1
|
Shahali S, Tavousi M, Sadighi J, Kermani RM, Rostami R. Health challenges faced by parents of children with disabilities: a scoping review. BMC Pediatr 2024; 24:619. [PMID: 39343886 PMCID: PMC11440903 DOI: 10.1186/s12887-024-05104-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 09/24/2024] [Indexed: 10/01/2024] Open
Abstract
BACKGROUND Parenting a child with disabilities can feel isolating and overwhelming. Understanding the health challenges of parents with disabled children is essential for providing effective healthcare. This study aims to offer a comprehensive view of the health challenges faced by these parents by synthesizing existing literature from various perspectives. METHOD This scoping review conducted using the JBI scoping review method. Searches were performed on PubMed, Web of Science, Scopus, and Google Scholar databases spanning from 2014 to 2024. The initial search yielded 388 articles, with 24 articles undergoing qualitative assessment and data analysis via narrative synthesis. RESULTS From the 24 selected articles, three health challenges were identified: physical, emotional, and social health challenges. CONCLUSION Parents of children with disabilities face intricate health challenges, including physical challenges like fatigue, musculoskeletal pain, and sleep issues. Additionally, they experience significant emotional strain, with symptoms of depression, anxiety, and hopelessness. Social isolation and stigma further compound these challenges. A collaborative approach involving healthcare professionals, policymakers, and support organizations can empower parents to thrive in their caregiving roles.
Collapse
Affiliation(s)
- Shadab Shahali
- Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Mahmoud Tavousi
- Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Jila Sadighi
- Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Ramin Mozafari Kermani
- Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Rahele Rostami
- Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| |
Collapse
|
2
|
De Bruyne E, Eloot S, Willem L, Van Hoeck K, Walle JV, Raes A, Van Biesen W, Goubert L, Van Hoecke E, Snauwaert E. Mental health and professional outcomes in parents of children with chronic kidney disease. Pediatr Nephrol 2024; 39:2741-2752. [PMID: 38653885 DOI: 10.1007/s00467-024-06372-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/08/2024] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND This study evaluated parenting stress, anxiety, and depression symptoms and their associated factors in parents of children with chronic kidney disease (CKD). METHODS This cross-sectional study compared parents of patients with CKD (0-18 years) with a matched control group of parents of healthy children. Both groups completed the Parenting Stress Index - Short Form, the Hospital Anxiety and Depression Scale, and a sociodemographic questionnaire. RESULTS The study group consisted of 45 parents (median age 39; 32 mothers) of CKD patients (median age 8; 36% female). Nearly 75% of children had CKD stages 2, 3, or 4, and 44.5% had congenital anomaly of the kidney and urinary tract. Five children (11%) were on dialysis, and 4 (9%) had a functioning kidney graft. Compared with parents of healthy children, more stress and anxiety symptoms were reported. Since the CKD diagnosis, 47% of parents perceived a deterioration of their own health, and 40% reduced work on a structural basis. Higher levels of stress, anxiety, and depression symptoms were associated with a more negative perception of own health, and more child medical comorbidities and school absence. CONCLUSIONS This study showed higher levels of parenting stress and anxiety symptoms in parents of children with CKD compared with parents of healthy children. This was associated with a less positive perception of their own health, especially if the child had more medical comorbidities or more absence from school. Psychosocial interventions to reduce the parental burden should be integrated in the standard care of pediatric nephrology departments.
Collapse
Affiliation(s)
- Elke De Bruyne
- Pediatric Psychology, Department of Pediatrics, Ghent University Hospital, Ghent, Belgium.
| | - Sunny Eloot
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
| | - Lore Willem
- Department of Child Nephrology and Organ Transplantation, Leuven University Hospital, Louvain, Belgium
| | - Koen Van Hoeck
- Department of Pediatric Nephrology, Antwerp University Hospital, Edegem, Belgium
| | - Johan Vande Walle
- Department of Pediatric Nephrology & Rheumatology, Ghent University Hospital, Ghent, Belgium
| | - Ann Raes
- Department of Pediatric Nephrology & Rheumatology, Ghent University Hospital, Ghent, Belgium
| | - Wim Van Biesen
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Eline Van Hoecke
- Pediatric Psychology, Department of Pediatrics, Ghent University Hospital, Ghent, Belgium
| | | |
Collapse
|
3
|
Ryan H, Burgess A, Jackson C, Hewson-Ravenscroft A, Meiser-Stedman R. High prevalence of depression in parents of children with Type 1 diabetes in a meta-analysis of data from five continents. Acta Paediatr 2024; 113:1145-1155. [PMID: 38140731 DOI: 10.1111/apa.17059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 11/30/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023]
Abstract
AIM This meta-analysis identified the prevalence of depression in parents of children with Type 1 diabetes. METHODS MEDLINE, PsycINFO and CINAHL databases were searched for papers published in English from 1980 to May 2022, yielding 18 studies (N = 2044 participants). The prevalence of parental depression was pooled across the studies. RESULTS The prevalence of depression among parents of children with Type 1 diabetes was high. Random-effects meta-analyses estimated the prevalence of moderate depression and above in the total sample as 18.4% (95% CI 12.8-24.6; k = 17, N = 2044), with rates of 17.3% in mothers (95% CI 12.7-22.5; k = 12, N = 1106) and 9% in fathers (95% CI 4.3-15.1; k = 6, N = 199). The estimated prevalence of mild depression and above in the total sample was 32.7% (95% CI 20.3-46.6; k = 8, N = 797), with rates of 29.4% in mothers (95% CI 17.8-42.6; k = 4 N = 330) and 13.6% in fathers (95% CI 5.2-25.2; k = 2 N = 44). All results were characterised by high levels of heterogeneity. The risk of publication bias was low. CONCLUSION More than 1 in 6 parents of children with Type 1 diabetes had depression in the moderate plus category. The limitations and implications of these results are discussed.
Collapse
Affiliation(s)
- Hayley Ryan
- Central Norfolk Stroke Services, Norwich Community Health and Care NHS Trust, Norwich Community Hospital, Norwich, Norfolk, UK
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
| | - Aaron Burgess
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
| | - Clare Jackson
- Department of Psychological Medicine, Cambridgeshire and Peterborough Foundation Trust, Cambridge, UK
- Addenbrookes Hospital, Cambridge, UK
| | - Alyssa Hewson-Ravenscroft
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
| |
Collapse
|
4
|
Bourke-Taylor HM, Leo M, Tirlea L. Health, Wellbeing and Empowerment E-workshops for Mothers of Children with Disabilities: A Non-randomised Comparison Study. J Autism Dev Disord 2024:10.1007/s10803-024-06287-5. [PMID: 38520587 DOI: 10.1007/s10803-024-06287-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2024] [Indexed: 03/25/2024]
Abstract
Mothers of children with disabilities can experience compromised health. Targeted interventions require investigation to determine effectiveness. Healthy Mothers Healthy Families (HMHF) is a health, wellbeing and empowerment program that addresses mothers need to protect, and or, recover their own health due to caregiving impacts. This study compared the effectiveness of HMHF e-workshops online compared to no intervention. The HMHF e-workshops were delivered to 290 mothers across the 2020-2022 Covid-19 pandemic and 172 participated in research. The HMHF e-workshops included 3 online 2- hour workshops facilitated by credentialled peer-facilitators, closed online group chat, e-workbook and online learning package. Participants in both groups completed surveys pre and post the workshops (or control) over 8-10 weeks. Mothers who participated in HMHF significantly increased health help seeking behaviours (p < .001), and improved mental health and health behaviors over time: health behavior (p < .001), positive wellbeing (p < .004) and depression (p < .001) and stress symptoms (p = .005). Compared to controls, HMHF e-workshop participants significantly improved health behaviours (p < .001) and self-reported symptoms of depression (p = .002) and stress (p = .005) over 8-10 weeks. E-workshops were accessible and effective for mothers of children with high care needs and family responsibilities across the COVID-19 pandemic. Compared to no intervention, the HMHF intervention was more effective for improving healthy behaviours and mental health.
Collapse
Affiliation(s)
- Helen M Bourke-Taylor
- Occupational Therapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Sciences, Monash University, Peninsula Campus, Building G, Level 4, McMahons Road, Frankston, VIC, 3199, Australia.
| | - Monica Leo
- Occupational Therapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Sciences, Monash University, Peninsula Campus, Building G, Level 4, McMahons Road, Frankston, VIC, 3199, Australia
| | - Loredana Tirlea
- Faculty of Health, Arts, and Design, Swinburne University of Technology, PO Box 218, Hawthorn, 3122, Australia
| |
Collapse
|
5
|
Ku B, Ghim S. Poor Physical Health in Caregivers of Children with ADHD or ASD and its Association with Health Risk Behaviours: NHIS 2016-2018. Int J Behav Med 2024:10.1007/s12529-023-10253-3. [PMID: 38172453 DOI: 10.1007/s12529-023-10253-3] [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: 12/20/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND There is a dearth of evidence regarding physical health problems and health risk behaviours (e.g., drinking, physical inactivity, smoking, and suboptimal sleep behaviour) in caregivers of children with attention deficit hyperactivity disorder or autism spectrum disorder (CCAA). The purposes of the current study were to examine differences in physical health problems between CCAA and caregivers of children without attention deficit hyperactivity disorder and autism spectrum disorder (CCWAA) and to explore health risk behaviours associated with those problems. METHOD Data from the 2016-2018 National Health Interview Survey were used in the current study. 10 common physical health problems were compared between CCAA and CCWAA by using multivariable logistic regressions. In addition, in order to detect associated health risk behaviours, decision tree analysis was performed for physical health problems in CCAA. RESULTS Of the 10 physical health problems, caregivers of children with ADHD showed significantly higher likelihood of experiencing nine (arthritis, asthma, back pain, high cholesterol, diabetes, heart problems, hypertension, neck pain, obesity), compared to CCWAA. Caregivers of children with autism spectrum disorder (ASD) showed significantly higher likelihoods of experiencing two physical health problems compared to CCWAA. The decision tree analysis revealed that age (> 42 years), and suboptimal sleep behaviour (not 7-8 hours), and smoking (current smoker) were the frequent predictors for physical health problems in CCAA. CONCLUSION The results of the current study represent an important milestone in further investigating physical health problems in CCAA.
Collapse
Affiliation(s)
- Byungmo Ku
- Department of Special Physical Education, Sports Sciecne Buliding 8405, 134 Yongindaehak-ro, Samga-dong, Cheoin-gu, Yongin-si, Gyeonggi-do, South Korea
| | - Seungbeen Ghim
- Health Management and Policy, College of Health, Oregon State University, 97333, Corvallis, OR, USA.
| |
Collapse
|
6
|
Bezgin S, Özkaya Y, Akbaş Y, Elbasan B. An investigation of computer-game addiction, physical activity level, quality of life and sleep of children with a sibling with a chronic condition. Child Care Health Dev 2024; 50:e13228. [PMID: 38265131 DOI: 10.1111/cch.13228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 11/28/2023] [Accepted: 12/24/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND It is known that chronic condition also affects siblings without chronic illness. Healthy siblings of children with a chronic condition and aged 9-14 years and healthy children with a sibling without chronic illness and their parents were included in the study. AIM The aim of our study was to examine the internet-game addiction, physical activity, quality of life and sleep in children with a sibling with chronic condition and compare them with their peers with a healthy sibling. METHODS Computer game addiction, physical activity, sleep quality and quality of life were evaluated respectively by Computer Game Addiction Scale for Children, Child Physical Activity Questionnaire, Children's Sleep Disorder Scale and Children's Quality of Life Scale. RESULTS While the mean age of 75 children with chronically ill siblings was 10.65 ± 1.59 years, the mean age of 75 healthy children with healthy siblings was 10.46 ± 2.09 years. It was observed that children with a sibling with a chronic condition were more tend to computer-game addiction, had lower sleep quality, lower quality of life in terms of school functionality and psychosocial health compared to children with a healthy sibling (p < 0.05). CONCLUSIONS It was revealed that in families with children with a chronic condition, siblings with no health problems should also be evaluated in psychosocial terms and supported by appropriate approaches, such as to increase the level of physical activity.
