Types, availability, and perception of social support among parents of young children with cognitive delays in Vietnam

Parents of young children with disabilities experience increased parenting stress owing to the caregiving demands the children place on them and concern over how they will raise and care for their children in the future. Support or understanding from others can be helpful in relieving the psychological and physical strain that caregivers experience. The project examined the types and availability of social support for Vietnamese parents of young children with cognitive delays, and their perceived social support and parenting stress. Fourteen types of informal support (spouse, wife's father, wife's mother, husband's father, husband's mother, wife's siblings, husband's siblings, sons, daughters, other relatives, friends, neighbors, and parents of other children with disabilities and social helpers) and eight types of professional support (teachers, therapists, doctors, private therapists, home helpers, social agencies, babysitters, and doctors in community health clinics) were available. When the level of intellectual functioning among children was lower, both mothers and fathers reported less availability of support from most types of informal support and teachers. For both mothers and fathers, a larger network of informal and professional support reduced the amount of stress they experienced. Specifically, however, when immediate family members were not available, mothers were more likely to experience parenting stress whereas the unavailability of friends and neighbors increased fathers' parenting stress. While addressing the stigma in society that affects the lives of the families of the children with disabilities in gaining informal support, the need for developing professional services in developing countries is discussed.     

The relationship between maternal chronic pain and child adjustment: the role of parenting as a mediator.

The role of parenting in the relationship between maternal chronic pain and negative child outcomes, including internalizing, externalizing, and social and health problems, was investigated. Parenting strategies used by mothers with chronic pain were compared to parenting strategies used by a control group of mothers without pain. Thirty-nine mothers experiencing chronic pain, their 55 children, 35 pain-free mothers, and their 48 children participated in the study. The results showed that for mothers with chronic pain, dysfunctional parenting strategies and the quality of the mother-child relationship were related to negative child outcomes. Mothers with chronic pain were more likely to engage in lax parenting and report reduced relationship quality with children than were control mothers. For the chronic pain group, over-reactive parenting was found to mediate the relationship between maternal physical functioning and child adjustment. Dysfunctional parenting strategies may constitute part of the risk that maternal chronic pain poses for children. The similarities between the impact of maternal chronic pain on child adjustment and that of other maternal stressors, such as depression, are discussed. PERSPECTIVE: In mothers with chronic pain, poor maternal physical functioning was associated with increased maternal over-reactive behavior that was in turn related to poor child adjustment. Maternal over-reactive behavior did not, however, differ in chronic pain and control mothers.     

Predictors of parenting self‐agency among mothers receiving substance abuse or mental health treatment

Mothers' mental health or substance use disorders impact the behaviours of their children both short‐term and long‐term. There is increased concern for mothers with mental health or substance use disorders to effectively handle parenting challenges. Children of these mothers are at risk for emotional and behavioural adjustment problems as well as poor academic performances. Parenting self‐agency refers to parents' perceptions of their confidence and ability to overcome barriers and manage issues in parenting. Examining the factors that predict parenting self‐agency aids in understanding how nurses can assist mothers and families. The purpose of this study was to explore predictors of parenting self‐agency among mothers who are impacted by mental health or substance use disorders. A secondary analysis was conducted using the baseline assessment data of a randomized trial that examined the efficacy of a nurse‐led family‐strengthening home‐health intervention. The data were obtained from 172 mothers who were receiving outpatient treatment for substance use or other mental health disorders and had children under 18. A multivariate linear regression analysis was conducted to find predictors of parenting self‐agency among participating mothers. The authors found that increased children's externalizing problems and intensity of hassle predicted lower parenting self‐agency, and family cohesion predicted higher parenting self‐agency. The authors conclude that treatments need to address family as a whole to increase mothers' parenting self‐agency, thus assisting these mothers in raising their children in the best possible environment.     

