Assessing the Quality of Life of Parents of Children With Disabilities Using WHOQoL BREF During COVID-19 Pandemic

Quality of life and associated factors among primary caregivers of children and adolescents with neurodevelopmental disorders attending public hospitals in Addis Ababa, Ethiopia: a cross-sectional study

BACKGROUND

Neurodevelopmental disorders are a set of disorders that negatively affect the acquisition of skills in a variety of developmental domains, including motor function, learning, socialization, language and cognition. However, there is no information available on the standard of living of Ethiopian primary caregivers of children and adolescents with neurodevelopmental disorders. Therefore, this study aimed to assess the quality of life (QOL) and associated factors among primary caregivers of children and adolescents with neurodevelopmental disorders in Addis Ababa, Ethiopia.

METHODS

A cross-sectional study was conducted during 1-30 May 2022. Systematic random sampling was used to obtain 352 samples. QOL was measured using the WHO Quality of Life Brief. The gathered information was coded, entered into EpiData 4.6.0.2 and analyzed with SPSS version 26. Multiple linear regression analysis was used to identify the correlates of QOL and the strength of the correlation was measured by β coefficient with 95% CI.

RESULTS

The mean score of the overall QOL was 62.61 with a SD of 5.17. The mean (±SD) scores for the physical health, psychological, environmental and social relationship domains of primary caregivers were 57.36±9.98, 66.98±9.39, 66.06±12.91 and 60.02±9.14, respectively. Age was significantly associated with physical domain (β=-0.25, 95% CI -0.43 to -0.07) and with environmental domain (β=-4.57, 95% CI -9.06 to -0.09). Being divorced/widowed was negatively associated with psychological health (β=-2.99, 95% CI -5.82 to -0.17) and social health (β=-0.62, 95% CI -1.33 to -0.10). The presence of medical illness was negatively associated with the physical health domain (β=-4.32, 95% CI -7.64 to -2.91) and the environmental domain (β=-3.11, 95% CI -5.71 to -0.51). Poor social support was negatively associated with psychological health (β=-3.25, 95% CI -5.89 to -0.61) and the social health domain (β=-3.39, 95% CI -11.3 to 4.6), and moderate social support (β=8.62, 95% CI 3.15 to 14.09) was positively associated with physical health. Depression (β=-6.32, 95% CI -11.96 to -0.67) and anxiety (β =-3.07, 95% CI -5.80 to -0.34) were negatively associated with physical health and the psychological health domain, respectively.

CONCLUSIONS

The findings from this study indicate that all dimensions of QOL of primary caregivers of children and adolescents with neurodevelopmental disorders in this study setting were compromised. Being divorced or widowed, lack of formal education, age, average monthly income, poor social support, depression, anxiety and the presence of medical illness were factors associated with QOL in all domains. This requires integrating a bio-psychosocial perspective, a positive mental health strategy and pharmaceutical therapies to enhance QOL for caregivers of children and adolescents with neurodevelopmental disorders.

Quality of life and family management of paediatric chronic condition amidst the COVID-19 pandemic

PURPOSE

This study aimed to describe the perception of parents of children/adolescents with chronic conditions of their quality of life and family functioning during the COVID-19 pandemic and explore how the COVID-19 pandemic affected family management of children/adolescents' chronic conditions.

DESIGN AND METHODS

A total of 237 parents of children/adolescents with chronic conditions participated in this cross-sectional study. Data were collected through an online questionnaire using the Paediatric Quality of Life Inventory™ Family Impact Module and an open-ended question about the impact of the pandemic on the family management of the paediatric chronic condition.

RESULTS

The Total Score of PedsQL™ FIM was slightly higher than the midpoint of the scale (M = 60.27; SD = 19.04), and the impact of the pandemic on the family's management of the chronic condition was perceived by 30% of parents as high or moderate. Statistically significant differences were found between parents who reported a high or moderate impact of the pandemic and those reporting little or no impact of the pandemic regarding parental quality of life and family functioning (t (233) = 8.13, p = .00, Cohen's d = 1.14). Two themes emerged from the analysis of the open-ended question: Impact on the child/adolescent and Impact on the family.

CONCLUSIONS

Parents of children/adolescents with chronic conditions reported an average quality of life, and the COVID-19 pandemic significantly impacted the family management of chronic conditions.

PRACTICE IMPLICATIONS

These results highlight the importance of developing interventions to support families in complex situations and contexts, targeting family functioning, family quality of life, and emotional management.