Collapse
Affiliation(s)
- Sabiha Bezgin
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hatay Mustafa Kemal University, Antakya, Hatay, Turkey
| | - Yunus Özkaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hatay Mustafa Kemal University, Antakya, Hatay, Turkey
| | - Yılmaz Akbaş
- Faculty of Medicine, Department of Child Neurology, Hatay Mustafa Kemal University, Antakya, Hatay, Turkey
| | - Bülent Elbasan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| |
Collapse
|
7
|
Bixby LE. Disability Is Not a Burden: The Relationship between Early Childhood Disability and Maternal Health Depends on Family Socioeconomic Status. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2023; 64:354-369. [PMID: 37097010 PMCID: PMC10486143 DOI: 10.1177/00221465231167560] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Narratives rooted in ableism portray disabled children as burdens on their families. Prior research highlights health disparities between mothers of disabled children and mothers of nondisabled children, but little is known about how socio-structural contexts shape these inequities. Using longitudinal data from the Future of Families and Child Wellbeing Study (n = 2,338), this study assesses whether the relationship between early childhood disability and maternal health varies by household socioeconomic status (SES). Findings reveal that, on average, mothers of children disabled by age five report worse health than mothers of nondisabled children; however, this pattern is only evident among lower SES mothers and disappears for higher SES mothers. Contextualizing the findings within the systemic ableism literature highlights how-instead of portraying disabled children as burdens on their families-scholars and policymakers should focus on how ableism and poverty burden disabled people and their families in ways that pattern health risks.
Collapse
|
8
|
Goscicki BL, Goldman SE, Burke MM, Hodapp RM. Applicants to a Special Education Advocacy Training Program: "Insiders" in the Disability Advocacy World. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 61:110-123. [PMID: 36996281 DOI: 10.1352/1934-9556-61.2.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/17/2022] [Indexed: 05/16/2023]
Abstract
Although social groups have "insiders," this construct has not been measured within the disability advocacy community. Examining 405 individuals who applied for an advocacy training program, this study examined the nature of insiderness within the disability advocacy community and ties to individual roles. Participants showed differences in mean ratings across 10 insider items. A principal components analysis revealed two distinct factors: Organizational Involvement and Social Connectedness. Non-school providers scored highest on Organizational Involvement; family members/self-advocates highest on Social Connectedness. Themes from open-ended responses supported the factors and showed differences in motivation and information sources across insiderness levels and roles. Qualitative analysis revealed two additional aspects of insiderness not addressed in the scale. Implications are discussed for future practice and research.
Collapse
Affiliation(s)
| | | | - Meghan M Burke
- Meghan M. Burke, University of Illinois, Urbana-Champaign
| | | |
Collapse
|
9
|
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
|
10
|
Yamaoka Y, Doi S, Isumi A, Fujiwara T. Health and social relationships of mothers of children in special education schools. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 131:104374. [PMID: 36395685 DOI: 10.1016/j.ridd.2022.104374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 10/28/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND AIMS The number of children in special education schools has increased in Japan. This study aimed to examine the association between special education school enrollment and the health and social relationships of mothers with children in these schools using population-based samples in Japan. METHODS AND PROCEDURES This study used data from the Kochi Child Health Impact of Living Difficulty (K-CHILD) study in 2016. First, fifth, eighth, and eleventh-grade children in all schools in Kochi prefecture were included (n = 12,623). Associations between school type (regular or special education school) and maternal physical and mental health and social relationships were investigated by multivariate regression models. OUTCOMES AND RESULTS There were 134 children in special education schools (1.1 %) and 12,489 children in regular schools. Mothers of children in special education schools were more likely to have higher body mass index (BMI), poorer mental health and lower neighborhood relations score. Mothers of children in regular schools had higher BMI when their children had higher behavioral problems. CONCLUSION AND IMPLICATIONS Mothers of children in special education schools are at risk of obesity, poor mental health, and having fewer social networks. Services and support should be expanded for caregivers based on their child's behavioral problems and school system.
Collapse
Affiliation(s)
- Yui Yamaoka
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Satomi Doi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan; Japan Society for the Promotion of Science, Tokyo, Japan
| | - Aya Isumi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan; Japan Society for the Promotion of Science, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan.
| |
Collapse
|
11
|
Ríos M, Zekri S, Alonso-Esteban Y, Navarro-Pardo E. Parental Stress Assessment with the Parenting Stress Index (PSI): A Systematic Review of Its Psychometric Properties. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1649. [PMID: 36360377 PMCID: PMC9688973 DOI: 10.3390/children9111649] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/20/2022] [Accepted: 10/26/2022] [Indexed: 11/26/2023]
Abstract
UNLABELLED Parental stress is a construct related to people's perception of difficulties and feelings of not being able to cope with the demands of parenting. This construct is often experienced as a negative or aversive response to parental obligations, and the available evidence also suggests that excessive parenting stress reduces the use of positive parenting behaviors and are related to dysfunctional parenting. Different instruments exist to assess parental stress. This article is part of a project to translate and adapt the Parenting Stress Index (PSI), fourth edition, in its two forms (full and short). The aim of this research is to identify the psychometric indicators obtained by this instrument and to review the evidence they can provide. METHOD Following the PRISMA guide (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), the studies related to the PSI were identified in different databases (ERIC, PsycArticles, PubMed, Scopus and Web of Science). RESULTS The screening process resulted in 16 articles; four have analyzed the psychometric properties of the PSI-4 and the rest have studied the PSI-3. Although version 4 was published in 2012, the studies are scarce. However, they follow the line noted in the previous short version, a high internal consistency and a factor structure of three factors. CONCLUSIONS The difficulties of working with a measurement instrument with 101 items means that the full version of the PSI has been little studied, except in translation and linguistic adaptation studies.
Collapse
Affiliation(s)
- Mercedes Ríos
- Centro de Estudios Marni (Servicio de Orientación), 46019 Valencia, Spain
| | - Sara Zekri
- Department of Developmental and Educational Psychology, Universitat de Valencia, 46010 Valencia, Spain
| | - Yurena Alonso-Esteban
- Department of Psychology and Sociology, University of Zaragoza Campus Teruel, 44003 Teruel, Spain
| | - Esperanza Navarro-Pardo
- Department of Developmental and Educational Psychology, Universitat de Valencia, 46010 Valencia, Spain
| |
Collapse
|
12
|
Lobato D, Montesinos F, Polín E, Cáliz S. Acceptance and Commitment Training Focused on Psychological Flexibility for Family Members of Children with Intellectual Disabilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13943. [PMID: 36360823 PMCID: PMC9653654 DOI: 10.3390/ijerph192113943] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
The objective of the study was to analyse the effect of a psychological flexibility intervention programme based on Acceptance and Commitment Therapy (ACT) on 36 family members of children with intellectual disabilities. The 6-PAQ (parental psychological flexibility), PSS-14 (perceived stress), GHQ-12 (psychological health), and WBSI (suppression of unwanted thoughts) were used as measurement instruments before the programme (pre), after (post), and at follow-up (after two months). Possible change in family interactions due to the family intervention was also assessed through self-monitoring. A decrease in psychological inflexibility, a reduction in stress, an improvement in psychological well-being, and a reduction in the tendency to suppress thoughts and emotions were observed after the programme. Furthermore, the effects seem to extend to family interactions, with an increase in positive interactions and a decrease in negative ones. The study leads us to think about the importance of psychological flexibility in children with chronic conditions as a process that mediates the impact of stress and family well-being.
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
|
13
|
Panczykowski H, Murphy L, Heyward K, Hupp T. Lived experiences of parents of children with disabilities engaged in a support group incorporating equines. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 128:104294. [PMID: 35780709 DOI: 10.1016/j.ridd.2022.104294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 06/15/2022] [Accepted: 06/21/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Parenting a child with disabilities comes with significant challenges to parental quality of life, often resulting in decreased physical, mental, and social health when compared to parents who raise typically developing children. AIMS To address the needs of this population a 10-week interdisciplinary support group, based in attachment theory and incorporating equines, was developed called Taking the Reins of Self-care. METHODS AND PROCEDURES Designed to utilize the human-equine bond, the support group facilitated development of self-care strategies to increase quality of life of 6 parents of children with disabilities in the United States OUTCOMES AND RESULTS: Qualitative phenomenological analysis of field notes and parent interviews revealed the following themes: confirming the horse as an emotional confidant, creating a safe haven, re-affirming identity, nourishing the emotional self, and meeting the challenge. CONCLUSIONS AND IMPLICATIONS Analysis of Taking the Reins of Self-care substantiates the value of complimentary therapeutic approaches, attachment theory and the human-equine bond, and supports further investigation of the benefits of specialized parental support groups to enrich the experience of raising a child with disabilities.
Collapse
|
14
|
Azzopardi C, Cohen E, Pépin K, Netten K, Birken C, Madigan S. Child Welfare System Involvement Among Children With Medical Complexity. CHILD MALTREATMENT 2022; 27:257-266. [PMID: 34219484 PMCID: PMC9003756 DOI: 10.1177/10775595211029713] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Children with medical complexity may be at elevated risk of experiencing child maltreatment and child welfare system involvement, though empirical data are limited. This study examined the extent of child welfare system involvement among children with medical complexity and investigated associated health and social factors. A retrospective chart review of children with medical complexity (N = 208) followed at a pediatric hospital-based complex care program in Canada was conducted. Descriptive statistics and odds ratios using logistic regression were computed. Results showed that nearly one-quarter (23.6%) had documented contact with the child welfare system, most commonly for neglect; of those, more than one-third (38.8%) were placed in care. Caregiver reported history of mental health problems (aOR = 3.19, 95%CI = 1.55-6.56), chronic medical conditions (aOR = 2.86, 95%CI = 1.09-7.47), and interpersonal violence or trauma (aOR = 17.58, 95%CI = 5.43-56.98) were associated with increased likelihood of child welfare system involvement, while caregiver married/common-law relationship status (aOR = 0.35, 95%CI = 0.16-0.74) and higher number of medical technology supports (aOR = 0.75, 95%CI = 0.57-0.99) were associated with decreased likelihood. Implications for intervention and prevention of maltreatment in children with high healthcare needs are discussed.
