1
|
Scheibner M, Scheibner C, Hornemann F, Arélin M, Hennig YD, Kiep H, Wurst U, Merkenschlager A, Gburek-Augustat J. The Impact of Demographic Characteristics on Parenting Stress among Parents of Children with Disabilities: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2024; 11:239. [PMID: 38397351 PMCID: PMC10887938 DOI: 10.3390/children11020239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/07/2024] [Accepted: 02/10/2024] [Indexed: 02/25/2024]
Abstract
Even though it is already known that parents of children with developmental delays or disabilities experience higher parenting stress than families of typically developing children, the contributing factors need to be analyzed in more detail. The aim of this cross-sectional study was to examine the influence of demographic characteristics on parenting stress from caring for a disabled child and to identify possible protective or additional stressful social factors. A total of 611 mothers and fathers of children with developmental delays, chronic diseases, or disabilities completed two questionnaires during their medical appointments at the Children's Development Center (CDC) of Leipzig University Hospital between June 2020 and February 2021. These consisted of the German versions of the Parenting Stress Index (PSI) and the Impact on Family Scale (IOFS). To determine differences between the various groups, we used parametric and non-parametric tests. Mothers and single parents are significantly more strained than fathers and non-single parents. Parents with vocational training, those who graduated with a higher-level diploma, and those within employment report a higher financial burden. While unemployed and full-time workers experience the lowest stress, parents who work part-time or exclusively take care of their child show higher levels of stress. Looking at the age of the child, parents of children of young primary school age are the most stressed, and those of infants are the least stressed. These findings suggest that mothers and single parents especially should receive more support, and parents need to be provided with more attention during their child's entry into school. Possible limitations and the influence of the COVID-19 pandemic are discussed.
Collapse
Affiliation(s)
- Maxi Scheibner
- Division of Neuropediatrics, Hospital for Children and Adolescents, University Hospital Leipzig, 04103 Leipzig, Germany; (C.S.); (A.M.); (J.G.-A.)
| | | | | | | | | | | | | | | | | |
Collapse
|
2
|
Riggall EA, Slomine BS, Suskauer SJ, Borda A, Lahey S, Ludwig NN. Caregiver and family functioning after pediatric disorder of consciousness: telephone-based outcome assessment. Brain Inj 2024; 38:99-107. [PMID: 38328910 DOI: 10.1080/02699052.2024.2304884] [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: 05/08/2023] [Accepted: 10/15/2023] [Indexed: 02/09/2024]
Abstract
OBJECTIVE Examine initial feasibility/utility of a telephone-administered measure in describing impact of child health on caregiver/family functioning in patients with a history of a disorder of consciousness (DoC) due to severe-acquired brain injury (ABI). METHOD Caregivers of patients admitted at least 1 year prior for inpatient rehabilitation with DoC completed a battery of measures administered via telephone examining the impact of child health on caregiver/family functioning (Pediatric Quality of Life Family Impact Module; PedsQL-FIM) and child functioning. RESULTS Forty-one caregivers of unique patients (age = 5-22 years; M = 14.9, SD = 5.1; 63% male; time since injury = 1-18 years; M = 5.3; SD = 4.2) completed the telephone measures. PedsQL-FIM floor and ceiling effects were minimal (administration time = 5-16 min, M = 7.4; SD = 2.8). Family functioning was lowest in Daily Activities and highest in Family Relationships. Relative to caregivers of patients with mild-severe ABI, caregivers reported lower caregiver/family functioning. Correlations were moderate between child functioning and caregiver/family functioning on some PedsQL-FIM scales. CONCLUSIONS Within this relatively small convenience sample, results indicate the PedsQL-FIM administered via telephone is feasible and useful in describing the impact of child health on caregiver/family functioning long after DoC associated with ABI. Future studies are needed to understand factors contributing to caregiver/family functioning to inform targeted interventions.
Collapse
Affiliation(s)
- Emily A Riggall
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Beth S Slomine
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Stacy J Suskauer
- Department of Rehabilitation, Kennedy Krieger Institute, Baltimore, Maryland, USA
- Department Physical Medicine and Rehabilitation and Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Allison Borda
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Sarah Lahey
- Neuropsychology, Brooks Rehabilitation, Jacksonville, Florida, USA
| | - Natasha N Ludwig
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
3
|
Ren L, Wang Y, Jiang H, Chen M, Xia L, Dong C. Development of a theory-based family resilience intervention program for parents of children with chronic diseases: A Delphi study. J Pediatr Nurs 2024; 74:41-50. [PMID: 37995476 DOI: 10.1016/j.pedn.2023.11.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 11/14/2023] [Accepted: 11/14/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Long-term illness exposes children with chronic diseases to a high risk of deterioration of physical and mental health. Developing an effective family resilience intervention program is a critical concern. OBJECTIVE To develop a theory-based family resilience intervention program for parents of children with chronic diseases and provide a reference for clinical intervention. METHODS A two-phased research design, guided by the Walsh family resilience process model, was employed to develop the intervention program. In phase 1, a scoping literature review was conducted to identify the possible elements of family resilience interventions. In phase 2, a three-round Delphi survey was conducted with experts (n = 14) using an online electronic survey to obtain their consensus on the intervention content. RESULTS Three main components were identified: (1) strengthening family beliefs, (2) adjusting the family organization pattern, and (3) improving the family communication process. And 8 modules were developed: "introducing adversity and family resilience", "finding and strengthening positive family beliefs, and building confidence to live with the disease", "analyzing and adjusting family structure", "assisting families to increase and utilizing internal and external resources", "optimizing communication skills", "strengthening collaborative problem-solving capacity", "enhancing the family narrative ability", and "enhancing emotional expression". After 3-round Delphi, the findings indicated that the intervention program is applicable and feasible for parents of children with chronic diseases in China. CONCLUSION The principal merit of this study lies in the development of a family resilience intervention program for parents of children with chronic diseases. The intervention's usability and efficacy should be investigated in future studies. IMPLICATIONS TO PRACTICE Developing a family resilience intervention program is a critical first step toward providing effective care for parents of children with chronic diseases, and evaluating the program's feasibility and suitability in the target population is warranted.
