STRESS IN THE PARENTS OF CHILDREN WITH PHYSICAL DISABILITY

 

Saira Khan¹

¹Assistant Professor, Department of Applied Psychology, GC Women University Faisalabad

Madina Town 38000-Faisalabad, Pakistan

 

Correspondence concerning this article should be addressed to Saira Khan,Assistant Professor, Department of Applied Psychology, GC Women University Faisalabad.

Email: sairakhan2003@gamil.com

ABSTRACT

 

OBJECTIVES

 The research was conducted to examine the level of the stress in the parents of children with physical disability. Furthermore study also aimed at assessing the physical disability of the children as the predictor of stress in their parents.

 

DESIGN

Correlational study

 

PLACE & DURATION OF STUDY

The study was completed in special education schools of Faisalabad from September 2012 to February 2013.

 

SUBJECTS AND METHODS

100 parents (mothers=48, fathers= 52) of the children (7-12 years old) with physical disability were selected through purposive sampling technique. Parenting Stress Index-Short Form was administered to parents of children with physical disability to measure their stress. Stepwise regression analysis, Correlation, t-test were applied to analyze the data.

 

RESULTS

 The parents of the children with physical disability showed elevated stress level and the mothers of these children were experiencing significantly higher level of stress than the fathers of such children, which was mainly related to their children’s disability, and the child’s difficulty was the primary predictor of parental stress.

 

CONCLUSION

It was concluded that children with physical disability had dysfunctional interaction with their parents and become a difficult child which mainly attributed to maternal stress.

 

KEYWORDS

Parental stress, Physical disability

 

 

INTRODUCTION

Stress is very common in the parents especially in mothers of the children with physical disability. Psychological stress is a relationship between the person and the environment that is appraised by the person as tough or exceeding his or her resources and endangering his or her well-being¹. Folkman explains this relationship between the person and environment as bidirectional, dynamic, and mutually reciprocal. Caring for a child with disabilities is a unique situation that commonly results in higher levels of parenting stress^{2, 3}.Maternal perception of a child as 'difficult' are associated with poor maternal psychological health.⁴.A study reported elevated parental stress in mothers of boys with Duchenne muscular dystrophy (DMD), possibly due to increased problem behaviors, particularly in social interactions, rather than due to the physical demands of the disease alone⁵.Level of partner support and its relation to maternal stress were examined in families raising children with cerebral palsy concluded that child's level of impairment and the interaction between partner support and child impairment were significant predictors of maternal stress⁶. It was found that the level of stress among parents of physically challenged children was much higher and significantly differed with their normal counterparts. The two groups also differed significantly in terms of their coping strategies where parents of normal children were much better than the parents of physically challenged group⁷.

In a longitudinal study Hanson and Hanline reported that the mothers of children with neurological impairments reported the highest stress associated with children’s demandingness in Years 1 and 3 and acceptability in Years 2 and 3.Mothers of children with Down Syndrome also reported higher stress scores associated with children’s acceptability in Years 2 and 3. In general higher levels of parenting stress scores were associated with children’s lower levels of adaptive behavior⁸.Pearson and Chan found a correlation between parent education level and parenting stress having a child with a mental handicap and concluded that the less educated mothers experiencing heightened parenting stress. It was recognized by the authors that a less educational level failed to provide these mothers with the coping skills essential to deal with the added difficulties imposed on them by their child’s handicap. Their study revealed further that parents with low education levels also tended towards low income and suggested that together, these two factors may have a multiplier effect on the degree of parenting stress experienced⁹.

 

METHODOLOGY

PARTICIPANTS

 100 parents (mothers=48, fathers= 52) of the children (7-12 years old) with physical disability were selected through purposive sampling technique. The children with physical disability were selected from different schools for special education situated in Faisalabad and their parents were taken as sample of the study. They belong to different socio economic status and having different educational level.

