Coping Strategies Among Mothers of Chronically Ill Children: A Case Study in Malaysia

ABSTRACT

 The purpose of this study is to identify the stresses and coping strategies of five mothers in caring for their chronically ill and disabled children. These mothers were receiving services from a nonprofit hospital in Malaysia. Through an in-depth case study design, the findings indicated that emotional stress caused high levels of depression, which decreased life satisfaction that led to poorer physical health. Issues explored included employment, noncooperation of family members, as well as factors related to the mother's individual abilities and how these factors might affect maternal caregiving. Recommendations for future research include identifying probable psychosocial stresses and other associated factors while emphasizing the importance of community-based programs that minimize these stresses.     

How do immigrant parents of children with complex health needs manage to cope in their daily lives?

Daily life with children who have complex health needs can be stressful for parents. Immigrant parents are vulnerable to stress because they may lack language skills and knowledge about the health care system and have limited social networks. In this study, we focus on how immigrant parents of children with complex health needs use emotion‐focused and problem‐focused coping strategies to manage their daily life, and how their self‐efficacy and the immigration process may affect their coping. This qualitative study had an exploratory design with individual and focus group interviews. The sample comprised 27 parents—18 mothers and 9 fathers—from Pakistan, Poland, and Vietnam. The findings indicated that the parents' love for their child helps them to cope in their daily life. Newly arrived migrants, single mothers with a severely ill child who lacked support and migrant parents with language difficulties struggle to cope. Some of the stress is related to personal, social and structural problems, and to the insufficient resources available to meet the child's needs. The parents used both emotion‐focused and problem‐focused coping strategies. The parents noted that access to both universal and selective welfare services is an important factor that contributed to their self‐efficacy and coping.     

Children's Illness Severity and Parent's Adaptation

This paper examines how parents cope with the stress of physical illnesses in their children. Three groups of parents, comprising 270 mothers and 106 fathers, whose children were either seriously ill, ill or from the control group, participated in this study. The variables examined included the parents' rating of the stress experienced, their satisfaction with coping, the family environment and the parents' adaptation. Implications of the findings for intervention are discussed.     

Examining the Experiences of Fathers of Children with a Life-Limiting Illness

Families who have a child diagnosed with a life-limiting illness (LLI) face substantial challenges resulting from the complexity and devastating impact of the condition and potential closeness of death. The experiences of fathers of a child with LLI have been understudied; therefore, this study explored the stresses, experiences, and strategies of these fathers, including their perceptions about support needs. Based on grounded theory, in-depth semi-structured interviews were conducted with 18 fathers of children with LLI. Six fathers had experienced the death of their child. The overarching themes were stresses, means of coping, and perceived needs for support. Generally, fathers in this study struggled relative to discursive and internalized notions of fathers as providers and protectors for their children, combined with an inability to ease their child’s vulnerability to LLI. Participants were engaged in the care of their child with LLI, but several felt marginalized by health care providers in care planning and staff/family communication. Some fathers recognized and valued their support network while others had few supports. Some described personal growth and desired to help other fathers. Practice implications and recommendations include renewed application of family-centered care, overcoming presumptions about fathers’ roles, and recognizing the impact of LLI beyond physical health.     

The changing social profile of mothers whose children are admitted into institutional care in Greece

The study sample consisted of 69 mothers in Greece whose children had been admitted into institutional care at an age of less than 7 years. These mothers were divided into two groups, 32 whose children were aged 2.5–5.5 years and 37 whose children were aged 15.5–17.5 years at the time of study. The mean age of the first group of mothers was 27 years and the second 42 years. Corresponding control groups consisted of 65 mothers, 24 younger and 37 older, in intact families. All the mothers were interviewed using a semistructured interview schedule. Study mothers of both groups were from a lower social class (occupation, education) than controls, had experienced more adversity in childhood and had more health problems. They had left their parental homes and given birth at a younger age and faced more difficulties (financial, housing problems, marital discord and/or divorce). The older group of study mothers more often had their children admitted into care because of financial difficulties or illegitimacy, in contrast with the younger mothers who more often gave the reason of marital breakdown. There were indications that the same kind of adversity that they had experienced themselves as children was the main reason for admission of their children into institutional care.     

