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Parents of Children with Special Health Care Needs Who have Better Coping Skills have Fewer Depressive Symptoms

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Abstract

Objectives Describe and quantify coping skills and prevalence of depressive symptoms in parents of children with special health care needs (CSHCN). Describe the association of coping skills with parental depressive symptoms, severity of child’s condition and family demographic characteristics. Methods A baseline questionnaire was administered to parents of CSHCN 2–11 years old. Data were analyzed cross-sectionally. Coping skills were assessed using F-COPES, and depressive symptoms were measured using CESD 10, both previously tested tools. Multivariable regression models measured the association of coping skills with depressive symptoms, parents’ rating of severity and demographic characteristics. Results Among 129 parents 54% had depressive symptoms above standard normal threshold. Parents with better coping skills had significantly fewer depressive symptoms. The severity of child’s condition, parental marital status and employment status were significantly related to depressive symptoms; after accounting for these factors, better coping skills were still associated with fewer depressive symptoms (P-value < 0.05). Conclusions Parents of CSHCN are at increased risk for depressive symptoms, especially if single and unemployed. In this study better parental coping skills were associated with fewer depressive symptoms, regardless of the severity of child’s condition; and remained significant after accounting for demographic factors. Educational interventions to improve coping skills for parents of children who have a variety of diagnoses and severity levels may potentially mitigate the manifestation of depressive symptoms and in turn improve parenting.

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Notes

  1. This description represents the MCHB definition of children with special health care needs.

References

  1. Bethell, C. D., Read, D., Blumberg, S. J., & Newacheck, P. W. (2008). What is the prevalence of children with special health care needs? Toward an understanding of variations in findings and methods across three national surveys. Maternal and Child Health Journal, 12(1), 1–14. doi:10.1007/s10995-007-0220-5.

    Article  PubMed  Google Scholar 

  2. Labbe, E. E. (1996). Emotional states and perceived family functioning of caregivers of chronically ill children. Psychological Reports, 79(3 Pt 2), 1233–1234.

    CAS  PubMed  Google Scholar 

  3. Ratliffe, C. E., Harrigan, R. C., Haley, J., Tse, A., & Olson, T. (2002). Stress in families with medically fragile children. Issues in Comprehensive Pediatric Nursing, 25(3), 167–188. doi:10.1080/01460860290042558.

    Article  PubMed  Google Scholar 

  4. Leung, D. W., & Slep, A. M. (2006). Predicting inept discipline: The role of parental depressive symptoms, anger, and attributions. Journal of Consulting and Clinical Psychology, 74(3), 524–534. doi:10.1037/0022-006X.74.3.524.

    Article  PubMed  Google Scholar 

  5. Eakes, G. G., Burke, M. L., & Hainsworth, M. A. (1998). Middle-range theory of chronic sorrow. Image–the Journal of Nursing Scholarship, 30(2), 179–184. doi:10.1111/j.1547-5069.1998.tb01276.x.

    Article  CAS  PubMed  Google Scholar 

  6. Kean, E. M., Kelsay, K., Wamboldt, F., & Wamboldt, M. Z. (2006). Posttraumatic stress in adolescents with asthma and their parents. Journal of the American Academy of Child and Adolescent Psychiatry, 45(1), 78–86. doi:10.1097/01.chi.0000186400.67346.02.

    Article  PubMed  Google Scholar 

  7. Lamontagne, L. L., Hepworth, J. T., Salisbury, M. H., & Riley, L. P. (2003). Optimism, anxiety, and coping in parents of children hospitalized for spinal surgery. Applied Nursing Research, 16(4), 228–235. doi:10.1016/S0897-1897(03)00052-1.

    Article  PubMed  Google Scholar 

  8. Lowes, L., & Lyne, P. (2000). Chronic sorrow in parents of children with newly diagnosed diabetes: A review of the literature and discussion of the implications for nursing practice. Journal of Advanced Nursing, 32(1), 41–48. doi:10.1046/j.1365-2648.2000.01418.x.

    Article  CAS  PubMed  Google Scholar 

  9. Magal-Vardi, O., Laor, N., Toren, A., Strauss, L., Wolmer, L., Bielorai, B., et al. (2004). Psychiatric morbidity and quality of life in children with malignancies and their parents. The Journal of Nervous and Mental Disease, 192(12), 872–875. doi:10.1097/01.nmd.0000146881.00129.ec.

