PERTANIKA JOURNAL OF SOCIAL SCIENCES AND HUMANITIES

This research aim to identify the prevalence and factors associated with maternal stress among mothers of children with cerebral palsy in rural Bangladesh. A cross-sectional study was performed among 200 mothers of children with cerebral palsy picked up from rural Bangladesh using a simple random sampling technique. A questionnaire divided into various sections and administered by the researchers was used for data collection. Descriptive statistics and logistic regression models were applied to summarize the respondents’ characteristics, main outcomes (maternal stress levels), and factors associated with maternal stress. The overall prevalence of maternal stress among mothers of children with CP was 56.5%, and the median (IQR) age of respondents was 30 (14), whereas that of the children with CP was 6 (8). Factors associated with a higher prevalence of maternal stress were older mothers, divorced/separated, living in a nuclear family, income, male children, and higher negative family impact (p < 0.05). The factors identified in this study could help to develop policies and strategies to minimize maternal stress associated with parenting children with cerebral palsy in rural Bangladeshi households.

• Ahmadizadeh, Z., Rassafiani, M., Khalili, M. A., & Mirmohammadkhani., M. (2015). Factors associated with quality of life in mothers of children with cerebral palsy in Iran. Hong Kong Journal of Occupational Therapy, 25(1), 15-21. https://doi.org/10.1016/j.hkjot.2015.02.002

• Ang, G. H. E., & Juhari, R. (2017). Maternal appraisal, social support and parenting stress among mothers of children with cerebral palsy. International Journal for Studies on Children, Women, Elderly and Disabled, 1, 1-8.

• Arneson, C. L., Durkin, M. S., Benedict, R. E., Kirby, R. S., Yeargin-Allsopp, M., Van Naarden Braun, K. V. N., & Doernberg, N. S. (2009). Prevalence of cerebral palsy: Autism and developmental disabilities monitoring network, three sites, United States, 2004. Disability and Health Journal, 2(1), 45-48. https://doi.org/10.1016/j.dhjo.2008.08.001

• Bangladesh National Portal. (n.d.). Background of Satkhira District. https://www.satkhira.gov.bd/site/page/22229c83-1c4b-11e7-8f57-286ed488c766/%E0%A6%B8%E0%A6%BE%E0%A6%A4%E0%A6%95%E0%A7%8D%E0%A6%B7%E0%A7%80%E0%A6%B0%E0%A6%BE%20%E0%A6%9C%E0%A7%87%E0%A6%B2%E0%A6%BE%E0%A6%B0%20%E0%A6%AA%E0%A6%9F%E0%A6%AD%E0%A7%82%E0%A6%AE%E0%A6%BF

• Berry, J. O., & Jones, W. H. (1995). The parental stress scale: Initial psychometric evidence. Journal of Social and Personal, 12(3), 463-472. https://doi.org/10.1177/0265407595123009

• Chauhan, A., Singh, M., Jaisawal, N., Agarwal, A., Sahu, J. K., & Singh, M. (2019). Prevalence of cerebral palsy in Indian children: A systematic review and meta-analysis. The Indian Journal of Pediatrics, 86, 1124-1130. https://doi.org/10.1007/s12098-019-03024-0

• Cheshire, A., Barlow, J. H., & Powell, L. A. (2010). The psychosocial well-being of parents of children with cerebral palsy: A comparison study. Disability and Rehabilitation, 32(20), 1673-1677. https://doi.org/10.3109/09638281003649920

• Christopher, S., Shakila, L. C., & Suganya, R. L. (2020). Stress in families of children with disabilities. Indian Journal of Public Health Research & Development, 11(2), 1-5. https://doi.org/10.37506/v11/i2/2020/ijphrd/194741

• Dambi, J. M., Mandizvidza, C., Chiwaridzo, M., Nhunzvi, C., & Tadyanemhandu, C. (2016). Does an educational workshop have an impact on caregivers’ levels of knowledge about cerebral palsy? A comparative, descriptive cross-sectional survey of Zimbabwean caregivers. Malawi Medical Journal, 28(4), 167-173. https://doi.org/10.4314/mmj.v28i4.4

