Adjustment of Mothers of Children With Obstetrical Brachial Plexus Injuries: Testing a Risk and Resistance Model.

Abstract

Objective: To investigate direct and moderating effects of risk and resistance factors on the adjustment of mothers of children with obstetrical brachial plexus injuries (OBPI). Participants: Fifty-three mothers of children with OBPI recruited from an OBPI clinic in an Australian pediatric hospital. Measures: OBPI Severity Scale, Parents of Children With Disabilities Inventory, Family APGAR, Short Form Social Support Questionnaire-6, Life Orientation Test—Revised, Perceived Control of Internal States Scale, General Health Questionnaire–12. Results: The factors explained 30% of maternal adjustment variation. Resistance factors explained a unique 18%. Optimism was the only significant moderator. Conclusions: Findings confirm the importance of risk and resistance factors in maternal adjustment and enhance understanding by identifying optimism as a moderator of the risk/adjustment relationship. Interventions promoting optimism may facilitate maternal adjustment. Obstetrical brachial plexus injuries (OBPI) are estimated to occur in 0.3 to 2.0 of every 1,000 live births. Damage to the nerves of the brachial plexus is thought to occur during birth when the infant’s neck and shoulders are stretched too far apart (Laurent & Lee, 1994). Children affected by OBPI are left with permanent deficits that range from subtle functional impairment to complete paralysis and lack of sensation in the affected arm (Michelow et al., 1994). Nerve damage can also extend to the face and cause pupil constriction, eyeball recession into the orbit, and lack of facial sweating on the injured side (Clarke & Curtis, 1995). Very little is known about the effects of this condition on the psychological adjustment of the children and their families. Parents of children with OBPI are confronted with a number of possible stressors associated with their child’s condition. These can include primary surgery (nerve graft surgery) on infants as young as 6 months old, secondary surgery (shoulder, hand, or