Stress In Parents Of Children Research Articles

Traumatic stress in parents of children with congenital heart disease: a scoping review.

Congenital heart disease is the most common birth defect in the United States, with many of the affected infants requiring surgical and/or interventional procedures within their first year of life. The parental impacts of a child's diagnosis, subsequent hospitalization, and transition to home after discharge are numerous and burdensome, and many experience symptoms of traumatic stress along this trajectory. The purpose of this scoping review was to summarize current available literature related to the traumatic stress experienced by parents of children with heart disease to better understand the prevalence, related factors, and consequences. The Joanna Briggs Institute Scoping Review Framework was implemented to identify 31 relevant peer-reviewed articles published between 2000 and early 2024, including 25 quantitative studies, 3 qualitative studies, and 3 systematic reviews or meta-analyses. This scoping review provides an overview of parent traumatic stress for clinicians caring for children with heart disease at every stage of their clinical course.

Parental stress in childhood epilepsy

Background. Epilepsy is a common and persistent neurological disorder that typically affects children. In addition to the obvious physical and emotional outcomes for a child, epilepsy, like other chronic conditions, can have a profound impact on the well-being of family members. In order to comprehensively address and manage parental stress, it is essential to have a thorough understanding of the various factors involved.Objective: to determine the influence of parental stress on the course of epilepsy in children.Material and methods. A search for publications devoted to the study of parental stress in pediatric epilepsy in scientific databases PubMed/MEDLINE, Google Scholar, ScienceDirect, eLibrary identified 2670 articles. After the selection, 39 publications were included in the review.Results. There are a number of questionnaires that allow determining the level of parental stress: PSI, PSI-SF, PIP, IPES. They have shown their accuracy and have been validated in studies devoted to parental stress in parents of children with chronic diseases, including epilepsy. The relationship between the level of parental stress and the prognosis of epilepsy course, psychological state of children and the quality of life of parents was shown. The need for additional psychological support for parents of children with epilepsy was indicated. The feasibility of using biomarkers of brain damage in children as an additional tool for assessing the severity of parental stress was presented.Conclusion. Children with chronic conditions, such as epilepsy, and their families often face a number of interrelated problems. These include parental stress, difficulties in following treatment plans and adjusting to school, social discrimination. Despite the relevance of this issue, there are no large-scale, longitudinal studies examining stress in parents of children with epilepsy, so the relationship between epilepsy and parental stress is not fully understood. A collaborative approach is necessary, in which both the child and parents take responsibility for the treatment of the disease.

Psychological Stress in Parents of Children with Autism Spectrum Disorder

Purpose: This study investigated the relationship between parents' educational level, child's birth order within the family, and family size with psychological stress in parents of children with Autism Spectrum Disorder (ASD). Methods: A cross-sectional study was conducted in Ho Chi Minh City, Vietnam. Parents of children with ASD were recruited through convenience sampling at Hospital (n = 230). The Perceived Stress Scale (PSS) assessed psychological stress. Independent-sample t-tests and one-way ANOVA were used to analyze the data. Results: The average score for the PSS among parents with children diagnosed with ASD was 19.83±6.13. Parents with higher educational attainment reported lower psychological stress compared to those with lower degrees. Parents of firstborn children diagnosed with ASD experienced greater stress than parents of children diagnosed later. Parents with one child with ASD reported higher stress compared to parents with two or three children. No significant difference in stress levels was observed between mothers and fathers. Conclusion: This study highlights the influence of educational level, child's birth order, and family size on parental stress in families with ASD children. These findings inform the development of targeted support strategies to create a more supportive environment for families coping with ASD.