    Article  PubMed  Google Scholar 

  10. Whittemore, R., Urban, A. D., Tamborlane, W. V., & Grey, M. (2003). Quality of life in school-aged children with type 1 diabetes on intensive treatment and their parents. The Diabetes Educator, 29(5), 847–854. doi:10.1177/014572170302900514.

    Article  PubMed  Google Scholar 

  11. Cox, A. D., Puckering, C., Pound, A., & Mills, M. (1987). The impact of maternal depression in young children. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 28(6), 917–928. doi:10.1111/j.1469-7610.1987.tb00679.x.

    Article  CAS  PubMed  Google Scholar 

  12. Cummings, E. M., & Davies, P. T. (1994). Maternal depression and child development. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 35(1), 73–112. doi:10.1111/j.1469-7610.1994.tb01133.x.

    Article  CAS  PubMed  Google Scholar 

  13. Downey, G., & Coyne, J. C. (1990). Children of depressed parents: An integrative review. Psychological Bulletin, 108(1), 50–76. doi:10.1037/0033-2909.108.1.50.

    Article  CAS  PubMed  Google Scholar 

  14. Lewinsohn, P. M., Olino, T. M., & Klein, D. N. (2005). Psychosocial impairment in offspring of depressed parents. Psychological Medicine, 35(10), 1493–1503. doi:10.1017/S0033291705005350.

    Article  PubMed  Google Scholar 

  15. Weissman, M. M., Pilowsky, D. J., Wickramaratne, P. J., Talati, A., Wisniewski, S. R., Fava, M., et al. (2006). Remissions in maternal depression and child psychopathology: A STAR*D-child report. Journal of the American Medical Association, 295(12), 1389–1398. doi:10.1001/jama.295.12.1389.

    Article  CAS  PubMed  Google Scholar 

  16. Schor, E. L. (2003). Family pediatrics: Report of the task force on the family. Pediatrics, 111(6 Pt 2), 1541–1571.

    PubMed  Google Scholar 

  17. Najman, J. M., Williams, G. M., Nikles, J., Spence, S., Bor, W., O’Callaghan, M., et al. (2000). Mothers’ mental illness and child behavior problems: Cause-effect association or observation bias? Journal of the American Academy of Child and Adolescent Psychiatry, 39(5), 592–602. doi:10.1097/00004583-200005000-00013.

    Article  CAS  PubMed  Google Scholar 

  18. Luoma, I., Tamminen, T., Kaukonen, P., Laippala, P., Puura, K., Salmelin, R., et al. (2001). Longitudinal study of maternal depressive symptoms and child well-being. Journal of the American Academy of Child and Adolescent Psychiatry, 40(12), 1367–1374. doi:10.1097/00004583-200112000-00006.

    Article  CAS  PubMed  Google Scholar 

  19. Moore, K. A., Hair, E., Vandivere, S., McPhee, C., McNamara, M., & Ling, T. (2006). Depression among moms: Prevalence, predictors, and acting out among third grade children. Washington DC: Child Trends.

    Google Scholar 

  20. Gibson, C. H. (1995). The process of empowerment in mothers of chronically ill children. Journal of Advanced Nursing, 21(6), 1201–1210. doi:10.1046/j.1365-2648.1995.21061201.x.

    Article  CAS  PubMed  Google Scholar 

  21. Rusch, N., Lieb, K., Bohus, M., & Corrigan, P. W. (2006). Self-stigma, empowerment, and perceived legitimacy of discrimination among women with mental illness. Psychiatric Services (Washington, DC), 57(3), 399–402. doi:10.1176/appi.ps.57.3.399.

    Google Scholar 

  22. Geist, R., Grdisa, V., & Otley, A. (2003). Psychosocial issues in the child with chronic conditions. Best Practice & Research. Clinical Gastroenterology, 17(2), 141–152. doi:10.1016/S1521-6918(02)00142-7.

    Article  Google Scholar 

  23. Singer, G. H., Ethridge, B. L., & Aldana, S. I. (2007). Primary and secondary effects of parenting and stress management interventions for parents of children with developmental disabilities: A meta-analysis. Mental Retardation and Developmental Disabilities Research Reviews, 13(4), 357–369. doi:10.1002/mrdd.20175.

    Article  PubMed  Google Scholar 

  24. Luther, E. H., Canham, D. L., & Young Cureton, V. (2005). Coping and social support for parents of children with autism. The Journal of School Nursing, 21(1), 40–47. doi:10.1177/10598405050210010901.