Collapse
Affiliation(s)
- Liya Ren
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yuxin Wang
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hao Jiang
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Meijia Chen
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Lin Xia
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China.
| |
Collapse
|
4
|
Lim Y, Hong I, Han A. The Impact of Raising Children with Barth Syndrome on Parental Health-Related Quality of Life and Family Functioning: Preliminary Reliability and Validity of the PedsQL™ Family Impact Module. Occup Ther Int 2023; 2023:5588935. [PMID: 38187035 PMCID: PMC10771332 DOI: 10.1155/2023/5588935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/02/2023] [Accepted: 12/21/2023] [Indexed: 01/09/2024] Open
Abstract
Objective This study examined the preliminary reliability and validity of the PedsQL™ Family Impact Module (PedsQL FIM) in families of children with Barth syndrome (BTHS). Method A total of 72 parents with children or youth between the ages of 5 and 19 participated in this study. Thirty-three parents of children with BTHS and 39 parents of unaffected children completed the PedsQL FIM and a demographic information form. Internal consistency reliability and item-total correlations were calculated to test the reliability of the PedsQL FIM. Construct validity was examined using the known-groups method. We estimated the mean score differences of the PedsQL FIM between the two groups using three different models, including unadjusted, multivariate regression, and propensity score matching with inverse probability of treatment weighting (PS-IPTW) models. Results The Cronbach's alpha coefficients were greater than 0.70 for all scales of the PedsQL FIM, except for the communication scale. The item-total correlations were significant for all scales with moderate to high correlations (p < .05). In construct validity, the mean scores of the PedsQL FIM between the two groups were significantly different (p < .05) for all scales and total score in the unadjusted and PS-IPTW models. However, in the multivariate regression model, the family relationships scale was not significant between the two groups. Conclusion The PedsQL FIM demonstrated adequate measurement properties of preliminary reliability and validity in assessing the impact of children with BTHS on parental health-related quality of life (HRQoL) and family functioning. Further research needs to be conducted to examine the psychometric properties of the PedsQL FIM with a large sample of BTHS and with other pediatric rare diseases.
Collapse
Affiliation(s)
- Yoonjeong Lim
- Division of Occupational Therapy, Binghamton University, Johnson City, NY 13790, USA
| | - Ickpyo Hong
- Department of Occupational Therapy, Yonsei University, Wonju 26493, Republic of Korea
| | - Areum Han
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| |
Collapse
|
5
|
Skrobanski H, Vyas K, Bowditch S, Hubig L, Dziadulewicz E, Fish L, Takhar P, Lo SH. The Burden of Caring for Individuals with Tuberous Sclerosis Complex (TSC) Who Experience Epileptic Seizures: A Descriptive UK Survey. PHARMACOECONOMICS - OPEN 2023; 7:299-312. [PMID: 36757566 PMCID: PMC10043106 DOI: 10.1007/s41669-023-00387-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/05/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Tuberous sclerosis complex (TSC) is a rare multisystem genetic condition characterised by benign tumours; prevalent manifestations include epilepsy and neuropsychiatric disorders. This study examined the burden of TSC for primary caregivers and families, exploring the impact of characteristics such as seizures. METHODS Primary caregivers of individuals with TSC in the United Kingdom participated in an online survey, comprising the Pediatric Quality of Life Inventory™ Family Impact Module, Hospital Anxiety and Depression Scale (HADS), and TSC-specific items. Responses were analysed using descriptive and regression analysis statistics (closed-ended) or qualitative content analysis (open-ended). RESULTS Seventy-three participants partially completed and 59 fully completed the survey; 95% were female, and 90% were parents of an individual with TSC. A median (range) of 2 (1-11) household members were carers. Primary caregivers spent a mean (standard deviation [SD]) of 104.3 (51.7) hours caring in the previous week, reporting high mean (SD) HADS scores of 11.2 (4.8) (anxiety) and 7.9 (4.4) (depression) and considerable family burden. Increased seizure frequency increased hours spent caring by primary caregivers (p = 0.01) and was associated with a decreased mean (SD) family functioning score of 46.2 (23.0) and parent health-related quality of life (HRQL) score of 45.4 (20.3) (both p = 0.03). Multivariable models predicted intellectual disability increased hours spent caring by primary caregivers (p = 0.01-0.04), and neuropsychiatric comorbidities decreased family functioning (p = 0.02) and caregiver HRQL (p < 0.01). CONCLUSION These findings highlight the role of epileptic seizures and neuropsychiatric disorders in the considerable burden of TSC on primary caregivers and families.
Collapse
Affiliation(s)
| | - Kishan Vyas
- Jazz Pharmaceuticals, Inc., 1 Cavendish Place, London, W1G 0QF, UK
| | - Sally Bowditch
- Jazz Pharmaceuticals, Inc., 1 Cavendish Place, London, W1G 0QF, UK.
| | - Lena Hubig
- Acaster Lloyd Consulting Ltd, London, UK
| | | | - Louise Fish
- Genetic Alliance UK, London, UK
- Tuberous Sclerosis Association, London, UK
| | | | | |
Collapse
|
6
|
Salud mental de cuidadores de niños con trastornos del neurodesarrollo durante la pandemia. NEUROLOGÍA ARGENTINA 2023. [PMCID: PMC9868982 DOI: 10.1016/j.neuarg.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Los cuidadores son especialmente propensos a verse más afectados psicológicamente durante las restricciones sociales y del sistema sanitario generadas por la pandemia por COVID-19. Los cuidadores de niños con trastornos del neurodesarrollo (es decir, autismo, discapacidad intelectual, déficit de atención, hiperactividad, discapacidad motora) tienen un papel más importante que los que acompañan niños sanos. Se diseñó un estudio cuantitativo transversal, utilizando técnicas estadísticas descriptivas, comparativas y correlacionales, para analizar la calidad de vida relacionada con la salud, el malestar emocional y la sobrecarga en cuatro subgrupos de cuidadores, clasificados según el diagnóstico del niño. Se incluyeron 132 cuidadores (86,4% mujeres). En el grupo 1 (discapacidad cognitiva) participaron 28 cuidadores; en el grupo 2 (TDAH) se incluyeron 51; en el grupo 3 (trastorno del espectro autista) participaron 33 cuidadores, y en el grupo 4 (discapacidad motora) se incluyeron 20. Los principales hallazgos de este estudio fueron: 1) alteraciones en el rol físico, el dolor corporal, la salud general y la vitalidad; 2) porcentajes muy bajos de sintomatología de depresión, ansiedad, estrés y sobrecarga; 3) diferencias en el funcionamiento social entre los grupos de discapacidad motora y TDAH, y en el estrés y la sobrecarga entre los grupos de autismo y discapacidad motora, y 4) correlaciones moderadas entre las dimensiones de dolor corporal y rol emocional y la depresión, la ansiedad, el estrés y la sobrecarga. Se concluyó que hay más afectación en variables asociadas con la salud física que con las de la salud mental.
