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 Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 9  |  Issue : 2  |  Page : 108-111

Predictors of quality of life for parents of children with autism disorders in Iran


1 Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
2 Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
3 Department of Epidemiology, Hamadan University of Medical Sciences, Hamadan, Iran
4 Pediatric Developmental Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran

Date of Web Publication8-May-2019

Correspondence Address:
Ensiyeh Jenabi
Pediatric Developmental Disorders Research Center, Hamadan University of Medical Sciences, Hamadan
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/AIHB.AIHB_56_18

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  Abstract 


Background: The objective of this survey was predictors of quality of life for parents with Autism disorder (AD) children in Hamadan City. Materials and Methods: The sample size was included 82 mothers and 81 fathers of children with AD. The questionnaires of Parenting Stress Index-Short Form (SF) and SF-34 were used. The three stress subscales (Parental Distress; Parent–Child Dysfunctional Interaction [PCDI] and Difficult Child [DC]), age of diagnosis of AD, age of child and number of siblings were considered as predictors. Results: These analyses showed that the model among mothers and fathers was able to predict high a significant of variance in quality of life (F = 7.841, P < 0.001; R2 = 0.34) and (F = 8.149, P < 0.001; R2 = 0.35), respectively. Conclusion: The predictors of this study were PCDI, DC and number of siblings.

Keywords: Autism disorders, Iran, quality of life


How to cite this article:
Bashirian S, Karami M, Khazaei S, Jenabi E. Predictors of quality of life for parents of children with autism disorders in Iran. Adv Hum Biol 2019;9:108-11

How to cite this URL:
Bashirian S, Karami M, Khazaei S, Jenabi E. Predictors of quality of life for parents of children with autism disorders in Iran. Adv Hum Biol [serial online] 2019 [cited 2019 Jul 22];9:108-11. Available from: http://www.aihbonline.com/text.asp?2019/9/2/108/257815




  Introduction Top


Autism disorders (ADs) is a neurological disorder affecting communication and social functioning of children.[1]

Parents of autistic children can play a fundamental role in the developmental of children's psychological, social and academic. Some surveys have reported that children's relief and progress outcomes are affected by their parents' mental health.[2]

'The construct of quality of life is defined as one of the comprehensive, multidimensional outcome measures that are based on the individual's subjective perception in relation to several aspects of life experiences and their goals'.[3] Many factors can affect either positively or negatively on the quality of life. The child affected neurological disorder can be very stressful for mother and father and this stress can lead to lower total quality of life for parent of the child.

Different studies have shown that quality of life for parents with AD children.[4] The better quality of life and lower levels of stress among parents have been reported in older children, higher socioeconomic status in family, having more children in family, appropriate services and support systems.[5],[6],[7]

A study in 2014 by Dardas and Ahmad was conducted in Jordan. In this study, the predictor for parent's quality of life was Parental Distress (PD). Furthermore, Difficult child (DC), household, number of siblings and income predicted only quality of life in mothers.[1] Other study showed that parents who experience stress affected on their quality of life.[8]

Up-to-date, no studies have carried out in the field of quality of life and stress of fathers and mothers with AD children in West of Iran. Therefore, the objective of this survey was predictors of quality of life for parents and the relationship parenting stress and quality of life in parents with AD children in Hamadan city.


  Materials and Methods Top


The study protocol has been approved by the Ethical Committee in Hamadan University of Medical Sciences (IR.UMSHA.REC.1396.878). The data collection was carried out during 3 months in 2018 (April–June). We counted children of autism in the city of Hamadan. A list of all the names of AD children was taken from autism education society in Hamadan city. All children were detected with the use of Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) and were followed up with the M-CHAT-R interview. We requested from parents to participate in this study. Parents participated in this study if they were satisfied. They attended a detailed description about the study's purposes and questionnaires. Then, parents received a package of three questionnaires including demographic characteristics, parenting stress and Short Form-36 (SF-36). The sample size was included 166 parents of children with AD. The statistical analysis was conducted by SPSS Version 16 (SPSS for Windows, SPSS Inc., Chicago, USA) and the significance level of 0.05. Independent t-test was conducted to report significant differences between parents in this study. Regarding the factors related to the quality of life, multiple linear regression method was applied with a backward stepwise approach. In other words, we started with all the predictors in the model and then removed the predictors with P > 0.2 (cut point), in continue refitted the model and stopped when all P < 0.2; finally, Parent–Child Dysfunctional Interaction (PCDI), DC and number of siblings were remained in adjusted model.

Demographic characteristics

Demographic characteristics are including the age of parent, educational level of parent, occupation of parent, incoming of family, age of AD child, child age in time of diagnose of AD, sex of child and number of live children.

