Skip to main content

Advertisement

Log in

Impact of Caring for a Child with Cerebral Palsy on the Quality of Life of Parents: A Systematic Review of the Literature

  • REVIEW ARTICLE
  • Published:
Journal of Developmental and Physical Disabilities Aims and scope Submit manuscript

Abstract

The implications of caring for a child with cerebral palsy (CP) are considerable, and parents have to cope with many changing demands related to the specific needs of their child. A new research field, devoted to the consequences of these caring tasks, has recently emerged. However, an overall vision is lacking, one that would enable us to understand how research is evolving and the relevant data that should be taken into account when planning interventions with these families. In this paper, we review the literature on the effects of caregiving on parents of children with CP, and summarize the factors related to these effects. A systematic search of online databases was performed and further studies were identified based on the reference lists of selected articles. Forty six articles that met the inclusion criteria were analysed. The review shows that caregivers of children with CP tend to have high levels of stress and depression and lower quality of life than parents of healthy children. We identify child behaviour and cognitive problems, low caregiver self-efficacy and low social support as factors that are consistently related with higher levels of stress and depression. The implications of these findings are discussed, especially those related to interventions that should be addressed to the family as a whole and which should aim to enhance parents’ competence and resources to better cope with the demands of the caring task.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Allen, R., & Petr, C. G. (1996). Toward developing standards and measurements for family-centered practice in family support programs. In G. H. S. Singer, L. E. Powers, & A. L. Olson (Eds.), Redefinning family support: innovations in public-private partnerships (pp. 57–86). Baltimore: Brookes.

    Google Scholar 

  • Amosun, S. L., Ikuesan, B. A., & Oloyede, I. J. (1995). Rehabilitation of the handicapped child. What about the caregiver? Papua New Guinea Medical Journal, 38(3), 208–214.

    PubMed  Google Scholar 

  • Baird, G., McConachie, H., & Scrutton, D. (2000). Parents’ perceptions of disclosure of the diagnosis of cerebral palsy. Archives of Disease in Childhood, 83, 475–480.

    Article  PubMed  Google Scholar 

  • Barlow, J. H., Cullen-Powell, L. A., & Cheshire, A. (2006). Psychological well-being among mothers of children with cerebral palsy. Early Child Development and Care, 176(3–4), 421–428.

    Article  Google Scholar 

  • Bauerle, S. (2003). How will internet use affect the patient. A review of computer network and closed Internet-based system studies and the implications in understanding how the use of the internet affects patient populations. Journal of Health Psychology, 8(1), 25–38.

    Article  Google Scholar 

  • Bella, G. P., Garcia, M. C., & Spadari-Bratfisch, R. C. (2011). Salivary cortisol, stress, and health in primary caregivers (mothers) of children with cerebral palsy. Psychoneuroendocrinology, 36(6), 834–842.

    Article  PubMed  Google Scholar 

  • Belsky, J., & Kelly, J. (1994). The transition to parenthood. New York: Delacorte.

    Google Scholar 

  • Blair, E. (2010). Epidemiology of the Cerebral Palsy. Orthopedic Clinics of North America, 41(4), 441–455.

    Article  PubMed  Google Scholar 

  • Blue-Banning, M., Summers, J. A., Frankland, H. C., Nelson, L., & Beegle, G. (2004). Dimensions of family and professional partnerships: constructive guidelines for collaboration. Exceptional Children, 2(70), 167–184.

    Google Scholar 

  • Bottcher, L. (2010). Children with spastic cerebral palsy, their cognitive functioning, and social participation: a review. Child Neuropsychology, 16(3), 209–228.

    Article  PubMed  Google Scholar 

  • Brehaut, J. C., Kohen, D. E., Raina, P., Walter, S. D., Russell, D. J., Swinton, M., O’Donnell, M., et al. (2004). The health of primary caregivers of children with cerebral palsy: how does it compare with that of other Canadian caregivers? Pediatrics, 114(2), e182–e191.

    Article  PubMed  Google Scholar 

  • Britner, P. A. (2003). Stress and coping: a comparison of self-report measures of functioning in families of young children with cerebral palsy or no medical diagnosis. Journal of Child and Family Studies, 12(3), 335–348.

    Article  Google Scholar 

  • Button, S., Pianta, R. C., & Marvin, R. S. (2001). Partner support and maternal stress in families raising young children with cerebral palsy. Journal of Developmental and Physical Disabilities, 13(1), 61–81.

