1
|
Dickinson C, Sheffield J, Mak C, Boyd RN, Whittingham K. When a baby is diagnosed at high risk of cerebral palsy: understanding and meeting parent need. Disabil Rehabil 2023; 45:4016-4024. [PMID: 36373179 DOI: 10.1080/09638288.2022.2144491] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 11/02/2022] [Indexed: 11/15/2022]
Abstract
PURPOSE To explore the experiences and needs of parents with an infant diagnosed at risk of cerebral palsy (CP) and to receive feedback on a new online support program (Parenting Acceptance and Commitment Therapy; PACT). MATERIALS AND METHODS Eleven parents from eight family dyads (8 mothers, 3 fathers) with infants under 24 months of age (age range 10-24 months) recently diagnosed as at risk of CP as well as fourteen clinicians participated in this qualitative study through interviews. RESULTS Parents reported conflicting emotions and grief. Further, they reported that they wanted honesty, support and normalisation of their experiences from clinicians. Parents pointed to a gap in service delivery in terms of non-pathologising psychological support specific to their needs. Clinicians reported a lack of skills in supporting distressed parents. Parent feedback on PACT was positive, with parents receptive to the online delivery. CONCLUSIONS Parents want acceptance without pathologisation, honesty, and flexible support. Clinicians working with children at risk of CP need training in grief awareness and support for their own coping. Health services should consider building better parental support into their systems of care.IMPLICATIONS FOR REHABILITATIONParents want clinicians to be honest, supportive and to normalise their griefClinicians in rehabilitation would benefit from up-skilling in grief supportParental support should be built into systems of care for children with cerebral palsy.
Collapse
Affiliation(s)
- Corrine Dickinson
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Faculty of Medicine, Child Health Research Centre, Brisbane, Australia
- Queensland Children's Hospital, Children's Health Queensland, Brisbane, Australia
| | - Jeanie Sheffield
- The School of Psychology, The University of Queensland, Brisbane, Australia
| | - Catherine Mak
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Faculty of Medicine, Child Health Research Centre, Brisbane, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Faculty of Medicine, Child Health Research Centre, Brisbane, Australia
- Queensland Children's Hospital, Children's Health Queensland, Brisbane, Australia
| | - Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Faculty of Medicine, Child Health Research Centre, Brisbane, Australia
| |
Collapse
|
2
|
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.
Collapse
Affiliation(s)
- Ayelet Gur
- Social Work Department, Tel-Hai College, Upper Galilee, Israel.
| | - Ari Reich
- Faculty of Education, Bar Ilan University, Ramat Gan, Israel
| |
Collapse
|
3
|
Liu F, Shen Q, Huang M, Zhou H. Factors associated with caregiver burden among family caregivers of children with cerebral palsy: a systematic review. BMJ Open 2023; 13:e065215. [PMID: 37012010 PMCID: PMC10083783 DOI: 10.1136/bmjopen-2022-065215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
OBJECTIVES To identify caregiver and children factors associated with caregiver burden on primary caregivers of children with cerebral palsy (CP). DESIGN Systematic review DATA SOURCES: Seven electronic databases, including PubMed, Cochrane Library, Scopus, PsycINFO, Web of Science, CINAHL and Embase, were systematically searched up to 1 February 2023. ELIGIBILITY CRITERIA Original observational studies reporting caregiver burden and related factors among caregivers of children with CP. DATA ABSTRACTION AND SYNTHESIS Two reviewers independently screened results and assessed the quality of studies. Title, abstract, full-text screening and data abstraction were done independently by two reviewers. Risk of bias was assessed using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies. The quality of evidence for factors was rated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS 16 articles were included in the review. All studies were cross-sectional and examined caregiver-reported burden measures. The Zarit Burden Interview was the most commonly used questionnaire. Depression of caregiver and severity of illness in children with CP were moderate quality of evidence for factors contributing to caregiver burden. CONCLUSIONS Higher caregiver burden is associated with more depressive feelings and worse life quality of the caregiver, and with more severe physical disability of the children. Future studies should focus on high-quality longitudinal research and appropriate assistance to reduce caregiver burden and improve the quality of caregiving for children with CP. PROSPERO REGISTRATION NUMBER CRD42021268284.
Collapse
Affiliation(s)
- Fang Liu
- Nursing School, Chongqing Medical University, Chongqing, Chongqing, China
| | - Qiao Shen
- Department of Nursing, Children's Hospital of ChongqingMedical University, Chongqing, China
| | - Miao Huang
- Nursing School, Chongqing Medical University, Chongqing, Chongqing, China
| | - Hengyu Zhou
- Nursing School, Chongqing Medical University, Chongqing, Chongqing, China
| |
Collapse
|
4
|
Lobato D, Montesinos F, Polín E, Cáliz S. Third-Generation Behavioural Therapies in the Context of Neurodevelopmental Problems and Intellectual Disabilities: A Randomised Clinical Trial with Parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4406. [PMID: 36901415 PMCID: PMC10002330 DOI: 10.3390/ijerph20054406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/23/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
The purpose of this study was to examine how 14 parents of children with autism and intellectual impairments responded to an Acceptance and Commitment Therapy (ACT)-based psychological flexibility intervention programme. A randomised clinical trial was conducted. Parents were randomly assigned to the training programme group (n = 8) or waiting list group (n = 6). The treatment effect was measured using the 6-PAQ, PSS-14, GHQ-12, and WBSI questionnaires. Changes in interactions were assessed through self-recording, including a baseline to observe the previous functioning. Measures were taken before and after the application of the intervention programme and three months later. After that, the control group was switched to the psychological flexibility programme condition. After the programme's implementation, we could see a reduction in stress and the tendency to suppress unwanted private events. The impacts also appeared to apply to family interactions, resulting in a rise in positive interactions and a decrease in unfavourable ones. The results led us to think about the importance of psychological flexibility for the parents of children with chronic conditions, facilitating a reduction in the emotional impact derived from parenting and the emission of behaviours that promote the harmonious development of the diagnosed child.
Collapse
Affiliation(s)
- David Lobato
- Department of Psychology, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Francisco Montesinos
- Department of Psychology, Universidad Europea de Madrid, 28670 Madrid, Spain
- Instituto ACT, 28036 Madrid, Spain
| | - Eduardo Polín
- Department of Psychology, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Saray Cáliz
- Department of Psychology, Universidad Europea de Madrid, 28670 Madrid, Spain
| |
Collapse
|
5
|
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.
Collapse
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:
| |
Collapse
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
Whittingham K, Sheffield J, Mak C, Wright A, Boyd RN. Parenting Acceptance and Commitment Therapy: An RCT of an online course with families of children with CP. Behav Res Ther 2022; 155:104129. [DOI: 10.1016/j.brat.2022.104129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/09/2022] [Accepted: 05/21/2022] [Indexed: 11/02/2022]
|
8
|
The Impact of COVID-19 Restrictions on Psychological Distress in Family Caregivers of Children with Neurodevelopmental Disability in the UK. J Autism Dev Disord 2021; 53:1573-1587. [PMID: 34286392 PMCID: PMC8294318 DOI: 10.1007/s10803-021-05132-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2021] [Indexed: 12/29/2022]
Abstract
Caregivers of a child with a neurodevelopmental disability are more vulnerable to mental health difficulties. These difficulties are influenced by the child’s challenging behaviours, and the caregiver’s coping strategies; factors impacted by the COVID-19 pandemic. An online mixed methods survey was conducted on caregivers of children with neurodevelopmental disabilities (n = 43) and children who are typically developing (n = 67). The results showed that presence of challenging behaviours related to neurodevelopmental disability, and caregiver coping strategies predicted caregiver psychological distress during lockdown. Themes that emerged included ‘confusing messages and guidance’, ‘loss of freedom’ and ‘unsupported and forgotten’. The results demonstrate the pressing need for the implementation of appropriate support to protect the mental health of caregivers across the UK.