Collapse
|
7
|
Borissov A, Bakolis I, Tekola B, Kinfe M, Ceccarelli C, Girma F, Abdurahman R, Zerihun T, Hanlon C, Hoekstra RA. Adaptation and validation of two autism-related measures of skills and quality of life in Ethiopia. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:1409-1422. [PMID: 34875883 PMCID: PMC9340138 DOI: 10.1177/13623613211050751] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Although most children with autism and other neurodevelopmental disorders live in low- and middle-income countries, assessment tools are lacking in these settings. This study aims to culturally adapt and validate two questionnaires for use in Ethiopia: the Autism Treatment Evaluation Checklist and the Pediatric Quality of Life Inventory™ Family Impact Module. Both questionnaires were adapted to be suitable for administration in low-literate caregivers and translated using the backward translation procedure. The factor structure, reliability and validity were investigated using caregiver-reports on 300 children with neurodevelopmental disorders or physical health conditions. Confirmatory factor analysis of the Pediatric Quality of Life Inventory™ Family Impact Module data indicated an acceptable fit of the hypothesised eight-factor structure. Internal consistency was high for both measures. Test–retest reliability was excellent for the Autism Treatment Evaluation Checklist and moderate to excellent for the Pediatric Quality of Life Inventory™ Family Impact Module. Both questionnaires demonstrated adequate known-group validity, with moderate to very large effect size group differences between case and control groups. The questionnaires correlated moderately with each other. In conclusion, the Ethiopian adaptations of the Autism Treatment Evaluation Checklist and the Pediatric Quality of Life Inventory™ Family Impact Module are valid and reliable tools for use in parents of children with neurodevelopmental disorders including autism. These adapted measures may also be valuable for use in other low-income settings.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Tigist Zerihun
- St. Paul's Hospital Millennium Medical College, Ethiopia
| | | | | |
Collapse
|
8
|
Verstraete J, Lloyd AJ, Jelsma J. Performance of the Toddler and Infant (TANDI) Health-Related Quality of Life Instrument in 3-4-Year-Old Children. CHILDREN-BASEL 2021; 8:children8100920. [PMID: 34682184 PMCID: PMC8534352 DOI: 10.3390/children8100920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 11/16/2022]
Abstract
The Toddler and Infant (TANDI) dimensions of Health-Related Quality of Life assess 'age appropriate' behaviour and measurement could be extended to older children. A sample of 203 children 3-4 years of age was recruited, and their caregivers completed the TANDI, Pediatric Quality of Life Inventory (PedsQL) and EQ-5D-Y Proxy. Spearman and Pearson's correlation coefficients, and Kruskal-Wallis H-test were used to explore the feasibility, known-group validity, discriminate validity and concurrent validity of the TANDI. Children with a health condition (n = 142) had a lower ceiling effect (p = 0.010) and more unique health profiles (p < 0.001) than the healthy group (n = 61). The TANDI discriminated between those with and without a health condition. In children with a health condition, the TANDI discriminated between clinician rated severity of the health condition. The TANDI had moderate to strong correlations with similar PedsQL and EQ-5D-Y items and scores. The TANDI is valid for children aged 3-4 years and is recommended for children with a health condition, whereas the PedsQL may be better for healthy children. The TANDI is recommended for studies with young children whereas the EQ-5D-Y Proxy is recommended for a sample including older children or for longitudinal studies with preschoolers. Further work on the TANDI is recommended to establish test-retest reliability and responsiveness.
Collapse
Affiliation(s)
- Janine Verstraete
- Department of Paediatrics and Child Health, Division of Pulmonology, University of Cape Town, Klipfontein Road, Rondebosch, Cape Town 7700, South Africa
- Correspondence:
| | | | - Jennifer Jelsma
- Deparment of Health and Rehabilitation Sciences, Division of Physiotherapy, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa;
| |
Collapse
|
9
|
Zachry AH, Jones T, Flick J, Richey P. The Early STEPS Pilot Study: The Impact of a Brief Consultation Session on Self-reported Parenting Satisfaction. Matern Child Health J 2021; 25:1923-1929. [PMID: 34613553 DOI: 10.1007/s10995-021-03234-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: 09/25/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Evidence-based parenting interventions can augment parental knowledge and skills to reduce parental stress and increase self-efficacy, leading to improved developmental outcomes for children. However, parenting interventions are often multi-session and require considerable time commitments from parents and primary care physicians. We conducted a pilot study to evaluate the effect of a brief consultation session on self-reported parental satisfaction and to assess the feasibility and effectiveness of incorporating occupational therapists (OTs) into a low-income urban pediatric primary care setting to conduct developmental screenings. METHODS OTs conducted one 45-min consultation on positive parenting practices and promoting child development with parents in a pediatric primary care practice. A one group pretest-posttest design with 6-month follow-up was utilized. Participants included 55 families with 60 children, ages 2 to 65 months 30 days. The primary outcome measure was the change in Parenting Sense of Competence Scale (PSOC) scores from baseline to 6-month follow-up. Additional outcomes were screening results, referral numbers, and follow through in obtaining early intervention services. RESULTS The paired difference between PSOC scores at baseline and 6 months indicated a significant increase in parenting satisfaction (p < 0.0001). Of 41 children referred, 26 were eligible and obtained services, 12 were lost to follow-up, and 3 did not qualify for services. DISCUSSION Our preliminary findings suggest one consultation session on positive parenting practices and promoting child development may increase parenting satisfaction. Moreover, OTs can reduce the burden on primary care physicians by providing screenings, consultations, and follow-up. Further research is warranted to evaluate these findings.
Collapse
Affiliation(s)
- Anne H Zachry
- Department of Occupational Therapy, University of Tennessee Health Science Center, 930 Madison Ave, Suite 616, Memphis, TN, 38163, USA.
| | - Tamekia Jones
- Department of Pediatrics, University of Tennessee Health Science Center, 50 N. Dunlap St., Memphis, TN, 38103, USA
| | - Jami Flick
- Department of Occupational Therapy, University of Tennessee Health Science Center, 930 Madison Ave, Suite 603, Memphis, TN, 38163, USA
| | - Phyllis Richey
- Department of Preventative Medicine, University of Tennessee Health Science Center, 66 N. Pauline St., Memphis, TN, 38163, USA
| |
Collapse
|
10
|
Asnani MR, Francis D, Knight-Madden J, Chang-Lopez S, King L, Walker S. Integrating a problem-solving intervention with routine care to improve psychosocial functioning among mothers of children with sickle cell disease: A randomized controlled trial. PLoS One 2021; 16:e0252513. [PMID: 34106974 PMCID: PMC8189456 DOI: 10.1371/journal.pone.0252513] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 05/16/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To assess the feasibility of a problem-solving skills training intervention in improving psychological outcomes in mothers of infants with sickle cell disease (SCD). DESIGN AND METHODS This parallel randomized controlled trial recruited 64 babies with SCD, 6 to 12 months of age, and their mothers. Baseline measurements assessed mothers' coping and problem-solving skills, depression, and parental stress before random assignment to intervention or control groups (n = 32 each). Problem-solving skills intervention was delivered through 6 monthly sessions, when babies attended for routine penicillin prophylaxis. All measurements were repeated for both groups at the end of the intervention period. Intention to treat analysis used repeated measures mixed models with the restricted estimation maximum likelihood approach. RESULTS The problem-solving intervention had no significant effect on mothers' problem-solving skills (adjusted treatment effect: -1.69 points (95% CI:-5.62 to 2.25)), coping behaviours (adjusted treatment effect: 0.65 points (95% CI:- -7.13 to 8.41)) or depressive symptoms (adjusted treatment effect: -0.41 (95% CI: -6.00 to 5.19)). It reduced mothers' level of difficulty in managing stressful events by 9.5 points (95% CI (-16.86 to -2.16); effect size: 0.21 SD). In the subgroup of mothers at risk of depression (n = 31 at baseline), the intervention reduced depression scores with treatment effect of 10.4 points (95%CI: -18.83 to -1.88; effect size: 0.67 SD). CONCLUSION This problem-solving skills intervention study suggests feasibility and possible efficacy in improving some maternal outcomes. Further refinement and culturally appropriate adaptations of the intervention could lead to stronger effects.
