Maternal Caregivers Of Children Research Articles

Childhood trauma and hair cortisol response over the year following onset of a chronic life event stressor

ObjectiveChildhood trauma may contribute to poor lifelong health in part through programming of the HPA-axis response to future life stressors. To date, empirical evidence shows an association of childhood trauma with dysregulation of the HPA-axis and blunted cortisol reactivity to acute stressors. Here, we conduct an initial examination of childhood trauma as a moderator of changes over time in perceived stress levels and HPA-axis response to a major chronic stressor in adulthood. MethodsParticipants were 83 maternal caregivers of children newly diagnosed with cancer who completed the Childhood Trauma Questionnaire (CTQ), and who, over the year following their child’s cancer diagnosis, had hair samples collected up to 7 times for the assessment of cortisol and completed monthly measures of perceived stress. ResultsCTQ scores were in the expected range for a community sample and associated with changes in perceived stress and cortisol concentration over time (γ =.003, p =.002; γ = −.0004, p =.008, respectively) independently of age, education, treatment intensity and randomization to stress management intervention. Maternal caregivers who endorsed lower childhood trauma showed a steeper decline in perceived stress and a larger increase in cortisol levels across the year than caregivers who recalled more childhood trauma. ConclusionsFindings extend animal models and studies that examine cortisol reactivity to acute stressors and suggest that childhood trauma may program a phenotype that is more psychologically reactive but shows a blunted HPA-axis response to chronic stress. While adaptive in the short-term, this early life programming may incur long-term costs for health. Further work is warranted to examine this possibility.

COVID-19 Pandemic Experiences and Symptoms of Pandemic-Associated Traumatic Stress Among Mothers in the US

The primary outcomes of the COVID-19 pandemic on the mental health of women with children remain largely unknown. To identify and describe clusters of mothers of children participating in the Environmental influences on Child Health Outcomes (ECHO) Program that characterize pandemic-associated hardships, coping mechanisms, and behaviors, and to evaluate associations between pandemic-associated hardships, coping strategies, and behavior changes with pandemic-associated traumatic stress symptoms. This multicenter cohort study investigated experiences during the COVID-19 pandemic between April 2020 and August 2021 among maternal caregivers of children participating in the ECHO Program. Data from self-identified mothers of ECHO-enrolled children from 62 US cohorts were included in analyses. Data were analyzed from November 2021 to July 2022. The primary exposures were pandemic-associated changes in mothers' health, health care utilization, work and finances, coping strategies, and health-associated behaviors. Exposures were assessed via a self-reported questionnaire designed by ECHO investigators. The primary outcome was the total symptoms score of pandemic-associated traumatic stress (PTS), defined as the number of items endorsed at least sometimes or more frequently, from a 10-item self-report measure. The study surveyed 11 473 mothers (mean [SD] age, 37.8 [7.4] years; 342 American Indian [2.98%], 378 Asian [3.29%], 1701 Black [14.83%], and 7195 White [62.71%]; 2184 with Hispanic/Latina ethnicity [19.04%]) and identified 2 clusters that best characterized their COVID-19 pandemic experiences-one characterized by higher life disruptions (eg, to work and health care), higher social isolation, more coping behaviors to mitigate the outcomes of the pandemic, and more changes to their health behavior routines (high change [1031 mothers]) and the other characterized by lower changes (low change [3061 mothers]). The high change cluster was more socioeconomically advantaged and reported higher PTS (mean [SD] number of symptoms, 3.72 [2.44] vs 2.51 [2.47]). Across both clusters, higher pandemic-associated hardships, coping mechanisms, and behavior changes were associated with higher PTS, and these associations were greater in the low change cluster. In this study of more than 11 000 US mothers, associations between socioeconomic factors, stressful life events, and mental health sequelae were complex. Accordingly, programs, policies, and practices targeting mental health during public health crises such as the COVID-19 pandemic should consider the range and configuration of hardships in designing the most effective interventions to mitigate long-term outcomes.

Understanding maternal resilience; Lesson learnt from rural mothers caring for a child with a chronic health condition.