    Article  Google Scholar 

  • Byrne, M. B., Hurley, D. A., Daly, L., & Cunningham, C. G. (2010). Health status of caregivers of children with cerebral palsy. Child: Care, Health and Development, 36(5), 696–702.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Colineau, N., & Paris, C. (2010). Talking about your health to strangers: understanding the use of online social networks by patients. New Review of Hypermedia and Multimedia, 16(1), 141.

    Article  Google Scholar 

  • Cowan, C. P., & Cowan, P. A. (1997). Becoming a parent. In A. S. Skolnick & J. H. Skolnick (Eds.), Family in transition (pp. 201–213). New York: Longman.

    Google Scholar 

  • Crowe, M., & Sheppard, L. (2011). A review of critical appraisal tools show they lack rigor: alternative tool structure is proposed. Journal of ClinicalEpidemiology, 64(1), 79–89.

    Google Scholar 

  • Cunningham, C. C. (2000). Familias con niños con Síndrome de Down. In M. A. Verdugo (Ed.), Familias y Discapacidad intelectual (pp. 41–71). Madrid: Feaps.

    Google Scholar 

  • Dagenais, L., Hall, N., Majnemer, A., Birnbaum, R., Dumas, F., Gosselin, J., Koclas, L., et al. (2006). Communicating a diagnosis of cerebral palsy: caregiver satisfaction and stress. Pediatric Neurology, 35(6), 408–414.

    Article  PubMed  Google Scholar 

  • Davis, E., Shelly, A., Waters, E., Boyd, R., Cook, K., & Davern, M. (2010). The impact of caring for a child with cerebral palsy: quality of life for mothers and fathers. Child: Care, Health and Development, 36, 63–73.

    Article  Google Scholar 

  • Dellve, L., Samuelsson, L., Tallbonr, A., Fasth, A., & Hallberg, L. R. M. (2005). Stress and wellbeing among parents of children with rare diseases: a prospective intervention study. Journal of Advanced Nursing, 53(4), 392–402.

    Article  Google Scholar 

  • Dunst, C., Trivette, C. M., & Deal, A. (1988). Enabling and empowering families: principles and guidelines for practice. Cambridge: Brookline Books.

    Google Scholar 

  • Dunst, C. J., Trivette, C. M., & Hamby, D. W. (2007). Meta-analysis of family-centered help giving practices research. Mental Retardation and Development Disabilities Research Reviews, 13(4), 370–378.

    Article  Google Scholar 

  • Eisenhower, A. S., Baker, B. L., & Blacher, J. (2005). Preeschool children with intellectual disability: sundrome specificity, behaviour problems and maternal well-being. Journal of Intellectual Disability Research, 49(9), 657–671.

    Article  PubMed  Google Scholar 

  • Eker, L., & Tüzün, E. H. (2004). An evaluation of quality of life of mothers of children with cerebral palsy. Disability and Rehabilitation, 26(23), 1354–1359.

    Article  PubMed  Google Scholar 

  • Florian, V., & Findler, L. (2001). Mental health and marital adaptation among mothers of children with cerebral palsy. The American Journal of Orthopsychiatry, 71(3), 358–367.

    Article  PubMed  Google Scholar 

  • Fox, S. (2011). Peer-to-peer healthcare: many people – especially those living with chronic or rare diseases – use online connections to supplement professional medical advice. Resource document. Washington, DC: The Pew Internet & American Life Project, 28th Feb. http://pewinternet.org/Reports/2011/P2PHealthcare.aspx.

  • Glasscock, R. (2000). A phenomenological study of the experience of being a mother of a child with cerebral palsy. Paediatric Nursing, 26(4), 407–410.

    Google Scholar 

  • 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.

    Article  Google Scholar 

  • Guillamón, N., Armayones, M., Hernández, E., & Gómez-Zúñiga, B. (2010). The role of patient organizations in participatory medicine: can virtual health communities help participatory medicine accomplish its objectives? Journal of Participatory Medicine, 2, e21.

    Google Scholar 

  • Guyard, A., Fauconnier, J., Mermet, M. A., & Cans, C. (2011). Impact sur les parents de la paralysie cérébrale chez l’enfant: revue de la littérature. Archives de Pédiatrie, 18, 204–214.

    Article  PubMed  Google Scholar 

  • Hamzat, T. K., & Mordi, E. L. (2007). Impact of caring for children with cerebral palsy on the general health of their caregivers in an African community. International Journal of Rehabilitation Research, 30(3), 191–194.

