured interview guide to conduct a one-on-one interview with participants. The analysis performed was thematic and content analysis. RESULTS The results revealed complexities of care demand and burden; thus, meeting the child's needs resulted in physical and mental exhaustion, frequent hospital visits, and substantial financial implications for fathers. CONCLUSIONS We conclude that the family, particularly fathers, need support to embrace the challenging care roles as parents to children with cerebral palsy. It is evident that caring for children is mainly reserved for mothers in the African context. However, the demanding nature of care for a child with a developmental disability requires the involvement of both parents to meet the child's care needs and reduce the caregiver's care burden. PRACTICE IMPLICATIONS Health professionals, particularly nurses must initiate and advocate for fathers' active participation in daily childcare. Tailored supportive care for families with children with disabilities in sub-Saharan Africa is required.
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Affiliation(s)
- Lucy Selorm Bentum
- Department of Public Health Nursing, University of Ghana, Legon, P.O Box LG 43, Accra, Ghana
| | - Lillian Akorfa Ohene
- Department of Public Health Nursing, University of Ghana, Legon, P.O Box LG 43, Accra, Ghana.
| | | | - Luke Laari
- Department of Public Health Nursing, University of Ghana, Legon, P.O Box LG 43, Accra, Ghana
| | - Menford Owusu Ampomah
- Department of Adult Health Nursing, University of Ghana, Legon(,) P.O Box LG 43, Accra, Ghana
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Baumgartel K, Caplan E, Glover C, Louis J, Schreiber J. A Feasibility Study to Assess Sleep and Subsequent Breast Milk Volume Among Mothers With Hospitalized Preterm Infants. J Perinat Neonatal Nurs 2023; 37:295-302. [PMID: 37878514 PMCID: PMC10605565 DOI: 10.1097/jpn.0000000000000657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
BACKGROUND Sleep is essential for optimal health, and disturbed postpartum sleep is associated with compromised infant attachment. The postpartum experience of mothers with preterm infants is unlike the biological norm, as they are separated from their infants and often express breast milk. PURPOSE The purpose of this study was to examine the feasibility of conducting a clinical research study among women with hospitalized preterm infants. We also explored for associations between maternal sleep patterns and sleep-related psychological states and subsequent breast milk volume. METHODS Participants were recruited from Magee-Womens Hospital, located in Pittsburgh, Pennsylvania New mothers completed daily sleep and pumping logs and scales to measure stress, trauma, depression, fatigue, and sleep quality. RESULTS A total of 78 women were screened, 18 women consented, and a total of 8 participants completed the study. Screening from the postpartum unit increased recruitment. The participants experience worsening sleep quality over time, moderate stress, and fatigue. Stress, postnatal depression, and fatigue are negatively associated with milk volume. IMPLICATIONS FOR PRACTICE AND RESEARCH Postpartum recruitment with frequent follow-ups improved recruitment and retention. We present a preliminary association between maternal stress, fatigue, and depression, and subsequent breast milk volume. Sleep-related psychological states may negatively influence milk volume.
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Affiliation(s)
- Kelley Baumgartel
- University of South Florida College of Nursing, Tampa (Dr Baumgartel); University of Pittsburgh School of Nursing, Health Promotion and Development, Pittsburgh, Pennsylvania (Ms Caplan); University of Pittsburgh, Pittsburgh, Pennsylvania (Ms Glover); College of Medicine Obstetrics and Gynecology, COPH Dean's Office, University of South Florida, Tampa (Dr Louis); and Duquesne University School of Nursing, Pittsburgh, Pittsburgh (Dr Schreiber)
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14
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Turner SE, Fedigan LM, Joyce MM, Matthews HD, Moriarity RJ, Nobuhara H, Nobuhara T, Stewart BM, Shimizu K. Mothers of disabled infants had higher cortisol levels in a free-ranging group of Japanese macaques (Macaca fuscata). Am J Primatol 2023:e23500. [PMID: 37189289 DOI: 10.1002/ajp.23500] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 04/15/2023] [Accepted: 04/29/2023] [Indexed: 05/17/2023]
Abstract
Glucocorticoids (GCs) are hormones released in response to stressors and can provide insight into an organism's physiological well-being. Experiencing chronic challenges to homeostasis is associated with significant deviations from baseline fecal GCs (fGCs) in many species, providing a noninvasive biomarker for assessing stress. In the group of free-ranging Japanese macaques (Macaca fuscata) at the Awajishima Monkey Center in Japan, ~17% have congenital limb malformations. We collected 646 fecal samples from 27 females over three consecutive birth seasons (May-August) and analyzed them using enzyme immunoassay to extract fGCs. We explored the relationship between fGC levels and individual (physical impairment and reproductive status), social (dominance rank and availability of kin for social support), and ecological variables (exposure to potential predators, rainfall, and wild fruit availability). A disabled infant was associated significantly with higher fGC in the mother; however, physical impairment in adult females was not significantly related to fGC levels. Females with higher dominance rank had significantly lower fGC levels than lower ranking females. Other factors did not relate significantly to fGC. These results suggest that providing care that meets the support needs of disabled infants poses a physiological challenge for mothers and suggests that physically impaired adults are able to effectively compensate for their disabilities with behavioral plasticity. Once an individual with congenital limb malformations survives infancy through their mother's care, physical impairment does not appear to influence fGC values, while social variables like dominance rank significantly influenced cortisol values in free-ranging female Japanese macaques.
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Affiliation(s)
- Sarah E Turner
- Department of Geography, Planning and Environment, Concordia University, Montreal, Quebec, Canada
| | - Linda M Fedigan
- Department of Anthropology and Archaeology, University of Calgary, Calgary, Alberta, Canada
| | - Megan M Joyce
- Department of Geography, Planning and Environment, Concordia University, Montreal, Quebec, Canada
| | - H Damon Matthews
- Department of Geography, Planning and Environment, Concordia University, Montreal, Quebec, Canada
| | - Robert J Moriarity
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Ontario, Canada
| | | | | | - Brogan M Stewart
- Department of Geography, Planning and Environment, Concordia University, Montreal, Quebec, Canada
| | - Keiko Shimizu
- Department of Zoology, Faculty of Science, Okayama University of Science, Okayama, Japan
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15
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Gur A, Reich A. Psychological flexibility of parents of children with disabilities: A systematic literature review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 136:104490. [PMID: 36966545 DOI: 10.1016/j.ridd.2023.104490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 02/27/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE Psychological flexibility, a popular concept in clinical psychology, is still evolving in the context of studying parents of children with disabilities. This study systematically reviewed the literature on the psychological flexibility of parents of children with disabilities to identify contributions of the literature and make recommendations for practice and future study. MATERIALS AND METHODS The systematic review was conducted according to the PRISMA guidelines and identified studies on the psychological flexibility of parents of children with disabilities using five electronic databases: PsychNet, PubMed, ERIC, Social Services Abstracts, and EBSCO. Twenty-six articles met the criteria and were included. A thematic analysis was conducted to extract major themes. RESULTS Three major themes emerged from the data: (1) psychological flexibility is associated with various aspects of mental health; (2) psychological flexibility is associated with parental functioning in caring for children with a disability; (3) acceptance and commitment therapy (ACT) based interventions effectively enhance the psychological flexibility of parents of children with disabilities. CONCLUSIONS The study concludes that psychological flexibility is extremely relevant to disability studies and should be further explored in relation to different parental well-being and functioning aspects. Professionals are encouraged to incorporate principles of acceptance and commitment therapy into their work with parents of children with disabilities.
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Affiliation(s)
- Ayelet Gur
- Social Work Department, Tel-Hai College, Upper Galilee, Israel.
| | - Ari Reich
- Faculty of Education, Bar Ilan University, Ramat Gan, Israel
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16
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Durán-Pacheco G, Silkey M, Johnson M, Liu C, Clinch S, Law K, Loss G. Effect of Children's Autism Spectrum Disorder Severity on Family Strain and Sleep Quality: A Cross-Sectional Online Survey in the U.S. J Autism Dev Disord 2023; 53:1795-1808. [PMID: 35118575 PMCID: PMC10123033 DOI: 10.1007/s10803-022-05457-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2022] [Indexed: 12/13/2022]
Abstract
To better understand the impact of children's autism spectrum disorder (ASD) severity on families, we evaluated pathways through which ASD severity affected child sleep quality, caregiver strain, and caregiver sleep quality. In a cross-sectional analysis through the U.S.-wide Simons Foundation Powering Autism Research for Knowledge (SPARK) cohort. Participants were caregivers of dependents with ASD aged 3-17 years (N = 3150). We found that increased severity strongly affects caregiver strain and child sleep quality. Child sleep quality was a minor mediator of increasing caregiver strain. Caregiver sleep quality depended on ASD severity only through child sleep quality and caregiver strain. Interventions aimed at improving child sleep quality or reducing caregiver strain could positively impact families of children with ASD.