 

 

MEASURE

The Parenting Stress Index (PSI) was created by Abidin as a screening and diagnostic assessment tool designed to yield level of stress in the parent-child system¹⁰.PSI is a self-report, Likert type questionnaire that identifies a wide range of potential influences on parenting practices. It consists of 54 parent-focused items, 47 child-focused items and also contains 19 items about general life stressors. PSI has also been translated into Urdu¹¹.The Parenting Stress Index- Short Form (Urdu version) was chosen for the present study for measuring the parenting stress level having the physically handicapped children. Abidin developed the 36 item PSI-SF as a direct derivative of the full length PSI. Factor analysis of the full length PSI yielded a three factor solution, parents distress (PD), parent child dysfunctional interaction (PCDI) and difficult child (DC). Within each subscale are 12 items or statements, which the subject is required to rate from 1(strongly disagree) to 5 (strongly agree). Adding the item scores for each subscale therefore results in a figure, which ranges from 12 to 60. By further adding the results of each subscale score, the researcher is provided with the resultant total parenting stress score (PSI-SF Total), which can range from 36 to 180. It is reliable and valid tool. Total stress scores of PSI correlated 0.94 with the PSI-SF total.

PROCEDURE

After getting permission from the principal of the schools, physically disable children of ages between 7 to 12 tears were selected with the help of their teachers. Parents of the selected children were contacted though the school administration. Parents were contacted in the school or at their home places according to their convenience. Informed consent was taken and then they were requested to complete the Parenting Stress Index- Short Form (PSI-SF). The data was analyzed with the help of SPSS version 13. The results were obtained through Pearson correlation and Regression analysis.

Results

 

Result showed that the mean of the parents stress score went above the cut off score for clinically significant stress that was 90 (M=111, SD=20.01).  The scores of parents were higher on all three subscales; Parental Distress (PD) (M = 36 SD = 8.46), Parent Child Dysfunctional Interaction (PCDI) (M = 38, SD = 7.60), and Difficult Child (DC) (M = 40, SD = 8.91).

t test has showed significant differences in the mean scores of mothers and fathers of children with physical disability for different subscales of Parent Stress Index-Short form, t (98) = 2.94, p< .005; t (98) = 2.24, p< .01. Mothers were having more stress as compared with fathers. There was also significant differences for difficult child and parent child dysfunctional interaction between mothers and fathers, t (98) = 2.01: t (98), p< .05, Mothers were more stressed (M = 42.46, SD =7.67: M= 39.95, SD= 7.92) as compared with fathers (M= 37.54, SD = 9.45: M = 35.65, SD = 6.83) (see table 2).

Stepwise regression analysis was performed to determine the contributing factors of parental stress. Difficult child sub scale of PSI-SF was emerged as the strongest predictor of parental stress β= .77, t= 8.29, p<.0001accounted for 59 % variance in total stress in parents. Parent distress β= .55, t= 7.89, p<.0001and parent dysfunctional interaction   β= .30, t= 5.02, p<.0001 were also the contributing factors in predicting the parental stress in parents of children with physical disability (see table 3). Correlation matrix of predictors strengthens our results. Total stress showed positive and strong relationship with difficult child (r = .77), parent child dysfunctional interaction (.69) and parent distress (.75).

 

Table 1

Descriptives of Subscales of PSI-SF of Parents of the Children with Physical Disability

Scales	Mean	SD
Parental Distress (PD)	36	8.64
Parent Child Dysfunctional Interaction (PCDI)	38	7.60
Difficult Child (DC)	39	8.91
Total Stress	111	20.02

 

 

Table 2

t-test of Parents of physically disable children, Fathers (n = 52) and Mothers (n =48 ) for their total score and  scores on Subscales of Parent Stress Index-Short Form(PSI-SF)

Groups	Fathers M (SD)	Mothers M (SD)	t
Total Stress	105.0(20.67)	117.21(17.6)	2.24*
Difficult Child	35.65(6.83)	42.46(7.67)	2.01*
Parent Child Dysfunctional Interaction		39.95(7.91)	2.06*
Parent Distress	32.81(8.15)	39.50(7.92)	2.94***

*p<.05. **p<.01.***p<005.