Psychosocial functioning in children with neurodevelopmental disorders and externalizing behavior problems

Abstract

Purpose: This study examines psychosocial functioning in children with neurodevelopmental disorders (NDDs) and/or externalizing behavior problems (EBPs) as compared to children with neither condition. Methods: The longitudinal sample, drawn from the Canadian National Longitudinal Survey of Children and Youth, included children who were 6 to 9 years old in Cycle 1 who were followed-up biennially in Cycles 2 and 3 (N?=?3476). The associations between NDDs and/or EBPs, child and family socio-demographic characteristics and parenting behaviors (consistency and ineffective parenting), were examined across several measures of child psychosocial functioning: peer relationships, general self-esteem, prosocial behavior and anxiety-emotional problems. Results: Children with NDDs, EBPs, and both NDDs and EBPs self-reported lower scores on general self-esteem. Children with NDDs and both NDDs and EBPs reported lower scores on peer relationships and prosocial behavior. Lastly, children with both NDDs and EBPs self-reported higher scores on anxiety-emotional behaviors. After considering family socio-demographic characteristics and parenting behaviors, these differences remained statistically significant only for children with both NDDs and EBPs. Child age and gender, household income and parenting behaviors were important in explaining these associations. Conclusions: Psychosocial functioning differs for children with NDDs and/or EBPs. Children with both NDDs and EBPs appear to report poorer psychosocial functioning compared to their peers with neither condition. However, it is important to consider the context of socio-demographic characteristics, parenting behaviors and their interactions to understand differences in children’s psychosocial functioning.

• Implication for Rehabilitation:

• Practitioners may wish to consider complexity in child health by examining a comprehensive set of determinants of psychosocial outcomes as well as comorbid conditions, such as neurodevelopmental disorders (NDDs) and externalizing behavior problems (EBPs).

• Other health care professionals working with children with NDDs and/or EBPs may wish to consider several child characteristics together, not just the child’s health conditions but also child sex and age.

• Developing specific intervention programs that improve the psychosocial functioning of children with complex health problems appears to be warranted.

     

The effects of hysterectomy on body image, self-esteem, and marital adjustment in Turkish women with gynecologic cancer

The purpose of this research was to investigate the differences in the effect of hysterectomy on body image, self-esteem, and marital adjustment in Turkish women with gynecologic cancer based on specific independent variables, including age, education, employment, having or not having children, and income. This cross-sectional study compared a group of women who underwent a hysterectomy (n = 100) with a healthy control group (n = 100). The study findings indicate that women who had a hysterectomy were found in worse conditions in terms of body image, self-esteem, and dyadic adjustment compared to healthy women. In terms of dyadic adjustment and body image among women who had undergone a hysterectomy, those with lower levels of income and education were found in poorer conditions. The study's findings show that hysterectomies have negative effects on body image, self-esteem, and dyadic adjustment in women affected by gynecologic cancer. Nursing assessment of self-esteem and marital adjustment indicators and implementation of strategies to increase self-confidence and self-esteem are needed for high-risk women.     

Positive Experiences of Mothers and Fathers of Children with Autism

Background The present study examined the positive experiences of parents raising school‐aged children with autism within the context of parenting stress. Materials and Methods Participants included 23 mother/father pairs raising children with autism (ages 5 to 11 years, M = 7.39). Parents completed measures of parenting stress and positive experiences of raising their children. Results Consistent with previous research in a pre‐school aged population of children with autism, mothers reported significantly more positive experiences than did fathers. Mothers’ and fathers’ reports of their positive experiences were negatively related to their reports of parenting stress. Fathers’, but not mothers’, positive experiences were negatively related to their partners’ reports of parenting stress. Conclusion Findings are discussed within a positive psychology framework suggesting that a focus on positive experiences may buffer against negative well‐being.     

Exploring the relationship between maternal migraine and child functioning

OBJECTIVE: To investigate the relationship between mothers' migraines and the roles and expectations of their children. METHODS: Twenty-five mothers diagnosed with migraine completed questionnaires concerning their levels of migraine-related disability and their parenting and child-rearing attitudes. Migraine-related disability was assessed using the Migraine-Specific Quality of Life Questionnaire (version 2.1). Parenting and child-rearing attitudes were assessed using the Adult-Adolescent Parenting Inventory. RESULTS: Significant positive relationships were found between the mothers' migraine-related disability and both inappropriate expectations of their children and parent-child role reversal; ie, the more migraine-related disability reported by the mothers, the more they reported having inappropriate expectations of their children and favoring parent-child role reversal. CONCLUSIONS: This study suggests that migraine may be associated with dysfunctional parenting patterns. More specifically, it suggests that in families wherein the mother has migraine, children may be at risk of inappropriately or prematurely assuming roles for which they are developmentally unready. Clinical implications are that mothers with migraine may benefit from some type of family-focused intervention, in addition to headache treatment.     