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Affiliation(s)
| | | | - Michelle Johnson
- Roche Products Ltd., Hexagon Place, 6 Falcon Way, Shire Park, Welwyn Garden City, AL7 1TW, UK.
| | - Chuang Liu
- F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Susanne Clinch
- Roche Products Ltd., Hexagon Place, 6 Falcon Way, Shire Park, Welwyn Garden City, AL7 1TW, UK
| | - Kiely Law
- Kennedy Krieger Institute, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Georg Loss
- F. Hoffmann-La Roche Ltd., Basel, Switzerland
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17
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Lee J, Schwichtenberg A, Bliwise D, Ali SZ, Hayat MJ, Clark PC, Spratling R. Simultaneous Recording of Objective Sleep in Mothers and School-aged Children with Developmental Disabilities: A Pilot Study of Actigraphy and Videosomnography. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2023:1-23. [PMID: 37361457 PMCID: PMC10088614 DOI: 10.1007/s10882-023-09896-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/15/2023] [Indexed: 06/26/2023]
Abstract
Mothers of school-aged children ages 3 to 17 years with developmental disabilities (DDs) commonly report sleep problems in their children associated with impaired maternal sleep. However, existing research relies heavily on mothers' self-reported sleep. This study aimed to determine the feasibility of objectively measuring child and mother sleep-wake patterns using actigraphy and videosomnography. This was an observational pilot study. Mothers wore actigraphy watches and video-recorded their child's sleep for 7 nights. Mothers also completed a 7-day sleep diary and questionnaires on sleep quality, depressive symptoms, stress, and child sleep problems. Ten mothers (32-49 years) and ten children with DDs (8-12 years) completed this study. Half of the children were boys with autism spectrum disorders. We successfully recruited 77% of eligible mothers for the study during the pandemic. Eight mothers successfully wore the actigraphy, and nine successfully video-recorded their child's sleep. Mothers rated their participation positively and considered the data collection protocol acceptable. While mothers' sleep patterns from actigraphy were mostly within recommendations, self-reported sleep quality was poor. Child's sleep estimates from videosomnography showed children slept substantially less than recommended sleep hours. Mothers also reported a high frequency of child sleep problems. Consistent with this pattern, mothers also endorsed elevated stress and depression. The use of actigraphy and videosomnography is feasible. Objective sleep measurement for mothers' and children's sleep is needed with self-report to measure multidimensional aspects of sleep and discrepancies between objective and self-report sleep measures. Future studies can use multi-methods sleep measures and work toward interventions that can improve family sleep and reduce mothers' stress and depression.
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Affiliation(s)
- Jiwon Lee
- School of Nursing, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, 140 Decatur Stress Urban Life Building Room 911, Atlanta, GA 30303 USA
| | - A.J. Schwichtenberg
- Department of Human Development & Family Studies, College of Health and Human Sciences, Purdue University, West Lafayette, IN USA
| | - Donald Bliwise
- Sleep Center, School of Medicine, Emory University, Atlanta, GA USA
| | - Syeda Zahra Ali
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA USA
| | - Matthew J. Hayat
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA USA
| | - Patricia C. Clark
- School of Nursing, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, 140 Decatur Stress Urban Life Building Room 911, Atlanta, GA 30303 USA
| | - Regena Spratling
- School of Nursing, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, 140 Decatur Stress Urban Life Building Room 911, Atlanta, GA 30303 USA
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18
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Zaidman-Zait A, Curle D, Jamieson JR. Health-related quality of life among mothers of children with cochlear implants with and without developmental disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 133:104397. [PMID: 36586392 DOI: 10.1016/j.ridd.2022.104397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/09/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Cochlear implants (CIs) are widely used among children with severe to profound hearing loss. Raising a child with a CI presents unique challenges to the family, especially when the child has a developmental disability (CI-DD). AIMS This study aimed to elucidate the relations between the functioning of children with CIs, their mothers' coping resources (i.e., social support and family-centered care), and maternal health-related quality of life (HRQoL). Also, it examined whether the presence of a DD in addition to the child's deafness moderated these relations. METHODS AND PROCEDURES A sample of 100 mothers of children with CIs (54 in the CI-DD group) completed questionnaires regarding perceived social support, family-centered care, and HRQoL. OUTCOMES AND RESULTS Mothers of deaf children with CIs and DD experienced lower levels of family functioning and HRQoL across all dimensions compared to mothers of deaf children with CIs without DD. In addition, social support was positively related to HRQoL only among mothers of children in the CI-DD group, indicating the protective role of social support. CONCLUSIONS AND IMPLICATIONS Social support is an important coping resource, and psychosocial support is needed for mothers of children with CIs, especially for mothers whose children also have a DD.
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Affiliation(s)
- Anat Zaidman-Zait
- Tel Aviv University, Israel; University of British Columbia, Canada.
| | - Deirdre Curle
- Washington Center for Deaf and Hard of Hearing Youth, USA.
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19
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Ivarsson M, Danielsson H, Andersson AK, Gothilander J, Granlund M. Structural validity and internal consistency of the Strengths and Stressors in Parenting (SSF) Questionnaire in parents of children with developmental disabilities. Scand J Psychol 2023. [PMID: 36602042 DOI: 10.1111/sjop.12897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/12/2022] [Accepted: 12/19/2022] [Indexed: 01/06/2023]
Abstract
The current study investigated the structural validity and internal consistency of the Strengths and Stressors (SSF) questionnaire. The SSF is used in Swedish habilitation services to measure the positive and negative consequences that the fostering of a child with a developmental disability can have on family functioning in six domains: parent's feelings and attitudes, social life, family finances, relationship to the other parent, siblings, and professional support. The proposed six-factor model was tested with confirmatory factor analysis with data collected from 291 parents of children with developmental disabilities. The six-factor model had an acceptable fit according to most fit indices, but two items were non-significant. Overall, the internal consistency was acceptable or good. The SSF, with the proposed six-factor solution, can be a useful tool when assessing parental perspectives on the impacts of having a child with a developmental disability in clinical settings and research.
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Affiliation(s)
- Magnus Ivarsson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Henrik Danielsson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Anna Karin Andersson
- School of Health and Welfare, Jönköping University, Jönköping, Sweden.,School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Jennifer Gothilander
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Mats Granlund
- School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
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20
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Jeoung B. Quality of life and health-promoting lifestyles for parents of children with intellectual and developmental disabilities. J Exerc Rehabil 2022; 18:361-368. [PMID: 36684527 PMCID: PMC9816611 DOI: 10.12965/jer.2244450.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 10/31/2022] [Indexed: 12/29/2022] Open
Abstract
The purpose of this study was to examine the relationship between a health-promoting lifestyle and quality of life in parents of children with intellectual and developmental disabilities. Participants were 254 South Korean parents of children with intellectual and developmental disabilities. We assessed participants using a quality of life scale and the Korean version of the Health-Promoting Lifestyle Profile-II (HPLP-II). The data were analysed using Pearson and Spearman rank correlation analysis, and linear regression was conducted using SPSS ver. 25.0. The results indicated statistically significant associations between health-promoting lifestyles and quality of life in parents of children with intellectual and developmental disabilities. Analysis showed that the HPLP-II subfactors of spiritual growth, health responsibility, exercise, nutrition, interpersonal relations, and stress management could significantly predict quality of life in parents of children with intellectual and developmental disabilities. Healthcare providers should help to improve the quality of life of parents of children with intellectual and developmental disabilities by facilitating health-promoting lifestyle behaviours through interventions designed to increase physical activity, nutrition, stress management, interpersonal relations, health responsibility, and spiritual growth.
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Affiliation(s)
- Bogja Jeoung
- Corresponding author: Bogja Jeoung, Department of Exercise Rehabilitation & Welfare, College of Health Science, Gachon University, 191 Hambangmoe-ro, Yeonsu-gu, Incheon 21936, Korea,
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21
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Ferrer Vidal F, Vilaseca Momplet R, Bersabé RM. Relationship between parental perceptions, family income and support received with family quality of life in families with a child with an intellectual disability. SIGLO CERO REVISTA ESPAÑOLA SOBRE DISCAPACIDAD INTELECTUAL 2022. [DOI: 10.14201/scero202253489108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Research has shown that families raising a child with intellectual disability (ID) face many challenges and need to implement adaptation strategies. Some authors suggest that positive parental perceptions and perceived control could reduce emotional impact and promote family wellbeing. Nevertheless, there are few studies about the relationship between parental perceptions and family quality of life (FQoL) in those families. In this study, we used data from a sample of 251 Spanish parents whose children have ID. Positive perceptions scale and control perceptions scale, Spanish FQoL scale under 18 years-old and a sociodemographic questionnaire were administered to those families. The results of bivariate analysis showed that some dimensions of positive perceptions were related to different areas of FQoL, for example, social inclusion and family accommodation. FQoL was associated with family income and support received. To predict the FQoL level, a multivariate linear regression analysis was conducted. Results indicated that FQoL scores can be predicted by a linear combination of positive perceptions and family income. Practical implications for promoting FQoL in these families are discussed.
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22
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Abstract
OBJECTIVES Sleep disorders are prevalent in children with Down Syndrome (DS). However, sleep treatment is not always readily accessed by this group. This study aims to understand families' experiences of having a child with DS and sleep difficulties, and in particular, their healthcare experiences, with the goal of informing practice improvements. METHODS We conducted semi-structured interviews with 34 parents (fathers n = 4 and mothers n = 30) with open-ended questions about parents' experiences of sleep, family dynamics, and healthcare. We operationalized a reflexive Thematic Analysis. RESULTS Parents normalized their experiences of having a child with DS and sleep problems. Parents acknowledged that sleep disruption has adverse and pervasive impacts on their wellbeing and family dynamics, but also found this difficult to identify as a health problem. They accepted sleep difficulties as a regular part of bringing up any child, particularly one with a disability. When they did seek treatment for their child's sleep difficulties, parents often reported encountering insensitive and inadequate care and described that, at times, healthcare professionals also normalized children's sleep difficulties, resulting in sub-optimal treatment. This included at times failure to refer to tertiary sleep medicine services when required. CONCLUSIONS Parents' and healthcare professionals' normalization of sleeping difficulties denies that they are both deleterious and modifiable. Practice implications include raising healthcare professionals' awareness of the importance of proactively addressing sleep, with sensitivity to families' normalization strategies, recognizing that families may require prompting to report concerns.