The challenges and coping strategies of single mothers caring for children with special needs: Experiences from Kashmir,India

Families play a significant role in the development of their children. Nearly 16% of children in the industrialized world live in single-parent households, which are mostly comprised of single mothers. Although motherhood is the most beautiful feeling a woman cherishes, this experience can be challenging when the woman has to raise their special-needs child on her own, without the support of her spouse or partner. This study aims to understand the challenges and coping strategies of single mothers while raising their special-needs children. To this end, in-depth case interviews were conducted with three single mothers selected purposively from the Srinagar area in Kashmir, India. The results revealed that multiple roles and responsibilities had an adverse effect on the psychological well-being of single mothers who had to deal with the financial burden of caring for their child's condition, including expenses for doctor visits, special therapies and medication, among other. In addition, they had to experience the social pressure and stigmatization attached to being a single mother. The most widely employed coping strategies include support from family and friends, religious faith, and self-coping. The study recommends the creation of welfare packages like free counseling, stipend support, inclusive education, free medical treatment, and therapies for Children with Special Needs (CWSNs) and their mothers.     

Stillbirth: The Mother's Experience and Implications for Improving Care

ABSTRACT

More children die as a result of stillbirth than all other causes of infant deaths combined (Ananth, Shiliang, Kinzler, and Kramer, 2005; Goldenberg, Kirby, and Culhane, 2004; Froen, 2005; National Institute of Health, 2004); yet, mothers experiencing stillbirth are often left without support afterwards (Kubler-Ross, 2004; Fahey-McCarthy, 2003; Fletcher 2002; Saddler, 1987; DeFrain, 1986; Kirkley-Best & Kellner, 1982). Despite social work's growing involvement in care at the end of life, parents of stillborn children have not experienced consistent, relevant, and competent professional care in coping with the tragedy of death. Forty-seven women between the ages of 19 and 51 were recruited through nonprofit agencies that provide bereavement care to grieving families. Results of this qualitative study suggest that stillbirth is emotionally complex with long-lasting symptoms of grief and significant struggles to find meaning. The findings also support the need for perceived psychosocial and spiritual support from professional caregivers, family, and friends. The women's own experiences argue for comprehensive approaches to support the grief and loss of stillbirth, and for the importance of social work involvement in both immediate and longer term interventions.     

Social Support for Mothers of Children With Disabilities in China

ABSTRACT.

This article analyzes the gendered parenting experiences of mothers of children with disabilities in China. These mothers struggle to meet their children's needs, including daily care, financial security, and child development. In the context of China's social welfare development, are social services responding to their needs, so that mothers can share responsibility for the needs of their children with disabilities? The research analyzed qualitative data about 6 case-study children in rural and urban China. The data were derived from observation and interviews with their parents and other family and community members. The analysis revealed that the capacity of the mother, community, and local social services had an impact on the rights of the children and mothers. They experienced social discrimination, insufficient social support, and local failure to implement central policy social services and income support. These findings are consistent with international research about disability rights. They reinforce the importance of economic redistribution to enable local implementation of the national disability rights policies, rather than merely relying on ephemeral concepts of cultural change. Further research about the comparative impact of economic and social change in China on mothers and children with disabilities would extend these findings.     

‘I want to be better than you:’ lived experiences of intergenerational child maltreatment prevention among teenage mothers in and beyond foster care

The growing body of research on teenage motherhood in foster care has largely focused on the risks involved for both mother and child, yet these mothers depict a much more complex picture of their own experience of becoming and being mothers. The current study employed interpretative phenomenological analysis to explore 18 in‐depth, qualitative interviews from six participants on the meaning and experience of motherhood among teenage mothers in foster care and in the years immediately after ageing out. This study focused on a particular dimension of motherhood: participants' efforts to break the cycle of child abuse and neglect with their own children. Two themes emerged as characteristic of these experiences: (i) treating children well/parenting differently and avoiding the system; and (ii) reducing isolation and enhancing support. Given the increased likelihood of the children of teen mothers – particularly those who have been maltreated – becoming involved with the child welfare system, study findings suggest possible strategies for disrupting cycles of intergenerational child welfare involvement generated by young mothers themselves. Practice implications for addressing possible substance abuse, mental health and relational and parenting needs are discussed.     