The Parenting Stress Index-Short Form

The Parenting Stress Index-SF (PSI-SF) questionnaires measuring parenting stress.[9] The questionnaire was included to three subgroups: PD, PCDI and DC. The PD assesses parents' judgment of their own behaviour such as marital conflict, perceived competence and life restrictions due to the parenting request. The PCDI assesses the parents' anticipations and interactions with their child. The DC determines the parents' perceptions of their child's compliance, demandingness and temperament. The questions are Likert-five options and are range from 1 to 5 (strongly disagree to strongly agree). In total, The crude scores more than 90 were considered clinically high degree of stress.[9] The time to complete the questionnaire is 10–15 min. The Iranian version for the PSI-SF was validated by Fadaei et al. in 2010.[10]

The 36-item Short-Form

The SF-36 questionnaire determines two components of physical and mental from quality of life. The physical health component is including four items: general health (5 questions), physical functioning (10 questions), role limitations due to physical problems (4 questions) and body pain (2 questions). Mental health components are including role limitation due to emotional problems (3 questions), social functioning (2 questions), vitality (4 questions) and mental health (5 questions). The reliability and validity the questionnaire was approved in Iran by Montazeri et al.[11]

In this study, the reliability and validity for questionnaires again were conducted. In the validity, some questions were modified. We used Cronbach's alpha to assess the reliability, and accordingly, the reliability in the PSI-SF questionnaires was 0.9 and in the SF-36 questionnaire was 0.92.


  Results Top


The sample size was included 163 parents (82 mothers and 81 fathers) of children with AD. Two of fathers and one of mothers did not contribute in this study. The gender of children with AD was 59 (71%) male and 23 (28%) female.

The baseline characteristics of parent's and child are presented in [Table 1] and [Table 2]. [Table 3] did not report significant differences between parents based on scales of PD, PCDI, DC, PSI and SF-36.
Table 1: Baseline characteristic for fathers and mothers

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Table 2: Baseline characteristic for children with autism disorders

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Table 3: Comparisons between fathers and mothers on scales of quality of life and parenting stress index

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The three stress subscales (PD; PCDI and DC), age of diagnosis of AD, age of child and number of siblings were considered as predictors. [Table 4] predicted quality of life among parents of children with AD. These results showed that the model among mothers and fathers was able to predict a significant of variance in quality of life (F = 7.841, P < 0.001; R2 = 0.34) and (F = 8.149, P < 0.001; R2 = 0.35), respectively. Among the three stress subscales, PCDI, DC and number of siblings of autism child were significant predictors in either of the adjusted regression equations.
Table 4: Predictors of quality of life among parents with autistic child in the adjusted model

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  Discussion Top


The findings this study reported that predictors of quality of life for parents were variables of PCDI, DC and number of siblings. Therefore, the quality of life (SF-36) scores were significantly and negatively correlated with the fathers and mothers stress scores. Furthermore, the findings showed that fathers and mothers of children with AD had high-stress level (total scale PSI-SF >90). Abidin et al. reported that parenting stress is created from a complex combination including the parent, the child and the child–parent interactions that show the stresses the parents are experiencing specifically related to their role as parents. The disturbance in the health of the father and mother can have direct negative effects on the child, their siblings and family.[9] Therefore, it is mainly to determine the quality of life of the parents when design care plan for child health problems.

Parenting Distress

A study has reported that stressful life can cause less psychological distress in men than in women.[12] Yamada et al. reported in 2012 that mothers experienced lower quality of life than fathers in some mental domains and this was related to scores of high care and low control.[13] Dardas and Ahmad investigated that parenting stress was significantly increased and predict the quality of life for parents.[1] According to the present study results, father and mother of children with AD experienced low level from the quality of life although PD was not significant.

Parent–Child Dysfunctional Interaction

In our findings, PCDI was able to predict the quality of life for parents. Dardas and Ahmad reported that PCDI could not significantly predict the quality of life for the fathers and mothers.[1] Abidin (1990) has reasoned that the stress experienced by parents is related to the self, the child's characteristics and interactions between the parent and their child.[9]

Difficult Child

In this study, the DC with AD could predict quality of life for parents. A study by Wang et al.[14] confirmed our finding. Dardas and Ahmad presented that the child's with AD difficult characteristics were can to predict quality of life for mothers.[1]

Number of siblings

Our study showed that with increase of sibling's number of AD child decreased quality of life. Some studies reported that increase of sibling's number may elevate behavioural and social adjustment problems because of their exposure to stressful life conditions and decreased interplay with their mothers and fathers[15] that these findings approved our results.

Child's age

Dardas and Ahmad found that the child's age was not a significant predictor for the parents' quality of life[1] that our study confirmed it. Some studies have reported that with increase of age of the child with AD, the parents experience less degree of psychological distress and adopt more adaptive coping skills.[2],[16]

Age of diagnosis of autism disorder

Our study did not show that the child's age is a significant predictor factor for the parents' quality of life.