Parenting Stress And Depression In Children Of Working Mother

The purpose of the present study was to investigate the relationship between parenting stress and depression in children of working mother. The sample of the study consisted of 100 respondents of whom 50 were mothers (Working Mothers = 25 and Non-working Mothers = 25) and 50 were their children (6 to 13 years of age). They were selected purposively from different coaching centers of Dhaka city. Bangla version of Parenting Stress Index (PSI) (Akhter and Afrose 2009) was used to measure parenting stress. Bangla version of Children’s Depression Inventory (CDI) (Parvez and Afrose 2009) was used to measure depression in children. In addition, a personal Information blank was also used. The obtained data were analyzed by using t-test and Pearson product moment correlation. It was found that the stress of working mothers (67.68) was greater than non-working mothers (55.64); the depression in children of working mothers (55.88) was more than the children of non-working mothers (49.04). The results also indicated that working mothers and their children suffer from more stress and depression as compared to non working mothers and their children. The parenting stress was positively correlated (r=0.29, p <0.05) with children’s depression. The results indicate that with the increase of parenting stress, the depression of their children also increases. The Chittagong Univ. J. B. Sci.,Vol. 7(1 &2):151-165 , 2012

Analysis Study To Gratitude And Parenting Stress On Parents Of Children With Special Needs

Parenting can provide many satisfactions while also presenting many challenges. The aim of this research is to determine the effect of gratitude on parenting stress in parents who have children with special needs. The method used is a quantitative research method. The sample in this study amounted to 56 people. The measuring instruments used are the gratitude scale and the parenting stress scale. The results of data analysis show that there is an influence of gratitude on parenting stress in parents of children with special needs with an R value of 0.388 at a significant level of 0.000 (p<0.05. The strength of the influence of gratitude on parenting stress is 11.4%, the remaining 88.6% is influenced by factors others not examined in this research. The hypothesis in this research is accepted. Keywords: gratitude, parenting stress, parents, children with special needs

Effects of 6-month customized home-based exercise on motor development, bone strength, and parental stress in children with simple congenital heart disease: a single-blinded randomized clinical trial

BackgroundNew “noncardiac” problems in children with congenital heart disease (CHD), such as developmental delay or long-term neurodevelopmental impairments, have attracted considerable attention in recent years. It is hypothesized that exercise might attenuate CHD-associated neurodevelopmental impairments; however, this has not been thoroughly investigated. The objective of this prospective, single-blinded, randomized controlled experiment was to evaluate the impact of customized home-based exercise for children with CHD.MethodsChildren aged 0–5 years with echocardiography-confirmed simple CHD subtypes who were scheduled to undergo cardiac catheterization were screened for enrolment. Among 420 screened CHD children, 192 were enrolled and randomly assigned at a 1:1 ratio to receive a 6-month intervention (30 min daily customized home-based exercise program with supervision for no less than 5 days per week, combined with home-based exercise education) or control treatment (home-based education). The primary outcome was motor development (gross motor quotient (GMQ), fine motor quotient (FMQ), and total motor quotient (TMQ)). The secondary outcomes were cardiac function and structure, bone quality, physical development, parental anxiety, caregiver burden, and quality of life. Children and their families were assessed before and 1, 3, and 6 months after catheterization; 183 (95.3%) children were included in the primary analysis.ResultsAfter 6-month treatment, the intervention group significantly increased their motor quotient, which was consistently higher than that of the control group (GMQ p < 0.0001, FMQ p = 0.02, TMQ p < 0.001). The physical developments in height, weight, and circumferences of the upper-arm, chest, and head were also significantly improved by exercise (all p < 0.017). No significant improvements in the bone strength or the cardiac structure and function were found among patients in the intervention group (all p > 0.017). For parents, higher quality of life level (total score p = 0.016) was observed in the intervention group; while effects of exercise on the anxiety (rude score p = 0.159, standard score p = 0.159) or the Zarit caregiver burden scale score (p = 0.404) were non-significant. No adverse events occurred during the study period.ConclusionsCustomized home-based exercise improved motor development in children with CHD. While the long-term effects of parent training in home-based exercise are unknown, the study results suggest positive outcomes.Trial registrationA home-based exercise program in congenital heart disease children with cardiac catheterization: a randomized controlled trial. (http://www.chictr.org.cn/, ChiCTR-IOR-16007762, January 14, 2016).