    Article  PubMed  Google Scholar 

  25. Twoy, R., Connolly, P. M., & Novak, J. M. (2007). Coping strategies used by parents of children with autism. Journal of the American Academy of Nurse Practitioners, 19(5), 251–260. doi:10.1111/j.1745-7599.2007.00222.x.

    Article  PubMed  Google Scholar 

  26. Sullivan, A. (2002). Gender differences in coping strategies of parents of children with Down syndrome. Down’s Syndrome, Research and Practice, 8(2), 67–73. doi:10.3104/reports.132.

    Article  PubMed  Google Scholar 

  27. Martin, S. C., Wolters, P. L., Klaas, P. A., Perez, L., & Wood, L. V. (2004). Coping styles among families of children with HIV infection. AIDS Care, 16(3), 283–292. doi:10.1080/09540120410001665295.

    Article  CAS  PubMed  Google Scholar 

  28. Cleve, L. V. (1989). Parental coping in response to their child’s spina bifida. Journal of Pediatric Nursing, 4(3), 172–176.

    CAS  PubMed  Google Scholar 

  29. Montagnino, B. A., & Mauricio, R. V. (2004). The child with a tracheostomy and gastrostomy: Parental stress and coping in the home—a pilot study. Pediatr Nurs, 30(5), 373–380, 401.

    PubMed  Google Scholar 

  30. McPherson, M., Arango, P., Fox, H., Lauver, C., McManus, M., Newacheck, P. W., et al. (1998). A new definition of children with special health care needs. Pediatrics, 102(1 Pt 1), 137–140. doi:10.1542/peds.102.1.137.

    Article  CAS  PubMed  Google Scholar 

  31. Stein, R. E., & Jessop, D. J. (1989). What diagnosis does not tell: The case for a noncategorical approach to chronic illness in childhood. Social Science and Medicine, 29(6), 769–778. doi:10.1016/0277-9536(89)90157-3.

    Article  CAS  PubMed  Google Scholar 

  32. Stein, R. E., & Jessop, D. J. (2003). The impact on family scale revisited: Further psychometric data. Journal of Developmental and Behavioral Pediatrics, 24(1), 9–16.

    PubMed  Google Scholar 

  33. Child and Adolescent Health Measurement Initiative. (2003). National Survey of Children’s Health, Data Resource Center on Child and Adolescent Health website. Data Resource Center on Child and Adolescent Health website; 2005 [cited 2006 September 6]; Available from: www.nschdata.org.

  34. Child and Adolescent Health Measurement Initiative. (2000–2001). National Survey of Children with Special Health Care Needs, Data Resource Center on Child and Adolescent Health website. Data Resource Center on Child and Adolescent Health website; 2005 [cited 2006 September 6]; Available from: http://cshcndata.org/ViewDocument.aspx?item=67.

  35. McCubbin, H., & Thompson, A. (1991). Family assessment inventories for research and practice. Madison, WI: University of Wisconsin System.

    Google Scholar 

  36. Stanford Patient Education Research Center. Center for Epidemiological Studies Short Depression Scale (CES-D 10). Palo Alto, CA [cited Accessed 2004]; Available from: http://patienteducation.stanford.edu/research/cesd10.html.

  37. Radloff, L. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. doi:10.1177/014662167700100306.

    Article  Google Scholar 

  38. Zauszniewski, J. A., Morris, D. L., Preechawong, S., & Chang, H. J. (2004). Reports on depressive symptoms in older adults with chronic conditions. Research and Theory for Nursing Practice, 18(2–3), 185–196. doi:10.1891/rtnp.18.2.185.61280.

    Article  PubMed  Google Scholar 

  39. Zich, J. M., Attkisson, C. C., & Greenfield, T. K. (1990). Screening for depression in primary care clinics: The CES-D and the BDI. International Journal of Psychiatry in Medicine, 20(3), 259–277.

    CAS  PubMed  Google Scholar 

  40. Hybels, C. F., Blazer, D. G., & Pieper, C. F. (2001). Toward a threshold for subthreshold depression: An analysis of correlates of depression by severity of symptoms using data from an elderly community sample. The Gerontologist, 41(3), 357–365.