• Dieleman, L. M., Soenens, B., Prinzie, P., De Clercq, L., Ortibus, E., & De Pauw, S. S. W. (2021). Daily parenting of children with cerebral palsy: The role of daily child behavior, parents’ daily psychological needs, and mindful parenting. Development and Psychopathology, 33(1), 184-200. https://doi.org/10.1017/S0954579419001688

• Dunst, C. J., Jenkins, V., & Trivette, C. M. (1984). Family support scale: Reliability and validity. Journal of Individual, Family, and Community Wellness, 1(4), 45-52.

• Duvdevany, I., & Abboud, S. (2003). Stress, social support and well-being of Arab mothers of children with intellectual disability who are served by welfare services in northern Israel. Journal of Intellectual Disability Research, 47(4-5), 264-272. https://doi.org/10.1046/j.1365-2788.2003.00488.x

• Glenn, S., Cunningham, C., Poole, H., Reeves, D., & Weindling, M. (2009). Maternal parenting stress and its correlates in families with a young child with cerebral palsy. Child: Care, Health, and Development, 35(1), 71-78. https://doi.org/10.1111/j.13652214.2008.00891.x

• Holly, L. E., Fenley, A. R., Kritikos, T. K., Merson, R. A., Abidin, R. R., & Langer, D. A. (2019). Evidence-base update for parenting stress measures in clinical samples. Journal of Clinical Child and Adolescent Psychology, 48(5), 685-705. https://doi.org/10.1080/15374416.2019.1639515

• Katkic, L. O., Morovic, M. L., & Kovacic, E. (2017). Parenting stress and sense of competence in mothers of children with and without developmental disabilities. Hrvatska Revija za Rehabilitacijska Istraživanja, 53, 63-76.

• Khandaker, G., Muhit, M., Karim, T., Smithers-Sheedy, H., Novak, I., Jones, C., & Badawi, N. (2019). Epidemiology of cerebral palsy in Bangladesh: A population-based surveillance study. Developmental Medicine and Child Neurology, 61(5), 601-609. https://doi.org/10.1111/dmcn.14013

• Kulsoom, B., & Afsar, N. A. (2015). Stress, anxiety, and depression among medical students in a multiethnic setting. Neuropsychiatric Disease and Treatment, 11, 1713-1722. https://doi.org/10.2147/NDT.S83577

• Kumari, R., & Singh, S. P. (2013). Stress and coping among mothers of cerebral palsy clients with a view to prepare a management protocol. i-manager’s Journal on Nursing, 2(4), 12-19. https://doi.org/10.26634/jnur.2.4.2102

• Lemeshow, S., Hosmer, D. W., Jr., Klar, J., & Lwanga, S. K. (1990). Adequacy of sample size in health studies. John Wiley & Sons. http://repository.universitasbumigora.ac.id/862/4/003%20Adequacy%20of%20Sample%20size%20in%20Health%20Studies.pdf

• Maloni, P. K., Despres, E. R., Habbous, J., Primmer, A. R., Slatten, J. B., Gibson, B. E., & Landry, M. D. (2010). Perceptions of disability among mothers of children with disability in Bangladesh: Implications for rehabilitation service delivery. Disability and Rehabilitation, 32(10), 845-854. https://doi.org/10.3109/09638280903326063

• May, P., Smithers-Sheedy, H., Muhit, M., Cumming, R., Jones, C., Booy, R., Badawi, N., & Khandaker, G. (2020). Immunisation status of children with cerebral palsy in rural Bangladesh: Results from the Bangladesh Cerebral Palsy Register (BCPR). Infectious Disorders Drug Targets, 20(3), 318-322. https://doi.org/10.2174/1871526518666181024101002

