The mediating role of perceived social support: alexithymia and parental burnout in parents of children with autism spectrum disorder

The mediator role of parenting stress in the effect of stigmatization on burnout in parents of children with autism: A structural equality model

PURPOSE

The purpose of this study was to report on the mediator role of parenting stress in the effect of stigmatization on burnout in parents of children with autism.

DESIGN AND METHODS

A descriptive and correlational research design was used in this study. The sample consisted of 146 parents who had children diagnosed with autism spectrum disorder and volunteered to participate in the study. A "Personal Information Form", the "Parents' Internalized Stigma of Mental Illness Scale", the "Parenting Stress Scale", and the "Parental Burnout Assessment" were used for data collection.

RESULTS

In the study, it was observed that the feeling of stigmatization increased as the education level increased and that variables such as the ages of the parent and the child and an increase in the number of children requiring care also affected the feeling of stigmatization. Parenting stress was found to have a "partial mediator" role in the effect of stigmatization on parental burnout.

CONCLUSION

Our findings emphasized the heterogeneous correlation between stigmatization, burnout, and stress levels of parents of children with autism.

PRACTICE IMPLICATIONS

This study has key implications for pediatric nursing practices. Pediatric nurses can educate the community about autism, what issues should be considered, and how to support parents. Furthermore, nurses can introduce parents who have children with autism to each other and direct them to parent-child activities that can regulate their moods.

Development and validation of a nomogram prediction model for ADHD in children based on individual, family, and social factors

OBJECTIVES

A reliable, user-friendly, and multidimensional prediction tool can help to identify children at high risk for ADHD and facilitate early recognition and family management of ADHD. We aimed to develop and validate a risk nomogram for ADHD in children aged 3-17 years in the United States based on clinical manifestations and complex environments.

METHODS

A total of 141,356 cases were collected for the prediction model. Another 54,444 cases from a new data set were utilized for performing independent external validation. The LASSO regression was used to control possible variables. A final risk nomogram for ADHD was established based on logistic regression, and the discrimination and calibration of the established nomogram were evaluated by bootstrapping with 1000 resamples.

RESULTS

A final risk nomogram for ADHD was established based on 13 independent predictors, including behavioral problems, learning disabilities, age, intellectual disabilities, anxiety symptoms, gender, premature birth, maternal age at childbirth, parent-child interaction patterns, etc. The C-index of this model was 0.887 in the training set, and 0.862 in the validation set. Internal and external validation proved that the model was reliable.

CONCLUSIONS

A nomogram, a statistical prediction tool that assesses individualized ADHD risk for children is helpful for the early identification of children at high risk for ADHD and the construction of a conceptual model of society-family-school collaborative diagnosis, treatment, and management of ADHD.

A systematic review of parental burnout and related factors among parents

BACKGROUND

Parenting is both a complex and stressful endeavor, so parents sometimes experience parenting burnout. The main objective of this study was to provide an overview of factors related to general parental burnout (PB) among parents with at least one child based on the Ecological Systems Theory (EST).

METHODS

PubMed, Web of Science, EBSCO, CNKI and WanFang were systematically searched for studies published from 2010 to July 2023 for peer-reviewed articles using keywords extracted from Medical Subject Headings such as "parenting", "parental", "burnout", "psychological burnout", "burn-out syndrome". Studies were included if they described associations between factors and PB among parents of children aged 0-18 years old in the general population, and published in an English or Chinese language peer-reviewed journal. The Quality Assessment Tool for Studies with Diverse Designs (QATSDD) was employed to assess the risk of bias of included studies.

RESULTS

Of 2037 articles, 26 articles met the inclusion criteria. Based on the Ecological Systems Theory (EST), we found that microsystem-individual factors such as gender, educational level, income, parental personality, internalization of maternal parental motivation, unmitigated communion, self-compassion and concern for others, alexithymia, anxiety and depressive symptoms, parental perfectionism, resilience, low self-esteem and high need for control, mother's attachment style were identified as being associated with parenting burnout. Mesosystem-interpersonal factors involve parent-child relationship and marital satisfaction. The exosystem-organizational or community factors include the number of children in the household, neighborhood and the number of hours spent with children, child's illness, child's behavior problems and social support. The macrosystem-society/policy or culture factors are mainly personal values and cultural values.

CONCLUSIONS

This systematic review found several factors that have been investigated in relation to PB. However, the majority of the factors were reported by one or two studies often implementing a cross-sectional design. Nevertheless, we still recommend that health policymakers and administrators relieve parenting burnout among parents with children by adjusting these modifiable factors.