Collapse
|
9
|
Yehene E, Steinberg P, Gerner M, Brezner A, Landa J. "Concurrent Ropes and Ladders": Mapping and Conceptualizing the Emotional Loss Experience of Parents Following Pediatric Acquired Brain Injury. QUALITATIVE HEALTH RESEARCH 2021; 31:1518-1533. [PMID: 34024215 PMCID: PMC8278457 DOI: 10.1177/10497323211012384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This grounded theory study aims to map, conceptualize, and theorize the emotional loss experienced by parents following their child's pediatric acquired brain injury (pABI). Data were obtained from 47 semi-structured interviews conducted with parents (72% mothers) at least 1 year following pABI. The study's theory of "concurrent ropes and ladders" emerged from a process of initial in vivo coding followed by focused and thematic coding. Codes were consolidated into five thematic categories capturing parents' emotional continuous loss experience: (a) comparing life before and after, (b) struggling to construct new realities, (c) recognizing instability and permanency, (d) adjusting and readjusting, and (e) grieving as an emotional shadow. These categories are at work simultaneously in parents' accounts, thus supporting a model of dynamic concurrency within and across their lived experiences. Recommendations for practitioners were derived from the theory to support parents' emotional coping with living loss throughout the chronic stage.
Collapse
Affiliation(s)
- Einat Yehene
- The Academic College of Tel Aviv–Yaffo, Tel Aviv, Israel
- Sheba Medical Center, Ramat Gan, Israel
| | | | | | | | - Jana Landa
- Sheba Medical Center, Ramat Gan, Israel
- Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
10
|
Expressed Emotion in Families of Children With and Without Autism Spectrum Disorder, Cerebral Palsy and Down Syndrome: Relations with Parenting Stress and Parenting Behaviors. J Autism Dev Disord 2021; 52:1789-1806. [PMID: 34021833 DOI: 10.1007/s10803-021-05075-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2021] [Indexed: 11/27/2022]
Abstract
This study examined the family emotional climate as assessed by Five Minute Speech Samples and the relation with parenting stress and parenting behaviors among parents of children (6-17 years, 64.7% boys) with autism spectrum disorder, cerebral palsy, Down syndrome, and without any known disability (n = 447). The large majority of parents (79%) showed low levels of Expressed Emotion, an indicator of a positive family climate. In all groups, more Emotional Over-involvement, more Criticism and fewer expressions of Warmth were associated with higher levels of parenting stress. Across groups, Emotional Over-involvement was related to more autonomy-supportive parenting, Criticism to more psychologically controlling and overreactive parenting, and Warmth was associated with more responsive and less psychologically controlling and overreactive parenting.
Collapse
|
11
|
Sivaratnam C, Devenish B, Howells K, Chellew T, Reynolds K, Rinehart N. Risk factors for mental health difficulties in parents of children with cerebral palsy: a systematic review and meta-analysis. CLIN PSYCHOL-UK 2021. [DOI: 10.1080/13284207.2020.1829945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- C. Sivaratnam
- Deakin Child Study Centre, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - B. Devenish
- Deakin Child Study Centre, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - K. Howells
- Deakin Child Study Centre, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - T. Chellew
- Deakin Child Study Centre, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - K. Reynolds
- Kids Plus Foundation, Highton, Victoria, Australia
| | - N. Rinehart
- Deakin Child Study Centre, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| |
Collapse
|
12
|
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.
Collapse
|
13
|
Yehene E, Manevich A, Rubin SS. Caregivers' Grief in Acquired Non-death Interpersonal Loss (NoDIL): A Process Based Model With Implications for Theory, Research, and Intervention. Front Psychol 2021; 12:676536. [PMID: 33995234 PMCID: PMC8119762 DOI: 10.3389/fpsyg.2021.676536] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 04/07/2021] [Indexed: 12/31/2022] Open
Abstract
The number of family members caring and caregiving for a loved one undergoing physical and mental changes continues to increase dramatically. For many, this ongoing experience not only involves the “burden of caregiving” but also the “burden of grief” as their loved-one’s newfound medical condition can result in the loss of the person they previously knew. Dramatic cognitive, behavioral, and personality changes, often leave caregivers bereft of the significant relationship they shared with the affected person prior to the illness or injury. This results in what we term conditions of acquired “non-death interpersonal loss” (NoDIL). Current approaches to these losses use an amalgam of models drawn from both death and non-death loss. Despite their utility, these frameworks have not adequately addressed the unique processes occurring in the interpersonal sphere where the grieving caregiver needs to reach some modus vivendi regarding the triad of “who the person was,” “who they are now,” and “who they will yet become.” In this paper we propose a process-based model which addresses cognitive-emotional-behavioral challenges caregivers meet in the face of their new reality. These require a revision of the interpersonal schemas and the relationships that takes into account the ongoing interactions with the affected family member. The model and its utility to identify adaptive and maladaptive responses to NoDIL is elaborated upon with clinical material obtained from caregivers of people diagnosed with major neuro-cognitive disorder and pediatric traumatic brain injury. The article concludes with implications for theory, research and clinical intervention.
Collapse
Affiliation(s)
- Einat Yehene
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel
| | - Alexander Manevich
- The School of Psychological Sciences and the International Laboratory for the Study of Loss, Bereavement and Human Resilience, University of Haifa, Haifa, Israel
| | - Simon Shimshon Rubin
- The School of Psychological Sciences and the International Laboratory for the Study of Loss, Bereavement and Human Resilience, University of Haifa, Haifa, Israel.,Department of Psychology, Max Stern Academic College of Emek Yezreel, Jezreel Valley, Israel
| |
Collapse
|
14
|
Rock JL, Becker H. Factors for Assisting Adolescents with Autism Develop Health Self-Management. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2020.10.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
15
|
Fernández-Ávalos MI, Pérez-Marfil MN, Ferrer-Cascales R, Cruz-Quintana F, Fernández-Alcántara M. Feeling of grief and loss in parental caregivers of adults diagnosed with intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 34:712-723. [PMID: 33244855 DOI: 10.1111/jar.12842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 09/11/2020] [Accepted: 11/09/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND The diagnosis of intellectual disability in children can produce complex grief-related feelings in their parents. Previous studies have focused on the moment of the diagnosis or the early life of the children, and little research has been conducted on their feelings of grief in adulthood. The objective was to analyse the process of grief/loss in parents of adult offspring with intellectual disability. METHOD The intentional sampling included sixteen parents who responded to semi-structured interviews. A qualitative study was conducted based on grounded theory. RESULTS Five categories were identified: "Reception of the diagnosis", "Emotional bonds with the child", "Experience of loss and feelings in response to intellectual disability diagnosis", "Recurrent grief" and "Coping strategies". CONCLUSIONS Recurring feelings of loss experienced by parents in relation to their child's diagnosis persist over time. Specialized emotional interventions are needed to help parents to reduce the intensity of their feelings of grief.
