Risk factors for mental health difficulties in parents of children with cerebral palsy: a systematic review and meta-analysis

Parenting stress and positive mental health among parents of children with special needs: A moderated serial mediation model

OBJECTIVES

To explore the impact of parenting stress on the mental health of parents of children with special needs, and to analyze the mediating role of family support and resilience, as well as the moderated role of optimism.

METHODS

This study utilized the Parenting Stress Index-Short Form, Family Support Scale, Resilience Scale, Subjective Well-being Scale, and Symptom Checklist-90 to survey 372 parents of children with special needs in Guangdong Province, China.

RESULTS

(1) Parenting stress significantly affected positive mental health (γ = 0.70,p < 0.001). When family support and resilience were included, the direct effect of parenting stress on positive mental health remained significant (γ = 0.45, p < 0.001). (2) Family support and resilience significantly mediated the relationship between parenting stress and positive mental health in a serial manner. (Direct effect =65.35 %, mediating effect =34.65 %). (3) Optimism significantly moderated the mediating effect of family support on positive mental health (γ = 0.13, p < 0.01).

CONCLUSIONS

The study results reveal the mechanisms through which parenting stress impacts the positive mental health of parents of children with special needs, as well as the protective roles of family support, resilience, and optimism. These findings have certain implications for promoting the mental health of parents and families of children with special needs.

Postnatal depressive symptoms in mothers of infants at high risk of cerebral palsy: the role of delayed infant communicative development

PURPOSE

Recent diagnostic advantages enable detection of cerebral palsy (CP) in infants before five months of age. Parents of children with CP often face mental health problems, but specific knowledge for infancy is needed. In this study, depressive symptoms in mothers of 16-week-old infants and associations with infant development were investigated.

MATERIALS AND METHODS

This cross-sectional study involves 56 families, 22 high-risk and 34 infants without risk of CP. High-risk-CP was identified following international clinical guidelines. We assessed infant cognitive and language development using the Bayley-III and motor development using the Alberta Infant Motor Scale. Maternal depressive symptoms were self-reported using the Edinburgh Postnatal Depression Scale.

RESULTS

Mothers of CP high-risk infants were 15.6 times more likely to experience risk of postnatal depression compared to mothers of infants without risk. Additionally, linear regression analyses showed that having an infant at high-risk of CP (β = .359, p = .006) and delayed language development (β = -0.510, p < .001) were associated with increased maternal depressive symptoms.

CONCLUSIONS

We recommend systematic screening of postnatal depressive symptoms following detection of high-risk-CP in infants. Early interventions could include a mother-infant interactional component to support caregivers in interpreting and responding to infant communicative cues.

Caring for the Caregiver (C4C): An Integrated Stepped Care Model for Caregivers of Children With Medical Complexity

Children with medical complexity (CMC) are a medically fragile subset of children who rely on parental caregivers for substantial care needs. Caregivers of CMC often experience adverse health outcomes such as depression and anxiety, sleep deprivation, financial hardships, and social isolation. Caregivers of CMC are at risk of premature mortality, which is thought to be mediated by chronic and elevated stress, as well as psychiatric morbidity risk. Access to mental health care, where the needs of both the caregiver and child are considered, can enable caregivers to meet high caregiving demands and improve both child and caregiver outcomes. We describe the Caring for the Caregiver (C4C) model, a novel integrated stepped care model consisting of collaboration between a psychiatrist and a pediatric complex care program. This model provides support in 3 steps: 1) early identification of distress, 2) social work assessment, intervention and psychotherapy, and 3) psychiatric care, including diagnosis or medication initiation, for caregivers of CMC. This innovative model will be the first to embed support for the mental health needs of caregivers of CMC within a pediatric team, facilitating access to psychiatric care and serving as a foundation for future integrated stepped care models.

Parenting in Cerebral Palsy: Understanding the Perceived Challenges and Needs Faced by Parents of Elementary School Children

Cerebral palsy (CP) can be considered the most frequent childhood physical disorder. The severity and type of dysfunction depend on the brain injury. Movement and posture are the most affected areas. CP is a lifelong condition, and parenting a child with this disorder brings additional challenges (e.g., dealing with grief) and needs (e.g., information). Identifying and characterizing their challenges and needs are pivotal to enrich the knowledge in this field and help draw more suitable support for parents. Interviews with 11 parents of children with CP attending elementary school were conducted. The discourse was transcribed, and a thematic analysis was performed. Three themes emerged from the data: (i) challenges of parenting a child with CP (e.g., internal challenges), (ii) crucial needs for parents to cope with a child with CP (e.g., information), and (iii) the intersection between challenges and needs of parents of children with CP (e.g., unawareness). Regarding the challenges and needs characterization, lifespan was the most frequent period of child development, and the microsystem was the context of life most reported. The findings may inform the design of educational and remediation interventions to support families of children with CP attending elementary school.