Parental stress and food allergy phenotypes in young children: A National Birth Cohort (JECS).

Food allergy children and their families tend to have emotional distress and anxiety. There have been few reports of differences in parenting stress and a child's food allergy phenotypes. We examined the associations between food allergy phenotypes in children and parenting stress assessed by the Parenting Stress Index-Short Form (PSI-SF) from a national birth cohort (Japan Environment and Children's Study). We included 65,805 children for statistical analysis. Of them, 7.2% of children had a food allergy diagnosis at 2 years old. The means of the total PSI-SF (39.9 ± 10.3, 39.1 ± 9.9), CD-SF (19.5 ± 5.4, 19.1 ± 5.2), and PD-SF (20.5 ± 6.3, 20.0 ± 6.1) scores are similar for caregivers in the with and without food allergy groups. Food allergy diagnosis resulted in significantly higher total PSI scores (coefficient .47, 95% CI 0.19-0.75, p = .001), CD-SF (coefficient .22, 95% CI 0.07-0.38, p = .004), and PD-SF (coefficient .24, 95% CI 0.08-0.41, p = .004). A similar trend was observed for allergy reactions to hen's egg. However, there was no clear relationship between allergic reactions to milk, wheat, nuts, and PSI-SF. Parental stress was significantly related to a child's food allergy. Furthermore, hen's egg allergy increased parental stress. Multiple food avoidance might also increase parental stress. Healthcare providers need to be aware of parental stress in our daily clinic.

Exploring relationship satisfaction in mothers of children with disabilities: the predictive role of interparental conflicts and moderating role of dyadic coping.

Parenting responsibilities, while a source of happiness, often lead to considerable stress for parents of children with disabilities. While most parents try to cope with these challenges together, some level of interparental conflict is almost inevitable. Frequently assuming primary responsibility for children with disabilities, mothers can be substantially impacted by interparental conflict with their partners and the resulting stress. However, implementing dyadic coping strategies in managing stressful situations serves as a buffer against adverse effects, while also enhancing relationship satisfaction. This study aimed to explore the relationship between interparental conflicts, dyadic coping, and relationship satisfaction among 232 mothers of children with disabilities in Croatia who were in an intimate relationship and shared a household with their partners, regardless of marital status. We analysed a non-probabilistic sample of women in Croatia who reported being in an intimate relationship, sharing a household with a partner (whether married or simply cohabitating) and being a mother to a child with a diagnosed developmental disability. Participants completed questionnaires online in March of 2021 (sociodemographic variables, the Parent Problem Checklist, the Dyadic Coping Inventory and the Marriage Quality Index). Results of hierarchical multiple regression show that mothers' perceptions of how they help their partner cope with stress do not predict how satisfied they are in a relationship; instead, relationship satisfaction depends on their perceptions of how their partner helps them and how they cope with stress as a team. Furthermore, moderation analysis revealed the effect of interparental conflicts were entirely mitigated by high supportive and low negative dyadic coping of the partner. When mothers felt adequately supported by their partner, the negative impact of stress caused by interparental conflicts did not spill over into their relationship. Our results suggest that by recognizing the importance of psychological support and couples therapy in strengthening dyadic coping, government and non-profit initiatives can effectively empower parents of children with disabilities, fostering healthier and more resilient family dynamics that promotes the well-being of parents and their children.

The Effectiveness of Gratitude Training on Reducing Parenting Stress in Parents Who Have Children with Special Needs

As the number of children with special needs in Indonesia increases, the number of cases of maltreatment of children with special needs by parents also increases. Caring for children with disabilities who have inhibitions and limitations and require special treatment brings its own difficulties for parents and can cause great stress. This study aims to determine whether gratitude training is effective in reducing parenting stress in parents of children with special needs. The research subjects were 20 parents who have children with special needs in the Sidoarjo and Surabaya areas. The type of research used is experimental method research, with experimental design One Group Pretest Postest Design. The parenting stress scale in this study, measured using the Indonesian version of the Parental Stress Scale (PSS) which has proven its validity and reliability and has been tested on 449 parents in Indonesia. The results of the hypothesis test study in this study, using Wilcoxon statistical test = -3.834 and significance = 0.000 (p &lt; 0.05), and the average level of parenting stress during the pretest (mean = 46.20) was higher than the average parenting stress during the postest (mean = 28.25) meaning that gratitude training was effective in reducing parenting stress in parents who have Children with Special Needs, It was proven that the average level of parenting stress during the postest decreased compared to the average parenting stress during the pretest.