Collapse
Affiliation(s)
| | - María Nieves Pérez-Marfil
- Faculty of Psychology, Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.,End-of-Life Research Network (EOL), Granada, Spain
| | - Rosario Ferrer-Cascales
- Department of Health Psychology, Faculty of Health Sciences, University of Alicante, Alicante, Spain
| | - Francisco Cruz-Quintana
- Faculty of Psychology, Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.,End-of-Life Research Network (EOL), Granada, Spain
| | - Manuel Fernández-Alcántara
- Department of Health Psychology, Faculty of Health Sciences, University of Alicante, Alicante, Spain.,End-of-Life Research Network (EOL), Granada, Spain
| |
Collapse
|
16
|
Roginsky E, Elefant C. Silent sounding: Communicability, musicality, and the use of music with nonspeaking individuals with cerebral palsies and multiple disabilities. NORDIC JOURNAL OF MUSIC THERAPY 2020. [DOI: 10.1080/08098131.2020.1810744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Efrat Roginsky
- School of Creative Arts Therapies, University of Haifa, Haifa, Israel
| | - Cochavit Elefant
- School of Creative Arts Therapies, University of Haifa, Haifa, Israel
| |
Collapse
|
17
|
Barreto TM, Bento MN, Barreto TM, Jagersbacher JG, Jones NS, Lucena R, Bandeira ID. Prevalence of depression, anxiety, and substance-related disorders in parents of children with cerebral palsy: a systematic review. Dev Med Child Neurol 2020; 62:163-168. [PMID: 31381150 DOI: 10.1111/dmcn.14321] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/15/2019] [Indexed: 12/28/2022]
Abstract
AIM To estimate the prevalence of mental illness in parents of children with cerebral palsy (CP). METHOD This is a systematic review that follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols in the search for observational studies determining the prevalence of depression, anxiety, and substance abuse in parents of individuals with CP. The information sources used for this study were: PubMed, SciELO, Cochrane Library, Clinical Trials, and Biblioteca Virtual de Saúde. RESULTS Fourteen articles were selected and included, investigating 1264 mothers and 105 fathers of children with CP. Data extracted for analysis were divided into three categories: study data, data about participants with CP, and data about parents. All studies included volunteer parents, of whom 95 per cent were female. INTERPRETATION CP is related to a higher prevalence of symptoms of depression and anxiety in parents. Factors such as a child's degree of functionality and socioeconomic level may influence the frequency of mental disorders in parents. However, these studies have heterogeneous samples and applied different criteria to characterize their populations. WHAT THIS PAPER ADDS Depression and anxiety are more prevalent for parents of children with cerebral palsy (CP) than parents of typically developing children. The child's illness severity is a risk factor for mental illness in parents of children with CP. The more time spent on child care, the higher the risk of mental illness among mothers of children with CP. There is a lack of reliable data in the literature on substance abuse in parents of children with CP.
Collapse
Affiliation(s)
- Tainara M Barreto
- Department of Neuroscience and Mental Health, Medical School of Bahia, Federal University of Bahia, Salvador, Brazil
| | - Mayara N Bento
- Department of Neuroscience and Mental Health, Medical School of Bahia, Federal University of Bahia, Salvador, Brazil
| | - Tamiris M Barreto
- Department of Neuroscience and Mental Health, Medical School of Bahia, Federal University of Bahia, Salvador, Brazil
| | - João Gabriel Jagersbacher
- Department of Neuroscience and Mental Health, Medical School of Bahia, Federal University of Bahia, Salvador, Brazil
| | - Nathalia S Jones
- Department of Neuroscience and Mental Health, Medical School of Bahia, Federal University of Bahia, Salvador, Brazil
| | - Rita Lucena
- Department of Neuroscience and Mental Health, Medical School of Bahia, Federal University of Bahia, Salvador, Brazil
| | - Igor D Bandeira
- Department of Neuroscience and Mental Health, Medical School of Bahia, Federal University of Bahia, Salvador, Brazil.,Postgraduate Program in Medicine and Health, Medical School of Bahia, Federal University of Bahia, Salvador, Brazil
| |
Collapse
|
18
|
OBEMBE OLAJIDEBENJAMIN, ADEYEMO SURAJU, OGUN OLUWAYEMICECILIA, IJAROGBE GRACETEMITAYO. The relationship between coping styles and depression among caregivers of children with cerebral palsy in Nigeria, West Africa. ARCH CLIN PSYCHIAT 2019. [DOI: 10.1590/0101-60830000000215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
19
|
Irwin L, Jesmont C, Basu A. A systematic review and meta-analysis of the effectiveness of interventions to improve psychological wellbeing in the parents of children with cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 95:103511. [PMID: 31670025 DOI: 10.1016/j.ridd.2019.103511] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 07/01/2019] [Accepted: 10/01/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Caregivers of children with cerebral palsy (CP) face unique demands and challenges, with potential negative impact on psychological wellbeing and consequences for both caregiver and child. Timely support could improve parental wellbeing. AIM To evaluate the effectiveness of interventions aimed at improving the psychological wellbeing of caregivers of children with CP. METHODS AND PROCEDURES Systematic review and meta-analysis of randomised controlled trials of interventions to improve the psychological well-being of caregivers of children with cerebral palsy. Databases (including MEDLINE, EMBASE, PsycINFO, Cochrane) were searched for relevant English language publications between January 1990 and December 2017. Risk of bias was assessed including randomization, allocation concealment, incomplete outcome data and selective outcome reporting. OUTCOME AND RESULTS We included 13 studies (1293 participants, 1/3 with CP). Six studies investigated a positive parenting intervention; the other seven studies covered a range of other interventions. Meta-analysis of 7 studies (662 participants) showed that interventions significantly improved parental wellbeing (standardised mean difference -0.61, 95% CI -0.92 to -0.30, z = 3.84, p = 0.0001). CONCLUSIONS AND IMPLICATIONS Limitations include small sample sizes and heterogeneity in study design; however, our results indicate that interventions can improve the wellbeing of parents of children with CP and should be made available.
Collapse
Affiliation(s)
- Louise Irwin
- School of Psychology/Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
| | - Ceit Jesmont
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
| | - Anna Basu
- Institute of Health and Society, Newcastle University and Department of Paediatric Neurology, Newcastle upon Tyne Hospitals NHS Foundation Trust, UK.
| |
Collapse
|
20
|
Yehene E, Brezner A, Ben-Valid S, Golan S, Bar-Nadav O, Landa J. Factors associated with parental grief reaction following pediatric acquired brain injury. Neuropsychol Rehabil 2019; 31:105-128. [PMID: 31556807 DOI: 10.1080/09602011.2019.1668280] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The present study investigated factors associated with parental grief reaction (PGR) following pediatric acquired brain injury (ABI), and compared PGR to the one exhibited following child death. Fifty-seven parents of 51 children (aged 3-18) whose ABI occurred 1-14 years before participation, completed the multi-scale Two-Track Bereavement Questionnaire; a socio-demographic questionnaire; and a scale assessing perceived behavioural changes in the child. Results from regression analysis indicated that time since injury had no impact on parents' grief other than having an adverse impact on their overall coping and functioning; A higher amount of weekly caring hours predicted only a greater traumatic perception of the loss; Older children's ages but mostly greater parental-perceived behavioural changes, predicted greater PGR on most scales. PGR was compared with the pre-existing data of bereaved parents who completed the same grief questionnaire. Although grief response patterns and intensity were similar in both groups, significant differences were found on scales assessing the continuing bond with the child: relational active grief, close and positive relationship, and conflictual relationship. Our findings indicate that parental grief is multi-dimensional following pediatric ABI and illuminate the interplay between elements characterizing parents' nonfinite vs. finite loss experience.
Collapse
Affiliation(s)
- Einat Yehene
- School of Behavioral Sciences, The Academic College of Tel-Aviv Yafo, Tel-Aviv, Israel.,Pediatric Rehabilitation Department, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel HaShomer, Israel
| | - Amichai Brezner
- Pediatric Rehabilitation Department, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel HaShomer, Israel
| | - Shani Ben-Valid
- School of Behavioral Sciences, The Academic College of Tel-Aviv Yafo, Tel-Aviv, Israel
| | - Sapir Golan
- School of Behavioral Sciences, The Academic College of Tel-Aviv Yafo, Tel-Aviv, Israel
| | - Ofri Bar-Nadav
- International Center for the Study of Loss, Bereavement and Human Resilience, Department of Psychology, University of Haifa, Haifa, Israel
| | - Janna Landa
- Pediatric Rehabilitation Department, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel HaShomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
21
|
van den Berg L, de Weerd AW, Reuvekamp HF, van der Meere JJ. The burden of parenting children with frontal lobe epilepsy. Epilepsy Behav 2019; 97:269-274. [PMID: 31254848 DOI: 10.1016/j.yebeh.2019.05.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/14/2019] [Accepted: 05/23/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Caring for a child with a chronic illness adds stress to the typical parenting stress in healthy developing children. This stress can place a heavy burden on parents and may increase when a child displays problem behavior. In general, parenting and child's behavior problems are associated. Furthermore, externalizing (more outgoing) behavior is reported frequently in children with frontal lobe epilepsy (FLE). Therefore, in this study, we first investigated the burden of parents of children with FLE, and second, we investigated the relation between the experienced burden and reported behavioral problems. The validity of parents' reports on proxy measures as well as duration of epilepsy is taken into account. METHODS Thirty-one parents of children with FLE completed validated questionnaires about behavioral problems and burden of parenting. To examine if parents tend to be inconsistent or unusually negative, we used the two validity scales of the Behavioral Rating Inventory of Executive Function (BRIEF) (Negativity and Inconsistency). RESULTS Only parents of children with FLE who have had epilepsy for 5 years or longer report more problems on the Nijmeegse Vragenlijst voor de Opvoedingssituatie (NVOS) subscales 'Able to manage', 'Child is a burden', and 'Good Interaction' compared with the healthy controls. The subscale 'Child is a burden' significantly predicts scores in about 20% to 49% on the main scales of the Child Behavior Checklist (CBCL), the Global Executive Composite (GEC), and Behavioral Regulation Index (BRI) of the BRIEF. Only 6% of parents scored in the clinical range of the negativity scale of the BRIEF. For the inconsistency scale, this was 45%. CONCLUSION Parents of children with FLE do not report excessive parental burden. Longer duration of epilepsy might be a risk factor in experiencing burden. The findings suggest a link between parental burden and behavioral problems in children with FLE. Externalizing behavioral problems are the most marked behavioral problems, which relate to the parental burden. Parents tend to be inconsistent in their ratings.