Coping, satisfaction, and the life cycle in families with mentally retarded persons.

The study focused on the variables influencing the functioning of 62 families with MR (mentally retarded) persons, living at home, in various stages of the life cycle. Results demonstrated the importance of some father characteristics to maternal coping skills in two-parent households. Although mean maternal coping scores were not statistically different between two-parent and single-parent households, single mothers' coping skills showed strong negative associations with both the number of children in the household and the age of the mother. This was not true of mothers in two-parent households. Single-parent mothers also appeared to be considerably more dissatisfied with family functioning than mothers in two-parent households. The supportive role of older fathers in mothers' coping in two-parent households also was apparent. Clinical implications of the study point to the need for greater support for mothers of young children with MR, mothers who are sole caregivers, and parents with many children. Differential support to mothers and fathers of an MR person may be required over the life cycle.     

Family dynamics and postnatal depression

Research has shown that postnatal depression (PND) affects 10-15% of mothers in Western societies. PND is not easily identified and therefore it often remains undetected. Untreated depression has a detrimental effect on the mother and child and the entire family. The purpose of this study was to ascertain the state of family dynamics after delivery and whether the mother's PND was associated with family dynamics. The study used a survey covering the catchment area of one Finnish university hospital. Both primi- and multiparas took part and data were collected using the Edinburgh Postnatal Depression Scale (EPDS) for mothers and the Family Dynamics Measure II (FDM II) for both mothers and fathers. The data were analysed using SPSS statistical programme and frequency and percentage distributions, means and standard deviations were examined. Correlations were analysed using Spearman's correlation coefficients. The significance of any differences between mothers' and fathers' scores was determined with a paired t-test. Of the families participating in the study (373 mothers and 314 partners), 13% of the mothers suffered from PND symptoms (EPDS score of 13 or more). As a whole, family dynamics in the families participating in the study were reported to be rather good. However, mothers having depressive symptoms reported more negative family dynamics compared with other families. With the exception of individuation, mothers having depressive symptoms reported more negative family dynamics than their partners. With the exception of role reciprocity, non-depressed mothers reported more positive family dynamics than their partners. Knowledge of the association of mothers' PND with family dynamics could help to develop nursing care at maternity and child welfare clinics and maternity hospitals. Depressed mothers and their families need support to be able to make family dynamics as good as possible.     

Parental and family well-being in families of children with Down syndrome: a comparative study.

The purpose of this study was to examine the effects of a child with Down syndrome on the individual functioning of both parents, marital functioning, and family functioning. Thirty-four families of children with Down syndrome were compared to 41 families with nondisabled children. Mothers and fathers in both groups completed a series of self-report measures. No significant differences were obtained between the two groups of families on any of the measures of individual, marital, or family functioning. The results of this study support a competence model in which parents may respond to the challenges associated with parenting a child with Down syndrome with resilience and adaptive functioning.     

The influence of fathers’ parenting participation with disabled children on parenting stress in mothers

[Purpose] The purpose of this research was two-fold: (1) to evaluate the effects of father’s parenting participation on parenting stress among mothers with disabled children and (2) more specifically, to investigate the importance of fathers’ parenting participation in decreasing mothers’ parenting stress. [Subjects and Methods] To examine these relationships, this study recruited 82 mothers with disabled children from rehabilitation centers in the Gwangju city. The common characteristics of parents and children, father’s parenting participation, and mother’s parenting stress were assessed using standard questionnaires. [Results] Based on mother reports, findings suggest that as fathers’ parenting participation increases mothers’ parenting stress decreases. [Conclusion] The present study reveals a need for improvement in parenting education and in providing fathers of disabled children with a temporary leave of absence from work. Specifically, this research highlights the importance of shared parenting responsibilities among family members. Finally, our findings suggest that developing a standardized national program for assisting parents with disabled children may help decrease parenting stress in mothers.Key words: Disabled children, Parenting, Stress     