Collapse
Affiliation(s)
- Monika R. Asnani
- Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
- * E-mail:
| | - Damian Francis
- School of Health and Human Performance, Georgia College, Milledgeville, Georgia, United States of America
| | - Jennifer Knight-Madden
- Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Susan Chang-Lopez
- Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Lesley King
- Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Susan Walker
- Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| |
Collapse
|
11
|
Darla S, Bhat D. Health-related quality of life and coping strategies among families with Down syndrome children in South India. Med J Armed Forces India 2020; 77:187-193. [PMID: 33867636 DOI: 10.1016/j.mjafi.2020.07.010] [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: 04/28/2020] [Accepted: 07/21/2020] [Indexed: 10/23/2022] Open
Abstract
Background Down Syndrome (DS) is the most common chromosomal disorder associated with intellectual disability. Besides clinical management, additional support to cope with the demands of life is also necessary. These parents are frequently unstable and forego their Quality of Life (QoL), suffer additional economic difficulties, ill health and have lower well-being than families without disabilities. Hence, the study intends to evaluate the Health-Related QoL (HR-QoL) and coping strategies among families of DS children. Methods This explorative, cross-sectional study was conducted among parents/caregivers of DS children (n = 51). Socio-demographic details, HR-QoL, coping strategies and perspectives on having a child with disability were obtained through a standard questionnaire. Results Most DS children were upper and upper-middle class of urban background. The mean score of the QoL of the families was found to be 68.98%. The least and the most affected domains were cognitive functioning (71.67%) and worry (57.33%), respectively. Maximum coping was through the instrumental social support, active coping and religious coping. Though 27.45% were upset with the diagnosis, most had a "feeling of love" towards the child (72.55%). 50.98% had limited knowledge about DS and lacked organizational support (60.78%). Conclusion With increasing life expectancy, the gap continues concerning the assessment of needs beyond medical aid among DS children. Better HR-QoL and coping with the stress could be ensured by the provision of comprehensive health policies inclusive of training programs, stress management, as well as psychosocial and organizational support across any socio-economic strata.
Collapse
Affiliation(s)
- Shreyans Darla
- MBBS Phase III Part 2, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Deepa Bhat
- Associate Professor (Anatomy), JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| |
Collapse
|
12
|
Toledano-Toledano F, Rodríguez-Rey R, Moral de la Rubia J, Luna D. A Sociodemographic variables questionnaire (Q-SV) for research on family caregivers of children with chronic disease. BMC Psychol 2019; 7:85. [PMID: 31864414 PMCID: PMC6925508 DOI: 10.1186/s40359-019-0350-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 11/11/2019] [Indexed: 12/13/2022] Open
Abstract
Background Chronic diseases in childhood can affect the physical and mental health of patients and their families. The literature on pediatric chronic diseases has found important associations between the sociodemographic variables of children and their caregivers and negative health consequences in families. Methods In this study, we aimed to design and validate a questionnaire on sociodemographic variables that would be useful for research on pediatric chronic diseases; and investigate the relationship between sociodemographic variables and psychosocial variables among family caregivers. First, we created a questionnaire that consists of 20 demographic, medical, and family-related items based on a literature review and expert evaluations. This questionnaire was then validated by 335 expert reviewers in the field of Social Work, who work daily with the families of patients with chronic diseases in 10 National Institutes of Health of Mexico. The validation was based on three empirical criteria created specifically for this study, and the reviewers evaluated the usefulness, relevance, and permanence of the items. In a second cross-sectional, correlational and comparative study, a total of 446 family caregivers of children with chronic diseases were interviewed, and they completed the Sociodemographic Variables Questionnaire for research on family caregivers of children with chronic sociodemographic diseases and four psychosocial measurement instruments for evaluating anxiety, depression, caregiver burden and quality of life. Results Based on the results of the first study, we created the Sociodemographic Variables Questionnaire (Q-SV) for research on family caregivers of children with chronic diseases, and it includes 17 items that assess demographic, medical, and family characteristics. The results of the second study showed that the 17 sociodemographic variables obtained in the validation by expert judges are useful for measuring and evaluating the relationship between psychosocial variables in families of children with chronic diseases. Conclusions Psychosocial and sociodemographic factors are relevant for the development of research processes for families that care for children with chronic diseases.
Collapse
Affiliation(s)
- Filiberto Toledano-Toledano
- Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez Instituto Nacional de Salud, Dr. Márquez 162, Doctores, Cuauhtémoc, 06720, México City, Mexico.
| | - Rocío Rodríguez-Rey
- Universidad Europea de Madrid. Calle Tajo, s/n, 28670 Villaviciosa de Odón, Madrid, Spain
| | - José Moral de la Rubia
- Facultad de Psicología, Universidad Autónoma de Nuevo León. Dr. Carlos Canseco, 110, Esq. Dr. Aguirre Pequeño, Col. Mitras Centro, 64460, Monterrey, Mexico
| | - David Luna
- Comisión Nacional de Arbitraje Médico, Mitla No. 250-10° Piso, esq. Eje 5 Sur (Eugenia). Col. Narvarte, 03020, Benito Juárez, Mexico City, Mexico
| |
Collapse
|
13
|
Arim RG, Miller AR, Kohen DE, Guèvremont A, Lach LM, Brehaut JC. Changes in the health of mothers of children with neurodevelopmental disabilities: An administrative data study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 86:76-86. [PMID: 30684833 DOI: 10.1016/j.ridd.2018.12.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 11/14/2018] [Accepted: 12/18/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Using linked administrative health data, this study compared the health and healthcare service utilization between mothers of children with and without neurodevelopmental disabilities (NDD), before, during, and after the birth of a child. METHODS The population (N = 25,388) was based on a cohort of children born in 2000 and who were, along with their mothers, continuously registered with the British Columbia's universal health insurance program between 2000 and 2007. RESULTS Compared to mothers of children without NDD, mothers of children with NDD were more likely to have chronic conditions and higher service utilization before child birth. Mothers of children with NDD showed a smaller increase in physician visits in the year before birth but a greater increase in different prescription drugs in the year after birth. There was no further divergence (or convergence) in health and service utilization between the groups in the 7-year period post-birth. CONCLUSIONS Differences in health and healthcare service utilization between mothers of children with and without NDD existed before the birth of the child and did not diverge in the 7 years post-birth. Replication of these findings is warranted as well as follow-up analyses examining longer term outcomes for mothers beyond 7 years post-birth.