Collapse
Affiliation(s)
- L van den Berg
- Stichting Epilepsie Instellingen Nederland, Postbus 563, 8000 AN Zwolle, Netherlands; RijksUniversiteitGroningen, Faculteit Gedrags- & Maatschappijwetenschappen, Klinische & Ontwikkelingsneuropsychologie, Grote Kruisstraat 2/1, 9712 TS Groningen, Netherlands.
| | - A W de Weerd
- Stichting Epilepsie Instellingen Nederland, Postbus 563, 8000 AN Zwolle, Netherlands
| | - H F Reuvekamp
- Stichting Epilepsie Instellingen Nederland, Postbus 563, 8000 AN Zwolle, Netherlands
| | - J J van der Meere
- RijksUniversiteitGroningen, Faculteit Gedrags- & Maatschappijwetenschappen, Klinische & Ontwikkelingsneuropsychologie, Grote Kruisstraat 2/1, 9712 TS Groningen, Netherlands
| |
Collapse
|
22
|
Sairanen E, Lappalainen R, Lappalainen P, Kaipainen K, Carlstedt F, Anclair M, Hiltunen A. Effectiveness of a web-based Acceptance and Commitment Therapy intervention for wellbeing of parents whose children have chronic conditions: A randomized controlled trial. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2019. [DOI: 10.1016/j.jcbs.2019.07.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
23
|
Olwit C, Mugaba M, Osingada CP, Nabirye RC. Existence, triggers, and coping with chronic sorrow: a qualitative study of caretakers of children with sickle cell disease in a National Referral Hospital in Kampala, Uganda. BMC Psychol 2018; 6:50. [PMID: 30342559 PMCID: PMC6196010 DOI: 10.1186/s40359-018-0263-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 10/09/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Worldwide, sickle cell disease is recognized as one of the major causes of morbidity and mortality. Caregivers and patients with such chronic illnesses experience economic, physical, social and psychological distresses which may lead to chronic sorrow. Chronic sorrow is viewed as a normal reaction to loss, however it can progress to a pathological state such as depression if the coping styles are ineffective. Therefore, the aim of this study was to explore the existence of chronic sorrow, triggers and coping with grief related feelings among caretakers of children with sickle cell disease. METHODS A descriptive qualitative study was conducted. Twelve in-depth interviews were conducted with eligible participants who were purposively selected. Deductive thematic analysis methods were used for data analysis. RESULTS Many (9 out of 12) of the caretakers experienced chronic sorrow. The grief related feelings were triggered by health worker related, disease related and support related factors. Caretakers used both external and internal coping strategies. External support was derived from community, family and health facility. Internal coping strategies were behavioral and cognitive. CONCLUSION Caretakers of children with sickle cell disease experienced chronic sorrow and employed both internal and external coping strategies to deal with it, which could be either effective or ineffective. This study recommends that health workers should routinely screen for chronic sorrow among caretakers of children with sickle cell disease and assist caretakers to strengthen effective coping strategies to ameliorate the negative effects of chronic sorrow.
Collapse
Affiliation(s)
- Connie Olwit
- Department of Nursing, College of health sciences, Makerere University, P.O.BOX. 7072, Kampala, Uganda.
| | - Maureen Mugaba
- Department of Nursing, College of health sciences, Makerere University, P.O.BOX. 7072, Kampala, Uganda
| | - Charles Peter Osingada
- Department of Nursing, College of health sciences, Makerere University, P.O.BOX. 7072, Kampala, Uganda
| | - Rose Chalo Nabirye
- Department of Nursing, College of health sciences, Makerere University, P.O.BOX. 7072, Kampala, Uganda
| |
Collapse
|
24
|
Sairanen E, Lappalainen P, Hiltunen A. Psychological inflexibility explains distress in parents whose children have chronic conditions. PLoS One 2018; 13:e0201155. [PMID: 30044852 PMCID: PMC6059465 DOI: 10.1371/journal.pone.0201155] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 07/10/2018] [Indexed: 11/19/2022] Open
Abstract
Experiential avoidance, cognitive defusion, and mindfulness have all been associated with psychological disorders and well-being. This study investigates whether they predict psychological distress, i.e., symptoms of burnout, depression, stress and anxiety, in parents of children with chronic conditions. We hypothesized that these factors would exhibit a large degree of common variance, and that when compared to mindfulness and defusion, experiential avoidance on its own would predict a larger proportion of unique variance. 75 parents of children with chronic conditions having burnout symptoms who participated in an intervention study completed measures of burnout, stress, anxiety, depression, experiential avoidance, cognitive defusion, and mindfulness at the beginning of the intervention study (baseline). We ran several regression analyses to assess the predictive ability of these different constructs. Experiential avoidance on its own accounted for 28–48% of the variance in different psychological symptoms. Cognitive defusion and mindfulness did not make a significant contribution to explaining burnout, stress and anxiety, but cognitive defusion contributed to explaining depression. The results confirmed our hypothesis, supporting research on the importance of psychological flexibility as a central factor in understanding the occurrence of psychological distress.
Collapse
Affiliation(s)
- Essi Sairanen
- Karlstad University, Department of Social and Psychological Studies, Karlstad, Sweden
- * E-mail:
| | - Päivi Lappalainen
- University of Jyväskylä, Department of Psychology, Jyväskylä, Finland
| | - Arto Hiltunen
- Karlstad University, Department of Social and Psychological Studies, Karlstad, Sweden
| |
Collapse
|
25
|
Comparing Parental Well-Being and Its Determinants Across Three Different Genetic Disorders Causing Intellectual Disability. J Autism Dev Disord 2017; 48:1651-1665. [DOI: 10.1007/s10803-017-3420-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
26
|
Wang Y, Wan Q, Huang Z, Huang L, Kong F. Psychometric Properties of Multi-Dimensional Scale of Perceived Social Support in Chinese Parents of Children with Cerebral Palsy. Front Psychol 2017; 8:2020. [PMID: 29209254 PMCID: PMC5702313 DOI: 10.3389/fpsyg.2017.02020] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 11/06/2017] [Indexed: 12/01/2022] Open
Abstract
The Multi-dimensional Scale of Perceived Social Support (MSPSS) is one of the most extensively used instruments to assess social support. The purpose of this research was to test the reliability, factorial validity, concurrent validity and measurement invariance across gender groups of the MSPSS in Chinese parents of children with cerebral palsy. A total of 487 participants aged 21-55 years were recruited to complete the Chinese MSPSS and Parenting Stress Index-Short Form (PSI-SF). Composite reliability was calculated as the internal consistency of the Chinese MSPSS and a (multi-group) confirmatory factor analysis (CFA) was conducted to test the factorial validity and measurement invariance across gender. And Pearson correlations were calculated to test the relationships between MSPSS and PSI-SF. The Chinese MSPSS had satisfactory internal reliability with composite reliability values of more than 0.7. The CFA indicated that the original three-factor model was replicated in this specific population. Importantly, the results of the multi-group CFA demonstrated that configural, metric, and scalar invariance across gender groups was supported. In addition, all the three subscales of MSPSS were significant related with PSI-SF. These findings suggest that the Chinese MSPSS is a reliable and valid tool for assessing social support and can generally be utilized across sex in the parents of children with cerebral palsy.