Collapse
Affiliation(s)
- Corry Azzopardi
- Suspected Child Abuse and Neglect Program, Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Eyal Cohen
- Child Health Evaluative Sciences, The Hospital for Sick Children, Department of Paediatrics and Institute of Health Policy, Management & Evaluation, Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Ontario, Canada
| | - Karine Pépin
- Department of Paediatric, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Quebec, Canada
| | - Kathy Netten
- Department of Social Work, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Catherine Birken
- Department of Paediatrics, University of Toronto, Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| |
Collapse
|
15
|
Easler JK, Taylor TM, Roper SO, Yorgason JB, Harper JM. Uplifts, Respite, Stress, and Marital Quality for Parents Raising Children With Down Syndrome or Autism. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 60:145-162. [PMID: 35297988 DOI: 10.1352/1934-9556-60.2.145] [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: 07/02/2020] [Accepted: 08/23/2021] [Indexed: 06/14/2023]
Abstract
Direct, indirect, and partner effects estimated among uplifts, respite care, stress, and marital quality across mothers and fathers of children with autism spectrum disorder (n = 102) and Down syndrome (n = 111) were examined in this cross-sectional study. Parents of children with ASD who reported more uplifts and less stress individually reported better marital quality; these wives reported better marital quality as their husbands reported more uplifts and less stress. Wives with children with DS who reported more uplifts, individually along with their husbands reported less stress and better marital quality. Respite was directly associated with marital quality for parents of children with ASD and indirectly associated with marital quality for parents of children with DS with reduced individual stress. Implications are discussed.
Collapse
Affiliation(s)
- Jamie K Easler
- Jamie K. Easler, Tina M. Taylor, Susanne Olsen Roper, Jeremy B. Yorgason, and JamesM. Harper, Brigham Young University
| | - Tina M Taylor
- Jamie K. Easler, Tina M. Taylor, Susanne Olsen Roper, Jeremy B. Yorgason, and JamesM. Harper, Brigham Young University
| | - Susanne Olsen Roper
- Jamie K. Easler, Tina M. Taylor, Susanne Olsen Roper, Jeremy B. Yorgason, and JamesM. Harper, Brigham Young University
| | - Jeremy B Yorgason
- Jamie K. Easler, Tina M. Taylor, Susanne Olsen Roper, Jeremy B. Yorgason, and JamesM. Harper, Brigham Young University
| | - James M Harper
- Jamie K. Easler, Tina M. Taylor, Susanne Olsen Roper, Jeremy B. Yorgason, and JamesM. Harper, Brigham Young University
| |
Collapse
|
16
|
Ghim S, Ku B. The prevalence of health problems and their association with physical activity in caregivers of children with disabilities: 2018 National Health Interview Survey. Child Care Health Dev 2022; 48:347-357. [PMID: 34850443 DOI: 10.1111/cch.12934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 10/22/2021] [Accepted: 11/22/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Caregivers of children with disabilities often experience poor health. One way for caregivers to promote their own health may be to participate in physical activity (PA). AIMS The purpose of this study was to examine the association between PA and psychological and physical health problems in caregivers of children with disabilities. METHODS The 2018 National Health Interview Survey (NHIS) data were used, and 890 household representatives were identified as caregivers of children with disabilities. Based on the national PA guidelines, caregivers were classified into three groups: inactive (IA), aerobically active (AA), and aerobically and muscularly active (AMA). RESULTS Multivariable logistic regression indicated that the AMA group had a lower likelihood of reporting depression compared to the IA group (OR: 0.73 [95% confidence interval: 0.54, 0.98]). The AMA group also had a lower likelihood of reporting back pain and obesity compared to the IA group (OR:0.69 [95% confidence interval: 0.56, 0.84] and OR:0.63 [95% confidence interval: 0.52, 0.76], respectively). CONCLUSIONS The results of the current study suggest that caregivers of children with disabilities may benefit from PA, especially from the combination of aerobic and muscle-strengthening PA.
Collapse
Affiliation(s)
- Seungbeen Ghim
- Health Management and Policy, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Byungmo Ku
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore, Singapore
| |
Collapse
|
17
|
Hartman AG, McKendry S, Bendixen R. Comparing contributors of parental sleep health in families with and without a child with Duchenne muscular dystrophy. Sleep Health 2021; 8:107-113. [PMID: 34924347 DOI: 10.1016/j.sleh.2021.11.003] [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] [Received: 12/28/2020] [Revised: 10/29/2021] [Accepted: 11/04/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The sleep health of caregivers of children with Duchenne muscular dystrophy (DMD) is often overlooked in clinical practice and research. This study characterizes the sleep health of caregivers of children with DMD (4-17 years) compared to parents of age-matched, unaffected children. We explore potential contributors to parental sleep efficiency and hypothesize that child awakenings will have a considerable influence on parental sleep efficiency. METHODS In this observational study, parents and their children were asked to wear the ActiGraph GT9X Link at night for 1 month. From these data, actigraphy variables (eg, percent sleep efficiency, nocturnal awakenings) were calculated and averaged for parents and children. We also used the Pittsburgh Sleep Quality Index (PSQI) to measure subjective sleep quality. MAIN FINDINGS Parents in the DMD group (n = 25, M = 84.5%) had significantly worse sleep efficiency compared to controls (n = 15, M = 87.8%, p = .048). This difference was sustained after controlling for parent age, child age, and average child awakenings (F(4, 23) = 2.68, p= .057, R2 = .32). Additionally, more parents in the DMD group scored as "poor sleepers" on the PSQI (above 5, 50%) compared to controls (23%), suggesting a strong, yet not statistically significant association between subjective poor sleep and group (χ2(1) = 2.47, p = .116, OR = 3.33). CONCLUSION Parents of children with DMD exhibit both objective and subjective differences suggesting their sleep is impaired. Interestingly, these sleep concerns are not significantly explained by child awakenings as hypothesized. Future research is needed to fully understand the prevalence and cause of poor sleep in a larger group of DMD caregivers as well as direct care for caregivers of children with disabilities.
Collapse
Affiliation(s)
- Amy G Hartman
- Department of Occupational Therapy, The University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
| | - Sarah McKendry
- Department of Occupational Therapy, The University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Roxanna Bendixen
- Department of Occupational Therapy, The University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
18
|
Özkan RS, Numanoğlu-Akbaş A. Physical activity and exercise benefits/barriers in mothers of children with motor disabilities. Ir J Med Sci 2021; 191:2147-2154. [PMID: 34822022 PMCID: PMC8613461 DOI: 10.1007/s11845-021-02800-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 09/30/2021] [Indexed: 12/04/2022]
Abstract
Background Mothers of children with motor disabilities face physical and emotional burdens. Aims This study aimed to determine the physical activity levels, exercise-related barriers, and facilitators in mothers of children with motor disabilities and investigate the differences between the physical activity levels of mothers who have children with different motor functional status. Methods In this cross-sectional study, mothers were assessed with the Exercise Benefits/Barriers Scale (EBBS) and International Physical Activity Questionnaire short form (IPAQ-SF). The motor functional status of the children was classified by Gross Motor Function Classification System (GMFCS), and the mothers were divided into two groups (GMFCS level I, II = mild motor disability n = 28, GMFCS level III–V = moderate-to-severe motor disability, n = 37) according to the motor level of their children. Results Sixty-nine mothers (36.56 ± 7.25 65) were included in this study. None of the mothers had adequate levels of physical activity (0%). According to the EBBS, the most frequently reported exercise barrier was lack of time (mothers of children with mild motor disability n = 26, 92.85%, the mothers of children with moderate-to-severe motor disability n = 34, 91.89%). The physical activity levels of the mothers of children with mild motor disability were higher compared to the mothers of children with moderate-to-severe motor disability (p = 0.032). Conclusion This study has revealed that the physical activity levels of mothers of children with motor disabilities are low, and this is related to the gross motor function level of the children. The focus should be on increasing the physical activity levels of mothers of children with motor disabilities.
Collapse
Affiliation(s)
- Rabia Seva Özkan
- Physical Therapy and Rehabilitation Unit, Sivas Numune Hospital, 58140, Sivas, Turkey.
| | - Ayşe Numanoğlu-Akbaş
- Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Sivas Cumhuriyet University, 58140, Sivas, Turkey
| |
Collapse
|
19
|
Bourke-Taylor HM, Joyce KS, Morgan P, Reddihough DS, Tirlea L. Maternal and child factors associated with the health-promoting behaviours of mothers of children with a developmental disability. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 118:104069. [PMID: 34438196 DOI: 10.1016/j.ridd.2021.104069] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 08/08/2021] [Accepted: 08/15/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND/AIM Mothers caring for their child or adult with a developmental disability can experience mental health disparity. Protective factors such as healthy behaviours are under-researched. This study investigated relationships between mental health, healthy behaviours, and disability factors. METHODS The cross-sectional online survey included: Depression Anxiety Stress Scales (DASS); Family Empowerment Scale (FES); Health Promoting Activities Scale (HPAS); and a measure of childhood quality of life (QoL). RESULTS All mothers were raising offspring (aged 3-36 years) with a developmental disability. Fifty-two percent of mothers (N = 81) had a mental health diagnosis. DASS scores were elevated for depression (58 %), anxiety (52 %) and stress (68 %). Mothers participated in health promoting activities infrequently and reported low satisfaction with community health-supporting facilities. Depressive symptoms, maternal empowerment and two indicators of child-related QoL explained 29.7 % of the variance in healthy behaviours. Depressive symptoms were the most important predictor of lack of health promoting behaviours. CONCLUSIONS Better mental health predicted more frequent participation in health promoting behaviour. Future research might explore the extent to which health promoting behaviours protect mental health. Service changes including family health focused services, and custom designed health promotion or coaching programs may improve the health behaviours of mothers with high care responsibilities.
Collapse
Affiliation(s)
- Helen M Bourke-Taylor
- Occupational Therapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Sciences, Monash University, Peninsula Campus, Building G, Level 4, McMahons Road, Frankston, VIC 3199, Australia.
| | - Kahli S Joyce
- Occupational Therapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Sciences, Monash University, Peninsula Campus, Building G, Level 4, McMahons Road, Frankston, VIC 3199, Australia
| | - Prue Morgan
- Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Sciences, Monash University, Peninsula Campus, Building B, McMahons Road, Frankston, VIC 3199, Australia
| | - Dinah S Reddihough
- Murdoch Children's Research Institute, Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Flemington Road, Parkville, VIC 3052, Australia
| | - Loredana Tirlea
- Faculty of Health, Arts, and Design, Swinburne University of Technology, PO Box 218, Hawthorn, 3122, Australia
| |
Collapse
|
20
|
Bourke-Taylor HM, Grzegorczyn S, Joyce KS. Peer mentor training: Pathway to competency for facilitators of Healthy Mothers Healthy Families workshops. Child Care Health Dev 2021; 47:575-587. [PMID: 33682965 DOI: 10.1111/cch.12865] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 12/22/2020] [Accepted: 02/27/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND Healthy Mothers Healthy Families (HMHF) is a women's health and empowerment programme designed to promote the health and well-being of mothers of children with a disability. An ongoing need to extend the reach of HMHF to more mothers, and increase scalability, resulted in development of a training programme based in principles of adult and transformative learning, to credential mothers as HMHF facilitators. The current study evaluated the process and outcomes of the competency training programme for new facilitators. METHODS A pretest and posttest design with midway data collection point was implemented to evaluate the facilitators' competence following the training programme. Surveys contained specifically designed demographic questions, open-ended questions, self-report of competency and estimation of need for education/training. Fifteen predetermined criteria enabled self-ratings. Training of facilitators occurred alongside delivery of 23-day HMHF workshops. Workshop participants provided anonymous objective evaluation of the facilitators' competencies. Triangulation enabled comparison of self-ratings, workshop participant ratings and author evaluation of new facilitators. RESULTS Facilitators (N = 7) completed all theory and practical elements of the HMHF facilitator education package and were successfully credentialed in May 2020. Overall, facilitators' competency ratings were highest at Time 3, which followed successful co-facilitation of at least three HMHF workshops. As expected, facilitators rated their highest need for education/training at baseline. At Time 3, facilitators self-reported a lower need for education/training for all competency criteria. All facilitators received mean anonymous competency ratings from workshop participants (N = 294), above the predetermined benchmark that was required to become credentialled. CONCLUSIONS The HMHF competency training programme, based on principles of adult and transformative learning, was effective in training seven HMHF facilitators who were mothers and had suitable professional backgrounds to deliver HMHF workshops. Training supports the fidelity of the HMHF intervention. Further research to evaluate maternal outcomes for participants attending the facilitator-lead workshops is warranted.
