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Linking Maternal Caregiving Burden to Maternal and Child Adjustment: Testing Maternal Coping Strategies as Mediators and Moderators

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Abstract

This study examined the links between maternal caregiving burden and maternal and child adjustment, and whether these links were mediated and moderated by maternal coping strategies. Cross-sectional data were collected from 173 Chinese families with kindergarten aged children with special needs in Hong Kong, China (mean age = 61.53 months; 72% of them were boys). Using questionnaires, mothers rated their caregiving burden, use of different coping strategies, and the adjustment of themselves and their children with special needs. Results demonstrated that maternal caregiving burden was negatively associated with maternal and child adjustment. Moreover, the associations of maternal caregiving burden with maternal life satisfaction and depression were partially mediated by maternal planful problem solving, positive reappraisal, and seeking emotional support, whereas the association between maternal caregiving burden and child prosocial behaviors was partially mediated by maternal positive reappraisal. There was little evidence, however, for the moderating effects of maternal coping strategies. Theoretically, our findings highlighted the role of parental coping in understanding the mechanism through which parental caregiving burden may affect the adjustment of both parents and their children. Practically, our findings pointed to the utility of supporting parents of children with special needs by reducing their caregiving burden and increasing their use of specific coping strategies.

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References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). Arlington: American Psychiatric Publishing.

    Google Scholar 

  • Andresen, E. M., Malmgren, J. A., Carter, W. B., & Patrick, D. L. (1994). Screening for depression in well older adults: Evaluation of a short form of the CES-D. American Journal of Preventive Medicine, 10, 77–84.

    PubMed  Google Scholar 

  • Bédard, M., Molloy, D. W., Squire, L., Dubois, S., Lever, J. A., & O'Donnell, M. (2001). The Zarit burden interview: A new short version and screening version. The Gerontologist, 41, 652–657.

    PubMed  Google Scholar 

  • Braithwaite, V. (1992). Caregiving burden: Making the concept scientifically useful and policy relevant. Research on Aging, 14, 3–27.

    Google Scholar 

  • Bryant, D. P., Bryant, B. R., & Smith, D. D. (2015). Teaching students with special needs in inclusive classrooms. Thousand Oaks: Sage Publications.

    Google Scholar 

  • Carver, C. S. (1997). You want to measure coping but your protocol’s too long: Consider the brief COPE. International Journal of Behavioral Medicine, 4, 92–100.

    PubMed  Google Scholar 

  • Census and Statistics Department. (2016). Population and household statistics 2015. Hong Kong: Census and Statistics Department.

    Google Scholar 

  • Chan, K. K. S., & Lam, C. B. (2018). Self-stigma among parents of children with autism spectrum disorder. Research in Autism Spectrum Disorders, 48, 44–52.

    Google Scholar 

  • Chan, T. S. F., Lam, L. C. W., & Chiu, H. F. K. (2005). Validation of the Chinese version of the Zarit burden interview. Hong Kong Journal of Psychiatry, 15, 9–14.

    Google Scholar 

  • Chien, L. Y., Chu, H., Guo, J. L., Liao, Y. M., Chang, L. I., Chen, C. H., & Chou, K. R. (2011). Caregiver support groups in patients with dementia: A meta-analysis. International Journal of Geriatric Psychiatry, 26, 1089–1098.

    PubMed  Google Scholar 

  • Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159.

    PubMed  Google Scholar 

  • Cooc, N., & Bui, O. T. (2017). Characteristics of parent center assistance from the federation for children with special needs. The Journal of Special Education, 51, 138–149.

    Google Scholar 

  • Costa, A. P., Steffgen, G., & Ferring, D. (2017). Contributors to well-being and stress in parents of children with autism spectrum disorder. Research in Autism Spectrum Disorders, 37, 61–72.

    Google Scholar 

  • Cox, M. J., Paley, B., & Harter, K. (2001). Interparental conflict and parent-child relationships. In J. H. Grych, J. H. Grych, & F. D. Fincham (Eds.), Interparental conflict and child development: Theory, research, and applications (pp. 249–272). Cambridge: Cambridge University Press.

    Google Scholar 

  • Dardas, L. A., & Ahmad, M. M. (2015a). Coping strategies as mediators and moderators between stress and quality of life among parents of children with autistic disorder. Stress and Health, 31, 5–12.

    PubMed  Google Scholar 

  • Dardas, L. A., & Ahmad, M. M. (2015b). For fathers raising children with autism, do coping strategies mediate or moderate the relationship between parenting stress and quality of life? Research in Developmental Disabilities, 36, 620–629.

    Google Scholar 

  • Diener, E. D., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The satisfaction with life scale. Journal of Personality Assessment, 49, 71–75.

    PubMed  Google Scholar 

  • Du, Y., Kou, J., & Coghill, D. (2008). The validity, reliability and normative scores of the parent, teacher and self report versions of the strengths and difficulties questionnaire in China. Child and Adolescent Psychiatry and Mental Health, 2, 8–23.

