الفهرس 
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Abstract
Summary
Mental retardation is a challenge and potential sources of stress to the family of an individual with this disorder. In Egypt, mentally retarded children account for 0.7%. Down syndrome (DS) is a frequent from of mental retardation with characteristic morphologic features and somatic abnormalities due to chromosomal aberration. It occurs at the rate of one Case/700 live births. The stress for caring for DS child places serious burden on parents/caregivers, with increased risk of psychological problems as depression, anxiety, distress, guilt, poor social, marital adjustment, less satisfaction with life, poor parent child interaction, and hopelessness. The nurse can support interventions that reduce the stigma of disability, and help people re-establish and maintain control over all aspects of their lives.
The aim of this study was to assess the psychological and social stressors of family caregivers for children with DS. The study was carried out in the Institution of Graduate Childhood Studies affiliated to Ain Shams University and the City Center of Mental Handicap affiliated to De La Salle High School in Elzaher region in Cairo using a cross-sectional analytic design. It included 70 parents providing care for their DS children. The data collection tools involved an interviewing questionnaire schedule that included child and parents’ socio demographic data, child health condition, degree of dependence, in addition to scales for psychosocial stressors of the parents, and for parenting styles. Data collection was carried out in the period from December 2010 to May 2011.
The study revealed the following findings:
Children age ranged between 3-12 years, with 57.7% males, and 20.0% with IQ below 70; the majority attended nursery (84.3%) and school (81.4%), and 12.9% had other chronic disorders.
Mothers constituted 85.7% of the caregivers, and 48.6% of them and 58.6% of the fathers had university education; 84.3% of the families had sufficient monthly income.
Overall 42.9% of the children had total dependence in their daily life activities.
The most frequent social stressors among parents were related to the time spent in helping child (60.0%), and having no time for rest (45.7%), whereas the most. reported psychological stressors were those of feeling continuously anxious (82.9%), satisfaction with disabled child (67.1%), and feel anxious about school entry (44.3%)
Overall, 65.7% of the parents had social stressors and 18.6% had psychological stressors.
The parenting style predominantly used by parents was the flexible style (82.9%), while none of them predominantly sued the strict style.
Parents social stressors were significantly higher with child age six or older (65.2%), and with a history of previous hospitalization (41.3%).
Psychological stressors significantly higher with child age six or older (84.6%), not attending nursery (38.5%), with introvert relation with siblings (38.5%), and fathers with no university education (69.2%).
Parents’ predominant parenting style had a statistically significant association with child age (p=0.004).
Statistically significantly higher scores of laissez faire and strict styles were revealed among parents with high social, psychological, and total stressors.
Statistically significant weak to moderate positive correlations between stressors scores and the laissez faire and strict parenting styles, the strongest being between social stressors and strict parenting style (r=0.579).
The scores of dependence in daily life activities had statistically significant negative correlations with the social stressors (r=-0.441), and the laissez faire and strict parenting styles, r=-0.294 and r=-0.296, respectively.
The study concludes that the family caregivers of DS children have more social than psychological stressors. The flexible parenting style is the most predominantly used by them. Parents using laissez faire and strict styles seem to have significantly higher stressors. Hence, the caregivers of DS children need support to relieve these stressors.
Therefore, it is recommended to provide make counseling services available to DS family caregivers along with training provided by multidisciplinary teams. Training programs in parenting styles suitable for DS children are needed. Parents should be encouraged to enroll their DS children in nurseries and schools. Services for the care of DS children must be established in the primary health care centers. Further research is needed to assess the impact of training programs in parenting styles specific for DS children on caregivers’ stressors.