Collapse
Affiliation(s)
- Helen M Bourke-Taylor
- Occupational Therapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Sciences, Monash University, Peninsula Campus, Frankston, VIC, Australia
| | - Sarah Grzegorczyn
- Occupational Therapy Department, Peninsula Health, Frankston, VIC, Australia
| | - Kahli S Joyce
- Occupational Therapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Sciences, Monash University, Peninsula Campus, Frankston, VIC, Australia
| |
Collapse
|
21
|
Magnacca C, Thomson K, Marcinkiewicz A, Davis S, Steel L, Lunsky Y, Fung K, Vause T, Redquest B. A Telecommunication Model to Teach Facilitator to Deliver Acceptance and Commitment Training. Behav Anal Pract 2021; 15:730-751. [PMID: 34422238 PMCID: PMC8366160 DOI: 10.1007/s40617-021-00628-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2021] [Indexed: 12/01/2022] Open
Abstract
Providing mediator training using a telecommunication format increases access to training by reducing geographical and financial barriers, while maintaining or increasing efficiency. Limited research has implemented this format to train facilitators in acceptance and commitment training (ACT), an empirically supported intervention. The aim of this research was to examine the efficacy of behavioral skills training via telecommunication for training novice facilitators to provide ACT to caregivers of individuals with neurodevelopmental disabilities. This two-part study involved concurrent multiple-baseline designs, each across four participants. Quantitative data on fidelity and confidence were collected at baseline, posttraining, and at 1-month follow-up. The results from this study provide preliminary support for the use of behavioral skills training via telecommunication to train ACT facilitators. Increasing the number of competently trained facilitators will help build capacity to increase access to ACT across geographical regions. Supplementary Information The online version contains supplementary material available at 10.1007/s40617-021-00628-x.
Collapse
Affiliation(s)
- Carly Magnacca
- Department of Applied Disability Studies, Brock University, St. Catharines, ON L2S 3A1 Canada
| | - Kendra Thomson
- Department of Applied Disability Studies, Brock University, St. Catharines, ON L2S 3A1 Canada.,Azrieli Adult Neuordevelopmental Centre (Centre for Addiction and Mental Health), Toronto, ON Canada
| | - Amanda Marcinkiewicz
- Azrieli Adult Neuordevelopmental Centre (Centre for Addiction and Mental Health), Toronto, ON Canada.,Department of Child and Youth Studies, Brock University, St. Catharines, ON Canada
| | - Sarah Davis
- Department of Child and Youth Studies, Brock University, St. Catharines, ON Canada
| | - Lee Steel
- Azrieli Adult Neuordevelopmental Centre (Centre for Addiction and Mental Health), Toronto, ON Canada
| | - Yona Lunsky
- Azrieli Adult Neuordevelopmental Centre (Centre for Addiction and Mental Health), Toronto, ON Canada
| | - Kenneth Fung
- Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | - Tricia Vause
- Department of Child and Youth Studies, Brock University, St. Catharines, ON Canada
| | - Brianne Redquest
- Azrieli Adult Neuordevelopmental Centre (Centre for Addiction and Mental Health), Toronto, ON Canada
| |
Collapse
|
22
|
Motyer G, Dooley B, Kiely P, Fitzgerald A. Parents' information needs, treatment concerns, and psychological well-being when their child is diagnosed with adolescent idiopathic scoliosis: A systematic review. PATIENT EDUCATION AND COUNSELING 2021; 104:1347-1355. [PMID: 33280964 DOI: 10.1016/j.pec.2020.11.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 11/06/2020] [Accepted: 11/18/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE We systematically reviewed the experiences of parents who have a child with adolescent idiopathic scoliosis in order to understand their needs and concerns related to their child's healthcare, and assist health professionals in supporting parents of this paediatric patient group. METHODS A systematic search strategy identified eighteen relevant studies published between 2000 and 2020. Quality was assessed using the Mixed Methods Appraisal Tool and the literature was narratively synthesised. RESULTS Three main themes were evident across the literature including information needs, treatment concerns, and psychological well-being. Studies predominantly focused on the surgical treatment of scoliosis. CONCLUSION Parents face challenges such as acquiring appropriate knowledge about scoliosis to participate in healthcare decisions and coping with their child undergoing invasive spinal surgery. Throughout this time, their psychological well-being can be negatively impacted. Considering parents' experiences and support needs throughout this anxiety-provoking time is an important step in delivering family-centered care and promoting better outcomes for paediatric patients. PRACTICE IMPLICATIONS Providing parents with appropriate resources and addressing concerns around surgical complications, postoperative pain, and how they can best support their child before and after surgery, may alleviate some of the emotional burden that parents experience.
Collapse
Affiliation(s)
- Gillian Motyer
- School of Psychology, University College Dublin, Belfield, Dublin, D04V1W8, Ireland.
| | - Barbara Dooley
- School of Psychology, University College Dublin, Belfield, Dublin, D04V1W8, Ireland
| | - Patrick Kiely
- Department of Orthopaedics, Children's Health Ireland at Crumlin, Crumlin, Dublin, D12N512, Ireland
| | - Amanda Fitzgerald
- School of Psychology, University College Dublin, Belfield, Dublin, D04V1W8, Ireland
| |
Collapse
|
23
|
Rydzewska E, Dunn K, Cooper SA, Kinnear D. Mental ill-health in mothers of people with intellectual disabilities compared with mothers of typically developing people: a systematic review and meta-analysis. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:501-534. [PMID: 33738865 DOI: 10.1111/jir.12827] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 12/01/2020] [Accepted: 02/20/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Mothers of people with intellectual disabilities (IDs) face exceptional challenges and may be more prone to experiencing mental ill-health compared with mothers of typically developing people. These mental ill-health problems may differ at different stages of the caregiving trajectory. However, there is no evidence synthesis on this topic. We aimed to systematically review evidence in this area and identify gaps in the existing literature. METHOD Prospero registration: CRD42018088197. Medline, Embase, CINAHL and PsycINFO databases were searched. No time limits were applied. Studies were limited to English language. Inclusion criteria were studies of mothers of people with IDs that also included a comparison group of mothers of typically developing/developed children. Data were extracted from selected studies using a structured database. Study selection and quality appraisal were double rated. Where possible, meta-analyses were performed. RESULTS Of the retrieved articles, 32/3089 were included, of which 10 reported on anxiety, 21 on depression and 23 on other indicators of mental ill-health. Overall, previous studies reported that mothers of people with IDs experienced poorer mental health as compared with mothers of typically developing people. Meta-analyses revealed significant findings for anxiety, depression, parenting stress, emotional burden and common mental disorders, but not for somatic symptoms. However, there was a considerable heterogeneity; hence, interpretation of results should be cautious. Identified gaps included scarce research on mental ill-health of mothers of adults with IDs at different stages of the caregiving trajectory. CONCLUSIONS There is evidence of poorer mental ill-health in mothers of people with IDs compared with mothers of typically developing people, but lack of focus on different stages of the caregiving trajectory, methodological inconsistencies between studies and lack of robust studies pose limitations. This highlights the need both for improved support for mothers of people with IDs and for further methodologically robust research.
Collapse
Affiliation(s)
- E Rydzewska
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - K Dunn
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - S-A Cooper
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - D Kinnear
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| |
Collapse
|
24
|
Wilkinson K, Ball S, Mitchell SB, Ukoumunne OC, O'Mahen HA, Tejerina-Arreal M, Hayes R, Berry V, Petrie I, Ford T. The longitudinal relationship between child emotional disorder and parental mental health in the British Child and Adolescent Mental Health surveys 1999 and 2004. J Affect Disord 2021; 288:58-67. [PMID: 33839559 DOI: 10.1016/j.jad.2021.03.059] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/16/2021] [Accepted: 03/19/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Research suggests parental psychopathology has an adverse effect on child mental health. However, due to the interactional nature of parent-child relationships and with a high rate of emotional disorders reported in school-age children, it is important to know whether the effect is reciprocal. METHODS We explored the longitudinal relationship between child and parent mental health in the British Child and Adolescent Mental Health Surveys (N=7,100 child-parent dyads) and their three-year follow-ups. The Development and Well-Being Assessment with DSM-IV diagnostic criteria was used to measure child psychiatric diagnoses, while parental mental health was assessed using the General Health Questionnaire. Multivariable logistic regression was used to explore the longitudinal association between child emotional disorder and parent mental health. RESULTS Parents of children who had an emotional disorder at baseline were more likely to have poor mental health three years later compared with parents whose children had no psychiatric diagnosis (33.3% versus 16.7%; crude odds ratio=2.52; adjusted odds ratio=2.19, 95% CI=1.58 to 3.05, p<0.001). Children of parents with poor mental health at baseline were more likely to develop an emotional disorder three years later compared with children whose parents had good mental health (5.2% versus 2.5%; crude odds ratio=2.08; adjusted odds ratio=1.63, 95% CI=1.18 to 2.25, p=0.003). LIMITATIONS The findings of this research are limited by the survey data collected, the measures used and survey dropout. CONCLUSIONS We detected a bi-directional relationship between child and parent mental health, suggesting that effective intervention for one individual may benefit other family members.