A social-competence group intervention featuring didactic teaching and practice in play contexts for preschool children with autism spectrum disorders

BackgroundRelatively few intervention programs of social competence have been specifically designed for preschool children with autism spectrum disorders (ASD). This randomized controlled trial (RCT) investigated the effectiveness of the social-competence group intervention (SCGI), which features a combination of didactic teaching and practice in play contexts for preschool children with ASD. MethodsA single-blind design was used with 34 preschool children with ASD, who were randomly allocated to either the SCGI group (n = 17) or the control group (n = 16). The SCGI group received 16 weekly group-based sessions with specific social topics, while the control group participated in their regular occupational therapy. Outcomes included measures of children’s social competence, children’s adaptive behaviors, and caregivers’ parental stress. ResultsA total of 25 children (12 in the SCGI and 13 in the control groups) completed the intervention and the pre- and post-intervention assessments. Compared with the control group, children in the SCGI group showed significantly greater enhancement of social competence (all p < .05, effect size η2 = 0.26–0.41). Additionally, caregivers’ parental stress decreased in the SCGI group but not in the control group (p < .05, effect size η2 = 0.25) after the intervention. However, the two groups did not show significant differences in adaptive behaviors (p = .06–.94). ConclusionsThe SCGI was effective in improving children’s social competence and reducing caregivers’ parental stress in preschool children with ASD. This RCT provides evidence of the effectiveness of the SCGI and guidance for clinicians to improve the social competence of preschool children with ASD.

Knowledge and belongingness: experiences of a programme for parents of children with autism

ABSTRACT Background Whilst lack of social support has been associated with stress for parents of children with autism, group programmes for parents which bring together those with similar experiences and provide learning and resources can offer a form of social support. Although studies of such programmes suggest positive outcomes, including in terms of children’s adaptive behaviour, research examining parental perspectives on interventions that set out specifically to provide support to reduce stress in parents of children with autism is still scarce. Purpose Set in a Swedish context, the aim was to investigate whether a group education programme for parents of children with autism could be viewed as a site of informal social support and considered fertile ground for procuring social capital. Method Participants were parents of children who had been given an autism diagnosis at around three years of age. They had all taken part in a group education programme designed to facilitate experience-sharing in meetings between parents. The parents were interviewed about their experiences and perceptions of its influence on their everyday lives. Data were analysed qualitatively, using a Community of Practice lens. Findings The in-depth analysis indicated that, according to participants, the programme had helped alleviate feelings of isolation and improve parenting confidence. The findings speak to the importance of personal investment for knowledge acquisition and implementation, demonstrating the connections between the acquisition of social capital and membership of a Community of Practice. Conclusion Building on previous research emphasising the role of social support for the quality of life for parents of children with autism, the study highlights how a parental group education programme can represent a valuable social setting which is conducive for learning and resource procurement. Knowledge and belongingness in a social community – which enables access to, and sharing of, resources – are both of crucial relevance to outcomes and quality of life for families.

Parental Symptoms of Anhedonia, Parenting, and Youth Outcomes: A Multi-Method, Multi-Informant Investigation.