Collapse
Affiliation(s)
- Rubab G Arim
- Health Analysis Division, Statistics Canada, 100 Tunney's Pasture Driveway, Ottawa, Ontario, K1A 0T6, Canada.
| | - Anton R Miller
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, 4480 Oak Street, Room 2D19, BC Children's Hospital, Vancouver, British Columbia, V6H 3V4, Canada
| | - Dafna E Kohen
- Health Analysis Division, Statistics Canada, 100 Tunney's Pasture Driveway, Ottawa, Ontario, K1A 0T6, Canada
| | - Anne Guèvremont
- Health Analysis Division, Statistics Canada, 100 Tunney's Pasture Driveway, Ottawa, Ontario, K1A 0T6, Canada
| | - Lucy M Lach
- School of Social Work, McGill University, 3506 University Street, #300, Montreal, Québec, H3A 2A7, Canada
| | - Jamie C Brehaut
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Box 511, Ottawa, Ontario, K1H 8L6, Canada
| |
Collapse
|
14
|
Piran P, Khademi Z, Tayari N, Mansouri N. Caregiving burden of children with chronic diseases. Electron Physician 2017; 9:5380-5387. [PMID: 29038725 PMCID: PMC5633241 DOI: 10.19082/5380] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 05/14/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The care demands of children with chronic diseases can affect caregivers' health by imposing caregiving burden to them. The health status of caregivers plays a vital role in the quality of care provided to such children and in their quality of life. OBJECTIVE To determine caregiving burden in caregivers and to identify relevant influential factors. METHODS In this cross-sectional study, a total number of 249 caregivers of children with chronic diseases who referred to hospitalization and ambulatory departments of Bandar Abbas, Iran in 2016 were selected using convenience sampling method. The main caregivers who were older than 18 years and provided care to a sick child for at least three months consecutively were included. Caregiving burden was measured using the Caregiver Burden Scale. Data was analyzed SPSS 16 using descriptive statistics, Spearman's correlation coefficient and Mann-Whitney U test. RESULTS Mean score of caregiving burden was 1.98 which was close to moderate level. The highest caregiving burden was observed in general strain dimension (2.35), and cerebral palsy imposed the maximum burden to caregivers (2.24). Correlation coefficient revealed that perceived caregiving burden was in connection with children's and caregivers' age, duration of disease and caregiving, child's level of disability, number of family members and income level (p<0.05). Mann-Whitney U test showed that female caregivers, villagers, and caregivers dealing with more than one patient experienced higher burden (p<0.05). CONCLUSION Different variables can increase caregiving burden. Therefore, planning for holistic and family-centered interventions to decrease caregiving burden is necessary for health care providers.
Collapse
Affiliation(s)
- Pegah Piran
- M.Sc. of Nursing, Faculty Member, Department of Nursing, Faculty of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Zahra Khademi
- M.Sc. of Nursing, Faculty Member, Department of Nursing, Faculty of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Narges Tayari
- M.Sc. of Nursing, Faculty member, Department of Nursing, Faculty of Nursing and Midwifery, Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Nafise Mansouri
- B.Sc. Student of Nursing, Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| |
Collapse
|
15
|
Dhooria GS, Singh HP, Bhat D, Bains HS, Soni RK, Kumar M. Multidimensional impact on families of children with steroid-sensitive nephrotic syndrome. J Paediatr Child Health 2017; 53:354-357. [PMID: 28058746 DOI: 10.1111/jpc.13445] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 09/07/2016] [Accepted: 11/13/2016] [Indexed: 11/29/2022]
Abstract
AIM Children with nephrotic syndrome (NS) have prolonged disease course with relapses requiring frequent visits and prolonged steroid therapy with their long-term concerns. All these factors affect the child and their families in many domains of functioning. The objective of this study was to assess multidimensional impact on families of children with nephrotic syndrome using (PedsQL) Family Impact Module (FIM). METHODS This cross-sectional study was conducted in a paediatric nephrology clinic of a tertiary care hospital. Fifty cases of steroid-sensitive nephrotic syndrome between age group of 2-18 years were included, and equal age-sex matched healthy children were taken as controls. Baseline demographic factors including age, gender and education status, modified Kuppuswamy's socio-economic status were collected and clinical variables of NS cases were recorded. FIM is a parent-reported instrument that measures the impact of paediatric chronic health conditions on care giver's HRQOL and their family function. Mean FIM scores were compared among the cases and controls, and different predictive factors affecting family impact (FI) were analysed. RESULTS The FI total score showed significantly lower scores in cases (mean score: 60.76 ± 15.66) as compared to controls (mean 100). Among the individual groups, lowest scores were found in two domains, namely 'worry' and 'emotional function' with mean scores of 46.20 ± 20.66 and 46.80 ± 24.61, respectively, although other domains were also significantly affected. CONCLUSION FI score should be evaluated in all cases of NS as parenting such children may significantly affect all domains of family functioning.
Collapse
Affiliation(s)
- Gurdeep S Dhooria
- Department of Pediatrics, Dayanand Medical College and Hospital, Ludhiana, India
| | - Harmeet P Singh
- Department of Medicine, Dayanand Medical College and Hospital, Ludhiana, India
| | - Deepak Bhat
- Department of Pediatrics, Dayanand Medical College and Hospital, Ludhiana, India
| | - Harmesh S Bains
- Department of Pediatrics, Dayanand Medical College and Hospital, Ludhiana, India
| | - Ravinder K Soni
- Department of Statistics, Preventive Medicine, Dayanand Medical College and Hospital, Ludhiana, India
| | - Mohit Kumar
- Department of Pediatrics, Dayanand Medical College and Hospital, Ludhiana, India
| |
Collapse
|
16
|
Isa SNI, Ishak I, Ab Rahman A, Mohd Saat NZ, Che Din N, Lubis SH, Mohd Ismail MF. Health and quality of life among the caregivers of children with disabilities: A review of literature. Asian J Psychiatr 2016; 23:71-77. [PMID: 27969083 DOI: 10.1016/j.ajp.2016.07.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 05/12/2016] [Accepted: 07/07/2016] [Indexed: 02/08/2023]
Abstract
Families caring for children with disabilities face particular challenges and demands compared to those caring for children without disabilities. Evidence suggests that there is considerable variation in how caregivers of children with disabilities adapt to their caregiving demands and stressors. The different adaptations to the children with disabilities may cause different impacts on the health and well-being of caregivers. This paper provides a brief overview of the literature on the impact of caring for children with disabilities on the health and quality of life of caregivers and the factors related to the health outcomes and quality of life. A literature search was conducted by using various electronic databases, including PsychINFO, ScienceDirect, ProQuest, and MEDLINE using specific key terms. Thirty-one articles published in peer-review journals from the last six years (2009-2014) were reviewed. Most of the studies were quantitative studies. Factors discussed that impact on caregivers' health and quality of life include the caregivers' sociodemographic background and child's disability-related factors. Several mediators and moderators including coping strategies, social support, parental stress, self-esteem and self-efficacy are described in this paper. This review highlighted the importance of these factors to better understand the complex nature of stress processes and the caregivers' adaptations to their children's disabilities.