• McConachie, H., Huq, S., Munir, S., Ferdous, S., Zaman, S., & Khan, N. Z. (2000). A randomized controlled trial of alternative modes of service provision to young children with cerebral palsy in Bangladesh. The Journal of Pediatrics, 137(6), 769-776. https://doi.org/10.1067/mpd.2000.110135

• McIntyre, L. L., & Brown, M. (2018). Examining the utilisation and usefulness of social support for mothers with young children with autism spectrum disorder. Journal of Intellectual & Developmental Disability, 43(1), 93-101. https://doi.org/10.3109/13668250.2016.1262534

• Mobarak, R., Khan, N. Z., Munir, S., Zaman, S. S., & McConachie, H. (2000). Predictors of stress in mothers of children with cerebral palsy in Bangladesh. Journal of Pediatric Psychology, 25(6), 427-433. https://doi.org/10.1093/jpepsy/25.6.427

• Moideen, N., & Mathai, S. M. (2018). Parental stress of mothers of children with learning disabilities. International Refereed Research Journal, 9(2), 256-263.

• Mouilly, M., Faiz, N., & Ahami, A. O. T. (2017). Factors associated with perceived stress of parents with children and teenagers suffering from cerebral palsy. IOSR Journal of Dental and Medical Sciences, 16(4), 55-59. https://doi.org/10.9790/0853-1604015559

• Murthy, G. V. S, Mactaggart, I., Mohammad, M., Islam, J., Noe, C., Khan, A. I., & Foster, A. (2014). Assessing the prevalence of sensory and motor impairments in childhood in Bangladesh using key informants. Archives of Disease in Childhood, 99(12), 1103-1108. https://doi.org/10.1136/archdischild-2014-305937

• Neece, C. L., Green, S. A., & Baker, B. L. (2012). Parenting stress and child behavior problems: A transactional relationship across time. American Journal on Intellectual and Developmental Disabilities, 117(1), 48-66. https://doi.org/10.1352/1944-7558-117.1.48

• Nuri, R. P., Aldersey, H. M., & Ghahari, S. (2019). Needs of families of children with cerebral palsy in Bangladesh: A qualitative study. Child: Care, Health and Development, 45(1), 36-44. https://doi.org/10.1111/cch.12624

• Omole, J. O., Adegoke, S. A., Omole, K. O., Mbada, C. E., Adedeji, G. A., & Adeyemi, O. A. (2017). Levels, correlates, and predictors of stress and caregivers burden among caregivers of children with cerebral palsy in Nigeria. Journal of Pediatric Neurology, 17(1), 13-21. https://doi.org/10.1055/s-0037-1612639

• Oskoui, M., Coutinho, F., Dykeman, J., Jetté, N., & Pringsheim, T. (2013). An update on the prevalence of cerebral palsy: A systematic review and meta-analysis. Developmental Medicine and Child Neurology, 55(6), 509-519. https://doi.org/10.1111/dmcn.12080

• Panditha, W. P. T. S., & Wickramasinghe, V. P. (2016). Level of maternal stress and its association with motor performance of children with cerebral palsy. Journal of the Postgraduate Institute of Medicine, 3, 1-9. https://doi.org/10.4038/jpgim.8102

• Parkes, J., Caravale, B., Marcelli, M., Franco, F., & Colver, A. (2011). Parenting stress and children with cerebral palsy: A European cross-sectional survey. Developmental Medicine and Child Neurology, 53(9), 815-821. https://doi.org/10.1111/j.1469-8749.2011.04014.x

• Pfeifer, L. I., Silva, D. B. R., Lopes, P. B., Matsukura, T. S., Santos, J. L. F., & Pinto, M. P. (2014). Social support provided to caregivers of children with cerebral palsy. Child: Care, Health and Development, 40(3), 363-369. https://doi.org/10.1111/cch.12077

• Power, R., Muhit, M., Heanoy, E., Karim, T., Galea, C., Badawi, N., & Khandaker, G. (2019). Depression, anxiety, stress among caregivers of adolescents with cerebral palsy in rural Bangladesh. Disability and Rehabilitation, 43(15), 2123-2130. https://doi.org/10.1080/09638288.2019.1692378