Parental depression is a well-established risk factor for youth psychopathology; however, depression is highly heterogeneous, and different parental symptom profiles may be differentially associated with risk mechanisms and youth psychopathology outcomes. Thus, this study examined associations between parental anhedonic symptoms of depression, specifically, and (1) parenting and (2) youth outcomes using a multi-method, multi-informant approach. Participants included 595 parents (89% mothers) and youth (ages 8-16; M[SD] = 12.07[2.39]). Regression analyses indicated that parental self-reported anhedonic symptoms at baseline demonstrated relatively specific prospective associations with chronic parent-child stress assessed using contextual stress interview methods, as well as youth self-reported depressive symptoms at 18-month follow-up. Findings also indicated concurrent associations between parental anhedonic symptoms and observed parental criticism, conflict, and responsiveness in the context of a 5-min discussion task, as well as parent self-reported monitoring/supervision, although results were no longer significant after controlling for parental co-occurring non-anhedonic depressive symptoms. Findings suggest that parental anhedonic symptoms may contribute to relatively unique reductions in the quality of the parent-child relationship and may be a particularly salient risk factor for youth depression.

PSYCHOSOCIAL DETERMINANTS OF ACADEMIC PERFORMACE AMONG UNIVERSITY STUDENTS

OBJECTIVE The aim of the study was to investigate and examine the social and psychological factors which are influencing the student’s academic performance. The study focuses on opinions of undergraduate and graduate students on psychosocial factors which are influencing their academic performance. STUDY DESIGN The qualitative research design was used in the present research. PLACE AND DURATION OF STUDY The present study was conducted in Lahore, Pakistan from December-September, 2020. SUBJECTS AND METHODS Purposive samples of 35 female university student’s age range 18-25years from Lahore College for Women University were interviewed. Focus Group Discussions (FGD) were employed as a tool for data collection. Five Focus Group Discussion (FGD) were conducted. All the collected information was than analyzed and interpreted. Thematic Analysis (TA) research was used. RESULTS Results of thematic analysis showed that financial issues, mobile misuse, Teacher student relationship, Role of family, Peer group, Environment, Stress, Child parent relationship, learning issues and Distance were the most frequently occurring psychosocial determinants which were influencing the academic progress of university students. CONCLUSION Based on the above-mentioned result it can be concluded that student’s educational progress is determined by psychosocial factors such as financial issues, mobile misuse, roles of family, peer group, teacher student relationship, parent child relationship, and environment, stress, distance and learning issues. KEYWORDS Psychosocial, Academic Performance, Focus Group Discussions (FGD), Thematic Analysis (TA)

Stress Symptoms Among Children and Their Parents After ICU Hospitalization.

Objective: Child survival after intensive care unit (ICU) hospitalization has increased, yet many children experience acute stress that may precipitate mental/behavioral health comorbidities. Parents report stress after their child's hospitalization. Little is known about the individual and family characteristics that may moderate intergenerational relationships of acute stress. Design: Following ICU admission at a large academic medical center, a prospective cross-sectional cohort study assessed the associations between intergenerational characteristics and acute stress among children and families. Patients: Parent-child dyads (N = 88) were recruited from the pediatric ICU and pediatric cardiovascular ICU (CVICU) following ICU discharge. Eligible children were between 8 and 18 years old with ICU stays longer than 24 hours. Children with developmental delays were excluded. Caregivers were proficient in English or Spanish. Surveys were collected before hospital discharge. Measurements/Main Results: The primary outcome was "child stress" defined as a score≥17, measured by the Children's Revised Impact of Events Scale (CRIES-8). "Parent stress" was defined as an elevated composite score on the Stanford Acute Stress Reaction Questionnaire. We used validated scales to assess the child's clinical and family social characteristics. Acute stress was identified in 34 (39.8%) children and 50 (56.8%) parents. In multivariate linear regression analyses adjusting for social characteristics, parent stress was associated with increased risk of child stress (adjusted odds ratio 2.58, 95% confidence interval 0.69, 4.46, p < .01). In unadjusted analyses, Hispanic ethnicity was associated with greater child stress. In adjusted analyses, race, income, ICU length of stay, and language were not associated with child stress and did not moderate the parent-child stress relationship. Conclusions: Parent stress is closely correlated with child stress during ICU hospitalization. Hispanic ethnicity may be associated with increased risk for child stress, but further studies are required to define the roles of other social and clinical measures.