    PubMed  PubMed Central  Google Scholar 

  • Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G* power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175–191.

    PubMed  Google Scholar 

  • Giallo, R., Wood, C. E., Jellett, R., & Porter, R. (2013). Fatigue, wellbeing and parental self-efficacy in mothers of children with an autism spectrum disorder. Autism, 17, 465–480.

    PubMed  Google Scholar 

  • Goh, Y. W., Sawang, S., & Oei, T. P. (2010). The revised transactional model (RTM) of occupational stress and coping: An improved process approach. The Australasian Journal of Organisational Psychology, 3, 13–20.

    Google Scholar 

  • Goodman, R. (1997). The strengths and difficulties questionnaire: A research note. Journal of Child Psychology and Psychiatry, 38, 581–586.

    PubMed  Google Scholar 

  • Greenglass, E. (2002). Proactive coping. In E. Frydenberg (Ed.), Beyond coping: Meeting goals, vision, and challenges (pp. 37–62). London: Oxford University Press.

    Google Scholar 

  • Guillemin, F. (1995). Cross-cultural adaptation and validation of health status measure. Scandinavian Journal of Rheumatology, 24, 61–63.

    PubMed  Google Scholar 

  • Han, Y., Hu, D., Liu, Y., Lu, C., Luo, Z., Zhao, J., et al. (2014). Coping styles and social support among depressed Chinese family caregivers of patients with esophageal cancer. European Journal of Oncology Nursing, 18, 571–577.

    PubMed  Google Scholar 

  • Hastings, R. P., Kovshoff, H., Brown, T., Ward, N. J., degli Espinosa, F., & Remington, B. (2005). Coping strategies in mothers and fathers of preschool and school-age children with autism. Autism, 9, 377–391.

    PubMed  Google Scholar 

  • Hoogsteen, L., & Woodgate, R. L. (2013). Centering autism within the family: A qualitative approach to autism and the family. Journal of Pediatric Nursing, 28, 135–140.

    PubMed  Google Scholar 

  • Hu, Y., & Scott, J. (2016). Family and gender values in China: Generational, geographic, and gender differences. Journal of Family Issues, 37, 1267–1293.

    Google Scholar 

  • Kane, J. B., & Lam, C. B. (2011). A promising approach to future biosocial research on the family: Considering the role of temporal context. In Biosocial foundations of family processes (pp. 247–264). New York: Springer.

    Google Scholar 

  • Kwok, S. Y. C. L., Leung, C. L. K., & Wong, D. F. K. (2014). Marital satisfaction of Chinese mothers of children with autism and intellectual disabilities in Hong Kong. Journal of Intellectual Disability Research, 58, 1156–1171.

    PubMed  Google Scholar 

  • Lai, K. Y., Luk, E. S., Leung, P. W., Wong, A. S., Law, L., & Ho, K. (2010). Validation of the Chinese version of the strengths and difficulties questionnaire in Hong Kong. Social Psychiatry and Psychiatric Epidemiology, 45, 1179–1186.

    PubMed  Google Scholar 

  • Lam, C. B., McHale, S. M., & Crouter, A. C. (2012). Parent–child shared time from middle childhood to late adolescence: Developmental course and adjustment correlates. Child Development, 83, 2089–2103.

    PubMed  PubMed Central  Google Scholar 

  • Lazarus, R. S., & Folkman, S. (1987). Transactional theory and research on emotions and coping. European Journal of Personality, 1, 141–169.

    Google Scholar 

  • Li, X., Lam, C. B., Chung, K. K. H., & Leung, C. (2019). Linking parents’ self-stigma to the adjustment of children with disabilities. American Journal of Orthopsychiatry., 89, 212–221.

    PubMed  Google Scholar 

  • Lindsay, E. K., & Creswell, J. D. (2017). Mechanisms of mindfulness training: Monitor and acceptance theory (MAT). Clinical Psychology Review, 51, 48–59.

    PubMed  Google Scholar 

  • Lopez, V., Clifford, T., Minnes, P., & Ouellette-Kuntz, H. (2008). Parental stress and coping in families of children with and without developmental delays. Journal on Developmental Disabilities, 14, 99–104.

    Google Scholar 

  • Lu, M., Yang, G., Skora, E., Wang, G., Cai, Y., Sun, Q., & Li, W. (2015). Self-esteem, social support, and life satisfaction in Chinese parents of children with autism spectrum disorder. Research in Autism Spectrum Disorders, 17, 70–77.

    Google Scholar 

  • Miller, R. B., Mason, T. M., Canlas, J. M., Wang, D., Nelson, D. A., & Hart, C. H. (2013). Marital satisfaction and depressive symptoms in China. Journal of Family Psychology, 27, 677–682.

    PubMed  Google Scholar 

  • Neece, C. L., Green, S. A., & Baker, B. L. (2012). Parenting stress and child behavior problems: A transactional relationship across time. American Journal on Intellectual and Developmental Disabilities, 117, 48–66.