Collapse
Affiliation(s)
- K Wilkinson
- NIHR ARC South West Peninsula (PenARC), University of Exeter Medical School, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK.
| | - S Ball
- NIHR ARC South West Peninsula (PenARC), University of Exeter Medical School, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - S B Mitchell
- Child Mental Health Group, University of Exeter College of Medicine and Health, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - O C Ukoumunne
- NIHR ARC South West Peninsula (PenARC), University of Exeter Medical School, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - H A O'Mahen
- University of Exeter Mood Disorders Centre, Sir Henry Wellcome Building, Streatham Drive, Exeter, EX4 4QG, UK
| | - M Tejerina-Arreal
- Child Mental Health Group, University of Exeter College of Medicine and Health, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - R Hayes
- Child Mental Health Group, University of Exeter College of Medicine and Health, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - V Berry
- NIHR ARC South West Peninsula (PenARC), University of Exeter Medical School, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - I Petrie
- Child Mental Health Group, University of Exeter College of Medicine and Health, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - T Ford
- Department of Psychiatry, University of Cambridge, Douglas House, 18B Trumpington Road, Cambridge, CB2 2AH, UK
| |
Collapse
|
25
|
Öhman M, Woodford J, von Essen L. Socioeconomic consequences of parenting a child with cancer for fathers and mothers in Sweden: A population-based difference-in-difference study. Int J Cancer 2021; 148:2535-2541. [PMID: 33320976 PMCID: PMC8048859 DOI: 10.1002/ijc.33444] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/09/2020] [Accepted: 12/09/2020] [Indexed: 12/21/2022]
Abstract
Parents are the primary source of support for children with cancer. To inform clinical practice and health policies, the socioeconomic consequences of childhood cancer for fathers and mothers in Sweden were investigated. A total of 3865 mothers and 3865 fathers of 3865 children diagnosed with cancer in Sweden when 0 to 18 years were followed for 5 years before and 10 years after diagnosis. Socioeconomic consequences of the cancer diagnosis on earnings and employment, and mental health (number of inpatient diagnoses), were investigated exploiting variation in timing of cancer diagnosis. Data were obtained from the Swedish Childhood Cancer Registry, Intergenerational Registry and Inpatient Registry. Childhood cancer has a negative short-term effect on fathers' and mothers' earnings; a negative long-term effect on fathers' earnings; a positive long-term effect on mothers' earnings; negative short- and long-term effects on fathers' and mothers' employment; and no effect on the number of inpatient diagnosis of mental and behavioral disorders for fathers or mothers. Taken together, findings show that in Sweden childhood cancer has negative effects on parents' employment, a more negative impact on fathers' than mothers' earnings and no effect on inpatient diagnosis of mental and behavioral disorders. Future research should explore mechanisms possibly explaining, for example, mental health, social support and priorities regarding work and private life potentially resulting in changes from full-time to part-time work or vice versa. The novel findings should change clinical practice and help inform health policies for parents of children with cancer in Sweden and countries with a similar health and welfare system.
Collapse
Affiliation(s)
- Mattias Öhman
- Institute for Housing and Urban Research, Uppsala UniversityUppsalaSweden
- Clinical Psychology in Healthcare, Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Joanne Woodford
- Clinical Psychology in Healthcare, Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Louise von Essen
- Clinical Psychology in Healthcare, Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| |
Collapse
|
26
|
Iacob CI, Avram E, Burtaverde V. Psychometric properties of the Kingston Caregiver Stress Scale in Romanian caregivers of children and adults with disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 112:103921. [PMID: 33676087 DOI: 10.1016/j.ridd.2021.103921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 01/18/2021] [Accepted: 02/24/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The Kingston Caregiver Stress Scale (KCSS) was designed to measure stress in caregivers of people with dementia, but empirical studies have used this instrument to measure stress in caregivers of children and adults with disabilities, without investigating its psychometric properties. AIMS This study analysed the factor structure, reliability, and validity of the KCSS in Romanian caregivers of children and adults with disabilities. METHODS AND PROCEDURES A total of 276 familial caregivers of children and adults with various disabilities completed measures of caregiver stress and related concepts. After 3 months, 72 participants were retested. OUTCOMES AND RESULTS A new bifactorial model with eight items was compared against the originally proposed trifactorial model and a previously proposed bifactorial model with 10 items. The bifactorial eight-item model had the best fit indices (χ2 = 41.4, df = 19, p = .002, CFI = .981, TLI = .971, RMSEA = .065 [90 % CI = .038, .092]), along with good test-retest reliability and convergent, divergent, and predictive validity of anxiety and depression. CONCLUSIONS AND IMPLICATIONS The KCSS is a reliable instrument for assessing caregiver stress among caregivers of children and adults with disabilities. Implications, limitations, and future research suggestions are discussed.
Collapse
Affiliation(s)
| | - Eugen Avram
- Department of Psychology, University of Bucharest, Romania
| | | |
Collapse
|
27
|
Heggestad T, Greve G, Skilbrei B, Elgen I. Complex care pathways for children with multiple referrals demonstrated in a retrospective population-based study. Acta Paediatr 2020; 109:2641-2647. [PMID: 32159873 DOI: 10.1111/apa.15250] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 03/05/2020] [Accepted: 03/09/2020] [Indexed: 11/29/2022]
Abstract
AIM To identify children with complex medical needs by examining their patterns of hospital care. METHODS We conducted a retrospective population-based study on 18 577 patients aged 6-12 years from the Haukeland University Hospital register over a 3-year period (from 2013 to 2015). Data were structured to examine the temporal patterns and sequences of referrals, care episodes and diagnoses, including flow across medical specialties. RESULTS Over a third of patients had repeated referrals, and 14.9% of all had three or more. Furthermore, 9.3% of patients were referred to both somatic and mental healthcare services. Patients with such combined referrals had a higher number of referrals as well as a higher number of different diagnoses. Overall, there was a high frequency of non-specific diagnoses, and 34.8% of patients still had a non-specific main diagnosis at the end of their hospital contact. CONCLUSION This study demonstrates an increased risk for complex care pathways in children with multiple referrals. Interdisciplinary patterns of referrals were relatively common, particularly for patients in mental health care. These findings highlight the importance of developing interdisciplinary-based approaches for patients with complex complaints.
Collapse
Affiliation(s)
- Torhild Heggestad
- Department of Research and Development Haukeland University Hospital Bergen Norway
| | - Gottfried Greve
- Department of Heart Disease Haukeland University Hospital Bergen Norway
- Department of Clinical Science University of Bergen Bergen Norway
| | - Birger Skilbrei
- Department of Research and Development Haukeland University Hospital Bergen Norway
| | - Irene Elgen
- Department of Clinical Medicine University of Bergen Bergen Norway
- Department of Child and Adolescent Psychiatry Division of Mental Health Haukeland University Hospital Bergen Norway
| |
Collapse
|
28
|
Watson SL, Stine F, Tumin D, Stiles KM. Employment and well-being among caregivers of children with autism spectrum disorder. CHILDRENS HEALTH CARE 2020. [DOI: 10.1080/02739615.2020.1810576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Sarah L. Watson
- Department of Sociology, East Carolina University, Greenville, NC, USA
| | - Fritz Stine
- Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC, USA
| | - Dmitry Tumin
- Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC, USA
| | - Karen M. Stiles
- Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC, USA
| |
Collapse
|
29
|
Fuller-Tyszkiewicz M, Richardson B, Little K, Teague S, Hartley-Clark L, Capic T, Khor S, Cummins RA, Olsson CA, Hutchinson D. Efficacy of a Smartphone App Intervention for Reducing Caregiver Stress: Randomized Controlled Trial. JMIR Ment Health 2020; 7:e17541. [PMID: 32706716 PMCID: PMC7414413 DOI: 10.2196/17541] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/30/2020] [Accepted: 05/18/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Caregivers play a pivotal role in maintaining an economically viable health care system, yet they are characterized by low levels of psychological well-being and consistently report unmet needs for psychological support. Mobile app-based (mobile health [mHealth]) interventions present a novel approach to both reducing stress and improving well-being. OBJECTIVE This study aims to evaluate the effectiveness of a self-guided mobile app-based psychological intervention for people providing care to family or friends with a physical or mental disability. METHODS In a randomized, single-blind, controlled trial, 183 caregivers recruited through the web were randomly allocated to either an intervention (n=73) or active control (n=110) condition. The intervention app contained treatment modules combining daily self-monitoring with third-wave (mindfulness-based) cognitive-behavioral therapies, whereas the active control app contained only self-monitoring features. Both programs were completed over a 5-week period. It was hypothesized that intervention app exposure would be associated with decreases in depression, anxiety, and stress, and increases in well-being, self-esteem, optimism, primary and secondary control, and social support. Outcomes were assessed at baseline, postintervention, and 3-4 months postintervention. App quality was also assessed. RESULTS In total, 25% (18/73) of the intervention participants were lost to follow-up at 3 months, and 30.9% (34/110) of the participants from the wait-list control group dropped out before the postintervention survey. The intervention group experienced reductions in stress (b=-2.07; P=.04) and depressive symptoms (b=-1.36; P=.05) from baseline to postintervention. These changes were further enhanced from postintervention to follow-up, with the intervention group continuing to report lower levels of depression (b=-1.82; P=.03) and higher levels of emotional well-being (b=6.13; P<.001), optimism (b=0.78; P=.007), self-esteem (b=-0.84; P=.005), support from family (b=2.15; P=.001), support from significant others (b=2.66; P<.001), and subjective well-being (b=4.82; P<.001). On average, participants completed 2.5 (SD 1.05) out of 5 treatment modules. The overall quality of the app was also rated highly, with a mean score of 3.94 out of a maximum score of 5 (SD 0.58). CONCLUSIONS This study demonstrates that mHealth psychological interventions are an effective treatment option for caregivers experiencing high levels of stress. Recommendations for improving mHealth interventions for caregivers include offering flexibility and customization in the treatment design. TRIAL REGISTRATION Australian New Zealand Clinical Trial Registry ACTRN12616000996460; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371170.
Collapse
Affiliation(s)
| | | | - Keriann Little
- Deakin University, Geelong, Australia
- Policy & Planning, Barwon Child Youth & Family, Geelong, Australia
- Neurodevelopment and Disability, Royal Children's Hospital, Melbourne, Australia
| | | | | | | | | | | | - Craig A Olsson
- Deakin University, Geelong, Australia
- Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Delyse Hutchinson
- Deakin University, Geelong, Australia
- Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| |
Collapse
|
30
|
Hong SW, Kim J, Bang HL. Validity and Reliability of the Life Transition Scale in Parents of Disabled Children Across the Life Transition Process. CHILD HEALTH NURSING RESEARCH 2020; 26:338-347. [PMID: 35004477 PMCID: PMC8650974 DOI: 10.4094/chnr.2020.26.3.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/11/2020] [Accepted: 03/16/2020] [Indexed: 11/12/2022] Open
Abstract
Purpose The Life Transition Scale (LTS) consists of 24 items that assess the life transition process of parents of autistic children. This study aimed to examine the validity and reliability of the LTS in parents of children with a wide spectrum of disabilities. Methods Data were collected from 260 parents of children with disabilities through self-report questionnaires. Validity was examined using exploratory and confirmative factor analysis to determine the factor structures of the LTS; socio-demographic differences in LTS scores were examined using the t-test or ANOVA. Reliability was examined using Cronbach's ⍺ coefficient. Results A four-factor structure was validated (x2=640.0, p<.001, GFI=.81, RMSEA=.07, NNFI=.89, CFI=.89, PNFI=.74, Q [x2/df]=2.60). The validity of the LTS was verified by exploratory factor analysis, with factor loading ranging from .30 to .80. There were significant differences in the accepting phase according to children's and parents' age and the type of disability, and in the wandering phase according to parental gender, educational level, job, and socioeconomic status. The Cronbach's ⍺s for the reliability of each of the four structures were acceptable, within a range of .80~.90. Conclusion The LTS is a valid and reliable measurement to assess the life transition process of parents with disabled children.