This study aimed to understand the lived experience of rural mothers caring for a child with a chronic health condition and to understand their perspectives on the support, services and resources they identify as necessary to effectively manage caregiving. Maternal caregivers in rural areas experience difficulty accessing specialist health care for their child and can also experience geographical and social isolation. Understanding the factors that enable these maternal caregivers to overcome the challenges and adversities faced is crucial to help nurses identify and facilitate avenues for support and resources. This study employed a phenomenological design. The study is reported in line with Consolidated criteria for reporting qualitative research guidelines (COREQ). Semi-structured interviews were conducted with 17maternal caregivers in rural New South Wales, Australia, who had at least one child with a chronic health condition aged between 2-18years. Data were collected from March to June 2018. Thematic analysis was used to develop a thematic framework. This paper reports on one of the major themes identified in this research, specifically maternal resilience. Participants demonstrated maternal resilience by creating meaningful social connections, cultivating networks, developing problem-solving skills, enhancing their self-efficacy and finding a sense of purpose through hope and optimism. These strategies provide nurses insight into how some rural women overcome adversities associated with their maternal labour required in caring for a child with a chronic health condition. This study found that participants overcame the challenges related to their caregiving work, emerging as resilient caregivers. Understanding maternal resilience assists nurses to provide the services rural mothers in Australia need to care for their child with a CHC. Findings from this study provide insight into the experiences of rural maternal caregivers of children with a chronic health condition and identify the strategies they adopt to overcome caregiver challenges. Understanding these strategies allows nurses to improve care and support for rural mothers using a strength-based approach to build maternal resilience.

The Experience of Stress-Related Growth among Maternal Caregivers of Children with Autistic Spectrum Disorder

A growing body of literature suggests that stressful life events and challenges can provide opportunities for stress-related growth (SRG). The aim of this study was to capture the characteristics of SRG among maternal caregivers of children with ASD. A total of 12 participants voluntarily participated in this study. Using constructivist grounded theory, three themes associated with these challenges were identified as positive outcomes: 1) experiencing personal growth, 2) developing closer relationships with others, and 3) generating coping strategies. Moreover, participants created a unique peer support group that contributed to their coping and SRG. These positive outcomes may contribute to individuals’ social and mental health benefits, suggesting that with adaptability stressful life experiences may lead to beneficial transformations.

0948 Sleep Quality, Depressive Symptoms, and Stress in Maternal Caregivers of Young Children with Bronchopulmonary Dysplasia

Abstract Introduction Maternal caregivers of young children with a chronic illness, like bronchopulmonary dysplasia (BPD), often report increased levels of stress and depressive symptoms, as well as poor quality of sleep. Caregiving duties are time-intensive and extend into the nighttime hours. The purpose of this study is to examine sleep, depressive symptoms, and stress in maternal caregivers of young children with BPD, as well as determine if depressive symptoms is a mediating variable between sleep quality and stress. Methods 61 maternal caregivers (mean age 29 yrs) of young children with BPD (mean age 14 mos) were recruited. Mothers had no reported history of a sleep disorder, and had a child diagnosed with BPD. The child had to have been home from the hospital for at least two months, and not require a ventilator or tracheotomy. Maternal caregivers were asked to complete a demographic questionnaire, as well as the Pittsburgh Sleep Quality Index (PSQI), the Perceived Stress Scale (PSS), and the Center for Epidemiological Studies-Depression Scale (CES-D). Upon completion, 56.9% of the sample was single, 67.2% were African American, and child had been home from hospital a mean of 8 mos. Results Over two thirds (67.2%) of the sample reported sleeping 6 or fewer hours a night, with a mean PSQI score of 7.6. Significant correlations were found between PSQI and CESD (; r=.546; p=.000), as well as PSQI and stress (r=.284; p=.031). Depressive symptoms were not found to mediate the relationship between sleep quality and stress, however, sleep quality was a significant predictor of stress (t=2.171; p=.034) and depressive symptoms (t=4.876; p=.000). Conclusion The majority of maternal caregivers of children with BPD reported insufficient and poor quality of sleep, which may affect their stress and depressive symptoms. Healthcare providers need to discuss the importance of sleep with caregivers, and ensure the child’s care schedule allows for sleep during the nighttime hours. Support

Self-efficacy, relationship satisfaction, and social support: the quality of life of maternal caregivers of children with type 1 diabetes.

ObjectivesTo examine maternal functioning and wellbeing as important aspects of a family’s adaptation to chronic paediatric conditions, in particular, children with diabetes.MethodThis cross-sectional study investigated the difference between the perceived quality of life of mothers of children with diabetes (n = 63) and mothers of children without diabetes (n = 114). The study also examined the role of self-efficacy, relationship satisfaction, number of social support providers, and satisfaction with social support in predicting quality of life.ResultsMothers who had a child with diabetes had lower quality of life measured by general health, vitality, social functioning, role-emotional, and mental health than mothers that did not have a child with diabetes. Self-efficacy, relationship satisfaction, and social support were significant predictors of quality of life (mental health domain).ConclusionIn order to enhance their psychological wellbeing, mothers of children with diabetes require adequate psychosocial support. Other implications for research and potential interventions are discussed.

