Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria 0001, South Africa.
NRF Chair in Substance Abuse and Population Mental Health, Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria 0001, South Africa.
Int J Environ Res Public Health. 2023 Feb 23;20(5):3969. doi: 10.3390/ijerph20053969.
Although acceptable levels of parental stress are experienced by all parents who raise children, this stress is substantially higher among parents who raise children with developmental disabilities. Sociodemographic determinants further exacerbate parental stress among parents in rural communities, which are disadvantaged in many ways. This study aimed to quantify parental stress among mothers and female caregivers of children with developmental disorders and investigate factors associated with such stress in rural Kwa-Zulu Natal, South Africa. A cross-sectional quantitative survey was used, in which the Parenting Stress Index-Short Form (PSI-SF) and a sociodemographic questionnaire was administered to mothers and caregivers who were raising children aged 1 to 12 years old who were living with developmental disabilities. The PSI-SF scores were used, where a total score of ≤84 percentile was categorised as normal/no parenting stress, 85-89 percentile was categorised as high parental stress, and scores of ≥90 were classified as clinically significant. The sample of 335 participants consisted of 270 (80.6%) mothers and 65 (19.4%) caregivers. Their ages ranged from 19 to 65 years, with a mean of 33.9 (±7.8) years. The children were mostly diagnosed with delayed developmental milestones, communication difficulties, epilepsy, cerebral palsy, autism, ADHD, cognitive impairment, sensory impairments, and learning difficulties. The majority (52.2%) of the participants reported very high-clinically significant stress levels (≥85%ile). The four factors that independently and significantly predicted high parental stress were the advanced age of mothers and caregivers ( = 0.002, OR 2.3, 95% CI 1.34-3.95), caring for a child with multiple diagnoses ( = 0.013, OR 2.0, 95% CI 1.16-3.50), non-school enrolment of the child ( = 0.017, OR 1.9, 95% CI 1.13-3.46), and frequent hospital visits ( = 0.025, OR 1.9, 95% CI 1.09-3.44). At the subscale level, child non-enrolment in a school was found to independently predict parent distress (PD) and parent-child dysfunctional interaction (P-CDI). Frequent hospital visits were statistically and significantly associated with the difficult child (DC) and P-CDI subscales. The study established high parental stress in mothers and caregivers raising children with developmental disabilities. Lack of access to school was an independent factor that consistently increased parental stress. There is a need for support and directed intervention programs aimed at supporting mothers and caregivers of children with developmental disabilities, which will enhance their parenting abilities.
尽管所有抚养孩子的父母都会经历可接受的父母压力水平，但对于抚养发育障碍儿童的父母来说，这种压力要高得多。社会人口决定因素进一步加剧了农村社区父母的压力，这些社区在许多方面都处于不利地位。本研究旨在量化南非夸祖鲁-纳塔尔省农村地区发育障碍儿童的母亲和女性照顾者的父母压力，并调查与这种压力相关的因素。使用了横断面定量调查，其中向抚养 1 至 12 岁发育障碍儿童的母亲和照顾者发放了父母压力指数-简短形式（PSI-SF）和社会人口学问卷。使用 PSI-SF 评分，总分≤84 百分位被归类为正常/无父母压力，85-89 百分位被归类为高父母压力，得分≥90 被归类为临床显著。335 名参与者的样本包括 270 名（80.6%）母亲和 65 名（19.4%）照顾者。他们的年龄从 19 岁到 65 岁不等，平均年龄为 33.9（±7.8）岁。这些孩子大多被诊断为发育迟缓、沟通困难、癫痫、脑瘫、自闭症、注意力缺陷多动障碍、认知障碍、感官障碍和学习困难。大多数（52.2%）参与者报告压力水平非常高（≥85%ile），临床意义显著。四个独立且显著预测父母压力高的因素是母亲和照顾者年龄较大（ = 0.002，OR 2.3，95%CI 1.34-3.95），照顾有多种诊断的儿童（ = 0.013，OR 2.0，95%CI 1.16-3.50），儿童未上学（ = 0.017，OR 1.9，95%CI 1.13-3.46），以及频繁住院（ = 0.025，OR 1.9，95%CI 1.09-3.44）。在子量表层面，发现儿童未入学与父母困扰（PD）和父母-子女功能障碍性互动（P-CDI）独立相关。频繁住院与困难儿童（DC）和 P-CDI 子量表有统计学和显著关联。该研究确立了母亲和照顾者在抚养发育障碍儿童方面的高父母压力。无法上学是持续增加父母压力的一个独立因素。需要支持和定向干预计划来支持发育障碍儿童的母亲和照顾者，这将增强他们的育儿能力。