    CAS  PubMed  Google Scholar 

  41. Stata Corp. (2004). Stata Statistical Software. Release 8.2 ed. College Station, TX: StataCorp LP.

  42. Centers for Disease Control. (1991). Followup to the 1988 National Maternal and Infant Health Survey Public-use Data Files. [cited 2006 April]; Available from: http://www.cdc.gov/nchs/products/elec_prods/subject/lfnmihs.htm.

  43. Lanzi, R. G., Pascoe, J. M., Keltner, B., & Ramey, S. L. (1999). Correlates of maternal depressive symptoms in a national Head Start program sample. Archives of Pediatrics and Adolescent Medicine, 153(8), 801–807.

    CAS  PubMed  Google Scholar 

  44. McCubbin, H. I., Thompson, E. A., Thompson, A. I., McCubbin, M. A., & Kaston, A. J. (1993). Culture, ethnicity, and the family: Critical factors in childhood chronic illnesses and disabilities. Pediatrics, 91(5 Pt 2), 1063–1070.

    CAS  PubMed  Google Scholar 

  45. Patterson, J. M., & Blum, R. W. (1993). A conference on culture and chronic illness in childhood: Conference summary. Pediatrics, 91(5 Pt 2), 1025–1030.

    CAS  PubMed  Google Scholar 

  46. Kuhlthau, K. A., & Perrin, J. M. (2001). Child health status and parental employment. Archives of Pediatrics and Adolescent Medicine, 155(12), 1346–1350.

    CAS  PubMed  Google Scholar 

  47. Nelson, A. E., Miles, M. S., Reed, S. B., Davis, C. P., & Cooper, H. (1994). Depressive symptomatology in parents of children with chronic oncologic or hematologic disease. Journal of Psychosocial Oncology, 12(4), 61–75. doi:10.1300/J077V12N04_04.

    Article  Google Scholar 

  48. Clements, D. B., Copeland, L. G., & Loftus, M. (1990). Critical times for families with a chronically ill child. Pediatr Nurs, 16(2), 157–161, 224.

    CAS  PubMed  Google Scholar 

  49. Heneghan, A. M., Mercer, M., & DeLeone, N. L. (2004). Will mothers discuss parenting stress and depressive symptoms with their child’s pediatrician? Pediatrics, 113(3 Pt 1), 460–467. doi:10.1542/peds.113.3.460.

    Article  PubMed  Google Scholar 

  50. Heneghan, A. M., Silver, E. J., Bauman, L. J., & Stein, R. E. (2000). Do pediatricians recognize mothers with depressive symptoms? Pediatrics, 106(6), 1367–1373. doi:10.1542/peds.106.6.1367.

    Article  CAS  PubMed  Google Scholar 

  51. Olson, A. L., Dietrich, A. J., Prazar, G., Hurley, J., Tuddenham, A., Hedberg, V., et al. (2005). Two approaches to maternal depression screening during well child visits. Journal of Developmental and Behavioral Pediatrics, 26(3), 169–176. doi:10.1097/00004703-200506000-00002.

    Article  PubMed  Google Scholar 

  52. Nolan, K. J., Camfield, C. S., & Camfield, P. R. (2006). Coping with Dravet syndrome: Parental experiences with a catastrophic epilepsy. Developmental Medicine and Child Neurology, 48(9), 761–765. doi:10.1017/S0012162206001629.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors would like to thank the parents who participated in the Building of Family Strengths project. Ms. Megan Sety coordinated recruitment and data collection. Funding was provided through Agency for Health Care Research and Quality, R01 HS13384, PI: Gail M. Kieckhefer.

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Authors and Affiliations

  1. Center for Children with Special Needs, Seattle Children’s Hospital and Research Institute, 1100 Olive Way, Suite 500, MPW 8-3, Seattle, WA, 98101, USA

    Shervin S. Churchill, Nanci L. Villareale, Teresa A. Monaghan & Virginia L. Sharp

  2. Achievement Rewards for College Scientists Foundation, University of Washington School of Nursing, Seattle, WA, USA

    Shervin S. Churchill

  3. Department of Family and Child Nursing, University of Washington, Seattle, WA, USA

    Gail M. Kieckhefer

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  1. Shervin S. Churchill
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  2. Nanci L. Villareale
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Correspondence to Shervin S. Churchill.

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Churchill, S.S., Villareale, N.L., Monaghan, T.A. et al. Parents of Children with Special Health Care Needs Who have Better Coping Skills have Fewer Depressive Symptoms. Matern Child Health J 14, 47–57 (2010). https://doi.org/10.1007/s10995-008-0435-0

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