Quality of Life in Individuals with Intellectual and Developmental Disabilities: The Congruency Effect between Reports

Assessing quality of life (QoL) is important to provide personalized and individualized support plans with the purpose of improving personal outcomes. Based on the conceptual model of QoL, the aim of this study was to assess the congruence between the perceptions of institutionalized individuals with intellectual and developmental disabilities (IDD) and the perception of a third party, regarding QoL. Forty-two individuals participated in this study, including twenty-one with mild to severe IDD and their family members/caregiver/reference technician, who responded to the Personal Outcomes Scale (Portuguese version). Significant differences (p < 0.05) were found between reports in the personal development (t = -2.26; p = 0.024), emotional well-being (t = -2.263; p = 0.024), physical well-being (t = -2.491; p = 0.013) and total QoL (t = -2.331; p = 0.02). The results further show that most third-party reports tend to undervalue the QoL of the individual with IDD, and that there is no congruence in any of the QoL domains. The inclusion of self-reports in the QoL assessment is important. In addition to the assessment of third-party reports, the process of making decisions appropriate to the context and individual characteristics is equally important. On the other hand, the inclusion of third-party reports is an opportunity to promote communication among all stakeholders, recognize and discuss differences, and promote QoL, not only of individuals with IDD, but also of families.

Positive experiences in the parent-child relationship during the COVID-19 lockdown in Poland: The role of emotion regulation, empathy, parenting self-efficacy, and social support

Despite the impact of the COVID-19 outbreak being largely negative on parents and children, for some families, lockdown could also bring about some positive effects, for example, increased emotional closeness, and more time for joint activity. The aim of the current study was to investigate cross-sectionally the most important correlates of the positive experiences in the parent-child relationship among Polish mothers and fathers during the lockdown in the initial phase of the COVID-19 outbreak. In May 2020, 228 mothers and 231 fathers completed the Brief version of the Empathic Sensitivity Questionnaire, Difficulties in Emotion Regulation Scale Short Form, Social Support Scale, Parenting Self-Agency Measure, and Scale of Positive Experiences in Parent-Child Relationship during the COVID-19 lockdown. Our results showed that parenting self-efficacy and social support were the strongest correlates of positive experiences in the parent-child relationship in both mothers and fathers during the lockdown. Perspective-taking was positively related to the positive experiences in mothers, whereas personal distress was positively associated with the positive experiences in the parent-child relationship in fathers. Our results point to factors of potential importance in designing preventive and therapeutic interventions for mothers and fathers to enhance positive experiences in the parent-child relationship during the pandemic.

Further detailed objectification within comparative analysis of quality of life - based on some sociodemographic characteris-tics/parameters and related statistical analysis - between mothers of children with congenital versus acquired neuropathology

Abstract: This study aimed to determine whether there is a difference in quality of life between mothers of children with congenital neuropathology and, respectively, those with acquired neuropathology based on some sociodemographic characteristics/parameters, taking into account data from the specialized literature on the influence of sociodemographic characteristics/parameters on mothers with disabled children. 85 subjects (divided into two groups, congenital and acquired) were included in the study conducted at the National Clinical Centre of Neurorehabilitation for Children “Dr. N. Robanescu. To objectify – if existing – such differences, as mentioned above, we used the clinical, functional quantified evaluation instrument PedsQL- Family Impact Module (PedsQL-FIM). According to our data, there were statistically significant differences between groups for physical functioning, emotional functioning, communication, and worry. There were no statistically significant differences between the groups for daily activity, social functioning, cognitive functioning, and family relationships. We also found weak negative correlations between the following dimensions of PedsQL-FIM: emotional functioning, social functioning, and communication) and education for the former group; a weak positive correlation between worry and education, a weak negative correlation between emotional functioning and income level, and two moderate negative correlations between social functioning, daily activities, and income level for the latter group. We can conclude that the variable education had the most significant influence on the quality of life for mothers of children with congenital neuropathology, in contrast, the variable income level had the most significant influence on mothers of children with acquired neuropathology. Keywords: sociodemographic characteristics, quality of life, disability

Challenges and coping strategies of parents of children with autism spectrum disorder in Eswatini

Background: Research shows that the debilitating effects of autism spectrum disorder (ASD) not only have an impact on the child, but on the parents and caregivers as well. This study aimed to explore the challenges and coping strategies of parents of children with ASD in Eswatini.Methodology: An exploratory, descriptive qualitative study that used purposive sampling to interview parents of children with ASD was utilised. Data were gathered using two focus groups, three dyads, and two semi-structured interviews. There were 18 participants in this study. Data were interpreted by thematic analysis, and considered according to Lazarus and Folkman's Transactional Model of Stress and Coping.Findings: The themes were in alignment with the aim of this study, namely the "challenges of parents of children with ASD" and "coping strategies of parents of children with ASD". Significant personal and societal difficulties, the severity of the symptoms of ASD, and challenges in the health and education systems were subthemes identified under the "challenges of parents" theme. The subthemes that emerged from the "coping strategies" theme were adaptive coping and maladaptive coping. Factors associated with adaptive coping included acceptance of the ASD diagnosis, optimism and faith in God, social support, and celebrating milestones. Maladaptive coping strategies encompassed using corporal punishment, avoidance, social withdrawal, and keeping the child locked in.Conclusion: Recommendations made to mitigate the challenges included strengthening research into ASD, increasing awareness in communities, and training professionals working in the field of ASD.