Collapse
Affiliation(s)
- Yongli Wang
- Education and Rehabilitation Department, Faculty of Education, East China Normal University, Shanghai, China
| | - Qin Wan
- Education and Rehabilitation Department, Faculty of Education, East China Normal University, Shanghai, China
| | - Zhaoming Huang
- Education and Rehabilitation Department, Faculty of Education, East China Normal University, Shanghai, China
| | - Li Huang
- Rehabilitation Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Feng Kong
- School of Psychology, Shanxi Normal University, Xi’an, China
| |
Collapse
|
27
|
Wang Y, Huang Z, Kong F. Parenting stress and life satisfaction in mothers of children with cerebral palsy: The mediating effect of social support. J Health Psychol 2017; 25:416-425. [DOI: 10.1177/1359105317739100] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
In this study, we investigated the mediating effect of social support on the relationship between parenting stress and life satisfaction in Chinese mothers of children with cerebral palsy ( N = 369). The results showed that family support and friend support, but not significant-other support, had mediating effects on the relationship between parenting stress and life satisfaction. Moreover, the mediating effect of friend support was equal to family support. These results suggest that the focus should be on reducing parenting stress and increasing support from family and friends to help improve life satisfaction in mothers of children with cerebral palsy.
Collapse
Affiliation(s)
- Yongli Wang
- Faculty of Education, East China Normal University, China
| | - Zhaoming Huang
- Faculty of Education, East China Normal University, China
| | | |
Collapse
|
28
|
Coughlin MB, Sethares KA. Chronic Sorrow in Parents of Children with a Chronic Illness or Disability: An Integrative Literature Review. J Pediatr Nurs 2017; 37:108-116. [PMID: 28751135 DOI: 10.1016/j.pedn.2017.06.011] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 05/17/2017] [Accepted: 06/19/2017] [Indexed: 12/01/2022]
Abstract
PROBLEM This integrative review aims to synthesize the findings of studies on chronic sorrow in parents, to analyze the findings along three specific research questions, and to identify areas for future research. ELIGIBILITY CRITERIA Studies of parents, mothers and/or fathers of non-adult children published in peer-reviewed journals that answered the research questions: 1) How does the experience of chronic sorrow differ between mothers and fathers? 2) What factors have been identified to impact the experience of chronic sorrow over time? 3) What strategies by health care providers for helping parents cope with chronic sorrow have been identified to be most and least helpful? SAMPLE Nineteen studies from a literature search within the databases of CINAHL, MEDLINE, PsycINFO, Psycarticles and SocIndex were included in the review. RESULTS Findings suggest that mothers experience more intense chronic sorrow compared with fathers. Health care crises and developmental milestones are potent triggers for resurgence of chronic sorrow. Helpful strategies by healthcare providers include providing information, helping to procure respite and being empathetic and compassionate. CONCLUSIONS Healthcare providers need to understand that chronic sorrow is a normal consequence of having a child with a chronic illness or disability. IMPLICATIONS Family-centered interventions should be individualized and aimed at providing increased comfort to parents in times of need. Further research that looks at the effectiveness of interventions is needed.
Collapse
Affiliation(s)
- Mary Beth Coughlin
- Laboure College, Milton, MA, United States; University of Massachusetts Dartmouth, United States.
| | - Kristen A Sethares
- Laboure College, Milton, MA, United States; University of Massachusetts Dartmouth, United States
| |
Collapse
|
29
|
Fernández-Alcántara M, Pérez-Marfil MN, Catena-Martínez A, Cruz-Quintana F. Grieving and loss processes: latest findings and complexities / Actualidad y complejidad de los procesos de duelo y pérdida. STUDIES IN PSYCHOLOGY 2017. [DOI: 10.1080/02109395.2017.1328210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Manuel Fernández-Alcántara
- Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), Universidad de Granada
- Red de Investigación en el Final de la Vida (EOL)
- Departamento de Psicología de la Salud, Universidad de Alicante
| | - Ma Nieves Pérez-Marfil
- Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), Universidad de Granada
- Red de Investigación en el Final de la Vida (EOL)
| | - Andrés Catena-Martínez
- Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), Universidad de Granada
| | - Francisco Cruz-Quintana
- Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), Universidad de Granada
- Red de Investigación en el Final de la Vida (EOL)
| |
Collapse
|
30
|
Hudson BF, Oostendorp LJM, Candy B, Vickerstaff V, Jones L, Lakhanpaul M, Bluebond-Langner M, Stone P. The under reporting of recruitment strategies in research with children with life-threatening illnesses: A systematic review. Palliat Med 2017; 31:419-436. [PMID: 27609607 PMCID: PMC5405809 DOI: 10.1177/0269216316663856] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Researchers report difficulties in conducting research with children and young people with life-limiting conditions or life-threatening illnesses and their families. Recruitment is challenged by barriers including ethical, logistical and clinical considerations. AIM To explore how children and young people (aged 0-25 years) with life-limiting conditions or life-threatening illnesses and their families were identified, invited and consented to research published in the last 5 years. DESIGN Systematic review. DATA SOURCES MEDLINE, PsycINFO, Web of Science, Sciences Citation Index and SCOPUS were searched for original English language research published between 2009 and 2014, recruiting children and young people with life-limiting conditions or life-threatening illness and their families. RESULTS A total of 215 studies - 152 qualitative, 54 quantitative and 9 mixed methods - were included. Limited recruitment information but a range of strategies and difficulties were provided. The proportion of eligible participants from those screened could not be calculated in 80% of studies. Recruitment rates could not be calculated in 77%. A total of 31% of studies recruited less than 50% of eligible participants. Reasons given for non-invitation included missing clinical or contact data, or clinician judgements of participant unsuitability. Reasons for non-participation included lack of interest and participants' perceptions of potential burdens. CONCLUSION All stages of recruitment were under reported. Transparency in reporting of participant identification, invitation and consent is needed to enable researchers to understand research implications, bias risk and to whom results apply. Research is needed to explore why consenting participants decide to take part or not and their experiences of research recruitment.
Collapse
Affiliation(s)
- Briony F Hudson
- Louis Dundas Centre for Children’s Palliative Care, UCL Institute of Child Health, London, UK
- Marie Curie Palliative Care Research Department, UCL Division of Psychiatry, London, UK
| | - Linda JM Oostendorp
- Louis Dundas Centre for Children’s Palliative Care, UCL Institute of Child Health, London, UK
| | - Bridget Candy
- Marie Curie Palliative Care Research Department, UCL Division of Psychiatry, London, UK
| | - Victoria Vickerstaff
- Marie Curie Palliative Care Research Department, UCL Division of Psychiatry, London, UK
| | - Louise Jones
- Marie Curie Palliative Care Research Department, UCL Division of Psychiatry, London, UK
| | - Monica Lakhanpaul
- Population, Policy and Practice Programme, UCL Institute of Child Health, London, UK
| | - Myra Bluebond-Langner
- Louis Dundas Centre for Children’s Palliative Care, UCL Institute of Child Health, London, UK
| | - Paddy Stone
- Marie Curie Palliative Care Research Department, UCL Division of Psychiatry, London, UK
| |
Collapse
|
31
|
Quantitative and qualitative insights into the experiences of children with Rett syndrome and their families. Wien Med Wochenschr 2016; 166:338-45. [PMID: 27491552 DOI: 10.1007/s10354-016-0494-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 07/07/2016] [Indexed: 12/27/2022]
Abstract
Rett syndrome is a rare neurodevelopmental disorder caused by a mutation in the MECP2 gene. It is associated with severe functional impairments and medical comorbidities such as scoliosis and poor growth. The population-based and longitudinal Australian Rett Syndrome Database was established in 1993 and has supported investigations of the natural history of Rett syndrome and effectiveness of treatments, as well as a suite of qualitative studies to identify deeper meanings. This paper describes the early presentation of Rett syndrome, including regression and challenges for families seeking a diagnosis. We discuss the importance of implementing strategies to enhance daily communication and movement, describe difficulties interpreting the presence of pain and discomfort, and argue for a stronger evidence base in relation to management. Finally, we outline a framework for understanding quality of life in Rett syndrome and suggest areas of life to which we can direct efforts in order to improve quality of life. Each of these descriptions is illustrated with vignettes of child and family experiences. Clinicians and researchers must continue to build this framework of knowledge and understanding with efforts committed to providing more effective treatments and supporting the best quality of life for those affected.