Maternal and Paternal Parenting, Acculturation, and Young Adolescents'' Psychological Adjustment in Korean American Families

PROBLEM: Maintaining healthy psychological adjustment may be more complicated for Korean American young adolescents than for their European American counterparts. Korean American families live in two cultures and the issue of acculturation challenges their parenting, which is a critical factor for young adolescents' psychological adjustment. METHODS: Hierarchical multiple regressions were used to analyze 106 family data (young adolescents, mothers, and fathers) on parenting (acceptance-rejection and behavioral control), acculturation (integration, assimilation, separation, and marginalization), and young adolescents' psychological adjustment. FINDINGS: Only young adolescents' reports of maternal and paternal acceptance-rejection were related to their report of psychological adjustment. However, maternal acculturation moderated the relation between mothers' reports of maternal acceptance-rejection and behavioral control and young adolescents' report of their psychological adjustment. CONCLUSIONS: Parental acceptance-rejection is related to young adolescents' psychological adjustment when adolescents perceive themselves as accepted or rejected by parents. The relation between mothers' report of maternal acceptance-rejection and behavioral control and adolescents' psychological adjustment needs to be considered within the context of maternal acculturation.     

A comparison of family functioning when mothers have chronic pain

Multiple aspects of family functioning were assessed when mothers experienced either chronic pain, a chronic illness (diabetes), or no illness. Mothers' and fathers' self-report measures of depression, anxiety, and family environment were collected. Children's self-report measures of depression and anxiety, as well as information about their overall adjustment, were collected. Family communication patterns were also assessed. Families with a mother who had chronic pain had poorer perceived family environments and higher levels of depression and anxiety compared to the other two groups of families. Children from chronic pain families also appeared to be adversely affected. The data suggest that level of disability appeared more salient than the type of chronic illness. Implications of the findings are discussed in light of the fact that mothers with chronic pain in the present sample reported relatively mild disability and were not actively seeking treatment for their condition.     

Stresses and coping strategies of mothers living with a child with cystic fibrosis: implications for nursing professionals

BACKGROUND: Cystic fibrosis (CF) is the most common inherited disease of childhood. Caring for a child with CF is stressful and this has implications for the main carer, the parental relationship, well siblings, family functioning as well as the affected child. AIM: This study aimed to explore current stresses and coping strategies used by mothers and to identify roles and strategies that nursing professionals could extend or adopt to support them and families of children with CF. METHOD: Semi-structured interviews were carried out with 17 mothers of children with CF who attended the regional cystic fibrosis hospital clinic. Interviews were analysed using the Framework method of analysis. FINDINGS: The study suggests that major stresses for many mothers are feeling in the middle in terms of decision-making particularly concerning the genetic implications of CF, the burden of responsibility for parenting a child with a chronic illness, and coming to terms with a personal change in identity. The most commonly used coping strategy was seeking support from others including nursing professionals. Relationships with health professionals in secondary care were generally positive, with nurses often the first people mothers turned to when they had concerns and also key in interpreting medical information. Relationships with primary care health professionals appeared to be more limited with a role reversal described by some mothers who felt it their responsibility to educate and inform primary care professionals about CF. CONCLUSIONS: This study suggests that nursing professionals in primary and secondary care need to look beyond the care of the child to the needs of the mother. It provides evidence to suggest that nursing professionals in primary and secondary care have a number of important roles to play as holders of hope, bridge builders and in providing continuity of care for such families. It also suggests strategies to strengthen nurse-patient relationship.     