The children with AD can profit from interventions of family-centred that the stress of parents is evaluate comprehensively and recognise its impacts on parents' well-being and quality of life.

Based on the guidelines was prepared by Abidin about the PSI-SF questionnaire,[9] the findings of this study presented that fathers and mothers who reported high total stress scores need that refer to psychiatric centres for their treatment and as a result improve their quality of life.

The limitation of the study was study's design. The design of this study was cross-sectional; we recommend this study conducted in a design of large cohort for evaluating of the process of time variation in the characteristics of the mothers and fathers at both the children group with AD and without AD.


  Conclusion Top


The findings this study reported that predictors of quality of life for parents were variables of PCDI, DC and number of siblings. Therefore, quality of life (SF-36) scores were significantly and negatively correlated with the fathers and mothers stress scores.

Acknowledgement

We would like to thank the Vice-chancellor of Search and Technology, Hamadan University of Medical Sciences, Hamadan, Iran, for financial support of this survey.

Financial support and sponsorship

We would like to thank the Vice-chancellor of Search and Technology, Hamadan University of Medical Sciences, Hamadan, Iran, for financial support of this survey.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Dardas LA, Ahmad MM. Predictors of quality of life for fathers and mothers of children with autistic disorder. Res Dev Disabil 2014;35:1326-33.  Back to cited text no. 1
    
2.
Dardas LA, Ahmad MM. Quality of life among parents of children with autistic disorder: A sample from the Arab world. Res Dev Disabil 2014;35:278-87.  Back to cited text no. 2
    
3.
World Health Organization. Quality of Life (WHOQOL) – Brief Questionnaire, Field Trial Version. Geneva: World Health Organization; 1996.  Back to cited text no. 3
    
4.
Taylor-Richardson KD, Heflinger CA, Brown TN. Experience of strain among types of caregivers responsible for children with serious emotional and behavioral disorders. J Emot Behav Disord 2006;14:157-68.  Back to cited text no. 4
    
5.
Dabrowska A, Pisula E. Parenting stress and coping styles in mothers and fathers of pre-school children with autism and down syndrome. J Intellect Disabil Res 2010;54:266-80.  Back to cited text no. 5
    
6.
Lee GK, Lopata C, Volker MA, Thomer ML, Nida RE, Toomey JA. Health-related quality of life of parents of children with high-functioning autism spectrum disorders. Focus Autism Other Dev Disabl 2009;24:227-39.  Back to cited text no. 6
    
7.
Hatton C, Emerson E. Does socioeconomic position moderate the impact of child behaviour problems on maternal health in south asian families with a child with intellectual disabilities? J Intellect Dev Disabil 2009;34:10-6.  Back to cited text no. 7
    
8.
Hastings RP. Child behaviour problems and partner mental health as correlates of stress in mothers and fathers of children with autism. J Intellect Disabil Res 2003;47:231-7.  Back to cited text no. 8
    
9.
Abidin RR. Parenting Stress Index-Short Form. Charlottesville, VA: Pediatric Psychology Press; 1990.  Back to cited text no. 9
    
10.
Fadaei Z, Dehghani M, Tahmasian K, Farhadi M. Investigating reliability, validity and factor structure of parenting stress-short form in mothers of 7-12-year-old children. J Res Behav Sci 2010;8:81-91.  Back to cited text no. 10
    
11.
Montazeri A, Milroy R, Hole D, McEwen J, Gillis CR. How quality of life data contribute to our understanding of cancer patients' experiences? A study of patients with lung cancer. Qual Life Res 2003;12:157-66.  Back to cited text no. 11
    
12.
Gadzella BM, Ginther DW, Tomcala M, Bryant GW. Differences between men and women on stress producers and coping strategies. Psychol Rep 1991;69:561-2.  Back to cited text no. 12
    
13.
Yamada A, Kato M, Suzuki M, Suzuki M, Watanabe N, Akechi T, et al. Quality of life of parents raising children with pervasive developmental disorders. BMC Psychiatry 2012;12:119.  Back to cited text no. 13
    
14.
Wang M, Turnbull AP, Summers JA, Little TD, Poston DJ, Mannan H, et al. Severity of disability and income as predictors of parents' satisfaction with their family quality of life during early childhood years. Res Pract Persons Severe Disabl 2004;29:82-94.  Back to cited text no. 14
    
15.
Kaminsky L, Dewey D. Psychosocial adjustment in siblings of children with autism. J Child Psychol Psychiatry 2002;43:225-32.  Back to cited text no. 15
    
16.
Crnic KA, Gaze C, Hoffman C. Cumulative parenting stress across the preschool period: Relations to maternal parenting and child behaviour at age 5. Infant Child Dev 2005;14:117-32.  Back to cited text no. 16
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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