    PubMed  PubMed Central  Google Scholar 

  • Oldfield, J., Humphrey, N., & Hebron, J. (2017). Risk factors in the development of behaviour difficulties among students with special educational needs and disabilities: A multilevel analysis. British Journal of Educational Psychology, 87, 146–169.

    PubMed  Google Scholar 

  • Paster, A., Brandwein, D., & Walsh, J. (2009). A comparison of coping strategies used by parents of children with disabilities and parents of children without disabilities. Research in Developmental Disabilities, 30, 1337–1342.

    PubMed  Google Scholar 

  • Patterson, J. M. (2002). Integrating family resilience and family stress theory. Journal of Marriage and Family, 64, 349–360.

    Google Scholar 

  • Peer, J. W., & Hillman, S. B. (2014). Stress and resilience for parents of children with intellectual and developmental disabilities: A review of key factors and recommendations for practitioners. Journal of Policy and Practice in Intellectual Disabilities, 11, 92–98.

    Google Scholar 

  • Pepperell, T. A., Paynter, J., & Gilmore, L. (2018). Social support and coping strategies of parents raising a child with autism spectrum disorder. Early Child Development and Care, 188, 1392–1404.

    Google Scholar 

  • Qiu, Y., & Li, S. (2008). Stroke: Coping strategies and depression among Chinese caregivers of survivors during hospitalisation. Journal of Clinical Nursing, 17, 1563–1573.

    PubMed  Google Scholar 

  • Raina, P., O'Donnell, M., Schwellnus, H., Rosenbaum, P., King, G., Brehaut, J., et al. (2004). Caregiving process and caregiver burden: Conceptual models to guide research and practice. BMC Pediatrics, 4, 1–13.

    PubMed  PubMed Central  Google Scholar 

  • Roper, S. O., Allred, D. W., Mandleco, B., Freeborn, D., & Dyches, T. (2014). Caregiver burden and sibling relationships in families raising children with disabilities and typically developing children. Families, Systems & Health, 32, 241–246.

    Google Scholar 

  • Schlebusch, L., & Dada, S. (2018). Positive and negative cognitive appraisal of the impact of children with autism spectrum disorder on the family. Research in Autism Spectrum Disorders, 51, 86–93.

    Google Scholar 

  • Seymour, M., Wood, C., Giallo, R., & Jellett, R. (2013). Fatigue, stress and coping in mothers of children with an autism spectrum disorder. Journal of Autism and Developmental Disorders, 43, 1547–1554.

    PubMed  Google Scholar 

  • Shavers, V. L. (2007). Measurement of socioeconomic status in health disparities research. Journal of the National Medical Association, 99, 1013–1020.

    PubMed  PubMed Central  Google Scholar 

  • Shrout, P. E., & Bolger, N. (2002). Mediation in experimental and nonexperimental studies: New procedures and recommendations. Psychological Methods, 7, 422–445.

    PubMed  Google Scholar 

  • Shulman, C. (2016). Research and practice in infant and early childhood mental health. Switzerland: Springer International Publishing.

    Google Scholar 

  • Silva, N., Carona, C., Crespo, C., & Canavarro, M. C. (2015). Caregiving burden and uplifts: A contradiction or a protective partnership for the quality of life of parents and their children with asthma? Journal of Family Psychology, 29, 151–161.

    PubMed  Google Scholar 

  • Social Welfare Department. (2018). Central referral system for rehabilitation services—Subsystem for disabled pre-schoolers: Manual of procedures. Hong Kong: Social Welfare Department.

    Google Scholar 

  • Sourander, A., Helstelä, L., & Helenius, H. (1999). Parent-adolescent agreement on emotional and behavioral problems. Social Psychiatry and Psychiatric Epidemiology, 34, 657–663.

    PubMed  Google Scholar 

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Acknowledgements

This research was supported by a grant by the Simon K.Y. Lee Foundation to Kevin Kien Hoa Chung. We thanked the research assistants and student helpers for their help in conducting this study, and the participating kindergartens and families for their insights about family relationships and child development.

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Authors and Affiliations

  1. The Department of Early Childhood Education, The Education University of Hong Kong, 10 Lo Ping Road, Tai Po, New Territories, Hong Kong

    Xiaomin Li, Chun Bun Lam & Kevin Kien Hoa Chung

  2. Centre for Child and Family Science, The Education University of Hong Kong, Tai Po, Hong Kong

    Chun Bun Lam & Kevin Kien Hoa Chung

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  1. Xiaomin Li
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  3. Kevin Kien Hoa Chung
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Correspondence to Kevin Kien Hoa Chung.

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Ethical Approval

All procedures performed in the current study involving human participants were in accordance with the ethical standards of the University’s institutional research committee (Human Research Ethics Committee, The Education University of Hong Kong, reference number 2016-2017-0093) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Li, X., Lam, C.B. & Chung, K.K.H. Linking Maternal Caregiving Burden to Maternal and Child Adjustment: Testing Maternal Coping Strategies as Mediators and Moderators. J Dev Phys Disabil 32, 323–338 (2020). https://doi.org/10.1007/s10882-019-09694-0

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