Collapse
|
32
|
Fernańdez-Alcántara M, García-Caro MP, Pérez-Marfil MN, Hueso-Montoro C, Laynez-Rubio C, Cruz-Quintana F. Feelings of loss and grief in parents of children diagnosed with autism spectrum disorder (ASD). RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 55:312-321. [PMID: 27235768 DOI: 10.1016/j.ridd.2016.05.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 04/24/2016] [Accepted: 05/09/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Various authors have reported feelings of loss and grief in parents of children with autism spectrum disorder. However, no previous studies have investigated the structure of these feelings. AIMS To analyze in depth the feelings of loss in parents of children diagnosed with autism spectrum disorder. METHOD A qualitative study was conducted based on grounded theory. Twenty parents participated through purposive sampling. PROCEDURE Semi-structured interviews were conducted, asking about different emotional aspects of the upbringing of a child with autism spectrum disorder. Atlas.ti 6.2 program was used for open, axial, and selective coding. RESULTS The core category that explained the feelings of these parents was unexpected child loss, associated with shock, negation, fear, guilt, anger, and/or sadness. Two processes were identified, one associated with the resolution of grief and the other with obstacles to overcoming it. IMPLICATIONS Feelings of loss play an important role in explaining the complex emotions experienced by these parents. Different intervention strategies are proposed.
Collapse
Affiliation(s)
- Manuel Fernańdez-Alcántara
- Faculty of Psychology, Department of Personality, Assessment and Psychological Treatment, Brain, Mind and Behavior Research Center (CIMCYC), University of Granada, Spain.
| | - M Paz García-Caro
- Faculty of Health Sciences, Department of Nursing, University of Granada, Spain
| | - M Nieves Pérez-Marfil
- Faculty of Psychology, Department of Personality, Assessment and Psychological Treatment, Brain, Mind and Behavior Research Center (CIMCYC), University of Granada, Spain
| | - Cesar Hueso-Montoro
- Faculty of Health Sciences, Department of Nursing, University of Granada, Spain
| | - Carolina Laynez-Rubio
- Unit of Monitoring and Early Assistance (UMEA), San Cecilio Clinical Hospital, Granada, Spain
| | - Francisco Cruz-Quintana
- Faculty of Psychology, Department of Personality, Assessment and Psychological Treatment, Brain, Mind and Behavior Research Center (CIMCYC), University of Granada, Spain
| |
Collapse
|
33
|
Whittingham K, Sanders MR, McKinlay L, Boyd RN. Parenting Intervention Combined With Acceptance and Commitment Therapy: A Trial With Families of Children With Cerebral Palsy. J Pediatr Psychol 2016; 41:531-42. [PMID: 26702629 PMCID: PMC4888113 DOI: 10.1093/jpepsy/jsv118] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 11/13/2015] [Accepted: 11/16/2015] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To examine the effects of Stepping Stones Triple P (SSTP) and Acceptance and Commitment Therapy (ACT) on child functioning, quality of life, and parental adjustment. METHOD 67 parents (97.0% mothers) of children (64.2% male; mean age 5.3 ± 3.0 years) with cerebral palsy participated in a randomized controlled trial with three groups: wait-list control, SSTP, and SSTP + ACT. This article details the secondary outcomes. RESULTS In comparison with wait-list, the SSTP + ACT group showed increased functional performance and quality of life as well as decreased parental psychological symptoms. No differences were found for parental confidence. No differences were found between SSTP and wait-list or between SSTP and SSTP + ACT. CONCLUSIONS ACT-integrated parenting intervention may be an effective way to target child functioning, quality of life, and parental adjustment.
Collapse
Affiliation(s)
- Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Parenting and Family Support Centre, School of Psychology, The University of Queensland, and
| | - Matthew R Sanders
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, and
| | - Lynne McKinlay
- Queensland Paediatric Rehabilitation Service, Royal Children's Hospital, Brisbane, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland
| |
Collapse
|
34
|
Jayanath S, Ong LC, Marret MJ, Fauzi AA. Parent-reported pain in non-verbal children and adolescents with cerebral palsy. Dev Med Child Neurol 2016; 58:395-401. [PMID: 26510627 DOI: 10.1111/dmcn.12943] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/04/2015] [Indexed: 11/30/2022]
Abstract
AIM This cross-sectional study aimed to determine the prevalence, frequency, and intensity of parent-reported pain among non-verbal children with cerebral palsy (CP) and explore associations with medical, demographic, and parental psychosocial factors. METHOD Participants were parents of non-verbal outpatients (aged 2-20y) with CP at University of Malaya Medical Centre, Kuala Lumpur and two community centres. Parents answered the Caregiver Priorities and Child Health Index of Life with Disabilities Questionnaire and a pro forma regarding parent-reported frequency and intensity of pain during the preceding 4 weeks. Parental psychosocial well-being was assessed via the Depression, Anxiety and Stress Scale and Multidimensional Scale of Perceived Social Support. RESULTS The response rate was 94%; 104 children (54 males, 50 females) were studied. The majority (51%) were in Gross Motor Function Classification System level V and 65% had spastic quadriplegia. Parents reported pain in 65%, intense pain in 17%, and daily pain in 28%. Intense and frequent pain was reported during physiotherapy. More intense pain was reported in older children (p=0.016) and those with spastic quadriplegia (p=0.020). INTERPRETATION Caregivers of non-verbal children with CP report a high frequency of pain. Pain intensity is associated with patient factors but not parental psychosocial factors.
Collapse
Affiliation(s)
- Subhashini Jayanath
- Department of Paediatrics, Faculty of Medicine, University of Malaya, Jalan Universiti, Kuala Lumpur, Malaysia
| | - Lai Choo Ong
- Department of Paediatrics, Faculty of Medicine, University of Malaya, Jalan Universiti, Kuala Lumpur, Malaysia
| | - Mary Joseph Marret
- Department of Paediatrics, Faculty of Medicine, University of Malaya, Jalan Universiti, Kuala Lumpur, Malaysia
| | - Aishah Ahmad Fauzi
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Jalan Universiti, Kuala Lumpur, Malaysia
| |
Collapse
|
35
|
Surviving or thriving: quality assurance mechanisms to promote innovation in the development of evidence-based parenting interventions. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2016; 16:421-31. [PMID: 24610566 DOI: 10.1007/s11121-014-0475-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Parenting interventions have the potential to make a significant impact to the prevention and treatment of major social and mental health problems of children. However, parenting interventions fail to do so because program developers pay insufficient attention to the broader ecological context that influences the adoption and implementation of evidence-based interventions. This context includes the professional and scientific community, end users, consumers, and broader sociopolitical environment within which parenting services are delivered. This paper presents an iterative stage model of quality assurance steps to guide ongoing research and development particularly those related to program innovations including theory building, intervention development, pilot testing, efficacy and effectiveness trials, program refinement, dissemination, and planning for implementation and political advocacy. The key challenges associated with each phase of the research and development process are identified. Stronger consumer participation throughout the entire process from initial program design to wider community dissemination is an important, but an often ignored part of the process. Specific quality assurance mechanisms are discussed that increase accountability, professional, and consumer confidence in an intervention and the evidence supporting its efficacy.
