How do autistic severity and family functioning influence parental stress in caregivers of children with autism spectrum disorder in China? The important role of parental self-efficacy

The Mediating Role of Psychological Capital in the Relationship Between Family Sense of Coherence and Caregiver Stress Among Parents of Children With Autism Spectrum Disorder

Caregiving for children with autism spectrum disorder (ASD) poses significant stress for parents, necessitating an exploration of mitigating factors. This study investigates the interplay between Family Sense of Coherence, Psychological Capital and caregiver stress in this context. A total of 205 caregivers of children with ASD participated in this cross-sectional study. Data were collected on Family Sense of coherence, Psychological Capital (encompassing hope, resilience, optimism and self-efficacy) and caregiver stress. Structural equation modelling was employed to test the mediation effect of psychological capital between family sense of coherence and caregiver stress. The results indicated a strong positive correlation between family sense of coherence and all subdomains of psychological capital, with coefficients ranging from 0.541 to 0.610. Conversely, psychological capital demonstrated significant negative correlations with various domains of the Kingstone Caregiver Stress Scale, including caregiving, family issues and financial issues (coefficients from -0.443 to -0.427). Furthermore, family sense of coherence showed a direct negative effect on stress (β = -0.384, p < 0.001). Notably, the study revealed a significant mediating role of psychological capital in the relationship between family sense of coherence and caregiver stress, with an indirect effect of family sense of coherence on stress through psychological capital (β = -0.127). The findings underscore the crucial role of family sense of coherence and psychological capital in enhancing psychological resources and mitigating stress among caregivers of children with ASD. These results suggest that interventions aimed at strengthening family coherence and building psychological capital could be effective strategies in alleviating stress among caregivers of children with ASD. Healthcare professionals should consider incorporating family coherence approaches and psychological capital techniques in their support programs for these caregivers.

A Systematic Review of Parental Self-Efficacy in Parents of Autistic Children

Parental self-efficacy (PSE) assesses a parent's expectations and beliefs about their ability to effectively parent their child. PSE has implications for a parent's well-being, parenting practices, mental health, the parent-child relationship, and child adjustment. While PSE has been extensively examined within the broader parenting literature, the examination of PSE specifically for parents of autistic children has gained increasing attention in recent years. The following systematic review aimed to investigate the role of PSE for parents of autistic children by examining variables that predict PSE or are predicted by PSE in relation to how they align with the broader parenting literature and are unique to autism. Utilizing PRISMA guidelines, peer-reviewed articles were included if (a) participants included caregivers of autistic children, (b) at least one quantitative outcome measure of PSE was utilized, and (c) the role of PSE was examined as an outcome, predictor, or variable in an explanatory model. A total of 53 studies were included in the review and the role of PSE was examined regarding family (e.g., parental characteristics, parent stress, well-being, and support) and child factors (e.g., autism symptomology, problem behaviors, interventions). Several themes emerged including a positive relationship between PSE and support, and a negative relationship between PSE and parenting stress, parent mental health outcomes (e.g., anxiety, depression), and autism symptomology. Findings were compared to the broader parenting and PSE literature to examine how increased considerations and challenges (e.g., child problem behaviors, social impairment, and caregiver strain) associated with raising an autistic child might impact PSE.

Development and evaluation of a family-child reading picture book on reducing autism spectrum disorder caregivers' psychological stress: a mixed method study

Introduction

The rapid increasing prevalence of ASD has become a significant global health issue. Caregivers of children with ASD are experiencing higher level of psychological stress and mental disorders. However, interventions to improve the psychological health of caregivers of children with ASD have largely been neglected.

Methods

Based on the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model, we initially did in-depth interviews with 8 caregivers, and conducted field observation in two rehabilitation centers to analyze the daily lives, the empowered components, the emotional moments of the children with autism and their caregivers. Then we designed the outline of the picture book, and developed it by a multi-disciplinary team by 4 rounds. After that, this picture book was sent out to 54 caregivers of children with ASD for family-child reading in one month. A quantitative questionnaire was administered before and after their reading to evaluate the efficacy of reducing their stress and affiliate stigma, and improving self-efficacy, resilience, empowerment capacity; and exit interviews were conducted after their initial reading to assess the acceptability, content appropriateness, perceived benefits and generalizability of this picture book. Quantitative data were analyzed by descriptive analysis and paired t-tests using IBM SPSS 26.0. Qualitative data were analyzed using template analysis.

Results

In total, 54 caregivers read the picture book with their child, with the total of 149 (an average of 2.76 per family) times reading in one month. Among them, 39 caregivers returned the following-up questionnaires. Although most of the outcome measures did not showed significant changes except the stress level decreased statistically significant (13.38 ± 3.864 to 11.79 ± 3.238, P=0.001), caregivers reported that the picture book echoed their daily lives and gave them a sense of warmth, inspiration, and hope, as well as some insight on family relationships and attitudes towards the disorder. They also expressed a willingness to disseminate the book to other families with children suffering ASD and the public.

Conclusion

This specially designed picture book has been proven to be an acceptable, content-appropriate, and effective family-centered psychological intervention, which could be easily scaled up.

Psychometric properties of the Turkish version of the parental competence scale for parents of children with autism

BACKGROUND

Parental competence is an important concept in increasing the quality of care provided to individuals with special needs and the quality of life of parents. This study was aimed to evaluate the psychometric properties of the Turkish version of the Parental Competence Scale designed for parents of children with autism spectrum disorders.

METHOD

This methodological study was conducted with 433 parents of children with autism between November 2021 and February 2023. Information Form, the Parental Competence Scale for Parents of Children with Autism, and the Parental Self-Efficacy Scale were used to collect the data. The data were assessed using content and construct validity, item analysis, confirmatory factor analysis, and internal consistency. Guidelines for reporting reliability and agreement studies (GRRAS) were adhered to in the study.

FINDINGS

The content validity index of the scale was 0.93. Item-total score correlation values ranged from 0.338 to 0.846. As a result of confirmatory factor analysis, the two-factor structure of the scale consisting of 19 items was confirmed. Factor loads were >0.30 and fit indices were >0.80. The Cronbach's alpha coefficient of the Turkish version of the scale was 0.85, and the Cronbach's alpha values of its sub-dimensions were 0.71 and 0.79.

CONCLUSION

The parental competence scale for parents of children with autism is a valid and reliable measurement tool for Turkey.

PRACTICE IMPLICATIONS

Pediatric nurses, all health professionals, special education professionals and teachers can use this scale in interventional studies aiming to evaluate or improve the competencies of parents with autistic children in the future.