    Article  PubMed  Google Scholar 

  • Hastings, R. P., Daley, D., Burns, C., & Beck, A. (2006). Maternal distress and expressed emotion: cross-sectional and longitudinal relatioinships with behaviour problems of children with intellectual disabilities. American Journal on Mental Retardation, 1(111), 48–61.

    Article  Google Scholar 

  • Ho, S. M. Y., Fung, B. K. K., Fung, A. S. M., Chow, S. P., Ip, W. Y., Lee, S. F. Y., Leung, E. Y. P., et al. (2008). Overprotection and the psychological states of cerebral palsy patients and their caretakers in Hong Kong: a preliminary report. Hong Kong Medical Journal = Xianggang Yi XueZaZhi/Hong Kong Academy Of Medicine, 14(4), 286–291.

    Google Scholar 

  • Huang, Y. (2010). Cerebral palsy: experiences of mothers after learning their child’s diagnosis. Journal of Advanced Nursing, 66(6), 1213.

    Article  PubMed  Google Scholar 

  • Huang, Y., Kellett, U., & St John, W. (2011). Being concerned: caregiving for Taiwanese mothers of a child with cerebral palsy. Journal of Clinical Nursing, 21(1–2), 189–197.

    PubMed  Google Scholar 

  • Kaya, K., Unsal-Delialioglu, S., Ordu-Gokkaya, N. K., Ozisler, Z., Ergun, N., Ozel, S., & Ucan, H. (2010). Musculo-skeletal pain, quality of life and depression in mothers of children with cerebral palsy. Disability and Rehabilitation, 32(20), 1666–1672.

    Article  PubMed  Google Scholar 

  • Ketelaar, M., Volman, M. J. M., Gorter, J. W., & Vermeer, A. (2008). Stress in parents of children with cerebral palsy: what sources of stress are we talking about? Child: Care Health and Development, 34(6), 825–829.

    Article  Google Scholar 

  • Lin, S. (2000). Coping and adaptation in families of children with cerebral palsy. Exceptional Children, 66(2), 201–218.

    Google Scholar 

  • Magill-Evans, J., Pain, K., Adkins, R., & Kratochvil, M. (2001). Are families with adolescents and young adults with cerebral palsy the same as other families? Developmental Medicine and Child Neurology, 43, 466–472.

    Article  PubMed  Google Scholar 

  • Magill-Evans, J., Darrah, J., & Galambos, N. L. (2011). The parenting journey of mothers of young adults with multiple impairments. Journal of Developmental and Physical Disabilities, 23(3), 183–193.

    Article  Google Scholar 

  • Manuel, J., Naughton, M. J., Balkrishnan, R., Paterson Smith, B., & Koman, L. A. (2003). Stress and adaptation in mothers of children with cerebral palsy. Journal of Pediatric Psychology, 28(3), 197–201.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Murray, E., Burns, J., See, T. S., Lai, R., & Nazareth, I. (2004). Interactive health communication applications for people with chronic disease. Cochrane Database System Review, 4, CD004274.

    Google Scholar 

  • Odding, E., Roebroeck, M. E., & Stam, H. J. (2006). The epidemiology of cerebral palsy: incidence, impairments and risk factors. Disability and Rehabilitation, 28(4), 183–191.

    Article  PubMed  Google Scholar 

  • Okurowska-Zawada, B., Kulak, W., Wojtkowsku, J., Sienkiewicz, D., & Paszko-Patej, G. (2011). Quality of life of parents of children with cerebral palsy. Progress in Health Sciences, 1(1), 116–123.

    Google Scholar 

  • Ones, K., Yilmaz, E., Cetinkaya, B., & Caglar, N. (2005). Assessment of the quality of life of mothers of children with cerebral palsy (primary caregivers). Neurorehabilitation and Neural Repair, 19(3), 232–237.

    Article  PubMed  Google Scholar 

  • Ong, L. C., Afifah, I., Sofiah, A., & Lye, M. S. (1998). Parenting stress among mothers of Malaysian children with cerebral palsy: predictors of child-and-parent-related-stress. Annals of Tropical Paediatrics, 18(4), 301–307.

    PubMed  Google Scholar 

  • Palisandro, R., Rosenbaum, P., Walter, S., Russell, D., Wood, E., & Galupi, B. (1997). Development and reliability of a system to classify gross motor function in children with cerebral palsy. Developmental Medicine and Child Neurology, 39, 214–223.