Collapse
Affiliation(s)
- Siti Nor Ismalina Isa
- School of Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia; Faculty of Health Sciences, Universiti Teknologi MARA, 42300 Puncak Alam, Selangor, Malaysia
| | - Ismarulyusda Ishak
- School of Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia.
| | - Azriani Ab Rahman
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Nur Zakiah Mohd Saat
- School of Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Normah Che Din
- Health Psychology Program, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Syarif Husin Lubis
- School of Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Muhammad Faiz Mohd Ismail
- School of Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| |
Collapse
|
17
|
Hsieh RL, Hsieh WH, Lee WC. Short-term family-centered workshop for children with developmental delays enhances family functioning and satisfaction: A prospective clinical trial. Medicine (Baltimore) 2016; 95:e4200. [PMID: 27495025 PMCID: PMC4979779 DOI: 10.1097/md.0000000000004200] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We investigated the clinical efficacy on family functioning and parental satisfaction of a short-term family-centered workshop for children with developmental delays.A total of 32 children with developmental delays and their parents participated in 2-hour weekly group therapy sessions over 6 weeks. The workshop was conducted by rehabilitation professionals and teachers using a family-centered multidisciplinary approach. Both before and after the 6-week workshop, the parents were administered the Pediatric Quality of Life Inventory (PedsQL) Family Impact Module, the PedsQL Healthcare Satisfaction Module, the Hospital Anxiety and Depression Scale, and the World Health Organization Quality of Life brief assessment instrument. Overall satisfaction with the workshop was also evaluated.Significant improvements were noted in physical aspect (P = 0.03), communication (P = 0.002), and daily activities (P = 0.04) in the PedsQL Family Impact Module, and in communication (P = 0.03) and technical skills (P = 0.05) in the PedsQL Healthcare Satisfaction Module. Overall satisfaction with the workshop was rated as very high. There was no significant effect on psychological distress or quality of life.Short-term family-centered workshops for children with developmental delays improved family functioning and the parental perception of satisfaction, including health care satisfaction.
Collapse
Affiliation(s)
- Ru-Lan Hsieh
- Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University
- Correspondence: Ru-Lan Hsieh, Department of Physical Medicine and Rehabilitation, Shin-Kong Wu Ho-Su Memorial Hospital, No. 95, Wen Chang Rd, Shih Lin District, Taipei 11101, Taiwan (e-mail: )
| | - Wen-Huei Hsieh
- Department of Child Care and Education and Research Center for Industry of Human Ecology, College of Human Ecology, Chang Gung University of Science and Technology
| | - Wen-Chung Lee
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| |
Collapse
|
18
|
Abstract
OBJECTIVES To describe family burden among caregivers of children who survived out-of-hospital cardiac arrest and who were at high risk for neurologic disability and examine relationships between family burden, child functioning, and other factors during the first year post arrest. DESIGN Secondary analysis of data from the Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital trial. SETTING Thirty-six PICUs in the United States and Canada. PATIENTS Seventy-seven children recruited to the Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital trial who had normal prearrest neurologic functioning and were alive 1 year post arrest. INTERVENTIONS Family burden was assessed using the Infant Toddler Quality of Life Questionnaire for children less than 5 years old and the Child Health Questionnaire for children 5 years old or older at baseline (reflecting prearrest status), 3 months, and 12 months post arrest. Child functioning was assessed using the Vineland Adaptive Behavior Scale II, the Pediatric Overall Performance Category, and Pediatric Cerebral Performance Category scales and caregiver perception of global functioning. MEASUREMENTS AND MAIN RESULTS Fifty-six children (72.7%) were boys, 48 (62.3%) were whites, and 50 (64.9%) were less than 5 years old prior to out-of-hospital cardiac arrest. Family burden at baseline was not significantly different from reference values. Family burden was increased at 3 and 12 months post arrest compared with reference values (p < 0.001). Worse Pediatric Overall Performance Category and Pediatric Cerebral Performance Category, lower adaptive behavior, lower global functioning, and higher family burden all measured 3 months post arrest were associated with higher family burden 12 months post arrest (p < 0.05). Sociodemographics and prearrest child functioning were not associated with family burden 12 months post arrest. CONCLUSIONS Families of children who survive out-of-hospital cardiac arrest and have high risk for neurologic disability often experience substantial burden during the first year post arrest. The extent of child dysfunction 3 months post arrest is associated with family burden at 12 months.
Collapse
|
19
|
Bemister TB, Brooks BL, Dyck RH, Kirton A. Predictors of caregiver depression and family functioning after perinatal stroke. BMC Pediatr 2015; 15:75. [PMID: 26174779 PMCID: PMC4502550 DOI: 10.1186/s12887-015-0397-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 06/30/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Perinatal stroke is a leading cause of cerebral palsy and lifelong neurological morbidity. Studies on perinatal stroke outcomes are increasing, although examinations of its broader impact on parents and families have been limited. A recent study found that parents of children with moderate and severe outcomes have increased risk for psychosocial concerns, including depressive symptoms and poor family functioning. Other parents adapt remarkably well, but how this occurs is unknown. The primary aim of this study was to examine predictors of parent and family outcomes, namely caregiver depression and family functioning. The secondary aim was to explore potential mediators and moderators of the relationship between condition severity and parent and family outcomes. METHODS Parents were recruited from a large, population-based perinatal stroke research cohort, and they completed measures assessing their demographics, social supports, stress levels, marital quality, feelings of guilt and blame, psychological well-being, and family functioning. Bivariate analyses compared these variables. Predictor variables, mediators, and moderators were chosen according to the strength of their relationship with the outcome variables (i.e., caregiver depression and family functioning) and theory. Hierarchical regression, mediator, and moderator analyses were conducted accordingly. RESULTS A total of 103 parents participated in this study (76 mothers, 27 fathers; mean age of 39.2 years; mean child age of 7.46 years). Condition severity, anxiety, social support, and blame independently predicted caregiver depression while condition severity, stress levels, and marital quality independently predicted family functioning. Blame regarding the cause of their child's condition also mediated the relationship between condition severity and caregiver depression. CONCLUSIONS Adverse parental outcomes can be predicted in perinatal stroke populations. Moreover, anxiety and stress management techniques, marital support, and psychoeducation regarding the unpreventable nature of perinatal stroke may be utilized in the future to enhance family outcomes.