Collapse
Affiliation(s)
- Sun Woo Hong
- Associate Professor, Department of Emergency Medical Services, Daejeon University, Daejeon, Korea
| | - JinShil Kim
- Professor, College of Nursing, Gachon University, Incheon, Korea
| | - Hwal Lan Bang
- Assistant Professor, Department of Nursing, Andong National University, Andong, Korea
| |
Collapse
|
31
|
Pari E, Cozzi F, Rodocanachi Roidi ML, Grange F, Toshimori K, Ripamonti E. Parenting girls with Rett syndrome: An investigation on self-perceived levels of stress. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 33:1348-1356. [PMID: 32573922 DOI: 10.1111/jar.12755] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 04/14/2020] [Accepted: 05/06/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although lives of parents of girls with Rett syndrome (RTT) are centred on the process of care, in the current literature their perceived levels of stress have been rarely investigated. METHODS We analysed levels of stress in a sample of 79 fathers and mothers parenting girls with RTT, who were required to compile the Parenting Stress Index (PSI) questionnaire. RESULTS We found clinical levels of stress in about 39% of fathers, as compared with 44% of the mothers. Severity of RTT, but not other factors such as the genetic domain, presence of epilepsy or scoliosis, predicted Total Stress scores in both fathers' subsample and mothers' subsample. A cumulative effect of caring, that is association of higher levels of stress with longer process of care, did also emerge from estimation of smoothing splines. CONCLUSIONS Fathers' resources should be taken more into account, especially in the rehabilitation and socialization process of adults with RTT.
Collapse
Affiliation(s)
- Elisa Pari
- IRCCS Fondazione Don Carlo Gnocchi, Milano, Italy
| | | | | | | | | | | |
Collapse
|
32
|
Parent Psychological and Physical Health Outcomes in Pediatric Hematopoietic Stem Cell Transplantation. Cancer Nurs 2020; 42:448-457. [PMID: 30362974 DOI: 10.1097/ncc.0000000000000652] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Parents of children undergoing hematopoietic stem cell transplantation (HSCT) are at risk of adverse health outcomes due to their intense caregiver demands. OBJECTIVE The aim of this study was to describe adverse health outcomes in parents of children who survived an allogeneic HSCT done within the past 1 to 10 years. METHODS This cross-sectional study, conducted at a children's hospital in the western United States, enrolled English- and Spanish-speaking parents of children who survived allogeneic HSCT between 2005 and 2015. Outcome measures included Beck Anxiety and Depression Inventories, Perceived Stress and Parent Stress Scales, Physical Symptom Inventory, and Short-Form 36 version 2. Parent scores were compared with normative means. Subsequently, the parent sample was stratified by the amount of time since their child's HSCT for comparison between groups. RESULTS Fifty-four mothers and 7 fathers (n = 61) were enrolled. Global mental health scores were lower for parents in the sample compared with norms (P = .003). Parents in the sample reported moderate anxiety and depression (20% and 23%, respectively), yet reported less parenting stress and superior health outcomes compared with norms (P < .001). Social functioning and general health scores were lower for parents whose children survived an allogeneic HSCT done within the past 1 to 4.99 years (P = .012). CONCLUSION Parents of survivors of allogeneic HSCT may concurrently experience posttraumatic growth and stress following their child's HSCT. IMPLICATIONS FOR PRACTICE Health screening and psychological support for parents of children post-HSCT may help to identify parents at risk of adverse outcomes and allow for early, targeted interventions.
Collapse
|
33
|
Masefield SC, Prady SL, Sheldon TA, Small N, Jarvis S, Pickett KE. The Caregiver Health Effects of Caring for Young Children with Developmental Disabilities: A Meta-analysis. Matern Child Health J 2020; 24:561-574. [PMID: 32048172 PMCID: PMC7170980 DOI: 10.1007/s10995-020-02896-5] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Mothers of school age and older children with developmental disabilities experience poorer health than mothers of typically developing children. This review assesses the evidence for the effect on mothers' health of caring for young children with developmental disabilities, and the influence of different disability diagnoses and socioeconomic status. METHODS Medline, EMBASE, PsycINFO and CINAHL were searched. Studies measuring at least one symptom, using a quantitative scale, in mothers of preschool children (0-5 years) with and without a diagnosed developmental disability were selected. Random effects meta-analysis was performed, and predictive intervals reported due to high expected heterogeneity. RESULTS The meta-analysis included 23 estimates of association from 14 retrospective studies for the outcomes of stress (n = 11), depressive symptoms (n = 9), general health (n = 2) and fatigue (n = 1). Caring for a child with a developmental disability was associated with greater ill health (standardised mean difference 0.87; 95% predictive interval - 0.47, 2.22). The largest association was for mixed developmental disabilities (1.36; - 0.64, 3.36) and smallest for Down syndrome (0.38; - 2.17, 2.92). There was insufficient socioeconomic information to perform subgroup analysis. The small number of studies and data heterogeneity limited the precision of the estimates of association and generalizability of the findings. CONCLUSIONS FOR PRACTICE Mothers of young children with developmental disabilities may have poorer health than those with typically developing children. Research is needed to identify whether the relationship is causal and, if so, interventions that could reduce the negative effect of caregiving.
Collapse
Affiliation(s)
- Sarah C Masefield
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK.
| | - Stephanie L Prady
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Trevor A Sheldon
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Neil Small
- Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Stuart Jarvis
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Kate E Pickett
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| |
Collapse
|
34
|
Cohn LN, Pechlivanoglou P, Lee Y, Mahant S, Orkin J, Marson A, Cohen E. Health Outcomes of Parents of Children with Chronic Illness: A Systematic Review and Meta-Analysis. J Pediatr 2020; 218:166-177.e2. [PMID: 31916997 DOI: 10.1016/j.jpeds.2019.10.068] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 09/12/2019] [Accepted: 10/25/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess health outcomes of parents caring for children with chronic illnesses compared with parents of healthy children. STUDY DESIGN We searched OvidSP MEDLINE, EBM Reviews-Cochrane Central Register of Controlled Trials, EMBASE, and EBSCOHost CINAHL through September 2019. Included were English-language studies reporting health conditions or mortality of parents of affected children compared with healthy controls. RESULTS Of 12 181 screened publications, 26 met inclusion criteria. Eight studies reported on anxiety, 23 on depression, 1 on mortality, and 1 on cardiovascular disease. Parents of chronically ill children had greater anxiety (standardized mean difference 0.42; 95% CI 0.24-0.60; P < .001) and depression scores (standardized mean difference 0.35; 95% CI 0.26-0.45; P < .001) than parents of healthy children. Thirty-five percent of parents of affected children met cut-offs for clinical depression, compared with 19% in the control (relative risk 1.75; 95% CI 1.55-1.97). Fifty-seven percent of such parents met cut-offs for anxiety, compared with 38% in the control (relative risk 1.40; 95% CI 1.18-1.67). One study of mothers of children with congenital anomalies reported a greater mortality risk than a comparison (adjusted hazard ratio 1.22; 95% CI 1.15-1.29), and another reported that these mothers experience an increased risk of cardiovascular disease (adjusted hazard ratio 1.15; 95% CI 1.07-1.23). CONCLUSIONS Parents of chronically ill children experience poorer mental health (more anxiety and depression), and mothers of those with congenital anomalies may have greater risk of cardiovascular disease and mortality than parents of unaffected children. Our findings suggest a need for targeted interventions to attenuate adverse parental caregiver health outcomes. PRIOR REGISTRATION PROSPERO CRD42018094657 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=94657).
Collapse
Affiliation(s)
- Liel N Cohn
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada; The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Petros Pechlivanoglou
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health, Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Yuna Lee
- Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| | - Sanjay Mahant
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health, Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Julia Orkin
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Alanna Marson
- The University of Western Ontario, London, Ontario, Canada
| | - Eyal Cohen
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health, Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|
35
|
Čvorović J. The Differential Impact of Religion on Self-Reported Health Among Serbian Roma Women. JOURNAL OF RELIGION AND HEALTH 2019; 58:2047-2064. [PMID: 31098830 DOI: 10.1007/s10943-019-00824-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The present paper offers an account of how self-reported health varies with religious affiliation and reproductive effort among Serbian Roma women. Data were collected in 2014-2018 in two Roma semi-urban settlements in central Serbia. The sample consisted of 177 Christian and 127 Muslim women, averaging 54 years of age. In addition to religious affiliation (Christianity/Islam), demographic data, reproductive histories, data on self-reported and children's health were collected, along with height and weight, and smoking status. Christian and Muslim Roma women differed significantly on a number of variables, with Muslim women reporting poorer health and higher reproductive effort. Among Roma women religion may be an important determinant of reproductive and fertility patterns, largely because it may have formed an important foundation upon which identity is based. This study adds to the literature on the cross-cultural relevance of the ways religion shapes reproductive behaviors for understanding the health variations of women from the same ethnic group who profess different religions.
Collapse
Affiliation(s)
- Jelena Čvorović
- Institute of Ethnography, Serbian Academy of Sciences and Arts, Belgrade, Serbia.
| |
Collapse
|
36
|
Lindly OJ, Zuckerman KE, Kuhlthau KA. Healthcare access and services use among US children with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:1419-1430. [PMID: 30497274 PMCID: PMC6941887 DOI: 10.1177/1362361318815237] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This study aimed to determine associations of healthcare access problems with services use among US children with autism spectrum disorder. We analyzed 2011-2014 National Health Interview Survey data on 651 children with autism spectrum disorder aged 2-17 years. There were three measures of healthcare access problems: (1) delays accessing healthcare, (2) difficulty affording healthcare, and (3) trouble finding a primary care provider. There were five service use measures: (1) ⩾4 office visits, (2) ⩾1 well-child visit, (3) flu vaccine, (4) prescription medication, and (5) ⩾1 emergency department visit. Multivariable regression models estimated associations of ⩾1 healthcare access problem with each service use variable and effect modification by socioeconomic status and race and ethnicity. Twenty-nine percent of children with autism spectrum disorder had ⩾1 healthcare access problem. Having ⩾1 healthcare access problem was associated with lower adjusted odds of ⩾1 well-child visit or prescription medication use but higher adjusted odds of ⩾4 office visits or ⩾1 emergency department visit. No significant association was found for flu vaccine. Associations of healthcare access problems with emergency department use were most pronounced for higher socioeconomic status and White, non-Hispanic subgroups. Intervention, such as insurance expansion, is needed to improve healthcare access for children with autism spectrum disorder.
Collapse
Affiliation(s)
- Olivia J Lindly
- 1 Harvard Medical School and Massachusetts General Hospital, USA
| | | | - Karen A Kuhlthau
- 1 Harvard Medical School and Massachusetts General Hospital, USA
| |
Collapse
|
37
|
Marquis S, Hayes MV, McGrail K. Factors Affecting the Health of Caregivers of Children Who Have an Intellectual/Developmental Disability. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2019. [DOI: 10.1111/jppi.12283] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Sandra Marquis
- School of Public Health and Social PolicyUniversity of Victoria Victoria BC Canada
| | - Michael V. Hayes
- School of Public Health and Social PolicyUniversity of Victoria Victoria BC Canada
| | - Kimberlyn McGrail
- Centre for Health Services and Policy ResearchUniversity of British Columbia Vancouver BC Canada
| |
Collapse
|
38
|
Bibbo J, Rodriguez KE, O’Haire ME. Impact of Service Dogs on Family Members' Psychosocial Functioning. Am J Occup Ther 2019; 73:7303205120p1-7303205120p11. [PMID: 31120842 PMCID: PMC6533052 DOI: 10.5014/ajot.2019.031690] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
IMPORTANCE A growing body of evidence supports service dogs' positive psychosocial impact on people with a chronic condition, but very little is known about the effect of service dogs on the family members with whom they live. OBJECTIVE To measure the impact that a service dog may have on family member functioning. DESIGN Cross-sectional with a single time-point assessment. SETTING Data were collected via a self-report survey completed online, over the phone, or by mail. PARTICIPANTS Potential participants were recruited from national service dog provider Canine Assistants. Participants were caregivers or spouses of a person with a disability or illness who either currently had a service dog (n = 51) or was on the waitlist to receive one (n = 77). Participants were 50 family members (46 parents-caregivers and 4 spouses-partners) living with a service dog and 76 family members (68 parents-caregivers and 8 spouses-partners) whose family member was on the waitlist to receive one. OUTCOMES AND MEASURES Participants completed standardized measures to quantify psychosocial health and functioning, health-related quality of life (HRQOL), and family functioning. RESULTS Living with a service dog was most closely associated with less health-related worry and better overall psychosocial health and emotional functioning, less total family impact from the chronic condition, and better emotional HRQOL. CONCLUSIONS AND RELEVANCE These findings provide preliminary evidence that, in addition to having an impact on recipients, service dogs can affect several aspects of family members' psychosocial health and functioning. WHAT THIS ARTICLE ADDS This research demonstrates that the impact of a service dog may extend beyond the recipient and have positive impacts on family members' psychosocial functioning as well. Occupational therapy practitioners should include family members in discussions regarding the integration of a service dog into the home and recognize the potential for family-wide effects from the service dog's assistance.