    Article  Google Scholar 

  • Parkes, J., McCullough, N., Madden, A., & McCahey, E. (2009). The health of children with cerebral palsy and stress in their parents. Journal of Advanced Nursing, 65(11), 2311–2323.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Pelchat, D., Levert, M.-J., & Bourgeois-Guérin, V. (2009). How do mothers and fathers who have a child with a disability describe their adaptation/transformation process? Journal of Child Health Care: For Professionals Working With Children In The Hospital And Community, 13(3), 239–259.

    Article  Google Scholar 

  • Pimm, P. L. (1996). Some of the implications of caring for a child or adult with cerebral palsy. British Journal of Occupational Therapy, 59(7), 335–341.

    Google Scholar 

  • Prudente, C. O. M., Barbosa, M. A., & Porto, C. C. (2010). Relation between quality of life of mothers of children with cerebral palsy and the children’s motor functioning, after ten months of rehabilitation. Revista Latino-Americana de Enfermagem, 18(2), 149–155.

    Article  PubMed  Google Scholar 

  • Raina, P., O’Donnell, M., Rosenbaum, P., Brehaut, J., Walter, S. D., Russell, D., et al. (2005). The health and well-being of caregivers of children with cerebral palsy. Pediatrics, 115(6), e626–e636.

    Article  PubMed  Google Scholar 

  • Rentinck, I. C. M., Ketelaar, M., Jongmans, M. J., & Gorter, J. W. (2007). Parents of children with cerebral palsy: a review of factors related to the process of adaptation. Child: Care, Health and Development, 33(2), 161–167.

    Article  Google Scholar 

  • Risdal, D., & Singer, G. H. S. (2004). Marital adjustment in parents of children with disabilities: a historical review and meta-analysis. Research and Practice for Persons with Severe Disabilities, 29(2), 95–103.

    Article  Google Scholar 

  • Rodrigues dos Santos, M. T. B., Bianccardi, M., Celiberti, P., & de Oliveira Guaré, R. (2009). Dental caries in cerebral palsied individuals and their caregivers’ quality of life. Child: Care, Health and Development, 35(4), 475–481.

    Article  Google Scholar 

  • Rodrigues dos Santos, M. T. B., Biancardi, M., Guare, R. O., & Jardim, J. R. (2010). Caries prevalence in patients with cerebral palsy and the burden of caring for them. Special Care In Dentistry: Official Publication Of The American Association Of Hospital Dentists, The Academy Of Dentistry For The Handicapped, And The American Society For Geriatric Dentistry, 30(5), 206–210.

    Article  Google Scholar 

  • Romeo, D. M., Cioni, M., Distefano, A., Battaglia, L. R., Costanzo, L., Ricci, D., De Sanctis, R., et al. (2010). Quality of life in parents of children with cerebral palsy: is it influenced by the child’s behaviour? Neuropediatrics, 41(3), 121–126.

    Article  PubMed  Google Scholar 

  • Rosenbaum, P., Paneth, N., Leviton, A., Goldstein, M., Bax, M., Damiano, et al. (2007). A report: the definition and classification of cerebral palsy April 2006. Developmental Medicine and Child Neurology, 109(Supplement), 8–14.

    PubMed  Google Scholar 

  • Sajedi, F., Alizad, V., Malekkhosravi, G., Karimlou, M., & Vameghi, R. (2010). Depression in mothers of children with cerebral palsy and its relation to severity and type of cerebral palsy. Acta Medica Iranica, 48(4), 250–254.

    PubMed  Google Scholar 

  • Sawyer, M. G., Bittman, M., La Greca, A. M., Crettenden, A. D., Borojevic, N., Raghavendra, P., & Russo, R. (2011). Time demands of caring for children with cerebral palsy: what are the implications for maternal mental health? Developmental Medicine and Child Neurology, 53(4), 338–343.

    Article  PubMed  Google Scholar 

  • Sipal, R. F., Schuengel, C., Voorman, J. M., Van Eck, M., & Becher, J. G. (2010). Course of behaviour problems of children with cerebral palsy: the role of parental stress and support. Child: Care, Health and Development, 36(1), 74–84.

    Article  Google Scholar 

  • Skok, A., Harvey, D., & Reddihough, D. (2006). Perceived stress, perceived social support, and wellbeing among mothers of school-aged children with cerebral palsy. Journal of Intellectual & Developmental Disability, 31(1), 53–57.

    Article  Google Scholar 

  • Smith, T. B., Innocenti, M. S., Boyce, G. C., & Smith, C. S. (1993). Depressive symptomatology and interaction behaviours of mothers having a child with disabilities. Psychological Reports, 73, 1184–1186.