Collapse
Affiliation(s)
- Taryn B Bemister
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1 N4, Canada. .,Calgary Pediatric Stroke Program, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, AB, T3B 6A8, Canada.
| | - Brian L Brooks
- Neurosciences, Brain Injury and Rehabilitation Program, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, AB, T3B 6A8, Canada. .,Departments of Paediatrics and Clinical Neurosciences, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4 N1, Canada. .,Alberta Children's Hospital Research Institute, Heritage Medical Research Building, Room 293, 3330 Hospital Drive NW, Calgary, AB, T2N 4 N1, Canada.
| | - Richard H Dyck
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1 N4, Canada.
| | - Adam Kirton
- Calgary Pediatric Stroke Program, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, AB, T3B 6A8, Canada. .,Departments of Paediatrics and Clinical Neurosciences, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4 N1, Canada. .,Alberta Children's Hospital Research Institute, Heritage Medical Research Building, Room 293, 3330 Hospital Drive NW, Calgary, AB, T2N 4 N1, Canada.
| |
Collapse
|
20
|
Hsieh RL, Lin MI, Huang HY, Lee WC. Correlations between functional performance, health-related quality of life, and parental impact on children with developmental delays. Dev Neurorehabil 2014; 17:176-83. [PMID: 24102385 DOI: 10.3109/17518423.2012.747569] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To examine the correlation of function, quality of life (QOL), and parental impact on developmental delayed children. METHODS Sixty parents of children with developmental delays (M:F = 36:24, mean age 4 years and 2 months) and 56 parents of age-sex matched typical development children were included. Pediatric Outcomes Data Collection Instrument and Child Health Questionnaire for children, World Health Organization-QOL, Impact on Family Scale, and Hospital Anxiety and Depression Scale for parents were assessed. RESULTS Functional performance was correlated with physical component of QOL in children (correlation coefficients: 0.7-0.9; p < 0.01), age of children (0.3-0.4; p < 0.05) and parents (0.3; p < 0.05), maternal employment (0.3-0.4; p < 0.05), parental QOL (0.3-0.4; p < 0.01), family impact (-0.3 to -0.5; p < 0.01), and parental emotion (-0.3 to -0.4; p < 0.05). CONCLUSIONS Children who exhibited higher levels of function had higher QOL, as did their parents, and less parental impact.
Collapse
Affiliation(s)
- Ru-Lan Hsieh
- Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital , Taipei , Taiwan
| | | | | | | |
Collapse
|
21
|
Maternal stress and behavioral adaptation in methadone- or buprenorphine-exposed toddlers. Infant Behav Dev 2013; 36:707-16. [DOI: 10.1016/j.infbeh.2013.08.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Revised: 06/27/2013] [Accepted: 08/01/2013] [Indexed: 11/21/2022]
|
22
|
Geok CK, Abdullah KL, Kee LH. Quality of life among Malaysian mothers with a child with Down syndrome. Int J Nurs Pract 2013; 19:381-9. [PMID: 23915407 DOI: 10.1111/ijn.12083] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The purpose of this paper is to examine the quality of life (QOL) among mothers with a child with Down syndrome using The World Health Organization Quality of Life scale instrument. A convenience sample of 161 mothers was accessed through the various institutions which provide interventional or educational programmes to children with disabilities within two of the regions of the Borneo State of Malaysia (Sarawak). Nearly half of the group of mothers perceived their QOL as neither poor nor good (n = 73). An overall QOL score of 14.0 ± 1.84 was obtained. The highest and lowest domain scores were found for social relationship domain (Mean = 14.9 ± 2.1) and environmental support domain (Mean = 13.3 ± 2.1) respectively. Correlation analysis of selected background variables (i.e. locality, education, income and marital status) and overall QOL indicated rho (161) = 0.22-0.28 (P < 0.01). Inverse correlation between maternal age and overall QOL score was indicated, with rho (161) = -0.17 (P < 0.05). Linear regression analysis indicated that the combination of these few variables together accounted for 14.5% of the QOL variability in the sample. Findings point to implications for priorities of care provisions by policy-makers and care professionals in their practice.
Collapse
Affiliation(s)
- Chan Kim Geok
- Faculty of Medicine and Health Sciences, Universiti Malaysia, Sarawak, Malaysia.
| | | | | |
Collapse
|
23
|
The impact of children with disabilities on parent health-related quality of life and family functioning in Kelantan and its associated factors. J Dev Behav Pediatr 2013; 34:262-8. [PMID: 23538932 DOI: 10.1097/dbp.0b013e318287cdfe] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Caring for children with disabilities brings about a significant impact on the parents and families. The purposes of this study were to determine the impact of having children with disabilities on parents' health-related quality of life (HRQOL), family functioning, and total family impact and to identify the associated factors. METHOD A total of 425 parents/caregivers of children with disabilities who were registered to community-based rehabilitation centers in 5 districts in Kelantan, Malaysia, participated in this study. The Malay version of PedsQL Family Impact Module was used as research instrument. General linear regression was applied to analyze the association between family impact scores (Total Impact, Parent HRQOL Summary, and Family Functioning Summary) and study factors using Stata/SE 11 software. RESULTS The mean (SD) Total Impact Score and Parent HRQOL Summary Score of the parents/caregivers was 75.1 (16.85) and 75.0 (18.74) respectively, and the median (IQR) of Family Functioning Summary Score was 84.4 (28.13). Mothers, non-Malays, and widowed parents/caregivers, parents/caregivers having male children with disabilities, and children with more complex disability had significantly lower parent HRQOL and family functioning. CONCLUSIONS Both parents/caregivers' characteristics and children's characteristics contributed to family impact in local setting. Results of this study emphasize the importance of the whole family involvement as the focus of services and supports by health care providers.
Collapse
|
24
|
Utility of the PedsQL™ family impact module: assessing the psychometric properties in a community sample. Qual Life Res 2013; 22:2899-907. [DOI: 10.1007/s11136-013-0422-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2013] [Indexed: 10/26/2022]
|
25
|
Hsieh RL, Hsueh YM, Huang HY, Lin MI, Tseng WC, Lee WC. Quality of life and impact of children with unclassified developmental delays. J Paediatr Child Health 2013; 49:E116-21. [PMID: 23316900 DOI: 10.1111/jpc.12081] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/09/2012] [Indexed: 11/29/2022]
Abstract
AIMS The study aims to evaluate the quality of life (QOL) and health of children with unclassified developmental delays and the impacts this had on the family. METHODS In total, 60 parents of pre-school children with unclassified developmental delays and 56 parents of age and gender-matched children with typical development were recruited. We administered the Pediatric Quality of Life Inventory (PedsQL)-Generic Core Scale and Pediatric Outcomes Data Collection Instrument to parents to evaluate the QOL and health status of their children. Parents were evaluated by World Health Organization-Quality of Life-Brief Version, PedsQL-Family Impact Module, Hospital Anxiety and Depression Scale, and PedsQL-Health satisfaction to assess the impacts of this situation on the family. Variables related to QOL and functions of children with unclassified developmental delays were analysed by stepwise regression analysis. RESULTS Comparing children with typical development, children with unclassified developmental delays had a significantly lower QOL (including both psychosocial and physical components) and health status. Their parents had a significantly lower QOL, family function and health satisfaction, and higher psychological distress than parents of children with typical development. Gross-motor delay impacts on QOL of these children (regression coefficient: -9.59, P < 0.05), global functioning is related to cognition delay (regression coefficient: -20.22, P < 0.01) and physical health of their parents (regression coefficient: 0.87, P < 0.01). CONCLUSIONS Children with unclassified developmental delays had lower QOL and health status, and their condition had greater impacts on the family than children with typical development. Gross motor and cognition development related to the QOL and global functioning in these children.