Children's Disclosure and Secrecy: Links to Maternal Parenting Characteristics and Children's Coping Skills

The relations between maternal parenting characteristics, child disclosure and secrecy, and child outcomes (positive and negative strategies for coping with distress), were examined in a study of 140 children (10–12‐year‐olds) and their mothers. Child disclosure and secrecy were shown to be distinct but related constructs with authoritativeness predictive of disclosure and dispositional anger predictive of secrecy. These relations held even when child compliance was included as a control variable. Mothers' authoritative parenting predicted disclosure which in turn predicted children's use of positive coping strategies. Mothers' dispositional anger predicted secrecy which mediated the relation between maternal anger and children's use of negative coping strategies. Results are discussed in terms of parent–child communication and opportunities for mothers to use knowledge gained from child disclosure to teach children successful ways of dealing with distress.     

Thrown back: Reintegration experiences of National Guard/Reserve mothers of young children

Few studies have examined the experiences and perceptions of servicewoman mothers and their children, even as an increasing number of them have experienced deployment and combat exposure. The present paper describes a qualitative study that explored National Guard/Reserve (NG/R) mothers' experiences with mothering and co‐parenting during reintegration and their perceived priorities, supports, challenges and needs. Interpretive phenomenological analysis of seven in‐depth qualitative interviews produced themes including reunion and loneliness, the importance of time, help seeking and gendered experiences. Notably, all participants transitioned immediately back into primary caregiver roles upon homecoming, and several described how difficult it was to readjust while privately dealing with unmet mental health needs. Findings underscore the importance of a flexible suite of service options that meet key needs, most importantly, child care, social–emotional support for children and peer‐based parenting support specific to servicewoman mothers. For NG/R mothers, who may live far from base, community‐based services are essential, but as participants described, civilian social workers and other professionals must develop specialized knowledge, skills and experience to provide appropriate support.     

The Helpfulness of Holistic Arts–Based Group Work with Children Living in Foster Care

This article discusses practice-based research that is exploring the helpfulness of holistic arts–based group work for the development of self-awareness and self-esteem in children living in foster care. The group program is arts based and encourages children to explore their beliefs, feelings, and behaviors. Examples of group exercises are provided, challenges in developing this group program are discussed, and qualitative research findings are presented, which are based on the analysis of fifteen 6-week groups. Findings indicate that children learned new skills, improved coping abilities, connected with feelings, and felt more positive. Practitioners are encouraged to consider how arts-based group work can help children in care.     

Parent–Child Emotional Communication and Children's Coping in Middle Childhood

Parent–child communication regarding children's negative emotions and coping were examined in a sample of 75 5th graders (53% boys) and their mothers and fathers. We predicted that emotionally open communication between a parent and his or her child would be related to children's use of constructive coping strategies. Parents reported on how they react to their child's negative emotions, and children reported on how much they share their negative feelings with each parent. Additionally, emotional communication was measured during a parent–child discussion task involving an event that was upsetting to the child. The results indicated that emotional communication, as reported by mothers, fathers, and children, as well as mother–child observed communication, were related to children's coping strategies. The findings point to a need to assess emotional communication using multiple measures that tap both the child's and the parents’ perspectives and that use different methodologies.     

Non‐abusing mothers' support needs after child sexual abuse disclosure: A narrative review

The role of maternal support has been perceived as vital throughout the recovery process of sexually abused children. However, it is important to look at the concept “support” from the perspective of non‐abusing mothers' personal needs. This narrative review of the literature aimed to find out how non‐abusing mothers' need for support in their responses to disclosure of child sexual abuse has been recognized. A comprehensive search on Jyväskylä University Library interface yielded 12 academic articles based on empirical research. These articles were selected from those considered to have sufficiently investigated support for non‐abusing mothers and included a mixture of qualitative, quantitative, and mixed‐method research. The data consisted of peer‐reviewed online articles published in English between 2000 and 2017. Four themes emerged from the thematic analysis: improving the quality of the whole social support network for non‐abusing mothers; being blamed, maternal guilt, and shame; anger; and coping strategies. The findings show that the support needs of non‐abusing mothers are usually explained based on their interaction with sexually abused children. However, it is necessary to listen to women's needs independently of their mothering role. If these mothers are better understood, not only they, but also their children, could be empowered.     