• Ramanandi, V. H., & Rao, B. (2015). Comparison of stress levels in the parents of children with cerebral palsy and parents of normal children in Vadodara region of Gujarat. International Journal of Physiotherapy, 2(2), 421-428. https://doi.org/10.15621/ijphy/2015/v2i2/65252

• Ribeiro, M. F. M., Sousa, A. L., Vandenberghe, L., & Porto, C. C. (2014). Parental stress in mothers of children and adolescents with cerebral palsy. Revista Latino-Americana de Enfermagem, 22(3), 440-447. https://doi.org/10.1590/0104-1169.3409.2435

• Robertson, C. M. T., Ricci, M. F., O’Grady, K., Oskoui, M., Goez, H., Yager, J. Y., & Andersen, J. C. (2017). Prevalence estimate of cerebral palsy in Northern Alberta: Births, 2008-2010. The Canadian Journal of Neurological Sciences, 44(4), 366-374. https://doi.org/10.1017/cjn.2017.33

• Rosenbaum, P., Paneth, N., Leviton, A., Goldstein, M., Bax, M., Damiano, D., Dan, B., & Jacobsson, B. (2007). A report: The definition and classification of cerebral palsy April 2006. Developmental Medicine and Child Neurology, 49(s109), 8-14.

• Schlebusch, L., & Dada, S. (2018). Positive and negative cognitive appraisal of the impact of children with autism spectrum disorder on the family. Research in Autism Spectrum Disorders, 51, 86-93. https://doi.org/10.1016/j.rasd.2018.04.005

• Sepa, A., Frodi, A., & Ludvigsson, J. (2004). Psychosocial correlates of parenting stress, lack of support and lack of confidence/security. Scandinavian Journal of Psychology, 45(2), 169-179. https://doi.org/10.1111/j.1467-9450.2004.00392.x

• Shahrier, M. A., Islam, M. N., & Debroy, M.-M. (2016). Perceived stress and social adaptation of the primary caregivers of children with intellectual disabilities. The Spanish Journal of Psychology, 19, Article E87. https://doi.org/10.1017/sjp.2016.93

• Stavsky, M., Mor, O., Mastrolia, S. A., Greenbaum, S., Than, N. G., & Erez, O. (2017). Cerebral palsy-trends in epidemiology and recent development in prenatal mechanisms of disease, treatment, and prevention. Frontiers in Pediatrics, 5, Article 21. https://doi.org/10.3389/fped.2017.00021

• Thompson, S., Hiebert-Murphy, D., & Trute, B. (2013). Parental perceptions of family adjustment in childhood developmental disabilities. Journal of Intellectual Disabilities, 17(1), 24-37. https://doi.org/10.1177/1744629512472618

• Tosi, M. (2023). Health and rehabilitation project. Rishilpi International Onlus. https://www.rishilpibd.org/progetto-health-and-rehabilitation/

• Trute, B., Hiebert-Murphy, D., & Levine, K. (2007). Parental appraisal of the family impact of childhood developmental disability: Times of sadness and times of joy. Journal of Intellectual & Developmental Disability, 32(1), 1-9. https://doi.org/10.1080/13668250601146753

• Uskun, E., & Gundogar, D. (2010). The levels of stress, depression and anxiety of parents of disabled children in Turkey. Disability and Rehabilitation, 32(23), 1917-1927. https://doi.org/10.3109/09638281003763804

• Wijesinghe, C. J., Hewage, C. G., & Fonseka, P. (2014). Prevalence and predictors of psychological problems among principal caregivers of children with cerebral palsy in Galle, Sri Lanka. Journal of the College of Community Physicians of Sri Lanka, 19(1), 8-17. http://doi.org/10.4038/jccpsl.v19i1.7621

• Yilmaz, G. (2019). Mothers with disabled children: Needs, stress levels and family functionality in rehabilitation. Scandinavian Journal of Caring Sciences, 34(2), 524-532. https://doi.org/10.1111/scs.12783