    Article  PubMed  Google Scholar 

  • Ström, H., Kreuter, M., & Rosberg, S. (2011). Quality of life in parents/caretakers of children with cerebral palsy in Kampong Cham, Cambodia. Journal of Tropical Pediatrics. doi:10.1093/tropej/fmr077.

  • Summers, J. A., Marquis, J., Mannan, H., Turnbull, A., Fleming, K., Poston, D., et al. (2007). Relationship of perceiving of adequacy of services, family-profesional partnerships, and family quality of life in early childhood service programs. International Journal of Developmental Disability and Education, 54(3), 319–338.

    Article  Google Scholar 

  • Svedberg, L. E., Englund, E., Malker, H., & Stener-Victorin, E. (2010). Comparison of impact on mood, health, and daily living experiences of primary caregivers of walking and non-walking children with cerebral palsy and provided community services support. European Journal Of Paediatric Neurology: EJPN: Official Journal of the European Paediatric Neurology Society, 14(3), 239–246.

    Article  Google Scholar 

  • Terra, V. C., Cysneiros, R. M., Schwartzman, J. S., Teixeira, M. C. T. V., Arida, R. M., Cavalheiro, E. A., Scorza, F. A., et al. (2011). Mothers of children with cerebral palsy with or without epilepsy: a quality of life perspective. Disability and Rehabilitation, 33(5), 384–388.

    Article  PubMed  Google Scholar 

  • Trivette, C., Dunst, C. J., Deal, A., & Hamer, W. (1990). Assessing family strenghs and family functioning style. Topics in Early Childhood Special Education, 10(1), 367–385.

    Article  Google Scholar 

  • Tuna, H., Ünalan, H., Tuna, F., & Kokino, S. (2004). Quality of life of primary caregivers of children with cerebral palsy: a controlled study with short form-36 questionnaire. Developmental Medicine and Child Neurology, 46(09), 647–648.

    Article  PubMed  Google Scholar 

  • Turnbull, A. (2005). La calidad de vida de la familia como resultado de los servicios: el nuevo paradigma. In M. A. Verdugo & F. B. Jordán de Urríes Vega (Eds.), Investigación, innovación y cambio. V Jornadas científicas de investigación sobre personas con discapacidad (pp. 61–82). Salamanca: Amarú Ediciones.

    Google Scholar 

  • Turnbull, A. P., Turbibville, V., & Turnbull, H. R. (2000). Evolution of family-professional partnership collective empowerment as the model for the early twenty-first century. In J. P. Sonkoff & S. J. Meisels (Eds.), Handbook of early childhood intervention. New York: Cambridge University Press.

    Google Scholar 

  • Turnbull, A., Brown, I., & Turnbull, R. (Eds.). (2004). Families and people with mental retardation and quality of life. International perspectives. Washington: AAMR.

    Google Scholar 

  • Unsal-Delialioglu, S., Kaya, K., Ozel, S., & Gorgulu, G. (2009). Depression in Mothers of children with cerebral palsy and related factors in Turkey: a controlled study. International Journal of Rehabilitation Research, 32(3), 199–204.

    Article  PubMed  Google Scholar 

  • Wanamaker, C. E., & Glenwick, D. S. (1998). Stress, coping, and perceptions of child behaviour in parents of preschoolers with cerebral palsy. Rehabilitation Psychology, 43(4), 297–312.

    Article  Google Scholar 

  • Wang, H., & Jong, Y. (2004). Parental stress and related factors in parents of children with cerebral palsy. The Kaohsiung Journal of Medical Sciences, 20(7), 334–340.

    Article  Google Scholar 

  • Weiss, J. B., Lorenzi, N. M., & Lorenzi, N. (2008). Synthesizing community wisdom: a model for sharing cancer-related resources through social networking and collaborative partnerships. AMIA Annual Symposium Proceedings, 793–7.

Download references

Acknowledgments

This work has been funded by the Spanish Ministry of Science and Technology (PSI2008-01124; Plan Nacional of I + D). Funds were used to pay the translation of the draft.

The authors of this article are members of PSiNET Research Group, which is recognized and supported by the Catalan Government (SGR09-197).

We thank Gerardo Ontiveros for his assistance with the search through the databases.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Modesta Pousada.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pousada, M., Guillamón, N., Hernández-Encuentra, E. et al. Impact of Caring for a Child with Cerebral Palsy on the Quality of Life of Parents: A Systematic Review of the Literature. J Dev Phys Disabil 25, 545–577 (2013). https://doi.org/10.1007/s10882-013-9332-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10882-013-9332-6

Keywords

Navigation