 

 

Table 3

Stepwise Multiple Regression for Prediction of stress in parents of children with physical disability (n=100). 

Variable	B	SE	Β	t	p
(R=.77,R²=.59) Difficult Child	1.73	.21	.77	8.29	.0001
(R=.90,R²=.82) Difficult Child	1.23	.16	.55	7.89	.0001
Parent Distress	1.21	.16	.53	7.58	.0001
(R=.93,R²=.88) Difficult Child	.99	.14	.45	7.37	.0001
Parent Distress	1.02	.14	.44	7.51	.0001
Parent Child Dysfunctional Interaction	.79	.16	.30	5.02	.0001

Step1; F (99) =68.79, p<.0001.Step 2;F (99) =103.61, p<.0001.Step 3;F (99) =113.1, p<.0001.

 

Table 4

Correlation Matrix of Predictors

Variable	2	3	4
1. Total Stress	.77**	.69**	.75**
2. Difficult Child	--	.46*	.42*
3. Parent Child Dysfunctional Interaction	--	--	.43*
4. Parent Distress	--	--	--

*p<.01.**p<.001.

 

Discussion

           

The present study was designed to investigate the relationship of child’s physical disability with stress experienced by parents, being the parents of children with physical disability. The results of the present investigation have provided evidence supporting the hypotheses that parents of children with disabilities report greater levels of stress. Furthermore, significant differences with respect to parent-related parenting stress were found between mothers and fathers. Present study hypothesized that the parents of children with physical disability would experience stress and in the present study the most of the parents of the children with physical disability reported having stress. The mean PSI Total fall on the 85th percentile while 86% of the study sample was identified as experiencing pathological levels of parenting stress with total scores of greater than 90. The findings of this study suggest that parenting a child with a disability is stressful and challenging experience. As such, these parents are at a risk for developing maladaptive, dysfunctional coping patterns to assist them in dealing with their disabled children.

For the present study it was hypothesized that mothers of physically handicapped children are more stressed that the fathers of the physically handicapped children. The results are consistent with the study Beckman ¹², who concluded that mothers in general reported greater stress than fathers. Author also reported that mothers reported more depression, more difficulties with their sense of competence, more restrictions on the parental role, and more difficulties in their relationship with their spouse, more effects on their health. Results of recent study revealed that mothers experienced total stress higher than the stress experienced by the fathers. Mothers of the present study also showed highly significant difference on all subscales of PSI-SF which indicates that the mothers as primary care giver were more attached than fathers as concluded byKrauss¹³that fathers’ reporting less attachment to their children, he also demonstrated that mothers reported more parent related stress with respect to their health, role restrictions, and relationships with their spouse. One more study showed that mothers had higher rates of stress, had more use of antidepressant, and also had frequent therapy use than did fathers¹⁴.

Relationship between parental total stress, parent distress, parent child dysfunctional interaction and difficult child was also explored by of the present study. Stepwise regression analysis of present data confirmed this assumption that difficult child, parent distress and parent child dysfunctional interaction were the predictors of total stress. Among these entire variables difficult child was the strongest predictor of total stress, accounted for 59% variance in total stress. Results of present study suggest that constant physical disability becomes the cause of parental stress and parental stress negatively effects the children with physical disability and produce self doubts in them which in turns become the cause of behavioral problems in children with physical disability and make the child more difficult for the parents which in turns increase the parental stress.

Conclusion

Stress levels of the parents of physical disabled children are generally very high. It is concluded that mothers in general reported greater stress than fathers. Mothers reported more depression, more difficulties with their sense of competence, more restrictions on the parental role, more difficulties in their relationship with their spouse, and their health more affected. The constant physical disability becomes the cause of parental stress and parental stress negatively affects the children with physical disability and produce self-doubts in them which in turns become the cause of behavioral problems in children with physical disability and make the child more difficult for the parents which in turns increase the parental stress.

 

References