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23
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Avieli H, Band-Winterstein T, Zamir A. Juggling between caregiving and self-actualization: Older parents' lifelong experience of caring for an adult child with developmental disabilities. PLoS One 2022; 17:e0276779. [PMID: 36327274 PMCID: PMC9632868 DOI: 10.1371/journal.pone.0276779] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 10/13/2022] [Indexed: 11/05/2022] Open
Abstract
Recently, the number of adults with Developmental Disabilities (DD) who live with their parents has increased. This study aims to explore how parents report retrospectively and interpret their experience in the context of self-actualization in the long-term care of a child with a developmental disability. Four forms of parents' experiences emerged from the analysis: "This child is my whole world"-Total devotion; "I Can Do Both"-Actualizing personal and familial goals as well as caregiving issues; "It's a mission, it's a calling, it's a full-time job"-Self-actualization through caregiving; and "Disability will not stop me"-Emphasizing self-actualization. While prior studies have created a distinct separation between caregiving and self-actualization, the current study focuses on the complex dynamics of lifelong parental caregiving for a child with DD, illustrating the parents' ways of actualizing their life goals in the context of caregiving over the years.
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Affiliation(s)
- Hila Avieli
- Department of Criminology, Ariel University, Haifa, Israel
| | - Tova Band-Winterstein
- Department of Gerontology, The Minerva Center on Intersectionality in Aging (MCIA), University of Haifa, Haifa, Israel
| | - Alon Zamir
- Department of Community Mental Health, The Minerva Center on Intersectionality in Aging (MCIA), University of Haifa, Haifa, Israel
- * E-mail:
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24
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Bin Eid W, Lim M, Gabrieli G, Kölbel M, Halstead E, Esposito G, Dimitriou D. Habilitation of sleep problems among mothers and their children with autism spectrum disorder: Insights from multi-level exploratory dyadic analyses. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:915060. [PMID: 36211831 PMCID: PMC9533106 DOI: 10.3389/fresc.2022.915060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022]
Abstract
Few habilitation strategies for children with autism spectrum disorder (ASD) consider their sleep-related problems. Together with the fact that caregivers of children with ASD also face issues with sleep, there may be yet-to-be uncovered relationships between caregiver-child sleep patterns and sleep quality, offering a key opportunity for clinicians to consider the needs of both child and caregiver in terms of sleep. 29 dyads of mothers and their children with ASD were recruited for this cohort study and both subjective (self-report questionnaires and sleep diaries) and objective (cortisol samples and actigraphy) measures of sleep were collected to investigate significant predictors of sleep quality. Comparative, correlational, and hierarchical analyses were conducted. Findings indicated that both mother and child experience sleep deprivation in terms of shorter sleep duration and poor sleep quality in terms of longer sleep onset latencies and a higher frequency of wake bouts. Exploratory hierarchical analyses also found that child-related sleep difficulties such as sleep disordered breathing and night waking significantly predict mothers’ sleep quality, which may point to the bi-directional influence of mother-child sleep. Based on these findings, it is recommended that clinicians adopt a family systems perspective and consider the sleep environment of the household, particularly that of the caregiver and child, when designing interventions for sleep-related problems in ASD. Finally, there is a need for additional support to promote good quality sleep among caregivers of children with ASD to bolster out-of-clinic care.
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Affiliation(s)
- Wasmiah Bin Eid
- Sleep Education and Research Laboratory, UCL Institute of Education, London, UK
| | - Mengyu Lim
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore
| | - Giulio Gabrieli
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore
| | - Melanie Kölbel
- Sleep Education and Research Laboratory, UCL Institute of Education, London, UK
- Department of Developmental Neurosciences Unit, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Elizabeth Halstead
- Sleep Education and Research Laboratory, UCL Institute of Education, London, UK
| | - Gianluca Esposito
- Affiliative Behaviour and Physiology Lab, Department of Psychology and Cognitive Science, University of Trento, Italy
| | - Dagmara Dimitriou
- Sleep Education and Research Laboratory, UCL Institute of Education, London, UK
- Correspondence: Dagmara Dimitriou
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25
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Hamama L. Modeling linkages between self-efficacy, normalization, and well-being factors among Israeli mothers of children with neurodevelopmental disorders. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 128:104295. [PMID: 35777249 DOI: 10.1016/j.ridd.2022.104295] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 06/16/2022] [Accepted: 06/22/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND AIMS Parents' well-being may be challenged by the neurodevelopmental disorders (NDs) of their children. This study explored general self-efficacy (personal resource) and normalization (coping strategy) and their possible association with mothers' well-being (satisfaction with life/SWL, positive affect, and presence of meaning in life/P-MIL). METHOD Data were obtained from 127 Israeli mothers, ages 23-63, of children (M = 12.08, SD = 3.39) with NDs (autism spectrum disorder, intellectual disability, cerebral palsy). All participants completed online self-report questionnaires. RESULTS After controlling for the effects of group, mother's age, and child's gender, bivariate associations showed that general self-efficacy was positively correlated with SWL (r =.46, p <.001), positive affect (r =.43, p <.001), and P-MIL (r =.37, p <.001). The study's mediation model was partly supported: General self-efficacy was related to normalization, which was related to SWL and positive affect, but not to P-MIL. CONCLUSIONS AND IMPLICATIONS This study contributes to the empirical knowledge on well-being in mothers raising children with NDs. Findings revealed that mothers' general self-efficacy alongside their strategy to adopt normalcy substantially contributed to their well-being. Hence, psychosocial services should strengthen general self-efficacy in this cohort and support their normalization efforts.
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Affiliation(s)
- L Hamama
- The Bob Shapell School of Social Work, Tel Aviv University, Ramat Aviv 69978, Israel.
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26
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Ragni B, Boldrini F, Mangialavori S, Cacioppo M, Capurso M, De Stasio S. The Efficacy of Parent Training Interventions with Parents of Children with Developmental Disabilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9685. [PMID: 35955038 PMCID: PMC9367974 DOI: 10.3390/ijerph19159685] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 07/31/2022] [Accepted: 08/02/2022] [Indexed: 06/15/2023]
Abstract
Parenting children with developmental disabilities (DD) can be generally characterized by a considerable psychological burden. The effects on parental and familial psychological well-being and, consequently, on children's developmental outcomes should not be underestimated, especially in early childhood. The current review aims to advance our understanding of the key factors (e.g., formats, sample characteristics, research design) that characterize parent training interventions, and that could be related to their outcomes, to guide researchers and clinical practitioners to develop and provide efficient programs. Studies were identified via an Internet search from three electronic databases, following PRIMSA guidelines. Studies published until November 2021 were taken into account. The initial search yielded a total of 2475 studies. Among them, 101 studies were fully reviewed. Finally, ten of the studies, which met all the inclusion criteria, formed the basis for this review. Participants' characteristics, main features of the interventions (i.e., study design, structure, and contents), outcome variables and treatment efficacy were deeply examined and discussed. Key factors of parent training interventions with parents of children affected by DD are enlightened, to guide researchers and clinicians in the design and implementation of tailored specific programs, aimed to sustain parenting and foster children's developmental outcomes, from early stages of life.
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Affiliation(s)
- Benedetta Ragni
- Department of Human Studies, LUMSA University, Piazza delle Vaschette, 101, 00193 Rome, Italy
| | - Francesca Boldrini
- Department of Human Studies, LUMSA University, Piazza delle Vaschette, 101, 00193 Rome, Italy
| | - Sonia Mangialavori
- Department of Pathophysiology and Transplantation, University of Milano, 20122 Milan, Italy
| | - Marco Cacioppo
- Department of Human Studies, LUMSA University, Piazza delle Vaschette, 101, 00193 Rome, Italy
| | - Michele Capurso
- Department of Philosophy, Social Sciences & Education, University of Perugia, 06123 Perugia, Italy
| | - Simona De Stasio
- Department of Human Studies, LUMSA University, Piazza delle Vaschette, 101, 00193 Rome, Italy
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27
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Sharp EA, Nicholson KJ, Taft M, Glaser DH, Gibson B, Kazmerski TM. Parent-in-training: Resident and fellow experiences from pregnancy to parenthood. J Hosp Med 2022; 17:609-623. [PMID: 35855539 DOI: 10.1002/jhm.12914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Residents and fellows with children face distinct challenges; however, knowledge of factors associated with increased parental stress is limited. OBJECTIVE This study aimed to investigate experiences and concerns of physician trainees and identify factors associated with higher parental stress. METHODS An anonymous survey was distributed to all resident and fellow trainees in June 2021 to assess experiences regarding parental leave, breastfeeding, and childcare. We used the Parental Stress Scale (PSS) to identify the factors associated with stress and analyzed the results using descriptive statistics, linear regression, and thematic analysis. RESULTS Of 1719 trainees, 509 participated (62% women, 30% response rate); half were parents. One-third of the respondents (152/470) said that childcare costs affected the number of children they plan to have; One-third of respondents (152/470) said that childcare costs affected the number of children they plan to have; 45% (210/470) said childcare costs affected when they plan to have children. Among parents, the mean PSS score was 44.3 ± 12.3, with no significant gender differences. More women identified as primary or coprimary caregivers (97% [113/117] vs. 79% [60/76], p < .001) and anticipated training extensions due to parental leave (36% vs. 13% men, p = .009). Breastfeeding was associated with significantly higher PSS scores (p = .017). Twenty-four percent of breastfeeding parents (22/93) felt that their program/institution did not support their breastfeeding goals; lack of perceived support was associated with significantly higher PSS scores (63.6 ± 13.1 vs. 38.6 ± 8.7, p < .001). Trainees experiencing unreliable childcare had significantly higher PSS scores (p = .005). Forty percent (64/159) changed their career plans after becoming parents. CONCLUSIONS Physician trainee parents experience high stress, with women bearing disproportionate burdens in the domains of parental leave and breastfeeding. These results should inform policies promoting trainee wellness and gender equity.