Collapse
|
36
|
|
37
|
Krstić T, Mihić L, Mihić I. Stress and resolution in mothers of children with cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 47:135-143. [PMID: 26421350 DOI: 10.1016/j.ridd.2015.09.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 08/04/2015] [Accepted: 09/13/2015] [Indexed: 06/05/2023]
Abstract
Parental resolution of diagnosis represents coming to terms with and accepting the diagnosis of a serious condition in their child. As risk factors for achieving resolution, we investigated: a child's functional status, cumulative stress, and maternal depression. The current study tested the hypothesis that mothers who are unresolved to their child's diagnosis would have considerably higher levels of risk factors, compared to resolved mothers. We also examined whether the observed risk factors could predict the resolution status. Maternal resolution was assessed by means of the Reaction to Diagnosis Interview. The sample consisted of 100 mothers of children aged 2-7, diagnosed with cerebral palsy. The results showed that unresolved mothers had children with poorer functional status, experienced more stressful life events, and were more depressed compared to resolved ones. The functional status of a child and maternal depression were shown to be significant resolution predictors. Importantly, they were more successful in predicting the resolved than the unresolved status. Further research is needed in order to investigate more extensively the unresolved parental status.
Collapse
Affiliation(s)
- Tatjana Krstić
- Department of Special Rehabilitation and Education, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia.
| | - Ljiljana Mihić
- Department of Psychology, Faculty of Philosophy, University of Novi Sad, Dr Zorana Đinđića 2, 21000 Novi Sad, Serbia.
| | - Ivana Mihić
- Department of Psychology, Faculty of Philosophy, University of Novi Sad, Dr Zorana Đinđića 2, 21000 Novi Sad, Serbia.
| |
Collapse
|
38
|
Brown FL, Whittingham K, Boyd RN, McKinlay L, Sofronoff K. Does Stepping Stones Triple P plus Acceptance and Commitment Therapy improve parent, couple, and family adjustment following paediatric acquired brain injury? A randomised controlled trial. Behav Res Ther 2015; 73:58-66. [PMID: 26255172 DOI: 10.1016/j.brat.2015.07.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Revised: 05/28/2015] [Accepted: 07/13/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate the efficacy of a behavioural family intervention, Stepping Stones Triple P (SSTP), combined with an Acceptance and Commitment Therapy (ACT) workshop in improving parent, family and couple outcomes following paediatric acquired brain injury (ABI). PARTICIPANTS AND SETTING Fifty-nine parents (90% mothers) of children (mean age 7 years; 35 males, 24 females) with ABI. INTERVENTION Participants were randomly assigned to a treatment (10-week group SSTP and ACT program) or a care-as-usual (CAU) control condition (10 weeks). Those in the CAU condition received the treatment after the waitlist period. OUTCOMES Self-report measures of parent psychological distress, parent psychological flexibility, parenting confidence, family functioning, and couple relationship, assessed at: pre-intervention, post-intervention, and 6-months post-intervention. RESULTS Post-intervention, the treatment group showed significant, small to medium improvements relative to the CAU group (at the p < .05 level) on parent psychological distress, parent psychological flexibility, parent confidence in managing behaviours, family adjustment,and number of disagreements between parents. Most improvements were maintained at 6-months. CONCLUSIONS Parent skills training and ACT may be efficacious in improving parent, family, and couple outcomes in families of children with an ABI.
Collapse
Affiliation(s)
- Felicity L Brown
- The School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Australia; Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Australia; Queensland Children's Medical Research Institute, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Australia.
| | - Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Australia; The School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Australia
| | - Lynne McKinlay
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Australia; Queensland Paediatric Rehabilitation Service, Royal Children's Hospital, Brisbane, Australia
| | - Kate Sofronoff
- The School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Australia
| |
Collapse
|
39
|
Barfoot J, Meredith P, Ziviani J, Whittingham K. Relationship-focused parenting intervention to support developmental outcomes for a young child with cerebral palsy: A practice application. Br J Occup Ther 2015. [DOI: 10.1177/0308022615583304] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Statement of context The effectiveness of early intervention for children with developmental disabilities is thought to be related to parental sensitivity and responsiveness. A brief relationship-focused occupational therapy intervention for Shelly, a young girl with cerebral palsy, and her mother, Jane, is described. Critical reflection on practice The distress of both mother and child at presentation compromised the ability of therapists to provide developmentally orientated interventions. Focusing on parent–child interactions enabled Shelly to make both emotional and physical gains, and facilitated ongoing interventions. Implications for practice Observations in this practice application demonstrate the need for further research into parenting interventions and developmental outcomes for children with cerebral palsy.
Collapse
Affiliation(s)
- Jacqui Barfoot
- PhD Candidate, Occupational Therapist, School of Health and Rehabilitation Sciences, The University of Queensland, Australia
| | - Pamela Meredith
- Senior Lecturer, School of Health and Rehabilitation Sciences, The University of Queensland, Australia
| | - Jenny Ziviani
- Professor, Children’s Allied Health Research, Children’s Health Queensland and School of Health and Rehabilitation Sciences, The University of Queensland, Australia
| | - Koa Whittingham
- Research Fellow, Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland and School of Psychology, The University of Queensland, Australia
| |
Collapse
|
40
|
Silva N, Crespo C, Carona C, Canavarro MC. Mapping the caregiving process in paediatric asthma: Parental burden, acceptance and denial coping strategies and quality of life. Psychol Health 2015; 30:949-68. [PMID: 25601492 DOI: 10.1080/08870446.2015.1007981] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Based on a multidimensional model of the caregiving process, the main goal of this study was to examine the direct and indirect links, via acceptance and denial coping, between the caregiving burden and the quality of life (QoL) in parents of children with asthma. The sample was composed of 182 parents of a child/adolescent between 8 and 18 years of age with a clinical diagnosis of asthma. Data were obtained via self-report questionnaires assessing the caregiving burden, acceptance and denial coping strategies and QoL. Results from structural equation modelling indicated a good fit for the mediation model, which explained 30% of the variability of the parents' QoL. Higher levels of caregiving burden were negatively and indirectly associated with the parents' QoL, via less use of acceptance and greater use of denial coping strategies. Multigroup analyses ascertained the invariance of these links across the children's asthma severity, age and socio-economic groups. These findings emphasise acceptance and denial as important coping mechanisms in the caregiving process. Thus, broad-spectrum family-centred interventions in paediatric asthma settings can target the development of the parents' coping tendencies characterised by greater acceptance and less denial as a way of reappraising caregiving demands as less burdensome and improving their QoL.
Collapse
Affiliation(s)
- Neuza Silva
- a Faculty of Psychology and Education Sciences , University of Coimbra , Coimbra , Portugal
| | | | | | | |
Collapse
|
41
|
Fernández-Alcántara M, García-Caro MP, Laynez-Rubio C, Pérez-Marfil MN, Martí-García C, Benítez-Feliponi Á, Berrocal-Castellano M, Cruz-Quintana F. Feelings of loss in parents of children with infantile cerebral palsy. Disabil Health J 2015; 8:93-101. [DOI: 10.1016/j.dhjo.2014.06.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 06/04/2014] [Accepted: 06/13/2014] [Indexed: 11/16/2022]
|
42
|
Parental attitudes and personality traits, self-efficacy, stress, and coping strategies among mothers of children with cerebral palsy. HEALTH PSYCHOLOGY REPORT 2015. [DOI: 10.5114/hpr.2015.51903] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
43
|
Brown FL, Whittingham K, Sofronoff K. Parental Experiential Avoidance as a Potential Mechanism of Change in a Parenting Intervention for Parents of Children With Pediatric Acquired Brain Injury. J Pediatr Psychol 2014; 40:464-74. [DOI: 10.1093/jpepsy/jsu109] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 11/21/2014] [Indexed: 11/14/2022] Open
|
44
|
Kayrouz N, Milne S, Cottier C, McDonald J. Families referred to a Child Assessment Team: the Campbelltown experience. J Paediatr Child Health 2014; 50:1008-12. [PMID: 24965901 DOI: 10.1111/jpc.12678] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/27/2014] [Indexed: 11/26/2022]
Abstract
AIM To study the socio-demographic and psychosocial risk factors of families presenting with their children for a diagnostic developmental assessment. METHODS Socio-demographic details of children who had a multidisciplinary developmental assessment with the Child Assessment Team at Campbelltown Hospital between January 2009 and December 2010 were collated and compared with census data. RESULTS In 2009 and 2010, 277 families were seen by the Child Assessment Team. A detailed socio-demographic profile was available for 251 (91%) families. Parents seen in the clinic were more likely to be younger, single, born overseas, have less post-school education, identify as Aboriginal and/or live in public housing compared with the district rates. CONCLUSIONS Families presenting to the developmental clinic have more socio-economic disadvantage compared with the referring district. This has implications for service delivery and clinical presentation, and highlights the importance of the social worker's role in a developmental diagnostic team.