Sickle cell disease in Sudanese children & psychosocial problems faced by children and parents – a two-scale study

ABSTRACT Sickle cell disease (SCD) is an inherited red blood cell (RBC) disorder transmitted to the child through the parental genes. SCD is a serious public health problem in Sudan, ranging from 18.2% to 30.4%, with the sickle cell anemia gene known to be prevalent in the Khartoum area. This study aimed to explore the psychosocial impact of SCD on affected children and parents and to identify the relationship between psychosocial problems experienced by children and parents with the use of two scales. To address the research aim, the Strengths and Difficulties Questionnaire (SDQ) was administered among n = 170 SCD children aged 6–12 years. In addition, the Depression, Anxiety, Stress Scale-21 (DASS-21) was used to measure levels of depression, anxiety, and stress in parents of children with SCD. Most of the children experienced substantially high emotional symptoms (n = 113), with conduct problems (n = 113), hyperactivity (n = 100), and peer problems (n = 86) being close to average. Most of the parents had the normal level of depression (n = 78), anxiety (n = 92), and stress (n = 85), with severe and extremely severe cases being the least recorded. Further analysis of the association between the SDQ scale and DASS-21 showed a significant association between parental stress and children’s conduct problems (p = 0.009), hyperactivity (p = 0.03), and the pro-social behavior of the child (p = 0.03). No association was found between parental anxiety, depression, and emotional symptoms, conduct problems, hyperactivity, and peer problems. Future research is recommended to explore the incidence of SCD in children at birth and parental actions after diagnosis.

Social and psychological assistance to families with children with disabilities

The article examines the essence of social and psychological assistance to families raising children with disabilities. The main problems of such families are identified. Methods and forms of work with families with children with disabilities are considered on the example of the Regional State Budgetary Institution of Social Service Multidisciplinary Rehabilitation Center «Podsolnukh (Sunflower) ". By means of diagnostic materials, socio-psychological problems of families with children with disabilities and emotional burnout of parents raising children with disabilities have been identified, and trainings for parents with children with disabilities have been conducted. The topics of the trainings were «Prevention of burnout syndrome in parents raising children with disabilities» and «Prevention of emotional stress in parents of children with disabilities».

The Effect of Parental Stress on Marital Quality in Parents of Children with Special Needs: The Mediating Role of Coping Styles

The issue of family marital quality has always been one of the hot topics of research in the field of family. The family is the basic unit and primary environment for the growth and development of children, and the structural integrity of the family and the marital performance of parents affect the physical and psychological development of children. The presence of a disability event is a serious negative life issue and source of family stress for family life, which can exacerbate the family's life difficulties and marital difficulties. Therefore, exploring the influential mechanisms behind the marital quality of parents of children with special needs is meaningful to repair the couple relationship of parents of children with disabilities and improve the quality of life of families. This study is a cross-sectional study that focuses on the relationship between parenting stress, coping styles, and marital quality of parents of special children using a questionnaire survey of 234 parents of special children from Chongqing, Shandong, and Sichuan, China. The results of the study showed that the parenting stress of children with special needs significantly affected marital quality, and the coping styles adopted by parents of children with special needs significantly affected their marital quality. Parents' coping styles partially mediated the relationship between parental stress and marital quality, i.e., parental stress affected marital quality both directly and indirectly through social support. The results of this study broaden the understanding of the intrinsic relationship between parenting stress and marital quality and explain the mediating role of coping styles in their relationship. Based on the findings, parents with special needs children should first adopt a positive coping style when facing parenting stressful events and marital problems, change self-perceptions of the events, and enhance their emotion regulation skills in order to reduce parenting stress and improve marital quality. At the same time, this study provides solid theoretical and practical implications for families of special needs children, social workers and policy makers.

Parental Stress Scale: Psychometric Properties in Parents of Preschool Children with Developmental Language Disorder.