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Affiliation(s)
- Eleanor A Sharp
- Department of Pediatrics, Division of Pediatric Hospital Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Maia Taft
- Department of Pediatrics, Division of Pediatric Hospital Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Daniel H Glaser
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Blake Gibson
- UPMC Western Psychiatric Hospital, Pittsburgh, Pennsylvania, USA
| | - Traci M Kazmerski
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Urizar GG, Ramírez I, Caicedo BI, Mora C. Mental health outcomes and experiences of family caregivers of children with disabilities during the COVID-19 pandemic in Bolivia. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:2682-2702. [PMID: 34845739 PMCID: PMC9015286 DOI: 10.1002/jcop.22763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 11/03/2021] [Indexed: 05/15/2023]
Abstract
This study examined whether certain demographic characteristics, caregiver strain, and coping behaviors were associated with the mental health outcomes of family caregivers of children with disabilities in Bolivia during the COVID-19 pandemic. A mixed-methods convergent study design was used with virtual interviews to quantitatively assess caregivers' demographic characteristics, caregiver strain, coping behaviors, and mental health outcomes, as well as qualitatively assess how the pandemic affected their family. Approximately 32%-71% of caregivers experienced poor mental health outcomes (stress, anxiety, and depression), especially among those experiencing poor health, high caregiver strain, and those using maladaptive coping strategies. Qualitative responses revealed that they experienced several unique stressors during the pandemic that affected them and their children. These findings highlight the need for culturally tailored prevention and treatment interventions to help offset the adverse effects of the COVID-19 pandemic on the mental health outcomes of this at-risk population.
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Affiliation(s)
- Guido G. Urizar
- Department of PsychologyCalifornia State UniversityLong BeachCaliforniaUSA
| | - Ivonne Ramírez
- Instituto de Investigaciones en NeurodesarrolloUniversidad Mayor, Real y Pontificia de San Francisco Xavier de ChuquisacaSucreBolivia
| | - Brianna I. Caicedo
- Department of PsychologyCalifornia State UniversityLong BeachCaliforniaUSA
| | - Cindy Mora
- Department of PsychologyCalifornia State UniversityLong BeachCaliforniaUSA
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29
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Bin Eid W, Lim M, Gabrieli G, Kölbel M, Halstead E, Esposito G, Dimitriou D. Alterations in Cortisol Profiles among Mothers of Children with ASD Related to Poor Child Sleep Quality. Healthcare (Basel) 2022; 10:healthcare10040666. [PMID: 35455843 PMCID: PMC9032515 DOI: 10.3390/healthcare10040666] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 11/25/2022] Open
Abstract
Caregivers of children with autism spectrum disorder (ASD) experience poorer sleep, but studies have not yet used objective measures to investigate how child and caregiver sleep affect each other. In this study, 29 mothers and their child with ASD aged between 6 and 16 years were recruited. Questionnaires measuring child autism, maternal depression, and maternal and child sleep quality were administered. Cortisol salivary samples were also obtained from the mothers over the course of a day. Results revealed that maternal depression is significantly correlated with their subjective sleep quality, sleep latency and daytime dysfunction. Child sleep quality was also found to be significantly correlated with ASD severity. In terms of maternal cortisol profiles, a significant number of mothers showed a flattened diurnal cortisol expression, and children of mothers with a flattened cortisol profile had significantly more sleep problems. Overall, results suggest that maternal and child sleep are affected by the child’s disability but also are mutually related. Future studies may consider employing measures such as actigraphy or somnography to quantify sleep quality and establish causal pathways between sleep, cortisol expression and caregiver and child outcomes. The present study has clinical implications in examining family sleep when considering treatment for ASD.
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Affiliation(s)
- Wasmiah Bin Eid
- Sleep Education and Research Laboratory, UCL Institute of Education, London WC1H 0AA, UK; (W.B.E.); (M.K.); (E.H.)
| | - Mengyu Lim
- Psychology Program, School of Social Sciences, Nanyang Technological University, 48 Nanyang Avenue, Singapore 639818, Singapore; (M.L.); (G.G.)
| | - Giulio Gabrieli
- Psychology Program, School of Social Sciences, Nanyang Technological University, 48 Nanyang Avenue, Singapore 639818, Singapore; (M.L.); (G.G.)
| | - Melanie Kölbel
- Sleep Education and Research Laboratory, UCL Institute of Education, London WC1H 0AA, UK; (W.B.E.); (M.K.); (E.H.)
- Department of Developmental Neurosciences Unit, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK
| | - Elizabeth Halstead
- Sleep Education and Research Laboratory, UCL Institute of Education, London WC1H 0AA, UK; (W.B.E.); (M.K.); (E.H.)
| | - Gianluca Esposito
- Affiliative Behaviour and Physiology Lab, Department of Psychology and Cognitive Science, University of Trento, Corso Bettini, 84, I-38068 Trento, Italy;
| | - Dagmara Dimitriou
- Sleep Education and Research Laboratory, UCL Institute of Education, London WC1H 0AA, UK; (W.B.E.); (M.K.); (E.H.)
- Correspondence:
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30
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Zwilling M, Romano A, Favetta M, Ippolito E, Lotan M. Impact of a Remotely Supervised Motor Rehabilitation Program on Maternal Well-Being During the COVID-19 Italian Lockdown. Front Psychol 2022; 13:834419. [PMID: 35345633 PMCID: PMC8957072 DOI: 10.3389/fpsyg.2022.834419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
COVID-19 Lockdown was particularly challenging for most mothers of people with intellectual disabilities, including those with Rett syndrome (RTT), leading to feelings of abandonment from healthcare services of their children. Within those days, telerehabilitation has represented a valid alternative to support physical activity and treatment, supporting parents in structuring their children’s daily routine at home. This article aims to describe the well-being level of two groups of mothers of girls and women with RTT who were involved in a home-based remotely supervised motor rehabilitation program, respectively, before and during the COVID-19 Italian lockdown. Forty participants with classic RTT were recruited before the lockdown and randomly assigned to two groups that performed the intervention immediately before (Group 1) and during (Group 2) the lockdown, respectively. The intervention included an individualized daily physical activity program carried out for 12 weeks by participants’ parents and fortnightly supervised throughout Skype contacts to plan, monitor, and accommodate individual activities in the participant’s life at home. The short form Caregivers Well-Being Scale was collected for the mothers in each group 12 weeks before intervention (T1), at intervention initiation (T2), immediately after intervention termination (T3), as well as at 12 weeks after intervention termination (T4). Mothers of participants in the Group 1 showed a stable level of well-being across all four evaluations with a slight improvement during the lockdown, without significant change. Similarly, the well-being level of mothers in the Group 2 showed a statistically significant increase in their well-being between T2 and T3 (during the lockdown) and its reduction to the pre-intervention level between T3 and T4 (after the lockdown). The results suggest that the lockdown did not negatively affect the participants’ mothers’ well-being, leading to its improvement. Moreover, the proposed intervention could have supported the mothers in managing the new daily routine at home, positively affecting maternal well-being.
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Affiliation(s)
- Moti Zwilling
- Department of Economics and Business Administration, Ariel University, Ari'el, Israel
| | - Alberto Romano
- Department of Health System Management, Ariel University, Ari'el, Israel.,Movement Analysis and Robotics Laboratory, Unit of Neurorehabilitation, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy.,Centro AIRETT Ricerca e Innovazione (CARI), Research and Innovation Airett Center, Verona, Italy
| | - Martina Favetta
- Movement Analysis and Robotics Laboratory, Unit of Neurorehabilitation, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy
| | | | - Meir Lotan
- Department of Physiotherapy, Ariel University, Ari'el, Israel.,Israeli Rett Syndrome National Evaluation Team, Sheba Hospital, Ramat-Gan, Israel
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31
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Tascini G, Dell'Isola GB, Mencaroni E, Di Cara G, Striano P, Verrotti A. Sleep Disorders in Rett Syndrome and Rett-Related Disorders: A Narrative Review. Front Neurol 2022; 13:817195. [PMID: 35299616 PMCID: PMC8923297 DOI: 10.3389/fneur.2022.817195] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/02/2022] [Indexed: 11/13/2022] Open
Abstract
Rett Syndrome (RTT) is a rare and severe X-linked developmental brain disorder that occurs primarily in females, with a ratio of 1:10.000. De novo mutations in the Methyl-CpG Binding protein 2 (MECP2) gene on the long arm of X chromosome are responsible for more than 95% cases of classical Rett. In the remaining cases (atypical Rett), other genes are involved such as the cyclin-dependent kinase-like 5 (CDKL5) and the forkhead box G1 (FOXG1). Duplications of the MECP2 locus cause MECP2 duplication syndrome (MDS) which concerns about 1% of male patients with intellectual disability. Sleep disorders are common in individuals with intellectual disability, while the prevalence in children is between 16 and 42%. Over 80% of individuals affected by RTT show sleep problems, with a higher prevalence in the first 7 years of life and some degree of variability in correlation to age and genotype. Abnormalities in circadian rhythm and loss of glutamate homeostasis play a key role in the development of these disorders. Sleep disorders, epilepsy, gastrointestinal problems characterize CDKL5 Deficiency Disorder (CDD). Sleep impairment is an area of overlap between RTT and MECP2 duplication syndrome along with epilepsy, regression and others. Sleep dysfunction and epilepsy are deeply linked. Sleep deprivation could be an aggravating factor of epilepsy and anti-comitial therapy could interfere in sleep structure. Epilepsy prevalence in atypical Rett syndrome with severe clinical phenotype is higher than in classical Rett syndrome. However, RTT present a significant lifetime risk of epilepsy too. Sleep disturbances impact on child's development and patients' families and the evidence for its management is still limited. The aim of this review is to analyze pathophysiology, clinical features, the impact on other comorbidities and the management of sleep disorders in Rett syndrome and Rett-related syndrome.