Collapse
Affiliation(s)
- Jessica Bibbo
- Jessica Bibbo, PhD, is Research Scientist, Center for Research and Education, Benjamin Rose Institute on Aging, Cleveland, OH. At the time of this research, she was Postdoctoral Research Fellow, Center for the Human–Animal Bond, Department of Comparative Pathobiology, Purdue University College of Veterinary Medicine, West Lafayette, IN;
| | - Kerri E. Rodriguez
- Kerri E. Rodriguez, MA, is Doctoral Candidate, Center for the Human–Animal Bond, Department of Comparative Pathobiology, Purdue University College of Veterinary Medicine
| | - Marguerite E. O’Haire
- Marguerite E. O’Haire, PhD, is Associate Professor, Center for the Human–Animal Bond, Department of Comparative Pathobiology, Purdue University College of Veterinary Medicine
| |
Collapse
|
39
|
Cohen E, Horváth-Puhó E, Ray JG, Pedersen L, Ehrenstein V, Adler N, Vigod S, Milstein A, Toft Sørensen H. Cardiovascular Disease Among Women Who Gave Birth to an Infant With a Major Congenital Anomaly. JAMA Netw Open 2018; 1:e182320. [PMID: 30646164 PMCID: PMC6324496 DOI: 10.1001/jamanetworkopen.2018.2320] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 07/08/2018] [Indexed: 01/13/2023] Open
Abstract
Importance Having a child with a major birth defect can be a life-changing and stressful event that may be associated with higher cardiovascular disease (CVD) risk, yet the long-term burden of CVD for the child's mother is unknown. Objective To assess whether mothers of an infant born with a major congenital anomaly are at higher risk of CVD compared with a comparison cohort. Design, Setting, and Participants A population-based cohort study using individual-level linked registry data in Denmark included 42 943 women who gave birth to an infant with a major congenital anomaly between January 1, 1979, and December 31, 2013; and follow-up was conducted until 2015. A comparison group, comprising 428 401 randomly selected women, was 10:1 matched to each affected mother by maternal age, parity, and her infant's year of birth. Data analyses were performed between November 1, 2017, and February 28, 2018. Exposures Live birth of an infant with a major congenital anomaly. Main Outcomes and Measures The primary outcome was a CVD composite outcome of acute myocardial infarction, coronary revascularization, or stroke. Secondary outcomes included individual components of the CVD composite and other cardiovascular outcomes, including unstable angina, congestive heart failure, atrial fibrillation, peripheral artery disease, ischemic heart disease, and aortic aneurysm. Cox proportional hazards regression analyses generated hazard ratios (HRs), adjusted for maternal demographic, socioeconomic, and chronic health indicators. Results Median maternal age at baseline was 28.8 years (interquartile range, 25.3-32.5 years). After a median follow-up of 19.5 years (interquartile range, 9.9-27.6 years), 914 women whose infant had a major congenital anomaly experienced a CVD event (1.21 per 1000 person-years; 95% CI, 1.13-1.28 per 1000 person-years) vs 7516 women in the comparison group (0.99 per 1000 person-years; 95% CI, 0.97-1.01 per 1000 person-years), corresponding to an unadjusted HR of 1.23 (95% CI, 1.15-1.32), and an adjusted HR (aHR) of 1.15 (95% CI, 1.07-1.23). Women who gave birth to an infant with multiorgan anomalies had an even higher aHR (1.37; 95% CI, 1.08-1.72). Mothers of infants with a major anomaly also had an increased aHR of the individual components of the composite outcome and the other cardiovascular outcomes. Conclusions and Relevance Women whose child had a major congenital anomaly experienced a 15% to 37% higher risk of premature cardiovascular disease. These women may benefit from targeted interventions aimed at improving their cardiovascular health.
Collapse
Affiliation(s)
- Eyal Cohen
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | | | - Joel G. Ray
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, St Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Lars Pedersen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Vera Ehrenstein
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Nancy Adler
- Center for Health and Community, School of Medicine, University of California, San Francisco
| | - Simone Vigod
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Reproductive Life Stages Program, Department of Psychiatry, Women’s College Hospital, Toronto, Ontario, Canada
| | - Arnold Milstein
- Clinical Excellence Research Center, Stanford University School of Medicine, Stanford, California
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
- Division of Epidemiology, Department of Health Research and Policy, Stanford University, Stanford, California
| |
Collapse
|
40
|
Gallagher S, Pilch M, Hannigan A. Prior depressive symptoms and persistent child problem behaviours predict future depression in parents of children with developmental disabilities: The growing up in Ireland cohort study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 80:170-179. [PMID: 30032060 DOI: 10.1016/j.ridd.2018.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 06/15/2018] [Accepted: 07/04/2018] [Indexed: 06/08/2023]
Abstract
Predictors of depression over time were examined in parental carers of children with developmental disabilities (DD) and parents of typically developing children (controls) who participated in the Growing up in Ireland Study. Parents completed measures of depression, the Centre for Epidemiological Depression Scale (CES-D) and child problem behaviours, the Strength and Difficulties Questionnaire when the children were aged 9 (Wave 1) and 13 (Wave 2). Using CES-D cut-off scores to indicate probable depression, caregivers were more likely to be depressed at both waves compared to controls with a Wave 1 rate of depression of 14.6% vs. 7.9% (p < 0.001, Cramer`s V = 0.059) and Wave 2 (14.8% vs. 10%, p = 0.003, Cramer`s V = 0.038). While overall rates of depression were stable for caregivers, a shifting pattern emerged; 59.6% of those who were depressed at Wave 1, were not at Wave 2; similarly, 10.9% who were not depressed at Wave 1, were at Wave 2. Parents of children with DD were also more likely to report greater problem behaviours in their children compared to controls at both waves. Depression in caregivers at Wave 1 and persistent child problem behaviours were significant predictors of depression at Wave 2. In conclusion, while overall rates of depression remain stable in caregivers, there are shifting patterns evident with prior depression and persistent behaviour problems predictive of ongoing depression.
Collapse
Affiliation(s)
- Stephen Gallagher
- Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory, Dept. of Psychology, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland.
| | - Monika Pilch
- Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory, Dept. of Psychology, University of Limerick, Limerick, Ireland
| | - Ailish Hannigan
- Health Research Institute, University of Limerick, Limerick, Ireland; Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
| |
Collapse
|
41
|
Najmi B, Heidari Z, Feizi A, Hovsepian S, Momeni F, Azhar SMM. Do Psychological Characteristics of Mothers Predict Parenting Stress? A Cross-Sectional Study among Mothers of Children with Different Disabilities. Arch Psychiatr Nurs 2018; 32:396-402. [PMID: 29784221 DOI: 10.1016/j.apnu.2017.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 11/23/2017] [Accepted: 12/03/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND/OBJECTIVE We aimed at assessing the parenting stress levels among mothers of children with different disabilities and its association with various mothers' psychological characteristics. METHODS In this cross-sectional study, 302 mothers of 6-12years old children suffering from sensory motor mental, chronic physical and psychological disabilities were enrolled. Parenting stress, coping stratyles, marital satisfaction and psychological problems of mothers were assessed using validated questionnaires. RESULTS In this study, mothers of 302 children with sensory-motor mental (n=64), psychological (n=149) and chronic physical (n=89) disabilities were investigated. Mean total score of parenting stress was significantly higher in mothers of children with psychological disabilities (F=4.285, P<0.05). There was positive significant relationship between emotion oriented coping style and parenting stress scores (β=0.56, P<0.05). Parenting stress had significant negative association with marital satisfaction (β=-0.3, P<0.001). CONCLUSIONS Our findings indicated different parenting stress levels among mothers of children with different disabilities. Mother's psychological characteristics such as marital satisfaction, psychological problems and coping styles are significant determinants of parenting stress. These findings provide baseline information for designing future interventional studies and developing more effective approaches for managing the parenting stress.
Collapse
Affiliation(s)
- Badroddin Najmi
- Noor Medical Center, Psychology Clinic, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Heidari
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health, and Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Silva Hovsepian
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzaneh Momeni
- Faculty of Psychology and Educational Sciences, Isfahan University, Isfahan, Iran
| | | |
Collapse
|
42
|
Bourke-Taylor HM, Jane FM. Mothers' Experiences of a Women's Health and Empowerment Program for Mothers of a Child with a Disability. J Autism Dev Disord 2018; 48:2174-2186. [PMID: 29417434 DOI: 10.1007/s10803-018-3486-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Substantial research identifies mothers of children with a disability as a vulnerable group with compromised health outcomes and restrictions for their own self-care, social, economic and leisure participation. This study investigated perceptions and experiences of mothers following attendance at health education and empowerment workshops (Healthy Mothers Healthy Families). Mixed methods evaluated mothers' experiences. A pragmatic qualitative approach was applied to data analysis of interviews with mothers (N = 19). Four themes emerged: Changes for me; Changes for my family; Wisdom gained; and Worthwhile workshops. Mothers described feeling validated and empowered in this facilitated group intervention and valued education about women's health, tailored research findings, individualised goal setting, time to learn and share with other mothers, and the workshop environment.