Spiritual Care Training for Mothers of Children with Cancer: Effects on Quality of Care and Mental Health of Caregivers.

The purpose of this study was to explore the effectiveness of a spiritual care training package in maternal caregivers of children with cancer. This study was a quasi-experimental study with pretest and posttest design consisting of a sample of 42 mothers of children diagnosed as having cancer. Participants were randomly assigned to either an experimental or a control group. The training package consisted of seven group training sessions offered in a children's hospital in Tehran. All mothers completed the Spirituality and Spiritual Care Rating Scale (SSCRS) and the Depression, Anxiety and Stress Scale (DASS-21) at pre and post test and after a three month follow up. There was significant difference between anxiety and spiritual, religious, Personalized care and total scores spiritual care between the intervention and control groups at follow-up (P<0.001).There was no statistically significant difference in stress and depression scores between the intervention and the control groups at follow-up. Findings show that spiritual care training program promotes spirituality, personalized care, religiosity and spiritual care as well as decreasing anxiety in mothers of children with cancer and decreases anxiety. It may be concluded that spiritual care training could be used effectively in reducing distressful spiritual challenges in mothers of children with cancer.

The Second-Chance Self: Transformation as the Gift of Life for Maternal Caregivers of Transplant Children

This paper examines the phenomenon of transformational growth in maternal caregivers of children who have undergone a kidney transplant. Semi-structured interviews were conducted with seven mothers of transplant children who shared narrative accounts of their lived experience. Through a phenomenological analysis of the interview data, the fundamental structure of positive growth in caregivers of transplant children was illuminated, revealing both themes of unresolved suffering and trauma and themes of posttraumatic growth and transformation.

The relationships among family management behaviors and asthma morbidity in maternal caregivers of children with asthma.

Numerous studies have identified the relationship of the family caregiver's perception regarding asthma management and the child's asthma outcomes, although few have examined family caregiver asthma management behaviors. The primary aim of this study was to examine the relationship among family management behaviors and asthma morbidity as perceived by maternal caregivers. The Family Management Style Framework was used to guide the research. Maternal caregivers (N = 101) with school-aged children diagnosed with persistent asthma and living in the United States were recruited from a specialty asthma clinic. When caregivers perceived they were expending much effort on their child's asthma management and were not confident in their ability to perform management activities, the child's asthma outcomes were worse. This is the first study to examine family management behaviors with maternal caregivers of school-aged children with asthma. Findings from this study encourage health care providers to tailor each educational opportunity with families to improve child asthma outcomes. An ongoing effort must be made to include families in asthma management. Health care partnerships between provider and family can lead to improved asthma management.

The Experience of Mothering a Child with a Kidney Transplant and the Implications of Illness-Related Uncertainty

Advances in the surgical and immunological aspects of organ transplantation have resulted in significant improvements in long-term outcomes and survival rates, making kidney transplantation the optimal therapy for children with chronic kidney disease (CKD). This study examines the phenomenon of sustained uncertainty as an element of the burden of care for maternal caregivers of children who have undergone kidney transplantation. This study indicates these mothers experience uncertainty in two prominent ways: 1) in their subjective sense of time, and 2) in their ongoing fear that their child will experience rejection of the transplanted kidney. Ultimately, this study advocates for nephrology social workers to begin addressing the social and emotional implications of uncertainty in the experience of illness for caregivers.

Cognitions and Distress in Caregivers after Their Child's Sexual Abuse Disclosure

The impact of child sexual abuse on children is well documented, but few studies have examined the impact of a child's sexual abuse disclosure on maternal caregivers. The studies that have been conducted suggest that parental response postdisclosure is variable. The present study examined the association between maternal attributions and abuse-specific cognitions with depression and trauma symptoms postdisclosure. Participants included 68 nonoffending maternal caregivers of children between the ages of 3 and 17 years who experienced child sexual abuse. Findings indicated that caregivers' abuse-specific cognitions were the best predictor of self-reported symptoms of depression after controlling for general negative attributions. These findings suggest that in order to reduce caregivers' distress and to enhance their support of their children, it is important to assess and treat caregivers' abuse-specific cognitions.