The ‘good mother’ struggles: Obstacles to the attainment of motherhood ideals among adult women formerly placed in residential care

We analysed narratives of motherhood produced by 13 women who were involved with the welfare system or the justice system during adolescence. The original contribution of our study was its focus on mothers who were turning age 30, so they were not in that period of generalized instability that characterizes the transition from care and into adulthood. This qualitative study was part of a larger study on French‐Canadian adolescents with a history of residential care. Semi‐directed interviews were conducted with 13 women, more than 15 years after their admission to residential care. Our data highlights that motherhood can contribute to the vulnerability of women who were involved with the welfare or the justice system as adolescents. Our results suggest that in order to shed a perceived deviant label and to compensate for the adverse events they experienced, they pursue internalized ideals of “good motherhood” that translate into restrictions and strain. Furthermore, they tend to refrain from allowing people into their lives and asking for help for fear of being judged. Yet, as their children are getting older and exhibiting problem behaviors of their own, the questioning of their parental practices and skills only becomes more intense.     

Caregiver's Spirituality and Its Influence on Maintaining the Elderly and Disabled in a Home Environment

ABSTRACT

This study examined the role that faith-based organizations play for caregivers in maintaining the elderly and disabled in their homes. The study explored if persons who use religious beliefs and practices cope with caregiver stress better than those who do not use religious beliefs and practices. The study also explored the role of religious coping as a factor affecting decisions to institutionalize, and the role that faith-based practices and organizations play in helping caregivers maintain the elderly and disabled in their homes.     

Psychological Distress Experienced by Parents of Young Children With Congenital Heart Defects: A Comprehensive Review of Literature

ABSTRACT

The purpose of this study was to examine the existing research on the psychological distress experienced by parents whose young children (between the ages of 0 and 5 years old) have a congenital heart defect (CHD). A more detailed understanding of the distress experienced by these parents, including stress associated with the child's age, the severity of the child's diagnosis, and parent characteristics, is vital as it would allow for more targeted and individualized support for this population to enhance parental coping strategies and increase the likelihood of more positive parent–child interactions. This review of 25 studies contributes to the parenting stress literature by focusing on parents of young children and categorizing studies by publication characteristics, research methodology, and findings. The research clearly demonstrates that parents report a great deal of stress throughout the continuum of their child's health care experience. Recommendations for future research and practice implications, such as developing a stress vulnerability model specific to parenting children with CHD, clarifying the role between interdisciplinary team members regarding provision of psychosocial support to parents, and referring parents to specific community-based ongoing social support services, are presented.     

Violence,Negligence and Suicidal Tendency among Physically Disabled Street Children

This study was carried out among physically disabled street children (PDSC) in the city of Dhaka in Bangladesh. The aim of the study was to explore violence, negligence and suicidal tendency among PDSC. To do this, 30 PDSC (15 male and 15 female) were conveniently selected and interviewed with an interview protocol developed by a step‐by‐step process. The results of this study revealed that all the participants experienced physical violence but female children were more likely to experience sexual violence than male children. Violence against disabled children came from both family members or relatives and other people. As with violence, all the participants experienced some sort of negligence, again both from family members or relatives and other people. More importantly, this study found that more than half of the physically disabled children had suicidal tendency to some extent, i.e. some thought of committing suicide at least once in their life, while others attempted to commit suicide due to the sufferings that came with disability. This study concludes with some policy implications, particularly: providing counseling to parents and the disabled children; training of the service providers who provide services to disabled persons; and building awareness through mass media.     

Attachment and Coping Strategies in Middle Childhood Children whose Mothers Have a Mental Health Problem: Implications for Social Work Practice

Mental health has implications for the quality of relationshipswithin a family, particularly between parents and children,but also between other family and non-family members. Previousresearch has investigated parental reports of attachment infamilies with mental health problems, but relationship representationsas experienced by these children, especially in middle childhood,have not been so frequently investigated. An understanding ofchildren’s representations of attachment relationshipsand the different coping strategies that may result is importantfor social work practice when offering support, not only tothe children, but also other family members. Methods of investigatingattachment, such as the Separation Anxiety Test, have been usedto understand the relationship issues, fears and coping strategiesof other vulnerable children, and this study was designed specificallyto investigate relationship issues in middle childhood childrenwhose mothers had previously been hospitalized with mental healthproblems. We found that these children tended to be less emotionallyopen and secure, and generated fewer adaptive coping strategiesthan children whose mothers had never had mental health problems.Other themes also emerged from the interviews, such as a senseof trust in the parent–child relationship and the ‘containment’of fears. Implications for social work practice are discussed.