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Zoromba MA, Atta MHR, Ali AS, El-Gazar HE, Amin SM. 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. Int J Ment Health Nurs 2024; 33:2157-2169. [PMID: 39548670 DOI: 10.1111/inm.13383] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 05/20/2024] [Accepted: 06/06/2024] [Indexed: 11/18/2024]
Abstract
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.
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Affiliation(s)
- Mohamed Ali Zoromba
- Nursing College, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, Mansoura University, Mansoura, Egypt
| | | | - Ahmed Salah Ali
- Pediatric Nursing Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt
| | - Heba Emad El-Gazar
- Nursing Administration Department, Faculty of Nursing, Port Said University, Port Fuad, Egypt
| | - Shaimaa Mohamed Amin
- Community Nursing Department, Faculty of Nursing, Damanhour University, Damanhour, Egypt
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Brennan J, Ward OF, Tomeny TS, Davis TE. A Systematic Review of Parental Self-Efficacy in Parents of Autistic Children. Clin Child Fam Psychol Rev 2024; 27:878-905. [PMID: 39160428 DOI: 10.1007/s10567-024-00495-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2024] [Indexed: 08/21/2024]
Abstract
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.
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Affiliation(s)
- Justine Brennan
- Department of Psychology, The University of Alabama, 348 Gordon Palmer Hall, Box 870348, Tuscaloosa, AL, 35487, USA.
| | - Olivia F Ward
- Department of Psychology, The University of Alabama, 348 Gordon Palmer Hall, Box 870348, Tuscaloosa, AL, 35487, USA
| | - Theodore S Tomeny
- Department of Psychology, The University of Alabama, 348 Gordon Palmer Hall, Box 870348, Tuscaloosa, AL, 35487, USA
| | - Thompson E Davis
- Department of Psychology, The University of Alabama, 348 Gordon Palmer Hall, Box 870348, Tuscaloosa, AL, 35487, USA
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
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Abdelaziz EM, Alsadaan N, Alqahtani M, Elsharkawy NB, Ouda MMA, Ramadan OME, Shaban M, Shokre ES. Effectiveness of Cognitive Behavioral Therapy (CBT) on Psychological Distress among Mothers of Children with Autism Spectrum Disorder: The Role of Problem-Solving Appraisal. Behav Sci (Basel) 2024; 14:46. [PMID: 38247698 PMCID: PMC10813282 DOI: 10.3390/bs14010046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/24/2023] [Accepted: 01/08/2024] [Indexed: 01/23/2024] Open
Abstract
Mothers of children with autism spectrum disorder (ASD) face considerable psychological distress. Cognitive behavioral therapy (CBT) has shown promise in reducing caregiver burden, but evidence in the Arab world is lacking. Problem-solving appraisal training may optimize CBT's benefits. This study evaluated a tailored CBT program emphasizing the role of problem-solving appraisal in managing distress through the process of CBT. Sixty mothers were randomly allocated in a 1:1 ratio to either the CBT intervention group or the control group. The CBT group received 3-month sessions incorporating problem-solving appraisal training within a CBT curriculum from October 2022 to April 2023. Problem-solving techniques are focused on equipping individuals with the skills to identify, approach, and effectively resolve problems, leading to a reduction in stress levels and an improved capacity to cope with difficult situations. All mothers completed assessments of socio-demographics such as age, level of education, marital status, occupation, and adequacy of family income, the Depression Anxiety Stress Scale (DASS-21) and the Problem-Solving Inventory (PSI) before and after the program. The CBT group showed significant pre-to-post reductions in depression, anxiety, stress, and general psychological distress compared to controls (all p < 0.05). They also exhibited significant improvements in problem-solving confidence, approach-avoidance style and personal control (all p < 0.05). The customized CBT program markedly improved psychological well-being for mothers of children with ASD in Egypt. Incorporating problem-solving techniques may optimize CBT's benefits cross-culturally. These findings have implications for the implementation of evidence-based support programs for families impacted by ASD worldwide.
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Affiliation(s)
- Enas Mahrous Abdelaziz
- College of Nursing, Jouf University, Sakaka 72388, Saudi Arabia; (E.M.A.); (N.B.E.); (M.M.A.O.); (O.M.E.R.); (M.S.)
- Psychiatric Mental Health Nursing Department, Faculty of Nursing, Cairo University, Cairo 11562, Egypt
| | - Nourah Alsadaan
- College of Nursing, Jouf University, Sakaka 72388, Saudi Arabia; (E.M.A.); (N.B.E.); (M.M.A.O.); (O.M.E.R.); (M.S.)
| | - Mohammed Alqahtani
- Department of Nursing, College of Applied Medical Sciences, King Faisal University, Al Hofuf 31982, Saudi Arabia;
| | - Nadia Bassuoni Elsharkawy
- College of Nursing, Jouf University, Sakaka 72388, Saudi Arabia; (E.M.A.); (N.B.E.); (M.M.A.O.); (O.M.E.R.); (M.S.)