Collapse
Affiliation(s)
- Ru-Lan Hsieh
- Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
| | | | | | | | | | | |
Collapse
|
26
|
Postural stability in patients with knee osteoarthritis: comparison with controls and evaluation of relationships between postural stability scores and International Classification of Functioning, Disability and Health components. Arch Phys Med Rehabil 2012; 94:340-6. [PMID: 23041145 DOI: 10.1016/j.apmr.2012.09.022] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 09/11/2012] [Accepted: 09/20/2012] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To assess the differences in postural stability between patients with knee osteoarthritis and controls without knee osteoarthritis, and to evaluate possible relations between postural stability scores and International Classification of Functioning, Disability and Health (ICF) components. DESIGN An age-matched, case-controlled trial with a cross-sectional design. SETTING A teaching hospital. PARTICIPANTS Patients with knee osteoarthritis (n=73) and age-matched controls (n=60). INTERVENTIONS Data on patients' postural stability and additional health-related variables were collected using various instruments. These included the Hospital Anxiety and Depression Scale, the Multidimensional Fatigue Inventory, the World Health Organization Quality of Life Brief Version, the physical function test (chair-rising time), the Chinese version of the Western Ontario and McMaster Universities Osteoarthritis Index, the Chinese version of the Knee Injury and Osteoarthritis Outcome Score, and the Biodex Stability System. MAIN OUTCOME MEASURES A comparison of postural stability in patients with knee osteoarthritis versus that of controls was performed. The relation between postural stability scores for patients with knee osteoarthritis and ICF components was evaluated. Pearson correlation tests were used to determine the variables that correlated with postural stability among these patients. RESULTS Patients with knee osteoarthritis displayed lower overall postural stability than controls (scores of 0.7 vs. 0.5, P=.006) and scored lower on the environmental domain of the World Health Organization Quality of Life Brief Version (62.2 vs 66.8, P=.014). For patients with knee osteoarthritis, postural stability was weakly associated with the ICF components of body functions and structures, including pain (r=.33-.34, P=.004), physical fatigue (r=.28, P=.016), and reduced motivation (r=.30, P=.011). Weak to moderate associations between postural stability and the ICF components of activities and participation were found; the relevant ICF variables included reduced activity (r=.38, P=.001), physical domain and function (r=.34-.48, P=.001 to P<.004), activities of daily living (r=.51, P<.001), and sports and recreation (r=.35, P=.003). A moderate association between postural stability and the ICF components of personal and environmental factors was observed, including age (r=.52, P<.001) and quality of life (r=0.4, P=.001). CONCLUSIONS Patients with knee osteoarthritis displayed lower postural stability and achieved lower scores in the environmental domain of quality-of-life measures than did controls. The postural stability of patients with knee osteoarthritis was weakly to moderately associated with the following ICF components: body functions and structures, activities and participation, and personal and environmental factors.
Collapse
|
27
|
Houtrow AJ, Yock TI, Delahaye J, Kuhlthau K. The family impacts of proton radiation therapy for children with brain tumors. J Pediatr Oncol Nurs 2012; 29:171-9. [PMID: 22647729 PMCID: PMC3587352 DOI: 10.1177/1043454212446345] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Children with brain tumors experience significant alterations to their health and well-being due to the tumors themselves and oncologic treatment. Caring for children with brain tumors can have significant impacts on families, especially during and shortly after treatment. In this study of the impacts on families caring for children undergoing proton radiation therapy for brain tumors, the authors found that families experienced a broad array of negative impacts. Families reported feeling like they were living on a roller coaster, feeling that others treated them differently, and having to give up things as a family. In the multivariable linear regression model, older age of the child and higher reported child health-related quality of life were associated with less family impact. The presence of concurrent chemotherapy was associated with increased family impact. This is the first study to specifically evaluate the families of children being treated with proton radiation therapy. The findings in this study are consistent with the findings in other studies of children treated with standard therapy that show that families experience a variety of stressors and negative impacts while their children are receiving treatment. Health care providers should be aware of the potential impacts on families of children with brain tumors and their treatment to provide robust services to meet the health, psychological, and social needs of such children and their families.
Collapse
|
28
|
Limbers CA, Ripperger-Suhler J, Boutton K, Ransom D, Varni JW. A comparative analysis of health-related quality of life and family impact between children with ADHD treated in a general pediatric clinic and a psychiatric clinic utilizing the PedsQL. J Atten Disord 2011; 15:392-402. [PMID: 20065072 DOI: 10.1177/1087054709356191] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To evaluate health-related quality of life (HRQOL) from the perspective of children with ADHD and their parents being seen in a Pediatric Clinic in comparison to healthy children and children with ADHD being seen in a Psychiatric Clinic. METHOD Participants were children with a physician diagnosis of ADHD ages 5-18 years and their parents (n=17, General Pediatric Clinic; n=181, Psychiatric Clinic). Children and parents completed the PedsQL™ 4.0 Generic Core Scales. Parents completed the PedsQL Family Impact Module and Vanderbilt ADHD Diagnostic Rating Scales. RESULTS Pediatric patients with ADHD being seen in the Pediatric Clinic demonstrated substantially lower HRQOL in comparison to the matched healthy sample, and significantly higher HRQOL and family functioning than pediatric patients with ADHD being seen in the Psychiatric Clinic. CONCLUSION These data demonstrate the substantial negative impact of ADHD on HRQOL from the perspective of both children and parents.).
Collapse
|
29
|
Chronic stress and health among parents of children with intellectual and developmental disabilities. Curr Opin Psychiatry 2010; 23:407-11. [PMID: 20592593 DOI: 10.1097/yco.0b013e32833a8796] [Citation(s) in RCA: 118] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE OF REVIEW This article reviews recent studies connecting chronic stress to health outcomes in parents of children with intellectual and developmental disabilities (I/DD). This review is timely owing to the increased rates of certain I/DD conditions and the adverse effects that chronic stressors may have on parental health. RECENT FINDINGS Although parents raising children with (versus without) I/DD have long reported greater levels of psychological stress, only recently have parental physical health problems been linked to aspects of the child with I/DD. SUMMARY Chronic stressors can wear down the body, particularly the cardiovascular, immune, and gastrointestinal systems. So far, increased rates of caregiver health problems have been linked to caring for an elderly parent or for a child with recurrent cancer. Parents of children with I/DD also more often encounter severe, chronic stressors, particularly those involving child behavior problems and extreme caregiving need. These child characteristics, especially for older parents or for parents of children with certain conditions (e.g. spina bifida), may adversely affect parental health. More research is needed to explore stress-health connections among parents of children with I/DD, as well as the clinical and policy implications of such findings.
Collapse
|