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Affiliation(s)
- Giorgia Tascini
- Department of Pediatrics, University of Perugia, Perugia, Italy
| | | | | | | | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases Unit, IRCCS "G. Gaslini" Institute, Genoa, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
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32
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Fielding-Gebhardt H, Swinburne Romine R, Bredin-Oja S, Brady N, Warren SF. Maternal well-being and family adaptation during COVID-19 in fragile X syndrome. Front Psychiatry 2022; 13:952118. [PMID: 36081464 PMCID: PMC9445157 DOI: 10.3389/fpsyt.2022.952118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
Mothers of children with fragile X syndrome are at increased risk of experiencing anxiety and depression due to potential genetic risk and to stress associated with parenting a child with significant behavioral, emotional, and educational support needs. During the initial shutdown and subsequent restrictions of the COVID-19 pandemic, mothers of children with fragile X reported experiencing elevated levels of anxiety and depression relative to their usual levels of well-being. Many indicated that the negative consequences of exposure to COVID-19 and related stressors, as well as the impacts of the pandemic on their family, directly affected their anxiety and depression. Mothers reported on specific sources of distress as well as potential sources of resilience and positive adaptation that occurred during the first year of the COVID-19 pandemic.
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Affiliation(s)
| | - Rebecca Swinburne Romine
- Schiefelbusch Institute for Life Span Studies, University of Kansas, Lawrence, KS, United States
| | - Shelley Bredin-Oja
- Department of Communication Sciences and Disorders, Minot State University, Minot, ND, United States
| | - Nancy Brady
- Schiefelbusch Institute for Life Span Studies, University of Kansas, Lawrence, KS, United States.,Department of Speech-Language-Hearing: Sciences and Disorders, University of Kansas, Lawrence, KS, United States
| | - Steven F Warren
- Schiefelbusch Institute for Life Span Studies, University of Kansas, Lawrence, KS, United States.,Department of Speech-Language-Hearing: Sciences and Disorders, University of Kansas, Lawrence, KS, United States
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33
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Moore SA, Sharma R, Martin Ginis KA, Arbour-Nicitopoulos KP. Adverse Effects of the COVID-19 Pandemic on Movement and Play Behaviours of Children and Youth Living with Disabilities: Findings from the National Physical Activity Measurement (NPAM) Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12950. [PMID: 34948560 PMCID: PMC8701838 DOI: 10.3390/ijerph182412950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/01/2021] [Accepted: 12/03/2021] [Indexed: 12/18/2022]
Abstract
All children and youth require ample physical activity (PA), low levels of sedentary behaviour (SB), and adequate sleep to stay healthy. Children and youth living with disabilities (CYWD) tend to have fewer opportunities for participation in PA and outdoor play compared with their typically developing peers. In turn, CYWD are typically less active and more sedentary, on average, compared with their peers. The COVID-19 pandemic reduced opportunities for many children and youth to participate in PA and outdoor play. The purpose of this study was to assess parent-perceived changes in PA (including outdoor play), SB (including screen time), and sleep quality and quantity, due to COVID-19 and related restrictions, in a national cohort of Canadian CYWD. We recruited parents of school-aged CYWD (N = 151) in May 2020. In an online survey, parents reported their child's previous 7-day PA, SB, and sleep, as well as perceived changes in their child's movement and play behaviours due to COVID-19 and related restrictions. Parent-perceived parental support for their child's movement and play behaviours during the pandemic was also assessed. We used descriptive statistics to describe the child's movement behaviours and assessed the association between movement behaviours and parental factors using Pearson and point-biserial correlations. Few (5.3%) CYWD met PA recommendations and 13.2% met screen time recommendations during the acute period of the COVID-19 pandemic. More CYWD (66.2%) were meeting sleep recommendations. Overall, only 1.3% of CYWD were meeting the combined movement guidelines. Parent encouragement was positively associated with the child's outdoor PA (0.23), wheeling, walking, and biking (0.19), indoor PA (0.16), and family-based PA (0.26). Parental co-play was similarly positively associated with the child's outdoor PA (0.26), wheeling, walking, and biking (0.39), indoor PA (0.16), and family-based PA (0.26). Parents perceived their CYWD to be less active and more sedentary as a result of COVID-19 and the related restrictions. Parents of CYWD have an important role in encouraging healthy movement behaviours. Return to movement and play post-COVID guidelines should include tailored strategies for CYWD and their families to mitigate the negative impacts of the pandemic.
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Affiliation(s)
- Sarah A. Moore
- School of Health and Human Performance, Faculty of Health, Dalhousie University, P.O. Box 15000, Halifax, NS B3H 4R2, Canada
- Department of Pediatrics, Faculty of Medicine, Dalhousie University, P.O. Box 15000, Halifax, NS B3H 4R2, Canada
- Healthy Populations Institute, Dalhousie University, P.O. Box 15000, Halifax, NS B3H 4R2, Canada
| | - Ritu Sharma
- Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord St., Toronto, ON M5S 2W6, Canada;
| | - Kathleen A. Martin Ginis
- School of Health and Exercise Sciences, University of British Columbia, 1147 Research Road, Kelowna, BC V1V 1V7, Canada;
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, 1088 Discovery Avenue, Kelowna, BC V1V 1V7, Canada
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, 818 W 10th Avenue, Vancouver, BC V5Z 1M9, Canada
- Centre for Chronic Disease Prevention and Management, University of British Columbia, 1088 Discovery Avenue, Kelowna, BC V1V 1V7, Canada
| | - Kelly P. Arbour-Nicitopoulos
- Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord St., Toronto, ON M5S 2W6, Canada;
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34
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Ortiz-Rubio A, Torres-Sánchez I, Cabrera-Martos I, Rodríguez-Torres J, López-López L, Prados-Román E, Valenza MC. The Caregiver Burden Inventory as a Sleep Disturbance Screening Tool for Parents of Children with Autism Spectrum Disorder. J Pediatr Nurs 2021; 61:166-172. [PMID: 34090081 DOI: 10.1016/j.pedn.2021.05.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 05/10/2021] [Accepted: 05/26/2021] [Indexed: 11/15/2022]
Abstract
PURPOSE The study was conducted to explore the degree to which caregiver burden is associated with sleep quality in parents of children with autism spectrum disorder, and to determine a statistically valid cutoff score for the Caregiver Burden Inventory (CBI) in order to identify parents of risk of poor sleep quality. DESIGN AND METHODS We conducted a cross-sectional analysis. We assessed caregiver burden with the CBI, sleep quality with the Pittsburgh Sleep Quality Index, emotional status with the Hospital Anxiety and Depression Scale, and impact on family with the Impact on Family Scale. Caregiver burden was evaluated with a logistic regression analysis. The best fit model was used in a receiver operating characteristic analysis. Likelihood ratios and post-test probabilities were calculated. RESULTS A total of 116 parents were included in this study. Higher caregiver burden was associated with a reduction in sleep quality in the logistic regression analysis (p < 0.001). The area under the curve for the univariate burden test model (best fit) was 76.70 (p < 0.001). The cutoff score for poor sleep quality was caregiver burden ≥26.50. The post-test probability of poor sleep quality increased to 82.02% from a pre-test probability of 76.72%. CONCLUSIONS Our findings suggest that caregiver burden is associated with sleep quality among parents of children with autism spectrum disorder. The findings suggest that a CBI cutoff score of 26.50 may help to detect risk of poor sleep quality in parents of children with autism spectrum disorder.
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Affiliation(s)
- Araceli Ortiz-Rubio
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Spain
| | - Irene Torres-Sánchez
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Spain
| | - Irene Cabrera-Martos
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Spain
| | | | - Laura López-López
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Spain
| | - Esther Prados-Román
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Spain
| | - Marie Carmen Valenza
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Spain.
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Alsaman MA, Abd El-Naiem HN. Stress in Egyptian parents of children with developmental disabilities. The moderating effect of social support. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 117:104045. [PMID: 34325099 DOI: 10.1016/j.ridd.2021.104045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/14/2021] [Accepted: 07/20/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Research shows that parents of children with developmental disabilities (DDs) are at increased risk for elevated stress. Child adaptive functioning as well as social supports are key factors influencing stress in parents. However, few studies have examined the interaction between these variables and their contribution to perceived stress especially in Egyptian parents. AIMS The present study investigated the relationship between parenting stress, child adaptive functioning, and social supports. It also examined the moderating role of social support in the relationship between child adaptive functioning and stress in Egyptian parents of children with DDs. METHOD Sixty-four Egyptian parents of children with DDs completed assessment measures of parenting stress, child adaptive functioning, and social supports. RESULTS Parenting stress was negatively associated with child adaptive functioning and informal social supports. However, there was no association between parenting stress and formal social supports. In addition, level of informal social support had a moderating effect on the relationship between child adaptive functioning and level of parenting stress. CONCLUSIONS The findings highlight the importance of interventions that reduce child-related stressors, particularly low adaptive functioning. Programs that address parenting stress and promote effective informal and formal social supports are crucial to help parents cope with stress.
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Affiliation(s)
- Marwa A Alsaman
- College of Special Education, Misr University for Science and Technology, Al-Motamayez District, 6th of October City, Giza, 12568, Egypt.
| | - Hanan N Abd El-Naiem
- College of Special Education, Misr University for Science and Technology, Al-Motamayez District, 6th of October City, Giza, 12568, Egypt
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36
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Atilgan ED, Tuncer A. The effects of breathing exercises in mothers of children with special health care needs:A randomized controlled trial. J Back Musculoskelet Rehabil 2021; 34:795-804. [PMID: 33896815 DOI: 10.3233/bmr-200327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVE Caring for a child with a disability affects musculoskeletal system pain, fatigue, sleep quality, and anxiety of the mothers. The purpose of the study was to determine the effectiveness of breathing exercises in mothers with chronic non-specific low back pain (NLBP). METHODS Forty-three mothers with chronic NLBP were randomly assigned to the experimental group (n= 23) and the control group (n= 20). The experimental group received breathing exercises with core stabilization exercises (BSET) for three sessions a week for 8 weeks, and the control group performed stabilization exercises (SET) only, for the same period. Pain severity, fatigue, anxiety, and sleep quality were evaluated before and after the treatment programs. RESULTS After the treatment programs, significant differences were observed in pain, fatigue, and sleep quality in both groups (p< 0.05). However, the BSET group showed a significantly better improvement in anxiety levels and sleep quality than the SET group (p< 0.05). CONCLUSIONS The improvements in pain, fatigue and sleep quality were seen in both groups after treatment programs. It is recommended breathing exercises are added to core stabilization programs to provide greater improvements in anxiety level and sleep quality for mothers of children with disabilities, who have NLBP.