Collapse
Affiliation(s)
- Norma Kayrouz
- Department of Community Paediatrics, Campbelltown Hospital, Campbelltown, New South Wales, Australia
| | | | | | | |
Collapse
|
45
|
Brown FL, Whittingham K, Boyd RN, McKinlay L, Sofronoff K. Improving child and parenting outcomes following paediatric acquired brain injury: a randomised controlled trial of Stepping Stones Triple P plus Acceptance and Commitment Therapy. J Child Psychol Psychiatry 2014; 55:1172-83. [PMID: 24635872 DOI: 10.1111/jcpp.12227] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Persistent behavioural difficulties are common following paediatric acquired brain injury (ABI). Parents and families also experience heightened stress, psychological symptoms and burden, and there is evidence of a reciprocal relationship between parent and child functioning, which may be mediated by the adoption of maladaptive parenting practices. Despite this, there is currently a paucity of research in family interventions in this population. The aim of this study was to determine the efficacy of Stepping Stones Triple P: Positive Parenting Program (SSTP), with an Acceptance and Commitment Therapy (ACT) workshop, in improving child outcomes and parenting practices following paediatric ABI. METHODS Fifty-nine parents of children (mean age 7 years, SD 3 years, 1 month; 35 males, 24 females) with ABI (Traumatic injuries 58%, Tumour 17%, Encephalitis or meningitis 15%, Cardiovascular accident 7%, Hypoxia 3%) who were evidencing at least mild behaviour problems were randomly assigned to treatment or care-as-usual conditions over 10 weeks. Mixed-model repeated-measures linear regression analyses were conducted to compare conditions from pre- to postintervention on child behavioural and emotional functioning (Eyberg Child Behavior Inventory, Strengths and Difficulties Questionnaire) and dysfunctional parenting style (Parenting Scale). Assessment of maintenance of change was conducted at a 6-month follow-up. The trial was registered on Australian New Zealand Clinical Trials Registry (ID: ACTRN12610001051033, www.anzctr.org.au). RESULTS Significant time-by-condition interactions were identified on number and intensity of child behaviour problems, child emotional symptoms and parenting laxness and overreactivity, indicating significant improvements in the treatment condition, with medium-to-large effect sizes. Most improvements were maintained at 6 months. CONCLUSIONS Group parenting interventions incorporating Triple P and ACT may be efficacious in improving child and parenting outcomes following paediatric ABI.
Collapse
Affiliation(s)
- Felicity L Brown
- Faculty of Health and Behavioural Sciences, The School of Psychology, The University of Queensland, Brisbane, Queensland, Australia; Faculty of Medicine and Biomedical Sciences, Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia; Faculty of Medicine and Biomedical Sciences, Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | | | | | | | | |
Collapse
|
46
|
Choi K, Vickers K, Tassone A. Trait Emotional Intelligence, Anxiety Sensitivity, and Experiential Avoidance in Stress Reactivity and Their Improvement Through Psychological Methods. EUROPES JOURNAL OF PSYCHOLOGY 2014. [DOI: 10.5964/ejop.v10i2.754] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Stress pervades daily society, often with deleterious consequences for those prone to react intensely to it. Intervention techniques to attenuate stress reactivity are thus paramount. With that goal in mind, researchers have sought to identify and alter malleable psychological dispositional variables that influence stress reactivity. Trait emotional intelligence (TEI), anxiety sensitivity (AS), and experiential avoidance (EA) are increasingly receiving attention in these research efforts. The self-reported emotional component of stress reactivity has been emphasized in investigations and is our focus. Specifically, this paper overviews the role of TEI, AS, and EA in self-reported stress responses. We also discuss empirically supported psychological methods to adjust suboptimal levels of these variables in normal populations. Both psycho-educational (information, skills) and mindfulness-based interventions (specific mindfulness therapies or components) are covered. Findings include that (1) TEI, AS, and EA are each correlated with the emotional component of stress reactivity to both naturalistic and lab-based stressors; (2) preliminary support currently exists for psycho-educational intervention of TEI and AS but is lacking for EA; (3) adequate evidence supports mindfulness-based interventions to target EA, with very limited but encouraging findings suggesting mindfulness methods improve TEI and AS; and (4) although more research is needed, stress management approaches based on mindfulness may well target all three of these psychological variables and thus appear particularly promising. Encouragingly, some methods to modify dispositional variables (e.g., a mindfulness-based format of guided self-help) are easily disseminated and potentially applicable to the general public.
Collapse
|
47
|
Abstract
Many parents who have children suffering from some form of chronic illness or mental disorder may experience chronic stress reactions of various types. Cognitive behavioral therapy (CBT) has been proved to be effective in reducing stress-related problems, but there seems to be no study to date in which CBT has been tested on this specific parent group. Two case studies were therefore performed. Case 1 centered on a 47-year-old married woman, who has lived in Sweden for 12 months. She described how she had become increasingly exhausted, and she wanted help to find strategies enabling her to cope with everyday life. Case 2 featured a 45-year-old single mother, who had been on part-time sick leave due to depression and stress. She described how she had always been anxious and worried and had had two episodes of depression. Both women had sons diagnosed with autism/Asperger syndrome. One of the women met the criteria for pathological burnout, while the other woman was just below the limit. The focus of the therapy for both women was on exhaustion, depression, and sleeping difficulties. In addition, therapy in Case 1 involved under-stimulation and in Case 2, anxiety. When the therapy ended, genuine improvements were registered for both clients. The results show that CBT can be an effective treatment of symptoms for this group of parents so that they can provide adequate support to their children, thus facilitating everyday life for a child with a chronic illness or disorder.
Collapse
|
48
|
Brown FL, Whittingham K, Sofronoff K, Boyd RN. Parenting a child with a traumatic brain injury: Experiences of parents and health professionals. Brain Inj 2013; 27:1570-82. [DOI: 10.3109/02699052.2013.841996] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
49
|
Stepping Stones Triple P and Acceptance and Commitment Therapy for Parents of Children with Cerebral Palsy: Trial Protocol. BRAIN IMPAIR 2013. [DOI: 10.1017/brimp.2013.19] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This project aims to optimise outcomes for children with cerebral palsy (CP) and their families by testing the efficacy of two complementary interventions novel to the CP population: (1) parenting intervention (Stepping Stones Triple P, SSTP); and (2) parental stress management (Acceptance and Commitment Therapy, ACT) tailored for parents of children with CP. The efficacy of SSTP and the additional effects of ACT will be tested in a wait-list randomised controlled trial, with parents of children with CP (N= 110) randomised into three groups; SSTP, SSTP + ACT and wait-list control. Intervention delivery will combine group sessions with phone consultations. Outcomes will be assessed post-intervention with retention of effect examined at 6-month follow-up. Child outcomes will include: externalising behaviour (primary child outcome), functional performance, parent-reported child quality of life; and parent outcomes will include: dysfunctional parenting (primary parent outcome), parental confidence in performing disability-related parenting practices, degree of problems in performing disability-related parenting practices, parental adjustment, psychological flexibility and parental attitude to child emotions. The theoretical background, study design and study procedures are discussed. The validation of a parenting intervention and a parenting stress intervention for parents of children with CP is crucial to better support parents of children with CP in their parenting role and in providing evidence-based intervention for behavioural and emotional problems in children with CP.
Collapse
|