Collapse
Affiliation(s)
- Helen M Bourke-Taylor
- Occupational Therapy Department, School of Primary and Allied Health Care, Monash University, Peninsula Campus, Building G, Level 4, Peninsula Campus, McMahons road, Frankston, VIC, 3192, Australia.
| | - Fiona M Jane
- Women's Health Research Program, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3002, Australia
| |
Collapse
|
43
|
Butler A, Van Lieshout RJ, Lipman EL, MacMillan HL, Gonzalez A, Gorter JW, Georgiades K, Speechley KN, Boyle MH, Ferro MA. Mental disorder in children with physical conditions: a pilot study. BMJ Open 2018; 8:e019011. [PMID: 29301763 PMCID: PMC5781020 DOI: 10.1136/bmjopen-2017-019011] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES Methodologically, to assess the feasibility of participant recruitment and retention, as well as missing data in studying mental disorder among children newly diagnosed with chronic physical conditions (ie, multimorbidity). Substantively, to examine the prevalence of multimorbidity, identify sociodemographic correlates and model the influence of multimorbidity on changes in child quality of life and parental psychosocial outcomes over a 6-month follow-up. DESIGN Prospective pilot study. SETTING Two children's tertiary-care hospitals. PARTICIPANTS Children aged 6-16 years diagnosed in the past 6 months with one of the following: asthma, diabetes, epilepsy, food allergy or juvenile arthritis, and their parents. OUTCOME MEASURES Response, participation and retention rates. Child mental disorder using the Mini International Neuropsychiatric Interview at baseline and 6 months. Child quality of life, parental symptoms of stress, anxiety and depression, and family functioning. All outcomes were parent reported. RESULTS Response, participation and retention rates were 90%, 83% and 88%, respectively. Of the 50 children enrolled in the study, the prevalence of multimorbidity was 58% at baseline and 42% at 6 months. No sociodemographic characteristics were associated with multimorbidity. Multimorbidity at baseline was associated with declines over 6 months in the following quality of life domains: physical well-being, β=-4.82 (-8.47, -1.17); psychological well-being, β=-4.10 (-7.62, -0.58) and school environment, β=-4.17 (-8.18, -0.16). There was no association with parental psychosocial outcomes over time. CONCLUSIONS Preliminary evidence suggests that mental disorder in children with a physical condition is very common and has a negative impact on quality of life over time. Based on the strong response rate and minimal attrition, our approach to study child multimorbidity appears feasible and suggests that multimorbidity is an important concern for families. Methodological and substantive findings from this pilot study have been used to implement a larger, more definitive study of child multimorbidity, which should lead to important clinical implications.
Collapse
Affiliation(s)
- Alexandra Butler
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Ellen Louise Lipman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Harriet L MacMillan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Jan Willem Gorter
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Kathy Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Kathy N Speechley
- Department of Paediatrics, Western University, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Michael H Boyle
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Mark A Ferro
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| |
Collapse
|
44
|
Reproductive Investment and Health Costs in Roma Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111337. [PMID: 29099752 PMCID: PMC5707976 DOI: 10.3390/ijerph14111337] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/12/2017] [Accepted: 10/24/2017] [Indexed: 11/17/2022]
Abstract
In this paper, we examine whether variation in reproductive investment affects the health of Roma women using a dataset collected through original anthropological fieldwork among Roma women in Serbia. Data were collected in 2014–2016 in several Roma semi-urban settlements in central Serbia. The sample consisted of 468 Roma women, averaging 44 years of age. We collected demographic data (age, school levels, socioeconomic status), risk behaviors (smoking and alcohol consumption), marital status, and reproductive history variables (the timing of reproduction, the intensity of reproduction, reproductive effort and investment after birth), in addition to self-reported health, height, and weight. Data analyses showed that somatic, short-term costs of reproduction were revealed in this population, while evolutionary, long-term costs were unobservable—contrariwise, Roma women in poor health contributed more to the gene pool of the next generation than their healthy counterparts. Our findings appear to be consistent with simple trade-off models that suggest inverse relationships between reproductive effort and health. Thus, personal sacrifice—poor health as an outcome—seems crucial for greater reproductive success.
Collapse
|
45
|
Ketelaar M, Bogossian A, Saini M, Visser-Meily A, Lach L. Assessment of the family environment in pediatric neurodisability: a state-of-the-art review. Dev Med Child Neurol 2017; 59:259-269. [PMID: 27696390 DOI: 10.1111/dmcn.13287] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/18/2016] [Indexed: 01/28/2023]
Abstract
The importance of the family environment for the development of children with neurodisabilities is undisputed. The objective of this study is to describe how family environment has been measured in research on families of children with neurodisabilities, in order to support researchers and clinicians to select appropriate methods for use. A three-step approach was used and 13 measures of family environment were identified within 77 studies. Five measures were used most commonly across a majority of studies (n=50). The measures varied considerably in terms of theoretical background, content, subscales, and populations for which they were developed and validated. These measures were used with considerable variability between studies and with a limited range of research respondents, most typically the child's mother. Challenges, opportunities, and suggestions on how to improve the application of family environment measures in research are discussed.
Collapse
Affiliation(s)
- Marjolijn Ketelaar
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Aline Bogossian
- School of Social Work and the Centre for Research on Children and Families, McGill University, Montreal, QC, Canada
| | - Michael Saini
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Anne Visser-Meily
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Lucyna Lach
- School of Social Work and the Centre for Research on Children and Families, McGill University, Montreal, QC, Canada
| |
Collapse
|
46
|
McCarthy MJ, Behimer G, Anderson JA, Riddle I. Caregiving for youth with co-occurring developmental disabilities and behavioral health issues when caregivers face additional health-related stressors: Analysis of risk and protective factors from a national sample. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 59:399-409. [PMID: 27721195 DOI: 10.1016/j.ridd.2016.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 08/08/2016] [Accepted: 09/15/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Family caregivers of youth with DD and behavioral health issues experience the highest level of caregiving strain. Many must also deal with their own or another family member's chronic health condition, which may place them at additional risk for poor outcomes. AIMS (1) Provide a "snapshot" of DD family caregivers based on a national sample; (2) identify risk and protective factors among groups of DD caregivers with graduated levels of health-related stressors; (3) examine the impact of risk and protective factors on strain for DD caregivers. METHODS AND PROCEDURES We conducted a secondary analysis of data from N=600 DD caregivers recruited through sites across the United States. Risk and protective factors were compared among three groups of caregivers at study enrollment: (1) those focused on providing care for the target youth with DD, without additional health-related stressors with which to contend; (2) those contending with minor additional health-related stressors; and, (3) those contending with major additional health-related stressors. Predictors of caregiving strain at six months post-enrollment were identified. RESULTS 52% of the overall sample was unemployed and 71% were living at or below poverty. Differences were found among groups on a variety of risk and protective factors. With some exceptions, predictors of caregiving strain were similar to non-DD populations. CONCLUSIONS AND IMPLICATIONS This study provides valuable information about a population of caregivers who are highly vulnerable to poor outcomes. Findings highlight the importance of considering the needs, strengths, and outcomes of family caregivers.
Collapse
Affiliation(s)
- Michael J McCarthy
- School of Social Work, College of Allied Health Sciences, University of Cincinnati, PO Box 210108, Cincinnati, OH 45221, United States.
| | - Gretchen Behimer
- Clermont County FAST TRAC, Clermont County Mental Health and Recovery Board, 2337 Clermont Center Drive, Batavia, OH 45103, United States.
| | - Jeffrey A Anderson
- School of Education, Indiana University, W.W. Wright Education Building Room 3232, Bloomington, IN 47405, United States.
| | - Ilka Riddle
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 4002, Cincinnati, OH 45229, United States.
| |
Collapse
|
47
|
Manor-Binyamini I, Nator M. Parental coping with adolescent developmental disabilities in terms of stress, sense of coherence and hope within the Druze community of Israel. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 55:358-367. [PMID: 27228006 DOI: 10.1016/j.ridd.2016.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Revised: 04/12/2016] [Accepted: 05/04/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Many studies have examined the coping resources of parents of children with disabilities but most have involved Western families and only a few refer to unique and traditional cultures. AIM This study sought to compare Druze parents of adolescents with and without developmental disabilities (DD) in the context of Druze traditions and beliefs and whether they may lead to better coping by parents of a child with DD. The study used the measures of stress; sense of coherence (SOC) - an orientation towards the world which reflects an ongoing confidence that things fall into place in a logical and meaningful way; and hope. METHODS AND PROCEDURES The sample group consisted of 99 Druze parents of adolescents with and without DD enrolled in regular and special schools in Israel. The parents were asked to complete four questionnaires on demography, stress, SOC (Sense of coherence) and hope. OUTCOMES AND RESULTS The research findings indicate a higher sense of parental stress and a lower overall SOC, particularly meaningfulness, and hope among parents of adolescents with DD. There was no difference between the two groups of parents with respect to marital, economic and overall stress or in the other two components of SOC. CONCLUSIONS AND IMPLICATIONS The results of the study partly contradict the assumption in the limited literature about Druze that they may cope better with life stressors as a result of their traditions and beliefs. The results also indicate the need for further research and culturally-based intervention programs.
Collapse
Affiliation(s)
- Iris Manor-Binyamini
- Department of Special Education, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa 3498838, Israel.
| | - Maha Nator
- Department of Special Education, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa 3498838, Israel.
| |
Collapse
|
48
|
Groleger Sršen K, Vidmar G, Zupan A. Validity, internal consistency reliability and one-year stability of the Slovene translation of the Measure of Processes of Care (20-item version). Child Care Health Dev 2015; 41:569-80. [PMID: 25297060 DOI: 10.1111/cch.12198] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Measure of Processes of Care (MPOC) was developed as a self-administered questionnaire for parents to report on behaviours of healthcare providers. The original (MPOC-56) and the 20-item version (MPOC-20) have established reliability and validity, but the instrument must be rechecked whenever translated and applied in a different social and cultural setting. The aim of our study was to evaluate validity, internal consistency reliability and 1-year stability of the Slovene translation of MPOC-20. METHODS Parents of children who were admitted as inpatients or outpatients of several hospitals and health centres were invited to participate. MPOC-20, the Client Satisfaction Questionnaire (CSQ-8) and a separate question on stress and worries were sent by mail. Descriptive item analysis was performed. Cronbach's alpha coefficient and corrected item-total correlations were used to assess internal consistency for each of the five MPOC-20 subscales. To evaluate validity, we correlated the MPOC-20 subscale scores with CSQ-8 scores and a stress alleviation rating. Assessment with MPOC-20 was performed again 1 year later and we used paired-samples tests to compare mean scores of both assessments. RESULTS Parents of 235 children participated in the study (80% mothers). They reported high general satisfaction as 15 out of the 20 MPOC-20 mean item scores were above 5 (out of 7) and none was below 4. The mean MPOC-20 mean subscale scores were 5.83 (SD 1.10) for Coordinated and Comprehensive Care for Child and Family, 5.62 (SD 1.12) for Respectful and Supportive Care, 5.45 (SD 1.23) for Enabling and Partnership, 5.33 (SD 1.61) for Providing Specific Information about the Child and 4.59 (SD 1.65) for Providing General Information. The ranking order of the mean rating of the MPOC-20 subscales was similar to previous studies. The parents reported that they felt their stress and worries had been notably or slightly reduced through the process of care in the last year in more than two-thirds of the cases. All the MPOC-20 subscales (as well as the CSQ-8 scale) showed high internal consistency: the corrected item-total correlations were far above the lower limit for item's acceptance of 0.3. After 1 year (66 returned questionnaires) none of the mean subscale scores changed statistically significantly (P-values 0.159-0.910). CONCLUSION The Slovene translation of the MPOC-20 can be considered as a valid and reliable instrument that shows good stability over a period of 1 year, and as such it can be adopted in clinical practice.
Collapse
Affiliation(s)
- K Groleger Sršen
- Department for Children Rehabilitation, University Rehabilitation Institute, Ljubljana, Republic of Slovenia
| | - G Vidmar
- Biostatistics and Scientific Informatics, University Rehabilitation Institute, Ljubljana, Republic of Slovenia
| | - A Zupan
- University Rehabilitation Institute, Ljubljana, Republic of Slovenia
| |
Collapse
|