Different risk factor patterns for metabolic syndrome in men with spinal cord injury compared with able-bodied men despite similar prevalence rates

OBJECTIVE: To determine if the prevalence of metabolic syndrome and risk factors differs between age- and race-matched men with spinal cord injury (SCI) and able-bodied men. DESIGN: Cross-sectional. SETTING: Urban university. PARTICIPANTS: Men with SCI (n=185), ages 20 to 59 years, were matched 1 to 1 with able-bodied men from the 1999-2002 National Health and Nutrition Examination Surveys. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Waist circumference, blood pressure, glucose, triglyceride (TG), total (TC), and low- (LDL) and high-density lipoprotein (HDL) cholesterol. RESULTS: Despite similar prevalence for metabolic syndrome, different risk factor patterns were found between groups. Men with SCI had a significantly lower mean HDL, TG, and glucose in addition to lower TC and LDL. After adjusting for smoking, education, and household income by using conditional logistic regression, men with SCI had a higher risk for abdominal obesity (odd ratio [OR]=1.78; 95% confidence interval [CI], 1.07-2.96) and reduced HDL (OR=1.76; 95% CI, 1.06-2.94) but lower risks for elevated glucose (OR=0.55; 95% CI, 0.33-0.94) than their able-bodied counterparts. By using linear regression and controlling for waist circumference, men with SCI had lower TC, LDL, TG, and glucose concentrations but lower HDL. Racial differences in risks were found in both SCI and able-bodied men; however, among the SCI men, prevalence for low HDL and elevated glucose was similar between whites and African Americans. CONCLUSIONS: Men with SCI do not appear to have an increased prevalence of metabolic syndrome compared with able-bodied counterparts, suggesting that other nontraditional risks may contribute to their increased mortality from cardiovascular disease and diabetes.     

Characteristics of psychosexual functioning in adults with cerebral palsy

OBJECTIVE: To investigate the characteristics of psychosexual functioning in adults with cerebral palsy, as compared with able-bodied control subjects, matched by gender and marital status, and to identify the factors affecting psychosexual functioning. DESIGN: Interview and survey using the Derogatis Sexual Functioning Inventory (DSFI). SETTING: Inpatient and outpatient units in a rehabilitation hospital and welfare facilities. SUBJECTS: Sixty-two adults with cerebral palsy and 142 age-matched able-bodied controls participated in this study. The participants were grouped into four subgroups according to gender and marital status. MAIN MEASURES: General characteristics of the subjects, 10 domain scores of the DSFI and Sexual Functioning Index (SFI) as a global score were assessed. The scores for each cerebral palsy group according to gender and marital status were compared with those of their corresponding able-bodied control group. RESULTS: Unmarried men with cerebral palsy demonstrated lower SFI and weakness in sexual information, experience, drive, attitude, psychological symptoms, affect and satisfaction, compared with unmarried able-bodied men (p < 0.05). In contrast to unmarried men, unmarried women did not reveal any significant differences in all but body image domain score (p < 0.05) between the groups. Married adults with cerebral palsy showed higher levels of psychological distress in both men and women and lower sexual satisfaction in women (p < 0.05). Nonambulatory people with cerebral palsy had significantly a lower sexual information, experience and satisfaction, and a lower SFI than ambulatory (p < 0.05). Barthel Index was significantly related to body image (p < 0.05). Psychosexual functioning was not significantly different according to cerebral palsy type. CONCLUSION: This study revealed the characteristics on psychosexual functioning in adults with cerebral palsy, depending on gender and marital status. The results suggested that nonambulatory unmarried men with cerebral palsy were at high risk in terms of psychosexual dysfunction.     

Parenting and Child Outcomes of HIV-Infected African American Mothers: A Literature Review

Parenting young children while living with HIV is an important public health concern. This article reviews maternal HIV and the impact it has on the parenting experience of African American mothers. Because living with HIV has been considered a family illness, the Family Systems Model provided a framework for this article. The model demonstrated an important link between maternal HIV and its impact on the health and wellbeing of not only the mother and her children, but her parenting and family roles as well. Research has documented an association between maternal HIV and negative parent–child outcomes among African American mothers. I examined studies on parenting and child outcomes among African American mothers living with HIV. The review assists in conceptualizing parenting with HIV as an area of increasing importance in health services delivery to HIV-infected African American mothers who are caring for young children.