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Affiliation(s)
| | - A Tuncer
- Department of Physiotherapy and Rehabilitation, Hasan Kalyoncu University, Gaziantep, Turkey
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37
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Mackay J, Nixon GM, Lafferty AR, Ambler G, Kapur N, Bergman PB, Schofield C, Seton C, Tai A, Tham E, Vora K, Crock P, Verge C, Musthaffa Y, Blecher G, Caudri D, Leonard H, Jacoby P, Wilson A, Choong CS, Downs J. Associations Between Hyperphagia, Symptoms of Sleep Breathing Disorder, Behaviour Difficulties and Caregiver Well-Being in Prader-Willi Syndrome: A Preliminary Study. J Autism Dev Disord 2021; 52:3877-3889. [PMID: 34498151 DOI: 10.1007/s10803-021-05265-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2021] [Indexed: 11/30/2022]
Abstract
Prader-Willi syndrome (PWS) is a rare genetic disorder characterised by neurodevelopmental delays, hyperphagia, difficulties with social communication and challenging behaviours. Individuals require intensive supervision from caregivers which may negatively affect caregiver quality of life. This study used data collected in the Australasian PWS Registry (n = 50, mean age 11.2 years) to evaluate associations between child behaviours and caregiver mental well-being. Symptoms of sleep-related breathing disorder, child depression and social difficulties were associated with poorer caregiver mental and physical well-being. Growth hormone therapy use was associated with better caregiver mental and physical well-being. Optimising management of problematic behaviours and sleep disturbances have the potential to support caregivers who are the most vital network of support for individuals affected by PWS.
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Affiliation(s)
- Jessica Mackay
- Telethon Kids Institute, The Centre for Child Health Research, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia.,School of Medicine, The University of Western Australia, Crawley, WA, Australia.,Royal Perth Hospital, Perth, WA, Australia
| | - Gillian M Nixon
- Melbourne Children's Sleep Centre, Monash Children's Hospital, Clayton, Victoria, Australia.,Department of Paediatrics, Monash University, Clayton, Victoria, Australia
| | - Antony R Lafferty
- Paediatric Endocrinology and Diabetes Service, Department of Paediatrics, Canberra Hospital, Garran, Australia.,Paediatric and Child Health, ANU Medical School, Canberra ACT, Australia
| | - Geoff Ambler
- The Sydney Children's Hospitals Network, Westmead, NSW, Australia.,Discipline of Child and Adolescent Health, The University of Sydney, Camperdown, NSW, Australia
| | - Nitin Kapur
- Respiratory and Sleep Medicine, Queensland Children's Hospital, South Brisbane, Queensland, Australia.,School of Clinical Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Philip B Bergman
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia.,Department of Paediatric Endocrinology & Diabetes, Monash Children's Hospital, Clayton, Victoria, Australia
| | - Cara Schofield
- Telethon Kids Institute, The Centre for Child Health Research, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia
| | - Chris Seton
- Department of Sleep Medicine, Children's Hospital Westmead, Westmead, NSW, Australia.,Woolcock Institute of Medical Research, Sydney University, Camperdown, NSW, Australia
| | - Andrew Tai
- Respiratory and Sleep Department, Women's and Children's Hospital, North Adelaide, SA, Australia
| | - Elaine Tham
- Endocrinology and Diabetes Department, Women's and Children's Hospital, North Adelaide, SA, Australia
| | - Komal Vora
- Department of Paediatric Endocrinology and Diabetes, John Hunter Children's Hospital, Newcastle, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Patricia Crock
- Department of Paediatric Endocrinology and Diabetes, John Hunter Children's Hospital, Newcastle, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia.,The Priority Research Centre GrowUpWell®, Newcastle, NSW, Australia
| | - Charles Verge
- Department of Endocrinology, Sydney Children's Hospital, Randwick, NSW, Australia.,School of Women's and Children's Health, The University of New South Wales, Sydney, NSW, Australia
| | - Yassmin Musthaffa
- Department of Endocrinology and Diabetes, Queensland Children's Hospital, South Brisbane, Queensland, Australia.,Department of Paediatrics, Logan Hospital, Brisbane, Queensland, Australia.,School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Greg Blecher
- Department of Sleep Medicine, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Daan Caudri
- Telethon Kids Institute, The Centre for Child Health Research, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia.,Discipline of Paediatrics, School of Medicine, The University of Western Australia, Crawley, WA, Australia.,Department of Paediatric Pulmonology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Helen Leonard
- Telethon Kids Institute, The Centre for Child Health Research, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia
| | - Peter Jacoby
- Telethon Kids Institute, The Centre for Child Health Research, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia
| | - Andrew Wilson
- Telethon Kids Institute, The Centre for Child Health Research, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia.,Discipline of Paediatrics, School of Medicine, The University of Western Australia, Crawley, WA, Australia.,Respiratory and Sleep Medicine, Perth Children's Hospital, Nedlands, WA, Australia.,Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - Catherine S Choong
- Telethon Kids Institute, The Centre for Child Health Research, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia.,Department of Endocrinology, Perth Children's Hospital, Nedlands, WA, Australia
| | - Jenny Downs
- Telethon Kids Institute, The Centre for Child Health Research, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia. .,Curtin School of Allied Health, Curtin University, Perth, WA, Australia.
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Rydzewska E, Dunn K, Cooper SA, Kinnear D. Mental ill-health in mothers of people with intellectual disabilities compared with mothers of typically developing people: a systematic review and meta-analysis. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:501-534. [PMID: 33738865 DOI: 10.1111/jir.12827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 12/01/2020] [Accepted: 02/20/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Mothers of people with intellectual disabilities (IDs) face exceptional challenges and may be more prone to experiencing mental ill-health compared with mothers of typically developing people. These mental ill-health problems may differ at different stages of the caregiving trajectory. However, there is no evidence synthesis on this topic. We aimed to systematically review evidence in this area and identify gaps in the existing literature. METHOD Prospero registration: CRD42018088197. Medline, Embase, CINAHL and PsycINFO databases were searched. No time limits were applied. Studies were limited to English language. Inclusion criteria were studies of mothers of people with IDs that also included a comparison group of mothers of typically developing/developed children. Data were extracted from selected studies using a structured database. Study selection and quality appraisal were double rated. Where possible, meta-analyses were performed. RESULTS Of the retrieved articles, 32/3089 were included, of which 10 reported on anxiety, 21 on depression and 23 on other indicators of mental ill-health. Overall, previous studies reported that mothers of people with IDs experienced poorer mental health as compared with mothers of typically developing people. Meta-analyses revealed significant findings for anxiety, depression, parenting stress, emotional burden and common mental disorders, but not for somatic symptoms. However, there was a considerable heterogeneity; hence, interpretation of results should be cautious. Identified gaps included scarce research on mental ill-health of mothers of adults with IDs at different stages of the caregiving trajectory. CONCLUSIONS There is evidence of poorer mental ill-health in mothers of people with IDs compared with mothers of typically developing people, but lack of focus on different stages of the caregiving trajectory, methodological inconsistencies between studies and lack of robust studies pose limitations. This highlights the need both for improved support for mothers of people with IDs and for further methodologically robust research.
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Affiliation(s)
- E Rydzewska
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - K Dunn
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - S-A Cooper
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - D Kinnear
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Lovell B, Elder GJ, Wetherell MA. Sleep disturbances and physical health problems in caregivers of children with ASD. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 113:103932. [PMID: 33730686 DOI: 10.1016/j.ridd.2021.103932] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/27/2020] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Caregivers of children with autism spectrum disorder self-report more physical health problems than controls. Sleep disturbances are also more prevalent in caregivers, and are positively associated with physical health problems. The negative impact of caring for a child with ASD on physical health therefore, might occur indirectly via poorer sleep. METHODS Participants, of which n = 43 were caregivers and n = 17 were controls, completed self-report measures of physical health problems and, to capture objective measures of sleep, wore an actigraphy device. RESULTS Physical health problems were greater in caregivers, as were subjective reports of disturbed sleep. Objectively, waking after sleep onset (WASO) and average number of awakenings were higher, as was sleep latency, and sleep efficiency was poorer, in caregivers. Total sleep time however, was greater in caregivers, as was time in bed. Physical health problems, while unrelated to actigraphy measures, were positively associated with self-reported sleep disturbances. Caregivers' increased risk for physical health problems occurred indirectly via greater self-reports of disturbed sleep. CONCLUSIONS Interventions that help alleviate caregivers' sleep disturbances might be effective, by reducing physical health problems, for improving quality of provided care, and this might be explored in future research.