Caregiving time in sickle cell disease: Psychological effects in maternal caregivers

Providing home care for a child with a chronic illness can be stressful for the family. The purpose of this paper is to examine patterns of caregiving and the associated psychological impact on maternal caregivers of children with sickle cell disease (SCD). Fourteen maternal caregivers of children with SCD were interviewed as part of a larger study of maternal caregivers of children with chronic illness. Forty-four caregivers of children with HIV and 36 caregivers of healthy children were included as comparison groups. Interviews included questions regarding amount of time spent providing care for the child (technical care, non-technical care, health care management), hospitalization, emergency room visits, illness stigma, and mental health of the caregiver. Children with SCD had significantly lower functional status and significantly more hospitalizations in the previous 3 months than children with HIV. Caregivers of children with SCD were more likely to work full-time and had higher incomes than caregivers of children with HIV. The three caregiving groups did not differ significantly on amount of total care, although caregivers of children with SCD and caregivers of children with HIV both reported significantly more time spent in technical care than caregivers of healthy children. Despite lower functional status of the children in the SCD group, when group comparisons on caregiving time variables were adjusted for child's functional status, the differences between groups increased. This appeared to be due to the fact that caregivers in the HIV group spent more time in all caregiving categories except skin, crisis, and other care. In terms of caregiver mental health, caregivers of children with HIV and SCD had significantly higher depressive mood scores than caregivers of healthy children but the groups did not differ on caregiving burden. The perceived care burden of caregivers of children with SCD may be related to the unpredictable nature of the crisis care they provide. Additional attention is warranted to developing adequate resources for caregivers of children with SCD to mitigate the stress of unexpected crises.

Pediatric adherence: Perspectives of mothers of children with HIV

This study approached pediatric adherence practices from the perspective of mothers of children with HIV in the USA. The study aimed to articulate what is involved in the daily life experience of giving or supervising a child's HIV medication (i.e., adherence practices) in order to clarify, in more dynamic terms than is often found in adherence research, what promotes or impedes adherence. A team-based qualitative analytic approach was used to analyze the narrative responses of 71 maternal caregivers of children with HIV to interview questions regarding the activities and stresses of caring for a child with HIV. Four themes of dealing with medication on a daily basis that impacted mothers’ adherence practices emerged from the analysis: (1) Mothers’ attitudes and feelings related to adherence practices. (2) The impact of the medications on adherence practices. (3) Interactions of mothers and children related to adherence practices. (4) Developmental issues and responsibility for medication adherence. These themes, taken together, demonstrate the contextual and longitudinal factors that impact adherence and illustrate the complexity of influences on adherence practices. We found that adherence practices were impacted in a positive way by mothers’ commitment to adherence, and in a negative way by feelings of stigma and guilt, by the effects of bereavement on children and by children adopting their mothers’ attitudes about medications. The interactive process of giving medication was shaped by children's behavior, mothers’ developmental expectations for children, and, for mothers with HIV, their adherence for themselves. We found that pediatric adherence often came at a cost to the caregiving mother's well-being.

Effects of child abuse and neglect: does social capital really matter?

To explore whether social capital and social support moderate the relationship between child maltreatment and emotional and behavioral outcomes such as depression-anxiety and aggression in 6-year-old children. Data from Longitudinal Studies of Child Abuse and Neglect were used. Data were collected through interviews and questionnaires at the child's birth and at the age of 6 years. General community. Two hundred fifteen maternal caregivers of children at high risk for child abuse and neglect were included in this study. Depression-anxiety and aggression were measured through the Child Behavior Checklist. Among 5 potential effect modifiers (3 social capital constructs and 2 measures of social support), only 1 (instrumental support) significantly modified the relationship between maltreatment and child aggression. Social capital did not modify the relationship between child maltreatment and either aggression or depression-anxiety. This might be related to the fact that many previous studies looked at social capital ecologically, whereas this study uses individuals as the unit of analysis. The results of this study might also indicate that previous studies of social capital and health outcomes might actually be using social capital as a proxy for social support.

Subjective Experiences of Prayer Among Women Who Care for Children with HIV

This descriptive study explores the nature, experience, and benefits of private prayer among maternal caregivers of children with HIV. Colloquial and meditative prayer were used frequently, in the course of daily activities. Among other benefits, prayer was used to shift attitudes and emotions toward positive perspectives. Positive states of mind grew out of prayer that nurtured gratitude, faith, trust, and wonder. Prayer was used to gain focus and calm, companionship, collaboration, guidance, and moral direction. Results of the study are directed toward the development of spiritual interventions using private prayer and for the development of sensitivity among health care providers.