- Maternal and Newborn Health Nursing Department, Faculty of Nursing, Cairo University, Cairo 11562, Egypt
| | - Marwa Mohamed Ahmed Ouda
- College of Nursing, Jouf University, Sakaka 72388, Saudi Arabia; (E.M.A.); (N.B.E.); (M.M.A.O.); (O.M.E.R.); (M.S.)
- Pediatric Nursing Department, Faculty of Nursing, Damanhur University, Damanhur 22516, Egypt
| | - Osama Mohamed Elsayed Ramadan
- College of Nursing, Jouf University, Sakaka 72388, Saudi Arabia; (E.M.A.); (N.B.E.); (M.M.A.O.); (O.M.E.R.); (M.S.)
- Pediatric Nursing Department, Faculty of Nursing, Cairo University, Cairo 11562, Egypt
| | - Mostafa Shaban
- College of Nursing, Jouf University, Sakaka 72388, Saudi Arabia; (E.M.A.); (N.B.E.); (M.M.A.O.); (O.M.E.R.); (M.S.)
- Geriatric Nursing Department, Faculty of Nursing, Cairo University, Cairo 11562, Egypt
| | - Evon S. Shokre
- Psychiatric Mental Health Nursing Department, Faculty of Nursing, Fayum University, Fayum 63514, Egypt;
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Dai Y, Chen M, Deng T, Huang B, Ji Y, Feng Y, Liu S, Zhang L. The importance of parenting self-efficacy and social support for family quality of life in children newly diagnosed with autism spectrum disorder: A one-year follow-up study. Autism Res 2024; 17:148-161. [PMID: 37987229 DOI: 10.1002/aur.3061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023]
Abstract
Improving the quality of family life (FQoL) is one of the ultimate goals for autism spectrum disorder (ASD) intervention, and parenting self-efficacy and social support are critical for the well-being of families. However, longitudinal studies focusing on FQoL and its predictors for families of children with ASD are scarce. This study aims to describe the characteristics of FQoL among parents of children newly diagnosed with ASD at two waves (newly diagnosed and diagnosed after one year) and to explore the predictors of FQoL at two waves. It was conducted at a tertiary hospital in Guangzhou, China. A total of 156 parents and their children were included in Wave 1, followed up with 110 in Wave 2 after 1 year. The overall satisfaction of FQoL improved (t = -2.128, p < 0.05), while satisfaction with physical/material well-being decreased (t = 5.972, p < 0.01). Additionally, the overall importance rating of FQoL improved but did not have statistical significance (p > 0.05). Parents with higher parenting self-efficacy (β = 0.716, P < 0.01), and more subjective social support (β = 1.127, p < 0.001) reported higher satisfaction with FQoL, and those with better social support utilization (β = 1.066, p < 0.05) reported higher importance for FQoL. FQoL needs to be improved in the early stage of ASD diagnosis, and parental self-efficacy and social support can serve as the intervention targets.
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Affiliation(s)
- Yushen Dai
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Miaoying Chen
- Child Development and Behavior Center, The Third Affiliated Hospital of Sun Yat-Sen University Lingnan Hospital, Guangzhou, China
| | - Tao Deng
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Baoqin Huang
- Child Development and Behavior Center, The Third Affiliated Hospital of Sun Yat-Sen University Lingnan Hospital, Guangzhou, China
| | - Yan Ji
- Child Development and Behavior Center, The Third Affiliated Hospital of Sun Yat-Sen University Lingnan Hospital, Guangzhou, China
| | - Yongshen Feng
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Shaofei Liu
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Lifeng Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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Kishimoto T, Liu S, Zhang L, Li S. 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. Front Psychol 2023; 14:956637. [PMID: 37303922 PMCID: PMC10248241 DOI: 10.3389/fpsyg.2023.956637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 05/02/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction Parental stress among primary caregivers of children with autism spectrum disorder (ASD) is a significant concern. While previous research indicates that both family and child factors substantially influence parental stress, a few studies have comprehensively examined these factors from family, parent, and child perspectives. Moreover, the psychological mechanisms underlying parental stress remain underexplored. Method This study obtained a valid sample of 478 primary caregivers of children diagnosed with ASD in China and employed mediation and moderated mediation analyses to investigate the relationships between family adaptability and cohesion (FAC), ASD severity, parental self-efficacy, and parental stress. Result Results revealed that higher FAC was linked to reduced parental stress through increased parental self-efficacy. The indirect effect of parental self-efficacy was more substantial for caregivers of children with severe symptoms than those with mild symptoms. Discussion These findings offer insights into how FAC influences parental stress and underscore the importance of parental self-efficacy as a coping resource for mitigating parental stress. This study provides valuable theoretical and practical implications for understanding and addressing parental stress, particularly in families raising children with ASD.
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Affiliation(s)
- Tomoko Kishimoto
- Department of Social Psychology, Zhou Enlai School of Government, Nankai University, Tianjin, China
| | - Shuang Liu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Lumei Zhang
- Department of Social Psychology, Zhou Enlai School of Government, Nankai University, Tianjin, China
| | - Shaowei Li
- Huli District Maternal and Child Health Hospital, Child Healthcare Department, Xiamen, China
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