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Affiliation(s)
- Brian Lovell
- Department of Psychology, Northumbria University, United Kingdom.
| | - Greg J Elder
- Department of Psychology, Northumbria University, United Kingdom
| | - Mark A Wetherell
- Department of Psychology, Northumbria University, United Kingdom
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40
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YARAR F, BAYRAMOĞLU S, ŞENOL H. COVID-19 Pandemi Döneminin Özel Gereksinimli Çocuk Annelerinde Anksiyete ve Yaşam Kalitesi Üzerine Etkisinin İncelenmesi. DÜZCE ÜNIVERSITESI SAĞLIK BILIMLERI ENSTITÜSÜ DERGISI 2021. [DOI: 10.33631/duzcesbed.871934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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41
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The effect of functioning on Quality of Life Inventory-Disability measured quality of life is not mediated or moderated by parental psychological distress. Qual Life Res 2021; 30:2875-2885. [PMID: 33939076 DOI: 10.1007/s11136-021-02855-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The measurement of quality of life (QOL) in children with intellectual disability often relies upon proxy report via caregivers. The current study investigated whether caregiver psychological distress mediates or moderates the effects of impairment on their ratings of QOL in children with intellectual disability. METHODS Caregivers of 447 children with an intellectual disability reported their child's day-to-day functioning, their own psychological distress using the Kessler Psychological Distress Scale, and the Quality of Life Inventory-Disability (QI-Disability), a measure of QOL for proxy report of a child's observable behaviours that indicate quality of life. Linear regression was used to assess the effects of the child's functional abilities on their QI-Disability score and causal mediation analysis to estimate the extent to which these effects were mediated by caregivers' psychological distress. RESULTS A minority of caregivers (n = 121, 27.1%) reported no psychological distress. Lower day-to-day functional abilities, such as being fully dependent on others to manage their personal needs were associated with lower total QOL scores. There was no significant mediation effect of caregiver psychological distress on the association between child functioning and total QOL scores. Moderation analyses revealed small and largely nonsignificant interaction coefficients, indicating that caregiver psychological distress did not influence the strength of the relationship between child functioning and total QOL scores. CONCLUSION Caregiver psychological distress did not mediate or moderate the relationship between the level of functional abilities and QOL in children with intellectual disability. QI-Disability measured observable child behaviours which may reduce the influence of caregiver factors on the accurate measure of QOL for children with intellectual disability.
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42
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Adler I, Weidner K, Eberhard-Gran M, Garthus-Niegel S. The Impact of Maternal Symptoms of Perinatal Insomnia on Social-emotional Child Development: A Population-based, 2-year Follow-up Study. Behav Sleep Med 2021; 19:303-317. [PMID: 32249601 DOI: 10.1080/15402002.2020.1746661] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Background: Poor sleep quality is a common problem in pregnant women, however there is scarce research evidence regarding the association between maternal perinatal insomnia and later social-emotional child development.Participants: This study is part of the Akershus Birth Cohort, a longitudinal population-based study. Birth record and questionnaire data of 1,346 women were used.Methods: Maternal symptoms of insomnia were measured at pregnancy week 32 and at eight weeks postpartum and social-emotional child development was assessed at two years of child age. Correlational and multiple linear regression analyzes were performed.Results: Both, pre- and postnatal symptoms of insomnia were significantly correlated with poorer social-emotional child development two years later (r = 0.09, p < .01 and r = 0.13, p < .001). Adjusting for potential confounding factors, the prospective effect of maternal symptoms of perinatal insomnia on social-emotional child development remained significant in the multiple linear regression analyzes (β = 0.08, p < .01 and β = 0. 10, p < .01).Conclusions: We found a prospective effect of maternal symptoms of perinatal insomnia on social-emotional child development, highlighting the potential relevance of both pre- and postnatal maternal sleep for later social-emotional child development. Future studies ought to examine the bio-psycho-social mechanisms and implications of poor maternal sleep in the perinatal time in more detail.
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Affiliation(s)
- Ida Adler
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the TU Dresden, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the TU Dresden, Germany
| | - Malin Eberhard-Gran
- Department for Infant Mental Health, Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway.,Institute of Clinical Medicine, Campus Ahus, University of Oslo, Lørenskog, Norway.,HØKH, Research Centre, Akershus University Hospital, Norway
| | - Susan Garthus-Niegel
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the TU Dresden, Germany.,Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
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43
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Chauke T, Poggenpoel M, Myburgh CPH, Ntshingila N. Experiences of parents of an adolescent with intellectual disability in Giyani, Limpopo province, South Africa. Health SA 2021; 26:1538. [PMID: 33936787 PMCID: PMC8063545 DOI: 10.4102/hsag.v26i0.1538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 02/25/2021] [Indexed: 11/04/2022] Open
Abstract
Background Parents of adolescents with intellectual disability experienced stress caused by challenges that come from having such adolescents. Those challenges affected the parents physically and emotionally, depending on the severity of the adolescent’s intellectual disability. Having an adolescent with an intellectual disability becomes a burden if the challenges were not resolved. Aim This study aimed to explore and describe the experiences of parents of adolescents with intellectual disability in Giyani. Setting This study was conducted at the participants’ homes in Giyani, Limpopo province, South Africa. Methods A qualitative, exploratory, descriptive and contextual design was utilised. The main question was ‘How is it to have an adolescent with intellectual disability?’ Eight purposively sampled parents participated, and data were collected through in-depth interviews, observations and field notes. Data were analysed by means of thematic coding and an independent coder was consulted. Results Four themes were identified. The study revealed that parents of adolescents with intellectual disability experienced negative emotional responses. Most parents reported a lack of support from family members and the community. They also reported caring challenges, yet some showed positive coping mechanisms. Conclusion Parents of adolescents with intellectual disability experienced various challenges in caring for these children. A collaborative approach from relevant stakeholders could have a positive impact in supporting the parents of adolescents with intellectual disabilities.
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Affiliation(s)
- Tsakani Chauke
- Department of Nursing, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Marie Poggenpoel
- Department of Nursing, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Chris P H Myburgh
- Department of Educational Psychology, Faculty of Education, University of Johannesburg, Johannesburg, South Africa
| | - Nompumelelo Ntshingila
- Department of Nursing, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
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Psychological Distress among Caregivers of Children with Neurodevelopmental Disorders in Nepal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052460. [PMID: 33801567 PMCID: PMC7967590 DOI: 10.3390/ijerph18052460] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/16/2021] [Accepted: 02/23/2021] [Indexed: 11/25/2022]
Abstract
Parenting a child with neurodevelopmental disorder (NDD) is related to a higher rate of anxiety and depression, increased stress, and reduced quality of life. Although there is reason to believe that parenting children with NDD in low- and middle-income countries (LMIC) can be challenging, there is a lack of knowledge on the psychological distress among these caregivers, especially in rural areas. The aim of the study was to examine the psychological distress among caregivers having children with NDD in rural Nepal. Sixty-three caregivers were visited in their homes and interviewed by experienced mental health professionals. This study examined demographic information, severity of disability, perceived caregiver burden, and psychological distress, measured by the General Health Questionnaire-12 (GHQ-12). The study found a high level of psychological distress in the caregivers (M = 5.38, SD = 2.8). A majority (90.5%) scored two or higher, indicating the presence of a common mental disorder (CMD). Almost half (46%) scored six or higher, indicating a high level of distress. A majority of the caregivers reported that caring for their disabled child had a negative effect on the caregiver’s economy (70%), physical health (65%), social life (64%), and dreams and expectations for the future (81%). There was a significant relationship between the caregiver’s psychological distress (GHQ-12) and degree of disability in the child (Gross Motor Function Classification System), degree of caregiver burden, feeding problems, having health workers as a possible source of help, receiving incentive from the government, having somebody to confide in, and caregiver illiteracy. A forward regression analysis entering the significant factors indicated that caregiver burden, having someone to confide in, and having health workers as a possible source of help were significant related to psychological distress. The final step of the model explained 42.4% of the variance in psychological distress among the caregivers. The study indicates a high level of psychological distress and high overall burden in caregivers of children with NDD in rural Nepal. Further implications for research and service development are discussed.
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45
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Iacob CI, Avram E, Cojocaru D, Podina IR. Resilience in Familial Caregivers of Children with Developmental Disabilities: A Meta-analysis. J Autism Dev Disord 2021; 50:4053-4068. [PMID: 32215818 DOI: 10.1007/s10803-020-04473-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The aim of this meta-analysis was to investigate factors associated with resilience in familial caregivers of children with developmental disabilities. The protocol was registered in the PROSPERO database, with the registration number CRD42018105180. Several electronic databases were searched for studies. A random-effects meta-analysis was performed on 26 selected studies that associated resilience to an array of other variables (i.e., psychological distress, social support, coping, perceived health, life satisfaction). Overall, the significant pooled effect sizes were small to medium, ranging from r = 0.291 for coping to r = 0.442 for social support. Although the literature on the topic has improved, there is a lot of study heterogeneity and the need for focusing on male caregivers becomes evident.
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Affiliation(s)
- Claudia I Iacob
- Faculty of Psychology and Educational Sciences, University of Bucharest, Panduri Avenue, No. 90, Sector 5, Bucharest, Romania.
| | - Eugen Avram
- Faculty of Psychology and Educational Sciences, University of Bucharest, Panduri Avenue, No. 90, Sector 5, Bucharest, Romania
| | - Daniel Cojocaru
- Faculty of Psychology and Educational Sciences, University of Bucharest, Panduri Avenue, No. 90, Sector 5, Bucharest, Romania
| | - Ioana R Podina
- Faculty of Psychology and Educational Sciences, University of Bucharest, Panduri Avenue, No. 90, Sector 5, Bucharest, Romania
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46
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Halstead EJ, Jones A, Esposito G, Dimitriou D. The Moderating Role of Parental Sleep Knowledge on Children with Developmental Disabilities and Their Parents' Sleep. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020746. [PMID: 33467212 PMCID: PMC7830639 DOI: 10.3390/ijerph18020746] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Children with intellectual and developmental difficulties often experience sleep problems, which in turn may impact parental sleep patterns. This study explored the role of parental sleep knowledge as a moderator on the relationship between child sleep and parental sleep impairment. METHODS 582 parents or caregivers (92.6% mothers) of children with different developmental disabilities (Age M = 9.34, 29.5% females) such as Down's syndrome, participated in an online survey. Multiple regression analysis was conducted. RESULTS Parental sleep knowledge of child sleep was a moderating variable in the relationship between child sleep nocturnal duration and parental sleep impairment. Although overall, sleep knowledge was high in this sample, two specific knowledge gaps were identified namely child sleep duration requirements, and the recognition of signs of a well-rested child. CONCLUSION This study has provided evidence that increased parental sleep knowledge can positively impact both child and parental sleep outcomes.