Parents of children with developmental disabilities experience more stress compared to those of typically developing children; therefore, measuring parental stress may help clinicians to address it. The Parental Stress Scale (PSS) is a self-rceport measure in the public domain that assesses stress related to child rearing. The present study tested the psychometric properties of the Greek version of the PSS in 204 parents (mean age: 39.4 ± 5.7, 124 mothers and 80 fathers) of kindergarten children diagnosed with Developmental Language Disorder (DLD) after a clinical assessment. Confirmatory factor analysis (CFA) was used to confirm the original four-factor structure. The results showed that the original four-factor structure (parental rewards, parental stressors, lack of control and parental satisfaction) is valid in this specific Greek population. The reliability was high (ω = 0.78) and there were weak correlations (r = -0.372, r = -0.337, r = -0.236), yet of statistical significance (p < 0.001), with similar psychological constructs (quality of life, emotional functioning and worries). Our data confirmed that the PSS is a reliable and valid tool to measure parental stress in parents of children with DLD. Greek clinicians (mental health professionals, speech-language pathologists) can evaluate parental stress and design early interventions targeting specific stress aspects, along with core language interventions for the children.

Illness-related parental stress and quality of life in children with kidney diseases.

This cross-sectional study investigated quality of life (QoL) and illness-related parental stress in children with kidney diseases by (1) comparing mean levels of these two variables between several kidney disease categories; (2) exploring correlations between QoL and parental stress; and (3) describing which disease category reports lowest QoL and highest parental stress. We included 295 patients with a kidney disease (0-18years) and their parents, followed at 6 reference centers for pediatric nephrology. Children's QoL was assessed by the PedsQL™ 4.0 Generic Core Scales, and illness-related stress by the Pediatric Inventory for Parents. All patients were divided into 5 kidney disease categories according to the multidisciplinary care program criteria prescribed by the Belgian authorities: (1) structural kidney diseases, (2) tubulopathies and metabolic diseases, (3) nephrotic syndrome, (4) acquired diseases with proteinuria and hypertension, and (5) kidney transplantation. Child self-reports showed no differences in QoL between kidney disease categories, in contrast to parent proxy reports. Parents of transplant patients reported lower QoL in their child and more parental stress compared with the 4 non-transplant categories. QoL and parental stress were negatively correlated. Lowest QoL and highest parental stress scores were mainly found in transplant patients. This study showed lower QoL and higher parental stress in pediatric transplant patients compared with non-transplants, based on parent reports. Higher parental stress is associated with worse QoL in the child. These results highlight the importance of multidisciplinary care for children with kidney diseases, with special attention to transplant patients and their parents. A higher resolution version of the Graphical abstract is available as Supplementary information.

Self-forgiveness, Guilt, Shame, and Parental Stress among Parents of Children with Autism Spectrum Disorder.

A mixed-method approach was used to explore and compare self-forgiveness, guilt, shame, and parental stress in parents of children with autism spectrum disorder (ASD) and parents of neurotypical (NT) children. The data were obtained by the Heartland Forgiveness Scale (Thompson et al., 2005), Guilt and Shame Experience Scale (Maliňáková et al., 2019), Parental Stress Scale (Berry & Jones, 1995) and by open-ended questions. The research sample consisted of 143 parents of children with ASD and 135 parents of NT children from Slovakia. The regression analysis confirmed that guilt, shame, and self-forgiveness explained 23% of the variance in parental stress, while the only significant negative predictor was self-forgiveness. Furthermore, shame mediated the pathway between self-forgiveness and parental stress in parents of children with ASD. Parents of children with ASD experience more shame than parents of NT children. The qualitative analysis obtained a more comprehensive understanding of both groups. Parents of children with ASD mostly experienced shame in regard to their child's inappropriate behavior or it being misunderstood by society, while parents of NT children mostly did not feel ashamed of their parenting. Acceptance, social support, religious beliefs, and love from the child were the most often mentioned factors helping self-forgiveness in parents of children with ASD. We highlight the importance of self-forgiveness as a potential coping mechanism for parental stress and suggest focusing on negative aspects of shame in parents of children with ASD.