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Affiliation(s)
- Elizabeth J. Halstead
- Sleep Education and Research Laboratory (SERL), UCL Institute of Education, London WC1H 0AA, UK; (E.J.H.); (A.J.)
| | - Alexandra Jones
- Sleep Education and Research Laboratory (SERL), UCL Institute of Education, London WC1H 0AA, UK; (E.J.H.); (A.J.)
| | - Gianluca Esposito
- Social and Affective Neuroscience Lab, Psychology Program-SSS, Nanyang Technological University, Singapore 639818, Singapore;
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
- Affiliative Behaviour and Physiology Lab, Department of Psychology and Cognitive Science, University of Trento, 38068 Trento, Italy
| | - Dagmara Dimitriou
- Sleep Education and Research Laboratory (SERL), UCL Institute of Education, London WC1H 0AA, UK; (E.J.H.); (A.J.)
- Correspondence:
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Levavi K, Menashe-Grinberg A, Barak-Levy Y, Atzaba-Poria N. The role of parental playfulness as a moderator reducing child behavioural problems among children with intellectual disability in Israel. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 107:103793. [PMID: 33260012 DOI: 10.1016/j.ridd.2020.103793] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 10/08/2020] [Accepted: 10/08/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Playfulness is well known to be vital for child development. However, not much is known regarding parental playfulness. We set out to investigate the role of parental playfulness in children with intellectual disabilities (ID) and typical development (TD) living in Israel. Specifically, we examined 1) differences in parental playfulness between groups and 2) parental playfulness as a moderator in the link between developmental status and behavioural problems (BP). METHOD One hundred forty-two families living in Israel and their children (48 % with ID) aged 4-7 years participated in the study. Parent-child play interaction was videotaped and coded for parental playfulness. Parents reported on child BP using the CBCL questionnaire. RESULTS Parents in the ID group showed lower levels of playfulness compared to parents in the TD group. Father's playfulness acted as a moderator in the link between developmental status and child BP. CONCLUSIONS These results highlight the unique role of father's playfulness in the developmental status of a child diagnosed with ID.
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Affiliation(s)
- Kinneret Levavi
- Department of Psychology, Ben-Gurion University of the Negev, Israel.
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48
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Suttora C, Salerni N, Selvagno E, Porro M, Gangi S, Squarza C, Gardon L, Picciolini O. Mind-mindedness and parenting stress in mothers of preterm and full-term infants: The moderating role of perceived social support. Infant Ment Health J 2020; 42:35-46. [PMID: 32965688 DOI: 10.1002/imhj.21891] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The goal of this study was to examine the effects of preterm birth and maternal childbirth-related posttraumatic stress and parenting stress on maternal mind-mindedness (MM). The study also investigated the effects of perceived social support on parenting stress and MM. Sixty-five preterm (N = 32) and full-term (N = 33) mother-infant dyads were observed at 6 months. Measures of maternal MM were obtained from observations of mother-infant interaction. Mothers also provided ratings of their posttraumatic stress disorder (PTSD) symptoms, parenting stress, and perceived social support via an online survey. Experiencing a preterm birth did not affect mothers' use of mental state descriptors during mother-infant interaction. Neither childbirth-related posttraumatic stress nor parenting stress directly affected maternal ability to comment on the child's mental states appropriately. However, at medium and high levels of perceived social support, a negative association between parenting stress and MM was observed. Maternal perception of being emotionally supported by significant others promoted MM in mothers showing low or mild levels of parenting stress, but not in mothers experiencing high stress in parenting their infants. Results suggest that a proclivity to MM might be affected by the interaction between parenting stress and social support, rather than by childbirth-related variables, such as prematurity.
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Affiliation(s)
- Chiara Suttora
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Nicoletta Salerni
- Department of Psychology, University of Milano-Bicocca, Milano, Italy
| | - Elena Selvagno
- Department of Psychology, University of Milano-Bicocca, Milano, Italy
| | - Matteo Porro
- Servizio di Follow-up del neonato a rischio evolutivo, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,UO Medicina Fisica e Riabilitativa Pediatrica, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Silvana Gangi
- Servizio di Follow-up del neonato a rischio evolutivo, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,UO di Neonatologia e Terapia Intensiva neonatale, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Chiara Squarza
- Servizio di Follow-up del neonato a rischio evolutivo, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Laura Gardon
- Servizio di Follow-up del neonato a rischio evolutivo, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Odoardo Picciolini
- Servizio di Follow-up del neonato a rischio evolutivo, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,UO Medicina Fisica e Riabilitativa Pediatrica, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
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Ljubičić M, Baković L, Ćoza M, Pribisalić A, Kolčić I. Awakening cortisol indicators, advanced glycation end products, stress perception, depression and anxiety in parents of children with chronic conditions. Psychoneuroendocrinology 2020; 117:104709. [PMID: 32450487 DOI: 10.1016/j.psyneuen.2020.104709] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 05/04/2020] [Accepted: 05/05/2020] [Indexed: 01/10/2023]
Abstract
This cross-sectional study aims to investigate awakening cortisol indicators and to explore their association with stress perception, advanced glycation end products (AGEs), depression and anxiety in parents of children with chronic conditions. We included five parental groups according to children's diagnoses: Down syndrome (DS; N = 31), autistic spectrum disorder (ASD; N = 29), cerebral palsy (CP; N = 15), diabetes mellitus type 1 (DMT1; N = 38), and a control group of heathy children (CG; N = 33). Salivary cortisol and AGEs were measured, alongside with psychological indices. Partial correlation and multiple linear regression were used in the analysis to identify parental characteristics associated with total awakening cortisol output (area under the curve with respect to the ground, AUCG), cortisol awakening response (area under the curve with respect to the increase, AUCI), perceived stress, and health outcomes (AGEs, depression and anxiety). There was no difference between groups for AUCG, while DS and DMT1 groups showed reduced AUCI (β = -0.241, p = 0.040; β = -0.249, p = 0.028, respectively), and ASD parents had a borderline insignificant result (β = -0.205, p = 0.081). Non-smokers had higher AUCG, and parental sedentary activity and sleep duration were associated with AUCI. AUCG was positively associated with AGEs (β = 0.218, p = 0.013), anxiety (β = 0.207, p = 0.004), and with depression (β = 0.156, p = 0.034), unlike the AUCI. DS parental group showed lower general stress perception (β = -0.260, p = 0.005). Parents of children with DMT1 had more pronounced depressive symptoms (β = 0.183, p = 0.039), while CP parents had a borderline insignificant result for depression (β = 0.143, p = 0.058). Based on these results, parents of children with chronic conditions have altered awaking cortisol response and are under increased risk of adverse health consequences.
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Affiliation(s)
- Marija Ljubičić
- Department of Health Studies, University of Zadar, Splitska 1, 23000 Zadar, Croatia; Department of Pediatrics, General Hospital Zadar, Boze Pericica 5, 23000 Zadar, Croatia.
| | - Lada Baković
- Department of Laboratory Diagnostics, General Hospital Zadar, Boze Pericica 5, 23000 Zadar, Croatia
| | - Martina Ćoza
- Department of Laboratory Diagnostics, General Hospital Zadar, Boze Pericica 5, 23000 Zadar, Croatia
| | - Ajka Pribisalić
- University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia
| | - Ivana Kolčić
- Department of Public Health, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia
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50
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Masefield SC, Prady SL, Sheldon TA, Small N, Jarvis S, Pickett KE. The Caregiver Health Effects of Caring for Young Children with Developmental Disabilities: A Meta-analysis. Matern Child Health J 2020; 24:561-574. [PMID: 32048172 PMCID: PMC7170980 DOI: 10.1007/s10995-020-02896-5] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Mothers of school age and older children with developmental disabilities experience poorer health than mothers of typically developing children. This review assesses the evidence for the effect on mothers' health of caring for young children with developmental disabilities, and the influence of different disability diagnoses and socioeconomic status. METHODS Medline, EMBASE, PsycINFO and CINAHL were searched. Studies measuring at least one symptom, using a quantitative scale, in mothers of preschool children (0-5 years) with and without a diagnosed developmental disability were selected. Random effects meta-analysis was performed, and predictive intervals reported due to high expected heterogeneity. RESULTS The meta-analysis included 23 estimates of association from 14 retrospective studies for the outcomes of stress (n = 11), depressive symptoms (n = 9), general health (n = 2) and fatigue (n = 1). Caring for a child with a developmental disability was associated with greater ill health (standardised mean difference 0.87; 95% predictive interval - 0.47, 2.22). The largest association was for mixed developmental disabilities (1.36; - 0.64, 3.36) and smallest for Down syndrome (0.38; - 2.17, 2.92). There was insufficient socioeconomic information to perform subgroup analysis. The small number of studies and data heterogeneity limited the precision of the estimates of association and generalizability of the findings. CONCLUSIONS FOR PRACTICE Mothers of young children with developmental disabilities may have poorer health than those with typically developing children. Research is needed to identify whether the relationship is causal and, if so, interventions that could reduce the negative effect of caregiving.
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Affiliation(s)
- Sarah C Masefield
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK.
| | - Stephanie L Prady
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Trevor A Sheldon
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Neil Small
- Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Stuart Jarvis
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Kate E Pickett
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
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